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Öğe Effects of acupuncture on pain and levels of IL-17 and IL-23 in the treatment of non-thermal endovenous ablation: A randomized clinical trial(Sage Publications Ltd, 2022) Orak, Yavuz; Eroglu, Erdinc; Baylan, Filiz Alkan; Yildiz, Sedat; Boran, Omer Faruk; Doganer, Adem; Altun, AhmetObjectives Acupuncture is one of the oldest therapeutic interventions in the world for the treatment of pain, musculoskeletal diseases, and inflammation. This study aimed to investigate the effect of acupuncture on pain and IL-17 and IL-23 levels in the treatment of endovenous ablation. Methods The study was a randomized controlled trial. Patients were divided into group C (Control, n = 35) and group A (Acupuncture, n = 35). Group A patients were treated with acupuncture 24 h preoperatively. Follow-up checkups were conducted intraoperatively, postoperatively, and on the third day. Results There was no difference between men; there was a difference between women. Visual analog scale score was lower in group A at the intraoperative third and fifth minutes (0.00 vs. 1 and 0.00 vs. 0.5). Analgesic consumption was lower in group A at the end of third day (p = 0.024). Postoperative IL-17 levels were higher than preoperative levels in group A (23.58 vs. 19.33). Postoperative IL-23 levels were lower than preoperative levels in group A (13.66 vs. 29.51). Group C showed increased postoperative IL-23 levels (28.81 vs. 33.51). Preoperative IL-17 and postoperative IL-23 levels were lower in group A than in group C (19.33 vs. 27.69 and 13.66 vs. 33.51). Although no difference was observed between group A and group C in preoperative saphenous vein diameter, postoperative saphenous vein diameter was smaller in group A (p = 0.008). Saphenous vein diameter was smaller on day 3 in group A than in group C (p = 0.043). Conclusion Acupuncture is effective on acute pain and level of IL-23 in the treatment of endovenous ablation using cyanoacrylate.Öğe Effects of Propofol versus Sevoflurane on Postoperative Pain and Neuroendocrine Stress Response in Oocyte Pickup Patients(Hindawi Ltd, 2021) Orak, Yavuz; Tolun, Fatma Inanc; Bakacak, Murat; Yaylali, Asli; Kiran, Hakan; oksuz, Hafize; Doganer, AdemBackground. Pain aggravates the autonomic response to stress and raises neuroendocrine stress hormone levels. We compared the effects of propofol and sevoflurane on postoperative pain and neuroendocrine stress hormones. A prospective, randomized, and controlled trial was conducted with 60 patients. Methods. We randomly allocated patients to groups P (remifentanil/propofol, n = 30) and S (remifentanil/sevoflurane, n = 30). Preoperative blood samples were taken to measure serum adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH), glucagon, cortisol, aldosterone, and prostaglandin E2 (PGE2) levels. Intraoperatively and postoperatively, clinical parameters were monitored at different time points. The hormone levels were again measured in the follicular fluid and blood postoperatively. Result. Demographic data were similar. The preoperative serum aldosterone levels were significantly higher in group P (p=0.001). Preoperative and postoperative serum ACTH, glucagon, cortisol, and PGE2 levels were significantly different in group P (p=0.009, p=0.004, p=0.029, and p=0.002); serum ACTH, glucagon, and PGE2 levels increased while serum cortisol levels decreased postoperatively. In group S, serum CRH and aldosterone levels, both increased in the postoperative period compared to the preoperative (p=0.001, p=0.006). Postoperatively, glucagon and PGE2 levels were both higher in group P than group S (p=0.019, p=0.015). In postoperative follicular fluid, glucagon and PGE2 levels were higher in group P, while cortisol levels were higher in group S (p=0.001, p=0.007, and p=0.001). Conclusion. The effects of anesthetic agents were different. In group P, in the preoperative and postoperative evaluation, ACTH, glucagon, and PGE2 increased postoperatively, while cortisol decreased. In group S, aldosterone and CRH increased postoperatively. Glucagon and PG E2 were higher in group P than S, postoperatively.Öğe Nöropatik ağrıda GABAerjik etkinliği modüle eden ilaçların ratlarda analjezik etkilerinin araştırılması(Sivas Cumhuriyet Üniversitesi, 2021) Orak, Yavuz; Bağçivan, İhsanNöropatik ağrı; somatosensör sinir sisteminin bir lezyonundan veya hastalığından kaynaklanır. Epidemiyolojik çalışmalar nöropatik ağrının prevalansının % 6.9-10 olduğunu tahmin etmektedir. Nöropatik ağrıyı tedavi etmek için yeni tedavilere duyulan ihtiyaçlar, analjezi başarısının analizleri ile gösterilmiştir. Çalışmalar, reçeteli ilaç kullananların % 64'ünde analjezik ilaçların zaman zaman yetersiz olduğunu ve yan tesirleri nedeniyle kullanılan ilaçların % 48'inin bırakıldığını tespit etti. Bu nedenle nöropatik ağrı tedavisinde yeni ve etkin tedavi metodu geliştirmek amaçlanmıştır. Çalışmamızda, Wister Albino cinsi erkek ratlar kullanıldı. Nöropatik ağrı modeli oluşturmak amacıyla siyatik sinir bağlama yöntemi kullanılarak, gabaerjik ilaçların antinosiseptif etkileri araştırıldı. Ratlarda siyatik sinir bağlama yöntemiyle nöropati modeli grubu, sham grubu ve tedavi grupları oluşturuldu. GABAerjik sistem üzerinde etkili olan dört farklı ajan üç farklı dozda ve farklı zaman aralıklarında uygulandı. Kullanılan ajanların antinosiseptif etkinliklerini araştırmak için hot plate ve tail flick testleri kullanıldı. Antinosiseptif etkiler % MPE değeri olarak hesaplandı. Bulgularda, baklofen tail flick ve hot plate testlerinde zamana ve doza bağımlı güçlü bir antinosiseptif etki gösterdi. Bu etki 15. dakika başladı, 60. dakikada pik noktasına ulaştı. Trans-4- aminocrotonic acid (TACA) tail flick ve hot plate testlerinde zamana ve doza bağımlı antinosiseptif etki gösterdi. Bu etki 15. dakika başladı 60. dakikada pik noktasına ulaştı. CL 966 tail flick ve hot plate testlerinde zamana ve doza bağımlı güçlü bir antinosiseptif etki gösterdi. Bu etki 4, 8. ve 16 mg da 15. dakikada başladı, 8 ve 16 mg dozlarında, 60. dakikada pik noktasına ulaştı. Vigabatrin, tail flick ve hot plate testlerinde zamana ve doza bağımlı güçlü bir antinosiseptif etki gösterdi. Bu etki her üç dozda 15. dakika başladı, 80 mg dozda 60. dakikada pik noktasına ulaştı. Nöropatik ağrı meydana getirilen sıçanlarda gabaerjik sistem üzerinden kullanılan tüm ilaçlarımız etkin oldu. En etkili bulunan ajan GABA b agonisti baklofen oldu.Öğe The use of empirical antibiotics in intensive care unit and relationship between nutrition and the incidence of infection(2019) Yıldırım, Salih; Orak, Yavuz; Menencioğlu, Rukiye; Altun, Ahmet; Orak, Filiz; Düger, Cevdet; Özpay, EsraObjective: Aim of study is to determine which antibiotic is started empirically in the ICU and to investigate whetherthe antibiotic started according to culture result was changed or not and the effect of this change on mortality, and toinvestigate the relationship between mortality and infection by determining whether enteral and parenterally fedpatients have attained sufficient calorie level.Method: After the approval of the local ethics committee, the files of 476 patients hospitalized in our hospital wereretrospectively reviewed. A total of 159 patients over 18 years of age who received mechanical ventilation therapy forat least 3 days were included in the study. Blood, urine and tracheal aspirate culture were determined. It wasrecorded whether antibiotics had changed according to the culture result. Nutritional patterns, number of feedingdays and basal caloric need were determined. It was investigated whether basal calorie need was met on 1, 3 and 5days. Factors affecting mortality were investigated.Results: Antibiotic exchange was significantly higher in the patients who died (P = 0.002). Mortality was higher inpatients who were unable to reach the target calorie (P = 0.01). Empirical changes in antibiotics (r: 0.174, P = 0.028),and culture positivity (r: 0.177, P = 0.026) were associated with mortality (r: 0.195, P = 0.014). In the subgroupanalysis, reproduction in tracheal aspirate culture was an important factor affecting mortality (r: 0.211 P: 0.008).Conclusions: The number of days of hospitalization, antibiotic change, culture positivity and inability to reach thetarget calories in nutrition are associated with mortality in the intensive care unit
