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Çevik B, Turgay G, Inanoğlu I, Kaya S, Sayin CB. Effect of acupressure applied to L4 point on the severity of fistula needle pain in patients: A randomised control trial. J Ren Care 2024; 50:47-54. [PMID: 36632716 DOI: 10.1111/jorc.12457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 12/16/2022] [Accepted: 12/30/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Patients usually feel pain when a needle is inserted into the fistula. This acute pain can be relieved by acupressure, which is a nonpharmacological application method. OBJECTIVE This study was designed to explore the effect of acupressure application to the Hegu point on the severity of acute pain caused by fistula needle insertion in patients with antecubital arteriovenous fistula. DESIGN It is a randomised control study. PARTICIPANTS The study was conducted with 32 intervention and 32 control patients, recruited from a dialysis centre of a foundation university in Turkey between October 2021 and January 2022. MEASUREMENTS Acupressure was applied 3 min before needle placement in the fistula area of the patients in the experimental group. RESULT While there was no decrease in the severity of acute pain during fistula needle insertion in the patients in the control group, there was a significant decrease in the mean acute pain severity scores experienced by the patients in the experimental group, whose Hegu point acupressure was applied. CONCLUSION The results of this study support the effectiveness of Hegu point acupressure as an effective and low-cost way to reduce the acute pain of needle insertion put on dialysis patients with a fistula. In addition, the results provide a practical reference for acute pain management for dialysis nurses.
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Affiliation(s)
- Banu Çevik
- Department of Nursing, Faculty of Health Science, Başkent University, Ankara, Turkey
| | - Gülay Turgay
- Vocational School of Health Services, Baskent University, Ankara, Turkey
| | | | - Semiha Kaya
- Baskent University Hospital Dialysis Center, Ankara, Turkey
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Aktaş A, Gençoğlu EA, Çolak T, Haberal KM, Özdemir BH, Sayin CB, Haberal M. Evaluation of Imaging Findings in Patients with Pretransplant and Posttransplant Tertiary Hyperparathyroidism. EXP CLIN TRANSPLANT 2024; 22:96-101. [PMID: 38385382 DOI: 10.6002/ect.mesot2023.o16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVES Tertiary hyperparathyroidism, characterized by autonomous overproduction of parathyroid hormone, can be seen in patients with long-standing secondary hyperparathyroidism (pretransplant) or after renal transplant (posttransplant). Parathyroid scintigraphy and ultrasonography are the most commonly used imaging procedures for the preoperative localization of abnormal parathyroid glands. We aimed to evaluate imaging findings in pretransplant and posttransplant tertiary hyperparathyroidism. MATERIALS AND METHODS This study included 32 patients with pretransplant tertiary hyperparathyroidism and 20 patients with posttransplant tertiary hyperparathyroidism. On parathyroid scintigraphy with technetium-99m sestamibi, early-phase and latephase images were acquired. Images were evaluated for the presence and the number of active foci and the degree of uptake on the late-phase image. The existence of an autonomous gland was based on latephase retention and was scored from 0 to 2 (retention score). On ultrasonography, the criteria threshold for autonomy was the maximum length of the largest gland ≥10 mm (ultrasonography score). RESULTS On parathyroid scintigraphy, the most commonly observed pattern in the pretransplant group was positivity in ≥3 glands, and in the posttransplant group the most commonly observed pattern was positivity in 1 to 2 glands. In pretransplant and posttransplant groups, the criteria threshold for the presence of an autonomous parathyroid gland on parathyroid scintigraphy (grade 2 retention) was met in 26 (81%) and 9 (45%) patients and on ultrasonography in 25 (78%) and 10 (50%) patients, respectively. In the whole group of patients (n = 52), correlation existed between ultrasonography score and retention score. Glandular weight was correlated with both retention score and ultrasonography score. CONCLUSIONS Higher numbers of detectable glands and the presence of parathyroid autonomy were more common in the pretransplant group. This might be explained by parathyroid gland involution after transplant. The results may also suggest that factors other than autonomy are responsible for posttransplant tertiary hyperparathyroidism.
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Affiliation(s)
- Ayşe Aktaş
- From the Department of Nuclear Medicine, Baskent University Faculty of Medicine, Ankara, Turkey
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Kiziltan G, Turker PF, Koseler Beyaz E, Saka M, Sayin CB. Effects of Nutritional Knowledge of Informal Caregivers on Depression and Metabolic Outcomes of Hemodialysis Patients. Ecol Food Nutr 2021; 61:110-123. [PMID: 34459351 DOI: 10.1080/03670244.2021.1968850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Chronic renal failure (CRF) makes significant changes in the life of patients and their families. A good family support has a positive effect on successful patients' adaptation to the treatment and compliance with dietary regimen. This study aimed to examine the effects of nutritional knowledge of informal caregivers on depression and metabolic outcomes of hemodialysis patients. This was a cross-sectional study conducted at Baskent University Hemodialysis Center with 116 hemodialysis patients and their informal caregivers. Findings revealed that the caregivers who were the couple of the patients had the highest nutritional knowledge level than the other caregivers (p < .05). The postgraduate caregivers were more likely to have high nutritional knowledge level than the others (p < .05). The inflammation marker of the patients was significantly lower in the group of caregivers with higher level (T3 group) of nutritional knowledge than the others (p < .05). The mean CES-D scores were also more likely to be low in T3 group than in the others (p < .05). These findings highlight that the nutritional knowledge of caregivers of hemodialysis patients may have an additional benefit on patients' nutritional management and metabolic outcomes.
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Affiliation(s)
- Gul Kiziltan
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkey
| | - Perim Fatma Turker
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkey
| | - Esra Koseler Beyaz
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkey
| | - Mendane Saka
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkey
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Karakaya E, Akdur A, Aydoğan C, Türk E, Sayin CB, Ayvazoğlu Soy E, Yücebaş SC, Alshalabi O, Haberal M. A model for acute kidney injury in severe burn patients. Burns 2021; 48:69-77. [PMID: 33879373 DOI: 10.1016/j.burns.2021.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/11/2020] [Accepted: 04/06/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION In patients with severe burns, morbidity and mortality are high. One factor related to poor prognosis is acute kidney injury. According to the AKIN criteria, acute kidney injury has 3 stages based on urine output, serum creatinine level, and renal replacement therapy. In this study, we aimed to create a decision tree for estimating risk of acute kidney injury in patients with severe burn injuries. METHODS We retrospectively evaluated 437 adult patients with ≥20% total burn surface area injury who were treated at the Baskent University Ankara and Konya Burn Centers from January 2000 to March 2020. Patients who had high-voltage burn and previous history of kidney disease were excluded. Patient demographics, medical history, mechanism of injury, presence of inhalation injury, depth of burn, laboratory values, presence of oliguria, need for renal replacement therapy, central venous pressure, and prognosis were evaluated. These data were used in a "decision tree method" to create the Baskent University model to estimate risk of acute kidney injury in severe burn patients. RESULTS Our model provided an accuracy of 71.09% for risk estimation. Of 172 patients, 78 (45%) had different degrees of acute kidney injury, with 26 of these (15.1%) receiving renal replacement therapy. Our model showed that total burn surface area was the most important factor for estimation of acute kidney injury occurrence. Other important factors included serum creatinine value, burn injury severity score, hemoglobin value, neutrophil-to-lymphocyte ratio, and platelet count. CONCLUSION The Baskent University model for acute kidney injury may be helpful to determine risk of acute kidney injury in burn patients. This determination would allow appropriate treatment to be given to high-risk patients in the early period, reducing the incidence of acute kidney injury.
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Affiliation(s)
- Emre Karakaya
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Aydıncan Akdur
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Cem Aydoğan
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Emin Türk
- Baskent University Konya Research Center, Department of General Surgery, Hocacihan Saray St., No:1, 42080 Selçuklu, Konya, Turkey.
| | - Cihat Burak Sayin
- Baskent University, Departmant of Nephrology, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Ebru Ayvazoğlu Soy
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Sait Can Yücebaş
- Canakkale Onsekiz Mart Univesity, Faculty of Engineering, Computer Engineering Department, arbaros, 17100 Kepez, Çanakkale, Turkey.
| | - Omar Alshalabi
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Mehmet Haberal
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
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Karakaya E, Akdur A, Soy EA, Karakayali FY, Yildirim S, Torgay A, Sayin CB, Moray G, Haberal M. High success rate of liver and kidney transplant during seven months COVID-19 period. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.op-1258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Emre Karakaya
- Department of General Surgery, Baskent University Hospital, Turkey
| | - Aydincan Akdur
- Department of General Surgery, Baskent University Hospital, Turkey
| | | | | | - Sedat Yildirim
- Department of General Surgery, Baskent University Hospital, Turkey
| | - Adnan Torgay
- Department of Anaesthesia and Reanimation, Baskent University Hospital, Turkey
| | | | - Gokhan Moray
- Department of General Surgery, Baskent University Hospital, Turkey
| | - Mehmet Haberal
- Department of General Surgery, Baskent University Hospital, Turkey
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Akdur A, Karakaya E, Ayvazoglu Soy EH, Yarbug Karakayali F, Yildirim S, Torgay A, Sayin CB, Coskun M, Moray G, Haberal M. Liver and Kidney Transplant During a 6-Month Period in the COVID-19 Pandemic: A Single-Center Experience. EXP CLIN TRANSPLANT 2020; 18:564-571. [PMID: 33143601 DOI: 10.6002/ect.2020.0388] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES With the declaration of COVID-19 as a pandemic, many studies have indicated that elective surgeries should be postponed. However, postponement of transplants may cause diseases to get worse and increase the number in wait lists. We believe that, with precautions, transplant does not pose a risk during pandemic. Here, we aimed to evaluate our transplant results, which we safely performed during a 6-month pandemic period. MATERIALS AND METHODS Until September 2020, 3140 kidney and 667 liver transplants have been performed in our centers. We evaluated 38 kidney transplants and 9 liver transplants procedures performed during the pandemic (March 1 to September 2, 2020). Recipient and donor candidates were screened for COVID-19 with polymerase chain reaction and thoracic computed tomography. All recipients had routine immunosuppressive protocol. During hospitalization at our COVID-19-free transplant facility, we restricted the interactions during multidisciplinary rounds. RESULTS During the pandemic, 38 kidney transplants with an average length of hospital stay of 8.1 days were performed. Mean serum creatinine values of recipients were 0.91, 0.86, and 0.74 mg/dL on postoperative days 7, 30, and 90, respectively. During the pandemic, 9 living donor liver transplants (1 adult, 8 pediatric) were performed with an average length of hospital stay of 17.1 days. Mean serum total bilirubin levels were 0.9, 0.5, and 0.4 mg/dL on postoperative days 7, 30, and 90, respectively. Mean serum aspartate aminotransferase levels were 38.1, 28.3, and 22.3 U/L on postoperative days 7, 30, and 90, respectively. All recipients and donors were successfully discharged. Only 1 liver recipient died (on day 55 after discharge as a result of oxalosis-induced heart failure). CONCLUSIONS According to our results, when precautions are taken, transplant does not pose a risk to patients during the pandemic period. We attribute the safety and success shown to our newly developed protocol in response to the COVID-19 pandemic.
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Affiliation(s)
- Aydincan Akdur
- From the Department of General Surgery, Baskent University Faculty of Medicine, Division of Transplantation, Ankara, Turkey
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Gurlek Demirci B, Sezer S, Sayin CB, Tutal E, Uyar ME, Ozdemir Acar FN, Haberal M. Post-transplantation Anemia Predicts Cardiovascular Morbidity and Poor Graft Function in Kidney Transplant Recipients. Transplant Proc 2015; 47:1178-81. [PMID: 26036548 DOI: 10.1016/j.transproceed.2015.01.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/05/2015] [Accepted: 01/28/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We aimed to investigate whether low post-transplantation-period hemoglobin levels are predictive of cardiovascular morbidity in terms of left ventricular (LV) hypertrophy and vascular stiffness and to determine the contributing factors of post-transplantation anemia in kidney transplant (KT) recipients. METHODS One hundred fifty (mean age, 38.9 ± 10.8 y; 113 male) KT recipients with functioning grafts were enrolled in the study. All subjects underwent clinical and laboratory evaluations (24-hour urinary protein loss, complete blood count) and transthoracic echocardiography to assess LV systolic function. Arterial stiffness was measured by means of carotid-femoral pulse-wave velocity (PWV). Mean hemoglobin levels were analyzed at the 1st, 6th, 12th, and 24th months after transplantation. Patients were divided into 2 groups according to presence of anemia: patients with anemia (group 1; n = 120) and normal (group 2; n = 30). RESULTS PWV values (6.8 ± 1.9 m/s vs 6.4 ± 1.1 m/s in groups 1 and 2, respectively; P = .002) and LV mass index (LVMI; 252.1 ± 93.7 g/m(2) vs 161.2 ± 38.5 g/m(2) groups 1 and 2, respectively; P = .001) were significantly higher in group 1. Estimated glomerular filtration rate and (64 ± 28.5 m/min vs 77.8 ± 30 m/min in groups 1 and 2, respectively; P = .001) LV systolic function (57.2 ± 5.8% vs 77.8 ± 30% in groups 1 and 2, respectively; P < .005) were significantly lower in group 1. In regression analysis, LV systolic function and LVMI were predictors of post-transplantation hemoglobin levels. CONCLUSIONS Post-transplantation anemia contributes to cardiovascular morbidity by deteriorating LV function and increasing PWV and is therefore associated with poor prognosis for graft survival. Early correction of post-transplantation anemia, especially with the use of erythropoietin, may be beneficial for both graft and recipient survivals.
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Affiliation(s)
- B Gurlek Demirci
- Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
| | - S Sezer
- Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - C B Sayin
- Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - E Tutal
- Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - M E Uyar
- Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - F N Ozdemir Acar
- Department of Nephrology, Baskent University Faculty of Medicine, Istanbul, Turkey
| | - M Haberal
- Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey
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Gurlek Demirci B, Sayin CB, Tutal E, Bal Z, Sezer S. SP455QUALITY OF SLEEP, QUALITY OF LIFE AND FATIGUE:ARE THEY RELATED WITH SERUM VITAMIN D LEVEL? Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv194.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gurlek Demirci B, Sayin CB, Eminsoy IO, Tutal E, Kulah E, Sezer S. SP421DIETARY FIBER INTAKE: ITS RELATION WITH GLYCATION END PRODUCTS AND ARTERIAL STIFFNESS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv193.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gurlek Demirci B, Sayin CB, Tutal E, Bal Z, Acar FN, Sezer S. SP395SEVELAMER HYDROCHLORIDE IMPROVES OXIDATIVE STRESS IN MAINTENANCE HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv193.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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