Browsing by Author "Firat, Pinar"

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Factors Affecting Inadequate Empirical Antimicrobial Therapy and the Clinical Course of Upper Urinary Tract Infections in Elderly Patients: A Multicenter Study
(GALENOS YAYINCILIK, 2020-01-01) Korkmaz, Pinar; Kurtaran, Behice; Ozdemir Armagan, Sule; Turan Ozden, Hale; Kacar, Fatma; Ates, Selma; Durmus, Gul; Bayindir Bilman, Fulya; Uygun Kizmaz, Yesim; Hamidi, Aziz Ahmad; Ozdemir, Burcu; Burcu Yikilgan, Aslihan; Firat, Pinar; Inan, Asuman; Okay, Gulay; Isik, Mehmet Emirhan; But, Ayse; Ugurlu, Kenan; Harman, Rezan; Ergut Sezer, Busra; Doyuk Kartal, Elif; Kuscu, Ferit; Sener, Alper; Mistanoglu Ozatag, Duru; Tukenmez Tigen, Elif; Dagli, Ozgur; Kocak, Funda; Kusoglu, Hulya; Erturk Sengel, Buket; Demirel, Aslihan; Naz, Hasan; Agalar, Canan; Ozturk Engin, Derya; Dokmetas, Ilyas; Cancan Gursul, Nur; Yilmaz Karadag, Fatma; Cayiroz, Mehmet Umut; Kurekci, Yesim; Kadanali, Ayten; Cakar, Zeynep Sule; Savasci, Umit; Erdem, Ilknur; Cagan Aktas, Sabahat
Introduction: In this study, we aimed to determine the risk factors associated with inadequate empirical antibiotherapy (IEAT) and hospital-related mortality in elderly patients being treated for upper urinary tract infections (UTI). Materials and Methods: This study included individuals aged 65 years and over who were hospitalized after being diagnosed of community-acquired UTI or community-onset healthcare-associated UTI and followed-up in clinics and/or intensive care units (ICU) of 33 hospitals between March and September 2017. Results: A total of 525 patients (48\% males
Interobserver Agreement Among Histological Patterns and Diagnosis in Lung Adenocarcinomas
(DE GRUYTER OPEN LTD, 2014-01-01) Urer, Halide Nur; Ahiskali, Rengin; Arda, Naciye; Batur, Sebnem; Cinel, Leyla; Dekan, Gerhard; Fener, Neslihan; Firat, Pinar; Geleff, Silvana; Oz, Buge; Ozluk, Yasemin; Yildiz, Kursat; Yilmazbayhan, Emine Dilek; Zeren, Handan; Uysal, Atilla
Objective: The aim of this study was to investigate the interobserver agreement in determination of the dominant histological pattern and the final diagnosis in lung adenocarcinomas. Material and Method: A total of 12 patients with a diagnosis of primary lung adenocarcinoma were included in the study. Twelve pathologists from eight study centers were asked first to determine the dominant histological pattern in these cases and then to decide whether the final diagnosis was in situ, minimally invasive or invasive adenocarcinoma. Results: The kappa value for the agreement in determining the dominant pattern among the pathologists was 0.36 (p< 0.001), with the values for the lepidic, acinar, papillary, solid, micropapillary patterns and mucinous character of adenocarcinoma being 0.34, 0.28, 0.30, 0.80, 0.16 and 0.38 respectively (p< 0.001, p< 0.001, p< 0.001, p< 0.001, p< 0.001, p< 0.001). None of the cases was diagnosed as in situ adenocarcinoma. On the other hand, the kappa value for the agreement in differentiating minimally invasive from invasive adenocarcinoma among reviewers was 0.17 (p< 0.001). Conclusion: The agreement among pathologists in determining the subtype of lung adenocarcinomas that depends on the identification of the dominant pattern was at intermediate level. In addition, the agreement in deciding whether the case is minimally invasive or invasive, was at low level. The criteria defining the histological patterns should be clarified and described in more detail. Educational activities and larger multicenter studies might be helpful in improving the agreement and standardization.
The importance of histological patterns on PD-L1 staining heterogeneity: Should we use pattern-based approach for selecting tumor samples for PD-L1 testing in lung
(TUBITAK SCIENTIFIC \& TECHNICAL RESEARCH COUNCIL TURKEY, 2021-01-01) Bulutay, Pinar; Firat, Pinar; Zeren, Handan; Erus, Suat; Tanju, Serhan; Dilege, Sukru
Background/aim: Programmed death ligand-1 (PD-L1) is a predictive marker for immunotherapeutic agents. However, heterogeneous staining of PD-L1 can cause false-negative results. The aim of this study is to evaluate the importance of histological patterns on PD-L1 staining heterogeneity in lung adenocarcinomas (LAC). Materials and methods: PD-L1 immunohistochemistry (IHC) stain was performed to two different tissue cores of 128 LAC cases, and cut-off values are given for grouping the cases according to the percentage of staining (1\%-10\%, 11\%-49\%, 50\%-100\%). Staining rates between cores were compared and analyzed by their histological patterns. Also, the relation of the PD-L1 expression with the clinicopathological characteristics of the cases was analyzed. Results: Overall, PD-L1 expression was observed in 53 of 128 cases (41.4\%, 1\% cut-off), 23.5\% of them were positive at 10\% cut-off and 14.1\% at 50\% cut-off. PD-L1 expression was significantly related to the high grade micropapillary and solid patterns of adenocarcinomas (p:0.01). Staining cut-offs were mostly similar between cores (43/50, 86\%) (k:0.843). However, 14\% of them were positive only in one core (7 of 50). This false negativity was mostly related to the histological patterns. Conclusion: Our data reveal the heterogeneous staining of PD-L1 expression, also micropapillary and solid patterns show higher rates of PDL expression. Therewithal, these findings also highlight the importance of taking into consideration of histological patterns, when choosing a paraffin block for the PDL1.
What does the Data of 354,725 Patients from Turkey Tell Us About Cervical Smear Epithelial Cell Abnormalities? - The Epithelial Cell Abnormality Rate is Increasing - Quality Control Studies and Corrective Activity are Musts
(DE GRUYTER OPEN LTD, 2017-01-01) Turkmen, Ilknur Cetinaslan; Usubutun, Alp; Cakir, Asli; Aydin, Ozlem; Bolat, Filiz Aka; Akbulut, Metin; Altinay, Serdar; Arici, Sema; Aslan, Figen; Astarci, Muzeyyen; Bagir, Emine Kilic; Bas, Yilmaz; Bassullu, Nuray; Celik, Betul; Cetiner, Handan; Cobanoglu, Bengu; Aydin, Abdullah; Demir, Hale; Dogan, Hayriye Tatli; Eken, Kamile Gulcin; Erhan, Selma Sengiz; Erdogan, Gulgun; Erdogan, Kivilcim Eren; Eren, Funda; Ersoz, Safak; Firat, Pinar; Gurses, Iclal; Haberal, Nihan; Kahraman, Dudu Solakoglu; Kamali, Gulcin Harman; Karabulut, Yasemin Yuyucu; Kefeli, Mehmet; Koyuncuoglu, Meral; Koseoglu, R. Dogan; Muezzinoglu, Bahar; Onal, Binnur; Onder, Sevgen; Ozcan, Zuhal; Kimiloglu, Elife; Ozer, Hatice; Sonmez, F. Cavide; Sahin, Sevinc; Sahin, Nurhan; Yalta, Tulin
Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories. Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire. Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08\% in the total 354,725 smears and ranging between 0.3\% to 16.64\% among centers. The Atypical squamous cells/Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers. Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.