Browsing by Author "Horasan, GD"

Now showing 1 - 20 of 28
  • No Thumbnail Available
    Item
    Seroprevalence of West Nile virus, Crimean-Congo hemorrhagic fever virus, Francisella tularensis and Borrelia burgdorferi in rural population of Manisa, western Turkey
    Gazi, H; Özkütük, N; Ecemis, T; Atasoylu, G; Köroglu, G; Kurutepe, S; Horasan, GD
    Background & objectives: Zoonotic diseases are well recognised threat to public health globally. The information of regional prevalence and associated risk factors allow the national programmes to determine and frame better strategies for their control, as they also provide the actual status of zoonosis in the region. The aim of this study was to determine the seroprevalence of West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus (CCHFV), Francisella tularensis and Borrelia burgdorferi among the rural residents of Manisa region, Turkey and to identify the associated risk factors. Methods: Cross sectional study was conducted in rural parts of Manisa, Aegean region of western Turkey in 2012. Blood samples from 324 randomly selected subjects were screened for the presence of IgG antibodies to WNV, CCHFV, F. tularensis and B. burgdorferi with commercially available kits. The demographic structure of the rural residents and risk factors related to lifestyle such as outdoor agriculture activities, animal husbandry, hunting and history of tick bite were questioned and their relationships with positive results were analyzed statistically. Results: It was observed that 49 subjects (15%) had IgG antibodies to at least one of the zoonotic agents studied. The seroprevalence of F. tularensis was highest with a percentage of 7.1% (n = 23). Distribution of the positive results for WNV, CCHFV and B. burgdorferi were 4.3% (n = 14), 3.7% (n = 12) and 0.9% (n = 3), respectively. Older age and uncompleted secondary education were the statistically significant risk factors for seropositivity to at least one zoonotic agent investigated. Logistic regression analyses confirmed that older age (over 50) increased the risk of WNV and CCHFV seropositivity. Interpretation & conclusion: Seropositivity rates were not found to be higher than the expected rates. Further, studies are needed to evaluate the threat of vector borne zoonoses and associated risk factors in the study area.
  • No Thumbnail Available
    Item
    Metabolic and demographic characteristics of children with urolithiasis in Western Turkey
    Ertan, P; Tekin, G; Öger, N; Alkan, S; Horasan, GD
    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.
  • No Thumbnail Available
    Item
    Diagnostic and prognostic value of procalcitonin and sTREM-1 levels in sepsis
    Bayram, H; Tünger, Ö; Çivi, M; Yüceyar, MH; Ulman, C; Horasan, GD; Çetin, CB
    Background/aim: Sepsis is still a major cause of morbidity and mortality despite the improvements in diagnosis and treatment. The aim of this study was to investigate the values of procalcitonin and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in the differential diagnosis of patients with sepsis and noninfectious systemic inflammatory response syndrome (NI-SIRS) and measure their importance in the prognosis of patients with sepsis. Materials and methods: This prospective study included 41 NI-SIRS and 33 sepsis patients hospitalized in Celal Bayar University Hospital, Manisa, Turkey. Blood samples were taken from NI-SIRS patients on days 0 and 3 and from sepsis patients on days 0, 3, 4, 7, and 14. Clinical status of the patients was determined with the SOFA scoring system. Results: The SOFA scoring system and procalcitonin and sTREM-1 measurements were significant in the differential diagnosis of sepsis and NI-SIRS patients. The SOFA scoring system was considered the most important indicator in determining the prognosis of sepsis patients. Procalcitonin and sTREM-1 levels increased progressively in nonsurvivors and decreased in survivors, but changes were statistically insignificant. Conclusion: In the differentiation of sepsis and NI-SIRS, and evaluation of the prognosis of sepsis, combined measurements of procalcitonin and sTREM-1 levels are important.
  • No Thumbnail Available
    Item
    VASCULAR CALCIFICATION AND GROWTH ARREST SPECIFIC PROTEIN 6 LEVELS IN CHRONIC RENAL DISEASE
    Toraman, A; Cetintepe, L; Elbi, H; Taneli, F; Yildiz, R; Duzgun, F; Pabuscu, Y; Horasan, GD; Kürsat, S
    Introduction: Cardiovascular disease is the main cause of mortality and morbidity in chronic renal failure. It's known that vascular calcification (VC) and carotid intima media thickness (CIMT) are strongly associated with cardiovascular diseases. Growth arrest specific protein 6 (Gas6) is a vitamin K-dependent protein and regulates various processes such as proliferation, cell survival, migration and inflammation. Gas6 is known to protect endothelial cells and vascular smooth muscle cells against apoptosis by inhibiting Bcl-2 induced Caspase 3 activation. The relationship between Gas6 and cardiovascular diseases has been demonstrated in many mouse models and cell cultures. However, there are conflicting reports whether Gas6 levels are increasing or decreasing in human studies of diabetic and/or chronic renal failure. In present study the aim was to examine plasma Gas6 levels and its relation with CIMT and coronary artery calcification score (CACS) in chronic kidney disease (CKD) patients. Methods: Total of 137 patients of which 32 chronic hemodialysis and 105 predialysis patients as well as 73 healthy controls were enrolled in the study. Human Gas6 levels in serum samples were studied by ELISA method. CIMT was measured by ultrasonography. CACS was measured by multislice computed tomography. Results: The mean age was 54.37 +/- 16.61 years in dialysis group, 55.20 +/- 14.80 years in predialysis group and 53.26 +/- 9.04 years in control group. Serum creatinine was 0.78 +/- 0.16 mg/dl in the control group and 1.96 +/- 1.64 mg/dl in the predialysis and 5.94 +/- 1.55 mg/dl in the dialysis group. 24 hours urine protein levels were significally higher in the dialysis group than the predialysis and the control group. CIMT values were similar in predialysis and dialysis groups. These values were significantly higher than control group. Although CACS was higher in dialysis group than predialysis and control group, the results were not statistically significant since the distribution range was very wide. Gas6 was 98.84 +/- 53.32 ng/mL in the control group and statistically higher than dialysis (63.85 +/- 38.92 ng/mL) and predialysis groups (54.96 +/- 38.49 ng/mL) (p=0.001). Gas6 levels were lower in diabetic patients than non-diabetics (53.69 +/- 35.26 ng/mL, 69.26 +/- 47.50 ng/mL, p=0.023, respectively). Negative correlation was detected between Gas6 and age, BMI, CACS, carotid IMT and proteinuria. In the logistic regression analysis, Gas6 remained significantly associated with BMI, CIMT and proteinuria. Conclusion: In our study, a negative correlation of Gas6 with BMI, CACS, CIMT and proteinuria and lower Gas6 levels in diabetic patients support that decreased Gas6 levels in chronic renal failure may have a role in vascular calcification through altered glucose tolerance, chronic inflammation, endothelial dysfunction and increased apoptosis. Our study has an importance because it is the first study showing a relation between Gas6 and proteinuria, CACS and carotid IMT in patients with chronic renal failure.
  • No Thumbnail Available
    Item
    Investigation of Sleep Breathing Disorders in Young Patients (Under 55 years) with Mild Stroke
    Kisabay, AKA; Saritas, AS; Batum, M; Göktalay, T; Horasan, GD; Selcuki, D; Yilmaz, H
    Introduction: Many patients with stroke also have sleep breathing disorders (SBD), most of which is obstructive sleep apnea (OSA). Methods: Sixty patients with a history of stroke aged under 55 years were included in our study. The demographic characteristics (age at stroke, sex, body mass index) of the patients and etiology of stroke was evaluated according to the Trial of Org 10712 in Acute Stroke (TOAST) classification. The National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) were used to evaluate functionality. All patients underwent polysomnography (PSG) investigations. Findings: Based on PSG investigations, seven patients were normal, 10 had primary snoring, and 14 had mild, 11 had moderate, and 18 had severe OSA. The demographic characteristics did not differ significantly between the groups. No significant correlation was found between disease severity and NIHSS, MRS or TOAST classifications. Large artery atherosclerosis in the etiology, facial paralysis and dysarthria in the neurological examination, and brain stem involvement in the stroke location were observed to accumulate in the severe OSA group. When the anterior system, posterior system, and association of both were compared for vessel location, no significant difference was found regarding circulatory systems. Conclusions: It is considered that SBD has also a role in the etiology of stroke in patients aged under 55 years, and it should be taken into consideration as much as other risk factors. This is the first study to emphasize the importance of this topic in the literature.
  • No Thumbnail Available
    Item
    Evaluation of Cognitive Function Using Objective and Subjective Tests in the Obstructive Sleep Apnea Syndrome
    Ak, AK; Sari, ÜS; Oktan, B; Korkmaz, T; Horasan, GD; Selçuki, D; Yilmaz, H
    Objective: The primary and secondary consequences which related to obstructive respiration to occur during sleep cause cognitive, emotional and behavioral changes indirectly. Aim of the present study was to evaluate quality of sleep and relationship between quality of sleep and cognitive function at baseline and during treatment in the patients having diagnosis of severe Obstructive Sleep Apnea syndrome (OSAS) being followed in sleep laboratory. Materials and Methods: Pittsburg, Epworth and Stroop tests to assess patient attention; P300 test was applied for the evaluation of memory and attention. Results: When the pre-treatment and post-treatment cognitive functions of the patients were compared; there was a significant decrease in daytime sleepiness after treatment (p=0.000) and a significant improvement in latency of P300 test (p=0.000-p=0.001-p=0.004). In Pittsburgh study; the pre-treatment total sleep quality scores were consistent with poor sleep quality, while the mean value obtained after treatment was found to be related to the healthy sleepiness (p=0.000). In the Stroop test for measuring attention, the rate of error correction obtained after treatment was significantly improved (p=0.010). Conclusion: In patients diagnosed with severe OSAS; the negative effects of disease on attention, alertness, and memory, challenges on maintaining the attention and its negative effects on the structure of sleep has been shown by using Stroop, Pittsburgh, P300 and Epworth tests unlike other publications. As a result of the tests performed after the treatment, the fact that it is an important development in the disease shows us how the treatment is important and necessary.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    Use of Tobacco Products in Turkish Children and Young People: Is there an Alarm for Hookah Use?
    Göktalay, T; Coskun, AS; Havlucu, Y; Horasan, GD
    OBJECTIVES: In the recent years, it has been observed that the use of hookah, a tobacco product, has increased in children and young people in Turkey. This study was conducted to determine the prevalence of cigarette and hookah use in children and young people specific to age and gender and to define the factors relevant to the use of hookah. MATERIALS AND METHODS: The study was conducted with secondary/high school students between 11 and 17 years of age (Survey 1, n=4718) and with university students between 18 and 23 years of age (Survey 2, n=1588) as two groups, which made a total of 6306 students. The students were asked to fill in a questionnaire which consisted of questions about socio-demographic data and the use of tobacco and tobacco products. RESULTS: It was determined that the use of cigarette and hookah was high in males, and it increased as the age increased in both genders (p<0.05). It was also determined that parents and friends using cigarette and hookah affected the use of cigarette and hookah in the study groups in both surveys (p<0.05). Additionally, it was determined that the educational level of the parents and being of a high social class were the social determiners of hookah use (p<0.05). CONCLUSION: It is important that we fight against the use of all tobacco products, especially in young people. Education about the damages of tobacco and applying tobacco products should start at an early age, and accurate tobacco control models may provide support in this field.
  • No Thumbnail Available
    Item
    Neurological outcome after cardiac arrest: a prospective study of the predictive ability of prognostic biomarkers neuron-specific enolase, glial fibrillary acidic protein, S-100B, and procalcitonin
    Ok, G; Aydin, D; Erbüyün, K; Gürsoy, C; Taneli, F; Bilge, S; Horasan, GD
    Background/aim: Factors affecting neurological outcome and the usefulness of neuron-specific enolase (NSE), S-100B, glial fibrillary acidic protein (GFAP), and procalcitonin (PCT) in predicting neurological outcomes were assessed in patients who survived at least 24 h after cardiopulmonary resuscitation (CPR). Materials and methods: Thirty successfully resuscitated cardiac arrest patients were included in this prospective clinical study. The initial cardiac arrest rhythm, duration of CPR, return of spontaneous circulation time, administered doses of adrenaline, base excess, blood sugar, and hemodynamic parameters were recorded. Patients with Glasgow Outcome Scale (GOS) scores of 1-3 were defined as Group I and patients with GOS scores of 4-5 were defined as Group II. Serum NSE, GFAP, S-100B, and PCT levels were compared between the two groups shortly after CPR (hour 0) and at hours 12 and 24 of the postresuscitation period. Results: Serum S-100B was significantly higher (P = 0.009) in Group II immediately after CPR. Serum S-100B and NSE after CPR at hours 0, 12, and 24 were significantly lower in patients who survived to hospital discharge. Serum PCT at hours 12 and 24 and serum S-100B after CPR at 0, 12, and 24 h reached 94.7% sensitivity. Serum NSE, GFAP, S-100B, and PCT specificities were lower than 50%. Conclusion: In predicting neurological outcomes, serum S-100B has high sensitivity and low specificity immediately after CPR.
  • No Thumbnail Available
    Item
    Factors affecting the views and experiences of women living in the city centre of Manisa, Turkey, regarding domestic violence
    Özpinar, S; Horasan, GD; Baydur, H; Canbay, T
    Domestic violence against women is an important social and public health problem worldwide resulting from unequal power relationships between men and women. The purpose of the present cross-sectional descriptive study was to determine the factors affecting the views and experiences of women living in the city centre of Manisa, Turkey, regarding domestic violence. The data were collected from a representative sample of women (n=873) in 2012. The socio-demographic questionnaire and the World Health Organization's Multi-country Study on Women's Health and Domestic Violence Against Women were used for data collection. The study results revealed that of the women, 14.8% were exposed to physical violence, 7.9% to sexual violence, 20.2% to emotional violence/abuse and 11.2% to economic violence/abuse within the last 12 months. Lower income level, lower social status, lower educational level, unemployment, being exposed to parental violence during childhood and being married to husbands exposed to parental violence during childhood were associated risk factors with domestic violence. The study results indicate that domestic violence against women is a common phenomenon in Manisa.
  • No Thumbnail Available
    Item
    Can Urinary Gamma Glutamyl Transferase be Used as a Bone Resorption Marker in Postmenopausal Osteoporosis?
    Tikiz, C; Ulman, C; Taneli, F; Acar, EY; Gümüser, G; Horasan, GD
    Objectives: To evaluate whether gamma-glutamyl transferase can be used as a new novel bone resorption marker in postmenopusal osteoporotic subjects. Design and methods: 156 postmenopausal subjects were divided into three groups according to their lumbar spine T-score measured by dual-energy X-ray absorptiometry as normal, (control group, n=56), osteopenic (n=50) and osteoporotic (n=50). Deoxypyridinoline and gamma-glutamyl transferase from urine samples and osteocalcin and bone specific alkaline phosphates from blood samples were assessed. Results: Osteocalcin and bone specific alkaline phosphates levels were increased in osteoporotic group (p<0.05). Although there is a tendency to increase in deoxypyridinoline values in osteoporotic group, this difference did not reach to a statistical significance. No significant differences were observed in urinary gamma-glutamyl transferase levels between the three groups (p>0.05). No significant correlation was found between urinary gamma-glutamyl transferase and deoxypyridinoline, bone specific alkaline phosphates and osteocalcin (p>0.05). Urinary gamma-glutamyl transferase levels showed no significant correlation with neither bone mineral density nor T scores in all subjects (r=0.058 p=0.625, r=-0.074 p=0.533 respectively). Conclusions: Our primary findings did not support the suggestion that urinary g-glutamyl transferase could be used as a potential marker for bone resorption in postmenopusal osteoporotic subjects.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    E-cadherin as an epithelial barrier protein in exhaled breath condensate
    Yuksel, H; Turkeli, A; Taneli, F; Horasan, GD; Kanik, ET; Kizilkaya, M; Gozukara, C; Yilmaz, O
    Airway epithelium plays an important role as a physical barrier and a modulator of allergic response. Junctions between cells provide epithelial integrity and barrier function. The aim of this study was to investigate the influence of atopy on airway epithelial integrity in asthma and to measure E-cadherin levels in exhaled breath condensate as an indicator epithelial damage. A total of 74 patients with asthma (35 atopic and 39 non-atopic) and 39 healthy children were enrolled in this case-control study. Sociodemographic characteristics and asthma severity parameters in the last three-month period were recorded and pulmonary function tests were performed. Blood samples were obtained to measure serum immunoglobulin E (IgE) levels and peripheral blood eosinophil count, and exhaled breath condensate (EBC) was obtained to measure E-cadherin. EBC E-cadherin levels were significantly lower in the asthmatics when compared to non-atopic controls (0.109 (0.076) versus 0.191 (0.184) ng mL(-1) respectively, p = 0.01). Atopic and non-atopic asthmatic groups had lower EBC E-cadherin levels compared to the control group. (0.112 (0.060) ng ml(-1), 0.106 (0.089) ng ml(-1) and 0.191 (0.184) ng ml(-1), p = 0.02 and p < 0.01 respectively). However, EBC E-cadherin levels were not different between atopic and nonatopic asthmatics. The results of our study support the role of E-cadherin in the pathogenesis of asthma. However, the absence of difference in E-cadherin levels between atopic and non-atopic asthmatics suggests that allergic sensitization is not the primary factor for development of epithelial barrier dysfunction in asthma.
  • No Thumbnail Available
    Item
    Sensitivity, predictive values, pretest--posttest probabilities, and likelihood ratios of presurgery clinical diagnosis of nonmelanoma skin cancers
    Ermertcan, AT; Öztürk, F; Gençoglan, G; Eskiizmir, G; Temiz, P; Horasan, GD
    Objective: This study aimed to compare clinical and histopathologic diagnoses of nonmelanoma skin cancers with regard to sensitivity, predictive values, pretest--posttest probabilities, and likelihood ratios. Methods: Two hundred nineteen patients with 241 nonmelanoma skin cancers were enrolled in this study. Of these patients, 49.4% were female and 50.6% were male. The mean age +/-+/- standard deviation (SD) was 63.66 +/-+/- 16.44 years for the female patients and 64.77 +/-+/- 14.88 years for the male patients. The mean duration of the lesions was 20.90 +/-+/- 32.95 months. One hundred forty-eight (61.5%) of the lesions were diagnosed as basal cell carcinoma (BCC) and 93 (38.5%) were diagnosed as squamous cell carcinoma (SCC) histopathologically. Results: Sensitivity, positive predictive value, and posttest probability were calculated as 75.96%, 87.77%, and 87.78% for BCC and 70.37%, 37.25%, and 37.20% for SCC, respectively. The correlation between clinical and histopathologic diagnoses was found to be higher in BCC. Conclusion: Knowledge of sensitivity, predictive values, likelihood ratios, and posttest probabilities may have implications for the management of skin cancers. To prevent unnecessary surgeries and achieve high diagnostic accuracies, multidisciplinary approaches are recommended.
  • No Thumbnail Available
    Item
    Atopy may result in more severe airway damage independent of the inflammatory cell type in pediatric asthma
    Turkeli, A; Yilmaz, O; Taneli, F; Horasan, GD; Kanik, ET; Kizilkaya, M; Gozukara, C; Yuksel, H
  • No Thumbnail Available
    Item
    ACCIDENT PREVALENCE AND ACCIDENT ASSOCIATED RISK FACTORS AMONG ELDERLY PEOPLE LIVING IN NURSING HOMES IN
    Altiparmak, S; Horasan, GD
    Introduction: Accidents of old age is an important health problem for the cases of morbidity and mortality. The aim of this study was to determine the accident prevalence and to identify associated risk factors among elderly people living in nursing homes in Manisa city. Materials and Method: This cross sectional study was conducted in all nursing homes (n=4) Manisa city in Aegean region of Turkey. The data were collected in March 2010-May 2010. The population of the study included elderly people living nursing homes (n=260). Of those elderly people, 210(80.8%) were face to face interviewed by means of a questionaire. The questionaire included three forms: sociodemographic variables form, Brief Disability Questionnaire, and accident experience form. All statistical analyses were performed using SPSS 11.0. Descriptive statistics, the chi(2) test, p for trend and logistic regression models were used for data analysis. Results: Prevalence of at least one accident experience in the previous year was 38.6% (n=81) in the study population. The most frequent accident type and accident place were falls (63.3%) and stairs, respectively. The most frequent accident reasons were balance disorder among personal reasons (20.2%) and wet and uneven floor among enviromental reasons (12.8%). We have found the use of an assistive device and disability was an important risk factor for accidents. Conclusion: Accidents are common among elderly elderly people living in nursing homes.
  • No Thumbnail Available
    Item
    E-cadherin as an epithelial barrier protein: relation to atopy in children with asthma
    Turkeli, A; Yilmaz, O; Taneli, F; Horasan, GD; Kanik, ET; Kizilkaya, MH; Gozukara, C; Yuksel, H
  • No Thumbnail Available
    Item
    IL-5, IL-8 and MMP-9 levels in exhaled breath condensate of atopic and nonatopic asthmatic children
    Turkeli, A; Yilmaz, O; Taneli, F; Horasan, GD; Kanik, ET; Kizilkaya, M; Gozukara, C; Yuksel, H
    Rationale: Asthma is a heterogeneous disease, and a great majority of pediatric patients with asthma demonstrate atopic characteristics and develop a Th2 type cytokine response. Nonatopic asthma, on the other hand, is seen more rarely. Methods: In this study, levels of IL-5, IL-8 and MMP-9 were measured in exhaled breath condensate (EBC) of the subjects to demonstrate the extent of tissue damage as well as eosinophilic and neutrophilic inflammation in children with atopic and nonatopic asthma. A total of 37 children with atopic asthma and 37 children with nonatopic asthma were enrolled in the study. Patients who exhibited protease positive aeroallergen (House dust mite, mould mix, olea, grass mix) sensitivity in allergen skin prick test were included in the atopic asthma group. To evaluate the EBC, the fluid content of the breath was collected by having the patients exhale into an EBC device, after which the IL-5, IL-8 and MMP-9 levels were assayed using the ELISA method. Results: The atopic asthmatics exhibited significantly higher IL-5 levels in their EBC samples than the nonatopic asthmatics (0.271 [0.198-0.489] pg/ml and 0.198 [0.125-0.344] pg/ml, respectively, p = 0.04), while no significant differences were observed in the levels of IL-8 and MMP-9 in the EBC samples of the atopic and nonatopic asthmatics. Conclusions: IL-5 levels, as a marker of eosinophilic inflammation, were demonstrated to be higher in the children with atopic asthma when compared to those with nonatopic asthma in EBC. The fact that no significant difference was apparent in the IL-8 levels between the groups suggests that it is the severity of the disease rather than the atopic state that plays an important role in IL-8 levels. Since no difference was recorded between the groups in terms of MMP-9 levels, lung damage in asthma sufferers seems to develop independent of atopia. (C) 2015 Elsevier Ltd. All rights reserved.
  • No Thumbnail Available
    Item
    The Prevalance of Myocardial Perfusion Defects in Type-2 Diabetes Mellitus Patients
    Batok, D; Gumuser, G; Hekimsoy, Z; Horasan, GD; Kafesciler, S; Bilgin, ES