Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Evaluation of the COVID-19 Rapid Antigen Test(2023) Sanli, Ozlem Oguc; Kuscu, Ozlem Ozkan; Incekas, Caner; 0000-0001-7899-0233; 0000-0001-9019-423XIntroduction: Coronavirus disease, is an infectious disease caused by the SARS-CoV-2. The gold standard method to diagnose is the reverse transcriptase polymerase chain reaction test. Rapid antigen tests can also be used for diagnosis. This study aims to compare the results of these two methods.Materials and Methods: Between November 2021 and July 2022, the study included 1811 patients who visited the emergency depart-ment with coronavirus-related symptoms and signs. Respiratory samples from these patients were simultaneously evaluated using both reverse transcriptase polymerase chain reaction and rapid antigen tests. The reverse transcriptase polymerase chain reaction tests were conducted using the BioSpeedy SARS-CoV-2 reverse transcriptase polymerase chain reaction kit (Bioeksen-Turkiye), while the rapid antigen tests were performed using the RapidForTM SARS-CoV-2 Ag (Vitrosens-Germany).Results: The comparison of the reverse transcriptase polymerase chain reaction test and rapid antigen test results showed a 90.67% sensitivity, 98.28% specificity, 91.27% positive predictive value, 98.15% negative predictive value, and 97.02% (1757/1811) accuracy. Qualitative results of both tests exhibited a very good agreement (Kappa= 0.892, p< 0.001). According to the reverse transcriptase polymerase chain reaction test, the sensitivity of the rapid antigen test was found to be 100% in 28 samples with a cycle threshold <17, 100% in 78 samples with a cycle threshold <20, 98.33% in 120 samples with a cycle threshold <22, and 96.28% in 215 samples with a cycle threshold <25.Conclusion: When the results of the study are evaluated, it is seen that the use of the rapid antigen test for screening purposes and confirmation of patients with negative test results by Reverse transcriptase polymerase chain reaction will provide advantages in terms of both time and cost. Due to the low sensitivity and high positive predictive value of the vitrosens rapid antigen test, we think that this test can be used in the first stage to accelerate the diagnosis of patients with high viral load, who are more likely to be infectious, to prevent transmission and to start their treatment quickly.Item The Turkish Clinical Microbiology and Infectious Diseases Society (KLIMIK) Evidence-Based Guideline for the Diagnosis and Treatment of Brucellosis, 2023(2023) Simsek-Yavuz, Serap; Ozger, Selcuk; Benli, Aysun; Ates, Can; Aydin, Mehtap; Aygun, Gokhan; Azap, Alpay; Azap, Ozlem; Basaran, Seniha; Demirturk, Nese; Ergonul, Onder; Kocagul-Celikbas, Aysel; Kuscu, Ferit; Saricaoglu, Elif Mukime; Sayin-Kutlu, Selda; Turker, Nesrin; Turkoglu-Yilmaz, EmineAlthough brucellosis is very common in the world and Turkiye, there are no evidence-based guidelines to guide the diagnosis and treatment of the disease. This guide has been prepared by the Turkish Society of Clinical Microbiology and Infectious Diseases to provide evidence-based recommendations to physicians from different specialties interested in the diagnosis and treatment of brucellosis. The recommendations of the Clinical Practice Guide Development Guide of the Infectious Diseases Society of America (IDSA) were taken as the basis for preparing this guide. The guideline preparation group determined 20 questions considered to be important in the diagnosis and treatment of brucellosis, and the publications that could answer these questions prepared in PICO (Population/Patient [P], Intervention [I], Comparison [C], Outcome [O]) format, were searched in ULAKBIM Tr Dizin, PubMed, Cochrane databases without date restrictions. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group method was used to rank the evidence and determine the strength of the recommendations for each PICO question and for each individual outcome. Meta-analyses of comparative clinical studies were performed to answer the PICO questions. Individual participant data (IPD) meta-analyses with data obtained from case reports and case series were conducted in the absence of comparative clinical studies. It is planned to update the recommendations at regular intervals in line with the results of new studies.Item The Changes with the New Legislations(2023) Bicakcioglu, Murat; Gedik, EnderOrgan transplantation is the most important option for the treatment of end-stage diseases. However, there is a large difference between the number of patients on the waiting list and the number of transplants performed. The gradual increase in this difference creates ethical problems related to organ transplantation. Ethical problems and other limitations require organ transplantation to be controlled by legal regulations. In our country, organ transplantation practice is carried out under the supervision of the state. Organ Transplant Practice Regulation has been updated by being published in the Official Gazette dated 09.12.2022 and numbered 32008. Possible end-of-life decisions in brain death are stated in accordance with the conditions of our country. "In cases where brain death is diagnosed, the organ preservation protocols applied are terminated in the absence of family or legal guardian approval regarding organ donation. In case of organ donation by the family or legal guardian, the organ preservation protocols needed for donor care are continued during the period until the transplantation of the organ to the waiting patient", and a solution has been presented to the intensive care physicians for the prognosis of the cases that donated or could not be donated.In the regulation in which the prerequisites of the brain death diagnostic criteria are specified, it is stated that the central body temperature should be =36 degrees C. With the new regulation, end-of-life decisions on brain death and changes made in relation to central body temperature have brought convenience in the diagnosis and follow- up process.Item Ethics and Clinical Communications(2023) Yesiler, Fatma Irem; Gedik, EnderThe diagnosis of brain death has medical, legal and ethical aspects. While the main determinant is the medical approach of the physician in terms of ethics, legal situations are also effective in the process. Non-harm, beneficence, respect for autonomy and justice are the principles that are widely accepted and form the basis of medical ethics. Understanding these principles is a must in order to talk about the ethics of brain death and organ transplantation. In the process of diagnosis and management of brain death, the physician should convey the process to the relatives of the patients in a clear and understandable language and in accordance with the educational-cultural levels of the relatives of the patients. The fact that the concept of brain death is misunderstood in the society or lack of knowledge creates social ethical problems. Special training should be given to health professionals for brain death awareness and early diagnosis, and their ability to resolve ethical problems should be strengthened. Human resources are of great importance in the diagnosis of brain death and in the process of organ transplantation from a cadaver. Communication skills are the mainstay of interaction within the clinic. Organ transplant coordinators should run the process smoothly by creating a bridge between the physician responsible for the case and the intensive care physicians. Such an approach will reduce ethical issues and ensure a successful diagnosis and donation process.Item Ancillary Tests(2023) Zeyneloglu, Pinar; Bozbay, SuhaAncillary 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.Item Intravesical BCG Immunotherapy: Sepsis and Multiorgan Failure Developed After Traumatic Catheterization(2014) Cicek, Tufan; Togan, Turhan; Erinanc, Hilal; Ugur, Murat; Gonulalan, Umut; Cifci, Egemen; 0000-0003-1401-6356; AAL-1268-2021Intravesical Bacillus Calmette-Guerin (BCG) instillation is a prophylactic therapy using for treating bladder cancer to prevent tumour progression and recurrence. Both local and systemic complications can arise after the installation. Although local complications are common, this therapy is generally well tolerated. Systemic complications are rarely than local complications but can be fatal. We report a case who died from severe complications such as sepsis, pneumonia, renal failure and granulomatous hepatitis after receiving the first maintanence installation of intravesical BCG immunotherapy for bladder transitional cell carcinoma.Item Transpaeritoneal Laparoscopic Simple Nephrectomy: A Single Center Experience(2014) Cicek, Tufan; Sen, Erhan; Gonen, Murat; Gonulalan, Umut; Kosan, Murat; Ozturk, Bulent; 0000-0003-1944-1722; AAJ-8576-2021; AAA-7140-2021Purpose: In this study, we planned to evaluate the efficacy and perioperative outcomes of transperitoneal laparoscopic simple nephrectomy at Baskent University Konya Application and Research Center. Material and Methods: The demographic and perioperative data of patients who underwent transperitoneal laparoscopic simple nephrectomy at Baskent University Konya Application and Research Center Urology clinic between February 2005 and November 2013 were analyzed retrospectively. Operative time, perioperative laboratory results, the durations of hozpitalization and follow-up, perioperative complications and demographic characteristics of each patient were recorded. Results: Overall, 58 patients were included. 27 patients were male (46%) and 31 patients were female (54%). The mean age was 45.3 +/- 17.12 (6-79). The mean operative time was 104.4 +/- 36.5 (40-185) minutes. The mean hospitalization duration was 2.7 +/- 0.7 (2-5) days. The mean preoperative and postoperative hemoglobin levels were 13.7 +/- 1.74 and 12.4 +/- 1.73 mg/dl, respectively. Postoperative hemoglobin levels were statistically significatly lower than preoperative hemoglobin levels (p<0.001). 4 patients (%6.9) needed blood transfusion. 5 patients had grade I, 4 patients had grade II and 2 patients had grade III complications according to modified Clavien classification system. Conclusion: Transperitoneal laparoscopic simple nephrectomy seems to be a safe and efficacious treatment option as having low complication rates.Item A Rare Epididymal Mass: Leiomyoma(2014) Cicek, Tufan; Coskunoglu, Esra Zeynep; Demir, Canan Cicek; Akbaba, Kaan; Uzunkopru, Resit; JBF-7113-2023; AAK-4857-2021Leiomyoma is a benign smooth muscle tumor. It rarely rises from epididymal structures and usually is encountred in adults. The patient, who had undergone total epididymectomy for right scrotal mass at another center, was diagnosed with Epididymal Leiomyoma. He was admitted to our clinic for further evaluation and follow up. The previous eididymectomy specimens obtained and refered to our pathology department for confirmation of diagnosis. Microscopy revealed a benign neoplastic lesion, consisting of spindle cells. Which form interlacing bundels. Mitotic figures and tumor necrosis was not. Observed. The previous diagnosis is confirmed as the tumor showed immunohistochemical smooth muscule actin and Desmin posivity Whereas S-100 was not expressed with in the tumoral cells. This case report also overviews epididymal leiomyoma with recent literature findings.Item Lower Extremity Involvement of a Primarily Intracranial Hydatid Cyst: A Case Report(2014) Altinel, Faruk; Tuncel, Deniz; Ozturk, Ahmet; Acikalin, Mustafa FuatHydatid Cyst is a parasitic disease. The host is usually the intestine of dog. Hydatid cyst is caused by water and food contaminated with parasites' larva. Primary intracranial cyst hydatids are rare. Approximately 75% of intracranial cyst hydatids are encountered in children. We report a pediatric case with intracerebral hydatid cyst occuring with a lower extremity involvement 5 months after the surgery with clinical, radiological and histopathological features.Item A Rare Cause of Duodenal Obstruction: Intramural Hematoma(2014) Coban, Goken; Cifci, Bilal Egemen; Gokturk, Savas; Unler, Ayse Gulhan Kanat; Yildirim, Erkan; 0000-0002-9057-722X; ABI-3856-2020; P-7533-2014Small bowel obstruction due to intramural hematoma secondary to anticoagulant therapy is a rare complication. Other risk factors include hemophilia, idiopathic thrombocytopenic purpura, leukemia, lymphoma, myeloma, chemotherapy, vasculitis, pancreatitis, and pancreatic cancer. The presentation of patients is usually with abdominal pain, nause and vomiting. The patients who were admitted to the emergency clinic with acute abdominal pain and had a history of anticoagulant use with prolonged international normalized ratios should alert to search for intraabdominal hematoma. Herein, we present a patient who was admitted to the emergency clinic with acute abdominal pain, severe nausea and vomiting, and diagnosed by abdominal computed tomography.