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Şimşek E, Karaca OG, Çetinkaya F, Can F, Günaydın S. Incidentally discovered cold hemagglutinins within autologous blood bag and cardioplegia line in a patient with a recent history of COVID-19 undergoing coronary artery surgery. Perfusion 2024; 39:436-438. [PMID: 36475516 PMCID: PMC9732487 DOI: 10.1177/02676591221141323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Cold agglutinin disease (CAD) is a rare autoimmune disorder characterized by destruction (hemolysis) of erythrocytes. In CAD, autoantibodies that cause agglutination at temperature of optimum +3-+4 ℃ degree cause symptoms. It is known that CAD often occurs after viral infections. Also, it has been reported in case reports that COVID-19 disease can cause CAD. CASE REPORT 46-year-old male patient with a history of diabetes mellitus and hypertension presented to outpatient clinic in our department to have CABG surgery. He recovered from COVID-19 disease 1.5 months ago. Cardiopulmonary bypass was initiated and the cross-clamp was placed and antegrade Delnido cardioplegia solution was started to be given at +4 ℃. It was observed that the cardioplegia line was agglutinated. On the other hand, it was seen that the autologous blood taken by the anesthesiologist was also agglutinated and formed air bubbles and became unusable. X-clamp was removed and the heart rhythm recovered. The patient was consulted to hematology during postoperative intensive care follow-ups. The cold agglutinin test performed at of +4 ℃ was reported as positive. In this case, we associated the CAD with covid-19 for three main reasons. First one, the patient's complaints about CAD started after COVID-19 disease. Secondly, in the national health archive, the patient's pre-COVID-19 blood tests were completely normal but it was seen that LDH increased and RBC-HCT incompatibility started after COVID-19. As the third, when we search the literature, we have seen the COVID-19 related CAD in many case reports published by hematologists. CONCLUSION With the rare cold agglutinin disease, it seems that we will encounter it more often after the COVID-19 pandemic. Except for deep hypothermia, the most important problem is seen during cardioplegia administration. Therefore, non-blood cardioplegia can be lifesaving.
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Affiliation(s)
- Erdal Şimşek
- Department of Cardiovascular
Surgery, Ankara City Hospital, Ankara, Turkiye
| | - Okay G Karaca
- Department of Cardiovascular
Surgery, Ankara City Hospital, Ankara, Turkiye
| | - Ferit Çetinkaya
- Department of Cardiovascular
Surgery, Ankara City Hospital, Ankara, Turkiye
| | - Ferda Can
- Department of Hematology, Ankara City Hospital, Ankara, Turkiye
| | - Serdar Günaydın
- Department of Cardiovascular
Surgery, Ankara City Hospital, Ankara, Turkiye
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Çetinkaya F, Doğan K, Taş A. Should varicocele screening be conducted in men diagnosed with chronic venous insufficiency? A prospective study. Kardiochir Torakochirurgia Pol 2024; 21:35-38. [PMID: 38693978 PMCID: PMC11059024 DOI: 10.5114/kitp.2024.138486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/30/2023] [Indexed: 05/03/2024]
Abstract
Introduction It has been previously proposed in numerous studies that chronic venous insufficiency (CVI) has similar pathogenesis to varicocele in males. Varicocele has been identified as the most common cause of infertility in men, accounting for 40% of cases. Aim This study investigates whether varicocele screening should be conducted in patients with CVI and, if so, which patients should undergo such screening. Material and methods The study included 102 adult male patients with venous insufficiency complaints who presented to the cardiovascular surgery clinic between January 2023 and June 2023. Data were prospectively collected through medical history interviews and Doppler ultrasound measurements performed by a single radiologist. The relationship between non-normally distributed measurement data of the two groups was evaluated using the Mann-Whitney U test, while the association between categorical variables was assessed using the χ2 test. ROC analysis was employed for determining predictive value. A type 1 error level of α = 0.05 was adopted. Results The mean left great saphenous vein (GSV) diameter of those with varicocele (6.6 ±2.3) was significantly larger compared to the mean left GSV diameter of those without varicocele (5.3 ±2.6) (p = 0.004). The area under the ROC curve for left GSV diameter was 67% (p = 0.005). When varicocele screening is performed in patients with a left GSV diameter of 5.35 cm and above, sensitivity is 71.4% and specificity is 61.2%. Conclusions There is a significant association between left GSV diameter and varicocele (p = 0.004). Varicocele screening can be carried out with 71.4% sensitivity in adult male patients with a left GSV diameter of 5.35 cm and above. Both cardiovascular surgeons and radiologists can conduct varicocele screening by measuring pampiniform veins in patients with a left GSV diameter of 5.35 cm and above. This approach has the potential to reduce the incidence of varicocele and associated infertility.
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Affiliation(s)
- Ferit Çetinkaya
- Department of Cardiovascular Surgery, Ağrı Education and Research Hospital, Ağrı, Turkiye
| | - Kamil Doğan
- Department of Radiology, Ağrı Education and Research Hospital, Ağrı, Turkiye
| | - Ayşe Taş
- Department of Public Health, Battalgazi District Health Directorate, Malatya, Turkiye
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Çetinkaya F, İşcan HZ, Türkçü MA, Mavioğlu HL, Ünal EU. Predictive Parameters of Type 1A Endoleak for Elective Endovascular Aortic Repair: A Single-Center Experience. Ann Vasc Surg 2024; 98:108-114. [PMID: 37453469 DOI: 10.1016/j.avsg.2023.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/30/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND One of the most important factors that affects the success of Endovascular Aortic Repair (EVAR) treatment is the morphology of the neck of the aneurysm. Today, EVAR can be performed even in patients who do not meet the Instruction For Use criteria with hostile neck risk factors; thanks to the developing experience and technology. Our aim in this study was to determine risk factors for Type 1a endoleaks in patients who underwent EVAR and predictive factors for Type 1a endoleaks in patients with combinations of these risk factors. METHODS Patients who underwent elective EVAR for infrarenal abdominal aortic aneurysm in our medical center between July 2016 and January 2021 were enrolled. Of these 244 patients, 180 patients with documented preoperative and postoperative computed tomographic angiography results and a follow-up of at least 1 year were included in the study. The Mann-Whitney U test and Student's t-test were used to assess the relationship between nominal data and numerical values, and the t-test and Wilcoxon test were used to compare dependent groups. Logistic regression analysis was performed to model risk factors associated with endoleaks. RESULTS The results showed that a neck length less than 15 mm increased the development of type 1a endoleak by 10.4 times (P < 0.001). Furthermore, a neck diameter more than 28 mm increased the development of type 1a endoleak by 21.9 times (P = 0.04). A conical neck structure (gradual neck dilation > 2 mm) increased the development of type 1a endoleaks 4.8 times (P = 0.04). The presence of calcification (> 150 Hounsfield Unit and > 2 mm) in the neck increased the risk of type 1a endoleaks fourfold (P = 0.04). Hostile neck parameters were analyzed and patients with only 1 parameter (n = 69) had a 7.2% type 1a endoleak rate, while patients with 2 parameters (n = 15) had 26.6% and patients with more than 2 parameters (n = 11) had 45.5% type 1a endoleak rate. CONCLUSIONS Morphologic features of the neck structure of the aneurysm are among the most important parameters that affect the success of EVAR treatment. Alternative treatments should be considered in patients with more than 1 unfavorable neck parameter.
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Affiliation(s)
- Ferit Çetinkaya
- Cardiovascular Surgery Clinic, Ankara City Hospital, Ankara, Turkiye.
| | - Hakkı Zafer İşcan
- Cardiovascular Surgery Clinic, Ankara City Hospital, Ankara, Turkiye
| | - Mehmet Ali Türkçü
- Cardiovascular Surgery Clinic, Ankara City Hospital, Ankara, Turkiye
| | | | - Ertekin Utku Ünal
- Department of Cardiovascular Surgery, School of Medicine, Ufuk University, Ankara, Turkiye
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Baydar Toprak O, Akpolat T, Uzun O, Pınar Deniz P, Kokturk N, Varol A, Guzel E, Ercelik M, Gultekin O, Guner R, Turan S, Gökbulut Bektaş Ş, Coskun N, Bakan N, Nuri Yakar M, Eren Kutsoylu O, Ergan B, Argun Barış S, Başyiğit I, Boyacı H, Çetinkaya F, Çolak H, Aykac N, Baran Ketencioğlu B, Türe Yüce Z, Akkaya Isık S, Serap Yılmaz E, Karaoğlanoğlu S, Berik Safci S, Ozkan G, Kose N, Kizilirmak D, Havlucu Y, Nural S, Kerget F, Sunal Ö, Yuksel A, Bestepe Dursun Z, Deveci F, Kuluozturk M, Ataoglu O, Dursun M, Keskin S, Emin Sezgin M, Aktepe Sezgin EN, Eser F, Akyildiz L, Selim Almaz M, Kayaaslan B, Hasanoğlu I, Bayrak M, Gümüş A, Sağcan G, Cuhadaroglu C, Kucuk H, Onyilmaz T, Mete B, Kilinc O, Oya Itil B. COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission. Eur Rev Med Pharmacol Sci 2023; 27:2132-2142. [PMID: 36930513 DOI: 10.26355/eurrev_202303_31586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.
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Affiliation(s)
- O Baydar Toprak
- Department of Chest Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Özen A, Yılmaz M, Yiğit G, Civelek İ, Türkçü MA, Çetinkaya F, Ünal EU, İşcan HZ. Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm? BMC Cardiovasc Disord 2021; 21:551. [PMID: 34798809 PMCID: PMC8603579 DOI: 10.1186/s12872-021-02366-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the value of Glasgow Aneurysm Score (GAS) in predicting long-term mortality and survival in patients who have undergone endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). METHODS A retrospective single-center study of 257 patients with non-ruptured AAA undergoing EVAR between January 2013 and 2021. GAS scores were compared between the survivors (group 1) and the long-term mortality (group 2) groups. Cox regression analysis was used to determine independent predictors of late mortality. Receiver operating characteristic curve (ROC) analysis was used to determine the optimum cut-off values of GAS values to determine the effect on late-mortality. Survival analysis was conducted using Kaplan-Meier. RESULTS The study included 257 patients with a mean age of 69.75 ± 7.75 (46-92), who underwent EVAR due to AAA. Average follow up period was 18.98 ± 22.84 months (0-88). Fourty-five (17.8%) mortalities occured during long-term follow-up. A past medical history of cancer resulted in a 2.5 fold increase in risk of long-term mortality (OR: 2.52, 95% CI 1.10-5.76; p = 0.029). GAS values were higher in group 2 compared to group 1 (81.02 ± 10.33 vs. 73.73 ± 10.46; p < 0.001). The area under the ROC curve for GAS was 0.682 and the GAS cut-off value was 77.5 (specificity 64%, p < 0.001). The mortality rates in patients with GAS < 77.5 and GAS > 77.5 were: 12.8% and 24.8% respectively (p = 0.014). Every 10 point increase in GAS resulted in approximately a 2 fold increase in risk of long-term mortality (OR: 1.8, 95% CI 1.3-2.5; p < 0.001). Five year survival rates in patients with GAS < 77.5 and > 77.5 were 75.7% and 61.7%, respectively (p = 0.013). CONCLUSIONS The findings of our study suggests that an increase in GAS score may predict long-term mortality. In addition, the mortality rates in patients above the GAS cut-off value almost doubled compared to those below. Furthermore, the presence of a past history of cancer resulted in a 2.5 fold increase in long-term mortality risk. Addition of cancer to the GAS scoring system may be considered in future studies. Further studies are necessary to consolidate these findings.
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Affiliation(s)
- Anıl Özen
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey.
| | - Metin Yılmaz
- Department of Cardiovascular Surgery, VM Medicalpark Hospital, Ankara, Turkey
| | - Görkem Yiğit
- Department of Cardiovascular Surgery, Yozgat City Hospital, Yozgat, Turkey
| | - İsa Civelek
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Ali Türkçü
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
| | - Ferit Çetinkaya
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
| | - Ertekin Utku Ünal
- Department of Cardiovascular Surgery, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Hakkı Zafer İşcan
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
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Yiğit G, Özen A, Çetinkaya F, Ünal EU, İşcan HZ, Birincioğlu CL, Sarıtaş A. Early and Late-Term Follow-Up Results of Patients Diagnosed with Aortic Aneurysm or Aortic Dissection with Aortic Regurgitation Undergoing Aortic Valve Repair or Valve-Sparing Aortic Surgery. Braz J Cardiovasc Surg 2021; 36:192-200. [PMID: 33113319 PMCID: PMC8163274 DOI: 10.21470/1678-9741-2020-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Valve-reimplantation and remodelling techniques used in aortic reconstruction provide successful early, mid, and long-term results. We present our early and late-term experience with 110 patients with aortic regurgitation (AR) who underwent aortic valve repair (AVr) or valve-sparing aortic root surgeries (VSARS) due to aortic dissection or aortic aneurysm. METHODS Nine hundred eighty-two patients who underwent aneurysm or dissection surgery and aortic valve surgery between April 1997 and January 2017 were analysed using the patient database. A total of 110 patients with AR who underwent AVr or VSARS due to aortic dissection or aortic aneurysm were included in the study. RESULTS In the postoperative period, a decrease was observed in AR compared to the preoperative period (P<0.001); there was an increase in postoperative ejection fraction (EF) compared to the preoperative values (P<0.005) and a significant decrease in postoperative left ventricle diameters compared to the preoperative values (P<0.001). Kaplan-Meier analysis revealed one, two, four, and five-year freedom from moderate-severe AR as 95%, 91%, 87%, and 70%, respectively. Freedom from reoperation in one, two, and five years were 97.9%, 93.6%, and 81%, respectively. Eight patients (7.4%) underwent AVr during follow-up. Out of the remaining 100 patients, 13 (12%) had minimum AR, 52 (48%) had 1st-2nd degree AR, and 35 (32%) had 2nd-3rd degree AR during follow-up. CONCLUSION For the purpose of maintaining the native valve tissue, preserving the EF and the left ventricular end-diastolic diameter, valve-sparing surgeries should be preferred for appropriate patients.
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Affiliation(s)
- Görkem Yiğit
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
| | - Anıl Özen
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
| | - Ferit Çetinkaya
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
| | - Ertekin Utku Ünal
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
| | - Hakki Zafer İşcan
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
| | | | - Ahmet Sarıtaş
- Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey
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Kaya A, Altınel N, Karakaya G, Çetinkaya F. Knowledge and attitudes among patients with asthma and parents and physicians towards influenza vaccination. Allergol Immunopathol (Madr) 2017; 45:240-243. [PMID: 27789065 DOI: 10.1016/j.aller.2016.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 08/01/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Influenza is an infectious disease, dangerous for all people, especially for some risk groups such as patients with chronic diseases and health care workers. But most of the people under the risk of influenza, including health care workers are not immunised because of misinformation. In this study, we aimed to determine the knowledge, beliefs and attitudes of patients with allergic rhinitis and asthma and parents of such children related to influenza vaccination. Attitudes and beliefs of physicians treating these patients about influenza vaccination were also investigated. METHODS Two different questionnaires consisting of various items related to influenza vaccine were distributed to physicians and patients and parents of children with asthma and allergic disease. RESULTS The physicians group consisted of 189 physicians from various branches. About one third of physicians from various branches reported that they did not believe the vaccine's effectiveness. Most of the participating physicians did not immunise themselves with influenza vaccination despite the fact that any patient of theirs had died due to influenza infection. Although nearly half of the 183 patients had been vaccinated with influenza vaccine, only 27% of adults and 11.7% of children had been vaccinated annually. CONCLUSIONS Asthmatic patients are not immunised regularly with influenza vaccine due to misperceptions about vaccine effectiveness and fear of adverse effects. Another important reason of this is that most the physicians caring for these patients neither immunise themselves nor recommend the vaccine to their patients.
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Affiliation(s)
- A Kaya
- Sisli Etfal Education and Research Hospital, Department of Pediatric Immunology and Allergy, Istanbul, Turkey
| | - N Altınel
- Bakırkoy Dr. Sadi Konuk Education and Research Hospital, Department of Pediatric Immunology and Allergy, Istanbul, Turkey
| | - G Karakaya
- Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
| | - F Çetinkaya
- International Hospital, Yesilkoy, Istanbul, Turkey.
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İşlek İ, Küçüködük Ş, Çetinkaya F, Cürses N. Effects ofAscarisinfection on iron absorption in children. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1993.11812798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Çetinkaya F, Sezgin G, Aslan OM. Dentists' knowledge about anaphylaxis caused by local anaesthetics. Allergol Immunopathol (Madr) 2011; 39:228-31. [PMID: 21236550 DOI: 10.1016/j.aller.2010.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 06/30/2010] [Accepted: 07/05/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND IgE-mediated systemic reactions to local anaesthetics may be seen--although rarely--by dentists. However, it is not known whether dentists are familiar with symptoms, signs and management of anaphylaxis. METHODS In this study we aimed to evaluate knowledge of dentists of the symptoms and signs and current treatment of anaphylaxis. For this, some dentists working in their private offices in Istanbul were asked to complete an anonymous questionnaire with 15 questions related to anaphylaxis. RESULTS A total of 86 dentists agreed to participate in the study. None of the attendants were completely aware of the symptoms and signs of anaphylaxis. About half of the attendants (48.8%) knew epinephrine as the first drug in the treatment of anaphylaxis and keep it in their offices (55.6%), but only one third of the dentists (31.5%) preferred intramuscular route as the most effective route for epinephrine injection. CONCLUSION Our data show that the level of dentists' knowledge of local anaesthetics allergy and anaphylaxis is inadequate. This may endanger patients' lives. An educational programme that may improve general dentists' knowledge about local anaesthetics allergy and anaphylaxis is urgently necessary.
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Affiliation(s)
- F Çetinkaya
- Department of Pediatrics and Pediatric Allergy, Maltepe University School of Medicine, Istanbul, Turkey.
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Okanli A, özyigit N, Çetinkaya F, Çelebioglu A, Gozum S. P85 Anxiety, depression and anger of Turkish men whose wives were diagnosed with breast cancer. Eur J Oncol Nurs 2010. [DOI: 10.1016/s1462-3889(10)70148-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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