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Öğe Analysis of 1242 cases with upper gastrointestinal system bleeding in Southeastern Turkey: A different etiologic spectrum(2005) Dursun M.; Yilmaz S.; Yükselen V.; Canoruç F.; Tuzcu A.Background/Aims: There are few detailed reports on gastrointestinal system bleeding in Turkey. The aim of this study is to analyze the characteristics of the patients with upper gastrointestinal system bleeding who were hospitalized in our clinic. Methodology: The patients who were hospitalized in Dicle University Hospital Department of Gastroenterology from March 1992 to June 2002 were analyzed retrospectively. Results: During this period of time, 296 females (23.8%) and 946 males (76.2%), total 1242 patients were hospitalized for upper gastrointestinal system bleeding. Mean age was 47 for both sexes. Distribution of the cases was as follows: 31.6% duodenal ulcer (n: 393), 30.5% esophageal variceal bleeding (n: 379), 13.7% erosive gastritis (n: 171), 6.8% erosive duodenitis (n: 85), 4.9% gastric ulcer (n: 62), 2.8% carcinoma (n: 35), and 3.5% other causes. Peptic ulcer related bleeding was the most encountered reason (37.5%, n: 466). Four percent of the cases other than esophageal variceal bleeding underwent urgent surgical intervention. Eleven percent of the cases (n: 138) resulted in death of which 65.9% were esophageal variceal bleeding (n: 91). Conclusions: The most striking result is the very high rate of esophageal variceal bleeding. This finding is in concordance with the high prevalence of the viral hepatitis in the region. © H.G.E. Update Medical Publishing S.A.Öğe Assessment of sound environment pleasantness by sound quality metrics in urban spaces(Istanbul Teknik Universitesi, Faculty of Architecture, 2016) Çakir Aydin D.; Yilmaz S.Purpose of this study is to generate Sound Quality Index (SQI) in order to estimate pleasantness of users with sound environment in urban spaces by employing sound quality metrics together such as loudness, sharpness and roughness, which are frequently stated in soundscape studies as it is directly related to human perception. For this purpose, binaural sound records have been conducted and quantitative data of loudness, sharpness and roughness of these metrics of the sound records has been calculated. 27 sound clips, containing different quantitative data of each of the three metrics, have been generated by picking them out of binaural sound records. Participants have listened to the sound clips at laboratory environment, and have been applied jury test. Correlations between pleasantness of users with sound environment and sound quality metrics have been determined by analyzing results from jury test and quantitative data of sound clips. SQI has been generated with a correlation model by using Regression Analysis method. In order to check the accuracy of the model, surveys have been conducted on users at the field and binaural sound records have been taken simultaneously to the surveys. Quantitative data obtained from sound records has been calculated by SQI, and pleasantness level of users with sound environment has been estimated. Results obtained from surveys conducted at the field and results estimated by SQI have been compared. Apart from quantitative data of sound records, effect of parameters that might affect pleasantness of users with sound environment in urban spaces has been determined. © 2016, Istanbul Teknik Universitesi, Faculty of Architecture. All rights reserved.Öğe The efficacy of flumazenil in subclinical to mild hepatic encephalopathic ambulatory patients: A prospective, randomised, double-blind, placebo-controlled study(SMW supporting association, 2003) Dursun M.; Caliskan M.; Canoruc F.; Aluclu U.; Canoruc N.; Tuzcu A.; Yilmaz S.Hepatic encephalopathy (HE) is a neuropsychiatric syndrome associated with fulminant hepatic failure and chronic liver disease. Its pathogenesis is unclear. One of the factors implicated is enhanced GABA-ergic tone, which is probably related to increased concentrations of cerebral benzodiazepine (BNZ). In the present study, we tested flumazenil, a cerebral BNZ antagonist, in cirrhosis patients with hepatic encephalopathy. Methods: Out of 47 patients, 7 were excluded prior to randomization for various reasons. Twenty patients were included in the flumazenil group and 20 in the placebo group in a prospective, randomized, double-blind, placebo-controlled study. Patients were given flumazenil (1 mg/h, continuous IV infusion) or an equal volume of saline solution for 5 hours. Before and after treatment, portosystemic encephalopathy (PSE) stage and number connection test (NCT) scores were checked every half hour for 5 hours. EEG was recorded 15 minutes before and 1 hour after treatment. Results: While significant improvements were determined in PSE stage and NCT score in the flumazenil group, there were no such improvements in the placebo group. There was no statistically significant difference between pre- and post-treatment EEGs in either group. Conclusion: It was concluded that continuous IV infusion of flumazenil had beneficial and safe effects in the treatment of hepatic encephalopathy patients.Öğe The evaluation of gastroesophageal reflux incidence in children with various symptoms by cintigraphy [3](1998) Yaramis A.; Gurkan F.; Haspolat K.; Dikici, Bünyamin; Derman O.; Soker M.; Yilmaz S.[No abstract available]Öğe Factors associated with mortality among tuberculosis patients in southeast Turkey(A. CARBONE Editore, 2015) Yilmaz S.; Taylan M.; Sen H.S.; Abakay O.; Demir M.; Kaya H.; Yilmaz Z.Introduction: Tuberculosis (TB) is a disease caused by bacillus mycobacterium tuberculosis. Tuberculosis is a preventable and treatable disease that, despite the rapid advances in active therapy, continues to cause global mortality. In this study, we investigated the risk factors associated with mortality in patients undergoing treatment for TB. Materials and methods: Records of 2,450 tuberculosis patients who were followed-up with in tuberculosis dispensaries in the city of Diyarbakir, southeast Turkey, between January 2005 and December 2011 were reviewed retrospectively. Case definitions and treatment outcomes were classified according to WHO criteria. Results: Of the 2,450 registered TB patients, 1,339 were male (54.7%) and 1,111 were female (45.3%). Their mean age was 32.15±17.87 years, and 51 (2.1%) of them died. Mortality rates were higher in pulmonary TB (PTB) patients, males, relapse patients, category 2 patients, those >65 years old, TB meningitis patients, and patients who self-administered their therapy. According to Kaplan-Meier analysis, the mortality rates were significantly higher in patients aged >65 years, in those with Category II and in those TB meningitis. The significant independent risk factors for mortality during anti-TB treatment were advanced age, TB meningitis and gastrointestinal TB. Conclusion: Mortality was increased in the elderly, males, those with relapse, and in category II and extrapulmonary TB patients. Based on these data, we suggest that tuberculosis control programs should pay more attention to the high-risk groups determined in the current and previous studies. Treatment regimens for these risk groups should be considered for revision.Öğe Fibulin-3 as a diagnostic biomarker in patients with malignant mesothelioma(Asian Pacific Organization for Cancer Prevention, 2015) Kaya H.; Demir M.; Taylan M.; Sezgi C.; Tanrikulu A.C.; Yilmaz S.; Bayram M.Background: New tumour biomarkers are being intensely investigated for malignant mesothelioma (MM). Fibulin-3 is produced in MM but its role remains uncertain. The aim of this study was to evaluate the validity of measuring serum fibulin-3 in the diagnosis and prognosis of MM. Materials and Methods: This prospective study was performed on 43 patients and 40 healthy controls who were admitted to our hospital between January 2012 and January 2014. Data from MM patients, including demographic and clinical features, routine laboratory data, levels of serum fibulin-3, and treatment outcomes were defined as potential prognostic factors. The receiver operating characteristic (ROC) curve for fibulin-3 was used to detect the cut-off value with highest sensitivity and specificity. Univariate survival analysis was performed using the Kaplan-Meier method in patients with MM. Afterwards, the possible factors identified with univariate analyses were entered into the cox regression analysis. Results: Our results revealed that patients with MM had significantly higher serum levels of fibulin-3 than controls. The results showed that the best cut-off point was 36.6 ng/ml with an AUC (area under the curve)=0.976, sensitivity=93.0% and specificity=90.0. In our study, the initial significant poor prognostic factors were advanced stage, high white blood cell count, high platelet count, high C-reactive protein (p<0.05 for each variable). Later, according to multivariate analysis the results showed only advanced stage as significant parameter (p=0.040). Conclusions: We determined that real use for serum fibulin-3 was not for prognosis but for diagnosis in MM. Also advanced stage was associated with poor MM prognosis.Öğe The nonlinear analysis of frames with semi-rigid connections and shear deformations(Civil-Comp Press, 2008) Görgün H.; Yilmaz S.In this study, the nonlinear analysis of frames composed of members flexibly connected to the nodes has been carried out taking into consideration the effect of shear deformations and a pertinent computer program has been prepared. First, using second order theory, the member stiffness matrix for a bar with rotational springs at the ends was obtained, taking shear deformations into consideration. Then, using pertinent differential equations, the fixed end forces were found for a uniformly distributed load, a concentrated load, a linearly distributed load, a symmetrical trapezoidal distributed load and a nonsymmetrical triangular distributed load. The validity of the implemented computer program was proved by solving some example problems in different ways and showing the match between the results. Problems in the literature, which were special cases of the problems treated in this study, were solved by the present computer program and the match of the results was observed. Using the implemented computer program and solving some examples, the variations of some elastostatic quantities with spring constants were examined and presented graphically. © Civil-Comp Press, 2008.Öğe An overview of thrombolytic treatment for pulmonary embolism: A single Centre experience(Acta Medica Mediterranea, 2014) Şen H.S.; Abakay Ö.; Sezgi C.; Yilmaz S.; Taylan M.; Kaya H.; Tanrikulu A.C.Introduction: A massive pulmonary embolism (MPE) has a poor prognosis and high mortality. Thrombolytic therapy is preferred in patients with life-threatening symptoms such as hypotension, cardiogenic shock, and right ventricular failure due to the risk of severe bleeding. Materials and methods: This is a retrospective analysis of patients who were hospitalized with the diagnosis of pulmonary embolism (PE) and given thrombolytic therapy in the chest diseases clinic of a tertiary university hospital between January 2008 and November 2013. Results: The subjects' mean age was 59.54 ± 13.76 years. Fourteen of 39 patients who were treated with thrombolytic therapy were male (35.89%) and 25 (64.10%) were female. The symptoms experienced by the patients included dyspnea in 39 patients, chest pain in 35 patients, hemoptysis in 6 patients, syncope in 13 patients and cough in 10 patients. Risk factors were advanced age (> 60 years) in 19, immobilization in 19, malignancy in 3, major surgery in 11 patients. The in-hospital mortality analysis showed that 32 patients were discharged and 7 patients died. Four patients died from their pulmonary embolism and 3 patients died because of a major bleeding complication. Conclusions: Pulmonary embolism is a disease that may lead to death within hours secondary to acute right heart failure. Early diagnosis and treatment can be life saving. Thrombolytic therapy has been shown to improve hemodynamic parameters in the early period post-PE. An increased risk of bleeding is one of the most important drawbacks of thrombolytic therapy. Nonetheless, it can be a life-saving therapy in properly selected patients.Öğe The prevalence of primary and secondary helicobacter pylori resistance to clarithromycin and probable contributing cofactors: Data from Southeastern Anatolia(2008) Tüzün Y.; Bayan K.; Yilmaz S.; Dursun M.; Ozekinci T.Background/Aims: Antibiotic resistance of Helicobacter pylori is the most important reason for failure in its eradication. We aimed to determine the prevalence of primary and secondary H. pylori resistance to clarithromycin in isolated H. pylori from dyspeptic patients in southeastern Anatolia and to evaluate the cofactors affecting this clinical problem. Methodology: The study involved adult patients who had already been diagnosed with symptomatic H. pylori infection based on rapid urease test, gastric histopathological examination and culture. H. pylori strains were isolated from antral biopsies taken during upper endoscopy in 142 dyspeptic patients with no previous therapy against the microorganism. MICs of clarithromycin were determined by E-test. Patients were treated for 14 days with standard triple-agent protocol. H. pylori eradication rate was assessed after 8 weeks. Each patient was re-interviewed to determine secondary resistance. Primary clarithromycin resistance was defined as pre-treatment resistance, while secondary as after treatment resistance. Strains were considered resistant to clarithromycin if the MIC > 1?g/mL. Results: In total 213-105 women and 108 men-patients was enrolled to the study. The mean age was 35.5±14.1 years. In 142 (66.7%) patients out of the total patients enrolled in the study, H. pylori was detected. H. pylori could be cultured from only 61 (43%) of them. In 16.4% of the cases, primary clarithromycin resistance was noted. After 8 weeks, seventy-seven (54.2%) of the 142 patients were reevaluated. Helicobacter pylori eradication could be achieved in 68.8% of them. The proportion of H. pylori eradication in clarithromycin-sensitive patients was 75.8% and the respective proportion was 10% for resistant cases. In the group where H. pylori was still positive the secondary resistance percentage was found to be 27.2%. Conclusions: The prevalence of primary clarithromycin resistance is relatively high in our geographical area. Secondary resistance rate was 27.2%. None of the criteria of age, gender, presence of endoscopic lesions, detected H. pylori concentration and gastritis activity showed any effect on the primary resistance. © H.G.E. Update Medical Publishing S.A.
