Browsing by Author "Gucyetmez, Bulent"

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Base-excess chloride
(PUBLIC LIBRARY SCIENCE, 2021-01-01) Gucyetmez, Bulent; Tuzuner, Filiz; Atalan, Hakan Korkut; Sezerman, Ugur; Gucyetmez, Kaan; Telci, Lutfi
To practically determine the effect of chloride (Cl) on the acid-base status, four approaches are currently used: accepted ranges of serum Cl values
Brain MRI Findings in Patients in the Intensive Care Unit with COVID-19 Infection
(RADIOLOGICAL SOC NORTH AMERICA, 2020-01-01) Kandemirli, Sedat G.; Dogan, Lerzan; Sarikaya, Zeynep T.; Kara, Simay; Akinci, Canan; Kaya, Dilaver; Kaya, Yildiz; Yildirim, Duzgun; Tuzuner, Filiz; Yildirim, Mustafa S.; Ozluk, Enes; Gucyetmez, Bulent; Karaarslan, Ercan; Koyluoglu, Isil; Kaya, Hande S. Demirel; Mammadov, Orkhan; Ozdemir, Ilkay Kisa; Afsar, Nazire; Yalcinkaya, Beyza Citci; Rasimoglu, Sevdinaz; Guduk, Duygu E.; Jima, Ararso Kedir; Ilksoz, Aylin; Ersoz, Vildan; Eren, Meltem Yonca; Celtik, Nilufer; Arslan, Serdar; Korkmazer, Bora; Dincer, Saban S.; Gulek, Elif; Dikmen, Ibrahim; Yazici, Murathan; Unsal, Serkan; Ljama, Taner; Demirel, Ismail; Ayyildiz, Aykut; Kesimci, Isil; Deveci, Sahika Bolsoy; Tutuncu, Melih; Kizilkilic, Osman; Telci, Lutfi; Zengin, Rehile; Dincer, Alp; Akinci, Ibrahim O.; Kocer, Naci
C-Reactive Protein and Hemogram Parameters for the Non-Sepsis Systemic Inflammatory Response Syndrome and Sepsis: What Do They Mean?
(PUBLIC LIBRARY SCIENCE, 2016-01-01) Gucyetmez, Bulent; Atalan, Hakan K.
Objectives Sepsis is one of the most common reasons of increased mortality and morbidity in the intensive care unit. The changes in CRP levels and hemogram parameters and their combinations may help to distinguish sepsis from non-sepsis SIRS. The aim of this study is to investigate the CRP and hemogram parameters as an indicator of sepsis. Methods A total of 2777 patients admitted to the ICU of two centers between 2006-2013 were evaluated retrospectively. The patients were diagnosed as SIRS (-), non-sepsis SIRS and sepsis. The patients who were under 18 years old, re-admitted, diagnosed with hematological disease, on corticosteroid and immunosuppressive therapy, SIRS (-), culture negative, undocumented laboratory values and outcomes were excluded. 1257 patients were divided into 2 groups as non-sepsis SIRS and sepsis. The patients' demographic data, CRP levels, hemogram parameters, length of ICU stay and mortality were recorded. Results 1257 patients were categorized as non-sepsis SIRS (816, 64.9\%) and sepsis (441, 35.1\%). In the multivariate analysis, the likelihood of sepsis was increased 3.2 (2.2-4.6), 1.7 (1.22.4), 1.6 (1.2-2.1), 2.3 (1.4-3.8), 1.5 (1.1-2.1) times by the APACHE II >= 13, SOFA score >= 4, CRP >= 4.0, Lym(C)<0.45 and PLTC<150 respectively (p<0.001 p = 0.007 p = 0.004 p<0.001 p = 0.027). The likelihood of sepsis was increased 18.1 (8.4-38.7) times by the combination of CRP >= 4.0, lym(C)<0.45 and PLTC<150 (P<0.001). Conclusions While WBCC, NeuC, Neu\%, NLCR and Eo(C) are far from being the indicators to distinguish sepsis from non-sepsis SIRS, the combinations of CRP, Lym(C) and PLTC can be used to determine the likelihood of sepsis.
Chordoma: Immunohistochemical Analysis of Brachury
(TURKISH NEUROSURGICAL SOC, 2018-01-01) Sun, H. Ibrahim; Guduk, Mustafa; Gucyetmez, Bulent; Yapicier, Ozlem; Pamir, M. Necmettin
AIM: Chordomas are rare, slow growing but locally aggressive malignancies of the axial skeleton. Skull base chordomas, due to their intricate anatomical localization, pose significant challenges to managing physicians. In classical and chondroid chordomas, the disease course cannot be reliably determined using only morphological criteria. Brachyury (T Gene) was shown to play a central role in chordoma pathogenesis and several studies also showed that this gene also carries potential as a prognostic biomarker. This study aims to correlate Brachyury expression with the clinical course in surgically treated skull base chordomas. MATERIAL and METHODS: Chordoma tumor samples from 14 patients with skull base chordomas, diagnosed using histopathological and immunohistochemistry criteria (epithelial membrane antigen (EMA), S100, pan cytokeratin (panCK)) were retrospectively analyzed for Brachyury expression using immunohistochemistry. Brachyury expression was graded using a 4 point semi-quantitative scoring system. Focal (grade II) and diffuse staining (grade III) were considered as overexpression. Patient recurrence-free survival and total survival were compared between Brachyury overexpressing and non-overexpressing groups using Kaplan-Meier survival analysis. RESULTS: Among the stained tumor samples, 85.7\% were positive for brachyury expression. In both groups, there was one sample that was negative. We did not observe any significant difference among the groups for staining, grade and percentage of brachyury positive cells. CONCLUSION: Brachyury expression in tumor samples is not a sensitive indicator of prognosis in chordomas.
Elective Tracheotomy Practices in Turkey
(PUBLIC LIBRARY SCIENCE, 2016-01-01) Gucyetmez, Bulent; Atalan, Hakan Korkut; Cakar, Nahit; Grp, Turkish Tracheotomy Survey
Objectives Elective tracheotomy (ET) procedures in intensive care units (ICU) might be different in accordance with countries and ICUs' features. The aim of the present study was to search the epidemiology of ET procedures in Turkey. Methods A questionnaire which consists of 43 questions was sent by e-mail to 238 ICUs which were officially recognized by The Turkish Ministry of Health. All answers were obtained between August 1, 2015 and August 31, 2015. Results Two hundred and three ICUs (85.3\%) participated in this study. 177 (87.2\%) and 169 (83.4\%) of ICU's were level III and mixed ICUs respectively. Anesthesiologists were the director of 189 (93.0\%) ICUs. Estimated total count of admitted, mechanically ventilated and tracheotomized patients in 2014 were 126282, 80569 (63.8\%) and 8989 (7.1\%) respectively. Most common indication for ET was prolonged mechanical ventilation (76.9\%). The first choice for ET procedure was percutaneous in 162 (79.8\%) ICUs. Griggs guide wire dilatational forceps (GWDF) technique was used as the first choice for elective percutaneous tracheotomy (EPT) by 143 (70.4\%) ICUs. Most common early EPT complication was bleeding (68.0\%) and late EPT complication was stenosis (35.0\%). While facilitation of weaning was most important advantage (26.1\%), bleeding and tracheal complications were most important disadvantages for EPT (29.1\%). Conclusions Most common indications for ET are prolonged MV and coma in Turkish ICUs. EPT is the preferred procedure for ET and GWDF is the most common technique. Bronchoscopy and USG are rarely used as a guide.
Late presentation of posttraumatic pulmonary arteriovenous fistulea occlusion with septal occluder device
(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2013-01-01) Gucyetmez, Bulent; Salihoglu, Ece; Ayyildiz, Aykut; Saltik, Levent; Telci, Lutfi
Posttraumatic pulmonary arteriovenous fistula is a rare complication of penetrating injury. Cases may remain asymptomatic for years prior to diagnosis. We present a case of pulmonary arteriovenous fistula related to a penetrating injury of the thorax 6 years previously that was occluded with a septal occluder device. Consistent use of CT or conventional catheter pulmonary angiography following penetrating injury to the thorax is essential to the early diagnosis of pulmonary arteriovenous fistula during the asymptomatic stage. Modern occlude devices facilitate the transcatheter approach as a viable alternative to surgery for the closure large, high pressure defects.
Serum Vitamin D Level at ICU Admission and Mortality
(AVES, 2017-01-01) Atalan, Hakan Korkut; Gucyetmez, Bulent
Objective: Vitamin D is a fat-soluble vitamin that plays a major role in the regulation of bone and calcium metabolism and has effects on the immune and cardiovascular systems. Vitamin D deficiency is commonly seen in the general population as well as in critically ill patients and is reported to be associated with increased mortality and morbidity. Our aim was to determine the relationship between vitamin D level at ICU admission and mortality. Methods: A total of 491 patients admitted to the ICU between January 2014 and January 2015 were evaluated retrospectively. The patients who were under 18 years old, had elective surgery, or whose serum vitamin D levels and outcomes were unknown were excluded. The patient's age, gender, APACHE II score, number of organ dysfunction, serum vitamin D level at ICU admission and outcomes were recorded. Results: Vitamin D level was low (<25 ng dL(-1)) in 166 (77.1\%) of the patients. In non-survivor patients, APACHE II score and the number of organ dysfunction were significantly higher than the survivor patients (p<0.001 and p<0.001). There was a negative correlation between vitamin D level and APACHE II score (r(2)=0.04, p=0.006). In multivariate analyses, the likelihood of mortality was increased 9.8-fold (range 4.2-17.6) and 8.9-fold (range 3.9-14.1) with an APACHE II score >= 24 and the number of organ dysfunction >= 2, respectively (p<0.001 and p<0.001). Conclusion: Vitamin D deficiency is commonly seen in intensive care patients. Although it is not an independently decisive factor for mortality, it might be related with poor clinical status at ICU admission. The APACHE II score and number of organ dysfunction are still important parameters for increased mortality.
Therapeutic plasma exchange in patients with COVID-19 pneumonia in intensive care unit: a retrospective study
(BMC, 2020-01-01) Gucyetmez, Bulent; Atalan, Hakan Korkut; Sertdemir, Ibrahim; Cakir, Ulkem; Telci, Lutfi; Grp, Covid 19 Study