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Biomedical subjects

Korhan Taviloğlu

Publications and source records attributed to Korhan Taviloğlu.

6 recordsLinked to original sources

[Prehospital life support in trauma patients: basic or advanced trauma life support].

The controversy between Advanced Trauma Life Support (ATLS) and Basic Life Support (BLS) in the prehospital care of trauma patients has not been resolved yet. The purpose of this study was to examine the literature with respect to the type of prehospital care applied to the trauma patients. A total of 76 papers on ATLS and/or BLS for trauma were reviewed regarding the variables such as intravenous catheter application, prehospital fluid resuscitation, transport time, intubation and mortality. As a conclusion, the data in the literature do not support the routine use of on-field ATLS in trauma patients. Prospective randomized trials comparing ATLS and BLS in prehospital management of trauma patients are needed to clarify this issue.

Advanced Cardiac Life Support↗

[A different approach to trauma scoring].

BACKGROUND: We have compared the Injury Severity Score (ISS) at admission to Emergency Surgery and Trauma Center (ES&TC) with the ISS during autopsy. Cases with ISS less than 14 (defined as preventable deaths) were evaluated and the results were compared with those in other countries. METHODS: The study was performed between January 1, 2000 and December 31, 2002 at Istanbul Medical Faculty TS&ES and the Turkish Council of Forensic Medicine. The 160 autopsies of trauma deaths which could have been performed within this three year period were evaluated. RESULTS: The average age of trauma victims in the study was 32,9+/-15,6 (r=1-79); the majority of victims were males 78,1% (n=125). In four autopsies (3%) ISS were rated as "preventable death" (ISS < or =14). The severely injured (ISS: 16-66) patients with lower survival rates were 96% (n=155). In addition, one case (1%) had an ISS score of 75. In clinical evaluations, ISS scores were found to be between 16-66 (68%), 75 (20%, n=32), and < or =14 (12%; n=19). CONCLUSION: Although it is widely used, difficulties in the applications of ISS still exist. Alcohol, drug, pregnancy and the presence of underlying diseases are the factors contributing to death but not being reflected by ISS. Moreover a difficulty exists in the evaluation of anatomical injuries which are not accompanied by physiological changes. ISS should be improved according to updates. In this way, evaluation of clinics' care quality and standardization of trauma centers can be done more accurately.

Adolescent↗

Intermittent pneumatic compression in the prevention of venous thromboembolism in high-risk trauma and surgical ICU patients.

BACKGROUND: Our aim was to evaluate the efficacy and safety of intermittent pneumatic compression methods (IPC) in the prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE) in high-risk patients followed in our intensive care unit (ICU) for whom anticoagulation is contraindicated due to high risk of bleeding. MATERIALS AND METHODS: This prospective study was conducted between October 2001 and June 2002 at the Trauma and Surgical Emergency Service of Istanbul Medical Faculty. Thirty eight surgical ICU patients who used IPC devices for prophylaxis of venous thromboembolisim were evaluated retrospectively. RESULTS: There were 27 male (71%) and 11 female patients (29%) with a mean age of 49.69 +/- 18.61 years. Their diagnoses were as follows; 21 multi-trauma, 11 major abdominal surgery, 11 severe gastrointestinal bleeding. None of the patients had manifested DVT by venous duplex scans. A leg swelling was present in one patient without evidence of DVT by duplex scans. Symptomatic and fatal pulmonary embolism were not detected. Asymptomatic pulmonary embolism was detected by spiral thorax CT examination in one patient (2.6%). CONCLUSIONS: IPC seems to be an effective and a safe modality in preventing both DVT and PE in high-risk ICU patients with severe trauma and for those undergoing major surgery.

Abdominal Injuries↗

[Approach to the lower gastrointestinal tract bleeding in patients with normal colonoscopic findings.].

BACKGROUND: Lower gastrointestinal bleeding is a commun clinical entity. Although colonoscopic examination is the first choice for diagnosis, it may not be enough to reveal the cause of bleeding in all subjects. METHODS: Eight patients who had massive lower gastrointestinal bleeding having normal colonoscopic findings were retrospectively evaluated at the Department of Trauma and Emergency Surgery, Istanbul University, Faculty of Medicine RESULTS: There were 5 male and 3 female patients with mean age of 51 (28 to 82). Patients received a mean of 13 U (range 2 to 23) with transfused erythrocyte concentrates. Four patients had found to be normal during angiographic, scintigraphy or enterocylytic examinations. Angiography was diagnostic in 4 patients, and identified bleeding from ileocolic pseudoaneurisms (n= 2) branches of jejunal artery (n=2). Embolization procedure were performed in these 4 patients and 3 of them developed intestinal necrosis and underwent surgery. One did not require further treatment. Two of the patients who underwent surgery expired due to sepsis. Patients were hospitalized for a mean of 17 days (range 5 to 37). CONCLUSION: Despite employment of all diagnostic procedures, the cause of bleeding were not detected in half of patients who had normal colonoscopic findings. If angiographic treatment is necessary, superselective arterial embolization should be performed.

Adult↗

[Evaluation of severe burns managed in intensive care unit].

BACKGROUND: This study designed to evaluate the results of the patients with severe burns treated in the intensive care unit. METHODS: Between May 1997 and May 2002, fifty-four patients who had thermal and electrical burns managed at the Intensive Care Unit of General Surgery of Istanbul University Medical Faculty. RESULTS: Forty-five of patients were males and nine were females with mean age of 39 years. The mean hospital stay was 26 days. The mean total body surface area burns was 60%. Pseudomonas aeruginosa was detected in wound cultures at the 68% of patients. 83% of cases died. Mortality was due to sepsis in 66% of patients. CONCLUSION: Besides early debridmant, early enteral feeding, woundcare and intensive care unit support, establishing of specific burncenters may reduce morbidity and mortality rates in severe burns.

Adolescent↗

[Our current approach in the treatment of sigmoid colon volvulus].

BACKGROUND: Our aim was to emphasize the role of endoscopic detorsion in the treatment of sigmoid colon volvulus, which we currently apply in the majority of our cases. METHODS: The data of 37 patients were analyzed in a retrospective manner, during a 86-month period, between May 1994 and July 2001. The patients were classified into three groups. The first group consisted of 9 patients with resection and anastomosis, the second group consisted of 20 patients with Hartmann's procedure, and the third group consisted of 8 patients with endoscopic detorsion. RESULTS: Complications were encountered in 7 patients (19%), and 3 patients (8%) died following treatment. CONCLUSION: We favor colonic resection following endoscopic treatment. Resection should be preferred, if endoscopic detorsion is not successful or in the presence of a complication.

Adult↗