Browsing by Author "Demir T."
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Item Treatment of severe asthma: Expert opinion; [Aǧi{dotless}r asti{dotless}m tedavisi: Uzman görüşü](Ankara University, 2014) Türktaş H.; Bavbek S.; Çelik G.; Demir T.; Gemicioǧlu B.; Günen H.; Kiyan E.; Mungan D.; Oǧuzülgen I.K.; Polatli M.; Saryal S.; Sayiner A.; Şen E.; Yildirim N.; Yildiz F.; Yorgancioǧlu A.Severe asthmatics account 10% of the all asthmatic population. Those asthmatics whose disease is inadequately controlled account for up to half of the cost for asthma, because they have more emergency room visits, more hospital admission and greater absenteeism from work. New therapeutic options were tried in those patients whose asthma was uncontrolled with standart high dose inhaled corticosteroid and long acting beta-2 agonsit combination therapy. In this paper taking into account the conditions of our country, current literature was reviewed and treatment options was discussed and graded recommendations are made for daily clinical practice in patients with severe treatment-refractory asthma.Item Stress Coping Strategies in Hemodialysis and Kidney Transplant Patients(Elsevier Inc., 2015) Gurkan A.; Pakyuz S.Ç.R.; Demir T.Objective The aim of this study was to determine the levels of anxiety and depression, and stress coping strategies used by hemodialysis and kidney transplant patients. Methods This study included 138 hemodialysis patients treated at the two private dialysis centers and 76 kidney transplantation patients followed up at the private hospital. Data were collected with socio-demographic characteristics, the Hospital Anxiety and Depression Scale, and the Coping Strategies Questionnaire (COPE). Results The anxiety and depression scores were significantly lower among the transplant group versus the hemodialysis patients. The use of non-functional coping strategies was higher among the patients who were treated with hemodialysis, compared to the renal transplantation patients. The use of problem focused and emotional focused coping strategies were higher among the renal transplant patients, compared to hemodialysis patients. When all participants were evaluated together, turning to religion was the most frequent coping strategy followed by active coping, and positive reinterpretation. In hemodialysis patients, there was a significantly negative correlation between age and problem-focused, emotion-focused and non-functional coping strategies. In contrast, the correlation between education level and both problem-focused and emotion-focused coping strategies was significantly positive. In transplant patients, gender and education level were significantly negative correlated with emotion-focused coping strategies. Conclusion The results of data analysis showed that the hemodialysis patients used fewer functional coping strategies and had more anxiety and depression than kidney transplant patients. It would be helpful to know an individual's coping strategies in the case of a stressful situation in order to determine treatment goals and monitor therapeutic efficacy. © 2015 Elsevier Inc. All rights reserved.Item Asthma-KOAH overlap syndrome; [Astım-KOAH overlap sendromu](Ankara University, 2015) Şen E.; Oğuzülgen K.; Bavbek S.; Günen H.; Kiyan E.; Türktaş H.; Yorgancioğlu A.; Polatli M.; Yildiz F.; Çelik G.; Demir T.; Gemicioğlu B.; Mungan D.; Saryal S.; Sayiner A.; Yildirim N.Asthma and chronic obstructive pulmonary disease (COPD) are common lung diseases characterized by chronic airway inflammation and airway obstruction. Among patient with COPD and asthma; there is a group of patients with an overlap between clinical, functional characteristics and airway inflammation patterns, named “Asthma-COPD Overlap Syndrome” (ACOS). ACOS is a syndrome characterized by reversible but persistant airflow limitation (postbronchodilator FEV1/FVC < 70%) which has some features of both asthma and COPD. ACOS should be suspected in a patient > 40 years, with smoking history, previous asthma diagnosis or history of childhood asthma who has persistant airflow limitation and reversible ariway obstruction (defined by an increase of > %12 of FEV1 pred or increase of FEV1 > 200 mL after inhalation of 400 mcg salbutamol or 1000 mcg terbutaline). The prevalence for ACOS has been reported 11-55% in different case series to date and increases by age and is more frequent in females in different age groups. Patients with ACOS are younger than COPD patients and older than asthma patients. Frequent and severe exacerbations and related hospitalization and emergency room visits are common in ACOS and this causes an impaired quality of life. Current recommendations of guidelines for pharmacologic treatment of ACOS have been composed of a combination with optimal COPD and asthma treatment. Future therapeutic approaches should be based on endotypes. Clinical phenotype and underlying endotype driven clinical studies may be the base of ACOS guidelines. © 2015, Ankara University. All rights reserved.Item Validity-reliability of nine types temperament scale adolescent form (NTTS-A) and relationship between temperament types and attention deficit hyperactivity disorder; [Dokuz Tip Mizaç Ölçeʇi Ergen (DTMÖ-E) Formunun Geçerlik-Güvenirliʇi ve Ergenlerde Dikkat Eksikliʇi Hiperaktivite bozukluʇu Ile Mizaç Tipleri Arasindaki Ilişki](Turkish Education Association, 2015) Yilmaz E.D.; Ünal O.; Palanci M.; Kandemir M.; Örek A.; Akkin G.; Demir T.; Üstündaʇ M.F.; Gürçaʇ S.N.; Aydemir O.; Selçuk Z.The purpose of this study is developing adolescent form (11-16 years old) of Nine Types Temperament Scale (NTTS) depending on Nine Types Temperament Model (Study 1) and evaluating and searching the relationship between Attention Deficit and Hyperactivity Disorder (ADHD) and Types of NTTM (Study 2). Sample of Study I consist of 1240 students who are between 11 and 16 years old. Pilot form of the Scale which consists of 90 items is tested with confirmatory factor analysis and with convergent and discriminant validity and the last version of the measure which consist of 82 items is prepared. Basic Personality Traits Inventory (BPTI) which depends on Fife Factor Model is used for Criterion-related validation. Results show that NTTS-A is valid and reliable measure for evaluating temperament types between 11-16 years adolescents. Their fit index is calculated as χ2/df <3; SRMR, 0.06; RMSEA, 0.045; CFI, 0.909: TLI, 0901 supported to validity data. Sample of Study II consist of 56 adolescents who are diagnosed with ADHD according to DSM-IV diagnosis criteria and 56 students who does not get diagnosed with ADHD or mental retardation/medical disorder. Temperament types of participants are evaluated by the agency of Study-I and NTTS-A, which is developed appropriate for Turkish culture. Indication of the study shows that there are more NTT7 and NTT8 in NTTM types between adolescents with ADHD than the group, who are not diagnosed with ADHD. As a result, it is discussed that traits which belong to some temperament types could have a predisposing effect on emergence of ADHD, experiencing these traits extreme severely could cause a view similar to ADHD and ADHD which is a neurodevelopmental disease could interact with temperament traits of person, in that way it could illustrate ADHD clinic. Available findings support critics about that students are labelled as ADHD specially in the last years in education environment even if they have mostly not developmental problems and students are diagnosed easily with limited observations. However, it is asserted that diagnosis based on temperament, treatment and psychosocial support programmes could be formed and effects of ADHD, which is a factor interacting with temperament traits, on personality structure of adolescents on their development process, could be predicted. Our study has the feature of being the first measure developing study which is intended to evaluate temperament types of adolescents between 11-16 years old and also it is has the feature of being the first study which searches relationship between NTTM types and ADHD.Item Koah ve astımda atak; [KOAH ve astımda atak](Ankara University, 2015) Yildirim N.; Demir T.; Gemicioğlu B.; Kiyan E.; Oğuzülgen K.; Polatli M.; Saryal S.; Sayiner A.; Yorgancioğlu A.; Bavbek S.; Çelik G.E.; Günen H.; Mungan D.; Şen E.; Türktaş H.; Yildiz F.Chronic obstructive pulmonary disease (COPD) and asthma are airway diseases with acute exacerbations. Natural course of both disease are affected by exacerbations. COPD exacerbations may be caused by infections and other causes; indoor and outdoor pollution, cardiovascular diseases, asthma-COPD overlap syndrome, COPD- obstructive sleep apnea syndrome, pulmonary embolism, gastro-oesophageal reflux, anxiety-depression, pulmonary hypertension. Exposure to triggering factors, viral infections, treatment insufficiency may cause asthma exacerbations. Smoking cessations, prevention of infections, long-acting anticholinergics, long-acting β2 agonists, inhaled corticosteroids, phosphodiesterase-4 inhibitors, mucolytics, prophilactic antibiotics can be effective on the prevention of COPD exacerbations. Asthma exacerbations may be decreased by the avoidance of allergens, viral infections, occupational exposures, airpollution, treatment of comorbid diseases. Effective treatment of asthma is required to prevent asthma exacerbations. Inhaled steroids and combined treatments are the most effective preventive therapy for exacerbations. Patient education and cooperation is an element of the preventive measures for asthma attacks. Compliance to therapy, inhalation techniques, written asthma plans are required. The essential of COPD and asthma exacerbation treatment is bronchodilator therapy. Steroids are also implemented to the therapy, targeting the inflammation. Specific treatments of the cause (infection, airpollution, pulmonary embolism etc.) should be administered. © 2015, Ankara University. All rights reserved.Item A subset of patients with acquired partial lipodystrophy developing severe metabolic abnormalities(Taylor and Francis Ltd, 2019) Ozgen Saydam B.; Sonmez M.; Simsir I.Y.; Erturk M.S.; Kulaksizoglu M.; Arkan T.; Hekimsoy Z.; Cavdar U.; Akinci G.; Demir T.; Altay C.T.; Mihci E.; Secil M.; Akinci B.Purpose/Aim of the study: Acquired partial lipodystrophy (APL) is a rare disease characterized by selective loss of adipose tissue. In this study, we aimed to present a subset of patients with APL, who developed severe metabolic abnormalities, from our national lipodystrophy registry. Materials and Methods: Severe metabolic abnormalities were defined as: poorly controlled diabetes (HbA1c above 7% despite treatment with insulin more than 1 unit/kg/day combined with oral antidiabetics), severe hypertriglyceridemia (triglycerides above 500 mg/dL despite treatment with lipid-lowering drugs), episodes of acute pancreatitis, or severe hepatic involvement (biopsy-proven non-alcoholic steatohepatitis (NASH)). Results: Among 140 patients with all forms of lipodystrophy (28 with APL), we identified 6 APL patients with severe metabolic abnormalities. The geometric mean for age was 37 years (range: 27–50 years; 4 females and 2 males). Five patients had poorly controlled diabetes despite treatment with high-dose insulin combined with oral antidiabetics. Severe hypertriglyceridemia developed in five patients, of those three experienced episodes of acute pancreatitis. Although all six patients had hepatic steatosis at various levels on imaging studies, NASH was proven in two patients on liver biopsy. Our data suggested that APL patients with severe metabolic abnormalities had a more advanced fat loss and longer disease duration. Conclusions: We suggest that these patients represent a potential subgroup of APL who may benefit from metreleptin or investigational therapies as standard treatment strategies fail to achieve a good metabolic control. © 2018, © 2018 Taylor & Francis.Item Effect of Agitation and Aeration on Keratinase Production in Bioreactors Using Bioprocess Engineering Aspects(Springer, 2021) Deniz I.; Demir T.; Oncel S.S.; Hames E.E.; Vardar-Sukan F.Streptomyces sp. 2M21 was evaluated for keratinase production in bioreactors using chicken feathers. Firstly, optimization of bioengineering parameters (agitation and aeration rates) using Response Surface Methodology was carried out in 2 L bioreactors. Optimized conditions identified by the modified quadratic model were verified as 150 rpm and 1 vvm experimentally corresponding to 351 U/ml of keratinase activity. Moreover, scaling up sequentially to 20 L bioreactors was implemented using constant impeller tip speed and constant mass transfer coefficient as key scale-up parameters. The keratinase activity in 5, 10 and 20 L bioreactors showed similar results with the one of shake flasks (412 U/ml) and 2 L bioreactors (351 U/ml)with respect to the keratinase activity values of 336, 385 and 344 U/ml, respectively. The results suggest keratinase production by evaluating chicken feathers in commercial level. Furthermore, this study has potential to contribute industrial scale production of keratinase by Streptomyces sp. 2M21 using the proposed bioreactor conditions. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.Item Gastrostomy in Hospitalized Patients with Acute Stroke: “NöroTek” Turkey Point Prevalence Study Subgroup Analysis; [Hastanede Yatan Akut İnmeli Hastalarda Gastrostomi: “NöroTek” Türkiye Nokta Prevalans Çalışması Alt Grup Analizi](Turkish Neurosurgical Society, 2022) Topçuoğlu M.A.; Özdemir A.Ö.; Aykaç Ö.; Milanoğlu A.; Gökçe M.; Bavli S.; Çabalar M.; Yayla V.; Erdoğan H.A.; Özkul A.; Güneş A.; Değirmenci B.; Aluçlu U.; Kozak H.H.; Güngör L.; Erdoğan M.; Acar Z.Ö.; Cenikli U.; Kablan Y.; Yılmaz A.; Genç H.; Nazliel B.; Çağlayan H.B.; Gencer E.S.; Ay H.; Demirbaş H.; Akdoğan Ö.; Emre U.; Yıldız Ö.K.; Bolayır A.; Demir T.; Tanrıverdi Z.; Tekan Ü.Y.; Akpınar Ç.K.; Özkan E.; İlik F.; Şirin H.; Güler A.; Önder H.; Bektaş H.; Öcek L.; Bakar M.; Ongun N.; Krespi Y.; Işıkay C.T.; Aslanbaba E.; Sorgun M.; Gürkaş E.; Karadeli H.H.; Midi İ.; İlgezdi İ.; Bilgiç A.B.; Akyol Ş.; Epçeliden M.T.; Atmaca M.M.; Kurşun O.; Keskin O.; Şirinocak P.B.; Baydemir R.; Akçakoyunlu M.; Öztürk Ş.; Özel T.; Ünal A.; Dora B.; Yürekli V.A.; Arlıer Z.; Eren A.; Yılmaz A.; Kısabay A.; Acar B.; Baştan B.; Niflioğlu B.; Güven B.; Kaya D.; Afşar N.; Yazıcı D.; Aytaç E.; Yaka E.; Toplutaş E.; Değirmenci E.; İnce F.B.; Büyükşerbetçi G.; Aydın İ.; Çetiner M.; Şen M.; Turgut N.; Kale N.; Çoban E.; Yeşilot N.; Ekizoğlu E.; Kizek Ö.; Birgili Ö.; Yevgi R.; Kunt R.; Giray S.; Akkaş S.Y.; Şenadım S.; Yoldaş T.; Asil T.; Duman T.; Atasoy T.; Çınar B.P.; Demir T.; Can U.; Ünsal Y.Ö.; Eşkut N.; Aslan Y.; Baş D.F.; Şener U.; Yılmaz Z.; Bozdoğan Z.; Alioğlu Z.; Arsava E.M.Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NöroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69±14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study. Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE. Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (β): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (β): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (β): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin’s scale score 0-2) functional outcome [exp (β): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (β): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later. Conclusion: The NöroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms of being economical and accurate it makes sense to use the point prevalence method. © 2022 by Turkish Neurological Society.Item Acute Stroke Management in Türkiye: Intravenous Tissue Plasminogen Activator and Thrombectomy NöroTek: Türkiye Neurology Single Day Study; [Türkiye’de Akut İnme Yönetimi: IV tPA ve Trombektomi NöroTek: Türkiye Nöroloji Tek Gün Çalışması](Turkish Neurosurgical Society, 2023) Topçuoğlu M.A.; Özdemir A.Ö.; Arsava E.M.; Güneş A.; Aykaç Ö.; Gencer E.S.; Çabalar M.; Yayla V.; Erdoğan H.A.; Erdoğan M.; Acar Z.Ö.; Giray S.; Kablan Y.; Tanrıverdi Z.; Tekan Ü.Y.; Asil T.; Akpınar Ç.K.; Yürekli V.A.; Acar B.; Şirin H.; Güler A.; Baydemir R.; Akçakoyunlu M.; Öcek L.; Çetiner M.; Nazlıel B.; Çağlayan H.B.; Ongun N.; Eren A.; Arlıer Z.; Cenikli U.; Gökçe M.; Bavli S.; Yaka E.; Özkul A.; Değirmenci B.; Aluçlu U.; Işıkay C.T.; Aslanbaba E.; Sorgun M.; Aytaç E.; Ay H.; Kunt R.; Şenadım S.; Ünsal Y.Ö.; Eşkut N.; Alioğlu Z.; Yılmaz A.; Genç H.; Yılmaz A.; Milanoğlu A.; Gürkaş E.; Değirmenci E.; Bektaş H.; İlgezdi İ.; Bilgiç A.B.; Akyol Ş.; Güngör L.; Kale N.; Çoban E.; Yeşilot N.; Ekizoğlu E.; Kizek Ö.; Kurşun O.; Yıldız Ö.K.; Bolayır A.; Kısabay A.; Baştan B.; Niflioğlu B.; Güven B.; Kaya D.; Afşar N.; Yazıcı D.; Toplutaş E.; Özkan E.; İlik F.; İnce F.B.; Büyükşerbetçi G.; Önder H.; Karadeli H.H.; Kozak H.H.; Demirbaş H.; Midi İ.; Aydın İ.; Epçeliden M.T.; Atmaca M.M.; Bakar M.; Şen M.; Turgut N.; Keskin O.; Akdoğan Ö.; Emre U.; Bilgili Ö.; Şirinocak P.B.; Yevgi R.; Akkaş S.Y.; Yoldaş T.; Duman T.; Özel T.; Ünal A.; Dora B.; Atasoy T.; Çınar B.P.; Demir T.; Demir T.; Can U.; Aslan Y.; Baş D.F.; Şener U.; Yılmaz Z.; Bozdoğan Z.; Özdemir G.; Krespi Y.; Öztürk Ş.Objective: To reveal the profile and practice in patients with acute stroke who received intravenous tissue plasminogen activator (IV tPA) and/or neuro-interventional therapy in Türkiye. Materials and Methods: On World Stroke Awareness Day, May 10, 2018, 1,790 patients hospitalized in 87 neurology units spread over 30 health regions were evaluated retrospectively and prospectively. Results: Intravenous tPA was administered to 12% of 859 cases of acute ischemic stroke in 45 units participating in the study. In the same period, 8.3% of the cases received neurointerventional treatment. The rate of good prognosis [modified Rankin score (mRS) 0–2] at discharge was 46% in 83 patients who received only IV tPA [age: 67 ± 12 years; National Institutes of Health Stroke Scale (NIHSS): 12 ± 6; hospital stay, 24 ± 29 days]; 35% in 51 patients who underwent thrombectomy (MT) alone (age: 64 ± 13 years; NIHSS: 14.1 ± 6.5; length of hospital stay, 33 ± 31 days), 19% in those who received combined treatment (age: 66 ± 14 years; NIHSS: 15.6 ± 5.4; length of hospital stay, 26 ± 35 days), and 56% of 695 patients who did not receive treatment for revascularization (age: 70 ± 13 years; NIHSS: 7.6 ± 7.2; length of hospital stay, 21 ± 28 days). The symptom-to-door time was 87 ± 53 minutes in the IV treatment group and 200 ± 26 minutes in the neurointerventional group. The average door-to-needle time was 66 ± 49 minutes in the IV tPA group. In the neurothrombectomy group, the door-to-groin time was 103 ± 90 minutes, and the TICI 2b-3 rate was 70.3%. In 103 patients who received IV tPA, the discharge mRS 0–2 was 41%, while the rate of mRS 0–1 was 28%. In 71 patients who underwent neurothrombectomy, the mRS 0–2 was 31% and mRS 0–1 was 18%. The door-to-groin time was approximately 30 minutes longer if IV tPA was received (125 ± 107 and 95 ± 83 minutes, respectively). Symptomatic bleeding rates were 4.8% in IV recipients, 17.6% among those who received only MT, and 15% in combined therapy. Globally, the hemorrhage rate was 6.8% in patients receiving IV tPA and 16.9% in MT. Conclusion: IV thrombolytic and neurointerventional treatment applications in acute ischemic stroke in Türkiye can provide the anticipated results. Heterogeneity has begun to be reduced in our country with the dissemination of the system indicated by the “Directive on Health Services to be Provided to Patients with Acute Stroke.”. © Copyright 2023 by the Turkish Neurological Society / Turkish Journal of Neurology published by Galenos Publishing House.Item Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study; [Türkiye’de İnme Hastalarında Atrial Fibrilasyonun Yönetimi: NöroTek Çalışması Gerçek Hayat Verileri](Turkish Neurosurgical Society, 2023) Topçuoğlu M.A.; Arsava E.M.; Özdemir A.Ö.; Aykaç Ö.; Çetiner M.; Gencer E.S.; Güneş A.; Krespi Y.; Yaka E.; Öcek L.; Tanrıverdi Z.; Tekan Ü.Y.; Özkul A.; Özkan E.; Şirin H.; Güler A.; Kurşun O.; Kunt R.; Cenikli U.; Acar B.; Kablan Y.; Yılmaz A.; Işıkay C.T.; Aslanbaba E.; Sorgun M.; Bektaş H.; Çabalar M.; Yayla V.; Erdoğan H.A.; Gökçe M.; Bavli S.; Ongun N.; Keskin A.O.; Akdoğan Ö.; Emre U.; Yıldız Ö.K.; Bolayır A.; Akpınar Ç.K.; Karadeli H.H.; Özel T.; Ünal A.; Dora B.; Arlıer Z.; Eren A.; Milanoğlu A.; Nazliel B.; Çağlayan H.B.; Güven B.; Erdoğan M.; Acar Z.Ö.; Bakar M.; Giray S.; Şenadım S.; Asil T.; Demir T.; Ünsal Y.Ö.; Eşkut N.; Aslan Y.; Baş D.F.; Şener U.; Değirmenci B.; Aluçlu U.; Baştan B.; Niflioğlu B.; Yazıcı D.; Aytaç E.; İnce F.B.; Ay H.; Önder H.; Kozak H.H.; İlgezdi İ.; Bilgiç A.B.; Akyol Ş.; Güngör İ.L.; Atmaca M.M.; Şen M.; Yevgi R.; Akkaş S.Y.; Yoldaş T.; Atasoy H.T.; Çınar B.P.; Yılmaz A.; Genç H.; Kısabay A.; İlik F.; Demirbaş H.; Midi İ.; Şirinocak P.B.; Duman T.; Demir T.; Can U.; Yürekli V.A.; Bozdoğan Z.; Alioğlu Z.; Kaya D.; Afşar N.; Gürkaş E.; Toplutaş E.; Değirmenci E.; Büyükşerbetçi G.; Aydın İ.; Epçeliden M.T.; Turgut N.; Kale N.; Çoban E.; Yeşilot N.; Ekizoğlu E.; Kizek Ö.; Bilgili Ö.; Baydemir R.; Akçakoyunlu M.; Yılmaz Z.; Öztürk Ş.Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Türkiye. Within the scope of NöroTek-Türkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms. Materials and Methods: On May 10, 2018 (World Stroke Awareness Day), 1,790 patients hospitalized at 87 neurology units in 30 health regions were prospectively evaluated. A total of 929 patients [859 acute ischemic stroke, 70 transient ischemic attack (TIA)] from this study were included in this analysis. Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received “effective” treatment [international normalization ratio ≥2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug. Conclusion: NöroTekTR revealed the high but expected frequency of AF in acute stroke in Türkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Türkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known AF. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by AF. © 2023 by the Turkish Neurological Society / Turkish Journal of Neurology published by Galenos Publishing House.Item Which implant is better for the fixation of posterior wall acetabular fractures: A conventional reconstruction plate or a brand-new calcaneal plate?(Elsevier Ltd, 2024) Tosyalı H.K.; Elibol F.K.E.; Hancıoğlu S.; Kaçmaz S.E.; Çalışkan Ö.İ.; Tolunay T.; Demir T.; Okçu G.Background: Increased posterior wall acetabular fractures among older adults, require precise treatment to restore stability to the joint, lower the risk of degenerative arthritis, and enhance overall functional recovery. The purpose of this study was to compare the fixation stability and mechanical characteristics of calcaneal buttress plate and conventional reconstruction plate under different loading condition. Methods: Typical acetabular posterior wall fractures were created on twenty synthetic hemipelvis models. They were fixed with calcaneus plate and reconstruction plate. Dynamic and static tests were performed. Displacements of fracture line and stiffness were calculated. Findings: After dynamic loading, calcaneus plate fixation has significantly less displacement than the reconstruction plate on the superior posterior wall. Under static loading condition, the calcaneus plate group has significantly less displacement than the reconstruction plate group on the inferior posterior part of the fracture. The average stiffness values of the calcaneus plate group and the reconstruction plate group were 265.16±53.98 N/mm and 167.48±36.87 N/mm, respectively and a statistically significant difference was found between the two groups. Interpretation: The calcaneal plate group demonstrated better stability along the fracture line after dynamic and static loading conditions. Especially when the fragment was on the acetabulum's superior posterior, inferior posterior, and inferior rim, Calcaneal buttress plates offer biomechanically effective choices. © 2024Item Asthma-chronic obstructive pulmonary disease overlap: Results from a national-multicenter study; [Astım KOAH overlap: Ulusal çok merkezli bir çalışma sonuçları](Ankara University, 2024) Çelik G.E.; Aydin Ö.; Şen E.; Demir T.; Gemicioğlu B.; Kiyan E.; Mungan D.; Kivilcim Oğuzülgen İ.; Polatli M.; Göksel Ö.; Sayiner A.; Yildirim N.; Yildiz F.; Yorgancioğlu A.; Elhan A.H.; Yildiz Ö.; Başyiğit İ.; Börekçi Ş.; Havlucu Y.; Okumuş G.; Türk M.; Saryal S.Introduction: Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) have a greater disease burden than those with COPD or asthma alone. In this study, it was aimed to determine the prevalence, risk factors, and clinical features of ACO because there are limited national data in Türkiye. Materials and Methods: The study was conducted in a cross-sectional design in nine tertiary-care hospitals. The patients followed with a diagnosis of asthma or COPD for at least one year were enrolled in the study. The frequency of ACO and the characteristics of the patients were evaluated in the asthma and COPD groups. Results: The study included 408 subjects (F/M= 205/203, mean age= 56.24 ± 11.85 years). The overall prevalence of ACO in both groups was 20.8% (n= 85). The frequency was higher in the COPD group than in the asthma group (n= 55; 33.3% vs. n= 22; 9.8%), respectively (p= 0.001). Patients with ACO had similarities to patients with COPD in terms of advanced age, sex, smoking, exposure to biomass during childhood, being born in rural areas, and radio-logic features. Characteristics such as a history of childhood asthma and allergic rhinitis, presence of chronic sinusitis, NSAID hypersensitivity, atopy, and high eosinophil counts were similar to those of patients with asthma (p< 0.001). The annual decline in FEV1 was more prominent in the ACO group (mean=-250 mL) than in the asthma (mean change=-60 mL) and COPD (mean change=-230 mL) groups (p= 0.003). Conclusion: This study showed that ACO was common among patients with asthma and COPD in tertiary care clinics in our country. ACO should be considered in patients with asthma and COPD who exhibit the abovementioned symptoms. © 2024 by Tuberculosis and Thorax.Item Regorafenib Treatment for Recurrent Glioblastoma Beyond Bevacizumab-Based Therapy: A Large, Multicenter, Real-Life Study(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Tünbekici S.; Yuksel H.C.; Acar C.; Sahin G.; Orman S.; Majidova N.; Coskun A.; Seyyar M.; Dilek M.S.; Kara M.; Dıslı A.K.; Demir T.; Kolkıran N.; Sahbazlar M.; Demırcıler E.; Kuş F.; Aytac A.; Menekse S.; Yucel H.; Biter S.; Koseci T.; Unsal A.; Ozveren A.; Sevınc A.; Goker E.; Gürsoy P.Background/Objectives: In the REGOMA trial, regorafenib demonstrated an overall survival advantage over lomustine, and it has become a recommended treatment for recurrent glioblastoma in guidelines. This study aimed to evaluate the effectiveness and safety of regorafenib as a third-line treatment for patients with recurrent glioblastoma who progressed while taking bevacizumab-based therapy. Methods: This retrospective, multicenter study in Turkey included 65 patients treated between 2021 and 2023 across 19 oncology centers. The main inclusion criteria were histologically confirmed isocitrate dehydrogenase (IDH)-wildtype glioblastoma, progression after second-line bevacizumab-based treatment, and an Eastern Cooperative Oncology Group (ECOG) performance status score of ≤2. Patients received regorafenib 160 mg once daily for the first 3 weeks of each 4-week cycle. Results: The median age of the patients was 53 years (18–67 years), with a median progression-free survival of 2.5 months (95% Confidence Interval: 2.23–2.75) and a median overall survival of 4.1 months (95% CI: 3.52–4.68). The median overall survival was improved in patients who received subsequent therapy after regorafenib treatment compared with those who did not (p = 0.022). Progression-free survival was longer in patients with ECOG 0–1 than in those with ECOG 2 (p = 0.042). The safety profile was consistent with that of the REGOMA trial, with no drug-related deaths observed. Conclusions: Regorafenib shows good efficacy and safety as a third-line treatment for recurrent glioblastoma after bevacizumab-based therapy. This study supports the use of regorafenib and emphasizes the need for further randomized studies to validate its role and optimize treatment strategies. © 2024 by the authors.