Ustundag, Hilal; Mertoglu, Cuma; Huyut, Mehmet Tahir

Objective: Coronavirus disease-2019 (COVID-19) is a disease that can progress with hypoxemia and severe respiratory distress in some patients. The oxyhemoglobin dissociation curve (ODC) is critical to understanding the effects of O2 exchange. This study aimed to evaluate the relationship between the ODC and oxygen-carrying capacity of hemoglobin (Hb) in COVID-19 patients.Materials and Methods: In the study, ODCs were created by examining the data obtained from the arterial blood gas analyses of 686 intensive care unit (ICU) and non-ICU COVID-19 patients retrospectively.Results: It was concluded that patients with COVID-19 and other respiratory distress patients had a slight right-leaning trend in the ODC compared with the standard curve. The P50 value of the ICU group was higher than the other groups (mean: 30.74 mmHg, n=131, p=0.047). While the percentage of oxyhemoglobin (mean: 65.44% vs 69.81%, p=0.015), the amount of glucose (mean: 163.39 mg/dL vs 195.36 mg/dL, p=0.002) and pH (median: 7.38 vs 7.41, p=0.007) in the non-ICU group was higher compared with the control group, the carboxyhemoglobin percentage (mean: 1.66% vs 1.13%, p=0.000), PCO2 (42.02 mmHg vs 39.44 mmHg, p=0.015), potassium (mean: 4.33 mmol/L vs 4.04, p=0.026), and sodium (mean: 138.10 mmol/L vs 135.80 mmol/L, p=0.000) were lower. The methemoglobin percentage of the ICU group was lower (p=0.000) than the other groups.Conclusion: The ODC of COVID-19 and other respiratory distress patients shifts slightly to the right, indicating that patients have partial respiratory difficulties.

Mertoglu, Cuma; Huyut, Mehmet Tahir; Ustundag, Hilal

Amaç: Koronavirüs hastalığı-2019 (COVID-19), hipoksemi ve bazı hastalarda ciddi derecede solunum sıkıntısı ile seyredebilen bir hastalıktır. Oksihemoglobin disosiasyon eğrisi (ODC), O2 değişiminin etkilerini anlamak için çok önemlidir. Bu çalışmanın amacı; COVID-19 hastalarında ODC ve hemoglobin (Hb) arasındaki oksijen taşıma kapasitesi ilişkisini değerlendirmektir. Gereç ve Yöntemler: Çalışmada, yoğun bakım ünitesi (YBÜ) COVID-19, yoğun bakım dışı (non-YBÜ) COVID-19 ve COVID-19 olmayan diğer solunum sıkıntılı toplam 686 hastanın arter kan gazından elde edilen veriler retrospektif olarak incelenerek oksihemoglobin eğrileri oluşturuldu. Bulgular: COVID-19 tanılı ve diğer solunum sıkıntılı hastaların ODC’lerinin standart eğriye göre hafif sağa eğilim gösterdiği belirlendi. YBÜ grubunun P50 değeri, diğer gruplara kıyasla daha yüksekti (ortalama: 30,74 mmHg, n=131, p=0,047). Kontrole kıyasla nonYBÜ grubunun; oksihemoglobin yüzdesi (ortalama: %65,44 vs %69,81, p=0,015), PO2 ’ı (46,98 mmHg vs 48,98 mmHg, p=0,001), glikoz miktarı (ortalama: 163,39 mg/dL vs 195,36 mg/dL, p=0,002) ve pH’sı (medyan: 7,38 vs 7,41, p=0,007) daha yüksek iken karboksihemoglobin yüzdesi (ortalama: %1,66 vs %1,13, p=0,000), PCO2 ’ı (42,02 mmHg vs 39,44 mmHg, p=0,015), potasyum (ortalama: 4,33 mmol/L vs 4,04, p=0,026) ve sodyum (ortalama: 138,10 mmol/L vs 135,80 mmol/L, p=0,000) seviyesi daha düşüktü. YBÜ grubunun methemoglobin yüzdesi ise diğer gruplara kıyasla daha düşüktü (p=0,000). Sonuç: COVID-19 ve diğer solunum sıkıntılı hastaların ODC’si hafif sağa kaymaktadır, bu sonuç hastaların kısmen solunum güçlüğü çektiğini göstermektedir.

Cezairli, Burak; Taskesen, Fatih; Coskun, Ummugulsum; Cezairli, Neslihan Seyhan; Tosun, Emre

The treatment modalities for odontomas are generally depend on the tumors size. Small and medium lesions can usually be removed easily allowing preservation of surrounding anatomical structures. In our study, we reported a conservative surgical treatment of a large complex odontoma. A 19-year-old woman was referred to our clinic after an incidentally observed lesion on her right mandibular angle. The patient was symptom-free at the time of visit. Computed tomography (CT) images showed a mass with a size of 3.5 cm x 3 cm x 2 cm. CT sections and tridimensional images showed partially eroded buccal and lingual cortex. Surgical treatment was indicated with an initial diagnosis of compound odontoma. The lesion removed after sectioning with bur and maxillo-mandibular fixation (MMF) were not thought to be necessary while the buccal and lingual cortexes were mostly reliable for preventing a fracture. In our case, the size of the odontoma was suitable for a conservative treatment method and with this modality we managed to prevent a possible fracture and eliminate the disadvantages of MMF.

Bilir, Ozlem; Ersunan, Gokhan; Kalkan, Asim; Eden, Arif Onur

Objective: The aim of this study was to evaluate pre-training perspectives of the staff, who were scheduled to undertake triage in hospitals of Ministry of Health, working in collaboration with university hospitals on the triage system. Materials and Methods: This study included 33 workers who volunteered to participate. A questionnaire consisting of 19 questions on demographic characteristics and perspective on triage system was prepared. Results: Of the sample group, 75.8% were female and the average age was 28.94 +/- 6.11 years. All participants in the study considered that emergency department was overused by the society. When the percentage of patients who were admitted to the emergency department for causes complying with the emergency criteria was questioned, 54.5% stated that 10% or less of the admissions were actual emergency cases. Triage practice was suggested by 54.5% of the participants to reduce crowding in emergency departments. Conclusion: Triage practice which allows correct identification of patients who need the most urgent intervention in emergency departments is important in terms of both giving the right care to the right patients and quality of service provided by healthcare workers. Community-based education as well as training of workers on this subject is a necessity.

Ersunan, Gökhan; Kalkan, Asım; Bilir, Ozlem; Eden, Arif Onur

Objective: The aim of this study was to evaluate pre-training perspectives of the staff, who were scheduled to undertake triage in hospitals of Ministry of Health, working in collaboration with university hospitals on the triage system.Materials and Methods: This study included 33 workers who volunteered to participate. A questionnaire consisting of 19 questions on demographic characteristics and perspective on triage system was prepared. Results: Of the sample group, 75.8% were female and the average age was 28.94±6.11 years. All participants in the study considered that emergency department was overused by the society. When the percentage of patients who were admitted to the emergency department for causes complying with the emergency criteria was questioned, 54.5% stated that 10% or less of the admissions were actual emergency cases. Triage practice was suggested by 54.5% of the participants to reduce crowding in emergency departments. Conclusion: Triage practice which allows correct identification of patients who need the most urgent intervention in emergency departments is important in terms of both giving the right care to the right patients and quality of service provided by healthcare workers. Community-based education as well as training of workers on this subject is a necessity.