Yazar "Gülsün, Serda" seçeneğine göre listele
Listeleniyor 1 - 3 / 3
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Assessment of perioperative antimicrobial prophylaxis using ATC/DDD methodology(Elsevier Ltd., 2013) Bozkurt, Fatma; Kaya, Şafak; Gülsün, Serda; Tekin, Recep; Deveci, Özcan; Dayan, Saim; Hoşo?lu, SalihObjectives: In the light of international experience and guidelines and in order to improve the quality of perioperative antimicrobial prophylaxis (PAP), various hospitals have set up their own multidisciplinary healthcare teams and have evaluated the density of PAP through close supervision and interventions. The aim of the present study was to compare the density, quality, and cost of PAP before and after an intervention implemented at our hospital in order to increase the quality of PAP. Methods: PAP was monitored using a form prepared in line with the international guidelines, which was completed by the infection control nurse under the supervision of the infectious diseases specialist. In order to reduce the frequent errors in our PAP procedures, an intervention was implemented, and the period before this intervention (January–April 2011) was compared with the post-intervention period 1 year later (January–April 2012). The density of PAP was calculated according to the Anatomical Therapeutic Chemical classification/defined daily dose (ATC/DDD) methodology. Results: A total of 2398 patients received PAP during this period. The most frequently used antibiotic before and after the intervention was cefazolin. Its use further increased after the intervention (p < 0.001). After the intervention, the ratio of the correct timing of the first antibiotic dose increased from 91.7% to 99.0% (p < 0.001), while the excessively long administration of PAP was reduced from 77.0% to 44.7% (p < 0.001). The ratio of full compliance with the guidelines increased from 15.5% to 40.2% (p < 0.001) and the rate of surgical site infections dropped from 18.5% to 12.0%. The density of antibiotic use dropped from 305.7 DDD/100 procedures = 3.1 DDD/procedure to 162.1 DDD/100 procedures = 1.6 DDD/procedure. Conclusion: The quality of PAP may be improved through better compliance with healthcare guidelines, close supervision, and training activities. Also, surgical site infections and the cost of PAP may be reduced through more appropriate antibiotic use, thus contributing to the national healthcare budget.Öğe The course of spinal tuberculosis (Pott disease): Results of the multinational, multicentre Backbone-2 study(Elsevier B.V., 2015) Batırel, Ayşe; Erdem, Hakan; Şengöz, Gönül; Pehlivanoğlu, Filiz; Ramosaço, Ergys; Gülsün, Serda; Tekin, RecepWe aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae.Öğe Reply about “Comparison of microbiological results of deep tissue biopsy and superficial swab in diabetic foot infections”(2012) Acemoğlu, Hamit; Hoşoğlu, Salih; Tekin, Recep; Bozkurt, Fatma; Gülsün, Serda[Abstract Not Available]
