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  • Küçük Resim
    Öğe
    Algoloji Polikliniğine BaĢvuran Onkolojik Hastalarda Tedavi ve Komplikasyon Yönetimi: Retrospektif Değerlendirme
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2013) Erdoğan Kayhan, Gülay; Gülhaş, Nurçin; Aslan, Abdulvahap; Durmuş, Mahmut
    Amaç: Bu çalışmada İnönü Üniversitesi Tıp Fakültesi Algoloji Bilim Dalına Ocak 2011-Mart 2012 tarihleri arasında başvuran 241 onkoloji hastasının ağrı şiddeti, uygulanan medikal tedavi yöntemleri, hasta memnuniyeti ve gelişen komplikasyonlar geriye dönük olarak değerlendirildi. Gereç ve Yöntemler: Demografik veriler, medikal tedavide kullanılan opioid analjezikler, nöropatik ağrıya yönelik adjuvan tedaviler, ek hastalıklar, vizüel analog skalagiriş ve kontrol değerleri, kaçak ağrısı, bulantı-kusma, kabızlık, kaşıntı, idrar retansiyonu, sedasyon gibi yan etkiler ve bunların tedavileri ve hasta memnuniyeti kaydedildi. Bulgular: Ağrı tedavisi için % 61 zayıf opioid, %9.1 güçlü opioid ve %29.9 zayıf + güçlü opioid kombinasyonu tercih edilmişti. Nöropatik ağrıya yönelik adjuvan tedavi başlanan 84 (% 35) hastada %47.5 pregabalin, %43.3 amitriptilin, %7.5 gabapentin ve %1,7 gabapentin+amitriptilin kullanıldığı saptandı. Poliklinik başvurusunda ağrı düzeyleri orta ve şiddetli iken (vizüel analog skala bazal değeri, 7.16 ± 1.5) %90.5 hastada vizüel analog skala kontrol değerinin 4 ve altında olduğu tespit edildi (vizüel analog skalakontrol 3.06 ± 1.1). İlaç memnuniyet oranımız %80 iken, bulantı-kusma oranı %30.3, konstipasyon %19.5, sedasyon %19.1, idrar retansiyonu %10 ve kaşıntı %5 idi. Sonuç: Opioid tedavisindeki tercihlerimiz, başarı oranlarımız ve hasta memnuniyetleri açısından verilerimizin literatür ile uyumlu olduğu görüldü. Kanser ağrısında iyi planlanmış ağrı protokolleriyle hasta memnuniyet skorlarının yüksek, yan etki insidansının ise düşük olduğu kanısındayız.
  • Küçük Resim
    Öğe
    Dexmedetomidine ameliorates TNBS induced colitis by inducing immunomodulator effect
    (Journal of Surgical Research, 2013) Erdoğan Kayhan, Gülay; Gül, Mehmet; Kayhan, Başak; Gedik, Ender; Özgül, Ülkü; Kurtoğlu, Elçin Latıfe; Durmuş, Mahmut; Ersoy, Mehmet Özcan
    Background: Since sedatives are often administered to immune-compromised and critically ill patients, our understanding of immunomodulation by sedation will be critical. Dexmedetomidine, a selective a2-adrenergic receptor agonist, is often used for sedation and analgesia especially in intensive care units. There are conflicting and little data concerning both the effect and the mechanism of dexmedetomidine on immune response. In our study, we aimed to investigate the effect of dexmedetomidine on immune system at two different doses (5 mg.kg 1 and 30 mg.kg 1 ) during inflammatory bowel disease by using an experimental model, which resembles both systemic and local inflammation. Methods: The effect of dexmedetomidine on the course of inflammatory bowel disease was investigated by measuring macroscopic and microscopic parameters. We investigated proinflammatory Th1, Th2, and Th17 cytokine levels in serum samples to analyze systemic immune response. Following this, local immune response was investigated by measuring cytokine levels in the presence of dexmedetomidine in spleen cell culture. Results: Dexmedetomidine administration led to amelioration of all disease associated pathological manifestations. According to our in vitro and in vivo results, dexmedetomidine shows anti-inflammatory effect by increasing IL-4 and IL-10 levels responsible from antiinflammatory response via Th2 pathway. Moreover, we showed for the first time in the study that dexmedetomidine administration reduces IL-23, which is responsible from initiation of inflammatory response via Th17 pathway. Conclusions: Dexmedetomidine can have beneficial effect on preoperative or postoperative inflammatory bowel disease patients in intensive care units by down-regulating inflammatory immune response not only in systemic circulation but also in tissue-specific manner.
  • Küçük Resim Yok
    Öğe
    Dexmedetomidine improves ultrastructural view of renal damage and biochemical parameters during an experimental inflammatory bowel disease
    (2018) Karaca, Zeynal Mete; Gül, Mehmet; Kayhan, Başak; Erdoğan Kayhan, Gülay
    Abstract: Abstract Investigation of the effect of Dexmedetomidine (Dex) on inflammatory bowel diseases (IBD) induced renal damage by using an experimental model. IBD frequently cause reduction in renal function and renal failure. Since perioperative anesthesia and postoperative conditions in intensive care can cause acute kidney injury and reduction on renal function; deciding on a sedative and anesthetic agent without side effects would reduce IBD caused renal damage. We investigated histopathological, electron microscopic analyzes and antioxidant effects of Dex on kidney tissue during trinitrobenzene sulfonic acid (TNBS) induced damage in BALB/c mice at two different concentrations of Dex; 5?g/kg and 30?g/kg. Blood samples were collected to analyze creatinine levels. The levels of malondialdehyde (MDA) and activity of antioxidant enzymes glutathione (GSH) and superoxide dismutase (SOD) were measured in tissue homogenates. Histopathological and ultrastructural changes in kidney following TNBS induction were significantly reduced in Dex treatment groups. Administration of Dex significantly reduced creatinine levels. MDA levels were significantly reduced in Dex groups. Administration of Dex brought back GSH level to control level. Administration of Dex significantly 1.48 and 1.96 times increased SOD activity at 5?g/kg and 30 ?g/kg, respectively. Dexmedetomidine treatment may have benefits to prevent IBD induced renal damage.