Browsing by Author "Fidan, Cihan"

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Acoustic Radiation Force Impulse Elastography Findings of Achilles Tendons in Patients on Chronic Hemodialysis and in Renal Transplant Patients
(2021) Rahatli, Feride Kural; Turnaoglu, Hale; Haberal, Kemal Murat; Kirnap, Mahir; Fidan, Cihan; Sayin, Cihat Burak; Uslu, Nihal; Haberal, Mehmet; 0000-0002-8211-4065; 0000-0002-9093-1524; 0000-0002-9093-1524; 30398098; R-9398-2019; F-5830-2019; F-5830-2019
Objectives: The Achilles tendon, which is composed of tendinous parts of gastrocnemius and soleus muscles, is the strongest and the largest tendon in the human body. Chronic renal disease can lead to reduced physical activity and exercise capacity. Spontaneous rupture of the Achilles tendon can occur in patients with chronic renal failure, with recurrent microtraumas, hypoxia, and chronic acidosis as predisposing factors. Here, we assessed and compared the elastographic findings in the Achilles tendon using acoustic radiation force impulse elastography in patients on chronic hemodialysis, in renal transplant patients, and in healthy volunteers. Materials and Methods: Our study included 25 patients on chronic hemodialysis, 25 renal transplant patients, and 25 healthy individuals (control group). The thickness and shear wave velocity of the Achilles tendons were measured bilaterally by ultrasonography and acoustic radiation force impulse elastography. Results: The mean shear wave velocity was 3.67 m/s in the right and 3.64 m/s in the left Achilles tendon in the hemodialysis group. In the renal transplant group, the mean shear wave velocity was 4.29 and 4.25 m/s for the right and left Achilles tendon, respectively. In the control group, the mean shear wave velocity was 6.68 and 6.59 m/s, respectively for the right and left Achilles tendon. A statistically significant difference in shear wave velocities was shown among the groups (P<.05). Conclusions: Achilles tendons in patients with chronic renal failure and on hemodialysis were softer than in renal transplant patients and softer than in the control group. Chronic tendinopathy causes softening of the tendon. In the renal transplant group, stiffness of the Achilles tendon was increased versus the hemodialysis group but still softer than the control group, which could be explained as a positive clinical effect of renal transplant. Acoustic radiation force impulse elastography is an objective, easy, and noninvasive method to assess Achilles tendinopathy.
Analysis of Quality of Life, Depression, and Sexual Function in Patients on the Liver Transplant List
(2021) Fidan, Cihan; Akdur, Aydincan; Kirnap, Mahir; Selcuk, Haldun; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-8726-3369; 34609310; AAJ-8097-2021; AAA-3068-2021
Background: I he only treatment in patients developing liver failure is liver transplantation. According to the Ministry of Health, the number of patients waiting for a liver transplantation is 2141, the average waiting period for liver transplantation is approximately 5 years, and 15-18% of these patients lose their life while waiting for transplantation. In these patients, limitations in daily activities and depression-anxiety are commonly found. The aim of this study was to analyze life quality, depression symptoms, and existence of sexual functional disorders of patients waiting for liver transplantation. Methods: A total of 74 patients, who were registered in Baskent University Hospital between 2015 and 2018, were included into the study. Short Form-36, Beck Depression Inventory, and Arizona Sexual Experiences Scale were applied to 56 patients who approved study. Results: Most of the patients were male (64.3%), and the mean age was 46 (18-64). Short Form-36 scores were low in all patients. The mean Beck Depression Inventory score of patients was found as 18.4 +/- 11.3, and they were suffering from moderate depressive symptoms. According to Arizona Sexual Experiences Scale, total mean scores of males was found as 16.3 +/- 5.5, and for females, it was 19.5 +/- 5.3 with a statistically significant difference (P < .05). It was found that sexual dysfunction mostly had moderate to mild. Conclusion: Depression and sexual dysfunction are common in patients with chronic liver diseases, and their life qualities deteriorate significantly. It is anticipated that evaluation of these patients in terms of psychological issues and sexual dysfunction will increase their quality of life during the organ waiting period and affect their well-being post-transplant.
As a potential treatment of COVID-19: Montelukast
(2020) Fidan, Cihan; Aydogdu, Ayse; 0000-0002-9093-1524; 32416408; F-5830-2019
It has been hypothesized that Montelukast, a cysteinyl leukotriene (cysLT) receptor antagonist, with effects of anti-inflammatory, suppress oxidative stress and reduce affect cytokine production, may limited progression of the disease on COVID-19 infection.
Diferansiye tiroid karsinomunda radyoaktif iyot tedavisinin kemik iliği üzerine etkileri ve sekonder kanser gelişimi
(Başkent Üniversitesi Tıp Fakültesi, 2018) Censur, Hakan; Fidan, Cihan
Tiroid kanserleri endokrin maligniteler içinde en sık görülen kanser olup kadınlarda en sık görülen ikinci kanserdir. Tiroid kanserlerinin büyük çoğunluğunu diferansiye tiroid kanserleri (DTK) oluşturmaktadır. Tiroid kanserinin insidansının artması ve iyi prognozlu olması, özellikle radyoiyodin tedavisinden sonra sekonder kanser gelişimi açısından endişeye yol açmaktadır. Bu çalışmada amacımız; RAİ tedavisinin zaman içinde kemik iliği üzerine etkilerini ve sekonder kanser gelişimini incelemektir. Bu çalışma, Başkent Üniversitesi Ankara Hastanesi’nde Ocak 2000 ve Aralık 2012 yılları arasında tiroid kanseri tanısı olan ve cerrahi işlem sonrası RAİ tedavisi alan 259 hastanın verileri retrospektif olarak taranarak yapılmıştır. Uygulanan RAİ tedavisinin öncesinde ve sonrasındaki 5 yıllık süreçte hastaların tam kan parametreleri, TSH ve tiroglobulin değerlerinin zaman içindeki değişimi incelendi. Ayrıca hastalarda sekonder kanser gelişimi olup olmadığı araştırıldı. Hastalara uygulanan ortalama RAİ dozu 118 mCi olarak tespit edilmiştir. Hastaların RAİ tedavisinden sonra kısa süreli takiplerinde kemik iliği supresyonu olduğu, ancak bu supresyonun uzun süreli takiplerinde normale döndüğü gözlenmiştir. Hastaların takiplerinde sekonder kanser gelişimi tespit edilmemiştir. RAİ tedavisinde 100 mCi üzeri yüksek doz olarak kabul görmekte ve bazı çalışmalarda RAİ sonrası sekonder kanser varlığından bahsedilmektedir. Bu çalışmalarda sekonder kanser varlığı ile RAİ ilişkisinin kesin olmadığı ve gelişen kanserlerin genetik yatkınlık, çevresel faktörler sebebiyle olabileceği de akılda tutulmalıdır. Türkiye’de verilen RAİ tedavisine bağlı sekonder kanser gelişiminin olmaması da RAİ’nin ülkemizde güvenle kullanılabileceğini düşündürmektedir. Thyroid cancers are the most common cancer among endocrine malignancies and the second most common cancer in women. The majority of thyroid cancers are differentiated thyroid cancers (DTK). Increasing incidence and good prognosis of thyroid cancer have led to concern about the development of second malignancy, especially after radioiodine treatment. Our aim in this study is; The effects of RAI treatment on bone marrow over time and the development of secondary cancer are examined. The study was carried out retrospectively from 259 patients diagnosed with thyroid cancer between January 2000 and December 2012 at the Ankara Hospital of Başkent University, Ankara, Turkey. The changes in whole blood parameters, TSH and thyroglobulin values of patients were examined over time before and after RAI treatment in 5 years. In addition, patients were investigated for the development of secondary cancer. The mean RAI administered to the patient was found to be 118 mCi. Patients had bone marrow suppression in short-term follow-up from RAI treatment, but this suppression was observed to return to normal in long-term follow-up. In patients' follow-up, the development of secondary cancer was not detected. It is accepted as a high dose of 100 mCi in the treatment of RAI, and in some studies, the presence of secondary cancer after RAI is mentioned. It should be kept in mind that in these studies, the presence of secondary cancer is not definitive, and that developing cancers may be due to genetic susceptibility, environmental factors. In the absence of secondary cancer development in Turkey linked to given RAI treatment, it is thought that RAI can be used safely in our country.
Effects of Hyperuricemia on Renal Function in Pediatric Renal Transplant Recipients
(2014) Baskın, Esra; Fidan, Cihan; Kantar, Asli; Gulleroglu, Kaan; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0002-9093-1524; https://orcid.org/0000-0003-1434-3824; B-5785-2018; F-5830-2019; AAJ-8833-2021
Evaluation of Nicotine Dependence Level and Factors Affecting the Success of Smoking Cessation in an Outpatient Clinic
(2021) Fidan, Cihan; Salguer, Funda; Simsek, Meliha Kubra; Birlik, Seyma Berfu; Akcay, Mueserref Sule
AIM: We aimed to determine the sociodemographic characteristics of those who applied to the smoking cessation outpatient clinic and to determine the factors affecting their smoking cessation success. MATERIALS AND METHODS: A total of 97 people who applied to Baskent University Hospital Family Medicine Smoking Cessation Outpatient Clinic between May 2019 and May 2020 were included in the descriptive cross-sectional study. A questionnaire form including demographic characteristics and smoking history, the Fagerstrom Test for Nicotine Dependence (FTND), and the Hospital Anxiety and Depression Scale (HADS) were applied to the participants. A pulmonary function test was performed; carbon monoxide (CO) and carboxyhemoglobin (COHb) levels were measured of the participants. RESULTS: The mean age of the participants was 42.9 & PLUSMN; 11.9, and 56.7% (n = 55) were male. The average number of cigarettes smoked daily was 23.2 & PLUSMN; 10.6, and the duration was 23.2 & PLUSMN; 11.7 years. FTND scores of the participants were determined as 14.4% (n = 14) very low, 18.6% (n = 18) low, 22.7% (n = 22) medium, 21.6% (n = 21) high, and 22.7% (n = 22) very high. The mean of FTND score was 5.4 & PLUSMN; 2.5, and the mean of CO and COHb levels was 11.2 & PLUSMN; 7.0 and 2.4 & PLUSMN; 1.1, respectively (r = 0.345, P = 0.001; r = 0.342, P = 0.001). A positive correlation was found between the FTND and HDS scores of participants and observed that depression scores increased as the level of nicotine addiction increased (r = 0.303, P = 0.003). Finally, 54.6% (n = 53) of the applicants were a quitter. There was a significant relationship between smoking cessation success and the number of drug boxes used in pharmacotherapy (P = 0.005). CONCLUSION: In this study, the most critical factor affecting smoking cessation success is ensuring that pharmacotherapy is completed within the recommended treatment period.
Knowledge, Preventive Behaviors and Risk Perception of the COVID-19 Pandemic: A Cross-Sectional Study in Turkish Health Care Workers
(2021) Arslanca, Tufan; Fidan, Cihan; Daggez, Mine; Dursun, Polat; 33836013
The coronavirus disease 2019 (COVID-19) outbreak spread to over 100 countries with a total of 100,000 cases during the first week of March 2020. Health care workers, as those on the frontline of the COVID-19 pandemic, are more susceptible to infection. Inadequate related knowledge and preventive behaviors among health care workers might lead to delayed treatment and result in the rapid spread of the infection. Therefore, this study evaluated the knowledge of health care workers with regard to COVID-19. A cross-sectional study was conducted from June 10-18, 2020. Participants were general practitioners, specialists, and nurses working at the forefront of the pandemic. Their knowledge, preventive behaviors, and risk perceptions concerning COVID-19 were evaluated using an online questionnaire created by our medical specialists. The questionnaire consisted of 29, 5, and 4 items about COVID-19 knowledge, preventive behaviors, and risk perceptions, respectively. A total of 251 health care workers completed the questionnaire. The mean age of the participants was 33.88 +/- 8.72 years old, and the sample consisted of 68 males (27.08%) and 183 females (72.91%). While there was no difference between the percentage of correct answers given by female and male participants to knowledge-based questions (p>0.05), the percentage of correct answers to the questions on preventive behaviors was significantly higher in female participants than in males (p<0.001). The overall average percentages of correct responses were 91.66% for knowledge-based questions and 85.96% for preventive behavior questions. The scores for knowledge-based questions were higher for medical specialists, whereas nurses scored higher on preventive behavior questions. Government hospital staff showed a significant difference in preventive behaviors compared to that of university hospitals (p<0.05). In addition, there was a positive correlation between knowledge scores and preventive behaviors. Although all the participants (100%) knew that contracting COVID-19 can lead to death, only 66.93% of them were willing to get vaccinated themselves. The knowledge level of health care workers concerning COVID-19 was above 90%, but the level of competence in terms of preventive behaviors was found to be low, especially in males.
Majör depresif bozukluk tanılı hastalarda ince bağırsak aşırı bakteri çoğalması durumu
(Başkent Üniversitesi Tıp Fakültesi, 2019) Petricli, Utku; Fidan, Cihan
Depresyon dünyada yaygın görülmekle birlikte yaşam kalitesini bozan ve yüksek oranda tekrarlayan bir hastalıktır. Birçok çalışma mikrobiyotanın santral sinir sistemini etkilediği göstermiş ve depresyonla ilişkilendirmiş olsa da, majör depresif bozukluğu olan hastalardaki temel patogenezi tam olarak bilinmemektedir. İnce bağırsak bakteri aşırı çoğalması, ince bağırsaktaki bakteri tiplerinin değişmesi ve/veya bakteri sayısının artışıdır. Stresin mikrobiyotayı değiştirdiği bilinmekte ve bu nedenle SIBO'nun majör depresif bozuklukla ilişkili olabileceği düşünülmektedir. Bu çalışma majör depresif bozukluk ile SIBO arasındaki ilişkiyi ortaya koymayı amaçlamaktadır. Çalışma 23.01.2019-15.07.2019 tarihleri arasında Başkent Üniversitesi Tıp Fakültesi Ankara Hastanesi Aile Hekimliği, Gastroenteroloji ve Psikiyatri Ana Bilim Dalı ve Sağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Psikiyatri Ana Bilim Dalı polikliniklerine başvurmuş olan 45 majör depresif bozukluk tanılı hasta ile 49 sağlıklı gönüllü olmak üzere toplam 94 kişiyle yürütülmüştür. Hastalara oral glukoz solüsyonu içirilmesini takiben Quintron Breath Tracker isimli cihaz kullanılarak nefeste H2 ve CH4 düzeyleri ölçülmüştür. Ayrıca demografik özellikleri, beck depresyon ölçeği, beck anksiyete ölçeği ve kısa semptom envanteri değerlendirmeleri yapılmıştır. Çalışmaya dahil edilen katılımcıların %60,6’sı (n=57) kadın, %39,4'i (n=37) erkekti. Yaş ortalamaları hasta grupta 38,9±15,2, kontrol grubunda 35,8±11.1 olarak bulunmuştur. BDÖ, BAÖ, KSE skorları sırasıyla hasta ve kontrol grubu olmak üzere ortalama 23,20±8,74 ve 4,86±2,85; 18,73±10,31 ve 6,06±4,57; 69,64±40,69 ve 17,63±11,93 olarak tespit edildi (p<0,001). Çalışmaya dahil edilen 94 kişinin %14,9'i (n=14) SIBO pozitif olup, gruplar arasında anlamlı bir ilişki tespit edilememiştir (p>0,05). Bununla birlikte metan pozitifliği hasta grubunda anlamlı olarak yüksek tespit edildi (p<0,05). Her iki grupta SIBO ile demografik özellikler ve vücut kitle indeksi arasında anlamlı bir ilişki yoktu (p>0,05). Bu çalışma majör depresif bozukluk ile SIBO'nun ilişkisini gösterememiş olmakla birlikte daha fazla sayıda MDB popülasyonlarında araştırma yapılması gerekir. Although depression is common in the world, it is a highly recurrent disease that deteriorates the quality of life. The main pathogenesis of major depressive disorder (MDD) is not fully understood, and many studies have shown that microbiota affects the central nervous system and is associated with depression. Small intestinal bacterial overgrowth (SIBO) is a change in the types of bacteria in the small intestine and / or an increase in the number of bacteria. Stress is also known to alter the microbiota, and therefore SIBO is thought to be associated with MDD. This study aims to reveal the relationship between MDD and SIBO. The study was carried out with 45 MDD patients and 49 healthy volunteers who were admitted to the outpatient clinic of Başkent University Faculty of Medicine Ankara Hospital and Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital between 23.01.2019-15.07.2019. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Brief Symptom Inventory (BSI) were performed. For the evaluation of SIBO, H2 and CH4 levels in breath were measured using Quintron Breath Tracker following oral glucose solution. Of the participants included in the study, 60,6% (n = 57) were female and 39,4% (n = 37) were male. The mean age was 38.9 ± 15.2 in the patient group and 35,8 ± 11.1 in the control group. BDI, BAI, BSI scores were 23,20±8,74 and 4,86±2,85; 18,73±10,31 and 6,06±4,57; 69,64±40,69 and 17,63±11,93, respectively (p <0.001). 14,9% (n = 14) of the participants (n = 94) were SIBO positive and there was no significant relationship between the groups (p> 0.05). However, methane positivity was significantly higher in the patient group (p <0.05). There was no significant relationship between SIBO and demographic characteristics and body mass index in both groups (p> 0.05). Although this study did not show the relationship between MDD and SIBO, more MDD populations need to be investigated.
Muscle Wasting Is Associated with Depression and Altered Mental Stage in Dialysis Patients
(2016) Fidan, Cihan; Tutal, Emre; Bal, Zeynep; Sezer, Siren; https://orcid.org/0000-0002-9093-1524; F-5830-2019; AAZ-5795-2021
Postoperative Gastrointestinal Bleeding After an Orthotopic Liver Transplant: A Single-Center Experience
(2014) Fidan, Cihan; Kirnap, Mahir; Akdur, Aydincan; Ozcay, Figen; Selcuk, Haldun; Arslan, Gulnaz; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-9093-1524; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-5214-516X; https://orcid.org/0000-0002-8445-6413; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24635817; F-5830-2019; AAH-9198-2019; AAA-3068-2021; ABG-5684-2020; AAJ-6976-2021; AAE-1041-2021; AAJ-8097-2021
Objectives: The overall incidence, causes, and treatment of posttransplant gastrointestinal bleeding, have been previously described. In this study, we examined the causes and treatment of postoperative gastrointestinal bleeding after orthotopic liver transplant. Materials and Methods: Clinical data of 335 patients who underwent an orthotopic liver transplant at our institution between September 2001 and December 2012 were analyzed retrospectively. The diagnosis and treatment of postoperative gastrointestinal bleeding after an orthotopic liver transplant were reviewed. Results: Gastrointestinal bleeding occurred in 13 patients (3.8%) after an orthotopic liver transplant. Five patients (38.4%) were adult and 8 patients (61.6%) were pediatric. The sites of the bleeding were Roux-en-Y anastomosis bleeding in 5 cases, peptic ulcer in 3 cases, erosive gastritis in 3 cases, gastric and esophageal varices in 1 case, and hemobilia in 1 case. These 13 patients with gastrointestinal bleeding were managed with conservative treatment, endoscopic treatment, radiologic interventional embolism, or exploratory laparotomy. No patients died because of gastrointestinal bleeding. During follow-up, 4 patients died because of sepsis and 1 patient died of recurrence of hepatocellular carcinoma. Conclusions: Gastrointestinal bleeding after liver transplant and its incidence, causes, and treatment are not well-described in the literature. Diagnosis and management of gastrointestinal bleeding requires a multidisciplinary approach involving surgeons, hepatologists, advanced and experienced endoscopists, and interventional radiologists.
Results of Liver Transplant in Elderly Patients: A Single Center Experience
(2015) Akdur, Aydincan; Fidan, Cihan; Soy, Ebru Ayvazoglu; Kirnap, Mahir; Karakayali, Feza Yarbug; Torgay, Adnan; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-5735-4315; 0000-0002-9093-1524; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-1874-947X; 0000-0002-0993-9917; 0000-0003-2498-7287; 0000-0002-6829-3300; 25894140; AAF-4610-2019; AAH-9198-2019; F-5830-2019; AAA-3068-2021; AAJ-8097-2021; AAB-3888-2021; AAC-5566-2019; AAE-1041-2021; AAJ-5221-2021
Objectives: With the increased life span, the need for liver transplant for elderly patients also increased in the world. In this study, we reviewed our experience to determine the outcomes and problems of patients aged > 60 years who had liver transplants. Materials and Methods: Data of recipients aged > 60 years were reviewed retrospectively. We analyzed 16 elderly patients who had liver transplant for chronic liver disease between 2001 and 2014 in our center. Results: In our series, there were 5 women and 11 men between age 60 and 65 years. The mean Child-Pugh score was 7.9 +/- 1.7 and Model for End-Stage Liver Disease score was 14.1 +/- 5.1. Primary liver disease was hepatitis B in 9 patients (34.5%), most of them with hepatocellular carcinoma. The other causes of liver failure were hepatitis C (n = 4), alcoholic cirrhosis (n = 2), and cryptogenic cirrhosis (n = 2); 1 patient had both hepatitis B and hepatitis C virus, and 1 patient had both hepatitis B virus and alcoholic cirrhosis. There were 9 patients who had hepatocellular carcinoma. Mortality was observed in 4 patients. The reasons for mortality were sepsis (n=3) and hepatocellular carcinoma (n=1). Conclusions: Liver transplant can be safely performed and has acceptable long-term outcomes in low-risk elderly recipients. Age alone should not be a contraindication for liver transplant in elderly patients.
Self-Medication Patterns among Turkish University Students
(2021) Zagil, Gamze Gursul; Fidan, Cihan; Oksuz, Ergun; Kut, Altug; 0000-0002-5723-5965; K-8238-2012
Objective: This study aims to determine the prevalence of self-medication practice among university students in Turkey and the effective factors and self-medication practices. Methods: To conduct a descriptive cross-sectional study, this study was conducted with 494 undergraduate students selected through a stratified random weight-proportional sample. The students were asked to fill in a self-report questionnaire form including introductory characteristics and self-medication practices. Analyses were carried out using descriptive statistics and binary logistic regression. Results: The prevalence of self-medication at any time was determined to be 81.6% (n=403). The prevalence of self-medication was 84.9% in females and 75.6% in males (OR 2.0, 95% CI 1.2-3.3, p=0.005). Of the participants, 27.5% (n=111) bought the medication by their own preferences and experiences. The most common self- medication symptoms of the participants were headache (90.8%). Self-medication drug groups were in the form of analgesics in 95.9% (n=259) of females and 93.2% (n=123) of males. The prevalence of antibiotic self-medication was 9.5% in the self-medication group and 7.7% for all participants. Due to self-medication, 8.2% (n=33) of the students experienced an adverse effect at any time. The students in the self-medication group believed that there would not be serious adverse effects caused by the OTC drugs even if they caused adverse effects (30.5%) or that they would not cause any adverse effects (3.8%). Conclusions: Self-medication is a common behavior among university students, with higher rates in females. Students practice this largely by relying on their previous experiences. They mostly prefer medicines previously given by their physicians for similar conditions.
Shear Wave Elastography Findings of Achilles Tendons in Patients on Chronic Hemodialysis and Patients with renal Transplantation
(2018) Rahatli, Feride Kural; Turnaoglu, Hale; Haberal, Murat; Kirnap, Mahir; Sayin, Burak; Fidan, Cihan; Uslu, Nihal; Haberal, Mehmet; 0000-0002-4226-4034; 0000-0002-0781-0036; 0000-0002-8211-4065; 0000-0001-8287-6572; 0000-0002-9093-1524; 0000-0002-6733-8669; 0000-0002-3462-7632; AAL-9808-2021; AAK-8242-2021; R-9398-2019; AAH-9198-2019; J-3707-2015; F-5830-2019; ABC-5258-2020; AAJ-8097-2021