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Sodium-glucose co-transporter-2 inhibitors are novel antihyperglycemic agents which have crucial effects on the heart and kidneys beyond their glucose-lowering features. Their main clinical benefits have been reported in individuals with type 2 diabetes mellitus, chronic kidney disease, heart failure, and proteinuria. However, adverse reactions (euglycemic ketoacidosis, kidney dysfunction, genital and urinary tract infections, hypovolemia, etc) remain to be the main object of the debate regarding their use. The recruited data have encouraged clinicians to use those medicines in individuals who fit the indications for use.

The aim of this study is to examine the effect of a plyometric training program on the physical performance of basketball players. 24 male basketball players between the ages of 18-36, who regularly practice basketball, participated in the study voluntarily. Participants were divided into two different groups as the experimental group (n=12, age: 26.50±4.58) and the control group (n=12, age: 22.32±0.90). A plyometric training program was applied to the experimental group 3 days a week for 6 weeks. Both participating groups continued their regular basketball training during the season. In addition to basketball training in the experimental group; Plyometric exercises known as Lateral jump, Box jump, Squat jump, Nordic hamstring curl, Overhead slam, Plyometric push-ups, and Medicine ball bench press were applied. Flexibility, balance, vertical jump, shuttle run test, speed, and T-test were measured before and after the training. SPSS 22.0 package program was used for the statistical analysis of the data. The Shapiro-Wilk test was used for the normality test. Paired Samples T-test was used for comparisons within groups. The significance level was determined as p0.05). As a result, it can be said that the 6-week plyometric training program applied to basketball players has a positive effect on physical performance. Article visualizations

Amaç: Aritmilere bağlı ani kardiyak ölüm (AKÖ), yaşlı hemodiyaliz (HD) hastalarında başlıca ölüm nedenlerindendir. Elektrokardiyografide (EKG) uzamış Tp-e aralığı (Tpe) ve artmış Tpe/QTc oranı ile AKÖ arasında güçlü bir ilişki olduğu bulunmuştur. Bu çalışmada serum elektrolit düzeylerindeki de¬ğişikliklerin HD öncesi ve sonrası EKG parametreleri, özellikle de Tpe üzerindeki etkilerini araştırmak amaçlanmıştır. Yöntem: Çalışma (QT aralığını etkilediği bilinen bir hastalığı veya ilaç kullanımı olmayan) 160 HD hastası ve normal böbrek fonksiyonlarına sahip, yaş ve cinsiyet uyumlu 80 kontrol içerdi. Tüm katılımcılar 55 yaş ve üzeri idi. HD öncesi ve sonrası serum elektrolit değerleri ve EKG kayıtları elde edildi. Kalp hızı, QRS aralığı, QTc, Tpe ve Tpe/QTc değerleri hesaplandı. HD öncesi veriler, HD sonrası veriler ve kontroller ile karşılaştırıldı. Bulgular: HD öncesi ve sonrası Tpe (iki karşılaştırma için de p, Aim: Sudden cardiac death (SCD) due to arrhythmias is a major cause of death in elderly patients on hemodialysis (HD). It has been found that prolonged Tp-e interval (Tpe) on electrocardiography (ECG) and increased Tpe/QTc ratio are strongly associated with SCD. In this study, we aimed to inves¬tigate the effects of changes in serum electrolyte levels on the pre- and post-HD ECG parameters, particularly Tpe. Methods: The study included 160 HD patients (with no disease or medication known to affect the QT interval) and 80 age- and sex-matched controls with normal kidney functions. All participants were aged 55 years or older. Pre- and post-HD serum electrolyte values and ECG re¬cordings were obtained. The heart rate, QRS interval, QTc, Tpe, and Tpe/QTc values were calculated. The pre-HD data were compared with the post-HD data as well as with controls. Results: The pre- and post-HD Tpe (p

In this study characterization of a novel Al66Co20Cu13Mg1 alloy produced by the mechanical alloying method was investigated. The effect of milling time on the produced alloy's microstructural evaluations, microhardness, and thermal behaviors was investigated. Scanning electron microscope and X-ray diffractometer results demonstrated that as the milling time was increased, the homogeneity was increased, the particle size was decreased, crystalline cubic Al(Co, Cu) solid solution, α-Co(Cu, Mg) solid solution phase and Al2Cu phase were formed with the mechanical alloying effect after milling of 50 h. When the powder alloy was milled for 100 h, most of the elemental peaks such as Al and Cu disappeared, and Al3.892Cu6.108 phase was formed. The crystallite size of the alloy powders after 100 h of milling was found as 17.42 ± 2 nm. Moreover, as the milling time was increased, both the lattice strain and dislocation density were increased because of fractures, the formation of new intermetallic phases, and excessive deformations. The microhardness of the pressed powder alloys was increased due to the cold welding and intermetallic phases formed in the powder alloy with increasing milling times. The lowest and highest microhardness values are found to be 275 ± 10 and 376 ± 10 HV for the unmilled alloy and the 100 h of milled alloy, respectively.

Background Urological complications after renal transplantation (RT), including urine leaks, remain the most common type of surgical complications in the early post-transplant period. In this study we evaluated 324 consecutive RTs recipients in whom Haberal’s corner-saving anastomosis technique was used for ureteroneocystostomy. Material and Methods Since January 2018, 461 RTs were performed at our center. Haberal’s corner-saving anastomosis technique was used in 324 of these 461 RTs and the effectiveness of the technique was analyzed retrospectively. There were 115 female patients and 209 male patients, with a mean age of 42.1 ± 13.9 years. The most common etiology resulting in RT was hypertension among the recipients. Results We observed 8 (2.4%) ureteral complications in 7 recipients as follows: ureteral stenosis in 2 recipients (0.6%), anastomotic leaks in 1 (0.3%), concomitant leak-stenosis in 1 (0.3%), and vesicoureteral reflux in 3 (0.9%). Six complications were treated with interventional radiological techniques and 2 were treated surgically. There was no graft and patient loss in the event of urological complications. Conclusion Because of the low complication rate, we believe that Haberal’s corner-saving ureteral anastomosis technique is a safe method for performing a ureteroneocystostomy.

Amaç: Böbrek nakli alıcılarında günde tek doz uzamış salınımlı takrolimus (tac-ER) kullanımı, erken salınımlı takrolimus (tac-IR) kullanımına benzer etkinlik ve daha iyi ilaç uyumu sağlaması amacıyla geliştirilmiştir. Ancak uzamış salınımlı takrolimus ile ilgili deneyimler daha çok nakil sonrası dönemde yapılan “switch” protokollerine dayanmaktadır. Bu çalışmada böbrek alıcılarında de novo tac-ER kullanımı ile ilgili deneyimlerimizi ve 1 yıllık sonuçları sunmayı amaçladık.Gereç ve Yöntem: Bu tek merkezli retrospektif çalışmaya Ocak 2022-Ocak 2021 arasında yapılan 72 de novo böbrek nakli hastası dahil edilmiştir. Hastalar tac-ER ve tac-IR alan iki gruba ayrıldı. Bir yıllık allogreft fonksiyonları ve sağ kalımları, hastaların günlük ilaç dozları ve bunların akut rejeksiyon atakları ile ilişkileri karşılaştırıldı. Allogreft fonksiyonları ve akut rejeksiyon atakları üzerine etki eden faktörler incelendi.Bulgular: Toplam 69 hastanın (uzamış salınımlı grupta 30 hasta ve erken salınımlı grupta 39 hasta) verileri incelendi. Üç hasta posttransplant erken dönemde öldüğü için analize dahil edilmedi. Nakil sonrası 12 aylık izlem boyunca her iki grup arasında serum kreatinin ve takrolimus çukur değerler bencer bulundu (p>0,05). İlk 3 ay içinde hedef takrolimus değerlere ulaşmak için, tac-ER grubunda daha yüksek günlük dozlar (milligra/gün ve milligram/gün/kg) gerekti (p, Aim: Once daily extended-release tacrolimus (tac-ER) was introduced to support medication adherence in kidney transplant (KTx) recipients, with similar efficacy to immediate-release tacrolimus (tac-IR). However, most of the experiences regarding tac-ER efficacy were obtained from the switches from tac-IR to tac-ER in kidney transplant recipients (KTRs). In this study, we aimed to demonstrate 1-year outcomes of de novo use of tac-ER in KTRs.Material and Method: This single-center retrospective study included 72 de novo KTRs between January 2020 and January 2021. KTRS were divided into two groups who received a tac-ER or tac-IR. 1-year allograft functions, allograft survival, daily doses of tacrolimus in milligram/day and milligram/kg/day, trough levels, and acute rejection episodes were compared between the two groups. The factors that might have an impact on allograft functions and acute rejection episodes also were investigated.Results: A total of 69 de novo kidney allograft recipients (30 recipients in the tac-ER and 39 recipients in the tac-ER groups); were evaluated. Three KTRs were excluded due to the deaths within the early posttransplant period. Serum creatinine and tacrolimus trough levels were similar for 12 months after transplantation (p>0.05). More daily tacrolimus doses (in milligram/day and milligram/kg/day) were required to obtain a targeted trough level up to 3 months in the tac-ER group. Acute rejection rates also were found similar between the two groups (p=0.281). Univariate regression analysis demonstrated that higher total daily tacrolimus doses within a posttransplant month 1 may (milligram/kg/day) have an impact on lower acute rejection episode(s) independent of tacrolimus trough levels (p=0.02).Conclusion: De novo use of extended-release tacrolimus Advagraf® is as effective as immediate-release tacrolimus in preventing acute rejection episode(s) and provides satisfactory 1-year allograft function and survival.

BACKGROUND AND AIMS Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included. RESULTS A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients; 15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days. Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms. CONCLUSION In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients. Table 2. Comparative presentation of patients data on the 28th day and between 28 and 90 day COVID-19 groupN = 635 Control groupN = 588 28th-day results, n(%) Death* 19(3.0) 0(0) Any respiratory symptoms* 152(23.9) 11(1.9) Rehospitalization for any reason* 52(8.2) 24(4.1) Need for home oxygen support * 26(4.1) 2(0.3) Lower respiratory tract infection* 65(10.2) 8(1.4) AV fistula thrombosis* 13(2.0) 2(0.3) Other thromboembolic events * 15(2.4) 4(0.7) Need for HD catheter placement* 21(3.3) 9(1.5) 28th day-90. day resultsa n(%) N:616 N:588 Death* 15(2.4) 4(0.7) Any respiratory symptoms* 45(7.3) 10(1.7) Rehospitalization for any reason* 44(7.1) 18(3.1) Need for home oxygen support* 12(1.9) 2(0.3) AV fistula thrombosis* 9(1.5) 1(0.2) Other thromboembolic events* 9(1.5) 2(0.3) Need for HD catheter placement 13(2.1) 10(1.7) HD: haemodialysis, AV: arteriovenous. *P

Amaç Böbrek alıcılarında sitomegalovirüs (CMV), poliyoma B-K virüs (BKV) ve kalsinörün inhibitörü (KNİ) toksisitesi ve malignite geliştiğinde immünosupresyonu azaltmak gerekir. İmmünosupresyon azaltma protokolleri genellikle standart doz KNİ’nin azaltılması ve bir mTORi eklenmesini içerir. Bu çalışmada standart bir immünsupresyon protokolünden mTORi içeren düşük immünosupresyon protokolüne geçtikten sonra ki greft fonksiyonlarını incelemeyi amaçladık. Metod Bu tek-merkezli, retrospektif ve gözlemsel çalışma 2014-2016 yılları arasında yapılmış böbrek nakillerinin sonuçlarını içermektedir. Toplan 322 alıcı incelendi ve bunların 231’i çalışmaya alındı. En az 12 ay mTORi alanlar mTORi kolunda değerlendirildi. CMV ve BKV test sonuçları ve hiç greft biyopsisi olmayan alıcılar çalışma dışı bırakıldı. Geriye kalan alıcılar mTORi içermeyen gurubu oluşturdu. mTORi öncesi ve mTORi sonrası birinci ve üçüncü yıl greft sağkalımları ve fonksiyonları karşılaştırıldı. Sonuçlar Toplam 231 alıcı ortalama 5 yıl takip edildi. mTORi kolunda CMV ve BKV pozitifliği daha sıktı (p=0,001). Ayrıca, mTORi kolunda akut rejeksiyon sıklığı daha fazlaydı; p=0,001. Tahmini glomerüler filtrasyon hızı (tGFH) mTORi sonrası birinci ve üçüncü yılda daha azdı (p=0,001). Ancak, mTORi sonrası birinci ve üçüncü yıl greft sağ kalım oranları mTORi kullanmayanlar ile benzerdi (p=0,52 ve p=0,72, sırasıyla). Sonuç Böbrek alıcılarında mTORi, genellikle immünsupresyon dozunun azaltılmak zorunda olduğu durumlarda (CMV ve BKV viremisi varlığı, KNİ ilişkili nefrotoksisite gibi) düşük doz KNİ’ler ile birlikte kullanılır. Tüm dezavantajlara rağmen mTORi standart protokollere benzer greft sağkalımı sağlayabilir. Ancak, mTORi kullanımı daha fazla akut rejeksiyon ile ilişkilidir ve tGFH’da azalmayı engelleyemeyebilir.

Background: Acute and chronic calcineurin inhibitors (CNI) nephrotoxicity is a common concern in kidney transplant (KT) recipients. It is unclear whether diltiazem use can reduce CNI induced acute and chronic nephrotoxicity in (KT) recipients. In this study, we investigated the impact of diltiazem on 1 –year allograft survival and function.Materials and Methods: This single-center retrospective study included 312 kidney transplant recipients and donors. Diltiazem receiving and diltiazem-free recipients were compared for 1-year allograft survival and functions. Available allograft biopsies were investigated for the evidence pieces of CNI induced nephrotoxicity. Factors may have a potential impact on allograft functions were evaluated (cytomegalovirus and polyoma BK viremia positivity, acute rejection episodes, donors and recipients ages and body mass indexes). A statistical package program was used for data analysis. P

Background Idiopathic focal segmental glomerulosclerosis (FSGS) commonly recurs in the early post-transplant period. The treatment protocols and results are conflictive in recurrent FSGS. We aimed to present the results of our treatment protocol and basic approach to the disease recurrences. Methods This prospective, single-center study was conducted between the years 2015 and 2018. Twelve patients who fit completely the diagnosis of idiopathic FSGS by clinical, laboratory, and biopsy findings were included. A specific treatment protocol which consists of plasma exchange and high dose intravenous cyclosporine was delivered to the patients independently of induction protocols. Twenty-four months of outcomes of graft functions were evaluated. Results Nine patients completed the treatment protocol and were documented for evaluation. All patients achieved a complete or partial remission in an average 24 months of follow-up period. Conclusion Idiopathic FSGS is more commonly recurrent than thought to be. The early detection of proteinuria is crucial because the administration of a plasma exchange–based treatment protocol can reverse proteinuria. We think our treatment protocol is a well-established, efficient, and safe choice for post-transplant recurrent FSGS in adults.

Background: Subclinical hypothyroidism (SCH) is a term to define a mild and early thyroid deficiency. Some reports claim SCH has an association with increased cardiovascular disease (CVD), especially in individuals 4 mIU/L TSH levels were labelled for SCH group. Both groups were evaluated for MPV, lipid profiles and epidemiological features. Results: SCH group had higher levels of MPV, total cholesterol (TC) and LDL cholesterol (LDL-C) levels (P

Arteriovenous fistula (AVF) dysfunction is one of the common obstacles in performing hemodialysis treatment. Acute and chronic thrombosis of the fistula, stenosis, and hematomas are the major causes of the dysfunction. Here, we present an unexpected complication of midodrine use which caused in AVF dysfunction in a female patient who was suffering from hemodialysis-related hypotension.

Aim: It has been indicated that COVID-19 is related to many endocrinological abnormalities. The aim of this study is to demonstrate whether there is an impact of COVID-19 and COVID-19 vaccines on development of subacute thyroiditis (SAT). Material and Method: This retrospective single-center study includes individuals with SAT who were diagnosed between March 2020 and August 2021. Patients were evaluated for a recent Covid-19 history and SARS-CoV-2 vaccination. SAT was diagnosed based on the clinical presentation and laboratory tests; including thyroid function tests, sedimentation rate, C-reactive protein, and thyroid ultrasound. SARS-CoV-2 PCR results of patients with past COVID-19 were obtained from the Ministry of Health electronic patient data system. Type, number, and dates of vaccine doses were recorded for each participant. Results: A total of 31 patients were included in the study. Six patients (19.4%) were diagnosed with SAT following a COVID-19 vaccination schedule. Four patients with SAT had received two inactive (CoronaVac) + one dose of mRNA vaccines (Pfizer-BioNTech). The other 2 patients had received either two doses of inactive vaccine or two doses of mRNA vaccine. Five patients were diagnosed with SAT after the second dose of the vaccine. The median interval between last vaccination dose and diagnosis of SAT was 25.8 days. In one patient, SAT developed 28 days after the mRNA vaccine. Seven patients (22.6%) were diagnosed with SAT after COVID-19 disease. The median interval from the diagnosis of COVID-19 disease to SAT was 27.3 days. All cases of post-COVID-19 and post-vaccination SAT patients exhibited similar clinical presentation and findings to idiopathic SAT. Conclusion: Covid-19 itself and Covid-19 vaccines might let a tendency to development of subacute thyroiditis. This study has to be supported by further studies.

Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients.

Aluminum and its alloys have become the most popular materials in applications aiming to provide lightness due to their low density. However, the low mechanical properties compared to other competitors are among the disadvantages of aluminum and its alloys. This is an important motivation factor in researching strength increasing mechanisms in aluminum and its alloys. In this study, the effects of reinforcement ratio and type on the microstructure, mechanical properties, and wear behavior of the AA7075/B4C composite produced by squeeze casting method were investigated. Two types of materials were produced and compared—non-reinforced AA7075 alloy and AA7075 allo matrix composite reinforced by 4, 8, 10, and 12 wt% B4C. Microstructures of two materials were analyzed by optical microscope, scanning electron microscope and energy distribution spectrometer. In addition, the mechanical and tribological properties of these materials were investigated. Microstructure and scanning electron microscope analysis reveals that the increasing B4C reinforcement ratio increased the tendency of agglomeration in the matrix. Although B4C reinforcement tends to agglomerate, B4C reinforcement positively affected the AA7075 alloy's hardness, tensile and bending strengths, elasticity modules, and wear resistance.

Background The existence of renal cell cancer (RCC) in a donated kidney may cause some confusion for clinicians. We aim to present our clinical experiences with 2 recipients who received an RCC-containing kidney from their living related donors. Methods Two male patients received a kidney containing resectable size RCC from their living related donors. The recipients were discharged with well-functioning kidneys and currently are being monitored on standard follow-up protocols, and there is no evidence of RCC in their grafts. Results The kidneys with resectable sizes of renal cell carcinoma were transplanted to the recipients after nephron-sparing surgery, with no sign of recurrent RCC in the 12-month follow-up period. Conclusions In the era of transplantation, the shortage of organ sources is the major barrier for the provision of organs to recipients. To enhance the graft donation pool, kidneys with resectable size RCC might be used in providing grafts to patients with end-stage kidney disease.

Amaç: Kronik böbrek hastalığının en önemli komplikasyonlarından biri kemik mineral bozukluklarıdır. Hastalığın erken evrelerinden itibaren fosfor, D-vitamini, FGF-23, kalsiyum ve parathormonun (PTH) da dahil olduğu kompleks bir ilişki içinde sekonder hiperparatiroidi (sHPT) ortaya çıkmaya başlar ve evre ilerledikçe görülme sıklığı artar. sHPT’nin vücuttaki olumsuz etkilerini engellemek ve d-vitamini eksikliğini tamamlamak için hastalara D-vitamini tedavisi verilmesi gerekmektedir. İntravenöz (i.v.) ilaç uygulamaları tablet formlara göre oldukça maliyetlidir. Çalışmamızda i.v. kalsitrol kullanan uygun hastaları oral forma değiştirerek kısa dönem sonuçlarını sunmayı amaçladık.Gereç ve Yöntem: Çalışmamıza merkezimizde en az 3 aydır hemodiyaliz programında olan ve tek nefrolog tarafından tedavileri düzenlenen 115 hasta dahil edildi. Son 3 aydır i.v. kalsitrol kullanan, malnütrisyonu, aktif enfeksiyonu, uzun süre hastane yatışı gerektirecek tıbbi bir sorunu olmayan, haftada 3 kez 4 saat hemodiyaliz seanslarına uyumu tam olan hastalar dahil edildi. Son 3 ay içerisinde hedef PTH 150-600 pg/ml, fosfor < 5,6 mg/dl, kalsiyum < 9,5mg/dl altında olacak şekilde KDIGO 2012 kılavuzlarına göre i.v. kalsitrol dozları düzenlenmişti ve bu dozlar yine mevcut parametrelere göre oral formlara değiştirildi. Hastalar 3 ay izlendi. 3 aylık ortalama kalsiyum, fosfor, PTH, KTV, albümin, hemoglonin, alkalen fosfataz (ALP), c-reaktif protein, kalsiyum x fosfor değerleri i.v. ve oral formlar arasında karşılaştırıldı. Veri kümeleri S.P.S.S versiyon 17 paket programı kullanılarak değerlendirildi. p

Presentation of COVID-19 in renal transplant recipients is similar to that shown in the nonimmunocompromised population; almost all recipients who have this disease present with symptoms of the respiratory system. Acute kidney injury has been found prevalent in transplant recipients with COVID-19. In those with severe COVID-19 disease who transfer to an intensive care unit prevalence of acute kidney injury is more than 50%. The pathophysiological mechanisms of kidney involvement and the type of involvement are unclear. Here, we present a 71-year-old kidney transplant recipient who was admitted to our hospital with pulmonary and renal involvement. A kidney allograft biopsy demonstrated diffuse intrarenal hemorrhage, capillary congestion, and severe acute tubular injury. COVID-19 RNA was detected by real-time polymerase chain reaction from lysed allograft tissues, but no findings of acute or chronic cellular or antibody-mediated rejection were detected. This case indicates that COVID-19 may involve the allograft by causing hemorrhage within the renal parenchymal via direct or indirect pathways.

Rivaroxaban associated spontaneous hemothorax Rivaroxaban is a highly selective direct thrombin inhibitor indicated in stroke prevention, non-valvular atrial fibrilation, treatment of pulmonary embolism and deep vein thrombosis, prevention of recurrent venous thromboembolism and VTE after elective hip/knee replacement surgery and secondary prevention after acute coronary syndrome. Hemorrhage is the major concern of the drug use. Subdural hematoma, cerebral hemorrhage, GIS hemorrhage, and also intra-articular bleeding has been published in postmarketing reports. Here, we report a case of spontaneous hemothorax under rivaroxaban treatment. A 73-year-old of man was consulted due to acute dyspnea and palpitation. His x-ray pulmonary images and thorax computed tomography were compatible with hemothorax, consequently, we performed thoracentesis, and macroscopic appearance, cell count revealed hemothorax. There was no sign of any disease, such as low pleural fluid pH and glucose, leucocytic dominance, dysplastic cell, which would indicate an another cause of the bleeding. He was taking rivaroxaban (15 mg Daily) due to chronic atrial fibrillation. Hemorrhage was drained and the drug was cessated. Hemothorax did not relapse in the three month-follow-up periods. Rivaroxaban (Xarelto) is a member of new anticoagulant drug class and has become favorable in the patient carrying systemic embolism risk with nonvalvular atrial fibrillation. It has predictable pharmacokinetics features, fewer food interactions, bleeding risk, and contrast to warfarin it does not need frequent INR monitoring. Despite promising features, serious hemorrhagic complications have been reported and bleeding risk is still its major challenge in clinical use. Cases of subdural hematoma, cerebral hemorrhage, GIS hemorrhage, and also intra-articular bleeding has been published (1). Hemothorax was assumed as a rare complication until recently published case reports (2, 3). Here, we announce our case to keep in mind that rivaroxaban is a cause of spontaneous hemothorax, as not uncommonly

Objective: The mortality was seen in the early period after kidney transplantation is one of the most undesirable consequences of kidney transplant treatment. This study was aimed to evaluate the factors affecting the 1st-year mortality in patients who underwent living donor kidney transplantation (LDKT) in our center. Material and Methods: Adult patients who underwent LDKT developed mortality within the 1st-year in our center between 2008 and 2020. Mortality group and the control group are compared according to donor and recipient characteristics. The risk factors that have an adjusted effect on 1st-year mortality after kidney transplantation were evaluated by cox regression survival analysis. Results: Total mortality incidence was 8.35% and the 1st-year mortality incidence was 1.67%. Median dialysis duration (13 months vs. 3 months) was longer in the mortality-group, p=0.022. Cardiovascular disease (CVD) was more common in the mortality-group (50% vs. 31.1%), p=0.037. Median HLA mismatch numbers was higher in the mortality-group (4 vs. 3), p=0.027. According to Model 1, in terms of 1st- year mortality, each 1 year increment in recipient's age increases the mortality by 1,034 times, and dialysis treatment increases the mortality 2.5 times. According to Model 2, in terms of 1st-year mortality, each 1 year increment in recipient's age increase the mortality by 1,039 times, dialysis treatment increases the mortality 2.8 times and each 1 mismatch increase in HLA mismatch numbers increases the mortality by 1.3 times. Receiver operating characteristic analysis showed that the moderate predictive power for recipient age was AUC 0.734 (95% CI 0.623-0.844, p

Objective: Delayed graft function (DGF) is related to enhanced acute rejection attacks in the short term and reduced graft survival and reduced overall survival in the long-term. In this study, we desired to ascertain the outcomes of DGF. Material and Methods: This study is a retrospective cohort study. Two hundred seventy-four patients who underwent a kidney transplant from a deceased donor were included. DGF was described as obtaining dialysis treatment within the first week of transplant. The kidney recipients were divided into groups DGF+ (Group 1) and DGF- (Group 2). Two groups were compared in terms of risk factors which were based on donor and recipient characteristics. Short-term outcomes, long-term graft survival and recipient survival results were compared. Results: The incidence of DGF was 50.3%. The rate of donors with expanded criteria donor (ECD) was 37.3%. Mean glomerular filtration rate (GFR) at one year after kidney transplantation was 57.5 ml/dk/1.73m2 for Group 1, and 73 ml/dk/1.73m2 for Group 2 (p

Background: we aimed to present the demographic characteristics, clinical presentation, and outcomes of our multicenter cohort of adult KTx recipients with COVID-19.Methods: we conducted a multicenter, retrospective study using data of patients hospitalized for COVID-19 collected from 34 centers in Turkey. Demographic characteristics, clinical findings, laboratory parameters (hemogram, CRP, AST, ALT, LDH, and ferritin) at admission and follow-up, and treatment strategies were reviewed. Predictors of poor clinical outcomes were analyzed. The primary outcomes were in-hospital mortality and the need for ICU admission. The secondary outcome was composite in-hospital mortality and/or ICU admission.Results: one hundred nine patients (male/female: 63/46, mean age: 48.412.4years) were included in the study. Acute kidney injury (AKI) developed in 46 (42.2%) patients, and 4 (3.7%) of the patients required renal replacement therapy (RRT). A total of 22 (20.2%) patients were admitted in the ICU, and 19 (17.4%) patients required invasive mechanical ventilation. 14 (12.8%) of the patients died. Patients who were admitted in the ICU were significantly older (age over 60 years) (38.1% vs 14.9%, p=0.016). 23 (21.1%) patients reached to composite outcome and these patients were significantly older (age over 60years) (39.1% vs. 13.9%; p=0.004), and had lower serum albumin (3.4g/dl [2.9-3.8] vs. 3.8g/dl [3.5-4.1], p=0.002), higher serum ferritin (679 mu g/L [184-2260] vs. 331 mu g/L [128-839], p=0.048), and lower lymphocyte counts (700/mu l [460-950] vs. 860 /mu l [545-1385], p=0.018). Multivariable analysis identified presence of ischemic heart disease and initial serum creatinine levels as independent risk factors for mortality, whereas age over 60 years and initial serum creatinine levels were independently associated with ICU admission. On analysis for predicting secondary outcome, age above 60 and initial lymphocyte count were found to be independent variables in multivariable analysis. Conclusion: over the age of 60, ischemic heart disease, lymphopenia, poor graft function were independent risk factors for severe COVID-19 in this patient group. Whereas presence of ischemic heart disease and poor graft function were independently associated with mortality., NA

Introduction: Management of COVID-19 in kidney transplant recipients should include treatment of the infection, regulation of immunosuppression, and supportive therapy. However, there is no consensus on this issue yet. This study aimed to our experiences with kidney transplant recipients diagnosed with COVID-19. Material and Methods: Kidney transplant recipients diagnosed with COVID-19 from five major transplant centers in Istanbul, Turkey, were included in this retrospective cohort study. Patients were classified as having moderate or severe pneumonia for the analysis. The primary endpoint was all-cause mortality. The secondary endpoints were acute kidney injury, the average length of hospital stay, admission to intensive care, and mechanical ventilation. Results: Forty patients were reviewed retrospectively over a follow-up period of 32 days after being diagnosed with COVID-19. Cough, fever, and dyspnea were the most frequent symptoms in all patients. The frequency of previous induction and rejection therapy was significantly higher in the group with severe pneumonia compared to the moderate pneumonia group. None of the patients using cyclosporine A developed severe pneumonia. Five patients died during follow-up in the intensive care unit. None of the patients developed graft loss during follow-up. Discussion: COVID-19 has been seen to more commonly cause moderate or severe pneumonia in kidney transplant recipients. Immunosuppression should be carefully reduced in these patients. Induction therapy with lymphocyte-depleting agents should be carefully avoided in kidney transplant recipients during the pandemic period., NA

Background Renal grafts with multiple renal arteries (MRA) are a compelling issue in surgery of kidney transplantation. Transplantations using "grafts with MRA" have conflicting results. Here, we present our experiences on the issue. Method This is a single-center, observational, descriptive study. One hundred ninety-nine patients with end-stage renal disease received a kidney graft from their living- or deceased-related donors in our center between July 2016 and May 2017. We included all recipients to the study. Patients were divided into the following 2 groups: Group 1, recipients who received a renal graft with single renal artery, and Group 2, recipients who received a renal graft with MRA. Groups were compared for estimated glomerular filtration rates (months 1-3 and 12), delayed graft function, and graft survival. Data were analyzed by using SPSS for Windows version 15. Results One hundred ninety-five recipients with all documented data were analyzed. Graft function was compared between 2 groups in months 1, 3, and 12 and found both to have similar outcomes. MRA has been indicated to have no impact on delayed graft function, higher risk for vascular injury, and biopsy-proven acute tubular necrosis. Also, anastomosis sides have been found to have no importance on graft function in recipients with MRA (P > .05 between all sides). Conclusion Our study indicates grafts with MRA and grafts with a single renal artery have comparable results in the first post-transplant year.

Son donem kronik bobrek hastalari ve diyaliz hastalarinda hemostaz bozulmustur. Bundan dolayi bu hastalar kanamaya meyillidir. Spontan retroperitoneal kanamalar genellikle gurultulu ciddi klinik semptom ve bulgular ile tani alir. Intermittant hemodiyaliz tedavisi sirasinda ortaya cikan asemptomatik retroperitoneal kanamali olgumuzu atipik seyri nedeniyle sunmayi uygun gorduk.

Background: Two unique biomarkers, soluble form of the urokinase-type plasminogen activator receptor (suPAR) and neopterin, play a crucial role in inflammatory processes. This study aimed to reveal whether it is possible to utilize these biomarkers in predicting tumor prognosis in patients with lung cancers. Methods: The present study was designed as a single center, prospective, and controlled research. The study was conducted with forty patients with lung cancer (case group) and 41 healthy individuals (control group) in Kırıkkale University, Faculty of Medicine between 2016-2020. The case group was also divided into two of the early and advanced stages. The blood samples were drawn to evaluate suPAR and neopterin levels, and these parameters were compared between the case and control groups. Also, the prognostic effects of age, stage of the tumor, and the levels of mentioned parameters were investigated with the survival analysis. Results: The median duration of the follow-up was 32 (4-75) months. suPAR and neopterin levels were found to be higher in the case group than in the control group. Cox regression showed that the high levels of neopterin and suPAR increased mortality risk [p=0.002, HR: 1.25 (1.08-1.45 95%CI) and p=0.023, HR:1.07 (1.01-1.13), respectively]. Finally, age and stage of the tumor were found to have no relationship with survival. Conclusion: suPAR and neopterin as members of the inflammatory pathway were found to be higher in cancer cases. Furthermore, both suPAR and neopterin levels were found to be predictive for the mortality of patients with lung cancers; therefore, they are thought to be used for the management of cancer.

yalim, zafer/0000-0001-7736-0205 WOS:000524254000022 PubMed: 32157616 Background Sudden cardiac death is the leading cause of cardiac-related death in hemodialysis patients. Hypotensive episodes in pre-, intra-, and post-dialytic periods can present serious clinical challenges that affect a patient's quality of life and prognosis. The aim of the present study was to evaluate cardiac autonomic control and arrhythmogenic risk by analyzing 24-h heart rate variability (HRV) and heart rate turbulence (HRT) in hypotensive hemodialysis patients. Methods A total of 79 patients on maintenance hemodialysis treatment, 39 normotensive and 40 with frequent hypotension episodes during non-dialysis periods, were included in the study. Dialysis-free periods were recorded with a 24-h Holter rhythm and ambulatory blood pressure monitor device. The time-domain parameters of HRV and HRT, including turbulence onset (TO) and turbulence slope (TS), were calculated. Results Values for SDNN (105.5 +/- 7.02, 127.6 +/- 6.2 p < 0.001), SDANN (95.1 +/- 5.9, 111.8 +/- 5.01 p < 0.001), and SDNN index (50.04 +/- 2.7, 55.6 +/- 3.7 p = 0.03), in the hypotensive group were significantly lower than in the normotensive group, respectively. Values for RMSSD (26.5 +/- 2.5, 27.3 +/- 2.7 p = 0.178), pNN50 (17 +/- 1.7, 55.6 +/- 3.7 p = 0.03), and TI (35.1 +/- 3.1, 34.7 +/- 2.6 p = 0.542) in both groups were not significantly different; however, there was a significant difference between HRT parameters, TO (- 1.8 +/- 0.37, - 2.4 +/- 0.39 p < 0.001) and TS (6.9 +/- 0.71, 8.2 +/- 0.97 p < 0.001), respectively, hypotensive and normotensive group. Conclusion Dialysis patients that experience frequent hypotensive episodes may also undergo significant changes in HRT and HRV which may be indicative of serious cardiac sequela. Thus, in such cases, a complete cardiologic evaluation is warranted.

Metal matrix composites (MMCs) with their splendid mechanical properties have been specifically designed for use in fields such as aerospace and aviation. The presence of hard ceramic particles in MMC increases the hardness of the matrix product and decreases its coefficient of friction. Therefore, the wear resistance is improved. Moreover, the mechanical properties of these composite materials can be improved by applying heat treatments. In this study, AlSi7Mg2 MMCs with 15 wt% SiC reinforcement were produced by squeeze casting technique. Some of the composites were aged by heat treatment. Hardness values of aged and non-aged composites were compared. In addition, abrasive wear behaviors of these composites were investigated on pin-on-disk device, depending on the load (7, 12 and 17 N), the sliding speed (0.2, 0.3 and 0.4 m/s) and the sliding distance (700, 1000 and 1300 m). Worn surfaces were also analyzed by scanning electron microscopy (SEM). As a result of the analyses, it was determined that both the hardness values and the wear resistance were higher in the composites subjected to aging treatment. Furthermore, it was observed that the increase in the applied load led up to the weight loss. The increase in the sliding distance increased both friction coefficient and weight loss. The increase in sliding speed also made way for the friction coefficient but ensured less weight loss. When SEM images were examined, it was ascertained that deformation and tribo-surface formation had a significant effect on weight losses.

Environmental friendly natural fibers have been used instead of petroleum-based synthetic fibers as reinforcements because of the depletion of oil resources, plastic waste disposal problems and the emissions generated during combustion. In these natural fibers, thermoplastic or thermoset materials are used as matrix material because of their low cost, light weight and durability. In this study, the effects of ply number (2 and 3 layer) and orientation angle of reinforcement (0/90° and ± 45°) and matrix type (thermoset and thermoplastic) on the tensile strength of jute reinforced composites were investigated. Also, the effect of the reinforcement orientation angle, sliding time (600, 1200 and 1800 s) and applied load (5, 10 and 15 N) on tribological characteristics were determined. Adhesive and abrasion wear tests were carried out at 0.15 m × s−1 sliding speed. It was observed that the matrix material and the reinforcement are very important in tensile and wear tests, while the ply number and the orientation angle only exert an influence in the tensile strength of composites. It was determined that an increase in load and sliding time is the most effective parameter on wear experiments.

Background: Sudden cardiac death is the leading cause of cardiac caused death in hemodialysis patients. Hypotensive episodes in pre- intra and post-dialytic periods are the serious clinical challenges that effect patients life quality and prognosis. We investigated whether hypotensive episodes have an association with ventricular arrhythmias and discuss literature. Methods: Totally 56 cases; twenty-two patients with frequent hypotension episodes, and 15 normotensives patients who were on maintenance hemodialysis treatment and 19 healthy individuals were included in the study. Pre-intra and post-dialytic periods recorded by using a 24-h Holter rhytm device. p< 0,05 is postulated as significantly distinct. Results: Records of 50 participants were evalated properly. Both in hypotensive and normotensive hemodialysis patients ventricular extrasystoles [VES] counts were in a strong relation with lower blood pressure p

Dema berhemên edebîyata kurdî ya klasîk tên vekolîn gelek beyt û bendên şîretwer ên cihêreng xuya dibin. Mijara vê xebatê ya sereke li ser gotinên şîretî û dîdaktîk ên di nav helbestên klasîk da cih girtine û armanca vê xebatê jî tesbîtkirina van beyt û bendan û şîrovekirina wan e. Şîretên li ser dîn û tesewif, fanîbûn û demkîbûna dinyayê, cir û exlaqên xweş, dostanî û wefa, rêzên civakî, girîngîya duayan, sebir, perwerdehî, qencî û xîret û hwd. bi gelek mînakan hatine tomarkirin di vê xebatê da. Gelek helbestvanên wêjeya kurdî ya klasîk hene, lê ji bo vê xebatê me çar helbestvan û şeş berhemên wan hilbijartin. Helbestvanê ku bûne mijara vê xebatê û navên berhemên wan ên hatine vekolîn ev in: Feqîyê Teyran (Feqîyê Teyran Hemû Helbest), Ehmedê Xanî (Mem û Zîn, Dîwan û Nûbihara Biçûkan), Mele Xelîlê Sertî (Nehcu’l Enam), Seyîd Elîyê Findikî (Dîwan). Ev xebat ji destpêkê û du beşan pêk hatiye: Di destpêkê da behsa mijar û armanca xebatê, rê û rêbaz, çarçove û çavkanîyên xebatê hatiye kirin. Beşa yekem bi kurtî edebîyata kurmancî ya klasîk, çavkanîyên wê, jîyana helbestvanên ku bûne mijara vê xebatê dihundirîne. Wekî din di edebîyata kurdî ya klasîk da helbesta dîdaktîk û dirokçeya wê ya edebîyata Îslamî ya klasîk da jî, di vê beşê da bi kurtî hatiye nivîsandin. Beşa duyem jî ji şîrovekirina hêmanên şîretî yên ku di berhemên navborî da derbas dibin pêk hatiye., Klasik Kürt edebiyatına ait eserler incelendiğinde çok sayıda ve çeşitte nasihat içeren beyit ve bentler göze çarpar. Bu çalışmanın başlıca amacı, klasik şiirlerde nasihat içeren ve öğretici nitelik taşıyan bu beyit ve bentleri tespit etmek ve yorumlamaktır. Din ve tasavvuf, dünyanın faniliği, güzel huy ve ahlaklar, dostluk ve vefa, toplumsal kurallar, duanın önemi, sabır, eğitim, iyilik ve cömertlik vs. ile ilgili nasihatler çok sayıda örneklerle bu çalışmada kaydedilmiştir. Klasik Kürt edebiyatında çok sayıda şairden ancak bu çalışma için dört şairin altı eserini seçtik. Bu çalışmaya konu olan şairler ve incelenen eserlerinin isimleri şunlardır: Feqîyê Teyran (Feqîyê Teyran Tüm Eserleri), Ehmedê Xanî (Mem ve Zîn, Dîwan ve Nûbihara Biçûkan), Mele Xelîlê Sêrtî (Nehcu’l Enam), Seyîd Elîyê Findikî (Dîwan). Bu çalışma, giriş ve iki bölümden oluşmaktadır: Giriş bölümünde bu çalışmanın konusu ve hedefi, yol ve yöntem, çalışmanın çerçevesi ve kaynakları üzerinde durulmuştur. Birinci bölümde genel hatlarıyla klasik kürt edebiyatı ile ilgili kısa bir değerlendirme yapılmış, bu çalışmaya konu olan klasik şairlerin hayatları ve eserleri hülasa edilmiştir. Ayrıca bu bölümde Klasik Kürt Edebiyatında nasihat içeren eserler de kısaca inceleme konusu edilmiş ve Klasik İslam Edebiyatı nasihatname tarzı eserlerin tarihçesi de kısaca belirtilmiştir. İkinci bölümde ise adı geçen eserlerde tespit edilen ve nasihat içeren unsurların yorumlandığı bir bölümdür.

It is not clear fasting during Ramadan affects the kidneypatients. The real scientific evidence absent in this regard, as serious scientific studiesare generally carried out in the western society and there is no such worshipwhere widespread individuals participate at the same time in western society., Ramazan ayında yapılan oruç ibadetinin böbrek hastalarınınasıl etkilediği tam olarak bilinmemektedir. Kabul gören ciddi bilimselçalışmaların genelde batı toplumunda yürütülmesi ve batı toplumunda genişkitlelerin aynı anda katıldığı böyle bir ibadetin olmamasından dolayı bu konudagerçek bilimsel veriler eksiktir.

Objective: The exact incidence of hepatosteatosis in pa­tients with metabolic syndrome (MetS) is unknown; also there is no valid, simple and inexpensive method to evaluate and follow-up for patients with MetS. In our study, we aimed to demonstrate the frequency of hepatosteatosis, and wheth­er demonstrate presence and degree of steatosis using liver ultrasonography may provide additional benefit for evaluat­ing and following-up in MetS patients with non-alcoholic fatty liver disease. Methods: One hundred and twelve patients with MetS were included to the study. Patients divided into three groups; con­trol group (n= 36) consisted of patients without hepatosteato­sis, group 1 (n=43) consisted of patients with grade 1 hep­atosteatosis. Finally, group 2 (n= 33) consisted of patients with grade 2 hepatosteatosis. The relationship between the presence and degree of the hepatosteatosis and MetS pa­rameters were analyzed. Results: The incidence of hepatosteatosis was found 69.4% in patients with MetS. There were significantly differences in HOMA-IR, AST, ALT and GGT levels among control group and group 1 (p, Amaç: Metabolik sendrom (MetS)\'lu hastalarda hepatos­teatoz sıklığı tam olarak bilinmemektedir, ayrıca MetS\'lu hastaların izleminde ve değerlendirilmesinde kabul gör­müş etkin, basit ve ucuz bir yöntem yoktur. Çalışmamız­da, MetS\'lu hastalarda hepatosteatoz sıklığını ve karaci­ğer ultrasonografi (USG)\'si ile saptanmış steatoz varlığı ve derecesinin MetS\'lu hastaların değerlendirilmesinde ek yarar sağlayıp sağlayamayacağını ortaya koymayı amaçladık. Yöntemler: Yüz on iki MetS\'lu hasta bu çalışmaya dâhil edildi. Hastalar karaciğer USG\'sine göre; steatozu olma­yan (kontrol, n=36), grade I steatozu olan (Grup 1, n=43), ve grade II steatozu olan (Grup 2, n=33) 3 gruba ayrıldı. Hepatosteatoz varlığı ve derecesi ile MetS parametreleri arasındaki ilişki bakıldı. Bulgular: Çalışmamızda MetS\'lu hastalarda hepatostea­toz sıklığı %69,94 olarak saptandı. Kontrol grubu ve grup 1 arasında açlık insülini, HOMA-IR, AST, ALT ve GGT farklıydı (hepsi için p