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Publication Metadata only Comparison of 28-Day Mortality Between Hospital- and Community-Acquired Influenza Patients(DOC DESIGN INFORMATICS CO LTD, 2023) Bilgin, Hueseyin; Basari, Tugce; Pazar, Nazli; Kucuker, Isil; Can-Sarinoglu, Rabia; Marmara University; Marmara University; Bahcesehir UniversityObjective: This study aimed to compare 28-day mortality between patients have hospital-acquired influenza (HAI) and those have community-acquired influenza (CAI) during the 2017-2019 influenza seasons in a tertiary care center in Istanbul, Turkiye.Materials and Methods: This retrospective cohort included all hospitalized patients who had confirmed influenza infection and were over 17 years old. HAI was defined as a case of influenza that tested negative in a PCR test or had no signs of influenza on admission but with a positive test result at any point after 72 hours of admission. CAI was defined as a case of influenza diagnosed within 72 hours of admission or before admission. The primary outcome was 28-day mortality after diagnosis. Biological sex, admission to the intensive care unit (ICU), presence of chronic obstructive pulmonary disease, cardiovascular and immunosuppressive comorbidities, influenza subtype, and other variables identified with univariate analyses (p<0.25) were entered into logistic regression analysis.Results: During the study period, 92 (46%) of 201 hospitalized patients who tested positive for influenza were identified as HAI, and the rest (109) were identified as CAI. Univariate analysis showed no differences between survivors and non-survivors in patient characteristics, except non-survivors were more likely to have an ICU admission. The multivariable logistic regression analysis results showed that HAI was associated with 5.6-fold increased odds of mortality (95% confidence interval [CI]=1.6-19.3, p=0.006, Figure 2), after adjustment for age, gender, comorbidity, and ICU admission. Conclusion: The results of this study revealed that patients who had HAI were more likely to die within 28 days compared to those who had CAI after controlling for key confounders. The high rate of HAI underscores the critical importance of robust infection control measures for hospital-acquired viral infections. Additional research and targeted interventions are necessary to improve the HAI prognosis.Publication Metadata only Intracranial Calcification after Probable Disseminated Bacillus Calmette-Guérin Infection in a Child with Severe Combined Immunodeficiency(Georg Thieme Verlag iaorl@iaorl.org, 2020) Eser Şimşek, Işıl; Uyan, Zeynep Seda; Çaki Kiliç, Suar; Uyur-Yalçın, Emek; Arısoy, Emin Sami; Tezcan, Gülsün; Aydoǧan, Metin; Eser Şimşek, Işıl, School of Medicine, Kocaeli Üniversitesi, İzmit, Turkey; Uyan, Zeynep Seda, Division of Pediatric Pulmonology, Kocaeli Üniversitesi, İzmit, Turkey; Çaki Kiliç, Suar, Pediatric Stem Cell Transplantation Unit, Bahçeşehir Üniversitesi, Istanbul, Turkey; Uyur-Yalçın, Emek, Division of Pediatric Neurology, Kocaeli Üniversitesi, İzmit, Turkey; Arısoy, Emin Sami, Department of Pediatric Infectious Diseases, Kocaeli Üniversitesi, İzmit, Turkey; Tezcan, Gülsün, Pediatric Stem Cell Transplantation Unit, Bahçeşehir Üniversitesi, Istanbul, Turkey; Aydoǧan, Metin, School of Medicine, Kocaeli Üniversitesi, İzmit, TurkeyBacillus Calmette-Guérin (BCG) vaccine is administered to infants in countries with a high prevalence of tuberculosis. Severe combined immunodeficiency (SCID) is one of the most severe forms of primary immunodeficiency disease, rendering patients prone to disseminated BCG infection. Early intensive antimycobacterial treatment and bone marrow transplantation may be lifesaving in patients with BCG infection and SCID. The central nervous system is rarely involved in BCG infection. We report a case of disseminated BCG infection with diffuse intracranial calcification, including periventricular white matter, subcortical area, pons and cerebellar white matter after bone marrow transplantation. © 2020 Elsevier B.V., All rights reserved.Publication Metadata only Use of combined fractional carbon dioxide laser and fractional microneedle radiofrequency for the treatment of acne scars: A retrospective analysis of 1-month treatment outcome on scar severity and patient satisfaction(Blackwell Publishing Ltd, 2020) Tatlıparmak, Aslı; Aksoy, Berna; Shishehgarkhaneh, Ladan Rastgar; Gökdemir, Gonca; Koç, Erol; Tatlıparmak, Aslı, Department of Dermatology, Bahçeşehir Üniversitesi, Istanbul, Turkey, Dermatology Clinic, Bahçeşehir Medicalpark Hospital, Istanbul, Turkey; Aksoy, Berna, Department of Dermatology, Bahçeşehir Üniversitesi, Istanbul, Turkey, Dermatology Clinic, VM Medicalpark Hospital, Kocaeli, Turkey; Shishehgarkhaneh, Ladan Rastgar, Faculty of Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Gökdemir, Gonca, Private Clinic, Istanbul, Turkey; Koç, Erol, Medical Park Hastanesi, Ankara, TurkeyBackground: Acne scars lead to social and psychological problems for patients, and they should be treated effectively. Ablative and nonablative lasers have been used for the treatment of acne scars in recent years. Aims: The aim of this study was to evaluate the effectivity of combined FCL and FmRF treatment for acne scars retrospectively. Methods: A total of 72 patients with acne scars who received FCL + FmRF treatment between 2014 and 2016 were included in this study. Photographs of patients before treatment and 1 month following the last treatment session were scored by two blinded researchers, according to the ECCA acne scar scoring method. Patients were contacted via telephone after 1 month following the last treatment and asked to evaluate their satisfaction with the treatment outcome using a 5-point Likert-type scale. Results: A significant decrease was noted in ECCA scores after the treatment along with temporary side effects. Change from pretreatment scores was significantly higher in patients very satisfied vs satisfied with treatment. The number of treatment sessions was positively correlated with treatment-related change in ECCA scores. Conclusions: In conclusion, our findings revealed association of FCL + FmRF treatment with significantly improved ECCA scores, mild pain experience, and low rate of side effects in patients with acne scars, despite usage of high-energy FLC dose and five sessions of treatment on average. More remarkable improvement in ECCA scores during treatment seems to be associated with higher patient satisfaction and to be more likely in patients with darker skin types. © 2020 Elsevier B.V., All rights reserved.Publication Metadata only Choroidal thickness in keratoconus(Springer editorial@springerplus.com, 2020) Bilgin, Burak; Karadaǧ, Ayse Sevgi; Bilgin, Burak, Department of Ophthalmology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Karadaǧ, Ayse Sevgi, Department of Ophthalmology, Adiyaman Üniversitesi, Adiyaman, TurkeyPurpose: Keratoconus is an ectatic eye disease characterized by progressive thinning and steepening of the cornea which leads to irregular astigmatism and visual function loss. Determination of choroidal thickness in keratoconus patients may help us to better understand and manage the keratoconus disease. Choroidal thickness may be a potential marker for disease activity in keratoconus patients. In this study, we aimed to determine choroidal thickness in keratoconus patients and compare the results with the age-matched control group. Methods: This is a prospective study with a control group. Keratometry and thinnest corneal thickness was measured and recorded in keratoconus patients. Choroidal thickness of all subjects was measured using an optical coherence tomography device (Spectralis OCT, version 6.0, Heidelberg Engineering, Germany) with an enhanced depth imaging mode without pupil dilation. Mean choroidal thickness of keratoconus patients was compared with healthy subjects. Results: One hundred and sixty eyes of 80 healthy subjects and 160 eyes of 80 keratoconus patients were included in the study. Mean thinnest corneal thickness of the keratoconus patients was 449.7 ± 3.2 microns. Mean corneal keratometry value and cylindrical refraction error in the keratoconus patients were 53.2 ± 0.2 and 3.3 ± 0.1 diopters, respectively. Mean choroidal thickness was 363.9 ± 59.8 and 328.4 ± 67.2 microns in keratoconus patients and healthy subjects, respectively. There was a very significant difference between keratoconus patients and healthy subjects in terms of choroidal thickness (P = 0.000). There was not a statistically significant correlation between choroidal thickness and thinnest corneal thickness in keratoconus patients (P = 0.814). Conclusion: Choroidal thickness was found to be increased in keratoconus patients. Choroidal thickness could potentially become a new clinical marker for disease activity in keratoconus patients. © 2020 Elsevier B.V., All rights reserved.Publication Open Access Assessment of Vascular Patency and Inflammation with Intravascular Optical Coherence Tomography in Patients with Superficial Femoral Artery Disease Treated with Zilver PTX Stents(Elsevier Inc. usjcs@elsevier.com, 2020) Hoyt, Taylor; Feldman, Marc David; Okutucu, Sercan; Lendel, Vasili; Marmagkiolis, Konstantinos; McIntosh, Victoria; Ates, Ismail; Kose, Gulcan; Mego, David M.; Paixao, Andre R.M.; Hoyt, Taylor, The University of Texas Health Science Center at San Antonio, San Antonio, United States; Feldman, Marc David, The University of Texas Health Science Center at San Antonio, San Antonio, United States; Okutucu, Sercan, Ankara Numune Hospital, Ankara, Turkey; Lendel, Vasili, Arkansas Heart Hospital, Little Rock, United States; Marmagkiolis, Konstantinos, Florida Hospital, Orlando, United States; McIntosh, Victoria, Arkansas Heart Hospital, Little Rock, United States; Ates, Ismail, School of Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kose, Gulcan, School of Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Mego, David M., Arkansas Heart Hospital, Little Rock, United States; Paixao, Andre R.M., Arkansas Heart Hospital, Little Rock, United StatesPurpose: Zilver PTX nitinol self-expanding drug-eluting stent with paclitaxel coating is effective for treatment of superficial femoral artery (SFA) disease. However, as with any stent, it induces a measure of vascular inflammatory response. The current clinical trial (NCT02734836) aimed to assess vascular patency, remodeling, and inflammatory markers with intravascular optical coherence tomography (OCT) in patients with SFA disease treated with Zilver PTX stents. Methods: Serial OCT examinations were performed in 13 patients at baseline and 12-month follow-up. Variables evaluated included neointimal area, luminal narrowing, thrombus area, stent expansion as well as measures of inflammation including, peri-strut low-intensity area (PLIA), macrophage arc, neovascularization, stent strut apposition and coverage. Results: Percentage of malapposed struts decreased from 10.3 ± 7.9% post-intervention to 1.1 ± 2.2% at 12-month follow-up, but one patient showed late-acquired stent malapposition (LASM). The percent of uncovered struts at follow-up was 3.0 ± 4.5%. Average expansion of stent cross-sectional area from baseline to follow-up was 35 ± 19%. The average neointimal area was 7.8 ± 3.8 mm2. Maximal luminal narrowing was 61.1 ± 25.0%, and average luminal narrowing was 35.4 ± 18.2%. Average peri-strut low-intensity area (PLIA) per strut was 0.017 ± 0.018 mm2. Average number of neovessels per mm of stent was 0.138 ± 0.181. Average macrophage angle per frame at follow-up was 7 ± 11°. Average thrombus area at follow-up was 0.0093 ± 0.0184 mm2. Conclusion: At 12-month follow-up, OCT analysis of Zilver PTX stent shows outward remodeling and minimal neointimal growth, but evidence of inflammation including PLIA, neovessels, thrombus and macrophages. Thirteen patients with PAD had paclitaxel-coated stents implanted in their SFAs and were then imaged with OCT at baseline and 12-month follow-up. OCT proxy metrics of inflammation were quantified. © 2020 Elsevier B.V., All rights reserved.Publication Metadata only Psychometric evaluation of Simulator Sickness Questionnaire and its variants as a measure of cybersickness in consumer virtual environments(Elsevier Ltd, 2020) Sevinc, Volkan; Berkman, Mehmet Ilker; Sevinc, Volkan, Game Design Graduate Programme, Bahçeşehir Üniversitesi, Istanbul, Turkey; Berkman, Mehmet Ilker, Communication Design Department, Bahçeşehir Üniversitesi, Istanbul, TurkeyCybersickness, i.e. visually induced motion sickness, remains as a negative effect that is detrimental to the user experience of VEs (virtual environments) developed for VR (virtual reality) consumers. As the VR technology evolves, it is rather triggered by application aspects rather than hardware limitations. For this reason, there is still a need for a measurement method to assess and compare VEs for cybersickness effects. SSQ (Simulation Sickness Questionnaire) is used for measuring users’ level of sickness symptoms and is highly appreciated in VR research. However, it is criticized for its psychometric qualities and applicability in VR, as a measure of cybersickness. Recently, two variants of SSQ were offered for measuring cybersickness, CSQ (Cybersickness Questionnaire) and VRSQ (Virtual Reality Sickness Questionnaire). There is also another variant with a different factor structure, which we call FSSQ, that is based on French translation of SSQ. Our study compares SSQ and these variants for their psychometric qualities, construct validity, discriminant validity, internal reliability, test-retest reliability and sensitivity to distinguish application aspects of VEs that are related to cybersickness. Using a within-subjects experiment design, we evaluated 7 different VEs with 32 participants through 9 sessions, resulting with 288 responses to the 16-item SSQ. Results suggested that both VRSQ and CSQ were valid and reliable measures of cybersickness, as well as being sensitive to application aspects such as translational and rotational movements required by users for navigation in VEs. Compared to SSQ and FSSQ, the cybersickness questionnaires, CSQ and VRSQ, revealed better indicators of validity. On the other hand, we assume that the development of the two cybersickness scales had limitations in sample size to represent VR consumers and limitations in stimuli to represent the applications aspects of consumer VEs. We suggest further evaluation of cybersickness symptoms with larger samples and broader range of applications to identify the symptoms and the construct of a subjective measurement tool. © 2019 Elsevier B.V., All rights reserved.Publication Metadata only Assessment of neuron-specific enolase, S100B and malondialdehyde levels in serum and vitreous of patients with proliferative diabetic retinopathy(Springer editorial@springerplus.com, 2020) Asadova, Vusala; Gül, Zülfiye; Büyükuysal, Rifat Levent; Yalcinbayir, Ozgur; Asadova, Vusala,; Gül, Zülfiye, Department of Pharmacology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Büyükuysal, Rifat Levent, Department of Pharmacology, Bursa Uludağ Üniversitesi, Bursa, Turkey; Yalcinbayir, Ozgur, Department of Ophthalmology, Bursa Uludağ Üniversitesi, Bursa, TurkeyPurpose: To assess the vitreous and serum levels of neuron-specific enolase (NSE), S100B and malondialdehyde (MDA) in proliferative diabetic retinopathy (PDR) cases and investigate the correlation between preoperative and postoperative anatomical and clinical features. Materials and methods: The study group included patients who had pars plana vitrectomy (PPV) for PDR. The control group included non-diabetic individuals who underwent PPV surgery for vitreoretinal interface disorders. Samples of serum were taken from all participants preoperatively, while vitreous samples were taken during the PPV. Vitreous and serum levels of NSE, S100B and MDA were measured, and comparisons were made between the groups. Results: The study group consisted of 56 eyes of 56 cases with PDR. The control group consisted of 20 eyes of 20 cases. The concentrations of vitreous NSE, S100B and MDA were significantly higher than the control group (p < 0.0001, p < 0.05, p < 0.001, respectively). Serum levels were statistically different for NSE and S100B (p < 0.05). Conclusion: Our results clearly show that vitreous levels of S100B, NSE and MDA and serum concentrations of NSE and S100B increased significantly in patients with PDR. The findings may possibly indicate neurodegeneration and oxidative stress, therefore, these markers may have a diagnostic value in patients with PDR. © 2020 Elsevier B.V., All rights reserved.Publication Metadata only Evaluation of the internal anatomy of paramolar tubercles using cone-beam computed tomography(Springer springer@springer.it, 2020) Çolakoǧlu, Gizem; Kaya-Büyükbayram, Isil; Elçin, Mehmet Ali; Kazak, Mağrur; Sezer, Hafize; Çolakoǧlu, Gizem, Department of Oral and Maxillofacial Surgery, İstanbul Aydın Üniversitesi, Istanbul, Turkey; Kaya-Büyükbayram, Isil, Department of Endodontics, İstanbul Aydın Üniversitesi, Istanbul, Turkey; Elçin, Mehmet Ali, Department of Oral and Maxillofacial Surgery, İstanbul Aydın Üniversitesi, Istanbul, Turkey; Kazak, Mağrur, Department of Restorative Dentistry, Bahçeşehir Üniversitesi, Istanbul, Turkey; Sezer, Hafize, Department of Biostatistics, İstanbul Aydın Üniversitesi, Istanbul, TurkeyPurpose: To evaluate the internal anatomy of paramolar tubercles (PTs) on molars, determine the existence of root canals in these structures that either communicate with or are isolated from the main root canals of teeth, and analyze the prevalence of root fusion and a C-shaped canal configuration using cone-beam computed tomography (CBCT). Materials and methods: Twenty-six molars with PTs from the study group and 664 molars without PTs from the control group were evaluated using CBCT. The locations and sizes of tubercles were noted. The existence of root canals in PTs was detected. All teeth were evaluated according to the presence or absence of root fusion and a C-shaped canal configuration. Statistical analyses were performed with Pearson Chi square and Fisher’s exact tests (p < 0.05). Results: Eleven (42.3%) PTs with their own canals communicated with the main root canals of teeth, and 10 of 11 PTs (90.9%) were larger than 4 mm in size. No PT possessed its own canal independent from the other canals. Teeth with PTs tended to have more root fusions than teeth without PTs. A statistically significant correlation was observed between PTs and the C-shaped canal configuration (p < 0.01). Maxillary second molars with PTs were the major teeth showing variations in the internal morphology. Conclusions: PTs are an uncommon anatomical variation that is specific to the coronal and radicular morphology. Therefore, clinicians should be aware of its unpredictable and complex internal anatomy, particularly in cases requiring endodontic treatment. CBCT is recommended for teeth with PTs, particularly maxillary second molars, to improve the prognosis of the teeth. © 2020 Elsevier B.V., All rights reserved.Publication Metadata only Evaluation of the relationship between gonial angle and impacted mandibular third molar teeth(Springer, 2020) Demirel, Oǧuzhan; Akbulut, Aslıhan; Demirel, Oǧuzhan, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Akbulut, Aslıhan, Department of Radiology, İstanbul Medipol Üniversitesi, Istanbul, TurkeyMandibular third molar teeth have the highest impaction frequency for several reasons such as lack of space which may be related to the direction of facial growth. Gonial angle is used for the definition of facial growth pattern with some other measures such as mandibular plane angle. Winter and Pell–Gregory classifications are used for defining the level and pattern of mandibular third molar impaction. The aim of this study is to define the relationship between mandibular third molar impaction pattern and gonial angle, also to evaluate relationship between mandibular third molar roots and inferior alveolar canal. Study included 90 patients who had undergone cone beam computed tomography assessment for mandibular third molar impaction. Impacted teeth were grouped according to Pell–Gregory depth (A, B, C) and ramus (1, 2, 3) classification and sub-groups were composed. Winter classification was used for angulation of third molars and their relationship between with inferior alveolar canal was recorded. Gonial angle was measured on panoramic radiographs. Of the evaluated 90 impacted third molars, mesioangular position was the most frequent (34.4%), followed by vertical, horizontal and distoangular positions. Nearly 77% of the impacted third molar roots were related to inferior alveolar canal. While no correlation was determined between gender, age, third molar angulation and gonial angle, C2 sub-group of Pell–Gregory classification showed statistically significant higher gonial angle values. Although no significance was found, gonial angle was higher in level C group. In conclusion, gonial angle is higher in patients with C2 impaction level. Also, although statistically insignificant, Pell–Gregory C group had higher gonial angle averages. © 2020 Elsevier B.V., All rights reserved.Publication Open Access Evaluation of monocyte to high-density lipoprotein ratio, lymphocytes, monocytes, and platelets in psoriasis(Elsevier Espana S.L., 2020) Aktaş Karabay, Ezgi; Demir, Damla; Aksu Çerman, Asli; Aktaş Karabay, Ezgi, Department of Dermatology and Venereology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Demir, Damla, Department of Dermatology and Venereology, University of Health Sciences, Istanbul, Turkey; Aksu Çerman, Asli, Department of Dermatology and Venereology, University of Health Sciences, Istanbul, TurkeyBackground: Psoriasis is a chronic immune-mediated inflammatory skin disease that is associated with cardiovascular comorbidities. Objectives: The objective of this retrospective study is to assess the C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio as inflammatory markers in patients with psoriasis and to search for a relationship between these parameters and psoriasis severity, as defined by the psoriasis area and severity index. Methods: There were 94 patients with psoriasis and 118 healthy controls enrolled in the study. The C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio values of two groups were retrospectively evaluated. Results: Statistically significant differences were observed in terms of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio between the patient and control groups (p = 0.001, p = 0.003, p = 0.038, and p = 0.007, respectively). Positive correlations were found between the psoriasis area and severity index and the values of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio (r: 0.381, p < 0.01, r: 0.203, p < 0.05, r: 0.268, p < 0.01, r: 0.374, p < 0.01, r: 0.294, p < 0.01, respectively). Study limitations: The small sample size and the retrospective design of the study are limitations. Conclusion: Elevated C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio were significantly associated with psoriasis. A positive correlation between C-reactive protein and monocyte-to-high-density-lipoprotein ratio leads to the suggestion that monocyte-to-high-density-lipoprotein ratio might be a reliable parameter in psoriasis during the follow-up. The relationship between the diasease and inflammatory parameters might provide early detection of cardiovascular morbidities in psoriasis patients. © 2020 Elsevier B.V., All rights reserved.