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Article Correlation of Clinical Signs and Magnetic Resonance Imaging Findings in Patients With Lumbar Spondylosis(Turkish League Against Rheumatism, 2023) Altan, Lale; Ökmen, Burcu Metin; Tuncer, Tiraje; Sindel, Dilşad; Çay, Hasan Fatih; Hepgüler, Simin; Uğurlu, HaticeObjectives: The purpose of the study was to contribute further to this debated topic by investigating the correlation of magnetic resonance imaging (MRI) findings with the clinical picture in lumbar spondylosis patients. Patients and methods: This multicenter retrospective study (as part of the epidemiological project of the TLAR-OASG [Turkish League Against Rheumatism-Osteoarthritis Study Group]) included 514 patients (101 males, 413 females; mean age: 63.6±10.8 years; range, 40 to 85 years) who were diagnosed as lumbar spondylosis by clinical examination and direct X-ray between December 2016 and June 2018. Demographic characteristics of patients, Visual Analog Scale for pain, presence of radiating pain, Roland-Morris disability questionnaire, straight leg raise test, deep tendon reflexes, neurogenic intermittent claudication symptoms, any decrease of muscle strength, and abnormality of sensation were recorded. Lumbar MRI findings of the patients were recorded as positive or negative in terms of disc herniation, intervertebral disc degeneration, root compression, osteophytes, spinal stenosis. Statistical analysis was done to assess the correlation between the clinical symptoms, physical examination, and MRI findings. Results: Correlation analysis of the MRI results and the clinical findings showed a significant correlation between straight leg raise test and root compression (p<0.001, r=0.328) and a significant correlation between neurogenic intermittent claudication and spinal stenosis (p<0.001, r=0.376). Roland-Morris disability questionnaire had a significant correlation with all MRI findings (p<0.05, r<0.200). Conclusion: The results of this study corroborate the notion that diligent patient history and physical examination are more valuable than MRI findings, even though a higher incidence of abnormal MRI findings have been obtained in patients with disability and dermatomal radiating pain.Article Citation - WoS: 9Citation - Scopus: 10Impact of Hospital-Acquired Acute Kidney Injury on Covid-19 Outcomes in Patients With and Without Chronic Kidney Disease: a Multicenter Retrospective Cohort Study(Tubitak Scientific & Technological Research Council Turkey, 2021) Ozturk, Savas; Turgutalp, Kenan; Arıcı, Mustafa; Çetinkaya, Hakkı; Altıparmak, Mehmet Rıza; Aydın, Zeki; Ateş, KenanBackground/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and methods: HA-AKI development was assessed in a group of stage 3–5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47–73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9–44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9–33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients.Key words: Acute kidney injury, chronic kidney disease, Covid-19, hospitalization, mortalityArticle Citation - WoS: 1Citation - Scopus: 1Karotis Arter Stentlemesinin Etkinliği ve Güvenliği: Tek Merkez Deneyimi(Kare Publ, 2020) Karaduman, Bilge Duran; Karaduman, Bilge Duran; Ayhan, Hüseyin; Ayhan, Hüseyin; Keles, Telat; Bozkurt, Engin; Karaduman, Bilge Duran; Ayhan, HüseyinAmaç: İnternal karotis arterdeki orta ve şiddetli darlıklar tüm inmelerin %10–15’ine neden olmaktadır. Bu çalışmada, üçüncü basamak bir referans merkezde karotis arter stentlemesinin (KAS) güvenliğini ve kısa dönem etkinliğini değerlendirmeyi amaçladık. Yöntemler: Üçüncü basamak merkezimizde Ocak 2017 ile Mayıs 2018 arasında KAS uygulanan hastalar geriye dönük olarak değerlendirildi. KAS uygulanan 145 hasta çalışmaya dahil edildi. Bulgular: Hastaların ortalama yaşı 70.1±8.6 yıl idi ve tüm grubun %75.2’si erkek olup %37.9’unda hipertansiyon mevcuttu. Hastaların 81’i (%55.9) semptomatik, 64’ü (%44.1) asemptomatik olarak gruplandırıldı. Semptomatik hastalarda koroner girişimler daha çok KAS sonrası (%38.9) yapılırken, asemptomatik grupta ise KAS öncesi (%25.9) ve sonrasında (%25.9) benzer oranlarda yapıldığı görüldü ama gruplar arasında istatistiksel fark yoktu. Semptomatik hastalarda (%59.2), asemptomatik hastalarda (%78.7) olduğu gibi distal emboli koruyucu cihaz (EKC), proksimal EKC’ye göre daha fazla kullanıldı. Ancak proksimal EKC, semptomatik hastalarda asemptomatik hastalara kıyasla anlamlı olarak daha fazla kullanıldı. Hastane içi ölüm görülmedi ve tüm popülasyonda 5 (%3.4) hastada inme veya geçici iskemik atak (GİA) gözlendi. Asemptomatik grupta GİA veya inme gözlenmedi, semptomatik grupta 2 hastada (%2.4) inme ve 3 hastada (%3.7) GİA görüldü. Sonuç: Bu çalışma kabul edilebilir komplikasyon oranları ile KAS’ın güvenirliğini ve uygulanabilirliğini ortaya koymuştur. KAS prosedürü, deneyimli girişimciler tarafından optimal tıbbi tedavi altında, agresif risk modifikasyonu ile EKC kullanılarak, uygun hastalarda en az komplikasyonla gerçekleştirilmelidir.Article Citation - Scopus: 5Real-World Data From Turkey: Is Sofosbuvir/Ledipasvir With or Without Ribavirin Treatment for Chronic Hepatitis C Really Effective?(AVES, 2021) Demirtürk,N.; Aygen,B.; Çelik,İ.; Mıstık,R.; Akhan,S.; Barut,Ş.; Doğan,N.Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice. Methods: Data from patients with chronic hepatitis C treated with SOF/LDV ± RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed. Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 ± 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV ± RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect. Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV ± RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment. © Copyright 2021 by The Turkish Society of Gastroenterology • Available online at turkjgastroenterol.orgArticle Citation - WoS: 3Citation - Scopus: 5Investigation of the Effect of Hyperthyroidism on Endoplasmic Reticulum Stress and Transient Receptor Potential Canonical 1 Channel in the Kidney(Tubitak Scientific & Technological Research Council Turkey, 2021) Aykanat, Nuriye Ezgi Bektur; Şahin, Erhan; Kaçar, Sedat; Bağcı, Rıdvan; Karakaya, Şerife; Dönmez, Dilek Burukoğlu; Şahintürk, VarolBackground/aim: Hyperthyroidism is associated with results in increased glomerular filtration rate as well as increased renin-angiotensin-aldosterone activation. The disturbance of Ca2+ homeostasis in the endoplasmic reticulum (ER) is associated with many diseases, including diabetic nephropathy and hyperthyroidism. Transient receptor potential canonical 1 (TRPC1) channel is the first cloned TRPC family protein. Although it is expressed in many places in the kidney, its function is uncertain. TRPC1 is involved in regulating Ca2+ homeostasis, and its upregulation increases ER Ca2+ level, activates the unfolded protein response, which leads to cellular damage in the kidney. This study investigated the role of TRPC1 in the kidneys of hyperthyroid rats in terms of ER stress markers that are glucose-regulated protein 78 (GRP78), activating transcription factor 6 (ATF6), (protein kinase R (PKR)-like endoplasmic reticulum kinase) (PERK), Inositol-requiring enzyme 1 (IRE1). Materials and methods: Twenty male rats were assigned into control and hyperthyroid groups (n = 10). Hyperthyroidism was induced by adding 12 mg/L thyroxine into the drinking water of rats for 4 weeks. The serum-free T3 and T4 (fT3, fT4), TSH, blood urea nitrogen (BUN), and creatinine levels were measured. The histochemical analysis of kidney sections for morphological changes and also immunohistochemical and western blot analysis of kidney sections were performed for GRP78, ATF6, PERK, IRE1, TRPC1 antibodies. Results: TSH, BUN, and creatinine levels decreased while fT3 and fT4 levels increased in the hyperthyroid rat. The morphologic analysis resulted in the capillary basal membrane thickening in glomeruli and also western blot, and immunohistochemical results showed an increase in TRPC1, GRP78, and ATF6 in the hyperthyroid rat (p < 0.05). Conclusion: In conclusion, in our study, we showed for the first time that the relationship between ER stress and TRPC1, and their increased expression caused renal damage in hyperthyroid rats.Key words: Hyperthyroidism, endoplasmic reticulum (ER) stress, transient receptor potential canonical 1 (TRPC1), kidney, ratReview Citation - WoS: 3Citation - Scopus: 4Akciğer Kanserinde İmmünoterapi ve Tedavide Multidisipliner Yaklaşım(Turkish Assoc Tuberculosis & Thorax, 2020) Karadurmuş, Nuri; Kaya, Akın; Göksel, Tuncay; Yılmaz, Ülkü; Tülek, NeclaAkciğer kanseri dünya genelinde kanserle ilişkili ölümlerin başlıca nedeniolmaya devam etmektedir. Son 20 yılda kanser biyolojisi ve patogenezi hakkındaki bilgiler artmış, immün kontrol noktası inhibitörleri (İKNİ) kullanımasunulmuş ve böylece solid kanserlerin tedavisinde önemli bir dönem başlamıştır. Bu derlemede; tedavide yenilikler, immünoterapi ve tedavide multidisipliner yaklaşım çerçevesinde akciğer kanseri ele alınmıştır. Küçük hücreli dışıakciğer kanseri (KHDAK) en sık görülen ve özellikleri nedeniyle İKNİ tedavisinden ideal olarak yararlanabilecek akciğer kanseri türü olması nedeniyleyazının odak noktasını oluşturmuştur. Bu derleme, akciğer kanseri tedavisindeimmünoterapi yaklaşımının göğüs hastalıkları başta olmak üzere tüm branşlarda multidisipliner farkındalığını artırmayı ve yönetimi hakkında bilgi sağlamayıamaçlayan ilk Türkçe derlemedir. Ayrıca bu derleme, KHDAK tedavisinde İKNİkullanımına ilişkin son klinik çalışmaların dikkat çekici sonuçlarını sunmasıaçısından önem teşkil etmektedir. İmmünoterapi kanser tedavisinde yeni bir dönem başlatmıştır ve İKNİ tedavisinin kendine özgü etki mekanizması yeni bazı advers olay grubunun ortaya çıkmasına nedenolmuştur, bunlar arasında pnömonitis özellikle önemlidir ve advers olaylar konusunda gerektiğinde hastaların ilgili uzmanlık dalları ilekonsülte edilmesi gerekmektedir. Akciğer kanserinde tedavi, hastanın özellikleri, histolojik özellikler, genetik durum göz önünde bulundurularak her bir hastaya özel planlanmalı ve akciğer kanserli bir hastanın tanısal değerlendirilmesi ve en uygun şekilde tedavisi içingöğüs hastalıkları, göğüs cerrahisi, tıbbi onkoloji, radyasyon onkolojisi, patoloji ve radyoloji uzmanlık dalları arasında işbirliği sağlanmalıdır. Bununla birlikte, aile hekimleri de akciğer kanserinin erken tanınmasında ve ayrıca hastalarını tütün bırakmayı teşvik ederekkanserin önlenmesinde önemli rol oynayabilirler. Ayrıca, toplumda farkındalık yaratmak ve erken tanı için akciğer kanseri yönündentarama çalışmaları yapmak hedeflenmelidirArticle Citation - WoS: 3Citation - Scopus: 3Characterization of Mesenchymal Stem Cells in Mucolipidosis Type Ii (i-Cell Disease)(Tubitak Scientific & Technological Research Council Turkey, 2019) Köse, Sevil; Kaya, Fatima Aerts; Kuşkonmaz, Bülent Barış; Çetinkaya, Duygu UçkanMucolipidosis type II (ML-II, I-cell disease) is a fatal inherited lysosomal storage disease caused by a deficiency of theenzyme N-acetylglucosamine-1-phosphotransferase. A characteristic skeletal phenotype is one of the many clinical manifestationsof ML-II. Since the mechanisms underlying these skeletal defects in ML-II are not completely understood, we hypothesized that adefect in osteogenic differentiation of ML-II bone marrow mesenchymal stem cells (BM-MSCs) might be responsible for this skeletalphenotype. Here, we assessed and characterized the cellular phenotype of BM-MSCs from a ML-II patient before (BBMT) and afterBM transplantation (ABMT), and we compared the results with BM-MSCs from a carrier and a healthy donor. Morphologically, wedid not observe differences in ML-II BBMT and ABMT or carrier MSCs in terms of size or granularity. Osteogenic differentiation wasnot markedly affected by disease or carrier status. Adipogenic differentiation was increased in BBMT ML-II MSCs, but chondrogenicdifferentiation was decreased in both BBMT and ABMT ML-II MSCs. Immunophenotypically no significant differences were observedbetween the samples. Interestingly, the proliferative capacity of BBMT and ABMT ML-II MSCs was increased in comparison to MSCsfrom age-matched healthy donors. These data suggest that MSCs are not likely to cause the skeletal phenotype observed in ML-II, butthey may contribute to the pathogenesis of ML-II as a result of lysosomal storage-induced pathology.Article Surgical Treatment of a Patient With Recurrent Bleb Leak and Glaucoma: Bleb Excision Combined With Gonioscopy-Assisted Transluminal Trabeculotomy(Galenos Publ House, 2022) Boluk, Ceyda Eristi; Aktas, ZeynepHere we present a case of intermittent bleb leakage with increased intraocular pressure (IOP) during recovery periods that was treated with gonioscopy-assisted transluminal trabeculotomy (GATT) combined with avascular bleb excision. A 60-year-old woman exhibiting simultaneous leaking bleb and glaucoma underwent GATT and bleb revision. At her final visit, the bleb leakage had resolved and IOP was under control without any further antiglaucoma medication. GATT may be useful for glaucoma patients exhibiting intermittent bleb leakage after failed trabeculectomy.Article Citation - WoS: 13Citation - Scopus: 13Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experience(Kare Publ, 2020) Karaduman, Bilge Duran; Kayaoğlu, Hüseyin Ayhan; Keleş, Telat; Bozkurt, EnginObjective: Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement. Our study aimed to evaluate the implementation of TAVI at our large-volume center, having an all-comer patient population with short and long-term follow-ups. Methods: This retrospective, single-center analysis included 556 consecutive patients with symptomatic severe aortic stenosis (AS) who underwent TAVI between July 2011 and December 2019. Results: The mean age of the entire population was 77.6±7.9 years, and 54.9% were women. The Society of Thoracic Surgeons (STS) mean score of the cohort was 6.0%±3.5%. The balloon-expandable valve (Sapien XT, Sapien 3; Edwards Lifesciences, Irvine, California) was the most frequently used valves in this cohort (94.6%). Transfemoral access was used in 96.3% of patients. Implantation success was achieved in 96.6% of cases. During the TAVI procedure, 7.2% of patients required permanent pacemaker implantation, with 37.5% in the Lotus valve group needing the most permanent pacemakers. The mean length of hospital stay for the entire cohort was 4.5±2.3 days. Overall, 22 (3.9%) in-hospital deaths occurred before hospital discharge. The mean follow-up period was 15.1±14.9 months for all patients, and a significant improvement was noted in all echocardiographic parameters and functional capacity. Paravalvular leak (PVL) was documented in 18.9% patients, mild in 17.9%, and moderate in 1% at discharge. No cases with severe PVL, necessitating additional procedures. The multiple logistic regression analysis revealed that sex, STS score, baseline SYNTAX score, bicuspid valve morphology, common femoral artery diameter, and post-TAVI PVL were independent predictors of overall mortality. Conclusion: To our knowledge, this study, which is the largest single-center real-world experience of TAVI in Turkey, demonstrated low complication rates with favorable short- and mid-term THV performance in patients undergoing TAVI.Article Citation - WoS: 2Citation - Scopus: 3The Clinical, Functional, and Radiological Features of Hand Osteoarthritis: Tlar-Osteoarthritis Multi-Center Cohort Study(Turkish League Against Rheumatism, 2022) Duruoz, Mehmet Tuncay; Gursoy, Didem Erdem; Tuncer, Tiraje; Altan, Lale; Ayhan, Figen; Bal, Ajda; Ugurlu, HaticeObjectives: This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population. Patients and methods: Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6 +/- 9.8 years) with hand OA were included in the study from 26 centers across Turkiye by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [ VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruoz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA. Results: The DHI had significant correlations with VAS- pain (r= 0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p= 0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p= 0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all). Conclusion: In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades.
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