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    Effects of Pain and Disability on Quality of Life in Patients with Carpal Tunnel Syndrome
    (Duzce Univ, 2013) Ozturk, Ayhan; Degirmenci, Yildiz; Kececi, Hulusi; Zateri, Coskun; Altan, Mehmet; Ankarali, Handan
    Objective: To evaluate the association between severity of carpal tunnel syndrome (CTS), pain, disability and to assess their effects on quality of life. Methods: CTS patients whose diagnosis were confirmed with nerve conduction studies were classified as mild, moderate, and severe. Pain evaluation was performed by Pain Quality Assessment Scale (PQAS) in all patients. Short form-36 (SF-36) was used to assess quality of life and Brief Disability Scale was used in the evaluation of disability. Results: 93.1% of the patients were women, and 6.9% were men. Mean age was 44.20 +/- 8.76 years (range=29-62). Mean duration of symptoms was 6.67 +/- 3.00 months (range=3-12 months). Most common symptom was paresthesia. Electrophysiological evaluations revealed moderate CTS in 43.8%, mild CTS in 44.8%, severe CTS in 6.9% of the patients. There was no significant association between CTS severity and time course subgroup of PQAS (p=0.222). But there was a statistically significant difference in the general pain subgroup and total scores of PQAS between moderate and severe CTS patients (p<0.05). There was a statistically significant difference in the mean scores of Brief Disability Questionnaire between patients with mild and severe CTS (4,46 +/- 3,61 and 11,50 +/- 4,94, p<0.05, respectively). A statistically significant negative correlation was found between the level of disability and physical function, pain, vitality, social function and mental health domains of SF-36. Conclusion: Quality of life is variably affected in patients with CTS due to the severity of CTS. On this aspect, it is important to diagnose and treat CTS on time to improve the quality of life of patients with CTS in early period, which is the best known and common compression neuropathy of upper extremity in community.
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    Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study
    (Elsevier Sci Ltd, 2024) Filiz, Mine; Erdem, Hakan; Ankarali, Handan; Puca, Edmond; Ruch, Yvon; Santos, Lurdes; Fasciana, Teresa
    Background: Blood culture-negative endocarditis (BCNE) is a diagnostic challenge, therefore our objective was to pinpoint high-risk cohorts for BCNE. Methods: The study included adult patients with definite endocarditis. Data were collected via the Infectious Diseases International Research Initiative (ID-IRI). The study analysing one of the largest case series ever reported was conducted across 41 centers in 13 countries. We analysed the database to determine the predictors of BCNE using univariate and logistic regression analyses. Results: Blood cultures were negative in 101 (11.65 %) of 867 patients. We disclosed that as patients age, the likelihood of a negative blood culture significantly decreases (OR 0.975, 95 % CI 0.963-0.987, p < 0.001). Additionally, factors such as rheumatic heart disease (OR 2.036, 95 % CI 0.970-4.276, p = 0.049), aortic stenosis (OR 3.066, 95 % CI 1.564-6.010, p = 0.001), mitral regurgitation (OR 1.693, 95 % CI 1.012-2.833, p = 0.045), and prosthetic valves (OR 2.539, 95 % CI 1.599-4.031, p < 0.001) are associated with higher likelihoods of negative blood cultures. Our model can predict whether a patient falls into the culture-negative or culture-positive groups with a threshold of 0.104 (AUC +/- SE = 0.707 +/- 0.027). The final model demonstrates a sensitivity of 70.3 % and a specificity of 57.0 %. Conclusion: Caution should be exercised when diagnosing endocarditis in patients with concurrent cardiac disorders, particularly in younger cases.
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    Neurotoxic effects of ketamine and different doses of ropivacaine administered intrathecally in rabbits
    (Turkiye Klinikleri, 2013) Sezen, Gülbin; Demiraran, Yavuz; Güven, Aysel; Ankarali, Handan; Sevinç, Özdemir; Karagöz, Ibrahim
    Objective: Although a variety of anesthetic medicines are used intrathecally, experimental neurotoxic studies on these drugs are not sufficient. In our study, we used immunocytochemical examination to assess the neurotoxic potential of ketamine and different doses of ropivacaine administered intrathecally. Material and Methods: Thirty rabbits were divided into five groups which were inserted spinal catheters under anesthesia. Each group received in a volume of 0.3 ml, as follows: the R0.2 group received 0.2% ropivacaine, the R0.75 group received 0.75% ropivacaine, the R1 group received 1.0% ropivacaine, the K group received preservative-free S (+) ketamine and the C group received 0.9% NaCl. The onset and duration of action were recorded by using Motor Dysfunction Index (MDI). Rabbits were observed for five days and then euthanasized. After catheters were removed, brains and spinal tissue samples were evaluated by light microscopy and immunocytochemical examination. Results: The longest onset of action was observed in the K group. Among the ropivacaine groups, the onset of action diminished and the duration of action extended with an increase in dose significantly. There was axonal degeneration in the R1 group, but this finding not reach significance. In the ketamine group, significant neuronal degeneration and reduction in number of neurons in the brain sections were observed. In the 1% ropivacaine group, a relative increase in neurofilament intensity was detected using immunocytochemical assessments in the medulla spinalis and brain sections. Conclusion: The intrathecal applications of 1% ropivacaine and ketamine can induce neurotoxic damage, despite a lack of observed functional neurologic deficits. © 2013 by Türkiye Klinikleri.
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    Prospective analysis of febrile neutropenia patients with bacteraemia: the results of an international ID-IRI study
    (Elsevier, 2023) Erdem, Hakan; Kocoglu, Esra; Ankarali, Handan; El-Sokkary, Rehab; Hakamifard, Atousa; Karaali, Ridvan; Kulzhanova, Sholpan
    Objectives: Bacteraemia during the course of neutropenia is often fatal. We aimed to identify factors predicting mortality to have an insight into better clinical management.Methods: The study has a prospective, observational design using pooled data from febrile neutropenia patients with bacteraemia in 41 centres in 16 countries. Polymicrobial bacteraemias were excluded. It was performed through the Infectious Diseases-International Research Initiative platform between 17 March 2021 and June 2021. Univariate analysis followed by a multivariate binary logistic regression model was used to determine independent predictors of 30-d in-hospital mortality (sensitivity, 81.2%; specificity, 65%). Results: A total of 431 patients were enrolled, and 85 (19.7%) died. Haematological malignancies were detected in 361 (83.7%) patients. Escherichia coli (n = 117, 27.1%), Klebsiellae (n = 95, 22% %), Pseudomonadaceae (n = 63, 14.6%), Coagulase-negative Staphylococci (n = 57, 13.2%), Staphylococcus aureus (n = 30, 7%), and Enterococci (n = 21, 4.9%) were the common pathogens. Meropenem and piperacillin-tazobactam susceptibility, among the isolated pathogens, were only 66.1% and 53.6%, respectively. Pulse rate (odds ratio [OR], 1.018; 95% confidence interval [CI], 1.002-1.034), quick SOFA score (OR, 2.857; 95% CI, 2.120- 3.851), inappropriate antimicrobial treatment (OR, 1.774; 95% CI, 1.011-3.851), Gram-negative bacteraemia (OR, 2.894; 95% CI, 1.437-5.825), bacteraemia of non-urinary origin (OR, 11.262; 95% CI, 1.368-92.720), and advancing age (OR, 1.017; 95% CI, 1.001-1.034) were independent predictors of mortality. Bacteraemia in our neutropenic patient population had distinctive characteristics. The severity of infection and the way to control it with appropriate antimicrobials, and local epidemiological data, came forward. Conclusions: Local antibiotic susceptibility profiles should be integrated into therapeutic recommendations, and infection control and prevention measures should be prioritised in this era of rapidly increasing antibiotic resistance.& COPY; 2023 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.
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    Re: The Negative Influence of Cigarette Smoke on Passive Smokers-Deteriorated Pulmonary Function Tests and Increased Urine Cotinine Levels
    (Aves, 2019) Ozturk, Omur; Sezen, Gulbin Yalcin; Ankarali, Handan; Ozlu, Onur; Demiraran, Yavuz; Ates, Hakan; Dost, Burhan
    [Anstract Not Available]
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    The reliability of the Turkish version of the Negative Act Questionnaire (NAQ-TR) for measuring to mobing at work
    (Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2013) Karaahmet, Elif; Kiran, Sibel; Atik, Levent; Atasoy, Nuray; Saracli, Ozge; Ankarali, Handan; Konuk, Numan
    Objective: The exposure to negative acts at work is one of the main issues highlighted adverse health effects within the scope of work life's psychosocial dimension. Mobbing is defined as both the most common one among the causes of stress being at work, and also more devastating and damaging than the other stressors of the work. The aim of the present study was to examine the reliability of the Turkish version of the Negative Act Questionnaire (NAQ-TR). Methods: The questionnaire was first translated into Turkish and then back translated into English and the equivalence of both versions was determined. An expert group analyzed the formulation of the translated items and they redrafted some of them according to agreedon criteria. Subsequently, it was administered to 456 workers from 11 different workplaces. The factor structure and internal consistency of the NAQ-TR was examined. Result: The instrument showed satisfactory internal consistency with an overall Cronbach a of 0.912. The factor analysis, as opposed to the original scale, yielded four factor solution (Personal bullying and isolation, Work-related bullying, destabilization and excessive workload). We found that NAQ-TR has high internal consistency. Conclusions: The Turkish version of NAQ was found to be reliable for mobbing in workplace. It can be used in epidemylogic trials.
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    Vaccine hesitancy and refusal among parents: An international ID-IRI survey
    (J Infection Developing Countries, 2022) Cag, Yakup; Al Madadha, Mohammad Emad; Ankarali, Handan; Cag, Yasemin; Onder, Kubra Demir; Seremet-Keskin, Aysegul; Kizilates, Filiz
    Introduction: Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale. Methodology: In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents' attitudes towards vaccination of their children. Results: Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p < 0.05 for all). Conclusions: Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR.