Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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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 Epidemiology of Colorectal Cancer in Turkey: A Cross-Sectional Disease Registry Study (A Turkish Oncology Group Trial)(2015) Aykan, Nuri Faruk; Yalcin, Suayib; Turhal, N. Serdar; Ozdogan, Mustafa; Demir, Gokhan; Ozkan, Metin; Yaren, Arzu; Camci, Celalettin; Akbulut, Hakan; Artac, Mehmet; Meydan, Nezih; Uygun, Kazim; Isikdogan, Abdurrahman; Unsal, Diclehan; Ozyilkan, Ozgur; Arican, Ali; Seyrek, Ertugrul; Tekin, Salim Basol; Manavoglu, Osman; Ozet, Ahmet; Elkiran, Tamer; Disci, Rian; 0000-0001-8825-4918; 25835113; AAD-2817-2021Background/Aims: This study aimed to determine the epidemiological characteristics of colorectal cancer in Turkey. Materials and Methods: In this multicenter, prospective, and cross-sectional registry study, data for 968 patients with colorectal cancer from 21 centers in 7 geographic regions were analyzed. Results: Diagnosis was colon cancer in 662 (68.4%) and rectum cancer in 306 (31.6%) patients. In total, 60.9% of patients was male; mean age was 58.9 +/- 12.6 years. Among patients, 15.0% was drinking alcohol, 17.5% was smoking, 1.5% had familial history of polyposis, 15.0% had diabetes mellitus, 1.0% had inflammatory bowel disease. Fruit and vegetable consumption was low (<3 times/week) in 35.5% and red meat consumption was high (>= 3 times/week) in 47.4% of the patients. Median time-to diagnosis was 3.0 months and 4.0 months for patients with colon and rectum cancer, respectively. Mean body mass index was >25 in all group of patients. Distal rectum (61.3%) and sigmoid colon (36.8%) were the most common locations of cancer, for rectum and colon respectively. In total, 85.6% of patients were operated; 25.8% had emergency surgery. Low anterior resection rate was 64.2% in rectum cancer. In majority (89.8%) of the patients with rectum cancer who received preoperative treatment, conventional chemo-radiotherapy regimen was given. pTNM staging at diagnosis showed that stage III and IV patients were in majority (35.9% and 29.7%, respectively). Conclusion: Colon cancer is more frequent than rectum cancer in Turkey. Colorectal cancer patients are diagnosed at later stages. Most of the cases were operated. Interregional differences for risk factors are worthwhile for evaluation in future trials.Item Relationship between the Psychiatric Symptoms in Expecting Parents and Postpartum Depression and Infantile Colic: A Multicenter Follow up Study(2015) Cak, H. Tuna; Karabekiroglu, Koray; Cengel Kultur, Ebru; Tarakcioglu, Mahmut Cem; Kaya, Rahime; Say, Gokce Nur; Gorker, Isik; Sapmaz, Dicle; Karabekiroglu, Aytul; Cakin Memik, Nursu; Yuce, Murat; Kose, Sezen; Ozbaran, Burcu; Foto Ozdemir, Dilsad; Akin Sari, Burcu; Ozkoc Erol, Serpil; Evinc, Gulin; Cengiz, Hakan; Varol, Fusun; 0000-0001-6631-9549; 0000-0002-0159-1864; 0000-0002-9077-8419; 0000-0001-9514-0855; 0000-0002-9730-7206; 0000-0002-2732-2873; 26111284; G-4424-2011; AAC-7008-2020; HJP-2418-2023; ABH-9832-2020; Y-9941-2018; V-6472-2017; HGB-6475-2022; ABC-1815-2020; I-9239-2013; A-7296-2013; HTL-2313-2023; I-9237-2013; ABB-4558-2021Objective: The aim of this study is to evaluate the relationship between postpartum depression (PPD), infantile colic (IC) and different psychosocial variables, psychiatric symptoms, attachment style and perceived social support in expecting parents. Method: Two hundred forty five expecting mothers and 150 expecting fathers were first interviewed between the 22-34 weeks of pregnancy Sociodemografic data form, Adult Attachment Style Scale (AASS), State Anxiety Inventory (SAT), Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS) and Brief Symptom Inventory (BSI) were filled out by each expecting parent. Second interview was conducted between the postpartum 4-24 weeks. Data form consisting health, nutrition, sleep and crying problems of the infant and EPDS and SAI were filled out by mothers and SAI by fathers. Results: One in every four mothers had PPD symptoms above the threshold on EPDS. Maternal and paternal insecure attachment style, maternal psychiatric symptoms and postpartum anxiety level were found to be the predictors of PPD. One in every five infants had IC and maternal education level, hostility score and PPD symptoms along with paternal insecure attachment style and psychiatric symptoms were the main predictors of IC. Conclusion: Results about PPD and IC regarding maternal variables are consistent with the literature. In addition, paternal insecure attachment style is found to be an important risk factor for both PPD and IC. Fathers should also be included in further studies exploring PPD or IC.Item Smoking and Lower Urinary Tract Symptoms(2015) Bolat, Mustafa Suat; Akdeniz, Ekrem; Ozkaya, Sevket; Batur, Ali Furkan; Kutman, Kerem Gencer; Goren, Resit; Erdemir, Fikret; Ece, Ferah; 0000-0002-2001-1386; 26706744; Y-6143-2019Purpose: Pharmacologic effects of nicotine are multifaceted and complicated. Despite numerous studies, the effect of smoking on lower urinary tract functions, have not been yet studied in detail. In this study, we aimed to investigate the effects of smoking addiction on lower urinary tract and sexual functions on the basis of respiratory functions. Materials and Methods: A total of 186 male patients who have been evaluated between May 2014 and January 2015 were recruited in this study. Smoking history, respiratory symptoms, respiratory function tests, uroflowmetry parameters relating to lower urinary tract symptoms (LUTS), prostate volume, post-voiding residual urine volume and sexual functions of patients have been retrospectively investigated. Results: We determined that as the mean number of cigarettes smoked daily increases, post-void residual urine volume and International Prostate Symptom Score (IPSS) also increase. Moreover in accordance with this finding, mean urinary flow rates and quality of life scores were statistically significantly decreased. In smoking addicts who have high mean package/year, post-void residual urine volume and IPSS levels were increased but proportionately maximum urinary flow rate and average urinary flow rate plus quality of life scores were found to be statistically significantly decreased. In patients with forced expiratory volume in first second:forced vital capacity (FEV1/FVC) ratio less than 80%, mean urinary flow rates were found to be statistically significantly low. Also, we determined that in smoking addicts who have high mean package/year, erectile functions were statistically significantly impaired. Conclusion: We showed negative impacts of smoking addiction on LUTS, patient's quality of life, and sexual functions.Item The Nutritional Risk Screening 2002 Tool For Detecting Malnutrition Risk in Hospitalised Patients: Perspective From A Developing Country(2014) Gokcan, Hale; Selcuk, Haldun; Tore, Emin; Gulseren, Pinar; Cambaz, Hatice; Saritas, Seniz; Ocal, Ruhsen; Basaran, Ozgur; Yilmaz, Ugur; Akin, Ebru; https://orcid.org/0000-0001-5663-0683; https://orcid.org/0000-0002-8445-6413; 25599788; AAR-8893-2020; AAJ-6976-2021; V-3553-2017Background/Aims: To verify the validity of the Nutritional Risk Screening (NRS) 2002 test in a Turkish population. Materials and Methods: We prospectively investigated 2566 patients at a tertiary referral hospital. Nutritional status was screened using NRS 2002, and the length of the stay (LOS) was the main outcome measure. Hospital stays >10 days were accepted as prolonged LOS. NRS scores >= 3 were accepted as indicating risk for malnutrition. Statistical analyses were performed to determine the independent risk factors for malnutrition risk and prolonged LOS. Results: The mean age of patients was 56.6 +/- 16.9 years. According to the NRS 2002, 964 patients (37.6%) were without risk, 1320 (51.4%) warranted surveillance and 282 (11%) were at high risk for malnutrition. Malnutrition rate was the highest in the intensive care unit (22.01%). Prolonged LOS was seen in 24.4% of patients. Intensive care unit stay [odds ratio (OR): 0.585; confidence interval (CI): 1.45-2.22; p<0.001] and an NRS score >= 3 (OR: 0.88; CI: 1.87-3.13; p<0.001) were independent risk factors for prolonged LOS. Conclusion: Improving healthcare outcomes while avoiding preventable healthcare costs is an important goal of healthcare provision in developing countries. NRS 2002 was predictive of LOS, and thus, of patient prognosis. Further community-based studies are warranted to assess the impact of NRS 2002 on reducing healthcare costs.Item Predictors of Obstructive Coronary Artery Disease vs Non-obstructive Lesions on Coronary Angiography in Patients with Non-ST Elevation Myocardial Infarction. A Retrospective Analysis from a University Hospital(2017) Ciftci, Orcun; Kayipmaz, Afsin Emre; Karacaglar, Emir; Yilmaz, Kerem Can; Muderrisoglu, Ibrahim Haldun; 0000-0001-8926-9142; 0000-0002-2538-1642; AAC-2597-2020; AAJ-1331-2021; W-5233-2018; ABI-6723-2020Item Relationship Between Melatonin and Cardiovascular Disease(2021) Ozkalayci, Flora; Kocabas, Umut; Altun, Betul U.; Pandi Perumal, Seithikurippu; Altun, Armagan; 0000-0002-3233-8263; 33654615; ABB-5844-2020Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality worldwide. The coronary atherosclerotic process involves different pathological mechanisms; inflammation is one of the major triggers for the development of atherosclerotic plaque. Although several studies showed the favorable effects of melatonin on the cardiovascular system (CVS), melatonin seems not to take its rightful place in today's clinical practice. This review aims to point out the role of melatonin on cardiovascular disease (CVD) and its' risk factors. All data were obtained via PuhMed, Wikipedia, and Google.Item Analysis of Risk Factors for Ultrasonographic Graf Type IIa (-) Hips in Developmental Dysplasia: A Hospital-Based Case-Control Study with Follow-Up Outcomes(2021) Haberal, Bahtiyar; Sahin, Orcun; Tuncay, Ismail Cengiz; 0000-0002-1668-6997; 0000-0002-6035-6258; W-9080-2019; AAF-4032-2021Objective: To examine the association of Graf type IIa(-) hips with maternal and infant risk factors in newborns and to evaluate the follow-up outcomes. Materials and Methods: Two different risk analyses were performed. In the first analysis, Graf type I hips were grouped as "controls," and Graf type II were grouped as "cases." In the second analysis, all the Graf type I and Type IIa(+) hips were grouped as "controls," and all Graf type IIa (-) hips were considered as "cases." Maternal age, presence of consanguinity, pregnancy, and smoking were considered as maternal risk factors. Sex, birth weight, gestational age, associated congenital anomalies, and family history were considered as infant risk factors. Further, we determined the risk factors for Graf type IIa and type IIa (-) hips. Results: The study population included 73 cases (11.4%) and 569 controls (88.6%), including 322 (50.2%) male and 320 (49.8%) female infants. Graf type IIa hips revealed significant differences for gestational age (>42 wk), birthweight (>3500 g), and maternal age (<= 20 y). At follow-up, all Graf type IIa(+) hips became Graf type I mature hips. In contrast, three Graf type IIa(-) hips (3/12, 25%) required additional treatment. Conclusion: Significant risk factors for Graf type IIa(-) hips were female sex, gestational age of >42 wk, and birthweight of >3500 g. Almost one-quarter of Graf type IIa (-) hips may require additional treatment. Thus, significant risk factors for Graf type IIa(-)should be remembered in clinical practice.Item Surgical treatment of consecutive exotropia: Comparison of different surgical methods applied to one eye in one session(2021) Sefi-Yurdakul, Nazife; Oto, Sibel; Pelit, Aysel; 0000-0003-2005-9256; 34308671; AAF-4678-2020Purpose: To compare the different surgical methods performed on a single eye in a single session and the factors that affect the success of patients having consecutive exotropia (XT) developed after esotropia surgery. Methods: The medical data of the patients who underwent surgery for consecutive XT were reviewed retrospectively. Patients with followed of 6 months or more were divided into four groups; patients with medial rectus (MR) advancement (Group 1 = 10), MR advancement and MR resection (Group 2 = 12), MR advancement and lateral rectus (LR) recession (Group 3 = 13), MR advancement, MR resection, and LR recession (Group 4 = 14). Success results and possible risk factors were investigated. Results: Forty-nine patients with consecutive XT (21 female, 28 male) were enrolled in the study. The mean age of overall patients was 22.97 years at surgery for consecutive XT. The groups did not display significant differences in terms of surgery ages, gender, refraction values, visual acuity, amblyopia, inferior oblique overaction, limitation of adduction, surgical success rates, and follow-up time (p > 0.05). Patients of Group 4 had larger preoperative and postoperative deviation, while Group 1 had smaller (p < 0.05). The surgical success rates of Groups 1, 2, 3, 4 were 90%, 75%, 76.9%, and 50%, respectively (p = 0.192). Statistically, no factor was found to be effective in surgical success rates (p > 0.05). Conclusion: Surgical treatment of consecutive XT is successful in most of the patients with numerous surgical options performed on a single eye in a single session. Patients, particularly with a high amount of deviation should be warned about the possibility of additional surgery.Item Characteristics of Newly Diagnosed Hepatocellular Carcinoma Patients Across Turkey: Prospective Multicenter Observational 3K Registry Study(2021) Ozyilkan, Ozgur; 34876392Aims: To evaluate patient profile for epidemiological and clinicopathological characteristics and potential risk/prognostic factors in newly diagnosed hepatocellular carcinoma (HCC) patients across Turkey. Methods: A total of 547 patients (mean (SD) age 62.6 (10.3) years, 81.9% were males) were included in this registry study. Data on patient characteristics, etiologies of HCC, laboratory values, and tumor characteristics and stages were recorded at study enrollment. Results: HBV infection (68.2%) was the leading etiology, followed by HCV infection (17.2%), HDV infection (5.5%), alcohol (6.4%), and NAFLD (3.5%), as the major etiologies. Considering that 51.6% of the patients had >5 cm HCC, 44% were Child-Pugh B/C and 57% were BCLC B-D, it appears that a significant group of HCC patients were diagnosed at advanced stages. Of 540 patients, 271 (50.2%) were referred or applied with the diagnosis of HCC. Patients with HCC at presentation had larger tumor size (median (min-max) 6.6 (0-30) vs. 4.8 (0-90) cm, P<.001) and more advanced BCLC stage (Stage C-D in 40.8% vs. 26.4%, respectively, P=.005), compared to patients who were diagnosed during follow-up. Conclusions: Our findings revealed that HBV infection was the leading etiology and a moderate-to-advanced disease was evident in more than half of patients at the time of diagnosis. HCC patients diagnosed at follow-up had smaller tumor size and earlier BCLC stage.