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Öğe Fatal interstitial pneumonia as an advers reaction in patient with rheumatoid arthritis : A case report(2008) Kaya, Sedat; Turhanoğlu, Selim; Turhanoğlu, Ayşe DicleAcute interstitial pneumonia developed three weeks after the administration of leflunomide(LEF) in a 53-year-old woman with rheumatoid arthritis. She developed nausea and diarrhea as well as dyspnea before coming to the hospital and LEF treatment was stopped. She suddenly experienced severe dyspnea and her chest x-ray showed reticular shadows in her lower lung fields which had not been detected before. Partial oxygen pressure of her arterial blood fell all of a sudden, which necessitated an emergency admission to the intensive care unit. After endotracheal intubation, mechanical ventilation support was started due to acute respiratory failure. The patient died of respiratory failure 7 days after the onset of acute interstitial pneumoniaÖğe Fatal interstitial pneumonia as an advers reaction in patient with rheumatoid arthritis: a case report(Turkish League Against Rheumatism-T L A R, 2008) Kaya, Sedat; Turhanoglu, Selim; Turhanoglu, Ayse DicleAcute interstitial pneumonia developed three weeks after the administration of leflunomide(LEF) in a 53-year-old woman with rheumatoid arthritis. She developed nausea and diarrhea as well as dyspnea before coming to the hospital and LEF treatment was stopped. She suddenly experienced severe dyspnea and her chest x-ray showed reticular shadows in her lower lung fields which had not been detected before. Partial oxygen pressure of her arterial blood fell all of a sudden, which necessitated an emergency admission to the intensive care unit. After endotracheal intubation, mechanical ventilation support was started due to acute respiratory failure. The patient died of respiratory failure 7 days after the onset of acute interstitial pneumonia.Öğe Is there an advantage in using low-dose intrathecal bupivacaine for cesarean section?(Springer Tokyo, 2009) Turhanoglu, Selim; Kaya, Sedat; Erdogan, HulyaSpinal anesthesia for cesarean section is associated with a high incidence of maternal hypotension. The aim of this study was to assess the efficacy of low-dose bupivacaine with fentanyl to reduce the incidence of hypotension in spinal anesthesia for cesarean section. Forty pregnant women undergoing elective cesarean section were randomly allocated to two groups; those receiving 10 mg bupivacaine to group B (n = 20) and those receiving 4 mg bupivacaine plus 25 mu g fentanyl to group BF (n = 20); the agents were given intrathecally with patients in the sitting position, with a combined spinal-epidural technique. Sensory block was adequate for surgery in all patients. Hypotension occurred in all patients in group B (100%) and in 15 patients in group BF (75%). The incidence of hypotension, number of ephedrine treatments, and need for ephedrine were significantly greater in group B than group BF. Three patients in group BF required i.v. fentanyl supplementation after delivery. In 1 of these patients, i.v. fentanyl was not adequate, and epidural supplementation of 1% lidocaine was required. The development of hypotension after spinal block in subjects undergoing cesarean section was not prevented despite low-dose (4 mg) bupivacaine plus 25 mu g fentanyl, but the severity of maternal hypotension, and the number of ephedrine treatments and the total dose of ephedrine were decreased.Öğe Lidocaine for prevention of propofol injection-induced pain(Elsevier Science Inc, 2008) Kaya, Sedat; Turhanoglu, Selim; Karaman, Haktan; Ozgun, Sule; Basak, NihalBACKGROUND: Many patients experience pain on injection of propofol. The use of lidocaine to prevent propofol injection pain is common. The analgesic effect of preinjected lidocaine has been found to increase when a tourniquet is used. OBJECTIVE: The aim of this study was to compare the effectiveness of various venous occlusion times with lidocaine analgesia to prevent pain during propofol injection. METHODS: In this prospective, randomized, double-blind, controlled study, women aged 18 to 45 years,, classified as American Society of Anesthesiologists physical status I or II, who were scheduled to undergo elective surgery under general anesthesia induced with propofol, were randomly assigned to 1 of 5 groups: group 1, 2% lidocaine 20 mg in saline in a total volume of 10 mL and no venous occlusion; group 2, 2% lidocaine 20 mg in saline in a total volume of 10 mL plus venous occlusion for 15 seconds; group 3, 296 lidocaine plus venous occlusion for 30 seconds; group 4, 2% lidocaine plus venous occlusion for 60 seconds; and group 5, saline 10 mL and no venous occlusion. When the first 25% of the calculated propofol dose was administered, patients were asked about propofol-induced pain using a verbal pain scale (0 = no pain; 1 = mild pain; 2 = moderate pain; and 3 = severe pain). All patients and the anesthesiologist who evaluated pain severity were blinded to the study preparation being used. RESULTS: The study comprised 100 women who were randomly divided into 5 groups of 20 patients each. Significantly more patients in group 5 (18 [90%] patients; P < 0.05) reported pain compared with the other treatment groups. In groups 2, 3, and 4, in which venous occlusion was applied, pain was reported during propofol injection in 6 (3096), 7 (35%), and 2 (10%) patients, respectively. The incidence of reported pain was significantly greater in group 1 (lidocaine without venous occlusion) than in group 4 (P < 0.05); however, the incidence of pain was similar in group I compared with groups 2 and 3. CONCLUSIONS: The present study found that pretreatment with lidocaine 20 mg with or without venous occlusion significantly reduced the incidence and the severity of pain during the injection of propofol when compared with the group with no venous occlusion administered saline. In addition, pretreatment with lidocaine 20 mg plus venous occlusion for 60 seconds significantly reduced the incidence of propofol-induced pain compared with lidocaine without venous occlusion.
