Nazan Atalan - Academia.edu (original) (raw)

Papers by Nazan Atalan

Journal of critical and intensive care, 2024

Göğüs kalp damar anestezi ve yoğun bakım derneği dergisi, 2013

Hemostaz; vasküler yaralanma sonrasında aşırı kan kaybını önleyen normal fizyolojik yanıttır. Bu ... more Hemostaz; vasküler yaralanma sonrasında aşırı kan kaybını önleyen normal fizyolojik yanıttır. Bu oldukça kompleks ve koruyucu mekanizma ile kanama durur ve kan kaybı önlenir. Hemostatik sistemin yeterli çalışmaması durumunda kanama riski ortaya çıkar. Kanama kontrolünde vasküler spazm, trombosit tıkacının oluşması ve kanın pıhtılaşması olmak üzere üç ayrı mekanizma rol oynar. Kan damarında bir yaralanma meydana geldiğinde fizyolojik hemostaz tetiklenerek ardışık bir sıra olayın oluşmasını sağlar. Kan akımını azaltmak amacıyla damarda konstruksiyon olur, dolaşımdaki trombositler damar duvarındaki zedelenmiş bölgeye adhezyon gösterirler, trombositler aktive ve aggrege olurlar ve koagulasyon faktörlerinin içerdiği bir seri enzimatik reaksiyon ile oluşan fibrin ile hemostatik pıhtı oluşur. Ek olarak hemostaz, dolaşım sisteminin devamlılığını da sağlar. Hemostaz bozuklukları artmış kanama ve tromboza, önemli morbidite ve mortaliteye neden olabilir.

Bu çalışmada ameliyat sonrası deliryum ve kognitif disfonksiyon arasındaki ilişki ve ameliyat son... more Bu çalışmada ameliyat sonrası deliryum ve kognitif disfonksiyon arasındaki ilişki ve ameliyat sonrası deliryumun kardiyak cerrahi sonrası uzun dönemdeki kognitif fonksiyon ve uyku bozuklukları üzerine olan etkileri araştırıldı. Ça lış ma pla nı: Mayıs 2010-Temmuz 2011 tarihleri arasında kliniğimizde açık kalp ameliyatı geçiren 285 hastadan çalışma kriterlerine uyan toplam 51 ardışık hasta çalışmaya alındı. Çalışmada ameliyat sonrası deliryum tanısı konulan 26 hasta (grup 1), deliryum tanısı konulmayan 25 hasta (grup 2) ile karşılaştırıldı. Kognitif fonksiyon, hastane taburculuğu öncesinde ameliyat sonrası 6. ve 12. ayda standardize mini-mental durum muayenesi (MMSE) testi ile değerlendirildi. Her iki grubun ameliyat sonrası 12. ayda çalışma hayatına katılımları sorgulandı. Fonksiyonel becerileri enstrümental günlük yaşam aktiviteleri (EGYA) için yardım ihtiyacı ile değerlendirirken, uyku sorunları, Pittsburgh uyku kalite indeksi (PSQI) ile değerlendirildi. Bul gu lar: Grup 1'deki hastaların ortalama MMSE skorları, grup 2'deki hastalara kıyasla, taburculuk öncesinde daha düşüktü (26.0 ile 28.6, p<0.001). Grup 1'de 6. ve 12. aylarda ortalama MMSE skorları anlamlı olarak daha düşük idi (sırasıyla, 26.7'ye karşılık 29.2 ve 28.0'a karşılık 29.9, p<0.001). Uyku sorunları, ameliyat sonrası 12. ayda grup 1'deki hastalarda, grup 2'ye kıyasla, daha fazla idi (%73.1'e karşılık %32.0, p<0.001). So nuç: Kalp cerrahisi sonrasında ameliyat sonrası deliryum geçirmek uzun süreli ameliyat sonrası kognitif disfonksiyon için bir risk faktörüdür. Ameliyat sonrası deliryum, cerrahi sonrası ilk yıl süresinde hem kognitif fonksiyonda anlamlı azalma hem de uyku bozuklukları ile ilişkilidir. Anah tar söz cük ler: Kardiyak cerrahi; kognitif fonksiyon bozukluğu; deliryum. Background: This study aims to investigate the association between postoperative delirium and cognitive dysfunction after cardiac surgery and to determine the effects of postoperative delirium on postoperative cognitive dysfunction and sleep disturbances in the long-term. Methods: Among 285 patients who underwent open cardiac surgery between May 2010 and July 2011, 51 patients who met the inclusion criteria were enrolled in the study. Twenty-six patients (group 1) who developed postoperative delirium were compared with 25 patients (group 2) without delirium. Cognitive function was assessed by mini-mental state examination (MMSE) test at pre-discharge, six and 12 months after surgery. Involving into the working life was questioned in both groups at the 12 months after surgery. Functional ability was assessed by the assistance need for instrumental activities of daily living (IADL), whereas sleep disturbances were assessed by the Pittsburgh sleep quality index (PSQI). Results: Patients in group 1 had lower mean MMSE scores compared to patients in group 2 before hospital discharge (26.0 versus 28.6, p<0.001). The mean MMSE scores were significantly lower in group 1 at six and 12 months after surgery (26.7 versus 29.2 and 28.0 versus 29, p<0.001, respectively). Sleep disturbances were also significantly higher at 12 months after surgery in group 1, compared to group 2 (73.1% versus 32.0%, p<0.001). Conclusion: Postoperative delirium after cardiac surgery is a risk factor for prolonged postoperative cognitive dysfunction. It is also associated with a significant decline in cognitive ability and sleep disturbances during the first year after cardiac surgery.

Göğüs kalp damar anestezi ve yoğun bakım derneği dergisi, 2014

Turkish Journal of Thoracic and Cardiovascular Surgery, Mar 20, 2013

Journal of Nephrology, Mar 22, 2017

of ischemia and renal injury such as ischemia modified albumin (IMA), protein oxidation parameter... more of ischemia and renal injury such as ischemia modified albumin (IMA), protein oxidation parameters [advanced oxidative protein products (AOPP), total thiol (T-SH)], neutrophil gelatinase-associated lipocalin (NGAL) and estimated glomerular filtration rate (eGFR) were measured in both groups. Results In group I, T-SH, NGAL and urea levels were found to be significantly increased postoperatively compared to preoperative measurements (p < 0.05). Also, postoperatively, NGAL, creatinine, aspartate aminotransferase and AOPP levels were higher in group I than group II (p < 0.05). Conclusion The correction of anemia with RBC transfusion in diabetic patients undergoing CABG could increase the risk of renal injury. Further studies verifying the effects of blood transfusions at the microcirculatory level are needed to optimize the efficacy of transfusions.

Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2014

Thymoma, the most common neoplasm of the anterior mediastinum especially in adults, accounts for ... more Thymoma, the most common neoplasm of the anterior mediastinum especially in adults, accounts for 20-25 % of all mediastinal tumors and 50 % of anterior mediastinal masses. These tumors are routinely asymptomatic for prolonged periods of time. Pericardial tamponade is a very rare initial manifestation of a thymoma. This report presents a patient who had hemorrhagic pericardial tamponade that likely resulted from the largest symptomatic mixed type (type AB) thymoma described in the literature.

SUMMARY Red Man Syndrome Vancomycin is one of the glycopeptide antibiotics which is used against ... more SUMMARY Red Man Syndrome Vancomycin is one of the glycopeptide antibiotics which is used against Gram (+) bacterial infections especially caused by Methicillin Resistant Staphylococcus Aureus (MRSA). In this case report, we want to present a patient in whom “Red Man Syndrome” (RMS) was developed due to vancomycin treatment for the mediastinitis following coronary arterial bypass surgery (CABG). A 56 year- old patient who had CABG developed MRSA mediastinitis. Based on the results of the antibiotic susceptibility tests, intravenous vancomycin (1g bid) treatment was started. At 5th day of the treatment disseminated and partly intermingled, itchy and erytematous rushes especially at the upper part of the body and hypotension were developed. Following dermatological evaluation, diagnosis of RMS was established. RMS usually happens as a result of rapid infusion of vancomycin. In these circumstances. Teicoplanin and Linezolid should be thought as alternative treatment regimens.

Journal of Health Services and Education, 2019

Today, science and technology are developing rapidly and enormous progress is being made. With th... more Today, science and technology are developing rapidly and enormous progress is being made. With this progress, early diagnosis and treatment methods have improved, deaths due to diseases have decreased, life expectancy at birth has increased, and the standard of living has increased. As a result, the aging population has been increasing since the second half of the 20th century. This situation does not only have a demographic problem, the production of the policies concerning the elderly, it is necessary to make the necessary arrangements. When we look at the demographic data, we see that the elderly population is increasing rapidly in our country. Therefore, this case shows us that we started to become an aging country’s situation needs to be considered for. In this article, the characteristics of the country examples and the elderly care services in the world are mentioned. They are given information about elderly care services in Turkey. It is tried to draw attention to the importance of the subject and to raise awareness about this issue.

Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2015

Balkan Medical Journal, Jan 20, 2018

Background: The humoral system is activated and various cytokines are released due to infections ... more Background: The humoral system is activated and various cytokines are released due to infections in tissues and traumatic damage. Nuclear factor-kappa B dimers are encoded by nuclear factor-kappa B genes and regulate transcription of several crucial proteins of inflammation such as tumour necrosis factor-alpha. Aims: To investigate the possible effect of polymorphisms on tumour necrosis factor-alpha serum levels with clinical and prognostic parameters of sepsis by determining the nuclear factor-kappa B-1-94 ins/ del ATTG and tumour necrosis factor-alpha (-308 G/A) gene polymorphisms and tumour necrosis factor-alpha serum levels. Study Design: Case-control study. Methods: Seventy-two patients with sepsis and 104 healthy controls were included in the study. In order to determine the polymorphisms of nuclear factor-kappa B-1-94 ins/del ATTG and tumour necrosis factor-alpha (-308 G/A), polymerase chain reaction-restriction fragment length polymorphism analysis was performed and serum tumour necrosis factor-alpha levels were determined using an enzyme-linked immunosorbent assay. Results: We observed no significant differences in tumour necrosis factor-alpha serum levels between the study groups. In the patient group, an increase in the tumour necrosis factor-alpha serum levels in patients carrying the tumour necrosis factor-alpha (-308 G/A) A allele compared to those without the A allele was found to be statistically significant. Additionally, an increase in the tumour necrosis factor-alpha serum levels in patients carrying tumour necrosis factor-alpha (-308 G/A) AA genotype compared with patients carrying the AG or GG genotypes was statistically significant. No significant differences were found in these 2 polymorphisms between the patient and control groups (p>0.05). Conclusion: Our results showed the AA genotype and the A allele of the tumour necrosis factor-alpha (-308 G/A) polymorphism may be used as a predictor of elevated tumour necrosis factor-alpha levels in patients with sepsis.

Annals of Thoracic Surgery, 2010

We present a patient with aortic root aneurysm and severe aortic regurgitation who had a previous... more We present a patient with aortic root aneurysm and severe aortic regurgitation who had a previous off-pump reduction ascending aortoplasty and external wrapping with concomitant coronary bypass grafting. Preliminary aortic dissection and erosion of the aortic intima were detected during the operation. This complication warrants the re-evaluation of the indications for reduction ascending aortoplasty and emphasizes the necessity for close follow-up.

Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2008

Thromboelastography is an alternative method to conventional coagulation tests for the general ev... more Thromboelastography is an alternative method to conventional coagulation tests for the general evaluation of hemostatic system. Cardiac surgery with cardiopulmonary bypass is accomplished by complex alterations of hemostasis, including acquired dysfunction of platelets, consumption coagulopathy and increased fibrinolysis. Despite major advances in blood conservation methods and perioperative care of the patients, transfusion rates in cardiac surgery remain high. Thromboelastography has an ability to assess almost all components of haemostatic system globally. Currently, thromboelastography is used with standard coagulation tests to decrease the microvascular bleeding and homologous blood transfusion in cardiac surgery with cardiopulmonary bypass. In this review, we aimed to discuss thromboelastography technology and its usage in cardiac surgery.