Gazi University Hospital Research Articles

P1082 Is mutiple switching between infliximab biosimilars safe in iInflammatory Bowel Disease?

Abstract Background A biosimilar biological drug is a biologic that has similar efficacy and safety to the original product.The goal of biosimilar therapy is to provide a cost-effective option that is as effective and safe as the original product.The introduction of biosimilars into clinical practice has raised several clinical concerns, such as disease activation and the development of immunogenicity(1,2).There are very few studies evaluating the effect of multiple switches between biosimilars on patients with inflammatory bowel disease (IBD). In this study, we aimed to evaluate the safety and efficacy of multiple switches between biosimilars in patients with IBD receiving Infliximab (IFX) Patients used the biosimilar available at the hospital pharmacy,because obtaining medication from an outside pharmacy was more difficult based on the patient’s preference. Methods The data of 147 patients who were followed at the IBD outpatient clinic of Gazi University Hospital and received IFX treatment were retrospectively reviewed from the hospital information system. 70 patients were excluded from the study due to discontinuation of follow-up, short follow-up duration, or receiving a low number of infliximab doses. A total of 77 patients were included in the study. In Turkey, three commercial IFX preparations are available, one of which is the original product: REMICADE® (Janssen Biotech, Inc., Horsham, PA, USA), REMSIMA™ (Celltron, Inc., Incheon, Korea), and IXIFI® (Pfizer, USA). The commercial formulation used by the patients, the number of biosimilar switches, disease duration, and the presence of disease activation during switches were evaluated. Results Of the 77 patients included in the study, 37.7% (n=29) had ulcerative colitis (UC) and 62.3% (n=48) had Crohn’s disease (CD). The average age at diagnosis was 35±14.58 years. Thirty-seven patients had used the same preparation continuously, while 40 patients used different biosimilars. The number of switches ranged from a minimum of 1 to a maximum of 6 times. After switching to biosimilars, only one patient experienced disease activation. There was no statistically significant difference between the patients who had switches and those who did not regarding primary non-response and secondary non-response (p=0.419 and p=0.314, respectively). Conclusion In this study, the safety and efficacy of multiple switches between biosimilars in IBD patients receiving IFX were evaluated. Our findings indicate that biosimilars have similar efficacy and safety profiles when compared to the original infliximab products. Our results are consistent with the studies in literature(3,4) . However, long-term effects of switching between biosimilars and original products should be evaluated in more comprehensive studies.

Chronic disease risk factors among hospital employees: A cross-sectional study in Türkiye.

Chronic diseases have become a significant public health problem with the prolongation of human life. There are four main behavioral risk factors for mortality. This study evaluated the significant risk factors for chronic diseases in university hospital employees. The cross-sectional study population consisted of hospital employees working at Gazi University Hospital for at least one year. The sample size was calculated to be 285, with a 100% response rate. The study's independent variables were age, gender, educational status, working department, and presence of chronic diseases. Dependent variables were smoking, alcohol use, physical inactivity, and body mass index (BMI) categories. Data on participants' characteristics, habits, and behaviors were obtained from the hospital system or with open-ended questions. Their body weight and height were measured. The International Physical Activity Questionnaire (IPAQ) was used to assess physical inactivity. The smoking prevalence of hospital employees was 41.8%. Regular alcohol use was 19.3%. Based on the BMI values obtained, 37.9% of the participants were pre-obese, and 18.2% were obese. According to the results of the IPAQ, 13.7% were inactive. The prevalence of smoking was 50.4%, alcohol consume 11.6%, physical inactivity 50.4%, and overweight 65.3% among those who graduated from high school or lower. In contrast, the prevalences were 35.4%, 25.0%, 69.5%, and 49.4%, respectively, among those who graduated from university or higher. A one-unit increase in age of participants without chronic disease increased BMI by 1.06 times (p<0.05). When individuals with a high school education or lower are taken as the reference group, it was found that physical inactivity is 1.78 times higher among those with a university degree or higher (p<0.05). The effect of education level on health habits and behaviors should be considered in terms of the target group and content of preventive health programs and awareness-raising studies.

The impact of the expression level of growth differentiation factor 15 in tumor tissue on the response to immunotherapy in non-small cell lung cancer

BackgroundGrowth differentiation factor-15 (GDF-15), a member of the TGF-β superfamily, is overexpressed in various cancers and facilitates immune evasion by inhibiting T-cell activation. GDFATHER-TRIAL’s phase 2a results demonstrated promising outcomes when combining the GDF-15 neutralizing antibody visugromab (CTL002) with nivolumab, enhancing the response to immunotherapy. This study evaluated the prognostic significance of GDF-15 expression in non-small cell lung cancer (NSCLC) tumor tissues in terms of immunotherapy response.MethodsThis retrospective study included 50 patients with metastatic NSCLC treated with nivolumab at Gazi University Hospital between January 2021 and July 2023. GDF-15 expression was evaluated using immunochemistry staining and categorized based on the intensity of cytoplasmic or membranous staining. Samples were divided into a low expression group (scores 0 and 1) and a high expression group (scores 2 and 3). The primary outcomes were progression-free survival (PFS) and overall survival (OS), which were analyzed using Kaplan‒Meier and Cox proportional hazards models. Objective response rates were assessed in secondary outcomes.ResultsOf the 50 patients, 43 were men (86%), with a median age of 63.9 years. Half of the patients exhibited low GDF-15 expression. High GDF-15 expression correlated with shorter PFS and OS. The median PFS was 7.8 months for the low-expression group versus 4.4 months for the high-expression group (HR, 0.41; 95% CI, 0.20–0.83; p = 0.013). The median OS was 18.1 months for the low-expression group compared to 11.8 months for the high-expression group (HR, 0.36; 95% CI, 0.16–0.78; p = 0.007). The objective response rate was significantly greater in the low GDF-15 group (52%) than in the high GDF-15 group (24%) (p = 0.040).ConclusionElevated GDF-15 expression in NSCLC tumor tissues is associated with poorer response to nivolumab, suggesting that GDF-15 is a potential prognostic biomarker for immunotherapy efficacy. These findings warrant further validation through prospective studies to optimize treatment strategies for NSCLC patients.

The investigation of janus kinase 2 and calreticulin mutations in patients with essential thrombocytosis

Aims: The aims of this study were to investigate the frequency of Janus Kinase 2 (JAK2) and calreticulin (CALR) mutations in patients with essential thrombocytosis (ET) and primary myelofibrosis (PMF) and to compare the data of each group with JAK2 and CALR mutations (+) and (-). Methods: The research group consisted of 80 patients with chronic myeloproliferative disease (CMPD) followed in Gazi University Hospital of Medical Faculty, Hematology Clinic. Results: Of the patients included in the study, 66.2% had ET and 33.8% had PMF. JAK2 mutation (+) was detected in 60% and CALR mutation (+) was found in 22.5% of the patients. JAK2 mutation (+) was detected in 60.4% of patients with ET and 59.3% of patients with PMF. In JAK2 (-) patients, CALR was detected as (+) in 11 patients (52.4%) with ET and 7 patients (63.6%) with PMF. Conclusion: Studies in the literature have shown that the incidence of CALR mutations in patients with CMPD is between 28% and 80% and that the mutation is mostly seen in patients with ET. As a result of our study, it was concluded that the laboratory findings of patients with CALR mutations (+) were similar to those in the literature and were more common in women and ET patients.

Calcineurin inhibitors in unplanned pregnancies with active lupus disease: A retrospective observational study.

To evaluate the use of calcineurin inhibitors (CNIs), specifically tacrolimus, in unplanned pregnancies with active lupus disease among patients with systemic lupus erythematosus (SLE). The study includes data from pregnancies in women diagnosed with SLE at Gazi University Hospital in Ankara, Türkiye, between January 2010 and July 2022. The study categorized pregnancies into planned and unplanned groups based on lupus nephritis presence, emphasizing the need for inactive lupus disease for at least 6 months before attempting conception in planned pregnancies. The outcomes of pregnancies involving CNIs, particularly tacrolimus, were assessed. In our cohort comprising 632 SLE patients, 39 individuals reported 42 pregnancies. Among the 42 pregnancies, 14 have a history of lupus nephritis. We observed that 8 of 14 patients with a history of lupus nephritis had unplanned pregnancies. Three patients used cyclosporine and 2 used tacrolimus during their pregnancy; their pregnancies were completely healthy, and no lupus flare was observed during their pregnancies. The pregnancy of 2 patients who used azathioprine and 1 last patient who used no immunosuppressive treatment ended in abortion. This study reveals that tacrolimus can be effectively used in unplanned pregnancies with active lupus disease, providing favorable maternal and fetal outcomes. The findings emphasize the importance of considering CNIs, particularly tacrolimus, in the management of SLE pregnancies, even in cases of unplanned pregnancies with a history of lupus nephritis.

Effects of the Covid-19 pandemic on the quality of life of oncology patıents

Aim: COVID-19 pandemic has affected all aspects of life. With this study, we aimed to evaluate the effects of the pandemic on the quality of life (QOL) of oncology patients. Material and Methods: This study was conducted on 220 outpatients and inpatients of medical oncology clinics of Gazi University Hospital, through face-to-face interviews in the period between August 2020 and February 2021. Data were collected with the WHOQOL Scale and the original questionnaire. Results: Being younger, being in a higher level of education, living in metropolitan cities, and having a higher salary; increased the patients' QOL. The physical subscale scores (SS) were found to be significantly lower in those who needed surgery, chemotherapy, and hospitalization (p

Low back pain, work overload, and associated factors among hospital caregivers.

Caregivers assist patients in treatment based on their care needs and living activities. Very few studies have been conducted specifically on the occupational health and safety of hospital caregivers. This study aimed to investigate the prevalence of excessive workload and low back pain among hospital caregivers and to identify potential associated factors. This cross-sectional study included caregivers working at Gazi University Hospital. Socio-demographic and working-life characteristics were assessed. The Role Overload Scale was used to determine excessive workload and the Roland-Morris Disability Questionnaire was used to evaluate low back pain. The study included 528 participants. A total of 18.7% had work accidents in their department. 49.0% had sharp injuries. 68.9% of the participants performed tasks such as positioning, turning, lifting, or helping patients to walk. 72.2% stood for a long time during the workday. 52.8% thought that they worked under stress. 57.6% had low back pain in the last year and 38.6% in the last month, Significant differences exist in low back pain according to gender, body-mass index, standing for a long time and working under stress. Those who worked at night, had a work accident, positioned patients, stood for a long time, and worked under stress had higher mean scores on the Role Overload Scale. Tools should be used to lift and transport patients. In addition to occupational health and safety training, awareness of musculoskeletal risks should be increased. Employee well-being can be improved through exercise and stress reduction techniques.

Frequency of sarcopenia in Turkish women with systemic lupus erythematosus

ObjectiveThis study aimed to evaluate the prevalence of sarcopenia and its clinical significance in Turkish women with SLE, exploring the association between muscle mass, muscle strength and SLE disease activity.MethodsA...

Log odds of positive nodes as a prognostic factor for rectal cancer: a retrospective study.

Rectal cancer is an important cause of mortality and morbidity globally. The aim of this study was to investigate whether the log odds of positive nodes system is a better indicator than tumor node metastasis and lymph node ratio systems to determine rectum cancer prognosis, which is an important cause of mortality and morbidity globally. This was a single-center retrospective cross-sectional study. Data were obtained from the medical records of patients with rectum adenocarcinoma followed at Gazi University Hospital. The clinicopathological data of 128 patients with rectum adenocarcinoma who underwent low anterior resection or abdominoperineal resection between January 2010 and December 2018 was retrospectively reviewed. Patients with rectum adenocarcinoma as the first and only primary diagnosis, which was confirmed by histopathological examination, than those who had undergone complete curative resection via low anterior resection or abdominoperineal resection were included. Those with familial adenomatous polyposis or Lynch syndrome, those under 18 years of age, with a synchronous tumor, peritoneal spread, or metastatic disease at the time of diagnosis, and those with <12 lymph nodes dissected from the resection material were excluded from the study. In multivariate analysis, age, perineural invasion, tumor node metastasis stage, lymph node ratio stage, and log odds of positive nodes stage were found to be independent prognostic factors (p<0.05). LODDS2 patients' mortality rates were 9.495 times higher than LODDS0 patients [hazard ratio=9.495, (95%CI 4.155-21.694), p<0.001] while LNR2 stage patients' mortality rates were 7.016 times higher than LNR0 stage patients [hazard ratio=7.016, (95%CI 3.123-15.765), p<0.001] and N2 stage patients had a 5.135 times higher risk of mortality than those who were in N0 stage [hazard ratio=5.135 (95%CI 2.451-10.756), p<0.001]. Log odds of positive nodes is a more valuable prognostic factor for rectal cancer patients than tumor node metastasis and lymph node ratio systems to determine rectum cancer prognosis.

The effect of virtual reality on pain, kinesiophobia and function in total knee arthroplasty patients: A randomized controlled trial

BackgroundVirtual reality (VR) has emerged as a promising new therapeutic approach, showing promise in the treatment of patients with a variety of diseases. This study aimed to investigate the effect of VR on pain, kinesiophobia, and function in patients undergoing total knee arthroplasty (TKA). MethodsThis randomized controlled trial was performed on patients who had TKA due to osteoarthritis at Gazi University Hospital from October 2019 to August 2021. For this study, 21 female TKA patients were divided into two groups by the blocked randomization method: VR (n = 10) and exercise (n = 11). The exercise group was given a home exercise program. The VR group received immersive VR application in addition to the exercise. Pain, kinesiophobia, pain catastrophizing, knee range of motion, functional status, and quality of life were assessed. The Wilcoxon Test and Mann–Whitney U Test were used for comparison of the results. ResultsThe VR group had a statistically significant difference in the intensity of pain at rest, at night, and during the Timed Up and Go Test (TUG), kinesiophobia, pain catastrophizing, active knee flexion, the TUG, and the stair-climb test scores (P = 0.005 (95% confidence interval (CI) (−5.000, −1.000)), P = 0.005 (95% CI (−7.000, −2.000)), P = 0.023 (95% CI (−4.000, 0)), P = 0.006 (95% CI (−15.000, −3.000)), P = 0.012 (95% CI (−19.000, −3.000)), P = 0.010 (95% CI (4.000, 17.333)), P = 0.017 (95% CI (−14.700, −0.850)), P = 0.011 (95% CI (−23.100, −1.000)), respectively). ConclusionIn the early period following total knee arthroplasty, using virtual reality integrated with exercise helps to reduce pain, kinesiophobia and pain catastrophizing, and to improve functional outcomes in female patients.

Comparison of the Results of Galactomannan and Beta Glucan Antigen Tests in the Suspicion of Invasive Pulmonary Aspergillosis

Opportunistic fungal infections are an important cause of morbidity and mortality in immunocompromised patients. Invasive aspergillosis (IA) has an important place among these infections with ~ 250.000 cases annually. Reducing the mortality rate due to invasive aspergillosis is possible with early diagnosis and treatment of the disease. Because of the low sensitivity in microscopic examination, the time consuming of culture growth, and the difficulties in distinguishing colonization/infection, serological methods are frequently used in the diagnosis of invasive aspergillosis. The aim of this study was to determine the diagnostic performance of galactomannan and beta glucan tests for the diagnosis of invasive pulmonary aspergillosis (IPA). Sixty patients, followed up with the suspicion of invasive pulmonary aspergillosis in Gazi University Hospital were included in the study. The clinical classification of the patients was made according to the revised European Organization for Research and Treatment of Cancer and the Mycoses Study Group (EORTC/MSG) criteria. A total of 10 patients were classified as probable invasive aspergillosis and 20 patients were classified as possible invasive fungal disease. Demographic data of the patients and various risk factors were recorded. One hundred and thirty serum and nine bronchoalveolar lavage (BAL) fluid samples were studied with Plateliaᵀᴹ Aspergillus Ag (Bio-Rad, France), Dynamiker Aspergillus Galactomannan and Dynamiker Fungus (1-3)-beta-D-Glucan (Dynamiker, China) kits. Sensitivity and specificity values were calculated according to U.S. Food and Drug Administration (FDA) approved Plateliaᵀᴹ Aspergillus Ag test. According to this study, the most important risk factors in the development of IPA were the use of steroids and immunomodulatory drugs. The sensitivity of the galactomannan test in the probable group was 77.8%, the specificity was 96.7%, the sensitivity of the beta glucan test was 61.1%, and the specificity was 92.6%. When these two tests were evaluated together, it was observed that the sensitivity in the probable group increased to 83.3% and the specificity decreased to 89.3%. The combined use of galactomannan and beta glucan tests increases the diagnostic sensitivity. Although the presence of prolonged neutropenia is an important risk factor for IA, the use of steroids and immunomodulatory drugs should be kept in mind in non-neutropenic patients.

Natural Course of Muscular Strength, Physical Performance, and Musculoskeletal Symptoms in Hospitalized Patients With COVID-19

ObjectiveTo investigate the course of muscle strength, musculoskeletal symptoms and physical performance over time in hospitalized COVID-19 patients, and their relation with disease severity at admission. DesignProspective cohort study. SettingPandemic clinic of Gazi University Hospital, Ankara, Turkey. Participants76 adult COVID-19 patients (aged >18 years) were enrolled in the study between March 2021 and May 2021 (N=76). The participants were grouped as “mild,” “moderate,” and “severe” according to clinical and radiological findings. Main Outcome MeasuresThe fraction of inspired oxygen (FiO2), oxygen saturation (SpO2), hand grip strength (HGS), 5-times sit and stand test (5XSTS), modified Borg scale at rest (mBorg-rest), modified Borg scale during activities of daily living (mBorg-ADL), Barthel index, and visual analog scale for myalgia (myalgia-VAS) values were recorded on the first day of hospitalization and in the first, third, and 12th weeks. Outcome measures were compared between disease severity groups. In addition, the changes in these outcome measures over time were also examined. ResultsThere were 15 (19.7%) participants in the mild, 20 (26.3%) in the moderate, and 41 (53.9%) in the severe groups. At the baseline evaluation, SpO2 (P<.001), FiO2 (P<.001), 5XSTS (P=.002), mBorg-rest (P=.016), and mBorg-ADL (P<.001) were different in 3 groups, but there were no differences for HGS, Barthel index, and myalgia-VAS score. HGS, 5XSTS, myalgia-VAS, and mBorg-ADL scores improved significantly over time in all the groups (P<.001, P≤.001, and P<.001, respectively). At the end of 12 weeks, only 5XSTS was different between the groups. 5XSTS was significantly longer in the severe group (P=.010). ConclusionAlthough significant improvement was observed in the muscle strength, physical performance, and musculoskeletal symptoms of patients with COVID-19 over time, the physical performance of these patients did not reach normal standards. We conclude that post-COVID-19 rehabilitation programs are needed to optimize the physical performance of the patients.

Health related quality of life in patients with primary biliary cholangitis

Aim: To assess the health related quality of life (HRQOL) in patients diagnosed with primary biliary cholangitis (PBC). Material and methods: A single-centered, prospective, cross-sectional study was conducted among patients diagnosed with primary biliary cholangitis in the Gastroenterology out-patient clinic at Gazi University Hospital, Ankara. Data was collected using a sociodemographic information form, hospital medical database and a PBC-40 questionnaire. Statistical comparison analysis was performed using Chi-square test for categorical variables and Mann-Whitney U test for continuous variables. P values less than 0.05 were considered significant. Results: A total of 37 PBC patients were included in the study. The mean age of the participants was 54.2±8.6. When evaluating the PBC-40 questionnaire scores from each domain in terms of severity, we found that majority of patients in itch %40.4 (n=19) and social %42,6 (n=20) domains had mild severity, as for fatigue %42.6 (n=20), cognitive %36 (n=17), emotional %40.4 (n=19) and other symptoms %44.7 ((n=21) domains had moderate severity. A statistically significant difference was found between AMA positive and AMA negative patient groups in the itch domain (p=0.007). Discussion: With this study on a Turkish based population using the PBK-40 questionnaire we were able to demonstrate that patients with PBC had a significantly impaired HRQOL and fatigue was the most seen symptom.

Comparison of ventilation strategies in intensive care units for airborne infection control

ABSTRACT Healthcare facilities are one of the most important buildings in an outbreak. With the tremendous increment of bed occupancy rates in intensive care units, cross-infection risks to healthcare workers also increase. Along with the personal and societal measures, airborne infection prevention via ventilation systems should be evaluated in detail for each design. In this study, the infection prevention performances of three different ventilation layouts inside a selected intensive care unit design, located in Gazi University Hospital, are compared. Three different ventilation strategies as conventional (head supply-feet exhaust, Case 1), switched (head exhaust-feet supply, Case 2), and local exhaust (Case 3) are evaluated with respect to their aerosol distribution characteristics, airflow patterns, and temperature distribution characteristics. As a result, aerosol removal efficiencies of conventional, switched, and local-exhaust approaches are found to be 18.7%, 68.3%, and 97.8%, respectively, whereas the temperature distribution in Case 3 may also meet the thermal comfort requirements.

Retrospective evaluation of viral respiratory tract infections in a university hospital in Ankara, Turkey (2016-2019).

Viruses are responsible for two-thirds of all acute respiratory tract infections. This study aims to retrospectively detect respiratory tract viruses in patients from all age groups who visited the hospital. A total of 1592 samples from 1416 patients with respiratory tract symptoms were sent from several clinics to the Molecular Microbiology Laboratory at Gazi University Hospital from February 2016 to January 2019. Nucleic acid extraction from nasopharyngeal swabs, throat swabs or bronchoalveolar lavage (BAL) samples sent to our laboratory was done using a commercial automated system. Extracted nucleic acids were amplified by a commercial multiplex-real time Polymerase Chain Reaction (PCR) method, which can detect 18 viral respiratory pathogens. Among 1592 samples, 914 (57.4%) were positive for respiratory viruses. The most prevalent were rhinovirus (25.2%) and influenza A virus (12.1%), the least prevalent was the bocavirus (2.6%). Rhinovirus was the most detected as a single agent (21.2%, 194/914) among all positive cases, followed by coronavirus (9.3%, 85/914). The detection rates of coronavirus, human adenovirus, respiratory syncytial virus A/B, human parainfluenza viruses, human metapneumovirus-A/B, human parechovirus, enterovirus and influenza B virus were 9.9%, 8%, 7.7%, 5%, 3.4%, 3.1%, 3%, and 2.8%, respectively. The most detected viral agents in our study were influenza A virus and rhinovirus. Laboratory diagnosis of respiratory viruses is helpful to prevent unnecessary antibiotic use and is essential in routine diagnostics for antiviral treatment. Multiplex Real-time PCR method is fast and useful for the diagnosis of viral respiratory infections.

CAN POSTPARTUM BLOOD LOSS BE PREDICTED VIA UTERINE ARTERY DOPPLER ANALYSIS?

Aim: Postpartum bleeding is one of the most important causes of maternal mortality. Herein, we attempted to predict hemoglobin (Hb) decrease by observing uterine artery doppler indices during the early postpartum period.&#x0D; Materials and Method: The study was designed as a prospective cohort study. Pregnant women who visited Gazi University Hospital for normal vaginal delivery between 09/01/2018–09/01/2019 were included, and no risk factors were included.&#x0D; Results: A total of 85 patients were included with the following parameters: average age at birth, 28.4 ± 4.6 years; average gestational age at birth, 38.83 ± 1.21 weeks. No significant correlation was observed among Hb, hematocrit (Htc), WBC, and other changes in PLT and mean uterine artery systole/diastole (S/D), resistance index (RI), and PI values. Furthermore, no statistically significant relationship was observed among uterus volume, mean uterine artery S/D, PI, and RI. Similarly, no significant relationship was observed among uterus volume, Hb, Htc, WBC, and PLT differences. Upon dividing primigravid and multigravida, the mean uterine artery PI median values did not differ according to the groups.&#x0D; Conclusion: No correlation was observed between possible Hb decrease and resistance in the uterine artery. At the same time, other factors that may affect were evaluated (uterus dimensions, gravida, parity, whether there was membrane rupture, delivery times, lacerations during delivery, episiotomy, and birth weight) and no correlation was noted among these factors.

Fracture Detection in Wrist X-ray Images Using Deep Learning-Based Object Detection Models.

Hospitals, especially their emergency services, receive a high number of wrist fracture cases. For correct diagnosis and proper treatment of these, images obtained from various medical equipment must be viewed by physicians, along with the patient’s medical records and physical examination. The aim of this study is to perform fracture detection by use of deep-learning on wrist X-ray images to support physicians in the diagnosis of these fractures, particularly in the emergency services. Using SABL, RegNet, RetinaNet, PAA, Libra R-CNN, FSAF, Faster R-CNN, Dynamic R-CNN and DCN deep-learning-based object detection models with various backbones, 20 different fracture detection procedures were performed on Gazi University Hospital’s dataset of wrist X-ray images. To further improve these procedures, five different ensemble models were developed and then used to reform an ensemble model to develop a unique detection model, ‘wrist fracture detection-combo (WFD-C)’. From 26 different models for fracture detection, the highest detection result obtained was 0.8639 average precision (AP50) in the WFD-C model. Huawei Turkey R&D Center supports this study within the scope of the ongoing cooperation project coded 071813 between Gazi University, Huawei and Medskor.

Evaluation of the Frequency of Side Effects after Coronovirus Inactive Vero Cell Vaccine in Healthcare Workers of Gazi University Hospital

Evaluation of the Frequency of Side Effects after Coronovirus Inactive Vero Cell Vaccine in Healthcare Workers of Gazi University Hospital

Assessment of olfactory and gustatory functions in COVID-19 patients

Background/aimThis study aims to evaluate of olfactory and gustatory functions of COVID-19 patients and possible risk factors for olfactory and gustatory dysfunctions. Materials and methodsThe cross-sectional study included adult patients who were diagnosed with COVID-19 in Gazi University Hospital between April 2020 and June 2020. Volunteered patients participated in a survey in which olfactory and gustatory functions and various clinical information were questioned. Sinonasal Outcome Test-22 was also administrated to all patients.ResultsA hundred and seventy-one patients participated in this study. Olfactory and gustatory dysfunctions rates were 10.5% (n: 18) and 10.5% (n: 18), respectively. Patients without any symptom other than smell and taste dysfunctions were clustered as group 1 and patients who are clinically symptomatic were clustered as group 2. Olfactory dysfunction occurred in 8% of group 1 and 17.4% of group 2 (p = 0.072). Gustatory dysfunction rate of smokers was 19.7% and significantly higher than gustatory dysfunction rate of nonsmokers (5.5%) (p = 0.007). Twenty-seven-point-eight percent of the patients with olfactory dysfunction (n = 5) were male and 72.2% (n: 13) were female. Sex did not show significant effect on rate of olfactory dysfunction. Twenty-five patients participated in psychophysical olfactory function test. No participant reported olfactory dysfunction at the time of test. Of the participants, 64% (n: 16) were normosmic and 36% (n: 9) were hyposmic according to Sniffin’ Stick test. ConclusionOlfactory and gustatory dysfunctions are more common in patients who are clinically symptomatic than those diagnosed during contact tracing. Objective tests may show that frequency of olfactory dysfunction is greater than frequency of self-reported olfactory dysfunction.

Identification of copy number variants in children and adolescents with autism spectrum disorder: a study from Turkey.

Copy number variants (CNVs) play a key role in the etiology of autism spectrum disorder (ASD). Therefore, recent guidelines recommend chromosomal microarrays (CMAs) as first-tier genetic tests. This study's first aim was to determine the clinical usefulness of CMAs in children diagnosed with ASD in a Turkish population. The second aim was to describe the CNVs and clinical phenotypes of children with ASD. This was a single-center retrospective cross-sectional study. Data were obtained from the medical records of children with ASD followed at Gazi University Hospital, (Ankara, Turkey). The sample consisted of 47 ASD cases (mean age: 60.34 ± 25.60months; 82.9% boys). The diagnostic yield of the CMAs was 8.5%. Four pathogenic CNVs were identified: 9p24.3p24.2 deletion, 15q11-q13 duplication, 16p11.2 deletion, and 22q13.3 deletion. Also, four variants were found at 2q36.3, 10p11.21, 15q11.2, and Xp11.22, which were classified as variants of uncertain significance (VUS). The TRAP12 and PARD3 genes in CNVs classified as VUS may be worth investigating for autism. The initial identification of both clinical and biological markers can facilitate monitoring, early intervention, or prevention and advance our understanding of the neurobiology underlying ASD.