Researcher: Esen, Buğra Han
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Esen, Buğra Han
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Publication Metadata only 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/AIntroduction: 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.Publication Metadata only COVID-19–associated mucormycosis: a systematic review and meta-analysis of 958 cases(Elsevier, 2023) Khostelidi, Sofya N.; Klimko, Nikolai; Cornely, Oliver; Zakhour, Johnny; Kanj, Souha S.; Seidel, Danila; Hoenigl, Martin; N/A; Özbek, Laşin; Topçu, Ahmet Umur; Manay, Mehtap; Esen, Buğra Han; Bektaş, Şevval Nur; Aydın, Serhat; Özdemir, Barış; Ergönül, Önder; Undergraduate Student; Undergraduate Student; Undergraduate Student; Undergraduate Student; Undergraduate Student; Undergraduate Student; Undergraduate Student; Faculty Member; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; N/A; N/A; N/A; N/A; N/A; 110398Background: mucormycosis, a rare fungal infection, has shown an increase in the number of reported cases during the COVID-19 pandemic. Objectives: to provide a comprehensive insight into the characteristics of COVID-19–associated mucormycosis, through a systematic review and meta-analysis. Methods of data synthesis: demographic information and clinical features were documented for each patient. Logistic regression analysis was used to predict the risk of mortality. Data sources: PubMed, Scopus, Web of Science, Cochrane, CINAHL, Ovid MEDLINE, and FungiSCOPE. Study eligibility criteria: studies reporting individual-level information in patients with adult COVID-19–associated mucormycosis (CAM) between 1 January 2020 and 28 December 2022. Participants: adults who developed mucormycosis during or after COVID-19. Interventions: patients with and without individual clinical variables were compared. Assessment of risk of bias: quality assessment was performed based on the National Institutes of Health quality assessment tool for case series studies. Results: nine hundred fifty-eight individual cases reported from 45 countries were eligible. 88.1% (844/958) were reported from low- or middle-income countries. Corticosteroid use for COVID-19 (78.5%, 619/789) and diabetes (77.9%, 738/948) were common. Diabetic ketoacidosis (p < 0.001), history of malignancy (p < 0.001), underlying pulmonary (p 0.017), or renal disease (p < 0.001), obesity (p < 0.001), hypertension (p 0.040), age (>65 years) (p 0.001), Aspergillus coinfection (p 0.037), and tocilizumab use during COVID-19 (p 0.018) increased the mortality. CAM occurred on an average of 22 days after COVID-19 and 8 days after hospitalization. Diagnosis of mucormycosis in patients with Aspergillus coinfection and pulmonary mucormycosis was made on average 15.4 days (range, 0–35 days) and 14.0 days (range, 0–53 days) after hospitalization, respectively. Cutaneous mucormycosis accounted for <1% of the cases. The overall mortality rate was 38.9% (303/780). Conclusion: mortality of CAM was high, and most reports were from low- or middle-income countries. We detected novel risk factors for CAM, such as older age, specific comorbidities, Aspergillus coinfection, and tocilizumab use, in addition to the previously identified factors.