Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Herpes Zoster Infections in Solid-Organ Transplant Recipients(2023) Sari, Nuran; Erol, Cigdem; Yalcin, Tugba Yanik; Azap, Ozlem Kurt; Arslan, Hande; Karakaya, Emre; Altinel, Cemile Tugba; Sezgin, Atilla; Incekas, Caner; Haberal, Mehmet; 0000-0002-4879-7974; 37885293; AAD-5466-2021Objectives: Herpes zoster infections can be complicated and mortal in solid-organ transplant recipients. In our study, we investigated herpes zoster infections in solid-organ transplant recipients.Materials and Methods: Until June 2022, our center has performed 3342 kidney, 708 liver, and 148 heart transplants. Herpes zoster infections were investigated in 1050 adult solid-organ transplant recipients from January 1, 2011, to June 31, 2022. We studied 44 patients diagnosed with herpes zoster infections.Results: Of the 44 patients with herpes zoster, 32 had kidney, 7 had heart, and 5 had liver transplant procedures. Crude incidence rate was 5.2%.,with 9.7% being heart, 5.1% being kidney, and 3.9% being liver transplant recipients; 72.7% were male patients. The median age was 47.5 years, and 61% of patients were aged >45 years. Postherpetic neuralgia was significantly higher in patients older than 45 years (P = .006). The median duration to infection posttransplant was 16.5 months. The dermatomes of patients were 43.2% thoracic. Sacral dermatome involvement was significantly higher in heart transplant patients than in other transplant recipients (P = .015). We reviewed specific findings of the Tzanck test in 36.4% of the patients. There was concomitant infection in 15.9% of the patients, and 6.8% had pneumonia. Acute neuritis was more common in kidney transplant recipients (65.6%). The mean duration of acute neuritis/neuralgia was longest in liver transplant recipients (13.5 months; P = .047). Postherpetic neuralgia was detected as high as 24%.Conclusions: Early specific and supportive treatment is important for transplant recipients with herpes zoster infections. Appropriate antiviral prophylaxis regimens and vaccination strategies for varicella zoster (chickenpox) and herpes zoster infections should be implemented in the vaccination schedule of solid -organ transplant candidates to prevent herpes zoster infections and complications.Item Kikuchi-Fujimoto Disease in a Patient with Mediastinal Lymphadenopathy(2014) Turan, Hale; Serefhanoglu, Kivanc; Apiliogullari, Burhan; Aribas, Olgun Kadir; Ekici, Zuhal; Timurkaynak, Funda; Arslan, Hande; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0003-3225-2686; https://orcid.org/0000-0002-5708-7915; ABG-7034-2021; AAV-4737-2021; AAD-5602-2021; ABG-7034-2021Kikuchi-Fujimoto disease is a benign self-limited syndrome with distinct histopathologic characteristics. Clinical symptoms include cervical lymphadenopathy with tenderness, fever of medium grade, night sweats, nausea, vomiting, and a sore throat. It is a rare disease worldwide. Diagnosis is based on histopathologic findings from an excisional lymph node biopsy. We present the case of a 37-year-old male patient with a fever of 15 days' duration. Clinical examination revealed no other pathologic signs except for oral aphthous lesions and a fever of unknown origin. The patient's fever did not resolve after 15 days' follow-up, and the results of computed tomographic study of the thorax revealed several sites of mediastinal lymphadenopathy. The diagnosis of Kikuchi-Fujimoto disease (histiocytic necrotising lymphadenitis) was based on the results of pathologic examination of the biopsy specimen. The patient's signs and symptoms resolved without antibiotic therapy. This case report of a patient with a fever of unknown origin is presented because of the rare involvement of mediastinal lymphadenopathy without cervical lymphadenopathy. Kikuchi-Fujimoto disease should be considered in the differential diagnosis of the patient who presents with fever and mediastinal lymphadenopathy.Item Infections in Liver Transplant Recipients(2014) Arslan, Hande; https://orcid.org/0000-0002-5708-7915; 24635787; ABG-7034-2021Liver transplant is a life-saving procedure for many end-stage liver diseases. Despite measures such as the use of protective barriers, antimicrobial prophylaxis, and vaccination, infections still represent a major cause of morbidity and mortality after liver transplant. This article reviews major infectious concerns after liver transplant.Item Does Brucellosis Cause Arterial Stiffness and Ventricular Remodelling Through Inflammation?(2015) Togan, Turhan; Ciftci, Ozgur; Gunday, Murat; Narci, Huseyin; Arslan, Hande; 0000-0002-6636-9391; 0000-0002-5708-7915; 0000-0002-6463-6070; 26148379; L-7182-2015; ABG-7034-2021; A-7318-2017Background Like other acute and chronic infections, Brucella infection leads to endothelial dysfunction. Furthermore, it has been suggested that the chronic inflammatory state present in chronic infectious diseases leads to an acceleration in atherosclerosis. For the prediction of CAD, it is possible to use epicardial fat thickness (EFT) as an adjunctive marker beside the classical risk factors, as it is easily and non-invasively evaluated by transthoracic echocardiography. The purpose of this study was to investigate the presence of impaired myocardial performance as well as of increased arterial stiffness and EFT in patients who had been infected with brucellosis in the past. Methods Included in the study were twenty-seven brucellosis patients and twenty-six healthy volunteers. Using EFT and transthoracic echocardiography, which included Doppler echocardiography in combination with tissue Doppler imaging (TDI), all the patients were examined to measure their aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values. Results A statistically significant increase was observed in hs-CRP, aortic stiffness index, aortic elastic modulus and EFT in brucellosis patients when compared with the controls (2.46 +/- 1.40 vs 1.71 +/- 0.61, P=0.016; 9.69 +/- 6.99 vs 2.14 +/- 0.72, P < 0.001; 11.17 +/- 8.60 vs 2.18 +/- 0.90, P < 0.001; 0.76 +/- 0.08 vs 0.63 +/- 0.10, P < 0.001). On the other hand, there was a significant decrease in aortic strain and aortic distensibility (7.41 +/- 6.82 vs 18.26 +/- 5.83, P < 0.001; 1.83 +/- 1.71 vs 5.22 +/- 1.72, P < 0.001, respectively). No difference was observed between the two groups with respect to the left ventricular myocardial performance index (MPI) (0.62 +/- 0.15 vs 0.61 +/- 0.13, P=0.859). Conclusions In this study, we demonstrated for the first time in the literature that there was impaired aortic elasticity and increased EFT in patients with brucellosis, while the myocardial performance index remained unaffected. We also determined that these effects had a significant correlation with inflammation.Item Colonization of Legionella Species in Turkish Baths in Hotels in Alanya, Turkey(2015) Erdogan, Haluk; Arslan, Hande; 0000-0002-5708-7915; 0000-0002-9033-4236; 25850992; ABG-7034-2021; O-2247-2015This study evaluated the prevalence of Legionella species in water samples collected from Turkish baths in hotels in Alanya, Turkey, from August 2003 to September 2013. Water samples were collected in 100-mL sterile containers and then concentrated by filtration. Heat treatment was used to eliminate other microorganisms from the samples, which were then spread on Legionella-selective-buffered charcoal yeast extract alpha (BCYE-alpha) agar and on BCYE-alpha agar supplemented with glycine, vancomycin, polymyxin, and cycloheximide. Cysteine-dependent colonies were identified by latex agglutination. In total, 135 samples from 52 hotels with Turkish baths were evaluated. Legionella species were identified in 11/52 (21.2 %) hotels and 18/135 (13.3%) samples. The most frequently isolated species was Legionella pneumophila, with most isolates belonging to serogroups 6 (55.6 %) and 1 (22.2 %). The colony count was <100 colony-forming units (CFU) mL(-1) in nine samples, from 100 to 1000 CFU mL(-1) in six samples, and >1000 CFU mL(-1) in three samples. These findings suggest that the hot water systems of Turkish baths in hotels must be viewed as a possible source of travel-associated Legionnaires' disease, and preventative measures should be put in place.Item A Fine Line Between A Major Surgery and Medical Therapy: The Diagnosis of Sternal Tuberculosis(2014) Yesilkaya, Aysegul; Azap, Ozlem Kurt; Kilic, Dalokay; Arslan, Hande; Uner, Halit; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0002-5388-4183; A-8902-2013; AAK-4089-2021; H-7700-2019; ABG-7034-2021; HOH-1335-2023Tuberculosis involving the sternum is rare. The most common symptoms at the early stage are chest pain and palpable masses on the sternum. Cutaneous fistulas, spontaneous fracture of sternum and extrasternal spread may develop in cases with late diagnosis. In this article, we report a 53-year-old male case admitted with a one-month history of chest pain and two palpable masses on his lower sternal part of chest in whom the diagnosis of sternal tuberculosis was confirmed by histopathologically and rnicrobiologically. The masses were reduced in size with two-month anti-tubercular therapy. The nine-month duration of the therapy produced satisfactory results without any adverse reactions.Item In vitro Susceptibility of Tigecycline against Multidrug-Resistant Gram-Negative Strains: Etest versus Agar Dilution(2014) Ozkok, Sezen; Togan, Turhan; Yesilkaya, Aysegul; Timurkaynak, Funda; Azap, Ozlem Kurt; Arslan, Hande; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; 25791941; A-8902-2013; AAK-4089-2021; ABG-7034-2021Background and Aim: Tigecycline is a semi-synthetic tetracycline with activity against most multidrug-resistant (MDR) bacteria. Methods: We studied in vitro activity of tigecycline by agar dilution (AD) and Etest methods to evaluate their correlation. The study included 206 isolates of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli, Klebsiella pneumoniae and MDR Acinetobacter baumannii recovered from blood cultures of patients of Baskent University between 2008 and 2010. Results: ESBL-producing E. coli had MIC50 /MIC90 values of 0.5/0.5 mu g/ml by AD and 0.25/0.5 mu g/ml by Etest. ESBL-producing K. pneumoniae had MIC50 /MIC90 values of 1/2 mu g/ml by AD and 0.75/2 mu g/ml by Etest, whereas MDR A. baumannii had MIC50 /MIC90 values of 4/4 mu g/ml by AD and 2/4 mu g/ml by Etest. The correlation between AD and Etest was weak for ESBL-producing E. coli and strong for ESBL-producing K. pneumoniae and MDR A. baumannii. Tigecycline MIC values for ESBL-producing E. coli were lower than the tigecycline concentration, while they were higher than the concentrations attainable by treatment doses for A. baumannii. Conclusion: Tigecycline is an appropriate agent in the treatment of E. coli bacteremia, but it is not for treating A. baumannii bacteremia. Tigecycline could be used for K. pneumoniae bacteremia treatment after determining its MIC value. Determining the MIC value by gold-standard methods is more appropriate due to the correlation between Etest and AD at high MIC values. (C) 2015 S. Karger AG, BaselItem Booster Shots and Additional Doses for COVID-19 in Solid Organ Recipients(2022) Erol, Cigdem; Sari, Nuran; Yalcin, Tugba Yanik; Akdur, Aydincan; Arslan, Hande; Haberal, Mehmet; 0000-0002-2535-2534; 0000-0002-3462-7632; AAJ-1219-2021; AAJ-8097-2021Item Assessment of Urinary Tract Infections Microbiologically in Kidney Transplant Recipients(2022) Sari, Nuran; Arslan, Hande; Karakaya, Emre; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-4879-7974; AAJ-8097-2021; AAD-5466-2021Item COVID-19 Clinical Outcomes, Coinfection and Secondary Infections in Solid Organ Transplant Recipients(2022) Yalcin, Tugba Yanik; Erol, Cigdem; Karakaya, Emre; Arslan, Hande; Haberal, Mehmet; 0000-0002-2535-2534; 0000-0002-4879-7974; 0000-0002-3462-7632; AAJ-1219-2021; AAD-5466-2021; AAJ-8097-2021