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Öğe Body mass index as a determinant of postoperative morbidity(Cardiology Academic Press, 2013) Gurkan, Selami; Gur, Ozcan; Gur, Demet Ozkaramanli; Ege, Turan; Canbaz, Suat; Iscan, SahinBACKGROUND: The impact of obesity on postoperative mortality and morbidity in coronary artery bypass grafting (CABG) operations is a widely studied but poorly defined topic. OBJECTIVE: To investigate the effect of body mass index (BMI) on in-hospital mortality and morbidity after isolated CABG surgery. METHODS: Prospectively collected data of a series of 1057 consecutive patients who underwent on-pump isolated CABG surgery were retrospectively analyzed. Patients were divided into five groups according to WHO BMI categorization (defined as underweight [BMI <20 kg/m(2)]; normal weight [BMI >= 20 kg/m(2) to <25 kg/m(2)]; overweight [BMI >= 25 kg/m(2) to <30 kg/m(2)]; obese, [BMI >= 30 kg/m(2) to <35 kg/m(2)]; and morbidly obese, [BMI >= 35 kg/m(2)]). RESULTS: Of 1057 patients, 13 patients (1.2%) were underweight, 298 (28.2%) were normal weight, 462 (43.7%) were overweight, 218 (20.6%) were obese and 66 (6.2%) were morbidly obese. The mean age was significantly lower in underweight patients, who were also more likely to be male. In contrast, obese and morbidly obese patients were older, and more likely to have comorbidities such as diabetes and hypertension. The incidence of postoperative bronchodilator use (P<0.001), leg wound infection (P=0.038), sternal dehiscence (P=0.039) and development of new-onset atrial fibrillation (P<0.001) was significantly higher in obese and morbidly obese groups. In contrast, postoperative prolonged ventilation (P<0.001), need for blood transfusions (P<0.001) and revision for bleeding (P=0.041), as well as gastrointestinal complications (P<0.001), were significantly higher in underweight patients. Multivariate logistic regression analysis showed that not BMI but female sex, older age and diabetes mellitis were independent risk factors for early mortality after CABG surgery. CONCLUSION: No effect of BMI on early postoperative mortality after CABG surgery could be demonstrated. However, in terms of morbidity, postoperative bleeding and revision for bleeding were increased in underweight patients while sternal dehiscence, wound infections and occurrence of atrial fibrillation were increased in obese and morbidly obese patients.Öğe The effects of sildenafil and n-acetylcysteine on ischemia and reperfusion injury in gastrocnemius muscle and femoral artery endothelium(Sage Publications Ltd, 2015) Aksu, Volkan; Yuksel, Volkan; Chousein, Serchat; Tastekin, Ebru; Iscan, Sahin; Sagiroglu, Gonul; Canbaz, SuatPurpose We aimed to examine the effects of sildenafil and n-acetylcystein on ischemia/reperfusion injury in femoral artery endothelium and gastrocnemius muscle. Basic methods 32 rats of Sprague-Dawley breed were randomly divided into four groups (n=8). Median laparotomy was performed, then a 120-minute ischemia was created by microvascular clamping of infrarenal aorta, followed by the release of clamping. In sildenafil group, 1mg/kg of sildenafil infusion and in the n-acetylcystein group, 100mg/kg of n-acetylcystein infusion was administered after release of clamps. Blood samples and tissue samples of femoral artery and gastrocnemius muscle were extracted for a histopathological evaluation. Principal findings Serum levels of malondialdehyde in ischemia/reperfusion group (6.160.79) were higher compared to the control group (4.69 +/- 0.33), whereas a significant decrease was detected in sildenafil (5.17 +/- 0.50) and n-acetylcystein (4.96 +/- 0.49) groups. Femoral artery tissue sections of the control group, mean tumor necrosis factor alpha and hypoxy-induced factor-1 alpha immunoreactivity were found to be negative. In the ischemia/reperfusion group, mean tumor necrosis factor immunoreactivity was intense and mean hypoxy-induced factor-1 alpha immunoreactivity was 51-75%. In the ischemia/reperfusion+Sildenafil and ischemia/reperfusion+NAS groups, mean tumor necrosis factor immunoreactivity was slight and mean hypoxy-induced factor-1 alpha immunoreactivity was 26-50%. Conclusions In conclusion, sildenafil and n-acetylcystein may reduce femoral artery endothelium and gastrocnemius muscle injury following lower extremity ischemia/reperfusion.Öğe An experimental model of aortic surgery and the effect of Iloprost on lung injury(Informa Healthcare, 2013) Iscan, Sahin; Huseyin, Serhat; Ozdemir, A. Coskun; Yalta, Tulin; Yuksel, Volkan; Aksu, Volkan; Ege, TuranObjectives. Ischemia/reperfusion (I/R) damage of the lung is a frequently encountered complication following aortic surgery. The aim of the present study is to investigate the histopathological effects of Iloprost on pulmonary damage developed after I/R. Design. Twenty-four Sprague-Dawley rats were randomly divided into 3 groups. In the control group, aortas were not clamped. In the I/R group, aortas were occluded, and after 1 h of ischemia, clamps were removed. After 2 h of reperfusion period, lungs of the rats were extracted. In the I/R + Iloprost group after 1 h of ischemia, Iloprost infusion was initiated, and maintained for the duration of 2 h reperfusion period. For histopathological scoring, density of polymorphonuclear leucocytes, congestion, interstitial edema, and bleeding were semiquantitatively evaluated, and histopathological changes were scored. Results. In the I/R group, multifocal-marked histopathological changes in 5 (62.5%), and multifocal-moderate histopathological changes in 3 (37.5%) rats were detected. In the I/R + Iloprost group, multifocal-moderate histopathological changes in 4 (50%), and multifocal-mild changes in 4 (50%) rats were detected. Conclusions. In the experimental rat model, administration of Iloprost has been shown to have preventive effects for pulmonary damage occurring after I/R generated by infrarenal aortic occlusion.Öğe Graft Materials for Popliteal Artery Patch Plasty(Elsevier Science Inc, 2015) Iscan, Sahin; Cakir, Habib; Yurekli, Ismail; Guclu, Orkut; Huseyin, Serhat; Yuksel, Volkan[Abstract Not Available]Öğe The impact of body mass index on mortality and morbidity in patients undergoing isolated valve surgery(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Gur, Ozcan; Gurkan, Selami; Gur, Demet Ozkaramanli; Yuksel, Volkan; Huseyin, Serhat; Iscan, Sahin; Canbaz, SuatBackground: This study aims to investigate the impact of body mass index (BMI) on early mortality and morbidity in patients undergoing isolated valve surgery. Methods: Between January 2004 and December 2012, medical records of 196 patients (115 males, 81 females; mean age 62.0 years; range 28 to 81 years) who underwent isolated valve surgery in our clinic with prospective follow-up data were retrospectively analyzed. The patients were divided into three groups according to their BMI values. Group 1 consisted of patients with a BMI <25 kg/m(2), group 2 consisted of patients with a BMI of >= 25 kg/m(2) to <30 kg/m(2) and group 3 consisted of patients with a BMI of >= 30 kg/m(2). Obesity was defined as a BMI of >= 30 kg/m(2). Groups were compared in terms of morbidity parameters including bleeding, respiratory, renal, neurological and sternal complications and in-hospital mortality. Results: Increased BMI was associated with increased diabetes prevalence and use of bronchodilator. According to postoperative data, there was no significant difference in duration of extubation, postoperative renal functions, neurological complications such as stroke and transient ischemic attack, length of intensive care unit or hospital stay among three groups. Obese patients in group 3 had significantly higher rates of respiratory complications including re-intubation (p=0.011) and postoperative bronchodilator need (p=0.034), sternal dehiscence and sternal infections (p=0.023) and in-hospital mortality (p=0.021). The bleeding complications were significantly higher in group 1 (p=0.004). Conclusion: Our study results suggest that obesity results in increased 30-day mortality and several morbidity parameters such as respiratory and sternal complications in patients undergoing isolated valve surgery.Öğe PATIENTS WITH LUNG CANCER PRESENTING WITH ACUTE ARTERIAL OCCLUSION(Lippincott Williams & Wilkins, 2012) Ege, Turan; Huseyin, Serhat; Yuksel, Volkan; Iscan, Sahin; Gur, Ozcan; Gurkan, Selami; Canbaz, Suat[Abstract Not Available]
