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Öğe Four-year study of entecavir efficacy and safety in nucleos (T)ide-naïve HBeAg positive chronic hepatitis B patients(Klinicka Bolnica Sestre Milosrdnice, 2014) Celen M.K.; Dal T.; Ayaz C.; Bayan K.; Mert D.; Deveci O.; Oruc E.K.Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naïve HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4±41.5 IU/L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA <300 copies; at month 48, 90% of patients had HBV DNA <50 IU/mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.Öğe Hepatitis B virus infection in patient with Hodgkin's and non-Hodgkin's lymphoma and clinical significance(2007) Altintaş A.; Kaplan M.A.; Çil T.; Yilmaz Ş.; Bayan K.; Daniş R.; Ayyildiz O.Hepatitis B virus (HBV) is a hepatotrophic virus that have also a potential to replicate in lymphoid cells. This has led to evaluation of potential association between HBV infection and lymphomas. In this study, we retrospectively determined the HBV surface antigen and anti-HBs antibody in Southeastern region of Turkey where the prevalence of this infection is relatively high. A total of 276 patients were recruited, 203 (73.6%) with non-Hodgkin's lymphoma (NHL) and 73 (26.4%) with Hodgkin's lymphoma (HL), in the period of January 1995 and December 2005. In total, 40 (14.5%) patients were positive for HBsAg. Of them, 12 (16.4%) were in HL group and 28 (13.7%) were in NHL group. Anti-HBs antibody was positive in total of 123 patients [29 (39.7%) in HL and 94 (46.3%) in NHL]. Eleven patients were taken lamivudine prophylaxis (100 mg po / day) in the last two years. Ten were not developed a reactivation, while one with diffuse large-cell NHL reactivated. Besides, one patients with HL who was not taking prophylaxis developed anti-HBcIgM positive with aminotransferase elevations compatible with acute hepatitis. Although HBsAg positivity was higher in lymphoma patients than in general population in our study, for a possible casual association there is need for prospective studies with wider populations. In conclusion, prophylaxis with lamivudine of HBV carriers is important and treatment should be continued until one year after termination of chemotherapy.Öğe Microchimerism, a dilemma in current medicine(2006) Özmen Ş.; Daniş R.; Altintaş A.; Bayan K.; Yilmaz Ş.Microchimerism refers to presence of a small number of cells, or DNA of one individual harbored in another individual. Many studies indicate that cell trafficking occurs between the fetus and mother during pregnancy and between others after organ transplantation or blood transfusions. These cells or DHA can persist in recipient's blood or tissues for decades, creating a state of physiologic microchimetism. In several recent studies, microchimerism has been shown to have potential roles in pathogenesis of different diseases. However, due to the fact that microchimerism has also been found in healthy individuals and in organs affected by non-autoimmune conditions, an alternative hypothesis has been suggested in which microchimeiic cells are associated with the healing process of a tissue injury as opposed to causing disease. As a conclusion of this review of recent studies, we can say that microchimerism studies yielded more questions than answers.Öğe The prevalence of primary and secondary helicobacter pylori resistance to clarithromycin and probable contributing cofactors: Data from Southeastern Anatolia(2008) Tüzün Y.; Bayan K.; Yilmaz S.; Dursun M.; Ozekinci T.Background/Aims: Antibiotic resistance of Helicobacter pylori is the most important reason for failure in its eradication. We aimed to determine the prevalence of primary and secondary H. pylori resistance to clarithromycin in isolated H. pylori from dyspeptic patients in southeastern Anatolia and to evaluate the cofactors affecting this clinical problem. Methodology: The study involved adult patients who had already been diagnosed with symptomatic H. pylori infection based on rapid urease test, gastric histopathological examination and culture. H. pylori strains were isolated from antral biopsies taken during upper endoscopy in 142 dyspeptic patients with no previous therapy against the microorganism. MICs of clarithromycin were determined by E-test. Patients were treated for 14 days with standard triple-agent protocol. H. pylori eradication rate was assessed after 8 weeks. Each patient was re-interviewed to determine secondary resistance. Primary clarithromycin resistance was defined as pre-treatment resistance, while secondary as after treatment resistance. Strains were considered resistant to clarithromycin if the MIC > 1?g/mL. Results: In total 213-105 women and 108 men-patients was enrolled to the study. The mean age was 35.5±14.1 years. In 142 (66.7%) patients out of the total patients enrolled in the study, H. pylori was detected. H. pylori could be cultured from only 61 (43%) of them. In 16.4% of the cases, primary clarithromycin resistance was noted. After 8 weeks, seventy-seven (54.2%) of the 142 patients were reevaluated. Helicobacter pylori eradication could be achieved in 68.8% of them. The proportion of H. pylori eradication in clarithromycin-sensitive patients was 75.8% and the respective proportion was 10% for resistant cases. In the group where H. pylori was still positive the secondary resistance percentage was found to be 27.2%. Conclusions: The prevalence of primary clarithromycin resistance is relatively high in our geographical area. Secondary resistance rate was 27.2%. None of the criteria of age, gender, presence of endoscopic lesions, detected H. pylori concentration and gastritis activity showed any effect on the primary resistance. © H.G.E. Update Medical Publishing S.A.Öğe Tenofovir disoproxil fumarate treatment in HbeAg-positive patients(EDIMES Edizioni Medico Scientifiche, 2015) Ayaz C.; Çelen M.K.; Dal T.; Deveci Ö.; Bayan K.; Mert D.; Oruç E.Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients’ initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirtyone patients completed 96 weeks of treatment. Mean age was 37.6±9.4 years. The initial mean value of ALT was 79±39.9 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3±0.7. Two of the patients (5.9%) achieved HBV DNA<300 copy at week 12 of treatment and 97.1% at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss. © 2015, EDIMES Edizioni Medico Scientifiche. All rights reserved.Öğe An unusual case of fever of unknown origin: Kikuchi-Fujimoto disease(2008) Tüzün Y.; Bayan K.; Altintaş A.; Çil T.; Yilmaz Ş.; Dursun M.Kikuchi-Fujimoto disease (KFD), also called histiositic necrotizing lenfadenitis is a self limited disease, which commonly affects young Asian women. Etiology of KFD is unknown. The disease presents with lymphadenopathy, predominantly in the cervical region, fever, leucopenia and high erythrocyte sedimentation rate. It has occasionally been misdiagnosed as malignant lymphoma. The diagnosis of disease is confirmed by histopathological examination of affected lymph node. Herein, we reported a patient who presented with fever of unknown origin and diagnosed as KFD. We suggest that KFD needs to be considered as one of the differential diagnoses in patients presenting with fever of unknown origin and lymphadenopathy.
