Biomedical subjects

Selim Kiliç

Publications and source records attributed to Selim Kiliç.

9 recordsLinked to original sources

PubMed2006

Does combination of antegrade and retrograde cardioplegia reduce coronary artery bypass grafting-related conduction defects?

BACKGROUND: Conduction disorders appearing after coronary artery bypass surgery (CABG) may have many different causes. In this study, we evaluated the postoperative conduction disorders after CABG with respect to the ante-grade blood cardioplegia and ante-grade plus continuous retrograde cardioplegia delivery methods. MATERIALS AND METHODS: This retrospective study included 1824 patients undergoing CABG between January 2001 and December 2005. There were 694 female patients (38%) and 1130 male patients (62%). Myocardial protection was done by isothermic hyperkalemic blood cardioplegia. Patents in Group 1 (n = 704) were operated on using only intermittent antegrade cardioplegia and those in group 2 (n = 1120) were operated on using the antegrade plus retrograde continuous cardioplegia. The postoperative occurrences of a new right bundle branch block, left anterior hemiblock, left posterior hemiblock, left bundle branch block, or third-degree atrioventricular block were evaluated and compared. RESULTS: Total mortality rate was 1.6% (29 patients) without significant difference between the groups. The preoperative and perioperative characteristics were statistically similar in the groups. The occurrence of conduction disorders was significantly higher in group 1 (P = .006, 55 versus 52 patients). The analysis of the patients with conduction disorders showed a significantly increased mortality rate (P < .001) in addition to a significantly increased period of intensive care unit follow-up and duration of postoperative hospitalization (P <.001). CONCLUSION: The present study demonstrated that the perioperative occurrence of conduction disorders after CABG was decreased by antegrade controlled and retrograde continuous combination cardioplegia.

Causality↗

PubMed2005

Direct versus guidewire-assisted pediatric radial artery cannulation technique.

OBJECTIVE: Radial artery cannulation is a more difficult procedure in pediatric patients. Direct technique commonly fails in these patients, and several techniques have been developed for successful arterial cannulation. The purpose of this study was to compare direct radial artery cannulation with guidewire-assisted cannulation in children undergoing cardiac or aortic surgery. The hypothesis was that the guidewire-assisted technique would lead to fewer attempts and provide better long-term blood pressure monitoring and blood sampling. MATERIALS AND METHODS: One hundred pediatric patients with congenital heart defects undergoing major cardiovascular surgery, who required a radial artery catheter, were included in the study. Patients were divided into 2 groups: group 1 included 50 patients who had radial artery cannulation with the direct technique, and group 2 included 50 patients who had a guidewire-assisted radial artery cannulation. RESULTS: A radial artery was successfully cannulated in 48 patients in group 2 but only 38 patients in group 1. Mean elapsed time for radial artery cannulation was 22 +/- 4.6 minutes in group 1 and 7 +/- 4.2 minutes in group 2 (p = 0.001). The average number of attempts for cannulation was 4.5 in group 1 and 2.1 in group 2 (p = 0.022). The opposite radial or an alternative artery was used more commonly in the direct technique group. Satisfactory blood pressure monitoring and sampling of blood were obtained in 28 patients in group 1 and 46 patients in group 2 (p < 0.001). CONCLUSION: The authors recommend the use of a guidewire-assisted radial artery cannulation technique rather than a direct technique. The guidewire-assisted technique provided easy, safe, and quick cannulation and allowed for long-term satisfactory blood pressure monitoring and blood sampling because of the longer length of the Teflon catheter advanced into the artery over the guidewire, and a low rate of dissection of the radial artery.

Blood Pressure↗

PubMed2005

Association between cigarette smoking and depressive symptoms among military medical students in Turkey.

An association has been documented between two important health concerns, smoking and depression. A cross-sectional study was carried out to explore whether this relationship exists in a sample of Turkish military medical undergraduates. Of a total of 779 military medical undergraduates, 690 agreed to participate in the study. The students completed a self-administered questionnaire including the Turkish adaptation of the Beck Depression Inventory (BDI) and gave a smoking history. It was determined that the smokers among medical students were 2.2 times more likely to have depressive symptoms than nonsmokers. This result extends the significant association between smoking and depressive symptoms in the literature to a sample of Turkish military medical undergraduates.

Adolescent↗

PubMed2005

Morbidity and mortality characteristics of infants hospitalized in the Pediatrics Department of the largest Turkish military hospital in 2001.

A descriptive study was conducted in the pediatric inpatient unit of Gulhane Military Medical Academy, to investigate the morbidity and mortality characteristics of 532 infants hospitalized between January 1 and December 31, 2001, for treatment purposes. Of the study participants, 55.8% were boys and 44.2% were girls. The most common cause of hospitalization was neonatal hyperbilirubinemia (19.7%). The most common admission month was January (12.4%). Of 532 infants, 510 (95.9%) were discharged, whereas 22 patients died in the hospital. Twenty-one patients died in the neonatal period, and respiratory distress syndrome and neonatal sepsis were identified as the most common causes of death. Our finding of associations between male gender and low birth weight and hospital death is consistent with previous knowledge. Despite the high frequencies of pneumonia and gastroenteritis as admission diagnoses, the finding of only one pneumonia-related death and no gastroenteritis-related deaths in the study population is pleasing.

Cause of Death↗

PubMed2004

Supraventricular tachyarrythmia prophylaxis after coronary artery surgery in chronic obstructive pulmonary disease patients (early amiodarone prophylaxis trial).

OBJECTIVES: Supraventricular tachyarrhythmias (SVT) is common after coronary artery bypass grafting in chronic obstructive pulmonary disease (COPD). Preoperative FEV(1) is the major predetermining factor of mortality, morbidity and SVT. METHODS: Patients were divided into two groups according to their preoperative FEV(1) values. FEV(1) is <75% of predicted value in group 1 (no. 200), and >/=75% of predicted value in group 2 (no. 100). Group 1 is divided into two subgroups. SVT prophylaxis was not done in A subgroup (no. 100) whereas arrhythmia prophylaxis was done with amiodarone in all B subgroups (no. 100) in the early postoperative period. RESULTS: Atrial fibrillation developed in 28 patients in group 1A, whereas it developed in 12 in group 1B (P=0.005). Atrial flutter developed in 10 patients in group 1A but in 3 patients in group 1B (P=0.045). Multifocal atrial tachycardia developed in 13 patients in group 1A and in 4 in group 1B (P=0.022). Multivariate analysis identified ejection fraction (P<0.002, odds ratio (OR) 0.93), inotropy requirement (P<0.001, OR 3.98) amiodarone (P<0.001, OR 0.18), and FEV(1)<75% of predicted value (P<0.048, OR 1.84) as predictor of SVT. There were statistically significant differences between A and B subgroups of group 1 for hospital (P<0.001) and intensive care unit (ICU) stay (P<0.001). There was also statistically significant difference between groups 1A and 2 comparison for ICU (P<0.001; 6.4+/-3.4 versus 1.4+/-0.6 days) and hospital stay (P<0.001; 17.6+/-8.2 versus 6.9+/-0.6 days). CONCLUSIONS: Early prophylactic amiodarone not only significantly reduces SVT but also reduces SVT-related hospital and ICU stay. We strongly recommend prophylactic early use of amiodarone in COPD patients.

Aged↗

PubMed2004

Evaluation of the dental health of the young adult male population in Turkey.

This study aimed to determine the prevalence of dental caries in military recruits and to assess the relation of dental caries with socioeconomic and demographic factors, and sugar consumption behavior, and to generalize the findings for the young adult male population to draw a picture of dental health status of this population segment in Turkey. In this cross-sectional study conducted between August and October 2000 in a military basic training center in Turkey, 2,766 male recruits of the age of 20 were examined by dental specialists to determine their mean number of decayed, missing, or filled teeth (DMFT) scores and were administered a questionnaire for capturing their demographic characteristics and sugar consumption behavior. The mean DMFT score for the 20-year-old male population in Turkey was found to be 5.97. DMFT scores were weakly correlated with income level and urbanization. Sugar consumption was strongly correlated with DMFT scores. The mean number of teeth with fillings component was strongly correlated with income level, moderately with the subject's education, and weakly with the mother's education, father's education, and urbanization. DMFT scores for the young adult male population in Turkey were strongly associated with sugar consumption behavior, whereas they were weakly or not at all associated with demographic factors such as education level, income level, and urbanization.

Adult↗

PubMed2003

Symptomatic intestinal amoebiasis and climatic parameters.

Symptomatic intestinal amoebiasis is an important problem, especially in the developing world. The relationships between climatic parameters and amoebic dysentery cases were evaluated in this study. Climatic data were obtained from the local meteorological department and the diagnosis of amoebic dysentery was established by clinical and laboratory investigation. Monthly mean temperature (r = 0.755, p = 0.005), monthly mean maximum temperature (r = 0.711, p = 0.01), monthly mean temperature at 100 cm underground (r = 0.818, p = 0.001) and monthly mean humidity values (r = -0.656, p = 0.02) correlated significantly with symptomatic disease. Although inverse relationships were found for humidity and atmospheric pressure, the monthly mean atmospheric pressure (r = -0.084) did not seem to have a significant effect on intestinal amoebiasis (p = 0.80). Thus, when the weather warmed up, the frequency of symptomatic intestinal amoebiasis increased significantly. To improve the ability to predict disease trends, it seems logical to assess the independent and interactive effects of climatic parameters on disease impact.

Animals↗

PubMed2002

Determination of the reasons for unfitness for military service in Turkey.

This study aims to evaluate the frequencies and diagnosis types of cases in which young adult males were classified as unfit for military service before or during military service. This cross-sectional study was conducted between November 1998 and October 1999 by investigating the military medical board records of 21,985 "unfit" cases. Unfit for military service decisions were based on any of 436 different diagnoses. Twenty-three diagnosis types, each with a frequency of greater than 1.0%, collectively accounted for the majority of cases (59.2%). Initial medical examinations before service detected 64.0% of cases, whereas the remaining 36.0% were detected during service. Initial medical examinations can be a remarkable data source to determine the health profile of a young adult male population. High rates of failure in initial medical examinations call for improvements to initial medical examination procedures, which should eventually lead to cost savings for the military.

Adult↗

PubMedDate not supplied

Both leaflet preservation during mitral valve replacement: modified anterior leaflet preservation technique.

BACKGROUND: Satisfactory results of bileaflet preserving mitral valve replacement (MVR) had forced several institutes to preserve both leaflets during MVR. Modifications were required to prevent the preserved tissue from interfering with prosthetic valve function, to implant an adequate size of valve and to prevent left ventricle outflow tract (LVOT) obstruction. MATERIALS AND METHODS: Conventional MVR was performed to 51 patients (group 1) and bileaflet preserving MVR was performed to 43 patients (group 2). Mitral anterior leaflet incised from the middle of the leaflet to mitral annulus without chordal injury in group 2 patients. Sutures were placed through the mitral annulus first and then passed from the bottom to the tip of anterior leaflet. Posterior leaflet was also preserved. Prosthetic valve was put down into the mitral annulus and sutures were ligated. Excessive anterior leaflet tissue was attached to left atrial wall. RESULTS: Cross-clamping time was 45 +/- 5.33 minutes versus 61.32 +/- 4.43 minutes (p = 0.0001) and total cardiopulmonary bypass time was 60.80 +/- 4.44 minutes versus 80.55 +/- 3.65 minutes (p = 0.0001) in groups 1 and 2, respectively. Inotropy requirement was higher in group 1 (p = 0.0058). When compared with preoperative values postoperative left ventricle ejection fraction (LVEF) increased both at rest (from 52.74% +/- 3.88% to 62.86% +/- 3.18%, p = 0.0001) and during exercise (from 53.16% +/- 3.16% to 64.11% +/- 2.46%, p = 0.0001) in bileaflet preserving MVR group. But in conventional MVR group LVEF decreased postoperatively both at rest (from 51.45% +/- 4.27% to 48.27% +/- 3.35%, p = 0.0001) and during exercise (from 54.47% +/- 7.36% to 42.96% +/- 3.58%, p = 0.0001). CONCLUSION: Leaflet preserving MVR operation not only improves the left ventricular performance but also reduces the mortality and morbidity after MVR. LVEF increases both at rest and during exercise. Risk of LVOT obstruction can be completely eliminated with our simple technique.

Adult↗