Person: OLGUN YILDIZELİ, ŞEHNAZ
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OLGUN YILDIZELİ
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ŞEHNAZ
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Publication Open Access Procalcitonin-Guided Antibiotic Treatment in Lower Respiratory Tract Infections(GALENOS YAYINCILIK, 2018-08-06) CEYHAN, BERRİN; Balci, Merih Kalamanoglu; Balcan, Baran; Yildizeli, Sehnaz Olgun; Ceyhan, BerrinObjective: Procalcitonin (PCT), C-reactive protein (CRP), and leukocyte count are important host response biomarkers to determine the presence of infection. The aim of the present study was to evaluate the usefulness of PCT with other markers in lower respiratory tract infections. Methods: A total of 78 patients with community-acquired pneumonia (CAP), chronic obstructive pulmonary disease (COPD) exacerbations, and healthy controls were evaluated. Baseline serum levels of PCT and CRP and leukocyte counts were assessed and repeated on day 7 of antibiotic treatment. Results: Procalcitonin levels and absolute neutrophil counts (ANCs) were higher in the CAP and COPD groups than in the control group. In the CAP and COPD exacerbation groups, the leukocyte count, ANC, and CRP and PCT levels decreased on day 7 of the treatment (p<0.001). In the CAP group, the baseline PCT levels were correlated with leukocyte counts (r=0.495, p<0.005), ANCs (r=0.426, p<0.019), and CRP levels (r=0.515, p<0.004). In receiver operating characteristic curve analysis, PCT threshold >0.12 ng/mL had a sensitivity of 70.4% and specificity of 68.7%, and CRP threshold >22.9 mg/L had a sensitivity of 85.2% and specificity of 75.0%. Conclusion: Procalcitonin is a useful marker to determine the initiation of antibiotic therapy and can also be used to cease the treatment.Publication Open Access Determination of Factors Affecting Mortality of Patients with Sepsis in a Tertiary Intensive Care Unit(BILIMSEL TIP PUBLISHING HOUSE, 2015-07-06) BALCAN, MEHMET BARAN; Balcan, Baran; Olgun, Sehnaz; Torlak, Fatih; Sagmen, Seda Beyhan; Eryuksel, Emel; Karakurt, SaitOBJECTIVES: Sepsis is a disease with high mortality that is frequently observed in intensive care units. This study aimed to determine the risk factors affecting mortality of patients with sepsis who were followed up in the intensive care unit (ICU). We aimed to contribute to literature by evaluating the relationship between mortality and pro-brain natriuretic peptide (pro-BNP9), C-reactive protein (CRP), thrombocyte count, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, duration of hospitalization in the intensive care unit, and the presence of multidrug-resistant microorganism. MATERIAL AND METHODS: Patients hospitalized in ICU because of the diagnosis of sepsis and septic shock between December 2010 and June 2012 were included in this retrospective study. RESULTS: A total of 141 patients, including 74 male (52.5%) and 67 female (47.5%) patients, were involved in the study, and the median age was 66.8 +/- 17.9 years. Sixty-nine patients (48.9%) were discharged from the ICU; however, 72 patients (51.1%) were exitus. Multi-drug-resistant microorganism was detected in 34 patients (24.1%). The patients' median SOFA score was 9.16 +/- 3.16, median APACHE-II score was 24.9 +/- 7.83, and median duration of hospitalization in the ICU was 8.44 +/- 11.61 days. It was found that mortality rate significantly increased in patients with the APACHE-II score of 24.5 and over, SOFA score of 8.5 and over, pro BNP value of 7241 ng/L and over, and CRP value of 96.5 mg/dL and over. Mortality rate was detected to be higher in patients undergoing invasive mechanical ventilation than in patients undergoing non-invasive mechanical ventilation. When thrombocyte count and mortality were associated with each other, it was found that the median value was 86000 mg/dL in exitus patients, whereas it was 185000 mg/dL in patients discharged from the ICU. CONCLUSION: It was revealed that increased APACHE-II score, increased SOFA score, increased pro BNP score, increased CRP, the presence of multidrug-resistant microorganism, and decreased thrombocyte count elevated the rate of mortality. However, no relationship was observed between the duration of hospitalization in the ICU and mortality.Publication Open Access Influence of rosuvastatin treatment on airway inflammatory markers and health related quality of life domains in asthmatic patients(MARMARA UNIV, FAC MEDICINE, 2017-05-14) CEYHAN, BERRİN; Olgun Yildizeli, Sehnaz; Kocakaya, Derya; Balcan, Baran; Ikinci, Aygun; Ahiskali, Rengin; Ceyhan, BerrinObjectives: Statins are lipid lowering agents which have pleiotropic and anti-inflammatory effects. Beneficial effects of statins have been shown in many inflammatory and asthmatic diseases. However, the results are still not consistent. The aim of this study is to determine the clinical and anti-inflammatory effects of rosuvastatin in asthmatic patients. Patients and Metods: A case control study among asthmatic patients was conducted. One hundred and thirty-six participants were screened. Seventy-four patients were eligible. Fifty-one patients have completed the trial. Twenty-five patients with blood levels of low-density-lipoprotein (LDL) above 130mg/dL, were treated with rosuvastatin 40mg for 8 weeks in addition to their standard treatment for asthma; 26 asthmatic patients were followed as control group. In both groups baseline and 8th week evaluation were recorded including pulmonary function test (PFT), bronchial provocation test (PD20), induced sputum and serum inflammatory markers, asthma control test (ACT) and quality of life scores (QoL). Results: Statin group showed improvement in FEV1/FVC (pp) (85.8 +/- 11.1% vs 90.2 +/- 8.8% P<0.043), FEF 25-75 % (63.6 +/- 7.8 % vs 74.6 +/- 8.4 %, P<0.0001) and FEF25-75(L/sc) (3.51 +/- 0.4 vs 4.1 +/- 0.4 P<0.05) and no change was seen in non-statin group (P>0.05) at the end of the 8-week treatment. Treatment with rosuvastatin resulted in decreased sputum eosinophilia percentage (P<0.05); IL-6 and TNFalpha levels (P<0.05) however, bronchial challenge test, ACT and QoL domains did not change in both groups (P>0.05). Conclusion: An 8-week treatment with 40mg rosuvastatin in asthma decreased the peripheral eosinophilia, total IgE levels and inflammatory markers in the induced sputum samples. Beneficial effects in PFT have also been observed. However, ACT and QoL domains were not affected. The implication of this study is that rosuvastatin could potentially have anti-inflammatory effects on asthmatic airways. Prospective randomised trials to evalute the clinical effects of rosuvastatin are warranted.Publication Open Access Does methylprednisolone affect time to recovery in COVID-19 pneumonia?(MARMARA UNIV, FAC MEDICINE, 2021-05-25) KOCAKAYA, DERYA; Kocakaya, Derya; Yildizeli, Sehnaz Olgun; Balcan, Mehmet Baran; Balcan, Baran; Eryuksel, Emel; Karakurt, SaitObjective: Current literature has conflicting results on the role of steroids in the treatment of coronavirus disease 2019 (COVID-19) pneumonia. This study aims to evaluate the effects of steroids on clinical recovery, duration of hospitalization, and time needed for the cessation of oxygen treatment. Patients and Methods: We retrospectively analyzed the medical records of patients hospitalized for COVID-19 between March and May 2020. Patient age, laboratory parameters, clinical stages, radiologic scores, length of hospital stay, and time needed for the cessation of oxygen supplementation were compared. Results: Thirteen patients were treated with steroids, and 12 controls were included in the analysis. Regarding the laboratory parameters, the groups were similar except for lymphocyte percentage (9.8 +/- 3.2, 7.0 +/- 2.9; p=0.033), which was higher, and 1)-dieter levels (0.75 (0.60-1.43), 157 (0.91-2.29); p-0.047), which were lower in the steroid group on admission. Steroid treatment provided a tendency of decrease in time to cessation of oxygen supplementation (6.23 +/- 3A vs 7.67 +/- 2.1, p=0.217). Conclusion: Although, systemic steroids, started in the subacute period, did not affect the length of hospital stay, they provided a tendency of decrease in the time until the cessation of oxygen supplementation in the subacute period.