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Item Treatment Outcomes of Breast Cancer Liver Metastasis Treated with Stereotactic Body Radiotherapy(2018) Onal, Cem; Guler, Ozan Cem; Yildirim, Berna Akkus; https://orcid.org/0000-0002-2742-9021; https://orcid.org/0000-0001-6908-3412; https://orcid.org/0000-0001-6661-4185; 30296648; HOC-5611-2023; AAC-5654-2020; V-5717-2017Background: To assess the outcomes of breast cancer liver metastasis (BCLM) treated with stereotactic body radiotherapy (SBRT) and systemic treatment. Materials and methods: Patients with oligometastasis at the time of liver metastasis (LM) or who became oligometastatic (<= 5 metastases) after systemic treatment were assessed. Twenty-nine liver metastatic lesions were treated with a total of 54 Gy delivered in 3 fractions. The local control (LC), overall survival (OS), and progression-free survival (PFS) rates were calculated using Kaplan-Meier analyses. Results: A total of 22 patients with 29 liver metastatic lesions treated with liver SBRT between April 2013 and September 2017 were retrospectively analyzed. After a median follow-up time of 16.0 months (range 4.4-59.4 months), 18 patients (82%) had disease recurrence, median of 7.4 months (range 1.0-27.9 months) after completion of liver SBRT. The 1- and 2-year OS rates were 85% and 57%, and the 1- and 2-year PFS rates were 38% and 8%, respectively. The 1- and 2-year LC rates were 100% and 88%, respectively. No significant prognostic factors, including disease extension, size of metastasis, number of liver metastasis and timing of liver metastasis, hormonal status affecting OS, PFS and LC were found. No patients experienced Grade 4 or 5 toxicity; furthermore, only one patient experienced rib fracture 6 months after completion of treatment, and one patient had a duodenal ulcer. Conclusion: This study is the first to evaluate the feasibility of SBRT to BCLM patients. Liver SBRT is a conservative approach with excellent LC and limited toxicities. (C) 2018 Elsevier Ltd. All rights reserved.Item Early Postoperative Acute Kidney Injury Among Pediatric Liver Transplant Recipients(2018) Sahinturk, Helin; Kundakci, Aycan; Zeyneloglu, Pinar; Gedik, Ender; Pirat, Arash; Haberal, Mehmet; 0000-0003-0159-4771; 0000-0002-7175-207X; 0000-0002-3462-7632; AAJ-1419-2021; AAH-7003-2019; ABI-2971-2020; AAJ-8097-2021Item Solving A Nonhomogeneous Linear System of Interval Differential Equations(2018) Gasilov, Nizami A.; Amrahov, Sahin Emrah; AAN-9386-2020In most application problems, the exact values of the input parameters are unknown, but the intervals in which these values lie can be determined. In such problems, the dynamics of the system are described by an interval-valued differential equation. In this study, we present a new approach to nonhomogeneous systems of interval differential equations. We consider linear differential equations with real coefficients, but with interval initial values and forcing terms that are sets of real functions. For each forcing term, we assume these real functions to be linearly distributed between two given real functions. We seek solutions not as a vector of interval-valued functions, as usual, but as a set of real vector functions. We develop a method to find the solution and establish an existence and uniqueness theorem. We explain our approach and solution method through an illustrative example. Further, we demonstrate the advantages of the proposed approach over the differential inclusion approach and the generalized differentiability approach.Item The Approach to Community-Acquired Pneumonia: A Survey Study(2018) Ozyurek, Berna Akinci; Erturk, Arzu; Aydemir, Yusuf; Sen, Nazan; Alizoroglu, Dursun; Ozhan, Mustafa Hikmet; https://orcid.org/0000-0002-4171-7484; AAI-8947-2021INTRODUCTION AND AIM: Community-acquired pneumonia (CAP), which is often seen in daily practice, is a lower respiratory tract and pulmonary parenchyma infection which develops in society and daily life with community-acquired pathogens in individuals with no known immune failure. Delay in the treatment of pneumonia is known to increase morbidity and mortality. Various scoring systems are currently used in the identification of treatment groups in pneumonia. With the aim of evaluating the approach to CAP cases, the infection. MATERIALS AND METHODS: Working Group of the Turkish Respiratory Research Association (TUSAD) prepared a 22-item questionnaire. RESULTS: The survey was published on the TUSAD official website between July 2013 and June 2016. A total of 78 individuals responded to the questionnaire on the website. CONCLUSION: The responses to the questionnaire could indicate the way forward for new guidelines for physicians in respect of the approach to CAP.Item Comparable Survival Using A CMV-Matched Or A Mismatched Donor For CMV Plus Patients Undergoing T-Replete Haplo-HSCT With PT-Cy For Acute Leukemia: A Study Of Behalf Of The Infectious Diseases And Acute Leukemia Working Parties Of The EBMT(2018) Cesaro, Simone; Crocchiolo, Roberto; Tridello, Gloria; Knelange, Nina; Van Lint, Maria Teresa; Koc, Yener; Ciceri, Fabio; Gulbas, Zafer; Tischer, Johanna; Afanasyev, Boris; Bruno, Benedetto; Castagna, Luca; Blaise, Didier; Mohty, Mohamad; Irrera, Giuseppe; Diez-Martin, J. L.; Pierelli, Luca; Pioltelli, Pietro; Arat, Mutlu; Delia, Mario; Fagioli, Franca; Ehninger, Gerhard; Aljurf, Mahmoud; Carella, Angelo Michele; Ozdogu, Hakan; Mikulska, Malgorzata; Ljungman, Per; Nagler, Arnon; Styczynski, Jan; https://orcid.org/0000-0002-8902-1283; 29330396; AAD-5542-2021The role of donor CMV serostatus in the setting of non T-cell depleted haplo-HSCT with post-transplant cyclophosphamide (PT-Cy) has not been specifically addressed so far. Here we analyzed the impact of the donor CMV serological status on the outcome of 983 CMV seropositive (CMV+), acute leukemia patients receiving a first, non T-cell depleted haplo-HSCT registered in the EBMT database. The 1-year NRM was 21.3% (95% CI: 18.4-24.8) and 18.8% (95% CI: 13.8-25.5) in the CMV D+P/R+ and D-/R+ pairs, respectively (p = 0.40). Similarly, 1-year OS was 55.1% (95% CI: 50.1-58.0) and 55.7% (95% CI: 48.0-62.8) in the same groups (p = 0.50). The other main outcomes were comparable. No difference in NRM nor OS was observed after stratification for the intensity of conditioning and multivariate anaysis confirmed the lack of significant association with NRM or OS. In conclusion, the choice of a CMV-seronegative donor did not impair early survival of CMV-seropositive patients with acute leukemia after a first, non T-cell depleted haploidentical HSCT and PT-Cy among this series of 983 consecutive patients. Future research may focus on the assessment of the hierarchy of all the donor variables.Item Bilgisayar Programlama Derslerinde Öğrenme Motivasyonu Ölçeğinin Türkçe Uyarlaması: Geçerlilik ve Güvenilirlik Çalışması(Başkent Üniversitesi Eğitim Bilimleri Fakültesi, 2018) Avcı, Ummuhan; Ersoy, Halil; 0000-0001-7007-1478; 0000-0003-1598-7656Bu araştırmanın amacı Law, Lee ve Yu 2010 tarafından geliştirilen Bilgisayar Programlama Derslerinde Öğrenme Motivasyonu Ölçeği’ni Türkçe’ye uyarlamaktır. Bu amaçla geçerlik ve güvenirlik analizlerini yapmak üzere altı faktör bireysel tutum ve beklenti, zorlayıcı amaçlar, belirgin hedefler, ödül ve takdir, ceza, sosyal baskı ve rekabet ve 19 maddeden oluşan altılı Likert tipindeki ölçek, özel bir üniversitede okuyan 312 mühendislik fakültesi öğrencisine uygulanmıştır. Doğrulayıcı faktör analizi sonuçları incelendiğinde, ölçeğin altı faktörden oluştuğu doğrulanmış ve ölçeğin uyum iyiliği indislerinin yeterli düzeyde olduğu görülmüştür. Ölçeğin güvenilirliği Cronbach alfa iç tutarlılık katsayısı ile değerlendirilmiştir. Cronbach alfa katsayısının ölçeğin tamamında 0.90 olduğu ve faktörler bazında 0.71 ile 0.83 arasında değiştiği görülmüştür. Bu sonuçlar ölçeğin, bilgisayar programlama derslerinde öğrenme motivasyonunun ölçülmesinde geçerli ve güvenilir bir ölçme aracı olduğunu göstermektedir. The aim of this study is to adapt the Learning Motivation in Computer Programming Courses Scale developed by Law, Lee ve Yu 2010 to Turkish. In order to determine its validity and reliability, the scale consisting of 19 six-point Likert-type items within six factors individual attitude and expectation, challenging goals, clear direction, reward and recognition, punishment and social pressure and competition was applied to 312 engineering faculty students at a private university. When the results of the confirmatory factor analysis were examined, it was confirmed that the scale had six factors, and the goodness of fit indices are at an acceptable degree. The reliability of the scale was assessed by the Cronbach alpha internal consistency coefficient. The Cronbach’s alpha coefficiencies were found to be 0.90 for the whole scale and between 0.71 and 0.83 for the factors. These results show that scale is a valid and reliable measuring tool for learning motivation in computer programming coursesItem Neonatal effects of thyroid diseases in pregnancy and approach to the infant with increased TSH: Turkish neonatal and pediatric endocrinology and diabetes societies consensus report(2018) Özon, A.; Tekin, N.; Şıklar, Z.; Gülcan, H.; Kara, C.; Taştekin, A.; Demir, K.; Koç, E.; Evliyaoğlu, O.; Kurtoğlu, S.; 31236034Thyroid functions in the fetus and newborn carry importance in terms of the baby’s health and development of the central nervous system. Maternal iodine deficiency, exposure to iodine, thyroid diseases (Hashimoto thyroiditis, Graves’) and drugs used by the mother affect thyroid functions in the fetus. Reflections of these effects are observed immediately after delivery. Investigation of the mother in terms of thyroid diseases during pregnancy, recognition and appropriate assessment of the required conditions, screening of all newborns in the first days of life in terms of congenital hypothyroidism, timely and appropriate evaluation of the screening results, early diagnosis and appropriate treatment of cases of congenital hypothyroidism, assessment and management of cases of transient thyroid hormone disorders and close monitoring of the thyroid functions and development of patients in whom treatment has been initiated with a diagnosis of hypothyroidism are crucial in terms of developmental outcomes of the babies who have thyroid function disorders or hypothyroidism. This guideline was written with the objective of guiding pediatricians, neonatologists and pediatric endocrinologists in the issue of assessment, diagnosis and management of thyroid function disorders and thyroid diseases concerning the fetus and baby during gestation and neonatal period. © Copyright 2018 by Turkish Pediatric Association.Item Neonatal Hyperglycemia, which threshold value, diagnostic approach and treatment?: Turkish Neonatal and Pediatric Endocrinology and Diabetes Societies consensus report(2018) Gökşen Şimşek, D.; Ecevit, A.; Hatipoğlu, N.; Çoban, A.; Arısoy, A.E.; Baş, F.; Mutlu, G.Y.; Bideci, A.; Özek, E.; 0000-0002-2232-8117; 31236036; AAJ-4616-2021Hyperglycemia has become an important risk factor for mortality and morbidity in the neonatal period, especially with increased survival rates of very low birth weight babies. Hyperglycemia in the neonatal period develops as a result of various mechanisms including iatrogenic causes, inability to supress hepatic glucose production, insulin resistance or glucose intolerance, specifically in preterm babies. Initiation of parenteral or enteral feeding in the early period in preterm babies increases insulin production and sensitivity. The plasma glucose is targeted to be kept between 70 and 150 mg/dL in the newborn baby. While a blood glucose value above 150 mg/dL is defined as hyperglycemia, blood glucose values measured with an interval of 4 hours of >180-200 mg/dL and +2 glucosuria require treatment. Although glucose infusion rate is reduced in treatment, use of insulin is recommended, if two blood glucose values measured with an interval of 4 hours are >250 mg/dL and glucosuria is present in two separate urine samples. © 2018 by Turkish Pediatric Association.Item Approach to hypoglycemia in the newborn: Turkish neonatal and pediatric endocrinology and diabetes societies consensus report(2018) Aiefendioğlu, D.; Çoban, A.; Hatipoğlu, N.; Ecevit, A.; Arısoy, A.E.; Yeşiltepe, G.; Baş, F.; Bideci, A.; Özek, E.Hypoglycemia is one of the most important and most common metabolic problems of the newborn because it poses a risk of neurological injury, if it is prolonged and recurs. Therefore, newborns who carry a risk of hypoglycemia should be fed immediately after delivery and the blood glucose level should be measured with intervals of 2-3 hours from the 30th minute after feeding. The threshold value for hypoglycemia is 40 mg/dL for the first 24 hours in symptomatic babies. In asymptomatic babies, this value is considered 25 mg/dL for 0-4 hours, 35 mg/dl for 4-24 hours, 50 mg/dL after 24 hours and 60 mg/dL after 48 hours. Screening should be performed with bed-side test sticks. When values near the limit value are obtained, confirmation with laboratory method should be done and treatment should be initiated, if necessary. The level targeted with treatment is considered 50 mg/dL in the postnatal first 48 hours before feeding, 60 mg/dL after 48 hours in babies with high risk and above 70 mg/dL in babies with permanent hypoglycemia. In cases in which the blood glucose level is below the threshold value and can not be increased by feeding, a glucose infusion of 6-8 mg/kg/min should be initiated. If symptoms accompany, a mini bolus of 10% dextrose (2 ml/kg/min) should accompany. Incements (2 mg/kg/min) should be performed, if the target level can not be achieved and decrements (2 ml/kg/ min) should be performed, if nutrition and stabilization is provided. The infusion should be discontinued, if the infusion rate decreases to 3-5 mg/ kg/min. If necessary, blood samples should be obtained during hypoglycemia in terms of differential diagnosis and the investigation should be performed following a 6-hour fasting period in babies fed enterally and at any time when the plasma glucose is <50 mg/dL in babies receiving parenteral infusion. The hypoglycemic babies in the risk group whose infusions have been terminated can be discharged, if the plasma glucose level is found to be at the target level for two times before feeding and babies with permanent, severe or resistant hypoglycemia can be discharged, if the plasma glucose level is >60 mg/dL following a 6-hour fast. © 2018 by Turkish Pediatric Association.Item Iatrogenic vascular injuries due to spinal surgeries: Endovascular perspective(2018) Gok, M.; Aydin, E.; Güneyli, S.; Akay, A.; Cinar, C.; Oran, I.; 0000-0003-0907-3647; 28191625; AAI-8276-2021AIM: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Surgical management of these injuries is challenging with high morbidity rates. In this study we aim to present the results of endovascular management of iatrogenic vascular injuries due to spinal surgeries. MATERIAL and METHODS: We retrospectively reviewed 11 patients (5 male, 6 female) who had vascular injuries due to cervical and lumbar spinal surgeries. Clinical findings were bleeding (n=5), leg edema (n=6) and right heart failure with severe dyspnea (n=1). The age range of the patients were between 42-67 (mean: 57.1). Six patients were reviewed with imaging before the procedures and the rest of the patients (n=5) were directly referred to the angiography unit for diagnosis and possible endovascular treatment. RESULTS: The types of surgeries were; cervical surgery (n=5) and lumbar disc operation (n=6). The type of vascular injuries were; vertebral artery stenosis (n=1), vertebral artery pseudoaneurysm (n=3), vertebral artery occlusion (n=1) and iliac arteriovenous fistula (n=6). The type of endovascular treatments were; parent artery occlusion (PAO) (n=2), covered stent graft implantation (n=6) and intrasaccular coil embolization of pseudoaneurysm (n=1). The remaining 2 patients were managed conservatively. No major complications or mortality occured during endovascular interventions. No bleeding or ischemia occured in the follow-up period. CONCLUSION: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Endovascular interventions are safe and effective in the diagnosis and treatment of such vascular injuries. © 2017, Turkish Neurosurgical Society.