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Öğe Acute Kidney Failure Associated with Anaphylactic Shock Caused by Diclofenac Sodium(Coll Physicians & Surgeons Pakistan, 2015) Çolak, Şahin; Kutlucan, Leyla; Erdoğan, Mehmet Özgür; Afacan, Mustafa Ahmet; Sarıtaş, Ayhan; Kandiş, Hayati…Öğe Association of "Controlling Nutritional Status Index'' and "Prognostic Nutritional Index'' with intensive care unit survival in elderly patients(Springer, 2016) Köş, Mehmet; Titiz, Hafize; Öneç, Birgül; Soysal, Tuba; Kutlucan, Ali; Emen, S. Şahiner; Kutlucan, LeylaObjectives: Providing proper nutritional support for the intensive care unit (ICU) patients is only possible with assessment of malnutrition. In this study, we aimed to evaluate associations between nutritional indexes which were developed to assess malnutrition using blood parameters, and survival among elderly patients in the ICU. Patients and methods: Patients older than 65 years of age and monitored in the ICU, were retrospectively screened with nutritional indexes in order to assess the nutritional status. Each patient was evaluated with both "Controlling Nutritional Status Index'' (CONUT) which includes albumin, total cholesterol, total lymphocyte counts, and "Prognostic Nutritional Index'' (PNI) which includes only albumin beside total lymphocyte count. Results: Two hundred twenty five patients were enrolled in this study. Median age was 79 (range: 65100). One hundred and eleven (49.3%) patients died during intensive care follow-up. CONUT and PNI scores displayed significant differences between patients who died and who were discharged (P = 0.02 and P = 0.03, respectively). Kaplan-Meier analysis revealed that high CONUT (>= 5) and low PNI (<40) scores were associated with intensive care unit survival but statistical significance was not provided for PNI (P = 0.04 and P = 0.06, respectively). Conclusion: Both CONUT and PNI indexes seems associated with survival but only CONUT score provides statistically significant prognostic information and may serve as a cost-effective nutritional assessment tool in elderly patients. Because this association did not retain its significance on multivariate analysis, the validity of this index in elderly patients should be further evaluated by prospective studies including larger samples. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Öğe Asystole after the first dose of lansoprazole(W B Saunders Co-Elsevier Inc, 2014) Candar, Melik; Güneş, Harun; Boz, Behiç Volkan; Kandiş, Hayati; Kutlucan, Leyla; Sarıtaş, AyhanAllergic reactions due to drug intake are responsible from an important amount of emergency admissions. Patients mostly complain of urticarial lesions. But clinical picture may sometimes include a large scale of signs and symptoms ranging from a simple confusion to serious conditions like coma and even cardiopulmonary arrest. In this article, a case of anaphylactic shock and respiratory arrest after lansoprazole intake is presented. Delays in reaching basic and advanced life support decrease chance of positive results of life support in anaphylactic shock victims. It is important to remember that any medication we usually prescribe in our daily practice for treatment of any disease has a potential to kill the patient.Öğe CAN LEUKOCYTE SUBGROUPS OF CRITICAL PATIENTS BE AN INDICATOR FOR MORTALITY, DURATION OF HOSPITALISATION AND DEVELOPMENT OF HOSPITAL INFECTION?(Pergamon-Elsevier Science Ltd, 2015) Kutlucan, Leyla; Kutlucan, Ali; Baştürk, Abdulkadir; Başaran, Betül; Kozanhan, Betül; Gür, M.; Köş, Mehmet…Öğe Dahiliye yoğun bakımdaki yaşlı ve çok yaşlı hastaların klinik özelliklerinin karşılaştırılması(2015) Köş, Mehmet; Titiz, Hafize; Öneç, Birgül; Soysal, Tuba; Aydın, Yusuf; Kutlucan, LeylaAmaç: Genel nüfustaki yaş ortalamalarındaki artış yoğun bakıma ihtiyaç duyan hasta popülasyonuna da yansımaktadır. Yaşla birlikte eşlik eden hastalıkların artması bu hastaların takibinde ayrıca dikkat edilmesi gereken bir konudur. Biz de medikal yoğun bakım (YB) ünitemizde takip edilen yaşlı (65-79 yaş) ve çok yaşlı (80 yaş üstü) gruptaki hastalarımızın klinik ve laboratuvar özelliklerini karşılaştırdık.Yöntemler: 65 yaş ve üstü YB hastalarının klinik ve laboratuvar verileri retrospektif olarak tarandı. Hastaların komorbiditeleri 19 hastalık ağırlıklı Charlson Comorbidity Index (CCI) ile değerlendirildi.Bulgular: Çalışmaya 231 yaşlı ve 216 çok yaşlı hasta alındı. Her iki hasta grubunda da pulmoner hastalıklar YB'ye en sık primer alınış sebebiydi. Yine her iki grupta da hipertansiyon ve kalp yetmezliği en sık komorbid hastalıklardı. Çok yaşlı hasta grubunda CCI skoru 3 olanların sayısı daha fazla idi. Takip süresince gruplar arasında medyan YB-sağkalım açısından fark saptanmazken 30 gün ve üzerindeki YB takiplerinde ise median YB-sağkalım yaşlı hastalarda 81 gün (%95 CI: 48,8-113,2) iken çok yaşlı hastalarda 41 gün (%95 CI: 36,6-45,4) idi (p0,009).Sonuç: 65 yaşın üzerindeki hastalarda artan yaşın YBsağ kalımlarında primer faktör olmadığını saptadık. Ancak yoğun bakımda uzun süreli yatışlarda artan yaş kısa sağ kalımla ilişkili olabilir.Öğe THE EFFECT OF ANEMIA AND RED CELL TRANSFUSIONS ON MORTALITY IN YOUNG AND ELDERLY INTENSIVE CARE PATIENTS WITH NOSOCOMIAL INFECTION(Pergamon-Elsevier Science Ltd, 2014) Kutlucan, Leyla; Kutlucan, Ali; Kandiş, Hayati; Titiz, Hafize; Şenocak, Elif; Baştürk, Abdulkadir; Geyik, M.…Öğe The effects of anemia and red cell transfusion on the risk of mortality among geriatric and non-geriatric patients with hospital-acquired infections in an intensive care unit(Geriatrics Society, 2015) Kutlucan, Leyla; Kutlucan, Ali; Baştürk, Abdulkadir; Kandiş, Hayati; Titiz, Hafize; Şenocak, Elif; Ankaralı, HandanIntroduction: This study aimed to investigate the effects of anemia and red blood cell transfusion on the risk of mortality in geriatric and non-geriatric Intensive Care Unit patients with Hospital- Acquired Infection. Materials and Method: This study included 546 patients aged ?18 years, from these, 112 patients had Hospital-Acquired Infection. Results: Among the patients aged ?65 years with Hospital-Acquired Infection who were treated in the medical Intensive Care Unit, the risk of mortality was significantly increased in patients with anemia or history of diabetes, in patients who were intubated or in patients with neurological disorders or respiratory failure. Although the abovementioned factors increased the risk of mortality in the elderly, the same relationship was not observed in patients aged<65 years. In addition, blood transfusion did not increase the risk of mortality in patients belonging to both the age groups. Conclusion: We conclude that in geriatric Intensive Care Unit patients with Hospital-Acquired Infection, anemia increases the risk of mortality but red cell transfusion does not affect the risk of mortality. © 2015, Geriatrics Society. All rights reserved.Öğe THE EFFECTS OF ANEMIA AND RED CELL TRANSFUSION ON THE RISK OF MORTALITY AMONG GERIATRIC AND NON-GERIATRIC PATIENTS WITH HOSPITAL-ACQUIRED INFECTIONS IN AN INTENSIVE CARE UNIT(Gunes Kitabevi Ltd Sti, 2015) Kutlucan, Leyla; Kutlucan, Ali; Baştürk, Abdulkadir; Kandiş, Hayati; Titiz, Hafize; Şenocak, Elif; Ankaralı, HandanIntroduction: This study aimed to investigate the effects of anemia and red blood cell transfusion on the risk of mortality in geriatric and non-geriatric Intensive Care Unit patients with Hospital-Acquired Infection. Materials and Method: This study included 546 patients aged >= 18 years; from these, 112 patients had Hospital-Acquired Infection. Results: Among the patients aged >= 65 years with Hospital-Acquired Infection who were treated in the medical Intensive Care Unit, the risk of mortality was significantly increased in patients with anemia or history of diabetes; in patients who were intubated or in patients with neurological disorders or respiratory failure. Although the abovementioned factors increased the risk of mortality in the elderly, the same relationship was not observed in patients aged<65 years. In addition, blood transfusion did not increase the risk of mortality in patients belonging to both the age groups. Conclusion: We conclude that in geriatric Intensive Care Unit patients with Hospital-Acquired Infection, anemia increases the risk of mortality but red cell transfusion does not affect the risk of mortality.Öğe Effects of different anesthesia protocols on lactation in the postpartum period(AVES Ibrahim Kara, 2014) Kutlucan, Leyla; Şeker, İlknur Suidiye; Demiraran, Yavuz; Ersoy, Özlem; Karagöz, İbrahim; Sezen, Gülbin; Köse, Seyit AliObjective: Many factors can influence the secretion of breast milk. Cesarean section is a risk factor for late onset of breastfeeding.Material and Methods: In our study, we compared the lactation process by mothers who underwent elective cesarean section under general anesthesia, spinal anesthesia, epidural anesthesia, and normal birth; 84 patients between 18-40 years of age with a risk of ASA I-II were included. Randomly patients were divided into four groups: group G (general anesthesia, n:21), group S (spinal anesthesia, n:21), group E (epidural anesthesia, n:21), and group V (vaginal birth, without anesthesia, n:21). Oxytocin and prolactin values of all patients before and after operation or birth were recorded. In addition the initiation time of lactation after delivery or cesarean section were recorded.Results: In all groups, there were no significant differences among hormone levels in the prepartum period (p=0.350). Prolactin levels in group G (p=0.011) and oxytocin levels in group V (p=0.012) in the postpartum period were significantly higher than in the other groups. The start of lactation was significantly delayed in group G (p=0.003).Conclusion: We consider that the onset time of lactation is delayed in patients undergoing cesarean section with general anesthesia when compared with patients who undergo cesarean section with spinal and epidural anesthesia and with patients who undergo normal vaginal birth. Because of the delay of awakening and recovery of cognitive functions in general anesthesia, communication between the mother and the newborn is delayed and so is the lactation. © 2014 by the Turkish-German Gynecological Education and Research Foundation.Öğe Enfeksiyon tanılı yoğun bakım hastalarında kısa ve uzun dönem mortaliteye etkili faktörler(2015) Kutlucan, Ali; Erdoğan, Murat; Kutlucan, Leyla; Ankaralı, Handan; Ermiş, Fatih; Gür, Mücahit; Aydın, YusufAmaç: Yoğun Bakım Ünitesindeki (YBÜ) enfeksiyöz hastalarda mortalite üzerinde etkili olabilecek risk faktörleri olan yaş, eşlik eden hastalıklar, prokalsitonin (PCT), C-reaktif protein (CRP), 25 -OH vitamin D düzeyi ve APACHE II skoru ile; bu parametrelerin yoğun bakımda ve hastane sonrası otuz ile doksan günlük mortalite arasındaki ilişkisini değerlendirmeyi amaçladık. Yöntem : Düzce Üniversitesi Tıp Fakültesi İç Hastalıları YBÜye 1 Eylül 2011 30 Ağustos 2012 tarihleri arasında enfeksiyon tanısı ile kabul e dilen 52 hasta prospektif olarak değerlendirilmiştir. Bulgular: Sepsis, YBÜde mortaliteyi belirgin artırmıştır. Eşlik eden hastalıklardan; hipertansiyon dışındakilerin taburculuk durumuna, 30 ve 90 günlük yaşam süresine ulaşmayla ilişkisi saptanmadı. Yatı ş laboratuar değerlerinde; CRP ve PCT yüksek, 25 -OH vitamin D ise düşük saptanmıştır. YBÜden taburculukta; yaş, 25 -OH vitamin D, PCT, APACHE IInin etkili olmadıkları, CRP artışının ölüm riski ile ilişkili olduğu görüldü. APACHE II skoru, otuz günlük yaşa mla; yaş ise, otuz ve doksan günlük yaşamla ilişkili bulunmuştur. YBÜ sonrası devredilen serviste yatış süresi uzun olanlarda, hastane sonrası yaşam süresinin yüksek olduğu saptanmıştır Sonuç : Sepsis, YBÜ mortalitesini, sepsisle beraber ileri yaş ta taburculuk sonrası 30 ve 90 günlük mortaliteyi artırabilir. APACHE II skoru, taburculuk sonrası uzun dönem sağkalım tahmininde kullanılabilir. PCT, CRP ve 25 - OH vitamin Dnin, YBÜ hastalarının takibi ve prognozunu belirlemede tek başl arına ideal yöntemler olarak kullanılmasının uygun olmadığı düşünülmektedir.Öğe Farklı anestezi uygulamalarının doğum sonrası annenin laktasyonu üzerine etkisi(Düzce Üniversitesi, 2012) Kutlucan, Leyla; Demiraran, YavuzYeni doğan bebeğin sağlıklı bir biçimde büyüyüp gelişmesinde anne sütünün önemi büyüktür. Birçok faktör annenin süt salgılamasını etkilemektedir. Sezaryen da, emzirmeye geç başlangıç için risk faktörüdür. Çalışmamızda; elektif sezeryan olgularında uygulanan genel anestezi, spinal anestezi ve epidural anestezi ile normal vajinal doğum yapan annelerin laktasyonı karşılaştırdık.Çalışmamızda yaşları 18?40 arası olan ve ASA II grubuna giren toplam 84 vaka incelendi. Çalışma kapsamına alınan olgular rastgele Grup G (Sezaryen operasyonu için genel anestezi uygulanan grup, n=21), Grup S (Sezaryen operasyonu için spinal anestezi uygulanan grup, n=21), Grup E (Sezaryen operasyonu için epidural anestezi uygulanan grup, n=21) ve Grup V (Spontan vajinal doğum yapan, anestezi almayan grup, n=21) olarak 4 gruba ayrıldı.Bütün gruplardaki olguların, doğum öncesi ve sonrası oksitosin, prolaktin, östrojen (E2) ve progesteron değerlerine bakıldı. Tüm olguların laktasyonlarının, doğumdan sonra kaçıncı saatte başladığı kaydedildi.Gruplar arasında yaş, kilo ve gebelik süreleri yönünden anlamlı fark yoktu. Grupların doğum öncesi anne sütünü etkileyebilen hormon düzeyleri arasında anlamlı fark saptanmadı. Doğum sonrasında ise genel anestezi grubunda prolaktin (p=0.011), normal doğum yapan grupta oksitosin (p=0.002) anlamlı olarak yüksek bulundu.Anne sütünün gelme zamanının genel anestezi alan grupta anlamlı olarak geciktiği saptandı.Öğe THE IMPORTANCE OF HIGH PLATELET-LYMPHOCYTE RATIO ON PROGNOSIS, DURATION OF HOSPITALISATION AND DEVELOPMENT OF HOSPITAL INFECTION AMONG INTENSIVE CARE PATIENTS(Pergamon-Elsevier Science Ltd, 2015) Kutlucan, Leyla; Kutlucan, Ali; Baştürk, Abdulkadir; Gür, M.; Şenocak, Elif…Öğe The predictive effect of initial complete blood count of intensive care unit patients on mortality, length of hospitalization, and nosocomial infections(Verduci Publisher, 2016) Kutlucan, Leyla; Kutlucan, Ali; Başaran, Betül; Dağlı, Mehmet; Baştürk, Abdulkadir; Kozanhan, Betül; Köş, MehmetOBJECTIVE: The mean platelet volume (MPV) can be used as an indicator of platelet activation. However, it has been shown that the platelet/lymphocyte ratio (PLR) can provide useful predictive information about inflammation and aggregation pathways. The neutrophil/lymphocyte ratio (NLR) may also be helpful as a marker of systemic or local inflammation. The main objective of this study evaluated to unselected critically ill patients the relationship of initial MPV, NLR, and PLR with mortality, length of hospitalization, and the risk of developing nosocomial infections in ICU patients. PATIENTS AND METHODS: In this retrospective study, we evaluated consecutive patients at our tertiary nine-bed ICU. One hundred seventy-three patients who were followed up during a 1-year period were included. RESULTS: MPV levels were found to be higher in patients who died in the hospital (p = 0.05). In addition, there was a significant positive correlation between expected mortality rate and MPV among non-survivors (p = 0.009). NLR levels were higher among non-survivors, but this difference was not statistically significant (p = 0.435). PLR levels were similar between non-survivors and survivors (p = 0.173). The initial NLR and PLR were significantly higher in patients with nosocomial infections. NLR and PLR had a significant positive correlation with length of hospitalization (p = 0.006 and p = 0.027, respectively). CONCLUSIONS: In our study, we found that high PLR and NLR may be indicators for the development of nosocomial infections. Moreover, the length of hospitalization may be prolonged in patients with high PLR and NLR.