Necdet Sut

Trakya University, Adrianoupolis, Edirne, Turkey

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Publications (96)189.94 Total impact

  • FTR - Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi 04/2015; 61(1):12-17. DOI:10.5152/tftrd.2015.04378 · 0.08 Impact Factor
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    ABSTRACT: The aim of this prospective study was to determine the efficacy of intraarticular levobupivacaine with and without intravenous dexketoprofen trometamol for postarthroscopy analgesia.
    Knee Surgery Sports Traumatology Arthroscopy 07/2014; DOI:10.1007/s00167-014-3191-2 · 2.84 Impact Factor
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    ABSTRACT: Objective. Some features of Behcet's syndrome (BS) tend to go together. We aimed to explore the association and timing of various vascular events in both the venous and the arterial vascular tree. Methods. We conducted a chart survey on the type and time of vascular involvement of BS. The cross-relationships of involvement were assessed by phi correlation coefficients. Multiple correspondence analysis was used to identify patterns of vascular involvement. The risk of vascular recurrence was also estimated. Results. We identified 882 patients with vascular involvement among 5970 BS patients (14.7%). Deep vein thrombosis (DVT), almost always in the legs, was the most frequent single vascular event (592/882; 67.1%). The cumulative risk of a recurrent vascular event was 38.4% at 5 years. Patients with extrapulmonary artery involvement (EPAI) were significantly older than those with venous and pulmonary artery involvement (PAI). There were significant correlations between dural sinus thrombosis (DST) and PAI, Budd-Chiari syndrome (BCS) and inferior vena cava syndrome (IVCS) and between IVCS and superior vena cava syndrome (SVCS). Multiple correspondence analysis further indicated clustering of PAI, DST, BCS, IVCS and SVCS. However, EPAI and DVT clustered separately from forms of vascular disease, the separate clustering of the DVT being attributed to its propensity to occur solo. Conclusion. The most common type of vascular involvement in BS is solo DVT, almost always occurring in the legs. Various forms of venous disease in BS segregate together and PAI is included in this group. EPAI segregates separately.
    Rheumatology (Oxford, England) 06/2014; 53(11). DOI:10.1093/rheumatology/keu233 · 4.44 Impact Factor
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    ABSTRACT: Lumbar puncture (LP) is one of the most common procedures performed in medicine. The aim of this prospective study is to determine the success rate of LP in lateral decubitus with 45-degree head-up tilt position, and compare it with traditional positions like sitting and lateral decubitus. Three hundred and thirty patients between 25 and 85 years of age who had undergone abdominal, urologic, and lower limb extremities surgeries were enrolled and 300 patients were divided into three different groups. The LP was performed with a 25-G atraumatic needle, either in the standard sitting position (group S, n = 100), lateral decubitus, knee-chest position (group L, n = 100) or lateral decubitus, knee-chest position with a 45-degree head-up tilt (group M, n = 100). The free flow of clear cerebrospinal fluid (CSF) upon first attempt was considered to be evidence of a successful LP. Total LP success rate was significantly higher in group M (85 %) than in groups S and L (70 and 65 %, respectively) (p = 0.004). When the significance between the groups was evaluated according to age, the increase in the LP success rate was not significant for ≤65 and >65 age groups. There were no differences among the three groups in terms of bloody CSF (p = 0.229) and the number of attempts before dural puncture (p = 0.052). The lateral decubitus in knee-chest position with a 45-degree head-up tilt may be the preferred position for spinal anesthesia in young and elderly patients, due to the high success rate.
    Journal of Anesthesia 01/2014; 28(4). DOI:10.1007/s00540-013-1764-8 · 1.12 Impact Factor
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    ABSTRACT: Objective: Oxidative stress plays an important role in the pathogenesis of liver ischemia/reperfusion injury. Thus, antioxidant treatment can be protective against to liver ischemia/reperfusion injury. The aim of this study to investigate the effects of alpha-lipoic acid and L-carnitine on liver total oxidant status, lipid peroxidation, protein oxidation, neutrophil infiltration and hepatic necrosis in liver ischemia/reperfusion model. Methods: Wistar albino male rats were divided into four groups randomly: Sham (n=7), ischemia/reperfusion (n=7), alpha-lipoic acid (n=8) and L-carnitine (n=8). alpha-Lipoic acid (100 mg/kg) and L-carnitine (100 mg/kg) were given intraperitoneally to alpha-lipoic acid group 15 minutes before and to L-carnitine group 30 minutes before ischemia/reperfusion protocol, respectively. To induce hepatic ischemia/reperfusion injury, ischemia (60 minutes) and reperfusion (30 minutes) were applied to all groups except sham group. Total oxidant status, malondialdehyde, advanced oxidation protein products and myeloperoxidase levels were measured in ischemic lobes of liver tissues. Hepatic necrosis was scored microscopically. Results: There was no significant change in myeloperoxidase levels as an indicator of neutrophil infiltration after reperfusion procedure. Both L-carnitine and alpha-lipoic acid caused a significant decrease in hepatic necrosis. While L-carnitine prevents an increase in total oxidant status, lipid peroxidation and protein oxidation, alpha-lipoic acid prevents only an increase in lipid peroxidation of the liver in hepatic ischemia/reperfusion injury. Conclusion: As a result; we can report that L-carnitine and alpha-lipoic acid have protective effects against to hepatic ischemia/reperfusion injury.
    Türk Biyokimya Dergisi / Turkish Journal of Biochemistry 01/2014; 39(2):169-175. DOI:10.5505/tjb.2014.02525 · 0.17 Impact Factor
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    ABSTRACT: To determine the frequency of and possible factors related to contrast-induced nephropathy (CIN) in hospitalised patients with cancer. Ninety adult patients were enrolled. Patients with risk factors for acute renal failure were excluded. Blood samples were examined the day before contrast-enhanced computed tomography (CT) and serially for 3 days thereafter. CIN was defined as an increase in serum creatinine (Cr) of 0.5 mg/dl or more, or elevation of Cr to 25 % over baseline. Relationships between CIN and possible risk factors were investigated. CIN was detected in 18/90 (20 %) patients. CIN developed in 25.5 % patients who underwent chemotherapy and in 11 % patients who did not (P = 0.1). CIN more frequently developed in patients who had undergone CT within 45 days after the last chemotherapy (P = 0.005); it was also an independent risk factor (P = 0.017). CIN was significantly more after treatment with bevacizumab/irinotecan (P = 0.021) and in patients with hypertension (P = 0.044). The incidence of CIN after CT in hospitalised oncological patients was 20 %. CIN developed 4.5-times more frequently in patients with cancer who had undergone recent chemotherapy. Hypertension and the combination of bevacizumab/irinotecan may be additional risk factors for CIN development. • Contrast-induced nephropathy (CIN) is a concern for oncological patients undergoing CT. • CIN occurs more often when CT is performed <45 days after chemotherapy. • Hypertension and treatment with bevacizumab appear to be additional risk factors.
    European Radiology 09/2013; 24(1). DOI:10.1007/s00330-013-2996-6 · 4.34 Impact Factor
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    ABSTRACT: The goal of this study was to evaluate the efficacy of CA-125 area under the curve (CA-125 AUC) as a prognostic factor following surgical treatment for ovarian cancer patients. A retrospective analysis was conducted on ninety-five patients with ovarian cancer who had primary treatment in a tertiary center between 2000 and 2010. After either optimal or cytoreductive surgery, all patients underwent adjuvant chemotherapy. CA-125 AUC was calculated for each patient that had a minimum of three CA-125 serum measurements during the treatment period. The mean age at diagnosis and mean survival were 53.9 years (range, 16-75 years) and 35.6 ± 22.9 months (range, 3.1-95.4 months), respectively. The mean (and median) CA-125 AUC of patients of FIGO stages I, II, III, and IV was 53.0 (42.5), 58.06 (58.06), 97.8 (54.6), and 405.2 (149.3) IU/ml day, respectively (p = 0.004). The mean CA-125 AUC was 57.7, 410.1, and 636.3 IU/ml day for patients with a complete response, partial response, and no response/progressive disease to first-line chemotherapy, respectively (p < 0.001). The CA-125 AUC cut-off level for an overall survival of ≥5 years was 99.75 IU/ml day with a sensitivity of 90.9 % (95 % CI, 70.8-98.6) with 1.27 as positive likelihood ratio. Patients who suffer from ovarian cancer, with a lower CA125 AUC, have a better overall survival than those with a higher CA125 AUC. CA-125 AUC could be used as an independent factor for evaluating the treatment efficacy and chemotherapy response.
    Medical Oncology 03/2013; 30(1):447. DOI:10.1007/s12032-012-0447-x · 2.06 Impact Factor
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    Kafkas Üniversitesi Veteriner Fakültesi Dergisi 01/2013; 19(2):253. DOI:10.9775/kvfd.2012.7620 · 0.29 Impact Factor
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    ABSTRACT: Objective: The aim of this study was to investigate the protective effect of L-carnitine against to liver damage caused by lipid peroxidation and oxidative stress in toxic hepatitis induced by acetaminophen. Materials and Methods: Wister-albino male rats were divided into three groups randomly: control, toxic hepatitis, and L-carnitine groups. To introduce a toxic hepatitis, single dose of acetaminophen (300 mg/kg) dissolved in warm saline was given intraperitoneally to toxic hepatitis and L-carnitine groups. A single dose of L-carnitine (500 mg/kg) was given intraperitoneally to L-carnitine group five minutes after introducing to toxic hepatitits. A single dose of warm saline was given intraperitoneally to control group. Results: In toxic hepatitis group, serum alanine and aspartate aminotransferase and plasma and liver malondialdehyde levels were higher whereas plasma Gc-globulin, whole blood and liver glutathione levels, erythrocyte and liver catalase activities and erythrocyte glutathione peroxidase activity were lower as compared to control group. In L-carnitine group, serum alanine and aspartate aminotransferase and plasma and liver malondialdehyde levels were lower whereas whole blood and liver glutathione levels, erythrocyte and liver catalase activities and erythrocyte glutathione peroxidase activity were higher as compared to toxic hepatitis group. There was no significant change between plasma Gc-Globulin levels of these groups. Histopathological changes in toxic hepatitis group were more prominent than those found in L-carnitine group. Conclusion: L-Carnitine has a protective effect against to liver damage caused by lipid peroxidation and oxidative stress in toxic hepatitis induced by acetaminopfen in rats.
    Türk Biyokimya Dergisi / Turkish Journal of Biochemistry 01/2013; 38(4):475-482. DOI:10.5505/tjb.2013.92063 · 0.17 Impact Factor
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    ABSTRACT: To evaluate the accuracy and precision of a new, noninvasive infrared thermometer applied to the temporal artery. Prospective randomized study. Trakya University Hospital. 60 ASA physical status 1 and 2 children undergoing surgery. During anesthesia, temperature measurements were recorded with three different techniques: temporal artery, nasopharynx, and axillary temperature. Temperatures measured from the nasopharynx, temporal artery, and the axilla were recorded at 15-minute intervals for the first hour, then at 30-minute intervals until the completion of surgery. During each measurement, heart rate and midarterial pressure were recorded. There were no statistically significant differences between temperatures recorded at the temporal artery and nasopharynx at 15, 30, 45, 60, 90, and 120 minutes, and the completion of surgery. Axillary temperatures were statistically lower than those recorded at the nasopharynx and the temporal artery (P < 0.001). Bland-Altman plots showed a correlation of temperature measurements between the temporal artery and nasopharyngeal methods. The axillary method had a lower correlation with the temporal artery and the nasopharyngeal methods. The temporal artery thermometer is a substitute for the nasopharyngeal thermometer for core temperature measurement during anesthesia in children.
    Journal of clinical anesthesia 12/2012; 24(8):647-51. DOI:10.1016/j.jclinane.2012.05.003 · 1.21 Impact Factor
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    ABSTRACT: In this study, the Ki-67 proliferative indices among the stages of the endometriosis were compared to clarify whether the proliferation was increased with increasing disease stage. Thirty-eight patients who underwent surgery either by laparotomy or by laparoscopy with the diagnosis of endometriosis and 21 patients, as controls, who underwent hysterectomy with the diagnosis of myoma uteri and without any endometrial pathology at our hospital between 2005 and 2007 were studied. Biopsy specimens of endometriotic foci and endometriomas in study group, and eutopic endometrium of hysterectomy specimens of control group were studied. Fifty-nine patients were divided into Group 1 (21 patients in control), Group 2 (19 patients in stage I and II of endometriosis), and Group 3 (19 patients in stage III and IV). A moderate correlation between the stage of endometriosis and the degree of Ki-67 staining was found. When Ki-67 immunohistochemical staining was considered according to the threshold value for CA-125 (35 U/mL), Ki-67 positivity was increased with the increase in CA-125 value, but this increase was not statistically significant. Endometriosis shows some characteristics of tumors such as high rate of invasion, getting autonomy, and proliferation as the disease progresses with subsequent damage to target organs. When the stage of the disease increases, environment becomes more suitable for increased proliferation and invasion. In this study, the increase in proliferative activity as the severity increases is shown by the increase in Ki-67 index. As more studies are being conducted in this field, pathogenesis will be clarified, which could help in the development of new treatment modalities.
    Taiwanese journal of obstetrics & gynecology 09/2012; 51(3):393-6. DOI:10.1016/j.tjog.2012.07.013 · 1.26 Impact Factor
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    ABSTRACT: BACKGROUND: Acoustic noise may have adverse effects, even in patients under general anesthetic. OBJECTIVE: We aimed to determine the effect of headphones on sevoflurane requirements in children undergoing general anesthesia for an MRI scan. MATERIALS AND METHODS: Children scheduled for MRI were enrolled in the study. Sevoflurane was used for general anesthesia in all children. Patients were randomly divided into two groups, one to wear headphones and the other none. After reaching a predetermined end-tidal concentration, the MRI scan was initiated, and the patient was evaluated by an observer blinded to the concentration of sevoflurane. Awakening was defined as eye opening, onset of continued purposeful movement or phonation. Using the Dixon up-and-down method, each target concentration was determined by the response of the previous child in the same group. RESULTS: The study included 28 children undergoing MRI. There was a significant difference in ED50 between the two groups (0.92, 0.81-1.02, vs. 0.47, 0.42-0.63; P < 0.001). The times to spontaneous arm and leg movements, eye opening and discharge from the post-anesthesia care unit were significantly shorter in patients with headphones than in those without (P < 0.001). However, there was no difference in times to hospital discharge (P = 0.056). CONCLUSION: Noise-concealing headphones decrease inhalational anesthetic requirements and facilitate recovery. We recommend the routine use of headphones in children undergoing an MRI scan.
    Pediatric Radiology 08/2012; 42(12). DOI:10.1007/s00247-012-2463-6 · 1.65 Impact Factor
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    ABSTRACT: OBJECTIVES: The numbers and recurrence rates of mucocutaneous manifestations can be highly variable among patients with Behçet's syndrome (BS) but it is not known whether these differences influence the disease course at the long-term. METHODS: We evaluated the outcome of 30 patients that made up the placebo arm of a 6 months controlled trial of thalidomide and looked at the relation between the frequencies of mucocutaneous manifestations during the trial and the development of major organ involvement necessitating immunosuppressives during the post-trial period. RESULTS: Fifteen (50%) patients had received immunosuppresives for major organ involvement during the post-trial period. Patients receiving immunosuppressive treatment were significantly younger at the onset of BS compared to those who did not (24.5±5 vs. 29.7±3.8 SD years; p=0.003). The mean number of oral ulcers recorded throughout the trial was significantly higher among patients using immunosuppressives compared to those who did not (2.09±0.96 vs. 1.43±0.8; p=0.029). This significance disappeared when adjusted for age of onset of BS (p=0.16). ROC curve analysis showed that having 10 or more ulcers during 6 months has a sensitivity of 86.7% and a specificity of 53% for the subsequent necessity of immunosuppressive use. The same association was not true for genital ulcers, follicular lesions and erythema nodosum. CONCLUSIONS: These findings on a limited number of patients suggest that frequent occurrence of oral ulceration during the initial years of the disease may predict the development of major organ involvement in men with BS.
    Clinical and experimental rheumatology 08/2012; · 2.97 Impact Factor
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    ABSTRACT: The aim of the study was cultural adaptation, validation, and test for responsiveness of the short forms of the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) in a Turkish population. To evaluate their validity, questionnaires were applied to 248 women. The questionnaires were compared with prolapse stage according to the Pelvic Organ Prolapse Quantification (POP-Q) system. The responsiveness of the questionnaires was assessed in 103 women with prolapse who also completed the questionnaires after reconstructive surgical treatment, with standardized response mean (SRM), effect size (ES), and the Wilcoxon signed-rank test. Cronbach alpha coefficients of the Turkish PFDI-20 and PFIQ-7 questionnaires were 0.908 and 0.830, respectively. Significant correlations were observed between the scores of the questionnaires with the vaginal examination findings. The PFDI-20 and PFIQ-7 scores were significantly improved after vaginal reconstructive surgery. Turkish translated versions of the PFDI-20 and PFIQ-7 are reliable, valid and responsive instruments for assessing symptom severity, impact on QoL in women with pelvic organ prolapse. They can be easily administered and self-completed by Turkish women.
    European journal of obstetrics, gynecology, and reproductive biology 04/2012; 162(2):229-33. DOI:10.1016/j.ejogrb.2012.03.004 · 1.63 Impact Factor
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    ABSTRACT: The objective of this study was to examine the quality of life in female Turkish patients with overactive bladder (OAB). The investigation was conducted as a cross-sectional study between January and April 2010. Two hundred eighty female patients responded to the Overactive Bladder Validated Eight-Question Screener, the OAB disease-specific health-related quality-of-life scale (OAB questionnaire (OAB-q)) and the general quality-of-life scale EuroQol Five-Dimensional Questionnaire (EQ-5D) for the study. Of the 280 patients, 38.9% was classified as having OAB. The mean age was 47.0 ± 8.7. All of the quality-of-life domains (coping, concern, sleep and social) and OAB-q total scores in women with OAB were significantly worse than in women without OAB (P < 0.001 for all). Similarly, the EQ-5D(index) and EQ-5D(VAS) scores for women with OAB were significantly worse than for women without OAB (P < 0.001 and P = 0.006, respectively). OAB-q and EQ-5D(index) scores in menopausal women were significantly lower than non-menopausal women (P < 0.05) in patients with OAB. In conclusion, OAB negatively affects quality of life in Turkish women. However, many women's quality of life can be improved if the patients seek medical treatment. Thus, nurses should encourage the patients to seek medical support in order to cope with health-related quality-of-life problems.
    International Journal of Nursing Practice 02/2012; 18(1):20-7. DOI:10.1111/j.1440-172X.2011.01983.x · 0.54 Impact Factor
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    ABSTRACT: We have previously reported distinct symptom clusters among our patients with Behçet's syndrome (BS). The presence of such clusters suggests that more than one pathogenetic mechanism might be operative in BS. Increases in the frequency of certain clusters in familial BS cases, if present, would further support this notion. To test this hypothesis, we compared the frequency of symptom clusters between familial (group F) and non-familial (group NF) cases of BS. We identified 380 BS patients who had reported a first-degree relative by reviewing 6031 patient charts. We were able to contact 186 (Group F). From the same initial pool, 500 patients were randomly selected. Of those, patients who did not report a family history of BS and who had attended our clinic during the previous 3 months made up group NF (n = 221). Both groups were questioned about their symptoms within the previous 3 months. Data were analysed using factor analysis, cluster analysis and χ2 tests. The make-up of the symptom clusters were very similar for the factor and the cluster analyses. The frequency of papulopustular lesions and joint involvement cluster was significantly higher in group F (39.2 vs. 21.5%, P < 0.001). Furthermore, the same cluster was shared in 5/17 related pairs from group F and in only 5/110 unrelated pairs from group NF [29 vs. 4.5%, P = 0.004; risk ratio (RR) = 6.47, 95% CI 2.15, 18.89]. The papulopustular lesions and arthritis cluster in BS appears to cluster in familial BS as well. This further supports the notion that the pathogenesis of BS may entail several distinct mechanisms resulting in separate phenotype clusters.
    Rheumatology (Oxford, England) 01/2012; 51(6):1053-60. DOI:10.1093/rheumatology/ker423 · 4.44 Impact Factor
  • Necdet Sut, Osman Simsek
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    ABSTRACT: With this research, we sought to examine the performance of six different regression tree data mining methods to predict mortality in head injury. Using a data set consisting of 1603 head injury cases, we assessed the performance of: the Classification and Regression Trees (CART) method; the Chi-squared Automatic Interaction Detector (CHAID) method; the Exhaustive CHAID (E-CHAID) method; the Quick, Unbiased, Efficient Statistical Tree (QUEST) method; the Random Forest Regression and Classification (RFRC) method; and the Boosted Tree Classifiers and Regression (BTCR) method, in each case based on sensitivity, specificity, positive/negative predictive, and accuracy rates. Next, we compared their areas under the (Receiver Operating Characteristic) ROC curves. Finally, we examined whether they could be grouped in meaningful clusters with hierarchical cluster analysis. Areas under the ROC curves of regression tree data mining methods ranged from 0.801 to 0.954 (p
    Expert Systems with Applications 11/2011; 38(12):15534-15539. DOI:10.1016/j.eswa.2011.06.006 · 1.97 Impact Factor
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    ABSTRACT: Several studies performed on pancreatic-duodenal homeobox 1 (PDX1) have demonstrated a loss of expression and negative tumor modulator effect in gastric carcinoma. Relations between PDX1 and gastric metaplasia, differentiated type of gastric carcinoma, and the early stage of the disease have been exhibited in previous reports. The aim of this study was to examine expressions of PDX1, caudal type homeobox 2 (CDX2) and mucin (MUC) profiles to address the role of PDX1 in gastric carcinogenesis and its relationship with CDX2. Seventy gastrectomy specimens were analyzed immunohistochemically for PDX1, CDX2, MUC2, MUC5AC, and MUC6 expressions. The sum of cytoplasmic and nuclear PDX1 immunostaining and PDX1 positivity were assessed. All of the antibodies were examined for a correlation with tumor type, clinicopathologic parameters, and metaplasias. The relation of Ki-67 proliferation index with the expression profiles was also investigated. Neither PDX1 (66/70) nor CDX2 (37/70) and the mucin profiles (MUC2:11/70, MUC5AC:48/70, MUC6:41/70) showed a significant difference between differentiated and undifferentiated types of gastric carcinoma and clinicopathologic parameters. The PDX1 expression frequency was 94.3%, with an average PDX1 score of 8.8 ± 4.2. PDX1 and CDX2 expression showed a significant difference (P = 0.026 and P = 0.002, respectively) among the phenotypic classification of gastric carcinomas. All of the gastric and intestinal mixed-phenotype gastric carcinomas (GI-type) showed both PDX1 and CDX2 immunopositivity. Except for the relation of PDX1 score with MUC6 expression, no significant difference was detected between PDX1 and CDX2, MUC2, and MUC5AC expressions. A relationship between CDX2 and MUC2 and also between MUC5AC and MUC6 was found statistically. The Ki-67 proliferation index revealed a significant positive correlation with PDX1, CDX2, and MUC2 positivity. PDX1 expression revealed a higher positivity in gastric carcinomas than the previous studies and showed no relation with tumor type, clinicopathologic parameters, CDX2 expression, or mucin profiles. However, a significant relation of PDX1 and CDX2 expressions among phenotypic classification of gastric carcinomas reveals an idea about similar functions for PDX1 and CDX2 in the evolution of gastric carcinoma.
    Journal of Cancer Research and Clinical Oncology 09/2011; 137(12):1749-62. DOI:10.1007/s00432-011-1044-7 · 3.01 Impact Factor
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    ABSTRACT: Septic shock is the leading causes of death in intensive care units. In addition to generous fluid administration, inotropic agents are commonly used to improve cardiac output. The effects of inotropic agents on regional blood flow remains unknown. The aim of this study was to assess the effects of levosimendan vs dobutamine added to dopamine on liver functions assessed using noninvasive liver function monitoring (LiMON) in patients with septic shock. Prospective analysis. We analyzed 30 patients with septic shock who were treated in an intensive care unit. Indocyanine green plasma disappearance rate (ICG-PDR) was conducted concurrently using the LiMON system. A dose of 0.3 mg/kg ICG was given through a cubital fossa vein as a bolus. Statistical analysis showed that the variation of hemodynamic variables was different between groups. In our results, the increase in systolic blood pressure, diastolic blood pressure, and mean arterial pressure was significantly higher in levosimendan group than in dobutamine group (P < .05). There was a decrease in before- and after-infusion ICG-PDR values in dobutamine group (20.38 ± 4.83 vs 20.34 ± 5.30), and no statistical difference was detected (P = .649). There was an increase in before- and after-infusion ICG-PDR values in levosimendan group (18.70 ± 2.59 vs 21.65 ± 3.20), and a statistical difference was detected (P = .001). There was statistical difference between groups (P = .000). These results suggest that levosimendan added to dopamine improves systemic hemodynamics and increases splanchnic perfusion assessed using the user-friendly noninvasive bedside system LiMON in patients with septic shock compared with dobutamine.
    Journal of critical care 08/2011; 27(3):318.e1-6. DOI:10.1016/j.jcrc.2011.06.008 · 2.19 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the effect of epidural levobupivacaine on recovery from vecuronium-induced neuromuscular block. Ninety patients undergoing lower abdominal surgery were randomised into two groups after an epidural test dose: the epidural group (n = 45) received a bolus of 15 ml of 0.5% levobupivacaine whereas the control group (n = 45) did not. Anaesthesia was induced and maintained with propofol, fentanyl, vecuronium and nitrous oxide. Neuromuscular block was induced with vecuronium 0.1 mg/kg and monitored with acceleromyographic train-of-four at the adductor pollicis. Patients in each group received neostigmine at 25% recovery of the first twitch of train-of-four during recovery from anaesthesia. The effect of epidural levobupivacaine on the speed of recovery of neuromuscular function was evaluated. The lag time, onset time and time from vecuronium administration until 25% T1 recovery did not differ between the groups. The times of the recovery index (the time from 25% to 75% recovery of T1) and of the DUR 25-train-of-four 90 (time from 25% T1 to train-of-four ratio of 0.9) in the epidural group were significantly longer than those for the control group (5.2 [2.1] vs 3.04 [1.02] minutes and 10.8 [3.3] vs 8.2 [2.3] minutes, P < 0.001). This study shows that epidural levobupivacaine significantly delays the train-of-four recovery from vecuronium-induced block. Although the interaction is small in the clinical setting, anaesthetists should take this interaction into consideration when combining general and epidural anaesthesia during surgery.
    Anaesthesia and intensive care 07/2011; 39(4):607-10. · 1.47 Impact Factor

Publication Stats

687 Citations
189.94 Total Impact Points


  • 2003–2014
    • Trakya University
      • • Department of Obstetrics and Gynecology
      • • Department of Medical Biology
      Adrianoupolis, Edirne, Turkey
  • 2005–2012
    • Istanbul University
      • Department of Family Medicine (Cerrahpasa Faculty of Medicine)
      İstanbul, Istanbul, Turkey