Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Assessment of Stem Cell Transplant Eligibility in Recipients with Oral Foci of Infection: Appropriate Conditioning Regimens(2023) Boga, Can; Sisli, Selen Nihal; Bahar, Abdul Rasheed; Tamer, Yusuf; Kasar, Mutlu; Bascil, Sibel; Ozdogu, Hakan; Asma, Suheyl; Demiroglu, Yusuf Ziya; Yeral, Mahmut; 0000-0002-0225-2477; 37341460; ADG-7352-2022Objectives: It is unclear whether patients with oral foci of infection should be approved for hematopoietic stem cell transplant with or without posttransplant cyclophosphamide. We compared the presence of oral foci of infection status on the effects of various conditioning regimens for such patients.Materials and Methods: Three groups were classified as autologous (carmustine-etoposide-cytarabinemelphalan, mitoxantrone-melphalan, and melphalan 200 mg/m2 groups; n = 502 patients), and 6 groups were classified as allogeneic (busulfan-fludarabinerabbit anti-T-lymphocyte globulin, busulfanfludarabine-posttransplant cyclophosphamide, fludarabine-cyclophosphamide-anti-T-lymphocyte globulin, busulfan-fludarabine-anti-T-lymphocyte globulin-posttransplant cyclophosphamide, total body irradiation-posttransplant cyclophosphamide, and other; n = 428 patients). Data were collected from a database that met international accreditation requirements. We evaluated dental radiological findings and calculated interobserver reliability.Results: Oral foci of infections increased febrile neutropenia and bacterial infection frequencies in both groups but only increased mucositis frequency in patients with allogeneic treatment. The frequencies of oral foci of infection-related complications were similar in both the autologous and allogeneic groups. Rate of graft-versus-host disease was not affected by oral foci of infection status. Periodontitis/cysts and periapical lesions increased the risk of infections at day 100 in the mitoxantrone-melphalan group versus the melphalan 200 mg/m2 group. We observed no differences among the autologous transplant groups in terms of early mortality. Similarly, no differences in early mortality were observed among the allogeneic groups.Conclusions: Transplant is a valid option in patients with oral foci of infections undergoing various autologous and allogeneic transplant protocols when time is of the essence, even at myeloablative dose intensities.Item Evaluation of 31 Cases with Urogenital Tuberculosis(2014) Kursun, Ebru; Turunc, Tahsin; Demiroglu, Yusuf Ziya; 0000-0002-7936-2172; 0000-0001-7956-7306; 0000-0002-9866-2197; ABD-4332-2020; AAG-5020-2020; GVT-0626-2022; AAZ-9711-2021Introduction: The present study evaluated the cases followed up and treated for urogenital tuberculosis in our hospital. Materials and Methods: Demographic and clinical characteristics, as well as laboratory data and treatment outcomes of 31 cases diagnosed as urogenital tuberculosis between January 2005 and January 2014 were retrospectively evaluated. Results: Of the 31 cases diagnosed with urogenital tuberculosis, nine (29%) had kidney, seven (22.5%) had bladder, nine (29%) had prostate, four (13%) had epididymis, and two (6.5%) had testicular involvement. History of contact with tuberculosis bacillus was present in five (16%) cases. Diabetes mellitus accompanied five (16%) and malignancy accompanied three (10%) cases. The most common complaints were dysuria (68%) and high fever (55%). Histopathological examination demonstrated tuberculosis bacillus in twenty cases (64.5%); whereas, Mycobacterium tuberculosis was isolated in the urine cultures of fifteen cases (48.4%) and acid-fast bacilli were detected in the urine samples of ten cases (32.3). It was determined that all cases had received quadruple anti-tuberculosis therapy for the first two months followed by dualanti-tuberculosis therapy for 4 to 10 months based on the site of involvement. One of the cases had undergone prostatectomy, one had undergone nephrectomy, one had undergone nephrectomy with ileocystoplasty in the same session, and one had undergone orchiectomy over the course of treatment with anti-tuberculosis drugs. It was determined that eight of the cases were lost on follow upafter anti-tuberculosis therapy was started and remaining cases recovered without complication. Conclusion: Tuberculosis is a chronic infectious disease that is difficult to diagnose and able to involve all systems and organs, and it remains important in developing countries like Turkey. We conclude that urogenital tuberculosis should be considered in patients with urogenital complaints that continuing for a long time period and do not respond to classical medical therapy.Item Evaluation of 28 Cases of Mucormycosis(2015) Kursun, Ebru; Turunc, Tuba; Demiroglu, Yusuf Ziya; Aliskan, Hikmet Eda; Arslan, Ayse Hande; 0000-0002-5708-7915; 0000-0001-9060-3195; 0000-0002-9866-2197; 0000-0001-7956-7306; 25590855; ABG-7034-2021; ADG-7352-2022; AAE-2282-2021; AAG-5020-2020; AAZ-9711-2021; GVT-0626-2022Mucormycosis is a rare but invasive fungal disease with high mortality. The present study aimed to retrospectively investigate the demographic characteristics, as well as the clinical, radiological and laboratory features and the results of treatment, in the patients followed in our hospital because of mucormycosis. The present study retrospectively evaluated 28 cases, which were followed in our hospital because of mucormycosis between January 2002 and July 2013. The clinical form was rhinocerebral in 27 cases (rhinoorbital in 12, nasal in 8 and rhinoorbitocerebral in 7) and disseminated in one case. With regard to predisposing factors, diabetes mellitus (n=20), haematological malignancy (n=6) and chronic renal insufficiency (n=5) were the leading concomitant diseases. Seventeen (61%) of 28 cases showed atypical clinical picture. With regard to the therapeutic outcomes; it was found that 14 (50%) cases died and six cases recovered with sequel. Today, when particularly the prevalence of immunosuppressive diseases and conditions are gradually increasing, the incidence of mucormycosis is also increased. Considering that the majority of our cases had atypical clinical involvement and complications, being familiar with the characteristics of this disease could be life-saving together with early diagnosis and treatment.Item Risk Factors for Occupational Brucellosis Among Veterinary Personnel in Turkey(2014) Kutlu, Murat; Ergonul, Onder; Sayin-Kutlu, Selda; Guven, Tumer; Ustun, Cemal; Alp-Cavus, Sema; Ozturk, Serife Baron; Acicbe, Ozlem; Akalin, Serife; Tekin, Recep; Tekin-Koruk, Suda; Demiroglu, Yusuf Ziya; Keskiner, Ramazan; Gonen, Ibak; Sapmaz-Karabag, Sevil; Bosnak, Vuslat; Kazak, Esra; https://orcid.org/0000-0002-9866-2197; 25132061; AAZ-9711-2021Veterinarians and veterinary technicians are at risk for occupational brucellosis. We described the risk factors of occupational brucellosis among veterinary personnel in Turkey. A multicenter retrospective survey was performed among veterinary personnel who were actively working in the field. Of 712 veterinary personnel, 84(11.8%) had occupational brucellosis. The median number of years since graduation was 7 (interquartile ranges [IQR], 4-11) years in the occupational brucellosis group, whereas this number was 9 (IQR, 4-16) years in the non-brucellosis group (p < 0.001). In multivariable analysis, working in the private sector (odds ratio [OR], 2.8; 95% confidence interval [95% CI], 1.55-5.28, p = 0.001), being male (OR, 4.5; 95% CI, 1.05-18.84, p = 0.041), number of performed deliveries (OR, 1.01; 95% CI, 1.002-1.02, p = 0.014), and injury during Brucella vaccine administration (OR, 5.4; 95% CI, 3.16-9.3, p < 0.001) were found to be risk factors for occupational brucellosis. We suggest that all veterinary personnel should be trained on brucellosis and the importance of using personal protective equipment in order to avoid this infection. (C) 2014 Elsevier B.V. All rights reserved.Item Cases of Multisystem Inflammatory Syndrome in Adults (MIS-A) Associated with SARS-CoV-2 Infection(2022) Demiroglu, Yusuf Ziya; Oruc, Ebru; Odemis, Ilker; Bilgel, Ziya Gokalp; 0000-0003-2638-0163; AAD-1638-2019Multisystem inflammatory syndrome in adults (MIS-A) is a rare condition that develops after coronavirus disease 2019 (COVID-19). We present two young adult male patients, aged 25 and 24 years, who admitted to our outpatient clinic with high fever, redness in the eyes, diarrhea, and maculopapular rash four weeks after after clinically mild COVID-19 infection. Echocardiography showed global hypokinesia in both cases. Therefore, the history of COVID-19 should be questioned, and the patient should be evaluated for possible MIS-A, especially when new heart failure is detected during the pandemic.Item Comparison of the clinical course of COVID-19 infection in sickle cell disease patients with healthcare professionals(2021) Boga, Can; Asma, Suheyl; Leblebisatan, Goksel; Sen, Nazan; Tombak, Anil; Demiroglu, Yusuf Ziya; Yeral, Mahmut; Akin, Sule; Yesilagac, Hasan; Habesoglu, Mehmet Ali; Aribogan, Anis; Kasar, Mutlu; Korur, Asli; Ozdogu, Hakan; 0000-0002-9866-2197; 34032899; AAZ-9711-2021; AAY-2668-2021It is highly expected that COVID-19 infection will have devastating consequences in sickle cell disease (SCD) patients due to endothelial activation and decreased tissue and organ reserve as a result of microvascular ischemia and continuous inflammation. In this study, we aimed to compare the clinical course of COVID-19 in adult SCD patients under the organ injury mitigation and clinical care improvement program (BASCARE) with healthcare professionals without significant comorbid conditions. The study was planned as a retrospective, multicenter and cross-sectional study. Thirty-nine SCD patients, ages 18 to 64 years, and 121 healthcare professionals, ages 21 to 53, were included in the study. The data were collected from the Electronic Health Recording System of PRANA, where SCD patients under the BASCARE program had been registered. The data of other patients were collected from the Electronic Hospital Data Recording System and patient files. In the SCD group, the crude incidence of COVID-19 was 9%, while in healthcare professionals at the same period was 23%. Among the symptoms, besides fever, loss of smell and taste were more prominent in the SCD group than in healthcare professionals. There was a significant difference between the two groups in terms of development of pneumonia, hospitalization, and need for intubation (43 vs 5%, P < 0.00001; 26 vs 7%, P = 0.002; and 10 vs 1%, P = 0.002, respectively). Prophylactic low molecular weight heparin and salicylate were used more in the SCD group than in healthcare professionals group (41 vs 9% and 28 vs 1%; P < 0.0001 for both). The 3-month mortality rate was demonstrated as 5% in the SCD group, while 0 in the healthcare professionals group. One patient in the SCD group became continously dependent on respiratory support. The cause of death was acute chest syndrome in the first case, hepatic necrosis and multi-organ failure in the second case. In conclusion, these observations supported the expectation that the course of COVID-19 in SCD patients will get worse. The BASCARE program applied in SCD patients could not change the poor outcome.Item 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-2108-2021Globally 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.Item An epidemiological study to define the recent clinical characteristics and outcomes of infective endocarditis in southern Turkey(2021) Acibuca, Aynur; Yilmaz, Mustafa; Okar, Sefa; Kursun, Ebru; Acilar, Onur; Tekin, Abdullah; Demiroglu, Yusuf Ziya; Muderrisoglu, Ibrahim Haldun; 0000-0002-9866-2197; 0000-0002-5658-870X; 33830167; AAZ-9711-2021; ABD-7304-2021Introduction: The aim of this study was to characterise the recent features of patients with infective endocarditis (IE) at one referral centre in southern Turkey, in order to be able to identify the high-risk subgroup and revise preventative measures and management strategies. Methods: Medical records of patients 18 years and older, who had been diagnosed with IE according to the Duke criteria between January 2009 and October 2019, were retrospectively evaluated in a referral general hospital. Results: The total of 139 IE cases comprised 59.7% males and 40.3% females, with a mean age of 55 +/- 16 years. The most encountered symptom was fever (55.4%) and the mitral valve (54%) was the most frequently involved. The most common causative micro-organisms were coagulase-negative staphylococci (30.2%). The in-hospital mortality rate was 30.2%, with congestive heart failure, chronic renal disease and chronic dialysis found to be significantly associated with in-hospital mortality. Conclusion: The study results demonstrate the recent epidemiological features of IE in southern Turkey that are important for clinicians to manage diagnostic and therapeutic processes successfully. Older age, the predominance of staphylococci and higher surgery rates are consistent with the changing trends of IE in some parts the world.Item Two Case of Rhino-Orbito-Cerebral Mucormicosis Developed After COVID-19 Infection(2021) Demiroglu, Yusuf Ziya; Odemis, Ilker; Oruc, Ebru; Ozer, Fulya; Ulas, Burak; Canpolat, Emine Tuba; Yalcin, Cigdem; Sanli, Ozlem Oguc; 0000-0003-2638-0163; 0000-0001-5381-6861; 0000-0003-2638-0163; 0000-0002-6099-4786; 34666667; AAG-2486-2022; ABC-1809-2020; AFK-3690-2022Coronavirus 2019 (COVID-19) infection causes excessive cytokine response and a decrease in cellular immune response and this increases susceptibility to fungal co-infections. Mucormycosis is a rare, life-threatening invasive fungal infection. In this report, two cases who developed rhino-orbito-cerebral mucormycosis shortly after having COVID-19 infection were presented. The first case was a 68-year old woman who admitted to our clinic with orbital cellulitis in her left eye and had a known diagnosis of asthma and rheumatoid arthritis. She was diagnosed with COVID-19 pneumonia 40 days ago, stayed in the intensive care unit for a long time, and received pulse steroid (1000 mg methylprednisolone), interleukin-1 (IL-1) inhibitor (anakinra) and broad-spectrum antibiotic treatments together with antiviral therapy during this period. The second case was a 63-year-old male patient with known diabetes mellitus, hypertension and retinitis pigmentosa, with a history of hospitalization in the intensive care unit due to COVID-19 pneumonia 20 days ago and received pulse steroid therapy during this period. He admitted to our clinic with the complaints of droopy right eyelid, swelling, nausea and vomiting. In both cases, paranasal sinus tomography findings were consistent with invasive sinusitis. Functional endoscopic sinus surgery was performed immediately in less than 16 hours from the first admission in both cases. Histopathological examination of the both cases revealed results consistent with mucormycosis. Mucorales spp. was isolated in sinus tissue culture of the second case taken during the operation. Both of the patients received liposomal amphotericin B. First case died on the 19th day of the treatment. Second case was discharged with full recovery after nine weeks of treatment. The suppression of cellular immunity during the COVID-19 infection, and the use of steroids and interleukin inhibitors in the treatment of severe cases may increase secondary invasive fungal infections. Therefore, clinicians should more frequently consider possible fungal infections in patients with COVID-19.Item Risk Factors for Urinary Tract Infection After Kidney Transplant: A Retrospective Analysis(2020) Tekkarimaz, Nihan; Ozelsancak, Ruya; Micozkadioglu, Hasan; Caliskan, Kenan; Demiroglu, Yusuf Ziya; Arslan, Ayse Hande; H, Mehmet; 0000-0001-5142-5672; 0000-0001-7631-7395; 0000-0002-0788-8319; 0000-0002-8767-5021; 0000-0002-3462-7632; 31424358; AAE-7608-2021; AAD-9088-2021; AAD-5716-2021; AAJ-7201-2021; AAJ-8097-2021Objectives: Urinary tract infections are the most common type of infections in kidney transplant recipients. They are also important factors for increased morbidity and mortality. The aims of this study were to evaluate the number of urinary tract infections, to identify possible donor/receiver-based risk factors, and to evaluate the impact of these infections on graft function. Materials and Methods: Medical records of patients who had undergone kidney transplant between 2010 and 2017 were retrospectively analyzed. Results: Our study included 145 patients (49 women [33.8%] and 96 men [66.2%]), with mean age of 35.2 +/- 12.4 years. There were 105 episodes of urinary tract infections in 55 of 145 patients (37.9%) during the first year after transplant. Female sex (P = .001), glomerulonephritis as primary kidney disease (P = .04), pretransplant diabetes (P = .05), and presence of ureteral stent (P = .03) were significant risk factors for the development of urinary tract infections. The most frequent pathogens identified were Escherichia coli and Klebsiella pneumoniae. Mean glomerular filtration rate at 12 months was significantly lower in patients with urinary tract infection than in patients without infection (80 +/- 25 vs 68 +/- 28 mL/min; P = .006). Conclusions: In kidney transplant recipients, urinary tract infections are common complications and have negative outcomes on graft function. These infections remain an important disease that requires frequent investigations and new ways of approach for prevention.