Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Acute Appendicitis During Coronavirus Disease 2019 in Turkiye: Changes in Clinical Approach, Treatment, and Diagnosis Modalities: A Retrospective and Cohort Study(2022) Ersoz, Siyar; Bozkurt, Mehmet Abdussamet; Kulle, Cemil Burak; Elhan, Atilla Halil; Gulcu, Baris; Tarim, Ismail Alper; Bozbiyik, Osman; Yasar, Necdet Fatih; Atalay, Vafi; Yonder, Huseyin; Yalav, Orcun; Kuzu, Mehmet Ayha; Karakayali, Feza Yarbug; 36453790BACKGROUND: The novel coronavirus disease 2019 (COVID-19) has resulted in major changes in health-care systems and emergency surgical interventions. Here, we examined patients with acute appendicitis who presented to emergency departments and compared diagnosis, treatment, and post-treatment processes before and during the pandemic period and investigated how the pandemic affected management of acute appendicitis. METHODS: A national, multicenter, and cohort study model was designed that included patients older than 18 years of age diagnosed with acute appendicitis clinically and/or radiologically, with patients compared before (pre-pandemic period: January 1-April 30, 2019) and after (pandemic period: January 1-April 30, 2020) the pandemic. Our investigation included comparisons of pre-operative imaging methods, presence of plastron appendicitis/abscess, conservative/surgical approach, type of anesthesia given, laparoscopic/ open surgical approach, bowel resection rates, drain insertion rates, and presence of post-operative complications RESULTS: For the two study groups, 8972 patients from 69 centers were examined, with 4582 patients operated in the pre-pandemic period and 4234 patients operated in the pandemic period. During the pandemic period, 63.6% of patients underwent open surgery, whereas 34.4% had laparoscopic surgery. Although 60 patients (1.3%) requested non-operative follow-up in the pre-pandemic period, 94 patients (2.2%) requested this in the pandemic period. When conditions of patients were evaluated regardless of their own wishes, 114 patients (2.4%) before and 163 patients (3.8%) during the pandemic received non-operative follow-up. CONCLUSION: Our study did not show the direct correlation between the application of COVID-19-related restrictions and the severity of acute appendicitis. Although non-operative management rates have been increased during the COVID-19 period, the incidences of both complicated and the uncomplicated appendicitis were similar during the COVID-19 crisis period. Given this information non-operative management can be employed for patients diagnosed with appendicitis.Item IgG Neutralizing Antibodies to SARS-CoV-2 Among Healthcare Workers Who Frequently Encountered Patients with COVID-19(2022) Yesilagac, Hasan; Aliskan, Hikmet Eda; Gumus, Hatice Hale; Odemis, Ilker; Unsal, Zuhal Ekici; 0000-0003-2638-0163; 0000-0001-9071-9606; AAD-1638-2019; AAJ-2108-2021Introduction: Since the Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) first emerged in Wuhan, on 12 December 2019, it has spread rapidly across the world and developed into a pandemic. As healthcare workers are frequently in contact with Coronavirus disease-2019 (COVID-19) patients, they can be affected more often than the general population. In this study we aimed to investigate the SARS-CoV-2 seroprevalence and the IgG antibody levels among healthcare workers who frequently encountered COVID-19 patients in our hospital.Materials and Methods: In total, 182 healthcare workers were identified from database and their data was retrospectively analyzed. Participants with previous PCR positivity, pregnant, autoimmune disease history or immunosuppressive treatment history were excluded. Participants were grouped depending on their frequency of contact with COVID-19 patients (high and medium risk). All the samples were tested simultaneously for anti-SARS-CoV-2-IgG antibodies by the ELISA method. A chi-square test was used to compare categorical variables. A t-test and an ANOVA test were carried out to where appropriate.Results: Serological testing of 182 HCWs exposed to SARS-CoV-2 patients illustrated that 13.2% of them (24 out of 182) might have experienced an asymptomatic or subclinical SARS-CoV-2 infection. High risk participants, anosmia, and ageusia were statistically significant risk factors. The rate of detection of antibody positivity among doctors (p=0.030) and patients with anosmia, and ageusia (p=0.047) were found significantly higher than the others. In addition, SARS-CoV-2 antibody ratio results were found significantly higher in the groups of high risk participants (p=0.046), patients with clinical signs (p=0.008), myalgia (p=0.039), anosmia, and ageusia (p=0.025), respectively.Conclusion: Our study showed that serological testing is useful for determining asymptomatic or subclinical infections prevelance of SARS-CoV-2 among those with close contact with COVID-19 patients. Serological tests can be helpful determining the prevelance COVID-19 infection, especially among the HCWs.Item COVID-19 Knowledge in Patients with Psoriasis Receiving Systemic Therapy: A Questionnaire Study(2022) Ozcelik, Sinan; Kilic, Fatma Arzu; 0000-0003-2983-065X; 36534539Introduction: Little is known about the impact of patient behavior on the treatment of psoriasis in the COVID-19 pandemic. Objectives: We aimed to investigate the COVID-19 knowledge of the patients with psoriasis receiving systemic therapy in the pandemic. Methods: The patients who received systemic treatment for psoriasis presented to our dermatology outpatient clinic were enrolled in the study. A questionnaire measuring the level of knowledge about COVID-19 and psoriasis was administered to patients. Demographics and disease characteristics of patients were recorded. Results: A total of 183 patients with psoriasis were enrolled in the study. Of the patients, 33.9% thought that psoriasis exposes them to a risk of getting COVID-19, 30.6% declared that psoriasis treatment exposes them to a risk of getting COVID-19, and 59.6% were worried about getting COVID-19. The treatment discontinuation rate was 42.1%. The patients with high scholar level showed more anxiety and discontinued their treatment. Conclusions: The patients with psoriasis did not have adequate knowledge of the effect of both psoriasis itself and its treatment on COVID-19 during the pandemic. The patients on biologic therapy tend to discontinue their treatment based upon the physician's recommendation, whereas those on conventional therapy mostly on their own will. Clinicians should inform patients about current evidence of COVID-19 and psoriasis.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 The development of acne vulgaris due to face masks during the pandemic, risk awareness and attitudes of a group of university students(2022) Tuncer Vural, Ayse; https://orcid.org/0000-0001-8770-5721; 35621247; AAQ-4123-2021Background Recent work conducted with healthcare workers and middle-aged populations has recognized the association between acne vulgaris (AV) and mask-wearing. Objective This study aimed to evaluate the correlation between the face mask and AV in a group of university students, triggering factors, the awareness, and attitudes of the students. Methods A face-to-face survey was conducted to 200 participants (84 males, 116 females) who composed of third- and fifth-grade medical faculty students. The questionnaire compiled the demographic data, skin care habits, mask-wearing habits, skin lesions developed on their faces with the use of face masks, awareness, and attitudes of the students. Results The mean age of the participants was 21.39 +/- 1.34 (range, 19-26 years). While 40.5% of the students developed new AV, 20.5% had exacerbation of their old AV. Lesions developed most frequently in the cheek (51%) and chin (45.5%) regions. During the COVID-19 pandemic, being female (p = 0.04), prolonged masks use (p = 0.001), and fewer mask changes throughout the day (p = 0.01) were found to be associated with the development of AV. Moreover, 90.5% of students stated that the face mask could cause the development of AV. The most frequent protective precautions of the students were the intermittent removal of face masks and regular handwashing. Conclusion The use of face masks triggers the development of AV in young people. Wearing masks over long periods of time without breaks and infrequently changing one's mask throughout the day may lead to the development of new or worsening of AV in young populations.Item Antibody Screening and Risk Assessment of Healthcare Professionals in the COVID-19 Pandemic(2021) Gumus, Hatice Hale; Demiroglu, Yusuf Ziya; Aliskan, Hikmet Eda; Odemis, İlker; Ceylan, Ozgur; Pocan, Ahmet Gurhan; Karagum, Ozlem; 0000-0001-9060-3195; 0000-0003-2638-0163; 0000-0002-9866-2197; 0000-0003-2638-0163; 0000-0001-6910-7250; 0000-0003-0681-8375; 0000-0003-3128-1602; 0000-0001-9071-9606; 34416802; AAE-2282-2021; AFK-3690-2022; AAX-9250-2021; AAZ-9711-2021; AAG-2486-2022; AAK-8276-2021; U-4084-2017; AAE-6310-2021; AAJ-2108-2021Globally 364102 healthcare professionals have been infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and 1253 of them died until 15 January 2021. Healthcare professionals serving at the forefront of combating the pandemic are in the high risk group. In our country, the data about coronavirus-2019 (COVID-19) among healthcare professionals are limited. The aim of this study was to investigate the anti-SARS-CoV-2 IgG seroprevalence in healthcare professionals, to evaluate the risks they encountered during work, and to examine their relationships with antibody positivity. A total of 572 healthcare professionals serving in various units of our hospital participated in our study and the presence of anti-nucleocapsid IgG was investigated by chemiluminescent microparticle immunoassay (SARS-CoV-2 IgG test, Abbott Laboratories Diagnostics, USA) method in serum samples collected between May 18, 2020 and June 30, 2020. The demographic characteristics, medical history, work conditions, medical procedures performed and possible risk factors were questioned with a questionnaire form. The average age of the participants was 33.5 +/- 9.2 (19-61) years, and 62.9% (360/572) of them were women. In our study, the anti-SARS-CoV-2 IgG seroprevalence was 3.7% (21/572). The association of the antibody positivity with age, gender and occupational status was not statistically significant (p> 0.05). Comorbid diseases which were significantly higher in seropositive healthcare professionals were hypertension (19%) and diabetes mellitus (14.3%) (p< 0.05). It was observed that antibody positivity was significantly higher in healthcare professionals working in high (52.4%) and medium risk (33.3%) areas, those who treat and/or examine patients with suspicious or positive COVID-19 (66.7%) and those who spend more than 30 minutes in COVID-19 patient rooms (76%) (p< 0.05). The symptoms associated with seropositivity in healthcare workers with a history of symptoms (46%) were loss of smell (23.5%), loss of taste (20.0%) and respiratory distress (16.7%) (p< 0.05). It was observed that the probability of being infected with SARS-CoV-2 increased 12 times if there was a colleague with COVID-19 in the hospital, four times if there was a patient in the house/lodging and six times if there was an infected person in the social environment (p< 0.05). The rate of those who had the flu vaccine among the participants was 10.8% (62/572) and 9.7% of them were found to be anti-SARS-CoV-2 IgG positive (p< 0.05, 95% CI= 1.31-9.48). The seropositivity was significantly higher in non-smokers (4.8 %) compared to smokers (0.0%) (p< 0.05). In our study, it was determined that the rate of seropositivity was 12 times higher in healthcare professionals who stated that they received hydroxychloroquine prophylaxis due to risky contact compared to those who did not receive prophylaxis (p< 0.05, 95% CI= 4.11-40.64). The ratio of the personnel who answered "always" to the frequency of wearing gloves, masks, goggles/face shields and overalls was 85.7%, 96.9%, 62.1% and 65.4%, respectively. In conclusion, regular and large-scale sero-epidemiological screening of healthcare professionals in the COVID-19 pandemic can contribute to the control of the pandemic by providing a better understanding of transmission dynamics and risk factors.Item Turkish Thoracic Society Experts Consensus Report: Recommendations for Pulmonary Function Tests During and After COVID 19 Pandemic(2020) Gemicioglu, Bilun; Borekci, Sermin; Dilektasli, Asli Gorek; Ulubay, Gaye; Azap, Ozlem; Saryal, Sevgi; 0000-0002-3171-8926; 0000-0003-2478-9985; 32584237; AAK-4089-2021; AAB-5064-2021The recommendation of conducting pulmonary function tests (PFTs) from different societies during and after the coronavirus disease (COVID-19) pandemic was rated by the experts of the Turkish Thoracic Society (TTS) and presented as the TTS experts consensus report. Information about the topic has been provided. Globally, as of mid-May 2020, there have been over 4.4 million confirmed cases of COVID-19. There are two main routes of transmission of COVID-19: respiratory droplets and contact transmission. PFTs are non-invasive tests that are commonly performed in routine assessment and follow-up of patients in the pulmonology units. However, PFTs may generate aerosols and require sharing common surfaces. With regard to the high prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the community, PFTs should not be performed routinely in confirmed or suspected patients with COVID-19 during the pandemic. Because of the risk of human-to-human transmission of COVID-19, PFTs should be restricted to a small patient population with selected indications. Triage for COVID-19 should be performed prior to testing. Only essential PFTs such as spirometry, diffusion capacity of the lungs for carbon monoxide (DLCO), arterial blood gas analysis, or pulse oximetry should be performed in the selected cases. Tests should be scheduled to allow sufficient time for donning and doffing of the technical personnel with the full personal protective equipment (PPE) (gown, a filtering respirator mask, goggles or full-face shield, and disposable gloves), ventilation of the room, and application of post-test cleaning and disinfection procedures of the equipment and the testing room.Item Covid-19: The Biggest Threat of the 21st Century: In Respectful Memory of the Warriors All Over the World(2020) Karcioglu, Oguz; Yuksel, Aycan; Baha, Ayse; Er, Aslihan Banu; Esendagli, Dorina; Gulhan, Pinar Yildiz; Karaoglanoglu, Selen; Ercelik, Merve; Serifoglu, Irem; Yildiz, Ethem; Kokturk, Nurdan; 0000-0002-6619-2952; 33352097; ABF-9398-2020Since the first case was diagnosed in China, the new coronavirus infection (COVID-19) has become the number one issue in the world and it seems to remain trend-topic for a long time. Until 17 April, it affected 210 countries, infected over 2 million people and caused approximately 150000 deaths. Although the course of the disease ranges from asymptomatic state to severe ARDS; the majority of patients reveal only mild symptoms. Though adults are the most commonly affected group; it can also be seen in newborns and elderly patients. Unfortunately, elderly patients are the most vulnerable group with higher mortality. Elderly patients, smokers and patients with comorbid conditions are most affected by the disease. In certain diagnostical tool is the real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) test. However, it can be resulted in false-negative results and in this case the computed thorax tomography (CT) is one of the most important tools with high sensitivity. Besides the supportive treatment, most commonly used agents are immunomodulatory drugs such as plaquenil and azitromycin, and anti-virals including oseltamivir, ritonavir-lopinavir, favipiravir. Until a vaccine or a specific therapy invented, the most important intervention to control the disease is to fight against transmission. This is a real war and the doctors are the soldiers.Item Laryngoscopic Examination During the COVID-19 Pandemic: Turkish Voice Speech and Swallowing Disorders Society and Turkish Professional Voice Society Recommendations(2020) Cobanoglu, H. Bengu; Enver, Necati; Akbulut, Sevtap; Atmis, E. Ozlem; Birkent, Hakan; Buyukatalay, Ciler; Demirhan, Erhan; Denizoglu, Ilter; Hasimli, Ramil; Korkmaz, Muge Ozcelik; Ozgursoy, Selmin Karatayli; Ozturk, Kayhan; Paltura, Ceki; Sirin, Seher; Tatar, Emel Cadalli; Tuzuner, Arzu; Yelken, Kursat; Coskun, H. Hakan; Oguz, Haldun; Oz, Ferhan; 33554203COVID-19 is highly transmissible and spreads rapidly in the population. This increases the occupational risk for health care workers. In otolaryngology clinic practice, patients with upper respiratory tract infection symptoms are common. Also, routine head and neck examinations such as oral cavity examination, nasal/nasopharyngeal examination, or video laryngostroboscopic evaluation are highly risky because of the aerosol formation. To emphasize this issue, two leading otolaryngology organizations in Turkey; 'Voice Speech and Swallowing Disorders Society', and 'Professional Voice Society' gathered a task force. This task force aimed to prepare a consensus report that would provide practical recommendations of the safety measurements during routine clinical care of laryngology patients. To fulfill this, universal aim, on the 2nd and 9th of May 2020, two web-based meetings were conducted by 20 expert physicians. This eighteen items list was prepared as an output.