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Doganci S, Ince ME, Ors N, Yildirim AK, Sir E, Karabacak K, Eksert S, Ozgurtas T, Tasci C, Dogan D, Ozkan G, Cosar A, Gulcelik MA, Aydin K, Yildirim V, Erdol C. A new COVID-19 prediction scoring model for in-hospital mortality: experiences from Turkey, single center retrospective cohort analysis. Eur Rev Med Pharmacol Sci 2020; 24:10247-10257. [PMID: 33090436 DOI: 10.26355/eurrev_202010_23249] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Although many studies reported prognostic factors proceeding to severity of COVID-19 patients, in none of the article a prediction scoring model has been proposed. In this article a new prediction tool is presented in combination of Turkish experience during pandemic. MATERIALS AND METHODS Laboratory and clinical data of 397 over 798 confirmed COVID-19 patients from Gülhane Training and Research Hospital electronic medical record system were included into this retrospective cohort study between the dates of 23 March to 18 May 2020. Patient demographics, peripheral venous blood parameters, symptoms at admission, in hospital mortality data were collected. Non-survivor and survivor patients were compared to find out a prediction scoring model for mortality. RESULTS There was 34 [8.56% (95% CI:0.06-0.11)] mortality during study period. Mean age of patients was 57.1±16.7 years. Older age, comorbid diseases, symptoms, such as fever, dyspnea, fatigue and gastrointestinal and WBC, neutrophil, lymphocyte count, C-reactive protein, neutrophil-to-lymphocyte ratio of patients in non-survivors were significantly higher. Univariate analysis demonstrated that OR for prognostic nutritional index (PNI) tertile 1 was 18.57 (95% CI: 4.39-78.65, p<0.05) compared to tertile 2. Performance statistics of prediction scoring method showed 98% positive predictive value for criteria 1. CONCLUSIONS It is crucial to constitute prognostic clinical and laboratory parameters for faster delineation of patients who are prone to worse prognosis. Suggested prediction scoring method may guide healthcare professional to discriminate severe COVID-19 patients and provide prompt intensive therapies which is highly important due to rapid progression leading to mortality.
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Affiliation(s)
- S Doganci
- Department of Cardiovascular Surgery, Gülhane School of Medicine, Health Sciences University, Ankara, Turkey.
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Altundag H, Dundar MS, Doganci S, Celik M, Tuzen M. The Use of a Sequential Extraction Procedure for Heavy Metal Analysis of House Dusts by Atomic Absorption Spectrometry. J AOAC Int 2019; 96:166-70. [PMID: 23513973 DOI: 10.5740/jaoacint.11-112] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abstract
In general, dust is considered as house or street dust. Indoor dust, as a contamination source, has been studied for many years. In this work, the original Community Bureau of Reference of the European Commission (BCR) three-stage sequential extraction procedure was applied to the fractionation of Cr, Cu, Fe, Mn, Pb, and Zn in 20 house dust samples from five different areas of Sakarya, Turkey. Acetic acid, hydroxylammonium chloride, and hydrogen peroxide plus ammonium acetate were used for the first, second, and third steps of the BCR method, respectively. The extracts were analyzed for the studied heavy metals using flame atomic absorption spectrometry. Validation of the results was performed by using a standard reference material (BCR 701 Sediment) to certify the experimental results obtained and to evaluate the reliability of the method used. The elemental loadings typically increased in magnitude according to the area order: İzmit Caddesi>Ankara Caddesi>Erenler>Karaman>Korucuk. The results were in agreement with values reported in the literature.
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Affiliation(s)
- Huseyin Altundag
- Sakarya University, Department of Chemistry, Esentepe Campus, 54187 Sakarya, Turkey.
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3
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Gurses K, Ozmen F, Kocyigit D, Yersal N, Bilgic E, Kaya E, Kopru C, Soyal T, Doganci S, Tokgozoglu L, Korkusuz P. The relationship of Netrin-1 expression with macrophage infiltration and polarization in human epicardial adipose tissue and severity of coronary artery disease. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bolcal C, Sargin M, Mataraci I, Iyem H, Doganci S, Kilic S, Temizkan V, Demirkilic U, Tatar H. Concomitance of varicoceles and chronic venous insufficiency in young males. Phlebology 2016. [DOI: 10.1258/026835506777304719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aim of this article was to evaluate the concomitance of symptomatic varicose veins and varicoceles in a young male patient group. Method: The study was conducted as a prospective, multicentre study in the cardiovascular outpatient clinics of two major military hospitals. The data of 1500 young male patients with symptomatic venous insufficiency were recorded regarding symptomatic varicoceles. Results: The median age of the patients was 21.2 ± 1.3 years. Symptomatic varicocele was a concomitant finding in 46.0% of the patients. In patients with chronic venous insufficiency, higher body mass index, high levels of smoking, standing occupation, positive family history, longer duration of symptoms and constipation were found as potential factors for concomitant varicocele in both univariate and multivariate analysis. A statistically significant, moderately positive correlation was found between grades of venous reflux in saphenofemoral junction and varicocele (Spearman's rho correlation r = 0.637, P <0.001). Conclusion: With the observation that varicoceles may be concomitant in nearly half of patients with venous insufficiency, it is thought that just a simple question in history taking may help these patients to be diagnosed and get treated for this potential cause of infertility.
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Affiliation(s)
- C Bolcal
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - M Sargin
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - I Mataraci
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - H Iyem
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - S Doganci
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - S Kilic
- Department of Public Health and Epidemiology, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - V Temizkan
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - U Demirkilic
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - H Tatar
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
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Doganci S, Yildirim V, Erol G, Yesildal F, Karabacak K, Kadan M, Ozkan G, Ince ME, Ozgurtas T. Polidocanol (Lauromacrogol 400) has anti-angiogenic effects in vitro and in vivo. Eur Rev Med Pharmacol Sci 2016; 20:1384-1389. [PMID: 27097963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Polidocanol is the most frequently used sclerosant for sclerotherapy all around the world. Our experimental research aims to find out the angiogenic effects of Polidocanol. MATERIALS AND METHODS Angiogenic activity of polidocanol was examined in vivo in the chick chorioallantoic membrane (CAM) model, cell viability assay (human umbilical vein endothelial cells - HUVECs) and in vitro tube formation assay of HUVECs. RESULTS In CAM assay, a significant decrease on CAM vessel growth was observed after the application of polidocanol solutions. Vessel growth inhibition was strongly dose-dependent. There was a cytotoxic effect on HUVECs in the presence of polidocanol observed with MTT assay (p < 0.05). In the tube formation assay, statistically significant decrease in tube formation was observed in polidocanol group. It was found that polidocanol had an anti-angiogenic effect (p < 0.05). The results provide evidence that polidocanol decreases angiogenesis and has a cytotoxic effect on ECs. CONCLUSIONS These results provide evidence that Polidocanol (lauromacrogol 400) have strong anti-angiogenic effects in vitro and in vivo. Further researches needed to reveal early and long-term effects of polidocanol in the human vascular system and new treatment approach as an anti-angiogenic therapy.
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Affiliation(s)
- S Doganci
- Department of Cardiovascular Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
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Ozkan G, Ince ME, Eskin MB, Erol G, Kadan M, Ozgur G, Doganci S, Yildirim V. Sedoanalgesia for cardioversion: comparison of alfentanil, remifentanil and fentanyl combined with propofol and midazolam: a prospective, randomized, double-blind study. Eur Rev Med Pharmacol Sci 2016; 20:1140-1148. [PMID: 27049269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Electrical cardioversion (EC) is a short but painful procedure to restore sinus rhythm. The aim of this study is to compare the effect of fentanyl, remifentanil and alfentanil in association with propofol and midazolam for elective EC. PATIENTS AND METHODS Ninety-nine patients older than 18-years, American Society of Anesthesiologists I/II/III grades undergoing elective EC were randomized into 3 groups. All patients received 2 mg midazolam and propofol (0.5 mg/kg). Group A received alfentanil (5 µg/kg i.v. bolus), Group F received fentanyl (0.5 µg/kg i.v. bolus) and Group R received remifentanil (0.25 µg/kg i.v. bolus). Hemodynamics and respiratory variables [Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), SpO2, respiratory rate (RR)], and Modified Aldrete recovery score (MARS) were assessed at six different time points (baseline, right after EC, and 3rd min, 5th min, 10th min, 30th min following EC). Also, induction times (time to reach RSS to 5) and recovery times (time to reach MARS to 8) were recorded. The incidence of respiratory depression, bradycardia, hypotension and adverse effects were also recorded. RESULTS Hemodynamic variables were similar in all groups. SpO2 values in Group R were significantly lower at 3rd min (p = 0.005). Induction and recovery times were longest in Group F. There were significant differences at 3rd, 5th and 10th minute MARS values between groups. The incidence of hypotension and bradycardia were similar in all groups (p > 0.05) but respiratory depression was higher in Group R (p = 0.047). CONCLUSIONS Propofol alfentanil combination has more beneficial advantages in their rapid onset, early recovery time and less respiratory depression than remifentanil and fentanyl.
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Affiliation(s)
- G Ozkan
- Department of Anesthesiology and Reanimation, Gulhane Military Academy of Medicine, Etlik, Ankara, Turkey.
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7
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Doganci S, Yildirim V, Yesildal F, Erol G, Kadan M, Ozkan G, Avcu F, Ozgurtas T. Comparison of angiogenic and proliferative effects of three commonly used agents for pulmonary artery hypertension (sildenafil, iloprost, bosentan): is angiogenesis always beneficial? Eur Rev Med Pharmacol Sci 2015; 19:1900-1906. [PMID: 26044238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Pulmonary artery hypertension (PAH) is devastating disease that has very serious outcomes. Dysregulated angiogenesis is one of the main responsible courses in pathophysiology of disease. Our experimental research intends to find out and compare the angiogenic effects of medications used sildenafil, iloprost, and bosentan in the treatment of PAH. MATERIALS AND METHODS This study was performed in Department of Biochemistry and Cancer and Stem Cell Research Laboratory of our institutes between August and October 2014. Angiogenic activity of sildenafil, iloprost, and bosentan were examined in vivo in chick chorioallantoic membrane (CAM) model and in vitro tube formation assay of human umbilical vein endothelial cells (HUVECs). Proliferative activity of these three agents was also determined through 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on HUVECs. RESULTS In CAM assay, when compared to the control and drug groups, treatment with sildenafil solutions resulted in a significant dose-dependent increase (budding, sprouting, extravasation) on CAM vessel growth. While there was no significant proliferative effect with iloprost and bosentan, presence of sildenafil caused a statistically significant proliferation on HUVECs following 24 and 48 h incubation (p < 0.05) compared to the control group. Comparing the tube length/area ratio values, there was statistically significant increase in sildenafil group with respect to the other 2 groups (p < 0.05). Iloprost and bosentan did not show a significant effect. CONCLUSIONS The results provide evidence that sildenafil but not iloprost and bosentan induces angiogenesis in vitro and in vivo. Dysregulated angiogenesis, as an important pathophysiological part in the progression of PAH, may be triggered by the chronic ingestion of sildenafil in the long treatment period and may cause negative effects.
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Affiliation(s)
- S Doganci
- Department of Cardiovascular Surgery, Department of Anesthesiology, Department of Biochemistry; Gulhane Military Academy of Medicine, Ankara, Turkey.
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8
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Karabacak K, Kaya E, Ulusoy KG, Seyrek M, Kurtoglu M, Doganci S, Yildirim V, Yildiz O, Demirkilic U. Effects of taurine on contractions of human internal mammary artery: a potassium channel opening action. Eur Rev Med Pharmacol Sci 2015; 19:1498-1504. [PMID: 25967726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Taurine is an abundant amino acid that is widely distributed in human and animal tissues. Pharmacodynamic studies show that taurine has hypotensive and myocardial protective effects. Studies in isolated tissue baths show that taurine relaxes precontracted arteries. This study aimed to show the effects of taurine on human internal mammary artery (IMA) in vitro and to explain the mechanisms of its effects. METHODS The response in the IMA was recorded isometrically by a force displacement transducer in isolated organ baths. Taurine (20, 40, 80 mM) was added to organ baths after precontraction with KCl (45 mM) or serotonin (5-HT, 30 µM). Taurine-induced relaxations were also tested in the presence of the cyclooxygenase inhibitor indomethacin (10 µM), the nitric oxide synthase inhibitor L-NAME (100 µM), the large conductance Ca2+-activated K+ channel inhibitor tetraethylammonium (TEA, 1 mM), the ATP-sensitive K+ channel inhibitor glibenclamide (GLI, 10 µM), the voltage-sensitive K+ channel inhibitor 4-aminopyridine (4-AP, 1 mM) and the inward rectifier K+ channel inhibitor barium chloride (BaCl2, 30 µM). RESULTS Taurine did not affect the resting tone of IMA. However, it produced relaxation in the 5-HT and KCl -precontracted preparations. The relaxation to IMA was not affected by GLI, 4-AP, BaCl2, indomethacin and L-NAME. But, TEA inhibited taurine -induced relaxations significantly (p < 0.05). CONCLUSIONS The preincubation of IMA with taurine antagonized KCl and 5-HT induced contractions in a concentration dependent manner, while it did not affect the resting tone. The relaxations to taurine were significantly antagonized by pretreatment with TEA. These results suggest that mechanism of vasodilator effect of taurine in IMA may be the activation of large conductance Ca2+-activated K+ channels.
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Affiliation(s)
- K Karabacak
- Department of Cardiovascular Surgery, Gulhane Faculty of Medicine, Ankara, Turkey.
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Karabacak K, Dogan D, Celik M, Kaya E, Kadan M, Isik H, Ocal N, Doganci S, Yildirim V, Demirkilic U. Local sympathetic stimulation not only have local effects in patients with Raynaud's phenomenon. Eur Rev Med Pharmacol Sci 2015; 19:1711-1715. [PMID: 26004614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Many other organs and system can be affected in the course of Primary Raynaud's Phenomenon (RP). Simultaneously increased vasospasm in the pulmonary vascular bed may likely affect the pulmonary function. Therefore, we investigated the effect of Raynaud's phenomenon on the respiratory functions in this study. PATIENTS AND METHODS Between March 2014 and December 2014, 30 patients with the diagnosis of PRP more than two years and 32 age-sex matched healthy controls were enrolled into this study. Cold stimulation test (CST) was performed. Pulmonary function test were performed following 30 minutes after CST and spirometric measurements were calculated. RESULTS There were no statistically significant differences between two groups regarding their demographic and clinical data. Mean duration of symptoms from onset to present was 3.01 ± 1.05 years. Patients with Primary RP had significantly lower FVC and higher FEV1/FVC values compared to the control groups (p = 0.015 and p=0.045, respectively). CONCLUSIONS We found that statistically significant decrease of FVC values in patients with Primary RP compared to the healthy controls could be a impaired innervation of pulmonary system and a predictor of pulmonary vasospasm and/or pulmonary Raynaud's phenomenon, which may develop in future periods.
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Affiliation(s)
- K Karabacak
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey.
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Yildirim V, Doganci S, Cinar S, Eskin MB, Ozkan G, Eksert S, Ince ME, Dogrul A. Acute high dose-fentanyl exposure produces hyperalgesia and tactile allodynia after coronary artery bypass surgery. Eur Rev Med Pharmacol Sci 2014; 18:3425-3434. [PMID: 25491618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Opioid-induced hyperalgesia is well known complication of acute high dose and chronic opioid therapy. In this study, we evaluated development of opioid-induced hyperalgesia following intraoperative short-term use of µ-opioid agonist fentanyl after coronary artery bypass surgery. PATIENTS AND METHODS 100 patients undergoing elective coronary artery bypass graft surgery is divided into two groups. In group I (low dose), anesthesia was induced with propofol 1-2.5 mg/kg and fentanyl 2 mcg/kg, in group II (high dose) fentanyl 40-70 mcg/kg was used. In group I, propofol 5-10 mg/kg/h, fentanyl 1-3 mcg/kg/h, in group II fentanyl 5-10 mcg/kg/h was used for maintenance of anesthesia. The tactile and thermal thresholds were measured before surgery and in 1st, 3rd and 7th postoperative days by using Von Frey filaments and a thermal source, respectively. RESULTS Tactile thresholds were significantly decreased at the first (6,08±0.21 and 3.76±0.13 g; p<0.001) and third (6.76±0.24 and 4.96±0.16 g; p<0.001) postoperative days compared to baseline preoperative values (7.72±0.26, and 7.60±0.21 g; p=816) in two groups. Postoperative 1st (13.45±0.33 and 10.05±0.24 sec; p<0.001) and 3rd day (14.77±0.28 and 13.17±0.26 sec; p<0.001) assessments showed a statistically significant thermal hyperalgesia compared to the preoperative baseline values (16.67±0.51 and 16.45±0.42 sec; p=0.997) in two groups. This decrease in both tactile and thermal thresholds returned to baseline control values at the 7th day of measurement. CONCLUSIONS Our results showed that patients undergoing coronary artery bypass surgery receiving fentanyl anesthesia developed postoperative tactile allodynia and thermal hyperalgesia and this was more prominent in high dose group.
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Affiliation(s)
- V Yildirim
- Department of Anesthesiology and Intensive Care, Gulhane Military Academy of Medicine, Ankara, Turkey.
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Doganci S, Gunaydin S, Kocak OM, Yilmaz S, Demirkilic U. Impact of the intensity of microemboli on neurocognitive outcome following cardiopulmonary bypass. Perfusion 2013; 28:256-62. [PMID: 23381348 DOI: 10.1177/0267659112470693] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study aimed to determine whether there was any association between the intensity of intraoperative gaseous microembolic signals (GME), neuropsychological testing and clinical outcome in high-risk patients undergoing coronary artery surgery (CABG). METHODS Over a 6-month period, GME activity was monitored in 102 Euroscore 6+ patients during cardiopulmonary bypass (CPB) with a conventional 32-micron arterial filter by non-invasive, real-time ultrasonic device. Cognitive tests; line bisection, the Stroop test, finger tapping, and the Rey Auditory Verbal Learning Test were performed at baseline, postoperative one week and postoperative one month. RESULTS The distribution of GME activity showed that there were three groups of patients: >500 total emboli (n = 38); 250 to 500 emboli (n = 30) and <250 emboli (n = 34) at a detection level of 2% of the circuit diameter on the arterial side. Line bisection, the Stroop test and finger tapping were impaired significantly in >500 emboli patients versus control (<250 emboli) in postoperative week one, but resolved in one month. CONCLUSIONS Correlation between intraoperative GME intensity and neurocognitive tests suggests that the level of GME might have a role in determining the psychological outcome after CABG with CPB.
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Affiliation(s)
- S Doganci
- Gulhane Military Academy of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey
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Sahin M, Yucel O, Guler A, Doganci S, Cingoz F, Arslan S, Gamsizkan M, Yaman H, Demirkilic U. OP-281: IS THERE ANY CARDIOPROTECTIVE ROLE OF TAURINE DURING COLD ISCHEMIC PERIOD FOLLOWING GLOBAL MYOCARDIAL ISCHEMIA? Int J Cardiol 2011. [DOI: 10.1016/s0167-5273(11)70278-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Doganci S, Yildirim V, Demirkilic U. Does Puncture Site Affect the Rate of Nerve Injuries Following Endovenous Laser Ablation of the Small Saphenous Veins? J Vasc Surg 2011. [DOI: 10.1016/j.jvs.2011.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Doganci S, Yildirim V, Demirkilic U. Does Puncture Site Affect the Rate of Nerve Injuries Following Endovenous Laser Ablation of the Small Saphenous Veins? Eur J Vasc Endovasc Surg 2011; 41:400-5. [DOI: 10.1016/j.ejvs.2010.11.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2010] [Accepted: 11/28/2010] [Indexed: 11/30/2022]
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Abstract
Sternal dehiscence after cardiac surgery occurs infrequently and can lead to mediastinitis and prolonged hospital stay and may even result in death. The most common treatment for mechanical sternal instability is rewiring with wound debridement. We present a case in which a modified titanium mesh plate fixation technique was used. A safe and easy to perform technique, this method can be an alternative option to wire closure in a sternum with fractures, instability or poor bone quality.
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Affiliation(s)
- M A Sahin
- Department of Cardiovascular Surgery, Gülhane Military Medical Academy, Ankara, Turkey.
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Doganci S, Demirkilic U. Comparison of 980 nm Laser and Bare-tip Fibre with 1470 nm Laser and Radial Fibre in the Treatment of Great Saphenous Vein Varicosities: A Prospective Randomised Clinical Trial. Eur J Vasc Endovasc Surg 2010; 40:254-9. [DOI: 10.1016/j.ejvs.2010.04.006] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2009] [Accepted: 04/11/2010] [Indexed: 11/28/2022]
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Oz BS, Mataraci I, Iyem H, Kuralay E, Doganci S, Demirkilic U, Yokusoglu M, Tatar H. Comparison of ultrasonically activated scalpel and traditional technique in radial artery harvesting: clinical research. Thorac Cardiovasc Surg 2007; 55:104-7. [PMID: 17377863 DOI: 10.1055/s-2006-924504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Use of the radial artery (RA) as a conduit in coronary artery bypass grafting (CABG) has become increasingly popular in recent years. The aim of this study was to compare the results of two different RA harvesting techniques. Use of the harmonic scalpel is suggested to be safe and additionally reduces spasm rates. MATERIAL AND METHODS From January 2000, the first 200 consecutive patients who underwent RA harvesting for CABG were enrolled in this study. Patients were divided into two groups. RA was harvested by means of electrocautery + hemoclips in Group I and by harmonic scalpel + hemoclips in Group II. 30 patients (30 %) in Group I and 25 patients (25 %) in Group II were female. Mean age was 53.9 +/- 9.3 and 53.5 +/- 8.4 years in Group I and Group II, respectively. Hand circulation and ulnar collateral flow was assured with a modified Allen test in all patients preoperatively. During the operation perfusion of the hand was monitored by oximetric plethysmography. The distal end of RA was also explored and clamped with a soft vascular clamp to evaluate the saturation values in the groups. During the clamping period, oxygen saturation values did not decrease so we harvested RAs in all patients. RESULTS There were no statistically significant differences between the groups with the exception of the RA harvesting times, the postoperative analgesia requirements, the rate of vasospasm and the need for hemostatic clips. CONCLUSION Harmonic scalpel usage in RA harvesting causes less trauma to adjacent tissues; the analgesia requirements, the rate of vasospasm, the RA harvesting time and the need of hemostatic clips decreases. We conclude that the use of a harmonic scalpel for radial artery harvesting is safer and faster than the routine technique.
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Affiliation(s)
- B S Oz
- Department of Cardiovascular Surgery, GATA - Gulhane Military Academy of Medicine, Ankara, Turkey.
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Bolcal C, Akay HT, Bingol H, Doganci S, Yildirim V, Yenicesu M, Demirkilic U, Tatar H. Leukodepletion improves renal function in patients with renal dysfunction undergoing on-pump coronary bypass surgery: a prospective randomized study. Thorac Cardiovasc Surg 2007; 55:89-93. [PMID: 17377860 DOI: 10.1055/s-2006-924571] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND We aimed to show the impact of leukodepletion on renal function in patients undergoing on-pump coronary revascularization. PATIENTS AND METHODS Fifty patients awaiting elective on-pump coronary revascularization with normal preoperative cardiac functions and with plasma creatinine levels ranging between 1.5 and 2.0 mg/dL were prospectively randomized into two groups: on-pump CABG with (group A: n = 25) and without leukodepletion (group B, n = 25). Renal glomerular and tubular injury were assessed by urinary alpha glutathione s-transferase (GST), plasma creatinine, and blood urea nitrogen (BUN) levels. RESULTS The patients consisted of 14 females and 36 males with a mean age of 57.6 +/- 5.3 years. In the leukodepletion group, the mean levels of creatinine, BUN and urinary GST were found to be decreased on the first, third and fifth postoperative days compared with the control group. There was no mortality. Three patients in the control group needed postoperative dialysis. CONCLUSION Patients with renal dysfunction undergoing on-pump CABG surgery seem to benefit from leukodepletion as a measure to prevent tubular damage and renal impairment compared with a control group.
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Affiliation(s)
- C Bolcal
- Department of Cardiovascular Surgery, Gülhane Military Medical Academy, Ankara, Turkey
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Bolcal C, Iyem H, Sargin M, Mataraci I, Doganci S, Kilic S, Karacalioglu O, Sahin MA, Demirkilic U, Tatar H. Primary and secondary lymphoedema in male patients with oedema in lower limbs. Phlebology 2006. [DOI: 10.1258/026835506778253328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: The purpose of this prospective study was to evaluate patients with clinically diagnosed lymphoedema of the lower extremities. The proportions of primary and secondary lymphoedema, the possible aetiologic factors and the concomitance of chronic venous diseases and lymphoedema were focused on. Method: The male patients who attended our outpatient clinic during 2000 and 2004 were evaluated. In all, 160 male patients with 5 cm circumference difference at calf level between two lower extremities or with clinically diagnosed bilateral leg oedema were enrolled. All patients underwent duplex venous ultrasonography and lymphoscintigraphy. Venography was performed in 12 patients with normal lymphoscintigraphy and ultrasonography. Results: The age distribution was between 20 and 54 years (mean ± SD; 22.9 ± 4.3). Among 160 patients, 70.0% had lymphoedema, while 7.5% had chronic venous insufficiency, 3.75% chronic deep venous thrombosis, 7.5% concomitant venous disease and lymphatic obstruction, and 7.5% idiopathic oedema. In the last 3.75% the pathology was Klippel–Trenaunay syndrome. Of the primary lymphoedema patients (16.25%), 18 were praecox, six tarda and two were congenital types. Conclusion: In young male patients, the causes of secondary lymphoedema are lymphadenectomy, neoplastic metastasis, cellulitis, lymphangitis, etc. Further techniques confirmed the clinical diagnosis of lymphoedema in 77.5% (sum of lymphoedema and concomitant disease) of all patients. With these findings lymphoedema can be diagnosed clinically, and further diagnostic techniques can be reserved unless treatment is effective.
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Affiliation(s)
- C Bolcal
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - H Iyem
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - M Sargin
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - I Mataraci
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - S Doganci
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - S Kilic
- Department of Public Health and Epidemiology Clinic, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - O Karacalioglu
- Department of Nuclear Medicine, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - M A Sahin
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - U Demirkilic
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
| | - H Tatar
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey
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Demirkilic U, Bolcal C, Gunay C, Doganci S, Temizkan V, Kuralay E, Tatar H. Results of endocardial radiofrequency ablation of atrial fibrillation during mitral valve surgery. J Cardiovasc Surg (Torino) 2006; 47:469-75. [PMID: 16953168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
AIM The aim of the study is to evaluate the efficacy of thermocontrolled endocardial radiofrequency (RF) ablation for the patients with mitral valve disorder and associated chronic atrial fibrillation during mitral valve replacement operation. METHODS Between February 2002 and January 2004, 43 patients with mitral valve disease and associated chronic atrial fibrillation underwent mitral valve replacement and thermocontrolled endocardial RF ablation with Cobra RF system flexible probe at Gulhane Military Academy of Medicine, Department of Cardiovascular Surgery. Eighteen of the patients (41.8%) were males, while the remaining 25 (58.2%) were females. The average age of the patients was 44+/-14.21 (18-66) years. Functional capacity of the patients was class II in 15 (34. 9%), class III in 24 (55.8%), class IV in 4 (9.3%) according to the NYHA classification. At the preoperative period all of the patients were evaluated routinely by twelve-lead ECG, chest film and transthoracic echocardiography (TTE). For the patients over 40 years of age, we performed additional coronary angiography to delineate any coronary lesions. The patients were evaluated at months 1, 3, 6 and annually by twelve-lead ECG, TTE and holter monitoring after discharge. RESULTS There were not any complications related to the performed technique. No operative and hospital mortality were recorded. At the follow-up period for 35 of 43 patients (81.4%) sinus rhythm was restored. The mean follow-up time was 24.3+/-11.2 (12-35) months. CONCLUSION Endocardial RF ablation especially during mitral valve surgery is a simple technique to be performed. Early and midterm results of the cohort are satisfying.
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Affiliation(s)
- U Demirkilic
- Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Cankaya, Ankara, Turkey.
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