Browsing by Author "Yilmaz, AI"

Now showing 1 - 10 of 10
  • No Thumbnail Available
    Item
    Determination of mining-induced hearing loss with otoacoustic emission method at Tki-Eli lignite field
    Yilmaz, AI
    Noise at the working environment is highly affecting the human health, especially in mining. Continuity of this noise causes hearing loss of miners. In this study, hearing loss based on noise is researched by audiometry and otoacoustic emission on casual staff of TKA degrees-ELA degrees coal mines. The difference of this method is taking the otoacoustic emission measurements before audiometry measurements. In 2007, audiometry and otoacoustic emission measurements were made on 639 miners at Ege Lignite Enterprises. It is determined that conductive hearing loss had seen at 32 miners and sensorineural hearing loss had seen at 83 miners. It was decided to dispatch 9 miners to Occupational Diseases Hospital after making tests to these 83 miners at Soma State Hospital. It is revealed that these 9 miners shouldn't be allowed to work at loud environment according to the first report of Occupational Diseases Hospital. The detection of the possible and occupational disease group hearing loss has become very easy with this method.
  • No Thumbnail Available
    Item
    Comparison of refugee patients with cystic fibrosis and their counterpart children from Turkey during the war
    Yilmaz, AI; Pekcan, S; Eyüboglu, TS; Hangül, M; Arslan, H; Kilinç, AA; Çokugras, H; Arik, E; Keskin, Ö; Özdemir, A; Ersoy, M; Ersoy, A; Köse, M; Özsezen, B; Ünal, G; Ercan, Ö; Girit, S; Oksay, SC; Gökdemir, Y; Karadag, B; Sen, V; Çakir, E; Yüksel, H; Tekin, MN; Aslan, AT
    Since the outbreak of the Syrian civil war in 2011, the population of Arab refugees in Turkey has rapidly increased. While cystic fibrosis (CF) is believed to be rare among Arabs, recent studies suggest it is underdiagnosed. This study aims to present the demographic, clinical, and genetic characteristics of CF patients among Arab refugees in Turkey. Additionally, a comparison is made between the findings in the National CF Registry 2021 in Turkey (NCFRT) and the refugee CF patient group. The study included refugee patients between the ages of 0 and 18 years who were diagnosed with CF and received ongoing care at pediatric pulmonology centers from March 2011 to March 2021. The study examined demographic information, age at diagnosis, age of diagnosis of patients through CF newborn screening (NBS), presenting symptoms, CF transmembrane conductance regulator (CFTR) mutation test results, sputum culture results, weight, height, and body mass index (BMI) z score. Their results were compared with the NCFRT results. The study included 14 pediatric pulmonology centers and 87 patients, consisting of 46 (52.9%) boys and 41 (47.1%) girls. All of the patients were Arab refugees, with 80 (92%) being Syrian. All the patients were diagnosed in Turkey. The median age at diagnosis of patients was 22.33 (interquartile range, 1-258) months. The median age of diagnosis of patients through NBS was 4.2 (interquartile range, 1-12) months. The median age of older patients, who were unable to be included in the NBS program, was 32.3 (interquartile range, 3-258) months. Parental consanguinity was observed in 52 (59.7%) patients. The mutation that was most frequently found was F508del, which accounted for 22.2% of the cases. It was present in 20 patients, constituting 32 out of the total 144 alleles. There was a large number of genetic variations. CFTR genotyping could not be conducted for 12 patients. These patients had high sweat tests, and their genetic mutations could not be determined due to a lack of data. Compared to NCFRT, refugee patients were diagnosed later, and long-term follow-up of refugee CF patients had significantly worse nutritional status and pseudomonas colonization. Conclusion: Although refugee CF patients have equal access to NBS programs and CF medications as well as Turkish patients, the median age at diagnosis of patients, the median age of diagnosis of patients through NBS, their nutritional status, and Pseudomonas colonization were significantly worse than Turkish patients, which may be related to the difficulties of living in another country and poor living conditions. The high genetic heterogeneity and rare mutations detected in the refugee patient group compared to Turkish patients. Well-programmed NBS programs, thorough genetic studies, and the enhancement of living conditions for refugee patients in the countries they relocate to can have several advantages such as early detection and improved prognosis.What is Known:center dot Children who have chronic diseases are the group that is most affected by wars.center dot The outcome gets better with early diagnosis and treatment in patients with Cystic Fibrosis (CF).What is New:center dot Through the implementation of a newborn screening program, which has never been done in Syria previously, refugee patients, the majority of whom are Syrians were diagnosed with cystic fibrosis within a duration of 4 months. center dot Despite equal access to the newborn screening program and CF medications for both Turkish patients and refugee patients, the challenges of living in a foreign country have an impact on refugees.
  • No Thumbnail Available
    Item
    Patients with cystic fibrosis who could not receive the CFTR modulator treatment: What did they lose in 1 year?
    Uytun, S; Cinel, G; Polat, SE; Tabakçi, SO; Kiper, N; Yalçin, E; Tural, DA; Özsezen, B; Sen, V; Sen, HS; Altintas, DU; Çokugras, H; Kilinç, AA; Baskan, AK; Yazan, H; Çollak, A; Uzuner, S; Ünal, G; Yilmaz, AI; Çaglar, HT; Damadoglu, E; Irmak, I; Demir, E; Öztürk, GK; Bingöl, A; Basaran, E; Sapan, N; Canitez, Y; Aslan, AT; Asfuroglu, P; Harmanci, K; Köse, M; Hangül, M; Özdemir, A; Çobanoglu, N; Özcan, G; Keskin, Ö; Yüksel, H; Özdogan, S; Topal, E; Çaltepe, G; Can, D; Ekren, PK; Kiliç, M; Emiralioglu, N; Eyüboglu, TS; Pekcan, S; Çakir, E; Özçelik, U; Dogru, D
    BackgroundCystic fibrosis (CF) is an autosomal recessive disorder caused by CF transmembrane conductance regulator (CFTR) genetic variants. CFTR modulators improve pulmonary function and reduce respiratory infections in CF. This study investigated the clinical and laboratory follow-up parameters over 1 year in patients with CF who could not receive this treatment. MethodsThis retrospective cohort study included 2018 and 2019 CF patient data from the CF registry of Turkey. Demographic and clinical characteristics of 294 patients were assessed, who had modulator treatment indications in 2018 but could not reach the treatment. ResultsIn 2019, patients younger than 18 years had significantly lower BMI z-scores than in 2018. During the 1-year follow-up, forced expiratory volumes (FEV1) and FEV1 z-scores a trend toward a decrease. In 2019, chronic Staphylococcus aureus colonization, inhaled antipseudomonal antibiotic use for more than 3 months, oral nutritional supplement requirements, and oxygen support need increased. ConclusionsPatients who had indications for modulator treatments but were unable to obtain them worsened even after a year of follow-up. This study emphasized the importance of using modulator treatments for patients with CF in our country, as well as in many countries worldwide.
  • No Thumbnail Available
    Item
    Evaluation of respiratory function at 6 years of age in patients with cystic fibrosis with frequent pulmonary exacerbations in the first 2 years of life
    Tabakci, SO; Cinel, G; Uytun, S; Polat, SE; Yalçin, E; Kiper, N; Erdal, MA; Sen, V; Savas, S; Çelebi, Ö; Altintas, DU; Serbes, M; Kilinç, AA; Çokugras, H; Arslan, H; Yazan, H; Kafi, HM; Çollak, A; Ünal, G; Yilmaz, AI; Çaglar, HT; Irmak, I; Damadoglu, E; Öztürk, GK; Demir, E; Basaran, E; Bingöl, A; Canitez, Y; Çekiç, S; Asfuroglu, P; Aslan, AT; Harmanci, K; Kiliç, G; Köse, M; Ersoy, A; Hangül, M; Özdemir, A; Özcan, G; Çobanoglu, N; Aydin, ZGG; Keskin, Ö; Yüksel, H; Özdogan, S; Topal, E; Çaltepe, G; Can, D; Ekren, PK; Kiliç, M; Eyüboglu, TS; Pecan, S; Çakir, E; Emiralioglu, N; Özçelik, U; Ersöz, DD
  • No Thumbnail Available
    Item
    Clinical characteristics of patients requiring lung transplantation referral in national cystic fibrosis registry data
    Onay, ZR; Eyüboglu, TS; Aslan, AT; Gürsoy, TR; Yalçin, E; Kiper, N; Emiralioglu, N; Sen, HS; Sen, V; Ünal, G; Yilmaz, AI; Kilinç, AA; Çokugras, H; Baskan, AK; Yazan, H; Çollak, A; Uzuner, S; Sasihüseyinoglu, AS; Özcan, D; Altintas, DU; Öztürk, GK; Demir, E; Bingöl, A; Basaran, E; Çekiç, S; Sapan, N; Irmak, I; Damadoglu, E; Tugcu, GD; Polat, SE; Özdemir, A; Harmanci, K; Kiliç, G; Hangül, M; Köse, M; Tamay, Z; Yüksel, H; Özcan, G; Topal, E; Can, D; Korkmaz, P; Çaltepe, G; Kiliç, M; Özdogan, S; Çakir, E; Çobanoglu, N; Pekcan, S; Cinel, G; Özçelik, U; Dogru, D
    Background. We aimed to determine the number of cystic fibrosis (CF) patients recorded in the Cystic Fibrosis Registry of Turkiye (CFRT) who were in need of lung transplantation (LT) referral and examine clinical differences between patients who were LT candidates due to rapid forced expiratory volume in one second (FEV1) decline and LT candidates without rapid FEV1 decline in the last year to identify a preventable cause in patients with such rapid FEV1 decline. Methods. All CF patients recorded in the CFRT in 2018 were evaluated in terms of LT. Patients were divided into those with FEV1 below 50% and in need of LT due to a decrease of 20% or more in the previous year (Group 1) and those who did not have FEV1 decline of more than 20% in the previous year but had other indications for LT (Group 2). Demographic and clinical features were compared between the two groups. Results. Of 1488 patients registered in CFRT, 58 had a need for LT. Twenty patients were included in Group 1 and others in Group 2. Our findings did not reveal any significant variations in treatment, chronic infection status, or complications between the two groups. The average weight z-score was significantly higher in Group 1. Positive correlations were detected between weight z-score and FEV1 in 2017 in Group 1 and between FEV1 values in 2017 and 2018 in Group 2. Conclusions. There appears to be a relationship between the nutritional status and weight z-scores of CF patients and pulmonary function, which may indirectly affect the need for lung transplantation referral.
  • No Thumbnail Available
    Item
    Early Pseudomonas aeruginosa colonization in cystic fibrosis patients
    Ocak, E; Tugcu, GD; Polat, SE; Cinel, G; Emiralioglu, N; Yalçin, E; Kiper, N; Sen,; Altintas, DU; Çokugras, H; Kilinç, AA; Yazan, H; Ünal, G; Yilmaz, AI; Damadoglu, E; Irmak, I; Demir, E; Öztürk, G; Basaran, AE; Bingöl, A; Sapan, N; Aslan, AT; Asfuroglu, P; Harmanci, K; Köse, M; Hangül, M; Özdemir, A; Özcan, G; Aydin, ZGG; Keskin, AÖ; Yüksel, H; Özdogan, S; Topal, E; Çaltepe, G; Can, D; Ekren, PK; Kiliç, M; Eyüboglu, TS; Pekcan, S; Çobanoglu, N; Çakir, E; Özçelik, U; Ersöz, DD
  • No Thumbnail Available
    Item
    Factors associated with pulmonary function decline of patients in the cystic fibrosis registry of Turkey: A retrospective cohort study
    Emiralioglu, N; Çakir, B; Sertçelik, A; Yalçin, E; Kiper, N; Sen, V; Altintas, DU; Serbes, M; Çokugras, H; Kilinç, AA; Baskan, AK; Hepkaya, E; Yazan, H; Türel, O; Kafi, HM; Yilmaz, AI; Ünal, G; Çaglar, T; Damadoglu, E; Irmak, I; Demir, E; Öztürk, G; Bingöl, A; Basaran, E; Sapan, N; Aslan, AT; Asfuroglu, P; Harmanci, K; Köse, M; Hangül, M; Özdemir, A; Tugcu, G; Polat, SE; Özcan, G; Gayretli, ZG; Keskin, O; Bilgic, S; Yüksel, H; Özdogan, S; Topal, E; Caltepe, G; Can, D; Ekren, PK; Kiliç, M; Süleyman, A; Eyüboglu, TS; Cinel, G; Pekcan, S; Çobanoglu, N; Çakir, E; Özcelik, U; Dogru, D
    Background: The decline in pulmonary function is a predictor of disease progression in patients with cystic fibrosis (CF). This study aimed to determine the decline rate of percent predicted forced expiratory volume in 1 s (ppFEV1) based on the data of the CF Registry of Turkey. The secondary aim was to investigate the risk factors related to the decline in ppFEV1. Methods: A retrospective cohort study of CF patients over 6 years old, with pulmonary function data over at least 2 years of follow-up was extracted from the national CF registry for years 2017-2019. Patients were classified according to disease severity and age groups. Multivariate analysis was used to predict the decline in ppFEV1 and to investigate the associated risk factors. Results: A total of 1722 pulmonary function test results were available from 574 patients over the study period. Mean diagnostic age was older and weight for age, height for age, and body mass index z scores were significantly lower in the group of ppFEV1 < 40, while chronic Pseudomonas aeruginosa (p < .001) and mucoid P. aeruginosa colonization (p < .001) were significantly higher in this group (p < .001). Overall mean annual ppFEV1 decline was -0.97% (95% confidence interval [CI] = -0.02 to -1.92%). The mean change of ppFEV1 was significantly higher in the group with ppFEV1 >= 70 compared with the other (ppFEV1 < 40 and ppFEV1: 40-69) two groups (p = .004). Chronic P. aeruginosa colonization (odds ratio [OR] = 1.79 95% CI = 1.26-2.54; p = .01) and initial ppFEV1 >= 70 (OR = 2.98 95% CI = 1.06-8.36), p = .038) were associated with significant ppFEV1 decline in the whole cohort. Conclusions: This data analysis recommends close follow-up of patients with normal initial ppFEV1 levels at baseline; advocates for early interventions for P. aeruginosa; and underlines the importance of nutritional interventions to slow down lung disease progression.
  • No Thumbnail Available
    Item
    The success of the Cystic Fibrosis Registry of Turkey for improvement of patient care
    Asfuroglu, P; Eyuboglu, TS; Aslan, AT; Gursoy, TR; Emiralioglu, N; Yalcin, E; Kiper, N; Sen, V; Sen, HS; Altintas, DU; Ozcan, D; Kilinc, AA; Cokugras, H; Baskan, AK; Yazan, H; Erenberk, U; Dogan, G; Unal, G; Yilmaz, AI; Keskin, O; Arik, E; Kucukosmanoglu, E; Irmak, I; Damadoglu, E; Ozturk, GK; Gulen, F; Basaran, AE; Bingol, A; Cekic, S; Sapan, N; Kilic, G; Harmanci, K; Kose, M; Ozdemir, A; Tugcu, GD; Polat, SE; Hangul, M; Ozcan, G; Aydin, ZGG; Yuksel, H; Topal, E; Ozdogan, S; Caltepe, G; Suleyman, A; Can, D; Ekren, PK; Bal, CM; Kilic, M; Cinel, G; Cobanoglu, N; Pekcan, S; Cakir, E; Ozcelik, U; Dogru, D
    Background Cystic fibrosis (CF) registries play an essential role in improving disease outcomes of people with CF. This study aimed to evaluate the association of newly established CF registry system in Turkey on follow-up, clinical, growth, treatment, and complications of people with this disease. Methods Age at diagnosis, current age, sex, z-scores of weight, height and body mass index (BMI), neonatal screening results, pulmonary function tests, history of meconium ileus, medications, presence of microorganisms, and follow-up were evaluated and compared to data of people with CF represented in both 2017 and 2019 registry data. Results There were 1170 people with CF in 2017 and 1637 in 2019 CF registry. Eight hundred and fourteen people were registered in both 2017 and 2019 of whom z-scores of heights and BMI were significantly higher in 2019 (p = 0.002, p =0.039, respectively). Inhaled hypertonic saline, bronchodilator, and azithromycin usages were significantly higher in 2019 (p =0.001, p = 0.001, p = 0.003, respectively). The percent predicted of forced expiratory volume in 1 sec and forced vital capacity were similar in 2017 and 2019 (88% and 89.5%, p = 0.248 and 84.5% and 87%, p =0.332, respectively). Liver diseases and osteoporosis were significantly higher, and pseudo-Bartter syndrome (PBS) was significantly lower in 2019 (p = 0.011, p = 0.001, p = 0.001, respectively). Conclusions The z-scores of height and BMI were higher, the use of medications that protect and improve lung functions was higher and incidence of PBS was lower in 2019. It was predicted that registry system increased the care of people with CF regarding their follow-up. The widespread use of national CF registry system across the country may be beneficial for the follow-up of people with CF.
  • No Thumbnail Available
    Item
    Eligibility of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulator therapies: cohort of cystic fibrosis registry of Türkiye
    Erdal, MA; Büyüksahin, HN; Sen, V; Kilinç, AA; Çokugras, H; Dogan, G; Yilmaz, AI; Ünal, G; Serbes, M; Altintas, DU; Arik, E; Keskin,Ö; Özaslan, MM; Karcioglu, O; Köse, M; Basaran, AE; Çakir, EP; Canitez, Y; Özdemir, A; Harmanci, K; Uytun, S; Polat, SE; Hangül, M; Yüksel, H; Özcan, G; Korkmaz, P; Kiliç, M; Aydin, ZGG; Çaltepe, G; Can, D; Dogru, S; Öztürk, GK; Süleyman, A; Topal, E; Özsezen, B; Hizal, M; Demirdögen, E; Ogun, H; Börekçi, S; Yazan, H; Sen, HS; Demir, AD; Çakir, E; Eyüboglu, TS; Emiralioglu, N; Pekcan, S; Özçelik, U; Dogru, D
    Background. Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) variants are essential for determining eligibility for CFTR modulator drugs (CFTRms). In contrast to Europe and the USA, the treatment eligibility profile of cystic fibrosis (CF) patients in T & uuml;rkiye is not known. In this study we aimed to determine the eligibility of CF patients in T & uuml;rkiye for the CFTRms. Methods. The Cystic Fibrosis Registry of T & uuml;rkiye (CFrT) data was used to determine the age of patients in the year 2021 and the genetic variants they were carrying. Age- and CFTR-variant appropriate modulator therapies were determined using the Vertex (R) algorithm. Results. Among a total of 1930 registered patients, CTFR gene analysis was performed on a total of 1841 (95.4%) patients. Mutations were detected in one allele in 10.7% (198 patients), and in both alleles in 79% (1455 patients) of patients. A total of 855 patients (51.7% for whom at least 1 mutation was detected) were eligible for the drugs. The most appropriate drug among genotyped patients was found to be elexacaftor/tezacaftor/ivacaftor for 486 patients (26.4%), followed by ivacaftor for 327 patients (17.7%) and lumacaftor/ivacaftor for 42 patients (2%). Conclusions. Only half of patients registered in CFrT were eligible for CFTRms, which is a significant difference from the CFTR variant profile seen in USA and Europe. However, access to treatment is hampered for some patients whose genes are not analysed. Further studies in CF populations, where rare mutations are relatively more common, will contribute to the field of CFTR modulator treatments for such rare mutations.
  • No Thumbnail Available
    Item
    Comparison of clinical features of cystic fibrosis patients eligible but not on CFTR modulators to ineligible for CFTR modulators
    Büyüksahin, HN; Emiralioglu, N; Yalçin, E; Sen, V; Sen, HS; Arslan, H; Baskan, AK; Çakir, FB; Koray, CF; Yilmaz, AI; Ercan, F; Altintas, DU; Serbes, M; Keskin, Ö; Arik, E; Gülen, F; Barlik, M; Karcioglu, O; Damadoglu, E; Köse, M; Ersoy, A; Bingöl, A; Basaran, E; Çakir, EP; Aslan, AT; Canitez, Y; Korkmaz, M; Özdemir, A; Harmanci, K; Soydas, SS; Hangül, M; Yüksel, H; Özcan, G; Korkmaz, P; Kiliç, M; Aydin, ZGG; Çaltepe, G; Can, D; Dogru, S; Öztürk, GK; Süleyman, A; Topal, E; Özsezen, B; Hizal, M; Demirdögen, E; Ogun, H; Börekçi, S; Yazan, H; Çakir, E; Eyüboglu, TS; Çobanoglu, N; Cinel, G; Pekcan, S; Özçelik, U; Dogru, D
    Introduction: Cystic fibrosis transmembrane conductance regulator (CFTR) modulator drugs target the underlying defect and improve CFTR function. They are a part of standard care in many countries, but not all patients are eligible for these drugs due to age and genotype. Here, we aimed to determine the characteristics of non-eligible patients for CFTR modulators in the CF registry of Turkey (CFRT) to highlight their clinical needs. Methods: This retrospective cohort study included CF patient data from the CFRT in 2021. The decision of eligibility for the CFTR modulator was determined according to the 'Vertex treatment-Finder' on the Vertex (R) website. Demographic and clinical characteristics of patients were compared between eligible (group 1) and ineligible (group 2) groups for CFTR modulators. Results: Among the study population (N = 1527), 873 (57.2%) were in group 1 and 654 (42.8%) were in group 2. There was no statistical difference between groups regarding sex, meconium ileus history, diagnoses via newborn screening, FEV1 z-score, CF-associated complications, organ transplant history, and death. Patients in group 2 had a higher incidence of pancreatic insufficiency (87.7% vs. 83.2%, p = .010), lower median height z-scores (-0.87 vs. -0.55, p < .001), lower median body mass index z-scores (-0.65 vs. -0.50, p < .001), longer days receiving antibiotics due to pulmonary exacerbation (0 [interquartile range, IQR: 0-2] vs. 0 [IQR: 0-7], p = 0.001), and more non-invasive ventilation support (2.6% vs. 0.9%, p = 0.008) than patients in group 1. Conclusion: The ineligible group had worse clinical outcomes than the eligible group. This highlights their need for life-changing drugs to improve clinical outcomes.