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Öğe Duzce University Hospital in the Pandemic Process: From the Perspective of Chief Physician(Duzce Univ, 2020) Akcan, Fatih Alper; Onec, Kursad; Annakkaya, Ali Nihat; Pehlivan, Mevlut; Karaduman, Zekeriya Okan; Balbay, Oner Abidin; Ergun, Hacer AkWe aimed to compile the effects of the preparations on the new coronavirus outbreak (Covid-19) in the largest pandemic, which is still visible in the world. Pandemics have caused millions of people to become ill, disabled and death for centuries Thanks to past pandemics that deeply affect the society health, socially and economically, preparations have been made again against possible pandemics. Preparations may not go as planned. Desperation may occur for unforeseen situations. Despite these despair, the tool that can contribute in practice besides the basic principles in combating pandemics can be obtained from the past. Like every pandemic, the pandemic will end one day. Those applied and not implemented after the outbreak will be evaluated and will remain a lesson from the past for future outbreaks.Öğe Mediation Effect of Depression on the Association between Food Addiction and Body Image in Individuals with Obesity(Duzce Univ, Fac Medicine, 2021) Usta, Esra; Pehlivan, MevlutObjective: This study aimed to examine the mediation effect of depression on the association between food addiction and body dissatisfaction in patients who seek for treatment for obesity. Methods: The study population consisted of 105 patients admitted to an obesity center in a university hospital. Data from were collected with the patient information form, the Yale Food Addiction Scale, the Beck Depression Inventory, and the Body Image Scale. The direct relationship between food addiction and body dissatisfaction and the mediating effect of depression in the relationship between these two constructs were examined using multi-group structural equation modeling analysis by gender. Results: The mean age of the patients was 50.22 +/- 10.05, 86.8% of them were females. The mean body mass index of the patients was calculated as 40.29 +/- 6.67. It was determined that 38.7% of the sample met the food addiction diagnosis criteria. It was found that 39.1% of females and 35.7% of males had food addiction. As a result of the modeling analysis, it was determined that there was no direct pathway between body dissatisfaction and food addiction, depression symptoms complete mediated the relationship between these two constructs. Results of multi-group analysis showed that the mediation model was consistent across gender. Conclusions: In the treatment of obesity cases in which food addiction and body image disorders coexist, examining the existence of depression and treating it can increase the success rate.Öğe The Prevalence of Obstructive Sleep Apnea in Bariatric Surgery Patients(Duzce Univ, Fac Medicine, 2023) Annakkaya, Ali Nihat; Balbay, Ege Gulec; Pehlivan, Mevlut; Balbay, Oner AbidinObjective: Obesity is one of the most important risk factors and also consequences of obstructive sleep apnea (OSA). Weight loss and positive airway pressure therapy are the main approaches in the treatment of OSA. In this study, it was aimed to evaluate the prevalence of OSA in obesity patients scheduled for bariatric surgery.Methods: In the University Hospital Obesity Center, 141 consecutive patients who were candidates for bariatric surgery in 2015 were clinically evaluated preoperatively for sleep-related respiratory disorders. Preoperative polysomnographic examination was recommended to all cases.Results: Of 141 bariatric surgery candidates with a mean age of 37 +/- 10 years, and 103 (73%) were female. The mean body mass index of the cases was 46.9 +/- 6.4 kg/m2. Among the major symptoms of OSA, snoring was present in 119 (84.4%), daytime sleepiness in 63 (44.7%) and witnessed apnea in 49 (34.8%) patients. OSA was detected because AHI>5/hour was found in 75.7% (84/111) of the patients who accepted the polysomnographic evaluation. 24.3% (27/111) of the cases who underwent polysomnography had non OSA, 29.7% (33/111) mild OSA, 17.1% (19/111) moderate OSA, and 28.8% (32 /111), severe OSA was detected. AHI was positively correlated with age (p=0.003), neck and waist diameter (p<0.001), and negatively correlated with percent of the forced vital capacity (p<0.001). In polysomnographic controls performed an average of 9 months after bariatric surgery, an average of 41.2% improvement in AHI was observed, compared to an average of 22.8% decrease in BMI.Conclusions: OSA prevalence was found to be very high in bariatric surgery candidates. It was thought that polysomnographic examination should be performed before bariatric surgery not only in symptomatic cases but also in all cases. Bariatric surgery can help improve OSA.Öğe Residual Gastric Volume Relationship and Weight Loss After Laparoscopic Sleeve Gastrectomy(Springer, 2020) Dogan, Sami; Onmez, Attila; Cetin, Mehmet Fuat; Ozaydin, Ismet; Pehlivan, MevlutBackground Laparoscopic sleeve gastrectomy (LSG) has become a popular procedure for treating obesity. Excessive residual gastric volume (RGV) may be one cause of insufficient weight loss following this surgery. The purpose of this study was to investigate the relationship between weight loss and the RGV measured during surgery over a 2-year follow-up period. Methods All patients undergoing LSG at our university surgery department were included in this prospective observational study. During the operation, the pylorus was grasped with a laparoscopic clamp, and saline solution dyed with methylene blue was introduced using an intraluminal glass-tipped injector when the residual stomach became fully visible. The amount of fluid given when the remaining gastric tissue ceased expanding was noted. The patients were divided into three groups depending on the volume of the residual gastric tissue. Percentages of excess weight loss (EWL%) were also evaluated 6, 12, and 24 months after the LSG. Results Sixty-two patients (50 females and 12 males) with a mean age of 36 (17-56) years were included in the study. There was no significant difference between the preoperative and postoperative body mass index values (p = 0.407 and p = 0.337, respectively) or between the preoperative and postoperative weight (p = 0.081 and p = 0.517, respectively) among the groups. A comparison of the participants' weight losses and EWL% values after 6, 12, and 24 months of follow-up revealed no significant difference among the groups at any time point (p > 0.005). Conclusion Greater weight loss was observed as the RGV decreased over the 24-month follow-up period. However, that weight loss was not statistically significant.Öğe Revisional Surgery After Failed Laparoscopic Sleeve Gastrectomy: Weight Loss and Improvement of Comorbidities(Mary Ann Liebert, Inc, 2024) Usta, Esra; Pehlivan, MevlutPurpose: This study aims to investigate the causes, outcomes, complications, and sustainable lifestyle changes of revision surgery performed after laparoscopic sleeve gastrectomy (LSG).Methods: This retrospective study included the outcomes of 30 patients who required a revisional surgery from a series of 538 primary LSGs. Demographic data of the patients, indications for revision surgery, complications, postoperative outcomes, and changes in lifestyle were recorded. Postoperative outcomes were analyzed over five periods.Results: In total, 18/30 patients (60.0%) underwent revision surgery for weight gain. Of the revision procedures, 53.3% were one anastomosis gastric bypass (OAGB), 33.3% were revisional sleeve gastrectomy (R-SG), and 13.3% were biliopancreatic diversion (BPD). Weight loss in patients after primary surgery was higher than the weight loss after revision surgery. However, while 43.20% of the total weight loss after primary surgery was recovered, only 23.54% was recovered after revision surgery. Except for obstructive sleep apnea syndrome, improvement in comorbidities was similar in primary surgery and revision surgery.Conclusions: Although revision surgery achieves lower weight loss than primary surgery, revision surgery is more successful in maintaining weight over time, and it has a limited effect on comorbidities.
