Person: BOLUKÇU, SİBEL
9 results
Search Results
Now showing 1 - 9 of 9
Publication Open Access 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 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 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 Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis(2015-06-01) ERDEM, Hakan; CAG, Yasemin; OZTURK-ENGIN, Derya; Defres, Sylviane; KAYA, SELÇUK; LARSEN, Lykke; POLJAK, Mario; BARSIC, Bruno; ARGEMI, Xavier; SORENSEN, Signe Maj; BOHR, Anne Lisbeth; TATTEVIN, Pierre; Gunst, Jesper Damsgaard; BASTAKOVA, Lenka; JEREB, Matjaz; JOHANSEN, Isik Somuncu; Karabay, Oguz; PEKOK, Abdullah Umut; Sipahi, Oguz Resat; Chehri, Mahtab; BERAUD, Guillaume; SHEHATA, Ghaydaa; DEL VECCHIO, Rosa Fontana; MARESCA, Mauro; Karsen, Hasan; SENGOZ, Gonul; Sunbul, Mustafa; Yilmaz, Gulden; Yilmaz, Hava; SHARIF-YAKAN, Ahmad; KANJ, Souha Shararah; Parlak, Emine; PEHLIVANOGLU, Filiz; KORKMAZ, Fatime; Komur, Suheyla; KOSE, Sukran; ULUG, Mehmet; Bolukcu, SİBEL; COSKUNER, Seher Ayten; Ince, Nevin; Akkoyunlu, YASEMİN; HALAC, Gulistan; Sahin-Horasan, Elif; TIRELI, Hulya; KILICOGLU, Gamze; AL-MANDAWI, Akram; Nemli, Salih Atakan; INAN, Asuman; SENBAYRAK, Seniha; STAHL, Jean Paul; VAHABOGLU, Haluk; BOLUKÇU, SİBEL; AKKOYUNLU, YASEMİNData in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome.Publication Open Access Assessment of the 24th Week Success of Anti-Retroviral Therapy in the Action against HIV in Istanbul Database: Results from a Region with Increasing Incidence(2019-05-01) Bolukçu, Sibel; METE, BİLGÜL; Gündüz, Alper; Karaosmanoglu, Hayat Kumbasar; Sargın, Fatma; DURDU, BÜLENT; Aydin, Ozlem Altuntas; Yildiz, Dilek; DÖKMETAŞ, İLYAS; Asian, Turan; TABAK, ÖMER FEHMİ; BOLUKÇU, SİBEL; DURDU, BÜLENTWe aimed to assess the 24-week virological and immunological success of the treatment of treatment-naive and treatment-experienced patients included in the Action against HIV in Istanbul (ACTHIV-IST) database. The ACTHIV-IST database was screened retrospectively from January 2012 to January 2014. The data for these patients such as age, sex, treatment-naive or treatment-experienced status, date of diagnosis, date of commencing antiretroviral therapy, antiretroviral therapy regimen, CD4+ cell count, and viral load before and after therapy were analyzed. In the 24th week of antiretroviral therapy, there were 40 (17.9%) and 29 (14.1%) virological and immunological failures, respectively. Virological failure (VF) was associated with a baseline viral load > 100,000 copies (p = 0.004). A CD4+ cell count lower than 200 cells/µl was not found to be associated with VF (p = 0.843). Immunological failure was substantially rare in patients with a baseline CD4+ cell count > 200 cells/µl (p = 0.005). Although an HIV-RNA 侑 100,000 copies/ml was protective against VF in the 24th week, in individuals with an HIV-RNA > 100,000 copies/ml, VF was 3.2 times more likely to occur. Baseline VF was the most predictive parameter to estimate 24th week virological success and VF. VF is an important prognostic parameter resulting in CD4+ cell depletion, AIDS-related events, and increased mortality.Publication Open Access Mortality markers in nosocomial Klebsiella pneumoniae bloodstream infection(2016-10-28) Durdu, BÜLENT; Hakyemez, Ismail Necati; BOLUKÇU, SİBEL; OKAY, GÜLAY; ASLAN, Turan; DURDU, BÜLENT; HAKYEMEZ, İSMAİL NECATİ; BOLUKÇU, SİBEL; OKAY, GÜLAY; SÜMBÜL, BİLGEPurpose: Klebsiella pneumoniae is the most common endogen agent for nosocomial infections. In this study, mortality markers were investigated in patients with nosocomial K. pneumoniae blood stream infection (NKp BSI). Methods: The characteristics of patients >16 years who had NKp BSI diagnosis by daily active surveillance between January 2012 and January 2016 were retrospectively evaluated. Patients who died until 28th day of the clinical follow up and those who survived until this time were statistically compared in terms of various risk factors. Results: One hundred ninety patients were included into the study. Mortality rate was 47.9%, carbapenem resistance was 43.2%. Statistical analysis have shown that in presence of post-NKp BSI sepsis, septic shock, following in intensive care unit (ICU), meropenem resistance, kidney failure, NKp BSI secondary to pneumonia, use of invasive instruments such as central venous catheter (CVC), urinary catheter (UC) and mechanical ventilator (MV), colostomy, transfusion and hemodialysis mortality was significantly higher. In patients admitted into the hospital for neurological disorders, pancreaticobiliary tract (PBT) diseases and patients who have undergone endoscopic retrograde cholangiopancreatography (ERCP) and patients in whom NKp BSI secondary to PBT infection mortality rate was lower. Conclusions: Sepsis, septic shock, clinical conditions requiring ICU treatment and meropenem resistance increase mortality rates in NKp BSI significantly. Mortality was higher also in patients with NKp BSI secondary to pneumonia, in kidney failure and when invasive instruments were used. On the other hand, in patients who were admitted to the hospital for neurological disorders and PBT diseases mortality rate was lower.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 Open Access 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.