Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Turkish Clinical Microbiology and Infectious Diseases Society (KLIMIK) Evidence-Based Guideline for the Diagnosis and Treatment of Brucellosis, 2023(2023) Simsek-Yavuz, Serap; Ozger, Selcuk; Benli, Aysun; Ates, Can; Aydin, Mehtap; Aygun, Gokhan; Azap, Alpay; Azap, Ozlem; Basaran, Seniha; Demirturk, Nese; Ergonul, Onder; Kocagul-Celikbas, Aysel; Kuscu, Ferit; Saricaoglu, Elif Mukime; Sayin-Kutlu, Selda; Turker, Nesrin; Turkoglu-Yilmaz, EmineAlthough brucellosis is very common in the world and Turkiye, there are no evidence-based guidelines to guide the diagnosis and treatment of the disease. This guide has been prepared by the Turkish Society of Clinical Microbiology and Infectious Diseases to provide evidence-based recommendations to physicians from different specialties interested in the diagnosis and treatment of brucellosis. The recommendations of the Clinical Practice Guide Development Guide of the Infectious Diseases Society of America (IDSA) were taken as the basis for preparing this guide. The guideline preparation group determined 20 questions considered to be important in the diagnosis and treatment of brucellosis, and the publications that could answer these questions prepared in PICO (Population/Patient [P], Intervention [I], Comparison [C], Outcome [O]) format, were searched in ULAKBIM Tr Dizin, PubMed, Cochrane databases without date restrictions. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group method was used to rank the evidence and determine the strength of the recommendations for each PICO question and for each individual outcome. Meta-analyses of comparative clinical studies were performed to answer the PICO questions. Individual participant data (IPD) meta-analyses with data obtained from case reports and case series were conducted in the absence of comparative clinical studies. It is planned to update the recommendations at regular intervals in line with the results of new studies.Item Comparison of Haematologic Side Effects of Different Pegylated Interferon-α Molecules Combined With Ribavirin(2014) Aydin, Mehtap; Aksoz, Elif; Korkut, Oguzhan; Akhan, Sila; https://orcid.org/0000-0003-4044-9366; HLX-0937-2023Objective: Treatment of chronic hepatitis C virus (HCV) infection with pegylated interferon (PegIFN) and ribavirin causes haematological side effects such as anemia, neutropenia and trombocytopenia. This study aimed to evaluate and compare the haematological side effects of PegIFN alpha-2a and PegIFN alpha-2b with ribavirin in the treatment of chronic HCV infection. Methods: 103 patients treated with PegIFN alpha-2b plus ribavirin and 70 patients treated with PegIFN alpha-2a plus ribavirin were included in this retrospective study. Patients' haematological parameters in first and third month's visits were compared with pretreatment test results. Results: In all patients, 21.2% had anemia (haemoglobin <10 g/dL), 3.8% had neutropenia (<750/mm(3)) and 6.2% had thrombocytopenia (<75x10(9)/L) at the end of the third month. When compared with initial levels, significant decreases in haemoglobin, neutrophil and thrombocyte counts were observed at first and third months in both groups. There wasn't a significant decrease in thrombocyte counts in the first month between two groups, however, a more significant decrease in thrombocyte counts were observed in patients who received PegIFN alpha-2a plus ribavirin than the patients receiving PegIFN alpha-2b plus ribavirin during the third month. Conclusions: PegIFN alpha-2b seems to have similar haematologic side effects, compared with PegIFN alpha-2a except the effects on the thrombocyte counts during the third month.Item Management of Chronic Hepatitis in Special Hosts and Special Situations: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases(2014) Mistik, Resit; Aydin, Mehtap; Aksoy, Suleyman; Altin, Nilgun; Altunal, Nilsun; Avsar, Kemal; Bezirgan, Selma; Buke, Cagri; Celik, Ali Kutta; Celik, Ekrem; Dikici, Nebahat; Hizel, Kenan; Iskender, Serap; Kaya, Ali; Korkmaz, Fatime; Kose, Sukran; Sacligil, Cahide; Sirmatel, Fatma; Tarakci, Huseyin; Turgut, Huseyin; Tutuncu, Ediz; Yulugkural, Zerrin; https://orcid.org/0000-0003-4044-9366; HLX-0937-2023Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases convened a meeting to develop a consensus report on management of chronic hepatitis in special hosts and special situations. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented at the end of each section such as therapy of chronic hepatitis B (CHB) in patients with compensated and decompensated cirrhosis, prevention and therapy of recurrent hepatitis B after liver transplantation, management of fulminant hepatitis B, therapy of CHB in hemodialysis patients, management of CHB in nonliver solid organ transplant recipients, management of CHB in immunosuppressed nontransplant patients, therapy of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection, management of HBV and hepatitis C virus (HCV) coinfection, management of CHB in alcoholic patients and injecting drug users, therapy of CHB in pregnancy and lactation period, extrahepatic manifestations in HBV infection, HBV, HCV and hepatitis D virus coinfection, therapy of chronic hepatitis C (CHC) in patients with compensated and decompensated cirrhosis, treatment of patients with recurrent HCV infection following liver transplantation, therapy of CHC in hemodialysis patients, management of CHC in nonliver solid organ transplant recipients, therapy of HCV, HBV and HIV coinfection, management of CHC in immunosuppressed nontransplant patients, HCV infection and biological agents, HCV infection and chemotherapy, management of CHC in alcoholic patients and injecting drug users, fatty liver and CHC, hemoglobinopathy and CHC, CHC in pregnancy and lactation period, extrahepatic manifestations in HCV infection.Item Multiple Brain Abscesses Due to Phialemonium in a Renal Transplant Recipient: First Case Report in the Literature(2015) Aydin, Mehtap; Ozcelik, Umit; Cevik, Halime; Cinar, Ozlem; Evren, Ebru; Demirag, Alp; 0000-0003-1073-2494; 0000-0003-4044-9366; 26640919; AAG-8651-2021; HLX-0937-2023; JAZ-1759-2023Fungal brain abscesses are a rare but serious complication in transplant recipients. Phialemonium organisms are rare causes of invasive mold infections. Here, we present the first case of a renal transplant recipient with multiple brain abscesses caused by Phialemonium infection A. A 51-year-old female kidney transplant recipient was admitted with pneumonia of an unknown cause and treated with empiric intravenous antibiotics. Her treatment was uneventful, and she was discharged 1010 days later. After 5 days, she was readmitted with fever, cerebral palsy, and speech disorder. The patient had undergone living-donor renal transplant 7 months earlier. A cranial computed tomography and magnetic resonance imaging were performed for a possible cerebro vascular pathology. The magnetic resonance imaging scan showed multiple brain abscesses located at the left parietal, frontal and occipital lobes; right parietal and occipital lobes; right basal ganglia; and left cerebellum. The patient received meropenem, linezolid, sulfamethoxazole and trimethoprim, and AmBisome for probable pathogenic infection, and immunosuppressive agents dosage was reduced increasingly immuno suppressed. We identified Phialemonium in cerebrospinal fluid culture. The patient received voriconazole 200 mg twice daily. Lesions could not be drained due to lack of capsula formation. The patient died on the 30th day of antifungal therapy. Phialemonium organisms, although a rare cause of fungal infections, are associated with a high mortality rate in immunocompromised patients. To our knowledge, this is the first case report in the literature describing multiple brain abscesses due to Phialemonium in a transplant recipient. Clinicians recipient should be alert about these rare opportunistic fungi in the differential diagnosis of brain abscess, and bronchoscopy and broncho alveolar lavage are recommended for transplant patients when they are admitted with pneumonia exclude fungal infections.Item Results of BK Virus Screening in Renal Transplant Recipients(2016) Ozcelik, Umit; Bircan, Huseyin Yuce; Aydin, Mehtap; Kulah, Eyyup; Karakayali, Feza Yarbug; Haberal, Mehmet; https://orcid.org/0000-0003-1073-2494; https://orcid.org/0000-0003-4044-9366; https://orcid.org/0000-0002-1874-947X; https://orcid.org/0000-0002-3462-7632; AAG-8651-2021; R-6394-2019; HLX-0937-2023; AAB-3881-2021; AAB-3888-2021; AAJ-8097-2021Item Epidemiology, Species Distribution, Clinical Characteristics and Mortality of Candidaemia in A Tertiary Care University Hospital in Turkey, 2007-2014(2017) Yesilkaya, Aysegul; Azap, Ozlem; Aydin, Mehtap; Ok, Mehtap Akcil; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0003-4044-9366; 28338249; A-8902-2013; AAK-4089-2021; HLX-0937-2023; AAZ-8170-2020Candidaemia still continues to be a serious medical concern and the epidemiology of candidaemia varies according to geographical areas. We aim to determine the incidence, local epidemiology, Candida species distribution and crude mortality rates of candidaemia. We retrospectively evaluated candidaemia episodes in between January 2007 and August 2014. We compared demographic, clinical, microbiological findings and mortality rates of episodes caused by Candida albicans and non-albicans Candida species. Overall the candidaemia incidences were 1.23 episodes/1000 admissions. A significant negative slope among candidaemia episodes and years was determined. Overall C. albicans (54.6%) was the most common species followed by Candida glabrata, Candida tropicalis and Candida parapsilosis respectively. Preinfection hospital stay and length of hospital stay were statistically longer in patients with non-albicans Candida candidaemia than in patients with C.albicans candidaemia. The source of candidaemia was unknown in 52.5% of all episodes. Central venous catheters among non-albicans Candida candidaemia episodes and urinary system among C.albicans candidaemia episodes were common source of candidaemia compared to each other. Previous antifungal therapy preceding candidaemia and concomitant bacteraemia were significantly associated with non-albicans Candida candidaemia. Continuous local surveillance will preserve its pivotal importance in formulating empirical antifungal therapy and improving management of candidaemia.Item Rational Use of Medicine in Dentistry: Do Dentists Prescribe Antibiotics in Appropriate Indications?(2017) Koyuncuoglu, Cenker Z.; Aydin, Mehtap; Kirmizi, N. Ipek; Aydin, Volkan; Aksoy, Mesil; Isli, Fatma; Akici, Ahmet; https://orcid.org/0000-0003-4044-9366; 28462430; HLX-0937-2023There are concerns regarding appropriate use of antibiotics in dentistry practice. Data on dental antibiotic prescribing patterns by dentists is relatively limited. This nationwide study aimed to examine dentists' antibiotic prescriptions in a diagnosis-based manner in Turkey. This retrospective study on utilization of systemic antibiotics for dental problems was based on the national health data of the dentists obtained from Prescription Information System between January 2013 and August 2015. Only those prescriptions containing single diagnosis and at least one systemic antibiotic were included in the study. Antibiotic prescribing was compared by diagnoses and expertise of dentists. A total of 9,293,410 antibiotics were detected in 9,214,956 prescriptions that contained "single diagnosis and at least one antibiotic." The number of antibiotics per prescription was 1.01. "Periapical abscess without sinus" (28.1%), "dental examination" (20.7%), and "dental caries" (16.2%) were the three most common indications in which antibiotics were prescribed by dentists. While only 3.4% of antibiotics were prescribed upon the single and appropriate "cellulitis and abscess of mouth" diagnosis, the remaining 96.6% was prescribed for irrational/uncertain indications. Consistent in all diagnoses, "amoxicillin + enzyme inhibitor" (58.6%) was the mainly prescribed antibiotic. Analysis of the most preferred "amoxicillin + enzyme inhibitor" prescriptions by expertise of dentists showed significantly much higher prescription rates among Group A specialists and Group B specialists (67.0 and 67.8%, respectively) than those in unidentified dental practitioners (58.2%, p < 0.0001). This study showed that dentists prescribed antibiotics in an arbitrary and mostly unnecessary manner. In general, their antibiotic choices for examined diagnoses could be regarded as irrational. These results indicate the urgent need for improvement of rational antibiotic prescribing habits of dentists.Item Factors Affecting Responsiveness to Hepatitis B Immunization in Dialysis Patients(2017) Asan, Ali; Demirhan, Huriye; Sorkun, Hulya Cetin; Ozkan, Sevgi; Aydin, Mehtap; Akin, Davut; Tatar, Bengu; Catak, Binali; Sener, Alper; Kose, Sukran; https://orcid.org/0000-0003-4044-9366; 28620716; HLX-0937-2023Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are widespread health problems all over the world and have high morbidity and mortality. Hemodialysis patients are more frequently exposed to these viruses as they have poor immune system and frequently undergo parenteral interventions. The vaccination against HBV prevents infection and it has been recommended for the prevention of HBV infection in all susceptible dialysis patients. This study aimed to determine the seroprevalence of HBV and HCV infections and analyzed the factors affecting inadequate response to HBV vaccine in dialysis patients. The data for 584 dialysis patients that were followed up at seven dialysis centers were analyzed. The patients received four doses of 40 mu g recombinant hepatitis B vaccine at 0, 1, 2, and 6 months and were tested for anti-HBs titer after one month of completion of vaccination. If patients showed a titer of anti-HBs < 10 IU/mL, an additional 40 mu g in four vaccine doses was administered immediately and they were retested for the anti-HBs following the same schedule. The patients were divided into two groups: responders and non-responders. HBsAg and anti-HCV seroprevalence was 3.4% and 10.3%, respectively. After vaccination schedule, 264 (83.5%) patients had antibody response to HBV vaccine and 52 (16.5%) had no response. Hepatitis B vaccine unresponsiveness is more common in the patients with hepatitis C positivity (p = 0.011), BMI > 30 (p = 0.019), over the age of 65 years (p = 0.009), and duration of dialysis treatment > 5 years (p = 0.001). There was no statistically significant difference between gender, causes of renal disease, erythropoietin treatment, and the type of dialysis. Hepatitis C infection, obesity, being elderly, and having long hemodialysis period reduced the hepatitis B vaccination response in hemodialysis patients.Item Increased Mortality Among Renal Transplant Patients With Invasive Pulmonary Aspergillus Infection(2018) Balcan, Baran; Ozcelik, Umit; Ugurlu, Aylin Ozsancakli; Aydin, Mehtap; Nalcaci, Serdar; Karakayali, Feza Yarbug; 0000-0003-1073-2494; 0000-0003-3598-3986; 0000-0003-4044-9366; 0000-0002-1874-947X; 30235978; A-4721-2018; AAG-8651-2021; AAA-2925-2020; HLX-0937-2023; AAB-3888-2021Introduction: Renal transplantation is the most effective and preferred definite treatment option in patients with end-stage renal disease. Due to long-term immunesuppressive treatment, renal transplant recipients become vulnerable to opportunistic infections, especially to fungal infections. Method: This was a single-center, retrospective observational study of 438 patients who underwent renal transplantation between 2010 and 2016. Results: Thirty-eight renal transplant recipients who had lower respiratory tract infection with median age of 41.5 years were evaluated for invasive pulmonary aspergillus (IPA). Of these, 52.6% were female and 84.2% had living donors. Eleven of 38 lower respiratory patients were found to have IPA infection, 5 with proven infection. Compared to patients who did not have fungal pulmonary infection, patients with invasive aspergillus were older and had high fever, galactomannan levels, and leukocyte counts. Mortality was also higher in those patients. Having fever at the baseline and IPA infection was significantly associated with mortality in univariate analysis and remained related in multivariate model after adjustment for age, gender, and fever. Conclusion: Invasive pulmonary aspergillus infection is highly associated with increased mortality rates in renal transplant patients. Fungal pulmonary infections in immune-suppressed patients should be diagnosed and treated immediately in order to avoid the life-threatening complications and may greatly improve prognosis.Item Urinary Tract Infections after Kidney Transplantation in Fourteen Medical Centers in Turkey(2018) Arslan, Hande; Demirkaya, Melike H.; Ak, Oznur; Aydin, Mehtap; Aydin, Gule; Aypak, Adalet; Bayindir, Yasar; Demiroglu, Ziya; Ergen, Pinar; Ersoz, Gulden; Gundes, Sibel; Kazak, Esra; Kurtaran, Behice; Oguz, Vildan; Tekce, Yasemin Tezer; Haberal, Mehmet; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0003-4044-9366; https://orcid.org/0000-0002-3462-7632; ABG-7034-2021; HLX-0937-2023; AAJ-8097-2021
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