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Öğe Anxiety, depression and post-traumatic stress disorder symptoms in adolescents during the COVID-19 outbreak and associated factors(Wiley-Hindawi, 2021) Selcuk, Engin Burak; Demir, Arzu Caliskan; Erbay, Lale Gonenir; Ozcan, Ozlem Ozel; Gurer, Huseyin; Donmez, Yunus EmreIntroduction Outbreaks of infectious diseases have negative effects on mental health. Currently, there is very little information about the psychological effects of the COVID-19 pandemic on adolescents and associated factors affecting their mental health. The aim of the present study is to determine the severity of anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in adolescents during the COVID-19 outbreak, and to investigate the associated factors with these symptoms. Methods The present study was conducted with a total of 447 adolescents. Psychiatric symptoms were evaluated by the use of DSM-5 Level 2 Anxiety Scale, DSM-5 Level 2 Depression Scale and National Stressful Events Survey PTSD Short Scale. The association between age, gender, residential area, presence of COVID-19 in the participant, presence of COVID-19 in the family or environment and psychiatric symptoms were evaluated with linear regression analysis. Results The mean age of participants was 15.06, and 38.3% of the participants were men and 61.7% were women. The rate of participants with moderate or high levels of anxiety, depression and PTSD symptoms was 28%, 37.6% and 28.5%, respectively. High age and living in an urban area were associated with increased anxiety, depression and PTSD symptoms. In addition, female gender was associated with increased depression symptoms, and the presence of COVID-19 in the family or environment was associated with increased anxiety symptoms. Conclusion The present study shows that adolescents have serious levels of anxiety, depression and PTSD symptoms during the COVID-19 pandemic. These results emphasise the need for mental health interventions that are appropriate for the characteristics of this age group.Öğe Applicability of the ROX index in decision-making for hospitalization in COVID-19 patients(Bayrakol Medical Publisher, 2022) Kasapoglu, Umut Sabri; Selcuk, Engin Burak; Yalcinsoy, Murat; Uckac, Kadir; Sahin, Abdullah Fahri; Bentli, RecepAim: Data on the outpatient follow-up of COVID-19 cases is still scarce. Also, the significance of the ROX index in decision-making for hospitalization in the ambulatory COVID-19 cases remains unknown. The aim of this study is to determine the general characteristics of COVID-19 patients treated as outpatients and to investigate whether the ROX index is applicable in hospitalization decisions.Material and Methods: This retrospective cohort study was conducted in confirmed adult COVID-19 cases between 15 October 2020 and 01 March 2021. A total of 5240 confirmed COVID-19 patients were included in the present study. Factors affecting hospitalization were investigated.Results: The study population was divided into two groups as those who require hospitalization (n=672) and those who did not (n=4568). The number of male patients and the mean age of the patients were significantly higher in hospitalized patients group (p=0.046, p<0.001). ROX index that was calculated at the home visit on the third day of disease was found significantly lower in the group of hospitalized patients (p<0.001). There was a significant correlation between ROX index and inflammatory biomarkers in the present study (p<0.001). The ROX index was found the most accurate parameter for decision-making for hospitalization in ambulatory COVID-19 patients (AUC=0.794 CI=0.773-0.814, p<0.001).Discussion: The ROX index can be a useful and objective clinical tool for decision making for hospitalization in the ambulatory COVID-19 cases.Öğe Atypical Presentation of Skull Metastasis from Rectal Adenocarcinoma as an Initial Symptom of Recurrence(Hindawi Ltd, 2012) Firat, Cemal; Aytekin, Ahmet Hamdi; Erbatur, Serkan; Aydin, Nasuhi Engin; Selcuk, Engin BurakMost malignant rectal tumors are histopathologically characterized as adenocarcinoma and generally metastasize to distant organs such as the lungs or the liver. Metastasis of rectal carcinomas to the skull is extremely rare. This study reports the initial diagnosis of rectal adenocarcinoma recurrence in a 65-year-old female with scalp metastasis. The patient's history indicated a colorectal adenocarcinoma that was resected five years earlier. A skull metastasis from a rectal adenocarcinoma has not yet been reported in the literature as an initial symptom for recurrence. This paper suggests that skull metastasis from any part of the body must be considered in the differential diagnosis of soft tissue tumors in the skull even in the absence of intestinal symptoms.Öğe Clinical features and prognostic factors affecting survival of ambulatory followed COVID-19 patients aged over 65 years(Bayrakol Medical Publisher, 2022) Yalcinsoy, Murat; Selcuk, Engin Burak; Uckac, Kadir; Sahin, Abdullah Fahri; Tas, Ayse; Kasapoglu, Umut; Bentli, RecepAim: The majority of the patients with COVID-19 are followed ambulatory. Determination of prognostic factors of mortality in risky groups is essential to improve patient management. The aim of this study is to describe the clinical presentation in patients over 65 years of age with COVID-19 who are followed up at home by a physician and provide insights into the initial prognostic factors in this distinctive population. Material and Methods: This is a retrospective and observational study. Clinical records of the patients aged over 65 years who were visited by the filiation team, including a physician at home, due to the diagnosis of COVID-19 disease within 2 months were reviewed. Factors affecting mortality were examined. Results: Our study included 51 deceased (mean age: 75,1 +/- 9,0 years, 40,2% males), and 102 patients with COVID-19 who survived (mean age: 73,0 +/- 6,9 years, 68,6% male). Platelet count ( < 150.000, OR 7,26, p=0,001), CRP level ( < 4, OR 4,55, p=0,02), albumin level ( OR 3,24, p=0,02), and Troponin I level (OR 0,03, p=0,02) were the strongest predictors for death. When propensity score matching was applied, gender (male, OR 7,14, p=0,02) and platelet count (< 150.000, OR 5,34, p=0,02) were the strongest predictor Discussion: Elderly COVID-19 patients have a high mortality rate. An easily measurable and accessible platelet count may be a predictor of a bad outcome. Close follow-up and timely treatment may significantly reduce mortality in high- risk elderly patients under.Öğe Comparison of lateral deltoid splitting and deltopectoral approaches in the treatment of proximal humerus fractures(Turkish Assoc Trauma Emergency Surgery, 2015) Korkmaz, Mehmet Fatih; Erdem, Mehmet Nuri; Karakaplan, Mustafa; Gormeli, Gokay; Selcuk, Engin Burak; Maras, Zeynep; Karatas, TurgayBACKGROUND: Fractures of the proximal humerus that limit function are quite common. The objective of this retrospective study was to compare deltoid splitting and deltopectoral approaches by using the same fixation method. METHODS: Eighty-six patients who underwent surgical treatment between September 2005 and July 2011 were included into the study group. Deltoid splitting approach was used by exploring the axillary nerve on Group A patients as described by Codman, and deltopectoral approach was used on Group B patients. Group A consisted of a total of fifty-six patients of whom twenty-two were male and thirty-four were female patients, with a mean age of 62.5 years (range, 26 to 90 years). Group B consisted of a total of thirty patients of whom fourteen were male and sixteen were female patients, with a mean age of 54.8 years (range, 24 to 84 years). PHILOS plate system was utilized as an internal fixation tool in all patients. Functional results and complications of the two groups were compared using Constant scores. RESULTS: It was observed that humeral head and tubercular fragment reduction were better with lateral deltoid splitting approach, and Constant shoulder scores were higher in the early stages (66.8-57.4 consecutively; p0.05). DISCUSSION: Deltoid splitting approach, especially with AO/ASIF B and C type fractures, enables reduction and plate fixing under 270 degree control of the proximal humerus without forceful retraction and soft tissue damage, providing easy access to posterior tubercular fragment. Compared to deltopectoral approach, patients treated with deltoid splitting approach achieved higher Constant scores at an earlier stage. Lateral deltoid splitting approach, by exploring the axillary nerve, is a useful surgical technique which provides an expansive and multi-dimensional control without risking the deltoid muscle function and the axillary nerve.Öğe Comparison of primary repair and placing a drain without repair methods in duodenum perforations(Turkish Assoc Trauma Emergency Surgery, 2023) Karatas, Turgay; Kanlioz, Murat; Karatas, Mehmet; Gokturk, Nurcan; Selcuk, Engin Burak; Cevirgen, Furkan; Turkoz, YusufBACKGROUND: Duodenal ulcer perforation is a serious condition. A number of methods have been defined and used in surgical treatment. In this study, it was aimed to compare the effectiveness of primary repair and drain placement without repair methods in duodenal perforations using an animal model.METHODS: Three equivalent groups of ten rats each were formed. Perforation was created in the duodenum in the first (primary repair/sutured group) and the second group (drain placement without repair/sutureless drainage group). In the first group, the per-foration was repaired with sutures. In the second group, only a drain was placed in the abdomen without sutures. In the third group (control group), only laparotomy was performed. Neutrophil count, sedimentation, serum C-reactive protein (CRP), serum total an-tioxidant capacity (TAC), serum total thiol, serum native thiol, and serum myeloperoxidase (MPO) analyses were performed on animal subjects in the pre-operative period and on the post-operative 1st and 7th days. Histological and immunohistochemical (transforming growth factor-beta 1 [TGF-131]) analyzes were performed. Blood analysis, histological, and immunohistochemical findings obtained from the groups were compared statistically.RESULTS: There was no significant difference between the first and second groups, except for the TAC on the post-operative 7th day and MPO values on the post-operative 1st day (P>0.05). Although tissue healing was more pronounced in the second group than in the first group, there was no significant difference between the groups (P>0.05). TGF-131 immunoreactivity observed in the second group was found to be significantly higher than in the first group (P<0.05). CONCLUSION: We think that the sutureless drainage method is as effective as the primary repair method in the treatment of duo-denal ulcer perforation and can be safely applied as an alternative to the primary repair method. However, further studies are needed to fully determine the efficacy of the sutureless drainage method.Öğe Delays in diagnosis in patients with pulmonary and extrapulmonary sarcoidosis(2019) Acarturk Tuncay, Eylem; Yalcinsoy, Murat; Gungor, Sinem; Selcuk, Engin Burak; Tokgoz Akyil, Fatma; Yavuz, Dilek; Sucu, Pakize; Alpaslan Bekir, Sumeyye; Ocakli, Birsen; Aksoy, EmineAim: Sarcoidosis is a multisystemic disease with typical or atypical pulmonary and extra-pulmonary symptoms or frequently without symptoms. Presence of typical clinical findings and symptoms contribute to rapid diagnosis, whereas asymptomatic progression leads to delays in the diagnosis. The aim of this study was to investigate the delay in diagnosis in between patients with pulmonary and/or extra-pulmonary involvement and related symptoms and those without symptoms. Material and Methods: Patients in the sarcoidosis clinics between 2010-2015, were retrospectively evaluated. The cases were grouped according to the presence or absence of symptoms (pulmonary and/or extra-pulmonary). The groups were compared with regard to the delay in diagnosis. Results: Among the 300 patients, 209 (69%) were female. The mean age was 43±11.68. The disease was stage I in 67.3%, stage II in 23.7%, stage III in 5.7% and stage 0 in 3.3% of the patients. No significant difference was observed between symptomatic and asymptomatic patients with regard to total duration until diagnosis (p=0.78). A statistically significant difference was observed between patients groups with regard to physician-related delayed diagnosis(p=0.026). The mean delay in physician-related diagnosis was observed to be longer in asymptomatic cases (21.44 days) compared to patients with pulmonary symptoms (13.66 days)(p=0.036). In asymptomatic cases, the mean duration of physician-related delayed diagnosis (21.44 days) was observed to be longer in comparison with patients with extra-pulmonary symptoms (12.79 days)(p=0.016). In patient-related delayed diagnosis, no difference was observed between groups with regard to the duration until diagnosis(p=0.78). Conclusion: Comparison of delayed diagnosis between patients with or without pulmonary and/or extra-pulmonary symptoms revealed a longer duration of delay in asymptomatic cases compared to symptomatic cases. The timing of diagnosis is very important in sarcoidosis in order to reduce morbidity and mortality; a suspicious approach to asymptomatic patients will increase the possibility of diagnosis and prevent delayed diagnosis.Keywords: Sarcoidosis; diagnosis; delay; extrapulmonary symptoms.Öğe Delays in diagnosis in patients with pulmonary and extrapulmonary sarcoidosis(2019) Tuncay Acarturk, Eylem; Yalcinsoy, Murat; Gungor, Sinem; Selcuk, Engin Burak; Tokgoz Akyil, Fatma; Yavuz, Dilek; Sucu, Pakize; Alpaslan Bekir, Sumeyye; Ocaklı, Birsen; Aksoy, EmineAbstract: Aim: Sarcoidosis is a multisystemic disease with typical or atypical pulmonary and extra-pulmonary symptoms or frequently withoutsymptoms. Presence of typical clinical findings and symptoms contribute to rapid diagnosis, whereas asymptomatic progressionleads to delays in the diagnosis. The aim of this study was to investigate the delay in diagnosis in between patients with pulmonaryand/or extra-pulmonary involvement and related symptoms and those without symptoms.Material and Methods: Patients in the sarcoidosis clinics between 2010-2015, were retrospectively evaluated. The cases weregrouped according to the presence or absence of symptoms (pulmonary and/or extra-pulmonary). The groups were compared withregard to the delay in diagnosis.Results: Among the 300 patients, 209 (69%) were female. The mean age was 43±11.68. The disease was stage I in 67.3%, stage IIin 23.7%, stage III in 5.7% and stage 0 in 3.3% of the patients. No significant difference was observed between symptomatic andasymptomatic patients with regard to total duration until diagnosis (p=0.78). A statistically significant difference was observedbetween patients groups with regard to physician-related delayed diagnosis(p=0.026). The mean delay in physician-relateddiagnosis was observed to be longer in asymptomatic cases (21.44 days) compared to patients with pulmonary symptoms (13.66days)(p=0.036). In asymptomatic cases, the mean duration of physician-related delayed diagnosis (21.44 days) was observed to belonger in comparison with patients with extra-pulmonary symptoms (12.79 days)(p=0.016). In patient-related delayed diagnosis, nodifference was observed between groups with regard to the duration until diagnosis(p=0.78).Conclusion: Comparison of delayed diagnosis between patients with or without pulmonary and/or extra-pulmonary symptomsrevealed a longer duration of delay in asymptomatic cases compared to symptomatic cases. The timing of diagnosis is veryimportant in sarcoidosis in order to reduce morbidity and mortality; a suspicious approach to asymptomatic patients will increasethe possibility of diagnosis and prevent delayed diagnosis.Öğe Effects of Rifaximin on Bacterial Translocation in Thioacetamide-Induced Liver Injury in Rats(Springer/Plenum Publishers, 2012) Harputluoglu, Murat M. M.; Demirel, Ulvi; Gul, Mehmet; Temel, Ismail; Gursoy, Sule; Selcuk, Engin Burak; Aladag, MuratIntestinal bacterial overgrowth (IBO) and increased mucosal permeability are suggested to increase bacterial translocation (BT) in liver injury. Rifaximin (RIF) is a minimally absorbed oral antimicrobial agent that restores gut microflora imbalance. The aim of the present study was to investigate the effects of RIF on BT frequency in thioacetamide (TAA)-induced liver injury. Group 1 was the control. In group 2 (TAA), rats received TAA daily for 3 days. In group 3 (TAA + RIF), RIF was commenced on the same day as the first dose of TAA. In group 4 (RIF), rats received only RIF. Ileal aspirate Escherichia coli counts were significantly lower in the TAA + RIF group than in TAA group. There was no difference in BT frequency between the TAA and TAA + RIF groups. Our results suggest that factors such as intestinal barrier dysfunction and impaired host immune shield, apart from IBO, play an important role in BT in this model.Öğe Effects of sleep disorders and 25-OH Vitamin D levels on HbA1c levels in geriatric type 2 diabetic patients.(Allied Acad, 2016) Keskin, Ahmet; Bilge, Ugur; Unalacak, Murat; Kilic, Seda; Yildiz, Pinar; Selcuk, Engin Burak; Bilgin, MuzafferIntroduction: Sleep disorders and insufficient vitamin D levels can impair control of diabetes mellitus. The aim of this study was to determine the prevalence of sleep disorders by using Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and by comparing them with a control group, and to investigate the possible relationship among sleep disorders, scores, 25-OH Vitamin D levels (25VD) and HbA1C levels. Materials and method: This study was conducted in type 2 diabetic patients who attended to the family medicine outpatient clinic for routine controls. One hundred and six geriatric patients having type 2 diabetes were included in the study, and simultaneously selected 102 adult age group patients were taken as controls. Blood analyses for routine diabetes control parameters (HbA1c, fasting blood glucose, lipid profile) were performed. Target value for HbA1C was accepted as below %7. Demographic form, the Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale were used as the data collection instruments. Results: There are significant differences in PSQI and ESS scores between adult and geriatric diabetic patients (6.16 +/- 3.62 vs 6.96 +/- 3.42, p=0.070 and 7.84 +/- 5.37, p <0.001, respectively). 25VD levels were found as 22.40 +/- 13.85 ng/ml in the adult group, 18.65 +/- 14.17 ng/ml in the geriatric group. There is a significant difference between the groups in terms of vitamin D levels (p=0.007). Epworth categories were found to have an effect on HbA1c levels in geriatric patients. Changes in levels of ESS scores were found to be related with 4.784 fold increase in HbA1c levels. Vitamin D levels and ESS scores have major effects on HbA1C levels in elderly population (p=0.007, 0.001, respectively). Conclusion: In elderly patients, low 25VD levels and daytime sleepiness are associated with abnormal HbA1c levels. These results are important indicators of roles of sleep quality and VD deficiency in glycemic control for elderly patients. In elderly diabetic patients, with difficult blood glucose regulation, sleep problems and VD deficiency must be considered.Öğe Effects of Sleep Disorders on Hemoglobin A1c Levels in Type 2 Diabetic Patients(Lippincott Williams & Wilkins, 2015) Keskin, Ahmet; Unalacak, Murat; Bilge, Ugur; Yildiz, Pinar; Guler, Seda; Selcuk, Engin Burak; Bilgin, MuzafferBackground: Studies have reported the presence of sleep disorders in approximately 50-70% of diabetic patients, and these may contribute to poor glycemic control, diabetic neuropathy, and overnight hypoglycemia. The aim of this study was to determine the frequency of sleep disorders in diabetic patients, and to investigate possible relationships between scores of these sleep disorders and obstructive sleep apnea syndrome (OSAS) and diabetic parameters (fasting blood glucose, glycated hemoglobin A1c [HbA1c], and lipid levels). Methods: We used the Berlin questionnaire (BQ) for OSAS, the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI) to determine the frequency of sleep disorders and their possible relationships with fasting blood glucose, HbA1c, and lipid levels. Results: The study included 585 type 2 diabetic patients admitted to family medicine clinics between October and December 2014. Sleep, sleep quality, and sleep scores were used as the dependent variables in the analysis. The ESS scores showed that 54.40% of patients experienced excessive daytime sleepiness, and according to the PSQI, 64.30% experienced poor-quality sleep. The BQ results indicated that 50.20% of patients were at high-risk of OSAS. HbAlc levels correlated significantly with the ESS and PSQI results (r = 0.23, P < 0.001 and r = 0.14, P = 0.001, respectively), and were significantly higher in those with high-risk of OSAS as defined by the BQ (P < 0.001). These results showed that HbAlc levels were related to sleep disorders. Conclusions: Sleep disorders are common in diabetic patients and negatively affect the control of diabetes. Conversely, poor diabetes control is an important factor disturbing sleep quality. Addressing sleep disturbances in patients who have difficulty controlling their blood glucose has dual benefits: Preventing diabetic complications caused by sleep disturbance and improving diabetes control.Öğe EFFECTS OF SLEEP QUALITY, INCOME LEVEL AND COMORBID CONDITIONS ON QUALITY OF LIFE IN A TURKISH ELDERLY POPULATION: A MULTICENTRE STUDY(Gunes Kitabevi Ltd Sti, 2015) Gunduz, Ercan; Eskin, Fatih; Gunduz, Mehmet; Bentli, Recep; Selcuk, Engin Burak; Zengin, Yilmaz; Icer, MustafaIntroduction: Our aim is to investigate the effects of sleep quality, income level and comorbid conditions on Quality of Life in a Turkish elderly population. Materials and Method: This multicentric study was performed in seven districts. A total of 1030 patients older than 65 years of age who applied to the internal medicine and geriatrics outpatient clinics of study centres between January and December 2014 were included. All patients underwent the Pittsburgh Sleep Quality Index and Quality of Life Assessment (Short Form 36) tests viaface to face interview method. The demographic properties of patients were also recorded during this interview. Results: The mean Quality of Life subscale scores, except for vitality, were significantly lower (p < 0.001) in patients with poor sleep quality. When analysing the relationship between Quality of Life and multiple chronic diseases, it was observed that patients having multiple chronic diseases had significantly lowered scores in three subscales (physical functioning, mental health and bodily pain; p=0.04, p=0.04, p=0.01, respectively). There were significant differences between patients with high versus low income level with respect to the mean physical functioning, mental health and bodily pain subscales (p=0.01). Conclusion: Our study demonstrated an adverse effect of low sleep quality, multiple chronic disorders and low income level on Quality of Life.Öğe Evaluation of Blood Glucose Profile and Perinatal Outcomes in Pregnant with Different Levels of Glucose Intolerance(Ankara Medical Journal, 2016) Selcuk, Engin Burak; Kafkaslı, Ayşe; Sertkaya, AyşeÖz: Amaç: Bu çalışmanın amacı farklı düzeylerde glukoz intoleransı gösteren gebelerde kan şekeri profilleri ve perinatal sonuçlarını karşılaştırarak gebelerin takip ve tedavilerine katkıda bulunmaktır. Materyal ve Metot: Gebe Polikliniği'ne müracaat eden 24-28. gebelik haftaları arasında ki gebelere 50 gram Glukoz Tolerans Testi (GTT) yapıldı ve sonucu pozitif olanlara 100 gram Oral Glukoz Tolerans Testi (OGTT) yapıldı. Test sonucuna göre gebeler Normal, Anormal Glukoz Tolerans Testi (AGTT) olanlar ve gestasyonel diyabeti (GDM) olanlar olarak 3 gruba ayrıldı. Her üç grupta demografik veriler, GTT ve OGTT sonuçları, doğum öncesi ve doğum sonrası kan şekeri profilleri, perinatal sonuçlar ve maternal komplikasyonlar yönünden kendi aralarında değerlendirildi. Bulgular: AGTT görülme sıklığı % 17,42 olarak bulunurken, GDM görülme sıklığı % 14,57 olarak bulundu. Gebelik öncesi ve 50 gram GTT sırasındaki vücut kitle indeksi (VKİ) yönünden karşılaştırıldığında, AGTT grubunda, normal gruba göre yüksek bulundu (p<0,05). AGTT grubunun 24 saatlik ve postpartum ilk 24 saatlik kan şekeri profilleri normal grupla karşılaştırıldığında yüksek bulundu (p<0.05). Bu değerler GDM grubunda da AGTT grubuna göre yüksek bulundu (p<0.05). Sonuç: AGTT grubunun GDM grubuna göre daha hafif şiddette, ancak normal grup ile karşılaştırıldığında anlamlı kabul edilecek kadar daha şiddetli glukoz intoleransına sahip olduğu görülmüştür. Bu nedenle AGTT saptanan gebelerin de GDM saptanan gebeler gibi yakın takibinin ve gerektiğinde tedavi edilmesinin gerek fetal komplikasyonlar, gerekse maternal komplikasyonların önlenmesi yönünden yararlı olacağı düşünülmektedir. Başlık (İngilizce): Farklı Düzeylerde Glukoz İntoleransı Bulunan Gebelerin Kan Şekeri Profilleri ve Perinatal Sonuçlarının Değerlendirilmesi Öz (İngilizce): Objectives: The aim of this study is to contribute to the monitoring and treatment in pregnant women with different levels of glucose intolerance by comparing blood glucose profiles and perinatal outcomes.Materials and Methods: A 50-gram Glucose Tolerance Test (GTT) was performed on pregnant women between 24th and 28th weeks of pregnancy who admitted to the outpatient clinic followed by a 100gram OGTT on those who tested positive with 50 g GTT. The patients were allocated into three groups according to the test results as Normal, Abnormal Glucose Challenge Test (AGCT) and Gestational Diabetes Mellitus (GDM). All groups were evaluated in terms of demographic data, GTT and OGTT results, prenatal and postnatal blood glucose profiles, maternal complications, and perinatal outcomes. Results: The prevalence of AGCT was found to be 17.42% while GDM was 14.57%. When compared as to prepregnancy and during 50 g OGTT values, the body mass index (BMI) was found significantly higher in AGTT group than the normal group (p<0.05). Twenty-four hour and postpartum first 24-hour blood glucose profiles of the AGCT group were found to be higher than the normal group (p<0.05), whereas these values were found to be significantly higher in the GDM group when compared to the AGCT group (p<0.05). Conclusion: We found that glucose intolerance in the AGCT group was slightly higher when compared to GDM group and appears to be significantly increased when compared to the normal group. Therefore, we suggest that the pregnant women with AGCT should be followed up closely and treated if needed, similar to the patients diagnosed with GDM in order to prevent both fetal and maternal complications.Öğe Evaluation of early thyroidectomy complications(Bayrakol Medical Publisher, 2022) Karatas, Turgay; Selcuk, Engin Burak; Karatas, Mehmet; Yildirim, Atilla; Ozbag, Davut; Cay, Mahmut; Senol, DenizAim: Our aim in this study is to reveal the relationships between patient findings, surgical methods and early thyroidectomy complications. Material and Methods: The files and operative notes of 308 patients who underwent thyroidectomy within 10 years were reviewed retrospectively. Gender, age, preoperative diagnosis, primary or reoperated cases, the type of thyroidectomy [ bilateral subtotal (BST), bilateral total (BTT), unilateral subtotal (UST) and unilateral total (UTT)] and early postoperative complications (hypocalcemia, bleeding, nervus laryngeus recurrens (NLR) injury, infection and seroma) were recorded. The peculiarity of this study is that NLR neuromonitoring was not used in thyroidectomy operations. Results: Of the 308 patients who underwent thyroidectomy, 287 were females and 21 were males. Two hundred eighty three cases of multinodular goiter, 18 cases of nodular goiter and 7 thyroid cancers were operated; 180 BTT, 100 BST, 17 UTT + UST, 7 UST and 4 UTT were applied. Complications were seen in a total of 20 (6.49%) patients who underwent 19 BTT and 1 BST. The only complication in BST was bleeding. There were 10 (3.24%) hypocalcemia, 4 (1.29%) bleeding, 2 (0.649%) NLR injury, 2 (0.649%) infections and 2 (0.649%) seromas. In terms of the frequency of early thyroidectomy complications, hypocalcemia was the first (P=0.0047). In addition, the rates of hypocalcemia and NLR injury were higher in reoperated patients than in primary patients (P<0.05). Discussion: The most common complication was hypocalcemia. NLR injury and hypocalcemia rates were higher in reoperated cases who underwent BTT.Öğe EVALUATION OF PSYCHIATRIST'S COMMUNICATION WITH PSYCHOSIS PATIENTS(Univ Chile, Centro Interdisciplinario Estudios Bioetica, 2022) Karatas, Mehmet; Kartalci, Sukru; Selcuk, Engin Burak; Yetis, Hakan; Karatas, Turgay; Gozukara, HarikaEvaluation of the physician-patient relationship is very important in determining priorities in medical practice and medicine. For this purpose, in this study the psychiatrist's communication with psychotic patients as a sensitive group was evaluated. A questionnaire was administered to 210 patients in a psychiatric clinic of Inonu University Hospital in Turkey to determine how the examination is performed in the facility for outpatients in the psychosis unit. According to the study conducted, it was observed that the evaluation score of the psychiatrist's communication with psychotic patients increased positively with increasing consultation duration. Our work is particularly noteworthy because it deals with a sensitive area, such as a group of psychiatric patients. The scores were obtained based on data from the evaluation of the questionnaires, which showed that the communication between the psychiatrist and the psychotic patient was conducted in a sensitive and careful manner, and without ethical problems.Öğe Evaluation of risk factors for necrotic tissue resections in elderly patients with groin hernia(Edizioni Luigi Pozzi, 2023) Karatas, Turgay; Selcuk, Engin Burak; Karatas, Mehmet; Tahtali, Ibrahim Nuvit; Yildirim, Atilla; Arslan, Ahmet KadirAim: To reveal the relationships between patient findings and tissue resection in elderly patients. Materials and methods: Between September 2020 and September 2022 three hundred eighty four patients over the age of 60 who were operated with the diagnosis of groin hernia were retrospectively analyzed. Gender, age, height, weight and body mass index value, groin and inguinal hernia types, hernia sides, primary or recurrent cases, hernia sac content, incarceration, tissue necrosis and resection presence, and accompanying pathologies were recorded. These findings were compared and evaluated in order to determine the relationships between patient findings and tissue resection, and the findings at risk for tissue resection. Results: Of the patients in the study, 352 (91.7%) were male and 32 (8.3%) were female. The mean age, height, weight and BMI were 67.48 +/- 5.893 years, 169.27 +/- 6.113 cm, 73.28 +/- 7.878 kg and 25,566 +/- 2.3518 kg/m2, respectively. There were 369 inguinal, 15 femoral, 285 indirect, 84 direct, 312 primary, and 72 recurrent hernias. Incarceration was present in 65 (16.9%) patients, 19 (4.9%) of these patients underwent resection due to tissue necrosis (twelve omentum and seven small intestine). Tissue resection was 3.1% in male, 25% in female, 4.3% in inguinal, 20% in femoral, 5.6% in indirect, 0% in direct, 3.5% in primary and 11.1% in recurrent hernias. Tissue resections were significantly higher in females, femoral hernias, indirect inguinal hernias and recurrent cases (p<0.05). Conclusions: We can say that female gender, femoral, indirect and recurrent hernias are important risk factors for tissue resection in elderly patients.Öğe Evaluation of the cardiovascular effects of varenicline in rats(Dove Medical Press Ltd, 2015) Selcuk, Engin Burak; Sungu, Meltem; Parlakpinar, Hakan; Ermis, Necip; Taslidere, Elif; Vardi, Nigar; Yalcinsoy, MuratBackground: Cardiovascular disease is an important cause of morbidity and mortality among tobacco users. Varenicline is widely used worldwide to help smoking cessation, but some published studies have reported associated cardiovascular events. Objective: To determine the cardiovascular toxicity induced by varenicline in rats. Materials and methods: We randomly separated 34 rats into two groups: 1) the control group (given only distilled water orally, n=10) and the varenicline group (given 9 mu g/kg/day varenicline on days 1-3, 9 mu g/kg twice daily on days 4-7, and 18 mu g/kg twice daily on days 8-90 [total 83 days], n=24). Each group was then subdivided equally into acute and chronic subgroups, and all rats in these groups were euthanized with anesthesia overdose on days 45 and 90, respectively. Body and heart weights, hemodynamic (mean oxygen saturation, mean blood pressure, and heart rate, electrocardiographic (PR, QRS, and QT intervals) biochemical (oxidants and antioxidants), and histopathological analyses (including immunostaining) were performed. Results: Acute varenicline exposure resulted in loss of body weight, while chronic varenicline exposure caused heart weight loss and decreased mean blood pressure, induced lipid peroxidation, and reduced antioxidant activity. Both acute and chronic varenicline exposure caused impairment of mean oxygen saturation. QT interval was prolonged in the chronic varenicline group, while PR interval prolongation was statistically significant in both the control and acute varenicline groups. Caspase-9 activity was also significantly increased by chronic exposure. Moreover, histopathological observations revealed severe morphological heart damage in both groups. Conclusion: Adverse effects of chronic varenicline exposure on cardiovascular tissue were confirmed by our electrocardiographic, biochemical, and histopathological analyses. This issue needs to be investigated with new experimental and clinical studies to evaluate the exact mechanism(s) of the detrimental effects of varenicline. Physicians should bear in mind the toxic effects of varenicline on the cardiovascular system when prescribing it for smoking cessation.Öğe Evaluation of the First Year Results of Smoking Cessation Therapy with Varenicline or Bupropion in Outpatient Clinic(Duzce Univ, 2016) Selcuk, Engin Burak; Tetik, Burcu Kayhan; Karatas, MehmetObjective: The aim of this study was to evaluate the one year efficacy of varenicline and bupropion treatment in patients admitted to smoking cessation clinic and started medical treatment. Methods: A total of 681 individuals who admitted to Smoking Cessation Outpatient Clinic in Family Medicine Department of Inonu University School of Medicine between January 2011 and May 2012, and who have been begun medical treatment. The patients invited for follow up controls on the 15th day and in the first, second, 3rd, 6th and 12th months after the medical treatment was started after the first interview. The patients were questioned for whether they were going on using the medications, for any side effects and their smoking cessation status during each visit. Results: A total of 681 subjects were enrolled in the study. In the first interview, a through physical examination was performed, routine laboratory tests were performed and then the patients were informed about smoking cessation methods by physicians who have received tobacco cessation training. In the Bupropion group 65.6% of the men (n=151) and 65% of the women (n=91) had quit smoking in the 15th day evaluation. In the follow-up at the end of the first month 75.6% of the men (n=174) and 72.1% of the women (n=101), and at the end of 12th month 64.7% of the men (n=149) and 72.8% of the women (n=102) had quit smoking. In the Vareniklin group 191 patients (61.4%) were male and 120 patients (38.6%) were female. In the 15th day evaluation 70.1% of the men (n=134) and 59.1% of the women (n=71) had quit smoking. In the follow up, at the end of the first month 74.8% of the men (n=143) and 64.1% of the women (n=77), and at the end of 12th month 63.3% of the men (n=121) and 53.3% of the women (n=64) had quit smoking. Conclusion: Given that smoking cessation process is a process of intense nicotine withdrawal symptoms, interviews should be planned as frequently as possible during the first 3 months. Continuous bio-psycho-social follow-up, which is also one of the basic characteristics of family medicine, will be an important part of success in smoking cessation.Öğe Incidence of emergency surgery in anterior abdominal wall hernias(Bayrakol Medical Publisher, 2023) Karatas, Turgay; Selcuk, Engin Burak; Karatas, Mehmet; Yildirim, Atilla; Tahtali, Ibrahim Nuvit; Arslan, Ahmet KadirAim: This prospective study was conducted to analyze the incidence of emergency surgery in anterior abdominal wall hernias (AWH). Material and Methods: A total of 659 patients with anterior AWH were examined. Patients with anterior AWH who underwent elective or emergency surgery were included in the study. In this study, groin and non-groin hernias constitute anterior AWHs. Gender, age, anesthesia and repair methods, elective and emergency surgery, hernia types, side of groin hernias, recurrent or primary hernias were determined and recorded. Emergency surgery incidences of hernias were evaluated in terms of gender, age, hernia types, groin hernia sides, primary or recurrent hernias.Results: Emergency surgery was performed in 64 patients (9.7%). The incidence of emergency surgery was found to be higher in females. In anterior AWHs, the emergency surgery incidence was found to be higher in non-groin hernias than in groin hernias (P<0.001). The emergency surgery incidence was highest in femoral hernias among groin hernias and incisional hernias in non-groin hernias. In terms of primary and recurrent cases, the emergency surgery incidence was significantly higher in recurrent cases (P<0.001). However, when the emergency surgical incidence of all anterior AWHs such as inguinal, femoral, incisional, umbilical and epigastric hernias in the study were compared, no significant difference was found among them. Discussion: Emergency surgery incidence was found to be higher in females and in recurrent cases. However, there was no significant difference in the incidence of emergency surgery among all anterior AWH types.Öğe The Knowledge Level of Medical Personnel in Turkey about Complementary Nutrition(Iranian Scientific Society Medical Entomology, 2015) Kayhan Tetik, Burcu; Bozcuk Guzeldemirci, Gamze; Kilic, Melek; Aksoy, Hilal; Sonmez, Bilge; Selcuk, Engin Burak; Tetik, Bora[Abstract Not Available]
