Researcher:
Tanrıöver, Cem

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Cem

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Tanrıöver

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Tanrıöver, Cem

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2020 - 202313

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    Metabolically healthy obesity: misleading phrase or healthy phenotype?
    (Elsevier B.V., 2023) Gaipov, Abduzhappar; Kuwabara, Masanari; Hornum, Mads; Van Raalte, Daniel H.; Tanrıöver, Cem; Çöpür, Sidar; Özlüşen, Batu; Akcan, Rüştü Emre; Kanbay, Mehmet; Undergraduate Student; Researcher; Undergraduate Student; Undergraduate Student; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; 368625; N/A; N/A; 110580
    Obesity is a heterogenous condition with multiple different phenotypes. Among these a particular subtype exists named as metabolically healthy obesity (MHO). MHO has multiple definitions and its prevalence varies according to study. The potential mechanisms underlying the pathophysiology of MHO include the different types of adipose tissue and their distribution, the role of hormones, inflammation, diet, the intestinal microbiota and genetic factors. In contrast to the negative metabolic profile associated with metabolically unhealthy obesity (MUO), MHO has relatively favorable metabolic characteristics. Nevertheless, MHO is still associated with many important chronic diseases including cardiovascular disease, hypertension, type 2 diabetes, chronic kidney disease as well as certain types of cancer and has the risk of progression into the unhealthy phenotype. Therefore, it should not be considered as a benign condition. The major therapeutic alternatives include dietary modifications, exercise, bariatric surgery and certain medications including glucagon-like peptide-1 (GLP-1) analogs, sodium-glucose cotransporter-2 (SGLT-2) inhibitors and tirzepatide. In this review, we discuss the significance of MHO while comparing this phenotype with MUO.
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    Kidney transplantation: a possible solution to obstructive sleep apnea in patients with end-stage kidney disease
    (Springer Science and Business Media Deutschland GmbH, 2023) Ureche, Carina; Covic, Alexandra M.; Sekmen, Mert; Kanbay, Asiye; Covic, Adrian; N/A; Kanbay, Mehmet; Çöpür, Sidar; Tanrıöver, Cem; Esen, Buğra Han; Faculty Member; Researcher; Undergraduate Student; Undergraduate Student; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 110580; 368625; N/A; N/A
    Introduction: Obstructive sleep apnea (OSA) is frequently reported among patients with chronic kidney disease resulting in considerable morbidity and mortality. OSA may cause repetitive stimulation of the sympathetic nervous system and elevations in pulmonary artery pressure leading to an elevated risk of cardiac and vascular complications in patients with chronic kidney disease. Furthermore, OSA is associated with progressive worsening of kidney injury and loss of renal function. Methods: In this systematic review and meta-analysis, we evaluated the effect of renal transplantation on the progression of OSA in patients with end-stage kidney disease. Results: The meta-analysis included eight studies with a total of 401 patients. Findings showed that kidney transplantation does not lead to a statistically significant effect on the apnea–hypopnea index (MD 2.6 events/hr, 95% CI −3.2 to 8.3, p = 0.21), total sleep time (MD 14.7 min/night, 95% CI −8.4 to 37.8, p = 0.76), sleep efficiency (MD 2.5%, 95% CI −1.4 to 6.3, p = 0.57), slow wave sleep (MD 0.4% of total sleep time, 95% CI −7.5 to 8.4, p = 0.05), and rapid eye movement sleep (MD 0.6% of total sleep time, 95% CI −2.2 to 3.3, p = 0.98). There was no statistically significant effect of kidney transplantation on OSA in patients with chronic renal disease.
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    Potential use of SGLT-2 inhibitors in obstructive sleep apnea: a new treatment on the horizon
    (Springer Heidelberg) Kanbay, Asiye; Sridhar, Vikas S.; Cherney, David Z., I; Tanrıöver, Cem; Uçku, Duygu; Akyol, Merve; Çevik, Enes; Kanbay, Mehmet; Undergraduate Student; Undergraduate Student; Undergraduate Student; Undergraduate Student; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; N/A; N/A; 110580
    Background: Obstructive sleep apnea (OSA) is characterized by hypoxic episodes due to collapse of the airway during sleep and is frequently associated with obesity, type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). There is currently no pharmacological agent approved for the treatment of OSA. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have the potential to both increase life expectancy and quality of life of these patients making them promising agents for this role. There are relatively few studies investigating this possible beneficial relationship between these drugs and OSA. Method: We aimed to increase awareness on the potential benefits of SGLT2 inhibitors in OSA patients by describing the current evidence on the effectiveness of these inhibitors in both overall and cardiovascular morbidity and mortality. We performed a literature search for articles reporting on the use of SGLT2 inhibitors in patients with OSA and T2DM. Results: We identified 4 manuscripts studying the use of SGLT2 inhibitors in 475 OSA patients with T2DM. Among them, 332 patients were administered SGLT2 inhibitors, and 143 patients were in a control group. SGLT2 inhibitors have many potential positive impacts on OSA patients by targeting various mechanisms involved in OSA pathogenesis. Conclusion: SGLT2 inhibitors are prime pharmacological candidates for the treatment of OSA, and additional studies are needed to better explore mechanisms and outcomes unique to this population. Additionally, patients with OSA often have multiple comorbidities that are clinical indications for SGLT2 inhibitor therapy. Physicians should recognize and encourage the use of these agents in such patients.
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    The mitochondrion: a promising target for kidney disease
    (Multidisciplinary Digital Publishing Institute (MDPI), 2023) Soler, Maria Jose; N/A; Kanbay, Mehmet; Çöpür, Sidar; Tanrıöver, Cem; Uçku, Duygu; Çakır, Ahmet Berke; Hasbal, Nuri Barış; Faculty Member; Researcher; Undergraduate Student; Undergraduate Student; Undergraduate Student; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 110580; 368625; N/A; N/A; N/A; 143778
    Mitochondrial dysfunction is important in the pathogenesis of various kidney diseases and the mitochondria potentially serve as therapeutic targets necessitating further investigation. Alterations in mitochondrial biogenesis, imbalance between fusion and fission processes leading to mitochondrial fragmentation, oxidative stress, release of cytochrome c and mitochondrial DNA resulting in apoptosis, mitophagy, and defects in energy metabolism are the key pathophysiological mechanisms underlying the role of mitochondrial dysfunction in kidney diseases. Currently, various strategies target the mitochondria to improve kidney function and kidney treatment. The agents used in these strategies can be classified as biogenesis activators, fission inhibitors, antioxidants, mPTP inhibitors, and agents which enhance mitophagy and cardiolipin-protective drugs. Several glucose-lowering drugs, such as glucagon-like peptide-1 receptor agonists (GLP-1-RA) and sodium glucose co-transporter-2 (SGLT-2) inhibitors are also known to have influences on these mechanisms. In this review, we delineate the role of mitochondrial dysfunction in kidney disease, the current mitochondria-targeting treatment options affecting the kidneys and the future role of mitochondria in kidney pathology.
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    A meta-analysis for the role of aminoglycosides and tigecyclines in combined regimens against colistin- and carbapenem-resistant Klebsiella pneumoniae bloodstream infections
    (Springer, 2022) N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Department of Industrial Engineering; N/A; Demirlenk, Yusuf Mert; Gücer, Lal Sude; Uçku, Duygu; Tanrıöver, Cem; Akyol, Merve; Kalay, Zeynepgül; Barçın, Erinç; Akcan, Rüştü Emre; Can, Füsun; Gönen, Mehmet; Ergönül, Önder; Undergraduate Student; Researcher; Researcher; Undergraduate Student; Undergraduate Student; Undergraduate Student; Master Student; N/A; Undergraduate Student; Faculty Member; Faculty Member; Faculty Member; Department of Industrial Engineering; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; School of Medicine; College of Engineering; School of Medicine; N/A; 375775; N/A; N/A; N/A; N/A; N/A; N/A; N/A 237468; 110398
    We aimed to describe the effect of aminoglycosides and tigecycline to reduce the mortality in colistin- and carbapenem-resistant Klebsiella pneumoniae (ColR-CR-Kp) infections. We included the studies with defined outcomes after active or non-active antibiotic treatment of ColR-CR-Kp infections. The active treatment was defined as adequate antibiotic use for at least 3 days (72 h) after the diagnosis of ColR-CR-Kp infection by culture. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and the checklist of PRISMA 2020 was applied. Crude and adjusted odds ratios (OR) with 95% confidence interval (CI) were calculated and pooled in the random effects model. Adding aminoglycosides to the existing treatment regimen reduced overall mortality significantly (OR 0.34, 95% CI 0.20-0.58). Overall mortality was 34% in patients treated with aminoglycoside-combined regimens and was 60% in patients treated with non-aminoglycoside regimens. Treatment with tigecycline is not found to reduce mortality (OR: 0.76, 95% CI: 0.47-1.23). Our results suggest that aminoglycoside addition to the existing regimen of colistin- and carbapenem-resistant Klebsiella pneumoniae infections reduces mortality significantly.
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    Successful fight against the COVID-19 pandemic: Singapore
    (Türk Tabipler Birliği, 2022) N/A; N/A; N/A; Uçku, Duygu; Tanrıöver, Cem; Kayı, İlker; Undergraduate Student; Undergraduate Student; Faculty Member; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; 168599
    Singapore has shown a successful fight against the COVID-19 pandemic. Singapore has always been prone to infectious diseases due to its location, climate and tourism. Lessons learned while tackling the past SARS epidemic have guided the country’s current approach to the pandemic. Singapore’s first case was reported on January 23, 2020, when a 66-year-old patient from Wuhan showed symptoms of pneumonia and had a positive PCR test. The country has adopted a multidimensional surveillance approach to combat the pandemic. This includes updated case definitions, contact tracing, expanded surveillance in different patient groups (respiratory tract infections and intensive care admissions) and increased testing opportunities for physicians, as well as investigation of the etiology of deaths from infectious causes. In this article, we discuss Singapore’s healthcare system, the measures that were implemented in order to fight against the COVID-19 pandemic and the reasons for their success. / COVID-19 pandemisi yönetimi bakımından Singapur örnek gösterilebilecek ülkeler arasında yer almaktadır. Singapur, lokasyonu, iklimi ve sık seyahat edilen bir ülke olması nedeniyle bulaşıcı hastalıklara yatkın bir ülke olmuştur. Geçmişteki SARS salgını ile mücadelede alınan dersler, ülkenin pandemi planına yön vermiştir. Singapur’un ilk vakası, 23 Ocak 2020’de Wuhan’dan gelen 66 yaşındaki bir hastanın pnömoni semptomları göstermesi ve PCR testinin pozitif çıkması ile doğrulanmıştır. Ülke, pandemiyle mücadelede çok boyutlu bir sürveyans yaklaşımını benimsemiştir. Bu, güncellenen vaka tanımları, temaslı izlemi, farklı hasta gruplarında (solunum yolu enfeksiyonları ve yoğun bakım yatışları) genişletilmiş bir sürveyans ve hekimlere artırılmış test imkanlarına ek olarak, enfeksiyöz nedenli ölümlerin etiyolojisinin araştırılması gibi farklı uygulamaları içermektedir. Bu yazıda Singapur’un sağlık sisteminin tanıtılmasının yanı sıra, COVID-19 pandemisinde yürüttüğü pandemi kontrol önlemleri ve bunların başarılı olmasındaki nedenler değerlendirilecektir.
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    Effect of sodium-glucose cotransporter 2 inhibitors on hemoglobin and hematocrit levels in type 2 diabetes: a systematic review and meta-analysis
    (Springer, 2022) Tapoi, Laura; Ureche, Carina; Afsar, Baris; Cherney, David Z., I; Covic, Adrian; N/A; Kanbay, Mehmet; Demiray, Atalay; Tanrıöver, Cem; Çevik, Enes; Faculty Member; Master Student; Undergraduate Student; Undergraduate Student; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; 110580; N/A; N/A; N/A
    Background Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve outcomes of patients with type 2 diabetes at high cardiovascular risk and chronic kidney disease. Recent studies showed an increase in hemoglobin and hematocrit after SGLT2i treatment. Materials and methods We did a systematic review and meta-analysis of randomized, double-blind, placebo-controlled studies of SGLT2i in patients with type 2 diabetes. We searched through PubMed/Medline, Web of Science, Embase (Elsevier), and the Cochrane Central Register of Controlled Trials (Wiley) from January 2010 to January 2021. Results We included seventeen randomized, double-blind, placebo-controlled studies. The total number of evaluated patients was 14,748. The treatment arm consisted of canagliflozin, dapagliflozin, empagliflozin and ipragliflozin. SGLT2i therapy significantly increased hemoglobin levels when compared to placebo (MD 5.60 g/L, 95% CI 3.73-7.47 g/L, P < 0.00001, considerable heterogeneity-I-2 = 94%). Each SGLT2i also led to a significant increase in the hematocrit level when compared to placebo (MD 1.32%, 95% CI 1.21-1.44, P < 0.00001, considerable heterogeneity-I-2 = 99%). Conclusions SGLT2i led to significant increases in hemoglobin and hematocrit levels when compared to placebo. In addition to their cardiovascular effect, SGLT2i also increases hemoglobin and hematocrit levels.
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    Acute kidney injury in hospitalized COVID-19 patients
    (2022) Medetalibeyoğlu, Alpay; Kanbay, Asiye; Naci; Konyaoğlu, Hilal; Akpınar, Timur S.; Köse, Murat; Covic, Adrian; Tükek, Tufan; N/A; Kanbay, Mehmet; Çevik, Enes; Tanrıöver, Cem; Baygül, Arzu Eden; Faculty Member; Undergraduate Student; Undergraduate Student; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; School of Medicine; School of Medicine; School of Medicine; 110580; N/A; N/A; 272290
    Background: Acute kidney injury (AKI) in COVID-19 patients is associated with poor prognosis. However, the incidence, risk factors and potential outcomes of AKI in hospitalized patients are not well studied. Materials and methods:  This is a retrospective cohort study conducted in two major university hospitals. Electronic health records of the patients, 18 years or older, hospitalized between 13 April and 1 June 2020 with confirmed COVID-19 were reviewed. We described the incidence and the risk factors for AKI development in COVID-19 patients. Furthermore, we investigated the effects of AKI on the length of hospital and intensive care unit (ICU) stay, the admission rates to ICU, the percentage of patients with cytokine storm and in-hospital mortality rate. Results: Among 770 hospitalized patients included in this study, 92 (11.9%) patients developed AKI. The length of hospitalized days (16 vs 9.9, p < 0.001) and days spent in the hospital until ICU admission (3.5 vs. 2.5, p = 0.003) were higher in the AKI group compared to patients without AKI. In addition, ICU admission rates were also significantly higher in patients with AKI (63% vs. 20.7%, p < 0.001). The percentage of patients with AKI who developed cytokine storm was significantly higher than patients without AKI (25.9% vs. 14%, p = 0.009). Furthermore, the in-hospital mortality rate was significantly higher in patients with AKI (47.2% vs. 4.7%, p < 0.001). Conclusions: AKI is common in hospitalized COVID-19 patients. Furthermore, we show that AKI increases the admission rates to ICU and in-hospital mortality. Our findings suggest that AKI should be effectively managed to prevent the adverse outcomes in COVID-19 patients.
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    Kidney transplantation: is it a solution to endothelial dysfunction?
    (Springer, 2022) Ureche, Carina; Covic, Alexandra M.; Sekmen, Mert; Covic, Adrian; N/A; Kanbay, Mehmet; Çöpür, Sidar; Tanrıöver, Cem; Faculty Member; Researcher; Undergraduate Student; School of Medicine; School of Medicine; School of Medicine; 110580; 368625; N/A
    Background Endothelial dysfunction is associated with elevated cardiovascular risk in patients with end-stage renal disease (ESRD). Kidney transplantation has demonstrated significant ability in reducing mortality and improving quality of life in recipients. Recent studies have also reported improvements in endothelial function following kidney transplantation; however, current literature is limited. Methods We performed a systematic review of PubMed/Medline, Web of Science, Scopus, Cochrane Library, and CINAHL databases for prospective cohort studies that assessed endothelial function prior to and following kidney transplantation via various clinical markers. Follow-up duration ranged from 1 month to 1 year. A meta-analysis of pooled data was conducted using random-effect models for four key markers: brachial artery flow-mediated dilatation (FMD), high-sensitivity C-reactive protein (hsCRP), nitroglycerin-mediated dilation (NMD), and adiponectin. Results We included nine studies in our final analysis with a total of 524 patients. Significant improvement of all four biomarkers was observed after transplantation. The mean difference was 2.81% (95% CI 1.92-3.71, p < 0.00001) for FMD, 17.27 mg/L (95% CI 5.82-28.72, p = 0.003) for hsCRP, 1.05%, (95% CI 0.56-1.54, p < 0.0001) for NMD, and 9.27 mu g/mL (95% CI 5.96-12.57, p < 0.00001) for adiponectin. Conclusion There is an immediate reversal of endothelial dysfunction in ESRD patients who undergo kidney transplantation, which may explain observed improvements in cardiovascular morbidity in transplant recipients. Future longitudinal studies are needed to understand possible re-emergence of endothelial dysfunction in the long-term postoperative period.
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    The pathophysiology and management of vascular calcification in chronic kidney disease patients
    (Taylor & Francis, 2023) Galassi, Andrea; Ciceri, Paola; Cozzolino, Mario; N/A; N/A; N/A; N/A; Çöpür, Sidar; Kanbay, Mehmet; Yavuz, Furkan; Tanrıöver, Cem; Researcher; Faculty Member; Undergraduate Student; Undergraduate Student; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 368625; 110580; N/A; N/A
    IntroductionVascular calcification (VC) which is the pathological mineral deposition in the vascular system, predominantly at the intimal and medial layer of the vessel wall, is an important comorbidity in patients with chronic kidney disease (CKD) leading to significant morbidity and mortality while necessitating appropriate treatment. Our review aims to provide an in-depth analysis of the current understanding of VC.Areas coveredIn this review, we first discuss the pathophysiology of VC in CKD patients, then we explain the methods to predict and assess VC. Afterwards, we provide the currently available as well as the potential therapeutic approaches of VC. We finally discuss our understanding regarding the current situation surrounding VC in our expert opinion section.Expert opinionPredicting, assessing and treating VC is crucial and the future advances in the field of research surrounding VC will potentially occur in one or more of these three areas of clinical management. There is a current lack of evidence and consensus regarding specific therapeutic options for alleviating VC and this situation may not necessitate VC to be determined, detected, and documented before the available options are implemented. Regardless, the prediction and assessment of VC is still important and requires further improvement together with the developments in therapeutic alternatives. The future has the potential to bring better research which would guide and improve the management of this patient group. A more specialized approach consisting of targeted therapies and more tailored management plans for patients with CKD and VC is on the horizon.