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Article Citation - WoS: 1Citation - Scopus: 1Factors Affecting Influenza and Pneumococcal Vaccination Rates in Hemodialysis Patients: a Multicenter Study(Dove Medical Press Ltd, 2025) Selen, Tamer; Merhametsiz, Ozgur; Onec, Kuersad; Ercan, Zafer; Islam, Mahmud; Altun, Gulsah; Demir, Mehmet EminPurpose: In patients with end-stage renal disease (ESRD), infections, particularly pneumonias, are the most common cause of hospital admissions and death after cardiovascular diseases. It is recommended that dialysis patients receive the pneumococcal vaccine every five years and the influenza vaccine annually. Our study aims to determine the awareness and factors affecting influenza and pneumococcal vaccination rates in hemodialysis patients. Patients and Methods: This cross-sectional study was conducted on patients undergoing regular hemodialysis treatment in 10 different hemodialysis centers across 4 cities. After excluding patients with less than one year of hemodialysis duration and those under 18 years of age, 548 patients were included in the study. Patients were administered a 20-item survey via face-to-face interview and electronic medical records. Results: Out of the 548 patients, only 19 (3.5%) had knowledge about the pneumococcal vaccine, while 238 (43.4%) had knowledge about the influenza vaccine. There were 220 patients (20.1%) who had knowledge about both vaccines. Among the patients, 95 (17.3%) had received the pneumococcal vaccine, with 41.1% of them having received it five years ago or more. A significant proportion (33.7%) of the patients could not recall the timing of their vaccination. While 183 (33.4%) patients had not received the influenza vaccine, only 140 (25.5%) had been vaccinated regularly every year. The reasons for not receiving the influenza and pneumococcal vaccines were stated as "I do not feel the need because I do not get the flu" (25%) and "I do not know about the pneumonia vaccine" (36.7%), respectively. The ROC curve analysis for the influenza questionnaire score showed an AUC of 0.822 (95% CI 0.787-0.856), with a p-value of <0.001. The statistically significant cutoff value for predicting influenza vaccination was determined to be 2.5. In the univariate analysis, dialysis duration (HD duration), diabetes mellitus (DM), and vascular access type were found to be statistically significant. In the multivariate logistic regression analysis, dialysis duration and DM were identified as independent factors predicting a higher level of knowledge about the influenza vaccine (p=0.009, 0.003, and p=0.041). The ROC curve analysis for the pneumococcal questionnaire score showed an AUC of 0.920 (95% CI 0.886-0.955), with a p-value of <0.001. The statistically significant cutoff value for predicting pneumococcal vaccination was determined to be 3.5. In the univariate analysis, residence, dialysis duration, and education level were found to be statistically significant. In the multivariate logistic regression analysis, dialysis duration and education level were identified as independent factors predicting a higher level of knowledge about the pneumococcal vaccine (p=0.038, 0.040, and p=0.010). physicians, nurses and nephrologists on this issue will increase vaccination rates.Article Citation - WoS: 5The 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 DoganBackground: 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.
