Browsing by Author "Erdem, Hakan"
Now showing 1 - 6 of 6
- Results Per Page
- Sort Options
Item Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs(BMC, 2011) Erdem, Hakan; Koruk, Suda Tekin; Koruk, İbrahim; Keten, Derya Tozlu; Kılıç, Aysegül Ulu; Öncül, Oral; Güner, Rahmet; Birengel, Serhat; Mert, Gürkan; Alpat, Saygın Nayman; Tülek, Necla Eren; Demirdal, Tuna; Elaldi, Nazif; Hatipoglu, Çiğdem Ataman; Yılmaz, Emel; Mete, Bilgul; Kurtaran, Behice; Ceran, Nurgül; Karabay, Oğuz; İnan, Dilara; Cengiz, Melahat; Sacar, Suzan; Dede, Behiye Yücesoy; Yılmaz, Sibel; Agalar, Canan; Bayındır, Yaşar; Alpay, Yeşim; Tosun, Selma; Yılmaz, Hava; Bodur, Hürrem; Erdem, Hüseyin A.; Dikici, Nebahat; Dizbay, Murat; Öncu, Serkan; Sezak, Nurbanu; Sarı, Tuba; Sipahi, Oğuz R.; Uysal, Serhat; Yeniz, Esma; Kaya, Selcuk; Ulcay, Asım; Kurt, Halil; Beşirbellioğlu, Bulent A.; Vahaboğlu, Haluk; Taşova, Yeşim; Usluer, Gaye; Arman, Dilek; Diktaş, Hüsrev; Ulusoy, Sercan; Leblebicioğlu, Hakan; Yılmaz, Emel; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0002-3894-1231; 22037135100Background: Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists. Methods: A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included. Results: A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients. Conclusions: The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.Publication Diagnostic dilemma of paraneoplastic arthritis: Case series(Wiley-blackwell, 2014-07-01) Kısacık, Bünyamin; Onat, Ahmet M.; Kaşifoğlu, Timuçin; Pehlivan, Yavuz; Pamuk, Ömer N.; Dönmez, Salim; Bilge, Sule Y.; Yilmaz, Sedat; Erdem, Hakan; Mercan, Ridvan; Özturk, Mehmet A.; Beş, Cemal; Soy, Mehmet; Erten, Sukran; Çobankara, Veli; Senel, Soner; Öner, Fatma A.; Direskeneli, Haner; Yılmaz, Sema; Yazıcı, Ayten; Emmungil, Hakan; Aksu, Kenan; Kul, Seval; Çetin, Gozde Y.; Sayarlıoğlu, Mehmet; DALKILIÇ, HÜSEYİN EDİZ; 0000-0002-6265-5227; 0000-0003-1537-2192; 0000-0003-1096-7306; 0000-0003-1710-7018; 0000-0003-0717-8365; 0000-0003-2598-5806; 0000-0002-4839-3777; 0000-0003-2167-4509; 0000-0001-5184-4404; JUV-4187-2023; JFJ-3399-2023; W-3342-2017; AAT-3636-2020; AAG-7687-2020; IZE-6133-2023; AAG-8227-2021; AAR-2072-2020; AAD-1796-2021; HLH-8218-2023; J-9960-2019; AAS-5508-2020; AAD-5233-2020Objectives: Paraneoplastic arthritis (PA) may mimic rheumatic diseases. While presenting the demographic and laboratory features of the patients diagnosed with PA, this study also aims to provide possible appropriate tools to differentiate the PA cases from early rheumatoid arthritis (ERA).Methods: Sixty-five patients with PA (male/female: 43/22) from 15 different rheumatology clinics and 50 consecutive patients with ERA (male/female: 13/37) fulfilling the 2010 American College of Rheumatology (ACR) criteria for the diagnosis if the RA from Gaziantep Rheumatology Early Arthritis Trial (GREAT) as controls who were diagnosed at least 12 months before, were enrolled into study.Results: Mean ages of the patients with PA and ERA were 50.2 +/- 15.3, and 42.7 +/- 12.3, respectively, and the mean ages of the patients with PA were significantly higher than the ERA. Unlike the ERA patients, in our case series PA was predominantly observed among males. Oligoarthritis was significantly higher in solid tumors in contrast to ERA (P = 0.001). Polyarthritis and symmetric arthritis were significantly higher in the ERA group in contrast to all malignancies (P = 0.001). Rheumatoid factor (RF) and anticyclic citrullinated peptide antibody (anti-CCP) positivity were significantly higher in the ERA group (each P = 0.001). Lactic dehydrogenase levels of hematologic malignancies were significantly higher than other groups (each, P = 0.001).Conclusions: ERA patients had more symmetric joint involvement than PA; laboratory markers could be also an alternative where there is high RF and anti-CCP positivity with antibody levels among the ERA patients. Finally, the demographic features can be used as differentiatingItem Efficacy and tolerability of antibiotic combinations in Neurobrucellosis: Results of the Istanbul study(American Society of Microbiology, 2012-03) Erdem, Hakan; Kılıç, Ayşegül Ulu; Kılıç, Selim; Karahocagil, Mustafa; Shehata, Ghaydaa; Tülek, Necla Eren; Yetkin, Funda; Çelen, Mustafa Kemal; Ceran, Nurgül; Gül, Hanefi Cem; Mert, Gürkan; Koruk, Suda Tekin; Dizbay, Murat; İnal, Ayşe Seza; Alpat, Saygın Nayman; Bosilkovski, Mile; İnan, Dilara; Saltoğlu, Neşe; Abdel-Baky, Laila; Adeva-Bartolome, Maria Teresa; Ceylan, Bahadır; Saçar, Suzan; Turhan, Vedat; Elaldı, Nazif; Tufan, Zeliha Koçak; Uğurlu, Kenan; Dokuzoğuz, Başak; Yılmaz, Hava; Gündeş, Sibel; Güner, Rahmet; Özgüneş, Nail; Ulçay, Asım; Ünal, Serhat; Dayan, Saim; Görenek, Levent; Karakaş, Ahmet; Tasova, Yeşim; Usluer, Gaye; Bayındır, Yaşar; Kurtaran, Behice; Sipahi, Oğuz Reşat; Leblebicioğlu, Hakan; Yılmaz, Emel; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 22037135100No data on whether brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or whether an intravenous extended-spectrum cephalosporin, namely, ceftriaxone, which does not accumulate in phagocytes, should be added to the regimen exist in the literature. The aim of a study conducted in Istanbul, Turkey, was to compare the efficacy and tolerability of ceftriaxone-based antibiotic treatment regimens with those of an oral treatment protocol in patients with these conditions. This retrospective study enrolled 215 adult patients in 28 health care institutions from four different countries. The first protocol (P1) comprised ceftriaxone, rifampin, and doxycycline. The second protocol (P2) consisted of trimethoprim-sulfamethoxazole, rifampin, and doxycycline. In the third protocol (P3), the patients started with P1 and transferred to P2 when ceftriaxone was stopped. The treatment period was shorter with the regimens which included ceftriaxone (4.40 +/- 2.47 months in P1, 6.52 +/- 4.15 months in P2, and 5.18 +/- 2.27 months in P3) (P = 0.002). In seven patients, therapy was modified due to antibiotic side effects. When these cases were excluded, therapeutic failure did not differ significantly between ceftriaxone-based regimens (n = 5/166, 3.0%) and the oral therapy (n = 4/42, 9.5%) (P = 0.084). The efficacy of the ceftriaxone-based regimens was found to be better (n = 6/166 [3.6%] versus n = 6/42 [14.3%]; P = 0.017) when a composite negative outcome (CNO; relapse plus therapeutic failure) was considered. Accordingly, CNO was greatest in P2 (14.3%, n = 6/42) compared to P1 (2.6%, n = 3/ 117) and P3 (6.1%, n = 3/ 49) (P = 0.020). Seemingly, ceftriaxone-based regimens are more successful and require shorter therapy than the oral treatment protocol.Publication 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-6992-2023Predicting 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 Management of Brucella endocarditis: Results of the Gulhane study(Elsevier, 2012-08) Koruk, Suda Tekin; Erdem, Hakan; Koruk, İbrahim; Erbay, Ayşe; Tekce, Yasemin Tezer; Erbay, Ali Rıza; Dayan, Saim; Deveci, Özcan; İnan, Asuman; Engin, Derya Öztürk; Güner, Rahmet; Dikici, Nebahat; Kartal, Elif Doyuk; Kurtaran, Behice; Pehlivanoğlu, Filiz; Sipahi, Oğuz Reşat; Yalcı, Aysun; Yemişen, Mücahit; Çavuş, Sema Alp; Gençer, Serap; Güzel, Gökhan; Öncül, Oral; Parlak, Mehmet; Tülek, Necla; Ulçay, Asım; Savaşçı, Ümit; Kazak, Esra; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; AAG-8459-2021; 24921238200Brucella endocarditis (BE) is a rare but life-threatening complication of human brucellosis. The aim of this study was to investigate the course of BE along with the therapeutic interrelations. A total of 53 patients with BE hospitalised in 19 health institutions between 2006 and 2011 were included in the Gulhane study. Diagnosis of brucellosis was established by either isolation of Brucella sp. or the presence of antibodies, and the definition of endocarditis was made according to Duke's criteria. There were four treatment groups: ceftriaxone combined with oral antibiotics (Group 1); aminoglycosides combined with oral antibiotics (Group 2); oral antibiotic combinations (Group 3); and aminoglycoside plus ceftriaxone combined with an oral antibiotic (Group 4). Involvement rates of the aortic, mitral and tricuspid valves were 49.1%, 43.4% and 5.7%, respectively. Thirty-two patients (60.4%) had an underlying cardiac valvular problem, including previous prosthetic valve replacement (n = 18). Medical treatment was provided to 32 patients (60.4%), whilst concordant medical and surgical approaches were provided to 21 patients (39.6%). Mortality in Group 1 was 15% (3/20), whilst in Group 2 it was 5.3% (1/19). In Group 3, 25.0% (3/12) of the cases died, whereas none of the cases in Group 4 died. In conclusion, mortality increased 47-fold with pericardial effusion and 25-fold due to congestive heart failure that developed after BE. Although mortality was lower in the aminoglycoside-containing arm (Groups 2 and 4), statistical analysis could not be performed owing to the small number of patients.Publication 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-6992-2023Background 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.