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Öğe Association of diabetic retinopathy stage with the severity of female urinary incontinence(Wiley, 2019) Cankurtaran, Veysel; Ozates, Serdar; Ozler, Serkan; Dirican, EmrePurpose To assess the relation between diabetic retinopathy (DR) severity and urinary incontinence (UI) in patients with diabetes mellitus (DM). Materials and methods This prospective and observational study included 153 subjects. Patients were divided into three subgroups, according to severity of DR, as: No-DR, nonproliferative DR (NPDR), and proliferative DR (PDR); 40 age-matched healthy subjects formed the control group. Turkish version of the Urogenital Stress Inventory 6 (UDI-6) and Incontinence Impact Questionnaire (IIQ-7) were used to assess the UI symptoms and their effect on quality of life. The UDI-6 and IIQ-7 scores were the primary outcomes of the study. Results No significant difference was observed between groups regarding age, maternal parity, body mass index, type of delivery, menopausal status, and smoking. The mean UDI-6 urgency UI questions score was significantly higher in the PDR group and significantly higher in the NPDR group than in the control group. The mean UDI-6 stress UI questions score was similar between groups. The mean UDI-6 voiding difficulty questions score was significantly higher in the PDR group and no significant difference was observed between other groups. The mean IIQ-7 score was significantly lower in the PDR group. A moderate and positive correlation was found between glycated hemoglobin level and the UDI-6 urgency UI and voiding difficulty questions and total scores. A weak and positive correlation was found between the duration of DM and the all UDI-6 scores. Conclusion The present study showed that UI symptoms and their effect on QOL were more severe in patients with PDR.Öğe Can we predict the duration of treatment requirement by complete blood count in chronic spontaneous urticaria patients receiving omalizumab?(Dicle Üniversitesi, 2020) Çelik, Ebru; Dirican, EmreObjectives: The main assay recommended in chronic urticaria is complete blood count (CBC). It is known that changes in the numerical values and rates of blood cells in the CBC are associated with inflammation and thrombotic risk. In addition, the improvement of some patients with short-term Omalizumab treatment, while others need long-term treatment raises the question of whether this difference can be predicted with parameters on the CBC. This study aimes to evaluate the effect of the drug on CBC parameters in patients with chronic spontaneous urticaria (CSU) receiving Omalizumab treatment. Methods: The study included 66 patients who received Omalizumab treatment with CSU and 34 healthy individuals as a control group. The values of 17 parameters from the biomarkers in the CBC were recorded in the patient group (before the treatment/after 12 weeks of treatment) and in the control group. In addition, patients with CSU according to the Omalizumab treatment requirement was divided into two groups as those who recovered in a short time (≤6 months) (group-1) and those who need longer treatment (> 6 months) (group-2). All data were compared statistically. Results: It was observed that many inflammatory and thrombotic activation markers in the CBC increased in the patient group before treatment compared to the control group, and even most of these values approached the values of healthy individuals after treatment. When the pre-treatment and post-treatment data of the patients are compared within themselves; neutrophil and platelet numbers and neutrophil-monocyte ratio decreased after treatment and there was a statistically significant difference. When the pre-treatment values of the two groups determined according to the treatment requirement period were compared, it was determined that the eosinophil-basophil ratio (EBR) value was significantly higher in the group- 2 patients. It was observed that the number of platelets in group-1 decreased and eosinophil-lymphocyte ratio and eosinophil-neutrophil ratio increased after treatment compared to pre-treatment; platelet, neutrophil counts and EBR values of patients in group-2 decreased, mean platelet volume (MPV) and platelet distribution width (PDW) values increased. Conclusion: It has been determined that Omalizumab treatment has positive effects on patients with CSU that it reduces many inflammatory and thrombotic activation markers in CBC. It was thought that an increase in EBR may be a biomarker that predicts that patients with CSU will need Omalizumab treatment for a longer period. In addition, it was concluded that MPV and PDW values increased during Omalizumab treatment of patients with long-term treatment needs, and that thrombotic activation markers of these patients should be followed more closely during the treatment.Öğe COVID-19 disease severity to predict persistent symptoms: a systematic review and meta-analysis(Cambridge Univ Press, 2022) Dirican, Emre; Bal, TayibeBackground: It is unclear, whether the initial disease severity may help to predict which COVID-19 patients at risk of developing persistent symptoms. Aim: The aim of this study was to examine whether the initial disease severity affects the risk of persistent symptoms in post-acute COVID-19 syndrome and long COVID. Methods: A systematic search was conducted using PUBMED, Google Scholar, EMBASE, and ProQuest databases to identify eligible articles published after January 2020 up to and including 30 August 2021. Pooled odds ratio (OR) and confidence intervals (CIs) were calculated using random effects meta-analysis. Findings: After searching a total of 7733 articles, 20 relevant observational studies with a total of 7840 patients were selected for meta-analysis. The pooled OR for persistent dyspnea in COVID-19 survivors with a severe versus nonsevere initial disease was 2.17 [95%CI 1.62 to 2.90], and it was 1.33 [95%CI 0.75 to 2.33] for persistent cough, 1.30 [95%CI 1.06 to 1.58] for persistent fatigue, 1.02 [95%CI 0.73 to 1.40] for persistent anosmia, 1.22 [95%CI 0.69 to 2.16] for persistent chest pain, and 1.30 [95%CI 0.93 to 1.81] for persistent palpitation. Conclusions: Contrary to expectations, we did not observe an association between the initial COVID-19 disease severity and common persistent symptoms except for dyspnea and fatigue. In addition, it was found that being in the acute or prolonged post-COVID phase did not affect the risk of symptoms. Primary care providers should be alert to potential most prevalent persistent symptoms in all COVID-19 survivors, which are not limited to patients with critical-severe initial disease.Öğe The effect of continuous positive airway pressure treatment on inflammatory parameters and periostin levels in patients with obstructive sleep apnea syndrome(Springer Heidelberg, 2023) Tosun, Fatma; Babayigit, Cenk; Dikmen, Nursel; Dogan, Serdar; Dirican, EmreBackground The purpose of the study was to examine the effects of continuous positive airway pressure (CPAP) treatment on inflammation parameters in patients with obstructive sleep apnea syndrome (OSAS). Methods Patients aged 18 to 65 years who underwent polysomnography (PSG) in the sleep clinic between January 1, 2019, and December 31, 2019, were included in the study. Patients with severe OSAS initiated treatment with CPAP. Patients and control subjects were assessed for levels of periostin, TNF-alpha, TGF-beta, and IL-6. Patients were re-evaluated 3 months later. Comparisons for the serum markers were made between controls and patients of different severity of OSAS. Comparisons of serum markers were also made between baseline and 3 month follow-up. Results A total of 92 patients were enrolled in the study, including 25 controls (apnea-hypopnea index or AHI < 5/h), 39 patents with mild to moderate OSAS who did not receive CPAP, and 28 patients with severe OSAS receiving CPAP treatment. When all three groups were compared, levels of periostin, TNF-alpha, TGF-beta, and IL-6, as inflammatory markers, were higher in the OSAS group, though not at a statistically significant level. In patients with severe OSAS, there were statistically significant decreases in the TGF-beta 1, TNF-alpha, and IL-6 values between baseline values and the same measures taken after 3 months of CPAP treatment. Periostin values also decreased after treatment, but this decrease was not at a significant level. Conclusion Inflammatory parameters of patients with OSAS were significantly higher compared with healthy participants. Regression of inflammation was detected after CPAP treatment.Öğe Effect of silibinin on the hyperlipidemia in rats fed with high cholesterol diet(Cukurova Univ, Fac Medicine, 2021) Duman, Didem; Arpaci, Abdullah; Dirican, Emre; Bozdogan, Server; Bayraktar, Hamdullah SuphiPurpose: Despite current hypolipidemic drugs, the search for a more effective hypolipidemic agent is ongoing. In this study, it was aimed to investigate the effect of Silibinin on hyperlipidemia in rats fed high cholesterol diet (HCD). Materials and Methods: Rats were made obese. Rats were given egg yolk for 60 days and then 50 mg/kg, 100 mg/kg Silibinin were applied i.p. for 7 days. Results: The first and last weights of the rats were significantly different. While total cholesterol (TC), LDL, TG and VLDL levels increased significantly in the groups fed with HCD, HDL level reduced compared to control group (CG). OxLDL and TAS were significantly different between groups. Conclusion: The effects of Silibinin on serum LDL, TC, VLDL, HDL, TG, OxLDL levels and to observe the antioxidant effect, TAS and TOS were investigated in experimental obese rat models. It was concluded that Silibinin plays an effective role in lowering TG and LDL levels, increasing HDL levels and decreasing hepatic lipid accumulation in HCD rats at 100 mg/kg dose. The use of Silibinin does not cause antihyperlipidemic effect but has antioxidant effect.Öğe Evaluation of acute stroke patients applying to a university emergency service in terms of risk factors(Bayrakol Medical Publisher, 2020) Tuncay, Suheyp; Yilmaz, Ahmet; Gocen, Omer; Aslanhan, Hamza; Dirican, EmreAim: Stroke is a group of diseases that causes morbidity and loss of function at the highest rate worldwide that mostly affects the quality of life and is the second leading cause of death after heart diseases. In the present study, we aimed to determine the risk factors of the patients who applied to the emergency service and their distributions. Material and Method: Our study was formed retrospectively by evaluating the follow-up files of 194 patients who applied to Dicle University Medical Faculty Emergency and Traumatology Polyclinic and were diagnosed with stroke and were followed between June1, 2014 and June 1, 2016. Results: Of the 194 patients included in the study, 98 (51%) were female and 96 (49%) were male, the mean age was 69.6 +/- 13.4. One hundred and seventeen of patients (60%) were diagnosed with ischemic stroke, 77 of them (40%) were diagnosed with a hemorrhagic stroke. The mean age of men and women were 69.9 +/- 10 and 69.3 +/- 15.7 years respectively. According to the types of stroke, the mean age for those with ischemic stroke was 69.9 +/- 12.6, for those with hemorrhagic stroke was 69.3 +/- 14.8. In both types of stroke, the values of systolic and diastolic blood pressure were higher than normal. When the age of the patients was compared in terms of both sex and type of stroke, no significant difference was determined in terms of age in the groups. The incidence of stroke was greater between the ages of 45 and 84 in 164 patients (84.5%). Discussion: The average age of the patients was in the advanced group and their average tension values were higher than normal. For this reason, advanced age and high blood pressure were considered as risk factors contributing to stroke development in our study group. It is significant to evaluate the risk factors of the patients during the continuous health services given to the patients and to provide appropriate treatment and regular follow-ups for those with risk factors.Öğe Evaluation of clinical and demographic characteristics of Turkish and Syrian pediatric cutaneous leishmaniasis patients from Hatay, Turkey after the Syrian civil war(Termedia Publishing House Ltd, 2020) Kaya, Ozlem Makbule; Serarslan, Gamze; Dirican, EmreIntroduction: Cutaneous leishmaniasis (CL) is a skin disease affecting all ages but especially children. Cutaneous leishmaniasis exists in Turkey, and, especially together with emigration from Syria to Turkey in recent years due to the civil war in Syria, the incidence of the disease has increased. Aim: To investigate Syrian patients (SP) and Turkish patients (TP) in the pediatric age group who were diagnosed with CL and to compare the age, gender, clinical type, number of lesions, and lesion localizations of these patients. Material and methods: We included CL patients aged 0-18 who were admitted to the outpatient clinic in the period 2015-2017 and in the first half of 2018. A total of 121 patients (SP, n = 87; TP, n = 34) were included in the study. Results: The mean ages of TP and SP were 12.06 +/- 4.47 and 8.68 +/- 5.18 years and the disease durations were 6.25 +/- 3.86 and 4.73 +/- 3.39 months respectively (p = 0.049). The total number of lesions was 247. The mean lesion number per child was 2.35 +/- 2.28 in SP, and 1.23 +/- 0.55 in TP (p = 0.002). Two and multiple lesions were significantly higher in SP (p = 0.005). It was found that the lesions were most frequently located in the head/neck (FIN) region (76.9%) and 44.1% of patients with HN localization belonged to the 7-12 age group. We also found that 57.1% of the HN lesions were of the papule type in the patients. Conclusions: We obtained similar results as in other studies in terms of age, gender, localization, and duration of lesions in general. When SP and TP were compared, we found that the number of lesions was higher, the disease duration was shorter, and the mean age was younger in SP.Öğe An evaluation with shear wave elastography of kidney elasticity in patients with familial Mediterranean fever(Wiley, 2023) Kayali, Alperen; Keles, Fatma Ozturk; Seyfettin, Ayca; Dirican, Emre; Celik, Muhammed MuratPurpose To investigate the changes in kidney elasticity in patients with familial Mediterranean fever using the non-invasive diagnostic method of shear wave elastography (SWE). Methods The kidney elasticity of 35 FMF patients and 23 healthy control subjects was evaluated with SWE. The relationships were evaluated of the SWE values with eGFR, microproteinuria, FMF severity score, number of attacks per month, and colchicine doses of the FMF patients. Results The kidney stiffness and velocity values of the FMF patients were found to be higher than those of the control group (p < 0.001). A negative correlation was found between the renal stiffness and velocity values and the colchicine dose (r = -0.48, p = 0.004, and r = -0.50, p = 0.003, respectively). Conclusion The results of the current study demonstrated that the SWE values of the FMF patients were significantly higher than those of the control group. SWE can be used as an alternative method in the follow up of FMF patients. In addition, a negative correlation was determined between the colchicine dose and renal stiffness. This suggests that SWE values could be used in the adjustments of colchicine doses. However, there is a need for further studies with greater numbers of patients to support this hypothesis.Öğe Intra-day changes in the levels of biochemistry parameters(Kare Publishing, 2022) Arpaci, Abdullah; Dogan, Serdar; Gul, Bahar Unlu; Kus, Berna; Dirican, EmreObjectives: People mostly live in the nonfasting state during a normal 24-h cycle. This study aims to compare the levels of 18 biochemical parameters during different hours of the day. Methods: A total of 18 biochemical tests of patients who visited outpatient clinics only once between January 1, 2010, and December 31, 2019, were evaluated at the Hatay Mustafa Kemal University (HMKU) Central Laboratory by using hospital database information. The tests are albumin (Alb), aspartate aminotransaminase (AST), alanine aminotransam-inase (ALT), alkaline phosphatase (ALP), amylase, blood urea nitrogen (BUN), calcium (Ca), total cholesterol (TC), cre-atine kinase (CK), creatinine (Cr), gamma-glutamyltransferase (GGT), glucose, high-density lipoprotein cholesterol (HDL-C), inorganic phosphorus (Pi), iron (Fe), total protein (TP), triglyceride (TG), and lipase. The blood samples of the patient were divided into eight groups according to their collection time as follows: (a) 07:00-07:59, (b) 08:00-08:59, (c) 09:00-09:59, (d) 10:00-10:59, (e) 11:00-11:59, (f) 12:00-13:59, (g) 14:00-14:59, and (h) 15:00-17:00. Results: A statistically significant difference was found between the groups in terms of all parameters except amylase, GGT, and TP (p<0.05). The effect size refers to the minimum amount of difference that is clinically significant. According to the effect size values, there was no significant difference between time groups in the following parameters: Alb, ALT, AST, Pi, Ca, TC, Cr, Fe, glucose, BUN, lipase, TG, ALP, HDL-C, and CK (?<0.30). Conclusion: When considering all of the results, nonfasting screening would not only be acceptable but also make physiologic sense. © 2022, Kare Publishing. All rights reserved.Öğe Lymphocyte-to-C-reactive protein ratio may serve as an effective biomarker to determine COVID-19 disease severity(Walter De Gruyter Gmbh, 2021) Bal, Tayibe; Dogan, Serdar; Cabalak, Mehmet; Dirican, EmreObjectives: We aimed to evaluate the ability of lymphocyte-C-reactive protein ratio (LCR) to discriminate between different levels of severity of COVID-19 disease. Methods: This retrospective observational single-center study was performed on 61 confirmed (PCR positive) COVID-19 patients between March and June 2020. The study population was separated into three groups: mild/moderate (n=24), severe (n=25) and critically ill (n=12). The optimal cutoff values of the LCR and neutrophil-to-lymphocyte ratio (NLR) in discriminating between patients with different severity levels were calculated by applying the receiver operating curve (ROC) analysis. Results: At baseline, the LCR decreased significantly across the three severity groups (mild/moderate > severe > critically ill). ROC analysis showed that a mean LCR of 43.21 was the cut-off value which best discriminated patients with the critically ill disease from severe patients (sensitivity: 84% and specificity: 69%). The discriminative performance of LCR (ROC AUC 0.820) was better than that of NLR (0.751) in this regard. LCR, unlike NLR was able to distinguish severe patients from mild/moderate patients, with a cut off value of 458.19 (sensitivity: 80% and specificity: 45%). Conclusion: LCR was observed to be able to distinguish COVID-19 infected patients of different severity (mild/moderate, severe and critically ill) and was superior to NLR in this regard.Öğe Perinatal effects of maternal FT3/FT4 ratio on gestational transient thyrotoxicosis(Sbem-Soc Brasil Endocrinologia & Metabologia, 2021) Gurkan, Eren; Dolapcioglu, Kenan; Dirican, EmreObjective: The effects of maternal thyroid hormone levels on the course of pregnancy and birth weight have attracted interest. The aim of the present study was to consider FT3 and FT3/FT4 ratio in the evaluation of the effects of maternal thyroid functions in gestational transient thyrotoxicosis (GTT). Materials and methods: This case-control study included 45 patients with GTT and 45 healthy pregnant women. Maternal history before pregnancy, thyroid function tests, thyroid autoantibodies, and thyroid ultrasonography results in 6th to 10th weeks of pregnancy were used in the differential diagnosis of GTT. In both groups, the effects of FT3, FT4 and FT3/FT4 ratios on gestational age and birth weight were evaluated. Results: There was no significant difference in the gestational age between the GTT and control groups (39,3 +/- 1,0 weeks and 39,2 +/- 1,2 weeks, respectively). Birth weights were similar in both groups (3205,2 +/- 4899 g and 3196,6 +/- 309,3 g, respectively). When maternal weight was adjusted, a positive correlation was observed between maternal FT3/FT4 ratio and birth weight (r=0,317, p=0,017). Additionally there was a positive correlation between the gestational age and the birth weight in the control group (rho = 0,726, p=0,001). Conclusion: GTT had no significant effect on the gestational age and the birth weight. On the other hand an increase in the maternal FT3/FT4 ratio had a positive effect on the birth weight in the patient with GTT. Maternal characteristics (age, weight, BMI) and FT3/FT4 ratio should be taken into consideration in future impact assessment studies on this issue.Öğe A potential new way to facilitate HCV elimination: The prediction of viremia in anti-HCV seropositive patients using machine learning algorithms(Elsevier, 2024) Bal, Tayibe; Dirican, EmreBackground and study aims: The present study was undertaken to design a new machine learning (ML) model that can predict the presence of viremia in hepatitis C virus (HCV) antibody (anti-HCV) seropositive cases. Patients and Methods: This retrospective study was conducted between January 2012-January 2022 with 812 patients who were referred for anti-HCV positivity and were examined for HCV ribonucleic acid (HCV RNA). Models were constructed with 11 features with a predictor (presence and absence of viremia) to predict HCV viremia. To build an optimal model, this current study also examined and compared the three classifier data mining approaches: RF, SVM and XGBoost. Results: The highest performance was achieved with XGBoost (90%), which was followed by RF (89%), SVM Linear (85%) and SVM Radial (83%) algorithms, respectively. The four most important key features contributing to the models were: alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB) and antiHCV levels, respectively, while ALB was replaced by the AGE only in the XGBoost model. Conclusion: This study has shown that XGBoost and RF based ML models, incorporating anti-HCV levels and routine laboratory tests (ALT, AST, ALB), and age are capable of providing HCV viremia diagnosis with 90% and 89% accuracy, respectively. These findings highlight the potential of ML models in the early diagnosis of HCV viremia, which may be helpful in optimizing HCV elimination programs.Öğe Presentation of two new mutations in the 3?untranslated region of the ?-globin gene and evaluating the molecular spectrum of thalassemia mutations in the Mediterranean region of Turkey(Springer, 2021) Arpaci, Abdullah; Gul, Bahar Unlu; Ozcan, Oguzhan; Ilhan, Gul; El, Cigdem; Dirican, Emre; Elmacioglu, SibelThalassemia is a common genetic disorder. We aimed to present thalassemia mutation data that covers a period of 7 years from the Mediterranean region of Turkey by comparing with hemoglobin indices and to contribute to prenatal diagnosis and genetic counseling studies which should be decided very quickly. In this study, in which a retrospective archive was scanned, the cases were first grouped as alpha and beta thalassemia, and then beta thalassemia mutations were examined in a total of 5 groups as UTR-Pro, Codon, IVS, beta(0), and beta(+). We have reached the family of the proband that analyzed their Hb indices and genetic mutation. All mutations were statistically compared with Hb indices, HbF, and HbA(2). We have identified two new beta thalassemia mutations that have the feature of not being defined previously [HBB:C*62 A>G. (3 ' UTR+1536 A>G) and HBB:C*1 G>A (3 ' UTR+1475 G>A)]. The most commonly encountered 23 mutations account for 74.7% of all mutations which is unlike the literature. In the beta thalassemia group, 73 different mutations were detected. The most common beta thalassemia mutation was HBB: c.93-21 G>A (IVS I-110 G>A) with a frequency of 19.72%. A statistically significant difference was found when comparing the mutation groups with Hb indices. We think that it may be useful to evaluate the mutations we have newly identified too together with the Hb indices especially in evaluating the carriers of thalassemia and it will contribute to prenatal diagnosis and genetic counseling studies which should be decided very quickly.Öğe RE: Are Cross-Sectional Imaging Modalities Enough for Sarcopenia Assessment?(2024) Cankurtaran, Rasim Eren; Güneş, Yasin Celal; Dirican, Emre; Algın, Oktay; Cankurtaran, Damla; Yürekli, Öykü TayfurÖğe Re: Are cross-sectional imaging modalities enough for sarcopenia assessment?(AVES, 2024) Cankurtaran, Rasim Eren; Gunes, Yasin Celal; Dirican, Emre; Algin, Oktay; Cankurtaran, Damla; Yurekli, Oyku Tayfur[No abstract available]Öğe Sarcopenia and Myosteatosis Assessed by Magnetic Resonance Enterography May Predict Negative Outcomes in Patients with Crohn's Disease(Aves, 2023) Cankurtaran, Rasim Eren; Gunes, Yasin Celal; Dirican, Emre; Algin, Oktay; Cankurtaran, Damla; Yurekli, Oyku TayfurBackground/Aims: Limited research has examined the clinical consequences of sarcopenia and myosteatosis in Crohn's disease. This study aimed to determine the prevalence, risk factors, and effects of sarcopenia and myosteatosis on prognostic outcomes in Crohn's disease patients who underwent magnetic resonance enterography. Materials and Methods: This retrospective observational study included 116 Crohn's disease patients who underwent magnetic resonance enterography between January 2015 and August 2021. Skeletal muscle index was the ratio of the cross-sectional area of skeletal muscles at the L3 vertebral level to the square of the neck in cross-sectional imaging. Sarcopenia was defined as skeletal muscle index <38.5 cm(2)/m(2) in women and <52.4 cm(2)/m(2) in men. Myosteatosis was considered positive if the ratio of the mean signal intensity of the psoas muscle to the mean signal intensity of the cerebrospinal fluid was above 0.107. Results: Among the negative results in the post-procedure follow-up of the patients, a significant increase was observed in the sarcopenia group regarding abscess and the need for surgery (P <.05). Anti-tumor necrosis factor initiation was found to be significantly higher in the follow-up than in patients without myosteatosis (P =.029). In the multivariate model established with these variables, the presence of sarcopenia in the surgical follow-up was odds ratio = 5.34 (CI: 1.02-28.03, P =.047) and was found to be significantly associated with the increased risk. Conclusions: The presence of myosteatosis and sarcopenia detected in magnetic resonance enterography may be a harbinger of negative outcomes in Crohn's disease patients. Nutritional support should be provided to these patients with the potential to alter the course of the disease.Öğe Scale and Pustule on Dermoscopy of Rosacea: A Diagnostic Clue for Demodex Species(Mattioli 1885, 2021) Serarslan, Gamze; Kaya, Ozlem Makbule; Dirican, EmreBackground: Demodex mites are highly found in the skin of patients with rosacea.The diagnosis of Demodex can be made by standardized skin surface biopsy. Dermoscopy is a tool used in the noninvasive diagnosis of various dermatological diseases. Objectives: To determine whether dermoscopic features of demodicosis are associated with the result of standardized skin surface biopsy in patients with rosacea and to compare dermoscopic features of rosacea in Demodex-positive and negative samples and Demodex type. Methods: A total of 30 patients (7 male, 23 female) were included in the study. Dermoscopic examination was performed on both the clinically most severely affected areas and adjacent healthy skin. The skin surface biopsy sample was taken from the same place from where the dermoscopic image was taken. Results: A total of 83 (lesion n = 60, non-lesion n = 23) areas were evaluated. Demodex was detected in 60.2% (n = 50) of the samples. Half of these samples revealed only Demodex folliculorum, and the remaining half revealed D folliculorum and Demodex brevis. Of theDemodex-positive samples, 88% had Demodex tails (P =0.001) and 68% Demodex follicular openings (P = 0.002) on dermoscopy. In D folliculorum+D brevis-positive samples, the rate of scale and pustule was higher than D folliculorum-positive samples (P = 0.017 and P = 0032,respectively). Conclusions: The sensitivity and specificity of Demodex tail are higher than Demodex follicular opening and scale and pustule detection with dermoscopy and may indicate the coexistence of both D folliculorum and D brevis.Öğe The Severity of premenstrual syndrome symptoms in sickle cell disease patients : A case- control study(Düzce Üniversitesi, 2019) Döner Güner, Pınar; Uslusoy, Sabahat; İlhan, Gül; Kokaçya, Sümeyya Havva; Dirican, Emre; Kokaçya, Mehmet Hanifi; Yengil, Erhan; Özer, CahitObjective: Sickle Cell Disease (SCD) patients experience recurrent pain attacks and up to 30% of these become chronic pain. There is known to be a relationship between chronic pain and depression and other psychological problems. Therefore, Sickle Cell Disease patients often experience a series of social and psychiatric problems. The aim of this study to determine the frequency and severity of premenstrual syndrome in women aged ≥18 years with sickle cell disease and to compare these values with healthy women. Methods: This case control study was conducted from January 2018 to March 2018. The data were collected using a questionnaire of 21 items and the Premenstrual Syndrome Scale (PMSS). Statistical analysis was performed using SPSS 21 software. Results: The study included 50 patients aged with 18 years who were diagnosed sickle cell anemia at the University Hospital and control group of 50 subjects have no chronic disease. Premenstrual Syndrome (PMS) according to DSM-5 was determined in 34 (68%) of the case group and 39 (78%) of the control group (p=0,26). Mean depressive effect subscale score was 15.64±6.56 in the sickle cell anemia group while, it was 19.48±6.67 in control group (p=0,05). Conclusions: Although PMS frequency and symptom severity in women with SCD were similar with normal population, the depressive effect subscale scores were lower in SCD group. This results’ cause could be attributed to PMS symptoms being perceived as less severe compared to the pain experienced in sickle cell crises. Keywords: Sickle Cell Disease, Premenstrual Syndrome, Chronic Pain, Depression, Hemoglobinopathies.Öğe The Treatment of Adolescent Pregnant and Adolescent Mothers Aged 13–18 Years With Non-Obstetric Surgery Indications: The opinions of Turkish surgeons(Logos Medical Publishing, 2022) Atıcı, Ahmet; Çelikkay, Mehmet Emin; Dolapçıoğlu, Kenan; Uğur, Mustafa; Dirican, Emre; Görür, Sadık; Akçora, BülentIntroduction: Adolescent pregnancy (AP) is defined as pregnancy in girls between the ages of 13–19 while adolescent motherhood (AM) describes adolescents who become mothers during this period. The current study aimed to gather the opinions of surgeons working in Pediatric Surgery, General Surgery, Gynaecology, and Urology in Turkey on which departments and specialists should perform the surgical management of these patients. Methods: A questionnaire designed to gather the opinions of Turkish surgeons working in Pediatric Surgery, General Surgery, Gynaecology, and Urology on the management of non-obstetric surgical diseases that occur in AP and AM was distributed using Google Forms. Results: The questionnaires were answered by pediatric surgeons (n=80), gynaecologists (n=62), general surgeons (n=45) and urologists (n=37). As seen in the responses, while 62,2% of general surgeons believed that all patients under the age of 18 should be considered as children and treated by pediatric surgeons, 88,5% of gynaecologists, 56,8% of urologists, and 52,5% of pediatric surgeons disagreed. The differences between the responses were also found to be significant (p<0.001). Conclusion: The results indicated that most pediatric surgeons working in Turkey ––and a significant number of adult surgeons from other specialisms –– believed that the surgical treatment of AP and AM patients should not be managed exclusively by pediatric surgeons. Further, the results suggested that in Turkey, pediatric surgeons and adult surgeons failed to agree on this issue, and thus, additional legal regulations are required to guide medical professionals on this issue to mitigate instances of malpractice cases and improve child safety in medical settings. Ultimately, we believe that the best solution is to reduce the number of adolescents becoming pregnant via education on abstinence and/or contraception © Logos Medical Publishing. All Rights Reserved.Öğe Ultrasonographic shear wave elastography of the thyroid in patients with sickle cell anemia(Walter De Gruyter Gmbh, 2022) Burakgazi, Gulen; Ilhan, Gul; Ozcan, Oguzhan; Dirican, EmreBackground Although thyroid radiology has been conducted in patients with sickle cell anemia (SCA), to our knowledge, there is no report of thyroid gland assessment using ultrasonographic shear wave elastography (US-SWE). Objectives To determine values for ultrasonographic US-SWE of the thyroid in patients with SCA and correlations between thyroid elasticity and biochemical variables used to evaluate thyroid function. Methods Prospective case-control observational study of 36 patients with SCA and 33 healthy volunteer controls. US-SWE measurements of thyroid gland parenchyma and biochemical parameters of the participants were obtained and compared, and the diagnostic accuracy of elasticity was determined. Results The thyroid volume was smaller in patients with SCA than that in controls (P = 0.001). Compared with the controls, the patients with SCA had significantly lower serum levels of free triiodothyronine (fT3) (P = 0.004) and thyroglobulin (Tg) (P = 0.001) and significantly higher levels of thyroid-stimulating hormone (P = 0.028). Thyroid stiffness was significantly higher in the left lobe (LL) of the patients with SCA than in the controls (P = 0.003). In the patients with SCA, we found a significant correlation between right lobe (RL) and LL stiffness and serum levels of Tg (RL [r = -0.439] and LL [r = -0.484]; P = 0.021) and fT3 (RL [r = -0.463] and LL [r = -0.386]; P = 0.012). Receiver operating characteristic (ROC) curve analysis of thyroid elasticity that represented a diagnosis of SCA found a cutoff of >7.31 kPa, a sensitivity of 52.0%, and a specificity of 72.0% for the RL (P = 0.316, area under the curve [AUC] 0.570), and a cutoff of >8.06 kPa, a sensitivity of 58.0%, and a specificity of 84.0% for the LL (P = 0.011, AUC 0.680). Conclusions US-SWE can be used to follow up thyroid changes in patients with SCA.
