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Background and Objective: To compare the therapeutic effects of ketamine alone or ketamine plus propofol on analgesia, sedation, recovery time, side effects in premedicated children with midazolam-ketamine-atropin who are prepared circumcision operation., Methods: 60 American Society of Anaesthesiologists physical status I-II children, aged between 3 and 9 years, undergoing circumcision operations under sedation were recruited according to a randomize and double-blind institutional review board-approved protocol. Patients were randomized into two groups via sealed envelope assignment. Both groups were administered a mixture of midazolam 0.05mg/kg+ketamine 3mg/kg+atropine 0.02mg/kg intramuscularly in the presence of parents in the pre-operative holding area. Patients were induced with propofol-ketamine in Group I or ketamine alone in Group II., Results: In the between-group comparisons, age, weight, initial systolic blood pressure, a difference in terms of the initial pulse rate was observed (p>0.050). Initial diastolic blood pressure and subsequent serial measurements of 5, 10, 15, 20thmin, systolic blood pressure, diastolic blood pressure and pulse rate in ketamine group were significantly higher (p<0.050)., Conclusion: Propofol-ketamine (Ketofol) provided better sedation quality and hemodynamy than ketamine alone in pediatric circumcision operations. We did not observe significant complications during sedation in these two groups. Therefore, ketofol appears to be an effective and safe sedation method for circumcision operation., (Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.)

Background and Objectives: Evaluating the incidence of nosocomial and invasive device-related infections enables the comparison of the health care associated infection (HAI) between the intensive care units of different hospitals and different units in the same hospital., Material and Methods: A retrospective surveillance study was performed to identify nosocomial infections, device-related infections rates, and causal agents from January 2007 through December 2010 in the Anesthesiology Intensive care unit (ICU). HAI were defined according to the CDC (Centers for Disease Control and Prevention) criteria, and invasive device-related infections were defined according to National Nosocomial Infection Surveillance System (NNIS) criteria., Results: During a two-year period, 939 patients were analyzed throughout a total of 7,892 patient-days. The rates of HAI were 53% in 2007, 29.15% in 2008, 28.85% in 2009 while 16.62% in 2010. Most common HAI was blood stream infection. The rate of soft tissue and skin infection was the second most common. Overall, the most common agents were Gram(-) 56.68%, Gram(+) 31.02% and Candida spp 12.3% among patients with nosocomial infections., Conclusions: The incidence of HAI in the ICU of our hospital was high, compared to the Turkish overall rates obtained at the Refik Saydam Center in 2007. When the rates of device-related infections between 2007 and 2008 were compared, they were higher in 2007. The rates of device-related infections were diminished in 2008 to below-national mean rates by infection control measures. Since the rate of urinary catheter-related infections are still high, we should exert continuous efforts for infection control., (Copyright © 2013 Elsevier Editora Ltda. All rights reserved.)

Background and Objectives: Evaluating the incidence of nosocomial and invasive device-related infections enables the comparison of the health care associated infection (HAI) between the intensive care units of different hospitals and different units in the same hospital., Material and Methods: A retrospective surveillance study was performed to identify nosocomial infections, device-related infections rates, and causal agents from January 2007 through December 2010 in the Anesthesiology Intensive care unit (ICU). HAI were defined according to the CDC (Centers for Disease Control and Prevention) criteria, and invasive device-related infections were defined according to National Nosocomial Infection Surveillance System (NNIS) criteria., Results: During a two-year period, 939 patients were analyzed throughout a total of 7,892 patient- days. The rates of HAI were 53% in 2007, 29.15% in 2008, 28.85% in 2009 while 16.62% in 2010. Most common HAI was blood stream infection. The rate of soft tissue and skin infection was the second most common. Overall, the most common agents were Gram(-) 56.68%, Gram(+) 31.02% and Candida spp 12.3% among patients with nosocomial infections., Conclusions: The incidence of HAI in the ICU of our hospital was high, compared to the Turkish overall rates obtained at the Refik Saydam Center in 2007. When the rates of device-related infections between 2007 and 2008 were compared, they were higher in 2007. The rates of device- related infections were diminished in 2008 to below-national mean rates by infection control measures. Since the rate of urinary catheter-related infections are still high, we should exert continuous efforts for infection control., (Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.)