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Öğe Causes of COVID-19’s Mortality and Prognostic Effect of Neutrophile-Lymphocyte Ratio(2022) Öterkuş, Mesut; Acun Delen, LemanObjectives: In this study, we aimed to investigate the prognostic value of the neutrophile-lymphocyte ratio and the effects of age, gender, and comorbidities on mortality. Methods: In our study, 100 patients who had a ground-glass opacification on computed thorax tomography and who had a positive polymerase chain reaction test were included in our study. Demographic data, laboratory data and comorbidities of the patients were recorded. Results: Sixty-five (65%) of the patients participating in the study were male. The mean age of the patients was 66 (21.5). The mortality rate was found to be 27% (n=27) High neutrophile-lymphocyte ratio, low lymphocyte count, high urea, and creatin levels were significant in terms of mortality. In addition, advanced age, diabetes mellitus, and hypertension are other factors that have an impact on mortality. Conclusion: The neutrophile-lymphocyte ratio can solely be used as a prognostic marker because it is simple and economical.Öğe The effect of low flow anesthesia on hemodynamic and peripheral oxygenation parameters in obesity surgery(Saudi Arabian Armed Forces Ministry of Defence and Activation, 2021) Öterkuş, Mesut; Dönmez, İlksen; Tezcan Nadir, Aysu Hayriye; Rencüzoğulları, İbrahim; Karabaǧ, Yavuz; Binnetoǧlu, KenanObjectives: To investigate the effects of low-flow anesthesia on hemodynamic parameters and recovery from anesthesia in obese individuals undergoing laparoscopic surgery. Methods: This randomized-controlled and prospective study included 44 obese patients who underwent laparoscopic sleeve gastrectomy operation. The patients were randomly allocated into 2 groups as low-flow and high-flow anesthesia. Further, the groups compared in terms of hemodynamic parameters, anesthesia recovery times, operation times, and arterial blood gas parameters. Results: The groups were similar with respect to demographic data. Heart rate, peripheral oxygen saturation, arterial blood pressure measurements, end-tidal, and CO2, lactate levels measurements were similar in both groups during the entire procedure. There was also no statistically significant difference in terms of arterial blood gas parameters or anesthesia recovery periods. Conclusion: Low-flow anesthesia in laparoscopic obesity surgery seems to be safer compared to high-flow anesthesia in terms of the adequacy of tissue perfusion, depth of anesthesia, and postoperative recovery.Öğe The Effectiveness Of The Ambu® Auragain™ Laryngeal Mask On Hemodynamic And Respiratory Parameters İn Patients Undergoing Septoplasty: A Randomized Prospective Clinical Study(2021-08-28) Öterkuş, Mesut; Selçuk Kuşderci, HaticeBackground/Aim: The use of laryngeal masks is increasing with the introduction of 3rd generation airway vehicles. However, endotracheal intubation is preferred by most anesthesiologists in septoplasty operations due to airway safety concerns. In this study, we aimed to compare the 3rd generation airway device, Ambu® Auragain ™ LMA, with tracheal intubation in terms of hemodynamic and respiratory parameters. Methods: This study included 69 patients aged 18–60 years with an ASA score of 1–2 who were scheduled for septoplasty in Adıyaman University Research and Educational Hospital between 2016.01.01 and 2017.06.31. Study groups were randomly defined as Group 1 - Ambu® AuraGain™ laryngeal mask (LMA, n = 37) and Group 2 - endotracheal intubation (ETT, n = 32), and the hemodynamic and respiratory parameters were measured and recorded. Results: The demographic data and partial oxygen saturation of the patients were similar (P>0.05 for all values). The patients in the ETT group had a higher heart rate at induction, intubation and at the first minute compared to the LMA group (P<0.05 for all values). The mean arterial pressure was significantly lower at induction, intubation, at minutes 1, 2, 3, and 4 of intubation, and at extubation in the LMA group (P<0.05 for all values). Conclusion: The Ambu® AuraGain™ laryngeal mask was similar to or better than tracheal intubation in terms of hemodynamic and respiratory parameters. The Ambu® AuraGain™ LMA can be used as an equivalent to tracheal intubation in terms of hemodynamic and respiratory parameters.Öğe Evaluation of postoperative residual curarization: a prospective clinical study(Malatya Turgut Özal Üniversitesi, 2024) Öterkuş, Mesut; Koca, Erdınc; Kutlusoy, SevgiBackground: Reversal of neuroblockade in general anesthesia is important to prevent possible complications. Currently, neostigmine and sugamedex are the agents of choice. The reversibility of blockade is evaluated by TOF (train-of-four ) as well as clinical observation. Our goal is to research and evaluate both agents in terms of complications and residual blockade. Materials and Methods: Our prospectively designed work included 100 cases operated under general anesthesia. demographic data, OF values, and complications were recorded. Results: A total of 100 patients, 63 neostigmine and 37 sugammedex, were consisted of in the search. The mean age of the sufferers was 41.9±16.9 years. When age was compared between the groups, it was found that the neostigmine (N) group was younger (p=0.027). There was a likeness between the groups in terms of surgical time, BMI (body mass index), Spo2, heart rate, mean arterial pressure, and total rocuronium consumption. The TOF value of the group N was 1(0.87-1), while that of the group sugamedex (S) was 1(0.91-1) and was found to be significant (p=0.045). There was no difference in TOF between cases who received an additional dose of rocuronium and those who did not receive an additional dose of rocuronium. Conclusions: As a result of the TOF values we obtained, we found that both agents were effective in removing the blockade, but the residual rate was statistically significantly lower in the sugamedex group, although not clinically significant. We did not encounter any complications in our study and we think that sugamedex is safer in terms of residual blockade.Öğe Evaluation of the Effect of Radiofrequency Denervation on Quality of Life of Patients with Facet Joint Syndrome by Oswestry Disability Index Score and Visual Analogue Scale Score(Universitas Carolına Pragensıs, 2021) Gündoğdu, Zafer; Öterkuş, Mesut; Karatepe, ÜmitAbstract In this study, we aimed to investigate the effect of radiofrequency denervation procedure on pain and quality of life of patients with facet joint syndrome. Forty-seven patients who were admitted to our hospital with low back pain and diagnosed with facet joint syndrome between January 2018 and December 2018 were included in our study. The patients underwent denervation with radiofrequency under fluoroscopy in a sterile operating room condition. The pre-procedure and 6th month follow-up VAS (visual analogue scale) and ODI (Oswestry disability index) scores of the patients were recorded. When the demographic data of the patients were analysed, the mean age of the patients was found to be 52. Of the patients, 61.7% were female. In the evaluation of VAS and ODI scores, which we used to measure the efficiency of the procedure, the 6th month values were found to be statistically lower than the pre-procedure values (p<0.05). The first treatment for facet joint syndrome is bed rest and medical treatment. Resistant cases also benefit from physical therapy and intra-articular steroid injection. In patients unresponsive to these treatments, denervation with radiofrequency appears to be an effective method. At least two levels must be performed for the procedure to be successful. Studies have shown that pain decreases in the long term (6-12 months) and quality of life increases. We also obtained similar results in our studies. In conclusion, we think that RF (radiofrequency) can be used as an effective method in cases where other treatments fail.Öğe Investigation of the Level of Serum Irisin in Patients With Gestational Diabetes Mellitus(2021-03-10) Kahraman, Gülcan; Kahraman, Mustafa; Öterkuş, MesutAim: In pregnancy, the most common metabolic disorder is Diabetes Mellitus (DM). Gestational diabetes mellitus (GDM) is glucose intolerance that first appears during pregnancy or is diagnosed. Especially in late pregnancy, the fetüs, rapidly growing glucose metabolism, directs glucose and amino acids to the fetus. The mother’s energy needs are arranged in the provision (free fatty acids, ketones, and glycerol) from alternative sources. It is the irisin the main function is turning from white adipose tissue to brown adipose tissue, uncover energy as heat and induced by exercises, such as weight loss, reduction in insulin resistance, associated with obesity, glucose regulation and effects on lipid metabolism are known to have many physiological properties. This study, it is aimed to investigate the level of irisin, which is GDM involved in energy metabolism, a new hormone. Material and Method: In Firat University Faculty of Medicine, Obstetrics and Gynecology Clinic, the 40 pregnant women diagnosed with GDM (Group 1) and 40 healthy pregnant women without any problems in pregnancy (Group 2) so that the total 80 patients were included in this study. These groups were divided into four subgroups, GDM in the second trimester, 20 patients (Group 1A), GDM in the third trimester, 20 patients (Group 1B), In the second trimester, 20 healthy patients (Group 2A), In the third trimester, 20 healthy patients (Group 2B). Results: In this study compared with control groups, serum irisin levels were increased significantly, including the 2. trimester higher (263.70±127.69 ng/ml) in the GDM group. There was no correlation between serum irisin level and BMI. Conclusion: In future studies, the necessity of questioned physical activity and exercise, the need for more extensive experimental and clinical studies, and if the pathophysiological mechanisms between the iris and GDM are illuminated, the clinical conclusion was reached irisin related options can be treated.Öğe MPV, RDW, LAKTAT, NA ve Albumin Düzeyleriyle Yoğun Bakım Hasta Mortalitesi Arasındaki İlişki(Malatya Turgut Özal Üniversitesi, 2022) Aydın, Ahmet; Kaçmaz, Osman; Öterkuş, Mesut; Miniksar, Ökkeş HakanGiriş ve Amaç: Yoğun bakım hasta mortalitesine yaş, yatış süresi, mekanik ventilasyon ihtiyacı ve süresi, eşlik eden yandaş hastalıklar, enfeksiyon ve laboratuvar parametreleri gibi birçok parametrenin etkisi vardır. Çalışmamızda bu parametrelerden hangilerinin yoğun bakım hasta mortalitesi üzerine etkisi olduğunu araştırmayı amaçladık. Yöntemler: Retrospektif planlanan çalışmamıza hastanemiz yoğun bakım servisinde Ocak 2018-Aralık 2019 tarihleri arasında yatan 18 yaş üstü 295 hasta dahil edildi. Taburcu ve ex olan hastalar olarak iki gruba ayrıldı. Gruplar arasında, parametrelerin mortalite ile arasındaki ilişkisi karşılaştırıldı. Bulgular: %53,6’sı (n:158) erkek olan hastaları yaş ortalaması ise 76 yıl olarak bulundu. Nörolojik hastalıkların varlığı, ileri yaş ve yüksek Apache II skoru mortalite oranında anlamlı artışa sebep olmaktadır. Entübe olarak kabul edilen hastalarda mortlite daha yüksekti. Yüksek laktat , yüksek RDW seviyesi ve düşük albumin düzeyi, artmış mortalite ile ilişkili bulundu. Sodyum ve MPV değerinin ise mortalite ile anlamlı bir ilişkisinin olmadığı saptandı. 15 günden az yatışı olan hastalarda ise mortalite oranı daha düşük bulundu. Sonuç: RDW, Albumin ve laktat değerlerinin yoğun bakımda yatan hastaların prognozu etkilediği görüldü. Bu değerlerin takibinin; erken dönemde tedavinin başlanabilmesi açısından fayda sağlayacaktır.Öğe MPV, RDW, LAKTAT, NA ve Albumin Düzeyleriyle Yoğun Bakım Hasta Mortalitesi Arasındaki İlişki(Mesut Öterkuş, 2022) Aydın, Ahmet; Kaçmaz, Osman; Öterkuş, Mesut; Miniksar, Ökkeş HakanGiriş ve Amaç: Yoğun bakım hasta mortalitesine yaş, yatış süresi, mekanik ventilasyon ihtiyacı ve süresi, eşlik eden yandaş hastalıklar, enfeksiyon ve laboratuvar parametreleri gibi birçok parametrenin etkisi vardır. Çalışmamızda bu parametrelerden hangilerinin yoğun bakım hasta mortalitesi üzerine etkisi olduğunu araştırmayı amaçladık. Yöntemler: Retrospektif planlanan çalışmamıza hastanemiz yoğun bakım servisinde Ocak 2018-Aralık 2019 tarihleri arasında yatan 18 yaş üstü 295 hasta dahil edildi. Taburcu ve ex olan hastalar olarak iki gruba ayrıldı. Gruplar arasında, parametrelerin mortalite ile arasındaki ilişkisi karşılaştırıldı. Bulgular: %53,6’sı (n:158) erkek olan hastaları yaş ortalaması ise 76 yıl olarak bulundu. Nörolojik hastalıkların varlığı, ileri yaş ve yüksek Apache II skoru mortalite oranında anlamlı artışa sebep olmaktadır. Entübe olarak kabul edilen hastalarda mortlite daha yüksekti. Yüksek laktat , yüksek RDW seviyesi ve düşük albumin düzeyi, artmış mortalite ile ilişkili bulundu. Sodyum ve MPV değerinin ise mortalite ile anlamlı bir ilişkisinin olmadığı saptandı. 15 günden az yatışı olan hastalarda ise mortalite oranı daha düşük bulundu. Sonuç: RDW, Albumin ve laktat değerlerinin yoğun bakımda yatan hastaların prognozu etkilediği görüldü. Bu değerlerin takibinin; erken dönemde tedavinin başlanabilmesi açısından fayda sağlayacaktır.Öğe mTOR signaling pathway genes effect in COVID-19 infection(Inonu University, 2024) Pala, Mukaddes; Yılmaz, Şenay Görücü; Tanriverdi, Elif Seren; Gunduz, Ayten; Delen, Leman Acun; Ozturk, Dilara Altay; Öterkuş, MesutCoronavirus disease 2019 (Covid-19) is an infectious disease that causes severe acute respiratory illness caused by coronavirus 2 (SARS-CoV-2). SARS-CoV-2 uses host-specific metabolic pathways, including mTOR. The mTOR pathway is hyperactive in viral respiratory tract infections and contributes positively to viral replication. 100 samples were evaluated, 50 patients (Female=23, Male=27), and 50 controls (Female=29, Male=21). The patients were individuals who were COVID-19 positive. We detected expression changes of 5 genes in mTOR complex 1 (mTORC1) and mTOR complex 2 (mTORC2) (MLST8, mTOR, RPTOR, MAPKAP1 and RICTOR). Serum samples were obtained from all patients. The expression changes of mTORC1 and mTORC2 Complex genes were evaluated with Real-time PCR method. Receiver operating curve (ROC) analysis was performed to define the diagnostic power of these genes. Expression changes of five genes in the mTORC1 and mTORC2 complex were statistically significant (p =0.001) and upregulated in serum. The area under the ROC Curve values indicating the diagnostic power of genes were 0.948, 0.771, 0.851, 0.798, and 0.805, respectively. These genes may be candidate for treatment targets. The high discriminative power of these genes in patients from controls indicates their diagnostic potential in serum samples.Öğe Sinovac vaccination and the course of COVID-19 disease in hospitalized patients in Turkey(King Faisal Specialist Hospital and Research Centre, 2022) Acun Delen, Leman; Öterkuş, MesutBACKGROUND: The Alpha variant of SARS-CoV-2 has a higher transmission rate than the first variant identified. The efficacy of vaccines is affected by the characteristics of SARS-CoV-2 variants. OBJECTIVE: Investigate the relationship of vaccination and virus variant on the course of the disease in patients who were hospitalized with a diagnosis of COVID-19. DESIGN: Retrospective, cohort study SETTING: Tertiary health institution PATIENTS AND METHODS: The study included patients older than the age of 18 years who were hospitalized in a COVID-19 service or the intensive care unit with a diagnosis of COVID-19 between 1 January 2021 and 30 April 2021. Demographic characteristics, vaccination and the Alpha virus variant status, comorbidities, and information about hospitalization were obtained from the hospital automation system and patient files. MAIN OUTCOME MEASURES: Vaccination rate and relationship with course of disease. SAMPLE SIZE: 608 RESULTS: Most of the patients (n=482, 79.3%) were admitted to the COVID-19 service. More of the COVID-19 service patients had the Alpha variant than the patients admitted to ICU (P<.009). The Alpha variant was also more common in younger patients (P<.001). There was no relationship between the Alpha virus and comorbid diseases such as diabetes mellitus and hypertension. Mortality was lower in the patients who had received a second dose of the Sinovac vaccine (P=.004) compared with unvaccinated patients. CONCLUSION: Although the Alpha variant spreads faster, it has a milder course. If only the Sinovac vaccine is available, we recommend that the two doses of the Sinovac vaccine be administered. LIMITATIONS: Our study is single-center and did not include pregnant and pediatric patients. CONFLICT OF INTEREST: None.Öğe Stress And Fluid Restriction Before Anesthesia İnduction, İnvestigation Of The Effects Of The Patient’s Clinic, Endocrine Responses, And The Level Of The Nesfatin-1(2021-05-15) Kahraman, Mustafa; Öterkuş, Mesut; Kahraman, GülcanBackground/Aim: Preoperative fasting, fluid restriction and stress trigger many hormonal responses, one of which is the newly described Nefsatin-1. It has important effects on energy metabolism and stress. In this study, we aimed to examine the relationship between stress, fasting, fluid restriction, and Nesfatin-1. Methods: A total of 100 ASA I-II adult patients between 18 and 60 years of age with no psychiatric, cardiovascular, or metabolic disorders, who were operated under general anesthesia for various reasons at Fırat University Hospital between June and November 2013 were included in this randomized prospective case-control study. Patients were categorized into fluid restriction (Group 1) and no-fluid restriction (Group 2) groups. These groups were further sub-categorized as those receiving (Groups 1A and 2A) and not receiving pre-medication (Group 1B and Group 2B). State Trait Anxiety Inventory was applied to all patients by an independent member of the research team before the surgical procedure. Also, blood samples were obtained 6-8 hours, 1 hour, and just before the induction to measure insulin, glucose, epinephrine, norepinephrine, cortisol, and Nesfatin-1 levels. Results: In both groups, the test score for pre-operative anxiety was 44. While there were no differences in serum insulin levels between the study groups (P>0.05), serum glucose and epinephrine levels were higher in Group 1A than in other groups (P<0.05 for both). Except for the 2nd period, serum norepinephrine levels were elevated in all stages (P<0.05). Serum cortisol levels were higher in Group 2B (P<0.05), while serum Nesfatin-1 levels were higher in Group 2A (P<0.05). Conclusion: According to our findings, the highest reflection of stress in patients, together with clinical and endocrine responses, coincided just before the induction period. Further studies are warranted before firmer conclusions can be drawn regarding the association between Nesfatin-1 and anxiety. We believe that if the pathophysiological mechanisms between anxiety and Nesfatin-1 are clarified, Nesfatin-1 targeting treatment approaches can be tried in the clinic.
