Browsing by Author "Demir, Canan"
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Article Citation Count: 0Avrupa Birliği Ülkeleri ve Türkiye’nin 2010-2021 Dönemi Toplam Antibiyotik Tüketiminin Karşılaştırılması: Akılcı İlaç Kullanımı ve Pandeminin Etkileri(Bilimsel Tip Yayinevi, 2023) Kavruk, Murat; Uçak, Samet; Sapmaz, Burcu; Demir, Canan Çiçek; Dursun, Ali Doğan; Basic Sciences; Nutrition and DieteticsGiriş: Antibiyotik tüketimini düşürmek adına dünya genelinde pek çok uygulama yapılmaktadır fakat bu uygulamaların karşılaştırmalı analizi ve pandemi gibi geniş çaplı değişkenler karşısındaki durumu yeterince analiz edilmemektedir. Bu kapsamda; Türkiye ve Avrupa ülkelerinin ATC grubu J01 toplam antibiyotik tüketim eğilimleri ve ülkeler arasındaki farklılıklar incelenmiş olup son dönemde yaşanan pandeminin antibiyotik tüketim verilerindeki değişime etkisi sorgulanmıştır. Materyal ve Metod: Türkiye ve 19 Avrupa ülkesinin 2010-2021 yılları arasındaki ATC grubu J01 toplam antibiyotik tüketimi (hastane + toplum) verileri birleştirilerek karşılaştırıldı. Çalışma için Avrupa Hastalık Önleme ve Kontrol Merkezi (ECDC) ve Türkiye İlaç ve Tıbbi Cihaz Kurumu (TICKK) verileri kullanılmıştır. Antibiyotik tüketim verileri, günlük 1000 hasta başına tanımlanmış günlük doz (DDD) cinsinden temsil edildi. Bulgular: Türkiye, odaklanılan dönemde en yüksek antibiyotik tüketimine sahip olmasına rağmen 2010-2015 tarihleri arasında 41.43 günlük 1000 hasta başına tanımlanmış günlük doz (DDD) ve 2016-2021 tarihleri arasında 32.24 günlük 1000 hasta başına tanım- lanmış günlük doz (DDD) antibiyotik tüketim verisi ile istatistiksel olarak (p= 0.05) anlamlı bir düşüş gösterdi. COVID-19 pandemisinin etkili olduğu 2021 yılında Avrupa’da, çalışmaya konu olan 2010-2021 yılları arasındaki en düşük düzeyi olan 14.91 günlük 1000 hasta başına tanımlanmış günlük doz (DDD)’a gerilerken Türkiye’de 2020 yılındaki kaydedilen 24.39 günlük 1000 hasta başına tanımlanmış günlük doz (DDD) seviyesine düşen antibiyotik tüketimi, 2021 yılında 26.97 günlük 1000 hasta başına tanımlanmış günlük doz (DDD) seviyesine yükseldi. Sonuç: Akılcı ilaç kullanımı uygulamaları, Türkiye için antibiyotik tüketimini azaltmada etkili olmakla birlikte, 2021 tüketim verileri ile trendin bozulduğu gözlemlenmiştir. Avrupa ülkeleri antibiyotik tüketim miktarlarında farklılık gösterse de toplamda COVID-19 pandemisi ile azalan bir tüketim durumuna girdiği tespit edilmiştir.Article Citation Count: 1The Evaluation of Serum Endocan, Interleukin-6, and CRP Levels Following Sleeve Gastrectomy(Dove Medical Press Ltd, 2023) Sariyildiz, Gulcin Turkmen; Demir, Canan Cicek; Demir, Mehmet Emin; Arslan, Aykut Ilker; Banli, Oktay; Dursun, Ali Dogan; Basic Sciences; Anesthesia ProgramBackground: The excessive accumulation of fat tissue in obesity is the source of chronic low-level inflammation and causes future dysmetabolic and cardiovascular disorders. Removal of this excessive fat tissue with the aid of bariatric surgery (BS) techniques, such as sleeve gastrectomy, may reverse adverse inflammatory outcomes. The aim of this study is to investigate the impact of sleeve gastrectomy on inflammatory markers, specifically endocan, IL-6, and CRP, in individuals with obesity.Methods: Thirty-two patients with class 3 obesity and class 2 obesity + comorbidities were enrolled in the study. Clinical characteristics including age, comorbidity, body mass index (BMI), waist, and hip circumferences of the participants were noted before and 3 months after sleeve gastrectomy. Blood samples were collected during those periods to assess biochemical features such as serum endocan, interleukin-6 (IL-6), C-reactive peptide, fasting insulin, glycosylated hemoglobin A1c levels, and lipid panel. A statistical package program was used for the analysis of those parameters, and p<0.05 was accepted as significant at a 95.0% confidence interval.Results: BMI reduced from 43.55 +/- 6.78 to 36.16 +/- 6.14 kg/m(2) within 3 months following BS (p<0.001). Preoperative serum endocan, IL-6, and CRP levels were correlated with BMI, and in line with BMI reduction, their serum levels decreased after BS (p<0.05). HOMA-IR also reduced after BS, and both in the pre and post-BS periods correlated with BMI, IL-6, endocan, and CRP levels (p<0.05). The mean total body weight loss was 20.4% within 3 months post-BS.Conclusion: BS techniques are effective in weight loss and reversing the inflammatory processes caused by obesity. Serum endocan, IL-6, and CRP levels are promising markers for describing obesity-related inflammation and objectively checking the alleviation of inflammation following BS.Article Citation Count: 0The impact of smoking on inflammation indices: A cross-sectional study(2023) Demir, Canan; Demir, Mehmet EminWe aim to investigate the association between smoking and systemic inflammation index (SII), the platelet-to-lymphocyte ratio (PLR), and the neutrophil-to- lymphocyte ratio (NLR) which are derivated from whole blood count. A total of 188 individuals who admitted to organ transplant outpatient polyclinics as donor candidates were included in this retrospective cross-sectional study. Donor candidates were divided into two groups; smokers and non-smokers. SII, PLR, and NLR were formulated from their hemogram during the preparation for donation. Serum C-reactive protein, uric acid, and creatinine levels were also compared between the two groups. P<0.05 was assumed as statistically significant. Seventy-five of 188 individuals (39.9%) were smokers. Smokers were older compared to nonsmokers and the mean smoking longevity was 21.14±12.92 years. SII, NLR, PLR, and CRP levels were higher in the smokers (p=0.020, p=<0.001, p=<0.001, and p=0.038, respectively). Smoking longevity had an impact on SII, PLR, NLR, and CRP (all p<0.001). Serum creatinine (and estimated glomerular filtration rate) had correlated with smoking and regression analysis indicated smoking was associated with high levels of serum creatinine (r=0.323, p<0.001, and r2=104). Smoking was a predictor for high levels of uric acid (p<0.001, r2=0.093). Smoking is associated with an increased inflammation status driven by changes in the immune response. The basic inflammation indices SII, NLR, and PLR, which can be derivated from whole blood count, and additionally CRP may be useful in the assessment of the inflammation status of smokers.Article Citation Count: 0Laparoscopic Sleeve Gastrectomy With Transit Loop Bipartition and Transit Bipartition in Type 2 Diabetic Patients With Obesity: A Retrospective Analysis(Lippincott Williams & Wilkins, 2023) Demir, Canan; Arslan, Ergin; Sariyildiz, Guelcin; Anil, Cueneyd; Banli, OktayAim:We aimed to compare 1-year postoperative results of patients with obesity and type 2 diabetes mellitus (T2DM) who underwent laparoscopic sleeve gastrectomy with transit bipartition (LSG-TB) and transit loop bipartition (LSG-TLB) and mini gastric bypass (MGB). Patients and Methods:This is a retrospective comparison of 2 novel bariatric surgery techniques with MGB. Primary outcome measure of the study was a rate of T2DM remission. Secondary outcomes included excess body mass index (BMI) loss, improvement in hepatosteatosis, and duration of operation. Revision surgery needs were also assessed. Results:Overall, 32 patients underwent the LSG-TLB, 15 underwent LSG-TB, and 50 underwent MGB. Mean age and sex distribution were comparable for all groups. Presurgical BMI was similar in MGB and LSG + TB groups, whereas LSG + TLB group had significantly lower BMI values compared with the MGB group. In both groups, BMI values reduced significantly compared with respective baseline values. Excess BMI loss was significantly higher in patients who underwent LSG-TLB compared with patients treated with LSG-TB and MGB. Bariatric surgery procedures lasted shorter in LSG-TLB than in LSG-TB. However, the shortest of all was MGB. The remission of T2DM rates were 71% and 73.3% in LSG-TLB and LSG-TB groups, respectively (P > 9.999). The rate of revision surgeries was comparable in both groups. Conclusion:In conclusion, LSG-TLB took less time and provided significantly higher excess BMI loss compared with LSG-TB. T2DM remission and improvement rates were similar in both groups. LSG-TLB seemed like a promising bariatric surgery technique in patients with obesity and T2DM.Article Citation Count: 0Serum asporin levels in maintenance hemodialysis patients without osteoarthritis(Galenos Publishing House, 2023) Dursun, Ali Doğan; Demir, Canan; Basic SciencesAims: Several human and experimental studies have shown that small leucine-rich proteoglycans might play a significant role in inflammation and fibrosis in various renal diseases. However, as far as we know, no study has reported asporin levels in patients with advanced renal disease. The primary aim of this study was to determine serum asporin levels in hemodialysis (HD) patients without symptomatic osteoarthritis. Methods: This single-center, cross-sectional study prospectively enrolled maintenance HD patients and healthy control subjects. Subjects with clinically clear osteoarthritis were excluded. Serum asporin level was measured via Human ASPN (Asporin) ELISA Kit (Elabscience Biotechnology Inc. Houston, Texas, USA) in fasting blood samples. Results: The study included 25 (mean age: 43.3±13.5 years, 60% were females) patients and 29 control subjects (mean age: 38.0±8.8 years, 37.9% were females). Patients and controls were similar in age and sex. Serum asporin levels were significantly higher in HD patients compared with the controls 2.4 (0.9-4.8) ng/mL vs. 0.3 (0.2-0.6) ng/mL, respectively, p<0.001). Asporin levels were not correlated with age (r=0.344, p=0.092) and the duration of HD (r=0.385, p=0.077). Among HD patients, asporin level was not significantly correlated with C-reactive protein, parathyroid hormone, calcium, or phosphorus levels. Conclusions: This study showed that serum asporin levels were significantly elevated in patients undergoing HD. Further studies must elucidate the possible origins of increased asporin in these patients.Article Citation Count: 0Serum irisin levels and osteoporosis in patients with advanced chronic kidney disease and renal transplant recipients(Springer, 2023) Demir, Canan; Dursun, Ali Dogan; Sariyildiz, Guelcin Tuerkmen; Arslan, Aykut Ilker; Basic Sciences; Anesthesia ProgramAimTo elucidate the association of serum irisin levels with bone mineral density (BMD) and calcium-phosphorus metabolism parameters in chronic kidney disease (CKD) patients and renal transplant recipients (RTRs).MethodsThis is a cross-sectional study involving CKD patients and RTRs. Healthy volunteers served as controls. Age, gender, and dialysis vintage were recorded. Serum irisin, creatinine, glucose, calcium, albumin, 25(OH) vitamin D, ferritin, C-reactive protein, A1C, and lipid profile were studied in all participants. Estimated glomerular filtration rate (eGFR), corrected calcium, and body mass index (BMI) were calculated.ResultsOverall, 49 patients (23 hemodialysis, 26 RTRs) and 25 control subjects were included. In hemodialysis (HD) group, 8 patients (34.8%) had osteoporosis, and 12 patients (52.2%) had osteopenia. In RTR group, 3 patients (11.5%) had osteoporosis, while 15 patients (57.7%) had osteopenia. Among controls, one had osteoporosis, and 7 had osteopenia. There was no significant difference between HD and RTRs; however, osteoporosis rate was significantly lower in control subjects. BMD measurements (femur and lumbar T- and Z-scores) were comparable between HD and RTR groups. Control group DEXA values were similar to RTRs; however, they were significantly higher compared to HD group. 25(OH) vitamin D levels were comparable between the HD and RTR groups, and these were significantly lower compared to values of the control group. Mean serum irisin level was 426.6 +/- 191.2 pg/mL in hemodialysis group, 342.6 +/- 174.8 in the RTR group, and 208.0 +/- 186.1 in controls. Serum irisin levels were similar in RTR and HD groups, but their values were significantly higher compared to controls. When we compared serum irisin levels between patients with and without osteoporosis in the whole cohort and hemodialysis and RTR groups, there was no difference. Serum irisin was positively correlated with lumbar T-score both in hemodialysis and RTR groups.ConclusionOur study is the first in the literature revealing the positive correlation of serum irisin level with femur T-score in RTRs. Serum irisin level was also positively correlated with femur T-scores in hemodialysis patients.