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    Fournier's gangrene: Review of 36 cases
    (Turkish Assoc Trauma Emergency Surgery, 2019) Caliskan, Selahattin; Ozsoy, Emrah; Sungur, Mustafa; Gozdas, Hasan Tahsin
    BACKGROUND: Fournier's gangrene (FG) is a very rare disease in daily urological practice. Despite medical improvements, mortality in FG is still high. Early diagnosis is very important to reduce additional instrumentations and mortality. In this study, we aimed to present the characteristics of the patients with Fournier's gangrene followed in two centers during ten years period. METHODS: The medical records of patients with FG were reviewed retrospectively. The patient characteristics, causative pathogens, laboratory findings and treatment modalities were evaluated. RESULTS: A total of 36 FG cases admitted between January 2008 and February 2018 were included in this study, consisting of 35 male patients, and one female patient with a mean age of 59.27 +/- 12.91 years. The mean duration of hospital stay was 19 +/- 10.44 days. The most common predisposing factor was diabetes mellitus, which was found in 28 patients. Malignancy was detected in three patients; prostate cancer in two patients and chronic lymphoblastic leukemia in one patient. Two patients had liver cirrhosis, and one patient had Behcet's disease and psoriasis. The microbiological agent was isolated from a wound culture in nine patients. After urgent surgical debridement, daily dressing with nitrofurazone (Furacin) was done. Additional debridement was conducted when necessary. Orchiectomy was performed in 10 patients; two of them underwent bilateral orchiectomy. One patient died because of sepsis on the seventh day of hospital admission. CONCLUSION: FG is a life-threatening urological emergency with a high mortality rate. Treatment with broad-spectrum antibiotics and urgent surgery is pivotal for the prevention of mortality.
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    Is Benzathine Penicillin the Treatment of Choice in Neurosyphilis?
    (Elsevier Science Inc, 2023) Gozdas, Hasan Tahsin; Dogan, Ahmet
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    Laboratory findings in acute bacterial meningitis and acute viral encephalitis
    (New Zealand Medical Assoc, 2024) Gozdas, Hasan Tahsin; Dogan, Ahmet
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    Monocyte-to-Hdl-Cholesterol Ratio as a Prognostic Marker in Covid-19
    (Jpms Publ, 2024) Ergenc, Hasan; Ergenc, Zeynep; Gozdas, Hasan Tahsin; Ocak, Ozlem Karaca; Ince, Ozgur; Bal, Tayibe
    Background: There is an urgent need for mortality predictors for COVID-19 so that clinicians can diagnose severe cases and triage them as soon as possible. Many studies have suggested using hematologic markers to predict mortality and severity of COVID-19 disease. This study investigates the use of monocyte-to-high density lipoprotein cholesterol ratio (MHR) as a predictive marker for COVID-19 severity and mortality. Methods: This retrospective cross-sectional study was performed on 81 PCR-confirmed COVID-19 patients between 25 March 2020 to 26 June 2020. Patients were classified into two presentation categories: the non-severe group (n=37) and the severe group (n=44). Patients in the severe group were also divided into two subgroups: severe survivors (n=14) and severe non-survivors (n=30). In the receiver operating characteristic (ROC) analysis, optimal cut -off values of the monocyte count, high -density lipoprotein cholesterol (HDL-C), and MHR were calculated for the differentiation of severe and non-severe COVID-19 patients, as well as survivors and non-survivors. Results: A total of 81 patients, 29 (35.8%) males and 52 (64.2) females, with a median age of 71 (IQR 63-81) years. Both HDL-C and MHR showed a reasonable ability to distinguish severe disease from non-severe disease, while MHR had a higher area under curve (AUC) than HDL-C (0.799, 95%CI 0.704-0.894, p < 0.001 vs 0.734, 95% Cl 0.626-0.843, p < 0.001). Only MHR could distinguish survivors from non-survivors with an ROC AUC of 0.735 (95%Cl 0.619-0.850). The optimal cut -off values of MHR for predicting severe disease were 0.0061 (sensitivity: 66% and specificity: 66%) and 0.0066 (sensitivity: 70% and specificity: 62%) for predicting mortality. The optimal cut -off value of MHR for predicting severe disease was 0.0061 (sensitivity: 66% and specificity: 66%), and it was 0.0066 for predicting mortality among patients with severe disease (sensitivity: 70% and specificity: 62%). Conclusion: Our results showed that MHR was observed to be able to distinguish severe COVID-19 patients from non-severe patients as well as survivors from non-survivors.
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    The Most Common Causes and Treatment Duration of Viral Encephalitis
    (Elsevier Inc., 2024) Gozdas, Hasan Tahsin
    [No abstract available]
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    An Outbreak of Postoperative Rapidly Developing and Multidrug-Resistant Klebsiella Pneumoniae Urosepsis Due to a Contaminated Ureteroscope
    (Medical University of Plovdiv, 2022) Güler, Yavuz; Erbin, Akif; Gozdas, Hasan Tahsin
    Introduction: Outbreaks caused by microorganisms contaminating the inside of rigid ureteroscopes are extremely rare. Some of these outbreaks, especially those caused by multidrug-resistant (MDR) infections, can cause serious problems, even death. Among these serious infections, we have no data about Klebsiella pneumoniae outbreaks caused by rigid ureteroscopes and their management and consequences. Aim: We aimed to report the outcomes of an outbreak of rapidly developing MDR K. pneumoniae urosepsis linked to rigid ureteroscopy (URS). Materials and methods: Data for 68 patients who had ureteroscopic lithotripsy (URS-L) operations using the same ureteroscope were retrospectively reviewed. Among them, 17 patients with postoperatively developing urosepsis were included in the study. Samples were taken from the operating room, camera heads, endoscopes, and ancillary instruments for culture workup. K. pneumoniae was produced in a swab culture obtained from the water inlet channel of the ureteroscope. Results: All patients had sepsis signs that developed within hours (2-7 hours). MDR K. pneumoniae was detected in the urine cultures of all patients. It was sensitive only to amikacin, tigecycline, colistin, and netilmicin. All patients were treated with tigecycline (100 mg intravenous daily). It was observed that K. pneumoniae growth continued without any symptoms in the first and fourth weeks of followup in 4 patients. These patients were accepted as colonization; no additional treatment was given. Conclusions: In the case of rapidly developing urosepsis after the URS procedure in a patient, instruments, devices, and endoscopes should be immediately checked for contamination to prevent the emergence of an outbreak. © 2022 Folia Medica. All rights reserved.
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    True indications for rabies postexposure prophylaxis
    (W B Saunders Co-Elsevier Inc, 2022) Gozdas, Hasan Tahsin
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