Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Innovations in Cervical Cancer Treatment-There is Still Room for Improvement(2023) Onal, Cem; Yavas, Guler; HOC-5611-2023; AAE-2822-2020Item Evaluation of Nutritional Status in Pediatric İntensive Care Unit Patients: The Results of A Multicenter, Prospective Study in Turkey(2023) Ozkale, Murat; 37601138; A-7806-2016IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score.Item The Influence of Different Sugammadex Doses on Neural Tube Development in Early-Stage Chick Embryos(2023) Ayhan, Asude; Efe, Ekin; Fidan, Pinar A.; Efe, Oguzhan E.; Ates, Eylem Gul; Sahinturk, Fikret; Ayhan, Selim; 0000-0002-6166-2601; 0000-0001-6955-9839; 0000-0002-3243-7843; 0000-0003-3047-0305; 0000-0002-0471-3177; 37565787; HGE-9282-2022; AAJ-2057-2021; AAJ-4728-2021; W-7908-2019; ABG-5365-2020; AAI-7972-2021Background: Sugammadex is a modified gamma-cyclodextrin that has been developed with the goal of reversing the steroidal neuromuscular blocking agents. The aim of the present study is to investigate the effects of different sugammadex doses on embryologic and neural tube development in an early-stage chick embryo model. Methods: A total of 100 specific pathogen-free, fertilized domestic chicken eggs were randomly divided into five groups (n = 20, each), and placed in an automatic cycle incubator. The eggs in the "control (C)" group were incubated without administration of any drug till the end of the experiment. Subblastodermic administration of 0.9% NaCl as vehicle control (VC) and different doses of sugammadex solutions prepared with the latter [2 mg/mL (LD), 4 mg/mL (MD), 16 mg/mL (HD)] were performed at 30 hr of incubation. All embryos were removed from the eggs at 72 hr when they were expected to reach Hamburger-Hamilton (HH) stages 19-20, then they were fixed, and evaluated histo-morphologically. Results: Embryonic development was not observed in 11 eggs (1 in C, 1 in VC; 3 in LD, 3 in MD, and 3 in HD). All the developed embryos were compatible with the HH stages 19-20. A neural tube closure defect was detected in one embryo in the HD group. No statistically significant difference was found between the groups in terms of embryonic and neural tube developments. Conclusions: No significant association was found between the drug and adverse outcomes; however, a trend with dosing was seen. Further studies are required before conclude on safety and extrapolate these results to human beings.Item Pulmonary Embolism as the First Sign of Hepatocellular Carcinoma in A Patient Who Was Cured After Five Years(2023) Esendagli, Dorina; Rahatli, Samed; Hekimoglu, Koray; Bozbas, Serife Savas; AAJ-3047-2021Pulmonary embolism (PE) is a preventable cause of death associated with high morbidity and mortality rates. Cancer is a significant risk factor for PE. In this case report, we present a patient with PE who was diagnosed with hepatocellular carcinoma (HCC) one month later. The patient had an unresectable tumor in the liver that had invaded both the inferior vena cava and the right atrium. He underwent transarterial chemoembolization (TACE) and sorafenib treatment. After two years, he underwent stereotactic radiosurgery, and he was switched to regorafenib. After five years, he was cured. This case is unique in terms of long survival compared to the literature.Item Determination of Risk Factors for Postoperative Acute Kidney Injury in Patients With Gynecologic Malignancies(2023) Doganci, Melek; Zeyneloglu, Pinar; Kayhan, Zeynep; Ayhan, Ali; 37575800; IVV-1127-2023; C-3736-2018; AAJ-4623-2021BackgroundPostoperative acute kidney injury (AKI) is an important cause of mortality and morbidity among surgical patients. There is little information on the occurrence of AKI after operations for gynecologic malignancies. This study aimed to determine the incidence of AKI in patients who underwent surgery for gynecological malignancies and determine the risk factors in those who developed postoperative AKI. MethodologyA total of 1,000 patients were enrolled retrospectively from January 2007 to March 2013. AKI was defined according to the Kidney Disease Improving Global Outcomes 2012 Clinical Practice Guideline for Acute Kidney Injury. Perioperative variables of patients were collected from medical charts.ResultsThe incidence of postoperative AKI was 8.8%, with stage 1 occurring in 5.9%, stage 2 in 2.4%, and stage 3 in 0.5% of the patients. Patients who had AKI were significantly older, had higher body mass index (BMI) higher preoperative C-reactive protein (CRP) levels, and more frequently had a history of distant organ metastasis when compared with those who did not have AKI. When compared with patients who did not develop AKI postoperatively, longer operation times and intraoperative usage of higher amounts of erythrocyte suspension and fresh frozen plasma were seen in those who developed AKI. ConclusionsPatients who had AKI were older, had higher BMI with higher preoperative CRP levels, more frequent distant organ metastasis, longer operation times, and higher amounts of blood transfused intraoperatively. Defining preoperative, intraoperative, and postoperative risk factors for postoperative AKI and taking necessary precautions are important for the early detection and intervention of AKI.Item Detection of Visual-Auditory Reaction Rates in Individuals with Type 2 Diabetes Mellitus(2023) Bilaloglu, Melisa; Ergun, Ahmet; Altay, Feride P.; Iyidir, Ozlem T.; Kiziltan, Erhan; 0000-0002-9994-9405; 0000-0001-6029-3835; 0000-0001-5305-6807; AAL-7975-2021; AAD-6090-2021; K-7904-2019AIM:The primary purpose of our study was to understand the damage in the peripheral nerves of patients with diabetes and to determine the change in patients' reaction rates and perceptions by the age groups, duration of diabetes, fasting plasma glucose and HbA1c values, and compare these with those of the healthy individuals. METHODS: This study was carried out at the Baskent University Hospital Endocrinology and Metabolic Diseases Outpatient Clinic. A total of 64 patients diagnosed with type 2 diabetes and 64 healthy controls were included in the study. Finger tapping, visual, and auditory reaction time tests were performed on the subjects, respectively. The subjects' fasting plasma glucose and HbA1c levels, and the duration of their diabetes were recorded. Analyses were per -formed using the SPSS version 25. Differences were considered statistically significant when the p-value is <0.05. RESULTS: It was observed that the participants in the control group between the ages of 18-34 showed a faster reaction in all tests (p=0.01), but the difference in reaction rates in both groups decreased as the age increased. There were positive cor-relations between the duration of type 2 diabetes and the visual and auditory examination results (r= 0.69, p<0.05, r=0.52, p<0.05, respectively). There was also a positive correlation between the HbA1c (%) and the visual (r=0.97, p<0.05) examina-tion results. CONCLUSIONS: As the patients' HbA1c levels and the time spent with type 2 diabetes increased, their reaction rate and per-ception skills decreased. Especially in the early stages of the disease, cognitive decline was observed to be rapid. It is thought that diabetic control is significant.Item The Effect of Acupressure Applied to Different Fistula Area on Fistule Needle Entry Pain(2023) Turgay, Gulay; Cevik, Banu; Inanoglu, Isilay; Kaya, Semiha; AAN-3284-2021Item The Effect of Glomerular C3 Deposition on Renal Outcome in Patients with Membranous Nephropathy: Data of the Tsn-Gold Study(2023) Gursu, Meltem; Ceheci, Egemen; Turkmen, Aydin; Dervisoglu, Erkan; Sezen, Mehnet; Turgutalp, Kenan; Sahin, Gulizar Manga; Trablus, Sinan; Kutlay, Sim; Uzun, Sami; Ustundag, Sedat; Dursun, Belda; Ayli, Deniz; Tatar, Erhan; Oztop, Kenan Evren; Basturk, Taner; Cevher, Simal Koksal; Yilmaz, Zulfikar; Tunca, Onur; Sevinc, Mustafa; Yadigar, Serap; Duranay, Murat; Arikan, Izzet Hakki; Elciuglu, Omer Celal; Karakan, Sebnem; Turkmen, Kultigin; Torun, Dilek; Gungor, Ozkan; Artan, Ayse Serra; Ozturk, Savas; Unsal, Abdulkadir; Seyahi, Nurhan; AAD-9111-2021Item Characteristics and Survival Data of Patients with Primary Focal Segmental Segmental Glomerulosclerosis: Tsn-Goldmulti-Center Study(2023) Dheir, Hamad; Cebeci, Egemen; Karadag, Serhat; Yildiz, Abdulmecit; Guller, Nurana; Altiparmak, Mehmet Riza; Eren, Necmi; Yilmaz, Zulfikar; Basturk, Taner; Sipahi, Savas; Sahin, Gulizar; Bakar, Betul; Okyay, Gulay Ulusal; Suleyman, Gultekin; Piskinpasa, Serhan Vahit; Dursun, Belda; Balal, Mustafa; Turgutalp, Kenan; Guzel, Fatma Betul; Kutlay, Sim; Tatar, Erhan; Elcioglu, Omer Celal; Karakan, Sebnem; Kayalar, Arzu Ozdemir; FarukAkcay, Omer; Yildirim, Tolga; Sahin, Idris; Sahin, Garip; Ogutmen, Melike Betul; Tokgoz, Bulent; Tunca, Onur; Gul, Cuma Bulent; Kurultak, Ilhan; Torun, Dilek; Ayar, Yavuz; Uzun, Sami; Yavuz, Mahmut; Oto, Ozgur Akin; Dincer, Mevlut Tamer; Ergul, Metin; Ozturk, Savas; Turkmen, Aydin; AAD-9111-2021Item Transarterial Chemoembolization Combined with Simultaneous Thermal Ablation for Solitary Hepatocellular Carcinomas in Regions with a High Risk of Recurrence(2023) Ozen, Ozgur; Boyvat, Fatih; Zeydanli, Tolga; Kesim, Cagri; Karakaya, Emre; Haberal, Mehmet; 0000-0001-7122-4130; 37455470; JVO-4809-2024; AAD-5996-2021; AAD-5466-2021; F-4230-2011; AAN-1681-2021Objectives: We evaluated the safety and efficacy of transarterial chemoembolization combined with percutaneous thermal ablation (radiofrequency or microwave ablation) in the treatment of solitary hepatocellular carcinoma tumors ranging from 2 to 4.5 cm at subdiaphragmatic, subcapsular, or perivascular locations. Materials and Methods: Fifteen patients (12 men, mean [range] age of 66.6 +/- 10.88 [34-75] y) who received transarterial chemoembolization combined with simultaneous percutaneous radiofrequency ablation (n = 5) or microwave ablation (n = 10) for hepatocellular carcinoma in regions with high risk of recurrence (subdiaphragmatic, subcapsular, or perivascular) between 2012 and 2018 were evaluated. We retrospectively investigated tumor diameter and localization, success rate, safety, local efficacy (imaging at month 1 after treatment), local tumor response (3 months posttreatment), local tumor progression, intrahepatic distant recurrence, overall survival and complications. Results: Tumor diameter ranged from 20 to 45 mm (mean 31.7 +/- 7.37 mm). Hepatocellular carcinoma diameter was 2 to 3 cm in 7 patients and 3.1 to 4.5 cm in 8 patients. The technical success rate was 100%, with no life-threatening complications. At enhanced imaging at 1-month follow-up, the complete necrosis rate was 100%; at 3 months, 100% of patients had a complete response. During a mean follow-up of 26 +/- 13.6 months, 7 patients (46.7%) had tumor progression. Three patients (20%) had local tumor response, and 4 patients (26.7 %) experienced distant recurrences in the untreated liver. The mean local tumor progression and mean intrahepatic distance recurrence times were 11 months and 29.5 months, respectively. Overall survival rates were 100% at 1 year, 73% at 3 years, and 47% at 5 years. Conclusions: Transarterial chemoembolization combined with simultaneous percutaneous thermal ablation is safe, feasible, and effective in enhancing the local control rate for solitary hepatocellular carcinoma ranging from 2 to 4.5 cm in regions with high risk of recurrence.