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SÜMBÜL, BİLGE

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BİLGE
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SÜMBÜL
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Now showing 1 - 4 of 4
  • PublicationMetadata only
    Kronik Hemodiyaliz Hastalarında BNT162b2 ve CoronaVac’a Karşı Hümoral Yanıt: Çok Merkezli Prospektif Çalışma
    (2022-11-09) Mirioğlu Ş.; Kazancıoğlu R.; Cebeci E.; Eren N.; Sakacı T.; Alagöz S.; Tuğcu M.; Tuğlular Z. S.; Sümbül B.; Seyahi N.; et al.; MİRİOĞLU, ŞAFAK; KAZANCIOĞLU, RÜMEYZA; SÜMBÜL, BİLGE
  • PublicationMetadata only
    Thorax computed tomography findings and anti-SARS-CoV-2 immunoglobulin G levels in polymerase chain reaction-negative probable COVID-19 cases.
    (2022-11-25) Yurtsever I.; Karatoprak C.; Sumbul B.; Kiskac M.; Tunc M.; Zorlu M.; Ogun H.; Durdu B.; Toluk O.; Cakirca M.; YURTSEVER, İSMAİL; KARATOPRAK, CUMALİ; SÜMBÜL, BİLGE; KISKAÇ, MUHARREM; TUNÇ, MUHAMMED; ZORLU, MEHMET; OGUN, HAMZA; DURDU, BÜLENT; TOLUK, ÖZLEM; ÇAKIRCA, MUSTAFA
    OBJECTIVE: This study aimed to evaluate the SARS-CoV-2 immunoglobulin G (IgG) levels after 6 months of polymerase chain reaction (PCR) negativebut assumed to be COVID-19 positive cases to investigate the relationship between IgG levels and thoracic computed tomography (CT) findings.METHODS: This was a single-center study that included patients whose PCR test results were negative at least three times using nasopharyngealswabs but had clinical findings of COVID-19 and thoracic CT findings compatible with viral pneumonia. Six months after discharge, the IgG antibodieswere analyzed. The cutoff value for negative and positive serology was defined as <1.4 (index S/C) and ≥1.4 (index S/C), respectively. In addition, thepatients were categorized according to their thoracic CT findings as high (typical) and low (atypical). Also, the patients were grouped into classes as<5% lung involvement versus ≥5% lung involvement.RESULTS: The patients’ mean age was 49.78±12.96 years. PCR was negative, but patients with COVID-19 symptoms who had SARS-CoV-2 IgGpositive were 81.9% (n=95). The antibody titer and lung involvement ≥5% were statistically significantly higher in SARS-CoV-2 IgG positive cases(p<0.001 and p=0.021). Age and chest CT findings were the risk factors for lung involvement (OR=1.08, p<0.001 and OR=2.19, p=0.010, respectively).CONCLUSION: This study is valuable because increasing severity (≥5%) of lung involvement appears to be associated with high and persistent IgGantibody titers. In probable cases of COVID-19, even if the PCR test is negative, high IgG titers 6 months after discharge can predict the rate of lungparenchymal involvement.
  • PublicationMetadata only
    Pandoraea norimbergensis; mortal seyreden kateter ilişkili kan dolaşımı enfeksiyonu etkeni
    (2023-02-01) Karakuş H. D.; Durdu B.; Akkoyunlu Y.; Okay G.; Aslan T.; Sümbül B.; Haliloğlu M.; KARAKUŞ, HATİCE DİLARA; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; OKAY, GÜLAY; ASLAN, TURAN; SÜMBÜL, BİLGE; HALİLOĞLU, MURAT
    AMAÇ: Pandoraea norimbergensis Gram negatif, hareketli, oksidaz pozitif, non-fermentatif, zorunlu aerob basildir. Genellikle kistik fibrozis, bronşektazi gibi kronik akciğer hastalığı olanlarda etken olarak tanımlanmıştır. Bununla birlikte toprak, gıda, su ve kan örneklerinden de izole edilmiştir. En yakın filogenetik akrabası Burkholderia cinsidir. Bu olguda yoğun bakım ünitesinde (YBÜ) takip edilen ve mortalite ile sonuçlanan Pandoraea norimbergensis’in etken olduğu kateter ilişkili kan dolaşım enfeksiyonu (KİKDE) sunulmuştur.OLGU: Hipertansiyon, diabetes mellitus, konjestif kalp yetmezliği, larinks kanseri tanıları olan 78 yaşında erkek hasta nefes darlığı, halsizlik şikayetleriyle acil kliniğimize başvurmuştur. Hemodinamik bozukluk ve solunum yetmezliği tespit edilen hasta YBÜ’ne yatırılmıştır. Yatışının 10. gününde ateş, akut faz reaktanlarında yükselme, hemodinamik bozulma (septik şok) olması üzerine ampirik olarak meropenem, kolistin ve norepinefrin başlanmıştır. Santral venöz kateter ve periferden alınan kan kültürlerinde Pandoraea norimbergensis üremiştir. İdentifikasyonu MALDI-TOF MS ile yapılmıştır. Otomatize sistem (VITEK® 2 bioMérieux) ile yapılan antibiyogram sonucu tablodaki gibidir. Antibiyogram sonucuna göre mevcut tedaviye levofloksasin eklenmiştir. Meropenem ve kolistinin 7.gününde, levofloksasinin 3. gününde kardiyak arrest gelişen hasta hayatını kaybetmiştir.SONUÇ: Literatür incelendiğinde Akut Lenfoblastik Lösemi tanılı bebek hastada Pandoraea pnomenusa’nın etken olduğu tek bir KİKDE olgusu bildirilmiştir. Pandoraea türleri daha çok kistik fibrozis ve bronşiektazi varlığında solunum yolu patojeni olarak tanımlanmıştır. Ampisilin, 3.,4. Kuşak sefalosporinler, piperasilin, azitromisin, aminoglikozidlere direnç bildirilmiştir. Kinolonlar ve trimetoprim/sulfumetoksazole değişken duyarlılık göstermektedir. Hastane enfeksiyonlarında nadir gördüğümüz bu etken çoklu ilaç direnci ile birlikte mortal seyredebilmektedir. Antibiyotik Duyarlılık Piperasilin/tazobaktam duyarlı Levofloksasin orta duyarlı Siprofloksasin dirençli Meropenem dirençli Ertapenem dirençli Sefepim dirençli Gentamisin dirençli Tobramisin dirençli TABLO : Pandoraea norimbergensis antibiyotik duyarlılık sonuçları
  • PublicationMetadata only
    Results of nucleos(t)ide analog treatment discontinuation in hepatitis b e-Antigen-negative chronic hepatitis b: Nucstop study
    (2024-01-01) Kiremitci S.; Kochan K.; SEVEN G.; Keskin E. B.; OKAY G.; AKKOYUNLU Y.; Koc M. M.; SÜMBÜL B.; ŞENTÜRK H.; KİREMİTÇİ, SERCAN; KOÇHAN, KORAY; SEVEN, GÜLSEREN; OKAY, GÜLAY; AKKOYUNLU, YASEMİN; SÜMBÜL, BİLGE; ŞENTÜRK, HAKAN
    Background/Aims: This study aims to investigate the effects of nucleos(t)ide analogs (NAs) discontinuation in eligible patients in accordance with the Asian Pacific Association for the Study of the Liver hepatitis B guideline and the factors affecting clinical and virological relapses. Materials and Methods: In this prospectively designed study, hepatitis B e antigen (HBeAg)-negative chronic hepatitis B patients who were followed up between 2012 and 2019 were evaluated and 57 patients were included. All participants enrolled the study were HBeAgnegative status at NA initiation. Results: The median age of the patients was 49 (29-72) years and 24 (42%) were females. The median treatment duration was 96 (36-276) months and patients were followed for a median duration of 27 months. Sixteen patients had a previous history of NA switch, and thirteen of these patients had a history of lamivudine resistance. Thirty-eight of 57 patients (66%) developed an elevated hepatitis B virus deoxyribonucleic acid level of 2000 IU/mL at least once, defined as virological relapse and 23 (60%) of them, experienced clinical relapse. Thirty-one of 57 patients were re-Treated during the follow-up, and hepatitis B surface antigen (HBsAg) loss occurred among 4 (7%) patients. All patients who experienced HBsAg loss had a history of lamivudine resistance (P = .002). Conclusion: Despite receiving NAs suppression therapy for a long time, HBsAg loss occurs rarely. Although it was not life-Threatening, most patients experienced relapses and treatment should be restarted. In our study, whether it is a coincidence that all patients with HBsAg loss are patients in whom NAs are used sequentially due to lamivudine resistance is an issue that needs to be further investigated.