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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only Can we improve our management of dysfunctional voiding in children and adults: international consultation on Incontinence research society; ICI-RS2018?(Wiley, 2019) von Gontard, Alexander; Apostolidis, Apostolos; Mosiello, Giovanni; Abrams, Paul; Tarcan, Tufan; Other; School of Medicine; 173289Aims: Dysfunctional voiding (DV) remains a poorly understood and a poorly managed problem, both in children and adults. The Think Tank (TT) discussed how to improve the management of DV in these two different age groups and in transitional care. Methods: During the 2018 International Consultation on Incontinence Research Society held in Bristol, a multidisciplinary TT on DV was created. The presentations and subsequent discussion, leading to research recommendations intended to improve the management of DV in children and adults are summarized. Results: To improve the management of DV in children and adults, the TT panel proposed: (1) to conduct reliable prevalence studies of DV; (2) to perform longitudinal studies to prospectively test the sequence hypothesis by answering the following questions: (a) Which, if any children show a progression from overactive bladder or voiding postponement to DV?; (b) Which children develop each disorder without precursors?; and (c) Is there a continuation of DV from childhood to adulthood, or are adult cases new-onset presentations?; (3) to obtain detailed information regarding psychopathology to understand which comorbid psychological disorders prevail and at which rate, in those suffering DV; (4) to develop and validate diagnostic tools specifically for DV; (5) to better establish urodynamic correlates of DV specific for different age groups; and (6) to generate prospective long-term data regarding the efficacy of different treatment options and management strategies. Conclusions: The future research recommendations of this TT may improve our management of DV in children and adults.Publication Metadata only The role of uric acid in mineral bone disorders in chronic kidney disease(Springer, 2019) Afsar, Baris; Sag, Alan A.; Kuwabara, Masanari; Cozzolino, Mario; Covic, Adrian; N/A; Öztosun, Çınar; Kanbay, Mehmet; Undergraduate Student; Faculty Member; School of Medicine; School of Medicine; N/A; 110580Increasing survival in the chronic kidney disease (CKD) population exposes the bone to the cumulative detrimental sequelae of CKD, now defined physiologically and histopathologically as chronic kidney disease mineral bone disorder (CKD-BMD). This disorder is increasingly recognized as a "nontraditional" driver of morbidity and mortality and presents an opportunity to improve CKD outcomes via research. However, recent advances in the literature on this topic have not yet been collected into a single review. Therefore, this report aims to discuss the disordered renal-bone axis in CKD-BMD, molecular and hormonal drivers, novel treatment strategies, and forthcoming research in a clinician-directed format. A key novel topic will be the unique impact of uric acid on CKD-BMD, which is poised to apply extensive existing research in the uric acid domain to benefit the CKD-BMD population.Publication Metadata only Therapeutic implications of shared mechanisms in non-alcoholic fatty liver disease and chronic kidney disease(Springer, 2021) Afsar, Baris; Sag, Alan A.; Siriopol, Dimitrie; Kuwabara, Masanari; Badarau, Silvia; Covic, Adrian; Ortiz, Alberto; N/A; Kanbay, Mehmet; Çöpür, Sidar; Bülbül, Mustafa Cem; Faculty Member; Researcher; Researcher; School of Medicine; School of Medicine; School of Medicine; 110580; 368625; 327626The most common cause of liver disease worldwide is now non-alcoholic fatty liver disease (NAFLD). NAFLD refers to a spectrum of disease ranging from steatosis to non-alcoholic steatohepatitis, causing cirrhosis, and ultimately hepatocellular carcinoma. However, the impact of NAFLD is not limited to the liver. NAFLD has extra-hepatic consequences, most notably, cardiovascular and renal disease. NAFLD and chronic kidney disease share pathogenic mechanisms including insulin resistance, lipotoxicity, inflammation and oxidative stress. Not surprisingly, there has been a recent surge in efforts to manage NAFLD in an integrated way that not only protects the liver but also delays comorbidities such as chronic kidney disease. This concept of simultaneously addressing the main disease target and comorbidities is key to improve outcomes, as recently demonstrated by clinical trials of SGLT2 inhibitors and GLP1 receptor agonists in diabetes. HIF activators, already marketed in China, also have the potential to protect both liver and kidney, as suggested by preclinical data. This review concisely discusses efforts at identifying common pathogenic pathways between NAFLD and chronic kidney disease with an emphasis on potential paradigm shifts in diagnostic workup and therapeutic management.Publication Metadata only Approaches of pediatric nephrologists to hypertensive patients in Turkey (Turkish pediatric hypertension working group study)(Springer, 2018) Demir, Belde Kasap; Hacıhamdioğlu, Duygu Övüç; Girişgen, İlknur; Dursun, Hasan; Çivilibal, Mahmut; Benzer, Meryem; Bıyıklı, Neşe Karaaslan; Özkayın, Neşe; Sönmez, Ferah; Taşdemir, Mehmet; Faculty Member; School of Medicine; 175867Objective: We aimed to evaluate the approaches of pediatric nephrologists in our country to the management of childhood hypertension. Methods: The pediatric nephrologists in our country were invited to fill out an online questionnaire including 24 questions. The answers were compared between those working in the field for <= 10 years (Group 1, n =74) and >10 years (Group 2, n = 62). Results: of 136 participants (M/F = 101/35), 52% were following a single guideline [31% Fourth Report of 2004, 17% European Society of Hypertension in 2016, and 52% American Academy of Pediatrics in 2017], which is more common in Group 1 (P =.035). The most commonly used guideline was American Academy of Pediatrics of 2017 and Group 2 used Fourth Report of 2004 more commonly (P =.042). The most common choice to diagnose hypertension was office + home + ambulatory blood pressure monitoring (59%). The frequency of screening for end-organ damage at first evaluation was 96%. The time to wait for the effect of lifestyle modifications was 3 months in 52%. The first choice medication was angiotensin-converting enzyme inhibitors (49%) or calcium-channel blockers (48%) in non-obese and angiotensin-converting enzyme inhibitors (74%) in obese children. Calcium-channel blockers were more commonly prescribed as the first choice in non-obese children in Group 1 (P =.035). The most accessible emergency drug was esmolol. Conclusion: Despite following recent guidelines, the time spent in the proficiency would change the practices.Publication Metadata only Hemolytic uremic syndrome outbreak in Istanbul-Turkey in 2015; outcome and eculizumab experience(Springer, 2017) Ağbaş, Ayşe; Göknar, Nilufer; Akıncı, Nurver; Yıldırım, Zeynep Yürük; Benzer, Meryem; Gökçe, İbrahim; Küçük, Nuran; Çalışkan, Salim; Taşdemir, Mehmet; Demirkol, Demet; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 175867; 108964N/APublication Metadata only Association between elevated serum uric acid and vitamin D insufficiency among the middle-aged and elderly population(Buluş Design, 2016) Takir, Mumtaz; Solak, Yalçın; Erek, Aybala; Kostek, Osman; Oral, Alihan; Elcioglu, Omer Celal; Bakan, Ali; Afsar, Baris; Ozkok, Abdullak; Jalal, Diana; Johnson, Richard J.; Aydin Bahat, Kubra; Odabas, Ali Riza; N/A; Kanbay, Mehmet; Faculty Member; School of Medicine; 110580OBJECTIVE: Vitamin D insufficiency might have a role in numerous diseases including autoimmune disease, cancer, diabetes mellitus, hypertension and heart diseases. The relationship between vitamin D insufficiency and hyperuricemia has been shown previously but there are conflicting results in studies. MATERIAL and METHODS: A total of 1562 patients who had serum uric acid and vitamin D levels measured at the same time were enrolled. Patients who were on vitamin D replacement therapy, receiving calcium and/or allopurinol, or had gout and chronic kidney disease were excluded. RESULTS: Hyperuricemic patients had significantly lower levels of serum vitamin D level compared with normouricemic patients (p<0.001) whereas there was no difference between the groups in terms of serum calcium, phosphorus, parathormone and alkaline phosphatase. Severe deficiency (25(OH) vitamin D <10) was significantly more common among patients with hyperuricemia (p<0.001). When vitamin D levels were analyzed according to age, a significant inverse correlation between vitamin D and serum uric acid level was found in decades 7 and 8. Age, eGFR and vitamin D level below 20 appeared as independent associates of serum uric acid levels. CONCLUSION: These data suggest that hyperuricemia associates with vitamin D deficiency. Further studies are needed to understand the mechanism underlying this association and its potential clinical implications. / AMAÇ: D vitamini eksikliği başta otoimmünite, kanser, diyabetes mellitus, hipertansiyon ve kalp hastalıkları olmak üzere birçok hastalıkla ilişkili olabilir. D vitamini eksikliği ile hiperürisemi arasında çelişkili sonuçlar daha önceki çalışmalarda gösterilmiştir. GEREÇ ve YÖNTEMLER: Serum D vitamini ve ürik asit değerleri eş zamanlı bakılan hastalar çalışmaya dahil edildi. D vitamini replasman tedavisi alanlar, kalsiyum ve/veya allopurinol kullananlar, gut ve kronik böbrek yetmezliği (glomeruler filtrasyon hızı <60 ml/min) olan hastalar çalışmaya dahil edilmedi. BULGULAR: Hiperürisemik hastaların serum vitamin D düzeyleri normoürisemik hastalara göre daha düşük olduğu görülmesine (p<0.001) karşın, gruplar serum kalsiyum, fosfor, parathormon ve alkalen fosfataz düzeyleri bakımından benzerdi. D vitamini düzeylerine göre değerlendirildiğinde ağır (vitamin D <10) düzeyde eksikliği olan hastaların daha çok hiperürisemik (p<0.001) grupta olduğu görüldü. Yaşa göre serum D vitamini ve ürik asit düzeyleri arasında anlamlı derecede negatif korelasyonun 7.ve 8. dekatlarda olduğu görüldü. Yaş, serum D vitamini düzeyinin <20 olması ve eGFR düzeyleri, serumürik asit düzeyi ile anlamlı korelasyon gösterdiği görüldü. SONUÇ: Çalışmamızda, hiperüriseminin D vitamini eksikliği ile ilişkili olduğu saptanmıştır. Bu ilişkiyi açıklayabilecek mekanizma ve bunun klinik açıdan etkilerine yönelik daha ileri çalışmalara ihtiyaç vardır.Publication Metadata only What is the best vascular access site for continuous renal replacement therapy during neonatal period?(Springer, 2015) Büyükpastırmacı, Müge; Karacabey, Burçin Nazlı; Aygün, Fatih.; Zeybek, Çiğdem Ayşe; N/A; Demirkol, Demet; Faculty Member; School of Medicine; 108964N/APublication Metadata only COVID-19 in children with chronic dialysis and kidney transplantation: a multicenter study from Istanbul(SPRINGER, 2021) Canpolat, Nur; Yıldırım, Zeynep Yürük; Yıldız, Nurdan; Göknar, Nilüfer; Evrengül, Havva; Gülmez, Rüveyda; Aksu, Bağdagül; Dursun, Hasan; Özçelik, Gül; Yavaşcan, Önder; Çiçek, Rümeysa Yasemin; Tülpar, Sebahat; Hacıhamdioğlu, Duygu Övünç; Nayir, Ahmet; Alpay, Harika; Taşdemir, Mehmet; Faculty Member; School of Medicine; Koç University Hospital; 175867N/APublication Metadata only The role of the size and number of index lesion in the diagnosis of clinically significant prostate cancer in patients with PI-RADS 4 lesions who underwent in-bore MRI-guided prostate biopsy(Springer, 2023) Kilic, Mert; Madendere, Serdar; Vural, Metin; N/A; Köseoğlu, Ersin; Esen, Tarık; Balbay, Mevlana Derya; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; 350876; 50536; 153320Purpose To evaluate the contribution of the size and number of the sampled lesions to the diagnosis of clinically significant prostate cancer (CSPC) in patients who had PI-RADS 4 lesions. Methods In this retrospective study, a total of 159 patients who had PI-RADS 4 lesions and underwent In-bore MRI-Guided prostate biopsy were included. Patients with a lesion classified as Grade Group 2 and above were considered to have CSPC. Univariate and multivariate regression analyses were used to evaluate the factors affecting the diagnosis of prostate cancer (PCa) and CSPC. Results A great majority (86.8%) of the patients were biopsy-naive. About three-fourths (71.7%) had PCa, and half (54.1%) had CSPC. When the patients were divided into three groups according to the index lesion size (< 5 mm, 5-10 mm, and > 10 mm), the prevalence of PCa was 64.3, 67.5, and 82.4% and the prevalence of CSPC was 42.9, 51.2, and 64.7%, respectively. In multivariate analysis, age, index lesion size, prostate volume (< 50 ml) and being biopsy-naive were found significant for PCa, while age and prostate volume (< 50 ml) were significant for CSPC. Conclusion The number of lesions was found to be insignificant in predicting PCa and CSPC. While the size of PI-RADS 4 lesions was significant in predicting PCa, it had no significance in detecting CSPC.Publication Metadata only Clinical value of ambulatory blood pressure: is it time to recommend for all patients with hypertension?(Springer, 2016) Solak, Yalcin; Kario, Kazuomi; Covic, Adrian; Afsar, Baris; Ozkok, Abdullah; Wiecek, Andrzej; N/A; Bertelsen, Nathan; Kanbay, Mehmet; Faculty Member; Faculty Member; School of Medicine; School of Medicine; N/A; 110580Hypertension is a very common disease, and office measurements of blood pressure are frequently inaccurate. Ambulatory Blood Pressure Monitoring (ABPM) offers a more accurate diagnosis, more detailed readings of average blood pressures, better blood pressure measurement during sleep, fewer false positives by detecting more white-coat hypertension, and fewer false negatives by detecting more masked hypertension. ABPM offers better management of clinical outcomes. For example, based on more accurate measurements of blood pressure variability, ABPM demonstrates that taking antihypertensive medication at night leads to better controlled nocturnal blood pressure, which translates into less end organ damage and fewer clinical complications of hypertension. For these reasons, albeit some shortcomings which were discussed, ABPM should be considered as a first-line tool for diagnosing and managing hypertension.