Person: BOLUKÇU, SİBEL
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Publication Open Access 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 Metadata only Impact of switching to E/C/F/TAF on lipid profile and renal function in HIV-infected patients(2019-11-01T00:00:00Z) Mete, B.; Gunduz, A.; Zerdali, E.; Senoglu, S.; BOLUKÇU, SİBEL; Nakir, I. Yilmaz; Karaosmanoglu, H. Kumbasar; Koc, MELİHA; Bilge, B.; Dokmetas, I.; Tabak, F.; BOLUKÇU, SİBEL; MERİÇ KOÇ, MELİHAPublication Open Access Tocilizumab treatment in severe COVID-19: a multicenter retrospective study with matched controls(2021-09-01T00:00:00Z) Mert, Ali; VAHABOĞLU, HALUK; ARSLAN, FERHAT; Batirel, Ayse; Saracoglu, Kemal Tolga; Bastug, Aliye; Cagatay, Atahan; IRMAK, İLİM; TELLİ DİZMAN, GÜLÇİN; Ertenli, Ihsan; Altunal, Lutfiye Nilsun; ERTÜRK ŞENGEL, BUKET; Bayram, Mehmet; Omma, Ahmet; Amikishiyev, Shirkhan; Aypak, Adalet; Bes, Cemal; BOLUKÇU, SİBEL; Icten, Sacit; TOPELİ İSKİT, ARZU; Bektas, Murat; Arslan, Birsen Yigit; Ozturk, Sinan; Comoglu, Senol; Aydin, Selda; Kucuksahin, Orhan; Icacan, Ozan Cemal; Ince, Burak; Aghamuradov, Sarvan; Mutlu, Melek Yalcin; Simsek, Funda; Emre, Salih; Ustun, Cemal; Ergen, Pinar; Aydin, Ozlem; MERİÇ KOÇ, MELİHA; Sevindik, Omur Gokmen; ODABAŞI, ZEKAVER; KORTEN, VOLKAN; Bodur, Hurrem; Guner, Rahmet; ÜNAL, SERHAT; Kocak, Mehmet; Gül, Ahmet; BOLUKÇU, SİBEL; MERİÇ KOÇ, MELİHACoronavirus disease-2019 (COVID-19) associated pneumonia may progress into acute respiratory distress syndrome (ARDS). Some patients develop features of macrophage activation syndrome (MAS). Elevated levels of IL-6 were reported to be associated with severe disease, and anti-IL-6R tocilizumab has been shown to be effective in some patients. This retrospective multicenter case-control study aimed to evaluate the efficacy of tocilizumab in hospitalized COVID-19 patients, who received standard of care with or without tocilizumab. Primary outcome was the progression to intubation or death. PSMATCH (SAS) procedure was used to achieve exact propensity score (PS) matching. Data from 1289 patients were collected, and study population was reduced to 1073 based on inclusion-exclusion criteria. The composite outcome was observed more frequently in tocilizumab-users, but there was a significant imbalance between arms in all critical parameters. Primary analyses were carried out in 348 patients (174 in each arm) after exact PS matching according to gender, ferritin, and procalcitonin. Logistic regression models revealed that tocilizumab significantly reduced the intubation or death (OR 0.40, p = 0.0017). When intubation is considered alone, tocilizumab-users had > 60% reduction in odds of intubation. Multiple imputation approach, which increased the size of the matched patients up to 506, provided no significant difference between arms despite a similar trend for intubation alone group. Analysis of this retrospective cohort showed more frequent intubation or death in tocilizumab-users, but PS-matched analyses revealed significant results for supporting tocilizumab use overall in a subset of patients matched according to gender, ferritin and procalcitonin levels.Publication Open Access Investigation the Relationship Between Body Mass Index and Mortality in COVID-19 Patients(2021-02-01T00:00:00Z) BOLUKÇU, SİBEL; ÖZMEN, MEHMET EMİN; EKŞİ, ÇAĞLA; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHA; BOLUKÇU, SİBEL; ÖZMEN, MEHMET EMİN; EKŞİ, ÇAĞLA; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHAObjective: Obesity might be a risk factor for patients with Coronavirus disease-19 (COVID-19). We aimed to investigate the association of the obesity with intensive care need and mortality caused by severe acute respiratory syndrome-CoV-2 (SARS-CoV-2) infection in this retrospective cohort. Methods: Between March 11th and May 1st, 135 patients, who were treated in our clinic, were enrolled in the study. Body mass index (BMIs) of the patients were grouped according as WHO criteria (<25 kg/m(2): normal, 25 30 kg/m(2): overweight, >30 kg/m(2): obese). Results: Of our patients, 34.1% (n=46) were obese. Mean BM! of the mortality group was 31.2 kg/m(2) and was not different from that of the survivors (p=0.09), However, mean BMI of the patients, in whom intensive care was needed, teas 31.2 kg/m(2) and higher than that of those intensive care was nut needed (p=0.04). In subgroup analyses, obesity (BMI >31) kg/m(2)) was more common among mortality group versus survivors in males older than 60 years old (p=0.03). Conclusion: Obesity with associated disorders are negative prognostic factors for COVID-19 and should be tackled as the end of the pandemic is obscure.Publication Open Access 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 Metadata only HIV care in Istanbul, Turkey: How far is it from the UNAIDS 90-90-90 targets?(2019-11-15T00:00:00Z) Mete, Bilgul; Gunduz, Alper; BOLUKÇU, SİBEL; Karaosmanoglu, Hayat K.; Yildiz, Dilek; Koc, MELİHA; Aydin, Ozlem A.; Dokmetas, Ilyas; Tabak, Fehmi; BOLUKÇU, SİBEL; MERİÇ KOÇ, MELİHAThe prevalence of human immunodeficiency virus (HIV) infection is low but it is steadily increasing in Turkey. In the current study, we aimed to assess the status of HIV infection management with the proposed 90-90-90 targets in a large HIV cohort in Istanbul, Turkey. The cohort included 2382 patients (2082 male, 300 female, mean age was 36.3 +/- 11.3 years). Mean CD4 cell count was 399 cells/mm(3) and HIV-RNA level was 576,235 copies/ml. According to the modeling by the Modeling tool of European Center for Diseases Control Software, 72 and 74% of all HIV patients had been diagnosed in 2016 and 2017, respectively (the first target). Among 2382 patients, 2191 (92%) were on antiretroviral therapy (the second target). The third target of virally suppressing those on treatment was achieved among 70.2% of the patients. The current study suggests that both the fraction of those living with undiagnosed HIV and the proportion of those on treatment who are virally suppressed should be targeted to sustain optimal HIV care. Efforts should continue to surpass the targets of 90-90-90.Publication Metadata only 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.