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 Feasibility of the Interferon-Gamma Enzyme-Linked Immunospot Assay in Chronic Renal Failure Patients and Immunocompetent Subjects: A Head-To-Head Comparison(2015) Dilektasli, Asli Gorek; Durukan, Elif; Eyuboglu, Fusun Oner; 0000-0002-8579-5564; 0000-0002-5525-8207; 25387208; AAJ-8621-2021; AAR-4338-2020Diagnosis of latent Mycobacterium tuberculosis infection (LTBI) by the tuberculin skin test (TST) is hampered due to anergy and impaired sensitivity in chronic renal failure (CRF) patients. We aimed to compare the diagnostic performance of the TST with that of interferon-gamma immunospot (T-SPOT.TB (R)) assay in diagnosing LTBI in CRF and immunocompetent (IC) patients. A total of 74 CRF and 75 IC patients prospectively underwent the TST and T-SPOT. TB. Latent M. tuberculosis infection estimated by TST and T-SPOT. TB was detected in 69% and 43 of CRF; 52 and 35% of IC patients, respectively. The sensitivity and specificity of the T-SPOT. TB were 73 and 74% in IC, whereas 50 and 55% in CRF patients. In conclusion, the prevalence of LTBI was noteworthy in both IC and CRF patients. T-SPOT. TB was less sensitive and specific than the IC group in CRF patients. Both T-SPOT. TB and TST were not associated with the TB exposure.Item Papanicolaou Smear Findings in Solid-Organ Transplant Recipients Compared With Normal Subjects According to the Bethesda 2001 System(2015) Atilgan, Alev Ok; Tepeoglu, Merih; Haberal, A. Nihan; Durukan, Elif; Kuscu, Esra; Haberal, Mehmet; 0000-0002-9894-8005; 0000-0002-3462-7632; 0000-0001-9852-9911; 0000-0001-8595-8880; 0000-0002-0992-6980; 0000-0002-8579-5564; 25894158; AAK-5222-2021; AAJ-8097-2021; AAK-4587-2021; AAK-3333-2021; AAI-8792-2021; AAJ-8621-2021Objectives: Solid-organ transplant recipients are at increased risk of developing cancer including cervical cancer compared with woman in the general population, mostly due to long-term immunosuppressive therapy. The Papanicolaou smear remains the primary method of screening cervical pathology including preinvasive and invasive lesions. The objective of this study was to evaluate Pap smear findings in solid-organ transplant recipients, determine the prevalence of abnormal smears, and compare these patients with the general population. Materials and Methods: We retrospectively examined 111 women patients who received liver or kidney transplant between January 1990 to December 2012 at Baskent University Ankara Hospital. Pap smear findings were compared with normal control patients matched for same age and technical procedure of cervical cytology. To selection of control patients, propensity score matching program was performed. All Pap smears were re-examined according to Bethesda 2001 criteria. Results: In 111 transplant patients, 2 patients (1.8%) had atypical squamous cells of undetermined significance, 8 patients (7.2%) had low-grade squamous intraepithelial lesion, 15 patients (13.5%) had Candida infection, 2 patients (1.8%) had Trichomonas vaginalis, 1 patient (0.9%) had herpes simplex infection, 13 patients (11.7%) had bacterial vaginosis, 15 patients (13.5%) had reactive changes due to inflammation, and 18 patients (16.2%) had atrophy. When we compared our results with the control group, there were statistically significant differences (P <= .05) between the 2 groups in epithelial cell abnormalities (low-grade squamous intraepithelial lesion), Candida infection, bacterial vaginosis, and atrophy. Conclusions: Pap smear screening potentially may help recognize cervical preinvasive and invasive lesions. The risk of developing cervical intraepithelial neoplasia is greater in transplant recipients because of immunosuppressive therapy. The incidence of low-grade squamous intraepithelial lesion was significantly greater in transplant recipients than the general population. Intensive follow-up with Pap smear in transplant recipients is important in the early detection of these lesions.Item Serum Interleukin-18 As an Early Marker of Acute Kidney Injury Following Open Heart Surgery(2014) Unal, Ertekin Utku; Ozen, Anil; Boysan, Emre; Tak, Sercan; Basar, Veysel; Turkcan, Basak Soran; Durukan, Elif; Tutun, Ufuk; Birincioglu, Cemal Levent; https://orcid.org/0000-0002-8579-5564; AAJ-8621-2021Background: This study aims to investigate whether serum interleukin (IL)-18 is an early biomarker of acute kidney injury (AKI). Methods: Thirty consecutive patients (22 males, 8 females; mean age 62.4 +/- 9.0 years; range 49 to 78 years) who underwent open-heart surgery were enrolled in this prospective study. Serum IL-18 concentrations were analyzed prior to induction of anesthesia, at weaning from cardiopulmonary bypass (CPB) and two hours after weaning from CPB. Serum creatinine levels were analyzed in the postoperative first, second, and third days. Acute kidney injury was defined as creatinine levels exceeding 50% of the basal value or exceeding the basal value by 0.3 mg/dl at 48 hours postoperatively. The patients were classified into two groups including AKI (n=12) and non-AKI (n=18). Serum IL-18 levels were compared between the groups. Results: Twelve patients (40%) developed AKI. The diagnosis was able to be made using the serum creatinine levels at 24 to 48 hours postoperatively. Although IL-18 concentrations at weaning from CPB decreased slightly in the AKI group, the decrease in the non-AKI presenting group was higher. Using univariate analyses, IL-18 concentrations at two hours after weaning from CPB were found to be related to AKI (p=0.031). The difference in serum IL-18 concentrations between the preoperative period and two hours after weaning from CPB were found to be statistically significant (p=0.017). According to the Receiver operating characteristic curve analysis, the threshold value for AKI prediction of serum IL-18 concentrations at two hours after weaning from CPB was 353.7 pg/ml with a sensitivity of 58.3% and a specificity of 83.3% (AUC=0.736). Conclusion: Serum IL-18 concentration may be used as a biochemical indicator for early detection of acute kidney injury following open heart surgery.Item University Students with Psoriatic Nail Changes Have a Greater Number of Tender Enthesial Points Than Those with Normal Nails(2014) Yucel, A. Eftal; Pamukcu, Melih; Durukan, Elif; Tosun, Busra; Batman, Berk; Ozkan, Omer; Korcak, Anil; https://orcid.org/0000-0002-8579-5564; AAJ-8621-2021Item A University Hospital Patients and Their Relatives' Opinions on Violence in Health(2017) Yasar, Zehtiye Fusun; Durukan, Elif; Buken, Erhan; 0000-0002-4779-0623; 0000-0002-8579-5564; AAL-6847-2021; AAJ-8621-2021Background. Currently, sectors rendering service for the public such as health, education transport and etc. are frequently exposed to violence without discriminating between age, gender, educational level and occupation. Within these sectors, health sector constitutes the most risky group because it generally renders service to individuals who are distressed and need care Aims. The study aimed to determine the opinions of patients and patient relatives s on violence against health professionals Methods: This descriptive study conducted in January-February 2015 and was implemented on 192 patients and patient relatives applied to a university hospital and who consented to participate the study. A questionnaire form was applied to the participants. IBM SPSS 22.0 statistical package program was used to analyze the data. Results. The mean age of the study participants was 41.3 +/- 13.7; 52,1 % were females and the educational level of 65.6% is university/doctorate level. Nearly 88% of patients stated that violence is not a method for seeking legal remedies, and they believed that it is wrong to use violence against the intervening doctor even in case where it was not possible to save the patient (91.7%). The participants stated that the cause of the increase in violence against health care workers; was related to lack of education of the patients and their relatives (73.2%) and was associated with longer waiting times in hospitals for examination (53.2%). Participants stated the reasons for getting angry in a healthcare facility as being ignored by healthcare professionals (76.6%) and failure in being informed about their patients' status. (54.2%). Thirteen (6.8%) of participants stated that they used violence against healthcare professionals and 7 of these stated that the incident took place in the emergency room. Conclusion. To prevent the violence cases, all individuals constituting the public, including patients/patient relatives and healthcare professionals should be trained. We think that presence of health care providers having high communication skills to communicate the individuals applied to health institution due to their illnesses and presence of effective security systems will contribute to solving of the problem.Item Does the Urea Breath Test Predict Eradication of Helicobacter Pylori Infection(2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Durukan, Elif; Erhamamci, Seval; https://orcid.org/0000-0003-0182-002X; https://orcid.org/0000-0002-8579-5564; 26852756; AAJ-8621-2021Background/Aim : Helicobacter pylori infection is common world-wide and has been linked to development of gastric and duodenal ulcers, gastric adenocarcinoma, and gastric lymphoma. However, antimicrobial resistance has decreased H. pylori eradication rates worldwide. This study aimed to evaluate the effect of-bacterial load on eradication rate. Method : This prospective study included 237 consecutive patients who presented to our institution with dyspeptic symptoms and underwent both upper endoscopy and urea breath tests (UBT). The patients were divided into three equal sized groups according to their UBT values. All subjects received a standard triple eradication regimen, followed by a bismuth-based quadruple eradication regimen if triple eradication was not successful. The three groups were compared with respect to age, endoscopic findings, sex, and eradication rates. Results : Our results were consistent with those of previous studies : higher UBT values were associated with failure of standard 14-day triple treatment (p < 0.05). However, in patients who received a quadruple eradication regimen, differences between groups were not significant (p = 0.434). There was no relationship between UBT values and gastric pathologies (p = 0.751). Age and sex also did not differ significantly between groups (p = 0.061). Conclusions : Our study and others have found that high bacterial loads are negatively associated with achievement of eradication with triple treatment. However, differences between groups were not significant in patients who received a quadruple eradication regimen. Comparisons of treatment results according to bacterial density may be informative. The importance of H. pylori density should be further evaluated with new treatment protocols.Item Evaluation of the Effect of Periodontitis on Quality of Life Using Oral-Dental Health-Related Quality of Life-United Kingdom Scale(2021) Kutsal, Derya; Cetin, Mehtap Bilgin; Durukan, Elif; Bulut, Sule; 0000-0002-8579-5564; 33797852; AAJ-8621-2021Objective The aim of this study was to investigate the impact of periodontitis on oral health-related quality of life (OHQoL) using Oral-Dental Health-Related Quality of Life-United Kingdom (OHRQoL-UK) scale and evaluate the contributing factors. Methods 50 patients with untreated periodontitis and 50 individuals without periodontitis were enrolled in the study. All subjects received detailed periodontal examination. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) measurements were examined. OHRQoL was assessed by the Oral Health Quality of Life-United Kingdom (OHRQoL-UK) scale. Symptoms of periodontitis were monitored by visual analogue scale (VAS). Socio-demographic characteristics, medical history, smoking status, hygiene habits of the participants were recorded. This study is registered at ClinicalTrials.gov as NCT04240014. Results Total OHRQoL-UK scores were 38.24 +/- 6.47 in periodontitis patients and 55.88 +/- 9.38 in non-periodontitis individuals (p < 0.001). The scores of all 4 parameters were significantly lower in patients with periodontitis compared to healthy individuals (p <0.001). Higher PI, GI, PD and CAL values were associated with extensive negative impacts of periodontitis on OHRQoL (p < 0.001). According to the results of linear regression analysis, only periodontitis was found to associate with OHRQoL. Periodontal disease reduces the total quality of life score by 15.087 (ss= -15.087; 95% CI = [(-18.934)-(-11.240)]. Conclusions Individuals with periodontitis has diminished OHRQoL compared to healthy individuals.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 Knowledge Level of Dentists in Turkey About Their Potential Role on the Disaster Victims Identification (DVI) Team(2019) Yasar, Zehtiye Fusun; Durukan, Elif; Buken, Erhan; 30417805Objective Although dentists are valuable assets in identification teams during disaster events, forensic dentistry is not used effectively in the identification studies conducted in Turkey, and the importance of dental data is ignored. The aim of this study was to determine the level of knowledge of dentists regarding their duties and responsibilities during major disasters. Methods This descriptive study was conducted between December 2015 and June 2016. Registered dentists (n=20.280) of the Turkish Dental Association were invited to complete the organization's online survey. A total of 539 dentists participated in the volunteer workshop. Data were analyzed using SPSS, version 22.0 (IBM Corp, Armonk, NY). The chi-square analysis was used to evaluate the knowledge level of dentists by group regarding disaster victim identification (DVI) - the process and procedure of recovering and identifying victims of major disasters (eg, earthquake, terrorist attack). Results The dentists included in the study consisted of 320 (59.4%) females and 219 (40.6%) males with a mean age of 37.4 +/- 12.6 years. The number of specialists and general dentists were 249 (45.6%) and 297 (54.4%), respectively; 249 (69.71%) dentists who had knowledge about forensic dentistry stated that they received this information during their formal training. The percentage of dentists who were aware of the existence of an organization of a disaster response operation in Turkey was 74.2%, but only 20.5% (n=110) had knowledge about DVI. We found that 92.9% (n=104) of these dentists believed that dentists should be included in the team for the identification of disaster victims. On the other hand, only half (52.3%) of the dentists with knowledge of DVI wanted to work on the identification teams. The majority (99.1%) considered DNA analysis to be the safest method for identification. Conclusion Our findings show that, although dentists know about the identification process, they do not have enough relevant knowledge. (Disaster Med Public Health Preparedness. 2019;13:533-538)