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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only An alarming emergence of measles in Europe: gaps and future directions(Galenos Publ House, 2024) Ozsurekci, Yasemin; Ergönül, Önder; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of MedicineN/APublication Metadata only Gait analysis in idiopathic normal pressure hydrocephalus: a single centre experience(Galenos, 2023) Youssef, Hussein; Özkan, Esra; Çakmak, Özgür Öztop; Akar, Kardelen; Kahraman, Atilla Deniz; Samancı, Mustafa Yavuz; Vural, Atay; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); Graduate School of Health Sciences; School of MedicineIntroduction: Gait impairment is the earliest symptom of idiopathic normal pressure hydrocephalus (iNPH). This study objectively investigates gait changes using Ambulatory Parkinson’s Disease Monitoring inertial sensors after cerebrospinal fluid withdrawal in patients with iNPH. Methods: Two-minute walkway tests were performed in eleven patients with iNPH before and after the spinal tap test (TT) or ventriculoperitoneal shunt surgery. Gait parameters were analyzed and compared for each patient individually before and after the intervention. Results: Eleven patients with iNPH (six female, five male) with a median age of 76 (68-76) were included in the study. After the spinal TT or ventriculoperitoneal shunt surgery, patients exhibited increased cadence (steps per minute) and decreased step and stride time (p=0.008, for all). Conclusion: APDM inertial sensors may provide a quantitative gait assessment in patients with iNPH.Publication Metadata only Indomethacin affects the inflammatory response via interaction with the rhoa-actin cytoskeleton in THP-1 cells(Istanbul University Press, 2023) Aldogan, Ebru Haciosmanoglu; Bulut, Seyma; Yapislar, Hande; Guncer, Basak; Bektas, Muhammet; Yöntem, Fulya Dal; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of MedicineObjective: Inflammation is a complex reaction present in numerous disorders. Indomethacin, a compound possessing an indoline core, is a Nonsteroidal Anti-Inflammatory Drug (NSAID) that is commonly prescribed for inflammation and pain. The actin network, plays a major role in cellular activities and it’s regulated by by Rho GTPases has important implications for cellular dynamics and orientation. In this research, we explore the effects of indomethacin on the inflammatory response as mediated via RhoA and pyrin inflammatory complexes using an inflammatory disease model with relation actin cytoskeleton. Materials and Methods: This study used Western blotting to examine the impact of indomethacin on the assembly processes related to the pyrin inflammasome complex and the RhoA signaling pathway in Lipopolysaccharide-stimulated THP-1 cells. Actin-indomethacin interaction was analyzed by Differential Scanning Fluorimetry (DSF). Results: We found that while the expression levels of pyrin decreased, phosphorylated-RhoA increased but overall RhoA levels did not change. The equilibrium dissociation constant (KD) for the G-actin-indomethacin complex was calculated to be 9.591± 1.608 ng/mL (R2= 0.8582) using ∆Tm measurements of indomethacin by DSF. Conclusion: Moreover, the effects of indomethacin on inflammation pathways may provide insight into the molecular mechanisms of pyrin inflammasome formation in various autoimmune diseases.Publication Metadata only Duloxetine in the treatment of women with urinary incontinence: a systematic review and meta-analysis of efficacy data from randomized controlled clinical trials(Galenos, 2023) Murat Uçar; Naşide Mangır; Ömer Gülpınar; Cüneyd Özkürkçigil; Oktay Demirkesen; Tarcan, Tufan; School of MedicineDuloxetine is the only available agent for the medical treatment of stress urinary incontinence (SUI). In this systematic review, we analyzed the efficacy and safety of duloxetine treatment in women with SUI and stress-predominant mixed urinary incontinence (SPMUI). We searched the literature using OVID MEDLINE, Embase and ULAKBIM (Turkish database) databases for placebo-controlled studies on the use of duloxetine in women with SUI or SPMUI. Data on change in incontinence episode frequency (IEF), decrease in the number of continence pads used, increase in voiding interval (minute) and discontinuation rates due to adverse effects and lack of efficacy (%) were extracted. A total of 12 randomized controlled trials were included. Duloxetine treatment results in an 18% decrease in IEF and 16% decrease in the number of incontinence pads used compared to pre-treatment status. It also increases the time interval between the voids by 18 min. Duloxetine treatment was associated with higher treatment discontinuation rates compared with placebo. The reason for discontinuation was related to the side effects of the treatment rather than lack of efficacy. Duloxetine can be an effective treatment option in women with UI based on high-level evidence supporting its efficacy. Further studies with larger patient populations and longer durations of follow-up are required to assess its safety profile.Publication Metadata only Is meat-free diet related to anxiety, depression and disordered eating behaviors? a cross-sectional survey in a Turkish sample(İnönü Üniversitesi, 2023) Çoşar, Behçet; Zorbozan, Emine Yağmur; Şanlı, Sevda Gümüş; Şentük, Erman; Geniş, Erman; Şentürk, Begüm Güler; Erus, Suat; School of MedicineAim: The foods that we eat don’t just impact our physical health. The link between what we eat and how we feel has become a trending topic. However, knowledge on the effects of diet types on this relation is still limited. The first aim of this study is to reveal the possible link between diet types and eating behaviors, anxiety and depression. Second one is to predict possible variables (demographic, health-related and medical) which cause higher depression scores among individuals following a meat-free diet and an omnivore diet. Materials and Methods: A questionnaire-based survey cross-sectional study was conducted among individuals with a meat-free diet and an omnivore diet (N = 836 with a vegan or a vegetarian diet, N = 519 with an omnivore diet) using an online questionnaire. Demographic, health-related and medical characteristics, The Three-Factor Eating Questionnaire-R 21, Hospital Anxiety and Depression Scale were used to assess variables. Results: A meat-free diet group showed significantly lower anxiety and depression scores, lower cognitive restraint, lower emotional eating and lower uncontrolled eating than omnivore diet group. Shared predictors of depression were dissatisfaction with physical appearance, uncontrolled eating and smoking in both meat-free diet group and omnivore diet group. Lower cognitive restraint and lower education level were predictors of depression in only omnivore diet group. Conclusion: This study revealed that an omnivore diet may be more associated with anxiety, depression, and some disordered eating behaviors than a meat-free diet.Publication Metadata only Efficacy and safety of ixabepilone in metastatic breast cancer after multiple treatments: analysis based on real-world data(Turkiye Klinikleri, 2024) Akdağ, Goncagül; Doğan, Akif; Yildirim, Sedat; Kinikoğlu, Oğuzcan; Majidova, Nargiz; Bayoğlu, İbrahim Vedat; Kapar, Caner; Erçin, Eda; Alaca Topçu, Zeynep; Guliyev, Murad; Işik, Deniz; Sever, Özlem Nuray; Odabaş, Hatice; Yildirim, Mahmut Emre; Turan, Nedim; Alan, Özkan; School of Medicine; Koç University HospitalObjective: Patients with metastatic breast cancer (MBC) with a history of treatment with anthracyclines and taxanes exhibit improvement with ixabepilone, a semi-synthetic analog of epothilone B. The present study, therefore, aimed to evaluate the safety and effectiveness of ixabepilone in patients with MBC who have previously received multiple lines of treatment Material and Methods: Patients with MBC who were treated with ixabepilone were included in the present study, which was designed as a retrospective multicenter analysis. Radiological responses were evaluated based on the RECIST criteria, and overall survival (OS) and progression-free survival (PFS) were calculated. The Common Terminology Criteria for Adverse Events version 5.0 was adopted to evaluate adverse events. Results: The analysis of 34 patients revealed a median OS of 10.0 months, a median PFS of 4.2 months, and an objective response rate (ORR) of 28%.The patients treated with ixabepilone prior to the fifth line of treatment exhibited a significantly better response (ORR 50%). In the subgroup analysis based on receptor status, ER+ and human epidermal growth factor receptor-2 (HER2+) patients presented the longest median PFS of 6.2 months. Conclusion: Ixabepilone demonstrated effectiveness in patients with MBC who had received multiple lines of treatments previously. The results suggest that early treatment regimens or targeted therapy for HER2+ patients could lead to better therapeutic outcomes when ixabepilone is administered. Ixabepilone is, therefore, a viable option for MBC patients who have received extensive treatment previously while maintaining a good performance status.Publication Metadata only The function of obesity related miR223-3P as a potential biomarker for weight loss prediction following bariatric surgery(Turaz Bilim Society, 2023) Ahmet Necati ŞANLI; Süleyman Bozkurt; Yunus YAPALAK; Erkan YARDIMCI; Halil COŞKUN; Özgür ÖZTÜTÜNCÜ; Beyza GÖNCÜ; Yığman, Samet; School of MedicineThe objective was to determine how miRNA expression levels related to obesity and weight loss interacted, to forecast how much weight patients could lose after surgery, and to maximize the advantages of a scheduled procedure. 17 patients who planned laparoscopic sleeve gastrectomy were included. Demographic variables, comorbid conditions, and postoperative excess weight loss rates (EWL%) were evaluated. Both intraoperative adipose tissue samples and blood samples were taken. The gene expression levels of the miRNAs (miR27b-3p, miR122- 5p, and miR223-3p) linked to diabetes and obesity were investigated. Mean body mass index was 49.17.6 kg/m2. Six individuals had diabetes mellitus, and their mean blood sugar and HbA1c levels were 133±59.4 mg/dl and 6.4±1.3%, respectively. All preoperative groups had considerably higher levels of miR223-3p expression, it was discovered. Blood samples taken before and after surgery showed considerably higher levels of miR223-3p gene expression than those of miR27b-3p and miR122-5p. Additionally, it was discovered that in individuals with diabetes mellitus, miR122-5p gene expression in fatty tissue was lower than that of miR223-3p and miR27b-3p. MiR223-3p expression has been linked to morbidly obese patients, particularly those with EWLs of 50% and above. After bariatric surgery, the miR223-3p gene may be utilized as a potential biomarker to predict a patient's capacity to lose weight. It is possible to identify patients who will not benefit from surgery and decide to perform a different kind of operation on them. However, additional research involving more patients, additional miRNAs, and various bariatric surgery techniques is required.Publication Metadata only Epidural anesthesia for postoperative analgesia following anterior vertebral body tethering(Galenos Publishing House, 2024) Manici, Mete; School of MedicineN/APublication Metadata only Single center experience of liver re-transplantation: indications-timing and complications(Istanbul Univ, Fac Medicine, Publ Off, 2024) Karataş, Cihan; Alim, Altan; Akbulut, Akın; Demir, Barış; Oğuz, Bahadır Hakan; Kanmaz, Turan; School of Medicine; Koç University HospitalObjective: Function loss, for whatever reason, of the graft used for liver transplantation requires re -transplantation. This study is an evaluation of all re -transplantations performed at our center. Material and Method: All liver re -transplantation patients whose surgeries had been performed at our clinic, whether at an early or late stage, were included in the study. Demographic information, details related to the surgery, and complications were evaluated retrospectively. Result: From 2018 to 2023, 236 liver transplantations were performed on 228 recipients in our institution. Of these patients, a total of 18 underwent re -transplantation, 10 of whom were from external centers and 8 of whom had had their first liver transplantation performed at our center. Of these patients, 12 were male and 6 were female, with a mean age of 6.7 years (+/- 4.8) for pediatric patients and 49 years (+/- 14.32) for adult patients. The mean weight for pediatric patients was 19.76 kg (+/- 8.86), and for adult patients it was 70.48 kg (+/- 11.83). The mean body mass index for pediatric patients was 17.41 kg/m2 (+/- 2.84), and for adult patients it was 22.33 kg/m2 (+/- 2.65). Six of these patients underwent early re -transplantation (7.6 +/- 5.4 days) and 12 underwent late re -transplantation (7.6 +/- 5.3 years). In terms of re -transplantation etiology, primary non -function was prominent for the early period, while secondary biliary cirrhosis, disease recurrence, and chronic rejection were detected for the late period. Seven recipients (39%) died during the perioperative period, and 1 -year survival was calculated as 61% in this patient group. Conclusion: Re -transplantation has high mortality and morbidity rates. Although early re -transplantation seems to overcome high mortality rates, especially in primary non-function cases, organ shortage and the need for living donors are significant problems.Publication Metadata only Determining the importance of glycemic variability in gestational diabetes mellitus using various techniques(Istanbul University Press, 2023) Öztop, Nida; Kubat Üzüm, Ayşe; Çelik, Selda; Idiz, Cemile; Bağdemir, Elif; Dinççağ, Nevin; Tütüncü, Yıldız; School of MedicineObjective: The study aims to determine glycemic variation in patients with gestational diabetes mellitus (GDM) and to evaluate the effect on the fetal growth using a continuous glucose monitoring system (CGMS) and to investigate the correlation between glucose variation through biomarkers including HbA1c, fructosamine (FRM), and 1.5-Anhydroglucitol (1.5-AG). Materials and Methods: The study involves 31 women with GDM at gestational week ≥35 who’d only had diet therapy. Blood glucose levels were monitored for three consecutive days using CGMS to evaluate mean blood glucose levels and mean absolute difference (MAD). Self-monitoring of blood glucose (SMBG) was required from the patients while having the CMGS on their body. Blood samples were collected to measure serum 1.5-AG, HbA1c, and FRM. Results: The mean levels were HbA1c=5.0±0.3%, FRM=2.1±0.2 μmol/L, 1.5-AG=17.0±4.9 ng/ml, and 3-day average max-min glucose range=131.1±22.5 and 54.7±11.6 mg/dl (MAD=6.7±3.1%). The mean glucose levels measured using SMBG and CGMS were similar (82.9±10.2 vs 86.1±10.3 mg/dL). No correlation occurred between CMGS and biomarkers. The baby weight at birth and head circumference was determined to be lower for patients with glucose fluctuations. Conclusion: Biomarkers do not reflect glycemic fluctuation, and regular SMBG is required to achieve the desired glucose level, even in diet-regulated GDM. Lower head circumference and birth weight were determined in GDM mothers with high glycemic fluctuations, and CGMS may be an alternative method despite its cost and application difficulties./Amaç: Gestasyonel Diabetes Mellitus (GDM)’da gün içi glukoz dalgalanmaları ve bunun bebek üzerine etkisini belirlemek; ayrıca, glukozdaki dalgalanmaların HbA1c, fruktozamin (FRM) ve 1,5-Anhidroglucitol (1,5-AG) ile korelasyonunu saptamaktır. Gereç ve Yöntem: Sadece diyetle takip edilen GDM tanısı alan ve ≥35 gebelik haftasındaki 31 hastada devamlı glukoz ölçüm sistemi (CGMS) ile 72 saatlik glisemik değişkenlikler (ortalama mutlak değer %MAD ve ortalama glukoz değeri) ölçüldü, ayrıca hastalardan, CGMS takılı olduğu günler, kendi kendine glukoz ölçüm sistemi (SMBG) her öğün öncesinde ve birinci saat sonrasında parmak ucundan kan glukoz düzeylerini ölçmeleri istendi. 1,5 AG, Hba1c ve FRM düzeyleri CGMS çıkarıldığı üçüncü gün hastalardan alındı. Bulgular: Hastaların ortalama HbA1c, FRM ve 1,5-AG sırasıyla %5,0±0,3, 2,1±0,2 μmol/L, ve 17,0±4,9 ng/mL idi. Üç günlük izlemde maximum-minimum glukoz düzeyi ortalaması 131,1±22,5 ve 54,7±11,6 mg/dL iken %MAD değeri %6,7±3,1 idi. SMBG ve CGMS ile ölçülen ortalama glukoz değeri birbiri ile koreleyken (82,9±10,2 ve 86,1±10,3 mg/dL); glukoz dalgalanması ile FRM, HbA1c ve 1,5-AG arasında anlamlı korelasyon yoktu. Hastaların glikoz dalgalanmaları varsa doğumdaki bebek ağırlığının ve baş çevresinin düşük olduğu belirlendi. Sonuç: Çalışmamızda biyobelirteçlerin glisemik dalgalanmayı yansıtmadığı; istenilen glukoz seviyesinin sağlanması için, diyetle regüle GDM de bile, SMBG’un sık, düzenli olarak yapılmasının gerekliliği saptanmıştır; ancak glisemik dalgalanmaları fazla olan GDM’li annenin bebeğinde baş çevresi ve doğum kilosu daha düşük saptanmıştır ve glisemik dalgalanmayı daha yakından gösteren CGMS’ in her ne kadar maliyet ve uygulama zorluğu olsa da, SMBG’ ye alternatif yöntem olabileceği gösterilmiştir.