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    Computed tomography findings of massive air embolism caused by cavitary lesion
    (Galenos Publishing House, 2023) Özer, Hamza; Genez, Samet
    A 23-year-old male patient had tetraplegia owing to a spinal cord injury after a traffic accident. In the intensive care unit, a tracheostomy was performed on the patient, who developed massive hemoptysis during follow-up. The patient was taken for urgent bronchoscopic evaluation by the thoracic surgeon, but no intervention could be carried out due to massive bleeding. A computed tomography angiography (CTA) was performed to determine the etiology of the bleeding. The chest CTA revealed that the heart’s four chambers and the arterial and venous vascular systems, including the portal venous system, were completely filled with air (Figures 1a, 1b, and 1c). Additionally, cavitary lesions, consolidation areas, and treein-bud appearance were observed in both lung parenchymas, and pneumothorax was detected on the right side.
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    Sarcopenia detected in aged patients in intensive care units is associated with poor prognosis
    (Asia Pacific League Clinical Gerontology & Geriatrics, 2024) Akan, Belgin; Gökçınar, Derya; Damgacı, Lale; Çakır, Esra; Özer, Hamza; Turan, Işıl Özkoçak
    Background/Purpose: Sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass. The aim of this study was to evaluate effects of sarcopenia on the prognosis of the critical aged patients admitted to intensive care unit (ICU). Methods: The study was planned as a retrospective and observational study and performed after the approval from the ethics committee (approval number is E. Kurul-E-18-1928). Patients older than 40 years of age having abdominal tomography and admitted to the ICU were included. All patients were divided into two groups as sarcopenic and non-sarcopenic by muscle mass measuring by abdominal tomography. We compared the prognosis and clinical features of the patients with and without sarcopenia. Results: A total of 105 patients were included in the study. Fifty five (59%) of the patients were found as sarcopenic and 70.8% over 70 years of age. The length of stay in ICU and in hospital were 27.8 +/- 29.7 and 33.0 +/- 31.2 days in sarcopenic patients, 15.1 +/- 17 and 23.8 +/- 21.3 days in nonsarcopenic patients respectively ( p <0.05). Thirty day mortality was found 49.1% in sarcopenic patients ( p <0.05). Conclusion: The presence of sarcopenia in critically aged patients is important because it is associated with increased 30 -day mortality, prolonged ICU and hospital stay. ISSN 2663-8851/Copyright (c) 2024, Asian Association for Frailty and Sarcopenia and Taiwan Association for Integrated Care. Published by Full Universe Integrated Marketing Limited.
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    Ultrasonography causes agitation and pain leading to hemodynamic disturbance in neonates: A prospective observational study
    (MDPI, 2023) Dinçer, Emre; Özer, Hamza; Topçuoğlu, Sevilay; Karatekin, Güner
    Background: Ultrasonography is widely used in neonatological practice and studies investigating the hemodynamic effects of various treatment protocols or clinical situations. On the other hand, pain causes changes in the cardiovascular system; so, in the case of ultrasonography leading to pain in neonates, it may cause hemodynamic alterations. In this prospective study, we evaluate whether ultrasonographic application causes pain and changes in the hemodynamic system. Methods: Newborns undergoing ultrasonographic examination were enrolled in the study. Vital signs, cerebral and mesenteric tissue oxygenation (StO(2)) levels, and middle cerebral artery (MCA) Doppler measurements were recorded, and NPASS scores were calculated before and after ultrasonography. Results: We enrolled 39 patients in the study. After ultrasonography, Neonatal Pain, Agitation, and Sedation Scale (NPASS) scores were significantly higher (p < 0.01), and all vital signs (heart rate, respiratory rate, SpO(2), diastolic and systolic blood pressure; p = 0.03; p < 0.01, p < 0.01, p < 0.01, p = 0.02, p = 0.03, respectively) were altered. Cerebral (p = 0.008) and mesenteric (p = 0.039) StO(2) levels were significantly lower in the whole study group, MCA end-diastolic velocity decreased (p = 0.02), and the resistive index (p = 0.03) increased in patients whose NPASS score was >7 after ultrasonography. Conclusions: This study is the first to show that ultrasonography may cause pain in newborn patients, and alters vital signs and hemodynamic parameters. Therefore, precautions should be taken to protect newborn babies from pain during ultrasound applications, as they are already exposed to many noxious stimuli. Furthermore, pain scores should be considered in studies using ultrasonography and evaluating hemodynamic parameters to increase the reliability of the studies.