Nevbahar Değirmenci - Academia.edu (original) (raw)

Papers by Nevbahar Değirmenci

PubMed, Mar 1, 2013

Objective: To determine incidence of abnormal reflux flow (ARF) in legs of cirrhotic patients by ... more Objective: To determine incidence of abnormal reflux flow (ARF) in legs of cirrhotic patients by Doppler ultrasonography (DUS). Methods: We prospectively studied 100 patients and 56 controls from the Faculty of Medicine, Eskisehir Osmangazi University Eskisehir, Turkey, between January 2010 and December 2011. We classified the legs according to the Clinical Etiology Anatomy Pathophysiology (CEAP) scores. Lower extremity superficial and deep veins were examined in supine position by DUS for ARF. Reflux flows more than 1000 msec were considered as abnormal. Abnormal reflux flow was classified in 3 categories as superficial (SARF), deep (DARF), and SARF and/or DARF (ARF). We also performed abdominal DUS to depict anterior abdominal collateral and paraumbilical vein. Statistical analysis was carried out by using analysis of variance with Tukey test, t-test, and correlation coefficient analysis. Results: Percentages of SARF in patients were 56%, DARF 52%, and ARF 58%. Correlation analysis showed association between SARF or DARF or ARF and cirrhosis (p=0.002, p=0.000, p=0.001). Patients were distributed within CEAP 1 to CEAP 4. There was an association between SARF or DARF and CEAP 1 (p=0.007, p=0.000) or CEAP 2 (p=0.004, p=0.041) or CEAP 4 (p=0.022, p=0.90). We showed no correlation between CEAP 3 and SARF or DARF. There were also correlation between paraumbilical vein and SARF (p=0.015). Conclusion: Cirrhotic patients increased incidence of ARF at lower extremity veins and CEAP classification creates and provides essential information.

Clinical Nephrology, Jun 1, 2013

Aims: Nephrotic syndrome (NS) may occur with acquired hypercoagulability, however, the fact that ... more Aims: Nephrotic syndrome (NS) may occur with acquired hypercoagulability, however, the fact that it is accompanied by an underlying hereditary thrombophilia, especially combined hereditary thrombophilia, would lead to thrombotic events. In this study, we aimed to evaluate the contribution of genetic thrombophilia to development of thrombotic events in adult patients with NS. Material and methods: Factor V Leiden (FVL), prothrombin, and methylenetetrahydrofolate reductase (MTHFR) gene mutation were studied in 51 newly diagnosed idiopathic NS patients and age-and gender-matched 20 healthy control subjects included in the study. Renal vein Doppler ultrasound was conducted in order to investigate the prevalence of subclinical renal vein thrombosis. Results: Of 51 patients, 6 (11.8%) were established to have thromboembolic (TE) complications at the time of diagnosis (4 symptomatic, 2 subclinical), and no recurring thrombotic episode was observed. Genetic mutation was established in all patients that were found to have TE complications. Acquired hypercoagulability factors were similar in patients without and with TE complication. Conclusions: The coexistence of inherited thrombophilia in NS may facilitate thromboembolic complications. If the cause of thrombosis cannot be explained by the usual factors attributed to the occurrence of thrombosis in NS, screening for the other factors, such as FVL, MTHFR, and prothrombin gene mutation, may be beneficial.

Renal Failure, Oct 21, 2011

Background: Iron support is an important component of treatment of anemia in hemodialysis (HD) pa... more Background: Iron support is an important component of treatment of anemia in hemodialysis (HD) patients. However, there are concerns about endovenous (EV) iron therapy that may cause endothelial dysfunction (ED) by increasing oxidative stress (OS) and lead to cardiovascular events. In this study, we aimed to evaluate the effects of high and repeated doses of EV iron sucrose on endothelial functions in acute and subacute phases. Methods: We included 15 HD patients to our study. There were 16 patients with iron deficiency but normal kidney functions in control group. We also evaluated endothelium-dependent vasodilatation (EDV) and nitroglycerin-induced vasodilatation (NIV) from the brachial artery by ultrasonography at the beginning of the study, and then 200 mg EV iron sucrose was given initially to both groups for 1 h in 250 cc 0.9% saline and 4 h after the end of the infusion (acute phase) sonographic vasodilatation parameters were measured from brachial artery. These measurements and laboratory tests were repeated 1 week after the end of a total 1000 mg EV iron sucrose replacement (200 mg/week). Results: There was a statistically significant increase in hemoglobin and ferritin levels after the EV iron sucrose therapy in both control and patient groups. EDV values in the HD group were significantly lower than that in the control group before therapy (6.25% vs. 10.53%, p < 0.05). EV iron sucrose therapy did not alter EDV and NIV values at the 4th hour and 6th week in both control and patient groups. Conclusion: According to our study, compared with the control group with normal kidney functions, HD patients had impaired endothelial functions. However, in HD patients, high and repeated doses of EV iron sucrose do not have deleterious effects on endothelial functions at acute and subacute phases and can be used safely in that patient group.

Rheumatology International, Dec 1, 2010

The objective of this study is to investigate the efficacy of low-level laser therapy (LLLT) in p... more The objective of this study is to investigate the efficacy of low-level laser therapy (LLLT) in patients with carpal tunnel syndrome (CTS). Sixty patients with CTS were included in this placebo-controlled and double-blind study and randomly assigned to three treatment groups: active laser with a dosage of 1.2 J/per painful point, active laser with a dosage of 0.6 J/per painful point, and placebo groups. A total of 5 points across the median nerve trace were irradiated with Gal-Al-As diode laser. All groups were treated 5 times per week for 3 weeks. Clinical assessments included pain intensity, grip strength, symptom severity score (SSS), functional status score (FSS), nerve conduction studies, and cross-sectional area (CSA) of the median nerve as measured by ultrasonography. Compared to baseline, post-treatment VAS scores (group 1, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; group 2, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; group 3, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), grip strength (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), SSS scores (group 1, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; group 2, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; group 3, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), and FSS scores (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) improved significantly in all groups. Only sensorial nerve velocity measurements on the palmar region showed a significant improvement in both active laser groups (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). There was no significant difference in any of the outcome measures among the groups. With the chosen laser type and dose regimen, the results suggested that LLLT was no more effective than placebo in CTS.

Ulusal romatoloji dergisi, Apr 1, 2021

Amaç: Böbrekte taş oluşumu, ankilozan spondilitin (AS) sık görülen ekstra-artiküler bulgularından... more Amaç: Böbrekte taş oluşumu, ankilozan spondilitin (AS) sık görülen ekstra-artiküler bulgularından birisidir. Bu çalışmada, AS hastalarında böbrek taşı varlığı ile bağırsak enflamasyonu arasında bir ilişki olup olmadığı araştırıldı. Yöntem: AS için 1984 Modifiye New York kriterlerini karşılayan hastalar çalışmaya dahil edildi. Renal taş (+) olan her hastaya karşılık gelen yaklaşık 3 renal taş (-) hasta çalışmaya dahil edildi. Bağırsak enflamasyonunun dolaylı göstergesi olan kalprotektin düzeyleri her hastada ölçüldü. Kalprotektin düzeyi >70 υg/g olan hastalara kolonoskopi ve gerekirse kolonoskopik biyopsi yapıldı. İnfliximab veya adalimumab alan AS hastaları çalışma dışı bırakıldı. Non-steroid antienflamatuvar kullanımı en az 6 hafta önce kesildi. Bulgular: Renal taş (+) olan her hastaya (n=26) karşılık gelen yaklaşık 3 renal taş (-) hasta (n=64) çalışmaya dahil edildi (E: 57; K: 33). Hastaların ortalama yaşı 43±10,9 yıl; ortalama tanı yaşı 33±10 yıl ve tanı gecikmesi 6,2±5 yıl idi. Renal taş (+) olan 3 hastada (%11,5) kalprotektin düzeyi 70 υg/g üzerindeyken, renal taş (-) olan 9 hastada (%14) kalprotektin düzeyi yüksekti. Yüksek kalprotektin düzeyi olan 12 hastanın 5'inde (%41) bağırsak enflamasyon kanıtlarına rastlandı. Bu 5 hastada renal taş yoktu. Renal taş (+) ve kalprotektin düzeyi yüksek olan 3 hastada bağırsakta mikroskopik enflamasyon bulgularına rastlanmadı. Sonuç: Dışkı kalprotektin düzeyi ile renal taş varlığı arasında bir ilişki bulunamadı. Çok daha fazla hasta sayısıyla, bağırsak mikro-çevresi üzerinde rolü olabilecek değişkenleri olabildiğince dışlayarak yapılacak seri kalprotektin ölçüm çalışmaları bu konuda çok daha sağlıklı sonuçlar verecektir.

Transplantation Proceedings, Sep 1, 2011

Background. Endothelial dysfunction is common in patients undergoing hemodialysis (HD), and cardi... more Background. Endothelial dysfunction is common in patients undergoing hemodialysis (HD), and cardiovascular morbidity and mortality are higher in these patients. In this study, we evaluated the late posttransplantation effects of cyclosporine and tacrolimus on endothelial function, inflammation, and cardiac architecture. Methods. The study included 12 patients undergoing hemodialysis (group 1); 22 renal transplant recipients, of which 13 were receiving cyclosporine therapy (group 2) and 9 were receiving tacrolimus therapy (group 3); and 12 healthy control individuals (group 4). Kidney recipients were included if the transplantation procedure had been performed at least 1 year before the study. Asymmetric dimethylarginine, C-reactive protein, carotid intima-media thickness, left ventricular posterior wall thickness, interventricular septal thickness, left ventricular muscle mass index, flow-mediated dilation, and nitroglycerineinduced dilation of the brachial artery were evaluated. Results: Serum asymmetric dimethylarginine, C-reactive protein, carotid intima-media thickness, left ventricular posterior wall thickness, interventricular septal thickness, and left ventricular muscle mass index values were significantly higher in patients undergoing HD than in the other 3 groups (P Ͻ .05), whereas percent change in flow-mediated dilation and nitroglycerine-induced dilation of the brachial artery was significantly lower (P Ͻ .05). Conclusion. Patients undergoing HD demonstrate endothelial dysfunction. In the late posttransplantation period, kidney recipients seem to have similar endothelial function and cardiac architecture as in the healthy population. This result may explain the reduction in cardiovascular morbidity and mortality after transplantation in patients undergoing HD. Tacrolimus and cyclosporine have similar effects on endothelial function.

International Urology and Nephrology, Jul 25, 2013

Background The few studies on the morphology and functions of CAPD and peritoneum have tended to ... more Background The few studies on the morphology and functions of CAPD and peritoneum have tended to use histological and histomorphometrical methods. However, such methods are known to require biopsy, which is an invasive method. The present study aims to determine the morphological changes established by ultrasonography in CAPD patients, as well as achieving a comparison between these changes and the functional properties of peritoneum in CAPD. We aim to determine the effects of the duration of CAPD upon peritoneal thickness. Methods The study included 42 CAPD patients. Twenty-four of them had peritoneal dialysis (PD) duration of less than 24 months (Group 1) and 18 of them had PD duration of longer than 48 months (Group 2). Patients with a history of surgery involving the peritoneum and abdomen and with a history of peritonitis in the last 3 months were excluded. We examined the parietal peritoneum by trans-abdominal ultrasonography. Results There was a statistically significant positive correlation between PD duration and peritoneal thickness of each quadrant. There was a statistically significant negative correlation between membrane thickness and creatinine clearance (CrCl), peritoneal Kt/V (pKt/V) and normalized protein catabolic rate. There was a positive significant correlation between membrane thickness and dialysate/plasma creatinine ratio. There was a statistically significant difference between the two groups according to their peritoneal membrane thickness. CrCl and pKt/V values were better in Group 1 than in Group 2. Conclusion Our study revealed that increased PD duration may have a relation with increased peritoneal membrane thickness, and this can be associated with less effective PD. Ultrasound imaging has an important role for evaluating peritoneal membrane thickness without using an invasive method such as biopsy and can be performed easily in dialysis clinics.

Journal of Ultrasound in Medicine, Dec 1, 2007

The purpose of this study was to evaluate the diagnostic usefulness of determining retrograde flo... more The purpose of this study was to evaluate the diagnostic usefulness of determining retrograde flow in the penile cavernosal-spongiosal communications (CSCs) with Doppler sonography. Methods. Thirty-two consecutive men with erectile dysfunction (mean age, 40 years; range, 19-61 years) underwent penile color Doppler sonography. All patients were evaluated for flow direction in the CSCs. Results. Eight of the 32 patients had normal Doppler sonographic findings; 8 had signs of veno-occlusive dysfunction; and 16 had arterial insufficiency. Doppler sonographic examinations of the patients with normal Doppler sonographic findings (100%) and veno-occlusive dysfunction (100%) showed a normal direction of flow in the CSCs. Thirteen of the 16 patients with arterial insufficiency had a normal direction of flow in the CSCs; however, reversal of the flow direction in the CSCs (from the urethral artery back to the cavernosal artery) was observed in the remaining 3 patients. Conclusions. Investigating the direction of flow in the cavernosal artery, CSCs, and urethral artery is not time-consuming and may help establish an accurate diagnosis of arteriogenic impotence, especially in patients with borderline peak systolic flow velocity values.

Ulusal Romatoloji Dergisi, 2021

Journal of Ultrasound in Medicine, 2007

Hemodialysis International, 2016

Introduction: Patients with chronic kidney disease (CKD) commonly experience 25‐hydroxyvitamin D3... more Introduction: Patients with chronic kidney disease (CKD) commonly experience 25‐hydroxyvitamin D3 (25‐OH‐D3) deficiency, and these patients have a higher incidence of cardiovascular diseases (CVDs) due to endothelial dysfunction (ED). The aim of our study was to investigate the effect of 25‐OH‐D3 deficiency and its supplementation on ED in patients with CKD. Methods: Twenty‐nine uremic patients on dialysis and 20 healthy controls were evaluated for ED by high‐resolution Doppler ultrasonography of the brachial artery. In addition, 25‐OH‐D3‐deficient patients (25‐OH‐D3 < 30 nmol/L) with CKD and healthy controls were evaluated for ED before and after 8 weeks of oral vitamin D (cholecalciferol, 50,000 units) treatment. All subjects were evaluated for percent flow‐mediated dilatation (%FMD), percent endothelium‐independent nitroglycerin‐induced vasodilatation (%NID), and bilateral carotid intima‐media thickness (CIMT). Findings: Patients on dialysis had lower %FMD and %NID 6.11 [2.27–...

Saudi Medical Journal, Dec 1, 2007

To determine the resistance of antibiotics for complicated urinary tract infection (UTI), includi... more To determine the resistance of antibiotics for complicated urinary tract infection (UTI), including urinary tract anomaly (UTA), for empirical antibiotic therapy of complicated UTI. Four hundred and twenty urine isolates were obtained from 113 patients with recurrent UTI, who used prophylactic antibiotics between February 1999 and November 2004 in the Eskisehir Osmangazi University, Eskisehir, Turkey. Reflux was found to be the most important predisposing factor for recurrent UTI (31.9%). Renal scar was detected more in patients with UTA than without UTA (59.2% versus 12.4%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Gram-negative organisms were dominant in patients with and without UTA (91.5% and 79.2%). Enterococci and Candida spp. were more prevalent in children with UTA than without UTA (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Isolates were significantly more resistant to ampicillin, trimethoprim-sulfamethoxazole, amikacin, co-amoxiclav, ticarcillin-clavulanate, and piperacillin-tazobactam in patients with UTA than without UTA. We found low resistance to ciprofloxacin and nitrofurantoin in UTI with and without UTA. Enterococci spp. was highly resistance to ampicillin and amikacin in patients with UTA. Aztreonam, meropenem, and ciprofloxacin seemed to be the best choice for treatment of UTI with UTA due to Escherichia coli and Klebsiella spp. Nitrofurantoin and nalidixic acid may be first choice antibiotics for prophylaxis in UTI with and without UTA. The UTI with UTA caused by Enterococci spp. might not benefit from a combination of amikacin and ampicillin, it could be treated with glycopeptides.

Urologia Internationalis, 2016

Introduction: Our aim was to predict the chemical composition of kidney stones according to their... more Introduction: Our aim was to predict the chemical composition of kidney stones according to their twinkle artefact (TA) features obtained by in vivo color Doppler ultrasonography and to determine the potential factors affecting the formation and intensity of TAs. Materials and Methods: A total of 101 patients who met the inclusion criteria were included in the study. All patients were evaluated for TAs using color Doppler ultrasonography. All stones were subjected to chemical analysis. The relationships between the TA and the size and chemical composition of the stone, presence of hydronephrosis and body mass index (BMI) were evaluated statistically. Results: According to the results of the chemical analysis, 66 (65.3%) were calcium oxalate stones. It was found that the in vivo TA intensity did not predict cystine and calcium oxalate monohydrate stones (p > 0.05) and the intensity of TAs increases with increasing BMI (p = 0.002). Conclusion: The present study is the first to show...

Transplantation Proceedings, 2011

Rheumatology International, 2010

Renal Failure, 2012

NDT Plus, 2011

Abstract INTRODUCTION AND AIMS: Recently, a novel tissue engineering approach using stem cells wi... more Abstract INTRODUCTION AND AIMS: Recently, a novel tissue engineering approach using stem cells with a decellularized scaffold for reconstitution of a complex organ, such as the heart, kidneys, lungs and liver has been proposed. These studies achieved organ-specific ...

International Urology and Nephrology, 2013

Clinical Nephrology, 2013

Saudi medical journal, 2013

To determine incidence of abnormal reflux flow (ARF) in legs of cirrhotic patients by Doppler ult... more To determine incidence of abnormal reflux flow (ARF) in legs of cirrhotic patients by Doppler ultrasonography (DUS). We prospectively studied 100 patients and 56 controls from the Faculty of Medicine, Eskisehir Osmangazi University Eskisehir, Turkey, between January 2010 and December 2011. We classified the legs according to the Clinical Etiology Anatomy Pathophysiology (CEAP) scores. Lower extremity superficial and deep veins were examined in supine position by DUS for ARF. Reflux flows more than 1000 msec were considered as abnormal. Abnormal reflux flow was classified in 3 categories as superficial (SARF), deep (DARF), and SARF and/or DARF (ARF). We also performed abdominal DUS to depict anterior abdominal collateral and paraumbilical vein. Statistical analysis was carried out by using analysis of variance with Tukey test, t-test, and correlation coefficient analysis. Percentages of SARF in patients were 56%, DARF 52%, and ARF 58%. Correlation analysis showed association between ...