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Öğe Tocilizumab as a first line biologic agent in rheumatoid arthritis patients with inadequate response to disease-modifying antirheumatic drugs: real life experience from the TReasure Registry(Clinical & Exper Rheumatology, 2024) Karadag, O.; Farisogullari, B.; Yagiz, B.; Erden, A.; Ademoglu, Z.; Kimyon, G.; Bilge, N. S.Objective To evaluate the retention rate, treatment response and safety of tocilizumab (TCZ) as first-line biologic treatment in rheumatoid arthritis (RA) patients with inadequate response to disease-modifying anti-rheumatic drugs (DMARD-IR). Methods The TReasure Registry is a multicentre, web-based registry of RA and spondyloarthritis patients across Turkey. DMARD-IR RA patients who received TCZ as first-line biologic treatment were included in this registry for efficacy and safety. Demographic and clinical data, treatments, and adverse events were collected. Drug retention rate was estimated using Kaplan-Meier analysis. Results Among 642 RA patients who ever used TCZ, 258 DMARD-IR RA patients (male/female: 18.2%/81.8%, mean age, 54.41 years) received TCZ as first-line biologic. The median disease duration was 97 (range, 60-179) months and the median TCZ treatment duration was 15 (range, 6-28) months. At the 6th and 12th months of TCZ treatment, the decrease in disease activity scores from baseline was significant. The Kaplan-Meier analysis revealed the retention rate of TCZ at the 12th, 24th, 36th, and 60th months as 81.1%, 73.8%, 66.2%, and 63.6%, respectively. Fifty-seven (22%) patients discontinued TCZ; the main reason being primary or secondary inefficacy (n=29). Conclusion Over 80% drug retention rate at 12th month of TCZ treatment in this real-world study was concordant with previously conducted TCZ clinical studies. Significant reductions not only in the disease activity score-28 but also in the simplified disease activity index (SDAI) and clinical disease activity index (CDAI) scores, along with health assessment questionnaire (HAQ) scores, supported the impact of TCZ in RA management with a good safety profile.Öğe A new marker of coronary collateral flow in patients presenting with acute myocardial infarction(Verduci Publisher, 2023) Demirkiran, A.; Aydin, C.; Yilmaz, A.; Celikkol, A.; Alpsoy, S.; Donbaloglu, O.; Topcu, 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.Öğe The importance of GRACE risk score in the development of high-grade atrioventricular conduction blocks after non-st-segment elevation myocardial infarction(Verduci Publisher, 2023) Uyan, U.; Aydin, C.; Gul, I.OBJECTIVE: The development of high-grade atrioventricular block (HG-AVB) after acute coronary syndrome (ACS) increases morbidity and mortality rates. A significant por-tion of HG-AVBs resolve spontaneously after re-vascularization. We aimed to evaluate the pow-er of the GRACE scoring system in predicting the development of HG-AVB and its importance in determining the need for cardiac pacemakers. PATIENTS AND METHODS: Patients who ap-plied to our center between July 2020 and Feb-ruary 2023 were included in the study. 600 pa-tients [340 (56.6%) male, mean age 65.4 +/- 13.6] without ST-segment elevation (NSTEMI) and who underwent revascularization were evalu-ated within the scope of the study. The heart rhythms of the patients were evaluated from the electrocardiograms (ECG) at admission. Pa-tients with HG-AVB and other patients were di-vided into two groups. The heart rhythms of these patients were evaluated during their hos-pitalization. Then, HG-AVB patients were also divided into two groups (with and without PPM need). Demographic, laboratory, angiographic, and echocardiographic characteristics of these patients were evaluated. RESULTS: Morbidity and mortality were high-er in the HG-AVB group. These patients had lon-ger intensive care and hospital stays. The mean age, creatinine value, GRACE score (GS), to-tal cholesterol (TC), and RCA lesion rates were higher in the HG-AVB group; hemoglobin level was found to be lower. As a result of regression analysis, RCA lesion, hemoglobin value, GRACE score, creatinine, and TC levels were predic-tors of HG-AVB development. In determining the need for PPM, these variables were found to be effective. ROC analysis was performed for GS, which predicted the development of HG-AVB, and the cut-off value was found to be 185.5. CONCLUSIONS: The development of HG-AVB after NSTEMI is an important health problem. By detecting these patients and those who may need PPM beforehand, various complications can be prevented, and the length of stay in the hospital can be shortened. Calculation of GS is an important parameter that can be used to pre-dict the development and course of HG-AVB.Öğe Investigation of the effectiveness of prone ventilation in patients followed up for acute respiratory distress syndrome in the intensive care unit(Verduci Publisher, 2023) Yildirim, I.; Aydin, C.; Gultekin, A.; Inal, M. T.; Memis, D.OBJECTIVE: Prone positioning has been found to improve oxygenation in most patients with acute respiratory distress syndrome (ARDS). The study aimed to investigate the effectiveness of the prone position in patients with ARDS.PATIENTS AND METHODS: The prone position is one of the ventilator techniques included in recent guidelines for acute respiratory distress syndrome. This study was a retrospective evaluation of the records of 100 ARDS patients who were administered prone position mechanical ventilation in our intensive care unit. All patients were placed in the prone position for a total of 12 hours per day at 4-hour intervals (supine-prone) while admitted to the intensive care unit. RESULTS: This study included 100 participants. These patients were divided into two groups as survivors [(n=38, 16 females, 22 males, median age: 60 (24-86)] and non -survivors [(n=62, 19 females, 43 males, median age: 64 (21-93)], according to their intensive care follow-ups. Acute physiology and chronic health evaluation (APACHE) II score, the sequential organ failure assessment score (SOFA), and in-flammation markers were statistically significantly higher in the non-survivor group. Between the two groups, there was no statistically signif-icant difference in terms of fundamental characteristics. In the sub-group evaluation of the subjects in patients with ARDS with and with-out novel coronavirus disease 2019 (COVID-19) groups, the patients in the COVID-19 (+) group were older, had shorter hospital stays, had higher APACHE II and SOFA scores, and higher rates of cardiovascular disease and sepsis.CONCLUSIONS: Applying prone-position mechanical ventilation in the cohorts of our patients with ARDS resulted in a demonstrable significant improvement in the oxygenation levels of our patients.Öğe Awareness or neglecting the diagnosis of cow milk protein allergy in the neonatal period(H E C Press, Healthy Eating Club Pty Ltd, 2023) Vardar, Gonca; Ozdil, Mine; Tufekci, SinanBackground and Objectives: Cow milk protein allergy (CMPA) can mimic surgical disease, gastroenteritis, sepsis, and necrotizing enterocolitis in the neonatal period. For this reason, we aimed to evaluate the clinical features, differential diagnosis, and treatment methods of neonates with CMPA. Methods and Study Design: The charts of twenty-six breastfed full-term and preterm newborns presenting with CMPA between October 2018 and February 2021 were retrospectively reviewed. The clinical symptoms, laboratory findings, and methods used in diagnosis and treatment were analyzed. Results: CMPA was diagnosed in preterm infants 50% (n=13) at the same rate as in full-term infants 50% (n=13) between 32 to 38 weeks corrected age (median 36 weeks). Among patients with CMPA, 69.2% (n=18) had blood in the stool at the onset. Cow's Milk-related Symptom Score score was found to be significantly higher prior to diagnosis vs. after treatment with the cow milk protein-free mom's milk diet [12(11-13) vs. 4(3-5), p<0.001]. Seventy-two hours after the commencement of the mothers' elimination diet, macroscopic blood in stool disappeared in all patients except one patient. Oral food challenge (OFC) for the diagnosis of CMPA was carried out on all (n=26) neonates. Eosinophilia was seen in 46.2% of patients (n=12). The methemoglobin concentration was 1.1 to 1.5% (median 1.3%). Conclusions: CMPA should be kept in mind for well-appearing preterm and full-term infants suspected of necrotizing enterocolitis and gastroenteritis, respectively, presenting with bloody stool and eosinophilia. The use of OFC can be implemented since neonates were very well monitored in the neonatal intensive care unit. Treatment is possible by continuing breastfeeding.Öğe The usefulness of tumor necrosis factor-like weak inducer of apoptosis in patients with acute ST-elevation myocardial infarction(Verduci Publisher, 2023) Celikkol, A.; Demirkiran, A.; Aydin, C.OBJECTIVE: We aimed to determine the utility of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) for the early diagnosis and prognosis of acute ST-elevation myocardial infarction (STEMI). PATIENTS AND METHODS: Patients presented with STEMI arrived at the hospital within 45 minutes after the onset of chest pain were included in this study. Blood samples for TWEAK, high-sensitivity C-reactive protein (hs-CRP), creatine kinase MB isoenzyme (CK-MB), and high-sensitivity cardiac troponin T (hs-TnT) levels were obtained at the time of arrival at the hospital. Subsequent samples were drawn at 4 h after primary percutaneous coronary intervention. RESULTS: The study cohort comprised patients with confirmed STEMI between January 2022 and September 2022, for a total of 45 enrolled STEMI patients. Plasma TWEAK levels were markedly elevated at hospital arrival, followed by a decrease at 4 hours after successful primary percutaneous coronary revascularization (PPCI). High-sensitive troponin T (HsTropT), CK-MB, and CRP were found within normal limits at the hospital arrival. Conversely, increased levels of CRP, CKMB, and hs-TropT were observed at 4 hours after PPCI. CONCLUSIONS: Plasma TWEAK levels were elevated earlier in the acute phase and decreased earlier after PPCI than other classic myocardial biomarkers.Öğe Quadratus lumborum and erector spinae plane blocks are effective for analgesia in laparoscopic hysterectomy: a randomized controlled trial(Verduci Publisher, 2023) Baran, O.OBJECTIVE: Total laparoscopic hysterectomy is the preferred technique for hysterectomy in obstetrics and gynecology clinics. However, patients who undergo these procedures often experience acute pain that may progress to chronic pain over time. Erector spinae plane block (ESPB) and anterior quadratus lumborum block (QLB) under ultrasound guidance are reported to be effective as part of the multi-modal analgesia protocol. Therefore, this study aimed to compare the effectiveness of erector spinae plane block and anterior quadratus lumborum block in reducing postoperative opioid consumption and pain scores in patients undergoing total laparoscopic hysterectomy. PATIENTS AND METHODS: Eighty-one patients who met the inclusion criteria were divided into three groups: the erector spinae plane block, anterior quadratus lumborum block, and control groups. All patients received general anesthesia and tramadol-based patient-controlled analgesia (PCA) during the postoperative period. Tramadol consumption and pain scores during the first 24 h were evaluated by a blinded researcher. Postoperative opioid consumption was the primary outcome of the study. RESULTS: Postoperative tramadol consumption was lower in the erector spinae plane block and quadratus lumborum block groups than that in the control group, with no significant differences observed between the two intervention -al groups. Postoperative pain scores were lower for at least 12 h in both block groups, with no significant differences observed between both groups. CONCLUSIONS: Erector spinae plane block and quadratus lumborum block improved post-operative pain management as part of the multi-modal analgesia protocol; however, erector spinae plane block may be preferable due to its rapid procedure time. The findings suggest that incorporating erector spinae plane block and quadratus lumborum block into multi-modal analgesia protocols for laparoscopic hysterectomy would have important implications for the development and standardization of pain management protocols.Öğe Plantar Dislocation of the Middle Cuneiform Bone With Medial Cuneiform Subluxation: A Case Report(Springernature, 2023) Can, Erdem; Dincel, Yasar M.The middle cuneiform is the keystone of the transverse arch and is located between the medial cuneiform and lateral cuneiforms. Isolated middle cuneiform plantar dislocations are rare injuries due to their shape and ligamentous structural connections. A 20-year-old female patient was admitted to the emergency service of another clinic after a 70 kg iron tractor piece fell on her foot 20 days before she was referred to our clinic. Conservative treatment with a short leg circular cast was applied, considering that there was a fracture in the cuneiforms on X-ray imaging. The patient, who was re-evaluated at the second-week follow-up, was referred to our hospital considering the complex injury of the cuneiforms. There was tenderness over the cuneiform in the physical examination. X-ray and computed tomography images of the patient revealed plantar dislocation of the middle cuneiform bone. with subluxation of the medial cuneiform. Open reduction and internal fixation were performed for the middle cuneiform. During the six-month follow-up, the patient had no complaints and was able to do routine work. No lucency or arthritic changes were observed in the X-ray at the 22-month control. Plantar middle cuneiform dislocations are rare and late diagnosis can lead to poor results. This case is presented to emphasize the importance of considering this rare injury and using advanced imaging studies when necessary, considering the mechanism of injury.Öğe Glans Diameter and Meatus Localization Are the Sole Predictors of Primary Distal Hypospadias Surgery Complications: A Multivariate Analysis of Single Surgeon Series(Cureus Inc, 2022) Akova, Fatih; Aydin, Emrah; Salabas, Emre; Bilgili, ZeynepIntroduction: Tubularized incised plate urethroplasty (TIPU) surgery is among the most successful techniques for distal hypospadias. Our objective was the investigation of complication rates and their predictors. Methods: Between 2010 and 2021, 150 patients with distal hypospadias were operated on consecutively by a single surgeon using the TIPU technique. The primary outcome was the complication rates including fistula, meatal stenosis, and glans dehiscence. Secondary outcomes were predictor factors of complications. Results: The average glans diameter was 13.9 +/- 0.10 mm and 57.0% of the patients had a glans diameter greater than 14 mm. Single-layer and double-layer urethroplasty were used in 55.3% (n = 83) and 44.7% (n = 67) of patients, respectively. Overall complication rate was 23.3% (n = 35), which included fistula (3.3%, n = 5), glans dehiscence (12.7%, n = 19), and meatal stenosis (8.6%, n = 13). Glandular meatus localization (OR = 58.8, p = 0.001) and smaller glans diameter (OR = 0.39, p = 0.001) were significant predictors in the multivariate analysis of overall complications. For fistula complications, only short operation time (OR = 0.83, p = 0.03) was found as a significant predictor. Glans width (<14 mm) was the only significant predictor of both glans dehiscence (OR = 3.4, p = 0.03) and stenosis (OR = 5.67, p = 0.013) complication. Conclusion: TIPU technique for distal hypospadias has notable success and acceptable complication rates. Dartos augmented single-layer urethral closure seems adequate for complication prevention. Preoperative assessment of the glans width and meatus site is advised to predict complication rates.Öğe Atorvastatin Improves the Propionic Acid- Induced Autism in Rats: The Roles of Sphingosine-1-Phosphate and Anti-inflammatory Action(Cureus Inc, 2023) Durankus, Ferit; Budak, Korkut; Albayrak, Yakup; Sever, Ibrahim H.; Ozkul, Bahattin; Uyanikgil, Yigit; Albayrak, NeslihanPurpose The aim of this study is to investigate the benefits of atorvastatin on the propionic acid-induced autism model via increasing sphingosine-1-phosphate and anti-inflammatory actions with imaging and brain tissue investigations. Materials and methods Twenty-five mg/kg/day/rat of propionic acid (PPA) was administered intraperitoneally to 20 male Wistar rats, and 10 male Wistar rats were fed orally. Study groups were designed as follows: Group 1: Control Group (orally fed control, n=10); Group 2 (PPA+saline, n=10); Group 3 (PPA+Atorvastatin, n=10). The brain biochemical and histopathology assessments and magnetic resonance (MR) imaging were conducted across groups in order to compare them. Results The PPA+Atorvastatin group was found to have significantly lower levels of brain malondialdehyde, IL -2 level, IL-17, tumor necrosis factor-alpha (TNF-??), and lactate compared to the PPA+saline group. The PPA+Atorvastatin group had higher levels of nerve growth factor and nuclear factor erythroid 2-related factor 2 (NRF-2) and sphingosine-1-phosphate. In histopathology assessments, the PPA+Atorvastatin group was found to have significantly higher neuronal counts of CA1 and CA2 in the hippocampus, and Purkinje cells in the cerebellum. Conclusions Current findings suggest that atorvastatin increases sphingosine-1-phosphate levels and decreases inflammatory actions which characterize the autism rodent model implemented in this study. These preliminary results have to be confirmed by further experimental and clinical studies.Öğe Heterotic grouping of wheat hybrids based on general and specific combining ability from line x tester analysis(Peerj Inc, 2024) Deviren, Birol; Bilgin, Oguz; Kutlu, ImrenThe most important step in plant breeding is the correct selection of parents, and it would be wise to use heterotic groups for this. The purpose of this study is to analyse yield and its components as well as genetic diversity in line x tester wheat populations. It also seeks to present a coherent framework for the isolation of early superior families and the development of heterotic groups in bread wheat. F1 1 and F2 2 generations of 51 genotypes, including 36 combinations between 12 lines and three testers and 15 parents, were evaluated for yield and its components in a three-replication experiment according to the randomized block design. Line x tester analysis of variance, general and specific combining abilities, heterosis, heterobeltiosis and inbreeding depression were calculated. Heterotic groups created based on general and specific combining abilities were compared with each other. The results showed that there was sufficient genetic variation in the population and that further genetic calculations could be made. The selections made based on general and specific combining abilities, heterosis values and average performance of genotypes without heterotic grouping indicated different genotypes for each feature. The creation of heterotic groups made it possible to select genotypes that were superior in terms of all the criteria listed. It was concluded that heterotic groups created based on specific combining abilities may be more useful for breeding studies.Öğe A Retrospective Analysis of the Neurological Evaluation of Cases With Neonatal Hypoglycemia(Springernature, 2022) Gurbuz, Gurkan; Gur, Selen; Tufekci, Sinan; Halis, HulyaIntroduction Hypoglycemia is a common treatable metabolic disorder in the neonatal period. It can cause several neurological problems if untreated. In this study, the neurological outcomes of cases with hypoglycemia in the neonatal period were examined retrospectively, and the study aimed to determine risk factors and prognostic factors. Methods In this retrospective study, cases were followed in the pediatric neurology outpatient clinic between 2019 and 2022, and patients with a history of hypoglycemia in the neonatal period were enrolled and analyzed retrospectively. The laboratory studies and clinical findings of the cases were obtained from follow-up records from the pediatric neurology outpatient clinic retrospectively. Physical examination findings, hypoglycemia levels, and symptoms of hypoglycemia, if any, were obtained retrospectively from the discharge files of the patients. Results A total of 70 cases were included in the study. Twenty-eight were girls and 42 were boys. Forty of the cases were preterm. The number of asymptomatic cases was 38, and the number of symptomatic cases was 32. There was no significant difference in regard to the mean lowest serum glucose levels between symptomatic and asymptomatic cases. Thirty-three of the patients had neurological problems such as neuromotor developmental delay, cortical blindness, and epilepsy. Abnormal magnetic resonance imaging (MRI) findings were detected in 30 of the symptomatic cases and eight of the asymptomatic cases. The rate of neurological sequelae in asymptomatic cases was found to be significantly lower than in symptomatic cases. Conclusions Patients who have a symptomatic hypoglycemic period, maternal gestational problems, and abnormal MRI carry a high risk for neurological sequelae, and these findings indicate poor prognosis.Öğe Effect of Educational Training to Promote Awareness Regarding Corneal Donation: Comparison of Students Enrolled in Health Care Versus Non-Health Care Curriculums at a Turkish University(Baskent Univ, 2023) Yildiz, Tulin; Onler, Ebru; Avcu, CaglaObjectives: The aim of this study was to determine the awareness of university students enrolled in health care versus nonhealthcare curriculums, to study knowledge on corneal donation before and after education. Materials and Methods: This cross-sectional and descriptive study was conducted at a university for 5 months, from January 2020 to May 2020. A team of researchers reviewed the literature and prepared a questionnaire consisting of 22 points of information, to assess the participants' knowledge and perceptions of corneal transplant. The questionnaire was used for face-to-face interviews conducted with the participants at 3 time points: before the educational training, immediately after the educational training, and 4 to 6 weeks after the educational training. The research sample consisted of 276 students. Data were analyzed with SPSS software (version 22.0). This study complies with the Helsinki Congress and Istanbul Declaration. Results: Although the average score before the educational training was 10.93, we observed an average score of 20.79 points immediately after the educational training and an average score of 19.65 points 4 to 6 weeks after the educational training, which demonstrated a significant increase in students' knowledge level. The mean score achieved by the nursing students from the questionnaire before and after the educational training was found to be significantly higher than the mean score of the physical education and sports students. The willingness of nursing students to donate their own cornea was significantly higher before and immediately after education, and the willingness to donate a relative's cornea was found to be significantly higher just before education. Conclusions: Greater awareness of corneal donation was associated with higher levels of education, suggesting that social awareness can increase when all health care professionals are informed about corneal donation via online platforms or face-to-face methods.Öğe Evaluation of the Quality of Life and the Demographic and Clinical Characteristics of Patients With Pemphigus With Oral Mucosal involvement: A Multicenter Observational Study(Mattioli 1885, 2024) Polat, Asude Kara; Mulayim, Mehmet Kamil; Gur, Tugba Falay; Acar, Ayda; Bozca, Burcin Cansu; Ceylan, Can; Kilinc, FadimeIntroduction: Pemphigus vulgaris (PV) is an autoimmune disease primarily affecting the oral mucosa. Objectives: This study aimed to determine the demographic, clinical and treatment characteristics of PV patients with oral mucosal involvement and to assess the impact on their quality of life. Methods: We conducted a prospective observational study among 106 patients diagnosed with PV and presenting oral mucosal involvement. Demographic data, clinical and treatment characteristics, and quality of life questionnaires were recorded. Results: The study included 106 patients, 55 (51.89%) were male and there was a predominance of the mucocutaneous subtype in 83 individuals (78.38%). Oral mucosa was the initial site of manifestation in 44 patients (41.51%). Bilateral buccal mucosa was the most frequently affected site. The predominant symptom reported was a burning sensation, noted in 91 patients (85.85%). Oral mucosal examination revealed erosions in 85.85% of the patients. Systemic steroids were the most commonly administered treatment, and rituximab was used in 18 patients (16.98%). A positive and significant correlation was found between pemphigus severity and Oral Health Impact Profile-14, Dermatology Life Quality Index and Dermatological Quality of Life Scale scores (P < 0.05). The presence of superficial ulcers, flaccid bullae, lesion diameter >= 1 cm, and >10 lesions were factors that markedly diminished quality of life. Complete response to treatment was noted in all patients administered rituximab. Conclusions: The most common area of involvement was bilateral buccal mucosa, and the severity of PV closely correlated with a decline in quality of life measures. These results highlight the need for careful clinical oversight of PV, taking into account its effects on patients quality of life.Öğe Safety and Efficacy of Live Retrograde Intrarenal Surgery in Patients with Kindey Stone: Outcomes from a Boutique Course Series Which Complies with the Live Surgery Event Policies(Iniestares, S.A., 2023) Ozman, Oktay; Citgez, Sinharib; Basatac, Cem; Akguel, Haci Murat; Kalender, Goektug; Yazici, Cenk Murat; Tanidir, YiloerenBackground: Live surgery events (LSEs) are frequently organized for sharing the surgical experiences with surgeons at the beginning of their learning curves. The aim of this study was to investigate whether the outcomes and complication rates of patients underwent retrograde intrarenal surgery (RIRS) at LSEs are comparable with regular cases. Methods: Ten courses were organized during 2017-2022. Data of 32 patients who operated in the LSEs were 1:3 matched (for stone burden and surgeon) with the data of patients who underwent regular RIRS within the course periods at the same centers (n = 96). All courses took place in concordance with the latest LSE policies. The primary outcomes were stone-free and complication rates. Fluoroscopy and operation times were the secondary outcomes. Results: Stone-free rates of the groups were similar (84% in LSE and 79% in control group; p = 0.520). Similarly, there were no differences in complication rates (p = 0.428) and fluoroscopy time (p = 0.477). Duration of the LSE cases (82.24 +/- 31.12 min) was slightly but insignificantly longer than regular cases (73.77 +/- 20.89 min, p = 0.092). Moreover, guest surgeons tend to have longer operation time with statistically insignificant prolongation (74.92 +/- 30.43 min for host, 89.52 +/- 28.34 min for guest surgeons, p = 0.064). Conclusions: RIRS can be performed without jeopardizing operation efficiency and patient safety in LSEs. If surgeon is not familiar with operating room set-up or staff, live surgery must be performed by host surgeon to avoid extended operating time.Öğe Does hot pack application change the morphology of the median and ulnar nerves?(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2023) Yaman, Fatima; Leblebicier, Merve Akdeniz; Ozlu, Aysun; Cihan, Emine; Ozkaya, Dilan BulutObjectives: This study aims to investigate the effect of the hot pack application on the morphology of healthy median and ulnar nerves. Patients and methods: Between August 2021 and September 2022, a total of 54 healthy volunteers (17 males, 37 females; mean age: 31.9 +/- 9.4 years; range, 21 to 63 years) were included in the study. The cross-sectional area (CSA) and depth of the right median and ulnar nerve were measured using ultrasonography before and after 20-min hot pack application. The right median nerve CSA and depth from the level of the scaphoid bone (at the level of the carpal tunnel) and from the mid- forearm were also measured. The right ulnar nerve CSA and depth from the level of the hook of hamate and the mid-forearm were evaluated. The depth measurements between the skin and the outer hyperechoic border of the nerve were performed. Results: After the hot pack application, there was an increase in both the median nerve CSA at the carpal tunnel (from 0.06 +/- 0.01 to 0.09 +/- 0.02 cm(2)) and forearm (from 0.06 +/- 0.02 to 0.09 +/- 0.02 cm(2)) levels (p<0.001) and the ulnar nerve CSA at the hook of hamate (from 0.04 +/- 0.03 to 0.06 +/- 0.01 cm(2)) and forearm (0.05 +/- 0.01 to 0.08 +/- 0.02 cm(2)) levels (p<0.001). No statistically significant difference was observed between the pre- and post-application depth measurements (p>0.05). Conclusion: Our study results show that the hot pack application leads to acute swelling of the median and ulnar nerves. In future studies, the relationship between morphological changes in healthy and pathological nerves and electrodiagnostic findings should be investigated.Öğe Pain types and risk factors in post-COVID-19(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2024) Ketenci, Aysegul; Zure, Mert; Akpinar, Fatma Merih; Ozdemir, Yelda Soluk; Balbaloglu, Oezlem; Akaltun, Mazlum Serdar; Erden, EnderObjectives: This study aims to accurately evaluate pain lasting longer than three months and falls under the category of chronic pain and to determine the risk factors to follow up and treat properly and to develop appropriate diagnostic and treatment algorithms. Patients and methods: Between March 2021 and December 2021, a total of 437 patients (162 males, 275 females; mean age: 44 +/- 14.6 years; range, 12 to 82 years) who were referred to the participating centers due to pain complaints and were diagnosed with post-COVID-19 condition according to the criteria defined by the World Health Organization (WHO) were included in the study. The patients were divided into three groups as nociceptive pain, neuropathic pain, and central sensitization, based on the physician's clinical evaluation and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Central Sensitization Inventory scores. Results: The most common diagnosis was nociceptive pain followed by central sensitization. Patients with nociceptive pain had less pain. It was found that not exercising regularly, having a chronic disease and being a woman were risk factors for central sensitization, having thyroid disease before COVID-19, and defining the current pain as very severe were risk factors for neuropathic pain. Conclusion: In the evaluation of post-COVID-19 pain, neuropathic pain and central sensitization should be also considered in addition to nociceptive pain and the severity of pain, systemic diseases and physical activity should be questioned.Öğe An unusual clinical presentation of nontraumatic myositis ossificans: Leg length discrepancy(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2024) Sirin, Akif; Sarifakioglu, Banu; Ustaoemer, Kuebra; Yilmaz, ErtanFunctional leg length discrepancy results from soft tissue tightness or weakness across any joint in the lower extremity or spine. Herein, we present a 23-year-old female patient with leg length discrepancy due to a nontraumatic myositis ossificans (MO). Interpretation of the imaging findings is quite decisive in diagnosing soft tissue pathologies. It is particularly valid for MO to differentiate from other malignant or infectious lesions. There is no consensus on the treatment of nontraumatic MO. Although there are studies stating the contrary, surgical interventions should be considered as second option for patients who failed with nonsurgical treatments such as physical therapy.Öğe Fluid-based wearable sensors: a turning point in personalized healthcare(Tubitak Scientific & Technological Research Council Turkey, 2023) Vural, Berin; Uludag, Inci; Ince, Bahar; Ozyurt, Canan; Ozturk, Funda; Sezginturk, Mustafa KemalNowadays, it has become very popular to develop wearable devices that can monitor biomarkers to analyze the health status of the human body more comprehensively and accurately. Wearable sensors, specially designed for home care services, show great promise with their ease of use, especially during pandemic periods. Scientists have conducted many innovative studies on new wearable sensors that can noninvasively and simultaneously monitor biochemical indicators in body fluids for disease prediction, diagnosis, and management. Using noninvasive electrochemical sensors, biomarkers can be detected in tears, saliva, perspiration, and skin interstitial fluid (ISF). In this review, biofluids used for noninvasive wearable sensor detection under four main headings, saliva, sweat, tears, and ISF-based wearable sensors, were examined in detail. This report analyzes nearly 50 recent articles from 2017 to 2023. Based on current research, this review also discusses the evolution of wearable sensors, potential implementation challenges, and future prospects.Öğe Investigation of the Effect of Farnesol on Biofilm Formation by Candida albicans and Candida parapsilosis Complex Isolates(Ankara Microbiology Soc, 2024) Erdal, Berna; Baylan, Bensu; Batar, Bahadir; Ozturk, Ali; Topcu, BirolThe incidence of infections caused by Candida species has significantly increased over the past three decades. Candida albicans is commonly recognized as the primary causative agent in cases of candidiasis; however, non-albicans Candida species, including Candida parapsilosis, are also frequently defined as pathogens. Treatment -resistant infections arise as a result of biofilm formation, which is one of the effective mechanisms in the pathogenesis of Candida infections. However, the mechanisms of action of farnesol, a quorum sensing (QS) system molecule, on biofilm formation by Candida species remain unclear. This study aimed to demonstrate the changes in the biofilm biomass of C.albicans and C.parapsilosis complex isolates in the presence of farnesol and reveal the expression of the EFG1 and BCR1 genes, which are believed to play a role in the production of QS molecules, using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) analysis. C.albicans (n= 91) and C.parapsilosis complex (n= 29) isolates obtained from different clinical samples were included in the study. The minimum inhibitory concentration (MIC) values of farnesol were determined using the broth microdilution method according to the M27 -A3 protocol of the Clinical and Laboratory Standards Institute (CLSI). The biofilm biomass of the isolates was examined without farnesol and at the MIC-0 and MIC-2 concentrations of farnesol. Changes in the expression of the biofilm-associated EFG1 and BCR1 genes were investigated using qRT-PCR. According to the results of the study, the MIC values of farnesol were detected in the range of 1-2 mM in 82.4% (n= 75) of the C.albicans isolates and in the range of 0.5-1 mM in 72.4% (n= 21) of the C.parapsilosis complex isolates. Of the C.albicans isolates, 27 (29.7%) exhibited a strong biofilm formation and 58 (63.7%) demonstrated a weaker biofilm formation, while these rates were 34.4% (n= 10) and 62.1% (n= 18), respectively, for the C.parapsilosis complex isolates. At the MIC-0 and MIC-2 concentrations, farnesol was observed to reduce biofilm biomass among C.albicans (n= 24, 88.9%) and C.parapsilosis complex (n= 8, 80.0%) isolates that formed strong biofilms and observed to increase biofilm biomass among those that formed weak biofilms [60.3% (n= 35) and 55.6% (n= 10), respectively]. On completion of the qRT-PCR analysis supporting the results of the biofilm experiment, it was determined that the expressions of the EFG1 and BCR1 genes decreased at the MIC-0 and MIC-2 concentrations of farnesol among the strong biofilm-forming C.albi- cans and C.parapsilosis complex isolates, but there was an increase in gene expressions among the weak biofilm-forming isolates. In addition to the antifungal effect of farnesol on Candida species, this study provided data on the efficacy of the MIC-0 and MIC-2 concentrations of farnesol against Candida biofilm biomass. Although our results suggest that farnesol can be used as an alternative agent to reduce biofilm formation in Candida infections, they need to be supported by further studies. Moreover, this research has significance as it represents the first study to determine the EFG1 and BCR1 gene expressions among C.parapsilosis complex isolates in the presence of farnesol.
