Browsing by Author "Dede B."
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Item The course of spinal tuberculosis (Pott disease): Results of the multinational, multicentre Backbone-2 study(Elsevier B.V., 2015) Batirel A.; Erdem H.; Sengoz G.; Pehlivanoglu F.; Ramosaco E.; Gülsün S.; Tekin R.; Mete B.; Balkan I.I.; Sevgi D.Y.; Giannitsioti E.; Fragou A.; Kaya S.; Cetin B.; Oktenoglu T.; Celik A.D.; Karaca B.; Horasan E.S.; Ulug M.; Senbayrak S.; Kaya S.; Arslanalp E.; Hasbun R.; Ates-Guler S.; Willke A.; Senol S.; Inan D.; Güclü E.; Ertem G.T.; Koc M.M.; Tasbakan M.; Ocal G.; Kocagoz S.; Kusoglu H.; Güven T.; Baran A.I.; Dede B.; Karadag F.Y.; Yilmaz H.; Aslan G.; Al-Gallad D.A.; Cesur S.; El-Sokkary R.; Sirmatel F.; Savasci U.; Karaahmetoglu G.; Vahaboglu H.We aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae. © 2015 European Society of Clinical Microbiology and Infectious Diseases.Item Comparison of brucellar and tuberculous spondylodiscitis patients: Results of the multicenter "backbone-1 Study"(Elsevier Inc., 2015) Erdem H.; Elaldi N.; Batirel A.; Aliyu S.; Sengoz G.; Pehlivanoglu F.; Ramosaco E.; Gulsun S.; Tekin R.; Mete B.; Balkan I.I.; Sevgi D.Y.; Giannitsioti E.; Fragou A.; Kaya S.; Cetin B.; Oktenoglu T.; Dogancelik A.; Karaca B.; Horasan E.S.; Ulug M.; Inan A.; Kaya S.; Arslanalp E.; Ates-Guler S.; Willke A.; Senol S.; Inan D.; Guclu E.; Tuncer-Ertem G.; Meric-Koc M.; Tasbakan M.; Senbayrak S.; Cicek-Senturk G.; Sirmatel F.; Ocal G.; Kocagoz S.; Kusoglu H.; Guven T.; Baran A.I.; Dede B.; Yilmaz-Karadag F.; Kose S.; Yilmaz H.; Aslan G.; Algallad D.A.; Cesur S.; El-Sokkary R.; Bekiroǧlu N.; Vahaboglu H.Background Context No direct comparison between brucellar spondylodiscitis (BSD) and tuberculous spondylodiscitis (TSD) exists in the literature. Purpose This study aimed to compare directly the clinical features, laboratory and radiological aspects, treatment, and outcome data of patients diagnosed as BSD and TSD. Study Design A retrospective, multinational, and multicenter study was used. Patient Sample A total of 641 (TSD, 314 and BSD, 327) spondylodiscitis patients from 35 different centers in four countries (Turkey, Egypt, Albania, and Greece) were included. Outcome Measures The pre- and peri- or post-treatment spinal deformity and neurologic deficit parameters, and mortality were carried out. Methods Brucellar spondylodiscitis and TSD groups were compared for demographics, clinical, laboratory, radiological, surgical interventions, treatment, and outcome data. The Student t test and Mann-Whitney U test were used for group comparisons. Significance was analyzed as two sided and inferred at 0.05 levels. Results The median baseline laboratory parameters including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were higher in TSD than BSD (p<.0001). Prevertebral, paravertebral, epidural, and psoas abscess formations along with loss of vertebral corpus height and calcification were significantly more frequent in TSD compared with BSD (p<.01). Surgical interventions and percutaneous sampling or abscess drainage were applied more frequently in TSD (p<.0001). Spinal complications including gibbus deformity, kyphosis, and scoliosis, and the number of spinal neurologic deficits, including loss of sensation, motor weakness, and paralysis were significantly higher in the TSD group (p<.05). Mortality rate was 2.22% (7 patients) in TSD, and it was 0.61% (2 patients) in the BSD group (p=.1). Conclusions The results of this study show that TSD is a more suppurative disease with abscess formation requiring surgical intervention and characterized with spinal complications. We propose that using a constellation of constitutional symptoms (fever, back pain, and weight loss), pulmonary involvement, high inflammatory markers, and radiological findings will help to differentiate between TSD and BSD at an early stage before microbiological results are available. © 2015 Elsevier Inc.Item Untitled(Turkiye Klinikleri Journal of Medical Sciences, 2016) Karabay O.; Hoşoğlu S.; Güçlü E.; Akalin Ş.; Altay F.A.; Aydin E.; Ceylan B.; Çelik A.; Çelik İ.; Demirdal T.; Demirli K.; Erben N.; Erkorkmaz Ü.; Erol S.; Evirgen Ö.; Gönen İ.; Güner A.E.; Güven T.; Kadanali A.; Koçoğlu M.E.; Kökoğlu Ö.F.; Küçükbayrak A.; Sargin F.; Sünnetçioğlu M.; Şenol Ş.; Taşbakan M.I.; Tekin R.; Turhan V.; Yilmaz G.; Dede B.Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics. Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician. Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had ≤5 years of occupational experience (junior specialists = JSs) and 942 (49.4%) of them were physicians. Specialists having >5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05). Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did. © TÜBITAK.Item Variables affecting quality of care of the outpatients having a chronic condition; [Kronik hastalığı nedeniyle ayaktan izlenen hastaların aldıkları sağlık hizmetlerinin niteliğini etkileyen değişkenler](Gulhane Military Medical Academy, 2016) Dede B.; Sarı M.; Gürsul A.; Hanedar A.; Gadis A.; Görgülü B.; Eti B.; Kalay C.; Aydin H.; Güler H.A.; Kala İ.; Görgülü K.; Dilşen M.; Yıldırımkaya U.; Tuğba S.; Eser E.Objective: The best known, most effective and widely used model for chronic illness management is “Chronic Care Model”. Patient Assessment of Care for Chronic Conditions (PACIC) (KBDh) is designed according to this model. The objectives of this study are; 1. To test the sensitivity of PACIC to diverse socio-economic and condition specific variables and 2. To define the quality of care (QOC) and the affecting variables on QOC of the patients in the outpatient wards of CBU hospital. Materials and Methods: In this descriptive study, we enrolled patients from Celal Bayar University Hospital, Departments of Internal Medicine (Endocrinology, Nephrology, Rheumatology, Oncology, and Gastroenterology), Neurology, Dermatology, and Pulmonary Medicine outpatient clinics. Patients were under follow-up care for more than 6 months (n=295) and they were asked to fill the survey containing PACIC scale, socio-demographic variables and other morbidity variables. Type 1 error was adopted as 0.05 and the SPSS 15.0 was used for statistical analysis. Results: The mean age was 51.6±15.2; 18.3% of patients aged 65 and over, and 64.7% were female. 28.8% of patients had type 2diabetes, 29.5% had hypertension, 16.7% had COPD, 15.5% had neurological disease (migraine, epilepsy, MS) and 9.5% had chronic allergic diseases. The mean duration of disease was 9.3±7.9 years, and there was at least one comorbidity in 48.8% of the patients. The overall PACIC scale score was 2.81±0.86. Lower education and income status; the lack of social security and migration to the region negatively affected the quality of follow-up (p<0.05). Patients with hypertension were more negatively affected than the other chronic illness patients in terms of patient activation and goal setting/tailoring dimension scores (p<0.05). Having continuous monitoring by a particular physician and having this physician as primary care physician increased the quality of monitoring (p<0.05). Also, for all chronic diseases and for all dimensions, improvement in quantity of monitoring improved quality of monitoring. Conclusion: Given the PACIC (KBDh) the total score and dimension scores and considering that patients were followed at a university hospital, the scores in this study show that the quality of monitoring is not sufficient level of. Monitoring of the patients in primary care conditions instead of at the second level improves the quality of follow-up. © GATA.Item Novel metal(II) complexes with bidentate Schiff base ligand: Synthesis, spectroscopic properties and dye decolorization functions(Polish Academy of Sciences, 2016) Karakaya C.; Dede B.; Cicek E.The bidentate Schiff base ligand 4-chloro-2-[1-(4-phenylphenyl)ethylideneamino]phenol and its mononuclear Co(II), Ni(II), Cu(II) and Zn(II) complexes have been synthesized. Ligand and metal complexes were characterized by elemental analyses, magnetic susceptibility, molar conductivity, 1H- and 13C-NMR, the Fourier transform infrared, UV-Vis, inductively coupled plasma optical emission spectrometry, and thermogravimetric-differential thermogravimetric studies. The results suggest that the mononuclear complexes have a metal to ligand mole ratio of 1:2 and the metal(II) ions are coordinated with the phenolic oxygen and imine nitrogen atoms. Octahedral structures are proposed for the complexes of the Schiff base ligand. Furthermore, the complexes were checked for their efficiency to decolorize the dye methylene blue. In our experiments we found that metal(II) complexes had an acceptable decolorization efficiency against the dye methylene blue.Item Clinical features of patients with chronic urticaria and the results of the skin prick tests(Bilimsel Tip Yayinevi, 2019) Bilgir F.; Özdemir R.B.; Değirmenci P.; Dede B.; Kirmaz C.Objective: Chronic urticaria (CU), which is mostly idiopathic, may also be a sign of an allergic or systemic disease. A variety of diseases and allergens that accompany CU have been reported in various studies. The aim of this study was to investigate the factors that play a role in the etiology of CU. Materials and Methods: The demographic and clinical data from 302 patients – aged over 18 years - who were being monitored for CU were recorded. Several tests were performed to analyze comorbidities such as infection, malignancy, and autoimmune and rheumatic diseases. Skin Prick Test (SPT) results and questionnaires were reviewed. Results: Two hundred and thirteen out of the 302 patients with a mean age of 40.26±14.3 years were females. The duration of CU was 43.30±62.60 months and 42.9% of the patients had comorbidities. The most common disease was autoimmune thyroiditis (13.9%). Fifty-five percent of the patients were sensitive to inhalant allergens, and 5% exhibited allergen positivity for food. The most common allergens were house (43.7%) dust mites. Allergen positivity was 37.2% in those with comorbidities, while it was 62.8% in those without any comorbidities and this relationship was statistically significant (p<0.05). Conclusion: This study showed that there was an association between house dust mite and CU dust sensitivity. House dust mite sensitivity may trigger CU. © 2019 Bilimsel Tip Yayinevi. All rights reserved.Item Production, optimization and characterization of polylactic acid microparticles using electrospray with porous structure(MDPI AG, 2021) Tasci M.E.; Dede B.; Tabak E.; Gur A.; Sulutas R.B.; Cesur S.; Ilhan E.; Lin C.-C.; Paik P.; Ficai D.; Ficai A.; Gunduz O.Polymeric microparticles with controlled morphologies and sizes are being studied by researchers in many applications, such as for drug release, healthcare and cosmetics. Herein, spherical and porous polymeric microparticles of different sizes and morphologies by electrospray technique have been developed as a viable alternative. In this work, polylactic acid (PLA) microparticles with a spherical shape and porous morphology were successfully produced via an electrospray technique in a single step. Molecular interactions between the components and the effect of parameters, such as varying solvent compositions, flow rates and voltage on microparticle morphology, were investigated over the particle formation. It was observed that the type of solvents used is the most effective parameter in terms of particle morphology, size and distribution. When the optical microscopy and SEM images of the microparticles were examined, 3 wt.% PLA in dichloromethane (DCM) solution concentration with an applied voltage of 18 kV and a flow rate of 20 µL/min was found to be the optimum parameter combination to achieve the desired spherical and porous micron-size particles. The average diameter of the particles achieved was 3.01 ± 0.58 µm. DCM was found to be a more suitable solvent for obtaining microparticles compared to the other solvents used. Finally, particles that are obtained by electrospraying of PLA–DCM solution are porous and monodisperse. They might have excellent potential as a carrier of drugs to the targeted sides and can be used in different biomedical applications. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Item Psychological Determinants of Turkish Farmers’ Health and Safety Behaviors: An Application of the Extended Theory of Planned Behavior(MDPI, 2023) Baydur H.; Eser E.; Sen Gundogan N.E.; Ayhan E.; Eser S.; Dede B.; Hazneci E.; Öztekin Y.B.; Ekuklu G.; Cevizci S.; Van den Broucke S.Background: Structural and behavioral factors are among the causes of occupational accidents in agriculture. The SACURIMA Cost network developed a questionnaire to measure the determinants of farmers’ safety behavior based on the extended theory of planned behavior (TPB). Extended TPB adds subjective norms, subjective control, physical barriers and safety culture to TPB. Objective: The aim of this study is to test the psychometric properties of the “Farmers Safety Behaviors questionnaire” developed by the SACURIMA Cost network. Methods: A Turkish version of the questionnaire was applied to 305 farmers producing six different agricultural products in Turkey. The tool consists of 64 items measuring the determinants of four risk-related behaviors (fall prevention, machine handling, chemical-pesticide use, and animal handling) in a single extended TPB model. Results: The alpha values for the six dimensions ranged from 0.69 to 0.89. The confirmatory factor analysis results for all dimensions were at acceptable levels (CFI range = 0.93–0.99; RMSEA range = 0.03–0.09). Four path models were used to test the behaviors and their predictors, and the results were found to be predictive. The criterion and known groups’ validity analyses results were sufficient. Conclusion: The “Farmers Safety Behaviors Questionnaire” is a valid and reliable tool to measure the determinants of occupational safety behaviors in Turkish farmers. © 2023 by the authors.Item Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study(Routledge, 2024) Eser E.; Cil E.; Sen Gundogan N.E.; Col M.; Yildirim Ozturk E.N.; Thomas D.T.; Sunter A.T.; Arslan H.N.; Citil R.; Onder Y.; Picakciefe M.; Dede B.; Demirel C.; Aydin N.; Caglayan C.; Aker A.A.; Borlu A.; Durmus H.; Can G.; Siddikoglu E.; Sumer E.H.; Uygun T.; Alkoy S.; Aktas Aycan K.; Koruk İ.; Kuzan R.; Demir L.S.; Hacilar E.; Sari H.; Kilinc Z.; Onal O.; Dogan E.; Emek M.; Terzioglu R.; Yapici G.; Erdal D.; Eser S.; Ayhan Akman E.; Kosan Z.; Yilmaz S.; Ayoglu F.N.; Acikgoz B.; Musal B.; Suner A.F.; Erdogan A.; Cilburunoglu İ.; Saygun M.; Daymaz D.; Arslantas D.; Onsuz M.F.; Beyhun N.E.; Ustundag M.G.; Ekuklu G.; Ozder Tas F.; Abacigil F.; Oncu S.; Hıdıroğlu S.; Ozaydin A.N.; Pirincci E.; Bulut I.; Tozun M.; Eskiocak M.; Gunel P.; Torun S.D.; Yavuz M.; Hasde M.; Camur D.; Gunes G.; Kurt B.; Guler Baysoy N.; Bakirci N.; Demir F.; Catak B.; Ozyurda F.; Turan M.Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians’ migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants’ migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22–1.54) times more likely to emigrate. The push factor that was related to emigration intention was the “working conditions in the country” (OR: 1.89, 95% CI: 1.56–2.28) whereas the “social environment/lifestyle abroad” was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45–2.06). In addition, the quality problem in medical schools also had a significant impact on students’ decisions (OR: 2.20, 95% CI: 1.83–2.65). Insights: Although the percentage of those who want to emigrate “definitely” was at the same level as in the other developing countries, the tendency to migrate “permanently” was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians. © 2023 Taylor & Francis Group, LLC.