Patients In Turkey Research Articles

Real-life experience of ledipasvir and sofosbuvir single-tablet regimen among chronic hepatitis C patients in Turkey.

Ledipasvir (LDV) and sofosbuvir (SOF) as single-tablet regimen (STR) has been approved for treatment of chronic HCV infection (CHC) for treatment-naïve or experienced cirrhotic or non-cirrhotic patients. Our aim was to analyse the effectiveness and safety of 12-24 weeks treatment of LDV/SOF (90mg/400 mg)±ribavirin in a real-life setting in Turkey. Between May-Dec 2016, 104 treatment-naïve or experienced adult patients with CHC and with or without cirrhosis (including decompensated cirrhosis) were included in this observational study. Patients were administered LDV/SOF STR± ribavirin once daily for 12 -24 weeks. SVR12 rates and effects of the baseline characteristics on SVR12 rates were assessed. Out of 104 enrolled patients (61.5% female, mean age 62.0 years); 60.6% were cirrhotic, 76.0% previously used peg-IFN, 94.2% had GT1. At the end of the treatment, 77.8% (77/99, no data for 21 patients) had undetectable HCV-RNA and 98.9% (94/95) had SVR12. In the baseline characteristics subgroups, the SVR12 rates varied between 94.4% and 100%, and none of the baseline characteristics had a significant effect on the SVR12 rates. During the study, 6 (5.8%) patients died and none of the deaths was suspected to be related to the LDV/SOF. No treatment-emergent adverse event was reported. In conclusion, LDV/SOF±ribavirin yielded very high SVR12 rates, without any safety or tolerability concern in Turkey. The effectiveness of the LDV/SOF treatment was not affected by the patient demographics or medical characteristics such as fibrosis level, cirrhosis status, previous treatment status, HCV-RNA level or HCV genotype.

Dentists’ Decision to Conduct CRA in Adult Patients in Turkey: A Questionnaire-based Survey

Aim: The concept of minimal intervention in dentistry is one of the most important stages of the preventive dentistry, and caries risk assessment (CRA) is an application that needs to be primarily evaluated in order to perform minimal intervention approaches. This study was aimed to evaluate the awareness of CRA and whether CRA is included in daily practice by dentists in Turkey. Materials and Methods: This study used a questionnaire survey. A survey was prepared and sent to the dentists who were registered with the Turkish Dental Association via e-mail. A total of 790 dentists returned and 95 respondents were excluded. All the registered dentists filled and returned their survey. Descriptive and logistic regression analyses were performed (n = 695). Results: A total of 86.9 percent dentists who took the survey said that they performed CRA in daily practice. “Lack of time” was specified as the most important factor by the respondents who did not perform CRA in daily practice (61.5%). Current oral hygiene status (96.4%) and the presence of one or more active caries lesions (74.5%) were considered the most important risk factors for not performing CRA. Results of multiple logistic regression analysis showed that clinical experience, number of patients treated per day, and type of practice were mostly associated with whether or not performing CRA ( P = .012, .018, and .035, respectively). Conclusions: It can be concluded that most of the dentists are aware of the importance of conducting CRA and, with differences in the factors considered, CRA is required in their daily practice in Turkey. The concept of minimal intervention in dentistry is one of the most important stages of preventive dentistry, and CRA is an application that needs to be primarily evaluated in order to perform minimal intervention approaches.

The acromegaly registry of ten different centers in Turkey

ObjectivesTo describe biochemical and clinical features, and therapeutic outcomes of acromegaly patients in Turkey. MethodsRetrospective multicenter epidemiological study of 547 patients followed in 10 centers of the Turkish Acromegaly registry. ResultsA total of 547 acromegaly patients (55% female) with a median age of 41 was included in this study. Majority of patients had a macroadenoma (78%). Transsphenoidal surgery was performed as primary treatment in 92% of the patients (n = 503). Surgical remission rate was 39% (197/503) in all operated patients. Overall disease control was achieved in 70% of patients. Remission group were significantly older than non-remission group (p = .002). Patients with microadenomas had significantly higher remission rates than patients with macroadenomas (p < .001). Patients with microadenomas were significantly older at the time of diagnosis when compared to patients with macroadenomas (p < .001). Preoperative growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels were significantly lower in the remission group (p < .001). Initial IGF-1 and GH levels were significantly higher in macroadenomas compared to microadenomas (p < .001). Medical treatment was administered as a second-line treatment (97%) in almost all patients without remission. Radiotherapy was preferred in 21% of the patients mostly as a third line treatment. ConclusionsThis is one of the largest real life studies evaluating the epidemiological characteristics and treatment outcomes of patients with acromegaly who were followed in different centers in Turkey. Transsphenoidal surgery in the treatment of acromegaly still remains the most valid method. Medical treatment options may improve long-term disease outcomes in patients who cannot be controlled with surgical treatment (up to 70%).

The factor structure of the posttraumatic growth inventory in cancer patients in Turkey.

Posttraumatic growth is a positive psychological change that occurs as a result of tackling vital crises. Although cancer is perceived as a fatal disease, the individual's struggle with many negative conditions during diagnosis and treatment can provide positive change and development. The aim of this study was to examine the factor structure of the posttraumatic growth inventory (PTGI) in Turkish cancer patients. This study included 265 cancer patients receiving treatment at the chemotherapy unit of two university hospitals located in northern Turkey. Percentages, frequencies, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to analyse the data, and Cronbach's α measured internal consistency. EFA yielded a five-factor structure: Spiritual and existential change, change in perception of life and selfness, relating to others, personal strength and new possibilities. Fit indices for CFA were root mean square error of approximation (RMSEA), 0.06; non-normed fit index (NNFI), 0.92; comparative fit index (CFI), 0.90; root mean residuals (RMR), 0.06; and goodness-of-fit index (GFI), 0.90. The overall Cronbach's α of the scale was 0.93. PTGI was determined as a reliable and valid tool for Turkish cancer patients. PTGI, which has a determined validity and reliability rate, can be used by healthcare professionals working with oncology patients to evaluate the positive psychological growth and changes in cancer patients and determine their adoption rate.

A nosocomial scabies outbreak originating from immunocompromised transplant patients in Turkey: Upholstery as a possible cause.

Inpatients with crusted scabies represent an important source of nosocomial transmission with consequent outbreaks among patients and healthcare workers. This study aimed to report the course of an institutional scabies outbreak, which progressed with infestation of immunosuppressed transplant patients, health care workers, and caregivers. Patients diagnosed with scabies in a nosocomial outbreak in a 200-bed, tertiary hospital were included. Following a diagnosis of scabies in the index patient, strict contact isolation measures were implemented. During the outbreak, a root cause analysis (RCA) was carried out by an infection prevention and control team. Forty-two individuals were affected (7 patients, 25 health care workers, and 10 family members of the patients) during the outbreak consisting of three attacks. Index case was a multiple myeloma patient who received hematopoietic stem cell transplantation and presented with crusted scabies. A RCA suggested that upholstery could serve as a means of reservoir. All upholstery of the sofa and armchairs in patient rooms as well as in lounge areas were replaced by wipeable leather material. After the 19-week course of the outbreak, no additional cases of scabies have been observed until now. A high index of suspicion should be maintained, particularly in immunocompromised patients, in order to achieve rapid diagnosis of scabies and to implement institutional infection control measures. It should also be borne in mind that the transmission may occur through direct contact as well as fomites, such as upholstery.

Caregiver Burden, Quality of Life and Related Factors in Family Caregivers of Dementia Patients in Turkey

This study aimed to evaluate caregiver burden and quality of life (QoL) and their predictors in family caregivers of dementia patients. A descriptive cross-sectional survey was carried out with a sample of 102 patients and their family caregivers. The Caregiver Burden Inventory (CBI) and Short Form-12 (SF-12) were used to collect data. CBI mean score was 37.97 ± 21.30. Mean scores of SF-12 sub-domains varied between 36.02 and 77.94 and were significantly lower as compared to normative means of the general population, excluding only the physical health subdomain. Among several patient and caregiver-related correlations, the number of medications and worse cognitive function of the patient, caregiver’s age and having limited space at home were found as predictors of burden, whereas caregiver’s chronic disease and having a limited space were predictors of QoL. Also, the burden and QoL were correlated. This study demonstrated a high burden and low QoL in dementia caregivers. In societies where caregivers are mostly informal such as that in Turkey, supportive systems should be established.

Molecular Identification of HIV-1 in the Presence of Hepatitis B Virus and Hepatitis C Virus Co-infections

Background:Because of their similar modes of transmission, the simultaneous infection of viral hepatitis and human immunodeficiency virus are increasingly seen as a big problem related to human health.Aims:To determine the drug mutations in hepatitis B virus and/or hepatitis C virus co-infected human immunodeficiency virus-1 patients in Turkey.Study Design:Retrospective cross-sectional study.Methods:The present study was conducted between 2010 and 2017. HBsAg, anti-hepatitis C virus, and anti-human immunodeficiency virus were tested with ELISA. All anti-human immunodeficiency virus positive results by ELISA were verified for anti-human immunodeficiency virus positivity by a Western blot test, and Anti-human immunodeficiency virus positive patients with HBsAg and/or anti-hepatitis C virus positivity were included in the study. Subtyping and genotypic resistance analyses were performed by population sequencing of the viral protease and reverse transcriptase regions of the human immunodeficiency virus-1 pol gene.Results:We detected 3896 human immunodeficiency virus-1 positive patients whose sera were sent from numerous hospitals across the country to our polymerase chain reaction unit for detection of drug resistance mutations and whose molecular laboratory tests were completed. Viral hepatitis co-infections were detected in 4.3% (n=170) of patients. Hepatitis B virus and hepatitis C virus co-infection were observed in 3.2% and 0.5% of all human immunodeficiency virus-1 infected patients, respectively. The major human immunodeficiency virus-1 subtype detected was group M, subtype B (62.9%). However, 13.5% of drug resistance mutation motifs were found in human immunodeficiency virus-1 genomes of patients included in the study.Conclusion:Due to similar transmission routes, HIV1 patients are at risk of hepatitis B and C virus co-infection. However, antiretroviral drug resistance mutation model is similar to patients with hepatitis negative.

The Geographical Distribution of Morbidity Caused By Chronic Obstructive Pulmonary Disease in Turkey: COPDTURKEY-2

Background:Chronic obstructive pulmonary disease (COPD) is one of the most prevalent causes for morbidity and mortality, and it creates a cumulative economic and social burden.Aims:To determine the distribution of the prevalence of patients in Turkey who were diagnosed with COPD and their morbidity rates, according to the regions and cities they belong to. Moreover, the study contributes to the prevention and cure services of COPD that should be planned in the future.Study Design:A retrospective cohort.Methods:The database of the Social Security Institution from 2016 has been scanned. All the data with prescription registration, with the code ICD-10, J44.0-J44.9, which were aimed for diagnosing and/or cure, have been evaluated with a retrospective cohort.Results:In 2016, 955,369 patients who were admitted as outpatients to the hospitals were diagnosed with COPD. The average number of annual COPD cases that were admitted was 2.09. Twenty percent (20%) of the outpatient applications were via emergency room. The rate of hospitalization among the applicants was 17.75%, with a total of 1,994,325. The average annual number of hospitalizations of men was higher than that of women. The average number of hospitalization days was 6.52. The region with the highest prevalence of outpatient admission and hospitalization was the Black Sea Region.Conclusion:The high rate of hospitalization was considered to be the outcome of the insufficient “outpatient” management.

Disease course and healthcare costs of a cohort of rheumatoid arthritis patients from Turkey.

The objective of the study is to assess the disease course and associated healthcare costs in a cohort of established rheumatoid arthritis (RA) patients in Turkey. The study cohort consisted of 75 RA patients from our outpatient clinic who took part in a previous multicenter study assessing RA-related healthcare costs 6years ago. In March 2018, we attempted to re-evaluate these patients with the same questionnaire of the previous study enabling us to get information on medication use, comorbidities, and RA-related healthcare costs. We used RAPID-3 for assessing disease activity, HAQ-DI for functional status and EQ-5D for quality of life. Sixty-two (83%) patients were re-evaluated, seven (9.3%) had died and three (4%) were receiving palliative care following major cardiovascular events. Forty-seven (76%) patients had used at least one biologic agent during 79.1 ± 3.3months after the previous study. At the last evaluation, 34 patients (55%) were on biologics, 22 (35%) were on csDMARDs and 6 (9.6%) were off RA treatment. The mean RAPID3 score (4.3 ± 1.6 SD) was similar to that of the previous study. HAQ-DI (0.69 ± 0.57 SD) and EQ-5D (0.68 ± 0.21 SD) scores showed significant improvement over time. Median direct costs (€2998) were higher than indirect costs (€304). Medication costs were high (€2958). Disease activity remained stable, while functional status and QoL had improved over time. Serious infections and cardiovascular disability are a concern. Medication costs are still the main determinant of RA-related healthcare costs.

Plasma amino acid levels in a cohort of patients in Turkey with classical phenylketonuria

Abstract Background In patients with phenylketonuria, the central nervous system is adversely affected by noncompliance with diet. The levels of phenylalanine and many different amino acids (AAs) in the plasma of patients with phenylketonuria can be measured simultaneously. Objectives To measure the blood plasma levels of neurotransmitter AAs in a cohort of patients in Sanliurfa province, Turkey, with phenylketonuria for use as a support parameter for the follow-up of patients. Methods The phenylketonurics that we followed (n = 100) were divided into 2 groups according to their compliance with their dietary treatment. Plasma AA analysis results of phenylketonurics were compared with those of healthy children in a control group (n = 50). Results In the diet incompliant group (n = 56), the mean levels of γ-aminobutyric acid (GABA; 0.96 ± 1.07 μmol/L) and glycine (305.1 ± 105.19 μmol/L) were significantly higher than those in the diet compliant group (n = 44; GABA P = 0.005, glycine P &lt; 0.001) and in the control group (GABA and glycine P &lt; 0.001), whereas the mean levels of glutamic acid (39.01 ± 22.94 μmol/L) and asparagine (39.3 ± 16.89 μmol/L) were lower (P &lt; 0.001) in the diet incompliant group. A positive correlation was observed between the levels of phenylalanine and GABA and glycine. A negative relationship was found between the levels of phenylalanine and glutamic acid and asparagine. Conclusions A relationship exists between the levels of plasma phenylalanine in a cohort of phenylketonurics in Sanliurfa province, Turkey, and the levels of some excitatory and inhibitory AAs. Excitatory and inhibitory AA levels in plasma may be used as support parameters in the follow-up of patients with phenylketonuria.

Prevalence and mortality of cancer among people living with HIV and AIDS patients: a large cohort study in Turkey.

Cancer is responsible for elevated human immunodeficiency virus (HIV)-related mortality but there are insufficient data about cancer in HIV-positive patients in Turkey. We aimed to investigate the prevalence and mortality of cancer among people living with HIVand AIDS patients in Istanbul, Turkey. Between January 1998 and December 2016, people living with HIVand AIDS patients were enrolled in this study by the ACTHIV-IST Study Group, which consists of 5 centres to follow-up HIV-positive patients in Istanbul. The cancer diagnoses included AIDS-defining cancers (ADCs) and non AIDS-defining cancers (NADCs). Among 1872 patients, 37 (1.9%) were diagnosed with concurrent cancer. Eleven patients were diagnosed during follow-up; the prevalence of cancer among people living with HIVand AIDS patients was 2.6%. Among 48 cancer patients, 35 patients had ADCs, and 32 of them were diagnosed at their first hospital admission. There were 1007 late presenters and 39 of them had cancer (29 were ADCs). The most prevalent NADCs were gastrointestinal, genitourinary, and pulmonary cancers. NADCs were mostly diagnosed during follow-up of patients. The mortality of this group was significantly higher than that of patients with ADCs (53.9% vs 22.9%). These results indicate the importance of cancer screening at diagnosis and during follow-up of HIV infection. A detailed physical examination contributes to diagnosis of the most prevalent ADCs (Kaposi's sarcoma and non-Hodgkin's lymphoma), especially in late presenters. For NADCs, individual risk factors should be considered.

Safety and efficacy of regorafenib in patients with treatment-refractory metastatic colorectal cancer in Turkey: the single-arm, open-label REGARD study

ObjectivesRegorafenib improved overall survival in patients with metastatic colorectal cancer (mCRC) refractory to standard therapies in two randomised, phase III trials, but has not been evaluated in Turkey. REGARD evaluated...

Detection of Toxoplasma gondii infection among diabetic patients in Turkey

BackgoundIn some recent studies, it has been suggested that there may be a relationship between Toxoplasma gondii (T. gondii) and type 2 diabetes mellitus (T2DM). T. gondii is of greater significance in these patients. ObjectivesIn the present study, it was aimed to investigate the seroprevalence of T. gondii in T2DM patients. MethodsTo define Toxoplasma IgG and IgM seropositivity and determine the seroprevalence of toxoplasmosis in patients presenting at the Internal Diseases outpatient clinic of the Healthcare Application and Research Hospital, where the ELISA method was used. 200 T2DM patients and 100 healthy individuals with no complaints took part in the study. ResultsToxoplasma IgG positivity was determined in 53% of the 200 T2DM patients and Toxoplasma IgM positivity in 13%. While in the control group, Toxoplasma IgG positivity was determined in 27% and Toxoplasma IgM positivity in 1%. The risk of toxoplasmosis infection in T2DM patients was two folds higher than healthy controls according to the IgG results. IgM results were further differentiated. ConclusionsWe believe that the seroprevalence of T. gondii is high in the T2DM patient group and that the causes should be investigated in more detail.

Atezolizumab in patients with metastatic urothelial carcinoma who have progressed after first-line chemotherapy: Results of real-life experience.

451 Background: Anti-tumor activity and manageable safety profile of atezolizumab (ATZ) has been demonstrated in the previous clinical trials in patients with locally advanced or metastatic platinum-resistant urothelial carcinoma. In this study, we reported the results of real-life data of urothelial carcinoma patients in Turkey who were treated with ATZ. Methods: Data of the patients with metastatic urothelial carcinoma registered to ATZ Expanded-Access Program and treated with at least one course of ATZ from 36 oncology centers in Turkey were collected. The primary endpoint was the overall response rate (ORR); secondary endpoints were overall survival (OS), progression-free survival (PFS), duration of the ATZ treatment and safety. Results: Data of 115 eligible patients were analyzed. Of the patients, 100 (87%) were male and 13% were female. The median age was 65.3 years (37-86). Most of the patients (92.3%) had received only one chemotherapy regimen prior to ATZ. The median follow-up time was 23.5 months. The complete response rate to ATZ, partial response rate, and ORR were 8.7% (n=10), 20.0% (n=23), and 28.7% (n=33), respectively. The median duration of response was 20.4 months (95% CI 6.47–28.8). Of the thirty-three patients who responded to treatment, 20 (60%) had an ongoing response at the time of the analysis. PFS and OS with ATZ were 3.8 months (95% 2.25–5.49) and 9.8 months (95% 6.7–12.9), respectively. The 12-month PFS rate was 22.3% and the 24-month PFS rate was 16.9%. The 12-month OS rate was 42.2% and the 24-month OS rate was 23.5%, respectively. Sixty-four percent of patients experienced a treatment-related adverse event of any grade, and 24 (20%) of patients had a grade 3–4 treatment-related adverse event. Because of treatment-related side effects, dose reduction was performed in 9 (7.8%) patients and ATZ was discontinued in 8 patients (7.0%). Adverse event that required systemic steroid use was reported in only 7 (6.1%) patients. Four patients (3.5%) died due to treatment-related causes. Conclusions: ATZ is an effective and tolerable treatment for patients with metastatic platinum-resistant urothelial carcinoma.

Organ involvement in immunoglobulin a vasculitis (Henoch-Shönlein purpura) children: Relation to immune profile

Aim of the workThe aim of this work was to study the pattern of immunoglobulin A (IgA) vasculitis organ involvement distribution in a cohort of patients in Turkey and to determine the relation to immune profile biomarkers. Patients and methodsTwo hundred and sixteen IgA vasculitis children were evaluated. Demographic characteristics, organ involvements, laboratory findings and immunological factors accompanying joint, gastrointestinal tract (GIT) and renal involvements were investigated through the data retrieved from patient files and hospital records. ResultsAll patients had palpable purpuric skin involvement, GIT involvement was present in 37%, joint involvement in 55.4% and renal in 31.5%. Leucocytosis was present in 46.3%, thrombocytosis in 20.4%, elevated erythrocyte sedimentation rate in 63%, positive C-reactive protein in 37%, antistroptolysin-O titre in 33.3%, high IgA in 13% and IgE in 24.1%. Patients with renal involvement had higher mean age and higher hemoglobin levels than those without (p < 0.05). The frequency of severe renal involvement was higher in patients with GIT involvement (p = 0.012). C4 levels and platelet counts were higher in patients with joint involvement than in those without (p = 0.04 and p = 0.02, respectively). Antinuclear antibody (ANA), anti-double stranded deoxyribonucleic acid (anti dsDNA), rheumatoid factor (RF), and perinuclear anti-neutrophil cytoplasmic antibody (ANCA) were negative, while factor XIII, fibrinogen, and von Willebrand factor (vWF) levels were normal. ConclusionsOlder age and GIT involvement in IgA vasculitis affect renal involvement and may lead to nephrotic-level proteinuria. In contrast, ANA, anti-dsDNA, RF, ANCA, factor XIII, fibrinogen and vWF levels were not related to organ involvement.

Demographic, Clinical and Management Characteristics of Newly Diagnosed COPD Patients in Turkey: A Real-Life Study.

PurposeIn order to determine the clinical and sociodemographic characteristics of newly diagnosed treatment-naïve asthma and COPD patients in Turkey, a multicenter study in 2012 was initiated . We aimed to investigate the characteristics and therapies of COPD patients in the original study in more detail.Patients and MethodsThis nation-wide, multicentric, non-interventional, prospective, real-life observational cohort study was conducted in 122 centers. The newly diagnosed patients were not receiving any treatment before the recruitment. Their general characteristics, the combined GOLD 2011 COPD categories and exacerbation histories were noted. The patients were followed up with 3 voluntary visits for 1 year. Their adherence to the inhaled treatment according to GOLD 2011 was evaluated during follow-up visits.ResultsThe study included 776 COPD patients. Their mean age was 59.4±9.1 years, and 11.9% of the patients were female. 35.1% of the patients were in the GOLD 2011 C and D category. 12.6% are frequent exacerbators, and 52.8% had at least one comorbid condition. 71.8% overtreatment rate was detected. Their attendance rates for three follow-up visits became 55.9%, 32.9% and 18.7%, respectively. The adherence rate to the treatment was measured as 81.9%.ConclusionAlthough these patients were diagnosed for the first time, the GOLD C and D categories and frequent exacerbator phenotype were found at a high rate. They were usually prescribed an overtreatment regimen. We think that newly diagnosed COPD patients should be evaluated carefully, and best effort should be made to treat these patients in accordance with the recommendations of the major COPD guidelines.

'I wanted my child dead' - Physical, social, cognitive, emotional and spiritual life stories of Turkish parents who give care to their children with schizophrenia: A qualitative analysis based on empowerment approach.

Schizophrenia deeply affects both the lives of patients and their families. The fact that schizophrenic patients in Turkey generally maintain their lives with their families may lead to serious problems for families and parents. The main purposes of this research are to determine the physical, social, cognitive, emotional and spiritual lives of parents of children with schizophrenia with the main concepts of the empowerment approach. The research was carried out with the qualitative research method. In-depth interviews were conducted with 30 parents in total, that is, 15 mothers and 15 fathers, through semi-structured interview form. Maxqda 2018 was used for the analysis of the research data. According to the research result, it is determined that the parents have problems due to physical, social, cognitive, emotional and spiritual disease process; gender perspective and roles; domestic functionality; social environment, social perception; and issues related to services. Considering the parents who are affected by the disease process which is a particularly quite difficult process and who affect the process, to recognize the situations that lead them to gain strength and that make them powerless in personal, interpersonal and political aspects, to activate the existing resources and to create new resources are highly important factors for them to cope with the disease process effectively.

Work Productivity Loss in Inflammatory Bowel Disease Patients in Turkey.

Background Beyond the medical treatment in inflammatory bowel disease (IBD), there are other issues which influence the quality of life adversely. The aim of this study was to determine the impact of the IBD patients' illness on working and education life. Method The participants were invited to participate in the online survey from the Turkish Crohn's and Ulcerative Colitis Patient Association network. The data was analysed and then discussed to improve the health-related quality of working and education life. Results One hundred and fifteen patients had ulcerative colitis (UC) (57.2%), and 86 had Crohn's disease (CD) (42.8%). There was a statistically significant difference in UC between retirement age group 1 (<40 age) and groups 2 (40-49 ages) and 4 (60-65 ages) (p < 0.05). There was the same significant difference in CD. Even though the data did not have significant statistical difference, there was clustering around negative perceptions the patients have about their working and education lives. Conclusion Our survey revealed a very strong causative relationship between work and IBD involving problems before, during, and at the end of employment. Young patients lower their career expectations, and that announces a clear need to support them and improve career guidance.

Assessment of the compatibility of the real-world nonvalvular atrial fibrillation patients in Turkey with the study population of Phase 3 novel oral anticoagulant trials: An auxiliary study of NOAC-TR

Introduction: Although the indication of novel oral anticoagulant (NOAC) treatment in atrial fibrillation (AF) is comparatively similar, Phase 3 NOAC trials have variable inclusion criteria that differentiate each other and also from the real-world population. Aim: We aim to investigate the similarity between real-world nonvalvular AF patients and the population of Phase 3 NOAC trials in terms of eligibility. Methods: A total of 2802 patients using rivaroxaban, dabigatran, and apixaban were retrospectively evaluated. All the patients met the exclusion criteria of NOAC Phase 3 trials. These patient population were compared with the population of Phase 3 rivaroxaban (ROCKET-AF), dabigatran (RELY), apixaban (ARISTOTLE), and edoxaban (ENGAGE) trials in terms of inclusion criteria. Furthermore, the patients were stratified on the basis of CHA2-DS2–VASCc is enaogh score. Results: The proportion of population who met the eligible criteria for ARISTOTLE trial (91%) was different from that of RELY (78%), ROCKET-AF (50%), and ENGAGE (61%) trials (P < 0,001). For the population at intermediate risk (CHA2DS2–VASc score ≥1), the proportion which met the inclusion criteria for RE-LY trial (99%) was different from that of ARISTOTLE (91.2%), ROCKET-AF (50%), and ENGAGE trials (61%) (P < 0.001). For the population at high risk (CHA2DS2–VASc score ≥2), the proportion which met the inclusion criteria was as follows: 94% for ARISTOTLE, 83% for RELY, 65% for ENGAGE, and 53% for ROCKET-AF trials (P < 0.001). In this population, 38% of patients using rivaroxaban, 46% of patients using dabigatran, and 12% patients of using apixaban did not meet the inclusion criteria for the ROCKET-AF, RE-LY, and ARISTOTLE trials, respectively. Conclusion: Eligibility of the real-world population for NOAC trials is variable. A considerable number of real-world patients using NOAC do not meet the inclusion criteria of the corresponding drug.

Telling The Truth To Patients In Turkey: In Terms Of Medical Ethics And Medical Law

Telling The Truth To Patients In Turkey: In Terms Of Medical Ethics And Medical Law