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1. Risk factors for relapse after discontinuation of tenofovir or entecavir in hepatitis B e antigen-negative patients.

Author

Mermutluoglu, Cigdem, Karasahin, Omer, and Celen, Mustafa Kemal

Subjects
TENOFOVIR, HEPATITIS B virus, DISEASE relapse, ANTIVIRAL agents, MEDICAL virology
Abstract

Background and Aim: This study aimed to define the relapse frequency and risk determinants in chronic hepatitis B (CHB) patients who discontinued nucleoside analog (NA) treatment, were HBeAg-negative, and had achieved both a virological and biochemical response. Materials and Methods: This retrospective cohort study reviewed patients with HBeAg-negative CHB who received antiviral therapy for at least 65 months between January 1, 2013, and December 31, 2020. These patients discontinued treatment after demonstrating a biochemical and virological response and were evaluated at 6, 12, and 24 months post-treatment discontinuation. Results: Sixty-seven patients with CHB who received NA therapy for at least 65 months, discontinued treatment, and had undetectable HBV DNA and normal ALT values were evaluated. After cessation of NA therapy, a relapse was observed in 38 patients (56.7%). The relapse rate was 71.0% in patients treated with tenofovir disoproxil fumarate (TDF) as the last NA type and 37.9% in patients treated with entecavir (ETV) (p=0.017). The cutoff value for the best estimate of age for predicting relapse was 42 years. The relapse rate was 69.2% in patients aged ≥42 years and 39.2% in patients aged <42 years (p=0.007). The relapse rate was 51.3% in patients with a pre-treatment fibrosis score of 2, 56.0% in those with a fibrosis score of 3, and 100% in those with a fibrosis score of 4 (p=0.089). Conclusion: Among HBeAg-negative CHB patients who achieved a virological and biochemical response to long-term antiviral therapy, those aged 42 years and older, those with high fibrosis scores before treatment, and those who used TDF before treatment cessation should be closely monitored for relapse, especially in the first 12 months after stopping NA treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Investigation of metabolic disorders in the etiology of delirium in geriatric patients

Author

Dinckal, Cigdem, Tasar, Pinar Tosun, Karasahin, Omer, Sahin, Sevnaz, Ulusoy, Merve Gulsah, Akcam, Nur Ozge, and Sarikaya, Ozan Fatih

Subjects
Metabolic Disorder, Delirium, Adults, Mortality, Geriatric
Abstract

Aim: The aim of this study was to examine metabolic parameters, which are among the factors that promote delirium, in geriatric patients pre-diagnosed with delirium by the Consultation-Liaison Psychiatry Unit of our medical school. Material and Methods: The diagnosis and treatment records of 1435 patients over 65 years of age were retrospectively screened. For patients diagnosed with delirium, demographic data, mode of presentation, leukocyte count, and levels of hematocrit, sodium, potassium, albumin, C-reactive protein (CRP), urea, creatinine, glucose, vitamin B12, TSH, and T4 were recorded. Results: Of the 1435 patients screened, 1147 patients with available survival and laboratory data were included in the study. Of these, 285 patients were diagnosed with delirium and 861 patients were not. In the delirium group, 63% of the patients had anemia, 33% had leukocytosis, 28% had hyponatremia, 47% had elevated serum creatinine, 90% had elevated CRP, 60% had hypoalbuminemia, and 53% had hyperglycemia. Discussion: Our comparison of patients with and without delirium indicates that metabolic disorders such as hyponatremia, hypopotassemia, hypoalbuminemia, impaired renal function, hyperglycemia, presence of infection, and anemia are contributing factors in delirium. Delirium is a serious and common problem that increases morbidity and mortality in geriatric patients. Identifying metabolic markers of delirium can help diagnose delirium and predict mortality.

Published
2022

9. Çocukluk çağı aşılarına yönelik ebeveyn tutumları ölçeğinin Türkçeye kültürel ve dil uyarlaması

Author

AKDEMİR KALKAN, İrem, ÖREN, Meryem Merve, KARASAHİN, Omer, YILDIZ, Yeşim, DEMİR, Yakup, DAL, Tuba, AKTAR, Fesih, BADUR, Selim, AYHAN, Merve, and ÇELEN, Mustafa Kemal

Subjects
Infectious Diseases, Aşı,aşı tereddüttü,validasyon,ölçek,tutum, Enfeksiyon Hastalıkları
Abstract

Amaç: Aşı tereddüdü hem Türkiye hem de dünya için toplumsal tehdit oluşturan bir tutumdur. Bu konuda Türkçeye validasyonu yapılmış bir ölçek bulunmamaktadır. Bu çalışmanın amacı Opel ve ark. tarafından 2011 yılında geliştirilip 2013 yılında revize edilen ve ‘Parent Attitudes About Childhood Vaccines Survey ‘isimli ölçeğin Türkçeye dil validasyonunun yapılmasıdır.Gereç ve Yöntem : Çalışma bir dil validasyonu çalışması olarak gerçekleştirilmiştir. Opel DJ ve arkadaşları tarafından geliştirilen ölçek için ‘Seri yöntem’ kullanılarak dil validasyonu çalışması yapılmıştır. Ölçeğin çeviri, gözden geçirme, geri çeviri, açıklığın ve aynılığın değerlendirmesi ile çevirisi sağlanmış ve Modifiye Lawshe yöntemiyle kapsam geçerlilik analizi yapılarak son hali verilmiştir. Uzmanların ölçek maddelerine yönelik içerik uygunluğu yönünden belirtmiş oldukları görüşlere göre her madde için kapsam geçerlilik oranı ve kapsam geçerlilik indeksi hesaplanmıştır.Bulgular. Tüm ölçek soruları için kapsam geçerlilik oranı kritik değer olan 0,455’in üzerinde saptanmıştır. Ölçeğin kapsam geçerlilik indeksi değeri ise 0,630 olup ölçek sorularının kapsam geçerliliğinin istatistiksel olarak anlamlı olduğu tespit edilmiştir.Çıkarımlar: Çocukluk çağı aşılarına yönelik ebeveyn tutumları ölçeğinin dil validasyonunun tamamlanması ve kapsam geçerlilik testlerinden istatistik olarak anlamlı sonuçlar alınmış olması bu ölçeğin Türkçe anlaşılırlığının sağlandığını göstermektedir. Sonrasında yapılacak geçerlilik ve güvenilirlik çalışmaları ile ölçeğin Türkiye’de aşı tereddüdü konusunda ebeveyn tutumlarını ölçebilir hale gelmesi hedeflenmektedir. Böylece daha geniş kitlelerde çalışılarak aşı tereddüdü ve mücadelesi konusunda yapılacak çalışmalara katkı sağlayacağı düşünülmektedir.

Published
2020

10. Factors Determining Mortality in Geriatric Palliative Care Patients

Author

Tasar, Pinar Tosun, Karasahin, Omer, Timur, Ozge, Yildirim, Filiz, Sahin, Sevnaz, and Ege Üniversitesi

Subjects
palliative care, mortality, elderly
Abstract

Background: As life expectancy at birth increases, the elderly population is growing, both in Turkey and globally. the aim of this study was to investigate the factors associated with 12-month mortality in patients receiving geriatric palliative care. Methods: Geriatric inpatients who were treated for 48 hours or more in the palliative care unit of our hospital between January 2016 and January 2017 were included in the study. Results: A total of 233 geriatric palliative care patients (50.6% women) with a mean age of 77.6 +/- 11.0 were included in the study. Eighty of the patients in our study died while in palliative care. Chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) were significantly more common among the deceased patients. of the 153 surviving patients, 94 (61.4%) died within 12 months of discharge and 59 (38.6%) survived beyond 12 months. Presence of CKD was associated with a 2.17-fold reduction in survival time and albumin level < 3.2 mg/L with 2.12-fold reduction in survival time. in addition, post-discharge 12-month survival time was 1.80-fold shorter in the presence of solid organ malignancy, 2.06-fold shorter with APACHE-II score > 20.5, 1.60-fold shorter with Charlson Comorbidity Index (CCI) > 6.5, and 1.98-fold shorter with albumin levels < 3.2 mg/L. Conclusion: CKD and low albumin were identified as independent risk factors for reduced hospital survival time. Independent risk factors for shorter post-discharge survival time included the presence of solid organ malignancy, high APACHE-II score, high CCI, and low albumin level. Copyright (C) 2020, Taiwan Society of Geriatric Emergency & Critical Care Medicine.

Published
2020

13. Factors Determining Mortality in Geriatric Palliative Care Patients.

Author

Tasar, Pınar Tosun, Karasahin, Omer, Timur, Ozge, Yıldırım, Filiz, and Sahin, Sevnaz

Abstract

Background: As life expectancy at birth increases, the elderly population is growing, both in Turkey and globally. The aim of this study was to investigate the factors associated with 12-month mortality in patients receiving geriatric palliative care. Methods: Geriatric inpatients who were treated for 48 hours or more in the palliative care unit of our hospital between January 2016 and January 2017 were included in the study. Results: A total of 233 geriatric palliative care patients (50.6% women) with a mean age of 77.6 - 11.0 were included in the study. Eighty of the patients in our study died while in palliative care. Chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) were significantly more common among the deceased patients. Of the 153 surviving patients, 94 (61.4%) died within 12months of discharge and 59 (38.6%) survived beyond 12 months. Presence of CKD was associated with a 2.17-fold reduction in survival time and albumin level < 3.2 mg/L with 2.12-fold reduction in survival time. In addition, post-discharge 12-month survival time was 1.80-fold shorter in the presence of solid organ malignancy, 2.06-fold shorter with APACHE-II score > 20.5, 1.60-fold shorter with Charlson Comorbidity Index (CCI) > 6.5, and 1.98-fold shorter with albumin levels < 3.2 mg/L. Conclusion: CKD and low albumin were identified as independent risk factors for reduced hospital survival time. Independent risk factors for shorter post-discharge survival time included the presence of solid organ malignancy, high APACHE-II score, high CCI, and low albumin level. [ABSTRACT FROM AUTHOR]

Published
2020
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14. Relationship between Sarcopenia and Mortality in Elderly Inpatients.

Author

Bayraktar, Elif, Tasar, Pınar Tosun, Binici, Dogan Nasır, Karasahin, Omer, Timur, Ozge, and Sahin, Sevnaz

Subjects
DIAGNOSIS of diabetes, MORTALITY risk factors, HOSPITAL care, LENGTH of stay in hospitals, INTERNAL medicine, RISK assessment, SARCOPENIA, BODY surface area, LEAN body mass, DESCRIPTIVE statistics, OLD age
Abstract

Objective: Sarcopenia, a geriatric syndrome, is an indicator of poor prognosis in elderly inpatients. In this study, we aimed to determine the effect of sarcopenia on mortality in elderly patients. Materials and Methods: Mobile/immobile geriatric inpatients, treated in the internal medicine ward between February and November 2018, were included in the study between Days 2 and 7 of hospitalization. The patients' fat-free mass (FFM) was measured by bioimpedance. The FFM index (FFMI) (kg/m²) was determined by dividing fat-free mass by body surface area (FFM/BSA). Sarcopenia was defined as a FFMI value at least two standard deviations below the gender-specific mean of normal young adults. Results: The study included 200 geriatric inpatients; 96 (48.0%) were men, and the mean age was 74.49±6.32 years. Sarcopenia was detected in 28 (14%) of the patients. Diabetes mellitus was associated with a signifi- cantly lower sarcopenia prevalence (p=0.006). The risk of sarcopenia was 9.046 times higher in malnourished patients. The sarcopenia group had more deaths (p=0.012). Conclusion: Sarcopenia in geriatric inpatients increased the length of hospital stay and mortality. Our findings may guide future studies examining the relationship between sarcopenia and mortality among elderly inpatients in other hospitals. [ABSTRACT FROM AUTHOR]

Published
2020
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20. Withdrawal of Staphylococcus aureus from intensive care units in Turkey

Author

Saim Dayan, Nail Ozgunes, Hasan Ucmak, Turan Aslan, Begin Altun, Adem Albayrak, Nefise Oztoprak, Selçuk Kaya, Tuna Demirdal, Salman Shaheer Ahmed, Fehmi Tabak, Iftihar Koksal, Hanefi Cem Gul, Yasemin Ersoy, Yeşim Taşova, Oral Oncul, Mehmet Bitirgen, Ibak Gonen, Murat Dizbay, Selma Karabey, Hakan Erdem, Nazif Elaldi, Fatma Sirmatel, İbrahim Erayman, Oznur Ak, Oguz Karabay, Birsen Cetin, Emel Azak, Bilgin Arda, Ercan Yenilmez, Hakan Leblebicioglu, Tumer Guven, Ayşe Willke, Recep Tekin, Saban Esen, Asim Ulcay, Davut Ozdemir, Serhat Ünal, Asuman Inan, Zeliha Kocak Tufan, Ilker Inanc Balkan, Sukran Kose, Filiz Akata, Aygul Dogan-Celik, Fatma Nurhayat Bayazit, Ayhan Akbulut, Gulden Yilmaz, Ömer Karaşahin, Derya Ozturk-Engin, Gokay Gungor, Güven Çelebi, Serkan Oncu, Levent Gorenek, Halis Akalin, Aysegul Ulu-Kilic, Aslihan Candevir, Hale Turan, [Erdem, Hakan -- Oncul, Oral -- Yenilmez, Ercan -- Gorenek, Levent -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Dizbay, Murat -- Karasahin, Omer] Gazi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Karabey, Selma] Istanbul Univ, Istanbul Sch Med, Dept Publ Hlth, Istanbul, Turkey -- [Kaya, Selcuk -- Koksal, Iftihar] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Demirdal, Tuna] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Inan, Asuman -- Ozturk-Engin, Derya] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erayman, Ibrahim -- Bitirgen, Mehmet] Selcuk Univ, Meram Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Ak, Oznur] Lutfi Kirdar Kartal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ulu-Kilic, Aysegul -- Ahmed, Salman Shaheer] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Yilmaz, Gulden] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Candevir, Aslihan -- Tasova, Yesim] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Gul, Hanefi Cem] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Gonen, Ibak] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Aslan, Turan] Bezmi Alem Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Azak, Emel -- Willke, Ayse] Kocaeli Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kocaeli, Turkey -- [Tekin, Recep -- Dayan, Saim] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Tufan, Zeliha Kocak] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Arda, Bilgin] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Gungor, Gokay] Sureyyapasa Chest Dis & Thorac Surg Educ & Res Ho, Resp Intens Care Unit, Istanbul, Turkey -- [Cetin, Birsen] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kose, Sukran] Izmir Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Turan, Hale] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Akalin, Halis] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Dogan-Celik, Aygul -- Tabak, Fehmi] Trakya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Edirne, Turkey -- [Albayrak, Adem -- Esen, Saban -- Leblebicioglu, Hakan] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Guven, Tumer] Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Celebi, Guven] Bulent Ecevit Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Zonguldak, Turkey -- [Ozgunes, Nail] Medeniyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ersoy, Yasemin] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Oztoprak, Nefise] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Balkan, Ilker Inanc -- Tabak, Fehmi] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Bayazit, Fatma Nurhayat] Fatih Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Ucmak, Hasan] Sutcu Imam Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Oncu, Serkan] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Ozdemir, Davut] Duzce Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Duzce, Turkey -- [Altun, Begin -- Unal, Serhat] Hacettepe Univ Ankara, Fac Med, Dept Med, Infect Dis Unit, Ankara, Turkey, Leblebicioglu, Hakan -- 0000-0002-6033-8543, UNAL, SERHAT -- 0000-0003-1184-4711, Candevir, Aslihan -- 0000-0001-9340-516X, Tufan, Zeliha Kocak -- 0000-0002-3294-014X, Gungor, Gokay -- 0000-0003-2294-489X, Elaldi, Nazif -- 0000-0002-9515-770X, Karabay, Oguz -- 0000-0003-0502-432X, Ersoy, Yasemin -- 0000-0001-5730-6682, Dizbay, Murat -- 0000-0003-4120-0781, Erdem, H, Dizbay, M, Karabey, S, Kaya, S, Demirdal, T, Koksal, I, Inan, A, Erayman, I, Ak, O, Ulu-Kilic, A, Karasahin, O, Akbulut, A, Elaldi, N, Yilmaz, G, Candevir, A, Gul, HC, Gonen, I, Oncul, O, Aslan, T, Azak, E, Tekin, R, Tufan, ZK, Yenilmez, E, Arda, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, Akbulut Uludağ, Ahsen, Zonguldak Bülent Ecevit Üniversitesi, Ondokuz Mayıs Üniversitesi, Arda, B, Gungor, G, Cetin, B, Kose, S, Turan, H, Akalin, H, Karabay, O, Dogan-Celik, A, Albayrak, A, Guven, T, Celebi, G, Ozgunes, N, Ersoy, Y, Sirmatel, F, Oztoprak, N, Balkan, II, Bayazit, FN, Ucmak, H, Oncu, S, Ozdemir, D, Ozturk-Engin, D, Bitirgen, M, Tabak, F, Akata, F, Willke, A, Gorenek, L, Ahmed, SS, Tasova, Y, Ulcay, A, Dayan, S, Esen, S, Leblebicioglu, H, Altun, B, Unal, S, and Çukurova Üniversitesi

Subjects
Staphylococcus aureus, medicine.medical_specialty, Pediatrics, Turkey, Epidemiology, health care facilities, manpower, and services, Staphylococcus, education, Staphylococcal infections, medicine.disease_cause, Tertiary Care Centers, Intensive care, health services administration, medicine, Humans, Retrospective Studies, Cross Infection, biology, business.industry, Health Policy, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, Retrospective cohort study, Staphylococcal Infections, Acinetobacter, medicine.disease, biology.organism_classification, Critical, Intensive Care Units, Infectious Diseases, Emergency medicine, Staphylococcus aureus infections, business
Abstract

WOS: 000326241700021, PubMed ID: 23663858, Background: In the past, Staphylococcus aureus infections have displayed various patterns of epidemiologic curves in hospitals, particularly in intensive care units (ICUs). This study aimed to characterize the current trend in a nationwide survey of ICUs in Turkey. Methods: A total of 88 ICUs from 36 Turkish tertiary hospitals were included in this retrospective study, which was performed during the first 3 months of both 2008 (period [P] 1) and 2011 (P2). A P value

Published
2013

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