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Köksal AŞ, Tozlu M, Sezgin O, Oğuz D, Kalkan İH, Altıntaş E, Yaraş S, Bilgiç Y, Yıldırım AE, Barutçu S, Hakim GD, Soytürk M, Bengi G, Özşeker B, Yurci A, Koç DÖ, İrak K, Kasap E, Cindoruk M, Oruç N, Ünal NG, Şen İ, Gökden Y, Saruç M, Ünal H, Eminler AT, Toka B, Basır H, Sağlam O, Ergül B, Gül Ö, Büyüktorun İ, Özel M, Şair Ü, Kösem G, Nedirli F, Tahtacı M, Parlak E. Acute pancreatitis in Turkey: Results of a nationwide multicenter study. Pancreatology 2024; 24:327-334. [PMID: 37880021 DOI: 10.1016/j.pan.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/12/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Acute pancreatitis (AP) is the most common gastrointestinal disease requiring hospitalization, with significant mortality and morbidity. We aimed to evaluate the clinical characteristics of AP and physicians' compliance with international guidelines during its management. METHODS All patients with AP who were hospitalized at 17 tertiary centers in Turkey between April and October 2022 were evaluated in a prospective cohort study. Patients with insufficient data, COVID-19 and those aged below 18 years were excluded. The definitions were based on the 2012 revised Atlanta criteria. RESULTS The study included 2144 patients (median age:58, 52 % female). The most common etiologies were biliary (n = 1438, 67.1 %), idiopathic (n = 259, 12 %), hypertriglyceridemia (n = 128, 6 %) and alcohol (n = 90, 4.2 %). Disease severity was mild in 1567 (73.1 %), moderate in 521 (24.3 %), and severe in 58 (2.6 %) patients. Morphology was necrotizing in 4.7 % of the patients. The overall mortality rate was 1.6 %. PASS and BISAP had the highest accuracy in predicting severe pancreatitis on admission (AUC:0.85 and 0.81, respectively). CT was performed in 61 % of the patients, with the majority (90 %) being within 72 h after admission. Prophylactic NSAIDs were not administered in 44 % of the patients with post-ERCP pancreatitis (n = 86). Antibiotics were administered to 53.7 % of the patients, and 38 % of those received them prophylactically. CONCLUSIONS This prospective study provides an extensive report on clinical characteristics, management and outcomes of AP in real-world practice. Mortality remains high in severe cases and physicians' adherence to guidelines during management of the disease needs improvement in some aspects.
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Affiliation(s)
- Aydın Şeref Köksal
- Sakarya University, School of Medicine, Department of Gastroenterology, Turkey.
| | - Mukaddes Tozlu
- Sakarya University, School of Medicine, Department of Gastroenterology, Turkey
| | - Orhan Sezgin
- Mersin University, School of Medicine, Department of Gastroenterology, Turkey
| | - Dilek Oğuz
- Kırıkkale University, School of Medicine, Department of Gastroenterology, Turkey
| | - İsmail Hakkı Kalkan
- TOBB Economy and Technology University, Department of Gastroenterology, Turkey
| | - Engin Altıntaş
- Mersin University, School of Medicine, Department of Gastroenterology, Turkey
| | - Serkan Yaraş
- Mersin University, School of Medicine, Department of Gastroenterology, Turkey
| | - Yılmaz Bilgiç
- İnönü University, School of Medicine, Department of Gastroenterology, Turkey
| | | | - Sezgin Barutçu
- Gaziantep University, School of Medicine, Department of Gastroenterology, Turkey
| | - Gözde Derviş Hakim
- Sağlık Bilimleri University, Izmir School of Medicine, Department of Gastroenterology, Turkey
| | - Müjde Soytürk
- Dokuz Eylül University, School of Medicine, Department of Gastroenterology, Turkey
| | - Göksel Bengi
- Dokuz Eylül University, School of Medicine, Department of Gastroenterology, Turkey
| | - Burak Özşeker
- Muğla Sıtkı Koçman University, School of Medicine, Department of Gastroenterology, Turkey
| | - Alper Yurci
- Erciyes University, School of Medicine, Department of Gastroenterology, Turkey
| | - Deniz Öğütmen Koç
- Sağlık Bilimleri University, Gaziosmanpaşa Education and Research Hospital, Department of Gastroenterology, Turkey
| | - Kader İrak
- Sağlık Bilimleri University, Başakşehir Çam and Sakura City Hospital, Department of Gastroenterology, Turkey
| | - Elmas Kasap
- Manisa Celal Bayar University, School of Medicine, Department of Gastroenterology, Turkey
| | - Mehmet Cindoruk
- Ankara Gazi University, School of Medicine, Department of Gastroenterology, Turkey
| | - Nevin Oruç
- Ege University, School of Medicine, Department of Gastroenterology, Turkey
| | - Nalan Gülşen Ünal
- Ege University, School of Medicine, Department of Gastroenterology, Turkey
| | - İlker Şen
- Sağlık Bilimleri University, Şişli Hamidiye Etfal Education and Research Hospital, Department of Gastroenterology, Turkey
| | - Yasemin Gökden
- Sağlık Bilimleri University, Prof. Dr. Cemil Taşçıoğlu City Hosoital, Department of Gastroenterology, Turkey
| | - Murat Saruç
- Acıbadem Mehmet Ali Aydınlar University, School of Medicine, Department of Gastroenterology, Turkey
| | - Hakan Ünal
- Acıbadem Mehmet Ali Aydınlar University, School of Medicine, Department of Gastroenterology, Turkey
| | - Ahmet Tarık Eminler
- Sakarya University, School of Medicine, Department of Gastroenterology, Turkey
| | - Bilal Toka
- Sakarya University, School of Medicine, Department of Gastroenterology, Turkey
| | - Hakan Basır
- Mersin University, School of Medicine, Department of Gastroenterology, Turkey
| | - Osman Sağlam
- İnönü University, School of Medicine, Department of Gastroenterology, Turkey
| | - Bilal Ergül
- Kırıkkale University, School of Medicine, Department of Gastroenterology, Turkey
| | - Özlem Gül
- Kırıkkale University, School of Medicine, Department of Gastroenterology, Turkey
| | - İlker Büyüktorun
- Dokuz Eylül University, School of Medicine, Department of Gastroenterology, Turkey
| | - Mustafa Özel
- Erciyes University, School of Medicine, Department of Gastroenterology, Turkey
| | - Ümit Şair
- Sağlık Bilimleri University, Gaziosmanpaşa Education and Research Hospital, Department of Internal Medicine, Turkey
| | - Gizem Kösem
- Manisa Celal Bayar University, School of Medicine, Department of Internal Medicine, Turkey
| | - Ferda Nedirli
- Gazi University, School of Medicine, Department of Internal Medicine, Turkey
| | - Mustafa Tahtacı
- Ankara Yıldırım Beyazıt University, Department of Gastroenterology, Turkey
| | - Erkan Parlak
- Hacettepe University, School of Medicine, Department of Gastroenterology, Turkey
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Ertaş K, Gül Ö, Yıldırım R, Özalkak Ş. Evaluation of cardiac electrophysiological features in patients with premature adrenarche. J Pediatr Endocrinol Metab 2024; 37:317-325. [PMID: 38386924 DOI: 10.1515/jpem-2023-0460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/05/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVES This study aimed to analyze the cardiac effects of hyperandrogenism in premature adrenarche (PA) and evaluate the risk of arrhythmia development. METHODS Fifty patients with PA and 50 healthy children from a pediatric endocrinology outpatient clinic were included in the study. The patients underwent echocardiography and electrocardiographic evaluations. Conventional echocardiography, tissue Doppler echocardiography, repolarization time, and repolarization dispersion time were evaluated. RESULTS The median age in the PA and control groups was 7.91 years (5.83-9.25), 8.08 years (5.75-9.33), respectively. Thirty percent of patients in the PA group were male. While mitral early diastolic velocity deceleration time (DT), isovolumetric relaxation time (IRT), and E/e' ratio were significantly higher in the PA group than in the control group, mitral lateral annulus tissue Doppler early diastolic velocity was significantly lower (p=0.0001, 0.0001, 0.003, 0.0001). While P wave dispersion (PWD), Tpe, and QT-dispersion (QT-d) values were significantly higher in the PA group than in the control group, the P minimum value was significantly lower in the PA group (p=0.0001, 0.02, 0.004, and 0.0001, respectively). CONCLUSIONS Early subclinical diastolic dysfunction was observed in the PA group. There was an increased risk of atrial arrhythmia with PWD and an increased risk of ventricular arrhythmia with increased Tpe and QT-d. There was a correlation between testosterone levels and diastolic function parameters. The increased risk of atrial arrhythmia is closely related to diastolic function.
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Affiliation(s)
- Kerem Ertaş
- Department of Pediatric Cardiology, 653583 Diyarbakir Children's Hospital , Diyarbakır, Türkiye
| | - Özlem Gül
- Department of Pediatric Cardiology, 653583 Diyarbakir Children's Hospital , Diyarbakır, Türkiye
| | - Ruken Yıldırım
- Department of Pediatric Endocrinology, Hepatology and Nutrition, 653583 Diyarbakir Children's Hospital , Diyarbakır, Türkiye
| | - Şervan Özalkak
- Department of Pediatric Endocrinology, Hepatology and Nutrition, 653583 Diyarbakir Children's Hospital , Diyarbakır, Türkiye
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Binay UD, Barkay O, Karakeçili F, Gül Ö, Tanoğlu C, Sümer B. A Case of Mediterranean Spotted Fever with Cerebral Infarction. Vector Borne Zoonotic Dis 2024. [PMID: 38608220 DOI: 10.1089/vbz.2023.0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024] Open
Affiliation(s)
- Umut Devrim Binay
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Orçun Barkay
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Faruk Karakeçili
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Özlem Gül
- Department of Infectious Disease and Clinical Microbiology, İstanbul Şişli Hamidiye Etfal Training and Research Hospital, Sisli, Turkey
| | - Ceyda Tanoğlu
- Department of Neurology, İzmir Tepecik Training and Research Hospital, Konak, Turkey
| | - Betül Sümer
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
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Çelik Ekinci S, Yenilmez E, Akengin Öcal G, Sönmezer MÇ, Tarakçı A, Aygün C, Akdağ D, Seyman D, Aşık C, Zerdali E, Yılmaz Karadağ F, Kaya Ş, Çelik M, Çifci Ş, Yıldız İE, Çölkesen F, Akgül F, Aldemir Ö, Bozdağ M, Özer D, Hızmalı L, Canbolat Ünlü E, Gür Altunay D, Şahin A, Ünlü G, Gençalioğlu AE, Tekin Şahin S, Özdemir Y, Ünlü S, Singil S, Altıntaş J, Akkaya Işık S, Gül Ö, Tuna N, Şimşek S, Özgüler M, Elbir Kılıç P, Işık ME, Karakuş A, Kıratlı K, Yardımcı AC, Volkan S, Olçar Y, Çakır Y, Özer Yılmaz N, Karaayvaz S, Batırel A, Duran ZC, Raşa HK, Köse Ş. Surgical Antimicrobial Prophylaxis Compliance in Turkey: Data from the Prospective, Observational, Multicenter Survey Including 7,978 Surgical Patients. Surg Infect (Larchmt) 2024; 25:231-239. [PMID: 38588521 DOI: 10.1089/sur.2023.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Background: Surgical antimicrobial prophylaxis (SAP) is the peri-operative administration of antimicrobial agents. Compliance rates vary worldwide from 15% to 84.3%, with studies in Turkey not exceeding 35%. The aim of this multicenter study was to determine the rate of appropriate antibiotic class, timing, and duration as well as discharge prescriptions in Turkey. Thus, we aimed to determine the rate of full compliance with SAP procedures in our country Patients and Methods: This multicenter, prospective, observational, descriptive study was conducted in 47 hospitals from 28 provinces in seven different regions of Turkey. Patients over 18 years of age in all surgical units between June 6, 2022, and June 10, 2022, were included in the study. Results: Of the 7,978 patients included in the study, 332 were excluded from further analyses because of pre-existing infection, and SAP compliance analyses were performed on the remaining 7,646 cases. The antibiotic most commonly used for SAP was cefazolin (n = 4,701; 61.5%), followed by third-generation cephalosporins (n = 596; 7.8%). The most common time to start SAP was within 30 minutes before surgery (n = 2,252; 32.5%), followed by 30 to 60 minutes before surgery (n = 1,638; 23.6%). Surgical antimicrobial prophylaxis duration was <24 hours in 3,516 (50.7%) patients and prolonged until discharge in 1,505 (21.7%) patients. Finally, the actual proportion of patients compliant with SAP was 19% (n = 1,452) after omitting 4,458 (58.3%) patients who were prescribed oral antibiotic agents at discharge as part of a prolonged SAP. Conclusions: Surgical antimicrobial prophylaxis compliance rates are still very low in Turkey. Prolonged duration of SAP and especially high rate of antibiotic prescription at discharge are the main reasons for non-compliance with SAP.
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Affiliation(s)
- Semiha Çelik Ekinci
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Ataşehir, İstanbul, Turkey
| | - Ercan Yenilmez
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Ataşehir, İstanbul, Turkey
| | - Gülfem Akengin Öcal
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Meliha Çağla Sönmezer
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Arzu Tarakçı
- Department of Infectious Diseases and Clinical Microbiology, Konya City Hospital, Konya, Turkey
| | - Cemanur Aygün
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Samsun Training and Research Hospital, Samsun, Turkey
| | - Damla Akdağ
- Department of Infectious Diseases and Clinical Microbiology, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
| | - Derya Seyman
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Cansu Aşık
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Esra Zerdali
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Fatma Yılmaz Karadağ
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | - Şafak Kaya
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Mehmet Çelik
- Department of Infectious Diseases and Clinical Microbiology, Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Şeyma Çifci
- Department of Infectious Diseases and Clinical Microbiology, Nevşehir State Hospital, Nevşehir, Turkey
| | - İlknur Esen Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University, Faculty of Medicine, Rize, Turkey
| | - Fatma Çölkesen
- Department of Infectious Diseases and Clinical Microbiology, Konya Numune Hospital, Konya, Turkey
| | - Fethiye Akgül
- Department of Infectious Diseases and Clinical Microbiology, Batman Training and Research Hospital, Batman, Turkey
| | - Özlem Aldemir
- Department of Infectious Diseases and Clinical Microbiology, Sivas Numune Hospital, Sivas, Turkey
| | - Merve Bozdağ
- Department of Infectious Diseases and Clinical Microbiology University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Deniz Özer
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Lokman Hızmalı
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Esra Canbolat Ünlü
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Deniz Gür Altunay
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
| | - Ahmet Şahin
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Gülten Ünlü
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Ayşe Eda Gençalioğlu
- Department of Infectious Diseases and Clinical Microbiology, Trabzon Fatih State Hospital, Trabzon, Turkey
| | - Sema Tekin Şahin
- Department of Infectious Diseases and Clinical Microbiology, Alanya Training and Research Hospital, Antalya, Turkey
| | - Yeliz Özdemir
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Sibel Ünlü
- Department of Infectious Diseases and Clinical Microbiology, Mersin Toros State Hospital, Mersin, Turkey
| | - Sarp Singil
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Jale Altıntaş
- Department of Infectious Diseases and Clinical Microbiology, Gebze Fatih State Hospital, Kocaeli, Turkey
| | - Sinem Akkaya Işık
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sultan 2.Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Özlem Gül
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Nazan Tuna
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Sümeyra Şimşek
- Department of Infectious Diseases and Clinical Microbiology, Çorlu State Hospital, Tekirdağ, Turkey
| | - Müge Özgüler
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Pınar Elbir Kılıç
- Department of Infectious Diseases and Clinical Microbiology, Tuzla State Hospital, İstanbul, Turkey
| | - Mehmet Emirhan Işık
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey
| | - Ayşe Karakuş
- Department of Infectious Diseases and Clinical Microbiology, Hendek State Hospital, Sakarya, Turkey
| | - Kazım Kıratlı
- Department of Infectious Diseases and Clinical Microbiology, Katip Çelebi University, İzmir Atatürk Training and Research Hospital, İzmir, Turkey
| | - Ahmet Cem Yardımcı
- Department of Infectious Diseases and Clinical Microbiology, VM Medical Park Mersin Hospital, Mersin, Turkey
| | - Serkan Volkan
- Department of Infectious Diseases and Clinical Microbiology, Aydın State Hospital, Aydın, Turkey
| | - Yıldız Olçar
- Department of Infectious Diseases and Clinical Microbiology, Kastamonu Training and Research Hospital, Kastamonu, Turkey
| | - Yasemin Çakır
- Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Nermin Özer Yılmaz
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training And Research Hospital, İstanbul, Turkey
| | - Serhat Karaayvaz
- Department of Infectious Diseases and Clinical Microbiology, Ezine State Hospital, Çanakkale, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Zeynep Cansu Duran
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Hüseyin Kemal Raşa
- Department of General Surgery, Anadolu Medical Center Gebze, Kocaeli, Turkey
| | - Şükran Köse
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
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Derin O, Öncül A, Türkkan HM, Demirbaş ND, Gül Ö, Diktaş H, Sevgi DY, Hayran O. Turkish Translation and Cross-Cultural Validity of Whoqol-HIV Bref Tool. Curr HIV Res 2024; 22:CHR-EPUB-138881. [PMID: 38425120 DOI: 10.2174/011570162x284526240219075823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The assessment of health-related quality of life among people living with HIV (PLWH) has gained increasing importance as it assesses their overall well-being, guides treatment decisions, and addresses psychosocial challenges, improving their quality of life. This study focuses on adapting and validating the Turkish version of the WHOQOL-HIV Bref, a tool developed by the World Health Organization (WHO) to measure health-related quality of life in PLWH. This adaptation is based on the generic WHOQOL-Bref Turkish and WHOQOL-HIV Bref inventory. METHODS In line with WHO guidelines, the tool was translated and tested on 189 PLWH from İstanbul Şişli Hamidiye Etfal Training and Research Hospital's HIV outpatient clinic. A variety of statistical methods were employed to assess content, construct, concurrent, and known-group validity, as well as internal consistency and reliability. RESULTS Participants' median age was 35 years (IQR: 14), with 178(94%) being male. The Turkish WHOQOL-HIV Bref showed overall satisfactory psychometric properties. Despite limitations in the spirituality domain, it demonstrated good internal consistency (alpha coefficient: 0.93) and strong validity across several metrics, including test-retest reliability (ICC: 0.79). CONCLUSION The WHOQOL-HIV BREF in Turkish is a reliable and valid instrument for assessing the quality of life in Turkish PLWH.
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Affiliation(s)
- Okan Derin
- Epidemiology Doctorate Program, Graduate School of Health Sciences, Istanbul Medipol University, İstanbul,
Türkiye
- Infectious Diseases and Clinical Microbiology Department, İstanbul Şişli Hamidiye Etfal Training and Research
Hospital, İstanbul, Türkiye
| | - Ahsen Öncül
- Infectious Diseases and Clinical Microbiology Department, İstanbul Şişli Hamidiye Etfal Training and Research
Hospital, İstanbul, Türkiye
| | - Hakkı Meriç Türkkan
- Infectious Diseases and Clinical Microbiology Department, İstanbul Şişli Hamidiye Etfal Training and Research
Hospital, İstanbul, Türkiye
- Infectious Diseases and Clinical Microbiology Department, Hamidiye Faculty of Medicine, Sağlık Bilimleri Üniversitesi, İstanbul, Türkiye
| | - Nazife Duygu Demirbaş
- Infectious Diseases and Clinical Microbiology Department, İstanbul Şişli Hamidiye Etfal Training and Research
Hospital, İstanbul, Türkiye
| | - Özlem Gül
- Infectious Diseases and Clinical Microbiology Department, İstanbul Şişli Hamidiye Etfal Training and Research
Hospital, İstanbul, Türkiye
| | - Hüsrev Diktaş
- Infectious Diseases and Clinical Microbiology Department, İstanbul Şişli Hamidiye Etfal Training and Research
Hospital, İstanbul, Türkiye
- Infectious Diseases and Clinical Microbiology Department, Hamidiye Faculty of Medicine, Sağlık Bilimleri Üniversitesi, İstanbul, Türkiye
| | - Dilek Yıldız Sevgi
- Infectious Diseases and Clinical Microbiology Department, İstanbul Şişli Hamidiye Etfal Training and Research
Hospital, İstanbul, Türkiye
- Infectious Diseases and Clinical Microbiology Department, Hamidiye Faculty of Medicine, Sağlık Bilimleri Üniversitesi, İstanbul, Türkiye
| | - Osman Hayran
- Public Health Department, Faculty of Medicine, İstanbul Medipol University, İstanbul, Türkiye
- Epidemiology Doctorate Program, Graduate School of Health Sciences, Istanbul Medipol University, İstanbul,
Türkiye
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6
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Dilli D, Akduman H, Zenciroğlu A, Çetinkaya M, Okur N, Turan Ö, Özlü F, Çalkavur Ş, Demirel G, Koksal N, Çolak R, Örün UA, Öztürk E, Gül Ö, Tokel NK, Erdem S, Meşe T, Erdem A, Bostan ÖM, Polat TB, Taşar M, Hatemi AC, Doyurgan O, Özkan M, Avşar MK, Sarıosmanoğlu ON, Uğurlucan M, Sığnak IŞ, Başaran M. Neonatal Outcomes of Critical Congenital Heart Defects: A Multicenter Epidemiological Study of Turkish Neonatal Society : Neonatal Outcomes of CCHD. Pediatr Cardiol 2024; 45:257-271. [PMID: 38153547 DOI: 10.1007/s00246-023-03362-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/20/2023] [Indexed: 12/29/2023]
Abstract
Critical congenital heart disease (CCHD) is one of the leading causes of neonatal and infant mortality. We aimed to elucidate the epidemiology, spectrum, and outcome of neonatal CCHD in Türkiye. This was a multicenter epidemiological study of neonates with CCHD conducted from October 2021 to November 2022 at national tertiary health centers. Data from 488 neonatal CCHD patients from nine centers were entered into the Trials-Network online registry system during the study period. Transposition of great arteria was the most common neonatal CHD, accounting for 19.5% of all cases. Sixty-three (12.9%) patients had extra-cardiac congenital anomalies. A total of 325 patients underwent cardiac surgery. Aortic arch repair (29.5%), arterial switch (25.5%), and modified Blalock-Taussig shunt (13.2%). Overall, in-hospital mortality was 20.1% with postoperative mortality of 19.6%. Multivariate analysis showed that the need of prostaglandin E1 before intervention, higher VIS (> 17.5), the presence of major postoperative complications, and the need for early postoperative extracorporeal membrane oxygenation were the main risk factors for mortality. The mortality rate of CCHD in our country remains high, although it varies by health center. Further research needs to be conducted to determine long-term outcomes for this vulnerable population.
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Affiliation(s)
- Dilek Dilli
- Department of Neonatology, Dr. Sami Ulus Research and Application Center, Health Science University of Turkey, Ankara, Turkey.
| | - Hasan Akduman
- Department of Neonatology, Dr. Sami Ulus Research and Application Center, Health Science University of Turkey, Ankara, Turkey
| | - Ayşegül Zenciroğlu
- Department of Neonatology, Dr. Sami Ulus Research and Application Center, Health Science University of Turkey, Ankara, Turkey
| | - Merih Çetinkaya
- Department of Neonatology, Başakşehir Çam Sakura City Hospital, Health Science University of Turkey, İstanbul, Turkey
| | - Nilüfer Okur
- Department of Neonatology, Gazi Yaşargil Research and Application Center, Health Science University of Turkey, Diyarbakır, Turkey
| | - Özden Turan
- Department of Neonatology, Başkent University, Medical Faculty, Ankara, Turkey
| | - Ferda Özlü
- Department of Neonatology, Çukurova University, Medical Faculty, Adana, Turkey
| | - Şebnem Çalkavur
- Department of Neonatology, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Health Science University of Turkey, İzmir, Turkey
| | - Gamze Demirel
- Department of Neonatology, İstanbul Medipol University, International Faculty of Medicine, Istanbul, Turkey
| | - Nilgün Koksal
- Department of Neonatology, Uludağ University, Medical Faculty, Bursa, Turkey
| | - Rüya Çolak
- Department of Neonatology, Beykent University Medical Faculty, Istanbul, Turkey
| | - Utku Arman Örün
- Department of Pediatric Cardiology, Dr. Sami Ulus Research and Application Center, Health Science University of Turkey, Ankara, Turkey
| | - Erkut Öztürk
- Department of Pediatric Cardiology, Başakşehir Çam Sakura City Hospital, Health Science University of Turkey, Istanbul, Turkey
| | - Özlem Gül
- Department of Pediatric Cardiology, Gazi Yaşargil Research and Application Center, Health Science University of Turkey, Diyarbakır, Turkey
| | - Niyazi Kürşad Tokel
- Department of Pediatric Cardiology, Başkent University, Medical Faculty, Ankara, Turkey
| | - Sevcan Erdem
- Department of Pediatric Cardiology, Çukurova University, Medical Faculty, Adana, Turkey
| | - Timur Meşe
- Department of Pediatric Cardiology, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Health Science University of Turkey, İzmir, Turkey
| | - Abdullah Erdem
- Department of Pediatric Cardiology, İstanbul Medipol University, International Faculty of Medicine, İstanbul, Turkey
| | - Özlem Mehtap Bostan
- Department of Pediatric Cardiology, Uludağ University, Medical Faculty, Bursa, Turkey
| | - Tuğçin Bora Polat
- Department of Pediatric Cardiology, Beykent University, Medical Faculty, İstanbul, Turkey
| | - Mehmet Taşar
- Department of Pediatric Cardiovascular Surgery, Dr. Sami Ulus Research and Application Center, Health Science University of Turkey, Ankara, Turkey
| | - Ali Can Hatemi
- Department of Pediatric Cardiovascular Surgery, Başakşehir Çam Sakura City Hospital, Health Science University of Turkey, İstanbul, Turkey
| | - Onur Doyurgan
- Department of Pediatric Cardiovascular Surgery, Gazi Yaşargil Research and Application Center, Health Science University of Turkey, Diyarbakır, Turkey
| | - Murat Özkan
- Department of Pediatric Cardiovascular Surgery, Başkent University, Medical Faculty, Ankara, Turkey
| | - Mustafa Kemal Avşar
- Department of Pediatric Cardiovascular Surgery, Çukurova University, Medical Faculty, Adana, Turkey
| | - Osman Nejat Sarıosmanoğlu
- Department of Pediatric Cardiovascular Surgery, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Health Science University of Turkey, İzmir, Turkey
| | - Murat Uğurlucan
- Department of Pediatric Cardiovascular Surgery, İstanbul Medipol University, International Faculty of Medicine, İstanbul, Turkey
| | - Işık Şenkaya Sığnak
- Department of Pediatric Cardiovascular Surgery, Uludağ University, Medical Faculty, Bursa, Turkey
| | - Murat Başaran
- Department of Pediatric Cardiovascular Surgery, Beykent University, Medical Faculty, Istanbul, Turkey
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Tutan H, Kutsal C, Gül Ö, Tanrıverdi ES, Barış A, Bulut ME, Aktaş E. [A New Case of Fournier's Gangrene Caused by Actinotignum schaalii]. MIKROBIYOL BUL 2024; 58:80-88. [PMID: 38263943 DOI: 10.5578/mb.20249908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Actinotignum schaalii (formerly known as Actinobaculum schaalii) is an anaerobic or facultative anaerobic gram-positive bacillus that can be found commensally in the urogenital region. It can be overlooked because it grows slowly and is difficult to identify with classical microbiology laboratory techniques. Colonies become visible after 48-72 hours of incubation on blood agar in anaerobic or CO₂-rich media. While it typically causes urinary tract infection in older individuals, cases of bacteremia, vertebral osteomyelitis, endocarditis and cellulitis have been reported. Fournier's gangrene caused by A.schaalii has been reported very rarely so far. Fournier's gangrene has been defined as necrotizing fasciitis of the external genitalia, perineal and perianal region. Diabetes, immunosuppression, peripheral vascular disease, urethral anomalies, chronic alcoholism and smoking are important predisposing factors. In addition, approximately 25% of the cases have no known or identifiable etiology. The bacteria causing the infection may originate from skin, urogenital or intestinal microbiota. In this case report, a new case of Fournier's gangrene caused by A.schaalii was presented. A 65-year-old male patient admitted to the emergency department with the complaints of pain, swelling, redness in the left testis and also nausea, vomiting and chills that started three days ago. Physical examination revealed increased diameter of the scrotum, intense hyperemia of the skin and foci of necrosis. It was learned that the patient had no known chronic disease other than benign prostatic hyperplasia. The patient reported smoking of 25 packs of cigarettes per year. Routine laboratory tests revealed leukocyte= 32.41 x 109/L, neutrophil= 89.9%, procalcitonin= 1.62 ug/L, CRP= 265.07 mg/L and the patient was operated with the diagnosis of Fournier's gangrene. Gram staining of the abscess specimen obtained during the operation showed gram-positive bacilli both inside and outside the leukocytes. After 24 hours, grampositive bacilli were detected in the Gram staining of thin, transparent/gray colonies grown on 5% sheep blood and chocolate agar. The isolate was identified as A.schaalii by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) VITEK® MS (bioMérieux, France) microbial identification system. VITEK®2 ID ANC (bioMérieux, France) bacterial identification card was also used for comparison but the bacteria could be identified. As a result of the sequence analysis performed for confirmation, it was shown to be 100% homologous with Actinobaculum schaalii (GenBank accession no: FJ711193.1). For susceptibility tests, 5% sheep blood Schaedler agar was used and incubated in anaerobic environment. According to the minimal inhibitory concentration (MIC) results evaluated after 48 hours, penicillin was found to be 0.032 mg/L, clindamycin 0.125 mg/L, ciprofloxacin 0.19 mg/L, ceftazidime 4 mg/L, and amoxicillin 0.19 mg/L. The primary cause that initiated the infection in the case could not be identified, but it was thought that the presence of prostatic hyperplasia and smoking history may have contributed to the occurence or the progress of the disease. It is noteworthy that the ciprofloxacin MIC result was quite low compared to other studies. In addition, this study revealed the value of MALDI-TOF MS based methods in identification. In conclusion, it is thought that a significant proportion of A.schaalii infections may be overlooked due to the difficulty in growth and identification. Increasing the diagnostic power of clinical microbiology laboratories for poorly identified bacteria and renewing the databases of commercial identification systems are important for the early and accurate diagnosis and treatment of serious infections that may occur with such agents.
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Affiliation(s)
- Hanife Tutan
- Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Medical Microbiology, İstanbul, Türkiye
| | - Cemil Kutsal
- Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Urology, İstanbul, Türkiye
| | - Özlem Gül
- Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Elif Seren Tanrıverdi
- Malatya Training and Research Hospital, Microbiology Laboratory Unit, Malatya, Türkiye
| | - Ayşe Barış
- Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Medical Microbiology, İstanbul, Türkiye
| | - Mehmet Emin Bulut
- Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Medical Microbiology, İstanbul, Türkiye
| | - Elif Aktaş
- Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Medical Microbiology, İstanbul, Türkiye
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8
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Kılıç Y, Doyurgan O, İrdem AK, Gül Ö, Borakay D, Aldudak B. Non-Conduit Repair of Truncus Arteriosus. Braz J Cardiovasc Surg 2023; 38:248-251. [PMID: 36259996 PMCID: PMC10069253 DOI: 10.21470/1678-9741-2022-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
INTRODUCTION The procedure of choice for treatment of truncus arteriosus is one-stage repair within the first few months of life. Establishing right ventricle-pulmonary artery direct continuity without conduit can be a good alternative in the absence of valved conduits in developing centers. METHODS Between January 2021 and June 2021, a total of five patients (three males, two females) underwent definitive repair of truncus arteriosus without an extracardiac conduit. We used the Barbero-Marcial technique to allow age-related growth, eliminate the risk of conduit-related complications, and to avoid forcing a conduit to place in a very small mediastinal space. RESULTS The patients' mean age was 31.2 days (11-54 days). Their mean bodyweight was 3.2 kg (2.7-3.8kg). Mean postoperative intensive care unit stay was 39.6 days (7-99 days). There were two mortalities in the intensive care unit on postoperative days 12 and 61 due to lung-related problems. The remaining three cases' mean ventilation time was 15.6 days (8-22 days). CONCLUSION Having access to a valved conduit is still challenging for some centers, and the non-conduit repair technique defined by Barbero-Marcial can be a successful, life-saving alternative easy for young surgeons to perform in newly based centers.
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Affiliation(s)
- Yiğit Kılıç
- Department of Pediatric Cardiac Surgery, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Onur Doyurgan
- Department of Pediatric Cardiac Surgery, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Ahmet Kuddusi İrdem
- Department of Pediatric Cardiac Surgery, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Özlem Gül
- Department of Pediatric Cardiology, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Dilek Borakay
- Department of Pediatric Cardiology, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Bedri Aldudak
- Department of Pediatric Cardiology, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
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9
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Efe C, Kulkarni AV, Terziroli Beretta-Piccoli B, Magro B, Stättermayer A, Cengiz M, Clayton-Chubb D, Lammert C, Bernsmeier C, Gül Ö, la Tijera FHD, Anders M, Lytvyak E, Akın M, Purnak T, Liberal R, Peralta M, Ebik B, Duman S, Demir N, Balaban Y, Urzua Á, Contreras F, Venturelli MG, Bilgiç Y, Medina A, Girala M, Günşar F, Londoño MC, Androutsakos T, Kisch A, Yurci A, Güzelbulut F, Çağın YF, Avcı E, Akyıldız M, Dindar-Demiray EK, Harputluoğlu M, Kumar R, Satapathy SK, Mendizabal M, Silva M, Fagiuoli S, Roberts SK, Soylu NK, Idilman R, Yoshida EM, Montano-Loza AJ, Dalekos GN, Ridruejo E, Schiano TD, Wahlin S. Liver injury after SARS-CoV-2 vaccination: Features of immune-mediated hepatitis, role of corticosteroid therapy and outcome. Hepatology 2022; 76:1576-1586. [PMID: 35567545 PMCID: PMC9348326 DOI: 10.1002/hep.32572] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS A few case reports of autoimmune hepatitis-like liver injury have been reported after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. We evaluated clinical features, treatment response and outcomes of liver injury following SARS-CoV-2 vaccination in a large case series. APPROACH AND RESULTS We collected data from cases in 18 countries. The type of liver injury was assessed with the R-value. The study population was categorized according to features of immune-mediated hepatitis (positive autoantibodies and elevated immunoglobulin G levels) and corticosteroid therapy for the liver injury. We identified 87 patients (63%, female), median age 48 (range: 18-79) years at presentation. Liver injury was diagnosed a median 15 (range: 3-65) days after vaccination. Fifty-one cases (59%) were attributed to the Pfizer-BioNTech (BNT162b2) vaccine, 20 (23%) cases to the Oxford-AstraZeneca (ChAdOX1 nCoV-19) vaccine and 16 (18%) cases to the Moderna (mRNA-1273) vaccine. The liver injury was predominantly hepatocellular (84%) and 57% of patients showed features of immune-mediated hepatitis. Corticosteroids were given to 46 (53%) patients, more often for grade 3-4 liver injury than for grade 1-2 liver injury (88.9% vs. 43.5%, p = 0.001) and more often for patients with than without immune-mediated hepatitis (71.1% vs. 38.2%, p = 0.003). All patients showed resolution of liver injury except for one man (1.1%) who developed liver failure and underwent liver transplantation. Steroid therapy was withdrawn during the observation period in 12 (26%) patients after complete biochemical resolution. None had a relapse during follow-up. CONCLUSIONS SARS-CoV-2 vaccination can be associated with liver injury. Corticosteroid therapy may be beneficial in those with immune-mediated features or severe hepatitis. Outcome was generally favorable, but vaccine-associated liver injury led to fulminant liver failure in one patient.
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Affiliation(s)
- Cumali Efe
- Department of GastroenterologyHarran University HospitalŞanlıurfaTurkey
| | - Anand V Kulkarni
- Department of Hepatology and Liver TransplantationAsian Institute of Gastroenterology HospitalsHyderabadIndia
| | | | - Bianca Magro
- Gastroenterology Hepatology and TransplantationASST Papa Giovanni XXIII-BergamoBergamoItaly
| | - Albert Stättermayer
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Mustafa Cengiz
- Department of GastroenterologyGülhane Training and Research HospitalAnkaraTurkey
| | | | - Craig Lammert
- Department of Medicine IndianaUniversity School of MedicineIndianapolisIndianaUSA
| | - Christine Bernsmeier
- Department of BiomedicineUniversity of BaselBaselSwitzerland.,University Centre for Gastrointestinal and Liver DiseasesBaselSwitzerland
| | - Özlem Gül
- Department of GastroenterologyKırıkkale UniversityKırıkkaleTurkey
| | | | - Margarita Anders
- Hepatology and Liver Transplant UnitHospital AlemánCiudad Autónoma de Buenos AiresArgentina
| | - Ellina Lytvyak
- Division of Gastroenterology and Liver UnitUniversity of AlbertaEdmontonAlbertaCanada
| | - Mete Akın
- Department of GastroenterologyAkdeniz University Faculty of MedicineAntalyaTurkey
| | - Tugrul Purnak
- Division of GastroenterologyHepatology and NutritionMcGovern Medical SchoolHoustonTexasUSA
| | - Rodrigo Liberal
- Gastroenterology and Hepatology DepartmentCentro Hospitalar e Universitário de São JoãoPortoPortugal.,World Gastroenterology Organization (WGO) Porto Training CenterPortoPortugal
| | - Mirta Peralta
- Hepatology SectionHospital Francisco J MuñizCiudad Autónoma de Buenos AiresArgentina.,Latin American Liver Research Educational and Awareness Network (LALREAN)PilarArgentina
| | - Berat Ebik
- Department of GastroenterologyGazi Yaşargil Education and Research HospitalDiyarbakirTurkey
| | - Serkan Duman
- Department of GastroenterologyAnkara University Medical FacultyAnkaraTurkey
| | - Nurhan Demir
- Department of GastroenterologyHaseki Training and Research HospitalIstanbulTurkey
| | - Yasemin Balaban
- Department of GastroenterologyFaculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Álvaro Urzua
- Gastroenterology and Hepatology UnitHospital Clínico Universidad de ChileSantiago de ChileChile
| | | | | | - Yılmaz Bilgiç
- Department of GastroenterologyInönü University School of MedicineMalatyaTurkey
| | - Adriana Medina
- Gastroenterology and Hepatology UnitHospital de Clínicas, Universidad Nacional de AsunciónSan LorenzoParaguay
| | - Marcos Girala
- Gastroenterology and Hepatology UnitHospital de Clínicas, Universidad Nacional de AsunciónSan LorenzoParaguay
| | - Fulya Günşar
- Department of GastroenterologyEge University School of MedicineİzmirTurkey
| | | | - Theodoros Androutsakos
- Department of PathophysiologyNational and Kapodistrian University of AthensMedical SchoolAthensGreece
| | - Ayelen Kisch
- Hepatology SectionHospital Bonorino UdaondoCiudad Autónoma de Buenos AiresArgentina
| | - Alper Yurci
- Department of GastroenterologyErciyes University School of MedicineKayseriTurkey
| | - Fatih Güzelbulut
- Department of GastroenterologyHaydarpaşa Numune Education and Research HospitalİstanbulTurkey
| | - Yasir Furkan Çağın
- Department of GastroenterologyInönü University School of MedicineMalatyaTurkey
| | - Enver Avcı
- Department of GastroenterologyKTO Karatay University Medical School Affiliated Konya Medicana HospitalKonyaTurkey
| | - Murat Akyıldız
- Department of GastroenterologyKoc University School of MedicineIstanbulTurkey
| | | | - Murat Harputluoğlu
- Department of GastroenterologyInönü University School of MedicineMalatyaTurkey
| | - Rahul Kumar
- Department of Gastroenterology and HepatologyChangi General HospitalMedicine Academic Clinical ProgrammeSing Health Duke-NUS Academic Medical CentreSingapore
| | - Sanjaya K Satapathy
- Department of Internal MedicineDonald and Barbara Zucker School of MedicineNorthwell HealthManhassetNew YorkUSA
| | - Manuel Mendizabal
- Latin American Liver Research Educational and Awareness Network (LALREAN)PilarArgentina.,Hepatology and Liver Transplant UnitHospital Universitario AustralPilarArgentina
| | - Marcelo Silva
- Latin American Liver Research Educational and Awareness Network (LALREAN)PilarArgentina.,Hepatology and Liver Transplant UnitHospital Universitario AustralPilarArgentina
| | - Stefano Fagiuoli
- Gastroenterology Hepatology and TransplantationASST Papa Giovanni XXIII-BergamoBergamoItaly
| | - Stuart K Roberts
- Department of GastroenterologyAlfred HealthMelbourneVictoriaAustralia.,Central Clinical SchoolDepartment of MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Neşe Karadağ Soylu
- Department of PathologyInönü University Faculty of MedicineMalatyaTurkey
| | - Ramazan Idilman
- Department of GastroenterologyAnkara University Medical FacultyAnkaraTurkey
| | - Eric M Yoshida
- Division of GastroenterologyUniversity of British Columbia and Vancouver General HospitalVancouverBritish ColumbiaCanada
| | - Aldo J Montano-Loza
- Division of Gastroenterology and Liver UnitUniversity of AlbertaEdmontonAlbertaCanada
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal MedicineNational Expertise Center of Greece in Autoimmune Liver DiseasesGeneral University Hospital of LarissaLarissaGreece.,European Reference Network on Hepatological Diseases (ERN RARE-LIVER)General University Hospital of LarissaLarissaGreece
| | - Ezequiel Ridruejo
- Latin American Liver Research Educational and Awareness Network (LALREAN)PilarArgentina.,Hepatology and Liver Transplant UnitHospital Universitario AustralPilarArgentina.,Hepatology SectionDepartment of MedicineCentro de Educación Médica e Investigaciones Clínicas, CEMICCiudad Autónoma de Buenos AiresArgentina
| | - Thomas D Schiano
- Division of Liver Diseasesthe Mount Sinai Medical CenterNew YorkNew YorkUSA
| | - Staffan Wahlin
- Hepatology Division, Department of Upper GI DiseasesKarolinska Institutet and Karolinska University HospitalStockholmSweden
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10
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Deniz M, Doğan M, Gül Ö, Özhan B, Agladıoğlu SY, Enli Y, Şenol H. Evaluation of cardiovascular system and determination of cardiometabolic risk using novel biomarkers in childhood obesity. Progress in Pediatric Cardiology 2022. [DOI: 10.1016/j.ppedcard.2022.101605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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11
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Gül Ö, Gündüz A, Sevgi DY, Demirbaş ND, Uzun N, Dökmetaş İ. Cognitive Assessment of Young Adults Before and After Initiation of Combination Antiretroviral Therapy. Infect Dis Clin Microbiol 2022; 4:163-171. [PMID: 38633390 PMCID: PMC10986713 DOI: 10.36519/idcm.2022.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/16/2022] [Indexed: 04/19/2024]
Abstract
Objective In the determination and monitoring of neurocognitive disorders in human immunodeficiency virus (HIV)-positive individuals, there is a need for significantly more practical methods which provide results in a shorter time than the tests that require challenging and specialized expertise. This study aimed to evaluate cognitive functions and the factors affecting them in naïve HIV-positive patients using by Montreal Cognitive Assessment (MoCA) test before and after the initiation of combination antiretroviral therapy. Materials and Methods HIV-positive, treatment-naïve patients monitored between January-June 2017 were included in the study. The MoCA test was performed at the beginning and the sixth month of the treatment. Results Forty male patients were included in the study. The mean age was calculated as 29.1±4.0. When the factors affecting the MoCA score were examined, there was a significant relationship between the education level and the MoCA score. Smoking, using alcohol, and substance did not have a significant impact on baseline MoCA values. A significant correlation was found between cluster differentiation 4 (CD4) count and HIV RNA level and attention function. There was a significant increase in the total MoCA score and the MoCA subgroup scores at the end of the sixth month of the treatment. Conclusion MoCA test is one of the most practical tests that can be applied in a short time period, and it was found useful in evaluating the changes in the cognitive functions of HIV-positive patients during antiretroviral treatment.
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Affiliation(s)
- Özlem Gül
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Alper Gündüz
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Dilek Yıldız Sevgi
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Nazife Duygu Demirbaş
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Nuray Uzun
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - İlyas Dökmetaş
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
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12
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Gül Ö, Binay UD, Barkay O, Karakeçili F. [The Importance of Differential Diagnosis During Pandemic: A Case Report with Coexistence of COVID-19, Brucellosis and Crimean-Congo Hemorrhagic Fever]. MIKROBIYOL BUL 2022; 56:365-370. [PMID: 35477238 DOI: 10.5578/mb.20229815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The coronavirus disease-2019 (COVID-19) pandemic, which affects millions of people around the world, has been affecting our country since March 2020. The fact that the symptoms such as fever, myalgia, headache, joint pain which are common in COVID-19 patients are quite similar to the symptoms of diseases such as Crimean-Congo hemorrhagic fever (CCHF) and Brucellosis. This may cause a diagnostic confusion in regions where these diseases are seen as endemic. In this report, a patient hospitalized with a pre-diagnosis of COVID-19 and diagnosed with acute Brucellosis, CCHF and COVID-19 during followup was presented. A 31-year-old female patient living in a rural area admitted to the emergency service with complaints of fever, weakness, headache, and body/joint pain. Physical examination revealed a temperature of 38.3°C, a pulse rate of 102/minute, and a peripheral capillary oxygen saturation of 97% in room air. The system examination was normal. In the laboratory findings, an increase in liver enzymes and acute phase reactants was observed and the platelet count was at the lower limit of the normal range. In terms of COVID-19, no involvement compatible with COVID-19 was detected in the thorax computed tomography (CT) of the patient whose nasopharyngeal and oropharyngeal mixed swab samples were taken.The patient was transferred to our infectious diseases service with a pre-diagnosis of COVID-19 and CCHF. Serum samples were sent to the Public Health Agency Microbiology Reference Laboratory Department (PHA-MRLD) for CCHF diagnostic tests and supportive treatment was started. Brucella Rose Bengal and Coombs' immuncapture (1/1280 titer) tests were found as positive in the patient, who was examined for brucellosis because of living in a rural area and having a history of consuming fresh dairy products. In the tests performed at PHA-MRLD, CCHF-specific IgM positivity and the presence of viral RNA were detected. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction (RT-PCR) test was negative. For Brucellosis, doxycycline and rifampicin were added to the treatment of the patient whom was given supportive therapy for CCHF. In the followup, the patient's fever was persisting and loss of taste and smell complaint developed. In this context, COVID-19 test was repeated and resulted as positive. Upon this, hydroxychloroquine sulfate treatment was started due to the recommendation of the current Ministry of Health Scientific Committee Guide. No new infiltration was detected in the chest radiography of the patient. The patient's fever subsided during follow-up and laboratory findings improved. The treatment of brucellosis was completed to eight weeks at the outpatient clinic. No problems were detected in the follow-up. This report was prepared because of a case with simultaneous brucellosis, CCHF and COVID-19 infections which could not be encountered in the literature review. As a result; in regions such as our country where both brucellosis and CCHF are seen as endemic, it is very important to keep these diseases in mind in the differential diagnosis of COVID-19 infection.
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Affiliation(s)
- Özlem Gül
- Binali Yıldırım University Mengücek Gazi Training and Research Hospital, Infectious Disease and Clinical Microbiology, Erzincan, Turkey
| | - Umut Devrim Binay
- Binali Yıldırım University Mengücek Gazi Training and Research Hospital, Infectious Disease and Clinical Microbiology, Erzincan, Turkey
| | - Orçun Barkay
- Binali Yıldırım University Mengücek Gazi Training and Research Hospital, Infectious Disease and Clinical Microbiology, Erzincan, Turkey
| | - Faruk Karakeçili
- Binali Yıldırım University Mengücek Gazi Training and Research Hospital, Infectious Disease and Clinical Microbiology, Erzincan, Turkey
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Abstract
Objective: The epidemiological characteristics, risk factors, complications, recurrence status, clinical and laboratory features, and treatment methods of the patients who admitted to our Pediatric Cardiology Outpatient Clinic with a pre-diagnosis of acute rheumatic fever (ARF) were evaluated. Materials and Methods: The data of 166 patients who admitted with a pre-diagnosis of ARF and were diagnosed with ARF, and the data of 51 patients who were not diagnosed with ARF, were retrospectively analyzed. Results: The patients with ARF were between the ages of 5 and 18. Most of the patients with ARF attack admitted in December (15.6%), January (13.8%), and February (13.2%). The most common complaints of the patients diagnosed with ARF were isolated joint pain and/or swelling, at 50.6%. While 91.5% of the patients were diagnosed for the first time, 8.5% had ARF recurrence. It was seen that the most common major criterion was carditis (94.6%). The severity of valve regurgitation and the rates of monoarthritis were significantly higher in patients with recurrence (P < .05). Non-compliance with prophylaxis was observed in 10 (71.4%) of 14 patients with recurrence, and in 43 (28.2%) of 152 patients without recurrence. Anti-streptolysin O was lower (P = .021) and alanine transaminase (ALT) was higher (P = .019) in the recurrence group. Conclusion: Our study showed that in patients with a pre-diagnosis of ARF, a differential diagnosis should be made with other diseases. Especially in patients with joint complaints as the only major symptom, a differential diagnosis should be made. ARF recurrence is associated with non-compliance with prophylaxis, and both the severity of valve regurgitation and monoarthritis rates are higher in patients who develop recurrence. Alanine aminotransferase is significantly higher in patients with ARF recurrence.
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Affiliation(s)
- Ahmet Güneş
- Department of Pediatrics, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Alper Akın
- Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
| | - Mehmet Türe
- Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
- Corresponding author:Mehmet Türe✉
| | - Hasan Balık
- Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
| | - Meki Bilici
- Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
| | - Özlem Gül
- Department of Pediatric Cardiology, Gazi Yaşargil Hospital, Diyarbakır, Turkey
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14
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Idzuchi H, Pientka F, Huang KF, Harada K, Gül Ö, Shin YJ, Nguyen LT, Jo NH, Shindo D, Cava RJ, Canfield PC, Kim P. Unconventional supercurrent phase in Ising superconductor Josephson junction with atomically thin magnetic insulator. Nat Commun 2021; 12:5332. [PMID: 34504077 PMCID: PMC8429564 DOI: 10.1038/s41467-021-25608-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/22/2021] [Indexed: 11/23/2022] Open
Abstract
In two-dimensional (2D) NbSe2 crystal, which lacks inversion symmetry, strong spin-orbit coupling aligns the spins of Cooper pairs to the orbital valleys, forming Ising Cooper pairs (ICPs). The unusual spin texture of ICPs can be further modulated by introducing magnetic exchange. Here, we report unconventional supercurrent phase in van der Waals heterostructure Josephson junctions (JJs) that couples NbSe2 ICPs across an atomically thin magnetic insulator (MI) Cr2Ge2Te6. By constructing a superconducting quantum interference device (SQUID), we measure the phase of the transferred Cooper pairs in the MI JJ. We demonstrate a doubly degenerate nontrivial JJ phase (ϕ), formed by momentum-conserving tunneling of ICPs across magnetic domains in the barrier. The doubly degenerate ground states in MI JJs provide a two-level quantum system that can be utilized as a new dissipationless component for superconducting quantum devices. Our work boosts the study of various superconducting states with spin-orbit coupling, opening up an avenue to designing new superconducting phase-controlled quantum electronic devices. Van der Waals structures provide a new platform to explore novel physics of superconductor/ferromagnet interfaces. Here, NbSe2 Josephson junction with Cr2Ge2Te6 enables non-trivial Josephson phase by spin-dependent interaction, boosting the study of superconducting states with spin-orbit coupling and phase-controlled quantum electronic device.
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Affiliation(s)
- H Idzuchi
- Department of Physics, Harvard University, Cambridge, MA, USA.,WPI Advanced Institute for Materials Research and Center for Science and Innovation in Spintronics, Tohoku University, Sendai, Japan
| | - F Pientka
- Department of Physics, Harvard University, Cambridge, MA, USA.,Institut für Theoretische Physik, Goethe-Universität, Frankfurt am Main, Germany
| | - K-F Huang
- Department of Physics, Harvard University, Cambridge, MA, USA
| | - K Harada
- Center for Emergent Matter Science (CEMS), RIKEN, Hatoyama, Saitama, Japan
| | - Ö Gül
- Department of Physics, Harvard University, Cambridge, MA, USA
| | - Y J Shin
- Department of Physics, Harvard University, Cambridge, MA, USA.,Center for Functional Nanomaterials, Brookhaven National Laboratory, Upton, NY, USA
| | - L T Nguyen
- Department of Chemistry, Princeton University, Princeton, NJ, USA
| | - N H Jo
- Department of Physics and Astronomy, Iowa State University, Ames, IA, USA.,Ames Laboratory, Iowa State University, Ames, IA, USA
| | - D Shindo
- Center for Emergent Matter Science (CEMS), RIKEN, Hatoyama, Saitama, Japan
| | - R J Cava
- Department of Chemistry, Princeton University, Princeton, NJ, USA
| | - P C Canfield
- Department of Physics and Astronomy, Iowa State University, Ames, IA, USA.,Ames Laboratory, Iowa State University, Ames, IA, USA
| | - P Kim
- Department of Physics, Harvard University, Cambridge, MA, USA.
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15
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Balaban ÖD, Parsanoğlu Z, Arıkan Ö, Gül Ö. Should C-Reactive Protein and Troponin Be Monitored for Early Diagnosis of Clozapine Induced Myocarditis? An Assessment Within the Framework of Two Cases. Turk Psikiyatri Derg 2021; 32:56-60. [PMID: 34181745 DOI: 10.5080/u25417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Clozapine is an important treatment option in patients with treatmentresistant schizophrenia and bipolar disorder. Clozapine has multiple systemic side effects with myocarditis and cardiomyopathy being considered as serious cardiovascular outcomes. Although the aetiology of myocarditis is still unknown, its frequent occurrence in the early stages of clozapine use suggests that type 1 drug hypersensivity may underlie. Although rare, the cardiovascular side effects can be lifethreatening and must be recognized and treated promptly. The nonspecific clinical presentation of these conditions makes risk evaluation and identification of the affected patients difficult. A consensus has not yet been formed on following up the patients without the suspected clinical cardiac symptoms. In this article we presented two cases of myocarditis associated with clozapine. We aimed to emphasize that C-Reactive Protein and troponin monitoring, in accordance with the current clozapine guidelines, was practical and useful for early detection of myocarditis in asymptomatic patients. We also wanted to draw attention to the factors that may increase the cardiovascular risk such as polypharmacy and concomitant use of lithium and valproate with clozapine.
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16
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Gül Ö, Günel HY, Lüth H, Rieger T, Wenz T, Haas F, Lepsa M, Panaitov G, Grützmacher D, Schäpers T. Giant magnetoconductance oscillations in hybrid superconductor-semiconductor core/shell nanowire devices. Nano Lett 2014; 14:6269-6274. [PMID: 25300066 DOI: 10.1021/nl502598s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The magnetotransport of GaAs/InAs core/shell nanowires contacted by two superconducting Nb electrodes is investigated, where the InAs shell forms a tube-like conductive channel around the highly resistive GaAs core. By applying a magnetic field along the nanowire axis, regular magnetoconductance oscillations with an amplitude in the order of e(2)/h are observed. The oscillation amplitude is found to be larger by 2 orders of magnitude compared to the measurements of a reference sample with normal metal contacts. For the Nb-contacted core/shell nanowire the oscillation period corresponds to half a flux quantum Φ0/2 = h/2e in contrast to the period of Φ0 of the reference sample. The strongly enhanced magnetoconductance oscillations are explained by phase-coherent resonant Andreev reflections at the Nb-core/shell nanowire interface.
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Affiliation(s)
- Ö Gül
- Peter Grünberg Institute (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich GmbH , 52425 Jülich, Germany
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17
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Altun H, Gül Ö, Öksüz AN, Şahin N. Cyclic vomiting syndrome treated successfully with fluoxetin. Turk Arch Pediatr 2014; 49:88-9. [PMID: 26078641 DOI: 10.5152/tpa.2014.1373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 10/30/2013] [Indexed: 11/22/2022]
Affiliation(s)
- Hatice Altun
- Department of Child and Adolescent Psychiatry, Kahramanmaraş University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Özlem Gül
- Department of Pediatrics, Kahramanmaraş University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Ali Nuri Öksüz
- Department of Psychiatry, Kahramanmaraş University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Nilfer Şahin
- Department of Child and Adolescent Psychiatry, Muğla Sıtkı Koçman University Education and Research Hospital, Muğla, Turkey
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18
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Yenice Ş, Kemahlı S, Bilenoğlu O, Gül Ö, Akar E, Başak AN, Akar N. Two Rare Hemoglobin Variants in the Turkish Population (Hb G-Coushatta (B 22(B4) GLU-ALA and Hb J Iran (B 77 (EF1) HIS-ASP). Turk J Haematol 2000; 17:27-28. [PMID: 27265760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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