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Ünlütürk U, Yıldırım T, Savaş M, Oğuz SH, Fırlatan B, Yüce D, Karakaplan ND, Selimova C, Yılmaz R, Erdem Y, Bayraktar M. Effect of post-transplant diabetes mellitus on cardiovascular events and mortality: a single-center retrospective cohort study. Endocrine 2024:10.1007/s12020-024-03770-y. [PMID: 38491339 DOI: 10.1007/s12020-024-03770-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE This study aims to investigate the impact of post-transplant diabetes mellitus (PTDM) on cardiovascular events, graft survival, and mortality and to determine the risk factors involved in developing PTDM. METHODS A total of 703 patients who underwent kidney transplantation were included in the study. The total sample was subdivided into three groups: (i) patients with PTDM; (ii) patients who had diabetes before the transplantation (DM); and (iii) patients without diabetes (NoDM). The data on graft failure, cardiovascular events, all-cause mortality, and the potential risk factors that play a role in developing PTDM were recorded and analyzed. RESULTS The patients were followed for a median of 80 (6-300) months after transplantation. Out of all patients, 41 (5.8%) had DM before transplantation, and 101 (14.4%) developed PTDM. Recipient BMI, post-transplant fasting plasma glucose, and hepatitis C seropositivity were independent risk factors for PTDM development. The incidence of cardiovascular events was 6.1% in the NoDM group, 14.9% in the PTDM group, and 29.3% in the DM group (p < 0.001). In PTDM patients, hepatitis C seropositivity and the recipient's age at transplant were independent predictors of a cardiovascular event. There were no significant differences between the groups regarding the risk of graft loss. PTDM had no significant effect on all-cause mortality. However, the survival rates of DM patients were significantly reduced compared to those with NoDM or PTDM. CONCLUSIONS PTDM had no impact on patient survival. Hepatitis C seropositivity and recipient age at transplant predicted cardiovascular events in PTDM patients.
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Affiliation(s)
- Uğur Ünlütürk
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey.
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Tolga Yıldırım
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
- Division of Nephrology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Merve Savaş
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Seda Hanife Oğuz
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Büşra Fırlatan
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | | | - Cemile Selimova
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Rahmi Yılmaz
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
- Division of Nephrology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Yunus Erdem
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
- Division of Nephrology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Miyase Bayraktar
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
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Batu ED, Şener S, Arslanoglu Aydin E, Aliyev E, Bagrul İ, Türkmen Ş, Akgün Ö, Balık Z, Tanatar A, Bayındır Y, Kızıldağ Z, Torun R, Günalp A, Coşkuner T, İşgüder R, Aydın T, Haşlak F, Kasap Cüceoğlu M, Esen E, Akçay U, Başaran Ö, Pac Kısaarslan A, Akal F, Yüce D, Özdel S, Bülbül M, Bilginer Y, Aktay Ayaz N, Sözeri B, Kasapçopur Ö, Ünsal E, Özen S. A score for predicting colchicine resistance at the time of diagnosis in familial Mediterranean fever: data from the TURPAID registry. Rheumatology (Oxford) 2024; 63:791-797. [PMID: 37228026 PMCID: PMC10907807 DOI: 10.1093/rheumatology/kead242] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/12/2023] [Accepted: 05/22/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES Colchicine forms the mainstay of treatment in FMF. Approximately 5-10% of FMF patients are colchicine resistant and require anti-IL-1 drugs. We aimed to compare the characteristics of colchicine-resistant and colchicine-responsive patients and to develop a score for predicting colchicine resistance at the time of FMF diagnosis. METHODS FMF patients (0-18 years) enrolled in the Turkish Paediatric Autoinflammatory Diseases (TURPAID) registry were included. The predictive score for colchicine resistance was developed by using univariate/multivariate regression and receiver operating characteristics analyses. RESULTS A total of 3445 FMF patients [256 (7.4%) colchicine-resistant and 3189 colchicine-responsive) were included (female:male ratio 1.02; median age at diagnosis 67.4 months). Colchicine-resistant patients had longer, more frequent attacks and were younger at symptom onset and diagnosis (P < 0.05). Fever, erysipelas-like erythema, arthralgia, arthritis, myalgia, abdominal pain, diarrhoea, chest pain, comorbidities, parental consanguinity and homozygosity/compound heterozygosity for exon 10 MEFV mutations were significantly more prevalent among colchicine-resistant than colchicine-responsive patients (P < 0.05). Multivariate logistic regression analysis in the training cohort (n = 2684) showed that age at symptom onset, attack frequency, arthritis, chest pain and having two exon 10 mutations were the strongest predictors of colchicine resistance. The score including these items had a sensitivity of 81.3% and a specificity of 49.1%. In the validation cohort (n = 671), its sensitivity was 93.5% and specificity was 53.8%. CONCLUSION We developed a clinician-friendly and practical predictive score that could help us identify FMF patients with a greater risk of colchicine resistance and tailor disease management individually at the time of diagnosis.
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Affiliation(s)
- Ezgi Deniz Batu
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Seher Şener
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Elif Arslanoglu Aydin
- Department of Pediatrics, Division of Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Research and Training Hospital, Ankara, Turkey
| | - Emil Aliyev
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İlknur Bagrul
- Department of Pediatrics, Division of Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Research and Training Hospital, Ankara, Turkey
| | - Şeyma Türkmen
- Department of Pediatrics, Division of Rheumatology, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Özlem Akgün
- Department of Pediatrics, Division of Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Balık
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ayşe Tanatar
- Department of Pediatrics, Division of Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Yağmur Bayındır
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Zehra Kızıldağ
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Rüya Torun
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Aybüke Günalp
- Department of Pediatrics, Division of Rheumatology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Taner Coşkuner
- Department of Pediatrics, Division of Rheumatology, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Rana İşgüder
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Tuncay Aydın
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Fatih Haşlak
- Department of Pediatrics, Division of Rheumatology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Müşerref Kasap Cüceoğlu
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Esra Esen
- Department of Pediatrics, Division of Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Ulaş Akçay
- Department of Pediatrics, Division of Rheumatology, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Özge Başaran
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Aysenur Pac Kısaarslan
- Department of Pediatrics, Division of Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Fuat Akal
- Department of Computer Engineering, Hacettepe University, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University, Ankara, Turkey
| | - Semanur Özdel
- Department of Pediatrics, Division of Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Research and Training Hospital, Ankara, Turkey
| | - Mehmet Bülbül
- Department of Pediatrics, Division of Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Research and Training Hospital, Ankara, Turkey
| | - Yelda Bilginer
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatrics, Division of Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Betül Sözeri
- Department of Pediatrics, Division of Rheumatology, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Özgür Kasapçopur
- Department of Pediatrics, Division of Rheumatology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Erbil Ünsal
- Department of Pediatrics, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Seza Özen
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Kocabay AP, Aslan F, Yüce D, Turkyilmaz D. Speech in Noise: Implications of Age, Hearing Loss and Cognition. Folia Phoniatr Logop 2022; 74:345-351. [PMID: 35738235 DOI: 10.1159/000525580] [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] [Received: 10/06/2021] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Individuals with hearing loss have reduced hearing sensitivity and may not adequately process the temporal cues in acoustic signals. Cognitive skills that decrease with aging and hearing loss contribute negatively on the ability to understand speech. Hence, they may experience communication problems in noisy environments. The aim of the study was to investigate the effect of sloping high frequency hearing loss on speech perception in noise and to examine the impact of temporal and cognitive processing in young and middle-age adults. METHODS Speech in noise (SIN), temporal processing and cognitive tests were conducted to hearing-loss and normal hearing individuals aged 18-59 years. The measurements included the Matrix Sentence Test, Binaural Temporal Fine Structure Sensitivity (TFS) Test, Visual Aural Digit Span (VADS) and Auditory Verbal Learning Test (AVLT). 20 participants with normal hearing were recruited in the control group, whereas 20 participants with hearing loss at high frequencies was composed of the study group. RESULTS Hierarchical regression analysis for SIN was performed by entering 3 separate blocks of independent variables. We entered age and hearing loss into the first block, which explained a significant amount of variability in SIN (R2=0.72, p<0.001). Block 2 was comprised of scores from TFS sensitivity test, this independent variable characterized temporal processing (R2 change= 0.002., p<0.001). Block 3 was consisted of scores from VADS test and AVLT; these variables characterized cognitive processing and accounted for a good portion of SIN variance (R2 change=0.04, p<0.001). The age, hearing loss, and VADS contributed independently in the presence of all independent variables. CONCLUSION The final model accounted for 76.2% of the variance in SIN. The results suggested that sloping hearing loss, aging and cognitive decline affected auditory performance and the poor performance starts from an early age. Additionally, the findings indicated that a more comprehensive approach might be recommended to evaluate the listening skills and identify communication problems.
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Affiliation(s)
| | - Filiz Aslan
- Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University, Ankara, Turkey
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Yüce Sarı S, Yılmaz MT, Elmalı A, Kılıç L, Yüce D, Özyiğit G, Cengiz M, Yazıcı G. Turkish translation and validation of the Xerostomia Inventory. Arch Rheumatol 2022; 37:351-360. [PMID: 36589609 PMCID: PMC9791545 DOI: 10.46497/archrheumatol.2022.8702] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 10/07/2021] [Indexed: 01/04/2023] Open
Abstract
Objectives The Xerostomia Inventory (XI) was developed to assess the severity of dryness in patients with xerostomia. It has a long and a short form with three- and five-point Guttman-type response options. In this study, we aimed to translate the XI into Turkish, to assess the validity and reliability of both response options in patients with head & neck cancer (HNC) or Sjögren syndrome (SS), and to select the optimal version for Turkish patients. Patients and methods Between January 2019 and June 2019, the XI was translated into Turkish (XI-T) and applied to patients aged ≥18 years with HNC and SS. All patients were applied two tests including both the three- and five-point options. The internal consistency was assessed by Cronbach alpha and test-retest reliability by intraclass correlation coefficients (ICCs). Content validity was based on expert opinion and patient reviews. Results A total of 186 patients (109 males, 77 females; median age: 54 years; range, 19 to 78 years) answered the XI-T. The number of patients with HNC and SS was 143 (77%) and 43 (23%), respectively. Median XI-T score was 17 for the three-point, and 24 for the five-point option, respectively. Overall internal consistency was satisfactory for both options (α=0.81 and α=0.89, respectively). Overall test-retest reliability was satisfactory and ICCs ranged between 0.71 and 0.92 for the three-point, and 0.36 and 0.94 for the five-point option, respectively. Assessments based on expert opinions and patient reviews also favored the content validity of the scale. Conclusion The XI-T with both three- and five-point options is a valid and reliable tool to evaluate the presence and severity of dryness in patients with HNC and SS who experience xerostomia. The three-point option is more comprehensible and can be preferred over the five-point option in the Turkish population.
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Affiliation(s)
- Sezin Yüce Sarı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Melek Tuğce Yılmaz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Ayşenur Elmalı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Levent Kılıç
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Gökhan Özyiğit
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Mustafa Cengiz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Gözde Yazıcı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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Aktepe OH, Güner G, Güven DC, Şahin TK, Ardıç FS, Yüce D, Yalçın Ş, Erman M. The platelet to lymphocyte ratio predicts overall survival better than the neutrophil to lymphocyte ratio in metastatic renal cell carcinoma. Turk J Med Sci 2021; 51:757-765. [PMID: 33350295 PMCID: PMC8203127 DOI: 10.3906/sag-2009-75] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 09/07/2020] [Accepted: 12/19/2020] [Indexed: 02/05/2023] Open
Abstract
Background/aim The prognostic values of systemic inflammatory markers, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) on overall survival (OS) of metastatic renal cell carcinoma patients (mRCC) treated with tyrosine kinase inhibitors (TKI) remain unclear. Thus, the present study aimed to investigate the prognostic impact of these markers on OS of mRCC patients. Materials and methods A total of 150 patients receiving TKIs were retrospectively analyzed. Progression-free survival and OS times were analyzed with the Kaplan–Meier method, and the log‐rank test was used for comparison. Univariable and multivariable Cox regression models evaluated the impact of NLR and PLR on OS of the patients. The receiver operating characteristic curve analysis determined that the optimal cut-off values of NL, and PLR in predicting OS were 2 and 204, respectively. Results Patient with PLR > 204 had significantly lower median OS time than those with PLR ≤ 204 (14.6 months vs. 31.6 months, P < 0.001). While the univariate analyses showed that both NLR and PLR associated with OS (NLR: P = 0.002; PLR: P < 0.001), PLR, not NLR, was an independent determinant for OS in the multivariate analyses (Hazard Ratio: 2.535, 95% CI: 1.564-4.108, P < 0.001). Additionally, the presence of brain metastases and International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) prognostic scoring system were identified as independent prognostic factors for OS (brain metastases: P = 0.040; IMDC: P < 0.001). Conclusion The PLR is a readily and inexpensively obtained marker, which may predict OS in patients with mRCC treated with TKIs.
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Affiliation(s)
- Oktay Halit Aktepe
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gürkan Güner
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Can Güven
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Taha Koray Şahin
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fadime Sinem Ardıç
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Şuayib Yalçın
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Aktepe OH, Güner G, Güven DC, Taban H, Yıldırım HÇ, Şahin TK, Ardıç FS, Yeter HH, Yüce D, Erman M. Impact of albumin to globulin ratio on survival outcomes of patients with metastatic renal cell carcinoma. Turk J Urol 2021; 47:113-119. [PMID: 33819441 DOI: 10.5152/tud.2021.20377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/14/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The albumin to globulin ratio (AGR) has been demonstrated to be associated with survival outcomes in various tumor types. However, the prognostic value of AGR in patients with metastatic renal carcinoma (mRCC) remains unclear. Therefore, this study aimed to investigate the impact of AGR values in predicting overall survival (OS) of patients with mRCC treated with targeted therapy. MATERIAL AND METHODS A total of 163 patients with mRCC treated with targeted therapy between 2008 and 2019 were enrolled. The AGR value was measured as AGR: albumin/(total protein-albumin). The Kaplan-Meier method with long-rank testing and Cox proportional hazard models were used to estimate the correlation of AGR with OS. RESULTS The receiver operating characteristic curve analysis showed that the optimal cut-off value of AGR in predicting OS was 1.11 with a sensitivity of 37.25% and specificity of 85.25% (area under curve, 0.62; 95% confidence interval [CI], 0.54-0.69; p=0.005). OS was significantly higher in patients with AGR>1.11 than in those with AGR≤1.11 (36.2 vs. 12.4 months; p<0.001). After adjustment for the number of covariates, multivariate Cox regression analysis identified a high AGR as an independent indicator of better OS (hazard ratio, 0.476; 95% CI, 0.304-0.745; p=0.001). CONCLUSION Our results suggested that AGR value, which is an easily obtainable and cost-effective marker in routine biochemistry testing, could function as an independent predictor of OS in patients with mRCC treated with targeted therapy.
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Affiliation(s)
| | - Gürkan Güner
- Hacettepe University Cancer Institute, Ankara, Turkey
| | | | - Hakan Taban
- Hacettepe University Cancer Institute, Ankara, Turkey
| | | | - Taha Koray Şahin
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fadime Sinem Ardıç
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hacı Hasan Yeter
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Sade LE, Keskin S, Can U, Çolak A, Yüce D, Çiftçi O, Özin B, Müderrisoğlu H. Left atrial mechanics for secondary prevention from embolic stroke of undetermined source. Eur Heart J Cardiovasc Imaging 2020; 23:381-391. [DOI: 10.1093/ehjci/jeaa311] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/03/2020] [Indexed: 02/01/2023] Open
Abstract
Abstract
Aims
Anticoagulation is not justified unless atrial fibrillation (AF) is detected in cryptogenic stroke (CS) patients. We sought to explore whether left atrial (LA) remodelling is associated with embolic stroke of undetermined source (ESUS).
Methods and results
In this prospective study, we evaluated consecutively 186 patients in sinus rhythm who presented with an acute ischaemic stroke (embolic and non-embolic) and sex- and age-matched controls. We performed continuous electrocardiogram (ECG) monitoring to capture paroxysmal AF episodes as recommended by the guidelines. After 12 months of follow-up, continuous ECG monitoring was repeated in patients with undetected AF episodes. We quantified LA reservoir and contraction strain (LASr and LASct) by speckle-tracking, LA volumes by 3D echocardiography. Out of 186 patients, 149 were enrolled after comprehensive investigation for the source of ischaemic stroke and divided into other cause (OC) (n = 52) and CS (n = 97) groups. CS patients were also subdivided into AF (n = 39) and ESUS (n = 58) groups. Among CS patients, LA strain predicted AF independently from CHARGE-AF score and LA volume indices. ESUS group, despite no captured AF, had significantly worse LA metrics than OC and control groups. AF group had the worst LA metrics. Moreover, LASr predicted both CS (embolic stroke with and without AF) and ESUS (embolic stroke with no detected AF) independently from LAVImax and CHA2DS2-VASc score. LASr >26% yielded 86% sensitivity, 92% specificity, 92% positive, and 86% negative predictive values for the identification of ESUS (areas under curve: 0.915, P < 0.0001, 95% confidence interval: 0.86–0.97).
Conclusion
Echocardiographic quantification of LA remodelling has great potential for secondary prevention from ESUS.
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Affiliation(s)
- Leyla Elif Sade
- Cardiology Department, University of Baskent, 54. sokak E blok No: 45 Bahcelievler, 06490 Ankara, Turkey
| | - Suzan Keskin
- Cardiology Department, University of Baskent, 54. sokak E blok No: 45 Bahcelievler, 06490 Ankara, Turkey
| | - Ufuk Can
- Neurology Department, University of Baskent, Ankara, Turkey
| | - Ayşe Çolak
- Cardiology Department, University of Baskent, 54. sokak E blok No: 45 Bahcelievler, 06490 Ankara, Turkey
| | - Deniz Yüce
- Preventive Oncology and Epidemiology Department, University of Hacettepe Cancer Institute, Ankara Turkey
| | - Orçun Çiftçi
- Cardiology Department, University of Baskent, 54. sokak E blok No: 45 Bahcelievler, 06490 Ankara, Turkey
| | - Bülent Özin
- Cardiology Department, University of Baskent, 54. sokak E blok No: 45 Bahcelievler, 06490 Ankara, Turkey
| | - Haldun Müderrisoğlu
- Cardiology Department, University of Baskent, 54. sokak E blok No: 45 Bahcelievler, 06490 Ankara, Turkey
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Bahadır Ağce Z, Şahın S, Yaran M, Yüce D, Bumin G. The Bournemouth Questionnaire for Neck Pain: Cross-cultural Adaptation, Reliability, and Validity of the Turkish Version. J Manipulative Physiol Ther 2020; 43:708-713. [PMID: 32893021 DOI: 10.1016/j.jmpt.2018.11.039] [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: 04/02/2018] [Revised: 07/12/2018] [Accepted: 11/02/2018] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was first to translate and culturally adapt the BQN, and then to investigate the validity and reliability of the Turkish version of the BQN in Turkish individuals with chronic neck pain. METHODS The English version of the BQN was translated into Turkish with permission from its authors. That translation was assessed using 85 participants with a mean age of 46.75 years who had chronic neck pain. At the same time, the participants were assessed sociodemographically and with the Neck Disability Index (NDI) and the Neck Pain and Disability Scale (NPAD). A test-retest procedure was performed with 62 participants who underwent a second assessment with the BQN within 24 hours of the first assessment, to test its reliability. RESULTS Internal consistency was strong and all Cronbach alpha values were between 0.97 and 0.99. The BQN showed high test-retest reliability (intraclass correlation coefficient ˃ 0.92) for all domains. The total mean (± standard deviation) scores for the 3 questionnaires were as follows: BQN, 30.9 (± 11.18); NPAD, 48.16 (± 12.93); NDI, 17.85 (± 6.29). The results of the Turkish version of the BQN illustrated adequate external construct validity and sensitivity. A Turkish translation of the test has not previously been available for chronic pain. CONCLUSION The BQN was successfully translated and culturally adapted into Turkish. The reliability and validity were tested against the NPAD and the NDI. The Turkish version of the BQN is multidimensional, short, practical, and suitable for use with individuals with neck pain.
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Affiliation(s)
| | - Sedef Şahın
- Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
| | - Mahmut Yaran
- Department of Therapy and Rehabilitation, Ondokuz Mayıs University, Samsun, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Gonca Bumin
- Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
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Abstract
Objectives: Intrauterine growth restriction (IUGR) is diagnosed when the estimated fetal weight remains below the 10th percentile of gestational age based on pathological restriction of growth and/or accompanying Doppler abnormalities. Endothelial dysfunction is a common pathogenetic pathway underlying IUGR etiology. Endocan (ESM-1) is a novel marker of endothelial dysfunction and inflammation found in the maternal circulation. This study was designed to compare plasma endocan levels between pregnancies complicated with IUGR and a control group.Study design: Forty-four pregnancies complicated with IUGR and 47 healthy pregnancies were included. Maternal plasma endocan levels were detected by ELISA. Parametric data was studied by Student's t-test. Mann-Whitney U-test was used in analyzing non-parametric data. Categorical variables underwent chi-square test. ROC analysis was performed to define the cutoff value of endocan in detecting IUGR. Spearman correlation test was performed.Results: Maternal plasma endocan level varied significantly between IUGR and healthy pregnancies and was 1.8 fold higher in the IUGR group (793.0 (IQR:544.4-1896.0) ng/L vs. 441.8 (IQR: 408.3-512.4) ng/L, p < .001). There was a weak negative correlation between endocan level and 5th and 10th minute APGAR Scores (r = -0.256; p = .015 and r = -0.215; p = .042, respectively), a weak positive correlation with umbilical artery pulsatility index, and a moderate negative correlation with cerebroplacental ratio (r = 0.394; p < .001 and r = -0.459; p < .001, respectively).Conclusions: There was a significant difference between endocan levels of IUGR and healthy pregnancies. Further studies might be designed to investigate the performance of endocan in predicting neonatal outcomes for pregnancies complicated with IUGR.
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Affiliation(s)
- Gokce Naz Kucukbas
- Department of Perinatology, Zekai Tahir Burak Women's Research and Tertiary Hospital, Ankara, Turkey
| | - Ozgur Kara
- Department of Perinatology, Zekai Tahir Burak Women's Research and Tertiary Hospital, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Dilek Uygur
- Department of Perinatology, Zekai Tahir Burak Women's Research and Tertiary Hospital, Ankara, Turkey
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10
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Güven DC, Dizdar Ö, Akman AC, Berker E, Yekedüz E, Ceylan F, Başpınar B, Akbıyık İ, Aktaş BY, Yüce D, Erman M, Hayran M. Evaluation of cancer risk in patients with periodontal diseases. Turk J Med Sci 2019; 49:826-831. [PMID: 31195790 PMCID: PMC7018248 DOI: 10.3906/sag-1812-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background/aim In this study, we aimed to assess the cancer risk among patients with periodontal disease. Materials and methods Patients diagnosed with periodontal diseases at Hacettepe University between 2007 and 2012 were included and data on the diagnosis of any cancer after periodontal disease were collected from patient files. The age- and sex-standardized incidence rates (SIRs) were calculated using Turkish National Cancer Registry 2013 data. Results A total of 5199 patients were included. Median follow-up was 7.2 years. Patients with periodontal diseases had 17% increased risk of cancer compared with the expected counts for the corresponding age and sex groups (SIR: 1.17; 95% CI: 1.04–1.3, P = 0.006). The increased cancer risk was statistically significant in women (SIR: 1.24; 95% CI: 1.05–1.45, P = 0.008) but not in men. Among women with periodontal disease, the risks of breast cancer (SIR: 2.19) and head and neck cancer (SIR: 4.71) were significantly increased. Among men, the risks of prostate cancer (SIR: 1.84), head and neck cancer (SIR: 3.55), and hematological cancers (SIR: 1.76) were significantly increased. Conclusion This study showed that periodontal diseases were associated with increased risk of several cancers. Besides other well-known benefits for health, the provision of oral/dental health should be considered and employed as a cancer prevention measure.
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Affiliation(s)
- Deniz Can Güven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ömer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Abdullah Cevdet Akman
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Ezel Berker
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Emre Yekedüz
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Furkan Ceylan
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Batuhan Başpınar
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İlgın Akbıyık
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burak Yasin Aktaş
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Ozgokce M, Ayyıldız VA, Ogul H, Arslan H, Batur A, Yavuz A, Ince S, Yüce D. Common coeliacomesenteric trunk: a computed tomography radiological study. Folia Morphol (Warsz) 2018; 77:683-686. [PMID: 29500896 DOI: 10.5603/fm.a2018.0021] [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: 09/20/2017] [Revised: 01/13/2018] [Accepted: 01/29/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is an increasing trend for administration of invasive radiological interventions, laparoscopic surgery, and transplantation procedures in recent years, and determining the vascular variations prior to these procedures is crucially important. Coeliacomesenteric trunk (CMT) is among these variations. This study aimed to retrospectively evaluate this rare anomaly by computed tomography (CT). MATERIALS AND METHODS A total of 1000 CT angiography images were analysed retrospectively, and the patients with mesenteric and coeliac arteries arising from the abdominal aorta with a single root were identified. The level that CMT arose, and its branching patterns were determined individually for all patients. RESULTS Ten patients (6 males and 4 females) with a mean age of 50.2 years (17-87 years) had CMT in CT images. CONCLUSIONS The knowledge of variations in the CMT prior to vascular or laparoscopic interventions will contribute to early intervention in case of a complication, or to avoid from a potential damage.
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12
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Akyol Ardıç Ü, Ercan ES, Aygüneş D, Yüce D, Durak S, Kosova B. [Response With Methylphenidate to ADHD-Like Symptoms in Pervasive Developmental Disorder: Does CES-1 Enzyme Gene Polymorphism Have a Role?]. Turk Psikiyatri Derg 2017; 28:89-94. [PMID: 29192941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Methylphenidate is the first-choice medication for the Pervasive Developmental Disorders (PDDs), and comorbid Attention Deficit Hyperactivity Disorder (ADHD). But this approach generally results with poor outcomes, and increased adverse effects. It is aimed to investigate the comparison of cases who diagnosed with PDDs and Mild Mental Retardation (MR) and cases with pure ADHD in terms of the clinical response to MPH. Also we aimed to investigate the relations between CES-1 polymorphism gene and the clinical response to MPH. METHODS For clarifying this we searched for three polymorphisms (Arg199/His, Ser75/Asn, and Ile49/Val) in carboxylesterase-1 gene (CES-1) in the saliva of patients diagnosed with PDD+ADHD. Also, we assessed the clinical response to MPH by dimensional approach using the Attention Deficit Hyperactivity Disorder Rating Scale IV and Clinical Global Impression-Improvement scale. RESULTS PDD+ADHD groups had significantly higher Arg199/His polymorphism, and clinically responded poorer with symptoms sometimes even worsening to the MPH treatment compared with "pure" ADHD and ADHD+MR groups. CONCLUSION This is the first study that an association between Arg199/His polymorphism in CES1 and altered treatment response to MPH in patients with PDD that presents with symptoms of ADHD.
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Çelik İ, Yüce D, Hayran M, Erman M, Kılıçkap S, Buzgan T, Irmak H, Tosun N, Tuncer M, Akdağ R. Nationwide Smoking Cessation Treatment Support Program--Turkey project. Health Policy 2014; 119:50-6. [PMID: 25497715 DOI: 10.1016/j.healthpol.2014.11.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 06/23/2014] [Revised: 11/10/2014] [Accepted: 11/23/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND In 2011, Turkish Ministry of Health (MoH) initiated a nation-wide "Smoking Cessation Treatment Support Program" (SCTSP), to provide smoking cessation drugs free of charge. METHODS SCTSP was conducted in all 81 cities of Turkey, at 228 smoking cessation clinics, and by over 400 physicians. In total, 164,733 participants took advantage of the program between January and November 2011. Varenicline (Champix(®), Pfizer) and Bupropion (Zyban(®), GlaxoSmithKline) were used in the program at a ratio of 0.7 and 0.3 respectively. Post-program data were obtained by phone interviews from randomly selected participants, who had completed a 1-year follow-up after enrollment in the program. FINDINGS Quit rates were 29.6% for those given Varenicline and 25.1% for those given Bupropion. The quit rates for participants with hypertension (35.0%), diabetes mellitus (36.9%), coronary artery disease (32.1%) and cerebrovascular events (34.0%) were higher than those without. Increased age, female gender, longer duration of cessation drug use, low Fagerstrom score, the presence of hypertension, the absence of chronic obstructive pulmonary disease, and the absence of cancer were found to be associated with higher success rates. INTERPRETATION SCTSP is the first successful report of a nation-wide community-based smoking cessation intervention. The real-life quit rates obtained herein are comparable to those of clinical evidence to date. The centralization of smoking cessation clinics, standardization of treatment guidelines, application of a specific drug assignment algorithm, and provision of primary care support and follow-ups by trained physicians, appeared to be key elements for success.
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Affiliation(s)
- İsmail Çelik
- Tobacco Control, Training, Taxation, and Research Center, Hacettepe University Cancer Institute, Turkey.
| | - Deniz Yüce
- Tobacco Control, Training, Taxation, and Research Center, Hacettepe University Cancer Institute, Turkey
| | - Mutlu Hayran
- Tobacco Control, Training, Taxation, and Research Center, Hacettepe University Cancer Institute, Turkey
| | - Mustafa Erman
- Tobacco Control, Training, Taxation, and Research Center, Hacettepe University Cancer Institute, Turkey
| | - Saadettin Kılıçkap
- Tobacco Control, Training, Taxation, and Research Center, Hacettepe University Cancer Institute, Turkey
| | | | - Hasan Irmak
- Republic of Turkey, Ministry of Health, Turkey
| | - Nihat Tosun
- Republic of Turkey, Ministry of Health, Turkey
| | | | - Recep Akdağ
- Ministerial Leadership in Health Program, Harvard School of Public Health, Turkey
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Kamisli S, Hayran M, Kucukcoban S, Kiliçkap S, Yüce D, Celik I. 160 Study of interaction with a group of cancer patients: guiding cancer patients through psychoeducational interventions. Eur J Oncol Nurs 2014. [DOI: 10.1016/s1462-3889(14)70177-2] [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: 10/24/2022]
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Sade LE, Eroğlu S, Yüce D, Bircan A, Pirat B, Sezgin A, Aydınalp A, Müderrisoğlu H. Follow-Up of Heart Transplant Recipients with Serial Echocardiographic Coronary Flow Reserve and Dobutamine Stress Echocardiography to Detect Cardiac Allograft Vasculopathy. J Am Soc Echocardiogr 2014; 27:531-9. [DOI: 10.1016/j.echo.2014.01.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Indexed: 01/08/2023]
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