Browsing by Author "Kalkan G."

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    The skills of defibrillation practice and certified life-support training in the healthcare providers in Turkey
    (Wiley-Hindawi, 2021) Derinoz-Guleryuz O.; Uysal-Yazici M.; Udurgucu M.; Karacan C.; Akça H.; Ongun E.A.; Ekinci F.; Duman M.; Akça-Çaglar A.; Vatansever G.; Bilen S.; Uysalol M.; Akcan-Yıldız L.; Saz E.U.; Bal A.; Piskin E.; Sahin S.; Kurt F.; Anil M.; Besli E.; Alakaya M.; Gültekingil A.; Yılmaz R.; Temel-Koksoy O.; Kesici S.; Akcay N.; Cebisli E.; Emeksiz S.; Kılınc M.A.; Köker A.; Çoban Y.; Erkek N.; Gurlu R.; Eksi-Alp E.; Apa H.; Kalkan G.; Azapagası E.; Yener N.; Sarac-Sandal O.; Horoz O.O.; Öztürk A.; Tuygun N.; Özdemir İ.; Göktuğ A.; Gökulu G.; Gümüs S.; Teksam O.; Turan C.; Zengin N.; Kardeş H.; Bozan G.; Ünal B.; Bardak S.; Arslanköylü A.E.; Yorulmaz A.; Celegen M.; Sevketoglu E.; Dursun O.; Perk O.; Başpınar O.; Akgul F.
    Aim of the study: Successful cardiopulmonary resuscitation and early defibrillation are critical in survival after in- or out-of-hospital cardiopulmonary arrest. The scope of this multi-centre study is to (a) assess skills of paediatric healthcare providers (HCPs) concerning two domains: (1) recognising rhythm abnormalities and (2) the use of defibrillator devices, and (b) to evaluate the impact of certified basic-life-support (BLS) and advanced-life-support (ALS) training to offer solutions for quality of improvement in several paediatric emergency cares and intensive care settings of Turkey. Methods: This cross-sectional and multi-centre survey study included several paediatric emergency care and intensive care settings from different regions of Turkey. Results: A total of 716 HCPs participated in the study (physicians: 69.4%, healthcare staff: 30.6%). The median age was 29 (27-33) years. Certified BLS-ALS training was received in 61% (n = 303/497) of the physicians and 45.2% (n = 99/219) of the non-physician healthcare staff (P <.001). The length of professional experience had favourable outcome towards an increased self-confidence in the physicians (P <.01, P <.001). Both physicians and non-physician healthcare staff improved their theoretical knowledge in the practice of synchronised cardioversion defibrillation (P <.001, P <.001). Non-certified healthcare providers were less likely to manage the initial doses of synchronised cardioversion and defibrillation: the correct responses remained at 32.5% and 9.2% for synchronised cardioversion and 44.8% and 16.7% for defibrillation in the physicians and healthcare staff, respectively. The indications for defibrillation were correctly answered in the physicians who had acquired a certificate of BLS-ALS training (P =.047, P =.003). Conclusions: The professional experience is significant in the correct use of a defibrillator and related procedures. Given the importance of early defibrillation in survival, the importance and proper use of defibrillators should be emphasised in Certified BLS-ALS programmes. Certified BLS-ALS programmes increase the level of knowledge and self-confidence towards synchronised cardioversion-defibrillation procedures. © 2021 John Wiley & Sons Ltd
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    Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity
    (Blackwell Publishing Ltd, 2021) Özkur E.; Karadağ A.S.; Üstüner P.; Aksoy B.; Eşme P.; Çalışkan E.; Akoğlu G.; Kalkan G.; Demirseren D.D.; Polat M.; Ozden M.G.; Kılınç F.; Yalçınkaya İyidal A.; Kıvanç Altunay İ.; Türkmen M.; Uğurer E.; Baysak S.; Fettahlıoğlu Karaman B.; Mammadlı K.; Baykal Selçuk L.; Türkoğlu Z.; Atcı T.; Didar Balcı D.; Adışen E.; Temel B.; Aktan Ş.; Kaçar N.; Gündüz K.; Türel Ermertcan A.; Özdemir M.; Ünal Çakıter A.; Çölgeçen E.; Uçmak D.; Kelekçi H.; Ataseven A.; Durmaz K.; Kaya Özden H.; Engin B.; Yazıcı S.; Alpsoy E.
    Background: Hidradenitis suppurativa (HS) is a chronic, relapsing and debilitating inflammatory disease associated with profound morbidity. Aim: In this multicentre study, we investigated the demographic and clinical features of HS, and determined risk factors of disease severity. Methods: In total, 1221 patients diagnosed with HS from 29 centres were enrolled, and the medical records of each patient were reviewed. Results: The mean age of disease onset was 26.2 ± 10.4 years, and almost 70% (n = 849) of patients were current or former smokers. Mean disease duration was 8.9 ± 8.4 years with a delay in diagnosis of 5.8 ± 3.91 years. Just over a fifth (21%; n = 256) of patients had a family history of HS. The axillary, genital and neck regions were more frequently affected in men than in women, and the inframammary region was more frequently affected in women than in men (P < 0.05 for all). Acne (40.8%), pilonidal sinus (23.6%) and diabetes mellitus (12.6%) were the most prevalent associated diseases. Of the various therapies used, antibiotics (76.4%) were most common followed by retinoids (41.7%), surgical interventions (32.0%) and biologic agents (15.4%). Logistic regression analysis revealed that the most important determinants of disease severity were male sex (OR = 2.21) and involvement of the genitals (OR = 3.39) and inguinal region (OR = 2.25). More severe disease was associated with comorbidity, longer disease duration, longer diagnosis delay and a higher number of smoking pack-years. Conclusions: Our nationwide cohort study found demographic and clinical variation in HS, which may help broaden the understanding of HS and factors associated with disease severity. © 2020 British Association of Dermatologists
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    Sociodemographic, clinical, laboratory, treatment and prognostic characteristics of 156 generalized pustular psoriasis patients in Turkey: a multicentre case series
    (John Wiley and Sons Inc, 2022) Kara Polat A.; Alpsoy E.; Kalkan G.; Aytekin S.; Uçmak D.; Yasak Güner R.; Topkarcı Z.; Yılmaz O.; Emre S.; Borlu M.; Türkoğlu Z.; Özkök Akbulut T.; Özaydın Yavuz G.; Kaya Erdoğan H.; Adışen E.; Satılmış Kaya A.; Oğuz Topal İ.; Yazıcı S.; Yılmaz E.; Koku Aksu A.E.; Kartal S.P.; Deveci B.N.; Öksüm Solak E.; Karadağ A.S.; Sarıkaya Solak S.; Kıvanç Altunay İ.; Türel Ermertcan A.; Özkesici Kurt B.; Gelincik Kaçar N.; Ataseven A.
    Background: Generalized pustular psoriasis (GPP) is a rare and severe inflammatory disease characterized by widespread and superficial sterile pustules on an erythematous background. Objectives: This multicentre study aimed to determine the clinical profile and course in a large cohort of patients with GPP. Methods: One hundred and fifty-six GPP patients (mean age, 44.2 ± 18.7 years) who met the diagnostic criteria of the European Consensus Report of GPP were included in the study. Sociodemographic characteristics, quality of life, triggering factors of the disease, clinical, laboratory, treatment and prognostic features were evaluated. Results: 61.5% of the patients were female. The rate of working at or below the minimum wage (≤$332.5/month) was 44.9%. Drugs (36.5%) were the most common trigger. While hypocalcaemia (35.7%) was the most important cause of GPP during pregnancy, systemic steroid withdrawal (20%) was the most frequently reported trigger for infantile/juvenile and mixed-type GPP (15%) (P < 0.05). Acute GPP (53.8%) was the most common clinic. Nails were affected in 43.6% of patients, and subungual yellow spots (28.2%) were the most common change. In annular GPP, fever (P < 0.001) and relapse frequency (P = 0.006) were lower than other subtypes, and the number of hospitalizations (P = 0.002) was lower than acute GPP. GPP appeared at a later age in those with a history of psoriasis (P = 0.045). DLQI score (P = 0.049) and joint involvement (P = 0.016) were also higher in this group. Infantile/juvenile GPP was observed in 16.02% of all patients, and arthritis was lower in this group (24.4 vs. 16%). GPP of pregnancy had the worst prognosis due to abortion observed in three patients. Conclusions: Recent advances in treatment have improved mortality associated with GPP, but abortion remains a significant complication. Although TNF-α inhibitors have proven efficacy in GPP, they can also trigger the disease. Mixed-type GPP is more similar to acute GPP than annular GPP with systemic manifestations and course. © 2022 European Academy of Dermatology and Venereology.
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    Epidemiological characteristics of different types of adult acne in Turkey: a prospective, controlled, multicenter study
    (Slovene Medical Society, 2023) Kutlu Ö.; Karadağ A.S.; Demirseren D.D.; İyidal A.Y.; Tosun M.; Kalkan G.; Polat M.; Kemeriz F.; Türkoğlu Z.; Erdoğan H.K.; Aktürk A.Ş.; Alyamaç G.; Özden H.K.; Kılıç S.; Kılınç F.; Akbulut T.Ö.; Ermertcan A.T.; Sarıcaoğlu H.; Cemil B.Ç.; Kayıran M.A.; Aksoy H.; Alpsoy E.
    Introduction: Acne occurring in adults over the age of 25 years is known as acne tarda or adult acne. Three types of adult acne are recognized: persistent, late-onset, and recurrent acne. Most studies do not compare the characteristics between the three variants. In addition, little is known about adult acne in males. This study describes the epidemiological factors of adult acne and investigates certain triggering factors by sex and different types of adult acne. Methods: A multicenter, prospective, descriptive study was conducted. Patients with adult acne and an acne-free control group were compared regarding medical history, family history, smoking and drinking habits, and dietary factors. In addition, triggering and prognostic factors were investigated by sex and three different types of acne: persistent, late-onset, and recurrent acne. Results: The participants included 944 (88.56%) female and 122 (11.44%) male patients with adult acne, and 709 (73.85%) female and 251 (26.15%) male control patients. The consumption of crackers, chocolate, and pasta was significantly more common in the acne group than in the control group (p = 0.017, 0.002, and 0.040, respectively). Male patients with adult acne had a significantly longer disease duration than female patients with adult acne (p = 0.024). The most common type of acne was recurrent acne, followed by persistent and late-onset acne. Among patients with persistent acne, 14.5% had polycystic ovary syndrome (PCOS), whereas 12.2% of patients with recurrent acne and 11.1% of patients with late-onset acne had PCOS. Severe acne was more common in the persistent acne type (28.13%). The cheek (59.90%) was the most common involvement area, and stress (55.23%) was the most common triggering factor regardless of sex. Conclusions: Although adult female and male patents with adult acne share similar triggering factors, the involvement areas can differ, which may indicate the additional hormonal etiology of female adult acne. Further epidemiological studies on adult acne in both sexes may illuminate the pathogenesis of the disease, thus making possible the development of new treatment strategies. © 2023, Slovene Medical Society. All rights reserved.
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    Clinical Features and Natural Course of Hidradenitis Suppurativa in Turkey: A Multicenter Study
    (S. Karger AG, 2024) Alpsoy E.; Fettahlloglu Karaman B.; Demirseren D.D.; Clnar S.L.; Kacar N.; Türel Ermertcan A.; Bulbul Baskan E.; Ucmak D.; Mammadli K.; Klllnc F.; Yazici S.; Temiz S.A.; Özkök Akbulut T.; Ataseven A.; Şikar Aktürk A.; Sarlcaoǧlu H.; Türkmen M.; Gülbaşaran F.; Engin B.; Kaya Özden H.; Durmaz K.; Güler Özden M.; Özdemir H.; Çevirgen Cemil B.; Sarlkaya Solak S.; Bilgili S.G.; Yavuz I.H.; Özaydln Yavuz G.; Güven M.; Polat Ekinci A.; Atcl T.; Didar Balci D.; Oztürk A.; Klvanç Altunay I.; Özkur E.; Ugurer E.; Karadag A.S.; Kalkan G.; Klllc S.; Erdoǧan B.; Yayli S.; Baykal Selçuk L.; Dönmez L.; Bilgic A.
    Introduction: The natural history, the progression of a disease process in an individual over time, has not yet been fully elucidated in hidradenitis suppurativa (HS). In this large multicenter study, we aimed to investigate the natural history of HS and its gender differences. Methods: This cross-sectional study included 827 patients. The chronological order of the clinical manifestations for each patient was recorded retrospectively. Sociodemographic characteristics, triggering factors, clinical, treatment, and prognostic featureswere also evaluated. Results: The mean age of disease onset was significantly younger in women than in men (22.42 ± 9.28 vs. 27.06 ± 20.56, p < 0.001) and those with a family history (p < 0.0001). The mean disease duration was 91.17 ± 83.64 months. The most common symptom was purulent discharge (81%). The mean duration of abscess was shorter in women than in men (3.11 ± 2.65 vs. 3.75 ± 3.75, p = 0.01). The axilla was the most common onset area followed by the inguinal and gluteal regions. The disease ran a more severe course in men. Abscess/inflammatory nodule was defined in the last 6 months in 88.6% of the patients; however, the first 5 years of the disease were the most active disease period in 67.5% of the patients. Multivariate analysis revealed being male, older age, family history, involvement of the axillary, inguinal, and perianal regions independently associated with HS severity. While antibiotic use was the most important factor in improving the disease symptoms, stress was themost common aggravating factor. Biological therapy in men, laser epilation and pregnancy in women were significant alleviating factors, whereas weight gain was a more common aggravating factor for women. Conclusion: HS shows a relentlessly progressive course with inflammatory attacks, but the first years of the disease are the most active period. This study confirms that environmental and hormonal factors may play an important role in the disease course, probably with other endogenous or exogenous factors. © 2024 S. Karger AG, Basel.
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    Analysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: a multicenter study of 1521 patients
    (Springer Nature, 2024) Erduran F.; Emre S.; Hayran Y.; Adışen E.; Polat A.K.; Üstüner P.; Öztürkcan S.; Öztürk P.; Ermertcan A.T.; Selçuk L.B.; Aksu E.K.; Akbaş A.; Kalkan G.; Demirseren D.; Kartal S.P.; Topkarcı Z.; Kılıç A.; Yaldız M.; Aytekin S.; Hızlı P.; Gharehdaghi S.; Borlu M.; Işık L.; Botsalı B.R.; Solak E.Ö.; Albayrak H.; Gönülal M.; Balcı D.D.; Polat M.; Daye M.; Ataseven A.; Yıldız S.; Özer İ.; Zorlu Ö.; Doğan S.; Erdemir V.A.; Dikicier B.S.
    Methotrexate (MTX) is commonly used as first-line systemic treatment agent in psoriasis. We aimed to evaluate the clinical characteristics and treatment responses of patients with psoriasis undergoing MTX monotherapy. Data from adult patients with plaque psoriasis who received MTX monotherapy for at least 3 months between April 2012 and April 2022 were retrospectively evaluated in 19 tertiary care centers. Our study included 722 female and 799 male patients, a total of 1521 participants. The average age of the patients was 44.3 ± 15.5 years. Mode of treatment was oral in 20.4% of patients while in 79.4% it was subcutaneous. The median treatment duration was 8 months (IQR = 5–15). The median weekly dose was 15 mg (IQR = 11–15). 1448 (95.2%) patients were taking folic acid supplementation. At week 12, 16.3% of the patients achieved PASI (Psoriasis Area and Severity Index) 90 response while at week 24, 37.3% achieved it. Logistic regression analysis for week 12 identified the following independent factors affecting PASI 90 achievement positively: median weekly MTX dose ≤ 15 mg (P = 0.011), subcutaneous administration (P = 0.005), no prior systemic treatment (< 0.001) and folic acid use (0.021). In logistic regression analysis for week 24; median weekly MTX dose ≤ 15 mg (P = 0.001), baseline PASI ≥ 10 (P < 0.001), no prior systemic treatment (P < 0.004), folic acid use (P = 0.001) and absence of comorbidities (P = 0.009) were determined as independent factors affecting the achievement of PASI 90. Adverse effects were observed in 38.8% of the patients, with nausea/vomiting (23.9%) and transaminase elevation (13%) being the most common. The most common reasons for interruptions (15.3%) and discontinuations (27.1%) of the treatment were patient related individual factors. The use of MTX as the first systemic treatment agent, at doses ≤ 15 mg/week and concurrent folic acid application are positive predictive factors for achieving the target PASI response both at weeks 12 and 24. In our study, which is one of the most comprehensive studies on MTX treatment in psoriasis, we observed that MTX is an effective and safe treatment option. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.