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Öğe Can Pneumothorax Developing in COVID-19 Patients be a Mortality Marker?(2022) OTERKUS, MESUT; Delen, Leman Acun; Kasapoglu, Umut SabriObjectives: The purpose of this study is to investigate the effects of pneumothorax (PX), a rare complication of COVID-19, on mortality. Methods: All patients admitted to our hospital with the diagnosis of COVID-19 were screened, and patients who developed PX were includ- ed in the study. Patient demographics data, number of days of hospital- ization for comorbidities, day and duration of thorax tube insertion, and laboratory findings during hospitalization were recorded by scanning the hospital automation system and patient records. Results: For our study, 7485 patients hospitalized with the diagno- sis of COVID-19 were screened in intensive care unit. PX was de - tected in 32 (0.296%) of the patients. About 59.4% of these patients included in the study were male. DM was the most common co - morbid condition at 56.3%. In these patients, the mortality rate was found to be 90.6%. Conclusion: The data obtained indicate that PX, a COVID-19 complica- tion, leads to a serious increase in mortality. We believe that using pro- tective ventilation methods to avoid the development of pneumotarax will help to reduce mortality.Öğe Covid 19 Hastalarında Kalış Süresini ve Mortaliteyi Etkileyen Risk Faktörleri: Laboratuvar Parametreleri, Komorbiditeler ve Demografik Özellikler(Duzce University, 2021) Delen, Leman Acun; Erdoğan, Esra; Yaşar, ŞeymaAmaç: Covid 19, ölümcül pnömoniye ve ciddi komplikasyonlara neden olabilen güncel pandemik hastalıktır. Hastalığın farklı evrelerinde farklı biyokimyasal parametrelerin düzeyinde artış görülmekte ve bu parametreler hastalığın seyri konusunda önemli bilgiler vermektedir. Bu çalışmada, Covid 19 hastalarındaki yatış süresi ve mortalite oranı ile biyokimyasal parametreler arasındaki ilişkinin araştırılması amaçlanmıştır. Materyal ve Metot: Bu retrospektif çalışmaya, hastanemizde yatan toplam767 Covid 19 hastası dahil edildi. Hastanenin veri tabanı ve hasta dosyaları incelenerek hastaların demografik özellikleri, yatış süreleri, ek hastalıları ve biyokimyasal parametreler taranarak kaydedildi. Hastalar yatış gününe göre, 1. Grup: 7 gün ve altı, 2. Grup: 8-10 gün arası 3. Grup: 11-13 gün arası, 4. Grup: 14 gün ve üzeri olmak üzere toplam 4 gruba ayrıldı. Hastaların demografik özellikleri, laboratuvar bulguları, ek hastalıkları ve mortalite oranları bu gruplara göre düzenlenerek istatiksel analiz yapıldı. Bulgular: Hastaların 459 (60%)’u erkek 308 (40%)’i kadındı. Grup 4 hastalarındaki CRP düzeyi, grup 1’deki hastalara göre istatiksel anlamlı olarak yüksekti (p=0.002). Grup 4 hastalarındaki LDH, PRO_BNP ve prokalsitonin düzeyi hem grup 1 hemde grup 2’ye göre istatiksel anlamlı olarak yüksekti (sırasıyla p<0.001, p=0.026, p=0.007). Fibrinojen düzeyi, grup 4 deki hastalarda grup 2’deki hastalara göre anlamlı olarak yüksekti (p=0.011). DM, HT, LDH ve ferritin düzeyi yüksekliği ölüm riskinin anlamlı olarak artırmıştı (sırasıyla p=0.022, p=0,006 p<0.001, p=0,041). Benzer olarak yaş ve yatış gününün uzaması ölüm riskini anlamlı olarak artırmıştı (p<0.001). Sonuç: Çalışmamızın sonuçları, Covid 19 hastalarının yatış süresinin uzamasıyla CRP, LDH, PCT, PROBNP ve fibrinojen düzeyinin doğru orantılı olarak arttığını ve hastalığın şiddetliye ilişkili olabileceğini göstermektedir. Yine bu sonuçlar, LDH ve ferritin düzeyinin, yaş, yatış gününün uzaması, HT, DM gibi ek hastalıkların varlığının mortalite oranını artırdığını ve prognoz açısından daha spesifik parametreler olduğunu göstermektedir.Öğe EFFECTS OF HYDROXYCHLOROQUINE PLUS FAVIPIRAVIR TREATMENT ON THE CLINICAL COURSE AND BIOMARKERS IN HOSPITALIZED COVID-19 PATIENTS WITH PNEUMONIA(Sestre Milosrdnice Univ Hospital, 2022) Delen, Leman Acun; Gok, Abdullah; Kasapoglu, Umut Sabri; Cagasar, Ozlem; Gok, Zarife; Berber, Nurcan; Derya, SerdarBackground: The novel coronavirus disease 2019 (COVID-19) has a broad spectrum of clin-ical manifestations, the most common serious clinical manifestation of the coronavirus infection being pneumo-nia. Unfortunately, the optimal treatment approach is still uncertain. However, many studies have been conducted on the effectiveness of several medications in the treatment of COVID-19 infection. The aim of this study was to evaluate the effectiveness of the hydroxychloroquine (HCQ) + favipiravir (FAV) treatment regimen and HCQ alone by comparing the patient's clinical response and laboratory results on the fifth day of treatment in patients hospitalized due to COVID-19 infection.Patients and methods: This retrospective cohort study was conducted in Malatya Training and Research Hospital between March 2020 and July 2020. The study included 69 patients with confirmed COVID-19 with pneumonia. The patients were divided into 2 groups, those receiving HCQ alone and those receiving the HCQ + FAV combination.Results: A total of 69 patients were included in the study, and the mean age was 60.09 +/- 15.56 years. A statisti-cally significant decrease was observed in C-reactive protein (CRP) levels, at the end of the fifth day, in patients who received HCQ + FAV treatment (p=0.002), whereas there was no decrease in CRP levels in patients who received HCQ treatment alone. In addition, an increase in lymphocyte count and a better fever response was observed at the end of the fifth day in patients who received HCQ + FAV (p=0.008). However, there was no statistical difference between both treatment regimens in terms of hospital stay and treatment results (p=0.008, p=0.744, p=0.517).Conclusion: Although the combination of HCQ + FAV treatment was observed to be effective on CRP levels and fever response in patients with COVID-19 pneumonia, there was no difference in terms of hospital stay and discharge.Öğe Evaluation of Changes in Optic Nerve Diameter in Obese Patients Undergoing Laparoscopic Surgery(Duzce Univ, Fac Medicine, 2026) Delen, Leman Acun; Oterkus, Mesut; Kasapoglu, Umut Sabri; Mizrak, Zeynep Koylu; Ondes, Bahadir; Kanat, Burhan HakanAim: During laparoscopic surgery (LC), intracranial pressure increases due to factors such as pneumoperitoneum (PP) and Trendelenburg position (TP). Measurement of the optic nerve sheath diameter is an important indicator of intracranial pressure. In this study, we compared the optic nerve diameter measurement (ONSD) during laparoscopic surgery in obese and normal weight individuals. Material and Methos: The search included 99 ills who underwent laparoscopic surgery at Malatya Training and Research Hospital. Optic nerve sheath age measurements were performed preoperatively, post-intubation, post-pneumoperitoneum, and post-extubation in obese (n: 50) and control group (n: 49) patients who underwent laparoscopic surgery. Additionally, operation information and demographic data were recorded. Result: We included 99 patients in the study. The data analysis we obtained in this study showed that although ONSD values were similar between the groups at T0 and T1 (p>0.05), they were wider in obese individuals at T2 and T3 (respectively p <0.001, p=0.044). In the within-group analysis; although there was an increase compared to T0 in the obese group at T1 and T2, there was a decrease compared to T2 at T3 (p<0.001). In normal-weight patients, the within-group measured T-times were similar to those in the obese group. In the statistical analysis performed using the SPSS 23.0 statistical package, Skewness and Kurtosis test, t-test, Mann-Whitney U test and ANOVA were used. Conclusion: Results of the analysis of research data; PP and TP in LC Cause increased intracranial pressure. In order to prevent possible complications, it is important to provide lower PP pressure, keep the operation time as short as possible, and keep EtCO2 within normal limits by making mechanical ventilator adjustments.Öğe Evaluation of hypoxia pathway genes and serum parameters in new coronavirus pneumonia (COVID-19)(Elsevier, 2025) Oterkus, Mesut; Pala, Mukaddes; Yilmaz, Senay Gorucu; Tanriverdi, Elif Seren; Gunduz, Ayten; Delen, Leman Acun; Doger, CihanBackground: Coronavirus disease-2019 (COVID-19) causes severe hypoxemia. Unlike normal pneumonia, pneumonia due to COVID-19 causes oxygen deprivation without breathing difficulties (i.e., silent hypoxia). We evaluated the relationship between COVID-19 and hypoxemia and examined possible mechanisms of pneumonia from the perspective of gene expression (HIF1A, vascular endothelial growth factor [VEGF], NF-kB, MEKK1, and EGFR) using real-time PCR and ELISA for serum parameters. Methods: We evaluated 100 individuals (50 patients and 50 controls). The patients were individuals with respiratory symptoms and pneumonia who were (COVID)-D-center dot-19 positive. The relative quantification of standardized samples wa s calculated according to the formula 2-Delta Delta CT. Receiver operating curve (ROC) analysis was made to define the diagnostic power of the genes. The expression changes of four genes in the hypoxia pathway were significant (excluding VEGF) and upregulated in the patients' serums. Results: The fold change values of the HIF1A, VEGF, NF-kB, MEKK1, and EGFR genes were 0.048, 0.688, 0.168, 0.207, and 0.171, respectively, in the cases checked against to the controls. The areas under the ROC values indicating the diagnostic power of the genes were 0.727, 0.538, 0.815, 0.734, and 0.936, respectively. Some serum parameters were significant (age, PCR, urea, LDH, WBC, ferritin, and pO2). Conclusions: The upregulation of some genes in the hypoxia pathway in COVID-19 pneumonia shows that these genes and protein products are candidates for treatment targets. At the same time, the high discriminative power of two genes (NF-kappa B and EGFR) in patients compared to controls indicates their diagnostic potential in serum samples.Öğe Evaluation of neurological disorders that develop concurrently with COVID-19 pneumonia: a retrospective analysis(Associacao Arquivos de Neuro-Psiquiatria Dr. Oswaldo Lange / Associação Arquivos de Neuropsiquiatria Dr Oswaldo Lange, 2022) Taşçı, İrem; Balgetir, Ferhat; Müngen, Bülent; Demir, Caner Feyzi; Gönen, Murat; Delen, Leman Acun; Kurt, OsmanBackground: During the pandemic, many neurological symptoms have been evaluated as complications of COVID-19 pneumonia. Objective: To investigate the frequency and characteristics of neurological findings, and their effects on the prognosis of patients with COVID-19 pneumonia who consulted with the Neurology department. Methods: Data on 2329 patients who were hospitalized with the diagnosis of COVID-19 pneumonia in our hospital were scanned. The clinical, laboratory and radiological findings relating to treatment of 154 patients who required neurological consultation were retrospectively evaluated by reviewing the clinical notes. Results: The number of COVID-19 pneumonia patients who required neurological consultations while hospitalized in the ICU was 94 (61.0%). The most common symptom among these patients was hyperactive delirium. Mean age, ferritin levels and CRP values ??of those with delirium were higher, while the mean lymphocyte percentage were lower, than those of the patients without delirium. Epileptic seizures were observed in eight patients without an epilepsy diagnosis. Two patients were diagnosed with GBS and one patient with ICU neuropathy. The D-dimer levels of patients with acute hemorrhagic CVD and the thrombocyte levels of patients with acute ischemic CVD were found to be higher than in patients without acute ischemic CVD. Conclusion: The proportion of patients who required neurological consultations was higher in the ICUs. We observed neurological symptoms more frequently in the advanced age group. There were no significant increases in the incidence of other neurological conditions except delirium, in COVID-19 patients. We think that further studies are needed to support our data.Öğe Investigation with Structural Equation Model of the Relationship between Covid-19 Phobia and Secondary Traumatic Stress Level in 112 Emergency Service Personnel(İstanbul Teknik Üniversitesi, 2021) Derya, Serdar; Tetik, Bora; Delen, Leman Acun[Abstract Not Available]Öğe mTOR signaling pathway genes effect in COVID-19 infection(Inonu University, 2024) Pala, Mukaddes; Yılmaz, Şenay Görücü; Tanriverdi, Elif Seren; Gunduz, Ayten; Delen, Leman Acun; Ozturk, Dilara Altay; Öterkuş, MesutCoronavirus disease 2019 (Covid-19) is an infectious disease that causes severe acute respiratory illness caused by coronavirus 2 (SARS-CoV-2). SARS-CoV-2 uses host-specific metabolic pathways, including mTOR. The mTOR pathway is hyperactive in viral respiratory tract infections and contributes positively to viral replication. 100 samples were evaluated, 50 patients (Female=23, Male=27), and 50 controls (Female=29, Male=21). The patients were individuals who were COVID-19 positive. We detected expression changes of 5 genes in mTOR complex 1 (mTORC1) and mTOR complex 2 (mTORC2) (MLST8, mTOR, RPTOR, MAPKAP1 and RICTOR). Serum samples were obtained from all patients. The expression changes of mTORC1 and mTORC2 Complex genes were evaluated with Real-time PCR method. Receiver operating curve (ROC) analysis was performed to define the diagnostic power of these genes. Expression changes of five genes in the mTORC1 and mTORC2 complex were statistically significant (p =0.001) and upregulated in serum. The area under the ROC Curve values indicating the diagnostic power of genes were 0.948, 0.771, 0.851, 0.798, and 0.805, respectively. These genes may be candidate for treatment targets. The high discriminative power of these genes in patients from controls indicates their diagnostic potential in serum samples.Öğe The effect of the selected anaesthesia method on mortality, the charlson comorbidity index, and complications in geriatric patients abstract(2026) Oterkus, Mesut; Delen, Leman Acun; Aytan, Nilgün NarmanOur study aimed to investigate how anaesthesia methods affect the chances of dying, needing intensive care after surgery, having complications, and scores on a health scale called the Charlson Comorbidity Index in the growing number of older people. In our study were 299 patients. We recorded their demographic data, American Society of Anaesthesiology score, need for transfusions, operation time, Charlson Comorbidity Index scores, need for intensive care after surgery, postoperative complications, such as respiratory problems, low blood pressure, nausea and vomiting, the number of days they stayed in the hospital and death rates. In our study, 195 patients (65.2%) were women. The average age was 73.9±7 years. No difference was found between the groups in terms of demographic data or Charlson Comorbidity Index scores. The patients who received spinal anaesthesia had shorter operation times and more hypotension. Overall, the factors affecting mortality were the American Society of Anaesthesiology score, cerebrovascular disease, cancer, embolisms, the need for postoperative intensive care, age, Charlson Comorbidity Index score, length of hospital stay, neutrophil, lymphocyte and albumin levels and operation duration. The data we obtained showed that mortality rates for patients receiving spinal or general anaesthesia were similar. However, the patients who received spinal anaesthesia needed less intensive care after surgery, had fewer complications, and had shorter hospital stays. Good care before and during surgery, careful monitoring after surgery, and proper pain relief can lower death rates and complications and reduce time in the hospital.Öğe Ventilatör ilişkili pnömoni hastalarında prognostik biyobelirteç olarak serum laktat/albümin oranının etkinliği(MediHealth Academy Yayıncılık, 2025) Berber, Nurcan Kırıcı; Dişli, Zeliha Korkmaz; Delen, Leman Acun; Gür, Lale Şahin; Yetişgen, Azize; Berber, İlhamiAmaçlar: Bu çalışmada, yoğun bakım ünitesinde (YBÜ) yatan ventilatör ilişkili pnömoni (VAP) hastalarında serum laktat/albümin oranının (LAR) prognostik bir belirteç olarak etkinliğinin değerlendirilmesi amaçlanmıştır. Yöntemler: Bu tek merkezli retrospektif gözlemsel klinik çalışma 1 Ocak 2022 ile 1 Ekim 2024 tarihleri arasında yürütülmüştür. Çalışma grubu, Türkiye Malatya Eğitim ve Araştırma Hastanesi YBÜ'lerine entübasyonla yatırılan ancak yatış sırasında pnömoni tanısı olmayan 58 hastadan oluşmuştur. Bu hastalara entübasyondan 48 saat sonra VAP tanısı konmuştur. Serum LAR, YBÜ'ye yatıştan sonraki ilk 24 saat içinde hesaplanmış ve mortalite ve morbidite ile ilişkilendirilmiştir. Sonuçlar: Hastaların ortalama yaşı 68 olup çoğunluğu 65 yaşın üzerindedir. Çalışmaya dahil edilen 58 hastanın 43'ü (%74,1) sonunda hastalıklarına yenik düştü. Çalışmada ölenlerin LAR'ı hayatta kalanların LAR'ından önemli ölçüde daha yüksekti. LAR, 1,13'lük bir kesme değeri uygulandığında %83,7 duyarlılık ve %60 özgüllük sergileyen güvenilir bir öngörücü olarak tanımlandı. LAR'ı ≤1,13 olan hastaların sağkalım süresi, oranı >1,13 olan hastalardan önemli ölçüde daha uzundu. Sonuç: Çalışmamızda, LAR'ın VAP'li hastalardaki mortalite öngörü performansı, serum laktat düzeyi veya serum albümin düzeyinin tek başına performansından daha üstündü. Bu nedenle, LAR, VAP hastalarının erken risk sınıflandırması için yararlı ve kolayca bulunabilen bir prognostik faktör olabilir.Öğe YOĞUN BAKIM ÜNİTELERİNDEN İZOLE EDİLEN PSEUDOMONAS AERUGİNOSA SUŞLARININ ANTİBİYOTİKLERE DUYARLILIKLARI(İnönü Üniversitesi, 2021) Erdoğan, Mehmet Mustafa; Delen, Leman Acun; Erdoğan, EsraPseudomonas aeruginosa suşları özellikle yoğun bakım ünitelerinde yatan hasta örneklerinden sıklıkla izole edilmektedir. Bu suşlar morbidite ve mortaliteyi artırıp, antibiyotik direnci nedeniyle zor tedavi edilen enfeksiyonlara yol açmaktadır. Bu çalışmanın amacı, Malatya Eğitim ve Araştırma Hastanesi’nin yoğun bakım hastalarından izole edilen P. aeruginosa izolatlarının çeşitli antibiyotiklere direncinin belirlenmesidir. Çalışmaya Temmuz 2016–Temmuz 2019 tarihleri arasında Malatya Eğitim ve Araştırma Hastanesi’nin yoğun bakım ünitelerinde izlenmiş olan hastaların çeşitli klinik örneklerinden izole edilen P. aeruginosa suşları dâhil edilmiştir. Suşların identifikasyonu ve in-vitro antibiyotik duyarlılıkları Vitek 2 otomatize sistemi (bioMérieux, France) ile belirlenmiştir. Çalışmaya dâhil edilen 468 P. aeruginosa suşunun % 51,7'si solunum yolu örneklerinden izole edilirken bunu % 31,2 ile idrar ve %9 ile abse ve yara örnekleri izlemiştir. P. aeruginosa suşları için en etkili antibiyotikler kolistin ve norfloksasin olarak belirlenirken, çalışılan antibiyotikler arasında en düşük duyarlılık aztreonam için tespit edilmiştir. Duyarlılık oranları amikasine %76,5, aztreonama %8,1, gentamisine %74,4, imipeneme %62,2, kolistine %97,1, levofloksasine %57,5, meropeneme %61,4, netilmisine %57,4, norfloksasine %89,9, piperasilin/tazobaktama %48,7, piperasiline %35,7, sefepime %57,7, seftazidime %62,7, siprofloksasine %66, tobramisine ise %80,9 olarak saptanmıştır. Özellikle yoğun bakım ünitelerinde yatan kritik hastalarda, etkin ve doğru enfeksiyon kontrol stratejileri geliştirebilmek, morbidite ve mortaliteyi azaltabilmek için enfeksiyon etkenlerinin dağılımının ve duyarlılıklarının bilinmesi önemlidir.
