Researcher:
Baygül, Arzu Eden

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Arzu Eden

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Baygül

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Baygül, Arzu Eden

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2020 - 202329

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    Improving the urine spot protein/creatinine ratio by the estimated creatinine excretion to predict proteinuria in pediatric kidney transplant recipients
    (Wiley, 2021) Palaoğlu, Kerim Erhan; N/A; İncir, Said; Taşdemir, Mehmet; Koçak, Burak; Yelken, Berna; Arpalı, Emre; Akyollu, Başak; Baygül, Arzu Eden; Bilge, İlmay; Türkmen, Aydın; Doctor; Faculty Member; Faculty Member; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; Doctor; N/A; School of Medicine; School of Medicine; N/A; N/A; N/A; School of Medicine; School of Medicine; N/A; Koç University Hospital; N/A; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; Koç University Hospital; 175430; 175867; 220671; N/A; N/A; N/A; 272290; 198907; N/A
    Background Since the daily creatinine excretion rate (CER) is directly affected by muscle mass, which varies with age, gender, and body weight, using the spot protein/creatinine ratio (Spot P/Cr) follow-up of proteinuria may not always be accurate. Estimated creatinine excretion rate (eCER) can be calculated from spot urine samples with formulas derived from anthropometric factors. Multiplying Spot P/Cr by eCER gives the estimated protein excretion rate (ePER). We aimed to determine the most applicable equation for predicting daily CER and examine whether ePER values acquired from different equations can anticipate measured 24 h urine protein (m24 h UP) better than Spot P/Cr in pediatric kidney transplant recipients. Methods This study enrolled 23 children with kidney transplantation. To estimate m24 h UP, we calculated eCER and ePER values with three formulas adapted to children (Cockcroft-Gault, Ghazali-Barratt, and Hellerstein). To evaluate the accuracy of the methods, Passing-Bablok and Bland-Altman analysis were used. Results A statistically significant correlation was found between m24 h UP and Spot P/Cr (p < .001, r = 0.850), and the correlation was enhanced by multiplying the Spot P/Cr by the eCER equations. The average bias of the ePER formulas adjusted by the Cockcroft-Gault, Ghazali-Barratt, and Hellerstein equations were -0.067, 0.031, and 0.064 g/day, respectively, whereas the average bias of Spot P/Cr was -0.270 g/day obtained by the Bland-Altman graphics. Conclusion Using equations to estimate eCER may improve the accuracy and reduce the spot urine samples' bias in pediatric kidney transplantation recipients. Further studies in larger populations are needed for ePER reporting to be ready for clinical practice.
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    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; 216646
    Objectives : 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.
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    Surgical reconstruction of major bile duct injuries: long-term results and risk factors for restenosis
    (Elsevier Ltd, 2023) Tekant, Yaman; Serin, Kürşat Rahmi; İbiş, Abdil Cem; Ekiz, Feza; Özden, İlgin; N/A; Baygül, Arzu Eden; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; 272290
    Background: A single-institution retrospective analysis was undertaken to assess long-term results of definitive surgical reconstruction for major bile duct injuries and risk factors for restenosis. Methods: Patients treated between January 1995 and October 2020 were reviewed retrospectively. The primary outcome measure was patency. Results: Of 417 patients referred to a tertiary center, 290 (69.5%) underwent surgical reconstruction; mostly in the form of a hepaticojejunostomy (n = 281, 96.8%). Major liver resection was undertaken in 18 patients (6.2%). There were 7 postoperative deaths (2.4%). Patency was achieved in 97.4% of primary repairs and 88.8% of re-repairs. Primary patency at three months (including postoperative deaths and stents removed afterwards) in primary repairs was significantly higher than secondary patency attained during the same period in re-repairs (89.3% vs 76.5%, p < 0.01). The actuarial primary patency was also significantly higher compared to the actuarial secondary patency 10 years after reconstruction (86.7% vs 70.4%, p = 0.001). Vascular disruption was the only independent predictor of loss of patency after reconstruction (OR 7.09, 95% CI 3.45–14.49, p < 0.001), showing interaction with injuries at or above the biliary bifurcation (OR 9.52, 95% CI 2.56–33.33, p < 0.001). Conclusions: Long-term outcome of surgical reconstruction for major bile duct injuries was superior in primary repairs compared to re-repairs. Concomitant vascular injury was independently associated with loss of patency requiring revision. © 2022 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland
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    PSA change after antibiotic treatment should not affect decision-making on performing a prostate biopsy
    (TÜBİTAK , 2023) Kayali, Yunus; Ilktac, Abdullah; Ersoz, Cevper; Toprak, Hueseyin; Akcay, Muzaffer; Dogan, Bayram; N/A; Balbay, Mevlana Derya; Tarım, Kayhan; Baygül, Arzu Eden; Faculty Member; Researcher; Faculty Member; School of Medicine; School of Medicine; School of Medicine; 153320; 327605; 272290
    Background/aim: To investigate the effect of antibiotic treatment on PSA when deciding on prostate biopsy.Materials and methods: A total of 206 patients with an elevated PSA level (2.5-30) were included. Mp-MRI could be done on 129 patients. Patients were given ciprofloxacin (500 mg, b.i.d. p.o.) for 4 weeks and PSA measurements were repeated. Systematic prostate biopsy was performed regardless of PSA changes on all patients. Additionally, cognitive biopsies were performed from PI-RADs III, IV, and V lesions.Results: Prostate cancer was detected in 36.4% of patients. 53.3% had Gleason score of 3+3, 46.7% had Gleason score >= 3+4. PSA values decreased in 56.3% and in 43.7% and remained the same or increased but cancer detection rates were not different: 34.5% vs. 38.9%, respectively (p = 0.514). PSA change in whole group was significant (6.38 ng/mL vs. 5.95 ng/mL, respectively (p = 0.01). No significant PSA decrease was observed in cancer patients (7.1 ng/mL vs. 7.05 ng/mL, p = 0.09), whereas PSA decrease was significant in patients with benign pathology (6.1 ng/mL vs. 5.5 ng/mL, p = 0.01). In patients with PI-RADs IV-V lesions, adenocarcinoma was present in 33.9% and 30.4% with or without PSA decrease, respectively (p = 0.209). Clinically significant cancer was higher in patients with after antibiotherapy PSA values >4 ng/mL regardless of PI-RADs grouping (p = 0.08). Addition of any PSA value to PI-RADs grouping did not have any significant effect on the detection of cancer.Conclusion: PSA change after antibiotic treatment has no effect in detecting cancer and should not delay performing a biopsy.
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    Association of graft to recipient weight ratio and outcomes of living and split donor liver transplantation in pediatric less than 20 kg
    (Wiley, 2021) N/A; N/A; N/A; N/A; N/A; N/A; Andaçoğlu, Oya Münevver; Karataş, Cihan; Baygül, Arzu Eden; Mecit, Nesimi; Kanmaz, Turan; Kalayoğlu, Münci; Doctor; Doctor; Faculty Member; Doctor; Faculty Member; Doctor; Koç University Hospital; N/A; N/A; 272290; N/A; 275799; N/A
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    Nsaids and paracetamol-induced hepatotoxicity: asystematic review and meta-analysis of observational studies
    (Wiley, 2021) Nafisi, Sara; N/A; Baygül, Arzu Eden; Gülmez, Sinem Ezgi; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 272290; 281312
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    Can immature granulocyte count and hemogram indices begood predictors of urinary tract infection in children?
    (Association of Clinical Biochemistry Specialists, 2021) Palaoğlu, Kerim Erhan; N/A; N/A; N/A; N/A; N/A; İncir, Said; Taşdemir, Mehmet; Çaltı, Hatice Kant; Baygül, Arzu Eden; Bilge, İlmay; Faculty Member; Faculty Member; Doctor; Faculty Member; Faculty Member; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; N/A; N/A; Koç University Hospital; N/A; N/A; 175430; 175867; N/A; 272290; 198907
    Objectives: A left shift in a complete blood count (CBC) indicates the presence of immature granulocytes (IGs), and an elevated count is associated with a bacterial infection. The aim of this study was to evaluate the role of the IG count and inflammatory CBC parameters and indices in children with a urinary tract infection (UTI). Methods: In this retrospective study, 55 children with a UTI (patient group) and 47 children with no infection matched for age and sex (control group) were enrolled. The symptoms, clinical findings, CBC parameters, and platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammatory index (SII), and urinalysis findings were recorded. The C-reactive protein (CRP) level, urine culture results, and radiological data for the UTI group were also noted and analyzed. Results: The IG count; leukocyte, platelet, and neutrophil counts; and the CRP value were higher in the patient group than in the control group (p=0.001, 0.001, 0.035, 0.001, and < 0.001, respectively). The NLR, PLR, SII, and mean platelet volume were not significantly different between the groups. The median hemoglobin level was significantly lower in the patient group than in the control group (10.9 g/dL vs. 12.2 g/dL; p=0.004). The area under the curve values for CRP, and counts of IG, leukocytes, and neutrophils were 0.851 (95% confidence interval [CI]: 0.761-0.917), 0.736 (95% CI: 0.633-0.823), 0.714 (95% CI: 0.609-0.804), and 0.670 (95% CI: 0.564-0.765), respectively. Conclusion: The IG count is an easily obtained measurement that can be utilized alongside the CRP value and other indicators to create better predictive value in the management of UTI.
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    Infiltration pattern predicts metastasis and progression better than the T-stage and grade in pancreatic neuroendocrine tumors: a proposal for a novel infiltration-based morphologic grading
    (Elsevier, 2022) Reid, Michelle D.; Bağcı, Pelin; Balcı, Serdar; Pehlivanoğlu, Burçin; Memiş, Bahar; Bozkurtlar, Emine; Leblebici, Can Berk; Birceanu, Adelina; Xue, Yue; Sökmensüer, Cenk; Scarpa, Aldo; Luchini, Claudio; Baştürk, Olca; Taşkın, Orhun Çığ; Armutlu, Ayşe; Demirtaş, Deniz; Saka, Burcu; Erkan, Murat Mert; Kapran, Yersu; Baygül, Arzu Eden; Adsay, Nazmi Volkan; Faculty Member; Teaching Faculty; Undergraduate Student; Faculty Member; Faculty Member; Faculty Member; Faculty Member; 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; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 166686; 133567; 371572; 222921; 214689; 168101; 272290; 286248
    The advancing edge profile is a powerful determinant of tumor behavior in many organs. In this study, a grading system assessing the tumor-host interface was developed and tested in 181 pancreatic neuroendocrine tumors (PanNETs), 63 of which were <=2 cm. Three tumor slides representative of the spectrum (least, medium, and most) of invasiveness at the advancing edge of the tumor were selected, and then each slide was scored as follows. Well-demarcated/encapsulated, 1 point; Mildly irregular borders and/or minimal infiltration into adjacent tissue, 2 points; Infiltrative edges with several clusters beyond the main tumor but still relatively close, and/or satellite demarcated nodules, 3 points; No demarcation, several cellular clusters away from the tumor, 4 points; Exuberantly infiltrative pattern, scirrhous growth, dissecting the normal parenchymal elements, 5 points. The sum of the rankings on the three slides was obtained. Cases with scores of 3-6 were defined as "non/minimally infiltrative" (NI; n = 77), 7-9 as "moderately infiltrative" (MI; n = 68), and 10-15 as "highly infiltrative" (HI; n = 36). In addition to showing a statistically significant correlation with all the established signs of aggressiveness (grade, size, T-stage), this grading system was found to be the most significant predictor of adverse outcomes (metastasis, progression, and death) on multivariate analysis, more strongly than T-stage, while Ki-67 index did not stand the multivariate test. As importantly, cases <=2 cm were also stratified by this grading system rendering it applicable also to this group that is currently placed in "watchful waiting" protocols. In conclusion, the proposed grading system has a strong, independent prognostic value and therefore should be considered for integration into routine pathology practice after being evaluated in validation studies with larger series.
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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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    Course of vitamin D levels before and after liver transplantation in pediatric patients
    (Wiley, 2021) N/A; N/A; N/A; N/A; N/A; N/A; Yüksel, Muhammed; Demir, Barış; Mızıkoğlu, Özlem; Akyıldız, Murat; Baygül, Arzu Eden; Arıkan, Çiğdem; Researcher; Doctor; Researcher; Faculty Member; Faculty Member; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); N/A; N/A; N/A; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; 123080; 272290; 240198
    Background: 25-hydroxy VD insufficiency is known in children undergoing LT but the serial post-transplant VD course and supplementation modalities in the peri-transplant period are lacking. We aimed to determine the pre-VD status and the post-transplant VD status course following VD supplementation and to elucidate its relationship with post-transplant outcome parameters such as infection and survival. Methods: Pre- and post-VD levels were monitored in parallel with interventions to adjust VD levels in LT patients. VD status was categorized as circulating levels <30–21 ng/ml (insufficiency), 20–10 ng/ml (deficiency), and <10 ng/ml (severe deficiency). Patients received stoss (300000IU) VD3 within the pretransplant period if serum levels were <20 ng/ml. Results: 135 transplanted children were included. The age at LT was 22 months (IQR: 8–60). The pretransplant median VD level was 14 ng/ml. Despite stoss dose, post-transplant median VD level was 1.8 ng/ml (day one), 4 ng/ml (week one), 19 ng/ml (month one), 33 ng/ml (month three), 38 ng/ml (months 6–12), and 40 ng/ml (month 24). After 6 months, VD status reached >30 ng/ml in 98% of patients. Only at pre-LT, higher infection rate (18.7%) in the severe VD deficiency group was observed compared to the VD deficiency group (2.9%, p = .04). Survival was not affected by serum VD levels. Conclusion: VD levels fell substantially after LT but are rectifiable by stoss dose, which was well tolerated. Only the infection rate was associated with the VD status.