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Öğe An alternative treatment approach in tetanus: Botulinum toxin(SAGE PUBLICATIONS INC, 2015) Demir, Nazlim Aktug; Sumer, Sua; Ural, Onur; Ozturk, Serefnur; Celik, Jale BengiTetanus is a preventable infectious disease caused by tetanus toxin (tetanospasmin) produced by Clostridium tetani. Tetanus is still an important health problem in low- and middle-income countries (LMICs). Botulinum toxin administration is a treatment approach that has been used in recent years to reduce rigidity and spasms in tetanus patients. This case report focuses on its efficacy.Öğe Clinical management of severe propafenone intoxication(AVES, 2015) Kara, Inci; Celik, Jale Bengi; Apiliogullari, Seza; Aydogan, EyupWe present a case of cardiopulmonary arrest after propafenone intoxication in a patient with normal cardiovascular function. She was admitted to the critical care unit within 40 min after 9000 mg propafenone consumption. Main findings were cardiac arrest, instable hemodynamics, and atrioventricular junction block. For its management, transient pacing was performed with catecholamine infusion. We achieved a good outcome in this case because of rapid resuscitation and aggressive treatment with monitoring and supportive care, including mechanical ventilation.Öğe Clinical Outcome Following the Use of Inadequate Solutions for Continuous Veno-Venous Hemodiofiltration(INFORMA HEALTHCARE, 2008) Celik, Jale Bengi; Topal, Ahmet; Kartal, Elmas; Yosunkaya, AlperBackgrounds. A short time ago, commercially available diafiltration and replacement fluids could be found o n the hospital in Turkey. Instead, peritoneal dialysis solution (PDS) for continue veno-venous hemodiafiltration (CVVHDF) therapy and normal saline as replacement fluid are used. In this retrospective study, we investigated the effects of PDS and bicarbonate-buffered hemofiltration solution (Bic-HFS). Methods. We did a retrospective chart review of 24 patients treated with continue renal replacement therapy (CRRT) between January 2004 and February 2008. Peritoneal dialysis solution (PDS) was used in 14 patients, and bicarbonate-buffered hemodialysis solution (bic-HFS) was used in 10 patients. Results. Demographic data, laboratory findings, and mortality rate were similar both groups. Blood glucose and lactate levels were higher in the PD group than the bic-HFS group (p 0.05). Hyperglycemia occurred more frequent in the PDS group than in the bic-HFS group (64% versus 30%, respectively; p 0.05). Metabolic acidosis occurred in eight patients (57%) in the PDS group and three patients (30%) in the bic-HFS group (p 0.05). Hypotension was higher in the PDS group (10, 71%) than in the bic-HFS group (3, 30%; p 0.05). Conclusion. Using PDS fluid as dialysate for CVVHDF therapy is not a preferable solution because of the metabolic disturbances that it can cause.Öğe A COMPARISON OF RECOVERY CHARACTERISTICS OF SEVOFLURANE AND PROPOFOL-REMIFENTANIL ANESTHESIA IN GERIATRIC PATIENTS(GUNES KITABEVI LTD STI, 2011) Celik, Jale Bengi; Topal, Ahmet; Erol, Atilla; Guven, Selcuk; Kara, InciIntroduction: In this study we aimed to compare the recovery characteristics of propofol/remifentanil and sevofluran/remifentanil anesthesia in 100 geriatric patients undergoing urological procedures. Materials and Method: The patients were randomized to receive either propofol-remifentanil (group P) or sevoflurane-remifentanil (Group S) anesthesia. Recovery characteristics, the time to post-anesthetic discharge scoring system (PADSS) score and Aldrete score of 9 point, Digit Symbol Substitution Test (DSST) and Trieger Dot Test (TDT) values were compared between two groups. Results: Extubation time was significantly shorter in group P than in group S (5.3 +/- 2.9 min vs 7.8 +/- 3.8 min, p=0.038). The times of first eye opening, response to verbal commands and orientation were similar in both groups. The time of Aldrete score of 9 points (grup P: 14.2 +/- 3.6 min, group S: 16.3 +/- 4.5 min) and PADSS of 9 points (group P: 19.3 +/- 5.7 min, group S: 22.1 +/- 4.2 min) were also similar (p > 0.05). Time to return to the normal value of DSST was significantly shorter in Group P compared with Group S, and TDT was similar in both groups (p > 0.05). No significant differences were observed in the incidence of postoperative complications and VAS score (p > 0.05). Conclusion: Both propofol-remifentanil and sevoflurane-remifentanil appears to be an adequate anesthesia in geriatric patients.Öğe A COMPARISON OF TWO DIFFERENT SEDATION TECHNIQUES IN GERIATRIC PATIENTS FOR ENDOSCOPIC UROLOGICAL SURGERY(GUNES KITABEVI LTD STI, 2012) Celik, Jale Bengi; Topal, Ahmet; Erdem, Tuba Berra; Kara, InciIntroduction: In this study, we evaluated the effectiveness and safety of intravenous propofol-fentanyl and ketamine-midazolam combinations for procedural sedation and analgesia in elderly patients undergoing urological endoscopic surgery. Materials and Method: This prospective study enrolled 80 patients aged 60-80 years ASA I-III requiring endoscopic urological procedures. Patients received intravenous bolus doses of either fentanyl 1 mu g.kg-1 and propofol 1-2 mg.kg-1 in group P or ketamine 1-1.5 mg.kg-1 and midazolam 0.1 mg.kg-1 in group K titrated according to Ramsay sedation scale in the range of 3-4. Results: There were no differences in vital signs, operating times and demographic variables. Time to Aldrete score >= 8 was similar in two groups. Time to PADSS >= 9 was significantly longer in group K than group P (p<0.05). The frequency of vertigo, nausea, vomiting, visual disturbances, laryngeal spasm and hallucinations were higher in group K (p<0.05). But pain of injection and respiratory depression were more frequent in group P (p<0.05). Excessive salivation, tachycardia, bradycardia, hypotension, hypertension were similar in both groups. Conclusion: Hemodynamic changes and degrees of sedation showed that propofol-fentanyl and ketamine-midazolam combinations can safely be used in geriatric patients undergoing endoscopic urological procedures. However, in the propofol-fentanyl group the incidence of side effects were lower and the recovery period was shorter than the ketamine-midazolam group.Öğe DOES PREOPERATIVE ADMINISTRATION OF ALLOPURINOL PROTECT THE LUNGS FROM ISCHEMIA-REPERFUSION INJURY OCCURED DURING CARDIOPULMONARY BYPASS?(SPRINGER TOKYO, 2009) Ergene, Neyhan; Gormus, Zulfikare Isik; Celik, Jale Bengi; Gormus, Niyazi; Solak, Hasan[Abstract not Available]Öğe The effect of the trendelenburg position on the internal jugular vein's cross-sectional area in overweight and obese children(E-CENTURY PUBLISHING CORP, 2016) Sekmenli, Tamer; Nayman, Alaaddin; Onal, Ozkan; AriYuca, Sevil; Apiliogullari, Seza; Ciftci, Ilhan; Celik, Jale BengiBackground: The Trendelenburg position is a common technique used during internal jugular vein (IJV) cannulation in pediatric patients. There has been some speculation as to the correlation between Trendelenburg positioning and increases in the cross-sectional area (CSA) of the IJV in obese child patients. In the present study, we use ultrasound (US) measurements to assess and determine the predictivity of Trendelenburg positioning on the CSA of the right IJV in obese child patients. Methods: The researchers of this studyenrolled 30 cases from the American Society of Anesthesiologists (ASA) II of patients under the age of 18 who underwent ultrasonographic examination between December 2013 and March 2015. US images of the right IJV of each patient were obtained in a transverse orientation at the cricoid level. The CSAs of the right IJVs were measured undert wo different conditions applied in a random orderin a sealed envelope: State 0, in which the table was flat (no tilt) and the patient lay in the supine position; and State T, in which the operating table wastilted 20 degrees to the Trendelenburg position. Results: The change in the CSA of the IJV from the supine to the Trendelenburg position (0.99 cm(2) vs 0.96 cm(2)) was not significant. In contrast, the CSA of the right IJV decreased in 14 of the 30 patients (9 of the 14 were female). Conclusions: The Trendelenburg position does not cause the mean CSA of the right IJV in obese child patients to increase; in fact, the position causes the CSA in some patients to decrease. The researchers of this study do not support the use of the Trendelenburg position for IJV cannulation in obese child patients.Öğe The effectiveness of trendelenburg positioning on the cross-sectional area of the right internal jugular vein in obese patients(PROFESSIONAL MEDICAL PUBLICATIONS, 2015) Onal, Ozkan; Apiliogullari, Seza; Nayman, Alaaddin; Saltali, Ali; Yilmaz, Huseyin; Celik, Jale BengiObjective: Trendelenburg positioning is a common approach used during internal jugular vein (IJV) cannulation. No evidence indicates that Trendelenburg positioning significantly increases the cross-sectional area (CSA) of the IJV in obese patients. The primary aim of this study was to determine the effectiveness of Trendelenburg positioning on the CSA of the right internal jugular vein assessed with ultrasound measurement in obese patients. Methods: Forty American Society of Anesthesiologists II patients with body mass index >= 30 kg/m(2) undergoing various elective surgeries under general endotracheal anesthesia were enrolled. Ultrasound images of the right IJV were obtained in a transverse orientation at the cricoid level. We measured the CSA of the right IJV two different conditions in a sealed envelope were applied In random order: State 0, table flat (no tilt), with the patients in the supine position, and State T, in which the operating table was tilted 200 to the Trendelenburg position. Results: The change in the CSA of the IJV from the supine to the Trendelenburg position (1.80 cm(2) vs 2.08cm(2)) was not significantly different. The CSA was paradoxically decreased in 10 of 36 patients when the position changed from State 0 to State T. Conclusions: Trendelenburg positioning does not significantly increase the mean CSA of the right IJV in obese patients. In fact, in some patients, this position decreases the CSA. The use of the Trendelenburg position for IJV cannulation in obese patients can no longer be supported.Öğe The Effects of 3 Different Intra-abdominal Pressures on the Thromboelastographic Profile During Laparoscopic Cholecystectomy(LIPPINCOTT WILLIAMS & WILKINS, 2011) Topal, Ahmet; Celik, Jale Bengi; Tekin, Ahmet; Yuceaktas, Ali; Otelcioglu, SerefObjective: The aim was to determine the influence of the pneumoperitoneum at 10, 13, and 16mm Hg on thromboelastograph (TEG) in laparoscopic cholecystectomy. Methods: Sixty patients were randomly allocated to 3 groups. The abdomen was insufflated with carbon dioxide to 10mm Hg (group 1), 13mm Hg (group 2), and 16mm Hg (group 3) intra-abdominal pressures. We evaluated changes in the TEG values [ reaction time (R), maximum amplitude (MA), alpha-angle, K time] preoperatively, intraoperatively, and postoperatively. Results: In the postoperative 24th hour, the R-value was significantly lower in group 3 than that in group 1 and group 2 (P< 0.05). We found increased values of MA intraoperative 30th minute and postoperative 24th hour in group 3 with respect to group 1 (P< 0.05) and postoperative 24th hour, and the MA value in group 3 was significantly higher than those of group 2 (P< 0.05). In group 3, the alpha-angle was significantly higher than that of group 1 and group 2 at intraoperative 30th minute and postoperative 24th hour (P< 0.05). In postoperative 24th hour, the K-value was significantly lower in group 3 than in group 2 and group 1 (P< 0.05). Conclusions: Laparoscopy with pneumoperitoneum at pressures of 10 and 13mm Hg did not alter the TEG values and low intra-abdominal pressure must be used for peritoneal insufflation.Öğe The effects of dexketoprofen on duration of analgesia to a thermal stimulus when compared with a systemic control in a rat sciatic nerve block with levobupivacaine(WILEY-BLACKWELL, 2014) Kara, Inci; Apiliogullari, Seza; Taylan, Sengal Bagci; Bariskaner, Hulagu; Celik, Jale BengiThis study was designed to investigate whether dexketoprofen added to perineuraly or subcutaneously alters the effects of levobupivacaine in a rat model of sciatic nerve blockade. Thirty-six rats received unilateral sciatic nerve blocks along with a subcutaneous injection by a blinded investigator assigned at random. Combinations were as follows: Group 1 (sham) perineural and subcutaneous saline; Group 2, perineural levobupivacaine alone and subcutaneous saline; Group 3, perineural levobupivacaine plus dexketoprofen and subcutaneous saline; Group 4, perineural levobupivacaine and subcutaneous dexketoprofen; Group 5, perineural dexketoprofen and subcutaneous saline; and Group 6, perineural saline and subcutaneous dexketoprofen. The levobupivacaine concentration was fixed at 0.05%, and the dose of dexketoprofen was 1mgkg(-1). Sensory analgesia was assessed by paw withdrawal latency to a thermal stimulus every 30min. The unblocked paw served as the control for the assessment of systemic, centrally mediated analgesia. Perineural and subcutaneous dexketoprofen coadministered with perineural levobupivacaine did not enhance the duration of sensory blockade when compared with levobupivacaine alone. There were significant differences between the operative and control paws for time points 30-90min in the perineural levobupivacaine alone, levobupivacaine+dexketoprofen and subcutaneous dexketoprofen added levobupivacaine group. Significant differences were not determined between the levobupivacaine alone group and dexketoprofen added groups in operative paw. The effects of dexketoprofen are unknown for perineural administration. There is no significant difference between the analgesic effects of peripheral nerve blocks using levobupivacaine alone and plus subcutaneous or perineural dexketoprofen.Öğe The effects of intrathecal morphine on patient-controlled analgesia morphine consumption, postoperative pain scores and satisfaction in patients undergoing gynecologic oncologic surgery under general anesthesia(OXFORD UNIV PRESS, 2012) Kara, Inci; Apiliogullari, Seza; Oc, Bahar; Celik, Jale Bengi; Duman, Ates[Abstract not Available]Öğe The effects of spinal anesthesia on auditory patients(ELSEVIER IRELAND LTD, 2016) Colpan, Bahar; Apiliogullari, Seza; Erdur, Omer; Celik, Jale Bengi; Duman, Ates; Senaran, Hakan; Ozturk, KayhanObjectives: Persistent or transient hearing loss (HL) is a less-recognized complication of spinal anesthesia (SA) in the pediatric population, although it has been previously reported in adults. The primary aim of this study was to investigate the effects of SA on auditory function in the pediatric population. Methods: After gaining institutional approval and parental consent, 30 American Society of Anesthesiologists physical status I-II children between 4 and 15 years undergoing lower extremity orthopedic surgery were enrolled in this prospective study. Spinal blocks were performed in the midline with a 25G Quincke needle using 0.5% hyperbaric bupivacaine. Transient evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) tests were administered before surgery and one-day postoperative. Children with detected HL were retested on postoperative day seven. Preoperative and postoperative results were compared. A Wilcoxin Signed-Ranks test (with Bonferroni correction) was used for statistical analyses. Results: There was no statistically significant HL in the postoperative period compared to the preoperative period. In 29 of 30 patients, no difference was detected at any frequency tested. In one patient, TEOAE and DPOAE tests were found to be decreased on postoperative day one. In this patient, control tests were found to be improved on postoperative day seven. Conclusions: Administration of SA may results in a low probability of transient hearing loss with no clinical significance in children 4-15 years of age. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Öğe Is a Neutral Head Position as Effective as Head Rotation During Landmark-Guided Internal Jugular Vein Cannulation? Results of a Randomized Controlled Clinical Trial(W B Saunders Co-elsevier Inc, 2012) Apiliogullari, Burhan; Kara, Inci; Apiliogullari, Seza; Arun, Oguzhan; Saltali, Ali; Celik, Jale BengiObjective: Central venous access remains a cornerstone procedure for a variety of clinical conditions. Ultrasound studies suggest that rotation of the head increases the magnitude of the overlap of the internal jugular vein with the carotid artery. The authors assessed whether a neutral position of the head during anatomic landmark-guided cannulation of the internal jugular vein (UV) was an attractive alternative to rotating the neck to a >45 degrees head turn. Design: A prospective, randomized, controlled study. Setting: An education and research hospital and a university-affiliated hospital. Participants: Eighty patients requiring central venous catheterization in the right IJV. Interventions: Under general anesthesia, patients were positioned in the Trendelenburg position with extension of the neck. In the rotated group, the head was rotated to the left at >45 degrees. In the neutral group, the head was placed in the neutral position. Right IJV cannulation was performed using the central approach with the needle angled toward the ipsilateral nipple. The primary outcome variable was the cumulative success rate, which was defined as IJV puncture achieved in the first 3 attempts using a finder needle. A p value of <0.05 was considered statistically significant. Measurements and Main Results: Groups were similar in terms of demographic data. The success rates of finder needle passes into the IJV on the first attempt were 87.5% and 37.5% (p < 0.05), and the cumulative success rates on the first 3 attempts were 97.5% and 57.5% in the rotated and neutral groups, respectively (p < 0.05). Carotid artery puncture only occurred in 2 patients in the rotated group. Conclusions: Because of the lower success rate, the neutral head position is not an attractive alternative for IJV catheterization when compared with the rotated head position in a central landmark IJV approach.Öğe Midazolam Can Decrease Salivation During Bronchoscopy(ELSEVIER, 2010) Apiliogullari, Seza; Celik, Jale Bengi; Duman, Ates[Abstract not Available]Öğe Neostigmine treatment protocols applied in acute colonic pseudo-obstruction disease: A retrospective comparative study(AVES, 2019) Ilban, Omur; Cicekci, Faruk; Celik, Jale Bengi; Bas, Mehmet Ali; Duman, AtesBackground/Aims: When conservative methods fail, neostigmine is recommended in the pharmacological treatment of acute colonic pseudo-obstruction (ACPO). The objective of this study was to analyze the response of patients to different neostigmine protocols. Materials and Methods: Patients diagnosed with ACPO in the intensive care unit between January 2015 and September 2017 were retrospectively studied. Either of the two neostigmine protocols, the bolus dose (BD) or continuous infusion (CI), was applied to the ACPO patients who were unresponsive to conservative treatments, and the results were analyzed. Results: In 79 of 122 (64%) patients, the resolution of symptoms was observed with conservative treatments. Of 43 patients who did not respond to conservative treatments, 20 were applied neostigmine as BD, and 23 were applied by CI. A total of 55% of patients in the BD group and 60.9% patients in the CI group responded to neostigmine therapy after the first dose. The group-specific protocols were reapplied in patients unresponsive to the first dose. A total of 25% in the BD group and 8.7% in the CI group responded to the second dose treatment. As a result, 80% of patients from the BD group and 69.6% from the CI group responded to neostigmine therapy. Although an overall response rate was higher in the BD group, there was no significant difference between groups (P=0.322). Colonic complications were observed in 2 patients, 1 from each group. There were no major side effects requiring treatment cessation. Conclusion: The safety and effectiveness of both neostigmine protocols applied to ACPO patients were similar. Clinical and radiological responses were obtained without serious side effects with CI.Öğe Ozone Prevents Cochlear Damage From Ischemia-Reperfusion Injury in Guinea Pigs(WILEY, 2017) Onal, Merih; Elsurer, Cagdas; Selimoglu, Nebil; Yilmaz, Mustafa; Erdogan, Ender; Celik, Jale Bengi; Kal, OznurThe cochlea is an end organ, which is metabolically dependent on a nutrient and oxygen supply to maintain its normal physiological function. Cochlear ischemia and reperfusion (IR) injury is considered one of the most important causes of human idiopathic sudden sensorineural hearing loss. The aim of the present study was to study the efficacy of ozone therapy against cochlear damage caused by IR injury and to investigate the potential clinical use of this treatment for sudden deafness. Twenty-eight guinea pigs were randomized into four groups. The sham group (S) (n=7) was administered physiological saline intraperitoneally (i.p.) for 7 days. The ozone group (O) (n=7) was administered 1mg/kg of ozone i.p. for 7 days. In the IR + O group (n=7), 1 mg/kg of ozone was administered i.p. for 7 days before IR injury. On the eighth day, the IR + O group was subjected to cochlear ischemia for 15min by occluding the bilateral vertebral artery and vein with a nontraumatic clamp and then reperfusion for 2h. The IR group was subjected to cochlear IR injury. After the IR procedure, the guinea pigs were sacrificed on the same day. In a general histological evaluation, cochlear and spiral ganglionic tissues were examined with a light microscope, and apoptotic cells were counted by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. The apoptotic index (AI) was then calculated. Blood samples were sent for analyses of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase, malondialdehyde (MDA), the total oxidant score (TOS), and total antioxidant capacity (TAC). Data were evaluated statistically using the Kruskal-Wallis test. The AI was highest in the IR group. The AI of the IR + O group was lower than that of the IR group. The biochemical antioxidant parameters SOD and GSH-Px and the TAC values were highest in the O group and lowest in the IR group. The MDA level and TOS were highest in the IR group and lowest in the O group. Controlled ozone administration stimulated endogenous antioxidant defense systems, thereby helping the body to combat IR injury. Although this study revealed a statistically significant decrease in cochlear IR damage following ozone therapy, further studies will be necessary to explain the protective mechanisms of ozone therapy in cochlear IR injury.Öğe Post-spinal hyperacute subdural hematoma(ELSEVIER SCIENCE INC, 2017) Onal, Ozkan; Aslanlar, Emine; Apiliogullari, Seza; Erkocak, Omer Faruk; Celik, Jale Bengi[Abstract not Available]Öğe Pulsed Radiofrequency of Dorsal Root Ganglia for the Treatment of Complex Regional Pain Syndrome in an Adolescent with Poliomyelitis Sequel: A Case Report(OXFORD UNIV PRESS, 2015) Apiliogullari, Seza; Aydin, Bahattin Kerem; Onal, Ozkan; Kirac, Yunus; Celik, Jale BengiObjectiveComplex regional pain syndrome (CRPS) is a painful and disabling syndrome in which the patient presents with neuropathic pain, edema, or vasomotor or pseudomotor abnormalities that are often refractory to treatment. Polio paralysis is caused by the damage or destruction of motor neurons in the spine, which lead to corresponding muscle paralysis. This report is a case report on the application of a pulsed radiofrequency (PRF) current to dorsal root ganglia (DRG) for the treatment of CRPS type 1 in an adolescent patient. DesignSingle case report. SettingSelcuk University Hospital. PatientA 16-year-old girl who suffered from CRPS type 1 secondary to surgeries for the sequelae of poliomyelitis. InterventionsPRF current application to the lumbar 4 and lumbar 5 DRG. Outcome MeasuresPain reduction. ResultsThe patient had complete resolution of her symptoms, which was maintained at a 6-month follow-up. ConclusionsThis case illustrates that PRF applied to lumbar 4 and lumbar 5 DRG may play a significant role in CRPS type 1 management after the surgical treatment of poliomyelitis sequelae in adolescent patients. Further randomized, controlled studies are needed to support this argument.Öğe The relationship between vasoactive-inotropic score and mortality in adult patients with traumatic brain injury(TURKISH NEUROSURGICAL SOC, 2019) Kara, Iskender; Sargin, Mehmet; Bayraktar, Yesim Serife; Sahinoglu, Mert; Ildarov, Gurban; Duman, Ipek; Celik, Jale Bengi; Karabaglı, HakanAIM: To assess the feasibility of the vasoactive-inotropic score (VIS) in determining the amount of vasoactive support and its relationship with the mortality rate and characteristics of the patients with traumatic brain injury (TBI). MATERIAL and METHODS: This study was conducted with a retrospective design involving the years 2013-2018 in a university hospital which provides tertiary intensive care service. A total of 102 patients who were admitted in the ICU with the diagnosis of severe TBI, and also were followed by neurosurgery service and who received vasoactive and inotropic support were analyzed concerning VIS value. RESULTS: The median age of the patients was 34 years, and 69.6% of the patients were male. Mortality rate was 43.1%. In the group with mean VIS >= 10, the admission duration in the ICU and hospital were shorter (p<0.0001) whereas mortality rates were higher (81.1% vs 21.5% and p<0.0001). Besides, the number of patients with a VIS score of >= 10, >= 15 and >= 20 were higher in the group of patients who died (p<0.0001). The results of the multivariate analysis such as VIS >= 10 were significant. CONCLUSION: We can conclude that VIS, which is used to determine the amount of vasoactive and inotropic medicines during cardiac surgery and in sepsis patients, may be useful in predicting mortality in TBI patients.Öğe Renal Effects of Coronary Artery Bypass Graft Surgery in Diabetic and Non-Diabetic Patients: A Study with Urinary Neutrophil Gelatinase-Associated Lipocalin and Serum Cystatin C(KARGER, 2015) Arun, Oguzhan; Celik, Gulperi; Oc, Bahar; Unlu, Ali; Celik, Jale Bengi; Oc, Mehmet; Duman, AtesBackground/Aims: Cardiac surgery and diabetes are major causes of acute kidney injury (AKI). We aimed to investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) and serum cystatin C, as early biomarkers for prediction of AKI in diabetic and nondiabetic adult patients undergoing cardiac surgery. Methods: 15 non-diabetic and 15 diabetic adult patients undergoing cardiac surgery were enrolled. Peri-operative clinical and laboratory variables were recorded. Urinary NGAL, serum cystatin C, serum creatinine (Cre) and blood urea nitrogen (BUN) were evaluated. Results: AKI was detected in 4 patients in non-diabetic group and 12 patients in diabetic group. Urinary NGAL levels of diabetic and non-diabetic patients and serum cystatin C levels of diabetic patients exceed upper normal limits or cut off values much earlier than BUN and Cre. cystatin C levels of non-diabetic patients remain unchanged. Cystatin C and NGAL levels of patients meeting AKI criteria and NGAL levels of patients not meeting AKI criteria exceeded upper normal limits or cut off values much earlier in than BUN and Cre. Conclusions: Measurement of cystatin C level in both diabetic and nondiabetic patients may reveal AKI earlier than NGAL and BUN. In diabetic patients, measurement of urinary NGAL and serum cystatin C levels may indicate AKI signs earlier than BUN and Cre. Copyright (C) 2015 S. Karger AG, Basel