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Öğe Anemia and Iron Deficiency Predict All-Cause Mortality in Patients with Heart Failure and Preserved Ejection Fraction: 6-Year Follow-Up Study(Mdpi, 2024) Köseoğlu, Fatoş Dilan; Özlek, Bülent; Urrechaga, EloisaAims: The aim of this study was to assess the prevalence of anemia and iron deficiency in patients with heart failure with preserved ejection fraction (HFpEF) and its impact on clinical outcomes. Methods: We retrospectively analyzed 212 patients with HFpEF and identified anemia as a serum hemoglobin level of less than 13 g/dL in men and less than 12 g/dL in women. Additionally, ID was defined as a serum ferritin concentration < 100 ng/mL or 100-299 ng/mL with transferrin saturation < 20%. Patients were followed up for an average of 66.2 +/- 12.1 months, with the endpoint being all-cause mortality among patients with HFpEF, both with and without anemia and iron deficiency. Furthermore, we explored other predictors of all-cause mortality. Results: The average age of the entire group was 70.6 +/- 10.5 years, with females comprising 55% of the patients. Anemia was present in 81 (38.2%) patients, while 108 (50.9%) had iron deficiency. At the end of the follow-up period, 60 (28.3%) of the patients had passed away. Patients with anemia displayed more heart failure (HF) symptoms, diastolic dysfunction, higher NT-pro-BNP levels, and worse baseline functional capacity than those without. Similarly, patients with iron deficiency showed more pronounced HF symptoms and worse functional capacity than those without. The results from the multivariable analyses revealed that anemia (hazard ratio [HR]: 5.401, 95% confidence interval [CI]: 4.303-6.209, log-rank p = 0.001), advanced age, iron deficiency (HR: 3.502, 95% CI: 2.204-6.701, log-rank p = 0.015), decreased left ventricular ejection fraction, chronic kidney disease, and paroxysmal nocturnal dyspnea were all independently associated with all-cause mortality. Conclusions: It is essential to consider anemia and iron deficiency as common comorbidities in managing and prognosis HFpEF, as they significantly increase mortality risk.Öğe Anemia, iron deficiency, and heart failure with preserved ejection fraction: The inseparable trio(Sage Publications Inc, 2024) Köseoğlu, Fatoş Dilan; Ozlek, Bulent[Abstract Not Available]Öğe Depression and anxiety in people with hemophilia A and B(Sage Publications Inc, 2024) Köseoğlu, Fatoş Dilan; Zuhal, Demirci; Onen-Sertoz, Ozen; Fahri, SahinObjective This study described the prevalence of and correlates of depression and anxiety in adult patients with hemophilia A and B. Methods In this cross-sectional study, we investigated patients with hemophilia who were being seen at an adult hemophilia center. Participants were screened for depression and anxiety during their annual clinic visit, which included administration of the Beck Depression Inventory and State-Trait Anxiety Scale. Results Of the 90 patients, 22 (24.4%) met criteria for significant depressive symptoms and and 67 (74.4%) met criteria for significant anxiety symptoms. There were no significant associations between depression and any psychosocial or clinical characteristics or adherence to hemophilia prophylaxis, except for educational status. No association was found between state and trait anxiety scores and psychosocial and clinical characteristics other than hemophilia type. After adjusting for confounding factors, multivariable analysis showed that high school education level was associated with depression (OR: 1.872, CI: 1.312-2.356, P = .010) and type B hemophilia was associated with anxiety (OR: 1.319, CI: 1.089-1.745, P = .042). Conclusion Depression and anxiety are major psychiatric comorbidities in patients with hemophilia in Turkey. Routine evaluation for mood and anxiety disorders are crucial in the care of patients with haemophilia.Öğe Diagnostic Dilemma: Acute Mesenteric Ischemia may Mimic Acute ST-Segment Elevation Myocardial Infarction(Galenos Publishing House, 2024) Özlek, Bülent; Dere, Özcan; Köseoğlu, Fatoş Dilan[No abstract available]Öğe JAKCalc: A machine-learning approach to rationalized JAK2 testing in patients with elevated hemoglobin levels(Lippincott Williams & Wilkins, 2024) Köseoğlu, Fatoş Dilan; Karadag, Fatma Keklik; Bulbul, Hale; Alici, Erdem Ugur; Ozyilmaz, Berk; Ozdemir, Taha ResidThe demand for Janus Kinase-2 (JAK2) testing has been disproportionate to the low yield of positive results, which highlights the need for more discerning test strategies. The aim of this study is to introduce an artificial intelligence application as a more rational approach for testing JAK2 mutations in cases of erythrocytosis. Test results were sourced from samples sent to a tertiary hospital's genetic laboratory between 2017 and 2023, meeting 2016 World Health Organization criteria for JAK2V617F mutation testing. The JAK2 Somatic Mutation Screening Kit was used for genetic testing. Machine learning models were trained and tested using Python programming language. Out of 458 cases, JAK2V617F mutation was identified in 13.3%. There were significant differences in complete blood count parameters between mutation carriers and non-carriers. Various models were trained with data, with the random forest (RF) model demonstrating superior precision, recall, F1-score, accuracy, and area under the receiver operating characteristic, all reaching 100%. Gradient boosting (GB) model also showed high scores. When compared with existing algorithms, the RF and GB models displayed superior performance. The RF and GB models outperformed other methods in accurately identifying and classifying erythrocytosis cases, offering potential reductions in unnecessary testing and costs.Öğe Non-Hodgkin’s Lymphoma of the tonsil: clinical features, treatment response and prognosis(2024) Köseoğlu, Fatoş Dilan; Demır, Derya; Çınar, Ezgi; Soyer, Nur; Vural, Filiz; Tobu, Mahmut; Sahin, FahriAim: Tonsillar lymphomas, specifically non-Hodgkin’s lymphomas in extranodal regions, are a significant subset of malignancies in the head and neck. Understanding the clinical and radiological characteristics of these lymphomas is pivotal for augmenting current knowledge and refining treatment approaches, particularly considering the notable incidence and distinctive pathophysiology of these malignancies. Materials and Methods: A retrospective study encompassing 45 patients diagnosed with tonsillar lymphoma across two university hospitals was undertaken. Comprehensive data, including demographics, symptoms, clinical and pathological findings, and treatment details, were analyzed. Various statistical tests explored factors influencing treatment responses and prognosis. Results: Patients predominantly presented with dysphonia, dysphagia, and dyspnea, alongside a notable prevalence of comorbidities such as hypertension and diabetes mellitus. Diagnosis largely leaned on excisional biopsy, revealing diffuse large B-cell lymphoma as the most common subtype. Treatment was majorly initiated with R-CHOP, witnessing an encouraging initial response. A mean time to progression was 13 months, with a median progression-free survival of 10 months and median overall survival of 55.8 months. Variables such as age, Ann Arbor stage, lymphoma subtype, R-IPI scores, double expression status, and presence of objective response to first line treatment status evidently influenced progression-free survival and overall survival, albeit none was an independent factor in multivariate analysis. Conclusion: The findings underscore the importance of comprehensive multi-faceted analyses in understanding tonsillar lymphomas. Although there was no independent risk factor for survival analyses, variables such as age, Ann Arbor stage, lymphoma subtype, R-IPI scores, double expression status, and presence of objective response to first line treatment were instrumental in influencing progression-free survival and overall survival, offering valuable insights for future research and potential tailoring of treatment approaches.Öğe TONSİL NON-HODGKİN LENFOMASI: KLİNİK ÖZELLİKLER, TEDAVİYE YANIT VE PROGNOZ(Ege University, 2024) Köseoğlu, Fatoş Dilan; Demir, Derya; Çınar, Ezgi; Soyer, Nur; Vural, Filiz; Töbü, Mahmut; Şahin, FahriAmaç: Tonsil lenfomaları, özellikle ekstranodal bölgelerdeki non-Hodgkin lenfomalar, baş ve boyun malignitelerinin önemli bir alt kümesidir. Bu lenfomaların klinik ve radyolojik özelliklerini anlamak, özellikle bu malignitelerin belirgin insidansı ve ayırt edici patofizyolojisi göz önüne alındığında, mevcut bilgiyi artırmak ve tedavi yaklaşımlarını rafine etmek için merkezi öneme sahiptir. Gereç ve Yöntemler: İki üniversite hastanesinde tonsiller lenfoma tanısı alan 45 hasta kapsayan retrospektif bir çalışma gerçekleştirildi. Demografi, semptomlar, klinik ve patolojik bulgular ve tedavi detaylarını içeren kapsamlı veriler analiz edildi. Çeşitli istatistiksel testler, tedavi yanıtlarını ve prognozu etkileyen faktörleri inceledi. Bulgular: Hastalar genellikle disfoni, disfaji ve dispne ile başvurdu. Hipertansiyon ve diyabet mellitus en sık saptanan iki komorbidite idi. Tanı, büyük ölçüde eksizyonel biyopsiye dayanıyordu ve en yaygın alt tip diffüz büyük B-hücreli lenfoma olarak saptandı. İlk basamak tedavide, sıklıkla R-CHOP ile başlanmış ve iyi bir objektif yanıt oranına ulaşılmıştı. Ortalama progresyona kadar geçen süre 13 ay, medyan progresyonsuz sağkalım 10 ay ve medyan genel sağkalım 55.8 ay olarak hesaplandı. Yaş, Ann Arbor evresi, lenfoma alt tipi, R-IPI skorları, double ekspresyon durumu ve birinci basamak tedaviye objektif yanıt varlığı gibi değişkenlerin, PFS ve OS'ye anlamlı etkisi olmakla beraber çok değişkenli analizde bağımsız bir faktör bulunamadı. Sonuç: Bulgular, tonsiller lenfomaları anlamada kapsamlı, çok yönlü analizlerin önemini vurgulamaktadır. Her ne kadar sağkalım analizleri için bağımsız bir risk faktörü olmasa da, yaş, Ann Arbor evresi, lenfoma alt tipi, R-IPI skorları, double ekspresyon durumu ve birinci basamak tedaviye objektif yanıt varlığı gibi değişkenler, PFS ve OS üzerinde etkili olup, gelecekteki araştırmalar ve potansiyel tedavi yaklaşımlarının kişiye özel olarak düzenlenmesi için değerli veri sunmaktadır.
