Hacettepe Üniversitesi Açık Erişim Sistemi (HÜAES)
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TIP FAKÜLTESİ ÖĞRENCİLERİNİN ZONA HASTALIĞI VE ZONA AŞISIYLA İLGİLİ BİLGİ DÜZEYİNİN DEĞERLENDİRİLMESİ: TANIMLAYICI KESİTSEL ÇALIŞMA
(Tıp Fakültesi, 2025) Merve KOÇAK BAŞAR; Aile Hekimliği
Herpes zoster develops through reactivation of latent varicella
zoster virus following prior varicella infection and can lead to serious complications particularly in older adults and immunosuppressed individuals. With population aging, the global incidence of the disease is rising, imposing an increasing burden on health systems and public health. Vaccination is one of the most effective current methods of prevention. The applicability of vaccination to target groups is directly related to
physicians’ knowledge and awareness. This study aims to assess the knowledge level of medical faculty students regarding herpes zoster and the herpes zoster vaccine. The study employed a descriptive cross-sectional design and was conducted by the Hacettepe University Faculty of Medicine, Department of Family Medicine between 15 May 2025 and 15 June 2025 among Year 3, 4, 5, and 6 medical students who presented to the Family Medicine outpatient clinics at Hacettepe University Hospital, Sıhhiye Campus, using a face-to-face questionnaire. The questionnaire comprised two parts: the first included 8 demographic questions; the second included 12 questions on herpes zoster and 8 on the zoster vaccine, totaling 28 questions. A total of 257 students participated. The overall knowledge level was moderate; across 20 knowledge questions, the mean correctness was 65.3% ± 20.4%. The principal factors that increased knowledge were class year (B=3.520; p<0.001) and receiving education about vaccines during training (B=2.750; p=0.003),
whereas age showed a negative association with knowledge (B=−0.620; p=0.004). In logistic regression, each higher class year increased the odds of having high knowledge by approximately 1.5-fold (OR=1.51; p<0.001), and having received vaccine education increased this odds by about 3.4-fold (OR=3.39; p=0.011); other sociodemographic variables (sex, presence of a healthcare worker in the family, presence of chronic disease, history of zoster, and zoster in close contacts) showed no independent effects. The highest correctness rates pertained to core clinical items (etiologic virus, risk groups, complications, and treatment), whereas notable knowledge gaps were observed for vaccine-related issues (efficacy, administration, licensure, and reimbursement). These findings indicate a need to strengthen curriculum content specifically on zoster vaccination.
Düşük Riskli Myelodisplastik Sendrom Hastalarının Progresyon Karakteristiğine Etki Eden Klinik ve Patolojik Faktörlerin Belirlenmesi
(Tıp Fakültesi, 2025-12-31) Elif Naz KABUKCU; İç Hastalıkları
Background: Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders with a highly heterogeneous clinical course, ranging from indolent low-risk forms to progression to high-risk MDS or acute myeloid leukemia (AML). Although numerous clinical, laboratory, pathological, and cytogenetic factors have been associated with disease progression, accurately predicting progression at the time of diagnosis remains a major clinical challenge. Early identification of patients at higher risk is crucial for optimizing follow-up strategies and therapeutic decision-making.
Objective: The aim of this study was to evaluate clinical, laboratory, pathological, and cytogenetic factors associated with progression to high-risk MDS or AML in patients diagnosed with low- and intermediate-risk MDS at baseline.
Methods: A total of 262 adult patients followed in the adult hematology unit of Hacettepe University Hospitals between January 1, 2010, and January 1, 2024, and classified as low or intermediate risk according to the Revised International Prognostic Scoring System (IPSS-R) at diagnosis were retrospectively analyzed. Disease progression was defined as progression to high- or very high-risk MDS or transformation to AML during follow-up. Demographic, clinical, laboratory, pathological, and cytogenetic data were recorded. Factors associated with progression
were assessed using univariate and multivariate logistic regression analyses. Overall survival and time-to-progression were analyzed using the Kaplan–Meier method.
Results: During follow-up, disease progression occurred in 23 patients (8.8%). The mortality rate among patients with progression was 82.6%. No significant association was observed between progression and age or sex. Baseline IPSS-R risk category was significantly associated with disease progression (p=0.002). Hemoglobin level, platelet count, absolute neutrophil count, serum ferritin level, number of dysplastic lineages, presence of sideroblasts, and bone marrow fibrosis were not identified as significant prognostic factors. A bone marrow blast percentage ≥5% at
diagnosis was an independent and strong predictor of progression (OR: 3.93; p =0.007). Cytogenetic analysis demonstrated that the presence of del(5q) significantly increased the risk of progression (OR: 4.06; p =0.031). Although del(7q) and del(11q) showed a trend toward increased progression risk, they did not reach statistical significance in multivariate analyses.
Conclusion: In patients with low- and intermediate-risk MDS, baseline IPSSR risk category, bone marrow blast percentage, and selected cytogenetic abnormalities are key determinants of disease progression. In contrast, cytopenias, dysplasia-related features, serum ferritin levels, and bone marrow fibrosis alone were insufficient to predict progression. These findings emphasize the importance of closer surveillance
strategies, particularly focusing on blast percentage and cytogenetic characteristics, in low- and intermediate-risk MDS patients.
Geçmişte Seçici Konuşmazlık Tanısı Alan Hastaların İzlem Çalışması ve Seçici Konuşmazlık Semptomları ile Mükemmeliyetçilik Arasındaki İlişkinin İncelenmesi
(Tıp Fakültesi, 2025) Özdemir, Zeliha Büşra; Aslan, Cihan; Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları
The aim of this study was to examine the current psychiatric status, anxiety levels, perfectionism traits, and self-esteem of adolescents diagnosed with selective mutism (SM) in childhood, and to evaluate the relationships between these variables and parental perfectionism and parenting attitudes. A total of 36 adolescents aged 12-18 years at the time of assessment, who had been diagnosed with SM between 2015 and 2020 according to the records of the Hacettepe University Department of Child and Adolescent Psychiatry, and their parents were included in this single-center, cross-sectional, descriptive-correlational follow-up study. The diagnosis of SM was confirmed through file review and clinical evaluation. Lifetime and current psychiatric diagnoses were assessed using the DSM-5-adapted K-SADS-PL semi-structured diagnostic interview. Adolescents completed the Screen for Child Anxiety Related Emotional Disorders (SCARED) to assess anxiety levels, the Child and Adolescent Perfectionism Scale (CAPS) to evaluate perfectionism, the Rosenberg Self-Esteem Scale to assess self-esteem, and the Parental Attitude Scale (PAS) to evaluate perceived parental attitudes. Parents completed the Hewitt Multidimensional Perfectionism Scale (HMPS) and the PARI (Parental Attitude Research Instrument). At least one psychiatric diagnosis during adolescence was identified in 94.4% of the sample. The most common comorbid diagnoses were attention-deficit/hyperactivity disorder (55.6%), specific learning disorder (41.7%), and social anxiety disorder (36.1%). Approximately half of the participants were still under psychiatric follow-up, and more than one-third were using psychotropic medication. While only 6 adolescents (16.7%) met the full diagnostic criteria for SM, 10 adolescents (27.8%) exhibited subthreshold SM symptoms. Higher levels of social anxiety were observed in cases in which SM symptoms persisted for a longer duration. Contrary to expectations, adolescents without current SM symptoms had higher levels of self-oriented perfectionism. Logistic regression analysis showed that self-oriented perfectionism was negatively associated with the presence of SM symptoms in adolescence. No significant relationship was found between parental perfectionism, parenting attitudes, and the persistence of SM symptoms during adolescence. Self-esteem levels were found to be more related to anxiety levels than to perfectionism symptoms; as anxiety increased, self-esteem decreased and perfectionism scores increased. In conclusion, selective mutism should not be considered merely a transient speech inhibition limited to early childhood; it may continue into adolescence as a multidimensional clinical condition associated with anxiety levels, neurodevelopmental comorbidities, and certain dimensions of perfectionism.
Göğüs Duvarı Deformitelerinde Uygulanan Non-Operatif Tedavide Hasta Memnuniyeti
(2025) TUNÇ TIĞLI; Çocuk Cerrahisi
Patients who underwent non-operative treatment for chest wall deformities at Hacettepe University Faculty of Medicine Department of Pediatric Surgery between 2018-2023 were retrospectively reviewed. 20 PE patients (15 male, 5 female; median age 9.0 years) and 10 PC patients (8 male, 2 female; median age 14.25 years) were included in the study. The time from noticing the deformity to diagnosis was median 15.0 months (25-75 percentile: 8.0-19.0) in the PE group and median 12.0 months (25-75 percentile: 10.0-14.0) in the PC group. Demographic data, anthropometric measurements, cardiopulmonary evaluations, and Body Image-Quality of Life questionnaire results were assessed. Vacuum therapy was applied to PE patients and compression brace therapy to PC patients. In the PE group, after median 10.0 months of treatment, a median 68.3% improvement in deformity depth at 12-month follow-up (25-75 percentile: 60.4%-75.4%), median 1.2 cm (25-75 percentile: 0.75-1.4) improvement in anteroposterior diameter, treatment motivation score of median 49.0, and Haller index of median 2.94 (25-75 percentile: 2.40-3.50) were achieved. In the PC group, after median 12.0 months of treatment, a 66.7% reduction in correction pressure (25-75 percentile: 62.2%-66.7%), median 1.5 cm (25-75 percentile: 1.3-2.5) improvement in anteroposterior diameter, and treatment motivation score of median 50.5 were obtained. In patient questionnaires, physical limitations score was significantly higher in the PE group (median 15.0 vs 7.0, p=0.001), while no significant difference was found between groups in terms of body image disturbance, treatment motivation and social disadvantage. In parental evaluations, body image disturbance and physical limitations were higher in the PE group, while treatment motivation was higher in the PC group. In conclusion, non-operative treatment methods provide objective anatomic improvement and positive psychosocial outcomes with appropriate patient selection and treatment compliance. It has been demonstrated that quality of life, body image, and psychosocial parameters should be evaluated in addition to anatomic improvement in assessing treatment success.
Yakınını Kaybetmiş Yaşlılarda Uzamış Yas Belirtilerini Yordayan Etkenlerin İncelenmesi
(Tıp Fakültesi, 2025) Fatma Özlem Coşkun Kurban; Ruh Sağlığı ve Hastalıkları
Kurban Coşkun, Ö., Investigation of Factors Predicting Prolonged Grief Symptoms in Bereaved Older Adults, Hacettepe University Faculty of Medicine, Department of Psychiatry, Dissertation Thesis in Psychiatry, Ankara, 2025. Grief is a complex and multidimensional adaptation response to the loss of a loved one. Although most individuals are able to adapt to their loss over time, in some individuals, this process can become prolonged, leading to significant emotional distress and loss of functionality. Due to increased physical, cognitive, and social frailties in old age, the grief process becomes more complex, and prolonged grief disorder stands out as an important mental health problem in this age group. The aim of this study is to examine the severity of prolonged grief symptoms and the sociodemographic and psychosocial factors associated with the diagnosis of Prolonged Grief Disorder in older adults who have experienced the loss of a first-degree relative. The study, conducted in a descriptive, cross-sectional, and relational design, included 82 older adults aged 60 and over who applied to the psychiatry and geriatrics outpatient clinics of Hacettepe University Adult Hospital and whose loss of a first-degree relative had occurred at least 6 months prior. All participants were administered the Prolonged Grief Disorder Scale (PG-13), Beck Depression Inventory, Multidimensional Continuing Bonds Scale, Grief and Meaning Reconstruction Inventory, Coping Skills Scale, Multidimensional Scale of Perceived Social Support, and Lawton-Brody Instrumental Activities of Daily Living Scale. Data were evaluated using descriptive statistics, correlation analyses, one-way analysis of variance, and multiple hierarchical regression. As a result of the evaluations, it was determined that the severity of prolonged grief symptoms in the sample was at a moderate-to-high level and that approximately one-third of the participants (32.9%) had a diagnosis of Prolonged Grief Disorder. In comparisons made according to the type of loss, it was found that those who experienced the loss of a child had significantly higher PG-13 scores, particularly compared to those who experienced the loss of a spouse or parent. It was determined that as the severity of depression increased, prolonged grief symptoms also increased significantly. In the final model of the hierarchical regression analysis; type of loss, time elapsed since the loss, age of the deceased, cognitive restructuring, perceived social support, continuing bonds, depression level, and daily living functionality were determined as significant predictors of prolonged grief symptom severity. Additionally, the established model explained a very large portion (91.9%) of the variance in prolonged grief symptom severity. In conclusion, it was determined that prolonged grief is prevalent among older adults, and the nature of the loss, accompanying depression, coping patterns, and daily living functionality significantly affect this process. Systematically questioning prolonged grief symptoms in the clinical assessment of older adults in the grieving process and developing targeted psychosocial interventions are of critical importance in terms of clinical course and quality of life.