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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 A community-based approach to prevention of pressure injuries: a study of the European Wound Management Association Research Grant(European Wound Management Association (EWMA), 2021) Karadağ, Ayişe; Çakar, Vildan; Faculty Member; School of Medicine; Graduate School of Health Sciences; 3549; N/APressure injuries (PIs) are important health problems all over the world because of their serious effects. Awareness of PIs and their effects has increased in recent years. Since patients’ relatives are part of the care team, they have an important role to play in the prevention of PIs. The most crucial aspect of the prevention of PIs is the education of healthcare professionals, patients and patients’ relatives and caregivers. This study aimed to educate caregivers on the prevention of PIs through the development of a digital game. With this purpose, we developed and used a technological education approach —a digital game— that employs gamification methodsPublication Open Access Clinical outcomes of salvage surgery in locally advanced distal rectal cancer patients with local regrowth following non-operative management(Galenos Yayınevi, 2021) Özgür, İlker; Kulle, Cemil Burak; Keskin, Metin; Bozkurt, Halil Alper; Bayram, Melek; Acunaş, Bülent; Türker, Mehmet; Gürses, Bengi; Kapran, Yersu; Buğra, Dursun; Balık, Emre; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; 113169; 168101; 1758; 18758Aim: locally advanced distal rectal cancer (LADRC) patients managed with non-operative management (NOM) with complete clinical response following neoadjuvant treatment will experience local regrowth in about 25% of cases. The long-term risks of this strategy or local regrowth treatment have not been well established, and the main concern is the probability of impaired oncological outcomes after salvage surgery. This study aimed to evaluate the feasibility and clinical outcomes of salvage surgery in LADRC patients with local regrowth following NOM. Method: all locally advanced, distal rectal cancer patients managed with NOM after neoadjuvant therapy with clinical complete response, who developed local regrowth during surveillance, between May 2016 and November 2018, were enrolled in the study. Patients were analyzed for the rate of salvage surgery, disease-free survival and overall survival. Results: eleven out of 63 (17.5%) patients developed local regrowth after a mean of 8.4 (3-15) months. The mean surveillance period was 31.8 (14- 50) months. Eleven (100%) patients underwent salvage surgery due to the principles of total mesorectal excision. LE was not performed. No patients experienced local recurrence and three out of eleven (27.3%) developed carcinomatosis peritonei and/or distant metastasis after a mean surveillance period of 12.2 (3-26) months. At 30 months, the local and/or systemic recurrence rate, disease-free survival, and overall survival in the patients undergoing surgical treatment were 100%, 73%, 73% and 91%, respectively. Conclusion: the vast majority of patients with regrowth following NOM were suitable for salvage surgery with curative intent and justifiable pelvic tumor control.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 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 Granulomatosis with Poliangiitis (GPA)(Hacettepe Tıp Fakültesi, 2021) Kanıtez, Nilüfer Alpay; Şentürk, Begüm Güler; Faculty Member; Researcher; School of Medicine; 239432; 327593NAPublication Open Access Has the Covid-19 pandemic increased postpartum depression risk?(T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi, 2021) Türkgeldi, Engin; Yıldız, Şule; Faculty Member; School of Medicine; 329649; 134205Aim: to observe if Coronavirus Disease 2019 (Covid-19) pandemic had an impact on postpartum depression (PPD) risk in women who delivered in a tertiary hospital in Istanbul, Turkey, by comparing Edinburgh Postnatal Depression Scale (EDPS) scores before and after the pandemic was declared. Materials and methods: all women who attended to the postpartum follow-up visit within 10-14 days of their delivery and completed the EPDS form were included. Women who completed forms before the declaration of pandemic (between January 14, 2020, and March 11, 2020) were labeled as the pre-pandemic group, whereas those between March 12, 2020 and June 28, 2020 were designated as the post-pandemic group. Baseline characteristics were recorded. Pre-pandemic and post-pandemic EPDS scores were compared. Results: a total of 164 women, 73 in the pre-pandemic and 91 in the post-pandemic period, were included in the study. Baseline characteristics were similar except for gravidity and parity, which were higher in the post-pandemic group. Median(25th-75th percentile) EPDS scores were similar at 7(4-11) and 6(3-10) in the in the pre- and post-pandemic periods, respectively (p=0.39). When we compared the characteristics of women with scores <9 and ?9; and <13 and ?13, all characteristics were similar. Conclusion: PPD risk increases with stressful events or lack of support. The handful of studies on the effect of Covid-19 pandemic and the restrictions related to it on PPD risk provide conflicting results. PPD risk was similar before and after pandemic in our population. Prospective, multi-centered studies from different cities and socioeconomic backgrounds may identify subgroups at risk. / Amaç: İstanbul’daki bir üçünçü basamak hastanede, pandemi öncesi ve sonrası Edinburgh Postpartum Depresyon Skalası (EPDS) skorlarını kıyaslayarak Coronavirus Disease 2019 (Covid-19) pandemisinin postpartum depresyon riskini artırıp artırmadığını araştırmak. Gereçler ve yöntem: doğumlarından 10-14 gün sonraki takip muayenelerine gelen ve EPDS formlarını tamamlayan tüm kadınlar çalışmaya dahil edildi. Formları pandeminin ilanından önce (14 Ocak 2020 - 11 Mart 2020) tamamlayan kadınlar pandemi-öncesi gruba, formları 12 Mart 2020 – 28 Haziran 2020 arası dolduran kadınlar pandemi-sonrası gruba dahil edildi. Hastaların bazal özellikleri kaydedildi. Pandemi öncesi ve sonrası EPDS skorları kıyaslandı. Bulgular: yetmiş-üçü pandemi öncesi, 91’i pandemi sonrası olmak üzere toplam 164 kadın çalışmaya dahil edildi. Gravida ve paritenin pandemi sonrası dönemdeki hastalarda daha yüksek olması dışında, bazal özellikler iki grup arasında benzerdi. Medyan (25-75 persentil) EPDS skoru pandemi-öncesi grupta 7(4-11), pandemi sonrası grupta 6(3-10) hesaplandı ve aradaki fark istatistiksel olarak anlamlı bulunmadı (p=0.39). Skorları <9 ile ?9; ve <13 ile ?13 olan kadınların bazal özellikleri benzer bulundu. Sonuç: PPD riski stresli olaylar ve destek eksikliğinda artmaktadır. Covid-19 pandemisinin ve kısıtlamaların PPD riskine etkisini bildiren az sayıda çalışmanın sonuçları çelişkilidir. Çalışma popülasyonumuzda pandemi öncesi ve sonrası PPD riskini benzer bulduk. Farklı şehirlerde ve sosyoekonomik gruplarda yürütülecek çok-merkezli prospektif çalışmalar, riskli alt grupları bulmada rol oynayabilir.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 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 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.