Wos Kapalı Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10753
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Item Burnout among Turkish Physicians: A Systematic Review(2021) Toktamis, Aydin; Akkucuk, M. Husamettin; https://orcid.org/0000-0003-4569-1143; https://orcid.org/0000-0001-8126-9228; AAJ-2828-2021; AAE-3687-2021Introduction and objectives: By evaluating systematically and collectively studies examining burnout and accompanying factors of physicians in Turkey. we aimed to obtain a meta-perspective of the relevant reader or researcher. Material and Methods: English and in Turkish databases (Pub Med, Google Scholar, Ulakbim) were searched by using key words of physician, burnout and Turkey to identify Turkish physician burnout studies that have been published. Results: The databases search resulted in finding of forty-nine articles most of which were regional and only seven representing the nationwide perspective. A total of 12,598 physicians were evaluated in the surveys. The calculated mean values, supposedly roughly representing the total universe evaluated in all studies. were 18.3 for emotional exhaustion (EE), 7.9 for depersonalisation (DP) and 20.1 for personal accomplishment (PA), respectively. Conclusion: There is a low level of EE, DP and a high decrease in the sense of PA in physicians working in Turkey. The overall burnout experienced by them is not very high, but also is not very low. Female physicians appear to be at higher risk for EE sub-dimension and the risk of burnout is reduced with increasing age or experience.Item Vestibular Illusions and Alterations in Aerospace Environment(2021) Demir, Abdurrahman Engin; Aydin, Erdinc; 0000-0001-6864-7378; 34386801; AAJ-2379-2021As the aerospace industry has grown rapidly over the years, aviators and astronauts have been exposed to some abnormal physiological changes arising from the dynamics of the aerospace environment. The vestibular system, encoding linear and angular movements of the head, is one of the main affected systems in which those abnormal changes can occur during flight. Despite the intricate and solid organization, vestibular units are such delicate structures that they can easily be deceived by aerial dynamics and gravity changes. Therefore, it is of vital importance for the continuity of flight safety to be aware of the detrimental alterations and impairments regarding the vestibular system and its reflex pathways. The aim of this paper was to present a review about how a healthy vestibular system is negatively affected within the aerospace environment and how some vestibular disorders become exaggerated or impaired during aviation and space activities.Item Can Hepatitis A Vaccine Provide Protection Against COVID-19?(2020) Sarialioglu, Faik; Apak, Fatma Burcu Belen; Haberal, Mehmet; 0000-0002-9278-6703; 0000-0002-3462-7632; 0000-0002-8257-810X; 32279655; AAJ-8171-2021; AAJ-8097-2021; AAL-7766-2021Item Plant-based diets to manage the risks and complications of chronic kidney disease(2020) Carrero, Juan J.; Gonzalez-Ortiz, Ailema; Avesani, Carla M.; Bakker, Stephan J. L.; Bellizzi, Vincenzo; Chauveau, Philippe; Clase, Catherine M.; Cupisti, Adamasco; Espinosa-Cuevas, Angeles; Molina, Pablo; Moreau, Karine; Piccoli, Giorgina B.; Post, Adrian; Sezer, Siren; Fouque, Denis; 32528189Traditional dietary recommendations for patients with chronic kidney disease (CKD) focus on the quantity of nutrients consumed. Without appropriate dietary counselling, these restrictions can result in a low intake of fruits and vegetables and a lack of diversity in the diet. Plant nutrients and plant-based diets could have beneficial effects in patients with CKD: increased fibre intake shifts the gut microbiota towards reduced production of uraemic toxins; plant fats, particularly olive oil, have anti-atherogenic effects; plant anions might mitigate metabolic acidosis and slow CKD progression; and as plant phosphorus has a lower bioavailability than animal phosphorus, plant-based diets might enable better control of hyperphosphataemia. Current evidence suggests that promoting the adoption of plant-based diets has few risks but potential benefits for the primary prevention of CKD, as well as for delaying progression in patients with CKD G3-5. These diets might also help to manage and prevent some of the symptoms and metabolic complications of CKD. We suggest that restriction of plant foods as a strategy to prevent hyperkalaemia or undernutrition should be individualized to avoid depriving patients with CKD of these potential beneficial effects of plant-based diets. However, research is needed to address knowledge gaps, particularly regarding the relevance and extent of diet-induced hyperkalaemia in patients undergoing dialysis. Emerging evidence suggests that plant-based diets could help to prevent chronic kidney disease (CKD), manage its symptoms and metabolic complications and delay disease progression. Here, the authors discuss the potential risks and benefits of these diets in patients with CKD, as well as implementation strategies and knowledge gaps.Item What We Learned about COVID-19 So Far? Notes from Underground(2020) Esendagli, Dorina; 0000-0002-6619-2952; 32584236; ABF-9398-2020The novel coronavirus pandemic poses a major global threat to public health. Our knowledge concerning every aspect of COVID-19 is evolving rapidly, given the increasing data from all over the world. In this narrative review, the Turkish Thoracic Society Early Career Taskforce members aimed to provide a summary on recent literature regarding epidemiology, clinical findings, diagnosis, treatment, prevention, and control of COVID-19. Studies revealed that the genetic sequence of the novel coronavirus showed significant identity to SARS-CoV and MERS-CoV. Angiotensin-converting enzyme 2 receptor is an important target of the SARS-CoV-2 while entering an organism. Smokers were more likely to develop the disease and have a higher risk for ICU admission. The mean incubation period was 6.4 days, whereas asymptomatic transmission was reported up to 25 days after infection. Fever and cough were the most common symptoms, and cardiovascular diseases and hypertension were reported to be the most common comorbidities among patients. Clinical manifestations range from asymptomatic and mild disease to severe acute respiratory distress syndrome. Several patients showed typical symptoms and radiological changes with negative RT-PCR but positive IgG and IgM antibodies. Although radiological findings may vary, bilateral, peripherally distributed, ground-glass opacities were typical of COVID-19. Poor prognosis was associated with older age, higher Sequential Organ Failure Assessment score, and high D-dimer level. Chloroquine was found to be effective in reducing viral replication in vitro. Likewise, protease inhibitors, including lopinavir/ritonavir, favipiravir, and nucleoside analogue remdesivir were proposed to be the potential drug candidates in COVID-19 management. Despite these efforts, we still have much to learn regarding the transmission, treatment, and prevention of COVID-19.Item Solid Organ Transplant Recipients with Pneumonia in Intensive Care UniT: A Single Center Study(2020) Yesiler, F. I.; Yazar, C.; Sahinturk, H.; Zeyneloglu, P.; Haberal, M.; 0000-0002-3462-7632; 0000-0002-0612-8481; 0000-0003-0159-4771; AAJ-8097-2021; AAJ-4212-2021; AAJ-1419-2021Item A Systematic Literature Review for Personnel Scheduling Problems(2020) Ozder, Emir Huseyin; Ozcan, Evrencan; Eren, Tamer; 0000-0002-1895-8060; Q-4772-2017Organizations need to focus on many parameters to reach their goals such as personnel satisfaction at the top level, profit maximization, increasing system efficiency and minimizing costs. By carefully examining the significant effect of personnel scheduling on the production of goods and services, achieving a fair distribution of work among the employees paves the way for higher motivation and performance of the employees, particularly, in production and service industries. In this paper, a systematic literature review (SLR) approach is used to demonstrate the necessity of scheduling studies in order to overcome the deficiencies in auxiliary activity groups. It sheds light on a new and very important areas such as examining the model structures of sector differences, and guiding researchers. New trends and approaches are presented for the personnel scheduling problems. Different classification perspectives are displayed.Item Neutrophil Gelatinase-Associated Lipocalin Measured on Clinical Laboratory Platforms for the Prediction of Acute Kidney Injury and the Associated Need for Dialysis Therapy: A Systematic Review and Meta-analysis(2020) Kavalci, Cemil; 32679151Rationale & Objective: The usefulness of measures of neutrophil gelatinase-associated lipocalin (NGAL) in urine or plasma obtained on clinical laboratory platforms for predicting acute kidney injury (AKI) and AKI requiring dialysis (AKI-D) has not been fully evaluated. We sought to quantitatively summarize published data to evaluate the value of urinary and plasma NGAL for kidney risk prediction. Study Design: Literature-based meta-analysis and individual-study-data meta-analysis of diagnostic studies following PRISMA-IPD guidelines. Setting & Study Populations: Studies of adults investigating AKI, severe AKI, and AKI-D in the setting of cardiac surgery, intensive care, or emergency department care using either urinary or plasma NGAL measured on clinical laboratory platforms. Selection Criteria for Studies: PubMed, Web of Science, Cochrane Library, Scopus, and congress abstracts ever published through February 2020 reporting diagnostic test studies of NGAL measured on clinical laboratory platforms to predict AKI. Data Extraction: Individual-study-data meta analysis was accomplished by giving authors data specifications tailored to their studies and requesting standardized patient-level data analysis. Analytical Approach: Individual-study-data meta analysis used a bivariate time-to-event model for interval-censored data from which discriminative ability (AUC) was characterized. NGAL cutoff concentrations at 95% sensitivity, 95% specificity, and optimal sensitivity and specificity were also estimated. Models incorporated as confounders the clinical setting and use versus nonuse of urine output as a criterion for AKI. A literature-based meta-analysis was also performed for all published studies including those for which the authors were unable to provide individual-study data analyses. Results: We included 52 observational studies involving 13,040 patients. We analyzed 30 data sets for the individual-study-data meta-analysis. For AKI, severe AKI, and AKI-D, numbers of events were 837, 304, and 103 for analyses of urinary NGAL, respectively; these values were 705, 271, and 178 for analyses of plasma NGAL. Discriminative performance was similar in both meta-analyses. Individual-study-data meta-analysis AUCs for urinary NGAL were 0.75 (95% CI, 0.73-0.76) and 0.80 (95% CI, 0.79-0.81) for severe AKI and AKI-D, respectively; for plasma NGAL, the corresponding AUCs were 0.80 (95% CI, 0.790.81) and 0.86 (95% CI, 0.84-0.8 6). Cutoff concentrations at 95% specificity for urinary NGAL were >580 ng/mL with 27% sensitivity for severe AKI and >589 ng/mL with 24% sensitivity for AKI-D. Corresponding cutoffs for plasma NGAL were >364 ng/mL with 44% sensitivity and >546 ng/mL with 26% sensitivity, respectively. Limitations: Practice variability in initiation of dialysis. Imperfect harmonization of data across studies. Conclusions: Urinary and plasma NGAL concentrations may identify patients at high risk for AKI in clinical research and practice. The cutoff concentrations reported in this study require prospective evaluation.Item Sodium-glucose cotransporter-2 inhibitors in heart failure patients: an appraisal of recent cardiovascular outcome trials(2020) Kocyigit, Duygu; Kocyigit, Alime S.; Hussain, Muzna; 33059407Although initially introduced as a novel oral glucose-lowering agent class, cumulative evidence from randomized controlled trials (RCTs) have led sodium-glucose cotransporter-2 inhibitors (SGLT2i) to become a component of primary and secondary prevention from atherosclerotic cardiovascular disease in patients with type 2 diabetes mellitus (T2DM). Dapagliflozin, one of the agents of this class, was investigated in 2019 in patients with heart failure (HF) independent of being diagnosed with T2DM at baseline. Since then, many other studies are being undertaken in this class of drugs. Herein, we aimed to review the RCTs, their subgroup and post-hoc analyses that examined the effects of SGLT2i on cardiovascular outcomes (including HF-related outcomes) in patients diagnosed with HF that were published until June 2020. We also summarized the ongoing trials that aim to assess the impact of SGLT2i on cardiovascular outcomes in patients with HF and listed available guideline recommendations regarding the use of SGLT2i for cardiovascular disease management.Item Clinical characteristics of avascular necrosis in patients with Behcet disease: a case series and literature review(2019) Atas, Nuh; Bitik, Berivan; Varan, Ozkan; Babaoglu, Hakan; Tufan, Abdurrahman; Haznedaroglu, Seminur; Goker, Berna; Ozturk, Mehmet Akif; 30560445Avascular necrosis (AVN), also known as osteonecrosis, is characterized by death of the osteocytes due to inadequate blood supply caused by various mechanisms. The hip is the most common affected joint followed by knee. Incidence of AVN in rheumatic diseases is variable and high corticosteroid (CS) therapy is a known major risk factor for development of AVN. Data on the AVN in Behcet disease (BD) are limited. The purpose of this study is to examine the clinical and treatment characteristics of BD patients with diagnosis of AVN. Retrospective medical records of 337 BD patients were reviewed. Nine BD patients with AVN were detected. The clinical data of these patients with AVN have been reviewed. All patients had MRI of the symptomatic joints compatible with AVN. All of the nine patients who were diagnosed with AVN were male. Median duration of BD was 7years. Median time between diagnosis of BD and detection of AVN was 3years (1-16years). Multiple joints were involved in seven patients. Six patients had bilateral knee AVN. Six patients had vascular BD. The median time interval between initial CS dose and AVN development was 24months (range=2-100). The median highest daily CS dose was 64mg/day (range=32-80) and median cumulative CS dose prior to AVN was 18g. All of patients had intravenous pulse steroids. CS treatment, smoking and vascular involvement may predispose to AVN in patients with BD. According to this cohort, AVN in BD frequently tended to be in the knee joint and bilateral.