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    Investigation Of The Effect Of Chemotherapy On Cytomegalovirus Reactivity İn Patients With Solid Organ Tumors
    (Sağlık Araştırmaları ve Stratejileri Derneği, 2021) Sönmez, Emine; Demirel, Aslıhan; Pilancı, Kezban Nur; İnan, Neşe; İris, Nur Efe; Baygül, Arzu; Demir, Gökhan
    Objectives: Chemotherapy induces an immunosuppressive state in patients with solid organ tumors. Cytomegalovirus (CMV) reactivation as a result of immunosuppression causes a severe clinical manifestation. However, in this group, CMV infections developing due to reactivation were not adequately discussed in the literature. The aims of this study were to determine the incidence of CMV reactivation after chemotherapy, to evaluate the contribution of chemotherapy to reactivation, to determine the incidence of asymptomatic and symptomatic infections and to investigate the results of the treatment.Methods: A total of 93 patients with solid tumors were included in the study. Weekly blood samples were collected from the patients for three weeks before and after chemotherapy. Quantitative analysis of DNA was detected using CMV PCR kit (GeneProof CMV PCR kit, Bruno, Czech Republic). Diagnosis and treatment of patients were retrospectively reviewed.Results: Of the patients, 65.6% were female and 34.4% were male. The mean age was 55 ± 12 years. The most common cancer types among the patients were breast cancer in 45.2%, lung cancer in 15.1%, and colon cancer in 12.9%. The mean leukocyte count of the patients was 7,647/mm3. CMV DNA was not detected in any patient. According to this result, none of the patients had CMV reactivation after chemotherapy. Conclusions: In this study including patients with solid organ tumors with mild to moderate level of immunosuppression CMV DNA was not detected in any patient. Based on this finding no standard prophylaxis was required for CMV in this group of patients.
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    Kateterle İlişkili Kan Dolaşımı İnfeksiyonları: Çok Merkezli Beş Yıllık İnceleme
    (AVES, 2019) Demirel, Aslıhan; Iris, Nur Efe; Çevik, Esin; Koçulu, Safiye; Baygül, Arzu; Taşdelen Fışgın, Nuriye
    Amaç: Bu çok merkezli çalışmanın amacı, hematoloji ve onkoloji servislerinde ve yoğun bakım ünitelerinde yatan hastalarda gelişen kateterle ilişkili kan dolaşımı infeksiyonları (Kİ-KDİ’ler)’nın klinik ve mikrobiyolojik yönden değerlendirilmesidir. Yöntemler: Bu çalışmada, Ocak 2013-Aralık 2017 tarihleri arasında üç ayrı özel hastanenin hematoloji ve onkoloji servisleri ve yoğun bakım ünitelerinde yatan hastalarda gelişen Kİ-KDİ, Amerika Birleşik Devletleri Hastalık Kontrol ve Önleme Merkezleri kriterlerine göre laboratuvar ve kliniğe dayalı aktif sürveyansla retrospektif olarak saptandı. Hastaların demografik özellikleri, klinik özellikleri, kateterin takıldığı ünite ve ven çevresi kızarıklığı gibi kateterle ilişkili özellikler, kan kültürlerinde üreyen etkenler kaydedildi. Etkenler, konvansiyonel yöntemlerin yanı sıra MicroScan autoSCAN-4 (Beckman Coulter, Brea, CA, ABD) otomatize sistemleriyle tanımlandı. İstatistiksel analizler MedCalc Statistical Software Version 12.7.7 (MedCalc Software bvba, Ostend, Belçika) programıyla gerçekleştirildi. Bulgular: 46 (%45 kadın) hastada Kİ-KDİ saptandı. Hastaların yaş ortalaması 61±19 idi. 24 (%52.2) hastada kalıcı kateter (port), 22 (%47.8) hastada santral venöz kateter takılıydı. Hastaların 40 (%87)’ından kan kültürü alındı; 24 hastada >2 saat zaman farkı vardı. Dokuz (%20) hastada kateter giriş yerinde kızarıklık saptandı. Üç (%6.5) hasta infeksiyona bağlı olarak kaybedildi. Tedavi süresi 13±4 gün olarak belirlendi. Gram-negatif bakteriler %50, Gram-pozitif bakteriler %25.4, mantarlar %23.9 oranında saptandı. Kateter ve port takılmasından sonraki 10 gün içinde üreyen etkenler Gram-negatif bakteriler ve mantarlar olup, Gram-pozitif etkenlerin ürememesi istatistiksel olarak anlamlı bulundu.
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    Validity and Reliability of the Assessment Tool for Asthma (ATA) Questionnaire: the ATA Study
    (AVES, 2020) Baygül, Arzu; Gemicioğlu, Bilun; Mungan, Dilşad; ., ve diğer.
    OBJECTIVES: A multicenter trial was designed to validate the "Assessment Tools for Asthma (ATA)" questionnaire, a newly developed questionnaire, which evaluates both asthma control and risk factors associated with asthma control with a single instrument. MATERIALS AND METHODS: This cross-sectional study involved 810 cases from 14 clinics in 9 Turkish cities. The ATA questionnaire and Asthma Control Test (ACT) were administered. The Visual Analog Scale (VAS) was used to evaluate the control status of 100 randomized cases. ATA is an eight-item physician-administered questionnaire. It comprises the following two sections-ATA1, assesses symptomatic control criteria, and the remaining section, queries the flare-up of asthma, control of comorbidities, treatment adherence, and inhaler technique. RESULTS: The mean scores for ATA1, ATA total, VAS, and ACT were 24.7 +/- 14.8, 53.8 +/- 19, 7.1 +/- 3, and 18.8 +/- 5.5, respectively. According to the ATA questionnaire, among all patients, 34.3% had controlled, 18.8% had partly controlled, and 46.9% had uncontrolled asthma. Furthermore, 16.6% patients had flare-ups between visits, 96.4% patients had uncontrolled comorbidity, 17% patients had irregular asthma treatment, and only 8.4% patients used the incorrect inhaler technique. The ATA questionnaire showed internal consistency (Cronbach's alpha coefficient=0.683). ACT, ATA1, and two specialists' evaluations using VAS correlated strongly with the ATA total scores (Spearman correlation coefficient (r) values: 0.776, 0.783, and 0.909, respectively; p-values: p<0.001, p<0.001, and p<0.001, respectively). According to Receiver Operating Characteristic analysis, the cut-off value of ATA was 50 (sensitivity=84.4%, specificity=82.40%).