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5. Acute hepatitis B virus infection in Turkey: epidemiology and genotype distribution

Author

Tasova, Y, Kilic, D, Kaygusuz, S, Leblebicioglu, H, Eroglu, C, Aribas, E, Sirmatel, F, Ayaz, C, Ozsoy, MF, Cavuslu, S, Turkyilmaz, R, Tutuncu, E, Sunbul, M, Esen, S, Turan, D, Akbulut, A, Cihangiroglu, M, Aygen, B, Usluer, G, Kartal, ED, Irmak, H, Evirgen, O, Tulek, N, Yetkin, MA, Dokmetas, I, Bakir, M, Yildiz, ORHAN, Sencan, I, Yamazhan, T, Ulusoy, S, Akcam, Z, Yayli, G, Ersoz, G, Kaya, A, Saltoglu, N, Ersoy, Y, Ozgenc, O, Parlak, M, Parlak, E, Koksal, I, Caylan, R, and OMÜ

Subjects
Adult, Male, Microbiology (medical), Hepatitis B virus, HBsAg, Genotype, Turkey, genotype, viral hepatitis, medicine.disease_cause, Polymerase Chain Reaction, Orthohepadnavirus, Prevalence, medicine, Humans, Hepatitis B e Antigens, Fulminant hepatitis, biology, business.industry, Acute infection, General Medicine, hepatitis D virus, Middle Aged, Hepatitis B, medicine.disease, biology.organism_classification, Virology, Infectious Diseases, Acute Disease, DNA, Viral, Female, Hepatitis D virus, business, Viral hepatitis, acute infection, hepatitis B virus, Polymorphism, Restriction Fragment Length
Abstract

42nd Interscience Conference on Antimicrobial Agents and Chemotherapy -- SEP 26-30, 2002 -- SAN DIEGO, CA Saltoglu, Nese/0000-0003-4239-9585; Leblebicioglu, Hakan/0000-0002-6033-8543; dokmetas, ilyas/0000-0003-3523-3923; Ersoy, Yasemin/0000-0001-5730-6682 WOS: 000221932100007 PubMed: 15191382 The aim of this study was to investigate the prevalence of hepatitis B virus (HBV) genotypes in Turkey. Epidemiological and clinical data for 158 patients with acute HBV infection from 22 medical centres in the period February 2001 to February 2002 were collected prospectively. HBV genotyping was based on analysis of restriction fragment length polymorphisms and nested PCR. There were 59 female and 99 male patients, with a mean age of 34.2 +/- 15.6 years. The most common probable transmission route was blood contact in 63 (41.1%) cases, but was unknown in 78 (49.4%) cases. The mean alanine aminotransferase level was 1718 +/- 1089 IU/L. Four of the 158 patients (2.5%) died because of fulminant hepatitis. One year after discharge, 11 (10.6%) of 103 cases were positive for hepatitis B surface antigen (HBsAg) and 80 (77.7%) were positive for anti-HBsAg. Genotype determination was unsuccessful in 11 cases because of a negative PCR; genotype D was found in the remaining 147 cases. The results suggested that acute HBV infection constitutes a significant health problem in Turkey and that genotype D is predominant.

Published
2004
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6. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu H, Erben N, Rosenthal VD, Sener A, Uzun C, Senol G, Ersoz G, Demirdal T, Duygu F, Willke A, Sirmatel F, Oztoprak N, Koksal I, Oncul O, Gurbuz Y, Güçlü E, Turgut H, Yalcin AN, Ozdemir D, Kendirli T, Aslan T, Esen S, Ulger F, Dilek A, Yilmaz H, Sunbul M, Ozgunes I, Usluer G, Otkun M, Kaya A, Kuyucu N, Kaya Z, Meric M, Azak E, Yýlmaz G, Kaya S, Ulusoy H, Haznedaroglu T, Gorenek L, Acar A, Tutuncu E, Karabay O, Kaya G, Sacar S, Sungurtekin H, Uğurcan D, Turhan O, Gumus E, and Dursu

Subjects
Cities, Cohort Studies, Hospitals, Humans, Prevalence, Prospective Studies, Surgical Wound Infection/*epidemiology, Turkey/epidemiology
Abstract

BACKGROUND: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. METHODS: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. RESULTS: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). CONCLUSIONS: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions.

Published
2015

7. International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Sener, A, Uzun, C, Senol, G, Ersoz, G, Demirdal, T, Duygu, F, Willke, A, Sirmatel, F, Oztoprak, N, Koksal, I, Oncul, O, Gurbuz, Y, Guclu, E, Turgut, H, Yalcin, AN, Ozdemir, D, Kendirli, T, Aslan, T, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Ozgunes, I, Usluer, G, Otkun, M, Kaya, A, Kuyucu, N, Kaya, Z, Meric, M, Azak, E, Yylmaz, G, Kaya, S, Ulusoy, H, Haznedaroglu, T, Gorenek, L, Acar, A, Tutuncu, E, Karabay, O, Kaya, G, Sacar, S, Sungurtekin, H, Ugurcan, D, Turhan, O, Gumus, E, Dursun, O, Geyik, MF, Sahin, A, Erdogan, S, Ince, E, Karbuz, A, Ciftci, E, Tasyapar, N, and Gunes, M

Subjects
infection, Surgical wound infection, Developing countries, Hospital infection, Nosocomial infection, Health care-associated
Abstract

Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

8. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H., Erben, N., Rosenthal, V.D., Sener, A., Uzun, C., Senol, G., Ersoz, G., Demirdal, T., Duygu, F., Willke, A., Sirmatel, F., Oztoprak, N., Koksal, I., Oncul, O., Gurbuz, Y., Güçlü, E., Turgut, H., Yalcin, A.N., Ozdemir, D., Kendirli, T., Aslan, T., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Sunbul, M., Ozgunes, I., Usluer, G., Otkun, M., Kaya, A., Kuyucu, N., Kaya, Z., Meric, M., Azak, E., Yýlmaz, G., Kaya, S., Ulusoy, H., Haznedaroglu, T., Gorenek, L., Acar, A., Tutuncu, E., Karabay, O., Kaya, G., Sacar, S., Sungurtekin, H., Uğurcan, Doğaç, Turhan, O., Gumus, E., Dursun, O., Geyik, M.F., Şahin, A., Erdogan, S., Ince, E., Karbuz, A., Çiftçi, E., Taşyapar, N., and Güneş, M.

Subjects
Turkey, Surgical wound infection, Health careeassociated infection, prevalence, infection rate, surgical infection, Article, Turkey (republic), Developing countries, Cohort Studies, hip prosthesis, Nosocomial infection, coronary artery bypass graft, Humans, Hospital infection, human, Prospective Studies, hospital, Cities, cesarean section, craniotomy, clinical trial, cohort analysis, shunting, Hospitals, hospital patient, multicenter study, city, prospective study
Abstract

Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright © 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

10. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Ahmet Şahin, Iftihar Koksal, Gaye Usluer, Hülya Sungurtekin, Tanıl Kendirli, Selçuk Kaya, Eylul Gumus, Gürdal Yýlmaz, Mehmet Faruk Geyik, Ertugrul Guclu, Nurettin Erben, Tuna Demirdal, Tuncer Haznedaroglu, Huseyin Turgut, Levent Gorenek, Erdal Ince, Melek Güneş, Hava Yilmaz, Necdet Kuyucu, Suzan Sacar, Alper Şener, Oguz Dursun, Nefise Oztoprak, Ahmet Dilek, Fatma Sirmatel, Ergin Çiftçi, Meliha Meric, Gulsume Kaya, Mustafa Sunbul, Metin Otkun, Emel Azak, Fatma Ülger, Gülden Ersöz, Yunus Gürbüz, Ayşe Willke, Sehnaz Kaya, Hakan Leblebicioglu, Oral Oncul, Davut Ozdemir, Nevin Taşyapar, Ali Acar, Ediz Tutuncu, Zeynep Kaya, Doğaç Uğurcan, Oguz Karabay, Victor D. Rosenthal, Fazilet Duygu, Saban Esen, Ali Kaya, Ata Nevzat Yalcin, Hülya Ulusoy, Gunes Senol, Adem Karbuz, Turan Aslan, Özge Turhan, Selvi Erdogan, Cengiz Uzun, Ilhan Ozgunes, Leblebicioglu, H, Erben, N, Rosenthal, VD, Sener, A, Uzun, C, Senol, G, Ersoz, G, Demirdal, T, Duygu, F, Willke, A, Sirmatel, F, Oztoprak, N, Koksal, I, Oncul, O, Gurbuz, Y, Guclu, E, Turgut, H, Yalcin, AN, Ozdemir, D, Kendirli, T, Aslan, T, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Ozgunes, I, Usluer, G, Otkun, M, Kaya, A, Kuyucu, N, Kaya, Z, Meric, M, Azak, E, Yylmaz, G, Kaya, S, Ulusoy, H, Haznedaroglu, T, Gorenek, L, Acar, A, Tutuncu, E, Karabay, O, Kaya, G, Sacar, S, Sungurtekin, H, Ugurcan, D, Turhan, O, Gumus, E, Dursun, O, Geyik, MF, Sahin, A, Erdogan, S, Ince, E, Karbuz, A, Ciftci, E, Tasyapar, N, Gunes, M, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Güçlü, Ertuğrul, MERİÇ KOÇ, MELİHA, and Ondokuz Mayıs Üniversitesi

Subjects
Turkey, Epidemiology, Surgical wound infection, Health careeassociated infection, Turkey (republic), Cohort Studies, hip prosthesis, Nosocomial infection, Prospective Studies, hospital, Prospective cohort study, Health Policy, craniotomy, clinical trial, cohort analysis, Hospitals, hospital patient, Infectious Diseases, Cohort, Surgical site infection, Cohort study, prospective study, medicine.medical_specialty, Health care-associated infection, prevalence, education, infection rate, surgical infection, Article, Developing countries, coronary artery bypass graft, Internal medicine, medicine, Humans, Hospital infection, human, Cities, cesarean section, business.industry, Public Health, Environmental and Occupational Health, findings of the International Nosocomial Infection Control Consortium (INICC)-, AMERICAN JOURNAL OF INFECTION CONTROL, cilt.43, ss.48-52, 2015 [Leblebicioglu H., Erben N., ROSENTHAL V. D. , ŞENER A., UZUN C., SENOL G., Ersoz G., Demirdal T., DUYGU F., Willke A., et al., -Surgical site infection rates in 16 cities in Turkey], Nosocomial infection control, Confidence interval, shunting, Surgery, Clinical trial, multicenter study, city, business
Abstract

Yalcin, Ata Nevzat/0000-0002-7243-7354; dursun, oguz/0000-0001-5482-3780; Oncul, Oral/0000-0002-1681-1866; Leblebicioglu, Hakan/0000-0002-6033-8543; demirdal, tuna/0000-0002-9046-5666; Ciftci, Ergin/0000-0002-4955-160X; Erben, Nurettin/0000-0003-0373-0132; Kendirli, Tanil/0000-0001-9458-2803; Acar, Ali/0000-0003-2008-5112; Geyik, Mehmet Faruk/0000-0002-0906-0902; Dursun, Oguz/0000-0001-5482-3780; KAYA, ZEYNEP/0000-0002-8468-2103; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517 WOS: 000347654600011 PubMed: 25564124 Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

11. Predictors of response to pegylated interferon treatment in HBeAg-negative patients with chronic hepatitis B

Author

Ömer Evirgen, Nail Ozgunes, Alper Gunduz, Mehmet Faruk Geyik, Serpil Erol, Hurrem Bodur, Neşe Demirtürk, Davut Ozdemir, Fatma Sargin, Ertugrul Guclu, Tuna Demirdal, Bahadir Ceylan, Ediz Tutuncu, Hasan Çetin Ekerbiçer, Kutbettin Demirdag, Nazan Tuna, Oguz Karabay, Saban Esen, Omer Faruk Kokoglu, Sıla Akhan, Mustafa Kasim Karahocagil, Selma Tosun, 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, Sargin, F, Tosun, S, Tutuncu, E, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Güçlü, Ertuğrul, Karabay, Oğuz, Ekerbiçer, Hasan Çetin, Esen, Sinan, and OMÜ

Subjects
Male, Turkey, Gastroenterology, Polyethylene Glycols, Tertiary Care Centers, Pegylated interferon, Interferon, hepatitis B, interferon, sustained virological response, viral load, Medicine, Young adult, virus diseases, General Medicine, Hepatitis B, Middle Aged, Viral Load, Prognosis, Recombinant Proteins, Infectious Diseases, Treatment Outcome, Hbeag negative, Female, Viral load, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Interferon alpha-2, Microbiology, Antiviral Agents, Young Adult, Hepatitis B, Chronic, Chronic hepatitis, Virology, Internal medicine, Humans, Aged, Retrospective Studies, business.industry, Interferon-alpha, Retrospective cohort study, medicine.disease, digestive system diseases, Surgery, DNA, Viral, Parasitology, business
Abstract

Geyik, Mehmet Faruk/0000-0002-0906-0902; demirdal, tuna/0000-0002-9046-5666; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Gunduz, Alper/0000-0001-9154-844X WOS: 000352106600012 PubMed: 25500658 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 log(10) 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 log(10) 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.

Published
2014

12. Evaluation of Post-operative Meningitis: Comparison of Meningitis Caused by Acinetobacter spp. and Other Possible Causes.

Author

Senturk GC, Ozay R, Kul G, Altay FA, Kuzi S, Gurbuz Y, Tutuncu E, and Eser T

Subjects
Acinetobacter Infections cerebrospinal fluid, Acinetobacter Infections drug therapy, Adult, Anti-Bacterial Agents therapeutic use, Craniotomy trends, Female, Humans, Male, Meningitis, Bacterial cerebrospinal fluid, Meningitis, Bacterial drug therapy, Middle Aged, Postoperative Complications cerebrospinal fluid, Postoperative Complications drug therapy, Retrospective Studies, Risk Factors, Treatment Outcome, Acinetobacter isolation & purification, Acinetobacter Infections diagnosis, Craniotomy adverse effects, Meningitis, Bacterial diagnosis, Postoperative Complications diagnosis
Abstract

Aim: To analyse postoperative meningitis (POM) after craniotomy, and to compare the clinical characteristics, treatment outcomes and mortality rates of POM that were caused by Acinetobacter spp. or other possible causes., Material and Methods: In this study, POM cases in our hospital between 2008 and 2016 were retrospectively reviewed. Cases were divided into three groups; Acinetobacter spp. meningitis (case group), non-Acinetobacter bacterial meningitis (control group 1) and culture negative meningitis (control group 2). Demographic, clinical, laboratory features, treatment modalities and mortality rates were compared between case and control groups., Results: A total of 112 patients with POM were included in the study. Cerebrospinal fluid (CSF) culture results were negative in 50 (44.6%) patients; bacteria were isolated from CSF of 62 (55.3%) patients. Acinetobacter spp. was isolated from 28 (45%) patients, while bacteria other than Acinetobacter spp. were detected in 34 (55%) patients. No significant differences were observed between case and control groups in terms of age, gender, comorbidity and operation type. For the case group, change of treatment according to culture result was significantly different from control groups (p < 0.001). Mortality was 55.6% in the case group, 24.2% in control group 1 (p=0.013), and 24% in control group 2 (p=0.006). In multivariate analysis, isolation of Acinetobacter spp. from CSF culture [OR < sub > adj < /sub > 5.2, 95% confidence interval (CI):1.2-22.0, p=0.026] and inappropriate treatment (OR < sub > adj < /sub > 15.7, 95%CI:3.6-68.9, p < 0.001) were determined to be independent risk factors for mortality., Conclusion: Postoperative meningitis, especially caused by Acinetobacter spp., and its inappropriate empirical treatment are associated with high mortality.

Published
2019
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13. Predictors of response to pegylated interferon treatment in HBeAg-negative patients with chronic hepatitis B.

Author

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, and Tutuncu E

Subjects
Adolescent, Adult, Aged, DNA, Viral blood, Female, Hepatitis B, Chronic diagnosis, Humans, Interferon alpha-2, Male, Middle Aged, Prognosis, Recombinant Proteins therapeutic use, Retrospective Studies, Tertiary Care Centers, Treatment Outcome, Turkey, Young Adult, Antiviral Agents therapeutic use, Hepatitis B, Chronic drug therapy, Interferon-alpha therapeutic use, Polyethylene Glycols therapeutic use, Viral Load
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.

Published
2014
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14. Acute mercury poisoning presenting as fever of unknown origin in an adult woman: a case report.

Author

Cicek-Senturk G, Altay FA, Ulu-Kilic A, Gurbuz Y, Tutuncu E, and Sencan I

Subjects
Acute Disease, Anti-Bacterial Agents therapeutic use, Bronchodilator Agents therapeutic use, Ceftriaxone therapeutic use, Chelation Therapy methods, Clarithromycin therapeutic use, Diagnosis, Differential, Doxycycline therapeutic use, Exanthema chemically induced, Exanthema drug therapy, Female, Fever chemically induced, Fever drug therapy, Fever of Unknown Origin drug therapy, Humans, Mercury blood, Mercury urine, Mercury Poisoning complications, Mercury Poisoning drug therapy, Middle Aged, Penicillamine therapeutic use, Treatment Outcome, Fever of Unknown Origin chemically induced, Mercury Poisoning diagnosis
Abstract

Introduction: Mercury intoxication may present in a wide range of clinical forms from a simple disease to fatal poisoning. This article presents a case of acute mercury poisoning, a rare condition that presents challenges for diagnosis with fever of unknown origin., Case Presentation: A 52-year-old Caucasian woman was admitted to the hospital with high fever, sore throat, a rash over her entire body, itching, nausea, and extensive muscle pain. She had cervical, bilateral axillary and mediastinal lymphadenopathies. We learned that her son and husband had similar symptoms. After excluding infectious pathologies, autoimmune diseases and malignancy were investigated. Multiple organs of our patient were involved and her fever persisted at the fourth week of admission. A repeat medical history elicited that her son had brought mercury home from school and put it on the hot stove, and the family had been exposed to the fumes for a long period of time. Our patient's serum and urine mercury levels were high. She was diagnosed with mercury poisoning and treated accordingly., Conclusions: Mercury vapor is a colourless and odorless substance. Therefore, patients with various unexplained symptoms and clinical conditions should be questioned about possible exposure to mercury.

Published
2014
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15. Evaluation of factors predictive of the prognosis in Crimean-Congo hemorrhagic fever: new suggestions.

Author

Ozturk B, Tutuncu E, Kuscu F, Gurbuz Y, Sencan I, and Tuzun H

Subjects
Adult, Alanine Transaminase blood, Antithrombin III metabolism, Aspartate Aminotransferases blood, C-Reactive Protein metabolism, Ceruloplasmin metabolism, Complement C3 metabolism, Complement C4 metabolism, Female, Fibrin Fibrinogen Degradation Products metabolism, Fibrinogen metabolism, Hemorrhagic Fever, Crimean metabolism, Humans, Immunoglobulin G blood, Immunoglobulin M blood, International Normalized Ratio methods, L-Lactate Dehydrogenase blood, Leukocyte Count methods, Male, Middle Aged, Partial Thromboplastin Time, Platelet Count methods, Prealbumin metabolism, Prognosis, Protein C metabolism, Protein S metabolism, Prothrombin Time methods, Hemorrhagic Fever, Crimean blood, Hemorrhagic Fever, Crimean diagnosis
Abstract

Background: Crimean-Congo hemorrhagic fever (CCHF) is one of the viral hemorrhagic fevers caused by tick bites. Common symptoms of the infection are fatigue, high fever, headache, and myalgia. In some patients hemorrhage may accompany these symptoms and is a sign of a poor prognosis. Typical laboratory changes are thrombocytopenia, leukopenia, elevation of aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine phosphokinase (CPK), and lactate dehydrogenase (LDH), and prolongation of prothrombin time (PT) and activated partial thromboplastin time (aPTT). Mortality rates vary between 3% and 30%. The aim of this study was to determine the factors affecting the prognosis of CCHF., Methods: A total of 70 patients with a diagnosis of CCHF who were followed at our clinic between 2005 and 2008 were included in this study. As well as patient clinical history, biochemical parameters tested during the first 5 days and the prognosis were evaluated. Findings were compared between patients who died and those who recovered. Non-parametric statistical tests were used for the statistical analysis., Results: When the laboratory parameters of patients who died and recovered were compared, PT, aPTT, international normalized ratio (INR), AST, LDH, fibrinogen, C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), D-dimer, IgM, IgG, C3 and C4 levels, and platelet count were found to be positively related with fatality. On the other hand, there was no significant difference between groups regarding ALT, CPK, prealbumin, ceruloplasmin, protein C, protein S, and antithrombin III levels, and white blood cell counts., Conclusions: It is essential to determine the possibility of a fatal prognosis in CCHF patients using clinical history and biochemical parameters so that the necessary precautions can be taken., (Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2012
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16. Evaluation of the association of serum levels of hyaluronic acid, sICAM-1, sVCAM-1, and VEGF-A with mortality and prognosis in patients with Crimean-Congo hemorrhagic fever.

Author

Ozturk B, Kuscu F, Tutuncu E, Sencan I, Gurbuz Y, and Tuzun H

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Biomarkers, Enzyme-Linked Immunosorbent Assay, Female, Hemorrhagic Fever, Crimean pathology, Humans, Male, Middle Aged, Prognosis, RNA, Viral blood, Reverse Transcriptase Polymerase Chain Reaction, Young Adult, Hemorrhagic Fever, Crimean diagnosis, Hemorrhagic Fever, Crimean mortality, Hyaluronic Acid blood, Intercellular Adhesion Molecule-1 blood, Vascular Cell Adhesion Molecule-1 blood, Vascular Endothelial Growth Factor A blood
Abstract

Background: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral hemorrhagic disease. Pathogenesis of the disease has not been well described yet. A well-known pathogenic feature of CCHF virus is its capability to damage endothelium. Increased hyaluronic acid (HA) levels indicate liver sinusoidal endothelial damage. Soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and vascular endothelial growth factor-A (VEGF-A) play a role in the inflammatory process, vascular damage and plasma leakage., Objectives: To investigate whether or not there is a relationship between HA, sICAM-1, sVCAM-1 and VEGF-A serum levels and fatality in CCHF., Study Design: Sixty-one patients who were confirmed by RT-PCR and serological tests for CCHF, included in the current study. HA, sICAM-1, sVCAM-1, VEGF-A levels in serum samples were analyzed by ELISA., Results: There were statistically significant differences between fatal and non-fatal CCHF patients in terms of HA, sICAM-1, sVCAM-1, and VEGF-A levels. In addition, AST and ALT levels were positively correlated with HA, sICAM-1, sVCAM-1, and VEGF-A levels., Conclusion: HA, sICAM-1, sVCAM-1, and VEGF-A levels of the patients that died during hospitalization were statistically significantly higher than the patients that survived, and this finding suggests that the level of these molecules could be used as a prognostic marker in CCHF.

Published
2010
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