Publications by authors named "Sevilay Karahan"

95 Publications

Influence of reciprocating and rotary instrumentation on microbial reduction: a systematic review and meta-analysis of studies.

Restor Dent Endod 2021 May 10;46(2):e19. Epub 2021 Mar 10.

Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Objectives: The purpose of this study was to conduct a systematic review and meta-analysis of studies regarding the effectiveness of reciprocating and rotary instrumentation on microbial reduction in root canals.

Materials And Methods: PubMed, Scopus, Web of Science, the Cochrane Library, and the gray literature were searched through December 2019. Studies comparing the influence of reciprocating and rotary instrumentation on the removal of microorganisms from root canals that quantified the antimicrobial effect were included. Data extraction was completed using a systematic form for data collection. The risk of bias of the studies was evaluated. Standardized mean differences (SMDs) and confidence intervals (CIs) were calculated using a random effects meta-analysis.

Results: Seventeen studies were included in this systematic review, of which 7 provided adequate data for inclusion in the meta-analysis. Both reciprocating and rotary systems were similarly effective in reducing the microbial load in infected root canals (SMD [95% CI], 0.0481 [-0.271, 0.367]). Three studies showed a low risk of bias, whereas most of the studies (82%) presented a medium risk.

Conclusions: Although both techniques decrease the microbial content (with reductions of 23.32%-88.47% and 23.33%-89.86% for reciprocating and rotary instrumentation, respectively), they are not able to provide complete disinfection of root canals.
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http://dx.doi.org/10.5395/rde.2021.46.e19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170383PMC
May 2021

assessment of periapical lesions created in sheep mandibles by using high resolution ultrasonography and cone beam computed tomography.

Dentomaxillofac Radiol 2021 Jun 10:20210048. Epub 2021 Jun 10.

Dept of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Objectives: Providing ultrasound images of periapical lesions may be problematic depending on the thickness of the overlying cortical bone. Clinically, it is crucial to determine the cut-off value of overlaying bone thickness in terms of interference with ultrasound imaging in conjunction with assessment of changes in periapical jaw bone lesions. Our aim was to determine the minimum amount of overlaying buccal bone thickness of artificial periapical lesions in order to be visible by ultrasound imaging and to compare width, height, depth, surface area and volume measurements of detectable periapical lesions obtained from ultrasound and CBCT images.

Methods: Periapical lesions were created in 16 molar teeth of sheep mandibles. Cavities were enlarged until the borders of lesions were visible on 14 MHz hockey probe ultrasound imaging. CBCT and ultrasound images were obtained simultaneously after drilling and enlarging each size of the cavities and replacing the teeth in their sockets. two observers separately assessed images twice within 2 weeks of interval. By using CBCT and ultrasound images, buccal bone thickness, maximum width, height, depth, surface area and volume of periapical lesions were measured. Intraclass correlation coefficient (ICC) was utilized and significance level was set at < 0.05.

Results: The mean buccal bone thickness ranged between 1.21 mm and 1.31 mm for both imaging techniques. For the measurement of buccal bone thickness, periapical lesion width, height, depth, surface area, and volume excellent ICC values were found in terms of intrarater (ranging between 0.907 and 1) and inter-rater (ranging between 0.864 and 1) reliability for both observers and their readings. There were no statistically significant differences for both observers and for their two readings between ultrasound and CBCT measurements of buccal bone thickness, and periapical lesion width and height ( > 0.05).

Conclusions: We suggested that a buccal thickness of approximately 1.28 mm might be accepted as a cut-off value for the detection of periapical lesions with 14 MHz hockey probe ultrasound. High resolution ultrasound provided accurate information for the measurement of buccal bone thickness and lesion width and height.
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http://dx.doi.org/10.1259/dmfr.20210048DOI Listing
June 2021

Six-year clinical evaluation of bulk-fill and nanofill resin composite restorations.

Clin Oral Investig 2021 Jun 10. Epub 2021 Jun 10.

Department of Cariology and Restorative Dentistry, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, FL, USA.

Objectives: This study aims to compare the performance of a bulk-fill and a nanofill resin composite in class II restorations after 6 years.

Materials And Methods: Fifty patients having at least two class II carious lesions were recruited for the study. One lesion in each patient was randomly assigned to be restored using either the Tetric EvoCeram Bulk Fill (TB) or Filtek Ultimate (FU) resin composites with their respective adhesives. One hundred four restorations were placed by two calibrated operators. Restorations were evaluated at baseline and annually over the course of 6 years by two examiners using modified USPHS criteria. Data were statistically analyzed using the Chi-square and Cochran Q tests (p < 0.05).

Results: Sixty-six restorations in 33 patients were evaluated after 6 years. Only one restoration was lost from FU group at 5 years. At the end of 6 years, marginal discoloration was observed in three (9.1%) TB and eight (36.4%) FU restorations creating a significant difference between the groups (p < 0.05). The FU group showed a significant increase in marginal discoloration at 6 years from the baseline (p < 0.05). Marginal adaptation was rated as Bravo for 9.1% and 24.2% of TB and FU restorations, respectively (p > 0.05). Significant degradation was observed within each group in terms of marginal adaptation (p < 0.05). There were no statistically significant differences between the groups for the other criteria tested (p > 0.05).

Conclusions: Bulk-fill restorations performed better for marginal discoloration. The remaining clinical performance criteria of bulk-fill and nanofill resin composite restorations were similar after 6 years.

Clinical Relevance: Bulk-fill resin might be a better alternative to incrementally placed restorative in terms of marginal discoloration under clinical conditions.
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http://dx.doi.org/10.1007/s00784-021-04015-2DOI Listing
June 2021

Validity and reliability study of coronavirus-related psychiatric symptom scale in children - parental form.

Turk Arch Pediatr 2021 1;56(3):200-206. Epub 2021 May 1.

Department of Pediatric Pulmonology, Hacettepe University School of Medicine, Ankara, Turkey.

Objective: The aim of this study is to develop a scale to assess the psychiatric symptoms that may emerge owing to the coronavirus disease 2019 (COVID-19) pandemic period in children and adolescents aged 4-18 years.

Material And Methods: To develop the scale, first, interviews with children, adolescents, and their parents were conducted, and the possible psychiatric symptom clusters were detected. The items were written with reference to the literature and reviewed by the experts. A 40-item scale form was shared as an online survey, and a factor analysis of the scale was carried out with data obtained from 441 participants. The test-retest reliability of the scale was carried out with data obtained from the 51 participants who filled the scale again after 14 days.

Results: According to the item-total correlations and factor analysis results with 40 items, 5 items with low correlation and factor load or loaded same under the two factors were removed from the scale. The final form had 35 items and had a two-factor structure. The internal consistency coefficient of the scale was calculated as 0.96, and the test-retest correlation coefficient was 0.98.

Conclusion: Coronavirus-related psychiatric symptom scale in children - parental form is a valid and reliable scale for measuring perceived psychiatric symptoms associated with COVID-19pandemic in children aged 4-18 years by their parents.
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http://dx.doi.org/10.5152/TurkArchPediatr.2021.20256DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152656PMC
May 2021

Factors associated with self-reported capacity to walk, jog and run in individuals with systemic lupus erythematosus.

Arch Rheumatol 2021 Mar 10;36(1):89-100. Epub 2020 Dec 10.

Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.

Objectives: This study aims to explore how disease and health-related quality of life (HRQOL) factors are associated with self-reported physical capacity in walking, jogging and running in systemic lupus erythematosus (SLE).

Patients And Methods: This cross-sectional study is part of an ongoing cohort research project which started in 2014. A total of 198 patients (21 males, 177 females; mean age 51.5±16.1 years; range, 20 to 82 years) with SLE answered a question concerning physical capacity and the answers were categorized as low (can walk less than 2 km) and high (can jog and run at least 2 km) capacity. Additional measurements of disease activity (Systemic Lupus Activity Measure-Revised, SLAM-R), organ damage (Systemic Lupus International Collaborating Clinics-Damage Index, SLICC-DI), physical activity (International Physical Activity Questionnaire-Short Form, IPAQ-SF), exercise during the past year, Hospital Anxiety and Depression Scale (HADS), and HRQOL according to EuroQol five-dimension score and EuroQol visual analog scale (EQ-VAS) were included. The independent variables in the multiple logistic regression analysis were age, body mass index (BMI), disease duration, SLAM-R, SLICC-DI, IPAQ-SF category, sitting hours (IPAQ-SF), and exercise during the past year as well as HADS and EQ-VAS.

Results: Patients that reported low physical capacity (n=120) were older (p<0.001), had longer disease duration (p<0.001), had more organ damage (p<0.001), reported that they were less physically active (p=0.003), exercised less during the past year (p=0.001), reported more pain/discomfort and depressive symptom (p<0.001) and had lower overall HRQOL (p<0.001) and mobility and usual activities than those that reported high capacity (n=78). The regression analysis showed that age (median ≤49 vs >49) (Exp) (B): 4.52 (95% confidence interval [CI]: 2.05 to 9.98) (p<0.001), disease duration (median ≤17 vs >17) Exp (B): 2.53 (95% CI: 1.15 to 5.60) (p=0.02), SLICC-DI (median <1 vs ≥1) Exp (B): 3.60 (95% CI: 1.48 to 8.73) (p=0.005), and EQ-VAS (median <72 vs ≥72) Exp (B): 4.63 (95% CI: 2.13 to 10.05) (p<0.001) were significant factors associated with physical capacity (Nagelkerke R Squared=0.46).

Conclusion: Patients with low physical capacity were less physically active, exercised less and had more pain and depressive symptoms than those that reported a high capacity. However, only age, disease duration, organ damage and overall HRQOL were indicators of low physical capacity. In order to increase physical capacity in the management of SLE, it is important to address overall HRQOL.
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http://dx.doi.org/10.46497/ArchRheumatol.2021.8193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140879PMC
March 2021

Correlation of Ocular Biometric Parameters and Macular Ganglion Cell Layer in Normal Eyes.

Semin Ophthalmol 2021 May 6:1-6. Epub 2021 May 6.

Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey.

Purpose: To determine the association between ocular biometric parameters and macular ganglion cell layer (MGCL) thickness in normal eyes.

Methods: This observational cohort study was conducted with 76 eyes of 76 healthy subjects. Keratometry, pachymetry, corneal volume, iridocorneal angle were measured with Sirius (CSO, Florence, Italy); axial length, anterior chamber depth, anterior chamber volume, corneal diameter were measured with IOL Master (Carl Zeiss Meditec, Dublin, California). For all participants, serial horizontal Spectralis Domain Optical Coherence Tomography (SD-OCT, Heidelberg Engineering, GmbH, Dossenheim, Germany) scans of the macula and peripapillary retinal nerve fiber layer (RNFL) analysis were obtained using SD-OCT. The relationship between numerical variables was given by Pearson correlation coefficient.

Results: The mean age of the subjects was 36.3 ± 11.9 years (between 19 and 70 y). Fifty-one patients were female (67.1%) and twenty-five patients were male (32.9%). MGCL was found to be correlated with anterior chamber depth, anterior chamber volume, iridocorneal angle, axial length and white to white ( = .015 r = 0.594, = .002 r = 0.365, = .013 r = 0.299, = .004 r = 0.335, = .013 r = 0.289, respectively). In addition, MGCL was correlated positively with the mean global and superotemporal RNFL (p ≤ 0.005). However, neither central corneal thickness nor keratometry values were found to be correlated with MGCL.

Conclusion: The results of this study showed that MGCL thickness is affected by ocular biometric parameters. Therefore, these parameters should be taken into consideration when interpreting MGCL thickness measurements in the diagnosis of glaucoma.
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http://dx.doi.org/10.1080/08820538.2021.1922711DOI Listing
May 2021

Contribution of XP-Endo files to the root canal filling removal: A systematic review and meta-analysis of in vitro studies.

Aust Endod J 2021 Mar 13. Epub 2021 Mar 13.

Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

This review was designed to analyse whether the supplementary use of XP-Endo Finisher and XP-Endo Finisher R contributes to the removal of root canal filling materials. Databases were searched up to November 2020. Studies were critically assessed according to inclusion and exclusion criteria. Risk of bias evaluation was performed. Pooled standardised mean differences (SMD) and 95% confidence intervals (95% CI) were calculated. Ten studies involving 192 teeth were eligible for systematic review and meta-analysis could be performed with eight of these studies. Strong evidence showed that XP-Endo Finisher R file contributed significantly to filling material removal from root canals (SMD (95% CI): 0.41 (0.06-0.76)). Although the evidence was conflicting, XP-Endo Finisher R file was superior than other irrigant activation techniques (SMD (95% CI): 0.47 (0.02-0.93)). The supplementary use of XP-Endo Finisher and XP-Endo Finisher R is beneficial in further removal of root canal filling materials from root canal system.
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http://dx.doi.org/10.1111/aej.12503DOI Listing
March 2021

Screening traumatic life events in preschool aged children: cultural adaptation of Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 years version.

Turk J Pediatr 2021 ;63(1):95-101

Departments of Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Background: Given the high prevalence of potentially traumatic events (PTEs), pediatric providers are in a novel position in early identification and referral of the children with PTEs. Yet paucity of culturally adapted instruments to screen PTEs and related symptoms in preschool-aged children limits pediatric providers. This multicenter study aimed to screen the traumatic life events of preschool-aged children admitted to pediatric outpatient clinics at four different cities of Turkey and to determine the socio-demographic risk factors associated with PTEs. Moreover, it was also intended to develop the cultural adaptation of the Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 Years version to Turkish and to analyze its reliability.

Methods: Participants of this multicenter study were collected from four different hospitals in three different regions (Central Anatolia, Black Sea, and Southeastern Anatolia regions) of Turkey. All parents of children at the age of 3-6 years who were admitted to the hospital for a clinical visit (sick-child or well-child visits) were invited to the study. In total, 188 preschool-aged children were included in the study. Socio-demographic characteristics of the child and the family were questioned and parents were asked to fill out the Turkish version of the CATS Caregiver-report.

Results: Internal consistency (Cronbach`s alpha) of the Turkish version of the CATS Caregiver-report 3-6 Years was found as 0.86. This study revealed that half of the participating children had experienced at least one PTE and more than one fourth experienced more than one event. Strikingly, no association between sociodemographic risk factors and PTE exposure was identified suggesting that PTE exposure is indeed widespread in our study population.

Conclusion: The findings of this study manifest the importance of routine screening of PTEs and related symptoms in children.
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http://dx.doi.org/10.24953/turkjped.2021.01.011DOI Listing
January 2021

Author reply.

Intern Med J 2021 01;51(1):156

Department of Internal Medicine, Section of General Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.

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http://dx.doi.org/10.1111/imj.15160DOI Listing
January 2021

The association of viral load and disease severity in children with COVID-19.

J Med Virol 2021 May 16;93(5):3077-3083. Epub 2021 Feb 16.

Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.

It is still not fully understood how to predict the future prognosis of patients at the diagnosis coronavirus disease 2019 (COVID-19) due to the wide clinical range of the disease. We aimed to evaluate whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load could predict the clinical course of pediatric patients. This study was conducted retrospectively with medical records of pediatric patients who were tested for SARS-CoV2 between April 12 and October 25, 2020 in the University of Health Sciences, Ankara Educating and Training Hospital and Hacettepe University Faculty of Medicine. We evaluated 518 pediatric patients diagnosed with COVID-19 and classified according to severity as asymptomatic (16.2%), mild (59.6%), moderate (20.2%), and critical/severe (3.9%) cases. We analyzed patients in four groups in terms of ages: <4, 5-9, 10-14, and 15-17 years. There was no statistically significant difference in terms of ∆C value among age groups, different gender and the existence of underlying diseases in each disease course. The ∆C values were relatively lower in the first 2 days of symptoms than after days in all groups. Our study has indicated that children with COVID-19 have similar amount of viral load in all disease courses irrespective of the age and underlying disease. It should be taken into account that, regardless of the severity of the disease, pediatric patients may have a role in the transmission chain.
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http://dx.doi.org/10.1002/jmv.26853DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014156PMC
May 2021

[Relationship Between Alcohol Dependence and Neuropeptide Y (NPY) Gene Promoter Polymorphisms in A Turkish Sample].

Turk Psikiyatri Derg 2020 ;31(4):232-238

Objective: Neuropeptide Y (NPY) is a protein widely expressed in the central nervous system and involved in diverse physiological processes, such as emotional regulation, nutritional behavior, and stress. In some populations, studies on alcohol dependence (AD) and the NPY gene have found that NPY variations increase alcohol consumption and thus may potentially be associated with AD. In this study, we investigated the relationship between NPY gene promoter polymorphisms and phenotypes related to alcohol use.

Method: A total of 417 male participants comprising 252 individuals with AD and 165 healthy individuals were included in this study and phenotypic data were collected. Polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP) and DNA sequencing METHODS were used for genotyping the rs16147 and rs17149106 polymorphisms in the promoter region of the NPY gene. The data of 384 participants were analysed to evaluate the possible relationship between genotypes and the diagnosis of AD, family history of AD, the severity of AD using the Michigan Alcoholism Screening Test (MAST), the age of onset of problematic alcohol use, the average amount of alcohol consumed per day for the last six months and the lifetime maximum alcohol consumption in one day.

Results: A significant difference was found between the AD and control groups concerning rs16147 polymorphism genotype distribution (p=0.025). No association with polymorphisms and alcohol-related phenotypes were demonstrated in the AD group.

Conclusion: To our knowledge, this study shows for the first time in the literature that alcohol dependence is associated with NPY rs16147 polymorphism in the Turkish population.
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January 2020

Evaluation of the accuracy and reliability of the percentage of glottic opening score.

Eur J Anaesthesiol 2021 02;38(2):202-205

From the Department of Anesthesiology and Reanimation, University of Health Sciences, Diskapi Yildirim Beyazit Teching Hospital (DUY, BG, BN, MS, SO) and Department of Biostatistics, Hacettepe University, School of Medicine, Ankara, Turkey (SK).

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http://dx.doi.org/10.1097/EJA.0000000000001331DOI Listing
February 2021

Basal serum thyroxine level should guide initial thyroxine replacement dose in neonates with congenital hypothyroidism.

J Clin Res Pediatr Endocrinol 2020 Dec 30. Epub 2020 Dec 30.

Hacettepe University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey.

Objective: Initial high-dose Na-L thyroxine (Na-LT4) (10-15 μg/kg/day) replacement for primary congenital hypothyroidism (CH) is recommended in guidelines. However, high-dose Na-LT4 has risks. In this study, we aimed to investigate normalizing effect of varying initial doses of Na-LT4 on serum thyroid hormone levels.

Methods: Fifty-two patients were analyzed retrospectively. The patients were classified into mild (27/51.9%), moderate (11/21.1%) and severe (14/26.9%) CH with respect to initial free thyroxine (FT4) levels. Time taken to achieve target hormone levels was compared within groups.

Results: Initial mean Na-LT4 doses for mild, moderate and severe disease were 6.9±3.3, 9.4±2.2 and 10.2±2 μg/kg/day. Serum FT4 levels reached the upper half of normal range (>1.32 ng/dL) in a median of 16, 13 and 16 days in patients with mild, moderate and severe CH with the mean time from initial treatment to first control visit 14.8 ± 6 days (range 1-36). There was no significant difference in terms of time to achieve target FT4 hormone levels according to disease severity (p=0.478). Seven (25.9%), 8 (72.7%) and 8 (57.1%) patients experienced hyperthyroidism (serum FT4 >1.94 ng/dL) in mild, moderate, severe CH groups in the first visit, respectively (p=0.016).

Conclusion: Not all patients diagnosed with CH require high-dose Na-LT4, initial dose of Na-LT4 may be tailored based on pre-treatment thyroid hormone levels. Some patients with moderate and severe CH, experienced iatrogenic hyperthyroidism even though the dose was close to the lower limit of the recommended range in guidelines; suggesting lower initial doses and closer follow-up within the first week.
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http://dx.doi.org/10.4274/jcrpe.galenos.2020.2020.0194DOI Listing
December 2020

The Comparative Efficacy of Conventional Short-Stretch Multilayer Bandages and Velcro Adjustable Compression Wraps in Active Treatment Phase of Patients with Lower Limb Lymphedema.

Lymphat Res Biol 2021 Jun 2;19(3):286-294. Epub 2020 Dec 2.

Department of Biostatistics, University of Hacettepe Faculty of Medicine, Ankara, Turkey.

Compression is the most important component of complete decongestive therapy (CDT), but there is no standard best method for applying compression. The aim of this study was to evaluate the comparative efficacy of conventional multilayer short-stretch bandaging, and a velcro adjustable compression wrap with regard to volume reduction, ultrasonographic measurements, functional-status, and quality of life (QoL) in the active CDT period of patients with lower limb lymphedema. The demographic and clinical variables of lower limb lymphedema patients were recorded. All patients received skin care education, manual lymphatic drainage, and supervised lyphedema exercises, and were randomly allocated to Group1 (multilayer short-stretch bandaging-Rosidal-K) or to Group 2 (adjustable-compression-velcro-wrap-Circaid Reduction-kit) for a duration of 3 weeks with 15 sessions. Limb volumes were assessed by perometer. Ultrasonographic measurements included subcutaneous soft tissue thickness. The functional disability and QoL were evaluated by the Lower Extremity Functional Scale and LYMQOL-Leg (Lymphedema Quality of Life Questionnaire-Leg), respectively, at baseline, after CDT, and at first-month follow-up. Thirty-six patients (10 male and 26 female) with mean age of 51.6 ± 11.7 years were included. Fourteen patients had primary and 22 patients had secondary lymphedema. The median duration of lymphedema was 68 months. Significant improvements in volumes and ultrasonographic measurments were observed in both groups at the end of therapies, and improvements sustained up to a month. Appearance, symptoms, and overall QoL-subscores were improved only in Group 2. In conclusion, adjustable compression velcro-wrap performed as a part of CDT can greatly reduce the volume similiar to conventional multilayer bandages, as well as improve the QoL. It can be a comfortable alternative to the conventional multilayer bandages in the active treatment phase of the CDT.
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http://dx.doi.org/10.1089/lrb.2020.0088DOI Listing
June 2021

IMPACT OF FETAL BRAIN TISSUE DERIVED MESENCHYMAL STEM CELL and FIBRIN GLUE ON FACIAL NERVE CRASH INJURY.

Turk J Med Sci 2020 Nov 27. Epub 2020 Nov 27.

Background/aim: To evaluate the clinical and histopathological effects of fetal brain tissue derived mesenchymal stem cells(FBTMSC) and fibrin glue(FG) on the facial nerve(FN) regeneration in rats with traumatic FN injury.

Materials And Methods: 28 Sprague Dawley rats were included in the study and divided into 4 groups. Traumatic FN injury(FP) was created by a surgical clamp compression to the main trunk of left FN in all groups. In the control group(Group 1) no treatment was applied, in Group 2(FBTMSC group)2x106FBTMSC was injected, in Group 3(FG group) only FG was applied, in group 4(FBTMSC & FG group) both FBTMSC and FG was applied to the injured section of the nerve. The FN functions were evaluated clinically, immediately after the procedure and at 3rd-5th-8th weeks postoperatively. The FNs of all subjects were excised after the 8th week; then the rats were sacrificed. The presence of stem cells in the injured zone was assessed by using BrdU, and apoptosis was determined by TUNEL method.

Results: After the damage, total FP was observed in all subjects. Statistically significant functional improvement was observed in Group 4 compared to all other groups(p<0.005). TUNEL positive cell count was statistically significantly higher in the control group than the other groups(p<0.001). TUNEL positive cell count was statistically significantly lower in Group 4 than the other groups. The proportion of BrdU-stained cells in Group 4(5%) was higher than Group 2(2%).

Conclusion: Clinically and histopathologically FBTMSC applied with FG may play a promising role as a regenerative treatment in posttraumatic FP.
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http://dx.doi.org/10.3906/sag-2004-3DOI Listing
November 2020

Long-Term Prognostic Value of Coronary Atherosclerotic Plaque Characteristics Assessed by Computerized Tomographic Angiography.

Angiology 2021 03 29;72(3):252-259. Epub 2020 Oct 29.

Department of Cardiology, 37515Hacettepe University Faculty of Medicine, Ankara, Turkey.

We aimed to present the long-term prognostic role of coronary computed tomography angiography (CTA) in a cohort of patients with coronary artery disease (CAD) and noncritical stenosis. A total of 1138 patients who underwent coronary CTA for suspected CAD were included in the study. For the categorization of the coronary atherosclerotic plaque (CAP), the coronary system was divided into 16 segments. For each segment, CAPs were categorized as calcified, noncalcified, and mixed. All-cause and cardiovascular (CV) mortality data were collected for prognostic evaluation. Coronary CTA analyses showed that 34.5% of patients had noncalcified CAP, 14.5% of patients had calcified CAP, and 11% of patients had mixed CAP. During a median of 141.5 months follow-up, CV and all-cause mortality was observed in 57 (5%) and 149 (13.1%) patients, respectively. In multivariable Cox regression analysis, calcified CAP morphology and the extent of involved segments were significant predictors of both CV and all-cause mortality. The presence of calcified CAP morphology and the higher number of diseased coronary segments via coronary CTA might help stratify patients at risk for adverse CV outcomes during long-term follow-up. Patients with these features at index coronary CTA may be evaluated more closely with aggressive preventive measures.
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http://dx.doi.org/10.1177/0003319720963677DOI Listing
March 2021

Evaluation of the effect of COVID-19 pandemic on anxiety severity of physicians working in the internal medicine department of a tertiary care hospital: a cross-sectional survey.

Intern Med J 2020 11 2;50(11):1350-1358. Epub 2020 Oct 2.

Department of Internal Medicine, Division of General Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Background: Internists who have an important role in the global response to the COVID-19 pandemic are under both physical and psychological pressures.

Aims: To assess the anxiety among physicians working in the internal medicine department of a tertiary care hospital who are on the frontline of the COVID-19 pandemic.

Methods: This single-centre, non-intervention, cross-sectional descriptive study was conducted using an online survey questionnaire from 1 April to 14 April 2020. Physicians of the Department of Internal Medicine were invited to participate with a self-administered questionnaire. The degree of symptoms of anxiety was assessed by the Turkish versions of the 7-item Generalised Anxiety Disorder scale and Beck Anxiety Inventory, respectively.

Results: A total of 113 participants consented for the study and completed the questionnaire. The median age was 29 (IQR = 5) years and 53.1% were male. A total of 72 internists (63.7%) worked as 'frontline' healthcare workers directly engaged in diagnosing, treating or caring for patients with or suspected to have COVID-19. Female gender was significantly associated with high scores and levels in all scales compared to the male gender (P < 0.005). Having family members over 65 years old and with chronic diseases were significantly associated with high anxiety scores and levels (P < 0.005).

Conclusions: In this survey of internists in a university hospital equipped with clinics, wards and intensive care unit for patients with COVID-19, female gender and having family members over 65 years old and with chronic diseases were associated with increased anxiety levels.
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http://dx.doi.org/10.1111/imj.14981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537014PMC
November 2020

Effect of Clozapine on Proton Magnetic Resonance Spectroscopy Findings in Hippocampus.

Turk Psikiyatri Derg 2020 ;31(3):159-167

Objective: The purpose of this study was to investigate the effect of clozapine on proton magnetic resonance spectroscopy (1H-MRS) findings in hippocampus in patients with schizophrenia. In addition, the relationship between the change in 1H-MRS findings and the change in psychopathology and neurocognitive functions was evaluated.

Method: Patients with schizophrenia (n=16) were assessed with the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale (CGI), a neurocognitive test battery and 1H-MRS at baseline, and twelve weeks after the initiation of clozapine. Healthy controls (n=8) were assessed once with a neurocognitive test battery and 1H-MRS. Bilateral multivoxel and left single voxel NAA/Cr, Cho/Cr, MI/Cr was calculated in the hippocampi.

Results: After 12 weeks of clozapine treatment, PANSS and CGI scores decreased; immediate recall, cumulative learning subtests of the Rey Auditory Verbal Learning Test, Category Verbal Fluency Test and Wechsler Memory Scale's visual reproduction delayed subtest scores increased significantly. Compared with healthy controls and patients after clozapine, hippocampi multivoxel and single voxel NAA/Cr, Cho/ Cr, MI/Cr ratios were not different in patients before clozapine. No significant correlations between change in 1H-MRS metabolite ratios and change in psychopathology, neurocognitive functions were detected.

Conclusion: This study is the first longitudinal study to investigate the effect of clozapine in hippocampus with 1H-MRS. There were no significant changes in 1H-MRS findings in hippocampi after twelve weeks of clozapine treatment. Clozapine's effect in hippocampus should be investigated further in longer follow up studies with larger samples to reach a final conclusion.
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January 2020

Psychiatric and general health effects of COVID-19 pandemic on children with chronic lung disease and parents' coping styles.

Pediatr Pulmonol 2020 12 28;55(12):3579-3586. Epub 2020 Sep 28.

Department of Pediatric Pulmonology, School of Medicine, Ihsan Dogramaci Children's Hospital, Hacettepe University, Ankara, Turkey.

Background: We aim to assess the anxiety and depressive symptoms related to the COVID-19 pandemic in children with chronic lung disease and their parents and also to evaluate parents' coping strategies.

Methods: Parents of children aged 4-18 years, with chronic lung disease (study group n = 113) and healthy control (n = 108) were enrolled in the study. General Health Questionnaire-12, specific COVID-19 related anxiety questions, The Coping Orientation to Problems Experienced inventory, coronavirus-related psychiatric symptom scale in children-parental form were used to analyze the psychiatric effects of COVID-19. Parents were also asked about how online education affected their family life and children. All data were compared between children/parents in the study and control groups. Risk factors related with anxiety scores of children were also analyzed.

Results: Talking about the pandemic, concern about coronavirus transmission, taking precaution to prevent coronavirus transmission, making pressure to protect from COVID-19 were significantly higher in parents within the study group (p < .05). Parents in the study group used more problem-focused coping than parents in the control group (p = .003). Anxiety symptoms score was higher in children of the study group (p = .007). Parents in the study group found online education more useful than parents in the control group.

Conclusion: Children with chronic lung diseases and their parents have more anxiety due to COVID-19 pandemic and these parents use more mature coping strategies to manage the stress of the pandemic. Longitudinal and larger studies should be done in all aspects of online education in children with chronic lung diseases.
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http://dx.doi.org/10.1002/ppul.25082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537125PMC
December 2020

STAR-Sonographic Thigh Adjustment Ratio: A Golden Formula for the Diagnosis of Sarcopenia.

Am J Phys Med Rehabil 2020 10;99(10):902-908

From the Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, BK, AB, LÖ) Department of Physical and Rehabilitation Medicine, Doctor Ayten Bozkaya Spastic Children Hospital and Rehabilitation Center, Bursa, Turkey (AMA); Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey (ÖÖ, ST); Geriatrics Unit, Yenimahalle Training and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey (ÖK); Department of Geriatrics, Hacettepe University Medical School, Ankara, Turkey (GŞA, MH); Department of Biostatistics, Hacettepe University Medical School, Ankara, Turkey (SK); Department of Biophysics, Hacettepe University Medical School, Ankara, Turkey (ARS); and Department of Public Health, Hacettepe University Medical School, Ankara, Turkey (BÇ).

Objective: The aim of the study was to explore an individualized sonographic muscle thickness ratio and its cutoff values in the diagnosis of sarcopenia.

Design: A total of 326 community-dwelling adults were included in this cross-sectional study. Total skeletal muscle mass was evaluated by bioelectrical impedance analysis, and nine-site muscle thickness measurements using ultrasound. Isometric handgrip and knee extension strengths were assessed. Physical performance was evaluated by usual Gait Speed, Chair Stand Test, and Timed Up and Go Test.

Results: Because the anterior thigh muscle thickness was the most significantly decreasing measurement with aging and the most significantly related value with body mass and height; sonographic thigh adjustment ratio was calculated by dividing it with body mass index. Using the two standard deviation values of our healthy young adults, sonographic thigh adjustment ratio cutoff values were found as 1.4 and 1.0 for male and female subjects, respectively. Sonographic thigh adjustment ratio values were negatively correlated with Chair Stand Test and Timed Up and Go Test in both sexes (all P < 0.05) and positively correlated with gait speed in female subjects and knee extension strength in male subjects (both P < 0.05).

Conclusions: Our results imply that regional (rather than total) muscle mass measurements should be taken into consideration for the diagnosis of sarcopenia.
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http://dx.doi.org/10.1097/PHM.0000000000001439DOI Listing
October 2020

Characteristics and Management of Children with COVID-19 in Turkey

Balkan Med J 2020 10 31;37(6):341-347. Epub 2020 Aug 31.

Department of Pediatric Infectious Diseases, Hacettepe University School of Medicine, Ankara, Turkey

Aims: Limited data about disease management strategies are available for pediatric patients with coronavirus disease-2019, particularly in Turkey. This study aimed to share the data on patients aged under 18 years in our country to be beneficial for understanding the disease course in children.

Methods: A retrospective review of the medical records of pediatric patients aged under 18 years who were confirmed as coronavirus disease-2019 between March 11, and June 23, 2020, and were admitted to our hospitals was conducted.

Results: A total of 220 pediatric patients with coronavirus disease-2019 were evaluated, of which 48.2% were boys, with a median age of 10 years, and 9.5% had underlying diseases. Patients were classified according to severity, with the percentages of asymptomatic, mild, moderate, and critical/severe cases determined to be 25.5%, 45%, 26.8%, and 2.7%, respectively. Extracorporeal membrane oxygenation was required in two patients (0.9%) and mechanical ventilation in three (1.4%). Targeted therapies were used in six patients (2.7%), with hydroxychloroquine being the most commonly used agent either alone (one patient) or in combination with favipiravir (five patients). Two patients (0.9%) died, and nine (4.1%) were still hospitalized during the study period.

Conclusion: Although the disease course of coronavirus disease-2019 seems to be mild in children, critical illness is significant, and the treatment strategy primarily should consist of supportive care according to our preliminary observations.
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http://dx.doi.org/10.4274/balkanmedj.galenos.2020.2020.7.52DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590545PMC
October 2020

Cross-Cultural Adaptation, Reliability, and Validity of a Turkish Version of the Work Rehabilitation Questionnaire (WORQ-Turkish).

J Occup Rehabil 2021 06;31(2):285-292

Department of Occupational Therapy, Faculty of Health Sciences, Biruni University, Istanbul, Turkey.

Purpose The Work Rehabilitation Questionnaire (WORQ) is an instrument based on the International Classification of Functioning Vocational rehabilitation core set. The aim of this study was to analyze the validity, reliability and cross-cultural adaptation of the WORQ to Turkish and evaluate its psychometric properties. Methods The cross-cultural adaptation and translation procedures were conducted following Beaton's guidelines. The test-re-test reliability was examined by Spearman Brown Coefficient (split half analysis), internal consistency was examined by Cronbach's alpha. Criterion related validity of the WORQ was determined by Beck Depression Inventory using Pearson correlation coefficient and known group differences regarding age, gender, work and educational levels using one-way ANOVA and t test. Construct validity was examined by confirmatory factor analysis using AMOS. Results Two hundred and fifty-seven participants with disabilities were included to the study from seven different provinces of Turkey. The WORQ-Turkish showed excellent internal consistency (0.906), good test-retest reliability (0.811), and good construct validity (good model fit indices). Criterion related validity analysis showed medium correlations between WORQ and Beck Depression Inventory (p < 0.001), however there were no statistical significant differences regarding known group parameters (p > 0.05). Conclusions In this study, the cross-cultural adaptation, and validity and reliability of WORQ-Turkish self-reported version were examined and the results indicated that WORQ-Turkish was a valid and reliable scale for analyzing vocational rehabilitation process of people with disabilities.
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http://dx.doi.org/10.1007/s10926-020-09917-8DOI Listing
June 2021

Outcome of noncritical COVID-19 patients with early hospitalization and early antiviral treatment outside the ICU

Turk J Med Sci 2021 04 30;51(2):411-420. Epub 2021 Apr 30.

Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

Background/aim: Despite the fact that the COVID-19 pandemic has been going on for over 5 months, there is yet to be a standard management policy for all patients including those with mild-to-moderate cases. We evaluated the role of early hospitalization in combination with early antiviral therapy with COVID-19 patients in a tertiary care university hospital.

Materials And Methods: This was a prospective, observational, single-center study on probable/confirmed COVID-19 patients hospitalized in a tertiary care hospital on COVID-19 wards between March 20 and April 30, 2020. The demographic, laboratory, and clinical data were collected.

Results: We included 174 consecutive probable/confirmed COVID-19 adult patients hospitalized in the Internal Medicine wards of the University Adult Hospital between March 20 and April 30, 2020. The median age was 45.5 (19–92) years and 91 patients (52.3%) were male. One hundred and twenty (69%) were confirmed microbiologically, 41 (23.5%) were radiologically diagnosed, and 13 (7.5%) were clinically suspected (negative microbiological and radiological findings compatible with COVID-19); 35 (20.1%) had mild, 107 (61.5%) moderate disease, and 32 (18.4%) had severe pneumonia. Out of 171 cases, 130 (74.3%) showed pneumonia; 80 were typical, and 50 showed indeterminate infiltration for COVID-19. Patients were admitted within a median of 3 days (0-14 days) after symptoms appear. The median duration of hospitalization was 4 days (0-28 days). In this case series, 13.2% patients were treated with hydroxychloroquine alone, 64.9% with hydroxychloroquine plus azithromycin, and 18.4% with regimens including favipiravir. A total of 15 patients (8.5%) were transferred to the ICU. Four patients died (2.2%).

Conclusion: In our series, 174 patients were admitted to the hospital wards for COVID-19, 69% were confirmed with PCR and/or antibody test. At the time of admission, nearly one fifth of the patients had severe diseases. Of the patients, 95.4% received hydroxychloroquine alone or in combination. The overall case fatality rate was 2.2%.
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http://dx.doi.org/10.3906/sag-2006-173DOI Listing
April 2021

Podoplanin expression in cutaneous squamous cell carcinomas and its relationship to histopathological prognostic factors.

J Histotechnol 2020 09 4;43(3):147-152. Epub 2020 Jun 4.

Department of Dermatology, School of Medicine, Hacettepe University , Ankara, Turkey.

There are several clinicopathological factors associated with the prognosis of cutaneous squamous cell carcinomas (cSCC), but there remains a lack of molecular markers associated with cSCC tumor progression. This study aimed to determine the association between histopathological prognostic parameters and tumoral podoplanin expression in cSCC. This study included 63 paraffin embedded cSCC samples that were evaluated for tumoral podoplanin expression using immunohistochemistry. Among the 63 tumor samples, 27% lacked podoplanin expression, 22% exhibited diffuse podoplanin expression, and 51% exhibited focal podoplanin expression. Tumoral podoplanin expression was correlated with lymphovascular invasion and lymph node metastasis ( value < 0.05, for both). Additional research is needed to further delineate how the tumoral podoplanin expression can be used as a prognostic marker in patients with cSCC.
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http://dx.doi.org/10.1080/01478885.2020.1757872DOI Listing
September 2020

Gross motor development of preschool children: effects of socioeconomic status and maternal education.

Turk J Pediatr 2020 ;62(1):10-18

Departments of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Motor development reflects the general health status of the child and affects other areas of development. It is influenced by biological and family characteristics especially in infancy and early childhood, and by environmental conditions in preschool age. We assessed the effect of several family and environment characteristics on gross motor developmental items included in the Denver-II test on 2,042 healthy children. Increasing maternal age and education were associated with later achievement in several items after age 12 months while socioeconomic status, sex and birth rank did not show a clear effect. Our observations suggest in a relatively homogenous urban population, few external factors affect gross motor development in preschool children.
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http://dx.doi.org/10.24953/turkjped.2020.01.002DOI Listing
January 2020

Environmental characteristics of older people attending physical medicine and rehabilitation outpatient clinics.

Cent Eur J Public Health 2020 Mar;28(1):33-39

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.

Objective: A residential environment refers to the physical and social characteristics in a neighbourhood. The physical characteristics include interior housing qualities, exterior neighbourhood characteristics, and the accessibility of essential facilities and services outside the neighbourhood. Older adults especially may be vulnerable to the negative impacts of the residential environment. The aim of this study is to elucidate the problems ageing people face in their neighbourhoods, buildings and public areas.

Methods: The study group consisted of a total of 1,001 people over the age of 65 who were admitted to physical medicine and rehabilitation clinics in Turkey and consented to participate. A questionnaire covering demographic, social and environmental information was used.

Results: Of the study group, 58.6% was living in an apartment building, but only 23.6% of these buildings had an elevator, and the stairs were inconvenient in 46.7% of the buildings. Only 49% of the elderly people went for a walk regularly. The most frequent complaint about the hospitals, community health centres and other public areas was the inappropriate restroom conditions. Eighty-six percent of the study group were not members of an organization, a foundation or a group, and 73.6% did not have personal hobbies.

Conclusions: The layouts of buildings and surroundings are inappropriate for older people, and the opportunities for them to participate in social activities are limited. Health and social programmes and governmental and local policies for older people are needed, and public awareness about this issue should be raised.
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http://dx.doi.org/10.21101/cejph.a5194DOI Listing
March 2020

Clinical predictors of pulmonary functions, respiratory/peripheral muscle strength and exercise capacity at discharge in adults with burn injury.

Disabil Rehabil 2020 Jan 30:1-7. Epub 2020 Jan 30.

Clinic of Burn, Ankara Numune Training and Research Hospital, Ankara, Turkey.

To identify clinical predictors of pulmonary functions, respiratory and peripheral muscle strength and functional exercise capacity in burn injury patients, and to compare these parameters with healthy subjects. The study included 47 burn injury patients aged 20-49 years, and 47 age and gender-matched healthy subjects. The patients were evaluated on the day of discharge from hospital. Pulmonary functions and respiratory muscle strength were assessed with a spirometer (Cosmed Pony FX). Hand grip and pain were evaluated with a Jamar dynamometer and visual analog scale, respectively. The six-minute walk test (6-MWT) was performed to determine the functional exercise capacity of the participants. With the exception of FEV/FVC, all the parameters of pulmonary functions test, respiratory and peripheral muscle strength and 6-MWT distances were lower in the burn injury patients than in the healthy subjects ( < 0.05). Significant predictors for these parameters were age, gender, height, body mass index, total burn surface area, burn injury type, the presence of trunk burn, hand burn, lower limb burn, inhalation injury, and intubation in the burn group ( < 0.05). Burn injury and the demographic characteristics of the patients are important determinants of clinical parameters. These results are clinically important as they can be of guidance in creating a personalized rehabilitation program. NCT03780218.Implications for rehabilitationBurn patients have impaired pulmonary functions and exercise capacity at discharge. Assessment of respiratory muscle strength should be added into clinical practice in adults with burn injury.Lung functions and exercise capacity should be evaluated in burn patients at discharge.It is important to monitor lung functions of burn patients after discharge.
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http://dx.doi.org/10.1080/09638288.2020.1720320DOI Listing
January 2020

Family-centred service: Perspectives of paediatric residents from a non-Western country.

Child Care Health Dev 2020 05 30;46(3):275-282. Epub 2020 Jan 30.

Department of Pediatrics, Division of Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Objectives: The concept of family-centred service (FCS), which is recognized as the standard of paediatric health care, emerged from Western countries, and integration of FCS can be challenging especially in non-Western countries. This study aims to explore family-centred behaviours of paediatric residents and their perspectives on FCS being trained in a non-Western country before and 6 months after an educational workshop. It was hypothesized that the workshop will increase the awareness of paediatric residents regarding FCS and improve their self-reported family-centred practices.

Study Design: Ninety-nine residents who are in a 4-year paediatric residency program were included. A 2-hr interactive workshop was conducted for all participants. The measure of processes of care for service providers was used to measure self-reported family-centred practices of paediatric residents, and a study specific questionnaire was utilized to understand their perspectives towards FCS prior to and 6 months after the workshop.

Results: There were statistically significant increases in the measure of processes of care for service providers scores suggesting improvements in self-reported family-centred practices of participants 6 months after the workshop. Moreover, the percentage of participants describing themselves as knowledgeable and competent increased. Viewpoints of paediatric residents on the implementation of FCS and several challenges perceived by participants were highlighted.

Conclusion: This is the first study conducted in a non-Western country exploring perspectives of paediatric residents towards the implementation of FCS and measuring their self-reported family-centred practices before and after an educational workshop. The study revealed that although a 2-hr interactive workshop improved the self-reported family-centred practices of participants, they still found FCS challenging.
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http://dx.doi.org/10.1111/cch.12753DOI Listing
May 2020

Immediate and long-term outcomes of cryoballoon catheter ablation in patients with atrial fibrillation and left common pulmonary vein anatomy.

J Interv Card Electrophysiol 2020 Oct 6;59(1):57-65. Epub 2019 Dec 6.

Department of Cardiology, Faculty of Medicine, Hacettepe University, 06230, Sıhhıye, Ankara, Turkey.

Purpose: The efficacy of cryoballoon (CB) for atrial fibrillation (AF) ablation is still debatable in case of anatomical variations like left common pulmonary vein (LCPV). We aimed to assess the impact of LCPV trunk on the acute and long-term clinical outcomes in patients with CB based AF ablation.

Methods: We compared a total of 82 AF patients (62.5% paroxysmal and 37.5% persistent) who underwent pulmonary vein isolation using CB (LCPV+ group) with a propensity score-matched cohort of 76 AF patients (LCPV- group) (61.8% paroxysmal and 38.2% persistent). Preprocedural computed tomography was performed in all patients and ostial dimensions and trunk distance were measured. Atrial tachyarrhythmia (ATa) recurrence was defined as detection of AF, atrial flutter, or atrial tachycardia (≥ 30 s) after a 3-month blanking period.

Results: Acute procedural success was similar between the groups (100% and 98.7% for LCPV- and LCPV+, respectively, P = 0.991). Overall, 22/76 (28.9%) patients in LCPV- and 21/82 (25.6%) patients in LCPV+ had ATa recurrence at a mean follow-up of 31 ± 15 months (P = 0.770). A multivariate analysis identified only the left atrial (LA) diameter as a predictor of recurrent ATs (HR, 3.28; 95% CI, 1.67-6.41; P = 0.001). In the LCPV+ group, patients with single application had higher ATa recurrence (8/18 patients) compared with sequential freeze group (13/64 patients) (P = 0.042).

Conclusions: Our findings indicated that CB was an effective tool in patients with LCPV and freedom from ATa was similar between LCPV- and LCPV+ groups. Only LA diameter predicted the ATa recurrence during long-term follow-up.
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http://dx.doi.org/10.1007/s10840-019-00676-yDOI Listing
October 2020

Cross-cultural adaptation, validity, and reliability of the Turkish version of Assistance to Participate Scale.

Child Care Health Dev 2020 01 19;46(1):83-89. Epub 2019 Dec 19.

Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Background: The Assistance to Participate Scale is a questionnaire to evaluate activity participation of children with developmental disabilities. The purpose of this study was to determine the validity and reliability of the Turkish version of the Assistance to Participate Scale.

Methods: Ninety-eight mothers' children with developmental disabilities were included in this study. The Assistance to Participate Scale, Pediatric Quality of Life Inventory, and Pediatric Evaluation of Disability Inventory were applied to all subjects. To evaluate reliability, Cronbach's alpha coefficient, minimal detectable change (MDC) with standard error of measurement (SEM), and intraclass correlation coefficient (ICC) for test-retest were used. The relationship between Assistance to Participate Scale, Pediatric Quality of Life Inventory, and Pediatric Evaluation of Disability Inventory was investigated, and exploratory and confirmatory factor analysis were used for construct validity.

Results: Cronbach's alpha value of the scale was found.93, demonstrating that this value has excellent internal consistency. Test-retest reliability was found 0.99 (ICC 95% CI [0.995, 0.998]; SEM:0.57, MDC:1.58). For construct validity, the correlations between Assistance to Participate Scale, Pediatric Quality of Life Inventory, and Pediatric Evaluation of Disability Inventory total scores and items were significant (p < .001). Factor analysis showed that the questionnaire had unidimensional and the explained variance was 0.84%.

Conclusions: The Turkish version of the Assistance to Participate Scale is valid and reliable scale for children with developmental disabilities.
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http://dx.doi.org/10.1111/cch.12728DOI Listing
January 2020