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    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, Seza
    Aim: 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.
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    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, Seref
    Objective: 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.