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Öğe Are bone morphogenetic protein-7 (BMP-7) serum levels correlated with development of hepatic fibrosis?(J Infection Developing Countries, 2014) Demir, Nazlim Aktug; Kolgelier, Servet; Inkaya, Ahmet Cagkan; Sumer, Sua; Demir, Lutfi Saltuk; Pehlivan, Fatma Seher; Arslan, MahmureIntroduction: Bone morphogenetic protein-7 (BMP-7) is a key protein in organogenesis and liver development. The protein has been studied in the context of liver fibrosis and regeneration. The aim of the present study was to explore any possible association between fibrosis levels (as revealed by liver biopsy) and serum BMP-7 levels. Methodology: A total of 189 patients with chronic hepatitis B and 51 healthy controls were enrolled in the study. Results: The study group contained 120 (63.5%) males and 69 (36.5%) females, and the control group contained 25 males (49.0%) and 26 females (51%). In general, serum BMP-7 values of patients were higher than those of controls (p = 0.001). Serum BMP-7 values of patients with liver fibrosis of stages 1, 2, 3, or 4 were higher than control values (all p values = 0.01), but the serum BMP-7 levels of patients with stage 5 fibrosis were similar to that of controls. Associations between fibrosis stage and the serum levels of BMP-7, ALT, HBVDNA, platelets, and albumin were all statistically significant (p = 0.001). The AUROC for the BMP-7 level in advanced stage fibrosis was found to be 0.23. The data were analyzed using the binary logistic regression analysis (backward stepwise method) and BMP-7, HBVDNA, and platelet levels were found to be risk factors associated with fibrosis (p values 0.031, 0.040, and 0.001, respectively). Conclusions: BMP-7 may play anti-inflammatory and anti-fibrogenic roles in the pathogenesis of chronic hepatitis B infection.Öğe Are Really Family Physicians Aware of Hepatitis B?(Drunpp-Sarajevo, 2016) Demir, Lutfi Saltuk; Demir, Nazlim Aktug; Inkaya, Ahmet Cagkan; Guler, Selma; Horasan, Elif Sahin; Kolgelier, Servet; Celik, UmitIntroduction: This study aimed to determine the level of knowledge of family physicians regarding hepatitis B infection, transmission ways, risk groups, clinical course, and protection methods. Methods: This study is held on 236 family physicians at Adiyaman, Mersin, Adana and Kahramanmaras. A questionnaire was held before the awareness raising seminars organized by provincial Health Directorates. Data was analyzed by SPSS 16.0 and descriptive statistics and chi-square test were used. Results: In general, 54.7% of the doctors enrolled in this study gave correct answers. Twenty three percent of physicians were not aware of HBsAg in diagnosis of hepatitis B virus (HBV), 14.8% did not know anti-HBs as indicating immunity against HBV. Though 94.4% of the family physicians administered routine hepatitis B vaccination, 62.3% of them were not informed about the lowest level of anti-HBs titer (10 IU/ml) providing immunity against HBV. Conclusion: This study showed that the level of knowledge of family physicians in HBV infections is inadequate and the family physicians should be trained about contagious diseases.Öğe Assessment of Quality of Life Following Radiotherapy in Patients with Rectum Cancer(Springer, 2022) Yavuz, Berrin Benli; Aktan, Meryem; Kanyilmaz, Gul; Demir, Lutfi SaltukPurpose The aim of the present study is to investigate the effects of radiotherapy (RT) on quality of life (QoL) and influencing factors. Methods Data of 106 patients who completely filled out the three questionnaires were evaluated in this prospective study. Quality of life was evaluated with cancer-specific QLQ-C30 and colorectal cancer module QLQ-CR29 created by European Organization for Research and Treatment of Cancer (EORTC). All statistical analyses were done with SPSS version 22 software. A p level of < 0.05 was accepted as statistically significant. Results Median age was 61 (27-86). Of the patients, 77 (72.6%) were male and 29 (27.4%) were female. When QLQ-C30 questionnaires were evaluated, it was observed that physical, role, cognitive, and emotional function scores were impaired following RT, however returned to pre-RT levels on control. According to the results of QLQ-CR29 questionnaire, after RT, impairment was observed in urination frequency, urinary incontinence, stool frequency, dysuria, fecal incontinence, embarrassment, and sexual interest in male scales; however, they returned to pre-RT values on control. When evaluated with regard to age, financial difficulty, global health score, mucus in stool, dysuria, dyspareunia, and abdominal pain were observed to be poorer in the young; urination frequency and urinary incontinence were observed to be poorer in the elderly. Conclusion Although both functional and symptom scales were shown to impair, most of them were detected to be temporal and patients could well tolerate radiotherapy. Additional assessment is required for evaluating the late effects of treatments on QoL.Öğe Association of sociodemographical features, antiviral treatment, and necroinflammatory activity with depression and anxiety in chronic hepatitis B patients(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2015) Celik, Mustafa; Demir, Nazlim Aktug; Sumer, Sua; Demir, Lutfi SaltukObjective: Psychiatric disorders like depression and anxiety are known to be more prevalent in patients with chronic hepatitis B than healthy individuals. This increased prevalence may be due to multiple factors such as psychological distress associated with having a chronic disease, necroinflammatory activity in liver, side effects of treatment with antiviral agents or interferons, and/or direct effect of hepatitis viruses on central nervous system. Purpose of this study was to evaluate several risk factors that may be associated with anxiety and depression in patients with chronic hepatitis B. Methods: This study included 195 chronic hepatitis B patients. A psychiatrist made clinical interviews with the patients and filled Sociodemographic Data Form, Hamilton Anxiety Rating Scale (HARS), and Hamilton Depression Rating Scale (HDRS). Needle biopsies were performed to 175 patients who met biopsy criteria of American Association for the Study of Liver Diseases. Knodell Histological Activity Index was used to evaluate biopsy materials. HBV DNA and ALT levels were measured from patients' sera. Findings: In the study sample, 119 patients were males and 76 were females. Mean HARS score was 7.3 +/- 6.2 and mean HDRS score was 8.8 +/- 6.6. Both HARS and HDRS scores were higher in females than males. HARS score was higher in patients with a family history of chronic hepatitis and both HARS and HDRS scores were higher in patients with comorbid medical illness. Alanine aminotransferase, HBV DNA levels, and level of fibrosis in liver biopsy didn't affect HARS or HDRS scores. Also, there wasn't a difference in HARS or HDRS scores according to patients' usage of pegylated interferon, or oral antiviral therapy. Conclusion: Multiple factors affect the relation between chronic hepatitis and psychiatric disorders like anxiety and depression. Results of our study suggest that female sex, presence of a family history for chronic hepatitis B, comorbidity of other medical diseases, and ethnic origin affect more than the level of necroinflammatory activity and cellular damage in the liver or antiviral treatments.Öğe ERGONOMIC EVALUATION OF DESK-BOUND WORK OFFICES OF A COMMUNITY HEALTH CENTER AND EFFECT OF ERGONOMIC INTERVENTION ON THE HEALTH COMPLAINTS OF THE WORKERS(Nobel Ilac, 2020) Tuncez, Ismail Hakki; Demir, Lutfi Saltuk; Kunt, Muammer; Sahin, Tahir KemalObjective: It has been known for many years that workplace environment of the individuals has a great impact on human health. The aim of this study was to determine the effect of ergonomic intervention on the health complaints of office workers. Material and Method: In this interventional study, the health complaints of workers were determined via implementing surveys before and after the intervention. Moreover, ergonomic observations were made for the participants and the working environment. In the context of intervention, an overall ergonomic training was provided and risk factors at work were decreased. Results: As the conclusion of the ergonomic intervention, an improvement was determined in the working posture and in equipment usage. As a result of this, the proportion of participants with at least one area of musculoskeletal complaints decreased from 81.2% to 62.5%, while the proportion of participants with any eye complaints decreased from 52.5% to 28.7%. Conclusion: The results imply the intervention program is very useful and it is necessary to implement such programs for all of the risk groups by occupational safety and health units.Öğe Evaluation of Depression, Anxiety Level and Quality of Life in Patients With Chronic Hepatitis B and Inactive Hepatitis B Virus Carriers(Aves, 2017) Yigit, Ozge; Ural, Onur; Aktug-Demir, Nazlim; Sumer, Sua; Guler, Ozkan; Demir, Lutfi SaltukObjective: The objective of this study was to compare the anxiety, depression and quality of life scores of chronic hepatitis B (CHB) patients and inactive hepatitis B virus (HBV) carriers with healthy control subjects and to demonstrate the need for a multidisciplinary approach in the follow-up and treatment of patients with HBV infection. Methods: The study was carried out by comparing 200 subjects including 100 CHB patients and 100 inactive HBV carriers, who were admitted to the Outpatient Clinic of Infectious Diseases and Clinical Microbiology Department, Faculty of Medicine, Selcuk University between August 2013 and August 2014 with 100 healthy control subjects. All subjects were given Hospital Anxiety and Depression (HAD) Scale and Short Form-36 (SF-36) to assess their quality of life. Results: Based on the HAD Scale, anxiety risk among the carriers was higher than the control group (p=0.031). Depression risk in the patient (p=0.031) and carrier groups (p=0.046) were higher than the control group. There was no significant difference between the patient and carrier groups with regard to anxiety risk or depression risk (p>0.05). Females had higher anxiety risk in the patient (p=0.015), carrier (p=0.035) and control (p=0.001) groups. Depression risk was also higher in females in the patient (p=0.037) and carrier (p=0.038) groups. There were no significant relations between marital status, family type, place of living and anxiety and depression risks (p>0.05). Three quality of life parameters including general health, role limitations due to physical health and vitality scores in the inactive HBV carriers and CHB patients were lower than those of the control group (p<0.05). Conclusions: Psychological state of the patients who are chronically infected with HBV should not be neglected during treatment and follow-up. If a psychiatric disturbance is identified, effective treatment will increaseÖğe Evaluation of Patients Followed by COVID-19 After Quarantine(Bilimsel Tip Yayinevi, 2020) Ural, Onur; Sumer, Sua; Aktug Demir, Nazlim; Yalcinkaya, Emine; Ucan, Elif; Demir, Lutfi SaltukIntroduction: The COVID-19 pandemic continues to affect the world with serious number of cases and deaths. For this reason, knowing the clinical findings and course of the disease is important for early diagnosis and treatment. In this article, COVID-19 cases followed up after quarantine were discussed. Materials and Methods: In this study, the data of 99 patients who were followed up during travel and post-Umrah quarantine between 31 March and 15 April 2020 were retrospectively reviewed. Results: Of the 99 patients included in the study, 66 (66.7%) were females, 33 (33.3%) were males, and mean age was 59.8 +/- 11.4 years. SARS-CoV-2 RT-PCR test was positive at the time of admission in 97 (98.0%) of the 99 patients. Thirty-nine (39.4%) of the patients were symptomatic and 25.3% of the patients had cough, 8.1% had fever, and 7.1% had shortness of breath. While SARS-CoV-2 RT-PCR test was negative in 2 (3.3%) of the 60 patients without complaints, 58 (96.7%) of them were positive for SARS-CoV-2 RT-PCR test. Leukopenia was detected as 3%, lymphopenia 66.7%, D-dimer height 47.5%, LDH elevation 38.4%, CRP elevation 45.5%. Ground glass opacities were present in 81 (81.8%) of the patients with lung involvement, and consolidation areas were present in 40 patients (40.4%). Underlying disease was present in 38 (38.4%) of the patients. Hypertension and diabetes mellitus were the most common underlying diseases. It was observed that 89 (89.4%) of our cases had negative SARS-CoV-2 RT-PCR test on the 5th day. Conclusion: COVID-19 infection is an infectious disease that can present with many different clinics. In asymptomatic COVID-19 cases, lung involvement findings and disorders in laboratory parameters may be observed. It should be kept in mind that asymptomatic cases pose a risk in terms of transmission.Öğe Evaluation of the Relation Between Hepatic Fibrosis and Basic Laboratory Parameters in Patients With Chronic Hepatitis B Fibrosis and Basic Laboratory Parameters(Kowsar Publ, 2014) Demir, Nazlim Aktug; Kolgelier, Servet; Ozcimen, Serap; Gungor, Gokhan; Sumer, Sua; Demir, Lutfi Saltuk; Inkaya, Ahmet CagkanBackground: The hepatitis B virus is an important healthcare problem. According to current clinical practice, a liver biopsy is required for the diagnosis and treatment of chronic liver disease. However, a liver biopsy is an invasive, inconvenient procedure, which requires an expert pathologist opinion. Therefore requirement of biochemical tests, which are considered to indicate hepatic fibrosis and may be repeated easily, increases gradually today. Objectives: This study evaluated the correlation between hepatic fibrosis and routine laboratory values in patients with chronic hepatitis B. Patients and Methods: The files of 456 patients with CHB (chronic hepatitis B) who were referred to the infectious diseases and clinical microbiology clinic between January 2009 and March 2012 were screened retrospectively. Liver biopsy samples were examined according to Ishak scoring. Laboratory parameters and histopathology reports were recorded, and correlations between the fibrosis grade and laboratory parameters were analyzed. Results: There were 320 male and 136 female patients, with a mean age 36.7 +/- 12.1 years. According to liver biopsy results, a low fibrosis score (stage 0-2) was detected in 281 patients (61.6%), and a high fibrosis score ( stage 3-5) was detected in 175 patients (38.4%). Patients with a high fibrosis score had significantly higher ALT (alanine amino transferase), AST (aspartate aminotransferase), and HBV-DNA values and a significantly lower platelet count compared with those with a low fibrosis score (P=0.001, 0.001, 0.025, and 0.001, respectively). A positive correlation was detected between the fibrosis score and age, BMI, HAI, ALT, and AST values, and a negative correlation was detected between the fibrosis score and albumin and platelet counts. In the regression analysis performed to evaluate the factors associated with high-stage fibrosis, fibrosis was determined to be associated with thrombosis, ALT, and gender. The results of the regression analysis demonstrated that the risk of fibrosis was 4.6 fold higher in men. Conclusions: According to the results obtained in our study, advanced age, higher BMI, AST, ALT, and HBV-DNA levels, and low albumin and platelet levels are correlated with advanced fibrosis in patients with CHB.Öğe High thioredoxin reductase 1 expression in meningiomas undergoing malignant progression(Springer Japan Kk, 2015) Esen, Hasan; Feyzioglu, Bahadir; Erdi, Fatih; Keskin, Fatih; Kaya, Bulent; Demir, Lutfi SaltukThioredoxin (Trx) is a redox active protein that regulates several physiological and biochemical functions, such as growth, apoptosis and cellular defense. The function of Trx itself is regulated by thioredoxin reductase (TrxR). This study was designed to determine the expression of TrxR1 in meningioma tissues of different World Health Organization grades (grade I-III). Meningioma tissues were extracted from the histopathological specimens of 29 patients. These samples included seven histologically normal meningeal tissues that served as a control group and 12 grade I, 12 grade II and 5 grade III meningioma samples. TrxR1 expression was evaluated using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunostaining. The proliferative and apoptotic indices of the specimens were investigated by Ki-67 immunostaining and TUNEL assay, respectively. TrxR1 expression, as assessed by qRT-PCR, increased significantly with meningioma grade (p < 0.001). The immunostaining intensity of TrxR1 increased significantly with meningioma grade (p < 0.001). Ki-67 index values increased significantly in accordance with grade progression (p < 0.001). The apoptotic index values were not significantly different in any group (p > 0.05). Trx system seems to be involved in the malignant progression of meningiomas. Further, large studies are required to elucidate the exact role of this system.Öğe Impaired Thiol-Disulfide Balance in Acute Brucellosis(Natl Inst Infectious Diseases, 2017) Kolgelier, Servet; Ergin, Merve; Demir, Lutfi Saltuk; Inkaya, Ahmet Cagkan; Demir, Nazlim Aktug; Alisik, Murat; Erel, OzcanThe objective of this study was to examine a novel profile: thiol-disulfide homeostasis in acute brucellosis. The study included 90 patients with acute brucellosis, and 27 healthy controls. Thiol-disulfide profile tests were analyzed by a recently developed method, and ceruloplasmin levels were determined. Native thiol levels were 256.72 +/- 48.20 mu mol/L in the acute brucellosis group and 461.13 +/- 45.37 mu mol/L in the healthy group, and total thiol levels were 298.58 +/- 51.78 mu mol/L in the acute brucellosis group and 504.83 +/- 51.05 mu mol/L in the healthy group (p < 0.001, for both). The disulfide/native thiol ratios and disulfide/total thiol ratios were significantly higher, and native thiol/total thiol ratios were significantly lower in patients with acute brucellosis than in the healthy controls (p < 0.001, for all ratios). There were either positive or negative relationships between ceruloplasmin levels and thiol-disulfide parameters. The thiol-disulfide homeostasis was impaired in acute brucellosis. The strong associations between thiol-disulfide parameters and a positive acute-phase reactant reflected the disruption of the balance between the antioxidant and oxidant systems. Since thiol groups act as anti-inflammatory mediators, the alteration in the thiol-disulfide homeostasis may be involved in brucellosis.Öğe Is serum high-mobility group box 1 (HMGB-1) level correlated with liver fibrosis in chronic hepatitis B?(Lippincott Williams & Wilkins, 2017) Inkaya, Ahmet Cagkan; Demir, Nazlim Aktug; Kolgelier, Servet; Sumer, Sua; Demir, Lutfi Saltuk; Ural, Onur; Pehlivan, Fatma SeherBackground: High-mobility group box 1 (HMGB1), identified as an alarmin molecule, was shown to have a role in virus-triggered liver injury. We aimed to evaluate the association between serum levels of HMGB1 and liver fibrosis. Method: This cross-sectional case-control study included 189 chronic hepatitis B (CHB) patients and 51 healthy controls. All patients underwent liver biopsy and modified Knodell scoring system used to determine the fibrosis level in CHB patients. Serum HMGB1 levels were determined with enzyme-linked immunosorbent assay (ELISA). Results: Mean serum HMGB1 levels of patients (58.1 +/- 54.7) were found to be higher than those of the control group (7.1 +/- 4.3) (P=. 001). HMGB1 levels of patients with advanced-stage fibrosis (stage 4 and 5) were detected to be higher than those of patients with early-stage fibrosis (stage 1-3). However, this difference was not statistically significant (P>. 05). Albumin levels of fibrosis 3 and 4 patients were lower than fibrosis 1 and 2 patients. ALT, HBV DNA, and AFP levels of fibrosis 5 patients were significantly higher than fibrosis 1 and 2 patients, and their platelet and albumin levels are lower than fibrosis 1 and 2 patients (P<. 001). In a logistic regression model, fibrosis levels were correlated with ALT values and inversely correlated with albumin levels. Conclusion: In this study, we demonstrated that serum HMGB1 levels increase in the early course of liver injury and this increase is not correlated with severity of the liver damage.Öğe Knowledge Level of Hepatitis B and its Prevalance in Policemen Working in Adiyaman(Modestum Ltd, 2015) Kolgelier, Servet; Demir, Nazlim Aktug; Demir, Lutfi Saltuk; Ozcimen, Serap; Inkaya, Ahmet CagkanAim of this study to investigate the level of knowledge about hepatitis B and prevalence of HBsAg carriage in police and other security staff. Hepatitis B knowledge of police and other staff working for Adiyaman police department were measured using a questionnaire. This questionnaire was prepared after a literature search and was applied to 683 subjects before an education seminar. Fully and regularly filled 437 questionnaires were selected for evaluation. HBsAg and Anti HBs values of subjects were measured. Data were recorded to SPSS 16.0 package program. Chi square test was used for data analyses. Of all the study subjects 406 (92.9%) were males and 31 (7.1%) were females. Three hundred sixty subjects (82.3%) were police staff, 60 (13.7%) were public serveants, 15 (3.4%) were commissaries and 2 (0.05%) were nightmen. Mean age was 34.5 +/- 7. Fifty four subjects gave correct answers to the question about transmission ways of hepatitis B. Three hundred eighty four subjects didn't have enough knowledge about transmission ways of this virus. HBsAg positivity was detected in 34 (7.7%) subjects. Three hundred twenty five (51,4%) subjects had adequate antibody level for immunity. As a result, we detected that knowledge level was inadequate and increased risk for infection in this profession. It was concluded that security staff should be educated regarding risks and screened for bloodborne diseases.Öğe Patient Knowledge, Attitudes, and Behaviors Associated with Organ Donation(Int Scientific Information, Inc, 2019) Uyar, Mehmet; Demir, Lutfi Saltuk; Durduran, Yasemin; Evci, Reyhan; Ardic, Zehra Diker; Sahin, Tahir KemalBackground: This study compared the knowledge, attitudes, and behaviors associated with organ donation and transplantation among patients undergoing dialysis versus those visiting family health centers (FHCs). Material/Methods: This cross-sectional study included patients undergoing hemodialysis treatment at the Meram Medical Faculty and those visiting FHCs in Meram district for other reasons. Results: The study participants were 128 individuals visiting FHCs and 111 patients undergoing dialysis. Of these, 169 individuals (70.7%) correctly answered the question What is brain death? The knowledge level in the FHC group was higher than that in the dialysis group. Less than half of the individuals indicated willingness to donate an organ. Furthermore, subjects in the dialysis group were more likely than those in the FHC group to answered no to the question Would you be willing to donate an organ to someone of a different religion? Conclusions: Positive attitude towards organ transplantation and donation does not necessarily reflect positive behavior these 2 groups.Öğe Patient Knowledge, Attitudes, and Behaviors Associated with Organ Donation(Int Scientific Information, Inc, 2019) Uyar, Mehmet; Demir, Lutfi Saltuk; Durduran, Yasemin; Evci, Reyhan; Ardic, Zehra Diker; Sahin, Tahir KemalBackground: This study compared the knowledge, attitudes, and behaviors associated with organ donation and transplantation among patients undergoing dialysis versus those visiting family health centers (FHCs). Material/Methods: This cross-sectional study included patients undergoing hemodialysis treatment at the Meram Medical Faculty and those visiting FHCs in Meram district for other reasons. Results: The study participants were 128 individuals visiting FHCs and 111 patients undergoing dialysis. Of these, 169 individuals (70.7%) correctly answered the question What is brain death? The knowledge level in the FHC group was higher than that in the dialysis group. Less than half of the individuals indicated willingness to donate an organ. Furthermore, subjects in the dialysis group were more likely than those in the FHC group to answered no to the question Would you be willing to donate an organ to someone of a different religion? Conclusions: Positive attitude towards organ transplantation and donation does not necessarily reflect positive behavior these 2 groups.Öğe Radiation-induced hypothyroidism in patients with breast cancer: a retrospective analysis of 243 cases(Elsevier Science Inc, 2017) Kanyilmaz, Gul; Aktan, Meryem; Koc, Mehmet; Demir, Hikmettin; Demir, Lutfi SaltukThis study aims to estimate the incidence of hypothyroidism (HT) and to evaluate the predictors affecting the development of HT after radiotherapy (RT) for breast cancer, with a focus on radiation dose-volumetric parameters. Between 2009 and 2015, 243 patients undergoing RT for breast cancer were retrospectively analyzed. Free triiodothyronine (FT3), free thyroxin (FT4), and thyrotropin (TSH) were monitored before and after RT. The relation between the doses to thyroid gland (D-mean, D-max, D-min), percentage of thyroid volume receiving > 10 Gy, 20 Gy, 30 Gy, 40 Gy, and 50 Gy (V10 to V50), absolute thyroid volume, and HT were analyzed. The risk of HT according to radiation fields and the other clinic factors were also evaluated. The median follow-up was 41 (range; 6 to 130) months. Sixty-seven percent of the patients received RT to the breast/chest wall and ipsilateral supraclavicular fossa. Of 243 patients, 51 (21%) were diagnosed with HT. The median time to the onset of HT was 27 (range; 5 to 64) months. There were no significant relationships observed between Dmin or V10 to V50 and HT. The surgery type, clinical stage, nodal status, RT field, Dmean, and Dmax were statistically significant predictors for HT in univariate analysis. The Dmean was the only prognostic factor predicting HT in multivariate analysis, and Dmean > 21 Gy was a threshold value for the evolvement of HT. In this study, we present evidence that postoperative irradiation of patients with breast cancer may frequently lead to HT. Patients who have received RT for breast cancer, especially irradiation on the supraclavicular region, may require thyroid function screening after RT. (C) 2017 American Association of Medical Dosimetrists.Öğe Screening for breast and cervix cancers in a rural part of Turkey(Allied Acad, 2017) Demir, Lutfi Saltuk; Asuk, Nuray Aksoy; Demir, Nazlim AktugBackground: Cancer is a common public health problem in whole world and various screening programs are used in the world for breast and cervix cancers. These screening programs are very important for promotion of public health. Materials and methods: This cross-sectional study involved all villages in Adiyaman city center which are above a population of 400 in 2010 and 2011. Mammography films and Pap smear test used for screening. Results: 817 women that approved screening were transported to screening center. 476 women participated in mammography screening for breast cancer and 733 women participated in cervical screening for cervical cancer. Among these women, 2.5% stated to have a previous mammography and 3 women (0.7%) have a previous pap smear due to some reason. In detailed evaluations, no woman was detected to have breast cancer and one CIN-1 cervix cancer was detected. Conclusion: Although cancer detection rate was low, participation to cancer screening program should be increased. Especially use of mobile screening vehicles may be helpful.Öğe Serum Levels of Annexin A2 as a Candidate Biomarker for Hepatic Fibrosis in Patients With Chronic Hepatitis B(Kowsar Publ, 2015) Kolgelier, Servet; Demir, Nazlim Aktug; Inkaya, Ahmet Cagkan; Sumer, Sua; Ozcimen, Serap; Demir, Lutfi Saltuk; Pehlivan, Fatma SeherBackground: Hepatologists have studied serologic markers of liver injury for decades. Annexins are a prominent group of such markers and annexin A2 (AnxA2) is one of the best characterized annexins. AnxA2 inhibits HBV polymerase among other functions. Its expression is up-regulated in regenerative hepatocytes. Objectives: To determine if serum AnxA2 level has a role in estimating liver damage in chronic HBV infection and investigate whether AnxA2 levels correlate with hepatic fibrosis. Patients and Methods: This study included 173 patients with chronic hepatitis B (CHB) and 51 healthy controls. Liver fibrosis was graded histologically on liver biopsy samples. Blood samples were taken from patients during biopsy and serum AnxA2 levels were measured with ELISA. Results: In a group of adult patients with CHB, AnxA2 values were far higher than those of the control group (P = 0.001). When we assessed AnxA2 levels based on fibrosis stages, serum AnxA2 levels of patients with early stage fibrosis (stages 1 - 3) were significantly higher than those of patients with advanced stage fibrosis (stages 4 - 5; P = 0.001). Conclusions: AnxA2 is a useful biomarker for early stage fibrosis in patients with CHB.Öğe Serum Neutrophil Gelatinase-Associated Lipocalin Levels in Acute Brucellosis and Brucellar Spondylodiscitis(Ankara Microbiology Soc, 2022) Sumer, Sua; Aktug Demir, Nazlim; Demir, Lutfi Saltuk; Findik, Duygu; Kolgelier, Servet; Ural, OnurBrucellosis is a zoonotic infectious disease caused by Brucella spp., an intracellular bacterium. The complications of acute Brucellosis may affect all organs and systems. The most common complication of the disease is musculoskeletal system involvement. The neutrophil gelatinase-associated lipocalin (NGAL) is a marker of neutrophil formation and acts as a siderophore-binding protein to prevent bacterial iron uptake and its use as a marker in the diagnosis and follow-up of bacterial infections is being investigated. The aim of this study was to measure the serum levels of NGAL in patients with acute Brucellosis and Brucellar spondylodiscitis, and to determine whether there is a correlation between NGAL levels and the progression and complications of the disease. This prospective case control study was conducted with 240 patients and 120 healthy controls. The diagnosis of acute Brucellosis was established when a person was asked to take an STA test due to clinical symptoms within the past eight weeks, and the test result that exceeded 1/160, or a 4-fold titer increase was found in the STA test after an interval of two weeks, and/or there was Brucella spp. growth in the blood culture. A contrasted lumbar magnetic resonance (MR) scan was performed on patients diagnosed with acute Brucellosis who had lower back pain. Presence of spondylodiscitis was assessed radiologically with contrasted lumbar MR images. NGAL levels were determined with ELISA assay. The median NGAL value was found to be 456.67 ng/L (101.41-5804.41 ng/L) in patients with acute Brucellosis and 113.84 ng/L (58.29-542.34 ng/L) in the control group. The median NGAL value was statistically higher in the patients than the control group (p= 0.001). Brucellar spondylodiscitis was detected in 57 (23.7%) of 240 patients diagnosed with acute Brucellosis. The median NGAL value was 1885.62 ng/L (143.21-5804.41 ng/L) in patients with Brucellar spondylodiscitis, and 356.87 ng/L (101.41-1874.07 ng/L) in those who did not have Brucellar spondylodiscitis. This difference was statistically significant (p= 0.001). Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were found to be higher in patients who had Brucellar spondylodiscitis. Blood cultures were drawn from 186 (77.5%) of the 240 patients diagnosed with acute Brucellosis. The blood culture positivity rate was 36.02%. Patients whose blood cultures were positive had higher NGAL levels (p= 0.001). The blood culture positivity rate was higher in patients who were diagnosed with Brucellar spondylodiscitis (p= 0.001). A regression analysis showed that female gender and high levels of NGAL, ESR, and alanine aminotransferase (ALT) could be used as predictors of Brucellar spondylodiscitis. The explanatoriness of the model was 82.3%. Although determination of NGAL levels is seen as a useful marker in the diagnosis of acute Brucellosis and predicting the presence of Brucellar spondylodiscitis, more comprehensive studies are required to be used in clinical practice in regions where Brucellosis is endemic.Öğe Social Attitude Towards COVID-19 Vaccine 1 Year After the Pandemic(Doc Design Informatics Co Ltd, 2022) Durduran, Yasemin; Aktug-Demir, Nazlim; Demir, Lutfi Saltuk; Kandemir, Bahar; Duman, Ipek; Yucel, MehtapObjective: To increase vaccine awareness, we aimed to determine individuals' knowledge and behavioral approach to the COVID-19 vaccine. Methods: The data of this cross-sectional study were obtained online between June and July 31, 2021. One thousand one hundred seventy-six people over the age of 18 were included in the study. The researchers developed a data collection form consisting of 27 questions. Mean +/- standard deviation and median (1st quarter-3rd quarter) values, numbers, and percentages were used to summarize the data. Chi-square (chi(2)) test was used to show the relationship between categorical variables. Independent predictors of participants' vaccine hesitancy/rejection were analyzed using logistic regression. Statistically, data with p<0.05 were considered significant. Results: A total of 1176 people, 55.7% of whom were women, with a mean age of 39.75 +/- 11.27 years, were included in the study. 71.6% of the participants were married, and 78.9% had a university/postgraduate degree. 9.7% of the participants stated that they were hesitant about the COVID-19 vaccine, and 7.1% refused the COVID-19 vaccine or would not be vaccinated when it was their turn. According to the logistic regression model established to examine the factors that may affect vaccine rejection; Age, the resources used to obtain information about the vaccine, the thought that it would not protect for two years, or the vaccine side effects were high, and the most effective way to get rid of the pandemic was not vaccination, were determined as the factors affecting vaccine rejection. Conclusion: As a result of the research, it was found that the participants had a positive attitude towards the COVID-19 vaccine. It was determined that 9.7% of the study group had vaccine hesitancy, and 7.1% had vaccine rejection.Öğe Texture analysis of multiparametric magnetic resonance imaging for differentiating clinically significant prostate cancer in the peripheral zone(Tubitak Scientific & Technological Research Council Turkey, 2023) Ozer, Halil; Koplay, Mustafa; Baytok, Ahmet; Seher, Nusret; Demir, Lutfi Saltuk; Kilincer, Abidin; Kaynar, MehmetBackground/aim: Texture analysis (TA) provides additional tissue heterogeneity data that may assist in differentiating peripheral zone (PZ) lesions in multiparametric magnetic resonance imaging (mpMRI). This study investigates the role of magnetic resonance imaging texture analysis (MRTA) in detecting clinically significant prostate cancer (csPCa) in the PZ.Materials and methods: This retrospective study included 80 consecutive patients who had an mpMRI and a prostate biopsy for sus-pected prostate cancer. Two radiologists in consensus interpreted mpMRI and performed texture analysis based on their histopathology. The first-, second-, and higher-order texture parameters were extracted from mpMRI and were compared between groups. Univariate and multivariate logistic regression analyses were performed using the texture parameters to determine the independent predictors of csPCa. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance of the texture parameters.Results: In the periferal zone, 39 men had csPCa, while 41 had benign lesions or clinically insignificant prostate cancer (cisPCa). The majority of texture parameters showed statistically significant differences between the groups. Univariate ROC analysis showed that the ADC mean and ADC median were the best variables in differentiating csPCa (p < 0.001). The first-order logistic regression model (mean + entropy) based on the ADC maps had a higher AUC value (0.996; 95% CI: 0.989-1) than other texture-based logistic regres-sion models (p < 0.001).Conclusion: MRTA is useful in differentiating csPCa from other lesions in the PZ. Consequently, the first-order multivariate regression model based on ADC maps had the highest diagnostic performance in differentiating csPCa.
