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Öğe The characteristics of patients with chronic hepatitis B in Turkey(Medical Association of Zenica-Doboj Canton, 2014) Kemal Celen M.; Tekin Koruk S.; Aygen B.; Dal T.; Karabay O.; Tosun S.; Koksal I.Aim To evaluate the characteristics of patients with hepatitis B virus (HBV) infection and summarize the treatment modalities. Methods By September 30, 2011 the data of 7871 HBsAg (+) patients were complied and analysed according to demographic and medical records (age, sex, laboratory tests, treatment with antiviral agents) in thirty centres of Turkey. Results Of the 7871 patients 3078 (39.1%) were females; mean (standard deviation) age was 35 (14) years, 3180 (40.4%) were HBsAg positive (+) after admission to a hospital, 1488 (18.9%) after blood donation and 967 (11.9%) were found during routine screening. The HBV prevalence among relatives of HBsAg (+) patients was 1764 (22.4%), and most frequently infected family members were siblings and mothers, 4961 (63.0%) and 2149 (27.3%), respectively). Anti-HDV was negative in 7407 94.1% of patients. Three-fourths of the patients 6383 (81.1%) were HBeAg negative (-). Mean (SD) ALT was 85.8 (266.4) U/L. Majority of patients, 5588 (71.0%) were chronic hepatitis-B patients under treatment, while 2283 (29.0%) were asymptomatic carriers without treatment and only 165 (2.1%) of patients were cirrhotic and 6612 (84.0%) of those were compensated. One-third of the patients 2983 (37.9%) were under a combined treatment, while others were under monotherapy. Lamivudine, entecavir and adefovir were the most frequently used oral therapies, used for 2583 (32.8%), 11.6% and 787 (10.0%) of patients, respectively), while 2975 (37.8%) of patients were under interferon treatment. Conclusion Hepatitis B is still a problem in our country. First task of the physicians and our state should be to prevent the development and spread of the disease with education and vaccination programs, safe blood transfusions, and control of barbers.Öğe Efficacy of colistin and non-colistin monotherapies in multi-drug resistant acinetobacter baumannii bacteremia/sepsis(Acta Medica Mediterranea, 2014) Karabay O.; Batirel A.; Balkan I.I.; Agalar C.; Akalin S.; Alici O.; Alp E.Objective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB). Materials and methods: Cases with MDR-AB from 27 tertiary-referral hospitals between January 2009 and December 2012 were included. Patients' data that were on either colistin monotherapy (CM) or non-colistin monotherapy (NCM) were compared. Mortality on Day 14 was the primary endpoint, whereas microbiological eradication and clinical outcome were the secondary ones. Results: Eighty-four cases were included in the study with 36 being in the CM group and 48 in the NCM group. Thirty-eight (45.2%) cases were male and the mean age was 60.2 years. The mean durations of pre-MDR-AB hospital stay and intensive care unit stay were 25.8 days and 20.9 days, respectively. All of the cases had fever (>38°C). The mean Pitt bacteremia score (PBS) of the patients was calculated as 6.8, APACHE 2 score as 18.9 and the Charlson co-morbidity index (CCI) as 3.7 (CM: 3.6 vs. NCM: 3.9). Twenty (55.6%) cases in the CM group and 26 cases in the NCM group (54.2%) (p=0.81) died; 9 cases in the CM group (25%) and 16 cases in the NCM group (33.3%) had treatment failure (P=0.55). Bacteriological eradication was achieved in 20 (55.6%) cases in the CM group and in 36 cases (75%) in the NCM group (P=0.061). Conclusions: No significant difference could be identified between the colistin monotherapy and non-colistin monotherapy options in MDR-AB cases with respect to the results of efficacy and 14-day mortality.Öğe Osteoporosis, subclinical vertebral fractures and related factors in patients with peripheral arterial disease(2012) Baydar M.; Karabay O.; Dilek B.; Şahin E.; Karasel S.A.; Manisali M.; Ünal B.Introduction: The aim of the present study is to investigate the factors,affecting osteoporosis and subclinical vertebral fracture in patients with peripheral arterial disease(PAD). Materials and Method: Eighty patients over 45 years of age with a diagnosis of PAD and without a history of osteoporosis were included in the study.The patients were queried in terms of demographic characteristics,calcium intake and physical activity.BMD was measured by a dual energy X-ray absorbsiometer(DEXA).The loss of vertebral height was determined.PAD was staged according to Fontaine's classification.Serum calcium,phosphorus,alkaline phosphatase, 25(OH)D,parathormone,homocysteine and B12 levels were measured and thyroid,renal and hepatic function tests were performed. Results: According to the DEXA measurements,19.17% (14)of the patients had osteoporosis while 63.01%(46) of them had osteopenia.Of the patients 28(36.70%)and 8(10.12%)had grade 1 and grade 2 vertebral fractures, respectively.Radiologically confirmed vertebral fractures were not present in 43(53.2%) patients.No significant relation was found between the stage of the PAD, BMD and t scores (p>0.05). On the other hand,subclinical vertebral fractures significantly correlated with the stage of the disease and the weakness symptom(p<0.05). Conclusion: The stage of the disease showed no correlation with osteoporosis,but correlated with the grade of subclinical vertebral fracture.Thus, this group of patients should be investigated for osteoporosis and evaluated both with BMD measurement and direct radiography.Öğe The prevalence and epidemiological characteristics of hepatitis B virus and hepatitis C virus coinfection in Turkey(Turkiye Klinikleri, 2013) Aygen B.; Çelen M.K.; Köksal I.; Tosun S.; Karabay O.; Yamazhan T.; Yildiz O.We aimed to determine prevalence and epidemiological characteristics of cases coinfected with hepatitis B virus (HBV)/hepatitis C virus (HCV) in Turkey. Material and Methods: The data for this study was obtained from Turk-Hepatitis Registry (HEP-NET) Project, which includes real-life cohort of hepatitis patients from 15 centers in Turkey, and is supported by Viral Hepatitis Society. In the project, 10,165 hepatitis cases were evaluated in 10 hospitals. Results: According to initial visit results, HBV/HCV coinfection was detected in 99 patients. The ratio was 974/100 000. The mean age of the cases was 40.9+21.7 years, 56.6% of them were males and 43.4% were females,. The major risk factors were dental therapy, any surgical procedure, hemodialysis and blood transfusion. The mean alanine aminotransferase (ALT) levels were 70.9±49.1 IU/L in coinfected patients. In 12% of cases HBeAg was positive. The median HCV RNA level was found 0 IU/mL (minimum: 50-maximum: 2.18x107 IU/mL), and the median HBV DNA level was found 2.50x102 IU/mL (minimum: 12-maximum: 1.70x108 IU/mL). In 8.1% of the patients both HCV RNA and HBV DNA were positive, and in 87.5% of cases HCV infection was dominant. The most important risk factor was hemodialysis (25%) in this group. Conclusion: This is the most detailed study which evaluates the prevalence of HBV/HCV coinfection in Turkey. HBV/HCV coinfection prevalence was not higher than HBV or HCV monoinfections. In cases where both HCV RNA and HBV DNA were positive, HCV was predominant. © 2013 by Türkiye Klinikleri.
