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    A bibliometric analysis of the field of anesthesia during 2009-2018
    (Elsevier Science Inc, 2020) Dogan, Guvenc; Karaca, Onur
    Objective: 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.
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    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, Guvenc
    Background/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.
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    Effects of Pelargonium sidoides (UMCA ®) on pulmonary contusion from blunt thoracic trauma in rats
    (2020) Doğan, Gül; Doğan, Güvenç; Karaca, Onur; Ayaz, Ercan
    Aim: 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.
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    Evaluation of Neuroprotective Effect of Sevoflurane in Acute Traumatic Brain Injury: An Experimental Study in Rats
    (2020) Doğan, Güvenç; Karaca, Onur
    AIM: 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.
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    EVALUATION OF RISK FACTORS AND COMORBITIES OF THE ORTHOPEDIC PATIENTS TREATED IN INTENSIVE CARE UNIT
    (Carbone Editore, 2019) Dogu, Cifiangir; Mutlu, Nevzai Mehmef; Turan, Sualp; Karaca, Onur; Kayir, Selcuk; Turan, Isil Ozkocak
    Introduction: The aim of this study is to investigate the comorbidities of orthopedic patients followed up in intensive care unit and to investigate the comorbid relationship of complications requiring intensive care. Material and methods: Ankara Numune Research Hospital Intensive care patients over the age of 18 admitted from the operating room and from orthopedic service were reviewed retrospectively between January 2010-December 2014. Results: 69 males and 98 females were postoperative patients in a total of 283 patients.28% of these patients were trauma patients and 62.3% were accepted after total hip prosthesis operations.The average age of postoperatively accepted patients was 73.5 years and preoperative was 61.5 years.The mean APACHE II score was similar.21% of postoperative patients have chronic obstructive pulmonary disease (COPD),while 18% of those without surgery had COPD(p=0.024).The need of close monitoring for intensive care admission was 62% in preoperative patients and 47% in postoperative patients(p=0.014).Symptomatic electrolyte imbalance was higher in preoperativ patients(p=0.027). The rate of vasopressors required hypotension was 11% in postoperative patients and 3% in non-operated patients (p=0.021).Charlson scores of postoperative patients were higher than those without surgery (p=0.001). Conclusion: Orthopedic patients who have high risk factors and comorbidities, we think that the consultation of the relevant branches and the initiation of treatment follow-ups in the early period may be useful in preventing intensive care requirement in the preoperative period.
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    N-methyl-D-aspartate Receptor Antagonists may Ameliorate Spinal Cord Injury by Inhibiting Oxidative Stress: An Experimental Study in Rats
    (2020) Doğan, Güvenç; Karaca, Onur
    AIM: 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.
  • Küçük Resim
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    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, Güvenç
    BACKGROUND: 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
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    The effects of dexmedetomidine in increased intestinal permeability after traumatic brain injury: An experimental study
    (2020) Karaca, Onur; Doğan, Güvenç
    BACKGROUND: 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.