Person: TUĞLULAR, ZÜBEYDE SERHAN
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TUĞLULAR
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ZÜBEYDE SERHAN
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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 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 Kidney failure in Sudan: thousands of lives at risk(2023-08-19) TUĞLULAR, ZÜBEYDE SERHAN; Hassan H. A., Hafez M. H., Luyckx V. A., TUĞLULAR Z. S., Abu-Alfa A. K.Publication Metadata only Böbrek Nakli Dirençli Akut Rejeksiyon Tedavisinde Ekulizumab Deneyimi(2022-12-08) TUĞCU, MURAT; BARUTÇU ATAŞ, DİLEK; TUĞLULAR, ZÜBEYDE SERHAN; VELİOĞLU, ARZU; Berke Menteşe İ., Barutçu Ataş D., Tuğcu M., Tuğlular Z. S. , Velioğlu A.Publication Metadata only Fibroscan detection of fatty liver and liver fibrosis in patients with systemic lupus erythematosus(2022-05-01) YILMAZ, YUSUF; BARUTÇU ATAŞ, DİLEK; ALİBAZ ÖNER, FATMA; DİRESKENELİ, RAFİ HANER; TUĞLULAR, ZÜBEYDE SERHAN; AŞICIOĞLU, EBRU; VELİOĞLU, ARZU; Yetginoglu O., Atas D., Yilmaz Y., Velioglu A., Arikan H., Alibaz-Oner F., Direskeneli H., Tuglular S., Asicioglu E.Objective Although liver dysfunction is not considered the main organ involvement in Systemic Lupus Erythematosus (SLE), the frequency of liver dysfunction or abnormal liver enzyme values may be observed in 50-60% of patients. The aim of this study was to assess fatty liver and liver fibrosis in SLE patients using Fibroscan as well as determine associated factors such as immunosuppressive medications. Methods 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. Results The prevalence of fatty liver disease was similar between SLE patients and healthy controls (21.7 vs 26.7%, p = .597). Liver fibrosis was also similar between the two groups (26.7 vs 10.0%, p = .069). Since the majority of SLE patients were female, we performed a subgroup analysis in female patients (n = 51) and controls (n = 25). Fatty liver disease was similar between female SLE patients and controls (23.5 vs 24.0%, p = .964). However, liver fibrosis in female patients with SLE was increased compared to female controls (29.4 vs 4.0%, p = .011) and was associated with age (Exp (B) 95% CI: 1.083 (1.006-1.166), p = .034) and low-dose cumulative glucocorticoid use (Exp (B) 95% CI: 14.116 (1.213-164.210), p = .034). Conclusion The prevalence of fatty liver was similar between SLE patients and 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. Larger studies are needed to confirm our findings and determine whether immunosuppressive use has any impact on the development of liver fibrosis in SLE patients.Publication Metadata only The relationship between perceived stress with anxiety, depression, sleep quality, insomnia and drug adherence in patients with systemic lupus erythematosus during the covid-19 pandemic(2022-05-01) DİRESKENELİ, RAFİ HANER; BARUTÇU ATAŞ, DİLEK; ARIKAN, İZZET HAKKI; GÖKMEN YILDIRIM, KARDELEN; VELİOĞLU, ARZU; ALİBAZ ÖNER, FATMA; TUĞLULAR, ZÜBEYDE SERHAN; AŞICIOĞLU, EBRU; TUĞCU, MURAT; GÖKMEN YILDIRIM K., BARUTÇU ATAŞ D., TUĞCU M., VELİOĞLU A., ARIKAN İ. H., ALİBAZ ÖNER F., DİRESKENELİ R. H., TUĞLULAR Z. S., AŞICIOĞLU E.AIMS: Sleep disorders, depression and anxiety are commonly reported in patients with systemic lupus erythematosus (SLE). Public health emergencies such as pandemics can also increase these psychosocial distresses. Early diagnosis and treatment of these disorders will substantially affect patients' quality of life and medication adherence. The aim of this study was to evaluate both medication non-adherence and the incidence of perceived stress, anxiety, depression, sleep quality and insomnia during the COVID pandemic in patients with SLE. METHOD: This was a cross-sectional, descriptive survey study. A total of 211 participants, including 160 SLE patients aged 18 years and older and 51 healthy volunteers who were similar in age and gender, were included. A questionnaire of socio-demographics and COVID-19 status, Medication Compliance Reporting Scale (MARS-5), Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale (HADA and HAD-D), Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) scales was assessed. The participants were interviewed face to face, and the answers were recorded by the researcher. RESULTS: The mean age of the patients was 41.85 ± 12.97 years and 142 (88.7%) of the patients were female. There was no significant difference between the patient and control groups in terms of the history of COVID-19 infection, symptoms and hospitalization. Fifty-nine (36.9%) patients had high perceived stress, 16 (10.0%) had anxiety, 45 (28.1%) had depression, 77 (48.1%) had poor sleep quality and 62 (38.8%) patients had insomnia. PSS (23.64 ± 7.86 versus 19.73 ± 4.80, P = .001), HAD-D (5.60 ± 3.40 versus 4.08 ± 2.21, P = .003), PSQI (6.31 ± 3.62 versus 4.43 ± 2.20, P = .001) and ISI (6.81 ± 4.98 versus 4.53 ± 2.83, P = .002) scores were significantly higher in the patient group than controls. Patients with PSS score ≥ 25 were categorized as patients with a high PSS score. Presence of anxiety, depression, poor sleep quality and insomnia were significantly higher in patients with a high PSS score. Medication non-adherence was detected in 79 (49.4%) of the patients. Interestingly, there was no difference in MARS-5 scores between high and low PSS groups. Comparison of baseline characteristics and clinical data of the patients according to PSS score is shown in Table 1. The high PSS score was positively correlated with HAD-A, HAD-D, PSQI and ISI scores. Regression analysis revealed that high perceived stress is an independent predictor of depression [Exp(β) 95% CI 1.488 (1.245-1.779), P < .001], and anxiety [Exp(β) 95% CI 1.235 (1.026-1.487), P = .026]. CONCLUSION: SLE patients demonstrated increased levels of perceived stress, depression, poor sleep quality and insomnia compared to the healthy population during the COVID-19 pandemic. SLE patients with high perceived stress had more depression, anxiety, poor sleep quality and insomnia than those without. It needs to be determined whether these findings will have an impact on patient outcomes during long-term follow-up. Palavras-chave adult; anxiety; conference abstract; controlled study; coronavirus disease 2019; depression; female; follow up; gender; Hospital Anxiety and Depression Scale; hospitalization; human; incidence; insomnia; Insomnia Severity Index; major clinical study; male; medication compliance; outcome assessment; pandemic; Perceived Stress Scale; physiological stress; Pittsburgh Sleep Quality Index; questionnaire; sleep quality; sociodemographics; systemic lupus erythematosus; young adultPublication Metadata only Strategies to prevent SARS-CoV-2 transmission in hemodialysis centres across Europe-lessons for the future(2023-03-01) TUĞLULAR, ZÜBEYDE SERHAN; Noordzij M., Meijers B., Gansevoort R. T., Covic A., Duivenvoorden R., Hilbrands L. B., Hemmelder M. H., Jager K. J., Mjoen G., Nistor I., et al.Background Early reports on the pandemic nature of coronavirus disease 2019 (COVID-19) directed the nephrology community to develop infection prevention and control (IPC) guidance. We aimed to make an inventory of strategies that dialysis centres followed to prevent infection with COVID-19 in the first pandemic wave. Methods We analyzed IPC measures taken by hemodialysis centres treating patients presenting with COVID-19 between 1 March 2020 and 31 July 2020 and that completed the European Renal Association COVID-19 Database centre questionnaire. Additionally, we made an inventory of guidelines published in European countries to prevent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in dialysis centres. Results Data from 73 dialysis units located in and bordering Europe were analyzed. All participating centres implemented IPC measures to mitigate the impact of SARS-CoV-2 during the first pandemic wave. Measures mentioned most often included triage with questions before entering the dialysis ward, measuring body temperature, hand disinfection, masking for all patients and staff, and personal protective equipment for staff members. These measures were also recommended in most of the 14 guidelines that were identified in the inventory of national guidelines and were also scored as being among the most important measures by the authors of this paper. Heterogeneity existed between centres and national guidelines regarding the minimal distance between dialysis chairs and recommendations regarding isolation and cohorting. Conclusions Although variation existed, measures to prevent transmission of SARS-CoV-2 were relatively similar across centres and national guidelines. Further research is needed to assess causal relationships between measures taken and spread of SARS-CoV-2.