Yazar "Kacmaz, Osman" seçeneğine göre listele
Listeleniyor 1 - 10 / 10
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Decreased brain-derived neurotrophic factor levels may predict early perioperative neurocognitive disorder in patients undergoing coronary artery bypass surgery: A prospective observational pilot study(Elsevier Science Inc, 2021) Miniksar, Okkes Hakan; Cicekcioglu, Ferit; Kilic, Mahmut; Honca, Mehtap; Miniksar, Dilsad Yildiz; Gocmen, Ayse Yesim; Kacmaz, OsmanStudy objective: To determine the prognostic value of the change in intraoperative BDNF (Brain-derived neurotrophic factor) levels during cardiac surgery with cardiopulmonary bypass (CPB) on early perioperative neurocognitive disorder (PND). Design: Prospective observational pilot study. Setting: The study was performed in the Medical Faculty Hospital, from January 2020 to August 2020. Patients: 45 adult patients undergoing elective coronary artery bypass surgery (CABG) with CPB. Interventions: None. Measurements: Cognitive function was evaluated 1 day before and 4 days after the surgery. Serum BDNF levels were measured at four time points (T1: after induction; T2: with aortic cross-clamp; T3: without aortic crossclamp; T4: 4 days after surgery) by enzyme-linked immunosorbent assay. Main results: The incidence of PND was 37.8% four days after surgery. Serum BDNF (T2 and T4) levels were significantly lower in PND group compared to non- PND group (p = 0.003 and p = 0.016, respectively). Moreover, lactate, rSO2 (regional cerebral oxygen saturation), aortic cross-clamp time, CPB duration, and the amount of blood transfusion differed between the groups. Logistic regression analysis identified serum BDNF-T2, age, cross-clamp time, and rSO2-T2 as independent risk factors for PND. Based on the ROC analysis, the area under curve (AUC) of BDNF-T2 concentration for prediction of PND was 0.759 with sensitivity of 71.4% and specificity of 64.7% (p < 0.01). Conclusion: Intraoperative BDNF serum levels may be a useful biomarker in predicting PND in patients undergoing CABG surgery. More comprehensive studies is needed in order to confirm the effect of decreasing intraoperative BDNF serum levels on the development of PND. Trial registration number: NCT04250935 www.clinicaltrials.gov.Öğe Determination of Absence of Right Internal Jugular Vein During Ultrasonographic Guided Central Venous Cannulation(Aves, 2017) Erdogan, Mehmet Ali; Colak, Yusuf Ziya; Kacmaz, Osman; Kolu, Mehmet; Toprak, Huseyin Ilksen[Abstract Not Available]Öğe Differential diagnosis of COVID-19 pneumonia from acute heart failure in pandemic: Importance of radiological and laboratory findings(Turkish Assoc Tuberculosis & Thorax, 2021) Kasapogu, Umut Sabri; Gok, Abdullah; Delen, Leman Acun; Sayan, Hasan; Kacmaz, Osman; Cagasar, Ozlem; Karaca, RukanIntroduction: COVID-19 pneumonia typically presents with high fever, cough, and shortness of breath and on thorax computed tomography (CT) peripheral ground glass opacities help the diagnosis. Although typical imaging findings for COVID-19 pneumonia are specified in thorax CT, these findings can confused with other diseases. The aim of this study is to investigate the roles of radiological imaging and laboratory findings in the differential diagnosis of COVID-19 pneumonia and acute heart failure (AHF). Materials and Methods: In the present study, 74 patients who admitted to the emergency department with respiratory distress during the pandemic period and received a diagnosis of COVID-19 pneumonia and AHF were included. Laboratory data and radiological findings of the patients, at the time of admission, were evaluated. Results: On admission, there was no difference in age, gender between two groups. However, COVID-19 exposure history was found significantly higher in COVID-19 pneumonia patients group (p< 0.001). Fever, cough, and fatigue were found significantly higher in the COVID-19 pneumonia patients group (p< 0.001). There was difference of lesions distribution between the two groups, centrally distributed lesions were found significantly higher in acute heart failure patients (p< 0.001). Pleural effusion and cardiomegaly were found significantly higher in AHF patients (p< 0.001, p< 0.001). Counts of the white blood cells and lymphocytes were found significantly lower in COVID-19 pneumonia patients 0.003, p= 0.009). COVID-19 pneumonia patients had significantly higher levels of CRP ferritin, LDH and CK compared with AHF patients (p< 0.001, p< 0.001, p= 0.002, p= 0.013). However the level of NT-proBNP was found significantly higher in the AHF patients group (p< 0.001). Conclusion: We believe that laboratory data and thorax CT findings can provide beneficial clinical information in differentiating COVID-19 pneumonia from AHF during the pandemic.Öğe Effects of different epidural initiation volumes on postoperative analgesia in cesarean section(Tubitak Scientific & Technological Research Council Turkey, 2020) Kacmaz, Osman; Gulhas, Nurcin; Erdogan Kayhan, Gulay; Durmus, MahmutBackground/aim: The aim of this study was to compare the effects of different epidural initiation volumes on postoperative pain scores, analgesic requirements, and side effects in pregnant women administered patient-controlled epidural analgesia (PCEA) for postoperative pain after cesarean sections. Materials and methods: Eighty-one pregnant women, aged 18-45 years, were included in this randomized, double-blind study. Combined spinal epidural anesthesia was administered for each cesarean section. The patients were divided into 3 groups and different volumes (20 mL, 10 mL, and 5 mL) of the study drug (0.0625% bupivacaine plus 2 mu g/ml, of fentanyl) were administered 90 min after the spinal block via epidural catheter. The visual analogue scale (VAS) scores at rest and during movement, first PCEA dose time, number of PCEA doses required per hour, total analgesic consumed, and side effects were recorded postoperatively. Results: There were no statistically significant differences among the groups in terms of the VAS rest and VAS movement scores. The times to the first analgesic dose requirement were longer in Group 10 and Group 20 than in Group 5. The analgesic requirement during the first 2 h was lower in Group 20 than in the other groups. Conclusions: The PCEA initiations with different volumes provided similar pain scores. However, the 20 mL volume resulted in a lower analgesic dose requirement during the early postoperative period, and it also delayed the requirement for analgesia.Öğe Emergency Difficult Airway Management in a Patient with Severe Epidermolysis Bullosa(Aves, 2016) Ozkan, Ahmet Selim; Kayhan, Gulay Erdogan; Akbas, Sedat; Kacmaz, Osman; Durmus, MahmutEpidermolysis bullosa (EB) is a rare disease characterised by vesiculobullous lesions with minimal trauma to the skin and mucous membranes. Bleeding, scar tissue, contractures, oedema and lesions that can spread throughout the body can cause a difficult airway and vascular access in patients with EB. Therefore, anaesthetic management in patients with EB is a major problem even for experienced anaesthesiologists. Herein, we report a case of difficult airway management in a patient diagnosed with severe EB who presented for emergency tracheostomy because of respiratory failure under general anaesthesia.Öğe Intensive Care Unit Admission Predictors of Geriatric Patients Who Underwent Hemiarthroplasty due to Hip Fracture(Turkish Soc Medical & Surgical Intensive Care Medicine, 2021) Miniksar, Okkes Hakan; Kacmaz, Osman; Yuksek, Ahmet; Aydin, Ahmet; Oz, HakanObjective: In this study, we aimed to investigate the clinical features of geriatric hip fracture cases that underwent hemiarthroplasty surgery and to reveal the predictors of hospitalization in ICU accordingly. Methods: In this study, 158 geriatric patients who underwent hemiarthroplasty surgery for femoral neck fracture between January 2017 and December 2019 were retrospectively analyzed. The patients were divided into two groups as patients who were admitted to the ICU (ICU) and patients who were not admitted to the ICU (non-ICU). The clinical characteristics of the patients were compared between the two groups, and predictors of ICU admission were determined by a multivariate regression model. Results: The mean age of the patients was 82.16 +/- 7.5 years, the mean duration of ICU hospitalization was 1.98 +/- 1.4 days, and the mortality rate was 9.5%. One hundred nineteen of the patients (75.31%) were admitted to the ICU after the surgery.According to the results of the univariate regression analysis, advanced age, presence of comorbidities (coronary artery disease, cerebrovascular disease), number of comorbidities, ASA score, Charlson age-corrected comorbidity index, transfusion of erythrocyte suspension, and cement application were significant risk factors for admission to ICU (p<0.02 for each). According to multivariate regression analysis, ASA score (OR=2.77, p=0.04) and cement application (OR=5.97, p<0.001) were determined as independent risk factors for hospitalization in ICU. Conclusion: Factors that are predictors of the need for ICU after hemiarthroplasty surgery (ASA score and cement application) should be considered in geriatric patients. More comprehensive research is required to show the potential effects of these predictors better.Öğe Intracardiac thrombosis after liver transplantation: Can be detected before surgery?(Medknow Publications & Media Pvt Ltd, 2017) Ozkan, Ahmet Selim; Kacmaz, Osman; Akbas, Sedat; Sahin, Mahmut; Durmus, Mahmut[Abstract Not Available]Öğe Management of the crush syndrome in critical patients: 10 cases(2017) Karakas, Bugra; Aydogan, Mustafa Said; Yucel, Aytac; Yucel, Neslihan; Kacmaz, Osman; Sari, Mirac SefaAbstract Introduction: Crush trauma may be life threating in extremities. Crush syndrome leads to a systemic disorder through muscle cytolysis and the spread of metabolic substance into the circulatory system. In the present study, we summarized the follow-up and treatment of 10 cases with intensive care unit (ICU) crush injury. Meterials and Methods: We have analyzed the clinical data of 10 patients with crush injury who were under treatment in the intensive care unit of our clinic. Age, sex, diagnosis, APACHE II score, sepsis, intensive care complications, treatment parameters in intensive care and arterial blood gases parameters, routine blood biochemistry, alanine aminotransferase, lactate dehydrogenase, creatine kinase, creatinine, existence of blood urea nitrogen, urinary protein and severity score of the patients have been recorded. Patients have been closely monitored for symptoms of crush injury, changes, crush area, urination and dangerous complications. Results: The mean age of 10 patients (10 male) was 41.3 ± 8.7 years. APACHE II score was 21,7. 8 out of 10 patients had traumatic shock, one showed acute renal failure and one presented with multiple organ dysfunction syndrome (MODS). In 3 patients presenting the criteria for crush syndrome, the symptoms of extremity distension and sensory function disorder were regulated with rapid surgical operation and hemodialysis, and urination increased, even in some patients, it reached the normal level. Serologic parameters were regulated in most of the patients after application. Amputation was applied to 5 (50%) patients in our group for serious infection and crush. 2 (20%) patients died, one because of MODS and one because of acute renal failure. Conclusion: Early and aggressive resuscitation, emergency treatment and close monitoring of serious complications are of great importance for saving the lives of the patients with crush syndrome under intensive careÖğe PROGNOSIS OF GERIATRIC COVID-19 PATIENTS ADMITTED TO INTENSIVE CARE UNIT ACCORDING TO VACCINATION STATUS(Gunes Kitabevi Ltd Sti, 2022) Aydin, Ahmet; Kacmaz, Osman; Koca, Erdinc; Kutlusoy, Sevgi; Kasapoglu, Umut Sabri; Oterkus, MesutIntroduction: As of June 27, 2022, the COVID-19 pandemic has caused over 540 million infections and 6.3 million deaths. We aimed to investigate the effect of the vaccine on the clinical course of elderly patients hospitalized in the intensive care unit and to determine the prognosis of the patients according to their vaccination status. Materials and Methods: The study included 157 patients over the age of 65. Patients were divided into two groups. The first group consisted of patients who were vaccinated with two doses of CoronaVac, and the second group consisted of patients who were not vaccinated. Demographic data of the patients, prehospital clinical frailty scales, Charlson Comorbidity Indexes, APACHE II scores, laboratory values, and patient prognoses were recorded. Results: Of the 157 patients, 93 (59.2%) were female, and the median age was 76 years (65-99). 96 (61.1%) patients were vaccinated and 61 (38.9%) patients were unvaccinated. Patients were grouped as survivors (n=26) and deceased. We found that APACHE II, prehospital clinical frailty scales, and Charlson Comorbidity Indexes scores were higher in patients who died. There was a significant difference between blood lymphocyte and ferritin levels and survival. The 28-day survival rate was higher and intensive care unit overall survival time were longer in the vaccinated group. Conclusions: We observed that the vaccinated patients had higher survival times and lower mortality rates than those who were not vaccinated. We think that it is important to vaccinate elderly patients and that additional doses may be needed.Öğe Retrospective Evaluation of Dental Treatment under General Anaesthesia(Aves, 2015) Ozkan, Ahmet Selim; Erdogan, Mehmet Ali; Sanli, Mukadder; Kacmaz, Osman; Durmus, Mahmut; Colak, CemilObjective: Most dental procedures can be performed with local anaesthesia, however noncompliant paediatric patients, patients with mental retardation or psychiatric disorders, severe anxiety, severe craniofacial anomalies and orofacial trauma may need general anaesthesia. In these patients accompanying central nervous system diseases and airway problems increase the risk of complications. Anaesthesia records of 467 cases of dental surgery performed under general anaesthesia between 2011-2014 is reported with information from the recent literature. Methods: In the study, 467 cases of dental procedures performed under general anaesthesia were taken from the Inonu University of Medicine, Dentistry Disabled Treatment Centre, after approval of the Inonu University Faculty of Medicine Ethics Committee. Demographic data, ASA classification, Mallampati (MP) score, duration of surgery, type of intubation and difficulties, comorbid diseases, premedication application, endocarditis prophylaxis, recovery time, analgesia and reasons for general anaesthesia were recorded as mean +/- standard deviation (SD) or as a number. Results: The mean age of the patients was 16.78 +/- 12 years and the female/male ratio was 277/190 (59.3%/40.7%). Of the 467 patients, 219 (46.9%) were classified as ASA I, 234 (50.1%) as ASA II and 14 (3%) as ASA III. Furthermore, 182 (38.9%) patients with mental retardation, 33 (7.1%) with cerebral palsy and 28 (6%) with autism were identified. The mean operative time was 114.53 +/- 35.4 min, and the average recovery time 40.4 +/- 6 was min. Of the endotracheal intubations 277 (59.3%) were oral, 82 (17.6%) were nasal, and 108 (23.1%) were nasal with the help of fibreoptics. Difficult intubation was observed in 20 (4.3%) patients. The MP score was 1 in 397 (85%) patients, 2 in 50 (10.7%) patients, 3 in 18 (3.9%) patients and 4 in 2 (0.4%) patients. General anaesthesia was applied because of cooperation difficulties in 213 (45.6%), mental retardation in 182 (38.9%), autism in 28 (5.9%), schizophrenia in 7 (1.7%) and jaw surgery in 37 (7.9%) patients. Local infiltration was used for analgesia in 141 (30.2%), morphine in 12 (2.6%), tramadol in 3 (0.6%) and paracetamol in 311 (66.6%) patients. Endocarditis prophylaxis was employed in 36 (7.7%) cases. Conclusion: General anaesthesia in dental procedures is becoming increasingly common. Anaesthetic management is important due to the frequency of genetic syndromes and mental retardation. In the anaesthetic management of these patients, strategies for the patient should be identified, the process should be implemented in the operating room and preparations should be made with risk analyses.
