Researcher: Tekin, Süda
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Tekin, Süda
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Publication Metadata only HIV ile yaşayan bireylerde HBV ve HCV koinfeksiyonu(DOC Design Informatics Co Ltd, 2023) Güle ÇINAR; Orçun BARKAY; İhami ÇELİK; Tekin, Süda; School of Medicineİnsan immün yetmezlik virusu (human immunodeficiency virus - HIV) ile yaşayan bireylerde, hepatit B virusu (HBV) ve hepatit C virusu (HCV) ile koinfeksiyon, karaciğer komplikasyonlarının artmasına neden olmaktadır. Hepatit B virusu ve HIV, kan yolu ve korunmasız cinsel ilişkiyle bulaşmaktadır. HBV ile infekte olan ve HIV’le yaşayan bireyler, karaciğerle ilişkili morbidite ve mortalite açısından yüksek risk altındadır. Hepatit C virusu ile ilişkili karaciğer hasarı, HIV ile koinfekte kişilerde daha hızlı ilerlemektedir. HCV infeksiyonu, HIV infeksiyonunun yönetimini de etkileyebilir. Bu derlemede, HIV-HCV ve HIV-HBV koinfeksiyonlarının yönetiminin irdelenmesi amaçlandı. / Coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in human immunodeficiency virus (HIV) infected individuals results in increased hepatic complications. HBV and HIV viruses are transmitted by blood and un-protected sexual intercourse. People with HIV and HBV coinfection are at increased risk for liver-related morbidity and mortality. HCV-related liver injury progresses more rapidly among people coinfected with HIV. HCV coinfection may also affect the management of HIV infection. This review aims to go over the management of HIV-HCV and HIV-HBV coinfections.Publication Metadata only Rapid initiation of antiretroviral therapy in Turkey: a modeling study(Frontiers Media Sa, 2024) Yaylalı, Emine; Erdoğan, Zikriye Melisa; Çalışır, Fethi; Pullukcu, Hüsnü; Yıldırım, Figen; İnan, Asuman; Aydın, Özlem Altuntaş; Sonmezer, Meliha Çagla; Şahin, Toros; Özçağlı, Tahsin Gökçem; Özelgün, Berna; Tekin, Süda; School of MedicineBackground To effectively control the HIV epidemic and meet global targets, policymakers recommend the rapid initiation of antiretroviral therapy (ART). Our study aims to investigate the effect of rapid ART programs on individuals diagnosed with HIV, considering varying coverage and initiation days after diagnosis, and compare it to standard-of-care ART treatment in Turkey.Methods We used a dynamic compartmental model to simulate the dynamics of HIV infection in Turkey. Rapid treatment, defined as initiation of ART within 7 days of diagnosis, was contrasted with standard-of-care treatment, which starts within 30 days of diagnosis. This study considered three coverage levels (10%, 50%, and 90%) and two rapid periods (7 and 14 days after diagnosis), comparing them to standard-of-care treatment in evaluating the number of HIV infections between 2020 and 2030.Results Annual HIV incidence and prevalence for a 10-year period were obtained from model projections. In the absence of a rapid ART program, the model projected approximately 444,000 new HIV cases while the number of cases were reduced to 345,000 (22% reduction) with 90% of diagnosed cases included in the rapid ART program. Similarly, 10% and 50% rapid ART coverage has resulted in 3% and 13% reduction in HIV prevalence over a 10-year period.Conclusion Rapid ART demonstrates the potential to mitigate the increasing HIV incidence in Turkey by reducing the number of infections. The benefit of the rapid ART program could be substantial when the coverage of the program reaches above a certain percentage of diagnosed population.Publication Metadata only Analysis of risk factors associated with candidemia among patients with or without Covid-19 in intensive care units during the pandemic process: a multicenter study(Bilimsel Tıp Yayınevi, 2023) Karakök, Taliha; Gözükara, Melih Gaffar; Uygun Kızmaz, Yeşim; Demir, Yakup; Törüyenler Coşkunpınar, Melike; Altun Demircan, Şerife; Arslan, Yusuf; Alp Göker, Eda; Doğan, Ahmet; Tüzün, Türkan; Sevim, Şükran; Çakır, Yasemin; Işık, Mehmet Emirhan; Mermutluoğlu, Çiğdem; Azap, Alpay; Kınıklı, Sami; Şimşek Yavuz, Serap; Öner, Sedef Zeliha; İrkören, Pelin; Tekin, Süda; School of MedicineIntroduction: The objective of this study was to compare the risk factors and mortality rates of candidemia among patients with and without COVID-19 in the intensive care units (ICU).Materials and Methods: This study is a retrospective multicenter observational study, in ICUs of 12 hospitals (eight tertiary and four secondary hospitals) in Tarkiye. All adult patients (>18 years) hospitalized in ICUs and developed candidemia between 01.01.2020-31.12.2021 were included. The following data were collected: age, gender, nasopharyngeal swab SARS-CoV-2 PCR test, species of Candida (Candida albicans or non-albicans Candida), comorbidities, ICU stay, antibiotic use, corticosteroid, and anti-cytokine therapy, central venous catheter (CVC), abdominal surgery, parenteral nutrition, mechanical ventilation (MV), other cultures isolated Candida spp., echocardiography (ECO), mortality. Data from patients with or without COVID-19 were compared.Results: A total of 188 patients, 66 COVID-19 and 122 non-COVID-19, were included in the study. The median age of the patients was 69.5 and there were no differences between the groups. 185 (98.4%) patients had a history of antibiotic use. Sixteen patients, all from the COVID-19 group, had a history of anti-cytokine therapy. Corticosteroid use was higher in COVID-19 patients (p< 0.001). Intraabdominal surgery was higher in the non-COVID-19 group (p< 0.014). C. albicans was isolated from 36.7% of total patients and the remaining were non-albicans Candida species. The overall mortality was higher in COVID-19 patients (p= 0.014). Alzheimer's and malignancies were higher in non-COVID-19 patients. Intraabdominal surgery, MV, and CVC were higher in tertiary care hospitals whereas parenteral nutrition was higher in secondary care hospitals.Conclusion: Immunosuppressive treatments administered to COVID-19 patients pose a risk in terms of candidemia. Risk factors may differ between secondary and tertiary care hospitals. Preventable risk factors should be determined on a hospital basis and appropriate infection control measures should be taken.Publication Metadata only Comparison of knowledge levels of general practitioners about viral hepatitis in Şanlıurfa in the years 2007 and 2011(DOC Design and Informatics, 2015) Koruk, İbrahim; Demir, Canan; Kutlu, Seher; Keklik, Ayşana Zehra; Havlioğlu, Suzan; N/A; Tekin, Süda; Faculty Member; School of Medicine; 42146Objective: Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation. The aim of the present study was to compare the knowledge levels of general practitioners about viral hepatitis in Şanlıurfa in the years 2007 and 2011. Methods: In 2007, a total of 94 general practitioners from the city center participated in an in-service training meeting related to viral hepatitis and answered a questionnaire form. In 2011, in another in-service training session, the same questionnaire was applied to 233 family physicians practicing in the city center and districts. Results: of the physicians, 59.6% in 2007 and 55.4% in 2011, stated that they thought their level of knowledge about viral hepatitis was sufficient. The difference in knowledge level of physicians about viral hepatitis types did not vary within time significantly (p0.05). In both years, it was found that about 70% of the participating practitioners knew that acute viral hepatitis had to be reported, and no significant difference was found between the years (p>0.05). Conclusions: It was seen that general practitioners employed at first-stage health centers did not have sufficient knowledge about viral hepatitis. In-service training is recommended in order to increase their knowledge level about viral hepatitis. / Amaç: Viral hepatit karaciğer kanserinin ve yine karaciğer naklinin önde gelen nedenidir. Bu çalışmanın amacı, 2007 ve 2011 yıllarında Şanlıurfa’daki pratisyen hekimlerin viral hepatitlerle ilgili bilgi düzeylerindeki değişimin gösterilmesidir. Yöntemler: 2007 yılında viral hepatitlerle ilgili düzenlenen bir hizmet içi eğitim toplantısına kent merkezinden 94 pratisyen hekim katılmıştır ve katılımcılara anket uygulanmıştır. 2011 yılında bir başka hizmet içi eğitim toplantısı öncesinde aynı anket il merkezi ve ilçelerde görev yapan 233 aile hekimine tekrar uygulanmıştır. Bulgular: Hekimlerin, 2007 yılında %59.6’sı, 2011 yılında %55.4’ü viral hepatitlerle ilgili bilgi düzeylerini yeterli bulduğunu ifade etmiştir. Yıllara göre hekimlerin viral hepatit tiplerini bilme düzeyinde anlamlı bir değişme olmazken (p0.05). Akut viral hepatitlerin bildiriminin yapılması gerektiğini belirtenler, her iki yılda da %70’lerde kalmış olup, yıllar arasında anlamlı bir fark bulunamamıştır (p>0.05). Sonuçlar: Birinci basamak sağlık hizmeti veren pratisyen hekimlerin, viral hepatitler hakkında bilgi düzeylerinin yeterli olmaması, bu bilgi eksikliklerinin düzeltilebilmesi için hizmet içi eğitimin gerekliliğini düşündürmektedir.Publication Metadata only A case of mediterranean spotted fever misdiagnosed as drug allergy(National Society of Allergy and Clinical Immunology, 2018) Gözaydın, Ayhan; Tekin, Süda; Öztürk, Ayşe Bilge; Faculty Member; Faculty Member; School of Medicine; School of Medicine; Koç University Hospital; 42146; 147629Skin rashes are observed in about 2-3% of patients taking medication for any reason. Since the cutaneous manifestations are also common in viral exanthemas, rickettsial-bacterial infections and rheumatologic diseases, it is important to exclude other conditions that may mimic drug-induced allergic reactions in patients having skin rashes. Here, we report a patient of Mediterranean Spotted Fever (MSF) who was initially misdiagnosed as a drug eruption. The clinician should take into account the skin manifestations that can also be seen in the course of infectious diseases and they should consider the possibility of various infections in the diagnosis of drug allergy such as a Mediterranean Spotted Fever. / Deri döküntüleri herhangi bir nedenle ilaç kullanan hastaların yaklaşık %2-3’ünde gözlenmektedir. Cilt bulguları aynı zamanda viral döküntüler, riketsiyal-bakteriyel enfeksiyonlar ve romatizmal hastalıklarda da sık görülen bir bulgu olduğundan, deri döküntüsü olan hastalarda ilacın neden olduğu allerjik reaksiyonları taklit eden diğer durumları dışlamak önemlidir. Burada, başlangıçta yanlış ilaç allerjisi tanısı almış bir Akdeniz Benekli Ateşi olgusu sunulmuştur. Klinisyenler enfeksiyon hastalıklarının seyrinde de görülebilen cilt bulguları konusunda dikkatli olmalı ve ilaç allerjisi ayırıcı tanısında Akdeniz Benekli Ateşi gibi çeşitli enfeksiyonların olasılığını düşünmelidir.Publication Metadata only Immature platelet fraction: Is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?(De Gruyter Open Ltd, 2021) Tasdemir, Z.A.; Palaoğlu, K.E.; N/A; İncir, Said; Komesli, Zeynep; Baygül, Arzu Eden; Çaltı, Hatice Kant; Kapmaz, Mahir; Tekin, Süda; Kılıç, Alparslan; Dağel, Tuncay; Okan, Ayşe; Somay, Kayra; Akpınar, Timur Selçuk; Doctor; Doctor; Faculty Member; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; School of Medicine; N/A; N/A; N/A; N/A; N/A; N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; 175430; N/A; 272290; N/A; N/A; 42146; N/A; N/A; N/A; N/A; 216646Objectives : In many diseases, immature platelet fraction (IPF%) is related to coagulopathy and poor outcome. This study aimed to investigate the predictive value of IPF% for the severity of pneumonia in patients with Coronavirus Disease 2019 (COVID-19). Methods : A total of 154 patients with COVID‐19 infections were included. The patients were divided into two groups according to the severity of pneumonia (severe and non-severe) regarding their oxygen demand. Results : Given laboratory parameters, the median IPF% was significantly higher in the severe group (11.9 vs. 3.9%, p<0.001). Mean platelet volume (p<0.001), platelet-large cell ratio (p=0.001), platelet distribution width (p=0.001), D-Dimer (p<0.001), INR (p=0.003), and aPTT (p=0.007) were also found to be significantly higher in the severe group. Moreover, IPF (p=0.014, Odds ratio = 2.000, 95%CI: 1.149-3.482) was an independent predictor for the severity. The curve value from receiver operating characteristics was 0.879 (p<0.001, 95%CI: 0.784-0.943) for determining the severity of pneumonia. IPF% had a sensitivity and specificity value of 69.5 and 92.4% to detect the disease’s severity. Conclusions : IPF% is an independent predictor for the severity of COVID-19 pneumonia. Assessment of IPF% may both help to early determine high-risk patients with COVID-19 and to alert the physicians. / Amaç : Pek çok hastalıkta, immatür platelet fraksiyonu (%İPF), koagülopati ve kötü sonuçla ilişkilidir. Bu çalışma, Coronavirus Hastalığı 2019 (COVID-19) olan hastalarda pnömoni şiddeti için %İPF’nin prediktif değerini araştırmayı amaçladı. Yöntem : COVID-19 enfeksiyonu olan toplam 154 hasta dahil edildi. Hastalar, oksijen ihtiyaçları göz önüne alınarak pnömoni şiddetine göre (ağır ve ağır olmayan) iki gruba ayrıldı. Bulgular : Laboratuvar parametrelerine bakıldığında, medyan İPF yüzdesi ağır grupta anlamlı olarak daha yüksekti (%11.9′a karşı %3.9, p<0.001). Ortalama trombosit hacmi (p<0.001), trombosit-büyük hücre oranı (p=0.001), trombosit dağılım genişliği (p=0.001), D-Dimer (p<0.001), İNR (p=0.003) ve aPTT (p=0.007) ağır grupta anlamlı olarak daha yüksek bulundu. Ayrıca, İPF (p=0.014, Odds oranı = 2.000, %95 CI: 1.149-3.482) hastalık şiddeti için bağımsız bir öngördürücü olarak bulundu. Algılayıcı işletim eğrisinden gelen eğri değeri, pnömoni şiddetini belirlemek için 0.879 (p<0.001, %95 CI: 0.784-0.943) idi. İPF, hastalığın şiddetini saptamak için %69.5′lik duyarlılık ve %92.4′lük özgüllük değerine sahipti. Sonuç : İPF, COVID-19 pnömonisinin şiddeti için bağımsız bir öngörücüdür. %İPF’nin değerlendirilmesi, hem COVID-19′lu yüksek riskli hastaları erken belirlemeye hem de hekimleri uyarmaya yardımcı olabilir.Publication Metadata only The prevalence of brucellosis and associated risk factors in Şanlıurfa city cente(DOC Design and Informatics, 2015) Tavşan, Öznur; Koruk, İbrahim; Tekin, Süda; Faculty Member; School of Medicine; Koç University Hospital; 42146Objective: The aim of the study was to detect the prevalence and the associated risk factors for brucellosis in Şanlıurfa city center. Methods: The study was performed between January 2010 and April 2010 in 1050 subjects above 18 years of age living in Şanlıurfa city center, by using the set sampling method for calculation. The survey form inquiring about sociodemographic characteristics and epidemiologic characteristics and the complaints specific for brucellosis was applied during a face to face interview to each participant. The seroprevalence was determined by rose Bengal (RB) and Wright standard tube agglutination (STA) tests. Results: A total of 1050 subjects were enrolled with the mean age 35.39±13.46 (age range: 18-90) years, and 702 (%66.9) of them were female. The RB test was positive in 39 (%3.7) subjects while the STA test was positive in 9 (%0.9) of the participants. There was no statistically significant difference in seropositivity status with respect to the age groups (p>0.05). While the rate of seropositivity was 1.0% in females and 0.6% in males, the difference was not statistically significant (p>0.05). No statistically significant difference in brucellosis seropositivity was found between the groups with respect to their social security, education or occupation (p>0.05). Conclusions: Few studies have been conducted on the brucellosis seropositivity in our region. It is observed that the disease reports do not cover all the cases when the prevalence studies and the data from the Ministry of Health are compared. Multicenter prevalence studies are required to obtain the actual country data until the reporting system yields better results. / Amaç: Bu çalışmanın amacı Şanlıurfa il merkezinde bruselloz prevalansı ve ilişkili risk faktörlerini saptamaktır. Yöntemler: Çalışma, Ocak 2010-Nisan 2010 tarihleri arasında, Şanlıurfa il merkezinde yaşayan, küme örnekleme yöntemiyle hesaplanan 18 yaş üstü 1050 kişide yapıldı. Sosyodemografik özelliklerin, bruselloza özgü epidemiyolojik özelliklerin ve şikayetlerinin sorgulandığı anket formu, her bir katılımcıyla yüz yüze görüşülerek uygulandı. Serum örneklerine "rose" Bengal (RB) lam aglütinasyon testi ve Wright standard tüp aglütinasyon (STA) testi uygulandı. Bulgular: Çalışmaya alınan 1050 kişinin 702 (%66.9)'si kadındı. Yaş ortalaması 35.39±13.46 (yaş aralığı 18-90) yıl olarak bulundu. RB testiyle 1050 kişinin 39 (%3.7)'unda, STA testiyle 9 (%0.9)’unda seropozitiflik saptandı. Seropozitiflik açısından yaş grupları arasında istatistiksel olarak anlamlı fark yoktu (p>0.05). Kadınlarda seropozitiflik %1.0 iken, erkeklerde %0.6 ile daha düşük olmakla birlikte, aradaki fark istatistiksel olarak anlamlı değildi (p>0.05). Sosyal güvence durumu, eğitim düzeyi, meslek grupları arasında bruselloz seropozitifliği açısından istatistiksel olarak anlamlı farklılık bulunmadı (p>0.05). Sonuçlar: Bölgemizdeki bruselloz seropozitifliğiyle ilgili az sayıda çalışma yapılmıştır. Prevalans çalışmaları ve Sağlık Bakanlığı verileri karşılaştırıldığında hastalık bildirimlerinin tüm olguları kapsamadığı görülmektedir. Bildirim sistemi daha iyi sonuçlar verinceye dek ülkenin gerçek verilerine ulaşmak amacıyla çok merkezli prevalans çalışmalarının yapılmasına ihtiyaç vardır.Publication Metadata only Re‐infection in COVID‐19: Do we exaggerate our worries?(Wiley, 2022) Arslan, Yusuf; Akgül, Fethiye; Sevim, Bünyamin; Varol, Zeynep Sedef; Tekin, Süda; Faculty Member; School of Medicine; 42146Background Protective long-term immunity following coronavirus disease 2019 (COVID-19) is unclear. The study evaluated the relationship between the vaccination status and risk factors in the re-infection of patients with a diagnosis of COVID-19 who reported to the Public Health Management System in a province in south-eastern Turkey. Methods Patients with positive results for the severe acute respiratory syndrome coronavirus 2 by the real-time reverse transcription polymerase chain reaction (RT-PCR) test in respiratory samples were defined as confirmed cases. Reinfection was diagnosed in cases with COVID-19 real-time RT-PCR positivity, with or without COVID-19-like symptoms, in at least 90 days after the first infection/disease. Results A total of 58 811 patients with the diagnosis of COVID-19 from March 11, 2020, to August 31, 2021, were included in the study. Re-infection was detected in 421 (0.07%) of all patients. The mean age of the cases was 38.0 +/- 16.0 years, and 51% of them were female. Eight (2.0%) of the cases resulted in death due to re-infection. No hospitalization or mortality was observed in fully vaccinated patients. Additionally, none of the mortal cases had completed the vaccination schedule. Conclusions We are concerned that the re-infection rates and mortality may increase due to new variant strains. Vaccination is the greatest weapon against progression to critical illness in re-infections, even with existing mutations. Therefore, it is important for those without a full vaccination schedule to be vaccinated, even if they have been previously infected.Publication Metadata only Is poliomyelitis sequelae a disadvantage for recovery from Covid-19 ARDS: a case report(Turkish Neuropsychiatry assoc-Turk Noropsikiyatri Dernegi, 2022) N/A; N/A; N/A; N/A; Topaloğlu, Mahir; Turan, Zeynep; Tekin, Süda; Şentürk, Evren; Taşkıran, Özden Özyemişçi; Doctor; Doctor; Faculty Member; Faculty Member; Faculty Member; N/A; N/A; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 42146; 48359; 133091We present a case with acute respiratory distress syndrome due to COVID-19 who had poliomyelitis sequelae. He was hospitalized in the intensive care unit and supported by non-invasive mechanical ventilation for 7 days. IL-6 inhibitor was administered due to cytokine storm. No steroid or sedative agents were administered. Early mobilization was performed in the intensive care unit. one month after discharge, physical examination revealed COVID-19 infection did not cause significant changes in muscle strength and physical performance in this patient with poliomyelitis sequelae. It is important to promote early mobilization in the intensive care unit to prevent post-intensive care syndrome in COVID-19 acute respiratory distress syndrome.Publication Metadata only Acute cytomegalovirus disease in immunocompetent adults: a report of four cases(DOC Design and Informatics, 2016) Karakoç, Zehra Çağla; Taşçıoğlu, Didem; Şimşek, Binnur; Tekin, Süda; Faculty Member; School of Medicine; Koç University Hospital; 42146Cytomegalovirus (CMV) disease is rarely seen in immunocompetent adults and usually asemptomatic. Symptomatic patients usually apply with complaints of fever and lymphmonocytosis. We report four cases of CMV disease in young immunocompetent adults with no accompanying comorbidities. They were presented with fever, mild-to-moderate increased liver enzymes, lymphomonocytosis and all healed with symptomatic treatment. / Sağlıklı erişkinde sitomegalovirus hastalığı nadir görülmekte ve çoğunlukla asemptomatik seyretmektedir. Semptomatik hastalar çoğunlukla ateş ve lenfomonositozla başvurmaktadır. Bu yazıda, eşlik eden komorbiditesi olmayan ve başvuru sırasında ateş, hafif-orta düzeyde karaciğer enzim yüksekliği ve lenfomonositozu olan, semptomatik tedaviyle düzelen dört genç erişkin olgu sunulmuştur.