Başkent Üniversitesi Yayınları

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    Fungal Infections in Solid Organ Recipients
    (Başkent Üniversitesi, 2005-12) Badiee, Parisa; Kordbacheh, Parivash; Alborzi, Abdolvahab; Zeini, Farideh; Mirhendy, Hossein; Mahmoody, Mahmood
    Background: Fungal infections are a major cause of morbidity and mortality after organ transplantation. The incidence of these infections has increased considerably over the last decade. Objectives: The aim of this study was to evaluate the incidence of fungal infections, to identify the most common fungal pathogens, and to determine the associated risk factors in solid organ recipients. Methods: One hundred twenty renal and 50 liver recipients were transplanted at the organ transplant unit of Nemazi Hospital in Shiraz, Iran, from September 2004 to August 2005 and were followed for fungal infections for at least 6 months. On admission to the hospital, all patients were evaluated for fungal colonization by mouth, vagina, urine, and rectal swabs cultured in Sabouraud Dextrose Agar. Samples of sputum, bronchoalveolar lavage, urine, cerebrospinal fluid (CSF), pleural tap, and tissue biopsy were evaluated by direct microscopic examination and were cultured for any clinical signs of fungal infections. Results: Fifty-four kidney recipients (45%) had Candida colonization in different sites of their bodies. Fungal infections presented in 13 of 120 recipients (10.8%). Five recipients had invasive fungal infections (3 had fungal pneumonitis and 2 had severe esophagitis), and 8 patients had cutaneous and mucocutaneous infections. All of the recipients with invasive fungal infections were colonized with Candida, and 2 of them died. Forty-two (84%) liver recipients had Candida colonization in different sites of their bodies. Fungal infections presented in 6 liver recipients. In 4 patients, invasive fungal infections occurred (2 fungal pneumonitis, 1 meningitis, and 1 severe esophagitis), 2 patients showed mucocutaneous infections. Three recipients with invasive fungal infections had Candida colonization. The mean time to diagnosis was 70 days after transplantation. The most common etiologic agent for fungal infections was Candida albicans. Conclusions: Renal and liver recipients with Candida colonization are at high risk for fungal infections and therefore, control of fungal colonization in liver and renal transplant candidates would reduce the risk of invasive fungal infections after transplantation.
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    Difüz Parankimal Akciğer Hastalıklarında Epidemiyoloji
    (Başkent Üniversitesi, 2009-01) S. Sarınç Ulaşlı,; Ş. Akçay
    Özet Difüz parankimal akciğer hastalıkları (DPAH) başlığı altında 200’den fazla, bazıları nadir, bazıları da etyolojileri bilinmeyen geniş bir hastalık listesi bulunmaktadır. Son yıllarda yapılan çalışmalarda, DPAH sıklığının giderek artış gösterdiği sonucuna ulaşılmaktadır. Toplumdaki DPAH prevalansının, klinik olarak tanı konmuş hastaların 10 katı olduğu tahmin edilmektedir. Tüm DPAH olgularının %30-40’ını oluşturan İPF, tanı olanaklarının (yüksek rezolüsyonlu bilgisayarlı tomografi ve invazif değerlendirme yöntemleri) artması ile daha sık teşhis konan bir hastalık durumuna gelmiştir. Transplantasyon sonrasında erken ve geç dönemde gelişen enfeksiyöz ve non-enfeksiyöz komplikasyonlar da difüz parankimal akciğer hastalıklarına neden olmaktadır. Maligniteler, kardiyovasküler hastalıklar, organ transplantasyonu sonrası rejeksiyon, sitotoksik ilaçlara bağlı akciğer hasarı, AIDS sonrası oluşan nonspesifik interstisyel pnömoniler, mesleksel ve çevresel maruziyetler ile gelişen interstisyel hasar gibi sayısı her geçen gün artan hastalıklar ile, DPAH insidansında artışın süreceği düşünülmektedir. Summary Epidemiology of Diffuse Parenchymal Lung Diseases Diffuse parenchymal lung diseases (DPLD) represent a group of more than 200 different entities, many of which are rare or idiopathic. Recent studies have pointed out an increased incidence of DPLD. With improved diagnostic approaches (high-resolution computed tomography and invasive evaluation methods), idiopathic pulmonary fibrosis—constituting 30% to 40% of all DPLD—has been diagnosed more frequently. Infectious and noninfectious complications during the acute and chronic period after transplant also cause DPLD. We believe that the incidence of DPLD will continue to increase as the numbers of malignancies, cardiovascular diseases, organ transplant rejections, cytotoxic drug-induced pulmonary damage, nonspecific interstitial pneumonitis due to HIV, and environmental and occupational disorders increase.