Yazar "Erdem, Hakan" seçeneğine göre listele
Listeleniyor 1 - 20 / 27
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe A novel id-iri score: development and internal validation of the multivariable community acquired sepsis clinical risk prediction model(Springer, 2020) Diktas, Husrev; Uysal, Serhat; Erdem, Hakan; Cag, Yasemin; Miftode, Egidia; Durmus, Gul; Ulu-Kilic, AysegulWe aimed to develop a scoring system for predicting in-hospital mortality of community-acquired (CA) sepsis patients. This was a prospective, observational multicenter study performed to analyze CA sepsis among adult patients through ID-IRI (Infectious Diseases International Research Initiative) at 32 centers in 10 countries between December 1, 2015, and May 15, 2016. After baseline evaluation, we used univariate analysis at the second and logistic regression analysis at the third phase. In this prospective observational study, data of 373 cases with CA sepsis or septic shock were submitted from 32 referral centers in 10 countries. The median age was 68 (51-77) years, and 174 (46,6%) of the patients were females. The median hospitalization time of the patients was 15 (10-21) days. Overall mortality rate due to CA sepsis was 17.7% (n = 66). The possible predictors which have strong correlation and the variables that cause collinearity are acute oliguria, altered consciousness, persistent hypotension, fever, serum creatinine, age, and serum total protein. CAS (%) is a new scoring system and works in accordance with the parameters in third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The system has yielded successful results in terms of predicting mortality in CA sepsis patients.Öğe Analyzing central-line associated bloodstream infection prevention bundles in 22 countries: The results of ID-IRI survey(Mosby-Elsevier, 2022) Devrim, Ilker; Erdem, Hakan; El-Kholy, Amani; Almohaizeie, Abdullah; Logar, Mateja; Rahimi, Bilal Ahmad; Amer, FatmaBackground: Because central line-associated bloodstream infections (CLABSIs) are a significant complication of central venous access, it is critical to prevent CLABSIs through the use of central line bundles. The purpose of this study was to take a snapshot of central venous access bundles in various countries. Methods: The participants in intensive care units (ICUs) completed a questionnaire that included information about the health center, infection control procedures, and central line maintenance. The countries were divided into 2 groups: those with a low or low-middle income and those with an upper-middle or high income. Results: Forty-three participants from 22 countries (46 hospitals, 85 ICUs) responded to the survey. Eight (17.4%) hospitals had no surveillance system for CLABSI. Approximately 7.1 % (n = 6) ICUs had no CLABSI bun-dle. Twenty ICUs (23.5%) had no dedicated checklist. The percentage of using ultrasonography during cathe-ter insertion, transparent semi-permeable dressings, needleless connectors and single-use sterile pre-filled ready to use 0.9% NaCl were significantly higher in countries with higher and middle-higher income (P < .05). Conclusions: Our study demonstrated that there are significant differences in the central line bundles between low/low-middle income countries and upper-middle/high-income countries. Additional measures should be taken to address inequity in the management of vascular access in resource-limited countries. (c) 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.Öğe Antituberculosis drug resistance patterns in adults with tuberculous meningitis: results of haydarpasa-iv study(Biomed Central Ltd, 2015) Senbayrak, Seniha; Ozkutuk, Nuri; Erdem, Hakan; Johansen, Isik Somuncu; Civljak, Rok; Inal, Ayse Seza; Kayabas, UnerBackground: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to provide insight into the empiric treatment of TBM. Methods: Mycobacterium tuberculosis was cultured from the cerebrospinal fluid (CSF) of 142 patients and was tested for susceptibility to first-line antituberculosis drugs, streptomycin (SM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB). Results: Twenty of 142 isolates (14.1 %) were resistant to at least one antituberculosis drug, and five (3.5 %) were resistant to at least INH and RIF, [multidrug resistant (MDR)]. The resistance rate was 12, 4.9, 4.2 and 3.5 % for INH, SM, EMB and RIF, respectively. The monoresistance rate was 6.3, 1.4 and 0.7 % for INH, SM and EMB respectively. There was no monoresistance to RIF. The mortality rate was 23.8 % in fully susceptible cases while it was 33.3 % for those exhibiting monoresistance to INH, and 40 % in cases with MDR-TBM. In compared to patients without resistance to any firstline drug, the relative risk of death for INH-monoresistance and MDR-TBM was 1.60 (95 % CI, 0.38-6.82) and 2.14 (95 % CI, 0: 34-13: 42), respectively. Conclusion: INH-resistance and MDR rates seemed not to be worrisome in our study. However, considering their adverse effects on treatment, rapid detection of resistance to at least INH and RIF would be most beneficial for designing anti-TB therapy. Still, empiric TBM treatment should be started immediately without waiting the drug susceptibility testing.Öğe Brucellosis in pregnancy: results of multicenter ID-IRI study(Springer, 2019) Inan, Asuman; Erdem, Hakan; Elaldi, Nazif; Gulsun, Serda; Karahocagil, Mustafa K.; Pekok, Abdullah U.; Ulug, MehmetBrucellosis in pregnant women is reported to be associated with obstetric complications (OCs), and adequate data for human brucellosis during pregnancy are largely lacking. We performed this multicenter retrospective cross-sectional study to evaluate the epidemiology, clinical course, treatment responses, and outcomes of brucellosis among pregnant women. The study period comprised a 14-year period from January 2002 to December 2015. All consecutive pregnant women diagnosed with brucellosis in 23 participating hospitals were included. Epidemiological, clinical, laboratory, therapeutic, and outcome data along with the assessment data of the neonate were collected using a standardized questionnaire. Data of 242 patients were analyzed. The OC rate was 14.0% (34/242) in the cohort. Of the 242 women, 219 (90.5%) delivered at term, 3 (1.2%) had preterm delivery, 15 (6.2%) aborted, and 5 (2.1%) had intrauterine fetal demise. Seventeen (7.0%) of the newborns were considered as low birth weight. Spontaneous abortion (6.1%) was the commonest complication. There were no maternal or neonatal deaths and pertinent sequelae or complications were not detected in the newborns. Splenomegaly (p=0.019), nausea and/or vomiting (p<0.001), vaginal bleeding (p<0.001), anemia (blood hemoglobin <11g/dL; p<0.001), high level of serum aspartate aminotransferase (>41IU/L; p=0.025), oligohydramnios on ultrasonography (p=0.0002), history of taking medication other than Brucella treatment during pregnancy (p=0.027), and Brucella bacteremia (p=0.029) were the significant factors associated with OCs. We recommend that pregnant women with OC or with fever should be investigated for brucellosis if they live in or have traveled to an endemic area.Öğe Büyüme üzerine kantitatif genetik araştırmalar: Genotip çevre etkileşimi, akrabalı yetişme ve üniformite problemi(Çanakkale Onsekiz Mart Üniversitesi, 2023) Erdem, Hakan; Savaş, TürkerBu tez projesi kantitatif genetik temelinde büyümeyi üç farklı konu ile ele almaktadır. Büyüme dönemindeki farklı yumurtacı tavuk genotiplerinde iç içe geçmiş besleme ve parazit çevrelerinde genotip çevre etkileşimi, farklı akraba çiftleştirmelerinden elde edilen akrabalı yetişmiş Japon bıldırcını palazlarının büyüme döneminde maruz kaldıkları parazit enfestasyonuna verecekleri tepkiler ve Japon bıldırcınlarında üniformite için büyümenin bir fonksiyonu olarak ele alınan canlı ağırlığın kalıntısına ait fenotiplere ilişkin genetik parametrelerin tahmin edilmesi bu tez projesinin konularıdır. Genotip çevre etkileşimi kapsamında yapılan çalışma, beslenme ortamında yapılan değişikliğin genotiplerin akar enfestasyonuna verdikleri tepkilerde değişikliklere neden olduğunu göstermektedir. Akrabalı yetişmiş bıldırcınlar ile yapılan çalışmada büyüme üzerine akrabalı yetiştirme depresyonu gözlenmiştir. Ayrıca aynı akrabalı yetiştirme depresyonunun büyüme üzerindeki şiddetinin, farklı akraba çiftleşmelerine göre farklılık gösterdiği görülmüştür. Üniform büyümenin irdelendiği çalışmada ise kalıntı varyansının içinde genetik bir varyansın olduğu ve bunun ayıklanabileceği görülmüştür.Öğe Can Inbreeding Increase Viability? A Case Study on An Infectious Outbreak in An Inbred Pigeon Flock(2025) Erdem, Hakan; Savaş, TürkerInbreeding increases homozygosity, resulting in a loss of alleles and lower genetic variation than the parental population. In a small population, this low genetic variation and homozygosity can quickly lead to adverse effects. This study was conducted on a flock of pigeons with 32 adult pigeons. A disease characterized by dyspnea, anorexia, vomiting and sudden death has occurred in birds. Mortality and morbidity were recorded during the outbreak. The inbreeding coefficient was determined in the flock, with pedigree records going back 12 years. Although not significant, the inbreeding coefficient of dead birds are lower than that of symptomatic or healthy birds. It is also seen that there is no statistical significance in terms of inbreeding depression in morbidity or mortality status. The result indicated that inbreeding depression in morbidity and mortality was not observed in this particular disease case.Öğe Central nervous system infections in the absence of cerebrospinal fluid pleocytosis(Elsevier B.V., 2017) Erdem, Hakan; Ozturk-Engin, Derya; Cag, Yasemin; Senbayrak, Seniha; Inan, Asuman; Kazak, Esra; Savasci, UmitPrevious multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated. © 2017 The Author(s)Öğe Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study(Springer Science and Business Media Deutschland GmbH, 2023) Erdem, Hakan; Baymakova, Magdalena; Alkan, Sevil; Letaief, Amel; Yahia, Wissal Ben; Dayyab, Farouq; Kolovani, EntelaFever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies). This research included 788 patients. FUO diagnoses were as follows: infections (51.6%; n = 407), neoplasms (11.4%, n = 90), collagen vascular disorders (9.3%, n = 73), undiagnosed (20.1%, n = 158), miscellaneous diseases (7.7%, n = 60). The most common infections were tuberculosis (n = 45, 5.7%), brucellosis (n = 39, 4.9%), rickettsiosis (n = 23, 2.9%), HIV infection (n = 20, 2.5%), and typhoid fever (n = 13, 1.6%). Cardiovascular infections (n = 56, 7.1%) were the most common infectious syndromes. Only collagen vascular disorders were reported significantly more from developed countries (RR = 2.00, 95% CI: 1.19-3.38). FUO had similar characteristics in LI/LMI and UMI/HI countries including the portion of undiagnosed cases (OR, 95% CI; 0.87 (0.65-1.15)), death attributed to FUO (RR = 0.87, 95% CI: 0.65-1.15, p-value = 0.3355), and the mean duration until diagnosis (p = 0.9663). Various aspects of FUO cannot be determined by the economic development solely. Other development indices can be considered in future analyses. Physicians in different countries should be equally prepared for FUO patients.Öğe Clinicopathological profile of peritoneal tuberculosis and a new scoring model for predicting mortality: an international ID-IRI study(Springer, 2023) Tanoğlu, Alpaslan; Erdem, Hakan; Friedland, Jon S.; Ankaralı, Handan; Garcia-Goez, Jose Fernando; Albayrak, Ayşe; Alkan Çeviker, SevilExisting literature about peritoneal tuberculosis (TBP) is relatively insufficient. The majority of reports are from a single center and do not assess predictive factors for mortality. In this international study, we investigated the clinicopathological characteristics of a large series of patients with TBP and determined the key features associated with mortality. TBP patients detected between 2010 and 2022 in 38 medical centers in 13 countries were included in this retrospective cohort. Participating physicians filled out an online questionnaire to report study data. In this study, 208 patients with TBP were included. Mean age of TBP cases was 41.4 +/- 17.5 years. One hundred six patients (50.9%) were females. Nineteen patients (9.1%) had HIV infection, 45 (21.6%) had diabetes mellitus, 30 (14.4%) had chronic renal failure, 12 (5.7%) had cirrhosis, 7 (3.3%) had malignancy, and 21 (10.1%) had a history of immunosuppressive medication use. A total of 34 (16.3%) patients died and death was attributable to TBP in all cases. A pioneer mortality predicting model was established and HIV positivity, cirrhosis, abdominal pain, weakness, nausea and vomiting, ascites, isolation of Mycobacterium tuberculosis in peritoneal biopsy samples, TB relapse, advanced age, high serum creatinine and ALT levels, and decreased duration of isoniazid use were significantly related with mortality (p < 0.05). This is the first international study on TBP and is the largest case series to date. We suggest that using the mortality predicting model will allow early identification of high-risk patients likely to die of TBP.Öğe Determination of Fermentation Characteristics of a Total Mixed Ration Prepared with Maize Forage with Different Dry Matter Contents(2025) Akbağ, Hande Işıl; Gezgin, Emre; Yiğit, Soner; Erdem, HakanThis study aims to assess the effects of silage on the quality characteristics and aerobic stability of total mixed rations (TMR) made with maize forage that have different dry matter (DM) contents. For this purpose, TMRs prepared using maize forage with two different dry matter (low dry matter (29.6 %); LDM, high dry matter (39.66 %); HDM) levels were divided into two groups. All groups were subjected to an aerobic stability test for 5 days at the end of the 45-day fermentation period. Aerobic stability tests of five repetitively generated TMR silages were determined by measuring internal temperatures through data loggers. During this process, chemical analysis, pH, and microbiological analysis were performed daily. It was determined that pH, crude protein (CP), acide detergent lignin (ADL), and dry matter (DM) concentrations of ensilled and unensilled TMR samples were affected by group x day interaction (P?0.05). The pH values in TMR samples increased during aerobic stability, but they were more noticeable in unensilled groups (P?0.05). The internal and ambient temperature values in ensilled TMR remain within the confidence intervals. On the contrary, the temperature values of unensilled TMR samples have been determined to be higher than ambient temperature values (P?0.05). Under aerobic conditions, unensilled TMR silages deteriorated rapidly. Therefore, the addition of high dry matter corn forage to TMR and esilled of TMR is more suitable for both good fermentation quality and resistance to aerobic deteriation. There is a need for studies to determine the aerobic deterioration and digestibility properties of TMR silages with different dry matter contents.Öğe Diagnosis and outcomes of fever of unknown origin cases with an erythrocyte sedimentation rate of 100 mm/h or more: An International ID-IRI (Infectious Diseases - International Research Initiative) Observational Retrospective Cohort Study(Lippincott Williams & Wilkins, 2025) Elbahr, Umran; Erdem, Hakan; Ben Yahia, Wissal; Baymakova, Magdalena Petrova; Letaief, Amel; Poposki, Kostadin; Grgic, SvjetlanaHerein, we aimed to analyze the final diagnosis in a well-defined cohort of fever of unknown origin (FUO) cases whose erythrocyte sedimentation rate (ESR) was 100 mm/h or more during the admission. The subgroup of the FUO patients with an ESR of 100 mm/h or more during the FUO evaluation, was extracted from the study database of a previously published multicenter study (European Journal of Clinical Microbiology & Infectious Diseases. April 15, 2023;42 (4):387-98). Data for 139 patients (17.6%, 139/788 of the original cohort) who fulfilled the study inclusion criteria, were obtained from 29 centers from 11 countries. Infections, neoplasms, and noninfectious inflammatory diseases were found to be the reason of fever in [n = 74 (53.2%)], [n = 14 (10%)], and [n = 13 (9.3%)] of 139 patients, respectively. Regardless of the diseases subgroup top 6 diseases that were determined to be the reasons of FUO were tuberculosis [n = 15 (10.8%)], HIV/AIDS [n = 13 (9.3%)], urinary tract infection [n = 9 (6.5%)], infective endocarditis [n = 9 (6.5%)], lymphoma [n = 9 (6.5%)], and abscess [n = 9 (6.5%)]. The most common infectious diseases were tuberculosis (15/74, 20.2%), HIV/AIDS (13/74, 17.5%), and infective endocarditis (9/74, 12.1%), along with urinary tract infection [n = 9 (6.5%)] and abscess [n = 9 (6.5%)]. The most common noninfectious inflammatory diseases were adult onset Still disease (3/13, 23%) and giant cell arteritis, also known as temporal arteritis (3/13, 23%), and followed by polyarteritis nodosa (2/13, 15.3%). The most common neoplasm was lymphoma (9/14, 64.2%), followed by lung cancer (2/14, 14.2%). Reason of fever could not be defined in (29/139, 20.8%) patients. The invasive procedures were performed in (64/139, 46%) patients. Gender, age > 50 or not, and income level (high-middle-low) of the participating country were not associated with a significant difference in the final diagnosis category of the FUO case (P > .05). To the best of our knowledge, this is the first study evaluating the FUO in the subgroup of cases with extreme ESR elevation and infectious diseases comprised the most cause of the FUO in this particular subgroup.Öğe Edremit Kelebek Güvercinlerinin Morfolojik Karakterizasyonu(Çanakkale Onsekiz Mart Üniversitesi, 2018-12-25) Savaş, Türker; Erdem, Hakan; Konyalı, CoşkunGüvercinler, yüzyıllardır insanoğlunun en çok ilgi duyduğu hayvan türlerinden biridir. Bir ırk zengini olan güvercin türünün ülke, bölge hatta bir yöreye ait lokal ırkları bulunmaktadır. Bölgenin sahip olduğu ve kültürel mirasın bir parçası olan hayvan tür veya ırklarının devamlılığı muhafaza stratejilerinin geliştirilmesi ile mümkün olmaktadır. Bu çalışmada, Edremit ve civarında yetiştirildiği bilinen Edremit Kelebek güvercin ırkının bazı özelliklerinin tanımlanması amaçlanmıştır. Çalışmanın materyalini Edremit’te yetiştirilen 83 Edremit Kelebek güvercini oluşturmuştur. Güvercinlerde kantitatif ve kalitatif gözlemler gerçekleştirilmiştir. Renklerine göre Siyah Tel-Kuyruk, Mavi Tel-Kuyruk, Siyah Boyun, Sarı Boyun, Kırmızı Boyun, Mavi Boyun, Şeş ve Siyah olmak üzere çeşitli varyeteleri bulunan Edremit Kelebek güvercini uçuş stili, dönüş hareketi ve renk özellikleri nedeniyle yetiştirilmektedir. Edremit Kelebek güvercinlerinde boynun arka kısmı siyah, mavi veya kırmızı renkte olabileceği gibi tüm vücut aynı renkte de olabilir. Orta uzunlukta bir kuyruğa sahip olan Edremit Kelebek güvercini 13 ile 17 arasında değişen kuyruk teleğine sahiptir. Edremit Kelebekleri solo uçucu olarak bilinirler. Çoklu uçuşlarda ise arı oğluna benzer şekilde karmakarışık uçarlar. Kanat vuruşları bir kelebeğin kanat vuruşlarını andırır. Uçuşları esnasında dönüş, kuşların gaga-kuyruk ekseninde kendi etraflarında dönmeleri ile gerçekleşir. Tanınması, muhafazası, devamlılığı bakımından Edremit Kelebek güvercinlerinin tescilli bir ırk haline gelmesi ülkemiz ve uluslar arası alanda lokal ırklarımızın yer edinmesi açısından önemli olacaktır.Öğe Effects of kinship matings on embryo losses and hatch-weight in japanese quails(2022) Erdem, Hakan; Savaş, TürkerInbreeding, which is the mating of related individuals, increases homozygosity and leads to depression, especially in traits with low heritability. In this study, parent-offspring, full-sibling and half-sibling mating groups were formed and their effects on embryo loss and hatch weight were investigated. In the study, a total of 2130 fertile Japanese quail eggs were used. Embryo losses were divided into three periods; early period (first 5-day), middle period (6-12th days) and late period (13-17th days). It was observed that mating groups affect all traits subject of this study (P?0.0001). The lowest hatchability of fertile eggs was observed in dam-male offspring mating (DM), while the highest was observed in half-sibling (HS) and control (C) matings (P?0.05). However, the highest hatch-weight were found in eggs of DM matings (P?0.05). DM has also the highest embryo losses for all periods (P?0.05). Most of the embryo losses, except the half-sibling group, occurred in the early period.Öğe Genotype-environment interaction in layer chickens in the growing stage: comparison of three genotypes at two different feeding levels with or without red mite (Dermanyssus gallinae) infestation(Copernicus GmbH, 2021) Erdem, Hakan; Savaş, TürkerThis study investigated how early growth was affected in various chicken genotypes, which were fed ad libitum or restricted and with or without poultry red mite (PRM) infestation. Atak-S (AS), New Hampshire Red (NHR), and Light Sussex (LS) genotypes were used in the study. In total, 120 chicks were used from each genotype. Four groups were formed: feed-restricted (FR) and infested with parasite (P+), FR only, fed ad libitum and P+ , and fed ad libitum only. Feed restriction was applied as 20ĝ€¯% of the feed consumption of the group fed ad libitum the day before for each genotype. The study was conducted between 2 to 12 weeks of age. Weekly live weights and feed consumption were recorded, and the feed conversion ratio was calculated. Traps were placed in cages to count parasites. Regarding the live weight, NHR tolerated the PRM infestation in the ad libitum feed conditions better than other genotypes. While the infested NHR and AS birds had lower live weights than the non-infested ones under FR conditions, there was no difference between infested and non-infested birds of NHR and AS genotypes when they fed ad libitum. The feed consumption of infested AS and NHR birds was higher than that of non-infested counterparts when fed ad libitum. By contrast, the LS chicks consumed less food in the infested environment. In conclusion, the genotypes responded differently to PRM infestation in different feeding environments.Öğe Hamsi scoring in the prediction of unfavorable outcomes from tuberculous meningitis: results of Haydarpasa-II study(Springer Heidelberg, 2015) Erdem, Hakan; Ozturk-Engin, Derya; Tireli, Hulya; Kilicoglu, Gamze; Defres, Sylviane; Gulsun, Serda; Sengoz, GonulPredicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria, Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13 variables. Age, nausea, vomiting, altered consciousness, hydrocephalus, vasculitis, immunosuppression, diabetes mellitus and neurological deficit remained in the final model. Scores 1-3 were assigned to the variables in the severity scale, which included scores of 1-6. The distribution of mortality for the scores 1-6 was 3.4, 8.2, 20.6, 31, 30 and 40.1 %, respectively. Altered consciousness, diabetes mellitus, immunosuppression, neurological deficits, hydrocephalus, and vasculitis predicted the unfavorable outcome in the scoring and the cumulative score provided a linear estimation of prognosis.Öğe Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study(Elsevier Sci Ltd, 2024) Filiz, Mine; Erdem, Hakan; Ankaralı, Handan; Puca, Edmond; Ruch, Yvon; Santos, Lurdes; Fasciana, Teresa; Şener, AlperBackground: Blood culture-negative endocarditis (BCNE) is a diagnostic challenge, therefore our objective was to pinpoint high-risk cohorts for BCNE. Methods: The study included adult patients with definite endocarditis. Data were collected via the Infectious Diseases International Research Initiative (ID-IRI). The study analysing one of the largest case series ever reported was conducted across 41 centers in 13 countries. We analysed the database to determine the predictors of BCNE using univariate and logistic regression analyses. Results: Blood cultures were negative in 101 (11.65 %) of 867 patients. We disclosed that as patients age, the likelihood of a negative blood culture significantly decreases (OR 0.975, 95 % CI 0.963-0.987, p < 0.001). Additionally, factors such as rheumatic heart disease (OR 2.036, 95 % CI 0.970-4.276, p = 0.049), aortic stenosis (OR 3.066, 95 % CI 1.564-6.010, p = 0.001), mitral regurgitation (OR 1.693, 95 % CI 1.012-2.833, p = 0.045), and prosthetic valves (OR 2.539, 95 % CI 1.599-4.031, p < 0.001) are associated with higher likelihoods of negative blood cultures. Our model can predict whether a patient falls into the culture-negative or culture-positive groups with a threshold of 0.104 (AUC +/- SE = 0.707 +/- 0.027). The final model demonstrates a sensitivity of 70.3 % and a specificity of 57.0 %. Conclusion: Caution should be exercised when diagnosing endocarditis in patients with concurrent cardiac disorders, particularly in younger cases.Öğe Japon bıldırcını palazlarında kum banyosunun kırmızı kanatlı akarına (Dermanyssus gallinae) karşı etkilerinin araştırılması(Çanakkale Onsekiz Mart Üniversitesi, 2017) Erdem, Hakan; Savaş, TürkerDermanyssus gallinae kanatlılarda görülen bir dış parazittir. Bu çalışmada Japon bıldırcını palazlarına etkileri ve bu etkilerin kum banyosu ile giderilip giderilemeyeceği araştırılmıştır. Çalışma enfestasyon yoğunluğu hariç aynı koşullarda iki farklı denemeyle gerçekleştirilmiştir. İlk denemede enfestasyon yoğunluğu düşük ikinci denemede yüksektir. Denemelerde 1 haftalık yaşta 80'er palaz kullanılmıştır. Palazlara adlibitum yem ve su sağlanmış, 16A:8K aydınlatma programı uygulanmıştır. Davranış gözlemi, canlı ağırlık ve yem tüketimi takibi yapılmıştır. Deneme sonunda eritrosit, lökosit, hemoglobin ve hematokrit değerleri tespit edilmiş, lökosit formülü için yayma preparatlar hazırlanmıştır. Bilateral uzuvların ölçümleri yapılıp taşlık, kalp, karaciğer ve dalak ağırlıkları alınmıştır. İlk denemede kontrol ve enfeste grupların deneme sonu canlı ağırlıkları sırasıyla 249,2 g ve 242,3 g 'dır (P?0,05). Enfeste grup kontrol grubuna göre %96 daha fazla kaşınma davranışı göstermiştir (P?0,05). Hematolojik değerler bakımından kontrol ve enfeste grupta sırasıyla eozinofil oranı %5,8 ve %18,5, hemoglobin miktarı 9,6 g/dl ve 7,7 g/dl 'dir (P?0,05). Bilateral uzuvlardan tibia uzunluğuna ilşikin asimetrinin enfeste bıldırcınlarda önemli derecede yüksek olduğu belirlenmiştir (P?0,05). İkinci denemede deneme sonu canlı ağırlık enfeste grupta 205,0 g kontrol grubunda 231,8 g 'dır (P?0,05). Enfeste grup kontrol grubuna göre %98 daha fazla kaşınmıştır (P?0,05). Hemoglobin, eritrosit ve hematokrit değerleri sırasıyla enfeste grup için 5,5 g/dl, 1,8x106/1mm3 ve %29,4, kontrol grubu için 11,3 g/dl, 3,8x106/1mm3 ve %43,5 olup gruplar arasındaki farklılaşma önemlidir (P=0,0001). İkinci denemede bilateral karakterler bakımından önemli bir farklılaşma yoktur (P?0,05). Dalak oransal ağırlığı kontrol grubunda %0,8 enfeste grupta %0,10 'dur (P=0,0595). İlk denemede kontrol ve enfeste grup arasında mortalite farkı önemsizken, ikinci denemede mortalite oranı enfeste grupta daha yüksektir (P?0,05). Dermanyssus gallinae 'in düşük enfestasyon yoğunluğunda bile enfeste edilen grupta gerek düşük hemoglobin seviyesi gerekse kaşınma oranındaki fazlalık akarın kuşlar üzerindeki etkisini göstermektedir. Banyo uygulamasının ele alınan parametrelere karşı bir etkisinin olmadığı görülmüştür.Öğe Managing penicillin resistant pneumococcal meningitis: an international id-iri study(Springer, 2025) Erdem, Hakan; Dogan, Elif; Ankarali, Handan; Dragovac, Gorana; Seyman, Derya; Tarakci, Arzu; Dalmanoglu, EnesPenicillin-resistant pneumococcal meningitis (PRPM) is a challenging and fatal infection. We conducted a multicentre international retrospective study to evaluate the clinical features, outcomes, predictors of outcomes antimicrobial efficacy and drug susceptibility in patients with PRPM. The study, conducted through the Infectious Diseases-International Research Initiative across 33 centers in 11 countries, analyzed PRPM patients treated between 2019 and 2024 using univariate and multivariate analyses. A total of 138 patients were included. Of these, 83 (60.1%) were fully cured, 27 (19.6%) died, and 28 (20.3%) survived with sequelae. Mortality was associated with ICU admission (OR 14.886; p = 0.021), mechanical ventilation (OR 7.205; p = 0.049), and vasopressor use (OR 8.983; p = 0.025). Higher CSF leukocyte count (OR 0.854; p = 0.060) and blood leukocyte count (OR 0.283; p = 0.021) were linked to lower mortality risk. Patients who developed sequelae were more likely to require mechanical ventilation (OR 9.354; p = 0.001), experience recurrent meningitis (OR 5.562; p = 0.081), and have lower platelet counts (OR 0.001; p = 0.050), compared to those who fully recovered. Sequelae patients had higher GCS scores (OR 1.365; p = 0.014), more corticosteroid use (OR 5.301; p = 0.061), and less vasopressor use (OR 0.205; p = 0.019) compared to those who died. The antibiotic susceptibility profiles of the isolates in our PRSP cohort were: Ceftriaxone (75/134, 55.9%), meropenem (26/44, 59%), moxifloxacin (47/48, 97.9%). PRPM is a fatal disease in which mortality and sequelae occurring in two-fifths of cases. Severe illness markers such as ICU admission, mechanical ventilation, and vasopressor use, along with recurrent meningitis are linked to worse outcomes. Thrombocytopenia, low leukocyte counts, and lower GCS scores are indicators of poor prognosis, while corticosteroid therapy appears protective in PRPM. Therapeutic optimization is challenged by rising resistance and pharmacokinetic limitations, though moxifloxacin shows the highest susceptibility; further research is warranted.Öğe Morphological and Morphometric Characterization of an Extremely Short-beaked Turkish Pigeon(Centenary University, 2025) Erdem, Hakan; Savaş, TürkerThis study examines the morphological and morphometric characteristics of the Mısıri pigeon, a unique short-beaked breed from Türkiye. Among Türkiye’s local short-beaked breeds, the Mısıri pigeon stands out with its extremely short beak, cubic head, and prominent eyes. Despite Türkiye’s long pigeon breeding history, limited scientific research has led to inconsistencies in breed classification. Morphological and morphometric traits were recorded in Mısıri pigeons. Analysis of variance and principal component analysis were applied to these traits. The three components explain 73.26% and 81.18% of the variation for head and body traits, respectively. The results showed that male Mısıri pigeons are larger than females, 275.59 g and 243.85 g respectively. However, significant differences were not found between color pattern varieties. Compared to other short-beaked breeds the Mısıri pigeon has the shortest beak ever recorded in Türkiye. Their beak lengths vary between 7.97-12.22 mm. Historical sources suggest that similar pigeons originated in Anatolia and were brought to Europe. However, the Mısıri pigeon’s unique skull structure and short beak distinguish it from related breeds. This study emphasizes the need to document and conserve Türkiye’s local pigeon breeds, which remain underrepresented in scientific registries. Despite their distinct traits, many breeds lack formal recognition due to the absence of studies. Identifying and preserving these genetic resources is crucial for maintaining Türkiye’s rich pigeon heritage. In conclusion, the Mısıri pigeon is a genetically and morphologically significant breed. Its documentation contributes to the conservation of Türkiye’s local breeds and the continuation of the country’s historical pigeon breeding culture. © 2025, Centenary University. All rights reserved.Öğe Mortality indicators in pneumococcal meningitis: therapeutic implications(Elsevier Sci Ltd, 2014) Erdem, Hakan; Elaldi, Nazif; Oztoprak, Nefise; Sengoz, Gonul; Ak, Oznur; Kaya, Selcuk; Inan, AsumanBackground: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.
