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.
Laparoskopik kolesistektomi uygulanan hastalara ultrasonografi eşliğinde yapılan subkostal transversus abdominis plan bloğu ile rekto-interkostal fasiyal plan bloğunun postoperatif analjezik etkinliklerinin karşılaştırılması
(Hitit Üniversitesi, 2025) Kitaplı, İbrahim; Kayır, Selçuk
Aim: Severe postoperative pain is observed in patients following laparoscopic cholecystectomy. Currently, peripheral nerve blocks, which are a part of multimodal analgesia, are widely used in postoperative pain management. This study investigated the effects of subcostal transversus abdominis plane nerve block (STAP), recto-intercostal fascial plane block (RIFPB) on postoperative NRS scores and tramadol consumption.
Material and method: This study was designed as a prospective, randomized, double-blind trial. Seventy-two patients scheduled for laparoscopic cholecystectomy were included in the study. One group received a bilateral STAP block (group S, n=35), while the other group received a bilateral recto-intercostal fascial plan block (RIFPB) (group R, n=35). For the peripheral nerve blocks, STAP was administered with 20 mL of 0.25% bupivacaine per side, RIFPB with 20 mL of 0.25% bupivacaine per side. These blocks were performed after the surgery but before the termination of general anesthesia. The postoperative NRS scores and tramadol consumption were compared between the groups.
Results: The groups were similar in terms of ASA scores and demographic characteristics. The rates of dermatomal involvement at the midclavicular line at T5 and T10 in the 2nd postoperative hour were found to be statistically significantly different between the groups (P=0.01 and P=0.044, respectively). Additionally, a statistically significant difference was observed between the groups in terms of T6–T9 dermatomal involvement at the midaxillary line at both the 2nd and 24th postoperative hours (P<.001). A statistically significant difference was also found between the groups regarding the time to mobilization (P=0.005). Furthermore, postoperative nausea and vomiting scores at hour 0 differed significantly between the groups (P=0.046).
Conclusion: In laparoscopic cholecystectomy procedures, both the STAP block and the RIFPB are effective in postoperative pain management. RIFPB may provide more effective analgesia compared to the STAP block alone, as it also targets the lateral cutaneous branches of the abdominal nerves in addition to those innervated by the STAP block.
Keywords: Laparoscopic cholecystectomy, Postoperative pain, Transversus abdominis plane block, Recto-intercostal fascial plane block
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.
Sivil toplum kuruluşlarında başarılı model tartışması: Ahbap örneği
(Hitit Üniversitesi, 2025) Demirtaş, Serkan; Bayramoğlu, Gökben
Non-Governmental Organizations, which have been an inseparable part of social life under different names throughout history, have gained increasing importance under the influence of neoliberal policies since the 1980s. With this new economic-political paradigm, where the welfare state model has given way to the welfare mix approach, states have begun to cooperate with Non-Governmental Organizations in implementing social policies or to transfer these responsibilities to Non-Governmental Organizations. This transformation has led to significant changes in the roles and functions of Non-Governmental Organizations.
Unlike profit-oriented organizations, the main purpose of Non-Governmental Organizations is not to make financial gains, but to fulfill their missions, provide social benefits and create social impact. Success criteria are evaluated based on abstract elements such as created social value, realization of the mission and ensuring social change and transformation, rather than measurable values such as financial performance.
The aim of this study conducted on Non-Governmental Organizations is to determine the basic elements required to create an effective management and organization model in Non-Governmental Organizations. The field work of the research was carried out in cooperation with Ahbap Association. Qualitative research method and phenomenological research design were used as research methodology. Semi-structured interview technique was preferred as the data collection tool and the data obtained from the interviews conducted with 13 participants who were in contact with Ahbap Association were analyzed using MAXQDA 2020 software.
Research findings show that the basic elements that determine the success of Non-Governmental Organizations can be gathered under three main categories. In the context of social impact; elements such as reliability, communication, social media, social marketing are of critical importance. In the context of leadership and human resources and volunteering; the identity of the leader, leadership style, competent human resources, volunteering and effective volunteer management were determined as prominent elements. In terms of strategic management and sustainability; It was determined that corporate governance concepts such as organizational mission, organizational culture, accountability and transparency reflecting the founding philosophy are important.
In this context, the findings of the study reveal that taking these elements into account in the management processes of Non-Governmental Organizations is of critical importance in terms of increasing their social impact and creating a sustainable organizational model.
