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Öğe Thyroid Autoimmunity may Affect Mean Platelet Volume(Gazi Univ, Fac Med, 2022) Sarı, Işılay Kalan; Arıkan, Senay; Yavuz, Şeyma; Çarlıoğlu, AyşeObjective: Mean platelet volume (MPV) has been associated with autoimmune diseases and is considered a potentially useful parameter to assess platelet activity and subclinical inflammation. In the present study, we aimed to investigate the effects of thyroid autoimmunity on MPV. Methods: 84 patients with newly diagnosed Hashimoto's thyroiditis (HT), including 44 euthyroid (EHT, mean age 41.4 +/- 10.8 years) and 40 hypothyroid (HHT, mean age 44.6 +/- 13.2 years) patients, 61 patients with newly diagnosed Graves' disease (GD, mean age 42.8 +/- 12.4 years) and 57 euthyroid control subjects (age-matched 46.4 +/- 11.6 years) were included in the study. Patients were not taking antithyroid medication or levothyroxine. Thyroid hormones and platelet parameters were determined in all study participants. Results: The MPV of the patients was significantly higher than that of the control group (p:0.008). There was no association between MPV and age, sex, or TSH (p:0.06, p:0.4, and p:0.9, respectively). MPV increased in chronic autoimmune thyroid disease regardless of age, sex, and TSH. Conclusion: Our results suggest that autoimmunity, rather than thyroid hormone levels, affects MPV in GD and HT.Öğe The prediction of lung cancer prognosis with blood lipid levels and ratios at the time of diagnosis(Wolters Kluwer Medknow Publications, 2022) Arslan, Ferhat; Yalçın, Selim; Karahan, İrfanBackground: Emerging evidence has linked lipid metabolism disorder with lung diseases, but the relationship between blood lipid profile and lung cancer risk is controversial and inconclusive. It was aimed to investigate the relationship of lipid levels and ratios at the time of diagnosis to the prognosis prediction of lung cancer. Methods: Sociodemographic and disease-related clinical characteristics of 92 patients diagnosed with lung cancer were reviewed retrospectively. Patients with available lipid parameters at the time of diagnosis were evaluated. Hemogram parameters of the patients included in the study, creatinine and estimated glomerular filtration rate, alanine aminotransferase level, albumin level, C-reactive protein level, as well as total cholesterol (TC)/high-density cholesterol (HDL) ratio, non-HDL/HDL ratio, low-density lipoprotein/HDL ratio, and triglyceride/HDL ratios were examined. Results: The mean age at presentation was 64.2 +/- 9.1 years. The distribution of lung cancers is 6 (6.5%) for small cell lung cancer (SCLC) and 86 (93.5%) for non-SCLC. The median follow-up period of the patients is 12 months. During the follow-up, 63 (68.5%) of the patients died. In the univariate analysis, increased non-HDL/HDL ratio was related to mortality. In multivariate analysis, disease stage, albumin level, and TC level were found to be variables affecting the mortality. Conclusion: TC levels at the time of diagnosis can be a guide in determining the prognosis. More experimental studies are needed to elucidate the relationship between the lipid metabolism and lung cancer etiology and to determine the role of lipid levels and ratios in prognosis prediction.Öğe The efficacy of palbociclib and ribociclib in the first-line treatment of metastatic hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer in male patients: a Turkish oncology group (TOG) study(Springer Japan Kk, 2024) Yıldırım, Hasan Çağrı; Kutlu, Yasin; Mutlu, Emel; Aykan, Musa Barış; Korkmaz, Mustafa; Yalcin, Selim; Sakalar, TeomanIntroductionMale breast cancer, comprising approximately 1% of all breast cancer cases, often leads to the exclusion of male patients as a criterion in clinical trials. While the efficacy of Cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors has been established in metastatic hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2 -) breast cancer in women, limited data exist on their effectiveness in male patients.We aimed to evaluate the efficacy and safety of palbociclib or ribociclib in male patients with breast cancer.IntroductionMale breast cancer, comprising approximately 1% of all breast cancer cases, often leads to the exclusion of male patients as a criterion in clinical trials. While the efficacy of Cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors has been established in metastatic hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2 -) breast cancer in women, limited data exist on their effectiveness in male patients.We aimed to evaluate the efficacy and safety of palbociclib or ribociclib in male patients with breast cancer.MethodsThis study is a multicenter, retrospective study. We included male patients with HR + and HER2-metastatic breast cancer who received palbociclib or ribociclib as first-line treatment. Our primary endpoints were progression-free survival (PFS), overall response rates (ORR), and drug-related adverse effects.ResultsA total of 46 male patients from 27 institutions were enrolled. The median age at initiation of CDK 4/6 inhibitors was 63.64 +/- 13.69 years, with a median follow-up of 21.33 (95% CI 14.92-27.74) months. The ORR were 84% for palbociclib and 76.2% for ribociclib. The mPFS for the entire cohort was 28.06 months (95% CI 18.70-37.42). No significant difference in PFS was observed between palbociclib and ribociclib (mPFS: 24.46 months (95% CI 11.51-37.42) vs 28.33 months (95% CI 14.77-41.88), respectively, p = 0.211). No new adverse events were reported.DiscussionThis study demonstrates that palbociclib and ribociclib are effective and safe options for first-line treatment in male patients with HR + /HER2 - metastatic breast cancer. However, further prospective studies are warranted to establish their efficacy in this population.Öğe The effects of trastuzumab therapy on endothelial functions of breast cancer patients(Assoc Medica Brasileira, 2024) Alp, Çağlar; Doğru, Mehmet Tolga; Yalçın, Selim; Karal, Ali OğuzhanOBJECTIVE: Breast cancer is among the highest causes of morbidity and mortality in women. Trastuzumab therapy, which is known to be significantly cardiotoxic, is mainly used to treat patients with resistant breast cancer, including estrogen receptor-positive type. We aimed to show the effects of METHODS: In this study, a total of 26 participants (24 female and 2 male patients, minimum age: 38 years, maximum age: 79 years, and mean age 57.3 +/- 12.7 years) were enrolled in the study. For the statistical evaluation of data, we classified the participants of the study as follows: Pretreatment: Before trastuzumab therapy; Treatment Period 1: 1 month after the first dose of trastuzumab; Treatment Period 2: 4 months after the first dose of trastuzumab; Treatment Period 3: 12 months after the first dose of trastuzumab. We conducted repeated-measures analysis of variance (Greenhouse-Geisser) and paired-sample t-tests to statistically compare the groups using flow-mediated dilation measurements. RESULTS: We determined that there are statistically significant differences between flow-mediated hyperemia and ratio values (flow-mediated dilation) of the groups (p<0.009 and p<0.001, respectively). CONCLUSION: Our data indicate that trastuzumab therapy could have negative effects on endothelial functions in breast cancer patients.Öğe The effect of danger-associated molecular patterns on survival in acute graft versus host disease(Springernature, 2024) Çelik, Serhat; Kaynar, Leylagül; Güven, Zeynep Tuğba; Duran, Kübra Atasever; Kontaş, Olgun; Keklik, Muzaffer; Ünal, AliDanger-associated molecular patterns (DAMPs) are molecules that can initiate and maintain robust inflammatory responses and were investigated in the pathogenesis of graft versus host disease (GvHD). Uric acid (UA) and fibrinogen (Fib) are DAMPs released from damaged tissue during allogeneic hematopoietic stem cell transplantation (allo-HCT) and GvHD. We aimed to evaluate the effects of UA and Fib levels on survival in GvHD. One hundred seventy-four patients with grade 2-4 acute GvHD were included. UA and Fib levels were evaluated on allo-HCT day 0 and GvHD on days 0, 7, 14, and 28. Fib GvHD day 0 was the independent predictor for overall survival (OS), non-relapse mortality (NRM), and progression-free survival in multivariable models (HR 0.98, p < 0.001; HR 0.98, p = 0.001, HR 0.98, p = 0.006, respectively). Also UA GvHD day 28 was the independent predictor for OS and NRM (HR 0.77, p = 0.004; HR 0.76, p = 0.011, respectively). Our results indicated that hypouricemia and hypofibrinogenemia were associated with a significantly shorter OS and higher NRM. UA and Fib are remarkable molecules in GvHD because they are routinely utilized, readily available, can be therapeutic targets, and have DAMPs and antioxidant features.Öğe The Diagnostic Value of Soluble Triggering Receptor Expressed on Myeloid Cells for Patients with Acute Stone Pyelonephritis(Mdpi, 2024) Özsoy, Metin; Ataman, Miraç; Sahin, Serhat Kazım; Şenocak, İbrahim; Varlıbaş, Artuner; Yuvanç, Ercan; Çifçi, AydınSoluble triggering receptor expressed on myeloid cells (sTREM-1) is a new biomarker that can be used for the diagnosis and monitoring of urinary system infections. This study aimed to evaluate the diagnostic performance of serum sTREM-1 in patients with a diagnosis of acute stone pyelonephritis (ASP). This prospective study included 46 patients with a diagnosis of ASP and a control group of 23 individuals without urinary system infection. Blood samples were taken from participants upon hospital admission, and basal serum sTREM-1 levels were analyzed using the ELISA method. Serum sTREM-1 concentrations were measured after treatment of ASP patients. Basal leukocyte counts, C-reactive protein (CRP) levels, procalcitonin (PCT), and sTREM-1 (98.6 vs. 68.4 pg/mL, p < 0.001) levels were higher in the ASP group compared to the control group. After treatment, the median leukocyte counts, PCT, and sTREM-1 levels decreased and were similar to those of the control group. The median CRP level also decreased after treatment, but it remained higher than that of the control group. In predicting patients with ASP, the baseline sTREM-1 exhibited a sensitivity of 74.6% and a specificity of 78.2%, while its diagnostic performance was lower than that of leukocyte counts, CRP, and PCT. Despite the findings that levels of sTREM-1 were higher upon hospital admission in patients with ASP and significantly decreased after treatment, the utility of sTREM-1 as a biomarker for predicting patients with ASP remains constrained when compared to established inflammatory markers.Öğe Subacute THYROiditis Related to SARS-CoV-2 VAccine and Covid-19 (THYROVAC Study): A Multicenter Nationwide Study(Endocrine Soc, 2023) Batman, Adnan; Yazıcı, Dilek; Dikbaş, Oğuz; Agbaht, Kemal; Saygılı, Emre Sedar; Demirci, İbrahim; Bursa, NurbanuContext The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. Methods This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19-related SAT (Cov-SAT), SARS-CoV-2 vaccine-related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. Results Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT etiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. Conclusion Since there is no difference in terms of follow-up parameters and outcomes, COVID-19- and SARS-CoV-2 vaccine-related SAT can be treated and followed up like classic SATs. Recurrence was determined by younger age and steroid therapy requirement. Steroid therapy independently predicts incident hypothyroidism that may sometimes be transient in overall SAT and is also associated with a lower risk of established hypothyroidism.Öğe Relationship between chewing ability and malnutrition, sarcopenia, and frailty in older adults(Wiley, 2022) Özsürekçi, Cemile; Kara, Murat; Güngör, Anıl Evrim; Ayçiçek, Gözde Şengül; Çalışkan, Hatice; Dogu, Burcu Balam; Cankurtaran, MustafaBackground Several studies reported that impaired nutrition is associated with reduced muscle mass, muscle strength, and physical performance. Chewing ability is essential to maintain balanced oral nutrient intake. The study was designed to define the possible relationship between chewing ability and nutrition-related problems (malnutrition, sarcopenia, and frailty) in a holistic perspective. Methods This cross-sectional study recruited adults aged >= 65 years. All patients were evaluated with comprehensive geriatric assessment. Sarcopenia was diagnosed according to European Working Group on Sarcopenia in Older People criterion. Malnutrition was determined according to body mass index, calf circumference, and Mini Nutritional Assessment short form (MNA-SF). Frailty status was diagnosed with the Clinical Frailty Scale. Masseter and gastrocnemius muscle thicknesses (MTs) were measured via ultrasonography imaging. Oral examinations were carried out by a dentist, and chewing performance was examined with a color-changeable chewing gum. Results Overall, 135 older adults (76 females) were analyzed. Mean +/- SD age was 75.7 +/- 7.2 years; 37.0% of the patients were frail, 3.7% were malnourished, 12.6% were sarcopenic, and 20.0% had poor chewing function. In the poor chewing function group, age and frailty scores were increased and the MNA-SF scores, handgrip strength, skeletal muscle index, and masseter MT were reduced (all P < 0.05). After adjusting for confounders, regression analysis showed that low grip strength and low gastrocnemius MT were independently associated with poor chewing ability. Conclusions Chewing ability was related to sarcopenia. Age and low grip strength in females and low cognitive scores and having low gastrocnemius MT in males were independent variables affecting chewing ability.Öğe Proposing a New Term for Organizational Behavior Literature: Achilles's Tendon Syndrome in Businesses(Univ Zagreb, Fac Organization & Informatics, 2022) Arar, Tayfun; Öneren, Melahat; Yurdakul, GülşenIn spite of threatening external factors such as uncertain environmental structure and market pitfalls, the companies struggling with the difficulty of retaining the current customer and finding the potential ones should first realize the existence of Achilles Tendons within themselves. To prevent this potential problem, they should focus on the labor which can be a very substantial weak point and an important asset as well. Regarding serious problems arisen from labor force, this study proposes a new term called as Achilles Tendon Syndrome to be used in organizational behavior literature. Various theories from different disciplines such as medicine, psychology, physics, economics and sociology support development process of the term. Similarities and differences with other close concepts are also provided throughout the paper. The current study aims to inspire future studies by filling an important gap in the organization and management literature.Öğe Prevalence of Pancreatic Steatosis and Its Associated Factors in Turkey: A Nation-Wide Multicenter Study(Aves, 2024) Sezgin, Orhan; Yaras, Serkan; Cindoruk, Mehmet; Kasap, Elmas; Ünal, Hakan; Köksal, Aydın Şeref; Yıldırım, Abdullah EmreBackground/Aims: Pancreatic steatosis (PS) is a pathology associated with metabolic syndrome (MS), endocrin and exocrine disfunctions of the pancreas, and fatty liver. The data on the frequency of PS are very limited. We aimed to evaluate the frequency of PS detected by transabdominal ultrasonography (TAU) in gastroenterology clinics located in different geographical regions of Turkey and the factors associated with it. Materials and Methods: Volunteers were evaluated by TAU for PS and hepatosteatosis (HS), and its degree. Pancreatic stiffness was evaluated by ultrasonographic shear wave elastography (SWE). All demographic, physical, and biochemical parametres were measured. Results: A total of 1700 volunteers from 14 centers throughout Turkey were included in the study. Mean age was 48.03 +/- 20.86 years (56.9% female). Prevalance of PS was detected in 68.9%. In the PS group, age, body mass index (BMI), waist circumference, systolic blood pressure, fasting blood glucose (FBG), lipid levels, insulin resistance, diabetes mellitus, hypertension, MS frequency, and pancreatic SWE score were increasing, and fecal elastase level was decreasing in correlation with the degree of PS. The frequency of HS was 55.5%. Hepatosteatosis [odds ratio (OR): 9.472], increased age (OR: 1.02), and BMI (OR: 1.089) were independent risk factors for the occurrence of PS. Lean -PS rate was 11.8%. The lean -PS group was predominantly female and younger than non -lean PS. Also it has lower blood pressure, FBG, liver enzymes, lipid levels, and HS rates. Conclusion: The frequency of PS was found 68.9% in Turkey. Its relationship was determined with age, BMI, HS, MS (and its components), pancreatic stiffness, and fecal elastase level.Öğe Be Aware of Critical Drugs in Emergency Departments: An Extreme Iatrogenic Insulin Overdose via Subcutaneous and Intramuscular Routes(Emergency Medicine Physicians Assoc Turkey, 2021) Coşkun, Figen; Vural, Sevilay; Eroğlu, Oğuz; Cömertpay, Ertan; Durmaz, Senay ArıkanIntroduction: Insulin is a highly used parenteral medication in emergency departments. Although most severe insulin overdoses occur as suicide attempts, medication errors can be the reason. We aimed to highlight the potential medication errors in emergency departments due to the poor control of critical drugs like insulin and the similarities between the brand names of drugs, as we experienced during this case. Case Report: We present a 75-year-old diabetic woman with an extreme insulin overdose. A total of 3000 UI of insulin was administered by subcutaneous and intramuscular routes. She developed typical and atypical episodes of hypoglycemia requiring intravenous dextrose, a high-calorie diet, and glucagon administration. Almost all of the classic side effects of glucagon occurred during her intensive care unit follow-up. She recovered without any sequela or recurrence of hypoglycemia at the end of 5 days of admission. Conclusion: Insulin overdose can be a life-threatening condition by causing hypoglycemia. Albeit rare, insulin overdose can occur as a medication error in hospitals. To prevent such incidents for emergency departments, the medication errors should be objectively laid out, and proactive strategies should be integrated without adversely affecting acute care.Öğe Automated Classification of Rheumatoid Arthritis, Osteoarthritis, and Normal Hand Radiographs with Deep Learning Methods(Springer, 2022) Üreten, Kemal; Maraş, Hadi HakanRheumatoid arthritis and hand osteoarthritis are two different arthritis that causes pain, function limitation, and permanent joint damage in the hands. Plain hand radiographs are the most commonly used imaging methods for the diagnosis, differential diagnosis, and monitoring of rheumatoid arthritis and osteoarthritis. In this retrospective study, the You Only Look Once (YOLO) algorithm was used to obtain hand images from original radiographs without data loss, and classification was made by applying transfer learning with a pre-trained VGG-16 network. The data augmentation method was applied during training. The results of the study were evaluated with performance metrics such as accuracy, sensitivity, specificity, and precision calculated from the confusion matrix, and AUC (area under the ROC curve) calculated from ROC (receiver operating characteristic) curve. In the classification of rheumatoid arthritis and normal hand radiographs, 90.7%, 92.6%, 88.7%, 89.3%, and 0.97 accuracy, sensitivity, specificity, precision, and AUC results, respectively, and in the classification of osteoarthritis and normal hand radiographs, 90.8%, 91.4%, 90.2%, 91.4%, and 0.96 accuracy, sensitivity, specificity, precision, and AUC results were obtained, respectively. In the classification of rheumatoid arthritis, osteoarthritis, and normal hand radiographs, an 80.6% accuracy result was obtained. In this study, to develop an end-to-end computerized method, the YOLOv4 algorithm was used for object detection, and a pre-trained VGG-16 network was used for the classification of hand radiographs. This computer-aided diagnosis method can assist clinicians in interpreting hand radiographs, especially in rheumatoid arthritis and osteoarthritis.Öğe Acute pancreatitis in Turkey: Results of a nationwide multicenter study(Elsevier, 2024) Koksal, Aydin Seref; Tozlu, Mukaddes; Sezgin, Orhan; Oğuz, Dilek; Kalkan, Ismail Hakk; Altıntaş, Engin; Yaraş, SerkanBackground: Acute pancreatitis (AP) is the most common gastrointestinal disease requiring hospitalization, with significant mortality and morbidity. We aimed to evaluate the clinical characteristics of AP and physicians ' compliance with international guidelines during its management. Methods: All patients with AP who were hospitalized at 17 tertiary centers in Turkey between April and October 2022 were evaluated in a prospective cohort study. Patients with insufficient data, COVID-19 and those aged below 18 years were excluded. The definitions were based on the 2012 revised Atlanta criteria. Results: The study included 2144 patients (median age:58, 52 % female). The most common etiologies were biliary (n = 1438, 67.1 %), idiopathic (n = 259, 12 %), hypertriglyceridemia (n = 128, 6 %) and alcohol (n = 90, 4.2 %). Disease severity was mild in 1567 (73.1 %), moderate in 521 (24.3 %), and severe in 58 (2.6 %) patients. Morphology was necrotizing in 4.7 % of the patients. The overall mortality rate was 1.6 %. PASS and BISAP had the highest accuracy in predicting severe pancreatitis on admission (AUC:0.85 and 0.81, respectively). CT was performed in 61 % of the patients, with the majority (90 %) being within 72 h after admission. Prophylactic NSAIDs were not administered in 44 % of the patients with post-ERCP pancreatitis (n = 86). Antibiotics were administered to 53.7 % of the patients, and 38 % of those received them prophylactically. Conclusions: This prospective study provides an extensive report on clinical characteristics, management and outcomes of AP in real -world practice. Mortality remains high in severe cases and physicians ' adherence to guidelines during management of the disease needs improvement in some aspects. (c) 2023 IAP and EPC. Published by Elsevier B.V. All rights reserved.Öğe A New Predictor for Insulin Resistance in Polycystic Ovary Syndrome: InsuTAG(Bentham Science Publ Ltd, 2024) Omma, Tülay; Gökçe, Aksanur; Çelik, Mustafa; Karahan, İrfan; Çulha, Cavit; Gülçelik, Neşe ErsözBackground: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among women of reproductive age. PCOS leads to metabolic dysfunction such as dyslipidemia, obesity, and glucose intolerance based on hyperandrogenemia, hyperinsulinemia, and dysregulated adipokine secretion.Objective: The aim of this study was to investigate whether a new marker, InsuTAG (fasting insulinxfasting triglycerides) could predict insulin resistance (IR) in patients of PCOS.Methods: In this study, retrospective data of 300 female patients diagnosed with PCOS were analyzed. The relationship between InsuTAG and HOMA-IR, TyG, and TG/HDL-C scores related to insulin resistance was evaluated. In addition, the distribution of the cases according to the cut-off values was determined.Results: Log-transformed forms of InsuTAG and HOMA-IR, TyG and TG/HDL-C results were positively correlated, respectively. (r = 0.85, p < 0.001; r = 0.78, p < 0.001; r = 0.72, p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive values for InsuTAG were calculated as 85%, 85%, 82% and 88%, respectively.Conclusion: This study is the first to compare the InsuTAG, another predictor of insulin resistance, with other IR markers in women with PCOS. InsuTAG is a novel biomarker based on plasma sampling of insulin and triglyceride, with minimally invasive, inexpensive and orientally accessible features.Öğe A Case of Miliary Tuberculosis Detected with Laryngeal Oedema: Complication with Septic Shock and Thrombocytopaenia(Aves, 2013) Bulcun, Emel; Ekici, Aydanur; Ekici, Mehmet; Gülhan, Pınar Yıldız; Güngör, Ömür; Kazkayası, MustafaTuberculosis, a disease with a wide clinical spectrum, can involve all tissues and organs. A 57-year-old case appeared in the form miliary tuberculosis after laryngeal oedema. Septic shock developed in the course of tuberculosis. Thrombocytopaenia then developed, while septic shock improved following antituberculosis treatment. Thrombocytopaenia improved after rifampicin was removed from the treatment regimen. We decided to present our case here as an interesting form of tuberculosis with complications.Öğe Mortality Trends from Ischemic Heart Disease in Turkey: 2009-2019(Kare Publ, 2022) Yalım, Zafer; Doğan, Nurhan; Yalım, Sümeyra AlanObjective: Cardiovascular diseases still play an important role in public health and epidemiology as the leading cause of death worldwide. Ischemic heart disease is the most common reason in this group. This study aims to analyze the latest trends in ischemic heart disease mortality rates in Turkey by age, gender, and region using the Turkish Statistical Institute mortality data and evaluate the results. Methods: We have obtained ischemic heart disease mortality data (2009-2019, in 12 regions) for Turkey from the mortality database of the Turkish Statistical Institute. Joinpoint analysis was used to estimate the annual percentage change and average annual percentage change to identify significant changes in trends. Results: The mean mortality rate for ischemic heart disease in Turkey was in an increasing trend from 2009 to 2019 (annual percentage change=1.7 (-0.8; 4.3), P = .166). This increase was more pronounced in women (annual percentage change = 2.2 (-0.7; 5.2), P=.121) compared to men (annual percentage change = 1.4 (-1.1; 3.9), P = .235). When the period between 2015 and 2019 was evaluated, it was determined that ischemic heart disease mortality was in a decreasing trend in the groups over 65 years of age. The death rate due to ischemic heart disease is almost 2 times higher in men than in women in Turkey, and this rate ratio is highest in the Istanbul region. Conclusion: Although ischemic heart disease mortality trends have decreased globally, our country's average is still on an increasing trend. However, significant decreases have been observed in ischemic heart disease mortality rates, especially in the group over 65 years of age, in the last 5 years.Öğe Diagnosis of osteoarthritic changes, loss of cervical lordosis, and disc space narrowing on cervical radiographs with deep learning methods(Turkish Joint Diseases Foundation, 2022) Maraş, Yüksel; Tokdemir, Gül; Üreten, Kemal; Atalar, Ebru; Duran, Semra; Maraş, HakanObjectives: In this study, we aimed to differentiate normal cervical graphs and graphs of diseases that cause mechanical neck pain by using deep convolutional neural networks (DCNN) technology. Materials and methods: In this retrospective study, the convolutional neural networks were used and transfer learning method was applied with the pre-trained VGG-16, VGG-19, Resnet-101, and DenseNet-201 networks. Our data set consisted of 161 normal lateral cervical radiographs and 170 lateral cervical radiographs with osteoarthritis and cervical degenerative disc disease. Results: We compared the performances of the classification models in terms of performance metrics such as accuracy,Öğe Pancreas and kidney changes in type 2 diabetes patients: the role of diffusion-weighted imaging(Tubitak Scientific & Technological Research Council Turkey, 2021) Şahan, Mehmet Hamdi; Özdemir, Adnan; Asal, Nese; Karadeniz Bilgili, Yasemin Mirace; Doğan, Adil; Güngüneş, AşkınBackground/aim: The aim of this study was to compare renal and pancreatic apparent diffusion-coefficient (ADC) values of diabetic patients and control subjects and to examine their potential association with several diabetes-related clinical parameters. Materials and methods: A total of 80 sex-and age-matched patients were included in the study. Of them, 40 were patients with type 2 diabetes and 40 were nondiabetic participants. Abdominal diffusion-weighted MRIs of both groups were retrospectively reviewed. Diabetes-related clinical parameters were recorded. Results: The difference between the mean ADC values of the patient group and the control group was significant (p = 0.012). It was also found that the mean pancreatic ADC values of diabetic patients and the control group significantly differed (p = 0.02). Besides, there were positive correlations between the mean pancreatic ADC values and age, Hb1Ac level, treatment type, and disease duration (p < 0.05). While eGFR values positively correlated with the mean renal ADC values (p < 0.05), there were negative correlations between such values and age, serum creatinine level, and disease duration (p < 0.05). Conclusion: Renal and pancreatic ADC values of diabetic patients could potentially play a role, as markers of renal and pancreatic functions, in clinical decisions in the follow-up of such patients.Öğe Assessment of erythrocyte morphology in patients with type 2 diabetes mellitus: a pilot study of electron microscopy-based analysis in relation to healthy controls(Tubitak Scientific & Technological Research Council Turkey, 2021) Mortaş, Tülay; Durmaz, Şenay Arıkan; Sezen, Şaban Cem; Savranlar, YaseminBackground/aim: The present study aimed to assess erythrocyte morphology in newly diagnosed type 2 diabetes mellitus patients using scanning electron microscopy. Materials and methods: In total, 30 patients admitted to endocrine outpatient clinics were included in the study. The patients were divided into two groups according to their fasting blood glucose levels: type 2 diabetes mellitus (n = 15, fasting blood glucose levels >= 126 mg/dL) and control (n = 15, fasting blood glucose levels < 99 mg/dL). The patient's demographic characteristics, haemoglobin A1c levels, and scanning electron microscopy findings regarding erythrocyte morphology were recorded. Results: There was no significant difference between the control and type 2 diabetes mellitus group in terms of the participants' age (51.13 +/- 8.53 vs. 50.33 +/- 8.72 years, p = 0.8) and the male/female ratio (9/6 vs. 9/6). In the control group, discocytes were abundant, echinocytes were rare, and spherocytes were absent. On the other hand, discocytes were less common and echinocyte-shaped erythrocytes were more common in the type 2 diabetes mellitus group than in the control group. In addition, spherocytes were detected in the type 2 diabetes mellitus group. Moreover, the diameter of discocytes was significantly lower (p = 0.014), and blood glucose and haemoglobin A1c levels were significantly higher (p < 0.05 for both) in the type 2 diabetes mellitus group than in the control group. Conclusion: Our findings indicate that high glucose levels in type 2 diabetes mellitus patients lead to significant alterations in erythrocyte morphology, including decreased erythrocyte deformability and the formation of echinocytes and spherocytes due to eryptosis. The possibility of decreased erythrocyte deformability due to excessive eryptosis may disturb microcirculation in newly diagnosed, treatment-naive type 2 diabetes mellitus patients who do not have any complications.Öğe Presenting Turkish Inappropriate Medication Use in the Elderly (TIME) Criteria Set in Turkish(Galenos Publ House, 2021) Bahat, Gülistan; Ilhan, Birkan; Erdoğan, Tuğba; Halil, Meltem; Savaş, Sumru; Ülger, Zekeriya; Akyüz, Filiz[Abstract No tAvailable]
