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Öğe A bibliometric analysis of the field of anesthesia during 2009-2018(Elsevier Science Inc, 2020) Dogan, Guvenc; Karaca, OnurObjective: The limited number of bibliometric studies in the literature have generally focused on the top-cited studies in the field of anesthesia, however, there is a lack of studies that made a holistic bibliometric evaluation of these works. The purpose of this study is to make a contemporary summary of the articles published in the field of anesthesia within the last 10 years through detailed bibliometric methods. Methods: The articles published between the years 2009 and 2018 were downloaded from the Web of Science (WoS) database and analyzed using bibliometric methods. The literature review was conducted using the keyword Anesthesiology in the Research Area category via the advanced search option available in WoS. The relation between the number of publications of the countries and the Gross Domestic Products and Human Development Index values were analyzed using Spearman's correlation coefficient. The number of articles between the years 2019 and 2021 was estimated through linear regression analysis. Results: A review of the literature indicated 41,003 articles in the Web of Science database. Estimations included 4,910 (3,971-5,849) articles for the year 2019. There was a high-level, positive significant correlation between the number of publications and Gross Domestic Product (r=0.776, p<0.001). Conclusion: The findings show that countries with high income are effective in the field of anesthesia, which indicates a strong association between research productivity and economic development. Undeveloped and developing countries should be encouraged to conduct research in the field of anesthesia. (C) 2020 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.Öğe Can Neutrophil-to-Lymphocyte or Platelet-to-Lymphocyte Ratio Be Used to Predict Postoperative Nausea and Vomiting in Breast Reduction?(Cureus Inc, 2020) Karaca, Onur; Dogan, GuvencBackground/Objective Postoperative nausea and vomiting (PONV) is one of the most frequently seen complications in the postoperative period. In several studies, the neutrophil-lymphocyte ratio (NLR) or the thrombocyte-lymphocyte ratio (PLR) has been suggested as a parameter to be used in the diagnosis of inflammatory diseases. However, the literature provides no information about this relationship for breast reduction. This study aims to investigate whether preoperative NLR or PLR was an indicator of PONV and identify its relationship with antiemetic use. Methods In this study, hemogram values and antiemetic amounts taken within 24 hours were obtained retrospectively by scanning the files of the patients received breast reduction diagnosis and operation. The confounder effect was controlled using the Propensity Score Matching analysis to distribute the case-control groups similarly. The Receiver Operating Characteristic (ROC) analysis was used to determine whether NLR and PLR could be a prognostic indicator for PONV prediction. Sensitivity and specificity values were calculated after the ROC analysis to determine the success of the cut-off points. Results The success of NLR and PLR in discriminating PONV was found to be statistically significant (cut-off: 1.97, area under the curve (AUC)=0.697, p=0.001, cut-off: 137.2, AUC=0.743; p<0.001, respectively). In addition, the sensitivity of PLR (77.8%) in discriminating PONV was found to be higher in comparison to NLR (73.3%). Conclusions One of the factors decreasing patient care quality and satisfaction is PONV. The results of this study showed that preoperative NLR and PLR could be taken into consideration in antiemetic use required for the prevention of postoperative nausea-vomiting in breast-reduction operations.Öğe Cognitive functions in geriatric patients undergoing elective surgery(Bayrakol Medical Publisher, 2020) Akdur, Fatma; Diker, Serap; Dogan, Guvenc; Cakir, Esra; Kilic, Inan; Ornek, Dilsen; Gogus, NerminAim: The aim of this study is to examine the effect of general anesthesia on cognitive functions in geriatric patients and to make recommendations based on the results obtained. The primary endpoint of the study is to investigate the effect of anesthesia on cognitive functions in geriatric patients with the Mini-Mental State test (MMST). Secondary endpoint; to compare our findings with other studies and evaluate the subject. Material and Methods: For this purpose, geriatric patients with basic education and below, undergoing non-cardiac surgery and general anesthesia were administered the mini-mental state test three times: preoperatively, 2, and 24 hours after the termination of anesthesia. The correlation between the cognitive functions of the patients measured with the sub-item and total mean scores of MMST and time of measurement, their age, gender, educational background, and ASA scores were evaluated. Results: In all cases, for all the scores obtained in MMST, there was a significant decrease in the scores measured at the second postoperative hour compared to the preoperative ones. While the scores measured at the 24th postoperative hour showed an increase, decreasing the difference with the preoperative scores of the patients, they still failed to reach their preoperative level. These changes between measurements are not always statistically significant. Compared to the preoperative period, the decrease in the mean attention and calculation score at the second postoperative hour was higher in females than in males, and the increase in the mean attention and calculation score at the 24th postoperative hour in comparison with the second postoperative hour was higher in females than in males (p<0.05). ` Discussion: In order for the subject to be clear and become classical knowledge, studies on a wider sample are necessary. This would be beneficial in terms of general anesthesia practices in geriatric patients.Öğe Comparison of the Clinical Effects of Ibuprofen and Paracetamol Used for Analgesic Purposes in Endoscopic Retrograde Cholangiopancreatography in Geriatric Patients(Taiwan Soc Geriatric Emergency & Critical Care Medicine-Tsgecm, 2020) Dogan, Guvenc; Kayir, SelcukBackground: Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure that is used to visualize the biliary pancreatic ductal system following the intravenous (IV) injection of an opaque contrast medium. Ibuprofen, a propionic acid derivative, has analgesic, anti-inflammatory, and antipyretic features similar to a non-selective cyclooxygenase inhibitor. In this study, we aimed to evaluate the effect of ibuprofen on geriatric patients with ERCP. Methods: A total of 80 patients and age > 65 years, were included in the study. Participants were divided into three groups: group P (n = 27) was administered a 1000 mg/100 ml paracetamol infusion 30 minutes (min) before the procedure; group I (n = 28) was administered a 400 mg/100 ml ibuprofen IV infusion 30 min before the procedure; and group C (n = 25), a control group, was not administered analgesics before the procedure. Results: Group I was found to have a significantly lower intraoperative fentanyl dose than group P and C. The intraoperative propofol dose was lowest in group I and highest in group C. While visual analog scale (VAS) scores demonstrated no significant differences among the groups in the first 15 min after the procedure; group I was found to have significantly lower VAS levels in 30 min after the procedure. Conclusion: The present study compared the effects of ibuprofen and paracetamol administered prior to the ERCP procedure with results demonstrating a reduction in the dose of intraoperative narcotics with intravenous ibuprofen. Copyright (C) 2020, Taiwan Society of Geriatric Emergency & Critical Care Medicine.Öğe Global Scientific Outputs of Brain Death Publications and Evaluation According to the Religions of Countries(Springer, 2020) Dogan, Guvenc; Kayir, SelcukIn 1950s, the concept of brain death, which began to be discussed primarily in terms of medicine and then in terms of religion, law, and ethics, became a central topic in all world countries as it was an early diagnosis of death. Despite the fact that brain death (BD) diagnosis is of importance for benefitting from organ and tissue transplantation of patients in the world, the literature still involves no bibliometric studies that made a holistic evaluation of the publications about this issue. The present study aims to investigate the top-cited articles about BD published between 1980 and 2018, identify the citation collaboration of the journals, demonstrate the collaboration between the countries, define the relationship between organ transplantation and BD, and reveal the latest developments and trend topics about this issue. In addition, this study aims to investigate the relationship between religions of countries and brain death publication productivity. Documents for bibliometric analysis were downloaded from Web of Science. The literature search was performed using the keywords brain death/dead during 1980-2018. The correlations between gross domestic product (GDP), Human Development Index (HDI) and publication productivity of the countries on BD were investigated with Spearman's correlation coefficient. There was a high-level, statistically significant correlation between the number of publications and GDP, and HDI and the number of publications about BD (r = 0.761, p < 0.001; r = 0.703, p < 0.001). The USA was the top country in terms of publication productivity, which was followed by developed countries such as Germany, Japan, France, and Spain. However, the contribution of the undeveloped or developing countries such as China, Brazil, Turkey, Iran, and South Africa was found to be considerably important. While many people in the world die with undamaged organs, many other people die needing those organs. Therefore, it is considered that the collaborations and thus multidisciplinary studies about BD should be increased in the world countries, and the countries should be involved in bigger collaborations instead of little clusters. Especially, Muslim countries should be encouraged to do research and publish studies about the issues of brain death and organ transplantation.Öğe Importance of the National Early Warning Score (NEWS) at the time of discharge from the intensive care unit(Tubitak Scientific & Technical Research Council Turkey, 2020) Dogu, Cihangir; Dogan, Guvenc; Kayir, Selcuk; Yagan, OzgurBackround/aim: To identify, at an early stage of intensive care, patients who will require readmission to the intensive care unit (ICU) based on their National Early Warning Score (NEWS-d) at discharge. Materials and methods: Overall, 536 patients aged >18 years who stayed at a tertiary ICU for >24 h were included. Patients who readmitted and not readmitted to the intensive care within 48 h after discharge were compared. Results: Mean patient age was 64.26 +/- 18.50 years and 252 (44.7%) patients were male. Mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 21.86 +/- 8.74; mean NEWS-d was 4.48 +/- 2.53. Forty-nine (9.1%) were readmitted to ICU. The reasons for initial admission, age, and NEWS-d vvalues were significantly different between the 2 groups. The NEWS-d values of the readmitted group were significantly higher (9.16 +/- 1.05) than nonreadmitted group (4.01 +/- 2.13). Based on receiver operation curve analysis, sensitivity and specificity were 98% and 95%, respectively, considering a NEWS-d cut-off value of 7.5 as the limit value for estimating readmission. Conclusion : A NEWS-d value of >7.5 demonstrated high sensitivity and specificity in identifying the risk of readmission for patients being discharged from ICU.Öğe The Effect of Daily Sedation-Weaning Application on Morbidity and Mortality in Intensive Care Unit Patients(Cureus Inc, 2018) Kayir, Selcuk; Ulusoy, Hulya; Dogan, GuvencBackground/aims Sedation is one of the most important components of intensive care unit (ICU) in patients who are mechanically ventilated at intensive care conditions. As a result of sedation and analgesia in the intensive care unit, the patient is to be awakened a comfortable and easy process. The aim of the study is to demonstrate the effects of day-time sedation interruptions in intensive care patients. Material and methods We made a retrospective review of 100 patients who were monitored, mechanically ventilated and treated at our intensive care unit between January 2008 and January 2013. Patients were divided into two groups, including Group P (continuous infusion of sedative agent) and Group D (daily sedation interruptions - daily recovery). Demographics, mechanical ventilation time, stay at intensive care unit, hospitalization period, time of first weaning, success of weaning, ventilator-related pneumonia (VRP), total doses of drugs, re-intubation frequency, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) scores and mortality rates of patients were compared. Ramsay Sedation Score (RSS) was used to evaluate the level of sedation. Considering that ideal sedation level is 3 with RSS, RSS < 3 is considered as mild sedation, while RSS > 3 is considered as deep sedation. Results There was no difference between demographics of patients. Mechanical ventilation period was significantly longer in Group P than Group D (p < 0.001). When stay at ICU unit was considered, ICU stay was significantly longer in Group P than Group D (p < 0.001). No statistically significant difference was found between two groups with respect to hospitalization period. In inter-group comparison, time to start first weaning was significantly late in Group P than Group D (p < 0.05). There was no difference between groups in terms of frequency of success of weaning and mortality rate (p > 0.05). In inter-group comparison the frequency of reintubation viewed in Group D was significantly less than in Group P (p < 0.05). Considering development of VRP, it was significantly more common in Group P in comparison with Group D (p < 0.05). No statistically significant difference was found between groups in terms of doses of sedative agents (p > 0.05). Considering doses of opioid analgesics, the total dose of fentanyl was significantly higher in Group P than Group D (p = 0.04), while no difference was found for doses of morphine (p > 0.05). Again, no statistical difference was found in doses of muscle relaxant agents (p > 0.05). Conclusion It was observed that the sedation technique with daily interruption is superior to continuous infusion of sedatives. Accordingly, we believe that daily weaning will make positive contributions to patients who are mechanically ventilated at intensive care unit.Öğe TRACHEOTOMY AMONG PATIENTS IN GERIATRIC AGE GROUP TREATED IN INTENSIVE CARE UNITS(Gunes Kitabevi Ltd Sti, 2019) Dogu, Cihangir; Kayir, Selcuk; Dogan, Guvenc; Ekici Akdagli, Arzu; Ozciftci, Serhat; Yagan, OzgurIntroduction: 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.
