Browsing by Author "Crisan, Alexandru"

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Hamsi scoring in the prediction of unfavorable outcomes from tuberculous meningitis: Results of haydarpasa-II study
(Springer, 2015-04-01) Erdem, Hakan; Öztürk-Engin, Derya; Tireli, Hülya; Kılıçoğlu, Gamze; Defres, Sylviane; Gülsün, Serda; Şengöz, Gönül; Crisan, Alexandru; Johansen, Isik Somuncu; Inan, Asuman; Nechifor, Mihai; Al-Mahdawi, Akram; Civljak, Rok; Özgüler, Müge; Savic, Branislava; Ceran, Nurgul; Cacopardo, Bruno; İnal, Ayşe Seza; Namiduru, Mustafa; Dayan, Saim; Kayabaş, Üner; Parlak, Emine; Khalifa, Ahmad; Kursun, Ebru; Sipahi, Oguz Resat; Yemisen, Mucahit; Akbulut, Ayhan; Bitirgen, Mehmet; Popovic, Natasa; Kandemir, Bahar; Luca, Catalina; Parlak, Mehmet; Stahl, Jean Paul; Pehlivanoğlu, Filiz; Simeon, Soline; Ulu-Kılıç, Ayşegül; Yasar, Kadriye; Yılmaz, Gülden; Yılmaz, Emel; Beovic, Bojana; Catroux, Melanie; Lakatos, Botond; Sunbul, Mustafa; Öncül, Oral; Alabay, Selma; Şahin-Horasan, Elif; Köse, Sükran; Shehata, Ghaydaa; Andre, Katell; Dragovac, Gorana; Gül, Hanefi Cem; Karakaş, Ahmet; Chadapaud, Stephane; Hansmann, Yves; Harxhi, Arjan; Kirova, Valerija; Masse-Chabredier, Isabelle; Öncü, Serkan; Şener, Alper; Tekin, Recep; Elaldi, Nazif; Deveci, Özcan; Özkaya, Hacer Deniz; Karabay, Oguz; şenbayrak, Seniha; Ağalar, Canan; Vahaboğlu, Haluk; YILMAZ, EMEL; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı; HJZ-6992-2023
Predicting 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.
The diagnostic utility of the "Thwaites' system" and "lancet consensus scoring system" in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients
(Bmc, 2020-10-23) Sulaiman, Tarek; Medi, Sai; Erdem, Hakan; Şenbayrak, Seniha; Öztürk-Engin, Derya; İnan, Asuman; Civljak, Rok; Nechifor, Mihai; Akbulut, Ayhan; Crisan, Alexandru; Özgüler, Müge; Namiduru, Mustafa; Savic, Branislava; Dulovic, Olga; Pehlivanoğlu, Filiz; Şengöz, Gönül; Yaşar, Kadriye; İnal, Ayşe Seza; Parlak, Emine; Johansen, Işık Somuncu; Kurşun, Ebru; Parlak, Mehmet; Yılmaz, Emel; Yılmaz, Gülden; Gül, Hanefi Cem; Öncül, Oral; Simeon, Soline; Tattevin, Pierre; Ulu-Kılıç, Ayşegül; Alabay, Selma; Beovic, Bojana; Catroux, Melanie; Hansmann, Yves; Harxhi, Arjan; Şener, Alper; Özkaya, Hacer Deniz; Cağ, Yasemin; Agalar, Canan; Vahaboğlu, Haluk; Uğur, Berna Kaya; Hasbun, Rodrigo; YILMAZ, EMEL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; HJZ-6992-2023
Background Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The "Thwaites' system" and "Lancet consensus scoring system" are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. Methods A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The "Thwaites' system" and "Lancet consensus scoring system" scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The "Thwaites' system" and "Lancet consensus scoring system" suggest a high probability of TBM with scores <= 4, and with scores of >= 12, respectively. Results A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P < 0.001). A total of 162 patients with TBM and 233 patients with non-TBM had unknown (140, 60.1%), fungal (41, 17.6%), viral (29, 12.4%), miscellaneous (16, 6.7%), and bacterial (7, 3.0%) etiologies. TMB patients were older and presented with lower Glasgow coma scores, lower CSF glucose and higher CSF protein (P < 0.001). Both criteria were able to distinguish TBM from bacterial meningitis; only the Lancet score was able to differentiate TBM from fungal, viral, and unknown etiologies even though significant overlap occurred between the etiologies (P < .001). Both criteria showed poor diagnostic accuracy to distinguish TBM from non-TBM etiologies (AUC-ROC was <. 5), but Lancet consensus scoring system was fair in diagnosing TBM (AUC-ROC was .738), sensitivity of 50%, and specificity of 89.3%. Conclusion Both criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.