PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Tuberculosis in Solid-Organ Transplant Recipients in Turkey: Meta-Analysis From the Tuberculosis Study Group of Turkish Transplantation Society, Solid Organ Transplantation Infections(2022) Avkan-Oguz, Vildan; Oner-Eyuboglu, Fusün; Turunc, Tuba; Ersoz, Gulden; Tezer-Tekce, Yasemin; Senbayrak, Seniha; https://orcid.org/0000-0002-5525-8207; 33455571; AAR-4338-2020Objectives: Tuberculosis risk in solid-organ transplant recipients is more than the general population, although tuberculosis incidence has been reported to decrease 5% in the last decade in Turkey. In Turkey, solid-organ transplants started in 1975; however, routine pretransplant tuberculosis risk screening programs are still not established. Therefore, we conducted a meta-analysis of tuberculosis prevalence, clinical forms, and prognosis of tuberculosis in solid organ transplant recipients. Materials and Methods: We searched PubMed, Web of Knowledge, Google Scholar, EBSCOhost, and Scopus databases in English and Turkish Medical Index of Turkish Academic Network and Information Center, Turkish Citation Index, Turkish Medline, Central Thesis of ULAKBIM databases in Turkish (from inception until December 2018) for national and international reference lists of all relevant papers. We used standard methodological procedures (Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009). Results: We found 199 published studies in English and 26 in Turkish. After exclusion of noneligible studies, there were 10 retrospective research articles and 16 case reports. There were 148 (3.2%) tuberculosis cases with 4553 solid-organ transplant recipients (4031 renal, 522 liver). Of the tuberculosis cases, 50 (33.8%) were pulmonary, 21 (14.2%) were pulmonary and extrapulmonary, 13 (8.8%) were miliary, 27 (18.2%) were disseminated, and 37 (25.0%) were extra pulmonary tuberculosis cases involving a maximum of 2 organs. There were 19 cases (12.8%) of graft lost. Of the patients with tuberculosis, 34 (19.9%) died resulting from either tuberculosis or other reasons. Conclusions: In this meta-analysis, most of the centers did not perform pretransplant risk evaluations; every center had different clinical procedures and follow-ups. Tuberculosis prevalence in solid-organ transplant recipients differs according to study population. Case reports were mostly about extrapulmonary tuberculosis. All such patients should be followed-up by a standard regimen during pretransplant and posttransplant periods. Prospective studies should be considered.Item Economic Burden Of Lung Cancer In Turkey: A Cost Of Illness Study From Payer Perspective(2021) Cicin, Irfan; Oksuz, Ergun; Karadurmus, Nuri Nuri; Malhan, Simten; Gumus, Mahmut; Yilmaz, Ulku; Cansever, Levent; Cinarka, Halit; Cetinkaya, Erdogan; Kiyik, Murat; Ozet, Ahmet; 0000-0002-5723-5965; 34173876; K-8238-2012Background This study was designed to estimate economic burden of lung cancer in Turkey from payer perspective based on expert panel opinion on practice patterns in clinical practice. Methods In this cost of illness study, direct medical cost was calculated based on cost items related to outpatient visits, laboratory and radiological tests, hospitalizations/interventions, drug treatment, adverse events and metastasis. Indirect cost was calculated based on lost productivity due to early retirement, morbidity and premature death resulting from the illness, the value of lost productivity due to time spent by family caregivers and cost of formal caregivers. Results Cost analysis revealed the total per patient annual direct medical cost for small cell lung cancer to be euro8772), for non-small-cell lung cancer to be euro10,167. Total annual direct medical cost was euro497.9 million, total annual indirect medical cost was euro1.1 billion and total economic burden of lung cancer was euro1.6 billion. Hospitalization/interventions (41%) and indirect costs (68.6%) were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively. Conclusions Our findings indicate per patient direct medical costs of small cell lung cancer and non-small-cell lung cancer to be substantial and comparable, indicating the substantial economic burden of lung cancer in terms of both direct and indirect costs. Our findings indicate that hospitalization/interventions cost item and indirect costs were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively. Our findings emphasize the potential role of improved cancer prevention and early diagnosis strategies, by enabling cost savings related to drug treatment and metastasis management cost items, in sustainability of cancer treatments.Item Identifying Clinical Characteristics of Hypoparathyroidism in Turkey: HIPOPARATURK-NET Study(2021) Degertekin, Ceyla Konca; Yavuz, Dilek Gogas; Pekkolay, Zafer; Saygili, Emre; Ugur, Kader; Koca, Arzu Or; Unubol, Mustafa; Topaloglu, Omercan; Aydogan, Berna Imge; Kutbay, Nilufer Ozdemir; Hekimsoy, Zeliha; Yilmaz, Nusret; Balci, Mustafa Kemal; Tanrikulu, Seher; Unsal, Yasemin Aydogan; Ersoy, Canan; Omma, Tulay; Keskin, Muge; Yalcin, Mehmet Muhittin; Yetkin, Ilhan; Soylu, Hikmet; Karakose, Melia; Yilmaz, Merve; Karakilic, Ersen; Piskinpasa, Hamide; Batman, Adnan; Akbaba, Gulhan; Elbuken, Gulsah; Bahadir, Cigdem Tura; Kilinc, Faruk; Bilginer, Muhammet Cuneyt; Iyidir, Ozlem Turhan; Canturk, Zeynep; Yilmaz, Banu Aktas; Sayiner, Zeynel Abidin; Eroglu, Mustafa; 34495356Hypoparathyroidism is an orphan disease with ill-defined epidemiology that is subject to geographic variability. We conducted this study to assess the demographics, etiologic distribution, treatment patterns and complication frequency of patients with chronic hypoparathyroidism in Turkey. This is a retrospective, cross-sectional database study, with collaboration of 30 endocrinology centers located in 20 cities across seven geographical regions of Turkey. A total of 830 adults (mean age 49.6 +/- 13.5 years; female 81.2%) with hypoparathyroidism (mean duration 9.7 +/- 9.0 years) were included in the final analysis. Hypoparathyroidism was predominantly surgery-induced (n = 686, 82.6%). The insulting surgeries was carried out mostly due to benign causes in postsurgical group (SG) (n = 504, 73.5%) while patients in nonsurgical group (NSG) was most frequently classified as idiopathic (n = 103, 71.5%). The treatment was highly dependent on calcium salts (n = 771, 92.9%), calcitriol (n = 786, 94.7%) and to a lower extent cholecalciferol use (n = 635, 76.5%) while the rate of parathyroid hormone (n = 2, 0.2%) use was low. Serum calcium levels were most frequently kept in the normal range (sCa 8.5-10.5 mg/dL, n = 383, 46.1%) which might be higher than desired for this patient group. NSG had a lower mean plasma PTH concentration (6.42 +/- 5.53 vs. 9.09 +/- 7.08 ng/l, p < 0.0001), higher daily intake of elementary calcium (2038 +/- 1214 vs. 1846 +/- 1355 mg/day, p = 0.0193) and calcitriol (0.78 +/- 0.39 vs. 0.69 +/- 0.38 mcg/day, p = 0.0057), a higher rate of chronic renal disease (9.7% vs. 3.6%, p = 0.0017), epilepsy (6.3% vs. 1.6%, p = 0.0009), intracranial calcifications (11.8% vs. 7.3%, p < 0.0001) and cataracts (22.2% vs. 13.7%, p = 0.0096) compared to SG. In conclusion, postsurgical hypoparathyroidism is the dominant etiology of hypoparathyroidism in Turkey while the nonsurgical patients have a higher disease burden with greater need for medications and increased risk of complications than the postsurgical patients.Item Inherited coagulation disorders in Turkish children: A retrospective, single-center cohort study(2020) Oner, Nergiz; Gursel, Turkiz; Kaya, Zuhre; Keskin, Ebru Yilmaz; Kocak, Ulker; Albayrak, Meryem; Yenicesu, Idil; Apak, Burcu Belen; Isik, Melek; 31980335Objective: This study aims to investigate the distribution, clinical characteristics and outcome of inherited coagulation disorders (ICD) in Turkish children. Subjects and methods: Data from all children (age < 18 years) with ICD examined in our center were retrospectively reviewed. Results: There were 403 children with ICD (233 males and 170 females) with a median age of four years at diagnosis. The percentages of von Willebrand disease (vWd), hemophilia and rare bleeding disorders (RBD) were 40 %, 34 % and 26 %, type-1, type-2 and type-3 vWd were 63 % 17 % and 20 %, hemophilia A and B were 84 % and 16 %, and severe, moderate and mild hemophilia were 48 %, 30 % and 22 %, respectively. Factor VII and FXI deficiencies were the most prevalent, comprising 56 % and 22 % of all children with RBD, respectively. Parental consanguinity rates were 72 % in type-3 vWd and 61 % in severe RBD. The overall prevalence of gastrointestinal bleedings was 4.5 % (18/403), intracranial bleeding (ICB) was 4.96 % (20/403), mortality from ICB was 30 % (6/20) and the overall mortality rate was 1.49 % (6/403). No life-threatening bleeding was seen during regular prophylaxis. Chronic arthropathy prevalence in severe hemophilia was 8 % with primary prophylaxis and 53 % with demand therap. Inhibitor prevalence was 14 % in hemophilia-A and 5 % in hemophiliaB. Conclusions: These data show that vWd is the most common ICD, type-3 vWd and RBD are prevalent due to frequent consanguineous marriages and diagnosis of ICD is substantially delayed in Turkish children. Prophylactic replacement therapy prevents occurrence of life-threatening bleedings and reduces the development of hemophilic arthropathy.Item Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience(2020) Gokturk, Huseyin Savas; 33626001Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population. Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed. Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%). Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Item HEV seroprevalence in blood donors in Turkey by two commercial total anti-HEV Ab ELISA kits(2019) Yasar, Osman; Karatayli, Ersin; Cengiz, Guniz; Kizilpinar, Mehtap; Yurdcu, Esra; Albayrak, Rabia; Guven, Aysel; Arslan, Onder; Karahan, Ceren; Otlu, Baris; Guducuoglu, Huseyin; Gokahmetoglu, Selma; Berk, Elife; Gitmisoglu, Ozlem; Sertoz, Ruchan; Yurdaydin, Cihan; Bozdayi, A. Mithat; Karatayli, Senem Ceren; 31403185Previous hepatitis E virus (HEV) seroprevalence studies in Turkey have shown high variabilities, leading to conflicting results. We aimed to re-evaluate HEV seroprevalence among blood donors in Turkey using the Wantai (Beijing, China) and the Dia.Pro (Milan, Italy) total anti-HEV antibody (Ab) enzyme-linked immunosorbent assay (ELISA) kits and compare their performances and to investigate the presence of HEV RNA in blood donors. Serum total anti-HEV antibodies were determined in a total of 2011 volunteer blood donor samples collected from different regions of Turkey (807 from Ankara, 243 from Kayseri, 284 from Izmir, 200 from Malatya, 200 from Kahramanmaras, and 277 from Van). HEV RNA was evaluated by a real-time polymerase chain reaction in a total of 272 anti-HEV seropositive samples. The country-wide HEV seroprevalence was calculated as 11.5% (Dia.Pro) and 12.2% (Wantai) with seropositivity rates of 12.0%-12.5% in Ankara, 7.4%-8.2% in Kayseri, 14.5%-15.5% in Malatya, 8.1%-8.8% in Izmir, 15.0%-16.0% in Kahramanmaras, and 12.6%-13.4% in Van by Dia.Pro and Wantai kits, respectively. The lowest detectable Ab concentrations were 0.16 and 0.14 units/mL WHO, for the Dia.Pro and the Wantai assays, respectively, showing no significant difference between assays. HEV RNA was not detected in any of the anti-HEV seropositive samples. Compared with previous studies, HEV was shown to have a higher overall seroprevalence in Turkey. Despite its limitation, the current study represents the most comprehensive HEV seroprevalence study in Turkey performed with two different commercial ELISA assays with high sensitivities so far. Further investigation is required to determine HEV genotypes in Turkey.Item An evaluation of empathic tendencies of dietitians working in Ankara(2019) Yildiz, Aysin; Ercan, Aydan; Muftuodu, Selen; 30345596Aim This study was carried out to determine the level of empathic tendencies of dietitians working in Ankara, Turkey. Methods The study was conducted between February and June 2016 on 175 dietitians aged between 20 and 60 who worked in Ankara, Turkey and volunteered to participate in the study. The Empathic Tendency Scale (ETS) and the Empathic Skill Scale (ESS) were used as data collection tools in the study. Results The median of ETS scores of male dietitians was found to be lower than that of female dietitians (P < 0.05). The differences between the median values of ETS and ESS were determined to be statistically significant in terms of the age groups and the 20-24 age range was found to be the age group with the lowest ETS and ESS (P < 0.05). In this study, it was found that the ETS and ESS median scores of married dietitians were higher, those of the dietitians with no children were lower, and that the ETS median score of the dietitians who had higher level of education was higher (P < 0.05). A positive relationship was found between the working environment satisfaction of the dietitians and empathic behaviours variable (r = 0.133, P = 0.008). Conclusions The empathic skill of the healthcare staff is an important part of the relationship that they establish with patients. When this is assessed from a nutritional point of view, dietitians need to be able to use communication skills effectively, especially empathy, in order to increase the effectiveness of nutrition education they provide.Item Celebrating the 25th anniversary of the International Conference on Population and Development: A perspective from Turkey(2019) Akin, Ayse; Ali, Moazzam; 31709532