Browsing by Author "Alkan S."
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Item Knowledge and practice of general pediatricians about childhood asthma and its treatment; [Genel çocuk uzmanlarinin çocukluk çaǧi astimi ve tedavisi konusundaki bilgi durumu ve uygulamalari](Kare Publishing, 2009) Yilmaz Ö.; Söǧüt 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.Item Validity and reliability of Turkish version of rhinitis and mini-rhinitis quality of life questionnaires(2009) Yuksel H.; Yilmaz O.; Alkan S.; Bayrak Deǧirmenci P.; 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 α 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. © 2009 SEICAP.Item Metabolic and demographic characteristics of children with urolithiasis in Western Turkey(2011) Ertan P.; Tekin G.; Öger N.; Alkan S.; Horasan G.D.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. © 2010 Springer-Verlag.Item Interrupter resistance changes in children with bronchiolitis(2012) Yilmaz O.; Sogut A.; Alkan S.; Yuksel H.Introduction: Determination of lung function in children younger than three years with bronchiolitis may aid in treatment; however, technical difficulties such as requirement of sedation and lack in standardization limit clinical use. Objectives: Aim of this study was to evaluate lung function changes using the interrupter technique in unsedated wheezing children younger than 3 years during and after acute bronchiolitis. Methods: Children with acute bronchiolitis younger than three years age were enrolled in this cohort study. Number of previous bronchiolitis episodes, severity of pulmonary findings, duration of acute bronchiolitis findings before presentation, requirement for hospitalization were recorded during initial enrollment. Duration of the current bronchiolitis was recorded. Interrupter resistance (Rint) measurements were performed on all children during and after bronchiolitis, using a face mask. Results: Mean (±SD) age of the children enrolled was 9.4 ±2.9 months. Mean bronchiolitis score was 5.6 ±1.4 at presentation. Mean duration of acute bronchiolitis before and after presentation were 10.1 ±13.0 and 5.1 ±2.3 days, respectively. There was a significant decrease in expiratory Rint values after clinical bronchiolitis findings terminated [1.08 (0.45) vs 0.80 (0.33) kPa.L-1.s, p=0.009]. Flow had not changed significantly while mouth pressure had decreased (p=0.96 and p=0.01, respectively). Conclusion: Interrupter technique measurements showed higher resistance during acute bronchiolitis in children, which decreased after acute findings, disappeared. Rint may be used as a method to detect the change in airway function in unsedated children younger than three years in ambulatory conditions, despite some limitations of standardization in this age group.Item Pilot Scheme Conceptual Analysis of Rooftop East–West-Oriented Solar Energy System with Optimizer(MDPI, 2023) 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. © 2023 by the authors.Item Unintentional Monotherapy in Rheumatoid Arthritis Patients Receiving Tofacitinib and Drug Survival Rate of Tofacitinib(Lippincott Williams and Wilkins, 2023) Inanc N.; Abacar K.Y.; Ozturk M.A.; Tufan A.; Karadeniz H.; Sari I.; Can G.; Erez Y.; Pehlivan Y.; Dalkilic H.E.; Ocak T.; Cefle A.; Yazici A.; Senel A.S.; Akar S.; Durak-Ediboǧlu E.; Koca S.S.; Piskin-Sagir R.; Yilmaz S.; Gulcemal S.; Soysal-Gunduz O.; Basibuyuk C.S.; Alkan S.; Cesur T.Y.; Onen F.Objective To 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. Methods This national, multicenter study included patients' data from the TURKBIO Registry. Demographics, clinical characteristics, disease duration and activity, comorbidities, and treatments were analyzed. Results Data 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. Conclusions Although 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. © Wolters Kluwer Health, Inc. All rights reserved.Item Cervical lymphadenopathy in a patient receiving anti-TNF a treatment: glandular tuberculosis or oropharyngeal tularemia?(Verduci International, 2023) Alkan S.; Şahinoğlu İ.; Şahinoğlu M.S.Background: Tularemia is a global anthroponotic disease that is endemic in some regions of Turkey, and it is carried by small rodents (hares) and arthropods (ticks, horseflies). Tularemia is caused by the Fran-cisella tularensis bacteria, which is a facultatively intracellular Gram-negative bacillus. Case presentation: Herein, we present a case of oropharyngeal tularemia living in an endemic region of Turkey. The patient was 64 years old, had rheumatoid arthritis, and had been taking anti-TNF (adalimum-ab) in combination with methotrexate for about a year. She had swelling in her neck. She also had a sore throat and recurrent mouth ulcers. Her vital signs showed no abnormality; she had no fever, and physical examination only revealed hyperemia in the left cervical region and an enlarged painful lymph node. Significant tularemia serological titers supported the diagnosis, with contaminated water consumption being the most likely transmission route. Streptomycin (15 mg/kg/day, intramuscular) was given for 10 days. The patient healed completely without any complications. Six months later, there had been no recurrence. Conclusions: Particularly in endemic regions, tularemia should be considered in the differential diagnosis of lymphadenopathy with necrotic granuloma in patients receiving anti-TNF α treatment. © 2023, Verduci International. All rights reserved.Item Severe hypoglycemia due to insulin auto-antibodies of newly diagnosed multiple myeloma: A case report(Springer, 2024) Guney S.C.; Miskioglu M.; Engurulu S.F.; Cavdar G.G.; Akcura C.; Alkan S.; Ozdemir N.; Hekimsoy Z.Objective: Insulin 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 presentation: An 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 µIU/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. Conclusion: IAS 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. © The Author(s), under exclusive licence to Research Society for Study of Diabetes in India 2023.Item Should adrenal incidentaloma patients be evaluated for muscle mass, function, and quality? A cross-sectional study(Springer, 2025) Alkan S.; Guney S.C.; Akcura C.; Ozdemir N.; Hekimsoy Z.Purpose: Our 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. Methods: 63 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. Results: There 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). Conclusion: Our 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. © The Author(s) 2025.Item Are Inflammation Markers Derived from Hemogram Parameters Predictive for Papillary Thyroid Carcinoma in Hashimoto’s Thyroiditis Patients?(Springer, 2025) Akcura C.; Guney S.C.; Alkan S.; Cavdar G.G.; Tan A.; 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. © Association of Surgeons of India 2025.