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Öğe Evaluation of Changes in Optic Nerve Diameter in Obese Patients Undergoing Laparoscopic Surgery(Duzce Univ, Fac Medicine, 2026) Delen, Leman Acun; Oterkus, Mesut; Kasapoglu, Umut Sabri; Mizrak, Zeynep Koylu; Ondes, Bahadir; Kanat, Burhan HakanAim: During laparoscopic surgery (LC), intracranial pressure increases due to factors such as pneumoperitoneum (PP) and Trendelenburg position (TP). Measurement of the optic nerve sheath diameter is an important indicator of intracranial pressure. In this study, we compared the optic nerve diameter measurement (ONSD) during laparoscopic surgery in obese and normal weight individuals. Material and Methos: The search included 99 ills who underwent laparoscopic surgery at Malatya Training and Research Hospital. Optic nerve sheath age measurements were performed preoperatively, post-intubation, post-pneumoperitoneum, and post-extubation in obese (n: 50) and control group (n: 49) patients who underwent laparoscopic surgery. Additionally, operation information and demographic data were recorded. Result: We included 99 patients in the study. The data analysis we obtained in this study showed that although ONSD values were similar between the groups at T0 and T1 (p>0.05), they were wider in obese individuals at T2 and T3 (respectively p <0.001, p=0.044). In the within-group analysis; although there was an increase compared to T0 in the obese group at T1 and T2, there was a decrease compared to T2 at T3 (p<0.001). In normal-weight patients, the within-group measured T-times were similar to those in the obese group. In the statistical analysis performed using the SPSS 23.0 statistical package, Skewness and Kurtosis test, t-test, Mann-Whitney U test and ANOVA were used. Conclusion: Results of the analysis of research data; PP and TP in LC Cause increased intracranial pressure. In order to prevent possible complications, it is important to provide lower PP pressure, keep the operation time as short as possible, and keep EtCO2 within normal limits by making mechanical ventilator adjustments.Öğe Evaluation of hypoxia pathway genes and serum parameters in new coronavirus pneumonia (COVID-19)(Elsevier, 2025) Oterkus, Mesut; Pala, Mukaddes; Yilmaz, Senay Gorucu; Tanriverdi, Elif Seren; Gunduz, Ayten; Delen, Leman Acun; Doger, CihanBackground: Coronavirus disease-2019 (COVID-19) causes severe hypoxemia. Unlike normal pneumonia, pneumonia due to COVID-19 causes oxygen deprivation without breathing difficulties (i.e., silent hypoxia). We evaluated the relationship between COVID-19 and hypoxemia and examined possible mechanisms of pneumonia from the perspective of gene expression (HIF1A, vascular endothelial growth factor [VEGF], NF-kB, MEKK1, and EGFR) using real-time PCR and ELISA for serum parameters. Methods: We evaluated 100 individuals (50 patients and 50 controls). The patients were individuals with respiratory symptoms and pneumonia who were (COVID)-D-center dot-19 positive. The relative quantification of standardized samples wa s calculated according to the formula 2-Delta Delta CT. Receiver operating curve (ROC) analysis was made to define the diagnostic power of the genes. The expression changes of four genes in the hypoxia pathway were significant (excluding VEGF) and upregulated in the patients' serums. Results: The fold change values of the HIF1A, VEGF, NF-kB, MEKK1, and EGFR genes were 0.048, 0.688, 0.168, 0.207, and 0.171, respectively, in the cases checked against to the controls. The areas under the ROC values indicating the diagnostic power of the genes were 0.727, 0.538, 0.815, 0.734, and 0.936, respectively. Some serum parameters were significant (age, PCR, urea, LDH, WBC, ferritin, and pO2). Conclusions: The upregulation of some genes in the hypoxia pathway in COVID-19 pneumonia shows that these genes and protein products are candidates for treatment targets. At the same time, the high discriminative power of two genes (NF-kappa B and EGFR) in patients compared to controls indicates their diagnostic potential in serum samples.Öğe Koronavirüs Hastalığıyla İlgili Akut Solunum Yetmezliği Sendromu'nda Non İnvaziv Solunum Desteği Tedavilerinin Başarısı ve NIRS'nin Başarısını Etkileyen Faktörler Üzerine Retrospektif Gözlemsel Kohort Bir Çalışma(2025) Oterkus, Mesut; İnceoğlu, Feyza; Kasapoglu, Umut Sabri; Mızrak, Zeynep KoyluAmaç: Non-İnvaziv solunum desteği, şiddetli vakalarda tedavinin önemli bir parçası olarak yaygın olarak kullanılmaktadır. Covid-19ile ilişkili Akut Solunum Sıkıntısı Sendromu vakalarında NIRS'nin başarısını etkileyen faktörleri belirlemeyi amaçladık. AraçlarveYöntem: Ağustos 2020 ile Mayıs 2021 tarihleri arasında hastanemizin yoğun bakım ünitesinde yatan şiddetli Covid-19enfeksiyonu olan 209 hasta çalışmaya dahil edildi. Hastaların demografik bilgileri, Akut Fizyoloji ve Kronik Sağlık DeğerlendirmesiII (APACHE-II) ve Sıralı Organ Yetmezliği Değerlendirmesi (SOFA) skorları, kalp hızları, asidoz, bilinç, oksijenasyon, solunum hızları ve laboratuvar sonuçları kaydedildi ve analiz edildi. Bulgular: İleri yaş, HT, kronik obstrüktif akciğer hastalığı, yüksek APACHE ve SOFA skorları, düşük albümin seviyeleri, yüksek LDH seviyeleri ve düşük PaO2/FiO2'nin NIRS başarısını azaltan faktörler olduğu bulundu. Ek olarak, düşük PaO2/FiO2 ve SatO2 ve kan Ph'ının erken evre başarısızlığını artırdığını belirledik. Sonuç: SonuçlarımızNIRS'nin Covid-19 hastaları için etkili bir tedavi yöntemi olabileceğinive hastalığınerken evrelerinde uygulanan NIRS'nin entübasyon ve mortalite riskini azaltabileceğini göstermiştir.Öğe PROGNOSIS OF GERIATRIC COVID-19 PATIENTS ADMITTED TO INTENSIVE CARE UNIT ACCORDING TO VACCINATION STATUS(Turkish Geriatrics Soc, 2022) Aydin, Ahmet; Kacmaz, Osman; Koca, Erdinc; Kutlusoy, Sevgi; Kasapoglu, Umut Sabri; Oterkus, MesutIntroduction: As of June 27, 2022, the COVID-19 pandemic has caused over 540 million infections and 6.3 million deaths. We aimed to investigate the effect of the vaccine on the clinical course of elderly patients hospitalized in the intensive care unit and to determine the prognosis of the patients according to their vaccination status. Materials and Methods: The study included 157 patients over the age of 65. Patients were divided into two groups. The first group consisted of patients who were vaccinated with two doses of CoronaVac, and the second group consisted of patients who were not vaccinated. Demographic data of the patients, prehospital clinical frailty scales, Charlson Comorbidity Indexes, APACHE II scores, laboratory values, and patient prognoses were recorded. Results: Of the 157 patients, 93 (59.2%) were female, and the median age was 76 years (65-99). 96 (61.1%) patients were vaccinated and 61 (38.9%) patients were unvaccinated. Patients were grouped as survivors (n=26) and deceased. We found that APACHE II, prehospital clinical frailty scales, and Charlson Comorbidity Indexes scores were higher in patients who died. There was a significant difference between blood lymphocyte and ferritin levels and survival. The 28-day survival rate was higher and intensive care unit overall survival time were longer in the vaccinated group. Conclusions: We observed that the vaccinated patients had higher survival times and lower mortality rates than those who were not vaccinated. We think that it is important to vaccinate elderly patients and that additional doses may be needed.Öğe Relationship between C-reactive protein/albumin ratio and lactate/albumin ratio and mortality in traumatic brain injury(2025) Oterkus, Mesut; Kuşderci, Hatice; Akdeniz, Sevda; Genc, Caner; Kayıkçi, EbruWe aimed to evaluate whether C-Reactive Protein/Albumin Ratio (CAR) and Lactate/Albumin ratio (LAR), which include acute phase reactants that are indicators of secondary brain injury processes such as inflammatory process, cytokine release, and hypoxia that develop after primary injury, are predictors of mortality in patients with traumatic brain injury (TBI). Patients who were admitted to the emergency department with a diagnosis of traumatic brain injury and stayed in the intensive care unit for more than 24 hours were included in the study. It was conducted by scanning the retrospective records of patients diagnosed with TBI between January 2022 and December 2023 in our hospital. As a result of our study, acute physiology and chronic health assessment II (APACHE II) and Injury Severity Score (ISS) were independent risk factors for mortality in TBI, while CAR and LAR were not independent variables in terms of mortality. Similar findings were valid for Glasgow Outcome Score (GOS). In addition, in patients who died; LAR, hypertension, high APACHE II score, low Glasgow Coma Scale (GCS), high ISS, mechanical ventilation requirements vasopressor requirements at first admission to intensive care, high lactate level, and low albumin levels were meaningful of the results. APACHE II and ISS were independent risk factors for mortality in TBI, while CAR and LAR were not independent variables in terms of mortality. Similar findings were valid for GOS. In addition, LAR levels were significantly higher in patients with ex. These results show us that LAR may be a parameter in mortality prediction.Öğe The effect of the selected anaesthesia method on mortality, the charlson comorbidity index, and complications in geriatric patients abstract(2026) Oterkus, Mesut; Delen, Leman Acun; Aytan, Nilgün NarmanOur study aimed to investigate how anaesthesia methods affect the chances of dying, needing intensive care after surgery, having complications, and scores on a health scale called the Charlson Comorbidity Index in the growing number of older people. In our study were 299 patients. We recorded their demographic data, American Society of Anaesthesiology score, need for transfusions, operation time, Charlson Comorbidity Index scores, need for intensive care after surgery, postoperative complications, such as respiratory problems, low blood pressure, nausea and vomiting, the number of days they stayed in the hospital and death rates. In our study, 195 patients (65.2%) were women. The average age was 73.9±7 years. No difference was found between the groups in terms of demographic data or Charlson Comorbidity Index scores. The patients who received spinal anaesthesia had shorter operation times and more hypotension. Overall, the factors affecting mortality were the American Society of Anaesthesiology score, cerebrovascular disease, cancer, embolisms, the need for postoperative intensive care, age, Charlson Comorbidity Index score, length of hospital stay, neutrophil, lymphocyte and albumin levels and operation duration. The data we obtained showed that mortality rates for patients receiving spinal or general anaesthesia were similar. However, the patients who received spinal anaesthesia needed less intensive care after surgery, had fewer complications, and had shorter hospital stays. Good care before and during surgery, careful monitoring after surgery, and proper pain relief can lower death rates and complications and reduce time in the hospital.Öğe Unexpected Events That Occur in Patients on the Day of Surgery: A Single-center, Prospective Observational Study(Elsevier Science Inc, 2025) Aydin, Ahmet; Koylu, Zeynep; Oterkus, MesutPurpose: The purpose of this study is to investigate the reasons for case cancellations on the day of surgery and determine the rates of unexpected events and case cancellations. Design: This is a prospective, cross-sectional study conducted at a single hospital. Methods: The patients' reasons for surgical cancellation were classified as preventable or nonpreventable. Patient data were obtained in the operating room after standard anesthesia monitoring by anesthesiologists. Unexpected problems that emerged in patients and cases canceled due to these problems were recorded. We evaluated blood pressure values according to the American College of Cardiology and American Heart Association guidelines. Findings: Elective surgery was planned for a total of 4,287 patients. The incidence of an unexpected event detected on the day of surgery was 5.8% (n = 250), and the case cancellation rate was 2.16%. Examination or medical condition-related factors (n = 78, 83.9%) were the most common reason for case cancellation. Among the 250 unexpected events, patients with undiagnosed hypertension were in the majority (n = 130, 52%). Severe hypertension was observed in 30 patients (12%) who were previously diagnosed with hypertension, and the surgery was canceled in 25 (83.3%) of these (P < .001). Conclusions: Preventable causes (60.2%) were more common than nonpreventable ones among case cancellations. Our findings showed that many patients had high blood pressure and were unaware of this condition. Our study allowed referral of patients to a cardiologist to begin the follow-up process. Additionally, our study highlights the need for adequate preoperative anesthesia preparation and comprehensive nursing care.
