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Öğe A bibliometric analysis of publications on trauma in critical care medicine during 1980–2018: A holistic view(Turkish Association of Trauma and Emergency Surgery, 2020) Karaca, Onur; Güldoğan, Cem EmirBACKGROUND: There is not a holistic bibliometric study evaluating the publications in the literature even though trauma is a paramount subject in the field of critical care. This study aimed to investigate the important articles and journals receiving the most citations and publishing the most articles, revealing international cooperation and uncovering trend topics in this subject as a consequence of analyzing articles on trauma in the field of critical care published between 1980 and 2018 using bibliometric analysis methods. METHODS: Publication scan in this study was performed using Web of Science (WoS) database. Literature review was limited to only publications indexed in the field of Critical Care. “Trauma” was used as the keyword to reach relevant publications. Linear regression analysis was performed to predict the number of articles foreseen to be published in the upcoming years in the subject of trauma. RESULTS: As a result of the literature review, a total of 10851 publications were found. Six thousand four hundred and eighty-nine (59.8%) of these publications were under the category of article. First three countries with the most publications were respectively as the United States of America (4096) (63.1%), Canada (401) and Germany (380). Turkey ranked 21 with 41 publications. The article titled “Evaluating trauma care-the triss method” published in 1987 had received the most citations. The journal with the most publications and citations was “Journal of Trauma Injury Infection and Critical Care”. CONCLUSION: This study will be a useful guide to all scientists and clinicians conducting research on trauma in critical care.Öğe A bibliometric analysis of the field of anesthesia during 2009?2018(Elsevier Editora Ltd., 2020) Doğan, Güvenç; Karaca, OnurObjective: The limited number of bibliometric studies in the literature have generally focused on the top-cited studies in the field of anesthesia, however, there is a lack of studies that made a holistic bibliometric evaluation of these works. The purpose of this study is to make a contemporary summary of the articles published in the field of anesthesia within the last 10 years through detailed bibliometric methods. Methods: The articles published between the years 2009 and 2018 were downloaded from the Web of Science (WoS) database and analyzed using bibliometric methods. The literature review was conducted using the keyword “Anesthesiology” in the “Research Area” category via the advanced search option available in WoS. The relation between the number of publications of the countries and the Gross Domestic Products and Human Development Index values were analyzed using Spearman's correlation coefficient. The number of articles between the years 2019 and 2021 was estimated through linear regression analysis. Results: A review of the literature indicated 41,003 articles in the Web of Science database. Estimations included 4,910 (3,971-5,849) articles for the year 2019. There was a high-level, positive significant correlation between the number of publications and Gross Domestic Product (r = 0.776, p < 0.001). Conclusion: The findings show that countries with high income are effective in the field of anesthesia, which indicates a strong association between research productivity and economic development. Undeveloped and developing countries should be encouraged to conduct research in the field of anesthesia.Öğe Acupuncture treatment in patients with chronic subjective tinnitus: A prospective, randomized study(Mary Ann Liebert, Inc., 2020) Kuzucu, İhsan; Karaca, OnurObjective: This study investigated the effect, onset, duration of action, and short-term outcomes of acupuncture therapy for treating patients with severe chronic subjective tinnitus. Materials and Methods: This randomized controlled trial evaluated patients with chronic, idiopathic, and severe tinnitus. A total of 105 participants were divided into 2 groups using a randomization method: a study group who received verum acupuncture therapy (n = 53) and a sham acupuncture group (n = 52). Ten acupuncture sessions were given over 5 weeks. After treatment, each participant was monitored for up to 3 months according to changes on a visual analogue Scale (VAS), and Tinnitus Handicap Inventory (THI), and Pure-Tone Audiometry and Speech Discrimination (Interacoustics AC-40, Denmark) scores. Results: The VAS and THI scores were evaluated. A statistically significant difference was noted between the sham and verum acupuncture groups at post-treatment follow-up (P < 0.001). Decreases in the THI and VAS scores became significant in the second week of treatment (P < 0.001 and P < 0.001, respectively), but these scores increased again in the third month post-treatment (P < 0.001 and P < 0.001, respectively). Conclusions: Acupuncture is an effective treatment for patients with severe chronic subjective tinnitus. Patient complaints, decreased beginning at the second treatment week; however, in the third post-treatment month, the complaints reappeared. Maintenance acupuncture therapy is necessary for patients with tinnitus; this approach should be investigated in future studies.Öğe Antidotlar(Aksaray Üniversitesi, 2020) Karaca, Onurİnsanoğlu günlük yaşamında yüzlerce binlerce kimyasal maddeye veya biyolojik etkene, başta diyet yoluyla olmak üzere tıbbi, çevresel, mesleki nedenlerlebilerek veya bilmeyerek akut veya kronik zehirlenmeye neden olabilecek pek çokajana maruz kalır. Toksisite oluşumunda doz, temas süresi, temas yolu ve temassıklığı son derece önemlidir. Evlerde yaygın olarak bulunabilen analjezikler, soğuk algınlığı ilaçları, antibiyotikler, vitaminler, antihistaminikler, antidepresanlar, demir preparatları gibi ilaçlar, temizlik malzemeleri (örn. çamaşır suyu), kozmetik ürünler (örn. kremler, tırnak bakım ürünleri, tıraş losyonları) ve bitkiler,pestisidler ve daha birçok amaçlı ksenobiyotik zehirlenmeye neden olabilecek etkenlere örnek olarak verilebilir [1,2]. Meydana gelebilecek her akut zehirlenme nin tedavisi hızlı ve etkin bir şekilde yapılmalıdır. Herzaman için tedavide ilk amaç hayati fonksiyonların devam ettirilmesidir. İkinci adım zehirlenme etkeninin absorpsiyonunun önlenmesi ve eliminasyonunun artırılmasıdır. Devamında da etki yerinde oluşmuş toksik etki minimuma indirilerek tedavi yapılmasıdır.Öğe Can Neutrophil-to-Lymphocyte or Platelet-to-Lymphocyte ratio be used to predict postoperative Nausea and Vomiting in breast reduction?(Cureus, 2020) Karaca, Onur; Doğan, GüvençPostoperative nausea and vomiting (PONV) is one of the most frequently seen complications in the postoperative period. In several studies, the neutrophil-lymphocyte ratio (NLR) or the thrombocyte-lymphocyte ratio (PLR) has been suggested as a parameter to be used in the diagnosis of inflammatory diseases. However, the literature provides no information about this relationship for breast reduction. This study aims to investigate whether preoperative NLR or PLR was an indicator of PONV and identify its relationship with antiemetic use. Methods In this study, hemogram values and antiemetic amounts taken within 24 hours were obtained retrospectively by scanning the files of the patients received breast reduction diagnosis and operation. The confounder effect was controlled using the Propensity Score Matching analysis to distribute the case-control groups similarly. The Receiver Operating Characteristic (ROC) analysis was used to determine whether NLR and PLR could be a prognostic indicator for PONV prediction. Sensitivity and specificity values were calculated after the ROC analysis to determine the success of the cut-off points. Results The success of NLR and PLR in discriminating PONV was found to be statistically significant (cut-off: 1.97, area under the curve (AUC)=0.697, p=0.001, cut-off: 137.2, AUC=0.743; p<0.001, respectively). In addition, the sensitivity of PLR (77.8%) in discriminating PONV was found to be higher in comparison to NLR (73.3%). Conclusions One of the factors decreasing patient care quality and satisfaction is PONV. The results of this study showed that preoperative NLR and PLR could be taken into consideration in antiemetic use required for the prevention of postoperative nausea-vomiting in breast-reduction operations.Öğe Effects of modic type 1 changes in the vertebrae on low back pain(Elsevier Science Inc, 2019) Hanımoğlu, Hakan; Çevik, Serdar; Yılmaz, Hakan; Kaplan, Atilla; Çalış, Fatih; Katar, Salim; Evran, Şevket; Karaca, OnurOBJECTIVE: The present study examined the physical extent of Modic type 1 (MT1) changes and other phenotypic magnetic resonance imaging (MRI) findings in the vertebrae of patients with low back pain (LBP) and MT1 changes. We also identified any correlations of these findings with the severity of pain and the Oswestry Disability Index (ODI). The relationship between the presence of pain and MT1 changes has been examined in several studies. However, to the best of our knowledge, no study has assessed the relationships between pain severity and ODI and the total vertebral area of MT1 involvement. METHODS: After excluding any patient with MT2 or MT3 changes, 49 patients with a diagnosis of LBP and MT1 changes demonstrated on MRI were included. MT1 involvement area, disc height, number of Schmorl's nodes, disc degeneration (Pfirrmann grade), and cross-sectional area of the lumbar muscles were obtained via MRI. Additionally, patient demographic data, body mass index, physical activity level, and disability (ODI) scores were assessed. RESULTS: The total vertebral area of MT1 involvement correlated significantly and positively with the ODI (P = 0.001). In the multivariate linear regression model, with ODI as the dependent variable and age, mean Pfirrmann grade, total vertebral area of MT1 involvement, and sex as independent variables, only the total vertebral area of MT1 involvement was significantly associated with the ODI. CONCLUSIONS: A significant positive correlation was noted between the vertebral MT1 involvement extent and changes in the ODI. Other MRI features of patients with LBP were not related to pain severity or ODI.Öğe Effects of Pelargonium sidoides (UMCA ®) on pulmonary contusion from blunt thoracic trauma in rats(İnönü Üniversitesi, 2020) Doğan, Gül; Doğan, Güvenç; Karaca, Onur; Ayaz, ErcanAim: The aim of the present study was to evaluate the effect of Pelargonium sidoides (UMCA ®) which was antibacterial, antiviral, anti-inflammatory and antioxidant, on pulmonary contusion (PC) caused by isolated blunt thoracic trauma (BTT) in an experimental rat model. Material and Methods: A total of 24 rats were divided into three groups: control group (CG), sham group (SG), and Pelargonium sidoidesgroup (PSG). PC was induced by isolated BTT for all the groups except the control group. Pelargonium sidoidestreatment was performed by gavage for 72 hours to the PSG after truma. Blood and tissue samples were collected from the groups. Malondialdehyde (MDA), superoxide dismutase (SOD),glutathione (GSH) and arterial blood gas parameters were measured. Lung tissue samples were collected for histopathology. Results: Histopathologically, alveolar congestion, hemorrhage,edema,disruption and neutrophil infiltrationwere significantly higher in SG when compared with CG(p<0.001, p=0.007, p=0.040, p=0.003, p=0.001). Leukocyte infiltration was significantly decreased in PSG when compared with SG (p=0.025). Biochemically, MDA level was significantly higher in SG than in CG (p<0.001) and GSH level was significantly lower in SG than in CG (p<0.001). MDA level was significantly lower in PSG than in SG (p=0.002). In blood gas parameters PH and PO2 level was significantly higher in PSG than in SG (p=0.013, p<0.001) and PCO2 level was significantly lower in PSG than in SG (p<0.001). Conclusion: PS prevents further injury by decreasing leukocyte infiltration,MDAand regulating ventilation -perfusion in lung contusions. PS may have a role in the progression of inflammation but not in preventing the pathologic disruption of pulmonary parenchyma exactly.Öğe Epidemiology of Self-poisoning with drug in the central anatolian region in Turkey(Cureus, 2020) Karaca, Onur; Ertaşkın, AyşegülAim: Deliberate self-poisoning (DSP) is a common cause of intensive care hospitalization among young adults and a serious health problem worldwide. Demographic data vary according to geographical and sociocultural characteristics of the regions. In recent years, studies investigating epidemiological features and prognosis of these patients have increased. In our study, we retrospectively examined patients who committed suicide with drugs and were treated in the ICU of our hospital. Materials and Methods: The files of 148 patients who took drugs or substances for committing suicide and who were hospitalized in the ICU of Aksaray Training and Research Hospital between 2015 and 2019 were examined. Demographic data of the patients, type of the agent used in the suicide, time to reach hospital, treatment methods applied, length of hospital stay, vital signs, complications, need for intubation, and mortality rates were recorded. Results: Mean age of the 148 patients who took drugs for suicide was 26.7. Female rate was 73%. The most frequently used drug for suicide was paracetamol (34.4%). Antidepressants took the second place and were followed by drugs in the NSAID group. The duration of admission in the hospital after taking the medicine ranged from 1 to 6 h, while it was less than 3 h in 68.2% of the patients. In most suicide patients, the treatment method was in the form of intravenous fluid and supportive therapy (95%). N-acetyl cysteine (paracetamol intoxication) was used in 7% of the patients, an intubation requirement developed in 2.7%, and three patients taking organophosphate died. Conclusion: In studies conducted in developing countries such as Turkey, female sex (63%-71%) and 25 years of age have been found to be the proportion of the patients (56%-63%), whereas our study found even higher ratios compared to those (73%-66%). In studies conducted in developed countries, most commonly used agents for suicide were benzodiazepines and tricyclic antidepressants, while the most common suicide agent was paracetamol in our study. We believe that the reason for this could be the possibility of accessing the agent without a prescription.Öğe Evaluation of neuroprotective effect of sevoflurane in acute traumatic brain injury: An experimental study in rats(Turkish Neurosurgical Society / Türk Nöroşirürji Derneği, 2020) Doğan, Güvenç; Karaca, OnurAIM: To examine the effect of sevoflurane, a halogenated anesthetic used in clinical applications, on oxidative stress and inflammation after an acute traumatic brain injury (TBI) in rats. MATERIAL and METHODS: Thirty male Sprague-Dawley rats were divided into three groups: control (Group 1), trauma (Group 2), and trauma+sevoflurane (Group 3). A diffuse TBI model was created for Groups 2 and 3. Sevoflurane anesthesia was applied 6 hours a day after induced trauma in Group 3. Glutathione (GSH), malondialdehyde (MDA), and tissue myeloperoxidase (MPO) activities were measured in the blood. Tumor necrosis factor alpha (TNF-alpha), vascular endothelial growth factor (VEGF), and Bax primary antibodies were used to determine the effects of TBI. RESULTS: MDA was significantly higher in Group 2 than in Group 1. There was a significant increase in tissue MPO levels in Groups 2 and 3 compared with those in Group 1. GSH levels decreased in Groups 2 and 3. Group 3 revealed degenerative changes in neurons and glial cells, vascular enlargement and congestion, and inflammatory cell infiltration around blood vessels. In Group 3, VEGF expression was positive in endothelial and inflammatory cells around blood vessels. Group 3 had positive TNF-alpha expression in neurons, small granular cells, and glial cells around blood vessels.Öğe Evaluation of risk factors and comorbities of the orthopedic patients treated in intensive care unit(Editore Carbone, 2019) Cihangir, Doğu; Mutlu, Nevzai Mehmet; Turan, Sualp; Karaca, Onur; Kayır, Selçuk; Turan, Işıl ÖzkoçakIntroduction: The aim of this study is to investigate the comorbidities of orthopedic patients followed up in intensive care unit and to investigate the comorbid relationship of complications requiring intensive care. Material and methods: Ankara Numune Research Hospital Intensive care patients over the age of 18 admitted from the operating room and from orthopedic service were reviewed retrospectively between January 2010-December 2014. Results: 69 males and 98 females were postoperative patients in a total of 283 patients.28% of these patients were trauma patients and 62.3% were accepted after total hip prosthesis operations.The average age of postoperatively accepted patients was 73.5 years and preoperative was 61.5 years.The mean APACHE II score was similar.21% of postoperative patients have chronic obstructive pulmonary disease (COPD),while 18% of those without surgery had COPD(p=0.024).The need of close monitoring for intensive care admission was 62% in preoperative patients and 47% in postoperative patients(p=0.014).Symptomatic electrolyte imbalance was higher in preoperativ patients(p=0.027). The rate of vasopressors required hypotension was 11% in postoperative patients and 3% in non-operated patients (p=0.021).Charlson scores of postoperative patients were higher than those without surgery (p=0.001). Conclusion: Orthopedic patients who have high risk factors and comorbidities, we think that the consultation of the relevant branches and the initiation of treatment follow-ups in the early period may be useful in preventing intensive care requirement in the preoperative period.Öğe N-methyl-D-aspartate receptor antagonists may ameliorate spinal cord injury by inhibiting oxidative stress: An experimental study in rats(Turkish Neurosurgical Society / Türk Nöroşirürji Derneği, 2020) Doğan, Güvenç; Karaca, OnurAIM: To investigate the neuroprotective effect of a N-methyl-D-aspartate (NM DA) receptor antagonist (amantadine) in an experimental spinal cord injury (SCI) model. MATERIAL and METHODS: Thirty male Sprague-Dawley rats were divided into three groups: control (I), SCI (II), and SCI + amantadine (III). SCI was created using clip compression technique. At the end of day 7, blood samples were obtained from the rats and analyzed using various biochemical markers. Histological examination was also performed. MDA, GSH, and MPO assays were done. VEGF, TNF-alpha, and Baxexpressions were also analyzed. RESULTS: The group III had several inflammatory cells in the gray and white matter, with mildly degenerated multipolar and bipolar cells. Some bipolar and multipolar neurons showed TNF-alpha expression; however, TNF-alpha was found to be weak in small groups of inflammatory cells around the blood vessels in the substantia grisea and alba. Positive Bax expression was observed in the substantia grisea layer, particularly in the membrane of some bipolar neurons and glial cells; however, negative Bax expression was observed in neuron and glial cells and showed positive VEGF expression in the vascular endothelium in the group III. CONCLUSION: NMDA receptor antagonists, especially amantadine, may ameliorate SCI by inducing angiogenesis, affecting inflammation and apoptosis. It inhibits oxidative stress and the signaling pathways following SCI in rats.Öğe The accurate identification of the percutaneous tracheostomy insertion site using digital palpation in children(NLM (Medline), 2023) Kılıçaslan, Cengizhan; Güran, Ekin; Karaca, OnurPercutaneous tracheostomy (PT) may be required frequently in long-term ventilated intensive care patients. Although the overall risks are low, serious complications may occur, especially in children. Hence, this study aimed to assess physician accuracy in identifying PT insertion sites by digital palpation in children aged between 5 and 13 years. METHODS: Participants were asked to identify the needle entry point (interspace between 2nd and 3rd or 3rd and 4th tracheal rings) for PT using digital palpation. Then, a single operator scanned the neck of each child with a linear high-frequency transducer. An accurate estimation was defined as a mark made between the upper and lower borders of the tracheal rings within the midline. RESULTS: In the study including 104 patients, the PT insertion site was accurately identified with digital palpation in a total of 50.9% of patients, compared with sonographic findings.Öğe The effect of demographic characteristics on anxiety and hemodynamic response during intubation in patients undergoing septoplasty(Annals of Medical Research, 2020) Karaca, Onur; Kuzucu, İhsanAim: To investigate whether the demographic characteristics of patients scheduled for septoplasty had an effect on their trait and preoperative state anxiety and hemodynamic response caused by endotracheal intubation. Material and Methods: In our prospective observational study, after the demographic characteristics of the patients were recorded, the State-Trait Anxiety Inventory (STAI) was administered three times to measure preoperative trait (STAI-1), preoperative state (STAI-2) and postoperative state (STAI-3) anxiety. The preoperative basal hemodynamic parameters were noted. The percentage changes in the hemodynamic responses of the patients during intubation (systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure) were evaluated. The relationship between the severity of anxiety and hemodynamic changes was investigated. Results: Preoperative state anxiety was present in 85% of the patients (STAI-2?50). The mean STAI-1 score was found to be statistically significantly lower in men (42.81) than in women (45.46) (p=0.005). The mean STAI-2 score, showing preoperative state anxiety, was statistically significantly lower in males (53.89) than in females (57.72) (p=0.001). The mean STAI-2 score was 58.05 in patients aged 45 and over and 54.15 in those under 45 years (p<0.001). In addition, the percentage changes in hemodynamic response were significantly higher in the group aged 45 and over (systolic arterial pressure: 16.32 mm-Hg, diastolic arterial pressure: 23.88 mm-Hg, mean arterial pressure: 20.34 mm-Hg) (p<0.001). Conclusion: In this study, we observed that preoperative state anxiety was more prevalent in elderly and female patients, and the vital changes during endotracheal intubation were seen at a higher rate in elderly patients.Öğe The effects of dexmedetomidine in increased intestinal permeability after traumatic brain injury: An experimental study(Turkish Association of Trauma and Emergency Surgery, 2020) Karaca, Onur; Doğan, GüvençBACKGROUND: This study aims to investigate whether or not dexmedetomidine (DEX) application affects inflammation, increased intestinal mucosa damage and intestinal permeability in traumatic brain injury (TBI). METHODS: The rats included in our study were randomized into three groups as the control group (Group 1, n=10), trauma group (Group 2, n=10) and the trauma+dexmedetomidine group (Group 3, n=10). While trauma was not induced in the control group, head trauma was induced in all rats in Groups 2 and 3 with the same method. The rats in Group 3 additionally received the DEX application. Intestinal THF-a, serum TNF-a, IL-6, IL-1b and D-lactate levels were measured six hours post-trauma to assess systemic and local infection. Histopathological evaluation of the terminal ileum was performed at the 6th hour to assess mucosal damage. Intestinal permeability was evaluated by measuring the level of dextran injected into the 5-cm ileum segment adhered to the proximal and distal edges at the 30th minute in the blood taken by cardiac puncture. RESULTS: Intestinal TNF-a (p=0.003), serum TNF-a (p=0.009), IL-6 (p=0.002), IL-1b (p=0.001), and D-lactate levels measured in Group 3 (p=0.046) were significantly lower than those measured in Group 2. Dextran level measured in blood in Group 3 was observed significantly lower than that of Group 2 (p<0.001). Histopathological evaluation of the intestines revealed no injuries in the ileum of the rats in Group 1, injury in the ileum, villus atrophy and mucosal damage in the rats in Group 2, and a significant recovery was observed in Group 3 in comparison to Group 2. CONCLUSION: It was seen in our study that DEX reduced TBI-induced increased inflammation, intestinal mucosa damage and intestinal permeability. These results suggest that DEX may ameliorate the damage done to the intestinal tissue by modulating post-TBI inflammatory responses.
