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Sayan M, Eren AA, Alali B, Mohammadipour S, Vahedi F, Daneshmand B, Abbas W, Hawsawi Y, Nader T, Joseph J, Wahby R, Ozgenc I, Mula-Hussain L, Moningi S, Orio PF, Eren MF. Prostate Cancer Awareness in the Middle East. Int J Radiat Oncol Biol Phys 2023; 117:e433-e434. [PMID: 37785413 DOI: 10.1016/j.ijrobp.2023.06.1602] [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] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A better understanding of cancer awareness is crucial to allow the appropriate implementation of interventions to improve screening and diagnosis. While the incidence of prostate cancer has been reported to increase over the last decade in the Middle East, data on prostate cancer awareness in this region remains limited. Therefore, an assessment of prostate cancer awareness is critically needed. The current study addresses this urgent need by investigating the level of awareness of prostate cancer among the general public in the Middle East. MATERIALS/METHODS A cross-sectional survey of men residing in 13 Middle Eastern countries was conducted in 2022. A validated prostate cancer awareness questionnaire was used to assess participants' knowledge on several domains of prostate cancer. Men younger than 40 years of age or history of prostate cancer were excluded from the study. RESULTS A total of 4,431 men completed the survey. The median age was 49 (range, 40-81) and the majority of participants (81%) had a formal education. Most participants (90%) were married and only 30% had a family history of cancer. Most participants (84%) reported hearing about prostate cancer in the past but only 31% of the participants recognized that prostate cancer is the most common malignancy in men and 22% thought that prostate cancer affects both men and women. Awareness of risk factors for prostate cancer was low: 29% of the participants recognized family history as a risk factor and 30% associated increasing age with prostate cancer. Most participants were not aware of screening, specifically only 19% of the participants knew that PSA test is used for PC screening. In terms of prognosis, participants thought that the majority of prostate cancer patients (mean, 75%) die due to their disease as opposed to old age or another cause of death. CONCLUSION Although the Middle Eastern men are familiar with the existence of prostate cancer, they are uninformed about the disease outcomes, risk factors, and screening. Overall, these results indicate critically low levels of awareness of prostate cancer in the Middle East. Thus, there is a vital need to target this population for practical interventions to increase awareness, in addition to screening and earlier diagnosis.
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Affiliation(s)
- M Sayan
- Dana Farber Cancer Institute, Boston, MA
| | - A Ay Eren
- Kartal Dr. Lütfi Kırdar Education and Research Hospital, Istanbul, Turkey
| | - B Alali
- Jaber Al Ahmad Hospital, Kuwait, Kuwait
| | | | - F Vahedi
- University of Tehran, Tehran, Iran (Islamic Republic of Iran)
| | | | - W Abbas
- Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of Iran)
| | - Y Hawsawi
- Al-Faisal University, Jeddah, Saudi Arabia
| | - T Nader
- Faculty of Medicine of Damascus University, Damascus, Syrian Arab Republic
| | - J Joseph
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - R Wahby
- Galala University, Suez, Egypt
| | - I Ozgenc
- University of Nicosia Medical School, Egkomi, Cyprus
| | | | - S Moningi
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - P F Orio
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - M F Eren
- Marmara Universitesi Hastanesi, Istanbul, Turkey
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Sayan M, Aynaci O, Eren AA, Eren MF, Kazaz IO, Ibrahim Z, Al-Akelie OT, Al-Mansouri L, Abuhijlih R, Moningi S, El Hajj A, Mula-Hussain L, Orio PF. Clinical Presentation and Management of Prostate Cancer in the Middle East. Int J Radiat Oncol Biol Phys 2023; 117:e433. [PMID: 37785412 DOI: 10.1016/j.ijrobp.2023.06.1601] [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] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Prostate cancer is one of the most common malignancies worldwide and the incidence rate continues to increase in the Middle East. In the absence of large well-established cancer registries, there are no data to reflect the disease stage at initial presentation and patterns of care in this region. In order to mitigate the disease burden and help stakeholders to implement new policies to improve patient outcomes, it is important to study the disease stage at the initial presentation. The purpose of this study was to evaluate the clinical presentation and treatment of prostate cancer in the Middle East. MATERIALS/METHODS We performed a retrospective review of 7 institutional databases in 6 Middle Eastern countries to identify patients diagnosed with prostate cancer in 2021. Demographic, clinical, and treatment variables were abstracted. Patients who missed ≥2 scheduled radiation therapy (RT) appointments (excluding planned treatment breaks) were deemed "noncompliant." RESULTS A total of 1,132 patients were identified with a median age was 70 (range, 50-84). Most of the patients (78%) were diagnosed after developing symptoms and not on routine PSA screening. Diagnostic workup was completed in 87% of the patient. At time of diagnosis, 35% men presented with clinical T3 or T4 disease, 53% with metastatic disease and 42% with Gleason score ≥ 8. Mean PSA at time of presentation was 84 ng/ml. Among the nonmetastatic patients, 23% underwent a prostatectomy, 48% received definitive RT with or without androgen deprivation therapy (ADT), 9% received ADT alone and 20% received no treatment. No brachytherapy was used. Hypofractionated RT was used in 49% patients and only 8% were deemed "noncompliant". Among the metastatic patients, 74% received ADT with or without additional systemic therapy, 25% had palliative RT and 22% received no treatment. CONCLUSION In this large cohort of prostate cancer patients in the Middle East, most men presented with symptoms and were found to have advanced-stage disease. However, substantial proportion of patients did not receive any treatment. Further interventions to optimize prostate cancer diagnosis and treatment in in the Middle East are urgently needed.
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Affiliation(s)
- M Sayan
- Dana Farber Cancer Institute, Boston, MA
| | - O Aynaci
- Karadeniz Technical University, Trabzon, Trabzon, Turkey
| | - A Ay Eren
- Kartal Dr. Lütfi Kırdar Education and Research Hospital, Istanbul, Turkey
| | - M F Eren
- Marmara Universitesi Hastanesi, Istanbul, Turkey
| | - I O Kazaz
- Karadeniz Technical University, Trabzon, Turkey
| | - Z Ibrahim
- King Hamad University Hospital, Al Sayh, Bahrain
| | - O T Al-Akelie
- Alamal National Hospital for Cancer Management, Baghdad, Iraq
| | | | | | - S Moningi
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - A El Hajj
- American University of Beirut Medical Center, Beirut, Lebanon
| | | | - P F Orio
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
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Paolacci S, Ergoren MC, De Forni D, Manara E, Poddesu B, Cugia G, Dhuli K, Camilleri G, Tuncel G, Kaya Suer H, Sultanoglu N, Sayan M, Dundar M, Beccari T, Ceccarini MR, Gunsel IS, Dautaj A, Sanlidag T, Connelly ST, Tartaglia GM, Bertelli M. In vitro and clinical studies on the efficacy of α-cyclodextrin and hydroxytyrosol against SARS-CoV-2 infection. Eur Rev Med Pharmacol Sci 2021; 25:81-89. [PMID: 34890038 DOI: 10.26355/eurrev_202112_27337] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new coronavirus responsible for the current pandemic of coronavirus disease 2019 (COVID-19). This virus attacks cells of the airway epithelium by binding transmembrane angiotensin-converting enzyme 2 (ACE2). Hydroxytyrosol has anti-viral properties. Alpha-cyclodextrin can deplete sphingolipids and phospholipids from cell membranes. The aim of the present experimental study was to evaluate the efficacy of α-cyclodextrin and hydroxytyrosol in improving defenses against SARS-CoV-2 infection in in vitro cell models and humans. PATIENTS AND METHODS For in vitro experiments on Vero E6 cells, RNA for RT-qPCR analysis was extracted from Caco2 and human fibroblast cell lines. For study in humans, the treatment group consisted of 149 healthy volunteers in Northern Cyprus, considered at higher risk of SARS-CoV-2 infection than the general population. The volunteers used nasal spray containing α-cyclodextrin and hydroxytyrosol for 4 weeks. The control group consisted of 76 healthy volunteers who did not use the spray. RESULTS RT-qPCR experiments on targeted genes involved in endocytosis showed a reduction in gene expression, whereas cytotoxicity and cytoprotective tests showed that the compounds exerted a protective effect against SARS-CoV-2 infection at non-cytotoxic concentrations. None of the volunteers became positive to SARS-CoV-2 RT-qPCR assay during the 30 days of treatment. CONCLUSIONS Treatment with α-cyclodextrin and hydroxytyrosol nasal spray improved defenses against SARS-CoV-2 infection and reduced synthesis of viral particles.
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Mamidanna S, Neibart S, Chundury A, Sayan M, Alexander H, August D, Berim L, Boland P, Grandhi M, Gulhati P, Gupta K, Hochster H, Kennedy T, Langan R, Minacapelli C, Spencer K, Nosher J, Jabbour S. Survival Outcomes of Patients With Unresectable Hepatocellular Carcinoma Secondary to Viral vs. Non-Viral Etiologies Treated with Definitive Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.398] [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: 12/01/2022]
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Yoon J, Sayan M, Wang S, Watts A, Greener A, Kelly M, Word N. Effect of Hydrogel Rectal Spacer on Intrafraction Prostate Motion During Radiotherapy of Prostate Cancer Patients. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.938] [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: 10/20/2022]
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Mamidanna S, Neibart S, Chundury A, Sayan M, Alexander H, August D, Berim L, Boland P, Grandhi M, Gulhati P, Gupta K, Hochster H, Kennedy T, Langan R, Minacapelli C, Spencer K, Nosher J, Jabbour S. Comparing Acute Toxicities of Patients With Unresectable Hepatocellular Carcinoma Treated With Definitive Proton vs. Photon-Based Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.399] [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: 10/20/2022]
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Neibart S, Mamidanna S, Chundury A, Sayan M, Alexander H, August D, Berim L, Boland P, Grandhi M, Gulhati P, Kennedy T, Langan R, Spencer K, Jabbour S. Predictors of Undergoing Surgical Resection after Neoadjuvant Chemoradiotherapy for Borderline Resectable and Resectable Pancreatic Adenocarcinoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.413] [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: 11/16/2022]
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8
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Sayan M, Şahin B, Mustafayev TZ, Kefelioğlu ES, Vergalasova I, Gupta A, Balmuk A, Güngör G, Ohri N, Weiner J, Karaarslan E, Özyar E, Atalar B. PO-0867: Risk of Symptomatic Radiation Necrosis Following Stereotactic Radiosurgery for Brain Metastases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00884-7] [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: 10/22/2022]
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Sayan M, Eren M, Kötek A, Oskeroğlu Kaplan S, Duran Ö, Çukurçayır F, Babalıoğlu İ, Derinalp Or Ö, Öztürk A, Eroğlu C, Teke F, Kurtul N, Kutuk T, Bicakci B, Senyurek S, Aktan M, Ohri N, Haffty B, Atalar B. Utilization of Radiation Therapy and Predictors of Noncompliance among Syrian Refugees with Cancer Living in Turkey. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.869] [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: 10/23/2022]
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Sayan M, Bas A, Gokce A, Dikmen AU, Celik A, Kurul IC, Tastepe AI. Surgical outcomes of sleeve resections performed for non-small cell lung cancer; A single center experience. Niger J Clin Pract 2020; 23:829-834. [PMID: 32525119 DOI: 10.4103/njcp.njcp_603_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/04/2022]
Abstract
Background Although bronchial sleeve resections were performed instead of pneumonectomy in patients with insufficient pulmonary function initially, it is currently available as an alternative to pneumonectomy even in patients with adequate pulmonary reserve. Aims In this study, we aimed to evaluate the sleeve resections performed for lung cancer in terms of technical, postoperative complication mortality, survival rates and survival factors, complication and to compare them with the literature. Methods Patients who underwent sleeve lung resection with diagnosis of non-small cell lung cancer at our department between January 2012 and December 2017 were included in the study. Patients' data were analyzed according to tumor size, tumor histopathology, hilar/mediastinal lymph nodes invasion status, postoperative complications, operative mortality, resection type, overall survival and diseases-free survival, tumor location, and length of stay in intensive care unit. Results A total of 71 patients included the study. Right upper sleeve lobectomy was applied to 40 (56.3%) patients and left upper sleeve lobectomy was performed to 19 (26.8%) patients. The most common histopathological diagnosis was squamous cell carcinoma. The mean tumor diameter was 3.39 (SD: 2.25) cm. There was no nodal invasion in 41 (57.7%) patients and N1 nodal positivity was detected in 18 (25.4%) patients and N2 positivity in 12 (16.9%) patients. Median survival time was 43.6 months (35.4-51.8 months), the 3- and 5-year overall survival were 65.7% and 40.6%, respectively. There was a statistically significant correlation relationship between nodal invasion and recurrence, but this relation was not found in overall survival. Conclusion In our study, no significant correlation was found between mediastinal lymph node invasion and overall survival. Supporting this result with multi-centered and prospective studies may encourage surgeons for sleeve resection in indicated patients had lung cancer with nodal invasion.
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Affiliation(s)
- M Sayan
- Department of Thoracic Surgery, Faculty of Medicine, Gazi University, 06500, Besevler, Ankara, Turkey
| | - A Bas
- Department of Thoracic Surgery, Faculty of Medicine, Gazi University, 06500, Besevler, Ankara, Turkey
| | - A Gokce
- Department of Thoracic Surgery, Faculty of Medicine, Gazi University, 06500, Besevler, Ankara, Turkey
| | - A U Dikmen
- Department of Public Health, Faculty of Medicine, Gazi University, 06500, Besevler, Ankara, Turkey
| | - Ali Celik
- Department of Thoracic Surgery, Faculty of Medicine, Gazi University, 06500, Besevler, Ankara, Turkey
| | - I C Kurul
- Department of Thoracic Surgery, Faculty of Medicine, Gazi University, 06500, Besevler, Ankara, Turkey
| | - A I Tastepe
- Department of Thoracic Surgery, Faculty of Medicine, Gazi University, 06500, Besevler, Ankara, Turkey
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11
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Sayan M, Bahsi E, Sayan S. The evaluation of the colour changes of traditional composites, ceramic blocks and cad/cam composites in different solutions. Niger J Clin Pract 2020; 23:660-667. [PMID: 32367873 DOI: 10.4103/njcp.njcp_593_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims The aim of this study is to investigate the color changes of three different traditional composites, one ceramic and two resin-based composites CAD/CAM blocks in different solutions. Methods The materials used in the study were CAD/CAM block containing lithium disilicate glass ceramic (Ivoclar), Vita Enamic containing resin (VITA), Lava Ultimate Block containing resin (3M ESPE), G-aenial anterior composite (GC,), Filtek™ Ultimate Universal composite (3M ESPE) and Clearfil Majesty Esthetic composite (Kuaray). As colouring solutions, red wine (Buzbaǧ), black tea (Lipton), coffee (Nescafe) and distilled water (EAU distillee) were used. For the preparation of the traditional composite samples to be used in the study, 7 × 7 mm square-shaped plexiglass moulds, 1.2 mm in thickness, were used. The CAD/CAM blocks with ceramic and resin content were cut at the same thickness using a Struers sensitive cutting device. The samples were then randomly separated into grups of 10 and of the 240 samples, groups were separated into 6 different materials and 4 different solutions. The colour measurements of the 240 samples were taken at baseline, 30 days and 120 days with a Lovibond spectrophotometer (Tintometer). Results A statistically significant difference was determined between the materials in respect of the ΔE values in the 30-day solution groups (P < 0.05). No statistically significant difference was determined in the ΔE values of the different materials in the 30-day and 120-day distilled water groups (P > 0.05). A statistically significant difference was determined between the materials in respect of the ΔE values in the 120-day solution groups (P < 0.05). Conclusion In respect of discolouration, ceramic blocks are more successful. Resin-based blocks and traditional aesthetic composites showed more discolouration. The dietary habits of the patient should be taken into consideration in the selection of the restorative material.
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Affiliation(s)
- M Sayan
- Department of Restorative Dentistry, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - E Bahsi
- Department of Restorative Dentistry, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - S Sayan
- Department of Restorative Dentistry, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
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Sayan M, Youssef I, Ohri N, Gupta A, Arscott W, Wagman R, Jabbour S, Haffty B, Weiner J, Kim S, Lee A. Assessing the Quality of Radiation Oncology Residency Websites. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2120] [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: 11/26/2022]
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13
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Jhawar S, Alpert N, Emanuela T, Sayan M, Bazan J, White J, Haffty B, Ohri N. Adjuvant Radiation Therapy Alone is Associated with Improved Overall Survival Compared to Hormonal Therapy Alone in Elderly Women with Favorable Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.669] [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: 11/27/2022]
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Vinken L, Fransen K, Pineda-Peña AC, Alexiev I, Balotta C, Debaisieux L, Devaux C, García Ribas S, Gomes P, Incardona F, Kaiser R, Ruelle J, Sayan M, Paraschiv S, Paredes R, Peeters M, Sonnerborg A, Vancutsem E, Van den Wijngaert S, Van Ranst M, Verhofstede C, Vandamme AM, Lemey P, Van Laethem K. A21 HIV-1 sub-subtype F1 outbreak among MSM in Belgium. Virus Evol 2017; 3:vew036.020. [PMID: 28845274 PMCID: PMC5565986 DOI: 10.1093/ve/vew036.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- L Vinken
- KU Leuven - University of Leuven, Department Microbiology and Immunology, Rega Institute for Medical Research, Leuven, Belgium
| | - K Fransen
- Department of Clinical Sciences, Aids Reference laboratory, Institute of Tropical Medicine, Antwerp, Belgium
| | - A C Pineda-Peña
- Global Health and Tropical Medicine-GHTM, Institute for Hygiene and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - I Alexiev
- National Reference Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - C Balotta
- 'L. Sacco' Hospital, Infectious Diseases and Immunopathology Section, Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy
| | - L Debaisieux
- AIDS Reference Laboratory, Université Libre de Bruxelles, Hopital Erasme, Brussels, Belgium
| | - C Devaux
- Department of Infection and Immunity, Laboratory of Retrovirology, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - S García Ribas
- Department of Clinical Sciences, Aids Reference laboratory, Institute of Tropical Medicine, Antwerp, Belgium
| | - P Gomes
- HEM - Centro Hospitalar de Lisboa Ocidental, SPC, LMCBM, Lisbon, Portugal
| | | | - R Kaiser
- University of Cologne, Institute of Virology, Cologne, Germany
| | - J Ruelle
- Unit of Medical Microbiology (MBLG), Université Catholique de Louvain, Institute of Experimental and Clinical Research (IREC), Brussels, Belgium
| | - M Sayan
- Clinical Laboratory, Kocaeli University, Izmit, Kocaeli, Turkey
| | - S Paraschiv
- Molecular Diagnostics Laboratory, National Institute for Infectious Diseases 'Matei Bals', Bucharest, Romania
| | - R Paredes
- Universitat Autònoma de Barcelona, IrsiCaixa AIDS Research Institute, Badalona, Catalonia, Spain
| | - M Peeters
- Institut de Recherche pour le Développement, INSERM U1175, and University of Montpellier, Unité Mixte Internationale 233, Montpellier, France
| | - A Sonnerborg
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden
| | - E Vancutsem
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - S Van den Wijngaert
- Department of Microbiology, Saint-Pierre University Hospital, Brussels, Belgium
| | - M Van Ranst
- KU Leuven - University of Leuven, Department Microbiology and Immunology, Rega Institute for Medical Research, Leuven, Belgium
| | - C Verhofstede
- Department of Clinical Chemistry, Microbiology and Immunology, AIDS Reference Laboratory, Ghent University, Ghent, Belgium
| | - A-M Vandamme
- KU Leuven - University of Leuven, Department Microbiology and Immunology, Rega Institute for Medical Research, Leuven, Belgium
| | - P Lemey
- KU Leuven - University of Leuven, Department Microbiology and Immunology, Rega Institute for Medical Research, Leuven, Belgium
| | - K Van Laethem
- KU Leuven - University of Leuven, Department Microbiology and Immunology, Rega Institute for Medical Research, Leuven, Belgium
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Akhan S, Sayan M, Sargin Altunok E, Aynioglu A. A case report: antiviral triple therapy with telaprevir in a haemodialysed HCV patient in Turkey. Acta Clin Belg 2016. [DOI: 10.1179/2295333715y.0000000046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Sayan M, Wilson K, Nelson C, Rubin D, Heimann R. A Novel Schedule of Accelerated Partial Breast Radiation Using Intensity Modulated Radiation Therapy in Elderly Patients: Survival and Toxicity Analysis of a Prospective Clinical Trial. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.678] [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: 10/20/2022]
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Akhan S, Sayan M, Sargin Altunok E, Aynioglu A. A case report: antiviral triple therapy with telaprevir in a haemodialysed HCV patient in Turkey. Acta Clin Belg 2016; 70:440-1. [PMID: 26790555 DOI: 10.1080/17843286.2015.1107199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
A 49-year-old woman was diagnosed with chronic hepatitis C 7 years ago. She began haemodialysis at the same time. She was on the waiting list for kidney transplantation (KTx). The real-time PCR technique revealed an HCV RNA viral load of 212,000 IU/ml, genotype 1a, IL28B the rs12979860 minor allele heterozygous CT (rs8099917 TT homozygous). She had a history of first antiviral treatment for 48 weeks of PEG-IFN-alpha 2a, 135 μg/week in 2011, but the HCV infection relapsed. Considering her relatively young age, candidacy for renal transplant, and the heterozygous pattern of IL28B, we decided to proceed with a second (and last) antiviral treatment using triple therapy with telaprevir at the regular dose of 750 mg every 8 hours+PEG-IFN-alpha 2a 135 μg/week sc+200 mg RBV three times a week. At the end of 6-month therapy, HCV RNA was found to be negative at months 3, 5, and 6.The patient has reached the sustained virological response (SVR) and is ready for KTx. All renal transplant candidates (dialysis-dependent, or not) with HCV should be assessed for antiviral treatment given the increased risk of progressive liver disease due to immunosuppressive therapy, increased life expectancy compared to other HCV-positive patients on dialysis, and the inability to receive interferon after transplantation.
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Affiliation(s)
- S Akhan
- Infectious Diseases and Clinical Microbiology, Kocaeli University Faculty of Medicine , Turkey
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Sayan M, Gündüz A, Ersöz G, İnan A, Deveci A, Özgür G, Sargın F, Karagöz G, İnci A, İnan D, Ülçay A, Karaoğlan I, Kaya S, Kutlu SS, Süer K, Çağatay A, Akalın H. Integrase Strand Transfer Inhibitors (INSTIs) Resistance Mutations in HIV-1 Infected Turkish Patients. HIV Clin Trials 2016; 17:109-13. [PMID: 27125365 DOI: 10.1080/15284336.2016.1153303] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Integrase strand transfer inhibitor (INSTI) is a new class of antiretroviral (ARV) drugs designed to block the action of the integrase viral enzyme, which is responsible for insertation of the HIV-1 genome into the host DNA. The aim of this study was to evaluate for the first time INSTI resistance mutations in Turkish patients. METHODS This study was conducted in Turkey, between April 2013 and April 2015 using 169 HIV-1-infected patients (78 ARV naive patients and 91 ARV-experienced patients). Laboratory and clinical characteristics of ARV naive and ARV-experienced patients were as follows: gender (M/F): 71/7 and 80/11, median age: 38 and 38.4; median CD4(+) T-cell: 236 and 216 cells/mm(3), median HIV-1 RNA: 4.95+E5 and 1.08E+6 copies/ml. Population-based seqeunces of the reverse transcriptase, protease, and integrase domains of the HIV-1 pol gene were used to detect HIV-1 drug resistance mutations. RESULT INSTI resistance mutations were not found in recently diagnosed HIV-1-infected patients. However, ARV-experienced patients had major resistance mutations associated with raltegravir and elvitegravir; the following results were generated:F121Y, Y143R, Q148R and E157Q (6/91 - 6.6%). CONCLUSIONS The prevalence of INSTI resistant mutations in ART-experienced patients suggested that resistance testing must be incorporated as an integral part of HIV management with INSTI therapies.
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Affiliation(s)
- M Sayan
- a Faculty of Medicine, Clinical Laboratory, PCR Unit , University of Kocaeli , Kocaeli , Turkey.,b Research Center of Experimental Health Sciences, University of Near East , Nicosia , Northern Cyprus
| | - A Gündüz
- c Clinic of Infectious Diseases , Sisli Etfal, Educational and Research Hospital , Istanbul , Turkey
| | - G Ersöz
- d Faculty of Medicine, Department of Infectious Diseases , University of Mersin , Mersin , Turkey
| | - A İnan
- e Clinic of Infectious Diseases , Haydarpasa Numune, Educational and Research Hospital , Istanbul , Turkey
| | - A Deveci
- f Faculty of Medicine, Department of Infectious Diseases , University of 19 Mayis , Samsun , Turkey
| | - G Özgür
- g Clinic of Infectious Diseases , Samsun Educational and Research Hospital , Samsun , Turkey
| | - F Sargın
- h Clinic of Infectious Diseases , Medeniyet University, Goztepe Educational and Research Hospital , Istanbul , Turkey
| | - G Karagöz
- i Clinic of Infectious Diseases , Umraniye Educational and Research Hospital , İstanbul , Turkey
| | - A İnci
- j Clinic of Infectious Diseases , Istanbul Kanuni Sultan Süleyman, Educational and Research Hospital , Istanbul , Turkey
| | - D İnan
- k Faculty of Medicine, Department of Infectious Diseases , University of Akdeniz , Antalya , Turkey
| | - A Ülçay
- l Clinic of Infectious Diseases , Gulhane Military Medical Academy , Istanbul , Turkey
| | - I Karaoğlan
- m Faculty of Medicine, Department of Infectious Diseases , University of Gaziantep , Gaziantep , Turkey
| | - S Kaya
- n Faculty of Medicine, Department of Infectious Disease , University of Karadeniz Technical , Trabzon , Turkey
| | - S S Kutlu
- o Faculty of Medicine, Department of Infectious Diseases , University of Pamukkale , Denizli , Turkey
| | - K Süer
- p Faculty of Medicine, Department of Infectious Diseases , University of Near East , Nicosia , Northern Cyprus
| | - A Çağatay
- q Faculty of Medicine, Department of Infectious Diseases , University of Istanbul , İstanbul , Turkey
| | - H Akalın
- r Faculty of Medicine, Department of Infectious Diseases , University of Uludag , Bursa , Turkey
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Sayan M, Akhan S, Aygen B, Koruk ST, Mistik R, Demirtürk N, Ural O. HCV NS3 inhibitors resistance mutations in the telaprevir started Turkish patients with chronic HCV. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.1367] [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: 10/25/2022] Open
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Sayan M, Willke A, Ozgunes N, Sargın F. HIV-1 subtypes and primary antiretroviral resistance mutations in antiretroviral therapy naive HIV-1 infected individuals in Turkey. Jpn J Infect Dis 2014; 66:306-11. [PMID: 23883841 DOI: 10.7883/yoken.66.306] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, we determined the subtype distribution and the primary drug-resistant mutations in HIV-1 strains isolated from antiretroviral therapy (ART)-naive patients in Turkey. The study included 117 newly diagnosed HIV-1 positive Turkish patients. HIV-1 subtypes and circulating recombinant forms (CRFs) were identified by phylogenetic analysis (neighbor-joining method), and drug-resistant mutations were analyzed according to the 2009 World Health Organization list of surveillance drug-resistant mutations. Subtype CRFs (CRF 02_AG, CRF 01_AE, CRF 12_BF and CRF 03_AB; 47%, 55/117) and B (33.3%, 39/117) were identified as the most common occurring HIV-1 subtypes in Turkey. The patients had primary antiretroviral resistance mutations to nucleos(t)ide reverse transcriptase (RT) inhibitors (NRTIs) (M41L, T215C, T215D, and K219Q), non-nucleoside RT inhibitors (NNRTIs; K103N), and protease inhibitors (PIs; I47V, G73S). The prevalence of overall primary antiretroviral resistance was 7.6% (9/117) in HIV-1 patients from Turkey and drug-resistant rate for NRTIs, NNRTIs, and PIs were 4.2% (5/117), 1.7% (2/117), and 1.7% (2/117), respectively. In this study, various CRFs of HIV-1 were determined, for the first time, in Turkey. The prevalence of HIV-1 primary drug-resistant mutations in ART-naive patients suggested that resistance testing should be incorporated as an integral part of HIV management, and the choice of a first-line therapy regime should be guided by the results of genotypic resistance in Turkey.
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Affiliation(s)
- M Sayan
- Clinical Laboratory, PCR Unit, Faculty of Medicine, University of Kocaeli, Kocaeli, Turkey.
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Cekmen MB, Bakirdoven S, Sayan M, Yilmaz A. BK virus nephropathy developing after renal transplantation and its treatment with ciprofloxacin: a case report. Transplant Proc 2013. [PMID: 23195024 DOI: 10.1016/j.transproceed.2012.03.059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BK virus nephropathy (BKVN) is among the most important problems in renal transplant recipients. This report presented an assessment of treatment with a fluoroquinolone antibiotic, ciprofloxacin, for 6 months in a 21-year-old male patient who developed BKVN after transplantation. Ciprofloxacin treatment reduced the viral load and improved the clinical findings.
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Affiliation(s)
- M B Cekmen
- Department of Biochemistry, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey.
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22
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Sayan M, Akhan S. Antiviral drug-associated potential vaccine-escape hepatitis B virus mutants in Turkish patients with chronic hepatitis B. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.251] [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: 10/28/2022] Open
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23
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Sayan M, Akhan SC. Antiviral drug-associated potential vaccine-escape hepatitis B virus mutants in Turkish patients with chronic hepatitis B. Int J Infect Dis 2011; 15:e722-6. [PMID: 21784687 DOI: 10.1016/j.ijid.2011.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 05/13/2011] [Accepted: 05/30/2011] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The hepatitis B virus (HBV) polymerase (pol) gene completely overlaps with the envelope (S) gene. Mutations in the pol gene of HBV, either from selection of primary or secondary resistance mutations, typically result in changes in the overlapping hepatitis B surface antigen (HBsAg). Recent studies have conferred a new acronym to these HBV pol/S gene overlap mutants: ADAPVEMs, for antiviral drug-associated potential vaccine-escape mutants. The present study aimed to assess the prevalence and pattern of ADAPVEMs in Turkish patients with chronic hepatitis B (CHB). METHODS The investigation was conducted between March 2007 and July 2010 and involved a total of 442 patients. These patients were in the following phases of HBV infection: immune tolerant (n=50), immune reactive (n=37), inactive carrier (n=90), HBeAg-negative CHB (n=217), and HBsAg-negative (n=12), or were hemodialysis patients (n=36). One hundred eighty-six patients were receiving nucleos(t)ide analogue (NUC) therapy and 256 patients had treatment-naïve CHB. RESULTS Seven types of ADAPVEM were detected in the total CHB patients: rtM204V/sI195M, rtM204I/sW196S, rtM204I/sW196L, rtV173L/sE164D, rtA181T/sW172*, rtA181T/sW172L, and rtA181V/sL173F. The ADAPVEMs were associated with lamivudine, telbivudine, and adefovir. The prevalence of ADAPVEMs in all CHB patients was found to be 10% (46/442). The difference in the prevalence of ADAPVEMs across the different CHB clinical phases was not significant (Pearson Chi-square, p=0.112). The prevalence of ADAPVEMs was 24% (44/186) in those undergoing NUC therapy and 0.7% (2/256) in the treatment-naïve group; this difference was significant (Pearson Chi-square, p=0.00). CONCLUSIONS We determined the prevalence and pattern of ADAPVEMs in Turkish patients in the different phases of CHB. Preferred drugs in Turkey, such as lamivudine, have the potential to cause the emergence of ADAPVEMs, with the possibility that these will spread to both individuals immunized with the hepatitis B vaccine and nonimmunized individuals. ADAPVEMs should be monitored in infected and treated patients and their public health risks assessed.
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Affiliation(s)
- M Sayan
- Clinical Laboratory, PCR Unit, Faculty of Medicine, University of Kocaeli, 41380 İzmit-Kocaeli, Turkey.
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24
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Dehghani F, Sayan M, Conrad A, Evers J, Ghadban C, Blaheta R, Korf HW, Hailer NP. Inhibition of microglial and astrocytic inflammatory responses by the immunosuppressant mycophenolate mofetil. Neuropathol Appl Neurobiol 2011; 36:598-611. [PMID: 20609108 DOI: 10.1111/j.1365-2990.2010.01104.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIMS Nucleotide depletion induced by the immunosuppressant mycophenolate mofetil (MMF) has been shown to exert neuroprotective effects. It remains unclear whether nucleotide depletion directly counteracts neuronal demise or whether it inhibits microglial or astrocytic activation, thereby resulting in indirect neuroprotection. METHODS Effects of MMF on isolated microglial cells, astrocyte/microglial cell co-cultures and isolated hippocampal neurones were analysed by immunocytochemistry, quantitative morphometry, and elisa. RESULTS We found that: (i) MMF suppressed lipopolysaccharide-induced microglial secretion of interleukin-1β, tumour necrosis factor-α and nitric oxide; (ii) MMF suppressed lipopolysaccharide-induced astrocytic production of tumour necrosis factor-α but not of nitric oxide; (iii) MMF strongly inhibited proliferation of both microglial cells and astrocytes; (iv) MMF did not protect isolated hippocampal neurones from excitotoxic injury; and (v) effects of MMF on glial cells were reversed after treatment with guanosine. CONCLUSIONS Nucleotide depletion induced by MMF inhibits microglial and astrocytic activation. Microglial and astrocytic proliferation is suppressed by MMF-induced inhibition of the salvage pathway enzyme inosine monophosphate dehydrogenase. The previously observed neuroprotection after MMF treatment seems to be indirectly mediated, making this compound an interesting immunosuppressant in the treatment of acute central nervous system lesions.
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Affiliation(s)
- F Dehghani
- Dr. Senckenbergische Anatomie, Institute of Anatomy 2, Goethe-University, Frankfurt am Main, Germany.
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Meric M, Sayan M, Dundar D, Willke A. Tularaemia outbreaks in Sakarya, Turkey: case-control and environmental studies. Singapore Med J 2010; 51:655-659. [PMID: 20848064] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Tularaemia is an important zoonotic disease that leads to outbreaks. This study aimed to compare the epidemiological characteristics of two tularaemia outbreaks that occurred in the Sakarya region of Turkey, analyse the risk factors for the development of outbreaks and identify Francisella (F.) tularensis in the water samples. METHODS Two tularaemia outbreaks occurred in the Kocadongel village in 2005 and 2006. A field investigation and a case-control study with 47 cases and 47 healthy households were performed during the second outbreak. Clinical samples from the patients and filtrated water samples were analysed for F. tularensis via real-time polymerase chain reaction. RESULTS From the two outbreaks, a total of 58 patients were diagnosed with oropharyngeal tularaemia based on their clinical and serological results. Both outbreaks occurred between the months of January and April, and the number of patients peaked in February. Logistic regression analysis revealed that the consumption of natural spring water was the only significant risk factor for tularaemia infection (odds ratio 3.5, confidence interval 1.23-10.07). F. tularensis was detected in eight clinical samples and in the filtrated natural spring water. CONCLUSION This study is the first report of tularaemia from this region. The results show that both tularaemia outbreaks were related to the consumption of untreated natural spring water. To prevent waterborne tularaemia, community water supplies should be treated and checked periodically.
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Affiliation(s)
- M Meric
- Kocaeli University, Medical Faculty, Department of Clinical Bacteriology and Infectious Diseases, Umuttepe/Kocaeli 41380, Turkey.
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Sayan M, Sentürk O, Akhan SÇ, Hülagü S, Cekmen MB. Monitoring of hepatitis B virus surface antigen escape mutations and concomitantly nucleos(t)ide analog resistance mutations in Turkish patients with chronic hepatitis B. Int J Infect Dis 2010; 14 Suppl 3:e136-41. [PMID: 20382061 DOI: 10.1016/j.ijid.2009.11.039] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 10/30/2009] [Accepted: 11/25/2009] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The hepatitis B virus (HBV) polymerase gene completely overlaps with the envelope gene. In the present study we aimed to monitor the prevalence and pattern of the typical mutations for hepatitis B surface antigen (HBsAg) escape, and concomitantly nucleos(t)ide analog (NUC) resistance mutations, in Turkish patients undergoing different antiviral therapies and in treatment-naïve patients with chronic hepatitis B (CHB). METHODS The investigation was undertaken between March 2007 and August 2009 and involved a total of 142 patients under NUC therapy (88 males; mean age 42 years (range 13-68); hepatitis B e antigen (HBeAg) negativity in 94 patients; HBV DNA median log 4.3 log(10) IU/ml (range 2.0->6.0); alanine aminotransferase (ALT) median level 76.1 IU/ml (range 12-1082)) and 185 treatment-naïve CHB patients (120 males; mean age 39 years (range 1-76 years); HBeAg negativity in 132 patients; HBV DNA median log 3.5 log(10) IU/ml (range 2.0-6.0); ALT median level 60.7 IU/l (range 8-874)). RESULTS The overall prevalence of typical HBsAg escape mutations found in the CHB patients was 8.3% (27/327). In the NUC therapy group the prevalence was 8.5% (12/142), with the following patterns: sY100C+sI110V, sL109I, sP120T, sP127T, sG130R+sG145X, sS132A+sY134N, sY134N+sG145R, sC137G, sD144E, sG145R. In the treatment-naïve group the prevalence was 8.1% (15/185), with the following patterns: sL109I, sI110V, sS117INST, sP120T, sP127T, sM133I, sC137L+sG145R, sS143L. However, NUC resistance mutations were found in 7.7% (11/142) of the patients on NUC therapy and 3.8% (7/185) of the treatment-naïve group patients. Interestingly, the treatment-naïve patients had preexisting drug resistance mutations related to lamivudine (rtL180M+rtM204I), adefovir (rtA181V, rtQ215S, rtI233V), entecavir (intermediate susceptibility with rtL180M+rtM204IHBV variant), telbivudine (rtL180M+rtM204I), and tenofovir (rtA194T). CONCLUSIONS The findings of this study show preexisting typical HBsAg escape and NUC resistance mutations are possible. The genetic arrangement of the HBV genome with polymerase and surface genes overlapping has substantial public health and diagnostic implications and relevance.
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Affiliation(s)
- M Sayan
- Clinical Laboratory, PCR Unit, Faculty of Medicine, University of Kocaeli, İzmit-Kocaeli, Turkey.
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Abstract
Naturally occurring amino-acid substitutions in the hepatitis B virus (HBV) polymerase gene may be responsible for resistance to nucleoside/nucleotide (NUCs) analogues. To date, only pre-existing lamivudine resistance has been extensively studied. The aim of the present study was to determine the naturally occurring or pre-existing amino-acid substitutions related to NUCs in treatment naive Turkish patients with chronic hepatitis B (CHB). The investigation involved a total of 88 patients (65 males and 23 females; mean age, 34 years; range, 15-61 years) who were diagnosed with CHB between April 2008 and January 2009. According to HBeAg status, 66 patients were HBeAg-negative and 22 patients were HBeAg positive. Naturally occurring substitutions in the HBV polymerase region were detected by DNA sequencing in 17 (19%) and 30 (34%) patients, based on manual and geno2pheno tool database interpretation, respectively. Each amino-acid substitution appeared alone and included rtA194T, rtV214A, rtQ215S, rtI233V and rtN236T. The median values for viral load, ALT and AST were 3.3 log(10) (2.0-6.0) IU/mL, 36 (12-515) U/L and 27 (13-284) U/L, respectively, but these did not correlate with the observed amino-acid substitutions in the polymerase region. By direct sequencing, genotype D of HBV was found to still be dominant among Turkish patients. In conclusion, every patient who is diagnosed with CHB should be monitored before the start of treatment for more effective management of patient treatment options.
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Affiliation(s)
- M Sayan
- PCR Unit, Clinical Laboratory, Faculty of Medicine, University of Kocaeli, 41380 Kocaeli, Turkey.
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Willke A, Meric M, Grunow R, Sayan M, Finke EJ, Splettstößer W, Seibold E, Erdoğan S, Ergonul O, Yumuk Z, Gedikoglu S. An outbreak of oropharyngeal tularaemia linked to natural spring water. J Med Microbiol 2009; 58:112-116. [PMID: 19074661 DOI: 10.1099/jmm.0.002279-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A tularaemia outbreak was investigated involving 188 suspected cases in the Kocaeli region of Turkey between December 2004 and April 2005. A case-control study comprising 135 laboratory-confirmed cases and 55 controls was undertaken to identify risk factors for the development of the outbreak and to evaluate laboratory diagnostic methods. Tularaemia was confirmed by a microagglutination test (MAT) titre of >or=1 : 160 in 90 of the patients. In MAT-negative sera, 23/44 (52 %) were positive by ELISA with Francisella tularensis LPS and 1/9 (11 %) by Western blotting with this antigen. A species-specific PCR was positive in 16/25 (64 %) throat swabs and 8/13 (62 %) lymph node aspirates. Multivariate analysis showed that drinking natural spring water was the leading risk factor for the development of tularaemia (P=0.0001, odds ratio 0.165, 95 % CI 0.790-0.346). The outbreak ceased after abandonment of the suspected natural water springs.
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Affiliation(s)
- A Willke
- Kocaeli University, Medical Faculty, Department of Clinical Bacteriology and Infectious Diseases, Kocaeli, Turkey
| | - M Meric
- Kocaeli University, Medical Faculty, Department of Clinical Bacteriology and Infectious Diseases, Kocaeli, Turkey
| | - R Grunow
- Robert Koch Institute, Centre for Biological Safety, Berlin, Germany
| | - M Sayan
- Kocaeli University, Medical Faculty, Clinical Laboratory, PCR Unit, Kocaeli, Turkey
| | - E J Finke
- Bundeswehr Institute of Microbiology, Munich, Germany
| | | | - E Seibold
- Bundeswehr Institute of Microbiology, Munich, Germany
| | - S Erdoğan
- Istanbul University, Cerrahpasa Medical Faculty, Department of Public Health, Istanbul, Turkey
| | - O Ergonul
- Marmara University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Z Yumuk
- Kocaeli University, Medical Faculty, Department of Microbiology, Kocaeli, Turkey
| | - S Gedikoglu
- Uludag University, Medical Faculty, Department of Microbiology, Bursa, Turkey
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Sayan M, Yumuk Z, Çelebi S, Willke A. R2217 Elimination of false negativity of internal amplification control in PCR assay. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)72056-3] [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: 11/15/2022]
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Affiliation(s)
- A Yüce
- Department of Microbiology and Infectious Diseases, Dokuz Eylül University, Medical Faculty Incirati, 35340 Izmir, Turkey.
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Sayan M, Alponat A, Yavuz N, Altinkaya E, Göksel S, Sariyar M. The effect of oral sodium taurocholate on endotoxemia and intestinal anastomotic wound healing in rats with obstructive jaundice. Surg Today 2000; 27:953-7. [PMID: 10870583 DOI: 10.1007/bf02388145] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The effect of sodium taurocholate (ST) on endotoxemia and intestinal anastomotic wound healing in obstructive jaundice was evaluated in a rat model. A total of 108 Wistar rats were divided into three main groups. Thus, 36 animals were given ileal anastomosis (IA) alone (IA group), 36 were given IA with bile duct ligation (BDL) (IA + BDL group), and 36 were given IA with BDL and oral sodium taurocholate (ST) (IA + BDL + ST group). These three main groups were then divided into three equal subgroups, A, B, and C, which were killed on postoperative days (POD) 3, 5, and 9, respectively. In the IA + BDL + ST group, ST was administrated perioperatively and ceased from POD 5 onwards. The anastomotic hydroxyproline level and bursting pressure were significantly lower in the IA + BDL animals compared with the others on POD 3, 5, and 9 (P < 0.008). Endotoxemia was prominent in the IA + BDL group from POD 3 (P = 0.011). After ST was stopped, 42% of the AI + BDL + ST animals developed endotoxemia by POD 9 (P = 0.008). Anastomotic wound healing was better in the IA + BDL + ST group (P < 0.01). These findings suggest that endotoxemia and its adverse effects on wound healing in obstructive jaundice can be prevented by the oral administration of ST.
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Affiliation(s)
- M Sayan
- Department of Surgery, University of Istanbul, Cerrahpasa Medical School, Aksaray, Istanbul, Turkey
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Ozsan HG, Pehlivan M, Demirkan F, Undar B, Sayan M, Cehreli C. High lactoferrin levels in disseminated intravascular coagulation and its possible negative role in coagulation. Thromb Res 2000; 98:111-4. [PMID: 10706939 DOI: 10.1016/s0049-3848(99)00214-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- H G Ozsan
- Department of Hematology and Oncology, School of Medicine, Dokuz EylülUniversity, 35340, Izmir, Turkey.
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