Browsing by Author "Alkan, S"

Now showing 1 - 18 of 18
  • No Thumbnail Available
    Item
    Are Inflammation Markers Derived from Hemogram Parameters Predictive for Papillary Thyroid Carcinoma in Hashimoto's Thyroiditis Patients?
    Akcura, C; Guney, SC; Alkan, S; Cavdar, GG; Tan, AY; Aydede, H; Hekimsoy, Z; Ozdemir, N
    Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) are two endocrine disorders, and chronic inflammation plays a key role in their pathogeneses. Recent studies have shown that some inflammation markers derived from hemogram parameters such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are helpful in showing inflammation in many autoimmune diseases and cancers. We aimed to investigate how the coexistence of HT and PTC will affect the inflammation markers derived from hemogram parameters. Eighty PTC patients with coexisting HT (Group 1) and PTC and 80 HT patients without PTC (Group 2) were selected. Hemogram parameters, thyroid function tests, and thyroid autoantibodies of the patients were analyzed. Relevant inflammatory markers were calculated, and the results were statistically analyzed. NLR, PLR, and SII values were found to be significantly higher in Group 1 (p = 0.032, p = 0.005, and p = 0.002, respectively) compared to Group 2. ROC curve analysis revealed the most appropriate cut-off point for NLR to be 495.34, for PLR to be 1.77, and for SII to be 115.99. NLR, PLR, and SII levels have been shown to be sensitive in predicting the development of PTC in HT patients.
  • No Thumbnail Available
    Item
    Metabolic and demographic characteristics of children with urolithiasis in Western Turkey
    Ertan, P; Tekin, G; Öger, N; Alkan, S; Horasan, GD
    Pediatric urolithiasis is an endemic disease in Turkey. We evaluated the clinical, radiological and metabolic features of children with urolithiasis in Western Turkey. We retrospectively reviewed the records of 85 children with urolithiasis who were followed-up between 2004 and 2010 in Pediatric Nephrology Department of Celal Bayar University, Manisa. The male/female ratio was 1.23/1. The mean age at diagnosis was 66.1 months (range 3-210 months). Family history of urolithiasis was found in 58 (68.2%) patients. 23 (27%) patients were born from consanguineous marriages. Stones were located in the upper urinary tract in 79 (92.9%) patients. In 66 (77.6%) patients, stones were single-sided and 41 (48.2%) patients had multiple stones. Calcium oxalate stones were the most common one among patients in whom stone analysis was performed (78.5%). Hypocitraturia was the most commonly detected urinary metabolic risk factor. In patients who were under 12 months of age at diagnosis, hypercalciuria was the most commonly seen urinary metabolic risk factor. At the end of follow-up period, 24 patients became free of stone disease and 4 patients had recurrence. In conclusion, metabolic abnormalities are common in pediatric stone patients and are strongly associated with recurrence. Considering that urolithiasis in children is an important risk factor for renal failure, early diagnosis, detailed metabolic evaluation and implementing appropriate treatment and follow-up protocols may prevent recurrence and renal damage.
  • No Thumbnail Available
    Item
    Pilot Scheme Conceptual Analysis of Rooftop East-West-Oriented Solar Energy System with Optimizer
    Alkan, S; Ates, Y
    In recent years, photovoltaic energy has become a popular alternative to traditional fossil fuels due to its renewable and sustainable nature, and the incentives provided by countries to encourage research and development in this field have accelerated the implementation of photovoltaic roofs. One important factor in maximizing the efficiency of solar panels is their orientation to harness maximum irradiation with minimum roof area. In this article, an optimizer-supported east-west-oriented solar power plant installation is experimentally presented to utilize more solar energy with less area compared to wide-area south orientation. Furthermore, an analysis of different angle placements is simulated by PVSOL and PVGIS to test the robustness of the presented approach, and the pros/cons of the features of the east-west and south orientation are discussed comparatively. The obtained results are promising for the ideal placement of solar systems along with the use of optimizers to further enhance their performance, and for the minimization of the economic return of such an investment.
  • No Thumbnail Available
    Item
    Evaluation of Achromobacter xylosoxidans subsp. denitrificans Infections at an University Hospital
    Senol Akar, S; Dindar Demiray, EK; Alkan, S; Özer, D; Kurutepe, S
    Introduction: Infections due to Achromobacter xylosoxidans (AX) type bacteria are very rare. There are few case reports from our country but knowledge about practical therapeutical applications is scarce. In this study we aimed to report AX denitrificans infections and clinical approach at our hospital. Materials and Methods: This study comprised patients over 18 years old who were hospitalised at Manisa Celal Bayar University Hafsa Sultan Hospital and who were positive for AX. denitrificans between 01.01.2016-31.12.2019. Data about these patients were obtained retrospectively from hospital records. Demographic clinical and bacteriologic data were analysed by suitable methods. Results: AX. denitrificans was detected in 16 cultures of 10 patients. Growth was detected from wound biopsy cultures in 11 specimens (68.7%). Nine patients were male and the mean age was 51.3 +/- 17. Seven of the patients had been hospitalised in the same clinic at different time intervals. The most common diagnosis was surgical site infection. All of AX. denitrificans induced infections were health care associated infections (HAI). Risc factors were found as being hospitalised and/or operated at the plastic and reconstructive surgery ward, antibiotic consumption within the last month and history of collagen tissue disorders. At the time of diagnosis with AX. denitrificans infection, 10 patients were using ampirical antibiotic for vairous reasons. One patient passed away before culture result was obtained. The most common ampirical antibiotic was found as third generation cephalosporins. When culture results were identified in 50% of the patients were receiving appropriate antibiotherapy. All 16 culture growths revealed sensitivity towards piperacillin/tazobactam. Conclusion: Even though AX. denitrificans is a rare community and hospital derived infectious agent, it should be kept in mind in clinics that show clustering and suitable ampiric therapy should be applied to keep the infection under control.
  • No Thumbnail Available
    Item
    Validity and reliability of Turkish version of rhinitis and mini-rhinitis quality of life questionnaires
    Yuksel, H; Yilmaz, O; Alkan, S; Degirmenci, PB; Kirmaz, C
    Background: The aim of the present study was to develop the Turkish version of Rhinitis Quality of Life Questionnaire (RQLQ) and mini-RQLQ for clinical and research purposes. Methods: Study included 55 patients with Allergic Rhinitis (AR), aged 18-69. Demographic characteristics and symptom score (T4SS) were recorded. All patients filled in the Turkish RQLQ and mini-RQLQ. Reliability analysis included internal consistency and item-total score correlations. Construct validity analysis was performed by Known Group method by correlation of RQLQ and mini-RQLQ scores with T4SS and SF36. Results: Mean age of patients was 36.4 +/- 10.6. Mean T4SS was 4.7 +/- 4.1. Cronbach's alpha. scores of all RQLQ domains were above 0.90 and those of mini-RQLQ were above 0.80. All items were significantly correlated with their domains. All correlation coefficients for item versus domain score were above 0.75 for RQLQ and above 0.84 for mini-RQLQ. Total RQLQ score was correlated with SF36 domains except physical functioning domain. Total mini-RQLQ score was significantly correlated with all SF36 domains (all r>-0.46). T4SS revealed significant correlation with RQLQ practical score (r=0.38). On the other hand, T4SS was correlated significantly with practical, nose and total scores of mini-RQLQ (r=0.33, 0.48, 0.34 respectively). Conclusions: Health is the complete state of well-being and AR has major impact on quality of life (QoL), therefore it seems essential to include QoL measures in clinical evaluation along with traditional parameters. This study has demonstrated that RQLQ and mini-RQLQ are valid measures for use in Turkish patients with AR. (C) 2009 SEICAP. Published by Elsevier Espana, S.L. All rights reserved.
  • No Thumbnail Available
    Item
    GASTROESOPHAGEAL REFLUX OR ASTHMA: WHICH COMES FIRST IN ATOPIC AND NONATOPIC CHILDREN?
    Yilmaz, O; Kasirga, E; Kader, S; Alkan, S; Yuksel, H
  • No Thumbnail Available
    Item
    Relationship of sleep and life quality with children monosymptomatic enuresis nocturna by using actigraphy
    Alkan, S; Ertan, P; Tekin, G; Yüksel, H; Yilmaz, Ö; Yilmaz, H
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    Gastroesophageal reflux disease in asthmatic children and its relation with atopy
    Yilmaz, Ö; Kasirga, E; Kader, S; Alkan, S; Yüksel, H
    Objective: The aim of this study was to determine frequency of gastroesophegeal reflux disease (GERD) and influence of GERD treatment on respiratory findings in atopic and nonatopic children with asthma. Materials and Methods: Thirty two nonatopic, 24 atopic children with asthma were enrolled in this retrospective study. GERD related respiratory symptoms and asthma severity parameters six months prior to and after pH monitoring were recorded. 24 hour pH monitoring results were also recorded. Results: Frequency of proximal GERD was 71.9% in atopic and 70.8% in nonatopic group (p=0.93). Distal GERD frequencies were similar (66.7% and 68.8% in atopic and nonatopic groups respectively, p=0.87). All parameters improved in nonatopic children after GERD treatment (p=0.01). However, only respiratory symptoms and hospitalization improved in atopic children (p=0.002 and p=0.007 respectively). Conclusion: Similar frequencies of GERD in atopic and nonatopic children may suggest role of asthma in development of GERD. However, improvement in all clinical parameters in nonatopic but not in atopic children might indicate that gastroesophageal reflux is the causal event in the association of asthma and GER in nonatopic children whereas it is the result in atopic ones. These findings need to be supported by further prospective cohort studies.
  • No Thumbnail Available
    Item
    Severe hypoglycemia due to insulin auto-antibodies of newly diagnosed multiple myeloma: A case report
    Guney, SC; Miskioglu, M; Engurulu, SF; Cavdar, GG; Akcura, C; Alkan, S; Ozdemir, N; Hekimsoy, Z
    ObjectiveInsulin autoimmune syndrome (IAS) is a rare condition that can be overlooked in the differential diagnosis of hypoglycemia. Hematologic malignancies such as multiple myeloma (MM) have been associated with IAS. Very few cases of IAS due to multiple myeloma have been reported in the literature. We wanted to present our case who applied to our clinic with severe hypoglycemia and was diagnosed with multiple myeloma-associated IAS.Case presentationAn 83-year-old male patient was admitted to our clinic with recurrent severe hypoglycemia episodes. When the patient's plasma glucose was 37 mg/dL, insulin level was high (2266 mu IU/ml), C-peptide level was relatively normal (3.44 ng/ml); cortisol and ACTH levels were also normal. No pathologic finding was detected in the abdominal MRI and Ga-68 PET/CT. Anti-insulin antibody (IAA) was tested for IAS, and the antibody level was found to be 95.9%. The patient was evaluated in terms of possible conditions that may lead to IAS. Hematology consultation was made due to the fact that the patient had anemia, chronic renal failure, and albumin/globuline discordance, and he was diagnosed with IgG kappa multiple myeloma. Bortezomib and dexamethasone treatment was initiated. A decrease in hypoglycemic symptoms was observed with chemotherapy.ConclusionIAS should be considered in the differential diagnosis of recurrent hypoglycemia cases of unknown cause. It should be kept in mind that IAS may develop due to multiple myeloma, especially in patients with advanced age and anemia.
  • No Thumbnail Available
    Item
    Knowledge and practice of general pediatricians about childhood asthma and its treatment
    Yilmaz, Ö; Sögüt, A; Alkan, S; Yüksel, H
    Aim: It is essential educate general pediatricians about childhood asthma and its treatment to standardize care. The aim of this study was to evaluate knowledge and practice of pediatricians about childhood asthma and its treatment. Material and Method: The study included 52 pediatricians who attended one of the seven meetings about asthma treatment. A questionnaire of 42 questions, 23 about asthma and its treatment and 19 about their practice were given before meeting. Results: Hospital of residency did not change answers to the questions, but presence of private office and duration of practice did. Among pediatricians who owned private office, 82.4% said the sentence: systemic steroids have a role in acute asthma exacerbation treatment was true, compared to the 47.1% of the ones without private office (p = 0.014). Referral to pediatric allergy center during or after acute asthma exacerbation was significantly lower among the pediatricians who owned private Office (p = 0.002 and p = 0.016 respectively). Duration of practice as a pediatrician influenced knowledge about use of inhaled steroids in asthma (p = .005). Conclusions: In conclusion, duration of practice and presence of private office influence knowledge and practice of general pediatricians about asthma and its treatment. The essence of postgraduate education to provide children more standardized treatment was emphasized with these results. (Turk Arch Ped 2009; 44: 29-34)
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    Beyond Infection: Unmasking the Impact of COVID-19 on Diabetes Emergency Trends
    Güney, SC; Akçura, C; Alkan, S; Çavdar, GG; Özdemir, N; Hekimsoy, Z
    Introduction The relationship between COVID-19 and diabetes has been demonstrated in many studies. However, it is thought that the psycho-socioeconomic effects of the pandemic led to a worsening of glycemic control and an increase in diabetes-associated clinical emergencies in diabetic patients without a diagnosis of COVID19. Objectives We aimed to reveal the change in the frequency of diabetes-related clinical emergencies before and during the COVID-19 pandemic. Patients and methods The data of the patients requiring endocrinology consultations in Manisa Celal Bayar University Faculty of Medicine Emergency Service between March 2018 and March 2022 were included. In total, 269 consultations were analyzed. The March 2018- March 2020 period was considered as pre-COVID, and March 2020- March 2022 as the COVID-19 period. The frequency of diabetes-related conditions between these two periods was compared. Results Compared to the pre-COVID period, there was a significant increase in the frequency of admissions with diabetic ketosis, hyperglycemic hyperosmolar state, hypoglycemia, and hyperglycemia in the COVID-19 period (p=0.022, p=0.037, p=0.044, and p=0.004 respectively). Although an increase was observed in the frequency of diabetic ketoacidosis (DKA) cases, no statistical significance was found. When the mortality data of the patients was evaluated, the total number of deaths was seen to increase significantly in the COVID-19 period (p=0.01). It was observed that the ratio of type 2 diabetes mellitus (DM)/type 1 DM among DKA patients increased significantly in the COVID-19 period (p=0.001). Conclusions It can be concluded that the increasing trend in diabetic emergencies that started even before the pandemic is exacerbated by COVID-19, especially in patients with poor glycemic control.
  • No Thumbnail Available
    Item
    Should adrenal incidentaloma patients be evaluated for muscle mass, function, and quality? A cross-sectional study
    Alkan, S; Guney, SC; Akcura, C; Ozdemir, N; Hekimsoy, Z
    PurposeOur study evaluated skeletal muscle mass, function and quality among mild autonomous cortisol secretion (MACS) patients and non-functioning adrenal incidentaloma (NFAI) patients in comparison with the control group without adrenal mass.Methods63 NFAI (49 female, 14 male) and 31 MACS (24 female, 7 male) patients were included in the study. As the control group, 44 patients (31 women, 13 men) who were known to have no radiological adrenal pathology on computed tomography or magnetic resonance imaging performed for other reasons were selected. After recording the laboratory parameters of the patients, anthropometric measurements, handgrip strength test with dynamometer, SARC-F survey and bioelectrical impedance analysis (BIA) measurements were performed.ResultsThere was no statistical difference among the groups in terms of age, gender, and BMI parameters. Handgrip strength (HGS), skeletal muscle mass (SMM) index (SMM/BMI), and skeletal muscle quality (HGS/SMM), values used to evaluate muscle strength and quality, were found to be significantly lower in both the MACS and NFAI groups compared to the control group (p = 0.004, p = 0.012 and p = 0.034 respectively). This significance was also present in women subgroup analyses (p = 0.002, p = 0.037 and p = 0.039 respectively), but these parameters lost their statistical significance in men. In the correlation analysis of the female subgroup, 24-h free urine cortisol value was inversely proportional to skeletal muscle quality (rs = -0.417, p = 0.008).ConclusionOur study showed that there is a decrease in muscle mass and function in female AI patients, and this decrease is more severe in MACS patients. These results may suggest that mild cortisol excess also has negative effects on skeletal muscle metabolism.
  • No Thumbnail Available
    Item
    Investigation of hematologic findings related to brucellosis in Anatolian region
    Çelik, M; Arslan, Y; Topcu, E; Sahinoglu, MS; Altindag, D; Gürbüz, E; Atalay, E; Demircan, SK; Emre, S; Kirik, Y; Atasoy, PY; Özer, D; Ipek, D; Dogan, E; Atli, SB; Kusçu, EG; Alkan, S; Çiçek, Y; Yüksekkaya, E; Aldemir,Ö; Sahin, A; Ürkmez, EY; Al, SÖ; Boran, R; Mizrakçi, SO; Demiray, EKD; Ceylan, MR; Erdogdu, H; Tekin, S
    Objectives: To investigate the prevalence of hematologic findings and the relationship between hemogram parameters and brucellosis stages in patients. Methods: This multi-center study included patients older than 16 years of age who were followed up with a diagnosis of brucellosis. Patients' results, including white blood cell, hemoglobin, neutrophil, lymphocyte, monocyte, mean platelet volume, platelet and eosinophil counts were analyzed at the initial diagnosis. Results: In this study 51.3% of the patients diagnosed with brucellosis were male. The age median was 45 years for female and 41 years for male. A total of 55.1% of the patients had acute brucellosis, 28.2% had subacute, 7.4% had chronic and 9% had relapse. The most common hematologic findings in brucellosis patients were anemia (25.9%), monocytosis (15.9%), eosinopenia (10.3%), and leukocytosis (7.1%). Pancytopenia occurred in 0.8% of patients and was more prominent in the acute phase. The acute brucellosis group had lower white blood cell, hemoglobin, neutrophil, eosinophil, and platelet counts and mean platelet volume, and higher monocyte counts compared to subacute and chronic subgroups. Conclusion: It was noteworthy that in addition to anemia and monocytosis, eosinopenia was third most prominent laboratory findings in the study. Pancytopenia and thrombocytopenia rates were low.
  • No Thumbnail Available
    Item
    UNINTENTIONAL MONOTHERAPY IN RHEUMATOID ARTHRITIS PATIENTS RECEIVING TOFACITINIB AND DRUG SURVIVAL RATE OF TOFACITINIB
    Inanc, N; Abacar, K; Ozturk, MA; Tufan, A; Karadeniz, H; Sari, I; Can, G; Erez, Y; Pehlivan, Y; Dalkiliç, E; Ocak, T; Cefle, A; Yazici, A; Senel, A; Akar, S; Ediboglu, ED; Koca, SS; Sagir, RP; Yilmaz, S; Gulcemal, S; Gündüz, ÖS; Basibüyük, CS; Alkan, S; Cesur, TY; Onen, F
  • No Thumbnail Available
    Item
    Unintentional Monotherapy in Rheumatoid Arthritis Patients Receiving Tofacitinib and Drug Survival Rate of Tofacitinib
    Inanc, N; Abacar, KY; Ozturk, MA; Tufan, A; Karadeniz, H; Sari, I; Can, G; Erez, Y; Pehlivan, Y; Dalkilic, HE; Ocak, T; Cefle, A; Yazici, A; Senel, AS; Akar, S; Durak-Ediboglu, E; Koca, SS; Piskin-Sagir, R; Yilmaz, S; Gulcemal, S; Soysal-Gunduz, O; Basibuyuk, CS; Alkan, S; Cesur, TY; Onen, F
    ObjectiveTo determine the rate of unintentional monotherapy (UM; switching to monotherapy from combination therapy of patients' own volition) in rheumatoid arthritis patients receiving tofacitinib and to evaluate tofacitinib survival rate.MethodsThis national, multicenter study included patients' data from the TURKBIO Registry. Demographics, clinical characteristics, disease duration and activity, comorbidities, and treatments were analyzed.ResultsData of 231 rheumatoid arthritis patients (84.8% female, median age, 56 years) were included; 153 were initially prescribed combination therapy and continued to their therapies; 31 were initially prescribed combination therapy but switched to monotherapy on their own volition (UM); 21 were initially prescribed monotherapy and switched to combination therapy; 26 were initially prescribed monotherapy and continued to their therapies. The rate of comorbidities at the time of data retrieval was higher in the UM group than in the combination group (83.3% vs. 60.3%, p = 0.031). Presence of comorbidities was a significant factor affecting switching to monotherapy (p = 0.039; odds ratio, 3.29; 95% confidence interval, 1.06-10.18). The combination and UM groups did not differ regarding remission rate assessed by Disease Activity Score 28-joint count C-reactive protein (60.5% and 70%, respectively; p = 0.328). Drug survival rates of the UM and combination groups did not differ. The median drug survival duration of tofacitinib was 27+ months with 1- and 4-year drug survival rates of 89.6% and 60.2%, respectively, in the UM group.ConclusionsAlthough 13.4% of the study population started monotherapy unintentionally, drug survival and remission rates of the UM and combination groups were not different. Comorbidity was a factor affecting transition from combination therapy to monotherapy.
  • No Thumbnail Available
    Item
    Clinicopathological Reflections of Hashimoto's Thyroiditis and Papillary Thyroid Carcinoma Coexistence
    Akcura, C; Alkan, S; Güney, SC; Çavdar, GG; Senol, E; Tan, AY; Özdemir, N; Aydede, H; Hekimsoy, Z
    Objective: Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid cancer. Hashimoto's thyroiditis (HT), a chronic inflammation of the thyroid gland, is one of the most common autoimmune diseases worldwide. In this study, we aimed to determine the relationship between PTC and HT and the clinicopathological effects of the combination of HT and PTC on the course of PTC. Methods: In this cross-sectional retrospective study, PTC cases who underwent surgery and were followed up at our institution's endocrinology outpatient clinic between 2014 and 2022 were divided into two groups according to the presence of HT. Demographic data of both groups, pathological features of the tumor, and preoperative laboratory findings were examined. Results: A total of 42.4% (n=118) of 278 cases were accompanied by HT. The mean age of the patients was 46.44 +/- 12.2 years. The majority of patients were female (80.6%, n=224). Multifocality was significantly less common in the HT group (p=0.037). Conclusion: Although multifocality was significantly less common in the HT group, no other statistically significant parameter was discovered in other clinicopathological findings. In light of these findings, the effect of HT on the course of PTC cannot be clearly determined. Considering the conflicting results regarding the effect of HT-PTC coexistence on the course of PTC in the literature, a comprehensive prospective study on this subject is necessary.