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    Comparison of the effects of continuous versus intermittent enteral feeding on plasma leptin and ghrelin levels in Intensive Care Units
    (Pontifícia Universidade Católica de Campinas, 2017) Yağan, Özgür; Taş, Nilay; Ayyıldız, Sema Nur; Karakahya, Murat; Noyan, Tevfik
    Objective The aim of this prospective randomized trial is to verify whether there is an association between the methods of administration of enteral nutrition and the leptin and ghrelin hormones, which have a major role in the regulation of energy metabolism. Methods This study enrolled 38 enteral-fed patients aged 18 to 85 in the Intensive Care Unit. The patients were prospectively randomized to receive either continuous infusion (n=19) or intermittent feeding (n=18) of enteral nutrition. In addition to routine biochemical assays, blood samples were taken from the patients for leptin and ghrelin analyses on the 1th, 7th, and 14th days of enteral nutrition. Results There was no statistically significant difference between the groups regarding descriptive statistics and categorical variables such as underlying diseases, complications, steroid use and others (p > 0.05). The decrease in the number of white blood cells and in creatinine and C-reactive protein levels over time were statistically significant (p=0.010, p=0.026, p < 0.001 respectively). There was no statistically significant difference between the groups with respect to leptin and ghrelin levels (p=0.982 and p=0.054). Leptin levels did not change over time; however, the ghrelin levels of both groups were significantly higher on the 7th and 14th days than on the first day of analysis (p=0.003). Conclusion This study revealed that both continuous and intermittent enteral nutrition feeding regimens were well tolerated in Intensive Care Unit patients showing minor complications. The method of administration of enteral nutrition alone did not affect the leptin and ghrelin levels. Randomized controlled large cohort trials are needed to to compare intermittent and continuous enteral nutrition to determine which one is more adaptable to diurnal patterns of secretion metabolic hormones.
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    Preoperative Vitamin D levels and respiratory complications of general anesthesia
    (Wolters Kluwer Medknow Publications, 2018) Taş, Nilay; Noyan, Tevfik; Yağan, Özgür; Hancı, Volkan; Çanakçı, Ebru
    Aims: This research aims to investigate whether there is a correlation between the respiratory complications occurring in patients under general anesthesia and preoperative Vitamin D levels. Settings and Design: The study was a prospective observational study. Materials and Methods: This study included 95 adult cases. The cases had total 25-hydroxyvitamin D (25OHD) levels identified in blood samples before the operation. Patients given routine general anesthesia and were assessed in terms of respiratory complications during anesthesia induction, extubation, anesthesia recovery, and the first 24-h postoperative. Statistical Analysis Used: The Shapiro-Wilk test, Student's-t-test, one-way ANOVA test, Pearson correlation coefficient, and Chi-square tests were used. Results: The mean 25OHD vitamin level identified in the preoperative period was 13.00 ± 6.57 ng/mL, with 25OHD vitamin levels found to be significantly low in female cases compared to male cases (P < 0.05). There was a statistically significant negative relationship between age and 25OHD vitamin levels identified (P = 0.045). When assessed in terms of surgery types, there was no significant difference found in Vitamin D levels in terms of surgery type. When examined for complications in the induction, extubation period, and postoperative recovery period, there was a significant difference identified between 25OHD vitamin levels and these complications (P < 0.01). Conclusions: This research observed that patients with low preoperative 25OHD vitamin levels encountered respiratory complications related to general anesthesia more often. Especially, in the early postoperative period, there is a very significant difference between complications and low 25OHD vitamin levels. © 2018 Nigerian Journal of Clinical Practice | Published by Wolters Kluwer - Medknow.