University Medical Faculty Hospital Research Articles

Distribution and antibiotic susceptibility of Stenotrophomonas maltophilia isolates isolated from various clinical specimens

Aim: This study was planned to contribute to epidemiological data by determining from which clinical samples Stenotrophomonas maltophilia (S.maltophilia) bacteria isolated in the microbiology laboratory were isolated, their distribution according to clinics and their susceptibility status. Materials and Methods: The study was carried out retrospectively from clinical specimens received by the Medical Microbiology Laboratory of Tokat Gaziosmanpaşa University Medical Faculty Hospital from various outpatient clinics and wards between January 2016 and September 2019. Results: Forty-five S. maltophilia strains isolated from clinical samples sent to the microbiology laboratory were included in the study. The highest number of bacteria were isolated from patients hospitalised in the ward. The most common comorbidity is malignancy. The most susceptible antibiotic was trimethoprim-sulfamethoxazole. Conclusions: Due to increasing resistance rates, it is important to organise empirical treatment according to antibiogram results in infections in which S.maltophilia strains are identified as causative agents.

Congenital Toxoplasmosis and Long-term Outcomes.

Congenital toxoplasmosis (CT) can have severe early and late sequelae in children. In this study, we aimed to evaluate the demographic, clinical, treatment characteristics of patients diagnosed with congenital Toxoplasma infection and to highlight the long-term complications of the patients. Patients with CT were included in this study who were followed between 2010 and 2022 in Cukurova University Medical Faculty Hospital. Demographic, clinical and treatment characteristics were searched retrospectively. In the diagnosis of maternal and CT, Toxoplasma IgM, IgG, IgG avidity, T. gondii polymerase chain reaction tests were used along with clinical and symptoms. Eighteen children (two twins) with CT and their mothers (n=16) were included in the study. Median age was 1 month. Ten (55.5%) of the children were male. CT diagnosis was made during pregnancy in 7 mothers (resulting in 8 babies) and postnatally in 9 mothers (resulting in 10 babies). The mothers of 5 (31.1%) babies with CT received spiramycin treatment during pregnancy. Three (60%) of 5 pregnant women who received spiramycin were diagnosed in the first trimester, 4 (80%) of the babies did not have any sequale and only 1 (20%) had microphthalmia. Ocular involvement was the most common presentation of the disease occured in 10 patients (55.5%), hydrocephalus and intracranial calcification developed in five patients (27.7%). Hearing loss developed in 2 (11.1%) patients. During the follow-up period, seizures developed in 3 patients (16.6%), microcephaly in 2 patients (11.1%), and neurodevolopmental retardation in 7 patients (38.8%), two of the patients had severe mental retardation. One (5.5%) patient with hydrocephalus died at 36 months of age due to complications after ventriculoperitoneal shunt application. In our study, we observed severe sequelae in vision, hearing, and neurodevelopmental aspects in children diagnosed with CT at birth and during follow-ups. Early diagnosis and treatment of infants, along with the detection of Toxoplasma infection during pregnancy, are essential in preventing severe sequelae that may arise due to CT.

The Effect of Age on Pancreaticoduodenectomy; Comorbidities, Short-term Outcomes, and Survival.

To evaluate the complications, mortality, and survival rates of patients aged >70 years undergoing pancreaticoduodenectomy, and to determine associated risk factors. Descriptive study. Place and Duration of the Study: General Surgery Clinic of Eskişehir Osmangazi University Medical Faculty Hospital, Eskişehir, Turkiye, from January 2014 to September 2020. A retrospective scrutiny of 94 patients who had undergone pancreaticodueodenectomy, was carried out. The patients were separated into two age groups of younger and older than 70 years, and were compared in respect of clinicopathological characteristics, comorbidities, perioperative characteristics, and complications. Independent risk factors for the endpoints of perioperative mortality and survival were investigated. No significant difference was determined between the groups in respect of biochemical values, and perioperative and histochemical characteristics. Comorbidities were present at a higher rate in the older patients (77.8% vs. 38.8%, p<0.001). The postoperative complication rates were similar (33.3% vs. 32.7%, p=0.944). Perioperative mortality (first 30 days) was determined at a significantly higher rate in the older age group (20.0% vs. 4.1%, p=0.016). The age of patients >70 years increased the risk of mortality 4.851-fold but was not an independent predictive factor (p=0.086). The groups were similar in respect of disease-free survival (DFS) and overall survival (OS, Log-rank p=0.780, p=0.386). Age [Hazard Ratio (HR): 1.029, p=0.048] and pancreas adenocarcinoma (HR: 1.846, p=0.028) were determined to be independent prognostic factors for DFS, and pancreas adenocarcinoma (HR 1.940, p=0.023) for OS. Older age was not seen to change survival in patients undergoing pancreaticoduodenectomy, but mortality within the first 30 days was affected. Age is not accepted as an absolute contraindication. It is recommended that pancreaticoduodenectomy is performed on patients aged >70 years with careful patient selection, prudent preoperative preparation, a meticulous surgical technique, and close multidisciplinary postoperative support. Pancreaticoduodenectomy, Elderly, Comorbidity, Complication, Mortality, Survival.

Neck Pain, Mental Status, and Associated Factors Among Hospital Secretaries: A Cross-Sectional Study From Turkey.

Neck disorders occur in the presence of various risk factors. Determining the cause-effect relationship is highly important in treating existing health problems. Our study aimed to determine the relationship between neck pain and mental status and the factors affecting them in hospital secretaries. The study was cross-sectional. A total of 427 people who had been working as hospital secretaries at Gazi University Medical Faculty Hospital for at least one year were included in the study. Sociodemographic characteristics, working conditions, psychopathology levels, and the presence of neck pain were questioned. The study was conducted with 354 (82.9%) people. 34.3% of the hospital secretaries had neck pain, and 26.3% required psychiatric evaluation. There was a statistically significant (p<0.001) difference in neck pain according to gender, adjustability of the chair, accessibility of the tools, and the need for psychiatric evaluation. Data was collected during November 2022. Those who did neck exercises during the study period had lower mean scores on the General Health Questionnaire-12 than those who did not, and the difference was statistically significant (p<0.001). According to the General Health Questionnaire-12 scores and the Bournemouth Neck Pain Questionnaire Scale, there is a significant (p<0.001), positive, and moderate (r=0.481) correlation between the frequency of mental problems and neck pain disability levels. The relationship between the need for psychiatric status evaluation and neck pain is striking. A significant proportion of hospital secretaries complain of neck pain, work in non-ergonomic conditions, and need psychiatric evaluation. The study's results underline the necessity of targeted workplace interventions and wellness procedures, highlighting the need to implement ergonomic improvements, promote regular exercise regimes, and provide psychosocial support services to improve the general well-being of hospital secretaries and develop a better working environment.

Anxiety, depression, sleep disorders and quality of life in parents of children with first unprovoked seizure and epilepsy.

Parents of a child with neurological problems such as seizures and epilepsy experience significant mental distress. Little is known about the mental state of parents in such a stressful situation. This study aims to determine the prevalence of self-reported depression, anxiety, sleep disorders, and quality of life in parents of children with epilepsy and first unprovoked seizure. This cross-sectional study was conducted among the parents of children diagnosed with first unprovoked seizure and epilepsy admitted to the Pediatric Neurology Department, Outpatient Unit of İnönü University Medical Faculty Hospital. Participants filled out a questionnaire investigating demographic variables, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and 36- Item Short-Form Health Survey (SF-36). 113 parents participated in the study. Depression was found in 7%, anxiety in 14%, and sleep quality disorder in 33.3% of parents of children diagnosed with epilepsy on the basis of moderate or higher severity, while depression was found in 8.9%, anxiety in 14.3%, and sleep disorder in 21.4% of parents of children diagnosed with first unprovoked seizure. There was no statistically significant difference between the groups. Mothers were at higher risk for loss of physical function and social functionality. There was a positive correlation between BAI, BDI, and PSQI scores. Quality of life sub-dimension measured by SF-36 was associated with different levels of depression, anxiety, and sleep quality. Addressing parental psychiatric problems by professionals involved in the treatment of children with a history of seizures may have the potential to provide further support for the family and the care of patients.

Kahramanmaraş-Pazarcık Earthquake 2023: Characteristics of Patients Presented to the Emergency Department of a Tertiary Hospital Far from the Region and Infection Characteristics in Hospitalized Patients.

The aim of this study is to determine the demographic, clinical characteristics, and outcomes of the patients who applied to the emergency department (ED) of Akdeniz University Faculty of Medicine Hospital (Antalya, Türkiye) after the Kahramanmaraş-Pazarcık earthquake dated February 6, 2023, as earthquake victims were included in the study. The results of the study could be a guide in terms of emergency health services and the healthy management of disasters. The study included patients over the age of 18 who presented as earthquake victims to the ED of Akdeniz University Medical Faculty Hospital from February 6, 2023 through March 8, 2023. The demographic data of the patients, including age, gender, earthquake zone, time and manner of arrival to the ED, time under debris, length-of-stay (LOS) in the service and intensive care unit (ICU), infection rates, culture results, and mortality, were retrospectively analyzed using the hospital automation system. A total of 1,833 earthquake victims presented to the ED. Of these patients, 1,294 were adults and 539 were children. Services and the ICU admitted a total of 137 adult patients. In the first week, 414 (31.99%) of the patients presented to the ED, while 82 (59.85%) of the hospitalized patients were admitted.Hatay ranked first with 573 (44.28%) patients in the distribution of patients presented to the ED according to earthquake regions. In the distribution of hospitalized patients by earthquake regions, the patients requiring the most hospitalization were from the province of Hatay, with 68 (49.63%) patients.During hospital observations, the medical staff took 132 culture samples based on the positive clinic of the patient. The microorganisms detected in the culture studies were different from the flora of the hospital. The mortality at seven days was two (1.45%), and at the end of 30 days, the mortality was six (4.37%). The ED evaluated all affected cases, with most patients being brought by their relatives using their own means, and had low mortality rates despite presenting with fewer injuries. New environmental conditions that developed after the earthquake caused unexpected results, especially in terms of community-acquired agents.

COMPARISON OF CLINICAL CHARACTERISTICS OF PATIENTS HOSPITALIZED DUE TO SARS-COV-2, INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS PNEUMONIA

OBJECTIVE: Influenza, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are agents that spread through droplets, have similar symptoms and radiological findings, and can cause respiratory failure. This study was conducted to compare the clinical features and mortality rates of patients with novel coronavirus disease (COVID-19), influenza, and respiratory syncytial virus pneumonia. MATERIAL AND METHODS: A total of 182 patients who were hospitalized at Baskent University Medical Faculty Hospital due to COVID-19, influenza, and RSV were included in the study. Patients were grouped according to their clinical status. Demographic characteristics, comorbidities, laboratory and radiological findings, respiratory support treatments and mortality rates of the patients were recorded and compared between the groups. RESULTS: The mean age was 69.4±7 years in the COVID-19 group (n:115), 72.9±17.1 years in the influenza group (n:33), and 66.5±22.4 years in the RSV group (n:34). There was no difference in age between the groups (p=0.305). The hospitalization rate was higher for male patients in the COVID-19 group (p=0.036). There was no difference between the groups in terms of comorbidities (p&amp;gt;0.05). There was no difference in mortality rates between the COVID-19, RSV, and influenza patient groups (p=0.260). CONCLUSIONS: Viral infections with pulmonary involvement require special attention because they can have a poor clinical course. The severity of the clinical course of COVID-19 pneumonia, which causes deaths in the current century, is not different from the clinical course of viral infections such as influenza and RSV.

SARS-CoV-2 Antibody Prevalence in Unvaccinated Children and Change in Antibody Levels Between 2020-2022

After the declaration of the COVID-19 pandemic by the World Health Organization (WHO), various restrictions were implemented, and face-to-face education was suspended in schools. In some countries, COVID-19 vaccines emergency use authorization has been granted for the pediatric age group. This study aimed to investigate COVID-19 antibody level in children who have not been vaccinated against COVID-19. A total of 1,000 pediatric patients aged 0-12 years, unvaccinated against COVID-19, admitted to Necmettin Erbakan University Medical Faculty Hospital Pediatrics clinics with different symptoms between October 2020 and April 2022 were included in this study. SARS-CoV-2 S total antibody levels were tested by ELISA method from the sera samples of these children. Of the children included in the study, 535 (53.5%) were male and 465 (46.5%) were female. Anti-SARS-CoV-2 S total Ig positivity rates were 75.9% in girls and 78.5% in boys and the difference between them was not statistically significant (p&gt;0.05). When the anti-SARS-CoV-2 S total Ig positivity rates of children were evaluated according to years, 23 (43.4%) in 2020, 183 (60%) in 2021, and 567 (88.3%) in 2022 was found positive. The difference between antibody results by years was found to be statistically significant (p&lt;0.001). Median value of SARS-CoV-2 antibody levels of patients with positive antibody test in 2020 46 AU/ml (min 5, max: 214 AU/ml), in 2021 130 AU/ml (min:1, max: 250 AU/ml), and in 2022 it was found to be 250 AU/ml (min:1, max: 250 AU/ml). When the antibody levels of patients with anti-SARS-CoV-2 S Ig total positive were evaluated, the difference between years was found to be statistically significant (p&lt;0.05). In our study, it was determined that the rate of SARS-CoV-2 S total antibody positivity reached 90% in unvaccinated children aged 12 and younger. Determining the SARS-CoV-2 antibody status of children aged 12 and under who unvaccinated against COVID-19 in our country will both give information about immunization by natural immunity and will be effective in deciding and planning the need for COVID-19 vaccination for children.

Comparison of the short and medium term efficacy of ortholox UHMWPE sternal cerclage band system and figure-of-8 wire sternum closure technique in patients at risk for sternal dehiscence

Aim: In this retrospective study, it was aimed to compare the short and medium term efficacy of Sternal Cerclage Band System and Figure-of-8 wire closure technique in open heart surgery patients with risk for sternal dehiscence. Material and Methods: In total, 320 open heart surgery patients with risk for sternal dehiscenceattempting to Kahramanmaraş Sütçü Imam University Medical Faculty Hospital between 28.12.2017 and 11.12.2021were subjected to this restrospective study. Since the study is retrospective, randomization and randomization procedures are not in question.The patients included in the study were divided into 2 groups as Steel Wire (standard procedureFigure 8 wiretechnique), and the Sternal Cerclage (sternum was closed with the Ortholox® Sternal Cerclage Band System). Baseline characteristics and outputs of patient groups were compared. Results: Age and body mass index (BMI) means were significantly higher in Cerclage Band group (p&lt;0.05). 53.8% of Cerclage Band group and 38.1% of Steel Wire group had obesity, and the difference was significant (p&lt;0.05). Diabetes mellitus (DM) rate was 36.3% in Steel Wire group and 48.4% in Cerclage Band with statistically significant differences (p&lt;0.05). In Cerclage Band group, 42.5% of patients were smoker, whereas 3.8% of Steel Wire group were smokers (p&lt;0.05). Length of hospital stay, sternal stability and infection after surgery rates were similar between patient groups with statistically insignificant differences (p&gt;0.05). Conclusion: Although there are differences between Cerclage Band and Steel Wire, results and outputs were similar, and showed that Sternal Cerclage Band System is a safe and useful technique in open heart surgery patients with risk for sternal dehiscence.

Clinicopathological characteristics and BRCA1/BRCA2 pathogenic variants ofpatients with breast cancer.

Although BRCA genes are well-known breast cancer genes, theclinicopathological features ofbreast cancer patients carrying BRCA1/2 pathogenic variants have not been adequately defined. Thegoals ofthis study were to determine thedistribution ofBRCA1/2 variants in theTurkish population and its correlation with clinicopathological features. Clinical data of151 women who underwent BRCA1/2 gene testing at Mersin University Medical Faculty Hospital between 2016 and 2019 were retrospectively analyzed. BRCA1/2 variants were detected as pathogenic (n = 11), variants ofuncertain significance (n = 5), likely benign (n = 3), and benign (n = 81) in breast cancer cases. TheBRCA1/2 pathogenic variant carriers had ahigher histological grade, rate oftriple- negative type, Ki-67 proliferation index, and rate ofno special type carcinoma than thegroup without mutation (p = 0.03, 0.01, 0.04, and 0.02 respectively). We analyzed thedistribution ofvariants we detected in women living in our region and found that pathogenic variants in patients with breast cancer were associated with high histological grade, triple-negative type, high Ki-67 proliferation index, and histological type. Studies in diverse populations are needed to establish aclinicopathological relationship with variants more easily.

Landscape Design in Hospital Gardens: The Example of Selcuk University Medical Faculty Hospital

Hospital gardens, located within urban open-green areas, are places created for patients coming to the hospital, their relatives and the staff working in the hospital to spend time in an environment where they can renew themselves. The importance of these places is increasing day by day. The purpose of this study is to examine the landscape design of the Selcuk University Faculty of Medicine hospital garden located on the Selcuk University Alaeddin Keykubad Campus. The findings show that the hospital garden was generally not designed in accordance with landscape design principles. With the suggestions developed, this hospital garden can be redesigned in accordance with landscape design principles and made more comfortable for people using the hospital garden.

ETIOLOGICAL FEATURES OF CASES WITH CHEST PAIN IN THE PEDIATRIC CARDIOLOGY OUTPATIENT CLINIC

Objective: Chest pain in children, especially in adolescence, constitutes a significant proportion of the presentations to pediatric cardiology clinics. We aimed to determine the frequency of chest pain causes in the pediatric age group and the importance of echocardiography.&#x0D; Material and Methods: We retrospectively examined the etiological and epidemiological characteristics of patients with chest pain who were admitted to Kırıkkale University Medical Faculty Hospital Pediatric Cardiology Clinic and Pediatric Emergency Service between 2014 and 2019.&#x0D; Results: One thousand hundred sixty-four patients were enrolled in this study. The mean age of the patients was 12.9±2.0 years (range 10-17 years). Echocardiographic evaluation was performed in 87.9% (n=1023) of 1164 patients. In 769 (75.2%) patients, there was no cardiac abnormality. Mitral valve prolapse (MVP) was detected in 164 (16.0%) patients. Out of these patients, 116 (11.3%) also had mitral insufficiency (MI). There was a female preponderance (117/164, 71.4%) among the patients with MVP. Patients with normal echocardiography findings, were compared with patients who had MVP+MI with respect to mean hemoglobin, mean corpuscular volume, Creatine kinase, Creatine kinase- MB, troponin, pro-B-type natriuretic peptide, and C-reaktif protein levels. There was no significant difference between these groups with respect to these parameters.&#x0D; Conclusion: We showed that MVP/MI is the most common cause of cardiac related chest pain in children. Therefore, chest pain, especially with physical examination findings, such as a murmur, should be evaluated by a pediatric cardiologist, ideally by echocardiography.

Mersin University Medical Faculty Hospital Emergency Department and Triage Organizatıon After the 2023 Kahramanmaraş Earthquake

Mersin University Medical Faculty Hospital Emergency Department and Triage Organizatıon After the 2023 Kahramanmaraş Earthquake

Comparison of cases with and without acute liver injury in pregnant women with SARS-CoV-2 infection; obstetric and neonatal outcomes.

The effect of SARS-CoV-2 infection on the liver during pregnancy and the impact of SARS-COV-2-related liver injury during pregnancy on obstetric and neonatal outcomes are not yet clear. The aim of this study was to determine the clinical features of pregnant women at risk of liver injury and to investigate the effect of liver dysfunction on obstetric and perinatal outcomes. Pregnant women who were followed up and treated at Selcuk University Medical Faculty Hospital and diagnosed with COVID-19 were determined retrospectively. All pregnant women whose PCR test results were positive between March 1, 2020 and July 31, 2022 were included. A total of 96 PCR positive pregnant women were included in the study. The patients were divided into two groups as those with and without liver damage. Both groups were compared in terms of obstetric and neonatal outcomes. While liver damage findings were observed in 34.4% of the 96 pregnant included in the study; No liver damage was observed in 65.6% of the patients. White blood cell, neutrophil, ferritin, D-dimer, troponin, C-reactive protein, systemic immune-inflammation index, interleukin-6, alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase levels were higher in patients with liver injury compared to pregnant women without liver injury. Prematurity, premature rupture of membranes, preterm premature rupture of membranes, preeclampsia and fetal death were observed relatively more in the patient group with liver injury, there was no statistical significiant difference between the groups in terms of these complications. Unfortunately, maternal death occurred in four mothers with liver injury and in one patient without liver injury. Birthweight, APGAR scores and obstetric complication rates were similar between two groups. Our study showed that pregnant patients with liver damage had worse inflammatory response than those without liver damage. Women with elevated liver enzymes tend to have severe disease, but obstetric and perinatal outcomes were similar between groups with and without liver damage.

Evaluation of children with type 1 diabetes in Kırıkkale

Aims: The aim of this study is to evaluate the clinical laboratory and demographic characteristics of children aged 0-18 with Type 1 Diabetes who applied to Kırıkkale University Hospital. Methods: Patients who applied to Kırıkkale University Medical Faculty Hospital between January 2011 and January 2021 and were diagnosed with Type 1 diabetes mellitus were included in the study. From file information; age at admission, age at diagnosis and laboratory values at admission were recorded. Results: Of the children, 48 (48.5%) were boys and 51 (51.5%) were girls. The mean age of all patients was 14.4±2.1 years. It was observed that its frequency increased during the adolescence period. It appeared that patients frequently increased in the autumn and winter months. Vitamin D was low in 74.4% of the patients. Statistical significance was found between HbA1c of those who applied to the hospital with a diagnosis of diabetic ketoacidosis. Conclusion: It is instructive to investigate the regional characteristics of the disease in terms of genetic and environmental factors that have an important place in the etiology. The findings of our study were consistent with similar studies and literature.

Retrospective Evaluation of Patients with Brucellosis: Five Years of Experience

Objective: We aimed to evaluate the epidemiological, clinical features, laboratory findings, and treatment regimens of patients with brucellosis in the Tokat region. Methods: In this cross-sectional study, the data of 236 adult patients followed with brucellosis in Tokat Gaziosmanpaşa University Medical Faculty Hospital between January 2016 and December 2021 were evaluated retrospectively. Diagnostic criteria of brucellosis were determined as culture positivity, or positivity in the Wright test at ≥ 1/160 titration, or a 4-fold increase in titer of the Wright test repeated at 2 – 3 week intervals. Demographic data, symptoms, physical examination findings, and laboratory results of the patients were evaluated. Results: 72% (n=170) of the patients were male, and the mean age was 44.47±16.64. 53% (n=125) were engaged in animal husbandry, 21.6% (n=51) consumed unpasteurized dairy products, and 13.1% (n=31) had a family member with brucellosis. Seven (2.9%) patients with a prediagnosis of Crimean-Congo hemorrhagic fever (CCHF) were diagnosed with acute brucellosis. The most common symptoms were muscle-joint pain (70.3%), fever (50.8%), and sweating (43.2%). Spondylodiscitis was observed in 13.6%, epididymal-orchitis in 8.2%, and neurobrucellosis in 0.4% of the patients. Blood culture positivity was detected in 7.2% of the cases. 91.5% had elevated C-reactive protein (CRP) levels, and 48.3% had elevated erythrocyte sedimentation rates. The most common hematological findings were anemia (28%), leukopenia (10.6%), and thrombocytopenia (8.5%). As a therapy doxycycline + rifampicin combination was started at 36%, doxycycline + gentamicin to 5.8%, doxycycline + streptomycin to 5.4%, and doxycycline + rifampicin + gentamicin to 29.7% of the patients. Alternative treatment regimens were given to 22.9% (n=54) of the patients. Conclusion: Brucellosis is still a critical zoonotic disease in our region. It should be kept in mind when diagnosing patients with fever, muscle-joint pain, and sweating, with epidemiological histories, have elevated acute phase reactants and cytopenia. It should also be remembered that brucellosis can be confused with CCHF in endemic areas.

EVALUATION AND DIAGNOSTIC EFFECTIVENESS OF HEMOGRAM, BIOCHEMISTRY AND INFLAMMATORY MARKERS (IMMATURE GRANULOCYTE, PROCALCITONIN, CRP, NLR, PLR) IN PATIENTS WITH SEPSIS

Aim&#x0D; This study aimed to reveal the contributions of hemogram values and inflammatory markers involved in the pathology and progression of sepsis, and other biochemical markers such as C-reactive protein, procalcitonin, delta neutrophil index (immature granulocyte), calcium and zinc levels to the diagnosis of sepsis, and the relationship of these markers with each other.&#x0D; Material and Method&#x0D; This is a descriptive epidemiological study. Patients aged 18 years and over who were diagnosed with sepsis in the Emergency Department and Internal Diseases Service of Kahramanmaraş Sütçü Imam University Medical Faculty Hospital between 11.10.2022 - 11.06.2023 were prospectively included in the study.&#x0D; Results&#x0D; In our study, it was found that leukocyte, neutrophil, neutrophil lymphocyte ratio, platelet lymphocyte ratio, immature granulocyte, copper, phosphorus, blood glucose, C-reactive protein and procalcitonin values were high in patients with sepsis. The levels of albumin, calcium, zinc and lymphocyte were found to be low. &#x0D; Conclusion&#x0D; The use of biomarkers in sepsis has increasingly become important in diagnosing, following treatment, determining prognosis and predicting mortality. The biomarkers examined in this study are believed to be a reference for future studies on their use in the diagnosis, treatment and prognosis follow-up of sepsis.

Another Face of the Post-COVID Syndrome in Elderly Patients: Increased Frailty Due to Systemic Inflammation

Aim: COVID-19 is known to be a condition that creates long-term morbidity and mortality in older adults. There is not enough information yet about the relationship between COVID-19 and frailty. In our study, we investigated whether COVID-19 increases frailty, a condition that can be counted among its long-term effects.&#x0D; &#x0D; Materials and Methods: The study included 73 patients over the age of 65 who were hospitalized in the Başkent University Medical Faculty Hospital COVID-19 Isolation Service, with positive COVID-19 PCR test. Patients were categorized as mild-moderate, severe, and critical pneumonia requiring intensive care unit admission. The FRAIL Frailty scale was applied to the patients on the first day of hospitalization. The FRAIL Frailty scale was applied again at the 3rd month follow-up after discharge. FRAIL index were compared on the first day of hospitalization and 3 months after discharge due to COVID-19.&#x0D; &#x0D; Results: 58.9% of the patients participating in our study were male and 41.1% were female. Their mean age was 77.48±7.68 years. The mean FRAIL score was 1.34±0.12 on the first day of hospitalization and 2.24±0.12 after discharge. The mean change in FRAIL score between the first day of hospitalization and after discharge was 60.3% and was statistically significant (p

Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap

Introduction: Mediastinitis is a rare occurrence following cardiac surgeries; however, it is a significant cause of both mortality and morbidity. Given the significance of mediastinal infections, early diagnosis, and treatment become of paramount importance. The management of this condition necessitates a multidisciplinary approach, involving collaboration and coordination among various medical specialties. Patients and Methods: 21 patients with a diagnosis of deep mediastinal infection who were treated at Eskişehir Osmangazi University Medical Faculty Hospital between January 2015 and May 2021 were included in the study. Broad-spectrum antibiotic therapy, serial debridement, and vacuum-assisted closure were applied to all patients. Among the patients who exhibited negative blood cultures and developed granulation tissue, those with tissue losses that did not extend to the sternum incision sites were assessed for potential flap procedures in conjunction with plastic and reconstructive surgery. In such cases, closure of the wound was achieved using a pectoral muscle flap. All patients were followed for one year. Results: Among the patients, 14 (66.6%) were female and seven (33.3%) were male, with a mean age of 62.7 ± 6.5 (range: 41-76 years). Three of the 21 patients included in the study had type I, two had type II, and 16 had type IIIA mediastinitis. Staphylococcus aureus (S. aureus) was the most commonly isolated microorganism with 11 patients (52.3%). The right pectoralis major muscle was used in four patients (19%), the left pectoralis major muscle in four patients (19%), and the bilateral pectoralis major muscle in 13 patients (62%). There was no need for re-intervention in the follow-up of the patients. No mortality because of infection, surgical muscle flap closure, and/or cardiac causes was observed in any of the patients who were treated. Conclusion: Mediastinitis is a costly treatment, requiring prolonged hospitalization and carrying the risk of mortality. The main objective is to prevent the occurrence of mediastinitis. We believe that this objective should be pursued through a multidisciplinary approach involving cardiovascular surgery, infectious diseases, and plastic and reconstructive surgery units.

Genel Anestezi Uygulanan Çocuk Hastaların Postoperatif Dönemde Ağrılarının Değerlendirilmesine Yönelik Hekim ve Hemşirelerin Görüşleri: Nitel Bir Çalışma

ABSTRACT&#x0D; Aim: It is aimed to determine the opinions of physicians and nurses on the evaluation of pain in the postoperative period of pediatric patients undergoing general anesthesia.&#x0D; Materials and Methods: Qualitative research method was used in the study. The study was carried out with a total of 13 physicians and nurses working voluntarily in the anesthesia and pediatric surgery clinic of Selçuk University Medical Faculty Hospital. Data were collected through individual in-depth interviews through a semi-structured questionnaire in October 2022. Individual interviews were held in a suitable meeting room within the hospital with the participation of two researchers. Note-taking technique was used in the interviews and a voice recorder was used. The qualitative data obtained were analyzed by the researchers with the content analysis method.&#x0D; Results: Qualitative findings were determined as four main themes: thoughts about pain, beliefs about pain management, the role of health professionals in pain management, and the role of family/parent in pain management.&#x0D; Conclusion: As a result of the study, it was determined that pain was followed, pharmacological methods were used, non-pharmacological methods were not in the clinical routine, teamwork was important in pain management, and the family/parent were with the child.