Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

Browse

Filters

2017 - 201912020 - 20212

Settings

search.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/openAccessSubject: search.filters.subject.Pneumonia

Search Results

Now showing 1 - 3 of 3
  • No Thumbnail Available
    Item
    Comparison of the clinical course of COVID-19 infection in sickle cell disease patients with healthcare professionals
    (2021) Boga, Can; Asma, Suheyl; Leblebisatan, Goksel; Sen, Nazan; Tombak, Anil; Demiroglu, Yusuf Ziya; Yeral, Mahmut; Akin, Sule; Yesilagac, Hasan; Habesoglu, Mehmet Ali; Aribogan, Anis; Kasar, Mutlu; Korur, Asli; Ozdogu, Hakan; 0000-0002-9866-2197; 34032899; AAZ-9711-2021; AAY-2668-2021
    It is highly expected that COVID-19 infection will have devastating consequences in sickle cell disease (SCD) patients due to endothelial activation and decreased tissue and organ reserve as a result of microvascular ischemia and continuous inflammation. In this study, we aimed to compare the clinical course of COVID-19 in adult SCD patients under the organ injury mitigation and clinical care improvement program (BASCARE) with healthcare professionals without significant comorbid conditions. The study was planned as a retrospective, multicenter and cross-sectional study. Thirty-nine SCD patients, ages 18 to 64 years, and 121 healthcare professionals, ages 21 to 53, were included in the study. The data were collected from the Electronic Health Recording System of PRANA, where SCD patients under the BASCARE program had been registered. The data of other patients were collected from the Electronic Hospital Data Recording System and patient files. In the SCD group, the crude incidence of COVID-19 was 9%, while in healthcare professionals at the same period was 23%. Among the symptoms, besides fever, loss of smell and taste were more prominent in the SCD group than in healthcare professionals. There was a significant difference between the two groups in terms of development of pneumonia, hospitalization, and need for intubation (43 vs 5%, P < 0.00001; 26 vs 7%, P = 0.002; and 10 vs 1%, P = 0.002, respectively). Prophylactic low molecular weight heparin and salicylate were used more in the SCD group than in healthcare professionals group (41 vs 9% and 28 vs 1%; P < 0.0001 for both). The 3-month mortality rate was demonstrated as 5% in the SCD group, while 0 in the healthcare professionals group. One patient in the SCD group became continously dependent on respiratory support. The cause of death was acute chest syndrome in the first case, hepatic necrosis and multi-organ failure in the second case. In conclusion, these observations supported the expectation that the course of COVID-19 in SCD patients will get worse. The BASCARE program applied in SCD patients could not change the poor outcome.
  • No Thumbnail Available
    Item
    Factors Affecting Mortality In Geriatric Patients Diagnosed With Community-Acquired Pneumonia Treated In Intensive Care Units
    (2021) Bozkurt Yilmaz, Hatice Eylul; Unsal, Zuhal Ekici; Habesoglu, Mehmet Ali; Kara, Sibel; Sen, Nazan
    Introduction: The aim of this study was to determine the factors affecting mortality in elderly patients with community-acquired pneumonia who were receiving intensive care unit. Materials and Methods: The study was retrospective, cross-sectional, and descriptive. The medical records of patients over 65 years of age who were admitted to the intensive care unit with a diagnosis of community-acquired pneumonia between January 1, 2013 and February 29, 2020 were reviewed. The factors associated with mortality in the patients who had died were examined. Results: A total of 208 patients with a mean age of 75.11 +/- 5.59 years, 78 of whom were women (37.5%), were included in the study. During the follow-up 35 (16.82%) of 208 patients had died from pneumonia or complications due to pneumonia. According to multiple linear regression analysis, the following parameters were found to be predictors of mortality: Charlson comorbidity index value (odds ratio: 1.44, 95% confidence interval: 1.132-1.1841, p=0.003), chronic obstructive pulmonary disease (odds ratio: 0.292, 95% confidence interval: 0.094-1.149, p=0.038), congestive heart failure (odds ratio: 0.199, 95% confidence interval: 0.051-0.782, p=0.021), saturation value in arterial blood gas (odds ratio: 0.569, 95% confidence interval: 0.804-0.939, p<0.001), intubation duration (odds ratio: 3.476, 95% confidence interval: 1.880-6.425, p<0.001), hypertension (odds ratio: 3.449, 95% confidence interval: 0.941-12.649, p=0.042), and the presence of diabetes mellitus (odds ratio: 3.116, 95% confidence interval: 2.673-59.021, p=0.046). Conclusion: Community-acquired pneumonia requiring intensive care unit is a clinical condition with high mortality in the elderly patient population. The presence of comorbid diseases and prolonged intubation time may be associated with higher mortality.
  • No Thumbnail Available
    Item
    Evaluation of nephrotoxicity and prognosis in patients treated with colistin due to hospital-acquired pneumonia
    (2017) Ulubay, Gaye; Korkmaz Ekren, Pervin; Toreyin, Zehra Nur; Berk Takir, Huriye; Kalamanoglu Balci, Merih; Gaygisiz, Ummugulsum; Gursel, Gul; Ergan, Begum; Yalcin, Aslihan; Saltürk, Cuneyt; Aydogdu, Muge; Ergun, Recai; Guven, Pinar; Gurun Kaya, Aslihan; Celtik, Aygul; Uluer, Hatice; Bacakoglu, Feza; Sayiner, Abdullah; 0000-0003-2478-9985; 29631525; AAB-5064-2021
    Introduction: Colistimethate sodium (CMS) is frequently used in the treatment of nosocomial multidrug-resistant gram-negative infections. Nephrotoxicity is the most important side effect. The aim of this study is to evaluate the effect of colistin on nephrotoxicity and to assess prognosis in patients treated with CMS due to hospital-acquired pneumonia (HAP). Materials and Methods: Patients treated with CMS for HAP due to multidrug-resistant Pseudomonas aeruginosa or Acinetobacter baumannii were included in this cohort study. Results: We evaluated 281 patients treated with two different brands of CMS whose administration dose is different: imported (n=58, low dose/kg) and domestic (n=223, high dose/kg). Nephrotoxicity developed in 175 patients (62.3%). The median age (73 vs. 66 years, p=0.004) and mortality rates were higher (66.9% vs. 52.8%, p=0.022) in patients having nephrotoxicity. The patients receiving high dose/kg had higher nephrotoxicity rate (67.7% vs. 41.4%, p < 0.001). The clinical, bacteriological response and mortality rates of the whole group were 52.0%, 61.0%, 61.6%, respectively. The clinical and bacteriological response rates were similar in the different dose groups. Multivariate analysis showed that nephrotoxicity was associated with domestic brand depending on use of high dose (OR=3.97), advanced age (beta=0.29, p=0.008), male gender (OR=2.60), hypertension (OR=2.50), red blood cells transfusion (OR=2.54), absence of acute kidney injury (OR=10.19), risk stage of RIFLE (OR=11.9). Conclusion: Nephrotoxicity is associated with the use of high dose colistin, age, gender, hypertension, red blood cells replacement and RIFLE stage. The mortality rate is higher in patients developing nephrotoxicity.