Researcher: Dağel, Tuncay
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Dağel, Tuncay
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Publication Metadata only Immature platelet fraction: Is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?(De Gruyter Open Ltd, 2021) Tasdemir, Z.A.; Palaoğlu, K.E.; N/A; İncir, Said; Komesli, Zeynep; Baygül, Arzu Eden; Çaltı, Hatice Kant; Kapmaz, Mahir; Tekin, Süda; Kılıç, Alparslan; Dağel, Tuncay; Okan, Ayşe; Somay, Kayra; Akpınar, Timur Selçuk; Doctor; Doctor; Faculty Member; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; School of Medicine; N/A; N/A; N/A; N/A; N/A; N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; 175430; N/A; 272290; N/A; N/A; 42146; N/A; N/A; N/A; N/A; 216646Objectives : In many diseases, immature platelet fraction (IPF%) is related to coagulopathy and poor outcome. This study aimed to investigate the predictive value of IPF% for the severity of pneumonia in patients with Coronavirus Disease 2019 (COVID-19). Methods : A total of 154 patients with COVID‐19 infections were included. The patients were divided into two groups according to the severity of pneumonia (severe and non-severe) regarding their oxygen demand. Results : Given laboratory parameters, the median IPF% was significantly higher in the severe group (11.9 vs. 3.9%, p<0.001). Mean platelet volume (p<0.001), platelet-large cell ratio (p=0.001), platelet distribution width (p=0.001), D-Dimer (p<0.001), INR (p=0.003), and aPTT (p=0.007) were also found to be significantly higher in the severe group. Moreover, IPF (p=0.014, Odds ratio = 2.000, 95%CI: 1.149-3.482) was an independent predictor for the severity. The curve value from receiver operating characteristics was 0.879 (p<0.001, 95%CI: 0.784-0.943) for determining the severity of pneumonia. IPF% had a sensitivity and specificity value of 69.5 and 92.4% to detect the disease’s severity. Conclusions : IPF% is an independent predictor for the severity of COVID-19 pneumonia. Assessment of IPF% may both help to early determine high-risk patients with COVID-19 and to alert the physicians. / Amaç : Pek çok hastalıkta, immatür platelet fraksiyonu (%İPF), koagülopati ve kötü sonuçla ilişkilidir. Bu çalışma, Coronavirus Hastalığı 2019 (COVID-19) olan hastalarda pnömoni şiddeti için %İPF’nin prediktif değerini araştırmayı amaçladı. Yöntem : COVID-19 enfeksiyonu olan toplam 154 hasta dahil edildi. Hastalar, oksijen ihtiyaçları göz önüne alınarak pnömoni şiddetine göre (ağır ve ağır olmayan) iki gruba ayrıldı. Bulgular : Laboratuvar parametrelerine bakıldığında, medyan İPF yüzdesi ağır grupta anlamlı olarak daha yüksekti (%11.9′a karşı %3.9, p<0.001). Ortalama trombosit hacmi (p<0.001), trombosit-büyük hücre oranı (p=0.001), trombosit dağılım genişliği (p=0.001), D-Dimer (p<0.001), İNR (p=0.003) ve aPTT (p=0.007) ağır grupta anlamlı olarak daha yüksek bulundu. Ayrıca, İPF (p=0.014, Odds oranı = 2.000, %95 CI: 1.149-3.482) hastalık şiddeti için bağımsız bir öngördürücü olarak bulundu. Algılayıcı işletim eğrisinden gelen eğri değeri, pnömoni şiddetini belirlemek için 0.879 (p<0.001, %95 CI: 0.784-0.943) idi. İPF, hastalığın şiddetini saptamak için %69.5′lik duyarlılık ve %92.4′lük özgüllük değerine sahipti. Sonuç : İPF, COVID-19 pnömonisinin şiddeti için bağımsız bir öngörücüdür. %İPF’nin değerlendirilmesi, hem COVID-19′lu yüksek riskli hastaları erken belirlemeye hem de hekimleri uyarmaya yardımcı olabilir.Publication Metadata only Noninvasive optical coherence tomography imaging correlates with anatomic and physiologic end-organ changes in healthy normotensives with systemic blood pressure variability(Lippincott Williams & Wilkins, 2020) Afşar, Barış; Sağ, Alan A.; N/A; Dağel, Tuncay; Derin, Gözde; Kesim, Cem; Taş, Ayşe Yıldız; Şahin, Afsun; Dinçer, Neris; Kanbay, Mehmet; Doctor; Undergraduate Student; Teaching Faculty; Faculty Member; Faculty Member; Undergraduate Student; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; 387367; 200905; 171267; 349025; 110580Objective: Blood pressure variability (BPV) is considered as a novel risk factor for cardiovascular disease including left ventricular hypertrophy, vascular stiffness, and renal dysfunction. In this study, we aimed to determine the relationship between ambulatory BPV with subclinical organ damage and vascular stiffness parameters in normotensive healthy subjects. Methods: A total of 100 healthy subjects over 18 years of age were included in this cross-sectional study. We divided the participants into two groups according to the median value of the SD of mean 24-h blood pressure (BP) (Group 1: SD of mean 24-h BP 10.15). BPs of these subjects were recorded over a 24-h period using ambulatory BP monitoring. Mobil-O-Graph device was used to estimate the augmentation index (AIx), pulse wave velocity (PWV), and ambulatory BP measurement. The choroidal thickness was measured by using optical coherence tomography device. Results: The mean age of the patients was 25.4 +/- 5.0 years. Choroidal thickness was correlated with PWV, AIx, protein excretion, and SD of systolic and diastolic BP (P < 0.05). Additionally, participants with higher BP variability have lower choroidal thickness and higher AIx. Conclusion: We showed that even in normotensive subjects, BPV correlates with choroid thickness. Thus, BPV can be an early prognostic parameter for pathologic vascular changes.Publication Metadata only The impact of exercise on physical function, cardiovascular outcomes and quality of life in chronic kidney disease patients: a systematic review(Springer, 2018) Afsar, Baris; Siriopol, Dimitrie; Kanbay, Asiye; Burlacu, Alexandru; Covic, Adrian; N/A; N/A; N/A; N/A; N/A; Aslan, Gamze; Eren, Özgür Can; Kılıç, Uğur; Dağel, Tuncay; Kanbay, Mehmet; Doctor; Researcher; Other; Doctor; Faculty Member; School of Medicine; School of Medicine; N/A; N/A; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; 110580The prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) is increasing steadily. CKD does not only relate to morbidity and mortality but also has impact on quality of life, depression and malnutrition. Such patients often have significantly decreased physical activity. Recent evidence suggests that low physical activity is associated with morbidity, mortality, muscle atrophy, quality of life impairment, cardiovascular outcomes and depression. Based on this, it is now recommended to regularly improve the physical activity of these patients. Furthermore, studies have shown the beneficial effects of various exercise programs with respect to outcomes such as low physical activity muscle atrophy, quality of life, cardiovascular outcomes and depression. Despite these encouraging findings, the subject is still under debate, with various aspects still unknown. In this review, we tried to critically summarize the existing studies, to explore mechanisms and describe future perspectives regarding physical activity in CKD/ESRD patients.Publication Metadata only A 70-year-old patient with seronegative lupus nephritis: rare case(Logos Tıp Yayıncılığı, 2018) N/A; N/A; N/A; N/A; N/A; N/A; Dağel, Tuncay; Meram, Ece; Önal, Emine Meltem; Erbil, Damla; Bülbül, Mustafa Cem; Uysal, Sanem Pınar; Doctor; Undergraduate Student; Undergraduate Student; Undergraduate Student; Researcher; Undergraduate Student; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; 327626; N/ASystemic lupus erythematosus (SLE) is an autoimmune disease known to be associated with various kinds of autoantibodies such as Antinuclear antibodies (ANA). ANA is found to be positive in most of the SLE patients. In fact, ANA positivity in serum is one of the diagnostic criteria of SLE. However, a minority of SLE patients may present with ANA negativity. We report a 70-year-old female who presented with massive edema and 10-gram/day proteinuria. Her serum antibodies for SLE were all negative and the renal biopsy showed a class V lupus nephritis. This case was unusual type of SLE due to multiple reasons namely the patient was an elderly woman, with isolated lupus nephritis and negative serology including ANA negativity.Publication Metadata only The crosstalk of gut microbiota and chronic kidney disease: role of inflammation, proteinuria, hypertension, and diabetes mellitus(Springer, 2018) Covic, Adrian; Vaziri, Nosratola D.; Afsar, Baris; N/A; Kanbay, Mehmet; Önal, Emine Meltem; Dağel, Tuncay; Yerlikaya, Aslıhan; Faculty Member; Undergraduate Student; Doctor; Undergraduate Student; School of Medicine; School of Medicine; N/A; School of Medicine; N/A; N/A; Koç University Hospital; N/A; 110580; N/A, N/A; N/AChronic kidney disease (CKD) has been shown to result in profound changes in the composition and functions of the gut microbial flora which by disrupting intestinal epithelial barrier and generating toxic by-products contributes to systemic inflammation and the associated complications. On the other hand, emerging evidence points to the role of the gut microbiota in the development and progression of CKD by provoking inflammation, proteinuria, hypertension, and diabetes. These observations demonstrate the causal interconnection between the gut microbial dysbiosis and CKD. The gut microbiota closely interacts with the inflammatory, renal, cardiovascular, and endocrine systems via metabolic, humoral, and neural signaling pathways, events which can lead to chronic systemic inflammation, proteinuria, hypertension, diabetes, and kidney disease. Given the established role of the gut microbiota in the development and progression of CKD and its complications, favorable modification of the composition and function of the gut microbiome represents an appealing therapeutic target for prevention and treatment of CKD. This review provides an overview of the role of the gut microbial dysbiosis in the pathogenesis of the common causes of CKD including hypertension, diabetes, and proteinuria as well as progression of CKD.Publication Metadata only Iron in kidney and heart failure: from theory to practice(Springer, 2018) Afsar, Baris; Voroneanu, Luminita; Siriopol, Dimitire; Covic, Adrian; N/A; N/A; N/A; N/A; N/A; Yerlikaya, Aslıhan; Bülbül, Mustafa Cem; Dağel, Tuncay; Aslan, Gamze; Kanbay, Mehmet; Undergraduate Student; Researcher; Doctor; Doctor; Faculty Member; School of Medicine; School of Medicine; N/A; N/A; School of Medicine; N/A; N/A; Koç University Hospital; School of Medicine; N/A; N/A; 327626; N/A; N/A; 110580There is evidence that serum iron levels, regardless of the presence of anemia, directly impact outcomes in congestive heart failure (CHF) including quality of life, hospitalization rate and overall survival. Despite modern medical treatments, the prognosis of CHF remains grim. Ironically, simple iron replenishment may serve as a powerful tool in the armamentarium. This review will start from fundamental concepts of iron in oxygen delivery and analyze evidence-based outcomes in CHF iron-directed therapeutic trials. Imaging rationale that dovetails with this pathophysiology will also be detailed in a clinician-directed fashion.Publication Metadata only Acute effects of salt on blood pressure are mediated by serum osmolality(Wiley, 2018) Afsar, Baris; Siriopol, Dimitrie; Kuwabara, Masanari; Rodriguez-Iturbe, Bernardo; Lanaspa, Miguel A.; Covic, Adrian; Johnson, Richard J.; N/A; Kanbay, Mehmet; Aslan, Gamze; Dağel, Tuncay; Çamkıran, Volkan; İncir, Said; Faculty Member; Doctor; Doctor; Doctor; Faculty Member; School of Medicine; N/A; N/A; N/A; School of Medicine; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; 110580; N/A; N/A; N/A; 175430It is classically thought that it is the amount of salt that is critical for driving acute blood pressure responses. However, recent studies suggest that blood pressure responses, at least acutely, may relate to changes in serum osmolality. Here, we test the hypothesis that acute blood pressure responses to salt can be altered by concomitant water loading. Ten healthy patients free of any disease and medication underwent 4 interventions each a week apart in which they took 300 mL of lentil soup with no salt (visit 1), lentil soup with 3 g salt (visit 2), or lentil soup with 3 g salt and 500 mL water (visit 3) or 750 mL water (visit 4). At each visit, hourly blood measurements and blood pressure measurements (baseline, 1st, 2nd, 3rd, and 4th hour) were performed and plasma osmolarity, sodium and copeptin levels were measured. Patients receiving the 3 g salt showed a 6 mOsm/L change in osmolality with a 2.5 mmol/L change in plasma sodium and 10 mm Hg rise in systolic blood pressure at 2 hours. When the same patients drank salty soup with water, the changes in plasma osmolarity, plasma sodium, and blood pressure were prevented. The ability to raise blood pressure acutely with salt appears dependent on changes in plasma osmolality rather than the amount of salt. Our findings suggest that concurrent intake of water must be considered when evaluating the role of salt in blood pressure.Publication Metadata only Can incidental vascular calcifications at mammography be used as a screening biomarker for heart and kidney disease?(Sage, 2019) Covic, Adrian; A. Sag, Alan; Afsar, Barış; N/A; Erbil, Damla; Önal, Emine Meltem; Demirel, Çağrı; Dağel, Tuncay; Kanbay, Mehmet; Undergraduate Student; Undergraduate Student; Undergraduate Student; Doctor; Faculty Member; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; 110580Mammography is a screening test with extensive international application and financial infrastructure promoting accessibility and affordability. Designed specifically to detect microcalcifications, mammography is powered to detect calcifications in vessel walls. Breast arterial calcifications (BAC) are one of the most common incidental findings documented by mammography. This review considers the literature regarding BAC in relation to cardiovascular disease (CVD) and its risk factors. The aim is to assess the possibility of using BAC as an early surrogate imaging biomarker of CVD.Publication Metadata only Disorders of lipid metabolism in chronic kidney disease(Karger Publishers, 2018) Afsar, Baris; Kuwabara, Masanarini; Covic, Adrian; N/A; Kanbay, Mehmet; Bülbül, Mustafa Cem; Dağel, Tuncay; Ulusu, Nuriye Nuray; Faculty Member; Researcher; Doctor; Faculty Member; School of Medicine; School of Medicine; N/A; School of Medicine; N/A; N/A; Koç University Hospital; N/A; 110580; 327626; N/A; 6807Cardiovascular disease (CVD) is the leading cause of death in chronic kidney disease (CKD). One of the most important pathophysiological mechanisms for CVD in patients with CKD is the widespread and possibly accelerated formation of atherosclerotic plaques due to hyperlipidemia, uremic toxins, inflammation, oxidative stress, and endothelial dysfunction. Recent studies showed that the level of oxidized lowdensity lipoprotein cholesterol increases, and that high-density lipoprotein cholesterol dysfunction occurs as kidney function declines and inflammation becomes more prevalent. In this review, we aimed to discuss the effect of kidney dysfunction, oxidative stress, and inflammation on lipid profile.Publication Metadata only Hyperthermic intraperitoneal chemotherapy is an independent risk factor for development of acute kidney injury(Imprimatur Publications, 2018) Afsar, Barıs; Dağel, Tuncay; Mısırlıoğlu, Selim; Tanju, Serhan; Selçukbiricik, Fatih; Erus, Suat; Vatansever, Doğan; Balık, Emre; Taşkıran, Çağatay; Dilege, Şükrü; Mandel, Nil Molinas; Buğra, Dursun; Yaltı, Mehmet Tunç; Kanbay, Mehmet; Doctor; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; N/A; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; 214690; 202015; 175565; 193687; N/A; 134190; 122573; 194197; 1758; 221690; 110580Purpose: Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) or hyperthermic intrapleural chemotherapy (HIC) has been established as the new treatment modality for selected patients with peritoneal and pleural malignancies. The purpose of the study was to compare the development of acute kidney injury (AKI) in patients who received intravenous cisplatin alone, HIPEC and underwent surgery. Methods: This retrospective study included 104 patients who underwent different therapeutic procedures including systemic cisplatin, surgery and HIPEC or HIC using cisplatin for the treatment of peritoneal carcinomatosis from a variety of primary tumors at Koc University Hospital and American Hospital between January 2015 to December 2017. Results: AKI developed in 18 (17.3%) patients. Baseline creatinine was significantly increased in 3 groups after therapies. The development of AKI was highest in patients treated with HIPEC compared to patients treated with intravenous cisplatin and patients who underwent surgery. AKI developed 31.2% in the HIPEC group (10 of 32 patients), 11.7% in the surgery group (4 of 34 patients) and 10.5% in intravenous cisplatin group (4 of 38 patients), respectively (p=0.04). Conclusion: HIPEC may not be so safe with regard to kidney function. Every attempt should be taken to decrease kidney damage during this procedure.