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In this study, it was aimed to evaluate the use of multiplex real time polymerase chain reaction (RtPCR) method, directly from whole blood and blood culture bottles of intensive care unit patients with a pre-diagnosis of sepsis for the determination of the causative agent by comparing it with the conventional method. The study was carried out prospectively between November 2019 and August 2020. Ninety patients hospitalized with a pre-diagnosis of sepsis were included in the study. Samples were collected simultaneously with aseptic technique as whole blood and at least two sets of blood cultures. Blood culture bottles were monitored by the BACT/ALERT 3D (bioMerieux, France) instrument. Blood culture bottles were studied both by Sepsis Pathogens Panel Kit v1 (Anatolia, Turkey) using the multiplex Rt-PCR and with the conventional culture methods. The duration of detection and reporting of the multiplex Rt-PCR methods were compared with the conventional method. In this study, a total of 90 whole blood samples and 280 blood culture bottles were collected from the patients. It was found that 73 (81%) patients had already been administered antibiotic treatment at the time of blood sampling. Conventional blood culture was accepted as the gold standard in the diagnosis of sepsis. Rt-PCR performed from blood culture bottles was found to have a sensitivity of 89.58%; specificity of 57.14%; positive predictive value of 70.49%; negative predictive value of 82.76% and accuracy of 74.44% (p= 0.019). On the basis of the bacterial species, the sensitivity of the Rt-PCR method was determined to be between 66.7-100% and the specificity was between 86.6-100%. The Rt-PCR performed from whole blood, was found to have a sensitivity of 11.67% and a specificity of 96.67%; positive predictive value of 87.50%; negative predictive value of 35.37% and accuracy of 40% (p= 1.684). In this study, the duration of reporting of blood culture results was in average 116:50 hours, that of PCR from blood culture bottles was 80:57 hours, and that of PCR from whole blood samples was 15:38 hours (p0.001). It was determined that the PCR from whole blood shortened the reporting time by an average of 101:12 hours (approximately four days), and that the PCR from blood culture bottles shortened the reporting time by an average of 35:53 hours (1.5 days) compared to the conventional method. In this study, the results determined by the Sepsis Pathogens Panel Kit v1 (Anatolia, Turkey) performed from blood culture bottles were superior compared to the conventional method. It has been determined that improvement is required for the usage of the sepsis kit directly from whole blood. On the other hand, considering the species detected by the blood culture method and not by the assay, the species range detected by the multiplex assay panel needs to be improved.

Background/aim Dexmedetomidine (DEX) is an alpha-2 adrenergic agonist that is commonly used as a sedative and anesthetic. The protective effects of DEX against oxidative damage under both in vitro and in vivo conditions have been demonstrated. It was aimed to evaluate and compare the protective effects of DEX and vitamin C (Vit C) on DNA against H2O2-induced DNA damage in human lymphocyte cell cultures in vitro by alkaline Comet assay. Materials and methods Lymphocyte cell cultures were divided into 5 groups, as the negative control, solvent control, positive control, hydrogen peroxide (H2O2; 150 μM) + DEX (1 μM; 2.5 μM; 5 μM), and H2O2 (150 μM) + Vit C (1 μM; 2.5 μM; 5 μM), and incubated at 37 °C for 1 h. Cell viability was measured using the Trypan blue test. DNA damage was measured using the Alkali Comet Technique and the % percent tail intensity was evaluated. Statistical analysis was performed using 1-way ANOVA and the Tukey multiple comparison test. Results It was observed that H2O2 significantly induced DNA damage in the lymphocytes and this damage was decreased significantly with Vit C and DEX. It was observed that Vit C at doses of 1 μM and 2.5 μM had a significantly stronger antioxidant effect, but there was no significant difference between the antioxidant effects of Vit C and DEX with a dose of 5 μM. The dose of 5 μM DEX was found to be the most effective in reducing oxidative DNA damage. Conclusion There is limited data on the protective effects of DEX against oxidative DNA damage. The primary effect might be cytoprotection. The results herein showed that DEX was protective against H2O2-induced in vitro oxidative DNA damage in lymphocyte cell cultures in a dose-dependent manner. DEX might have a potential therapeutic value in the prevention of oxidative DNA damage in patients.

Introduction : The aim of this study is to compare the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in septic and non-septic intensive care patients. Material and methods : Fifty consecutive patients admitted to the intensive care unit (ICU) were enrolled in either the septic or non-septic group according to the criteria in the International Sepsis Definitions Conference in 2001. Demographic and clinical data, procalcitonin and lactate levels at admission, and death within 28 days were registered. Five blood samples were collected from all patients for NT-proBNP measurements. Results: Septic patients had higher APACHE II (19 (16.00–24.25) vs. 16 (13.00–18.25)), and SOFA (8 (5–10) vs. 6 (4–7)) scores (p

Background and objectives: Carbon monoxide is a toxic gas for humans and is still a silent killer in both developed and developing countries. The aim of this case series was to evaluate early radiological images as a predictor of subsequent neuropsychological sequelae, following carbon monoxide poisoning. Case 1: After carbon monoxide exposure, early computed tomography scans and magnetic resonance imaging findings of a 52-year-old woman showed bilateral lesions in the globus pallidus. This patient was discharged and followed for 90 days. The patient recovered without any neurological sequela. Case 2: In a 58-year-old woman exposed to carbon monoxide, computed tomography showed lesions in bilateral globus pallidus and periventricular white matter. Early magnetic resonance imaging revealed changes similar to that like in early tomography images. The patient recovered and was discharged from hospital. On the 27th day of exposure, the patient developed disorientation and memory impairment. Late magnetic resonance imaging showed diffuse hyperintensity in the cerebral white matter. Conclusion: White matter lesions which progress to demyelination and end up in neuropsychological sequelae cannot always be diagnosed by early computed tomography and magnetic resonance imaging in carbon monoxide poisoning. Resumo: Justificativa e objetivos: Monóxido de carbono é um gás tóxico para os seres humanos, além de ser um assassino silencioso em países tanto desenvolvidos quanto em desenvolvimento. O objetivo desta série de casos foi avaliar as imagens radiológicas iniciais como um preditivo de sequelas neuropsicológicas subsequentes após intoxicação por monóxido de carbono. Caso 1: Após exposição ao monóxido de carbono, os achados iniciais em tomografias computadorizadas e ressonâncias magnéticas de uma mulher de 52 anos de idade mostraram lesões em globo pálido bilateralmente. A paciente recebeu alta e foi acompanhada por 90 dias. A paciente se recuperou sem sequelas neurológicas. Caso 2: Paciente do sexo feminino, 58 anos de idade, exposta ao monóxido de carbono. A tomografia computadorizada mostrou lesões em globo pálido, bilateralmente, e substância branca periventricular. A ressonância magnética inicial revelou alterações semelhantes àquelas em tomografias precoces. A paciente se recuperou e recebeu alta. No vigésimo sétimo dia de exposição, a paciente evoluiu com desorientação e perda de memória. Ressonância magnética posterior mostrou hiperintensidade difusa da substância branca cerebral. Conclusão: As lesões da substância branca que progridem para desmielinização e resultam em sequelas neuropsicológicas nem sempre podem ser diagnosticadas em tomografias e ressonâncias iniciais em casos de intoxicação por monóxido de carbono. Keywords: Intensive care, Carbon monoxide, Imaging, Poisoning, Palavras-chave: Tratamento intensivo, Monóxido de carbono, Imagem, Intoxicação

Introduction The aim of this study was to evaluate intensive care unit (ICU) performance using risk-adjusted ICU mortality rates nationally, assessing patients who died or had been discharged from the ICU. For this purpose, this study analyzed the Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) databases, containing detailed clinical and physiological information and mortality of mixed critically ill patients in a medical ICU at secondary and tertiary referral ICUs in Turkey. Material and methods A total of 690 adult intensive care units in Turkey were included in the study. Among 690 ICUs evaluated, 39.7% were secondary and 60.3% were tertiary ICUs. A total of 4188 patients were enrolled in this study. Intensive care units of ministry, university, and private hospitals were evaluated all over Turkey. During the study period, clinical data that were collected concurrently for each patient contained demographic details and the diagnostic category leading to ICU admission. APACHE II and SOFA scores following ICU admission were calculated and recorded. Patients were followed up for outcome data until death or ICU discharge. Results The mean age of patients was 68.8 ±19 and 54% of them were male. The mean APACHE II score was 20 ±8.7. The ICUs' mortality rate was 46.3%, and mean predicted mortality was 37.2% for APACHE II. The standardized mortality ratio was 1.28 (95% confidence interval: 1.21-1.31). Conclusions There was a wide difference in outcome for patients admitted to different ICUs and severity of illness using risk adjustment methods. The high mortality rate in patients could be related to comorbid diseases, high mechanical ventilation rates and older ages.

Background: Individual differences in the activity of enzymes that metabolize xenobiotics can impact health and disease. Beta-2 adrenoreceptor (ADRB2) is a functional G-coupled protein expressed in the vascular endothelium of lungs, alveolar walls, and the ganglions of cholinergic nerves which induces bronchodilation in response to catecholamines. Glutathione S-Transferase-P1 (GSTP1) is a candidate pi class GST gene, which controls pi class glutathione S-transferase activity. Aims: In this study we determined the relationship between the ADRB2 Arg16Gly polymorphism and GSTP1 polymorphisms, involved in bronchodilator response and oxidative stress, respectively, with susceptibility to asthma. Methods: In this study, 129 asthmatic patients and 127 healthy control cases were recruited to determine ADRB2 and GSTP1 genotypes by allele-specific polymerase chain reaction and restriction fragment length polymorphism assays, respectively. Results: The ADRB2 genotype frequencies of the patients and control cases were found to be 10.9% (Arg16Arg), 48.8% (Arg16Gly), and 40.3% (Gly16Gly) and 24.4% (Arg16Arg), 36.2% (Arg16Gly), and 39.4% (Gly16Gly), respectively. GSTP1 genotype frequencies of patients and control cases were found to be 55% (Ile105Ile), 43.4% (Ile105Val), and 1.6% (Val105Val) and 75.6% (Ile105Ile), 22% (Ile105Val), and 2.4% (Val105Val), respectively. In the case of the GSTP1 gene, we found statistically significant differences in the genotype frequency of Ile105Val and the allele frequency of Val105 in the asthmatic group compared with the controls. Moreover, we observed a relationship between allele frequencies and clinical phenotypes including atopia nocturnal dyspnea, and steroid dependency in the asthmatic patients. Conclusion: Our results suggest that the GSTP1 Ile105Val polymorphism may be linked to the severeness of airway dysfunction.

This study was established to assess the effects of low dose enoxaparin on plasma malondialdehyde levels during laparoscopic cholecystectomy as a model of ischemia-reperfusion.Fifty patients, scheduled for laparoscopic cholecystectomy, were randomized into two groups of 25 patients in each. In enoxaparin group, patients had 20 mg/0.2 ml subcutaneous (sc) enoxaparin 2 hr before surgery. Blood samples were obtained for malondialdehyde, alanine transferase, aspartate transferase, measurements before the insufflation, 1 min before deflation, and 20 min after deflation.Plasma malondialdehyde concentrations were insignificant between enoxaparin and control groups before insufflation (1.64 ± 2.66 vs. 2.45 ± 4.42 μmol l(-1); p = 0.44) and 1 min before deflation (1.55 ± 2.61 vs. 3.66 ± 5.68 μmol l(-1); p = 0.38). Malondialdehyde levels significantly increased in control group 20 min after deflation in respect to enoxaparin group (1.52 ± 2.67 vs. 6.04 ± 7.85 μmol l(-1)), (p = 0.049). In control group, plasma malondialdehyde concentrations increased significantly compared with initial level throughout the study (p = 0.001). Within enoxaparin group, no statistically significant change was observed (p = 0.28). Plasma alanine transferase and aspartate transferase levels increased similarly in both groups during the study (p0.05). Alanine transferase and aspartate transferase increases within each group were statistically significant for all times (p0.05).As a conclusion, mini dose of enoxaparin used sc'ly 2 hr before the operation, prevented the malondialdehyde increase during reperfusion period after laparoscopic cholecystectomy without causing any bleeding disorder while having no effect on serum alanine transferase, aspartate transferase increase.

(Headache 2010;50:869-881) Epidural blood patch is an effective treatment with a low complication rate. It is also an invasive method that can cause permanent neurological sequelae such as early and late back pain, radiculopathy, spinal-subdural hematoma, spinal-epiarachnoid hematoma, intrathecal hematoma, arachnoiditis, and infection. We report a case in which a postdural puncture headache resolved within 2 minutes of a greater occipital nerve block, a minimally invasive and easy procedure with a low complication rate. This case report suggests that a greater occipital nerve block may be a successful alternative treatment for patients with post-dural puncture headache.

Sardas, Semra/0000-0001-5456-8636 WOS: 000259373300005 PubMed: 18784201 Sepsis and septic shock remains as leading cause of death in adult intensive care units. It is widely accepted that gram-negative bacteria and their endotoxins cause sepsis and septic shock, predominantly. Enhanced generation of reactive oxygen species may be responsible for tissue injury in septic shock and endotoxemia. The aim of this study was to assess oxidative DNA damage and the total antioxidant status (TAS) in peripheral lymphocytes of rats during different intraperitoneal gram-negative sepsis stages. Adult male Sprague-Dawley rats were divided randomly into four groups. Control group was intraperitoneally inoculated with 2 ml, of pyrogene-free saline (Group I, n = 6), and the other rats received an intraperitoneal inoculum with 2 ml, of saline containing 2 x 10(8) CFU of Escherichia coli. The animals were killed at time zero (Group 1, n = 6), at 6th (Group 11, n = 7), 12th (Group M, n = 7), and 24th (Group IV, n = 7) hour after the E. coli inoculation. Oxidative DNA damage in peripheral lymphocytes of rats was evaluated by modified comet assay (single-cell gel electrophoresis). Formamido-pyrimidine DNA glycosylase (Fpg) and Endonuclease III (Endo III) were used to detect oxidized purines and pyrimidines, respectively. Total antioxidant quantification was carried out using ABTS+ (2,2'-Azino-di-[3 ethyl-benzthiazoline sulphonate]) radical formation kinetics (Randox kit) in serum samples. Significant elevations of basal levels of strand breaks (SB) in Group IV were observed as compared with Group I, II, and III. There was a significant increase in Fpg sites in Group III as compared with Group I and II. However, there was no significant difference in terms of Endo III sites in any of the groups. Although the TAS was decreased with the stages of sepsis, this moderate decrease was significant in only Group IV as compared with Group I. There was no statistically significant correlation between DNA damage and TAS for any of the groups.

Batislam, Ertan/0000-0002-7493-4573 WOS: 000244914800038 PubMed: 17338610 Purpose: To assess whether intravenous magnesium sulfate infusion affects analgesic requirements during monitored anesthesia care (MAC) for shockwave lithotripsy (SWL). Patients and Methods: Fifty patients in ASA class I or II undergoing SWL with MAC were randomized into two groups. Induction of MAC was produced by bolus doses of midazolam 0.03 mg/kg(-1) and fentanyl 0.5 mu g/kg(-1) followed by intravenous infusion of midazolam 0.015 to 0.06 mg/kg(-1)/hr(-1) with fentanyl supplementation 0.2 mu g/kg(-1). In addition, group I patients received magnesium sulfate 30 mg/kg(-1) intravenously as a bolus dose followed by a continuous infusion of 10 mg/kg(-1) /hr(-1) beginning 15 minutes before induction of sedation. The midazolam infusion rate and additional fentanyl doses were adjusted by verbal analog scale (VAS) measurements, observer assessment sedation score (OAA/S), and achieving a target bispectral index (BIS) in a range of 70 to 90. At the end of SWL, the total midazolam and total fentanyl consumptions were recorded, and the serum magnesium concentration was measured. Results: Magnesium caused significant decreases in the total consumption of midazolam (P = 0.001) and fentanyl (P = 0.001). The VAS values at the 15th, 20th, and 25th minute in group I were significantly lower than in group II. In group I, hemodynamic and arterial oxygen parameters were better than in group II. Conclusion: A magnesium bolus and infusion can be utilized to reduce analgesic requirements under MAC during SWL.

Live kidney transplantation has several advantages than cadaveric-kidney transplantation and is still frequently performed. When assessed in terms of donor consent and religious concepts, there is a negative relationship between these terms and live kidney transplantation. However, there is little information about renal disease, social and psychological problems of donors after donation.

PubMed: 17132602 Pharmacogenetics is the study of genetic variations that cause a variable drug response characterized by alteration in drug metabolism or in pharmacodynamics. The polymorphisms in genes encoding receptors relevant to treatment cause variation in sensitivity to many drugs. ?2 Adrenoceptor genetic variation contributes to regulation of blood pressure and hemodynamic changes by mediating peripheral vasodilatation. Laryngoscopy and tracheal intubation associated with hemodynamic changes. Although there are four nonsynomic single-nucleotide polymorphisms (SNPs) of ?2 adrenoceptor gene, codon 16 (Arg16Gly) and codon 27 (Gln27Glu) SNPs are both common and functionally important. In this paper, the authors investigated the ?2 adrenoceptor Gly16 and Glu27 SNPs in response to drugs relevant to anesthesia and how these SNPs impacted upon the cardiovascular phenotypes. The authors measured arterial systolic and diastolic blood pressure, heart rate, and rate-pressure product before induction of anesthesia and 1 min following laryngoscopy and tracheal intubation. Genomic DNA was amplified and genotyped using allele-specific polymerase chain reaction (ASPCR) and restriction fragment length polymorphism (RFLP) assays, respectively. When the authors compared hemodynamic results according to genotypes, the patients with Gln homozygote allele at codon 27 exhibited significant increase of heart rate than patients with Glu allele after laryngoscope and tracheal intubation. Copyright © American College of Toxicology.

In this study, genotoxic activities of four halogenated anesthetics (halothane, isoflurane, sevoflurane and desflurane) were investigated in human peripheral blood lymphocytes (PBLs) and sperm cells in vitro by alkaline comet assay. For this purpose, sperm or lymphocyte suspension was exposed to different concentrations (0.1 mM, 1 mM, 10 mM and 100 mM) of anesthetic agents and 1% dimethyl sulfoxide (DMSO) or phosphate-buffered saline (PBS) as controls. The DNA strand breaks as well as alkali-labile sites were measured as percentage tail intensity with comet assay. The results of this study demonstrate that all analyzed drugs were capable of inducing DNA damage on PBLs in a dose-dependent manner in vitro. However, the results in sperm cells were slightly different since we did not observe any genotoxic effect for desflurane in any of the exposure doses, and the genotoxic effect of halothane was not dose dependent. This experimental study points out to the presence of DNA damage after exposure to halogenated anesthetics in both PBLs and sperm cells, although this effect seems to be higher in PBLs.

The potential mutagenic/carcinogenic action of waste anaesthetic gases and antineoplastic drugs in occupationally exposed human populations has been previously reported in several studies. Antineoplastic agents discovered in the first two decades of cancer therapy (1950 to 1970) largely interact with DNA or precursors, inhibiting the synthesis of DNA or causing irreparable damage to DNA itself. Considering the mechanisms of the antineoplastic drugs that are used, it is not surprising that many persons involved in health care, especially nurses, are worried about the health effects of these drugs. Experimental and epidemiological studies suggest that genotoxic effects can arise from inhalation anaesthetics. Due to their widespread use in operating rooms, there is a great concern that operating room personnel as well as patients might be at health risk from anaesthetics. The aim of the present study was to assess the possible genotoxic risk, by the alkaline comet assay, in the peripheral blood lymphocytes of nurses who are handling antineoplastic drugs or are exposed to waste anaesthetic gases.

WOS: 000253802900004 PubMed: 17892615 Background and objectives: The measurement of alpha-glutathione-S-transferase enzyme Is one of the most sensitive indicators of hepatocellular function. Variation in the glutathione-S-transferase PI gene clusters has been intensively investigated and polymorphism has been described. The aim of the study was to assess whether an association exists between glutathione-S-transferase P1 gene polymorphism and serum alpha-glutathione-S-transferase concentrations for the first postoperative day in patients who underwent anaesthesia with sevoflurane. Methods: In all, 54 unrelated patients were enrolled in this study. Anaesthesia was induced with thiopental and fentanyl. Vecuronium was used for neuromuscular relaxation before endotracheal intubation. Anaesthesia was maintained with sevoflurane in a gas mixture containing 50% nitrous oxide in oxygen. Peripheral venous blood samples to determine serum alpha-glutathione-S-transferase concentrations were collected before induction (T-1), at the end of anaesthesia (T-2) and at 24-h postoperatively (T-3). Enzyme-linked immunosorbent assay (ELISA) immunoassay was used to measure alpha-glutathione-S-transferase levels. Genomic DNA was isolated from serum samples using a genomic DNA purification kit. In order to detect the variants of glutathione-S-transferase P1, polymerase chain reaction - restriction fragment length polymorphism analysis was employed. Results: Early postoperative serum alpha-glutathione-S-transferase levels for all patients were significantly increased when compared with preanaesthetic and 24-h postoperatively (P < 0.05). Serum alpha-glutathione-S-transferase concentrations, in individuals with glutathione-S-transferase P1 Ile105Val genotypes (heterozygote gene), remained elevated at 24 h (P < 0.05), whereas levels in individuals with glutathione-S-transferase P1 Ile105Ile (wild gene) decreased (P > 0.05). Conclusions: Although alpha-glutathione-S-transferase levels were elevated in all patients after sevoflurane anaesthesia, levels remained high at 24 h in patients with glutathione-S-transferase P1 Ile105Val genotypes compared to controls.

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WOS: 000260134200006 PubMed: 18929283 Study Objectives: To investigate the hemodynamic, cardiovascular, and recovery effects of dexmedetomidine used as a single preanesthetic dose. Design: Randomized, prospective, double-blind study. Setting: University Hospital of Kirikkale, Kirikkale, Turkey. Patients: 40 ASA physical status I and II patients, aged 20 to 60 years, who were scheduled for elective cholecystectomy. Interventions: Patients were randomly divided into two groups to receive 0.5 mu g kg(-1) dexmedetomidine (group D, n = 20) or saline solution (group C, n = 20). Anesthesia was induced with thiopental sodium and vecuronium, and anesthesia was maintained with 4% to 6% desflurane. Measurements: Mean arterial pressure (MAP), heart rate (HR), (ejection fraction (EF), end-diastolic index (EDI), cardiac index (CI), and stroke volume index (SVI) were recorded at 10-minute intervals. The times for patients to "open eyes on verbal command" and postoperative Aldrete recovery scores were also recorded. Main Results: In group C, an increase in HR and MAP occurred after endotracheal intubation. In group D, HR significantly decreased after dexmedetomidine was given. The EDI, Cl, SVI, and EF values were similar in groups D and C. The modified Aldrete recovery scores of patients in the recovery room were similar in groups C and D at the 15th minute. Conclusions: A single dose of dexmedetomidine given before induction of anesthesia decreased thiopental requirements without serious hemodynamic effects or any effect on recovery time. Crown Copyright (C) 2008 Published by Elsevier Inc. All rights reserved.

Sardas, Semra/0000-0001-5456-8636 WOS: 000223054200006 PubMed: 15346723 In this study, genotoxic effects of repeated sevoflurane anaesthesia were investigated in rabbits with or without antioxidant supplementation. Twenty-one New Zealand male rabbits were included in the study and randomized into three groups as: placebo treated ( Group I), vitamin E supplemented ( Group II) and selenium supplemented ( Group III). Vitamin E and selenium were given intraperitoneally for 15 days before anaesthesia treatment. Anaesthesia was administered using 3% sevoflurane in 4 L/min oxygen for a 3-hour period and continued for 3 days. Blood samples were collected before anaesthesia ( Sample 1), after the first, second and third days of sevoflurane administration ( Sample 2, Sample 3 and Sample 4 respectively) and the last samples were taken 5 days after the last sevoflurane administration ( Sample 5). Genotoxic damage was examined using the comet assay. The degree of damage is assessed by grading the cells into three categories of no migration (NM), low migration (LM) and high migration (HM) depending on the fraction of DNA pulled out into the tail under the influence of the electric field. The number of comets in each sample was calculated ( 1 x number of comets in category NM + 2 x number of comets in category LM + 3 x number of comets in category HM) and expressed as the total comet score (TCS), which summarizes the damage frequencies. In Group I, a significant increase in the mean TCSs was observed for Samples 3 and 4 as compared with Sample 1. However, there were no significant differences between Samples 1, 2 and 5. The mean TCS of Sample 4 was significantly higher than Sample 1, 2 and 3 in Group II. Group III demonstrated no significant mean TCSs for any experimental conditions. Statistical differences were also observed between the groups with significant P values. This experimental study points out the presence of DNA damage with repeated sevoflurane anaesthesia and the genoprotective role of antioxidant supplementation on DNA damage in mononuclear leukocytes of rabbits by highly sensitive comet assay.

Cadaveric kidney transplantation is performed according to a patient list formed by matching and point score in our country. Demand for renal transplantation can not be met by the number of cadavers introduced to the system because of the increase in number of patients with chronic renal failure who require renal transplantation.

Tel.: +90 312 595 31 75 E-pos ta: namikozcan@gmail.com Gelis Tarihi/Received: 15.03.2012 Kabul Tarihi/Accepted: 19.04.2012 Amac: Calismada, enteral nutrisyona standart lifli ve lifsiz urunle baslanan ve devam edilen hastalarda gastrik reziduel volum (GRV) ve gastrointestinal komplikasyonlarin karsilastirilmasi amaclanmistir. Gerec ve Yontem: Yogun Bakim Unitesi’nde mekanik ventilasyon destegi altinda 10 gunden fazla kalmasi beklenen ve nazogastrik ile enteral yoldan beslenecek 60 hasta calismaya alindi. Hastalar randomize olarak iki gruba ayrildi. Lifsiz grup; standart izoosmolar (Osmolite, Abbott, Illinois, USA) urunle, Lifli grup; standart lifli izoosmolar urunle (Jevity, Zwolle, Holland) beslenmeye baslandi. Hedeflenen maksimum kalori degerine ulasmis hastalar 3 gun sure ile takip edildi. Her gun 3 kez GRV olculdu. Abdominal distansiyon, kusma, regurjitasyon, aspirasyon, ishal gibi komplikasyonlar kaydedildi. Bulgular: Hastalarin 3 gunluk izlemleri boyunca gruplarin GRV’leri arasinda anlamli istatistiksel farklilik bulunmamistir. Kusma, regurjitasyon ve distansiyon acisindan gruplar arasinda istatistiksel olarak anlamli farklilik gozlenmemistir. Hicbir hastada ishal ve aspirasyon gerceklesmemistir. Calisma suresince Lifli grupta 20 (%66,66), Lifsiz grupta 17 (%56,66) hastada en az 1 komplikasyon gozlenmistir. Gruplar arasi fark istatistiksel olarak anlamli degildir. Sonuc: Sonuc olarak enteral nutrisyona lif iceren veya icermeyen standart urunle baslanan ve devam edilen hastalarda GRV ve gastrointestinal komplikasyonlar acisindan istatistiksel fark bulunmamistir. (Turk Yo €un Ba k›m Der ne €i Der gi si 2012; 10: 46-51) Anah tar Ke li me ler: Enteral beslenme, kusma, respiratuar aspirasyon, komplikasyon OZET SUMMARY