Browsing by Author "Yorulmaz, I"

Now showing 1 - 10 of 10
  • No Thumbnail Available
    Item
    Masses of the tongue and floor of the mouth: findings on magnetic resonance imaging
    Ozturk, M; Yorulmaz, I; Guney, E; Ozcan, N
    The purpose of this study was to determine the value of MR imaging for the demonstration of masses in the tongue and floor of the mouth. Nine patients were prospectively examined with MR imaging after physical examination. Imaging protocol included T2 and contrast-enhanced and non-contrast-enhanced T1-weighted turbo spin-echo sequences, and the findings were compared with surgical and histopathological results. Histopathological examination revealed four squamous cell carcinomas, one adenoid cystic carcinoma, two tongue abscesses, and one chronic inflammatory change. The other case was diagnosed as hemangioma depending on clinical and imaging findings alone. In cases with squamous cell carcinoma, staging was done on the basis of MR imaging findings, and was found to be T4 in two cases, T3 in one case, and T2 in another. The primary role of MR imaging of the tongue and oropharynx is not to make a tissue diagnosis. Multiple deep biopsies are mandatory for the differentiation of other inflammatory and neoplastic lesions. Magnetic resonance imaging produces coronal and sagittal image planes to assess the volume and spread of the lesion and helps the surgeon determine the direction in which the biopsy should be performed.
  • No Thumbnail Available
    Item
    Comparison of brain perfusion SPECT and MRI findings in children with neuronal ceroid-lipofuscinosis and in their families
    Sayit, E; Yorulmaz, I; Bekis, R; Kaya, G; Gumuser, FG; Dirik, E; Durak, H
    Neuronal ceroid-lipofuscinoses (NCL) are among the progressive encephalopathies of childhood that are inherited in an autosomal recessive manner. In this study we specifically aimed to investigate any white-matter changes in the carriers (parents) and the healthy siblings of individuals with neuronal ceroid lipofuscinosis disease and whether we may be able to predict the occurrence of any neurological symptoms in healthy children in the future thus enabling early management. Materials and Methods: Since the NCLs are genetically determined diseases, we investigated fifteen individuals in three families that had diseased children of the juvenile type, with brain perfusion SPECT and MRI. Brain per-fusion SPECT was performed after administering 222555 MBq (6-15 mCi) Tc-99m HMPAO intravenously in a dimmed and quiet room. Imaging was performed at least one hour after injection, with a three headed gamma camera equipped with high resolution collimators. A Metz filter (FWHM: 11 mm) was used for processing. Cranial MRI was performed with an imager operating at 1.5 Tesla. Spin-echo T1- and T2-weighted and FLAIR slices were obtained for each individual. Results: In all of the five diseased children we observed pathologic findings both on MRI and Tc-99m HMPAO SPECT. The findings on MRI were mainly features of cerebral and cerebellar atrophy and the observations on Tc-99m HMPAO SPECT were regional perfusion abnormalities. We observed some structural abnormalities on MRI in four of the parents and two of the four healthy siblings. We also noted perfusion abnormalities on Tc-99m HMPAO SPECT in two of the parents and two of the healthy siblings. Conclusion: Because the disease is inherited in an autosomal recessive manner, the parents and the healthy siblings were not supposed to exhibit any demonstrable brain lesions, but the brain perfusion SPECT and MRI examinations clearly revealed multiple lesions in some of the parents and healthy siblings. Detailed neurological examinations of these individuals were normal except for one apparently healthy sibling (EY). Follow-up imaging of these families is being undertaken and further studies are essential in understanding the pathogenesis and genetics of neuronal ceroid-lipofuscinoses.
  • No Thumbnail Available
    Item
    Low back pain and posture
    Tüzün, C; Yorulmaz, I; Cindas, A; Vatan, S
    This study was designed to analyse postural aberrations of the back and lower back region in patients with acute and chronic low back pain and to investigate the accordance of clinical and radiological assessments. Fifty patients with acute and 50 with chronic low back pain and 50 controls were studied and a detailed spinal physical examination was performed. In addition, the angles of thoracic kyphosis, lumbar lordosis and sacral inclination were assessed radiologically. Differences among the three groups, correlations of radiological parameters with each other and with clinical parameters such as age, gender and body mass index, and the accordance of clinical and radiological postural assessments were investigated. It was concluded that there were no statistically significant differences among the groups for angles of thoracic kyphosis, lumbar lordosis and sacral inclination; however, we found significant correlations among all radiological parameters, especially between lumbar lordosis and sacral inclination. Both lumbar lordosis and sacral inclination were increased with body mass index, and lumbar lordosis and thoracic kyphosis were increased with age. Clinical assessments of thoracic kyphosis and lumbar lordosis were not in accordance with radiological assessments.
  • No Thumbnail Available
    Item
    Preoperative ultrasound to predict technical difficulties of conventional cholecystectomy
    Uncu, H; Yorulmaz, I; Aker, Y; Kaya, Y; Sakarya, A; Çiftdogan, C
  • No Thumbnail Available
    Item
    A multicentre study of abdominal aorta diameters in a Turkish population
    Sariosmanoglu, N; Ugurlu, B; Karacelik, M; Tuzun, E; Yorulmaz, I; Manisali, M; Oto, A; Besim, A; Oto, O
    The aim of this study was to determine the normal values for aortic diameters and the prevalence of aortic dilatation in a mixed Turkish population. Between March 1998 and May 2000, patients who were undergoing abdominal ultrasonography examination for pathologies not involving the aorta, in three different cities, were enrolled into the study prospectively. The anterior posterior aortic diameters were measured at the subdiaphrogmatic and aortic bifurcation levels using ultrasonography. A total of 596 patients were included (302 females, 294 males). The mean age was 48 +/- 16 years (range, 6 - 88 years). The mean aortic diameter in the whole group was 19.0 +/- 3.9 mm (10 - 45 mm) at the subdiaphragmatic level and 15.7 +/- 3.6 mm (9 +/- 65 mm) at the aortic bifurcation level. The mean subdiaphragmatic aortic diameter was 18 +/- 3 mm in females and 19 +/- 4 mm in males. The mean aortic diameters at the bifurcation level was 15 +/- 3 mm in females and 16 +/- 4 mm in males. An aortic bifurcation diameter > 30 mm was encountered in 0.67% of the population. This ratio increased to 1.8% in patients over 55 years of age, regardless of sex. A subdiaphragmatic aorta diameter above 30 mm was observed in 1.2% of the population. In patients over the age of 55 years, this ratio increased to 2.7% (3.6% in males and 1.9% in females). In this national study, the subdiaphragmatic aortic diameters were similar to mean values reported in the world literature. The mean aortic bifurcation diameters were generally lower when compared with the literature, which may be due to difficulties in standardization of the measurements. Aneurysmal dilatation rates in this study also conform to those reported in studies conducted in other countries. Considering the significant number of patients with aneurysmal dilatation of the aorta in the elderly population, we believe it would be prudent to evaluate the aorta in all patients undergoing abdominal ultrasonographic examination.
  • No Thumbnail Available
    Item
    Socioeconomic status has direct impact on asthma control: Turkish adult asthma registry
    Arslan, B; Türk, M; Hayme, S; Aydin,Ö; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Celik, GE; Uysal, MA
    BackgroundAsthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma-related death.ObjectiveIn this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region.MethodsThis is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e-mail. Parameters related to social status and poor disease control were analyzed.ResultsIlliteracy (OR:2.687 [95% CI: 1.235-5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002-3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074-1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262-3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085-1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year.ConclusionAs a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.
  • No Thumbnail Available
    Item
    Picturing asthma in Turkey: results from the Turkish adult asthma registry
    Celik, GE; Aydin, O; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EY; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Arslan, B; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A
    IntroductionNational data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention.MethodsCase entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes.ResultsThe registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3-5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions.ConclusionThe picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery.
  • No Thumbnail Available
    Item
    Trends in prescribing montelukast in patients with asthma in real-life: Results from the Turkish adult asthma registry
    Beyaz, S; Erdinç, M; Hayme, S; Aslan, AF; Aydin,Ö; Gökmen, D; Buhari, GK; Sözener, ZC; Gemicioglu, B; Bulut, I; Örçen, C; Özdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EYÖ; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Göksel,Ö; Karaoglanoglu, S; Erkekol, FÖ; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker,Ü; Oguzülgen, IK; Basyigit, I; Baris, SA; Uçar, EY; Erdogan, T; Polatli, M; Ediger, D; Günaydin, FE; Türk, M; Pür, L; Katran, ZY; Sekibag, Y; Aykaç, EF; Mungan, D; Gül,Ö; Cengiz, A; Akkurt, B; Özden, S; Demir, S; Ünal, D; Can, A; Guemuesburun, R; Bogatekin, G; Akten, HS; Inan, S; Ögüs, AC; Kavas, M; Yulug, DP; Çakmak, ME; Kaya, SB; Alpagat, G; Özgür, ES; Uzun, O; Gülen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Doenmez, H; Arslan, B; Çetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Öztürk, AB; Sevinç, C; Simsek, GÖ; Abadoglu,Ö; Çerçi, P; Yücel, T; Yorulmaz, I; Tezcaner, ZÇ; Tatar, EÇ; Süslü, AE; Özer, S; Dursun, E; Yorgancioglu, A; Çelik, GE
    Montelukast, a leukotriene receptor antagonist (LTRA) approved for the treatment of asthma and allergic rhinitis, is widely used, though real-world data on its application in asthma management remain limited. This registry-based study evaluated the use of montelukast in adult asthma patients, examining demographic and disease characteristics, asthma control status, asthma phenotypes, presence of atopy, and treatment regimens. Among 2053 patients analyzed, 61.76% (n = 1268; mean age: 46.2 +/- 14.3 years), predominantly females (similar to 76%), received montelukast. Montelukast users showed higher rates of allergic rhinitis (P < 0.001), hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (P = 0.008), and chronic rhinosinusitis (P = 0.008). Montelukast group also had higher atopy and total IgE levels and tended to be more eosinophilic. Montelukast was commonly preferred in allergic, eosinophilic, NSAID-exacerbated respiratory disease, and severe asthma phenotypes (P < 0.001). Patients receiving Steps 4 and 5 treatments are more likely to be prescribed montelukast (P < 0.001). Montelukast usage was higher among patients with uncontrolled asthma [ACT< 20 (OR:1.29, 95%CI:1.052-1.582, P = 0.014)]. In addition, logistic regression analyses identified the main factors associated with increased montelukast use as; female gender (OR:1.33, 95%CI:1.041-1.713, P = 0.02), presence of atopy (OR:1.46, 95%CI:1.157-1.864, P = 0.002), comorbid allergic rhinitis (OR:2.12, 95%CI:1.679-2.293, P < 0.001), and severe asthma (OR:2.18, 95%CI:1.712-2.784, P < 0.001). These findings reveal that montelukast use is prevalent among asthma patients, particularly in females, middle-aged adults, and those with comorbid allergic rhinitis, uncontrolled asthma, or specific asthma phenotypes, underscoring the factors that influence its prescription in asthma management. (c) 2025 Codon Publications. Published by Codon Publications.
  • No Thumbnail Available
    Item
    Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registry
    Gemicioglu, B; Gokmen, D; Can, A; Sevinc, C; Oguzulgen, IK; Soyyigit, S; Yakut, T; Havlucu, Y; Aydin, O; Buhari, GK; Sozener, ZC; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, A; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Donmez, H; Arslan, B; Cetin, GP; Kara, BY; Dursun, AB; Karakis, GP; Kendirlinan, R; Ozturk, AB; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Çelik, GE
    Current guidelines recommend adding long-acting muscarinic antagonists (LAMAs) in patients with uncontrolled asthma, despite the use of moderate to high doses of inhaled steroid-long-acting beta agonists (ICS/LABA). This study aims to analyze the factors related to the prescription of add-on LAMA in clinical practice for asthma patients, shedding light on physicians' preferences. This study included adult asthma patients on add-on LAMA and ICS/LABA monitored for at least one year in a national registry comprising 2053 asthmatics. Patients' characteristics and disease profiles were analyzed to identify factors associated with the prescription of add-on LAMA across the entire cohort. A comparative analysis was performed among three groups: MART (ICS/formoterol as a maintenance and reliever therapy) plus LAMA, Conventional (ICS/LABA as a maintenance and short-acting beta agonist as reliever) plus LAMA and Triple (ICS/ LABA/LAMA single inhaler). LAMAs were added to ICS/LABA in 11.7 % of patients in the national registry. Logistic regression analysis revealed that older age, low FEV1 (%), Asthma Control Test (ACT) scores less than 20, and severe exacerbation were the main factors influencing the initiation of LAMA in our registry. However, demographic characteristics of asthma, control status, pulmonary function test results were similar among the three groups of LAMA users (p > 0.05). Physicians used LAMAs without phenotyping based on allergic status or eosinophil levels (p > 0.05). Mepolizumab was added after LAMA in all patients, while omalizumab was initiated before LAMA in 16.9 % of the patients receiving LAMA along with biologics. Add-on LAMAs were predominantly prescribed for older, uncontrolled, and exacerbated asthma patients with low FEV1.
  • No Thumbnail Available
    Item
    Asthma patients with obesity have a unique phenotype: a subanalysis of the Turkish adult asthma registry
    Celebi Sozener, Z; Oguzulgen, IK; Ozalp Ates, FS; Baccioglu, A; Argun Baris, S; Ediger, D; Gunaydin, FE; Sevinc, C; Seker, U; Yilmaz Kara, B; Beyaz, S; Mungan, D; Aydin, O; Gokmen, D; Buhari, GK; Gemicioglu, B; Bulut, I; Orcen, C; Kepil Ozdemir, S; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Alan Yalim, S; Yilmaz, I; Koca Kalkan, I; Uysal, MA; Ozgun Niksarlioglu, EY; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Akkor Gelincik, A; Dirol, H; Goksel, O; Karaoglanoglu, S; Oner Erkekol, F; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Basyigit, I; Yilmazel Ucar, E; Erdogan, T; Polatli, M; Turk, M; Pur, L; Yegin Katran, Z; Sekibag, Y; Aykac, EF; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Polat Yulug, D; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Arslan, B; Cetin, GP; Soyyigit, S; Pasaoglu Karakis, G; Dursun, AB; Kendirlinan, R; Ozturk, AB; Omeroglu Simsek, G; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Cadalli Tatar, E; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Celik, GE
    Objective: The obese-asthma phenotype has gradually increased in the last few years. We aimed to assess the differences between obese and non-obese patients with asthma. Methods: This research is a subanalysis of the Turkish Adult Asthma Registry (TAAR). Clinical presentation, disease control, severity, and demographics of obese and non-obese (normal-weight, overweight) patients were compared. Results: The obesity rate in TAAR was 32.2% (n=619/1919; 18-83years; 527F/92 M). Patients with asthma and obesity had higher rates of childhood obesity, longer symptom duration, later onset of asthma, and more severe asthma. These patients were more likely to be female, older, less educated, and live in rural areas. Patients with obesity had more scheduled visits and emergency visits compared with non-obese patients, but similar asthma control, oral corticosteroid use, hospitalizations, intensive care unit admissions, and unscheduled visits. They also had a higher frequency of T2-high but lower frequency of possible T2-low phenotypes compared with normal-weight asthmatics. The risk of severe asthma in patients with obesity was 6.04 times higher for allergic than non-allergic patients and 3.58 times higher for the T2-high phenotype than for possible T2-low phenotypes. A one-unit increase in the asthma control test reduced the risk of severe asthma by 22%. Conclusions: A good definition of this phenotype is important to ensure that appropriate treatment strategies are implemented to achieve the control goal. We also believe that prevention of childhood obesity is an effective and pivotal strategy to achieve the goal of asthma control.