11 research outputs found
Predictive performance of CT for adverse outcomes among COVID-19 suspected patients: a two-center retrospective study
The aim of the study was to compare the performance of various computed tomography (CT) reporting tools, including zonal CT visual score (ZCVS), the number of involved lobes, and Radiological Society of North America (RSNA) categorization in predicting adverse outcomes among patients hospitalized due to the lower respiratory symptoms during the coronavirus disease 2019 (COVID-19) pandemic. A total of 405 patients admitted with severe respiratory symptoms who underwent a chest CT were enrolled. The primary adverse outcome was intensive care unit (ICU) admission of patients. Predictive performances of reporting tools were compared using the area under the receiver operating characteristic curves (AUC ROC). Among the 405 patients, 39 (9.63%) required ICU support during their hospital stay. At least two or more observers reported a typical and indeterminate COVID-19 pneumonia CT pattern according to RSNA categorization in 70% (285/405) of patients. Among these, 63% (179/285) had a positive polymerase chain reaction (PCR test for the SARS-CoV-2 virus. The median number of lobes involved according to CT was higher in patients who required ICU support (median interquartile range [IQR], 5[3; 5] vs. 3[0; 5]). The median ZCVS score was higher among the patients that subsequently required ICU support (median [IQR], 4[0; 12] vs. 13[5.75; 24]). The bootstrap comparisons of AUC ROC showed significant differences between reporting tools, and the ZCVS was found to be superior (AUC ROC, 71-75%). The ZCVS score at the first admission showed a linear and significant association with adverse outcomes among patients with the lower respiratory tract symptoms during the COVID-19 pandemic
Immunological Analysis Of A Cchfv Mrna Vaccine Candidate In Mouse Models
Development of new vaccine platforms against viral diseases is considered urgent. In recent years, mRNA constructs have attracted great interest in this field due to unique advantages over conventional gene transfer platforms. In the present study, we developed a new naked conventional mRNA vaccine expressing the non-optimized small (S) segment of the Ank-2 strain of Crimean-Congo Hemorrhagic Fever virus (CCHFV). We then analyzed its single and booster dose immunogenicity and protection potential in the challenge assay in two mice models, including IFNα/β/γR−/− and C57BL/6. The results obtained from the immunological assays, namely IL-4 and IFN-gamma ELISPOT, intracellular IFN-gamma staining, in-house sandwich ELISA, and survival data, demonstrated that our construct elicited the production of anti-nucleocapsid (N) specific immune responses in both mice models. A 100% protection rate was only obtained in the booster dose group of IFNα/β/γR−/− mice, indicating that this platform needs further optimization in future studies. In conclusion, we assessed a novel approach in CCHFV vaccination by introducing a conventional mRNA platform which can be considered in future experiments as an efficient and safe way to battle this disease.PubMedWoSScopu
Evalution of Geriatric Infections in Past Six Years
WOS: 000417398900002Introduction: Infections are one of the most important reasons for hospitalization, morbidity, and mortality among geriatric patients. Materials and Method: The present study, retrospectively evaluated demographic characteristics, underlying diseases, and distribution of infections in patients aged 65 years who were hospitalized for treatment between January-1, 2010 and December-31, 2015, at the infectious diseases and clinical microbiology department of Ankara Numune Training and Research Hospital. Results: Overall, 853 geriatric patients were included in this study, with 435 (51%) woman and 418 (49%) men, the mean age was 76.8 +/- 7.3 years, and 86.2% of patients had at least one comorbid chronic disease. Hypertension, cardiovascular diseases and diabetes mellitus were most common comorbidities, and most common reasons for hospitalization included pneumonia (37.9%), urinary tract infection (22.9%) and cellulitis (7.7%). Moreover, beta-lactam antibiotics (88.2%), quinolones (21.1%) and macrolides (19.6%) were most frequent antibiotics used for treatment. The average length of hospital stay was 6.8 +/- 5.1 days. Overall, 17 (2%) patients died during the study, 62 (7.3%) were transferred to other clinics, 53 patients (6.2%) were transferred to intensive care units, 51 (6%) were discharged with their current medical status, 670 (78.5%) were discharged with full recovery. Nursing home stay and being transferred from intensive care units were independent risk factors for mortality (p = 0.001). Conclusion: The number of geriatric patients and their mean age are increasing as life expectancy increases. Advanced age and underlying diseases are predisposing factors for infections, and consequently, infections are one of the most common causes of hospitalization in elderly patients
Concordance and generalization of an AI algorithm with real-world clinical data in the pre-omicron and omicron era
All viruses, including SARS-CoV-2, the virus responsible for COVID-19, continue to evolve, which can lead to new variants. The objective of this study is to assess the agreement between real-world clinical data and an algorithm that utilizes laboratory markers and age to predict the progression of disease severity in COVID-19 patients during the pre-Omicron and Omicron variant periods. The study evaluated the performance of a deep learning (DL) algorithm in predicting disease severity scores for COVID-19 patients using data from the USA, Spain, and Turkey (Ankara City Hospital (ACH) data set). The algorithm was developed and validated using pre-Omicron era data and was tested on both pre-Omicron and Omicron-era data. The predictions were compared to the actual clinical outcomes using a multidisciplinary approach. The concordance index values for all datasets ranged from 0.71 to 0.81. In the ACH cohort, a negative predictive value (NPV) of 0.78 or higher was observed for severe patients in both the pre-Omicron and Omicron eras, which is consistent with the algorithm's performance in the development cohort
Assessing predictive accuracy for outcomes of ventilator-associated events in an international cohort: the EUVAE study
PURPOSE: To analyze the impact on patient outcome of ventilator-associated events (VAEs) as defined by the Centers for Disease Control and Prevention (CDC) in 2008, 2013, and the correlation with ventilator-associated pneumonia (VAP) or tracheobronchitis (VAT). METHODS: This was a prospective, observational, multicenter, international study conducted at 13 intensive care units (ICUs); thirty consecutive adults mechanically ventilated for ≥ 48 h per site were eligible, with daily follow-up being recorded in a collaborative web database; VAEs were assessed using the 2013 CDC classification and its 2015 update. RESULTS: A total of 2856 ventilator days in 244 patients were analyzed, identifying 33 VAP and 51 VAT episodes; 30-day ICU mortality was significantly higher (42.8 vs. 19.6%, p
Evaluation of epidemiological, clinical, and laboratory features and mortality of 144 HIV/AIDS cases in Turkey
Tocilizumab treatment in severe COVID-19: a multicenter retrospective study with matched controls
Coronavirus disease-2019 (COVID-19) associated pneumonia may progress into acute respiratory distress syndrome (ARDS). Some patients develop features of macrophage activation syndrome (MAS). Elevated levels of IL-6 were reported to be associated with severe disease, and anti-IL-6R tocilizumab has been shown to be effective in some patients. This retrospective multicenter case-control study aimed to evaluate the efficacy of tocilizumab in hospitalized COVID-19 patients, who received standard of care with or without tocilizumab. Primary outcome was the progression to intubation or death. PSMATCH (SAS) procedure was used to achieve exact propensity score (PS) matching. Data from 1289 patients were collected, and study population was reduced to 1073 based on inclusion-exclusion criteria. The composite outcome was observed more frequently in tocilizumab-users, but there was a significant imbalance between arms in all critical parameters. Primary analyses were carried out in 348 patients (174 in each arm) after exact PS matching according to gender, ferritin, and procalcitonin. Logistic regression models revealed that tocilizumab significantly reduced the intubation or death (OR 0.40, p = 0.0017). When intubation is considered alone, tocilizumab-users had > 60% reduction in odds of intubation. Multiple imputation approach, which increased the size of the matched patients up to 506, provided no significant difference between arms despite a similar trend for intubation alone group. Analysis of this retrospective cohort showed more frequent intubation or death in tocilizumab-users, but PS-matched analyses revealed significant results for supporting tocilizumab use overall in a subset of patients matched according to gender, ferritin and procalcitonin levels
Quality of life and related factors among chronic hepatitis B-infected patients: a multi-center study, Turkey
Background: The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors