TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Applicability of the Vienna Sale Agreement (CISG) for Advanced Purchase Agreements of COVID-19 Vaccines in EU Member States(2022) Cortoglu Koca, SemaThe 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.Item Retinal Scan with Optical Coherence Tomography in Adult Attention Deficit Hyperactivity Disorder(2021) Tunel, Munevver; Sahinoglu Keskek, NedimeObjective: In this study, the retinal nerve fiber layer (RNFL) thicknesses were compared between adult attention deficit hyperactivity disorder (ADHD) cases and healthy controls. Method: The study included adults diagnosed with ADHD based on the DSM-5 criteria and age and gender matched healthy controls. Spectral area optical coherence tomography (OCT) was performed on the 52 eyes of 26 participants with ADHD and the 52 eyes of the 26 healthy control individuals. Results: Comparing the data on the 52 eyes of 26 ADHD participants and the 52 eyes of 26 healthy control participants indicated that the central macular thickness (CMT) and the RNFL thicknesses, the ganglion cell complex (GCC), the mean inner macular ring (MIRAVG) and the mean outer macular ring (MOR-AVG) thicknesses were significantly lower in the ADHD group. Conclusion: This is the first study in the literature on the RNFL thickness in adult ADHD patients. Our findings demonstrated that RNFL thickness is lower in ADHD cases as the unmyelinated axons are reduced in ADHD. Hence, the quantitative and reproducible nature of Spectral Domain-OCT thickness measurements can be used as biomarkers to monitor disease progression in ADHD cases.Item The Effects of Lithium on Calcium and Parathormone Levels: A Cross-sectional Study with Healthy Controls(2019) Tuncel, Ozlem Kuman; Akdeniz, Fisun; Ozbek, Suha Sureyya; Kavukcu, Gulgun; Unal Kocabas, Gokcen; 31613975Objective: Despite lithium associated hyperparathyroidism (LAH) can lead to many complications, little notice has been paid to this side-effect. The aim of this study was to investigate the effects of lithium on calcium and parathyroid hormone levels and the relation between lithium use and thyroid diseases. Method: This cross-sectional study was carried out with 87 lithium-treated patients and 65 volunteers who had a similar age and gender distribution with the lithium group. Serum levels of corrected calcium, intact parathormone, phosphorus, magnesium, alkaline phosphatase, free thyroxine, thyroid stimulating hormone, thyroid autoantibodies and creatinine were assessed, and also, thyroid and parathyroid ultrasonography was conducted. Further detailed investigations were made depending on the elevation of the initially measured calcium and/ or parathormone levels. Results: Median values of serum levels of the corrected calcium and the intact parathormone were significantly higher in the lithium group. Calcium levels had a mild correlation with the duration of lithium treatment. In the first assessment, while all control individuals had values within the normal reference range, 11 lithium-treated patients had corrected calcium and/or intact parathormone levels above the normal reference levels. All of the five patients, who were diagnosed with LAH after further investigation, were also diagnosed with a thyroid disorder. Conclusion: These results demonstrate that lithium treatment has a relationship with calcium and parathormone levels. The 5.7% prevalence of LAH and potential life-threatening conditions associated with LAH necessitates the use of available low-cost methods to monitor blood calcium levels of lithium-treated patients for early diagnosis.Item Tuberous sclerosis complex; a single center experience(2015) Erol, Ilknur; Savas, Tulin; Sekerci, Sevda; Yazici, Nalan; Erbay, Ayse; Demir, Senay; Saygi, Semra; Alkan, Ozlem; 26078697Aim: This study was planned with the aim of retrospectively reviewing the clinical and laboratory findings and therapies of our patients diagnosed with tuberous sclerosis and redefining the patients according to the diagnostic criteria revised by the 2012 International Tuberous Sclerosis Complex Consensus Group and comparing them with the literature. Material and Methods: 20 patients diagnosed with tuberous sclerosis complex in the Pediatric Neurology Clinic were examined retrospectively in terms of clinical findings and therapies. The diagnoses were compared again according to 1998 and 2012 criteria. Results: It was observed that the complaint at presentation was seizure in 17 of 20 patients and hypopigmented spots on the skin in 3 of 20 patients. On the initial physical examination, imaging findings related with the disease were found in the skin in 17 of the patients, in the eye in 5, in the kidneys in 7 and in the brain in 17. No cardiac involvement was observed in the patients. Infantile spasm was observed in 7 of the patients who presented because of seizure (n=17), partial seizure was observed in 7 and multiple seizure types were observed in 3. It was found that sirolimus treatment was given to 9 of 20 patients because of different reasons, 7 of these 9 patients had epileptic seizures and sirolimus treatment had no effect on epileptic seizures. According to 2012 diagnostic criteria, no marked change occured in the diagnoses of our patients. Conclusions: It was observed that the signs and symptoms of our patients were compatible with the literature. Molecular genetic examination was planned for the patients who were being followed up because of possible tuberous sclerosis complex. It was observed that sirolimus treatment had no marked effect on the seizure frequency of our patients.Item An Unexpected Pseudomonas Luteola Bacteremia: Case Report(2015) Turan, Hale; Togan, TurhanPseudomonas luteola has rarely been reported as a human pathogen. It was showed in previous studies showed that P. luteola may cause septicemia, bacteremia, peritonitis, and endocarditis in patients with underlying disease or with indwelling devices. In this article we report a case of P. luteola bacteremia without any source. We successfully treated our patient with ceftriaxone and ciprofloxacin combination.Item Quality of Life in Panic Disorder: Follow Up Study for 3 Months(2015) Altintas, Ebru; Uguz, Sukru; Levent, Bekir AydinPurpose: Panic Disorder is a common psychiatric condition which is higher risk for substance abuse, suicide attempts and functional disability. It is 2-3 times more common in women and estimated to range from 1,4% to 3,8% of the general population. Studies reported that quality of life in Panic Disorder is negatively affected and overall health (emotional and psyhical health), social activities, risk of unemployment increases. The aim of this study was investigate the affects of quality of life on panic disorder and depression and follow the treatment response after the 3 months. Material and Methods: 22 women and 9 men (total 31) within in age range of 20-73(mean age 40,3 +/- 12,9) diagnosed as Panic Disorder; 27 women and 15 men (total 42) within in age range of 18-57(mean age 33,6 +/- 11,5) diagnosed as Panic Disorder with Agoraphobia; 54 women and 19 men (total 73) within in age 20-69(mean age 38,5 +/- 11,7) diagnosed on Major Depression were included to study. Psychiatric interview were carried out using Structured Clinical Interview for Diagnose(SCID-I), Sociodemographic Data Form, Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale(HAM-D), Panic and Agoraphobia Scale and Endicott's Work Productivity Scale (EWPS) were applied in 0., 1., 3. months. Results: Quality of life had negatively affected in all of the groups. In this study we found significant impairment in pain, general health, energy, social function, emotional role disability and mental health subgroups of quality of life scale (SF-36) in Depression group than Panic Disorder group. Panic Disorder with Agoraphobia had affected the quality of life worse than comparison with Panic Disorder without Agoraphobia. Conclusion: At the end of the treatment, there were no differences in quality of life between all of the groups statistically.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 A Rare Cause of Acute Abdominal Pain: Primary Appendagitis(2015) Ergun, Tarkan; Lakadamyali, HaticePrimary appendagitis epiploica - one of the causes of acute abdominal pain - is a self-limited rare benign inflammatory condition involving the colonic epiploic appendages. Their therapy is conservative and clinically mimics other conditions requiring surgery such as acute appendicitis or omental torsion. However, being a quite rare condition is the reason they are usually neglected by both the surgeon and the radiologist. However the computed tomography (CT) findings are rather characteristic and pathognomonic. Thus, to consider CT as the diagnostic modality of choice is extremely important in order to diagnose the condition and to avoid unnecessary surgical interventions. This is a paper reporting an acute abdominal pain case of primary appendicitis epiploica diagnosed using computed tomography.Item 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-4623-2021Factor 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.Item Quantitative elastography in differentiating benign and malignant breast lesions(2016) Purbager, Aysin; Pekoz, Burcak Cakir; Aslan, Hulya; Agildere, Ahmet Muhtesem; 0000-0003-4223-7017; 0000-0002-7138-246X; AAB-5802-2020; AAK-9104-2021Purpose: The purpose of this study was to evaluate the effectiveness of quantitative elastography in differentiating benign and malignant breast lesions that were detected by B-mode ultrasonography, to compare shear wave velocities of benign and malignant lesions, and to determine cut-off values differentiating malignant lesions from benign ones Material and Methods: In this prospective study we enrolled 254 breast lesions of 240 patients detected by B-mode ultrasonography, and underwent biopsy in our department. Shear wave elastography was performed to all lesions before biopsies. The patients who had radiotherapy or chemotherapy previously were not included. Elastography examinations were performed by one of the two radiologists specialising in breast radiology. The mean and median shear wave velocities, and standard deviation values were measured in meters/second. Both mean and median shear wave velocities were compared with histopathology results. Sensitivity, specificity, and the area under the curve were obtained by using a receiver operating characteristic curve analysis Results: The mean age of the patients, lesion size, mean and median shear wave velocities were significantly different between benign and malignant groups. The mean shear wave velocity of benign and malignant lesions were 3.59 +/- 1.2m/s and 5.59 +/- 1.9m/s, respectively. The cut-off value for the mean shear wave velocity was 4.08 m/s (71.6% sensitivity and 69.6% specificity) to differentiate malignant lesions from benign ones Conclusion: Quantitative elastography is an effective and complementary method making a significant contribution in differentiating benign and malignant lesions. In this respect, we believe that clinical usage of shear wave elastography should be generalized