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Öğe The awareness of physicians and allied health professionals about cardiopulmonary rehabilitation: A cross-sectional survey study [Kardiyopulmoner rehabilitasyon konusunda hekimler ve diger sagli{dotless}k çali{dotless}şanlari{dotless}ni{dotless}n farki{dotless}ndali{dotless}k düzeyi: Kesitsel bir anket çali{dotless}şmasi{dotless}](Turkish Society of Physical Medicine and Rehabilitation, 2014) Sarikaya S.; Sonel Tur B.; Kurtaiş Y.; Üzümcügil Karapolat H.; Soyupek F.; Hafiz M.; Sarp Ü.; Duyur Çakit B.; Demirsoy N.; Özyemişci Taşkiran Ö.; Dülgeroglu Erdogdu D.; Tomruk Sütbeyaz S.; Alemdaroglu E.; Ünsal Delialioglu S.; Dogan A.; Ordu Gökkaya N.K.; Köseoglu F.; Güzel R.; Ayhan F.F.; Tuncay F.; Geler Külcü D.; Ekşioglu E.Objective: Cardiopulmonary (CPR) programs were developed to improve and stabilize the physical, psychological, social, mental, professional, and economic conditions of patients with cardiovascular and pulmonary diseases. Although it is known that CPR reduces mortality and morbidity, it is not widely implemented as it is in Turkey. In this study, we aimed to determine the level of CPR awareness among physicians and allied health professionals. Material and Methods: This was a multi-center, cross-sectional survey study. The study included physicians, nurses, physiotherapists, and other allied health professionals who were informed about the survey and provided written consent to participate. Results: A total of 727 volunteers from 12 different centers were included in the study. Of the participants, 59.5% were physicians, 31.4% were nurses, 5.9% were physiotherapists, and 3.2% were other allied health professionals; 79.3% participants answered the question on if they have had any idea about CPR. Participants indicated that patients should be referred to cardiac pulmonary rehabilitation after a coronary artery bypass (83.8%), chronic obstructive pulmonary disease (83.2%), and cardiac valve surgery (38.9%). Only 40.1% of the survey participants provided information about CPR to patients, while 20.5% did not provide any information about CPR. Conclusion: This survey study determined that in centers where CPR could be implemented, health professionals have knowledge about CPR. If the study were conducted nationwide, the level of awareness might be even lower. Although it is an idea of CPR, the level of knowledge for this issue is not adequate. As the number of the CPR centers will increase, the knowledge of doctors and allied health professionals will advance. © 2014 by Turkish Society of Physical Medicine and Rehabilitation.Öğe Factors affecting complication rates of percutaneous nephrolithotomy in children: Results of a multi-institutional retrospective analysis by the Turkish pediatric urology society(2014) Önal B.; Dogan H.S.; Satar N.; Bilen C.Y.; Güneş A.; Özden E.; Ozturk A.; Demirci D.; Istanbulluoglu O.; Gurocak S.; Nazli O.; Tanriverdi O.; Kefi A.; Korgali E.; Silay M.S.; Inci K.; Izol V.; Altintas R.; Kilicarslan H.; Sarikaya S.; Yalcin V.; Aygun C.; Gevher F.; Aridogan I.A.; Tekgul S.Purpose We assessed factors affecting complication rates of percutaneous nephrolithotomy in children. Materials and Methods We retrospectively evaluated data on 1,205 renal units in 1,157 children treated with percutaneous nephrolithotomy at 16 Turkish centers between 1991 and 2012. Of the patients 28.3% had a history of urolithiasis. Complications were evaluated according to the Satava classification system and modified Clavien grading system. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates. Results A total of 515 females and 642 males were studied. Mean ± SD patient age was 8.8 ± 4.7 years (range 4 months to 17 years). Mean ± SD stone size, operative time and postoperative hospital stay were 4.09 ± 4.06 cm2, 93.5 ± 48.6 minutes and 5.1 ± 3.3 days, respectively. Postoperative stone-free rate was 81.6%. A total of 359 complications occurred in 334 renal units (27.7%). Complications were intraoperative in 118 cases and postoperative in 241. While univariate analysis revealed that stone history, positive urine culture, operative time, length of hospitalization, treatment success, punctured calyx and location of the stone significantly affected the complication rates (p <0.05), operative time, sheath size, mid calyceal puncture and partial staghorn formation were the statistically significant parameters affecting complication rates on multivariate logistic regression analysis. Conclusions Percutaneous nephrolithotomy is the treatment of choice for most renal calculi in children. The technique is effective and safe in children, with a high success rate and a low rate of major complications. The significant factors identified should be considered by clinicians to decrease associated complication rates. © 2014 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION AND RESEARCH, INC.Öğe Factors affecting complication rates of ureteroscopic lithotripsy in children: Results of multi-institutional retrospective analysis by pediatric stone disease study group of Turkish pediatric urology society(2011) Dogan H.S.; Onal B.; Satar N.; Aygun C.; Piskin M.; Tanriverdi O.; Gurocak S.; Gunay L.M.; Burgu B.; Ozden E.; Nazli O.; Erdem E.; Yucel S.; Kefi A.; Demirci D.; Uluocak N.; Aridogan I.A.; Turunc T.; Yalcin V.; Kilinc M.; Horasanli K.; Tan M.O.; Soygur T.; Sarikaya S.; Kilicarslan H.; Turna B.; Doruk H.E.; Tekgul S.Purpose: We evaluated factors affecting complication rates of ureteroscopy for pediatric ureteral calculi. Materials and Methods: We retrospectively evaluated 642 children who underwent ureteroscopy at 16 Turkish centers between 2000 and 2010. Semirigid ureteroscopy was used with various calibers to treat 670 ureteral units in 660 sessions. Complications were evaluated according to the Satava and Clavien classification systems. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates. Results: A total of 367 females and 265 males were studied. Mean ± SD patient age was 90.2 ± 51.4 months (range 4 to 204). Mean ± SD stone size, operative time and postoperative hospital stay were 8.9 ± 4.7 mm, 45.8 ± 23.8 minutes and 1.8 ± 2.8 days, respectively. At a mean ± SD followup of 13.3 ± 17.6 months 92.8% of patients were stone-free and efficacy quotient was 90.3%. Complications, which occurred in 8.4% of patients (54 of 642), were intraoperative in 25 (Satava grade I to II in 22), early postoperative in 25 (Clavien grade I to II in 23) and late postoperative in 4 (all grade III). While operative time, age, institutional experience, orifice dilation, stenting and stone burden were statistically significant on univariate analysis, multivariate analysis revealed that operative time was the only statistically significant parameter affecting the complication rate. Conclusions: Semirigid ureteroscopy is effective, with a 90% stone-free rate and efficacy quotient. Most complications are low grade and self-limiting. Our results confirm that prolonged operative time is an independent predictor of complications, and should be considered when choosing and performing the treatment modality. © 2011 American Urological Association Education and Research, Inc.Öğe Response to growth hormone with respect to pubertal status on increased dose in idiopathic growth hormone deficiency: An analysis of Turkish children in the KIGS database (Pfizer International Growth Study)(Freund Publishing House Ltd, 2005) Darendeliler F.; Berberoglu M.; Öcal G.; Adiyaman P.; Bundak R.; Günöz H.; Baş F.; Darcan Ş.; Gökşen D.; Arslanoglu I.; Yildiz M.; Ercan O.; Ercan G.; Özerkan E.; Can Ş.; Böber E.; Adal E.; Sarikaya S.; Dallar Y.; Şiklar Z.; Bircan I.; Bideci A.; Yüksel B.; Büyükgebiz A.Aim: To compare the growth response to growth hormone (GH) treatment in patients with idiopathic GH deficiency (IGHD) who were prepubertal with the response of those who were pubertal at the onset of GH therapy on an increased GH dose. Patients and methods: Among the Turkish patients enrolled in the Pfizer International Growth Study (KIGS) database with the diagnosis of IGHD, the growth data over 2 years of GH therapy were analyzed longitudinally of 113 (79 M) prepubertal (Group 1) and 44 (33 M) pubertal (Group 2) patients. Pubertal signs were reported to be present initially or to have appeared within 6 months of GH therapy in Group 2. Mean ± SD age at onset of therapy was 8.7 ± 3.5 and 13.5 ± 1.8 years; height SDS -4.2 ± 1.4 and -3.2 ± 1.1 (p <0.05) in Groups 1 and 2, respectively. Mid-parental height (MPH) SDS did not show a significant difference between the two groups (4.5 ± 1.1 vs -1.7 ± 1.1). Results: Delta height SDS over 2 years of therapy was significantly higher in Group 1 (1.1 ± 1.0) than in Group 2 (0.7 ± 0.6) (p <0.05) in spite of a significantly lower dose of GH (14.6 ± 3.3 in Group 1 vs 17.0 ± 3.1 IU/m2/week in Group 2, p <0.05). Ht - MPH SDS showed an increase from -2.4 ± 1.7 to -1.4 ± 1.5 in Group 1 and from -1.5 ± 1.5 to -0.8 ± 1.3 in Group 2. Overall delta height SDS showed negative correlations with age (r = -0.32), height SDS (r = -0.41) and height - MPH SDS (r = -0.40) at onset of therapy (p <0.001). Conclusions: These data show that in IGHD the slight increase (15-20%) in the dose of GH during puberty was not adequate to maintain height velocity at the same magnitude as in prepuberty, and thus was not cost effective. © Freund Publishing House Ltd., London.Öğe What do patients really know about cardiopulmonary rehabilitation: A cross-sectional survey study(2012) Karapolat H.U.; Kurtaiç Y.; Tur B.S.; Demirsoy N.; Özyemişci Taşkiran Ö.; Sarp Ü.; Hafiz M.; Külcü D.G.; Sarikaya S.; Soyupek F.; Sütbeyaz S.T.; Delialioglu S.Ü.; Alemdaroglu E.; Ordu Gökkaya N.K.; Dogan A.; Köseoglu F.; Ekşioglu E.; Duyur Çakit B.; Dülgeroglu Erdogdu D.; Tuncay F.; Figen Ayhan F.; Güzel R.Background. Although it is known that cardiopulmonary rehabilitation (CPR) reduces mortality and morbidity, it is not widely implemented as is in Turkey. One factor might be lack of demand since the levels of knowledge and awareness among patients who are eligible for CPR seem to be insufficient. Aim. It is aimed to investigate the level of awareness and knowledge of CPR among patients with cardiopulmonary problems. Design. Cross-sectional survey study Setting. Outpatient Methods. Knowledge regarding CPR was assessed by questionnaires given to 690 patients recruited in seven university hospitals and six training and research hospitals in which either comprehensive or limited CPR services are available. Population. Patients who have cardiopulmonary problems Results. Of the patients, 34.7% were given information on CPR by healthcare staff, and 25.3% reported that their source of information was physicians. Although 49-9% of the patients knew that they needed to exercise for their cardiac/pulmonary problems, only 23.4% and 32.1% of those were aware that fast walking and climbing stairs, respectively, would not pose a risk to their cardiac/pulmonary health. The majority of the patients believed that activities of daily living, which comprise the most important component of exercise-based CPR, were harmful for their cardiopulmonary health. We found that 31.1% of the patients exercised regularly. During their stay at the hospital, certain kinds of exercises were suggested to 62.7% of the patients, and 34.7% of these patients performed various exercises. Of the patients who were given detailed information on cardiopulmonary rehabilitation, 69% stated that they would be willing to participate in a similar program. Conclusion. Although nearly half of the patients stated that they needed CR, it was observed that the ratio of patients who had true knowledge of CPR was low among patients. It is imperative to furnish patients with information on CPR, both in the field of PMR and throughout Turkey, and to put more effort into running those services effectively. Furthermore, we should make an effort to increase the level of liaison between patients and physicians and other healthcare professionals who participate in the treatment of cardiac/pulmonary patients.
