Hacettepe Üniversitesi Açık Erişim Sistemi (HÜAES)
- HÜAES, Hacettepe Üniversitesi bünyesinde üretilen kitap, makale, tez, bildiri, rapor gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, etkisini artırmak için telif haklarına uygun olarak Açık Erişime sunar.
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Recent Submissions
YATAY TARAMA GÖVDELERİ VARLIĞININ VE TARAMA STRATEJİSİNİN TAM ARK İMPLANT DESTEKLİ PROTEZLERDE DİJİTAL ÖLÇÜ DOĞRULUĞUNA ETKİSİ: İN VİTRO ÇALIŞMA
(Sağlık Bilimleri Enstitüsü, 2026-02-16) NURTAN VALİZADA; Protetik Diş Tedavisi
VALIZADA N. Effect of the Presence of Horizontal Scan Bodies and Scanning Strategy on the Accuracy of Digital Impressions in Complete-Arch Implant-Supported Prostheses: An In Vitro Study. Hacettepe University, Faculty of Dentistry, Department of Prosthodontics, Specialty Thesis, Ankara, 2026.
The aim of this in vitro study was to evaluate the effects of horizontal scan body usage and different scanning strategies on the accuracy of digital impressions for complete-arch implant-supported fixed prostheses. A mandibular edentulous stone model with six parallel implant analogs was used. A total of 120 digital scans were obtained (n = 10) using two scan body designs, three scanning strategies, and two intraoral scanners. The stone model was digitized with a laboratory scanner to generate the reference model. For all scans, a screw-retained one-piece framework was digitally designed, and the STL files were imported into an inspection software to assess impression accuracy. Frameworks from the reference and experimental models were superimposed, and deviation values were calculated for each implant.
Significantly lower deviation values were observed in the horizontal scan body groups compared with the conventional scan body groups (p < 0.05). Scanning strategies significantly affected impression accuracy, with midline-initiated strategies providing more consistent and lower deviation values. However, some scanning directions did not show a statistically significant effect on accuracy (p > 0.05).
Within the limitations of this in vitro study, digital impression accuracy in complete-arch implant-supported prostheses was significantly influenced by scan body design and scanning strategy. Horizontal scan bodies may be considered a promising option for improving digital impression accuracy by providing stable geometric reference structures.
Death following pulmonary complications of surgery before and during the SARS-CoV-2 pandemic
(2021-12) STARSurg Collaborative and COVIDSurg Collaborative; Gultekin M; Kadın Hastalıkları ve Doğum
Background
This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.
Methods
This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 2019) and the second during the SARS-CoV-2 pandemic (local emergence of COVID-19 up to 19 April 2020). Both included patients undergoing elective resection of an intra-abdominal cancer with curative intent across five surgical oncology disciplines. Patient selection and rates of 30-day postoperative pulmonary complications were compared. The primary outcome was 30-day postoperative mortality. Mediation analysis using a natural-effects model was used to estimate the proportion of deaths during the pandemic attributable to SARS-CoV-2 infection.
Results
This study included 7402 patients from 50 countries; 3031 (40.9 per cent) underwent surgery before and 4371 (59.1 per cent) during the pandemic. Overall, 4.3 per cent (187 of 4371) developed postoperative SARS-CoV-2 in the pandemic cohort. The pulmonary complication rate was similar (7.1 per cent (216 of 3031) versus 6.3 per cent (274 of 4371); P = 0.158) but the mortality rate was significantly higher (0.7 per cent (20 of 3031) versus 2.0 per cent (87 of 4371); P < 0.001) among patients who had surgery during the pandemic. The adjusted odds of death were higher during than before the pandemic (odds ratio (OR) 2.72, 95 per cent c.i. 1.58 to 4.67; P < 0.001). In mediation analysis, 54.8 per cent of excess postoperative deaths during the pandemic were estimated to be attributable to SARS-CoV-2 (OR 1.73, 1.40 to 2.13; P < 0.001).
Conclusion
Although providers may have selected patients with a lower risk profile for surgery during the pandemic, this did not mitigate the likelihood of death through SARS-CoV-2 infection. Care providers must act urgently to protect surgical patients from SARS-CoV-2 infection.
This study provides multispecialty, multicountry data with global generalizability; 7402 patients were included across 50 countries. It is the first study able to directly compare death after pulmonary complications of surgery before and during the pandemic, including both the direct effect of SARS-CoV-2 and the collateral impact of the pandemic on the safety of elective surgery.
The role of office hysteroscopy in symptomatic or asymptomatic patients in the postmenopausal period
(2023) Bilal Esat Temiz; Bilal Emre Erzeneoglu; Fatma Caner Cabukoglu; Eylül Akdeniz; Hasan Volkan Ege; Derman Basaran; Nejat Ozgul; Murat Gultekin; Kadın Hastalıkları ve Doğum
Introduction/Background
The role of office hysteroscopy in symptomatic or asymptomatic patients in the postmenopausal period
Methodology
This retrospective document study comprised 347 patients who had undergone office hysteroscopy and endometrial biopsy in our hospital since 2015. Age, BMI, presence of symptoms, endometrial thickness in sonographic evaluation, and histological diagnosis were analyzed. The study population was divided into five groups based on their histological diagnoses: benign/physiological endometrium (group A), endometrial polyp (group B), endometrial hyperplasia or intraepithelial neoplasia(EIN)(group C), endometrioid carcinoma (group D) and non-endometrioid carcinoma (group E)
Results
A total of 347 patients underwent office hysteroscopy and endometrial biopsy (77 asymptomatic, 270 postmenopausal bleeding). The median age of the patients was 54, and the mean BMI was 29.8 kg/m2. The distribution of patients was n=157(%45.2) Group A, n=155 (44.7) Group B, n=14 (%4) Group C, n=17 (%4.9) Group D, n=4 (%1.2) Group E patients. Endometrial thickness was increasing from Group A to Group E. The mean endometrial thickness is 9.2mm, 10.4mm, 13.8mm, 14.4mm, 16.2mm, respectively.
Cancer was detected in 20 (7.3%) of 271 patients with postmenopausal bleeding. Cancer was detected in only one of the asymptomatic patients. Endometrial cancer was present in 5.6% of the patients with postmenopausal polyps.
When the endometrial thickness threshold was 10 mm, 7/35 (20%) patients could not be diagnosed with cancer. When the endometrial thickness threshold was 20 mm, this figure 1 increased to 25/35 (71.4%).
Conclusion
Postmenopausal bleeding is a condition that needs attention due to the risk of endometrial cancer. In asymptomatic patients, if there is no obvious focal lesion, office hysteroscopy may not be performed.
Investigating vulvar lichen sclerosus and high-risk oncogenic HPV association
(2023) Bilal Emre Erzeneoglu; Bilal Esat Temiz; Volkan Ege; Derman Basaran; Murat Gultekin; Nejat Ozgul; Kadın Hastalıkları ve Doğum
Introduction
This prospective study aims to explore the potential connection between vulvar lichen sclerosus (LS) and the prevalence of high-risk oncogenic HPV infection.
Methods
Conducted at Hacettepe University Hospital from January to July 2023, the study included LS-confirmed biopsy and benign/nonspecific groups. Inclusion criteria encompassed women aged 30 to 40, single, 1–4 partners, non-smokers, and no diseases/condylomas. The Chi-square test assessed significance.
Results
Out of 198 vulvar biopsies, 173 had complete data. LS group (76 patients) & control (97 patients) were analyzed. LS: 34.2% (26/76) HPV-positive, 65.8% (50/76) negative. Control: 19.5% (19/97) HPV-positive, 80.5% (78/97) negative (P < 0.05).
Conclusion/Implications
The study concludes that due to the premalignant nature of vulvar lichen sclerosus, vigilant monitoring of vulvar lesions is crucial. Notably, a significant elevation in high-risk oncogenic HPV prevalence was observed among LS patients. The calculated Odds Ratio (OR) of approximately 2.84 (95% CI: [2.829, 6.235]) underscores this association’s importance. Therefore, thorough cervical pathology follow-up is advised for individuals diagnosed with vulvar LS. Larger studies can provide a deeper understanding of the complex relationship. This study contributes to the growing knowledge on vulvar LS and its potential implications on cervical health, emphasizing the need for comprehensive patient care and further research. By shedding light on this link, clinicians can better tailor their approach to LS patients, ensuring early detection and management of associated risks.
Community Palliative Care in Turkey: A Collaborative Promoter to a New Concept in the Middle East
(2016-01) Ezgi Hacıkamiloglu; Ezgi Simsek Utku; Zafer Cukurova; Bekir Keskinkilic; Ibrahim Topcu; Murat Gultekin; Michael Silbermann; Kadın Hastalıkları ve Doğum
The Middle East has been struggling with basic issues of cancer care, and in specific, palliative care, at the primary health care level in the communities. The Middle East Cancer Consortium designated this issue as the highest priority of its activities in the region. Following basic and advanced courses and national and international workshops, local governments recognized the essentiality of developing palliative care services in their respective countries. As the result of these training activities, in 2010, the Ministry of Health in Turkey initiated a novel program whereby population-based and home-based palliative care teams were developed throughout the country, including peripheral regions in the countries where appropriate care was not available. This initiative led to a dramatic increase in the number of cancer patients receiving palliative care at their homes. The Turkish initiative can serve as a model to other countries in the Middle East and beyond it.