Publications by authors named "M Deniz Yilmaz"

2,886 Publications

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Strategic Recommendations to Bridge the Gaps in Awareness, Diagnosis and Prevention of Heart Failure in the Middle East Region and Africa.

J Saudi Heart Assoc 2022 15;34(1):53-65. Epub 2022 Apr 15.

Cardiology Department, Eskisehir Osmangazi University, Eskisehir, Turkey.

Objective: With the increasing burden of heart failure (HF) in the Middle East Region and Africa (MEA), it is imperative to shift the focus to prevention and early detection of cardiovascular diseases. We present a broad consensus of the real-world challenges and strategic recommendations for optimising HF care in the MEA region.

Method: To bridge the gaps in awareness, prevention, and diagnosis of HF, an assembly of experts from MEA shared their collective opinions on the urgent unmet needs.

Results: Lack of awareness in the community, high prevalence of risk factors, poor accessibility and affordability of care and diagnostics are the major barriers for delayed or missed diagnosis of HF in MEA. Enhancing patient awareness, through digital or social media campaigns, alongside raising knowledge of healthcare providers and policymakers with training programmes, can pave the way for influencing policy decisions and implementation of robust HF programmes. Multicountry registries can foster development of guidelines factoring in local challenges and roadblocks for HF care. Region-specific guidelines including simplified diagnostic algorithms can provide a blueprint of care for early detection of at-risk patients and facilitate efficient referral, thus mitigating clinician "therapeutic inertia." Multidisciplinary care teams and HF clinics with expanded role of nurses can streamline lifestyle modification and optimum control of dyslipidaemia, blood pressure, and glycaemia through guideline-recommended prevention therapies such as sodiumglucose co-transporter-2 inhibitors-thus supporting pleiotropic effects in high-risk populations.

Conclusion: Development of regional guidelines, enhancing awareness, leveraging digital technology, and commitment for adequate funding and reimbursement is pivotal for overcoming structural and health system-related barriers in the MEA region.
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http://dx.doi.org/10.37616/2212-5043.1294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059727PMC
April 2022

Venetoclax Combined with FLAG-IDA Induction and Consolidation in Newly Diagnosed Acute Myeloid Leukemia.

Am J Hematol 2022 May 18. Epub 2022 May 18.

Department of Leukemia.

Background: Multi-agent induction chemotherapy (IC) improves response rates in younger patients with acute myeloid leukemia (AML), however relapse remains the principal cause of treatment failure. Improved induction regimens are needed.

Methods: A prospective single-center phase Ib/II study evaluating fludarabine, cytarabine, G-CSF, and idarubicin combined with venetoclax (FLAG-IDA+VEN) in patients with newly diagnosed (ND) or relapsed/refractory AML. The primary efficacy endpoint was assessment of overall activity (overall response rate [ORR]: complete remission [CR]+ CR with partial hematologic recovery [CRh]+CR with incomplete hematologic recovery [CRi]+ morphologic leukemia free state+ partial response). Secondary objectives included additional assessments of efficacy, overall survival (OS), and event-free survival (EFS). Results of the expanded ND cohort with additional follow-up are reported.

Results: Forty-five patients (median age: 44 years [range 20-65]) enrolled. ORR was 98% (N=44/45; 95% credible interval 89.9-99.7%). 89% (N=40/45) of patients attained a composite CR (CRc+CRh+CRi) including 93% (N=37/40) who were measurable residual disease (MRD) negative. Twenty-seven (60%) patients transitioned to allogeneic stem cell transplant (alloHSCT). Common non-hematologic adverse events included febrile neutropenia (44%; N=20), pneumonia (22%, N=10), bacteremia (18%, N=8), and skin/soft tissue infections (44%, N=20). After a median follow-up of 20 months, median EFS and OS was not reached. Estimated 24-month EFS and OS were 64% and 76%.

Conclusions: FLAG-IDA+VEN is an active regimen in ND-AML capable of producing high MRD-negative remission rates and enabling transition to alloHSCT when appropriate in most patients. Toxicities were as expected with IC and were manageable. Estimated 24-month survival appears favorable compared to historical IC benchmarks. This article is protected by copyright. All rights reserved.
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http://dx.doi.org/10.1002/ajh.26601DOI Listing
May 2022

Which is the best for the warfarin monitoring: Following up by fixed or variable physician?

North Clin Istanb 2022 10;9(2):93-101. Epub 2022 Mar 10.

Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.

Objective: Warfarin therapy has some difficulties in terms of close monitoring and dosage. This study aims to evaluate the effect of same-fixed versus different-variable physician-based monitoring of warfarin therapy on treatment quality and clinical end-points.

Methods: A total of 625 consecutive patients requiring warfarin treatment were enrolled at seven centers. INR values of the patients measured at each visit and registered to hospital database were recorded. Time in therapeutic range (TTR) was calculated using linear interpolation method (Rosendaal's method). A TTR value of ≥65% was considered as effective warfarin treatment. If a patient was evaluated by the same-fixed physician at each INR visit, was categorized into the same-physician (SP) group. In contrast, if a patient was evaluated by different-variable physicians at each INR visit, was categorized into variable physician (VP) group. Enrolled patients were followed up for bleeding and embolic events.

Results: One hundred and fifty-six patients (24.9%) were followed by SP group, 469 (75.1%) patients were followed by VP group. Median TTR value of the VP group was lower than that of SP group (56.2% vs. 65.1%, respectively, p=0.009). During median 25.5 months (9-36) of follow-up, minor bleeding, major bleeding and cerebral embolic event rates were higher in VP group compared to SP group (p<0.001, p=0.023, p<0.001, respectively). In multivariate analysis, INR monitoring by VP group was found to be an independent predictor of increased risk of bleeding events (OR 2.55, 95% CI 1.64-3.96, p<0.001) and embolism (OR 3.42, 95% CI 1.66-7.04, p=0.001).

Conclusion: INR monitoring by same physician was associated with better TTR and lower rates of adverse events during follow-up. Hence, it is worth encouraging an SP-based outpatient follow-up system at least for where warfarin therapy is the only choice.
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http://dx.doi.org/10.14744/nci.2021.06981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039632PMC
March 2022

In Regard to Bellon et al.

Int J Radiat Oncol Biol Phys 2022 Jun;113(2):471-472

Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.

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http://dx.doi.org/10.1016/j.ijrobp.2022.02.027DOI Listing
June 2022

Tuning the Metal-Insulator Transition Properties of VO Thin Films with the Synergetic Combination of Oxygen Vacancies, Strain Engineering, and Tungsten Doping.

Nanomaterials (Basel) 2022 Apr 26;12(9). Epub 2022 Apr 26.

Department of Physics, Faculty of Science, Islamic University of Madinah, AlMadinah Almonawara 42351, Saudi Arabia.

Vanadium oxide (VO) is considered a Peierls-Mott insulator with a metal-insulator transition (MIT) at T = 68° C. The tuning of MIT parameters is a crucial point to use VO within thermoelectric, electrochromic, or thermochromic applications. In this study, the effect of oxygen deficiencies, strain engineering, and metal tungsten doping are combined to tune the MIT with a low phase transition of 20 °C in the air without capsulation. Narrow hysteresis phase transition devices based on multilayer VO, WO, MoWO and/or MoO oxide thin films deposited through a high vacuum sputtering are investigated. The deposited films are structurally, chemically, electrically, and optically characterized. Different conductivity behaviour was observed, with the highest value towards VO/WO and the lowest VO on FTO glass. VO/WO showed a narrow hysteresis curve with a single-phase transition. Thanks to the role of oxygen vacancies, the MIT temperature decreased to 35 °C, while the lowest value (T = 20 °C) was reached with MoWO/VO/MoO structure. In this former sample, MoWO was used for the first time as an anti-reflective and anti-oxidative layer. The results showed that the MoO bottom layer is more suitable than WO to enhance the electrical properties of VO thin films. This work is applied to fast phase transition devices.
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http://dx.doi.org/10.3390/nano12091470DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099983PMC
April 2022
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