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Evaluation of Operating Room Noise by Different Medical Specialists

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Journal of Environmental Protection 2023年第12期14卷 1016-1024页

作者： Ezgi Erkiliç Yasemin Akçaalan Ayça Dumanli Özcan Yusuf Furkan Güneş Levent Öztürk Tülin Gümüş orhan Kanbak Anesthesiology and Reanimation Department Ataturk City Hospital Ankara T&uumlrkiye

Noise pollution is in an increasing trend in the operating rooms, as has been the case in various other domains in life. It has been shown in studies that the main cause of this noise pollution consist of the behavior related to the operating room personel and the surgical equipment. These higher than normal noise levels may increase stress and decrease communication and performance, apart from the negative health effects on the operating team. In this study, we aimed to explore the sources of noise pollution and the place of music on these effects on anesthesiology and surgical doctors. Questions formulated through a questionnaire have been asked to the anesthesiology and surgical department physicians on a voluntary basis, and their approach to the concept of noise has been assessed. The study was planned as a descriptive study. In total, highest impact from noise pollution was found to be the aspirator (74.3%), chatting (55.4%), noises from the monitors (54.8%), alarms (48.6%), surgical material (25.9%) and music (23.8%). Noise had the most impact on the concentration of the doctors with a rate of 61.9%. Anesthesiologists, when compared to other surgical department physicians, were found to be impacted most by music with 37.2%. It is not realistic to eliminate all the noise and distraction. On the other hand, it can be minimalized through sufficient measures. Yet, general measures to keep the silence isn’t too likely to keep the noise down during long operations. Whereas music stays as a matter of personal choice. Controlled studies on whether to keep or not the music in the operating rooms aren’t yet sufficient, due to which, general recommendations do not apply. As a result of this study, we have found that while music might have performance increasing effects, it still has a potential as a distraction and interfere with the communication in the operating room.

关键词： Operating Room Noise Music

Comparison of Fractional Flow Reserve-Guided Revascularization Strategies in Isolated Proximal Left Anterior Descending Coronary Artery Disease

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Open Journal of Internal Medicine 2018年第3期8卷 167-176页

作者： Mehmet Timur Selcuk Enis Grbovic orhan Maden Hatice Selcuk Murat Gül Kevser Gülcihan Balci Mustafa Mücahit Balci Cardiology Turkiye Yuksek Ihtisas Research and Education Hospital Ankara Turkey

The data about FFR-guided revascularization in isolated proximal LAD disease are limited and studies comparing long-term outcomes of FFR-guided PCI versus FFR-guided CABG in single-vessel proximal LAD disease are lacking. We aimed to assess the 4-year long-term safety and effectiveness of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) and FFR-guided coronary artery bypass graft surgery (CABG) for the treatment of proximal left anterior descending (LAD) lesions. The study included 129 patients with functionally significant (FFR ≤ 0.80) isolated proximal LAD stenosis (PCI, 88 patients vs. CABG, 41). Clinical endpoints were assessed by Kaplan-Meier method and compared by the log-rank test. At a mean follow-up time of 47 ± 12 months, a higher incidence of myocardial infarction in the PCI group (PCI: 32% vs. CABG: 15%;p = 0.003) and a higher incidence of stroke in the CABG group (CABG: 3 (7%) vs. PCI 0 (0%);p = 0.031) were observed. However, there were no significant differences in the primary composite endpoint, death and target vessel revascularization between PCI and CABG groups. The PCI and CABG in isolated proximal LAD lesions yielded similar long-term outcomes regarding the primary composite clinical endpoints. However, stroke was more frequent in the CABG group than in the PCI group.

关键词： Coronary Artery Bypass Grafting Fractional Flow Reserve Percutaneous Coronary Intervention

Antioxidants vitamin E and C attenuate hepatic fibrosis in biliary-obstructed rats

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World Journal of Gastroenterology 2006年第42期12卷 6835-6841页

作者： Ali Riza Soylu Nurettin Aydogdu Umit Nusret Basaran Semsi Altaner orhan Tarcin Nursal Gedik Hasan Umit Ahmet Tezel Gulbin Dokmeci Huseyin Baloglu Mevlut Ture Kemal Kutlu Kadir Kaymak Division of Gastroenterology Trakya University Edirne Turkey Department of Physiology Trakya University Edirne Turkey Department of Pediatric Surgery Trakya University Edirne Turkey Department of Pathology Trakya University Edirne Turkey Division of Gastroenterology Gumussuyu Military Hospital Istanbul Turkey Department of Biochemistry Kas?mpasa Naval Hospital Istanbul Turkey Department of Pathology Haydarpasa GATA/ Education Hospital Istanbul Turkey Department of Biostatistics Trakya University Edirne Turkey

AIM： To investigate whether antioxidants vitamin E and C can retard development of hepatic fibrosis in the bilian/obstructed rats. METHODS： Fifty Wistar albino rats were randomly assigned to 5 groups （10 rats in each）. Bile duct was ligated in 40 rats and they were treated as follows： group vitC, vitamin C 10 mg/kg sc daily; group vitE, vitamin E 15 mg/kg sc daily; group vitEC, both of the vitamins; bile duct-ligated （BDL, control） group, physiological saline sc. The fifth group was assigned to sham operation. At the end of fourth week, the rats were decapitated, and hepatic tissue biochemical collagen content and collagen surface area were measured. Hepatic tissue specimens were histopathologically evaluated according to Scheuer system. Serum hyaluronate levels were measured by ELISA method. RESULTS： Despite being higher than sham group, hepatic collagen level was significantly decreased in each of the vitC, vitE and vitEC groups （32.7 ± 1.2, 33.8 ± 2.9, 36.7 ± 0.5 ）μg collagen/mg protein, respectively） compared to BDL （48.3 ± 0.6 mg collagen/g protein）（P 〈 0.001 for each vitamin group）. Each isolated vitamin C, isolated vitamin E and combined vitamin E/C supplementation prevented the increase in hepatic collagen surface density （7.0% ± 1.1%, 6.2% ± 1.7%, 12.3% ± 2.0%, respectively） compared to BDL （17.4% ± 5.6%）（P 〈 0.05 for each）. The same beneficial effect of vitamin C, vitamin E and combined vitamin E/C treatment was also observed on the decrease of serum hyaluronate levels compared to BDL group （P 〈 0.001）. The relative liver and spleen weights, serum transaminases, cholestatic enzymes, bilirubins and histopathological inflammation scores were not different between the antioxidant treatment groups and the control. However, fibrosis staging scores were obviously reduced only in the vitamin E/C combination group （vit EC： 2.4 ± 0.8 vs BDL： 3.1 ± 0.7; P 〈 0.05）. CONCLUSION： Each antioxidant vitamin E, vitamin C and their combination retard hepatic fibrosis in bi

关键词： Hepatic fibrosis Biliary obstruction Collagen Vitamin E Vitamin C

Lamivudine resistance mutations in patients infected with hepatitis B virus genotype D

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World Journal of Gastroenterology 2011年第45期17卷 4987-4992页

作者： orhan Yιldιz Bilgehan Aygen Nese Demirtürk Tuna Demirdal Dilara Inan Taner Yιldιrmak Arzu Kantürk Ediz Tütüncü Hepatitis B Study Group Department of Infectious Diseases and Clinical Microbiology Medical School of Erciyes University Department of Infectious Diseases and Clinical Microbiology Medical School of Kocatepe University Department of Infectious Diseases and Clinical Microbiology Medical School of Akdeniz University Okmeydani Training and Research Hospital of the Ministry of Health 34384 Istanbul Turkey SB Diskapi Yildirim Beyazit Training and Research Hospital of the Ministry of Health

AIM: To determine the distribution of viral genotypes for primary or acquired lamivudine resistance. METHODS: A total of 283 patients with chronic hepatitis B virus (HBV) infection (245 patients with chronic hepatitis B and 38 inactive hepatitis B surface antigen carriers) were included in the study. The HBV geno-type was determined by using quantitative real-time polymerase chain reaction and sequence analysis, and tyrosine-methionine-aspartate-aspartate (YMDD) motif mutations were determined using the reverse transcriptase hybridization method. RESULTS: Lamivudine resistance was determined in a total of 25 (10.7%) chronic hepatitis B patients. Eight subjects (4%) had primary resistance to lamivudine, and 17 (53.1%) had secondary resistance to lamivudine. Genotype D, which was isolated from 267 of the patients with chronic HBV infection, was the dominant genotype in Turkey. CONCLUSION: Identification of YMDD motif mutations should have a positive impact on the selection of proper antiviral medication for patients, even for those who are nucleoside nave.

关键词： Hepatitis B virus Genotype Resistance Lamivudine Tyrosine-methionine-aspartate-aspartate mutation