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    A Novel Mechanism of Anti-T-Lymphocyte Globulin Mediated by Fractalkine in Renal Ischemia-Reperfusion Injury in Rats
    (ELSEVIER SCIENCE INC, 2013) Gunay, Y.; Inal, A.; Yener, N.; Sinanoglu, O.; Selvi, O.; Bircan, H. Y.
    Background. Ischemia-reperfusion injury (IRI) is among the main challenges in kidney transplantation. It causes delayed graft function and graft loss in long-term follow-up studies. Anti-T lymphocyte globulin (ATG), a common induction immunosuppressive, has been used in kidney transplantation to prevent rejection. Fractalkine (FKN) is among the main chemokines involved in IRI. This study was designed to identify the relationship between ATG and FKN after warm ischemia in rat kidneys. Methods. Rats were divided into three groups: Control, IRI+normal saline(NS) and IRI+ATG. After IRI was initiated, rats received a dose of ATG or NS during surgery as well as two more doses at 24 and 48 hours after surgery. All rats were humanely killed at 72 hours. Results. The concentration of FKN as well as dendritic cells (DC) and macrophages were lower in both peripheral blood and the injured kidney among ATG-treated versus control rats. Additionally cell necrosis, cytoplasmic vacuolization, cast formation, and tubular dilatation were improved among ATG-treated rats. Serum creatinine levels were lower in rats that received ATG. Conclusion. ATG depleted the concentration of FKN, which inhibits migrations of DCs and macrophages into the kidney, and reduces IRI-related pathology.
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    Ultrasound guided erector spinae plane block as a cause of unintended motor block
    (ELSEVIER SCIENCE BV, 2018) Selvi, O.; Tulgar, S.
    Erector spinae plane block (ESPB) as postoperative analgesia method has been successfully carried out in several surgical interventions. Postoperative pain treatment for cesarean section is considered one of the important challenges for anesthesiologists due to the risk of chronic pain development and even pospartum depression. Regional anesthesia techniques were effectively used to prevent the pain together with multimodal analgesia regimes in cesarean section. Formerly, successful erector spinae plane block was documented as postoperative analgesia treatment for cesarean section; however, no motor weakness was recorded as a side effect. In this case report, we present an unexpected motor weakness as a side effect of the erector spinae plane block after cesarean delivery operation in a 29 year old patient. To our knowledge, this is the first report of motor weakness related to the ESPB. (C) 2018 Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor. Published by Elsevier Espana, S.L.U. All rights reserved.
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    Use of quips survey for the assessment of quality in postoperative pain management
    (Anestezi Dergisi, 2016) Ozütemiz, M.; Selvi, O.; Tulgar, S.; Özer, Z.
    Objective: Although there are guidelines and advanced pain management techniques, quality of postoperative pain management can not still be measured with a standard method considering safety issues. Many factors like nausea, vomiting, functional disability and immobility have an effect on the achivement of postoperative pain therapy. QUIPS is a survey which takes all these factors into account. In this study we tried to evaluate the quality of postoperative pain management by using QUIPS. Method: This study was conducted on 400 volunteers who were planned for surgical operation between 07.2014 - 01.2015 at Maltepe University Medical Faculty Hospital. QUIPS was applied to these patients the day after the surgery Results: Fifty-four percent (n:216) of the patients were women and 46% (n:184) of them were men. These patients were asked about their pain level in questions 3 and 4. The highest scores for pain were recorded in neurosurgery and orthopedics. In the fifth question patients were asked to answer whether they had immobility problems due to pain and the highest scores were in neurosurgery patients (p<0.01). The most satisfied patients with their pain theraphy were in ENT group. Conclusion: The fact that focusing on only pain revealing therapies are not adequate while approaching towards postoperative pain was the main motivation in preaparation of QUIPS. Beacuse of this fact QUIPS can be used as a useful tool to evaluate pain, pain related symptoms and quality of postoperative pain management.