Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Evaluation of Machine Learning Algorithms for Renin-Angiotensin-Aldosterone System Inhibitors Associated Renal Adverse Event Prediction(2023) Guven, Alper Tuna; Ozdede, Murat; Sener, Yusuf Ziya; Yildirim, Ali Osman; Altintop, Sabri Engin; Yesilyurt, Berkay; Uyaroglu, Oguz Abdullah; Tanriover, Mine Durusu; 0000-0002-6310-4240; 37217407Background: Renin-angiotensin-aldosterone system inhibitors (RAASi) are commonly used medications. Renal adverse events associated with RAASi are hyperkalemia and acute kidney injury. We aimed to evaluate the performance of machine learning (ML) algorithms in order to define event associated features and predict RAASi associated renal adverse events.Materials and Methods: Data of patients recruited from five internal medicine and cardiology outpatient clinics were evaluated retrospectively. Clinical, laboratory, and medication data were acquired via electronic medical records. Dataset balancing and feature selection for machine learning algorithms were performed. Random forest (RF), k-nearest neighbor (kNN), naive Bayes (NB), extreme gradient boosting (xGB), support vector machine (SVM), neural network (NN), and logistic regression (LR) were used to create a prediction model.Results: 409 patients were included, and 50 renal adverse events occurred. The most important features predicting the renal adverse events were the index K and glucose levels, as well as having uncontrolled diabetes mellitus. Thiazides reduced RAASi associated hyperkalemia. kNN, RF, xGB and NN algorithms have the highest and similar AUC (> 98%), recall (> 94%), specifity (> 97%), precision (> 92%), accuracy (> 96%) and F1 statistics (> 94%) performance metrics for prediction.Conclusion: RAASi associated renal adverse events can be predicted prior to medication initiation by machine learning algorithms. Further prospective studies with large patient numbers are needed to create scoring systems as well as for their validation.Item Neuroblastoma Accompanied by Hyperaldosteronism(2014) Gulleroglu, Kaan; Bayrakci, Umut; Kinik, Sibel Tulgar; Uslu, Nihal; Atilgan, Alev O. K.; Sarialioglu, Faik; Baskin, Esra; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-8257-810X; https://orcid.org/0000-0003-4361-8508; 25340174; AAJ-8833-2021; ABC-5258-2020; AAK-3333-2021; AAL-7766-2021; B-5785-2018Background: Tumors known derived from kidneys which take place in secondary hyperaldosteronism etiology are juxtaglomerular cell tumor and Wilms' tumor. Neuroblastoma presenting with hyperaldosteronism is rare. Case: A 15-month-old girl who had been having diarrhea and fever for 2 weeks presented with a 3 day history of bilious vomiting, metabolic acidosis and severe hypokalemia. She was referred to our hospital with the pre-diagnosis of unknown manifest hypertension etiology, diarrhea, and paralytic ileus after having therapy-resistant hypokalemia and severe resistant acidosis. On her examination after being admitted to our clinic, she was weak, unwell and lethargic with a blood pressure of 140/93 mmHg. Due to the hypertension and severe hypokalemia, the patient was considered to be hyperaldosteronism. Serum aldosterone level, plasma renin activity and cortisol level were elevated. Radiologic findings were compatible with neuroblastoma. The patient underwent an abdominal surgery and the mass excision. The histopathological examination was proved neuroblastoma. Conclusion: Hyperaldosteronism can be presented by unexpected atypical forms as in our patient.Item Factors Affecting Risk of Anxiety and Depression Among Diabetic and Hypertensive Patients Who Refer to Family Health Centers(2018) Emre, Nilufer; Topal, Kenan; Edirne, Tamer; Gereklioglu, CigdemThis cross-sectional study was carried out to investigate the factors which influence risk of anxiety and depression among diabetic and hypertensive patients who refer to family health centers. The Hospital Anxiety and Depression Scale (HADS) was applied for assessment of emotional status of the patients and the Hypertension Compliance Assessment Scale (HCAS) was applied for assessment of adherence to anti-hypertensive therapy. Of a total of 380 patients, 170 had hypertension (HT), 83 had type 2 diabetes mellitus (T2DM), and 127 had both HT and T2DM. According to HADS, 18.7% of the patients had risk of anxiety, 24.7% had risk of depression, and 12.6% had both risk of anxiety and depression. Mean HAD-Anxiety (HADS-A) score and HADS-Depression (HADS-D) score were significantly lower in the patients who had an adequate compliance to medication therapy (5.1 +/- 4.1 and 3.8 +/- 3.4, respectively) compared to the patients who had a low compliance to therapy (7.6 +/- 4.3 and 5.8 +/- 4.0, respectively) according to the Hypertension Compliance Assessment Scale ((2)=15.26, p<0.01 and (2)=13.80, p<0.01). Mean HADS-D score was found significantly lower among the diabetic patients with good glycemic control (3.7 +/- 2.9) compared to the patients with poor glycemic control (4.5 +/- 3.7) ((2)=25.00, p<0.05). Anxiety and depression are among the most frequent disorders as hypertension and diabetes in primary care setting. We revealed that risk of anxiety and/or depression was greater among hypertensive and diabetic patients, consistently with the previous studies. Our study also revealed that this condition negatively affected treatment compliance in hypertensive patients and glycemic control in diabetic patients.Item Smoking Behavior of Heart Transplant Patients: A Retrospective Study(2018) Sozen, Fisun; Cetinel, Yasemin; Kul, Ozdemir Efe; Sezgin, Atilla; 0000-0002-1951-2693; 29528018; AAC-1823-2021Objectives: Smoking is an important risk factor for development of complications in heart transplant patients and plays an important role in the mortality of these patients.The aim of this study was to compare the survival of heart transplant patients after transplant versus their smoking status before transplant. Materials and Methods: Patients who had heart transplant procedures at the Baskent University Hospital Cardiovascular Surgery Department between 2005 and 2016 were analyzed retrospectively with regard to their smoking status and survival after transplant. We divided the 51 included adult patients into 2 groups: nonsmokers and ex-smokers. Data were analyzed with SPSS software (Statistical Package for Social Sciences for Windows, version 23.0, SPSS Inc., Chicago, IL, USA). Descriptive statistics are shown as means +/- standard deviation, and differences between means were determined with t tests. Survival statistics were evaluated with Kaplan-Meier analyses using log rank test. Results: Of 51 heart transplant patients, 40 were male (78.4%) and 11 were female (21.6%) patients. Mean age was 42.5 +/- 14.2 years in male patients and 30.4 +/- 13.2 years in female patients (95% confidence interval, 2.4-21.8). Although 36 patients(70.6%) were still living at follow-up, 15 patients had died (29.4%). According to smoking status, 30 patients (58.8%) were nonsmokers and 21 patients (41.2%) were ex-smokers, who showed smoking rate of 23.7 +/- 26.0 packs/year. We found that patients who were nonsmokers survived longer; however, at time of analysis (September 30, 2017), survival was not mature yet for the nonsmoking group. Median survival time for patients who were ex-smokers was 93.0 months(log-rank test = .099) Conclusions: Our study showed that patients in the nonsmoking group survived longer after heart transplant. Early smoking cessation can prolong survival of heart transplant patients.Item Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study(2021) Vuruskan, Ediz; Ercil, Hakan; Unal, Umut; Alma, Ergun; Anil, Hakan; Sumbul, Hilmi Erdem; Deniz, Mehmet Eflatun; Goren, Mehmet Resit; 33873196Introduction: The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension. Methods: Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated. Results: Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 +/- 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (p = 0.071, p = 0.973, respectively), but the increase in age and hypertension duration (p = 0.030 and p < 0.001, respectively) and the presence of metabolic syndrome (p = 0.002) significantly decreased the complete response rates. Conclusions: Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.