Tıp Fakültesi / Faculty of Medicine

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2019 Turkish Hypertension Consensus Report
(2019) Aydogdu, Sinan; Guler, Kerim; Bayram, Fahri; Altun, Bulent; Derici, Ulver; Abaci, Adnan; Tukek, Tufan; Sabuncu, Tevfik; Arici, Mustafa; Erdem, Yunus; Ozin, Bulent; Sahin, Ibrahim; Erturk, Sehsuvar; Bittigen, Atilla; Tokgozoglu, Lale; 31483311
The Turkish Hypertension Consensus Report was prepared for the first time in 2015 to adapt the European and American international guidelines to our clinical practice and to create a practical report that could be a basic reference for all physicians dealing with hypertensive patients. This report, which was prepared by a committee with representation from 5 leading hypertension associations, has been accepted and is widely used. New clinical studies in hypertension literature and updated international guidelines since 2015 have demanded an update of the Turkish Hypertension Consensus Report as well. In this updated 2019 report, blood pressure levels were classified as Normal, Elevated, Stage 1, and Stage 2 hypertension. A new section was added for secondary hypertension. It was specified that drug treatment may be initiated with any 1 or a combination of 4 groups of drugs (diuretics, calcium channel blockers, angiotensin-converting enzyme [ACE] inhibitors, and angiotensin receptor blockers [ARBs]), except a combination of an ACE inhibitor and an ARB. It was emphasized that beta-blockers may be a first choice for hypertension treatment in diseases such as atrial fibrillation, heart failure, and coronary artery disease. The initial recommendation for hypertension treatment is a combination therapy in patients with a blood pressure level >= 150/90 mmHg. Target blood pressure values were redefined according to age and the presence of comorbidities. The hypertension treatment algorithm was renewed; it is proposed that drug therapy can also be initiated with a risk-based approach for the group with an elevated blood pressure (systolic blood pressure: 120-139 mmHg, diastolic blood pressure: 80-89 mmHg). The threshold clinic systolic blood pressure level was reduced from 160 mmHg to >= 150 mmHg for the initiation of drug therapy in individuals 80 years of age or more. The section on the treatment of special groups has now been expanded to include pregnancy and lactation. As in the previous report, in this update, practical recommendations for the most common cases seen in the clinic were the goal, rather than a comprehensive report that addresses all aspects of hypertension. This report has evidence-based recommendations for most patients; however, it should be kept in mind that there may be differences from 1 patient to another and that physicians should take an individualized approach according to a good clinical evaluation.
A. Lazer ve Isik Sistemleri
(2020) Ozcan, Hamdi
Laser and light systems are being used and demanded by patients more and more everyday in the treatment of acne and scars. Various devices are used in active acne and scar treatment. The effects of light systems on acne and scar tissue have been reported in different magnitudes. Since there are differences in practice and methodology, no judgement can be made on the success of treatment methods. The effectiveness of light systems increases with combined therapies. Their use in combination with medical therapies may increase the rate of success.
Acute Cerebral Venous Sinus Thrombosis: Two Different Presentations
(2014) Kilicaslan, Buket; Erol, Ilknur; Demir, Senay; Yazici, Nalan; AAW-9958-2021
Acute cerebral venous sinus thrombosis is a rare disorder in children, but is often secondary to infections. The clinical features of cerebral venous sinus thrombosis are based on the localization and size of the affected vessel and age of the patient. In this article we encountered two different presentations of acute cerebral venous sinus thrombosis in two children aged 8 and 12 years old.
Acute Respiratory Distress Syndrome Associated with Legionnaires' Disease: Two Case Reports
(2018) Erdogan, Haluk; Arslan, Hande; 0000-0002-9033-4236; 0000-0002-5708-7915; O-2247-2015; ABG-7034-2021
Introduction: Acute respiratory distress syndrome (ARDS) is characterized by the acute onset of illness, bilateral chest radiographic infiltrates consistent with pulmonary edema, and poor systemic oxygenation. ARDS has severe morbidity and mortality. The most common risk factor for the development of community-acquired ARDS is severe sepsis with a pulmonary source of infection. The first step in the therapy of ARDS is identification and treatment of the underlying disease. Here, we report two cases of ARDS associated with Legionnaires disease. Case 1: A 54-year-old male tourist with diabetes mellitus apply to our institution with diarrhea and high fever. At the time of admission, the patient had a temperature of 39.5 degrees C, a blood pressure of 140/70 mmHg, a heart rate of 102 beats/min and a respiratory rate of 24 breaths/min. His oxygen saturation was 93% while breathing room air. Chest examination revealed rales and the chest x-ray showed right-lower zone infiltrates. Legionella urinary antigen was positive on admission day. Treatment with levofloxacin (1000 mg/day) was started in the first 4 hours of admission after taking cultures. The patient had progressive dyspnea and cyanosis was developed. Analysis of arterial blood gas revealed a pH of 7.29, CO2 pressure of 30 mmHg, O-2 pressure of 37 mmHg and oxygen saturation of 62%. Roentgenogram of the chest worsened and showed bilateral infiltration, indicating ARDS. Thirty-two hours after admission, the patient was admitted to intensive care unit for ventilator support. The patient's clinical status continued to deteriorate. He was hypotensive and required dopamine infusions for blood pressure support. Legionella pneumophila serogroup 1 was isolated on sputum culture. Five days after hospitalization, chlarithromycin (1000 mg/day) and ciprofloxacin (1200 mg/day) were substituted for the initial antibiotics. The patient had nosocomial pneumonia caused by methicilline resistant Staphylococcus aureus during subsequent days. Vancomycine 2 gr/days was added to treatment. Clinical status improved and the body temperature fell below 37.5 degrees C on the eleventh day. On the patient's relatives' request, he was flown back to his country by air ambulance. One year later, the patient came back again as a tourist and had fully recovered from the illness. Case 2: A 82-year-old female with diabetes mellitus applied to our institution with high fever, dyspnea and mental change. She had been treated for pulmonary edema without any response to this therapy in a private hospital. She had been hospitalized in another hospital due to gastrointestinal bleeding approximately two weeks prior to her application. Chest examination revealed diffuse rales and the chest x-ray showed bilateral infiltrates. Analysis of arterial blood gas revealed pH of 7.31, CO2 pressure of 41.7 mm Hg, O-2 pressure of 21.9 mmHg and oxygen saturation of 33.6%. The patient was admitted to intensive care unit for ventilator support. Legionella urinary antigen was positive on admission day. Treatment with ciprofloxacin (1200 mg/day) and chlarithromycin (1000 mg/day) was started on admission after taking cultures. Legionella pneumophila serogroup 1 was isolated on endotracheal aspirate culture. The patient died on the 7th day. Conclusions: The clinicians should be aware of Legionnaires disease in etiology of ARDS. Early diagnosis and treatment are important factors in determining prognosis.
Adequacy of Physicians Knowledge Level of Cardiopulmonary Resuscitation to Current Guidelines
(2015) Gulsum, Kocalar Ummu; Deniz, Arslan Engin; Cemil, Kavalci; Kayipmaz, Afsin Emre; Gulsum, Kavalci; Sukru, Yorulmaz; Akin, Giray Tufan
Aim: The purpose of this study is to test the level of information on CPR and suitability to current application of the phsicians practicing in hospital ANEAH. Material and Method: The form of a test of 20 questions fort his purpose has been prepared in accordance with the 2010 AHA-ERC CPR guidelines. This form distributed to volunteer physicians to fill in. A total of 173 physicians agreed to participate in he study. The results were analyzed statistically and tried to determine the factors affecting the level of information. Results:According to the results of the study physicians gender, age and the total duration of physicians and medical asistance doesn't affect the level of information. The number of CPR within I month positively affect the level of knowledge. The number of theoretical and practical training in medical school, have taken the positive impact the level of knowledge of physicians. The training period after graduation, significantly increased the level of physicians information, The order of these training sessions with the asistant courses, congress, seminars and lessions on the sempozims are effective. Discussion: CPR trainig programs for physicians should be standardized, updated and expanded. Recurent in-service trainig should be provided to increase phsicians knowledge on skills.
After a Workshop on the Novel Antivirals for Treatment of Hepatitis C Virus Infection (4-6 December 2015, Istanbul)
(2016) Tekin, Suda; Aygen, Bilgehan; Aydin, Mehtap; Simsek, Funda
Ancillary Tests
(2023) Zeyneloglu, Pinar; Bozbay, Suha
Ancillary tests are the tests those help to confirm the clinical diagnosis of brain death. These tests are in 2 groups as electrophysiological and tests for the evaluation of cerebral blood circulation. They indicate the absence of cerebral blood circulation and brain electrical activity. They should not replace clinical evaluation.
Anesthesia management for laparoscopic bariatric surgery: retrospective analysis of 62 patients
(2017) Ozmete, Ozlem; Bali, Cagla; Ergenoglu, Pinar; Akin, Sule; Aribogan, Anis; AAJ-2094-2021; AAI-7779-2021; AAI-8790-2021; J-5282-2013; S-8336-2019
Purpose: The aim of this study was to present our experience in patients who underwent laparoscopic bariatric surgery and to discuss the current literature on the perioperative management Material and Methods: Sixty two patients with ASA risk classification II-III were evaluated retrospectively who underwent obesity surgery in our hospital. Demographic characteristics of the patients, surgical time, complications that seen in the perioperative period and the length of hospital stay were recorded Results: The age of the patients ranged from 19 to 59 years and 75.9% of them were female. Mean operation time was 167 minutes and the length of hospital stay was 5 days. Complications seen during intraoperative period were tachycardia, hypertension and arrhythmia. In the following days, 6 (9.7%) patients were re-operated and there was no mortality Conclusion: The prevention of complications that may occur in laparoscopic obesity surgery is required with a equipped team and teamwork, a good preoperative preparation, thromboembolism prophylaxis, tight hemodynamics and blood gas monitoring for safe anesthesia
Anesthesia practices in intracranial mass surgery: a retrospective study
(2017) Ozmete, Ozlem; Aribogan, Anis; AAI-7779-2021; S-8336-2019
Purpose: The aim of this retrospective study was to present our evaluate anesthesia experience in patients who underwent intracranial tumor surgery and to discuss the current literature on the perioperative management Material and Methods: ASA risk classification I-III 112 patients between the ages of 3-78 were evaluated retrospectively who underwent intracranial mass surgery between the years 2015-2016. Anesthesia registration forms, patient files and hospital computer system was used. for data. The demographic characteristics of patients, anesthetic management, and postoperative data were recorded Results: The age of patients ranged from 3-78 years and 57.1% of them were men. Masses were localized in supratentorial area in 87.5% ( 98) of cases. Mean operation time was 184 minutes, mean length of intensive care unit was 3 days and length of hospital stay was 7 days. Common vomplications seen during intraoperative period were tachycardia ( 5.4%), bradycardia (3.6%), hypertension (3.6%) and hypotension (1.8%). In the following days, 13 (11.6%) patient received repeated operation. There was not mortality Conclusion: Several anesthetic techniques may be used successfully to provide anesthesia for resection of intracranial mass surgery. To reduced morbidity and mortality, the possible complications must be recognized and treated early with invasive monitoring, strict hemodynamics and blood gas monitoring
Anti-Tumor Necrosis Factor Alpha Treatment and Tuberculin Skin Test
(2015) Bozkirli, Emine Duygu Ersozlu; Tufan, Muge Aydin; Ozisik, Lale; Sen, Nazan; Yucel, Ahmet Eftal
Purpose: The use of anti-tumor necrosis factor alpha (anti-TNF) drugs has been a milestone in the treatment of rheumatic diseases. Despite their strong efficacy, there are some factors restricting the use of anti-TNF agents. We must be careful especially for the granulomatous diseases which can be seen endemic in our country such as tuberculosis and leishmaniasis. In our country according to the RAED 2005 Consensus Meeting Reports, patients candidate for anti-TNF treatment are evaluated for both active and inactive tuberculosis before treatment and prophylaxis with isoniazid (INH) has been performed where indicated. Material and Methods: Tuberculin skin tests (TST) of 43 patients followed up in the Rheumatology Clinic and receiving anti-TNF therapy were repeated under treatment. Patients' pretreatment first TST results, drugs they used, INH prophylaxis state, smoking status and the duration of anti-TNF treatment were evaluated. Results: 14 patients (32.6%) were women, while 29 (67.4%) were men. The mean of first TST values were 11.72 +/- 90.3 mm (0-30) and the mean of second TST values were 12.06 +/- 12.4 mm (0-45). 48.8% of the patients were smoking and 74.4% of the patients had received INH prophylaxis for 9 months. The mean total duration of anti-TNF drug use was found as 22.67 +/- 19.11 (5-68) months. No statistically significant difference (p=0.888) was observed between the first pretreatment and second under treatment TST results of the patients. Discussion: Tuberculosis remains to be a serious public health problem for both our country and the whole world. For this reason in our country, a detailed assessment is performed for all patients before anti-TNF treatment. In our study patients who are planned to start anti-TNF therapy were assessed with their first TST values and INH prophylaxis were given to 32 patients (74.4%) before treatment. No statistically significant difference was observed between pre and post-treatment TST values when control TST were performed with the earliest after five months of treatment. These findings may suggest that there is no evident increase in the risk of tuberculosis for patients receiving anti-TNF treatment with appropriate INH prophylaxis.
Antibiotic resistance of streptococcus pneumoniae and haemophilus influenzae isolated from respiratory tract specimens
(2016) Aliskan, Hikmet Eda; Colakoglu, Sule; Gocmen, Julide Sedef
Purpose: Streptococcus pneumoniae and Haemophilus influenzae are two of the major pathogens in respiratory infections, treatment is usually started empirically. The aim of this study was to detect in vitro resistance rates of S. pneumoniae and H. influenzae strains isolated from different lower respiratory clinical samples to the antibotics which are used for therapy of infections due to these pathogens. Material and Methods: Seventy seven S. pneumoniae and 117 H. influenzae strains, isolated from patients were included in the study. S. pneumoniae isolates which gave an inhibition zone diameter of > 20 mm for oxacillin were considered susceptible for penicilin. For the isolates which had an oxacillin zone diameter of <20 mm, MIC values of penicillin and cefotaxime were obtained by E-test method (bioMerieux, Marcy-l'Etoile, France). Results: Of 77 S. pneumoniae isolates, 24.6 % were resistant (MIC> 2 mg/l) and 31.1 % were intermediately resistant to parenteral penicillin. Resistance rates to antibiotics were as follows: erythromycin 40 %, trimethoprim/sulphametoxazole (TMP/SMX) 54.5 % and ofloxacin 6.4%. beta-lactamases were detected in 15.6% of the H. influenzae isolates by nitrocefin positivity. Conclusion: H. influenzae strains (8.6%) were identified as beta-lactamase negative ampicillin resistant (BLNAR) strains. Resistance rates for other antibiotics were as follows: ampicillin 28.6%, cefaclor 36.5%, cefuroxime 30.1%, clarithromycin 9.6%, cloramphenicol 7% and TMP-SMX 43.9%.
Antibiotic Use in Pediatric and Neonatal Intensive Care Units; Multicenter Point Prevalence Study
(2014) Tolunay, Orkun; Celik, Umit; Yucel, Gulperi; Celik, Tamer; Mert, Mustafa Kurthan; Resitoglu, Salim; Ozdemir, Ulas; Narli, Nejat; Hanta, Deniz; Yapicioglu, Hacer; Gulcan, Hande; Ozcan, Kenan; Yildizdas, Dincer; Tolunay, Ilknur; Gokay, Naime; Kiraz, Kemal
Objective: Identifying antibiotic use in pediatric and neonatal intensive care units with a point prevalence study in Adana, Turkey's sixth largest city. Material and Methods: In this point prevalence study, demographic information and antibiotic treatment data were taken on the same day from patients in pediatric and neonatal intensive care units of 6 hospitals located in Adana's city center. Results: Four pediatric intensive care units (two university, one research and training hospital, and one public hospital) and six neonatal intensive care units (two university, one research and training hospital, one public hospital, and two private hospital) were included in the study; 220 patients were at the intensive care units at the time of the study-44 (20%) of the patients were in the pediatric intensive care units, and 176 (80%) of them were at the neonatal intensive care units. Also, 146 (66.4%) of the patients were using antibiotics. The frequency of antibiotic use was 72.7% in the pediatric intensive care units and 64.8% in neonatal intensive care units. There was a pediatric infectious disease physician at the university and research and training hospital. Antibiotic usage was lower (p= 0.002) in clinics where pediatric infectious disease physician consultations could be done. Dual antibiotic combination was applied most frequently. Mostly, ampicillin was preferred at neonatal intensive care units. Clarithromycin was used as a second choice because of seasonal lower respiratory tract infections. Vancomycin was the most preferred antibiotic in pediatric intensive care units, and meropenem and linezolid were the second and third choices. At both intensive care units, use of empiric antibiotic treatment was more frequent. Empiric treatment was applied in 22 (68.7%) patients in the pediatric intensive care units and 95 (83.3%) in neonatal intensive care units. Antibiotics were given to 14.3% of the patients in line with the resulting cultures. Conclusion: Intensive care units are services where antibiotics are used most frequently both in Turkey and in the world. In our opinion, protocols need to be established in clinics, national and international guides should be followed; and pediatric infectious disease physician consultations should be increased in order to reduce the frequency of antibiotic use, inappropriate indications, and inappropriate doses.
Antibody Screening and Risk Assessment of Healthcare Professionals in the COVID-19 Pandemic
(2021) Gumus, Hatice Hale; Demiroglu, Yusuf Ziya; Aliskan, Hikmet Eda; Odemis, İlker; Ceylan, Ozgur; Pocan, Ahmet Gurhan; Karagum, Ozlem; 0000-0001-9060-3195; 0000-0003-2638-0163; 0000-0002-9866-2197; 0000-0003-2638-0163; 0000-0001-6910-7250; 0000-0003-0681-8375; 0000-0003-3128-1602; 0000-0001-9071-9606; 34416802; AAE-2282-2021; AFK-3690-2022; AAX-9250-2021; AAZ-9711-2021; AAG-2486-2022; AAK-8276-2021; U-4084-2017; AAE-6310-2021; AAJ-2108-2021
Globally 364102 healthcare professionals have been infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and 1253 of them died until 15 January 2021. Healthcare professionals serving at the forefront of combating the pandemic are in the high risk group. In our country, the data about coronavirus-2019 (COVID-19) among healthcare professionals are limited. The aim of this study was to investigate the anti-SARS-CoV-2 IgG seroprevalence in healthcare professionals, to evaluate the risks they encountered during work, and to examine their relationships with antibody positivity. A total of 572 healthcare professionals serving in various units of our hospital participated in our study and the presence of anti-nucleocapsid IgG was investigated by chemiluminescent microparticle immunoassay (SARS-CoV-2 IgG test, Abbott Laboratories Diagnostics, USA) method in serum samples collected between May 18, 2020 and June 30, 2020. The demographic characteristics, medical history, work conditions, medical procedures performed and possible risk factors were questioned with a questionnaire form. The average age of the participants was 33.5 +/- 9.2 (19-61) years, and 62.9% (360/572) of them were women. In our study, the anti-SARS-CoV-2 IgG seroprevalence was 3.7% (21/572). The association of the antibody positivity with age, gender and occupational status was not statistically significant (p> 0.05). Comorbid diseases which were significantly higher in seropositive healthcare professionals were hypertension (19%) and diabetes mellitus (14.3%) (p< 0.05). It was observed that antibody positivity was significantly higher in healthcare professionals working in high (52.4%) and medium risk (33.3%) areas, those who treat and/or examine patients with suspicious or positive COVID-19 (66.7%) and those who spend more than 30 minutes in COVID-19 patient rooms (76%) (p< 0.05). The symptoms associated with seropositivity in healthcare workers with a history of symptoms (46%) were loss of smell (23.5%), loss of taste (20.0%) and respiratory distress (16.7%) (p< 0.05). It was observed that the probability of being infected with SARS-CoV-2 increased 12 times if there was a colleague with COVID-19 in the hospital, four times if there was a patient in the house/lodging and six times if there was an infected person in the social environment (p< 0.05). The rate of those who had the flu vaccine among the participants was 10.8% (62/572) and 9.7% of them were found to be anti-SARS-CoV-2 IgG positive (p< 0.05, 95% CI= 1.31-9.48). The seropositivity was significantly higher in non-smokers (4.8 %) compared to smokers (0.0%) (p< 0.05). In our study, it was determined that the rate of seropositivity was 12 times higher in healthcare professionals who stated that they received hydroxychloroquine prophylaxis due to risky contact compared to those who did not receive prophylaxis (p< 0.05, 95% CI= 4.11-40.64). The ratio of the personnel who answered "always" to the frequency of wearing gloves, masks, goggles/face shields and overalls was 85.7%, 96.9%, 62.1% and 65.4%, respectively. In conclusion, regular and large-scale sero-epidemiological screening of healthcare professionals in the COVID-19 pandemic can contribute to the control of the pandemic by providing a better understanding of transmission dynamics and risk factors.
Antimicrobial Resistance of Salmonella Isolates in A Holiday Center on the South of Turkey
(2016) Erdogan, Haluk; Erdogan, Askin; Arslan, Hande; 0000-0002-9033-4236; 0000-0002-5708-7915; O-2247-2015; AAD-5420-2020; ABG-7034-2021
Objective: Salmonella is an important pathogen that causes food-borne infection in children and adults worldwide. The aim of this study is to evaluate the antimicrobial activity of antimicrobial agents against Salmonella isolates in Alanya, an important holiday center in Turkey. Material and Method: The study was carried out at Baskent University Alanya Research and Teaching Hospital between January 2004 and September 2013. Salmonella spp. were isolated from stool samples and stored at -80 degrees C for antimicrobial susceptibility. Antimicrobial susceptibility was determined according to the Clinical and Laboratory Standards Institute (CLSI) criteria. The antimicrobial agents tested against Salmonella spp. included ampicillin, trimethoprim-sulfamethoxazole, tetracycline, chloramphenicol, nalidixic acid, ciprofloxacine and ceftriaxone. Quality control was ensured by testing Escherichia coli ATCC 25922. Results: A total of 63 consecutive Salmonella spp. were assessed for their antimicrobial susceptibility patterns, 21 of which were obtained from travellers. Serogroup D1 was the most common serotype (65.1%), followed by B (22.2%), A (7.9%), C1 (1.6%) and C2-C3 (3.2%). The resistances against ampicillin, tetracycline, trimethoprim-sulfamethoxazole and chloramphenicol were found to be 15.9%, 15.9%, 14.3%, and 11.1%, respectively. None of the strains was resistant to ciprofloxacin and ceftriaxone, while 14.3% were nalidixic acid-resistant. Antimicrobial resistance rates of Salmonella isolates obtained from travellers and local residents were not significantly different (p>0.05). Conclusion: This study suggests that ciprofloxacin and ceftriaxone can be used as empirical therapies in patients who are suspected to have salmonellosis with predisposing factors to severe infection and a history of travel to Alanya, Turkey. However, the nalidixic acid resistance of Salmonella isolates may be a cause for concern.
Application of spinal anesthesia in a pediatric patient with Duchenne's muscular dystrophy
(2016) Ozmete, Ozlem; Sener, Mesut; Caliskan, Esra; Aribogan, Anis; 27225742
Duchenne's muscular dystrophy (DMD) is a neuromuscular disease with a progressive course. It is the most common and most severe muscular dystrophic disorder for which the application of anesthesia is critical, due to muscle weakness, and cardiac and pulmonary involvement. Successful application of spinal anesthesia in a 2-year-old boy with DMD undergoing bilateral inguinal hernia repair is described in the present report. It is proposed that spinal anesthesia is an effective alternative to general anesthesia in certain pediatric patients, including those with DMD, for whom general anesthesia poses increased risk.
Are Bone Turnover Markers Related with Fracture Risk in Initial Diagnose Postmenopausal Osteoporosis? A Cross-Sectional Clinical Study
(2015) Yalbuzdag, Seniz Akcay; Sarifakioglu, Banu; Sengul, Ilker; Cetin, Nuri
Objective: In this study, we investigated the relationships between 10 year fracture risk calculated with FRAX assessment tool and bone turnover markers (BTM) in women with diagnosed as postmenopausal osteoporosis for the first time. Materials and Methods: After exclusion of the causes of secondary osteoporosis 61 postmenopausal women diagnosed with osteoporosis for the first time were enrolled. Height and weight measurements, comorbid diseases, menopause age, and laboratory investigations were recorded. Lumbar and femur neck and femur total T scores were measured by dual-energy x-ray absorptiometry (DXA). As BTM, serum osteocalcin (OC) and urine deoxypridinoline levels were measured. 10-year fracture risk of hip and major osteoporotic fracture was calculated with FRAX assessment tool. Results: The mean age of patients was 61 +/- 39 years. Median value of menopause year was 15.13 years (min: 2, max: 40). The median 10-year hip fracture and major osteoporotic fracture risks were calculated as 1.10% (min: 0, max: 23), 6.9% (min: 3, max: 34) respectively. There was no significant relationship between BTM and fracture risk. Positive significant correlation was found between menopause year and hip fracture risk, and between menopause year and major osteoporotic fracture risks (p=0.031, 0.276; p=0.025, r=0.287). Negative significant correlation was detected between body mass index and hip fracture risk (p=0.002, r=-0.392). Conclusion: In our study, we couldn't find relationship between BTM and fracture risks assessed by using FRAX tool in patients with initially diagnosed of postmenopausal osteoporosis. Further studies are needed to investigate the relationship between BTM and fracture risk in different patient groups.
Assesment of Spatial QRS-T Angle in Patients with Cardiac Syndrome X
(2019) Muderrisoglu, Mustafa; Muderrisoglu, Haldun; 0000-0002-9635-6313; AAG-8233-2020
Objective: Cardiac syndrome x (CSX) is defined as typical exertional angina, one or more abnormal cardiac stress test(s), and normal coronary arteries after exclusion of spontaneous or inducible epicardial coronary spasm. The aim of this study was to investigate cardiovascular adverse events risks in patients with CSX. For this purpose, spatial QRS-T angle that is predictor of these risks was evaluated in patients with CSX and control subjects. Methods: In a retrospective study, a total of 179 subjects (95 patients with CSX, 84 control) were examined. Control subjects had a normal coronary computed tomography. Spatial QRS-T angle value was calculated and compared in patients with CSX and control group, p values <0.05 were considered as statistically significant. Results: There was a statistically significant difference between the groups in terms of spatial QRS-T angle values [control group spatial QRS-T angle value median 35 (12.5 - 60), CSX group spatial QRS-T angle value median 51 (27 - 115), p<0.001]. Conclusion: According to our results, spatial QRS-T angle value was elevated in patients with CSX than in normal population. Furthermore, these results may indirectly suggest that the risk of adverse cardiac events may be increased in patients with CSX.
Association of Body Mass Index with Depression and Alexithymia
(2014) Karagol, Arda; Ozcurumez, Gamze; Taskintuna, Nilgun; Nar, Asli; https://orcid.org/0000-0002-3548-5517; https://orcid.org/0000-0003-0998-8388; ABE-8882-2020; AAK-3556-2021; AAA-2743-2021
Objective: Association between body mass index (BMI) and mental disorders had long been investigated. Recent researches declare a relation between obesity and depressed mood as well as clinical depression. On the other hand mental disorders such as alexithymia are also found to be correlated with an increased risk of obesity. Therefore we aimed to evaluate depression and alexithymia together among normal, overweight and obese adults in order to assess what kind of an association is there between BMI, depression and alexithymia. Methods: We enrolled 100 adults, aged between 18 to 67 from department of endocrinology outpatient clinic whom had normal levels of TSH, fT3 and fT4 thyroid hormones and formed three groups according to their Body Mass Index (BMI). Individuals who had had BMI between 18.5 and 24.99 formed the normal, BMI between 25 and 29.99 formed the overweight and BMI 30 and above formed the obese groups. All three groups were evaluated by Composite International Diagnostic Interview for clinical diagnosis and also given Toronto Alexithymia Scale-26 item (TAS-26) as well as Beck Depression Inventory (BDI). Results: There was a positive relation between BMI and current depressive episode and this finding was stronger in women. There was no such relation with lifelong depression. TAS-26 total and subscale scores revealed no difference between three groups. As BDI total scores got higher TAS-26 scores were higher. Hence there was a strong positive relation between depression and alexithymia. Conclusion: Our findings indicate that higher BMI increases current depressive episode. No association is found between BMI and lifelong depression. Depression and depression severity are strongly associated with alexithymia. Contradictive with literature, alexithymia and its severity are not found to be related with BMI. Following overweight and obese individuals is important to offset the adverse outcomes of depression.
B. Kimyasal Peeling
(2020) Ozcan, Hamdi
Although chemical peeling is used more widely for skin rejuvenation and aesthetic purposes, it is also used for the treatment of acne lesions and scars. Superficial peeling is used more for the treatment of active acne lesions, whereas medium and deep peeling for treating scars. Their side effects can be considerably reduced if used in a controlled and knowledgeable manner. In acne treatment, chemical peeling may be used in combination with medical therapies, surgical methods and even laser therapy, which can increase their overall efficacy.
Biofilm Formation Research of Coagulase-Negative Staphylococci Isolates' Isolated from Blood and Hand Culture at Nanofilm Covered Micro Plaques by Plasma Polymerization Technique: An Experimental Model
(2017) Hortac Istar, Elvan; Gocmen, Julide Sedef; Cokeliler, Dilek; Mutlu, Mehmet; Kaleli Can, Gizem; Alparaslan, Sezin; Cetin, Ceren; Kartal, Naz; Ozcelik, Ugur Can; Aycan, Cagri; 0000-0002-4335-6897; 0000-0001-6423-7523; AAP-6138-2021
Introduction: Coagulase-negative staphylococci (CNS) can protect themselves from the effects of antibiotics by producing biofilms through breeding on biomaterials, medical equipment and devices. It is possible to influence biofilm formation with the aid of various surface modifications. In our study, plasma polymerization method, which is a surface modification technique, was used. The plasma polymerization technique is an environmentally-friendly technique that allows you to modify the nanometer level only at the surface without affecting the stack using the fourth state of the material. The possibility to generate surfaces with different properties (hydrophilic, hydrophobic, biocompatible etc.) by the help of various monomers and gases has made this technique more popular. In this study, the effect of the microplate surfaces modified by three different monomers on the biofilm formation of CNS was investigated. Materials and Methods: A total of 60 isolated CNS isolates from blood and hand cultures were included into the study. As control strains, Staphylococcus epidermidis ATCC 35984, known to be biofilm positive, and S. epidermidis ATCC 12228 which do not form biofilm, were used. Slime formation was determined by the quantitative plaque assay method described by Christensen. In microplates, which were plain or modified by three different monomers, the biofilm formation behavior of all strains was investigated simultaneously and comparatively. Results: There was no difference in biofilm positivity between strains isolated from hand and blood. A total of 71.6% biofilm formation was observed on microplates, which were not coated with plasma technique, and on plasma-modified microplated surfaces, 80% (monomer: 3- mercaptopropionic acid), 65% (monomer: 2-hydroxyethyl methacylate) and 31.6% (monomer: ethylene glycol dimethacylate) biofilm formation was observed, respectively. It was found that ethylene glycol dimethacrylate in three monomers significantly inhibited biofilm formation when compared to other monomers. Conclusion: In recent years CNS, especially S. epidermidis has become the most frequently isolated bacteria in catheter infections and responsible for the 28% of nosocomial bacteremia. The widespread use of prosthetic and permanent devices has been shown as a reason for the increase in the frequency of this effect. In 90% of patients with S. epidermidis bacteremia, there is an intravascular catheter history. Biofilm is an extracellular structure containing water, proteins and carbohydrates and is responsible for the unwanted adhesion of microorganisms to host cells and artificial surfaces. The biofilm mechanism can be altered by the interaction between the material surface and the bacterial surface. In our study, in-vitro results were obtained showing the potential to reduce the risk of biofilm-associated infection by microorganism biofilm formation on modified surfaces with appropriate monomer selection.