Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
Browse
14 results
Search Results
Item Re-Evaluation of Logistics Strategy During COVID-19 Pandemic Environment: Reduced Customer Service Commitment(2023) Kara, Ali; Spillan, John E.; Acikdilli, Gaye; Kirkbesoglu, Erdem; 0000-0002-6781-9753; ABI-3973-2020The Bowersox and Daugherty's (1987) typology has been tested in international markets, providing valuable insights into its relevance. However, the literature has yet to examine its effectiveness in business environments affected by pandemics. The purpose of this study is to empirically assess the resilience of the logistics strategy framework in an emerging market during the COVID-19 pandemic. To measure the three dimensions of the overall logistics strategy, as well as mediator variables such as logistics integration and customer service commitment, we collected 326 responses from logistics managers in Turkey. Using a structural equation model (SEM), we found that the three dimensions of the overall logistics strategy remained robust during the pandemic, thus supporting the durability of the Bowersox and Daugherty's (1987) framework. However, the customer service commitment was found to have a statistically insignificant role in mitigating the overall logistics strategy and the firm's competitive responsiveness.Item Clinical Features of SARS-CoV-2 Infection in Patients Undergoing Solid-Organ Transplant: Baskent University Experience(2023) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Tek, Korhan; Bozbas, Serife Savas; Erol, Cigdem; Buyukasik, Piril; Haberal, Kemal Murat; Arslan, Ayse Hande; Akcay, Muserref Sule; Haberal, Mehmet; 0000-0002-2535-2534; 34635037; AAJ-1219-2021Objectives: The clinical features and treatment approaches, outcomes, and mortality predictors of COVID-19 in solid-organ transplant recipients have not been well defined. This study investigated the clinical features of COVID-19 infection in solid-organ transplant recipients at our center in Turkey. Materials and Methods: Our study included 23 solid-organ transplant recipients and 336 nontransplant individuals (143 previously healthy and 193 patients with at least 1 comorbidity) who were hospitalized due to COVID-19 disease in our hospital between March 2020 and January 2021. Demographic, clinical, and laboratory data of patients were compared. We used SPSS version 20.0 for statistical analysis. All groups were compared using chi-square and Mann-Whitney U tests. P <.05 was considered statistically significant. Results: Mean age of solid-organ transplant recipients was 49.8 +/- 13.7 years (78.3% men, 21.7% women). Among the 23 recipients, 17 (73.9%) were kidney and 6 (26.1%) were liver transplant recipients. Among nontransplant individuals, 88.7% (n = 298) had mild/moderate disease and 11.3% (n = 38) had severe disease. Among transplant recipients, 78.3% (n = 18) had mild/moderate disease and 21.7% (n = 5) had severe disease (P =.224). Transplant recipients had greater requirements for nasal oxygen (P =.005) and noninvasive mechanical ventilation (P =.003) and had longer length of intensive care unit stay (P =.030) than nontransplant individuals. No difference was found between the 2 groups in terms of mortality (P =.439). However, a subgroup analysis showed increased mortality in transplant recipients versus previously healthy patients with COVID-19 (P <.05). Secondary infections were major causes of mortality in transplant recipients. Conclusions: COVID-19 infection resulted in higher mortality in solid- organ transplant recipients versus that shown in healthy patients. More attention on secondary infections is needed in transplant recipients to reduce mortality.Item The Impact of COVID-19 Infection on Hemodialysis Patients vs Kidney Transplant Patients(2023) Tasci, Halil Ibrahim; 38131360AIM: AS in the whole world, there has been a decrease in the number of both cadaveric and living-donor kidney transplants in our country due to the COVID-19 pandemic. This study aimed at comparing the data of patients who previously underwent a kidney transplant in our clinic and patients on hemodialysis treatment and were diagnosed with COVID-19 during their follow-ups to find answer to the question "Should we postpone kidney transplants during the pandemic or perform transplants as soon as possible?". MATERIAL AND METHOD: Among those diagnosed with COVID-19 during follow-ups between March 2020 and March 2021 and treated on an inpatient or outpatient basis, the data of patients who previously underwent a kidney transplant in Baskent University Faculty of Medicine, Department of Transplantation, Konya Practice and Research Hospital and hemodialysis patients followed up by the Nephrology Clinic were retrospectively analyzed. RESULTS: In our study, intensive care stay (Group 1:48.8%, Group 2: 40.4%, P=.34), intubation requirement (Group 1: 35%, Group 2: 34.6%, P=.96) and mortality (Group 1: 36.3%, Group 2: 34%, P=.84) rate was higher in the hemodialysis group, although no statistically significant difference was found. CONCLUSION: All this literature information and our study suggests that mortality rates were statistically similar or lower for transplant group. So it is unnecessary to delay kidney transplantation in patients with appropriate indications.Item Medical Education in Times of Pandemic: To Practice or to Protect?(2022) Gultekingil, Ayse; Canbolat, Elif; Gurel, Fazil Serdar; Baskin, Esra; 0000-0001-7955-5735; AAR-9945-2020Introduction: In the beginning of March 2020 with first case of COVID-19 reported in Turkey, measures that were assumed to decrease the spread of SARSCoV-2 were taken quickly. Use of personel protective equipments and limiting number of people contacting with the patients were some of the most important precautions. Although these precautions protected medical student from risk of infection, they limited their practical learning oportunities and probably negatively effected their education. Aim of our study was to measure the effect of pandemic on medical education of grade 6 medical students. Materials and Methods: We had 6th grade medical students that finished their education between July 2020 and June 2021 fill out a questionnaire that measures their self-esteem on evaluation and procedural practice in pediatric patients and presents their subjective opinions on this period and their solution suggestions with closed and open ended questions. Results: Forty nine grade 6 student was included in the study. Their self-esteem was average (general competency in pediatric patients was 2.31 +/- 0.94 and general self reported competency in clinical practices was 2.65 +/- 1.42). The practice they feel most confident was hand washing (4.44 +/- 1.16), and the practice the feel least confident was establishment of vascular access (1.94 +/- 1.09). When they were asked to evaluate their self-competency in pediatric patients from 1 to 5,the procedure they most frequently observed was establishment of vascular access (74%) and least frequently observed was lumbar puncture (12%). Most frequently performed procedure was urinary catheterization (20%). 80.9% them stated that they felt unlucky to be 6th grade in COVID-19 pandemic and they would like to have more opportunities to contact with the patients with personal protective equipment (PPE). Conclusion: Education of 6th grade medical students affected negatively with decreasing number and diversity of patients and limited opportunity to evaluate patients and observe and perform procedures. Improvements should be made in pediatric departments to increase possibility of student to encounter patients and continue hands on learning with the right precautions.Item Comparison Of Clinical Characteristics Of Second And Third Peaks Of COVID-19 Pandemic: Effects Of Vaccination And Preventive Measures(2022) Ozdemir, Ozer; Arslan, Atakan; Bulbul, Hande M.; Ozdemir, PelinBACKGROUND: Understanding the differences in consequent peaks of COVID-19 may guide us for better predicting future disease characteristics. In this study, we aimed to compare clinical and radiological characteristics as well as out-comes of hospitalized patients with the diagnosis of COVID-19 in second and third peaks of disease.METHODS: We retrospectively included 303 hospitalized patients with COVID-19. The study population was examined in two groups: patients hospitalized between October 2020 and January 2021 during second peak and patients hospital-ized between March and June 2021 during third peak.RESULTS: There were 171 patients in group 1 and 132 patients in group 2. The patients in group 2 were younger (64 +/- 13.27 vs. 56.02 +/- 15.39, respectively; P<0.001) and female proportion was higher (64.9% and 48.5% males; P=0.005). Smoking history and presence of comorbidities were less in group 2 (41.5% vs. 25.7%, P=0.008; and 78.5% vs. 59.1%, P<0.001) and symptom duration was shorter (median 7 days vs. 6 days, P=0.039). CT severity scores, LDH, CRP, D-di-mer, Ferritin, and creatinine levels were lower in group 2 (P=0.003, P=0.008, P<0.001, P<0.001, P<0.001, respectively), and mortality ratio was lower (N.=39 [28%] vs. N.=15 [11.4%], P=0.01). Duration of hospital stay and need for intensive unit care were similar across groups (median 8 days vs. 7 days, P=0.673 and N.=39 [22.8%] vs. N.=33 [25.2%], P=0.683).CONCLUSIONS: Although duration of hospital stay was lower in third peak, clinical severity scores and prognostic markers were lower compared with second peak. These may reflect the increased proportion of immunized people, and the effect of preventive measures.Item Characteristics Of Our Hypoxemic COVID-19 Pneumonia Patients Receiving Corticosteroids And Mortality-Associated Factors(2022) Sengul, Aysun; Mutlu, Pinar; Ozdemir, Ozer; Satici, Celal; Turan, Muzaffer Onur; Arslan, Sertac; Ogang, Nalan; Unsal, Zuhal Ekici; Bozkus, Fulsen; Capraz, Aylin; Demirkol, Mustafa Asim; Mutlu, Levent Cern; Gulhanm, Pinar Yildiz; Alkilinc, Ersin; Fazlioglu, Nevin; Soyler, Yasemin; Kabalak, Pinar Akin; Kizilgoz, Derya; Turan, Pakize Ayse; Yildirim, Fatma; Aydemir, Yusuf; Sen, Nazan; Mirici, Arzu; 35839345Background COVID-19 is a disease associated with diffuse lung injury that has no proven effective treatment yet. It is thought that glucocorticoids may reduce inflammation-mediated lung injury, disease progression, and mortality. We aimed to evaluate our patient's characteristics and treatment outcomes who received corticosteroids for COVID-19 pneumonia. Methods We conducted a multicenter retrospective study and reviewed 517 patients admitted due to COVID-19 pneumonia who were hypoxemic and administered steroids regarding demographic, laboratory, and radiological characteristics, treatment response, and mortality-associated factors. Results Of our 517 patients with COVID-19 pneumonia who were hypoxemic and received corticosteroids, the mortality rate was 24.4% (n = 126). The evaluation of mortality-associated factors revealed that age, comorbidities, a CURB-65 score of >= 2, higher SOFA scores, presence of MAS, high doses of steroids, type of steroids, COVID-19 treatment, stay in the intensive care unit, high levels of d-dimer, CRP, ferritin, and troponin, and renal dysfunction were associated with mortality. Conclusion Due to high starting and average steroid doses are more associated with mortality, high-dose steroid administration should be avoided. We believe that knowing the factors associated with mortality in these cases is essential for close follow-up. The use of CURB-65 and SOFA scores can predict prognosis in COVID-19 pneumonia.Item Thyroxin And Thyroid-Stimulating Hormone Changes In Patients With Covid-19(2022) Kayhan, Sanem; Kirnap, Nazli GulsoyObjective: Whether COVID-19 has any effect on thyroid function is still up for debate. The aim of this study was to assess thyroid function in COVID-19 patients. Materials and methods: Clinical signs, laboratory results, and computed tomography scans of the chest of patients followed up in our hospital due to COVID-19 infection, who did not have a known history of thyroid disease, were analyzed retrospectively. Prior to the initiation of treatment for COVID-19 infection, a total of 131 patients who underwent thyroid function tests and 70 healthy volunteers were included in the study as the control group. Serum free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels of COVID-19 and control groups were measured and compared. Results: When compared with the healthy control group, within the normal range, COVID-19 patients had a significantly lower TSH level and significantly higher fT4 level (p=0.001, p < 0.001, respectively). When each group was compared with the control group in terms of clinical severity, it was found that TSH levels were significantly lower in the critical case group (p < 0.001), and fT4 levels were significantly higher in all levels of clinical severity of COVID-19 (mild to critical) (p < 0.001, p < 0.001, p=0.001, and p=0.006, respectively). Conclusion: Although TSH and fT4 levels were within the normal range in COVID-19 infection, they changed significantly. This suggests that the changes in thyroid function tests in COVID-19 did not have any clinical significance, but caution should be exercised for the transition to thyrotoxicosis in patients with borderline thyroid function tests.Item A Case of Transient Visual Field Defect following Administration of Pfizer-BioNTech COVID-19 Vaccine(2022) Sezenoz, Almila Sarigul; Gungor, Sirel Gur; Kibaroglu, Seda; https://orcid.org/0000-0002-7030-5454; https://orcid.org/0000-0001-6178-8362; https://orcid.org/0000-0002-3964-268X; 35404749; AAJ-4860-2021; AAD-5967-2021; AAJ-2956-2021Purpose To report a case of transient visual field (VF) defect after coronavirus disease-19 (COVID-19) vaccination. Case Report A 38-year-old Caucasian, otherwise healthy female patient, presented with a complaint of vision loss in the outer quadrant in her left eye after the second dose of Pfizer (R)-BioNTech (TM) COVID-19 vaccine. The Snellen visual acuity was 20/20 in both eyes. She did not have relative afferent pupillary defect nor disturbance of color vision. Her intraocular pressures, slit lamp and fundus examinations were normal. In the VF test, a temporal hemifield defect in the left eye and a nasal peripheral VF defect in the right eye were detected. Other imaging characteristics and neurological examination were normal. She was followed without any treatment. One week later, the patient was re-evaluated and complete resolution of the VF defect was observed. Conclusion Clinicians should be aware that patients can experience transient visual symptoms following COVID-19 vaccination.Item Anxiety Levels and Changes in Health and Hygiene Behaviors in Mothers of Children with Asthma in Early COVID-19 Lockdown in Turkey(2022) Sancakli, Ozlem; Tuncel, Tuba; Eren Akarcan, Sanem; Kanik, Ali; Ozyurt, Gonca; Ozdogru, Emine Ece; 35290751Objective: The restrictions imposed by the coronavirus disease 2019 (COVID-19) pandemic have caused significant changes in people's lives. This study aimed to investigate anxiety levels and changes in health and hygiene behaviors in mothers of children with asthma in early COVID-19 lockdown in Turkey.Materials and Methods: This study was a cross-sectional survey conducted on children with asthma, 6 to 11 years of age, between June 1 and 30, 2020, in Turkey. A sociodemographic data form, health and hygiene behavior form, childhood asthma control test, and state-trait anxiety inventory were administered to the mothers of the children.Results: The asthma group included 123 children (Female: 39.0%) and median age, interquartile range (IQR) [minimum-maximum]: 8.0 (6) [6-12] years; the control group included 88 children (Female: 47.7%) median age, IQR [minimum-maximum]: 8.0 (7) [5-12] years. Increased hygiene behaviors and high compliance with social isolation measures were recorded in the early lockdown, with no difference between the groups. Before the pandemic, the most frequently used cleaning products were general-purpose cleaners. During the early lockdown, however, the most frequently used product was disinfectants and was similar in both groups.In both groups, the rate of using nutritional supplements increased during the pandemic period, but the rate was higher in children with asthma both before and during the early lockdown (P < 0.001). The anxiety levels of the mothers in asthma and control groups were similar.Conclusion: This study is the first in Turkey demonstrating that, in mothers of children with asthma, lifestyle changes related to health and hygiene and anxiety levels are similar to those of other children and their mothers during the early lockdown period of COVID-19 pandemic.Item An experience in the COVID-19 pandemic period: Turkish Cardiovascular Surgery Online Board Exam 2020(2022) Sahin, Hatice; Ozgur, Alper; Paker, Tufan; Atay, Yuksel; 35444842Background: The aim of this study was to provide information about the results of the Turkish Cardiovascular Surgery Board written exam, which was held online due to the pandemic. Methods: This cross-sectional study included a total of 41 cardiovascular surgeons and residents (39 males, 2 females) in November 21st, 2020 between 10:00 A.M. and 12:00 P.M. After the online exam was completed, data on participant information and answers to exam questions were obtained from the information system. Results: Of all participants, 39% were working in university hospitals. A total of 82.9% of the participants were specialists. The total mean score of the participants was 60.3 +/- 10.2 and 53.7% of them were declared successful-passed. Aortic surgery (63%), heart failure surgery (50%), and mitral valve surgery (50%) were the most incorrectly answered questions. Conclusion: With the online exam, the Board gained different experiences regarding exam planning and implementation. The Turkish Cardiovascular Surgery Board did not give up the Board exam during the pandemic period and conducted a reliable written exam with many participants.