Browsing by Author "Elhan A.H."

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    Turkish league against rheumatism (TLAR) recommendations for the pharmacological management of rheumatoid arthritis: 2018 update under guidance of current recommendations
    (Turkish League Against Rheumatism (TLAR), 2018) Ataman Ş.; Sunar İ.; Yilmaz G.; Bodur H.; Nas K.; Ayhan F.F.; Akgül Ö.; Akinci A.; Altay Z.; Birtane M.; SOY Buğdayci D.; Çapkin E.; Çevik R.; Garİp Çimen Y.; Duruöz M.T.; Elhan A.H.; Gürer G.; Kaçar C.; Kamanli A.; Kaptanoğlu E.; Kaya T.; Kocabaş H.; Kuru Ö.; Alkan Melikoğlu M.; Özel S.; Rezvani A.; Sezer İ.; Yurdakul F.G.
    Objectives: This study aims to report the assessment of the Turkish League Against Rheumatism (TLAR) expert panel on the compliance and adaptation of the European League Against Rheumatism (EULAR) 2016 recommendations for the management of rheumatoid arthritis (RA) in Turkey. Patients and methods: The EULAR 2016 recommendations for the treatment of RA were voted by 27 specialists experienced in this field with regard to participation rate for each recommendation and significance of items. Afterwards, each recommendation was brought forward for discussion and any alteration gaining ≥70% approval was accepted. Also, Turkish version of each item was rearranged. Last version of the recommendations was then revoted to determine the level of agreement. Levels of agreement of the two voting rounds were compared with Wilcoxon signed-rank test. In case of significant difference, the item with higher level of agreement was accepted. In case of no difference, the changed item was selected. Results: Four overarching principles and 12 recommendations were assessed among which three overarching principles and one recommendation were changed. The changed overarching principles emphasized the importance of physical medicine and rehabilitation specialists as well as rheumatologists for the care of RA patients in Turkey. An alteration was made in the eighth recommendation on treatment of active RA patients with unfavorable prognostic indicators after failure of three conventional disease modifying anti-rheumatic drugs. Remaining principles were accepted as the same although some alterations were suggested but could not find adequate support to reach significance. Conclusion: Expert opinion of the TLAR for the treatment of RA was composed for practices in Turkish rheumatology and/or physical medicine and rehabilitation clinics. © 2018 Turkish League Against Rheumatism. All rights reserved.
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    Pediatric kidney care experience after the 2023 Türkiye earthquake
    (Oxford University Press, 2024) Bakkaloǧlu S.A.; Delibaş A.; Döven S.S.; Taner S.; Yavuz S.; Erfidan G.; Vatansever E.D.; Aynaci F.; Yilmaz K.; Taşdemir M.; Akaci O.; Akinci N.; Güven S.; Çiçek N.; Dursun I.; Keleşoǧlu E.; Sancaktar M.; Alaygut D.; Saygili S.; Yavaşcan Ö.; Yilmaz A.; Gülleroǧlu K.; Ertan P.; Demir B.K.; Poyrazoǧlu H.; Pinarbaşi S.; Gençler A.; Baştuǧ F.; Günay N.; Çeleǧen K.; Noyan A.; Parmaksiz G.; Avci B.; Çayci F.Ş.; Bayrakçi U.; Özlü S.G.; Aksoy Ö.Y.; Yel S.; Inal G.A.; Köse S.; Bayazit A.K.; Atmiş B.; Saribaş E.; Çaǧli Ç.; Tabel Y.; Elmas A.T.; Selçuk Ş.Z.; Kiliç B.D.; Kara M.A.; Büyükçelik M.; Balat A.; Tiryaki B.D.; Erdoǧdu B.; Aksu B.; Mahmudova G.; Dursun H.; Candan C.; Göknar N.; Mutlubaş F.; Çamlar S.A.; Başaran C.; Akbulut B.B.; Düzova A.; Gülhan B.; Oruç Ç.; Peru H.; Alpay H.; Türkkan Ö.N.; Gülmez R.; Çelakil M.; Doǧan K.; Bilge I.; Pehlivanoǧlu C.; Büyükkaragöz B.; Leventoǧlu E.; Alpman N.; Zeybek C.; Tülpar S.; Gülşan R.Y.Ç.; Kara A.; Gürgöze M.K.; Önder E.N.A.; Atikel Y.Ö.; Pul S.; Sönmez F.; Yildiz G.; Akman S.; Elmaci M.; Küçük N.; Yüksel S.; Kavaz A.; Nalçacioǧlu H.; Alparslan C.; Dinçel N.; Elhan A.H.; Sever L.
    Background. Two earthquakes on 6 February 2023 destroyed 10 cities in Türkiye. We report our experience with pediatric victims during these catastrophes, with a focus on crush syndrome related-acute kidney injury (Crush-AKI) and death. Method. Web-based software was prepared. Patient demographics, time under rubble (TUR), admission laboratory data, dialysis, and kidney and overall outcomes were recorded. Results. A total of 903 injured children (median age 11.62 years) were evaluated. Mean TUR was 13 h (interquartile range 32.5, max 240 h). Thirty-one of 32 patients with a TUR of > 120 h survived. The patient who was rescued after 10 days survived. Two-thirds of the patients were given 50 mEq/L sodium bicarbonate in 0.45% sodium chloride solution on admission day. Fifty-eight percent of patients were given intravenous fluid (IVF) at a volume of 2000-3000 mL/m2 body surface area (BSA), 40% at 3000-4000 mL/m2 BSA and only 2% at > 4000 mL/m2 BSA. A total of 425 patients had surgeries, and 48 suffered from major bleeding. Amputations were recorded in 96 patients. Eighty-two and 66 patients required ventilator and inotropic support, respectively. Crush-AKI developed in 314 patients (36% of all patients). In all, 189 patients were dialyzed. Age > 15 years, creatine phosphokinase (CK) =20 950 U/L, TUR =10 h and the first-day IVF volume < 3000-4000 mL/m2 BSA were associated with Crush-AKI development. Twenty-two deaths were recorded, 20 of 22 occurring in patients with Crush-AKI and within the first 4 days of admission. All patients admitted after 7 days survived. Conclusions. These are the most extensive pediatric kidney disaster data obtained after an earthquake. Serum CK level was significantly associated with Crush-AKI at the levels of > 20 950 U/L, but not with death. Adolescent age and initial IVF of less than 3000-4000 mL/m2 BSA were also associated with Crush-AKI. Given that mildly injured victims can survive longer periods in the disaster field, we suggest uninterrupted rescue activity for at least 10 days. © The Author(s) 2024.
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    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.