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Öğe Advantages of early intervention with arterial embolization for intra-abdominal solid organ injuries in children(2019) Demircan, Mehmet; Gürünlüoğlu, Kubilay; Gözükara Bağ, Harika; Sığırcı, Ahmet; Saraç, Kaya; Kutlu, Ramazan; Yıldırım, İsmail OkanAbstract: PURPOSE Active bleeding due to abdominal trauma is an important cause of mortality in childhood. The aim of this study is to demonstrate the advantages of early percutaneous transcatheter arterial embolization (PTAE) procedures in children with intra-abdominal hemorrhage due to blunt trauma. METHODS Children with blunt abdominal trauma were retrospectively included. Two groups were identified for inclusion: patients with early embolization (EE group, n=10) and patients with late embolization (LE group, n=11). Both groups were investigated retrospectively and statistically analyzed with regard to lengths of stay in the intensive care unit and in the hospital, first enteral feeding after trauma, blood transfusion requirements, and cost. RESULTS The duration of stay in the intensive care unit was greater in the LE group than in the EE group (4 days vs. 2 days, respectively). The duration of hospital stay was greater in the LE group than in the EE group (14 days vs. 6 days, respectively). Blood transfusion requirements (15 cc/kg of RBC packs) were greater in the LE group than in the EE group (3 vs. 1, respectively). The total hospital cost was higher in the LE group than in the EE group (4502 USD vs. 1371.5 USD, respectively). The time before starting enteral feeding after first admission was higher in the LE group than in the EE group (4 days vs. 1 day, respectively). CONCLUSION Early embolization with PTAE results in shorter intensive care and hospitalization stays, earlier enteral feeding, and lower hospital costs for pediatric patients with intra-abdominal hemorrhage due to blunt trauma.Öğe The association between TLR4 polymorphisms and pulmonary tuberculosis(2019) Vaizoğlu, Reika Dilara; Gözükara Bağ, Harika; Acar, CerenAbstract: Tuberculosis (TB) is a major health problem which causes many deaths every year in the world. According to the World Health Organization (WHO) report, 1.5 million people lose their lives due to tuberculosis in every year. Although some of the infected people are showing the symptoms, in some the disease never develops, even about 90% of the affected ones are improved by the immune system's response. As in many infectious diseases, the difference between the number of infected people and the number of sick people is caused by differences in balance between the host defense and the virulence of the organism. In this case, the genetic basis of the response to infectious agents needs to be investigated in order to understand the relationship between infectious diseases and host. For this purpose; we investigated the effects of TLR4 polymorphisms (rs4986790 & rs4986791) that are involved in immune system mechanisms against susceptibility to Mycobacterium tuberculosis (MTB). In order to understand the association we did genotyping in 65 TB patients from Malatya. The results of the genotyping showed no significant association to the single nucleotide polymorphisms (SNPs) mentioned, for rs4986790 the p value was 0.80 and for rs4986791 p value was 0,517 for the genotypes. The population size was the limiting factor for the statistical analysis and it should be also taken into account that a number of genes are taking part in the signal transduction pathway that TLR4 is involved.Öğe Association of Vitamin D Receptor Polymorphisms to Pulmonary Tuberculosis in Turkish Patients: An Up-to-date Meta-Analysis and A Case-Control Study(2021) Gözükara Bağ, Harika; Acar, Ceren; Vaizoğlu, Refika DilaraAbstract: Introduction: Tuberculosis is a major global health issue, threatening millions of lives every year. To understand the interactions between host and the pathogenic factors, many association studies are being held in different populations and most of the time results are controversial. Vitamin D receptor is one of the immunomodulatory molecules that may have an effect on susceptibility to tuberculosis. Up to now, there was no positive association reported with the tuberculosis and Fok I or Taq I polymorphisms of VDR gene in tuberculosis patients of Turkish origin. The aim of this study was to make an updated meta-analysis and a case-control study in our group of patients for figuring out the association between Fok I and Taq I polymorphisms of VDR and TB. Materials and Methods: In the present study, association of pulmonary tuberculosis and VDR gene’s Fok I (rs 2228570) and Taq I (rs20731236) polymorphisms were investigated in our patient group from Malatya, and a comparison was made by a meta-analysis with the mentioned polymorphisms. Ninety-four healthy controls and 80 patients are subjects of case control study. The samples are genotyped for Taq I and Fok I polymorphisms by using TaqMan SNP genotyping kits. The allelic and genotypic distributions were analyzed by exact significance of the Pearson’s test or Fisher’s exact tests. Meta-analyses for each SNP were conducted under four different genetic models. The statistical significance of the pooled ORs was determined by a Z test and publication bias was evaluated by Egger’s test. Results: Our case control study Taq I polymorphism showed no significant association to TB which also matched with our meta-analysis. On the other hand, for Fok I polymorphism, genotypes and allele frequencies were significantly different in our focus group (p 0.044). Sex based analysis gave significantly different results in women with TB as well even though our meta-analysis showed no association to that polymorphism. Conclusion: The reasons underlying the susceptibility to TB is still not clear. The immune response process is so complex and many molecules are taking part in these reactions. So, there are a lot of candidate molecules to be checked in the association studies. VDR is still one of those molecules and may be other than by checking single SNPs, haplotypes could be under investigation with bigger populations.Öğe Carriage of streptococcus pyogenes in primary school children M protein types pyrogenic toxin genes and investigation of the clonal relationships between the isolates(Mikrobiyoloji Bulteni, 2015) Otlu, Barış; Karakurt, Cemşit; Bayındır, Yaşar; Kayabaş, Üner; Yakupoğulları, Yusuf; Gözükara Bağ, HarikaM-proteini ve pirojenik toksinler Streptococcus pyogenes’in en önemli virülans faktörleri olup, bu faktörler sırasıyla akut romatizmal ateş ve kızıl hastalığının patofi zyolojisinde önemli rol oynarlar. Bu çalış- mada, ilköğretim okulu çocuklarının farengeal S.pyogenes taşıyıcılık durumları, suşlar arasındaki klonal ilişki, izolatların M-protein tipleri ve pirojenik toksin gen varlığının araştırılması amaçlanmıştır. Çalışmaya, bölgemizdeki iki ilköğretim okulunda bulunan 668 çocuktan (yaş aralığı: 6-16 yıl) alınan boğaz kültürü örnekleri dahil edilmiştir. İzole edilen grup A streptokok suşları arasındaki klonal ilişki DiversiLab (BioMérieux, Fransa) yöntemiyle araştırılmış ve tespit edilen klonal ilişkiler PFGE (pulsed-fi eld gel electrophoresis) yöntemi ile doğrulanmıştır. İzolatların M-protein (emm) tiplemesi Centers for Disease Control and Prevention (CDC) tarafından önerilen DNA dizi analizi yöntemiyle gerçekleştirilmiştir. Pirojenik toksin kodlayan genlerden speA ve speC’nin varlığı in-house multipleks polimeraz zincir reaksiyonu (PCR) yöntemi ile araştırılmıştır. Çalışmada toplam 134 (%20.05) öğrencinin boğaz kültüründen S.pyogenes izole edilmiştir. 10 yaş ve üzeri öğrencilerin GAS taşıyıcılık oranı, 7-9 yaş grubu öğrencilerine göre istatistiksel olarak daha yüksek bulunmuştur (%22’ye karşı %16.4; p< 0.05). Dizi analizi ile bu izolatlardan 123’ünün M protein geni tiplendirilebilmiş ve 20 farklı emm tipi saptanmıştır. En sık tespit edilen emm tipi emm1 (n= 38, %30.9) olmuş, bunu sırasıyla emm12 (n= 18, %14.6), emm89 (n= 10, %8.1), emm118 (n= 8, %7.3) ve emm4 (n= 7, %5.7) izlemiştir. Toplam 25 (%18.6) izolatta pirojenik toksin geni bulunmuş; bunların 11’inde (%8.2) speA, 12’sinde speC (%8.9) ve ikisinde (%1.5) her iki gen birden saptanmıştır. DiversiLab yöntemi ile 134 S.pyogenes suşu içerisinde 62 farklı Rep (Repetitive extragenic palindromic)-PCR profi li belirlenmiştir. Klonal olarak ilişkili 36 izolat, 13 farklı küme içerisinde yer almıştır. Suşların kümeleşme oranı %26.9 olarak bulunmuş; aynı küme içerisinde yer alan izolatların tümü arasındaki klonal ilişki, PFGE yöntemi ile de doğrulanmıştır. Çalışmamızda, bölgemizdeki ilköğretim çocukları arasında GAS taşıyıcı- lığının yüksek olduğu ve M-protein tiplerine göre suşların 30 valanlı aşı tarafından kapsanma oranının %90’nın üzerinde olduğu tespit edilmiştir. İzolatların yaklaşık beşte birinde pirojenik toksin geni bulunması, taşıyıcılarda da kızıl hastalığı riskinin yüksek olabileceğini göstermiştir. Bununla birlikte, izolatlar arasında tespit edilen klonal ilişki oranı, okul içi GAS yayılımının risk oluşturabileceği lehine yorumlanmıştır.Öğe Clinical features and laboratory values associated with disease severity in Covid-19 patients: a single center experience(2021) Berber, Nurcan; Berber, İlhami; Ulutaş, Özkan; Sarıcı, Ahmet; Yıldırım, Aslı; Çağasar, Özlem; Gözükara Bağ, HarikaAbstract: Background: To date, several studies were published about clinical features and laboratory values associated with diseaseseverity in Covid-19 patients. We aimed to show the relationship between disease severity and clinical and laboratorycharacteristics of the patients as a single center experience.Material and Method: Clinical features and laboratory data of fifty patients diagnosed with Covid-19 by PCR was evaluatedat diagnosis. These patients divided into 2 groups as early and advanced disease. Clinical features and laboratory data werecompared in terms of severity of disease.Results: In all patients, the most common accompanying disease was coronary artery disease. Cough and headache were the most common complaints. Laboratory values showed low lymphocyte count and high CRP levels in all patients. Twenty fourpatients in early stage and 26 patients in advanced stage were compared in terms of clinical features and laboratory values.In advanced stage, it was observed that body weight, number of comorbid diseases, age, CRP, procalcitonin, BUN, GGT,fibrinogen, D-dimer and ferritin levels of patients were higher whereas height, serum total protein, albumin and potassiumlevels were lower when compered with early stage patients (p<0.05).Conclusions: Our data showed that older age, having cough, increased number of comorbid diseases, CRP, BUN, GGT,fibrinogen, D-dimer and ferritin and decresed serum total protein, albumin, potassium levels at the time of diagnosis inCovid-19 patients were associated with advanced stage disease.Öğe Comparison of routine laboratory tests in acute appendicitis and intussusception in childhood(2019) Gürünlüoğlu, Kubilay; Taşcı, Aytaç; Gözükara Bağ, Harika; Demircan, MehmetAbstract: Aim: Acute appendicitis and idiopathic intussusception are two major causes of acute abdomen in childhood. In this study, we investigated the clinical, laboratory and radiological findings of these two surgical emergencies during the first presentation. Material and Methods: In this study, we retrospectively reviewed the records of pediatric patients with acute appendicitis and idiopathic intussusception between 2015-2018. Patients were identified according to inclusion criteria. Results: Physical examination findings were positive in all patients with acute appendicitis and idiopathic intussusception. White Blood Cell (WBC) [15.55] and C-Reaktif Protein (CRP) [3.75] were high in the laboratory test in patients with acute appendicitis. In patients with idiopathic intussusception, lactate dehydrogenase (LDH) [302] and CRP [0.6] were high and Ultrasound findings were positive. In addition, WBC [10,1 (5,07)] was normal in patients with idiopathic intussusception. Conclusion: While WBC, CRP, physical examination is valuable in the diagnosis of acute appendicitis, physical examination, CRP, LDH and USG are valuable in the diagnosis of intussusception. In an Idiopathic intussusception patient, WBC may be normal at first admission.Öğe Comparison the serologic tests used in the diagnosis of brucellosis; brucellacapt, brucella coombs gel, and brucella coombs tube agglutination tests(2021) TANRİVERDİ, Elif Seren; Duman, Yücel; Gözükara Bağ, Harika; Tekerekoğlu, Mehmet SaitAbstract: Aim: Brucellosis is the most common bacterial zoonosis in the world and in our country. The definitive diagnosis of the disease is the isolation of the agent in culture, but in routine diagnosis serologic tests are mostly used. In the routine serological diagnosis of brucellosis, rose bengal, standard tube agglutination (STA) and coombs tube agglutination (CTA) tests were used. The aim of this study was to determine the effectiveness of Brucellacapt (BCAP) and Coombs Gel (CJ) tests by comparing with STA and CTA tests. Materials and Methods: A total of 100 samples (47 positive and 53 negative by CTA test) were included in the study between June 2018 and July 2019. Titters detected as ?1 / 160 in STA, CTA, BCAP (METSER Brucella test with Coombs, Savas Medical, Istanbul), CJ (ODAK Brucella Coombs Gel test, Toprak Medical, Istanbul) tests were accepted as positive. Cohen kappa (?) analysis was used to evaluate the consistency between the tests. Results: Out of 100 samples included in the study were found positive, 20 with STA, 48 with CAP and 53 with CJ tests, respectively. Among the 47 patients who were positive with CTA test, 44 were positive with BCAP and CJ tests, also 2 of them were negative with BCAP and 1 with CJ test. Among the samples found negative with the CTA test, 3 were found positive with BCAP and 7 with the CJ test. STA test was negative in 27 samples that were positive by CTA test. ? = 0.900 for CTA and BCAP, ? = 0.841 for CTA and CJ, ? = 0.860 for BCAP and CJ; showed a high level of agreement. The STA test showed a very low level of agreement with all three methods (? = 0.440 for CTA with STA, ? = 0.426 for BCAP with STA, ? = 0.363 for CJ with STA). Conclusion: Compared to CTA testing, the applicability of BCAP and CJ tests is easier. Among the three tests, the CJ test gives the fastest results. In the serologic diagnosis of brucellosis, BCAP and CJ test can be used because of high compatibility with CTA test, and it is thought that the compatibility between the tests should be evaluated with more comprehensive studies.Öğe The effects of acrylamide and vitamin E administration during pregnancy on adults’ ovarian tissue: An experimental study(2019) Erdemli, Mehmet Erman; Erdemli, Zeynep; Türköz, Yusuf; Gözükara Bağ, Harika; Selamoğlu, ZelihaAbstract: Aim: The aim of the present study is to investigate the effects on ovarian tissues of adult female rats, which were the offspring of rats administered acrylamide (AA) and vitamin E during pregnancy. Material and Methods: Thirty rats were divided into 5 groups of 6 pregnant rats, as the Control, Corn Oil, Vitamin E, AA, Vitamin E + AA groups. The births were monitored on the 21st day to select the female rats. The selected female rats were decapitated at the end of the 8th week and their ovarian tissues were removed under anesthesia malondialdehyde (MDA), reduced glutathione (GSH), total antioxidant capacity (TAS), total oxidant capacity (TOS), oxidative stress index (OSI), superoxide dismutase (SOD), catalase (CAT) and nitric oxide (NO) levels were examined. Results: Administration of AA during pregnancy caused an increase in MDA, TOS, OSI and NO levels and a decrease in GSH, SOD, CAT and TAS levels in the ovarian tissues of the rats when compared to the control group. It was determined that vitamin E administration caused an increase in GSH, SOD, CAT and TAS levels in ovarian tissues, compared to all other groups (P <0.05). Conclusion: Exposure to food-induced AA toxicity increases each day and the parallel increase in infertility suggests that it could be related to AA toxicity. Although vitamin E is capable to exert a protective effect against AA toxicity through increasing the antioxidant capacity of ovarian tissue, there is certain necessity for further studies.Öğe The effects of hydrostatic reduction and operative manual reduction on the success of intussusception reduction(2018) Gürünlüoğlu, Kubilay; Taşcı, Aytaç; Gözükara Bağ, Harika; Sığırcı, Ahmet; Demircan, MehmetAbstract: Aim: Intussusception is the most common cause of bowel obstruction in children aged 3 months to 6 years. Ultrasonically guided Hydrostatic reduction (UGHR) and operative manual reduction (OMR) are among the treatment methods. The aim of this study is to compare the effects of UGHR and OMR techniques on successful reduction in children with intussusception. Material and Methods: This study was performed retrospectively between January 2015 and May 2018. The data of intussusception child patients were reviewed. A total of 63 patients’ records were reached. A total of 31 UGHR procedures and 32 OMR procedures were recorded. Demographic data, recurrence, reduction success of UGHR and OMR patients were calculated and evaluated statistically. Results: No significant difference was found in terms of demographic information. There was no recurrence in both groups. While rate of successful reduction of patient with UGHR is 77.4%, OMR’s success is 87.5%. There was no statistically significant difference in terms of reduction success. It was determined that what was important in the reduction success was the first application time. Conclusions: When we evaluated our results, we found that the factor affecting the reduction success in a patient with intussusception was not the method of reduction. We found that the most important factor affecting reduction success was the time between onset of symptoms and initiation of reduction. If this is less than 24 hours, we have found that the reduction success is very good.Öğe The Evaluation of Common Chromosomal Rearrangements and Their Frequencies in Adult Acute Myeloid Leukemia Cases in Malatya Province of Turkey(2020) Gülbay, Gonca; Yesilada, Elif; Erkurt, Mehmet Ali; Gözükara Bağ, HarikaAbstract: Recurrent balanced translocations are generally considered as the main parameter for prognosis in acute myeloid leukemia (AML). In recent years, genetic studies have focused on the ascertaintment of molecular aspects of various oncofusion proteins associated with AML, such as t(15;17) PML-RARA, t(8;21) RUNX1-RUNX1T1, t(9;22) BCR-ABL1 and inv (16) CBFB-MYH11. Therefore, we evaluated AML cases with RT-PCR for known specific genetic abnormalities that could lead to more accurate prognosis. In our study, we retrospectively reviewed the records of 211 cases (59.2% males and 40.8% females). RT-PCR technique was performed to identify t(15;17) PML-RARA, t(8;21) RUNX1-RUNX1T1, t(9;22) BCR-ABL1 and inv (16) CBFBMYH11. The most common rearrangement was found to be t (15; 17) (%12.8) followed by t (8; 21) (7.11%), t (9; 22) (7.6%) and inv (16) (1.42%). Also, in two other cases (0.95%) t(15;17) and t(8;21) were seen together. In addition, none of these rearrangement were found in 148 cases (70.14%) with AML. The presence of chromosomal rearrangements are very important in the diagnosis of AML. Therefore, rapid identification of specific rearrangements during diagnosis is important for prognostic purposes and can help identifying the cause of leukemogenesis and provide new strategies for the treatment of cases. This study is useful for both in Turkey oncologists and transplant centers in other regions will be a reference for the future analyzes and epidemiological data.Öğe Histopathological investigation of the effects of acombination of parenteral nutrition and hunger on rabbitsplenic tissue(2021) Gürünlüoğlu, Semra; Kayhan Kuştepe, Elif; Gözükara Bağ, HarikaAim: Parenteral nutrition (PN) is a life-saving practice when the use of the gastrointestinal tract is not possible. However, PN can cause a variety of complications despite its many benefits. In this study, we examined the histopathological effects of PN combined with hunger in the splenic tissue of rabbits.Materials and Methods: The rabbits were divided into four groups. The hunger + PN (PNH) group was completely starved and received the daily energy requirement with PN via an intravenous central catheter. The second group received enteral nutrition + PN (PNEN), wherein half of the required daily calories were provided through enteral nutrition, and the other half, through PN. A third group comprised semi-hungry (SH) rabbits that were provided only half the required daily calories by oral feeding.They did not receive PN. The last group was the control group. After 10 days, the rabbits were euthanized, and splenic tissue samples were collected from all the groups and examined histopathologically.Results: The histopathological examination for the PNH group revealed damage in the form of germinal center effacement, reduction of white pulp, congestion of red pulp, and decreased cellularity in the periarteriolar lymphoid sheath. Immunohistochemical examination revealed a significant increase in the apoptotic activity of the splenic tissues of this group. The corresponding findings were mild in the PNEN group, and no signs of damage were found in the other two groups.Conclusion: PN combined with hunger appears to cause damaging effects on splenic tissue in rabbits. Adding enteral nutrition to PN may reduce these effects.Öğe İdiyopatik trombositopenik purpuralı gebelerin maternal ve neonatal sonuçları(2017) Melekoğlu, Rauf; Eraslan, Sevil; Baştemur, Ayşe Gülçin; Çelik, Ebru; Gözükara Bağ, HarikaÖz: Amaç: Bu çalışmada kliniğimizde gebelik takibi ve doğumu gerçekleştirilen idiyopatik trombositopenik prupura (ITP) tanısı almış gebelerin maternal ve neonatal sonuçlarını ortaya koymayı amaçladık. Yöntem: Çalışmamızda inönü Üniversitesi Tıp Fakültesi Hastanesi Kadın Hastalıkları ve Doğum Kliniği’nde, 01.01.2010 – 01.01.2017 tarihleri arasında gebelik takibi ve doğumu gerçekleştirilen idiyopatik trombositopenik purpural› gebelerin ve yenidoğanların dosyalar› retrospektif olarak taranarak, çal›flma kriterlerine uygun hastalar çal›flmaya dahil edildi. Bulgular: Çalşma periyodu boyunca ITP tan›s› ile izlenen 68 hastadan 12’sinin (%17.6) gebelik s›ras›nda, 56’s›n›n (%82.4) ise gebelik öncesi ITP tan›s› ald›ğ› saptand›. Do¤um s›ras›nda trombosit say›s› 50×109 /l’nin alt›nda olan hastalarda steroid kullan›m›, trombosit say›s› 50×109/l’nin üstünde olan hastalara göre istatistiksel olarak anlaml› düzeyde yüksek bulundu (p=0.003). Trombosit say›s› >50×109 /l olan ITP’li gebe grubunda 13 (%29.5) hastada, trombosit say›s› <50×109 /l olan gebe grubunda ise 1 (%4.2) hastada gebelik öncesinde splenektomi operasyonu geçirme öyküsü izlendi (p=0.013). Doğum flekli sezaryen olan hasta grubu ile vajinal doğum olan hasta grubu aras›nda yenidoğan yoğun bak›m ihtiyac› ve yenidoğan tedavi gereksinimi aç›s›ndan anlamlı fark izlenmedi (s›ras›yla p=0.889 ve p=0.598). Doğum s›ras›nda 6 (%8.8) hastada postpartum kanama gözlenirken, 17 (%25) hastada trombosit aferez, 5 (%7.3) hastada intravenöz immunglobulin (IVIG), 8 (%13.2) hastada ise trombosit aferez ile birlikte IVIG tedavisi kullan›ld›. Doğumda maternal trombosit say›s› ile doğumda yenido¤an trombosit say›s› aras›nda anlaml› ilişki saptanmad› (p=0.625; r=0.06). Sonuç: ITP’li gebelerin maternal ve neonatal prognozu genellikle iyidir. Gebelik sırasında maternal trombosit sayısının <50×109 /l olması gebelik sırasında daha fazla medikal tedavi gereksinimi ve doğum sırasında daha fazla kan ürünü ihtiyac› ile ilişkili olup doğum fleklinin perinatal sonuçlar üzerine etkisi görünmemektedir.Öğe The impact of laboratory features and comorbidities on the prognosis of patients with COVID-19(2021) Sarıcı, Ahmet; Berber, Nurcan; Çağasar, Özlem; Biçim, Soykan; Cagin, Yasir Furkan; Ulutaş, Özkan; Gözükara Bağ, Harika; Berber, İlhamiAbstract: Objective: Demographic and laboratory values predicting clinical severity in coronavirus disease 2019 (COVID-19) patients havebeen a matter of curiosity since the beginning of the disease. We aimed to show the relationship between the severity of COVID-19disease and comorbidities, clinical and laboratory features of the patients.Material and Method: The data of COVID-19 patients diagnosed with polymerase chain reaction (PCR), were analyzed retrospectively.The patients were divided into 3 groups according to their clinical severity as mild, moderate and severe. Comorbidities and theCharlson comorbidity index (CCI) at the time of diagnosis were calculated for each patient from the patients’ records. Demographicdata, laboratory values, comorbidity and CCI scores were compared between the patient groups. The effect of CCI on survival andlength of hospital stay was examined.Results: One hundred and four patients were included in the trial. The most common comorbid disease in the patients included in thetrial was hypertension. The moderate-severe stage patients were statistically significantly older (p<0.001). The CCI was found to bestatistically significantly different between mild, moderate and severe groups (p<0.001). When CCI increases by one unit, the risk ofdeath increases by 1.193 times (p=0.017). The neutrophil-to-lymphocyte ratio (NLR) was statistically significantly different betweenthe mild, moderate and severe patient groups. It was observed that as the severity of the disease increased, the NLR increased. Olderage, WBC, neutrophil count, NLR, BUN, creatinine, AST, potassium level, C-reactive protein (CRP), procalcitonin, aPTT, fibrinogen,d-dimer, and ferritin levels were found to be higher in the clinically severe patient group. Lymphocyte and eosinophil counts, totalprotein, albumin and sodium levels were found to be lower in the clinically severe patient group.Conclusion: This trial showed that calculating the CCI score in COVID-19 patients can be useful in predicting the severity of thedisease. Examination of CCI, age, WBC, neutrophil, lymphocyte, eosinophil counts, BUN, creatinine, AST, total protein, albumin,sodium, potassium level, CRP, procalcitonin, aPTT, fibrinogen, d-dimer and ferritin levels at the time of diagnosis can be suggested.Öğe Integral Dose and Dosimetric Comparison of NeoAdjuvant Simultaneous Integrated Boost (SIB) Radiotherapy Technique for Rectal Cancer Using Intensity-Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), and Helical Tomotherapy (HT)(2019) Temelli, Öztun; Demirtaş, Mehmet; Uğurlu, Berat Tuğrul; Gözükara Bağ, HarikaAbstract: The purpose of the present study is to compare the Intensity-Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), Helical Tomotherapy (HT) techniques in rectal cancer. A total of 10 patients, were randomly selected for this study. Three separate plans were made for each patient: IMRT, VMAT and HT. By using the Simultaneous Integrated Boost (SIB) technique, 45 Gy to pelvic lymph nodes, and 50 Gy 25 fractions were prescribed to the rectum and mesorectum. The PTV parameters, Integral dose, Dose Volume Histograms (DVH) and Organ at Risk were evaluated with 3 separate plans. The PTV Dmax, Integral dose was ensured at the lowest level in HT. The D2 was detected at the lowest level in HT, and at the highest level in D98. Although there was no difference between Homogeneity Indices (HI), Conformity Index (CI) was found to be better in IMRT and VMAT. The total MU and Beam on Time values were found to be high in HT. The bladder, which is one of the risky organs, was provided at the best level in HT, the volume in the bowel was provided in VMAT at the lowest level with 35 Gy, and the 45 Gy volume was provided in IMRT. The healthy tissue volume was 5 Gy and 10 Gy (cc) as the highest in HT, and 20 Gy volume (cc) was high in IMRT. The Mean V10, V20, V30, V40, Dmean values of the pelvic whole bones were higher in HT.Öğe Is Gastroesophageal Reflux Disease a Common Complication in Infants with Congenital Heart Disease?(2019) Demirtas, Mehmet Semih; Karakurt, Cemşit; Selimoğlu, Ayşe; Gözükara Bağ, HarikaAbstract: Objective: Gastroesophageal reflux disease (GERD) is believed to be one of the most common complications of congenital heart disease (CHD) in infants though the exact prevalence is not known. In this study, we aimed to investigate GERD symptoms in infants with CHD. Material and Methods: Infant Gastroesophageal Reflux Questionnaire Revised was applied twice for 109 infants with CHD and 81 healthy infants, both with a median age of 5 months, two months apart and data were analyzed. Results: Mean reflux score was 4.81±0.56 (0-23) and 5.1±5.71 (0-24) in the CHD and control groups, respectively (p=0.62). According to ROC curve analysis, we considered a score of 7 (95% CI=53%-76.6%) as being a cut-off value for GERD. Thirteen infants, 7 with CHD (6.42%) and 6 healthy infants (7.40%) had reflux score?16 (p==0.79). Conclusion: GERD is not more common in CHD than in healthy babies. As the only difference in terms of individual symptom prevalence is in apnea and cyanosis, symptoms of CHD as well, it was concluded that there is a need for more objective methods and new questionnaires to be used for infants with CHD.Öğe Is the change in platelet parameters in children with allergic rhinitis an indicator of allergic inflammation?(2018) Topal, Erdem; Sancak, Recep; Gözükara Bağ, Harika; Demir, Filiz; Çeliksoy, Mehmet HalilAbstract: It was aimed to find out whether MPV can be used as an indicator of allergic inflammation in children with allergic rhinitis by looking at the changes in MPV and MPV/ Plt in this study. Pediatric patients between the ages of 6 and 18 who had a diagnosis of allergic rhinitis were included in the study. Sex- and age-matched healthy children who visited the outpatient clinic for routine controls were included as control in order to compare the changes in patients’ total blood count parameters (e.g.,WBC, Hb, RDW, PLT, PDW, MPV). 95 pediatric (50 male, mean age: 120 months ) patients and 90 healthy children (38 male, mean age: 120 months) were included in the study. There were no statistical differences between gender (p=0.15) and ages (p=0.33) of both groups. WBC (p=0.21), Hb (p=0.8), RDW values (p=0.3) and platelet numbers (p=0.05) of both groups were similar. In the allergic rhinitis group, mean MPV value (p?0.001), mean PDW value (p=0.005) were lower and mean Plt/MPV rate was higher (p=0.001). In addition, no significant association was found between the severity of allergic rhinitis and MPV (p=0.61). MPV value of 7.0 fL was identified as the cut off value at diagnosis with a sensitivity of 51.6 % and specificity of 83.3 % (AUC = 0.716; p=0.001). MPV values decrease in children with allergic rhinitis and MPV value is smaller than 7 fl is specific for allergic rhinitis.Öğe MALDI-TOF MS’nin EMB Agarda Üreyen Gram-negatif Bakterileri Tanımlama Performansı: Tanı Etkinliğini Arttıran Basit Bir Yöntem(2019) Yakupoğulları, Yusuf; Otlu, Barış; Çelik, Betül; Gözükara Bağ, HarikaÖz: Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS), bakteriyel ve fungal patojenleri doğru ve hızlı tanımlaması nedeniyle mikrobiyoloji laboratuvarlarında kullanımı artan yeni bir yöntemdir. Ancak, bu yöntemle yapılacak tanımlamalarda günümüze kadar tek bir gram-negatif seçici besiyerinin önerilmiş olması rutin klinik tanıda bazı sorunlara neden olmaktadır. EMB agar, yaygın olarak kullanılan geleneksel bir gram-negatif seçici besiyeri olmakla birlikte MALDI TOF MS’nin bu besiyerinde üreyen gram-negatif bakterileri tanımlama etkinliği hakkında bilimsel literatürde bilgi yoktur. Bu çalışmada, MALDI-TOF MS’nin EMB agarda üreyen gram-negatif bakterileri tanımlama performansının saptanması ve bu performansı arttırıcı basit ve hızlı bir örnek hazırlama yönteminin geliştirilmesi amaçlanmıştır. Toplam 20 farklı cins ve 37 farklı türden olmak üzere 468 gram-negatif klinik izolat çalışmaya alınmıştır. İzolatların EMB agarda üreyen kolonileri hem direkt ve hem de iki aşamalı koloni yıkama işlemi (bir kez serum fizyolojik, üç kez %70 etanol ile yıkama) sonrasında Vitek MS (Bio Mérieux, Fransa) MALDI-TOF MS cihazı ile tanımlanmıştır. Her iki tanımlamaya ait veriler istatistiksel olarak karşılaştırılmıştır. EMB agar besiyerinden direkt okumada, çalışılan 468 izolatın 382’si (%81.6) tür düzeyinde doğru olarak tanımlanmıştır, 80 (%17) izolat tanımlanamamış ve 6 (%1.2) izolat (dördü cins düzeyinde) ise yanlış tanımlanmıştır. Direkt okumada MALDI-TOF MS’in tanı performansı Stenotrophomonas maltophilia, Klebsiella oxytoca, Salmonella spp. ve Proteus mirabilis’in de içinde bulunduğu 14 tür için mükemmel (%100) iken, en düşük tanı performansı Providencia spp. (%62.5), Escherichia coli (%70.5) ve Acinetobacter spp. (%70.7) için saptanmıştır. Ortalama 20 dakika süren ve basit laboratuvar malzemeleri ile gerçekleştirilebilen yıkama işlemi sonrası, 434 (%92.7) izolat tür düzeyinde doğru olarak tanımlanmıştır, 30 (%6.4) izolat tanımlanmamıştır ve 4 (%0.85) izolat (ikisi cins düzeyinde) ise yanlış tanımlanmıştır. İstatistiksel veri analizi, tanımladığımız koloni yıkama işleminin besiyerinden yoğun boya absorbe eden E.coli ve A.baumannii gibi türler başta olmak üzere EMB agarda üreyen gram-negatif bakterilerin MALDITOF MS ile tanımlama oranını toplamda anlamlı düzeyde arttırdığını göstermiştir (p= 0.001). Bu çalışmada, kütle spektrometrik tanımlamaya uygunluğu hakkında bu güne kadar veri bulunmayan EMB agarın, MALDI-TOF MS ile yapılacak bakteriyel tanımlamada kullanılabileceği ve EMB besiyerinden direkt okumada tanımlanamayan gram-negatif bakterilerin burada açıkladığımız koloni yıkama işlemi sonrasında tanımlanabilecekleri ortaya konulmuştur. Farklı besiyeri alternatiflerinin belirlenmesi, MALDI-TOF MS’nin mikrobiyoloji laboratuvarlarında daha etkin kullanımına katkı sağlayacaktır.Öğe Pre-, intra- and post-operative management in phacoemulsification surgery for completely monocular cases(2019) Dikci, Seyhan; Demirel, Soner; Fırat, Penpe Gül; Öztürk, Emrah; Türkoğlu, Elif Betül; Ceylan, Osman Melih; Yılmaz, Turgut; Gündüz, Abuzer; Gözükara Bağ, HarikaAbstract: Aim: To evaluate the results of phacoemulsification (PE) surgery in completely monocular cases and to emphasize the important points in the pre-, intra- and post-operative periods. Material and Methods: A total of 42 patients who had no light perception in one eye and had underwent PE surgery in the other eye at our clinic between January 2014 and March 2016 were included in the study. The charts of the patients were evaluated retrospectively. The age and gender of the cases, whether there was an additional pathology in the eye undergoing surgery, the reason of visual loss in the other eye, the type of anesthesia used, pre- and post-operative best corrected visual acuity (BCVA) with the Snellen chart, intraocular pressure and intra- and post-operative complications were investigated. Results: There were17 (40.5%) female and 25 (59.5%) male patients with a mean age of 74.2±10.5 (45-93) years. The most common causes of the monocular state were glaucoma, cataract and trauma, the most common accompanying pathologies in the eyes undergoing cataract surgery were glaucoma, zonular weakness and age-related macular degeneration. Mean BCVA was 0.07±0.1 (0.01-0.4) pre-operatively and 0.5±0.3 (0.01-1) post-operatively (p?0.001). The mean follow-up duration was 3.9±5.6 months (1 week to 24 months). The most common post-operative complication was corneal edema. Conclusion: The stress created by cataract surgery on the physician and patient is quite high in monocular cases. However, satisfactory results with PE are obtained in these cases by carefully using pre-, intra- and post-operative methods.Öğe Profilaktik polisaj protokolleri ve ağız gargaralarının farklı adeziv restoratif materyallerin yüzey pürüzlülüğü üzerine Etkisi(2016) Toz Akalın, Tuğba; Demir, Becen; Öztürk Bozkur, Funda; Gözükara Bağ, HarikaÖz: Amaç: Bu çalışmanın amacı profilaktik polisaj protokolleri ve ağız gargaralarının genellikle sınıf V kaviteler için tercih edilen farklı adeziv restoratif materyallerin yüzey pürüzlülüğü üzerine etkisini incelemektir. Gereç ve Yöntem: Güçlendirilmiş geleneksel cam iyonomer, rezin modifiye cam iyonomer, akışkan composit ve nanohibrid kompozit kullanılmıştır. Her restoratif materyalden 40 örnek hazırlanmış, polisaj yapılmış ve profilometre ile başlangıç yüzey pürüzlülüğü ölçümleri elde edilmiştir. Örnekler daha sonra profilaktik polisaj protokollerine göre iki gruba ayrılmıştır: ultrasonic temizleme; ultrasonic temizleme ve air polishing. Ra değerlerinin elde edilmesinin ardından gruplar iki alt gru-ba ayrılmış ve farklı iki ağız gargasına maruz kalmış ve Ra değerleri elde edilmiştir. Son olarak örnekler tekrar polisajlanıp son Ra ölçümleri alınmıştır. Bulgular: Profilaktik polisaj protokolları, özellikle air polishing, yüzey pürüzlülüğünde anlamlı derecede artışa sebep olurken (p<0.001), ağız gargaraları etkisi az olmuştur (p>0.05). Tekrar polisajlama uygulaması yüzey pürüzlülüğünü değerlerini düşürmüştür. Kompozitlerle karşılaştırıldığında test edilen cam iyonomerler daha kötü yüzey pürüzlülüğü değerleri vermiştir. Sonuç: Bu çalışmanın sonucu profilaktik polisaj protokollerinin restoratif materyallerin özellikle cam iyonomerlerin yüzey pürüzlülüğünü artırdığını göstermiştir.Öğe The role of Crocin in an acrylamide-induced neurotoxicity model in Wistar rats(2019) Erdemli, Erman Mehmet; Erdemli, Zeynep; Gözükara Bağ, Harika; Altinoz, EyüpAbstract: Aim: The changes in rat brain tissues treated with Crocin (Cr) as a protective agent in an acrylamide (AA) neurotoxicity model wereinvestigated.Material and Methods: The present with of the experimental animal ethics committee at Inonu University, Faculty of Medicine (2016/ A-59). Forty male rats were randomly divided into 4 groups with study was conducted the approval equal number of rats (10): Control, Cr, AA, Cr + AA Groups. Malondialdehyde (MDA), reduced glutathione (GSH), total antioxidant status (TAS), total oxidantstatus (TOS), Oxidative stress index (OSI), superoxide dismutase (SOD), catalase (CAT) and protein values were examined in thebrain tissues.Results: MDA, TOS and OSI levels increased in brain tissues of AA administered rats when compared to the other groups, whilethe GSH, TAS, SOD and CAT levels decreased in the group (p < 0.05). GSH, TAS, SOD and CAT levels increased, but MDA, TOS andOSI levels decreased in the AA + Cr administered group when compared to the AA group (p < 0.05). It was observed that oral AAadministration altered the antioxidant/oxidant balance favoring the oxidants in male rat brain tissues, leading to oxidative stressinduced neurotoxicity, while Cr administration reestablished the normal antioxidant/oxidant balance, preventing the oxidative stressinduced neurotoxicity via detoxification.Conclusion: The present study concluded that the administered Cr dose was sufficient to prevent neurotoxicity and we recommendthat adequate amounts of Cr should be consumed to prevent AA-induced toxicity and improve antioxidant capacity.
