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AKKOYUNLU, YASEMİN

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AKKOYUNLU
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    Understanding clinical outcomes and factors influencing mortality in intensive care unit patients with COVID-19-associated candidemia
    (2024-01-01) AYDIN S.; MERT A.; YILMAZ M.; Al Maslamani M.; Rahimi B. A.; Ayoade F.; El-Kholy A.; Belitova M.; Sengel B. E.; Jalal S.; et al.; AKKOYUNLU, YASEMİN
    Background: During the COVID pandemic, research has shown an increase in candidemia cases following severe COVID infection and the identification of risk factors associated with candidemia. However, there is a lack of studies that specifically explore clinical outcomes and mortality rates related to candidemia after COVID infection.Objectives: The aim of this international study was to evaluate the clinical outcomes and identify factors influencing mortality in patients who developed candidemia during their COVID infection.Patients/Methods: This study included adult patients (18 years of age or older) admitted to the intensive care unit (ICU) and diagnosed with COVID-associated candidemia (CAC). The research was conducted through ID-IRI network and in collaboration with 34 medical centres across 18 countries retrospectively, spanning from the beginning of the COVID pandemic until December 2021.Results: A total of 293 patients diagnosed with CAC were included. The median age of the patients was 67, and 63% of them were male. The most common Candida species detected was C. albicans. The crude 30-day mortality rate was recorded at 62.4%. The logistic regression analysis identified several factors significantly impacting mortality, including age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02-1.07, p < .0005), SOFA score (OR 1.307, 95% CI 1.17-1.45, p < .0005), invasive mechanical ventilation (OR 7.95, 95% CI 1.44-43.83, p < .017) and duration of mechanical ventilation (OR 0.98, 95% CI 0.96-0.99, p < .020).Conclusions: By recognising these prognostic factors, medical professionals can customise their treatment approaches to offer more targeted care, leading to improved patient outcomes and higher survival rates for individuals with COVID-associated candidemia.
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    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.