Researcher: Aksu, Ekin Deniz
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Aksu, Ekin Deniz
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Publication Open Access Vitamin D status across age groups in Turkey: results of 108,742 samples from a single laboratory(Galenos Yayınevi, 2020) Bereket, Abdullah; Hatun, Şükrü; Yeşiltepe Mutlu, Rahime Gül; Aksu, Ekin Deniz; Faculty Member; School of Medicine; 153504; 153511; N/AObjective: the aim was to determine vitamin D status in the general population in Turkey between 2011 and 2016, and to evaluate the effectiveness of the national vitamin D supplementation programme. Methods: serum 25-hydroxyvitamin D (25-OHD) measurement data were retrieved from an internationally accredited laboratory, operating nationwide. A total of 108,742 measurements of 25-OHD were analyzed using the cut-off values of 0-11 ng/mL, 12-19 ng/mL, 20-49 ng/mL, 50-70 ng/mL and >70 ng/mL for vitamin D deficiency, insufficiency, sufficiency, possibly harmful and excess respectively. Results: the mean±standard deviation 25-OHD level was 21.6±13.3 ng/mL. Mean 25-OHD concentrations by age groups were: 37.3 ng/mL, 30.1 ng/mL and 23.7 ng/mL for <1, 1-10 and 11-18 year old groups, respectively. Mean 25-OHD levels of children <1 year and 1-3 years of age were significantly higher than those found in other age groups. The prevalence of vitamin D deficiency (<12 ng/mL) was lowest in children at 1-3 years of age (5%). In subjects older than 18 years of age, mean 25-OHD levels were 18.2 ng/mL, 20.1 ng/ mL, 21.9 ng/mL and 21.1 ng/mL for age groups 19-30, 31-50, 51-70 and >70 years, respectively. Conclusion: successful implementation of the national vitamin D supplementation programme, appears to have nearly eliminated vitamin D deficiency for children under 1-years of age. However, the positive impact of the vitamin D supplementation diminishes as children get older suggesting that supplementation may be required in the older children and adults. In addition, improved awareness of the benefits and risks of excess vitamin D should prevent unnecessary and excessive use of vitamin D supplements.Publication Open Access Effect of initial antifungal therapy on mortality among patients with bloodstream infections with different Candida species and resistance to antifungal agents: A multicentre observational study by the Turkish Fungal Infections Study Group(Elsevier, 2020) Yeşilkaya, A.; Menekşe, Güler Ö.; Karakoç, Ç.; Çınar, G.; Aydın, M.; Keske, Şahin, S.; Hacıseyitoğlu, D.; Yalçın, D.; Albayrak, Ö.; Can, F.; Doğan, Özlem; Kapmaz, Mahir; Tekin, Süda; Ataç, Nazlı; Albayrak, Özgür; Aksu, Ekin Deniz; Can, Füsun; Ergönül, Önder; Faculty Member; Researcher; Faculty Member; Faculty Member; School of Medicine; N/A; N/A; N/A; N/A; N/A; N/A; 103165; 110398This study aimed to describe the effect of initial antifungal therapy on patient mortality and to detail the current distribution and resistance patterns of Candida spp. among patients with candidaemia. A prospective observational study was performed among consecutive patients with candidaemia from 10 Turkish medical centres between January 2015 and November 2018. The primary outcome was 10-day mortality. Species were identified using MALDI-TOF/MS. A total of 342 patients with candidaemia were included, of which 175 (51.2%) were male and 68 (19.9%) were aged <18 years. The most common species were Candida albicans (47.4%), Candida parapsilosis (26.6%), Candida tropicalis (9.6%) and Candida glabrata (7.6%). Among all Candida spp., the 10-day case fatality rate (CFR) was 32.2%. The CFR was highest in patients with C. albicans (57.3%) and lowest in patients with C. parapsilosis (21.8%). The resistance rate to fluconazole was 13% in C. parapsilosis, with no significant effect on mortality. No resistance to echinocandins was detected. In the multivariate analysis, being in the ICU [OR = 2.1 (95% CI 1.32–3.57); P = 0.002], renal failure [OR = 2.4 (1.41–3.97); P = 0.001], total parenteral nutrition [OR = 2 (1.22–3.47); P = 0.006], C. albicans infection [OR = 1.7 (1.06–2.82); P = 0.027] and echinocandin as primary agent [OR = 0.6 (0.36–0.99); P = 0.047] were significantly associated with mortality. Candidaemia is a deadly infection. Fluconazole resistance is emerging, although it was not significantly related to mortality. Using an echinocandin as the primary agent could be life-saving.