Özen Önen Sertöz

Bio: Özen Önen Sertöz is an academic researcher from Ege University. The author has contributed to research in topics: Anxiety & Population. The author has an hindex of 9, co-authored 23 publications receiving 458 citations.

Comparison of 4- and 8-h dialysis sessions in thrice-weekly in-centre haemodialysis: A prospective, case-controlled study

Abstract: Background Longer dialysis sessions may improve outcome in haemodialysis (HD) patients. We compared the clinical and laboratory outcomes of 8- and 4-h thrice-weekly HD. Methods Two-hundred and forty-seven HD patients who agreed to participate in a thrice-weekly 8-h in-centre nocturnal HD (NHD) treatment and 247 age-, sex-, diabetes status- and HD duration-matched control cases to 4-h conventional HD (CHD) were enrolled in this prospective controlled study. Echocardiography and psychometric measurements were performed at baseline and at the 12th month. The primary outcome was 1-year overall mortality. Results Overall mortality rates were 1.77 (NHD) and 6.23 (CHD) per 100 patient-years (P = 0.01) during a mean 11.3 ± 4.7 months of follow-up. NHD treatment was associated with a 72% risk reduction for overall mortality compared to the CHD treatment (hazard ratio = 0.28, 95% confidence interval 0.09-0.85, P = 0.02). Hospitalization rate was lower in the NHD arm. Post-HD body weight and serum albumin levels increased in the NHD group. Use of antihypertensive medications and erythropoietin declined in the NHD group. In the NHD group, left atrium and left ventricular end-diastolic diameters decreased and left ventricular mass index regressed. Both use of phosphate binders and serum phosphate level decreased in the NHD group. Cognitive functions improved in the NHD group, and quality of life scores deteriorated in the CHD group. Conclusions Eight-hour thrice-weekly in-centre NHD provides morbidity and possibly mortality benefits compared to conventional 4-h HD.

An analysis of nursing and medical students’ attitudes towards and knowledge of complementary and alternative medicine (CAM)

Abstract: Aims and objectives. This study aims to evaluate and compare nursing and medical students’ attitudes and knowledge about complementary and alternative medicine (CAM). Background. Despite increased popularity of the use of complementary and alternative medicine, it is not included in nursing and medicine schools’ curricula in many countries. Design. A cross-sectional design was used. Method. This study’s research population included 972 students who were educated at a school of nursing and a faculty of medicine during the academic year 2006–2007. The study used a questionnaire the researchers prepared as data collection form. Pearson chi-square test was used to observe the differences between nursing and medical students. A p-value <0·05 was accepted statistically significant. Results. The population was 49·1% nursing students and 50·9% medical students. Of the nursing students, 57·8% agreed with the statements that complementary and alternative medicine modalities should be integrated into clinical practice, 61·3% agreed for curriculum. Of the medical school students, 32·6% agreed for clinical practice and 37·9% for curriculum. The nursing students had sufficient knowledge of mostly massage and imagery; and medical students had sufficient knowledge of mostly diet therapy, vitamins and prayer. Conclusions. The results of current study reveal that nursing students adopt more positive attitudes than medical students towards complementary and alternative medicine therapies and that both student groups have limited knowledge of complementary and alternative medicine modalities. Relevance to clinical practice. Physicians and nurses play important roles in helping patients use complementary and alternative medicine safely and accurately. Therefore, as future nurses and physicians, nursing and medical students should have sufficient knowledge of and education on complementary and alternative medicine modalities. In this context, handling complementary and alternative medicine on a scientific scale and including it in nursing and medical students’ educational programmes should be among the goals and plans in Turkey.

The role of BDNF and HPA axis in the neurobiology of burnout syndrome.

Abstract: Chronic stress is known to affect the HPA axis. The few clinical studies which have been conducted on HPA-axis function in burnout have produced inconsistent results. The etiological relationship between sBDNF and burnout has not yet been studied. The aim of the current study was to investigate the role of BDNF and HPA axis in the neurobiology of burnout. In the current study 37 clinically diagnosed burnout participants were compared with 35 healthy controls in terms of BDNF, HPA axis, burnout symptoms, depression, anxiety and psychosomatic complaints. Basal serum cortisol, sBDNF and cortisol level after 1 mg DST was sampled. We found no significant differences in terms of HPA-axis function (for basal serum cortisol, p = 0.592; for cortisol level after 1 mg DST, p = 0.921), but we did find lowered sBDNF levels in burnout group (88.66 ± 18.15 pg/ml) as compared to healthy controls (102.18 ± 20.92 pg/ml) and the difference was statistically significant ( p = 0.005). Logistic Regression Analysis revealed that emotional exhaustion ( p = 0.05), depersonalization ( p = 0.005) and depression ( p = 0.025) were significantly associated with burnout. sBDNF levels correlated negatively with emotional exhaustion ( r = −,268, p = 0.026), depersonalization ( r = −,333, p = 0.005) and correlated positively with competence ( r = 0.293, p = 0.015) sub-scales of burnout inventory. However, there were no significant relationships between cortisol levels and sBDNF levels ( r = 0.80, p = 0.51), depression, anxiety, psychosomatic complaints and burnout inventory. Our results suggest that low BDNF might contribute to the neurobiology of burnout syndrome and it seems to be associated with burnout symptoms including altered mood and cognitive functions.

When Not Enough Is Too Much: The Role of Insufficient Glucocorticoid Signaling in the Pathophysiology of Stress-Related Disorders

Abstract: Objective: Previous theories have emphasized the role of excessive glucocorticoid activity in the pathology of chronic stress. Nevertheless, insufficient glucocorticoid signaling (resulting from decreased hormone bioavailability or reduced hormone sensitivity) may have equally devastating effects on bodily function. Such effects may be related in part to the role of glucocorticoids in restraining activation of the immune system and other components of the stress response, including the sympathetic nervous system (SNS) and corticotropin-releasing hormone (CRH). Method: The literature on neuroendocrine function and glucocorticoid-relevant pathologies in stress-related neuropsychiatric disorders, including posttraumatic stress disorder and major depression, was reviewed. Results: Although not occurring together, both hypocortisolism and reduced responsiveness to glucocorticoids (as determined by dexamethasone challenge tests) were reliably found. Stress-related neuropsychitric disorders were also associated ...

EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion

Abstract: Atrial fibrillation (AF) is the most common clinically relevant cardiac arrhythmia. The estimated prevalence in the general population is 1–2% and increases with age.1–8 Patients with AF are at increased risk of thromboembolism, in particular ischaemic stroke. The risk of stroke in patients with non-valvular (essentially non-rheumatic) AF is ∼5% per year.9 Moreover, strokes related to AF are associated with a higher mortality and morbidity when compared with non-AF strokes, emphasizing the need for more effective stroke prevention in these patients.10 The CHADS2 score (cardiac failure, hypertension, age, diabetes, stroke counted double) was established to assess the risk of thrombo-embolic events in patients with AF of non-valvular origin.11 Although there is a clear relationship between the CHADS2 score and stroke rate, the CHA2DS2-VASc score has recently been introduced and adopted by the European Society of Cardiology (ESC) as well as by American Heart Association, American College of Cardiology, and Heart Rhythm Society and other national bodies’ guidelines for AF in an attempt to improve risk stratification in the low-risk group by considering additional stroke risk factors (gender, vascular disease) in addition to old factors including cardiac failure, hypertension, age (divided to two risk classes) diabetes, and stroke that may influence a decision for anticoagulation therapy.12 Prospective and randomized studies show that oral anticoagulation (OAC) significantly reduces the risk of thromboembolism.13 However, this treatment is underutilized in patients with AF due to poor patient compliance, contraindications, and potential bleeding complications.14–18 The pathogenesis of thrombogenesis in AF is multifactorial and includes the Virchow triad of events leading to thrombus formation, i.e. endothelial or endocardial damage or dysfunction, abnormal blood stasis, and altered haemostasis, platelet function, and fibrinolysis.19 There is evidence for endothelial damage, as …