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INTRODUCTION Nowadays, with the rise in average life expectancy, the rate of hospitalization of the elderly population in intensive care unit (ICU) is gradually increasing. Unfortunately, there are no ideal combination of prognostic factors predicting the mortality in older patients admitted to the ICU. In the present study, we aim to determine the prognostic factors and their impacts on short-time mortality in very elderly critically ill patients. MATERIALS AND METHODS This retrospective cohort study was performed between January 2019 and February 2020. We included 133 patients aged ?80 years and hospitalized ?24 hours in the ICU. RESULTS A total of 133 critically ill patients enrolled in the present study. And, the median age of the patients was 85 (80-106) years. 30-day and overall ICU mortality rates were found 30.1% and 34.6% respectively. The patients were grouped as survivors (n=94) and non-survivors (n=39). Hospital length of stay before the ICU admission was found significantly longer in non-survivors (p=0.001). Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score were significantly higher in those who died within 30 days (p

Introduction: COVID-19 pneumonia typically presents with high fever, cough, and shortness of breath and on thorax computed tomography (CT) peripheral ground glass opacities help the diagnosis. Although typical imaging findings for COVID-19 pneumonia are specified in thorax CT, these findings can be confused with other diseases. The aim of this study is to investigate the roles of radiological imaging and laboratory findings in the differential diagnosis of COVID-19 pneumonia and acute heart failure (AHF). Materials and Methods: In the present study, 74 patients who admitted to the emergency department with respiratory distress during the pandemic period and received a diagnosis of COVID-19 pneumonia and AHF were included. Laboratory data and radiological findings of the patients, at the time of admission, were evaluated. Result: On admission, there was no difference in age, gender between two groups. However, COVID-19 exposure history was found significantly higher in COVID-19 pneumonia patients group (p

Gebelikle birlikte kan hacmi, kalp debisi, kalp hızı artarken sistemik vasküler direnç azalır. Hemodilüsyon ve fizyolojik anemi görülür. Bu değişiklikler sağlıklı kadınlar tarafından tolere edilebilirken kalp hastalığı olan gebelerde kalp üzerinde ayrı bir yük oluşturmaktadır. Bunun sonucunda peripartum morbidite ve mortalite artmaktadır. Bu hastaların anestezi seçimi kalp hastalığının tipi, kullanılan ilaçlar, cerrahinin aciliyetine göre değişmektedir. 32 yaşında olan hastamızın 4 gebelik, 2 doğum ve 2 abortusu mevcuttu. Hastamıza 39 haftalık gebeliği ne-deniyle sezeryan planlanmıştı. Preoperatif mu-ayenesinde 5 yıl önce perkütan mitral balon valvüloplasti geçirdiği öğrenildi. Ekokardiyog-rafide mitral kapak alanı 1 cm2 olduğu, 30 aort yetmezliği ve pulmoner arter basıncı 35 mm Hg olarak tespit edildi. Hastaya lomber 4-5 verteb-ra aralığından oturur pozisyonda kombine spi-nal–epidural anestezi yapıldı. Epidural katater yoluyla perioperatif ve postoperatif anestezi ve analjezi sağlandı. Sonuç olarak kalp hastalığı olan gebelerde sezaryen uygulamasında düşük doz kombine spinal-epidural anestezi ile hemo-dinaminin daha stabil olacağını ve epidural ka-tater yoluyla da postoperatif analjezi sağlanarak taşikardi, hipertansiyon, ajitasyon gibi olumsuz etkilerin önleneceğini düşünüyoruz., During pregnancy, while the blood volume, cardiac output, heart rate increase, the systemic vascular resistance decreases. Hemodilution and physiological anemia can be seen.These changes can be tolerated by pregnant healthy women but they can be an overload on the heart with pregnant women who have cardiac diseases. For this reason the peripartum morbidity and mortality increase. The selection of anesthesia in these patients varies according to the type of cardiac disease, drugs used,and to the urgency of the surgery. Our case was a 32 year-old who had four gravity, two parity and two abortions. Caesarean section was planned for the patient at 39 weeks of gestation In the preoperative examination we learned that she had underwent a percutaneous mitral balloon valvuloplasty five years ago. In echocardiography the mitral valve area was 1 square centimeter, 30 aortic insufficiency was detected and pulmonary artery pressure was 35 mm Hg. The spinal-epidural anesthesia was performed through the L4-L5 intervertebral space with the patient in the sitting position. Perioperative anesthesia and analgesia was provided by epidural catheter. As a result we believe that the low-dose combined spinal-epidural anaesthesia will be more stable on the hemodynamics in the implementation of cesarean section in pregnant women with heart disease and we believe that providing postoperative analgesia via an epidural catheter may prevent the adverse effects such as tachycardia, hypertension and agitation.

Ankilozan spondilit seronegatif spondiloartropatilergrubundan ağrılı, kronik, inflamatuar bir hastalıktır. Ankilozan spondilit’lihastalarda zor entübasyon ihtimali, eşlik edenhastalıkların varlığı ve nöroaksial blok uygulama zorluklarını hatırlamak çokönemlidir.Biz bu olgu sunumunda 32 yaşında, 165 cm boyunda ve 96 kgağırlığında 40 haftalık gebe hastayı inceledik. Ağız açıklığı 4 cm, tiromentalmesafe 7 cm ve mallampati skoru 2 idi. Hastanın 4 yıldır ankilozan spondilit tanısı mevcuttu. Hastanın boyun ekstansiyonunda ve lomber bölge fleksiyonundakısıtlılık tespit edildi. Gebelik esnasında gestasyonel diyabet tanısıile takip edildiğini öğrenildi. Hastayaoturur pozisyonda tek seferde sağ paramedian yaklaşımla spinal anesteziuygulandı. İşlem sırasında ve sonrasında herhangi bir komplikasyon olmadı., Ankylosingspondylitis is a painful, chronic, inflammatory disease in the group ofseronegative spondyloarthropathies. It is very important to remember thepossibility of difficult intubation, the presence of concomitant diseases andneuraxial block implementation challenges in AS patients. In thisarticle we presented a case report 32-year-old, 165 cm tall, 96 kg, 40 weeks pregnantpatient. The mouth opening was 4 cm, mallampati score was II and thethyromental distance was 7cm. The patientwas diagnosed as ankylosing spondylitis for 4 years. Limitations were identified in the patient's neck extensionand flexion of the lumbar region. It is learned that she was being followedwith diagnosis of gestational diabetes during pregnancy. Spinal anesthesia was administered to the patient in seatedposition with right paramedian approach at once. There were no complications during and after the procedure.