Wos İndeksli Yayınlar Koleksiyonu

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    Heart failure with non-reduced ejection fraction: Epidemiology, pathophysiology, phenotypes, diagnosis and treatment approaches
    (2022) Cavusoglu, Yuksel; Celik, Ahmet; Altay, Hakan; Nalban, Sanem; Ozden, Ozge; Temizhan, Ahmet; Ural, Ditek; Unlu, Serkan; Yilmaz, Mehmet Birhan; Zoghi, Mehdi; 35969235
    Heart failure (HF) has been classified as reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) by the recent HF guidelines. In addition, HF with improved ejection fraction has been defined as a subgroup of HFrEF. In HFrEF, diagnostic workup and evidence-based pharmacological and device-based therapies have been well established. However, HFpEF, which comprises almost half of the HF population, represents significant uncertainties regarding its pathophysiology, clinical phenotypes, diagnosis and treatment. Diagnostic criteria of HFpEF have been changed a few times over the years and still remained a matter of debate. New paradigms including a prominent role of co-morbidities. inflammation, endothelial dysfunction have been proposed in its pathophysiology. As a complex, multifactorial syndrome HFpEF consists of many overlapping clinical and hemodynamic phenotypes. In contrast to HFrEF, clinical outcomes of HFpEF have not improved over the last decades due to lack of proven effective therapies. Although HFrEF and HFpEF have different clinical spectrums and proposed pathophysiological mechanisms, there is no clear defining syndrome postulated for HFmrEF. Clinical characteristics and risk factors of HFmrEF overlap with HFrEF and HFpEF. HFmrEF is also referred as a transitional zone for dynamic temporal changes in EF. So. HFpEF and HFmrEF, both namely HF with non-reduced ejection fraction (HF-NEF), have some challenges in the management of HF. The purpose of this paper is to provide a comprehensive review including epidemiology, pathophysiology, clinical presentation and phenotypes of HF-NEF and to guide clinicians for the diagnosis and therapeutic approaches based on the available data in the literature.
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    Psikososyal Stres Faktorleriyle Tetiklenen Erken Baslangicli Konversiyon Bozuklugu Olarak Astazi-Abazi Olgusu 2
    (2022) Guler Aksu, Gulen; KAYAR, Ozan; TAN, Muhammet Emin; KUTUK, Meryem ozlem; BOZLU, Gulcin; TOROS, Fevziye
    Conversion disorder is defined as the loss or change of motor, sensory, and autonomic nervous system-related functions that cannot be explained completely with organic causes. The etiology of the disease may be explained by psychoanalytic theory, learning theory, sociocultural factors, and some traumatic life events besides genetic and neurobiological factors. The onset is usually between late childhood and early adulthood. The disorder occurs after a high rate of psychosocial stressors and the symptoms can vary. While astasia, as one of the possible complaints in conversion disorder, is defined as not being able to stand due to loss of motor power or sensory loss; abasia is identified as patients having no apparent motor problem but not being able to walk properly. Both conditions can be of organic as well as the psychogenic origin. In this paper, the clinical signs of a seven-year-old boy who was admitted to emergency service of Mersin University Faculty of Medicine with the complaints of astasia and abasia but was found to have conversion disorder is presented. The results of the medical examinations and the possible psychosocial stress factors behind these symptoms, as well as the treatment process of the case, were shared. With this report, we is aimed to draw attention to the importance of early diagnosis of the disorder, the necessity of an interdisciplinary approach in the treatment process, and the handling of psychosocial factors leading to somatic symptoms.
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    Effect Of Tacrolimus In The Inner Ear Of Rats
    (2022) Uysal, Fatmanur; Erbek, Selim S.; Erbek, Seyra; Culhaoglu, Belde
    Purpose: Tacrolimus, an immunosuppressive agent, is used especially after organ transplantation. It has been asserted that tacrolimus has protective effects on the auditory system in some studies while it has negative effects in other studies. The purpose of our study is to investigate the effect of tacrolimus on the inner ear of the rats. Materials and Methods: 20 healthy Sprague Downey male rats weighing 250-350 grams were included in our study. The first group of rats were given 1mg/kg tacrolimus (n:7), the second group of rats were given 0.1 mg/kg tacrolimus (n:7), and the third group (n:6) was the non-administered control group. The first measurements of all rats were taken with distortion-product otoacoustic emission before starting the experiment. Then, tacrolimus drug was administered by gavage method to the 1st and 2nd groups along 30 days. The last measurement was repeated on the 30th day. Results: According to the results of the first measurements, emission was obtained in all rats and the responses were found to have similar characteristics. Similarly, the difference between the signal noise rate values in the last measurements taken from the groups not show any statistical significance. Conclusions: Based on the distortion-product otoacoustic emission measurements, it can be said that Tacrolimus does not have ototoxic effects on the auditory system of rats considering the administered dosage and time.
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    Safety and efficacy of angio-seal use in patients with acute ischemic stroke who received thrombolytic therapy and underwent mechanical thrombectomy
    (2022) Tanburoglu, Anil; Karluka, Ismail; Mazican, Mustafa; Andic, Cagatay
    Purpose: This study aims to evaluate the efficacy and safety of closure of the femoral artery access site using the Angio-Seal Vascular Closure Device in patients who underwent bridging intravenous thrombolytic therapy and subsequent mechanical thrombectomy (MT). Materials and Methods: The retrospective, observational study was performed in patients who were diagnosed with acute ischemic stroke and treated with MT after bridging IVT between September 2018 and September 2021. A total of 97 patients whose femoral artery access sites were closed with Angio-Seal after the procedure was performed were included in the study. Primary demographic data, accompanying risk factors, major and minor complication rates, frequency distributions of categorical variables, and descriptive statistics of quantitative data were calculated and recorded. Results: It was found that 96.9% of the patients did not have major complications, where 97.9% did not have minor complications either. Successful hemostasis was achieved in the groin region in all patients. Major complications observed were recorded as follows: 1 (1%) pseudo-aneurysm, 1 (%) inguinal incision site infection, and 1 (1%) Angio-Seal placement failure. No major complications were observed in 98.2% of those using 6 Fr (French) Angio-Seal and 95.1% of those using 8 Fr Angio-Seal. Conclusion: The findings of the study indicate that Angio-Seal is an effective and safe method for providing groin hemostasis in patients with acute ischemic stroke
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    The Blockade of the Dardanelles Strait and the Occupation of Bozcaada During the Tripoli and Balkan Wars, Through the Eyes of Telegrapher Ihsan (Pere) Bey
    (2022) Ozcan, Halil
    Tripoli and Balkan Wars accelerated the process leading to the collapse of the Ottoman Empire. In these wars, the Dardanelles Strait and the islands near the strait were the common target chosen by Italy and Greece for the surrender of the Ottoman Empire. In both wars, Ihsan (Pere) Bey served as the telegraph officer of the British Eastern Cable Company in Bozcaada. The Tripoli War was continuing when Ihsan Bey, who had started his civil service as an officer of the Istanbul Beyoglu British Cable Company, was appointed as officer to Bozcaada for the second time. Ihsan Bey's witnessing in Bozcaada to the hot war of the Italian Navy and the Turkish Redoubts on April 18, 1912 and the detailed information he has given are important. In addition, the occupation of Bozcaada by Greece during the Balkan War is also included in detail in Ihsan Bey's memoirs. The originality of this study results from the fact that Ihsan Bey's memoirs when Italians reached to the entrance of the Dardanelles and regarding the occupation of Bozcaada are evaluated scientifically and published for the first time.
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    Evaluation of performance levels of students for moodle learning management system in terms of usability Criteria with PSI-Entropy-Marcos integration
    (2022) Yorulmaz, Muhammet; Can, Gulin Feryal
    The study, it is aimed to determine and compare the end-user performances within the scope of achieving the determined objectives while using the Moodle Learning Management System (LMS). Accordingly, considering multiple usability criteria, 18 users were prioritized in terms of their performances in using Moodie LMS. In this direction, Preference Selection Index (PSI) and Entropy integration was used to determine the importance weights of usability criteria, and the Measurement of Alternatives and Ranking according to Compromise Solution (MARCOS) method was used to prioritize the end-users. A new hybrid weighting method has been proposed by integrating the PSI method with the Entropy method, taking into account both the uncertainty in the performance values of the end-users according to the criteria and the preference change values of the criteria. This proposed method is applied for a three-dimensional initial decision matrix Thus, the traditional two-dimensional initial decision matrix which consists of the alternatives and the values that the alternatives take according to the criteria, has been developed and made more flexible. The objective criteria taken into account in the analysis were measured by the Morae V3 program, with the tasks defined as predetermined goals being performed by the users on the Moodie LMS. In addition, the criteria weights obtained from the proposed PSI-Entropy integration were used in the MARCOS method to rank the end-users according to their performance levels.
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    Should We Accept the HPV Type 66 into a Probable High-Risk Group? The Prevalence, Clinical and Histopathological Evaluation of HPV Type 66 in Gazi University, Ankara
    (2021) Kazanci, Ferah; Kocak, Aylin Altay; Colak, Meryem; Erdem, Ozlem; Onan, M. Anil; Bozdayi, Gulendam; 0000-0002-0451-0142; AAI-8012-2021
    Introduction: The prevalence of infection by different genotypes of human papillomavirus (HPV) varies among different geographic areas. The objective of the study is to determine the prevalence and distribution of HPV66 genotype among women with normal or abnormal Pap smear tests. Methods: This retrospective study was conducted in a tertiary care university hospital between January 2017 and February 2018, in central Anatolia of Turkey. This study included 288 women, 66 (%22.9) of whom had HPV DNA positive. HPV DNA screening was done by an automatized system using real time PCR method (Cobas 4800 System, Roche Diagnostics Ltd, Switzerland) and this method distinguishes types 16 and 18, while the other 12 oncogene types are reported as high-risk HPV (HR-HPV: 31,33,35,39,45,51,52,56,58,59,66,68). For the genotyping of other oncogene types, a commercial real time PCR method (NLM Genotypes 14 Real-TM Quant, NLM Diagnostic, Italy) was used. Results: The most common identified HPV types were HPV16 (%6.3), HPV 56 (%3.8), HPV 18(%3.1), HPV 66 (%3.1), HPV 51 (%2.8), HPV 52(%2.1). HPV type 66 which has admitted recently other-subtypes with their unclear oncogenicity is the third most identified type in our study. In our study 9 (%3.1) women had type 66 and 2 (%0.7) of whom had abnormal Pap smear results. One patient with syphilis whose pap smear test results was ASC-H/HSIL was evaluated by colposcopic examination and LEEP (Loop Electrosurgical Excision Procedure) and ECC (Endocervical Curettage) were performed. The result of histopatological report was benign. The other patient whose Pap smear test result was LSIL evaluated by colposcopic examination and found no pathological finding. Conclusion: The frequency of HPV 66 infection was found to be higher in our study compared to previous reports. In 2 patients out of 9 cases (% 2.4) who were detected HPV 66 had normal pap test results.
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    A Comparison of Echocardiography and the Pressure Recording Analytical Method (PRAM) for Predicting Fluid Responsiveness after Passive Leg Raising
    (2021) Ozdemirkan, Aycan; Aitakhanoya, Manat; Gedik, Ender; Zeyneloglu, Pinar; Pirat, Arash; 0000-0002-7175-207X; ABI-2971-2020
    Objective: This study aims to assess the agreement between the cardiac index (CI) measured by pressure recording analytical method (PRAM) and transthoracic echocardiography (TTE) before and after the passive leg raise (PLR) maneuver. Methods: This is a prospective observational study in critically ill patients who were monitored with MostcareUp/PRAM (Vygon, Vytech, Padova, Italy). Cardiac index (CI) values and percent changes in CI values in response to PLR were recorded by TTE and PRAM. Results: Data of a total of 25 patients were collected. The median CI values that were calculated by TTE before and after PLR were 2.5 (1.2-4.7) L/min/m(2) and 2.9 (1.4-5.6) L/min/m(2), respectively. The median CI values that were calculated by PRAM before and after PLR were 2.5 (1.5-4.8) L/min/m(2) and 2.6 (1.7-5.7) L/min/m(2), respectively. There was significant correlations between the measured CI values both by TTE and PRAM before and after PLR (r=0.635, p=0.001 and r=0.610, p=0.001, respectively). The median percent changes in CI with TTE and PRAM were -0.13 (-0.7-0.4) and -0.11 (-0.5-0.5), respectively. Sixteen patients were determined as FR by TTE (64%) and 13 patients were determined as FR by PRAM (52%). The Kappa test showed moderate agreement between TTE and PRAM for predicting fluid responsiveness (k=0.595; p=0.002). The mean biases between the CI values measured by TTE and PRAM before and after PLR were 0.04 +/- 0.77 L/min/m(2) and 0.22 +/- 0.88 L/min/m(2), respectively. Conclusion: This study showed a significant correlation for CI values measured by both methods. For predicting fluid responsiveness there was agreement between the two methods after PLR.
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    Can Digital Game Play Improve Older Adults' Cognitive Skills?
    (2021) Secer, Ilmiye
    Cognitive skills are essential for the performance of basic and instrumental daily living activities such as self-care, medication, and finance management. A decline in cognitive abilities with increasing age thus hinders older adults' ability to remain independent in society and negatively influences their quality of life. Therefore, many studies have investigated ways that can maintain and effectively improve such skills. Digital games have become a favored leisure activity by all age groups and are played for entertainment and stress relief. In this context, the ease with which digital games can be played within the home and their entertaining nature have led researchers to examine their effectiveness in enhancing older adults' cognitive skills. Although the findings indicate cognitive advantages, such as improved reaction times, working memory, and task-switching abilities, many questions require further clarification before claiming that digital game play is an effective cognitive training regime. Therefore, the current review aims to examine the cognitive advantages of digital games for older adults and suggests future research directions. The following topics need to be further explored: the existence of far transfer effects, that is, whether such improvements lead to better performance of daily activities, the long-term maintenance of enhanced skills and the underlying responsible mechanisms, the ecological validity of digital games, and digital games' provision of benefits beyond cognitive simulations. Furthermore, the importance to consider placebo effects, which was suggested by Boot, Blakely, and Simons (2011) and Boot, Simons, Stothart, and Stutts (2013), is emphasized.