Browsing by Author "Dursun, B"
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Item ASSESMENT OF DAYLIGHTING PERFORMANCES OF CLASSROOMS: A CASE STUDY IN KIRKLARELI UNIVERSITY, TURKEYYüksek, I; Görgülü, S; Kocabey, S; Tuna, M; Dursun, BThis study was conducted to evaluate the daylighting performances of classrooms. For this study, a classroom in Kayali Campus and two classrooms in Kavakli Campus of Kirklareli University have been selected. In these buildings, the illuminance levels have been measured and standards and design rules have been investigated. Modelling in the Velux Daylight Visualiar simulation program, the classrooms have been evaluated in terms of daylighting parameters. Consequently, window properties that can provide better natural lighting in the classroom have been identified. According to the measurements and the results of the simulation, daylight illuminance levels in these environments has been found to vary by directions. The buildings' orientation, the window openings on the facade of buildings and the shading elements should be designed at the point of the natural lighting idea by expert designers in the field.Item PERFORMANCE ASSESSMENT OF A COMBINED SOLAR AND WIND SYSTEMTaskin, S; Dursun, B; Alboyaci, BThis paper deals with a feasibility study of a solar and wind hybrid system for highway energy requirements. The paper describes the modeling of two emerging electricity systems based on renewable energy: photovoltaic and wind power. The study presents an evaluation of combined solar and wind system for highway energy requirements such as lighting, SOS, billboard, etc. A new model Savonius Wind Turbine was used for this study. The Savonius Turbine rotor has 3 stages with total of 2520 mm height; each stage has three plates of 1220 mm in diameter deviated at 120 degrees from each other. Savonius turbine performance tests were realized to determine its experimental parameters. Also, cost optimization and feasibility of the combined system were evaluated. According to the result of the optimization, optimum numbers for solar panels, wind turbines, and batteries are computed as 16, 5, and 278 respectively for one km highway illumination. The proposed system with the present prototype is to be tested in situ.Item Severe hyponatremia and rhabdomyolysis associated with hypothyroidismToraman, A; Dursun, B; Batmazoglu, Mhypothyroidism and usually occurs in elderly patients. In this report we presented a young patient with hypothyroidism induced severe hyponatremia and rhabdomyolysis. A nineteen-year-old woman was brought to the hospital with confusion. Because of acute hyponatremia with confusion, she was treated with hypertonic saline. The neurological examination returned to normal after treatment and fluid restriction, then serum sodium level increased to normal. Because of recurrent hyponatremia futher investigations were held. She was diagnosed as Hashimoto's thyroiditis. Hyponatremia improved with levothyroxine therapy and serum sodium level remained normal range. The elevated parameters of rhabdomyolysis decreased with levothyroxine therapy. Hypothyroidism should be considered in patients presenting with hyponatremia and rhabdomyolysis.Item Asthma in elderly in Turkey: a multicenter studyGemicioglu, B; Mungan, D; Ogus, C; Erkekol, FO; Dursun, B; Saka, D; Yorgancioglu, A; Topcu, F; Bogatekin, G; Deveci, F; Turktas, H; Bayram, H; Kalyoncu, F; Tor, M; Yildiz, FItem Clinical outcomes of cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors in patients with male breast cancer: A multicenter studyYildirim, HC; Mutlu, E; Chalabiyev, E; Özen, M; Keskinkiliç, M; Ön, S; Çelebi, A; Dursun, B; Acar, O; Kahraman, S; Aykan, MB; Kaman, O; Dogan, A; Erdogan, AP; Celayir, OM; Günenç, D; Güven, DC; Bayoglu, IV; Yavuzsen, T; Hacibekiroglu, I; Inanç, M; Kiliçkap, S; Yalçin, S; Aksoy, SBackground: Since breast cancer is less common in men than in women, data on the use of new therapeutic agents, including cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors, are limited in patients with metastatic hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) male breast cancer. Therefore; we aimed to investigate the treatment responses of metastatic HR+, HER2-male breast cancer patients treated with CDK 4-6 inhibitors in a multicenter real-life cohort. Methods: Male patients with a diagnosis of HR+ and HER2-metastatic breast cancer, treated with any CDK 4-6 inhibitor, were included in the study. Demographic and clinical characteristics of the patients were recorded. We aimed to determine progression-free survival (PFS) time, response rates and drug related side effects. Results: A total 25 patients from 14 institutions were recruited. The mean age at diagnosis was 57 years. Median follow-up was 19.53 (95% CI: 14.04-25.02) months. The overall response rate was 60%. While the median PFS was 20.6 months in the whole cohort, it wasn't reached in those using CDK 4-6 inhibitors in first line and 10 months in the subsequent lines (p:0.009). No new adverse events were encountered. Conclusion: In our study, we found that CDK 4-6 inhibitors are effective and safe options in men with HR+ and HER2-metastatic breast cancer as in women. Our results support the use of CDK 4-6 inhibitor-based combinations in the first-line treatment of HR+ and HER2-metastatic male breast cancer.Item The validation of the Turkish version of Asthma Control Test (vol 22, pg 1773, 2013)Uysal, MA; Mungan, D; Yorgancioglu, A; Yildiz, F; Akgun, M; Gemicioglu, B; Turktas, H; Ozkan, G; Yilmaz, I; Incioglu, M; Boyaci, H; Atis, S; Yalcin, A; Bayram, NG; Deveci, F; Pulur, D; Ozgur, ES; Dursun, B; Bulbul, Y; Sulu, E; Yilmaz, VItem Asthma control test administered by web-based text messaging (short message service-SMS): Is it comparable with paper form?Uysal, MA; Mungan, D; Yorgancioglu, A; Yildiz, F; Akgun, M; Gemicioglu, B; Ozkan, G; Yilmaz, I; Incioglu, M; Boyaci, H; Atis, S; Yalcin, A; Bayram, NG; Deveci, F; Pulur, D; Özgür, ES; Dursun, B; Bülbül, Y; Sulu, E; Yilmaz, V; Turktas, HItem Asthma phenotypes in Turkey: a multicenter cross-sectional study in adult asthmatics; PHENOTURK studyYildiz, F; Mungan, D; Gemicioglu, B; Yorgancioglu, A; Dursun, B; Erkekol, FO; Ogus, C; Turktas, H; Bogatekin, G; Topcu, F; Deveci, F; Bayram, H; Tor, M; Kalyoncu, AFBackground and AimsTo evaluate asthma phenotypes in patients with asthma from different regions of Turkey. MethodsA total of 1400 adult asthmatic patients (mean (SD) age: 44.0 (13.9) years, 75% females) from 14 centers across Turkey were included in this study and a standard questionnaire was applied between the time period of February 2011-January 2012. ResultsThe disease onset40 years of age was higher percentage in obese vs. normal/overweight patients and nonallergic vs. allergic patients (P<0.01). The percentage of patients who had FEV1 values over 80% was higher in allergic than nonallergic and normal/overweight than obese patients (P<0.01). Uncontrolled asthmatics have more severe disease (P<0.01). There were more frequent hospital admissions in nonallergic and uncontrolled asthmatics (P<0.01). Chronic rhino-sinusitis was the leading comorbid disorder in normal/overweight and allergic asthma, while gastroesophageal reflux disorder was more frequent in nonallergic and uncontrolled asthma (P<0.01). Asthma control rate was the highest (39.0%) in patients from Marmara region among all geographical regions (P<0.05). ConclusionIn conclusion, our findings revealed existence of clinical/trigger related phenotypes based on BMI, allergic status, control level and geographical region with more frequent respiratory dysfunction and/or adverse health outcomes in uncontrolled, obese and nonallergic phenotypes.Item Asthma phenotypes in Turkey: A multicenter studyYildiz, F; Mungan, D; Gemicioglu, B; Dursun, B; Saka, D; Yorgancioglu, A; Erkekol, FO; Ogus, C; Turktas, H; Bogatekin, G; Topcu, F; Deveci, F; Bayram, H; Tor, M; Kalyoncu, FItem Drug allergy in tertiary care in Turkey: Results of a national survey. The ADAPT study: Adult drug allergy perception in TurkeyÇelik, GE; Karakaya, G; Öztürk, AB; Gelincik, A; Abadoglu, Ö; Sin, A; Damadoglu, E; Yilmaz, I; Demirtürk, M; Dursun, B; Özdemir, SK; Çelikel, S; Degirmenci, P; Bozkurt, B; Göksel, Ö; Erkekol, FÖ; Aydin, Ö; Kavut, AB; Kirmaz, C; Kalpaklioglu, F; Büyüköztürk, S; Kalyoncu, FBackground: No data are available on the incidence of drug hypersensitivity (DH) reactions in outpatient settings of tertiary allergy/immunology clinics. Our aims were to document the frequency of outpatient hospital admissions due to DH reactions to allergy/immunology clinics in adults and the management of these reactions in real life. We also investigated whether drug allergy affected social and medical behaviours of the patients. Methods: This multi-centre study was performed for one year with the participation of 11 out of 16 tertiary allergy/clinical immunology clinics in Turkey. The study group consisted of the patients with DH reactions. Results of a questionnaire including drug reactions and management were recorded. Results: Among 54,863 patients, 1000 patients with DH were enrolled with a median of 2.1% of all admissions. In real life conditions, the majority of approaches were performed for finding safe alternatives (65.5%; 1102 out of 1683) with 11.7% positivity. Diagnostic procedures were positive in 27% (154/581) of the patients. The majority of the patients had higher VAS scores for anxiety. A total of 250 subjects (25%) reported that they delayed some medical procedures because of DH. Conclusion: Our results documented the frequency of admissions due to DH reactions to allergy/clinical immunology clinics for the first time. Although physicians mostly preferred to perform drug tests in order to find safe alternatives, considering the fact that DH was confirmed in 27% of the patients, use of diagnostic tests should be encouraged, if no contraindication exists in order to avoid mislabelling patients as DH. (C) 2013 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.Item Turkish Thoracic Society asthma management and prevention guideline: key pointsYildiz, F; Ogüzcilgen, K; Dursun, B; Mungan, D; Gemicioglu, B; Yorgancioglu, AAsthma still has high morbidity and cost despite all advances in pathogenesis, diagnosis and treatment. Although asthma can be controlled with proper diagnosis and treatment, the low rates of control in our country and in the world can not be attributed to the variable course of the disease and patients' psycho-social behaviours for chronic disease. In this context, Turkish Thoracic Society (TTS) has decided to update Asthma Diagnosis and Management Guide latest published in 2000. National data were collected, compiled and prepared by authors, and final form given by the TTS Asthma and Allergy Study Group, after presenting to consultant individuals and institutions. In June 2009, the National Asthma Management and Prevention Guideline were published in Turkish. In this paper, we aimed to present the national guide in English with its basics and individual differences.Item The predictors of COVID-19 mortality in a nationwide cohort of Turkish patientsKokturk, N; Babayigit, C; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Yuce, ZT; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Sakar, A; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, HItem The efficacy of palbociclib and ribociclib in the first-line treatment of metastatic hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer in male patients: a Turkish oncology group (TOG) studyYildirim, HÇ; Kutlu, Y; Mutlu, E; Aykan, MB; Korkmaz, M; Yalçin, S; Sakalar, T; Celayir, ÖM; Kayikçioglu, E; Aslan, F; Hafizoglu, E; Altintas, YE; Keskinkiliç, M; Chalabiyev, E; Çelebi, A; Dursun, B; Kapar, C; Özen, M; Acar, O; Dülgar,Ö; Kut, E; Biter, S; Kus, F; Almuradova, E; Erdogan, AP; Saray, S; Güven, DC; Simsek, ET; Üskent, N; Kemal, Y; Çakar, B; Acikgöz,Ö; Kiliçkap, S; Aksoy, SIntroductionMale breast cancer, comprising approximately 1% of all breast cancer cases, often leads to the exclusion of male patients as a criterion in clinical trials. While the efficacy of Cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors has been established in metastatic hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2 -) breast cancer in women, limited data exist on their effectiveness in male patients.We aimed to evaluate the efficacy and safety of palbociclib or ribociclib in male patients with breast cancer.IntroductionMale breast cancer, comprising approximately 1% of all breast cancer cases, often leads to the exclusion of male patients as a criterion in clinical trials. While the efficacy of Cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors has been established in metastatic hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2 -) breast cancer in women, limited data exist on their effectiveness in male patients.We aimed to evaluate the efficacy and safety of palbociclib or ribociclib in male patients with breast cancer.MethodsThis study is a multicenter, retrospective study. We included male patients with HR + and HER2-metastatic breast cancer who received palbociclib or ribociclib as first-line treatment. Our primary endpoints were progression-free survival (PFS), overall response rates (ORR), and drug-related adverse effects.ResultsA total of 46 male patients from 27 institutions were enrolled. The median age at initiation of CDK 4/6 inhibitors was 63.64 +/- 13.69 years, with a median follow-up of 21.33 (95% CI 14.92-27.74) months. The ORR were 84% for palbociclib and 76.2% for ribociclib. The mPFS for the entire cohort was 28.06 months (95% CI 18.70-37.42). No significant difference in PFS was observed between palbociclib and ribociclib (mPFS: 24.46 months (95% CI 11.51-37.42) vs 28.33 months (95% CI 14.77-41.88), respectively, p = 0.211). No new adverse events were reported.DiscussionThis study demonstrates that palbociclib and ribociclib are effective and safe options for first-line treatment in male patients with HR + /HER2 - metastatic breast cancer. However, further prospective studies are warranted to establish their efficacy in this population.Item The prognostic impact of Her2 status in early triple negative breast cancer: a Turkish Oncology Group (TOG) studyÖzyurt, N; Alkan, A; Gülbagci, B; Seyyar, M; Aydin, E; Sahbazlar, M; Türker, M; Kinikoglu, O; Yerlikaya, T; Dinç, G; Aytaç, A; Kalkan, Z; Ebinç, S; Gültürk, I; Keskinkiliç, M; Isleyen, ZS; Çaglayan, D; Türkel, A; Aydin, E; Sakalar, T; Sekmek, S; Yildirim, N; Koçak, S; Okutur, K; Özveren, A; Dursun, B; Kitapli, S; Eren, OÖ; Beypinar, I; Hacibekiroglu, I; Çabuk, D; Karaman, E; Acar, Ö; Paydas, S; Eryilmaz, MK; Demir, B; Oruç, Z; Yilmaz, M; Biricik, FS; Salim, DK; Tanriverdi, Ö; Dogan, MThe studies evaluating the impact of Her2 levels in neoadjuvant setting have conflicting data. The aim of the study was to evaluate the prognostic impact of Her2 status in early triple negative breast cancer(TNBC). In the study TNBC patients who were treated with neoadjuvant chemotherapy (NAC) and surgery were analyzed retrospectively. The primary aim of the study was to analyze the impact of Her2 status(Her2-0 and Her2-low) on pathological complete response (pCR). The secondary objectives were disease free survival (DFS) and overall survival (OS). 620 female triple negative breast cancer patients were evaluated. 427 patients (68.9%) had Her2-0 and 193(31.1%) had her2-low pathology. The pCR rates were similar between Her2-0 and Her2-low patients (33.0% vs. 27.5%, p = 0.098). Although Her2-0 group has better DFS (106 vs. 50 months, p = 0.002), in multivariate analysis it had a HR of 0.74 (p = 0.06). In addition, OS was similar (131 vs. 105 months, p = 0.13) with a HR of 0.88 (p = 0.61). In multivariate analysis; presence of LVI (HR:2.2 (95% CI 1.1-3.5) p = 0.001), Clinical stage T1/T2 (HR:0.39 (95% CI 0.2-0.6) p < 0.001) and lymph node negativity (HR:0.35 (95% CI 0.1-0.9) p = 0.03) were independent factors for OS. Although there were pathological and clinical differences, the pCR, DFS and OS were similar between Her2-0 and Her2-low TNBC patients. The importance of Her2 status of TNBC in neoadjuvant setting should be further studied.Item The predictors of COVID-19 mortality in a nationwide cohort of Turkish patientsKokturk, N; Babayigit, C; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Ture, Z; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Coskun, AS; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, HThe COVID-19-related death rate varies between countries and is affected by various risk factors. This multi-center registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5-5.6). The univariate analysis demonstrated that various factors, including male sex, age >= 65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6-23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored.Item The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohortBabayigit, C; Kokturk, N; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Ture, Z; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Coskun, A; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, HBackground and objectivesAlthough several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity. MethodsPatients admitted to 26 different hospitals located in 16 different provinces between March 11-July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation. ResultsWe retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 +/- 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalization, including ICU admission, was 7 (5-12) days. Favipiravir (n = 328), lopinavir/ritonavir (n = 55), and oseltamivir (n = 761) were administered as antiviral agents, and hydroxychloroquine (HCQ, n = 1,382) and azithromycin (n = 738) were used for their immunomodulatory activity. Lopinavir/ritonavir (beta [95% CI]: 4.71 [2.31-7.11]; p = 0.001), favipiravir (beta [95% CI]: 3.55 [2.56-4.55]; p = 0.001) and HCQ (beta [95% CI]: 0.84 [0.02-1.67]; p = 0.046) were associated with increased risk of lengthy hospital stays. Furthermore, favipiravir was associated with increased risks of ICU admission (OR [95% CI]: 3.02 [1.70-5.35]; p = 0.001) and invasive mechanical ventilation requirement (OR [95% CI]: 2.94 [1.28-6.75]; p = 0.011). ConclusionOur findings demonstrated that antiviral drugs including lopinavir, ritonavir, and favipiravir were associated with negative clinical outcomes such as increased risks for lengthy hospital stay, ICU admission, and invasive mechanical ventilation requirement. Therefore, repurposing such agents without proven clinical evidence might not be the best approach for COVID-19 treatment.