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- ÖgeSusceptibility-Weighted Imaging in Grading of Infiltrative Glial Tumors(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2020-03-03)ABSTRACT Purpose: Histopathological and radiological examination is necessary for the evaluation of tumor types and staging. Histopathologic examination is considered as the gold standard, while the radiological examination is used for preoperative evaluation. The purpose of the present study was to evaluate susceptibility-weighted imaging (SWI) the in grading of infiltrative glial tumors. Materials and Methods: The SWI sequences in pre-operative magnetic resonance imaging (MRI) images were retrospectively assessed in a total of 67 patients (mean age, 36.7 years; age range, 4–79 years; 29 female, 38 male) who were diagnosed with a glial tumor based on histopathological examination. The numbers of punctate intratumoral susceptibility sign (ITSS) in the SWI sequence in the tumors were determined by two radiologists on a consensus-based approach. Lesions with no ITSS were graded as Grade 0, while those having 1–5, 6–15, >15 ITSS were categorized as Grade 1, Grade 2, and Grade 3, respectively. No susceptibility was classified as ITSS, “non-punctate with blurred margins” and diffuse susceptibility were categorized as >15. ITSS grades were compared to the results of histopathological grading and diagnosis. Results: The sensitivity, specificity, negative predictive value, and positive predictive value of the presence of ITSS regarding differentiating high and low-grade glial tumors were 97.6%, 88%, 95.65%, and 93.18%, respectively. Conclusion: In diffuse glial tumors, while the presence of ITSS is indicative of high-grade tumors, its absence is associated with low-grade tumors. These data suggest that the presence rather than the number of ITSS yields more information on the grade of this type of tumor.
- ÖgeAdana Acıbadem Hastanesinde Hastane Enfeksiyonları Surveyansı: Bir Yıllık Analiz Sonuçları(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2020-03-03)ÖZET Amaç: Hastanemizde gelişen hastane enfeksiyonuna (HE) neden olan etkenlerin dağılımı ve antibiyotik duyarlılıklarının belir lenmesi. Hastalar ve yöntem: Yaklaşık 116 yatak kapasiteli hastanemizde, Ocak 2017 – Aralık 2017 tarihleri arasındaki hastane enfeksiyon ları surveyans yöntemi ile retrospektif olarak değerlendirildi. Bulgular: Ocak 2017-Aralık 2017 tarihleri arasında Acıbadem Adana Hastanesinde 9931 hasta yatışı yapıldı. Hastaların 92’sinde hastane enfeksiyonu geliştiği saptandı. Tüm hastane genelinde enfeksiyon hızı %1,32 idi. HE dağılımı; 30 hastada bakteriyemi (%29,4), 22 hastada cerrahi alan enfeksiyonu (%21,5), 20 hastada üriner sistem enfeksiyonu (%19,6) ve 15 hastada pnomoni (%14,7) olarak saptandı. Çocukluk yaş grubunda bakteriyemi ve pnömoni, yetişkin yaş grubunda ise üriner sistem ve cerrahi alan enfeksiyonu en sık sapta nan HE idi. HE gelişen hastaların %97,7’de bir ya da daha fazla etken izole edilirken, %2,3’de herhangi bir etken izole edilemedi. Hastane genelinde en sık izole edilen mikroorganizmalar sırasıyla; Klebsiella spp. (%29,5), E.coli (%22,7), maya mantarları %20 ,5 ve S.aureus (%9) idi. HE en sık olarak onkoloji servisinde (%57,8), genel yoğun bakım ünitesinde (%24,5) ve pediatrik kemik iliği ünitesinde (%17,6) görüldü. Sonuçlar: HE yataklı tedavi kurumlarının hizmet kalitesinin önemli göstergelerinden biri olup artık tüm dünyada önemli bir sağ lık sorunu olarak görülmektedir. HE önlemek için düzenli olarak surveyans çalışmaları yapılarak elde edilen sonuçlar düzenli bir şekilde takip edilmeli, ayrıca gereksiz invaziv işlemlerden kaçınılmalıdır. Tüm hastaneler ve hastane içinde birimlerin; hastane enfeksiyonuna neden olan mikroorganizmaları ve bunların direnç oranlarını surveyans çalışmaları ile belirlemeleri, tedavi karar larını buna göre vermeleri gerekir.
- ÖgeFizik Tedavi ve Rehabilitasyon Uygulamalarında Kullanılabilecek Anlık Denge Kontrolü ve Biyolojik Geri Bildirimi Sağlayan Giyilebilir Sensör Tasarımı(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2020-03-03)ÖZET Denge ve performansın iyileştirilmesi için motor bilgilerinin arttırılması yoluyla statik ve dinamik görevlerde motor kontrolünü destekleyen biyolojik geri besleme, rehabilitasyon sırasında hastalara, fizik tedavi ve rehabi litasyon uzman doktorları ile fizyoterapistlere yardımcı olmak için kullanılmaktadır. Postürel kontrol ve denge eksikliği, günlük yaşam aktiviteleri sırasında hastaların mobilizasyonu ve bağımsız performansları üzerinde en büyük etkiye sahiptir. Bir bireyin “statik” dengesi, sabit dururken veya bir seferde tek bir görevi yerine getirirken kabul edilebilir olsa da; “dinamik” denge sorunları, mobilizasyon sırasında veya bir seferde birden fazla görev yaparken ortaya çıkabilir. Bu nedenle, hastanın gerçek zamanlı dinamik dengesinin farkında olmak hem hasta hem de uzman doktor ile fizyoterapist için önemlidir. Bu araştırmada, ortopedik ve nöromusküler hastalıkların fizik tedavi ve rehabilitasyonu sırasında kullanılmak üzere tasarlanan dokunsal ve görsel biyolojik geri bildirim mekanizması geliştirilmiştir.
- ÖgeThe Level of Knowledge of Healthcare Workers, Excluding Physicians, Regarding HIV, and Their Approach to People Living with HIV(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2020-03-03)ABSTRACT Since its discovery, the Human Immunodeficiency Virus (HIV) continues to be a major health concern globally. Unofficial records show that over 14000 cases of HIV have been reported in Turkey, and this number is on the rise. People living with HIV (PLHIV) have become subjected to stigmatisation and discrimination all around the globe, including Turkey. This approach had a negative impact on PLHIV, especially in the healthcare industry. Previous studies, in Turkey and globally, have shown that healthcare workers lacked sufficient knowledge about HIV and PLHIV. Consequently, their approach to PLHIV was at times inappropriate and unequal. This study aimed to look at the level of knowledge of healthcare workers, excluding physicians, and their approach to PLHIV. A survey based on a questionnaire was conducted in 3 private hospitals in Istanbul, Turkey. A total of 161 participants-of which 67 were nurses, 54 were receptionists, 16 were laboratory technicians, 13 were physiotherapists, and 11 were caregivers-took part in this study. The questionnaire consisted of 14 total questions, divided into three sections; ‘Modes of HIV transmission’, ‘Protection from HIV transmission’ , and ‘HIV in the workplace’ . On average, 41% of healthcare workers lacked sufficient knowledge regarding modes of HIV transmission, and 48% lacked sufficient knowledge regarding protection from transmission of HIV. Furthermore, 48% had a different approach to PLHIV compared to other patients. Healthcare workers lack sufficient knowledge regarding HIV, and this reflects on their approach towards PLHIV. As a result of this stigmatisation, PLHIV are subjected to discriminative attitudes from the moment they set foot in a hospital environment. Therefore, educating healthcare workers about HIV is crucial to ensure that their approach to PLHIV is equal to that of other patients.
- ÖgeMartius Flap for Rectovaginal Fistula Repair: Operative Technique and Postoperative Outcomes(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2020-03-03)ABSTRACT Purpose: The most common reason for rectovaginal fistula (RVF) is obstetric trauma and the other most common cause is Crohn’s disease (CD). Various surgical options, including sphincteroplasty, gracilis flaps, Martius flaps, fecal diversion and advancement flaps are discussed. The aim of this study is to present the techniques of Martius flap and present patients’ long-term surgical outcomes, quality of life and sexual activity. Methods: A total of six patients with RVF who underwent Martius flap procedure were included in this study. Patient demographics, perioperative outcomes, short and long-term results including quality of life (QOL), sexual function and complications were evaluated. Results: Between April 2014 and August 2014 six female patients with RVF underwent Martius flap procedure. Mean age and body mass index were 47±14.17 (range, 33-68) and 25 (range, 20-36), respectively. The indications for operation were Crohn’s disease (n=3), obstetrical trauma (n=1) and postsurgical complications including stapler misfire (n=1) and rectocele repair (n=1). The mean follow up was 32± 1.47 (range, 3-34) months. Cosmetic outcomes were good for all patients. As the result of the Female Sexual Function Index (FSFI), 66% (n=4) of patients have an active sexual life. QOL is well for all patients. The CGQL score was 0.8. Five patients are followed without recurrence but a patient with CD has recurrence at 18 mo. of operation. Conclusion: Considering the aforementioned advantages, the Martius flap is a feasible technique for RVF repair when performed selectively by experienced hands