Browsing by Author "Oksuz, Ergun"

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Amifostine enhances the antioxidant and hepatoprotective effects of UW and HTK preservation solutions
(2014) Akbulut, Sami; Sevmis, Sinasi; Karayakali, Hamdi; Bayraktar, Nilufer; Unlukaplan, Muge; Oksuz, Ergun; Dagdeviren, Atilla; 25232264
AIM: To investigate whether amifostine contributes to the antioxidant and cytoprotective effects of histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) preservation solutions. METHODS: Forty-eight Sprague Dawley male rats were equally divided into six groups: (1) ringer Lactate (RL) group; (2) RL + amifostine (RL + A) group; (3) HTK group; (4) HTK + A group; (5) UW group; and (6) UW + A group. Rats in the RL + A, HTK + A and UW + A groups were administered amifostine intraperitoneally at a dose of 200 mg/kg prior to laparotomy. The RL group was perfused with RL into the portal vein. The RL + A group were perfused with RL into the portal vein after amifostine administration. The HTK group received an HTK perfusion while the HTK + A group received an HTK perfusion after administration of amifostine. The UW group received a perfusion of UW, while the UW + A group received a UW perfusion after amifostine administration. Liver biopsy was performed to investigate histopathological, immunochemical [transferase mediated dUTP nick end labeling (TUNEL), inducible nitric oxide syntetase (iNOS)] and ultrastructural alterations. Biochemical alterations were determined by examining levels of alanine aminotransferase, alkaline phosphatase and nitric oxide in the perfusion fluid. RESULTS: Pathological sinusoidal dilatation and centrilobular hydropic alteration were significantly lower in the groups that received amifostine prior to preservation solution perfusion. Although the best results were obtained in the UW + A group, we did not observe a statistically significant difference between the UW + A and HTK + A groups. iNOS grades were significantly lower in the amifostine groups 12 h after treatment. When the amifostine groups were compared against each other, the iNOS grades obtained from the UW + A and HTK + A groups were similar while the RL + A group had a much poorer score. TUNEL assays demonstrated a lower apoptosis ratio in the amifostine groups than in the non-amifostine groups 12 h after treatment. No statistically significant difference was observed between the UW + A and HTK + A groups for apoptosis. Cellular ultrastructure was best preserved in the UW + A and HTK + A groups. CONCLUSION: Here, we show that preoperative administration of a single dose of amifostine is sufficient to minimize the preservation damage in hepatic cells. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
Analysis of the treatment costs of HIV/AIDS in Turkey
(2016) Malhan, Simtem; Zengin, Tuba Elbir; Yenilmez, Fatma Betul; Dalgic, Canan; Cerci, Pamir; Oksuz, Ergun; Unal, Serhat; 0000-0002-5723-5965; K-8238-2012
OBJECTIVE: Infection with the human immunodeficiency virus (HIV), the causative agent of acquired immune deficiency syndrome (AIDS), is a major global health problem. Patients with HIV can live normal lives with today's new treatment options. As the treatment is generally successful, the life expectancy of patients infected with HIV is rising. As a result, the economic burden of HIV treatment on health systems is set to increase. According to the Ministry of Health, there were more than 6000 HIV-positive patients in Turkey in 2013. The aim of this study was to determine the direct costs of HIV treatment in Turkey. METHOD: A retrospective data analysis was performed from the reimbursement agency perspective. Data for 252 patients at a university hospital in Ankara from 2001 to 2012 were used for the analysis. The average costs of treatment per HIV patient and the average costs per HIV patient, depending on the state of the patient's health, were calculated. The latter was determined according to the number of CD4 cells/ml, as defined by the CDC's classification system for HIV infection. The cost of treatment was calculated based on published reimbursement prices in 2013, per patient per year. RESULTS: The CD4 values of 25.3%, 29%, and 45.7% of the 252 patients were < 100 cells/mm(3), 100-300 cells/mm(3), and > 300 cells/mm(3), respectively. The treatment costs per patient per year for 2013 for those with CD4 values of < 100 cells/ mm(3), 100-300 cells/mm(3), and > 300+ cells/mm(3) were $ 5,637.04, $ 2,211.54, and $ 2,182.35, respectively. The weighted average of the treatment cost per patient was $ 3,344.64 for 2013. CONCLUSION: This analysis is unique to Turkey and calculates the cost only of HIV treatment in Turkey. Lower CD4 values are associated with higher treatment costs. Appropriate HIV treatment is crucial for controlling CD4 values and lowering the treatment costs of HIV patients. These findings need to be considered by policy makers who may need to focus on HIV.
Assessment of the Direct Medical Costs of Type 2 Diabetes Mellitus and its Complications in Turkey
(2014) Malhan, Simten; Oksuz, Ergun; Babineaux, Steven M.; Ertekin, Ali; Palmer, James P.; 0000-0002-5723-5965; K-8238-2012
Purpose: To estimate the direct annual medical costs of Type 2 diabetes and its complications in diagnosed patients in Turkey. Material and Method: A cost-of-illness model was developed. The prevalence of Type 2 diabetes was derived from the Turkish Diabetes Epidemiology Study, estimated as 13.7% in adults, with one-third of patients previously undiagnosed. Complication costs were extracted from the records of 7095 patients at a Turkish tertiary care hospital in 2009. For each modelled complication, acute phase costs were applied to globally derived incidence rates, and one-year follow-up costs were applied to globally derived prevalence rates. Costs and frequencies of ongoing antihyperglycaemic treatment and disease management were derived from treatment guidelines and Turkish hospital records. Parameter variation was performed. Results: The cost of Type 2 diabetes in diagnosed patients was estimated at between 11.4 to 12.9 billion Turkish Lira, 1% of Gross Domestic Product. Cardiovascular complications comprised the largest share of total medical costs (between 24.3% and 32.6%), followed by renal complicationsrelated costs (between 25% and 28.3%) and concomitant cardiovascular and antihypertensive medication costs (between 14.2% and 16%). Antihyperglycaemic medications and screening costs comprised between 10.9% to 12.3% and between 4.4% to 5% of total costs, respectively. Discussion: Type 2 diabetes is a disease burden and economic burden in Turkey; the complications cost is higher than the cost of disease control. For preventing complications, any activities effect positively limited resources and also quality of life.
The Changing Dynamics Of Neutralizing Antibody Response Within 10 Months Of SARS-Cov-2 Infections
(2022) Bastug, Aliye; Bodur, Hurrem; Aydos, Omer; Filazi, Nazlican; Oksuz, Ergun; https://orcid.org/0000-0002-5723-5965; 34967013; K-8238-2012
There are limited data on how long neutralizing antibody (NAb) response elicited via primary SARS-CoV-2 infection will last. Eighty-four serum samples were obtained from a prospective cohort of 42 laboratory-confirmed COVID-19 inpatients at the time of discharge from the hospital and in the late convalescent phase. A virus neutralization assay was performed to determine the presence and titers of NAbs with authentic SARS-CoV-2. Long-term dynamics of NAbs and factors that may have an impact on humoral immunity were investigated. Mild and moderate/severe patients were compared. The mean sampling time was 11.12 +/- 5.02 days (4-28) for the discharge test and 268.12 +/- 11.65 days (247-296) for the follow-up test. NAb response was present in 83.3% of the patients about 10 months after infection. The detectable long-term NAb rate was significantly higher in mild patients when compared to moderate/severe patients (95.7% vs. 68.4%, p = 0.025). In the follow-up, NAb-positive and -negative patients were compared to determine the predictors of the presence of long-term humoral immunity. The only significant factor was disease severity. Patients with mild infections have more chance to have NAbs for a longer time. Age, gender, and comorbidity did not affect long-term NAb response. NAb titers decreased significantly over time, with an average rank of 24.0 versus 19.1 (p = 0.002). Multivariate generalized estimating equation analysis revealed that no parameter has an impact on the change of NAb titers over time. The majority of the late convalescent patients still had detectable low levels of neutralizing antibodies. The protective effect of these titers of NAbs from re-infections needs further studies.
Cost of hemophilia A in Turkey: an economic disease burden analysis
(2021) Malhan, Simten; Oksuz, Ergun; Antmen, Bulent; Ar, Muhlis Cem; Balkan, Can; Kavakli, Kaan; 0000-0002-5723-5965; 34355649; K-8238-2012
Objective: Hemophilia A is the second most common bleeding disorder causing patients to have lifelong follow-up and treatment. Despite being a rare disease, hemophilia A has a high economic burden on individuals and the public. The purpose of this study was to estimate the total disease cost of hemophilia A in Turkey. Materials and Methods: Data used in this analysis were collected through literature review, including studies conducted in Turkey in December 2018. A disease burden analysis was performed by modeling hemophilia A-related costs among patients, their relatives, and the social security system. Two expert panels were held to evaluate real-world data sources and to provide further information. All direct medical and non-medical costs were calculated annually from the Social Security Institution of the Republic of Turkey perspective, while indirect costs were estimated from the patient and community perspective. Results: For the calendar year of 2018, the number of hemophilia A patients in Turkey were estimated to be 5,055, with an average weight of 64.7 kg. The average annual direct medical, direct non-medical, and indirect costs of hemophilia A were calculated as euro93,268 ($109,286; (sic)502,717), euro2,533 ($2,968; (sic)13,655), and euro7,957 ($9,323; (sic)42,888) per patient, respectively, with a total annual cost of euro103,759 ($121,578; (sic)559,259). For the management of patients with inhibitors (4.9%), the average annual total cost was calculated to be euro325,439 ($381,330; (sic)1,754,117) per patient. The total annual disease burden of hemophilia A in 2018 was estimated to be about euro524 million ($614 million; (sic)2.82 billion), which corresponded to 1.6% of the total health expenditure in Turkey. Conclusion: The most important reason hemophilia A has a significant economic burden in Turkey is that replacement therapy is expensive. The major cost contributor was identified as factor replacement therapy. With inhibitor development, the average annual cost increased more than 3-fold.
Cost of illness among patients with diabetic foot ulcer in Turkey
(2016) Oksuz, Ergun; Malhan, Simten; Sonmez, Bilge; Tekin, Rukiye Numanoglu; 0000-0002-5723-5965; 27795820; K-8238-2012
AIM To evaluate the annual cost of patients with Wagner grade 3-4-5 diabetic foot ulcer (DFU) from the public payer's perspective in Turkey. METHODS This study was conducted focused on a time frame of one year from the public payer's perspective. Cost-of-illness (COI) methodology, which was developed by the World Health Organization, was used in the generation of cost data. By following a clinical path with the COI method, the main total expenses were reached by multiplying the number of uses of each expense item, the percentage of cases that used them and unit costs. Clinical guidelines and real data specific to Turkey were used in the calculation of the direct costs. Monte Carlo Simulation was used in the study as a sensitivity analysis. RESULTS The following were calculated in DFU treatment from the public payer's perspective: The annual average per patient outpatient costs $579.5 (4.1%), imaging test costs $283.2 (2.0%), laboratory test costs $284.8 (2.0%), annual average per patient cost of intervention, rehabilitation and trainings $2291.7 (16.0%), annual average per patient cost of drugs used $2545.8 (17.8%) and annual average per patient cost of medical materials used in DFU treatment $735.0 (5.1%). The average annual per patient cost for hospital admission is $7357.4 (51.5%). The average per patient complication cost for DFU is $210.3 (1.5%). The average annual per patient cost of DFU treatment in Turkey is $14287.70. As a result of the sensitivity analysis, the standard deviation of the analysis was $5706.60 (n = 5000, mean = $14146.8, 95% CI: $13988.6-$14304.9). CONCLUSION The health expenses per person are $-PPP 1045 in 2014 in Turkey and the average annual per patient cost for DFU is 14-fold of said amount. The total health expense in 2014 in Turkey is $-PPP 80.3 billion and the total DFU cost has a 3% share in the total annual health expenses for Turkey. Hospital costs are the highest component in DFU disease costs. In order to prevent DFU, training of the patients at risk and raising consciousness in patients with diabetes mellitus (DM) will provide benefits in terms of economy. Appropriate and efficient treatment of DM is a health intervention that can prevent complications.
Cost-Effectiveness Analysis of Remdesivir Treatment in COVID-19 Patients Requiring Low-Flow Oxygen Therapy: Payer Perspective in Turkey
(2021) Oksuz, Ergun; Malhan, Simten; Gonen, Mustafa Sait; Kutlubay, Zekayi; Keskindemirci, Yilmaz; Jarett, James; Sahin, Toros; Ozcagli, Gokcem; Bilgic, Ahmet; Bibilik, Merve Ozlem; Tabak, Ozlem; 0000-0002-5723-5965; 34379304; K-8238-2012
Introduction This study aims to evaluate the cost-effectiveness of remdesivir compared to other existing therapies (SoC) in Turkey to treat COVID-19 patients hospitalized with < 94% saturation and low-flow oxygen therapy (LFOT) requirement. Methods We compared remdesivir as the treatment for COVID-19 with the treatments in the Turkish treatment guidelines. Analyses were performed using data from 78 hospitalized COVID-19 patients with SpO(2) < 94% who received LFOT in a tertiary healthcare facility. COVID-19 episode costs were calculated for 78 patients considering the cost of modeled remdesivir treatment in the same group from the payer's perspective. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) was calculated for remdesivir versus the SoC for the population identified. For Turkey, a reimbursement threshold value between USD 8599 (1 x per capita gross domestic product-GDP) and USD 25.797 (3 x GDP) per QALY was used. Results In the remdesivir arm, the length of hospital stay (LOS) was 3 days shorter than the SOC. The low ventilator requirement in the remdesivir arm was one factor that decreased the QALY disutility value. In patients who were transferred to intensive care unit (ICU) from the ward, the mean LOS was 17.3 days (SD 13.6), and the mean cost of stay was USD 155.3/day (SD 168.0), while in patients who were admitted to ICU at baseline, the mean LOS was 13.1 days (SD 13.7), and the mean cost of stay was USD 207.9/day (SD 133.6). The mean cost of episode per patient was USD 3461.1 (SD 2259.8) in the remdesivir arm and USD 3538.9 (SD 3296.0) in the SOC arm. Incremental QALYs were estimated at 0.174. Remdesivir treatment was determined to be cost saving vs. SoC. Conclusions Remdesivir, which results in shorter LOS and lower rates of intubation requirements in ICU patients than existing therapies, is associated with higher QALYs and lower costs, dominating SoC in patients with SpO(2) < 94% who require oxygen support.
COVID-19 healthcare cost and length of hospital stay in Turkey: retrospective analysis from the first peak of the pandemic
(2021) Oksuz, Ergun; Malhan, Simten; Gonen, Mustafa Sait; Kutlubay, Zekayi; Keskindemirci, Yilmaz; Tabak, Fehmi; 0000-0002-5723-5965; 34623528; K-8238-2012
Background During the COVID-19 pandemic, health care systems are under extreme pressure. This study analyzed health care resource use (HCRU) and costs in patients admitted to the hospital for COVID-19 and aimed to estimate the one-year direct medical cost of the disease in Turkey. Methods This retrospective cohort study was conducted between March and July 2020 in a tertiary hospital (n = 1056) in Istanbul. Patient demographics, clinical and treatment characteristics at admission, comorbidities, disease severity, and costs from a payer perspective were evaluated using the microcosting method. The results include LOS, hospital costs, and univariate and generalized linear models to investigate influencing factors. The data were extrapolated to provide a country-level estimate. Results The mean length of stay was 9.1 days (SD 6.9). The mean length of stay was 8.0 days (4.7) for patients hospitalized in wards versus 14.8 days (SD 12.0) for patients hospitalized in the ICU. In univariate analysis, several factors, including O-2 therapy (+ 3.7 days), high CRP > 41.8 mg/L (+ 3.8 days), and elevated ferritin (+ 3.5), were found to be associated with a longer LOS (p < 0.05). The direct annual medical cost of COVID-19 was estimated at PPP$ 2.1 billion. The COVID-19 pandemic resulted in a direct medical burden that corresponds to 2.0% of the government health expenditures and 0.8 per thousand of Turkey's gross domestic product (GDP). Conclusions Estimating the impact of this pandemic in terms of HCRU and costs to the health care system can help design strategies to manage the pandemic.
Economic Burden Of Lung Cancer In Turkey: A Cost Of Illness Study From Payer Perspective
(2021) Cicin, Irfan; Oksuz, Ergun; Karadurmus, Nuri Nuri; Malhan, Simten; Gumus, Mahmut; Yilmaz, Ulku; Cansever, Levent; Cinarka, Halit; Cetinkaya, Erdogan; Kiyik, Murat; Ozet, Ahmet; 0000-0002-5723-5965; 34173876; K-8238-2012
Background This study was designed to estimate economic burden of lung cancer in Turkey from payer perspective based on expert panel opinion on practice patterns in clinical practice. Methods In this cost of illness study, direct medical cost was calculated based on cost items related to outpatient visits, laboratory and radiological tests, hospitalizations/interventions, drug treatment, adverse events and metastasis. Indirect cost was calculated based on lost productivity due to early retirement, morbidity and premature death resulting from the illness, the value of lost productivity due to time spent by family caregivers and cost of formal caregivers. Results Cost analysis revealed the total per patient annual direct medical cost for small cell lung cancer to be euro8772), for non-small-cell lung cancer to be euro10,167. Total annual direct medical cost was euro497.9 million, total annual indirect medical cost was euro1.1 billion and total economic burden of lung cancer was euro1.6 billion. Hospitalization/interventions (41%) and indirect costs (68.6%) were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively. Conclusions Our findings indicate per patient direct medical costs of small cell lung cancer and non-small-cell lung cancer to be substantial and comparable, indicating the substantial economic burden of lung cancer in terms of both direct and indirect costs. Our findings indicate that hospitalization/interventions cost item and indirect costs were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively. Our findings emphasize the potential role of improved cancer prevention and early diagnosis strategies, by enabling cost savings related to drug treatment and metastasis management cost items, in sustainability of cancer treatments.
Economic Burden of Pediatric Asthma in Turkey: A Cost of Illness Study from Payer Perspective
(2020) Sekerel, Bulent Enis; Turktas, Haluk; Bavbek, Sevim; Oksuz, Ergun; Malhan, Simten; 0000-0002-5723-5965; 32687785; K-8238-2012
OBJECTIVES: To estimate economic burden of pediatric asthma in Turkey from payer perspective. MATERIALS AND METHODS: This cost of illness study was based on identification of per patient annual direct medical costs for the management of pediatric asthma in Turkey from payer perspective. Average per patient direct medical cost was calculated based on cost items related to outpatient visits, laboratory and radiological tests, hospitalizations and interventions, drug treatment and equipment, and co-morbidities/complications. RESULTS: Based on total annual per patient costs calculated for outpatient admission ($113.14), laboratory-radiological tests ($35.94), hospitalizations ($725.92), drug treatment/equipment ($212.90) and co-morbidities/complications ($144.62) cost items, total per patient annual direct medical cost related to management of pediatric asthma was calculated to be $1,232.53 from payer perspective. Hospitalizations and interventions (58.9%) was the main cost driver. Direct cost for managing controlled and uncontrolled pediatric asthma were calculated to be $530.17 [key cost driver: drugs/equipment (40.0%)] and $1,023.16 [key cost driver: hospitalization/interventions (59.0%)], respectively. CONCLUSION: Our findings indicate that managing patients with pediatric asthma pose a considerable burden to health economics in Turkey, with hospitalizations identified as the main cost driver and two-fold cost increment in case of uncontrolled disease.
Efficacy and Cost-Effectivity Analysis of Outpatient Parenteral Antimicrobial Therapy Unit in Infectious Disease Clinical Practices: Turkey Perspective
(2021) Bastug, Aliye; Oksuz, Ergun; Kazancioglu, Sumeyye; Malhan, Simten; Ozbay, Bahadir Orkun; Bodur, Hurrem; 0000-0002-5723-5965; 33709495; K-8238-2012
Background Outpatient parenteral antimicrobial treatment (OPAT) has become a common treatment modality in developed countries. OPAT units are not widespread in Turkey, and their cost-effectivity analysis has not been studied, yet. Aims To analyze the clinical efficacy and cost-effectiveness of the OPAT unit, based on a 1000-bed teaching hospital. Methods The records of patients, who were treated between October 2013 and December 2017, in an OPAT unit of a tertiary hospital in Ankara, were obtained retrospectively. The cost that would arise if the patients were hospitalized for the same treatment period with the same diagnosis was calculated and compared with the actual treatment cost of the patients in the OPAT unit. Results A total of 594 patients who received antimicrobial treatment at the OPAT unit were enrolled. The mean age of the patients was 55.39 +/- 16.37 years and 313 (52.7%) were males. Based on the end-of-treatment goals, 98.5% of the patients reached the treatment goal. An indirect cost analysis revealed that the OPAT unit was 487.625 94 TL/129.008 78 $ less costly than inpatient parenteral antibiotic treatment. In other words, OPAT cost was 75% of the equivalent inpatient costs. It was also determined that a total of 7078 bed days and 11.9 bed days per person were saved. Conclusions OPAT units should be expanded increasingly in Turkey. The evaluation together with the health care system conditions in Turkey revealed that the OPAT program is safe, effective, and cost-efficient.
Evaluation of the Methods Used for the Vital Signs Measurement in Hospitalized Patients
(2018) Numanoglu, Rukiye; Kocak, Onur; Malhan, Simten; Oksuz, Ergun; 0000-0002-5723-5965; K-8238-2012
In general, vital signs measurements which includes measurement of blood pressure, body temperature, pulse and oxygen levels provide very important information about the health status of the hospitalized patients and the effects of treatment. Measurements and documentation of the vital signs carried out by nurses at hospitals. In this study, the methods used in vital signs measurements of hospitalized patients were evaluated by observations and interviews at a foundation university hospital and the advantages and disadvantages of the existing technologies were determined. As a result of interviews with healthcare providers and observations, it was determined that vital signs measurements of hospitalized patients were performed by 2 different methods. The mean time of vital signs measurements were determined as 3 minutes and 4 seconds (SD: 00:31) in medical treatment patients, 2 minutes and 11 seconds (SD: 00:18) in surgical patients, and 2 minutes and 37 seconds (SD: 00:37) in all patients. It was determined that the measurement results were recorded in the patient physical file in an average of 1 minute 2 seconds (SD: 00:52) and it was revealed that 15% of the measurement records were wrong, 26.9% were delayed and 10.6% were not recorded which performed by the nurses. It was also determined that the measurement results were not included in the hospital information system. It is thought that vital findings will provide important data for artificial intelligence studies in the following period with the recording of the results of the measurement to the electronic environment.
Patient Characteristics And Management Practices In Chronic Myeloid Leukemia In Turkey: Reflections From An Expert Meeting
(2022) Eskazan, Ahmet Emre; Ali, Ridvan; Alnigenis, Ebru; Ayyildiz, Orhan; Haznedaroglu, Ibrahim; Kirkizlar, Onur; Kurtoglu, Erdal; Malhan, Simten; Oksuz, Ergun; https://orcid.org/0000-0002-5723-5965; 35184657; K-8238-2012
Introduction The therapeutic landscape of chronic myeloid leukemia (CML) has evolved significantly since the introduction of imatinib. The European LeukemiaNet (ELN) recommendations serve as a guide for diagnosis, treatment, and monitorization of CML, but availability and accessibility of diagnostic tools and medications affect their applicability. Areas covered This article provides an overview of the current clinical management of CML in Turkey with reference to the key outputs of the online expert meeting held in November 2020. The applicability of the ELN 2020 recommendations for treating CML in clinical practice was also discussed. Expert opinion Imatinib is the only reimbursed and the most preferred first-line treatment in CML restricting the upfront use of second-generation tyrosine kinase inhibitors (TKIs), thereby limiting the applicability of treatment-free remission approach in Turkey. The ELN recommendations about using the EUTOS Long-Term Survival (ELTS) score for risk assessment and focusing on patient reported outcomes and quality of life can be enhanced with educational activities. The widespread availability of standardized technical infrastructure for diagnosing and monitoring CML will contribute to better disease management. Establishing a sustainable national database for CML is valuable for observing patient characteristics and disease outcomes as well as the impact of treatment patterns over time.
Practical Utility of Diagnostic Clinical Breast Examination in the Diagnosis of Breast Cancer
(2021) Turan, Muberra; Sozen, Fisun; Eminsoy, Muzaffer G.; Sencelikel, Tugce; Kut, Altug; Yildirim, Sedat; Oksuz, Ergun; 0000-0002-5723-5965; 34646704; K-8238-2012
Objectives We aimed to investigate the effectiveness of physician-performed diagnostic clinical breast examination (DCBE) for the diagnosis of breast cancer in clinical practice and to determine the rates of breast cancer diagnosed with DCBE compared to the results of breast ultrasonography (US), mammography (MG), and histopathology. Methods In the retrospective cohort study, the files of female patients diagnosed with breast cancer and admitted to the general surgery outpatient clinics of a university hospital over a 10-year period (2011-2021) were examined. Patients with complete DCBE findings in their files were identified and analyzed (n = 1,091). The examinations of the patients were performed by general surgery specialists with 5-22 years of experience and by radiologists with 4-15 years of experience. Results The mean age of breast cancer diagnosis of the patients was 55.1 +/- 13.5 years. While the sensitivity of IX:BE was found to be 88.9%, MG sensitivity was 89.8% and breast US sensitivity was 95.1%. Cancer was detected by MG, breast US, and DCBE in 47.9% (n = 523), by breast US and DCBE in 38.9% (n = 424), by MG and breast US in 5.6% (n = 61), by DCBE alone in 3.6% (n = 39), by MG and KBE in 2.4% (n = 26), and by breast US alone in 1.6% (n = 18). Early-stage breast cancer (p = 0.00) consisted of 73.2% (n = 383) of cancers detected with DCBE, breast US and MG, 74.6% (n = 316) of cancers detected with DCBE and breast US, 93.4% of cancers detected with breast US and MG (n = 57), 92.3% (n = 24) of cancers detected with DCBE and MG, 94.4% (n = 17) of cancers detected with breast US alone, and 69.2% of cancers detected with DCBE alone (n = 27). Conclusions CBE still maintains its importance in societies where screening participation and awareness of breast cancer are low. A breast cancer diagnosis is often done after a complaint of a palpable mass in the breast, and only then are more advanced-stage breast cancers are seen. CBE is among the important diagnostic methods preventing breast cancer from being overlooked, especially in places where health resources are limited.
Self-Medication Patterns among Turkish University Students
(2021) Zagil, Gamze Gursul; Fidan, Cihan; Oksuz, Ergun; Kut, Altug; 0000-0002-5723-5965; K-8238-2012
Objective: This study aims to determine the prevalence of self-medication practice among university students in Turkey and the effective factors and self-medication practices. Methods: To conduct a descriptive cross-sectional study, this study was conducted with 494 undergraduate students selected through a stratified random weight-proportional sample. The students were asked to fill in a self-report questionnaire form including introductory characteristics and self-medication practices. Analyses were carried out using descriptive statistics and binary logistic regression. Results: The prevalence of self-medication at any time was determined to be 81.6% (n=403). The prevalence of self-medication was 84.9% in females and 75.6% in males (OR 2.0, 95% CI 1.2-3.3, p=0.005). Of the participants, 27.5% (n=111) bought the medication by their own preferences and experiences. The most common self- medication symptoms of the participants were headache (90.8%). Self-medication drug groups were in the form of analgesics in 95.9% (n=259) of females and 93.2% (n=123) of males. The prevalence of antibiotic self-medication was 9.5% in the self-medication group and 7.7% for all participants. Due to self-medication, 8.2% (n=33) of the students experienced an adverse effect at any time. The students in the self-medication group believed that there would not be serious adverse effects caused by the OTC drugs even if they caused adverse effects (30.5%) or that they would not cause any adverse effects (3.8%). Conclusions: Self-medication is a common behavior among university students, with higher rates in females. Students practice this largely by relying on their previous experiences. They mostly prefer medicines previously given by their physicians for similar conditions.
Usage of Analgesics among Young Girls and Dysmenorrhea
(2017) Oksuz, Ergun; Sozen, Fisun; Kavas, Ece; Arik, Elif Pinar; Akgun, Yasemin; Bingol, Puren; Kotuz, Pinar; Ogus, Ersin; 0000-0002-9877-421X; 0000-0002-5723-5965; 0000-0002-1951-2693; AAJ-1058-2021; K-8238-2012; AAC-1823-2021
Objective: This study aimed to determine dysmenorrhea prevalence and menstruation characteristics among young girls and whether dysmenorrhea affects the use of analgesics. Methods: This cross-sectional study was conducted in female university students who applied to Baskent University's Medicosocial Center. Results: There were 190 participants in the dysmenorrhea group and 80 participants in the control group. The prevalence of dysmenorrhea was 70%. Reading of the drug prospectus in the dysmenorrhea group was higher than in the control group (69.9% vs. 46.8%, p < 0.05). Recommending her own drug to someone else (67.8% versus 53.3%, p < 0.05) and not paying attention to the recommended drug use period (72.5% vs. 59.7%; p < 0.05) was higher in the dysmenorrhea group than in the control group. In the dysmenorrhea group, the reasons to take the last pain relievers were headache or abdominal pain in the same order as the control group and the rate of abdominal pain was higher in the study group (30.0% versus 11.5%, p < 0.05). The inability to remember the name of the last used pain reliever was higher in the study group (24.2% versus 17.5%, p < 0.05). The rate of knowing the name of any three different pain relievers was higher in the study group (81.6% versus 80.4%, p < 0.05). Conclusion: University students who are in need of medication due to diseases more frequently encounter drugs. Developing behaviors on rational drug use in these students may provide productive results. It may be effective to organize contact meetings for students on the use of non-prescription drugs.