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    Popliteal artery and vein occlusion following cerclage wiring of the distal femur: a case report
    (EDIZIONI MINERVA MEDICA, 2008) Narin, C.; Ege, E.; Onoglu, R.; Yeniterzi, M.
    Vascular complications in orthopedic surgery are not frequent, but they can be severe and occasionally limb-threatening. While spontaneous complications are not directly dependent on the surgical procedure, iatrogenic complications are those actively caused by surgical maneuvers or by instrumentation. Although vascular injury during placement of a cerclage wire is feared by all surgeons, its occurrence is rare and we have been able to find only one reported case describing an injury to the femoral artery and vein. This case report describes the surgical management of occlusions of the popliteal artery and vein following a cerclage wiring procedure of the distal femur during a total knee replacement procedure. Surgical treatment was accomplished by resection of the entrapped artery and vein segments and reattachment with end to end anastomosis. The orthopedic surgeon must be aware of prevalent risk of vascular injury during knee surgery and be diligent and methodological about performing preoperative and postoperative vascular examination in these patients.
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    Pre-operative Atorvastatin Therapy to Decrease the Systemic Inflammatory Response after Coronary Artery Bypass Grafting
    (SAGE PUBLICATIONS LTD, 2008) Dereli, Y.; Ege, E.; Kurban, S.; Narin, C.; Sarigul, A.; Yeniterzi, M.
    The effect of pre-operative atorvastatin on systemic inflammatory response syndrome (SIRS), often seen after coronary artery bypass grafting (CABG) was evaluated in 40 patients undergoing elective CABG. Patients were divided into two groups: group I (pre-operative LDL cholesterol 100 mg/dl; n = 20) received 20 mg/day atorvastatin for at least 15 days pre-operatively; group II (pre-operative LDL cholesterol < 100 mg/dl; n = 20) did not receive antihyperlipidaemic agents. All patients underwent CABG with cardiopulmonary bypass. Blood samples were taken pre-operatively and 24 h post-operatively. There were no significant differences between the two groups in terms of demographic, pre-operative or operative parameters. At 24 h post-operatively, median high-sensitivity C-reactive protein and mean interleukin-6 levels were significantly lower in group I compared with group II. There were no other significant differences in postoperative parameters between the two groups, except for duration of stay in the intensive care unit, which was shorter in group I patients. In conclusion, pre-operative atorvastatin treatment in patients undergoing elective CABG decreased inflammation parameters and could be effective in preventing SIRS.
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    A useful new coma scale in acute stroke patients: FOUR score
    (AUSTRALIAN SOC ANAESTHETISTS, 2012) Kocak, Y.; Ozturk, S.; Ege, E.; Ekmekci, A. H.
    Assessment of the severity of unconsciousness in patients with impaired consciousness, prediction of mortality and prognosis are currently the most studied subjects in intensive care. The aim of this study was to investigate the usefulness of the Full Outline of UnResponsiveness (FOUR) score in intensive care unit patients with stroke and the associations of FOUR score with the clinical outcome and with other coma scales (Glasgow [GCS] and Acute Physiology and Chronic Health Evaluation 11). One hundred acute stroke patients (44 male, 56 female), who were followed in a neurology intensive care unit, were included in this prospective study. The mean age of the patients was 70.49 +/- 12.42 years. Lesion types were determined as haemorrhagic in 30 and ischaemic in 70 patients. FOUR scores on the day of admission and the first, third and 10th days of patients who died within 15 days were lower when compared to scores of patients who survived (P=0.005, P=0.000, P=0.000 and P=0.000 respectively). Receiver operating characteristic curve analysis showed significant trending with both FOUR score and GCS for prognosis; the area under curve ranged from 0.675 (95% confidence interval 0.565 to 0.786) when measurements had been made on day 3 to 0.922 (95% confidence interval 0.867 to 0.977) and 0.981 (95% confidence interval 0.947 to 1.015) for day 10. We suggest that FOUR score is a useful scale for evaluation of acute stroke patients in the intensive care unit as a homogeneous group, with respect to the outcome estimation.