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  • Küçük Resim
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    Evaluation of pain after uterine artery embolization
    (2005) Zeteroğlu, Şahin; Üstün, Yusuf; Engin Üstün, Yaprak; Şengül, Muzaffer; Harman, Mustafa; Kamacı, Mansur
    Objective: In this study our aim was to determine the severity of post procedure pain associated with uterine artery embolization (UAE). Study Design: Twenty-one women with symptomatic uterine fibroid were recruited for the study. The procedure was performed in the angiography unit under conscious sedation. All patients received prophylactic intravenous antibiotics and analgesic, ibuprofen 600 mg. At the completion of the procedure, all patients were given ibuprofen 600 mg orally every six hours. The patients were discharged with oral ibuprofen (600 mg 4 times daily). The main outcome measure was severity of pain. The instrument for evaluation of pain was visual analog scale. The measurements were taken at every hour. Results: Twenty-one procedures were performed. The mean age was 43.04±4.21 years (range 34-52) and median parity was 4 (0-6). The mean post procedure pain scores after 1, 2 and 3 hours were 3.33±2.00, 4.57±1.74, 4.95±1.71 respectively. After the completion of embolization, it was found that pain appeared to peak in the initial 3-4 post-embolization hours, reached a plateau and then declined by 9 hours. Conclusion: There is an increased need for post procedural pain control for UAE patients, especially in the first 6 hours after the procedure.
  • Küçük Resim
    Öğe
    Fetüsü sezaryenle doğurtulan maternal ölüme neden olan serebral infarkt olgusu
    (2004) Şahin, Güler; Zeteroğlu, Şahin; Kamacı, Mansur; Altınok Yiğit, Filiz; Harman, Mustafa
    21 yaşında, G.2, P.O, A. 1, Y.O ve 35 haftalık gebe olarak şiddetli baş ağrısı ve anlamsız konuşma yakınması ve intrakranial kitle ön tanısı ile Beyin Cerrahi kliniğine yatırılan Bilgisayarlı Beyin Tomografisi (BBT)'nde sol parietalde 3x2cm.lik akut infarkt alanının, ertesi gün yapılan Magnetik Rezonans Görüntüleme (MRG)'sinde ise sol parietotemporooksipital lopta infarkt sabitlendiğinden medikal tedavi için Nöroloji kliniğine taburcu edildiği ve obstetrik muayene ve ultrasongrafısinde 35 haftalık ınakad prezentasyonlu canlı gebeliği saptanan olgunun, izlemi sırasında pulmoner arrest olması üzerine mekanik ventilasyon için Yoğun bakım ünitesine yatırıldı. Obstetrik rekonsültasyon sonrası sezaryen yapılarak makadi prezentasyonlu 1640 gram ağırlıklı I -5.dakika Apgar skoru 7-9 olan canlı erkek çocuk duğurtuldu. Postoperatuvar 2. gün kardiyak arrest gelişen olgu resusitasyon girişimlerine rağmen exitus önlenemedi. MRI, serebral infarkt tanısında ilk tercih edilen görüntüleme yöntemi olmalı ayrıca anjiyografı yardımıyla trombolitik tedavi seçeneğinin de bundan sonraki akut serebral infarktlı olguların medikal tedavisinde yer alması düşünülmektedir.
  • [ N/A ]
    Öğe
    Uterine Artery Catheterisation and Selective Leiomyoma Embolization: Patient Acceptance and Clinical Outcome
    (Galenos Yayincilik, 2007) Zeteroglu, Sahin; Caliskan, Eray; Harman, Mustafa; Sengul, Muzaffer; Coskun, Ebru; Tiras, Bulent; Kamaci, Mansur
    Objective: To evaluate the patient acceptance and clinical outcome after selective uterine leiomyoma embolization. Materials and Methods: Twenty-four women with symptomatic uterine fibroid were recruited for this study. Selective uterine leiomyoma embolization proceeded until complete vascular occlusion was achieved. The main outcome measure was the decrease in the leiomyoma volume and factors that predict it. Pearson correlation analysis and linear regression analysis were performed to identify possible correlates and predictors of decrease in leiomyoma volume. Patient satisfaction was assessed by asking the subjects to indicate their degree of satisfaction on a five-point scale. Results: The mean age of the patients was 41.5 +/- 4.9 (Range: 28-52). The mean leiomyoma volume before the procedure was 157 +/- 214 cm(3) which was calculated to be 44 +/- 66 cm3 with a 76 +/- 17% (Range: 30-99%) decrease in the mean leiomyoma volume at the end of one year. Correlation analysis revealed that only preoperative estradiol level was positively correlated with the extent of decrease in the leiomyoma volume (r=0.54, p=0.005). This was also proved in the regression analysis (beta=0.25, p=0.01). During the follow-up 17 (70.8%) patients had complete remission of the symptoms, 5 (20.8%) had partial remission and 2 (8.3%) had no clinically significant change. Twenty patients (83.3%) were completely satisfied, 2 were satisfied and 2 were dissatisfied with the leiomyoma embolization procedure. Discussion: There is a positive correlation between the preoperative estradiol level and the extent of the decrease in the leiomyoma volume after the embolization procedure. As leiomyoma is a hormone dependent tumor, the shrinkage of the leiomyoma seems also dependent on the estradiol levels before the precedure besides the incurred ischemic necrosis secondary to arterial embolization.
  • Küçük Resim
    Öğe
    Uterine artery catheterization and selective embolization for leiomyoma : Patient acceptance and clinical outcome
    (2007) Zeteroğlu, Şahin; Çalışkan, Eray; Harman, Mustafa; Şengül, Muzaffer; Coşkun, Ebru; Tıraş, Bülent; Kamacı, Mansur
    OBJECTIVE: To evaluate the patient acceptance and clinical outcome after selective uterine leiomyoma embolisation. MATERIAL-METHODS: Twenty-four women with symptomatic uterine fibroid were recruited for this study. Selective uterine leiomyoma embolisation proceeded until complete vascular occlusion was achieved. The main outcome measure was decrease in the leiomyoma volume and factors that predict it. Pearson correlation analysis and lineer regression analysis were performed to identify possible correlates and predictors of decrease in leiomyoma volume. Patient satisfaction was assessed by asking the subjects to indicate their degree of satisfaction on a five-point scale. RESULTS: The mean age of the patients was 41.5±4.9 (Range: 28-52). The mean leiomyoma volume before the procedure was 157 ± 214 cm3 which was calculated to be 44 ± 66cm3 with a 76 ± 17 % (Range= 30-99%) decrease in the mean leiomyoma volume at the end of one year. Correlation analysis revealed that only preoperative estradiol level was positively correlated to the extent of decrease in the leiomyoma volume (r=0.54, p=0.005). This was also proved in the regression analysis (beta=0.25, p=0.01). During the follow-up 17 (70.8%) patients had complete remission of the symptoms, five (20.8%) had partial remission and two (8.3%) had no clinically significant change. Twenty patients (83.3%) were completely satisfied, two were satisfied and two were dissatisfied with the leiomyoma embolisation procedure. CONCLUSION: There is a positive correlation between the preoperative estradiol level and the extent of the decrease in the leiomyoma volume after the embolisation procedure. As leiomyoma is a hormone dependent tumor, the shrinkage of the leiomyoma seems also dependent on the estradiol levels before the precedure besides the ischemic necrosis caused secondary to arterial embolisation.