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Item Giant but Silent Lesion of the Stomach in A Geriatric Patient(2016) Etik, Digdem Ozer; Tumay, Volkan; Aktas, Hikmet; Meric, Mehmet; Zorluoglu, Abdullah; 0000-0002-6206-9332; 0000-0002-4724-0728; 27782902; A-2109-2019; AAJ-4707-2021Item Approach of pulmonologists in Turkey to noninvasive mechanical ventilation use in acute respiratory failure(2016) Ugurlu, Aylin Ozsancak; Kivanc, Tulay; Dogrul, Ilgaz; 26963304Introduction: Noninvasive mechanical ventilation (NIV) has been increasingly used worldwide for acute respiratory failure (ARF), especially in patients with chronic lung disorders. We aimed to define the approach of pulmonologists in Turkey to NIV use for ARF management. Materials and Methods: A 38-question survey, developed and tested by authors, was distributed by e-mail to a total of 2.205 pulmonologists in Turkey. Results: Response rate was 27% (n=596). Seventy-one percent of responders were practicing NIV in clinic. NIV use was found to be associated with responder's academic title, age, duration of medical license, type of physician's hospital and its region, patient load, NIV experience during residency, and duration of NIV and intensive care unit (ICU) experience (p<0.001). Based on sub-group analysis of responders using NIV, median number of NIV patients followed-up per week was 4 [interquartile range (IQR): 2-6]. Most of the NIV users reported employment of wards (90%) and/or ICUs (86%) to follow-up patients, while 8.4% of the responders were applying NIV only in ICU's. Chronic obstructive lung disease (COPD) (99.5%), obesity hypoventilation syndrome (93.7%) and restrictive lung disease (89.4%) were the most common indications. Majority of NIV users (87%) were applying NIV to > 60% of patients with COPD, and success rate in COPD was reported as over 60% by 93% of users. Oronasal mask (median and IQR 90, 80-100%, respectively) and home care NIV ventilators (median and IQR 50, 10-85%, respectively) were the most commonly utilized equipment. Conclusion: NIV use in ARF varies based on hospital type, region and, especially, experience of the physician. Although consistent with guidelines and general practice, NIV use can still be improved and increased.Item Effect of Hereditary Hemochromatosis Gene H63D and C282Y Mutations on Iron Overload in Sickle Cell Disease Patients(2016) Terzi, Yunus Kasim; Balci, Tugce Bulakbasi; Boga, Can; Koc, Zafer; Celik, Zerrin Yilmaz; Ozdogu, Hakan; Karakus, Sema; Sahin, Feride Iffet; 27095682Objective: Hemochromatosis is an autosomal recessive disease that is one of the most important reasons for iron overload. Sickle cell disease is a hemoglobinopathy that occurs as a result of a homozygous mutation in the hemoglobin gene. Erythrocyte transfusion is frequently used in the treatment of this disease. Iron overload as a result of transfusion is important in the mortality and morbidity of sickle cell anemia patients as well as in other hemoglobinopathies. In this study, the effect of hemochromatosis gene (HFE) p.H63D and p.C282Y mutations on transfusion-related cardiac and liver iron overload in sickle cell disease patients who carry homozygous hemoglobin S mutation has been investigated. Materials and Methods: This is a prospective single-center cross-sectional study in patients with homozygous hemoglobin S mutation between the years 2008 and 2013. The patients were divided into two groups. The first group (group A, n=31) was receiving chelation therapy and the second group (group B, n=13) was not. Direct and indirect iron loads were analyzed by magnetic resonance imaging and biochemically, respectively. HFE gene mutations were analyzed by polymerase chain reaction-restriction fragment length polymorphism method. Statistical analyses were performed by independent samples t-test. Results: p.H63D mutation was detected in 10 (32.3%) patients in group A and in only 1 patient (7.7%) in group B. When the 2 groups were compared for iron overload, iron deposition in the liver was significantly higher in group B (p=0.046). In addition, in group A, iron deposition was significantly higher in HFE mutation carriers compared to patients without the mutation (p=0.05). Conclusion: Results of this study showed that HFE gene mutations are important in iron deposition in the liver in patients with sickle cell disease.Item The LOFT mission concept - A status update(2016) Inam, S.C.The Large Observatory For x-ray Timing (LOFT) is a mission concept which was proposed to ESA as M3 and M4 candidate in the framework of the Cosmic Vision 2015-2025 program. Thanks to the unprecedented combination of effective area and spectral resolution of its main instrument and the uniquely large field of view of its wide field monitor, LOFT will be able to study the behaviour of matter in extreme conditions such as the strong gravitational field in the innermost regions close to black holes and neutron stars and the supra-nuclear densities in the interiors of neutron stars. The science payload is based on a Large Area Detector (LAD, > 8m(2) effective area, 2-30 keV, 240 eV spectral resolution, 1 degree collimated field of view) and a Wide Field Monitor (WFM, 2-50 keV, 4 steradian field of view, 1 arcmin source location accuracy, 300 eV spectral resolution). The WFM is equipped with an on-board system for bright events (e. g., GRB) localization. The trigger time and position of these events are broadcast to the ground within 30 s from discovery. In this paper we present the current technical and programmatic status of the mission.Item Volumetric and morphologic changes due to effect of unilateral extraction of teeth(2016) Kurkcuoglu, Ayla; Pelin, CanObjective: Chewing includes the rhythmic movement of the jaw muscles. In this study, we investigated volumetric changes in the masticatory muscles and morphometric changes in the mandibular condyle due to unilateral extraction of the teeth in the sixth and twelfth weeks of life. Materials and Methods: Eighteen rats were used. The rats were divided into three groups. In the experimental groups (Groups I and II), all of the teeth on one side of the upper and lower jaws of the rats were extracted. In the control group all the teeth were intact. Volumetric changes of the masseter and temporal muscles were evaluated. In addition, morphometric changes of the mandibular condyle were investigated. Results: The measurements performed six weeks after tooth extraction did not reveal any difference in the temporal muscles between the two sides, however the volume of the masseter muscle on the side of the extraction was significantly reduced (Group I). Twelve weeks after the tooth extraction, the volumes of the masseter and temporal muscles showed significant reduction on the side of the extraction (Group II). A morphometric reduction in the mandibular condyle was observed in the longer period of time. No asymmetry was observed either for muscular volumes or for mandibular condyle dimensions in the control group. Conclusion: Unilateral tooth loss may cause volumetric reduction in the masseter and temporal muscles ipsilaterally. However, the cause of the morphometric reduction in the mandibular condyle on the contralateral side in the longer period of time is surprising.Item New bronchodilators in treatment of chronic obstructive pulmonary disease(2016) Balcan, BaranChronic obstructive pulmonary disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Clinical diagnosis of COPD should be considered in any individual, who has dyspnea, chronic cough, sputum production, and positive history of risk factors. Pharmacologic therapy can reduce COPD symptoms, reduce the frequency and severity of exacerbations, and improve health status and exercise tolerance. After cessation of smoking and life style modification, bronchodilator therapy is the first step in COPD treatment. Beside commonly used bronchodilator therapy newly developed bronchodilators started to be preferred. These drugs consist of long-acting beta2 agonist (Indacatarol, Vilanterol, Olodaterol, Abediterol), long acting muscarinic antagonism (Umeclidinium), long-acting beta2 agonist with inhaled steroid (combination of fluticasone furoate and vilanterol), long-acting beta2 agonist with a long-acting muscarinic antagonist (Fixed-dose combination of indacaterol with glycopyrronium by means of breezhaler device).Item Atypical Herpetic Corneal Endothelitis:: A Case Report(2016) Karalezli, Aylin; Kucukoduk, Ali; Bozkurt, BanuCorneal endotheliitis; frequently caused by viruses, is a disorder in which corneal endothelium is the primary site of the inflammation. We discuss a case of atypical herpetic endotheliitis presented with unilateral diffuse corneal edema with no signs of anterior chamber reaction.Item Effects of Radial Extracorporeal Shock Wave Therapy on Pain, Grip Strength, and Functionality in Patients with Lateral Epicondylitis: A Randomized Controlled Study(2016) Yuruk, Zeliha Ozlem; Kirdi, Nuray; Simsek, NihalObjective: In this study, the effects of radial extracorporeal shock wave therapy (RESWT) on pain, grip strength, and functionality were investigated in patients with lateral epicondylitis. Methods: The study included 30 patients who were divided into two groups: RESWT and exercise and placebo RESWT and exercise. In the RESWT and exercise group, RESWT was applied at 2000 pulses, once a week, for a total of three sessions, and in the placebo RESWT and exercise group, RESWT was applied at 20 pulses, once a week, for a total of three sessions. Patients in all groups underwent stretching and eccentric strengthening exercises. Patients were evaluated before and after undergoing the treatment and at 6 and 12 weeks after undergoing the treatment using a visual analog scale (VAS) for pain intensity during palpation and gripping, dynamometer for grip strength, and patient-rated tennis elbow evaluation (PRTEE) for functionality. Results: There were statistically significant differences between groups with respect to all parameters, except VAS during palpation (p<0.05). With time, there were more significant changes in VAS during palpation and gripping, grip strength, and PRTEE in the RESWT and exercise group compared with those in the placebo RESWT and exercise group (p<0.05). Conclusion: We concluded that using RESWT combined with other conservative treatments, mostly exercise, could be more effective.Item Diagnosis and treatment in primary bladder small cell carcinoma: Literature review(2016) Celik, Orcun; Ekin, Gokhan; Ipekci, Tumay; Budak, Salih; Ilbey, Yusuf Ozlem; 27072176Small cell bladder carcinoma is a rare and frequently fatal disease. It can be distinguished from classical urothelial carcinoma microscopically and immunohistochemically. Small cell bladder carcinoma has histologically similar properties with other small cell carcinomas in other organs. It has a worse prognosis when compared to urothelial bladder cancer. Multimodal treatments are recommended although there is no widely accepted consensus regarding to the treatment algorithm because of its rarity. In this review, clinical properties and diagnosis of small cell bladder carcinoma, its histopathological and immunohistochemical properties and treatment modalities are examined.Item Use and Outcomes of Noninvasive Ventilation for Acute Respiratory Failure in Different Age Groups(2016) Ugurlu, Aylin Ozsancak; Sidhom, Samy S.; Khodabandeh, Ali; leong, Michael; Mohr, Chester; Lin, Denis Y.; Buchwald, Irwin; Bahhady, Imad; Wengryn, John; Maheshwari, Vinay; Hill, Nicholas S.; 26374908BACKGROUND: The prevalence of chronic disease and do-not-intubate status increases with age. Thus, we aimed to determine characteristics and outcomes associated with noninvasive ventilation (NIV) use for acute respiratory failure (ARF) in different age groups. METHODS: A database comprising prospective data collected on site on all adult patients with ARF requiring ventilatory support from 8 acute care hospitals in Massachusetts was used. RESULTS: From a total of 1,225 ventilator starts, overall NIV utilization, success, and in-hospital mortality rates were 22, 54, and 18% in younger (18-44 y); 34, 65, and 13% in middle-aged (45-64 y); 49, 68, and 17% in elderly (65-79 y); and 47, 76, and 24% in aged (>= 80 y) groups, respectively (P < .001, P = .08, and P = .11, respectively). NIV use for cardiogenic pulmonary edema and subjects with a do-not-intubate order increased significantly with advancing age (25, 57, 57, and 74% and 7, 12, 18, and 31%, respectively, in the 4 age groups [P < .001 and P = .046, respectively]). For subjects receiving NIV with a do-not-intubate order, success and in-hospital mortality rates were similar in different age groups (P = .27 and P = .98, respectively). CONCLUSIONS: NIV use and a do-not-intubate status are more frequent in subjects with ARF >= 65 y than in those < 65 y, especially for subjects with cardiogenic pulmonary edema. However, NIV success and mortality rates were similar between age groups.