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Öğe Effect of Carnitine on Cutaneous Wound Healing in Immunosuppressed Rats(Academic Press Inc Elsevier Science, 2009) Akkuş, Abdullah; Aydınuraz, Kuzey; Daphan, Çağatay; Saygun, Oral; çağlayan, Osman; Edremitlioğlu, Mustafa; Ağalar, FatihBackground. The wound is ischemic in nature. Chronic steroid administration impairs wound healing by changing enzymes in the glycolytic pathway. Carnitine supplementation may help to restore the energy deficiency caused by chronic steroid administration in the wound. The aim of this study was to evaluate the effect of carnitine on impaired wound healing. Methods. The study was conducted in three groups. Surgical intervention was a 4 cm long midline skin incision at the back. In Group A, eight rats received methylprednisolone for 7 d prior to surgical intervention, and it was continued until the end of the experiment. In Group B, 12 rats received methylprednisolone for 7 d prior to surgical intervention. After surgery, methylprednisolone injection was continued and carnitine was supplemented until the end of the experiment. In Group C, eight rats received no medication. The wound of half of the animals in each group was harvested on the seventh day after surgical intervention and the remaining on the 14th d. Tensile strength and hydroxyproline content were measured in all groups. Results. There was no significant difference in parameters in any of the groups on day seven. On day 14, all parameters were statistically different between methylprednisolone and control groups (P < 0.05). Values for tensile strength were higher in the methylprednisolone/carnitine group compared with methylprednisolone group (P < 0.05). Carnitine administration had also increased hydroxyproline levels in the methylprednisolone/carnitine group compared with the control group (P < 0.05). Conclusions. Carnitine is shown to increase tensile strength of the wound when supplemented to immunosuppressed rats in which wound healing is impaired by methylprednisolone. (C) 2009 Elsevier Inc. All rights reserved.Öğe Effect of chlorhexidine on oral airway biofilm formation of Staphylococcus epidermidis(2015) Büyükkoçak, Ünase; Ağalar, Canan; Deniz, Turgut; Çeken, Sabahat; Ağalar, FatihAmaç: Airway yüzeyinde biofilm oluşması supraglottik kolonizasyona, bu da alt solunum yolu enfeksiyonlarına neden olabilir. Lokal dezenfektanların biofilm oluşumuna etkisini araştıran pek fazla çalışma bulunmamaktadır. Bu çalışmanın amacı airwayleri klorhekzidinle kaplamanın Staphylococcus epidermidis'in biofilm oluşturmasına etkisinin araştırılmasıdır.Yöntemler: Biofilm deneyi için kültür ve elektron mikroskobi yöntemleri kullanıldı. Airwayler, klorhekzidinin biofilm oluşumu ve bakteri sayısına etkisini araştırmak üzere, iki gruba ayrıldı. Grup 1 (Kontrol Grubu): Katkısız airway, Staphylococcus epidermidis, Grup 2: Klorhekzidinle kaplanmış airway, Staphylococcus epidermidis. Grup 1'e bir işlem yapılmazken, Grup 2'ye 4 saniye boyunca % 0,2 konsantrasyonda klorhekzidin sprey sıkıldı ve kurutuldu. Materyale tutunan bakteri sayısı mikrobiyolojik yöntemle incelendi, biofilm oluşumu elektron mikroskobik inceleme ile gösterildi. İstatistik analiz için Mann-Whitney U testi kullanıldı.Bulgular: Grup 2'de bakteri sayısı 1x102-8x102 cfu/ml iken Grup 1'de 3x103-1x104 cfu/ml idi. Klorhekzidinin airwaye tutunan bakteri sayısını istatistiksel olarak anlamlı oranda azalttığı görüldü (p0,04). Elektron microskobik incelemede de sonuç uyumluydu.Sonuç: Bu çalışmada, klorhekzidinin airway üzerinde biofilm oluşumu ve tutunan bakteri sayısını azaltmada etkili olduğu gösterildiÖğe The effect of G-CSF in an experimental MRSA graft infection in mice(Taylor & Francis Inc, 2005) Ağalar, Canan; Eroğlu, Erol; Sari, Mustafa; Sari, Aliye; Daphan, Çağatay; Ağalar, FatihWound infection after prosthetic material implantation is a troublesome complication with an incidence of 2% to 10%. The effect of granulocyte colony-stimulating factor (G-CSF) was studied in an experimental methicillin-resistant Staphylococcus aureus (MRSA) graft infection model. Eighty adult mice were used. Under general anesthesia an abdominal incision of 2 cm in length was performed. A subcutaneous cavity of 2 x 2 cm in size was created. Polypropylene mesh pieces of 2 x 1 cm and MRSA solution of 0.1 ml of 10(8) CFU/mL were used. G-CSF was applied systemically or locally in a dosage of 0.02 MU/30 g body weight. There were 8 groups: group I, wound + MRSA; group II, wound + mesh + MRSA; group III, wound + mesh + MRSA + G-CSF (ip, 48 h before operation); group IV, wound + mesh + MRSA + G-CSF (ip, 24 h before operation); group V, wound + mesh + MRSA + G-CSF (locally, into the cavity); group VI, wound + mesh (incubated in G-CSF solution for 4 h) + MRSA; group VII, wound + mesh + MRSA + G-CSF, ip, 24 h from operation; and group VIII (positive control group), wound + mesh + MRSA + Teicoplanin (0.03 mg/30 g body weight, ip, 1/2 h before operation). Three days after, animals were killed and incisions were examined for possible infection or abscess formation and wound failure. Meshes were removed; after vortexing and dilution, samples were incubated with 5% agar media. Results of bacterial incubation were evaluated 24 h and 48 h later. There were symptoms of wound infection and abscess formation in all groups except group VIII. In group VIII, MRSA was isolated in 7 events with a colony count below 10(3). Bacterial counts were above 106 (10(6)-10(8)) in all other groups. Thus, it was observed that wound infection could be created with this model, but G-CSF could not prevent the development of wound infection, whether it was administered systemically or locally. Teicoplanin decreased the number of colony-forming units of MRSA, and prevents wound infection in this MRSA wound infection model.Öğe The Effect of Simvastatin on Pulmonary Damage in Experimental Peritonitis in Rats(Springer India, 2015) Altunal, Çetin; Ağalar, Fatih; Ağalar, Canan; Daphan, Çağatay; Saygun, Oral; Aydınuraz, Kuzey; Dom, SedatStatins are widely used in the treatment of hyperlipidemia, as they inhibit cholesterol synthesis. They also have anti-inflammatory, antioxidant, immunomodulatory, and positive endothelial-functional effects. It is hypothesized that simvastatin ameliorates pulmonary damage secondary to peritonitis in rats. Forty Wistar albino rats were divided into four groups. In sham group, laparotomy was the standard procedure. In simvastatin group, simvastatin was given perorally before laparotomy. In sepsis group, peritoneal sepsis was constituted by cecal ligation and puncture technique. In sepsis+simvastatin group, the procedures of simvastatin and sepsis groups were applied together. After sacrification at the 72nd hour, tissue samples from lungs were harvested for histopathological examination, wet and dry weight measurements, and tissue culture, tissue malondialdehyde, and nitric oxide tests. Blood samples were taken for C-reactive protein and whole blood count. While the malondialdehyde levels were found to be significantly higher in sepsis group, nitric oxide levels were found to be significantly lower in simvastatin+sepsis group. Alveolar hemorrhage was highest in simvastatin+sepsis group. There was no difference for C-reactive protein, leukocyte levels, and histopathological examination between any groups. The ratios of wet and dry lung weights were higher in simvastatin-given groups. Simvastatin has no positive effect in terms of lung dysfunction on experimental sepsis model. For a better understanding of the effects of simvastatin on lung injury in peritoneal sepsis, experimental models of longer duration that enable to search the effects of simvastatin beyond 3 days will be more useful.Öğe Effects of different anesthetic techniques on serum leptin, C-reactive protein, and cortisol concentrations in anorectal surgery(Medicinska Naklada, 2006) Büyükkoçak, Ünase; Daphan, Çağatay; Çağlayan, Osman; Aydinuraz, Kuzey; Kaya, Tahsin; Saygun, Oral; Ağalar, FatihAim To compare the effects of intratracheal general anesthesia (ITGA) and regional (saddle block) anesthesia on leptin, C-reactive protein (CRP), and cortisol blood concentrations during anorectal surgery. Methods Fifty-eight patients suffering from hemorrhoidal disease, pilonidal sinus, anal fissure, or anal fistula were included the study. Patients were randomly assigned into one of the two groups (n = 29). Patients in one group received ITGA. After thiopental and fentanyl induction, vecuronium was used as a muscle relaxant. Anesthesia was maintained with sevoflurane. In the other group we applied saddle block, injecting hyperbaric bupivacaine into the subarachnoid space, through the L3-L4 intervertebral space, in the sitting position. Blood samples were collected for leptin, CRP, and cortisol analysis before the induction of anesthesia at 3 and 24 hours postoperatively. Results Preoperative leptin, CRP, and cortisol concentrations were comparable between the groups. There was no significant difference in postoperative levels of leptin and CRP in both groups. Although not significant, leptin and CRP concentrations were lower in the saddle block group at three hours postoperatively (mean SD, 6.95 +/- 8.59 and 6.02 +/- 12.25, respectively) than in the ITGA group (mean SD, 9.04 +/- 9.89 and 8.40 +/- 15.75, respectively). During early postoperative period, cortisol increased slightly in the ITGA group and remained at similar level in the saddle block group, but later decreased in both groups. Cortisol levels in the saddle block group were significantly lower than in the ITGA group at 3 hours postoperatively (343.7 +/- 329.6 vs 611.4 +/- 569.8; P = 0.034). Conclusion Saddle block, a regional anesthetic technique, may attenuate stress response in patients undergoing anorectal surgery, by blocking afferent neural input during early postoperative period.Öğe Effects of granulocyte-colony stimulating factor on peritoneal defense mechanisms and bacterial translocation after administration of systemic chemotherapy in rats(Baishideng Publishing Group Inc, 2007) Çerçi, Celal; Ergin, Çagrı; Eroğlu, Erol; Ağalar, Canan; Ağalar, Fatih; Çerçi, Sureyya; Bülbül, MahmutAIM: To investigate the effects of granulocyte-colony stimulating factor (G-CSF) on peritoneal defense mechanisms and bacterial translocation after systemic 5-Fluorouracil (5-FU) administration. METHODS: Thirty Wistar albino rats were divided into three groups; the control, 5-FU and 5-FU + G-CSF groups. We measured bactericidal activity of the peritoneal fluid, phagocytic activity of polymorphonuclear leucocytes in the peritoneal fluid, total peritoneal cell counts and cell types of peritoneal washing fluid. Bacterial translocation was quantified by mesenteric lymph node, liver and spleen tissue cultures. RESULTS: Systemic 5-FU reduced total peritoneal cell counts, neutrophils and macrophage numbers. It also altered bactericidal activity of the peritoneal fluid and phagocytic activity of polymorphonuclear leucocytes in the peritoneal fluid. 5-FU also caused significant increase in frequencies of bacterial translocation at the liver and mesenteric lymph nodes. G-CSF decreased bacterial translocation, it significantly enhanced bactericidal activity of the peritoneal fluid and phagocytic activity of polymorphonuclear leucocytes in the peritoneal fluid. It also increased total peritoneal cell counts, neutrophils and macrophage numbers. CONCLUSION: Systemic 5-FU administration caused bacterial translocation, decreased the bactericidal activity of peritoneal fluid and phagocytic activity of polymorphonuclear leucocytes in the peritoneal fluid. G-CSF increased both bactericidal activity of the peritoneal fluid and phagocytic activity of polymorphonuclear leucocytes in the peritoneal fluid, and prevented the bacterial translocation. We conclude that intraperitoneal GCSF administration protects the effects of systemic 5-FU on peritoneal defense mechanisms. (C) 2007 The WJG Press. All rights reserved.Öğe Gold and gold-palladium coated polypropylene grafts in a S-epidermidis wound infection model(Academic Press Inc Elsevier Science, 2006) Saygun, Oral; Ağalar, Canan; Aydınuraz, Kuzey; Ağalar, Fatih; Daphan, Çağatay; Saygun, Meral; Denkbaş, Emir BakiBackground. The use of non-absorbable mesh grafts in both abdominal wall defects and inguinal hernias are impossible in the presence of contamination. This study was conducted for evaluation of the efficiencies of polypropylene mesh grafts coated with gold and palladium-gold. Materials and methods. Ten piece of 1 x 2 cm. of polypropylene mesh grafts were used in each group of naive, gold-coated, and palladium-gold-coated. The grafts were incubated in physiological saline buffered and 0.5 McFarland slime positive Staphylococcus epidermidis for 24 h. At intervals of 6,12,24,48, 72 h grafts were washed with saline and vortexed for 2 min in 2 ml of physiological saline. There were 100 mu l of samples of vortexed material incubated in blood agar and 24 h later, colony numbers were assessed. In the second part of study, the grafts were implanted below the musculoaponeurotic layer at inguinal. region of rats following the same procedure of incubation and washing. On the 8th day, the rats were examined for infection rate and their wound cultures were obtained. Results. The least amount of bacterial growth was detected in the samples obtained from gold-palladium coated grafts; whereas the highest rate of growth was found in samples of naive grafts. The superficial surgical site infection rate was 0% in gold-palladium coated, 30% in gold-coated and 100% in naive polypropylene group. The bacterial growth rate from wound cultures confirmed the superficial surgical site infection rates in all groups. Conclusion. Prosthetic graft infection with S. epidermidis can be prevented by coating the graft with gold-palladium or gold. (c) 2006 Elsevier Inc. All rights reserved.Öğe The interactions between doctors and pharmaceutical companies(2005) Ağalar, Canan; Ağalar, Fatih; Sayek, İskenderIn this review, the interactions between doctors and drug companies were evaluated within the scope of current literature. Unethical deviation from healthy interactions between the pharmaceutical industry and doctors is becoming a serious problem in the era of modern medical practice. Many contemporary guidelines on this issue from different countries and authorities exist. They address various ethical questions such as drug promotion, gift giving, sponsorship, the acceptable range of promotional activities, and continuous medical education and drug companies. The Turkish Medical Association recently declared the tenet of "Medical Doctor and Drug Advertisement Principles". The association has also established a strong relation with topic 15 of "Ethics in Medical Science Profession" and this declaration. There is also a contemporary regulation of the Turkish Ministry of Health addressing the same issue. Their contents are similar to the guidelines and regulations which were presented from other countries. Despite great efforts, the problem remains unresolved. Society-based new application models, statutes and regulatory mechanisms are needed.Öğe Mild Hypothermia Improves Survival During Hemorrhagic Shock Without Affecting Bacterial Translocation(Taylor & Francis Inc, 2009) Deniz, Turgut; Agalar, Canan; Özdoğan, Mehmet; Edremitlioglu, Mustafa; Eryılmaz, Mehmet; Devay, Seda Duygulu; Ağalar, FatihBackground: Accidental hypothermia in patients with hemorrhagic shock (HS) is associated with increased mortality. However, experimental mild and moderate hypothermia has beneficial effects. The mechanisms for beneficial effects of hypothermia have not been completely understood. Therefore, the aim of this study was to investigate the effect of hypothermia on survival, bacterial translocation (BT), and remote pulmonary injury in a controlled HS model in rats. Methods: HS was achieved by blood withdrawal through femoral vein. Rats in the normothermia group (group I) were maintained at 37C. Mild hypothermia group (group II) was observed at 32C that was spontaneously induced by exposure to ambient temperature. Moderate hypothermia of 28C was actively induced by external cooling in group III for 90 min. Survival and neurological deficit scores (NDS) were recorded at 24th hr. Mesenteric lymph nodes, liver and spleen samples were collected. Myeloperoxidase (MPO) and malondialdehyde (MDA) levels were measured in lung tissue. Results: Blood pressure significantly increased in hypothermia groups. Mild hypothermia significantly increased survival. No difference was found in BT rates in groups. Hypothermia was found to significantly decrease the NDS points in group III, compared to group I. There was no difference in lung tissue MPO levels among groups. Lung tissue MDA levels increased significantly in groups II and III. Conclusions: Mild hypothermia improved blood pressure, survival, and neurological outcome with a possible detrimental effect on pulmonary ROS production during HS in rats. These effects of hypothermia are not associated with BT.Öğe Protective Effect of Hypothermia in a Blunt Thoracic Trauma and Hemorrhagic Shock Model(Georg Thieme Verlag Kg, 2014) Ülger, Hüseyin; Deniz, Turgut; Çomu, Faruk; Ağalar, Canan; Kısa, Üçler; Ağalar, FatihBackground The aim of this study was to investigate the effect of volume-controlled hemorrhage and hypothermia on rats with blunt chest trauma, evaluating bacterial translocation (BT), lung tissue malondialdehyde (MDA), nitric oxide (NO) levels, and erythrocyte deformability (ED). Methods In our study, 10 animals each were included in 6 groups. Groups were as follows: a group with blunt chest trauma only (Group T), a group with hemorrhage only (Group H), a normothermic group with comorbidity of trauma and hemorrhage (Group NT), a mild hypothermic group with trauma and hemorrhage (Group MH), a moderate hypothermic group with trauma and hemorrhage (Group MoH), and a control group (Group C). Sodium pentobarbital (50 mg/kg, intraperitoneally) anesthesia was administered. Thoracic trauma was generated using kinetic energy at the middle of the chest (2.45 J). Stage 3 hemorrhagic shock was initiated. After 24 hours, the rats were killed and red blood cell deformability, BT development in the liver, spleen, and mesenteric lymph nodes, and NO and MDA levels in lung tissue, kept at -80 degrees C, were measured. Results In Groups MH and MoH, there was no difference in ED values, though they were lower than those in Group NT (p < 0.05). BT was more prevalent in Group NT than in the other groups. In Group NT, the growth of BT was greater than in other groups (p < 0.05). The level of NO in Group H was higher than in the control group (p < 0.05). In Group MoH, the level of MDA was lower than in Group MH (p < 0.05). Conclusion Hypothermia seems to demonstrate protective effects on ED and BT by reducing oxidative stress. The protective effects of therapeutic hypothermia on ED may be due to the effect of reducing NO and/or MDA. There was no difference in effect between mild and moderate hypothermia in terms of the formation of ED and BT.Öğe A rat model of polypropylene graft infection caused by Staphylococcus epidermidis(Blackwell Publishing, 2006) Ağalar, Canan; Özdoğan, Mehmet; Ağalar, Fatih; Saygun, Oral; Aydınuraz, Kuzey; Akkuş, Abdullah; Aktürk, SelçukBackground: The aim of this study was to constitute a valid graft infection model with Staphylococcus epidermidis in rats. Method: Rats were divided into seven groups. In groups 1 and 2, 2 cm x 2 cm polypropylene grafts were incubated with 10(8) c.f.u./mL slime-positive S. epidermidis at 37 degrees C for 2 and 24 h and were then placed subfascially to the groins of rats. In the third group, naive grafts were placed and 0.5 mL of 3 x 10(7) c.f.u. slime-positive S. epidermidis were injected on the inside of the wounds. Rifampicin (30 mg/kg) in group 4 and teicoplanin (20 mg/kg) in group 5 were applied i.p. to rats with 2-h incubated grafts for prophylaxis. The same prophylactic regimens were given to groups 6 and 7 in which rats were incubated for 24 h. At eighth day, rats were killed and wounds were assessed with macroscopic evaluation and cultures. Results: No death occurred in any of the groups. In groups 1 and 2, 100% infection rates were achieved. However, graft infection was detected in only two (20%) of the rats in group 3 (P = 0.001). Prophylactic application of teicoplanin or rifampicin decreased the infection rates significantly in the short-incubation groups. Conclusion: Incubation of polypropylene grafts with slime-producing S. epidermidis for 2 and 24 h in the pre-application period achieved the occurrence of a standardized graft infection. Prophylactic use of teicoplanin and rifampicin decreased the infection rates. We propose to use this reproducible and reliable animal model of graft infection in future studies.Öğe The results of surgical treatment in the elderly acute abdomen patients(1999) Ağalar, Fatih; Özdoğan, Mehmet; Daphan, Çağatay Erden; Topaloğlu, Serdar; Sayek, İskenderThe aim of this study was to evaluate the factors affecting the outcome of geriatric patients presenting with acute abdomen. Eighty patients who underwent surgery with the diagnosis of acute abdomen were analysed retrospectively. The effects of age, sex, American Society of Anaesthesiology (ASA) class, preexisting disease, admission time after the onset of the symptoms, followup interval before the operation on morbidity, mortality and length of hospital stay were evaluated. Male/female ratio was 1.3, mean age was 72.4. Main causes were biliary system disease (38.8%), intestinal obstruction (31.3%), peptic ulcer perforation (12.5%) and acute appendicitis (8.7%). Median ASA class was 3 and 76.3% of the patients had at least one preexisting disease. ASA class was significantly effective on mortality and complication rate. Shock at the admission, malignity, male sex, mechanical ventilation and transfusion were the factors that have statistically significant effect on mortality. 58.8% of the patients had complications. Complications were significantly related to mortality, prolonged intensive care unit (ICU) stay and hospital stay. Male sex, ASA class, malign diseases, peptic ulcer perforation, colonic obstruction, shock, mechanical ventilation and blood transfusion were the factors affecting mortality in the elderly. Preexisting diseases other than malignity, period between the onset of symptoms and admission, follow-up time and operation time did not influence mortality. Complications and ASA classification were associated with a prolonged ICU and hospital stay.Öğe Staged abdominal repair for treatment of moderate to severe secondary peritonitis(Springer, 2005) Ağalar, Fatih; Eroğlu, Erol; Bülbül, Mahmut; Ağalar, Canan; Tarhan, Ömer Rıdvan; Sarı, MustafaThe aim of this study was to evaluate the effects of planned relaparotomy and to assess factors that may contribute to mortality in patients with moderate to severe secondary peritonitis. A total of 36 consecutive patients with an Acute Physiologic and Clinical Health Evaluation (APACHE) II score of >10 were enrolled the study for a 2-year period. The mean age of the patients was 56 years (17-92 years), and 23% of them were male. One-third of them had postoperative peritonitis; 152 scheduled operations were done, and the overall mortality rate was 36%. For patients whose septic source was in the upper gastrointestinal system, control of the source was more difficult (p = 0.004). Overall, 28 complications developed in 61% of the patients. Initial and second-day APACHE II scores were 14.5 (11-27) and 12.0 (9-25), respectively. The initial APACHE II score of survivors was lower than that of nonsurvivors [p = 0.0001, 95% confidence interval (CI) -9.5, -3.6]. Second-day APACHE II scores were not different (p = 0.19; 95% Cl -3.79, 0.80). Striking end or lateral duodenal leaks were clearly associated with high mortality. It is found that the initial APACHE II score, the success of controlling the source, the occurrence of complications, and the type of illness are independent factors that may affect mortality. We concluded that staged abdominal repair should be used with caution in the treatment of lateral or end duodenal leaks. It is a good alternative to conventional laparotomy for moderate to severe forms of secondary peritonitis from other sources.Öğe Ülkemizde Acil Tıp Anabilim Dalları’nda acil servislerin fonksiyonel mimari açısından değerlendirilmesi(2007) Deniz, Turgut; Aydınuraz, Kuzey; Oktay, Cem; Saygun, Meral; Ağalar, FatihAMAÇ Ülkemizdeki Acil Tıp Anabilim Dalları’na (ATAD) bağlı acil servislerinin iç ve dış mimari yapıları araştırıldı. GEREÇ VE YÖNTEM Tanımlayıcı tipteki bu araştırmada, çalışmanın yapıldığı tarihte mevcut olan 26 ATAD’ye anket formları gönderildi. Bu anketle acil servislerin iç ve dış mimari yapıları ve fonksiyonel hizmet durumları sorgulandı. Anketi yanıtlayan 22 ATAD’nin verileri değerlendirmeye alındı. Henüz kurulma aşamasında olan ve hizmet vermeyen iki Anabilim Dalı çalışmaya dahil edilmedi. BULGULAR Geri bildirimlerin değerlendirilmesinde ATAD’den ancak %59’unun (n=13) hizmet verdikleri alanın acil servis alanı olarak planlandığı izlendi. Acil servislerin ambulans girişlerinin %77 oranında uygun olmadığı, %54,5 ATAD’de (n=12) acil servis girişinde ambulansların hasta bıraktığı alanın hava koşullarından korumalı olmadığı görüldü. Gelen yanıtlara bakıldığında ancak %59 ATAD’de (n=13) acil serviste triyaj ünitesinin bulunduğu, yine sadece bir ATAD’de (%4,5) acil serviste temizlenme (dekontaminasyon) odası bulunduğu bildirildi. Halen hizmet vermekte olan ATAD’lerine bağlı acil servislerin ancak %32’sinde (n=8) mevcut lokal risk faktörleri doğrultusunda genişleyebilme düzeyinin yeterli olabileceği belirlendi. ATAD’lerin sadece %18’inde (n=4) özürlü tuvaletinin var olması ülke genelinde özürlülere yönelik mimari değişikliklerin eksikliğinin acil servislerde de olduğunun göstergesidir. Acil tıbbın ülkemizde 12 yıllık geçmişi olduğu düşünüldüğünde ATAD’lerin ancak %68’inde (n=15) seminer odalarının var olması, akademik yapılanmaya fiziksel alt yapı yetersizliği olan yerlerde başlandığının göstergesidir. SONUÇ Ülkemizdeki acil tıp yapılanması içerisinde acil servis mimarisine gereken önemin verilmediğini, verilen hizmetteki bilimselliğin mimari yetersizliklerle gölgelendiğini göstermiştir. Acil servis mimari tasarımı, bilimsel veri ve kurallar çerçevesinde sağlanmalıdır. Bunun için hastane ve özellikle acil servis mimarisi hakkında bilgi ve tecrübesi olan mimar veya mimarlar yetkili kişiler ile hedefler üzerinde bir anlaşmaya varmalıdırlar.Öğe V. Ulusal Travma ve Acil Cerrahi Kongresi bildirilerinin değerlendirilmesi(2008) Deniz, Turgut; Saygun, Meral; Şahiner, İbrahim Tayfun; Ağalar, Fatih; Taviloğlu, Korhan; Yorgancı, Kaya; Ertekin, CemalettinAMAÇ: V. Ulusal Travma ve Acil Cerrahi Kongresi’nde sunulan bildiri özetlerinin öz yazım kılavuzuna uygunluğu değerlendirildi; demografi, metodoloji ve yazım tekniği yönünden incelendi. GEREÇ-YÖNTEM: Kongre kitapçığındaki 451 bildiri değerlendirmeye alındı. Değerlendirilen parametreler; çalışmanın türü ve içeriği, çalışmanın yapıldığı kurumlar, yazar sayısı, başlık kullanımının uyumluluğu, yapısal öz kullanımı, sözcük sayısı, dilin akıcılığı, uygun istatistiksel değerlendirme ve sonuç-öz ilişkisiydi. BULGULAR: Çalışmaların %49’u retrospektif, %29’u olgu sunumuydu. Bildirilerin %33’ü izole organ yaralanması, %26’sı tek sistem yaralanması, %24’ü çoklu sistem yaralanmasına ilişkindi. Çalışmaların %43’ü üniversite, %38’i devlet hastanesi kökenliydi. Çalışmaların %40’ı genel cerrahiyle ilgiliydi, %29’u ise multidisiplinerdi. Çalışmalardaki ortalama yazar sayısı 5,6±1,8 idi; üniversite ve devlet hastaneleri arasında istatistiksel olarak anlamlı farklılık saptandı (p=0,001). Bildirilerin %91’inde yapısal öz vardı, %57’si 100-250, %42’si ise 250-500 sözcük içermekteydi. Çalışmaların %73’ü akıcı olarak değerlendirildi. Tüm bildirilerin %19’unda istatistiksel yöntem uygulandığı belirlendi. Bildirilerin çoğu akıcı idi. İstatistiksel analiz uygulama yönünden üniversite ve devlet hastaneleri arasında anlamlı fark saptandı (p=0,001). Sonuç-öz ilişkisi bildirilerin %71’inde yeterli olarak değerlendirildi. SONUÇ: Bildiri özeti yazma konusunda bazı sorunlarımızın olduğu saptanmıştır. Yapısal öz kullanımı, akıcılık ve yazım kurallarına uyumu artırmaktadır. Özellikle çoklu yaralanlamaları irdeleyen klinik çalışmalar ve deneysel çalışmalar özendirilmeli, bu yönde araştırmalar teşvik edilmelidir.
