Browsing by Author "Kazak, E."
Now showing 1 - 2 of 2
- Results Per Page
- Sort Options
Publication Impact of revised EORTC/MSGERC 2020 criteria on diagnosis and prognosis of invasive pulmonary aspergillosis in patients with hematological malignancies undergoing bronchoscopy(Masson Editeur, 2022-06-14) Acet-Öztürk, N. A.; Ömer-Topcu, D.; Vurat-Acar, K.; Aydın-Güçlü, O.; Pınar, I. E.; Demirdoğen, E.; Görek-Dilektaşli, A.; Kazak, E.; Özkocaman, V; Ursavaş, A.; Akalın, H.; Özkalemkas, F.; Ener, B.; Ali, R.; ACET ÖZTÜRK, NİLÜFER AYLİN; ÖMER TOPÇU, DİLARA; VURAT ACAR, KÜBRA; AYDIN GÜÇLÜ, ÖZGE; PINAR, İBRAHİM ETHEM; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; ÖZKOCAMAN, VİLDAN; URSAVAŞ, AHMET; AKALIN, EMİN HALİS; ÖZKALEMKAŞ, FAHİR; ENER, BEYZA; ALİ, RIDVAN; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 0000-0001-9907-1498; 0000-0002-7380-2501; JII-3270-2023; FRE-8778-2022; GXC-7806-2022; GXD-8045-2022; JGM-6601-2023; JIA-5197-2023; CRM-4095-2022; CZK-6380-2022; JIR-6730-2023; AAI-3169-2021; EJJ-6847-2022; JIW-1248-2023; CNK-0895-2022; GXD-8209-2022Introduction: The first consensus definitions for invasive fungal diseases (IFD) were published in 2002. Advan-ces in diagnostic tests and a clear need for improvement in certain areas led to a revision of these definitions in 2008. However, growing data on Aspergillus galactomannan (GM) thresholds and the introduction of new polymerase chain reaction-based diagnostic tests resulted in a further update by EORTC and Mycoses Study Group Education and Research Consortium (MSGERC) in 2020. Compared to the 2008 version, the 2020 EORTC/MSGERC criteria have stricter definitions, especially regarding GM levels, which should lead to improved specificity. Thus, our study aimed to evaluate diagnostic changes, based on GM levels, resulting from these new definitions and ascertain the impact of the new classification on mortality rates. Method: Patients hospitalized in a single tertiary care center with hematologic malignancies and undergoing bronchoscopy for suspected IPA between April 2004 and December 2019 were included in this retrospective study. Results: The study population consisted of 327 patients with 31 patients (nine patients with proven IPA and 22 patients with no IPA) excluded from the study. 194 patients were classified as probable IPA cases according to 2008 EORTC/MSG criteria. However, 53 (27.3%) of these patients were re-classified as possible IPA according to 2020 EORTC/MSGERC criteria, due to novel galactomannan cut-off levels. Compared to re-classified possible IPA patients, those remaining in the probable IPA category experienced a higher incidence of septic shock (34.0% vs 16.9%, p=0.02), and required more non-invasive (12.0% vs 0.0%, p=0.004) and invasive (44.6 vs 24.5%, p=0.01) mechanical ventilation. There was a higher in-hospital mortality rate in probable IPA patients than in the re-clas-sified possible IPA group (42.5% vs 22.6%, p=0.01). Patients reassigned to possible IPA had similar underlying dis-eases, radiological features and prognosis to patients already classified as possible IPA. Independent risk factors for mortality were classification as probable IPA according to 2020 EORTC/MSGERC criteria, lack of remission from hematologic malignancy, and number of nodules in Thorax CT. Conclusion: The use of 2020 EORTC/MSGERC criteria resulted in a 27.3% significant reduction in probable IPA diagnoses and created a more homogeneous category of patients with respect to treatment response, prog-nosis and mortality. Therefore, 2020 EORTC/MSGERC criteria afford more reliable mortality prediction than 2008 EORTC/MSG criteria.(c) 2022 SFMM. Published by Elsevier Masson SAS. All rights reserved.Publication Update on treatment options for spinal brucellosis(Wiley-blackwell, 2014-02-01) Ulu-Kılıç, A.; Karakas, A.; Erdem, H.; Türker, T.; İnal, A. S.; Ak, O.; Turan, H.; İnan, A.; Duygu, F.; Demiraslan, H.; Kader, C.; Sener, A.; Dayan, S.; Deveci, O.; Tekin, R.; Saltoğlu, N.; Aydın, M.; Horasan, E. S.; Gül, H. C.; Ceylan, B.; Kadanalı, A.; Karabay, O.; Karagoz, G.; Kayabaş, U.; Turhan, V.; Engin, D.; Gülsün, S.; Elaldı, N.; Alabay, S.; Kazak, E.; KAZAK, ESRA; Bursa Uludağ Üniversitesi/Tıp Fakültesi; AAG-8459-2021We evaluated the efficacy and tolerability of antibiotic regimens and optimal duration of therapy in complicated and uncomplicated forms of spinal brucellosis. This is a multicentre, retrospective and comparative study involving a total of 293 patients with spinal brucellosis from 19 health institutions. Comparison of complicated and uncomplicated spinal brucellosis was statistically analysed. Complicated spinal brucellosis was diagnosed in 78 (26.6%) of our patients. Clinical presentation was found to be significantly more acute, with fever and weight loss, in patients in the complicated group. They had significantly higher leukocyte and platelet counts, erythrocyte sedimentation rates and C-reactive protein levels, and lower haemoglobulin levels. The involvement of the thoracic spine was significantly more frequent in complicated cases. Spondylodiscitis was complicated, with paravertebral abscess in 38 (13.0%), prevertebral abscess in 13 (4.4%), epidural abscess in 30 (10.2%), psoas abscess in 10 (3.4%) and radiculitis in 8 (2.7%) patients. The five major combination regimens were: doxycycline 200mg/day, rifampicin 600mg/day and streptomycin 1g/day; doxycycline 200mg/day, rifampicin 600mg/day and gentamicin 5mg/kg; doxycycline 200mg/day and rifampicin 600mg/day; doxycycline 200mg/day and streptomycin 1g/day; and doxycycline 200mg/day, rifampicin 600mg/day and ciprofloxacin 1g/day. There were no significant therapeutic differences between these antibiotic groups; the results were similar regarding the complicated and uncomplicated groups. Patients were mostly treated with doxycycline and rifampicin with or without an aminoglycoside. In the former subgroup, complicated cases received antibiotics for a longer duration than uncomplicated cases. Early recognition of complicated cases is critical in preventing devastating complications. Antimicrobial treatment should be prolonged in complicated spinal brucellosis in particular.