Tülek, Necla
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Tülek,N.
N.,Tulek
Tülek, Necla
Eren Tülek N.
T., Necla
Tulek,Necla
Necla, Tulek
Necla, Tülek
N., Tülek
Necla Tülek
Tulek,N.
Tulek, Necla
Tulek N.
T.,Necla
N., Tulek
Tülek N.
N.,Tülek
N.,Tulek
Tülek, Necla
Eren Tülek N.
T., Necla
Tulek,Necla
Necla, Tulek
Necla, Tülek
N., Tülek
Necla Tülek
Tulek,N.
Tulek, Necla
Tulek N.
T.,Necla
N., Tulek
Tülek N.
N.,Tülek
Job Title
Profesör Doktor
Email Address
necla.tulek@atilim.edu.tr
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Turkish CoHE Profile ID
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Scholarly Output
13
Articles
6
Citation Count
4
Supervised Theses
0
13 results
Scholarly Output Search Results
Now showing 1 - 10 of 13
Article Citation Count: 0Özel Hasta Gruplarında Kronik Hepatit B Yönetimi: Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Viral Hepatit Çalışma Grubu Uzlaşı Raporu-2023 Güncellemesi(DOC Design and Informatics Co. Ltd., 2023) Tülek, Necla; Tekin, Süda; Karakeçili, Faruk; Biinay, Umut Devrim; Çelik, İlhami; Tülek, Necla; Tütüncü, Ediz; Demirtürk, Neşe; Basic SciencesTürk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Viral Hepatit Çalışma Grubu, kronik hepatit B(KHB)’nin özel konaklarda ve özel durumlarda yönetimine ilişkin uzlaşı raporunu güncelledi. İlgili literatür ve uluslararası kıla- vuzlar gözden geçirildi ve üzerinde anlaşmaya varılan tavsiyeler her bölümün sonunda sunuldu. Raporda, hepatit B virusu (HBV) ve insan immün yetmezlik virusu (HIV) koinfeksiyonunun tedavisi, HBV ve hepatit C virusu (HCV) koinfeksiyonunun yönetimi, şiddetli COVID-19 hastalarında KHB’nin yönetimi, nakil yapılmayan bağışıklığı baskı- lanmış hastalarda KHB, kompanse ve dekompanse sirozu olan hastalarda KHB tedavisi başta olmak üzere tüm özel grup hepatit B hastalarının takibi irdelendi.Editorial Citation Count: 0Photo Quiz; Anthrax or Orf?(Doc design informatics Co Ltd, 2019) Tülek, Necla; Kilic, Esra Kaya; Ertem, GunayTuncer; Yuksekkaya, Esra; Basic Sciences[No Abstract Available]Review Citation Count: 0Hepatit B İnfeksiyonlarının İmmünopatogenezi(Bilimsel Tip Yayinevi, 2019) Tülek, Necla; Basic SciencesHepatit B infeksiyonları tüm dünyada majör sağlık problemleri arasında olup, siroz ve hepatoselüler karsinomanın en önemli nedenidir.Tedavide gelişmelere rağmen henüz kronik hepatit B infeksiyonunda kür sağlanamamaktadır. Hepatit B infeksiyonlarında klinik sonuçinfeksiyonun alınma yaşı, viral yük ve konağın immün yanıtına bağlıdır. Akut hepatitlerde klinik seyir subklinik hastalıktan, anikterikhepatite, ikterik hepatite ve fulminant hepatite kadar değişebilirken, kronik hepatitlerde hastalığın seyri asemptomatik inaktif durumdankronik hepatite, siroz ve hepatoselüler karsinomaya kadar değişebilir. Hepatit B virüsü hepatositlerde sitopatik olmayarak çoğalır veklinik sendromların çoğu immün yanıt ile ilişkilidir. İmmün sistem aktivasyonu virüsün eliminasyonunu sağladığı gibi karaciğer hasarınada neden olur. Hepatit B patogenezinde hücresel immün yanıt özellikle de CD8+ T hücreler santral olmasına rağmen immün sistemindiğer komponentleri de katkıda bulunur. Kronik hepatitli hastalarda hem doğal hem de adaptif immün yanıt zayıflamış ve T hücreyanıtı tükenmiş durumdadır. İmmünopatolojideki mekanizmaların daha iyi anlaşılması, yeni etkin tedavi stratejilerinin geliştirilmesindeyararlı olacaktır.Article Citation Count: 0Impact of the COVID-19 Pandemic on Diabetic Foot Patients A Shift in the Infectious Agent Profile Toward Nonfermentative(Amer Podiatric Med Assoc, 2024) Tülek, Necla; Acar, Ali; Saltoglu, Nese; Tulek, Necla; Acar, Ali; Turha, Ozge; Nazliserin, Elif; Yapar, Derya; Kaya, Sibel Dogan; Basic SciencesBackground: 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.Conference Object Citation Count: 0Evaluation of Infectious Diseases in Pregnant Women(Aves, 2020) Tülek, Necla; Tulek, Necla; Kinikli, Sami; Erdinc, Fatma Sebnem; Ataman-Hatipoglu, Cigdem; Tuncer-Ertem, Gunay; Cesur, Salih; Basic SciencesObjective: 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.Article Citation Count: 0Risk Factors for Rectal Colonization with Carbapenemase Producing Enterobacteriaceae(Bilimsel Tip Yayinevi, 2021) Tülek, Necla; Ertem, Gunay; Yucel, Mihriban; Basar, Hulya; Kaya Kilic, Esra; Ozcan, Ayse; Tulek, Necla; Basic SciencesIntroduction: 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.Article Citation Count: 4Impact 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; Tülek, Necla; Bouetard, Laura; Civljak, Rok; Michon, Jocelyn; Tulek, Necla; Lejeune, Sophie; Epaulard, Olivier; Basic SciencesObjectives: 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/).Review Citation Count: 0Akciğer Kanserinde İmmünoterapi ve Tedavide Multidisipliner Yaklaşım(Turkish Assoc Tuberculosis & Thorax, 2020) Tülek, Necla; Karadurmuş, Nuri; Kaya, Akın; Göksel, Tuncay; Yılmaz, Ülkü; Tülek, Necla; Basic SciencesAkciğer kanseri dünya genelinde kanserle ilişkili ölümlerin başlıca nedeniolmaya devam etmektedir. Son 20 yılda kanser biyolojisi ve patogenezi hakkındaki bilgiler artmış, immün kontrol noktası inhibitörleri (İKNİ) kullanımasunulmuş ve böylece solid kanserlerin tedavisinde önemli bir dönem başlamıştır. Bu derlemede; tedavide yenilikler, immünoterapi ve tedavide multidisipliner yaklaşım çerçevesinde akciğer kanseri ele alınmıştır. Küçük hücreli dışıakciğer kanseri (KHDAK) en sık görülen ve özellikleri nedeniyle İKNİ tedavisinden ideal olarak yararlanabilecek akciğer kanseri türü olması nedeniyleyazının odak noktasını oluşturmuştur. Bu derleme, akciğer kanseri tedavisindeimmünoterapi yaklaşımının göğüs hastalıkları başta olmak üzere tüm branşlarda multidisipliner farkındalığını artırmayı ve yönetimi hakkında bilgi sağlamayıamaçlayan ilk Türkçe derlemedir. Ayrıca bu derleme, KHDAK tedavisinde İKNİkullanımına ilişkin son klinik çalışmaların dikkat çekici sonuçlarını sunmasıaçısından önem teşkil etmektedir. İmmünoterapi kanser tedavisinde yeni bir dönem başlatmıştır ve İKNİ tedavisinin kendine özgü etki mekanizması yeni bazı advers olay grubunun ortaya çıkmasına nedenolmuştur, bunlar arasında pnömonitis özellikle önemlidir ve advers olaylar konusunda gerektiğinde hastaların ilgili uzmanlık dalları ilekonsülte edilmesi gerekmektedir. Akciğer kanserinde tedavi, hastanın özellikleri, histolojik özellikler, genetik durum göz önünde bulundurularak her bir hastaya özel planlanmalı ve akciğer kanserli bir hastanın tanısal değerlendirilmesi ve en uygun şekilde tedavisi içingöğüs hastalıkları, göğüs cerrahisi, tıbbi onkoloji, radyasyon onkolojisi, patoloji ve radyoloji uzmanlık dalları arasında işbirliği sağlanmalıdır. Bununla birlikte, aile hekimleri de akciğer kanserinin erken tanınmasında ve ayrıca hastalarını tütün bırakmayı teşvik ederekkanserin önlenmesinde önemli rol oynayabilirler. Ayrıca, toplumda farkındalık yaratmak ve erken tanı için akciğer kanseri yönündentarama çalışmaları yapmak hedeflenmelidirLetter Citation Count: 0Medical Education During the Covid-19 Pandemic: Experience From a Newly Established Medical School(Springer india, 2020) Tulek, Necla; Tülek, Necla; Gonullu, Ugur; Gönüllü, Uğur; Basic Sciences[No Abstract Available]Letter Citation Count: 0Medical Education During the Covid-19 Pandemic: Experience From a Newly Established Medical School(Springer, 2020) Tülek, Necla; Tulek,N.; Gönüllü, Uğur; Gonullu,U.; Basic Sciences[No abstract available]
