Person: KORTEN, VOLKAN
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KORTEN
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VOLKAN
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Publication Open Access A rare Case of otitis media-associated polymicrobial anaerobic meningitis and brain abscess(2021-12-01) ERTÜRK ŞENGEL, BUKET; TİGEN, ELİF; OLUÇ, YUSUF; ÜLGER, NURVER; KORTEN, VOLKAN; ERTÜRK ŞENGEL B., TİGEN E., YILDIZ F., OLUÇ Y., ÜLGER N., KORTEN V.Otitis media-associated complications are widespread when it is not treated with appropriate antimicrobial treatment. Meningitis and brain abscess are the most reported intracranial complications of otitis media, usually caused by the direct spread of organisms from the contagious site. While anaerobic microorganisms are well-known in brain abscesses, they are not common in meningitis. When the clinical history and pathogenesis of otitis mediaassociated meningitis are combined, special methods to identify and cover anaerobic pathogens should be consideredPublication Open Access Diagnostic performance between RT-PCR and chest CT in outpatients with clinically suspected COVID-19(2023-08-01) TİGEN, ELİF; ERTÜRK ŞENGEL, BUKET; ÇİMŞİT, CANAN; APAYDIN KAYA, MEMNUNE ÇİĞDEM; KORTEN, VOLKAN; TİGEN E., ERTÜRK ŞENGEL B., ÇİMŞİT C., PERK GURUN H., APAYDIN KAYA M. Ç., KORTEN V.Objective: To investigate the diagnostic performance between chest computed tomography (CT) and reverse transcription-polymerase chain reaction (RT-PCR) in outpatients with suspected coronavirus disease 2019 (COVID-19). Patients and Methods: Between March and June 2020, a total of 812 patients with clinically suspected COVID-19 who underwent both chest CT and initial-single RT-PCR on admission to outpatient units were retrospectively enrolled. CT severity-score (CT-SS) was calculated and data were matched with PCR results. Results: Of 812 patients, 54% (439/812) had positive RT-PCR results, and 47% (425/812) had a positive chest CT scan. With RT-PCR results as reference, the sensitivity, specificity, accuracy of chest CT in defining COVID-19 infection were 60%, (95% CI 56-65%, 265/439 patients), 57% (95% CI 52-62%, 213/373), 59% (95% CI 55-62%, 478/812), respectively. Three hundred eighty-seven (47%) patients had no CT findings, 380/812 (46.8%) had mild, 45/812 (5.5%) had moderate, and no patients in the severe group Conclusion: Chest CT did not show high sensitivity for the diagnosis of COVID-19 for outpatients. We suggest RT-PCR should be the primary diagnostic tool. Chest CT might be considered if there is a strong clinical suspicion with repeatedly negative RT-PCR test results, ensuring infection prevention and control measures can be preserved.Publication Open 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 KORTENHepatit 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.Publication Metadata only Prevalence of HIV-associated neurocognitive disorder (HAND) in Turkey and assessment of Addenbrooke's Cognitive Examination Revised (ACE-R) test as a screening tool(WILEY, 2021) TİGEN, ELİF; Korten, V; Ay, U.; Hari, E.; Tigen Tukenmez, E.; Gencer, S.; Akca Kalem, S.; Demirtas Tatlidede, A.; Gurvit, I. H.Objectives We aimed to assess the Addenbrooke's Cognitive Examination Revised (ACE-R) and three questions (3Qs, European Aids Clinical Society Guidelines) as potential screening tools for HIV-associated neurocognitive disorder (HAND). In addition, we tried to determine the prevalence and associated factors for HAND among people living with HIV (PLWH) in Turkey. Methods Persons living with HIV were enrolled from two teaching hospitals between March 2018 and September 2018. Participants underwent screening tools, a neuropsychological test battery (NTB) and an assessment of activities of daily living. HAND was diagnosed according to Frascati's criteria and applying the Global Deficit Score (GDS) approach. A receiver operating characteristic (ROC) curve analysis was performed to compare the predictive accuracy of ACE-R to that of the NP test battery. Factors associated with HAND were evaluated using multivariate logistic regression analysis. Results The study sample included 162 participants (94% male). The HAND prevalence was 45.7% [asymptomatic neurocognitive impairment (ANI), 37.7%; mild neurocognitive disorder (MND), 7.4%; HIV-associated dementia (HAD), 0.6%] according to the Frascati criteria and 31.5% (ANI, 25.9%; MND, 4.9%; HAD, 0.6%) using the GDS. In the ROC analysis, the ACE-R showed an area under the curve of 0.68 at a cut-off score of 89. The sensitivity, specificity and correct classification rate of screening tests for HAND diagnosis were as follows: ACE-R (62.2%, 67%, 64.8%) and 3Qs (10.8%, 88.6%, 53%). In multivariate analysis, only education level (adjusted odds ratio [aOR] = 0.84, 95% CI: 0.76-0.92,P <= 0.001) was an independent risk factor for HAND. Conclusions HAND is a common comorbidity in PLWH in Turkey. The sensitivities and specificities of 3Qs and the ACE-R as screening tools are lower than desired.Publication Metadata only Rectal colonization with multidrug-resistant gram-negative bacteria in patients with hematological malignancies: a prospective study(TAYLOR & FRANCIS LTD, 2020) TİGEN, ELİF; Komurcu, Burak; Tukenmez Tigen, Elif; Toptas, Tayfur; Firatli Tuglular, Tulin; Korten, VolkanObjectives To investigate the risk factors for rectal colonization with carbapenem-resistantEnterobacteriaceae(CRE) and extended-spectrum ss-lactamase-producingEnterobacteriaceae(ESBL-E) in hematological malignant patients with febrile neutropenia (FN); rate of rectal colonization and infection/colonization with CRE and ESBL-E; whether empirical treatment can be revised. Methods Adult patients receiving chemotherapy were included. Rectal swab cultures of patients were screened for CRE and ESBL-E using selective chromogenic agars. Results Fifty-seven FN episodes of 57 patients were studied. Rectal colonization rates were 40.4% (23/57) and 8.8% (5/57) for ESBL-E and CRE, respectively. ESBL-E bacteremia was diagnosed in 2 (8.6%) ESBL-E colonized patients, while CRE bacteremia was detected in 1 (20%) CRE colonized patient. Amikacin (100%) and carbapenem (93%) were the most effective antibiotics against gram-negative enteric bacteria. Beta-lactam usage within the last 3 months was a significant risk factor for ESBL-E colonization. Conclusions For the treatment of FN patients either colonized with ESBL-E or having significant risk factors for ESBL-E infection, aminoglycoside containing combinations may become an alternative to carbapenems due to their high sensitivity rates. When CRE colonized hematological cancer patients develop FN or if they are hemodynamically unstable, CRE covering empiric antibiotherapy should be preferred due to high mortality rates of CRE bacteremia.Publication Metadata only C. auris outbreak in COVID-19 intensive care unit(2022-04-26) ERTÜRK ŞENGEL, BUKET; TİGEN, ELİF; ODABAŞI, ZEKAVER; KORTEN, VOLKAN; ERTÜRK ŞENGEL B., TİGEN E., SAYIN E., SEVDALİYEVA A., ÇERİKÇİOĞLU N., CİNEL İ., KORTEN V., ODABAŞI Z.Publication Open Access Occupation-Related Injuries Among Healthcare Workers: Incidence, Risk Groups, and the Effect of Training(CUREUS INC, 2021-04-06) ERTÜRK ŞENGEL, BUKET; Sengel, Buket Erturk; Tigen, Elif Tukenmez; Bilgin, Huseyin; Dogru, Arzu; Korten, VolkanBackground and objective Occupation-related injuries (ORIs) are undesirable and harmful situations among healthcare workers (HCWs) and may have serious consequences. In this study, we aimed to identify and analyze ORI incidences, risk groups, and the outcomes of a training program to prevent them. Materials and methods Between January 2011 and December 2019, HCWs who applied for infection prevention and control (IPC) due to ORIs (percutaneous needlestick and sharp-object injury or contact with blood or body fluids) were included in the study. Their characteristic features, vaccine histories, injury types, viral serologies, and administered prophylaxis were recorded. After 2014, a periodic ORI training program was started. We used joinpoint regression analysis to compare the ORI incidences before and after the education program. Results During the nine-year study period, 965 ORIs were registered. The mean age of HCWs was 39.3 +/- 8.4 years, and 67.9% of them were female. The total injury incidence for all professions was 34.1 (95% CI: 33.1-37.5) per 1,000 HCWs. The injury incidences were significantly higher in nurses compared to other HCWs (p<0.01). Most of the injuries occurred in the ward setting (37%). HCWs were injured most commonly while administering treatment (36.7%). The trend analysis for the incidence of injuries showed no significant change throughout the study period. The trend in personal protective equipment (PPE) use showed a significant increase (annual percentage change: 1.7, p<0.01). Conclusions The major finding of this study with respect to its implication on the healthcare system is that nurses are an important risk group for ORIs. Although the ORI incidence did not change during the study period, a significantly increased use of appropriate PPE following a systematic training program implementation was observed.Publication Metadata only Prevalence of cardiovascular disease (cvd) and comparison of risk category predictions of systemic coronary risk evaluation 2 (score2) and four other cvd risk calculators among plwhiv in Turkey(2022-10-01) TİGEN, ELİF; KORTEN, VOLKAN; TİGEN E., Gokengin D., Ozdemir H. O. , Akalin H., Kaya B., Deveci A., Inan A., Inan D., Altunsoy A., Ozel A., et al.Publication Metadata only Ventricular and atrial functions assessed byspeckle-trackingechocardiography in patients with human immunodeficiency virus(WILEY, 2021) ÇİNÇİN, AHMET ALTUĞ; Cincin, Altug; Ozben, Beste; Tukenmez Tigen, Elif; Sunbul, Murat; Sayar, Nurten; Gurel, Emre; Tigen, Kursat; Korten, VolkanPurpose Antiretroviral therapy (ART) has dramatically changed the clinical manifestation of human immunodeficiency virus (HIV) associated cardiomyopathy from severe left ventricular (LV) systolic dysfunction to a pattern of subclinical cardiac dysfunction. The aim of this study was to evaluate by speckle tracking echocardiography (STE) LV, right ventricular (RV), and biatrial functions in HIV-infected patients under different ART combinations. Methods We consecutively included 128 HIV-infected patients (mean age 44.2 +/- 10.1 years, 110 males) and 100 controls (mean age 42.1 +/- 9.4 years, 83 males). Ventricular and atrial functions were assessed by both conventional and STE. Results Although there was not any significant difference in conventional echocardiographic variables, HIV-infected patients had significantly lower LV global longitudinal strain (GLS), RV GLS, left atrial (LA) reservoir and conduit strain, and right atrial conduit strain. HIV patients receiving integrase strand transfer inhibitors and protease inhibitors (PI) had significantly lower LV GLS and LA conduit strain, while patients receiving non-nucleoside reverse transcriptase inhibitors and PI had significantly lower RV GLS than controls. CD4 count at the time of echocardiography was strongly correlated with LV GLS (r= .619,P< .001) and RV GLS (r = .606,P< .001). Conclusion Biventricular and atrial functions are subclinically impaired in HIV-infected patients. ART regimen may also affect myocardial functions.Publication Metadata 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.