Browsing by Author "Cesur S."

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    The course of spinal tuberculosis (Pott disease): Results of the multinational, multicentre Backbone-2 study
    (Elsevier B.V., 2015) Batirel A.; Erdem H.; Sengoz G.; Pehlivanoglu F.; Ramosaco E.; Gülsün S.; Tekin R.; Mete B.; Balkan I.I.; Sevgi D.Y.; Giannitsioti E.; Fragou A.; Kaya S.; Cetin B.; Oktenoglu T.; Celik A.D.; Karaca B.; Horasan E.S.; Ulug M.; Senbayrak S.; Kaya S.; Arslanalp E.; Hasbun R.; Ates-Guler S.; Willke A.; Senol S.; Inan D.; Güclü E.; Ertem G.T.; Koc M.M.; Tasbakan M.; Ocal G.; Kocagoz S.; Kusoglu H.; Güven T.; Baran A.I.; Dede B.; Karadag F.Y.; Yilmaz H.; Aslan G.; Al-Gallad D.A.; Cesur S.; El-Sokkary R.; Sirmatel F.; Savasci U.; Karaahmetoglu G.; Vahaboglu H.
    We aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae. © 2015 European Society of Clinical Microbiology and Infectious Diseases.
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    Comparison of brucellar and tuberculous spondylodiscitis patients: Results of the multicenter "backbone-1 Study"
    (Elsevier Inc., 2015) Erdem H.; Elaldi N.; Batirel A.; Aliyu S.; Sengoz G.; Pehlivanoglu F.; Ramosaco E.; Gulsun S.; Tekin R.; Mete B.; Balkan I.I.; Sevgi D.Y.; Giannitsioti E.; Fragou A.; Kaya S.; Cetin B.; Oktenoglu T.; Dogancelik A.; Karaca B.; Horasan E.S.; Ulug M.; Inan A.; Kaya S.; Arslanalp E.; Ates-Guler S.; Willke A.; Senol S.; Inan D.; Guclu E.; Tuncer-Ertem G.; Meric-Koc M.; Tasbakan M.; Senbayrak S.; Cicek-Senturk G.; Sirmatel F.; Ocal G.; Kocagoz S.; Kusoglu H.; Guven T.; Baran A.I.; Dede B.; Yilmaz-Karadag F.; Kose S.; Yilmaz H.; Aslan G.; Algallad D.A.; Cesur S.; El-Sokkary R.; Bekiroǧlu N.; Vahaboglu H.
    Background Context No direct comparison between brucellar spondylodiscitis (BSD) and tuberculous spondylodiscitis (TSD) exists in the literature. Purpose This study aimed to compare directly the clinical features, laboratory and radiological aspects, treatment, and outcome data of patients diagnosed as BSD and TSD. Study Design A retrospective, multinational, and multicenter study was used. Patient Sample A total of 641 (TSD, 314 and BSD, 327) spondylodiscitis patients from 35 different centers in four countries (Turkey, Egypt, Albania, and Greece) were included. Outcome Measures The pre- and peri- or post-treatment spinal deformity and neurologic deficit parameters, and mortality were carried out. Methods Brucellar spondylodiscitis and TSD groups were compared for demographics, clinical, laboratory, radiological, surgical interventions, treatment, and outcome data. The Student t test and Mann-Whitney U test were used for group comparisons. Significance was analyzed as two sided and inferred at 0.05 levels. Results The median baseline laboratory parameters including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were higher in TSD than BSD (p<.0001). Prevertebral, paravertebral, epidural, and psoas abscess formations along with loss of vertebral corpus height and calcification were significantly more frequent in TSD compared with BSD (p<.01). Surgical interventions and percutaneous sampling or abscess drainage were applied more frequently in TSD (p<.0001). Spinal complications including gibbus deformity, kyphosis, and scoliosis, and the number of spinal neurologic deficits, including loss of sensation, motor weakness, and paralysis were significantly higher in the TSD group (p<.05). Mortality rate was 2.22% (7 patients) in TSD, and it was 0.61% (2 patients) in the BSD group (p=.1). Conclusions The results of this study show that TSD is a more suppurative disease with abscess formation requiring surgical intervention and characterized with spinal complications. We propose that using a constellation of constitutional symptoms (fever, back pain, and weight loss), pulmonary involvement, high inflammatory markers, and radiological findings will help to differentiate between TSD and BSD at an early stage before microbiological results are available. © 2015 Elsevier Inc.
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    Production, optimization and characterization of polylactic acid microparticles using electrospray with porous structure
    (MDPI AG, 2021) Tasci M.E.; Dede B.; Tabak E.; Gur A.; Sulutas R.B.; Cesur S.; Ilhan E.; Lin C.-C.; Paik P.; Ficai D.; Ficai A.; Gunduz O.
    Polymeric microparticles with controlled morphologies and sizes are being studied by researchers in many applications, such as for drug release, healthcare and cosmetics. Herein, spherical and porous polymeric microparticles of different sizes and morphologies by electrospray technique have been developed as a viable alternative. In this work, polylactic acid (PLA) microparticles with a spherical shape and porous morphology were successfully produced via an electrospray technique in a single step. Molecular interactions between the components and the effect of parameters, such as varying solvent compositions, flow rates and voltage on microparticle morphology, were investigated over the particle formation. It was observed that the type of solvents used is the most effective parameter in terms of particle morphology, size and distribution. When the optical microscopy and SEM images of the microparticles were examined, 3 wt.% PLA in dichloromethane (DCM) solution concentration with an applied voltage of 18 kV and a flow rate of 20 µL/min was found to be the optimum parameter combination to achieve the desired spherical and porous micron-size particles. The average diameter of the particles achieved was 3.01 ± 0.58 µm. DCM was found to be a more suitable solvent for obtaining microparticles compared to the other solvents used. Finally, particles that are obtained by electrospraying of PLA–DCM solution are porous and monodisperse. They might have excellent potential as a carrier of drugs to the targeted sides and can be used in different biomedical applications. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.