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Yayın Patients with toxic epidermal necrolysis in intensive care unit of Regional Burn Center [Bölge Yanik Merkezi· yogun bakim üni·tesi·'nde toksi·k epi·dermal nekroli·zi·s'li· hastalar](Anestezi Dergisi, 2014) Kuzucuoglu T.; Saracoglu A.; Yakupoglu S.; Erhan T.; Ersoy B.; Demirhan R.Objective: Toxic epidermal necrolysis (TEN) is a potentially life-threatening rare disorder, resulting in possible sepsis and death. The aim of this study is to determine the mortality rate, associated comorbidities, the clinical and epidemiological characteristics of 12 TEN patients hospitalized in our burn unit. Method: Twelve patients diagnosed with TEN and admitted to the burn intensive care unit were included in the study. Age, gender, medication, percentage and depth of skin burn damage, APACHE II scores, surgical interventions, hospitalization time, the duration of mechanical ventilation, complications, mortality and morbidity rates of patients were documented in a retrospective manner. The Scorten Scale was utilized to determine the mortality rate of the patients. Results: Mean age was 35±5.7 years. The ratio of males to females was 5:7 and the average APACHE II score was 15.4±3.2. Epidermal detachment was greater than 75% of the body surface area with a mean hospitalization time of 17±1.2 days. One patient had a history of paracetamol and etodolac, 3 had phenytoin medication. TEN symptoms were seen as a result of anti-tuberculosis treatment in another patient and appeared in four patients after treatment with sultamicilin. Other patients had an unknown etiology. Mean duration of mechanical ventilation support was 3.2±0.7 days. The mortality rate was 16.6% (2/12). Conclusion: Due to the high risk of mortality, patients with TEN may require different approaches and management strategies. We concluded that early identification and interception of the responsible drug and the provision of a specialized supportive care in a burn unit may reduce the mortality rate for toxic epidermal necrolysis.Yayın Videothoracoscopic approach to recurrence primary spontaneous pneumothorax: Using of electrocoagulation in small bulla/blebs(2009) Orki A.; Demirhan R.; Ciftci H.; Coskun T.; Kutlu C.A.; Arman B.Objective: To evaluate the effectiveness of electrocoagulation of bullae/blebs and apical pleurectomy via videothoracoscopic approach. Methods: We reviewed 42 patients who underwent Videoassisted thoracoscopy (VATS) procedure for recurrence primary spontaneous pneumothorax (PSP) from 200022006. There were 30 male and 12 female patients with a median age of 30 years. The percentage of pneumothorax was calculated median of 60% (British Thoracic Society Guideline - 2003). Thirty-two (76.2%) bullae/blebs were observed with the median diameter of 15 mm (5-30). Results: Bulla ablation via cauterisation and apical pleurectomy was performed in 32 patients. Ten patients underwent only apical pleurectomy/abrasion because in this group there was not any either bulla or bleb could be found. The median duration of drainage time was 3 days. There was no mortality and complications occurred in five (11.9%) patients. Only two (4.76%) recurrence occurred during the 52 months (5 to 76) median follow-up period. Conclusion: Videothoracoscopic bulla ablation with apical pleurectomy is a safe method for recurrence PSP. Especially, if the bulla or bleb is smaller than 20 mm the ablation via cauterisation reduces the expenses of VATS procedure by avoiding the use of stapler devices. © 2009 Association of Surgeons of India.