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Öğe Association between hemogram parameters and survival of critically Ill patients(Sage Publications Inc, 2019) Karagöz, İbrahim; Aktaş, Gülali; Yoldaş, Hamit; Yıldız, İsa; Ögün, Muhammed Nur; Bilgi, Murat; Demirhan, AbdullahAim: Recently, hemogram parameters, such as mean platelet volume (MPV), had been proposed as novel inflammatory and prognostic factors. In present retrospective analysis, we aimed to determine and compare MPV of survived and dead patients whom admitted to intensive care unit (ICU) of our institution. Methods: We recorded hemogram parameters and other laboratory data and demographic characteristics of patients treated in ICU. Patients are divided into 2 groups-dead patients and survived patients. Laboratory data of survived patients compared to those of dead patients. Results: Age, gender, and other laboratory variables were not significantly different between dead and survived patients. On the other hand, MPV of survived patients was significantly higher than that of the dead patients (P = .001). Conclusion: We think that elevated MPV levels in an ICU patient should alert clinicians for worse outcome. Physicians should be more careful in the management of these patients.Öğe Association between hemogram-derived indices and culture-positive infections in intensive care population(Comenius Univ, 2019) Yoldaş, Hamit; Karagöz, İbrahimAIM: To investigate the relationship between hemogram parameters and bacterial growth in cultures of blood, urine or sputum in intensive care unit patients. METHODS: This retrospective, observational, cross-sectional study was conducted in a tertiary referral hospital between March 2015 and December 2017. Baseline demographic and clinical characteristics, hemogram parameters and other laboratory test results of patients admitted to intensive care unit were recorded. Patients were divided into two groups as patients who were infected, and those who did not have any infectious agents grown in the culture dish, and then the groups were compared with each other. RESULTS: There were no significant differences between the groups in terms of baseline demographic and clinical characteristics. When the groups were compared in terms of hemogram parameters, the neutrophil-to-lymphocyte ratio (p < 0.001), platelet-to-lymphocyte ratio (p = 0.013), plateletcrit (p = 0.028) and mean platelet volume (p < 0.001) were significantly higher in infected patients than in non-infected patients. CONCLUSION: We suggest that neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, plateletcrit, and mean platelet volume could be used as infection markers in the intensive care unit population (Tab. 1, Ref. 25).Öğe Atropa belladonna and associated anticholinergic toxic syndrome: a case report(Univ Udayana, 2017) Karagöz, İbrahim; Bilgi, Murat; Boduç, Elif; Pehlivan, Murat; Solmaz, KübraAtropa belladonna causes poisoning by its anticholinergic effects. Excessive ingestion of this plant may cause peripheral anticholinergic effects, and moreover, a more severe clinical picture can be seen due to its central effects which can result in lethargy, coma or even death. In this article, we aimed to present a case with Atropa belladonna intoxication and to emphasize that Atropa belladonna poisoning should be kept in mind in cases with anticholinergic findings.Öğe C-reactive protein-to-serum albumin ratio as a marker of prognosis in adult intensive care population(Aepress Sro, 2023) Karagöz, İbrahim; Özer, Bahri; İtal, Kasım İlker; Türkoğlu, Mustafa; Dişikırık, Akın; Özer, Songül PeltekBACKGROUND: Patients in intensive care unit (ICU) require close follow up and clinical attention due to variability in the course of their underlying morbidities. The estimation of prognosis in these subjects has an utmost importance. Recent studies showed that C-reactive protein-to-serum albumin ratio (CAR) could be a reliable marker of inflammation in certain conditions. We aimed to compare CAR levels of deceased patients to those in survived subjects treated in ICU.PATIENTS AND METHODS: We retrospectively analyzed the data of adult patients. CAR was simply calculated by dividing the levels of CRP by those of serum albumin. Patients were grouped either as deceased or survived according to the prognosis. The data of the survived and deceased ICU subjects were compared.RESULTS: A total of 208 subjects, 101 deceased and 107 survived, were enrolled in the study. Median CAR levels of the deceased and survived subjects were 49.5 (3-153 %) and 11 (0.2-119 %), respectively (p < 0.001). CAR was significantly correlated with PDW (r = 0.24; p < 0.001) and serum creatinine (r = 0.27; p < 0.001) levels. In ROC analysis, CAR values higher than 30.2 % have 72 % sensitivity and 70 % specificity in predicting mortality in ICU population (AUC: 0.74; p < 0.001; 95% CI: 0.67-0.81).CONCLUSIONS: We suggest that CAR levels of the subjects in ICU should be evaluated during medical care. Increased CAR levels should alert physicians for a worse outcome in those subjects (Tab. 1, Fig. 1, Ref. 21). Text in PDF www.elis.skÖğe Could red cell distribution width be a marker of thyroid cancer?(Coll Physicians & Surgeons Pakistan, 2017) Aktaş, Gülali; Şit, Mustafa; Karagöz, İbrahim; Erkuş, Edip; Özer, Bahri; Koçak, Mehmet Zahid; Yaman, Semih; Keyif, Fatih; Altınordu, Rabia; Erkol, Hayri; Şavlı, HalukObjective: To study red cell distribution width (RDW) values, a novel inflammatory marker in routine hemogram, of patients with benign or malignant thyroid nodules and to compare with healthy population. Study Design: Descriptive study. Place and Duration of Study: Abant Izzet Baysal University Hospital, Bolu, Turkey, from November 2015 and February 2017. Methodology: The hemogram values of patients undergone thyroid surgery for thyroid nodule between November 2015 and February 2017 were retrospectively analyzed, and compared to those in healthy subjects. Subjects with infectious or inflammatory diseases were excluded. Patients' characteristics and laboratory data were obtained from institutional computerized database. Preoperative hemogram values of thyroid nodule patients were recorded. One-way ANOVA and Kruskal-Wallis tests were performed to compare variables with significance at p<0.05. Results: Median RDW of malignant nodule group was 15.8 (12.9-19.5) and was significantly higher than both of those in benign nodule (15) and control groups (14), (p<0.001). Conclusion: Elevated RDW in patients with thyroid nodules in preoperative period should alert the physician for possible malignancy and this cost-effective marker also can help support other modalities (ultrasound scan, and fine needle aspiration biopsy) to distinguish malignant from benign nodules.Öğe Does hemogram biomarkers predict mortality in intensive care population?(2019) Karagöz, İbrahimAim: To compare hemogram-mediated inflammatory markers such as mean platelet volume (MPV), red cell distribution width (RDW), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), MPV to platelet ratio (MPR) and RDW to platelet ratio (RPR) in predicting outcome in the intensive care units (ICU) population. Methods: After obtaining approval of intuitional board the patients whom were treated in the Anesthesiology and Reanimation ICU of Bolu Abant Izzet Baysal University Hospital between March 2017 and December 2018 were evaluated retrospectively and enrolled to the study. The abovementioned laboratory parameters of the deceased and survivors were compared. Results: The PDW, MPV, C-reactive protein (CRP), RPR and MPR values were significantly different between deceased and survived subjects. Moreover, MPV and PDW values were significantly and positively correlated with serum CRP level. Conclusion: We suggest that PDW, MPV, MPR and RPR could be used in determining the severity of the disease in ICU patients along with CRP. Since these hemogram results could be obtained in a much shorter time period compared to CRP, they could be useful in this population; in which hours and even minutes are important in the treatment in ICU.Öğe An easy and reliable way to prevent electrocardiographic deteriorations of patients undergoing off-pump coronary artery bypass surgery: Preoperative anxiolytic treatment(Soc Brasil Cirurgia Cardiovasc, 2019) Demirhan, Abdullah; Velioğlu, Yusuf; Yoldaş, Hamit; Karagöz, İbrahim; Coşgun, Mehmet; Çalışkan, Duygu; Yıldız, İsa; Erdem, Kemalettin; Bilgi, MuratObjective: To investigate the effects of preoperative anxiety relieving on electrophysiological changes in patients undergoing off-pump coronary artery bypass surgery. Methods: A total of 61 patients at ASA III risk group in the age range of 18-65 years were enrolled in the present study. Patients were randomly divided into two groups. Group S (Sedation group) was administered 0.04 mg/kg lorazepam per os (PO) twice before the operation. Group C (control group) was not administered with any anxiolytic premedication. State Trait Anxiety Inventory (STAI-I) and Beck Anxiety Inventory (BAI) were used to evaluate the level of anxiety. Electrocardiography (ECG), pulse oximeter and standard monitoring were performed for each patient. QT and P dispersions in each derivation of all ECGs were calculated. Results: Preoperative STAI-I scores were significantly lower in sedation group compared to the controls. Mean values of QT dispersion measured before induction, at the 1st minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.024; P=0.027; P=0.001; P=0.033, respectively). The mean values of P dispersion measured before induction, at the 3rd minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.001; P=0.020; P=0.023; P=0.005, respectively). Conclusion: Elevated anxiety levels in patients undergoing coronary bypass surgery have a negative effect through prolonged QT and P-wave dispersion times. Anxiolytic treatment before surgery may be useful to prevent ventricular and atrial arrhythmias and associated complications through decreasing the QT and P-wave dispersion duration.Öğe Effect of chronic obstructive pulmonary disease on washout time of sevoflurane anesthesia: a placebo controlled randomized trial(E-Century Publishing Corp, 2016) Şeker, İlknur Suidiye; Demiraran, Yavuz; Haftacı, Engin; Cangür, Şengül; Sezen, Gülbin; Karagöz, İbrahimBackground: Respiratory functions and gas exchange deteriorates in patients with COPD. In our study, we aimed to investigate if there is any relationship between the washout time of sevoflurane and chronic obstructive pulmonary disease (COPD). Method: Sixty patients, American Society of Anesthesiology (ASA) 1-3 status; aged between 18-60 years old who underwent general anesthesia for an operation were enrolled in our study. Patients were divided into two groups: Group N (non-COPD n = 33), group COPD (patients with COPD, n = 33). Two patients were excluded from the study, a total of 31 patients in Group COPD. Pre-operative respiratory function tests were performed and standard monitoring was provided in the operation room. Both groups received propofol 2 mg/kg, fentanyl 1.5-2 mcg/kg and rocuronium 0.6 mg/kg intravenously, and an oxygen-air mixture of 50%/50% with a tidal volume of 6 ml/kg (ideal body weight) and sevoflurane of 1 MAC. Remifentanil was administered at 0.05-0.1 mcg/ kg/min intravenously in the maintenance of anesthesia. All patients were monitored by an anesthesia machine until extubation. A sevoflurane vaporizer was closed at the end of the operation and the measurement time was started. FiO2, Fi(ins), Fi(exp) of sevorain, End-tidal CO2 were recorded during the operation and Fins (Sevo)/Fexp (Sevo) ratio, MAC1, MAC2, MAC3, MAC4, extubation times were recorded. Fi(ins)1: percentage of sevorain filiation in inspirium before closing 1 MAC vaporizer. Fi(exp)1: percentage of sevorain filiation in expirium before closing 1 MAC vaporizer. Fi(ins)2: percentage of sevorain filiation in inspirium after closing 0.1 MAC vaporizer. Fi(exp)2: percentage of sevorain filiation in expirium after closing 0.1 MAC vaporizer. Results: There was no significant relationship between the respiratory function tests of individuals with or without COPD and MAC1, MAC2, MAC3, MAC4 and extubation time (P > 0.05). The cut-off criterion for MAC4 was determined to be 210 seconds. Conclusion: Although there was no difference between the washout and extubation times of both groups, increased BMI and decreased intraoperative hemoglobin values should be carefully considered during anesthetic management in the COPD group.Öğe Effects of bispectral index-controlled use of magnesium on propofol consumption and sedation level in patients undergoing colonoscopy(2019) Yoldaş, Hamit; Yıldız, İsa; Karagöz, İbrahim; Demirhan, Abdullah; Bilgi, Murat; Şit, Mustafa; Ogün, Muhammed NurObjective: The aim of this study is to investigate the effects of bispectral index-controlled use of magnesium on propofol consumption, periprocedural hemodynamic response and patient comfort.Material: A total of 60 patients were enrolled in the study. In Group 1 (magnesium), a single dose 50 mg/kg magnesium sulfate diluted with 100 mL 0.9% NaCl was administered 10 min-utes before the beginning of the procedure. Initially bolus dose of 0.5 mg/kg propofol was ap-plied. The maintenance dose of propofol was 60 mcg/kg/min. During the procedure, the propo-fol infusion was increased by titration until the bispectral index (BIS) value of 70 was achieved. In Group 2 (saline), 100 ml 0.9% NaCl was administered 10 minutes before the beginning of the procedure. The bolus and maintenance doses of propofol, and target BIS values were the same as those in Group 1.Results: When BIS values were compared between the groups, the initial BIS values in the magnesium group (Group 1) were significantly higher than those of the saline group (Group 2) (p<0.05). The time to reach BIS 70 was significantly shorter in the magnesium group (p<0.05). Propofol consumption was greater in Group 2 than in Group 1 (p<0.05). The time to reach BIS 70 was significantly shorter in Group 1 (p<0.05). No significant difference was found between the groups in terms of patient- and endoscopist-satisfaction (p<0.05).Conclusion: The use of magnesium in addition to propofol may be an efficient and reliable op-tion to reduce the drug consumption during colonoscopic interventions.Öğe Effects of lidocaine oropharyngeal spray applied before endotracheal intubation on qt dispersion in patients undergoing coronary artery bypass grafting: A prospective randomized controlled study(Soc Brasil Cirurgia Cardiovasc, 2020) Bilgi, Murat; Velioğlu, Yusuf; Yoldaş, Hamit; Coşgun, Mehmet; Yüksel, Ahmet; Karagöz, İbrahim; Yıldız, İsa; Eş, Abdülhamit; Erdem, Kemalettin; Demirhan, AbdullahObjective: To investigate the effects of lidocaine oropharyngeal spray applied before endotracheal intubation on hemodynamic responses and electrocardiographic parameters in patients undergoing coronary artery bypass grafting. Methods: A total of 60 patients who underwent coronary artery bypass grafting surgery were included in this prospective randomized controlled study. Patients were randomly divided into two groups, the topical lidocaine group (administration of 10% lidocaine oropharyngeal spray, five minutes before laryngoscopy and endotracheal intubation) and the control group. Both groups were compared with each other in terms of main hemodynamic parameters including mean arterial pressure and heart rate, as well as P and QT wave dispersion durations, before and after endotracheal intubation. Results: The groups were similar in terms of age, gender, and other demographics and basic clinical characteristics. There was a statistically significant difference between the groups in terms of QT dispersion durations after laryngoscopy and endotracheal intubation. The increase in QT dispersion duration was not statistically significant in the topical lidocaine group, whereas the increase in QT dispersion duration was statistically significant in the control group. When the groups were compared in terms of P wave dispersion durations, there were significant decreases in both groups, but there was no significant difference between the groups. Conclusion: Our study revealed that the topical lidocaine administration before endotracheal intubation prevented increase of QT dispersion duration in patients undergoing coronary artery bypass grafting.Öğe Effects of magnesium sulphate on liver ischemia/reperfusion injury in a rat model(2019) Akkoca, Kerem; Yoldaş, Hamit; Şit, Mustafa; Karagöz, İbrahim; Yıldız, İsa; Demirhan, Abdullah; Bilgi, MuratAim: To investigate the protective efficacy of magnesium sulphate in a model of rat liver ischemiareperfusion (I/R) injury. Method: 32 adult female Wistar-Albino rats (250 to 350 g) were used in this experimental study. Rats were divided into 4 groups according to liver ischemia and magnesium sulfate application methods. Group 1 (C); control, group 2 (M); magnesium sulphate, group 3 (I/R); liver I/R, group 4 (I/R+M); I/R + magnesium sulphate treated. The blood samples were centrifuged for the study of aspartate aminotransferase (AST), alanine aminotransferase, prothrombin time (PT), international normalized ratio (INR) troponin I, total antioxidant status (TAS), total oxidant status (TOS) assays. The livers of the animals were removed at the end of the study and samples were taken for histopathological examination. Results: AST and INR values were significantly decreased in I/R+M group compared to I/R group. There was no significant difference in ALT values of the groups. Although not statistically significant, the TAS values were increased in I/R + M group compared to I/R group rats. In addition, the value of TOS was found to be lower in I/R + M group rats. In the histopathological examination, the mean values of apoptosis and necrosis were lower in the IR+M group compared to the I/R group. Conclusion: The main finding of the present study suggested that magnesium sulphate pretreatment moderately decreased the liver damage through its anti-inflammatory and anti-oxidant effects in a rat model of liver I/R.Öğe Evaluation of olfactory memory after sevoflurane anesthesia: is really short-term memory influenced?(Scientific Publishers India, 2016) Bayır, Hakan; Yıldız, İsa; Yoldaş, Hamit; Karagöz, İbrahim; Kurt, Adem Deniz; Şereflican, MuratObjective: Olfactory disorders can negatively effect the quality of life. Few clinical studies and case reports have investigated the relationship between anesthesia and olfactory dysfunction. The aim of this study was to investigate the effect of sevoflurane on olfactory memory with Brief-Smell Identification Test (TM) in patients used sevoflurane. Patients and Methods: This, prospective, clinical study was performed on 60 ASA physical status I-II patients, between 18-65 years of age who were scheduled for expected surgery duration of 40-120 minutes. All patients were preoperatively informed about Brief-Smell Identification Test. For induction 2 mg.kg(-1)propofol, 0.5 mg.kg(-1) rocuronium and 1 mu g.kg(-1) iv fentanyl were administered. Anesthesia was maintained with the inhalational of anesthetic sevoflurane (2%). Brief-Smell Identification Test scores are recorded 30 minutes before the surgery and when the Aldrate Recovery Score reached 10 in the postoperative period. Preoperative and postoperative results were compared and p-values<0.05 were considered statistically significant. Results: The patients mean age were 47.1 +/- 13.8. There was no statistically significant difference between the mean preoperative and intraoperative HR and MAP values. Preoperative total correct answer rate to odorous substances was 85.4%, and postoperative rate was 84.5%. Percentage of the odor identification by the patients revealed no statistically significant difference when pre and post-operative rates were compared (P>0.05).Öğe Evaluation of olfactory memory after sevoflurane anesthesia: Is really short-term memory influenced?(Scientific Publishers of India, 2016) Bayir, Hakan; Yildiz, Isa; Yoldas, Hamit; Karagöz, İbrahim; Kurt, Adem Deniz; Kocoglu, Hasan; Sereflican, MuratObjective: Olfactory disorders can negatively effect the quality of life. Few clinical studies and case reports have investigated the relationship between anesthesia and olfactory dysfunction. The aim of this study was to investigate the effect of sevoflurane on olfactory memory with Brief-Smell Identification Test™ in patients used sevoflurane. Patients and Methods: This, prospective, clinical study was performed on 60 ASA physical status I-II patients, between 18-65 years of age who were scheduled for expected surgery duration of 40-120 minutes. All patients were preoperatively informed about Brief-Smell Identification Test. For induction 2 mg.kg-1propofol, 0.5 mg.kg-1 rocuronium and 1 ?g.kg-1 iv fentanyl were administered. Anesthesia was maintained with the inhalational of anesthetic sevoflurane (2%). Brief-Smell Identification Test scores are recorded 30 minutes before the surgery and when the Aldrate Recovery Score reached 10 in the postoperative period. Preoperative and postoperative results were compared and p-values<0.05 were considered statistically significant. Results: The patients mean age were 47.1 ± 13.8. There was no statistically significant difference between the mean preoperative and intraoperative HR and MAP values. Preoperative total correct answer rate to odorous substances was 85.4%, and postoperative rate was 84.5%. Percentage of the odor identification by the patients revealed no statistically significant difference when pre and post-operative rates were compared (P>0.05). © 2016, Scientific Publishers of India. All rights reserved.Öğe Novel mortality markers for critically Ill patients(Sage Publications Inc, 2020) Yoldaş, Hamit; Karagöz, İbrahim; Ögün, Muhammed Nur; Velioğlu, Yusuf; Yıldız, İsa; Bilgi, Murat; Demirhan, AbdullahAim: Inflammatory markers, such as the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), derived from a complete blood count have recently attracted attention as potential markers of morbidity and mortality in various diseases. The aim of the present study was to assess the usefulness of the NLR and PLR as markers of hospital stay and mortality of patients in intensive care units (ICUs). Methods: Patients treated in the ICU of our institution between October 2016 and August 2017 were enrolled in the study. After obtaining approval from the institutional committee, patient data were sourced from the institution's computerized database and retrospectively analyzed. The patients were assigned to 2 groups according to the outcomes: survivors and deceased. Results: The NLR of survivors and deceased patients was 2.06 (1.18-21.68) and 10.42 (2.85-48.2), respectively. The NLR was significantly elevated in deceased patients as compared with that of survivors (P < .001). Similarly, the median PLR of patients in the deceased group (268.9 [150-3000]) was significantly higher than that of patients in the survivor group (55.7 [11.8-152.5]). The difference in the PLR between groups was significant (P < .001). Conclusion: Both the NLR and PLR, as well as C-reactive protein, predicted mortality in this critically ill population. The PLR and NLR are easy-to-measure, inexpensive markers. Physicians should be aware of elevations in PLR and NLR in patient care in ICUs.Öğe Tip 2 diyabetli hastalarda diyabet süresi ve HBA1C düzeyleri ile olfaktör disfonksiyon arasındaki ilişki: Pilot çalışma(2017) Demirkol, Muhammed Emin; Ögün, Muhammed Nur; Yoldaş, Hamit; Karagöz, İbrahim; Çalışkan, DuyguAmaç: Bu çalışmada Tip 2 diyabetes mellitus (DM) tanısı olan hastaların diyabet süreleri ve HbA1c seviyelerinin olfaktör disfonksiyon ile ilişkili olup olmadığını araştırmayı amaçladık. Hastalar ve Yöntem: Önceden bilinen Tip 2 DM tanısı alan ve bu nedenle ilaç kullanan 50 hasta çalışmaya dahil edildi. Hastaların koku fonksiyonlarını test etmek için 12 farklı koku maddesi bulunan The Brief Smell Identification Test (B-SIT) Türkçe versiyonu kullandı. Çalışmaya katılan hastaların yaş, kilo, boy, kilo, HbA1C seviyeleri, diyabet süreleri ve test sonuçları kaydedilerek gerekli analiz yapıldı. p değeri <0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Diyabet süresi ve HbA1c düzeyleri ile B-SIT skorları arasında anlamlı korelasyon saptanmadı.
