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SIĞIRLI, DENİZ

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    Relationship of magnesemia with myocardial damage and mortality in patients with COVID-19
    (John Libbey Eurotext Ltd, 2021-07-01) Günay, Şeyda; Çalışkan, Serhat; Sığırlı, Deniz; Günay, Şeyda; SIĞIRLI, DENİZ; 000-0003-0012-345X; AAI-5350-2021; AAA-7472-2021
    Background: Magnesium (Mg) is the second most abundant intracellular cation and plays a significant role in immune system and cardiac protection. Mg deficiency contributes to chronic low-grade inflammation leading to cardiovascular diseases, and low Mg level exacerbates virus-induced inflammation. Aim: The aim of the study was to investigate whether serum magnesium level is associated with myocardial damage and prognosis of COVID-19. Method: This was a single-center, observational retrospective study of patients with COVID-19. The study population was divided into two groups according to in-hospital mortality: a survivor group (SG) and a non-survivor group (NSG). Myocardial damage was defined as blood levels of cardiac troponin I (cTnI) above the 99th percentile upper reference limit. Magnesium, variables regarding inflammation, and myocardial damage were compared between the groups. Results: A total of 629 patients with COVID-19 were included. Mortality rate was 11.85% (n = 82). There were 61 (74.4%) and 294 male patients (53.7%) in NSG and SG, respectively (p = 0.001). The median age of NSG was 64.5 years (min-max: 37-93) and the median age of SG was 56.0 years (min-max: 22-92) (p < 0.001). Median serum magnesium levels of NSG and SG were 1.94 mg/dL (min-max: 1.04-2.87) and 2.03 mg/dL (min-max: 1.18-2.88), respectively (p = 0.027). Median cTnI levels of NSG and SG were 25.20 pg/mL (min-max: 2.10-2240.80) and 4.50 pg/mL (min-max: 0.50-984.3), respectively (p < 0.001). The cTnI levels were lower in those patients whose serum Mg levels were higher than 1.94. Conclusion: Although serum magnesium level was not a predictor for in-hospital mortality, there was a significant negative correlation between magnesemia and myocardial damage.
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    Examining cronbach alpha, theta, omega reliability coefficients according to the sample size
    (Wayne State Univ Press, 2007-05-01) Ercan, İlker; Yazıcı, Berna; Sığırlı, Deniz; Ediz, Bülent; Kan, İsmet; ERCAN, İLKER; SIĞIRLI, DENİZ; Ediz, Bülent; Kan, İsmet; Uludağ Üniversitesi/Biyostat Bölümü; 0000-0002-2382-290X; ABF-2367-2020; AAA-7472-2021; EXB-2757-2022; FCI-0480-2022
    Differentiations according to the sample size of different reliability coefficients are examined. It is concluded that the estimates obtained by Cronbach alpha and teta coefficients are not related with the sample size, even the estimates obtained from the small samples can represent the population parameter. However, the Omega coefficient requires large sample sizes.
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    Predictors of drug survival of biologic therapies in psoriasis patients (vol 45, pg 813, 2020)
    (Taylor & Francis, 2020-08-31) Zorlu, Özge; Başkan, Emel Bülbül; BÜLBÜL BAŞKAN, EMEL; Yazıcı, Serkan; YAZİCİ, SERKAN; Sığırlı, Deniz; SIĞIRLI, DENİZ; Budak, Ferah; BUDAK, FERAH; Sarıcaoğlu, Hayriye; SARICAOĞLU, HAYRİYE; Aydoğan, Kenan; AYDOĞAN, KENAN; Cevhertas, Laçin; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim; 0000-0001-5555-130X; 0000-0001-6407-0962; 0000-0001-7625-9148; 0000-0002-0193-1128; 0000-0003-2287-3569; AAH-1388-2021; AAH-6216-2021; AAA-7472-2021; F-4657-2014; IZP-9398-2023; AAH-2459-2021
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    Examining the variations in the results of the hotelling T² test in case of changing baseline landmarks in the bookstein coordinates
    (Springer Heidelberg, 2015-06-01) Ercan, İlker; Sığırlı, Deniz; Özkaya, Güven; ERCAN, İLKER; SIĞIRLI, DENİZ; ÖZKAYA, GÜVEN; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-2382-290X; 0000-0003-0297-846X; AAA-7472-2021; A-4421-2016; ABF-2367-2020
    In many biological and biomedical investigations, the most effective way to analyze the forms of whole biological organs or organisms is by recording geometric locations of landmark points. If we want to compare shapes, then individuals should be translated, rotated and scaled in such a way that all of the individuals lie in a standard position and are centered. Bookstein conducted this process by choosing two landmarks as reference landmarks. Each individual is translated, rotated and scaled according to these reference landmarks. The aim of the present study was to examine the change in the p values in the case of choosing different baseline landmarks when performing the Hotelling T (2) test, which is commonly used when comparing two sample shape configurations based on Bookstein coordinates. For this purpose, the changes in the p values were investigated in shape configurations that are composed of a different number of landmarks by taking all of the possible paired landmark combinations at different variance levels and sample sizes. As a result of the present study, it was observed that with the increase in the landmark number, the number of possible baseline landmark combinations also increases and, for this reason, a substantial number of variations occur in the p values. Therefore, it is an important to decide which landmarks should be taken as reference landmarks when using the Bookstein coordinates.
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    Examining the efficiency of models using tangent coordinates or principal component scores in allometry studies
    (Springer Heidelberg, 2015-09-01) Sığırlı, Deniz; Ercan, İlker; SIĞIRLI, DENİZ; ERCAN, İLKER; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-2382-290X; AAA-7472-2021; ABF-2367-2020
    Most of the studies in medical and biological sciences are related to the examination of geometrical properties of an organ or organism. Growth and allometry studies are important in the way of investigating the effects of diseases and the environmental factors effects on the structure of the organ or organism. Thus, statistical shape analysis has recently become more important in the medical and biological sciences. Shape is all geometrical information that remains when location, scale and rotational effects are removed from an object. Allometry, which is a relationship between size and shape, plays an important role in the development of statistical shape analysis. The aim of the present study was to compare two different models for allometry which includes tangent coordinates and principal component scores of tangent coordinates as dependent variables in multivariate regression analysis. The results of the simulation study showed that the model constructed by taking tangent coordinates as dependent variables is more appropriate than the model constructed by taking principal component scores of tangent coordinates as dependent variables, for all sample sizes.
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    A nomogram based on myocardial damage and novel inflammatory indexes for post-discharge survival rates of covid-19
    (Clin Lab Publ, 2022-01-01) Çalışkan, Serhat; Günay, Seyda; GÜNAY POLATKAN, ŞEYDA; Sığırlı, Deniz; SIĞIRLI, DENİZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.
    Background: In the course of SARS-CoV-2 infection, early prognostic evaluation is important since clinical symp-toms may worsen rapidly and may be fatal. Inflammation plays an important role in the pathogenesis of COVID-19 and can cause myocardial damage which is common in severe COVID-19 patients. Therefore, novel inflamma-tory indexes and myocardial damage may be predictive of prognosis in patients with COVID-19. The aim of the study was to evaluate the role of cardiac troponin I (cTnI), modified Glasgow prognostic score (mGPS), systemic immune inflammation index (SII), prognostic nutritional index (PNI), and CRP to albumin ratio (CAR) in the outcome estimation of COVID-19 and to develop a risk model predicting the survival probability of COVID-19 survivors during early post-discharge. Methods: This was a single-center, observational, retrospective cohort study. Laboratory confirmed COVID-19 patients (n = 265) were included and grouped according to in-hospital mortality. ROC curve analysis was per -formed and Youden's J index was used to obtain optimal cutoff values for inflammatory indexes in discriminating survivors and non-survivors. Cox regression analysis was performed to assess the possible predictors of in -hospi-tal mortality. A nomogram was constructed based on the Cox regression model, to calculate 7-and 14-day surviv-al. Results: The area under the ROC curve (AUC) of the variables ranged between 0.79 and 0.92 with the three highest AUC values for albumin, PNI, and cTnI (0.919, 0.918, and 0.911, respectively). Optimal threshold value for cTnI was 9.7 pg/mL. Univariate analysis showed that gender, albumin, CRP, CAR, PNI, SII, cTnI, and mGPS were significantly related to in-hospital mortality. The Cox regression analysis indicated that mGPS (p = 0.001), CRP (p = 0.026), and cTnI (p = 0.001) were significant prognostic factors. Conclusions: cTnI should not be considered merely as an indicator of myocardial damage. It also reflects the in-flammatory phase and, along with other inflammatory markers, it should be included in risk models as a prognos-tic factor for COVID-19. (Clin. Lab. 2022;68:602-612.
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    Relationship between PET/CT response and survival in patients with non-small-cell lung cancer treated with definitive chemoradiotherapy
    (Akad Doktorlar Yayınevi, 2021-01-01) Sarıhan, Süreyya; Bilgin, Gökçe Belge; Sığırlı, Deniz; SARIHAN, SÜREYYA; Bilgin, Gökçe Beige; SIĞIRLI, DENİZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nükleer Tıp Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-4816-5798; AAH-4970-2021; AAA-7472-2021; EMG-1218-2022
    We aimed to evaluate the relationship between PET/CT response and survival in patients with non-small cell lung cancer (NSCLC) treated with curative chemoradiotherapy. Between January and December 2012, 51 patients were treated. The median age was 61 (29-79) and the M/F ratio was 46/5. Eighty two percent of the cases were stage III and 53% were squamous cell carcinoma. Median 6300 cGy (4860-7525) radiotherapy delivered and 92% of patients received chemotherapy. The median follow-up was 27 months (7-96 months) in November 2019. The objective response was 71% with CT at 1 month and 76% with PET/CT at 3 months. There was a significant correlation between response-1 and response-3 (p< 0.001). Tumor SUVmean3 < 2.81, SUVmax change >= 70% was associated with response-1 (p< 0.05). The median and 5-year overall (OS) and progression-free (PFS) survival rates were 54 months, 40% and 35 months, 38%, respectively. In Cox model, for each 1 unit increase, SUVmeanbase (HR: 1.18, 95% CI: 1.01-1.38) and SUVmean3 (HR: 2.65, 95% CI: 1.24-5.66) were found unfavorable factors for OS, whereas SUVmean3 (HR: 2.01, 95% CI: 1.02-3.93) was also found to be a poor prognostic factor for PFS. PET/CT parameters can be used as useful markers for prognosis in patients with NSCLC undergoing curative chemoradiotherapy. It is believed that early assessment during and after treatment can be advantageous in terms of treatment modification.
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    Is routine pregnancy test necessary in women of reproductive age admitted to the emergency department?
    (Zhejiang Univ Sch Medicine, 2013-09-01) Köksal, Özlem; KÖKSAL, ÖZLEM; Özdemir, Fatma; ÖZDEMİR, FATMA; Armağan, Erol; ARMAĞAN, EROL; Öner, Nuran; Sert, Pınar Çınar; Sığırlı, Deniz; SIĞIRLI, DENİZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistk Anabilim Dalı.; AAH-8846-2021; AAK-8332-2020; AAA-7472-2021
    BACKGROUND: This study aimed to determine the necessity of pregnancy test in women of reproductive age admitted to emergency department (ED) in routine practice.METHODS: We retrospectively reviewed the records of patients who presented to the ED between January 1, 2006 and December 31, 2010 and received a pregnancy test.RESULTS: The median age of 1 586 patients enrolled into the study was 27 years. Of these patients, 19.55% had a positive result of pregnancy test. The most common complaint at admission was abdominal pain in 60.15% of the patients, and pregnancy test was prescribed. 15.83% of the patients with abdominal pain had a positive result of pregnancy test. Of the patients, 30.64% had nausea-vomiting at admission, and 11.52% had a positive result of pregnancy test. When other complaints were considered, the most commonly observed complaints were non-specific symptoms such as dizziness, malaise and respiratory problems. Of the patients, 70.93% were not remembering the date of last menstruation, and 9.51% showed a positive result of pregnancy test. Urinary tract infection (UTI) was commonly diagnosed with an incidence of 17.65%, which was followed by nonspecific abdominal pain (NSAP) (16.77%) and gastrointestinal disorders such as gastritis and peptic ulcer (6.87%). Of the patients, 88.40% were discharged from ED, and 11.60% were hospitalized.CONCLUSION: Pregnancy test should be given to women of reproductive age as a routine practice in ED in developing countries like Turkey.
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    The relationship between venous insufficiency and serum magnesium level
    (John Libbey Eurotext Ltd, 2022-10-01) Çalışkan, Serhat; Atay, Mehmet; GÜNAY POLATKAN, ŞEYDA; Sığırlı, Deniz; SIĞIRLI, DENİZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; GNH-5913-2022
    Background: Magnesium is the second most common cation in the cell. In addition to its role as a cofactor in many enzymatic pathways in physiological processes, it is necessary for the regular functioning of vascular smooth muscle cells. Magnesium deficiency has been associated with exacerbation of inflammation, which plays a role in the aetiopathogenesis of many diseases. Aim: To investigate the potential relationship between serum magnesium level and the development of chronic venous insufficiency by comparison with healthy individuals. Methods: The study included 394 patients with venous insufficiency based on physical examination findings and colour Doppler ultrasonography, and 206 controls without venous insufficiency. Venous insufficiency was defined by colour Doppler as reflux lasting 0.5 seconds or more in superficial veins, and longer than one second in femoral and popliteal veins. Clinical, haematological and biochemical parameters, including serum magnesium level and indicators of inflammation, were compared between groups. Results: A total of 600 participants were included. There was no significant difference between the groups in terms of age and gender. In total, 187 (47.46%) patients with chronic venous insufficiency and 105 (50.97%) of the control group were male (p=0.414). The median age of the patients with chronic venous insufficiency was 48 (min-max: 41-49), and the median age of the control group was 49.00 (min-max: 45.00-60.25) (p=0.064). Serum magnesium level was found to be significantly lower in the group with chronic venous insufficiency compared to the control group; 1.90 mg/dL (min-max: 1.82-2) versus 2.1 mg/dL (min-max: 2-2.2) (p<0.001), respectively. Conclusion: Low serum magnesium levels may pose a potential risk for the development of chronic venous insufficiency, which is common in the community.
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    The effect of calcineurin inhibitors on anthropometric measurements in kidney transplant recipients
    (Bmc, 2022-11-19) Sayılar, Emel Işıktaş; Ersoy, Alparslan; Ersoy, Canan; Oruç, Ayşegül; Ayar, Yavuz; Sığırlı, Deniz; Sayılar, Emel Işıktaş; ERSOY, ALPARSLAN; ERSOY, CANAN; ORUÇ, AYŞEGÜL; Ayar, Yavuz; SIĞIRLI, DENİZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-0342-9692; 0000-0003-4607-9220; W-2575-2017; CPX-5894-2022; AAH-8861-2021; AAH-4002-2021; O-9948-2015; AAA-7472-2021
    Background This study was designed to investigate the effect of calcineurin inhibitors (CNIs), cyclosporine (CsA), and tacrolimus (Tac) on anthropometrics in kidney transplant recipients. Methods 111 of 128 adult kidney transplant recipients who received post-transplant CNIs were included in this retrospective study. Anthropometrics were recorded in the pre-transplant and post-transplant 4-year follow-up periods (1(st), 3(rd), 6(th), 12(th), 24(th), 36(th) and 48(th) months). Results Compared to pre-transplant values, significant increases in body weight and body mass index (between 3(rd) and 48(th) months), waist and hip circumferences (between 1(st) and 48(th) months), waist-to-hip ratio (between 1(st) and 3(rd) or 6(th) months) and neck circumference (between 1(st) and 12(th) or 24(th) months) were observed in both CsA and Tac groups. A significant increase was noted in post-transplant body fat percentage values for the 3(rd) to 24(th) months in the CsA group, whereas for the 24(th) to 48(th) months in both CsA and Tac groups. Hip circumferences percentage changes from the pre-transplant period to the 1(st), 12(th) and 24(th) months were significantly higher in CsA than in the Tac group. At each time point, there was no significant difference in percentage changes for other anthropometric parameters between the CsA and Tac groups. De novo diabetes mellitus developed in 8.3% of the CsA group and 19.1% of the Tac group. Conclusions After a successful kidney transplant, anthropometric measurements increase in most recipients. Although the effect of calcineurin inhibitor type on weight gain is unclear, a regression analysis showed that CNI type was not a risk factor for the development of obesity in the 48(th) month. However, it is helpful to be cautious about its dyslipidemic effect in patients using CsA and the potential hazards of using Tac in patients with a diabetic predisposition.