Sağlık Bilimleri Enstitüsü / Health Science Institute

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Compliance with Long-Term Use of Orthoses Following Spinal Cord Injury
(2022) Yemisci, Oya U.; Ozen, Selin; Cosar, Sacide N. Saracgil; Afsar, Sevgi, I; 35532629
Background: Prescription of orthoses and assistive devices that facilitate physical function is a major component of the rehabilitation process in spinal cord injury (SCI). Objective: To evaluate the long-term use of orthoses prescribed during inpatient rehabilitation in people with SCI and investigate the factors related to discarding the device. Materials and Methods: Medical records of 202 SCI patients who were included in an inpatient rehabilitation program of a tertiary research hospital were reviewed retrospectively. Patients' demographic data, neurological level of spinal cord injury functional state and use of assistive devices for ambulation (orthoses, walkers, etc.) at discharge were recorded. At follow-up, study participants were contacted by telephone and queried regarding the frequency and duration of use of orthoses; if the individual had discontinued using the orthoses, the reasons for discarding the device were sought. Results: The majority of the study participants (62.7%) had been prescribed a knee-ankle-foot orthosis during their inpatient stay. At follow-up, the regular use of orthoses was ongoing in 67.6% of the participants, and nonuse was determined in 32.4%. The most common cited reasons for discarding the device were difficulty in donning and doffing, functional improvement, and mechanical problems of the orthoses. Conclusions: A significant number of patients had discarded their orthoses at the long-term follow-up and the main reasons for discarding the devices were orthotic factors. Timely reevaluation of the patient and orthosis modification according to patients' needs is necessary to achieve long-term compliance.
Disease Characteristics of Psoriatic Arthritis Patients May Differ According to Age at Psoriasis Onset: Cross-Sectional Data from the Psoriatic Arthritis-International Database
(2021) Bilgin, E.; Aydin, S. Z.; Tinazzi, I.; Bayindir, O.; Kimyon, G.; Ozisler, C.; Dogru, A.; Dalkilic, E.; Aksu, K.; Cetin, G. Yildirim; Yilmaz, S.; Solmaz, D.; Omma, A.; Can, M.; Kucuksahin, O.; Yavuz, S.; Ersozlu, E.D.; Kilic, L.; Tarhan, E.F.; Tufan, M.A.; Akyol, L.; Cinar, M.; Erden, A.; Gonullu, E.; Yildiz, F.; Bakirci, S.; Erbasan, F.; Esmen, S.Ergulu; Kucuk, A.; Tufan, A.; Balkarali, A.; Mercan, R.; Erten, S.; Akar, S.; Kasifoglu, T.; Duruoz, T.; Yazisiz, V.; Kalyoncu, U.; 32662407
Objective To explore the impact of early versus late-onset psoriasis (PsO) on the disease characteristics of psoriatic arthritis (PsA) in a large-multicentre cohort. Methods The data from a multicentre psoriatic arthritis database was analysed. Patients were grouped according to age at psoriasis onset (early onset; 40 years of age, late-onset; 40 years of age) and disease characteristics of the groups were compared by adjusting for BMI and PsA duration, where necessary. Results At the time of analyses, 1634 patients were recruited [62.8% females; early onset 1108 (67.8%); late-onset, 526 (32.2%)]. The late-onset group was more over-weight [66.8% vs. 86.8%, p<0.001; adjusted for age -aOR 1.55 (1.11-2.20; 95% CI)]. The early onset group had more scalp psoriasis at onset (56.7% vs. 43.0%, p<0.001), whereas extremity lesions were more common in the late-onset group (63.8% vs. 74.2%, p<0.001). Axial disease in males and psoriatic disease family history in females were significantly higher in the early onset group [38.0% vs. 25.4%; p=0.005; adjusted for PsA duration -aOR 1.76 (1.19-2.62; 95% CI) / 39.5% vs. 30.1%; p=0.003; OR 1.51 (1.15-1.99; 95% CI), respectively]. Psoriatic disease activity parameters, patient-physician reported outcomes and HAQ-DI scores were similar in both groups. Conclusion Clinical features of PsA may be affected by the age at onset of PsO. Different genetic backgrounds in early and late-onset PsO may be driving the differences in psoriasis and PsA phenotypes.
The effect of elastic therapeutic taping and rigid taping on pain, functionality, and tissue temperature in lumbar radiculopathy: a randomized controlled study
(2021) Bozkurt, Tugce; Kilic, Rabia Tugba; Yosmaoglu, Hayri Baran; 34635000
Purpose To compare the therapeutic effects of different taping materials and techniques on pain, functionality, and tissue temperature in patients with lumbar radiculopathy. Methods: Patients with lumbar radiculopathy were included in the study (n = 51). Patients were randomly divided into three groups, which were the elastic taping (n = 17), rigid taping (n = 17), and placebo taping groups (n = 17). All patients were enrolled in a physiotherapy and rehabilitation program that included thermotherapy, electrotherapy, and exercise five times a week for 2 weeks. The pain was measured before and after treatment using the Visual Analogue Scale. Functionality and quality of life were measured using the Oswestry Low Back Pain Disability Questionnaire and Roland-Morris Disability Questionnaire. The tissue temperature of the treated area in the lumbar region was measured by digital electronic infra-red thermography. Results: After the treatment, pain, functionality, and quality of life were improved in all groups (p < 0.05). Elastic taping was more effective in decreasing pain and increasing functionality than placebo taping (p < 0.05), but no difference was observed between placebo taping and rigid tapping. Local tissue temperature did not change before and after treatment in the elastic taping group (p > 0.05). Tissue temperature increased in the rigid and placebo taping groups (p < 0.05). Conclusion: Taping therapy in patients with lumbar radiculopathy has a positive effect on pain and functional status. Elastic taping can be recommended for clinical use because its effect is superior in some recovery parameters and its ease of use.
Effectiveness Of Negative-Pressure Wound Therapy Compared To Wet-Dry Dressing In Pressure Injuries
(2022) Sahin, Ezgi; Rizalar, Selda; Ozker, Emre; 35022147
This study aims to compare the effects of Negative-Pressure Wound Therapy (NPWT) and wet-to-dry dressing on Stages 3 and 4 pressure injuries (PI), This study is a randomized controlled trial. A total of 30 patients with Stages 3 and 4 pressure injuries were included in the study. The patients were divided into two groups: NPWT group and the wet-to-dry dressing group. All patients received 3 rounds of treatment. Data were collected with a Patient Identification Form, Pressure Ulcer Scale for Healing (PUSH) Tool and the findings of the Three-Dimensional Wound Measurement (3DWM) device. We found that granulation tissue formation was more significant in the experimental group (p < .05), and that there was more significant wound shrinkage (p < .05) with a more significant decrease in the PUSH Tool scores (p < .05). The wounds were assessed with the tool and the 3DWM system. Device measurements were found to be correlated with PUSH Tool findings (p < .05). There was a significant correlation between device-measured granulation findings and PUSH Tool score results of the experimental group's third measurements (p < .05). We conclude that NPWT is an effective treatment method for pressure injuries, and 3DWM device is a useable wound assessment tool.
The Effects of Clinical Pilates Exercises on Patients with Shoulder Pain: A Randomised Clinical Trial
(2017) Atilgan, Esra; Aytar, Aydan; Caglar, Aslican; Tigli, Ayca Aytar; Arin, Gamze; Yapali, Gokmen; Kisacik, Pinar; Berberoglu, Utku; Sener, Hulya Ozlem; Unal, Edibe; 29037638; HIR-3735-2022
Aim: The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain. Material and methods: Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI). Results: The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05). Conclusion: It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them. (c) 2017 Elsevier Ltd. All rights reserved.
The effects of enteral supplementation of glutamine and arginine in lipopolysaccharide (LPS) induced sepsis
(2019) Bakir, Binnur Okan; Oztezcan, Serdar; Saka, Mendane; Karalti, Iskender; Ozkan, Ferda; Ok, Mehtap Akcil; AAZ-8170-2020
Sepsis is the leading cause for death in critically ill patients. While the exact mechanisms are not clear, multiple organ dysfunction syndrome induced by sepsis might cause mitochondrial dysfunction. Spesific nutrients may help regulating immunological and inflammatory responses. Glutamine and arginine amino acids have both important roles in growth, tissue repair, cell renewal and collagen synthesis. There are different results of studies with immunmodulatory nutrients in critically ill patients such, they have no effect on mortality or decrease sepsis incidance. The aim of this study is to evaluate the effects of enteral supplementation of glutamine, arginine and glutamine and arginine combination in lipopolysaccharide (LPS) induced sepsis. Twenty eight male Sprague Dawley rats were randomly divided into four groups: Glutamine, Arginine, Glutamine + Arginine and Control. Glutamine group received 500 mg/kg/day glutamine, Arginine group recieved 500 mg/kg/day arginine, Glutamine + Arginine group received 250 mg/kg/day glutamine and 250 mg/kg/day arginine containing suspension. Rats were fed for 10 days and 3 mg/kg LPS was implemented. 24 hours later, all rats were sacrified. C-Reactive Protein (CRP), Interleukin (IL)-1 beta, IL-6, Tumor Necrosis Factor-alpha(TNF-alpha), Aspartat aminotransferase (AST) and Alanine aminotransferase(ALT) levels were studied, livers were examined histopathologically. Serum TNF-alpha levels were significantly lower in Glutamine + Arginine group in comparison with Control group. Liver histopathology analysis showed that apsis, hepatocyte damage, kupffer cell proliferation and portal inflammation were more frequent and severe in control group than all groups. These results revealed that enteral supply of glutamine, arginine and their combination have positive effects on liver damage and inflammation.
Effects of Non-Pharmaceutical Interventions Against COVID-19: A Cross-Country Analysis
(2021) Gokmen, Yunus; Baskici, Cigdem; Ercil, Yavuz; 0000-0003-0712-1481; 33819370
Prolonging non-pharmaceutical interventions (NPIs) used in the control of pandemics can cause a devastating effect on the overall economic and social welfare levels. Therefore, policymakers are facing a difficult duty in terms of implementing economically and socially sustainable and acceptable measures. The aim of this study is to investigate the effectiveness of NPIs implemented to control the COVID-19 pandemic. To this end, eight NPI measures were analysed, and their effects on the number of cases were investigated for France, Spain, China, and South Korea. In the study, the treatment effect of these mechanisms on the daily increase rate of the total number of cases during a certain period was analysed by using logarithmic linear regression with a dummy variables model. The findings indicate that the measures are effective against the spread of the pandemic at different levels. The findings also suggest that the most effective measure in decreasing the number of cases is workplace closure. An analysis comparing the effectiveness of countrywide measures and regional measures shows that school closing is the most effective measure to decrease the number of cases when implemented countrywide as opposed to regional implementation.
Exposure of Pregnant Women to Violence by Partners and Affecting Factors in Turkey
(2016) Alan, Hacer; Koc, Gulten; Taskin, Lale; Eroglu, Kafiye; Terzioglu, Fusun
This study aims to determine the exposure of women to violence by their partners during pregnancy and the factors affecting this condition. The current study conducted as descriptive included a total of 442 pregnant women who were married and at the last trimester of their pregnancy. The data were collected using a semi-structure questionnaire and face to face interview with the pregnant women and were evaluated using descriptive statistics, chi-square test, and logistic regression analysis. Of the pregnant women, 39.8 % experienced at least one type of violence, and the most common type of violence experienced was verbal violence (31.4 %). Among the participants, 18.2 % exposed to violence expressed that their partners perpetrated violence because of jealousy, and 30.1 % reported that they just cried when exposed to violence. According to the results of the logistic regression analysis, insufficient prenatal care increases all types of violence in pregnancy. Working with pregnant women and their partners together under the scope of prenatal care services, and especially planning the attempts to prevent violence by discussing the causes of violence with couples, will facilitate more successful violence prevention programs.
Extended use up to 5 years of the etonogestrel-releasing subdermal contraceptive implant: comparison to levonorgestrel-releasing subdermal implant
(2016) Ali, Moazzam; Akin, Ayse; Bahamondes, Luis; Brache, Vivian; Habib, Ndema; Landoulsi, Sihem; Hubacher, David; 0000-0003-2379-3325; 27671673; AAK-1688-2021
Is it possible to extend the use of the 3-year one-rod etonogestrel (ENG)-releasing subdermal contraceptive implant to 5 years? The extended use of the one-rod ENG-releasing subdermal contraceptive implant showed 100% efficacy in years 4 and 5. The initial regulated trials on the ENG-releasing subdermal contraceptive implant conducted in the 1990 s were designed to measure cumulative 3-year efficacy. The ENG-implant has both well established safety and efficacy for up to 3 years. Pharmacokinetic data on ENG show high levels at 3 years and some previous clinical research confirms efficacy beyond the current approved duration of 3 years. Today, many women, because the labeled duration has been reached, have the ENG implant removed at 3 years, increasing costs, inconvenience and risks. For the first 3 years, this study was an open-label, multi-centre randomized trial comparing the 3-year ENG implant to the 5-year levonorgestrel (LNG)-releasing implant. After 3 years, a subset of 390 ENG participants, consented to extended use. We compared efficacy, side effects and removal procedures of both implants. We used Kaplan-Meier (K-M) analysis. We included an observational cohort of copper intrauterine device (IUD) users as non-users of hormonal contraceptive method for comparative purposes. The study took place in family planning clinics in seven countries worldwide. Women were enlisted after an eligibility check and informed consent, and 1328 women were enrolled: 390, 522 and 416 in the ENG-implant, LNG-implant and IUD groups, respectively. Over 200 women used the ENG implant for at least 5 years. No pregnancies occurred during the additional 2 years of follow up in the ENG or LNG implant group. The overall 5-year K-M cumulative pregnancy rates for ENG- and LNG- implants were 0.6 per 100 women-years (W-Y) [95% confidence interval (CI): 0.2-1.8] and 0.8 per 100 W-Y [95% CI: 0.2-2.3], respectively. Complaints of bleeding changes were similar; however, ENG-users were more likely than LNG-users to experience heavy bleeding (p < 0.05). The median duration of the implant removal procedure was 64 seconds shorter for the one-rod ENG-implant (inter-quartile range (IQR) = 30.5, 117.5) compared to the two-rod LNG product (IQR = 77.0, 180.0). The 2-year rate for pregnancy in the IUD group compared with the two implant groups combined was 4.1 per 100 W-Y [95% CI: 2.5-6.5]. Few women were a parts per thousand currency sign19 years old or nulligravida. Although there was no weight limit for enrolment in the study, the number of women a parts per thousand yen70 kg were few. The results from this study corroborate previous evidence showing high contraceptive efficacy through 4 years for the ENG-implant. Data through 5 years are a novel contribution and further proof of the product's capability to provide safe and effective contraception that rivals the current 5-year LNG-subdermal implant. The findings provide valuable information for policy makers, family planning programmers and clinicians that the ENG-releasing subdermal implant is still highly effective up to 5 years after insertion. Compared to previous efforts, our study population was geographically diverse and our study had the highest number of participants completing at least 5 years of use. The trial was registered as ISRCTN33378571. The contraceptive devices and funds for conduct of the study were provided by the United Nations Development Programme/United Nations Population Fund/World Health Organization (WHO)/UNICEF/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR), WHO. This report contains the collective views of an international group of experts, and does not necessarily represent the decisions or the stated policy of the WHO. All stated authors have no conflict of interest, except Dr Hubacher who reported grants from United States Agency for International Development, during the conduct of the study; other from Advisory Boards (Teva, Bayer, OCON), outside the submitted work.
HNF1A gene p.I27L is associated with co-existing preeclampsia in gestational diabetes mellitus
(2019) Beysel, Selvihan; Pinarli, Ferda Alparslan; Eyerci, Nilnur; Kizilgul, Muhammed; Hepsem, Sema; Alhan, Ali; Kan, Seyfullah; Caliskan, Mustafa; Bozkurt, Erhan; Cakal, Erman; 31825269
The association of the FTO gene and HNF1 alpha gene on gestational diabetes mellitus (GDM) and preeclampsia remains unclear. This is the first study to examine whether HNF1 alpha gene and FTO gene were associated with having GDM and preeclampsia in Turkish women. Healthy pregnant women (n = 101) and women with GDM (n = 169) were included. GDM was divided into two groups as GDM-only (n = 90) and GDM-preeclampsia (n = 79). Genotyping of HNF1 alpha gene p.I27L, p.A98V, and p.S487N, and FTO gene rs9939609 SNPs were performed using RT-PCR. The frequency of p.S487N, p.A98V, and FTO genotype were similar between the groups (p > .05). p.I27L GG-wild, GT, and TT genotype were 56.5%, 36.6%, and 6.9% in controls; 40.0%, 51.1%, and 8.9% in GDM-only; and 26.6%, 51.9%, and 21.5% in GDM-preeclampsia (p = .034). TT and GT genotype was more frequent in GDM-preeclampsia than in controls (p < .05). GT genotype was increased in GDM-only compared with controls (p < .05). TT genotype was more frequent in GDM-preeclampsia than in GDM-only (p < .05). p.I27L TT genotype was independently associated with increased blood pressure (BP) and urinary protein. p.I27L TT genotype was associated with increased preeclampsia risk in patients with GDM by increasing BP and urinary protein.
HNF1A gene p.I27L is associated with early-onset, maturity-onset diabetes of the young-like diabetes in Turkey
(2019) Beysel, Selvihan; Eyerci, Nilnur; Pinarli, Ferda Alparslan; Kizilgul, Muhammed; Ozcelik, Ozgur; Caliskan, Mustafa; Cakal, Erman; 31109344
BackgroundThe molecular basis of the Turkish population with suspected maturity-onset diabetes of the young (MODY) has not been identified. This is the first study to investigate the association between HNF1A-gene single-nucleotide polymorphisms (SNPs) and having early-onset, MODY-like diabetes mellitus in the Turkish population.MethodsAll diabetic patients (N=565) who presented to our clinic between 2012 and 2015 with a clinical suspicion of MODY were included in the study. Analysis of HNF1A, HNFB, HNF4A, GCK gene mutations was performed using real-time polymerase chain reaction sequencing. After genetic analysis, diabetics (n=46) with HNF1A, HNF1B, HNF4A, GCK gene mutations (diagnosed as MODY) and diabetics (n=30) with HNF1B, HNF4A, GCK gene SNPs were excluded. Patients with early-onset, MODY-like diabetes (n=486) and non-diabetic controls (n=263) were included. Genetic analyses for the HNF1A gene p.S487N (rs2464196), p.A98V (rs1800574) and p.I27L (rs1169288) SNPs were performed using Sanger-based DNA sequencing among the control group.Resultsp.S487N and p.A98V was similar between the diabetics and controls in dominant and recessive models with no association (each, p>0.05). p.I27L GT/TT carriers (GT/TT vs. GG, OR=1.68, 95% CI: [1. 21-2.13]; p=0.035) and p.I27L TT carriers had increased risk of having MODY-like diabetes (GT/GG vs. TT, OR=1.56, 95% CI: [1. 14-2.57]; p=0.048). Family inheritance of diabetes was significantly more common in patients with the p.I27L TT genotype. The p.I27L SNP was modestly associated with having diabetes after adjusting for body mass index and age (=1.45, 95% CI: [1. 2-4.2]; p=0.036).ConclusionsThe HNF1A gene p.I27L SNP was modestly associated with having early-onset, MODY-like diabetes in the Turkish population. HNF1A gene p.I27L SNP might contribute to age at diabetes diagnosis and family inheritance.
Investigating The Effects of Poverty on Health and Quality of Life in Poor People Aged 65 and Over in Etimesgut District, Ankara
(2014) Yilmaz, Fikriye; Celik, Cansu; Numanoglu Tekin, Rukiye; https://orcid.org/0000-0002-4884-3803; AAZ-4775-2020
Introduction: The purpose of this research was to examine the effects of poverty on health and quality of life of poor people aged 65 and over in Etimesgut District, Ankara. Materials and Method: A questionnaire was administered to 116 people over the age of 65 who were deemed a priority group for assistance by the Etimesgut Social Assistance and Solidarity Foundation in Ankara. The questionnaire comprised questions related to socio-demographic characteristics, health status and health care utilization of elderly people, along with the World Health Organization Quality of Life Instrument-Older Adults Module. Research data were evaluated using the Chi-Square Test, Independent Samples T Test, One-Way Analysis of Variance, Mann-Whitney U Test and Kruskal-Wallis Test. Results: The average monthly income of the elderly participants was 168.94 +/- 54.67 Turkish liras and they lived completely under the poverty line determined for Turkey. However, it was found that women, illiterate participants and those receiving the old age pension were poorer, and of those whose income was below average, more delayed/did not seek help when they were ill. Statistical analysis revealed that total quality of life scores of participants aged 65-74 and literate participants were higher; the "social participation" scores of participants whose income was below average and those received an old-age pension were lower. Conclusion: Poverty has negative effects on the health status, health care utilization and quality of life of elderly people.
Maternal genetic contribution to pre-pregnancy obesity, gestational weight gain, and gestational diabetes mellitus
(2019) Beysel, Selvihan; Eyerci, Nilnur; Ulubay, Mustafa; Caliskan, Mustafa; Kizilgul, Muhammed; Hafizoglu, Merve; Cakal, Erman; 31114636
IntroductionPre-pregnancy obesity, gestational diabetes mellitus (GDM), and gestational weight gain (GWG) are associated with each other. This is the first study to investigate whether genetic variants were associated with having GDM, and whether genetic variants-related GDM were associated with adiposity including pre-pregnancy obesity and excessive GWG in Turkish women.Patients and methodsWomen with GDM (n=160) and without GDM (n=145) were included in case-controlled study. Genotyping of the HNF1A gene (p.I27L rs1169288, p.98V rs1800574, p.S487N rs2464196), the VDR gene (p.BsmI rs1544410, p.ApaI rs7975232, p.TaqI rs731236, p.FokI rs2228570), and FTO gene (rs9939609) SNPs were performed by using RT-PCR.ResultsThe FTO AA genotype was associated with an increased risk of having GDM (AA vs. AT+TT, 24.4% vs. 12.4%, OR=2.27, 95% CI [1.23-4.19], p=0.007). The HNF1A p.I27L GT/TT genotype was associated with increased GDM risk (GT+TT vs. GG-wild, 79.4% vs. 65.5%, OR=2.02, 95% CI 1.21-3.38], p=0.007). However, all VDR gene SNPs and the HNF1A p.A98V, p.S487N were not associated with having GDM (p>0.05). The FTO AA genotype was associated with an increased risk for pre-pregnancy overweight/obesity (OR=1.43, 95% CI [1.25-3.4], p=0.035), but not associated with excessive GWG after adjusting for pre-pregnancy weight (p>0.05). Pre-pregnancy weight, weight at delivery, and GWG did not differ in both VDR and HNF1A gene carriers (p>0.05). HOMA-IR and HbA1c were increased in both p.I27L TT and FTO AA genotype carriers (p<0.05).ConclusionThe adiposity-related gene FTO is associated with GDM by the effect of FTO on pre-pregnancy obesity. The diabetes-related p.I27L gene is associated with GDM by increasing insulin resistance.
Parathyroidectomy improves cardiovascular risk factors in normocalcemic and hypercalcemic primary hyperparathyroidism
(2019) Beysel, Selvihan; Caliskan, Mustafa; Kizilgul, Muhammed; Apaydin, Mahmud; Kan, Seyfullah; Ozbek, Mustafa; Cakal, Erman; 31068134
BackgroundParathyroidectomy has ameliorated cardiovascular risk factors in patients with hypercalcemic primary hyperparathyroidism (PHPT), but the effect of parathyroidectomy on normocalcemic PHPT is not exactly known. This case-controlled study aimed to investigate the effect of parathyroidectomy on cardiovascular risk factors in patients with normocalcemic and hypercalcemic PHPT.MethodsSubjects with normocalcemic PHPT (n=35), age- and sex-matched hypercalcemic PHPT (n=60) and age- and sex-matched control (n=60) were included. Cardiometabolic disorders were investigated with traditional cardiometabolic risk factors and the Framingham cardiovascular risk score (CRS) before and 6months after parathyroidectomy.ResultsDiabetes, dyslipidemia, hypertension, obesity, insulin resistance, osteoporosis, having fractures were similarly increased in the hypercalcemic and normocalcemic PHPT groups (p>0.05) compared with the controls (p<0.05). Blood pressures, glucose metabolism (glucose, insulin, HOMA-IR) and lipid profiles were similarly increased in the PHPT groups (p>0.05) compared with the controls (p<0.05). After parathyroidectomy, blood pressures, serum total cholesterol, and HOMA-IR were decreased in both PHPT groups (p<0.05). CRS was lower in the controls (5.743.24, p<0.05). After parathyroidectomy, CRS was decreased in the normocalcemic (11.98 +/- 10.11 vs. 7.37 +/- 4.48) and hypercalcemic (14.62 +/- 11.06 vs. 8.05 +/- 7.72) PHPT groups. Increased blood pressures were independent predictors of serum iPTH.Conclusion p id=Par4 The normocalcemic and hypercalcemic PHPT groups had similarly increased cardiovascular risk factors, even independently of serum calcium. Parathyroidectomy ameliorated the increased cardiovascular risk factors in both normocalcemic and hypercalcemic PHPT.
Prefrontal Brain Activation in Subtypes of Attention Deficit Hyperactivity Disorder: A Functional Near-Infrared Spectroscopy Study
(2018) Dolu, Nazan; Altinkaynak, Miray; Guven, Aysegul; Izzetoglu, Meltem; Demirci, Esra; Ozmen, Sevgi; Pektas, Ferhat; 0000-0002-3104-7587; AAG-4494-2019
According to clinical symptoms, attention deficit and hyperactivity disorder (ADHD) is categorized into three groups: the predominantly inattentive subtype (ADHD-I),the predominantly hyperactive-impulsive subtype (ADHD-HI), and the combined subtype (ADHD-C). Recent advances in neuroimaging have demonstrated new approaches for assessing the ADHD subtypes with underlying pathophysiology.This study aims to examine the hemodynamic response and reaction time (RT) in healthy children and the ADHD subtypes as measured by functional near-infrared spectroscopy (fNIRS) during an auditory oddball attention task. The sample was made up of 40 children divided into four groups: control group (n=14), ADHD-I group (n=9), ADHD-HI group (n=6), and ADHD-C group (n=11). The target responses were identified and were grand-averaged for each participant. Right prefrontal cortex hemodynamic responses and groups performances on RT were compared between subtypes and between controls and subtypes. Functional near-infrared spectroscopy indicated that while control subjects exhibited higher activation than all ADHD subtypes, the ADHD subtypes did not differ from one another. Relative to control subjects, a longer RT was observed in all ADHD subtypes. The ADHD-I group showed significantly longer RTs compared to the ADHD-HI and ADHD-C groups.This study can bring a new perspective to the continuing controversy about ADHD subtypes, and the findings may help in the evaluation of fNIRS, RT, and RT variability studies in ADHD.
Protective effect of Nigella sativa oil on acoustic trauma induced hearing loss in rats
(2017) Culhaoglu, Belde; Erbek, Selim S.; Erbek, Seyra; Hizal, Evren; 0000-0002-8453-6069; 0000-0003-4825-3499; 0000-0002-9699-6783; 28791082; AAJ-2445-2021; B-7604-2019; A-5853-2018
Acoustic trauma is a common reason for hearing loss. Different agents are used to prevent the harmful effect of acoustic trauma on hearing. The aim of this study was to evaluate the potential preventive effect of Nigella sativa (black cumin) oil in acoustic trauma. Our experimental study was conducted with 20 Sprague Downey female rats (mean age, 12 months; mean weight 250 g). All of the procedures were held under general anesthesia. Following otoscopic examinations, baseline-hearing thresholds were obtained using auditory brainstem responses (ABR). To create acoustic trauma, the rats were then exposed to white band noise of 4 kHz with an intensity level of 107 dB in a soundproof testing room. On Day 1 following acoustic trauma, hearing threshold measurements were repeated. The rats were divided into two groups as the study group (n: 10) and the controls (n: 10). 2 mL/kg/day of Nigella sativa oil was given to the rats in the study group orally. On Day 4 following acoustic trauma, ABR measurements were repeated again. There was no difference between the baseline hearing thresholds of the rats before acoustic trauma (P>0.005). After the acoustic trauma, hearing thresholds were increased and there was no significant statistically difference between the hearing thresholds of the study and control groups (P=0.979). At the 4th day following acoustic trauma, hearing thresholds of the rats in control group were found to be higher than those in the study group (P=0.03). Our results suggest that Nigella sativa oil has a protective effect against acoustic trauma in early period. This finding should be supported with additional experimental and clinical studies, especially to determine the optimal dose, duration and frequency of potential Nigella sativa oil therapy.
Relationship Between Exercise Perception With Physical Activity Level, Body Awareness, and Illness Cognition in Renal Transplant Patients: A Pilot Study
(2019) Tigli, Ayca; Soy, Ebru Hatice Ayvazoglu; Aytar, Aydan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 30777573; AAC-5566-2019; HIR-3735-2022; AAE-1041-2021; AAJ-8097-2021
Objectives: Transplantation offers better quality of life and long-term survival benefits. Further knowledge is needed regarding exercise in daily life of transplant recipients. Here, we investigated the relationship between exercise perception and physical activity level, body awareness, and illness cognition in renal transplant patients. Materials and Methods: Our study included 53 renal transplant recipients (Standardized Mini-Mental Test score = 26.35 +/- 1.36; age = 41.11 +/- 13.52 year, body mass index = 25.96 +/- 5.26 kg/m(2), elapsed time after transplant = 3.68 +/- 1.53 year). Perceived benefits and barriers to exercise, physical activity level, body awareness, and illness cognition were assessed with the Exercise Benefits/Barriers Scale, International Physical Activity Questionnaire, Body Awareness Questionnaire, and Patient Illness Perception Questionnaire, respectively. Correlations were established with Spearman test for nonparametric data, with regression analysis used to find determinants of physical activity levels. Results: We observed correlations between physical activity level and perceived benefits and barriers to exercise. There was a positive relationship between body awareness and perceived benefits and barriers to exercise and also illness cognition, with significant correlation between perceived benefits and barriers to exercise and illness cognition (P < .05). Perceived benefits and barriers to exercise (P = .006, R = 0.373, R2 = 0.139, beta = 0.373, t = 2.867, F = 8.22) were determining factors for physical activity level. Conclusions: Psychologic and physical factors, including negative emotions and body dissatisfaction, are risk factors for poor quality of life. Although it is important to increase quality of life, tools to enhance body awareness and to develop strategies to alter motor behaviors in daily living activities are needed. Treatment and assessment strategies on body awareness and illness perception should be considered, with emphasis on the importance of physical activity posttransplant.
Sagittal skeletal correction using symphyseal miniplate anchorage systems: Success rates and complications
(2019) Cubuk, Secil; Kaya, Burcak; Sahinoglu, Zahire; Ates, Ufuk; Ozcirpici, Ayca Arman; Uckan, Sina; 30413832
ObjectivesAim of this study is to evaluate success rates and complications related with symphyseal miniplate anchorage systems used for treatment of Class2 and Class3 deformities.MethodsAtotal of 58miniplates applied to 29growing patients were evaluated. The first group comprised 24symphyseal miniplates applied to 12patients and Forsus Fatigue Resistant Devices were attached to the head of the miniplates for mandibular advancement. The second group consisted of 34symphyseal miniplates applied to 17patients and intermaxillary elastics were applied between acrylic appliances placed on the maxillary dental arch and the symphyseal miniplates for maxillary protraction. Success rate and complications of the symphyseal plate-screw anchorage system were evaluated.ResultsThe overall success rate of symphseal miniplates was 87.9%. Six miniplates showed severe mobility and 2miniplates broke during orthodontic treatment. Infection, miniplate mobility and mucosal hypertrophy were statistically different between the two groups.ConclusionsSymphyseal miniplates were generally used as successful anchorage units in most patients. Infection, mobility, and mucosal hypertrophy occurred more frequently in Class2 deformity correction. However, the success rates regarding the two treatment modalities were comparable. ZusammenfassungZieleZiel der vorliegenden Studie ist es, Erfolgsraten und Komplikationen im Zusammenhang mit symphysealen Miniplattenverankerungssystemen zur Behandlung von Klasse-II- und -III-Anomalien zu bewerten.MethodenAusgewertet wurden insgesamt 58Miniplatten, die bei 29Patienten im Wachstum inseriert wurden. In der ersten Gruppe wurden 24symphyseale Miniplatten bei 12Patienten inseriert. Zur Korrektur der Unterkieferrucklage wurden Forsus-Apparaturen an den Miniplatten verankert. In der zweiten Gruppe wurden 34symphyseale Miniplatten bei 17Patienten inseriert. Zur Protraktion des Oberkiefers wurden intermaxillare Elastics verwendet, die zwischen Acrylgeraten im Oberkiefer und den symphysealen Miniplatten eingehangt wurden. Untersucht wurden Erfolgs- und Komplikationsraten des symphysealen Platten-Schrauben-Verankerungssystems.ErgebnisseDie Gesamterfolgsrate der symphsealen Miniplatten betrug 87,9%. Bei 6Miniplatten zeigte sich eine hohe Mobilitat, 2frakturierten wahrend der kieferorthopadischen Behandlung. Das Auftreten von Infektion, Miniplattenmobilitat und Schleimhauthypertrophie war zwischen den beiden Gruppen statistisch unterschiedlich.SchlussfolgerungenSymphyseale Miniplatten wurden in der Regel bei den meisten Patienten als erfolgreiche Verankerungseinheiten eingesetzt. Infektion, Mobilitat und Schleimhauthypertrophie traten haufiger bei Klasse-2-Korrekturen auf, die Ergebnisse beider Behandlungsmethoden unterschieden sich jedoch nur geringfugig.
Scenarios to Manage The Hepatitis C Disease Burden and Associated Economic Impact of Treatment in Turkey
(2017) Ormeci, Necati; Malhan, Simten; Balik, Ismail; Ergor, Gul; Razavi, Homie; Robbins, Sarah; 29027109
Hepatitis C virus (HCV) infection is a significant health problem. The aim of this study is to evaluate the cost-effectiveness of HCV treatment and estimate its economic burden in Turkey. An Excel-based disease progression model was used to estimate the HCV-infected population for 2015-2030. Direct costs in US dollars (USD) including diagnostic, laboratory, and healthcare costs were provided by experts in the country. Indirect costs were estimated as lost productivity using the World Health Organization (WHO) disability-adjusted life years (DALYs) metric from the Global Burden of Disease study. Three scenarios were developed to estimate the cost-effectiveness of HCV treatment through 2030: Base 2016, Increase Treatment and SVR (where SVR is sustained virological response), and WHO Targets. Additionally, the WHO Targets scenario was assessed at three different treatment price points: 10,900 USD, 16,730 USD (base cost), and 27,285 USD. Cumulative total direct and indirect costs (2015-2030) for the WHO Targets scenario were estimated to be 10.8 billion USD, or a 1.5 % increase compared with Base 2016. However, by the following decade, due to a marked decline in DALYs, cumulative direct and indirect costs were estimated to be 45 % less when compared with Base 2016. At a threshold of 9125 USD, all scenarios were cost-effective. By implementing the WHO Targets scenario, Turkey would be able to lower HCV prevalence by 80 % and reduce the total number of liver-related deaths by > 65 % by 2030. Treating HCV infection in the country is cost-effective if healthcare and indirect costs are taken into consideration.
Three-dimensional finite element analysis of stress distribution in inlay-restored mandibular first molar under simultaneous thermomechanical loads
(2016) Koycu, Berrak Celik; Imirzalioglu, Pervin; Oezden, Utku Ahmet; 27041006
Functional occlusal loads and intraoral temperature changes create stress in teeth. The purpose of this study was to evaluate the impact of simultaneous thermomechanical loads on stress distribution related to inlay restored teeth by three-dimensional finite element analysis. A mandibular first molar was constructed with tooth structures, surrounding bone and inlays of Type II gold alloy, ceramic, and composite resin. Stress patterns on the restorative materials, adhesive resin, enamel and dentin were analyzed after simulated temperature changes from 36 degrees C to 4 or 60 degrees C for 2 s with 200-N oblique loading. The results showed that the three types of inlays had similar stress distribution in the tooth structures and restorative materials. Concerning the adhesive resin, the composite resin inlay model exhibited lower stresses than ceramic and gold alloy inlays. Simultaneous thermomechanical loads caused high stress patterns in inlay-restored teeth. Composite resin inlays may be the better choice to avoid adhesive failure.