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Selcuk M, Keskin M, Cinar T, Gunay N, Dogan S, Cicek V, Kilic S, Asal S, Yavuz S, Keser N, Orhan A. Prognostic significance of N-Terminal Pro-BNP in patients with COVID-19 pneumonia without previous history of heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The objective of the present research was to evaluate the possible association between the N-terminal pro-brain type natriuretic peptide (NT-proBNP) levels and in-hospital mortality in coronavirus disease 2019 (COVID-19) pneumonia patients who did not have pre-existing heart failure (HF).
Methods
A total of 137 consecutive patients without pre-existing HF and hospitalized due to COVID-19 pneumonia were enrolled into the current research. The main outcome of the research was the in-hospital death. The independent parameters linked with the in-hospital death were determined by multivariable analysis.
Results
A total of 26 deaths with an in-hospital mortality rate of 18.9% was noted. Those who died were older with an increased frequency of co-morbidities such as hypertension, chronic kidney disease, coronary artery disease, stroke and dementia. They had also increased white blood cell (WBC) counts and had elevated glucose, creatinine, troponin I, and NT-pro-BNP levels but had decreased levels of hemoglobin. By multivariable analysis; age, NT-pro-BNP, WBC, troponin I, and creatinine levels were independently linked with the in-hospital mortality. After ROC evaluation, the ideal value of the NT-pro-BNP to predict the in-hospital mortality was found as 260 ng/L reflecting a sensitivity of 82% and a specificity of 93% (AUC:0.86; 95% CI: 0.76–0.97).
Conclusion
The current research clearly shows that the NT-proBNP levels are independently linked with the in-hospital mortality rates in subjects with COVID-19 pneumonia and without HF. Thus, we believe that this biomarker can be used as a valuable prognostic parameter in such cases.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- M Selcuk
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - M Keskin
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - T Cinar
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - N Gunay
- Ümraniye Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - S Dogan
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - V Cicek
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - S Kilic
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - S Asal
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - S Yavuz
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - N Keser
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - A.L Orhan
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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Selcuk M, Cinar T, Gunay N, Keskin M, Cicek V, Kilic S, Asal S, Orhan AL. Comparison of D-dimer level measured on the third day of hospitalization with D-dimer level in predicting in-hospital mortality in COVID-19 patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
The present study aimed to compare the value of D-dimer measured on the 3rd day of hospitalization with admission D-dimer level in predicting in-hospital mortality in coronavirus disease 2019 (COVID-19) cases.
Method
In total, 231 patients with COVID-19 disease were included in the study. D-dimer levels were estimated using immunoturbidimetric assay with normal range of 0–500 μg/mL. In the current research, the primary outcome was the in-hospital mortality.
Results
In the present research, 39 (16.8%) COVID-19 cases died during the index hospitalization. In a multivariable analysis; age, D-dimer (3rd day) (OR: 1.00, 95% CI: 1.00–1.00, p<0.001), WBC count, and creatinine were independent predictors of the in-hospital death for COVID-19 cases. The ideal value of D-dimer level on the 3rd day of hospitalization was 774 μq/mL (area under curve (AUC): 0.903, 95% CI: 0.836–0.968; p<0.01) with sensitivity of 83.2% and specificity of 83.6%. It was noted that D-dimer level on the 3rd day of hospitalization had a higher sensitivity (83.2% vs 67.6%, respectively) and AUC value than that of D-dimer level on admission (0.903 vs 0.799, respectively).
Conclusion
The main finding in this investigation was that D-dimer elevation on the 3rd of hospitalization is more sensitive predictor of in-hospital mortality than D-dimer elevation on admission in COVID-19 patients. Even though further investigations are needed to forecast precise prognosis in patients with COVID-19 disease in terms of D-dimer levels, we believe that D-dimer levels on the 3rd day of hospitalization have an enhanced potential to be used as a prognostic marker in routine clinical practice.
Funding Acknowledgement
Type of funding sources: None. Table 1Figure 1
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Affiliation(s)
- M Selcuk
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - T Cinar
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - N Gunay
- Ümraniye Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - M Keskin
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - V Cicek
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - S Kilic
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - S Asal
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - A L Orhan
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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Selcuk M, Cinar T, Gunay N, Keskin M, Cicek V, Kilic S, Asal S, Orhan AL. Comparison of D-dimer Level Measured on the Third Day of Hospitalization with Admission D-dimer Level in Predicting In-hospital Mortality in COVID-19 Patients. Medeni Med J 2021; 36:1-6. [PMID: 33828883 PMCID: PMC8020183 DOI: 10.5222/mmj.2021.07348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/27/2020] [Indexed: 12/23/2022] Open
Abstract
Objective The present study aimed to compare the value of D-dimer measured on the 3rd day of hospitalization with admission D-dimer level in predicting in-hospital mortality in coronavirus disease 2019 (COVID-19) cases. Method In total, 231 patients with COVID-19 disease were included in the study. D-dimer levels were estimated using immunoturbidimetric assay with normal range of 0-500 μg/mL. In the current research, the primary outcome was the in-hospital mortality. Results In the present research, 39 (16.8%) COVID-19 cases died during the index hospitalization. In a multivariable analysis; age, D-dimer (3rd day) (OR: 1.00, 95% CI: 1.00-1.00, p<0.001), WBC count, and creatinine were independent predictors of the in-hospital death for COVID-19 cases. The ideal value of D-dimer level on the 3rd day of hospitalization was 774 μq/mL (area under curve (AUC): 0.903, 95% CI: 0.836-0.968; p<0.01) with sensitivity of 83.2% and specificity of 83.6%. It was noted that D-dimer level on the 3rd day of hospitalization had a higher sensitivity (83.2% vs 67.6%, respectively) and AUC value than that of D-dimer level on admission (0.903 vs 0.799, respectively). Conclusion The main finding in this investigation was that D-dimer elevation on the 3rd of hospitalization is more sensitive predictor of in-hospital mortality than D-dimer elevation on admission in COVID-19 patients. Even though further investigations are needed to forecast precise prognosis in patients with COVID-19 disease in terms of D-dimer levels, we believe that D-dimer levels on the 3rd day of hospitalization have an enhanced potential to be used as a prognostic marker in routine clinical practice.
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Affiliation(s)
- Murat Selcuk
- Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Tufan Cinar
- Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Nuran Gunay
- Health Sciences University, Ümraniye Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Muhammed Keskin
- Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Vedat Cicek
- Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Sahhan Kilic
- Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Süha Asal
- Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Ahmet L Orhan
- Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
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Ileri C, Dogan Z, Ozben B, Karaoglu C, Gunay N, Tigen K, Basat S, Uyan C. Evaluation of the relation between cardiac biomarkers and thorax computed tomography findings in COVID-19 patients. Biomark Med 2021; 15:285-293. [PMID: 33501850 PMCID: PMC7863677 DOI: 10.2217/bmm-2020-0388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/22/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Troponin levels may be elevated in COVID-19 infection. The aim of this study was to the explore relation between troponin levels and COVID-19 severity. Materials, methods & Results: One hundred and forty consecutive patients with COVID-19 pneumonia were included. Diagnosis of COVID-19 pneumonia was based on positive chest computed tomography (CT) findings. Quantitative PCR test was performed in all patients. Only 74 patients were quantitative PCR-positive. Twenty four patients had severe CT findings and 27 patients had progressive disease. These patients had significantly lower albumin and higher ferritin, D-dimer, lactate dehydrogenase, C-reactive protein, and high-sensitivity cardiac troponin I (hs-cTnI). Conclusion: COVID-19 patients with severe CT findings and progressive disease had higher hs-cTnI levels suggesting the use of hs-cTnI in risk stratification.
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Affiliation(s)
- Cigdem Ileri
- Department of Cardiology, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zekeriya Dogan
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Beste Ozben
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Cagla Karaoglu
- Department of Internal Medicine, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nuran Gunay
- Department of Cardiology, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kursat Tigen
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Sema Basat
- Department of Internal Medicine, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Cihangir Uyan
- Department of Cardiology, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
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Kahyaoglu M, Gunay N, Bayam E, Yilmaz Y, Gecmen C, Ozdil K, Uyan C. Atrial peak longitudinal strain may be predictive of pancolitis in patients with ulcerative colitis. J Clin Ultrasound 2020; 48:102-107. [PMID: 31273822 DOI: 10.1002/jcu.22752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/31/2019] [Accepted: 06/16/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Ulcerative colitis is a chronic idiopathic inflammatory bowel disease of the colon that is characterized by a relapsing and remitting course. Previous studies have shown that arterial stiffness, carotid intima media thickness, atrial electromechanical delay, and global longitudinal strain suggested subclinical cardiovascular disorders in ulcerative colitis patients. The aims of our study was to evaluate the left atrial function of patients with ulcerative colitis by using speckle tracking echocardiography, and to assess the relationship between echocardiographic variables and the extent of the disease. METHODS We recruited 51 outpatients with ulcerative colitis in remission phase and 52 healthy volunteers. The ulcerative colitis patients were evaluated by for the extent of the disease by endoscopy at the initial diagnosis. RESULTS E/Em , left atrial volume, and left atrial stiffness index were higher, and peak atrial longitudinal strain was lower in pancolitis than in non-pancolitis patients. In the multivariate logistic regression test, peak atrial longitudinal strain and E/Em were found to be independent predictors for pancolitis. CONCLUSION Early detection of myocardial abnormalities by conventional echocardiography and speckle tracking echocardiography, which is a simple and non-invasive technique, may be useful for giving insights to the extent of the disease in ulcerative colitis patients.
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Affiliation(s)
- Muzaffer Kahyaoglu
- Department of Cardiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Nuran Gunay
- Department of Cardiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Emrah Bayam
- Department of Cardiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Yusuf Yilmaz
- Department of Cardiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Cetin Gecmen
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Turkey
| | - Kamil Ozdil
- Department of Gastroenterology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Cihangir Uyan
- Department of Cardiology, Umraniye Training and Research Hospital, Istanbul, Turkey
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Bulbul E, Sener EF, Gunay NE, Taslidere B, Taslidere E, Koyuncu S, Gunay N. Corrigendum to "A role of the endothelial nitric oxide system in acute renal colic caused by ureteral stone" [Am J Emerg Med. 2018 Feb;36(2):266-270. doi: 10.1016/j.ajem.2017.08.008. Epub 2017 Aug 7]. Am J Emerg Med 2018; 37:1008. [PMID: 30528049 DOI: 10.1016/j.ajem.2018.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- E Bulbul
- Kayseri Training and Research Hospital, Department of Emergency Medicine, Kayseri, Turkey
| | - E F Sener
- Erciyes University, Faculty of Medicine, Department of Medical Biology, Kayseri, Turkey
| | - N E Gunay
- Kayseri Training and Research Hospital, Department of Clinical Biochemistry, Kayseri, Turkey
| | - B Taslidere
- Malatya State Hospital, Department of Emergency Medicine, Malatya, Turkey
| | - E Taslidere
- Bezmialem Vakif University, Faculty of Medicine, Department of Histology and Embryology, İstanbul, Turkey
| | - S Koyuncu
- Gaziosmanpasa University, Faculty of Medicine, Department of Emergency Medicine, Tokat, Turkey
| | - N Gunay
- Erciyes University, Faculty of Medicine, Department of Emergency Medicine, Kayseri, Turkey.
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Gunay N, Ocal L, Aksoy S, Baktir AO, Keser N. A Giant Isolated Cardiac Hydatid Cyst in the Interventricular Septum. Korean Circ J 2017; 47:418-419. [PMID: 28567094 PMCID: PMC5449538 DOI: 10.4070/kcj.2016.0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/14/2016] [Accepted: 10/25/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
- Nuran Gunay
- Department of Cardiology, Umraniye Research and Training Hospital, Istanbul Health Sciences University, Istanbul, Turkey
| | - Lutfi Ocal
- Department of Cardiology, Umraniye Research and Training Hospital, Istanbul Health Sciences University, Istanbul, Turkey
| | - Sukru Aksoy
- Department of Cardiology, Umraniye Research and Training Hospital, Istanbul Health Sciences University, Istanbul, Turkey
| | | | - Nurgul Keser
- Department of Cardiology, Umraniye Research and Training Hospital, Istanbul Health Sciences University, Istanbul, Turkey.,Department of Cardiology, Faculty of Medicine, University of Sakarya, Sakarya, Turkey
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Keser M, Cetin P, Solmaz D, Kozacı D, Gunay N, Oztürk S, Sarı I, Akar S, Birlik M, Akkoc N, Onen F. AB0744 There is NO Relationship between Glucagon like Peptide-1 and Inflammation in Psoriasis and Psoriatic Arthritis: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ozturk S, Keser M, Kozaci D, Cetin P, Gunay N, Onen F, Akkoc N, Sari I. THU0088 Fetuin-A and Its Association with Disease Activity in Psoriatic Arthritis: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sari I, Savran Y, Kozaci DL, Gunay N, Onen F, Akar S. THU0462 Increased Oxidative Stress and Macrophage Migration Inhibitory Factor in Patients with Familial Mediterranean Fever. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sari I, Savran Y, Kozaci DL, Gunay N, Onen F, Akar S. P01-021 – Macrophage migration inhibitory factory in FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952681 DOI: 10.1186/1546-0096-11-s1-a25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Taylan A, Sari I, Akinci B, Bilge S, Kozaci D, Akar S, Yalcin H, Gunay N, Akkoc N. AB0864 Extensive evaluation of biomarkers related with bone turnover in patients with ankylosing spondylitis:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rosenthal VD, Ramachandran B, Villamil-Gómez W, Armas-Ruiz A, Navoa-Ng JA, Matta-Cortés L, Pawar M, Nevzat-Yalcin A, Rodríguez-Ferrer M, Yıldızdaş RD, Menco A, Campuzano R, Villanueva VD, Rendon-Campo LF, Gupta A, Turhan O, Barahona-Guzmán N, Horoz OO, Arrieta P, Brito JM, Tolentino MCV, Astudillo Y, Saini N, Gunay N, Sarmiento-Villa G, Gumus E, Lagares-Guzmán A, Dursun O. Impact of a multidimensional infection control strategy on central line-associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC). Infection 2012; 40:415-23. [PMID: 22371234 DOI: 10.1007/s15010-012-0246-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 02/04/2012] [Indexed: 02/07/2023]
Abstract
PURPOSE To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control strategy including a practice bundle to reduce the rates of central line-associated bloodstream infection (CLAB) in patients hospitalized in pediatric intensive care units (PICUs) of hospitals, which are members of the INICC, from nine cities of five developing countries: Colombia, India, Mexico, Philippines, and Turkey. METHODS CLAB rates were determined by means of a prospective surveillance study conducted on 1,986 patients hospitalized in nine PICUs, over a period of 12,774 bed-days. The study was divided into two phases. During Phase 1 (baseline period), active surveillance was performed without the implementation of the multi-faceted approach. CLAB rates obtained in Phase 1 were compared with CLAB rates obtained in Phase 2 (intervention period), after implementation of the INICC multidimensional infection control program. RESULTS During Phase 1, 1,029 central line (CL) days were recorded, and during Phase 2, after implementing the CL care bundle and interventions, we recorded 3,861 CL days. The CLAB rate was 10.7 per 1,000 CL days in Phase 1, and in Phase 2, the CLAB rate decreased to 5.2 per 1,000 CL days (relative risk [RR] 0.48, 95% confidence interval [CI] 0.29-0.94, P = 0.02), showing a reduction of 52% in the CLAB rate. CONCLUSIONS This study shows that the implementation of a multidimensional infection control strategy was associated with a significant reduction in the CLAB rates in the PICUs of developing countries.
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Affiliation(s)
- V D Rosenthal
- International Nosocomial Infection Control Consortium, Corrientes Ave #4580, Floor 11, Apt. A, 1195 Buenos Aires, Argentina.
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Karasu-Minareci E, Gunay N, Minareci K, Sadan G, Ozbey G. What may be happen after an organophosphate exposure: Acute myocardial infarction? J Forensic Leg Med 2012; 19:94-6. [DOI: 10.1016/j.jflm.2011.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2011] [Revised: 06/14/2011] [Accepted: 07/20/2011] [Indexed: 11/26/2022]
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Gunay N. P56 Infection control precautions in oncology units. Eur J Oncol Nurs 2010. [DOI: 10.1016/s1462-3889(10)70119-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gunay N, Kose B, Demiryurek S, Ocak AR, Erel O, Demiryurek AT. Effects of a selective Rho-kinase inhibitor Y-27632 on oxidative stress parameters in acute dichlorvos poisoning in rats. Cell Biochem Funct 2008; 26:747-54. [DOI: 10.1002/cbf.1500] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
A 31 year old man with prosthetic aortic valve replacement presented with sudden onset of colic right flank pain. Analysis of the urine revealed haematuria, and the international normalised ratio was suboptimal. The patient was misdiagnosed as having ureteral colic. On the second day, an ultrasound showed no signs of obstructive uropathy, and there was no evidence of absent function on intravenous pyelogram. Computed tomography with contrast agent was performed and revealed a right renal infarction. Renal angiography demonstrated total occlusion of the right renal artery. Fibrinolytic therapy and angioplasty were unsuccessful. To our knowledge, aortic prosthetic valve thrombus as a source of renal artery embolism mimicking renal colic has not been reported previously. This case underlines the importance of renal colic as a manifestation of renal infarction in patients with prosthetic valves and the need for a high index of suspicion of renal embolism.
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Affiliation(s)
- V Davutoglu
- Department of Cardiology, School of Medicine, University of Gaziantep, Sahinbey Medical Center, Gaziantep, Turkey.
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Lardner RW, Al-Rabeh AH, Gunay N. Optimal estimation of parameters for a two-dimensional hydrodynamical model of the Arabian Gulf. ACTA ACUST UNITED AC 1993. [DOI: 10.1029/93jc01411] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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