PubMed Kapalı Erişimli Yayınlar

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De Novo Malignant Neoplasms in Renal Transplant Patients
(2016) Akcay, Eda Yilmaz; Tepeoglu, Merih; Ozdemir, Binnaz Handan; Deniz, Ebru; Borcek, Pelin; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-9894-8005; 0000-0002-7528-3557; 0000-0001-6831-9585; 27805524; AAJ-8097-2021; AAK-5222-2021; X-8540-2019; AAK-1960-2021
Objectives: The aim of this study was to evaluate the incidence of posttransplant malignancy in kidney transplant patients and investigate the clinical and histopathologic features of these patients. Materials and Methods: We retrospectively reviewed information on donor and recipient characteristics, patient and graft survival, and cancer incidence after transplant for 867 kidney transplant patients. Patients with neoplasms prior to transplant were excluded. A follow-up study estimated cancer incidence after transplant. Results: Neoplasms were diagnosed in 59 patients (6.8%), 41 men and 18 women; 22 (37.3%) had skin tumors, 19 (32.2%) had solid tumors, 10 (16.9%) had posttransplant lymphoproliferative disorders, and 8 (13.6%) had Kaposi sarcoma. The mean age at the time of malignant tumor diagnosis was 42.7 +/- 13.6 years, and statistically significant differences were found between tumor groups (P < .01). The average latency period between transplant and diagnosis of malignant tumors was 99.8 +/- 56.9 months for solid tumors, 78.4 +/- 52 months for skin tumors, 64.5 +/- 48.8 months for posttransplant lymphoproliferative disorders, and 13.5 +/- 8.8 months for Kaposi sarcoma, with significant difference found between tumor groups (P < .01). Ten patients (16.9%) had more than 1 malignant tumor. Eighteen patients died, with a mean time to death of 31.5 +/- 22.8 months after tumor diagnosis. A significant positive association was found between survival and the number of tumors (P = .001); 5-year survival after tumor diagnosis was 81% and 40% for patients with 1 malignant tumor and patients with more than 1 malignant tumor, respectively. Conclusions: Malignancy is a common cause of death after renal transplant. Early detection and treatment of posttransplant malignancies is an important challenge. Screening these patients for malignancies posttransplant is crucial, and efforts should be directed to define effective immunosuppressive protocols that are associated with a lower incidence of malignancy.
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.
The relation of presenting symptoms with staging, grading, and postoperative 3-year mortality in patients with stage I-III non-metastatic colon cancer
(2016) Bedir, Osman; Kiziltas, Safak; Kostek, Osman; Ozkanli, Seyma; 27210779
Background/Aims: To evaluate the association of presenting symptoms with staging, grading, and postoperative 3-year mortality in patients with colon cancer. Materials and Methods: A total of 132 patients-with a mean (standard deviation; SD) age of 63.0 (10.0) years and of whom 56.0% were males-with non-metastatic stage I-III colon cancer were included. Symptoms prior to diagnosis were evaluated with respect to tumor localization, tumor node metastasis (TNM) stage, histological grade, and postoperative 3-year mortality. Results: Constipation and abdominal pain were the two most common symptoms appearing first (29.5% and 16.7%, respectively) and remained most predominant (25.0% and 20.0%, respectively) up to diagnosis. The frequency of admission symptoms significantly differed with respect to tumor location, TNM stage and histological grade. The postoperative 3-year survival rate was 61.4%. Multivariate logistic regression revealed that melena and rectal bleeding increased the likelihood of 3-year mortality by 13.6-fold (p=0.001) and 4.08-fold (p=0.011), respectively. Conclusion: Our findings revealed differences in presenting symptom profiles with respect to the time of manifestation and predominance as well as to the TNM stage, histological grade, and tumor location. Given that melena and rectal bleeding increased the 3-year mortality risk by 13.6-fold and 4.08-fold, respectively, our findings indicate the association of admission symptoms with outcome among patients with colon cancer.
Etiologies, outcomes, and prognostic factors of pediatric acute liver failure: A single center's experience in Turkey
(2016) Ozcay, Figen; Karadag-Oncel, Eda; Baris, Zeren; Canan, Oguz; Moray, Gokhan; Haneral, Mehmet; 0000-0003-2498-7287; 0000-0002-3462-7632; 0000-0002-5214-516X; 0000-0003-0614-4497; 27782894; AAE-1041-2021; AAJ-8097-2021; ABG-5684-2020; AAB-4153-2020; AAI-9386-2021
Background/Aims: Our aim was to determine the etiologies, outcomes, and prognostic indicators in children with acute liver failure. Materials and Methods: Ninety-one patients who were followed for pediatric acute liver failure (PALF) over a 15-year period were included. Patients who survived with supportive therapy were designated as Group 1, while those who died or underwent liver transplantation were designated as Group 2. Results: There were 37 (40.6%) patients in Group 1 (spontaneous recovery) and 54 (59.4%) patients in Group 2. Thirty-two patients (35.2%) underwent liver transplantation. Infectious and indeterminate causes were the most common etiologies (33% each). Among the infectious causes, hepatitis A (76%) was the most frequent. Hepatic encephalopathy grade 3-4 on admission and during follow-up and high Pediatric Risk of Mortality (PRISM) and Pediatric End-Stage Liver Disease (PELD) scores within the first 24 h were related with a poor prognosis. Group 2 had a more prolonged prothrombin time, higher international normalized ratio, more prolonged activated partial thromboplastin time (aPTT), and higher levels of total and direct bilirubin, ammonia, and lactate (for all, p<0.01). Conclusion: Infectious and indeterminate cases constituted the most common etiology of PALF, and the etiology was related to the prognosis in our series. Although high PELD and PRISM scores were related to poor prognoses, no sharp thresholds for individual laboratory tests could be elucidated. Liver transplantation was the only curative treatment for patients with poor prognoses and resulted in high survival rates (1-, 5-, and 10-year survival rates of 81.3%, 81.3%, and 75%, respectively) in our study.
Is there any association between colonic polyps and gastric intestinal metaplasia?
(2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Korkmaz, Huseyin; Erinanc, Ozgur Hilal; 27210777
Background/Aims: Chronic gastritis progression is a multistep process of atrophy, intestinal metaplasia (IM), and dysplasia, which may lead to invasive carcinoma. In this study, we identified an association of colonic polyps with gastric IM in patients undergoing colonoscopy. Materials and Methods: This retrospective case-control, cross-sectional study was conducted in a tertiary-care institution in Turkey. Pathology and endoscopy reports were reviewed. The study group comprised 400 patients with colonic adenomatous polyps, and the control group comprised 360 patients without colonic adenomatous polyps on colonoscopy. Results: The risk of gastric IM was 1.42-fold higher in the study group (p<0.05). The risk of IM in patients aged >= 50 years with colonic polyps was 3.35-fold higher than in those aged <50 years (p<0.05). The risk of Helicobacter pylori infection in the study group was 1.07-folder higher than that in the control group (p<0.05). H. pylori infection prevalence was higher only in patients with high-grade colonic polyp dysplasia (p<0.05). There were no statistically significant differences in the proportion of incomplete IM between the groups (p<0.05). Conclusion: This study observed increased rates of gastric IM with colonic polyps. An increased risk of gastric IM was associated with higher grades of polyp dysplasia.
Assessing the knowledge in primary health care following an educational course structured in the context of GARD chronic airway diseases national control program
(2017) Balkan, Arzu; Oner Erkekol, Ferda; Kokturk, Nurdan; Mungan, Dilsad; Sackesen, Cansin; Onen, Zeynep Pinar; Ozkan, Secil; Ergun, Pinar; Kocabas, Can Naci; Baran Aksakal, Nur; Ekici, Banu; Ozkan Altunay, Zubeyde; Gemicioglu, Bilun; Yorgancioglu, Arzu; 0000-0002-4032-0944; 28990886; AAC-7548-2020
Introduction: Chronic obstructive pulmonary diseases are common causes of disease in the community and account for considerable percent of the caseload in primary health care facilities. For this reason, it is important to question and improve the knowledge of primary health care physicians. This study is designed to assess the level of knowledge for bronchial asthma and COPD of the primary healthcare physicians, both before and immediately after an educational course structured in the context of GARD Chronic Airway Diseases National Control Program. Materials and Methods: The participating physicians attended an intensive educational course on asthma and COPD. Twenty five item questionnaires for asthma and COPD were administered to the participants both before and immediately after the end of the course. Contribution of education to the level of knowledge was investigated by comparing the percentages of the correct answers in the pre-and post-test. Results: From 11 different cities, 1817 and 1788 primary health care physician were attended to the asthma and COPD educations, respectively. The accuracy rate of >= 75% was obtained from only 4 questions in pre-test asthma questionnaire. On the contrary, in 15 questions the accuracy rate was < 50%. The mean accuracy rate for the whole asthma test was 45.8%, and this rate raised to 69.6% after education course. The accuracy rate of >= 75% could not be obtained from any of the questions in pre-test COPD questionnaire. On the contrary, in 19 questions the accuracy rate was < 50%. The mean accuracy rate for the whole asthma test was 42.0%, and this rate raised to 71.3% after education course. Conclusion: It has been shown that, in primary care settings, the level of knowledge in asthma and COPD should be enhanced and that this increase can be achieved with an education course.
Evaluation of nephrotoxicity and prognosis in patients treated with colistin due to hospital-acquired pneumonia
(2017) Ulubay, Gaye; Korkmaz Ekren, Pervin; Toreyin, Zehra Nur; Berk Takir, Huriye; Kalamanoglu Balci, Merih; Gaygisiz, Ummugulsum; Gursel, Gul; Ergan, Begum; Yalcin, Aslihan; Saltürk, Cuneyt; Aydogdu, Muge; Ergun, Recai; Guven, Pinar; Gurun Kaya, Aslihan; Celtik, Aygul; Uluer, Hatice; Bacakoglu, Feza; Sayiner, Abdullah; 0000-0003-2478-9985; 29631525; AAB-5064-2021
Introduction: Colistimethate sodium (CMS) is frequently used in the treatment of nosocomial multidrug-resistant gram-negative infections. Nephrotoxicity is the most important side effect. The aim of this study is to evaluate the effect of colistin on nephrotoxicity and to assess prognosis in patients treated with CMS due to hospital-acquired pneumonia (HAP). Materials and Methods: Patients treated with CMS for HAP due to multidrug-resistant Pseudomonas aeruginosa or Acinetobacter baumannii were included in this cohort study. Results: We evaluated 281 patients treated with two different brands of CMS whose administration dose is different: imported (n=58, low dose/kg) and domestic (n=223, high dose/kg). Nephrotoxicity developed in 175 patients (62.3%). The median age (73 vs. 66 years, p=0.004) and mortality rates were higher (66.9% vs. 52.8%, p=0.022) in patients having nephrotoxicity. The patients receiving high dose/kg had higher nephrotoxicity rate (67.7% vs. 41.4%, p < 0.001). The clinical, bacteriological response and mortality rates of the whole group were 52.0%, 61.0%, 61.6%, respectively. The clinical and bacteriological response rates were similar in the different dose groups. Multivariate analysis showed that nephrotoxicity was associated with domestic brand depending on use of high dose (OR=3.97), advanced age (beta=0.29, p=0.008), male gender (OR=2.60), hypertension (OR=2.50), red blood cells transfusion (OR=2.54), absence of acute kidney injury (OR=10.19), risk stage of RIFLE (OR=11.9). Conclusion: Nephrotoxicity is associated with the use of high dose colistin, age, gender, hypertension, red blood cells replacement and RIFLE stage. The mortality rate is higher in patients developing nephrotoxicity.
A Comparison of Er:YAG Laser with Photon-Initiated Photoacoustic Streaming, Nd:YAG Laser, and Conventional Irrigation on the Eradication of Root Dentinal Tubule Infection by Enterococcus faecalis Biofilms: A Scanning Electron Microscopy Study
(2017) Gulsahi, Kamran; Ungor, Mete; Ozkaya, Burcu Ozses; Gocmen, Julide Sedef; 0000-0003-3510-7265; 29279728; ABG-7526-2020; AAF-7291-2021; AAX-5565-2021
This study evaluated the antimicrobial efficacy of Er:YAG laser activation with photon-initiated photoacoustic streaming (PIPS), Nd:YAG laser disinfection, and conventional irrigation on Enterococcus faecalis biofilms using scanning electron microscopy (SEM). Biofilms were grown on 110 root halves and divided into the following: Groups 1 and 2 (saline and 1% NaOCl with apical position of PIPS, resp.), Groups 3 and 4 (saline and 1% NaOCl with coronal position of PIPS, resp.), Groups 5 and 6 (Nd: YAG laser after saline and 1% NaOCl irrigation, resp.) and Groups 7, 8, and 9 (conventional irrigation with 1% NaOCl, 6% NaOCl, and saline, resp.). SEM images of the apical, middle, and coronal levels were examined using a scoring system. Score differences between Groups 1 and 2 were insignificant at all levels in the remaining biofilm. Group 4 had significantly greater bacterial elimination than Group 3 at all levels. Differences in Nd: YAG laser irradiation between Groups 5 and 6 were insignificant. Groups 7 and 8 were insignificantly different, except at the middle level. Saline group had a higher percentage of biofilms than the others. In this study, PIPS activation with NaOCl eliminates more E. faecalis biofilms in all root canals regardless of the position of the fiber tip.
Schistosomiasis and pulmonary hypertension
(2017) Sen, Nazan; 0000-0002-4171-7484; 29135402; AAI-8947-2021
Schistosomiasis is one of the most prevelant parazitic diseases in the world. It is endemic in more than 70 countries, and more than 200 million people worldwide are infected with Schistosoma. Pulmonary hypertension (PHT) is one of the chronic complications of schistosomiasis. The exact pathogenesis of schistosomiasisassociated pulmonary hypertension (S-PHT) remains unclear, although several mechanisms such as parazitic arterial embolisation, pulmonary arteriopathy, and portopulmonary hypertension have been suggested. Pathological pulmonary vascular changes in S-PHT were found similar to those in idiopathic pulmonary arterial hypertension (IPAH). The fact that schistosomiasis is one of the most common causes of pulmonary arterial hypertension (PAH), particularly in the developing countries, underlines the importance of enhancing our knowledge on this disease. Developments in the treatment of PAH have resulted in improved prognosis and significant increase in life expectancy and quality of life in the last two decades, which has enhanced the importance of S-PHT. Schistosomiasis is treated with praziquantel. Nevertheless, there is limited evidence that this treatment is effective for PHT. Although antihelmintic medications do not lead to significant improvement, they have beneficial effects and may slow down disease progression. Using PAH-specific treatments in the patients with schistosomiasis-associated PAH (S-PAH) can improve prognosis. However, inadequate clinical studies and limited sources in the endemic regions restrict extensive usage of these expensive medications. Further studies are required to determine the efficacy of these treatment modalities.
Comparison of Tunnel and Crestal Incision Techniques in Reconstruction of Localized Alveolar Defects
(2017) Altiparmak, Nur; Uckan, Sina; Bayram, Burak; Soydan, Sidika; 28520823
Purpose: The aim of this study was to compare the complication rates of recipient sites prepared using two incision techniques: crestal and tunnel. Materials and Methods: In this prospective study, patients underwent augmentation procedures (68 patients; 75 sites) by the same surgeon that were performed consecutively using the crestal incision technique (27 horizontal, 10 vertical; crestal group) or the tunnel incision technique (27 horizontal, 11 vertical; tunnel group). Autogenous bone block grafts were harvested with a piezoelectric surgical device, and the grafts were fixed at the recipient sites by two titanium screws in both groups. The authors evaluated minor exposure, transient paresthesia, major exposure, permanent paresthesia, gingival recession at adjacent teeth, surgery time, and visual analog scale pain scores. Results: Soft tissue dehiscence and graft failure were significantly lower in patients undergoing the tunnel technique. Conclusion: The tunnel incision technique significantly decreased soft tissue exposure, the most common complication of augmentation procedures with autogenous onlay bone grafts. This technique should be considered an alternative to the crestal incision technique for preparation of the recipient site.
Turkish Contribution to Journal of Neurosurgery and Acta Neurochirurgica
(2017) Altinors, Nur; Comert, Serhat; Sonmez, Erkin; Altinel, Faruk; 0000-0002-5693-3542; 0000-0002-8326-3900; 27593822; AAI-8820-2021; AAJ-5382-2021
AIM: To evaluate the contribution of Turkish scientists to four journals published by Journal of Neurosurgery (JNS) Publishing Group and to Acta Neurochirurgica (AN) and to its Supplement (ANS). MATERIAL AND METHODS: We reviewed every issue of those journals to December 2015 for the total number of articles, articles produced from studies performed entirely in Turkey, and for publications overseas co-authored by the Turkish scientists using the websites of these journals. Citations were searched using "Web of Science" and "Google Scholar" databases. RESULTS: The total number of articles published was 19822 for JNS, 3227 for JNS Spine, 2526 for JNS Pediatrics and 2997 for Neurosurgical Focus. Turkish contribution was 556 articles. 337 (60.61%) articles were the products of studies performed entirely in Turkey, while 219 (39.38%) articles came from overseas, co-authored by Turkish scientists. Overall contribution was 1.94%. A total of 6469 articles were published in AN. 340 papers were the products of studies performed entirely in Turkey. Turkish scientists working overseas co-authored 37 articles. Total contribution was 377 articles (5.82%). 4134 papers had been published in ANS. Contribution was 69 articles (1.66%). CONCLUSION: Turkish contribution to these journals has started late. The gap has been compensated with publications in the last two decades. Manuscripts of higher scientific level with greater number of citations are needed to increase Turkish contribution to such journals.
The role of lifestyle changes in gastroesophageal reflux diseases treatment
(2017) Dagli, Ulku; Kalkan, Ismail Hakki; 0000-0003-0664-0976; 29199165; S-4068-2018
Lifestyle modification has an important role in the treatment of gastroesophageal reflux disease (GERD). The development of GERD symptoms with various foods shows individual differences. Although there is not enough evidence that certain substances in a diet could lead to GERD symptoms, the literature suggests that there might be a relationship between reflux development and salt, salted foods, chocolate, fatty foods, and fizzy drinks. Because lying on the left side and raising the head of the bed in a supine position reduces the development of nocturnal reflux symptoms, the head should be elevated for patients with reflux symptoms at night, and the patient should lie on the left side. Smoking and obesity (especially abdominal) trigger GERD symptoms. Whereas excessive physical activity is a significant risk factor for the development of GERD, regular and mild-moderate physical activity has been shown to reduce the symptoms of reflux.
Results of a Multicenter Study Investigating Plasmid Mediated Colistin Resistance Genes (mcr-1 and mcr-2) in Clinical Enterobacteriaceae Isolates from Turkey
(2017) Aliskan, Hikmet Eda; Sari, Ayse Nur; Suzuk, Serap; Karatuna, Onur; Ogunc, Dilara; Karakoc, Ayse Esra; Cizmeci, Zeynep; Comert, Fsun; Bakici, Mustafa Zahir; Akpolat, Nezahat; Cilli, Fatma Feriha; Zer, Yasemin; Karatas, Aysel; Karapinar, Bahar Akgun; Bayramoglu, Gulcin; Ozdamar, Melda; Kalem, Fatma; Delialioglu, Nuran; Aktas, Elif; Yilmaz, Nisel; Gurcan, Saban; Gulay, Zeynep; 0000-0001-9060-3195; 28929967; AAE-2282-2021
Colistin is a polymyxin antibiotic which is considered as one of the last line agents against infections due to multidrug resistant or carbapenem resistant gram-negative pathogens. Colistin resistance is associated with chromosomal alterations which can usually cause mutations in genes coding specific two component regulator systems. The first plasmid-mediated colistin resistance gene, mcr-1 was described in Escherichia coli and Klebsiella pneumoniae isolates in December 2015 and followed by another plasmid-mediated colistin resistance gene mcr-2 in 2016. The rapid and interspecies dissemination of plasmid-mediated resistance mechanisms through horizontal gene transfer, have made these genes considerably threatening. After the first reports, although mcr-1/mcr-2 producing Enterobacteriaceae isolates have been reported from many countries, there have been no reports from Turkey. Thus, the aim of this study was to investigate the presence of mcr-1/mcr-2 in clinical Enterobacteriaceae isolates from different parts of our country. A total of 329 Enterobacteriaceae isolates from 22 laboratories were collected which were isolated between March, 2015 and February, 2016. mcr-1/mcr-2 were investigated by polymerase chain reaction during February-March, 2016. Two hundred and seventeen of Klebsiella pneumoniae (66%), 75 of Salmonella spp. (22.8%), 31 of Esherichia coli (9.4%), 3 of Enterobacter cloacae (0.9%), 2 of Klebsiella oxytoca (0.6%) and 1 of Enterobacter aerogenes (0.3%) isolates were included to the study. Agarose gel electrophoresis results of PCR studies have shown expected band sizes for positive control isolates as 309 bp for mcr-1 and 567 bp for mcr-2. However, the presence of mcr-1/mcr-2 genes was not detected among the tested study isolates of Enterobacteriaceae. Although mcr-1/mcr-2 were not detected in our study isolates, it is highly important to understand the mechanism of resistance dissemination and determine the resistant isolates by considering that colistin is a last-line antibiotic against infections of multidrug or carbapenem resistant gram-negative bacteria. Thus, it is suggested that these mechanisms should be followed-up in both clinical and non-clinical (e.g. isolates from food animals, raw meats and environment) isolates of special populations.
Treatment of reflux disease during pregnancy and lactation
(2017) Dagli, Ulku; Kalkan, Ismail Hakki; 0000-0003-0664-0976; 29199169; S-4068-2018
Gastroesophageal reflux disease (GERD) is frequently seen during pregnancy. In the medical treatment of pregnant women with GERD, alginic acid and sucralfate can be used. Calcium- and magnesium-based antacids can also be used, particularly for patients with preeclampsia. In particular, ranitidine -a histamine-2 receptor blocker-is preferred. In the case of non-responsiveness to the abovementioned treatments, proton pump inhibitors (PPIs), except omeprazole, can be given considering the benefit-harm ratio for the mother and fetus after the first trimester. In cases with GERD during the lactation period, drugs having minimum systemic absorption, such as sucralfate and alginic acid, are preferable but there is no data.
Prognostic factors for maximally or optimally cytoreduced stage III nonserous epithelial ovarian carcinoma treated with carboplatin/paclitaxel chemotherapy
(2018) Ayhan, Ali; Cuylan, Zeliha Fırat; Meydanli, Mehmet M.; Sari, Mustafa E.; Akbayir, Ozgur; Celik, Husnu; Dede, Murat; Sahin, Hanifi; Gungorduk, Kemal; Kuscu, Esra; Ozgul, Nejat; Gungor, Tayfun; 29727055
ObjectiveTo identify factors predictive of poor prognosis in women with stage III nonserous epithelial ovarian cancer (EOC) who had undergone maximal or optimal primary cytoreductive surgery (CRS) followed by six cycles of intravenous carboplatin/paclitaxel chemotherapy. MethodsA multicenter, retrospective department database review was performed to identify patients with stage III nonserous EOC who had undergone maximal or optimal primary CRS followed by six cycles of carboplatin/paclitaxel chemotherapy at seven gynecological oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. ResultsA total of 218 women met the inclusion criteria. Of these, 64 (29.4%) patients had endometrioid, 61 (28%) had mucinous, 54 (24.8%) had clear-cell and 39 (17.9%) had mixed epithelial tumors. Fifty-five (25.2%) patients underwent maximal CRS, whereas 163 (74.8%) had optimal debulking. With a median follow-up of 31.5 months, the 5-year progression-free survival (PFS) and overall survival (OS) rates were 34.8% and 44.2%, respectively. Bilaterality (hazard ratio [HR] 1.44, 95% CI 1.01-2.056; P = 0.04), age (HR 2.25, 95% CI 1.176-4.323; P = 0.014) and maximal cytoreduction (HR 0.34, 95% CI 0.202-0.58; P < 0.001) were found to be independent prognostic factors for PFS. However, age (HR 2.6, 95% CI 1.215-5.591; P = 0.014) and maximal cytoreduction (HR 0.31, 95% CI 0.166-0.615; P < 0.001) were defined as independent prognostic factors for OS. ConclusionThe extent of CRS seems to be the only modifiable prognostic factor associated with stage III nonserous EOC. Complete cytoreduction to no gross residual disease should be the main goal of management in these women.
Marginal Adaptation of Provisional CAD/CAM Restorations Fabricated Using Various Simulated Digital Cement Space Settings
(2018) Ozcelik, Tuncer Burak; Yilmaz, Burak; Seker, Emre; Shah, Karnik; 30231093
Purpose: The ideal digital cement space value for the fabrication of provisional computer-aided design/ computer-aided manufacturing (CAD/CAM) crowns with clinically acceptable marginal adaptation is not well known. The aim of this study was to evaluate the effect of different simulated cement space settings on the marginal tit of poly(methyl methacrylate) (PMMA) provisional CAD/CAM restorations. Materials and Methods: An extracted premolar tooth was prepared using ceramic crown preparation guidelines and represented both natural teeth and/or custom implant abutments. The prepared tooth abutment was scanned with a three-dimensional (3D) laboratory scanner (D900, 3Shape). CAD design software was used to subsequently design a premolar crown core with three different simulated cement space settings (20 to 40 mu m, 20 to 50 mu m, 20 to 60 mu m). PMMA blocks were used to mill the specimens (n = 9, N = 27). Using a stereo zoom microscope, a total of 36 images for each of the 3 groups (9 crowns per group, 4 sites per crown) were captured to measure the mean vertical marginal discrepancy for every group. One-way analysis of variance (ANOVA) was used to analyze the data, and the post hoc Tukey multiple comparison test was performed. Results: The marginal gap values of the PMMA cores fabricated using the three cement space settings were significantly different from each other (P < .001). The marginal gap was smaller with a 20- to 60-mu m setting compared with 20 to 50 mu m and 20 to 40 mu m, and the 20- to 50-mu m setting allowed for smaller marginal gaps compared with 20 to 40 mu m (P < .001). Conclusion: Within the limitations of this study, the marginal gaps of CAD/CAM-fabricated PMMA cores were smaller when the cement space was larger. The smallest marginal gaps were achieved when a 20- to 60-mu m cement space was used (P < .001).
Altered pulmonary functions due to biomass smoke in a rural population of Turkish women: a descriptive study
(2018) Ozsancak Ugurlu, Aylin; Balcan, Baran; Akan, Selcuk; Ceyhan, Berrin; 30246655; A-4721-2018
Introduction: Wood or other organic sources of fuel are used as source of energy for heating or cooking particularly in developing countries. The aim of the current study was to evaluate the association between biomass exposure time and parameters of pulmonary function tests. Materials and Methods: Four hundred twenty-four consecutive women who lived and exposed to biomass smoke in a small province in Eastern Turkey were involved. This study was performed with women who had come to pulmonology out-patient clinic with symptom of dyspnea. Results: The independent variables assessed in the study patients were age, BMI, starting age of cooking, hours per day and weeks per month spent cooking, and cooking years; the dependent variables were PFT parameters. Ninety-two (21.6%) patients had an obstructive PFT pattern. Sixty-seven (73%) of these patients were classified as GOLD 2 and 25 (27%) patients were classified as GOLD 3. Seventy-five (17.6 %) of the patients had restrictive lung disease; 54 (72%) of these patients were found to have a mild and 21 (27%) had a moderate restrictive pattern. Increased number of years in cooking and to start cooking at younger ages were a risk factors for the development of obstructive and restrictive disease. There was a statistically significant and negative correlation between increased number of years and the value of FEV1 (r=-0.917; p=<0.001), FEV1/FVC (r=-0.739; p<0.001), and FVC (r=-0.906; p<0.001). The median time of cooking required was 23 years for the development of obstruction, and 25 years for restriction, respectively. Conclusion: Cumulative biomass exposure time is associated with impairment in PFT parameters; results in both obstructive and restrictive lung disease. Biomass exposure is a public health problem and pre-cautions should be taken in order to prevent impaired pulmonary functions.
Evaluation of 2015-2016 MOTAKK HBV DNA and HCV RNA external quality assessment national program results [MOTAKK HBV DNA ve HCV RNA diş kalite kontrol ulusal programi 2015-2016 sonuçlarinin deǧerlendirilmesi]
(2018) Karatayli, E.; Soydemir, E.; Aksoy, Z.B.; Kizilpinar, M.; Altay Koçak, A.; Karatayli, S.C.; Yurdu, E.; Yildirim, U.; Güriz, H.; Bozdayi, G.; Yurdaydin, C.; Ilhan, O.; Yildirim, Y.; Bozdayi, A.M.; 0000-0002-0451-0142; 0000-0001-9060-3195; 30522421; AAI-8012-2021; AAE-2282-2021
MOTAKK, as a national external quality control program has been launched to evaluate the molecular detection of viral infections including HBV DNA and HCV RNA in molecular microbiology diagnostic laboratories in Turkey. This program is prepared in compliance with ISO 17043:2010 (Conformity assessment general requirements for proficiency testing) standards, and aims to take the place of external quality control programs from abroad, contributing to standardization and accuracy of molecular diagnostic tests in our country. The aim of this study was to evaluate 2015 and 2016 results of the MOTAKK External Quality Control Program for HBV DNA and HCV RNA viral load. The calls were announced on the web page of MOTAKK (www.motakk.org). The quality control samples were sent to participating laboratories in 2015 and 2016. Main stocks were prepared from patients with chronic hepatitis B and C who had viral load detection with reference methods according to WHO reference materials for viral load studies to improve quality control sera. From these main stocks, samples with different viral loads were prepared from dilutions of plasma with HBV, HCV, HAV, HIV, Parvovirus B19 and CMV negative serologic markers. Quality control samples were sent to the participating laboratories along with the negative samples in the cold chain. The laboratories accomplished the related tests within 2-3 weeks and entered their results on the MOTAKK web page. These results were analysed according to ISO 13528 (Statistical methods for use in proficiency testing by interlaboratory comparison) and scoring reports were created by a software developed by MOTAKK and sent to participating labs. Each laboratory evaluated their own results in comparison with the other laboratory results, reassessed the tests via observing the distance from the mean result and the reference values. The number of laboratories participating in the HBV DNA and HCV RNA external quality control program was 70-73 in 2015-2016. Participants were able to comply with the program tools, registering, entering results and receiving the results reports without problem. In HBV panel, 72.6-89.1% and 84.7-90.3% of the participant laboratories were in 1 standard deviation (SD) in 2015-2016, respectively. In HCV panel, 70.8-89.1% and 84.7-90.3% of the participant laboratories were in 1 SD in 2015-2016, respectively. A national external quality control program for HBV DNA and HCV RNA in Turkey has been prepared for the first time with this project and implemented successfully. All the data provided in the MOTAKK external quality control program final report, compensate all the data provided by the quality control program final reports from abroad; additionally, the report allows comparison of used technologies and commercial products. © 2018 Ankara Microbiology Society. All rights reserved.
Obese patients require higher, but not high pneumatic tourniquet inflation pressures using a novel technique during total knee arthroplasty
(2018) Tuncali, Bahatin; Boya, Hakan; Kayhan, Zeynep; Arac, Sukru; 0000-0003-0579-1115; 0000-0002-7898-2943; 0000-0001-6110-4004; 29526158; AAJ-4623-2021; AAJ-7840-2021; AAJ-7840-2021
Objectives: This study aims to investigate the effect of obesity on pneumatic tourniquet inflation pressures determined with a novel formula during total knee arthroplasty (TKA). Patients and methods: Data of 208 patients (19 males, 199 females; mean age 69.8 years; range, 53 to 84 years) who were performed TKA between January 2013 and December 2016 were evaluated prospectively. Patients were divided into two groups as non-obese (body mass index [BMI] <= 30.0 kg/m(2)) and obese (BMI > 30.0 kg/m(2)) according to BMI. Tourniquet inflation pressures were set using arterial occlusion pressure (AOP) estimation method and adding 20 mmHg of safety margin to AOP value. All patients were assessed intra-and postoperatively with outcome measures such as systolic blood pressure, AOP, tourniquet pressure and its effectiveness. The quality of the surgical field and complications were assessed by the surgical team in a blinded fashion. Results: The study included 118 and 90 lower extremity operations in obese and non-obese groups, respectively. Compared to non-obese group; extremity circumference, initial and maximal systolic blood pressures, AOP values, initial and maximal tourniquet pressures were higher in obese group. The performance of the tourniquet was assessed as "excellent" and "good" at almost all stages of the surgical procedure in all patients in both groups. No complication occurred intra-or postoperatively. Conclusion: Compared to non-obese patients, higher tourniquet inflation pressure is required in obese patients during TKA due to their wider extremity circumference and higher systolic blood pressure profile.
The influence of adjunctive caudal epidural steroid injection on the therapeutic effect of transforaminal epidural steroid injection
(2018) Kircelli, Atilla; Cansever, Tufan; Yilmaz, Cem; 0000-0002-2353-8044; 0000-0003-2109-1274; 29322966; AAK-2948-2021
Background: Epidural steroid injection is widely used to treat the short and long-term symptoms of low back and radicular pain. To the best of our knowledge, the influence of transforaminal epidural steroid injection (TFSI) combined with caudal epidural steroid injection (CESI) on pain intensity, patient satisfaction, and quality of life in lumbar radiculopathy has not been examined. Aim: To evaluate the short and long-term efficacy of TFSI, and TFSI combined with CESI (TFSI + CESI) in patients with lumbar radiculopathy. Materials and Methods: We retrospectively examined the records of 104 patients with lumbar radicular pain and L4/5 and/or L5/S1 intervertebral disc disease who underwent TFSI or TFSI + CESI. We compared the pain intensity using a Visual Numeric Scale (VNS), North American Spine Society (NASS) pain satisfaction index, and EuroQol five dimensions (EQ-5D) quality of life scores before intervention, and after 1, 6 and 12 months. Results: In the TFSI group, the mean pre-treatment VNS score was 9.2, which improved to 4.9 after 1 month and to 7.2 after 12 months. In the TFSI + CESI group, the mean pre-treatment VNS score was 9.4, which improved to 2.6 and 4.6 after 1 and 12 months, respectively. Improvement in the VNS scores was significantly higher in the TFSI + CESI group (P < 0.0001 for each). Mean EQ-5D quality of life index in the TFSI group improved from 0.59 in the pre-treatment phase to 0.76 after 12 months of intervention, while it improved from 0.62 in the pre-treatment phase to 0.84 at 12 months of intervention in the TFSI + CESI group. The EQ-5D scores were significantly better in the TFSI + CESI group at 1, 6, and 12 months after the procedure (P = 0.004, 0.036, and 0.042, for 1, 6, and 12 months, respectively). The NASS scores were significantly better in the TFSI + CESI group at 6 and 12 months after the intervention (P = 0.025 and 0.001 for 6 months and 12 months, respectively). Conclusion: In patients with lower lumbar radiculopathy, a combined TFSI + CESI technique offers superior short and long-term pain relief, quality of life, and long-term patient satisfaction, than when TFSI is performed alone.