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https://hdl.handle.net/20.500.12428/2270

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Deep neural network ensemble for on-the-fly quality control-driven segmentation of cardiac MRI T1 mapping
(Elsevier B.V., 2021) Hann, Evan; Popescu, Iulia A.; Zhang, Qiang; Gonzales, Ricardo A.; Barutcu, Ahmet
Recent developments in artificial intelligence have generated increasing interest to deploy automated image analysis for diagnostic imaging and large-scale clinical applications. However, inaccuracy from automated methods could lead to incorrect conclusions, diagnoses or even harm to patients. Manual inspection for potential inaccuracies is labor-intensive and time-consuming, hampering progress towards fast and accurate clinical reporting in high volumes. To promote reliable fully-automated image analysis, we propose a quality control-driven (QCD) segmentation framework. It is an ensemble of neural networks that integrate image analysis and quality control. The novelty of this framework is the selection of the most optimal segmentation based on predicted segmentation accuracy, on-the-fly. Additionally, this framework visualizes segmentation agreement to provide traceability of the quality control process. In this work, we demonstrated the utility of the framework in cardiovascular magnetic resonance T1-mapping - a quantitative technique for myocardial tissue characterization. The framework achieved near-perfect agreement with expert image analysts in estimating myocardial T1 value (r=0.987, p<.0005; mean absolute error (MAE)=11.3ms), with accurate segmentation quality prediction (Dice coefficient prediction MAE=0.0339) and classification (accuracy=0.99), and a fast average processing time of 0.39 second/image. In summary, the QCD framework can generate high-throughput automated image analysis with speed and accuracy that is highly desirable for large-scale clinical applications.
A rare presentation of Susac syndrome: Report of three pediatric cases
(Elsevier B.V., 2021) Çitçi Yalçınkaya, Beyza; Ertürk Çetin, Özdem; Kılıç, Hüseyin; Demirci, Onat; Çokyaman, Turgay; Uygunoğlu, Uğur
Susac syndrome is a rare disorder that is clinically characterized by encephalopathy, retinopathy and hearing loss. Most of the reported cases in the literature are adult patients, pediatric presentation is extremely rare. Here we present three pediatric patients aged between 10-15; diagnosed as Susac syndrome. They all had thalamic involvement in addition to typical callosal lesions. All of the three patients had a monophasic course and good treatment response.
Analysis of Scientific Publications on Acinetobacter bacteremia in Web of Science
(The Turkish Society Of Clinical Microbiology and Infectious Diseases, 2021) Alkan, Sevil; Dindar Demiray, Emine Kübra; Yıldız, Emel; Özlu, Can
Objective: We aimed to investigate the literature on Acinetobacter bacteremia (AB), which is always on the agenda because of increased mortality and morbidity.Methods: We used the keywords “Acinetobacter and bacteremia” and limited our search to the journal articles. Retrieved data were analysed to present various bibliometric indicators while maps were visualised using the VOSviewer technique. Data pertaining to the growth of publications, the most active countries and institutions, the most cited journals, and the mapping of molecular mechanisms of resistance were analysed.Results: A total of 179 journal articles were retrieved, with an average of 24.68 citations per article. The annual growth of AB articles showed an increasing pattern during the study period. The articles were usually written in English (96.08%), and in 56.42% the research area was infectious diseases (56.42%). In terms of geography, three out of five countries were Asian in origin, and the leading country was Taiwan (30.72%). Conclusions: Publications on AB have been increased in the last two decades. The most of the publications on AB contributed by Taiwan and the growing numbers in Asia and the globe.
Trends of COVID 19 Vaccines: International Collaboration and Visualized Analysis
(The Turkish Society Of Clinical Microbiology and Infectious Diseases, 2021) Alkan, Sevil; Öntürk, Hatice; Alıravcı, Işıl Deniz; Sıddıkoğlu, Duygu
Objective: We aimed to evaluate the research and publication trends on the coronavirus disease (COVID-19) vaccine, and so guide future studies. Materials and Methods: A bibliometric analysis was performed using a VOSviewer visualization methodology. Information about publications Web of Science database outputs, countries, institutions, journals, keywords, and citation counts was retrieved. Results: A total of 929 eligible publications from January 1, 2020, to February 28, 2021, were derived from the WOS database according to the search criteria. Publications were written in nine languages, mainly in English (96.7%). From these results, a total of 300 articles were reached by filtering. The average number of citations was found to be 7.73. The H-index of the articles, which were cited 2320 times in total, was 22. Most of the publications were articles (32.29%) and editorials (28.09%). There were 73 different research areas, mostly in general internal medicine (26.6%) and immunology (19.05%). The United States of America produced the majority of articles (31.32%). Conclusion: This bibliometric analysis presents that publications on the COVID-19 vaccine are rapidly changing at a time when exactly the effective vaccines of COVID-19 have not been discovered yet.
Central Anticholinergic Syndrome Following Excessive Mydriatic Use in an Eight-Year-Old Patient
(Aydın Pediatric Society, 2021) Kaymaz, Nazan; Uzun, Mehmet Erdem; Battal, Fatih; Güzel, Yusuf; Aylanç, Hakan
Cyclopentolate hydrochloride, belonging to a class of drugs known as anticholinergics, is an ophthalmic solution frequently used in ophthalmology clinics because of its cycloplegic and mydriatic effects in both refractions as well as fundus examinations. After application, the maximum cycloplegic effect begins approximately after 30-60 min, which can further continue up to 24 h. Due to a dose-dependent relationship, cyclopentolate hydrochloride’s side effects can be observed both in an ocular and systemic manner which may occur if solutions more than 0.5% concentration are used. Herein, we report central anticholinergic syndrome due to the administration of excessive amounts of cyclopentolate hydrochloride in a child.
Exceptional Variant with Distant Cutaneous Metastasis as the First Clinical Sign in Gastric Signet-Ring Carcinoma
(Springer, 2022) Bulut, Ezgi; Taştekin, Ebru; Topuz, Canberk; Özturk, Sevgi; Gökyer, Ali
Objective: Skin metastases from gastric cancer are rare and usually occur very late in the course of the disease. The most common metastatic sites liver, the peritoneal surfaces, and the non regional or distant lymph nodes. Case report: In this case we report the short-term survival of a 67-year-old man complined of multiple nodular lesions in various part of his skin. Histology showed a metastatic signet ring cell adenocarsinoma. Esophagogastroduodenoscopy was performed and a crater- like ulcer, about 3 cm in diameter, was observed on the anterior part of the stomach corpus distal. A biopsy specimen was obtained, and histopathological findings were consistent with gastric signet-ring cell carcinoma. XELOX chemotherapy regimen was initiated for the patient. Conclusion: Skin metastasis of gastric adenocarcinoma is a rare condition with a poor prognosis. It may be the first manifestation of a clinically silent visceral cancer or may represent a recurrence of an internal malignancy.
New results for monogenic diabetes with analysis of causative genes using next-generation sequencing: a tertiary centre experience from Turkey
(Springer, 2021) Karakılıç, Ersen; Saygılı, Emre Sedar; Sılan, Fatma; Önduç, Gonca Gül; Ağcaoğlu, Uğurcan
Background: Although monogenic diabetes accounts for a small proportion of diabetes cases, accurate diagnosis may significantly change treatment. This study aimed to contribute to knowledge about the genotype-phenotype relationship in monogenic diabetes. Methods: This study used data from a tertiary centre in Turkey. Genetic analysis outcomes for 36 patients were evaluated. The panel included 23 genes related to maturity-onset diabetes of the young (MODY), neonatal diabetes, and some genes related to hyperglycemic hypoglycemia. The next-generation sequencing method was used after DNA isolation from the peripheral blood. Results: Mutations were identified in 19 (52.8%) of 36 patients. Of the 19 mutations, 7 (36.8%) were new mutations. A total of 20 cases met the MODY clinical criteria, and mutations were identified in 11 (55%) of them. In total, nine patients had more than one mutation. Mutations were identified on the ABCC8 (n = 7), PDX1 (n = 6), GLIS3 (n = 6), ZFP57 (n = 5), GCK (n = 4), HNF1A (n = 3), GLUD (n = 3), and HNF4A, KLF11, NKX2-2, and INSR genes (n = 1 each). Conclusion: Our findings highlight a broad clinical and genetic spectrum of MODY, and genetic analysis may provide a better understanding of diabetes and improve the individualised treatment approach.
Screening autonomic functions in patients with restless legs syndrome: A case-control study in a tertiary care hospital
(Elsevier B.V., 2022) Başaran, Şehnaz; Akıncı, Erhan
Purpose: The clinical importance of autonomic involvement in patients with restless legs syndrome (RLS) remains unclear. To our knowledge, no study has explored the relationship between autonomic dysfunction and disease-related variables in patients with RLS. Therefore, this study aimed 1) to determine the presence of autonomic symptoms in drug-naïve patients with RLS in comparison with healthy controls using Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT) questionnaire and 2) to evaluate the possible associations of autonomic dysfunction with clinical factors in RLS. Methods: A total of 70 drug-naïve patients with RLS and 85 healthy volunteers were enrolled. The SCOPA-AUT questionnaire and Epworth Sleepiness Scale (ESS) scores were used to determine autonomic functions and sleep propensity, respectively. Moreover, the International Restless Legs Syndrome Study Group rating scale was used to evaluate disease severity in the patient group. Results: Compared with the control group, the RLS group had significantly higher subscale scores (gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual [women]) and total scores of the SCOPA-AUT questionnaire (p < 0.05). In the patient group, there was a significant correlation between the total scores and subscale scores (gastrointestinal, cardiovascular, and thermoregulatory subscales) of the SCOPA-AUT questionnaire and disease severity. Moreover, ESS was positively correlated with the total scores and subscale scores (urinary, cardiovascular, and pupillomotor) of the SCOPA-AUT questionnaire. Conclusion: Disease severity and daytime sleepiness may be related to autonomic dysfunction in RLS. Further studies focusing on autonomic functions in RLS are required to improve management strategies and clinical outcomes.
Silence After The Storm; A Case of Bickerstaff’s Brainstem Encephalitis
(T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi, 2021) Tekin, Emine; Çokyaman, Turgay; Taşdemir, Haydar Ali; Özyürek, Hamit
A pediatric case with Bickerstaff’s brainstem encephalitis (BBE), which is a very rare monophasic post-infectious condi- tion characterized by central nervous system involvement, unconsciousness, ophthalmoplegia and ataxia, is presented. Twelve years old patient was brought with difficulty in eye movements and ataxia. On the second day, she became agitated and lethargic, and then bulbar palsy and whole body paralysis developed. Upper motor neuron involvement was evident. Routine biochemical parameters and serologic tests, cranial magnetic resonance imaging, lumbar puncture, autoimmune, paraneoplastic, and electrophysiological studies were evaluated. All were normal except for the encephalopathic first electroencephalography (EEG) and the EEG repeated on the 25th day was reported to be normal. Anti-ganglioside antibody, anti-GQ1b was found positive. Intravenous immunoglobulin (IVIG) started on the fourth day. A very rapid improvement was seen in the first week of IVIG treatment. She was able to walk in the second week. She was completely normal in 3 months. Although seven years passed, our patient has not had any relapse or neurological deficit. We presented a case diagnosed as BBE treated successfully with single dose intravenous Immunoglobulin. We wanted to emphasize that BBE has a good prognosis even though it is an acutely developing severe condition.
Mortality analysis of COVID-19 infection in chronic kidney disease, haemodialysis and renal transplant patients compared with patients without kidney disease: a nationwide analysis from Turkey
(Oxford University Press, 2021) Özturk, Savaş; Turgutalp, Kenan; Arıcı, Mustafa; Odabaş, Ali Rıza; Altıparmak, Mehmet Rıza; Aydın, Zeki; Bakırdöğen, Serkan
Background. Chronic kidney disease (CKD) and immunosuppression, such as in renal transplantation (RT), stand as one of the established potential risk factors for severe coronavirus disease 2019 (COVID-19). Case morbidity and mortality rates for any type of infection have always been much higher in CKD, haemodialysis (HD) and RT patients than in the general population. A large study comparing COVID-19 outcome in moderate to advanced CKD (Stages 3-5), HD and RT patients with a control group of patients is still lacking. Methods. We conducted a multicentre, retrospective, observational study, involving hospitalized adult patients with COVID-19 from 47 centres in Turkey. Patients with CKD Stages 3-5, chronic HD and RT were compared with patients who had COVID-19 but no kidney disease. Demographics, comorbidities, medications, laboratory tests, COVID-19 treatments and outcome [in-hospital mortality and combined in-hospital outcome mortality or admission to the intensive care unit (ICU)] were compared. Results. A total of 1210 patients were included [median age, 61 (quartile 1-quartile 3 48-71) years, female 551 (45.5%)] composed of four groups: Control (n = 450), HD (n = 390), RT (n = 81) and CKD (n = 289). The ICU admission rate was 266/ 1210 (22.0%). A total of 172/1210 (14.2%) patients died. The ICU admission and in-hospital mortality rates in the CKD group [114/289 (39.4%); 95% confidence interval (CI) 33.9-45.2; and 82/289 (28.4%); 95% CI 23.9-34.5)] were significantly higher than the other groups: HD = 99/390 (25.4%; 95% CI 21.3-29.9; P<0.001) and 63/390 (16.2%; 95% CI 13.0-20.4; P<0.001); RT = 17/81 (21.0%; 95% CI 13.2-30.8; P = 0.002) and 9/81 (11.1%; 95% CI 5.7-19.5; P = 0.001); and control = 36/450 (8.0%; 95% CI 5.8-10.8; P<0.001) and 18/450 (4%; 95% CI 2.5-6.2; P<0.001). Adjusted mortality and adjusted combined outcomes in CKD group and HD groups were significantly higher than the control group [hazard ratio (HR) (95% CI) CKD: 2.88 (1.52- 5.44); P = 0.001; 2.44 (1.35-4.40); P = 0.003; HD: 2.32 (1.21- 4.46); P = 0.011; 2.25 (1.23-4.12); P = 0.008), respectively], but these were not significantly different in the RT from in the control group [HR (95% CI) 1.89 (0.76-4.72); P = 0.169; 1.87 (0.81-4.28); P = 0.138, respectively]. Conclusions. Hospitalized COVID-19 patients with CKDs, including Stages 3-5 CKD, HD and RT, have significantly higher mortality than patients without kidney disease. Stages 3-5 CKD patients have an in-hospital mortality rate as much as HD patients, which may be in part because of similar age and comorbidity burden. We were unable to assess if RT patients were or were not at increased risk for in-hospital mortality because of the relatively small sample size of the RT patients in this study.
Ways of coping with pain in the elderly
(Springer Heidelberg, 2013) Tanrıverdi, Gülbu; Özışık Karaman, Handan Işın; Okanlı, Ayşe; Çetin, H.; Özyazıcıoğlu, N.
Health-related quality of life of nursing student's with or without premenstrual syndrome
(Wiley, 2016) Özkan, Arife; Tanrıverdi, Gülbu; Özenli, Yarkın; Bakar, Coşkun; Özışık Karaman, Handan Işın
The application of traditional medicine in epilepsy: Canakkale sample
(Springer Heidelberg, 2013) Tanrıverdi, Gülbu; Yalçın Gürsoy, Melike; Şen, Halil Murat; Özışık Karaman, Handan Işın
Paradoxical Radiologic Progression Despite Appropriate Anti-Tuberculous Therapy
(Ankara Microbiology Soc, 2012) Gönlügür, Uğur; Koşar, Şule; Mirici, Arzu
Clinical or radiological deterioration of tuberculosis despite appropriate anti-tuberculous therapy is defined as paradoxical response. Since identification of paradoxical response presents difficulties, this issue is not only of medical importance but also of legal importance. In this report, a tuberculosis case who got worse paradoxically during the course of anti-tuberculous therapy, was presented. Human immunodeficiency virus (HIV)-negative 68-year-old male patient was admitted to the hospital with the complaints of cough, chest pain, and weight loss. Computed tomography of the chest revealed an irregular non-homogenous opacity involving the apical and posterior segments of superior lobe of the right lung. Since acid-fast bacilli were detected in the sputum sample, active pulmonary tuberculosis was diagnosed and four-drug regimen treatment (isoniazid 300 mg/day, rifampicin 600 mg/day, pyrazinamide 2 g/day, etambutole 1.5 g/day) was initiated. At the end of the first month of therapy radiological lesions increased. There was no endobronchial lesion on bronchoscopy, and no acid-fast bacilli in bronchial lavage fluid. Therapy protocol was not changed, however radiological lesions regressed gradually. It was concluded that temporary deteriorations might occur in previous pulmonary infiltrates in patients who were under appropriate anti-tuberculous therapy. The gold standard for monitorization of anti-tuberculous therapy is microbiological methods rather than the radiological ones. Comorbid conditions, drug reactions, patient compliance and treatment failure are important parameters in the differential diagnosis. This case was presented to emphasize the importance of tuberculosis which is still prevalent in Turkey.
SUBJECTIVE SLEEP QUALITY IN PREMENSTRUAL SYNDROME
(Wiley-Blackwell, 2011) Özışık Karaman, Handan Işın; Tanrıverdi, Gülbu; Değirmenci, Yıldız
Porous and modified HA particles as potential drug delivery systems
(Elsevier Science Bv, 2012) Şahiner, Nurettin; Sılan, Coşkun; Sağbaş, Selin; Ilgın, Pınar; Bütün, Sultan; Erduğan, Hüseyin; Ayyala, Ramesh S.
Composite silica-hyaluronic acid (Si-HA) micro particles were synthesized, employing tetraethyl orthosilicate (TEOS) in the presence of linear HA and a crosslinker, divinyl sulfone (DVS) via a water-in-oil microemulsion polymerization technique. Porous HA (PHA) hydrogel particles were generated after removal of silica particles upon treatment of HA composites with hydrofluoric acid (FIF). Furthermore, HA particles were quaternized (QHA) by chemical modification using 3-chloro-2-hydroxypropyl trimethyl ammonium chloride as a quarternization agent. The size of HA based particles were ranged between 1.26 and 2.95 mu m. The PHA particles have a surface area of 2.7 m(2)/g confirmed by the surface area measurements. Modified HA particles were used in the absorption and release studies of two model drugs in PBS, trimethoprim (TMP) and sodium diclofenac (SDF) which are acidic and basic in nature, respectively. The ability to control the size, charge and porosity of the HA particles which showed almost linear drug release profiles. (C) 2012 Elsevier Inc. All rights reserved.
The impact of neuropsychiatric burden on Restless Legs Syndrome (RLS) disease severity
(Elsevier, 2025) Kılınçarslan, Mehmet Göktuğ; Ocak, Özgül; Şahin, Erkan Melih
Objective: In patients with Restless Legs Syndrome (RLS), neuropsychiatric comorbidities like anxiety, depression, and somatization are common, yet the precise connection between somatization and RLS severity remains unclear. This study aims to elucidate the influence of neuropsychiatric comorbidities on RLS severity, focusing particularly on the role of somatization. Methods: This cross-sectional analytical study was conducted at a tertiary hospital. All 113 RLS patients who followed in neurology clinic for at least a year were invited, and 87 participated. Data collection included sociodemographic details, the International Restless Legs Syndrome Study Group rating scale (IRLS), the Beck Depression Inventory, Beck Anxiety Scale, and Somatization Scale. Elastic-net regularized path analysis was used as the statistical method. Results: Among the 87 participants (70.1 % female, mean age 52.5 +/- 13.2 years), the mean duration of RLS diagnosis was 4.95 +/- 4.53 years. Univariate statistics revealed positive correlations among RLS severity, anxiety, depression, and somatization. Path analysis showed that somatization was associated with RLS severity (p = 0.014). Anxiety had no direct effect on RLS severity but influenced it indirectly through its positive association with somatization (p < 0.001). Depression was found to have no effect on RLS severity, either directly or through somatization. Conclusions: The relationship between anxiety and RLS severity is mediated by somatization. Furthermore, the association between RLS severity and somatization appears to be more significant than previously recognized, highlighting the importance of considering somatization in addressing the neuropsychiatric burden of RLS patients.
P(4-VP) based nanoparticles and composites with dual action as antimicrobial materials
(Elsevier Science Bv, 2010) Özay, Özgür; Alper Akçalı; Tatman Otkun, Müşerref; Sılan, Coşkun; Aktaş, Nahit; Şahiner, Nurettin
Polymeric 4-VP (p(4-VP)) particles were synthesized in an oil-in-water microemulsion system using various amounts of ethylene glycol dimethacrylate (EGDMA) as crosslinker. The prepared p(4-VP) particles were chemically modified to obtain positively charged particles as polyelectrolytes. Furthermore, these p(4-VP) particles were used for in situ Ag and Cu metal nanoparticle syntheses to provide dual action with an additional advantage as bactericidal particles. The synthesized p(4-VP) particles with positive charges and metal constituents were tested for potential antibacterial action against various bacteria such as Staphylococcus aureus ATCC6538, Pseduomonas aeruginosa ATCC9027, Bacillus subtilis ATCC6633, Escherichia coli ATCC8739. It was found that p(4-VP) particles, especially the positively charged forms had potential as antibacterial materials. The synthesized particle dimensions were characterized with TEM, and DLS measurements. Chemical modification of the particles was confirmed by FT-IR spectroscopy and zeta potential measurements, and the metal nanoparticle contents were determined with thermogravimetric (TGA) studies. (C) 2010 Elsevier B.V. All rights reserved.
Epilepside Geleneksel Tıp Uygulamaları: Çanakkale Örneği
(Kare Publ, 2013) Tanrıverdi, Gülbu; Yalçın Gürsoy, Melike; Şen, Halil Murat; Özışık Karaman, Handan Işın
Objectives: The aim of this study was to define known Traditional Medicine (TM) practices in the city center of Canakkale. Methods: This descriptive research was conducted with patients aged 18 and above. The sample calculation formula for a known population was used. There were 553 individuals included in this study. Permissions were obtained from the relevant institutions. The data obtained by the researchers was generated using a face-to-face interview method, which was collected using a questionnaire over five months. The data was evaluated with SPSS 13. Results: In the study, 3.1% (n=17) of participants suffered from epilepsy either themselves or had at least one family member (mother, father, or siblings) with epilepsy; 8.3% (n=46) of the participants' second degree relatives suffered with epilepsy; 6% (n=33) had friends or neighbors that had been diagnosed with epilepsy; and 26.4% (n=146) of the participants knew of at least one TM method of how to cope with epilepsy. Conclusion: Health care professionals need to know the cultural characteristics of the society they are working in and be aware of TM methods used in order to increase the chances of success in treating patients with epilepsy.
Reliability and Validity of the Turkish versions of the Davos Assessment of Cognitive Biases Scale (DACOBS) and Cognitive Biases Questionnaire for Psychosis (CBQp)
(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2024) Korkmaz, Şükrü Alperen; Keleş Altun, İlkay; Sağbaş, Serap; Köksalan, Fatmagül Eda; Atagün, Murat İlhan
Introduction: Cognitive biases can be defined as dysfunctional patterns of thought formation that lead to incorrect conclusions and abnormal perceptions and are critical factors in the development and maintenance of psychosis. Two self-report measures assessing cognitive biases in psychosis spectrum disorder (PSD) have recently been developed: the Davos Assessment of Cognitive Biases Scale (DACOBS) and the Cognitive Biases Questionnaire for Psychosis (CBQp). This study aimed to validate the Turkish versions of the DACOBS and CBQp. Methods: The sample consisted of 171 patients with PSD and 162 age and sex-matched healthy controls (HC). We investigated I) the factor structure with confirmatory factor analysis (CFA), II) the reliability (internal consistency and test-retest reliability), III) discriminative power, IV) convergent validity, and V) the concurrent validity of DACOBS and CBQp. Results: The 7-factor solution for DACOBS, similar to the original study, and the 5-factor solution for CBQp provided the best fit. DACOBS and CBQp total and their subscale scores showed good internal consistency and test-retest reliability. DACOBS and CBQp total and their subscale scores could differentiate between PSD patients and HCs when controlling for age, sex, and education. DACOBS and CBQp showed a positively moderate correlation. DACOBS and CBQp scores were associated with psychotic symptoms in PSD patients and positive psychic experiences in HCs. Conclusions: Both the DACOBS and the CBQp have good psychometric properties and are suitable instruments for assessing cognitive biases in the Turkish population. The Turkish versions of the DACOBS and CBQp were as reliable and valid as the original.

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