Fakülteler / Faculties
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Item 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-1697-2021Introduction. 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.Item Importance of Malnutrition in Patients with Cirrhosis(2015) Gokturk, Huseyin Savas; Selcuk, Haldun; 0000-0002-8445-6413; 26038997; AAJ-6976-2021Malnutrition is common in patients with chronic liver disease and is associated with poor outcomes. Inadequate intake, poor quality diet, maldigestion, malabsorption, altered macronutrient metabolism, and hypermetabolism all contribute to the development of malnutrition in this patient population. Although it is generally easy to detect, clinicians often overlook malnutrition and its measurement is complicated by the lack of a simple, standardized diagnostic method. Early detection of malnutrition and multidisciplinary treatment approaches greatly increase the probability for successful outcomes.Item Effects of Enteral Protein Supplements on Nutritional Status and Clinical Outcome in Unconscious Elderly Malnourished Patients(2014) Gulsen Atalay, Betul; Yagmur, Cahide; Nursal, Tarik; Atalay, Hakan; Sezgin, Nurzen; Giray, Semih; Selcuk, Haldun; https://orcid.org/0000-0002-0722-3181; https://orcid.org/0000-0002-8445-6413; IQV-1169-2023; AAH-1091-2020; AAJ-6976-2021Aim: Unconscious malnourished patients have reduced serum proteins. Enteral protein supplements may improve their nutritional status and clinical outcome. Our aim for the present study was to determine the effect on nutritional status and patient prognosis of enteral protein supplementation in tube-fed hospitalised unconscious elderly malnourished patients. Methods: In total, 20 patients were fed a standard enteral nutrition formula during the four-day adaptation period. The study group (n = 10) received an enteral protein supplement (2 g/kg/day protein) and the control group (n = 10) received only standard enteral nutrition (1 g/kg/day protein) during the 12-day study period. Nutritional status and clinical outcome were assessed. Results: No difference was observed between the groups with regard to biochemical, inflammatory parameters, anthropometric measurements or nitrogen balance (P > 0.05). Triceps and subscapular skinfold thickness mean levels were elevated in the study group at the end of the study compared with the beginning of the study (P < 0.05). No significant difference was observed between the groups with regard to complications or mortality rate (P > 0.05). Conclusions: In the present study, the use of enteral protein support (EPS) in unconscious malnourished patients provided some advantages in the early stages of medical treatment. Triceps skinfold thickness and subscapular skinfold thickness mean levels were increased significantly in our study group. Although there was no significant difference, serum insulin-growth factor, retinol-binding protein and prealbumin mean values showed a tendency to increase in the study group at the end of the study. We believe that further research is required to determine the effects of EPS on these values in malnourished elderly patients.Item The Nutritional Risk Screening 2002 Tool For Detecting Malnutrition Risk in Hospitalised Patients: Perspective From A Developing Country(2014) Gokcan, Hale; Selcuk, Haldun; Tore, Emin; Gulseren, Pinar; Cambaz, Hatice; Saritas, Seniz; Ocal, Ruhsen; Basaran, Ozgur; Yilmaz, Ugur; Akin, Ebru; https://orcid.org/0000-0001-5663-0683; https://orcid.org/0000-0002-8445-6413; 25599788; AAR-8893-2020; AAJ-6976-2021; V-3553-2017Background/Aims: To verify the validity of the Nutritional Risk Screening (NRS) 2002 test in a Turkish population. Materials and Methods: We prospectively investigated 2566 patients at a tertiary referral hospital. Nutritional status was screened using NRS 2002, and the length of the stay (LOS) was the main outcome measure. Hospital stays >10 days were accepted as prolonged LOS. NRS scores >= 3 were accepted as indicating risk for malnutrition. Statistical analyses were performed to determine the independent risk factors for malnutrition risk and prolonged LOS. Results: The mean age of patients was 56.6 +/- 16.9 years. According to the NRS 2002, 964 patients (37.6%) were without risk, 1320 (51.4%) warranted surveillance and 282 (11%) were at high risk for malnutrition. Malnutrition rate was the highest in the intensive care unit (22.01%). Prolonged LOS was seen in 24.4% of patients. Intensive care unit stay [odds ratio (OR): 0.585; confidence interval (CI): 1.45-2.22; p<0.001] and an NRS score >= 3 (OR: 0.88; CI: 1.87-3.13; p<0.001) were independent risk factors for prolonged LOS. Conclusion: Improving healthcare outcomes while avoiding preventable healthcare costs is an important goal of healthcare provision in developing countries. NRS 2002 was predictive of LOS, and thus, of patient prognosis. Further community-based studies are warranted to assess the impact of NRS 2002 on reducing healthcare costs.Item Real World Data Estimation: Management and Cost-analysis of Stroke in Tertiary Hospitals in Turkey and the Impact of Co-morbid Malnutrition(2016) Arsava, Ethem Murat; Ozcagli, Tahsin Gokcem; Berktas, Mehmet; Giray, Semih; Guler, Ayse; Gungor, Levent; Ozdemir, Ozcan; Uluc, Kayihan; Yaka, Erdem; Yesilot, Nilufer; https://orcid.org/0000-0002-0722-3181; AAH-1091-2020Objective: To evaluate the management and cost analysis of first-ever stroke patients in Turkey and determine the impact of comorbid malnutrition. Methods: This study was based on expert's view on the management and cost analysis of stroke patients with or without malnutrition via standardized questionnaire forms filled by experts according to their daily clinical practice. Cost items were related to medical treatment, healthcare resources utilization, tests, consultations and complications. Per admission and total annual direct medical costs were calculated with respect to co-morbid malnutrition. Results: Malnutrition was evident in 7.8(3.6)% [mean(standard error of mean; SEM)] of patients at admission; an additional 7.1(4.8)% and 0.9(0.6)% patients developed malnutrition during Neuro-ICU and stroke unit hospitalization, respectively. Length of hospital stay (LOS) was almost 2-fold in patients with malnutrition (P<0.01 for all hospital units). During the 1-year follow-up period a mean(SEM) of 93.8(15.4)% with and 43.3(3.7)% without malnutrition were expected to experience at least 1 complication. The mean (SEM) per patient annual cost of stroke was US$5201(740) in patients with malnutrition and US$3619(614) in patients without malnutrition, while the corresponding figures for per admission were US$3061(513) and US$1958(372), respectively. Conclusions: In conclusion, our findings revealed that management of stroke and its complications have a relatively high burden on the Turkish health reimbursement system. Furthermore, co-morbid malnutrition, being not uncommonly encountered, increased the overall costs and was associated with longer LOS and higher rate of expected complications during 1-year follow up.