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Öğe Comparison of Nutritional Parameters among Adult and Elderly Hemodialysis Patients(IVYSPRING INT PUBL, 2011) Celik, Gulperi; Oc, Bahar; Kara, Inci; Yilmaz, Mumtaz; Yuceaktas, Ali; Apiliogullari, SezaAim: The aim of this study was to compare the nutritional biochemical parameters, prealbumin levels, and bioimpedance analysis parameters of adult and elderly hemodialysis (HD) patients. Methods: This prospective cross-sectional study included 50 adult HD patients (42.0 % female). Nutritional status was assessed by post-dialysis multifrequency bioimpedance analysis (BIA), serum prealbumin and other nutritional biochemical parameters. Results: Mean age of patients was 57.4 +/- 15.1 years (range: 30-83 years) and mean dialysis duration was 68.3 +/- 54.5 months (range: 3-240 months). When the patients were divided into two groups according to age of patients (<65 and >= 65), prealbumin (p=0.003), blood urea nitrogen (BUN) (p=0.000), serum creatinine (p=0.013), albumin (p=0.016), protein catabolic rate per normalized body weight (nPCR) (p=0.001), intracellular water (ICW)/total body weight (0.003), body fat mass (p00.000), lean body mass (p=0.031), lean dry mass (p=0.001), illness marker (p=0.005), basal metabolism (p=0.007), body mass index (BMI) (p=0.028), body fat mass index (BFMI) (p=0.000), fat free mass index (FFMI) (p=0.040) values were significantly different between the groups. In the elderly patients (age >= 65), body fat mass, illness marker, BMI, BFMI were higher compared to adult patients (age <65). Additionally, in the elderly patients, prealbumin, BUN, creatinine, albumin, nPCR, ICW/ total body weight, lean body weight, lean dry weight, basal metabolism and FFMI were lower than adult patients. Conclusions: Our results indicate that BFMI were higher, albumin, prealbumin, nPCR and lean body mass and FFMI were lower in elderly patients compared to adults. These results imply that elderly HD patients may be prone sarcopenic obesity and may require special nutritional support.Öğe Comparison of Spinal and General Anesthesia in Lumbar Disc Surgery(2011) Kara, Inci; Celık, Jale Bengu; Oc, Bahar; Apıllıoğulları, Seza; Karabaglı, HakanAmaç: Bu çalışmanın amacı genel (GA) ve spinal (SA) anestezinin perioperatif avantaj ve dezavantajlarını karşılaştırmaktır. Yöntem ve Gereç: Lomber disk operasyonu geçirecek rasgele 60 hasta (GA,n30, SA,n30) seçildi. Hastalar demografik veriler, peroperatif vital bulgular, ağrı skorları, kan kaybı miktarı, cerrah memnuniyeti, perioperatif komplikasyonlar ve hasatanede kalış süresi yönünden karşılaştırıldı. Bulgular: İntraoperatif ve postoperatif dönemde hipertansiyon ve taşikardi GA grubunda daha sıktı (p0.05). Cerrah memnuniyeti GA grubunda daha yüksekti (p0.05). Anestezi ve cerrahi süre GA grubunda daha uzun idi (p0.05), bu grupta bulantı, kusma, ağrı, daha fazlaydı ve antiemetik ve analjezik ihtiyacı yüksek bulundu (p0.05). Cerrahi sonrası 24 saat içinde derlenme odasında kalma zamanı, mobilizasyon, hastanede kalma zamanı, antiemetik ve analjezik gereksinimi, ağrı skoru, bulantı, üriner retansiyon ve baş ağrısı iki grupta benzerdi (p0.05), bununla birlikte bu dönemde kusma GA grubunda daha sıktı (p0.05). Sonuç: Lomber disk operasyonu geçirecek hastalar için spinal anestezi genel anestezi kadar güvenli ve etkindir. Spinal anestezinin spesifik avantajları antiemetik ve analjezik ihtiyacının daha az olması ve düşük komplikasyon oranıdır.Öğe Comparison of Spinal and General Anesthesia in Lumbar Disc Surgery(JOURNAL NEUROLOGICAL SCIENCES, 2011) Kara, Inci; Celik, Jale Bengu; Oc, Bahar; Apilliogullari, Seza; Karabagli, HakanAim: The purpose of this study was to compare the perioperative advantage and disadvantage between general (GA) and spinal anesthesia (SA). Material and Methods: Sixty patients (randomize GA, n=30, SA, n=30) undergoing lumbar disc surgery were enrolled. Patients were matched for demographic data, perioperative physiological changes, pain score, amount of blood loss, surgeon 'satisfaction, perioperative complications and length of stay in hospital. Results: Intraoperatively and postoperatively, the incidence of tachycardia and hypertension were more frequent with GA (p<0.05). The surgeon's satisfaction was reported to be higher in the GA group (p<0.05). Anesthetic and operative times were longer for patients in GA group (p<0.05), in whom more nausea, vomiting, pain and greater requirements for antiemetic and pain medication were also during PACU (p<0.05). 24 hours after surgery, PACU time, ambulation of day of surgery, hospital stay, requirement of antiemetic and analgesic medication, pain score, nausea, urinary retention and headache were similar in two groups (p>0.05), however vomiting was more frequent in GA group in this period (p<0.05). Conclusion: For patients undergoing lumbar disc surgery, spinal anesthesia was as safe and effective as general anesthesia. Specific advantages to spinal anesthesia include decreased antiemetic and analgesic medication and reduced overall complication rate.Öğe The effects of intra-articular injection of ibuprofen on knee joint cartilage and synovium in rats(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2019) Kutahya, Emine Cepni; Oc, Bahar; Ugurluoglu, Ceyhan; Duman, Ipek; Arun, OguzhanObjective: The aim of this animal study was to investigate the short and long-term local histomorphologic effects and the utility of intra-articular application of ibuprofen. Methods: Forty-six Wistar Albino rats were used in the study. The rats were randomized into 5 groups of 8 and a sham group of 6. The 40 rats in the study groups were anaesthetised with 60 mg/kg of ketamine, then 0.25 ml ibuprofen (25 mg) was injected to the right knee joint of each rat (ibuprofen group) and 0.25 ml 0.9% saline to the left knee joint as the control group. To the 6 rats in the sham group, only puncture was applied to both knee joints. The rats in each of the 5 study groups were sacrificed on days 1, 2, 7, 14 and 21 respectively. The histomorphologic changes were graded on a 6-point scale regarding inflammation of the synovia, cartilage tissue, and subchondral bone. Inflammation scores were compared using the Mann Whitney U-test and comparisons of the sacrifice day and drug used were evaluated with the Kruskal Wallis test. The p values below 0.05 were considered as significant. Results: Statistically significant difference was found between the ibuprofen injected knees (10/40) and the saline injected (0/40) and sham knees (0/12) in respect of hematoma positivity (p = 0.002). Significantly higher inflammation scores were found in ibuprofen injected knees on the 1st, 2nd, 7th and 14th days compared to controls and sham (p < 0.05). Inflammation scores were similar in ibuprofen injected knees with and without hematoma (p > 0.05). Inflammation of the ibuprofen injected group was most severe on day one and the severity of inflammation reduced gradually throughout the 3 weeks. Conclusion: Our results show that intra-articular injection of ibuprofen can cause intra-articular hematoma. It also leads to transient inflammation of the synovia that is more severe in the early period, which gradually recovers. (C) 2019 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.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 Effects of propofol and sevoflurane on isolated human umbilical arteries pre-contracted with dopamine, adrenaline and noradrenaline(WILEY-BLACKWELL, 2015) Gunduz, Ergun; Arun, Oguzhan; Bagci, Sengal Taylan; Oc, Bahar; Salman, Alper; Yilmaz, Setenay Arzu; Celik, CetinAimTo assess the effects of propofol and sevoflurane on the contraction elicited by dopamine, adrenaline and noradrenaline on isolated human umbilical arteries. MethodsUmbilical arteries were cut into endothelium-denuded spiral strips and suspended in organ baths containing Krebs-Henseleit solution bubbled with O-2+CO2 mixture. Control contraction to phenylephrine (10(-5)M) was recorded. Response curves were obtained to 10(-5)M dopamine, 10(-5)M adrenaline or 10(-5)M noradrenaline. Afterwards, either cumulative propofol (10(-6)M, 10(-5)M and 10(-4)M) or cumulative sevoflurane (1.2%, 2.4% and 3.6%) was added to the organ bath, and the responses were recorded. Responses are expressed percentage of phenylephrine-induced contraction (meanstandard deviation) (P<0.05=significance). ResultsPropofol and sevoflurane elicited concentration-dependent relaxations in strips pre-contracted with dopamine, adrenaline and noradrenaline (P<0.05). Highest (10(-4)M) concentration of propofol caused significantly higher relaxation compared with the highest (3.6%) concentration of sevoflurane in the contraction elicited by dopamine. High (10(-5)M) and highest concentrations of propofol caused significantly higher relaxation compared with the high (2.4%) and highest concentrations of sevoflurane on the contraction elicited by adrenaline. High and highest concentrations of sevoflurane caused significantly higher relaxation compared with the high and highest concentrations of propofol on the contraction elicited by noradrenaline. ConclusionDopamine, adrenaline and noradrenaline elicit contractions in human umbilical arteries, and noradrenaline causes the highest contraction. Both propofol and sevoflurane inhibit these contractions in a dose-dependent manner. Propofol caused greater relaxation in the contractions elicited by dopamine and adrenaline while sevoflurane caused greater relaxation in the contraction elicited by noradrenaline.Öğe Endovenous Laser Ablation under General Anesthesia for Day Surgery: Feasibility and Outcomes of the 300 Patients(MEDICAL TRIBUNE INC, 2014) Arun, Oguzhan; Oc, Bahar; Duman, Ates; Yildirim, Serkan; Simsek, Murat; Farsak, Bora; Oc, MehmetPurpose: Endovenous laser ablation (EVLA) for superficial venous insufficiency is traditionally performed under tumescent local anesthesia as day case surgery. The aim of this study is to evaluate the feasibility of general anesthesia in addition to tumescent anesthesia in patients undergoing EVLA. Methods: The anesthesia and clinical registration records of 341 extremities of 300 adult patients were reviewed and analyzed retrospectively. Demographic and clinical data, preoperative anesthetic evaluation data (ASA physical status, preoperative airway assessment, Mallampati score), type of supraglottic device, duration of anesthesia and surgery, any surgical and/or anesthetic complication, timing of mobilization and discharge, and postoperative course were evaluated. Results: Mean duration of operation and anesthesia was 28 (12-55) and 40 (20-65) minutes, respectively. Mobilization and discharge timing was 25 (11-45) and 139 (110-200) minutes, respectively. All patients were discharged the same day of surgery. Conclusion: The combination technique of administering general anesthesia with supraglottic device and tumescent anesthesia is a safe and effective method to reduce the patients' pain and discomfort during the EVLT procedure within the scope of day case surgery.Öğe Extremely Low Birth Weight Infants with Patent Ductus Arteriosus: Searching for the Least Invasiveness(FORUM MULTIMEDIA PUBLISHING, LLC, 2012) Oc, Mehmet; Farsak, Bora; Oc, Bahar; Yildirim, Serkan; Simsek, MuratPatent ductus arteriosus (PDA) is an important problem in premature infants. Extremely low birth weight infants (ELBWI) are so fragile with respect to surgical stress that minimally invasive procedures are required. We report 26 ELBWI cases with PDA who underwent surgical closure. All had failed indomethacin treatment, or it had been contraindicated. The mean gestational age at birth was 27 weeks (range, 24-38 weeks), and the mean birth weight was 960.96 g (range, 710-1440 g). The mean age at operation was 18.06 days (range, 7-34 days), and the mean body weight at operation was 989.42 g (range, 680-1460 g). There was no surgery-related mortality or morbidity. Our surgical procedures consisted of posterior muscle-sparing thoracotomy, clipping the PDA and no ligation, and closing the thorax without a tube thoracostomy. Muscle-sparing thoracotomy reduces the likelihood of long-term physical impairment and deformity, the clipping technique minimizes the dissection of surrounding PDA tissue, and the thorax is closed without a tube. Nursing care is simplified, costs are reduced, and the number of chest x-rays needed postoperatively is reduced. We believe that surgical closure of PDA without chest tube drainage can be accomplished safely in premature infants.Öğe Is neutrophil gelatinase associated lipocalin enough valuable in the diagnosis of acute kidney injury?(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2014) Arun, Oguzhan; Oc, Bahar; Duman, Ates; Oc, Mehmet[Abstract not Available]Öğe Peroperative effects of fresh frozen plasma and antithrombin III on heparin sensitivity and coagulation during nitroglycerine infusion in coronary artery bypass surgery(LIPPINCOTT WILLIAMS & WILKINS, 2011) Kanbak, Meral; Oc, Bahar; Salman, Mehmet A.; Ocal, Turgay; Oc, MehmetNitroglycerin (NTG) reduces the anticoagulant effects of heparin and may lead to heparin resistance. Fresh frozen plasma (FFP) and antithrombin III (ATIII) may be used for the treatment of heparin resistance. We aimed to compare the effects of FFP and ATIII on heparin requirement, coagulation parameters, and bleeding in patients undergoing coronary artery bypass graft surgery (CABGS) with moderate dose of intraoperative NTG infusion. Forty-eight patients undergoing CABGS with NTG infusion were randomly allocated to three groups. Group C served as control, whereas the patients in group P received FFP and those in group A received ATIII after anesthesia induction. ATIII activity and coagulation parameters were measured at five different times intraoperatively. Total heparin requirement, heparin consumption, and heparin sensitivity were calculated. ATIII activity and ACT were significantly higher and activated partial thromboplastin time and fibrinogen level were significantly lower during cardiopulmonary bypass in group A than in groups P and C. Heparin sensitivity was significantly higher and total heparin requirement and consumption were significantly lower in ATIII group than in other groups. ATIII administration increases heparin sensitivity and decreases heparin requirements compared with FFP in patients undergoing CABGS with peroperative NTG infusion. ATIII may be preferred to FFP in patients with heparin resistance due to NTG infusion undergoing CABGS. Blood Coagul Fibrinolysis 22:593-599 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.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, BaselÖğe Surgical Treatment of Right Ventricular Hydatid Cyst(FORUM MULTIMEDIA PUBLISHING, LLC, 2012) Oc, Mehmet; Ulular, Omer; Oc, BaharHydatid cyst is a serious endemic parasitic disease found in cattle-raising areas of the world. Cardiac hydatid cysts arc rare and appear in 0.5% to 2% of hydatid cyst cases. A 24-year-old male patient was admitted to the hospital because of chest pain. A cystic mass (4 4 3 cm) was demonstrated with transthoracic echocardiography, computed tomography, and magnetic resonance imaging. A hydatid cyst was located in the right ventricular wall near the inferior branch of the acute marginal branch of the right coronary artery and was located such that it pushed the tricuspid valve inward. The cystic materials were removed with the patient on cardiopulmonary bypass. The surgery for cardiac hydatid disease is safe, and the results are satisfactory.Öğe Unilateral spinal anesthesia in a pediatric patient with Duchenne muscular dystrophy: a case report(WILEY-BLACKWELL, 2013) Apiliogullari, Seza; Oc, Bahar; Kara, Inci; Celik, Derya; Duman, Ates; Senaran, Hakan[Abstract not Available]
