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Öğe Can Age at Diagnosis and Sex Improve the Performance of the American Thyroid Association Risk Stratification System for Prediction of Structural Persistent and Recurrent Disease in Patients With Differentiated Thyroid Carcinoma? A Multicenter Study(Elsevier B.V., 2022) Zuhur, Sayid Shafi; Ağgül, Hünkar; Çelik, M.; Avcı, U.; Erol, Selvinaz; Kılınç, F.; Altuntaş, Yüksel; Bilen, O.; Elbuken, G.; Topçu, B.Objective: Although the age at diagnosis has been suggested as a major determinant of disease-specific survival in the recent TNM staging system, it is not included in the recent American Thyroid Association (ATA) guidelines to estimate the risk of recurrence. Nevertheless, the effect of sex on differentiated thyroid carcinoma (DTC) recurrence is controversial. Therefore, this multicenter study was conducted to assess whether age at diagnosis and sex can improve the performance of the ATA 3-tiered risk stratification system in patients with DTC with at least 5 years of follow-up. Methods: In this study, the computer-recorded data of the patients diagnosed with DTC between January 1985 and January 2016 were analyzed. Only patients with proven structural persistent/recurrent disease were selected for comparisons. Results: This study consisted of 1691 patients (female, 1367) with DTC. In Kaplan-Meier analysis, disease-free survival (DFS) was markedly longer in females only in the ATA low-risk category (P = .045). Nevertheless, a markedly longer DFS was observed in patients aged <45 years in the ATA low- and intermediate-risk categories (P = .004 and P = .009, respectively), whereas in patients aged <55 years, DFS was markedly longer only in the ATA low-risk category (P < .001). In the Cox proportional hazards model, ages of ?45 and ?55 years at diagnosis and the ATA risk stratification system were all independent predictors of persistent/recurrent disease. Conclusion: Applying the age cutoff of 45 years in the ATA intermediate- and low-risk categories may identify patients at a higher risk of persistence/recurrence and may improve the performance of the ATA risk stratification system, whereas sex may improve the performance of only the ATA low-risk category. © 2021 AACEÖğe Evaluation of Falls and Fall Risk Factors in Multiple Sclerosis Patients(Wiley, 2020) Kurtuluş, N.; Ünal, Aysun; Gundogdu, Aslı Aksoy; Dilek, Filiz; Topçu, B.[No Abstract Available]Öğe Evaluation of the relationship between the frequency of attention deficit, hyperactivity disorder symptoms and nutritional habits in children(2024) Elvin, ÖD.; Aydan, ÇV.; Güzel, E.Ç.; Topçu, B.INTRODUCTION: Attention deficit and hyperactivity disorder (ADHD) is a common chronic neurodevelopment disorder characterised by inattention, hyperactivity and impulsivity at levels that are not compatible with age. ADHD is one of the high social and individual costs for the population of the country. In the present study, it was aimed to investigate the relationship between some sociodemographic characteristics, nutrition and sleep patterns, certain habits and various factors with ADHD in primary school children aged between 6 to 10 years. MATERIALS AND METHODS: In the study, a total of 600 children's parents were asked to fill in the Conners Parent Rating Scale - Short Form (CPRS-48), which consists of 48 questions. The questions in the scale are answered by the parents on a four-point Likert scale. The responses were scored as 0, 1, 2 and 3 for 'never', 'rarely', 'often' and 'always', respectively. It was accepted that the children who scored at least 18 for the behaviour problem subscale, at least five for the learning problem subscale, at least six for the aggression, hyperactivity subscale, and at least seven for the defying subscale were considered to be in the problematic category. In order to determine the eating habits of the children included in the study, their parents filled out the food consumption frequency form. Foods in the form of food consumption frequency are divided into two groups as healthy and unhealthy foods. Individuals were given scores between 0 and 6 according to the frequency of food consumption. The healthy food group and unhealthy food group scores were collected separately. RESULTS: Of the children included in the study, 312 (52%) were male, with a mean age of 8.24±1.30 (range: 6 10) years. The mean CPRS-48 score was 23.88±19.71. The Cronbach's Alpha value of the CPRS-48 scale, which consists of 48 questions in total, was obtained as 0.957. The mean CPRS-48 score was significantly higher in boys (p = 0.014), in those whose mothers smoked during pregnancy (p = 0.008), those who did not receive breast feeding at birth or those who received less than 2 months (p = 0.035), those who frequently skipped meals (p < 0.001), those who do not have breakfast regularly (p = 0.002), those who spend more than four hours a day using a tablet/computer (p = 0.007), those who watch television more than 2 hours a day (p = 0.003), those who do not have regular sleep (p = 0.012), those who sleep less than 8t hours a night (p = 0.031), those who do not spend quality time with their families at least 2 days a week (p = 0.002) and those who do not have a hobby or sport that they were constantly interested in (p = 0.007). CONCLUSION: The finding of the present study show that CPRS score in children is associated with some factors such as mother's habits in pregnancy, behaviours in having meals, daily habits and regular sleep. Although eating habits are a risk factor for ADHD, when the right eating habits are acquired, they can reduce the risk or symptoms of ADHD. However, more extensive and valid studies should be conducted to better explain this issue.Öğe A new marker of coronary collateral flow in patients presenting with acute myocardial infarction(NLM (Medline), 2023) Demirkıran, A.; Aydın, C.; Yılmaz, A.; Çelikkol, A.; Alpsoy, Ş.; Donbaloğlu, O.; Topçu, B.OBJECTIVE: Multimerin-2 is an adhesion substrate between pericytes and basal membranes during angiogenesis. The present study aimed to assess the relationship between serum Multimerin-2 and coronary collateral flow grade. PATIENTS AND METHODS: Between April 2022 and August 2022, 88 patients with subacute ST-elevation myocardial infarction were included in this study. The main inclusion criteria were patients who present 12-48 hours after symptom onset and aged between 18 and 90 years. The patients were divided into two groups according to the Rentrop classification: poor collateral group (Rentrop grade 0-1) and good collateral group (Rentrop grade 2-3). Biochemical and hematological parameters were measured before coronary angiography. RESULTS: Serum Multimerin-2 levels were found to be significantly different between the two groups, and levels were higher in the Rentrop 2-3 group than in the Rentrop 0-1 group (3,527.9 ± 1,194.2 pg/ml and 946.7 ± 249.1 pg/ml; p < 0.00). Receiver operating characteristic curve analysis indicated that the area under the curve was 0.918 (p = 0.001), and the best cut-off value of 849 pg/ml had a sensitivity of 90.1% and a specificity of 84.1% for predicting Rentrop grade 2-3 coronary flow. The number of patients with low left ventricular ejection fraction (LVEF) by echocardiography at 30 days was significantly higher in patients with poor collateralization. CONCLUSIONS: Multimerin-2 levels were found to be higher in patients with Rentrop grade 2-3 coronary flow than Rentrop grade 0-1 coronary flow after myocardial infarction. We detected a potential relationship between MMR-2 and good coronary collateral formation.
