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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only test(KU yayınevi, 2024-12-30) bir, bir; test, test; Çanak, Tuba Akbaytürk; Department of Molecular Biology and Genetics; College of EngineeringjjlkjlşkkşlkşlşlkşkşlkPublication Metadata only An alarming emergence of measles in Europe: gaps and future directions(Galenos Publ House, 2024) Ozsurekci, Yasemin; Ergönül, Önder; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of MedicineN/APublication Metadata only Clinical, radiological, and surgical outcomes of 431 patients with adrenal incidentalomas: retrospective study of a 10-year single-center experience(Tubitak Scientific & Technological Research Council Turkey, 2024) Imga, Narin Nasiroglu; Aslan, Yilmaz; Catak, Merve; Tuncel, Altug; Berker, Dilek; N/A; Aykanat, İbrahim Can; N/A; Koç University HospitalBackground/aim: The incidence of adrenal tumors is increasing due to the widespread utilization of radiographic imaging techniques. Factors such as tumor size, radiological characteristics, and functionality of adrenal adenomas play crucial roles in diagnosis and subsequent management. In this retrospective study, we investigated the clinical, radiological, and surgical features of patients with adrenal incidentalomas (AIs) and evaluated their follow-up results. Materials and methods: We analyzed data from 431 patients diagnosed with AIs (130 males, 301 females) who underwent adrenal hormone evaluation at our center. We compared nonfunctioning and functioning AIs in terms of radiological features. We also compared baseline and follow-up characteristics in nonfunctioning AIs. Results: The mean age of the patients was 55.4 +/- 11.5 years, with a mean tumor size of 25.9 +/- 14.3 mm. Mean follow-up duration was 3.17 +/- 2.07 years. Adenoma localization revealed 165 (38.3%) right-sided, 185 (42.9%) left-sided, and 81 (18.8%) bilateral cases. Most patients (76.6%) had nonfunctioning AIs. During follow-up, nonfunctioning AIs exhibited increased fasting blood glucose, fasting insulin and HOMA-IR values (p = 0.002, <0.001 and 0.004, respectively). Among the functioning AIs cases (23.4%), autonomous cortisol secretion, Cushing's syndrome, pheochromocytoma, and primary aldosteronism were observed in 10.4%, 5.1%, 3.9%, and 3.9% of cases, respectively. Receiver operating characteristic curve analysis determined an adrenal adenoma size of 26.5 mm as the optimal cut-off for distinguishing between functioning and nonfunctioning AIs, with a sensitivity and specificity of 61.4% and 70.0%, respectively. Conclusion: Although the majority of AIs are nonfunctioning, the prevalence of functioning adrenal adenomas is not rare. Our findings suggest that adenoma size emerges as a valuable predictor for early detection of functioning adenomas. In addition, smaller masses appear to carry a lower risk of malignancy.Publication Metadata only Letter to the editor regarding "effect of propolis on precocious puberty in female rats" - does propolis induce thelarche and gynecomastia in prepubertal children?(Galenos Publ House, 2023) Ağladıoğlu, Sebahat Yılmaz; Eviz, Elif; Yeşiltepe Mutlu, Rahime Gül; Hatun, Şükrü; School of Medicine; Koç University HospitalPublication Metadata only Current management of Type 1 diabetes in children: guideline-based expert opinions and recommendations(Galenos Yayınevi, 2024) Smart, Carmel; Hanas, Ragnar; Hatun, Şükrü; Gökçe, Tuğba; Can, Ecem; Eviz, Elif; Karakuş, Kağan Ege; Yeşiltepe Mutlu, Rahime Gül; School of Medicine; Koç University HospitalSuccessful management of type 1 diabetes (T1D) requires not only optimal glycemic outcomes, but also a holistic approach that encompasses all aspects of life and recommendations to address needs. Current goals include optimal glycemic values, quality of life and life expectancy similar to peers, prevention of long-term complications, prevention of severe hypoglycemia as far as possible and facilitation of glucose management. The International Society for Pediatric and Adolescent Diabetes (ISPAD) has been updating its guidelines for diabetes care every four years since 1995, covering more and more topics. For optimal metabolic outcomes, diabetes teams need to follow these current recommendations, adapt them to their clinical practice and provide guidance to people with T1D and their families. In this review, in the light of ISPAD 2018-2022 guidelines and clinical experiences, "10 Key Recommendations", emphasizing the importance of teamwork and the use of technology, current T1D treatment is described for practical applications.Publication Metadata only Comprehensive insights into pediatric craniopharyngioma: endocrine and metabolic profiles, treatment Challenges, and long-term outcomes from a multicenter Study(Galenos Yayınevi, 2024) Şıklar, Z.; Özsu, E.; Kızılcan, Çetin, S.; Özen, S.; Çizmecioğlu-Jones, F.; Balkı, H.G.; Aycan, Z.; Goksen, D.; Kilci, F.; Abseyi, S.N.; Tercan, U.; Gürpınar, G.; Poyrazoğlu, Ş.; Darendeliler, F.; Demir, K.; Besci, Ö.; Özgen, İ.T.; Akın, S.B.; Kocabey, Sütçü, Z.; Aykaç, Kaplan, E.H.; Çamtosun, E.; Dundar, İ.; Sağsak, E.; Korkmaz, H.A.; Anık, A.; Özcabi, B.; Uçar, A.; Dağdeviren, Çakır, A.; Selver, Eklioğlu, B.; Kırel, B.; Berberoğu, M.; Yeşiltepe Mutlu, Rahime Gül; School of MedicineObjective: Craniopharyngiomas (CPG) have complex treatment challenges due to their proximity to vital structures, surgical and radiotherapeutic complexities, and the tendency for recurrence. The aim of this study was to identify the prevalence of endocrine and metabolic comorbidities observed during initial diagnosis and long-term follow-up in a nationwide cohort of pediatric CPG patients. A further aim was to highlight the difficulties associated with CPG management. Methods: Sixteen centers entered CPG patients into the & Ccedil;EDD NET data system. The clinical and laboratory characteristics at presentation, administered treatments, accompanying endocrine, metabolic, and other system involvements, and the patient's follow-up features were evaluated. Results: Of the 152 evaluated patients, 64 (42.1%) were female. At presentation, the mean age was 9.1 +/- 3.67, ranging from 1.46 to 16.92, years. The most common complaints at presentation were headache (68.4%), vision problems (42%), short stature (15%), and nausea and vomiting (7%). The surgical procedures were gross total resection (GTR) in 97 (63.8%) and subtotal resection in 55 (36.2%). Radiotherapy (RT) was initiated in 11.8% of the patients. Histopathological examination reported 92% were adamantinamatous type and 8% were papillary type. Postoperatively, hormone abnormalities consisted of thyroid-stimulating hormone (92.1%), adrenocorticotropic hormone (81%), antidiuretic hormone (79%), growth hormone (65.1%), and gonadotropin (43.4%) deficiencies. Recombinant growth hormone treatment (rhGH) was initiated in 27 (17.8%). The study showed hesitancy among physicians regarding rhGH. The median survival without relapse was 2.2 years. Median (range) time of relapse was 1.82 (0.13-10.35) years. Relapse was related to longer followups and reduced GTR rates. The median follow-up time was 3.13 years. Among the last follow-up visits, the prevalence of obesity was 38%, but of these, 46.5% were already obese at diagnosis. However, 20% who were not obese at baseline became obese on follow-up. Permanent visual impairment was observed in 26 (17.1%), neurological deficits in 13 (8.5%) and diabetes mellitus in 5 (3.3%) patients. Conclusion: Recurrence was predominantly due to incomplete resection and the low rate of postoperative RT. Challenges emerged for multidisciplinary regular follow ups. It is suggested that early interventions, such as dietary restrictions and increased exercise to prevent obesity, be implemented.Publication Metadata only Exploring regional disparities in heart failure epidemiology and outcomes: a comprehensive study across geographical regions in Türkiye(Galenos Publ House, 2024) Sahin, Anil; Coellueoglu, Tugce; Celik, Ahmet; Ata, Naim; Yilmaz, Mehmet Birhan; Kanik, Arzu; Ayvali, Mustafa Okan; Uelgue, Mustafa Mahir; Birinci, Suayip; Ural, Dilek; School of MedicineBackground: Heart failure (HF) is a common condition that affects 1-3% of the general population. Its prevalence exhibits notable international and intranational disparities, partly explained by socioeconomic status, religion, ethnic diversity, and geographic factors. A comprehensive understanding of the epidemiological symptoms of HF in different regions of Turkiye has yet to be revealed. Aims: To examine epidemiological data from 2016 to 2022, focusing on crucial patient characteristics and geographical regions, to determine the incidence and prevalence of HF in Turkiye across seven diverse geographical regions.Study Design: A nationwide population-based retrospective cohort study.Methods: The comprehensive National Electronic Database of the Turkish Ministry of Health was used in this study to obtain data that covers the whole Turkish population from January 1, 2016, to December 31, 2022. The International Classification of Diseases-10 (ICD-10) codes were used to identify adults with HF (n = 2,701,099) and associated comorbidities. Turkiye is divided into seven geographically distinct regions. Epidemiological characteristics and survival data of these regions were analyzed separately. All-cause mortality was set as the primary outcome. Results: In , the total estimated prevalence of adult patients with HF is 2.939%, ranging from 2.442% in Southeastern Anatolia to 4.382% in the Black Sea Region. Except for the Eastern Anatolia Region, the three most often reported comorbidities were hypertension, dyslipidemia, and anxiety disorders. The rates of prescribing guideline-directed medical therapy (GDMT) for HF and other medications varied significantly. GDMT prescription rates were lowest in the Eastern Anatolia Region (82.6% for beta-blockers, 48.7% for RASi, 31.8% for mineralocorticoid receptor antagonists, and 9.4% for SGLT2i). The Mediterranean and Aegean regions had the highest median N-terminal brain natriuretic peptide (NT-proBNP) levels of 1,990,0 pg/ml (518.0-6,636,0) and 1,441,0 pg/ml (363.0-5,000,0), respectively. From 2016 to 2022, 915,897 (33.9%) of 2,701,099 patients died. The Eastern Anatolia Region had the lowest all-cause mortality rate of 26.5%, whereas the Black Sea Region had the highest all-cause mortality rate of 35.3%.Conclusion: Our real-world analysis revealed geographic disparities in HF characteristics, such as decreased mortality in socioeconomically challenged regions. Higher stress susceptibility in developed regions may increase the likelihood of adverse outcomes.Publication Metadata only Bronchiectasis in Türkiye: data from a multicenter registry (Turkish adult bronchiectasis adtabase)(Galenos Publ House, 2024) Edis, Ebru Cakir; Cilli, Aykut; Kizilirmak, Deniz; Coskun, Ayson Sakar; Guler, Nurcan; Cicek, Sedat; Sevinc, Can; Agca, Meltem Coban; Gulmez, Inci; Kabak, Mehmet; Niksarlioglu, Elif Yelda Ozgun; Kokturk, Nurdan; Sayiner, Abdullah; Çağlayan, Benan Niku; School of MedicineBackground: Bronchiectasis is a chronic lung disease characterized by permanent bronchial wall dilatation. Although it has been known as an orphan disease, it has recently gained attention because of registry -based studies and drug research. Aims: We aimed to use a multicenter database to analyze and compare data regarding the etiology, associated comorbidities, microbiological characteristics, and preventive strategies of bronchiectasis in T & uuml;rkiye to those of other countries. Study Design: A multicenter prospective cohort study. Methods: The multicenter, prospective cohort study was conducted between March 2019 and January 2022 using the Turkish Adult Bronchiectasis Database, in which 25 centers in T & uuml;rkiye participated. Patients aged > 18 years who presented with respiratory symptoms such as cough, sputum, and dyspnea and were diagnosed with non -cystic fibrosis bronchiectasis using computed tomography were included in the study. Demographic information, etiologies, comorbidities, pulmonary functions, and microbiological, radiological, and clinical data were collected from the patients. Results: Of the 1,035 study participants, 518 (50%) were females. The mean age of the patients was 56.1 +/- 16.1 years. The underlying etiology was detected in 565 (54.6%) patients. While postinfectious origin was the most common cause of bronchiectasis (39.5%), tuberculosis was identified in 11.3% of the patients. An additional comorbidity was detected in 688 (66.5%) patients. The most common comorbidity was cardiovascular disease, and chronic obstructive pulmonary disease (COPD) and bronchiectasis was identified in 19.5% of the patients. The most commonly detected microbiological agent was Pseudomonas aeruginosa (29.4%). Inhaled corticosteroids (ICS) were used in 70.1% of the patients, and the frequency of exacerbations in the last year was significantly higher in patients using ICS than in nonusers (p < 0.0001). Age [odds ratio (OR): 1.028; 95% confidence interval (CI): 1.005-1.051], cachexia (OR: 4.774; 95% CI: 2,054-11,097), high modified medical research council dyspnea scale score (OR: 1,952; 95% CI: 1,459-2,611), presence of chronic renal failure (OR: 4,172; 95% CI: 1,249-13,938) and use of inhaled steroids (OR: 2,587; 95% CI: 1,098-6,098) were significant risk factors for mortality. Mortality rates were higher in patients with COPD than in those with no COPD (21.7-9.1%, p = 0.016). Patients with bronchiectasis and COPD exhibited more frequent exacerbations, exacerbation -related hospitalizations, and hospitalization in the intensive care unit in the previous year than patients without COPD. Conclusion: This is the first multicenter study of bronchiectasis in T & uuml;rkiye. The study results will provide important data that can guide the development of health policies in T & uuml;rkiye on issues such as infection control, vaccination, and the unnecessary use of antibiotics and steroids.Publication Metadata only Diffuse normolipemic plane xanthoma: remarkable dermatological gindings observed in a series of patients(Galenos Publ House, 2024) Baykal C, Erdem Y, Çiftçi FKG, Çevik AA, Öztürk Sarı Ş; Büyükbabani, Nesimi; Koç University HospitalPublication Metadata only Approaches of pediatric nephrologists to hypertensive patients in Turkey (Turkish pediatric hypertension working group study)(Springer, 2018) Demir, Belde Kasap; Hacıhamdioğlu, Duygu Övüç; Girişgen, İlknur; Dursun, Hasan; Çivilibal, Mahmut; Benzer, Meryem; Bıyıklı, Neşe Karaaslan; Özkayın, Neşe; Sönmez, Ferah; Taşdemir, Mehmet; Faculty Member; School of Medicine; 175867Objective: We aimed to evaluate the approaches of pediatric nephrologists in our country to the management of childhood hypertension. Methods: The pediatric nephrologists in our country were invited to fill out an online questionnaire including 24 questions. The answers were compared between those working in the field for <= 10 years (Group 1, n =74) and >10 years (Group 2, n = 62). Results: of 136 participants (M/F = 101/35), 52% were following a single guideline [31% Fourth Report of 2004, 17% European Society of Hypertension in 2016, and 52% American Academy of Pediatrics in 2017], which is more common in Group 1 (P =.035). The most commonly used guideline was American Academy of Pediatrics of 2017 and Group 2 used Fourth Report of 2004 more commonly (P =.042). The most common choice to diagnose hypertension was office + home + ambulatory blood pressure monitoring (59%). The frequency of screening for end-organ damage at first evaluation was 96%. The time to wait for the effect of lifestyle modifications was 3 months in 52%. The first choice medication was angiotensin-converting enzyme inhibitors (49%) or calcium-channel blockers (48%) in non-obese and angiotensin-converting enzyme inhibitors (74%) in obese children. Calcium-channel blockers were more commonly prescribed as the first choice in non-obese children in Group 1 (P =.035). The most accessible emergency drug was esmolol. Conclusion: Despite following recent guidelines, the time spent in the proficiency would change the practices.