Person: BOLUKÇU, SİBEL
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Publication Analysis of infectious spondylodiscitis: 7-years data(2018-11-01) Koc, Meliha Meric; Okay, GÜLAY; Akkoyunlu, YASEMİN; Bolukcu, SİBEL; Durdu, BÜLENT; Hakyemez, Ismail Necati; OKAY, GÜLAY; AKKOYUNLU, YASEMİN; BOLUKÇU, SİBEL; DURDU, BÜLENT; HAKYEMEZ, İSMAİL NECATİ; MERİÇ KOÇ, MELİHAObjective: Infectious spondylodiscitis (SD) is an infectious disease that is rare and difficult to diagnose due to its non-specific clinical features. In this study, we aimed to describe the clinical and diagnostic features of infectious spondylodiscitis. Methods: All patients who were diagnosed with SD at our hospital during a 7-year period from January 1, 2011 through December 31, 2017 were included in the study. Spondylodiscitis is divided into the following three types: pyogenic, tuberculous, and brucellar. Clinical and laboratory data were collected retrospectively from the medical records of the patients. Results: Of the 118 patients, 66 (55.9%) were female, 81 (68.6%) had pyogenic SD (PSD), 21 (17.8%) had tuberculous SD (TSD), and 16 (13.6%) had brucellar SD (BSD). The mean age was 59.3 ± 14.6 years. Leucocytosis was significantly higher in patients with PSD (p=0.01) than in patients with other types of SD. Thoracic involvement (47.6%) was significantly higher in patients with TSD (p=0.005) than in other patients. Sacral involvement (12.5%) was significantly higher in patients with BSD (p=0.01) than in other patients. Paravertebral abscess formation (42.8%) occurred most frequently in patients with TSD. Microbiologic agents were defined in 50% (18/36) of the surgical specimens and in 12.5% of the fine needle aspiration biopsy (FNAB) specimens. Staphylococcus aureus was the most common microbiological agent in patients with PSD. Spinal surgery was defined as a risk factor for PSD (p = 0.0001). Binary logistic regression analysis revealed that female gender, thoracic involvement and night sweats were the predictive markers for TSD (OR 4.5 [95% CI 1.3-15.3] and OR 5 [95% CI 1.7-14.6]). Conclusion: PSD is the most frequent form of SD. Leucocytosis is most common in patients with PSD. Thoracic involvement and paraspinal abscess were prominent in patients with TSD. Sacral involvement was most common in patients with BSD. Thoracic involvement, female gender and night sweats were the predictive markers for TSD. The microbiological culture positivity rate was higher in surgical specimens compared to FNAB specimens. The need for surgical treatment was most common in patients with TSD.Publication Presence of Status Epilepticus with Ebstein Barr Virus Encephalitis(2018-04-01T00:00:00Z) DENİZ, ÇİĞDEM; ASİL, Talip; BOLUKÇU, SİBEL; Zengin, S. Ulgen; DENİZ, ÇİĞDEM; ASİL, TALIP; BOLUKÇU, SİBELNeurological involvement, mostly in the form of meningoencephalitis or encephalitis, represents the leading cause of death in patients with infectious mononucleosis (EF). Central nervous system involvement usually occurs after the first 1 to 3 weeks of disease, although patients presenting with neurological signs and symptoms have been rarely reported. In this case presentation, our aim was to examine the association between acute Ebstein barr virus (EBV) infection and refractory myoclonic convulsions in a patient presenting with myodonic status.Publication Red Cell Volume Distribution Width to Platelet Ratio is an Important Predictor of Liver Fibrosis and Cirrhosis in Chronic Hepatitis B(2016-08-01) Hakyemez, Ismail Necati; BOLUKÇU, SİBEL; Durdu, BÜLENT; ASLAN, Turan; HAKYEMEZ, İSMAİL NECATİ; BOLUKÇU, SİBEL; DURDU, BÜLENTObjective: In recent years, a lot of non-invasive tests have been examined for estimating the severity of liver fibrosis in patients with chronic hepatitis B (CHB). We aimed to evaluate the role of simple and valuable platelet-derived indices in estimating the stage of fibrosis and cirrhosis in patients with CHB.Publication Evaluation of tularaemia courses: a multicentre study from Turkey(2014-12-01T00:00:00Z) ERDEM, H.; OZTURK-ENGIN, D.; YESILYURT, M.; Karabay, O.; ELALDI, NAZİF; Celebi, G.; KORKMAZ, N.; GUVEN, T.; Sumer, S.; TULEK, N.; Ural, O.; Yilmaz, G.; ERDINC, S.; Nayman-Alpat, S.; SEHMEN, E.; Kader, C.; SARI, N.; Engin, A.; CICEK-SENTURK, G.; ERTEM-TUNCER, G.; GULEN, G.; Duygu, F.; Ogutlu, A.; Ayaslioglu, E.; Karadenizli, A.; Meric, MELİHA; ULUG, M.; ATAMAN-HATIPOGLU, C.; Sirmatel, F.; CESUR, S.; COMOGLU, S.; KADANALI, A.; KARAKAS, A.; ASAN, A.; Gonen, I.; KURTOGLU-GUL, Y.; ALTIN, N.; OZKANLI, S.; YILMAZ-KARADAG, F.; CABALAK, M.; GENCER, S.; PEKOK, A. Umut; YILDIRIM, D.; SEYMAN, D.; TEKER, B.; Yilmaz, H.; YASAR, K.; Balkan, I. Inanc; Turan, H.; Uguz, M.; KILIC, S.; Akkoyunlu, YASEMİN; Kaya, S.; ERDEM, AHMET CAN; INAN, A.; CAG, Y.; Bolukcu, SİBEL; Ulu-Kilic, A.; OZGUNES, N.; GORENEK, L.; BATIREL, A.; AGALAR, C.; MERİÇ KOÇ, MELİHA; AKKOYUNLU, YASEMİN; ERDEM, AHMET CAN; BOLUKÇU, SİBELIn this multicentre study, which is the largest case series ever reported, we aimed to describe the features of tularaemia to provide detailed information. We retrospectively included 1034 patients from 41 medical centres. Before the definite diagnosis of tularaemia, tonsillitis (n=653, 63%) and/or pharyngitis (n=146, 14%) were the most frequent preliminary diagnoses. The most frequent clinical presentations were oropharyngeal (n=832, 85.3%), glandular (n=136, 13.1%) and oculoglandular (n=105, 10.1%) forms. In 987 patients (95.5%), the lymph nodes were reported to be enlarged, most frequently at the cervical chain jugular (n=599, 58%), submandibular (n=401, 39%), and periauricular (n=55, 5%). Ultrasound imaging showed hyperechoic and hypoechoic patterns (59% and 25%, respectively). Granulomatous inflammation was the most frequent histological finding (56%). The patients were previously given antibiotics for 1176 episodes, mostly with -lactam/-lactamase inhibitors (n=793, 76%). Antituberculosis medications were provided in seven (2%) cases. The patients were given rational antibiotics for tularaemia after the start of symptoms, with a mean of 26.8 +/- 37.5days. Treatment failure was considered to have occurred in 495 patients (48%). The most frequent reasons for failure were the production of suppuration in the lymph nodes after the start of treatment (n=426, 86.1%), the formation of new lymphadenomegalies under treatment (n=146, 29.5%), and persisting complaints despite 2weeks of treatment (n=77, 15.6%). Fine-needle aspiration was performed in 521 patients (50%) as the most frequent drainage method. In conclusion, tularaemia is a long-lasting but curable disease in this part of the world. However, the treatment strategy still needs optimization.Publication Efficacy and safety of co-formulated elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide in HIV-positive patients: real-world data(2021-02-01T00:00:00Z) TABAK, Ömer Fehmi; Zerdali, Esra; Altuntas, Ozlem; Gunduz, Alper; BOLUKÇU, SİBEL; METE, Bilgül; Nakir, Inci Y.; Kumbasar Karaosmanoglu, Hayat; Yildiz, Dilek S.; MERİÇ KOÇ, MELİHA; Dokmetas, Ilyas; BOLUKÇU, SİBEL; MERİÇ KOÇ, MELİHAObjectives: Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) is a recommended and widely used regimen for HIV infection. In this study, we aimed to determine the efficacy and safety of E/C/F/TAF in people living with HIV (PLWH), who are either treatment-naive or switched from any tenofovir disoproxil fumarate-containing regimen. For switched patients, we aimed to determine the impact of switching from tenofovir disoproxil fumarate (TDF) to TAF on lipid profile and kidney functions. Methods: ACTHIV-IST Study Group produced a database, and five dedicated HIV centres in Istanbul entered data of PLWH who switched from any TDF-containing regimen to E/C/F/TAF and treatment-naive patients who were initiated with the E/C/F/TAF regimen between January 2017 and December 2019. Clinical findings, viral parameters, lipid studies, renal function tests, adverse events and adherence to the treatment were recorded in this prospective observational study. Results: The study included a total of 614 switched and treatment-naive patients. Of 430 treatment-experienced patients, 89% (382) were men, and the mean age was 42 +/- 12 years. Among them, 47% (181/382) self-identified as men who have sex with men (MSM). The median duration of HIV diagnosis was 54 +/- 29 months. The median duration of E/C/F/TAF use was 20 +/- 36 months and that of previous treatment was 23 +/- 18 months. HIV-RNA was undetectable at baseline and month 12 in 84.1% (360/428) and 86.1% (328/381) of patients, respectively (p > 0.05). Mean CD4 counts were 708 +/- 287 cells/mu L and 802 +/- 305 cells/mu L at baseline and month 12, respectively (p < 0.001). Serum creatinine levels remained stable during the treatment period. Mean total cholesterol levels at baseline and month 12 were 172 and 211 mg/dL (p < 0.01), LDL-cholesterol 104 and 138 mg/dL (p < 0.01), HDL-cholesterol 39 and 49 mg/dL (p < 0.01) and triglycerides 134 and 174 mg/dL (p < 0.01), respectively. The treatment was generally well tolerated. Eight patients discontinued the therapy (drug interaction: 3; lost to follow-up: 1; pregnancy: 1; pulmonary tuberculosis: 1; side effect: 1; patient-s decision: 1). Of 184 treatment-naive patients, 88% (162) were men, and the mean age was 36.5 +/- 12 years. Among them, 50% (81/162) self-identified as MSM. The mean duration of HIV infection was 21.6 +/- 17.1 months. The mean duration of E/C/F/TAF use was 16 +/- 4 months. HIV-RNA was undetectable at baseline and month 12 in 1% and 89.1% of patients, respectively. Mean CD4 counts at baseline and month 12 were 469 +/- 223 cells/mu L and 740 +/- 298 cells/mu L, respectively. During the treatment period, creatinine levels remained stable. Total cholesterol, LDL-cholesterol, triglyceride and also HDL-cholesterol levels increased. Mean total cholesterol levels at baseline and month 12 were 167 and 211 mg/dL (p < 0.01), LDL-cholesterol 108 and 143 mg/dL (p < 0.01), HDL-cholesterol 41 and 47 mg/dL (p < 0.01) and triglycerides 136 and 172 mg/dL, respectively (p < 0.01). The treatment was generally well tolerated. Three patients discontinued the therapy (drug interaction: 1; non-responder: 1; patient-s decision: 1). Conclusion: Starting with or switching to E/C/F/TAF in PLWH effectively suppresses HIV infection, is associated with an increase in CD4 cell count and is well tolerated in a real-life setting. Renal functions remained stable during the treatment.Publication Infective endocarditis case due to streptococcus parasanguinis presented with spondylodiscitis(2016-01-01) Hakyemez, Ismail Necati; Durdu, BÜLENT; Okay, GÜLAY; GULTEPE, Bilge; Bolukcu, SİBEL; ASLAN, Turan; HAKYEMEZ, İSMAİL NECATİ; DURDU, BÜLENT; OKAY, GÜLAY; BOLUKÇU, SİBEL; SÜMBÜL, BİLGEStreptococcus parasanguinis is a natural member of oral flora. It is an opportunistic pathogen, and rarely cause systemic infections due to it-s low virulence. Subacute infective endocarditis may present with various clinical manifestations (eg., spondylodiscitis). A sixty-five years old male patient from Northern Iraq has referred to our emergency service with high fever, weight loss, back pain and inability to walk. The patient was a veterinarian. He was operated three years ago for colonic carcinoma and irradiated. In magnetic resonance imaging, spondylodiscitis was detected localized in lumbar 1-2 region. Transthorasic echocardiography demonstrated aortic valve vegetation. S. parasanguinis was identified in the blood cultures. In conclusion; all in all, it-s remarkable to isolate S. parasanguinis as a causal agent of infective endocarditis in a patient who is a veterinarian with history of colonic carcinoma presented with clinical manifestation of spondylodiscitis.Publication A rare cause of liver abscess secondary to hydatid cyst: pseudomonas stutzeri(2016-01-01) Durdu, BÜLENT; Hakyemez, Ismail Necati; Bolukcu, SİBEL; Okay, GÜLAY; ASLAN, Turan; DURDU, BÜLENT; HAKYEMEZ, İSMAİL NECATİ; BOLUKÇU, SİBEL; OKAY, GÜLAYPseudomonas stutzeri is non-fermentative gram negative bacteria which rarely leads to infections. In this report, we presented for the first time a liver abscess which was caused by P.stutzeri.Publication COVID-19 and Influenza Coexistence(2021-02-01T00:00:00Z) Uslu Ersoz, Ayse Betul; BOLUKÇU, SİBEL; Andic, Nurgul; Karakus, Dilara; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHA; USLU, AYŞE BETÜL; BOLUKÇU, SİBEL; ANDIÇ, NURGÜL; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHAObjective: Viral pneumonia cases occur quite frequently in the community. The rate of viral infections in community-acquired pneumonia is about 25%. severe acute respiratory syndrome coronas i rus-2 (SARS-CoV-2) and influenza are also viruses that can cause pneumonia. In this study. we aimed to determine the rate of influenza co-infection in Coronavirus disease-19 (COVID-19) Cases. Methods: The data of adult patients who applied to Bezmialem Vakif University Hospital between March 6, 2020, and May 21, 2020, which were positive with the SARS-CoV-2 polymerase chain reaction (PCR) test and influenza antigen test were retrospectively scanned from the hospital automation system. Results: SARS-CoV-2 PCR test was found positive in 498 adult patients who applied to our hospital. Two hundrend-sixty of these patients were hospitalized and 238 were followed up on an outpatient basis. In 88 patients SARS-CoV-2 PCR and influenza antigen were studied, and 6 of them had positive influenza antigen. COVID-19 and influenza co- i n feet ion was not detected. Conclusion: In order to determine the exact rate of influenza and COVID-19 co-infection, it is necessary to evaluate the patients who applied with the appropriate clinical picture from the beginning of the seasonal influenza period by using reverse transcription-PCR fur these two viral infections, if possible. Further research is needed in this area.Publication Prospective Assessment of Blood Cultures Which Were Sent to the Clinical Microbiology Laboratory(2018-08-01T00:00:00Z) BOLUKÇU, SİBEL; Basran, Seniha; Cagatay, Atahan; Ozsut, Halit; Eraksoy, Haluk; BOLUKÇU, SİBELObjective: We aimed to evaluate the patient factors which increase the probability of achieving a positive blood culture, distribution of microorganisms grown, and to reveal the impact of various factors during collection of blood on blood culture positivity.Publication Bir Üniversite Hastanesine Ayaktan Başvuran >=65 Yaşındaki Yüz Yetmiş Dört Hastanın Değerlendirmesi(2017-10-08) Sümbül Gültepe, Bilge; Durdu, BÜLENT; Okay, GÜLAY; Bolukçu, SİBEL; HAKYEMEZ, İSMAİL NECATİ; AKKOYUNLU, YASEMİN; ASLAN, TURAN; BOLUKÇU, SİBEL; OKAY, GÜLAY; SÜMBÜL, BİLGE; HAKYEMEZ, İSMAİL NECATİ; DURDU, BÜLENT; AKKOYUNLU, YASEMİN
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