Araştırma Çıktıları
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Item Comprehensive Analysis of Severe Viral Infections of Respiratory Tract admitted to PICUs during the Winter Season in Turkey(JAYPEE BROTHERS MEDICAL PUBLISHERS PVT LTD, 2019-01-01) Kockuzu, Esra; Bayrakci, Benan; Kesici, Selman; Citak, Agop; Karapinar, Bulent; Emeksiz, Serhat; Anil, Ayse Berna; Kendirli, Tanil; Yukselmis, Ufuk; Sevketoglu, Esra; Paksu, Sukru; Kutlu, Onur; Agin, Hasan; Yildizdas, Dincer; Keskin, Halil; Kalkan, Gokhan; Hasanoglu, Arzu; Yazici, Mutlu Uysal; Sik, Guntulu; Kilinc, Arda; Durak, Fatih; Perk, Oktay; Talip, Mey; Yener, Nazik; Uzuner, SelcukObjectives:To analyze the course of seasonal viral infections of respiratory tract in patients hospitalized in pediatric intensive care units (PICU) of 16 centers in Turkey. Materials and methods: It is a retrospective, observational, and multicenter study conducted in 16 tertiary PICUs in Turkey includes a total of 302 children with viral cause in the nasal swab which required PICU admission with no interventions. Results: Median age of patients was 12 months. Respiratory syncytial virus (RSV) was more common in patients over one year of age whereas influenza, human Bocavirus in patients above a year of age was more common (p <0.05). Clinical presentations influencing mortality were neurologic symptoms, tachycardia, hypoxia, hypotension, elevated lactate, and acidosis. The critical pH value related with mortality was <= 7.10, and critical PCO2 >= 60 mm Hg. Conclusion: Our findings demonstrate that patients with neurological symptoms, tachycardia, hypoxia, hypotension, acidosis, impaired liver, and renal function at the time of admission exhibit more severe mortal progressions. Presence of acidosis and multiorgan failure was found to be predictor for mortality. Knowledge of clinical presentation and age-related variations among seasonal viruses may give a clue about severe course and prognosis. By presenting the analyzed data of 302 PICU admissions, current study reveals severity of viral respiratory tract infections and release tips for handling them.Item Effect of harmless acute pancreatitis score, red cell distribution width and neutrophil/lymphocyte ratio on the mortality of patients with nontraumatic acute pancreatitis at the emergency department(ZHEJIANG UNIV SCH MEDICINE, 2015-01-01) Gulen, Bedia; Sonmez, Ertan; Yaylaci, Serpil; Serinken, Mustafa; Eken, Cenker; Dur, Ali; Turkdogan, Figen Tunali; Sogut, OzgurBACKGROUND: Harmless acute pancreatitis score (HAPS), neutrophile/lymphocyte ratio and red blood cell distribution width (RDW) are used to determine the early prognosis of patients diagnosed with nontraumatic acute pancreatitis in the emergency department (ED). METHODS: Patients diagnosed with acute pancreatitis (K 85.9) in the ED according to the ICD10 coding during one year were included in the study. Patients with chronic pancreatitis and those who had missing data in their files were excluded from the study. Patients who did not have computed tomography (CT) in the ED were not included in the study. RESULTS: Ultimately, 322 patients were included in the study. The median age of the patients was 53.1 (IQR=36-64). Of the patients, 68.1\% (n=226) had etiological causes of the biliary tract. The mortality rate of these patients within the first 48 hours was 4.3\% (n=14). In the logistic regression analysis performed by using Balthazar classification, HAPS score, RDW, neutrophile/lymphocyte ratio, age, diabetes mellitus and systolic blood pressure, the only independent variable in determining mortality was assigned as Balthazar classification (OR: 15Item Validation of the EuroSCORE risk models in Turkish adult cardiac surgical population(OXFORD UNIV PRESS INC, 2011-01-01) Akar, Ahmet Ruchan; Kurtcephe, Murat; Sener, Erol; Alhan, Cem; Durdu, Serkan; Kunt, Ayse Gul; Guvenir, Halil Altay; Cardiovasc, Working Grp Turkish SocObjective: The aim of this study was to validate additive and logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) models on Turkish adult cardiac surgical population. Methods: TurkoSCORE project involves a reliable web-based database to build up Turkish risk stratification models. Current patient population consisted of 9443 adult patients who underwent cardiac surgery between 2005 and 2010. However, the additive and logistic EuroSCORE models were applied to only 8018 patients whose EuroSCORE determinants were complete. Observed and predicted mortalities were compared for low-, medium-, and high-risk groups. Results: The mean patient age was 59.5 years (+/- 12.1 years) at the time of surgery, and 28.6\% were female. There were significant differences (all p < 0.001) in the prevalence of recent myocardial infarction (23.5\% vs 9.7\%), moderate left ventricular function (29.9\% vs 25.6\%), unstable angina (9.8\% vs 8.0\%), chronic pulmonary disease (13.4\% vs 3.9\%), active endocarditis (3.2\% vs 1.1\%), critical preoperative state (9.0\% vs 4.1\%), surgery on thoracic aorta (3.7\% vs 2.4\%), extracardiac arteriopathy (8.6\% vs 11.3\%), previous cardiac surgery (4.1\% vs 7.3\%), and other than isolated coronary artery bypass graft (CABGItem Prognostic Factors in Patients who Underwent Aneurysmal Clipping due to Spontaneous Subarachnoid Hemorrhage(TURKISH NEUROSURGICAL SOC, 2016-01-01) Orakdogen, Metin; Emon, Selin Tural; Somay, Hakan; Engin, Taner; Ates, Ozkan; Berkman, Mehmet ZaferAIM: Despite technical and medical advances, aneurysmal subarachnoid hemorrhages (SAH) continue to be a challenging pathology, associated with high rates of morbidity and mortality. In this regard, a definition is required of the various prognostic indicators of an SAH. The aim of the present retrospective study is to examine the various prognostic factors of the clinical outcomes of the patients who underwent a neurosurgical clipping of aneurysms due to aneurysmal SAH. MATERIAL and METHODS: The data of 104 patients that had suffered an aneurysmal SAH were analyzed. The baseline demographic, clinical and radiological data were all analyzed. The prognostic study was derived from an analysis of these variables. Relationship between prognostic factors and outcome was evaluated by univariate and logistic multivariate regression analysis. RESULTS: This study has identified unfavorable outcomes on the Glasgow Outcome Scale at discharge after the surgical treatment of aneurysmal SAH associated with increased age, poor World Federation of Neurosurgical Societies (WFNS) grade on admission, higher Fisher's grade on admission computed tomography scan, larger aneurysm, and clinical vasospasm. In a multivariate logistic regression analysis, age, high WFNS grade, positive clinical vasospasm and size of aneurysm were found to be independent risk factors for mortality. The presence of hydrocephalus, number of aneurysms, positive risk factors, and the presence of Doppler vasospasm did not reach statistical significance. CONCLUSION: The most important prognostic factors in patients undergoing surgery due to aneurysmal subarachnoid hemorrhage were WFNS grade, age, size of aneurysm and clinical vasospasm.Item Serum sclerostin levels, arteriovenous fistula calcification and 2-years all-cause mortality in prevalent hemodialysis patients(SOC ESPANOLA NEFROLOGIA DR RAFAEL MATESANZ, 2016-01-01) Kirkpantur, Alper; Balci, Mustafa; Turkvatan, Aysel; Afsar, BarisBackground: Bone and mineral abnormalities, and cardiovascular calcification are associated with increased cardiovascular mortality in patients with chronic kidney disease (CKD). Recent studies have implicated Wnt signaling pathway in the pathogenesis of bone metabolism and vascular calcification. Sclerostin is a soluble inhibitor of Wnt signaling pathway and has been shown to be associated with decreased bone tumover and vascular calcification in CKD patients. Objectives: The aim was to investigate whether the circulating levels of sclerostin are associated with all-cause mortality in prevalent hemodialysis patients. Methods: Data are prospectively collected for 24 months for survival analysis in 350 prevalent hemodialysis patients. At baseline, serum sclerostin levels were measured and arteriovenous fistula calcification was detected by using a 64-detector computerized tomographic scanner. Results: During the follow-up, 84 (24\%) patients died. Patients who died had higher serum sclerostin levels. Kaplan Meier curve revealed that patients with increasing tertiles of serum sclerostin levels at baseline, had a worse survival. In the multivariate Cox regression analysis age, albumin, and presence of arteriovenous fistula calcification, but not sclerostin levels, were found to be independent predictors of survival in maintenance hemodialysis patients. Conclusion: Further clinical studies with longer follow-up are needed to clarify the impact of serum sclerostin levels on morbidity and mortality of maintenance hemodialysis patients. Clinical trial registration number: The study was performed as a post hoc survival analysis of the patients involved in a single-center prospective trial investigating the association between serum sclerostin levels and arteriovenous fistula calcification and patency {[}Balm M, et al. Herz 2015Item Prediction of Mortality in Patients with Sepsis Due to Gram-negative Bacteremia: Pitt Bacteremia Score, qSOFA, SIRS(BILIMSEL TIP YAYINEVI, 2021-01-01) Kiran, Pinar; Batirel, Ayse; Gencer, SerapIntroduction: Sepsis is a syndrome of physiologic, biochemical and pathologic abnormalities induced by infection and has been associated with high mortality and morbidity. This study aimed to compare Systemic Inflammatory Response Syndrome (SIRS) criteria, Pitt bacteremia score and quick Sequential Organ Failure Assessment (qSOFA) for the prediction of mortality in patients with sepsis due to Gram-negative bacteremia. Materials and Methods: Patients with sepsis due to Gram-negative bacteremia admitted to emergency medicine clinic were observed retrospectively from March 2016 to March 2018. Clinical data, laboratory results, co-morbidities, antimicrobial treatment, Pitt bacteremia score, qSOFA score, SIRS criteria of patients were evaluated. Results: A total of 106 patients with sepsis due to gram-negative bacteremia according to Sepsis-2 definition were included. Thirty-day mortality was 20.8\%. Multivariate analysis determined Pitt bacteraemia score (OR:1.63, 95\% CI 1.29-2.05, p< 0.001) as predictors of mortality among septic patients. The area under the ROC curve was 0.885 (95\% CI 0.737-0.933) for Pitt bacteremia score 0.808 (95\% CI 0.713-0.904) for qSOFA and 0.623 (95\% CI 0.492-0.753) for SIRS. Pitt bacteremia score showed the highest specificity (\%71.4) and positive predictive value (\%40.0) as compared to other scores. Conclusion: As the result of the analyses, the mortality rate in patients with sepsis due to gram-negative bacteremia was better predicted with the Pitt bacteremia score than qSOFA score and SIRS criteria.