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Publication Open Access Jinekolojik kanser kontrolü ve hemşirelik(Hacettepe Üniversitesi Hemşirelik Fakültesi, 2014) Koç, Gülten; Eroğlu, Kafiye; Faculty Member; School of Nursing; 6061Kanser ile ilgili son veriler, hem dünyada hem de ülkemizde jinekolojik kanserlerin insidans ve mortalite açısından ilk on kanser türü içinde yer aldığını göstermektedir. Jinekolojik kanserler tedavinin manevi ve maddi yükünün fazlalığı ile diğer kanserlerden farklıdır. Bu nedenle jinekolojik kanser mortalite ve morbiditesinin azaltılmasında kanser kontrolüne yönelik geliştirilmiş stratejiler daha da önem kazanmaktadır. Hemşireler kanser kontrolünün her aşamasında önemli rolleri olan sağlık çalışanlarıdır. Kanser kontrolünde hemşire kanseri önleme, tarama ve tanılamada danışmanlık yapma, bakım verme, sağlık eğitimi yapma, kanser vakalarını yönetme ve araştırma yapma rollerine sahiptir. Bu nedenle jinekolojik kanser ile ilişkili faktörleri bilerek kapsamlı bir tanılama, risk belirleme, genetik yatkınlık konularında analiz ve sentez yapabilecek bilgiye sahip olmalıdır. Böylece jinekolojik kanser gelişmesini önlemeye ve kansere bağlı ölümleri azaltmaya yönelik bireye özgü programlar geliştirebilir. Anahtar kelimeler: Jinekolojik kanser, kanserden korunma, sağlığın geliştirilmesi, hemşirelik. / The most recent data about cancer demonstrate that gynaecological cancers rank among the top ten types of cancer in terms of both incidence and mortality in the world and in Turkey. The gyneacological cancers differ from other cancers with respect to the high financial and moral burden of their therapies. For that reason, the strategies developed for cancer control in reducing the gyneacological cancer mortality and morbidity have become even more prominent. Nurses are healthcare professionals who have crucial roles in every level of cancer control. In cancer control, a nurse assumes roles of preventing cancer, counseling during screening and diagnosis, providing care, conducting health education, managing cancer cases and carrying out research. Therefore, s/he should have enough knowledge for being able to do analysis and synthesis by doing a comprehensive diagnosis, risk identification and genetic predisposition with awareness of gynaecological cancer-related factors. Thus, personalized programs geared towards preventing the development of gynaecological cancer and reducing cancer-related deaths may be developed.Publication Open Access Granulomatosis with Poliangiitis (GPA)(Hacettepe Tıp Fakültesi, 2021) Kanıtez, Nilüfer Alpay; Şentürk, Begüm Güler; Faculty Member; Researcher; School of Medicine; 239432; 327593NAPublication Open Access First case of severe late ovarian hyperstimulation syndrome in a patient who was treated with in-vitro maturation of human oocytes and planed short gonadotropin stimulation(Open Journal of Clinical and Medical Case Reports, 2016) N/A; Ata, Mustafa Barış; Faculty Member; School of Medicine; 182910In-vitro maturation is a technique used to perform assisted reproduction in women with high ovarian reserve, who are at risk for ovarian stimulation. With this technique occasionally 3-4 days of gonadotropins are planned to enlarge the follicles and aid in oocyte collection. Human choreinonic gonadotropin is also given to ease the collection. These few days of ovarian stimulation were felt to be insufficient to cause severe ovarian hyperstimlation syndrome. However, the case of a 32 year old women with polycystic ovary syndrome who underwent planned ovarian stimulation with four days of gonadotropins for a stimulated IVM cycle, and who developed severe ovarian hyperstimulation syndrome is presented. This is the first case of ovarian hyperstimulation syndrome in an IVM cycle. Clearly, only unstimulated IVM can be used to completely avoid ovarian hyperstimulation syndrome.Publication Open Access Comparison of anxiety and depression scores between patients with and without ST-segment elevation acute coronary syndrome(Bayçınar Tıbbi Yayıncılık ve Reklam Hizmetleri, 2021) Palabıyık, Mert; Sinan, Ümit Yaşar; Çetinarslan, Özge; Oktay, Veysel; Özkan, Alev; Faculty Member; School of Medicine; Koç University Hospital; 12695Objectives: we aimed to investigate the difference between anxiety and depression status among ST-segment elevation acute coronary syndrome (STE-ACS) and non-ST-segment elevation ACS (NSTE-ACS) patients. Patients and methods: this study is a cross-sectional study that included 165 patients (132 males, 33 females; mean age: 59.3±10.5 years; range, 48 to 71 years) who were hospitalized with a final diagnosis of ACS (both NSTE-ACS and STE-ACS) between January 2019 and April 2019. The Hospital Anxiety and Depression Scale (HADS) was used to measure the patients’ anxiety and depression status. Results: according to current European Society of Cardiology (ESC) guidelines, 91 (55.2%) patients were classified as NSTE-ACS and 74 (44.8%) patients as STE-ACS. According to the HADS scores, 33 (20%) of the total study population had anxiety diagnoses, and 28 (17%) of them had depression . While the mean depression score was 4.8±4.9 for NSTE-ACS patients, it was 4.6±4.3 for STE-ACS patients (p=0.723). The mean anxiety score was 6.1±5.1 for NSTE-ACS patients and 5.6±4.5 for STE-ACS patients (p=0.546), which was similar between the two groups. Conclusion: although NSTE-ACS and STE-ACS are two different entities of ACS spectrum, patients hospitalized with these diagnoses have similar anxiety and depression scores.Publication Open Access Infrared temassız alın termometresi: çocukların ateş ölçümünde güvenilir bir yöntem mi? sistematik derleme(Hemşirelikte Araştırma Geliştirme Derneği, 2014) Ekim, Ayfer; Ocakçı, Ayşe Ferda; Faculty Member; School of Nursing; 1729Amaç: Bu sistematik derlemede, son yıllarda çocuklarda yaygın olarak kullanılmaya başlanan infrared temassız alın termometresi ölçümlerinin, diğer ölçüm yöntemleri ile karşılaştırıldığı araştırmaların gözden geçirilmesi amaçlanmıştır. Yöntem: Konu ile ilgili araştırmalara ulaşmak için PubMed, Ulakbim, Türk Medline, Ulusal Tez Tarama veri tabanı ve ülkemizde düzenli olarak yayınlanan, editörlü ve çevrimiçi olarak ulaşılabilen 13 hemşirelik dergisinin arşivleri kullanılmıştır. Bulgular: Araştırmalar, infrared temassız alın termometresinin duyarlılığının “yüksek”, özgüllüğünün “düşük” olduğunu göstermektedir. İncelenen araştırmaların %37,5’i çocukların ateş ölçümlerinde en güvenilir yöntemin rektal ölçümler olduğu, infrared temassız alın termometresinin, rektal ölçüm yapılamadığı durumlarda ancak alternatif olarak kullanılabileceği, %12,5’i ise bu yöntemin kullanılmaması gerektiğini ortaya koymaktadır. Araştırmaların %31,2’sinde rektal termometre ve infrared temassız alın termometre ölçüm sonuçları arasında korelasyon düzeyinin yüksek olduğu (0,74-0,91) saptanmış olup, infrared temassız alın termometresinin çocuklarda güvenle kullanılabileceği gösterilmektedir. Sonuç: Çocuklarda, infrared temassız alın termometresi ölçümlerinin etkililiğini ortaya koyma konusunda verilerin oldukça sınırlı olmasına rağmen, araştırma sonuçları, 0-3 ay arası çocuklarda ve yoğun bakım kliniklerinde infrared temassız alın termometresinin kullanılmasının uygun olmadığını göstermektedir. Bunun yanında, ev ortamında çocuğun ateşinin değerlendirilmesi ve hızlı kullanımından dolayı da taramalarda kullanılabileceği belirtilmektedir. / Objective: In this systematic review, it was aimed to take a glance at the studies in which non-contact infrared forehead thermometer measurements were compared to other measurement techniques. Method: In order to access the studies on the issue, Pubmed, Ulakbim, Turkish Medline, National Thesis Scanning Database and the archives of 13 Nursing journals published either written or online were used. Results: The studies showed that the sensitivity of infrared non-contact forehead thermometer was “high” and its specificity was “low”. In 37.5% of the studies, it was revealed that the most reliable method of measuring fever was rectal measurement, and infrared non-contact forehead thermometer measurement could only be used as an alternative way when rectal measurement could not be performed. In addition; according to 12.5% of studies, infrared non-contact thermometer measurement technique should never be used. In 31.2% of the studies, it was shown that a high correlation (0.74 - 0.91) was determined between the rectal thermometer results and the results of infrared non-contact forehead thermometer, and infrared non-contact thermometer could safely be used in children. Conclusion: Even though the data on efficiency of infrared non-contact forehead thermometer measurements in children are rather limited, the study results set forth that it is not appropriate to use that technique in children between 0-3 months and in intensive care units. However, it is stated that infrared non-contact forehead thermometer is an easy to use technique at home owing to its easy evaluation and practicality.Publication Open Access The importance of a preoperative surgical strategy meeting for good patient outcomes(Pamukkale Üniversitesi, 2022) Ömeroğlu, Sinan; Tanal, Mert; Kaya, Cemal; Özoran, Emre; Bozkurt, Emre; Özata, İbrahim Halil; Teaching Faculty; School of Medicine; Koç University Hospital; 307296; N/APurpose: interest in measures to surgical quality improvement is increasing with increased awareness of iatrogenic injuries. These injuries can be prevented by an improved organisational safety habit. We implemented preoperative surgical strategy meeting chart in the clinical and operational basis in our hospital to improve postoperative outcomes. This study was conducted as comparement of outcomes of patients with and without implementation of preoperative surgical strategy meeting forms. Material and methods: data including the demographic characteristics of patients, procedural data, and data of preoperative surgical strategy meeting were recorded retrospectively. Patients were divided into two groups according to the preoperative surgical strategy meeting chart application status. Group 1 included the patients with provided PSSM and group 2 included the remaining patients. Data related with surgical procedure and patients’ outcomes were compared between these groups. Results: one hundred and forty patients were enrolled in this study. The mean age of the patients was 45.28±17 years. The female to male ratio was 62:78. Patients were grouped according to the application status of PSSM. There was no statistically significant difference in the mean age, sex, operation type (emergent or elective) and conversion to open surgery rates. In Group 2 being ready of patient file in the operating theatre preoperatively was statistically significantly low when compared to Group 1 (p=0.021). Operation time was detected statistically significant short for patients in Group 1 (p<0.001). Conclusion: integrating this behavioural intervention into the clinical routine demonstrated the improvements in patient outcomes and adherence to the safety process. / Amaç: iyatrojenik yaralanmalar konusunda farkındalık arttıkça, cerrahi kalite gelişimi konusunda ilgi artmaktadır. Bu yaralanmalar artan organizasyonel güvenlik kültürü ile önlenebilmektedir. Hastanemizde, ameliyat sonrası sonuçlanımları geliştirmek için klinik ve ameliyathanede cerrahi strateji toplantısı şablonu oluşturulmuştur. Bu çalışmada ameliyat öncesi cerrahi strateji toplantısı şablonu uygulanan ve uygulanmayan hastaları karşılaştırmak için düzenlenmiştir. Gereç ve yöntem: hastaların demografik verileri, ameliyat verileri ve ameliyat öncesi cerrahi strateji toplantısı verileri retrospektif olarak toplandı. Hastalar ameliyat öncesi cerrahi strateji toplantısı şablonu (PSSM) uygulama durumuna göre iki gruba ayrıldı. Grup 1’deki PSSM’si olan hastaları, grup 2 diğer hastaları içermektedir. İki gruptaki cerrahi prosedürle ilgili veriler ve hastaların sonuçları karşılaştırılmıştır. Bulgular: çalışmaya 140 hasta dahil edilmiştir. Hastaların ortalama yaşı 45,28±17 idi. Çalışmaya katılan hastaların kadın erkek oranı 62:78 idi. Hastalar PSSM’nin uygulanma statüsüne göre gruplandılar. Ortanca yaş (p=0,966), cinsiyet (p=1), ameliyat tipi (acil veya elektif p=0,323) ve açık cerrahiye geçme oranları (p=0,295) arasında istatistiksel olarak farklılık saptanmadı. Grup 2’de hastaların dosyalarının ameliyathanede ameliyat öncesi hazır bulunma oranı Grup 1’e oranlar istatistiksel olarka anlamlı derecede düşüktü (p=0,021). Grup 1’deki hastaların ameliyat süreleri istatistiksel olarak anlamlı derecede kısaydı (p<0,001). Sonuç: bu davranışsal girişimin klinikte rutin olarak uygulanması hasta sonuçlarında iyileşme, güvenlik prosedürlerin uyumu arttırmaktadır.Publication Open Access The effect of chewing gum on oral mucositis in children receiving chemotherapy(Insight Medical Publishing, 2014) Ayverdi, Didem; Ekim, Ayfer; Ocakçı, Ayşe Ferda; Faculty Member; School of Nursing; 1729Background: Oral mucositis is an important clinical problem, resulting in significant patient morbidity, a change in health-related quality of life, and supportive care. The purpose of this study was to assess the efficiency of chewing gum on children, who are receiving chemotherapy regimens, for prevention and treatment of oral mucositis. Method and Material: The study sample consisted of 60 children (30 study group-30 control group) between the ages 6-18 years. All the children have received chemotherapy at least once. Study group children chewed non-sugar gums three times a day at least 20 minutes during 10 days. In oral assessment, WHO Oral Mucositis Assessment Scale and Eilers’ Oral assessment Guide was used and also salivary pH measurement was done. Results: The rate of children who was assessed as Grade 1 and Grade 2, decreased 46.1% in study group and this rate decreased to 20.8% in the control group. At the beginning of the study, 13.3% of the study group children were assessed as Grade 3 but at the end of the study none of the children were observed at Grade 3. Also, statistically significant difference was found between study and control groups’ pH values. Conclusion: The results of that study show new evidence about preventing and decreasing severity of oral mucositis for the children, receiving chemotherapy.Publication Open Access A case of radiologically isolated syndrome developing Balo's concentric sclerosis lesions on long-term follow-up(Elsevier, 2022) Danyeli, Ayça Ersen; Altıntaş, Ayşe; Çalışkan, İlay; Peker, Selçuk; Faculty Member; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Graduate School of Health Sciences; Koç University Hospital; 11611; N/A; N/A; 11480Background; Radiologically Isolated Syndrome (RIS) depicts a clinical scenario with multiple sclerosis (MS)-like magnetic resonance imaging (MRI) findings in individuals without clinical features of a demyelinating bout. Balo’s concentric sclerosis (BCS) on the other hand, is a variant of MS characterized by concentrically layered white mater demyelinating lesions. Case presentation: a 49-year-old male with an incidental brain lesion on MRI underwent a stereotactic biopsy and diagnosed as a demyelinating process. He remained asymptomatic throughout the long term clinical and radiological follow-up. However, the patient developed new demyelinating lesions with some showing concentric layers of BCS. Conclusion:this is the first reported case; to our knowledge, whereby a pathologically verified RIS patient developed characteristic BCS lesions. Our case highlights the heterogeneity of RIS as a clinico-radiological entity, requiring further sub-classification of the spectrum for improved managementPublication Open Access The effect of leg ischemia/reperfusion injury on the liver in an experimental breast cancer model(SelSistem, 2021) Erkent, Murathan; Akbulut Dinç, Güneş; Horzum, Utku; Esendağlı, Güneş; Meriçöz, Çisel Aydın; Teaching Faculty; School of Medicine; Koç University Hospital; 162418Background/aim: Ischemia/reperfusion (I/R) injury occurs during breast cancer surgery, especially those involving a modified radical mastectomy, lumpectomy, and axillary lymph node dissection. Tissue damage and stress due to I/R alter immune system functions, especially those of the myeloid cells. The immunologic impact of this I/R injury on myeloid-derived cancerous cells remains unknown. We sought to investigate the effect of I/R injury in the extremity close the breast tumor location on myeloid cell population in the liver and liver metastasis. Methods: 4T1 breast tumors were created in the left inguinal breast region of the experimental animals. When the tumor reached 0.5 cm in diameter, ischemia was produced on the left down-extremity for 90 min and reperfusion was induced for short (3 days), middle (7 days), and long terms (14 days). At the end of the reperfusion period, proximal limbs and livers were harvested. The limb and liver samples were histopathologically examined with H&E staining. Immune cell percentages were determined in the liver by flow cytometry. Results: there was an increase in muscle fiber degeneration and disorganization in the I/R induced proximal legs on days 3 and 7 of I/R in both tumor free and tumor bearing animals with a further impact in tumor bearing mice. Even though I/R injury did not affect tumor metastasis to the liver, it had an impact on liver myeloid cell percentages in both tumor free and tumor bearing animals. Additionally, tumor bearing mice demonstrated higher myeloid cell percentages in both the pre-I/R and post-I/R experimental groups. There was a remarkable change in the levels of granulocytic, and monocytic myeloid cells and macrophages due to the I/R injury. Conclusion: with the formation of short-term I/R injury in a distant site, tumor development and/or seeding to metastasis sites after surgery could be prevented. This study contributes to the understanding of the inflammatory process after I/R injury occurring during interventions.Publication Open Access Urinary retention after non-urological surgeries: management patterns and predictors of prognosis(Elsevier, 2022) Kılıç, Mert; Tekimana, Fadimana Bozkurt; Acar, Ömer; Köseoğlu, Ersin; Tarcan, Tufan; Faculty Member; Faculty Member; Other; School of Medicine; 237530; 350876; 173289Objective: urinary retention after non-urological surgery is a common morbidity, yet its etiology and treatment approaches are still a matter of debate. The primary aims of this study are to evaluate the management of urinary retention after non-urological surgeries, determine the predictors of prognosis, and report follow-up data. Methods: patients who were referred to the urology clinic at a single center due to postoperative urinary retention between December 2014 and November 2021 were included. Demographical, clinical, and surgical parameters were recorded. In all patients, a urethral catheter was kept in-situ for at least 5 days after urinary retention. In case of persistent urinary retention after catheter removal, clean intermittent catheterization (CIC) was recommended. Results of the patients who spontaneously regained micturition after conservative treatment and those with persistent urinary retention were compared. Results: among 95 patients, the median age was 65 (24–90) years. In 75 patients (78.9%), spontaneous micturition returned with conservative management (Group 1). Twenty patients (21.1%) required CIC due to persistent urinary retention (Group 2). The percentages of males in Group 1 and 2 were 81.3% and 50% respectively (p<0.05). The ratio of non-supine positioning in Group 1 and Group 2 were, 10.6% (8/75) and 35% (7/20), respectively (p=0.02). Female gender and non-supine operative position remained significant predictors of persistent urinary retention after conservative treatment with odds ratios of 3.5 and 3.6, respectively (Confidence intervals, 1.2–10 and 1–12.1, p= 0.02 and 0.04, respectively). During a median follow-up duration of 36 (2–86) months, only 5 patients (20%) stopped doing CIC and voided spontaneously. The median CIC duration of these 5 patients was 6 (1–9) months. Conclusion: the majority of the patients who developed urinary retention after non-urological surgeries regained spontaneous micturition with conservative management. Female gender and non-supine operative positioning were independent risk factors for persistent urinary retention. In patients with persistent urinary retention, spontaneous micturition could be expected to return in approximately 6 months.