Browsing by Author "Demirci, Nilgun Yilmaz"

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Anxiety and Depression Levels of Healthcare Workers During COVID-19 Pandemic
(2021) Turan, Muzaffer Onur; Demirci, Nilgun Yilmaz; Ak, Guntulu; Akcay, Sule; Akturk, Ulku Aka; Bilaceroglu, Semra; Coskun, Funda; Kokturk, Oguz; Mirici, Arzu; Cengiz, Ozdemi. R.; Sen, Nazan; Yilmaz, Ulku
Effect of Asbestos Exposure on the Frequency of EGFR Mutations and ALK/ROS1 Rearrangements in Patients With Lung Adenocarcinoma A Multicentric Study
(2021) Yilmaz, Senay; Demirci, Nilgun Yilmaz; Metintas, Selma; Zamani, Adil; Karadag, Mehmet; Guclu, Ozge A.; Kabalak, Pinar Akin; Yilmaz, Ulku; Ak, Guntulu; Kizilgoz, Derya; Ozturk, Akin; Yilmaz, Ufuk; Batum, Ozgur; Kavas, Murat; Serifoglu, Irem; Unsal, Meftun; Komurcuoglu, Berna E.; Cengiz, Tuba Inal; Ulubay, Gaye; Ozdemirel, Tugce S; Ozyurek, Berna A.; Kavurgaci, Suna; Alizoroglu, Dursun; Celik, Pinar; Erdogan, Yurdanur; In, Erdal; Aksoy, Asude; Altin, Sedat; Gunluoglu, Gulsah; Metintas, Muzaffer; 33399308
Objective: The aim of this study is to investigate the effect of asbestos exposure on cancer-driver mutations. Methods: Between January 2014 and September 2018, epidermal growth factor receptor (EGFR), anaplastic lymphoma receptor tyrosine kinase (ALK), and c-ros oncogene 1 receptor tyrosine kinase gene (ROS1) alterations, demographic characteristics, asbestos exposure, and asbestos-related radiological findings of 1904 patients with lung adenocarcinoma were recorded. Results: The frequencies of EGFR mutations, ALK, and ROS1 rearrangements were 14.5%, 3.7%, and 0.9%, respectively. The rates of EGFR mutations and ALK rearrangements were more frequent in asbestos exposed non-smokers (48.7% and 9%, respectively). EGFR mutation rate was correlated to female gender and not-smoking, ALK rearrangement rate was correlated to younger age, not-smoking, and a history of asbestos exposure. Conclusions: The higher rate of ALK rearrangements in asbestos-exposed lung adenocarcinoma cases shows that asbestos exposure may most likely cause genetic alterations that drive pulmonary adenocarcinogenesis.
Evaluation of Exudative Pleural Effusions: A Multicenter, Prospective, Observational Study
(2022) Ak, Guntulu; Metintas, Selma; Taskin, Ayse Naz; Sener, Melahat Uzel; Soyler, Yasemin; Yilmaz, Meltem; Turna, Akif; Kabalak, Pinar Akin; Bilaceroglu, Semra; Koksal, Deniz; Demirci, Nilgun Yilmaz; Sogukpinar, Ozlem; Boga, Sibel; Ercelik, Merve; Karadeniz, Gulistan; Polat, Gulru; Guldaval, Filiz; Akturk, Ulku Aka; Yilmaz, Senay; Ogan, Nalan; Yilmaz, Saliha; Esendagli, Dorina; Caglayan, Benan; Zeybek, Arife; Kocak, Nagihan Durmus; Mutlu, Pinar; Baytemir, Cansel Atinkaya; Mutlu, Pinar; Baytemir, Cansel Atinkaya; Sarbay, Ismail; Yilmaz, Ulku; Metintas, Muzaffer; 36173482
Purpose The aim of this study is to determine the diagnostic performances of pleural procedures in undiagnosed exudative pleural effusions and to evaluate factors suggestive of benign or malignant pleural effusions in tertiary care centers. Methods This was a multicenter prospective observational study conducted between January 1 and December 31, 2018. A total of 777 patients with undiagnosed exudative pleural effusion after the initial work-up were evaluated. The results of diagnostic procedures and the patients' diagnoses were prospectively recorded. Sensitivity, specificity, and accuracy estimates with 95% confidence intervals were used to examine the performance of pleural procedures to detect malignancy. Results The mean age +/- SD of the 777 patients was 62.0 +/- 16.0 years, and 68.3% of them were male. The most common cause was malignancy (38.3%). Lung cancer was the leading cause of malignant pleural effusions (20.2%). The diagnostic sensitivity and accuracy of cytology were 59.5% and 84.3%, respectively. The diagnostic sensitivity of image-guided pleural biopsy was 86.4%. The addition of image-guided pleural biopsy to cytology increased diagnostic sensitivity to more than 90%. Thoracoscopic biopsy provided the highest diagnostic sensitivity (94.3%). The highest diagnostic sensitivity of cytology was determined in metastatic pleural effusion from breast cancer (86.7%). Conclusion The diagnostic performance increases considerably when cytology is combined with image-guided pleural biopsy in malignant pleural effusions. However, to avoid unnecessary interventions and complications, the development of criteria to distinguish patients with benign pleural effusions is as important as the identification of patients with malignant pleural effusions.
Five-Year Trends in Direct Costs of Chronic Obstructive Pulmonary Disease in Turkey: COPDTURKEY-3
(2021) Ozdemir, Tarkan; Kilic, Hatice; Demirci, Nilgun Yilmaz; Ozdilekcan, Cigdem; Bektemur, Guven; Turkkani, Mustafa Hamidullah; Malhan, Simten; Hasanoglu, H. Canan; Koc, Orhan; Ozturk, Can; 35110213
OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is one of the major causes of mortality and morbidity worldwide. The aim of this study was to reveal the trend in direct costs related to COPD between 2012 and 2016, and to evaluate hospital costs in 2016, together with their subcomponents. MATERIAL AND METHODS: A population-based descriptive study was conducted using administrative healthcare data in Turkey. The total direct cost of COPD diagnosis-treatment for each year from 2012 to 2016, was calculated. The distribution of the hospital's COPD-related costs for the year 2016 was also examined, together with morbidity data. RESULTS: The direct costs of the patients who were admitted to step 1, step 2, and step 3 health care centers between 2012 and 2016 increased by 41% [895 041 403TL ($496 930 501) in 2012 to 1 263 288 269TL ($417 834 197) in 2016]; the increase was 60% and 24%, for inpatient and outpatient groups respectively. In the year 2016, the direct total cost was 1003TL ($332) per patient. In 2016, mean specialist consultations per patient with mean cost per specialist consultation, and mean emergency visits per patient with mean cost per emergency visit, were 1.7, 42 TL ($14), and 0.4, 71TL ($23) respectively. For the inpatient group, the mean number of hospitalizations per patient, mean number of hospitalization days, and the mean cost per hospitalization were 0.4, 6.5, and 1926T1 ($637), respectively. CONCLUSION: When the readmissions of patients with COPD were evaluated together with the costs, and compared with the statistics from other countries, it was found that the costs per patient were lower in Turkey. However, the reasons for the significant rise in inpatient costs compared to outpatient costs should be investigated. Further investigations are required regarding pulmonary rehabilitation, home health care services, preventive measures for infections, management of comorbidities, and treatment optimization, which may reduce hospitalizations.