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Akbulut S, Tamer M, Saritas S, Unal O, Akyuz M, Unsal S, Kucukakcali Z, Karabulut E, Usta S, Yilmaz S. Immunosuppressive Medication Adherence in Patients With Hepatocellular Cancer Who Have Undergo Liver Transplantation: A Case Control Study. Transplant Proc 2023:S0041-1345(23)00164-1. [PMID: 37080874 DOI: 10.1016/j.transproceed.2023.02.064] [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] [Received: 11/22/2022] [Revised: 01/08/2023] [Accepted: 02/22/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND We aimed to compare the adherence to immunosuppressive medication use in patients who underwent liver transplantation (LT) due to hepatocellular carcinoma (HCC) and non-HCC reasons. METHODS The study population was determined as 242 patients with HCC and 1290 patients with non-HCC who had LT performed in our institute between March 2002 and November 2021; all these patients were contacted by phone in March 2022. The sample size was calculated using the MedCalc software program, and the number of patients required in each group was determined as 111 patients. Furthermore, we used the sample.int function, a random integer generator in the R (version 4.1.2) software program. Whereas demographic and clinical parameters were determined as independent variables, the immunosuppressive medication adherence scale (IMAS) score was determined as a dependent variable. Patients were evaluated by the IMAS. This 11-item IMAS scale evaluates the lowest compliance score as 11 and the highest as 55. RESULTS Out of a total number of 221 patients, 161 (72%) were men and 60 (27.1%) were women, with a median age of 58 years (IQR: 14); one patient in the non-HCC group was excluded due to lack of data. Among the HCC and non-HCC groups, significant differences were found in terms of the variables of age (P = .003), IMAS score (P < .001), sex (P = .001), working status (P = .004), chronic diseases (P = .008), tacrolimus alone (P < .001), tacrolimus plus everolimus (P < .001), and often medication changes (P < .001). A statistically significant correlation was found between the IMAS score and whether the patients had HCC (P < .001) and frequently changing immunosuppressive drugs (P = .023). CONCLUSION This study showed that patients with frequent drug changes or non-HCC etiology had better adherence to immunosuppressive drug use.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey; Department of Public Health, Inonu University Faculty of Medicine, Malatya, Turkey; Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Turkey.
| | - Murat Tamer
- Department of Surgical Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Serdar Saritas
- Department of Surgical Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Ozlem Unal
- Department of Internal Medicine Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Musap Akyuz
- Department of Surgical Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Selver Unsal
- Department of Nursing Service, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Zeynep Kucukakcali
- Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Ertugrul Karabulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sertac Usta
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sezai Yilmaz
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
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Akbulut S, Kucukakcali Z, Saritas H, Bozkir C, Tamer M, Akyuz M, Bagci N, Unsal S, Akbulut MS, Sahin TT, Colak C, Yilmaz S. Effect of the COVID-19 Pandemic on the Psychological Health of Patients Who Underwent Liver Transplantation Due to Hepatocellular Carcinoma. Diagnostics (Basel) 2023; 13:diagnostics13081410. [PMID: 37189511 DOI: 10.3390/diagnostics13081410] [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: 02/19/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The primary aim of this study was to compare liver transplant (LT) recipients with and without hepatocellular carcinoma (HCC) in terms of COVID-19-related depression, anxiety, and stress. METHOD A total of 504 LT recipients with (HCC group; n = 252) and without HCC (non-HCC group; n = 252) were included in the present case-control study. Depression Anxiety Stress Scales (DASS-21) and Coronavirus Anxiety Scale (CAS) were used to evaluate the depression, stress, and anxiety levels of LT patients. DASS-21 total and CAS-SF scores were determined as the primary outcomes of the study. Poisson regression and negative binomial regression models were used to predict the DASS and CAS scores. The incidence rate ratio (IRR) was used as a coefficient. Both groups were also compared in terms of awareness of the COVID-19 vaccine. RESULTS Poisson regression and negative binomial regression analyses for DASS-21 total and CAS-SF scales showed that the negative binomial regression method was the appropriate model for both scales. According to this model, it was determined that the following independent variables increased the DASS-21 total score: non-HCC (IRR: 1.26; p = 0.031), female gender (IRR: 1.29; p = 0.036), presence of chronic disease (IRR: 1.65; p < 0.001), exposure to COVID-19 (IRR: 1.63; p < 0.001), and nonvaccination (IRR: 1.50; p = 0.002). On the other hand, it was determined that the following independent variables increased the CAS score: female gender (IRR:1.75; p = 0.014) and exposure to COVID-19 (IRR: 1.51; p = 0.048). Significant differences were found between the HCC and non-HCC groups in terms of median DASS-21 total (p < 0.001) and CAS-SF (p = 0.002) scores. Cronbach's alpha internal consistency coefficients of DASS-21 total and CAS-SF scales were calculated to be 0.823 and 0.783, respectively. CONCLUSION This study showed that the variables including patients without HCC, female gender, having a chronic disease, being exposed to COVID-19, and not being vaccinated against COVID-19 increased anxiety, depression, and stress. High internal consistency coefficients obtained from both scales indicate that these results are reliable.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
- Department of Public Health, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
- Department of Biostatistics, Bioinformatics and Medical Informatics, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
| | - Zeynep Kucukakcali
- Department of Biostatistics, Bioinformatics and Medical Informatics, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
| | - Hasan Saritas
- Department of Surgical Nursing, Siirt University Faculty of Health Science, 56100 Siirt, Turkey
| | - Cigdem Bozkir
- Department of Nutrition and Dietetics, Inonu University Faculty of Health Science, 44280 Malatya, Turkey
| | - Murat Tamer
- Department of Surgical Nursing, Inonu University Faculty of Nursing, 44280 Malatya, Turkey
| | - Musap Akyuz
- Department of Surgical Nursing, Inonu University Faculty of Nursing, 44280 Malatya, Turkey
| | - Nazlican Bagci
- Department of Surgical Nursing, Inonu University Faculty of Nursing, 44280 Malatya, Turkey
| | - Selver Unsal
- Department of Nursing Service, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
| | | | - Tevfik Tolga Sahin
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
| | - Cemil Colak
- Department of Biostatistics, Bioinformatics and Medical Informatics, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
| | - Sezai Yilmaz
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
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Akbulut S, Barut B, Garzali IU, Sarici KB, Tamer M, Unsal S, Karabulut E, Baskiran A, Bayindir Y, Yilmaz S. Effect of Pre-Transplant COVID-19 Exposure On Post-Liver Transplant Clinical Outcomes. Transplant Proc 2023:S0041-1345(23)00089-1. [PMID: 36973149 PMCID: PMC9968604 DOI: 10.1016/j.transproceed.2023.01.024] [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: 10/14/2022] [Revised: 11/21/2022] [Accepted: 01/04/2023] [Indexed: 03/01/2023]
Abstract
Background and Aim COVID-19 has led to an unprecedented global health crisis. This situation caused an immediate reduction in solid organ transplantation activity. The aim of this study was to present the follow-up results of patients with chronic liver disease (CLD) who underwent LT after a previous history of COVID-19 infection. Methods Socio-demographic characteristics and clinicopathological data of 474 patients who underwent LT at Inonu University Liver Transplant Institute between March 11, 2020, and March 17, 2022, were prospectively recorded and analyzed retrospectively. Among these, the data of 35 patients with CLD who were found to be exposed to COVID-19 infection in the pre-LT period were analyzed for this study. Results The median BMI, Child, and MELD/PELD scores of the 35 patients were calculated as 25.1 kg/m2 (IQR: 7.4), 9 (IQR: 4) and 16 (IQR: 10), respectively. Graft rejection occurred in four patients at a median of 25 days post-transplant. Five patients underwent retransplantation at median 25 days post-transplant. The most common cause of retransplantation is early hepatic artery thrombosis. There were 5 deaths during postoperative follow up. Mortality developed in 5 (14.3%) of the patients who were exposed to COVID-19 infection in the pre-transplant period, while mortality occurred in 56 (12.8%) of the patients who were not exposed to COVID-19 infection. There was no statistically significant difference in mortality between the groups (p=0.79). Conclusion The results of this study showed that exposure to COVID-19 before LT does not affect post-transplant patients and graft survival.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey.
| | - Bora Barut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | | | - Kemal Baris Sarici
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Murat Tamer
- Department of Surgical Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Selver Unsal
- Department of Nursing Service, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Ertugrul Karabulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Adil Baskiran
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Yasar Bayindir
- and Department of Infectious Diseases and Clinical Microbiology, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sezai Yilmaz
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
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Akbulut S, Tamer M, Kucukakcali Z, Akyuz M, Saritas H, Bagci N, Ciftci F, Akbulut MS, Karabulut E, Yilmaz S. Factors affecting anxiety, depression, and stress among patients with hepatocellular carcinoma during COVID-19 pandemic. Eur Rev Med Pharmacol Sci 2023; 27:704-712. [PMID: 36734727 DOI: 10.26355/eurrev_202301_31073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Patients with chronic disease whose treatments are limited may experience depression, anxiety, and stress-related symptoms, as well as an increase in the levels of these conditions. This study aims to determine the factors affecting the depression, stress, and anxiety levels of hepatocellular carcinoma (HCC) patients due to the fear of COVID-19 exposure. PATIENTS AND METHODS 118 patients with advanced HCC treated with non-transplant treatment options or on the waiting list due to the lack of a donor were enrolled. To evaluate the stress, depression, and anxiety levels during the COVID-19 process, Depression Anxiety Stress Scales (DASS-21) and the Coronavirus Anxiety Scale (CAS) were administered to 118 patients through a face-to-face interview. Sociodemographic and clinical characteristics were recorded, and the primary endpoint measure was the total score of DASS. In addition, the multilayer perceptron (MLP) model was constructed to predict the scores of the DASS-21 total. RESULTS There were significant differences between DASS depression (p=0.010; p=0.030) DASS anxiety (p=0.010; p=0.010) and DASS total (p=0.046; p=0.023) scores in terms of gender and protective effect of the vaccine. Also, a significant difference between gender for the CAS scale was determined (p=0.044). The median score of the DASS total in the COVID-19 group was higher than in the non-COVID-19 group; however, the increase was not significant. MLP model revealed that chronic disease, gender, age, place of residence, smoking, type of vaccine, and COVID-19 exposure were the most important predictors for the DASS total. CONCLUSIONS Chronic disease, gender, and age were prominent factors in predicting the DASS-21 total score in HCC patients. Therefore, the crucial factors were clinically considered for managing depression, stress, and anxiety in HCC patients.
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Affiliation(s)
- S Akbulut
- Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey.
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Kasgoz A, Tamer M, Kocyigit C, Durmus A. Effect of the comonomer content on the solid-state mechanical and viscoelastic properties of poly(propylene- co
-1-butene) films. J Appl Polym Sci 2018. [DOI: 10.1002/app.46350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Alper Kasgoz
- Department of Chemical Engineering, Faculty of Engineering; Istanbul University; 34320 Avcılar Istanbul Turkey
- Polymer Engineering Department, Faculty of Engineering; Yalova University; 77100 Yalova Turkey
| | - Murat Tamer
- Department of Chemical Engineering, Faculty of Engineering; Istanbul University; 34320 Avcılar Istanbul Turkey
- Department of Chemical Engineering, Faculty of Engineering; Anadolu University; 26555 Eskişehir Turkey
| | - Ciler Kocyigit
- Department of Chemical Engineering, Faculty of Engineering; Istanbul University; 34320 Avcılar Istanbul Turkey
| | - Ali Durmus
- Department of Chemical Engineering, Faculty of Engineering; Istanbul University; 34320 Avcılar Istanbul Turkey
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Gultekin A, Pashaei P, Khan Z, Ozturk M, Tamer M, Bas Y. DFT and X-RAY study of structural, electronic, elastic and optical properties in Be 1–XZn XS alloys depending on vegard’s law. Int J CMEM 2015. [DOI: 10.2495/cmem-v3-n4-340-349] [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: 11/09/2022] Open
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Pereira B, Tamer M, Khalifa K, Mokbel K. General practitioners' greater choice for sentinel node biopsy than patients in the UK. Curr Med Res Opin 2004; 20:417. [PMID: 15025851 DOI: 10.1185/030079904125003099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
BACKGROUND Recent studies have demonstrated that the sentinel node biopsy (SNB), which utilises a simple principle, is a reliable and minimally invasive method for determining the status of the regional lymph nodes in patients with clinically node-negative breast cancer. The technique is increasingly being used in the management of patients with early breast cancer despite the lack of long-term data from randomised controlled trials which are currently in progress. However, increasing numbers of breast cancer patients are specifically requesting SNB in order to avoid axillary nodal clearance (ANC) if the sentinel node is negative for malignancy. The aim of this study is to determine the proportion of female patients attending a breast unit who would choose the SNB in preference to ANC. METHODS A detailed questionnaire, based on a utility analysis and containing clear and precise information on arm morbidity associated with ANC (1 in 10) versus a potential reduction in the 5-year-survival rate with SNB (1 in 1000) was distributed to 200 female patients attending the Princess Grace Hospital Breast Unit (London, UK) during January 2003. The questionnaire consisted of two possible treatment scenarios (ANC or SNB) for early-stage breast cancer with their associated risks and benefits, and participants were asked to choose one of the two options. RESULTS A total of 200 completed questionnaires were received. Out of the 200 women, 99 (49.5%) chose the SNB option and 101 (50.5%) chose the ANC option. There is no significant relationship between the option made with a woman's age (mean age: 53.4 vs 54), family history of breast cancer (p = 0.118), personal history of breast cancer (p = 0.85), or employment status (p = 0.96). CONCLUSION This study demonstrates that a high level of acceptance exists among women for SNB as an alternative to ANC as the preferred treatment of early breast cancer, despite the risk involved. As this exciting technique continues to evolve and improve, it is hoped that more women will be given the choice to opt for this treatment and that eventually SNB may completely replace ANC as the standard treatment for early breast cancer.
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Affiliation(s)
- M Asaad
- The Princess Grace Hospital, London, UK
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Massad M, Srouji M, Awdeh A, Slim M, Tamer M, Tabbara M. Neonatal appendicitis: case report and a revised review of the English literature. Z Kinderchir 1986; 41:241-3. [PMID: 3765890 DOI: 10.1055/s-2008-1043351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A case of perforated neonatal appendicitis in a surviving premature infant is presented. An up-dated review of the English literature on this subject is included. Of 111 cases with adequate documentation, 29 neonates had the inflamed appendix located within the inguinal hernial sac and survived after operation. In contrast only 24 (29%) of the remaining 82 patients with intra-abdominal acute appendicitis survived. The operative mortality rate in this review since 1901 with and without appendiceal perforation was 61% and 41% respectively. The diagnosis of acute appendicitis since 1976 was made at laparotomy in all patients except one, whereas it was made at necropsy in 57% of the cases of abdominal appendicitis that were reported previously.
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