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YABACI TAK, AYŞEGÜL

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    PublicationOpen Access
    Comparative Evaluation of Orthostatic Hypotension in Patients with Diabetic Nephropathy.
    (2021-07-20T00:00:00Z) Aytaş, Gamze; Elçioğlu, Ömer C; Kazancıoğlu, Rümeyza; Gürsu, Meltem; Artan, A Serra; Yabacı, Ayşegül; Soysal, PINAR; Bilgi, Kadir; Özçelik, Semra; KAZANCIOĞLU, RÜMEYZA; ELÇİOĞLU, ÖMER CELAL; GÜRSU, MELTEM; YABACI TAK, AYŞEGÜL; SOYSAL, PINAR; ÖZÇELİK, SEMRA
    Introduction: Orthostatic hypotension (OH) affects 5-20% of the population. Our study investigates the presence of OH in diabetic nephropathy (DNP) patients and the factors affecting OH in comparison with nondiabetic chronic kidney disease (NDCKD) patients. Method: Patients presented to the nephrology clinic, and those who consented were included in the study. DNP was defined by kidney biopsy and/or clinical criteria. NDCKD patients of the same sex, age, and eGFR were matched to DNP patients. Demographic parameters and medications were obtained from the records. OH was determined by Mayo clinic criteria. The same researcher used an electronic device to measure blood pressure (BP). All samples were taken and analyzed the same day for biochemical and hematologic parameters and albuminuria. Results: 112 (51 F, 61 M, mean age: 62.56 ± 9.35 years) DNP and 94 (40 F, 54 M, mean age: 62.23 ± 10.08 years) NDCKD patients were included. There was no significant difference between DNP and NDCKD groups in terms of OH prevalence (70.5 vs. 61.7%, p = 0.181). Male patients had significantly higher OH prevalence than female patients (74.7 vs. 60.0%, p = 0.026). There was no significant difference in change in systolic BP between the groups (24.00 [10.00-32.00] mm Hg vs. 24.00 [13.75-30.25] mm Hg, p = 0.797), but the change in diastolic BP was significantly higher in the DNP group (8.00 [2.00-13.00] mm Hg vs. 6.00 [2.00-9.00] mm Hg, p = 0.025). In the DNP group, patients with OH had significantly higher uric acid levels than those without OH (7.18 ± 1.55 vs. 6.36 ± 1.65 mg/dL, p = 0.017). And, 73.7% of patients on calcium channel blockers developed OH (p = 0.015), and OH developed in 80.6% of 36 patients on alpha-blockers (p = 0.049). Conclusion: OH prevalence is very high in CKD, and etiology of CKD does not have a statistically significant effect on the frequency of OH, despite a difference that could be meaningful clinically. Therefore, patients with CKD are checked for OH, with or without concurrent diabetes mellitus. Evaluation of postural BP changes should be a part of nephrology practice.
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    PublicationOpen Access
    Comparison Between Sleeve Gastrectomy and Exenatide on Type 2 Diabetic Patients
    (2020-02-01T00:00:00Z) Elbasan, Onur; Şişman, Pınar; Peynirci, Hande; Yabacı, Ayşegül; Ersoy, Canan; YABACI TAK, AYŞEGÜL
    Background: Diabetes and obesity are major causes of mortality and morbidity that are increasing all over the world. As obesity is a major risk factor for type 2 diabetic patients, weight loss is important in the treatment of type 2 diabetic patients. In our study, our aim was to evaluate the effects of exenatide and laparoscopic sleeve gastrectomy (LSG) in obese type 2 diabetic patients on the clinical and laboratory parameters. Methods: Twenty-five LSG and 25 exenatide patients followed up in our outpatient clinic were involved in the study. Results: At the end of the 6-month follow-up, weight loss was ∼35.4 kg in the surgery group and 11.5 kg in the exenatide group. Although postprandial glucose and hemoglobin A1c were significantly decreased in both groups, the decrease was significantly higher in LSG group compared to the exenatide group. Although there was no significant change in fasting blood glucose (FBG) in the exenatide group, there was a significant decrease in FBG in LSG group. Conclusion: LSG is a method that should be performed up on indication and much more radical compared to exenatide administration, but appears to be a more efficient application that corrects diabetes- and obesity-related metabolic parameters compared to exenatide therapy in type 2 diabetic obese patients. © Copyright 2020, Mary Ann Liebert, Inc., publishers 2020.
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    The Influence of Gender and Age on Laparoscopic Sleeve Gastrectomy Short-Term Outcomes in Type-2 Diabetic Obese Patients
    (2021-06-01T00:00:00Z) Elbasan, Onur; Şişman, Pınar; Peynirci, Hande; Yabacı, Ayşegül; Ersoy, Canan; YABACI TAK, AYŞEGÜL
    Background Bariatric surgery has come out as an effective treatment for morbid obesity due to its effects as stabilized weight loss and remission of obesity related comorbidities like type 2 diabetes. Postoperative weight loss is affected by many factors and predictors of weight loss after bariatric surgery are controversial.This study has been performed to evaluate the impact of gender and age on the shortterm outcomes of laparoscopic sleeve gastrectomy (LSG) in type 2 diabetic(T2D) obese patients. Material and Methods In this retrospective study,the records of morbidly obese patients with a body mass index(BMI)≥40 kg/m2,aged between 18-65 years old who underwent LSG and were followed-up for at least 6 months postoperatively were reviewed.Patients were subdivided into two groups according to age(≥50 y,<50 y),gender(female, male) and compared. Results The study included 25 patients, 17(68%) female and 8(32%) male, 14(56%) were in <50 years old group and 11(44%) were in ≥50 years old group.At the postoperative 6th month,there was a significant decrease in weight,BMI,diastolic blood pressure,fasting blood glucose,postprandial glucose and HbA1c in both gender and age groups (p<0.05).A significant decrease was observed in Triglyceride(TG) at 6th month in both gender.While a significant increase in High-density Lipoprotein (HDL) was observed in patients aged ≥50 (p=0.028),no significant change was observed in the younger group.There was a positive correlation between change in Total Cholesterol(TCh),TG and age (respectively;r=0.436,p=0.030, r=0.528,p=0.007). Conclusions LSG is an effective treatment method for morbid obesity for younger(<50 y) and advanced aged(≥50 y) T2D patients in both genders. The percentage changes in the decreament of TG in male gender and TCh in younger age were more prominent in short-term follow-up
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    PublicationOpen Access
    SHORT TERM EFFECT OF LAPAROSCOPIC SLEEVE GASTRECTOMY ON CLINICAL, RENAL PARAMETERS AND URINARY NGAL LEVELS IN DIABETIC AND NON DIABETIC OBESITY
    (2019-09-01T00:00:00Z) Elbasan, Onur; Şişman, Pınar; Peynirci, Hande; Yabacı, Ayşegül; Dirican, Melehat; Öz Gül, Özen; Cander, Soner; Ersoy, Canan; YABACI TAK, AYŞEGÜL
    Background. Although diseases such as diabetes, hypertension, obstructive sleep apnea and hyperlipidemia are clearly documented as obesity associated diseases, it is not wellknown whether obesity causes renal pathologies. The aim of the present study was to evaluate the effect of weight loss following laparoscopic sleeve gastrectomy on clinical, renal parameters and urinary Neutrophil gelatinase-associated lipocalin (NGAL) levels in diabetic and non-diabetic obese patients. Methods. Nineteen morbidly obese patients (10 diabetic and 9 non diabetic) who underwent laparoscopic sleeve gastrectomy were evaluated clinically (anthropometric measurements) and biochemically before surgery and at 6 months from surgery. Results. Significant decreases in weight, BMI, FPG, PPG and HbA1c levels were observed in the diabetic group when the baseline and 6th month parameters of the patients were compared. There was also a significant decrease in SBP and DBP. At 6th month following laparoscopic sleeve gastrectomy, renal parameters such as creatinine, mAlb/creatinine, NGAL/ creatinine did not differ in the diabetic group. In the nondiabetic group, serum creatinine levels were significantly decreased, but other renal parameters such as mAlb/creatinine and NGAL/ creatinine were not significantly different. Conclusions. Our findings revealed significant decreases in weight, body mass index and glycemic parameters after sleeve gastrectomy in diabetic and non-diabetic patients, while no significant alteration was noted in renal functions, urinary NGAL and microalbumin levels. Key words: sleeve gastrectomy, obesity, urinary NGAL, kidney, weight loss, T2DM.
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    Kesikli Veriler İçin Ortalama-Ortanca Eşitsizliği Üzerine İyileştirilmiş Bir Ders Kitabı Kuralı
    (2020-05-01T00:00:00Z) Aydemir, İlhan; Demirtaş, Hakan; Vardar Acar, Ceren; Gao, Ran; Yabacı, Ayşegül; YABACI TAK, AYŞEGÜL
    Objective:Many introductory statistics books cover the mean-median inequality, which states that if the skewness value is positive/negative, the mean is greater/less than the median. However, this textbook rule is often violated especially when one tail is long and the other is heavy. The purpose of this paper is to propose a refinement that solves the problem to a meaningful extent by bringing the area to the left and right of the median into the picture for discrete data, where violations are more common and severe. The improved version is simple and effective enough to replace the existing rule.Material and Methods:Three distributional settings were utilized for illustration: The Poisson, binomial, and discretized normal mixture distributions. A simulation study was devised to assess the relative performances of the current and new rules for count data under the Poisson distribution assumption.Results:The new rule adds a simple layer to the current rule: For right skew, the mean is greater/less than the median if the area to the left of the median is less/greater than the area to the right. Similarly, for left skew, the mean is less/greater than the median if the area to the left the median is greater/less than the area to the right. In other words, the new component comes in the form of a comparative area restriction.Conclusion:All three distributional examples lead to the sameConclusion:The proposed version is associated with substantially better results. Although it is not a complete solution, it is a serious improvement.Keywords: Tail behavior; Introductory statistics; Symmetry; Mean; Median
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    Tıpta Uzmanlık Tezlerinde Yapılan İstatistiksel Hataların Değerlendirilmesi
    (2019-10-28T00:00:00Z) Yabacı, Ayşegül; Can, Fatma Ezgi; Kesin, Fisun; Ahmadian, Robab; Ercan, İlker; YABACI TAK, AYŞEGÜL
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    PublicationOpen Access
    Fibromiyalji Sendromu ile Bağırsak Mikrobiyotası Arasındaki İlişkinin Araştırılması
    (2021-03-01T00:00:00Z) Albayrak, Büşra; Süsgün, Seda; Küçükakkaş, Okan; Akbaş, Fahri; Yabacı, Ayşegül; Özçelik, Semra; SÜSGÜN, SEDA; KÜÇÜKAKKAŞ, OKAN; AKBAŞ, FAHRİ; YABACI TAK, AYŞEGÜL; ÖZÇELİK, SEMRA
    Fibromiyalji sendromu (FMS), yetişkin popülasyonda bildirilen prevalansı %3-10 olan, kronik yaygın ağrının sık görülen formlarından biridir. Tipik ağrının klinik görünümü ve ilişkili somatik ve psikolojik semptomların varlığı tanıya temel oluşturur. FMS sinir sistemi disfonksiyonu ile ilişkilidir ve nörotransmitterler fibromiyalji için onaylanmış bir dizi ilacın hedefi olarak rol oynamaktadır. Bununla birlikte, FMS’de altta yatan mekanizmalar kesin olarak henüz bilinmemekle birlikte birçok hipotez ortaya konmuştur. Fibromiyalji ve irritabl bağırsak sendromu (IBS) arasındaki ilişki göz önüne alındığında, değişen bağırsak mikrobiyomu fibromiyalji ile ilişkili olabilir. Bu çalışmada, FMS tanılı hastalarda sağlıklı kontrollere göre değişen bağırsak mikrobiyom düzeylerinin araştırılması amaçlanmıştır. Mikrobiyom çalışması için FMS tanılı 54 hastadan ve 36 sağlıklı kişiden oluşan kohorttan fekal örnekler toplanmıştır. Kontrol grubunda herhangi bir mental ve/veya fiziksel hastalığı olanlar çalışma dışında bırakılmıştır. FMS’li hasta grubu, -American College of Rheumatology (ACR)- 2010 tanı kriterlerine bağlı kalınarak belirlenmiştir. Fekal örnekler, kullanılana kadar -80°C’de muhafaza edilmiş ve buz üzerinde çözülmüş; her ekstraksiyon için 0.3 g feçes tartılmıştır. DNA izolasyonu, ticari kit ile üreticinin protokolüne uygun olarak gerçekleştirilmiştir. Örnekler, gerçek zamanlı polimeraz zincir yöntemi ile Bacteroidetes, Firmicutes, Enterobacter, Lactobacillus, Streptococcus ve Bifidobacterium’a özgül primerler ile 16S rRNA gen amplifikasyonu yapılarak karşılaştırılmıştır. Sonuçlara göre, hasta grubunda Bacteroidetes ve Bifidobacterium istatistiksel olarak anlamlı bir şekilde artarken (p< 0.05), Firmicutes’in azaldığı saptanmıştır (p< 0.001). Enterobacter, Streptococcus ve Lactobacillus için istatistiksel olarak anlamlı sonuç bulunamamıştır (p> 0.05). Bakteriler arasındaki ilişki değerlendirildiğinde, Bacteroidetes ile Firmicutes yüzdesi arasında istatistiksel olarak yüksek anlamlı ve negatif korelasyon bulunurken (r= -0.778, p< 0.001), Enterobacter ve Bifidobacterium yüzdesi arasında orta derecede istatistiksel anlamlılık ve pozitif korelasyon gözlenmiştir (r= 0.460, p= 0.005). Sonuçlar, bağırsak mikrobiyotasının fibromiyaljide rol oynayabileceğini göstermektedir. Bağırsaktaki Firmicutes ve Bacteroidetes filumlarının dengesinin bağırsak homeostazı için önemli etkilere sahip olduğu bilinmektedir. Özetle, daha büyük kohortlarda yapılacak büyük ölçekli araştırmaların, bağırsak mikrobiyomu ve FMS arasındaki ilişkiyi anlamada ve olası tedavi seçeneklerini değerlendirmede etkili olacağı açıktır.
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    Erişkin Akut Böbrek Hasarı Etiyolojisi ve Prognozunu Etkileyen Faktörlerin Retrospektif Olarak Değerlendirilmesi
    (2020-06-01T00:00:00Z) Göçken, Abdülkadir; Ayar, Yavuz; Yavuz, Mahmut; Yabacı, Ayşegül; YABACI TAK, AYŞEGÜL
    Amaç:Akut böbrek hasarı (ABH) günümüzde hala önemli bir morbidite ve mortalite nedenidir. Sıklığı, etiyolojisi, prognozu ve mortalitesinde birçok faktör etkili olmaktadır. Çalışmamızda ABH etiyolojisi ve prognostik faktörleri ortaya koymayı amaçladık.Yöntemler:Çalışmaya nefroloji servisine akut böbrek yetmezliği tanısı ile Ocak 2011- Aralık 2015 tarihleri arasında yatarak tedavi edilmiş 272 hasta dahil edildi. Hastaların demografik özelliklerinin yanı sıra klinik ve laboratuvar bulguları retrospektif olarak incelendi.Bulgular:Hastaların %47,4’ü kadın, %52,6’sı erkek idi. Tüm hastaların yaş ortalaması 61,6, ortalama yatış süresi 13,3 gün, hemodiyaliz sayısı 1,24, mortalite oranı %4,8 bulundu. Hemodiyaliz ihtiyacı ve sayısı yaşlı grupta (>65 yaş) anlamlı şekilde yüksekti. Hemodiyaliz ihtiyacı ve sayısı renal ABH’li grupta daha fazlaydı (%48,7, 1,9). Renal ABH’lilerde yatış süresi ve mortalite diğer gruplarla kıyaslandığında daha yüksekti (16,4 gün, %8,8). Enfeksiyonu olanlarda (%42) mortalite, yatış süresi ve hemodiyaliz sayısı anlamlı şekilde artmıştı.Sonuç:ABH’de etiyoloji ve eşlik eden enfeksiyon varlığı mortaliteyi etkileyen en önemli faktörlerdir. Bunun yanında anemi ve ileri yaş hastanede yatış süresini ve hemodiyaliz ihtiyacını arttırmaktadır.Anahtar Kelimeler:Akut böbrek hasarı, mortalite, prognostik faktörler
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    Occurrence of Rhabdochona fortunatowi Dinnik, 1933 (Nematoda: Rhabdochonidae) in Two Endemic Cyprinid Species (Capoeta spp.) in Turkey
    (2021-05-01T00:00:00Z) Aydoğdu, Ali; Emre, Yılmaz; Emre, Nesrin; Yabacı, Ayşegül; YABACI TAK, AYŞEGÜL
    Two endemic freshwater cyprinid fishes, Capoeta caelestis Schöter, Özuluğ & Freyhof, 2009 and C. angorae (Hankó, 1925), have been studied for the presence of parasitic nematodes in Fırnız Stream, K. Maraş, Göksu River, Antalya, in the Anatolian Region of Turkey. Only a species of the genus Rhabdochona was found in intestines and identified as R. fortunatowi Dinnik, 1933. Totally, 104 specimens of R. fortunatowi infected 19 out of 99 individuals of C. caelestis (prevalence 19.1 %, mean intensity 5.4). In C. angorae, 40 specimens of R. fortunatowi infected 15 out of 178 fish individuals (prevalence 8.4 %, mean abundance 2.6). Prevalence and intensity of R. fortunatowi infection were calculated across the seasons as well as in age groups and sexes of hosts. The present study provides the first record of R. fortunatowi in Turkey and the first host records of this parasite in both C. caelestis and C. angorae, thus expanding the known geographical and host range of this nematode species.
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    The impact of obesity on acute pancreatitis outcomes in older patients
    (2020-03-01T00:00:00Z) Büyükaydın, Banu; Yabacı, Ayşegül; Kiremitçi, Sercan; Soysal, Pınar; Biberci Keskin, Elmas; Şentürk, Hakan; BİBERCİ KESKİN, ELMAS; BÜYÜKAYDIN, BANU; SOYSAL, PINAR; YABACI TAK, AYŞEGÜL; ŞENTÜRK, HAKAN
    AimThe aim of this study was to investigate the impact of obesity on acute pancreatitis outcomes in older patients.FindingsObesity in older patients with acute pancreatitis was not associated with worse outcomes, including in-hospital mortality, long-term mortality, and recurrence.MessageThe impact of obesity in older people with acute pancreatitis may not be as deleterious as seen in younger patients.AbstractPurposeAlthough obesity is an established risk factor for a number of diseases, several epidemiological studies have demonstrated that older obese patients have better survival rates than non-obese old patients in various disease states. In this context, the relationship between obesity and acute pancreatitis outcome in older patients is controversial. Therefore, the authors aimed to investigate the impact of obesity on acute pancreatitis outcomes in older patients.MethodsPatients aged > 65years who had been hospitalized for acute pancreatitis were retrospectively analyzed. Among them, 190 patients were included. The median age was 73 (68–79) years, and 118 (62.1%) were women. Obesity was assessed according to body mass index, and patients were classified as either obese or non-obese. The primary endpoint of the study was in-hospital major adverse events (major in-hospital complications and death). The secondary endpoints were acute pancreatitis recurrence, 30-day all-cause mortality, and long-term all-cause mortality.ResultsA total of 77 (40.5%) patients were obese. In-hospital major adverse events were observed in 40 (21.1%) patients. There was no statistical difference in major in-hospital adverse events between the two groups (27 [23.9%] in non-obese patients vs. 13 [16.9%] in obese patients,p = 0.24). Further, the 30-day mortality, long-term survival, and acute pancreatitis recurrence rates were similar (allp > 0.05). The median follow-up time was 18 (0–80) months.ConclusionObesity does not result in higher mortality or complications in older patients with acute pancreatitis. Although the underlying mechanism needs to be elucidated, the deleterious effect of obesity seems to be diminished in older patients.