Browsing by Subject "disease burden"
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Item Asthma in the context of global alliance against respiratory diseases (GARD) in Turkey(AME Publishing Company, 2018) Yorgancioğlu A.; Gemicioglu B.; Ekinci B.; özkan Z.; Bayram H.; Ergan B.; Ersu R.; Kocabaş A.; Köktürk N.[No abstract available]Item Daily allergic multimorbidity in rhinitis using mobile technology: A novel concept of the MASK study(Blackwell Publishing Ltd, 2018) Bousquet J.; Devillier P.; Anto J.M.; Bewick M.; Haahtela T.; Arnavielhe S.; Bedbrook A.; Murray R.; van Eerd M.; Fonseca J.A.; Morais Almeida M.; Todo Bom A.; Menditto E.; Passalacqua G.; Stellato C.; Triggiani M.; Ventura M.T.; Vezzani G.; Annesi-Maesano I.; Bourret R.; Bosse I.; Caimmi D.; Cartier C.; Demoly P.; Just J.; Portejoie F.; Siroux V.; Viart F.; Bergmann K.C.; Keil T.; Klimek L.; Mösges R.; Pfaar O.; Shamai S.; Zuberbier T.; Mullol J.; Valero A.; Spranger O.; Tomazic P.V.; Kowalski M.L.; Kuna P.; Kupczyk M.; Raciborski F.; Samolinski B.; Toppila-Salmi S.K.; Valovirta E.; Cruz A.A.; Sarquis-Serpa F.; da Silva J.; Stelmach R.; Larenas-Linnemann D.; Rodriguez Gonzalez M.; Burguete Cabañas M.T.; Kvedariene V.; Valiulis A.; Chavannes N.H.; Fokkens W.J.; Ryan D.; Sheikh A.; Bachert C.; Hellings P.W.; VandenPlas O.; Ballardini N.; Kull I.; Melén E.; Westman M.; Wickman M.; Bindslev-Jensen C.; Eller E.; Bosnic-Anticevich S.; O'Hehir R.E.; Agache I.; Bieber T.; Casale T.; Gemicioğlu B.; Ivancevich J.C.; De Vries G.; Sorensen M.; Yorgancioglu A.; Laune D.Background: Multimorbidity in allergic airway diseases is well known, but no data exist about the daily dynamics of symptoms and their impact on work. To better understand this, we aimed to assess the presence and control of daily allergic multimorbidity (asthma, conjunctivitis, rhinitis) and its impact on work productivity using a mobile technology, the Allergy Diary. Methods: We undertook a 1-year prospective observational study in which 4 210 users and 32 585 days were monitored in 19 countries. Five visual analogue scales (VAS) assessed the daily burden of the disease (i.e., global evaluation, nose, eyes, asthma and work). Visual analogue scale levels <20/100 were categorized as “Low” burden and VAS levels ≥50/100 as “High” burden. Results: Visual analogue scales global measured levels assessing the global control of the allergic disease were significantly associated with allergic multimorbidity. Eight hypothesis-driven patterns were defined based on “Low” and “High” VAS levels. There were <0.2% days of Rhinitis Low and Asthma High or Conjunctivitis High patterns. There were 5.9% days with a Rhinitis High—Asthma Low pattern. There were 1.7% days with a Rhinitis High—Asthma High—Conjunctivitis Low pattern. A novel Rhinitis High—Asthma High—Conjunctivitis High pattern was identified in 2.9% days and had the greatest impact on uncontrolled VAS global measured and impaired work productivity. Work productivity was significantly correlated with VAS global measured levels. Conclusions: In a novel approach examining daily symptoms with mobile technology, we found considerable intra-individual variability of allergic multimorbidity including a previously unrecognized extreme pattern of uncontrolled multimorbidity. © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.Item Quality of Life and Associated Risk Factors in Caregivers of Patients with Obsessive Compulsive Disorder(Taylor and Francis Ltd., 2019) Sücüllüoğlu Dikici D.; Eser E.; Çökmüş F.P.; Demet M.M.INTRODUCTION: Obsessive compulsive disorder (OCD) is a chronic disease that affects social relationships, and occupational and academic performance of patients and their relatives due to cognitive, emotional, and behavioural aspects of the disease. Quality of life (QoL) in relatives of patients with OCD has previously been reported and compared with caregivers of patients with other psychiatric conditions. However, there are few studies available in the literature regarding the causality of QoL in caregivers of patients with OCD. OBJECTIVE: The aim of this study was to evaluate QoL of caregivers of patients with OCD and predictors of QoL of the family caregivers. METHODS: The study population comprised of 68 patients with OCD and their caregivers. The dependent variable of this study is “QoL of caregivers” as assessed by the short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF-TR). The Structured Clinical Interview for DSM-IV/Clinical Version (SCID-I/CV), Yale-Brown obsessive-compulsive scale (Y-BOCS), Y-BOCS symptom checklist, Hamilton Depression Rating Scale (HAM-D), and WHOQOL-BREF-TR were completed by the patients, whereas the SCID-I/CV, WHOQOL-BREF-TR, and Burden Assessment Scale (BAS) were completed by the caregivers. Student’s t-test, MWU, ANOVA, Kruskal–Wallis ANOVA, and Spearman’s correlations were used in univariate analyses, and multiple linear regression tests were run in multivariate analyses. Critical VIF values were taken as 5.0 for detecting collinearity among independent variables in the regression analyses. Type 1 error was taken as 0.05 in the analyses. RESULTS: Linear regression analysis showed that caregivers’ sex, education level, occupational status, disease burden, and patients’ sex, physical QoL, and disease severity were predictors of caregivers’ QoL. Moreover, disease burden was the only common predictor that affected all four dimensions (physical, psychological, social relations, environmental) of the caregiver’s QoL, and as the perceived disease burden increased, the caregiver’s QoL deteriorated. © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Item Brief report: International perspectives on the pediatric COVID-19 experience(John Wiley and Sons Inc., 2020) Yilmaz O.; Gochicoa-Rangel L.; Blau H.; Epaud R.; Lands L.C.; Lombardi E.; Moore P.E.; Stein R.T.; Wong G.W.K.; Zar H.J.The 2019 novel coronavirus (SARS-CoV-2) is endangering human health worldwide; scarcity of published pediatric cases and current literature and the absence of evidence-based guidelines necessitate international sharing of experience and personal communication. On 31 March 2020 the International Committee of the American Thoracic Society Pediatrics Assembly recorded an online podcast, during which pediatric pulmonologists worldwide shared their experience on the novel coronavirus disease (COVID-19) in children. The aim was to share personal experience in organizing pediatric care in different health care settings globally, protecting health care workers, and isolation practices. This manuscript summarizes the common themes of the podcast which centered around three main topics: more benign clinical disease and progression in pediatric cases compared to adults, a strong need for strategies to protect health care workers, and social or economic disparities as a barrier to successful pandemic control. © 2020 Wiley Periodicals, Inc.Item Disease burden and associated factors in caregivers of patients with obsessive-compulsive disorder(Kare Publishing, 2020) Suculluoglu-Dikici D.; Cokmus F.P.; Akin F.; Eser E.; Demet M.M.Objective: Obsessive-compulsive disorder (OCD) is one of the leading causes of disability and poor quality of life, with impairment in many areas. It can also adversely affect family members and friends that the person lives with, and this results in a burden. We aimed to evaluate the disease burden in caregivers of patients with OCD and the factors that negatively affect caregiver burden. Method: The study population consisted of 94 patients with OCD and their caregivers. The Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Hamilton Depression Rating Scale, and the World Health Organization Quality of Life Questionnaire Brief Form were filled out by the patients, and the Burden Assessment Scale (BAS) by the caregivers. Results: Longer duration of treatment, higher YBOCS obsession and compulsion scores of the patients, and lower environmental quality of life dimension scores of the patients were found to increase the BAS scores of the caregivers. Additionally, these variables were found to be significant predictors for disease burden (BAS score) (p<0.05). Conclusion: Our study revealed that many variables affect burden, even in caregivers who have no extra burden (who has no disease to cause a burden). Caregivers of patients with OCD should be included in the behavioral and pharmacologic treatment process for the benefit of both the OCD treatment management and the protection of family health. © 2020 Yerkure Tanitim ve Yayincilik Hizmetleri A.S.. All rights reserved.Item Are hormonal agents better than chemo in metastatic castration-resistant prostate cancer?(Istanbul Tip Fakultesi, 2021) Yildirim S.; Erdoğan A.P.OBJECTIVE In this study, we aim to determine which treatment is more appropriate in castration-resistant chemo-therapy-naive patients. Therefore, docetaxel and agents active in the androgen pathway (abiraterone and enzalutamide) were compared retrospectively in patients progressing on androgen deprivation therapy. METHODS The study was designed as a retrospective and multicenter study. Patients from five centers in Turkey were included in the study. The primary endpoint of the study was overall survival (OS) and the second-ary endpoint was progression-free survival. RESULTS Median OS of the docetaxel group was 18.66 months, it was 16.26 months in the hormonal treatment group. There was no statistically significant difference between the groups (p=0.311). Median progression-free survival of the chemotherapy group was 5.6 months, while it was 9 months in the hormonal therapy group. There was statistically significant difference between the groups (p=0.024). CONCLUSION There was statistical difference in progression-free survival in favor of hormonal therapies in our study. The difference did not reflect on OS and there was no difference between hormonal therapies and docetaxel. Heterogeneity in the selection of patients is considered to lead to this result; however, larger randomized controlled studies are needed to determine the most appropriate treatment in these patients. © 2021, Turkish Society for Radiation Oncology.Item Economic burden of severe asthma in turkey: A cost of illness study from payer perspective(EDRA S.p.A, 2021) Bavbek S.; Malhan S.; Mungan D.; Misirligil Z.; Erdinc M.; Gemicioglu B.; Kivilcim Oguzulgen I.; Oksuz E.; Yildiz F.; Yorgancioglu A.Objective. To estimate economic burden of severe asthma in Turkey from payer perspective based on expert panel opinion on practice patterns in clinical practice. Methods. This cost of illness study was based on identification of per patient annual direct medical costs for the management of severe asthma in Turkey from payer perspective. Average per patient direct medical cost was calculated based on cost items related to outpatient visits, laboratory and radiological tests, hospitalizations and interventions, drug treatment and equipment, and co-morbidities/complications. Results. Based on total annual per patient costs calculated for outpatient admission ($ 177.91), laboratory and radiological tests ($ 82.32), hospitalizations/interventions ($ 1,154.55), drug treatment/equipment ($ 2,289.63) and co-morbidities ($ 665.39) cost items, total per patient annual direct medical cost related to management of severe asthma was calculated to be $ 4,369.76 from payer perspective. Drug treatment/equipment (52.4%) was the main cost driver in the management of severe asthma in Turkey, as followed by hospitalizations/interventions (26.4%) and co-morbidities (15.2%). Conclusions. In conclusion, our findings indicate that managing patients with severe asthma pose a considerable burden to health economics in Turkey, with medications as the main cost driver. © 2021 Associazione Allergologi Immunologi Italiani Territoriali e Ospedalieri-AAIITO. Published by EDRA SpA. All rights reserved.Item Improving access to affordable quality-assured inhaled medicines in low- and middle-income countries(International Union Against Tuberculosis and Lung Disease, 2022) Stolbrink M.; Chinouya M.J.; Jayasooriya S.; Nightingale R.; Evans-Hill L.; Allan K.; Allen H.; Balen J.; Beacon T.; Bissell K.; Chakaya J.; Chiang C-Y.; Cohen M.; Devereux G.; El Sony A.; Halpin D.M.G.; Hurst J.R.; Kiprop C.; Lawson A.; Macé C.; Makhanu A.; Makokha P.; Masekela R.; Meme H.; Khoo E.M.; Nantanda R.; Pasternak S.; Perrin C.; Reddel H.; Rylance S.; Schweikert P.; Were C.; Williams S.; Winders T.; Yorgancioglu A.; Marks G.B.; Mortimer K.BACKGROUND: Access to affordable inhaled medicines for chronic respiratory diseases (CRDs) is severely limited in low- and middle-income countries (LMICs), causing avoidable morbidity and mortality. The International Union Against Tuberculosis and Lung Disease convened a stakeholder meeting on this topic in February 2022. METHODS : Focused group discussions were informed by literature and presentations summarising experiences of obtaining inhaled medicines in LMICs. The virtual meeting was moderated using a topic guide around barriers and solutions to improve access. The thematic framework approach was used for analysis. RESULT S : A total of 58 key stakeholders, including patients, healthcare practitioners, members of national and international organisations, industry and WHO representatives attended the meeting. There were 20 pre-meeting material submissions. The main barriers identified were 1) low awareness of CRDs; 2) limited data on CRD burden and treatments in LMICs; 3) ineffective procurement and distribution networks; and 4) poor communication of the needs of people with CRDs. Solutions discussed were 1) generation of data to inform policy and practice; 2) capacity building; 3) improved procurement mechanisms; 4) strengthened advocacy practices; and 5) a World Health Assembly Resolution. CONC L U S ION: There are opportunities to achieve improved access to affordable, quality-assured inhaled medicines in LMICs through coordinated, multi-stakeholder, collaborative efforts. © 2022 International Union against Tubercul. and Lung Dis.. All rights reserved.Item Body mass index does not affect response of rituximab in patients with rheumatoid arthritis: results from the TURKBİO registry(Turkiye Klinikleri, 2023) Karataş A.; Pişkin Sağir R.; Koca S.S.; Dalkiliç E.; Can G.; Pehlivan Y.; Yazici A.; İnanç N.; Cefle A.; Ertürk Z.; Akar S.; Şenel S.; Birlik M.; Akkoç N.; Önen F.Background/aim: Adipose tissue produces several inflammatory mediators. Thus, obesity affects the disease course and the responses to the antirheumatic agents in inflammatory diseases. The aim of the study was to determine whether the body mass index (BMI) is involved in the response to rituximab in rheumatoid arthritis (RA). Materials and methods: This multicenter retrospective study included 206 RA patients who received rituximab from the Turkish Biologic (TURKBIO) registry between 2011 and the end of May 2017. Demographic and clinical data including age, sex, disease type, disease duration, and previous or current treatment with disease-modifying antirheumatic drugs (DMARDs) and biological drug durations are stored in the database. Patients with a BMI ≥30 kg/m2 were classified as obese, and patients with a BMI <30 kg/m2 were classified as nonobese. Kaplan-Meier survival analysis was performed to estimate the drug survival. The subgroups were compared using the log-rank test. Results: The mean BMI of 206 patients included in the study was 27.05 (17.2–43.4) kg/m2. There were 59 (28.6%) patients in the obese group and 147 (71.4%) patients in the nonobese group. The mean age, female percentage, and baseline disease activity score 28 (DAS28) were higher in the obese group than in the nonobese group. However, the ΔDAS28 at both 6 and 12 months were not significantly different between the groups (p = 0.785 and p = 0.512, respectively). Patient pain Visual Analogue Scale (VAS), patient fatigue VAS, and patient global VAS scores were also significantly higher at baseline in the obese group (p = 0.003, p = 0.006, and p = 0.006, respectively). However, no significant difference was found in terms of changes in patient pain VAS, patient fatigue VAS, patient global VAS and physician global VAS scores at 6 and 12 months compared to those at baseline. Rituximab treatment was ongoing for 71.2% of the obese and 63.3% of the nonobese patients (p = 0.279). The median drug survival duration was 77 months in the obese group and 62 months in the nonobese group (p = 0.053). The estimated drug survival rates for rituximab were not statistically significantly different in the obese and nonobese groups. Rituximab-related side effects were also similar between the groups. Conclusion: In obese and nonobese patients with RA, rituximab treatment exhibits similar side effects and similar long-term efficacy. These results suggest that obesity does not alter drug survival for rituximab and response rates, in RA and rituximab may be a favorable treatment agent in patients with RA and obesity. © TÜBİTAK.Item Salivary inflammatory burden in pre- and postmenopausal women: Associations with body mass index, patient-reported health, serum cytokines, and periodontal parameters(John Wiley and Sons Inc, 2024) Yakar N.; Bostanci N.; Özdemir G.; Atmaca H.; Türedi A.; Şahin Ç.; Köse T.; Emingil G.Background: The decline of estrogen levels during menopause impacts weight, mood, and overall health, both orally and systemically. This study assessed salivary levels of tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), IL-10, and IL-7 in postmenopausal (PMW) and regularly menstruating premenopausal (RMPW) women, while considering serum cytokine levels, body mass index (BMI), periodontal health, and self-reported physical and emotional well-being. Methods: In this study, 75 PMW and 71 RMPW were included. Clinical and periodontal parameters were evaluated, and perceived health was assessed with the Women's Health Questionnaire (WHQ). Cytokine levels in both saliva and serum were quantified by enzyme-linked immunosorbent assay (ELISA). Covariate evaluations of salivary cytokines were conducted using hierarchical linear regression modeling. Results: Cytokines were detectable in saliva from 71 PMW and 67 RMPW. In the initial unadjusted model, IL-7, IL-10, and TNF-α exibited significant differences between RMPW and PMW. However, these differences became non-significant (p > 0.05) in the final model after adjusting for age, which implies a negligible effect of the investigated covariates on salivary cytokine levels when age was considered. Lower levels of IL-6 in PMW, which initially showed no significant difference, became borderline (p = 0.054) in the final model after adjusting for age. Conclusions: After adjusting for multiple factors, no significant difference was found in the salivary levels of the investigated cytokines between RMPW and PMW. Factors such as BMI, perceived health, serum cytokine levels, and periodontal parameters seem to minimally influence these levels in PMW. However, age may be a stronger confounding factor. © 2023 The Authors. Journal of Periodontology published by Wiley Periodicals LLC on behalf of American Academy of Periodontology.