Yesim Senol

Publications of Yesim Senol

• Knowledge, attitudes and behaviour of students from a medicine faculty, dentistry faculty, and medical technology Vocational Training School toward HIV/AIDS.

  Authors: Ozge Turhan, Yesim Senol, Timucin Baykul, Rabin Saba, Ata Nevzat Yalçin

  International journal of occupational medicine and environmental health. 01/2010; 23(2):153-60.

  With increasing numbers of HIV/AIDS patients, physicians, dentists, and nurses taking care of these patients should have sufficient knowledge of the disease, and their attitude and behaviour shouldWith increasing numbers of HIV/AIDS patients, physicians, dentists, and nurses taking care of these patients should have sufficient knowledge of the disease, and their attitude and behaviour should be proper. In our study, we aimed to examine the level of knowledge about HIV/AIDS among students from a medicine faculty, dentistry faculty, and medical technology vocational training school, to investigate attitudes and behaviour, and differences between first- and last-year students (if any) and to determine students' perception of the importance of this disease for our country and our world. This descriptive study comprised first-year and last-year students of Akdeniz University Faculty of Medicine, Akdeniz University Medical Technology Vocational Training School (MTVTS), and Süleyman Demirel University Faculty of Dentistry. A questionnaire was administered to a total of 357 students. Lack of the relevant education is obvious among all three occupational groups in our study. The importance of HIV/AIDS as a public health problem all over the world should be emphasized more, and awareness of all humanity should be augmented.

• Efficacy, tolerability, and side effects of oxcarbazepine monotherapy: a prospective study in adult and elderly patients with newly diagnosed partial epilepsy.

  Authors: Ebru Apaydin Dogan, Burcu Ekmekci Usta, Rengin Bilgen, Yesim Senol, Berrin Aktekin

  Epilepsy & behavior : E&B. 08/2008; 13(1):156-61.

  OBJECTIVE: The aim of the study described here was to investigate the efficacy, tolerability, and side effects of oxcarbazepine (OXC) monotherapy in newly diagnosed, previously untreated adult andOBJECTIVE: The aim of the study described here was to investigate the efficacy, tolerability, and side effects of oxcarbazepine (OXC) monotherapy in newly diagnosed, previously untreated adult and elderly patients with partial epilepsy. METHODS: We prospectively analyzed and recorded the efficacy, tolerability, and side effects of OXC monotherapy. The results were analyzed on the basis of etiologic classifications and age distributions. Remission was defined as seizure freedom for at least 1 year. RESULTS: A total of 147 patients were evaluated in a single center for a median of 18 months (range: 14-36 months). Overall, 92 patients (62.6%) were seizure free for at least 12 months and 55 of them (37.4%) were unresponsive despite treatment with the maximum tolerable dose of OXC. There was a significant difference in the outcomes of patients with cryptogenic (75% remission) and symptomatic (51.9% remission) epilepsy (P=0.004). Patients with cerebral tumors did worse than the remainder of the patients in the symptomatic group (36.7% remission) (P=0.03). Results were favorable for the elderly; 14 patients (73.6%) in the elderly subgroup became seizure free for at least 1 year, and the remission was achieved with low to moderate doses (approximately 900 mg/day). Overall, 13 patients (8.8%) discontinued OXC due to intolerable side effects. Side effects leading to discontinuation were: Stevens-Johnson syndrome (n=2, 1.4%); fatigue and drowsiness (n=2, 1.4%); dizziness, nausea, and vomiting with normal laboratory tests (n=2, 1.4%); dizziness, nausea, and vomiting with serum Na levels <130 mEq/L (n=5, 3.4%); and elevated serum gamma-glutamyl transferase levels (GGT>200mg/dL) (n=1, 0.7%). OXC proved to be a tolerable drug for the elderly; only one patient experienced symptomatic hyponatremia with mild symptoms and responded well to fluid restriction, which did not lead to discontinuation of OXC. CONCLUSION: Although the limitations of our study include its open-label design, the results suggest that OXC monotherapy may be regarded as an effective first-line monotherapy option for adult and elderly patients with partial epilepsy, but has low efficacy in patients with cerebral tumors.

• Missed opportunities for coronary heart disease diagnoses: primary care experience.

  Authors: Mehtap Turkay, Yesim Senol, Mustafa Kemal Alimoglu, Mehmet R. Aktekin, Necmi Deger

  Croatian medical journal. 07/2007; 48(3):362-70.

  AIM: To investigate missed opportunities to reveal existing but not formerly diagnosed coronary heart disease cases and related risk factors in primary health care. METHODS: The study comprised 850AIM: To investigate missed opportunities to reveal existing but not formerly diagnosed coronary heart disease cases and related risk factors in primary health care. METHODS: The study comprised 850 people aged over 30 years with no known history of coronary heart disease, receiving health services from a primary care center located in a suburban area of Antalya, Turkey. Data on their age, gender, education level, health insurance status, income, smoking behavior, and physical activities were collected. Undiagnosed coronary heart disease patients were determined by the Rose questionnaire, physical examination, and electrocardiogram. Height and weight, blood pressure, serum glucose and cholesterol levels were measured, and body-mass index and waist-hip ratio calculated. Each patient was given a risk score regarding age, smoking behavior, systolic blood pressure, and cholesterol levels. Estimated risk ratio of each person for developing coronary heart disease in the next decade was determined. RESULTS: The number of formerly undiagnosed coronary heart disease cases was 126 (14.8%). Overall mean (+/-standard deviation) risk score for developing coronary heart disease in the next decade in study group was 6.1+/-6.8. Diseases facilitating development of coronary heart disease: hypertension, diabetes, and hypercholesterolemia were present in 255 (30.4%), 70 (8.2%), and 364 (43.4%) participants, respectively. Obesity was detected in 315 (37.1%) subjects and there were 222 (26.1%) current smokers. For patients who attended primary health care, the estimated percentage risk for developing coronary heart disease in the next ten years was 7 to 45% in men and 2 to 45% in women. CONCLUSION: Opportunities to reveal coronary heart disease and its risk factors are being missed in primary care. Measures should be taken to ensure timely diagnosis of coronary heart disease and related risk factors.

• Withdrawal of antiepileptic drugs in adult patients free of seizures for 4 years: a prospective study.

  Authors: Berrin Aktekin, Ebru Apaydin Dogan, Yurttas Oguz, Yesim Senol

  Epilepsy & behavior : E&B. 06/2006; 8(3):616-9.

  We aimed to assess the relapse rate of epilepsy, prospectively attributable to antiepileptic drug (AED) withdrawal in seizure-free patients and to determine the risk factors for seizure recurrence.We aimed to assess the relapse rate of epilepsy, prospectively attributable to antiepileptic drug (AED) withdrawal in seizure-free patients and to determine the risk factors for seizure recurrence. Seventy-nine patients with epilepsy who were seizure-free for at least 4 years were enrolled into the study. The AEDs were tapered by one-sixth every 2 months. The EEG and clinical examination were performed at the beginning; at each visit during discontinuation and 2, 6, 12, 24, and 36 months after the complete drug withdrawal. For each patient, records were obtained of the main demographic and clinical variables. A total of 49 patients completed the discontinuation programme. Twenty-eight patients (57%) relapsed while 21 of those (42.8%) did not suffer a relapse at the end of the study period. In patients discontinuing treatment, the probability of relapse was 21.4% during the tapering period (especially in the last months), 28.6% at 1 month, 14.3% at 3 months, 3.6% at 6 months, 7.1% at 12 months, 17.8% at 24 months, and 7.1% at 36 months. The age at onset of epilepsy and the duration of active disease were found to affect the risk of relapse. Although drug withdrawal could be considered in adult patients free of seizures for 4 years, the final decision should be tailored to the patient's clinical, emotional, and socio-cultural profile.

• The incidence of smoking and risk factors for smoking initiation in medical faculty students: cohort study.

  Authors: Yesim Senol, Levent Donmez, Mehtap Turkay, Mehmet Aktekin

  BMC public health. 02/2006; 6:128.

  BACKGROUND: Medical education requires detailed investigation because it is a period during which the attitudes and behaviors of physicians develop. The purpose of this study was to calculate theBACKGROUND: Medical education requires detailed investigation because it is a period during which the attitudes and behaviors of physicians develop. The purpose of this study was to calculate the yearly smoking prevalence and incidence rates of medical faculty students and to identify the risk factors for adopting smoking behaviour. METHODS: This is a cohort study in which every student was asked about their smoking habits at the time of first registration to the medical faculty, and was monitored every year. Smoking prevalence, yearly incidence of initiation of smoking and average years of smoking were calculated in analysis. RESULTS: At the time of registration, 21.8% of the students smoked. At the end of six years, males had smoked for an average of 2.6 +/- 3.0 years and females for 1.0 +/- 1.8 years (p < 0.05). Of the 93 medical students who were not smokers at the time of registration, 30 (32.3%) were smokers at the end of the 6 years of the course. CONCLUSION: The first 3 years of medical education are the most risky period for initiation of smoking. We found that factors such as being male, having a smoking friend in the same environment and having a high trait anxiety score were related to the initiation of smoking. Targeted smoking training should be mandatory for students in the Medical Faculty.

• Effects of some hematological parameters on whole blood tacrolimus concentration measured by two immunoassay-based analytical methods.

  Authors: S Halide Akbas, Sebahat Ozdem, Serkan Caglar, Murat Tuncer, Alihan Gurkan, Levent Yucetin, Yesim Senol, Alper Demirbas, Meral Gultekin, F Fevzi Ersoy, Mustafa Akaydin

  Clinical biochemistry. 07/2005; 38(6):552-7.

  OBJECTIVES: Tacrolimus (FK506) is a potent immunosuppressive drug used for prevention of rejection following transplantation. Several methods including immunoassays have been used for monitoringOBJECTIVES: Tacrolimus (FK506) is a potent immunosuppressive drug used for prevention of rejection following transplantation. Several methods including immunoassays have been used for monitoring tacrolimus levels. The purpose of the present study was to compare the effects of various hematological parameters on whole blood tacrolimus concentrations which were measured with two different analytical methods, namely the microparticle enzyme immunoassay (MEIA II) and enzyme multiplied immunoassay technique (EMIT). DESIGN AND METHODS: The effects of hematological variables, namely hematocrit (Htc), hemoglobin (Hb), red blood cell (RBC), mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), red cell distribution width (RDW) and platelet (PLT) counts on tacrolimus concentrations (n = 2430 measurements) measured with EMIT (n = 1171) and MEIA II (n = 1259) methods in whole blood samples from kidney or liver or combined kidney-pancreas transplant patients (n = 162) during a 2-year post-transplantation period were compared. RESULTS: The whole blood tacrolimus concentrations measured with MEIA II method were affected much more significantly by hematological parameters than those measured with EMIT method. In MEIA II method, RDW (r = 0.479, P < 0.01) showed a stronger correlation with tacrolimus concentration than Htc (r = -0.239, P < 0.01) in all patients. A negative significant correlation (r = -0.468, P < 0.01) was also observed between the Htc and tacrolimus concentration in patients with Htc values < or =25% in MEIA II method. CONCLUSIONS: The results of the present study suggest that EMIT method might be preferred to MEIA II in determination of whole blood tacrolimus concentrations in anemic transplant patients. For better therapeutic drug monitoring, physicians should be aware of these assay differences. Evaluation of hematologic factors that affect the whole blood concentrations of tacrolimus may be helpful in deciding the dosage of this drug.

• Efficacy, tolerability, and side effects of oxcarbazepine monotherapy: A prospective study ın adult and elderly patients with newly diagnosed partial epilepsy

  Authors: Ebru Apaydın Dogan, Burcu Ekmekci Usta, Rengin Bilgen, Yesim Senol, Berrin Aktekin

  Epilepsy & Behavior.

  ObjectiveThe aim of the study described here was to investigate the efficacy, tolerability, and side effects of oxcarbazepine (OXC) monotherapy in newly diagnosed, previously untreated adult andObjectiveThe aim of the study described here was to investigate the efficacy, tolerability, and side effects of oxcarbazepine (OXC) monotherapy in newly diagnosed, previously untreated adult and elderly patients with partial epilepsy.MethodsWe prospectively analyzed and recorded the efficacy, tolerability, and side effects of OXC monotherapy. The results were analyzed on the basis of etiologic classifications and age distributions. Remission was defined as seizure freedom for at least 1 year.ResultsA total of 147 patients were evaluated in a single center for a median of 18 months (range: 14–36 months). Overall, 92 patients (62.6%) were seizure free for at least 12 months and 55 of them (37.4%) were unresponsive despite treatment with the maximum tolerable dose of OXC. There was a significant difference in the outcomes of patients with cryptogenic (75% remission) and symptomatic (51.9% remission) epilepsy (P = 0.004). Patients with cerebral tumors did worse than the remainder of the patients in the symptomatic group (36.7% remission) (P = 0.03). Results were favorable for the elderly; 14 patients (73.6%) in the elderly subgroup became seizure free for at least 1 year, and the remission was achieved with low to moderate doses (approximately 900 mg/day). Overall, 13 patients (8.8%) discontinued OXC due to intolerable side effects. Side effects leading to discontinuation were: Stevens–Johnson syndrome (n = 2, 1.4%); fatigue and drowsiness (n = 2, 1.4%); dizziness, nausea, and vomiting with normal laboratory tests (n = 2, 1.4%); dizziness, nausea, and vomiting with serum Na levels <130 mEq/L (n = 5, 3.4%); and elevated serum γ-glutamyl transferase levels (GGT > 200 mg/dL) (n = 1, 0.7%). OXC proved to be a tolerable drug for the elderly; only one patient experienced symptomatic hyponatremia with mild symptoms and responded well to fluid restriction, which did not lead to discontinuation of OXC.ConclusionAlthough the limitations of our study include its open-label design, the results suggest that OXC monotherapy may be regarded as an effective first-line monotherapy option for adult and elderly patients with partial epilepsy, but has low efficacy in patients with cerebral tumors.

• Effects of some hematological parameters on whole blood tacrolimus concentration measured by two immunoassay-based analytical methods

  Authors: S. Halide Akbas, Sebahat Ozdem, Serkan Caglar, Murat Tuncer, Alihan Gurkan, Levent Yucetin, Yesim Senol, Alper Demirbas, Meral Gultekin, F. Fevzi Ersoy, Mustafa Akaydin

  Clinical Biochemistry.

  Objectives:Tacrolimus (FK506) is a potent immunosuppressive drug used for prevention of rejection following transplantation. Several methods including immunoassays have been used for monitoringObjectives:Tacrolimus (FK506) is a potent immunosuppressive drug used for prevention of rejection following transplantation. Several methods including immunoassays have been used for monitoring tacrolimus levels. The purpose of the present study was to compare the effects of various hematological parameters on whole blood tacrolimus concentrations which were measured with two different analytical methods, namely the microparticle enzyme immunoassay (MEIA II) and enzyme multiplied immunoassay technique (EMIT).Design and methods:The effects of hematological variables, namely hematocrit (Htc), hemoglobin (Hb), red blood cell (RBC), mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), red cell distribution width (RDW) and platelet (PLT) counts on tacrolimus concentrations (n = 2430 measurements) measured with EMIT (n = 1171) and MEIA II (n = 1259) methods in whole blood samples from kidney or liver or combined kidney-pancreas transplant patients (n = 162) during a 2-year post-transplantation period were compared.Results:The whole blood tacrolimus concentrations measured with MEIA II method were affected much more significantly by hematological parameters than those measured with EMIT method. In MEIA II method, RDW (r = 0.479, P < 0.01) showed a stronger correlation with tacrolimus concentration than Htc (r = −0.239, P < 0.01) in all patients. A negative significant correlation (r = −0.468, P < 0.01) was also observed between the Htc and tacrolimus concentration in patients with Htc values ≤25% in MEIA II method.Conclusions:The results of the present study suggest that EMIT method might be preferred to MEIA II in determination of whole blood tacrolimus concentrations in anemic transplant patients. For better therapeutic drug monitoring, physicians should be aware of these assay differences. Evaluation of hematologic factors that affect the whole blood concentrations of tacrolimus may be helpful in deciding the dosage of this drug.

• Propuštene prilike za dijagnosticiranje koronarne srčane bolesti u primarnoj zaštiti

  Authors: Mehtap Turkay, Yesim Senol, Mustafa Kemal Alimoglu, Mehmet R. Aktekin, Necmi Deger

  Croatian Medical Journal (cmj@mef.hr); Vol.48 No.3.

  Aim To investigate missed opportunities to reveal existing but not formerly diagnosed coronary heart disease cases and related risk factors in primary health care. Methods The study comprised 850Aim To investigate missed opportunities to reveal existing but not formerly diagnosed coronary heart disease cases and related risk factors in primary health care. Methods The study comprised 850 people aged over 30 years with no known history of coronary heart disease, receiving health services from a primary care center located in a suburban area of Antalya, Turkey. Data on their age, gender, education level, health insurance status, income, smoking behavior, and physical activities were collected. Undiagnosed coronary heart disease patients were determined by the Rose questionnaire, physical examination, and electrocardiogram. Height and weight, blood pressure, serum glucose and cholesterol levels were measured, and body-mass index and waist-hip ratio calculated. Each patient was given a risk score regarding age, smoking behavior, tolic blood pressure, and cholesterol levels. Estimated risk ratio of each person for developing coronary heart disease in the next decade was determined. Results The number of formerly undiagnosed coronary heart disease cases was 126 (14.8%). Overall mean (±standard deviation) risk score for developing coronary heart disease in the next decade in study group was 6.1 ± 6.8. Diseases facilitating development of coronary heart disease: hypertension, diabetes, and hypercholesterolemia were present in 255 (30.4%), 70 (8.2%), and 364 (43.4%) participants, respectively. Obesity was detected in 315 (37.1%) subjects and there were 222 (26.1%) current smokers. For patients who attended primary health care, the estimated percentage risk for developing coronary heart disease in the next ten years was 7 to 45% in men and 2 to 45% in women. Conclusion Opportunities to reveal coronary heart disease and its risk factors are being missed in primary care. Measures should be taken to ensure timely diagnosis of coronary heart disease and related risk factors.