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Aydin S, Derin O, Sahin M, Dinleyici R, Yilmaz M, Ceylan B, Tosun AI, Ozturk R, Mert A. Epidemiology of nosocomial candidemia, mortality and antifungal resistance, 7-year experience, in Turkey. Jpn J Infect Dis 2022; 75:597-603. [PMID: 35908875 DOI: 10.7883/yoken.jjid.2022.181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Candidemia is an important clinical condition that prolongs the period of hospitalization and increases morbidity, mortality, and hospital costs. In this retrospective study, we aimed to evaluate the epidemiological and microbiological characteristics of patients with candidemia, between January 2013 and December 2019. Two hundred forty-one candidemia episodes were observed in the 230 patients, of whom 45% were female. The median age was 63 and 53.9% of the episodes were in the ICU. Frequently observed predisposing factors for candidemia included the use of antibiotics (71.3%), urinary catheterization (56.3%), Central venous catheter placement (50.3%), total parenteral nutrition (47.9%), solid-organ malignancy (46%), a surgical intervention (48.6%), chemotherapy (37%), steroid treatment (25.5%). The crude mortality rate was 52.7%. A significant difference was found between survivors and non-survivors (p = 0.007) with the Charlson comorbidity index. However, no statistically significant association was found between mortality and age, sex, surgical intervention, catheter-related candidemia, or Candida spp. The most frequently isolated Candida spp. was C. albicans (51%). Overall resistance to fluconazole, voriconazole, caspofungin, micafungin and flucytosine was 3.7%, 0%, 2.5%, 1.8%,1.8%, respectively. Consequently, there is a need for tests that yield higher success rates and rapid in diagnosis candidemia and local epidemiological data for antifungal resistance.
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Affiliation(s)
- Selda Aydin
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, School of Medicine, Turkey
| | - Okan Derin
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science Turkey, Sisli Hamidiye Etfal Training and Research Hospital, Turkey
| | - Meyha Sahin
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, School of Medicine, Turkey
| | - Rumeysa Dinleyici
- Department of Clinical Pharmacy, Istanbul Medipol University, School of Pharmacy, Turkey
| | - Mesut Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, School of Medicine, Turkey
| | - Bahadır Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, School of Medicine, Turkey
| | - Ayse Istanbullu Tosun
- Department of Medical Microbiology; Istanbul Medipol University School of Medicine, Turkey
| | - Recep Ozturk
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, School of Medicine, Turkey
| | - Ali Mert
- Department of Internal Medicine, Istanbul Medipol University, School of Medicine, Turkey
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Ceylan B, Franchini E. Ischemic preconditioning does not improve judo-specific performance but leads to better recovery in elite judo athletes. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.08.004] [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: 11/25/2022]
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Kubatova N, Qureshi NS, Altincekic N, Abele R, Bains JK, Ceylan B, Ferner J, Fuks C, Hargittay B, Hutchison MT, de Jesus V, Kutz F, Wirtz Martin MA, Meiser N, Linhard V, Pyper DJ, Trucks S, Fürtig B, Hengesbach M, Löhr F, Richter C, Saxena K, Schlundt A, Schwalbe H, Sreeramulu S, Wacker A, Weigand JE, Wirmer-Bartoschek J, Wöhnert J. 1H, 13C, and 15N backbone chemical shift assignments of coronavirus-2 non-structural protein Nsp10. Biomol NMR Assign 2021; 15:65-71. [PMID: 33159807 PMCID: PMC7648550 DOI: 10.1007/s12104-020-09984-1] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
The international Covid19-NMR consortium aims at the comprehensive spectroscopic characterization of SARS-CoV-2 RNA elements and proteins and will provide NMR chemical shift assignments of the molecular components of this virus. The SARS-CoV-2 genome encodes approximately 30 different proteins. Four of these proteins are involved in forming the viral envelope or in the packaging of the RNA genome and are therefore called structural proteins. The other proteins fulfill a variety of functions during the viral life cycle and comprise the so-called non-structural proteins (nsps). Here, we report the near-complete NMR resonance assignment for the backbone chemical shifts of the non-structural protein 10 (nsp10). Nsp10 is part of the viral replication-transcription complex (RTC). It aids in synthesizing and modifying the genomic and subgenomic RNAs. Via its interaction with nsp14, it ensures transcriptional fidelity of the RNA-dependent RNA polymerase, and through its stimulation of the methyltransferase activity of nsp16, it aids in synthesizing the RNA cap structures which protect the viral RNAs from being recognized by the innate immune system. Both of these functions can be potentially targeted by drugs. Our data will aid in performing additional NMR-based characterizations, and provide a basis for the identification of possible small molecule ligands interfering with nsp10 exerting its essential role in viral replication.
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Affiliation(s)
- N Kubatova
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - N S Qureshi
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - N Altincekic
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - R Abele
- Institute for Biochemistry, Biocentre, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - J K Bains
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - B Ceylan
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - J Ferner
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - C Fuks
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - B Hargittay
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - M T Hutchison
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - V de Jesus
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - F Kutz
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - M A Wirtz Martin
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - N Meiser
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - V Linhard
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - D J Pyper
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - S Trucks
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - B Fürtig
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - M Hengesbach
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany.
| | - F Löhr
- Institute of Biophysical Chemistry, Center for Biomolecular Magnetic Resonance (BMRZ), Johann Wolfgang Goethe-University, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - C Richter
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - K Saxena
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - A Schlundt
- Institute for Molecular Biosciences, Johann Wolfgang Goethe-University, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - H Schwalbe
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany.
| | - S Sreeramulu
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - A Wacker
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - J E Weigand
- Department of Biology, Technical University of Darmstadt, Schnittspahnstr 10, 64287, Darmstadt, Germany
| | - J Wirmer-Bartoschek
- Institute for Organic Chemistry and Chemical Biology, Johann Wolfgang Goethe-University Frankfurt, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
| | - J Wöhnert
- Institute for Molecular Biosciences, Johann Wolfgang Goethe-University, Max-von-Laue-Str. 7, 60438, Frankfurt/M, Germany
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Arslan F, Alp S, Büyükasık Y, Ozkan MC, Şahin F, Basaran S, Cagatay AA, Eraksoy ÖH, Aksu K, Ertunç B, Korten V, Ceylan B, Mert A. Hemophagocytic Lymphohistiocytosis in Adults: Low Incidence of Primary Neoplasm as a Trigger in a Case Series from Turkey. Mediterr J Hematol Infect Dis 2018; 10:e2018047. [PMID: 30210740 PMCID: PMC6131110 DOI: 10.4084/mjhid.2018.047] [Citation(s) in RCA: 4] [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: 02/22/2018] [Accepted: 07/11/2018] [Indexed: 01/17/2023] Open
Abstract
Hemophagocytic Lymphohistiocytosis (HLH) is an indicator of an exaggerated immune response and eventually adverse outcomes. This study aimed to investigate the clinical and laboratory features and outcomes of patients with HLH. The medical records of 26 HLH adult patients (≥ 16 years of age) were retrospectively analyzed. Gender, age, the duration of fever, time to diagnosis, etiology and laboratory data were extracted from the records. The mean age was 38 ± 18 years, and 15 (58%) patients were female. A total of nine cases had infectious diseases; four cases had rheumatologic diseases, three cases had hematological malignancies while nine cases could not have a definitive diagnosis. The median time to detection of HLH was 20 days (IQR: 8-30 d). Of the 25 patients, 11 (44%) died. The erythrocyte sedimentation rates of the surviving and non-surviving patients were 39 ± 22 mm/h and 15 ± 13 mm/h, respectively. When a long-lasting fever is complicated by bicytopenia or pancytopenia (especially), clinicians should promptly consider the possibility of HLH syndrome to improve patients' prognosis.
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Affiliation(s)
- Ferhat Arslan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Sehnaz Alp
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yahya Büyükasık
- Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Melda Comert Ozkan
- Department of Hematology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Fahri Şahin
- Department of Hematology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Seniha Basaran
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Arif Atahan Cagatay
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ömer Haluk Eraksoy
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kenan Aksu
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Barış Ertunç
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Volkan Korten
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Bahadır Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ali Mert
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
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Mert A, Arslan F, Kuyucu T, Koç EN, Yılmaz M, Turan D, Altın S, Pehlivanoglu F, Sengoz G, Yıldız D, Dokmetas I, Komur S, Kurtaran B, Demirdal T, Erdem HA, Sipahi OR, Batirel A, Parlak E, Tekin R, Tunçcan ÖG, Balkan II, Hayran O, Ceylan B. Miliary tuberculosis: Epidemiologicaland clinical analysis of large-case series from moderate to low tuberculosis endemic Country. Medicine (Baltimore) 2017; 96:e5875. [PMID: 28151863 PMCID: PMC5293426 DOI: 10.1097/md.0000000000005875] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to determine the clinical features, and outcome of the patients with miliary tuberculosis (TB).We retrospectively evaluated 263 patients (142 male, 121 female, mean age: 44 years, range: 16-89 years) with miliary TB. Criteria for the diagnosis of miliary TB were at least one of the followings in the presence of clinical presentation suggestive of miliary TB such as prolonged fever, night sweats, anorexia, weight loss: radiologic criterion and pathological criterion and/or microbiological criterion; pathological criterion and/or microbiological criterion.The miliary pattern was seen in 88% of the patients. Predisposing factors were found in 41% of the patients. Most frequent clinical features and laboratory findings were fever (100%), fatigue (91%), anorexia (85%), weight loss (66%), hepatomegaly (20%), splenomegaly (19%), choroid tubercules (8%), anemia (86%), pancytopenia (12%), and accelerated erythrocyte sedimentation rate (89%). Tuberculin skin test was positive in 29% of cases. Fifty percent of the patients met the criteria for fever of unknown origin. Acid-fast bacilli were demonstrated in 41% of patients (81/195), and cultures for Mycobacterium tuberculosis were positive in 51% (148/292) of tested specimens (predominantly sputum, CSF, and bronchial lavage). Blood cultures were positive in 20% (19/97). Granulomas in tissue samples of liver, lung, and bone marrow were present in 100% (21/21), 95% (18/19), and 82% (23/28), respectively. A total of 223 patients (85%) were given a quadruple anti-TB treatment. Forty-four (17%) patients died within 1 year after diagnosis established. Age, serum albumin, presence of military pattern, presence of mental changes, and hemoglobin concentration were found as independent predictors of mortality. Fever resolved within first 21 days in the majority (90%) of the cases.Miliary infiltrates on chest X-ray should raise the possibility of miliary TB especially in countries where TB is endemic. Although biopsy of the lungs and liver may have higher yield rate of organ involvement histopathologicaly, less invasive procedures including a bone marrow biopsy and blood cultures should be preferred owing to low complication rates.
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Affiliation(s)
- Ali Mert
- Department of Internal Medicine, Istanbul Medipol University
| | - Ferhat Arslan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University
| | - Tülin Kuyucu
- Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital
| | - Emine Nur Koç
- Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital
| | - Mesut Yılmaz
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University
| | - Demet Turan
- Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Department of Chest Disease
| | - Sedat Altın
- Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Department of Chest Disease
| | - Filiz Pehlivanoglu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital
| | - Gonul Sengoz
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital
| | - Dilek Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul
| | - Ilyas Dokmetas
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul
| | - Suheyla Komur
- Department of Infectious Diseases and Clinical Microbiology, Cukurova University Medical Faculty, Adana
| | - Behice Kurtaran
- Department of Infectious Diseases and Clinical Microbiology, Cukurova University Medical Faculty, Adana
| | - Tuna Demirdal
- Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University
| | - Hüseyin A. Erdem
- Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey
| | - Oguz Resat Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, LutfiKirdar Training and Research Hospital, Istanbul, Turkey
| | - Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Özlem Güzel Tunçcan
- Department of Clinical Microbiology and Infectious Diseases, Gazi University Hospital, Ankara, Turkey
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Osman Hayran
- Faculty of Medicine, Department of Public Health, Medipol University, Istanbul, Turkey
| | - Bahadır Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey
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Ceylan B, Arslan F, Sipahi OR, Sunbul M, Ormen B, Hakyemez İN, Turunc T, Yıldız Y, Karsen H, Karagoz G, Tekin R, Hizarci B, Turhan V, Senol S, Oztoprak N, Yılmaz M, Ozdemir K, Mermer S, Kokoglu OF, Mert A. Variables determining mortality in patients with Acinetobacter baumannii meningitis/ventriculitis treated with intrathecal colistin. Clin Neurol Neurosurg 2016; 153:43-49. [PMID: 28013184 DOI: 10.1016/j.clineuro.2016.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 12/03/2016] [Accepted: 12/13/2016] [Indexed: 12/01/2022]
Abstract
AIM To examine the variables associated with mortality in patients with Acinetobacter baumannii-related central nervous system infections treated with intrathecal colistin. MATERIALS AND METHODS This multi-centre retrospective case control study included patients from 11 centres in Turkey, as well as cases found during a literature review. Only patients with CNS infections caused by multidrug-resistant or extensively drug-resistant Acinetobacter baumannii treated with intrathecal colistin were included in this study. The variables associated with mortality were determined by dividing the patients into groups who died or survived during hospitalisation, and who died or survived from Acinetobacter meningitis. RESULTS Among the 77 cases enrolled in the study, 35 were found through a literature review and 42 were cases from our centres. Forty-four cases (57.1%) were male and the median age was 48 years (range: 20-78 years). Thirty-seven patients (48%) died during hospitalisation. The variables associated with increased all-cause mortality during hospitalisation included old age (odds ratio, 1.035; 95% confidence interval (CI), 1.004-1.067; p=0.026) and failure to provide cerebrospinal fluid sterilisation (odds ratio, 0.264; 95% confidence interval, 0.097-0.724; p=0.01). There is a trend (P=0.062) towards higher mortality with using of meropenem during meningitis treatment. Fifteen cases (19%) died from meningitis. There were no significant predictors of meningitis-related mortality. CONCLUSIONS The mortality rate for central nervous system infections caused by multidrug-resistant or extensively drug-resistant Acinetobacter baumannii is high. Old age and failure to provide CSF sterilisation are associated with increased mortality during hospitalisation.
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Affiliation(s)
- Bahadır Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Turkey
| | - Ferhat Arslan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Goztepe, Istanbul, Turkey.
| | - Oguz Resat Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Mustafa Sunbul
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, 19 Mayıs University, Samsun, Turkey
| | - Bahar Ormen
- Department of Infectious Disease and Clinical Microbiology, Atatürk Education and Training Hospital, Izmir, Turkey
| | - İsmail N Hakyemez
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine,Vakıf Gureba Bezmi Alem University, Istanbul, Turkey
| | - Tuba Turunc
- Department of Infectious Diseases and Clinical Microbiology, Baskent University, Adana, Turkey
| | - Yeşim Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Hasan Karsen
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Gul Karagoz
- Department of Infectious Diseases and Clinical Microbiology, Umraniye Education and Training Hospital, Istanbul, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Burcu Hizarci
- Department of Anesthesiology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Vedat Turhan
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdulhamid Education and Training Hospital, Istanbul, Turkey
| | - Sebnem Senol
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Nefise Oztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Education and Training Hospital, Antalya, Turkey
| | - Mesut Yılmaz
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Turkey
| | - Kevser Ozdemir
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Sinan Mermer
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Omer F Kokoglu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Sutcu Imam University, Kahramanmaras, Turkey
| | - Ali Mert
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Turkey
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Yilmaz M, Elaldi N, Balkan İİ, Arslan F, Batırel AA, Bakıcı MZ, Gozel MG, Alkan S, Çelik AD, Yetkin MA, Bodur H, Sınırtaş M, Akalın H, Altay FA, Şencan İ, Azak E, Gündeş S, Ceylan B, Öztürk R, Leblebicioglu H, Vahaboglu H, Mert A. Mortality predictors of Staphylococcus aureus bacteremia: a prospective multicenter study. Ann Clin Microbiol Antimicrob 2016; 15:7. [PMID: 26860463 PMCID: PMC4748515 DOI: 10.1186/s12941-016-0122-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 02/01/2016] [Indexed: 12/20/2022] Open
Abstract
Background Staphylococcus aureus is one of the causes of both community and healthcare-associated bacteremia. The attributable mortality of S. aureus bacteremia (SAB) is still higher and predictors for mortality and clinical outcomes of this condition are need to be clarified. In this prospective observational study, we aimed to examine the predictive factors for mortality in patients with SAB in eight Turkish tertiary care hospitals. Methods Adult patients with signs and symptoms of bacteremia with positive blood cultures for S. aureus were included. All data for episodes of SAB including demographics, clinical and laboratory findings, antibiotics, and outcome were recorded for a 3-year (2010–2012) period. Cox proportional hazard model with forward selection was used to assess the independent effect of risk factors on mortality. A 28-day mortality was the dependent variable in the Cox regression analysis. Results A total of 255 episodes of SAB were enrolled. The median age of the patients was 59 years. Fifty-five percent of the episodes were considered as primary SAB and vascular catheter was the source of 42.1 %. Healthcare associated SAB was defined in 55.7 %. Blood cultures yielded methicillin-resistant S. aureus (MRSA) as a cause of SAB in 39.2 %. Initial empirical therapy was inappropriate in 28.2 %. Although overall mortality was observed in 52 (20.4 %), 28-day mortality rate was 15.3 %. Both the numbers of initial inappropriate empirical antibiotic treatment and the median hours to start an appropriate antibiotic between the cases of fatal outcome and survivors after fever onset were found to be similar (12/39 vs 60/216 and 6 vs 12 h, respectively; p > 0.05). High Charlson comorbidity index (CCI) score (p = 0.002), MRSA (p = 0.017), intensive care unit (ICU) admission (p < 0.001) and prior exposure to antibiotics (p = 0.002) all were significantly associated with mortality. The Cox analysis defined age [Hazard Ratio (HR) 1.03; p = 0.023], ICU admission (HR 6.9; p = 0.002), and high CCI score (HR 1.32; p = 0.002) as the independent predictive factors mortality. Conclusions The results of this prospective study showed that age, ICU stay and high CCI score of a patient were the independent predictors of mortality and MRSA was also significantly associated with mortality in SAB.
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Affiliation(s)
- Mesut Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bağcılar, 34214, İstanbul, Turkey.
| | - Nazif Elaldi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
| | - İlker İnanç Balkan
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
| | - Ferhat Arslan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bağcılar, 34214, İstanbul, Turkey.
| | - Ayşe Alga Batırel
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
| | - Mustafa Zahir Bakıcı
- Department of Medical Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
| | - Mustafa Gokhan Gozel
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
| | - Sevil Alkan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Trakya University, Edirne, Turkey.
| | - Aygül Doğan Çelik
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Trakya University, Edirne, Turkey.
| | - Meltem Arzu Yetkin
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
| | - Hürrem Bodur
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
| | - Melda Sınırtaş
- Department of Medical Microbiology, Faculty of Medicine, Uludag University, Bursa, Turkey.
| | - Halis Akalın
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Uludag University, Bursa, Turkey.
| | - Fatma Aybala Altay
- Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
| | - İrfan Şencan
- Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
| | - Emel Azak
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - Sibel Gündeş
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - Bahadır Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bağcılar, 34214, İstanbul, Turkey.
| | - Recep Öztürk
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
| | - Hakan Leblebicioglu
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University, Samsun, Turkey.
| | - Haluk Vahaboglu
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Istanbul, Turkey.
| | - Ali Mert
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bağcılar, 34214, İstanbul, Turkey.
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Karabay O, Hoşoğlu S, Güçlü E, Akalin Ş, Altay FA, Aydin E, Ceylan B, Çelik A, Çelik İ, Demirdal T, Demirli K, Erben N, Erkorkmaz Ü, Erol S, Evirgen Ö, Gönen İ, Güner AE, Güven T, Kadanali A, Koçoğlu ME, Kökoğlu ÖF, Küçükbayrak A, Sargin F, Sünnetçioğlu M, Şenol Ş, İşikgöz Taşbakan M, Tekin R, Turhan V, Yilmaz G, Dede B. Impact of antimicrobial drug restrictions on doctors' behaviors. Turk J Med Sci 2016; 46:133-8. [PMID: 27511346 DOI: 10.3906/sag-1405-26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 04/24/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics. MATERIALS AND METHODS A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician. RESULTS A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had ≤5 years of occupational experience (junior specialists = JSs) and 942 (49.4%) of them were physicians. Specialists having >5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05). CONCLUSION This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did.
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Affiliation(s)
- Oğuz Karabay
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Health Science Institute, Sakarya, Turkey
| | - Salih Hoşoğlu
- Department of Infectious Diseases and Clinical Microbiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Ertuğrul Güçlü
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Health Science Institute, Sakarya, Turkey
| | - Şerife Akalin
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University, Faculty of Medicine, Denizli, Turkey
| | - Fatma Aybala Altay
- Department of Infectious Diseases and Clinical Microbiology, Ankara Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Emsal Aydin
- Department of Infectious Diseases and Clinical Microbiology, Kafkas University, Faculty of Medicine, Kars, Turkey
| | - Bahadır Ceylan
- Division of Infectious Diseases and Clinical Microbiology, Health Ministry İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Aygül Çelik
- Department of Infectious Diseases and Clinical Microbiology, Trakya University, Faculty of Medicine, Edirne, Turkey
| | - İlhami Çelik
- Department of Infectious Diseases and Clinical Microbiology, Health Ministry Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Tuna Demirdal
- Department of Infectious Diseases and Clinical Microbiology, İzmir Kâtip Çelebi University, İzmir, Turkey
| | - Keziban Demirli
- Division of Infectious Diseases and Clinical Microbiology, Health Ministry Gebze Fatih State Hospital, Kocaeli, Turkey
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Eskisehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey
| | - Ünal Erkorkmaz
- Department of Biostatistics, Sakarya University, Faculty of Medicine, Sakarya, Turkey
| | - Serpil Erol
- Department of Infectious Diseases and Clinical Microbiology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Ömer Evirgen
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - İbak Gönen
- Department of Infectious Diseases and Clinical Microbiology, Süleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Ayşe Ebru Güner
- Hospital Pharmacy, Sakarya University, Training and Research Hospital, Sakarya, Turkey
| | - Tümer Güven
- Department of Infectious Diseases and Clinical Microbiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Ayten Kadanali
- Department of Infectious Diseases and Clinical Microbiology, Ümraniye Training and Research Hospital, İstanbul, Turkey
| | - Mücahide Esra Koçoğlu
- Department of Clinical Microbiology, Abant İzzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Ömer Faruk Kökoğlu
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Abdulkadir Küçükbayrak
- Department of Infectious Diseases and Clinical Microbiology, Abant İzzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Fatma Sargin
- Department of Infectious Diseases and Clinical Microbiology, Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Mahmut Sünnetçioğlu
- Department of Infectious Diseases and Clinical Microbiology, Yüzüncü Yıl University, Faculty of Medicine, Van, Turkey
| | - Şebnem Şenol
- Department of Infectious Diseases and Clinical Microbiology, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Meltem İşikgöz Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University, Faculty of Medicine, İzmir, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Vedat Turhan
- Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpaşa Training Hospital, İstanbul, Turkey
| | - Gürdal Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Behiye Dede
- Department of Infectious Diseases and Clinical Microbiology, Ümraniye Training and Research Hospital, İstanbul, Turkey
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Ceylan B, Arslan F, Batırel A, Fincancı M, Yardımcı C, Fersan E, Paşaoğlu E, Yılmaz M, Mert A. Impact of fatty liver on hepatitis B virus replication and virologic response to tenofovir and entecavir. Turk J Gastroenterol 2015; 27:42-6. [PMID: 26674977 DOI: 10.5152/tjg.2015.150348] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND/AIMS We aimed to evaluate the impact of non-alcoholic fatty liver disease (NAFLD) on viral kinetics and virologic response to tenofovir and entecavir treatment in patients with chronic hepatitis B virus (HBV) infection. MATERIALS AND METHODS This study was designed as a retrospective multicenter cohort study. The impact of hepatosteatosis on pre-treatment serum HBV DNA levels and also on the virologic response to either tenofovir or entecavir at 6 and 12 months of therapy was investigated. RESULTS A total of 145 cases were involved in the study [median age 40 (18-73) years, 90 (62%) males]. In multivariate analysis, it was detected that patients with NAFLD were older and had a higher body mass index (BMI) [Odds ratio (95% confidence interval) and p-value for age were 1.040 (1.003-1.079) and 0.033 and for BMI were 1.348 (1.190-1.528) and 0.0001, respectively]. When only the 43 patients who were younger than 35.5 years old and who had a BMI less than 27.59 were investigated, serum high-density lipoprotein (HDL) levels and serum HBV DNA levels were lower in patients with NAFLD in multivariate analysis [Odds ratio (95% confidence interval) and p-values for serum HDL level and HBV DNA level were 0.864 (0.061-0.980) and 0.023 and 0.995 (0.990-0.999) and 0.025, respectively]. Totally, 57 and 75 of the patients had received entecavir and tenofovir, respectively. CONCLUSION Viral replication decreases in patients with chronic HBV infection in the presence of NAFLD, and NAFLD had no impact on the virologic response to entecavir and tenofovir treatment.
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Affiliation(s)
- Bahadır Ceylan
- Department of Infectious Diseases and Clinical Microbiology, İstanbul Medipol University, İstanbul, Turkey.
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Başaranoğlu M, Canbakan B, Yıldız K, Ceylan B, Baysal B, Uysal Ö, Şentürk H. Fatty liver disease might increase the risk of abdominal operation in patients with fatty liver and the prevalence of cancer in first-degree relatives. Turk J Gastroenterol 2015; 25 Suppl 1:138-41. [PMID: 25910292 DOI: 10.5152/tjg.2014.7674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS We investigated the risk of abdominal operation in patients with fatty liver and the risk of any cancer in first-degree relatives of patients with fatty liver. MATERIALS AND METHODS We evaluated 105 patients with nonalcoholic fatty liver disease (NAFLD), 121 patients with biopsy-proven hepatitis C (61 patients with fatty liver and 60 patients without fatty liver), 50 patients with inflammatory bowel disease (IBD), and 109 patients with dyspepsia. RESULTS There was no difference in sex, mean age, and marital status among the groups except that patients with IBD were younger than the others (p<0.001). The frequency of cancer among family members was 18% in IBD, 9% in dyspepsia, 28% in hepatitis C with steatosis, 21.5% in hepatitis C without steatosis, and 27% in NAFLD (p=0.006). Then, we divided the study group into two groups as follows: group 1: (IBD+dyspepsia+hepatitis C without steatosis) and group 2: (hepatitis C with steatosis+NAFLD). We found that the frequency of cancer was 16% in group 1 versus 24.4 % in group 2 (p=0.037). We also investigated the risk of abdominal operation in patients with fatty liver. The results were as follows: 33% in group without fatty liver versus 43% in group with fatty liver (p=0.043). CONCLUSION Understanding the underlying causes of fatty liver forms might decrease the cancer frequency in the population and number of operations in patients with fatty liver.
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Affiliation(s)
- Metin Başaranoğlu
- Department of Gastroenterology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
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11
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Ceylan B, Aslan T, Çınar A, Ruhkar Kurt A, Akkoyunlu Y. Can platelet indices be used as predictors of complication in subjects with appendicitis? Wien Klin Wochenschr 2015; 128:620-625. [PMID: 25869761 DOI: 10.1007/s00508-015-0760-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 01/28/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND We examined the changes of mean platelet volume (MPV) and platelet distribution width (PDW) in subjects with appendicitis and whether MPV and PDW could be used to predict the development of complication due to appendicitis. METHODS The healthy control group, the cases of appendicitis with perforation, and the cases of appendicitis without perforation were compared with regard to MPV and PDW. We determined whether MPV and PDW were independent variables predictive of the development of complication in subjects with appendicitis. RESULTS This retrospective case-control study included a total of 362 patients (249 of which were male (68.8 %) and 113 were female (31.2 %); median age, 30 [range, 18-84 years]). One hundred and ninety-two subjects (53 %) presented with appendicitis and 170 (47 %) comprised the healthy control group. Sixty-six (18.2 %) of the subjects with appendicitis developed complication. MPVs were lower in subjects of appendicitis without complication compared to the subjects of appendicitis with complication and the control group (MPV, 9.78 ± 0.99 vs. 10.20 ± 1.21 and 10.14 ± 1.03, respectively [p = 0.005]). The PDW levels were not different between the three groups. Independent variables predictive of the presence of complication included increased MPV and time from onset of symptoms to hospital presentation (odds ratio[confidence interval], p-value: 1.507[1.064-2.133], 0.021 and 18.887[5.139-69.410], 0.0001, respectively). CONCLUSIONS Our findings suggested these, MPV values in cases of appendicitis without complication were lower than the cases with complication and healthy control and MPV is a predictor of the development of complication in subjects with appendicitis.
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Affiliation(s)
- Bahadır Ceylan
- Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakıf University, Vatan Caddesi, Fatih, İstanbul, Turkey. .,, Yıldırım Beyazıt Caddesi, Zafer Mahallesi, Bosnapark Evleri, No: 8, Daire 13, Kat 3, Yenibosna, Bahçelievler, Istanbul, Turkey.
| | - Turan Aslan
- Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakıf University, Vatan Caddesi, Fatih, İstanbul, Turkey
| | - Ahmet Çınar
- Medical Faculty, Department of Internal Diseases, Bezmialem Vakıf University, Vatan Caddesi, Fatih, İstanbul, Turkey
| | - Ayşe Ruhkar Kurt
- Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakıf University, Vatan Caddesi, Fatih, İstanbul, Turkey
| | - Yasemin Akkoyunlu
- Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakıf University, Vatan Caddesi, Fatih, İstanbul, Turkey
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Guclu E, Tuna N, Karabay O, Akhan S, Bodur H, Ceylan B, Demirdal T, Demirdag K, Demirturk N, Ekerbicer H, Erol S, Esen S, Evirgen O, Geyik MF, Gunduz A, Karahocagil MK, Kokoglu OF, Ozdemir D, Ozgunes N, Sargın F, Tosun S, Tutuncu E. Predictors of response to pegylated interferon treatment in HBeAg-negative patients with chronic hepatitis B. J Infect Dev Ctries 2014; 8:1601-8. [PMID: 25500658 DOI: 10.3855/jidc.4953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/13/2014] [Accepted: 07/05/2014] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Although pegylated interferons (pegIFNs) alpha-2a and alpha-2b have been used in chronic hepatitis B (CHB) treatment for many years, there are few studies concerning predictors of sustained virologic response (SVR) to pegIFN therapy. In this study, we aimed to investigate the predictors of response to pegIFN treatment in cases with HBeAg-negative CHB infection. METHODOLOGY Seventeen tertiary care hospitals in Turkey were included in this study. Data from consecutively treated HBeAg-negative CHB patients, who received either pegIFN alpha-2a or alpha-2b, were collected retrospectively. SVR is defined as an HBV DNA concentration of less than 2,000 IU/mL six months after the completion of therapy RESULTS SVR was achieved in 40 (25%) of the 160 HBeAg-negative CHB patients. Viral loads in patients with SVR were lower compared to those with no SVR, beginning in the third month of treatment (p < 0.05). The number of cases with a decline of 1 log10 IU/mL in viral load after the first month of treatment and with a serum HBV DNA level under 2,000 IU/mL after the third month of treatment was higher in cases with SVR (p < 0.05). The number of patients who had undetectable HBV DNA levels at week 48 among responders was significantly greater than among post-treatment virological relapsers (p < 0.05). CONCLUSIONS Detection of a 1 log10 decline in serum HBV DNA level at the first month of treatment and a serum HBV DNA level < 2000 IU/mL at the third month of therapy may be predictors of SVR.
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Affiliation(s)
- Ertugrul Guclu
- Faculty of Medicine, Sakarya University, Sakarya, Turkey.
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Ceylan B, Turhan V. The efficacy of ribavirin in Crimean-Congo hemorrhagic fever—randomized trials are urgently needed. Int J Infect Dis 2014; 29:297-8. [DOI: 10.1016/j.ijid.2014.08.015] [Citation(s) in RCA: 7] [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] [Received: 07/24/2014] [Accepted: 08/20/2014] [Indexed: 11/29/2022] Open
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Affiliation(s)
- Ali Mert
- Department of Internal Medicine, İstanbul Medipol University Faculty of Medicine, İstanbul, Turkey.
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Abstract
OBJECTIVES The purpose of this study is to determine the frequency of menopausal symptoms in Turkish women and the impact of these symptoms and related factors on the quality of life. METHODS The sample in this cross-sectional study consisted of 1030 women, aged 40-59 years. The researcher collected the data at the women's homes via the face-to-face interview method using the Menopause-Specific Quality of Life (MENQOL) questionnaire and a questionnaire developed and drawn up in line with the literature. RESULTS The mean age (± standard deviation) of the women participating in the study was 48.58 ± 5.61 years and their mean menopausal age was 46.4 ± 4.4 years. While the most frequently experienced menopausal symptoms in the study were feeling tired and worn out (79.2%), aches in the muscles and joints (79.1%) and low backache (77.8%), the least experienced symptom was an increase in facial hair (28.3%). Significant differences were found between the subdomain mean scores on the MENQOL according to menopausal periods (p = 0.000). Significant differences were detected in all subdomain mean scores of the MENQOL questionnaire according to age groups, perception of income, education, parity and body mass index (p < 0.05). CONCLUSION In women in the climacteric period, the time that quality of life is the most affected among all the menopausal periods is the postmenopausal period. Women in menopause should not be forgotten; health-care services addressing the health needs of women should not be restricted only to the period of fertility but continued with the same sensitivity throughout the life cycle.
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Affiliation(s)
- B Ceylan
- Department of Fundamentals of Nursing, Ege University Faculty of Nursing , Bornova-Izmir , Turkey
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Affiliation(s)
- Yasemin Akkoyunlu
- Bezmialem Vakif University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey.
| | - Bahadır Ceylan
- Bezmialem Vakif University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Turan Aslan
- Bezmialem Vakif University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Ulu-Kilic A, Karakas A, Erdem H, Turker T, Inal AS, Ak O, Turan H, Kazak E, Inan A, Duygu F, Demiraslan H, Kader C, Sener A, Dayan S, Deveci O, Tekin R, Saltoglu N, Aydın M, Horasan ES, Gul HC, Ceylan B, Kadanalı A, Karabay O, Karagoz G, Kayabas U, Turhan V, Engin D, Gulsun S, Elaldı N, Alabay S. Update on treatment options for spinal brucellosis. Clin Microbiol Infect 2013; 20:O75-82. [PMID: 24118178 DOI: 10.1111/1469-0691.12351] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/26/2013] [Accepted: 07/27/2013] [Indexed: 12/14/2022]
Abstract
We evaluated the efficacy and tolerability of antibiotic regimens and optimal duration of therapy in complicated and uncomplicated forms of spinal brucellosis. This is a multicentre, retrospective and comparative study involving a total of 293 patients with spinal brucellosis from 19 health institutions. Comparison of complicated and uncomplicated spinal brucellosis was statistically analysed. Complicated spinal brucellosis was diagnosed in 78 (26.6%) of our patients. Clinical presentation was found to be significantly more acute, with fever and weight loss, in patients in the complicated group. They had significantly higher leukocyte and platelet counts, erythrocyte sedimentation rates and C-reactive protein levels, and lower haemoglobulin levels. The involvement of the thoracic spine was significantly more frequent in complicated cases. Spondylodiscitis was complicated, with paravertebral abscess in 38 (13.0%), prevertebral abscess in 13 (4.4%), epidural abscess in 30 (10.2%), psoas abscess in 10 (3.4%) and radiculitis in 8 (2.7%) patients. The five major combination regimens were: doxycycline 200 mg/day, rifampicin 600 mg/day and streptomycin 1 g/day; doxycycline 200 mg/day, rifampicin 600 mg/day and gentamicin 5 mg/kg; doxycycline 200 mg/day and rifampicin 600 mg/day; doxycycline 200 mg/day and streptomycin 1 g/day; and doxycycline 200 mg/day, rifampicin 600 mg/day and ciprofloxacin 1 g/day. There were no significant therapeutic differences between these antibiotic groups; the results were similar regarding the complicated and uncomplicated groups. Patients were mostly treated with doxycycline and rifampicin with or without an aminoglycoside. In the former subgroup, complicated cases received antibiotics for a longer duration than uncomplicated cases. Early recognition of complicated cases is critical in preventing devastating complications. Antimicrobial treatment should be prolonged in complicated spinal brucellosis in particular.
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Affiliation(s)
- A Ulu-Kilic
- Department of Infectious Disease and Clinical Microbiology (IDCM), Erciyes University School of Medicine, Kayseri, Turkey
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Ceylan B, Yardimci C, Fincanci M, Eren G, Tozalgan U, Muderrisoglu C, Akkoyunlu Y. Comparison of tenofovir and entecavir in patients with chronic HBV infection. Eur Rev Med Pharmacol Sci 2013; 17:2467-2473. [PMID: 24089225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Sustained suppression of serum HBV DNA levels with nucleos(t)ide analogues is the most important success obtained in the treatment of chronic HBV infection today. Tenofovir and entecavir provide more robust viral suppression. AIM The aim of this study is to compare tenofovir and entecavir in terms of viral kinetics, side effects and virological response in patients with chronic HBV infection. PATIENTS AND METHODS Patients with chronic hepatitis B treated with tenofovir or entecavir were included in this retrospective study. Using survey analysis, we evaluated independent variables reflecting virological response to treatment and determined whether use of tenofovir or entecavir was one of them. We compared the decline in serum HBV DNA levels at the 3rd, 6th, 12th, 18th and 24th months of treatment between two groups. We also compared entecavir and tenofovir in terms of side effect rates. RESULTS 117 patients [average age: 44 (20-73), 65 males (55.6%), 30 HBeAg positive (25.6%)] were enrolled in the study. Sixty-six patients (56.4%) used tenofovir and 51 (43.6%) patients used entecavir. Virological response was better in patients using tenofovir (Odd's ratio of 1.796 and p = 0.014) and having high fibrosis score (Odd's ratio of 0.182 and p = 0.018). Entecavir was more effective in reducing serum HBV DNA levels at the 3rd month of treatment (serum HBV DNA decline of 4.45 and 3.96 log10 units for entecavir and tenofovir respectively, p = 0.031), but decline rates were similar at other months. There was no difference between patient groups in terms of side effects and discontinuation of treatment due to side effects. CONCLUSIONS Patients with chronic HBV infection using tenofovir have better virological response than those using entecavir.
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Affiliation(s)
- B Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey.
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Erdem H, Kilic S, Sener B, Acikel C, Alp E, Karahocagil M, Yetkin F, Inan A, Kecik-Bosnak V, Gul H, Tekin-Koruk S, Ceran N, Demirdal T, Yilmaz G, Ulu-Kilic A, Ceylan B, Dogan-Celik A, Nayman-Alpat S, Tekin R, Yalci A, Turban V, Karaoglan I, Yilmaz H, Mete B, Batirel A, Ulcay A, Dayan S, Seza Inal A, Ahmed S, Tufan Z, Karakas A, Teker B, Namiduru M, Savasci U, Pappas G. Diagnosis of chronic brucellar meningitis and meningoencephalitis: the results of the Istanbul-2 study. Clin Microbiol Infect 2013; 19:E80-6. [DOI: 10.1111/1469-0691.12092] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Revised: 10/15/2012] [Accepted: 10/31/2012] [Indexed: 11/29/2022]
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Tunç N, Tunç SY, Görük NY, Ceylan B. The relationship between gestation and iron deficiency anemia in women applied to obstetrics and gynecology outpatient clinic. J Clin Exp Invest 2012. [DOI: 10.5799/ahinjs.01.2012.01.0110] [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: 11/23/2022] Open
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