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    Blood transfusion in pediatric intracranial tumor surgery
    (Bmc, 2024) Soner, Huelya Tosun; Oygen, Oemer; Guvenc, Bayram; Turkan, Rojda Tanik; Sener, Fuat; Soner, Serdar; Uzundere, Osman
    Background Pediatric central nervous system tumors are the most common solid tumors in children and leading cause of cancer-related morbidity and mortality. Various factors may influence the practice of blood transfusion during this tumor diagnosis. The primary aim of this study was to determine the factors that may influence intraoperative blood transfusion in pediatric patients undergoing surgery for intracranial tumors and to predict patients who may require blood transfusion. Methods A retrospective study was performed in all pediatric patients younger than 15 years who underwent craniotomy for brain tumor removal from January 2018 to December 2023 in our institution. Preoperative, intraoperative and postoperative data were collected from medical and store anesthesia records. The predictors of intraoperative blood transfusion were determined using multivariate logistic regression. Results A total of 138 patients were enrolled in the study, of whom 62 (44.9%) required intraoperative blood transfusion. In multivariate regression analysis age < 4 years and operating time > 490 min were determined as independent variables in terms of need for intraoperative blood transfusion. It was determined that the need for transfusion was higher in patient who were operated on urgently and patients with comorbidities (p = 0.023, p = 0.005). Conclusion In conclusion, the findings obtained in this study suggest that age and surgical duration are independent risk factors for intraoperative blood transfusion in pediatric patients undergoing surgery for intracranial tumors. Particularly, in younger patients and prolonged surgeries, closer monitoring and awareness may enhance early detection, leading to the prevention of complications.
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    Comparison of The Effects of Low Flow Desfluran and High Flow Desfluran on Oxidative Stress and DNA Damage in Anesthesia Applications
    (Reial Acad Medicina Illes Balears, 2024) Soner, Hulya Tosun; Kaplan, Ibrahim; Uzundere, Osman; Soner, Serdar; Celik, Feyzi
    Background: Studies have reported that volatile anesthetics may affect genotoxic and oxidative stress in the present study, we aimed to compare low and high flow anesthesia techniques in terms of DNA damage and oxidative stress. Methods: We included 60 patients who underwent high and low flow desflurane anesthesia, and those who underwent low and high flow anesthesia were categorized in Groups I (n=31) and II (n=29), respectively. The hemodynamic and respiratory parameters of the patients were recorded and 8-OhdG (8-hydroxy deoxyguanosine) values for DNA (deoxyribonucleic acid) damage, MDA(Malondialdehyde), cystatin C, TAS (total antioxidant status), TOS (total oxidative status), and LPO (lipid peroxid) values for oxidative stress were measured from the blood samples collected from the patients preoperatively, intraoperatively at the third hour and at the postoperative twenty-fourth hour. Results: Postoperative MDA value was significantly higher in the high flow group than in the low flow group (p<0.05). There was no significant intergroup difference in terms of TAS, TOS, cystatin C, LPO and 8 OhdG values (p>0.05). Conclusion: In conclusion, MDA values, an indicator for oxidative stress, increased significantly in high flow desflurane application. There was no intergroup difference in terms of DNA damage.
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    Diyarbakır ilindeki gebe kadınlarda Toksoplazma, Rubella ve Sitomegalovirus seroprevalansı
    (Dicle Üniversitesi Tıp Fakültesi, 2019) Obut, Mehmet; Doğan, Yasemin; Bademkıran, Muhammed Hanifi; Akgöl, Sedat; Kahveci, Bekir; Peker, Nurullah; Uzundere, Osman; Kaçar, Cem Kıvılcım; Özbek, Erdal; Gül, Talip
    Amaç: Bu çalışmada; gebelerde, Toxoplasma gondii, Rubella virüs ve Cytomegalovirus infeksiyonlarının bölgemizdeki seroprevalanslarının belirlemesi amaçlanmıştır. Yöntemler: Bu çalışmada hastanemize Eylül 2016 ile Haziran 2018 tarihleri arasında kadın hastalıkları ve doğum polikliniklerine ilk prenatal vizite gelen 18-45 yaş arası gebeler dahil edildi. Bu hastalardan Toxoplasma gondii, Rubella ve Cytomegalovirus virüs serolojisi çalışılanların test sonuçları retrospektif olarak incelendi. Bulgular: Toxoplasma gondii antikorları açısından 8175 hastanın 2853’ inde (%34,9) anti toksoplazma gondii IgG antikorları, 91’ inde (%1,1) anti Toxoplasma gondii IgM antikorları pozitif olarak saptandı. Cytomegalovirus antikorları açısından 2797 hastanın 2775’ inde (%99,2) anti Cytomegalovirus IgG, 20’ sinde (%0,7) anti Cytomegalovirus IgM pozitif olarak saptandı. Rubella virüs antikorları açısından 8158 hastanın 7677’ sinde (%94,1) anti Rubellavirus IgG, 5’ inde (%0,1) anti Rubellavirus IgM pozitif olarak saptandı. Sonuç: Bu çalışmada hastanemize başvuran gebelerin çoğunun toksoplazma seronegatif (%65,1) olduğu tespit edildi. Rubella seroprevalansı (%94,1) Türkiye verileri ile uyumludur. Gebelerin Cytomegalovirus seroprevalansı için seropozitiflik oranı (%99,2) dünya verileri ile uyumludur.
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    Effect of non-invasive bilateral sphenopalatine ganglion block on postoperative pain in patients undergoing septorhinoplasty surgery: a randomized controlled study
    (Edizioni Minerva Medica, 2024) Tosun Soner, Hulya; Haznedar, Berzan; Soner, Serdar; Erdal Erbatur, Meral; Acil, Fatma; Kaya, Sedat; Uzundere, Osman
    BACKGROUND: The objective of this study was to assess the impact of preoperative sphenopalatine ganglion block (SPGB) on postoperative pain and assess intraoperative and postoperative analgesic consumption in patients undergoing septorhinoplasty. METHODS: In this prospective, randomized controlled study, 72 patients were included and divided into two groups: group 1 (36 patients) received the sphenopalatine ganglion block (SPGB), while group 2 (36 patients) served as the control group. Patient assessments, using the numerical rating scale (NRS), were conducted at the postoperative first hour, fourth hour, and 24 t h hour. Additionally, intraoperative hemodynamics, analgesic requirements, and postoperative analgesic requirements were documented. RESULTS: The patients in group 1 exhibited significantly lower NRS scores at postoperative first, fourth, and 24 t h hour than those in group 2 (P<0.001 for all three time points). Additionally, the mean Riker Sedation-Agitation Scale (RSAS) scores were significantly lower in group 1 than in group 2 (P=0.006). Both intraoperative remifentanil use and postoperative analgesic consumption were significantly higher in patients in group 2 (P<0.001 and 0.004, respectively) than those in group 1. Analysis of intraoperative heart rate and mean arterial pressure (MAP) revealed that patients in group 1 had lower postoperative heart rates (P=0.040) than those in group 2, and MAP values after intraoperative block, at 30 min, and postoperatively were significantly lower (P=0.005, P=0.001, and P=0.034, respectively) than those in group 2. CONCLUSIONS: We advocate for the adoption of the noninvasive SPGB method in patients undergoing septorhinoplasty surgery. This approach significantly reduces the need for intraoperative analgesics, alleviates postoperative pain, and reduces the demand for postoperative analgesics. Moreover, it improves the overall surgical experience because of its ease of application, contributing to a more comfortable surgical process.
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    Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery
    (2021) Uzundere, Osman; Ege, Serhat; Kahveci, Bekir; Budak, Mehmet Sukru; Kahveci, Gaye; Peker, Nurullah; Sucu, Mete
    OBJECTIVE: Postoperative hematoma following abdominal surgery is relatively rare and mainly depends on the type of surgery. Specific treatment including surgery or interventional radiology is sometimes necessary. The aim of this study is to evaluate the cases of postoperative hematoma after gynecologic and obstetric surgery.STUDY DESIGN: This is a retrospective cohort study of 30 patients with hematoma developed after gynecologic and obstetric surgery. We included the patients who hospitalized with the diagnosis of a postoperative hematoma between June 2017 and April 2019 at Gazi Yasargil Training and ResearchHospital of Health Sciences University. Hematomas occurring after endoscopic surgery and episiotomywere not included. The diagnosed cases were divided into three groups as wound hematoma, rectussheath hematoma and intra-abdominal hematoma (intraperitoneal and retroperitoneal). All cases wereassessed by patient demographics and clinical findings, hematoma of characteristics, treatment methods and results.RESULTS: A total of 30 patients were included in the study with a mean age of 33.0±8.6 years.Incidence of hematoma account for 0.2%. The mean c-reactive protein was 37.9±47.4 mg/dL at admission and 14.6±25.8 mg/dL at discharge, respectively. The decrease was statistically significant (p <0.001). The mean hemoglobin was 10.6±2.1 g/dL at admission and 10.7±1.5 g/dL at discharge. Feverwas detected in 7 (23.3%) patients. Only 12 patients (40%) were followed up by observation and symptom management. In 10 (33.3%) patients, antibiotics were included in the treatment due to infection. Inaddition, 4 patients (13.3%) had relaparotomy, 5 patients (16.7%) underwent percutaneous radiologicaldrainage and 8 (26.7%) received blood transfusion. The mean time of resorption of the hematoma was4.6 ± 2.0 days. The evaluation of the hematoma locations revealed that 14 patients (46.7%) had woundhematoma, 7 patients (23.3%) had rectus sheath hematoma (Type I: 2 cases, type II: 3 cases, type III:2 cases), 8 patients (26.7%) had pelvic hematoma and 2 patients (6.7%) had a retroperitonealhematoma. The mean hematoma size was 68.1±15.18 mm.CONCLUSIONS: In cases of hematoma resistant to antibiotic treatment and non-resorbable hematoma,we can consider percutaneous catheter drainage as an alternative to surgical intervention