Browsing by Author "Kaya, D"

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    Design of Pulsed Electromagnetic Field Generator and Applicator and the Effect of Wound Healing
    Kaya, A; Tuglu, MI; Kaya, D
    Today, biomedical devices have become an issue where system manufacturers are working intensively. At present, many domestic and foreign biomedical companies offer various EMA products. Electromagnetic fields (EMF) has a significant impact on our body. These fields are being used for bone problems, cartilage regeneration, and pain removal for physiotherapy purposes. Lately, EMFs are often used in in vitro and in vivo assays. In this study, in vivo test results of the applied pulsed electromagnetic fields (PEMF) with our designed Helmholtz coil array system are given. The skin wound healing conducted in rats as an experimental model provides important information for evaluating the efficacy and mechanism of these kind of treatments. For this purpose, effectiveness of PEMF compared to control groups on experimental skin healing effect was examined macroscopically. Compared with the control groups a faster wound healing process was followed by PEMF application at 75 Hz frequency.
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    The effect of 8-week different-intensity walking exercises on serum hepcidin, IL-6, and iron metabolism in pre-menopausal women
    Buyukyazi, G; Ulman, C; Çelik, A; Çetinkaya, C; Sisman, AR; Çimrin, D; Dogru, Y; Kaya, D
    Objective: Hepcidin may be an important mediator in exercise-induced iron deficiency. Despite the studies investigating acute exercise effects on hepcidin and markers of iron metabolism, we found no studies examining the chronic effects of walking exercises (WE) on hepcidin and markers of iron metabolism in premenopausal women. The chronic effects of two 8-week different-intensity WE on hepcidin, interleukin 6 (IL-6), and markers of iron metabolism in pre-menopausal women were examined. Methods: Exercise groups (EG) [moderate tempo walking group (MTWG), n = 11; brisk walking group (BWG), n = 11] walked 3 days/week, starting from 30 to 51 min. Control group (CG; n = 8) did not perform any exercises. BWG walked at similar to 70%-75%; MTWG at similar to 50%-55% of HRRmax. VO2max, hepcidin, IL-6, and iron metabolism markers were determined before and after the intervention. Results: VO2max increased in both EGs, favoring the BWG. Hepcidin increased in the BWG (p < 0.01) and CG (p < 0.05). IL-6 decreased in the BWG and the MTWG (p < 0.05; p < 0.01). While iron, ferritin, transferrin, and transferrin saturation levels did not change in any group, total iron binding capacity (p < 0.05), red blood cells (p < 0.05), and hematocrit (p < 0.01) increased only in the BWG. Conclusion: Both WE types may be useful to prevent inflammation. However, brisk walking is advisable due to the positive changes in VO2max and some iron metabolism parameters, which may contribute to prevent iron deficiency. The increase in hepcidin levels remains unclear and necessitates further studies.
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    Activation of peripheral opioid receptors has no effect on heart rate variability
    Ellidokuz, E; Kaya, D; Uslan, I; Celik, A; Esen, AM; Barutca, I
    Opioid receptors involved in regulating the motility of the gastrointestinal tract have been localized in both contractile and neuronal tissues. Trimebutine, a peripheral opioid receptor agonist, modulates gastrointestinal motor activity in both directions and also may act on cardiac tissue. This study investigated the effects of trimebutine in clinical doses on cardiac autonomic functions with heart rate variability. The effect of trimebutine on cardiac autonomic outflows was evaluated in 11 healthy subjects. Trimebutine (200 mg) or placebo was administered orally at random in a double-blind, cross-over manner. Continuous electrocardiography recordings were obtained before and after drug administration during three states: rest, controlled breathing, and a hand grip exercise. Heart rate variability analysis showed that there was no significant difference between subjects administered with placebo or trimebutine throughout rest, controlled breathing, or the hand grip exercise. We concluded that trimebutine, in clinical doses, has no significant effect on cardiac autonomic functions.
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    Gastrostomy in Hospitalized Patients with Acute Stroke: NoroTek Turkey Point Prevalence Study Subgroup Analysis
    Topçuoglu, MA; Özdemir, AÖ; Aykaç, Ö; Milanoglu, A; Gökçe, M; Bavli, S; Çabalar, M; Yayla, V; Erdogan, HA; Özkul, A; Günes, A; Degirmenci, B; Aluçlu, U; Kozak, HH; Güngör, L; Erdogan, M; Acar, ZÖ; Cenikli, U; Kablan, Y; Yilmaz, A; Genç, H; Nazliel, B; Çaglayan, HB; Gencer, ES; Ay, H; Demirbas, H; Akdogan, Ö; Emre, U; Yildiz, ÖK; Bolayir, A; Demir, T; Tanriverdi, Z; Tekan, ÜY; Akpinar, ÇK; Özkan, E; Ilik, F; Sirin, H; Güler, A; Önder, H; Bektas, H; Öcek, L; Bakar, M; Ongun, N; Krespi, Y; Isikay, CT; Aslanbaba, E; Sorgun, M; Gürkas, E; Karadeli, HH; Midi, I; Ilgezdi, I; Bilgiç, AB; Akyol, S; Epçeliden, MT; Atmaca, MM; Kursun, O; Keskin, O; Sirinocak, PB; Baydemir, R; Akçakoyunlu, M; Öztürk, S; Özel, T; Ünal, A; Dora, B; Yürekli, VA; Arlier, Z; Eren, A; Yilmaz, A; Kisabay, A; Acar, B; Bastan, B; Acar, Z; Niflioglu, B; Güven, B; Kaya, D; Afsar, N; Yazici, D; Aytaç, E; Yaka, E; Toplutas, E; Degirmenci, E; Ince, FB; Büyükserbetçi, G; Aydin, I; Çetiner, M; Sen, M; Turgut, N; Kale, N; Çoban, E; Yesilot, N; Ekizoglu, E; Kizek, Ö; Birgili, Ö; Yevgi, R; Kunt, R; Giray, S; Akkas, SY; Senadim, S; Yoldas, T; Asil, T; Duman, T; Atasoy, T; Çinar, BP; Demir, T; Can, U; Ünsal, YÖ; Eskut, N; Aslan, Y; Bas, DF; Sener, U; Yilmaz, Z; Bozdogan, Z; Alioglu, Z; Arsava, EM
    Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NoroTek 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 (ss): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (ss): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (ss): 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 (ss): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (ss): 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 NoroTek 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.
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    Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study
    Topçuoglu, MA; Arsava, EM; Özdemir, AÖ; Aykaç, Ö; Çetiner, M; Gencer, ES; Günes, A; Krespi, Y; Yaka, E; Öcek, L; Tanriverdi, Z; Tekan, ÜY; Özkul, A; Özkan, E; Sirin, H; Güler, A; Kursun, O; Kunt, R; Cenikli, U; Acar, B; Kablan, Y; Yilmaz, A; Isikay, CT; Aslanbaba, E; Sorgun, M; Bektas, H; Çabalar, M; Yayla, V; Erdogan, HA; Gökçe, M; Bavli, S; Ongun, N; Keskin, AO; Akdogan, Ö; Emre, U; Yildiz, ÖK; Bolayir, A; Akpinar, ÇK; Karadeli, HH; Özel, T; Ünal, A; Dora, B; Arlier, Z; Eren, A; Milanoglu, A; Nazliel, B; Çaglayan, HB; Güven, B; Erdogan, M; Acar, ZÖ; Bakar, M; Giray, S; Senadim, S; Asil, T; Demir, T; Ünsal, YÖ; Eskut, N; Aslan, Y; Bas, DF; Sener, U; Degirmenci, B; Aluçlu, U; Bastan, B; Acar, Z; Niflioglu, B; Yazici, D; Aytaç, E; Ince, FB; Ay, H; Önder, H; Kozak, HH; Ilgezdi, I; Bilgiç, AB; Akyol, S; Güngör, IL; Atmaca, MM; Sen, M; Yevgi, R; Akkas, SY; Yoldas, T; Atasoy, HT; Çinar, BP; Yilmaz, A; Genç, H; Kisabay, A; Ilik, F; Demirbas, H; Midi, I; Sirinocak, PB; Duman, T; Demir, T; Can, U; Yürekli, VA; Bozdogan, Z; Alioglu, Z; Kaya, D; Afsar, N; Gürkas, E; Toplutas, E; Degirmenci, E; Büyükserbetçi, G; Aydin, I; Epçeliden, MT; Turgut, N; Kale, N; Çoban, E; Yesilot, N; Ekizoglu, E; Kizek, Ö; Bilgili, Ö; Baydemir, R; Akçakoyunlu, M; Yilmaz, Z; Öztürk, S
    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 Turkiye. Within the scope of NoroTek-Turkiye (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: NoroTekTR revealed the high but expected frequency of AF in acute stroke in Turkiye, 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 Turkiye. 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.
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    Acute Stroke Management in Türkiye: Intravenous Tissue Plasminogen Activator and Thrombectomy NöroTek: Türkiye Neurology Single Day Study
    Topçuoglu, MA; Özdemir, AÖ; Arsava, EM; Günes, A; Aykaç, Ö; Gencer, ES; Çabalar, M; Yayla, V; Erdogan, HA; Erdogan, M; Acar, ZÖ; Giray, S; Kablan, Y; Tanriverdi, Z; Tekan, ÜY; Asil, T; Akpinar, ÇK; Yürekli, VA; Acar, B; Sirin, H; Güler, A; Baydemir, R; Akçakoyunlu, M; Öcek, L; Çetiner, M; Nazliel, B; Çaglayan, HB; Ongun, N; Eren, A; Arlier, Z; Cenikli, U; Gökçe, M; Bavli, S; Yaka, E; Özkul, A; Degirmenci, B; Aluçlu, U; Isikay, CT; Aslanbaba, E; Sorgun, M; Aytaç, E; Ay, H; Kunt, R; Senadim, S; Ünsal, YÖ; Eskut, N; Alioglu, Z; Yilmaz, A; Genç, H; Yilmaz, A; Milanoglu, A; Gürkas, E; Degirmenci, E; Bektas, H; Ilgezdi, I; Bilgiç, AB; Akyol, S; Güngör, L; Kale, N; Çoban, E; Yesilot, N; Ekizoglu, E; Kizek, Ö; Kursun, O; Yildiz, ÖK; Bolayir, A; Kisabay, A; Bastan, B; Acar, Z; Niflioglu, B; Güven, B; Kaya, D; Afsar, N; Yazici, D; Toplutas, E; Özkan, E; Ilik, F; Ince, FB; Büyükserbetçi, G; Önder, H; Karadeli, HH; Kozak, HH; Demirbas, H; Midi, I; Aydin, I; Epçeliden, MT; Atmaca, MM; Bakar, M; Sen, M; Turgut, N; Keskin, O; Akdogan, Ö; Emre, U; Bilgili, Ö; Sirinocak, PB; Yevgi, R; Akkas, SY; Yoldas, T; Duman, T; Özel, T; Ünal, A; Dora, B; Atasoy, T; Çinar, BP; Demir, T; Demir, T; Can, U; Aslan, Y; Bas, DF; Sener, U; Yilmaz, Z; Bozdogan, Z; Özdemir, G; Krespi, Y; Öztürk, S
    Objective: To reveal the profile and practice in patients with acute stroke who received intravenous tissue plasminogen activator (IV tPA) and/or neurointerventional therapy in Turkiye. 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 Turkiye 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.