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Tomak L, Demirel T, Demir I. Evaluation of the demographic characteristics and general health status of earthquake survivors affected by the 2023 Kahramanmaraş earthquake; a section from Gaziantep Nurdağı district. BMC Public Health 2024; 24:937. [PMID: 38561730 PMCID: PMC10986009 DOI: 10.1186/s12889-024-18444-7] [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: 09/12/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND An earthquake with a magnitude of 7.7 occurred in Pazarcık District of Turkey at 04.17 on February 6, 2023 and another earthquake of 7.6 occurred at 13.24 on the same day. This is the second largest earthquake to have occurred in Turkey. The aim of this study is to investigate the earthquake-related level of knowledge, attitudes and behaviours, general health and psychological status of survivors who were affected by the 2023 Kahramanmaraş Earthquake and who were living in Nurdağı District of Gaziantep after the earthquake. METHODS Data of 2317 individuals older than 18 years of age who were living in earthquake neighbourhoods, tents and containers in Nurdağı District of Gaziantep were examined. Variables were evaluated to find out the demographic characteristics and general health status of earthquake victims. General Health Questionnaire (GHQ-12) was used to find out psychological states of earthquake victims. RESULTS The rate of injuries was 14.2% and leg and foot injuries were the most common with 44.2%. The relationship between injury status; and age, marital status, and being trapped under debris was revealed (p < 0.05). Mean GHQ-12 score of the survivors was 3.81 ± 2.81 and 51.9% experienced psychological distress. In the evaluation with logistic regression, it was found that female gender, being injured in the earthquake, loss of first degree and second degree relatives (with a higher rate in loss of first degree relative), having a severely damaged -to be demolished house and having a completely destroyed house were correlated with higher level of psychological distress (p < 0.05). CONCLUSION General characteristics, injury prevalence and affecting factors of earthquake survivors were evaluated in the present study. Psychological distress was found in victims. For this reason, providing protective and assistive services to fight the destructive effects of earthquake is vital. Accordingly, increasing the awareness of people residing in earthquake zones regarding earthquakes is exceptionally important.
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Affiliation(s)
- Leman Tomak
- School of Medicine, Department of Biostatistics and Medical Informatics, Ondokuz Mayis University, 55200, Samsun, Turkey.
| | - Tolga Demirel
- Turkish Statistical Institute, Gaziantep Recional Office, Degirmicem Mah. Sehit Murat Yasilak Sok. No:13/A, Gaziantep, Turkey
| | - Ibrahim Demir
- Turkish Statistical Institute, Devlet Mah. Necatibey Cad. No:114 Cankaya, Ankara, Turkey
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Yucel S, Balci IG, Tomak L. Diagnostic Performance of Thyroid Nodule Risk Stratification Systems: Comparison of ACR-TIRADS, EU-TIRADS, K-TIRADS, and ATA Guidelines. Ultrasound Q 2023; 39:206-211. [PMID: 37918114 DOI: 10.1097/ruq.0000000000000653] [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: 11/04/2023]
Abstract
ABSTRACT The purpose of this study was to compare the diagnostic performance of 4 different ultrasound-based risk scoring systems for thyroid nodules (TNs). This study consecutively included 256 patients (mean age: 43.98 ± 12.94 years, min-max: 18-89 years; 225 females, 31 males) with 266 TNs. Each nodule was evaluated and classified according to the American Thyroid Association (ATA), American College of Radiology (ACR), European Thyroid Association, and Korean Thyroid Imaging Reporting and Data System (ACR-TIRADS, EU-TIRADS, and K-TIRADS, respectively) before performing ultrasound-guided fine-needle aspiration biopsy. Pathological results were reported according to the Bethesda system. Outcomes of the 4 classification systems were compared with respect to Bethesda results. Twenty-eight (10.5%) nodules had malignant cytology results. Diagnostic performances of the scoring systems were comparable with similar area under the curve values according to the reference standards of category 5 of each scoring system. The sensitivity and specificity values of these guidelines were as follows: ACR-TIRADS, 60.7% and 95.4%; EU-TIRADS, 71.4% and 93.3%; ATA-2015, 71.4% and 93.3%; and K-TIRADS, 67.9% and 93.3%. The biopsy rate of malignant nodules was 57.1% for K-TIRADS and ATA, whereas this value was 46.4% for ACR and EU-TIRADS. ACR-TIRADS had the lowest unnecessary biopsy rate (141 of 238 benign nodules, 46%). The diagnostic performance of 4 risk stratification systems appears to be comparable, as shown by similar sensitivity, specificity, and area under the curve values. However, the ACR-TIRADS had slightly higher accuracy and necessitated fewer unnecessary biopsies for benign nodules.
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Affiliation(s)
- Serap Yucel
- Radiology Section, Basaksehir Cam ve Sakura State Hospital, Istanbul
| | - Isa Gokturk Balci
- Department of Radiology, Baskent University School of Medicine, Adana
| | - Leman Tomak
- Department of Biostatistics and Medical Informatics, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
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Sullu Y, Tomak L, Demirag G, Kuru B, Ozen N, Karagoz F. Evaluation of the relationship between Ki67 expression level and neoadjuvant treatment response and prognosis in breast cancer based on the Neo-Bioscore staging system. Discov Oncol 2023; 14:190. [PMID: 37875716 PMCID: PMC10597910 DOI: 10.1007/s12672-023-00809-w] [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: 05/13/2023] [Accepted: 10/20/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Neoadjuvant chemotherapy (NAC) is widely used in the treatment of primary breast cancer. Different staging systems have been developed to evaluate the residual tumor after NAC and classify patients into different prognostic groups. Ki67, a proliferation marker, has been shown to be useful in predicting treatment response and prognosis. We aimed to investigate the prognostic importance Neo-Bioscore stage and pretreatment and posttreatment Ki67 levels in breast cancer patients who received NAC and correlations between Neo-Bioscore stage and pretreatment and posttreatment Ki67 levels. METHODS A total of 176 invasive breast carcinoma patients who underwent NAC were included in the study. Ki67 levels were evaluated by immunohistochemical methods in Trucut biopsy and surgical excision specimens. Patients were classified into prognostic groups using the Neo-Bioscore staging system. RESULTS Patients with high pretreatment Ki67 score were more likely to be in the higher Neo-Bioscore risk group (p < 0.001). Patients with a high posttreatment Ki67 score were more likely to be in the higher Neo-Bioscore prognostic risk group (p < 0.001). Overall survival (OS) and disease-free survival (DFS) were shorter in patients with high posttreatment Ki67 scores and in patients in the higher Neo-Bioscore risk group. We also determined a cutoff 37% for pathological complete response. CONCLUSION Neo-Bioscore staging system is found to be important in predicting survival. The posttreatment Ki67 level is more important than pretreatment Ki67 level in predicting survival.
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Affiliation(s)
- Yurdanur Sullu
- Department of Pathology, Faculty of Medicine, Ondokuz Mayis University, 55139, Samsun, Turkey.
| | - Leman Tomak
- Department of Biostatistics and Informatics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Guzin Demirag
- Department of Medical Oncology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Bekir Kuru
- Department of Surgery, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Necati Ozen
- Department of Surgery, Medical Park Hospital, Samsun, Turkey
| | - Filiz Karagoz
- Department of Pathology, Faculty of Medicine, Ondokuz Mayis University, 55139, Samsun, Turkey
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Koç S, Tomak L, Karabulut E. A Predictive Model for the Risk of Infertility in Men Using Machine Learning. jus 2022. [DOI: 10.4274/jus.galenos.2022.2021.0134] [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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Koç S, Tomak L, Karabulut E. A Predictive Model for the Risk of Infertility in Men Using Machine Learning. jus 2022. [DOI: 10.4274/jus.galenos.2022.2021.0048] [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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Yucel S, Aycicek T, Ceyhan Bilgici M, Dincer OS, Tomak L. 3 Tesla MRI in diagnosis and follow up of children with pneumonia. Clin Imaging 2021; 79:213-218. [PMID: 34116298 DOI: 10.1016/j.clinimag.2021.05.027] [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: 11/22/2020] [Revised: 05/10/2021] [Accepted: 05/27/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate the utilization of 3-Tesla (3 T) magnetic resonance imaging (MRI) in detection of pulmonary abnormalities in children with pneumonia. MATERIALS AND METHODS Forty-seven children with pneumonia prospectively underwent 3 T thoracic MRI and posteroanterior (PA) chest radiography (CR). Of these, 15 patients also underwent contrast-enhanced thorax computed tomography (CT) or high-resolution CT (HRCT). The MRI protocol included axial and coronal T2-weighted spectral presaturation with inversion recovery (SPIR) Multivane-XD and axial echo-planar diffusion-weighted imaging (EPI DWI) with respiratory gating. Kappa statistics, Cochran Q, and McNemar tests were used to investigate the results. RESULTS Agreement between CR and MRI was substantial in detecting consolidation/infiltration (k = 0.64), peribronchial thickening (k = 0.64), and bronchiectasis (k = 1); moderate in detecting cavity (k = 0.54) and pleural effusion (k = 0.44); and fair in detecting empyema (0.32) and bilateral involvement of lungs (k = 0.23). MRI was superior to CR in detecting bilateral involvement (p < 0.001), lymph node (p < 0.001), pleural effusion (p < 0.001), and empyema (p = 0.003). MRI detected all the consolidation/infiltration also detected on CT imaging. A kappa test showed moderate agreement between MRI and CT in detecting pleural effusion and ground-glass opacity (GGO), and substantial or almost perfect agreement for all other pathologies. No statistically significant difference was observed between MRI and CT for detecting pneumonia-associated pathologies by the McNemar test. CONCLUSION Thoracic 3 T MRI is an accurate and effective technique for evaluating children with pneumonia. MRI detected more pathologies than CR and had similar results to those of thorax CT.
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Affiliation(s)
- Serap Yucel
- Mus State Hospital, Department of Radiology, Mus, Turkey.
| | - Tugba Aycicek
- M.D. Prof. Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Disease, Samsun, Turkey
| | - Meltem Ceyhan Bilgici
- Ondokuz Mayıs University Faculty of Medicine, Department of Radiology, Samsun, Turkey
| | - Oguz Salih Dincer
- M.D. Prof. Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Disease, Samsun, Turkey
| | - Leman Tomak
- Ondokuz Mayis University Faculty of Medicine, Department of Biostatistics and Medical Informatics, Samsun, Turkey
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Abstract
BACKGROUND Although transthoracic needle biopsy (TTNB) is an effective method for diagnosis of lung tumors, it has some complications. It is crucial to know the frequency and severity of the complications of TTNB and its risk factors in order to avoid them. OBJECTIVES Evaluate the complications and risk factors of computed tomography guided core needle lung biopsies (CT-CNLB). DESIGN Prospective evaluation of complications. SETTING Single center in Turkey. PATIENTS AND METHODS For CT-CNLBs performed between October 2017 and March 2018, the complications of biopsies were noted and classified as major and minor based on guidelines of the Society of Interventional Radiology. MAIN OUTCOME MEASURES The complications and risk factors for complications were evaluated. SAMPLE SIZE 123 adult patients. RESULTS The most common complications were pulmonary hemorrhage (30.9%) and pneumothorax (22%). Increased overall pulmonary hemorrhage was observed with underlying emphysema (P=.022), non-peripheral location of the lesion (P<.001), increased needle pathway (P<.001), fissure penetration (P=.011), increased number of pleura penetrations (P=.024), prolonged needle time across pleura (P=.037), and decreased lesion size (P=.033). The pneumothorax rate increased with non-peripheral location of the lesion (P<.007), fissure penetration (P=.021), prolonged needle time across the pleura (P=.013), and decreased lesion size (P=.002). In the logistic regression analyses for he two most common complications, the only risk factor for both alveolar hemorrhage and pneumothorax was a non-peripheral location of the lesion (P<.001, OR=14.7, 95% CI=3.9-55.4 for alveolar hemorrhage) and (P=.001, OR=156.2, 95% CI =7.34-3324.7 for pneumothorax). CONCLUSION Most common complications of CT-CNLB were pneumothorax and pulmonary alveolar hemorrhage with a 5.7% major complication rate. Choosing the shortest possible trans-pulmonary needle pathway minimizes the risk of complications. LIMITATIONS Limited number of patients, absence of rare complications as death, air embolism, and needle tract seeding. CONFLICT OF INTEREST None.
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Affiliation(s)
- Serap Yucel
- From the Radiology Section, Mus State Hospital, Mus, Turkey
| | - Asli Tanrivermis Sayit
- From the Department of Radiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Leman Tomak
- From the Department of Biostatistics and Medical Informatics, Ondokuz Mayis University, Samsun, Turkey
| | - Cetin Celenk
- From the Department of Radiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Kaya C, Cebeci H, Tomak L, Ozbalci GS. Prospective Randomized Trial Between Propofol Intravenous and Sevoflurane Inhaled Anesthesia on Cerebral Oximetry. Bariatr Surg Pract Patient Care 2020. [DOI: 10.1089/bari.2019.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Cengiz Kaya
- Department of Anesthesiology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Halil Cebeci
- Department of Anesthesiology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Leman Tomak
- Department of Biostatistics and Public Health, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Gokhan Selcuk Ozbalci
- Department of General Surgery, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Kaya C, Bilgin S, Cebeci GC, Tomak L. Anaesthetic Management of Patients Undergoing Bariatric Surgery. J Coll Physicians Surg Pak 2019; 29:757-762. [PMID: 31358099 DOI: 10.29271/jcpsp.2019.08.757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 03/08/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To describe perioperative anaesthetic management with laparoscopic sleeve gastrectomy (LSG). STUDY DESIGN An observational study. PLACE AND DURATION OF STUDY Department of Anesthesiology, Ondokuz Mayis University, Turkey, between January 2012 and December 2017. METHODOLOGY Patients who underwent LSG at the study centre were considered. Hospital records were retrospectively reviewed. Information was collected on demographic characteristics, comorbidities, haemodynamic parameters, airway and anaesthetic management and complications. RESULTS The study included 95 patients (mean age, 37.4±12.1 years; mean body mass index, 46 Kg/m2). Despite high airway assessment scores in some patients, 93 patients (98%) were conventionally intubated using our modified ramp position. Anaesthesia induction involved propofol, and anaesthesia maintenance involved inhalation anaesthetics (remifentanil supplementation). Additionally, rocuronium and sugammadex were used. Postoperative pain was managed with multimodal analgesia. Dose calculations were mostly based on lean/ideal body weight. Significant differences were found in the mean arterial pressure, heart rate and arterial oxygen saturation before induction and 5 min after induction. Intraoperatively, 3 patients (3.2%) developed bronchospasm and 1 (1.1%) developed bradycardia. There were no postoperative complications. CONCLUSION Inhalational anaesthesia with remifentanil and rocuronium-sugammadex is a safe option in bariatric surgery. Although conventional techniques are sufficient to establish the airway in most cases, preparations for difficult intubation should be made. Furthermore, careful patient selection, preoperative anaesthetic management planning and appropriate postoperative monitoring are necessary.
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Affiliation(s)
- Cengiz Kaya
- Department of Anesthesiology, Ondokuz Mayis University, School of Medicine, Kurupelit, Samsun, Turkey
| | - Sezgin Bilgin
- Department of Anesthesiology, Ondokuz Mayis University, School of Medicine, Kurupelit, Samsun, Turkey
| | - Gunes C Cebeci
- Department of Anesthesiology, Ondokuz Mayis University, School of Medicine, Kurupelit, Samsun, Turkey
| | - Leman Tomak
- Department of Biostatistics and Public Health, Ondokuz Mayis University, School of Medicine, Kurupelit, Samsun, Turkey
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Ergün S, Altay DU, Güneş S, Büyükalpelli R, Karahan SC, Tomak L, Abur Ü. Tr-KIT/c-KIT ratio in renal cell carcinoma. Mol Biol Rep 2019; 46:5287-5294. [DOI: 10.1007/s11033-019-04985-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/17/2019] [Indexed: 01/08/2023]
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Aslan K, Gunbey HP, Tomak L, Incesu L. Multiparametric MRI in differentiating solitary brain metastasis from high-grade glioma: diagnostic value of the combined use of diffusion-weighted imaging, dynamic susceptibility contrast imaging, and magnetic resonance spectroscopy parameters. Neurol Neurochir Pol 2019; 53:227-237. [PMID: 31180131 DOI: 10.5603/pjnns.a2019.0024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/22/2019] [Accepted: 06/03/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The purpose of this study was to determine whether the combined use of diffusion weighted imaging (DWI), magnetic resonance spectroscopy (MRS), and dynamic susceptibility contrast imaging (DSCI) parameters could provide a more accurate diagnosis in the differentiation of high-grade glioma (HGG) from solitary brain metastasis (SBM) in the enhancing tumour and in the peritumoural region. MATERIALS AND METHODS Fifty-six patients who received DWI, DSCI, and MRS before surgery were assessed. In differentiating SBM from HGG, the cutoff values of the DWI-apparent diffusion coefficient (ADCmin, ADCmax, and ADCmean), DSCI-relative cerebral blood volume (rCBV), and MRS-Cho/Cr, Cho/NAA, and NAA/Cr parameters for the peritumoural region were determined with ROC. The combined ROC curve was used for the different combinations of the peritumoural region DWI, DSCI, and MRS parameters in differentiating between the two tumours, and the best model combination was formed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. This study was approved by the Institutional Review Board at our institutes. RESULTS In the enhancing tumour, all the parameters except NAA/Cr (P = 0.024) exhibited no statistical difference in differentiating between these two groups (P > 0.05). AUC values for ADCmin, ADCmax, ADCmean, rADCmin, rADCmax, rADCmean, rCBV, Cho/Cr, Cho/NAA, and NAA/Cr parameters in the peritumoural region in differentiating SBM from HGG were 0.860, 0.822, 0.848, 0.822, 0.801, 0.822, 0.906, 0.851, 0.903, and 0.784, respectively. In differentiating HGG from SBM, the best model consisted of the combination of peritumoural ADCmin, rCBV, and Cho/NAA parameters. AUC values were 0.970. CONCLUSIONS The combination of peritumoural region ADCmin, rCBV, and Cho/NAA parameters can help in differentiating SBM from HGG, with a diagnostic accuracy of 97%.
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Affiliation(s)
- Kerim Aslan
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey, 55139 Samsun, Turkey.
| | - Hediye Pinar Gunbey
- Department of Radiology, Health Sciences University Kartal Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey, 34865 Istanbul, Turkey
| | - Leman Tomak
- Department of Biostatistics, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey, 55139 Samsun, Turkey
| | - Lutfi Incesu
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey, 55139 Samsun, Turkey
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Delen D, Davazdahemami B, Eryarsoy E, Tomak L, Valluru A. Using predictive analytics to identify drug-resistant epilepsy patients. Health Informatics J 2019; 26:449-460. [DOI: 10.1177/1460458219833120] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Epilepsy is one of the most common brain disorders that greatly affects patients’ quality of life and poses serious risks to their health. While the majority of the patients positively respond to the existing anti-epilepsy drugs, others who developed the refractory type of epilepsy show resistance against drug therapy and need to undergo advance treatments such as surgery. Given that identifying such patients is not a straightforward process and requires long courses of trial and error with anti-epilepsy drugs, this study aims at predicting those at-risk patients using clinical and demographic data obtained from electronic medical records. Specifically, the study employs several predictive analytics machine-learning methods, equipped with a novel approach for data balancing, to identify drug-resistant patients using their comorbidities and demographic information along with the initial epilepsy-related diagnosis made by their physician. The promising results we obtained highlight the potential use of machine-learning techniques in facilitating medical decisions and suggest the possibility of extending the proposed approach for developing a clinical decision support system for medical professionals.
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Bolat MS, Yürük E, Çınar Ö, Akdeniz E, Altunrende F, Özkuvancı Ü, Tomak L, Kadıoğlu A, Müslümanoğlu AY. The prevalence of Burnout Syndrome among Turkish Urologists: Results of a Nationwide Survey. Turk J Urol 2018; 45:449-455. [PMID: 30475702 DOI: 10.5152/tud.2018.34202] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 07/17/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the prevalence of Burnout syndrome (BS) with its emotional exhausting (EE), depersonalization (DP), and personal accomplishment (PA) dimensions among Turkish urologists. MATERIAL AND METHODS A total of 2,259 certified Turkish urologists were invited by e-mail to participate in this cross-sectional survey-based study. An online survey was conducted to evaluate three dimensions of BS ie: -EE, DP and PA-and their association with socio-demographic variables of Turkish urologists using the Maslach Burnout Inventory (MBI). RESULTS Of the 2259 urologists contacted, 362 (with a mean age of 44±9.9 years) completed the survey. The mean EE, DP and PA scores were 16.8±8.7, 6.6±4.6 and 8.2±5.6, respectively. Cronbach's α reliability co-efficiencies were 0.920 for EE, 0.819 for DP and 0.803 for PA. Antidepressant drug usage was quite prevalent among participants (21.9%), and the most common comorbidity was hypertension (13%). The academic title, age, smoking status, monthly income and relationships between colleagues and employers were associated with BS (p<0.05). CONCLUSION The prevalence of BS among Turkish urologists is quite prevalent in terms of EE and DP subscales and may negatively affect the psychosocial status and well-being of the urologists. In this study, a high prevalence of BS has been reported among Turkish urologists. In conclusion the BS could become an important occupational and health problem, if it is not properly managed.
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Affiliation(s)
- Mustafa Suat Bolat
- Department of Urology, Health Sciences University, Training and Research Hospital, Samsun, Turkey
| | - Emrah Yürük
- Department of Urology, Health Sciences University, Bağcılar Training and Research Hospital, İstanbul Turkey
| | - Önder Çınar
- Department of Urology, Health Sciences University, Training and Research Hospital, Samsun, Turkey
| | - Ekrem Akdeniz
- Department of Urology, Health Sciences University, Training and Research Hospital, Samsun, Turkey
| | - Fatih Altunrende
- Department of Urology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Ünsal Özkuvancı
- Department of Urology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Leman Tomak
- Department of Biostatistics, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ateş Kadıoğlu
- Department of Urology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Ahmet Yaser Müslümanoğlu
- Department of Urology, Health Sciences University, Bağcılar Training and Research Hospital, İstanbul Turkey
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Tomak L, Midik O. Primary principles in developing scale with Rasch analysis: Portfolio anxiety assessment. Niger J Clin Pract 2018; 21:1296-1303. [PMID: 30297562 DOI: 10.4103/njcp.njcp_275_17] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Rasch model is a useful method for developing a new scale. This study aims to determine the fitting between data obtained from answers for a portfolio anxiety scale and Rasch model and describes how the scale can be modified to increase the fitting through different steps. MATERIALS AND METHODS A portfolio scale was applied to 171 students of the Faculty of Medicine, Ondokuz Mayis University. The partial credit model was used, and fit statistics were assessed to determine the fitting of the data to Rasch model. Person separation index (PSI) was used for reliability. RESULTS For a satisfaction subscale, the average item fit residual value was 0.47 and the average person fit residual value was -0.29. For the item-trait χ2 interaction, P = 0.655 and PSI = 0.81. For a writing anxiety subscale, the average item fit residual value was 0.08 and the average person fit residual value was -0.24. For the item-trait χ2 interaction, P = 0.698 and PSI = 0.73. For a reflection anxiety subscale, the average item fit residual value was 0.64 and the average item fit residual value was 0.64. For the item-trait χ2 interaction, P = 0.195 and PSI = 0.73. CONCLUSION The validity and reliability of Rasch analysis portfolio scale were analyzed, and items that worked well were included in the study. The results show that Rasch model provides a more accurate analysis for developing and adapting scales. Both the fit statistics and fit graphs help improve the analyses.
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Affiliation(s)
- L Tomak
- Department of Biostatistics and Medical Informatics, Ondokuz Mayis University, Samsun, Turkey
| | - O Midik
- Department of Medical Education, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
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Aslan K, Gunbey HP, Tomak L, Incesu L. The diagnostic value of using combined MR diffusion tensor imaging parameters to differentiate between low- and high-grade meningioma. Br J Radiol 2018; 91:20180088. [PMID: 29770735 DOI: 10.1259/bjr.20180088] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine whether the combined use of MR diffusion tensor imaging (DTI) parameters [DTI-apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD)] could provide a more accurate diagnosis in differentiating between low-grade and atypical/anaplastic (high-grade) meningioma. METHODS Pathologically proven 45 meningioma patients [32 low-grade, 13 high-grade (11 atypical and 2 anaplastic)] who had received DTI before surgery were assessed retrospectively by 2 independent observers. For each lesion, MR DTI parameters (ADCmin, ADCmax, ADCmean, FA, AD, and RD) and ratios (rADCmin, rADCmax, rADCmean, rFA, rAD, and rRD) were calculated. When differentiating between low- and high-grade meningioma, the optimum cutoff values of all MR DTI parameters were determined by using receiver operating characteristic (ROC) analysis. Area under the curve (AUC) was measured with combined ROC analysis for different combinations of MR DTI parameters in order to identify the model combination with the best diagnostic accuracy in differentiation between low and high-grade meningioma. RESULTS Although the ADCmin, ADCmax, ADCmean, AD, RD, rADCmin, rADCmax, rADCmean, rAD, and rRD values of high-grade meningioma were significantly low (p = 0.007, p = 0.045, p = 0.035, p = 0.045, p = 0.003, p = 0.02, p = 0.03, p = 0.03, p = 0.045, and p = 0.01, respectively), when compared with low-grade meningioma, their FA and rFA values were significantly high (p = 0.007 and p = 0.01, respectively). For all MR DTI parameters, the highest individual distinctive power was RD with AUC of 0.778. The best diagnostic accuracy in differentiating between low- and high-grade meningioma was obtained by combining the ADCmin, RD, and FA parameters with 0.962 AUC. CONCLUSION This study shows that combined MR DTI parameters consisting of ADCmin, RD, and FA can differentiate high-grade from low-grade meningioma with a diagnostic accuracy of 96.2%. Advances in knowledge: To the best of our knowledge, this is the first study reporting that a combined use of all MR DTI parameters provides higher diagnostic accuracy for the differentiation of low- from high-grade meningioma. Our study shows that any of the model combinations was superior to use of any individual MR DTI parameters for differentiation between low and high-grade meningioma. A combination of ADCmin, RD, and FA was found to be the best model for differentiating low-grade from high-grade meningioma and sensitivity, specificity, and AUC values were found to be 92.3%, 100%, and 0.96, respectively. Thus, a combination of MR DTI parameters can provide more accurate diagnostic information when differentiation between low and high-grade meningioma.
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Affiliation(s)
- Kerim Aslan
- 1 ¹Department of Radiology, Ondokuz Mayis University Faculty of Medicine , Samsun , Turkey
| | - Hediye Pinar Gunbey
- 1 ¹Department of Radiology, Ondokuz Mayis University Faculty of Medicine , Samsun , Turkey
| | - Leman Tomak
- 2 Department of Biostatistics, Ondokuz Mayis University Faculty of Medicine , Samsun , Turkey
| | - Lutfi Incesu
- 1 ¹Department of Radiology, Ondokuz Mayis University Faculty of Medicine , Samsun , Turkey
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Yucel S, Ceyhan Bilgici M, Kara C, Can Yilmaz G, Aydin HM, Elmali M, Tomak L, Saglam D. Acoustic Radiation Force Impulse Quantification in the Evaluation of Thyroid Elasticity in Pediatric Patients With Hashimoto Thyroiditis. J Ultrasound Med 2018; 37:1143-1149. [PMID: 29064111 DOI: 10.1002/jum.14459] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/30/2017] [Accepted: 07/31/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To evaluate the parenchymal elasticity of the thyroid gland with acoustic radiation force impulse imaging in pediatric patients with Hashimoto thyroiditis and to compare it with healthy volunteers. METHODS Twenty-six patients with Hashimoto thyroiditis and 26 healthy volunteers between 6 and 17 years were included. The shear wave velocity (SWV) values of both thyroid lobes in both groups were evaluated. RESULTS The age and sex characteristics of the controls and patients with Hashimoto thyroiditis were similar. The SWV of the thyroid gland in patients with Hashimoto thyroiditis (mean ± SD, 1.67 ± 0.63 m/s) was significantly higher than that in the control group (1.30 ± 0.13 m/s; P < .001). There was no significant difference between the thyroid lobes in both groups. A receiver operating characteristic curve analyses showed an optimal cutoff value of 1.41 m/s, with 73.1% sensitivity, 80.8% specificity, a 79.2 % positive predictive value, and a 75.0% negative predictive value (area under the curve, 0.806; P < .001). In patients with Hashimoto thyroiditis, there was a positive correlation between the SWV values versus anti-thyroperoxidase (Pearson r = 0.46; P = .038). There were no correlations between age, body mass index, thyroid function test results, and anti-thyroglobulin values and versus SWV values. Also, no significant differences were seen between the groups for gland size, gland vascularity, and l-thyroxine treatment. CONCLUSIONS Acoustic radiation force impulse elastography showed a significant difference in the stiffness of the thyroid gland between children with Hashimoto thyroiditis and the healthy group. Using acoustic radiation force impulse elastography immediately after a standard ultrasound evaluation may predict chronic autoimmune thyroiditis.
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Affiliation(s)
- Serap Yucel
- Departments of Radiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Meltem Ceyhan Bilgici
- Departments of Radiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Cengiz Kara
- Departments of Pediatric Endocrinology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Gulay Can Yilmaz
- Departments of Pediatric Endocrinology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - H Murat Aydin
- Departments of Pediatric Endocrinology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Muzaffer Elmali
- Departments of Radiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Leman Tomak
- Departments of Medical Biostatistics, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Dilek Saglam
- Departments of Radiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
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Baydin A, Duran L, Şengüldür E, Katı C, Tomak L. Evaluation of Usefulness of Cardiopulmonary Resuscitation Education on Public Health Physicians. J Clin Exp Invest 2017. [DOI: 10.5799/jcei.382406] [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: 11/23/2022] Open
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18
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Bilgici MC, Bekci T, Ulus Y, Ozyurek H, Aydin OF, Tomak L, Selcuk MB. Quantitative assessment of muscular stiffness in children with cerebral palsy using acoustic radiation force impulse (ARFI) ultrasound elastography. J Med Ultrason (2001) 2017; 45:295-300. [DOI: 10.1007/s10396-017-0824-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 08/07/2017] [Indexed: 01/22/2023]
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19
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Bilgici MC, Bekci T, Genc G, Tekcan D, Tomak L. Acoustic Radiation Force Impulse Quantification in the Evaluation of Renal Parenchyma Elasticity in Pediatric Patients With Chronic Kidney Disease: Preliminary Results. J Ultrasound Med 2017; 36:1555-1561. [PMID: 28390141 DOI: 10.7863/ultra.16.08033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 10/11/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To evaluate renal parenchymal elasticity with acoustic radiation force impulse imaging in pediatric patients with chronic kidney disease (CKD) and compare with healthy volunteers. METHODS Thirty-eight healthy volunteers and 30 pediatric CKD patients were enrolled in this prospective study. The shear wave velocity (SW) values of both kidneys in CKD patients and healthy volunteers were evaluated. RESULTS The mean SW in healthy volunteers was 2.21 ± 0.34 m/s, whereas the same value was 1.81 ± 0.49, 1.72 ± 0.63, 1.66 ± 0.29, 1.48 ± 0.37, and 1.23 ± 0.27 for stages 1, 2, 3, 4, and 5 in CKD patients, respectively. The SW was significantly lower for each stage in the CKD patients compared with healthy volunteers. Acoustic radiation force impulse could not predict the different stages of CKD, with the exception of stage 5. The cut-off value for predicting CKD was 1.81 m/s; at this threshold, sensitivity was 76.5% and specificity was 92.1% (area under the curve = 0.870 [95% confidence interval: 0.750-0.990]; P < .001). Interobserver agreement expressed as intraclass coefficient correlation was 0.65 (95% confidence interval: 0.34 to 0.83; P < .001). CONCLUSIONS Acoustic radiation force impulse may be a potentially useful tool in detecting CKD in pediatric patients.
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Affiliation(s)
- Meltem Ceyhan Bilgici
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Tumay Bekci
- Zonguldak Atatürk State Hospital, Radiology Clinic, Zonguldak, Turkey
| | - Gurkan Genc
- Department of Pediatrics, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Demet Tekcan
- Van Region Education and Research Hospital, Pediatrics Clinic, Van, Turkey
| | - Leman Tomak
- Department of Medical Biostatistics, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
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20
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Kemal YN, Demirag GN, Bedir AM, Tomak L, Derebey M, Erdem DL, Gör U, Yücel I. Serum human epididymis protein 4 levels in colorectal cancer patients. Mol Clin Oncol 2017; 7:481-485. [PMID: 28894584 DOI: 10.3892/mco.2017.1332] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 07/04/2017] [Indexed: 01/12/2023] Open
Abstract
Tumour markers are widely used for the diagnosis, staging and monitoring of colorectal cancer (CRC) patients in clinical practice. Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are the most frequently used biomarkers in CRC patients. A number of studies have recently investigated the presence of human epididymis protein 4 (HE4) overexpression in certain cancer types. Its significance in ovarian and endometrial cancer has been well-demonstrated. The aim of the present study was to evaluate the significance of serum HE4 levels in CRC patients. A total of 46 newly diagnosed CRC patients and 36 age- and gender-matched healthy subjects were included in the study. The concentrations of CEA and CA19-9 were also determined and compared according to HE4 levels. HE4 positivity was determined in 13 of the 46 cases (28.3%) in the CRC group, but no HE4-positive subjects were identified in the control group (0%; P=0.009). The area under the receiver operating characteristic curve for HE4 positivity was 0.641 (95% CI: 0.523-0.760). HE4 was statistically significantly positive in patients with stage III-IV disease and in those with high CA 19-9 levels (all P<0.01). To the best of our knowledge, this is the first study to investigate HE4 expression in CRC patients, and the findings suggest that it may be a useful biomarker, particularly in stage III-IV patients.
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Affiliation(s)
- Yasemi N Kemal
- Department of Medical Oncology, Samsun Training and Research Hospital, Samsun 55100, Turkey
| | - Guzi N Demirag
- Department of Medical Oncology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Abdulkeri M Bedir
- Department of Biochemistry, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Leman Tomak
- Department of Biostatistics, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Murat Derebey
- Department of General Surgery, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Di Lek Erdem
- Department of Medical Oncology, Medical Park Samsun Hospital, Samsun 55200, Turkey
| | - Ufuk Gör
- Department of Biochemistry, Faculty Of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Idris Yücel
- Department of Medical Oncology, Faculty Of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
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21
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Ceyhan Bilgici M, Sağlam D, Delibalta S, Yücel S, Tomak L, Elmalı M. Shear wave velocity of the healthy thyroid gland in children with acoustic radiation force impulse elastography. J Med Ultrason (2001) 2017; 45:75-80. [DOI: 10.1007/s10396-017-0788-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
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22
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Polat AK, Karabacak U, Mutlu V, Tomak L, Bilgici A. Early Diagnosis of Lymphedema after Breast Cancer Treatment: Bio-Impedance Spectroscopy. J Breast Health 2017; 13:83-87. [PMID: 31244534 DOI: 10.5152/tjbh.2016.3357] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 12/25/2016] [Indexed: 02/05/2023]
Abstract
Objective Breast cancer-related lymphedema is an important health problem. The aim of this study is to ensure early diagnosis of patients at risk of developing lymphedema and revealing the predisposing factors. Materials and Methods Measurements in the pre-operative period and in postoperative months 3, 6, 9 and 12 and years 2 and 3 were performed prospectively with bio-impedance spectroscopy for patients treated for breast cancer between November, 2013 and November, 2016. Demographic and clinical-pathological data of the patients were investigated to assess the factors that affect the development of lymphedema. Results 245 measurements were obtained from the 67 patients who participated in the study. 18 (26.8%) patients were diagnosed with lymphedema and 16 (89%) of these patients were clinically diagnosed with stage 0 and 2 (1%) patients with stage 1 lymphedema. The median age was 50.7 (32-77) years. Performing axillary dissection and positivity in more than 3 nodes were found to be statistically significant with a percentage of 63.3% (n=15) and 64.7% (n=11) p=0.049 and p<0.001, respectively. Conclusion Periodic measurements with bio impedance spectroscopy can be an effective method to diagnose early stage lymphedema after breast cancer, and enable selecting the group of patients who would benefit from early treatment.
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Affiliation(s)
- Ayfer Kamalı Polat
- Department of Genaral Surgery, Ondokuz Mayıs University School of Medicine Samsun, Turkey
| | - Ufuk Karabacak
- Department of Genaral Surgery, Ondokuz Mayıs University School of Medicine Samsun, Turkey
| | - Vahit Mutlu
- Department of Genaral Surgery, Ondokuz Mayıs University School of Medicine Samsun, Turkey
| | - Leman Tomak
- Department of Biostatistics and Medical Informatics, Ondokuz Mayıs University School of Medicine Samsun, Turkey
| | - Ayhan Bilgici
- Department of Physical Medicine and Rehabilitation, Ondokuz Mayıs University School of Medicine Samsun, Turkey
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23
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Ceyhan Bilgici M, Bekci T, Ulus Y, Bilgici A, Tomak L, Selcuk MB. Quantitative assessment of muscle stiffness with acoustic radiation force impulse elastography after botulinum toxin A injection in children with cerebral palsy. J Med Ultrason (2001) 2017; 45:137-141. [PMID: 28271231 DOI: 10.1007/s10396-017-0780-y] [Citation(s) in RCA: 14] [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: 11/25/2016] [Accepted: 02/03/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE Our objective in this study was to assess the changes in medial gastrocnemius muscle (GCM) stiffness after botulinum toxin A (BTA) injection in children with cerebral palsy (CP) by using acoustic radiation force impulse (ARFI) elastography and to research the usability of this technique in clinical practice. MATERIALS AND METHODS Twenty-four spastic lower extremities of 12 children with CP were assessed. BTA injection treatment was applied to the medial GCM. Muscle stiffness was measured with the ARFI technique before the procedure and a month after the procedure. The patients were assessed with the modified Ashworth scale (MAS) in the physiotherapy department at about the same time. Shear wave velocity (SWV) values and MAS scores before and after the treatment were compared. RESULTS Mean SWV values were measured as 3.20 ± 0.14 m/s before BTA and as 2.45 ± 0.21 m/s after BTA, and the difference between them was found to be statistically significant (p < 0.001). Mean MAS score (2.33 ± 0.70) after BTA decreased significantly when compared to the score before BTA (2.96 ± 0.62) (p = 0.001). SWV values positively correlated with MAS scores (ρ = 0.578, p = 0.003). The interobserver agreement expressed as interclass correlation coefficient (ICC) was 0.65 (95% CI 0.33-0.84, p < 0.001). CONCLUSION ARFI elastography for identifying structural changes that occur in the spastic muscle after BTA injection in children with CP can yield more valuable information with combined use of MAS.
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Affiliation(s)
- Meltem Ceyhan Bilgici
- Ondokuz Mayis University Faculty of Medicine, Department of Radiology, Samsun, Turkey
| | - Tumay Bekci
- Zonguldak State Hospital, Radiology Clinic, Zonguldak, Turkey.
| | - Yasemin Ulus
- Ondokuz Mayis University Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Samsun, Turkey
| | - Ayhan Bilgici
- Ondokuz Mayis University Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Samsun, Turkey
| | - Leman Tomak
- Ondokuz Mayis University Faculty of Medicine, Department of Medical Biostatistics, Samsun, Turkey
| | - Mustafa Bekir Selcuk
- Ondokuz Mayis University Faculty of Medicine, Department of Radiology, Samsun, Turkey
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Bekci T, Ceyhan Bilgici M, Genc G, Tekcan D, Veysel Polat A, Tomak L. Evaluation of Renal Parenchyma Elasticity With Acoustic Radiation Force Impulse Quantification in Nutcracker Syndrome and Comparisons With Grayscale Doppler Sonography and Laboratory Findings. J Ultrasound Med 2017; 36:61-67. [PMID: 27925644 DOI: 10.7863/ultra.16.03010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 04/12/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES We sought to evaluate renal parenchymal elasticity with Virtual Touch quantification of acoustic radiation force impulse imaging in nutcracker syndrome and to compare shear-wave velocity (SWV) values with grayscale Doppler sonography and laboratory findings. METHODS Thirty-eight healthy volunteers and forty-three nutcracker syndrome patients were enrolled in this prospective study. SWV values for both kidneys in nutcracker syndrome patients and healthy volunteers were evaluated. Grayscale Doppler ultrasound and laboratory findings were obtained and compared with SWV values in both nutcracker syndrome patients and healthy volunteers. RESULTS In nutcracker syndrome patients, SWV values for the left kidney were significantly lower than those for the right kidney (n = 43; 1.93 ± 0.43 m/s vs 2.53 ± 0.45 m/s [P < .001]). Healthy volunteers' SWV values for both kidneys had no statistically significant differences. There was a statistically significant difference between nutcracker syndrome patients and healthy volunteers for the SWV values and body mass index values. There was no statistically significant correlation between SWV values of nutcracker syndrome patients and age, gender, glomerular filtration rate, body mass index, vein diameter ratio, peak velocity ratio, or resistive indices. CONCLUSIONS Acoustic radiation force impulse imaging offers new, additional information on the affected left kidney parenchymal changes in nutcracker syndrome patients.
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Affiliation(s)
- Tumay Bekci
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Meltem Ceyhan Bilgici
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Gurkan Genc
- Department of Pediatrics, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Demet Tekcan
- Department of Pediatrics, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Ahmet Veysel Polat
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Leman Tomak
- Department of Biomedical Statistics, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
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Öztürk M, Polat AV, Süllü Y, Tomak L, Polat AK. Background Parenchymal Enhancement and Fibroglandular Tissue Proportion on Breast MRI: Correlation with Hormone Receptor Expression and Molecular Subtypes of Breast Cancer. J Breast Health 2017; 13:27-33. [PMID: 28331765 DOI: 10.5152/tjbh.2016.3247] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 10/21/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the relationship between background parenchymal enhancement (BPE) and fibroglandular tissue (FGT) proportion on breast magnetic resonance imaging (MRI) and hormone receptor expression and molecular subtypes in invasive breast cancer. MATERIALS AND METHODS This retrospective study enrolled 75 breast cancer patients who underwent breast MRI before treatment. T1-weighted images were reviewed to determine the FGT proportion, and contrast-enhanced fat-suppressed T1-weighted images were reviewed to determine BPE. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2-neu (HER2) status, and molecular subtypes of the tumors were compared with the BPE and FGT proportions. RESULTS Women with high BPE tended to have increased rate of ER and PR positive tumors (p=0.018 and p=0.013). FGT proportion was associated with ER positivity (p=0.009), but no significant differences between FGT proportion and PR positivity were found (p=0.256). There was no significant difference between HER2 status and any of the imaging features (p=0.453 and p=0.922). For premenopausal women, both FGT proportion and BPE were associated with molecular subtypes (p=0.025 and p=0.042). FGT proportion was also associated with BPE (p<0.001). CONCLUSION In women with invasive breast cancer, both high FGT containing breasts and high BPE breasts tended to have ER positive tumors.
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Affiliation(s)
- Mesut Öztürk
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ahmet Veysel Polat
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Yurdanur Süllü
- Department of Pathology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Leman Tomak
- Department of Medical Biostatistics, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ayfer Kamalı Polat
- Department of General Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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Bolat MS, Akdeniz E, Asci R, Erdemir F, Cinar O, Tomak L. Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomised prospective study. Andrologia 2016; 49. [PMID: 27882592 DOI: 10.1111/and.12746] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2016] [Indexed: 02/02/2023] Open
Abstract
Seventy-two male patients, who were included in this study, underwent ureteroscopic stone surgery (study group). Forty-two healthy males were enrolled as control group. Changes in sexual function were evaluated using International Index of Erectile Function questionnaire in pre-operative, first and third postoperative terms. Overall satisfaction in relation to the age, operation time, presence of stents, body mass index, educational status, previous operations, International Index of Erectile Function score, International Prostate Symptom Score, Quality of Life, income status, Male Sexual Health Questionnaire, stone-free rates and Beck's depression scale were evaluated. Erectile and ejaculatory functions, quality of life and lower urinary tract symptoms were negatively affected due to ureteroscopic stone surgery, while educational status, psychogenic aspect and income status remained stable. In conclusion, ureteroscopic stone surgery with JJ catheterisation seems to have a progressively decreasing negative effect on male sexual function and whenever possible, stenting should be avoided. If JJ stenting is necessary, patients should be informed that they may experience sexual dysfunction at least for 3 months and if stenting proves necessary the indwelling should be kept as short as possible.
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Affiliation(s)
- M S Bolat
- Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey
| | - E Akdeniz
- Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey
| | - R Asci
- Department of Urology, Ondokuz Mayis University, Samsun, Turkey
| | - F Erdemir
- Department of Urology, Gazi Osman Pasa University, Tokat, Turkey
| | - O Cinar
- Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey
| | - L Tomak
- Department of Urology, Ondokuz Mayis University, Samsun, Turkey
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Atilla A, Doğanay Z, Çelik HK, Tomak L, Günal Ö, Kılıç SS. Central line-associated bloodstream infections in the intensive care unit: importance of the care bundle. Korean J Anesthesiol 2016; 69:599-603. [PMID: 27924201 PMCID: PMC5133232 DOI: 10.4097/kjae.2016.69.6.599] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 04/01/2016] [Revised: 05/24/2016] [Accepted: 05/26/2016] [Indexed: 01/06/2023] Open
Abstract
Background The importance and efficacy of a care bundle for preventing central line-associated bloodstream infections (CLABSIs) and infectious complications related to placing a central venous catheter (CVC) in patients in the intensive care unit (ICU). Methods A care bundle was implemented from July 2013 to June 2014 in a medical ICU and surgical ICU. Data were divided into three periods: the prior period (July 2012–June 2013), the intervention period (July 2013–June 2014; first and second periods), and the post-intervention period (July 2014–December 2014; third period). A care bundle consisting of optimal hand hygiene, skin antisepsis with chlorhexidine (2%) allowing the skin to dry, maximal barrier precautions for inserting a catheter (sterile gloves, gown, mask, and drapes), choice of optimal insertion site, prompt catheter removal, and daily evaluation of the need for the CVC was introduced. Results The catheterization duration was longer and femoral access was more frequently observed in patients with CLABSIs. CLABSI rates decreased with use of the care bundle. The CLABSI rate in the medical ICU was 6.20/1,000 catheter days during the prior period, 3.88/1,000 catheter days during the intervention period, and 1.05/1,000 catheter days during the third period. The CLABSI rate in the surgical ICU was 8.27/1,000, 4.60/1,000, and 3.73/1,000 catheter days during these three periods, respectively. Conclusions The choice of an optimal catheter insertion site, use of all barrier precautions, and removal of catheters when they are no longer needed are essential to decrease the CLABSI rate.
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Affiliation(s)
- Aynur Atilla
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Zahide Doğanay
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun, Turkey
| | - Hale Kefeli Çelik
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun, Turkey
| | - Leman Tomak
- Department of Biostatistics, Ondokuzmayis University Faculty of Medicine, Samsun, Turkey
| | - Özgür Günal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - S Sırrı Kılıç
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
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Bekci T, Polat AV, Aslan K, Tomak L, Ceyhan Bilgici M, Danaci M. Diagnostic performance of diffusion-weighted MRI in the diagnosis of ovarian torsion: comparison of torsed and nonaffected ovaries. Clin Imaging 2016; 40:1029-33. [DOI: 10.1016/j.clinimag.2016.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 06/02/2016] [Accepted: 06/06/2016] [Indexed: 11/16/2022]
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Turk AC, Fıdan N, Ozcan O, Ozdemır F, Tomak L, Ozkurt S, Sahın F. Painful and painless shoulder magnetic resonance imaging comparisons in hemodialysis patients and correlation with clinical findings. J Back Musculoskelet Rehabil 2016; 30:BMR715. [PMID: 27232087 DOI: 10.3233/bmr-160715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Shoulder pain is frequently observed in haemodialysis patients. OBJECTIVE To compare haemodialysis patients with or without shoulder pain in terms of shoulder motion ranges, β2 microglobulin levels and magnetic resonance imaging findings. METHODS Forty-three patients undergoing dialysis were enrolled, of which 23 patients had explicit shoulder pain at night, which appeared during dialysis. Range of joint motion and impingement tests were evaluated. β 2 microglobulin value was recorded. MRI was used to evaluate rotator cuff tendons for thickness, homogeneity, integrity and presence of effusion. RESULTS Ranges of motion were significantly lower in the painful shoulder group. Supraspinatus tendon thickness and the number of areas with effusion were higher in the painful group. There was a positive correlation between the β 2 microglobulin level and supraspinatus (r:0.352 p< 0.05) and subscapular (r:0.454 p< 0.05) tendon thicknesses. While effusion areas and pain (r:0.351 p< 0.05) showed positive correlation, there was a negative correlation between pain and shoulder motion ranges. CONCLUSIONS Shoulder pain in dialysis patients can be related with tendon thickness and effusion. While the β 2 microglobulin level affects tendon thickness, it has no relation to pain and movement constraint.
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Affiliation(s)
- Ayla Caglıyan Turk
- Department of Physical Medicine and Rehabilitation, Hitit University Training and Research Hospital, Corum, Turkey
| | - Nurdan Fıdan
- Department of Radiology, Hitit University Training and Research Hospital, Corum, Turkey
| | - Oguzhan Ozcan
- Department of Biochemistry, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Ferda Ozdemır
- Department of Physical Medicine and Rehabilitation, Kolan International Hospital, Sisli, Istanbul, Turkey
| | - Leman Tomak
- Department of Biostatistics, Faculty of Medicine, Ondokuzmayıs University, Samsun, Turkey
| | - Sultan Ozkurt
- Department of Nephrology, Hitit University Training and Research Hospital, Corum, Turkey
| | - Fusun Sahın
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Atilla A, Tomak L, Katrancı AO, Ceylan A, Kılıç SS. Mortality risk factors in burn care units considering the clinical significance of acinetobacter infections. ULUS TRAVMA ACIL CER 2016; 21:34-8. [PMID: 25779710 DOI: 10.5505/tjtes.2015.76814] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study aimed to evaluate risk factors and the role of Acinetobacter isolates in mortality due to burns since morbidity and mortality rates are considerably high. METHODS A total of four hundred and sixty-five patients hospitalized in our Burn Care Unit between January 2009 and May 2011 were reviewed retrospectively. Logistic regression analysis was used in order to predict the risk. RESULTS Mortality rates were as follows: 7.5% in general, 3.9% for under 17 years of age, 12% for between 18-64 years of age, and 24% for over 65 years of age (p<0.001). CONCLUSION As the burnt body surface area increased, higher mortality rates were detected. Despite higher mortality rates, Acinetobacter infections were not found risk factors for mortality.
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Affiliation(s)
- Aynur Atilla
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey.
| | - Leman Tomak
- Department of Biostatistics, Ondokuzmayis University Faculty of Medicine, Samsun, Turkey
| | - Ali Osman Katrancı
- Department of Pediatric Surgery, Samsun Training and Research Hospital, Samsun, Turkey
| | - Alper Ceylan
- Department of General Surgery, Samsun Training and Research Hospital, Samsun, Turkey
| | - S Sırrı Kılıç
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
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Atalay YO, Kaya C, Koksal E, Ustun YB, Tomak L. Determining a Safe Time for Oral Intake Following Pediatric Sedation. Dicle Med J 2016. [DOI: 10.5798/diclemedj.0921.2016.01.0638] [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: 11/14/2022] Open
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Turk AC, Sahin F, Ozkurt S, Tomak L, Guray G. Effect of arteriovenous fistula and usage of arm with fistula on bone mineral density in hemodialysis patients. Ren Fail 2016; 38:648-53. [PMID: 26905486 DOI: 10.3109/0886022x.2016.1150100] [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: 11/13/2022] Open
Abstract
We aimed to determine the incidence of osteoporosis in hemodialysis patients, to evaluate the differences due to arteriovenous fistula on bone mineral density (BMD) and to investigate whether usage of arm with fistula has an effect on BMD. In this cross-sectional study, 96 patients with chronic renal disease undergone to dialysis were included. Place of fistula (radial and brachial) and dominant hand were recorded. All patients were asked to complete Likert's scale in order to determine the frequency of their usage of arm with fistula. Patients were assigned in two groups: age >51 and < 50 years. Age-matched control group included 60 subjects. BMD measurements were done on lumbar vertebra, femur and both forearms. BMD measurement of proximal femur and total radius were significantly lower in patients >50 years compared to healthy controls and bone density measurement of lumbar vertebra, proximal femur, 1/3 distal and total radius were significantly lower in patients < 50 years compared to healthy controls (p < 0.05). BMD measurement was significantly lower in arms with fistula, especially with radial fistula, compared to both arms without fistula and healthy controls (p < 0.05). When all patients were evaluated, BMD scores were lowering by increasing age, duration of dialysis and fistula and decreasing usage of arm with fistula. BMD in hemodialysis patients is lower than normal population. BMD of arm with fistula is lower than arm without fistula and healthy controls. Both radial and brachial fistula affect negatively ipsilateral BMD. Movement of arm with fistula has positive effects on BMD.
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Affiliation(s)
- Ayla Cagliyan Turk
- a Department of Physical Medicine and Rehabilitation , Hitit University Training and Research Hospital , Corum , Turkey
| | - Fusun Sahin
- b Department of Physical Medicine and Rehabilitation, Faculty of Medicine , Pamukkale University , Denizli , Turkey
| | - Sultan Ozkurt
- c Department of Nephrology , Hitit University Training and Research Hospital , Corum , Turkey
| | - Leman Tomak
- d Department of Biostatistics, Faculty of Medicine , Ondokuzmayıs University , Samsun , Turkey
| | - Gurkan Guray
- e Department of Nuclear Medicine , Edirne Training and Research Hospital , Edirne , Turkey
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Tomak L, Bek Y, Cengiz MA. Graphical modeling for item difficulty in medical faculty exams. Niger J Clin Pract 2016; 19:58-65. [PMID: 26755220 DOI: 10.4103/1119-3077.173701] [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: 11/04/2022]
Abstract
BACKGROUND There are different indexes used in the evaluation of exam results. One important index is the difficulty level of the item that is also used in this study to obtain control charts. This article offers some suggestions for the improvement of multiple-choice tests using item analysis statistics. MATERIALS AND METHODS The graphical modeling is important for the rapid and comparative evaluation of test results. The control chart is a tool that can be used to sharpen our teaching and testing skills by inspecting the weaknesses of measurements and producing reliable items. The research data for the application of control charts were obtained using the results of the fourth and fifth-grade student's exams at Ondokuz Mayis University, Faculty of Medicine. I-chart or moving range chart (MR) is preferred for whole variable data. RESULTS It is seen that all observations are within control limits for I-chart, but three points on MR-chart are settled on the LCL. Using X--chart with subgroups, it was determined that control measurements were within the upper and lower limits in both charts. The difficulty levels of items were examined by obtaining different variable control charts. The difficulty level of the two items exceeded the upper control limit in R- and S-charts. CONCLUSION The control charts have the advantage for classifying items as acceptable or unacceptable based on item difficulty criteria.
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Affiliation(s)
- L Tomak
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ondokuz Mayis University, Atakum, Samsun, Turkey
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Erenler AK, Kulaksiz F, Ülger H, Çapraz M, Tomak L, Baydin A. Predictors of Crimean-Congo hemorrhagic fever in the Emergency Department. Eur Rev Med Pharmacol Sci 2015; 19:3811-3816. [PMID: 26531263] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Crimean-Congo hemorrhagic fever (CCHF) is an acute illness affecting multiple organ systems characterized by thrombocytopenia, and/or leukopenia, elevated levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatine kinase (CK) and it has a case-fatality of 8% to 80%. In this article, we aimed to determine the clinical and laboratory findings that predicts the disease on admission. PATIENTS AND METHODS We retrospectively analyzed the medical data of the patients admitted to our emergency department (ED) due to tick bite. These patients were divided into two groups according to their transcriptase-polymerase chain reaction (RT-PCR) test results. Findings of PCR (+) (Group 1) and PCR (-) (Group 2) patients were compared. RESULTS Epistaxis was found to be statistically significant clinical finding in Group 1. Also, while aspartate transaminase (AST) levels and potassium (K) level were significantly higher, platelet count and white blood count (WBC) were significantly lower in Group 1 when compared to Group 2. CONCLUSIONS Predictors of CCHF in the ED are epistaxis, leukopenia, thrombocytopenia and elevated K and AST levels. In our study, the fatality rate of CCHF was found to be 21.6%.
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Affiliation(s)
- A K Erenler
- Emergency Department, Hitit University Çorum Education and Research Hospital, Çorum, Turkey.
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Kemal Y, Gonullu G, Bedir A, Tomak L, Derebey M, Erdem D, Gor U, Yucel I. Serum human epididymis protein 4 (HE4) levels in colorectal cancer patients. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e14650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Guzin Gonullu
- Ondokuzmayis University Faculty of Medicine, Department of Medical Oncology, Samsun, Turkey
| | - Addulkerim Bedir
- 19 Mayis University Hospital, Department of Biochemistry, Samsun, Turkey
| | - Leman Tomak
- 19 Mayis University Hospital, Department of Biostatistics, Samsun, Turkey
| | - Murat Derebey
- 19 Mayis University Hospital, Department of General Surgery, Samsun, Turkey
| | - Dilek Erdem
- Samsun Education and Research Hospital, Samsun, Turkey
| | - Ufuk Gor
- 19 Mayis University Hospital, Department of Biochemistry, Samsun, Turkey
| | - Idris Yucel
- 19 Mayis University Hospital, Department of Medical Oncology, Samsun, Turkey
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Tomak L, Bek Y. Item analysis and evaluation in the examinations in the faculty of medicine at Ondokuz Mayis University. Niger J Clin Pract 2015; 18:387-94. [DOI: 10.4103/1119-3077.151720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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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Gürler HŞ, Bilgici B, Akar AK, Tomak L, Bedir A. Increased DNA oxidation (8-OHdG) and protein oxidation (AOPP) by low level electromagnetic field (2.45 GHz) in rat brain and protective effect of garlic. Int J Radiat Biol 2014; 90:892-6. [DOI: 10.3109/09553002.2014.922717] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pınarlı FA, Okten G, Beden U, Fışgın T, Kefeli M, Kara N, Duru F, Tomak L. Keratinocyte growth factor-2 and autologous serum potentiate the regenerative effect of mesenchymal stem cells in cornea damage in rats. Int J Ophthalmol 2014; 7:211-9. [PMID: 24790860 DOI: 10.3980/j.issn.2222-3959.2014.02.05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 11/25/2013] [Indexed: 01/07/2023] Open
Abstract
AIM To investigate the healing process after severe corneal epithelial damage in rats treated with mesenchymal stem cells (MSCs) cultured with or without keratinocyte growth factor (KGF-2) and autologous serum (AS) on amniotic membrane (AM). Many patients are blind and devastated by severe ocular surface diseases due to limbal stem cell deficiency. Bone marrow-derived MSCs are potential sources for cell-based tissue engineering to repair or replace the corneal tissue, having the potential to differentiate to epithelial cells. METHODS The study included 5 groups each including 10 female "Sprague Dawley" rats in addition to 20 male rats used as bone marrow donors. Group I rats received AM+MSCs, Group II rats AM+MSCs cultured with KGF-2, Group III rats AM+MSCs cultured with KGF-2+AS, Group IV rats only AM and Group V rats, none. AS was derived from blood drawn from male rats and bone marrow was obtained from the femur and tibia bones of the same animals. Therapeutic effect was evaluated with clinical, histopathological and immunohistochemical assessment. MSC engraftment was demonstrated via detection of donor genotype (Y+) in the recipient tissue (X) with polymerase chain reaction. RESULTS Corneal healing was significantly better in Groups I-III rats treated with MSC transplantation compared to Group IV and Group V rats with supportive treatment only. The best results were obtained in Group III rats with 90% transparency, 70% lack of neovascularization, and 100% epithelium damage limited to less than 1/4 of cornea. CONCLUSION We suggest that culture of MSCs with KGF-2 and AS on AM is effective in corneal repair in case of irreversible damage to limbal stem cells.
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Affiliation(s)
- Ferda Alpaslan Pınarlı
- Department of Medical Biology and Genetics, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Gülsen Okten
- Department of Medical Biology and Genetics, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Umit Beden
- Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Tunç Fışgın
- Department of Pediatric Hematology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Mehmet Kefeli
- Department of Pathology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Nurten Kara
- Department of Medical Biology and Genetics, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Feride Duru
- Department of Pediatric Hematology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
| | - Leman Tomak
- Department of Medical Biostatistics, Faculty of Medicine, Ondokuz Mayis University, Samsun 55270, Turkey
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Atmaca A, Tander B, Kan EK, Ulus Y, Ecemis GC, Akyol Y, Tomak L. Assessment of balance performance and fear of falling in acromegalic patients: a comparative study. J Endocrinol Invest 2013; 36:759-63. [PMID: 23612352 DOI: 10.3275/8944] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Acromegaly may lead to balance disturbances and fear of falling due to changes in body composition and co-morbidities. AIM The aim of this study was to evaluate balance and fear of falling in acromegalic patients and their relation with disease characteristics. MATERIALS AND METHODS Forty-eight acromegalic patients and 41 age- and gender-matched controls were enrolled in the study. The median ages of the patients and controls were 48 (25-75) and 50 (25-67) yr, respectively. Berg Balance Scale (BBS) and one-leg stance test (OLST) were used to compare dynamic and static balance respectively, 50 meters walking test was used to compare functional capacity and falls efficacy scale-international (FES-I) was used to compare fear of falling between the groups. RESULTS Balance tests (BBS and 50 meter walking test) and fear of falling (FES-I) were significantly disturbed in patients compared with controls. There was no significant difference in OLST. BBS and OLST were negatively and FES-I was positively correlated with age. FES-I was negatively correlated with BBS and OLST was positively correlated with 50 meters walking test. Only OLST was negatively correlated with disease duration. Logistic regression analysis revealed that balance was not affected by the presence of co-morbidities, postoperative vision loss and disease control. CONCLUSIONS This is the first study showing that balance is disturbed in acromegalic patients. This disturbance is not related to disease control and co-morbidities but somewhat to disease duration.
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Affiliation(s)
- A Atmaca
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Atakum 55200, Samsun, Turkey.
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Amanvermez R, Gunay M, Piskin A, Keles G, Tomak L. TNF-α, IL-1β, and oxidative stress during fracture healing with or without ankaferd. ACTA ACUST UNITED AC 2013; 114:621-4. [DOI: 10.4149/bll_2013_132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tural S, Kara N, Alayli G, Tomak L. Association between osteoporosis and polymorphisms of the bone Gla protein, estrogen receptor 1, collagen 1-A1 and calcitonin receptor genes in Turkish postmenopausal women. Gene 2012; 515:167-72. [PMID: 23137636 DOI: 10.1016/j.gene.2012.10.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 09/06/2012] [Accepted: 10/10/2012] [Indexed: 01/26/2023]
Abstract
In this study, we have investigated the association between osteoporosis and osteocalcin (BGLAP) -298 C>T, estrogen receptor 1 (ER1) 397 T>C, collagen type1 alpha 1 (Col1A1) 2046 G>T and calcitonin receptor (CALCR) 1340 T>C polymorphisms. Genomic DNA was obtained from 266 persons (158 osteoporotic and 108 healthy controls). Genomic DNA was extracted from EDTA-preserved peripheral venous blood of patients and controls by a salting-out method and analyzed by PCR-RFLP. As a result, there was no statistically significant difference in the genotype and allele frequencies of patients and controls for BGLAP -298 C>T, Col1A1 2046 G>T, ER1 397 T>C and CALCR 1340 T>C polymorphisms. However, ER1 CC genotype compared with TT+TC genotypes was found to increase the two fold the risk of osteoporosis [p=0.039, OR=2.156, 95% CI (1.083-4.293)] and CALCR CC genotype compared with TT+TC genotypes was found to have protective effect against osteoporosis [p=0.045, OR=0.471, 95% CI (0.237-0.9372)]. In the combined genotype analysis, ER1/CALCR TCCC combined genotype was estimated to have protective effect against osteoporosis [p=0.0125, OR=0.323, 95% CI (0.1383-0.755)] whereas BGLAP/Col1A1 CCTT and ER1/CALCR CCTT combined genotypes were estimated as risk factors for osteoporosis in Turkish population (p=0.027, p=0.009 respectively).
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Affiliation(s)
- Sengul Tural
- Ondokuz Mayis University, Faculty of Medicine, Dept. of Medical Biology and Genetics, Samsun, Turkey.
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Yıldırım T, Bilgin K, Çiftçi GY, Eçik ET, Şenkuytu E, Uludağ Y, Tomak L, Kılıç A. Synthesis, cytotoxicity and apoptosis of cyclotriphosphazene compounds as anti-cancer agents. Eur J Med Chem 2012; 52:213-20. [DOI: 10.1016/j.ejmech.2012.03.018] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 03/07/2012] [Accepted: 03/09/2012] [Indexed: 12/01/2022]
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Abstract
Subtrochanteric osteotomy of the femur using a bent dynamic compression plate is a simple, safe, and stable technique for correction of severe medial femoral torsion.
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Affiliation(s)
- Yilmaz Tomak
- Ondokuz Mayis University, Faculty of Medicine, Department of Orthopaedics and Trauma Surgery, 55139, Kurupelit--Samsun, Turkey
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Abstract
Cubitus varus and valgus are the most common complications of supracondylar and lateral condylar fractures. Various combinations of osteotomy and fixation have been described to correct these deformities but each is associated with significant complications. In this study, we used distraction osteogenesis and Ilizarov frame fixation to treat 24 elbows in 23 patients with cubitus varus or valgus. Their clinical outcome was evaluated using the protocol of Bellemore et al. The mean time to follow-up was 18.3 months (10 to 36) and the mean time to frame removal was 13.5 weeks (8 to 20). The mean carrying angle was corrected from −18.7° (−10° to −30°) to 6.1° (2° to 10°) in patients with cubitus varus and from 36.5° (25° to 45°) to 9.4° (4° to 15°) in patients with cubitus valgus. There were 18 excellent and six good results. The Ilizarov method with gradual distraction is a safe, stable, adjustable and versatile method of treating deformities at the elbow without the problems of an unsightly scar or limited range of movement, and gives a good clinical and radiological outcome. Tardy ulnar nerve palsy should be treated first by anterior transposition.
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Affiliation(s)
| | - Y. Tomak
- Department of Orthopaedic Surgery
| | - C. Sen
- Department of Orthopaedic Surgery, Gazi Osman Pasa University, Faculty of Medicine, 60100 Tokat, Turkey
| | - L. Tomak
- Department of Biostatistics Ondokuz Mayis University, Faculty of Medicine, 55139 Kurupelit, Samsun, Turkey
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Tomak Y, Kocaoglu M, Piskin A, Yildiz C, Gulman B, Tomak L. Treatment of intertrochanteric fractures in geriatric patients with a modified external fixator. Injury 2005; 36:635-43. [PMID: 15826624 DOI: 10.1016/j.injury.2004.10.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2004] [Indexed: 02/02/2023]
Abstract
Forty-two geriatric patients who had an intertrochanteric fracture were treated with a semicircular modification of the Ilizarov frame designed by Cattaneo and Catagni between January 1997 and September 2001. Twenty-five of the patients were female, 17 male. The average age of the patients was 77.5 years (range, 63-99). No intraoperative complication occurred. Deep pin-track infection was found in four patients and varus deformity was observed in two patients and shortening of less than 2 cm in 10 patients. Fixator removal was achieved in a mean time of 12 weeks (range, 10-18). No implant failure, refracture or stiffness of knee and hip joint movements was recorded. We concluded that the treatment of intertrochanteric fractures of the elderly patients with our modification provides significant advantages such as minimal operative and anaesthetic risks, no blood loss, early weight-bearing, short hospitalisation time and rapid union time.
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Affiliation(s)
- Yilmaz Tomak
- School of Medicine, Department of Orthopaedics and Trauma Surgery, Ondokuz Mayis University, 55139 Kurupelit-Samsun, Turkey.
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Affiliation(s)
- Yilmaz Tomak
- Department of Orthopaedics and Trauma Surgery, Ondokuz Mayis University, Medicine Faculty, 55139, Kurupelit, Samsun, Turkey.
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