Tıp Fakültesi
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Article Citation - WoS: 3Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?(ELSEVIER, 2023) Güzel, Tuncay; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, MuhammedBackground In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥75 years) than in younger (<75 years) patients. Methods This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically signifcant hematoma (CSH), pericardial efusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results The overall sample included 1923 patients (1419<75 years and 504 aged≥75 years). There was no diference between the groups in terms of cumulative events defned as primary outcome (3.5% vs. 4.4%, p=0.393). Infection related to device system was signifcantly higher in the≥75 age group (1.8% vs. 3.4%, p=0.034). There was no signifcant diference between the groups in terms of clinically signifcant hematoma and pneumothorax (0.7% vs. 0.4%, p=0.451, 1.4% vs. 1.0%, p=0.477, respectively). In multivariate model analysis, no association was found between age≥75 years and infection related to the device system. Conclusion Infection rates were relatively higher in the patient group aged≥75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.Article Citation - WoS: 3Citation - Scopus: 3Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?(Springer, 2023) Güzel, Tuncay; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, MuhammedBackground: In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥ 75 years) than in younger (< 75 years) patients. Methods: This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results: The overall sample included 1923 patients (1419 < 75 years and 504 aged ≥ 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the ≥ 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age ≥ 75 years and infection related to the device system. Conclusion: Infection rates were relatively higher in the patient group aged ≥ 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.Article Citation - WoS: 5Citation - Scopus: 5Comparison of Growth Factor Levels in Injectable Platelet-Rich Fibrin Obtained From Healthy Individuals and Patients With Chronic Periodontitis: a Pilot Study(BMC, 2024) Savas, Hasan Basri; Karci, BilgeBackground This study aimed to assess and compare the concentrations of growth factors, white blood cells (WBCs), and platelets in injectable platelet-rich fibrin (i-PRF) derived from people with healthy periodontal conditions and those with chronic periodontitis.Methods Venous blood samples were obtained from 30 patients diagnosed with chronic periodontitis (test group) and 30 participants with healthy periodontal conditions (control group). The i-PRF was then acquired from centrifuged blood. The growth factors (VEGF, IGF-1, TGF-beta 1, PDGF-BB and EGF) released from the i-PRF samples were compared between groups with ELISA testing. The amounts of WBCs and platelets were also compared.Results No significant differences in the concentrations of growth factors were found between the groups (the mean values for the control and test groups were, respectively: IGF: 38.82, 42.46; PDGF: 414.25, 466.28; VEGF: 375.69, 412.18; TGF-beta 1: 21.50, 26.21; EGF: 138.62, 154.82). The test group exhibited a significantly higher WBC count than the control group (8.80 vs. 6.60, respectively). However, the platelet count did not show a statistically significant difference between the groups (control group 242.0 vs. test group 262.50). No significant correlation was observed between WBC count and growth factor level in either group.Conclusions The growth factor levels in i-PRFs did not exhibit significant difference between the two groups. This suggests that the levels of these growth factors may be unaffected by the periodontal disease.Article Citation - WoS: 1Citation - Scopus: 1The distribution and the antimicrobial susceptibility features of microorganisms isolated from the burn wounds; a ten-year retrospective analysis(Oxford University Press, 2023) Özkaçmaz, Ayşe; Dicle, Yalçın; Bayram, Yasemin; Parlak, Mehmet; Akış, Feride; Çallı, İskanIn this study we aimed to evaluate the distribution features and antimicrobial susceptibility test results of the microorganisms isolated from the wounds of pediatric and adult burn patients. The culture and susceptibility test results of the microorganisms isolated from the wound swabs of the patients hospitalised in a tertiary burn care center in 10-years period, were retrospectively screened on the microbiology department databases. Their distribution of isolated microorganisms regarding species and susceptibility test results were compared with previous studies. A total of 367 microorganisms isolated from the burn wounds of 293 patients (13± 18.9 years, F/M: 0.93) (73 adult and 220 pediatric patients), were included in this study. A solitary agent was isolated in 239 (81.6%) patients, while two were isolated in 43 (14.7%) and three or more agents in 11 (3.8%). From these, 33% of the isolated microorganisms were gram positive cocci, 61% were gram negative bacteria and 6% were Candida spp. The most common isolated microorganisms were Staphylococcus aureus (18.5%), Pseudomonas spp. (16.9) and Escherichia coli (%11.2), while the least common was Streptococcus spp. (2.5%). Methicillin resistance was 15% among the S. aureus strains. No resistance was observed against levofloxacin, vancomycin, teicoplanin, linezolid, daptomycin, fusidic acid and tigecycline in S. aureus strains. The highest resistance rates were observed against levofloxacin (64%), tobramycin (64%), pip/tazobactam (63%), imipenem (63%), and the lowest against colistin (5%) and ceftazidime (29%), among Pseudomonas spp. The most common causative agents in burn wound infections and their current antimicrobial susceptibility features should be well identified, in order for prevention of serious complications and optimal management the condition to occur.Article Citation - WoS: 6Citation - Scopus: 5Effects of Acute Carbon Monoxide Poisoning on Liver Damage and Comparisons of Related Oxygen Therapies in a Rat Model(Taylor & Francis Ltd, 2024) Demirtas, Berjan; Taskin, Seyhan; Gokdemir, Gul Sahika; Seker, UgurAcute carbon monoxide (CO) poisoning may cause liver damage and liver dysfunction. Therefore, in this study, we aimed to compare the efficiency of normobaric oxygen (NBO) and high-flow nasal cannula oxygen (HFNCO) treatments on liver injury. For that purpose, 28 male Wistar albino rats were divided into four groups (Control, CO, CO + NBO, and CO + HFNCO). The control group was allowed to breath room air for 30 min. Acute CO poisoning in CO, CO + NBO, CO + HFNCO was induced by CO exposure for 30 min. Thereafter, NBO group received 100% NBO with reservoir mask for 30 min. HFNCO group received high-flow oxygen through nasal cannula for 30 min. At the end of the experiment, all animals were sacrificed by cardiac puncture under anesthesia. Serum liver function tests were measured. Liver tissue total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) levels, tissue histomorphology and immunoexpression levels of Bax, Caspase 3, TNF-alpha, IL-1 beta, and NF-kappa B were also examined. Our observations indicated that acute CO poisoning caused significant increases in blood COHb, serum aminotransferase (AST), alanine aminotransferase (ALT0, alkaline phosphatase (ALP), total protein, albumin, and globulin levels but a decrease in albumin to globulin ratio (all, p < 0.05). Furthermore, acute CO poisoning significantly increased the OSI value, and the immunoexpresssion of Bax, Caspase 3, TNF-alpha, IL-1 beta, and NF-kappa B in liver tissue (all, p < 0.05). These pathological changes in serum and liver tissue were alleviated through both of the treatment methods. In conclusion, both the NBO and HFNCO treatments were beneficial to alleviate the acute CO poisoning associated with liver injury and dysfunction. [GRAPHICS] .Article Citation - WoS: 2Citation - Scopus: 2Evaluation of patients diagnosed with congenital hypothyroidism by newborn screening between 2011-2019 in Diyarbakir, Turkey(LWW, 2023) Toktaş, İzzettin; Erdem, Özgür; Sarıbaş, Seyfettin; Özbek, Mehmet NuriThis study aimed to determine the incidence of congenital hypothyroidism in Turkey’s Diyarbakir Province and assess the development and growth conditions of people with congenital hypothyroidism. Patients born between 2011-2019 and diagnosed with congenital hypothyroidism within the scope of the newborn screening program were included. The medical records of these patients were retrospectively reviewed. The length and weight for age, weight for length, and body mass index standard deviation scores were calculated. We investigated the treatment status of the patients, whether their relatives had a similar disorder, and the presence of consanguinity between parents. Blood samples were collected from 380,592 newborns. As a result of further tests, 498 newborns were diagnosed with congenital hypothyroidism (incidence: 1/764). Demographic and anthropometric data of 241 patients were analyzed. The patients comprised 46.9% (n = 113) females and 53.1% (n = 128) males. It was determined that 44.4% of the individuals had transient congenital hypothyroidism and 53.6% had permanent congenital hypothyroidism. The parents of 29.8% of the individuals diagnosed with transient congenital hypothyroidism and 44.2% of the individuals diagnosed with permanent congenital hypothyroidism were consanguineous (P = .02). According to the latest anthropometric assessment, 6.8% of individuals diagnosed with congenital hypothyroidism had a weight z-score below −2 SD and 16.9% had a length z-score below −2 SD. The incidence of congenital hypothyroidism was higher in our region. The ratio of consanguinity between parents was higher in patients diagnosed with permanent congenital hypothyroidism than in those diagnosed with transient congenital hypothyroidism. According to the most recent follow-up, weight and age were found to be similar in patients with transient and permanent congenital hypothyroidism.Article Citation - WoS: 2Citation - Scopus: 2Examining the effect of COVID-19 vaccines on the menstrual cycle: A study from Turkey(LWW, 2023) Toktaş, İzzettin; Akelma, Hakan; Araç, EşrefConcerns about a possible relationship between vaccination against Coronavirus Disease 2019 (COVID-19) and menstrual disorders have been raised in the media. In addition, different studies have shown that the COVID-19 vaccine may be associated with menstrual changes. This study was conducted to investigate the effects of COVID-19 vaccines on the menstrual cycle in women. This cross-sectional descriptive study was conducted between August 16 and September 17, 2021. Data were collected through a self-administered questionnaire via an online form sent to the participants through social media. Data of 586 women were included in this study. A total of 82.4% (n = 483) of the participants were aged between 31 and 50 years. The BioNTech vaccine (2 doses) was administered to 75.8% (n = 444), Sinovac (3 doses) to 9.0% (n = 53) of the participants. 53.1% (n = 311) of the women experienced changes in their menstrual cycles. The most common menstrual changes after vaccination were delayed menstruation (n = 176; 30.0%) and prolonged menstrual duration (n = 132; 22.5%). Menstrual delay, prolonged menstrual duration, heavy bleeding, and early menstruation were more common in women than prior to receiving the vaccine (P < .05). More than half of the women experienced menstrual cycle changes after receiving the COVID-19 vaccine. Women experienced significantly higher rates of menstruation delay, prolonged menstrual duration, heavy bleeding, and early bleeding compared to before vaccination.Article Citation - WoS: 7Citation - Scopus: 7Hydrogel burn dressing effectiveness in burn pain(Elsevier Sci Ltd, 2024) Celik, Enes; Akelma, HakanSevere burns are painful and dramatic injuries. Studies show that pain is underestimated and often not adequately treated. This study aims to evaluate the analgesic efficacy of hydrogel burn dressing and silver sulfadiazine, which are two agents commonly used in first-aid dressings for burn patients. This study, designed as a prospective, observational, and cross-sectional study. Study included 64 pediatric patients admitted to our burn center between 01.03.2020 and 01.09.2020 who were examined by our burn service after their first treatment in the emergency dressing room. Two groups of patients were included in the study. Pain level was assessed in the dressing room before and 10 min after the procedure using the Visual Analog Scale and FLACC (Face, Legs, Activity, Cry, Consolability) pain assessment scales.During the study period, Burnaid (R) was applied to 62.5% of patients (40 patients) and silver sulfadiazine to 37.5% (24 patients). In terms of pain scores, pre-dressing FLACC values were higher in Group B (p = 0.039); post-dressing VAS and FLACC values were significantly lower in group B (p 0.001; p 0.001). In terms of additional analgesia, we found more patients in Group S received analgesics (p 0.001).We believe that its effect on burn wound pain is superior to that of silver sulfadiazine.(c) 2023 Elsevier Ltd and ISBI. All rights reserved.Article Citation - WoS: 9Citation - Scopus: 10Laparoscopic versus open portoenterostomy for treatment of biliary atresia: a meta-analysis(SpringerLink, 2023) Bilici, Salim; Mehmet Hanif Okur, Bahattin Aydoğdu, Mustafa Azizoğlu, Salim Bilici, Salih Bayram, Fikret SalikAbstract Objective Our goal was to compare laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia. Materials and methods Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing laparoscopic and open surgery for the treatment of biliary atresia were included. Results Twenty-three studies comparing laparoscopic portoenterostomy (LPE) (n=689) and open portoenterostomy (OPE) (n=818) were considered appropriate for meta-analysis. Age at surgery time was lower in the LPE group than OPE group (I 2=84%), (WMD − 4.70, 95% CI − 9.14 to − 0.26; P=0.04). Signifcantly decreased blood loss (I 2=94%), (WMD − 17.85, 95% CI − 23.67 to − 12.02; P<0.00001) and time to feed were found in the laparoscopic group (I 2=97%), (WMD − 2.88, 95% CI − 4.71 to − 1.04; P=0.002). Signifcantly decreased operative time was found in the open group (I 2=85%), (WMD 32.52, 95% CI 15.65–49.39; P=0.0002). Weight, transfusion rate, overall complication rate, cholangitis, time to drain removal, length of stay, jaundice clearance, and two-year transplant-free survival were not signifcantly diferent across the groups. Conclusions Laparoscopic portoenterostomy provides advantages regarding operative bleeding and the time to begin feeding. No diferences in remain characteristics. Based on the data presented to us by this meta-analysis, LPE is not superior to OPE in terms of overall results.Article Citation - WoS: 7Citation - Scopus: 10Metabolic Syndrome in School Children in Mardin, South-Eastern of Turkey(AVES Ibrahim Kara, 2014) Battaloğlu İnanç, BetülAmaç: Okul çocukları popülasyonunda, metabolik sendrom (MES) prevelansının tespit edilmesi amaçlandı.Gereç ve Yöntem: Türkiye'nin güneydoğusundaki, Mardin şehir merkezinde, üç ilköğretim okulundaki, 7-15 yaşları arası, üç bin dört yüz altmış çocuk, Nisan-Mayıs 2011'de çalışmaya dahil edildi. Yaş, cins, boy, ağırlık, bel çevresi, kalça çevresi, bel/kalça oranı, sistolik ve diyas tolik kan basınçları ölçüldü ve kan testleri kaydedildi. MES tanısı için Uluslararası Diyabet Federasyonu (IDF) kriterleri kullanıldı.Bulgular: Çocukların %9,42'si fazla kilolu ve %8'i obezdi. Obezite kızlarda %9,1, erkekler de %6,9'du. Obezite prevelansı, kızlar arasında erkeklerden daha yüksek ve anlamlıydı (p<0.001). Vücut kitle indeksi (VKI) ve bel ve kalça çevresi, bel/kalça oranı, sistolik ve diyasto lik kan basıncı, trigliserid arasında pozitif korelasyon bulundu (p=0.0001). Total kolesterol, trigliserid, VKI, sistolik ve diyastolik kan basıncı obez MES'lu grupta, obez olmayanlardan anlamlı farklı idi (p<0.05). Kızların bel/kalça oranı referans değerleri, erkeklerinkinden anlamlı olarak daha yüksekti (p>0.05). MES prevelansı %6,3'tü. MES, kızlarda ve obezlerde daha yüksekti. Obez çocuklarda MES oranı %30,3'tü.Sonuç: Çocukluk döneminde obezite, hipertansiyon ve MES sıklığı her geçen gün artmakta dır. Santral obezite ve yüksek vücut kitle indeksine sahip olan çocuklar, MES için daha dikkat li değerlendirilmelidir. Ve toplumun yaşam kalitesi, yaşam tarzı değişiklikleri ile risklerin azaltılması yoluna gidilerek, gerekli tedavi ve takiplerle sağlanmalıdır.Article Citation - WoS: 12Citation - Scopus: 9The Nephroprotective Effect of Quercetin in Cyclophosphamide-Induced Renal Toxicity Might Be Associated With Mapk/Erk and Nf-Κb Signal Modulation Activity(Taylor & Francis Ltd, 2024) Kavak, Deniz Evrim; Dokumaci, Fatma Zehra; Kizildag, Sefa; Irtegun-Kandemir, Sevgi; Seker, UgurThe present study aimed to examine the protective effect of quercetin (QUE) on cyclophosphamide (CTX)-induced nephrotoxicity. For that purpose, 24 mice were divided into four groups (Control, QUE, CTX, and CTX + QUE). The CTX and CTX + QUE groups received 200 mg/kg of cyclophosphamide on the 1(st) and 7(th) days. The QUE and CTX + QUE groups were treated with 50 mg/kg of quercetin daily for 14 days. At the end of the experiment, the animals were sacrificed, and kidney samples were analyzed. The results indicated that CTX leads to severe morphological degenerations and disruption in renal function. Serum BUN, Creatinine, Uric acid, tissue Bax, Caspase 3, TNF-alpha and IL-1 beta expression levels were upregulated in the CTX group compared to Control and QUE groups (p < 0.05). Although MAPK/ERK phosphorylation level is not affected in CTX group, there was a significant increase in CTX + QUE group (p < 0.05), but the NF-kappa B was significantly suppressed in this group (p < 0.01). The RT-qPCR results showed that the cyt-c and the Bax/Bcl-2 ratio mRNA expression folds were upregulated in the CTX group (p < 0.01), which was downregulated in the CTX + QUE group. However, there was a significant difference in the CTX + QUE group compared to the Control and QUE groups (p < 0.01). The findings showed that administering quercetin along with cyclophosphamide alleviated renal injury by regulating apoptotic and inflammatory expression. Moreover, the administration of quercetin and cyclophosphamide could synergistically improve renal function test results, and activate cellular responses, which upmodulate MAPK/ERK phosphorylation and suppression of NF-kappa B.Article Citation - WoS: 1Citation - Scopus: 1Prognostic Significance of the Chemerin Level in Coronavirus Disease 2019 Patients(Lippincott Williams & Wilkins, 2024) Arac, Songul; Yokus, Beran; Gokdemir, Guel Sahika; Gokdemir, Mehmet TahirIncreased serum chemerin levels have been reported in several inflammatory diseases. Few studies have investigated the relationship between chemerin and clinical features of COVID-19. Thus, chemerin may modulate the development and progression of COVID-19. We compared the serum chemerin concentration between patients with and without SARS-CoV-2 infection and its association with the severity and prognosis of COVID-19 pneumonia. This is a prospective, single-center, cross-sectional study. We enrolled COVID-19 patients who presented to our tertiary hospital and healthy controls. The COVID-19 patients were conducted and the dates of symptom onset were recorded. After admission to the hospital and stabilization, blood samples were obtained for routine hemogram, biochemistry, and chemerin. The chemerin level was 37.93 +/- 17.3 ng/mL in patients followed in the ICU, 29.41 +/- 12.79 ng/mL in inpatients, 30.48 +/- 10.86 ng/mL in outpatients, and 25.12 +/- 9.82 ng/mL in healthy controls. The difference between patients treated in the ICU and healthy controls was significant (P < .001). The high-sensitivity C-reactive protein (hs-CRP), ferritin, procalcitonin (PCT), and D-dimer levels were significantly higher in the intensive care unit (ICU) group (P < .001). Moreover, the chemerin level of patients who died was significantly higher than that of those who survived (P < .001). The chemerin level was increased in COVID-19 patients and also increased with increasing disease severity. The chemerin level was higher in the COVID-19 patients than healthy controls and was significantly higher in patients who died compared to those who did not.Article Citation - WoS: 3Citation - Scopus: 3Thiol–disulfide balance and trace element levels in patients with seasonal allergic rhinitis(African Health Sciences, 2022) Savas, Hasan Basri; Gunizi, HuseyinAbstract Background: The prevalence of allergic diseases is gradually increasing worldwide. The most common such allergic disease is allergic rhinitis (AR). Objective: The present study investigated the possible relationship between seasonal AR and the thiol-disulfide balance and zinc and copper levels in adult individuals. Study Design and Methods: 130 male and female adults were included in the study. The participants’ serum thiol-disulfide balance and zinc and copper levels were measured spectrophotometrically using commercial kits. Statistical significance was accepted as p < 0.05 between the groups. Results: The serum copper (p = 0.001), native thiol (p = 0.006), reduced thiol (p < 0.001), and thiol oxidation reduction ratio (p < 0.001) levels were significantly lower in the seasonal AR group than in the control group. Conclusion: In AR patients, the low level of copper, which is an important trace element, the deterioration of the thiol-disulfide balance, which represents a unique indicator of the oxidant-antioxidant balance, the increased disulfide level caused by oxidative stress, and the decreased native thiol level can all serve as important biochemical markers.
