Browsing by Author "Demir, Mehmet Emin"

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Böbrek Naklinde de Novo Uzamış Salınımlı Takrolimus Kullanımı Sonuçları: Tek Merkez, 1 Yıllık Sonuçlar
(2022) Sarıyıldız, Gülçin Türkmen; Demir, Mehmet Emin; Sezer, Siren; Sozener, Ulas; Ercan, Zafer; Gulen, Merter; Özşeker, Fatma Necla
Amaç: Böbrek nakli alıcılarında günde tek doz uzamış salınımlı takrolimus (tac-ER) kullanımı, erken salınımlı takrolimus (tac-IR) kullanımına benzer etkinlik ve daha iyi ilaç uyumu sağlaması amacıyla geliştirilmiştir. Ancak uzamış salınımlı takrolimus ile ilgili deneyimler daha çok nakil sonrası dönemde yapılan “switch” protokollerine dayanmaktadır. Bu çalışmada böbrek alıcılarında de novo tac-ER kullanımı ile ilgili deneyimlerimizi ve 1 yıllık sonuçları sunmayı amaçladık. Gereç ve Yöntem: Bu tek merkezli retrospektif çalışmaya Ocak 2022-Ocak 2021 arasında yapılan 72 de novo böbrek nakli hastası dahil edilmiştir. Hastalar tac- ER ve tac-IR alan iki gruba ayrıldı. Bir yıllık allogreft fonksiyonları ve sağ kalımları, hastaların günlük ilaç dozları ve bunların akut rejeksiyon atakları ile ilişkileri karşılaştırıldı. Allogreft fonksiyonları ve akut rejeksiyon atakları üzerine etki eden faktörler incelendi. Bulgular: Toplam 69 hastanın (uzamış salınımlı grupta 30 hasta ve erken salınımlı grupta 39 hasta) verileri incelendi. Üç hasta posttransplant erken dönemde öldüğü için analize dahil edilmedi. Nakil sonrası 12 aylık izlem boyunca her iki grup arasında serum kreatinin ve takrolimus çukur değerler bencer bulundu (p>0,05). İlk 3 ay içinde hedef takrolimus değerlere ulaşmak için, tac-ER grubunda daha yüksek günlük dozlar (milligra/gün ve milligram/gün/kg) gerekti (p<0,05). Nakil sonrası ilk 12 ay içinde her iki grupta da rejeksiyon oranları benzerdi (p=0,281). Tek değişkenli analizde posttransplant 1. aydaki takrolimus dozu (milligram/kg/gün) takrolimus çukur değerinin aksine rejeksiyon gelişimi üzerinde etkili görüldü (p=0,02). Sonuç: Böbrek naklinde uzamış salınımlı takrolimusun (Advagraf®) de novo kullanımı, erken salınımlı takrolimus kullanımına benzer etkinlik, allogreft sağ kalımı ve fonksiyonu sağlar.
Citation - WoS: 1
The 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 Program
Background: 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.
The Impact of Smoking on Inflammation Indices: a Cross-Sectional Study
(2023) Demir, Canan; Demir, Mehmet Emin
We 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.
Citation - WoS: 6
Citation - Scopus: 7
The Results of Sglt-2 Inhibitors Use in Kidney Transplantation: 1-Year Experiences From Two Centers
(Springer, 2023) Demir, Mehmet Emin; Ozler, Tuba Elif; Merhametsiz, Ozgur; Sozener, Ulas; Uyar, Murathan; Ercan, Zafer; Turkmen Sariyildiz, Gulcin; Surgical Sciences
PurposeSodium-glucose co-transporter-2 inhibitor (SGLT-2i) administration is associated with some concerns in regard to the increased risk of genital and urinary tract infections (UTI) in kidney transplant recipients (KTR). In this study, we present the results of SGLT-2i use in KTR, including the early post-transplant period.MethodsParticipants were divided into two groups: SGLT-2i-free diabetic KTR (Group 1, n = 21) and diabetic KTR using SGLT-2i (Group 2, n = 36). Group 2 was further divided into two subgroups according to the posttransplant prescription day of SGLT-2i; < 3 months (Group 2a) and >= 3 months (Group 2b). Groups were compared for development of genital and urinary tract infections, glycated hemoglobin a1c (HgbA1c), estimated glomerular filtration rate (eGFR), proteinuria, weight change, and acute rejection rate during 12-month follow-up.ResultsUrinary tract infections prevalence was 21.1% and UTI-related hospitalization rate was 10.5% in our cohort. Prevalence of UTI and UTI-related hospitalization, eGFR, HgbA1c levels, and weight gain were similar between the SGLT-2i group and SGLT-2i-free group, at the 12-month follow-up. UTI prevalence was similar between groups 2a and 2b (p = 0.871). No case of genital infection was recorded. Significant proteinuria reduction was observed in Group 2 (p = 0.008). Acute rejection rate was higher in the SGLT-2i-free group (p = 0.040) and had an impact on 12-month follow-up eGFR (p = 0.003).ConclusionSGLT-2i in KTR is not associated with an increased risk of genital infection and UTI in diabetic KTR, even in the early posttransplant period. The use of SGLT-2i reduces proteinuria in KTR and has no adverse effects on allograft function at the 12-month follow-up.