Person: UYSAL, HARUN
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Publication Open Access Use of the gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography cases under sedation/analgesia(2016-05-01) Daskaya, HAYRETTİN; UYSAL, HARUN; Ciftci, Taner; BAYSAL, Birol; IDIN, Kadir; Karaaslan, KAZIM; DAŞKAYA, HAYRETTİN; UYSAL, HARUN; KARAASLAN, KAZıMBackground/Aims: In this study, we aimed to analyze the effects of Gastro-Laryngeal Tube (GLT) use on intraoperative and postoperative hemodynamic parameters, comfort of the procedure, and patients’ satisfaction in endoscopic retrograde cholangiopancreatography (ERCP). Materials and Methods: A total of 80 patients between the ages of 20 and 75 years who were scheduled for elective ERCP were enrolled. The patients were randomly assigned to two groups: groups N and G. Those in group N underwent the procedure with sedation without any airway instruments and those in group G underwent procedure after sedation and airway management with GLT. Intraoperative and postoperative vital signs as well as the satisfaction of the patients were recorded. Results: The duration to esophageal visualization was found to be significantly higher in group N (16 s) than in group G (7 s) (p=0.001). The mean Visual Analogue Scale for Pain (VAS) was significantly higher in group G (1.85) than in group N (0.45) (p=0.016). Group G had higher endoscopist satisfaction scores than group N. The incidence of desaturation during ERCP was significantly higher in group N (60%) than in group G (0%) (p=0.000). Conclusion: In conclusion, ERCP should be performed under optimal conditions to avoid the occurrence of unwanted complications, such as aspiration-related disorders. Therefore, according to the structural properties of GLT, sedation anesthesia application with GLT in ERCP will be safer, more comfortable, and more effective.Publication Open Access Temporary vision loss after spinal anesthesia(2015-01-01) BAŞARANOĞLU, GÖKÇEN; IDIN, KADIR; UMUTOGLU, TARIK; TOPUZ, UFUK; ESEN, ASIM; UYSAL, HARUN; BAŞARANOĞLU, GÖKÇEN; UYSAL, HARUNPerioperative visual loss is a rare complication mostly associated with cardiac, spine, and head and neck surgery that could severely affect quality of life. We report a case of temporary visual loss without any other subjective symptom after spinal anesthesia.Publication Open Access Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study(2015-05-01) BAKAN, Mefkur; UMUTOGLU, Tarik; TOPUZ, Ufuk; UYSAL, HARUN; Bayram, MEHMET; Kadioglu, HÜSEYİN; SALIHOGLU, Ziya; UYSAL, HARUN; BAYRAM, MEHMET; KADIOĞLU, HÜSEYİNJustificativa e objetivos: O uso de opioides no período intraoperatório pode estar associado à hiperalgesia e ao aumento do consumo de analgésicos no período pós-operatório. Efeitos colaterais como náusea e vômito no período pós-operatório, por causa do uso perioperatório de opioides, podem prolongar a alta. Nossa hipótese foi que a anestesia venosa total com o uso de lidocaína e dexmedetomidina em substituic¸ão a opioides pode ser uma técnica opcional para a colecistectomia laparoscópica e estaria associada a uma menor solicitac¸ão de fentanil e incidência de náusea e vômito no período pós-operatório. Métodos: Foram programados para colecistectomia laparoscópica eletiva 80 pacientes adultos, estado físico ASA I-II. Os pacientes foram randomicamente alocados em dois grupos para receber anestesia livre de opioides com infusões intravenosas (IV) de dexmedetomidina, lidocaína e propofol (Grupo DL) ou anestesia baseada em opioides com infusões de remifentanil e propofol (Grupo RF). Todos os pacientes receberam um regime padrão de analgesia multimodal. Um dispositivo de analgesia controlada pelo paciente foi ajustado para liberar fentanil IV por seis horas após a cirurgia. O desfecho primário foi o consumo de fentanil no pós-operatório. Resultados: O consumo de fentanil na segunda hora de pós-operatório foi significativamente menor no grupo DL do que no Grupo RF, 75 ± 59g e 120 ± 94g, respectivamente, mas foi comparável na sexta hora de pós-operatório. Durante a anestesia, houve mais eventos hipotensivos no Grupo RF e mais eventos hipertensivos no grupo DL, ambos estatisticamente significativos. Apesar de apresentar um tempo de recuperac¸ão mais prolongado, o Grupo DL apresentou escores de dor e consumo de analgésicos de resgate e de ondansetrona significativamente mais baixosPublication Open Access Tocilizumab challenge: A series of cytokine storm therapy experiences in hospitalized COVID-19 pneumonia patients(2020-06-01T00:00:00Z) Borku Uysal, Betul; Ikitimur, Hande; Yavuzer, Serap; İKİTİMUR, Barış; UYSAL, HARUN; Islamoglu, Mehmet Sami; Ozcan, Erkan; Aktepe, Emre; YAVUZER, Hakan; Cengiz, Mahir; UYSAL, HARUNTo recognize the period of exaggerated cytokine response in patients with coronavirus disease 2019 (COVID-19) pneumonia, and to describe the clinical outcomes of using tocilizumab as a treatment option. The data of 12 adult COVID-19 pneumonia patients who were followed in the inpatient clinics of Biruni University Medical Faculty Hospital (Istanbul, Turkey) were retrospectively analyzed. Diagnostic tests, laboratory examinations, clinical findings, and computed tomography of the thorax imaging results were evaluated. A dramatic laboratory and clinical improvement was observed in 83% (10 out of 12) of patients after tocilizumab. In 17% (2 out of 12) of our patients, short-term ventilator support was required in the intensive care unit. The longest hospital stay was 18 days. However, in the end, all of our patients were discharged home with good health. Although arterial oxygen saturations (87.58 +/- 3.12%) dropped in room air in the pre-tocilizumab period, post-tocilizumab they normalized in all patients (94.42 +/- 1%). None of them had fever after tocilizumab treatment and the levels of C-reactive protein (13.08 +/- 12.89) were almost within normal limits. Eosinophil values were quite low at the time of diagnosis (10 +/- 17.06), but increased significantly post-tocilizumab (155.33 +/- 192.69). There is currently no proven treatment for COVID-19 induced by novel coronavirus SARS-CoV-2. Based on our experience with twelve adult COVID-19 pneumonia patients,we can say that tocilizumab, an IL-6 inhibitor, is more beneficial in preventing the damage caused by excessive cytokine response in the body if administered at the right time and provides clinical and radiological recovery.Publication Open Access Usefulness of oxidative stress marker evaluation at admission to the intensive care unit in patients with COVID-19(2021-07-01T00:00:00Z) Daşkaya, Hayrettin; Yılmaz, Sinan; Uysal, Harun; Sümbül, Bilge; Karaaslan, Kazım; DAŞKAYA, HAYRETTİN; YILMAZ, SİNAN; UYSAL, HARUN; ÇALIM, MUHITTIN; SÜMBÜL, BİLGE; YURTSEVER, İSMAİL; KARAASLAN, KAZıMObjective:Two critical processes in the coronavirus disease 2019 (COVID-19) pandemic involve assessing patients- intensive care needs and predicting disease progression during patients- intensive care unit (ICU) stay. We aimed to evaluate oxidative stress marker status at ICU admission and ICU discharge status in patients with COVID-19.Methods:We included patients in a tertiary referral center ICU during June-December 2020. Scores of Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and clinical severity, radiologic scores, and healthy discharge status were noted. We collected peripheral blood samples at ICU admission to evaluate total antioxidants, total oxidants, catalase, and myeloperoxidase levels.Results:Thirty-one (24 male, 7 female) patients were included. At ICU admission, patients- mean APACHE II score at ICU admission was 17.61 ± 8.9; the mean SOFA score was 6.29 ± 3.16. There was no significant relationship between clinical severity and oxidative stress (OS) markers nor between radiological imaging and COVID-19 data classification and OS levels. Differences in OS levels between patients with healthy and exitus discharge status were not significant.Conclusions:We found no significant relationship between oxidative stress marker status in patients with COVID-19 at ICU admission and patients- ICU discharge status.Publication Open Access Prospective evaluation of remifentanil-propofol mixture for total intravenous anesthesia: A randomized controlled study(2021-11-01T00:00:00Z) Bakan, Mefkur; Umutoglu, Tarik; Topuz, Ufuk; Guler, Emine Yilmaz; UYSAL, HARUN; Ozturk, Erdogan; UYSAL, HARUNApplication of total intravenous anesthesia (TIVA) may be considered as unpractical when compared with inhalational anesthesia. Although it is mostly not recommended, mixing intravenous agents is popular in clinical practice. The aim of the present study was to investigate the suitability of using remifentanil-propofol mixture (MIXTIVA) for TIVA. Adult patients with an American Society of Anesthesiologists grade of I-II scheduled for elective thyroidectomy were randomly allocated to 3 groups (n=32 for each) to receive TIVA with remifentanil and propofol infusions separately (control group, Group I) or with MIXTIVA infusion that contained remifentanil/propofol at a proportion of 2/1,000 or 3/1,000 (remifentanil concentration, 20 or 30 mu g/ml in 1% propofol in Group II or Group III, respectively). The extubation time (the primary outcome of the study), the orientation time and number of patients in whom intraoperative hypotension, hypertension or bradycardia episodes were encountered during anesthesia were comparable among the groups. The mean remifentanil infusion rate in Group III was significantly higher than that in the other groups. The mean propofol infusion rates and mean bispectral index (BIS) scores during anesthesia were comparable among groups. Hypotension accompanied with a high BIS was encountered in one patient in Group III. In conclusion, compared to the standard TIVA technique using separate drug infusions, MIXTIVA infusion used for thyroidectomies did not result in any statistically significant difference in recovery and clinical outcomes. This technique may be considered as a practical implementation for busy ambulatory centers performing general anesthesia.Publication Open Access Determining host factors contributing to disease severity in a family cluster of 29 hospitalized SARS-CoV-2 patients: Could genetic factors be relevant in the clinical course of COVID-19?(2020-10-01T00:00:00Z) Ikitimur, Hande; Uysal, Betul Borku; Cengiz, Mahir; İKİTİMUR, Barış; UYSAL, HARUN; Ozcan, Erkan; Islamoglu, Mehmet Sami; Seyhan, Serhat; YAVUZER, Hakan; Yavuzer, Serap; UYSAL, HARUNIn this study, we report a large family cluster consisting of 29 genetically related patients hospitalized with coronavirus disease-2019 (COVID-19). We sought to determine the clinical characteristics relevant to the clinical course of COVID-19 by comparing the family cluster to unrelated patients with SARS-CoV-2 infection so that the presence of potential determinants of disease severity, other than traditional risk factors previously reported, could be investigated. Twenty-nine patient files were investigated in group 1 and group 2 was created with 52 consecutive patients with COVID-19 having age and gender compatibility. The virus was detected for diagnosis. The clinical, laboratory and imaging features of all patients were retrospectively screened. Disease course was assessed using records regarding outcome from patient files retrospectively. Groups were compared with respect to baseline characteristics, disease severity on presentation, and disease course. There was no difference between the two groups in terms of comorbidity and smoking history. In terms of inhospital treatment, use differed not significantly between two groups. We found that all 29 patients in the group 1 had severe pneumonia, 18 patients had severe pneumonia. Hospitalization rates, length of hospital stay, and transferred to intensive care unit were found to be statistically significantly higher in the group 1. In the present study, COVID-19 cases in the large family cluster were shown to have more severe disease and worse clinical course compared with consecutive patients with COVID-19 presenting to the same time. We believe further studies into potential genetic mechanisms of host susceptibility to COVID-19 should include such family clusters.Publication Open Access The Impact of Sheath Size in Miniaturized Percutaneous Nephrolithotomy in Adult Patients; A Matched-pair Analysis(2019-11-01T00:00:00Z) Erbin, Akif; Ucpinar, Burak; Cubuk, Alkan; Yazici, Ozgur; UYSAL, HARUN; Savun, Metin; Basal, Seref; Akbulut, Mehmet Fatih; UYSAL, HARUNPurpose: The miniaturized percutaneous nephrolithotomy (mPNL) can be performed by using a very wide range of different access sheaths (14-22 Fr).It has been well known that tract size is one of the main parameters affecting the complication rates in PNL. We aimed to compare 21 Fr with 16.5 Fr mPNL tract sizes in adult patients. Material and methods: From May 2013 to April 2018, 604 patients with kidney stone underwent mPNL in our department. The study was designed as retrospective and match-pair analysis was the preferred method for the formation of groups. The 21 Fr mPNL cases were matched with 16.5 Fr mPNL cases at a 1:1 ratio, according to the patients' age, gender, body mass index, American Society of Anesthesiologists (ASA) score, stone characteristics (stone size, opacity and localization) and hydronephrosis. Patients with solitary kidney, renal anomalies, musculoskeletal abnormalities, and pediatric patients (< 18 years old) were excluded from the study. Both groups (21 Fr and 16.5 Fr) were compared in terms of demographics, stone characteristics, operative data and post-operative outcomes. Results: A total of 260 patients were included in the study (130; 21 Fr mPNL group and 130; 16.5 Fr mPNL group). The operation time was significantly shorter in 21 Fr group (21 Fr; 85.2±37.5, 16.5 Fr; 101.7±37.7 minutes, p: 0.001). Complete stone clearance rates were 76.9% and 62.3% in 21 Fr and 16.5 Fr mPNL, respectively (p: 0.01). There was no significant difference between the groups in terms of overall operative and post-operative complications. However, in subgroups analysis, post-operative fever was higher in 16,5 Fr mPNL (4 patients in 16.5 Fr, no patients in 21 Fr group, p: 0.044); steinstrasse, renal colic and post-operative JJ stent requirement rates were higher in 21 Fr mPNL procedure (p: 0.018, p: 0.031 and p: 0.046, respectively). The hospitalization time was significantly higher in 21 Fr (p: 0.01). Conclusions: Although 21 Fr mPNL procedure has advantages such as better success rates and shorter operation time, some post-operative complications (steinstrasse, renal colic, post-operative JJ stent requirement) are against of 21 Fr mPNL when compared with 16.5 Fr mPNL procedure. Further randomized prospective studies with larger patient volume are needed to confirm these results.Publication Open Access The Effect of Exogenous Human Albumin Administration on Acute Kidney Injury Development in Hypoalbuminemic Patients in the Intensive Care Unit(2022-04-01T00:00:00Z) Yeşiltaş, Serdar; Güzel, Cumali; Sümer, İsmail; Uysal, Harun; Daşkaya, Hayrettin; Türkay, Meltem; Karaaslan, Kazım; YEŞİLTAŞ, SERDAR; SÜMER, İSMAİL; UYSAL, HARUN; DAŞKAYA, HAYRETTİN; KARAASLAN, KAZıMObjective: Hypoalbuminemia is an independent risk factor for acute kidney injury (AKI) and mortality. The primary aim of our study was to investigate the effect of exogenous human albumin (EHA) administration on hypoalbuminemic patients in the intensive care unit (ICU) regarding the development of AKI. Our secondary aim was to compare the ICU admission duration and mortality rates of these patients. Methods: After receiving ethics committee approval, the researchers retrospectively screened database for 5,989 patients admitted to the adult ICU from 01.01.2014 to 01.06.2018. The demographic data, serum albumin and creatinine levels, ICU admission duration and mortality rates of patients were recorded. Stage 2-3 AKI was accepted based on the AKI network criteria, while hypoalbuminemia was accepted as serum albumin values below 3.5 g/dL. Patients not given EHA were assigned to group none human albumin (Group NHA), while patients given EHA were assigned to group human albumin (Group HA). The rate of AKI development, duration of stay in ICU and mortality rates were compared between the groups. Results: The mean age, AKI development rate, mortality rate and ICU admission duration in Group HA were statistically significantly higher than in Group NHA (p=0.0001, p=0.0001, p=0.0001, p=0.0001). There was no difference in terms of the gender distribution in the groups. The mean albumin value in Group HA was statistically significantly lower than Group NHA (p=0.0001). Conclusion: In conclusion, EHA administration in hypoalbuminemic patients prolong stay in ICU in addition to the increase in the development of AKI and mortality.Publication Open Access The Attitudes and Behaviors of Pregnant Women about Labor Anesthesia(2014-06-01T00:00:00Z) BAŞARANOĞLU, Gökçen; Batmaz, Gonca; Topuz, Ufuk; UYSAL, HARUN; SALİHOĞLU, Ziya; BAŞARANOĞLU, GÖKÇEN; UYSAL, HARUNObjective: The aim of this study is to analyze pregnant women’s knowledge, attitude, and behavior toward labor analgesia. Methods: Between March 2011 and December 2011, 533 pregnant women who visited an antenatal clinic were administered a survey that measured their attitude, behavior, and knowledge about labor analgesia. Results: There was no difference between age, pregnancy week, and desire for labor analgesia, but there was a significant difference between the number of pregnancies and desire for labor analgesia. Women who did not want labor analgesia had more pregnancies, births, and children and a large household. Women who desired labor analgesia had an occupation (64%); 31% of pregnant women who did not want labor analgesia considered it unnecessary; 13% thought it would be harmful to the baby, herself, or the birth process; 2% found it expensive; 16% feared it; and 0.5% found it contradictory to religious beliefs. Conclusion: Although no prior information was given to the pregnant women who attended the survey, the number of births and education level affected the labor analgesia desire. If labor analgesia is emphasized in formal and common education, this might increase the request for it.