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Öğe Analysis of biochemical laboratory values to determine etiology and prognosis in patients with subarachnoid hemorrhage: a clinical study(Taylor & Francis Ltd, 2019) Ogden, Mustafa; Bakar, Bulent; Karagedik, Mustafa Ilker; Bulut, Ibrahim Umud; Cetin, Cansel; Aydin, Gulcin; Ozveren, Mehmet FaikObjectives: The aim of this study was to establish prognostic and predictive markers in patients with subarachnoid hemorrhage (SAH) using simple laboratory methods. Methods: A retrospective examination was made of patients with SAH diagnosed secondary to isolated head trauma, isolated anterior communicating artery aneurysm rupture, and angiography-negative SAH. Age, gender, Glasgow Coma Scale (GCS) scores, and Fisher's grade scores, Glasgow Outcome Scale (GOS) scores, leukocyte count, neutrophil count, lymphocyte count, platelet count, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio results (PLR) were evaluated. Results: NLR and PLR values, which were similar in patients with spontaneous SAH, were significantly high in patients with traumatic SAH. NLR and PLR values could be 80% sensitive and 75% specific for distinguishing traumatic SAH from spontaneous SAH. Eosinophil count was lower in patients with angiography-negative SAH and patients with aneurysmal SAH than in patients with traumatic SAH. Initially measured GCS score, Fisher's grade score, eosinophil, neutrophil and lymphocyte counts could be prognostic in all patients with SAH. Moreover, it was concluded that the initially measured number of eosinophils might be directly related to patient prognosis. The eosinophil count was generally found to be high in traumatic SAM patients and it was observed that this parameter could be predictive for these patients. Lymphocyte count and NLR values could be prognostic markers in patients with angiography-negative SAH. Conclusion: NLR, PLR and eosinophil count values could be predictive for etiological factors (traumatic SAH or spontaneous SAH) of patients who were admitted unconscious to the emergency room with SAH detected on radiological imaging.Öğe Anesthesia management of a newborn with Pena-Shokeir Syndrome(Elsevier Science Inc, 2018) Aydin, Gulcin; Gencay, Isin; Colak, Selim…Öğe Dexmedetomidine as an Alternative Anesthetic Agent for Flap Surgery: An Intravital Evaluation in the Cremaster Muscle Flap(Lippincott Williams & Wilkins, 2019) Gencay, Isin; Boybeyi, Ozlem; Unlu, Gulhan; Yazici, Ilker; Aydin, Gulcin; Buyukkocak, UnaseIntroduction: Flap surgery is one of the most commonly used techniques of reconstructive surgery for effective repair of damaged tissue. Optimal anesthetic technique and anesthetic agent plays an important role in flap perfusion. This study aimed to evaluate the effects of dexmedetomidine infusion on the microcirculation in the cremaster muscle flap by direct in vivo monitoring. Materials and Methods: We randomly divided 9 Wistar albino rats into 3 groups. The rats in the control group underwent the surgical procedure (isolation of the cremaster muscle) alone; the rats in the experimental groups 1 and 2 received an infusion of dexmedetomidine (10 and 30 min) after the surgical procedure. Results: The means of vessel diameters, number of functional capillaries, and movements of leukocytes in all groups were evaluated using intravital microscopic examination. The diameters of the arterioles and venules of the cremaster muscle significantly increased in the dexmedetomidine groups. The number of functional capillaries was higher in the dexmedetomidine groups than in the control group. No difference was observed in the movements of leukocytes between the control and experimental groups. Dexmedetomidine significantly increased the diameters of the arterioles and venules of the cremaster flap and the number of functional capillaries. Conclusion: On the basis of the effects of dexmedetomidine on microcirculation, we suggest that dexmedetomidine continue to be used as an anesthetic agent, and may be considered also for reconstructive procedures, particularly flap surgery.Öğe The effect of insulin resistance on mortality in critically ill patients in the intensive care unit(INDIAN ANAESTHETISTS FORUM, 2020) Bakkal, Ayse Gulcan; Buyuksekerci, Murat; Gencay, Isin; Aydin, Gulcin; Caglayan, Osman; Buyukkocak, UnaseBackground and Aims: Insulin resistance can be described as a subnormal biological response to a specific insulin concentration or deterioration of an accepted response to insulin in glucose homeostasis and deficiency of insulin response. The aim of this study is to evaluate the effect of insulin resistance on mortality in critically ill patients. Methods: Over 18-year-old and nondiabetic 150 patients that had been hospitalized in an intensive care unit (ICU) between September 2013 and October 2014 were enrolled in this study. The Acute Physiology and Chronic Health Enquiry II (APACHE II), Glasgow Coma Scale, and Richmond Agitation and Sedation Scale were calculated on the day of admission to the ICU, and following 4th day and 1st, 2nd, 3rd, and 4th weeks. Insulin resistance was calculated using the HOMA formula. Infection and other complications during ICU stay, the requirement of mechanical ventilation (MV), nutritional status (parenteral and/or enteral), vasopressor, steroid, and insulin treatment were also recorded. Patients followed in the ICU were recorded as survivors and nonsurvivors. Results: Glucose levels were found to be higher in nonsurvivor group at the 1st week and there was a significant positive relationship between APACHE II score and insulin resistance at the 3rd week. There was a significant relationship between mortality and requirement of MV, vasopressor medication, complications, and infection. Conclusion: We conclude that the effect of insulin resistance seems to affect the mortality in critically ill patients after at least a 3 weeks long follow-up time.Öğe The Efficacy of Ultrasound-Guided Paravertebral Block in Laparoscopic Cholecystectomy(Mdpi, 2018) Aydin, Gulcin; Aydin, OktayBackground and objectives: Despite its wide use in thoracic procedures, to date, few studies have assessed the effectiveness of paravertebral block (PVB) in laparoscopic cholecystectomy (LC) in an adult population. In these studies, PVB was performed bilaterally using nerve stimulator guidance. To the best of our knowledge, the effectiveness of unilateral preoperative and postoperative ultrasound-guided PVB has not been evaluated in patients undergoing elective LC. The aim of this study was to evaluate the efficacy of single-dose unilateral paravertebral block (PVB) in patients undergoing laparoscopic cholecystectomy (LC) under general anesthesia. Materials and Methods: Patients undergoing LC were randomly separated into control, preoperative block, and postoperative block groups. PVB was performed unilaterally using bupivacaine under ultrasound guidance. Postoperative pain within the first 24 h, side effects, intraoperative opioid and postoperative analgesic requirements were noted. Evaluation was made of a total of 90 patients (25 males, 65 females) with a mean age of 45.78 +/- 14.0 years (range, 19-74 years). Results: Opioid and additional analgesic needs and nausea/vomiting rates were significantly reduced in the preoperative block group compared to the other groups (p < 0.05). Visual Analog Scale (VAS) scores were significantly lower in the preoperative and postoperative block groups compared to the control group (p < 0.05 for all). When the VAS scores were compared between the preoperative and postoperative block groups, a significant difference in favor of the preoperative group was observed in terms of the zero minute-, 1st and 2nd h assessments (p < 0.05 for all). Conclusions: Ultrasound-guided PVB is a useful and safe approach for pain management during and after LC. Preoperative block can also reduce the rate of requirement for intraoperative opioid and postoperative analgesia.Öğe Extracavally Malpositioned Central Venous Catheter(COLL PHYSICIANS & SURGEONS PAKISTAN, 2020) Aydin, Gulcin; Akcaboy, Zeynepnur[Özet Yok]Öğe The Healing Effects of Thymoquinone and Dexpanthenol in Sciatic Nerve Compression Injury in Rats(Taylor & Francis Inc, 2019) Ogden, Mustafa; Karaca, Sahika Burcu; Aydin, Gulcin; Yuksel, Ulas; Dagli, Ahmet Turan; Akkaya, Suleyman; Bakar, BulentIntroduction: Functional healing of peripheral nerve injuries is still difficult. In this study, potential healing effects of thymoquinone and dexpanthenol in sciatic nerve compression injury (SCI) were investigated. Method: Twenty-four male Wistar albino rats which were applied compression injury to their sciatic nerves were randomly separated into four groups as following: "control" group contained six rats administered no pharmacological agent; "TMK" group consisted of six rats administered 10 mg/kg intraperitoneal thymoquinone once a day for one week; "DXP" group contained six rats administered 50 mg/kg intraperitoneal dexpanthenol once a day for one week; and "TMK-DXP" group consisted of six rats administered separately 10 mg/kg intraperitoneal thymoquinone and 50 mg/kg intraperitoneal dexpenthanol once a day for one week. Four weeks later from SCI, sciatic nerve function index (SFI) was applied before sacrifice of all rats, and then their crushed sciatic nerves were histopathologically examined, in terms of "Schwann cell count", "axon and myelin degeneration", "axon shape/size differences", "fibrosis", and "neovascularisation". Results: "Schwann cell count" (p = 0.011), "axon and myelin degeneration" (p = 0.001), "axon shape/size differences" (p = 0.011), and "fibrosis and neovascularisation" (p = 0.026) scores were different between the control and TMK-DXP groups. SFI scores were different between the control and TMK groups (p = 0.002), between the control and TMK-DXP groups (p < 0.001), and between the DXP and TMK-DXP groups (p = 0.029). Conclusions: This study results revealed that these pharmacological agents used alone had no histopathological healing effect in rats with SCI, but thymoquinone could improve walking function. However, thymoquinone and dexpanthenol used together had a significant histopathological and functional healing effect.Öğe Healing of Ischemic Colon Anastomosis in Rats Could Be Provided by Administering Dexpanthenol or Coenzyme Q10(Mdpi, 2018) Pehlivanli, Faruk; Aydin, Oktay; Karaca, Gokhan; Aydin, Gulcin; Devrim, Tuba; Bulut, Huri; Daphan, Cagatay ErdenBackground: In this study, the effectiveness of dexpanthenol and coenzyme Q10 (CoQ10) on the healing of ischemic colon anastomosis was investigated. Methods: Forty eight maleWistar Albino rats were divided into four equal groups (Sham-S, Sham-I, DXP, Q10). Following full layer colon resection, single layer colon anastomosis, without creating ischemia, was performed on the Sham-S group. The same experimental model was performed on remaining groups after ischemia was created. Intraperitoneal dexpanthenol and CoQ10 was administered to the DXP and Q10 groups once a day for three days. Ten days later, all colon anastomoses were investigated histopathologically and biochemically, as well as their burst pressure values, in all sacrificed rats. Results: The highest burst pressure value was observed in the Sham-S group, decreasing from high to low in the DXP, Q10, and Sham-I groups, respectively (p = 0.008). Furthermore, tissue hydroxyproline (p = 0.001) level values were significantly different among the groups. Additionally, histopathological analysis revealed a significant difference among groups regarding reepithelization (p = 0.027) and polymorphonuclear leukocyte density (p = 0.022). Conclusions: This preliminary study has shown that ischemia-reperfusion injury may impair the healing of colon anastomosis and it has been concluded that dexpanthenol and CoQ10 may have positive effects on the healing of ischemic colon anastomosis in rat, although re-epithelization may be adversely affected using CoQ10.Öğe Hyperbaric oxygen treatment resistant carbon monoxide poisoning(Elsevier Science Inc, 2018) Aydin, Gulcin…Öğe Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study(Tubitak Scientific & Technical Research Council Turkey, 2019) Aydin, Gulcin; Sayan, Cemile DayanganBackground/aim: In this study, it was aimed to investigate the relationship between body mass index (BMI) and cerebral oxygenation during spinal anesthesia in women undergoing cesarean section. This study also aimed to demonstrate whether fetal cord blood oxygenation was affected by maternal BMI and/or delivery time. Materials and methods: The study included parturients with ASA I score undergoing cesarean section under spinal anesthesia in 2015 and 2016. They were divided into two groups according to BMI: Group 1 comprised parturients with BMI of < 30 (n = 11) and Group 2 comprised parturients with BMI of = 30 (n = 17). Right cerebral oxygenation (RSO2) and left cerebral oxygenation (LSO2) monitoring was performed using near-infrared spectroscopy (NIRS). The participants were divided into two groups according to the duration of fetal delivery. Group A included parturients with delivery time of < 2 min (n = 7) and Group B those with delivery time of > 2 min (n = 18), and fetal cord blood oxygenation was measured using a blood gas analyzer. Results: Evaluation was made of a total of 25 patients. The RSO2 values were measured at the 20th, 30th, and 35th minutes of the cesarean section procedure and the median values of all the time intervals in Group 1 were significantly lower than those of Group 2 (P < 0.05). The LSO2 value was significantly lower in Group 1 at the 35th minute compared to Group 2 (P < 0.05). The PO2 values of fetal cord blood were significantly lower in Group B (P < 0.05). Conclusion: The results of this study showed that parturients with BMI of < 30 who are undergoing cesarean section under spinal anesthesia might have an increased risk of complications due to decreased cerebral oxygenation related with hypotension. Therefore, it can be suggested that before and during cesarean section these patients should be closely monitored for cerebral oxygenation using NIRS.Öğe Suprapubic Midline Extraperitoneal Approach for Widespread Retroperitoneal Abscess Originating from Anorectal Abscess(Southeastern Surgical Congress, 2018) Aydin, Oktay; Pehlivanli, Faruk; Karaca, Gokhan; Aydin, Gulcin; Ozler, Ismail; Daphan, CagatayÖğe Unexpected local anesthesia toxicity during the ultrasonography-guided peripheral nerve block(Elsevier Science Inc, 2018) Aydin, Gulcin…
