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Sarıgül Yıldırım F, Üser Ü, Didem Sarı N, Kurtaran B, Önlen Y, Şenateş E, Gündüz A, Zerdali E, Karsen H, Batırel A, Karaali R, Güner R, Yamazhan T, Köse Ş, Erben N, İnce N, Köksal İ, Çuvalcı Öztoprak N, Yörük G, Kömür S, Bal T, Kaya S, Bozkurt İ, Günal Ö, Esen Yıldız İ, İnan D, Barut Ş, Namıduru M, Tosun S, Türker K, Şener A, Hızel K, Baykam N, Duygu F, Bodur H, Can G, Gül HC, Sağmak Tartar A, Çelebi G, Sünnetçioğlu M, Karabay O, Kumbasar Karaosmanoğlu H, Sırmatel F, Tabak F. In a Real-Life Setting, Direct-Acting Antivirals to People Who Inject Drugs with Chronic Hepatitis C in Turkey. Turk J Gastroenterol 2022; 33:971-978. [PMID: 36415900 PMCID: PMC9797763 DOI: 10.5152/tjg.2022.21834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. METHODS We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. RESULTS Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). CONCLUSION Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization's objective of eliminating viral hepatitis.
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Affiliation(s)
- Figen Sarıgül Yıldırım
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ülkü Üser
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Nagehan Didem Sarı
- Department of Infectious Diseases, İstanbul Education Research Hospital, İstanbul, Turkey
| | - Behice Kurtaran
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Yusuf Önlen
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Ebubekir Şenateş
- Department of Gastroenterology, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Alper Gündüz
- Department of Infectious Diseases, İstanbul Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Esra Zerdali
- Department of Infectious Diseases, Haseki Education Research Hospital, İstanbul, Turkey
| | - Hasan Karsen
- Department of Infectious Diseases and Clinical Microbiology, Harran University Faculty of Medicine, Şanlıurfa, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases, İstanbul Doctor Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey
| | - Rıdvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Şükran Köse
- Department of Infectious Diseases, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Nevin İnce
- Department of Infectious Diseases and Clinical Microbiology, Düzce University Medical School, Düzce, Turkey
| | - İftihar Köksal
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Teknik University Faculty of Medicine, Trabzon, Turkey
| | - Nefise Çuvalcı Öztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gülşen Yörük
- Department of Infectious Diseases, İstanbul Education Research Hospital, İstanbul, Turkey
| | - Süheyla Kömür
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Tayibe Bal
- Department of Gastroenterology, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Sibel Kaya
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - İlkay Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Özgür Günal
- Department of Infectious Diseases, Samsun Education Research Hospital, Samsun, Turkey
| | - İlknur Esen Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Medical School, Antalya, Turkey
| | - Şener Barut
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Medical Faculty, Tokat, Turkey
| | - Mustafa Namıduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University Medical Faculty, Gaziantep, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Kamuran Türker
- Department of Infectious Diseases, İstanbul Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Kenan Hızel
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Fazilet Duygu
- Department of Infectious Diseases, Ankara Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Hürrem Bodur
- Department of Infectious Diseases, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Güray Can
- Department of Gastroenterology, Bolu İzzet Baysal University Medical Faculty, Bolu, Turkey
| | - Hanefi Cem Gül
- Department of Infectious Diseases, Health Science University Gülhane Faculty of Medicine, Ankara, Turkey
| | - Ayşe Sağmak Tartar
- Department of Infectious Diseases and Clinical Microbiology, Fırat University School of Medicine, Elazığ, Turkey
| | - Güven Çelebi
- Department of Infectious Diseases and Clinical Microbiology, Zonguldak Bülent Ecevit University Training and Research Hospital, Zonguldak, Turkey
| | - Mahmut Sünnetçioğlu
- Department of Infectious Diseases and Clinical Microbiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Oğuz Karabay
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Hayat Kumbasar Karaosmanoğlu
- Department of Infectious Diseases, İstanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Fatma Sırmatel
- Department of Infectious Diseases and Clinical Microbiology, Bolu İzzet Baysal University Medical Faculty, Bolu, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Medical Faculty, Tokat, Turkey
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Önlen Y, Bal T, Çabalak M, Çuvalcı Öztoprak N, Didem Sarı N, Kurtaran B, Şenateş E, Gündüz A, Zerdali E, Karsen H, Batırel A, Karaali R, Güner R, Yamazhan T, Köse Ş, Erben N, İnce N, Köksal İ, Sarıgül Yıldırım F, Yörük G, Kömür S, Kaya S, Esen Ş, Günal Ö, Esen Yıldız İ, İnan D, Barut Ş, Namıduru M, Tosun S, Türker K, Şener A, Hızel K, Baykam N, Duygu F, Akıncı E, Can G, User Ü, Cem Gül H, Akbulut A, Çelebi G, Sünnetçioğlu M, Karabay O, Kumbasar Karaosmanoğlu H, Sırmatel F, Tabak F. Efficacy and Safety of Direct-Acting Antivirals in Elderly Patients with Chronic Hepatitis C: A Nationwide Real-Life, Observational, Multicenter Study from Turkey. Turk J Gastroenterol 2022; 33:862-873. [PMID: 35946896 PMCID: PMC9623221 DOI: 10.5152/tjg.2022.21271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 01/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C. METHODS In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (≥65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups. RESULTS The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P = .879, P = .508 for modified evaluable population and P = .058, P = .788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir+ribavirin had a significantly lower sustained virological response 12 rates (P < .001, P = .047, P = .013, and P = .025, respectively). CONCLUSION Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.
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Affiliation(s)
- Yusuf Önlen
- Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | - Tayibe Bal
- Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | - Mehmet Çabalak
- Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | | | | | | | - Ebubekir Şenateş
- Department of Gastroenterology, Medeniyet University Faculty of Medicine, İstanbul, Turkey
| | - Alper Gündüz
- Department of Infectious Diseases, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Esra Zerdali
- Department of Infectious Diseases, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Hasan Karsen
- Department of Infectious Diseases and Clinical Microbiology, Harran University Faculty of Medicine, Urfa, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases, Kartal Training and Research Hospital, İstanbul, Turkey
| | - Rıdvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Şükran Köse
- Department of Infectious Diseases, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osman Gazi University, Eskişehir, Turkey
| | - Nevin İnce
- Department of Infectious Diseases and Clinical Microbiology, Düzce University Faculty of Medicine, Düzce, Turkey
| | - İftihar Köksal
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Figen Sarıgül Yıldırım
- Department of Infectious Diseases, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gülşen Yörük
- Department of Infectious Diseases, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Süheyla Kömür
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Sibel Kaya
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Şaban Esen
- Department of Infectious Diseases and Clinical Microbiology, Samsun 19 Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Özgür Günal
- Department of Infectious Diseases, Samsun Training and Research Hospital, Samsun, Turkey
| | - İlknur Esen Yıldız
- Department of Infectious Diseases and Clinical Microbiology, RTE University Faculty of Medicine, Rize, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Şener Barut
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Mustafa Namıduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Selma Tosun
- Department of Infectious Diseases, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Kamuran Türker
- Department of Infectious Diseases, Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Kenan Hızel
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Fazilet Duygu
- Department of Infectious Diseases, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Esragül Akıncı
- Department of Infectious Diseases, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Güray Can
- Department of Gastroenterology, Bolu İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Ülkü User
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Hanefi Cem Gül
- Department of Infectious Diseases, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Ayhan Akbulut
- Department of Infectious Diseases and Clinical Microbiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Güven Çelebi
- Department of Infectious Diseases and Clinical Microbiology, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Mahmut Sünnetçioğlu
- Department of Infectious Diseases and Clinical Microbiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Oğuz Karabay
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, Hatay, Turkey
| | | | - Fatma Sırmatel
- Department of Infectious Diseases and Clinical Microbiology, Bolu İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Fehmi Tabak
- İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty of Medicine, İstanbul, Turkey
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Özarslan TO, Sırmatel F, Karabörk ŞÖ, Düzcü SE, Astarcı HM. Acinetobacter baumannii pneumonia increases surfactant proteins SP-A, SP-B, and SP-D levels, while decreasing SP-C level in bronchoalveolar lavage in rats. Microbes Infect 2022. [DOI: 10.1016/j.micinf.2022.105064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Yılmaz Karadağ F, Şimşek-Yavuz S, Cınar Aydın G, Tukenmez Tigen E, Sırmatel F, Karadeniz A, Aydın Ö, Ergen P, Yilmaz N, Çabadak H, Tekin R, Aydın M. Assessment of the Knowledge and Awareness Levels of Dentists Regarding Prophylaxis for Infective Endocarditis. Medeni Med J 2019. [DOI: 10.5222/mmj.2019.76736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Ozturk-Engin D, Erdem H, Hasbun R, Wang SH, Tireli H, Tattevin P, Argemi X, Ouamara-Digue E, Gombos A, Lakatos B, Sırmatel F, Cag Y, Pekok AU, Senbayrak S, Balkan II, Gheno M, Uzun N, Kaya S, Cicek-Senturk G, Şengöz G, Tekin R, Çelen MK, Nayman-Alpat S, Ergen P, Şener A, Agalar C, Köse S, Inkaya AÇ, Kaptan F, Al-Majid F, Savasci U, Vahaboglu H. Predictors of unfavorable outcome in neurosyphilis: Multicenter ID-IRI Study. Eur J Clin Microbiol Infect Dis 2018; 38:125-134. [PMID: 30368740 DOI: 10.1007/s10096-018-3403-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 10/12/2018] [Indexed: 11/28/2022]
Abstract
Neurosyphilis (NS) has different clinical manifestations and can appear during any stage of syphilis. We aimed to identify the factors affecting poor outcome in NS patients. Patients with positive cerebrospinal fluid Venereal Disease Research Laboratory test, and positive serological serum treponemal or nontreponemal tests were classified as definite NS. The data of 141 patients with definite NS were submitted from 22 referral centers. Asymptomatic NS, syphilitic meningitis, meningovascular syphilis, tabes dorsalis, general paresis, and taboparesis were detected in 22 (15.6%), 67 (47.5%), 13 (9.2%), 10 (7%), 13 (9.2%), and 16 patients (11.3%), respectively. The number of HIV-positive patients was 43 (30.4%). The most common symptoms were headache (n = 55, 39%), fatigue (n = 52, 36.8%), and altered consciousness (50, 35.4%). Tabetic symptoms were detected in 28 (19.8%), paretic symptoms in 32 (22.6%), and vascular symptoms in 39 patients (27.6%). Eye involvement was detected in 19 of 80 patients (23.7%) who underwent eye examination and ear involvement was detected in eight of 25 patients (32%) who underwent ear examination. Crystallized penicillin was used in 109 (77.3%), procaine penicillin in seven (4.9%), ceftriaxone in 31 (21.9%), and doxycycline in five patients (3.5%). According to multivariate regression analysis, while headache was a protective factor in NS patients, double vision was significantly associated to poor outcome. We concluded that double vision indicated unfavorable outcome among NS patients. A high clinical suspicion is needed for the diagnosis NS. As determined in our study, the presence of headache in syphilitic patients can help in early diagnosis of central nervous system disease.
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Affiliation(s)
- Derya Ozturk-Engin
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
| | - Hakan Erdem
- Principal Coordinator of ID-IRI, Ankara, Turkey
| | - Rodrigo Hasbun
- Department of Infectious Diseases, UT Health McGovern Medical School, Houston, TX, USA
| | - Shu-Hua Wang
- Division of Infectious Diseases, Deparment of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Hulya Tireli
- Department of Neurology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Xavier Argemi
- Department of Infectious Diseases and Clinical Microbiology, Nouvel Hôpital Civil, Strasbourg, France
| | - Enora Ouamara-Digue
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Andrea Gombos
- Department of Infectious Disease and Clinical Microbiology, Saint Laszlo Hospital Budapest, Budapest, Hungary
| | - Botond Lakatos
- Department of Infectious Disease and Clinical Microbiology, Saint Laszlo Hospital Budapest, Budapest, Hungary
| | - Fatma Sırmatel
- Department of Infectious Disease and Clinical Microbiology, Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Abdullah Umut Pekok
- Department of Infectious Diseases and Clinical Microbiology, Private Erzurum Sifa Hospital, Erzurum, Turkey
| | - Seniha Senbayrak
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Ilker Inanç Balkan
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Marie Gheno
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Nuray Uzun
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Selçuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Gönül Cicek-Senturk
- Department of Infectious Disease and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Gönül Şengöz
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Mustafa Kemal Çelen
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Saygın Nayman-Alpat
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Pınar Ergen
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Canan Agalar
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Sükran Köse
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Education Hospital, İzmir, Turkey
| | - Ahmet Çagkan Inkaya
- Department of Infectious Disease and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Figen Kaptan
- Department of Infectious Diseases and Clinical Microbiology, Atatürk Training and Research Hospital, İzmir Kâtip Çelebi University, İzmir, Turkey
| | - Fahad Al-Majid
- Department of Medicine, Infectious Diseases Division, King Saud University Hospital, Riyadh, Saudi Arabia
| | - Umit Savasci
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey
| | - Haluk Vahaboglu
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
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Idilman R, Baykam N, Kaymakoğlu S, Tabak F, Bahçecioğlu HI, Bektaş A, Bulut C, Günşar F, İnan D, Karaosmanoğlu HK, Karasu Z, Kuşçu F, Mete B, Özbakır Ö, Özdoğan OC, Parlak M, Sırmatel F, Topalak Ö, Ünsal B, Guidelines Study Group VH. Turkey 2017 Clinical Practice Guidelines on recommendations for screening diagnosing and managing hepatitis C virus. Turk J Gastroenterol 2018; 28:90-93. [PMID: 29303105 DOI: 10.5152/tjg.2017.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present guideline updates the Turkish recommendations for the screening, diagnosis and management of Hepatitis
C virus (HCV) infection prepared by the Turkish Association for the Study of the Liver (TASL) and Viral Hepatitis
Society (VHS). The aim of this guidance was to provide updates recommendations to physicians, who are interested
in HCV care on the optimal screening, diagnosis and pre-treatment management for patients with HCV infection
in Turkey. These recommendations, produced by panel experts, were aimed to addresses the management issues
ranging from diagnosis and linkage to care, to the optimal treatment regimen in patients with HCV infection. Recommendations
are based on evidence and opinions of more than 70% of the panelists. This guidance is supported by
the memberships of two societies and not by pharmaceutical companies. This guidance will be updated frequently
as new data become available.
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Affiliation(s)
- Ramazan Idilman
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nurcan Baykam
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Sabahattin Kaymakoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fehmi Tabak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Halil I Bahçecioğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ahmet Bektaş
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Cemal Bulut
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fulya Günşar
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Dilara İnan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Hayat K Karaosmanoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Zeki Karasu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ferit Kuşçu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Birgül Mete
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Özbakır
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Osman C Özdoğan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Mehmet Parlak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fatma Sırmatel
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Topalak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Belkis Ünsal
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
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Abstract
BACKGROUND Tularaemia is a zoonotic infectious disease caused by Francisella tularensis, an aerobic, uncapsulated, gram-negative coccobacillus. Several case reports have appeared on the dermatological manifestations of tularaemia, but relatively few longer-term studies are available. AIM To identify skin features of tularaemia that aid in its diagnosis. METHODS In total, 168 patients (68 male, 100 female) diagnosed with tularaemia were retrospectively examined. All dermatological data for these patients were evaluated. RESULTS Of the 168 patients, 149 (88.69%) had tularaemia of the oropharyngeal type, 12 (7.73%) had the ulceroglandular type, 5 (2.9%) had the oculoglandular type and 2 (0.59%) had the pulmonary type. Secondary skin manifestations were found in 26 patients (15.47%). Sweet syndrome (SS) was found in 11 patients (6.54%), most of whom presented with the oropharyngeal form, while erythema nodosum (EN) was found in 7 patients (4.16%), dermatitis in 2 (1.19%), urticaria in 2 (1.19%), acneiform eruptions in 1 (0.59%), vasculitis-like eruptions in 1 (0.59%) and SS + EN in 1 (0.59%). Patients with the oropharyngeal form had a statistically significant (P < 0.001) higher number of skin findings than patients with the other forms. CONCLUSIONS In clinical practice, tularaemia may present with various cutaneous manifestations, and dermatologists who work in endemic regions must be aware of the possibility of this disease.
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Affiliation(s)
- M Polat
- Department of Dermatology, Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - T Karapınar
- Department of Dermatology, Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - F Sırmatel
- Department of Infectious Diseases, Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
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Korkmaz P, Demirturk N, Batırel A, Cem Yardimci A, Cagir U, Atakan Nemli S, Korkmaz F, Zeynep Akcam F, Sener Barut H, Bayrak B, Karakecili F, Tarakci H, Yulugkural Z, Yuksel E, Aktug Demir N, Ural O, Sumer S, Harman R, Kadanali A, Ozturk S, Cetin Akhan S, Eren Tulek N, Keten D, Sener A, Aygen B, Kocagul Celikbas A, Yilmaz Karadag F, Aydin G, Arslan E, Sacligil C, Akengin Ocal G, Tanoglu A, Ulcay A, Karagoz E, Saltoglu N, Sırmatel F, Akdeniz H, Aynıoglu A, Arslan Ozel S, Dirgen Caylak S, Celik I, Alpay Y, Bestepe Dursun Z, Bekcibasi M, Tuncer Ertem G, Tigli A, Sargin Altunok E, Avsar K, Suer K, Sayan M. Noninvasive Models to Predict Liver Fibrosis in Patients with Chronic Hepatitis B: A Study from Turkey. Hepat Mon 2017; In Press. [DOI: 10.5812/hepatmon.60266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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Şahmelikoğlu Onur Ö, Çukurova M, Bağ S, Yalçın S, Çakır Şen C, Karşıdağ Ç, Süleyman Can S, Tuğçe Akçaer E, Taşdelen Kul A, İspir M, Bakkal O, Algül A, Ebrinç S, Süleyman Can S, Taşdelen Kul A, Yükselir C, Zincir S, Öztürk P, Karaahmetoğlu B, Baş Ö, Şahmelikoğlu Onur Ö, Ulukaya S, Süleyman Can S, Soykan Ç, Çayköylü A, Taşdelen Kul A, Yazar N, Başar Kocagöz Z, Özçetin A, Bahar Ölmez S, Ataoğlu A, Hasan Balcioglu Y, Demir Berkol T, Ekim Cevik F, Oncu F, Ozgen G, Demiröz D, Yardım Özayhan H, Seven H, Çağrı Yıldız M, Başaran R, Eren İ, Özlem Canazlar E, Sevinçok L, Doğan B, Öykü Memiş Ç, Baran Tanrikulu A, İnanli̇ İ, Çağri̇ Yi̇ldi̇z M, Şerife Elmas T, Eren I, Alperen Korkmaz Ş, Pınar Şen C, Fatih Ceylan M, Hesapçıoğlu ST, Bakar B, Tuncer C, Yeni Elbay R, Görmez A, Tokgöz Y, Bolu A, Çelik C, Uzun Ö, Kirlioglu SS, Balcioglu YH, Aydin PC, Uğurlu M, Uğurlu GK, Akçaer ET, Can SS, Çayköylü A, Koç Z, Kapubağlı N, Tuncer ÖF, Ünlü G, Balcioglu YH, Kirlioglu SS, Ozgen G, Çayköylü A, Uğurlu M, Şahin EK, Uğurlu GK, Can SS, Apaydın ZK, Kaymak SU, Peker O, Can SS, Koç Z, Çayköylü A, Özkan B, Kılıçoğlu AG, Karaçetin G, Yücehan Z, Elmas TŞ, Demiröz D, Yağlı N, İlhan BÇ, Eren İ, Aker DA, Kıvılcım Y, Solmaz M, Kutlu YR, Yeşil B, Almış BH, Küçük B, Cerit C, Sarici B, Kaypak AC, Baysak E, Ergün S, Yildiz M, Ibiloglu AO, Atli A, Asoglu M, Ozkan M, Memik NÇ, Ünver H, Gündoğdu ÖY, Uzun N, Akça ÖF, Aral G, Aykut DS, Maden Ö, İspir M, Gündoğmuş İ, Algül A, Ebrinç S, Gok F, Kiraz S, Cipil A, Eroglu MZ, Çiftçi E, Aslan Z, Gül MK, Taştepe N, Demirci E, Özmen S, Doğru H, Karayağmurlu E, Karayağmurlu A, Göksu M, Tügen LE, Ayaz AB, Arman A, Başaran R, Özayhan HY, Altunova D, Demiröz D, Eren İ, Yıldız MÇ, Balcioglu YH, Kirlioglu SS, Aydin PC, Can SS, Soykan Ç, Atagün Mİ, Çayköylü A, Uğurlu GK, Kul AT, Güldaş E, Göl G, Savcı U, Tufan AE, Özbek SY, Özbek S, Uygur H, Demirel B, Esra Çiçek İ, Eren İ, Kara H, Balcı MM, Karaca S, Kuloğlu MM, Aytaç HM, Ger MC, Atli A, İbiloğlu AO, Asoğlu M, Çakır A, Aykut DS, Tiryaki A, Çelme GG, Boztaş MH, Sırmatel F, Balcioglu YH, Erdogan M, Dayan C, Atakli HD, Kartalcı G, Yücel E, Kartalcı Ş, Eroğlu MZ, Çipil A, Çalışkan M, Kaymak SU, Uğurlu GK, Peker O, Koç Z, Atagün Mİ, Çayköylü A, Çavusoglu EC, Özdemir YÖ, Çiftçi E, Atli A, İbiloğlu AO, Asoğlu M, Demiröz D, Özayhan HY, Yücehan Z, Elmas TŞ, Eren İ, Fındıklı E, Aytaç HM, Şahin B, Karabekiroğlu K, Kurt M, Memiş ÇÖ, Doğan B, Sevinçok D, Sevinçok L, Sertdemir M, Akça ÖF, Sevinçok D, Memiş ÇÖ, Doğan B, Sevinçok L, Ay R, Yılmaz N, Demirkaya SK, Aksu H, Gizem Gerçek H, Karakoç G, Altıntoprak AE, Coşkunol H, Yazici IP, Utku Yazici K, Doğru H, Kiraz S, Altıntaş K, Gök F, Eroğlu MZ, Yaylacı F, Erkuran HÖ, Eyüboğlu M, Göverti D, Yüksel RN, Bülbül A, Aydemir MÇ, Göka E, Kınalı I, Hacıoğlu MY, Kaypak AC, Sarıcı B, Baysak E, Ergün S, Sayar K, Gündoğmuş İ, İspir M, Algül A, Ebrinç S, Doğan H, Doğan H, Bağ S, Çukurova M, Akay Ö, Karşıdağ Ç, Gündoğmuş İ, Bakkal O, Algül A, Ebrinç S, Kim H, Lee H, Soykan Ç, Can SS, Çayköylü A, Kul AT, Karagöz A, Gündoğmuş İ, Kullakçı H, Maden Ö, Algül A, Ebrinç S, Can SS, Duman Y, Atagün Mİ, Kul AT, Çayköylü A, Çokünlü Y, Aydın M, Elmas TŞ, Eren İ, Tanrıkulu AB, Aydın M, Elmas TŞ, Altunova D, Eren İ, Taner HA, Sarı BA, Yektaş Ç, Samurcu ND, Tufan AE, Elmas TŞ, Çalışır S, Aydın M, Demiröz D, Tanrıkulu AB, Eren İ, Kullakçı H, İspir M, Algül A, Ebrinç S, İspir M, Gündoğmuş İ, Maden Ö, Algül A, Ebrinç S, Ekinci Ö, Tan ME, Kalınlı M, Kıyançiçek M, Gündoğmuş İ, Maden Ö, Algül A, Küçükdağ M, Yektaş Ç, Gül HK, Aykut DS, Uysal E, Arslan FC, Uysal E, Aykut DS, Gül HK, Karagüzel EÖ, Demiröz D, Özayhan HY, Seven H, Başaran R, Yıldız MÇ, Eren İ, Karakök B, Çak HT, Çankaya PK, Altun İK, Abatan E, Uysal E, Çokünlü Y, Elmas TŞ, Özbek S, Çalışkan AM, Eren İ, Çakı HK, Doğangün B, Kadak MT, Kefeli M, Arıcı A, Altun H, Acıpayam C, Bayhan PÇ, Taştepe N, Gül MK, Özmen S, Demirci E, Elmas TŞ, Çalışır S, Tanrıkulu AB, Çokünlü Y, Yıldız MÇ, Yücehan Z, Eren İ, Tan ME, Ekinci Ö, Altun İK, Çankaya PK, Uysal E, Sungur EN, İnci Kenar AN, Ersoy SA, Gürok MG, Yildiz S, Korucu T, Keles DD, Atmaca M, Hoşoğlu E, Akça ÖF, Kılınç K, Şen B, Örnek E, Çelebi C, Kani AS, Yanartaş Ö, Şenkal Z, Akvardar Y, Kora K, Egilmez Ü, Kandeğer A, Güler Ö, Yazici KU, Yazici IP, Kösker SD, Budak EA, Karasin ZD, Güleken MD, Celik M, Yazici IP, Yazici KU, Yıldırım H, Altıntoprak AE, Güler B, Veznedaroğlu B, Lale F, Çak Esen HT, Haliloğlu G, Yeşil B, Almış BH, Ekinci N, Bilgili GÖ, Tuncer C, Seneger V, Elbay RY, Görmez A, Işık Ü, Aşut G, Yaylacı ET, Asan Ö, Göka E, Güneş S, Yeşil B, Çalışkan AM, Çiftçi E, Yaşar SA, İnanlı İ, Eren İ, Altıntaş K, Kiraz S, Sertçelik S, Eroğlu MZ, Bakkal O, Gündoğmuş İ, Maden Ö, Algül A, Ebrinç S, Atli A, İbiloğlu AO, Asoğlu M, Avci SH, Görmez A, Tuncer C, Seneger V, Gündoğmuş İ, İspir M, Maden Ö, Algül A, Ebrinç S, Altıntaş K, Yaşar AB, Sertçelik S, Tuncer C, Bakar B, Karatepe HT, Elbay RY, Dönmez M, Topçuoğlu V, Yanartaş Ö, Sertdemir M, Bilgiç A, Doğru H, Doğru V, Bozkurt A, Şahin B, Karabekiroğlu K, Kalyoncu T, Çıldır DA, Beşer C, Fiş NP, Güneş S, Ulgar ŞB, Ayaydın H, Takatak H, Ayaydin H, Çobanoğlu C, Müjdeci M, Şahin B, Gümüş YY, Kalınlı M, Ekinci Ö, Güneş S, Akbaş B, Akça ÖF, Doğru H, Sevgen FH, Altun H, Aytaç HM, Öncü F, Şahin N, Balkan D, Coşkun F, Yılmaz S, Akça ÖF, Çelikkol Ç, Yılmaz S, Emlik GD, Çaksen H, Arslan D, Arısoy Ö, Şair A, Şair YB, Sarı D, Ispir M, Algul A, Ebrinç S, Ölmeztoprak VK, Zayman EP, Ünal S, Demiröz D, Özayhan HY, Yaşar SA, Öztürk AH, Eren İ, Karabucak B, Çengel Kültür ES, Çak Esen TH, Çipil A, Eroğlu MZ, Yaşar AB, Çalışkan M, Yaylacı F, Erkuran HÖ, Eroğlu MZ, Çalışkan M, Kiraz S, Çipil A, Özaktaç İF, Altın M, Sarıdoğan AS, Buluş E, Bülbül A, Güneş S, Yüksel RN, Aydemir MÇ, Göka E, Ayaydın H, Takatak H, Koyuncu Z, Kadak MT, Bingöl RH, Doğangün B, Uzgel M, Ayas S, Kıvrak Y, Şahbal Y, Kocagöz K, Aykut DS, Kutlu G, Baz A, Göl G, Güldaş E, Cansız MA, Tufan AE, Çıldır DA, Kalyoncu T, Duman Y, Can SS, Soykan Ç, Kul AT, Sağlam E, Akça ÖF, Önen Ö, Kutlu A, Erkuran HÖ, Erkuran HÖ, Aşık EA, Sapmaz ŞY, Kalyoncu T, Çıldır DA, Erermiş S, Ünver H, Şişmanlar ŞG, Karka İ, Kilicaslan F, Asoglu M, Hürmeydan CE, Onur ÖŞ, Bağ S, Yalçın S, Onur OS, Sarı DN, Kılıç B, Kurt EM, Ak İ, Şevik AE, Yalçın AD, Tural Ü, Yaşar H, Can SS, Duman Y, Çayköylü A, Korkmaz ŞA, Uğurlu GK, Kul AT, Balcioglu YH, Kirlioglu SS, Ozgen G, Altunova D, Başaran R, Yıldız MÇ, Tanrıkulu AB, Karaaslan M, Eren İ, Kizilağaç F, Tural Ü, Tokgöz Y, Öznur T, Çelik C, Uzun Ö, Baran Tanri̇kulu A, Yildiz MÇ, İnanli İ, Elmas TŞ, Çokünlü Y, Öztürk SS, Seven H, Demiröz D, Özbek S, Çiçek İE, Eren İ, Zayman EP, Karlıdağ R, Akan M, İnce LU, Reyhani İ, Tetik DÇ, Büyükaslan A, Yılanlı M, Cesur E, Bağ S, Karşıdağ Ç, Balcioglu YH, Kirlioglu SS, Oncu F, Belger F, Başay BK, Seneger V, Tuncer C, Karatepe HT, Görmez A, Şen CP, Ceylan MF, Hesapcioglu ST, Elmas TŞ, Çalışır S, Çalışkan AM, Tanrıkulu AB, Eren İ, Ibiloglu AO, Atli A, Asoglu M, Ozkan M, Onur ÖŞ, Cesur E, Teksin G, Yalçın S, Bağ S, Güneş S, Çalışkan AM, Çiftçi E, Yaşar SA, İnanlı İ, Eren İ, Baysak E, Kupeli NY, Ergun S, Kora K, Asoğlu M, Takatak H, Atlı A, Okan İbiloğlu A, Asoğlu M, Akıl Ö, Atlı A, İbilioğlu AO. 9th International Congress on Psychopharmacology & 5th International Symposium on Child and Adolescent Psychopharmacology. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1308709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Gürbüz Y, Tülek NE, Tütüncü EE, Koruk ST, Aygen B, Demirtürk N, Kınıklı S, Kaya A, Yıldırmak T, Süer K, Korkmaz F, Ural O, Akhan S, Günal Ö, Tuna N, Köse Ş, Gönen İ, Örmen B, Türker N, Saltoğlu N, Batırel A, Tuncer G, Bulut C, Sırmatel F, Ulçay A, Karagöz E, Tosun D, Şener A, Aynıoğlu A, Altunok ES. Evaluation of Dual Therapy in Real Life Setting in Treatment-Naïve Turkish Patients with HCV Infection: A Multicenter, Retrospective Study. Balkan Med J 2016; 33:18-26. [PMID: 26966614 DOI: 10.5152/balkanmedj.2015.15859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/30/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Before the introduction of direct-acting antivirals in the treatment of chronic hepatitis C patients, the combination of peginterferon alpha and ribavirin was the standard therapy. Observational studies that investigated sustained virological response (SVR) rates by these drugs yielded different outcomes. AIMS The goal of the study was to demonstrate real life data concerning SVR rate achieved by peginterferon alpha plus ribavirin in patients who were treatment-naïve. STUDY DESIGN A multicenter, retrospective observational study. METHODS The study was conducted retrospectively on 1214 treatment naïve-patients, being treated with peginterferon alpha-2a or 2b plus ribavirin in respect of the current guidelines between 2005 and 2013. The patients' data were collected from 22 centers via a standard form, which has been prepared for this study. The data included demographic and clinical characteristics (gender, age, body weight, initial Hepatitis C virus RNA (HCV RNA) level, disease staging) as well as course of treatment (duration of treatment, outcomes, discontinuations and adverse events). Renal insufficiency, decompensated liver disease, history of transplantation, immunosuppressive therapy or autoimmune liver disease were exclusion criteria for the study. Treatment efficacy was assessed according to the patient's demographic characteristics, baseline viral load, genotype, and fibrosis scores. RESULTS The mean age of the patients was 50.74 (±0.64) years. Most of them were infected with genotype 1 (91.8%). SVR was achieved in 761 (62.7%) patients. SVR rate was 59.1% in genotype 1, 89.4% in genotype 2, 93.8% in genotype 3, and 33.3% in genotype 4 patients. Patients with lower viral load yielded higher SVR (65.8% vs. 58.4%, p=0.09). SVR rates according to histologic severity were found to be 69.3%, 66.3%, 59.9%, 47.3%, and 45.5% in patients with fibrosis stage 0, 1, 2, 3 and 4, respectively. The predictors of SVR were male gender, genotype 2/3, age less than 45 years, low fibrosis stage, low baseline viral load and presence of early virological response. SVR rates to each peginterferon were found to be similar in genotype 1/4 although SVR rates were found to be higher for peginterferon alpha-2b in patients with genotype 2/3. The number of patients who failed to complete treatment due to adverse effects was 33 (2.7%). The number of patients failed to complete treatment due to adverse effects was 33 (2.7%). CONCLUSION Our findings showed that the rate of SVR to dual therapy was higher in treatment-naïve Turkish patients than that reported in randomized controlled trials. Also peginterferon alpha-2a and alpha-2b were found to be similar in terms of SVR in genotype 1 patients.
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Affiliation(s)
- Yunus Gürbüz
- Department of Infectious Diseases and Clinical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Necla Eren Tülek
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Emin Ediz Tütüncü
- Department of Infectious Diseases and Clinical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Süda Tekin Koruk
- Department of Infectious Diseases and Clinical Microbiology, Harran University Faculty of Medicine, Şanlıurfa, Turkey
| | - Bilgehan Aygen
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Neşe Demirtürk
- Department of Infectious Diseases and Clinical Microbiology, Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar, Turkey
| | - Sami Kınıklı
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ali Kaya
- Department of Infectious Diseases and Clinical Microbiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Taner Yıldırmak
- Department of Infectious Diseases and Clinical Microbiology, Okmeydanı Training and Research Hospital, İstanbul, Turkey
| | - Kaya Süer
- Department of Infectious Diseases and Clinical Microbiology, Near East University Faculty of Medicine, Nicosia, North Cyprus
| | - Fatime Korkmaz
- Department of Infectious Diseases and Clinical Microbiology, Konya Training and Research Hospital, Konya, Turkey
| | - Onur Ural
- Department of Infectious Diseases and Clinical Microbiology, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Sıla Akhan
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Özgür Günal
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Nazan Tuna
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Şükran Köse
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, İzmir, Turkey
| | - İbak Gönen
- Department of Infectious Diseases and Clinical Microbiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Bahar Örmen
- Department of Infectious Diseases and Clinical Microbiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Nesrin Türker
- Department of Infectious Diseases and Clinical Microbiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Neşe Saltoğlu
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases and Clinical Microbiology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey
| | - Günay Tuncer
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Cemal Bulut
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Fatma Sırmatel
- Department of Infectious Diseases and Clinical Microbiology, Abant İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Asım Ulçay
- Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpaşa Training and Research Hospital, İstanbul, Turkey
| | - Ergenekon Karagöz
- Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpaşa Training and Research Hospital, İstanbul, Turkey
| | - Derviş Tosun
- Department of Infectious Diseases and Clinical Microbiology, Ulus State Hospital, Ankara, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Aynur Aynıoğlu
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Elif Sargın Altunok
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
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Erdem H, Elaldi N, Batirel A, Aliyu S, Sengoz G, Pehlivanoglu F, Ramosaco E, Gulsun S, Tekin R, Mete B, Balkan II, Sevgi DY, Giannitsioti E, Fragou A, Kaya S, Cetin B, Oktenoglu T, DoganCelik A, Karaca B, Horasan ES, Ulug M, Inan A, Kaya S, Arslanalp E, Ates-Guler S, Willke A, Senol S, Inan D, Guclu E, Tuncer-Ertem G, Meric-Koc M, Tasbakan M, Senbayrak S, Cicek-Senturk G, Sırmatel F, Ocal G, Kocagoz S, Kusoglu H, Guven T, Baran AI, Dede B, Yilmaz-Karadag F, Kose S, Yilmaz H, Aslan G, ALGallad DA, Cesur S, El-Sokkary R, Bekiroğlu N, Vahaboglu H. Comparison of brucellar and tuberculous spondylodiscitis patients: results of the multicenter "Backbone-1 Study". Spine J 2015; 15:2509-17. [PMID: 26386176 DOI: 10.1016/j.spinee.2015.09.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/24/2015] [Accepted: 09/03/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND CONTEXT No direct comparison between brucellar spondylodiscitis (BSD) and tuberculous spondylodiscitis (TSD) exists in the literature. PURPOSE This study aimed to compare directly the clinical features, laboratory and radiological aspects, treatment, and outcome data of patients diagnosed as BSD and TSD. STUDY DESIGN A retrospective, multinational, and multicenter study was used. PATIENT SAMPLE A total of 641 (TSD, 314 and BSD, 327) spondylodiscitis patients from 35 different centers in four countries (Turkey, Egypt, Albania, and Greece) were included. OUTCOME MEASURES The pre- and peri- or post-treatment spinal deformity and neurologic deficit parameters, and mortality were carried out. METHODS Brucellar spondylodiscitis and TSD groups were compared for demographics, clinical, laboratory, radiological, surgical interventions, treatment, and outcome data. The Student t test and Mann-Whitney U test were used for group comparisons. Significance was analyzed as two sided and inferred at 0.05 levels. RESULTS The median baseline laboratory parameters including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were higher in TSD than BSD (p<.0001). Prevertebral, paravertebral, epidural, and psoas abscess formations along with loss of vertebral corpus height and calcification were significantly more frequent in TSD compared with BSD (p<.01). Surgical interventions and percutaneous sampling or abscess drainage were applied more frequently in TSD (p<.0001). Spinal complications including gibbus deformity, kyphosis, and scoliosis, and the number of spinal neurologic deficits, including loss of sensation, motor weakness, and paralysis were significantly higher in the TSD group (p<.05). Mortality rate was 2.22% (7 patients) in TSD, and it was 0.61% (2 patients) in the BSD group (p=.1). CONCLUSIONS The results of this study show that TSD is a more suppurative disease with abscess formation requiring surgical intervention and characterized with spinal complications. We propose that using a constellation of constitutional symptoms (fever, back pain, and weight loss), pulmonary involvement, high inflammatory markers, and radiological findings will help to differentiate between TSD and BSD at an early stage before microbiological results are available.
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Affiliation(s)
- Hakan Erdem
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey.
| | - Nazif Elaldi
- Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Sani Aliyu
- Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Gonul Sengoz
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Filiz Pehlivanoglu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ergys Ramosaco
- University Hospital Center "Mother Teresa", Infectious Diseases Hospital, Tirana, Albania
| | - Serda Gulsun
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Birgul Mete
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Dilek Yildiz Sevgi
- Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Efthymia Giannitsioti
- Department of Internal Medicine, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Archontoula Fragou
- Department of Internal Medicine, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Selcuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Birsen Cetin
- Department of Infectious Diseases and Clinical Microbiology, Koc University School of Medicine, Istanbul, Turkey
| | - Tunc Oktenoglu
- Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
| | - Aygul DoganCelik
- Department of Infectious Diseases and Clinical Microbiology, Trakya University School of Medicine, Edirne, Turkey
| | - Banu Karaca
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Elif Sahin Horasan
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Mehmet Ulug
- Department of Infectious Diseases and Clinical Microbiology, Private Umit Hospital, Eskisehir, Turkey
| | - Asuman Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Safak Kaya
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Esra Arslanalp
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Selma Ates-Guler
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Sutcu Imam University, Kahramanmaras, Turkey
| | - Ayse Willke
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Sebnem Senol
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Celal Bayar University, Manisa, Turkey
| | - Dilara Inan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ertugrul Guclu
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Gunay Tuncer-Ertem
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - Seniha Senbayrak
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Gonul Cicek-Senturk
- Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training & Research Hospital, Ankara, Turkey
| | - Fatma Sırmatel
- Department of Infectious Diseases and Clinical Microbiology, Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Gulfem Ocal
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Sesin Kocagoz
- Department of Infectious Diseases and Clinical Microbiology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Hulya Kusoglu
- Department of Infectious Diseases and Clinical Microbiology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Tumer Guven
- Department of Infectious Diseases and Clinical Microbiology, Ankara Atatürk Training & Research Hospital, Ankara, Turkey
| | - Ali Irfan Baran
- Department of Infectious Diseases and Clinical Microbiology, Yuzuncuyil University School of Medicine, Van, Turkey
| | - Behiye Dede
- Department of Infectious Diseases and Clinical Microbiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Fatma Yilmaz-Karadag
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hava Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Gonul Aslan
- Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training & Research Hospital, Ankara, Turkey
| | - D Ashraf ALGallad
- Infection Control Unit, Zagazig University Hospitals, Az Zagazig, Egypt
| | - Salih Cesur
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Rehab El-Sokkary
- Infection Control Unit, Zagazig University Hospitals, Az Zagazig, Egypt
| | - Nural Bekiroğlu
- Department of Biostatistics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Haluk Vahaboglu
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
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Arısoy Ö, Altunrende B, Boztaş MH, Gürel S, Sırmatel F, Sercan M. Kognitif Bozukluk, Epileptik Nöbetler, Sol Amigdala/Hippokampal Bölgede Sinyal Artışı ve Belirgin Atrofi ile Seyreden bir Nörosifilis Olgusu. tnd 2014. [DOI: 10.4274/tnd.43534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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