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https://hdl.handle.net/20.500.12941/16

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Comparison of the Results of BAL and ETA Culture in Intubated COVID-19 Patients
(Nigerian Journal of Clinical Practice, 2024) Kılıç, Hasan Hüseyin; Gözüküçük, Ramazan
Background: The isolation of pathogens using bronchoalveolar lavage (BAL) culture or endotracheal aspirate (ETA) culture may enhance the treatment success for secondary pneumonia due to COVID-19, thereby reducing the risk of morbidity and mortality. Aim: This study aimed to retrospectively analyze the results of BAL and ETA cultures in intubated COVID-19 patients and to determine whether BAL has an advantage over ETA. Methods: We routinely perform BAL culture via bronchoscopy or ETA culture within the first 48 h after intubation. We retrospectively reviewed cases that underwent BAL and ETA. The patients were divided into two groups: Group B (BAL) and Group E (ETA). Various parameters were evaluated and compared between the two groups. Results: The demographic data and blood test results were similar between the two groups. However, ICU stay, duration of intubation, and culture positivity were significantly higher in Group B. Although not statistically significant, the mortality rate was higher in Group E. The most commonly isolated microorganisms were Candida species. Conclusion: The observed mortality rates were consistent with the existing literature. Since the microorganism isolation rate is higher with BAL, leading to more effective antimicrobial treatment, early deaths were prevented, and ICU stay durations were prolonged. Conversely, these durations were shorter in the ETA group due to higher mortality. In intubated COVID-19 patients, a more effective treatment process can be achieved by clearing the airway with fiberoptic bronchoscopy and tailoring the treatment based on BAL culture results. This approach may positively impact prognosis and mortality rates.
Beyond conventional wisdom: unexplored risk factors for penile fracture
(Sexual Medicine, 2024) Arıkan, Mehmet Gürkan; Akgül, Burak; Türk, Semih; Tantekin, Ömer Onur; Çakıroğlu, Basri; Arda, Ersan
Background Sexual intercourse is a predominant cause of penile fractures (PF). Aim To evaluate the relationship between body metrics and the severity of PF, identifying how anthropometric factors of patients and their partners influence the incidence and severity of PF. Methods This study analyzed 47 patients with PF over 9 years across multiple centers. Demographic and anthropometric data were collected for both patients and their partners. Injuries were categorized by the sexual position or activity causing them, including partner-related positions (man-on-top, woman-on-top, and doggy-style) and isolated actions (rolling-over, blunt trauma, masturbation, or manipulation). Statistical analysis was performed using the ?2-test. Outcomes The study aimed to uncover correlations between body metrics and the risk profile for PF, focusing on body mass index (BMI), weight, height, and age. Results The majority of PFs occurred during sexual activities (74.5%), particularly in “doggy” and “man-on-top” positions. Urethral involvement was observed in 10.6% of cases. Significant correlations were found between patient and partner ages (r = 0.915), patient BMI and weight (r = 0.874), patient height and weight (r = 0.502), and partner weight and BMI (r = 0.805). Higher BMI in patients was linked to delayed hospital visits (r = 0.377), and frequent sexual activity was strongly correlated with urethral complications (r = 0.727). Clinical Implications These findings emphasize the importance of considering body metrics in assessing PF risk and could guide future preventive strategies and clinical interventions. Strengths & Limitations The study’s strength lies in its comprehensive analysis of anthropometric factors and their correlation with PF severity. Limitations include a relatively small sample size and the potential for reporting bias in sexual activity data. Conclusion The study confirms sexual intercourse as the main cause of PF and highlights significant links between anthropometric factors and fracture severity. Higher BMI and weight in partners are associated with more centrally located fractures and urethral injuries, particularly in taller patients or those with larger partners.
Immediate Effects of High-Intensity Blood Flow Restriction Training on Muscle Performance and Muscle Soreness
(Routledge Journals, Taylor & Francis Ltd, 2024) Korkmaz Dayıcan, Damla; Ülker Ekşi, Büşra; Yiğit, Şafak; Utku Umut, Gulsena; Özyürek, Burçin; Yılmaz, Hayrettin Emir; Akıncı, Buket
Purpose: The aim was to investigate the immediate effects of high-intensity resistance training with blood flow restriction (HIRT-BFR) on rectus femoris (RF) muscle activity, reaction time, muscular performance, and delayed onset muscle soreness (DOMS) in healthy young adults. Methods: Twenty-four healthy young adults were randomized into the HIRT-BFR group or HIRT group. Both groups performed a single session of training with 80% of 1RM, 8 repetitions, 2 sets, and 3 minutes rest to RF muscle. The activity and reaction time of the dominant extremity RF muscle were evaluated by superficial electromyography (sEMG), muscular performance by single-leg squat test, and DOMS by the Visual Analog Scale. Results: Single-leg squat performance was significantly increased in HIRT-BFR (p = .001) and HIRT group (p = .04). Additionally, in HIRT group resting average (p = .03), resting maximal voluntary contraction % (p = .04), and relaxation minimum (p = .02) values of RF were significantly increased. DOMS level decreased significantly in HIRT-BFR (p < .001) and HIRT group (p = .019). The differences were similar in the groups for sEMG parameters, muscle performance, and DOMS level. Conclusion: We observed that HIRT-BFR and HIRT were similar in terms of muscle activation, reaction time, muscular performance of the RF, and DOMS level.
Kanamamış Anevrizmalarda Takip ve Tedavi Kararı
(2022) Özlük, Enes; Işlak, Civan
Günümüzde, görüntüleme tekniklerinin git- tikçe yaygınlaşması ve görüntüleme çözünür- lüğünün artması nedeniyle asemptomatik ve kanamamış intrakranial anevrizmalarla (KİA) daha sık karşılaşılmaktadır. KİA saptanması hem hasta hem de hekim için bir ikilem oluştur- maktadır. Anevrizma rüptürü yüksek morbidite ve mortalite ile sonlanabilirken tedavi girişimi de belli oranda morbi-mortaliteye sahiptir. Dolayısıyla takip ya da tedavi kararı bilimsel veriler ışığında alınmalıdır. Bu bölümde, hangi anevrizmalar tedavi edilmeli sorusuna yanıt aranarak geriye kalan popülasyonda tedavi yarar-zarar riskleri ortaya konarak takip ve tedavi seçeneklerine yaklaşım irdelenecektir. Buradaki bilgiler literatür bilgileri ile birlikte uzun yıllar bu hastaların tedavi ve takibini yapmış bir hekimin kişisel kanaatlerini de taşımaktadır.
The role of primary nocturnal enuresis in the aetiology of overactive bladder syndrome
(Polish Urological Assoc, 2023) Çakıroğlu, Basri; Arıkan, Mehmet Gürkan; Taş, Tuncay; Bilir, Burak
Introduction The aim of this study was to investigate the effect of nocturnal enuresis (NE) in childhood on the development and course of overactive bladder (OAB) in adulthood. Material and methods Between January and September 2021, data from patients who visited the Urology Outpatient Clinic with OAB symptoms were collected. Patients with a history of diabetes mellitus, neurological diseases, bladder outlet obstruction, active urinary system infection, or previous medical treatment for OAB and those who did not agree to join the study were excluded. Patients with a diagnosis of NE in childhood were classified as group 1, and patients without a diagnosis of NE were classified as group 2. Demographic data were recorded. Frequency of incontinence, and the number of daytime voids and nocturia were evaluated according to a three-day voiding diary. In addition, the maximum urinary flow ratio (Qmax), bladder wall thickness, and postvoid residual volume were determined using uroflowmetry and pelvic ultrasound. Results After applying the inclusion/exclusion criteria, the mean age of the study group of 103 patients, consisting of 34 women and 69 men, was 32.85 +/- 11.20 years (18-65), and the mean BMI of both groups was 26.62 +/- 3.34 (19.49-39.18). Sixty-five of 103 patients (63.1%) had a history of childhood NE diagnosis. Patients in the group with a history of NE were younger than those without a history of NE. Conclusions The earlier onset and more intense course of OAB symptoms in patients diagnosed with NE in childhood suggests that NE may be a triggering factor in the aetiology of OAB.
Investigation of the Relationship Between Heavy Metals (Cadmium, Arsenic, and Lead) and Metallothionein in Multiple Sclerosis
(Springer Nature, 2024) Keçecioğlu, Can; Sarıkaya, Cansu; Aydın, Ahmet; Charehsaz, Mohammad; Efendi, Hüsnü
Background and aim: Multiple sclerosis (MS) is one of the most common neurological disorders. Metals are important for the maintenance and preservation of homeostasis and dysregulated metal homeostasis has an impact on neurodegeneration. Environmental factors are considered to contribute to MS risk and progression. Heavy metals such as arsenic (As), cadmium (Cd), and lead (Pb) are widely found in the environment and because of their toxic nature, they pose a great danger to human health. Metallothioneins (MTs) play important roles in metal homeostasis and detoxification of heavy metals. Objective: The aim of this study was to investigate the relationship between levels of heavy metals (As, Cd, and Pb) and MT levels in MS patients and also to assess the oxidative stress status of patients. Method: Fifty subjects (20 healthy subjects and 30 MS patients) were included. Demographic characteristics of the patients, plasma MT levels, blood Cd, As, and Pb levels, as well as iron (Fe), copper (Cu), and zinc (Zn) levels, were determined. Malondialdehyde (MDA) levels were investigated as a marker of oxidative stress. Results: MT levels were slightly higher in the MS group (p > 0.05). As Cd and Pb levels were significantly higher in the control subjects. MDA levels were significantly higher in MS patients. Conclusion: Our results support the relevance of MT and MDA levels in MS. Further clinical studies with larger cohorts will provide more insights into these factors.
Using Cluster Analysis to Identify Metabolic Syndrome Components and Physical Fitness in Patients with Metabolic Syndrome
(2024) Yiğit, Şafak; Akıncı, Buket; Ülker Ekşi, Büşra; Korkmaz Dayıcan, Damla; Çalıkoğlu, Fulya; Çelik, Yusuf; Yeldan, İpek; Satman, İlhan
Background: Metabolic syndrome (MetS) comprises a cluster of cardiovascular risk factors. Physical inactivity and reduced physical fitness are associated with one or more components of MetS. However, MetS has many components, and the unclear relationship between the components and physical fitness parameters can provide a plain and straightforward understanding of the clustering method.Aim: To identify the relationship between physical fitness parameters, physical activity levels, and components of MetS using hierarchical cluster analysis.Methods: One hundred twenty-one patients (mean age = 51.4 +/- 7.1/years, F:90, M:31) who were diagnosed as having MetS according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria were included in the study. Fasting plasma glucose (FPG), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were analyzed. Systolic and diastolic blood pressures, (SBP and DBP), were evaluated. Body composition (waist and hip circumference, (WC and HC), waist-to-hip ratio (WHR), body mass index (BMI), percent body fat, and visceral fat), upper and lower extremity muscle strength (dynamometer), and functional exercise capacity [6-minute walk test (6MWT)] were assessed as physical fitness parameters. Physical activity levels were assessed using a pedometer and number of steps (NS) was determined.Results: Of the patients, 45.5% were diagnosed as having MetS based on four components. The dendrogram consisted of two main clusters and four subclusters. The main cluster I composed of BMI, HC, WC, visceral fat, HDL-C, percent fat, SBP, DBP, and percent quadriceps. The main cluster II comprised FPG, TG, WHR, handgrip strength, 6MWT, and NS.Conclusion: MetS components clustered with different physical fitness parameters. The clusters in the dendrogram can provide substantial implications for heterogeneous MetS components and physical fitness parameters. Future studies are needed to elucidate the effectiveness of dendrogram-derived exercise programs in MetS.
In situ gels loaded with naringin as ocular drug delivery carriers; development and preliminary characterization
(Journal of Research in Pharmacy, 2024) Siafaka, Panoraia; Yağcılar, Ayşe Pınar; Karaotmarlı, Gökçe; Yoltas, Aysegul; Üstündağ Okur, Neslihan
Ocular drug delivery of any molecule is quite complex and challenging due to the ophthalmic anatomy. The current ocular formulations such as drops, gels or ointments cannot deliver the active molecules efficiently, therefore newer dosage forms are being developed. In situ gels which are in the liquid state in room temperature or in certain pH but transform to gels when instilled onto the eye belongs to such innovative dosage forms. Herein, the fabrication of in situ gels for naringin ocular delivery is presented since there are very few studies examining the use of naringin as an active molecule for eye delivery. Naringin which is hydrolyzed in naringenin, is a flavonoid glucoside found on citrus fruits and has been studied as antioxidant and anti-inflammatory agent or potent antimicrobial agent. The naringin loaded in situ gels developed via cold method using Poloxamer 407, sodium alginate and hydroxypropyl methylcellulose E5. The temperature-responsive in situ gels were characterized for clarity, sol-gel transition temperature, gelling capacity, pH and viscosity. All the results were of desirable limits. Furthermore, in vitro drug release demonstrated that the in situ gels showed sustained pattern Antimicrobial studies indicated specific antimicrobial potency against Enterococcus faecalis. Future studies will involve in vivo studies and ocular irritation analysis.
The Effect of Thirst, Dry Mouth, Mouth Taste, and Bad Mouth Odor in Laparoscopic Cholecystectomy Patients: A Randomized Controlled Trial
(2024) Mert, Sabiha; Çalışkan, İlknur; Koruk, Senem
Purpose: This study aimed to determine the effect of menthol ice application on thirst, dry mouth, mouth taste, and bad mouth odor in patients who underwent laparoscopic cholecystectomy in the postoperative period. Design: The study was conducted as a randomized controlled trial with an experimental design. Methods: The study sample consisted of 90 patients who underwent laparoscopic cholecystectomy and met the inclusion criteria. Patients were divided into three groups by randomization program. Patients in the menthol ice and ice popsicle (ice prepared with drinking water only) group were administered menthol ice/ice popsicle (10 mL) twice at 20 minutes intervals. Patients in the control group did not receive any intervention. Routine practices of the clinic were performed by the nurses of the general surgery clinic. Postoperative thirst intensity, severity of dry mouth, bad taste, and bad odor in the mouth were evaluated at 0, 20, and 40 minutes. Findings: No statistically significant difference was found between the sociodemographic and clinical characteristics of the patients in the control group, menthol ice group, and ice popsicle group (P > .05). A statistically significant difference was found between the 3 groups in terms of thirst intensity and severity of dry mouth at times at the 20th and 40th minutes after the application (P < .01). We found a statistically significant difference between the bad taste and bad odor sensation scores of the patients in the control and intervention groups at the 20th and 40th minutes after the application (P < .05). Conclusions: The study concluded that menthol ice and ice popsicle application are effective strategies to reduce the intensity of thirst, severity of dry mouth, bad taste, and bad odor in postoperative patients.
The Effect of Cold Oral Applications in the Management of Postoperative Thirst: A Systematic Review
(2024) Çelik, Sevilay Şenol; Mert, Sabiha; Arslan, Hande Nur
Purpose: Thirst is one of the most bothersome symptoms experienced by surgical patients. Effective thirst intervention and management in the Post Anesthesia Care Unit (PACU) and hospital wards is critical because patients are less sedated and more aware than in the past. There is a need to review the literature on the identification and management of thirst in the inpatient and PACU settings. The aim of this systematic review was to examine the available evidence on the effectiveness of oral cold applications on thirst in postoperative patients. Design: This was a systematic review study. Articles in PUBMED, Web of Science, ScienceDirect, TÜBİTAKULAKBİM, and TRDizin databases between January 2008 and January 2023 that included oral cold applications to relieve the thirst of patients in the postoperative period were included. Methods: The PICOT-SD (Patients Interventions Comparison Outcome Time-Study Design) method was used as an eligibility criterion for inclusion in the study. The eligibility criteria included that the articles were written in English-Turkish and within the target dates, the studies included nursing interventions, the primary outcome of the studies was thirst, and the study sample included postoperative patients. The risk of bias was assessed using the RoB2 tool developed by Cochrane. Findings: A total of 254 articles were retrieved from the databases using the specified keywords. 244 articles did not meet the study criteria: 30 were excluded because they were not interventional studies, 61 were not conducted in a postoperative population, 56 were duplicates, and 79 were not on a related topic. A total of 10 studies consisting of randomized controlled trials and quasi-experimental articles met the criteria for our review. Oral cold applications effectively reduced the thirst rate of postoperative patients and improved their health-related quality of life. The intervention has also been shown to reduce other anesthesia-related complications. Conclusions: This systematic review concluded that cold oral applications have promising effects on thirst, dry mouth, and health-related quality of life. Cold oral applications are cost-effective and suitable for largescale health care applications.
Efficacy of pentosan polysulfate treatment in patients with interstitial cystitis/bladder pain syndrome
(Pol Scientific, 2023) Arıkan, Mehmet Gürkan; Çakıroğlu, Basri
Objectives: Pentosan Polysulfate (PPS) is the only oral treatment for interstitial cystitis (IC)-bladder pain syndrome (BPS) approved by the World Health Organization. Self-evaluation scales can provide more objective results on pre- and post-treatment satisfaction. The aim of this study was to investigate the effect of pentosan polysulfate treatment on symptoms in IC-BPS patients. Methods: This study included 37 adult male and female patients with IC-BPS who reported pain, urinary urgency, polyurea, and nocturia without urinary tract infection for a minimum of six months prior to the study and were taking 300 mg/day oral pentosan polysulfate. Pre- and post-treatment symptoms, Interstitial Cystitis Symptom Index (ICSI) Scores, quality of life (QoL) scores (1-4), and satisfaction conditions were examined. Results: Following the application of inclusion and exclusion criteria, mean age of 37 suitable patients was 46.0±11.9 years and 27% (10 individuals) of the patients were male. Pre-treatment, ICSI scores, and measures of satisfaction degree and QoL increased significantly after the treatment (p<0.001). Adverse reaction was detected in two patients (5.4%) among the patients treated with pentosan polysulfate. Conclusions: Oral pentosan polysulfate for the treatment of interstitial cystitis/bladder pain syndrome treatment could achieve recovery in symptoms, increase Interstitial Cystitis Symptom Index score and improve quality of life and patient satisfaction.
Minimally invasive connective water vapor energy method for benign prostatic hyperplasia
(SAGE Publications Ltd., 2023) Çakıroğlu, Basri
The Rezum system has emerged as a promising treatment option for benign prostatic hyperplasia (BPH) by employing endoscopic removal of prostate tissue. This meta-analysis aimed to evaluate the benefits and drawbacks of Rezum therapy in recent studies. A systematic literature search was conducted in EMBASE, PubMed, and the Cochrane Library databases until December 2021, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search utilized keywords such as water vapor thermal therapy, Rezum, convective water vapor thermal therapy, and convective radiofrequency water vapor thermal therapy. A total of 21 studies were included in the analysis, comprising 5 prospective randomized studies, 2 case series, 2 randomized controlled trials, 1 crossover study, and 11 retrospective studies. The collective sample involved 2090 patients with a mean follow-up period of 14.42 +/- 18.08 (1-72) months and a mean age of 68.12 +/- 4.79 years. Significant improvements were reported in the International Prostate Symptom Score (IPSS), quality of life (QoL), maximal flow rate (Qmax), postvoid residual urine volume (PVR), prostate volume (PV), and International Erectile Index Function (IIEF) values. Unlike other BPH treatments that often require general or regional anesthesia, the connective water vapor energy system can be administered with sedo-analgesia and local anesthesia, potentially leading to improved sexual function scores. Considering the relief of symptoms, Rezum therapy may serve as a viable alternative to transurethral surgery for patients with prostate volumes ranging from <30 to >80 cc.
The importance of hematological parameters in the prognosis of patients with severe COVID-19, a single-center retrospective study
(Wolters Kluwer Medknow Publications, 2023) Gözüküçük, Ramazan; Kılıç, Hasan Hüseyin; Uyanık, Bekir Sami; Çakıroğlu, Basri
Background: Inflammation biomarkers known as acute phase reactants (APRs) show significant variations in serum concentrations during inflammation brought on by both viral and noninfectious diseases. The erythrocyte sedimentation rate (ESR), the C-reactive protein (CRP), the lactate dehydrogenase (LDH), the ferritin, the fibrinogen, the procalcitonin, the D-dimer, and the troponin I are all significant APRs. During inflammation, the serum levels of each of these positive APRs rise. The sensitivity and specificity of hematologic parameters and indices are as high as the inflammatory biomarkers mentioned above for monitoring disease severity and treatment response. Aim: We aimed to evaluate the differences in hematological parameters and indices, and to reveal their treatment and prognostic values, especially in deceased patients with COVID-19. Materials and Methods: The hemogram parameters of 169 critical patients with COVID-19 (125 males and 44 females) who received inpatient treatment at …. between 1 March 2020 and 31 December 2021 were analyzed retrospectively. The patients were divided into two groups—deceased (77) and surviving (92)—noting demographic data such as age and gender. All analyses were performed using SPSS 25.0. Results: Analyses of the hematological parameters used during the treatment processes revealed statistically significant differences between the two patient groups. White blood cell (WBC), neutrophil, and neutrophil to lymphocyte ratio (NLR) values were significantly higher (P = 0.019, P = 0.000 and P = 0.000, respectively) for deceased subjects, while lymphocyte, platelet and plateletcrit (PCT) values were significantly lower (for all values, P = 0.000). Platelet volume (MPV) and platelet distribution width (PDW), as well as MPV/PLT, PDW/PLT, MPV/PCT, and PDW/PCT, levels were significantly higher in deceased subjects (P = 0.000). Particularly in our deceased cases, receiver operating characteristic analyses were performed to reveal the importance of such analyses in prognostic status evaluation in COVID 19 since the hematological parameters are quite different. Cut off values were determined for each parameter, and sensitivity and specificity ratios were calculated. While the sensitivities of MPV/PLT, PDW/PLT, MPV/PCT, and PDW/PCT indices are over 80%, neutrophil and white blood cell sensitivities were found to be lower (74%, 68.8%, respectively). Conclusion: In addition to NLR, which is an important biomarker, the hematological indices MPV/PLT, PDW/PLT, MPV/PCT, and PDW/ PCT can be used to determine the risk of death in patients with severe COVID-19.
Preparation and characterization of carbopol based hydrogels containing dexpanthenol
(University of Ankara, 2023) Çağlar, Emre Şefik; Karaotmarli Güven, Gökçe; Üstündağ Okur, Neslihan
Objective: The purpose of this study is to create dexpanthenol-loaded hydrogel formulations to alter the release patterns and enhance the physicochemical qualities of the market product. Material and Method: To make hydrogel formulations, Carbopol Ultrez was utilized in concentrations of 1%, 1.5%, and 2% (w/w). The active component dexpanthenol was then added to the formulations at a concentration of 5% (w/w). pH, viscosity, texture profile analysis, spreadability, bioadhesion, and in vitro release characteristics were all assessed for the formulations. Result and Discussion: The formulations were found to be suitable for cutaneous application. TPA analysis revealed that the G1 and G1-DXP formulations had the hardness value 10.185?1.219 and 30.854?1.637 g, respectively. That formulations’ bioadhesion strength has grown because they are more flexible than previous formulations while having low hardness values. As such, it has been observed that the formulations release more than 50% of DXP in three hours while the market preparation was not even reach the 10% drug release. In the in vitro release kinetics study, it was calculated that all formulations fit the Higuchi model. As a result, a more effective drug delivery system has been developed compared to the market preparation. The currently prepared formulations are also promising formulations in terms of their use in treatment.
Comment on Vázquez-Gandullo et al. Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review. Int. J. Environ. Res. Public Health 2022, 19, 5564
(MDPI, 2023) Yiğit, Şafak; Akıncı, Buket
In May 2022, the paper “Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review” was published in the International Journal of Environmental Research and Public Health. Sixteen studies were included in the review, and it was concluded that in the pulmonary rehabilitation program in which the inspiratory muscles were trained by using the Inspiratory Muscle Training (IMT) devices benefited the quality of life in patients with COPD [1]. We have read with great interest the systematic review which gives broad information about types of IMT and current devices used for the training. We would like to share our views and ask questions about the review.
Does the variant positivity and negativity affect the clinical course in COVID-19?: a cohort study
(Lippincott Williams and Wilkins, 2023) Yıldırım, Erkan; Kılıçkan, Levent; Aksoy, Süleyman Hilmi; Gözüküçük, Ramazan; Kılıç, Hasan Hüseyin; Tomak, Yakup; Dalkılıç, Orhan; Tanboğa, İbrahim Halil; Kılıçkan, Fevzi Duhan Berkan
The primary aim of the current study is to analyze the clinical, laboratory, and demographic data comparing the patients with Coronavirus Disease 2019 (COVID-19) admitted to our intensive care unit before and after the UK variant was first diagnosed in December 2020. The secondary objective was to describe a treatment approach for COVID-19. Between Mar 12, 2020, and Jun 22, 2021, 159 patients with COVID-19 were allocated into 2 groups: the variant negative group (77 patients before December 2020) and the variant positive group (82 patients after December 2020). The statistical analyses included early and late complications, demographic data, symptoms, comorbidities, intubation and mortality rates, and treatment options. Regarding early complications, unilateral pneumonia was more common in the variant (-) group (P = .019), whereas bilateral pneumonia was more common in the variant (+) group (P < .001). Regarding late complications, only cytomegalovirus pneumonia was observed more frequently in the variant (-) group (P = .023), whereas secondary gram (+) infection, pulmonary fibrosis (P = .048), acute respiratory distress syndrome (ARDS) (P = .017), and septic shock (P = .051) were more common in the variant (+) group. The therapeutic approach showed significant differences in the second group such as plasma exchange and extracorporeal membrane oxygenation which is more commonly used in the variant (+) group. Although mortality and intubation rates did not differ between the groups, severe challenging early and late complications were observed mainly in the variant (+) group, necessitating invasive treatment options. We hope that our data from the pandemic will shed light on this field. Regarding the COVID-19 pandemic, it is clear that there is much to be done to deal with future pandemics.
How well do ESWL nomograms predict treatment success in pediatric patients?
(Sage, 2022) Çakıroğlu, Basri; Gözüküçük, Ali; Uyanık, Bekir Sami
Objective: To study was to identify the variables that influence the outcomes of pediatric SWL patients in our clinic and to compare our findings to previously published nomograms. Methods: All children who underwent SWL at a single center between 2005 and 2020 were included in this retrospective study. Depending upon the age and mental state of the children, SWL procedures were performed with or without anesthesia. Data from the hospital information system were obtained on patient characteristics, metabolic evaluation, imaging, SWL details, and post-procedure results, and their correlation with the Onal and Dogan nomograms was evaluated. Results: The present study included 112 pediatric patients in total. The average age was 8.22 ± 4.9 (83.3 ± 58.1 months, 4 months-16 years), and the median stone size was 9.5 ± 3.2 mm (4-20 mm). Even though there was quite a significant positive correlation between age and the number of shots and the intensity of shots (intensity and number of shots increased with increasing age), there was no statistical difference in the number of sessions and stone-free rates. The number of shots and sessions was significantly lower in patients with hydronephrosis (N = 70) than in those without (N = 42) (p < 0.001). When the stone-free rates of patients without and with hydronephrosis were compared, it was discovered that they were 69.05% and 92.86%, respectively, which was statistically significant (p < 0.01). Conclusions: It is believed that the nomograms developed for SWL in pediatric patients should be reviewed, and larger, prospective studies should be conducted.
Antibiotic susceptibility of escherichia coli strains isolates determined as a cause of urinary tract infection in pediatric patients
(ScopeMed, 2022) Gözüküçük, Ali; Çakıroğlu, Basri
Urinary tract infections (UTIs) are bacterial infections that are most commonly encountered by physicians in all age groups both in the Nasocomial hospital and community acquired hospital. International guidelines are used for the selection of antibiotics. However, it is recommended to adopt the international guidelines into local epidemiological data before using it to select the routine treatment. In this study, it was aimed to determine the antimicrobial susceptibility of Escherichia coli (E.Coli) strains isolated from urinary tract infections in children applied due to urinary system infections and treated accordingly. It was designed to be examined to be raised from 249 children, with sales route design and sale to the pediatric and urinary outpatient clinic between July 1, 2019 and July 1, 2020. 210 patients with n?105 cfu/ml bacteria. Patients with vesicourethral reflux and neurogenic patients were excluded from the study. At the same time, people who can be displayed in the products that have been in use in the last six months and people who have grown Klebsiella, Proteus mirabilis, Candida and ESBL positive bacteria. 98 cultures included in the study were evaluated The mean age of totally 98 patients including 84 females and 14 males diagnosed with urinary tract infection was 37 (1-192) months. There was a statistically significant difference between each group with respect to age and they were as F:49 month and M: 9 respectively (p<0.001). Amoclavin-claviculinate 33.6%, ampicillin 20.4%, cefuroxime 25.5%, trimethoprimsulfamethoxazole (TMP-SMX) 19.4%, ciprofloxacin 7.1%, ceftriaxone 19.3% by disc diffusion and / or automated system tests in 141 isolated E. coli strains, 6.1% and 11.2% nitrofurantoin resistance rates were determined. ESBL was found positive in 7 (4.96%) of 141 E. coli isolated and these patients were excluded from the study. Recently, antibiotics are given empirically before performing urine culture and antibiograms and this situation causes the problem of resistance to widely preferred antibiotics. Cefixime, ampicillin or trimethoprim-sulfamethoxazole can be used as the first option in empirical treatment of pediatric urinary tract infections. However, urine culture and antibiogram should be performed if possible before antibiotics are given. It should not be ignored that the rates of resistance may change over time according to the frequent preference of antibiotics initiated empirically in that region or country.
Michelin Rehberi’nin İstanbul ve İstanbul’daki restoran işletmelerine olası etkileri üzerine bir değerlendirme
(2022) İbiş, Salim; Çakmak, Muzaffer; Çoşan, Dilek
Restoranlar, insanların temel gereksinimi olacak yeme içme ihtiyaçlarını ev dışında karşılamak amacıyla ortaya çıkmış işletmelerdir. Bu işletmeler her geçen gün nicelik olarak artmakla birlikte nitelik olarak da gelişmektedir. Tüketicilerin bu işletmelerden beklentileri her geçen gün değişmekle birlikte işletmeler arası rekabet de artmaktadır. Bu durum restoran işletmeleri arasında bir değerlendirme sürecini başlatmıştır. Dünya genelinde kabul görmüş önde gelen restoran değerlendirme rehberi Michelin Rehberi’dir. Bu çalışmanın amacı Michelin Rehberi’nin başta İstanbul’daki restoran işletmeleri olmak üzere, etkilerini literatürdeki araştırma sonuçlarından faydalanarak ortaya koymaktır. Bu amaçla farklı destinasyonlara ve farklı işletmelere yönelik daha önce yapılmış çalışmaların sonuçlarından yola çıkılarak uygulamanın İstanbul ve İstanbul’daki işletmelere olası etkileri araştırılmıştır. Araştırma sonuçları, Michelin Rehberi’nin İstanbul’da değerlendirmelere başlamasının; yiyecek içecek sektörünün gelişmesine, İstanbul’un bir gastronomi merkezi olmasına ve buna bağlı olarak nitelikli istihdam olanaklarının gelişmesine katkı sağlayacaktır. Bu sürecin aynı zamanda, inovasyon kültürünün geliştirmesine katkıda bulunurken lezzet ve kalite standartlarının yükselmesini beraberinde getireceği düşünülmektedir. Bununla birlikte geleneksellikten uzaklaşma, yerel mutfağın olumsuz etkilenmesi gibi bazı olası tehditlerin de ortaya çıkabileceği düşünülmektedir.
The effects of stone density on surgical outcomes of retrograde intrarenal stone surgery
(NLM (Medline), 2022) Aksoy, Süleyman Hilmi; Çakıroğlu, Basri; Taş, Tuncay; Yurdaışık, Işıl
OBJECTIVE: Several pre-operative parameters have been studied to estimate stone-free rate (SFR) following retrograde intrarenal surgery (RIRS) procedures. The objective of this study was to evaluate the effects of stone density on surgical outcomes of RIRS. METHODS: This retrospective study included 30 stone-free patients (Group SF) and 30 patients with residual fragments (Group RF). Patients' age and gender, laterality, non-contrast CT findings, including size and density of the kidney stones, infundibular pelvic angle (IPA), operational time, and post-operative pain were recorded and compared between the two groups. The stone density was measured by free hand region of interest (ROI) determination coincident with the stone borders and expressed as Hounsfield units (HUs). RESULTS: The rate of single stones was significantly higher in Group SF compared to Group RF (p < 0.001). The mean stone size was found as 11.93 ± 7.81 mm in Group SF and 16.27 ± 7.29 mm in Group RF with the difference being statistically significant (p < 0.001). The mean IPA was 53.87 degrees in Group SF and 50.33 degrees in Group RF. The mean density was measured as 748.17 ± 318.14 HU in Group SF and 945.90 ± 345.30 HU in Group RF. The mean stone density was statistically significantly higher in patients with residual fragments compared to the stone-free patients (p < 0.001). CONCLUSION: This study revealed that stone density as measured as HU affects the treatment outcomes with RIRS procedure and the mean density is significantly higher in patients with residual stone fragments. ADVANCES IN KNOWLEDGE: Studies about the effects of HUs on stone-free rate are limited in the literature. Stone density affects the treatment outcomes with RIRS procedure and the mean density is significantly higher in patients with residual stone fragments.

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