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Öğe Drug-drug interactions in intensive care units and potential clinical consequences of these interactions(2019) Oksuz, Ersoy; Bugday, Muhammet Serdar; Soyalp, Celaleddin; Karaaslan, Erol; Oto, Gokhan; Temelli Goceroglu, Rezzan; Berber, IlhamiAim: Drug-drug interactions (DDIs) are an important factor that can lead to serious health problems by increasing or decreasing the effects of drugs. This study aimed to evaluate the frequency of DDIs in the intensive care unit (ICU).Material and Methods: All patients who were hospitalized for more than 24 h in the ICU of our hospital between January and September 2018 and received 2 or more medications were included in this retrospective study. Frequency and severity of the DDIs were detected using the Rx Mediapharma and Lexi-Interact programs.Results: Of the 972 patients enrolled in the study, 2742 incidences of DDIs were detected in 626 patients (64%). Of the different drug pairs administered, 422 had DDIs, and 64 of those had 10 or more DDIs, constituting 67% of all of the DDIs. The most common potential clinical consequences of DDIs were increased risk of bleeding (12.3%), hyperkalemia (8.2%), arrhythmia (7.9%), and CNS depression (6.6%). Conclusion: The results indicated that DDIs in the ICU were very common in our hospital. Moreover, these results indicated that patients should be closely monitored for the prevention of adverse effects, such as electrolyte disturbance, bleeding risk, and arrhythmia of drugs.Öğe Efficacy of tocilizumab therapy in severe COVID-19 pneumonia patients and determination of the prognostic factors affecting 30 days mortality(Marmara Univ, Fac Medicine, 2022) Delen, Leman; Kasapoglu, Umut Sabri; Gok, Abdullah; Cagasar, Ozlem; Tetik, Bora; Oksuz, ErsoyObjective: In coronavirus disease - 19 (COVID-19) patients, cytokine storm develops due to the increase of pro-inflammatory cytokines. Tocilizumab (TU.), has been used in the treatment of COVID-19 patients and successful results have been obtained. The aim of this study was to determine the efficacy of TCZ and also investigate the prognostic factors affecting the success of treatment and mortality in COVID-19 patients treated with TCZ. Patients and Methods: Between March 2020 and August 2021, a total of 326 confirmed severe COVID-19 pneumonia patients, treated in the intensive care unit, were included in the study. Results: The mean age of the patients was 63.02 +/- 11.58 years, and 203 (62.3%) of the patients were male. Patients treated with TCZ had a longer survival time compared with the standard therapy (p=0.012). It was found that type of respiratory support (HR:2.19, CI:1.10-4.36, p=0.025) and hyperlactatemia on the day of TCZ therapy admission (HR:2.93 CI:1.53-5.64, p=0.001) were the significant and independent prognostic factors of survival in severe COVID-19 pneumonia patients treated with TCZ. Conclusion: Tocilizumab therapy improved 30-days survival in critically ill COVID-19 pneumonia patients. Also, among the patients with TCZ, types of respiratory support and hyperlactatemia on the day of TCZ admission were the independent prognostic factors.Öğe Evaluation of post-transplant complications, patient and graft survival in patients with autosomal dominant polycystic kidney disease after renal transplantation; A single center experience(2021) Bugday, Cigdem; Bugday, Muhammet Serdar; Oksuz, Ersoy; Turkmen, AydinAim: Autosomal dominant polycystic kidney disease (ADPKD) is systemic, progressive hereditary disease, characterized by cyst formation in multiple organs. Patients with ADPKD mostly develop end stage renal disease (ESRD) and require renal replacement therapy, preferably renal transplantation (RT). In this study, we aimed to compare the post-RT complications, patient and graft survivals in patients with ADPKD and other etiologies of ESRD. Materials and Methods: We retrospectively evaluated patients’ baseline characteristics, post-RT complications, patient and graft survival in patients with ESRD underwent renal transplantation due to ADPKD and other etiologies. We included 28 patients in ADPKD and 28 patients in the control group. Results: The mean survival time was 224.83 ± 7.53 months in all patients. During follow-up period 1 patient died in both groups and 10 years patients and graft survivals were similar for both groups. The graft survival, acute and chronic rejections and glomerular filtration rate levels were similar in both groups end of the first year of RT but total cholesterol and glucose levels were significantly higher in the ADPKD group. Moreover, developing of ischemic heart disease was significantly higher in ADPKD (32% vs 0%, p=0.002), the other complication rates were similar in both. Conclusion: As a comparesion to patients with ESRD underwent RT due to ADPKD and different etiologies, both groups have similar patient and graft survival rates. Patients with ADPKD after transplantation may have a higher incidence of ischemic heart disease.