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    Evaluation of Prolonged Rt-Pcr Positivity and Viral Load in COVID-19 Patients
    (2023) Urkmez, Fatma Yekta; Erol, Ozlem; Polat, Esra; Kaygusuz, Sedat
    Aim: Real-time reverse transcription polymerase chain reaction (RT-PCR) test is used in the diagnosis of COVID-19. It was aimed to evaluate the factors affecting the viral conversion time, to examine the relationship between viral load, and to determine other factors that may be associated with viral load. Material and Methods: Patients were hospitalized between 15.03.2020-01.08.2020, and viral conversion detected were evaluated retrospectively. Patients were divided into two according to viral conversion time (0-14 days vs >14 days). Results: 349 patients were included in the study (284 vs 65 patients). The age and gender characteristics were similar. Prolonged PCR positivity group had more death (p=0.036) and lower cycle-threshold (CT) value (p=0.017). In the examination of CT values of 246 patients, 228 patients with viral conversion and 18 patients without viral conversion due to death, the CT value was found to be lower, therefore the viral load was higher in patients over 60 years of age (p=0.006), in the presence of cardiovascular system disease (p<0.001) and in patients who died (p<0.001). Conclusion: Prolonged PCR positivity may indicate excess viral load and adverse outcomes. An evaluation including the patient's age, CT value, comorbid conditions, and viral conversion time can give an idea about the prognosis.
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    Hyperlipidemia in Patients with Calcific Tendinitis
    (Aves, 2022) Polat, Esra; Ozyer, Fatih; Yuce, Elif Ilkay; Inanc, Ibrahim Halil
    Objective: Calcific tendinitis is a disease of unclear etiology and is associated with metabolic diseases. Hyperlipidemia, one of the metabolic diseases with systemic effects, may be associated with tendinopathy and tendinitis. In this study, we aimed to evaluate the relationship between hyperlipidemia and hypertriglyceridemia, calcific tendinitis, the location of tendinitis, and the frequency of severely symptomatic tendinitis attacks. Methods: This retrospective study included a total of 2055 patients diagnosed with calcific tendinitis between August 1, 2019, and August 1, 2021. The patients were evaluated in terms of their hyperlipidemia and hypertriglyceridemia status, statin and/or fibrate use, and the frequency of tendinitis, and the location of attack. Results: It was observed that 64.4% (n = 230) of the patients had hyperlipidemia and 11.8% (n = 42) had hypertriglyceridemia. It was determined that the most common tendinitis area among 357 patients was the shoulder. There was no statistically significant difference between the frequency of attacks (P = .712), and the location of attack (P = .069) in patients with hyperlipidemia. There was no statistically significant difference between the frequency of attacks (P = .735) and the location of attack (P = .286) in patients with hypertriglyceridemia. However, a statistically significant difference was found between the attack area (P = .032) in patients with triglyceride values higher than the target recommended values. Conclusion: The frequency of hyperlipidemia is high in patients with calcific tendinitis; it will be useful to evaluate patients with calcific tendinitis in terms of hyperlipidemia.
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    Predictive value of c-reactive protein to albumin ratio and systemic immune-inflammation index for the long-term mortality in COVID-19
    (2023) Polat, Esra; Şabanoğlu, Cengiz; Caner, Muhdedir; Urkmez, Fatma Yekta; İnanç, Fulden Akyüz; Öztürk, Ünal; Kandemir, Hüseyin
    Aim: Several studies have investigated the association between biomarkers and short-term prognosis in the coronavirus infectious disease 2019 (COVID-19). However, data on the long-term prognosis are limited. To determine the predictive value of systemic immune-inflammation index (SII) and C-reactive protein (CRP) to albumin ratio (CAR) for in-hospital and 1-year outcomes during COVID-19. Material and Method: The primary outcomes were in-hospital and 1-year mortality. The secondary outcomes were the intensive care unit (ICU) need at admission and transfer to the ICU later on. Results: The study included 449 (53.6%) males and 389 (46.4%) females with a mean age of 53.8±18.5 years. Previously known heart failure (HF), COVID-19-related HF, acute renal failure (ARF), diabetes mellitus, hypertension, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD)/asthma, high CO-RADS scores (>4), low ejection fraction (EF), higher CAR and SII were associated with an increased in-hospital and 1-year mortality (p<0.05). After multivariate analysis; CAR, SII, ARF, and diabetes mellitus were independent predictors of in-hospital and 1-year mortality,whereas CAD was only an independent predictor of 1-year mortality. After ROC analysis, CAR cut-off levels of 2.54 and 2.23 predicted in-hospital and 1-year mortality, respectively (p<0.001). The SII cut-off levels of 1274 and 1191 predicted in-hospital and 1-year mortality, respectively (p<0.001). Conclusion: CAR and SII can be used as valuable prognostic indexes to predict both the short-term and long-term mortality in COVID-19.
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    Sleeve gastrektomi cerrahisi geçiren hastalara uygulanan anestezi yönteminin perioperatif gelişmiş derlenme (ERAS) üzerine etkilerinin değerlendirilmesi
    (Kırıkkale Üniversitesi, 2023) Polat, Esra; Peker, Kevser
    Polat, E, Sleeve Gastrektomi Cerrahisi Geçiren Hastalara Uygulanan Anestezi Yönteminin Perioperatif Gelişmiş Derlenme (ERAS) Üzerine Etkilerinin Değerlendirilmesi, Kırıkkale Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı Uzmanlık Tezi, Kırıkkale, 2023. Giriş/Amaç: Çalışmamızda morbid obezite nedeniyle laparoskopik sleeve gastrektomi operasyonu yapılan hastalarda kullandığımız farklı anestezi yöntemlerinin ERAS (cerrahi sonrası hızlandırılmış iyileşme) protokolleri üzerine etkisini incelemeyi amaçladık. Gereç/Yöntem: Çalışmamıza hastanemiz Genel Cerrahi Kliniği tarafından Ocak 2022-Eylül 2022 tarihleri arasındaki laparoskopik sleeve gastrektomi operasyonu uygulanan, Amerikan Anesteziyoloji Derneği (ASA) skoru II-III olan 60 hasta dahil edildi. Tüm hastalara standart elektrokardiyogram (EKG), non invaziv kan basıncı (NIBP), periferik oksijen saturasyonu (SpO2) monitörizasyonu yapıldı. Hastalara propofol, fentanil ve rokuronyum ile standart anestezi indüksiyonu uygulandıktan sonra anestezi idamesinde sevofluran+deksmedetomidin (grup 1) kullanılanlar ve desfluran+deksmedetomidin kullanılanlar (grup 2) olarak 2 gruba ayrıldı. Hastalar cerrahi işlem bitince sugammadeks ile extübe edildi. Hastaların intraoperatif spirometrik parametreleri, perioperatif hemodinamik parametreleri, kullanılan anestezik ajan miktarları, postoperatif derlenme ve bulantı-kusma özellikleri karşılaştırıldı. Bulgular: Çalışmamızda grup 1 de kullanılan anestezik miktarının ve maliyetinin grup 2 den anlamlı derecede daha az olduğunu gözlemlendi (p<0,05). Grup 1 de insuflasyon ile kompliyans değişikliği anlamlı farklı görüldü ama intraoperatif spirometrik parametrelerde ve postoperatif akciğer fonksiyonlarında anlamlı farklılık görülmedi. Grupların extübasyon ve PACU sürelerinde ve postoperatif bulantı-kusma oranlarında anlamlı farklılık görülmedi (p>0,05). Grup 2 de intraoperatif kullanılan deksmedetomidin ihtiyacı anlamlı derecede yüksek gözlemlendi (p<0,05). Sonuç: Bu çalışma ile laparoskopik sleeve gastrektomi uygulanan hastalarda anestezi idamesinde kullandığımız sevofluranın intraoperatif anestezik ajan maliyetini ve deksmedetomidin ihtiyacını azaltarak ERAS protokollerine anlamlı etkisi olabileceği sonucuna vardık.