Browsing by Author "Kilic, E"

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    Community-acquired pneumonia in patients with chronic obstructive pulmonary disease requiring admission to the intensive care unit: Risk factors for mortality
    Cilli, A; Erdem, H; Karakurt, Z; Turkan, H; Yazicioglu-Mocin, O; Adiguzel, N; Gungor, G; Bilge, U; Tasci, C; Yilmaz, G; Oncul, O; Dogan-Celik, A; Erdemli, O; Oztoprak, N; Samur, AA; Tomak, Y; Inan, A; Karaboga, B; Tok, D; Temur, S; Oksuz, H; Senturk, O; Buyukkocak, U; Yilmaz-Karadag, F; Ozcengiz, D; Karakas, A; Savasci, U; Ozgen-Alpaydin, A; Kilic, E; Elaldi, N; Bilgic, H
    Purpose: The aims of this study are to identify factors predicting mortality in patients with chronic obstructive pulmonary disease (COPD) and community-acquired pneumonia (CAP) requiring intensive care unit (ICU) admission and to examine whether noninvasive ventilation treatment reduces mortality. Materials and Methods: An analysis was performed on data from patients with CAP hospitalized in the ICUs of 19 different hospitals in Turkey between October 2008 and January 2011. Predictors of mortality were assessed by both univariate and multivariate statistical analyses. Results: Two hundred eleven patients with COPD and CAP were included. The overall ICU mortality was 23.9%. Noninvasive ventilation treatment (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.03-0.49; P=.003), hypertension (OR, 0.13; 95% CI, 0.02-0.93; P=.042), bilateral infiltration (OR, 13.92; 95% CI, 2.94-65.84; P=.001), systemic corticosteroid treatment (OR, 0.19; 95% CI, 0.35-0.96; P=.045), length of ICU stay (OR, 0.65; 95% CI, 0.47-0.89; P=.007), and duration of invasive mechanical ventilation (OR, 1.11; 95% CI, 1.01-1.22; P=.032) were independent factors related to mortality. Conclusion: Noninvasive ventilation, hypertension, systemic corticosteroid treatment, and shorter ICU stay are associated with reduced mortality, whereas bilateral infiltration and longer duration of invasive mechanical ventilation are associated with increased risk of mortality in patients with COPD and CAP requiring ICU admission. (C) 2013 Elsevier Inc. All rights reserved.
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    Mortality indicators in community-acquired pneumonia requiring intensive care in Turkey
    Erdem, H; Turkan, H; Cilli, A; Karakas, A; Karakurt, Z; Bilge, U; Yazicioglu-Mocin, O; Elaldi, N; Adiguzel, N; Gungor, G; Tasci, C; Yilmaz, G; Oncul, O; Dogan-Celik, A; Erdemli, O; Oztoprak, N; Tomak, Y; Inan, A; Karaboga, B; Tok, D; Temur, S; Oksuz, H; Senturk, O; Buyukkocak, U; Yilmaz-Karadag, F; Ozcengiz, D; Turker, T; Afyon, M; Samur, AA; Ulcay, A; Savasci, U; Diktas, H; Ozgen-Alpaydin, A; Kilic, E; Bilgic, H; Leblebicioglu, H; Unal, S; Sonmez, G; Gorenek, L
    Background: Severe community-acquired pneumonia (SCAP) is a fatal disease. This study was conducted to describe an outcome analysis of the intensive care units (ICUs) of Turkey. Methods: This study evaluated SCAP cases hospitalized in the ICUs of 19 different hospitals between October 2008 and January 2011. The cases of 413 patients admitted to the ICUs were retrospectively analyzed. Results: Overall 413 patients were included in the study and 129 (31.2%) died. It was found that bilateral pulmonary involvement (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.1-5.7) and CAP PIRO score (OR 2, 95% CI 1.3-2.9) were independent risk factors for a higher in-ICU mortality, while arterial hypertension (OR 0.3, 95% CI 0.1-0.9) and the application of non-invasive ventilation (OR 0.2, 95% CI 0.1-0.5) decreased mortality. No culture of any kind was obtained for 90 (22%) patients during the entire course of the hospitalization. Blood, bronchoalveolar lavage, and non-bronchoscopic lavage cultures yielded enteric Gram-negatives (n = 12), followed by Staphylococcus aureus (n = 10), pneumococci (n = 6), and Pseudomonas aeruginosa (n = 6). For 22% of the patients, none of the culture methods were applied. Conclusions: SCAP requiring ICU admission is associated with considerable mortality for ICU patients. Increased awareness appears essential for the microbiological diagnosis of this disease. (C) 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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    Discriminant validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with non-radiographic axial spondyloarthritis and ankylosing spondylitis: a cohort study
    Kilic, E; Kilic, G; Akgul, O; Ozgocmen, S
    The aim of this study was to assess discriminant validity of Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) and to compare with The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) as clinical tools for the measurement of disease activity in patients with non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS). Also, the cut-off values for ASDAS-CRP in nr-axSpA and AS is revisited. Patients with axSpA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and were assessed for disease activity, quality of life and functional measures. The discriminatory ability of ASDAS-CRP and ASDAS-ESR was assessed using standardized mean differences and receiver operating characteristic (ROC) curves analysis. Optimal cut-off values for disease activity scores were calculated. Two hundred and eighty-seven patients with axSpA (nr-axSpA:132, AS:155) were included in this study. Two ASDAS versions and BASDAI had good correlations with patient's and physician's global assessment in both groups. Discriminatory ability of ASDAS-CRP, ASDAS-ESR and BASDAI were similar in patients with nr-axSpA and AS when the patients were assigned into low and high disease activity according to the ASAS partial remission, patient's and physician's global assessment scores (based on the comparison of ROC curves). ASDAS cut-off values are quite similar between groups indicating that ASDAS-CRP works similarly well in nr-axSpA and AS. The performance of ASDAS to discriminate low and high disease activity and cut-off values are quite similar in patients with AS and non-radiographic axial SpA.
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    Presence of enthesopathy demonstrated with ultrasonography in systemic sclerosis
    Kilic, E; Kilic, G; Akgul, O; Ozgocmen, S
    Objective. The aim of this study was to sonographically assess the presence and distribution of enthesopathy in systemic sclerosis (SSc). Methods. Consecutive patients with SSc and age-matched healthy controls were included in this study. All of the patients met the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria for SSc. Six entheses sites were evaluated using gray scale and Doppler ultrasonographies (USs) with a linear transducer and were scored using the Madrid Sonography Enthesitis Index (MASEI). Results. We evaluated 52 patients with SSc (46.10 +/- 13.42 years) and 41 healthy controls (49.59 +/- 9.35 years). Patients with SSc had significantly higher MASEI scores than the healthy controls. Except for plantar aponeurosis, the tendons and ligaments were thicker in the SSc group. In the SSc group, there were 25 (48.1%) diffuse cutaneous SScs and 22 (42.3%) limited cutaneous SScs. Variables such as age, BMI, disease duration, diagnostic delay and MASEI scores were similar in subgroups of SSc. There was a positive correlation between MASEI score and age, modified Rodnan's skin score and dyspnea grade, and a negative correlation with handgrip strength. Conclusion. To the best of our knowledge, this is the first study showing the presence of enthesopathy in patients with SSc using US. Enthesopathy should be kept in mind in symptomatic patients with SSc; additionally, it can be easily identified with US.
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    SERUM AND TISSUE LEVELS OF HYALURONAN IN PATIENTS WITH SYSTEMIC SCLEROSIS
    Kilic, E; Kilic, G; Karadas, G; Akgul, O; Aytekin, M; Sonmez, MF; Ozgocmen, S