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Öğe Correction of Financial Disclosure(2019) Miniksar, Okkes Hakan; Colak, Yusuf ZiyaÖğe 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 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 Knowledge, Attitudes, and Behaviors of Mosque Imams regarding Organ Donation(Int Scientific Literature, Inc, 2014) Keten, Hamit Sirri; Keten, Derya; Ucer, Huseyin; Cerit, Mustafa; Isik, Oguz; Miniksar, Okkes Hakan; Ersoy, OzgurBackground: In this study we aimed to determine knowledge, attitudes, and behaviors of mosque imams regarding organ donation. Material/Methods: This study involved 322 mosque imams working in Kahramanmaras, a city in the Mediterranean region of Turkey. A questionnaire was used to determine participants' sociodemographic characteristics, knowledge, attitudes, and behaviors regarding organ donation. Results: Out of a total of 322 participants, 253 (78.6%) stated that organ donation is allowed in Islam, while 5 (1.6%) expressed that it is religiously forbidden, and 64 (19.9%) stated that they have no idea about the issue. Only 2 (0.6%) participants were registered organ/tissue donors, wile 320 (99.4%) were not. Out of all participants, 72 (22.4%) imams were willing to donate organs. Forty-six (14.3%) imams had previously received basic training about organ donation, and 166 (51.6%) were willing to attend a related training. Television programs and healthcare professionals were the most common means of learning about organ donation. Educational programs by healthcare professionals for imams and the public were proposed to be effective in increasing the number of organ donations. Conclusions: This study revealed that the knowledge of mosque imams regarding organ donation is poor and they had little willingness to donate their organs. Interestingly, many imams had no knowledge about organ donation under Islam. Collaboration of media, healthcare professionals, and mosque imams regarding organ donation might help increase organ donation.Öğe Videolaryngoscopy versus direct laryngoscopy in without muscle relaxation intubation conditions in tympanomastoidectomy: A randomized, prospective clinical study(2019) Miniksar, Okkes Hakan; Colak, Yusuf ZiyaAim: The aim of this study was to compare the effects of direct laryngoscopy and videolaryngoscopy on the intubation conditions and hemodynamic responses, in the patients scheduled for tympanoplasty and mastoidectomy operation and intubated without muscle relaxation. Material and Methods: This randomized, prospective study was performed in 62 patients aged 18-65 years with ASA (American Society of Anesthesiologists) I-II and Mallampati score I-II and scheduled for elective tympanoplasty and mastoidectomy with general anesthesia. The patients were divided into two groups as the direct laryngoscopy group (Group D) and the videolaryngoscopy group (Group V). The induction of anesthesia was performed with 1 mg / kg lidocaine, 3 μg / kg remifentanil and 2.5 mg / kg propofol for both groups. Hemodynamic responses (heart rate, systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure), number of intubation attempts, duration of laryngoscopy, duration of intubation, intubation conditions (degree of coughing, jaw relaxation, ease of laryngoscopy and position of vocal cords), and postoperative hoarseness and sore throat were evaluated. Results: Hemodynamic responses to intubation were similar in both groups. There were no statistically significant differences between the groups in terms of the number of intubation attempts and the duration of laryngoscopy. The duration of intubation was significantly longer in Group V (29.19 sec) than in Group D (22.19 sec). Intubation conditions showed no significant difference between the groups. Conclusion: In patients without intubation difficulty, McGrath® MAC video laryngoscope showed no superiority in intubation conditions compared with Macintosh direct laryngoscope, during intubation without muscle relaxants; the effects on hemodynamic responses were also similar.
