Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4809
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Item Fifteen Years Of Central Catheter Applications And Outcomes In Intensive Care Patients: A Single-Center Pediatric Experience(2022) Silahli, Musa; Kesim, Cagri; https://orcid.org/0000-0003-0944-7178; https://orcid.org/0000-0002-8964-291X; 35100890; AAD-5996-2021Background: To investigate the clinical outcome of central line placement in the pediatric age group and to evaluate the risk factors for central line-associated bloodstream infection (CLABSI). Methods: We retrospectively examined the outcomes and CLABSI risk factors of pediatric patients aged 0-17 years admitted to intensive care units who had central catheters placed between January 2005 and December 2020. Results: Of the 2718 catheter admissions, 1502 catheter admissions were eligible for the regression and other outcome analyses. Fifty-seven percent of the study group were umbilical artery and vein catheters and 43% were other central catheter admissions, including ultrasound-guided catheter admissions. Logistic regression analysis showed us that right internal jugular vein (RIJV) (OR = 1.5, 95% CI = 1.15-2.02, p = 0.030) was the insertion site and ultrasound-guided interventional radiology catheter placement was the technique (OR = 1.7, 95% CI = 1.07-2.90, p = 0.024), duration of catheter stay (OR = 1.07, 95%CI = 1.06-1.08, p < 0.001), catheter placement in patients older than 2 years (OR = 2.42, 95% CI = 1.69-3.45, p < 0.001), were risk factors for CLABSI. Conclusion: Although CLABSI has variable risk factors, the most important risk factor seems to be the length of catheter stay.Item Effects of personality traits on severity of sepsis(2021) Pehlivanlar Kucuk, Mehtap; Kucuk, Ahmet Oguzhan; Komurcu, Ozgur; Dikmen, Yalim; Kadioglu, Mustafa; Uzan, Cagdas Alp; Ergin Ozcan, Perihan; Orhun, Gunseli; Unal Akdemir, Neslihan; Eroglu, Ahmet; Ilyas, Yasir; Zeyneloglu, Pinar; Sahinturk, Helin; Dai Ozcengiz, Dilek; Firat, Ahmet; Aydin, Davut; Ozlu, Tevfik; Pehlivanlar, Aysegul; Kirakli, Cenk; Acar Cinleti, Burcu; Gok, Funda; Yosunkaya, Alper; Aktas, Murat; Ozturk, Cagatay Erman; Ulger, Fatma; 0000-0003-0159-4771; 34581156; AAJ-1419-2021Introduction: The aim of this study was to reveal the effect of the individual's lifestyle and personality traits on the disease process in patients with sepsis and to have clinical predictions about these patients. Materials and Methods: The study was planned as a multi-center, prospective, observational study after obtaining the approval of the local ethics committee. Patients were hospitalized in different intensive care units. Besides demographics and personal characteristics of patients, laboratory data, length of hospital and ICU stay, and mortality was recorded. Two hundred and fifty-nine patients were followed up in 11 different intensive care units. Mortality rates, morbidities, blood analyses, and personality traits were evaluated as primary outcomes. Results: Of the 259 patients followed up, mortality rates were significantly higher in men than in women (p=0.008). No significant difference was found between the patients' daily activity, tea and coffee consumption, reading habits, smoking habits, blood groups, atopy histories and mortality rates. Examining the personal traits, it was seen that 90 people had A-type personality structure and 51 (56.7%) of them died with higher mortality rate compared to type B (p=0.038). There was no difference between personalities, in concomitant ARDS occurrence, need for sedation and renal replacement therapies. Conclusion: Among individuals diagnosed with sepsis/septic shock, mortality increased significantly in patients with A-type personality trait compared to other personality traits. These results showed that personal traits may be useful in predicting the severity of disease and mortality in patients with sepsis/septic shock.Item An Investigation into Bacterial Bloodstream Infections and Antibiotic Resistance Profiles in a Tertiary Hospital for a Ten-Year Period(2020) Mataj, Valbona; Guney, Mustafa; Sig, Ali Korhan; Uskudar-Guclu, Aylin; Albay, Ali; Bedir, Orhan; Baysallar, Mehmet; 0000-0002-1872-028X; 32776752; AAU-6196-2020Background: Bloodstream infections are one of the major causes of healthcare-associated morbidity and mortality. The present study aims to investigate the prevalence of the microorganisms isolated from blood cultures and to evaluate susceptibilities to antimicrobial agents in a tertiary center, Gulhane Training and Research Hospital, Ankara, Turkey. Methods: Blood cultures (BCs) were incubated in BACTEC/9050 (Becton Dickinson, USA) (2007 - 2015) and BacT/ALERT (bio-Merieux, France) (2014 - 2016) automated systems. Phoenix (TM) 100 system (Becton Dickinson, USA) (2007 - 2014), MALDI-TOF MS (Bruker, USA) (2015 - 2016) and conventional techniques were used for the identification of isolated microorganisms. According to CLSI (2007 - 2014) and EUCAST (2015 - 2016) criteria, Kirby-Bauer disc diffusion method, Phoenix (TM) system, and broth microdilution were applied for antimicrobial susceptibility testing. Two five-year periods were statistically compared regarding antibiotic resistance. Results: From the overall evaluated 31,380 BCs, 7,367 cultures (23.5%) were positive, excluding 503 BCs (6.4%), which were interpreted as contamination. Of 7,367 isolated microorganisms, 3,680 (50.0%) were gram-negative, 3,303 (44.8%) were gram-positive bacteria, and 384 (5.2%) were fungi. Coagulase-negative staphylococci (CoNS) were predominantly isolated (n = 2,075; 28.2%) among gram-positives. E.coli (n = 978; 13.3%) was the most frequently isolated gram-negative species. Between the first and the last five-year period, three genera (Enterococcus spp., Acinetobacter spp., Streptococcus spp.) showed significant differences when isolated, and only Enterococcus spp. showed increased isolation rates. In total, 90.3% of CoNS and 32% of S. aureus were methicillin-resistant. Only 75 strains of Enterococcus spp. (12.1%) were vancomycin-resistant. ESBL was detected in 40.6% of E. coli and 30.7% of Klebsiella spp. isolates. Carbapenem resistance showed a significant increase, particularly in K. pneumoniae (> 20%). Conclusions: The findings suggest that there was a threatening condition in antimicrobial resistance rates, especially for some antimicrobials between two periods. Although antimicrobial resistance is usually associated with MRSA, carbapenem resistance, ESBL, and VRE, the problem is far beyond these definitions, consisting of not just medicine, but also commercial companies, food industry, veterinarians, and other areas.Item The effects of enteral supplementation of glutamine and arginine in lipopolysaccharide (LPS) induced sepsis(2019) Bakir, Binnur Okan; Oztezcan, Serdar; Saka, Mendane; Karalti, Iskender; Ozkan, Ferda; Ok, Mehtap Akcil; AAZ-8170-2020Sepsis is the leading cause for death in critically ill patients. While the exact mechanisms are not clear, multiple organ dysfunction syndrome induced by sepsis might cause mitochondrial dysfunction. Spesific nutrients may help regulating immunological and inflammatory responses. Glutamine and arginine amino acids have both important roles in growth, tissue repair, cell renewal and collagen synthesis. There are different results of studies with immunmodulatory nutrients in critically ill patients such, they have no effect on mortality or decrease sepsis incidance. The aim of this study is to evaluate the effects of enteral supplementation of glutamine, arginine and glutamine and arginine combination in lipopolysaccharide (LPS) induced sepsis. Twenty eight male Sprague Dawley rats were randomly divided into four groups: Glutamine, Arginine, Glutamine + Arginine and Control. Glutamine group received 500 mg/kg/day glutamine, Arginine group recieved 500 mg/kg/day arginine, Glutamine + Arginine group received 250 mg/kg/day glutamine and 250 mg/kg/day arginine containing suspension. Rats were fed for 10 days and 3 mg/kg LPS was implemented. 24 hours later, all rats were sacrified. C-Reactive Protein (CRP), Interleukin (IL)-1 beta, IL-6, Tumor Necrosis Factor-alpha(TNF-alpha), Aspartat aminotransferase (AST) and Alanine aminotransferase(ALT) levels were studied, livers were examined histopathologically. Serum TNF-alpha levels were significantly lower in Glutamine + Arginine group in comparison with Control group. Liver histopathology analysis showed that apsis, hepatocyte damage, kupffer cell proliferation and portal inflammation were more frequent and severe in control group than all groups. These results revealed that enteral supply of glutamine, arginine and their combination have positive effects on liver damage and inflammation.Item On computer-aided prognosis of septic shock from vital signs(2019) Ogul, Hasan; Baldominos, Alejandro; Asuroglu, Tunc; Colomo-Palacios, Ricardo; AAC-7834-2020Sepsis is a life-threatening condition due to the reaction to an infection. With certain changes in circulatory system, sepsis may progress to septic shock if it is left untreated. Therefore, early prognosis of septic shock may facilitate implementing correct treatment and prevent more serious complications. In this study, we assess the feasibility of applying a computer-aided prognosis system for septic shock. The system is envisaged as a tool to predict septic shock at the time of sepsis onset using only vital signs which are collected routinely in intensive care units (ICUs). To this end, we evaluate the performances of computational methods that take the sequence of vital signs acquired until sepsis onset as input and report the possibility of progressing to a septic shock before any further clinical analysis is performed. Results show that an adaptation of multivariate dynamic time warping can reveal higher accuracy than other known time-series classification methods on a new dataset built from a public ICU database. We argue that the use of computational intelligence methods can promote computer-aided prognosis of septic shock in hospitalized environment to a certain degree.Item Exogenous Recombinant Adiponectin Improves Survival in Experimental Abdominal Sepsis(2014) Salman, Bulent; Yilmaz, Tonguc Utku; Tezcaner, Tugan; Demir, Ebru fluoglu; Pasaoglu, Ozge Tugce; 25337421Background: Adiponectin, which has anti-inflammatory features, is an important substance in several metabolic mechanisms. Aims: The aim of this study is to evauate the effects of exogenous intraperitoneal administration of adiponectin on the survival, intrabdominal adhesion and inflammatory cytokine levels in an experimental sepsis model. Study Design: Animal experimentation. Methods: Ninety rats were divided into a control group, adiponectin group and sham group. A cecal puncture abdominal sepsis model was performed in the adiponectin and control groups. Every three hours, exogenous adiponectin was administrated to the adiponectin group. At the 3(rd) and 24(th) hours, 10 rats were sacrified in each group in order to measure plasma tumor necrosis factor-alpha (TNF-alpha), interleukin (IL) 10, soluble intracellular adhesion molecule (ICAM)-1, IL-6 and macrophage inhibitory factor levels, and the activity of nuclear factor (NF)-kappa B. The remaining rats were followed for survival. Results: The plasma levels of TNF-alpha, soluable ICAM-1, IL-6, and macrophage inhibitory factor were significantly higher in the control group than in the adiponectin and sham group (p<0.05). The increase in inflammatory cytokines with time was more prominent in the control group. The activity of NF-kappa B in the control group was higher than in the adiponectin group (p<0.05). The survival rate of the adiponectin group was higher than in the control group. Conclusion: Administration of exogenous adiponectin to the peritoneum in abdominal sepsis increased survival and decreased intrabdominal adhesions by decreasing the inflammatory response.