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Nava V, Chandra S, Aherne J, Alfonso MB, Antão-Geraldes AM, Attermeyer K, Bao R, Bartrons M, Berger SA, Biernaczyk M, Bissen R, Brookes JD, Brown D, Cañedo-Argüelles M, Canle M, Capelli C, Carballeira R, Cereijo JL, Chawchai S, Christensen ST, Christoffersen KS, de Eyto E, Delgado J, Dornan TN, Doubek JP, Dusaucy J, Erina O, Ersoy Z, Feuchtmayr H, Frezzotti ML, Galafassi S, Gateuille D, Gonçalves V, Grossart HP, Hamilton DP, Harris TD, Kangur K, Kankılıç GB, Kessler R, Kiel C, Krynak EM, Leiva-Presa À, Lepori F, Matias MG, Matsuzaki SIS, McElarney Y, Messyasz B, Mitchell M, Mlambo MC, Motitsoe SN, Nandini S, Orlandi V, Owens C, Özkundakci D, Pinnow S, Pociecha A, Raposeiro PM, Rõõm EI, Rotta F, Salmaso N, Sarma SSS, Sartirana D, Scordo F, Sibomana C, Siewert D, Stepanowska K, Tavşanoğlu ÜN, Tereshina M, Thompson J, Tolotti M, Valois A, Verburg P, Welsh B, Wesolek B, Weyhenmeyer GA, Wu N, Zawisza E, Zink L, Leoni B. Plastic debris in lakes and reservoirs. Nature 2023; 619:317-322. [PMID: 37438590 DOI: 10.1038/s41586-023-06168-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/04/2023] [Indexed: 07/14/2023]
Abstract
Plastic debris is thought to be widespread in freshwater ecosystems globally1. However, a lack of comprehensive and comparable data makes rigorous assessment of its distribution challenging2,3. Here we present a standardized cross-national survey that assesses the abundance and type of plastic debris (>250 μm) in freshwater ecosystems. We sample surface waters of 38 lakes and reservoirs, distributed across gradients of geographical position and limnological attributes, with the aim to identify factors associated with an increased observation of plastics. We find plastic debris in all studied lakes and reservoirs, suggesting that these ecosystems play a key role in the plastic-pollution cycle. Our results indicate that two types of lakes are particularly vulnerable to plastic contamination: lakes and reservoirs in densely populated and urbanized areas and large lakes and reservoirs with elevated deposition areas, long water-retention times and high levels of anthropogenic influence. Plastic concentrations vary widely among lakes; in the most polluted, concentrations reach or even exceed those reported in the subtropical oceanic gyres, marine areas collecting large amounts of debris4. Our findings highlight the importance of including lakes and reservoirs when addressing plastic pollution, in the context of pollution management and for the continued provision of lake ecosystem services.
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Affiliation(s)
- Veronica Nava
- Department of Earth and Environmental Sciences, University of Milano-Bicocca, Milan, Italy.
| | - Sudeep Chandra
- Global Water Center, Department of Biology, University of Nevada, Reno, NV, USA
- Department of Biology, University of Nevada, Reno, NV, USA
| | - Julian Aherne
- School of the Environment, Trent University, Peterborough, Canada
| | - María B Alfonso
- Research Institute for Applied Mechanics, Kyushu University, Fukuoka, Japan
| | - Ana M Antão-Geraldes
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
| | - Katrin Attermeyer
- WasserCluster Lunz - Biologische Station, Lunz am See, Austria
- Department of Functional and Evolutionary Ecology, University of Vienna, Vienna, Austria
| | - Roberto Bao
- Centro Interdisciplinar de Química e Bioloxía (CICA), GRICA Group, University of A Coruña, A Coruña, Spain
| | - Mireia Bartrons
- Aquatic Ecology Group, University of Vic - Central University of Catalonia, Vic, Spain
| | - Stella A Berger
- Department of Plankton and Microbial Ecology, Leibniz Institute of Freshwater Ecology and Inland Fisheries, Stechlin, Germany
| | - Marcin Biernaczyk
- Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology, Szczecin, Poland
| | - Raphael Bissen
- Department of Mining and Petroleum Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Justin D Brookes
- School of Biological Sciences, University of Adelaide, North Terrace, Adelaide, Australia
| | - David Brown
- Department of Environmental Data, Horizons Regional Council, Palmerston North, New Zealand
| | - Miguel Cañedo-Argüelles
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), FEHM-Lab, Barcelona, Spain
| | - Moisés Canle
- Cátedra EMALCSA-UDC, React! Group, Faculty of Sciences & CICA, University of A Coruña, A Coruña, Spain
| | - Camilla Capelli
- Institute of Earth Sciences, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Mendrisio, Switzerland
| | - Rafael Carballeira
- Centro Interdisciplinar de Química e Bioloxía (CICA), GRICA Group, University of A Coruña, A Coruña, Spain
- Cavanilles Institute of Biodiversity and Evolutionary Biology, University of Valencia, Valencia, Spain
| | - José Luis Cereijo
- Water and Environmental Engineering Group, University of A Coruña, A Coruña, Spain
| | | | | | | | | | - Jorge Delgado
- Water and Environmental Engineering Group, University of A Coruña, A Coruña, Spain
| | - Tyler N Dornan
- School of Biological Sciences, University of Adelaide, North Terrace, Adelaide, Australia
| | - Jonathan P Doubek
- School of Natural Resources & Environment, Lake Superior State University, Sault Sainte Marie, MI, USA
- Center for Freshwater Research and Education, Lake Superior State University, Sault Sainte Marie, MI, USA
| | - Julia Dusaucy
- Savoie Mont Blanc University, CNRS, Université Grenoble Alpes, EDYTEM, Chambéry, France
| | - Oxana Erina
- Department of Hydrology, Lomonosov Moscow State University, Moscow, Russia
- Faculty of Biotechnology and Fisheries, Moscow State University of Technologies and Management (FCU), Moscow, Russia
| | - Zeynep Ersoy
- FEHM-Lab (Freshwater Ecology, Hydrology and Management), Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona (UB), Barcelona, Spain
- Rui Nabeiro Biodiversity Chair, Mediterranean Institute for Agriculture, Environment and Development (MED), Universidade de Évora, Évora, Portugal
| | - Heidrun Feuchtmayr
- Lake Ecosystems Group, UK Centre for Ecology & Hydrology, Lancaster, United Kingdom
| | - Maria Luce Frezzotti
- Department of Earth and Environmental Sciences, University of Milano-Bicocca, Milan, Italy
| | - Silvia Galafassi
- Water Research Institute, National Research Council, Verbania, Italy
| | - David Gateuille
- Savoie Mont Blanc University, CNRS, Université Grenoble Alpes, EDYTEM, Chambéry, France
| | - Vitor Gonçalves
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO Laboratório Associado, BIOPOLIS Program in Genomics, Biodiversity and Land Planning; UNESCO Chair - Land Within Sea: Biodiversity & Sustainability in Atlantic Islands, Universidade dos Açores, Ponta Delgada, São Miguel, Açores, Portugal
- Institute of Biochemistry and Biology, Potsdam University, Potsdam, Germany
| | - Hans-Peter Grossart
- Department of Plankton and Microbial Ecology, Leibniz Institute of Freshwater Ecology and Inland Fisheries, Stechlin, Germany
- Institute of Biochemistry and Biology, Potsdam University, Potsdam, Germany
| | - David P Hamilton
- Australian Rivers Institute, Griffith University, Nathan, Queensland, Australia
| | - Ted D Harris
- Kansas Biological Survey & Center for Ecological Research, University of Kansas, Lawrence, KS, USA
| | - Külli Kangur
- Estonian University of Life Sciences, Tartu, Estonia
| | | | - Rebecca Kessler
- Kansas Biological Survey & Center for Ecological Research, University of Kansas, Lawrence, KS, USA
| | - Christine Kiel
- Department of Plankton and Microbial Ecology, Leibniz Institute of Freshwater Ecology and Inland Fisheries, Stechlin, Germany
| | - Edward M Krynak
- Global Water Center, Department of Biology, University of Nevada, Reno, NV, USA
- Department of Biology, University of Nevada, Reno, NV, USA
| | - Àngels Leiva-Presa
- Aquatic Ecology Group, University of Vic - Central University of Catalonia, Vic, Spain
| | - Fabio Lepori
- Institute of Earth Sciences, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Mendrisio, Switzerland
| | - Miguel G Matias
- Rui Nabeiro Biodiversity Chair, Mediterranean Institute for Agriculture, Environment and Development (MED), Universidade de Évora, Évora, Portugal
- Museo Nacional de Ciencias Naturales, CSIC, Madrid, Spain
| | | | - Yvonne McElarney
- Fisheries and Aquatic Ecosystems, Agri-Food and Biosciences Institute, Belfast, Northern Ireland
| | - Beata Messyasz
- Department of Hydrobiology, Institute of Environmental Biology, Adam Mickiewicz University, Poznań, Poland
| | - Mark Mitchell
- Department of Science and Innovation, Horizons Regional Council, Palmerston North, New Zealand
| | - Musa C Mlambo
- Department of Freshwater Invertebrates, Albany Museum, Grahamstown, South Africa
| | - Samuel N Motitsoe
- Department of Zoology and Entomology, Rhodes University, Grahamstown, South Africa
| | - Sarma Nandini
- FES Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
| | - Valentina Orlandi
- Department of Earth and Environmental Sciences, University of Milano-Bicocca, Milan, Italy
| | - Caroline Owens
- Department of Ecology, Evolution, and Marine Biology, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Deniz Özkundakci
- Environmental Research Institute - Te Pūtahi Rangahau Taiao, The University of Waikato, Hamilton, New Zealand
| | - Solvig Pinnow
- Department of Plankton and Microbial Ecology, Leibniz Institute of Freshwater Ecology and Inland Fisheries, Stechlin, Germany
| | - Agnieszka Pociecha
- Department of Freshwater Biology, Institute of Nature Conservation, Polish Academy of Sciences, Kraków, Poland
| | - Pedro Miguel Raposeiro
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO Laboratório Associado, BIOPOLIS Program in Genomics, Biodiversity and Land Planning; UNESCO Chair - Land Within Sea: Biodiversity & Sustainability in Atlantic Islands, Universidade dos Açores, Ponta Delgada, São Miguel, Açores, Portugal
- Faculdade de Ciências e Tecnologias, Universidade dos Açores, Ponta Delgada, Portugal
| | - Eva-Ingrid Rõõm
- Institute of Agricultural and Environmental Sciences, Estonian University of Life Sciences, Tartu, Estonia
| | - Federica Rotta
- Institute of Earth Sciences, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Mendrisio, Switzerland
| | - Nico Salmaso
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - S S S Sarma
- FES Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
| | - Davide Sartirana
- Department of Earth and Environmental Sciences, University of Milano-Bicocca, Milan, Italy
| | - Facundo Scordo
- Instituto Argentino de Oceanografía, Universidad Nacional del Sur (UNS)-CONICET, Bahía Blanca, Argentina
- Departamento de Geografía y Turismo, Universidad Nacional del Sur, Bahía Blanca, Argentina
| | - Claver Sibomana
- Center of Research in Natural and Environmental Sciences, University of Burundi, Bujumbura, Burundi
| | | | - Katarzyna Stepanowska
- Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology, Szczecin, Poland
| | | | - Maria Tereshina
- Department of Hydrology, Lomonosov Moscow State University, Moscow, Russia
| | - James Thompson
- Fisheries and Aquatic Ecosystems, Agri-Food and Biosciences Institute, Belfast, Northern Ireland
- School of Geography and Environmental Sciences, Ulster University, Coleraine, Northern Ireland
| | - Monica Tolotti
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - Amanda Valois
- National Institute of Water and Atmospheric Research, Freshwater Ecology, Hamilton and Wellington, New Zealand
| | - Piet Verburg
- National Institute of Water and Atmospheric Research, Freshwater Ecology, Hamilton, New Zealand
| | - Brittany Welsh
- School of the Environment, Trent University, Peterborough, Canada
| | - Brian Wesolek
- Biological Services Department, Bay Mills Indian Community, Brimley, MI, USA
| | - Gesa A Weyhenmeyer
- Department of Ecology and Genetics, Limnology Group, Uppsala University, Uppsala, Sweden
| | - Naicheng Wu
- Department of Geography and Spatial Information Techniques, Ningbo University, Ningbo, China
| | - Edyta Zawisza
- Institute of Geological Sciences, Polish Academy of Sciences, Warsaw, Poland
| | - Lauren Zink
- Department of Biological Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Barbara Leoni
- Department of Earth and Environmental Sciences, University of Milano-Bicocca, Milan, Italy
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Sahinturk H, Aykenar B, Uslu A, Ersoy Z, Yesiler FI, Zeyneloglu P, Haberal M. Relationship Between Postoperative Acute Kidney Injury and Early Extubation After Pediatric Liver Transplant. EXP CLIN TRANSPLANT 2023. [PMID: 37073989 DOI: 10.6002/ect.2023.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
OBJECTIVES Postoperative acute kidney injury after pediatric liver transplant is a serious complication with considerable short-term and long-term consequences. We hypothesized that incidence of postoperative acute kidney injury after pediatric liver transplant is lower among patients extubated early after surgery in the operating room. MATERIALS AND METHODS In this retrospective cohort study, we reviewed the medical records of all patients aged <18 years who underwent liver transplant from January 2012 to December 2020. Early extubation was defined as extubation in the operating room. Children were divided into 2 groups: those who were extubated in the operating room and those who were extubated in the intensive care unit. RESULTS A total of 132 pediatric liver transplant recipients were analyzed. The mean age of transplant was 58.2 ± 60.1 months, and 54.5% were male recipients. Early immediate tracheal extubation in the operating room was performed in 86 patients (65.2%). Postoperative acute kidney injury was seen in 24 children (18.2%) of which 15 (11.4%) had stage 1 acute kidney injury, 8 (6.1%) had stage 2, and 1 (0.8%) had stage 3. There was no statistically significant difference between the 2 groups regarding development of acute kidney injury (18.6% vs 17.4%; P > .05). Compared with patients who were not extubated in the operating room, the need for an open-abdomen procedure (76.9% vs 23.1%; P = .001) was significantly higher in patients who were extubated in the operating room. Durations for length of stay in the intensive care unit and hospital were significantly shorter in patients who were extubated in the operating room (P < .001). CONCLUSIONS Our results showed that early extubation was performed in nearly two-thirds of our cohort. There was no association between early extubation and development of acute kidney injury among pediatric liver transplant recipients.
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Affiliation(s)
- Helin Sahinturk
- From the Department of Anesthesiology and Critical Care, Baskent University Faculty of Medicine, Ankara, Turkey
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3
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Uslu A, Çekmen N, Ersoy Z, Torgay A. Liver Transplantation in a Patient with Crigler-Najjar Syndrome Type 1: A Case Report of Two Cases. AACC 2023. [DOI: 10.18502/aacc.v9i1.11953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Crigler Najjar syndrome(CNS); is a disease in which the diphosphate glucuronosyltransferase (bilirubin-UGT) enzyme function, which plays a role in the glucuronidation of bilirubin, is deficient as a result of mutation in the uridine 5'-diphosphate-glucuronosyltransferase 1A1 (UGT1A1) gene.1 As a result, non-hemolytic unconjugated hyperbilirubinemia is seen. Orthotopic liver transplantation (OLT) is seen as a curative treatment option in Crigler Najjar syndrome type 1 (CNS1). In this case report, we present our patients who were 11 months old and 8 years old with a diagnosis of CNS1, whose bilirubin levels were controlled by preoperative daily phototherapy and plasmapheresis, and who had OLT from their parents to two siblings. We wanted to show the importance of a close follow-up and multidisciplinary treatment approach in the early period before OLT in CNS1 patients and thus the benefit to the patient's prognosis in the postoperative period.
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Ersoy Z, Abril M, Cañedo-Argüelles M, Espinosa C, Vendrell-Puigmitja L, Proia L. Experimental assessment of salinization effects on freshwater zooplankton communities and their trophic interactions under eutrophic conditions. Environ Pollut 2022; 313:120127. [PMID: 36089138 DOI: 10.1016/j.envpol.2022.120127] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/15/2023]
Abstract
Freshwater ecosystems are becoming saltier due to human activities. The effects of increased salinity can lead to cascading trophic interactions, affecting ecosystem functioning and energy transfer, through changes in community and size structure. These effects can be modulated by other environmental factors, such as nutrients. For example, communities developed under eutrophic conditions could be less sensitive to salinization due to cross-tolerance mechanisms. In this study, we used a mesocosm approach to assess the effects of a salinization gradient on the zooplankton community composition and size structure under eutrophic conditions and the cascading effects on algal communities. Our results showed that zooplankton biomass, size diversity and mean body size decreased with increased chloride concentration induced by salt addition. This change in the zooplankton community did not have cascading effects on phytoplankton. The phytoplankton biomass decreased after the chloride concentration threshold of 500 mg L-1 was reached, most likely due to direct toxic effects on the osmotic regulation and nutrient uptake processes of certain algae rather than as a response to community turnover or top-down control. Our study can help to put in place mitigation strategies for salinization and eutrophication, which often co-occur in freshwater ecosystems.
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Affiliation(s)
- Zeynep Ersoy
- FEHM-Lab (Freshwater Ecology, Hydrology and Management), Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Institut de Recerca de l'Aigua (IdRA), Universitat de Barcelona, Barcelona, Spain; Rui Nabeiro' Biodiversity Chair, MED - Mediterranean Institute for Agriculture, Environment and Development, Universidade de Évora, Évora, Portugal
| | - Meritxell Abril
- BETA Technological Center, University of Vic- Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Miguel Cañedo-Argüelles
- FEHM-Lab (Freshwater Ecology, Hydrology and Management), Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Institut de Recerca de l'Aigua (IdRA), Universitat de Barcelona, Barcelona, Spain; Institute of Environmental Assessment and Water Research (IDAEA), CSIC, Barcelona, Spain
| | - Carmen Espinosa
- BETA Technological Center, University of Vic- Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Lidia Vendrell-Puigmitja
- BETA Technological Center, University of Vic- Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Lorenzo Proia
- BETA Technological Center, University of Vic- Central University of Catalonia (UVic-UCC), Vic, Spain.
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Çekmen N, Ersoy Z, Günay YI, Ghavam AA, Tufan MYS, Şahin İM. Evaluation of coronavirus diseases (COVID-19) in terms of epidemiological and clinical features, comorbidities, diagnostic methods, treatment, and mortality. J Educ Health Promot 2022; 11:236. [PMID: 36177413 PMCID: PMC9514254 DOI: 10.4103/jehp.jehp_1328_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes COVID-19. On March 11, 2020, the WHO declared it a pandemic. SARS-CoV-2 indicates that it poses a significant threat to public health and global economy. The aim of the study was to determine (a) patient characteristics, (b) demographic characteristics, (c) comorbidities, diagnostic methods used, treatment, and outcomes, and (d) mortality rates of patients. MATERIALS AND METHODS This retrospective cohort study included 352 hospitalized adult patients from Baskent University Hospital in Ankara who were confirmed cases of COVID-19 between March 2020 and March 2021. SPSS v. 14.0 was used for statistical analysis. RESULTS Out of 352 patients, 55 died (males: 37, females: 18), while 297 survived (males: 162, females: 135). The most common comorbidities were hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD), cancer, Vitamin D deficiency, and chronic obstructive pulmonary disease. Comorbidities associated with mortality rate were obesity (33%) (P = 0.118), Vitamin D deficiency (28%) (P = 0.009), DM (25%) (P = 0.004), CAD (21.2%) (P = 0.142), cancer (20.9%) (P = 0.084), and HT (16.6%) (P = 0.90). Normal ward admission resulted in death in 67.3% and survival in 93.9% (P = 0.001), intensive care unit (ICU) admission resulted in death in 69.1% and survival in 18.5% (P = 0.001), and oxygen therapy was used in 80% death and survival in 39.4% (P = 0.001). CONCLUSIONS Our study shows that male gender, advanced age, and presence of comorbidities in COVID 19 patients are at higher risk for severe disease, ICU admission, and death. We emphasize that morbidity and mortality can be reduced by early and comprehensive identification of risk factors and the warning systems that will meet the ICU needs of these patients.
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Affiliation(s)
- Nedim Çekmen
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Zeynep Ersoy
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Baskent University, Ankara, Turkey
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Ersoy Z, Scharfenberger U, Baho DL, Bucak T, Feldmann T, Hejzlar J, Levi EE, Mahdy A, Nõges T, Papastergiadou E, Stefanidis K, Šorf M, Søndergaard M, Trigal C, Jeppesen E, Beklioğlu M. Impact of nutrients and water level changes on submerged macrophytes along a temperature gradient: A pan-European mesocosm experiment. Glob Chang Biol 2020; 26:6831-6851. [PMID: 32893967 DOI: 10.1111/gcb.15338] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/06/2020] [Accepted: 08/16/2020] [Indexed: 06/11/2023]
Abstract
Submerged macrophytes are of key importance for the structure and functioning of shallow lakes and can be decisive for maintaining them in a clear water state. The ongoing climate change affects the macrophytes through changes in temperature and precipitation, causing variations in nutrient load, water level and light availability. To investigate how these factors jointly determine macrophyte dominance and growth, we conducted a highly standardized pan-European experiment involving the installation of mesocosms in lakes. The experimental design consisted of mesotrophic and eutrophic nutrient conditions at 1 m (shallow) and 2 m (deep) depth along a latitudinal temperature gradient with average water temperatures ranging from 14.9 to 23.9°C (Sweden to Greece) and a natural drop in water levels in the warmest countries (Greece and Turkey). We determined percent plant volume inhabited (PVI) of submerged macrophytes on a monthly basis for 5 months and dry weight at the end of the experiment. Over the temperature gradient, PVI was highest in the shallow mesotrophic mesocosms followed by intermediate levels in the shallow eutrophic and deep mesotrophic mesocosms, and lowest levels in the deep eutrophic mesocosms. We identified three pathways along which water temperature likely affected PVI, exhibiting (a) a direct positive effect if light was not limiting; (b) an indirect positive effect due to an evaporation-driven water level reduction, causing a nonlinear increase in mean available light; and (c) an indirect negative effect through algal growth and, thus, high light attenuation under eutrophic conditions. We conclude that high temperatures combined with a temperature-mediated water level decrease can counterbalance the negative effects of eutrophic conditions on macrophytes by enhancing the light availability. While a water level reduction can promote macrophyte dominance, an extreme reduction will likely decrease macrophyte biomass and, consequently, their capacity to function as a carbon store and food source.
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Affiliation(s)
- Zeynep Ersoy
- Limnology Laboratory, Department of Biological Sciences, Middle East Technical University, Ankara, Turkey
- 'Rui Nabeiro' Biodiversity Chair, MED - Mediterranean Institute for Agriculture, Environment and Development, Universidade de Évora, Évora, Portugal
| | - Ulrike Scharfenberger
- Department of River Ecology, Helmholtz Centre for Environmental Research UFZ, Magdeburg, Germany
- Leibniz Institute of Freshwater Ecology and Inland Fisheries (IGB), Berlin, Germany
| | - Didier L Baho
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Tuba Bucak
- Limnology Laboratory, Department of Biological Sciences, Middle East Technical University, Ankara, Turkey
- Nature Conservation Centre, Ankara, Turkey
| | - Tõnu Feldmann
- Centre for Limnology, Institute of Agricultural and Environmental Sciences, Estonian University of Life Sciences, Tartumaa, Estonia
| | - Josef Hejzlar
- Institute of Hydrobiology, Biology Centre of the Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Eti E Levi
- Limnology Laboratory, Department of Biological Sciences, Middle East Technical University, Ankara, Turkey
- Department of Bioscience, Aarhus University, Silkeborg, Denmark
| | - Aldoushy Mahdy
- Department of Zoology, Faculty of Science, Al-Azhar University (Assiut Branch), Assiut, Egypt
| | - Tiina Nõges
- Centre for Limnology, Institute of Agricultural and Environmental Sciences, Estonian University of Life Sciences, Tartumaa, Estonia
| | | | - Konstantinos Stefanidis
- Department of Biology, University of Patras, Rio, Greece
- Institute of Marine Biological Resources and Inland Waters, Hellenic Centre for Marine Research, Anavissos Attiki, Greece
| | - Michal Šorf
- Institute of Hydrobiology, Biology Centre of the Czech Academy of Sciences, České Budějovice, Czech Republic
- Faculty of Science, University of South Bohemia, České Budějovice, Czech Republic
| | - Martin Søndergaard
- Department of Bioscience, Aarhus University, Silkeborg, Denmark
- Sino-Danish Centre for Education and Research, University of Chinese Academy of Sciences, Beijing, China
| | - Cristina Trigal
- Species Information Center, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Erik Jeppesen
- Limnology Laboratory, Department of Biological Sciences, Middle East Technical University, Ankara, Turkey
- Department of Bioscience, Aarhus University, Silkeborg, Denmark
- Sino-Danish Centre for Education and Research, University of Chinese Academy of Sciences, Beijing, China
- Centre for Ecosystem Research and Implementation (EKOSAM), Middle East Technical University, Ankara, Turkey
| | - Meryem Beklioğlu
- Limnology Laboratory, Department of Biological Sciences, Middle East Technical University, Ankara, Turkey
- Centre for Ecosystem Research and Implementation (EKOSAM), Middle East Technical University, Ankara, Turkey
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Akdur A, Baskin E, Ersoy Z, Moray G, Haberal MA. Surgical Complications after Pediatric Kidney Transplantation. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.1073] [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: 11/25/2022]
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Ersoy Z, Brucet S, Bartrons M, Mehner T. Short-term fish predation destroys resilience of zooplankton communities and prevents recovery of phytoplankton control by zooplankton grazing. PLoS One 2019; 14:e0212351. [PMID: 30768619 PMCID: PMC6377254 DOI: 10.1371/journal.pone.0212351] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 01/31/2019] [Indexed: 11/18/2022] Open
Abstract
Planktivorous fish predation directly affects zooplankton biomass, community and size structure, and may indirectly induce a trophic cascade to phytoplankton. However, it is not clear how quickly the zooplankton community structure and the cascading effects on phytoplankton recover to the unaffected state (i.e. resilience) once short-term predation by fish stops. The resilience has implications for the ecological quality and restoration measures in aquatic ecosystems. To assess the short-term zooplankton resilience against fish predation, we conducted a mesocosm experiment consisting of 10 enclosures, 6 with fish and 4 without fish. Plankton communities from a natural lake were used to establish phytoplankton and zooplankton in the mesocosms. High biomasses (about 20 g wet mass m-3) of juvenile planktivorous fish (perch, Perca fluviatilis) were allowed to feed on zooplankton in fish enclosures for four days. Thereafter, we removed fish and observed the recovery of the zooplankton community and its cascading effect on trophic interactions in comparison with no fish enclosures for four weeks. Short-term fish predation impaired resilience in zooplankton community by modifying community composition, as large zooplankton, such as calanoids, decreased just after fish predation and did not re-appear afterwards, whereas small cladocerans and rotifers proliferated. Total zooplankton biomass increased quickly within two weeks after fish removal, and at the end even exceeded the biomass measured before fish addition. Despite high biomass, the dominance of small zooplankton released phytoplankton from grazer control in fish enclosures. Accordingly, the zooplankton community did not recover from the effect of fish predation, indicating low short-term resilience. In contrast, in no fish enclosures without predation disturbance, a high zooplankton:phytoplankton biomass ratio accompanied by low phytoplankton yield (Chlorophyll-a:Total phosphorus ratio) reflected phytoplankton control by zooplankton over the experimental period. Comprehensive views on short and long-term resilience of zooplankton communities are essential for restoration and management strategies of aquatic ecosystems to better predict responses to global warming, such as higher densities of planktivorous fish.
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Affiliation(s)
- Zeynep Ersoy
- Aquatic Ecology Group, University of Vic- Central University of Catalonia, Vic, Spain
- Department of Biology and Ecology of Fishes, Leibniz-Institute of Freshwater Ecology and Inland Fisheries (IGB), Berlin, Germany
- * E-mail: (ZE); (TM)
| | - Sandra Brucet
- Aquatic Ecology Group, University of Vic- Central University of Catalonia, Vic, Spain
- Catalan Institution for Research and Advanced Studies, ICREA, Barcelona, Spain
| | - Mireia Bartrons
- Aquatic Ecology Group, University of Vic- Central University of Catalonia, Vic, Spain
| | - Thomas Mehner
- Department of Biology and Ecology of Fishes, Leibniz-Institute of Freshwater Ecology and Inland Fisheries (IGB), Berlin, Germany
- * E-mail: (ZE); (TM)
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Haberal M, Kirnap M, Gokce ON, Bacanli D, Ersoy Z, Bayzakov M, Torgay A, Ozdemir H, Erdem R. Technique of Ileobladder and Kidney Transplant in Rats and Pigs. EXP CLIN TRANSPLANT 2018; 16:1-9. [PMID: 29409436] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Kidney transplant is the best choice for treatment of patients with advanced chronic renal disease. However, small, poorly compliant, and unstable bladders can result in major problems for patients. Here, we aimed to develop and evaluate a new ileobladder model. MATERIALS AND METHODS Fifteen rats (250-300 g) and 5 pigs (~100 kg) were cared for according to institutional and published guidelines. After general anesthesia, laparotomy was done through midline incision. Ileal loops were prepared for ileobladder. After cystectomy (0.5 cm above the trigone in rats, 1 cm above the trigone in pigs), anastomoses were done between antimesenteric sides of ileal loops and bladder remnant with 6/0 Prolene suture. Three other pigs received simultaneous renal transplant. RESULTS One rat died on day 1 postsurgery from multiorgan hemorrhage. Two rats survived for 5 days, 3 rats for 7 days, and 3 rats for 11 days; 6 rats were killed for pathologic evaluation after 3 months. One pig survived for 22 days and 1 for 9 days. Of the 3 pigs that received a simultaneous renal transplant, 2 pigs were alive and doing well 80 and 72 days after surgery with normal urinary discharge (1 pig was killed for pathologic evaluation after 3 days). When ileobladder was opened, complete recovery of the anastomosis line was observed. Pathologic examination of the anastomosis sites reported a normal healing process with moderate inflammation and the muscular wall of the intestine showed hypertrophia that nearly reached the size of the bladder muscularis propria. CONCLUSIONS Although we had some complications because no draining procedure was used, in terms of technique, our new ileobladder model is promising for providing functional bladder volume. A larger scale series in the clinical setting is planned. This technique can be useful for small bladders and bladder physiology disorders.
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Affiliation(s)
- Mehmet Haberal
- From the Department of Transplant Surgery, Baskent University, Ankara, Turkey
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10
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Ayhan A, Ersoy Z, Ulas A, Zeyneloglu P, Pirat A, Haberal M. Incidence and Patient Outcomes in Renal Replacement Therapy After Orthotopic Liver Transplant. EXP CLIN TRANSPLANT 2017; 15:258-260. [PMID: 28260481 DOI: 10.6002/ect.mesot2016.p126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Our objective was to evaluate the incidence of renal replacement therapy after orthotopic liver transplant and to evaluate and analyze patient outcomes. MATERIALS AND METHODS We performed a retrospective analysis of 177 consecutive patients at a tertiary care unit who underwent orthotopic liver transplant between January 2010 and June 2016. Patients who were admitted to the intensive care unit after orthotopic liver transplant and who required renal replacement therapy were included. RESULTS A total of 177 (79 adult, 98 pediatric) orthotopic liver transplants were performed during the study period. Of these, 35 patients (19%) required renal replacement therapy during the early posttransplantation period. After excluding 5 patients with previous chronic renal failure, 30 patients (17%; 20 adult [25% ], 10 pediatric [10% ]) with acute kidney injury required renal replacement therapy. The mean patient age was 31.1 ± 20.0 years, with a mean Model for End-stage Liver Disease score of 16.7 ± 12.3. Of the patients with acute kidney injury who underwent renal replacement therapy, in-hospital mortality was 23.3% (7 of 30 patients), and 40% remained on dialysis. No significant difference was seen in mortality between early versus delayed initiation of renal replacement therapy in patients with stage 3 acute kidney injury (P = .17). CONCLUSIONS Of liver transplant recipients who present with acute kidney injury, 19% require renal replacement therapy, and in-hospital mortality is 20% in the early postoperative period.
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Affiliation(s)
- Asude Ayhan
- Department of Anaesthesiology and Reanimation, Baskent University School of Medicine, Ankara, Turkey
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11
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Ersoy Z, Ayhan A, Ozdemirkan A, Polat GG, Zeyneloglu P, Arslan G, Haberal M. Anesthetic and Perioperative Management of Nontransplant Surgery in Patients After Liver Transplant. EXP CLIN TRANSPLANT 2017; 15:42-45. [PMID: 28260430 DOI: 10.6002/ect.mesot2016.o24] [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: 11/05/2022]
Abstract
OBJECTIVES We aimed to document the anesthetic management and metabolic, hemodynamic, and clinical outcomes of liver-graft recipients who subsequently undergo nontransplant surgical procedures. MATERIALS AND METHODS We retrospectively analyzed the data of 96 liver-graft recipients who underwent 144 nontransplant surgeries between October 1998 and April 2016 at Başkent University Hospital. RESULTS The median patient age at the time of nontransplant surgery was 32 years, and 35% were female (n = 33). The median time between transplant and nontransplant surgery was 1231 days. The most frequent types of nontransplant surgery were abdominal (22%), orthopedic (16%), and urologic (13%). Seventy patients had an American Society of Anesthesiologists status of 2 (49%); the status was 3 in 71 patients (49%) and 4 in 3 patients (2%). Of the 144 procedures, 23 were emergent (16%) and 48% were abdominal. General anesthesia was used in 69%, regional anesthesia in 19%, and sedoanalgesia in 11%. Twenty-five patients required intraoperative blood-product transfusion (17%). Intraoperative hemodynamic instability developed in 17% of patients, and hypoxemia developed in 2%. Eleven patients remained intubated at the end of surgery (8%). Of the 144 procedures, 19 (13%) required transfer to the intensive care unit, 108 (75%) transferred to the ward, and the remaining 17 (12%) were discharged on the same day. Eight patients developed respiratory failure (6%), 7 had renal dysfunction (5%), 4 had coagulation abnormalities (3%), and 10 had infectious complications (7%) in the early postoperative period. The median hospital stay was 4 days, and 5 patients (4%) developed rejection during hospitalization. Five patients died of respiratory or infectious complications (4%). CONCLUSIONS Most liver-graft recipients who undergo nontransplant surgery are given general anesthesia, transferred to the ward after the procedure, and discharged without major complications. We suggest that orthotopic liver transplant recipients may undergo nontransplant surgery without any postoperative graft dysfunction.
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Affiliation(s)
- Zeynep Ersoy
- Department of Anesthesiology, Baskent University Hospital, Ankara, Turkey
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12
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Ersoy Z, Kaplan S, Ozdemirkan A, Torgay A, Arslan G, Pirat A, Haberal M. Effect of Graft Weight to Recipient Body Weight Ratio on Hemodynamic and Metabolic Parameters in Pediatric Liver Transplant: A Retrospective Analysis. EXP CLIN TRANSPLANT 2017; 15:53-56. [PMID: 28260433 DOI: 10.6002/ect.mesot2016.o32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To analyze how graft-weight-to-bodyweight ratio in pediatric liver transplant affects intraoperative and early postoperative hemodynamic and metabolic parameters. MATERIALS AND METHODS We reviewed data from 130 children who underwent liver transplant between 2005 and 2015. Recipients were divided into 2 groups: those with a graft weight to body weight ratio > 4% (large for size) and those with a ratio ≤ 4% (normal for size). Data included demographics, preoperative laboratory findings, intraoperative metabolic and hemodynamic parameters, and intensive care follow-up parameters. RESULTS Patients in the large-graft-for-size group (>4%) received more colloid solution (57.7 ± 20.1 mL/kg vs 45.1 ± 21.9 mL/kg; P = .08) and higher doses of furosemide (0.7 ± 0.6 mg/kg vs 0.4 ± 0.7 mg/kg; P = .018). They had lower mean pH (7.1 ± 0.1 vs 7.2 ± 0.1; P = .004) and PO2 (115.4 ± 44.6 mm Hg vs 147.6 ± 49.3 mm Hg; P = .004) values, higher blood glucose values (352.8 ± 96.9 mg/dL vs 262.8 ± 88.2 mg/dL; P < .001), and lower mean body temperature (34.8 ± 0.7°C vs 35.2 ± 0.6°C; P = .016) during the neohepatic phase. They received more blood transfusions during both the anhepatic (30.3 ± 24.3 mL/kg vs 18.8 ± 21.8 mL/kg; P = .013) and neohepatic (17.7 ± 20.4 mL/kg vs 10.3 ± 15.5 mL/kg; P = .031) phases and more fresh frozen plasma (13.6 ± 17.6 mL/kg vs 6.2 ± 10.2 mL/kg; P = .012) during the neohepatic phase. They also were more likely to be hypotensive (P < .05) and to receive norepinephrine infusion more often (44% vs 22%; P < .05) intraoperatively. More patients in this group were mechanically ventilated in the intensive care unit (56% vs 31%; P = .035). There were no significant differences between the groups in postoperative acute renal dysfunction, graft rejection or loss, infections, length of intensive care stay, and mortality (P > .05). CONCLUSIONS High graft weight-to-body-weight ratio is associated with adverse metabolic and hemodynamic changes during the intraoperative and early postoperative periods. These results emphasize the importance of using an appropriately sized graft in liver transplant.
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Affiliation(s)
- Zeynep Ersoy
- Department of Anesthesiology, Baskent University, Ankara, Turkey
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13
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Ersoy Z, Araz C, Taşkın D, Moray G, Torgay A. Malposition of a Peripherally Inserted Central Venous Catheter in the Graft Hepatic Vein. EXP CLIN TRANSPLANT 2016; 13 Suppl 3:81-3. [PMID: 26640920 DOI: 10.6002/ect.tdtd2015.p45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Central venous catheters are used for delivering medications and parenteral nutrition, measuring hemodynamic variations, and providing long-term intravenous access. In our clinic, during liver transection using a living-liver donor, peripherally inserted central venous catheters are generally preferred because they involve a less invasive technique with a lower risk of complications. In this report, we present the case of a 36-year-old male liver donor into whom we peripherally inserted a central venous catheter from his left basilic vein. After transecting the hepatic vein, the surgeon found foreign material inside the venous lumen, which turned out to be the distal segment of the catheter.
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Affiliation(s)
- Zeynep Ersoy
- From the Department of Anesthesiology and Critical Care Medicine, Başkent University School of Medicine, Ankara, Turkey
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14
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Ersoy Z, Araz C, Kırnap M, Zeyneloğlu P, Torgay A, Arslan G. Anesthesia Management of a Deceased Cadaveric-Donor Combined Liver and Kidney Transplant for Primary Hyperoxaluria Type 1: Report of a Case. EXP CLIN TRANSPLANT 2016; 13 Suppl 3:97-100. [PMID: 26640925 DOI: 10.6002/ect.tdtd2015.p60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Primary hyperoxaluria type 1 is an autosomal recessive disorder that is responsible for the overproduction of oxalate and has an incidence of 1 in 120 000 live births. Indications for combined liver and kidney transplant are still debated. However, combined liver and kidney transplant is preferred in various conditions, including primary hyperoxaluria, liver-based metabolic abnormalities affecting the kidney, and structural diseases affecting both the liver and the kidney, such as congenital hepatic fibrosis and polycystic kidney disease. When compared with sequential liver and kidney transplant, the rejection rate of both liver and kidney allografts was reported to be lower than with combined liver and kidney transplant. With proper anesthesia management, the probable increased complications with combined liver and kidney transplant can be prevented. In this report, we present the anesthesia care of a 22-year-old patient with primary hyperoxaluria type 1 who had deceased-donor combined liver and kidney transplant.
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Affiliation(s)
- Zeynep Ersoy
- From the Department of Anesthesiology and Critical Care Medicine, Baskent University Faculty of Medicine, Ankara, Turkey
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Ersoy Z, Ozdemirkan A, Pirat A, Torgay A, Arslan G, Haberal M. Perioperative Characteristics of Siblings Undergoing Liver or Kidney Transplant. EXP CLIN TRANSPLANT 2016; 13 Suppl 3:101-6. [PMID: 26640926 DOI: 10.6002/ect.tdtd2015.p61] [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: 11/05/2022]
Abstract
OBJECTIVES Reasons for chronic liver and kidney failure may vary; sometimes more than 1 family member may be affected, and may require a transplant. The aim of this study was to examine the similarities or differences between the perioperative characteristics of siblings undergoing liver or kidney transplant. MATERIALS AND METHODS The medical records of 6 pairs of siblings who underwent liver transplant and 4 pairs of siblings who underwent kidney transplant at Baskent University Hospital between 1989 and 2014 were retrospectively analyzed. Collected data included demographic features; comorbidities; reasons for liver and kidney failure; perioperative laboratory values; intraoperative hemodynamic parameters; use and volume of crystalloids, colloids, blood products, cell saver system, and albumin; duration of anesthesia; urine output; and postoperative follow-up data. RESULTS The mean age of the 6 sibling pairs who underwent liver transplant was 16.3 ± 12.2 years. All 12 patients had Child-Pugh grade B cirrhosis, with mean disease duration of 7.8 ± 3.9 years. There were no significant differences between siblings with respect to intraoperative blood product transfusion, crystalloid and colloid fluid replacements, hypotension frequency, blood gas analyses, urinary output, duration of anhepatic phase, inotropic agent administration, postoperative laboratory values, need for mechanical ventilation and vasopressors, occurrence of acute renal failure and infections, and duration intensive care unit stay (P > .05). The mean age of the 4 sibling pairs who underwent kidney transplant was 21.3 ± 6.4 years, with mean duration of renal insufficiency of 2.2 ± 1.6 years. There were no significant differences between siblings with respect to intraoperative crystalloid and colloid fluid administration, duration of anesthesia, intraoperative mannitol and furosemide administration, and postoperative laboratory values (P > .05). CONSLUSIONS In conclusion, the 6 sibling pairs who underwent liver transplant and 4 sibling pairs who underwent kidney transplant in our cohort had similar perioperative characteristics.
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Affiliation(s)
- Zeynep Ersoy
- From the Department of Anesthesiology and Critical Care Medicine, Baskent University Faculty of Medicine, Ankara, Turkey
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16
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Ozdemirkan A, Ersoy Z, Zeyneloglu P, Gedik E, Pirat A, Haberal M. Percutaneous Dilational Tracheotomy in Solid-Organ Transplant Recipients. EXP CLIN TRANSPLANT 2016; 13 Suppl 3:48-51. [PMID: 26640911 DOI: 10.6002/ect.tdtd2015.o38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Solid-organ transplant recipients may require percutaneous dilational tracheotomy because of prolonged mechanical ventilation or airway issues, but data regarding its safety and effectiveness in solid-organ transplant recipients are scarce. Here, we evaluated the safety, effectiveness, and benefits in terms of lung mechanics, complications, and patient comfort of percutaneous dilational tracheotomy in solid-organ transplant recipients. MATERIALS AND METHODS Medical records from 31 solid-organ transplant recipients (median age of 41.0 years [interquartile range, 18.0-53.0 y]) who underwent percutaneous dilational tracheotomy at our hospital between January 2010 and March 2015 were analyzed, including primary diagnosis, comorbidities, duration of orotracheal intubation and mechanical ventilation, length of intensive care unit and hospital stays, the time interval between transplant to percutaneous dilational tracheotomy, Acute Physiology and Chronic Health Evaluation II score, tracheotomy-related complications, and pulmonary compliance and ratio of partial pressure of arterial oxygen to fraction of inspired oxygen. RESULTS The median Acute Physiology and Chronic Health Evaluation II score on admission was 24.0 (interquartile range, 18.0-29.0). The median interval from transplant to percutaneous dilational tracheotomy was 105.5 days (interquartile range, 13.0-2165.0 d). The only major complication noted was left-sided pneumothorax in 1 patient. There were no significant differences in ratio of partial pressure of arterial oxygen to fraction of inspired oxygen before and after procedure (170.0 [interquartile range, 102.2-302.0] vs 210.0 [interquartile range, 178.5-345.5]; P = .052). However, pulmonary compliance results preprocedure and postprocedure were significantly different (0.020 L/cm H2O [interquartile range, 0.015-0.030 L/cm H2O] vs 0.030 L/cm H2O [interquartile range, 0.020-0.041 L/cm H2O); P = .001]). Need for sedation significantly decreased after tracheotomy (from 17 patients [54.8%] to 8 patients [25.8%]; P = .004]). CONCLUSIONS Percutaneous dilational tracheotomy with bronchoscopic guidance is an efficacious and safe technique for maintaining airways in solidorgan transplant recipients who require prolonged mechanical ventilation, resulting in possible improvements in ventilatory mechanics and patient comfort.
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Affiliation(s)
- Aycan Ozdemirkan
- From the Department of Anesthesiology and Critical Care Medicine, School of Medicine, Baskent University, Ankara, Turkey
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17
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Adıbelli B, Araz C, Ersoy Z, Kayhan Z. Anaesthesia Management of a Patient with Factor XI Deficiency. Turk J Anaesthesiol Reanim 2016; 44:149-51. [PMID: 27366578 DOI: 10.5152/tjar.2016.90267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 12/02/2015] [Indexed: 11/22/2022] Open
Abstract
Factor XI deficiency is an extremely rare disease presenting no clinical symptoms, unless there is an inducing reason such as trauma or surgery. Normally, factor levels are in the range of 70-150 U dL-1 in healthy subjects. Although no clinical symptoms are seen, only high levels of aPTT can be found. Once a prolongation is detected in aPTT, factor XI deficiency should be suspected and factor levels should be analysed. With careful preoperative preparations in factor-deficient people, preoperative and postoperative complications can be decreased. In this case report, management of anaesthesia during total hip arthroplasty of a patient with factor XI deficiency is presented.
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Affiliation(s)
- Bilgehan Adıbelli
- Department of Anaesthesiology, Başkent University School of Medicine, Ankara, Turkey
| | - Coşkun Araz
- Department of Anaesthesiology, Başkent University School of Medicine, Ankara, Turkey
| | - Zeynep Ersoy
- Department of Anaesthesiology, Başkent University School of Medicine, Ankara, Turkey
| | - Zeynep Kayhan
- Department of Anaesthesiology, Başkent University School of Medicine, Ankara, Turkey
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18
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Özdoğan HK, Karateke F, Özyazıcı S, Özdoğan M, Özaltun P, Kuvvetli A, Gökler C, Ersoy Z. The predictive value of red cell distribution width levels on mortality in intensive care patients with community-acquired intra-abdominal sepsis. ULUS TRAVMA ACIL CER 2016; 21:352-7. [PMID: 26388271 DOI: 10.5505/tjtes.2015.26737] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Red cell distribution width (RDW) is a part of the complete blood count (CBC) panel reflecting quantitative measure of variability in the size of circulating red blood cells. It has been known that higher RDW is associated with increased mortality in several diseases. The aim of this study was to investigate the association between RDW and hospital mortality in intensive care unit (ICU) patients with community-acquired intra-abdominal sepsis (C-IAS). METHODS A retrospective analysis of the patients with C-IAS was performed between January 1, 2010 and March 31, 2013. Patients' demographics, co-morbidities, laboratory measures including RDW on admission to the ICU, and Acute Physiologic and Chronic Health Evaluation II (APACHE II) score were analyzed. RESULTS A total of one hundred and three patients with C-IAS were included into the study with a mean age of 64±14 years. Overall mortality was 50.5%. RDW day 1 (RDW1) values and APACHE II scores were significantly higher in non-survivors than in survivors. In multivariate analysis, only RDW1 and APACHE II predicted mortality. The area under the receiver operating curves (AUC) of RDW1 and APACHE II were 0.867 (95% CI, 0.791-0.942) and 0.943 (95% CI, 0.902-0.984), respectively. CONCLUSION This study suggests that increased RDW is associated with mortality in ICU patients with C-IAS.
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Affiliation(s)
- Hatice Kaya Özdoğan
- Department of Anesthesia and Reanimation, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Faruk Karateke
- Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Sefa Özyazıcı
- Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Mehmet Özdoğan
- Department of General Surgery, Medical Park Hospital, Adana, Turkey
| | - Pınar Özaltun
- Department of Biostatistics, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Adnan Kuvvetli
- Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Cihan Gökler
- Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Zeynep Ersoy
- Department of Anesthesia and Reanimation, Adana Numune Training and Research Hospital, Adana, Turkey
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Kundakci Ozdemirkan A, Ersoy Z, Zeyneloglu P, Gedik E, Pirat A, Haberal M. PERCUTANEOUS DILATIONAL TRACHEOTOMY IN LIVER TRANSPLANT RECIPIENTS. Intensive Care Med Exp 2015. [PMCID: PMC4798163 DOI: 10.1186/2197-425x-3-s1-a905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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