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Öğe Are Fetuin-A levels beneficial for estimating timing of sepsis occurrence?(Saudi Med J, 2018) Altinisik, Hatice B.; Altinisik, Ugur; Uysal, Sema; Sacar, Suzan; Simsek, Tuncer; Demiraran, YavuzObjectives: To evaluated Fetuin-A levels of patients admitted in the intensive care unit with a diagnosis of sepsis. Methods: This study was conducted at the Faculty of Medicine, Canakkale Onsekiz Mart University Hospital, Canakkal, Turkey, between February 2015 and October 2015. Forty septic patients were included in the study. Subsequent to clinical suspicion of sepsis, serum levels of C-reactive protein (CRP) and procalcitonin; and white blood cell (WBC) counts were evaluated at 3 time-points: 0 (basal), 24, and 72 hours. Results: The mean Fetuin-A levels at the 3 time-points were 58.5 +/- 29.2 ng/mL, 40.9 +/- 23.6 ng/mL, and 47.8 +/- 25.7 ng/mL, respectively. Fetuin-A levels at 24 hours were significantly lower than the basal level (p<0.05), where as no significant difference was observed between the basal levels and those at 72 hours (p>0.05). Correlation between the temporal changes in Fetuin-A levels and the changes in other inflammatory markers (CRP, procalcitonin and WBC) was examined. Fetuin A was found to have only a negative correlation with serum procalcitonin level (p<0.05). Conclusion: In this study, serum Fetuin-A levels in septic patients decreased significantly in the first 24 hours, followed by an insignificant increase at 72 hours. These findings suggest that monitoring of Fetuin-A levels may help predict the time of occurrence of sepsis and prognosis of sepsis.Öğe Bilateral alt ekstremite uzuv kaybı olan geriatrik hastada spinal anestezi: 2 olgu sunumu(2013) Erbaş, Mesut; Öztürk, Ömür; Kiraz, Hasan Ali; Toman, Hüseyin; Şahin, Hasan; Demiraran, YavuzYaşam kalitesinin yükselmesi, yeni teşhis ve tedaviolanaklarının geliştirilmesi ile yaşlı popülasyon tüm dünyadahızla artmaktadır. Yaşlı hasta grubundaki yandaş hastalıklarve gelişebilecek komplikasyonlar nedeniyle rejyonel anesteziteknikleri genel anesteziye tercih edilmektedir. Spinalanestezinin operasyon sırasında kognitif fonksiyonların vehava yolu reflekslerinin korunması, postoperatif dönemdeetkin analjezinin sağlanması ile birlikte erken mobilizasyongibi avantajları vardır. Spinal anestezide lokal anesteziğinsefale doğru yayılması ile birlikte preganglionik sempatikliflerde blokaj olması, kardiovasküler yan etkilere yol açabilir.Özellikle geriatrik hastalarda bu hemodinamik instabilitedenkaçınmak için lokal anesteziğin mümkün olan en düşükdozda kullanılması tercih edilmelidir. Biz bu yazıda geriatrik,bilateral alt ekstermite uzuv kaybı olan ve ürolojik girişimgeçirecek olan yüksek riskli iki olgumuzda spinal anesteziuygulamamızı ve bilateral uzuv kaybının uyguladığımız lokalanestezik d ozuna etkisini literatür eşliğinde tartışmayıamaçladık.Öğe Comparison of effects on the oxidant/antioxidant system of sevoflurane, desflurane and propofol infusion during general anesthesia(Elsevier Science Inc, 2015) Erbas, Mesut; Demiraran, Yavuz; Yildirim, Hayriye Ak; Sezen, Gulbin; Iskender, Abdulkadir; Karagoz, Ibrahim; Kandis, HayatiBackground and objectives: Desflurane and sevoflurane are frequently used for maintenance of anesthesia and studies have shown that these anesthetics cause a variety of changes to the oxidative stress and antioxidative defense mechanisms. This study aims to compare the effects of sevoflurane, desflurane and propofol infusion anesthesia on the oxidant and antioxidant systems of patients undergoing laparoscopic cholecystectomy. Methods: 45 patients between 18 and 50 years with planned laparoscopic cholecystectomy under general anesthetic were included in the study. Patients were divided into three groups on the way to surgery: propofol (group P n: 15), sevoflurane (group S n: 15) and desfiurane (group D n: 15). All groups were given hypnotic 2 mg/kg propofol IV, 1 mcg/kg fentanyl IV and 0.1 mg/kg vecuronium IV for induction. For maintenance of anesthesia group S were ventilated with 2% sevoflurane, group D cases were given 6% desflurane and group P were given propofol infusions of 12 mg/kg/h for the first 10 min, 9 rrig/kg/h for the second 10 min and 6 mg/kg/h after that. Before induction and after the operation venous blood samples were taken to evaluate the levels of glutation peroxidase, total oxidants and antioxidants. Results and conclusions: The 45 patients included in the study were 22 male and 23 female patients. The demographic characteristics of the groups were similar. In the postoperative period we observed that while sevoflurane and propofol increased antioxidants by a statistically significant level, desfiurane increased the total oxidants level by a significant amount compared to levels before the operation. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe Effects of Inadvertent Perioperative Hypothermia on Metabolic and Inflammatory Mediators(Aves, 2019) Aydin, Halide; Simsek, Tuncer; Demiraran, YavuzObjective: The aim of the present study was to investigate the effects of perioperative undesirable hypothermia on inflammatory (interleukin (IL)-8, IL-10, IL-18, IL-23 and pentraxin (PTX)-3) and metabolic responses (cortisol and insulin) and recovery time. Methods: A total of 60 patients between the ages of 18 and 65 years who were in the lumbar stabilisation operation were included in the study. In this prospective, randomised controlled study, two groups were constituted as with warmed (Group N) and not warmed (Group C) patients before and during the operation. Diuresis, blood loss, body temperature and side effects were recorded with IL-8, IL-10, IL-18, IL-23, PTX-3, cortisol and insulin levels. Results: Perioperative diuresis was significantly higher in Group C. Aldrete score was significantly higher in Group N with less shivering and vomiting in the postoperative period. IL-10, PTX-3 and cortisol levels were found to be significantly higher in Group C in the first postoperative hour. PTX-3 and cortisol were found to be significantly higher in Group C after 24 h of the operation. Insulin was significantly higher in Group N. In 72 h, IL-8 in Group N and cortisol level in Group C were significantly higher. Conclusion: Positive effects of heating the patients in the perioperative period on haemorrhage, diuresis, complications and recovery time were observed in our study. In addition, maintenance of normothermia appeared to modulate the biomarkers that indicate the inflammatory and metabolic responses.Öğe Neurotoxic effects of ketamine and different doses of ropivacaine administered intrathecally in rabbits(Turkiye Klinikleri, 2013) Sezen, Gülbin; Demiraran, Yavuz; Güven, Aysel; Ankarali, Handan; Sevinç, Özdemir; Karagöz, IbrahimObjective: Although a variety of anesthetic medicines are used intrathecally, experimental neurotoxic studies on these drugs are not sufficient. In our study, we used immunocytochemical examination to assess the neurotoxic potential of ketamine and different doses of ropivacaine administered intrathecally. Material and Methods: Thirty rabbits were divided into five groups which were inserted spinal catheters under anesthesia. Each group received in a volume of 0.3 ml, as follows: the R0.2 group received 0.2% ropivacaine, the R0.75 group received 0.75% ropivacaine, the R1 group received 1.0% ropivacaine, the K group received preservative-free S (+) ketamine and the C group received 0.9% NaCl. The onset and duration of action were recorded by using Motor Dysfunction Index (MDI). Rabbits were observed for five days and then euthanasized. After catheters were removed, brains and spinal tissue samples were evaluated by light microscopy and immunocytochemical examination. Results: The longest onset of action was observed in the K group. Among the ropivacaine groups, the onset of action diminished and the duration of action extended with an increase in dose significantly. There was axonal degeneration in the R1 group, but this finding not reach significance. In the ketamine group, significant neuronal degeneration and reduction in number of neurons in the brain sections were observed. In the 1% ropivacaine group, a relative increase in neurofilament intensity was detected using immunocytochemical assessments in the medulla spinalis and brain sections. Conclusion: The intrathecal applications of 1% ropivacaine and ketamine can induce neurotoxic damage, despite a lack of observed functional neurologic deficits. © 2013 by Türkiye Klinikleri.Öğe Re: The Negative Influence of Cigarette Smoke on Passive Smokers-Deteriorated Pulmonary Function Tests and Increased Urine Cotinine Levels(Aves, 2019) Ozturk, Omur; Sezen, Gulbin Yalcin; Ankarali, Handan; Ozlu, Onur; Demiraran, Yavuz; Ates, Hakan; Dost, Burhan[Anstract Not Available]
