Browsing by Author "Arat, Zubeyde"

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Acute Renal Failure and Its Impact on Survival Following Cardiac Transplantation
(2016) Sezer, Siren; Yavuz, Demet; Canoz, Mujdat Batur; Altunoglu, Alparslan; Sezgin, Atilla; Arat, Zubeyde; Ozdemir Acar, Fatma Nurhan; Haberal, Mehmet; 0000-0002-4082-6320; 0000-0002-3462-7632; ABG-9980-2021; AAJ-8097-2021
OBJECTIVE: We evaluated the incidence and risk factors for acute renal failure (ARF) and also the associated hazard of death in recipients of cardiac transplants. MATERIAL and MET HODS: We included 25 patients in the study; 18 patients developed ARF (72%) and underwent continuous venovenous hemodiafiltration (Group I) and 7 patients had stable renal function (28%) (Group II). We retrospectively retrieved demographic variables; clinical, perioperative, postoperative complications and echocardiographic data; and biochemical parameters at the time of the surgery and six months later. RESULTS: Cumulative survival was 72.2% after 6 months, 64.2% after 24 months, and 51.4% after 32 months for Group I and 50% after 32 months for Group II (p> 0.05). A total of 8 patients died (32%); 1 (5.5%) from Group I and 7 (87.5%) from Group II. Risk factors for ARF were preoperative serum BUN, creatinine levels, and cardiopulmonary bypass time (p< 0.05). Only one patient underwent chronic hemodialysis because of chronic renal dysfunction in Group I while there was no such patient in group II. CONCLUSION: Preoperative serum BUN, creatinine value, and cardioopulmonary bypass time were found to be risk factors for ARF after cardiac transplantation. Postoperative renal dysfunction did not affect long-term renal function and survival.
Endothelial Nitric Oxide Synthase Polymorphism Influences Renal Allograft Outcome
(2014) Uyar, Murathan; Sezer, Siren; Ozdemir, Fatma Nurhan; Kulah, Eyup; Arat, Zubeyde; Atac, Fatma Belgin; Haberal, Mehmet; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-5682-0943; https://orcid.org/0000-0001-6041-4254; https://orcid.org/0000-0001-6868-2165; https://orcid.org/0000-0002-3462-7632; 24372826; AAK-5313-2021; JYQ-2550-2024; AAK-1697-2021; AAJ-5764-2021; ABG-9966-2020; AAJ-8097-2021
BackgroundAtherosclerotic lesions within the graft are considered to be a major cause of interstitial fibrosis/tubular atrophy (IF/TA). We evaluated the factors that influence the development of IF/TA and three- and five-yr graft survival including nitric oxide synthase (eNOS) and angiotensin II type 1 and type 2 receptor gene polymorphism. MethodsSeventy-one male and 35 female patients (age: 34.911.2yr) who underwent living-related renal transplantation were included. Angiotensin type 1 and type 2 receptor gene polymorphisms and eNOS intron 4 gene polymorphism were analyzed. The pre- and post-transplant laboratory data, patient characteristics, acute rejection episodes, and presence of IF/TA were evaluated. ResultsPatients with the bb allele of eNOS gene had a lower prevalence of post-transplant third year (12.6% and 38.5%, p=0.005) and fifth year IF/TA (46.6% and 82.3%, p=0.02) and a lower incidence of five-yr graft failure (35.4% and 55.6%, p<0.005). The eNOS gene polymorphism was independent and was the most prominent factor associated with third and fifth year IF/TA (p=0.01, RR: 29.72, and p=0.03, RR: 4.1, respectively). No significant relationship existed when angiotensin II gene polymorphisms were considered. ConclusionsWe concluded that recipient eNOS gene polymorphism can predict IF/TA, and the presence of the bb allele is associated with better graft outcome.
Free Triiodothyronine in Hemodialysis Patients Link With Malnutrition and Inflammation
(2014) Yavuz, Demet; Sezer, Siren; Yavuz, Rahman; Canoz, Mujdat Batur; Altinoglu, Alpaslan; Elsurer, Rengin; Arat, Zubeyde; Ozdemir, Fatma Nurhan; https://orcid.org/0000-0002-4082-6320; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-5682-0943; 24878944; ABG-9980-2021; JYQ-2550-2024; AAK-1697-2021
Introduction. Free triiodothyronine (FT3) is a marker of comorbidity in end-stage renal disease and in many acute and chronic diseases. There is lack of data about the link between FT3 levels and malnutrition and inflammation in hemodialysis patients. The objective of the present study was to investigate the link between FT3 and malnutrition and inflammation in hemodialysis patients. Materials and Methods. A total of 84 patients were included in the study (38 men and 46 women; mean age, 56.2 +/- 14.8 years; hemodialysis duration, 95.72 +/- 10.35 months). Serum FT3, free thyroxin, and thyroid-stimulating hormone concentrations were determined. Demographic data and laboratory values were evaluated. Patients' comorbidity status was determined using the Charlson Comorbidity Index (CCI), and malnutrition-inflammation status was determined by Malnutrition-Inflammation Score (MIS). Results. Serum FT3 concentration inversely correlated with age (r = -0.328, P =.002), CCI (r = -0.591, P < .001), C-reactive protein (r = -0.299, P =.01), and MIS (r = -0.671, P < .001), and positively correlated with serum albumin (r = 0.389, P < .001). In multivariate linear regression analysis, FT3 was independently associated with MIS (beta, -0.14; 95% confidence interval, -0.175 to 0.063, P = .003), adjusted for CCI, C-reactive protein level, serum albumin level, and MIS. Conclusions. The results of this study indicate that FT3 is negatively correlated with inflammatory markers, namely C-reactive protein, and it is independently related with MIS in hemodialysis patients. Therefore, we suggest that FT3 can be accepted as an inflammatory marker in hemodialysis patients.
Hemodiyaliz hasta ve yakınlarında tükenmişlik sendromu, hasta yakınlarının yaşam kalitelerinin değerlendirilmesi ve etkileyen faktörler
(Başkent Üniversitesi Sağlık Bilimleri Enstitüsü, 2006) Arat, Zubeyde; Akgün, Seval
Kronik hastalıklarda aile etmenlerinin önemli bir kısmı "Expressed Emotion" (Duygu Dışavurumu-DD) kavramı ile incelenmektedir. Bu çalışmada hasta ve hasta yakınlarının duygu dışavurumları ile birlikte hasta yakınlarının yaşam kaliteleri ve hastaların umutsuzluk düzeyleri eş zamanlı değerlendirilerek mevcut durumun ve bu durumu oluşturabileceği düşünülen ek faktörlerin saptanması amaçlanmıştır. Çalışmaya yaş ortalamaları 42,8+-18,2 (18-78) olan 30 erkek (%57,7), 22 kadın (%42,3) toplam 52 hasta ve yaş ortalamaları 46,4+-16,6 (20-73) olan 17 erkek (%32,7), 35 kadın (%67,3) toplam 52 hasta yakını dahil edilmiştir. Kronik hasta gruplarında aile kavramını ve tükenmişliğini ölçen, hastalara uygulanan LEE Duygu Dışavurum ölçeği, hasta yakınlarına uygulanan EE Duygu Dışavurum (p<0,02) ve yaşam kalitesi ölçeği ile ilişkili (p<0,005) bulunmuştur. EE ölçeğindeki ilişki yanlızca EE Eleştirel-Düşmancıl oluş alt ölçeğindende saptanmıştır (p<0,01). Hastalara uygulanan BECK umutsuzluk ölçeği ile hasta yakınlarına uygulanan EE Duygu Dışavurum EE Aşırı-İlgi-Koruyucu-Kollayıcı olma alt ölçeği (p<0,02) ve SF-36 Yaşam Kalitesi ölçeği arasında anlamlı bir ilişki saptanmamıştır (p<0,001). SF-36 ölçeği ile olan bu anlamlı ilişki yalnızca ruhsal sağlık alt ölçeğinde görülmüştür (p<0,0001). Bu sonuç hasta yakınlarının davranış tutum ve tepkilerinin hastanın durumu ile etkileşim halinde olduğunu yansıtmaktaydı. Familial factors in chronic diseases are mostly evaluated by the "Expressed Emotion (EE)" concept. The aim of the study was to determine the expressed emotion of the patients and patients' relatives, to simultaneously evaluate the life qualities of patients' relatives and patients' desperation levels, to disclose the current situation and additional factors which may be responsible for the situation. Fifty-two patients (mean age: 42.8+-18.2 years, range: 18-78 years) of whom 30 were males (57.7%) and 22 were females (42.3%) and 52 patients' relatives (mean age: 46.4+-16.6 years, range: 20-73 years) of whom 17 were males (32.7%) and 35 were females (67.3%) were included in the study. LEE Expressed Emotion scale, which measures familial factors and exhaustion in chronically ill patients, was related with EE Expressed Emotion (p<0.02) and Quality of Life scales (p<0.005) of patients' relatives. The association with EE scale was present only in the EE Critisizm-Hostility subscales (p<0.01). BECK desperation scale of patients was significantly related with EE Emotional Expression EE-Emotional Overinvolvement subscale (p<0.02) and SF-36 Quality of life scale (p<0.001) of patients' relatives. The association with SF-36 was present only in the mental health subscale (p<0.0001). These results reflected that the behaviors, attitudes and reactions of the patients' relatives were interacting with emotional status of the patients.