Browsing by Author "Çilli, A"

Now showing 1 - 11 of 11
  • No Thumbnail Available
    Item
    Serum procalcitonin and C-reactive protein kinetics as indicators of treatment outcome in hospitalized patients with community-acquired pneumonia
    Tasbakan, MS; Gündüz, C; Sayiner, A; Çilli, A; Karaboga, BC; Çoskun, AS; Yaman, FD; Kilinç, O; Soylar, OK
    Background/aim: There has been growing interest in the use of serum procalcitonin (PCT) and C-reactive protein (CRP) in patients with community-acquired pneumonia (CAP). The aim of this study was to investigate whether an assessment of fever, leukocyte count, and serum CRP and PCT levels on admission and during follow-up (day 3) provides any information about the clinical outcome in hospitalized patients with CAP. Materials and methods: Patients with a diagnosis of CAP who were admitted to and followed at four university hospitals were evaluated retrospectively using the Turkish Thoracic Society Pneumonia Database. Results: A total of 103 hospitalized CAP patients (57 males, mean age: 61.5 +/- 16.7 years) were enrolled in the study. Treatment failure (TF) was observed in 20 patients (19.4%). Pneumonia Severity Index scores, serum CRP levels, and PCT levels on admission were significantly higher in the TF group. There were significant decreases in CRP and PCT levels between admission day and day 3 in the treatment success group. Conclusion: In patients with CAP, the body temperature and leukocyte count on admission do not predict outcome. Monitoring levels of CRP and PCT may be useful as a predictor of treatment outcome.
  • No Thumbnail Available
    Item
    Factors affecting treatment success in community acquired pneumonia (CAP)
    Gündüz, C; Tasbakan, MS; Sayiner, A; Çilli, A; Karaboga, B; Kilinç, O; Kiliç, Ö; Coskun, AS; Çetinkaya, C; Hazar, A; Tokgöz, F
  • No Thumbnail Available
    Item
    Long-Term Omalizumab Treatment: A Multicenter, Real-Life, 5-Year Trial
    Yorgancioglu, A; Erkekol, FÖ; Mungan, D; Erdinç, M; Gemicioglu, B; Özseker, ZF; Degirmenci, PB; Nayci, S; Çilli, A; Erdenen, F; Kirmaz, C; Ediger, D; Yalçin, AD; Büyüköztürk, S; Öztürk, S; Güleç, M; Isik, SR; Kalyoncu, AF; Göksel, Ö; Aydin, O; Havlucu, Y; Ar, IB; Erdogdu, A
    Background: Omalizumab has demonstrated therapeutic benefits both in controlled clinical trials and real-life studies. However, research concerning the long-term effects and tolerability of omalizumab is needed. The main objective of this study was to evaluate the effectiveness and tolerability of treatment with omalizumab for up to 5 years. Methods: A multicenter, retrospective, chart-based study was carried out to compare documented exacerbations, hospitalizations, systemic steroid requirement, FEV1, and asthma control test (ACT) results during 1 year prior to omalizumab treatment versus at 1, 3, and 5 years of treatment. Adverse events and reasons for discontinuation were also recorded at each time point. Results: Four hundred and sixty-five patients were enrolled in the study. Outcome variables had improved after the 1st year and were sustained after the 3rd and 5th years of treatment with omalizumab. Omalizumab treatment reduced the asthma exacerbation rate by 71.3% (p < 0.001) at 1 year, 64.3% (p < 0.001) at 3 years, and 54.8% (p = 0.002) at 5 years. The hospitalization rate also decreased; by the 5th year of the treatment no patients were hospitalized. ACT results had also improved significantly: 12 (p < 0.001) at 1 year, 12 (p < 0.001) at 3 years, and 12 (p = 0.002) at 5 years. Overall, 12.7% of patients reported adverse events (most of these were mild-to-moderate) and the overall dropout rate was 9.0%. Conclusion: Omalizumab had a significant effect on asthma outcomes and this effect was maintained over 5 years. The drug was found to be generally safe and treatment compliance was good. (C) 2018 S. Karger AG, Basel
  • No Thumbnail Available
    Item
    Bronchiectasis in Türkiye: Data from a Multicenter Registry (Turkish Adult Bronchiectasis Database)
    Edis, EC; Çilli, A; Kizilirmak, D; Coskun, AS; Güler, N; Çiçek, S; Sevinç, C; Agca, MC; Gülmez, I; Çaglayan, B; Kabak, M; Niksarlioglu, EYO; Köktürk, N; Sayiner, A
    Background: Bronchiectasis is a chronic lung disease characterized by permanent bronchial wall dilatation. Although it has been known as an orphan disease, it has recently gained attention because of registry -based studies and drug research. Aims: We aimed to use a multicenter database to analyze and compare data regarding the etiology, associated comorbidities, microbiological characteristics, and preventive strategies of bronchiectasis in T & uuml;rkiye to those of other countries. Study Design: A multicenter prospective cohort study. Methods: The multicenter, prospective cohort study was conducted between March 2019 and January 2022 using the Turkish Adult Bronchiectasis Database, in which 25 centers in T & uuml;rkiye participated. Patients aged > 18 years who presented with respiratory symptoms such as cough, sputum, and dyspnea and were diagnosed with non -cystic fibrosis bronchiectasis using computed tomography were included in the study. Demographic information, etiologies, comorbidities, pulmonary functions, and microbiological, radiological, and clinical data were collected from the patients. Results: Of the 1,035 study participants, 518 (50%) were females. The mean age of the patients was 56.1 +/- 16.1 years. The underlying etiology was detected in 565 (54.6%) patients. While postinfectious origin was the most common cause of bronchiectasis (39.5%), tuberculosis was identified in 11.3% of the patients. An additional comorbidity was detected in 688 (66.5%) patients. The most common comorbidity was cardiovascular disease, and chronic obstructive pulmonary disease (COPD) and bronchiectasis was identified in 19.5% of the patients. The most commonly detected microbiological agent was Pseudomonas aeruginosa (29.4%). Inhaled corticosteroids (ICS) were used in 70.1% of the patients, and the frequency of exacerbations in the last year was significantly higher in patients using ICS than in nonusers (p < 0.0001). Age [odds ratio (OR): 1.028; 95% confidence interval (CI): 1.005-1.051], cachexia (OR: 4.774; 95% CI: 2,054-11,097), high modified medical research council dyspnea scale score (OR: 1,952; 95% CI: 1,459-2,611), presence of chronic renal failure (OR: 4,172; 95% CI: 1,249-13,938) and use of inhaled steroids (OR: 2,587; 95% CI: 1,098-6,098) were significant risk factors for mortality. Mortality rates were higher in patients with COPD than in those with no COPD (21.7-9.1%, p = 0.016). Patients with bronchiectasis and COPD exhibited more frequent exacerbations, exacerbation -related hospitalizations, and hospitalization in the intensive care unit in the previous year than patients without COPD. Conclusion: This is the first multicenter study of bronchiectasis in T & uuml;rkiye. The study results will provide important data that can guide the development of health policies in T & uuml;rkiye on issues such as infection control, vaccination, and the unnecessary use of antibiotics and steroids.
  • No Thumbnail Available
    Item
    A new scoring system to predict mortality in community-acquired pneumonia: CURB (S)-65
    Bahçecioglu, SN; Köktürk, N; Baha, A; Yapar, D; Aksakal, FNB; Gunduz, C; Tasbakan, S; Sayiner, A; Coskun, AS; Yaman, F; Çilli, A; Celenk, B; Kilinç, O; Mersin, SS; Hazar, A; Tokgoz, F
    OBJECTIVE: The first decision to be made in the case of community-acquired pneumonia (CAP) is whether hospitalization of the patient is mandatory. In this study, we aimed to investigate whether the addition of oxygenation parameters to CURB-65 has diagnostic value in predicting mortality in CAP. PATIENTS AND METHODS: A total of 903 CAP patients were included in the study. Patients with a CURB-65 score of 0 and 1 were classified as Group 1 and patients with a CURB-65 score of 2 or more were classified as Group 2. The prediction of mortality through Pneumonia Severity Index (PSI), CURB-65 and CURBS-65/CURBP- 65 with the addition of SaO(2) and PaO2 values; hence the four different models, was compared among all patient groups. RESULTS: As a result, 3.3% of the cases in Group 1 and 12.7% of the cases in Group 2 died. In both CURB-65 groups, it was noted that the frequency of patients with SaO(2) <90% was significantly higher in the dead group than in the alive patient group (p= 0.009 and p= 0.001, respectively). In the univariate analysis, PaO2<60, and SaO(2)<90 were significantly associated with mortality. Model 2 (CURBS-65) and Model 3 (CURBP-65) were examined, SaO(2)< 90 (OR 2.08) was found to have an effect on death. In predicting mortality by the receiver operating characteristics (ROC) analysis, it was understood that the CURBS-65 score had a slightly higher area under the curve (AUC) value than CURB-65. CONCLUSIONS: As a result, it has been shown that the use of CURBS-65 scoring instead of CURB-65 clinical scoring may be more useful in predicting mortality.
  • No Thumbnail Available
    Item
    Clinical Course of Coronavirus disease 2019 C-19 in Patients with Bronchiectasis
    Edis, EÇ; Çilli, A; Kizilirmak, D; Coskun, AS; Sayiner, A; Çiçek, S; Gülmez, I; Agca, MÇ; Çaglayan, B; Özçelik, N; Köktürk, N; Ocakli, B; Uçan, ES
    OBJECTIVE: Coronavirus disease 2019 (COVID-19) has affected the whole world and caused the death of more than 6 million people. The disease has been observed to have a more severe course in patients with chronic lung diseases. There are limited data regarding COVID-19 in patients with bronchiectasis. The aim of this article is to investigate the course of COVID-19 and factors affecting the clinical outcome in patients with bronchiectasis. MATERIAL AND METHODS: This study was conducted using the Turkish Adult Bronchiectasis Database (TEBVEB) to which 25 centers in T & uuml;rkiye contributed between March 2019 and January 2022. The database consisted of 1035 patients, and COVID-19-related data were recorded for 606 patients. RESULTS: One hundred nineteen (19.6%) of the bronchiectasis patients (64 female, mean age 57.3 +/- 13.9) had COVID-19. Patients with bronchiectasis who developed COVID-19 more frequently had other comorbidities (P = .034). They also more frequently had cystic bronchiectasis (P = .009) and their Bronchiectasis Severity Index was significantly higher (P = .019). Eighty-two (68.9%) of the patients who had COVID-19 were followed up in the outpatient clinic, 27 (22.7%) in the inpatient ward and 10 (8.4%) patients in the intensive care unit. There tended to be a higher percentage of males among patients admitted to the hospital (P = .073); similarly, the mean age of the patients admitted to the hospital was also higher (60.8 vs 55.8 years for the outpatients), but these differences did not reach statistical significance (P = .071). CONCLUSION: In conclusion, this study showed that severe bronchiectasis, presence of cystic bronchiectasis and worse Bronchiectasis Severity Index are associated with the development of COVID-19, but not with the severity of infection.
  • No Thumbnail Available
    Item
    Effects of vaccination on clinical presentation of community acquired pneumonia (CAP)
    Çetinoglu, ED; Uzaslan, E; Çilli, A; Kilinç, O; Coskun, AS; Sayiner, A; Hazar, A; Kokturk, N; Filiz, A; Polatli, M
  • No Thumbnail Available
    Item
    Antibiotic treatment outcomes in community-acquired pneumonia
    Çilli, A; Sayiner, A; Çelenk, B; Sakar Coskun, A; Kilinç, O; Hazar, A; Aktas Samur, A; Tasbakan, S; Waterer, GW; Havlucu, Y; Kiliç, Ö; Tokgöz, F; Bilge, U
    Background/aim: The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with community-acquired pneumonia in nonintensive care unit (ICU) wards and treated with a beta-lactam, beta-lactam and macrolide combination, or a fluoroquinolone. Materials and methods: This prospective cohort study was perfbrined using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey. Results: Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated bacteria were S. pneumoniae (21.8%) and P. aeruginosa (19.2%). The clinical cure rate and length of stay were not different among patients treated with beta-lactam, beta-lactam and macrolide combination, and fluoroquinolone. Forty-seven patients (9.2%) died during the hospitalization period. There was no difference in survival among the three treatment groups. Conclusion: In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between beta-lactam, beta-lactam and macrolide combination, and fluoroquinolone regimens.
  • No Thumbnail Available
    Item
    Factors affecting short and long-term mortality after community-acquired pneumonia
    Akyil, FT; Hazar, A; Yalçinsoy, M; Çilli, A; Çelenk, B; Kilinç, O; Kilinç, Ö; Sayiner, A; Tasbakan, S; Köktürk, N; Coskun, AS; Havlucu, Y; Filiz, A; Edis, EÇ
  • No Thumbnail Available
    Item
    Clinical characteristics and outcome of healthcare associated pneumonia in Turkey
    Gündüz, C; Tasbakan, MS; Sayiner, A; Çilli, A; Kilinç, O; Sakar Coskun, A
    Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with community-acquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65.3 +/- 16.4, 530 male) registered to Turkish Thoracic Society Respiratory Infections Study Group CAP database (TURCAP) were examined. The demographic data, clinical history, pneumonia severity scores (PSI), laboratory and radiologic findings of the CAP and HCAP patients were compared. Results: Out of 785 cases, 207 (26.4%) were diagnosed with HCAP and 578 (73.6%) with CAP. Among HCAP cases, 140/207 (67.6%) had preceding hospitalization in the last 90 days, 28/207 (13.5%) were on a hemodialysis program during the previous 30 days and 22/207 (10.6%) were staying in nursing homes. Patients with HCAP more frequently had comorbidities (93.2% vs. 81.6%; p= 0.001) and higher PSI scores (103.9 +/- 37.2 vs. 94.6 +/- 35.4; p= 0.002) compared to patients with CAP. A causative microorganism was isolated in only 12.1% (70/578) of CAP and 14.5% (30/207) of HCAP patients. The length of stay in hospital was higher in HCAP than CAP (8.6 +/- 5.5 vs. 7.5 +/- 6.1 days, p= 0.03); however the rates of treatment failure, intensive care unit admission and mortality were similar. Conclusion: In comparison to CAP, HCAP patients tend to have more severe disease, despite have no difference in mortality. The current criteria for HCAP do not predict worse clinical outcomes. Further work is required to define local risk factors for multidrug-resistant pathogens.
  • No Thumbnail Available
    Item
    Factors affecting treatment success in community-acquired pneumonia
    Gündüz, C; Tasbakan, MS; Sayiner, A; Çilli, A; Kilinç, O; Coskun, AS
    Background/aim: Treatment failure in hospitalized patients with community-acquired pneumonia is a major cause of mortality. The aim of this study was to evaluate the factors affecting treatment success in community-acquired pneumonia. Materials and methods: A total of 537 patients (mean age: 66.1 +/- 15.8 years, 365 males) registered to the Turkish Thoracic Society Pneumonia Database were analyzed. Of these, clinical improvement or cure, defined as treatment success, was achieved in 477, whereas 60 patients had treatment failure and/or died. Results: Lower numbers of neutrophils (5989.9 +/- 6237.3 vs. 8495.6 +/- 7279.5/mm(3)), higher blood urea levels (66.1 +/- 42.1 vs. 51.2 +/- 38.2 mg/dL), higher Pneumonia Severity Index (PSI) scores (123.3 +/- 42.6 vs. 96.3 +/- 32.9), higher CURB-65 scores (2.7 +/- 1.2 vs. 2.2 +/- 0.9), lower PaO2/FiO(2) ratios (216.3 +/- 86.8 vs. 269.9 +/- 65.6), and the presence of multilobar (33.3% vs. 16.4%) and bilateral (41.7% vs. 18.9%) radiologic infiltrates were related to treatment failure. The PSI score and PaO2/FiO(2) ratio were independent param-eters affecting treatment results in multivariate linear regression analysis (P < 0.001). Conclusion: The risk of treatment failure is high in patients with severe pneumonia and with respiratory failure. Effective treatment and close monitoring are required for these cases.