Yazar "Demir, Mehmet Emin" seçeneğine göre listele

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  • [ X ]
    Öğe
    An unexpected complication in a hemodialysis patient: midodrine related A-V fistula dysfunction
    (2021) Demir, Mehmet Emin; Alp, Çağlar
    Arteriovenous fistula (AVF) dysfunction is one of the common obstacles in performing hemodialysis treatment. Acute and chronic thrombosis of the fistula, stenosis, and hematomas are the major causes of the AVF dysfunction. Here, we present an unexpected complication of midodrine use which caused in AVF dysfunction in a female patient who was suffering from hemodialysis-related hypotension.
  • [ X ]
    Öğe
    Hemodiyaliz hastalarında intravenöz kalsitriolden oral kalsitriole geçiş: etkili, güvenilir ve maliyet etkin dönüşüm
    (2020) Demir, Mehmet Emin; Karahan, İrfan
    Amaç: Kronik böbrek hastalığında D-vitamini tedavisi verilmesi gerekebilmektedir. İntravenöz (i.v.) ilaç uygulamaları tablet formlara göre oldukça maliyetlidir. Bu çalışmayla i.v. kalsitriol kullanan uygun hastaları oral formla değiştirerek kısa dönem sonuçlarını sunmayı amaçlanmıştır. Gereç ve Yöntem: Çalışmaya merkezimizde en az üç aydır hemodiyaliz programında olan 115 hasta dahil edildi. Son üç aydır i.v. kalsitriol kullanan, malnütrisyonu, aktif enfeksiyonu, uzun süre hastane yatışı gerektirecek tıbbi bir sorunu olmayan, haftada üç kez hemodiyaliz seanslarına uyumu tam olan hastalar dahil edildi. Son üç ay içerisinde hedef parathotmon (PTH) 150-600 pg/ml, serum fosfor <5,6mg/dl, kalsiyum <9,5mg/dl altında olacak şekilde i.v. kalsitriol dozları düzenlenmişti ve bu dozlar yine mevcut parametrelere göre oral formlarla değiştirildi. Hastalar üç ay oral form, üç ay i.v. form olmak üzere altı ay süreyle izlendi. Üç aylık ortalama kalsiyum, fosfor, PTH, KTV, albümin, hemoglobin, alkalen fosfataz (ALP), C-reaktif protein, kalsiyum x fosfor değerleri i.v. ve oral formlar arasında karşılaştırıldı. Bulgular: Çalışma 25 erkek (%56,8), 19 (%43,2) kadın toplam 44 hasta ile tamamlandı. Hemodiyaliz hastalarının yaklaşık %56’sı D vitamini almaktaydı. Oral D vitamini kullanımı %0 idi. 3 aylık izlem sonunda i.v. formdan oral forma geçiş ile serum PTH, kalsiyum ve fosfor değerlerinde istatistiksel anlamlı bir değişim olmadı (sırasıyla p=0,94; 0,64; 0,47). Sonuç: Çalışma ile i.v. kalsitriol formlardan oral formlara dönülmesi; etkili, güvenilir ve maliyet etkin bulundu. Bu yaklaşım, seçilmiş uygun hastalarda göz önünde bulundurulabilir.
  • Küçük Resim
    Öğe
    Investigation of heart rate variability and heart rate turbulence in chronic hypotensive hemodialysis patients
    (SPRINGER, 2020) Yalim, Zafer; Demir, Mehmet Emin; Yalim, Sumeyra Alan; Alp, Caglar
    Background Sudden cardiac death is the leading cause of cardiac-related death in hemodialysis patients. Hypotensive episodes in pre-, intra-, and post-dialytic periods can present serious clinical challenges that affect a patient's quality of life and prognosis. The aim of the present study was to evaluate cardiac autonomic control and arrhythmogenic risk by analyzing 24-h heart rate variability (HRV) and heart rate turbulence (HRT) in hypotensive hemodialysis patients. Methods A total of 79 patients on maintenance hemodialysis treatment, 39 normotensive and 40 with frequent hypotension episodes during non-dialysis periods, were included in the study. Dialysis-free periods were recorded with a 24-h Holter rhythm and ambulatory blood pressure monitor device. The time-domain parameters of HRV and HRT, including turbulence onset (TO) and turbulence slope (TS), were calculated. Results Values for SDNN (105.5 +/- 7.02, 127.6 +/- 6.2 p < 0.001), SDANN (95.1 +/- 5.9, 111.8 +/- 5.01 p < 0.001), and SDNN index (50.04 +/- 2.7, 55.6 +/- 3.7 p = 0.03), in the hypotensive group were significantly lower than in the normotensive group, respectively. Values for RMSSD (26.5 +/- 2.5, 27.3 +/- 2.7 p = 0.178), pNN50 (17 +/- 1.7, 55.6 +/- 3.7 p = 0.03), and TI (35.1 +/- 3.1, 34.7 +/- 2.6 p = 0.542) in both groups were not significantly different; however, there was a significant difference between HRT parameters, TO (- 1.8 +/- 0.37, - 2.4 +/- 0.39 p < 0.001) and TS (6.9 +/- 0.71, 8.2 +/- 0.97 p < 0.001), respectively, hypotensive and normotensive group. Conclusion Dialysis patients that experience frequent hypotensive episodes may also undergo significant changes in HRT and HRV which may be indicative of serious cardiac sequela. Thus, in such cases, a complete cardiologic evaluation is warranted.
  • Küçük Resim
    Öğe
    Prognostic effects of SuPAR and Neopterin Levels on Patients with Lung Cancer
    (WALTER DE GRUYTER GMBH, 2020) Yalcin, Selim; Demir, Mehmet Emin; Ozturk, Reyhan; Kilinc, Aytun Sadan; Suer, Hatice; Karahan, Irfan
    Background: Two unique biomarkers, soluble form of the urokinase-type plasminogen activator receptor (suPAR) and neopterin, play a crucial role in inflammatory processes. This study aimed to reveal whether it is possible to utilize these biomarkers in predicting tumor prognosis in patients with lung cancers. Methods: The present study was designed as a single center, prospective, and controlled research. The study was conducted with forty patients with lung cancer (case group) and 41 healthy individuals (control group) in Kirikkale University, Faculty of Medicine between 2016-2020. The case group was also divided into two of the early and advanced stages. The blood samples were drawn to evaluate suPAR and neopterin levels, and these parameters were compared between the case and control groups. Also, the prognostic effects of age, stage of the tumor, and the levels of mentioned parameters were investigated with the survival analysis. Results: The median duration of the follow-up was 32 (4-75) months. suPAR and neopterin levels were found to be higher in the case group than in the control group. Cox regression showed that the high levels of neopterin and suPAR increased mortality risk [1)=0.002, HR: 1.25 (1.081.45 95%CI) and p=0.023, HR:1.07 (1.01-1.13), respectively]. Finally, age and stage of the tumor were found to have no relationship with survival. Conclusion: suPAR and neopterin as members of the inflammatory pathway were found to be higher in cancer cases. Furthermore, both suPAR and neopterin levels were found to be predictive for the mortality of patients with lung cancers; therefore, they are thought to be used for the management of cancer.