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Öğe Adriyamisin ile oluşturulan nefrotik sendromda sandostatinin etkisi(Ege Üniversitesi, 2019) Duman, SonerGiriş: Nefrotik sendrom podosit ayaksı çıkıntılarının silinmesi, aktin iskeletinin yıkılmasının sonucudur. Podosit aktin hücre iskeleti ve ayaksı çıkıntılarındaki silinme sonucu podositlerde belirgin şekil değişikliklerine yol açarak ağır proteinüri ile sonuçlanabilir. Bu neden ile matür podositlerde fenotipik değişikliklere yol açan faktörler yeni patojenik mekanizmaları gündeme getirmektedir. Podositlerin moleküler, anatomik ve fonksiyonel özellikleri araştırılıp, tanı ve tedaviye yön vermeye çalışılmaktadır. Son yıllarda glomerüler ve tubulointerstisyel patobiyolojinin ana aracısı olan sitokin TGF-beta'nın rolünün keşfinden beri böbrekte TGF-beta sinyalizasyon çalışmaları, fibrogenezin moleküler biyolojisi üzerine yoğunlaştı. Geçtiğimiz on yıllarda glomerüler hastalıkların tedavisinde ve proteinüri azaltılmasında birkaç immün modüle edici ajan kullanılmıştır. Biz de bu bilgiler ışığında adriyamisin ile oluşturulan nefrotik sendrom modelinde oktreotidin proteinuri ve inflamasyon üzerine etkilerini araştırmayı amaçladık. Metot: Çalışmamızda Human Podocyte Primary Cell Culture - T75 Plated Cells, Celprogen hücre hattını kullandık. Satın alınan hücre hattı 37?C de çoğaltılarak önce 25mL'lik flasklara bölündü. Daha sonra 12'lik wellplatelere aktarıldı. Her bir well'de 1X106 hücre konuldu. Hücrelerin çoğaltılması için RPMI 1640 medyum kullanıldı. Medyum hücre proliferasyonu için %10 FBS ve IFN-? ve sekonder bakteri üremesini engellemek için Penisilin/Streptomisin ile muamaele edildi. İlaç inkübasyonları sırasında FBS ve IFN minumum düzeyde tutuldu. Hücre hatlarının çoğaltılması sırasında standart yöntemler ve bunun için DMSO, PBS ve Tripsin kullanıldı. Öncelikli olarak adriamisinin artan dozlarda oluşturduğu toksisite araştırıldı. Adriamisin ve octreotid ile inkübasyon sonrası (0.8.24.48.96. saat) hücre lizatlarında ELISA yöntemiyle TGF-beta bakıldı. Bulgular: Adriyamisin ile oluşturulan nefrotik sendrom modelinde podosit hasarı kollajen 4 düzeyi ile değerlendirildi. Ardından nefrotik sendrom modeli oluşturulan hücrelerde oktreotid sonrası proteinuri oranları ölçüldü. Son olarak da yine aynı modelde oktreotid sonrası TGF-B düzeyleri ölçüldü. Oktreotid ile 24.saat belirgin olmak üzere anlamlı olarak proteinuride azalma görüldü ve 24. ve 48. saatlerde TGF-B düzeylerinde düşüş gözlendi. Sonuç: Proteinüri, glomerüler hastalıklarda karakteristik bir bulgudur. Buna ek olarak, proteinüriyi düşüren terapötik girişimler renal prognozu iyileştirir. Bilimsel kanıtlar podositlerin glomerüler hasar ve proteinüri için anahtar modülatör olduğunu göstermiştir. Bizim Çalışmamızda da adriyamisin ile oluşturulan nefrotik sendrom modelinde oktreoid ile antiinflamatuvar ve antiproteinurik bulgular izlenmiştir.;Nefrotik Sendrom, Podosit, Adriyamisin, Oktreotid, TGF-Beta.;Nephrotic Sydrome, Podocyte, Adriamycin, Octreotide, TGF-Beta.Öğe Akciğer kanser hücresi üzerine propolisin etkisi(Ege Üniversitesi, 2021) Duman, Soner; Özkan, Oğuzcan; Yıldırım, Hatice Kalkan; Dinçkal, Çiğdem; Sözmen, Eser; Olukman, MuratPropolis bal arıları tarafından ağaçların kabuklarından, bitkilerin tomurcuk ve filizlerinden toplanan, çok kuvvetli antiviral, anti-bakteriyel, antifungal etkiye sahip yapışkan bir maddedir. Propolisin antioksidan etkisinin yanı sıra antimikrobiyal, antiseptik, antibakteriyal, antiinflamatuvar, antimutajenik, immünmodülatör ve sitotoksik etkilere de sahip olduğu bilinmektedir. Kafeik asit ve esterlerinin de (CAPE) propolisin karsinostatik etkisinden sorumlu en önemli maddelerden olduğu belirtilmektedir. Propolisin pek çok solid tümör hücre hattı üzerinde sitotoksik ve apoptotik etkileri incelenmiştir. Akciğer kanseri, her iki cins için de küresel olarak kansere bağlı ölümlerin en sık nedenidir. Son yıllarda akciğer kanseri tanısında ve tedavisinde kaydedilen ilerlemeler hastaların sağ kalımlarına ve yaşam sürelerine önemli katkılarda bulunmuştur. Benzer şekilde, gerçekleştirilen yoğun moleküler çalışmalarla akciğer kanserine bakış ve tedavi prensipleri de tamamen yenilenmiş durumdadır. Çalışmamızda akciğer kanseri hücre hatlarında propolisin sitotoksik etkinliğinin gösterilmesi ve IC50 dozlarının belirlenmesi amaçlanmaktadır.;Akciğer Kanseri, Propolis, Sitotoksisite.;lung cancer, propolis, cytotoxicity.Öğe Akciğer kanseri hücresi üzerine palosuranın etkisi(Ege Üniversitesi, 2021) Duman, Soner; Olukman, Murat; Sözmen, Eser; Duman, Elif; Angın, Mesude; Dinçkal, ÇiğdemÜrotensin-II onun güçlü vazokonstriktör etkinliği ile tanımlanan bir somatostatin benzeri halkalı küçük peptit yapıda bir moleküldür. Pek çok tümor dokusundan tanımlanmıştır. Belki alternatif bir prognostik marker olarak insan kanserlerinde kullanımı mümkün olacaktır. Anjiogenezde, hücre çoğalması ve tümör biyolojisinde rolü olduğu düşünülmektedir. Ürotensin II bu etkilerini promitojenik patway PKC(Protein Kinase C)- ERK1/2 (Ekstraselüler Signal Regulated Kinase) ve p38 MAPK (Mitogen Activated Protein Kinases) üzerinden otokrin ve parakrin büyümeyi uyararak yaptığı düşünülmektedir. Akciğer kanseri, her iki cins için de küresel olarak kansere bağlı ölümlerin en sık nedenidir. Son yıllarda akciğer kanseri tanısında ve tedavisinde kaydedilen ilerlemeler hastaların sağ kalımlarına ve yaşam sürelerine önemli katkılarda bulunmuştur. Benzer şekilde, gerçekleştirilen yoğun moleküler çalışmalarla akciğer kanserine bakış ve tedavi prensipleri de tamamen yenilenmiş durumdadır. Çalışmamızda akciğer kanseri hücre hatlarında ürotensin II reseptör antogonisti palosuranın promitojenik sinyal yolağı üzerindeki etkilerini, in vitro olarak palosuranın sitotoksik etkinliğinin gösterilmesi ve IC50 dozlarının belirlenmesi amaçlanmaktadır. Uzun erimde ise, palosuranın cisplatinle kombinasyonunun olası sinerjistik sitotoksik/apoptotik etkilerinin ortaya konması, çalışmadan olası elde edilecek umut vaat edici sonuçlara dayanılarak bu kombinasyonun in vivo denenmesi ve klinikte yeni bir kombinasyon tedavisi için bir temel oluşturması hedeflenmektedir.;Akciğer Kanseri, Palosuran, Sitotoksisite.;Lung Cancer, Palosuran, Cytotoxicity.Öğe Alpha-Galactosidase A Activity Levels in Turkish Male Hemodialysis Patients(Wiley, 2012) Ucar, Sema Kalkan; Sozmen, Eser; Duman, Soner; Basci, Ali; Coker, MahmutFabry disease is an X-linked lysosomal storage disorder due to deficient activity of alpha-galactosidase A (alpha-Gal A) leading to renal insufficiency in males. The aim of present study was to investigate the level of alpha-Gal A activity and to determine the prevalence of Fabry disease in a Turkish male hemodialysis population. The activity of plasma alpha-Gal A was measured in a group of 808 male hemodialysis patients using fluorimetric methods. Patients with low alpha-Gal A activity were evaluated clinically and genetic testing was carried out. A correlation with creatinine, uric acid, urea, white blood cell (WBC), and high sensitivity (hs)CRP and alpha-Gal A activity was also investigated. Plasma a-Gal A activity among this male population undergoing hemodialysis was 7.88 +/- 5.18 mu M/hour/L (0.4055.72), significantly lower when compared to controls. No influence of creatinine, uric acid, WBC, or hsCRP on measured alpha-Gal A activity was reported. Two new Fabry disease patients were identified. Both were previously diagnosed with diabetes mellitus type 2. These findings provide, for the first time, data regarding the prevalence of alpha-Gal A deficiency (0.24%) in Turkish males receiving hemodialysis.Öğe Arm circumference: its importance for dialysis patients in the obesity era(Springer, 2013) Akpolat, Tekin; Kaya, Coskun; Utas, Cengiz; Arinsoy, Turgay; Taskapan, Hulya; Erdem, Emre; Yilmaz, M. Emin; Ataman, Rezzan; Bozfakioglu, Semra; Ozener, Cetin; Karayaylali, Ibrahim; Kazancioglu, Rumeyza; Camsari, Taner; Yavuz, Mahmut; Ersoy, Fevzi; Duman, Soner; Ates, KenanThe purposes of this study were to investigate the association between arm circumference and body mass index (BMI) and to discuss problems, mainly arm circumference and cuff size mismatch, that could affect the reliability of home blood pressure monitoring (HBPM) among peritoneal dialysis (PD) and hemodialysis (HD) patients. 525 PD and 502 HD patients from 16 centers were included in the study. A two-part questionnaire was used to gather information from the participants. Arm circumferences were categorized into four groups according to the British Hypertension Society cuff size recommendations. Mean BMI and arm circumference of all participants were 25.0 kg/m(2) and 27.6 cm, respectively. There was a significant correlation between BMI and arm circumference. The mean BMI and arm circumference values were higher in PD patients than in HD patients. Requirement of a large-sized adult cuff was more common among PD patients compared to HD patients (14 % vs 8 %, p = 0.002). Since HBPM is a useful tool for clinicians to improve BP control, nephrologists should be aware of the problems related to HBPM in dialysis patients and take an active role to increase the reliability of HBPM.Öğe The association between HbA1c levels and cardiovascular diseases in non-diabetic peritoneal dialysis patients(Oxford Univ Press, 2007) Dheir, Hamad; Toz, Huseyin; Asci, Gulay; Duman, Soner; Ertilav, Muhittin; Kircelli, Fatih; Sevinc, Ebru Gunay; Sipahi, Savas; Sezis, Meltem; Kose, Timur; Ok, Ercan; Ozkahya, MehmetÖğe Atorvastatin ameliorates morphological changes in encapsulated peritoneal sclerosis rat models(Oxford Univ Press, 2006) Sipahi, Savas; Sezak, Murat; Duman, Soner; Ozkan, Sultan; Sen, Sait; Ok, ErcanÖğe The benefit of salt restriction in the treatment of end-stage renal disease by haemodialysis(Oxford Univ Press, 2009) Kayikcioglu, Meral; Tumuklu, Murat; Ozkahya, Mehmet; Ozdogan, Oner; Asci, Gulay; Duman, Soner; Toz, Huseyin; Can, Levent H.; Basci, Ali; Ok, ErcanBackground. Most haemodialysis (HD) centres use anti-hypertensive drugs for the management of hypertension, whereas some centres apply dietary salt restriction strategy. In this retrospective cross-sectional study, we assessed the effectiveness and cardiac consequences of these two strategies. Methods. We enrolled all patients from two dialysis centres, who had been on a standard HD programme at the same centre for at least 1 year. All patients underwent echocardiographic evaluation. Clinical data were obtained from patients' charts. Centre A (n = 190) practiced 'salt restriction' strategy and Centre B (n = 204) practiced anti-hypertensive-based strategy. Salt restriction was defined as managing high blood pressure (BP) via lowering dry weight by strict salt restriction and insistent ultrafiltration without using anti-hypertensive drugs. Results. There was no difference regarding age, gender, diabetes, history of cardiovascular disease and efficiency of dialysis between centres. Antihypertensive drugs were used in 7% of the patients in Centre A and 42% in Centre B (P < 0.01); interdialytic weight gain was significantly lower in Centre A (2.29 +/- 0.83 kgversus 3.31 +/- 1.12 kg, P < 0.001). Mean systolic and diastolic blood pressures were similar in the two centres. However, Centre A had lower left ventricular (LV) mass (indexed for height(2.7): 59 +/- 16 versus 74 +/- 27 g/m(2.7), P < 0.0001). The frequency of LV hypertrophy was lower in Centre A (74% versus 88%, P < 0.001). Diastolic and systolic functions were better preserved in Centre A. Intradialytic hypotension (hypotensive episodes/100 patient sessions) was more frequent in Centre B (11 versus 27, P < 0.01). Conclusions. This cross-sectional study suggests that salt restriction and reduced prescription of antihypertensive drugs may limit LV hypertrophy, better preserve LV functions and reduce intradialytic hypotension in HD patients.Öğe Bioimpedance spectroscopy for the differential diagnosis of hyponatremia(Taylor & Francis Ltd, 2015) Kose, Sennur Budak; Hur, Ender; Magden, Kemal; Yildiz, Gursel; Colak, Derya; Kucuk, Emrah; Toka, Bilal; Kucuk, Hamdi; Yildirim, Ibrahim; Kokturk, Furuzan; Duman, SonerBackground: Hyponatremia is classified according to volume status with the help of physical examination, biochemical measures, urine and serum osmolalities, and echocardiography. Bioimpedance spectroscopy (BIS) has been getting popularity for revealing tissue compositions of various patient groups. The aim of this observational study was to investigate the role of BIS for the differential diagnosis of hyponatremia (ClinicalTrials.gov Identifier: NCT01838759). Patients and methods: Personal characteristics of age, sex, weight, height, and blood pressure were recorded. Body composition monitor (BCM) was used for hydration status for each individual. Primary outcome was investigated by the accuracy of volume status measured by BIS. Statistics: Kappa statistic (K) is a measure of agreement between two sources, which is measured on a binary scale (i.e., condition present/absent). K statistic can take values between 0 and 1: poor agreement: K<0.20, fair agreement: 0.2.0-0.3.9, moderate agreement: 0.40-0.59, substantial: 0.60-0.79, very good agreement: 0.80-1.00. Results: Fifty-eight hyponatremia-diagnosed patients, 32 (55.2%) of male with the mean age of 65.2 +/- 11 (40-89) years were included. Kappa statistic (K) were very good (K = 0.925) for male (p<0.00), substantial agreement (K = 0.601) for female (p<0.002) with the use of BIS for the differential diagnosis of either hypo or hypervolemia in hyponatremic patients compared with gold standard tests which were the combination of echocardiography, serum, and urine osmolality biochemical tests, and physical examination. Conclusion: Bioimpedance spectroscopy is a practical and an inexpensive method. This is the first study in the literature showing the role of BIS for the determination of the volume status and differential diagnosis of hyponatremia when compared with echocardiography.Öğe Böbrek nakli yapılmış hastalarda RAU lezyonları varlığının araştırılması(1999) Kandemir, Şükrü; İlgenli, Tunç; Atilla, Fatma Gül; Ünsal, Abdülkadir; Duman, SonerAraştırmalarda recurrent aphtous ulcer (RAU)'nun etyolojisinde immünitenin rolü ile ilgili çelişkili görüşler vardır. İmmunosupresif ajanların RAU oluşma sıklığını ve çıkan lezyon sayısını azalttığı iddia edilmektedir. Böbrek nakli yapılan hastalarda organ reddini önlemek amacıyla, siklosporin (CsA) kortikosteroid ve azotioprin'den oluşan 3'lü İmmünosüpresif tedavi uygulanmaktadır. Bu durum gözönüne alınarak böbrek nakli yapılmış ve 3 'lü İmmünosüpresif tedavi alan hastalarda RAU oluşumunu ve bu ilaçlar kullanılmaya başlandıktan sonra RAU oluşumunda bir değişiklik olup olmadığını araştırmak amacı ile bu çalışma planlandı Böbrek nakli (Tx) yapılmış 100 hasta araştırmaya dahil edildi. Bu hastaların 13'ünde Tx öncesi dönemde RAU' nun görüldüğü, Tx sonrası bu hastaların 9'unda lezyonların kaybolduğu belirlendi. Tx sonrası dönemde ise 100 hastanın 11'inde RAU lejyonlarının var olduğu saptandı. Bu 11 hastanın 7'sinde Tx öncesi dönemde RAU lezyonları görülmezken, Tx sonrası dönemde bu lezyonların ortaya çıktığı saptandı Bulgularımıza göre, immunosüpresif ilaç kullanan böbrek nakli hastalarının %11'inde Tx sonrası dönemde RAU varlığı saptandı. Bu da normal popülasyon ile benzerlik göstermektedir. Sonuç olarak hücresel immünitenin baskılandığı böbrek nakli yapılmış hastalarda 3'lü immunosüpresif tedavinin yeni RAU lezyonu oluşumuna veya var olan RAU lezyonlarının kaybolmasına belirgin anlamda katkısı olamayacağını söyleyebilirizÖğe Body composition monitor measurement technique for the detection of volume status in peritoneal dialysis patients: the effect of abdominal fullness(Springer, 2011) Sipahi, Savas; Hur, Ender; Demirtas, Saadet; Kocayigit, Ibrahim; Bozkurt, Devrim; Tamer, Ali; Gunduz, Huseyin; Duman, SonerBioimpedance spectroscopy (BIS) is used to assess volume status in peritoneal dialysis (PD) patients. However, it is proposed that it may be troubling in patients with abnormal fluid distribution and body geometry. It is not clear whether having an empty abdomen or not interferes with the BIS results and its relation with echocardiographic findings in PD patients. Twenty-five prevalent PD patients were enrolled. Echocardiography and body composition analysis using BIS technique (50 frequencies, the Body Composition Monitor, BCM) were performed. Overhydration (OH), extracellular water (ECW) in liters and OH/ECW ratio were used as volume status indices. Differences in volume and echocardiographic findings, in patients with empty and with full abdomen, and their correlations with echocardiographic parameters were investigated. Mean age and PD duration were 61 +/- A 2.5 years and 42 +/- A 33 months, respectively. Sixty-four percent were male and 24% were diabetic. Mean left ventricular mass index (LVMi) was 131 +/- A 43 g/m (,) (2) mean left atrium diameter (LA) was 4.1 +/- A 0.1 cm, mean left ventricular ejection fraction (EF) was 64 +/- A 10%. Mean OH in patients with full abdomen were 1.67 +/- A 1.51 L and 1.68 +/- A 1.48 L, depending on the inclusion or exclusion of the dialysate volume, respectively. In patients with an empty abdomen, mean OHs were 2.12 +/- A 1.76 L and 1.91 +/- A 1.56 L, depending on the inclusion or exclusion of the dialysate volume. BIS measurements with an empty, but not with a full abdomen, was related to the echocardiographic parameters. BIS is a reliable method to evaluate volume status in PD patients. BIS performed after peritoneal equilibration test with an empty abdomen, better reflects overhydration and is related to echocardiographic parameters.Öğe CAN N-ACETYLCYSTEINE PRESERVE PERITONEAL FUNCTION AND MORPHOLOGY IN ENCAPSULATING PERITONEAL SCLEROSIS?(Multimed Inc, 2009) Bozkurt, Devrim; Hur, Ender; Ulkuden, Burcu; Sezak, Murat; Nar, Hasim; Purclutepe, Ozlem; Sen, Sait; Duman, SonerLong-term use of the peritoneum as a dialysis membrane results in progressive irreversible dysfunction, described as peritoneal fibrosis. Oxidative stress during peritoneal dialysis has been established in many studies. Generation of reactive oxygen species (ROS) by conventional peritoneal dialysis solutions, regardless of whether produced by high glucose, angiotensin II, or glucose degradation products may be responsible for progressive membrane dysfunction. The well-known antioxidant molecule N-acetylcysteine (NAC) is capable of direct scavenging of ROS. The aim of the present study was to investigate the effect of NAC therapy on both progression and regression of encapsulating peritoneal sclerosis (EPS). We divided 49 nonuremic Wistar albino rats into four groups: Control group-2 mL isotonic saline intraperitoneally (IP) daily for 3 weeks; CG group-2 mL/200 g 0.1% chlorhexidine gluconate (CG) and 15% ethanol dissolved in saline injected IP daily for a total of 3 weeks; Resting group CG (weeks 1-3), plus peritoneal resting (weeks 4-6); NAC-R group-CG (weeks 1-3), plus 2 g/L NAC (weeks 4-6). At the end of the experiment, all rats underwent a 1-hour peritoneal equilibration test with 25 mL 3.86% PD solution. Dialysate-to-plasma ratio (D/P) urea, dialysate white blood cell count (per cubic milliliter), ultrafiltration (UF) volume, and morphology changes of parietal peritoneum were examined. The CG group progressed to encapsulating peritoneal sclerosis, characterized by loss of UF, increased peritoneal thickness, inflammation, and ultimately, development of fibrosis. Resting produced advantages only in dialysate cell count; with regard to vascularity and dialysate cell count, NAC was more effective than was peritoneal rest. Interestingly, we observed no beneficial effects of NAC on fibrosis. That finding may be a result of our experimental severe peritoneal injury model. However, decreased inflammation and vascularity with NAC therapy were promising results in regard to membrane protection.Öğe Can Subtypes of White Blood Cells Predict Mortality in Hemodialysis Patients?(Ortadogu Ad Pres & Publ Co, 2011) Duman, Soner; Sazak, Hakan Savas; Baskan, Onur; Basci, AliObjective: To investigate whether increased white blood cell count (WBC) is an independent risk factor for mortality in hemodialysis (HD) patients. There are limited number of studies that evaluate the WBC subtypes and mortality in HD patients. Material and Methods: In this 36 months long prospective study, predictive value of WBC subtypes for mortality was investigated in 910 HD patients (male 55%, diabetes 29.3%, age 59 +/- 14; HD duration 44 +/- 39 months). Results: There was significant correlation between high sensitive C-reactive protein and neutrophils (r= 0.43, p< 0.001) and monocytes (r= 0.24, p< 0.001). During the study 202 (22%) patients died mainly of cardiovascular disease (%57). Survivals at 1,2 and 3 years were calculated with Kaplan Meier analysis and were found as 90%, 80% and %73, respectively. Kaplan Meier analysis showed that increased basal neutrophil count (>5.040/mm(3)), increased monocytes (>740/mm(3)) and decreased lymphocytes (<1.620/mm(3)) were correlated with poor survival. In Cox regression analysis, monocyte count over 1.267/mm(3) and lymphocyte count less than 461/mm(3) were found as independent factors for overall survival after correction for classical risk factors. However, neutrophil count was not correlated with mortality. Conclusion: Increased blood monocyte count and decreased lymphocyte count are independent risk factors for long-term mortality.Öğe Can we use CT pulmonary angiography as an alternative to echocardiography in determining right ventricular dysfunction and its severity in patients with acute pulmonary thromboembolism?(Springer, 2013) Cok, Gursel; Tasbakan, Mehmet Sezai; Ceylan, Naim; Bayraktaroglu, Selen; Duman, SonerOur aim was to investigate the role of computed tomography pulmonary angiography (CTPA) in the diagnosis of right ventricular dysfunction (RVD) and massive pulmonary thromboembolism (PTE). We retrospectively involved a total of 61 patients. In CTPAs, pulmonary arterial obstruction index (PAOI), right ventricular/left ventricular diameter ratio (RV/LV), and superior vena cava (SVC) diameters were calculated, followed by echocardiography (ECHO), and clinical results were evaluated based on the reports available. CTPA findings that included PAOI, RV/LV ratio, and SVC diameter were, respectively, 54.9 +/- A 22.7 %, 1.58 +/- A 0.51, and 20.3 +/- A 0.2 mm in patients with RVD on ECHO, whereas corresponding values were, respectively, 37.8 +/- A 24.2 %, 1.32 +/- A 0.47, and 18.4 +/- A 3.3 mm in those without RVD (respectively, p = 0.006, p = 0.038, and p = 0.026). PAOI was 63.3 +/- A 22.0 % in patients among whom massive PTE was detected and 43.1 +/- A 23.9 % in the group without massive PTE (p = 0.01). As for mortality; given an RV/LV ratio > 1.0, this ratio had 100 % sensitivity and 35.6 % specificity, whereas given a PAOI of a parts per thousand yen50 %, sensitivity and specificity were 83.3 % and 57.8 %, respectively. We concluded that in the patients with PTE, PAOI a parts per thousand yen50 % and RV/LV > 1.0 in CTPA could be helpful to demonstrate RVD.Öğe Can we use CT pulmonary angiography as an alternative to echocardiography in determining right ventricular dysfunction and its severity in patients with acute pulmonary thromboembolism?(Springer, 2013) Cok, Gursel; Tasbakan, Mehmet Sezai; Ceylan, Naim; Bayraktaroglu, Selen; Duman, SonerOur aim was to investigate the role of computed tomography pulmonary angiography (CTPA) in the diagnosis of right ventricular dysfunction (RVD) and massive pulmonary thromboembolism (PTE). We retrospectively involved a total of 61 patients. In CTPAs, pulmonary arterial obstruction index (PAOI), right ventricular/left ventricular diameter ratio (RV/LV), and superior vena cava (SVC) diameters were calculated, followed by echocardiography (ECHO), and clinical results were evaluated based on the reports available. CTPA findings that included PAOI, RV/LV ratio, and SVC diameter were, respectively, 54.9 +/- A 22.7 %, 1.58 +/- A 0.51, and 20.3 +/- A 0.2 mm in patients with RVD on ECHO, whereas corresponding values were, respectively, 37.8 +/- A 24.2 %, 1.32 +/- A 0.47, and 18.4 +/- A 3.3 mm in those without RVD (respectively, p = 0.006, p = 0.038, and p = 0.026). PAOI was 63.3 +/- A 22.0 % in patients among whom massive PTE was detected and 43.1 +/- A 23.9 % in the group without massive PTE (p = 0.01). As for mortality; given an RV/LV ratio > 1.0, this ratio had 100 % sensitivity and 35.6 % specificity, whereas given a PAOI of a parts per thousand yen50 %, sensitivity and specificity were 83.3 % and 57.8 %, respectively. We concluded that in the patients with PTE, PAOI a parts per thousand yen50 % and RV/LV > 1.0 in CTPA could be helpful to demonstrate RVD.Öğe Close Monitoring for Polyneuropathy/Myopathy Is Warranted Among Liver Transplant Recipients on Long-Term Treatment With Telbivudine.(Wiley-Blackwell, 2014) Karasu, Zeki; Turan, Ilker; Duman, Soner; Sozbilen, Murat; Gunsar, Fulya; Ersoz, Galip; Akarca, Ulus S.Öğe Comparison of 4- and 8-h dialysis sessions in thrice-weekly in-centre haemodialysis(Oxford Univ Press, 2011) Ok, Ercan; Duman, Soner; Asci, Gulay; Tumuklu, Murat; Sertoz, Ozen Onen; Kayikcioglu, Meral; Toz, Huseyin; Adam, Siddik M.; Yilmaz, Mumtaz; Tonbul, Halil Zeki; Ozkahya, MehmetBackground. Longer dialysis sessions may improve outcome in haemodialysis (HD) patients. We compared the clinical and laboratory outcomes of 8- and 4-h thrice-weekly HD. Methods. Two-hundred and forty-seven HD patients who agreed to participate in a thrice-weekly 8-h in-centre nocturnal HD (NHD) treatment and 247 age-, sex-, diabetes status-and HD duration-matched control cases to 4-h conventional HD (CHD) were enrolled in this prospective controlled study. Echocardiography and psychometric measurements were performed at baseline and at the 12th month. The primary outcome was 1-year overall mortality. Results. Overall mortality rates were 1.77 (NHD) and 6.23 (CHD) per 100 patient-years (P = 0.01) during a mean 11.3 +/- 4.7 months of follow-up. NHD treatment was associated with a 72% risk reduction for overall mortality compared to the CHD treatment (hazard ratio = 0.28, 95% confidence interval 0.09-0.85, P = 0.02). Hospitalization rate was lower in the NHD arm. Post-HD body weight and serum albumin levels increased in the NHD group. Use of antihypertensive medications and erythropoietin declined in the NHD group. In the NHD group, left atrium and left ventricular end-diastolic diameters decreased and left ventricular mass index regressed. Both use of phosphate binders and serum phosphate level decreased in the NHD group. Cognitive functions improved in the NHD group, and quality of life scores deteriorated in the CHD group. Conclusions. Eight-hour thrice-weekly in-centre NHD provides morbidity and possibly mortality benefits compared to conventional 4-h HD.Öğe Comparison of Acute and Chronic Stabilization Efficiencies of Two Suturing Methods Used in Pectoral Muscle Fixation of Cardiac Implantable Electronic Devices(Wiley, 2023) Gunes, Mustafa Talha; Simsek, Evrim; Duman, Soner; Demir, Derya[Abstarct Not Available]Öğe Comparison of dialysates with and without glucose in hemodialysis patients(Oxford Univ Press, 2007) Asci, Gulay; Toz, Huseyin; Duman, Soner; Ozkahya, Mehmet; Sayin, Kerime; Kircelli, Fatih; Gunay, Ebru; Boydak, Can; Sipahi, Savas; Basci, Ali; Sever, Mehmet S.; Ok, ErcanÖğe Delirium is associated with increased mortality in the geriatric population(Taylor & Francis Ltd, 2018) Tasar, Pinar Tosun; Sahin, Sevnaz; Akcam, Nur Ozge; Dinckal, Cigdem; Ulusoy, Merve Gulsah; Sarikaya, Ozan Fatih; Duman, Soner; Akcicek, Fehmi; Noyan, AysinObjective: The aim of this study was to investigate the prevalence of delirium and its association with mortality rates in elderly inpatients.Methods: The medical records of 1435 patients over 65years old who were treated at a regional university hospital and were referred to the university's Consultation and Liaison Psychiatry Clinic for psychological evaluation were retrospectively analyzed. Patients with and without a diagnosis of delirium were compared. The National Survival Database was used to determine mortality rates.Results: The prevalence of delirium was 25.5%. The delirium group was older (p<.0001) and had a larger proportion of males (p<.0001). Mortality rate was higher in the delirium group at 1, 2, 3, 4, and 5years (p<.0001 for all). Age, gender, lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer's disease emerged as significant parameters associated with mortality. Multivariate analysis of these parameters indicated that comorbid diseases (lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer's disease) are risk factors for mortality independent of demographic data such as age and gender.Conclusions: Independent of all other factors, delirium is associated with higher mortality risk.
