Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Involvement and Complications Associated with Brucellosis Connected Rare Evaluation of 46 Cases(2014) Turunc, Tuba; Kursun, Ebru; Demiroglu, Y. Ziya; Aliskan, Eda; 0000-0001-7956-7306; 0000-0001-9060-3195; 0000-0002-9866-2197; GVT-0626-2022; AAG-5020-2020; AAE-2282-2021; AAZ-9711-2021Purpose: The present study of us assesses brucellosis with atypical involvement and its complications aimed to draw attention to the infection that may interfere with many diseases related to infection or not. Material and Method: In our clinic, a total of 447 cases of brucellosis between March 2004 - March 2011 were followed retrospectively. 46 of these cases included in this study which have not specific terms of brucellosis symptoms, signs and / or laboratory data as well as non expected involvement during the course of the disease and / or complications. Results: A total of 46 patients in terms of disease and / or complications evaluated atypical Brucellosis, 17 (39.9%) female and 29 (63.04%) were male. Mean age was 40.8 +/- 10.2. 19 patients (41.3%) blood, 2 cases (4.3%) urine, 4 patients (8.6%), abscess, 1 patient pleural fluid, 1 case (2.1%) mitral valve, 1 patient joint fluid aspiration while 1 patient (2.1%) both peritoneal and pleural fluid samples of Brucella spp. were isolated. Brucellosis related atypical involvement and / or complication was observed in particularly the musculoskeletal system, the central nervous system, cardiovascular system, genitourinary system, and hematologic system, as well as in the skin and mucous membrane of the serous tissues. However, it is found that 37 cases (80.4%) applied for the different sections outside the Department of Infectious Diseases and evaluated respectively. Conclusion: In this study, it is determined that cases were followed with brucellosis (10.2%) atypical disease and / or complications, and the first assesses made by outside the Department of Infectious Diseases. For this reason, we think not only experts in Infectious Diseases, all other branches of physicians should keep in mind in the differential diagnosis of brucellosis.Item Evaluation of 31 Cases with Urogenital Tuberculosis(2014) Kursun, Ebru; Turunc, Tahsin; Demiroglu, Yusuf Ziya; 0000-0002-7936-2172; 0000-0001-7956-7306; 0000-0002-9866-2197; ABD-4332-2020; AAG-5020-2020; GVT-0626-2022; AAZ-9711-2021Introduction: The present study evaluated the cases followed up and treated for urogenital tuberculosis in our hospital. Materials and Methods: Demographic and clinical characteristics, as well as laboratory data and treatment outcomes of 31 cases diagnosed as urogenital tuberculosis between January 2005 and January 2014 were retrospectively evaluated. Results: Of the 31 cases diagnosed with urogenital tuberculosis, nine (29%) had kidney, seven (22.5%) had bladder, nine (29%) had prostate, four (13%) had epididymis, and two (6.5%) had testicular involvement. History of contact with tuberculosis bacillus was present in five (16%) cases. Diabetes mellitus accompanied five (16%) and malignancy accompanied three (10%) cases. The most common complaints were dysuria (68%) and high fever (55%). Histopathological examination demonstrated tuberculosis bacillus in twenty cases (64.5%); whereas, Mycobacterium tuberculosis was isolated in the urine cultures of fifteen cases (48.4%) and acid-fast bacilli were detected in the urine samples of ten cases (32.3). It was determined that all cases had received quadruple anti-tuberculosis therapy for the first two months followed by dualanti-tuberculosis therapy for 4 to 10 months based on the site of involvement. One of the cases had undergone prostatectomy, one had undergone nephrectomy, one had undergone nephrectomy with ileocystoplasty in the same session, and one had undergone orchiectomy over the course of treatment with anti-tuberculosis drugs. It was determined that eight of the cases were lost on follow upafter anti-tuberculosis therapy was started and remaining cases recovered without complication. Conclusion: Tuberculosis is a chronic infectious disease that is difficult to diagnose and able to involve all systems and organs, and it remains important in developing countries like Turkey. We conclude that urogenital tuberculosis should be considered in patients with urogenital complaints that continuing for a long time period and do not respond to classical medical therapy.Item Evaluation of 28 Cases of Mucormycosis(2015) Kursun, Ebru; Turunc, Tuba; Demiroglu, Yusuf Ziya; Aliskan, Hikmet Eda; Arslan, Ayse Hande; 0000-0002-5708-7915; 0000-0001-9060-3195; 0000-0002-9866-2197; 0000-0001-7956-7306; 25590855; ABG-7034-2021; ADG-7352-2022; AAE-2282-2021; AAG-5020-2020; AAZ-9711-2021; GVT-0626-2022Mucormycosis is a rare but invasive fungal disease with high mortality. The present study aimed to retrospectively investigate the demographic characteristics, as well as the clinical, radiological and laboratory features and the results of treatment, in the patients followed in our hospital because of mucormycosis. The present study retrospectively evaluated 28 cases, which were followed in our hospital because of mucormycosis between January 2002 and July 2013. The clinical form was rhinocerebral in 27 cases (rhinoorbital in 12, nasal in 8 and rhinoorbitocerebral in 7) and disseminated in one case. With regard to predisposing factors, diabetes mellitus (n=20), haematological malignancy (n=6) and chronic renal insufficiency (n=5) were the leading concomitant diseases. Seventeen (61%) of 28 cases showed atypical clinical picture. With regard to the therapeutic outcomes; it was found that 14 (50%) cases died and six cases recovered with sequel. Today, when particularly the prevalence of immunosuppressive diseases and conditions are gradually increasing, the incidence of mucormycosis is also increased. Considering that the majority of our cases had atypical clinical involvement and complications, being familiar with the characteristics of this disease could be life-saving together with early diagnosis and treatment.Item Hamsi Scoring in the Prediction of Unfavorable Outcomes from Tuberculous Meningitis: Results of Haydarpasa-II Study(2015) Kursun, Ebru; 25634680Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria, Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13 variables. Age, nausea, vomiting, altered consciousness, hydrocephalus, vasculitis, immunosuppression, diabetes mellitus and neurological deficit remained in the final model. Scores 1-3 were assigned to the variables in the severity scale, which included scores of 1-6. The distribution of mortality for the scores 1-6 was 3.4, 8.2, 20.6, 31, 30 and 40.1 %, respectively. Altered consciousness, diabetes mellitus, immunosuppression, neurological deficits, hydrocephalus, and vasculitis predicted the unfavorable outcome in the scoring and the cumulative score provided a linear estimation of prognosis.Item Prognostic Value of Procalcitonin in Infection-Related Mortality of Cancer Patients(2016) Sedef, Ali Murat; Kose, Fatih; Sumbul, Ahmet Taner; Dogan, Ozlem; Kursun, Ebru; Yurdakul, Zafer; Gultepe, Bilge Sumbul; Mertsoylu, Huseyin; Sezer, Ahmet; Ozyilkan, Ozgur; https://orcid.org/0000-0002-0156-5973; https://orcid.org/0000-0002-5573-906X; https://orcid.org/0000-0002-1932-9784; https://orcid.org/0000-0002-6445-1439; https://orcid.org/0000-0001-8825-4918; 27569098; G-4827-2016; D-4793-2014; GZH-1913-2022; AAG-5020-2020; M-9530-2014; AAD-2667-2020; AAD-2817-2021Purpose: Infectious diseases are a major cause of morbidity and mortality in cancer patients. Tumor-induced inflammatory responses may increase the value of classical inflammatory markers in blood, so these markers may not be as useful in cancer patients as in non-cancer patients. Serum procalcitonin (PCT) is a sensitive and specific biomarker for severe infection, and has been shown to be unaffected by tumor-induced inflammatory response. In this study we aimed to evaluate the possible role of PCT in mortality in cancer patients with infection. Methods: In total, 104 consecutive adult cancer patients who presented with fever (body temperature >= 38.3 degrees C or >= 38 degrees C on two consecutive measurements) during follow-up and needing hospitalization for infection were enrolled in this study. Results: The majority (72%) of the patients were male. The most common diagnosis and type of infection were lung cancer (40.4%) and pneumonia (56.7%), respectively. The overall mortality rate was 17%. Statistical analysis showed a significant relationship between PCT levels and mortality (p=0.001), but not between classical inflammatory markers and mortality (p>0.05). The mortality rate of patients with a PCT value > 2 ng/mL was 34.3%, compared with 9.6% in patients with a PCT below this value (p=0.005). Furthermore, PCT predicted in-ward cancer patient mortality with a sensitivity of 66% and a specificity of 76%. Conclusion: PCT is a unique serum biomarker significantly related to infection-related mortality and predicts mortality with a relatively high sensitivity and specificity.Item Pneumonia in Renal Transplant Recipients: A Single-Center Study(2018) Kara, Sibel; Sen, Nazan; Kursun, Ebru; Yabanoglu, Hakan; Yildirim, Sedat; Akcay, Sule; Haberal, Mehmet; 0000-0002-4171-7484; 0000-0002-1161-3369; 0000-0002-5735-4315; 0000-0002-8360-6459; 0000-0002-3462-7632; 29528008; AAI-8947-2021; AAG-5020-2020; AAJ-7865-2021; AAF-4610-2019; AAI-8069-2021; AAB-5175-2021; AAJ-8097-2021Objectives: Pulmonary infections are a significant cause of morbidity and mortality in solid-organ transplant recipients despite enhanced facilities for perioperative care. The aim of this study was to evaluate the demographic characteristics, clinical course, and outcomes of renal transplant recipients with pneumonia. Materials and Methods: The medical records of all renal transplant recipients from January 2010 to December 2014 were retrospectively reviewed, and patients diagnosed with pneumonia according to Centers for Disease Control and Prevention criteria were evaluated. Pneumonia was classified as community acquired or nosocomial. Patient demographics, microbiologic findings, need for intensive care/mechanical ventilation over the course of treatment, and information about clinical follow-up and mortality were all recorded. Results: Eighteen (13.4%) of 134 renal transplant recipients had 25 pneumonia episodes within the study period. More than half (56%) of the pneumonia episodes developed within the first 6 months of transplant, whereas 44% developed after 6 months (all > 1 year). Eight cases (32%) were considered nosocomial pneumonia, and 17 (68%) were considered community-acquired pneumonia. Bacteria were the most common cause of pneumonia (28%), and fungi ranked second (8%). No viral or mycobacterial agents were detected. No patients required prolonged mechanical ventilation. No statistically significant difference was found in the need for intensive care or regarding mortality between patients with nosocomial and community-acquired pneumonia. Two patients (11%) died, and all remaining patients recovered. Conclusions: The present study confirmed that pneumonia after renal transplant is not a rare complication but a significant cause of morbidity. Long-term and close follow-up for pneumonia is necessary after renal transplant.Item Evaluation of extensively drug-resistant gram-negative bacteremia among solid-organ transplant recipients: a multicenter study(2021) Yanik Yalcin, Tugba; Azap, Ozlem; Kose, Adam; Bayindir, Yasar; Saricaoglu, Elif Mukime; Cinar, Gule; Uygun Kizmaz, Yesim; Kursun, Ebru; Aliskan, Hikmet Eda; Tezer Tekce, Yasemin; Eren Kutsoylu, Oya Ozlem; Egeli, Tufan; Ari, Alpay; Albayrak, Yurdagul; Cabadak, Hatice; Deniz, Secil; Demir Onder, Kubra; Kizilates, Filiz; Ozger, Selcuk; Guzel Tunccan, Ozlem; Haberal, Mehmet; 0000-0001-9060-3195; 0000-0002-3462-7632; 33865241; AAE-2282-2021; AAJ-8097-2021Background/aim: The aim of this study is to evaluate the distribution, sources, clinical features, and mortality rates of bacteremia due to evaluation of extensively drug-resistant (XDR) gram negative among solid-organ transplant (SOT) recipients. Materials and methods: A retrospective study of SOT recipients with bacteremia due to XDR gram-negative pathogens in 11 centers between 2016 and 2018 was conducted. Patients' records were evaluated. Results: Of 171 bacteremia that occurred in 164 SOT recipients, 93 (56.7%) were liver, 46 (28%) kidney, 14 (8.5%) heart, and 11 (6.7%) lung recipients. Bacteremia episodes were recorded in the first year in 63.7% of the patients (n = 109), early-onset bacteremia was recorded in 45% (n = 77) of the episodes. In multivariate analysis, catheter-associated bacteremia was an independent risk factor for 7-day mortality (p = 0.037), and early-onset bacteremia was found as an independent risk factor for 30-day mortality (p = 0.017). Conclusion: Difficult-to-treat infections due to XDR bacteria in SOT recipients shadow the success of transplantation. Central venous catheters seem to be the main risk factor. Judicious use of medical devices is of pivotal importance.