Araştırmacılar(26)

• Akagunduz, Baran
• Akbaş, Emin Murat
• Akyildiz, Arif
• Aldemir, Mehmet Naci
• Aydinli, Onur
• Capoglu, Ilyas
• Demirtas, Levent
• Duzgun, Eren
• Ergül, Çetin
• Gül, Vandet
• Gümüş, Burak
• Inan, Hamza
• Islamoglu, Mahmut Sami
• Kara, Ali Veysel
• Karataş, Beliz
• Memis, Fulya
• Odluyurt, Hülya
• Oksuzoglu, Berna
• Ozcicek, Adalet
• Ozcicek, Fatih
• Ozdemir, Ridvan V.
• Ozturk, Ersin V.
• Ozudogru, Osman
• Öksüzoglu, Omur Berna
• Soylu, Yasin Emrah
• Timuroglu, Aysu

• ArticleYayıncıda açık erişim2026/r/ebyu/19273
  Yoğun bakım hastalarında akut böbrek hasarının mekanik ventilatörden ayırma üzerine etkisinin değerlendirilmesi

  Aydin, Emre; Aydin, Fatma Yilmaz; Kara, Ali Veysel; Kadiroğlu, Ali Kemal; Yilmaz, Zülfükar; Yilmaz, Mehmet Emin; Eynel, Eren; Yildirim, Yasar

  Arka plan: Akut böbrek hasarı (AKI), yoğun bakım ünitesindeki (YBÜ) hastaların %5–30’unu etkiler ve artmış mortalite (%40–90), uzamış YBÜ yatışı ve daha yüksek sağlık maliyetleri ile ilişkilidir. Akciğer ve böbrek hasarı arasındaki karşılıklı etkileşim giderek daha fazla tanınmakla birlikte, AKI’nin mekanik ventilasyondan (MV) ayırma sürecine etkisi yeterince araştırılmamıştır. Bu çalışma, YBÜ hastalarında AKI’nin MV’den ayırma sonuçları üzerindeki etkisini değerlendirmektedir. Yöntemler: Bu retrospektif kohort çalışma, Dahiliye Yoğun Bakım Ünitesi’nde (2010–2015) yürütüldü. Solunum yetmezliği nedeniyle entübe edilen ve en az 48 saat mekanik ventilasyon (MV) altında kalan ≥18 yaş hastalar dâhil edildi. Kronik böbrek hastalığı, kronik akciğer hastalığı veya kalp yetmezliği olan hastalar ile mekanik ventilasyon başladıktan sonra AKI gelişen hastalar çalışma dışı bırakıldı. AKI, KDIGO kriterlerine göre serum kreatinin düzeylerine dayanarak tanımlandı (48 saat içinde ≥0.3 mg/dL artış veya 7 gün içinde ≥1.5 kat artış). Retrospektif veri yapısı nedeniyle idrar çıkışı verileri tüm hastalar için güvenilir şekilde mevcut olmadığından AKI tanımında kullanılmadı. AKI, yoğun bakım sürecinde elde edilen veriler temel alınarak değerlendirildi ve yoğun bakım yatışı sırasında gelişmiş kabul edildi. AKI tanısı olan 100 hasta ile AKI olmayan 100 hasta karşılaştırıldı; demografik veriler (yaş, cinsiyet), laboratuvar parametreleri (kreatinin, albümin, hemoglobin, pH, PaO₂, PaCO₂), SOFA ve APACHE II skorları, sepsis durumu ve ventilatörden ayırma sonuçları analiz edildi. İstatistiksel analizlerde Student t-testi, Ki-kare testi ve çok değişkenli lojistik regresyon kullanıldı. Çok değişkenli modelde AKI durumu, yaş, APACHE II skoru, SOFA skoru, albümin düzeyi ve sepsis değişkenleri yer aldı. Bulgular: Genel MV’den ayırma başarısı %28’di (56/200). AKI grubunda başarı oranı %13 iken AKI olmayan grupta %43 idi (p<0.001). AKI hastalarında kreatinin (2.99±1.3 vs. 0.78±0.22 mg/dL, p<0.001), APACHE II (28.2±5.4 vs. 22.3±4.6, p<0.001) ve SOFA skorları (10.1±3.1 vs. 7.7±2.7, p<0.001) daha yüksekti. Çok değişkenli lojistik regresyon analizinde, AKI olmaması ventilatörden ayırma başarısı ile bağımsız olarak ilişkili bulundu (OR: 2.29, %95 GA: 1.03–5.13, p=0.043). Ayrıca, daha düşük APACHE II skoru da ventilatörden ayırma başarısı ile bağımsız olarak ilişkiliydi (OR: 0.901, %95 GA: 0.820–0.990, p=0.030). Yaş sınırda anlamlılık gösterirken (p=0.081), SOFA skoru, albümin düzeyi ve sepsis ile ayırma başarısı arasında bağımsız bir ilişki saptanmadı (tüm p>0.05). Sonuç: AKI, yoğun bakım hastalarında mekanik ventilasyondan ayırma sürecini anlamlı ölçüde olumsuz etkilemektedir. Hastalık şiddeti için düzeltme yapıldıktan sonra dahi, AKI ventilatörden ayırma başarısızlığının bağımsız bir belirleyicisi olarak kalmaktadır. AKI’nin erken tanınması, klinik yönetimi iyileştirebilir ve başarılı ventilatörden ayırmayı kolaylaştırabilir.

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• ArticleAçık Erişim2026/r/ebyu/19044
  The Effects of Medications Used in the Treatment of Rheumatological Diseases on Pregnancy and Fertilization: A Single-center Experience

  Şahin, Ali; Karataş, Beliz; Yalçın, İlker; Çelik, Neşe Çabuk; Pire, Gizem; Eren, Hatice Seyma; Karakaş, Burak; Kuzu, Merve Şenol; Yildirim, Merve; Özdamar, Burcu Nur

  Objective: Considering that the group of rheumatological patients generally consists of women in their reproductive period due to hormonal effects, we aimed to investigate the effects of the treatments given to prevent joint and organ damage caused by these diseases on pregnancy and fertilization. Methods: This study included 1,000 female patients who were followed up due to rheumatological diseases at the rheumatology department of the internal medicine department of our hospital between January 2014 and January 2021. The patients’ ages, rheumatological disease diagnoses, pregnancy status, abortion status, curettage status, medications used, medications used during pregnancy, pregnancy complications, infertility data were retrospectively analyzed. Results: The number of patients who became pregnant after diagnosis increased with the use of colchicine and anakinra, while it decreased with the use of methotrexate and leflunomide. It was observed that the number of abortions before diagnosis increased in the presence of antiphospholipid antibody syndrome (APS) and systemic lupus erythematosus. It was determined that the number of patients giving live births decreased in the presence of an APS diagnosis. It was determined that the number of patients who had live births with the use of colchicine and hydroxychloroquine during pregnancy increased. Conclusion: It should be considered that women of reproductive age with rheumatic diseases may desire pregnancy and may present to the clinic with either planned or unplanned pregnancies during their follow-ups, and accordingly, efforts should be made to avoid medications that could cause infertility as much as possible.

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• ArticleAçık Erişim2026/r/ebyu/19025
  The Relationship Between Non-alcoholic Fatty Liver Disease and Epicardial Adipose Tissue Thickness, Carotid Intima Media Thickness, and Aortic Propagation Velocity

  Aydin, Sonay; Ozcicek, Fatih; Hayme, Serhat; Coşgun, Muharrem Said; Ozturk, Ersin; Öztürk, Gülay Kızılgün

  Objective: Cardiovascular disease is prevalent among individuals diagnosed with non-alcoholic fatty liver disease (NAFLD). Epicardial adipose tissue (EAT), carotid intima-media thickness (CIMT), and aortic propagation velocity (APV) are associated with atherosclerosis and cardiovascular disease (CVD). The aim of this study is to determine whether NAFLD is associated with EAT, CIMT, and APV. Methods: Individuals aged ≥18 and <65 years who presented for routine follow-up were included. The study population comprised 75 healthy controls (40 females, 35 males) and 141 patients with NAFLD (68 females, 73 males). Epicardial adipose tissue thickness, carotid intima-media thickness, and aortic propagation velocity were evaluated using transthoracic echocardiography in patients who were diagnosed with hepatosteatosis by ultrasound during routine check-ups at the internal medicine clinic. Results: NAFLD was positively associated with epicardial adipose tissue thickness and carotid intima–media thickness, and negatively associated with aortic propagation velocity. Patients with NAFLD had significantly higher EAT and CIMT values and lower APV values than controls. Logistic regression analysis identified body mass index (BMI) and EAT as independent predictors of hepatosteatosis. Each unit increase in BMI was associated with a 1.29-fold increase in the risk of hepatosteatosis, whereas each unit increase in EAT was associated with a 5.49-fold increase. Conclusion: Given the established associations of CIMT, APV, and EAT with atherosclerosis and cardiovascular disease, assessment of patients with NAFLD using these noninvasive parameters may help identify subclinical cardiovascular risk.

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• ArticleAçık Erişim2026/r/ebyu/19018
  Nutritional and Inflammatory Indicators for Identifying Sarcopenia in Hemodialysis Patients

  Kara, Ali Veysel; Şahin, Hilal; Doğan Akagündüz, Diğdem

  Objective: Sarcopenia represents a frequent clinical condition in patients receiving maintenance hemodialysis and is linked to adverse functional and health-related outcomes. Owing to its multifactorial nature, early identification of patients at risk remains challenging in routine practice. This study evaluated nutritional and inflammatory indicators associated with sarcopenia and their ability to identify patients with sarcopenia. Methods: This cross-sectional study included 72 clinically stable adults receiving maintenance hemodialysis between August and September 2024. Sarcopenia was defined according to European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria, requiring low muscle strength and reduced muscle mass assessed by handgrip dynamometry and bioelectrical impedance analysis. Nutritional status was evaluated using the Subjective Global Assessment (SGA), and dietary energy and protein intake were assessed using 2 non-consecutive 24-hour recalls analyzed with BEBİS software. Serum albumin, C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio were measured. Multivariable logistic regression and receiver-operating characteristic analyses were performed. Results: Sarcopenia was identified in 18 patients (25%). Sarcopenic individuals had significantly lower protein and energy intake, lower serum albumin levels, and higher CRP concentrations than non-sarcopenic patients. In multivariable analyses, low protein intake (<1.0 g/kg/day), inadequate energy intake (<25 kcal/kg/day), hypoalbuminemia (<3.5 g/dL), elevated CRP (>5 mg/L), and SGA category B/C were independently associated with sarcopenia, whereas adequate energy intake was inversely associated. Receiver-operating characteristic analysis showed acceptable discrimination for individual indicators, with the highest accuracy for serum albumin (area under the curve [AUC] = 0.77). A combined nutritional–inflammatory model integrating dietary intake, albumin, and CRP demonstrated the greatest discriminatory ability (AUC = 0.83). Conclusion: Routinely available nutritional and inflammatory indicators are closely associated with sarcopenia in hemodialysis patients. Their combined assessment may facilitate early identification of individuals with sarcopenia and support timely nutritional evaluation and intervention.

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• ArticleYalnız künye2026/r/ebyu/11219
  Evaluation of the Relationship Between Sarcopenia, Nutritional Status, and Frailty in Older Patients with Cancer

  Doğan Akagündüz, Diğdem; Şahin, Hilal; Akagündüz, Baran

  Sarcopenia, malnutrition, and frailty frequently coexist in older adults with cancer, adversely affecting treatment tolerance, functional independence, and survival. While comprehensive geriatric assessment (CGA) is the gold standard for frailty evaluation, its resource-intensive nature limits routine use, and simple tools are needed. This cross-sectional study included 291 patients aged ≥70 years with histologically confirmed cancer, evaluated at a oncology outpatient clinic between January and November 2024. Sarcopenia was defined according to EWGSOP2 criteria: handgrip strength (HGS) and skeletal muscle index (SMI) by bioelectrical impedance analysis (BIA). Nutritional status was assessed with the Mini Nutritional Assessment–Short Form (MNA-SF), and frailty was defined as G8 ≤ 14. Additional measures included SARC-F, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale. The median age was 74 years, and 53% were male. Possible sarcopenia was identified in 39.5%, confirmed sarcopenia in 33.7%, severe sarcopenia in 26.8%. Nutritional risk was observed in 66.7%, and frailty in 44.7%. Frailty correlated strongly with nutritional status and moderately with muscle strength and mass. In multivariable analysis, low HGS, low SMI, nutritional risk, and depression independently predicted frailty. ROC analysis showed, G8 with HGS and nutritional assessment improved predictive accuracy. These findings highlight that simple measures enhance frailty detection and may support personalized care.

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• ArticleYayıncıda açık erişim2026/r/ebyu/10904
  Glycaemic control and complications in haemodialysis patients: The TURK-HEMODIAB Study

  Gungor, Ozkan; Korucu, Berfu; Oguz, Ebru Gok; Eren, Necmi; Ural, Zeynep; Dheir, Hamad; Tatar, Erhan; Inci, Ayca; Kocyigit, Ismail; Aydin, Zeki

  Background The most common cause of end-stage kidney disease is diabetes mellitus (DM). The most commonly used renal replacement therapy in Turkey and in many countries around the world is haemodialysis (HD). Glycaemia control is important in these populations. In this study we aimed to screen for glycaemic control and complications in a large population of diabetic HD patients in Turkey. Methods A total of 16 043 patients were screened in 253 dialysis centres in Turkey and 5038 diabetic HD patients were included in the study. At participating centres, patients' diabetes history, complications, medications, haemoglobin A1c (HbA1c) and other laboratory data were reviewed and recorded by nephrologists. Results The average age of the patients was 64.0 ± 11.2 years and 56% were male. The mean HbA1c was 7.4 ± 1.5%. Patients were divided into three groups according to the HbA1c level (<6.5%, 6.5-8% and >8%). As the HbA1c levels increased, the mean systolic blood pressure and diastolic blood pressure increased significantly. In addition, as the HbA1c levels increased, the number of patients with coronary artery disease, patients undergoing coronary artery bypass graft surgery and the rate of patients with diabetic retinopathy and vision loss increased. Diabetic foot disease and amputation rates were also higher in the group with poor glycaemic control. The number of patients using intensive or mixed insulin was also higher in the group with high HbA1c levels. In ordinal logistic regression analysis, age significantly decreased and higher body mass index slightly increased the risk of a higher HbA1c. Also, the need for a diabetic diet was greater in those with high HbA1c levels. Conclusion Our study highlights that the target values for diabetic HD patients in Turkey are partially compatible with the 2022 Kidney Disease: Improving Global Outcomes guidelines for diabetes management. Nevertheless, more effort and teamwork are needed to improve patient outcomes.

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• ArticleYayıncıda açık erişim2026/r/ebyu/10819
  Turkish cross-sectional survEy of glycemic and other Metabolic parameters in patients with type 2 Diabetes in 2023: Comparison with 2018 nationwide data (TEMD-2 study)

  Sonmez, Alper; Haymana, Cem; Demirci, Ibrahim; Cetinarslan, Berrin; Gonen, Mustafa Sait; Akbas, Emin Murat; Yalin, Gulsah Yenidunya; Avcı, Ugur; Tasci, Ilker; Salman, Serpil

  Aim Five years after the first “Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with type 2 Diabetes” (TEMD-1), attainment of glycemic, arterial blood pressure (ABP), and LDL-cholesterol (LDL-C) goals was re-investigated in patients with type 2 diabetes mellitus (T2DM), with an additional focus on therapeutic inertia. Methods This cross-sectional study consecutively enrolled patients from 70 tertiary endocrine centers across Türkiye (November 2022–January 2023). Metabolic targets were HbA1c <7% (<53 mmol/mol), home ABP <135/85 mmHg, and risk-stratified LDL-C <55, <70, or <100 mg/dL (<1.4, <1.8, or <2.6 mmol/L). Therapeutic inertia was defined as failure to intensify treatment at enrollment. Results Among the 4956 participants (mean age: 58.9 ± 10.0 years, women: 59.8%), HbA1c, ABP, LDL-C and triple metabolic control target attainment rates were 36.7%, 71.1%, 8.7%, and 2.8%, respectively. Glycemic control rate was found lower than the previous survey (40.0% vs. 36.7%, p < 0.001), while LDL-C control rate improved (7.0% vs. 8.7%, p = 0.002). Patients with established cardiovascular disease (CVD) showed worse outcomes, with triple metabolic control rate of 1.6%. The rate of severely uncontrolled diabetes (HbA1c >9%/75 mmol/mol) was 23.6%. Therapeutic inertia was observed by 33.5%, persisting uniformly across subgroups. Younger age, male sex, longer diabetes duration, lower socioeconomic status, and microvascular complications were independently associated with poor glycemic control. Conclusions Metabolic control remains suboptimal in Turkish T2DM patients, and one-third of patients with severe hyperglycemia showed therapeutic inertia. Systematic interventions and intensified strategies are urgently needed to improve diabetes outcomes and treatment inertia ( ClinicalTrials.gov number NCT06347445 ).

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• ArticleYalnız künye2026/r/ebyu/10782
  Associations Between Nutritional Status, Sleep Quality, and Clinical Factors in Patients With Metastatic Prostate Cancer

  Akagunduz, Digdem Dogan; Sahin, Hilal; Hendem, Engin; Akagunduz, Baran

  PURPOSE – Malnutrition and poor sleep quality are common but underrecognized issues among patients with metastatic prostate cancer (mPC). This study aimed to examine the associations between nutritional status, sleep quality, and clinical outcomes in men with mPC. METHODS – In this cross-sectional study, 91 men with stage IV prostate cancer were evaluated for nutritional status using the Subjective Global Assessment (SGA) and sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Clinical and laboratory parameters, including albumin, hemoglobin, C-reactive protein (CRP), and quality-of-life scores (EORTC QLQ-C30 and QLQ-PR25), were compared across SGA categories and sleep quality groups. Multivariable logistic regression was used to identify predictors of poor sleep (PSQI >5).RESULTS – Overall, 60.4% of patients were castration-resistant, and 38.5% were severely malnourished (SGA C). Poor sleep quality was observed in 65.9% of patients and was significantly more prevalent among those with moderate-to-severe malnutrition (P < .001). Patients with worse nutritional status exhibited lower albumin and hemoglobin levels, higher CRP, poorer performance status, and worse quality-of-life scores across all domains (P < .001). In multivariable analysis, independent predictors of poor sleep included higher CRP (odds ratio [OR], 1.33 [95% CI, 1.11 to 1.61), lower hemoglobin (OR, 0.66 [95% CI, 0.46 to 0.93]), and poorer nutritional status (SGA C v A, OR, 5.06 [95% CI, 1.70 to 15.05]).CONCLUSION – Malnutrition and systemic inflammation are closely linked with impaired sleep quality and diminished quality of life in mPC. Nutritional screening and targeted interventions may represent an important component of supportive care for optimizing well-being in this population.

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• ArticleYayıncıda açık erişim2026/r/ebyu/10552
  Factors Affecting the Use of Colchicine in FMF Patients and Alternative Treatments in FMF Management: Limits of Colchicine and Solutions

  Karataş, Beliz

  Objective: The main medication for treating Familial Mediterranean Fever (FMF) is colchicine. We aimed to identify situations that affect the response to colchicine in the treatment of FMF, such as ineffectiveness and side effects, and to discuss alternative treatments, with anti-IL-1 (anti-interleukin-1) agents being at the forefront in these situations. Material and Methods: Our research is a descriptive case series. The age, gender, disease duration, MEFV gene mutation, colchicine preparation used, doses, duration, anti-IL-1 preparation and doses used, duration, reason for intolerance to domestic and/or imported colchicine, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum amyloid A (SAA) values at baseline and 3rd and 6th month visits in patients diagnosed with FMF followed and treated on an outpatient or inpatient basis in the internal medicine rheumatology clinic of our university, the presence and frequency of FMF attacks, their clinical status during attacks, and FMF complications (proteinuria, chronic kidney damage, dialysis status) were recorded retrospectively for 25 patients diagnosed with FMF. Results: During colchicine treatment, non-response was present in 19 patients (76%), diarrhea in four patients (16 liver dysfunction in six patients (24%), and myopathy in 1 patient (4%). For these reasons, treatment with anti-IL-1 agents was continued. Conclusion: Side effects such as diarrhea, elevated liver enzymes, myopathy, cytopenia or unresponsiveness limit the use of this medication. In this case, changing the colchicine preparation or switching to anti-IL-1 agents will help us overcome the difficulties in treatment and protect the patient from complications, such as secondary amyloidosis. As part of our continuing mission to enrich the sharing of ideas between medical and scientific communities around the world, the Yale Journal of Biology and Medicine is published Open Access on PubMed Central (PMC). Any user may read, download, or reproduce a digital copy of any article, so long as proper credit is given to the authors and to the Journal as the place of original publication. Al

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• ArticleYayıncıda açık erişim2026/r/ebyu/10303
  AI-Assisted Dialysis Decision-Making: Assessing Agreement Between ChatGPT and Nephrologist in Initial Dialysis Indication and Prescription in Emergency and ICU Settings

  Kara, Ali Veysel; Ozturk, Ersin V.; Islamoglu, Mahmut Sami; Ozdemir, Ridvan V.; Hayme, Serhat V.

  Background: Material/Methods: Results: Conclusions: Artificial intelligence (AI) is increasingly explored as a clinical decision-support tool in nephrology; however, its real-world applicability for dialysis decision-making in emergency and intensive care unit (ICU) settings remains insufficiently studied. Hemodialysis initiation and prescription are complex, time-sensitive, and dynamic processes that require expert clinical judgment. This retrospective observational study evaluated agreement between AI-generated (ChatGPT) and nephrologistmade dialysis decisions in emergency and ICU settings. Adult patients undergoing first-time dialysis were included. Agreement was assessed for dialysis initiation, modality selection, and key prescription parameters. To ensure clinical relevance, continuous prescription variables were categorized into predefined ranges. Agreement was quantified using Gwet’s AC1 coefficient and Cramér’s V statistic. Eighty-four patients were included. AI demonstrated 100% agreement with nephrologists regarding dialysis initiation. Overall agreement for dialysis modality selection was 92.9% (Cramér’s V=0.87, P<0.001). Agreement for core dialysis prescription parameters – including blood flow rate, dialysate sodium, potassium, and calcium concentrations – was high across modalities (all P<0.001). Lower agreement was observed for ultrafiltration-related parameters, particularly ultrafiltration duration, reflecting the individualized and dynamic nature of volume management during dialysis. AI-assisted decision support demonstrated high agreement with nephrologist decisions for initial dialysis initiation, modality selection, and core prescription parameters in emergency and ICU settings. Discrepancies were primarily confined to ultrafiltration-related decisions, underscoring the necessity of ongoing bedside clinical judgment. These findings support the role of AI as a decision-support tool rather than a replacement for clinician-led dialysis management.

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