Hitit Üniversitesi Kurumsal Akademik Arşivi
DSpace@Hitit, Hitit Üniversitesi tarafından doğrudan ve dolaylı olarak yayınlanan; kitap, makale, tez, bildiri, rapor, araştırma verisi gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, Üniversitenin akademik performansını izlemeye aracılık eder, kaynakları uzun süreli saklar ve telif haklarına uygun olarak Açık Erişime sunar.
Güncel Gönderiler
Kronik böbrek hastalığı olanlarda serum proprotein konvertaz subtilisin/ keksin tip 9 düzeyinin endotel disfonksiyonu ve subklinik ateroskleroz ile ilişkisi
(Hitit Üniversitesi, 2025) Avcı, Ahmet; Eser, Barış
Objective: This study aims to investigate the relationship between serum PCSK9 values and subclinical atherosclerosis and endothelial dysfunction in patients with chronic kidney disease.
Materials and methods: A total of 127 participants over the age of 20 those receiving hemodialysis (HD) (n=30), those receiving continuous peritoneal dialysis (PD) (n=36), stage 3-4 CKD (n=31), and non-CKD control group (n=30) participants] were included in this clinical cross-sectional study. Flow-mediated dilatation (FMD) for ED, endothelial deceleration time (EDT) for left ventricular diastolic dysfunction (LVDD), and carotid intima media thickness (CIMT) for subclinical atherosclerosis were measured by echocardiography. Blood samples were taken for simultaneous PCSK9 measurements.
Results: Of the 122 participants who participated in the study, 30 (24.5%) were in the control group, 31 (25.4) in the stage 3-4 CKD patient group, 31 (25.4) in the peritoneal dialysis group, and 30 (24.5%) in the hemodialysis patient group. Although no significant difference was found between the study groups in FMD BASE and FMD HYPEREMIA; FMD ratio was found to be significant (P values, respectively; 0.552; 0.435; 0.001). A significant difference was found between the CIMT groups (both 0<.001). E/e', one of the parameters indicating LVDD was found to be significantly different (P:0.009).
Conclusion: There was a statistically significant difference in endothelial dysfunction and subclinical atherosclerosis in chronic kidney disease patients compared to the healthy group. However, no significant difference was found in PCSK9 correlation.
Keywords: Proprotein convertase subtilisin/kexin type 9, chronic kidney disease, endothelial dysfunction, subclinical atherosclerosis
İzole hipertansiyon hastalarında nondipper kalp hızı varlığının ventriküler aritmiler ile ilişkisi
(Hitit Üniversitesi, 2025) Sarıhan, Abdullah; Bekar, Lütfü
Objective: In healthy individuals, the increase in parasympathetic tone during nighttime leads to a decrease in heart rate. When this decrease does not occur or happens minimally, it is an indicator of increased sympathetic activity. This condition could be an important mechanism that may increase the susceptibility to ventricular arrhythmias, especially in hypertensive individuals. The aim of this study is to compare the frequency of ventricular arrhythmias and other clinical parameters between cases with and without a heart rate decrease during the night in isolated hypertensive patients monitored by a rhythm Holter. Materials and Methods: A total of 229 isolated hypertensive patients (mean age 58.2±12.5 years, 89 (38.9%) male) who underwent transthoracic echocardiography, rhythm Holter, and amulatory blood pressure monitoring and applied to the Department of Cardiology at Hitit University Faculty of Medicine in the last 12 months up until March 2025 were included in this study. The cases included in the study were divided into two groups based on their nighttime heart rate decrease in the rhythm Holter: the 'dipper' group, with a decrease of 10% or more, and the 'non-dipper' group, with a decrease of less than 10%. The primary comparisons were made between these two groups. Then, according to the Lown classification, patients in the low Lown class (Lown 0) were compared with those in the high Lown class (Lown 1-4), and the same comparisons were repeated between these two groups. Parameters that were significantly different between the Lown class 0 and Lown class 1-4 groups were included in multivariate analysis, aiming to identify independent and significant parameters that may influence the development of cardiac arrhythmias in isolated hypertensive patients. Results: In Holter rhythm analyses, 170 patients (mean age 57.8±12.2 years, 66 [38.8%] male) with a nocturnal heart rate decrease of ≥10% were classified as the dipper group, while 59 patients (mean age 59.3±13.4 years, 23 [29%] male) with a decrease of <10% were classified as the non-dipper group. There was no significant difference between the dipper and non-dipper groups in terms of baseline demographic parameters, laboratory values, or medications used. When transthoracic echocardiographic parameters were compared between the two groups, interventricular septal thickness (11.9±1.6 vs. 11.3±1.4 mm; p=0.005), posterior wall thickness (11.7±1.6 vs. 11.3±1.6 mm; p=0.047), left ventricular (LV) mass (193.8±47.1 vs. 174.7±48.6 g; p=0.009), LV mass index (103.9±26.2 vs. 95.3±28.2 g/m²;VIII p=0.040), presence of LV hypertrophy (78% vs. 60.6%; p=0.016), and presence of concentric hypertrophy (55.9% vs. 37.6%; p=0.014) were significantly higher in patients with non-dipper heart rate compared to those with dipper heart rate. When Holter rhythm parameters were compared between the two groups, both the number of ventricular extrasystoles (1039 [8– 1600] vs. 120 [0–321] beats; p<0.001) and the number of atrial premature beats (451 [3– 1366] vs. 129 [0–445] beats; p<0.001) were found to be significantly higher in the non-dipper heart rate group. Comparing the Lown classification between the two groups, arrhythmia frequency was observed to be higher in patients with non-dipper heart rate (p<0.001). Based on Lown classification, 139 patients (mean age 57.2±13.4 years, 58 [41.7%] male) were categorized in Lown class 0, and 90 patients (mean age 59.8±10.8 years, 31 [34.4%] male) in Lown class 1–4. No significant differences were observed between these groups in terms of baseline demographic characteristics, laboratory findings, or medications used. However, echocardiographic parameters such as interventricular septal thickness (11.8±1.6 vs. 11.3±1.5 mm; p=0.005), posterior wall thickness (11.7±1.6 vs. 11.2±1.6 mm; p=0.011), LV mass (187.8±47.2 vs. 174.3±49.3 g; p=0.040), LV mass index (102.8±26.2 vs. 94.1±28.6 g/m²; p=0.021), presence of LV hypertrophy (73.3% vs. 59.7%; p=0.036), and presence of concentric hypertrophy (52.2% vs. 36%; p=0.015) were significantly higher in patients in the Lown class 1–4 group compared to the Lown class 0 group. Additionally, 24-hour average systolic blood pressure (p=0.015), daytime average systolic blood pressure (p=0.014), and nighttime average systolic blood pressure (p=0.011) were significantly higher in the Lown class 1–4 group among ambulatory blood pressure monitoring parameters. When rhythm Holter parameters were compared between these two groups, both the number of ventricular extrasystoles (908 [122–2509] vs. 0 [0] beats; p<0.001) and the number of atrial premature beats (671 [122–1863] vs. 52 [0–360] beats; p<0.001) were found to be significantly higher in the Lown class 1–4 group. Furthermore, non-dipper heart rate status was more frequently observed in the Lown class 1–4 group (89.9% vs. 50%; p<0.001). In correlation analysis, a weak but statistically significant negative correlation was detected between percentage change in heart rate and both LV mass (r= -0.256; p=0.018) and LV mass index (r= -0.243; p=0.031). In multivariate analysis, the presence of concentric hypertrophy (Relative Risk: 2.879; 95% Confidence Interval: 1.843–9.829; p=0.041) and a nocturnal heart rate decrease of less than 10% (Relative Risk: 9.616; 95% Confidence Interval: 4.563–20.261; p=0.001) were identified as independent predictive parameters for the development of cardiac arrhythmias.
Enflasyon muhasebesinin TMS/TFRS, BOBİ FRS, MSUGT/VUK açısından karşılaştırmalı incelenmesi ve örnek uygulama
(Hitit Üniversitesi, 2025) Başer, Burak; Akdoğan, Habib
The comparability and reliability of financial reports are essential for business management, shareholders, investors, and other financial statement users in making informed decisions. However, during periods of high inflation, financial statement figures may fail to reflect economic reality, leading to a loss of meaningful information, reduced reliability, and diminished comparability. Globally, as high inflation became a persistent issue in the 1980s, historical cost-based accounting principles no longer accurately represented businesses' financial positions, necessitating an approach to incorporate inflation effects into financial reports. This study provides a comparative analysis of inflation accounting regulations under MSUGT/VUK and the standards outlined in TAS 29 and LMSE FRS Section 25, 'Financial Reporting in Hyperinflationary Economies,' with an illustrative application for each framework. While TAS 29 and LMSE FRS Section 25 align in many aspects, MSUGT/VUK diverges in terms of objectives, scope, general price index, financial statements subject to restatement, borrowing costs, and comparative financial information. The results indicate that restating the statement of profit or loss under these standards positively impacts operating results, yet differences in the general price index (CPI) used for adjustments and the measurement of certain non-monetary items based on current valuation models (such as fair value and revaluation model) result in a lower restated total asset amount compared to the existing system.
Epworth, Pittsburgh, Stanford, Jenkins, STOP-BANG ve Berlin ölçeklerinin yüksek apne hipopne indeksi ve oksijen desaturasyonunu öngörmedeki başarısı
(Hitit Üniversitesi, 2025) Arıcı, İrem Eker; Yılmaz, Yasemin Arı
Aim: Various sleep assessment tools have been developed to assess the risk of Obstructive Sleep Apnea Syndrome (OSAS), including the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Stanford Sleepiness Scale (SSS), Jenkins Sleep Questionnaire (JSS), STOP-BANG and Berlin Questionnaire (BA). The aim of our study was to evaluate the predictive accuracy of these tools in identifying individuals with high apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) by comparing them with the results of Polysomnography (PSG), which is accepted as a reference.
Material and Method: Our study was conducted on a sample of 164 patients who underwent PSG in a clinic specializing in sleep disorders. Participants completed six sleep assessment instruments prior to PSG. The scores obtained from the instruments were statistically analyzed to assess their ability to predict high AHI and ODI.
Results: In our study, it was found that the age, BMI and neck circumference values of the severe OSAS (AHI >30) group (50,48 years, 33,70 kg/ m2, 42,55 cm) were higher than those of the mild (45,03 years, 30,25 kg/ m2, 40,18 cm) or normal (39,56 years, 27,80 kg/ m2, 38,0 cm) groups. It was found that STOP-BANG (p=0,003) and BA (p=0,004) showed a statistically significant relationship with AHI (p<0,05). After including the independent variables, the correct classification percentages of STOP-BANG and BA were determined as (88,4% and 78,7%), respectively. The most important factor affecting the correct classification of STOP-BANG was neck circumference (p=0,025), while for BA this factor was found to be BMI value (p=0,004).
Conclusion: STOP-BANG and BA stand out as more useful tools in clinical practice due to their higher sensitivity in identifying patients with moderate-severe OSAS. Since ESS, PSQI, SSS and JSS have lower diagnostic specificity, their ability to accurately predict OSAS remains limited.
Keywords: Apnea hypopnea index, Oxygen desaturation index, Polysomnography, Obstructive sleep apnea syndrome, Sleep assessment tools
Üçüncü basamak bir hastanede dermatoloji polikliniğinebaşvuran hastaların deri prick test sonuçlarının iki yıllıkretrospektif analizi
(Hitit Üniversitesi, 2025) Çalışkan Ataç, Damla; Öztekin, Aynure
Objective: The prevalence of allergic diseases has increased worldwide over the years. This trend highlights the need for allergy tests that are easy to perform and evaluate, cost-effective, and have high sensitivity and specificity. The skin prick test is a minimally invasive, cost-effective, and rapid diagnostic tool widely used to detect type I hypersensitivity reactions. This study aims to retrospectively assess the skin prick test results of patients presenting to our clinic with allergic complaints, identifying differences in test outcomes according to age, gender, and diagnoses and examining the relationships between these variables.
Materials and Methods: Patients aged 5–72 years presenting with allergic complaints, such as allergic rhinitis, asthma, atopic dermatitis, and urticaria, and who underwent a skin prick test in the Dermatology and Venereal Diseases outpatient clinics of Hitit University Medical Faculty Training and Research Hospital between December 15, 2021, and December 15, 2023, were retrospectively evaluated.
Results: Of the 505 patients included, 343 (67.9%) were female, and 162 (32.1%) were male. The age distribution was as follows: 141 (27.9%) in the 0–18 age group, 164 (32.5%) in the 19–30 age group, 87 (17.2%) in the 31–40 age group, 61 (12.1%) in the 41–50 age group, and 52 (10.3%) aged 51 and older. Diagnoses included allergic rhinitis in 342 (67.7%) patients, asthma in 146 (28.9%), atopic dermatitis in 63 (12.5%), and urticaria in 143 (28.3%). A total of 183 (36.2%) patients were sensitized to at least one allergen, with 84 (16.6%) sensitive to a single allergen and 99 (19.6%) sensitive to multiple allergens. Patients with allergic rhinitis showed a significantly higher rate of sensitization to multiple allergens compared to those without allergen sensitivity (p<0.001). Among those with urticaria, the rate of sensitivity to multiple allergens was significantly lower than that of those sensitive to a single allergen or without allergen sensitivity (p<0.001). The most frequently detected allergen was house dust mite (13.5%), followed by storage mites (7.1%). Patients with urticaria had a lower rate of sensitivity to house dust mites compared to those without sensitivity (p = 0.075). Male patients showed a significantly higher rate of sensitivity to storage mites than female patients (p = 0.042). Additionally, the rate of allergic rhinitis was significantly higher among those with storage mite sensitivity (p = 0.018). Sensitivity to cat dander was significantly higher in female patients than male patients (p = 0.042).
Conclusion: Identifying allergen sensitivity through skin prick testing supports the avoidance of suspected allergens and aids in the treatment of the disease. Our study found that individuals with atopic disease living in the Çorum region were most frequently sensitized to house dust mites, followed by storage mites, in line with the region's climate conditions. We believe that this study will contribute to the literature by mapping allergen distribution in our region and serve as a guide for preventive measures and treatment for patients and healthcare providers.
Keywords: Skin prick test, Allergic rhinitis, Asthma, Atopic dermatitis, Urticaria
