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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only Investigation of nursing students' knowledge levels and attitudes in incontinence-associated dermatitis management through game-based learning: a mixed methods study(HMP, 2024) Kaya, Nurten; Kirkland-Kyhn, Holly; N/A; Şengül, Tuba; Akyaz, Dilek Yılmaz; Cevizci, Tuğba; Oldaç, Tuğçe; Koyun, Hamza Can; School of Nursing; Koç University HospitalPURPOSE: This study aimed to assess nursing students' knowledge levels and attitudes towards the etiology, risk factors, and preventive measures of incontinence-associated dermatitis (IAD) using an escape room game. DESIGN: A mixed-method study. SUBJECTS AND SETTING: The sample size of the study was 32 students. METHODS: Quantitative data obtained with the Knowledge, Attitude and Practice of Nurses in Managing Incontinence-Associated Dermatitis Questionnaire (KAP-IAD-Q) and qualitative data obtained through FGDs following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist were analyzed using a thematic approach. RESULTS: The average age of the participants was 22.63 +/- 0.90, 87.5% of them were female (n=28), and 50% were third (n=16) and fourth-year students (n=16). KAP-IAD-Q total posttest score (88.06+7.00) was found to be high. Data obtained from the FGDs were categorized under 3 main themes: main focus areas during participation in the IAD-themed escape room game; advantages and disadvantages of teamwork in IAD management; and the game's contribution to a better understanding and classification of IAD. CONCLUSIONS: The use of the escape room game facilitated high, fast, and efficient learning of IAD knowledge and attitudes. It revealed challenges in collaborative decision-making, accurate diagnosis, distinguishing from other wounds, and attitude development in the management of IAD.Publication Metadata only Chitosan in cancer therapy: a dual role as a therapeutic agent and drug delivery system(Walter de Gruyter Gmbh, 2024) Atmaca, Harika; Ilhan, Suleyman; N/A; Oğuz, Ferdi; Graduate School of Health SciencesAlthough chemotherapy is still the most preferred treatment for cancer, most chemotherapeutic agents target both cancer cells and healthy cells and cause serious side effects due to high toxicity. Improved drug delivery systems (DDSs), which enhance the efficacy of current chemotherapeutic drugs while reducing their toxicity, offer potential solutions to these challenges. Chitosan (CS) and its derivatives are biopolymers with biodegradable, biocompatible, and low-toxicity properties, and their structure allows for convenient chemical and mechanical modifications. In its role as a therapeutic agent, CS can impede the proliferation of tumor cells through the inhibition of angiogenesis and metastasis, as well as by triggering apoptosis. CS and its derivatives are also frequently preferred as DDSs due to their properties such as high drug-carrying capacity, polycationic structure, long-term circulation, and direct targeting of cancer cells. Various therapeutic agents linked to CS and its derivatives demonstrate potent anticancer effects with advantages such as reduced side effects compared to the original drugs, owing to factors like targeted distribution within cancer tissues and sustained release. This review emphasizes the utilization of CS and its derivatives, both as therapeutic agents and as carriers for established chemotherapeutic drugs.Publication Metadata only Anesthesiological and surgical perspectives on using 8 MMHG versus 12 MMHG pneumoperitoneum pressures during robotic radical prostatectomy: Results of a prospective randomized study(Turkish Assoc Trauma Emergency Surgery, 2024) N/A; Manici, Mete; Aykanat, İbrahim Can; Tarım, Kayhan; Gürkan, Yavuz; Canda, Abdullah Erdem; School of Medicine; Koç University HospitalBACKGROUND: This study aims to compare the effects of 8 mmHg and 12 mmHg pneumoperitoneum (PNP) pressures on operative, postoperative, and anesthesiological parameters in robot -assisted laparoscopic radical prostatectomy (RARP). METHODS: In this prospective study, 43 patients undergoing RARP performed by a single experienced surgeon were randomly assigned to either the low-pressure group (8 mmHg - Group I) or the standard -pressure group (12 mmHg - Group II). We evaluated the operative and postoperative parameters from both urological and anesthesiological perspectives. All patients were treated using the AirSeal (R) insufflation system. RESULTS: No statistically significant differences were observed between the groups in terms of console time, estimated blood loss, time to first flatus, or hospital length of stay. PNP was increased due to bleeding in six patients in the 8 mmHg group and two patients in the 12 mmHg group. Except for the heart rate measured five minutes after the initial incision, there were no observed differences between the groups in terms of blood pressure, ventilation, and administered medications. The heart rate was significantly lower in Group I (54.4 vs. 68.8, p=0.006). Additionally, during the surgery, the number of manipulations performed by the anesthesiologists, including drug administrations and ventilator management, was significantly lower in Group I (6.1 vs. 9.6, p=0.041). CONCLUSION: In RARP, while the 8 mmHg PNP pressure does not demonstrate differences in operative parameters compared to the 12 mmHg pressure, it offers the advantage of requiring fewer anesthetic interventions, thus minimizing the impact on cardiovascular and respiratory systems.Publication Metadata only Thermal immersion in managing greater weever sting: A case study on delayed recovery(Turkish Assoc Trauma Emergency Surgery, 2024) Eyinç, Erim; N/A; Aslan, Lercan; Gökdemir, Erdinç; Çalışkan, Emrah; School of Medicine; Koç University HospitalWe report the case of a 49-year-old woman who suffered an envenomation from a greater weever during a seaside vacation along the Aegean coast in Izmir, Türkiye. Following the incident, she experienced intense pain and sought treatment at an emergency department, where she received analgesics and cold compresses. Unfortunately, this approach failed to alleviate her pain, which persisted for approximately 24 hours. On the twelfth day, with symptoms worsening and the emergence of a larger wound than the one sustained on the day of the incident, she visited the University Hospital for further care, where she received periodic wound cleaning and a six-week antibiotic treatment regimen for possible osteomyelitis after suspicious findings on her Magnetic Resonance Imaging. The standard treatment for piscine envenomation involves hot water immersion to neutralize thermolabile toxins, providing pain relief and preventing subsequent complications. The water temperature should be between 40 and 45 degrees Celsius, and the affected body part should be immersed for at least 60 minutes. This case underscores the critical nature of hot water immersion in managing envenomation, a step which, if omitted, can result in extended pain duration and the evolution of a wound requiring over five months to heal.Publication Metadata only Can TRIF/TICAM-1 dependent pathway be target pathway in lumbar intervertebral disc degeneration?(Turkish Neurosurgical Society, 2023) ALIZADA, Orkhan; AKYOL, Sibel; OZLEN, Fatma; CETINTAS, Semih Can; TURK, Okan; HANCI, Murat; N/A; Akgün, Mehmet Yiğit; N/A; Koç University HospitalAIM: To elucidate the role of the TIR-domain-containing adaptor-inducing interferon-β (TRIF) dependent pathway in intervertebral disc degeneration (IVD). MATERIAL and METHODS: A total of adult male patients with low back pain (LBP) (+/- radicular pain) were further evaluated by magnetic resonance imaging (MRI) with surgical indication for microscopic lumbar disc herniation (LDH). Preoperatively, patients were classified according to Modic Changes (MC), nonsteroidal anti-inflammatory drugs (NSAIDs) use, and the presence of radicular pain in addition to the LBP. RESULTS: The age of the 88 patients ranged from 19 to 75 years (mean: 47.3 ± 19.6 years). Twenty eight of the patients were evaluated as MC I (31.8%), 40 as MC II (45.4%), and 20 as MC III (22.7%). The majority of patients (81.8%) had radicular LBP, while 16 patients (18.1%) had only LBP. Predominantly, 55.6% of all patients were taking NSAIDs. Levels of all adaptor molecules were highest in the MC I group and lowest in the MC III group. The levels of IRF3, TICAM1, TICAM2, NF-kB p65, TRAF6, and TLR4 were significantly increased in the MC I group compared to the MC II and MC III groups. The variations of the individual adaptor molecules showed no statistically significant difference in the use of NSAIDs and radicular LBP. CONCLUSION: As a result of the impact assessment, the current study clearly demonstrated for the first time that the TRIF-dependent signalling pathway plays a crucial role in the degeneration process in human lumbar intervertebral disc specimens. © 2023. All Right Reserved.Publication Metadata only Is the modular dynamic system as effective as classical dynamic systems in long segment dynamic thoracolumbar stabilization?(Turkish Neurosurgical Society, 2024) N/A; Günerbüyük, Caner; Akgün, Mehmet Yiğit; Özer, Ali Fahir; School of Medicine; Koç University HospitalAIM: To evaluate the outcomes of dynamic stabilization in the multilevel degenerative spondylotic spine, and to compare the two dynamic systems (Dynesys (R) and Orthrus (R)) to reveal the increasing role of dynamic systems in the management of the degenerative spine. MATERIAL and METHODS: A total of 74 patients who received dynamic stabilization for degenerative pathologies were retrospectively analyzed. Demographic details: preoperative data including neurological status, pain scores, and radiology; and intraoperative data including blood loss, duration of surgery, complications, and postoperative data including the neurologic status, duration of hospital stay, and pain scores were examined. RESULTS: Patients in both groups showed statistically significant improvements in their Visual Analog Scale and Oswestry Disability Index scores. Significant corrections of thoracic kyphosis (T2 -T12), the sagittal vertical axis, and T10 -L2 thoracolumbar kyphosis were obtained in our cohort (p<0.05). A total of 4 patients received revision surgery due to screw loosening. Patients were discharged after 3-4 days and mobilized on the first postoperative day. CONCLUSION: We did not experience any serious issues in terms of stabilization in the cases in which we employed both systems. Our patients' clinical results were satisfactory in both systems. Existing systems can be used safely even in long -segment stabilization surgeries.Publication Metadata only Pain types and risk factors in post-Covid-19(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2024) Zure, Mert; Akpinar, Fatma Merih; Ozdemir, Yelda Soluk; Balbaloglu, Oezlem; Akaltun, Mazlum Serdar; Erden, Ender; Turk, Ayla Cagliyan; Korkmaz, Merve Damla; Okmen, Burcu Metin; Altindag, Oezlem; Soyupek, Feray; Yaksi, Elif; Sindel, Dilsad; Sezgin, Nalan; Ustaomer, Kubra; Kesiktas, Fatma Nur; Dere, Didem; Gunes, Sevket; Ceylan, Cansin Medin; Tur, Birkan Sonel; Evcik, Deniz; N/A; Ketenci, Ayşegül; School of MedicineObjectives: This study aims to accurately evaluate pain lasting longer than three months and falls under the category of chronic pain and to determine the risk factors to follow up and treat properly and to develop appropriate diagnostic and treatment algorithms. Patients and methods: Between March 2021 and December 2021, a total of 437 patients (162 males, 275 females; mean age: 44 +/- 14.6 years; range, 12 to 82 years) who were referred to the participating centers due to pain complaints and were diagnosed with post-COVID-19 condition according to the criteria defined by the World Health Organization (WHO) were included in the study. The patients were divided into three groups as nociceptive pain, neuropathic pain, and central sensitization, based on the physician's clinical evaluation and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Central Sensitization Inventory scores. Results: The most common diagnosis was nociceptive pain followed by central sensitization. Patients with nociceptive pain had less pain. It was found that not exercising regularly, having a chronic disease and being a woman were risk factors for central sensitization, having thyroid disease before COVID-19, and defining the current pain as very severe were risk factors for neuropathic pain. Conclusion: In the evaluation of post-COVID-19 pain, neuropathic pain and central sensitization should be also considered in addition to nociceptive pain and the severity of pain, systemic diseases and physical activity should be questioned.Publication Metadata only Is it possible to objectively determine morning stiffness in rheumatoid arthritis?(Baycinar Medical Publ-Bayçınar Tıbbi Yayıncılık, 2024) Mengi, Gönen; Aydoğmuş, Hüseyin; Göğüş, Feride; Beyazova, Mehmet; N/A; Taşkıran, Özden Özyemişçi; School of MedicineObjectives: This study aimed to objectively and quantitatively exhibit morning stiffness by using electrophysiological methods. Patients and methods: The prospective, controlled study was conducted with 52 participants between February 2013 and February 2014. Of the participants, 26 were recruited among RA patients (3 males, 23 females; mean age: 55.9±11.2 years; range, 24 to 74 years) followed at the rheumatology clinic, and 26 were healthy subjects (4 males, 22 females; mean age: 54.9±8.3 years; range, 41 to 70 years) for the control group. Duration and severity of morning stiffness were recorded for all participants. Activity of disease and functional status were evaluated by the Disease Activity Score 28 and Health Assessment Questionnaire (HAQ), respectively. Electrophysiological reaction times, severity of pain (Visual Analog Scale), HAQ, and grip strength were measured for each participant twice in 24 h in the morning (08:00-09:00 am) and afternoon (03:00-05:00 pm). Results: In the RA group, motor reaction and response times and severity of pain values were significantly lower in the afternoon compared to the morning (p=0.030, p=0.031, and p=0.002, respectively), and hand grip strengths were significantly higher in the afternoon (p=0.007). In the control group, no change was observed between morning and afternoon measurements in the strength and reaction time variables. Conclusion: Our hypothesis that stiffness would slow down the movements in the morning in RA was supported by the prolonged motor and response times in the morning compared to the afternoon. However, in the control group (no morning stiffness), there was no difference in reaction time variables between the morning and afternoon, objectively demonstrating the concept of morning stiffness in this study. © 2024 Turkish Society of Physical Medicine and Rehabilitation. All rights reserved.Publication Metadata only Does fear of activity predict exercise capacity in patients with coronary artery disease in both sexes? A cross-sectional multicenter study(Baycinar Medical Publ-Bayçınar Tıbbi Yayıncılık, 2024) Demirsoy, Nesrin; Atan, Tugba; Durmus, Dilek; Tur, Birkan Sonel; Findikoglu, Gulin; Guzel, Rengin; Uzumcugil, Hale; Eksioglu, Emel; Sarikaya, Selda; Soyupek, Feray; Ayhan, Fikriye Figen; Kabayel, Derya Demirbag; Ozdemir, Hande; Duran, Ummugulsum Dogan; Aydemir, Koray; Karaahmet, Ozgur; Sutbeyaz, Serap; Aytur, Yesim Kurtais; Dulgeroglu, Deniz; N/A; Taşkıran, Özden Özyemişçi; School of MedicineObjectives: This study aimed to identify whether fear of activity predicts exercise capacity in patients with coronary artery disease (CAD) and whether there is a difference between sexes regarding this relationship. Patients and methods: One hundred ninety-seven patients (145 males, 52 females; mean age: 56.3 +/- 10.8 years; range, 22 to 80 years) with a diagnosis of CAD or cardiac event in the previous one to 60 months were enrolled in this cross-sectional multicenter study between November 2015 and February 2017. Demographic and clinical features were recorded. Fear of activity was assessed by the fear of activity scale in patients with CAD (FactCAD). A 6 -min walk test was used to assess exercise capacity. Results: Female participants were older, less educated, and less employed (p=0.045, p=0.048, and p<0.001, respectively) than males. Prevalence of myocardial infarction was higher in males. Comorbidities were higher in females. Multiple linear regression predicted 6 -min walk distance (6MWD) based on FactCAD, sex, and education level with an r -squared of 0.321 (p<0.001). Fear of activity had an effect on walking distance in males (each additional score of FactCAD predicts a decrease of 1.3 m in 6MWD), together with disease duration, presence of chronic pulmonary disease, and low back pain, whereas fear of activity was not a predicting factor on walking distance in females. Age, education, and presence of angina predicted 6MWD in females. Conclusion: This study emphasizes that fear of activity is one of the predictors of 6MWD in males with CAD, and its assessment is recommended as a possible barrier to rehabilitation.Publication Metadata only Transient ageusia and dysgeusia following thalamic cyst drainage(Turkish Neurosurgical Society, 2024) N/A; Nokay, Aziz Emre; Erden, Mert Emre; Samancı, Mustafa Yavuz; Peker, Selçuk; School of MedicineTaste consists of sensation and perception. Specific neural structures transmit a stimulus from the taste buds to the gustatory cortex to generate taste sensation. Any disruption of this pathway, whether it affects sensation or perception, can result in taste disorders. Stereotactic procedures involving the thalamus may result in gustatory complications. A 41-year-old female patient who underwent stereotactic drainage of a thalamic cyst suffered transient ageusia. Subsequently, she developed metallic taste perception. When her stereotactic plan was re-evaluated, it was noted that the posteromedial ventral thalamus nucleus was in the path of the needle tract and the needle had passed through it. Follow-up was recommended and her symptoms completely resolved within 2 months following surgery. Modern imaging techniques allow for the visualization of neural structures related to the sense of taste. Additionally, care must be taken when planning stereotactic procedures for such lesions.