Wos Açık Erişimli Yayınlar

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    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-2108-2021
    Globally 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.
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    Two Case of Rhino-Orbito-Cerebral Mucormicosis Developed After COVID-19 Infection
    (2021) Demiroglu, Yusuf Ziya; Odemis, Ilker; Oruc, Ebru; Ozer, Fulya; Ulas, Burak; Canpolat, Emine Tuba; Yalcin, Cigdem; Sanli, Ozlem Oguc; 0000-0003-2638-0163; 0000-0001-5381-6861; 0000-0003-2638-0163; 0000-0002-6099-4786; 34666667; AAG-2486-2022; ABC-1809-2020; AFK-3690-2022
    Coronavirus 2019 (COVID-19) infection causes excessive cytokine response and a decrease in cellular immune response and this increases susceptibility to fungal co-infections. Mucormycosis is a rare, life-threatening invasive fungal infection. In this report, two cases who developed rhino-orbito-cerebral mucormycosis shortly after having COVID-19 infection were presented. The first case was a 68-year old woman who admitted to our clinic with orbital cellulitis in her left eye and had a known diagnosis of asthma and rheumatoid arthritis. She was diagnosed with COVID-19 pneumonia 40 days ago, stayed in the intensive care unit for a long time, and received pulse steroid (1000 mg methylprednisolone), interleukin-1 (IL-1) inhibitor (anakinra) and broad-spectrum antibiotic treatments together with antiviral therapy during this period. The second case was a 63-year-old male patient with known diabetes mellitus, hypertension and retinitis pigmentosa, with a history of hospitalization in the intensive care unit due to COVID-19 pneumonia 20 days ago and received pulse steroid therapy during this period. He admitted to our clinic with the complaints of droopy right eyelid, swelling, nausea and vomiting. In both cases, paranasal sinus tomography findings were consistent with invasive sinusitis. Functional endoscopic sinus surgery was performed immediately in less than 16 hours from the first admission in both cases. Histopathological examination of the both cases revealed results consistent with mucormycosis. Mucorales spp. was isolated in sinus tissue culture of the second case taken during the operation. Both of the patients received liposomal amphotericin B. First case died on the 19th day of the treatment. Second case was discharged with full recovery after nine weeks of treatment. The suppression of cellular immunity during the COVID-19 infection, and the use of steroids and interleukin inhibitors in the treatment of severe cases may increase secondary invasive fungal infections. Therefore, clinicians should more frequently consider possible fungal infections in patients with COVID-19.
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    A Rare Complication of Brucellosis: Testicular Abscess
    (2015) Gul, Umit; Demiroglu, Yusuf Ziya; Erbay, Gurcan; Kocer, Nazim Emrah
    Brucellosis is a zoonosis caused by Brucella species. Brucella epididymo-orchitis had been reported in up to 20% of patients with brucellosis. This case was a male patient who developed Brucella epidiymo-orchitis and testicular abscess. He had fever, arthralgia and his right epididymis and right testicle were enlarged and tender. Ultrasound evaluation showed hypertrophy of the right epididymis and testis and moreover hypoechoic area within the testis. Brucella serology was positive and the patient did not respond completely to treatment with streptomycin, doxycycline, and rifampicina. Unilateral orchidectomy was decided. In areas where brucella infection is endemic brucella epididymo-orchitis should be considered in the differential diagnosis. Effective and rapid treatment is important. It should be noted that these patients may develop testicular abscess.
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    Isolated Tuberculous Epididymoorchitis Developing After Allogeneic Haematopoietic Stem Cell Transplantation: A Case Report
    (2017) Yeral, Mahmut; Demiroglu, Yusuf Ziya; Gul, Umit; Aytan, Pelin; 0000-0002-2553-7715; 0000-0003-3249-0895; 0000-0002-9866-2197; AAE-3833-2019; AAK-8394-2021; AAZ-9711-2021; ABC-4148-2020
    We report a case of isolated tuberculous epididymoorchitis developing in a patient after haematopoietic stem cell transplantation (HSCT). Forty-four-year-old male was admitted to the hospital with scrotal pain and swelling 6 months after an allogeneic HSCT using a fullymatched sibling donor because of his acute myeloid leukemia. There were scrotal tenderness, thickening and erythema on the right side. Brucella standard tube agglutination test was negative. Increased scrotal skin thickening, edema in the right epididymis and increased testicular vascularization were detected on ultrasonography. He was readmitted to our hospital with recurrent scrotal pain after 3 months of partial improvement with oral ciprofloxacin administered for a diagnosis of right epididymoorchitis. Pelvic magnetic resonance imaging revealed bilateral epididymoorchitis and scrotal abscess. Acid fast bacilli were detected on Ehrlich-Ziehl-Neelsen staining of the content of abscesses drained under local anesthesia. Mycobacterium tuberculosis complex was isolated on the 24th day of quadruple anti-tuberculosis therapy. Scrotal fistula developed on the first month of therapy which healed spontaneously after discontinuation of immunosuppressive agents. Full recovery was achieved after six months of antituberculosis therapy. As a result, tuberculous epididymoorchitis should be kept in mind in the presence of chronic epididymoorchitis developing in patients receiving immunosuppressive therapy.