TR-Dizin Kapalı Erişimli Yayınlar

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An add-on therapy for neuropathic pain: Infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue
(2019) Eker, Hatice Evren; Yalcin Cok, Oya; Bozdodan Ozyilkan, Nesrin; Aribodan, Anis; 30633313
In some situations, the cause of the supposed neuropathic pain might be related to abnormal tissue recovery such as scar formation due to wound retraction that might create mechanical compression on the nerve tissue. In this report we describe infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue to reduce mechanical stress in 3 patients. The infiltration technique might resolve the tension of the contracted scar tissue by tearing the adhesions and the eliminated mechanical compression would reduce the pressure on nerve tissue and hence neuropathic pain symptoms.
ADHERENCE TO GUIDELINE-DIRECTED MEDICAL AND DEVICE THERAPY IN HEART FAILURE WITH REDUCED EJECTION FRACTION
(2020) Kocabas, Umut; Kivrak, Tarik; Oztekin, Gulsum Meral Yilmaz; Tanik, Veysel Ozan; Ozdemir, Ibrahim; Kaya, Ersin; Yuce, Elif Ilkay; Demir, Fulya Avci; Dogdus, Mustafa; Pehlivanoglu, Seckin; ABA-3670-2020
After a Workshop on the Novel Antivirals for Treatment of Hepatitis C Virus Infection (4-6 December 2015, Istanbul)
(2016) Tekin, Suda; Aygen, Bilgehan; Aydin, Mehtap; Simsek, Funda
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.
Answer Regarding: Potent P2Y12 Inhibitors and Bleeding Complications
(2022) Akinci, Sinan; Coner, Ali; Akbay, Ertan; Adar, Adem; Muderrisoglu, Haldun; 36200724
Applicability of the Vienna Sale Agreement (CISG) for Advanced Purchase Agreements of COVID-19 Vaccines in EU Member States
(2022) Cortoglu Koca, Sema
The European Commission has signed advanced purchase agreements with various vaccine manufacturers for the production, purchase and supply of the COVID-19 vaccine in the EU. Some parts of the agreement texts with AstraZeneca, CurevacAg and Pfizer Inc./BioNTech have been blacked out. In these agreements, it is understood that Belgian courts are competent and Belgian law is chosen. In a dispute, it is possible for the competent courts to apply CISG since Belgium is a party to the CISG. Even if choice of law hasn't been made, the fact that the workplaces of all parties to these ageements are party to CISG, makes the CISG applicable. This study evaluates the applicability of the CISG to advanced purchase agreements (especially made with AstraZeneca) in EU Member States.
Arf numerical semigroups with multiplicity 11 and 13
(2022) Karakas, Halil Ibrahim; Ilhan, Sedat; Suer, Meral; AAY-4394-2021
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.
Assessment of patients with von Willebrand disease with ISTH-BAT and PBQ scores
(2019) Belen, F. B.; Umit, E. G.; Zengin, Y.; Evim, M.S.; Unal, E.; Ozbas, H. M.; Acipayam, C.
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.
Budget impact of incorporating non-invasive prenatal testing in prenatal screening for Down syndrome in Turkey
(2019) Okem, Zeynep Guldem; Orgul, Gokcen; Kasnakoglu, Berna Tari; Cakar, Mehmet; Beksac, Mehmet Sinan
Objectives: To provide information to the government about the budget impact of implementing non-invasive prenatal testing (NIPT) into prenatal screening strategies to detect Down syndrome (DS) in singleton pregnancies in Turkey; the likely costs or savings associated with NIPT in comparison to the current practice were calculated. Methods: A decision-analytic model was developed to calculate the cost estimates for 1,309,771 women who gave birth in 2016; 84.8% of whom were <35-years-of-age. The superior combined test (CT) among current strategies is compared with contingent NIPT for women <35-years-of-age; and usual practice of amniocentesis (AC) for women >= 35 years-of-age was replaced with universal NIPT. Results: When the market price of NIPT (1,077 PPPUS$) is used, contingent NIPT offered to high-risk women <35-years-of-age adds 34,907,225 PPPUS$; and for women-35 >= years-of-age the universal NIPT leads to 142,785,818 PPPUS$ more cost to the government compared to current strategies. The additional costs with NIPT are partially compensated by the cost-savings due to reduction of the number of invasive tests and procedure related losses (17,826,476 PPPUS$ for women <35-years-of-age and 37,070 PPPUS$ for women >= 35-years-of-age). Results are sensitive to the NIPT costs; with a lower cost of NIPT, a total saving would be 33,116,046 PPPUS$ with new strategies. Conclusions: NIPT might be the choice of prenatal screening strategies if its price is lowered to economically acceptable levels. Until that time, currently accepted protocols seem to be more realistic. On the other hand, decision makers should also consider possible savings and the women's quality of life that can be improved with the new technology. (C) 2019 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.
Burnout Syndrome Among Physicians: The Role of Socio-Demographic Characteristics
(2017) Ozkula, Guler; Durukan, Elif; 0000-0002-8579-5564; AAJ-8621-2021
Objective: Burnout is a syndrome that occurs in occupational groups, which are in close relation with people and includes dimensions of; emotional exhaustion, depersonalization and low sense of personal accomplishment. The aim of the present study is to investigate the relationship between socio-demographic characteristics and burnout syndrome in academic personel working at a hospital of Faculty of Medicine. Method: 258 physicians working at Baskent University Ankara Hospital have been included in the present study voluntarily, between January - April 2014 and they have been administered Socio-Demographic Data Form and Maslach Burnout Inventory. Results: Age, academic title, time span in the profession and at the institution, the number of patients daily examined, administrative tasks, receiving research supports, the number of lectures given were related to all dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment. Personnel assignment, the number of monthly shifts, daily duration of work were related to emotional exhaustion and depersonalization. Specialty preferences and intention to continue on the profession were associated with emotional exhaustion and personal accomplishment. Personnel assignment criteria and time reserved for academic study were related to only emotional exhaustion whereas accessibility to scientific literature was linked to personal accomplishment. Conclusion: Older age, having an academic title, longer time span in the profession and at the institution, concidering the long term consequences of specialty selection are all individual factors that can be related to burnout syndrome. Developing health policies for an optimal organization of daily work duration, number of patients daily examined and personnel assignment criteria could prevent burnout. Also developing organizational climate to create time for academic study, supporting researches, increasing accessibility to scientific literature and optimization of education seminars in academic physicians could protect them from burnout syndrome. Prospective studies modeling individual and organizational risk factors for burnout on academic physicians will help to further illuminate the measures to protect physicians from burnout syndrome and also contribute to the enhancement of treatment service quality and foster the contribution to academic arena.
Cephalometric Mandibular Dimensions in Growing Turkish Children: Trends of Change, Sex-Specific Differences, and Comparisons with Published Norms
(2022) Pamukcu, Hande; Tuncer, Nilufer Irem; Pelin, Ismail Can; Zengin, Hatice Yagmur; 36155404
Objective: The aims of this study were to investigate cephalometric mandibular dimensions in growing Anatolian Turkish children and to identify the periods of rapid growth for boys and girls. Furthermore, the secondary aim was to compare obtained values with published standards in the literature. Methods: A total of 528 pretreatment lateral cephalometric radiographs, grouped according to age and sex, were analyzed. Effective mandibular length, ramus height, and corpus lengths were comparatively evaluated within age groups for boys and girls and between sexes for the same age group. Data acquired from this study were compared with American, Canadian, Chinese, and European norms. Growth curves for mandible were constructed for each sex group. Results: Effective mandibular length was almost always significantly longer in boys, except for 9- and 12-year-age groups. Effective mandibular length in girls increased significantly between ages 8 and 10, 10 and 12, and 11 and 13 years, while in boys between ages 8 and 10, 9 and 11, and 13 and 15 years. Turkish girls had significantly shorter effective mandibular lengths than American girls at age 14. No significant difference was found between Turkish and Chinese girls and boys. Turkish girls and boys had significantly shorter corpus lengths from their Norwegian counterparts at age 12. Conclusion: Except for 9- and 12-year-age groups, effective mandibular length was almost always significantly longer in boys compared to the girls. It is suggested to use norm values from more recently conducted studies and which are representative of the studied population. Growth curves can be used to predict the approximate mandibular dimensions at a particular age.
Clinical features and immunoglobulin replacement therapy outcomes of adults with common variable immunodeficiency: a single centre experience
(2021) Musabak, Ugur; Erdogan, Tuba; 0000-0002-3143-2442; 34022776; ABH-5354-2020
Background/aim: Common variable immunodeficiency (CVID) characterized by defective immunoglobulin production is the most prevalent form of symptomatic primary immunodeficiency (PID) in adults. We aimed to reveal the clinical features of adults with CVID and to evaluate the effects of immunoglobulin replacement treatment (IRT) on hemato-immunological findings. Materials and methods: This study included 26 adult patients receiving IRT. Two measurements of complete blood counts and major immunoglobulin levels obtained at the beginning-end of follow up period were used for comparisons. Lymphocyte subsets and B-cell subgroups were measured only at the time of presentation. Results: The most common complications were related to respiratory and digestive systems and organomegaly. Chronic diarrhoea and low body weight were positively correlated with the percentage of CD8(+) T cells (p = 0.019 and p = 0.003, respectively) but negatively correlated with the CD4/CD8 ratio and the percentage of CD19(+) B cells (p = 0.019 and p = 0.005 for both parameters, respectively). At the end of period, the distribution of haematological parameters significantly improved, and immunoglobulin M (IgM) level increased to detectable levels (p = 0.035). Conclusions: There are apparent relationships among chronic diarrhoea and low body weight, and deterioration of T and B cell immunity in adults with CVID. IRT improves the whole blood parameters and stimulates immunoglobulin M (IgM) production. The later effect supports the immunomodulatory feature of this therapy.
Comparison of Long-term Clinical Outcomes of the Preferred Surgical Techniques in Secondary Hyperparathyroidism Cases
(2022) Karakaya, Emre; Erkent, Murathan; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-3592-5092; AAD-5466-2021; CAA-2756-2022
Objective: Secondary hyperparathyroidism (SHPT), that progresses with the deterioration of calcium-phosphorus metabolism detected in chronic kidney disease patients. Recurrence of SHPT may result in the recurrence of symptoms. Our aim was to compare the 5-year clinical results of autotransplantation after total parathyroidectomy (PTX-AT) with subtotal parathyroidectomy (SPTX). Materials and Methods: We analyzed 140 patients retrospectively from January 2000 and October 2020 who were operated due to SHPT. Clinical and demographic characteristics of the patients, preoperative and postoperative (1st day, 1st month, 6th month, 1st year, 5th years) serum PTH, calcium (Ca), phosphorous (P) values and length of hospital stay (LOS) were compared in terms of operations performed. The Shapiro-Wilks test was used for analyzing normally distributed datas. Mann Whitney U test used to evaluate of comparison of numerical data. Fisher's Exact or chi-square test was used for ratio comparisons or correlation. P<0.05 was considered statistical significance level. Results: Of these 140 patients, 106 (75.7%) had SPTX. On the other hand, 34 patients (24.3%) underwent PTX-AT surgery. When the groups were compared in terms of the gender, age and comorbidities, the differences were statistically significant. Additionally, no statistically significant difference was found between the groups in terms of postoperative complications (p=0.206). The difference between the weights and sizes of the parathyroid glands removed between the operation groups was not statistically significant (p=0.751, p=0.176). The difference was not statistically significant between the groups in terms of PTH, Ca and P levels measured. LOS was statistically significantly longer in PTX-AT patients (p=0). Conclusion: The surgical methods in the treatment of SHPT have no difference each other. Depending on the surgeon's preference, both surgical methods can be safely applied with high success rates.
Comparison of obese and non-obese patients in terms of self-esteem, body perception, body weight perception and sociodemographic components
(2019) Engur, Sevgi; Karagol, Arda
Objective: The aim of the study is to compare the randomly selected obese patients from the endocrinology outpatient clinic of a university hospital and the randomly selected non-obese patients from the general internal diseases outpatient clinic of the same hospital in the sense of self-esteem, body perception, body weight perception and some other sociodemographic features. Methods: The study included a total of 350 patients, of whom 175 were obese (147 female patients, 84%) and 175 were non-obese (115 female patients, 65.7%). The body mass indexes of the patients who were included in the study were measured. While the Rosenberg Self Esteem Scale was used to assess self-esteem, the body perception scale was used to assess the body perception of these patients. The consistency between the body mass index classifications and the self-body weight perceptions of the patients was also assessed. Results: The obese patients were found to have lower self-esteem and be less pleased about their bodies, and tend to perceive their body weights lower than their actual body weight when compared with the non-obese group. The non-obese patients in our study were found to be more pleased about their bodies whereas they showed higher levels of self-esteem and perceived their body weights more accurately. Discussion: In the light of these findings, obese patients should be evaluated in terms of psychiatry and get psychiatric help if needed. Eventually, obesity is an important issue which should be addressed multidisciplinary.
Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes
(2021) Altay, Hakan
An array of medical practitioners, including endocrinologists, family physicians, internal medicine specialists in nephrology and cardiology, unceasingly investigate, diagnose and treat over 8 million diabetic patients in Turkey. Apart from routine glycemic regulation, several frequent coexisting comorbidities such as obesity, hypertension, dyslipidemia, and their associated complications should also be promptly managed. Due to the concomitant occurrence of complications, the involvement of additional specialties in the precise management of such conditions becomes indispensable. Owing to the ever-expanding knowledge about the prevalence and clinical manifestations of diabetes, various international medical societies publish annual diabetes guidelines, which makes it too cumbersome as well as challenging for the practicing physicians to follow these comprehensive guidelines in clinical practice. There is an unmet need for an easyto-read and concise document for all physicians working for diabetes management for a standardized approach for better management of diabetes and improved patient care. This consensus report was prepared collectively by the Society of Endocrinology and Metabolism Turkey, Turkish Society of Cardiology, Turkish Society of Nephrology, Turkish Society of Hypertension and Renal Diseases to prevent cardiac and renal complications of diabetes, to timely detect these complications by using pertinent measures and to develop, implement and monitor strategies for managing them effectively.
Dabigatran for Stroke Prevention in Real Life in a Sample of Population from Turkey: D-SPIRIT Registry
(2021) Altin, Cihan; 34881702
Objective: The D-SPIRIT registry is designed to investigate the safety and effectiveness of dabigatran etexilate in patients with atrial fibrillation in routine clinical practice. Methods: D-SPIRIT is the first national, multicenter, prospective, observational, postmarketing registry that investigates the usage of dabigatran in real life. A total of 326 noveloral anticoagulant-eligible patients with atrial fibrillation who have been taking dabigatran etexilate therapy for stroke prevention at least 6 months from 9 different centers were enrolled into the registry. Patients were followed up for 2 years to evaluate the effectiveness and safety of the treatment. All adverse clinical events including bleeding, thromboembolic events, stroke, systemic embolism, transient ischemic attack, myocardial infarction, and all-cause death were recorded. Results: The mean age was 71.1 +/- 9.6 years, and 57.4% of the study participants were female. The mean CHA(2)DS(2)-VASc (congestive heart failure, hypertension, age >= 75 years, diabetes mellitus, stroke or transient ischemic attack [TIA], vascular disease, age 65-74 years, sex category) score was 3.4 +/- 1.6. The cumulative adverse clinical events rate was 6.30% per year. The rate for embolic events including TIA, ischemic stroke, and peripheral embolism was 1.26% per year. The rate for major bleeding was 2.20% per year, and the mortality rate was 0.94% per year. Conclusion: This registry obtained an important overview of the current safety and effectiveness of the dabigatran etexilate in Turkey. Our results indicate similar rates of thromboembolic and bleeding events with pivotal phase 3 trial and other real-life registries. However, rate of undertreatment usage of dabigatran etexilate in real life was found to be considerable.
A descriptive study of facial lacerations presenting to pediatric emergency in Turkey
(2021) Albayati, Abbas; Ozkan, Burak; Eyuboglu, Atilla; Uysal, Cagri A.; Ertas, Nilgun M.; https://orcid.org/0000-0003-2806-3006; https://orcid.org/0000-0001-6236-0050; 33394475; AAC-3344-2021; AAJ-2949-2021
BACKGROUND: Soft tissue trauma of the face is considered a leading cause of presentation and referral to the pediatric emergency department. The present study aims to evaluate the demographics properties of facial injuries presenting to the pediatric emergency. METHODS: In this study, 1160 patients presented with a simple facial laceration to the pediatric emergency department of Baskent University were reviewed from 2011 to 2017. Patients up to 18 years of age were included. We evaluated demographics about patients' age, sex, the cause of injury, the location of laceration and timing of the injury. Age was categorized according to the National Institute of Child Health and Human Development (NICHD) pediatric terminology into five groups as follows: 0-12 months, 12 months-2 years, 2-5 year, 6-11 year, and 12-18 years. The following analyses were performed to each age group: a number of cases, male to female predominance, timing of injury (e.g., early morning, afternoon, evening, late evening and at night), the place that the injury has occurred (e.g., at home, at school, in sport hall), the cause of injury (fall, hitting a hard subject, sports-related), the location of laceration (forehead, periorbital area, cheek, perioral area, nose, submental area) and the incidence according to the season. RESULTS: Number and relative percentages of cases were as follows: 0-12 months (n=127, 10.9%), 12-24 months (n=113, 9.7%), 3-5 years (n=385, 33.1%), 6-11 years (n=403, 34.7%) and 12-17 years (n=132, 11.3%). The average age of children was 6.5 year (range, 5 month - 17.9 year). The age group 6-11 showed a higher incidence compared to other age groups (n=403, 34.7%). Fifty-three percent of the population was younger than six years and there was a male predominance in all age groups. CONCLUSION: The demographic data provided in this study can be useful in trauma prevention programs which are effective in reducing the incidence, nature and severity of facial lacerations. Parents should be reminded of age-specific preventive measures in injury avoidance.
Development of an Innovative Product Using Axiomatic Design Methodology
(2020) Uluturk, Ibrahim; Yurdakul, Mustafa; Ic, Yusuf Tansel
In this study, axiomatic design methodology is applied to design an innovative rifle butt. The developed rifle butt model is sized to fit into common rifle types and ANSYS Workbench program is used for its structural analysis. So that, this study presents in detail a new product design and engineering process to develop a completely new product that satisfies customer requirements without copying any existing products designs.