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    A 6-year prospective surveillance study for healthcare associated infections in a neurology unit
    (Riyadh Armed Forces Hospital, 2008) Geyik, Mehmet F.; Hosoglu, Salih; Aluclu, Mehmet U.; Celen, Mustafa K.; Ayaz, Celal
    Objective: To assess the epidemiology of healthcare-associated infections (HAIs) in a neurology unit in a university hospital. Methods: The study was carried out prospectively at Dicle University Hospital, Diyarbakir, Turkey (1050-bed) between 1st January 1999 and 31st December 2004. Active surveillance for HAIs was performed by the infection control team, using the criteria proposed by the Centers for Diseases Control and Prevention (CDC) and National Nosocomial Infections Surveillance System (NNIS) methodology. Results: During the 6-year follow up period, 219 HAIs episodes were detected in 203 patients out of 3323 in patients. The mean length of stay of patients with HAI was 28 5 days, while that of patients without infections was 11 +/- 1 days. Eighty-two patients died with HAIs, while 1330 died in the patients without infections. The overall incidence rates (HAI/100) and incidence densities (HAI/1000 days of stay) of HAIs were 6.6% and 4.4/1,000 patients-days. The most common HAIs by primary site were urinary tract infection (44.2%) and decubitus infection (30.4%). The most prevalent microorganisms were Escherichia coli (27%), Klebsiella species (14%), Pseudomonas aeruginosa (13%), Enterobacter species (12%), coagulase-negative Staphylococci (10%) and Staphylococcus aureus (7%). Conclusion: The results may contribute to observe the magnitude and characteristics of HAIs and to plan and evaluate policies and guidelines of infection control in neurology units.
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    Development of pneumatoceles after viral infection
    (Saudi Med J, 2006) Celen, Mustafa K.; Ayaz, Celal; Ozmen, Esen; Hosoglu, Salih; Geyik, Mehmet F.
    [Abstract Not Available]
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    Efficacy and safety of telbivudine versus tenofovir treatment based on the Roadmap concept: Results from a randomized, controlled trial in HBeAg-negative chronic hepatitis B patients
    (Wiley-Blackwell, 2014) Krastev, Zahary; Kotzev, Iskren A.; Celen, Mustafa K.; Mc Neeley, David; Hamed, Kamal A.
    [Abstract Not Available]
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    Efficacy and Safety of Tenofovir Alafenamide (TAF) at 96 Weeks in Chronic HBV (CHB) Patients with Risk Factors for Use of Tenofovir Disoproxil Fumarate (TDF)
    (Wiley, 2017) Buti, Maria; Stepanova, Tatjana; Celen, Mustafa K.; Flisiak, Robert; Ryder, Stephen D.; Streinu-Cercel, Adrian; Gurel, Selim
    [Abstract Not Available]
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    The efficacy of dexamethasone treatment in adult patients with acute bacterial meningitis
    (Riyadh Armed Forces Hospital, 2008) Ayaz, Celal; Celen, Mustafa K.; Geyik, Mehmet F.; Ulug, Mehmet
    Objectives: To evaluate the efficacy of dexamethasone added to the treatment of adult patients with bacterial meningitis in our region. Methods: One hundred and forty-four patients were randomized prospectively and evaluated to determine the efficacy of dexamethasone treatment in adult patients with acute bacterial meningitis at Dicle University Hospital, Diyarbakir, Turkey between January 2000 and December 2004. While the first group received ceftriaxone 4 gr/day plus dexamethasone, the second group received ceftriaxone 4 gr/day only. Dexamethasone was given 10-15 minutes before the first 8 mg dose of antibiotic treatment. It was continued at 16 mg/day for 3 days. Results: The study included 144 patients with the diagnosis of acute bacterial meningitis. Cerebrospinal fluid (CSF) was analyzed at the time of admission, after 24-48 hours (Table 1), and at the end of treatment. Accordingly, CSF leukocyte level was found to be 1710 2140/mm(3) in group 1 receiving dexamethasone treatment compared to 1950 +/- 2244/mm(3) in group 2 (p=0.001). The consciousness in the group receiving dexamethasone improved significantly more rapidly than the control group (p=0.001). While mortality was 9.7% in the patient group receiving dexamethasone it was 16.7% in the control group, however, it was not significant (p=0.093). Conclusion: The use of dexamethasone in adult patients is still under debate, and the administration of dexamethasone 10-15 minutes before antibiotherapy to unconscious patients in a poor state of health, is effective in the clinical improvement of the patient.
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    The evaluation of microbiology and Fournier's gangrene severity index in 27 patients
    (Elsevier Sci Ltd, 2009) Ulug, Mehmet; Gedik, Ercan; Girgin, Sadullah; Celen, Mustafa K.; Ayaz, Celal
    Objectives: The objectives of this study were to identify the causative microorganisms and factors associated with survival in patients with Fournier's gangrene and to determine the accuracy of the Fournier's gangrene severity index. Materials and methods: We retrospectively evaluated 27 patients with Fournier's gangrene who were treated and followed up at our hospital between January 2005 and December 2006. Biochemical, hematologic, and bacteriologic study results at admission and at the final evaluation, etiologic and predisposing factors at admission, physical examination findings, the timing and extent of surgical debridement, and antibiotic therapy used were all recorded. Results: The admission laboratory parameters that were significantly correlated with outcome included urea, creatinine, sodium, and potassium; at the final evaluation, in addition to these parameters, hematocrit, albumin, and bicarbonate levels were also significantly associated with outcome. The mean Fournier's gangrene severity index score (FGSIS) at admission for survivors was 5.04 + 2.49 compared with 13.6 + 4.61 for non-survivors. There was a strong correlation between the FGSIS and mortality (p < 0.0001). Escherichia coli and Pseudomonas aeruginosa were the most commonly isolated microorganisms. Conclusions: Patient metabolic status and predisposing factors are important in the prognosis of Fournier's gangrene. Hence, we believe that the FGSIS should be used clinically to evaluate therapeutic options and assess results. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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    Features of the metabolic syndrome are associated with lack of serum ALT normalization during therapy for chronic hepatitis B
    (Wiley, 2016) Fung, Scott; Yatsuhashi, Hiroshi; Tak, Won Young; Celen, Mustafa K.; Flaherty, John F.; Kim, Kyungpil; Myers, Robert P.
    [Abstract Not Available]
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    Multiresistant bacterial colonization due to increased nurse workload in a neurology intensive care unit
    (Riyadh Armed Forces Hospital, 2006) Celen, Mustafa K.; Tamam, Yusuf; Hosoglu, Salih; Ayaz, Celal; Geyik, Mehmet F.; Apak, Ismail
    Objective: To determine the relationship between nurse workload and multiresistant bacteria colonization or infection (MRB+) in a neurology intensive care unit (ICU). Methods: We studied the relationship between nurse workload and MRB+ development in patients who were hospitalized in Dicle University Neurology Department ICU, Turkey during a 6-month period from November 15, 2003 to April 15, 2004. The intensity of workload and procedures applied to the patients were scored with the Project de Recherche en Nursing (PRN) and the Omega scores. Results: Of 138 patients followed, 71 (51.4%) were female and 67 (48.6%) were male. The mean age of females was 65.6 +/- 6.7 years, and of males was 62.2 +/- 15.8 years. The mean time of hospitalization in the ICU was 13 +/- 7.6 days. In 26 (18.8%) cultures taken from patients, multiresistant bacteria (MRB) were demonstrated. The development of MRB+ infection was correlated with length of stay (LOS), Omega 2, Omega 3, Total Omega, daily PRN, and total PRN (p<0.05). There was no correlation between development of MRB+ infection with gender, age, APACHE-II and Omega 1 scores (p>0.05). In the PRN system, when the workload of nurses was compared, it was seen that in the MRB colonized patient group, the workload of nurses was meaningfully higher than the MRB patient (-) group (p<0.001). Conclusion: As a result, the risk of MRB+ development in the ICU is directly proportional to understaffing, increased nurse workload, LOS, and procedures applied to patients. In management of nosocomial infection, it is crucial to increase the number of nurses in the ICU, and thus, decrease the workload.