Sağlık Hizmetleri Meslek Yüksekokulu / Vocational School of Health Services

Permanent URI for this collectionhttps://hdl.handle.net/11727/3080

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THE COST-EFFECTIVENESS ANA LYSIS FOR HIV TREATMENT ALTERNATIVES IN TURKEY
(2014) Kockaya, G.; Yenilmez, F.B.; Zengin, Elbir T.; Dalgic, C.; Malhan, S.; Cerci, P.; Oksuz, E.; Tayfun, K.; Unal, S.; 27202504
CHARACTERISTICS OF THE MEDICINES WHICH HAVE ANNUAL AVERAGE HIGHEST AMOUNT OF SALES OF BETWEEN YEARS 2008-2013
(2014) Akbulat, A.; Dogan, E.; Babacan, S.; Uman, N.; Tolun, C.; Vural, I. M.; Vural, E. H.; Yilmaz, Safak E.; Dasdag, M. M.; Kahveci, R.; Malhan, S.; Artiran, G.; Kerman, S.; 27201011
PANCREATIC CYSTIC LYMPHANGIOMA: DIAGNOSTIC APPROACH WITH MDCT AND MR IMAGING
(2014) Macin, G.; Hekimoglu, K.; Uner, H.; Tarhan, C.
Lymphangiomas are rare congenital benign tumors arising from the lymphatic system mostly encountered in the neck and axillary regions of pediatric patients. Pancreatic cystic lymphangiomas very rarely occur in adults. Radio-logically, the lesion may mimic pancreatic carcinoma and should be considered in the differential diagnosis of any patient found to have an abdominal cystic mass. In this article, we present a 50-year-old man who presented with pain in the upper abdomen, nausea, and abdominal swelling. On computed tomography (CT) and magnetic resonance (MR) imaging, a gross septated cystic lesion was detected in the upper abdomen which extended from the pancreatic corpus to the left liver lobe. The patient underwent complete resection of tumor Pathology revealed a cystic lymphangioma.
The effect of dentin desensitizers, and Nd:YAG laser pre-treatment on microtensile bond strength of self-adhesive resin cement to dentin
(2014) Acar, Ozlem; Tuncer, Duygu; Yuzugullu, Bulem; Celik, Cigdem
PURPOSE. The purpose of this study is to evaluate if pre-treatment with desensitizers have a negative effect on microtensile bond strength before cementing a restoration using recently introduced self-adhesive resin cement to dentin. MATERIALS AND METHODS. Thirty-five human molars' occlusal surfaces were ground to expose dentin; and were randomly grouped as (n=5); 1) Gluma-(Glutaraldehyde/HEMA) 2) Aqua-Prep F-(Fluoride), 3) Bisblock-(Oxalate), 4) Cervitec Plus-(Clorhexidine), 5) Smart protect-(Triclosan), 6) Nd:YAG laser, 7) No treatment (control). After applying the selected agent, RelyX U200 self-adhesive resin cement was used to bond composite resin blocks to dentin. All groups were subjected to thermocycling for 1000 cycles between 5-55 degrees C. Each bonded specimen was sectioned to microbars (6 mm X 1 mm X 1 mm) (n=20). Specimens were submitted to microtensile bond strength test at a crosshead speed of 0.5 mm/min. Kolmogorov-Smirnov, Levene's test, Kruskal Wallis One-way Analysis of Variance, and Conover's nonparametric statistical analysis were used (P<.05). RESULTS. Gluma, Smart Protect and Nd:YAG laser treatments showed comparable microtensile bond strengths compared with the control group (P>.05). The microtensile bond strengths of Aqua-Prep F, and Cervitec Plus were similar to each other but significantly lower than the control group (P<.05). Bisblock showed the lowest microtensile bond strength among all groups (P<.001). Most groups showed adhesive failure. CONCLUSION. Within the limitation of this study, it is not recommended to use Aqua-prep F, Cervitec Plus and Bisblock on dentin when used with a self-adhesive resin cement due to the decrease they cause in bond strength. Beside, pre-treatment of dentin with Gluma, Smart protect, and Nd:YAG laser do not have a negative effect.
Estimation of the Cost of Childhood Asthma in Turkey
(2014) Sekerel, B.; Malhan, S.; 27202032
EFFECTS OF REFERENCE PRICE SYSTEM ON MEDICINES WHICH HAVE ANNUAL AVERAGE HIGHEST AMOUNT OF SALES OF BETWEEN YEARS 2008-2013
(2014) Uman, N.; Tolun, C.; Babacan, S.; Dogan, E.; Vural, I.M.; Dasdag, M. M.; Yilmaz, Safak E.; Malhan, S.; Kahveci, R.; Akbulat, A.; Artiran, G; Kerman, S.; 27201003
A COST-EFFECTIVENESS EVALUATION FOR A NEW THERAPY IN HIV TREATMENT
(2014) Malhan, S.; Kockaya, G.; Zengin, Elbr T.; Dalgic, C.; Yenilmez, F.B.; Cerci, P.; Oksuz, E.; Tayfun, K.; Unal, S.; 27202495
THE EFFECTS OF REFORMS, PRICE CUTS AND GLOBAL BUDGET IMPLEMENTATION ON BIOTECHNOLOGICAL MEDICINE SALES WHICH HAVE ANNUAL AVERAGE HIGHEST AMOUNT OF SALES BETWEEN 2008-2013 IN TURKEY
(2014) Vural, E.H.; Vural, I.M.; Yiğit, O.; Uman, N.; Tolun, C.; Babacan, S.; Dogan, E.; Akbulat, A.; Kahveci, R.; Malhan, S.; Artiran, G.; Kerman, S.; 27200997
THE EFFECTS OF REFORMS, PRICE CUTS AND GLOBAL BUDGET IMPLEMENTATION ON ORIGINAL/GENERIC MEDICINE SALES WHICH HAVE ANNUAL AVERAGE HIGHEST AMOUNT OF SALES BETWEEN 2008-2013 IN TURKEY
(2014) Vural, I.M.; Vural, E.H.; Yiğit, O.; Dogan, E.; Babacan, S.; Tolun, C.; Uman, N.; Akbulat, A.; Malhan, S.; Kahveci, R.; Artiran, G.; Kerman, S.; 27201007
COST-EFFECTIVENESS OF EXENATIDE TWICE DAILY (BID) ADED TO BASAL INSULIN COMPARED TO A BOLUS INSULIN AD-ON IN TURKEY
(2014) Malhan, S.; Guler, S.; Yetkin, I.; Baeten, S.; Verheggen, B.; 27200672
THE DIRECT COST OF ASTHMA IN TURKEY
(2014) Turktas, H.; Bavbek, S.; Malhan, S.; 27202030
Effects of self-ligating and conventional brackets on halitosis and periodontal conditions
(2015) Kaygisiz, Emine; Uzuner, Fatma Deniz; Yuksel, Sema; Taner, Levent; Culhaoglu, Rana; Sezgin, Yasemin; Ates, Can; 25101909
Objective: To evaluate the effects of fixed orthodontic treatment with steel-ligated conventional brackets and self-ligating brackets on halitosis and periodontal health. Materials and Methods: Sixty patients, at the permanent dentition stage aged 12 to 18 years, who had Angle Class I malocclusion with mild-to-moderate crowding were randomly selected. Inclusion criteria were nonsmokers, without systematic disease, and no use of antibiotics and oral mouth rinses during the 2-month period before the study. The patients were subdivided into three groups randomly: the group treated with conventional brackets (group 1, n = 20) ligated with steel ligature wires, the group treated with self-ligating brackets (group 2, n = 201, and the control group (group 3, n = 20). The periodontal records were obtained 1 week before bonding (T1), immediately before bonding (T2), 1 week after bonding (T3), 4 weeks after bonding (T4), and 8 weeks after bonding (T5). Measurements of the control group were repeated within the same periods. The volatile sulfur components determining halitosis were measured with the Halimeter at T2, T3, T4, and T5. A two-way repeated measures of analysis of variance (ANOVA) was used to compare the groups statistically. Results: No statistically significant group x time interactions were found for plaque index, gingival index, pocket depth, bleeding on probing, and halitosis, which means three independent groups change like each other by time. The risk of tongue coating index (TCI) being 2 was 10.2 times higher at T1 than at T5 (P < .001). Therefore, the probability of higher TCI was decreased by time in all groups. Conclusions: The self-ligating brackets do not have an advantage over conventional brackets with respect to periodontal status and halitosis.
DAPAGLIFLOZIN VERSUS A DIPEPTIDYL PEPTIDASE 4 INHIBITOR (DPP4) BOTH ADDED TO METFORMIN IN PATIENTS WITH TYPE 2 DIABETES MELLITUS (T2DM): IMPACT ON HEALTH, QUALITY OF LIFE AND COSTS IN THE TURKISH CLINICAL SETTING
(2015) Malhan, S.; Guler, S.; Yetkin, I.; Ignacio, T.J.; Verheggen, B.; Charokopou, M.
IMPORTANCE OF HYPOGLYCEMIA BARRIER ON THE TREATMENT OF DIABETES MELLITUS (DM) - SURVEY WITH TURKISH PHYSICIANS
(2015) Malhan, S.; Emral, R.; Guler, S.
The role of shear wave elastography in the diagnosis of chronic autoimmune thyroiditis
(2015) Hekimoglu, Koray; Donmez, Fuldem Yildirim; Arslan, Serdar; Ozdemir, Adnan; Demir, Canan; Yazici, Canan; 26343080
Aims: The aim of this study is to assess the applicability of shear wave elastography (SWE) in the diagnosis of chronic autoimmun thyroiditis (CAT) patients. Material and methods: The study group consisted of 50 patients with first-diagnosed CAT and 40 control subjects (CS). In all patients with CAT and CS, sonoelastographic measurements were made in both thyroid lobes. Optimal cut-off values were chosen to maximize the sum of sensitivity and specificity. Positive predictive value (PPV), negative predictive value (NPV), and accuracy values were also calculated. Results: Quantitative elastographic analysis evaluated by SWE in CAT patients (2.56 +/- 0.30 m/s) was significantly higher compared with CS (1.63 +/- 0.12 m/s) (p<0.001). The optimal cut-off value was 2.42 m/s. SWE had 77% sensitivity, 71% specificity, 92% PPV, 81% NPV, and 87% accuracy for the presence of CAT. Conclusions: Our data indicate that SWE correctly defines the elasticty of thyroid parenchyma, and this technique may assist in the diagnosis and treatment monitoring of CAT.
The Effect of Three Different Crown Heights and Two Different Bone Types on Implants Placed in the Posterior Maxilla: Three-Dimensional Finite Element Analysis
(2016) Cinar, Duygu; Imirzalioglu, Pervin; 27004295
Purose: The purpose of this study was to determine the amount and localization of functional stresses in implants placed in two different bone types (type 3 and type 4) with three different crown heights in the atrophic posterior maxilla using finite element analysis. Materials and Methods: A three-dimensional finite element model of the posterior maxilla was created from a computerized tomography image by using the Marc 2005 (MSC Software) program. Three different crown/implant ratios (1/1, 1.5/1, 2/1) in the first molar tooth zone were modeled. Type 3 and type 4 bone quality according to the classiication system of Lekholm and Zarb was created. The total oblique force of 300 N with a 30-degree angle was applied from the locations of the mesiobuccal cusp (150 N) and the distobuccal cusp (150 N) of first molar teeth. Results: For the implants, the highest stresses were observed around the implant neck at the crown/implant ratio of 2/1 (430.57 MPa). As the crown/implant ratio increased two times, the von Mises stresses increased at a rate of 47%. The highest tensile values exceeded the ultimate tensile strength of the cortical bone for all the designs. Also, the highest compressive values exceeded the ultimate compressive strength of the cortical bone in the 2/1 design for type 3 bone, and in the 1.5/1 and 2/1 designs for type 4 bone. As the crown/implant ratio increased from 1/1 to 2/1, the highest tensile value and the highest compressive value increased 13%. For the spongious bone, as the crown/implant ratio increased, the highest tensile value increased 42% and 85%, respectively. Tensile stresses increased at a rate of 26% in the 1/1 ratio, 30% in the 1.5/1 ratio, and 32% in the 2/1 ratio when the density of spongious bone decreased. Compression-related values also increased 34% in the 1/1 ratio, 35% in the 1.5/1 ratio, and 36% in the 2/1 ratio when the density of spongious bone decreased. Conclusion: Compressive and tensile stresses formed mostly at the alveolar bone around the implant neck that was cortical bone. Thus, it had to be preserved during the surgical procedures. Deformation due to the stresses had great importance for the type IV spongious bone due to the increase caused by the higher crown height levels.
Portopulmonary hypertension in liver transplant candidates
(2016) Bozbas, Serife Savas; Bozbas, Huseyin; 26877607
Pulmonary vascular disorders including portopulmonary hypertension (PoPHT) are among the common complications of liver disease and are prognostically significant. Survival is very low without medical treatment and liver transplantation. With advances in medical therapy for elevated pulmonary artery pressure (PAP) and liver transplant surgery, survival of patients with PoPHT and advanced liver disease is significantly improved. Because of the prognostic significance of PoPHT and the limited donor pool, a comprehensive preoperative cardio-pulmonary assessment is of great importance in cirrhotic patients prior to transplant surgery. Therefore, a detailed transthoracic Doppler echocardiographic examination must be an essential component of this evaluation. Patients with mild PoPHT can safely undergo liver transplant surgery. In cases of moderate to severe PoPHT, right heart catheterization (RHC) should be performed. In patients with moderate to severe PoPHT on RHC (mean PAP 35-45 mmHg), vasodilator therapy should be attempted. Liver transplantation should be encouraged in cases that demonstrate a positive response. Bridging therapy with specific pulmonary arterial hypertension treatment agents should be considered until the transplant surgery and should be continued during the peri-and post-operative periods as needed.
COST EFFECTIVENESS OF PEGFILGRASTIM FOR REDUCING INCIDENCE OF FEBRILE NEUTROPENIA EVENTS AFTER CYTOTOXIC CHEMOTHERAPY FOR SOLID TUMORS IN TURKEY
(2016) Malhan, Simtem; Saka, G; Villa, G.; Worth, G.; Barron, R.; Lyman, G.H.
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.
Dedifferentiated Epithelial-Myoepithelial Carcinoma of the Parapharyngeal Area: Case Report
(2016) Akcay, F. Yilmaz; Canpolat, T.; Erkan, A. N.; Borcek, P.; Gunhan, O.; 0000-0001-7138-1400; AAK-8107-2021; H-1063-2019