Publications by authors named "Oktay Demirkiran"

7 Publications

  • Page 1 of 1

Religious and Cultural Aspects of Organ Donation in the Turkish Population.

Transplant Proc 2019 Sep 31;51(7):2158-2162. Epub 2019 Jul 31.

Department of Anesthesiology and Reanimation, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa.

Objective: Organ donation is becoming more important with increasing organ transplantation possibilities. We aimed to determine the knowledge, sociocultural view, and influences of religious belief regarding opinions on organ donation.

Material And Method: This study was based on a self-administered survey questionnaire distributed via the Internet. The study sample was sent to Internet communication groups.

Results: Three hundred and seventeen participants completed the survey: 39.4% of respondents said that they would definitely donate their organs; 6.9% would only give via live donation; 51.4% were undetermined; and 2.2% absolutely refused to donate. Muslim respondents favored organ donation (36.5%) and linked it to religious reasons (6.3%). Only 4 (1.3%) of the 6 (1.9%) Muslim respondents who said they would definitely not donate did so because they felt that organ donation was religiously inappropriate. Of 22 Muslim participants (7.3%), 5 (1.6%) attributed the idea of living donation to religious reasons and 11 (3.6%) did not have enough information. The atheist respondents believed that the reason for organ donation was to do someone else a favor (88.8%). The deist and agnostic believers also ascribed to this view. In order to evaluate the effects of cultural causes, we examined regional responses and found that 85 of the 196 participants in the Marmara Region would definitely donate organs, 18 would do so only for live donations, and 5 would definitely not donate.

Conclusion: Religious and cultural factors affect people's decision to donate their organs. In the survey we conducted on Turkish responders, we saw that religious causes are particularly effective in organ donation.
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September 2019

Development and internal validation of the multivariable CIPHER (Collaborative Integrated Pregnancy High-dependency Estimate of Risk) clinical risk prediction model.

Crit Care 2018 Oct 30;22(1):278. Epub 2018 Oct 30.

King Abdullah University Hospital, Ar Ramtha, 3030, Ramtha, Jordan.

Background: Intensive care unit (ICU) outcome prediction models, such as Acute Physiology And Chronic Health Evaluation (APACHE), were designed in general critical care populations and their use in obstetric populations is contentious. The aim of the CIPHER (Collaborative Integrated Pregnancy High-dependency Estimate of Risk) study was to develop and internally validate a multivariable prognostic model calibrated specifically for pregnant or recently delivered women admitted for critical care.

Methods: A retrospective observational cohort was created for this study from 13 tertiary facilities across five high-income and six low- or middle-income countries. Women admitted to an ICU for more than 24 h during pregnancy or less than 6 weeks post-partum from 2000 to 2012 were included in the cohort. A composite primary outcome was defined as maternal death or need for organ support for more than 7 days or acute life-saving intervention. Model development involved selection of candidate predictor variables based on prior evidence of effect, availability across study sites, and use of LASSO (Least Absolute Shrinkage and Selection Operator) model building after multiple imputation using chained equations to address missing data for variable selection. The final model was estimated using multivariable logistic regression. Internal validation was completed using bootstrapping to correct for optimism in model performance measures of discrimination and calibration.

Results: Overall, 127 out of 769 (16.5%) women experienced an adverse outcome. Predictors included in the final CIPHER model were maternal age, surgery in the preceding 24 h, systolic blood pressure, Glasgow Coma Scale score, serum sodium, serum potassium, activated partial thromboplastin time, arterial blood gas (ABG) pH, serum creatinine, and serum bilirubin. After internal validation, the model maintained excellent discrimination (area under the curve of the receiver operating characteristic (AUROC) 0.82, 95% confidence interval (CI) 0.81 to 0.84) and good calibration (slope of 0.92, 95% CI 0.91 to 0.92 and intercept of -0.11, 95% CI -0.13 to -0.08).

Conclusions: The CIPHER model has the potential to be a pragmatic risk prediction tool. CIPHER can identify critically ill pregnant women at highest risk for adverse outcomes, inform counseling of patients about risk, and facilitate bench-marking of outcomes between centers by adjusting for baseline risk.
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October 2018

Rare case of bilateral incarcerated obturator hernia: a case report.

Ulus Travma Acil Cerrahi Derg 2018 May;24(3):278-280

Department of General Surgery Istanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.

Here, we report the case of an 84-year-old woman with acute mechanical intestinal obstruction (AMIO) who was admitted to our Emergency Department. Computed tomography (CT) scan revealed an incarcerated bilateral obturator hernia, and the defect was resolved using transabdominal preperitoneal (TAPP) technique with polypropylene mesh. The patient was administered an oral regimen two days after the operation. The patient stayed in the intensive care unit for 4 days and was uneventfully discharged on the 9th postoperative day. Follow-up was scheduled at the 6th month, during which no adverse events were detected and the patient did not report any complaints. Obturator hernia is among the differential diagnoses of intestinal obstruction requiring early diagnosis and prompt surgical intervention. Laparoscopic approach is less invasive compared with open surgery, and it can be attempted in cases presenting with no sign of ischemia or peritonitis. TAPP technique should be preferred since it allows the control of all intraabdominal pathologies and the viability of the intestines.
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May 2018

The effects of pneumothorax on the respiratory mechanics during laparoscopic surgery.

J Laparoendosc Adv Surg Tech A 2008 Jun;18(3):423-7

Department of Anesthesia, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.

Pneumothorax is rare but can be a severe complication of laparoscopic surgery. Diagnosis of pneumothorax in laparoscopy includes the sudden increase in end-tidal carbon dioxide (EtCO(2)) with a decrease in compliance and an abnormal increase in airway pressure. By these case reports, we recommend the simultaneous monitoring of airway pressures, dynamic compliance, and particularly, EtCO(2) for an immediate diagnosis and prompt treatment of pneumothorax.
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June 2008

Effects of sevoflurane, propofol and position changes on respiratory mechanics.

Middle East J Anaesthesiol 2004 Jun;17(5):811-8

General Surgery, University of Istanbul, Medical School of Cerrahpasa, Anaesthesia and Reanimation Department, Istanbul, Turkey.

This study was designed to investigate the effects of propofol, sevoflurane and position changes on respiratory mechanics. Forty patients scheduled for thyroid surgery were divided randomly into two groups; those receiving sevoflurane (group S) (n=20), and those receiving TIVA propofol (group P) (n=22). Dynamic compliance (Cdyn), peak inspiratory pressure (PIP), and respiratory resistance (Rr) values were recorded with a VenTrak respiratory monitor (Novometrix Inc. USA) at three time instances. The first measurement was done immediately after the beginning of ventilation and before the inhalation agent was initiated (Induction). Second measurement was done after 5 minutes of thyroid position (Thyroid) (ventilation with 1 MAC sevoflurane concentration or propofol infusion at the rate of 6 mg/kg/h). The third measurement was performed 5 minutes after end of surgery in the supine position (Supine) Blood gases were measured at the three time instances. Respiratory mechanics did not change in the P group (51 +/- 13, 46 +/- 11, 48 +/- 10 mL/cmH2O) at Induction, Thyroid and Supine positions). In the S group, dynamic compliance measurements showed changes statistically significant in the supine position (52 +/- 6 mL/cmH2O)) when compared to Induction (47 +/- 9 mL/cmH2O) and Thyroid position (47 +/- 6 mL/cmH2O) measurements (p<0.05). When the groups were compared with each other, there was no significant difference whatsoever at all periods (p>0.05). His concluded that sevoflurane, propofol and position changes exhibit similar effects on respiratory mechanics and blood gases at described dose and concentration.
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June 2004

Chediak-Higashi syndrome in the intensive care unit.

Paediatr Anaesth 2004 Aug;14(8):685-8

Department of Anaesthesiology, Cerrahpasa Medical School, Istanbul University, Sadi Sun ICU, Istanbul, Turkey.

Chediak-Higashi Syndrome is a rare autosomal recessive disease characterized by recurrent infections, giant cytoplasmic granules and oculocutaneous albinism. We describe the clinical and laboratory findings of a patient with Chediak-Higashi syndrome who was diagnosed and treated in the intensive care unit because of bleeding tendency after surgery.
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August 2004