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Aztekin Y, Güp AA, Cenikli U, Bayar B. The effects of trunk repositioning errors on trunk and extremity functions in stroke. Neurol Res 2024:1-8. [PMID: 38591732 DOI: 10.1080/01616412.2024.2339099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/30/2024] [Indexed: 04/10/2024]
Abstract
AIM The aim of this study was to analyze the TRE in three directions including forward flexion, lateral flexion to the hemiparetic side, and rotation to the hemiparetic side in patients with stroke and to compare the errors with age- and sex-matched healthy subjects. In addition, it was investigated which functional outcomes were explanatory for TRE in patients with stroke. METHODS Forty-one patients with subacute/chronic stroke (age 59 ± 14.5 years) and 41 healthy subjects (age 57 ± 12.8 years) were included in the study. Demographic and clinical data were collected. TREs were measured using an inclinometer. The Trunk Impairment Scale (TIS), Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Timed Up and Go Test, and 10-m walk test (10MWT) were also used to assess trunk control, motor impairment, upper extremity function, and lower extremity function, respectively, in patients with stroke. RESULTS TRE scores in three directions were higher in patients with stroke than in healthy subjects (p < 0.001). TREs in three directions were significantly strongly correlated with all functional outcomes (ρ > 0.60, r < 0.001). Multiple regression analysis determined 10MWT, WMFT-Performance, TIS, and FMA-Upper Extremity as explanatory factors for TRE. CONCLUSION The model presented in this study could help clinicians and researchers to predict the TRE in patients with stroke. Gait speed, upper extremity motor ability, upper extremity motor impairment, and trunk control should be considered for TRE after a stroke.
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Affiliation(s)
- Yılmaz Aztekin
- Physiotherapy and Rehabilitation Department, Muğla Sıtkı Koçman University, Menteşe, Turkey
| | - Asalet Aybüke Güp
- Physiotherapy and Rehabilitation Department, Muğla Sıtkı Koçman University, Menteşe, Turkey
| | - Utku Cenikli
- Department of Neurology, Muğla Sıtkı Koçman University, Menteşe, Turkey
| | - Banu Bayar
- Physiotherapy and Rehabilitation Department, Muğla Sıtkı Koçman University, Menteşe, Turkey
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Güp AA, Ipek Dongaz Ö, Özen Oruk D, Deveci EE, Bayar B, Bayar K. Prediction of hospitalization time and independence level with functional outcomes for patients with acute stroke: a retrospective study. Neurol Res 2023; 45:947-956. [PMID: 37641526 DOI: 10.1080/01616412.2023.2252275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVES The objective of this study was to develop predictive models for estimating the length of stay (LOS) with standardized clinical outcome measures (Functional Independence Measure, Trunk Impairment Scale, Postural Assessment Scale for Stroke Patients, Fugl Meyer Assessment Scale, and Functional Ambulation Category) during acute care setting. METHODS One hundred sixty-nine patients were included in the retrospective study. Predictors chosen for the LOS included scores of functional outcome measures at admission. We used Spearman's rank correlation coefficients to calculate correlations among clinical outcome measures and LOS, stepwise multiple regression analysis to develop a predictive model, and receiver operating characteristics curve to analyze the predictive value of explanatory factors obtained from the previous model for discharge Functional Independence Measure score. RESULTS The predictive equation explained 81% of the variance in LOS. The most important predictors were trunk impairment, motor function of the upper extremity, walking ability, and independence level at admission. The receiver operating characteristic curve was obtained with a cut-off score of 13 points for the Trunk Impairment Scale, 47 points for Fugl Meyer Assessment-Upper Extremity, and 2 points for Functional Ambulation Category, demonstrating the highest percentage of the accurately predicted ability of independence level at discharge. DISCUSSION The models presented in this study could help clinicians and researchers to predict the LOS and discharge independence level of clinical outcomes for patients with acute stroke enrolled in an acute care setting.
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Affiliation(s)
- Asalet Aybüke Güp
- Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Özge Ipek Dongaz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Dilara Özen Oruk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Emrah Emre Deveci
- Faculty of Medicine, Department of Neurology Diseases, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Banu Bayar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Kılıçhan Bayar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
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Ugurlu C, Gok H, Sahin A, Bayar B, Olcucuoglu E, Kulacoglu H. Prevalence of rectus diastasis is higher in patients with inguinal hernia. Hernia 2023:10.1007/s10029-023-02820-0. [PMID: 37335520 DOI: 10.1007/s10029-023-02820-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 06/04/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE To determine the prevalence of rectus diastasis (RD) in patients with inguinal hernia. MATERIAL AND METHODS Multicenter, cross-sectional study. Patients with inguinal hernia were included in the study group (IH) and those with benign proctologic complaints created the control group (CG). Age, gender, BMI, family history for inguinal hernias, comorbid diseases, alcohol use, smoking, constipation, malignancy, chemotherapy, number of births, multiple pregnancies and prostate hypertrophy history of all patients in both groups were recorded. All patients were evaluated for RD and umbilical hernias by physical examination. RESULTS A total of 528 consecutive patients were included in the study (292 IH / 236 CG). Overall prevalence of RD was 35.6% and it was significantly higher in IH than in CG (46.9% vs 21.6%, p < 0.001). Also, umbilical hernia was more frequently detected in the patients with inguinal hernia. Other risk factors for RD were age, BMI, DM, BPH and smoking. The mean inter-rectus distance for 528 patients was 18.1 mm; it was 20.71 ± 10.68 mm in IH and 14.88 ± 8.82 in CG (p < 0.001). It was determined that the increase in age and BMI caused an increase in the inter-rectus distance, and that the presence of DM, inguinal hernia and umbilical hernia increased the inter-rectus distance quantitatively. CONCLUSIONS The prevalence of RD seems to be higher in patients with inguinal hernia comparing to that in general population. Increased age, high BMI and DM were found to be independent risk factors for RD development.
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Affiliation(s)
- C Ugurlu
- Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, Sevki Erek Yerleskesi, 60030, Tokat, Turkey.
| | - H Gok
- Department of General Surgery, Hernia Istanbul Comprehensive Hernia Center, Istanbul, Turkey
| | - A Sahin
- Department of General Surgery, University of Health Science, Konya City Hospital, Konya, Turkey
| | - B Bayar
- Department of General Surgery, Mus State Hospital, Mus, Turkey
| | - E Olcucuoglu
- Department of General Surgery, Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey
| | - H Kulacoglu
- Department of General Surgery, Ankara Hernia Center, Ankara, Turkey
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Güp AA, Bayar B. Immediate effects of trunk Kinesio Taping® on functional parameters in the acute stage of patients with mild stroke: A randomized controlled trial. Physiother Theory Pract 2023:1-12. [PMID: 37083470 DOI: 10.1080/09593985.2023.2204353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND Improving early trunk control, balance, and sitting activity following acute stroke is critical for functional prognosis. PURPOSE To compare the immediate efficacy of Kinesio Taping® (KT) application on anterior and posterior trunk muscles in terms of improving trunk control, balance, and sit-to-stand performance in the acute stage of stroke. METHODS Sixty-nine patients with acute mild stroke were allocated to the anterior KT group (AKT) (age = 65.95 ± 9.67; 12 females, 11 males; Modified Rankin Score = 3), posterior KT group (PKT) (age = 65.39 ± 10.39; 10 females, 13 males; Modified Rankin Score = 3), and control group (CG) (age = 65.34 ± 8.91; 11 females, 12 males; Modified Rankin Score = 2). Trunk control, balance, and sit-to-stand performance were assessed at the baseline and after 45 minutes and 48 hours post-KT. Data were analyzed using repeated-measures ANOVA. RESULTS All outcome measures scores improved in all groups significantly after 48 hours (p < .001). A significant improvement after 45 minutes was only seen in trunk control compared to the CG (p < .001; d = 1.32 for AKT and p = .038; d = 0.75 for PKT). Trunk control, balance, and sit-to-stand performance improved in both AKT and PKT compared to the CG at 48 hours post-taping. Trunk control (p < .001; d = 0.26) and balance (p < .001; d = 0.72) results were in favor of the AKT, while sit-to-stand performance results did not make a difference between KT groups (p = .335; d = 0.47). CONCLUSION KT application on anterior or posterior trunk muscles was effective for improving trunk control, balance, and sit-to-stand performance in acute stage of stroke in the short term. KT application on anterior trunk muscles had the advantage of improving trunk control and balance.
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Affiliation(s)
- Asalet Aybüke Güp
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Banu Bayar
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey
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Ugurlu C, Gok H, Sahin A, Bayar B, Olcucuoglu E, Kulacoglu H. P-125 INCIDENCE OF DIASTASIS RECTI ABDOMINIS SEEMS TO BE HIGHER IN PATIENTS WITH INGUINAL HERNIAS. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
To find the incidence of Diastasis Recti Abdominis (DRA) in patients with inguinal hernias.
Materials and Methods
Prospective, multicenter, cross-sectional study. Patients with inguinal hernias constitues the study group (IH), and patients with proctological disorders in the control group (PC). Investigated parameters: age, gender, BMI, family history, systemic comorbidities, alcohol consumption, tobacco use, constipation, malignancies, chemotherapy, number of births, multiple pregnancies, prostate hypertrophy. The measurements were done at 3 cm above the umbilicus. Any separation ≥20 mm was accepted as DRA. The existence of paraumbilical hernia (PUH)was also recorded.
Results
36 female and 212 male patients with a mean age of 51.3± 1.4 in IH, whereas 137 women and 305 men with a mean age of 44.5±15.9 in PC. 48.0% of IH and 21.1% of PC were diagnosed with DRA (p=0.001). Incidences of PU were 16.5% and %5.2 respectively (p=0.01). BMI ≥25, chronic pulmonary disease, multiple pregnancies and prostatic enlargement were associated with DRA. Multivariate analysis revealed that inguinal hernia and multiple pregnancies were independent factors for DRA.
Conclusions
Incidences of DRA and PUH seem to be higher in patients with inguinal hernias in comparison with control subjects.
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Affiliation(s)
- C Ugurlu
- Surgery, Tokat Gaziosmanpasa University , Tokat , Turkey
| | - H Gok
- Surgery, Hernia Istanbul Comprehensive Hernia Center , Istanbul , Turkey
| | - A Sahin
- Surgery, Konya City Hospital , Konya , Turkey
| | - B Bayar
- Surgery, Mus State Hospital , Mus , Turkey
| | - E Olcucuoglu
- Surgery, Diskapi Yildirim Beyazit Teaching and Research Hospital , Ankara , Turkey
| | - H Kulacoglu
- Surgery, Ankara Hernia Center , Ankara , Turkey
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Ugurlu C, Celasin H, Bayar B, Kulacoglu H. Internet search by the patients undergoing hernia surgery about the disease and surgeon selection. Hernia 2022; 26:769-778. [PMID: 35020092 DOI: 10.1007/s10029-021-02558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/19/2021] [Indexed: 11/04/2022]
Abstract
AIM To find out the current status of the internet use of patients who undergo surgery for repair of their hernias. MATERIALS AND METHODS The patients who were diagnosed with abdominal wall hernia and scheduled for elective hernia repair were requested to answer a questionnaire. The questions were directed face-to-face by the surgeons themselves. The age, gender, education status, American Society of Anesthesiologists (ASA) physical status, place of living, health insurance, access to the Internet, surgical method, the person who did the search, previous hernia surgery, recurrence of previous hernia surgery, surgery other than hernia, and the hernia type were the recorded parameters at the first stage. Then, the answers for three main questions were taken: "Did you make a search about your hernia?", "Did you make a search about your surgeon?", "Would you prefer another surgeon if you could?" RESULTS A total of 200 patients were included in the study (146 male/54 female). 55.5% of the patients made an Internet search about their hernias. 58.5% of the patients made a search to find a proper surgeon. 12.5% of the patients stated that they would like to go to another surgeon for the hernia repair if it was possible. Internet search rate was significantly higher in younger patients in comparison with older patients. The higher the education level of the patients, the higher the rate of making Internet searches about the hernias and surgeons. Patients who live in the cities more frequently made Internet searches in comparison with those living in towns or villages. Internet searches about the hernias were similar in patients who had a history of hernia surgery (n = 23, 52%), and were even operated for recurrence of the same hernia (n = 30, 60%), compared to other patients (p = 0.569). Similarly, the rates of conducting surgeon research of the patients in these two groups (66.7%, 56.5%, respectively) were statistically similar (p = 0.450). The effect of ASA classification of patients on the Internet researches conducted about the disease and about the surgeons was not statistically significant (p = 0.799, p = 0.388, respectively). It was found that the rates of researching about the disease and about the surgeon on the Internet were significantly higher in patients who had undergone a minimally invasive surgery (p < 0.001, p < 0.001, respectively). CONCLUSIONS Less than two-thirds of the hernia patients make Internet search about their disease. Higher education level, younger age, patient's preference for minimally invasive surgery and living in a city positively affect Internet search rates.
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Affiliation(s)
- C Ugurlu
- Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, Sevki Erek Yerleskesi, 60030, Tokat, Turkey.
| | - H Celasin
- Department of General Surgery, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey
| | - B Bayar
- Department of General Surgery, Mus State Hospital, Mus, Turkey
| | - H Kulacoglu
- Department of General Surgery, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey
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Bayar B, Güp AA, Özen Oruk D, Ipek Dongaz Ö, Doğu E, Bayar K. DEVELOPMENT OF THE POSTURAL HABITS AND AWARENESS SCALE (PHAS): A RELIABILITY AND VALIDITY STUDY. Int J Occup Saf Ergon 2022; 29:815-820. [PMID: 35622409 DOI: 10.1080/10803548.2022.2082694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives. The aim of this study was to develop a scale that assesses postural awareness and habits, as well as to establish the validity and reliability thereof. Methods. The 19-item Postural Habits and Awareness Scale was developed. The scale has a score range of 0-95, with a higher score indicating good posture and awareness. 278 healthy adults with an age range of 18-65 years were included in the study. The sociodemographic form, Short Form 36 Health Survey (SF-36), and Body Awareness Questionnaire (BAQ) were used to test the validity and reliability of this newly developed scale. Results. From factor analyses, it was observed that the items clustered in 4 factors, which explained 55.99% of the variance. The Cronbach's α for each factor of the scale varied between 0.619 and 0.832. A high correlation was observed regarding test-retest reliability of the scale (r: 0.905). Conclusion. This newly developed self-reported scale allows for the comprehensive determination of both postural habits and awareness together. The PHAS is a valid and reliable scale that can be used by professionals who are interested in posture.
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Affiliation(s)
- Banu Bayar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Asalet Aybüke Güp
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Dilara Özen Oruk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Özge Ipek Dongaz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Eralp Doğu
- Faculty of Science, Department of Statistics, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Kılıçhan Bayar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Turkey
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Kırmızı Nİ, Aydın V, Akıcı N, Bayar B, Akıcı A. Utilization of biotechnological drugs in rare diseases requiring the use of off-label drugs in children in Turkey. Turk J Med Sci 2021; 51:1791-1799. [PMID: 33600094 PMCID: PMC8569737 DOI: 10.3906/sag-2012-355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background/aim Pediatric patients, especially those with rare diseases, represent a population that has a high tendency towards off- label drug use (OLDU) and needs a more careful practice of pharmacotherapy than in adults. We aimed to investigate biotechnological drug use in children with rare diseases requiring OLDU. Materials and methods This retrospective study examined all single-diagnosed OLDU applications (n = 5792) for 4992 children (<18- year) in Turkey. Applications of rare diseases were selected, and their descriptive characteristics were examined, including demographic features of patients, biotechnological drug utilization status, and disease categories. The off-label statuses of the drugs at the end of 2020 were also examined. Results In total, 77.7% (n = 4501) of OLDU applications were made for rare diseases. Biotechnological drug use was higher in rare disease applications than in nonrare diseases (37.9% vs. 19.2%, respectively; p < 0.0001). Canakinumab was the top applied biotechnological drug (73.2%). Compared to that in small-molecule drugs, the mean age of patients was higher in biotechnological drug-containing applications (8.1 ± 5.3 vs. 9.7 ± 4.9, respectively; p < 0.0001). Biotechnological drug use was higher in nonneoplastic rare diseases (40.3%) than in neoplastic rare diseases (26.4%), (p < 0.0001). At the end of 2020, the approval status of the off-label indications covered in 2016 was significantly higher for rare (24.4%) vs. nonrare (5.2%, p < 0.0001) diseases and for biotechnological (32.3%) vs. small- molecule (13.9%, p < 0.0001) drugs. In total, 87.7% of the drugs would have to be still used in the off-label setting at the end of 2020. Conclusion It was seen that more than three-quarters of the pediatric OLDU applications are for rare diseases, and the need for biotechnological OLDU in this group is almost 2-fold of small-molecule drug use. While further projected findings imply a higher approval tendency for rare diseases and biotechnological drugs, there seems to be more room for improvement for pediatric drug use.
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Affiliation(s)
- N. İpek Kırmızı
- Department of Medical Pharmacology, School of Medicine, Istanbul Medipol University, İstanbul, Turkey
| | - Volkan Aydın
- Department of Medical Pharmacology, International School of Medicine, Istanbul Medipol University, İstanbul, Turkey
| | - Narin Akıcı
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, İstanbul, Turkey
| | - Banu Bayar
- Turkish Medicines and Medical Devices Agency, Ministry of Health, Ankara, Turkey
| | - Ahmet Akıcı
- Department of Medical Pharmacology, School of Medicine, Marmara University, İstanbul, Turkey
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Akıcı N, Kırmızı Nİ, Aydın V, Bayar B, Aksoy M, Akıcı A. Off-label drug use in pediatric patients: a comparative analysis with nationwide routine prescription data. Turk J Pediatr 2020; 62:949-961. [PMID: 33372433 DOI: 10.24953/turkjped.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Children constitute a special population for off-label drug use (OLDU), yet limited drug-focused data exist regarding pediatric OLDU in clinical practice. This study aimed to investigate pediatric OLDU practice and compare it with pediatric drug utilization patterns of routine prescribing data. METHODS This cross-sectional study examined all approved pediatric OLDU applications, compared with electronic prescription data on national Prescription Information System of Turkish Medicines and Medical Devices Agency in 2015. OLDU applications and prescriptions were analyzed for demographic characteristics, healthcare/socioeconomic indices as well as details of drugs and diagnoses. RESULTS We found 7,896 OLDU applications and 7,029,512 prescriptions for the pediatric population in 2015. OLDU applications and prescriptions were mostly practiced for `2-11-year-old` children (52.7% vs. 63.4%, respectively; p < 0.01). OLDU applications and prescriptions were detected to have a positive correlation with socio-economic development index (r = 0.45, p < 0.0001 and r: 0.40, p = 0.0002; respectively) and the physician density (r = 0.66, p < 0.0001 and r: 0.43, p < 0.0001; respectively). In addition, OLDU was also positively correlated with the number of hospital beds per province (r = 0.39, p = 0.0003). Antineoplastic/immunomodulating agents were the most commonly applied drug category in OLDU (47.0%), compared with respiratory system drugs (36.6%) in routine prescribing. Eculizumab (6.5%), mycophenolate (5.6%), and canakinumab (4.4%) were the top drugs used as off-label. OLDU applications and routine prescription data revealed the most frequent diagnosis as `I27-other pulmonary heart diseases` (7.4%) and `J06-acute upper respiratory infections` (12.6%), respectively. CONCLUSIONS This is the first nationwide study to show indication- and drug-centered aspects of pediatric OLDU and prescribing practice. Though OLDU applications is overall consistent with routine clinical practice in terms of demographics and institutional capacity, substantial variations exist regarding main drug classes and diseases. Our findings are expected to shed light on interventions focused on improving `indicated` pediatric use of drugs currently applied as off-label.
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Affiliation(s)
- Narin Akıcı
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, İstanbul, Turkey
| | - N İpek Kırmızı
- Department of Medical Pharmacology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Volkan Aydın
- Department of Medical Pharmacology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Banu Bayar
- Turkish Medicines and Medical Devices Agency, Ministry of Health, Ankara, Turkey
| | - Mesil Aksoy
- Turkish Medicines and Medical Devices Agency, Ministry of Health, Ankara, Turkey
| | - Ahmet Akıcı
- Department of Medical Pharmacology, Marmara University Faculty of Medicine, İstanbul, Turkey
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Yurtoğulları Ş, Rahmanlar H, Alkan A, Bayar B, Gürsöz H, Uzun Adatepe N. A Multifaceted Evaluation of National Off-label Neurology Applications. tnd 2020. [DOI: 10.4274/tnd.2020.37791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Vural EH, Şafak Yılmaz E, Bektemür G, Vural İM, Bayar B, Gürsöz H. Evaluation of Top-selling Biotechnological Medicine from 2003 to 2016 in Turkey. Haseki 2019. [DOI: 10.4274/haseki.galenos.2018.4566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abstract
Background/aim: Off-label drug use (OLDU) is under the control of the Turkish Medicines and Medical Devices Agency (TMMDA) in Turkey. It was aimed to investigate demographic and medical features of patients with OLDU applications in Turkey. Materials and methods: A total of 4426 electronic OLDU application records of the TMMDA were evaluated retrospectively. Information regarding patients? demographic characteristics, diagnoses, requested drugs, institutions, and specialties of the physicians were evaluated. Results: OLDU applications were mostly made by rheumatologists (21.5%) and 95.2% of them were approved by the TMMDA. The mean age of the patients was 35 years and 54.4% of them were female. Off-label drugs were mostly prescribed for patients aged 18?64 years (62.1%) and were most frequently prescribed by physicians from university medical centers (81.0%). Systemic lupus erythematosus (10.1%) was the most common diagnosis. Mycophenolate (16.1%) and rituximab (10.1%) were the most frequently prescribed off-label drugs. There were differences regarding some characteristics of patients and their physicians among most frequently prescribed off-label drugs (P < 0.05). Conclusion: It is noteworthy that OLDU applications showed demographical and institutional differences. It is expected that this study will provide important contributions to physicians working in the relevant area with respect to treatment alternatives of diseases with treatment challenges.
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Karaca S, Ipek Ö, Bayar B, Bayar K. AB1105-HPR Evaluating of Rheumatologic Patients' Views on Physiotherapy and Rehabilitation Programs: A Pilot Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Benekli M, Yalcin S, Ozkan M, Elkiran ET, Sevinc A, Cabuk D, Coskun HS, Oksuzoglu B, Bayar B, Akbulat A, Ozet A. Efficacy of sorafenib in advanced differentiated and medullary thyroid cancer: experience in a Turkish population. Onco Targets Ther 2014; 8:1-5. [PMID: 25548522 PMCID: PMC4271783 DOI: 10.2147/ott.s70670] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Antivascular endothelial growth factor tyrosine kinase inhibitors have been used recently in the treatment of advanced differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC). Off-label sorafenib is used in Turkey with special permission by the Ministry of Health for this indication. Patients and methods Patients with advanced DTC and MTC were retrospectively identified from the Turkish Ministry of Health database. Data on these patients were prospectively collected before permission is granted to use sorafenib. Results Thirty patients with complete data were analyzed: 14 DTC (papillary number [n] =10; follicular n=4) and 16 MTC. The median age of the patients was 57 years (range: 28–79 years), and there were 18 males and 12 females. All DTC patients were iodine refractory and had received a median three doses of radioactive iodine (range: 1–7 doses). Sorafenib was used for a median of 12 months (range: 1–49 months). The overall response rate was 20%, all partial responses, with no complete response. The overall response rate was 14% in DTC and 25% in MTC patients. The median progression-free survival (PFS) was 17.1 months (95% confidence interval [CI]: 7.3–26.8) and overall survival (OS) was not reached. The 2-year PFS and OS were 39% and 68%, respectively. DTC and MTC patients had similar survival outcomes: median PFS of 21.3 months (95% CI: 5.8–36.7) versus 14.5 months (95% CI: 3.7–25.2), respectively (P=0.36), with the median OS not reached in either group (P=0.17). Tumor marker levels did not have any prognostic or predictive role. The toxicity profile was similar to that of other sorafenib trials. Conclusion Sorafenib is an effective and well-tolerated treatment in advanced thyroid cancers.
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Affiliation(s)
- Mustafa Benekli
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Suayib Yalcin
- Department of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Metin Ozkan
- Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Emin Tamer Elkiran
- Department of Medical Oncology, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Alper Sevinc
- Department of Medical Oncology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Devrim Cabuk
- Department of Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Hasan Senol Coskun
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Berna Oksuzoglu
- Department of Medical Oncology, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Banu Bayar
- Ministry of Health of Turkey, General Directorate of Pharmaceuticals and Medical Devices, Ankara, Turkey
| | - Akif Akbulat
- Ministry of Health of Turkey, General Directorate of Pharmaceuticals and Medical Devices, Ankara, Turkey
| | - Ahmet Ozet
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
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Yakut E, Bayar B, Meriç A, Bayar K, Yakut Y. Reliability and validity of reverse visual analog scale (right to left) in different intensity of pain. ACTA ACUST UNITED AC 2013. [DOI: 10.1163/156856903321196429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Bek N, Uygur F, Bayar B, Armutlu K. Analysis of age and gender related differences in pressure pain threshold and pressure pain tolerance levels. ACTA ACUST UNITED AC 2013. [DOI: 10.1163/15685690260494843] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Uğurlu N, Bayar B, Bayar K, Göktaş A, Karakaya IÇ, Polat H. Development, validity and reliability of the Turkish version of the Hung Postpartum Stress Scale. J Obstet Gynaecol Res 2012; 38:705-13. [PMID: 22381128 DOI: 10.1111/j.1447-0756.2011.01754.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of the current study was to translate the Hung Postpartum Stress Scale into Turkish and test the reliability and validity of the Turkish version of the scale. METHODS The translation process of the Hung Postpartum Stress Scale into Turkish and the testing of reliability and validity of the newly developed scale on postpartum stress in women are described. The questionnaire was translated using a back-translation technique. Expert review of internal consistency reliability, content validity, factor analysis of construct validity and criterion-related validity were examined. RESULTS Cronbach's alpha for the Turkish version of the Hung Postpartum Stress Scale was 0.931, indicating very good reliability. Factor analyses resulted in a two factor scale structure: maternal concerns and acceptability of the newborn by the family. Analyses also indicated good test-re-test reliability for the Turkish version of the Hung Postpartum Stress Scale (P < 0.01). CONCLUSIONS The present study describes the design of a Turkish version of the Hung Postpartum Stress Scale. The newly developed scale proved to be reliable and valid and will be a valuable instrument for women's healthcare professionals.
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Affiliation(s)
- Nezihe Uğurlu
- Department of Nursing, Muğla School of Health Sciences, Muğla University, Muğla, Turkey.
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18
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Ugurbas SH, Can M, Koksal M, Dincel A, Bozkurt A, Bayar B. Effect of ocular compression on intraocular penetration of systemic ofloxacin. Adv Ther 2007; 24:394-401. [PMID: 17565931 DOI: 10.1007/bf02849909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Intraocular levels of ofloxacin are documented after topical and systemic administration, but systemic administration of ofloxacin in ocular compression has not yet been studied. This study was undertaken to determine the intraocular penetration of systemic ofloxacin into aqueous and vitreous humor after the application of ocular compression in rabbit eyes. Ocular compression with the Honan balloon was applied for 30 min to the right eyes of 11 albino New Zealand white rabbits. After the application of ocular compression, 2 mg/mL of ofloxacin was administered intravenously. Samples from aqueous and vitreous humor were collected 30 min after infusion. Ofloxacin concentrations were determined through high-performance liquid chromatography. The mean aqueous level of ofloxacin was significantly higher in the compression group (2.40+/-1.00 microg/mL) than in the no-compression group (1.61+/-1.06 microg/mL) (P<.05). The mean vitreous concentrations of ofloxacin were 0.70+/-0.33 microg/mL and 0.50+/-0.18 microg/mL in the compression and no-compression groups, respectively. A significant difference was observed between vitreous levels of ofloxacin in the compression and no compression groups (P<.05). Ocular compression enhanced the penetration of ofloxacin in both aqueous and vitreous humor. The drug level in the aqueous humor was sufficient for the minimum inhibitory concentration for 90% of isolates (MIC90) to inhibit most microorganisms. Although the mean vitreous ofloxacin concentration was increased by previous ocular compression, it was not sufficiently above the MIC90 for most ocular pathogens that caused endophthalmitis.
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Affiliation(s)
- Suat Hayri Ugurbas
- Department of Ophthalmology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.
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Yağci R, Oflu Y, Dinçel A, Kaya E, Yağci S, Bayar B, Duman S, Bozkurt A. Penetration of second-, third-, and fourth-generation topical fluoroquinolone into aqueous and vitreous humour in a rabbit endophthalmitis model. Eye (Lond) 2006; 21:990-4. [PMID: 16732216 DOI: 10.1038/sj.eye.6702414] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIMS This study was designed to investigate the penetration of second-, third- and fourth-generation topical fluoroquinolone into aqueous and vitreous humour in a rabbit endophthalmitis model. METHODS Thirty New Zealand white rabbits were divided into six groups. Left eye was infected with an intravitreal inoculum of Staphylococcus aureus. Groups 1, 2, 3, 4, and 5 received topical ofloxacin, ciprofloxacin, lomefloxacin, levofloxacin, or moxifloxacin treatment 24 h after the inoculation, respectively. No treatment was given to group 6 as the control group (n=5). Aqueous and vitreous samples were obtained 30 min after the last drop. High-performance liquid chromatography was used to determine the fluoroquinolone concentration. RESULTS In the normal and inflamed eyes, mean aqueous concentrations of ofloxacin were 1.90 and 2.69 mug/ml, ciprofloxacin were 2.16 and 3.65 mug/ml, lomefloxacin were 3.54 and 1.19 mug/ml, levofloxacin were 2.89 and 9.41 mug/ml, and moxifloxacin were 4.92 and 43.33 mug/ml, respectively. Mean vitreous concentrations of ofloxacin were 0.25 and 0.07 mug/ml, ciprofloxacin were 0.08 and 0.32 mug/ml, lomefloxacin were 0.001 and 0.03 mug/ml, levofloxacin were 0.03 and 0.09 mug/ml, and moxifloxacin were 0.28 and 2.68 mug/ml, in normal and inflamed eyes, respectively. Moxifloxacin achieved a significantly higher concentration in aqueous and vitreous humour of infected eyes compared with ofloxacin (P<0.01), ciprofloxacin (P<0.05), lomefloxacin (P<0.01), and levofloxacin (P<0.05). CONCLUSION This study demonstrated that fourth-generation fluoroquinolone, moxifloxacin, seems to have better penetration to inflamed ocular tissues in rabbit.
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Affiliation(s)
- R Yağci
- Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey.
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Babaoglu MO, Bayar B, Aynacioglu AS, Kerb R, Abali H, Celik I, Bozkurt A. Association of the ABCB1 3435C>T polymorphism with antiemetic efficacy of 5-hydroxytryptamine type 3 antagonists. Clin Pharmacol Ther 2006; 78:619-26. [PMID: 16338277 DOI: 10.1016/j.clpt.2005.08.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2005] [Accepted: 08/16/2005] [Indexed: 11/15/2022]
Abstract
BACKGROUND Resistance to antiemetic treatment with 5-hydroxytryptamine type 3 (5-HT(3)) receptor antagonists is still a major problem resulting in patient discomfort and poor compliance to chemotherapy. We hypothesized that clinical resistance to 5-HT(3) antagonists is associated with the single-nucleotide polymorphism (3435C>T) in the gene that codes for the drug efflux transporter adenosine triphosphate-binding cassette subfamily B member 1 (ABCB1). METHODS Patients with cancer (N = 216) treated with chemotherapeutic regimens composed of highly or moderately emetogenic agents were examined for their antiemetic responses to tropisetron, ondansetron, or granisetron. The efficacy of antiemetic treatment was documented by self-report charts for 5 days after chemotherapy. ABCB1 3435C>T genotype was determined to analyze its association with the antiemetic efficacy of 5-HT(3) antagonists. RESULTS Within the first 24 hours of chemotherapy, the complete control rate of nausea and vomiting was higher in subjects with the ABCB1 TT genotype (n = 49) as compared with those with the CC (n = 60) or CT (n = 107) genotype (P = .044). The type of 5-HT(3) antagonists influenced the effect of genotype on antiemetic responses. The complete control rates were 92.9% in TT subjects (n = 14) in comparison to homozygote (47.6%, n = 21, P = .009) or heterozygote (56.1%, n = 41, P = .02) carriers of the 3435 C allele in granisetron-treated patients. However, during the delayed phase of chemotherapy, the complete control rates did not differ across genotypes. CONCLUSION These results suggest that ABCB1 3435C>T polymorphism is associated with antiemetic treatment efficacy in patients with cancer treated with 5-HT(3) antagonists, particularly in granisetron-treated patients, during the short-term phase of chemotherapy.
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Affiliation(s)
- Melih O Babaoglu
- Department of Pharmacology, Hacettepe University Faculty of Medicine, 06100 Sihhiye, Ankara, Turkey.
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Abstract
The purpose of this study was to investigate the effects of a 4 week physiotherapy programme on patients who were given a spinal orthosis for neuromuscular scoliosis. This study was planned as a single group pre- and post-intervention repeated measures design. All patients were given a polyethylene spinal orthosis with an anterior opening. Fifteen (15) patients with neuromuscular diseases and a mean age of 12.46 years were evaluated. An exercises programme consisting of postural training, muscle strengthening and stretching exercises with special emphasis on respiratory exercises was given as an adjunct to orthotic treatment. The degree of impairment in forced vital capacity was 17.56% upon wearing an orthosis, it decreased to 9.28% following therapy (p < 0.05). There was also a statistically significant increase in muscle strength, balance duration and a significant decrease in limitation of range of motion. The results of the study imply that the conservative treatment of neuromuscular scoliosis should include an exercise programme as an adjunct to an orthosis, both to reduce the compromising effect of an orthosis on respiratory function and to support the patient's physical capacities.
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Affiliation(s)
- B Bayar
- Hacettepe University, School of Physical Therapy and Rehabilitation, Unit of Orthotics and Biomechanics, Ankara, Turkey.
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Tekes E, Bayar B, Emre-Aydingoz S, Tuncer M. Mechanism of action of the cisapride-induced vasodilatation in renal vasculature of rat. Indian J Med Res 2004; 119:115-20. [PMID: 15115163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND & OBJECTIVES Cisapride is a prokinetic agent with cholinomimetic and 5-HT4 receptor agonistic properties. It has been proposed that cisapride-induced hypotension is partly mediated by cholinergic system. The aim of this study was to investigate the mechanism of cisapride-induced dilatation in the rat isolated perfused kidney. METHODS Left kidneys of Wistar rats were isolated and perfused via renal artery and the perfusion pressure was recorded. Cisapride given as bolus injections (10(-10)-3x10(-5) mol/l) produced dose-dependent dilatations. Perfusion of antagonists or inhibitors was started 30min before the onset of phenylephrine perfusion. RESULTS 4-Diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP; blocker of M1, and M3 muscarinic receptors; 10(-7) mol/l) inhibited the responses to the lower doses of cisapride while, dextran (10(-7) mol/l), glibenclamide (inhibitor of ATP-sensitive potassium channels; 10(-5) mol/l) and capsaicin (for neuromediator depletion; 10(-6) mol/l) inhibited those to the higher doses. Dilatations induced by most of the doses of cisapride were inhibited by atropine (non-selective muscarinic receptor antagonist; 10(-7) mol/l), methylene blue (inhibitor of soluble guanylate cyclase; 10(-5) mol/l), 1H-[1,2,4] oxadiazolo-[4,3-a] Quinoxalin-1-One (ODQ; inhibitor of soluble guanylate cyclase; 10(-5) mol/l), and NG-nitro-L-arginine (L-NOARG; NO synthase inhibitor; 10(-4) mol/l). Inhibition induced by L-NOARG was reversed by L-arginine (10(-3) mol/l). The dilatation induced by cisapride was not affected by GR113808 (5-HT4 receptor antagonist; 10(-7) mol/l) and indomethacin (cyclooxygenase inhibitor; 10(-5) mol/l). INTERPRETATION & CONCLUSION The findings indicated that cisapride caused vasodilatation through the release of nitric oxide (NO) as a result of the release of a substance acting on muscarinic receptors, in the renal vascular bed of the rat. The role of 5-HT4 receptors and prostanoids seemed unlikely.
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Affiliation(s)
- Ender Tekes
- Department of Pharmacology, Faculty of Medicine, University of Hacettepe, Sihhiye 06100, Ankara, Turkey
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23
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Bayar B, Bayar K, Yakut E, Yakut Y. Reliability and validity of the Functional Rating Index in older people with low back pain: preliminary report. Aging Clin Exp Res 2004; 16:49-52. [PMID: 15132292 DOI: 10.1007/bf03324532] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS The Functional Rating Index (FRI) was developed to provide an assessment instrument which has not only clinical usefulness but also quantifies the patient's current state of pain and dysfunction in a reliable and valid manner for spinal conditions. There is no study on the FRI applied to older people with low back pain (LBP). The primary aim of this study was to evaluate the validity and reliability of the FRI in older people with LBP. METHODS A total of 76 subjects aged 65 to 90 years with LBP, of which 37 were cognitively intact and were followed up on a second occasion, were assessed by the FRI, numeric rating scale (NRS), Roland Morris Questionnaire (RMQ) and spinal movement test. Reliability was assessed by statistical analysis of test results for test-retest and internal consistency. To assess construct validity, the FRI was compared with the RMQ. Concurrent validity was assessed using the NRS and spinal mobility test. RESULTS The FRI demonstrated high internal consistency, with alpha=0.921 for test and alpha=0.901 for retest. Item-scale correlations were between 0.549-0.871. Test-retest correlation was 0.913 (p=0.000). There was very good construct validity between the FRI and the RMQ for test (r=0.663, p<0.000) and retest (r=0.603, p<0.000). The FRI showed high correlation with the NRS (r=0.701, p<0.000 for test; r=0.743, p<0.000 for retest) and no correlation with the spinal movement test (r=0.173, p=0.307 for test; r=0.024, p=0.888 for retest). CONCLUSIONS In this preliminary report, the FRI appears to be easy to administer, seems to have significant validity and reliability, and may be useful in geriatric assessment of older people with LBP.
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Affiliation(s)
- Banu Bayar
- School of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Babaoglu MO, Ocal T, Bayar B, Kayaalp SO, Bozkurt A. Frequency and enzyme activity of the butyrylcholinesterase K-variant in a Turkish population. Eur J Clin Pharmacol 2004; 59:875-7. [PMID: 14735258 DOI: 10.1007/s00228-003-0716-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2003] [Accepted: 12/03/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Among variants of the butyrylcholinesterase gene ( BChE), the K-variant causing Ala539Thr substitution is the most common one associated with about one-third reduction in the enzyme activity. This study aimed to detect the frequency of the K-variant allele in a Turkish population sample and also to evaluate how the plasma BChE activity was influenced by this variant. METHODS Patients administered for elective surgery ( n=77) were examined for the presence of the K allele. The enzyme activity was determined in plasma. RESULTS The K-variant of BChE is a common allele with a frequency of 0.266 (CI(95%) 0.196-0.336) in our sample from a Turkish population. Mean enzyme activity in subjects homozygous for the K-variant was about 40% lower than other subjects. CONCLUSION The frequency of the BChE K-variant was significantly higher in a Turkish population than those reported for other populations and it is associated with a diminished enzyme activity.
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Affiliation(s)
- Melih O Babaoglu
- Department of Pharmacology, Hacettepe University Faculty of Medicine, Sihhiye, 06100 Ankara, Turkey.
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Abstract
We studied the value of the Widal tube agglutination test for the diagnosis of typhoid fever. The subjects were all adults >18 years of age and were divided into four groups: (i) 317 healthy blood donor controls, (ii) 31 bacteriologically confirmed patients with Salmonella enterica serotype Typhi, (iii) 21 patients with a clinical diagnosis of typhoid fever, and (iv) 41 febrile nontyphoid patients. Blood donor controls were screened with a slide agglutination test for the Salmonella enterica serotype Typhi O and H antigens, and positives were then tested with the Widal test. Acute- and convalescent-phase sera from patients in groups 2, 3, and 4 were obtained 7 to 10 days apart and tested by the Widal test. Using a cutoff of >or = 1/200 for the O antigen test performed on acute-phase serum gave a sensitivity of 52% and a specificity of 88% with a positive predictive value (PPV) of 76% and a negative predictive value (NPV) of 71%. This increased to 90% sensitivity and specificity with a PPV of 88% and an NPV of 93% when the convalescent-phase serum was tested. We concluded that O and H agglutinin titers of > or = 1/200 are of diagnostic significance. The Widal test is easy, inexpensive, and relatively noninvasive. It can be of diagnostic value when blood cultures are not available or practical. The results must be interpreted cautiously because of the low sensitivity of the test. The Widal test done on convalescent-phase serum gave more-reliable results with higher specificity and sensitivity.
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Affiliation(s)
- Ayse Willke
- Kocaeli Universitesi Tip Fakultesi Klinik Bakteriyoloji ve Infeksiyon Hastaliklari AD, Izmit, Turkey.
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Memikoğlu KO, Bayar B, Kurt O, Cokça F. [In vitro sensitivity of methicillin-resistant Staphylococcus aureus to fusidic acid and trimethoprim-sulfamethoxazole]. MIKROBIYOL BUL 2002; 36:141-5. [PMID: 12652865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
In this study, a total of 225 methicillin resistant Staphylococcus aureus strains isolated from various clinical specimens (114 wounds, 27 blood, 16 of each catheter and sputum, 14 throat swabs, 10 tracheal aspirates, 7 of each urine and drain materials, 6 pleural fluids, 5 graft materials, 2 cerebrospinal fluids, 1 ascitis fluid) of hospitalized patients, were tested in-vitro for their susceptibilities to fusidic acid and trimethoprim-sulfamethoxazole (TMP-SMX) by disk diffusion method. Two-hundred-eighteen (96.9%) of isolates were found susceptible to both fusidic acid and TMP-SMX, 4 (1.8%) were resistant to both of the agents (3 isolates from wound, 1 from sputum), 2 (0.9%) (both of them were wound isolates) were resistant only to fusidic acid, and 1 (0.4%) (throat isolate) was resistant only to TMP-SMX.
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Affiliation(s)
- K Osman Memikoğlu
- Ankara Universitesi Tip Fakültesi, Infeksiyon Hastaliklari ve Klinik Bakteriyoloji Anabilim Dali, Ankara
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Aksaray S, Dokuzoguz B, Guvener E, Yucesoy M, Yulug N, Kocagoz S, Unal S, Cetin S, Calangu S, Gunaydin M, Leblebicioglu H, Esen S, Bayar B, Willke A, Findik D, Tuncer I, Baysal B, Gunseren F, Mamikoglu L. Surveillance of antimicrobial resistance among gram-negative isolates from intensive care units in eight hospitals in turkey. J Antimicrob Chemother 2000; 46:649. [PMID: 11020272 DOI: 10.1093/oxfordjournals.jac.a020883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sg Aksaray
- Ankara Numune Hospital. Dokuz Eylul University Faculty of Medicine. Hacettepe University Faculty of Medicine. Istanbul University Faculty of Medicine. Ondokuz Mayis University Faculty of Medicine. A. U. Ibn-i Sina Hospital. Selcuk University Fa
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Aksaray S, DokuzoGuz B, Güvener E, Yücesoy M, Yuluğ N, Kocagöz S, Unal S, Cetin S, Calangu S, Günaydin M, Leblebicioğlu H, Esen S, Bayar B, Willke A, Findik D, Tuncer I, Baysal B, Günseren F, Mamikoğlu L. Surveillance of antimicrobial resistance among gram-negative isolates from intensive care units in eight hospitals in Turkey. J Antimicrob Chemother 2000; 45:695-9. [PMID: 10797096 DOI: 10.1093/jac/45.5.695] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
With the participation of eight major reference hospitals in Turkey, 749 aerobic Gram-negative isolates obtained from 473 intensive care patients in 1997 were tested for their susceptibility to 13 commonly employed antibacterial agents. The frequency with which species were isolated and resistance rates were compared with data from the previous 2 years. Imipenem was the most active agent against the majority of isolates (75%), followed by ciprofloxacin, cefepime and amikacin. The per cent susceptibility to all antibiotics declined from 1995 to 1996. With the exception of imipenem, for which there was no change in resistance, the per cent susceptibility somewhat increased in 1997. However, it was still lower than in 1995.
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Affiliation(s)
- S Aksaray
- Ankara Numune Hospital. Dokuz Eylül University Faculty of Medicine. Ankara Numune Hospital, Turkey
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Teitelbaum DH, Han-Markey T, Drongowski RA, Coran AG, Bayar B, Geiger JD, Uitvlugt N, Schork MA. Use of cholecystokinin to prevent the development of parenteral nutrition-associated cholestasis. JPEN J Parenter Enteral Nutr 1997; 21:100-3. [PMID: 9084013 DOI: 10.1177/0148607197021002100] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Neonates are at high risk for the development of parenteral nutrition-associated cholestasis when receiving a prolonged course of total parenteral nutrition (TPN). Although this cholestasis is of unknown etiology, it may result from a lack of gastrointestinal hormone formation, including cholecystokinin, which normally occurs after enteral feedings. METHODS Two groups of neonates were studied. The treatment group consisted of 21 consecutive, prospectively enlisted neonates receiving TPN for > 14 days. The nontreatment group consisted of 21 infants from the 2 years preceding the study who were matched to the treatment group by gestational age, diagnosis, and duration of TPN. The major outcome determinant was direct bilirubin. Cholestasis was defined as a direct bilirubin > 2.0 mg/dL and was considered severe if the direct bilirubin was > 5.0 mg/dL after other causes were ruled out. RESULTS The mean direct bilirubin levels in the nontreated group progressively rose over time, whereas the mean direct bilirubin the treated group remained level. The incidence of infants with a direct bilirubin > 2.0 mg/dL was 24% and 43% in the CCK+ and CCK- groups, respectively, and was not significant (p = .14). The percentage of infants with a direct bilirubin > 5.0 mg/dL was 9.5% and 38% in the treatment and nontreatment groups, respectively, and was significant, p = .015. CONCLUSIONS Levels of direct bilirubin were lower in the treated compared with the nontreated group. These findings suggest that cholecystokinin prophylaxis in high-risk neonates may help prevent the development of parenteral nutrition-associated cholestasis.
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Affiliation(s)
- D H Teitelbaum
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, USA
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Bayar B, Vocilka I, Zaitseva N, Novgorodov A. Fast gas-thermochromatographic separation of ruthenium neutron-deficient isotopes from silver chloride. ACTA ACUST UNITED AC 1978. [DOI: 10.1016/0022-1902(78)80452-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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