PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
Browse
42 results
Search Results
Item Turkish Thoracic Society Consensus Report: Interpretation of Spirometry(2019) Ulubay, Gaye; Dilektasli, Asli Gorek; Borekci, Sermin; Yildiz, Oznur; Kiyan, Esen; Gemicioglu, Bilun; Saryal, Sevgi; 0000-0003-2478-9985; 30664428; AAB-5064-2021Currently, the criteria for applying and evaluating spirometer measurements have been defined by American and European Respiratory Societies. Several pulmonary function test laboratories in Turkey as well as in the world use these standards. However, different interpretation results are observed in different pulmonary function test laboratories. This report is prepared to provide a basis for a standardized asssessment in our pulmonary function test in our country.Item Evaluation of Blood Culture Practices: Use of System (Epicenter) Data(2019) Basustaoglu, Ahmet; Suzuk Yildiz, Serap; Mumcuoglu, Ipek; Karahan, Zeynep Ceren; Ogunc, Dilara; Kaleli, Ilknur; Kursun, Senol; Evren, Ebru; Ozhak, Baysal Betil; Demir, Melek; Murray, Patrick; 30683035Sepsis is a serious clinical problem and estimated to be responsible for 18 million annual deaths worldwide. Therefore, the use and the rapid processing of blood cultures are important for the transition from empiric therapy to directed therapy. The aim of this study was to assess the best blood culture practices in Turkey. We have examined the collection practices and techniques at four different hospitals, and a total of 165.443 blood culture bottles were evaluated (2013-2015). At the preanalytical phase most of the data which were important and which could support hospital quality systems/practices were not entered into the HIS and EpiCenter system. At the analytical phase loading of the bottles and removal of positive bottles primarily occurred between 6:00 and 9:00 AM but the positivity rate of the bottles showed a homogeneous distribution throughout the day. In other words, there were significant delays at processing positive blood culture bottles related to laboratory workers. The effect of education regarding best practices, transition from single bottle to two bottle cultures was successful in all hospitals. Single bottle usage decreased below 10% in all hospitals. Significantly more positive cultures were detected at multiple cultures when compared with the single bottle collection practice. In retrospective patient records, it was seen that all the laboratories reported the results of Gram staining to the clinics. However, these data were not recorded to the Epicenter. The contamination rates of Ankara Numune Hospital and Akdeniz University Faculty of Medicine Hospital are 6.2% and 5.4% respectively, contamination rates were not reported in other hospitals. The most common isolates detected in blood cultures were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Staphylococcus aureus, and Acinetobacter baumannii. The mean time for the detection of these organisms were less than 20 hours in the aerobic bottle and anaerobic bottles. A total of 79.6% of facultative anaerobic isolates were detected in both bottles; 9.8% were detected only in the aerobic bottles; 10.6% of the isolates were detected only in the anaerobic bottles. As a result, the educational efforts in Turkey have met with success for transition from collecting single bottle blood culture sets to two bottle blood cultures. However, further efforts are needed to increase the number of blood culture sets collected during a 24 hour's period. In addition, errors at the preanalytical, analytical and postanalytical periods (taking samples, loading bottles into the system and processing positive blood cultures) should be eliminated.Item Prognostic significance of lymphovascular space invasion in low-risk endometrial cancer(2019) Ayhan, Ali; Sahin, Hanifi; Sari, Mustafa Erkan; Yalcin, Ibrahim; Haberal, Ali; Meydanli, Mehmet Mutlu; 30665899Objective The purpose of this study was to assess the prognostic significance of lymphovascular space invasion in women with low-risk endometrial cancer. Methods A dual-institutional, retrospective department database review was performed to identify patients with 'low-risk endometrial cancer' (patients having <50% myometrial invasion with grade 1 or 2 endometrioid endometrial cancer according to their final pathology reports) at two gynecologic oncology centers in Ankara, Turkey. Demographic, clinicopathological and survival data were collected. Results We identified 912 women with low-risk endometrial cancer; 53 patients (5.8%) had lymphovascular space invasion. When compared with lymphovascular space invasion-negative patients, lymphovascular space invasion-positive patients were more likely to have post-operative grade 2 disease (p<0.001), deeper myometrial invasion (p=0.003), and larger tumor size (p=0.005). Patients with lymphovascular space invasion were more likely to receive adjuvant therapy when compared with lymphovascular space invasion-negative women (11/53 vs 12/859, respectively; p<0.001). The 5-year recurrence-free survival rate for lymphovascular space invasion-positive women was 85.5% compared with 97.0% for lymphovascular space invasion-negative women (p<0.001). The 5-year overall survival rate for lymphovascular space invasion-positive women was significantly lower than that of lymphovascular space invasion-negative women (88.2% vs 98.5%, respectively; p<0.001). Age >= 60 years (HR 3.13, 95% CI 1.13 to 8.63; p=0.02) and positive lymphovascular space invasion status (HR 6.68, 95% CI 1.60 to 27.88; p=0.009) were identified as independent prognostic factors for decreased overall survival. Conclusions Age >= 60 years and positive lymphovascular space invasion status appear to be important prognostic parameters in patients with low-risk endometrial cancer who have undergone complete surgical staging procedures including pelvic and para-aortic lymphadenectomy. Lymphovascular space invasion seems to be associated with an adverse prognosis in women with low-risk endometrial cancer; this merits further assessment on a larger scale with standardization of the lymphovascular space invasion in terms of presence/absence and quantity.organizational unit.listelement.badge Cardiac biomarkers in coronary slow flow: Endocan and omentin-1(2019) Okyay, Kaan; 31219435; AAK-7355-2020Item 2019 Turkish Hypertension Consensus Report(2019) Aydogdu, Sinan; Guler, Kerim; Bayram, Fahri; Altun, Bulent; Derici, Ulver; Abaci, Adnan; Tukek, Tufan; Sabuncu, Tevfik; Arici, Mustafa; Erdem, Yunus; Ozin, Bulent; Sahin, Ibrahim; Erturk, Sehsuvar; Bittigen, Atilla; Tokgozoglu, Lale; 31483311The Turkish Hypertension Consensus Report was prepared for the first time in 2015 to adapt the European and American international guidelines to our clinical practice and to create a practical report that could be a basic reference for all physicians dealing with hypertensive patients. This report, which was prepared by a committee with representation from 5 leading hypertension associations, has been accepted and is widely used. New clinical studies in hypertension literature and updated international guidelines since 2015 have demanded an update of the Turkish Hypertension Consensus Report as well. In this updated 2019 report, blood pressure levels were classified as Normal, Elevated, Stage 1, and Stage 2 hypertension. A new section was added for secondary hypertension. It was specified that drug treatment may be initiated with any 1 or a combination of 4 groups of drugs (diuretics, calcium channel blockers, angiotensin-converting enzyme [ACE] inhibitors, and angiotensin receptor blockers [ARBs]), except a combination of an ACE inhibitor and an ARB. It was emphasized that beta-blockers may be a first choice for hypertension treatment in diseases such as atrial fibrillation, heart failure, and coronary artery disease. The initial recommendation for hypertension treatment is a combination therapy in patients with a blood pressure level >= 150/90 mmHg. Target blood pressure values were redefined according to age and the presence of comorbidities. The hypertension treatment algorithm was renewed; it is proposed that drug therapy can also be initiated with a risk-based approach for the group with an elevated blood pressure (systolic blood pressure: 120-139 mmHg, diastolic blood pressure: 80-89 mmHg). The threshold clinic systolic blood pressure level was reduced from 160 mmHg to >= 150 mmHg for the initiation of drug therapy in individuals 80 years of age or more. The section on the treatment of special groups has now been expanded to include pregnancy and lactation. As in the previous report, in this update, practical recommendations for the most common cases seen in the clinic were the goal, rather than a comprehensive report that addresses all aspects of hypertension. This report has evidence-based recommendations for most patients; however, it should be kept in mind that there may be differences from 1 patient to another and that physicians should take an individualized approach according to a good clinical evaluation.Item The opinion and recommendations of Turkish Board for Accreditation in Cardiology on Board Examination(2019) Yildirir, Aylin; Altun, Armagan; Ural, Dilek; Ozdemir, Murat; Aslan, Ozgur; Muderrisoglu, Haldun; 31582681; ABB-5844-2020Item The Effects of Lithium on Calcium and Parathormone Levels: A Cross-sectional Study with Healthy Controls(2019) Tuncel, Ozlem Kuman; Akdeniz, Fisun; Ozbek, Suha Sureyya; Kavukcu, Gulgun; Unal Kocabas, Gokcen; 31613975Objective: Despite lithium associated hyperparathyroidism (LAH) can lead to many complications, little notice has been paid to this side-effect. The aim of this study was to investigate the effects of lithium on calcium and parathyroid hormone levels and the relation between lithium use and thyroid diseases. Method: This cross-sectional study was carried out with 87 lithium-treated patients and 65 volunteers who had a similar age and gender distribution with the lithium group. Serum levels of corrected calcium, intact parathormone, phosphorus, magnesium, alkaline phosphatase, free thyroxine, thyroid stimulating hormone, thyroid autoantibodies and creatinine were assessed, and also, thyroid and parathyroid ultrasonography was conducted. Further detailed investigations were made depending on the elevation of the initially measured calcium and/ or parathormone levels. Results: Median values of serum levels of the corrected calcium and the intact parathormone were significantly higher in the lithium group. Calcium levels had a mild correlation with the duration of lithium treatment. In the first assessment, while all control individuals had values within the normal reference range, 11 lithium-treated patients had corrected calcium and/or intact parathormone levels above the normal reference levels. All of the five patients, who were diagnosed with LAH after further investigation, were also diagnosed with a thyroid disorder. Conclusion: These results demonstrate that lithium treatment has a relationship with calcium and parathormone levels. The 5.7% prevalence of LAH and potential life-threatening conditions associated with LAH necessitates the use of available low-cost methods to monitor blood calcium levels of lithium-treated patients for early diagnosis.Item Determination of anthropometric measurements in obstructive sleep apnea syndrome in Turkish population(2019) Savas Bozbas, Serife; 32050866Introduction: In this study, we aimed to determine the values of anthropometric measurements and rates used in the evaluation of obstructive sleep apnea syndrome (OSAS) in our country. Materials and Methods: Twenty accredited sleep centers in thirteen provinces participated in this multicenter prospective study. OSAS symptoms and polysomnographic examination and apnea-hypopnea index (AHI) >= 5 cases OSAS study group; patients with AHI <5 and STOP-Bang <2 were included as control group. Demographic characteristics (age, sex, body mass index-BMI) and anthropometric measurements (neck, waist and hip circumference, waist/hip ratio) of the subjects were recorded. Results: The study included 2684 patients (81.3% OSAS) with a mean age of 50.50 +/- 0.21 years from 20 centers. The cases were taken from six geographical regions of the country (Mediterranean, Eastern Anatolia, Aegean, Central Anatolia, Black Sea and Marmara Region). Demographic characteristics and anthropometric measurements; age, neck, waist, hip circumference and waist/hip ratios and BMI characteristics when compared with the control group; when compared according to regions, age, neck, waist, hip circumference and waist/hip ratios were found to be statistically different (p<0.001, p<0.001, p<0.05, respectively). When compared by sex, age, neck and hip circumference, waist/hip ratio, height, weight and BMI characteristics were statistically different (p<0.001, respectively). Neck circumference and waist/hip ratio were respectively 42.58 +/- 0.10 cm, 0.99 +/- 0.002, 39.24 +/- 0.16 cm, 0.93 +/- 0.004 were found in women. Conclusion: The neck circumference was lower than the standard value in men, but higher in women. The waist/hip ratio was above the ideal measurements in both men and women. In this context, the determination of the country values will allow the identification of patients with the possibility of OSAS and referral to sleep centers for polysomnography.Item Arthroscopic excision of elastofibroma dorsi at scapulothoracic joint: a surgical technique(2014) Cakmak, Gokhan; Ergun, Tarkan; Sahin, M.SukruElastofibroma dorsi is a rare soft tissue pseudotumor which is located at the anteroinferior aspect of the scapula. In this article, we report a 19-year-old female case who had arthroscopic marginal excision of elastofibroma dorsi at the scapulothoracic joint without recurrences during follow-up. The artiaroscopic marginal excision of the elastofibroma dorsi may have good clinical results in selected cases.Item Tuberous sclerosis complex; a single center experience(2015) Erol, Ilknur; Savas, Tulin; Sekerci, Sevda; Yazici, Nalan; Erbay, Ayse; Demir, Senay; Saygi, Semra; Alkan, Ozlem; 26078697Aim: This study was planned with the aim of retrospectively reviewing the clinical and laboratory findings and therapies of our patients diagnosed with tuberous sclerosis and redefining the patients according to the diagnostic criteria revised by the 2012 International Tuberous Sclerosis Complex Consensus Group and comparing them with the literature. Material and Methods: 20 patients diagnosed with tuberous sclerosis complex in the Pediatric Neurology Clinic were examined retrospectively in terms of clinical findings and therapies. The diagnoses were compared again according to 1998 and 2012 criteria. Results: It was observed that the complaint at presentation was seizure in 17 of 20 patients and hypopigmented spots on the skin in 3 of 20 patients. On the initial physical examination, imaging findings related with the disease were found in the skin in 17 of the patients, in the eye in 5, in the kidneys in 7 and in the brain in 17. No cardiac involvement was observed in the patients. Infantile spasm was observed in 7 of the patients who presented because of seizure (n=17), partial seizure was observed in 7 and multiple seizure types were observed in 3. It was found that sirolimus treatment was given to 9 of 20 patients because of different reasons, 7 of these 9 patients had epileptic seizures and sirolimus treatment had no effect on epileptic seizures. According to 2012 diagnostic criteria, no marked change occured in the diagnoses of our patients. Conclusions: It was observed that the signs and symptoms of our patients were compatible with the literature. Molecular genetic examination was planned for the patients who were being followed up because of possible tuberous sclerosis complex. It was observed that sirolimus treatment had no marked effect on the seizure frequency of our patients.