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Öğe Bibliometric Analysis of Top 100 Most Cited Articles Related To “Liver Transplantation” in Anesthesia Literature(2020) Kayır, Selçuk; Doğan, Güvenç; Yağan, Özgür; Hancı, VolkanObjective: For treatment of acute liver failure, end-stage liver diseases and liver-sourced malignant tumors, liver transplantation is a treatment method applied as a last resource. In our study, the aim was to assess 100 articles with most citations about liver transplantation in the anesthesia literature. Methods: Our study used the “advanced mode” feature of the “Institute for Scientific Information (ISI) Web of Science (WOS)” search engine. The search was performed on 11.12.2018 and 100 articles with most citations related to liver transplantation were determined. For each article, total citation number, annual citation number, authors, and catalogue information for the study and journal were determined using Web of Science (WOS) and PubMed. Results: The total mean number of citations for 103 studies with most citations was determined as 75.87±68.48. The annual citation numbers for the studies varied from 34.18 to 1.15, with mean of 4.98±4.60. When the areas of focus of the studies are investigated, the first three areas were transfusion practice in 17 articles (16.5%), thromboelastography in14 (13.6%) and hemodynamic monitoring in 10 (9.7%). The mean number of citations of authors from the European continent was significantly higher than authors from other continents (p<0.01). Conclusion: Our study is the first to evaluate and analyze the top 103 articles receiving most citations related to liver transplantation in the anesthesia literature. Bibliographic studies created using scientific search engines are illustrative of the topics of focus for authors and researchers.Öğe Comparison of the effects of Neostigmine and Sugammadex on Colonic Anastomotic Strength in Rats(Academic Press Inc., 2020) Doğan, Gül; Doğan, Güvenç; Kayır, Selçuk; Yağan, Özgür; Hancı, VolkanBackground:After colorectal surgery, anastomotic leakage is a major cause of mortality andmorbidity. There are many factors affecting anastomotic leakage. It is known that agentssuch as neostigmine that is used to reverse neuromuscular blockade have certain effectson anastomosis. In our study, in which we planned to test this hypothesis, we aimed tocompare the possible effects of different doses of sugammadex and neostigmine on colonanastomosis strength in a colonic resection anastomosis model in rats.Materials and methods:Forty adult Wistar albino male rats were divided into five groups ascontrol (group C), Sugammadex 16 mg/kg (group SL), sugammadex 96 mg/kg (group SH),neostigmine 0.3mmol/kg (group NL), and neostigmine 1.5mmol/kg (group NH). The trans-verse colons of all rats were resected, and colonic anastomosis was performed. Appropriatedrug doses according to the groups were given on the postoperative seventh day, and tissuehydroxyproline (TH) level and anastomotic bursting pressure were measured.Results:Anastomotic bursting pressure values were statistically significantly different be-tween the groups (P¼0.001). The bursting pressure in group SH was significantly highercompared with group C, group NL, and group NH. The hydroxyproline values were sta-tistically significantly different between the groups (P¼0.015). According to the post hoctest results, the difference was between group SH and group C (P¼0.007). There were nosignificant differences between the other groups (P>0.05). There was no significant dif-ference in terms of intra-abdominal adhesion rates between the groups.Conclusions:In our study, we found that low and high doses of neostigmine had no variableeffect on anastomosis, but high dose of sugammadex (96 mg/kg) had an increasing effecton intestinal anastomosis strengthÖğe Early biochemical predictors of sepsis in patients with burn injury: current status and future perspectives(Lippincott Williams & Wilkins, 2020) Erenler, Ali Kemal; Baydın, Ahmet; Ay, Mehmet Oğuzhan; Doğan, Güvenç; Yastı, Ahmet ÇınarSepsis is the leading cause of morbidity and mortality in patients with burn injury and emerges as a clinical challenge for both emergency specialists and critical care staff. Since early diagnosis and appropriate treatment are known to be the milestones of sepsis management, use of biomarkers in diagnosis is highly recommended in the initial stage of sepsis. Although currently used Procalcitonin, as a traditional marker, may accurately indicate the presence of a systemic inflammation in burn patients, there is a need for more accurate markers of sepsis in burn patients. For now, use of a combination of markers may be suggested for a more accurate diagnosis. In the near future, gene therapy may make not only early prediction, but also appropriate treatment of sepsis in burn patients possible. In this article, we aimed to clarify roles of current biomarkers in early diagnosis of sepsis in burn patients and make future reflections in this growing field. Copyright (C) 2020 Wolters Kluwer Health, Inc. All rights reserved.Öğe Effect of sugammadex on recovery from ketamine anesthesia: An experimental study(2020) Kayır, Selçuk; Doğan, Güvenç; Yağan, Özgür; Hancı, VolkanAim: Previous studies have shown cyclodextrins bind to a variety of medications. The hypothesis in our study is to determine whether or not sugammadex interacts with the lipophilic medication of ketamine to shorten the effect duration and ensure earlier recovery. Material and Methods: The study used 24 adult male Sprague-Dawley rats. Rats were randomly divided into 4 equal groups. Each rat was administered 75 mg/kg ketamine intraperitoneal (ip) bolus and then in the fifth minute rats was administered sugammadex at appropriate doses for their group through the lateral vein in the tail. Group C (control group) were administered 15 mL/kg physiologic serum (PS) (n=6), Group Sgdx 16 were administered 16 mg/kg sugammadex (n=6), Group Sgdx 100 were administered 100 mg/kg sugammadex (n=6) and Group Sgdx 1000 were administered 1000 mg/kg sugammadex (n=6). The heart rate, respiratory rate and recovery durations of the rats were recorded. Results: The recovery duration in the Sgdx 100 group was statistically significantly shorter compared to the control group (p=0.026), while the recovery duration in the Sgdx 1000 group was statistically significantly shorter than the control group (p<0.001) and the Sgdx 16 group (p=0.015). Heart rate was statistically significantly low in the Sgdx 1000 group compared to the control group (p<0.05). Respiratory rates were similar. Conclusion: Our study showed that 100 mg/kg and 1000 mg/kg sugammadex doses significantly shortened recovery. We conclude that there is a need for more research about the interaction between ketamine and sugammadex.Öğe Effects of caffeic acid phenethyl ester on testicular torsion/detorsion injury in rats(Science Printers and Publishers Inc., 2018) İpek, Hülya; Doğan, Gül; Doğan, Güvenç; Deveci, EnginOBJECTIVE: To investigate the protective effect of caffeic acid phenethyl ester (CAPE) on testicular torsion/detorsion-induced ischemia-reperfusion (I/R) injury. STUDY DESIGN: Thirty male Wistar albino rats were randomly categorized into 3 groups: Sham, torsiondetorsion (T/D), and T/D+CAPE. Malondialdehyde (MDA), SOD, CAT, GSH levels, histopathological damage, and expression levels of endothelin-1 and ADAM-15 were examined in testicular tissue. RESULTS: The MDA level in the T/D group testes were significantly higher than those in the sham group. MDA levels of testes were lower in the CAPE-treated group than those in the T/D group. The T/D group had significantly lower SOD, CAT, and GSH levels in the testes than did the sham group. SOD, CAT, and GSH levels of the testes were lower in the CAPE-treated group than in the T/D group. In T/D group the thickness of the basal membrane in the tubules was increased, and degeneration and apoptosis in spermatogenetic cells, organization disorder in Sertoli cells, and sperm cells in the lumen were observed. The CAPE-treated group showed less atrophy and degeneration of the tubule epithelium than did the T/D group. CONCLUSION: It has been thought that CAPE administration after T/D testis damage may affect spermatogenesis development by inducing cell-cell junction by reducing apoptotic development which can regulate blood flow and microcirculation in testes. © 2018 Science Printers and Publishers, Inc.Öğe Effects of Pelargonium sidoides (UMCA ®) on pulmonary contusion from blunt thoracic trauma in rats(2020) Doğan, Gül; Doğan, Güvenç; Karaca, Onur; Ayaz, ErcanAim: The aim of the present study was to evaluate the effect of Pelargonium sidoides (UMCA ®) which was antibacterial, antiviral, anti-inflammatory and antioxidant, on pulmonary contusion (PC) caused by isolated blunt thoracic trauma (BTT) in an experimental rat model. Material and Methods: A total of 24 rats were divided into three groups: control group (CG), sham group (SG), and Pelargonium sidoidesgroup (PSG). PC was induced by isolated BTT for all the groups except the control group. Pelargonium sidoidestreatment was performed by gavage for 72 hours to the PSG after truma. Blood and tissue samples were collected from the groups. Malondialdehyde (MDA), superoxide dismutase (SOD),glutathione (GSH) and arterial blood gas parameters were measured. Lung tissue samples were collected for histopathology. Results: Histopathologically, alveolar congestion, hemorrhage,edema,disruption and neutrophil infiltrationwere significantly higher in SG when compared with CG(p<0.001, p=0.007, p=0.040, p=0.003, p=0.001). Leukocyte infiltration was significantly decreased in PSG when compared with SG (p=0.025). Biochemically, MDA level was significantly higher in SG than in CG (p<0.001) and GSH level was significantly lower in SG than in CG (p<0.001). MDA level was significantly lower in PSG than in SG (p=0.002). In blood gas parameters PH and PO2 level was significantly higher in PSG than in SG (p=0.013, p<0.001) and PCO2 level was significantly lower in PSG than in SG (p<0.001). Conclusion: PS prevents further injury by decreasing leukocyte infiltration,MDAand regulating ventilation -perfusion in lung contusions. PS may have a role in the progression of inflammation but not in preventing the pathologic disruption of pulmonary parenchyma exactly.Öğe Evaluation of Neuroprotective Effect of Sevoflurane in Acute Traumatic Brain Injury: An Experimental Study in Rats(2020) Doğan, Güvenç; Karaca, OnurAIM: To examine the effect of sevoflurane, a halogenated anesthetic used in clinical applications, on oxidative stress and inflammation after an acute traumatic brain injury (TBI) in rats. MATERIAL and METHODS: Thirty male Sprague–Dawley rats were divided into three groups: control (Group 1), trauma (Group 2), and trauma+sevoflurane (Group 3). A diffuse TBI model was created for Groups 2 and 3. Sevoflurane anesthesia was applied 6 hours a day after induced trauma in Group 3. Glutathione (GSH), malondialdehyde (MDA), and tissue myeloperoxidase (MPO) activities were measured in the blood. Tumor necrosis factor alpha (TNF-?), vascular endothelial growth factor (VEGF), and Bax primary antibodies were used to determine the effects of TBI. RESULTS: MDA was significantly higher in Group 2 than in Group 1. There was a significant increase in tissue MPO levels in Groups 2 and 3 compared with those in Group 1. GSH levels decreased in Groups 2 and 3. Group 3 revealed degenerative changes in neurons and glial cells, vascular enlargement and congestion, and inflammatory cell infiltration around blood vessels. In Group 3, VEGF expression was positive in endothelial and inflammatory cells around blood vessels. Group 3 had positive TNF-? expression in neurons, small granular cells, and glial cells around blood vessels. CONCLUSION: Sevoflurane administration in acute TBI did not prevent the development of oxidative stress and inflammation.Öğe Evaluation of the Effect; of Menstrual Cycle Phaseson Preoperative Anxiety(2020) Kayır, Selçuk; Ekici, Arzu Akdağlı; Doğan, Güvenç; Yağan, Özgür; Kısa, Alperen; Yalvaç, Mehmet; Kayır, TubaAim: The menstrual cycle has two phases, before ovulation (follicularphase) and after ovulation (luetalphase). Inbothphase periods, a physiological fluctuationprocess is observed dueto hormonal changes. Stress and anxietymayoccur in many patients who will undergo surgery. The aim of this study is to evaluate the effects of patients under going surgery on anxiety in different periods of the menstrual cycle. Methods: Eighty patients between the ages of 20-45, who were planned to under goelective surgery, who had a physical status of ASA I-II, regularmenstrualcycle, were not in meno pause, had nopremenstrualtension, and did not use oral contraceptiveagents. Inthestudy, data were collectedusing Spielberg's State-Trait Anxiety Inventory (STAI 1-2) [State Anxiety Inventory (STAI1),Trait Anxiety Inventory (STAI2)] and Visual Analogue Scale (VAS). Results: The meanage of the Follicular Phase group was 31.09 ± 7.77 and the meanage of the Luteal Phasegroupwas 32.26 ± 7.41. Meanages were similar between the groups(p=0.493).STAI1and Anxiety scores were statistically significantly higher in the lutealphase group(p=0.034, p=0.028,respectively). STAI2scoreswere not statistically different between the groups (p=0.180).Öğe Experimental study on prophylactic effects of vardenafil in ischemia–reperfusion model with intestinal volvulus injury in rats(W.B. Saunders, 2019) Doğan, Gül; İpek, Hülya; Baş, Yılmaz; Doğan, Güvenç; Kayır, SelçukAim: An experimental study was performed to evaluate the effects of Vardenafil on ischemia–reperfusion (I/R) injury in an experimental volvulus model by histochemical and biochemical methods. Materials and methods: Thirty-five male Wistar rats were divided in five groups (n = 7). In Group 1, a 5 cm segment of small intestine 2 cm proximal to cecum was excised to have a control group. In the second group, 5 cm segment of small intestine 2 cm proximal to cecum was rotated 360° clockwise direction and sutured with 4/0 polyglactin to generate an experimental model of volvulus. At the end of 2 h of ischemia, the same intestinal segment was sampled. In group 3, after achieving ischemia similar to group 2, two hours of reperfusion injury was obtained by removing the sutures. Rats in Group 4 received vardenafil after 1.5 h of ischemia and then 2 h of reperfusion. And finally, in Group 5, vardenafil was administered 2 h before laparotomy and 5 cm of intestine was removed without I/R injury. Intestinal segments were evaluated for total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) with biochemical and histopathological analysis. Results: Serum TOS levels and OSI were not significantly different between groups (p = 0.910, P = 0,43 respectively). The serum TAS level was decreased in group 3 as compared to vardenafil groups 4 and 5, without a statistical significance (p = 0.428). In histopathologic analysis, we found that vardenafil, partially reduced I/R injury. The villus structure was preserved but, congestion and inflammation were moderate. Conclusion: Vardenafil partially reduced I/R injury histopathologically on intestine. Our study shows that it does not have statistically antioxidant effect on intestinal I/R injury in experimental model of volvulus. However, effects of vardenafil in I/R injury of liver, kidney, heart, testis, over and brain which were cited in literature were not confirmed with I/R injury on intestine. © 2019 Elsevier Inc.Öğe Internal Jugular Vein Catheterization: The Landmark Technique versus Ultrasonography Guidance in Cardiac Surgery(Cureus Inc, 2019) Kayır, Selçuk; Özyalçın, Sertan; Doğan, Güvenç; Diken, Adem İlkay; Türkmen, UfukBackground Central venous catheterization is an invasive procedure that must be performed during cardiovascular surgery. The addition of ultrasound guidance to the catheterization technique has shown effectiveness in reducing complications because it allows for the visualization of anatomical variations prior to intervention and the continual visualization of the needle during the placement. The purpose of this study was to evaluate the effectiveness of needle-guiding ultrasound for internal jugular venous cannulation. Method Patients undergoing coronary bypass surgery at Hitit University, department of cardiovascular surgery, from January 2014 to June 2018, were included in the study. The patients were divided into two groups: those with catheterization with ultrasound guidance (Group U) and those with catheterization performed with the anatomic landmark technique (Group L). Results A total of 584 cases were investigated. The success of the procedure and complication rates for both methods were compared. Central vein catheterization with ultrasonography produced success and complication rates significantly better than those for catheterization using the landmark technique (p=0.04 and p=0.00001, respectively). Conclusion This study demonstrated that the use of ultrasonography for internal jugular vein catheterization for patients undergoing coronary bypass surgery significantly reduced the complication rates as compared to those of patients where the landmark technique was used for catheterization.Öğe Minimal, Düşük ve Orta Akım Hızlı Anestezi Uygulamalarının İntraoperatif Kas Gevşetici Tüketimine Etkisi: Prospektif Kohort Çalışma(2019) Doğan, Güvenç; Kayır, Selçuk; Demir, Emre; Yavuz, Yasemin; Hancı, VolkanAmaç: Çalışmada düşük akım anestezi uygulamasında vücut ısısının daha iyi korunması nedeniyle intra-operatif kas gevşetici ihtiyacında bir artış olup olmayacağının belirlenmesi amaçlanmıştır. Bu amaçla çalışmada minimal, düşük ve orta akım hızlı anestezi uygulamalarının intra-operatif kas gevşetici tüketimine olan etkileri incelendi. Gereç ve Yöntem: Çalışmaya ASA I-III, ortalama 90-120 dakika süreli genel anestezi altında elektif şartlarda opere olacak 18-75 yaş arası 120 hasta dahil edildi. Hastalar randomize olarak minimal akım (n=40, taze gaz akımı 0,5 L/dk), düşük akım (n=40, taze gaz akımı 1 L/dk) ve orta akım (n=40, taze gaz akımı 2 L/dk) olarak üç gruba ayrıldı. Nazofaringeal vücut sıcaklığı, kalp hızı, periferik oksijen satürasyonu, sistolik arteriyel basınç, diyastolik arteriyel basınç, ortalama arter basıncı ve indüksiyon sonrası; 1., 5., 10., 15., 30. ve sonrasında 30 dakikada bir; inspire edilen anestezik ajan fraksiyonu (FiSevo), ekspire edilen anestezik ajan fraksiyonu (FeSevo), inspire edilen oksijen fraksiyonu (FiO2 ), inspire edilen karbondioksit fraksiyonu (FiCO2 ), minimum alveolar konsantrasyon değerleri ve end-tidal karbondioksit değeri (EtCO2 ) indüksiyon sonrası 5., 10., 15., 30. ve sonrasında 30 dakikada bir kayıt edildi. Bulgular: Gruplar arasında entübasyona geçme süreleri (train of four: TOF 0) benzerdi (p=0,727). Minimal akım için 106,12±38,94, düşük akım için 110,87±38,04, orta akım için 104,45±34,80 saniyede geçilmiştir. Birinci ek doz uygulama zamanı (TOF 25) gruplar arasında benzerdi (p=0,476). İkinci ek doz uygulama zamanı (ikinci kez TOF 25) gruplar arasında benzerdi (p=0,317). Akım gruplarına göre 1. ve 2. ek doz kas gevşetici miktarları arasında anlamlı fark yoktu (sırasıyla; p=0,170, p=0,214). Sonuç: Minimal akım anestezisinin rokuronyum ile oluşturulan nöromüsküler blokajda kas gevşetici tüketimini arttırıcı etkisinin olduğu ancak bu etkinin sınırlı bir etki olduğu düşünülmektedir. Minimal akımlı anestezi, ameliyathane havasının temiz kalmasını sağlamakta, operasyon maliyetini azaltmakta ve solunum devresindeki nem ve sıcaklık değerlerini yükseltmektedir. İntra-operatif daha iyi fizyolojik solunum şartları sağlaması ve intra-operatif hipotermiyi azaltması nedeniyle teşvik edilmesi gereken bir anestezi yöntemidir.Öğe Mortal seyreden tetanoz vakası: olgu sunumu(Kocaeli Derince Eğitim ve Araştırma Hastanesi, 2017) Doğan, Güvenç; Kayır, Selçuk; Akdağlı Ekici, Arzu; Aşıcı, ElifTetanoz nadir görülen, akut gelişen ve ileri yaşlarda ölümcül seyredebilen Clostridium tetani kaynaklı nörotoksinlerle oluşan, dirençli tonik spazmlarla karakterize bir hastalıktır. Solunum kasları tutulumu sonucu gelişen solunum sıkıntısı en ciddi bulgudur. Hastalarda görülen solunum yetersizliği ve hava yolu tıkanıklığı sıklıkla ventilatör desteği gerektirmektedir. Olgumuz 68 yaşında, uygun immünizasyonu olmayan, jeneralize tip tetanoz tanısı alıp sonrasında solunum yetmezliği gelişen bir olguydu. Entübe edilerek yoğun bakım ünitesine alındı. Sedasyon sağlanarak 11 gün mekanik ventilatör desteği aldı. Gelişen otonomik disfonksiyonları tedaviye rağmen düzeltilemedi. Hasta 11. günde ex oldu.Öğe N-methyl-D-aspartate Receptor Antagonists may Ameliorate Spinal Cord Injury by Inhibiting Oxidative Stress: An Experimental Study in Rats(2020) Doğan, Güvenç; Karaca, OnurAIM: To investigate the neuroprotective effect of a N-methyl-D-aspartate (NMDA) receptor antagonist (amantadine) in an experimental spinal cord injury (SCI) model. MATERIAL and METHODS: Thirty male Sprague–Dawley rats were divided into three groups: control (I), SCI (II), and SCI + amantadine (III). SCI was created using clip compression technique. At the end of day 7, blood samples were obtained from the rats and analyzed using various biochemical markers. Histological examination was also performed. MDA, GSH, and MPO assays were done. VEGF, TNF-?, and Baxexpressions were also analyzed. RESULTS: The group III had several inflammatory cells in the gray and white matter, with mildly degenerated multipolar and bipolar cells. Some bipolar and multipolar neurons showed TNF-? expression; however, TNF-? was found to be weak in small groups of inflammatory cells around the blood vessels in the substantia grisea and alba. Positive Bax expression was observed in the substantia grisea layer, particularly in the membrane of some bipolar neurons and glial cells; however, negative Bax expression was observed in neuron and glial cells and showed positive VEGF expression in the vascular endothelium in the group III. CONCLUSION: NMDA receptor antagonists, especially amantadine, may ameliorate SCI by inducing angiogenesis, affecting inflammation and apoptosis. It inhibits oxidative stress and the signaling pathways following SCI in rats.Öğe Objective and Subjective Evaluations of the Effects of Different Types of Intubation Tube Applications on Voice Performance in the Early Postoperative Period(Cureus Inc, 2019) Kayır, Selçuk; Doğan, Güvenç; Atan, DoğanObjective Changes in voice performance in the postoperative period due to trauma suffered during endotracheal intubation or edema occurring in the postoperative period are often observed. The present study aimed to evaluate the effects of different types of intubation tube applications on voice performance in the early postoperative period using objective and subjective voice analysis methods. Materials and Methods A total of 88 patients who underwent endotracheal intubation either using a cuffed endotracheal (n = 44) or spiral-embedded cuffed endotracheal (n = 44) tube were included in this study. An endotracheal tube of 7.5 mm was used for female patients and that of 8 mm was used for male patients. Preoperative acoustic voice analysis was performed, and fundamental frequency (F0), jitter%, and shimmer% values were recorded. In addition, the voice handicap index-30 (VHI-30) questionnaire was completed by the patients for subjective evaluation. The same procedure was repeated in the first 48 hours postoperatively. The preoperative and postoperative data were statistically compared. In addition, the effect of the type of endotracheal intubation tube on acoustic voice analysis parameters and VHI-30 scores was statistically evaluated. Results In the early postoperative period, a significant decrease in the FO value and a significant increase in jitter% and shimmer% values were detected. The VHI-30 score was also found to be significantly higher in the early postoperative period than in the preoperative period. The effects of both the intubation tubes on voice performance were found to be similar. Conclusion Objective and subjective evaluations revealed that voice performance was declined in the early postoperative period after orotracheal intubation.Öğe Predictive Value of Serial Rapid Shallow Breathing Index Measurements for Extubation Success in Intensive Care Unit Patients(MDPI, 2024) Turhan, Semin; Tutan, Duygu; Şahiner, Yeliz; Kısa, Alperen; Önen Özdemir, Sibel; Tutan, Mehmet Berksun; Kayır, Selçuk; Doğan, GüvençAbstract: Background and Objectives: Extubation success in ICU patients is crucial for reducing ventilator-associated complications, morbidity, and mortality. The Rapid Shallow Breathing Index (RSBI) is a widely used predictor for weaning from mechanical ventilation. This study aims to determine the predictive value of serial RSBI measurements on extubation success in ICU patients on mechanical ventilation. Materials and Methods: This prospective observational study was conducted on 86 ICU patients at Hitit University between February 2024 and July 2024. Patients were divided into successful and unsuccessful extubation groups. RSBI values were compared between these groups. Results: This study included 86 patients (32 females, 54 males) with a mean age of 54.51 ± 12.1 years. Extubation was successful in 53 patients and unsuccessful in 33. There was no significant difference in age and intubation duration between the groups (p = 0.246, p = 0.210). Significant differences were found in RSBI-1a and RSBI-2 values (p = 0.013, p = 0.011). The median RSBI-2a was 80 in the successful group and 92 in the unsuccessful group (p = 0.001). The ?RSBI was higher in the unsuccessful group (p = 0.022). ROC analysis identified optimal cut-off values: RSBI-2a ? 72 (AUC 0.715) and ?RSBI ? ?3 (AUC 0.648). RSBI-2a ? 72 increased the likelihood of successful extubation by 10.8 times, while ?RSBI ? ?3 increased it by 3.4 times. Using both criteria together increased the likelihood by 28.48 times. Conclusions: Serial RSBI measurement can be an effective tool for predicting extubation success in patients on IMV. These findings suggest that serially measured RSBI may serve as a potential indicator for extubation readiness.Öğe Statistical Analysis Of Covid-19 Publications In The Fields Of Pediatrics(2020) Doğan, Gül; Doğan, GüvençObjective: This study aims to conduct the statistical analysis of the scientific outputs about COVID-19 in the field of Pediatrics, identify the top effective studies, and reveal the trend topics. Material and Methods: Statistical analysis was performed for all the publications published between 2019 and 2020 in the “Pediatrics” research area in the Web of Science database and included the “COVID-19”, “SARS-CoV-2”, “2019-nCoV”, “n- CoV”, and “coronavirus” keywords in their title. Results: The literature review indicated 15140 publications, 397 (2.62%) of which were in the “Pediatrics” research area. The top 3 journals that had the highest number of publications were Pediatric Blood & Cancer, Lancet Child & Adolescent Health, Pediatric Pulmonology. The top-cited 3 articles were published in the journals of Translational Pediatrics, Pediatric Pulmonology, Acta Paediatrica. According to the trend analysis results, the trend topics included the keywords such as pregnancy, neonate(s), newborn(s), adolescents, breastfeeding, treatment, epidemiology, pneumonia, vertical transmission, asthma, breast milk, clinical characteristics, computed tomography, diagnosis, human milk, infant, myocarditis, survey, and symptoms. Conclusion: The pandemic affecting the whole world has also changed the course of academic publications. This bibliometric study provided a summary of the publications about COVID-19 in the field of Pediatrics.Öğe The effect of parent and child operational stress on postoperative pain level in children(Bayrakol Medical Publisher, 2020) Şahiner, Yeliz; Özçiftçi, Serhat; Doğan, Güvenç; Önen Özdemir, Sibel; Demir, EmreAim: Children's perception of pain may vary depending on defenselessness, negative and exaggerated behavior, level of persuasion, personality characteristics, and previously experienced negative experiences. This study was designed to investigate the relationship between anxiety and postoperative pain perception of children and the family's anxiety about the child's pain and negative attitudes on the effects of the pain. Material and Methods: Thirty-five patients undergoing appendectomy between August-December 2017 were included in this prospective study. Seven patients were excluded because of incongruity. Face, leg, activity, cry, consolidation (FLACC), preoperative anxiety scale of Yale, and Post-Anesthetic Delirium scale were applied. In the postoperative period, parents and children were asked to complete a pain questionnaire. Results: It is found that, as family education level increased, the anxiety of both children and parents decreased. The parents were found to have fewer levels of rumination as the level of education increased when the effect of postoperative analgesia selection on the visual analog pain scale (VPS) was investigated, there was a statistically significant difference between pain VPS scores only after surgery. It was found that mothers were more anxious than fathers. A moderately positive correlation was found between the VPS score and the child and parental rumination scale scores. It was seen that the education level of the family had a positive effect on the pain perception of the child. Discussion: The results of the surgical experience in the long-term memory revealed that the children had a comfortable postoperative period and that they did not think much about the operation, but that they would be afraid to undergo surgery again.Öğe The effects of dexmedetomidine in increased intestinal permeability after traumatic brain injury: An experimental study(Turkish Association of Trauma and Emergency Surgery, 2020) Karaca, Onur; Doğan, GüvençBACKGROUND: This study aims to investigate whether or not dexmedetomidine (DEX) application affects inflammation, increased intestinal mucosa damage and intestinal permeability in traumatic brain injury (TBI). METHODS: The rats included in our study were randomized into three groups as the control group (Group 1, n=10), trauma group (Group 2, n=10) and the trauma+dexmedetomidine group (Group 3, n=10). While trauma was not induced in the control group, head trauma was induced in all rats in Groups 2 and 3 with the same method. The rats in Group 3 additionally received the DEX application. Intestinal THF-a, serum TNF-a, IL-6, IL-1b and D-lactate levels were measured six hours post-trauma to assess systemic and local infection. Histopathological evaluation of the terminal ileum was performed at the 6th hour to assess mucosal damage. Intestinal permeability was evaluated by measuring the level of dextran injected into the 5-cm ileum segment adhered to the proximal and distal edges at the 30th minute in the blood taken by cardiac puncture. RESULTS: Intestinal TNF-a (p=0.003), serum TNF-a (p=0.009), IL-6 (p=0.002), IL-1b (p=0.001), and D-lactate levels measured in Group 3 (p=0.046) were significantly lower than those measured in Group 2. Dextran level measured in blood in Group 3 was observed significantly lower than that of Group 2 (pÖğe The effects of dexmedetomidine in increased intestinal permeability after traumatic brain injury: An experimental study(2020) Karaca, Onur; Doğan, GüvençBACKGROUND: This study aims to investigate whether or not dexmedetomidine (DEX) application affects inflammation, increased intestinal mucosa damage and intestinal permeability in traumatic brain injury (TBI). METHODS: The rats included in our study were randomized into three groups as the control group (Group 1, n=10), trauma group (Group 2, n=10) and the trauma+dexmedetomidine group (Group 3, n=10). While trauma was not induced in the control group, head trauma was induced in all rats in Groups 2 and 3 with the same method. The rats in Group 3 additionally received the DEX application. Intestinal THF-a, serum TNF-a, IL-6, IL-1b and D-lactate levels were measured six hours post-trauma to assess systemic and local infection. Histopathological evaluation of the terminal ileum was performed at the 6th hour to assess mucosal damage. Intestinal permeability was evaluated by measuring the level of dextran injected into the 5-cm ileum segment adhered to the proximal and distal edges at the 30th minute in the blood taken by cardiac puncture. RESULTS: Intestinal TNF-a (p=0.003), serum TNF-a (p=0.009), IL-6 (p=0.002), IL-1b (p=0.001), and D-lactate levels measured in Group 3 (p=0.046) were significantly lower than those measured in Group 2. Dextran level measured in blood in Group 3 was observed significantly lower than that of Group 2 (p<0.001). Histopathological evaluation of the intestines revealed no injuries in the ileum of the rats in Group 1, injury in the ileum, villus atrophy and mucosal damage in the rats in Group 2, and a significant recovery was observed in Group 3 in comparison to Group 2. CONCLUSION: It was seen in our study that DEX reduced TBI-induced increased inflammation, intestinal mucosa damage and intestinal permeability. These results suggest that DEX may ameliorate the damage done to the intestinal tissue by modulating postTBI inflammatory responses.Öğe Tracheotomy Among Patients In Geriatric Age Group Treated In Intensive Care Units(2019) Doğu, Cihangir; Kayır, Selçuk; Doğan, Güvenç; Akdağlı Ekici, Arzu; Özçiftçi, Serhat; Yağan, ÖzgürIntroduction: In intensive care units, numerous geriatric patients are mechanically ventilated, and those with prolonged mechanical ventilation show high mortality. Such geriatric patients may greatly benefit from tracheotomy because it facilitates pulmonary care, increases patient comfort and helps wean them off mechanical ventilation. Materials and Method: A total of 70 mechanically ventilated geriatric patients were includ-ed. Patients’ electronic data, file records, age, sex, mechanical ventilation requirement, Acute Physiology and Chronic Health Evaluation II score, intubation and intensive care unit stay durations, discharge status and complications were examined. Results: The mean patient age was 78.6±7.4 years, and the mean Acute Physiology and Chronic Health Evaluation II score was 27.0±5.9. Tracheotomy was performed after a mean duration of 34.8±17 days, and the mean intensive care unit stay duration was 94±54 days. Major and minor haemorrhage were observed in 1 (1.4%) and 3 (4.2%) patients, respectively. Total 53 (76%) patients died, 8 (11%) patients were discharged and 9 (13%) patients are still hospitalized. Conclusion: The reluctance of geriatric patients’ relatives to perform tracheotomy affects the time of procedure and duration of intensive care unit stay.
