TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar

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2019 Turkish Hypertension Consensus Report
(2019) Aydogdu, Sinan; Guler, Kerim; Bayram, Fahri; Altun, Bulent; Derici, Ulver; Abaci, Adnan; Tukek, Tufan; Sabuncu, Tevfik; Arici, Mustafa; Erdem, Yunus; Ozin, Bulent; Sahin, Ibrahim; Erturk, Sehsuvar; Bittigen, Atilla; Tokgozoglu, Lale; 31483311
The Turkish Hypertension Consensus Report was prepared for the first time in 2015 to adapt the European and American international guidelines to our clinical practice and to create a practical report that could be a basic reference for all physicians dealing with hypertensive patients. This report, which was prepared by a committee with representation from 5 leading hypertension associations, has been accepted and is widely used. New clinical studies in hypertension literature and updated international guidelines since 2015 have demanded an update of the Turkish Hypertension Consensus Report as well. In this updated 2019 report, blood pressure levels were classified as Normal, Elevated, Stage 1, and Stage 2 hypertension. A new section was added for secondary hypertension. It was specified that drug treatment may be initiated with any 1 or a combination of 4 groups of drugs (diuretics, calcium channel blockers, angiotensin-converting enzyme [ACE] inhibitors, and angiotensin receptor blockers [ARBs]), except a combination of an ACE inhibitor and an ARB. It was emphasized that beta-blockers may be a first choice for hypertension treatment in diseases such as atrial fibrillation, heart failure, and coronary artery disease. The initial recommendation for hypertension treatment is a combination therapy in patients with a blood pressure level >= 150/90 mmHg. Target blood pressure values were redefined according to age and the presence of comorbidities. The hypertension treatment algorithm was renewed; it is proposed that drug therapy can also be initiated with a risk-based approach for the group with an elevated blood pressure (systolic blood pressure: 120-139 mmHg, diastolic blood pressure: 80-89 mmHg). The threshold clinic systolic blood pressure level was reduced from 160 mmHg to >= 150 mmHg for the initiation of drug therapy in individuals 80 years of age or more. The section on the treatment of special groups has now been expanded to include pregnancy and lactation. As in the previous report, in this update, practical recommendations for the most common cases seen in the clinic were the goal, rather than a comprehensive report that addresses all aspects of hypertension. This report has evidence-based recommendations for most patients; however, it should be kept in mind that there may be differences from 1 patient to another and that physicians should take an individualized approach according to a good clinical evaluation.
2020 ESC Core Curriculum for the Cardiologist: What has changed? Why? Should we also change our curriculum?
(2020) Yildirir, Aylin; 0000-0001-8750-5287; 33257609; 33257609; A-4947-2018
A. Lazer ve Isik Sistemleri
(2020) Ozcan, Hamdi
Laser and light systems are being used and demanded by patients more and more everyday in the treatment of acne and scars. Various devices are used in active acne and scar treatment. The effects of light systems on acne and scar tissue have been reported in different magnitudes. Since there are differences in practice and methodology, no judgement can be made on the success of treatment methods. The effectiveness of light systems increases with combined therapies. Their use in combination with medical therapies may increase the rate of success.
Abdominal Compartment Syndrome
(2015) Zeyneloglu, Pinar
Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra- abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.
Abdominopelvic Tumor Implants Detected with a Bone Scan in a Case of Borderline Ovarian Tumor
(2015) Gencoglu, Esra Arzu; Cinar, Alev; Aktas, Aysel; 0000-0002-3426-2987; 0000-0003-4631-1683; ABA-7670-2021; ABG-1864-2020
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
Ageism During the Covid-19 Pandemic: Discussion and Recommendations
(2021) Madran, H. Andac Demirtas
The spread of the coronavirus disease 2019 (Covid-19) was labeled a "pandemic" by the World Health Organization on March 11, 2020. It has caused not only health-related issues but also economic, educational, psychological, and social problems. Further, discrimination associated with the pandemic has been observed around the globe. Besides the obvious negative consequences faced by the individuals targeted, pandemic-related discrimination has affected the spread of the virus by influencing public attitudes toward disease prevention and the restrictions imposed by authorities. Discrimination toward foreigners, minorities, and certain religious groups (e.g., Muslims) increased during this period. Additionally, the pandemic saw ageism spread rapidly to become more visible than ever. Acknowledging that Covid-19 poses a higher risk for individuals over a certain age, several countries implemented restrictions specific to those age groups. However, this practice resulted in the emergence of problems that were not considered initially, especially the escalation of ageism. This study examines ageism during the Covid-19 pandemic based on major theories and current research. First, discrimination and ageism are defined in detail. Then, pandemic-related ageism is discussed within the framework of basic theoretical approaches. Finally, recommendations for preventing ageism related to the pandemic and in general are presented.
Anaesthesia Management for Edward's Syndrome (Trisomy 18)
(2016) Bali, Cagla; Ozmete, Ozlem; Ergeneoglu, Pinar; Akin, Sule; Aribogan, Anis; 27366581; AAI-8790-2021; AAI-7779-2021; J-5282-2013; AAJ-2094-2021; S-8336-2019
Anaesthesia Management of a Patient with Factor XI Deficiency
(2016) Adibelli, Bilgehan; Araz, Coskun; Ersoy, Zeynep; Kayhan, Zeynep; 0000-0002-4927-6660; 0000-0003-0767-1088; 0000-0003-0579-1115; 27366578; AAJ-4576-2021; AAF-3066-2021; AAJ-4623-2021
Factor XI deficiency is an extremely rare disease presenting no clinical symptoms, unless there is an inducing reason such as trauma or surgery. Normally, factor levels are in the range of 70-150 U dL-1 in healthy subjects. Although no clinical symptoms are seen, only high levels of aPTT can be found. Once a prolongation is detected in aPTT, factor XI deficiency should be suspected and factor levels should be analysed. With careful preoperative preparations in factor-deficient people, preoperative and postoperative complications can be decreased. In this case report, management of anaesthesia during total hip arthroplasty of a patient with factor XI deficiency is presented.
Analysis of the effect of the number of criteria and alternatives on the ranking results in applications of the multi criteria decision making approaches in machining center selection problems
(2020) Ic, Yusuf Tansel; Yurdakul, Mustafa
Multi criteria machining center selection models are widely used in the literature. In the applications of multi-criteria decision making models, machining center selection criteria are directly taken from catalogues. It is known that to have a ranking model sensitive to the weights of the selection criteria, it is especially important to limit the number of selection criteria to 7 +/- 2. A similar proposal can be put forward for the number of machining centers. In this study, whether or not reducing the number of criteria and alternative machining centers make the ranking results more sensitive to the changes in the criteria weights is studied using Spearman's rank correlation test. The study results show that the ranking results become more sensitive with a reduced number of criteria and alternative machining centers.
Anesthesia management for laparoscopic bariatric surgery: retrospective analysis of 62 patients
(2017) Ozmete, Ozlem; Bali, Cagla; Ergenoglu, Pinar; Akin, Sule; Aribogan, Anis; AAJ-2094-2021; AAI-7779-2021; AAI-8790-2021; J-5282-2013; S-8336-2019
Purpose: The aim of this study was to present our experience in patients who underwent laparoscopic bariatric surgery and to discuss the current literature on the perioperative management Material and Methods: Sixty two patients with ASA risk classification II-III were evaluated retrospectively who underwent obesity surgery in our hospital. Demographic characteristics of the patients, surgical time, complications that seen in the perioperative period and the length of hospital stay were recorded Results: The age of the patients ranged from 19 to 59 years and 75.9% of them were female. Mean operation time was 167 minutes and the length of hospital stay was 5 days. Complications seen during intraoperative period were tachycardia, hypertension and arrhythmia. In the following days, 6 (9.7%) patients were re-operated and there was no mortality Conclusion: The prevention of complications that may occur in laparoscopic obesity surgery is required with a equipped team and teamwork, a good preoperative preparation, thromboembolism prophylaxis, tight hemodynamics and blood gas monitoring for safe anesthesia
Anesthesia practices in intracranial mass surgery: a retrospective study
(2017) Ozmete, Ozlem; Aribogan, Anis; AAI-7779-2021; S-8336-2019
Purpose: The aim of this retrospective study was to present our evaluate anesthesia experience in patients who underwent intracranial tumor surgery and to discuss the current literature on the perioperative management Material and Methods: ASA risk classification I-III 112 patients between the ages of 3-78 were evaluated retrospectively who underwent intracranial mass surgery between the years 2015-2016. Anesthesia registration forms, patient files and hospital computer system was used. for data. The demographic characteristics of patients, anesthetic management, and postoperative data were recorded Results: The age of patients ranged from 3-78 years and 57.1% of them were men. Masses were localized in supratentorial area in 87.5% ( 98) of cases. Mean operation time was 184 minutes, mean length of intensive care unit was 3 days and length of hospital stay was 7 days. Common vomplications seen during intraoperative period were tachycardia ( 5.4%), bradycardia (3.6%), hypertension (3.6%) and hypotension (1.8%). In the following days, 13 (11.6%) patient received repeated operation. There was not mortality Conclusion: Several anesthetic techniques may be used successfully to provide anesthesia for resection of intracranial mass surgery. To reduced morbidity and mortality, the possible complications must be recognized and treated early with invasive monitoring, strict hemodynamics and blood gas monitoring
Anti-Tumor Necrosis Factor Alpha Treatment and Tuberculin Skin Test
(2015) Bozkirli, Emine Duygu Ersozlu; Tufan, Muge Aydin; Ozisik, Lale; Sen, Nazan; Yucel, Ahmet Eftal
Purpose: The use of anti-tumor necrosis factor alpha (anti-TNF) drugs has been a milestone in the treatment of rheumatic diseases. Despite their strong efficacy, there are some factors restricting the use of anti-TNF agents. We must be careful especially for the granulomatous diseases which can be seen endemic in our country such as tuberculosis and leishmaniasis. In our country according to the RAED 2005 Consensus Meeting Reports, patients candidate for anti-TNF treatment are evaluated for both active and inactive tuberculosis before treatment and prophylaxis with isoniazid (INH) has been performed where indicated. Material and Methods: Tuberculin skin tests (TST) of 43 patients followed up in the Rheumatology Clinic and receiving anti-TNF therapy were repeated under treatment. Patients' pretreatment first TST results, drugs they used, INH prophylaxis state, smoking status and the duration of anti-TNF treatment were evaluated. Results: 14 patients (32.6%) were women, while 29 (67.4%) were men. The mean of first TST values were 11.72 +/- 90.3 mm (0-30) and the mean of second TST values were 12.06 +/- 12.4 mm (0-45). 48.8% of the patients were smoking and 74.4% of the patients had received INH prophylaxis for 9 months. The mean total duration of anti-TNF drug use was found as 22.67 +/- 19.11 (5-68) months. No statistically significant difference (p=0.888) was observed between the first pretreatment and second under treatment TST results of the patients. Discussion: Tuberculosis remains to be a serious public health problem for both our country and the whole world. For this reason in our country, a detailed assessment is performed for all patients before anti-TNF treatment. In our study patients who are planned to start anti-TNF therapy were assessed with their first TST values and INH prophylaxis were given to 32 patients (74.4%) before treatment. No statistically significant difference was observed between pre and post-treatment TST values when control TST were performed with the earliest after five months of treatment. These findings may suggest that there is no evident increase in the risk of tuberculosis for patients receiving anti-TNF treatment with appropriate INH prophylaxis.
Antibiotic resistance of streptococcus pneumoniae and haemophilus influenzae isolated from respiratory tract specimens
(2016) Aliskan, Hikmet Eda; Colakoglu, Sule; Gocmen, Julide Sedef
Purpose: Streptococcus pneumoniae and Haemophilus influenzae are two of the major pathogens in respiratory infections, treatment is usually started empirically. The aim of this study was to detect in vitro resistance rates of S. pneumoniae and H. influenzae strains isolated from different lower respiratory clinical samples to the antibotics which are used for therapy of infections due to these pathogens. Material and Methods: Seventy seven S. pneumoniae and 117 H. influenzae strains, isolated from patients were included in the study. S. pneumoniae isolates which gave an inhibition zone diameter of > 20 mm for oxacillin were considered susceptible for penicilin. For the isolates which had an oxacillin zone diameter of <20 mm, MIC values of penicillin and cefotaxime were obtained by E-test method (bioMerieux, Marcy-l'Etoile, France). Results: Of 77 S. pneumoniae isolates, 24.6 % were resistant (MIC> 2 mg/l) and 31.1 % were intermediately resistant to parenteral penicillin. Resistance rates to antibiotics were as follows: erythromycin 40 %, trimethoprim/sulphametoxazole (TMP/SMX) 54.5 % and ofloxacin 6.4%. beta-lactamases were detected in 15.6% of the H. influenzae isolates by nitrocefin positivity. Conclusion: H. influenzae strains (8.6%) were identified as beta-lactamase negative ampicillin resistant (BLNAR) strains. Resistance rates for other antibiotics were as follows: ampicillin 28.6%, cefaclor 36.5%, cefuroxime 30.1%, clarithromycin 9.6%, cloramphenicol 7% and TMP-SMX 43.9%.
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-2108-2021
Globally 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.
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.
Application of spinal anesthesia in a pediatric patient with Duchenne's muscular dystrophy
(2016) Ozmete, Ozlem; Sener, Mesut; Caliskan, Esra; Aribogan, Anis; 27225742
Duchenne's muscular dystrophy (DMD) is a neuromuscular disease with a progressive course. It is the most common and most severe muscular dystrophic disorder for which the application of anesthesia is critical, due to muscle weakness, and cardiac and pulmonary involvement. Successful application of spinal anesthesia in a 2-year-old boy with DMD undergoing bilateral inguinal hernia repair is described in the present report. It is proposed that spinal anesthesia is an effective alternative to general anesthesia in certain pediatric patients, including those with DMD, for whom general anesthesia poses increased risk.
Are Bone Turnover Markers Related with Fracture Risk in Initial Diagnose Postmenopausal Osteoporosis? A Cross-Sectional Clinical Study
(2015) Yalbuzdag, Seniz Akcay; Sarifakioglu, Banu; Sengul, Ilker; Cetin, Nuri
Objective: In this study, we investigated the relationships between 10 year fracture risk calculated with FRAX assessment tool and bone turnover markers (BTM) in women with diagnosed as postmenopausal osteoporosis for the first time. Materials and Methods: After exclusion of the causes of secondary osteoporosis 61 postmenopausal women diagnosed with osteoporosis for the first time were enrolled. Height and weight measurements, comorbid diseases, menopause age, and laboratory investigations were recorded. Lumbar and femur neck and femur total T scores were measured by dual-energy x-ray absorptiometry (DXA). As BTM, serum osteocalcin (OC) and urine deoxypridinoline levels were measured. 10-year fracture risk of hip and major osteoporotic fracture was calculated with FRAX assessment tool. Results: The mean age of patients was 61 +/- 39 years. Median value of menopause year was 15.13 years (min: 2, max: 40). The median 10-year hip fracture and major osteoporotic fracture risks were calculated as 1.10% (min: 0, max: 23), 6.9% (min: 3, max: 34) respectively. There was no significant relationship between BTM and fracture risk. Positive significant correlation was found between menopause year and hip fracture risk, and between menopause year and major osteoporotic fracture risks (p=0.031, 0.276; p=0.025, r=0.287). Negative significant correlation was detected between body mass index and hip fracture risk (p=0.002, r=-0.392). Conclusion: In our study, we couldn't find relationship between BTM and fracture risks assessed by using FRAX tool in patients with initially diagnosed of postmenopausal osteoporosis. Further studies are needed to investigate the relationship between BTM and fracture risk in different patient groups.
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.
B. Kimyasal Peeling
(2020) Ozcan, Hamdi
Although chemical peeling is used more widely for skin rejuvenation and aesthetic purposes, it is also used for the treatment of acne lesions and scars. Superficial peeling is used more for the treatment of active acne lesions, whereas medium and deep peeling for treating scars. Their side effects can be considerably reduced if used in a controlled and knowledgeable manner. In acne treatment, chemical peeling may be used in combination with medical therapies, surgical methods and even laser therapy, which can increase their overall efficacy.