Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Evaluation of Clinical Approach and Outcomes Staphylococcus aureus Bacteremia(2023) Yanik Yalcin, Tugba; Erol, Cigdem; Demirkaya, Melike Hamiyet; Durukan, Elif; Kurt Azap, Ozlem; 0000-0002-3171-8926; 0000-0001-5996-8639; 0000-0002-8579-5564; 0000-0002-2535-2534; 38633900; AAK-4089-2021; AAA-4708-2022; AAJ-8621-2021; AAJ-1219-2021Objective: Despite appropriate treatment and early diagnosis methods, Staphylococcus aureus bacteremia (SAB) is still associated with a high mortality rate. This study aims to evaluate the clinical features and approaches to SAB and to analyze the parameters that may affect 7-day and 30-day mortality. Materials and Methods: Adult patients with SAB data between 2011 and 2018 were evaluated retrospectively. Clinical data, patient demographics, and 7-day and 30-day mortality rates were obtained from their medical records.Results: In total, 144 patients were included in the study; 57.6% (83/144) of patients were men, and the mean age was 65.2 +/- 16.5 years. The most common source of infection was the central-line catheter (38.9%), followed by intra-abdominal (21%), respiratory (16.7), infective endocarditis (5.6%), and osteoarticular foci (2.1%). Fifteen percent (15%) of the strains were methicillin resistant. Transthoracic echocardiography (TTE) was performed for 80.6% (116/144) patients. Infectious diseases specialist consultation within 96 hours from blood culture signal was requested in 79.9%. Overall, 7-day mortality was 11.8%, and 30-day mortality was 21.5%. Staying in intensive care units (ICU) increased the risk of 30-day mortality by 1.1 times, and respiratory-focused SAB increased the risk by 4.3 times.Conclusion: SAB is still a big threat. Staphylococcal pneumonia remains a severe infection. Several prognostic factors influence mortality. Identifying the source, ensuring source control, and appropriate initial therapy as soon as possible are critical for reducing mortality and morbidity in SAB.Item The Evaluation of Vaccine Hesitancy and Refusal for Childhood Vaccines and the COVID-19 Vaccine in Individuals Aged Between 18 and 25 Years(2021) Durukan, Elif; Akdur, Recep; 0000-0002-9766-1117; 0000-0002-8579-5564; AAK-1044-2021; AAJ-8621-2021Objective: The aim of this study is to determine vaccine hesitancy and refusal for childhood vaccines and the Coronavirus disease-2019 (COVID-19) vaccine in individuals aged between 18 and 25 years and the affecting factors. Materials and Methods: In this descriptive study, an online questionnaire was implemented on 1.033 people aged between 18 and 25 years and living in Turkey between January 28, 2021, and February 19, 2021, by reaching them via e-mail and messaging applications. Results: Among the participants, 68.8% considered getting their children vaccinated, 11.4% were hesitant and 3.1% refused. Among the participants, 36.6% considered getting vaccinated against COVID-19, 34.8% hesitated and 28.6% refused. Hesitation/rejection of childhood vaccines increased with age and when negative information about childhood vaccines was obtained. The acceptance of the COVID-19 vaccine was higher in men, in those who assumed that the COVID-19 virus was of a natural origin, in those who obtained information on the COVID-19 vaccine from the Ministry of Health, and in those who made search in scientific papers. Conclusion: The rates of hesitation and rejection in the COVID-19 vaccines are quite high compared to childhood vaccines. It shows that participants are influenced by speculative news. Therefore, it is recommended that this age group be given trainings based on scientific evidence regarding both childhood vaccines and the benefits of the COVID-19 vaccine.Item The Prevalence, Etiologic Agents and Risk Factors for Urinary Tract Infection Among Spinal Cord Injury Patients(2014) Togan, Turhan; Azap, Ozlem Kurt; Durukan, Elif; Arslan, HandeBackground: Urinary tract infections (UTIs) are important causes of morbidity and mortality in patients with spinal cord injury and 22% of patients with acute spinal cord injury develop UTI during the first 50 days. Objectives: The aim of this study was to determine the prevalence, etiologic agents and risk factors for asymptomatic bacteriuria and symptomatic urinary tract infections in patients with spinal cord injury. Patients and Methods: This was a prospective investigation of spinal cord injury patients with asymptomatic bacteriuria and symptomatic urinary tract infections in Baskent University Medical Faculty Ayas Rehabilitation Center and Ankara Physical Therapy and Rehabilitation Center between January 2008 and December 2010. The demographic status, clinical and laboratory findings of 93 patients with spinal cord injury were analyzed in order to determine the risk factors for asymptomatic or symptomatic bacteriuria Results: Sixty three (67.7%) of 93 patients had asymptomatic bacteriuria and 21 (22.6%) had symptomatic urinary tract infection. Assessment of the frequency of urinary bladder emptying methods revealed that 57 (61.3%) of 93 patients employed permanent catheters and 24 (25.8%) employed clean intermittent catheterization. One hundred and thirty-five (48.0%) of 281 strains isolated form asymptomatic bacteriuria attacks and 16 (66.6%) of 24 strains isolated from symptomatic urinary tract infection attacks, totaling 151 strains, had multidrug resistance (P > 0.05). One hundred (70.4%) of 142 Escherichia coli strains and 19 (34.5%) of 55 Klebsiella spp strains proliferated in patients with asymptomatic bacteriuria; 8 (80%) of 10 E. coli strains and 4 (80%) of 5 Klebsiella spp. strains were multidrug resistant. Conclusions: The most common infectious episode among spinal cord injury patients was found to be urinary tract infection. E. coli was the most common microorganism isolated from urine samples. Antibiotic use in the previous 2 weeks or 3 months, hospitalization during the last one-year and previous diagnosis of urinary tract infection were the risk factors identified for the development of infections with multi-drug resistant isolates. Urinary catheterization was found to be the only independent risk factor contributing to symptomatic urinary tract infection.Item Burnout Syndrome Among Physicians: The Role of Socio-Demographic Characteristics(2017) Ozkula, Guler; Durukan, Elif; 0000-0002-8579-5564; AAJ-8621-2021Objective: Burnout is a syndrome that occurs in occupational groups, which are in close relation with people and includes dimensions of; emotional exhaustion, depersonalization and low sense of personal accomplishment. The aim of the present study is to investigate the relationship between socio-demographic characteristics and burnout syndrome in academic personel working at a hospital of Faculty of Medicine. Method: 258 physicians working at Baskent University Ankara Hospital have been included in the present study voluntarily, between January - April 2014 and they have been administered Socio-Demographic Data Form and Maslach Burnout Inventory. Results: Age, academic title, time span in the profession and at the institution, the number of patients daily examined, administrative tasks, receiving research supports, the number of lectures given were related to all dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment. Personnel assignment, the number of monthly shifts, daily duration of work were related to emotional exhaustion and depersonalization. Specialty preferences and intention to continue on the profession were associated with emotional exhaustion and personal accomplishment. Personnel assignment criteria and time reserved for academic study were related to only emotional exhaustion whereas accessibility to scientific literature was linked to personal accomplishment. Conclusion: Older age, having an academic title, longer time span in the profession and at the institution, concidering the long term consequences of specialty selection are all individual factors that can be related to burnout syndrome. Developing health policies for an optimal organization of daily work duration, number of patients daily examined and personnel assignment criteria could prevent burnout. Also developing organizational climate to create time for academic study, supporting researches, increasing accessibility to scientific literature and optimization of education seminars in academic physicians could protect them from burnout syndrome. Prospective studies modeling individual and organizational risk factors for burnout on academic physicians will help to further illuminate the measures to protect physicians from burnout syndrome and also contribute to the enhancement of treatment service quality and foster the contribution to academic arena.