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    Batman Devlet Hastanesine Başvuran Kişilerde Hepatit ve HIV Serolojisinin Sonuçları
    (2012) Çelen, Mustafa Kemal; Mert, Duygu; Değirmen, Elif; Işık, Sehavet Tezcan; Demirpençe, Özlem; Gümüş, Alper
    Amaç: Günümüzde viral hepatitler ve HIV enfeksiyonu önemli küresel sağlık sorunlarıdır. Bu çalışma, 3 Mart 2010 ve 8 Mart 2011 tarihleri arasında Batman Bölge Hastanesi polikliniklerine başvuran bireylerde; HAV IgG, HBsAg, anti-HBs, anti-HCV ve anti-HIV seropozitiflik oranlarının belirlenmesi amacı ile yapılmıştır.Gereç ve Yöntemler: Alınan kan örnekleri CMIA (Chemiluminescent Microparticle İmmunoassay) yöntemi ile (Architect İ2000 SR, USA) çalışılmıştır.Bulgular: HBsAg açısından incelenen 11131 serum örneğinin 1398inde (%12,6) HBsAg pozitifliği, anti-HBs açısından incelenen 10957 serum örneğinin 5266sında (%48,06) anti-HBs pozitifliği, anti-HCV açısından incelenen 9666 örneğin 186sında (%1,9) anti-HCV pozitifliği, HAV IgG açısından incelenen 2606 örneğin 2447sinde (%93,9) HAV IgG pozitifliği, anti-HIV 1/2 açısından incelenen 6442 örneğin sadece 1inde (%0,015) anti-HIV pozitifliği saptanmıştır. Sonuç: Sonuç olarak, viral hepatitler ilimiz için önemli sağlık problemleridir. Aşılama, enfeksiyon kontrol programları ve halkın eğitimi yeni enfeksiyonların riskini azaltabilir. Anti-HIV pozitifliği ilimizde çok düşük bulunmuştur. (Viral Hepatit Dergisi 2012; 18(1): 6-10)
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    BRUCELLOSIS IS A MAJOR PROBLEM: A FIVE YEARS EXPERIENCE
    (Carbone Editore, 2013) Dal, Tuba; Celen, Mustafa Kemal; Ayaz, Celal; Dal, Mehmet Sinan; Kalkanli, Sevgi; Mert, Duygu; Yildirim, Necmettin
    Brucellosis is a chronic granulomatous infection which is endemic in Mediterranean countries and Turkey. The aim of this study is to analyze the clinical, laboratory findings and therapeutic features in patients with brucellosis. A retrospective study was conducted with 91 patients who developed brucellosis between 2005 to 2009. The diagnosis was based on clinical findings compatible with brucellosis, serological tests positive, and/or isolation of Brucella species from blood, or other tissues. The mean age was 33 years (16-67 years). Sixty-threes of patients (69.2%) were male. Forty (44%) cases had an occupational history relevant for Brucella exposure and 85 (93%) cases consumption with contaminated animal product. The mean diagnostic delay was 15 days, much longer in focal brucellosis. A total of 77 (85 %) cases had acute brucellosis. The focal brucellosis complications were observed in 39 (42.8%) cases: osteoarticular involvement 32 (82%), epididymo-orchitis 4 (10%), and central nervous system involvement 3 (8%). Chronic brucellosis occurs in 3 (3.3%) cases. Clinical manifestations included non-specific symptoms such as fever (95%). sweats (90%), arthralgia and lower back pain (63%). Of the patients 84 (92%) had serological titre =1/160 and 28 (31%) blood cultures were positive. All of the patients were cured by antibiotic therapy (Doxycycline+rifampicin/streptomycine, streptomycine+rifampicin/Doxycycline, ceftiraxone/rifampicin). Relapse was observed in 5 (5.4%) patients. Brucellosis is an infection with multiple presentations. Its early diagnosis was mandatory to avoid severe complications.
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    Efficacy and safety of tenofovir disoproxil fumarate in pregnancy for the prevention of vertical transmission of HBV infection
    (Baishideng Publishing Group Inc, 2013) Celen, Mustafa Kemal; Mert, Duygu; Ay, Muzeyyen; Dal, Tuba; Kaya, Safak; Yildirim, Necmettin; Gulsun, Serda
    AIM: To evaluate the effects of tenofovir disoproxil fumarate (TDF) use during late pregnancy to reduce hepatitis B virus (HBV) transmission in highly viremic mothers. METHODS: This retrospective study included 45 pregnant patients with hepatitis B e antigen (+) chronic hepatitis B and HBV DNA levels > 10(7) copies/mL who received TDF 300 mg/d from week 18 to 27 of gestation (n = 21). Untreated pregnant patients served as controls (n = 24). All infants received 200 IU of hepatitis B immune globulin (HBIG) within 24 h postpartum and 20 mu g of recombinant HBV vaccine at 4, 8, and 24 wk. Perinatal transmission rate was determined by hepatitis B surface antigen and HBV DNA results in infants at week 28. RESULTS: At week 28, none of the infants of TDF-treated mothers had immunoprophylaxis failure, whereas 2 (8.3 %) of the infants of control mothers had immunoprophylaxis failure (P = 0.022). There were no differences between the groups in terms of adverse events in mothers or congenital deformities, gestational age, height, or weight in infants. At postpartum week 28, significantly more TDF-treated mothers had levels of HBV DNA < 250 copies/mL and normalized alanine aminotransferase compared with controls (62% vs none, P < 0.001; 82% vs 61%, P = 0.012, respectively). CONCLUSION: TDF therapy during the second or third trimester reduced perinatal transmission rates of HBV and no adverse events were observed in mothers or infants. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.
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    FOUR-YEAR STUDY OF ENTECAVIR EFFICACY AND SAFETY IN NUCLEOS(T)IDE-NAIVE HBeAg POSITIVE CHRONIC HEPATITIS B PATIENTS
    (Sestre Milosrdnice Univ Hospital, 2014) Celen, Mustafa Kemal; Dal, Tuba; Ayaz, Celal; Bayan, Kadim; Mert, Duygu; Deveci, Ozcan; Oruc, Ebru Kursun
    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-naive 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.
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    Retrospective analysis of 286 Brucellosis cases in the southeast of Turkey
    (2012) Deveci, Özcan; Tekin, Recep; Bozkurt, Fatma; Karakoç, Zehra Çağla; Demirpençe, Özlem; Mert, Duygu
    Amaç: Çalışmamızda; Türkiyenin Güneydoğu Anadolu bölgesinde yer alan Diyarbakır, Mardin ve Batman illerindeki brusellozlu hastaların klinik, laboratuvar ve tedavi özellikleri yönünden değerlendirilmesi amaçlanmıştır. Gereç ve yöntem: Haziran 2007- Temmuz 2009 tarihleri arasında Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniğinde bruselloz tanısı ile izlenen 286 hasta geriye dönük olarak değerlendirilmiştir. Bulgular: Hastaların 156 (%55)i kadın, 130 (%45)i erkek ve yaş ortalamaları 32,8 + 15,3 (15-78) idi. Vakaların %75 akut, %23 subakut ve %2sini kronik olarak gruplandırıldı. Hastalığın bulaşmasındaki en önemli faktörün taze peynir yeme olduğu ve bölgede hayvan hareketlerinin kontrolünün olmadığı belirlendi. Hastalarda en sık rastlanan şikayetler yorgunluk, ateş, kas ve eklem ağrıları ve gece terlemesi idi. Ateş (%90,8), artrit (%54,1), splenomegali (%18,3) ve hepatomegali (%11) en sık rastlanan muayene bulgularıydı. Laboratuvarda ise C- Reaktif Protein (CRP) değerinin %60 yüksek olarak saptanması en sık rastlanan bulguydu. Tanı klinik belirtilerle birlikte pozitif Rose-Bengal ve Brusella tüp aglütinasyon testinin 1/160 ve üzeri olması ile konuldu. Tedavide ise çoğunlukla rifampisin ve doksisiklin kombinasyonu tercih edildi. Sonuç: Bruselloz hala ülkemizde önemli mortalite ve morbiditeye neden olan bir halk sağlığı sorunudur. Brucella, özellikle endemik bölgelerde, ateş, lökopeni ve osteoartiküler bulguların varlığında ayırıcı tanıda mutlaka akılda bulundurulmalıdır.
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    Seroprevalence of HAV, HBV, HCV and HIV in People Admitted to Batman State Hospital
    (Galenos Publ House, 2012) Demirpence, Ozlem; Isik Tezcan, Sehavet; Degirmen, Elif; Mert, Duygu; Gumus, Alper; Celen, Mustafa Kemal
    Objective: At the present time viral hepatitis and HIV infection are important global health problems. The aim of this study was to investigate the rates of HAV, HBV, HCV and HIV seropositivity in people those admitted to Batman State Hospital between Macrh 2010 and March 2011. Materials and Methods: Blood samples were searched for HAV IgG, HBsAg, AntiHBs, Anti-HCV and Anti-HIV with CMIA (Chemiluminescent Microparticle Immunoassay) method (Architect I2000 SR, USA). Results: For anti-HBs, 10957 samples were analyzed and 5266 (48.06%) of these samples were positive. For anti-HCV 9666 samples were analyzed and 186 (1.9%) of these samples were positive. For HAV IgG 2606 samples were analyzed and 2447 (93.9%) of these samples were positive. For anti-HIV 1/ 2 6442 samples were analyzed and only 1 sample was positive (0.015%). Conclusion: In conclusion; despite the relatively lower rate of HIV seropositivity, hepatitis viruses, particularly HBV remains to be a significant health problem in our province. Effective vaccination coverage and public awareness about infection control measures would be expected to decrease the emergence of new cases.
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    Serum paraoxonase, TAS, TOS and ceruloplasmin in brucellosis
    (E-Century Publishing Corp, 2014) Demirpence, Ozlem; Sevim, Bunyamin; Yildirim, Mustafa; Nurlu, Nilhan Ayan; Mert, Duygu; Evliyaoglu, Osman
    It is possible that brucellosis may be related to increase free radical production and antioxidant depletion. Thus, in the present study we aimed to evaluate the oxidative status in patient with brucellosis and healthy controls. Methods: This study includes the patients with brucellosis diagnosed by clinical findings and positive agglutination titer. The paraoxonase, ceruloplasmin, total antioxidant capacity and total oxidant status values were measured from the samples taken. The oxidative stress index value was calculated through the total antioxidant capacity and total oxidant status values. Results: A total number of 93 people, 40 women (43%) and 53 men (57%) were included to the study. The levels of ceruloplasmin were found higher in patients when compared to the control group (p < 0.001). The total antioxidant capacity level was found significantly higher in the patients group when compared to the control group (p < 0.001). The oxidative stress index value was significantly lower in the patients group when compared to the control group (p < 0.001). The paraoxonase-1 level was not different in control and patient groups (p = 0.077). Conclusions: Brucellosis is an infection that is frequently seen in Mediterranean countries. This infection breaks the oxidant and antioxidant balance. In this disease, oxidant-antioxidant system indicators such as ceruloplasmin, total antioxidant capacity, total oxidant status and oxidative stress index can be used for showing the role of the brucella infection and for the monitoring of the treatment results.