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Öğe Can antibiotic preference affect bleeding in percutaneous nephrolithotomy? Retrospective comparative study of two commonly used antibiotics(Professional Medical Publications, 2020) Akkoç, Ali; Aydın, Cemil; Uçar, Murat; Topçuoğlu, MuratObjective: Bleeding is one of the most common and alarming complication of percutaneous nephrolithotomy (PCNL). In this study, we aimed to compare the effects of ciprofloxacin and cefuroxime on the bleeding in PCNL procedures. Methods: The study was a retrospective analysis of 97 patients who underwent PCNL between February 2011 and June 2017. We just included the patients who had single tract lower pole PCNL for more objective evaluation of bleeding in the study. The patients were divided into two groups as ciprofloxacin group (Group-I, n:40) and cefuroxime group (Group-II, n:56) according to the type of antibiotic used in the operation. Patient age, gender, body mass index, stone size, preoperative INR, preoperative and postoperative platelet counts and difference, operative time, need for blood transfusion, postoperative fever, hospital stay, postoperative hemoglobin and hematocrit drop were analyzed. Results: There was no statistically significant difference in patients' gender distribution, body mass index, preoperative INR, preoperative and postoperative platelet counts, preoperative and postoperative platelet difference, duration of operation, hospital stay, postoperative fever and need for postoperative blood transfusion between two antibiotic groups (p > 0.05). Mean patient age was 42,75 +/- 16,97 in Group-I and 35,54 +/- 14,71 in Group-II (p < 0.05). The mean stone size of Group-I and Group-II were 27,23 +/- 7,05 mm and 30,59 +/- 8,20, respectively (p < 0.05). The mean postoperative hemoglobin and hematocrit drop were significantly higher in Group-I than in Group-II. The mean hemoglobin drop was 1,73 +/- 0,95 for Group-I and 1,28 +/- 0,67 for Group-II (p < 0.05). The mean hematocrit drop was 5,17 +/- 2,76 for Group-I and 3,80 +/- 1,99 for Group-II (p < 0.05). Conclusion: On the basis of the results of the initial study, the antibiotic preference in patients undergoing surgery may be one of the bleeding factors during and after PCNL.Öğe Can subfoveal choroidal thickness replace subjective tests in patients using tadalafil to treat erectile dysfunction?(Blackwell Publishing Ltd, 2020) Aslan, Fatih; Topçuoğlu, Murat; Öktem, Çağlar; Akkoç, Ali; Uçar, MuratWe aimed to determine the effect on choroidal thickness of daily 5 mg tadalafil use in patients with erectile dysfunction (ED) and to evaluate agreement between short form of International Index of Erectile Function (IIEF 1–5, 15) scores and choroidal thickness during follow-up. Enhanced depth imaging spectral domain–optical coherence tomography (EDI-OCT) was used to measure full choroidal thickness in the subfoveal area, choroidal thickness (CT) and small-choroidal-vessel-layer (SCVL) thickness. Thirty of the 45 patients included complete their follow-ups and exhibited medication continuity. Patients were divided into two groups, five (16.7%) with ED at any level at third-month follow-up, and 25 (83.3%) with no ED, and subgroup analysis was then performed. Median changes in SCVL thickness at first- and sixth-month follow-ups were 20.5 µm versus 9.0 ?m (p =.001) and 23.5 µm versus 12.5 µm (p =.005) in patients without and with ED respectively. The SCVL thickness increased by 20 ?m compared with the baseline level, indicating an improvement in the patient's complaints of erectile dysfunction. The level of increase in SCVL thickness can be a useful and objective guide to clinicians if they cannot be present when the IIEF questionnaire is administered. © 2020 Blackwell Verlag GmbHÖğe Can we predict preoperative tumor aggressivity with hemogram parameters in renal cell carcinoma? a novel calculation method(Springer, 2019) Uçar, Murat; Soyupek, Sedat; Oksay, Taylan; Özorak, Alper; Akkoç, Ali; Topçuoğlu, Murat; Koşar, AlimWe aim to investigate the prognostic significance of the hemoglobin X lymphocyte / neutrophil ratio (HLNR) and hemoglobin x lymphocyte / platelet ratio (HLPR) with tumor aggressivity in patients with renal cell carcinoma. We retrospectively analyzed 127 patients' data who had diagnosed as renal cell carcinoma between 2008 and 2019 in Suleyman Demirel University Hospital. Tumor and patient characteristics, hemoglobin, neutrophil, lymphocyte, platelet values HLNR and HLPR were calculated in preoperative hemogram parameters. The relationship between tumor pathological stage, Fuhrman nuclear grade and tumor necrosis with HLPR and HLNR analyzed with statistically. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLNR. P values are 0.003, 0.012 and 0.015 respectively. HLNR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLPR. P values are 0.001, 0.014 and 0.047 respectively. HLPR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. High pathological stage, high Fuhrman nuclear grade and existence of tumor necrosis are associates with preoperative low HLNR and low HLPR in renal cell carcinoma patients. They can be used as prognostic markers in patients with renal mass preoperatively.Öğe Evaluation of exposure and awareness of radiation in healthcare professionals exposed to ionizing radiation(2020) Uçar, Murat; Akkoç, Ali; Topçuoğlu, Murat; Öztürk, Sefa Alperen; Demir, MuratAim: To evaluate radiation exposure and awareness of radiation in healthcare professionals exposed to ionizing radiation. Material and Methods: The study was carried out at the Alanya Alaaddin Keykubat University Training and Research Hospital and the Süleyman Demirel University Hospital. Physicians, nurses, paramedics, anesthesia technicians, caregivers and cleaning staff exposed to radiation, participated in the study. An inquiry form was prepared to carry out the study, in which the demographic characteristics of the healthcare professionals, the characteristics related to the radiation they were exposed to, the effects that may occur due to this exposure were asked; the relationship between these was statistically analyzed according to the answers. Results: One hundred twenty-nine healthcare professionals, 81 men and 48 women, participated in the study. Most of the healthcare professionals exposed to radiation have been working for more than 10 years and at a distance of less than 3 meters to the radiation source. Thirty-two of the participants (24.8%) did not use any personal protective equipment. On the day of exposure to radiation, 91 persons (70.54%) were experiencing symptoms such as weakness, fatigue, and headache, unlike other days. It was determined that personal protective equipment use did not correlate to education levels and radiation training background. Conclusion: Most of the healthcare professionals exposed to radiation have not previously received any training on radiation and do not use personal protective equipment regularly. This situation causes these persons to complain of weakness, tiredness or headaches at the end of the day.Öğe Evaluation of the effect of a novel ?3-adrenergic agonist on choroidal vascularity(2021) Topçuoğlu, Murat; Aslan, FatihPURPOSE. To determine the effect of the new ?3-agonist (mirabegron), which is used for overactive bladder (OAB) treatment, on central retinal thickness (CRT) and choroidal vascularity. MATERIAL AND METHODS. The 26 eyes of 26 cases using 50 mg tablet mirabegron once per day for OAB were included in this prospective case control study. The CRT, choroidal thickness (ChT), and choroidal vascularity were measured at baseline, week 1 (W1), month 1 (M1), month 2 (M2), and month 3 (M3). Subfoveal ChT measurement included the total subfoveal choroidal thickness (SFCT), and the small and large choroidal vessel layer (SCVL and LCVL) thickness. The total choroidal area (TCA), lumen area (LA), stromal area (SA), stroma/lumen ratio, and choroidal vascularity index (CVI) were measured with the Image-J software. RESULTS. The largest SFCT increase compared to baseline was at M1 (26.8 ± 40.8 ?m, P = 0.001). The subfoveal SCVL thickness showed a significant decrease at M2 and M3 (?6.0 ± 8.9 ?m, P = 0.002; ?7.8 ± 13.4 ?m, P = 0.046, respectively). LCVL thickness showed a significant increase at W1, M1, and M2, with the largest at M1. CVI showed a significant increase at M1, M2, and M3 (P < 0.05 for all). The TCA, LA, and SA showed a significant increasing trend at all follow-up periods. LA/SA decreased at W1 because of stromal expansion but increased at M3 with more prominent vascular dilatation. CRT values showed no significant change. CONCLUSIONS. Mirabegron had a significant effect on choroidal thickness. Choroidal vascular response is in the form of narrowing in the choriocapillaris and enlargement in the Haller's layer.Öğe İyonlaştırıcı radyasyona maruz kalan sağlık çalışanlarında radyasyon maruziyeti ve farkındalığının değerlendirilmesi(Alanya Alaaddin Keykubat Üniversitesi, 2020) Uçar, Murat; Akkoç, Ali; Topçuoğlu, Murat; Öztürk, Sefa Alperen; Demir, MuratAmaç: İyonize radyasyona maruz kalan sağlık çalışanlarında radyasyon maruziyeti ve farkındalığını değerlendirmek.Gereç ve Yöntem: Çalışma Alanya Alaaddin Keykubat Üniversitesi Eğitim ve Araştırma Hastanesi ve Süleyman Demirel Üniversitesi Hastanesi’nde gerçekleştirildi. Çalışmaya radyasyona maruz kalan hekimler, hemşireler, sağlık memurları, anestezi teknisyenleri, hasta bakıcıları ve temizlik personelleri katıldı. Çalışmayı gerçekleştirmek için bir sorgulama formu hazırlandı. Bu formda çalışanların demografik özellikleri, maruz kaldığı radyasyon ile ilgili özellikler, bu maruziyete bağlı oluşabilecek etkiler soruldu ve cevaplara göre aralarında ilişki olup olmadığı istatistiksel olarak incelendi. Bulgular: Çalışmaya 81 erkek, 48 kadın olmak üzere 129 sağlık çalışanı katıldı. Radyasyona maruz kalan sağlık çalışanlarının çoğu 10 yıldan daha uzun süredir ve radyasyon kaynağına 3 metreden daha yakın mesafede çalışmaktaymış. Çalışmaya katılanlardan 32 (%24,8) si hiçbir kişisel koruyucu donanım (KKD) kullanmıyordu. Radyasyona maruz kalındığı gün 91 kişi diğer günlerden farklı olarak halsizlik, yorgunluk, baş ağrısı gibi bir şikayet hissediyormuş. KKD kullanımının öğrenim düzeyi ve radyasyon eğitimi almakla ilişkisi olmadığı saptandı.Sonuç: Radyasyona maruz kalan sağlık çalışanlarının çoğu radyasyon ile ilgili daha önce bir eğitim almamış ve KKD’leri düzenli kullanmamaktadır. Bu durum kişinin gün sonunda halsizlik, yorgunluk ya da baş ağrısı gibi şikayetleri olmasına neden olmaktadır.Öğe The effect of potassium citrate on overactive bladder disease: A cross-sectional study(Coll Physicians & Surgeons Pakistan, 2020) Uçar, Murat; Akkoç, Ali; Topçuoğlu, Murat; Özturk, Sefa Alperen; Demir, MuratObjective: To show the effect of potassium citrate treatment on overactive bladder disease in patients with kidney stone and overactive bladder symptoms. Study Design: Experimental study. Place and Duration of Study: Department of Urology, Alanya Alaaddin Keykubat University and Department of Urology, Suleyman Demirel University, Turkey, from October 2019 to July 2020. Methodology: Patients with an indication for starting potassium citrate therapy because of kidney stone, and patients with symptoms of overactive bladder disease were included in the study. At the beginning of the treatment, the overactive bladder-version 8 form was filled and potassium citrate 10 meq 2x2 dose was started to the patients. The effect of potassium citrate on the symptoms of overactive bladder disease was demonstrated by filling the overactive bladder-version 8 form after one month of treatment. Results: A total of 82 people, 36 men and 46 women, participated in the study. Potassium citrate treatment caused a significant increase in urine pH levels (p<0.001). After potassium citrate treatment, there was a significant decrease in the score of the overactive bladder-version 8 form. (p<0.001). A positive correlation was found between age and overactive bladder-version 8 score change (p = 0.004). Conclusion: Potassium citrate can be used in the treatment of overactive bladder disease. The effect of potassium citrate treatment on ameliorating overactive bladder symptoms is more distinct in elderly patients.
