Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Clinical Impact of Sarcopenia on Gastric Cancer and the Effect of Neoadjuvant Chemotherapy on Sarcopenia(2022) Parsak, Cem Kaan; Gumus, Serdar; Gul, Mehmet Onur; Altiok, Merih; Unal, Ayse Gizem; Yalav, Orcun; Bali, CaglaBackground: Sarcopenia may adversely affect treatment responses and oncological outcomes in cancer patients. However, the importance of pretreatment nutritional assessment as an indicator of treatment response and outcome in patients with gastric cancer undergoing neoadjuvant chemotherapy remains unclear. Objectives: This study aims to investigate the clinical impact of sarcopenia on gastric cancer and to determine the effect of neoadjuvant chemotherapy (NC) on sarcopenia, as well as body mass index (BMI), psoas muscle index (PMI), and prognostic nutrition index (PNI). Methods: A retrospective review was performed on patients with gastric adenocarcinoma who were operated on after the NC therapy between January 2016 and December 2019. Weight, BMI-, PMI-, and PNI-dependent variables were compared before and after the NC treatment. Sarcopenia was defined according to PMI at the level of the third lumbar vertebra based on computed tomography. Results: Forty-five patients (64.4% women) with a mean age of 56.9 +/- 11.2 years were included in the study. After the NC treatment, the mean BMI of the cohort decreased from 26.1 +/- 4.3 kg/m(2) to 25.1 +/- 4.2 kg/m(2), the mean PMI decreased from 5.69 +/- 1.39 cm(2)/m(2) to 5.16 +/- 1.50 cm(2)/m(2), and the mean PNI decreased from 46.6 +/- 6.5 to 40.0 +/- 7.0 (All, P<0.001). The NC treatment increased the frequency of sarcopenia from 48.9% to 64.5% (P<0.001). According to the Clavien-Dindo (CD) scoring, grade >3 CD complications were more common in the sarcopenic group (27.2%), compared to the non-sarcopenic group (8.7%) (P=0.049). The one-year and three-years overall survival rates were lower in the sarcopenic group (91.7% and 38.2%, respectively), compared to the non-sarcopenic group (93.8% and 45.8%, respectively). However, it was not statistically significant (P=0.509). Conclusion: Sarcopenia is associated with severe postoperative complications in gastric cancer. In addition, the NC treatment reduces PMI, BMI, as well as PNI, and increases sarcopenia frequency. Therefore, patients should be examined in terms of sarcopenia at the time of diagnosis.Item Bifid Epiglottis In Anesthesia Practice(2022) Bali, CaglaItem Pneumorrhachis and Pneumocephalus with Severe Chest Pain Symptom: A Rare Complication of Epidural Steroid Injection(2014) Ergenoglu, Pinar; Bali, Cagla; Akin, Sule; Ozyilkan, Nesrin B.; Aribogan, AnisItem Effect of low dose dexmedetomidine premedication on propofol consumption in geriatric end stage renal disease patients(2015) Ergeneoglu, Pinar; Akin, Sule; Bali, Cagla; Eker, Hatice Evren; Cok, Oya Yalcin; Aribogan, Anis; 26323728Background and objective: Sedation in dialysis dependent end-stage renal disease patients requires caution as a result of performing high doses of sedatives and its complications. Multidrug sedation regimens might be superior and advantage on lesser drug consumption and by the way adverse events which occur easily in end-stage renal disease patients. We evaluated the effects of dexmedetomidine premedication on propofol consumption, sedation levels with Observer's Assessment of Alertness and Sedation scores and the bispectral index and the hemodynamic changes, potential side effects in geriatric patients with end-stage renal disease who underwent hip fracture surgery under spinal anesthesia. Method: In this randomized, controlled, double-blind study 60 elderly patients (age >= 65 years) with end-stage renal disease and hip fracture scheduled for anterograde femoral intramedullary nailing were assigned to groups that received either intravenous saline infusion (Group C) or dexmedetomidine 0.5 mu g/kg/10 min infusion for premedication (Group D). All the patients received propofol infusion after the induction of the spinal anesthesia. Results: Total propofol consumption, propofol dose required for targeted sedation levels according to Observer's Assessment of Alertness and Sedation scores and bispectral index levels, recovery times were significantly lower in Group D (p< 0.001). The time to reach to Observer's Assessment of Alertness and Sedation score 4 and to achieve bispectral index <= 80 was significantly lower in Group C compared with Group D (p< 0.001). Adverse events were similar in both groups. Conclusion: Dexmedetomidine premedication lowers intraoperative propofol consumption to maintain targeted level of sedation. Therefore low dose dexmedetomidine premedication in addition to propofol infusion might be an alternative in geriatric patients with end-stage renal disease for sedation. (c) 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Item Anaesthesia Management for Edward's Syndrome (Trisomy 18)(2016) Bali, Cagla; Ozmete, Ozlem; Ergeneoglu, Pinar; Akin, Sule; Aribogan, Anis; 27366581; AAI-8790-2021; AAI-7779-2021; J-5282-2013; AAJ-2094-2021; S-8336-2019Item Anesthesia management for laparoscopic bariatric surgery: retrospective analysis of 62 patients(2017) Ozmete, Ozlem; Bali, Cagla; Ergenoglu, Pinar; Akin, Sule; Aribogan, Anis; AAJ-2094-2021; AAI-7779-2021; AAI-8790-2021; J-5282-2013; S-8336-2019Purpose: The aim of this study was to present our experience in patients who underwent laparoscopic bariatric surgery and to discuss the current literature on the perioperative management Material and Methods: Sixty two patients with ASA risk classification II-III were evaluated retrospectively who underwent obesity surgery in our hospital. Demographic characteristics of the patients, surgical time, complications that seen in the perioperative period and the length of hospital stay were recorded Results: The age of the patients ranged from 19 to 59 years and 75.9% of them were female. Mean operation time was 167 minutes and the length of hospital stay was 5 days. Complications seen during intraoperative period were tachycardia, hypertension and arrhythmia. In the following days, 6 (9.7%) patients were re-operated and there was no mortality Conclusion: The prevention of complications that may occur in laparoscopic obesity surgery is required with a equipped team and teamwork, a good preoperative preparation, thromboembolism prophylaxis, tight hemodynamics and blood gas monitoring for safe anesthesiaItem Congenital insensitivity to pain: How should anesthesia be managed?(2017) Ozmete, Ozlem; Sener, Mesut; Bali, Cagla; Caliskan, Esra; Aribogan, Anis; 0000-0003-2615-1918; 0000-0001-6497-0610; 0000-0002-4419-5693; 0000-0001-5845-699X; 29168371; AAI-7779-2021; AAI-8790-2021; S-8336-2019; AAI-7866-2021Congenital insensitivity to pain syndrome is a rare, sensorial and autonomic neuropathy characterized by unexplained fever, insensitivity to pain and anhidrosis. Patients may require anesthesia even for minor surgical procedures due to mental retardation and trauma arising from self-mutilating behavior. A child diagnosed with congenital insensitivity to pain syndrome was scheduled for gastric endoscopy under sedation due to suspected ingestion of a household cleaning disinfectant. Deep sedation was achieved, and spontaneous respiration was maintained. We did not encounter any complications. There is limited data regarding the safe anesthesia management in these patients because of the rarity of the disease. Therefore, we think that more clinical experience, case reports and studies are needed to establish the appropriate anesthesia management.