Yazar "Cömert, Ela" seçeneğine göre listele

Listeleniyor 1 - 7 / 7
  • [ X ]
    Öğe
    BAŞ BOYUN KANSERLERİNDE NÜTRİSYON
    (2021) Cömert, Ela
    Nütrisyon, baş ve boyun kanserli hastalarda morbidite ve mortalite üzerinde etkili faktörlerden biridir. Bu hastalarda kanserin neden olduğu olumsuz metabolik etkiler tümöre bağlı bölgesel faktörlere ek olarak gözlenir. Baş boyun bölgesine uygulanan cerrahi, radyoterapi ve kemoterapi tedavileri beslenmeyi olumsuz etkiler. Bu nedenle baş boyun kanserli hastanın tedavi öncesi beslenmesinin değerlendirilmesi, tedavi öncesi, sırasında ve sonrasında desteklenmesi gerekir. Baş boyun kanserli hastalarda beslenme desteğine ihtiyaç duyan hastalar vücut kitle indeksi 18.5 kg/m2’nin altında olan, 3-6 ayda %10 ve üzeri kilo kaybı olan, 5 gün üzerinde oral alımı azalmış ve katabolik etkilerin gözlendiği hastalardır. Planlanacak beslenme hastanın oral alımının olup olmadığı, beslenme desteğinin ne kadar süre gerekli olduğu ve besin alım sorununun kısmi veya total olmasına bağlı değişir. Oral beslenebilen hastalara gıda aralarında yüksek protein içerikli, lösin veya dallı zincirli aminoasitler ve omega-3 yağ asidinden zengin, yüksek enerji içerikli (2 kcal/mL) beslenme solüsyonları önerilir. Oral alımı olmayan hastalarda kısa süreli kullanımda parenteral beslenme, uzun süreli durumlarda veya evde hasta takibinde tüple beslenmeye geçilmelidir.
  • [ X ]
    Öğe
    Does face mask affects sleep quality in patients with nasal septal deviation: evaluated by mini sleep questionnarie
    (2022) Şencan, Ziya; Cömert, Ela; Muluk, Nuray Bayar; Koçak, Furkan Melih; Tekin, Yasin
    Objectives: The aim of this study was to investigate the effects of face mask usage on the sleep quality of patients with nasal septal deviation. Material and Method: Thirty-four patients with unilateral nasal septum deviation (Group 1) and 27 healthy subjects without septum deviation (Group 2, control) were included in the study. Mask usage time per day (hours) in the last week, weight, length and BMI values, smoking, and alcohol habits were asked. In both groups, the sleep quality of the patients was evaluated by Mini Sleep Questionnaire (MSQ). Sleep delay (SD), sleep awakenings (SA), sleep medications (SM), daytime sleep (DS), morning fatigue (MF), habitual snoring (HS), morning awakening (MA), morning headache (MH), chronic fatigue (CF), and restless sleep (RS); and total MSQ items were evaluated. Results: All subjects used surgical masks. In the nasal septal deviation group, the right-sided deviation was detected in 15 (44.1%) patients and left-sided deviation was detected in 19 (55.9%) patients. Deviation located was anterior deviation in 12 (35.3%) patients, posterior deviation in 13 (38.2%) patients and antero-posterior deviation in 9 (26.5%) patients. Sleep Medications (SM) and Morning Headache (MH) values of the deviation group (Group 1) were significantly lower than those in the control group (p<0.05). There was no difference between other MSQ items and total MSQ score of the septal deviation and control groups (p>0.05). In older patients with septal deviation, Sleep Awakenings (SA), Habitual Snoring (HS), Morning Awakening (MA), and Total MSQ scores increased (p<0.05) Conclusion: Facial mask usage did not cause sleep disorders in patients with nasal septal deviation. However, aging may cause disturbed sleep quality.
  • [ X ]
    Öğe
    EFFECT OF DIABETES AND SYSTEMIC INFLAMMATION PARAMETERS ON THE PROGNOSIS OF BELL’S PALSY
    (2021) Şencan, Ziya; Cömert, Ela; Şimşek, Gökçe; Muluk, Nuray Bayar; Yaman, Serdar Hanzala
    Objective: This study aimed to evaluate the prognostic importance of diabetes mellitus, hematologic and biochemical test findings including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation response index and triglyceride-glucose index in patients with Bell’s palsy and to compare these results with healthy subjects.Material and Methods: The study included 75 patients with incomplete Bell’s palsy.and 24 healthy subjects as the control group. Patients were divided into two groups as diabetes mellitus and non- diabetes mellitus patients. Complete blood count, biochemical tests including glucose, liver and renal function tests and blood lipid profile were analyzed from all the subjects and neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation response index and triglyceride-glucose index values were calculated from these results.Results: Neutrophil-to-lymphocyte ratio and systemic inflammation response index values were higher in patients with Bell’s palsy when compared with the control group. Triglyceride-glucose index was positively correlated with recovery time in all patients and the diabetes mellitus group. It was also positively correlated with prognosis in non- diabetes mellitus patients. High neutrophil-to-lymphocyte ratio was predictive for delayed recovery time only in non- diabetes mellitus patients.Conclusion: Our results indicated that diabetes mellitus didn’t influence severity, recovery time and prognosis of Bell’s palsy. High triglyceride levels and triglyceride-glucose index values were associated with long recovery time in patients with Bell’s palsy. For both diabetes mellitus and non- diabetes mellitus patients, House-Brackmann facial nerve grading scale-initial was the best parameter to predict the prognosis. Neutrophil-to-lymphocyte ratio and systemic inflammation response index values were significantly higher in patients with Bell’s palsy.
  • [ X ]
    Öğe
    PROGNOSTIC FACTORS IN DEEP NECK INFECTION
    (2022) Cömert, Ela; Şimşek, Buğra
    Objective: The present study aimed to evaluate the prognostic importance of hematologic test findings in addition to the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic inflammation response index, and C-reactive protein in the patients with deep neck infection and to compare these results with healthy subjects.Material and Methods: The study included 32 patients diagnosed as deep neck infection and treated by surgical intervention and parenteral antibiotics. As none of the patients had life-threatening complications, the prognosis was determined by the length of stay in the hospital. The effect of age, sex, pre-treatment blood parameters, abscess culture results, and medical comorbidities on prognosis were analysed. Pre- and post-treatment blood parameters were compared in each patient. Blood parameters were also compared between healthy subjects and patients.Results: When comparing patients with length of stay in the hospital ?7 days and >7 days, significant differences were observed for age (t=-2.568, p=0.015) and red blood cell distribution width values obtained preoperatively (Z=-2.343, p=0.019). The correlation analysis revealed a positive correlation between age and length of stay in the hospital. (r=0.450, p=0.010), and between length of stay in the hospital and comorbidity (r=0.366, p=0.039). Logistic Regression analysis revealed that age could be the best marker in the prediction of the patients with worse prognosis (percentage of predicting patients with worse prognosis=73.3%, B=0.054, Wald=4.967, p=0.026).Conclusion: The present study confirmed that the prognosis was worse in older patients and patients with comorbid disease whereas no relation was observed between the inflammatory markers and prognosis.
  • [ X ]
    Öğe
    THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS
    (Kırıkkale Üniversitesi, 2024) Cömert, Ela; Çetinkaya, Elif; Şimşek, Buğra; Şencan, Ziya; Bayar Muluk, Nuray; Bakar, Bülent
    Objective: The facial nerve and its branches are at risk during facial surgery. The surgery with the highest risk is parotid and submandibular gland surgery. An attempt was made to determine threshold values in terms of paralysis in nerve monitoring parameters. These determined values could not be used to predict facial nerve function after surgery. The aim of this study is to investigate the relationship between the parameters detected by nerve stimulation during surgery and postoperative facial nerve dysfunction in patients who underwent parotid and submandibular gland surgery.Material and Methods: A total of 29 facial nerve branches of 13 patients who underwent superficial parotidectomy or submandibular gland resection were examined. Patients were examined in two groups: those who did not develop paralysis after surgery and those who developed paralysis or sequelae. The relationship between the patient's pre- and postoperative House-Brackmann staging and potential changes detected during surgery was investigated.Results: Paralysis was detected in 8 of 29 nerves that were stimulated, and the affected branches were the cervicofacial branch and the marginal mandibular branch. No difference was observed in the mean threshold stimulation values and responses determined before, during and at the end of dissection between patients who developed paralysis and those who did not.Conclusion: Unlike the literature, it is determined that no electrophysiological measurement result can predict the postoperative phase as a result of ROC-curve analysis and logistic regression analysis. It is thought that these results are caused by the fact that the developing paralysis is at low stages and heal within one month.
  • Küçük Resim
    Öğe
    Tonsillar and Parotid Gland Metastases of Breast Cancer: Two Cases and A Literature Review
    (2019) Cengiz, Abdurrahman; Cömert, Ela; Tunçel, Ümit; Dilek, Gülay; Benzer, Emine
    Breast cancer is the most common tumor in women. One in eight women is affected by this disease in her lifetime. Both parotid gland and tonsillar metastases of breast cancer are extremely rare. Here, we present two separate cases of parotid gland and tonsillar metastases of breast carcinoma mimicking second primary tumors. The patient having parotid gland metastasis had disseminated disease and received palliative chemotherapy and hormone therapy. The other patient who had tonsillar metastasis underwent surgery without significant morbidity. Surgical resection of isolated tonsillar metastasis appears to have an influence on survival as the patient is free of disease at 12 months post-surgery.
  • [ X ]
    Öğe
    UYANIK FİBEROPTİK ENTÜBASYON: BEKLENEN ZOR HAVA YOLU
    (2019) Aydın, Gülçin; Saraçoğlu, Ayşe Gizem; Şahin, Ahmet Tuğrul; Alparslan, Murat; Gündoğan, Seydi; Koçak, Yahya Fatih; Cömert, Ela
    Zor hava yolu anestezistler tarafından zor yüz maskeventilasyonu ve zor trakeal entübasyonu kapsayan bir durumolarak tanımlanır. Entübasyon girişimlerinin %0.5-2.5’indezorlukla karşılaşılır. Başarısız girişimler perioperatif dönemdemorbidite ve mortaliteyi etkilemektedir. Beklenen zor hava yoluvakalarında ayrıntılı bir preoperatif değerlendirme ve ekipmanhazırlığı önemlidir. Zor hava yolunu öngörebilecek çeşitlianatomik ve antropometrik özellikler saptanan hastalarda yaygınfiberoptik entübasyon ihtiyacı olmaktadır. Fiberoptik entübasyoniçin ideal sedasyon tekniği sağlanmalıdır. Bu teknik hastanınanksiyetesini azaltan, konforunu bozmayan ve hemodinamikstabilitesini bozmayan bir teknik olmalıdır. İşlem süresindehastaların uyumlu ve koopere olması da çok önemlidir. Biz buyazımızda beklenen zor hava yolu vakasındaki anesteziyaklaşımımızı literatürler eşliğinde sunmayı amaçladık.