Turkish Journal of Medical Sciences最新文献

{"title":"The relationship between drug-induced immunogenicity and hypersensitivity reactions and skin tests related to infliximab, etanercept and adalimumab in patients with rheumatoid arthritis and ankylosing spondylitis.","authors":"Alper Doğanci, Şebnem Ataman, Ali Erhan Özdemirel, Recep Bülent Seçkin, Ayşe Peyman Yalçin, Sevim Bavbek","doi":"10.55730/1300-0144.5914","DOIUrl":"10.55730/1300-0144.5914","url":null,"abstract":"<p><strong>Background/aim: </strong>We aimed to investigate the relationship between serum antidrug antibodies (ADAbs), systemic hypersensitivity, or local injection site reactions to tumor necrosis factor (anti-TNF) drugs and to detect the role of skin tests in the diagnosis of hypersensitivity reactions (HSRs) against anti-TNFs.</p><p><strong>Materials and methods: </strong>Sixty-nine ankylosing spondylitis (AS) and 46 rheumatoid arthritis (RA) patients taking infliximab (IFX), adalimumab (ADA), and etanercept (ETN) were enrolled. The demographical data, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP) levels of the patients were determined, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) assessment for AS patients and DAS28 (disease activity score) for RA patients were assessed. Serum levels of anti-TNFs and ADAbs to these agents were measured with ELISA. These blood samples were taken 24 h before the next drug dose. The patients with anti-TNF-associated HSRs were evaluated with a skin-prick test (SPT) and intradermal test (IDT). Readings for the SPT and IDT were conducted after 15 min and 24, 48, and 72 h. Heel diameter of 3 mm or more greater than the negative control was considered positive for SPT, and if the size of the initial wheal had increased by at least 3 mm in diameter and was surrounded by erythema it was considered positive for IDT. Symptoms such as urticaria/angioedema and flushing were considered immediate-type HSRs. Findings developed at the injection site such as swelling and erythema were considered injection-site reactions (ISRs). An overall p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A statistically significant association was found between HSRs (immediate type and ISRs) and IDT reported by patients taking biological drugs (p = 0.001). In the subgroup analysis, a statistically significant association was found between ISRs and IDT in those taking ADA and ETN (respectively p = 0.012, p = 0.013). No relationship was found between skin test positivity and the presence of IgG ADAbs to anti-TNFs or disease activity scores.</p><p><strong>Conclusion: </strong>This study demonstrates that patients who exhibit ISRs to anti-TNFs produce notably positive results to IDT without maintaining a direct relationship to serum levels of ADAbs.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 6","pages":"1310-1318"},"PeriodicalIF":1.2,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventral-approach augmented nontransected anastomotic (vANTA) urethroplasty for bulbar urethral strictures: a single-center experience.","authors":"Musab Ali Kutluhan, Sait Aygün, Selman Ünal, Asım Özayar, Emrah Okulu, Kemal Ener, Önder Kayigil","doi":"10.55730/1300-0144.5848","DOIUrl":"https://doi.org/10.55730/1300-0144.5848","url":null,"abstract":"<p><strong>Background/aim: </strong>This study describes ventral-approach augmented nontransected anastomotic (vANTA) urethroplasty and presents the preliminary functional results of patients treated with this technique.</p><p><strong>Materials and methods: </strong>Twenty-three patients who underwent vANTA urethroplasty were included in the study. Stricture location, stricture length, preoperative uroflowmetry parameters (maximum flow rate (Qmax) and mean flow rate (Qmean)), preoperative International Index of Erectile Function (IIEF)-5 scores, operation time, postoperative complications, length of hospital stay, and follow-up periods were recorded. The Qmax, Qmean, and IIEF-5 scores of the patients were recorded again in the second and twelfth postoperative months. Preoperative and postoperative Qmax values and IIEF-5 scores were compared. Kaplan-Meier survival analysis was performed to demonstrate recurrence-free survival.</p><p><strong>Results: </strong>The mean age of the patients included in the study was 52.1 ± 16.9 years. Mean stricture length was 2.5 ± 0.5 cm. There was a statistically significant difference between preoperative and 2-month postoperative uroflowmetry Qmax values (6.9 (0.0-14.5) vs. 18.5 (5.5-41.5) mL/s; p < 0.001). There was no statistically significant difference in preoperative and 2-month postoperative IIEF-5 scores (p > 0.05). There was a statistically significant difference between preoperative and 1-year postoperative median Qmax values (7.2 (0.0-12.3) vs. 17.4 (11.2-24.3) mL/s; p = 0.001). There was no statistically significant difference between preoperative and 1-year postoperative IIEF-5 scores (p > 0.05). According to Kaplan-Meier recurrence-free survival analysis, the recurrence-free survival rate at 6 months was 95.7.</p><p><strong>Conclusion: </strong>In cases of bulbar urethral strictures, vANTA urethroplasty is an effective treatment option with limited postoperative complications. Preserving the underlying corpus spongiosum is important to avoid impaired sexual function.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 4","pages":"771-777"},"PeriodicalIF":1.2,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic approach to heart failure in Türkiye.","authors":"Dilek Ural, Lale Dinç Asarcikli, İnci Tuğçe Çöllüoğlu, Anıl Şahin, Yüksel Çavuşoğlu, Mehmet Birhan Yilmaz, Sanem Nalbantgil, Naim Ata, Mustafa Mahir Ülgü, Şuayip Birinci, Selda Murat, Emre Demir, Emine Arzu Kanik, Ahmet Çelik","doi":"10.55730/1300-0144.5932","DOIUrl":"10.55730/1300-0144.5932","url":null,"abstract":"<p><strong>Background/aim: </strong>Final diagnosis of heart failure (HF) relies on a combination clinical findings, laboratory and imaging tests. The aim of this study was to review the diagnostic approach to HF in Türkiye.</p><p><strong>Materials and methods: </strong>This study is a subanalysis of the nationwide TRends-HF study, based on anonymized data from National Electronic Database between January 1, 2016, and December 31, 2022. Variables including date of birth, sex, socioeconomic development index, place of initial HF diagnosis, comorbidities, investigations, and diagnostic procedures were reported. Laboratory variables, including complete blood count, natriuretic peptides (NP), estimated glomerular filtration rate, uric acid, electrolytes, albumin, lipid profile, ferritin and hemoglobin A1c levels, and other imaging techniques (coronary angiogram [CAG], transthoracic echocardiography [TTE], chest X-ray [CXR], etc.) during the initial diagnosis and/or follow-up of HF patients, were obtained from the National Electronic Database. The diagnostic test usage rates were analyzed according to years, geographical regions, and socioeconomic regions of Türkiye.</p><p><strong>Results: </strong>The study population consisted of 2,722,151 HF patients (51.7% female, mean age 68.33 ± 14.01 years). All HF patients had at least one electrocardiogram and one TTE examination, and all underwent routine biochemical tests at least once during the follow-up period. CXR utilization rate was 93.7%, while CAG utilization rate was 17.9%. Coronary computed tomographic angiography and cardiac magnetic resonance imaging were performed in only 1.8% and 0.3% of patients, respectively. Among all Turkish HF patients, 16.3% had at least one NP measurement. The highest rate of NP use was observed in the Central Anatolia Region (21.0%), while the lowest rate was in the Aegean Region (11.7%). NP measurement during HF diagnosis revealed a rising trend over time (12.3% in 2016 vs. 26.3% in 2021).</p><p><strong>Conclusion: </strong>The widespread use of TTE at the beginning of the diagnosis and during follow-up is important for providing quality care to HF patients in Türkiye. However, detailed laboratory tests and advanced imaging methods are not utilized sufficiently, which could lead to issues in patient management.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 7","pages":"1461-1469"},"PeriodicalIF":1.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaching a nationwide registry: analyzing big data in patients with heart failure.","authors":"Tuğçe Çöllüoğlu, Anıl Şahin, Ahmet Çelik, Emine Arzu Kanik","doi":"10.55730/1300-0144.5931","DOIUrl":"10.55730/1300-0144.5931","url":null,"abstract":"<p><strong>Background/aim: </strong>Randomized controlled trials usually lack generabilizity to real-world context. Real-world data, enabled by the use of big data analysis, serve as a connection between the results of trials and the implementation of findings in clinical practice. Nevertheless, using big data in the healthcare has difficulties such as ensuring data quality and consistency. This article aimed to examine the challenges in accessing and utilizing healthcare big data for heart failure (HF) research, drawing from experiences in creating a nationwide HF registry in Türkiye.</p><p><strong>Materials and methods: </strong>We established a team including cardiologists, HF specialists, biostatistics experts, and data analysts. We searched certain key words related to HF, including heart failure, nationwide study, epidemiology, incidence, prevalence, outcomes, comorbidities, medical therapy, and device therapy. We followed each step of the STROBE guidelines for the preparation of a nationwide study. We obtained big data for the TRends-HF trial from the National Healthcare Data System. For the purpose of obtaining big data, we screened 85,279,553 healthcare records of Turkish citizens between January 1, 2016 and December 31, 2022.</p><p><strong>Results: </strong>We created a study cohort with the use of ICD-10 codes by cross-checking HF medication (n = 2,722,151). Concurrent comorbid conditions were determined using ICD-10 codes. All medications and procedures were screened according to ATC codes and SUT codes, respectively. Variables were placed in different columns. We employed SPSS 29.0, MedCalc, and E-PICOS statistical programs for statistical analysis. Phyton-based codes were created to analyze data that was unsuitable for interpretation by conventional statistical programs. We have no missing data for categorical variables. There was missing data for certain continuous variables. Propensity score matching analysis was employed to establish similarity among the studied groups, particularly when investigating treatment effects.</p><p><strong>Conclusion: </strong>To accurately identify patients with HF using ICD-10 codes from big data and provide precise information, it is necessary to establish additional specific criteria for HF and use different statistical programs by experts for correctly analyzing big data.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 7","pages":"1455-1460"},"PeriodicalIF":1.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical and advanced heart failure therapies in Türkiye.","authors":"Sanem Nalbantgil, Emre Demir, Ahmet Çelik, İnci Tuğçe Çöllüoğlu, Naim Ata, Mehmet Birhan Yilmaz, Anıl Şahin, Dilek Ural, Mustafa Mahir Ülgü, Emine Arzu Kanik, Lale Dinç Asarcikli, Yüksel Çavuşoğlu, Selda Murat, Şuayip Birinci","doi":"10.55730/1300-0144.5933","DOIUrl":"10.55730/1300-0144.5933","url":null,"abstract":"<p><strong>Background/aim: </strong>Effective management of heart failure involves evidence-based use of multiple medications and their combinations. Furthermore, dosage escalation of the recommended medications is advised. In cases of advanced heart failure, long-term mechanical assistance devices or heart transplantation surgery may be necessary. Socio-economic disparities create unequal opportunities for people to access these treatments.The study aimed to analyze and compare medical and advanced heart failure treatments recommended by guidelines across various regions in Türkiye.</p><p><strong>Materials and methods: </strong>About 85 million citizens medical treatment records were utilized between January 1, 2016, and December 31, 2022. Medical and heart replacement treatment opportunities for heart failure in Türkiye were evaluated in the general population and across different geographical regions.</p><p><strong>Results: </strong>According to this study, beta-blockers were the most commonly prescribed medication for heart failure in Türkiye. This was followed by angiotensin-converting enzyme inhibitors at 44% and mineralocorticoid receptor antagonists at 38.9%. However, only 0.6% of patients used angiotensin receptor blocker-neprilysin inhibitors. Despite the high incidence of diabetes mellitus among heart failure patients, only 11% used sodium-glucose cotransporter two inhibitors. The study also found that using an implantable cardioverter defibrillator (ICD) was 0.8%, and cardiac resynchronization therapy (CRT) was 0.3% among all intracardiac device treatments. Heart replacement therapies, cardiac transplantation surgery, and long-term left ventricle-assisted device (LVAD) surgery had very low rates.</p><p><strong>Conclusion: </strong>The use of guideline-directed medical therapy is not optimal in Türkiye and varies across different geographical regions. It is a fact that heart transplant or LVAD surgery, CRT, and ICD implantation rates in Türkiye are significantly lower than those in developed countries, regardless of geographical region.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 7","pages":"1470-1477"},"PeriodicalIF":1.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of comorbidities in heart failure patients in Türkiye.","authors":"Yüksel Çavuşoğlu, Selda Murat, Anıl Şahin, İnci Tuğçe Çöllüoğlu, Dilek Ural, Mehmet Birhan Yilmaz, Sanem Nalbantgil, Naim Ata, Mustafa Mahir Ülgü, Şuayip Birinci, Emre Demir, Emine Arzu Kanik, Lale Dinç Asarcikli, Ahmet Çelik","doi":"10.55730/1300-0144.5934","DOIUrl":"10.55730/1300-0144.5934","url":null,"abstract":"<p><strong>Background/aim: </strong>Heart failure (HF) is associated with a wide range of comorbidities that negatively impact clinical outcomes and cause high economic burden. We aimed to evaluate the frequency and burden of comorbidities in HF patients in Türkiye and their relationships with patients' demographic characteristics.</p><p><strong>Materials and methods: </strong>Based on ICD-10 codes in the national electronic database of the Turkish Ministry of Health covering the entire population of Türkiye (n = 85,279,553) from 1 January 2016 to 31 December 2022, data on the prevalence of comorbidities in HF patients were obtained. The frequency and burden of comorbidities were analyzed separately by age groups, sex, and socioeconomic status (SES).</p><p><strong>Results: </strong>Between 2016 and 2022, there were 2,722,151 patients (51.7% female) of all ages who were diagnosed with HF. In Türkiye, the most common comorbidities of HF patients were hypertension (HT) (97.6%), atherosclerotic cardiovascular disease (ASCVD) (84.9%), dyslipidemia (59.5%), anxiety disorder (48.1%), diabetes mellitus (DM) (45.2%), chronic obstructive pulmonary disease (COPD) (43.6%), anemia (40.6%), and atrial fibrillation (AF) (37.1%). Female patients had higher rates of anemia, DM, HT, and anxiety disorders, while male patients had higher rates of ASCVD, COPD, and dyslipidemia. The most common comorbidity in patients under 20 years of age was congenital heart disease (52.3%). More than 90% of HF patients had ≥2 comorbidities. HF patients with ≥5 comorbidities increased from 18.1% in the group aged 20-49 years to 38.3% in the group aged 50-79 years. Comorbidities were similar across SES groups.</p><p><strong>Conclusion: </strong>The most common comorbidities in cases of HF in Türkiye are HT, ASCVD, dyslipidemia, DM, COPD, anemia, and AF, respectively, and more than 90% of patients have ≥2 comorbidities. While ASCVD and dyslipidemia were more common in male patients, anemia, DM, and anxiety disorders were more common in female patients. The number of comorbid conditions increased with advanced age.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 7","pages":"1478-1487"},"PeriodicalIF":1.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is gut microbiota of patients with ALS different from that of healthy individuals?","authors":"Zerin Özaydin Aksun, Seyda Erdoğan, Ayşe Kalkanci, Elif Ayça Şahin, Tuğba Çuhadar, H Özden Şener","doi":"10.55730/1300-0144.5825","DOIUrl":"https://doi.org/10.55730/1300-0144.5825","url":null,"abstract":"<p><strong>Background/aim: </strong>Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Several studies have shown that alterations of microbiota increase the risk of neurodegenerative disorders. We aimed to reveal whether there is a difference in the gut microbiota of patients with ALS.</p><p><strong>Materials and methods: </strong>The participants are divided into three groups. Group 1 comprised patients with ALS. Healthy family members living in the same house of the patients formed Group 2. Lastly, sex- and age-matched healthy people were included in Group 3. Fecal samples were collected in 15-mL falcon tubes and stored at -80 °C. Genomic DNA isolation was performed on samples. Bacterial primers selected from the 16S rRNA region for the bacterial genome and ITS1 and ITS4 (internal transcribed spacer) were used for the identification of DNA. Next generation sequence analysis (NGS) and taxonomic analyses were performed at the level of bacterial phylum, class, order, family, genus, and species. Alpha and beta diversity indexes were used. The linear discriminant analysis (LDA) effect size method (LEfSe) was applied to identify a microbial taxon specific to ALS disease.</p><p><strong>Results: </strong>The relative abundances of the Succinivibrionaceae and Lachnospiraceae families were significantly lower in patients. The dominant families among patients were Streptococcaceae and Ruminococcaceae, while the dominant families among healthy controls were Bacteroidaceae and Succinivibrionaceae. The LEfSe analysis revealed that four families (Atopobiaceae, Actinomycetaceae, Erysipelatoclostridiaceae, Peptococcacceae) differed significantly between the patients and healthy controls (LDA values> 2.5, p < 0.05).</p><p><strong>Conclusion: </strong>Comparison with family members living in the same house is the strength of this study. We found that there were changes in the microbiota of the patients, consistent with the literature. Studies that analyze the composition of the gut microbiota in the predisease period may be needed to understand whether dysbiosis is caused by the mechanisms inherent in the disease or whether it is dysbiosis that initiates the disease.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 3","pages":"579-587"},"PeriodicalIF":1.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sharp edge of immunosuppressive treatments: infections.","authors":"Aybegüm Özşahin, Tuba Ilgar, Sudem Mahmutoğlu Çolak, Kübra Akyüz, Melih Gaffar Gözükara, Uğur Kostakoğlu, İlknur Esen Yildiz, Ayşe Ertürk","doi":"10.55730/1300-0144.5845","DOIUrl":"https://doi.org/10.55730/1300-0144.5845","url":null,"abstract":"<p><strong>Background and aim: </strong>Different side effects, including infections, are encountered in patients receiving anticytokines used for the treatment of severe coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the infections and the effects of these infections that develop in this patient group.</p><p><strong>Materials and methods: </strong>This study included 208 patients who were followed-up with the diagnosis of severe COVID-19 in two different hospitals. Patient data were obtained retrospectively from the hospital information system.</p><p><strong>Results: </strong>Of the 208 patients included, 54 were in the anakinra group, and 154 were in the tocilizumab group. Of these patients, 73 (35.1%) developed infection, 160 (76.9%) were admitted to the intensive care unit (ICU), and the 30-day mortality rate was 46.6%. The ICU admission, 30-day mortality, and infection rates were higher in the anakinra group, but it was not statistically significant (p = 0.137, p = 0.127, and p = 0.132, respectively), while pneumonia and bloodstream infection (BSI) rates were higher (p = 0.043 and p = 0.010 respectively). The 30-day mortality rate was significantly higher in patients who developed infection, especially in the tocilizumab group (p < 0.001 and p = 0.001). The independent risk factors affecting the development of infection were evaluated via regression analysis, in which it was found that age, sex, and the type of immunosuppressive treatment had no significant effect, while ICU admission increased the risk of infection by 32.8 times (95% CI: 4.4-245.8) and each day of hospitalization slightly increased the risk of infection by 1.06 times (95% CI: 1.03-1.09).</p><p><strong>Conclusion: </strong>Infection rates were higher in the anakinra group, especially the pneumonia and BSI rates were higher than in the tocilizumab group. The 30-day mortality rates were higher in patients who had an infection, especially in the tocilizumab group. This is one of the rare studies that evaluated infections developing in patients treated with anakinra and tocilizumab together.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 4","pages":"752-760"},"PeriodicalIF":1.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of heart failure in Türkiye.","authors":"Naim Ata, İnci Tuğçe Çöllüoğlu, Anıl Şahin, Mehmet Birhan Yilmaz, Sanem Nalbantgil, Şuayip Birinci, Mustafa Mahir Ülgü, Emine Arzu Kanik, Dilek Ural, Lale Dinç Asarcikli, Emre Demir, Yüksel Çavuşoğlu, Selda Murat, Ahmet Çelik","doi":"10.55730/1300-0144.5930","DOIUrl":"10.55730/1300-0144.5930","url":null,"abstract":"<p><strong>Background/aim: </strong>The epidemiological data on heart failure (HF) vary between regions within the same country. We aimed to investigate the epidemiological data on HF in Türkiye across all age groups regarding seven geographical regions.</p><p><strong>Materials and methods: </strong>We included all patients from the Turkish population who received a first diagnosis of HF between January 1, 2016 and December 31, 2022, using ICD-10 codes from the National Electronic Healthcare Database. The data were categorized by seven geographical regions of Türkiye.</p><p><strong>Results: </strong>The median age of index diagnosis of HF was 70 (60-78) years in all age groups and 4 (1-12) years in pediatric population. The prevalence rate of HF was the highest in the Black Sea Region at 3.103%, while the Southeastern Anatolia Region exhibited the lowest at 1.436%. In all age groups, female patients with HF were older and had a higher prevalence rate across all geographical regions than male patients. From 2017 to 2021, incidence rates of HF declined to 3.0 per 1000 person years, with a consistent decrease for each geographical region. The highest incidence rates of HF were seen in the Black Sea Region, while the Southeastern Anatolia Region had the lowest. Evaluating pediatric population with HF, prevalence of HF was 0.81 per 1000 people (female children: 0.77 per 1000 people, male children: 0.84 per 1000 people). Female children with HF demonstrated the highest prevalence in the Central Anatolia Region with a rate of 1.04 per 1000 people, while male pediatric population with HF exhibited the greatest prevalence of HF in the Mediterranean Region, reaching 0.89 per 1000 people. The lowest prevalence of children with HF in both sexes was observed in the Eastern Anatolia Region (female children: 0.62 per 1000 people, male children: 0.48 per 1000 people).</p><p><strong>Conclusion: </strong>Despite regional variations, prevalence of HF in Türkiye's regions aligns with global trends. Sex-based differences in HF prevalence were evident across all age groups, including pediatric population. Incidence rates of HF in each region exhibited a substantial decline by 2021.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 7","pages":"1447-1454"},"PeriodicalIF":1.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of celiac disease in Behçet's syndrome patients: a study based on the database of Türkiye.","authors":"Nuray Yilmaz Çakmak, Naim Ata, Serdar Can Güven, Emin Gemcioğlu, Mustafa Mahir Ülgü, Şuayip Birinci","doi":"10.55730/1300-0144.5815","DOIUrl":"10.55730/1300-0144.5815","url":null,"abstract":"<p><strong>Background/aim: </strong>Our primary aim was to investigate the effects of concomitant celiac disease (CD) on the clinical characteristics of Behçet's syndrome (BS) patients.</p><p><strong>Materials and method: </strong>The study was a retrospective, nationwide, multicenter study. Turkish Ministry of Health National Electronic Database (e-Nabız) is used under Health Ministry's supervision to extract the subject's data.</p><p><strong>Statistical analysis: </strong>Statistical analyses were made by the Statistical Package for Social Sciences (SPSS) software version 20 (IBM Corp., Armonk, New York). Continuous variables were presented by mean ± standard derivation (SD) or median (min-max) according to normality and compared by student-t test. A binary logistic regression analysis was performed to further investigating the relation between having a concomitant CD with each BD manifestation and comorbidity, frequencies of which were detected to be significantly different in the student-test.</p><p><strong>Results: </strong>A total of 84,241 patients diagnosed with BS were analyzed, and CD was identified in 175 (0.21 %) patients. The group with CD had a mean age of 41.30 ± 13.69 which was significantly younger. the prevalence of females was significantly higher (71.4%). The mean age of first admission for BS was also significantly younger in the group with CD (36.64 ± 13.28). BS patients with CD had a significantly higher prevalence of inflammatory bowel disease (27.2% vs. 7.3%, p < 0.001). When comorbid conditions were investigated depression (35.4% vs. 23.3%, p < 0.001), migraine (7.4 % vs. 2.6%, p < 0.001), fibromyalgia (10.9% vs. 4.5%, p < 0.001) and osteoporosis (12.6% vs. 6.6%, p = 0.001) were significantly more frequent in BS patients with CD.</p><p><strong>Conclusion: </strong>Our results suggest coexistence of CD in BS patients is related to female dominance and probably to an earlier disease onset. Several CD-related comorbidities as well as inflammatory bowel disease were more frequent in the CD group which implied an increased overall disease burden.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"54 3","pages":"493-501"},"PeriodicalIF":1.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}