Bölüm "İstanbul Medipol Üniversitesi, Sağlık Bilimleri Enstitüsü, Epidemiyoloji Ana Bilim Dalı" seçeneğine göre listele
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Öğe Admission to intensive care unit, intubation and pneumonia development status in patients with COVID-19 diagnosis according to vaccination status: The İstanbul sample(Bilimsel Tıp Yayınevi, 2023) İkiışık, Hatice; Sezerol, Mehmet Akif; Taşcı, Yusuf; Şahin, Çağrı Emin; Maral, IşılIntroduction: The COVID-19 pandemic, which has been a global threat for more than two years, continues to impose a heavy burden on health services with its discovered and yet undiscovered various features, despite the measures to prevent, control, and avoid the spread of the disease. This study aimed to evaluate the clinical course, pneumonia development status, intubation status, and hospitalization based on the demographic characteristics and vaccination status of the COVID-19 cases who underwent SARS-CoV-2 variant analysis in İstanbul. Materials and Methods: The study included 12.709 cases over the age of 18 in İstanbul, for whom variant analysis was performed between 1 and 15 September 2021. Results: Of the cases, 4296 (33.8%) were fully vaccinated, 2082 (16.4%) were partially vaccinated, 1544 (12.1%) were unvaccinated (at least one dose of vaccination and less than 14 days past the last vaccination date), while 4787 (37.7%) did not get any vaccine for COVID-19. Of the 12.709 cases examined, 176 (2.4%) were admitted to the intensive care unit, 108 (1.5%) were intubated, 292 (3.9%) developed pneumonia, and 600 (4.7%) were followed up in the hospital. Delta variant was detected in 10.862 (85.5%) cases. In the logistic regression model created with variables that may affect intensive care unit admission, intubation, pneumonia development, and hospital follow-up, it was found that intensive care unit admission was 1.90 times higher for males than females, 1.09 times for all ages, and 1.85, 2.01, and 6.51 times higher for partially vaccinated, unvaccinated, and never vaccinated patients compared to fully vaccinated patients, respectively. Intubation was 1.66 times more common in males than in females, 1.09 times in all ages, and 1.99, 2.09, and 6.06 times higher in partially vaccinated, unvaccinated, and never vaccinated patients compared to fully vaccinated patients, respectively. The risk of pneumonia development was 1.07 times higher for all ages and 1.70, 2.15, and 4.80 times higher for partially vaccinated, unvaccinated, and never vaccinated compared to fully vaccinated, respectively. The risk of being followed in the hospital instead of the home was 1.37 times more common in men than in women, 1.09 times in all ages, and 2.14, 2.61, and 6.23 times higher in partially vaccinated, unvaccinated, and never vaccinated patients compared to fully vaccinated, respectively. Conclusion: Fully vaccinated individuals have the least risk for admission to the intensive care unit, intubation, pneumonia, and hos- pitalization; however, the risk is increased in those who are partially vaccinated, unvaccinated, and never vaccinated. In conclusion, individuals protected by vaccines have a milder disease course for different variants, even if they have COVID-19 infection.Öğe Breastfeeding self-efficacy, personal well-being and related factors in pregnant women living in a district of Istanbul(Multidisciplinary Digital Publishing Institute (MDPI), 2023) Değer, Mehmet Sait; Sezerol, Mehmet Akif; Altaş, Zeynep MevaIn this study, we examined breastfeeding self-efficacy levels, well-being and sociodemographic factors in pregnant women. The population of this descriptive study consisted of women with a pregnancy of 27 weeks or more in the Sultanbeyli district of Istanbul, Türkiye. A questionnaire was administered via telephone calls to pregnant women aged 18 years and older. The first part of the questionnaire included questions regarding breastfeeding history and sociodemographic information. The second part included the Prenatal Breastfeeding Self-Efficacy Scale, and the last part included the Personal Well-Being Scale. Higher scale scores indicate higher levels of self-efficacy and well-being. In total, 385 women participated in the study. The median age of the pregnant women was 28.0 years (18.0–43.0). The median gestational week was 33.0 (27.0–42.0). Among women who had received breastfeeding counseling, those with a higher level of knowledge about breastfeeding had higher breastfeeding self-efficacy (p < 0.05). Women with better economic status also had higher well-being scores (p < 0.05). There was a positive correlation between well-being and breastfeeding self-efficacy approaching the statistical significance level (p = 0.052). It is important to consider factors that may be associated with women’s well-being and self-efficacy.Öğe COVID-19 vaccine hesitancy and related factors among unvaccinated pregnant women during the pandemic period in Turkey(MDPI, 2023) Sezerol, Mehmet Akif; Davun, SelinThe COVID-19 virus appeared in Wuhan, China in 2019 and spread rapidly all over the world. Vaccination guidelines have recommended pregnant women to get vaccinated against COVID-19 to prevent disease. This study aimed to understand the willingness of pregnant women to vaccinate and the factors associated with their hesitation and resistance. This cross-sectional study was conducted between March and April 2022. The sample size was not calculated and tried to reach all pregnant women who did not have any COVID-19 vaccine. In the first part of the questionnaire, socio-demographic questions, and in the last part, the short form of the 12-item anti-vaccine scale, which was prepared as a 5-point Likert scale, were applied. The study was completed with 561 pregnant women. The mean score of the pregnant women who participated in this study from the vaccine hesitancy scale was found to be 33.40 ± 6.07. It was found that as the income of pregnant women decreased, the vaccine hesitancy scores decreased. Vaccine hesitancy scores of those who stated no one gave advice were significantly higher. The vaccination of pregnant women will bring significant success to the fight against the COVID-19 pandemic when implemented as part of the public health policies of countries.Öğe Evaluation of autism awareness and knowledge levels among Syrian migrants living in Türkiye(2024) Davun, Selin; Sezerol, Mehmet AkifThis study was conducted to evaluate the autism knowledge level and awareness of individuals over the age of 18 who applied to immigrant health centers in Istanbul, Gaziantep and Kilis, where the Syrian immigrant population is dense. This cross-sectional study was conducted between December 2022 and April 2023 in 896 immigrants. The sample of the research consists of immigrants residing in Turkiye and who applied to the immigrant health centers in Istanbul, Gaziantep and Kilis for any reason at the time of the research. A questionnaire consisting of three parts was applied to the immigrant people face-to-face. While 38.4% of the participants were female, 61.6% were male. The mean age of the participants is 34.63 +/- 10.74. It was determined that people's place of residence, whether they have children, marital status and income status have significant effects on autism knowledge levels (p < 0.001). Since the importance of early diagnosis in autism is known, it is of great importance for people to have knowledge and awareness on this issue. This study will investigate the awareness of the immigrant population, who are faced with traumatic events such as war and migration, and will shed light on future intervention studies.Öğe Factors associated with the prevalence of postpartum anxiety disorder and depression in Syrian Migrant women living in Turkey: A cross-sectional study(MDPI, 2023) Atak, Muhammed; Sezerol, Mehmet Akif; Değer, Mehmet Sait; Kurubal, HamzaThe global migration trend has brought attention to the mental health of immigrant populations, especially postpartum women. The prevalence of postpartum anxiety and depression among these populations remains a growing concern. This study aimed to explore the factors associated with postpartum anxiety and depression among immigrant women, with a special emphasis on Syrian migrants in Turkey. A cross-sectional design was employed, enrolling postpartum women who visited the Strengthened Migrant Health Center in Istanbul between July and December 2022. Data were collected using a three-part questionnaire comprising sociodemographic details and scores from the Edinburgh Postpartum Depression Scale (EPDS) and Beck Anxiety Scale (BAI). The average age of participants was 25.73 years. The mean EPDS and BAI scores were low at 1.27 and 3.85, respectively. Notably, 97.1% of women scored below the EPDS cut-off point of 13. EPDS scores showed a significant relationship between income levels and COVID-19 vaccination status, while BAI scores were significantly associated with educational levels. There was an inverse correlation between EPDS scores and the number of cohabitants in a household. The observed low rates of postpartum depression and anxiety could be attributed to the accessible health services and psychosocial support for immigrants in Turkey. It would be useful to conduct multicenter and comprehensive epidemiological studies on migrant puerperas.Öğe Family physicians overestimate diagnosis probabilities regardless of the test results(Frontiers Media SA, 2024) Ataç, Ömer; Küçükali, Hüseyin; Tokaç Farımaz, Ayşe Zülal; Palteki, Ayşe Seval; Çavdar, Sabanur; Aslan, Melek Nur; Atak, Muhammed; Sezerol, Mehmet Akif; Taşçı, Yusuf; Hayran, OsmanIntroduction: As useful tools for clinical decision-making, diagnostic tests require careful interpretation in order to prevent underdiagnosis, overdiagnosis or misdiagnosis. The aim of this study was to explore primary care practitioners’ understanding and interpretation of the probability of disease before and after test results for six common clinical scenarios. Methods: This cross-sectional study was conducted with 414 family physicians who were working at primary care in Istanbul via face-to-face interviews held between November 2021 and March 2022. The participants were asked to estimate the probability of diagnosis in six clinical scenarios provided to them. Clinical scenarios were about three cancer screening cases (breast, cervical and colorectal), and three infectious disease cases (pneumonia, urinary tract infection, and COVID-19). For each scenario participants estimated the probability of the diagnosis before application of a diagnostic test, after a positive test result, and after a negative test result. Their estimates were compared with the true answers derived from relevant guidelines. Results: For all scenarios, physicians’ estimates were significantly higher than the scientific evidence range. The minimum overestimation was positive test result for COVID-19 and maximum was pre-test case for cervical cancer. In the hypothetical control question for prevalence and test accuracy, physicians estimated disease probability as 95.0% for a positive test result and 5.0% for a negative test result while the correct answers were 2.0 and 0%, respectively (p < 0.001). Discussion: Comparing the scientific evidence, overestimation in all diagnostic scenarios, regardless of if the disease is an acute infection or a cancer, may indicate that the probabilistic approach is not conducted by the family physicians. To prevent inaccurate interpretation of the tests that may lead to incorrect or unnecessary treatments with adverse consequences, evidence-based decision-making capacity must be strengthened.Öğe Frequency of sars-cov-2 infection and covid-19 vaccine uptake and protection among Syrian refugees: covid-19 vaccine among Syrian refugees(2024) Altaş, Zeynep Meva; Sezerol, Mehmet AkifIt is aimed to examine the frequency of COVID-19 disease, the rates of COVID-19 vaccination and the vaccine effectiveness (VE) among Syrian refugees. It is a retrospective cohort study. Syrian refugees aged 18 years and above registered to a family health center in Sultanbeyli district in Istanbul were included. Vaccine effectiveness were calculated for both Pfizer BioN-Tech and CoronaVac (Sinovac) vaccines. The data of 2586 Syrian people was evaluated in the study. The median age of the participants was 34.0 years (min:18.0; max: 90.0). Of the participants 58.4% (n = 1510) were female, 41.6% (n = 1076) were male. In our study of the refugees 15.7% had history of COVID-19 infection. Refugees having full vaccination with Biontech and Sinovac have a significantly lower COVID-19 infection rate than those without vaccination (HR = 8.687; p < 0.001). Adjusted VE for Biontech, Sinovac, and both were 89.2% (95.0% CI:83.3–93.1), 81.2% (95.0% CI:48.72–93.1) and 88.5% (95.0% CI:82.7–92.3), respectively. The results of the study highlight the importance of vaccinations against COVID-19 pandemic, since both vaccines were highly protective in refugees.Öğe Gender and age trends in hiv incidence in Turkey between 1990 and 2021: joinpoint and age–period–cohort analyses(2024) Derin, OkanBackground and Objectives: Despite a global decrease in HIV incidence, recent trends in Türkiye indicate a concerning rise, particularly among younger populations and women. This study investigates the local and regional dynamics influencing these trends using advanced epidemiological methodologies. Material and Methods: Utilizing Age–period–cohort analysis and joinpoint regression, we analysed HIV incidence and prevalence data from the Global Burden of Disease study for Türkiye. These methods allowed for a detailed examination of changes over time, identifying specific age groups and periods with significant shifts in incidence rates. Results: Key findings include a 13.03% increase in annual percentage change among males aged 15–19 and an 11.37% increase among females in the same age group. Additionally, the incidence rates among females have shown a significant rise after 2008. Conclusions: The rising HIV incidence in Türkiye reflects complex socio-economic, cultural, and biological factors, with significant increases among young people and women. Addressing these challenges requires targeted interventions, comprehensive educational programs, and inclusive healthcare services to align with global efforts and commitments. The study underscores the importance of incorporating young people in decision-making processes to effectively combat HIV in Türkiye.Öğe Genital erüpsiyonla başvuran bir hasta: Türkiye’deki ikinci maymun çiçeği olgusu(Ankara Microbiology Society, 2023) Derin, Okan; Öztürk, Esin Nagihan; Demirbaş, Nazife Duygu; Sevgi, Dilek Yıldız; Dökmetaş, İlyasİnsan maymun çiçeği (MPX) hastalığı, vaccinia ve variola gibi “poxviridae” ailesine ait maymun çiçeği virüsünün neden olduğu, yeniden önem kazanan zoonotik bir hastalıktır. Avrupa Hastalık Önleme ve Kontrol Merkezi [European Center for Disease Prevention and Control (ECDC)] tarafından Avrupa’da olağandışı bulaşma yollarına sahip bir MPX salgını bildirilmiştir. Bu raporda, erkekten erkeğe cinsel ilişki ilk kez insandan insana yakın bir temas yolu olarak tanımlanmıştır. Türkiye Cumhuriyeti Sağlık Bakanlığı, Türkiye’de MPX virüsü polimeraz zincir reaksiyonu [polymerase chain reaction (PCR)] ile doğrulanmış ilk olgunun 30 Haziran 2022’de bir hastanede kabul edildiğini ve izole edildiğini sosyal medya paylaşımı ile bildirmiştir. Bu bildiriden dört gün sonra merkezimize başvuran yirmi dört yaşında Türk erkek hasta lokal cerrahi işlem sonrası peniste ve skrotumda ortaya çıkan bakteriyel yumuşak doku enfeksiyonu ile kliniğimize yatırılmıştır. Öyküsünde bir hafta önce ortaya çıkan siğil benzeri lezyonlar nedeni ile dış merkezde lokal radyofrekans ablasyon tedavisi yapıldığını belirtmiştir. Yatışından bir gün sonra yüzünde, burun ucunda, vücudunda, kollarında ve parmaklarında giderek belirginleşen farklı evrelerde cilt lezyonları (makül, papül, göbekli papül) ve birkaç erüpsiyon gözlenen hasta, risk faktörleri değerlendirilerek MPX hastalığı açısından izole edilmiş ve Sağlık Bakanlığı rehberine göre MPX virüsü aranmak üzere örnekleri referans laboratuvara gönderilmiştir. Alınan örneklerde PCR ile MPX nükleik asidi saptanmıştır. Hastanın sekonder bakteriyel enfeksiyon tedavisi ve 21 günlük izolasyon süresi tamamlanarak taburcu edilmiştir. Bu olgu raporunda daha önce Türkiye’den bildirilmemiş olan MPX hastalığı, cinsel yolla bulaşan enfeksiyonlar (CYBE) ayırıcı tanısının ve tarama testlerinin önemi ve MPX hastalığı olgusuna uygulanan lokal ablasyon tedavisi sonrası gelişen yumuşak doku enfeksiyonu sunulmuştur. Yeni ve yeniden önem kazanan enfeksiyon hastalıklarına hazırlıklı olmak için güncel epidemiyolojik verilere dayalı iyi kurgulanmış sürekli eğitimin gerekliliğine vurgu yapılmıştır. Son zamanlarda, cinsel temas, MPX hastalığının yeni bulaşma yolu olarak tanımlanmaktadır ve semptom ve bulgular, “molluscum contagiousum” veya sifilis gibi diğer ülseratif cinsel yolla bulaşan enfeksiyonları (CYBE) taklit edebilir. Türkiye için ORF hastalığı da MPX hastalığı ayırıcı tanısı içindedir. Ayrıca bildirimi zorunlu olmayan CYBE ile başvuran hastalar, diğer tarama testleri yapılmadan sağlık hizmeti alabilmektedir. Kolay ulaşılabilen tanısal yeterliliği yüksek CYBE tarama merkezlerinin yaygınlaşması ile bu hastalıkların kontrol altına alınması sağlanabilir.Öğe Rational drug and antibiotic use status, e-health literacy in Syrian immigrants and related factors: A cross-sectional study(Multidisciplinary Digital Publishing Institute (MDPI), 2023) Değer, Mehmet Sait; Sezerol, Mehmet Akif; Atak, MuhammedRational drug use is a pivotal concept linked with morbidity and mortality. Immigration plays a significant role as a determinant affecting individuals’ health-related attitudes, behaviors, and the pursuit of health services. Within this context, the study was initiated to assess the factors influencing health literacy and rational drug use among Syrian immigrants in Istanbul. A cross-sectional study was undertaken on 542 Syrian adults utilizing a three-part questionnaire encompassing sociodemographics, rational drug use, and the e-health literacy scale (eHEALS). With an average age of 39.19 ± 13.10 years, a majority of participants believed medications should solely be doctor-prescribed (97%) and opposed keeping antibiotics at home (93.7%). Yet, 62.5% thought excessive herbal medicine use was harmless. The mean eHEALS score stood at 20.57 ± 7.26, and factors like age, marital status, income, and duration of stay in Turkey influenced e-health literacy. Associations were seen between low e-health literacy and being female, being older, having a lower education level, and regular medication use. Syrian immigrants displayed proper knowledge concerning antibiotics yet exhibited gaps in their understanding of general drug usage, treatment adherence, and herbal medicines. Approximately 80.3% had limited health literacy, pointing to the need for targeted interventions for enhanced health and societal assimilation.Öğe Registry-based retrospective cohort study of mortality among adults admitted to intensive care units in İstanbul with hospital acquired pseudomonas aeruginosa bloodstream-infection between 2014–2021(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Derin, Okan; Şahin, Meyha; Dumlu, Rıdvan; Başgönül, Sedef; Bayrak, Ahmet Doğukan; Arduç, Şevval; Bayram, Sümeyye; Mikaliyova, Nurlana; Kantürk, Arzu; Öncül, Ahsen; Yıldız Sevgi, Dilek; Gençer, Serap; Bayraktar, Banu; Dökmetaş, İlyas; Mert, AliBackground: Managing Pseudomonas aeruginosa bloodstream infections (BSIs) is challenging due to increasing antimicrobial resistance, limited therapeutic options, and high mortality rates. In this study, we aimed to identify 30-day mortality risk factors and assess infectious diseases consultants’ preferences for combination or monotherapy. Methods: The study was conducted in four hospitals in Istanbul, Turkey, involving 140 adult ICU beds and 336,780 ICU-bed-days between 1 January 2014, and 31 December 2021. A total of 157 patients were included in the study. Cox proportional hazard regression was performed to assess the factors on 30-day mortality. Results: The 30-day mortality rate was 44.6% (70/157). Higher Charlson Comorbidity Index (CCI) score, severe sepsis, primary bloodstream infection, being in COVID-19 pandemic period, and infection caused by MDR strain were associated with higher hazard of 30-day mortality. Combination therapy was more commonly used in patients with BSIs with MDR or DTR (difficult-to-treat) strains but did not significantly improve the hazard of 30-day mortality. Conclusions: Targeted interventions and vigilant management strategies are crucial for patients with defined risk factors. While infectious disease consultants tended to favor combination therapy, particularly for drug-resistant strains, our analysis revealed no significant impact on 30-day mortality hazard. The increased incidence of P. aeruginosa BSIs during the pandemic emphasizes the need for infection control measures and appropriate antibiotic prescribing practices.Öğe Relative effectiveness of covid-19 vaccine booster doses in people aged 65 and older - a retrospective cohort study in Türkiye(2024) Sezerol, Mehmet Akif; Sarısaltık, AlicanBackground: Immunization in the elderly population is critical due to the high frequency of health outcomes related to COVID-19. Objectives: This study aimed to compare the effectiveness levels of COVID-19 vaccine schedules in preventing SARS-CoV-2 infection in the older adult group who received at least one booster dose. Design: Retrospective cohort study. Methods: This study evaluated 8969 adults aged 65 and over in the Sultanbeyli district of İstanbul. COVID-19 vaccination and SARS-CoV-2 polymerase chain reaction testing data between January 14, 2021 and December 2, 2022 were obtained from the National Public Health Management System. Results: The median age of participants was 71 years. The vaccines were mostly administered as CoronaVac for the first and second doses (81.4% and 82.2%, respectively) and BNT162b2 for the third and fourth doses (61.8% and 73.1%, respectively). Turkovac was administered only in booster doses (third dose 0.6%, fourth dose 4.8%). The adjusted relative vaccine effectiveness (rVE) was found to be 61.8% (95% confidence interval (CI) 51.5–69.9) in two doses of inactivated vaccine and one dose of mRNA vaccine schedule compared to the homolog booster of CoronaVac primary vaccine schedule. In two booster doses receipts, the adjusted rVE was found to be 45.4% (95% CI 13.8–65.4) in three doses of inactivated and one dose mRNA vaccine schedule and 43.0% (95% CI 20.5–59.2) in two doses of inactivated and two doses of mRNA vaccines schedule compared to the two homolog boosters with CoronaVac primary vaccine schedule. Conclusion: In this study, the effectiveness of the mRNA vaccine as a booster dose was higher than that of the homologous boosters in participants receiving the CoronaVac primary series for those aged 65 and over.Öğe Turkish translation and crosscultural validity of WHOQoL-HIV Bref Tool(Wiley, 2023) Derin, Okan; Öncül, Ahsen; Türkkan, Hakkı Meriç; Demirbaş, Nazife Duygu; Gül, Özlem; Diktaş, Hüsrev; Sevgi, Dilek Yıldız; Hayran, Osman[Abstract Not Available]
