Browsing by Author "Tulek, Necla"

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Evaluation of Infectious Diseases in Pregnant Women
(Aves, 2020) Ozsoy, Metin; Tulek, Necla; Kinikli, Sami; Erdinc, Fatma Sebnem; Ataman-Hatipoglu, Cigdem; Tuncer-Ertem, Gunay; Cesur, Salih; Basic Sciences
Objective: In this study, we aimed to investigate the infections and their clinical outcomes in pregnant women who were hospitalized with a diagnosis of any infectious disease. Methods: Distribution of bacterial and viral infections in 60 pregnant women who were hospitalized due to any infectious disease between years 2015 and 2018 during a three-year period were evaluated retrospectively. Results: Urinary tract infections (65%) and gastroenteritis (8.3%) were the most common bacterial infections, and human immunodefficiency virus (HIV) infection and chickenpox were most common viral infections. All patients were followed at the inpatient clinic except two patients who had hospitalized in intensive care unit due to influenza and Listeria meningitis. An HIV-positive pregnant woman received zidovudin intrapartum and was followed up later. All the other infections recovered without complications. Conclusions: Urinary tract infection was the most common infectious disease among pregnant women. The necessity of hospitalization due to community-acquired but avoidable and vaccine-preventable diseases verified that informing pregnant women about the prevention of infections and screening them before pregnancy against vaccine-preventable diseases.
Citation - Scopus: 1
Impact of the COVID-19 Pandemic on Diabetic Foot Patients A Shift in the Infectious Agent Profile Toward Nonfermentative
(Amer Podiatric Med Assoc, 2024) Acar, Ali; Saltoglu, Nese; Tulek, Necla; Turha, Ozge; Nazliserin, Elif; Yapar, Derya; Kaya, Sibel Dogan; Basic Sciences
Background: Diabetes foot infection is a very important public health problem that causes serious health problems, mortality, and high health expenditures, and is one of the most important complications of diabetes mellitus. There are concerns that approaches such as limited personal visits to doctors, avoidance of hospitals, and restrictions on nonemergency surgical procedures during the coronavirus disease of 2019 pandemic pose a threat to those with diabetic foot problems, including diabetic foot ulcers (DFUs), ischemia, and infection, resulting in increased limb loss and mortality. Methods: This multicenter, retrospective, cross-sectional study was conducted in 14 tertiary care hospitals from various regions of Turkey. A total of 1,394 patient records were evaluated, 794 of which were between January 1, 2019, and January 30, 2020 (prepandemic [Pre-P]), and 605 of which were between February 1, 2020, and February 28, 2021 (pandemic period [PP]). Results: During the PP, diabetic foot patient follow-up decreased by 23.8%. In addition, the number of hospitalizations attributable to DFU has decreased significantly during the PP (P = .035). There was no difference between the groups regarding patient demographics, medical history, DFU severity, biochemical and radiologic findings, or comorbidities, but the mean duration of diabetes mellitus years was longer in patients in the Pre-P than in those in the PP (15.1 years versus 13.7 years). There was no difference between the two groups in terms of major complications such as limb loss and mortality, but infection recurrence was higher in the PP than in the Pre-P (12.9% versus 11.4%; P < .05). The prevalence of nonfermentative gram-negative bacteria as causative agents in DFU infections increased during the PP. In particular, the prevalence of carbapenem-resistant Pseudomonas spp. increased statistically during the PP. Conclusions: The rapid adaptation to the pandemic with the measures and changes developed by the multidisciplinary diabetic foot care committees may be the reasons why there was no increase in complications because of DFU during the pandemic in Turkey.
Citation - WoS: 9
Citation - Scopus: 9
Impact of Vaccination on the Presence and Severity of Symptoms in Hospitalized Patients With an Infection of the Omicron Variant (b.1.1.529) of the Sars-Cov (subvariant Ba.1)
(Elsevier Sci Ltd, 2023) Beraud, Guillaume; Bouetard, Laura; Civljak, Rok; Michon, Jocelyn; Tulek, Necla; Lejeune, Sophie; Epaulard, Olivier; Basic Sciences
Objectives: The emergence of SARS-CoV-2 variants raised questions about the extent to which vaccines designed in 2020 have remained effective. We aimed to assess whether vaccine status was associated with the severity of Omicron SARS-CoV-2 infection in hospitalized patients.Methods: We conducted an international, multi-centric, retrospective study in 14 centres (Bulgaria, Croatia, France, and Turkey). We collected data on patients hospitalized for >= 24 hours between 1 December 2021 and 3 March 2022 with PCR-confirmed infection at a time of exclusive Omicron circu-lation and hospitalization related or not related to the infection. Patients who had received prophylaxis by monoclonal antibodies were excluded. Patients were considered fully vaccinated if they had received at least two injections of either mRNA and/or ChAdOx1-S or one injection of Ad26.CoV2-S vaccines. Results: Among 1215 patients (median age, 73.0 years; interquartile range, 57.0-84.0; 51.3% men), 746 (61.4%) were fully vaccinated. In multivariate analysis, being vaccinated was associated with lower 28 -day mortality (Odds Ratio [95% Confidence Interval] (OR [95CI]) = 0.50 [0.32-0.77]), intensive care unit admission (OR [95CI] = 0.40 [0.26-0.62]), and oxygen requirement (OR [95CI] = 0.34 [0.25-0.46]), independent of age and comorbidities. When co-analysing these patients with Omicron infection with 948 patients with Delta infection from a study we recently conducted, Omicron infection was associated with lower 28-day mortality (OR [95CI] = 0.53 [0.37-0.76]), intensive care unit admission (OR [95CI] = 0.19 [0.12-0.28]), and oxygen requirements (OR [95CI] = 0.50 [0.38-0.67]), independent of age, comorbidities, and vaccination status.Discussion: Originally designed vaccines have remained effective on the severity of Omicron SARS-CoV-2 infection. Omicron is associated with a lower risk of severe forms, independent of vaccination and pa-tient characteristics. Guillaume Beraud, Clin Microbiol Infect 2023;29:642 (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
Citation - WoS: 2
Citation - Scopus: 1
Management of Chronic Hepatitis B in Special Patient Groups: a Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases-2023
(Doc design informatics Co Ltd, 2023) Tekin, Sueda; Karakecili, Faruk; Binay, Umut Devrim; Celik, Ilhami; Tulek, Necla; Tutuncue, Ediz; Demirturk, Nese; Basic Sciences
Turkish Society of Clinical Microbiology and Infectious Diseases Viral Hepatitis Working Group updated the consensus report on the management of chronic hepatitis B (CHB) in private hosts and special situations. Relevant literature and international guidelines are reviewed, and agreed recommendations are presented at the end of each chapter. In the report, treatment of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection, management of HBV and hepatitis C virus (HCV) coinfection, management of CHB in severe COVID-19 patients, non-transplant immunocompromised patients.
Medical Education During the Covid-19 Pandemic: Experience From a Newly Established Medical School
(Springer india, 2020) Tulek, Necla; Gonullu, Ugur; Basic Sciences
[No Abstract Available]
Photo Quiz; Anthrax or Orf?
(Doc design informatics Co Ltd, 2019) Tulek, Necla; Kilic, Esra Kaya; Ertem, GunayTuncer; Yuksekkaya, Esra; Basic Sciences
[No Abstract Available]
Citation - WoS: 1
Retrospective Evaluation of Potential Rabies Exposure Cases Over Nine Years: Single-Center Experience
(Bilimsel Tip Yayinevi, 2024) Demircan, Serife Altun; Kilic, Esra Kaya; Tulek, Necla; Kinikli, Sami; Bulut, Cemal; Basic Sciences
Introduction: T & uuml;rkiye is the only European country where suspected rabies exposure from animal contact is a significant public health concern. In this study, we evaluate cases investigated in our vaccination center, where individuals with suspected rabies exposure have been seeking consultation for many years. The evaluation encompasses demographic characteristics, distribution by years and seasons, the type of animal involved in the contact, the prevalence of stray animals, and the rabies vaccination status of owned animals. Materials and Methods: The study involves cases reported to the Public Health Center from those who sought consultation at our center between January 1, 2011, and December 31, 2019. Demographic characteristics, distribution by years and seasons, the type of animal involved in the contact, the prevalence of stray animals, and the rabies vaccination status of owned animals were retrospectively evaluated. Results: Over the nine years, there were a total of 39.731 cases, resulting in an average of 4414 cases per year. Of these cases, 61% were male, and 68.83% were between the ages of 15 and 64. The most cases occurred in summer and autumn. Of the suspected rabies contacts, 69% involved dogs, and 83.4% of these dogs were unowned. Forty-one point eight percent of the owned dogs were vaccinated. Eighty-nine point six percent of the cats were unowned, and the rate of vaccination among the owned cats was 28.2%. Over the years, there has been a decrease in the use of the 10 -day observation approach, while an increase in the administration of rabies vaccine and/or immunoglobulin has been observed. Conclusion: Seventy percent of all risky rabies contacts involve dogs, with a high rate of 84% of these dogs being unowned. To mitigate contact involving the risk of rabies, addressing the uncontrolled reproduction of stray animals, particularly dogs, and ensuring control and vaccination of the existing animal population appear to be primary measures. Improving the vaccination rate of owned animals, currently at only 30-40%, can prevent people from encountering risky rabies contacts, thereby potentially reducing the need for rabies prophylaxis significantly.
Risk Factors for Rectal Colonization with Carbapenemase Producing Enterobacteriaceae
(Bilimsel Tip Yayinevi, 2021) Hekimoglu, Sirin; Ertem, Gunay; Yucel, Mihriban; Basar, Hulya; Kaya Kilic, Esra; Ozcan, Ayse; Tulek, Necla; Basic Sciences
Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) is the most common pathogens acquired in intensive care units (ICU). Materials and Methods: This study was designed as prospective observational study at the Ankara Healthcare Application and Research Center of the University of Health Sciences. The study was conducted between September 2017 and May 2018 in the tertiary Anesthesiology and Reanimation ICU. Rectal swab samples were taken from each hospitalized patient during hospitalization and weekly thereafter. Sixty-five patients with CRE colonization were considered as the study group and 65 patients without CRE colonization were considered as the control group. Results: The 51% of the cases are male and 49% are females. The mean age of all cases was 69.1 +/- 17.6 and the median age was 73. The majority of bacteria grown in rectal swabs are constituted by Klebsiella pneumoniae (43-58.1%) and Escherichia colt (16-21.6%). Duration of hospitalization in the ICU was 19.6 +/- 15.8 in the control group and 48.5 +/- 38.2 in the study group. Duration of hospitalization in CRE-infected patients were longer than non-infected patients (p<0.001). The use of a central venous catheter and tracheostomy showed statistically significant difference between the groups (p< 0.05). Nineteen cases (29.2%) had CRE positivity at their admission to the ICU. Eighteen of these patients came from another clinical service or hospital (p< 0.005). In the control group, carbapenem was used in a mean of 11.9 +/- 9.9 days and in the study group a mean of 16.3 +/- 8.5 days (p= 0.002). In multivariate analysis of risk factors, duration of hospitalization in the ICU increases the risk of CRE positivity in rectal culture 1.04 (95%GA, 1,005-1,072, p= 0.024) times more. Conclusion: In our study, it can be said that it is important to question the indications of invasive procedures to be applied to the patients. We recommend that patients should be admitted to service follow-up when the ICU follow-up and treatment indications are terminated. Carbapenem treatment times should be shortened. As a result, it would be wise to take rectal surveillance cultures in ICUs to detect and control carbapenem-resistant strains.