Browsing by Author "Demir U."

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Assessment of the relationship between C-Reactive Protein/Albumin ratio and 28-day mortality in critically very elderly patients (≥ 85 years) with acute ischemic stroke
(2022-01-01) Soylu V.G.; Karahan E.; Yılmaz A.; Taşkın Ö.; Demir U.
Background & Objectives: The aim of this study is investigate the relationship of C-reactive protein, albumin, C-reactive protein/albumin ratio with prognosis and 28-day mortality in critically ill patients over 85 years of age with acute ıschaemic stroke. Methods: This study is a retrospective and observational study. A total of 189 patients aged 85 years and older who were followed up in the intensive care unit between 2017 and 2020 were included in the study. Demographic data of the patients included in the study, length of stay in the intensive care unit, comorbidities, laboratory data of hospitalization in the intensive care unit, C-reactive protein, albumin, C-reactive protein/albumin ratio, neutrophil/lymphocyte ratios, thrombocyte/lymphocyte ratios, APACHE II, SAPS II values of intensive care admissions were recorded. Results: In the statistical analysis performed for C-reactive protein, albumin, C-reactive protein/albumin ratio between survival and non-survival groups, a statistically significant difference was found between the groups (For C-reactive protein, p = 0.03; for albumin, p = 0.02; for C-reactive protein/albumin ratio, p= 0.03). The logistic regression model was applied to investigate the independent risk factors affecting the patients’ mortality at 28 days. Albumin, CRP, C-reactive protein/albumin ratio was found to be associated with 28-day mortality according to the logistic regression analysis. (For albumin; p= 0.04, for C-reactive protein; p= 0.04, for C-reactive protein/albumin ratio; p= 0.04). According to the ROC curve analysis result, Cut-off value was found to be 2.47 for C-reactive protein/albumin ratio. Conclusion: The CRP/albumin ratio is a valuable parameter that can be used to predict 28-day mortality in critically ill very elderly patients with acute ischemic stroke.
Association Between Prognostic Nutrition Index, Geriatric Nutrition Risk Index and 28-Day Mortality in Critically Very Elderly Patients (≥85 Years)
(2023-06-01) Soylu V.G.; İnan F.Ç.; Yılmaz A.; Taşkın Ö.; Demir U.
Background/Purpose: The aim of this study is to association the Prognostic Nutrition Index(PNI) and Geriatric Nutrition Risk Index(GNRI) with 28-day mortality in critically very elderly patients and compare these indexes with APACHE II and SAPS II scores. Methods: This study is a observational and retrospective study. A total of 189 patients aged 85 years and older who were followed up in the intensive care unit between 2017 and 2021 were included in the study. Demographic data of the patients included in the study, length of stay in the intensive care unit, comorbidities, laboratory data of hospitalization in the intensive care unit, neutrophil/lymphocyte ratios, thrombocyte/lymphocyte ratios, APACHE II, SAPS II, PNI and GNRI index values of intensive care admissions were recorded. Results: In the statistical analysis performed for PNI and GNRI between Survival and Non-survival groups, a statistically significant difference was found between the groups (p=0.022 for PNI, p=0.010 for GNRI). The optimal threshold values of PNI and GNRI were 33.8 and 92.6, respectively. Sensitivity and specificity were 56.1% and 56.9% for PNI, 60.6% and 60.2% for the GNRI. Conclusion: The prognostic nutrition index and geriatric nutrition risk index are associated with 28-day mortality and malnutrition in very elderly patients treated in the intensive care unit. However, these scorings are not as sensitive and specific as APACHE II and SAPS II scores in predicting 28-day mortality.
Does prolonged prone position affect intracranial pressure? prospective observational study employing Optic nerve sheath diameter measurements
(2023-12-01) Demir U.; Taşkın Ö.; Yılmaz A.; Soylu V.G.; Doğanay Z.
Background: Our aim in this observational prospective study is to determine whether the prone position has an effect on intracranial pressure, by performing ultrasound-guided ONSD (Optic Nerve Sheath Diameter) measurements in patients with acute respiratory distress syndrome (ARDS) ventilated in the prone position. Methods: Patients hospitalized in the intensive care unit with a diagnosis of ARDS who were placed in the prone position for 24 h during their treatment were included in the study. Standardized sedation and neuromuscular blockade were applied to all patients in the prone position. Mechanical ventilation settings were standardized. Demographic data and patients’ pCO2, pO2, PaO2/FiO2, SpO2, right and left ONSD data, and complications were recorded at certain times over 24 h. Results: The evaluation of 24-hour prone-position data of patients with ARDS showed no significant increase in ONSD. There was no significant difference in pCO2 values either. PaO2/FiO2 and pO2 values demonstrated significant cumulative increases at all times. Post-prone SPO2 values at the 8th hour and later were significantly higher when compared to baseline (p < 0.001). Conclusion: As a result of this study, it appears that the prone position does not increase intracranial pressure during the first 24 h and can be safely utilized, given the administration of appropriate sedation, neuromuscular blockade, and mechanical ventilation strategy. ONSD measurements may increase the safety of monitoring in patients ventilated in the prone position.
Extracorporeal Circulation and Optic Nerve Ultrasound: A Pilot Study
(2023-02-23) Taşkın Ö.; Demir U.
Background and Objectives: Cardiopulmonary bypass (CPB) is an extracorporeal circuit that provides surgical access to an immobile and bloodless area, allowing for technical and procedural advances in cardiothoracic surgery. CBP can alter the integrity of the blood-brain barrier and cause changes in intracranial pressure (ICP) postoperatively. Optical nerve sheath diameter (ONSD) measurement is among the alternative non-invasive methods for ICP monitoring. In this study, we aimed to evaluate the optic nerve sheath diameter measurements under the guidance of ultrasonography for ICP changes during the extracorporeal circulation process. Materials and Methods: The study population included 21 patients over 18 years of age who required extracorporeal circulation. Demographic data of the patients, such as age, gender, comorbidity, American Society of Anesthesiologists (ASA) classification and reason for operation (coronary artery disease or mitral or aortic valve disease) were recorded. The ONSD was measured and evaluated before the extracorporeal circulation (first time) and at the 30th minute (second time), 60th minute (third time) and 90th minute (fourth time) of the extracorporeal circulation. Non-invasive ICP (ICP ONSD) values were calculated based on the ONSD values found. Results: The mean ONSD values measured before the extracorporeal circulation of the patients were found to be 4.13 mm (3.8-4.6) for the right eye and 4.36 mm (4.1-4.7) for the left eye. Calculated nICPONSD values of 11.0 mm Hg (1.0-21.0) for the right eye and 10.89 mm Hg (1.0-21.0) for the left eye were found. It was observed that there was a significant increase in the ONSD and nlCPONSD values recorded during the extracorporeal circulation of all patients compared to the baseline values (p < 0.005). Conclusions: During extracorporeal circulation, ultrasound-guided ONSD measurement is an easy, inexpensive and low-complication method that can be performed at the bedside during the operation to monitor ICP changes.
Ferritin / albumin ratio could be a new indicator of COVID-19 disease mortality
(2023-01-01) Taşkin Ö.; Yilmaz A.; Soylu V.G.; Demir U.; Inan F.Ç.
Introductions: Despite significant advances in the management of patients with COVID-19, there is a need for markers to guide treatment and predict disease severity. In this study, we aimed to evaluate the relationship of the ferritin/albumin (FAR) ratio with disease mortality. Methodology: Acute Physiology and Chronic Health Assessment II scores and laboratory results of patients diagnosed with severe COVID-19 pneumonia were retrospectively analyzed. The patients were divided into two groups: survivors and non-survivors. Data for ferritin, albumin, and ferritin/albumin ratio among COVID-19 patients were analyzed and compared. Results: The mean age was higher in non-survivors (p = 0.778, p < 0.001, respectively). The ferritin/albumin ratio was significantly higher in the non-survival group (p < 0.05). Taking the cut-off value of the ferritin/albumin ratio of 128.71 in the ROC analysis, it predicted the critical clinical status of COVID-19 with 88.4% sensitivity and 88.4% specificity. Conclusions: ferritin/albumin ratio is a practical, inexpensive, and easily accessible test that can be used routinely. In our study, the ferritin/albumin ratio has been identified as a potential parameter in determining the mortality of critically ill COVID-19 patients treated in intensive care.
Retrospective Comparison of Anesthetic Methods for Percutaneous Balloon Kyphoplasty Surgery: General Anesthesia and Erector Spinae Plane Block
(2023-02-01) Demir U.; Taşkın Ö.
Background and Objectives: This study aims to investigate whether erector spinae plane (ESP) block can be an alternative to general anesthesia as a primary anesthesia method in percutaneous balloon kyphoplasty surgery. In addition, postoperative intensive care needs were compared in terms of length of intensive care unit stay and length of hospital stay. Materials and Methods: Medical records of patients who underwent percutaneous balloon kyphoplasty operation at Kastamonu Training and Research Hospital between January 2020 and November 2022 were reviewed retrospectively. Among 70 patients who underwent percutaneous balloon kyphoplasty, 58 patients with ASA (American Association of Anesthesiologists) classification III or IV, who underwent general anesthesia as the anesthesia method or ESP block, were included in the study. The patients were divided into two groups according to the anesthesia method applied. Group GA: general anesthesia group (n = 19) and Group ESP: ESP block group (n = 39). Group data for age, gender, ASA classification, number of surgical levels, surgical urgency, duration of surgery, postoperative complications, need for intensive care, length of stay in the intensive care unit, and hospital stay were compared. Results: There was no statistically significant difference between Group GA and Group ESP in terms of age, gender, ASA classification, surgical urgency, number of surgical levels, duration of surgery, and postoperative complication data of the patients included in the study. Seven (36.6%) patients in Group GA and six (15.4%) patients in Group ESP needed intensive care, and there was no statistically significant difference between the groups (p = 0.06). However, the need for intensive care was higher in Group GA. A statistically significant difference was found in Group GA and Group ESP, which was higher in Group GA for the length of stay in the intensive care unit (p = 0.02) and length of hospitalization (p = 0.04). Conclusions: ESP block may be an alternative method to general anesthesia as the primary anesthetic option for single or multilevel percutaneous balloon kyphoplasty surgery. With the ESP block, the length of stay in the intensive care unit and the length of stay in the hospital can be reduced, especially in high-risk patients.
Space weather studies of IONOLAB group
(2016-10-19) Arikan F.; Sezen U.; Toker C.; Artuner H.; Bulu G.; Demir U.; Erdem E.; Arikan O.; Tuna H.; Gulyaeva T.; Karatay S.; Mosna Z.
IONOLAB is an interdisciplinary research group dedicated for handling the challenges of near earth environment on communication, positioning and remote sensing systems. IONOLAB group contributes to the space weather studies by developing state-of-the-art analysis and imaging techniques. On the website of IONOLAB group, www.ionolab.org, four unique space weather services, namely, IONOLAB-TEC, IRI-PLAS-2015, IRI-PLAS-MAP and IRI-PLAS-STEC, are provided in a user friendly graphical interface unit. Newly developed algorithm for ionospheric tomography, IONOLAB-CIT, provides not only 3-D electron density but also tracking of ionospheric state with high reliability and fidelity. The algorithm for ray tracing through ionosphere, IONOLAB-RAY, provides a simulation environment in all communication bands. The background ionosphere is generated in voxels where IRI-Plas electron density is used to obtain refractive index. One unique feature is the possible update of ionospheric state by insertion of Total Electron Content (TEC) values into IRI-Plas. Both ordinary and extraordinary paths can be traced with high ray and low ray scenarios for any desired date, time and transmitter location. 2-D regional interpolation and mapping algorithm, IONOLAB-MAP, is another tool of IONOLAB group where automatic TEC maps with Kriging algorithm are generated from GPS network with high spatio-temporal resolution. IONOLAB group continues its studies in all aspects of ionospheric and plasmaspheric signal propagation, imaging and mapping.