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KORTEN, VOLKAN

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2015 - 201942020 - 20245
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Author: SİLİ, ULUHAN ×

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Now showing 1 - 9 of 9
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    PublicationOpen Access
    A qualitative study of hand hygiene compliance among health care workers in intensive care units
    (J INFECTION DEVELOPING COUNTRIES, 2019-02-28) TEKER SAYIN, AYŞE GÜLSEN; Ay, Pinar; Teker, Ayse Gulsen; Hidiroglu, Seyhan; Tepe, Pinar; Surmen, Aysen; Sili, Uluhan; Korten, Volkan; Karavus, Melda
    Introduction: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. Methodology: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. Results: Participants mostly practiced hand hygiene depending on the sense of dirtiness and cleanliness. Some of the participants indicated that on-job training delivered by the infection control team changed their perception of emotionally based hand hygiene to indication based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. Conclusions: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed.
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    PublicationOpen Access
    Successful treatment of an invasive fungal infection caused by Talaromyces sp. with voriconazole
    (ELSEVIER SCIENCE BV, 2015-06) BİLGİN, HÜSEYİN; Sili, Uluhan; Bilgin, Huseyin; Masania, Rikesh; Eryuksel, Emel; Cimsit, Nun I. Cagatay; Ayranci, Gulcicek; Richardson, Malcolm; Korten, Volkan
    Invasive fungal infections (lFl) are on the rise due to increasing numbers of immunosuppressed and critically ill patients. A malignant-looking pulmonary nodule in an immunosuppressed patient may indeed be caused by a fungal organism. We report a patient, who was eventually diagnosed with an IFI caused by an agent of hyalohyphomycosis, Talaromyces sp determined via molecular methods and succesfully treated with voriconazole. (C) 2015 The Authors, International Society for Human and Animal Mycology Published by Elsevier B.V.
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    PublicationOpen Access
    Marmara Üniversitesi Pendik Eğitim ve ID_x000D_ Araştırma Hastanesi’nde 2014-2018 Yılları_x000D_ Arasındaki Kronik Hepatit C Prevalansı,_x000D_ Genotip Dağılımı ve Tedavi Yanıtları
    (2020) ERTÜRK ŞENGEL, BUKET; Betül ERTÜRK ŞENGEL;Tuğçe BAŞARI;Elif TÜKENMEZ TİGEN;Rabia CAN SARINOĞLU;Barış CAN;ULUHAN SİLİ;Volkan KORTEN
    Hepatit C dünyada yaygın olarak görülen ve mortaliteye neden olabilen ciddi bir hastalıktır.Bu çalışmada Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi’nebaşvuran hastalarda anti-HCV seropozitiflik sıklığının ve kronik viral hepatit C (HCV)tanısı konarak tedavi verilen hastaların genotip dağılımları ile tedavi başarılarınındeğerlendirilmesi amaçlanmıştır. Çalışmada retrospektif olarak Ocak 2014-Aralık 2018tarihleri arasında anti-HCV istemi yapılan serum örnekleri taranmıştır. Reaktif bulunanörneklerin HCV RNA pozitiflikleri ile genotip dağılımları ve kronik HCV tanısı ile tedaviverilen hastaların kalıcı viral yanıt başarı oranları değerlendirilmiştir. Total 76,413 hastadan100,100 serum örneğinde anti-HCV istemi yapılmış ve 1,808 (% 2,36) hastadapozitif bulunmuştur. Bu hastaların 1,286’sında (% 71) HCV RNA bakılmış ve 291 (% 23)hastada pozitif saptanmıştır. HCV RNA tespit edilen hastalarda 129’una (% 44) hastanemizdekronik HCV tanısı ile tedavi verilmiştir. En sık genotip 1b saptanmış olup, tedavisonrası 24’üncü haftada kalıcı viral yanıt hastaların % 87’sinde elde edilmiştir. Sonuçolarak antiviral tedavi ile virolojik başarı oranları yüz güldürücü olsa da halen tanı vetedavi alması gereken ancak tespit edilemeyen hasta sayısı da oldukça yüksektir.
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    PublicationOpen Access
    Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit
    (J INFECTION DEVELOPING COUNTRIES, 2019-08-31) BİLGİN, HÜSEYİN; Sili, Uluhan; Ay, Pinar; Bilgin, Huseyin; Hidiroglu, Seyhan; Korten, Volkan
    Introduction: While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital. Methodology: A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance. Results: Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for before clean/aseptic procedure indication and highest compliance was 68.6% for after touching a patient indication. Although > 90% healthcare workers correctly identified the World Health Organization's five indications for HH, 82 -85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training. Conclusions: Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.
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    PublicationMetadata only
    Clinical Pharmacist-Led Medication Review in Hospitalized Confirmed or Probable Patients with COVID-19 During the First Wave of COVID-19 Pandemic
    (2024-01-01) ÜNDER, DUYGU; ENVER, CÜNEYD; DEMİRCİ, MUHAMMED YASİR; AYHAN, YUNUS EMRE; ÖZGAN, BETÜL; İLERLER, ENES EMİR; OKUYAN, BETÜL; ERTÜRK ŞENGEL, BUKET; KOCAKAYA, DERYA; SİLİ, ULUHAN; TİGEN, ELİF; KARAKURT, SAİT; KORTEN, VOLKAN; SANCAR, MESUT; ÜNDER D., ENVER C., DEMİRCİ M. Y., AYHAN Y. E., ÖZGAN B., İLERLER E. E., OKUYAN B., ERTÜRK ŞENGEL B., KOCAKAYA D., SİLİ U., et al.
    Objectives: Drug-related problems (DRPs) result in serious problems among hospitalized patients, high rates of morbidity and mortality, and increased healthcare costs. This study aimed to identify DRPs by clinical pharmacist-led medication review in hospitalized probable patients with coronavirus disease-2019 (COVID-19) during the first wave of the COVID-19 pandemic. Materials and Methods: This retrospective cross-sectional study was conducted at the COVID-19 inpatient services of a tertiary university hospital in Türkiye for 3 months (between March 2020 and June 2020) and included hospitalized confirmed or probable COVID-19 patients. The World Health Organization and Turkish Ministry of Health Guidelines case definitions were used to define confirmed and probable COVID-19 patients. Six clinical pharmacy residents provided medication review services during their education and training. DRPs were classified based on the Pharmaceutical Care Network Europe V9.00. The physician’s acceptance rate of clinical pharmacists’ recommendations was assessed. Results: Among 202 hospitalized patients with probable or confirmed COVID-19, 132 (65.3%) had at least one drug-related problem. Two hundred and sixty-four DRPs were identified. Drug selection (85.6%) and dose selection (9.2%) were the most common causes of these problems. Among the 80 clinical pharmacist interventions, 48.8% were accepted by the physicians. Conclusion: Clinical pharmacists identified a significant number of DRPs during the COVID-19 pandemic, particularly those related to drug interactions and drug safety, such as adverse drug reactions. This study highlights the importance of detecting and responding to DRPs in the COVID-19 pandemic.
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    PublicationOpen Access
    Impact of tocilizumab on clinical outcomes in severe COVID-19 patients and risk of secondary infection: A case-control study
    (MARMARA UNIV, FAC MEDICINE, 2021-05-25) ERTÜRK ŞENGEL, BUKET; Sengel, Buket Erturk; Ozel, Serra; Gul, Fethi; Ilgin, Can; Tigen, Elif Tukenmez; Altunal, Luftiye Nilsun; Kabadayi, Feyyaz; Sili, Uluhan; Aydin, Mehtap; Odabasi, Zekaver; Cinel, Ismail; Korten, Volkan
    Objective: This study aimed to identify the effect of tocilizumab (TCZ) on clinical outcomes in severe COVID-19 patients. Material and Methods: We included hospitalized COVID-19 patients with an initial WHO scale >= 4. We matched the patients with baseline characteristics by using propensity scores. Then, we selected patients with C-reactive protein levels above 30 and showing an upward trend. We assessed the effect of TCZ in patients on clinical outcomes by using Mann - Whitney U and Chi-square tests. Results: Of 200 patients who had an initial WHO scale >= 4, 42 (21%) were given it? in addition to standard of care (SOC). Twenty-five patients (50%) needed mechanical ventilation (MV) in the TCZ group, compared with 35 (21%) of 158 patients with SOC (p<0.01). Nineteen (45%) and 37 (23%) patients died in 30 days in these groups, respectively (p <0.01). The secondary infection rate was significantly higher in the TCZ group (p=0.004). However, no difference was observed in all these parameters in the propensity score-matched cohort (14 patients in ICZ and 14 in the SOC group) (p=0.45, 0.45, 1.0 respectively). Conclusions: Tocilizumab does not provide a beneficial effect on MV requirement and mortality in severe COVID-19, and it does not increase the risk of secondary bacterial infection.
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    PublicationOpen Access
    Chronic Viral Hepatitis in Human Immunodeficiency Virus-infected Patients
    (GALENOS YAYINCILIK, 2016-08-15) SİLİ, ULUHAN; Sili, Uluhan; Tekin, Aysun; Korten, Volkan
    Infectious diseases physicians taking care of human immunodeficiency virus-infected patients should investigate for the presence of chronic hepatitis caused by hepatitis B and hepatitis C virus infections. This is important as chronic viral hepatitis progresses more rapidly to end-stage liver disease in human immunodeficiency virus-infected patients. Once diagnosed, there are effective drugs for the treatment chronic viral hepatitis. Tenofovir containing anti-retroviral therapy effectively suppresses hepatitis B replication. Hepatitis C cure can be achieved with directly acting antiviral agents.
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    PublicationMetadata only
    Prevalence of polypharmacy and potential drug-drug interactions associated with risk factors in the era of hiv integrase inhibitors: A prospective clinical study
    (2023-02-01) YAĞÇI ÇAĞLAYIK, DİLEK; TİGEN, ELİF; SİLİ, ULUHAN; ERTÜRK ŞENGEL, BUKET; KORTEN, VOLKAN; Altunal L. N., YAĞÇI ÇAĞLAYIK D., Ozel A. S., TİGEN E., SİLİ U., ERTÜRK ŞENGEL B., Aydin M., KORTEN V.
    People living with human immunodeficiency virus (PLWH), with the availability of modern antiretroviral drugs, have multiple comorbidities, which increase the risk of polypharmacy and potential drug-drug interactions (PDDIs). This is a particularly important issue for the aging population of PLWH. This study aims to review the prevalence and risk factors for PDDIs and polypharmacy in the era of HIV integrase inhibitors. A cross-sectional, two-center, prospective observational study was conducted on Turkish outpatients between October 2021 and April 2022. Polypharmacy was defined as the use of >= 5 non-HIV medications, excluding over-the-counter (OTC) drugs, and PDDIs were classified using the University of Liverpool HIV Drug Interaction Database (harmful/red flagged and potentially clinically relevant/amber flagged). The median age of the 502 PLWH included in the study was 42 +/- 12.4 years and 86.1% were males. Most individuals (96.4%) were given integrase-based regimens (unboosted 68.7% and boosted 27.7%). In total, 30.7% of individuals were taking at least one OTC drug. The prevalence of polypharmacy was 6.8% (9.2% when OTC drugs were included). During the study period, the prevalence of PDDIs was 1.2% for red flag PDDIs and 16% for amber flag PDDIs. CD4(+) T cell count >500 cells/mm(3), number of comorbidities >= 3, comedication with drugs affecting blood and blood-forming organs, cardiovascular drugs, and vitamin/mineral supplements were associated with red flag or amber flag PDDIs. Drug interaction prevention is still important in HIV care. Individuals with multiple comorbidities should be closely monitored for non-HIV medications to prevent PDDIs.
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    PublicationOpen Access
    COVID-19 hastalığı nedeniyle ayaktan takip edilen erişkin hastaların 28 gün içinde hastaneye yatış insidansı ve etkileyen faktörler
    (2023-09-01) SİLİ, ULUHAN; APAYDIN KAYA, MEMNUNE ÇİĞDEM; KORTEN, VOLKAN; AY, NADİYE PINAR; BİLGİN H., TOPUZOĞLU A., SİLİ U., APAYDIN KAYA M. Ç., CAN SARINOĞLU R., KORTEN V., AY N. P.
    Amaç: Çalışmanın amacı, ayaktan takip edilen COVID-19 hastalarında ilk başvurunun ardından 28 günlük dönem - deki hastaneye yatış insidansının ve hastaneye yatış ile ilişkili risk faktörlerinin belirlenmesidir. Yöntemler: Retrospektif kohort olarak planlanan çalışmada, hastaların sosyodemografik özellikleri, başvuru şikayet - leri, komorbidite varlığı ve viral yükü gösteren döngü eşik (cycle threshold - Ct) değerleri bağımsız değişkenler olarak, başvurudan sonraki 28 günlük hastaneye yatış ise bağımlı değişken olarak tanımlandı. Hastaneye yatışa neden olan faktörler tek ve çok değişkenli istatistiksel analizlerle incelendi. Çok değişkenli istatistiklerde Cox regresyon analizi yapıldı ve etki büyüklüğü “hazard ratio” (HR) ile ifade edildi. İstatistiksel anlamlılık düzeyi p<0.05 olarak belirlendi. Bulgular: Çalışmaya 368 hasta dahil edildi. Ortanca (25.-75. persantil) yaşı 36 (28-45) yıl olarak saptanan hastaların %46.1’i kadındı. İlk 28 günde hastaneye yatış 65 (%17.7) hastada gerçekleşti. Çok değişkenli analizde ≤29 yaş refe - rans alındığında; ≥50 yaş [HR=4.1, %95 güven aralığı (GA)=1.7-9.6], 40-49 yaş (HR=3.0, %95 GA=1.3-6.6) ve 30-39 yaş (HR=1.6, %95 GA=0.6-3.6), başvuru anında ateş ve/veya üşüme titreme (HR=2.3, %95 GA=1.3-4.1), nefes darlığı (HR=2.0, %95 GA=1.1-3.4), yorgunluk/bitkinlik (HR=1.9, %95 GA=1.0-3.5), kusma (HR=3.0, %95 GA=1.5-5.8) ve boğaz ağrısı (HR=0.4, GA=0.2-0.8) hastaneye yatışın bağımsız belirleyicileri olarak saptandı. Hipertansiyon varlığı (HR=2.2, %95 GA=1.0-4.4) yatışı öngördüren tek komorbidite olarak belirlendi. Sonuç: İleri yaş, sistemik ve alt solunum yolu infeksiyon bulgularının varlığı ve hipertansiyon, 28 gün içinde yatış riskini artırırken, boğaz ağrısının olması yatış riskini azaltan faktör olarak belirlendi. Boğaz ağrısının yatış riskini düşürmesi, hastalığın hafif bir üst solunum yolu infeksiyonu olarak atlatılacağı ve yatış gerektirmeyeceği şeklinde yo - rumlanabilir. Bu çalışmada eksik veriler nedeniyle riski artırabilecek tüm faktörler değerlendirilemedi. Yatış riskini daha doğru tahmin eden bir model oluşturabilmek için başvuru anındaki klinik, laboratuvar ve radyolojik bulguların da dahil edildiği çalışmalara ihtiyaç vardır.