Scopus İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Heart failure with non-reduced ejection fraction: Epidemiology, pathophysiology, phenotypes, diagnosis and treatment approaches(2022) Cavusoglu, Yuksel; Celik, Ahmet; Altay, Hakan; Nalban, Sanem; Ozden, Ozge; Temizhan, Ahmet; Ural, Ditek; Unlu, Serkan; Yilmaz, Mehmet Birhan; Zoghi, Mehdi; 35969235Heart failure (HF) has been classified as reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) by the recent HF guidelines. In addition, HF with improved ejection fraction has been defined as a subgroup of HFrEF. In HFrEF, diagnostic workup and evidence-based pharmacological and device-based therapies have been well established. However, HFpEF, which comprises almost half of the HF population, represents significant uncertainties regarding its pathophysiology, clinical phenotypes, diagnosis and treatment. Diagnostic criteria of HFpEF have been changed a few times over the years and still remained a matter of debate. New paradigms including a prominent role of co-morbidities. inflammation, endothelial dysfunction have been proposed in its pathophysiology. As a complex, multifactorial syndrome HFpEF consists of many overlapping clinical and hemodynamic phenotypes. In contrast to HFrEF, clinical outcomes of HFpEF have not improved over the last decades due to lack of proven effective therapies. Although HFrEF and HFpEF have different clinical spectrums and proposed pathophysiological mechanisms, there is no clear defining syndrome postulated for HFmrEF. Clinical characteristics and risk factors of HFmrEF overlap with HFrEF and HFpEF. HFmrEF is also referred as a transitional zone for dynamic temporal changes in EF. So. HFpEF and HFmrEF, both namely HF with non-reduced ejection fraction (HF-NEF), have some challenges in the management of HF. The purpose of this paper is to provide a comprehensive review including epidemiology, pathophysiology, clinical presentation and phenotypes of HF-NEF and to guide clinicians for the diagnosis and therapeutic approaches based on the available data in the literature.Item Psikososyal Stres Faktorleriyle Tetiklenen Erken Baslangicli Konversiyon Bozuklugu Olarak Astazi-Abazi Olgusu 2(2022) Guler Aksu, Gulen; KAYAR, Ozan; TAN, Muhammet Emin; KUTUK, Meryem ozlem; BOZLU, Gulcin; TOROS, FevziyeConversion disorder is defined as the loss or change of motor, sensory, and autonomic nervous system-related functions that cannot be explained completely with organic causes. The etiology of the disease may be explained by psychoanalytic theory, learning theory, sociocultural factors, and some traumatic life events besides genetic and neurobiological factors. The onset is usually between late childhood and early adulthood. The disorder occurs after a high rate of psychosocial stressors and the symptoms can vary. While astasia, as one of the possible complaints in conversion disorder, is defined as not being able to stand due to loss of motor power or sensory loss; abasia is identified as patients having no apparent motor problem but not being able to walk properly. Both conditions can be of organic as well as the psychogenic origin. In this paper, the clinical signs of a seven-year-old boy who was admitted to emergency service of Mersin University Faculty of Medicine with the complaints of astasia and abasia but was found to have conversion disorder is presented. The results of the medical examinations and the possible psychosocial stress factors behind these symptoms, as well as the treatment process of the case, were shared. With this report, we is aimed to draw attention to the importance of early diagnosis of the disorder, the necessity of an interdisciplinary approach in the treatment process, and the handling of psychosocial factors leading to somatic symptoms.Item 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, HalilTripoli 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.Item Should We Accept the HPV Type 66 into a Probable High-Risk Group? The Prevalence, Clinical and Histopathological Evaluation of HPV Type 66 in Gazi University, Ankara(2021) Kazanci, Ferah; Kocak, Aylin Altay; Colak, Meryem; Erdem, Ozlem; Onan, M. Anil; Bozdayi, Gulendam; 0000-0002-0451-0142; AAI-8012-2021Introduction: The prevalence of infection by different genotypes of human papillomavirus (HPV) varies among different geographic areas. The objective of the study is to determine the prevalence and distribution of HPV66 genotype among women with normal or abnormal Pap smear tests. Methods: This retrospective study was conducted in a tertiary care university hospital between January 2017 and February 2018, in central Anatolia of Turkey. This study included 288 women, 66 (%22.9) of whom had HPV DNA positive. HPV DNA screening was done by an automatized system using real time PCR method (Cobas 4800 System, Roche Diagnostics Ltd, Switzerland) and this method distinguishes types 16 and 18, while the other 12 oncogene types are reported as high-risk HPV (HR-HPV: 31,33,35,39,45,51,52,56,58,59,66,68). For the genotyping of other oncogene types, a commercial real time PCR method (NLM Genotypes 14 Real-TM Quant, NLM Diagnostic, Italy) was used. Results: The most common identified HPV types were HPV16 (%6.3), HPV 56 (%3.8), HPV 18(%3.1), HPV 66 (%3.1), HPV 51 (%2.8), HPV 52(%2.1). HPV type 66 which has admitted recently other-subtypes with their unclear oncogenicity is the third most identified type in our study. In our study 9 (%3.1) women had type 66 and 2 (%0.7) of whom had abnormal Pap smear results. One patient with syphilis whose pap smear test results was ASC-H/HSIL was evaluated by colposcopic examination and LEEP (Loop Electrosurgical Excision Procedure) and ECC (Endocervical Curettage) were performed. The result of histopatological report was benign. The other patient whose Pap smear test result was LSIL evaluated by colposcopic examination and found no pathological finding. Conclusion: The frequency of HPV 66 infection was found to be higher in our study compared to previous reports. In 2 patients out of 9 cases (% 2.4) who were detected HPV 66 had normal pap test results.Item A Comparison of Echocardiography and the Pressure Recording Analytical Method (PRAM) for Predicting Fluid Responsiveness after Passive Leg Raising(2021) Ozdemirkan, Aycan; Aitakhanoya, Manat; Gedik, Ender; Zeyneloglu, Pinar; Pirat, Arash; 0000-0002-7175-207X; ABI-2971-2020Objective: This study aims to assess the agreement between the cardiac index (CI) measured by pressure recording analytical method (PRAM) and transthoracic echocardiography (TTE) before and after the passive leg raise (PLR) maneuver. Methods: This is a prospective observational study in critically ill patients who were monitored with MostcareUp/PRAM (Vygon, Vytech, Padova, Italy). Cardiac index (CI) values and percent changes in CI values in response to PLR were recorded by TTE and PRAM. Results: Data of a total of 25 patients were collected. The median CI values that were calculated by TTE before and after PLR were 2.5 (1.2-4.7) L/min/m(2) and 2.9 (1.4-5.6) L/min/m(2), respectively. The median CI values that were calculated by PRAM before and after PLR were 2.5 (1.5-4.8) L/min/m(2) and 2.6 (1.7-5.7) L/min/m(2), respectively. There was significant correlations between the measured CI values both by TTE and PRAM before and after PLR (r=0.635, p=0.001 and r=0.610, p=0.001, respectively). The median percent changes in CI with TTE and PRAM were -0.13 (-0.7-0.4) and -0.11 (-0.5-0.5), respectively. Sixteen patients were determined as FR by TTE (64%) and 13 patients were determined as FR by PRAM (52%). The Kappa test showed moderate agreement between TTE and PRAM for predicting fluid responsiveness (k=0.595; p=0.002). The mean biases between the CI values measured by TTE and PRAM before and after PLR were 0.04 +/- 0.77 L/min/m(2) and 0.22 +/- 0.88 L/min/m(2), respectively. Conclusion: This study showed a significant correlation for CI values measured by both methods. For predicting fluid responsiveness there was agreement between the two methods after PLR.Item The Importance of Health Literacy and Health Communication: Evaluation of Delayed Admission Time to Hospital in Women During Myocardial Infarction in Turkey in Terms of Gender Inequality(2021) Altun, Armagan; 0000-0002-3233-8263; 33709913; ABB-5844-2020Item Immunological Mechanisms of Allergic Rhinitis(2021) Koycu, Alper; Yucel, Aysegul Atak; 0000-0003-1290-3509; AAF-3650-2021Allergic rhinitis is a specific immunoglobulin (Ig)E-mediated reaction developed against respiratory allergens. The main symptoms of allergic rhinitis; sneezing, runny nose, nasal congestion, itching in the nose, eyes and palate. Cells, cytokines, surface markers, transcription factors and other mediators have been revealed with the sequential removal of nasal biopsy and lavages in human and animal models exposed to allergens over the years. Respiratory allergen induces Th2 lymphocyte proliferation with a combination of cytokines including interleukin (IL)-3, IL-4, IL-5, IL-9, IL-10, and IL-13. These molecules promote allergen specific IgE, mast cells, basophils, eosinophils, adhesion molecules and chemokines. In this review, immunological mechanisms in allergic rhinitis re-examined by reviewing the current literature.Item Antibody Screening and Risk Assessment of Healthcare Professionals in the COVID-19 Pandemic(2021) Gumus, Hatice Hale; Demiroglu, Yusuf Ziya; Aliskan, Hikmet Eda; Odemis, İlker; Ceylan, Ozgur; Pocan, Ahmet Gurhan; Karagum, Ozlem; 0000-0001-9060-3195; 0000-0003-2638-0163; 0000-0002-9866-2197; 0000-0003-2638-0163; 0000-0001-6910-7250; 0000-0003-0681-8375; 0000-0003-3128-1602; 0000-0001-9071-9606; 34416802; AAE-2282-2021; AFK-3690-2022; AAX-9250-2021; AAZ-9711-2021; AAG-2486-2022; AAK-8276-2021; U-4084-2017; AAE-6310-2021; AAJ-2108-2021Globally 364102 healthcare professionals have been infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and 1253 of them died until 15 January 2021. Healthcare professionals serving at the forefront of combating the pandemic are in the high risk group. In our country, the data about coronavirus-2019 (COVID-19) among healthcare professionals are limited. The aim of this study was to investigate the anti-SARS-CoV-2 IgG seroprevalence in healthcare professionals, to evaluate the risks they encountered during work, and to examine their relationships with antibody positivity. A total of 572 healthcare professionals serving in various units of our hospital participated in our study and the presence of anti-nucleocapsid IgG was investigated by chemiluminescent microparticle immunoassay (SARS-CoV-2 IgG test, Abbott Laboratories Diagnostics, USA) method in serum samples collected between May 18, 2020 and June 30, 2020. The demographic characteristics, medical history, work conditions, medical procedures performed and possible risk factors were questioned with a questionnaire form. The average age of the participants was 33.5 +/- 9.2 (19-61) years, and 62.9% (360/572) of them were women. In our study, the anti-SARS-CoV-2 IgG seroprevalence was 3.7% (21/572). The association of the antibody positivity with age, gender and occupational status was not statistically significant (p> 0.05). Comorbid diseases which were significantly higher in seropositive healthcare professionals were hypertension (19%) and diabetes mellitus (14.3%) (p< 0.05). It was observed that antibody positivity was significantly higher in healthcare professionals working in high (52.4%) and medium risk (33.3%) areas, those who treat and/or examine patients with suspicious or positive COVID-19 (66.7%) and those who spend more than 30 minutes in COVID-19 patient rooms (76%) (p< 0.05). The symptoms associated with seropositivity in healthcare workers with a history of symptoms (46%) were loss of smell (23.5%), loss of taste (20.0%) and respiratory distress (16.7%) (p< 0.05). It was observed that the probability of being infected with SARS-CoV-2 increased 12 times if there was a colleague with COVID-19 in the hospital, four times if there was a patient in the house/lodging and six times if there was an infected person in the social environment (p< 0.05). The rate of those who had the flu vaccine among the participants was 10.8% (62/572) and 9.7% of them were found to be anti-SARS-CoV-2 IgG positive (p< 0.05, 95% CI= 1.31-9.48). The seropositivity was significantly higher in non-smokers (4.8 %) compared to smokers (0.0%) (p< 0.05). In our study, it was determined that the rate of seropositivity was 12 times higher in healthcare professionals who stated that they received hydroxychloroquine prophylaxis due to risky contact compared to those who did not receive prophylaxis (p< 0.05, 95% CI= 4.11-40.64). The ratio of the personnel who answered "always" to the frequency of wearing gloves, masks, goggles/face shields and overalls was 85.7%, 96.9%, 62.1% and 65.4%, respectively. In conclusion, regular and large-scale sero-epidemiological screening of healthcare professionals in the COVID-19 pandemic can contribute to the control of the pandemic by providing a better understanding of transmission dynamics and risk factors.Item Investigation of the effects of psychological factors on implementing protective behaviors against coronavirus(2021) Bucakc, Merve Gul; Gunhan, Ipek Selin; Erku, Ozlem Kahraman; 0000-0002-9788-6797; ABD-2782-2021Objective: This study aims at investigating the psychological factors that may influence the implementation of protective behaviors of Turkish people against the novel coronavirus pandemic. For this purpose, the relationship between the implementation of the protective behaviors and risk perception, risk taking behaviors, positive and negative affect and coping strategies were examined. Method: Data collection tools were The Protective Behavior Implementation Scale, The Positive and Negative Affect Schedule, The Ways of Coping with Stress Scale and The Sensation Seeking-Risk Taking Scale. 364 of the participants were female and 193 were male. The age range was 20-64 and the mean age was 34.69. Results: The hierarchical regression analysis showed that a positive relationship between age, sex and protective behaviors exists. Another positive relationship was found between protective behaviors, risk perception and positive affect. Moreover, a negative relationship was present between submissive coping and protective behaviors. Discussion: Psychological factors are influential on the implementation of the protective behaviors against the coronavirus. As the perceived risk regarding the disease increases, protective behaviors are elevated. Else, the increasement in the protective behaviors are related to the positive affect. People who carry out protective behaviors are observed not to be using submissive coping. This may be related to the self-control perception. In addition to that, increased age is associated with applying more protective behaviors and women are found to be more likely to use protective behaviors than men. The study is important as it investigated the impact of psychological factors on cultural settings.Item A goal programming approach for multi objective, multi-trips and time window routing problem in home health care service(2021) Dengiz, Asiye Ozge; Atalay, Kumru Didem; Altiparmak, FulyaThe structure of services in the health sector is changed by the epidemic diseases affecting the world, the population growth and developing technologies. Due to the advantages it provides, home health care (HHC) services are increasingly being demanded by patients. With the in-crease in demand for HHC, the interest of researchers in Home Health Care Routing Problem (HHCRP) is also increasing. In this study, HHCRP has been studied based on information gathered from a relevant unit of a State Hospital providing HHC services in Ankara. Due to the limited resources in the hospital under consideration, vehicles often need to be used for multiple rounds. Thus, the HHCRP is considered as a multi-tour routing problem. Besides, the problem has been created with time window constraints in order to ensure that the demands of the patients are met on time. Meantime, meeting all the patient demands and reducing the environmental impacts are two important goals in HHCRP. The reduction of the environmental impacts can be achieved by minimizing the carbon emission of the vehicles used in the HHC. Thus, the problem addressed in this study has been defined as a multi-objective, multi-trip and time-windows home healthcare routing problem (MTTW-HHCRP). Weighted goal programming (GP) method is used to solve the proposed problem. Test problems are randomly generated based on the data and the information obtained from the hospital in Ankara, and the solutions obtained through scenario analysis are evaluated to guide the decision-making process.
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