Person: BOLUKÇU, SİBEL
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Publication Metadata only A novel id-iri score: development and internal validation of the multivariable community acquired sepsis clinical risk prediction model(2020-04-01T00:00:00Z) Diktas, Husrev; Uysal, Serhat; Erdem, Hakan; Cag, Yasemin; Miftode, Egidia; Durmus, Gul; ULU KILIÇ, AYŞEGÜL; Alabay, Selma; Szabo, Balint Gergely; Lakatos, Botond; Fernandez, Ricardo; Korkmaz, Pinar; Caliz, Michael Cruz; Argemi, Xavier; Kulzhanova, Sholpan; Kormaz, Fatime; Yilmaz-Karadag, Fatma; Ergen, Pinar; Atilla, Aynur; Puca, Edmond; Dogan, Mustafa; Mangani, Francesca; Sahin, Suzan; Grgic, Svjetlana; Grozdanovski, Krsto; Yilmaz, Gul Ruhsar; Del-Vecchio, Rosa Fontana; Demirel, Aslihan; SIRMATEL, FATMA; ŞENER, ALPER; Sacar, Suzan; Aydin, Emsal; Batirel, Ayse; Dragovac, Gorana; El-Sokkary, Rehab; Alexandru, Crisan; Arslan-Ozel, Selcan; BOLUKÇU, SİBEL; Ozkaya, H. Deniz; Nayman-Alpat, Saygin; Inan, Asuman; Al-majid, Fahad; Kaya-Ugur, Berna; Rello, Jordi; BOLUKÇU, SİBELWe aimed to develop a scoring system for predicting in-hospital mortality of community-acquired (CA) sepsis patients. This was a prospective, observational multicenter study performed to analyze CA sepsis among adult patients through ID-IRI (Infectious Diseases International Research Initiative) at 32 centers in 10 countries between December 1, 2015, and May 15, 2016. After baseline evaluation, we used univariate analysis at the second and logistic regression analysis at the third phase. In this prospective observational study, data of 373 cases with CA sepsis or septic shock were submitted from 32 referral centers in 10 countries. The median age was 68 (51-77) years, and 174 (46,6%) of the patients were females. The median hospitalization time of the patients was 15 (10-21) days. Overall mortality rate due to CA sepsis was 17.7% (n = 66). The possible predictors which have strong correlation and the variables that cause collinearity are acute oliguria, altered consciousness, persistent hypotension, fever, serum creatinine, age, and serum total protein. CAS (%) is a new scoring system and works in accordance with the parameters in third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The system has yielded successful results in terms of predicting mortality in CA sepsis patients.Publication Metadata only Investigation of the changing etiology and risk factors of prosthetic joint infections : a university hospital surveillance study from 2011-2017(2020-03-01T00:00:00Z) Gultepe, Bilge Sumbul; OKAY, GÜLAY; Bolukcu, Sibel; DURDU, BÜLENT; Koc, Meliha Meric; TUNCAY, İBRAHİM; BOLUKÇU, SİBEL; DURDU, BÜLENT; SÜMBÜL, BİLGE; TUNCAY, İBRAHİM; MERİÇ KOÇ, MELİHAWe sought to characterize the causative pathogens of prosthetic joint infections (PJIs), evaluate the trends in microbial etiologies, and identify potential risk factors for PJI. This was a retrospective study analyzing 70 patients with PJI following 3,253 total joint arthroplasties between 2011 and 2017. Staphylococci were the most common cause of infection (52.9%). There was a significant trend in the percentage of carbapenem-resistant gram-negative bacilli (GNB) (increased to 66.7% in 2016 from 0.0% in 2011) (p=0.021). GNB and polymicrobial etiology were found at significantly high levels in cases involving early PJIs (p=0.005 and p=0.048, respectively). While staphylococci were significantly higher in PJIs after total knee arthroplasty (75%), GNB were significantly higher in PJIs after total hip arthroplasty (49.1%) (p<0.001 and p=0.001, respectively). Binary logistic regression analysis showed that the risk of PJI was significantly higher in cases with fracture and diabetes mellitus (odds ratio [OR], 4.3, 95% confidence interval [CI], 1.78-10.5; OR, 4.1, 95% CI, 1.66-10.5, respectively). These results suggest that the empirical and targeted antimicrobial treatment of PJIs may become more difficult in the future.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.