Person: TUĞLULAR, ZÜBEYDE SERHAN
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TUĞLULAR
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ZÜBEYDE SERHAN
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Publication Metadata only Böbrek nakli adaylarında kırılganlık tanımlanması ve gözlemi(2021-10-13) ŞANAL TOPRAK, CANAN; BARUTÇU ATAŞ, DİLEK; TUFAN ÇİNÇİN, ASLI; VELİOĞLU, ARZU; TUĞLULAR, ZÜBEYDE SERHAN; Rustamzade A., BARUTÇU ATAŞ D., ŞANAL TOPRAK C., TUFAN ÇİNÇİN A., VELİOĞLU A., TUĞLULAR Z. S.Publication Metadata only Histopathological changes and tumour necrosis factor-alpha, transforming growth factor-beta and tenascin expression in patients with primary type I membranoproliferative glomerulonephritis in remission(WILEY, 2009) ARIKAN, İZZET HAKKI; Arikan, Hakki; Koc, Mehmet; Cakalagaoglu, Fulya; Tuglular, Serhan; Ozener, Cetin; Akoglu, EmelAim: Primary type I membranoproliferative glomerulonephritis (MPGN) is a rare cause of glomerular disease with a high relapse rate and poor prognosis. The aim of this study was: (i) to evaluate the histopathological findings associated with remission; and (ii) to document the possible clinical and histopathological factors predicting relapses. Methods: Eleven type I MPGN patients (five men, six women; mean age, 38.8 +/-13.5 years) who were in remission for at least 1 year after the cessation of immunosuppressive drugs were re-biopsied. The intensity of immunostaining for tumor necrosis factor (TNF)-alpha, transforming growth factor (TGF)-beta 1, and tenascin was graded from 0 (no staining) to 3+ (maximum staining). Results: Mean baseline mesangial cellularity score and tubulointerstitial infiltration score were reduced and mesangial matrix expansion score was increased at protocol re-biopsies compared to baseline. The glomerular and tubulointerstitial staining scores for TGF-beta 1 and tenascin were higher than that of baseline. Reduced tubulointerstitial TNF-alpha expression was found in re-biopsy specimens compared to baseline. Patients have been followed for a mean time of 51.5 +/- 22.2 months after the protocol biopsy. Eight patients had a relapse. Mesangial cellularity score and glomerular tenascin expression at re-biopsy specimens were higher in relapsed patients compared to those without a relapse. Conclusion: Our study shows that mesangial cellularity and tubulointerstitial cell infiltration are reducing whereas mesangial matrix expansion, glomerular and tubulointerstitial TGF-beta 1 and tenascin expression are increasing with remission. The higher mesangial cell proliferation and glomerular tenascin scores in remission are associated with the development of relapse.Publication Metadata only Waist circumference is associated with carotid intima media thickness in peritoneal dialysis patients(SPRINGER, 2013) VELİOĞLU, ARZU; Asicioglu, Ebru; Kahveci, Arzu; Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, Cetin IshakAtherosclerosis is responsible for the high mortality rate in end-stage renal disease patients. Defining risk factors for atherosclerosis may lead to reduction in cardiovascular disease through modification of these factors. Peritoneal dialysis (PD) patients are subjected to high glucose loads on a daily basis, which results in considerable weight gain and an increase in waist circumference (WC). WC as an indicator of abdominal obesity is a risk factor for atherosclerosis in the general population. Carotid artery intima media thickness (CIMT) measurement is a reliable method for the detection of early atherosclerosis. The aim of this study was to investigate the relationship between WC and CIMT and to define risk factors associated with CIMT in PD patients. Fifty-five PD patients and 40 healthy controls were included. Atherosclerosis was assessed using measurement of CIMT. Fasting blood was collected for analysis. Anthropometric parameters (age, weight, BMI, and WC) were measured. Peritoneal dialysis patients had higher WC (93.9 +/- A 1.7 vs. 87.3 +/- A 1.2 cm, p < 0.05) and CIMT (0.70 +/- A 0.02 vs. 0.57 +/- A 0.01 mm, p < 0.01) than the control group. On univariate analysis, age, WC, plaque formation, and D/P creatinine were positively correlated with CIMT, whereas residual renal function, albumin, ultrafiltration volume, and D/D0 glucose were negatively correlated. On multivariate analysis, only age, WC, and plaque formation showed correlation (p < 0.001). Carotid artery intima media thickness is associated with age, plaque formation, and WC in PD patients. WC measurement is a simple, inexpensive, reproducible, and reliable method of evaluating atherosclerosis risk in PD patients and should be assessed at every visit. Appropriate counsel should be provided to patients with greater WC who are deemed to be at risk for atherosclerosis.Publication Metadata only Sepsiste serum laktat yüksekliği-sidemi ilişkisinin böbrek fonksiyonları penceresinden incelenmesi(2022-12-08) TUĞCU, MURAT; AŞICIOĞLU, EBRU; ARIKAN, İZZET HAKKI; BARUTÇU ATAŞ, DİLEK; TUĞLULAR, ZÜBEYDE SERHAN; VELİOĞLU, ARZU; Karadağ H., Berke Menteşe İ., Barutçu Ataş D., Tuğcu M., Aşıcıoğlu E., Velioğlu A., Tuğlular Z. S. , Arıkan İ. H.Publication Metadata only Health-related quality of life assessed by LupusQoL questionnaire and SF-36 in Turkish patients with systemic lupus erythematosus(SPRINGER LONDON LTD, 2016) DİRESKENELİ, RAFİ HANER; Yilmaz-Oner, Sibel; Oner, Can; Dogukan, Fatih Mert; Moses, Toklong Filam; Demir, Kubra; Tekayev, Nazar; Atagunduz, Pamir; Tuglular, Serhan; Direskeneli, HanerThe LupusQoL is a disease-specific health-related quality of life (HRQoL) measure for patients with lupus. We conducted this study to compare the efficiency of LupusQoL-TR (validated Turkish version of the LupusQoL questionnaire) with the 36-item Short-Form Health Survey (SF-36), a generic quality of life (QoL) scale, in Turkish patients with lupus. Both questionnaires were conducted at a single visit to the clinic. Disease activity was measured with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Associations between the LupusQoL-TR and SF-36 domains were examined while also examining age, disease duration, and disease activity for each questionnaire. Descriptive statistics, Spearman's correlation coefficients, and Students t test were performed to analyze the data. A total of 113 consecutive patients with lupus (F/M 108:5, mean age 40.6 +/- 11.9 years, mean disease duration 8.5 +/- 7.0 years) were included, and 69 % of these were active. The median SLEDAI score was 2 (0-24), the mean global LupusQoL-TR score was 60.9 +/- 23.3, and the mean SF-36 score was 41.2 +/- 9.0. There was a significant correlation between LupusQoL-TR and SF-36 mean scores (r = 0.83; p < 0.001). QoL assessed by LupusQoL-TR and SF-36 did not correlate with disease activity (r = -0.11; p = 0.244 and r = -0.03; p = 0.721, respectively). LupusQoL-TR and SF-36 questionnaires were beneficial instruments in evaluating HRQoL in Turkish lupus patients. However, LupusQoL-TR and SF-36 were not associated with SLEDAI scores, which suggested that QoL might be affected by other factors besides disease activity, especially in clinically inactive or mildly active patients.Publication Metadata only Renal artery stenting in solitary functioning kidneys: Technical and clinical results(ELSEVIER IRELAND LTD, 2006) BALTACIOĞLU, FEYYAZ; Sahin, S; Cimsit, C; Andac, N; Baltacioglu, F; Tuglular, S; Akoglu, EObjective: To evaluate the clinical and technical results of renal artery stenting for the treatment of renovascular hypertension and renal failure in patients with solitary functioning kidney. Materials and methods: Fifteen patients with solitary functioning kidney underwent renal artery stenting and were followed up for 12-60 months. Before the procedures, systolic and diastolic blood pressures and serum creatinine levels were measured and the number of antihypertensive drugs was recorded and followed up after stenting. In case of restenosis, either in-stent percutaneous transluminal renal angioplasty or stent-in-stent placement was performed. Results: Primary technical success rate was 100%. One lesion was nonostial while 14 were ostial. Primary patency rates were 100% for 6 months, 92.3% for 12 months, and 69.2% for 24 months. The secondary patency rate at 24 months was 100%. The differences between the baseline and postprocedural values of systolic blood pressures, diastolic blood pressures and the number of antihypertensive drug were statistically significant (P < 0.05), except the values of serum creatinine. Hypertension was cured in 1 (6.7%) patient, improved in 4 (26.6%) and stabilized in 10 (66.7%) patients. Renal function improved in 9 (60%), stabilized in 4 (26.6%), and deteriorated in 2 (13.4%) patients. Minor complication rate was 13.4% and major complication rate was 13.4%. Conclusion: Revascularization of renal artery stenosis using stent in solitary functioning kidneys is a safe and efficient procedure with high primary technical results, low restenosis rates and acceptable complication rates. It has an improving and controlling effect on blood pressure and renal functions. (c) 2005 Elsevier Ireland Ltd. All rights reserved.Publication Metadata only Kronik hemodiyaliz hastalarında bnt162b2 ve coronavac’a karşı hümoral yanıt: çok merkezli prospektif kohort çalışması(2022-11-09) TUĞLULAR, ZÜBEYDE SERHAN; TUĞCU, MURAT; Mirioğlu Ş., Kazancıoğlu R., Cebeci E., Eren N., Sakacı T., Alagöz S., Tuğcu M., Tuğlular Z. S., Sümbül B., Seyahi N., et al.Giriş: Kronik hemodiyaliz (HD) hastalarında SARS-CoV-2 için geliştirilmiş olan inaktif aşılara dair veriler hala sınırlıdır. Bu çalışmada, kronik HD hastalarında CoronaVac’ın uyardığı hümoral yanıtları BNT162b2 ile kıyaslayarak araştırmayı amaçladık. Yöntemler: COVID-19 geçirmemiş ve BNT162b2 veya CoronaVac ile aşılanmayı planlayan erişkin kronik HD hastaları bu çok merkezli prospektif kohorta dahil edildi. Katılımcılardan aşılanmadan önce ve 2 doz aşıdan 1 ile 3 ay sonra serum örnekleri alındı. Virüsün reseptör bağlayıcı bölgesine karşı gelişen anti-SARS-CoV-2 IgG antikorları ölçüldü ve ≥50 AU/ml pozitif kabul edildi. Aşılanmaya rağmen yaşanan COVID-19 enfeksiyonları ve aşıdan sonra gelişen advers olaylar kaydedildi. Bulgular: Doksan iki hasta çalışmaya dahil edildi ve 68’i (% 73.9) başlangıçta seronegatifti. BNT162b2 ve CoronaVac sırasıyla 38 (% 55.9) ve 30 (% 44.1) hastaya uygulandı, bu iki grubun başlangıçtaki özellikleri genel olarak benzerdi (Tablo 1). Birinci ayda seropozitiflik oranı BNT162b2 grubunda % 93.1 iken CoronaVac grubunda % 88’di (p=0.519), antikor seviyeleri ise BNT162b2 grubunda daha yüksekti (p<0.001). Üçüncü ayda seropozitiflik oranı (% 96.4 ile % 78.3, p=0.045) ve antikor seviyeleri (p=0.001) BNT162b2 grubunda CoronaVac’a kıyasla daha yüksek bulundu (Tablo 2). Beş hasta (% 7.4) aşılanmaya rağmen COVID-19 yaşadı ancak hepsi sekelsiz iyileşti. Advers olaylar BNT162b2 ile daha sık görüldü, fakat tamamı hafif seyirliydi. Çoklu lineer regresyon modeli sadece aşı seçiminin (BNT162b2) hümoral yanıtla ilişkili olduğunu gösterdi (β=0.272, p=0.038). Başlangıçta seropozitif olan hastalar (n=24) tüm ölçüm noktalarında daha yüksek antikor seviyelerine sahipti. Sonuç: BNT162b2 ve CoronaVac naif kronik HD hastalarında hümoral yanıtları uyarmaktadır, ancak bu yanıtlar BNT162b2 ile daha güçlü ve uzun ömürlüdür. Her iki aşı da başlangıçta seropozitif olan hastalarda yüksek antikor seviyelerini sağlamaktadır (Bu çalışma Bezmialem Vakıf Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından desteklenmiştir. Proje numarası: 20210613)Publication Metadata only Simple provocative maneuvers in renal transplant scintigraphy for detecting urine leak(SPRINGER, 2007) DEDE, FUAT; Dede, Fuat; Ones, Tunc; Caliskan, Billur; Civen, Huseyin; Erdil, Tanju Y.; Inanir, Sabahat; Tuglular, Zubeyde S.; Yegen, Cumhur; Akoglu, Emel; Turoglu, Halil T.Urine leak in the early postoperative period following renal transplantation is a serious complication requiring early identification and aggressive intervention, which significantly reduces the morbidity and mortality. Renal transplant scintigraphy is a noninvasive method to evaluate the perfusion and function of a transplanted kidney and urinary drainage including urine leak. Here, we reported two cases in which the standard transplant renogram failed to demonstrate urine leak. The cases were referred for a diethylenetriaminepentaacetic acid renogram following the transplantation to evaluate the cause of symptoms or elevated serum creatinine level. In both the cases, urine leak was successfully detected following simple maneuvers such as diuretic administration or Foley catheter irrigation. Renal transplant scintigraphy is an effective and safe technique and the use of these simple maneuvers can enhance the diagnostic sensitivity of the transplant renogram in the detection of urine leak.Publication Metadata only Elevated Plasma Levels of PAI-1 Predict Cardiovascular Events and Cardiovascular Mortality in Prevalent Peritoneal Dialysis Patients(TAYLOR & FRANCIS LTD, 2009) ARIKAN, İZZET HAKKI; Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, Cetin; Akoglu, EmelBackground. Elevated plasminogen activator inhibitor-1 (PAI-1) levels are associated with increased cardiovascular (CV) risk in the general population. It has been shown that peritoneal dialysis (PD) patients have increased plasma levels of PAI-1. The aim of this study was to investigate whether PAI-1 independently predicted CV outcome in PD patients. Material and Methods. Seventy-two PD patients (53% females, mean age 49.9 +/- 16.1 years) were studied. Twelve patients who underwent kidney transplantation and 14 patients who transferred to hemodialysis during follow-up were excluded from the analysis. The remaining 46 patients (54% female, mean age 54 +/- 16 years, dialytic age 42 +/- 30 months) were followed a mean time of 45.4 +/- 19.4 months (range 8-71 months). Baseline PAI-1, clinical, and laboratory parameters were assessed in all patients. Survival analyses were made with Kaplan-Meier and Cox regression analysis, with all-cause mortality and CV mortality and CV events (CVEs) as clinical end points. Results. During the follow-up, 29 patients died (17 from CV causes), and 28 fatal and non-fatal CVEs were recorded. The patients were divided according to plasma PAI-1 levels (i.e., <= or >41 ng/mL). The significant independent predictors of all-cause of mortality were age (>60 years; p = 0.018), CRP (>5 mg/L; p = 0.015), and serum albumin (<3.5 g/L; p = 0.011). Multivariable Cox regression analysis showed that plasma PAI-1 >41 ng/mL was independently predictive of higher CV mortality (p = 0.021) and CVEs (p = 0.001). The only other independent predictor of CV mortality was only CRP (>5 mg/L; p = 0.008). Conclusions. Plasma levels of PAI-1 >41 ng/mL is a significant predictor of CV mortality and CVEs in PD patients.Publication Metadata only Mo174fibroscan detection of fatty liver and liver fibrosis in systemic lupus erythematosus(2021-05-01) BARUTÇU ATAŞ, DİLEK; VELİOĞLU, ARZU; ARIKAN, İZZET HAKKI; ALİBAZ ÖNER, FATMA; DİRESKENELİ, RAFİ HANER; TUĞLULAR, ZÜBEYDE SERHAN; AŞICIOĞLU, EBRU; Yetginoğlu Ö., BARUTÇU ATAŞ D., VELİOĞLU A., ARIKAN İ. H., YILMAZ Y., ALİBAZ ÖNER F., DİRESKENELİ R. H., TUĞLULAR Z. S., AŞICIOĞLU E.BACKGROUND AND AIMS: Systemic Lupus Erythematosus (SLE) is a chronic, multi-organ, systemic autoimmune disease that is more common in women than men and is typically diagnosed during the reproductive age. Although liver dysfunction is not considered the main organ pathology in SLE, the frequency of liver dysfunction or abnormal liver enzyme values may be observed in 50-60% of patients. Liver-related complications may present as asymptomatic hepatomegaly, subclinical steatosis and abnormal liver enzymes. The most common causes are drug-associated liver injury, lupus-associated hepatitis, and fatty liver disease. The aim of this study was to assess fatty liver and liver fibrosis in SLE patients using the FibroScan method as well as associated factors such as immunosuppressive medications. METHOD: Sixty SLE patients and 30 healthy controls were included. Patients with HBV, HCV or cirrhosis, malignancy, cardiac disease, or patients on dialysis were excluded. All participants underwent FibroScan measurements. Demographic data and cumulative doses of immunosuppressive medications were extracted from patient charts. Fasting blood was collected for analysis RESULTS: Demographic and clinical characteristics of the study groups are shown in Tables 1. The prevalence of fatty liver disease was similar between SLE patients and healthy controls (21.7% vs 26.7%, p= 0.597) and was associated with body mass index (BMI) (p= 0.026) and C-reactive protein (CRP) (p= 0.046) in multivariate analysis. Liver fibrosis was also similar between the two groups (26.7% vs 10.0%, p= 0.069). There was no relationship between cumulative drug doses including glucocorticoids with either fatty liver disease or liver fibrosis. Since the majority of SLE patients were female, we performed a subgroup analysis in female patients (n=51) and healthy controls (n=25). Fatty liver disease was similar between female SLE patients and healthy controls (23.5% vs 24.0%, p= 0.964). However, liver fibrosis in female patients with SLE was increased compared to the female healthy population (29.4% vs 4.0%, p= 0.011) and was associated with age (p= 0.034) and low-dose cumulative glucocorticoid use (p = 0.034). Low-dose cumulative glucocorticoid use was defined as less than 17.45 g, which was the 75th percentile value. Only 1 out of 15 female patients with fibrosis had high-dose cumulative glucocorticoid use (>17.45 g), while the remaining 14 patients had used lower doses (<17.45 g). CONCLUSION: The prevalence of fatty liver was similar between SLE patients and healthy controls, while liver fibrosis was increased in the female patient group as compared to controls. Furthermore, liver fibrosis was associated with age and low dose cumulative glucocorticoid use. Interestingly, fatty liver did not precede liver fibrosis in the majority of cases, contrary to what is observed in the general population. We hypothesized that liver fibrosis may be the result of subclinical inflammation and autoimmunity associated with SLE itself and the use of steroids may prevent or prolong fibrosis formation in the liver.