Tıp Fakültesi / Faculty of Medicine
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Item Mitigating infusion-related reactions (IRRs) with cetirizine and montelukast in patients (pts) receiving REGN7075, an EGFRxCD28 bispecific antibody (bsAb)(Başkent Üniversitesi Tıp Fakültesi, 2025) Segal, N. H.; Girda, E.; Keenan, B. P.; Hecht, J. R.; Le, X.; Johnson, M. L.; Jimenez, J. Torres; Gomez-Roca, C. A.; Ghiringhelli, F.; Ates, O.; Garcia, V. Moreno; Laux, D.; Berz, D.; Chen, R.; Wang, J.; Han, H.; Mathias, M. D.; Seebach, F. A.; Kinnaman, M. D.; Sohal, D.Item Identifying future risk factors of uncontrolled asthma control: the TAAR study perspective(Başkent Üniversitesi Tıp Fakültesi, 2025) Erdogan, Tuba; 41305966Objective: Risk factors associated with asthma symptom control is crucial for disease management. This study aimed to determine the risk factors of patients with uncontrolled asthma and to examine the relationship with their geographical patterns. Methods: This cross-sectional study was conducted at 36 centers across Turkey. Future risk factors (FRFs) such as exposure to triggers/allergens and inadequate or poor inhalation technique, etc., were identified based on the Global Initiative for Asthma (GINA) guidelines. The associations between FRFs and demographic and clinical characteristics, geographical regions, and levels of asthma control were analyzed. Results: The study included 2,053 adult asthma patients. At least one FRF was identified in 1576(76.8%) patients. The most common FRFs were exposure to allergens/triggers (n: 664; 32.3%), impaired asthma symptom control (n: 540; 26.3%), and eosinophilia (n: 526; 25.6%). Regarding regional differences, the most prevalent FRFs in the Marmara region were exposure to allergens/triggers and frequent use of short-acting beta-2 agonists (>3 boxes/year). In contrast, eosinophilia was more common in the Southeastern region, while inadequate or poor inhalation technique, noncompliance with treatment, and psychosocial or socioeconomic problems were more frequently observed in the Eastern Anatolia region. Asthma control was achieved in 79.5% of patients without any FRFs; however, this rate decreased significantly to 25% among patients with more than four FRFs. Conclusions: This study demonstrates that FRFs in asthma vary according to demographic and disease characteristics, as well as geographical distribution. An increased number of FRFs was associated with asthma control. However, an individualized approach remains essential for achieving optimal asthma management.Item The Influence of Different Sugammadex Doses on Neural Tube Development in Early-Stage Chick Embryos(2023) Ayhan, Asude; Efe, Ekin; Fidan, Pinar A.; Efe, Oguzhan E.; Ates, Eylem Gul; Sahinturk, Fikret; Ayhan, Selim; 0000-0002-6166-2601; 0000-0001-6955-9839; 0000-0002-3243-7843; 0000-0003-3047-0305; 0000-0002-0471-3177; 37565787; HGE-9282-2022; AAJ-2057-2021; AAJ-4728-2021; W-7908-2019; ABG-5365-2020; AAI-7972-2021Background: Sugammadex is a modified gamma-cyclodextrin that has been developed with the goal of reversing the steroidal neuromuscular blocking agents. The aim of the present study is to investigate the effects of different sugammadex doses on embryologic and neural tube development in an early-stage chick embryo model. Methods: A total of 100 specific pathogen-free, fertilized domestic chicken eggs were randomly divided into five groups (n = 20, each), and placed in an automatic cycle incubator. The eggs in the "control (C)" group were incubated without administration of any drug till the end of the experiment. Subblastodermic administration of 0.9% NaCl as vehicle control (VC) and different doses of sugammadex solutions prepared with the latter [2 mg/mL (LD), 4 mg/mL (MD), 16 mg/mL (HD)] were performed at 30 hr of incubation. All embryos were removed from the eggs at 72 hr when they were expected to reach Hamburger-Hamilton (HH) stages 19-20, then they were fixed, and evaluated histo-morphologically. Results: Embryonic development was not observed in 11 eggs (1 in C, 1 in VC; 3 in LD, 3 in MD, and 3 in HD). All the developed embryos were compatible with the HH stages 19-20. A neural tube closure defect was detected in one embryo in the HD group. No statistically significant difference was found between the groups in terms of embryonic and neural tube developments. Conclusions: No significant association was found between the drug and adverse outcomes; however, a trend with dosing was seen. Further studies are required before conclude on safety and extrapolate these results to human beings.Item The Effect of Acupressure Applied to Different Fistula Area on Fistule Needle Entry Pain(2023) Turgay, Gulay; Cevik, Banu; Inanoglu, Isilay; Kaya, Semiha; AAN-3284-2021Item The Effect of Glomerular C3 Deposition on Renal Outcome in Patients with Membranous Nephropathy: Data of the Tsn-Gold Study(2023) Gursu, Meltem; Ceheci, Egemen; Turkmen, Aydin; Dervisoglu, Erkan; Sezen, Mehnet; Turgutalp, Kenan; Sahin, Gulizar Manga; Trablus, Sinan; Kutlay, Sim; Uzun, Sami; Ustundag, Sedat; Dursun, Belda; Ayli, Deniz; Tatar, Erhan; Oztop, Kenan Evren; Basturk, Taner; Cevher, Simal Koksal; Yilmaz, Zulfikar; Tunca, Onur; Sevinc, Mustafa; Yadigar, Serap; Duranay, Murat; Arikan, Izzet Hakki; Elciuglu, Omer Celal; Karakan, Sebnem; Turkmen, Kultigin; Torun, Dilek; Gungor, Ozkan; Artan, Ayse Serra; Ozturk, Savas; Unsal, Abdulkadir; Seyahi, Nurhan; AAD-9111-2021Item Characteristics and Survival Data of Patients with Primary Focal Segmental Segmental Glomerulosclerosis: Tsn-Goldmulti-Center Study(2023) Dheir, Hamad; Cebeci, Egemen; Karadag, Serhat; Yildiz, Abdulmecit; Guller, Nurana; Altiparmak, Mehmet Riza; Eren, Necmi; Yilmaz, Zulfikar; Basturk, Taner; Sipahi, Savas; Sahin, Gulizar; Bakar, Betul; Okyay, Gulay Ulusal; Suleyman, Gultekin; Piskinpasa, Serhan Vahit; Dursun, Belda; Balal, Mustafa; Turgutalp, Kenan; Guzel, Fatma Betul; Kutlay, Sim; Tatar, Erhan; Elcioglu, Omer Celal; Karakan, Sebnem; Kayalar, Arzu Ozdemir; FarukAkcay, Omer; Yildirim, Tolga; Sahin, Idris; Sahin, Garip; Ogutmen, Melike Betul; Tokgoz, Bulent; Tunca, Onur; Gul, Cuma Bulent; Kurultak, Ilhan; Torun, Dilek; Ayar, Yavuz; Uzun, Sami; Yavuz, Mahmut; Oto, Ozgur Akin; Dincer, Mevlut Tamer; Ergul, Metin; Ozturk, Savas; Turkmen, Aydin; AAD-9111-2021Item Transarterial Chemoembolization Combined with Simultaneous Thermal Ablation for Solitary Hepatocellular Carcinomas in Regions with a High Risk of Recurrence(2023) Ozen, Ozgur; Boyvat, Fatih; Zeydanli, Tolga; Kesim, Cagri; Karakaya, Emre; Haberal, Mehmet; 0000-0001-7122-4130; 37455470; JVO-4809-2024; AAD-5996-2021; AAD-5466-2021; F-4230-2011; AAN-1681-2021Objectives: We evaluated the safety and efficacy of transarterial chemoembolization combined with percutaneous thermal ablation (radiofrequency or microwave ablation) in the treatment of solitary hepatocellular carcinoma tumors ranging from 2 to 4.5 cm at subdiaphragmatic, subcapsular, or perivascular locations. Materials and Methods: Fifteen patients (12 men, mean [range] age of 66.6 +/- 10.88 [34-75] y) who received transarterial chemoembolization combined with simultaneous percutaneous radiofrequency ablation (n = 5) or microwave ablation (n = 10) for hepatocellular carcinoma in regions with high risk of recurrence (subdiaphragmatic, subcapsular, or perivascular) between 2012 and 2018 were evaluated. We retrospectively investigated tumor diameter and localization, success rate, safety, local efficacy (imaging at month 1 after treatment), local tumor response (3 months posttreatment), local tumor progression, intrahepatic distant recurrence, overall survival and complications. Results: Tumor diameter ranged from 20 to 45 mm (mean 31.7 +/- 7.37 mm). Hepatocellular carcinoma diameter was 2 to 3 cm in 7 patients and 3.1 to 4.5 cm in 8 patients. The technical success rate was 100%, with no life-threatening complications. At enhanced imaging at 1-month follow-up, the complete necrosis rate was 100%; at 3 months, 100% of patients had a complete response. During a mean follow-up of 26 +/- 13.6 months, 7 patients (46.7%) had tumor progression. Three patients (20%) had local tumor response, and 4 patients (26.7 %) experienced distant recurrences in the untreated liver. The mean local tumor progression and mean intrahepatic distance recurrence times were 11 months and 29.5 months, respectively. Overall survival rates were 100% at 1 year, 73% at 3 years, and 47% at 5 years. Conclusions: Transarterial chemoembolization combined with simultaneous percutaneous thermal ablation is safe, feasible, and effective in enhancing the local control rate for solitary hepatocellular carcinoma ranging from 2 to 4.5 cm in regions with high risk of recurrence.Item Evaluation of Machine Learning Algorithms for Renin-Angiotensin-Aldosterone System Inhibitors Associated Renal Adverse Event Prediction(2023) Guven, Alper Tuna; Ozdede, Murat; Sener, Yusuf Ziya; Yildirim, Ali Osman; Altintop, Sabri Engin; Yesilyurt, Berkay; Uyaroglu, Oguz Abdullah; Tanriover, Mine Durusu; 0000-0002-6310-4240; 37217407Background: Renin-angiotensin-aldosterone system inhibitors (RAASi) are commonly used medications. Renal adverse events associated with RAASi are hyperkalemia and acute kidney injury. We aimed to evaluate the performance of machine learning (ML) algorithms in order to define event associated features and predict RAASi associated renal adverse events.Materials and Methods: Data of patients recruited from five internal medicine and cardiology outpatient clinics were evaluated retrospectively. Clinical, laboratory, and medication data were acquired via electronic medical records. Dataset balancing and feature selection for machine learning algorithms were performed. Random forest (RF), k-nearest neighbor (kNN), naive Bayes (NB), extreme gradient boosting (xGB), support vector machine (SVM), neural network (NN), and logistic regression (LR) were used to create a prediction model.Results: 409 patients were included, and 50 renal adverse events occurred. The most important features predicting the renal adverse events were the index K and glucose levels, as well as having uncontrolled diabetes mellitus. Thiazides reduced RAASi associated hyperkalemia. kNN, RF, xGB and NN algorithms have the highest and similar AUC (> 98%), recall (> 94%), specifity (> 97%), precision (> 92%), accuracy (> 96%) and F1 statistics (> 94%) performance metrics for prediction.Conclusion: RAASi associated renal adverse events can be predicted prior to medication initiation by machine learning algorithms. Further prospective studies with large patient numbers are needed to create scoring systems as well as for their validation.Item The Influence of Percutaneous Vertebral Augmentation Techniques on Recompression in Patients with Osteoporotic Vertebral Compression Fractures. Percutaneous Vertebroplasty versus Balloon Kyphoplasty(2023) Sahinturk, Fikret; Sonmez, Erkin; Ayhan, Selim; Gulsen, Salih; Yilmaz, Cem; 0000-0002-5693-3542; 0000-0002-2353-8044; 0000-0002-0471-3177; 37257650; AAJ-5746-2021; AAI-8820-2021; AAK-2948-2021; AAI-7972-2021-OBJECTIVE: The purpose of this study was to determine whether percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BK) have any mid-term to long-term effects on the structural integrity of augmented vertebrae.-METHODS: According to our hospital records, 351 patients underwent BK and PVP as a result of osteoporotic vertebral compression fractures between 2010 and 2020. The demographic, surgical, and radiologic characteristics of the patients were analyzed retrospectively using the electronic hospital records and PACS (picture archiving and communication system). In our study, 55 patients who had a single level of PVP or BK filled with at least 6 mL og polymethylmethacrylate (PMMA) for T11-L5 levels and 3 mL of PMMA for T6-T10 levels via a bipedicular approach and who had only 1 vertebral fracture in a 10-year follow-up period were included in our study. The patients were divided into 2 groups: BK (n = 40) and PVP (n = 15). All measurements were performed on standing lateral radiographs from the postoperative first day and the last radiographs that were obtained during the follow-up. The anterior and posterior heights of the fractured vertebral body and local kyphosis angles were measured.-RESULTS: The mean follow-up time was 2.53 & PLUSMN; 1.78 years in the BK group and 3.07 & PLUSMN; 2.02 years in the PVP group. The decrease in the vertebral height and increasing kyphosis that develop from the early to late postoperative periods were found to be statistically significant in the BK group (P < 0.05). In the PVP group, vertebral height and kyphosis angle measurements did not differ significantly between the early and late postoperative periods. In addition, in terms of the percentage change, anterior parts of the vertebral bodies are more affected. However, the absolute difference for the measurement of the vertebral heights did not confirm this finding.-CONCLUSIONS: To our knowledge, our study is unique because it has the longest follow-up in the literature comparing BK and PVP in terms of recollapse of the augmented vertebrae. Our study shows that BK does not prevent height loss of the augmented vertebral bodies in the mid-to long term.Item Long-Term Results of Kidney Transplantation in Patients with Familial Mediterranean Fever(2023) Bitik, Berivan; Hatipoglu, Bugra; Sayin, Burak; Kanbur, Aysenur Yalcintas; Bursa, Nurbanu; Oygur, Cagdas Sahap; Ozdemir, Handan; Colak, Turan; Haberal, Mehmet; Yucel, Ahmet Eftal; 0000-0001-5803-915X; 0000-0002-7528-3557; 0000-0002-3462-7632; 0000-0002-0168-2993; 36544375; AAI-9195-2021; X-8540-2019; AAJ-8097-2021IntroductionLong-term kidney transplantation (KT) results in patients with familial Mediterranean fever (FMF)-related amyloidosis are not well studied. This study reviewed the long-term survival outcomes of FMF patients who underwent KT. MethodsWe compared the outcomes of 31 patients who underwent (KT) for biopsy-proven amyloidosis secondary to FMF with 31 control patients (five with diabetes mellitus and 26 with nondiabetic kidney disease) undergoing KT between 1994 and 2021 at Baskent University Hospital. All data were recorded retrospectively from patients' files. Results: The median age (quartile deviationQD) at the time of KT in the FMF and control group were 31 (6.7) and 33 (11), respectively. The median follow-up period (QD) after KT was 108 (57) months in the FMF and 132 (72) months in the control group. In the FMF group, graft and patient survivals were 71% and 84% at 5 years and 45% and 48% at 10 years, respectively. In the control group, graft and patient survivals were 79% and 100% at 5 years and 63% and 71% at 10 years, respectively. Patient survival in the FMF group at 5 years was significantly lower than in the control group (p = .045). There was no statistically significant difference between the FMF and control groups in terms of graft and patient survival, and serum creatinine levels at 10 years. All patients were given triple immunosuppressive treatment with cyclosporine, mycophenolate mofetil, and prednisolone. Three patients received anakinra and one received canakinumab in addition to colchicine treatment. One FMF patient also underwent heart transplantation due to AA amyloidosis. Of the FMF patients, 11 died during follow-up. ConclusionWe have found that the long-term outcome of KT in patients with FMF amyloidosis is numerically worse but not statistically different from the control group. However, short- and long-term complications still need to be resolved.