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1. Managing atypical and typical herpetic central nervous system infections: results of a multinational study

Author

Signe Maj Sørensen, Jean-Paul Stahl, Seher Ayten Coskuner, Pierre Tattevin, Mauro Maresca, Sibel Bolukcu, Oğuz Reşat Sipahi, Rosa Fontana, Lykke Larsen, Xavier Argemi, Lenka Baštáková, Guillaume Béraud, Mario Poljak, Gamze Kilicoglu, Matjaž Jereb, Bruno Baršić, Akram Al-Mahdawi, Nevin Ince, Isik Somuncu Johansen, Filiz Pehlivanoglu, Sylviane Defres, Hasan Karsen, Yasemin Akkoyunlu, Asuman Inan, Souha S. Kanj, Hava Yilmaz, Nazif Elaldi, Elif Sahin-Horasan, Jesper Damsgaard Gunst, Emine Parlak, Hulya Tireli, Hakan Erdem, Anne Lisbeth Bohr, Fatime Korkmaz, Oguz Karabay, Haluk Vahaboglu, Gulden Yilmaz, Ghaydaa A. Shehata, Süheyla Kömür, Stephen L. Leib, Mahtab Chehri, Salih Atakan Nemli, Abdullah Umut Pekok, Sukran Kose, Derya Ozturk-Engin, Seniha Senbayrak, Mehmet Ulug, Gulistan Halac, Mustafa Sunbul, Gonul Sengoz, Selçuk Kaya, Ahmad Sharif-Yakan, Yasemin Cag, Institute of Microbiology and Immunology, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Fonction, structure et inactivation d'ARN bactériens, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire [Grenoble] (CHU), Cumhuriyet Universitesi, AKKOYUNLU, YASEMİN, Institute of Microbiology and Immunology - Inštitut za mikrobiologijo in imunologijo [Ljubljana, Slovenia], Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Ege Üniversitesi, [Cag, Y.] Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erdem, H.] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Leib, S.] Univ Bern, Inst Infect Dis, CH-3012 Bern, Switzerland -- [Defres, S.] Univ Liverpool, Inst Infect & Global Hlth, Liverpool L69 3BX, Merseyside, England -- [Defres, S.] Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Trop Infect Dis Unit, Liverpool, Merseyside, England -- [Kaya, S.] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Larsen, L. -- Johansen, I. S.] Odense Univ Hosp, Dept Infect Dis Q, Odense, Denmark -- [Poljak, M.] Univ Ljubljana, Inst Microbiol & Immunol, Fac Med, Ljubljana, Slovenia -- [Ozturk-Engin, D. -- Bolukcu, S. -- Inan, A. -- Senbayrak, S.] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Barsic, B.] Univ Zagreb, Dr Fran Mihaljev Univ Hosp Infect Dis, Dept Infect Dis, Sch Med, Zagreb, Croatia -- [Argemi, X.] Nouvel Hop Civil, Dept Infect Dis, Strasbourg, France -- [Sorensen, S. M.] Aalborg Univ Hosp, Dept Infect Dis, Aalborg, Denmark -- [Bohr, A. L.] Rigshosp, Copenhagen Univ Hosp, Inst Inflammat Res, Dept Infect Dis & Rheumatol, Copenhagen, Denmark -- [Tattevin, P.] Univ Hosp Pontchaillou, Dept Infect & Trop Dis, Rennes, France -- [Gunst, J. D.] Aarhus Univ Hosp, Dept Infect Dis, Aarhus, Denmark -- [Bastakova, L.] Masaryk Univ, Fac Hosp Brno, Dept Infect Dis, Fac Med, Brno, Czech Republic -- [Jereb, M.] Univ Med Ctr, Dept Infect Dis, Ljubljana, Slovenia -- [Karabay, O.] Sakarya Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Sakarya, Turkey -- [Pekok, A. U.] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Sipahi, O. R.] Ege Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Izmir, Turkey -- [Chehri, M.] Hvidovre Univ Hosp, Dept Infect Dis, Copenhagen, Denmark -- [Beraud, G.] Univ Poitiers Hosp, Dept Infect Dis, Poitiers, France -- [Shehata, G.] Assiut Univ Hosp, Dept Neurol & Psychiat, Assiut, Egypt -- [Fontana, R. -- Maresca, M.] Univ Catania, Infect Dis Sect, Dept Clin & Mol Biomed, Catania, Italy -- [Karsen, H.] Harran Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sanliurfa, Turkey -- [Sengoz, G. -- Pehlivanoglu, F.] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Sunbul, M. -- Yilmaz, H.] Ondokuz Mayis Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Samsun, Turkey -- [Yilmaz, G.] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Sharif-Yakan, A. -- Kanj, S.] Amer Univ Beirut, Med Ctr, Beirut, Lebanon -- [Parlak, E.] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Korkmaz, F.] Konya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Komur, S.] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Kose, S.] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Ulug, M.] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Coskuner, S. A.] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Stahl, J. P.] Univ Grenoble 1, Grenoble, France -- [Stahl, J. P.] Univ Hosp Grenoble, Dept Infect Dis, Grenoble, France -- [Ince, N.] Duzce Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Duzce, Turkey -- [Akkoyunlu, Y.] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Halac, G.] Bezmi Alem Vakif Univ, Sch Med, Dept Neurol, Istanbul, Turkey -- [Sahin-Horasan, E.] Mersin Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Mersin, Turkey -- [Tireli, H.] Haydarpasa Numune Training & Res Hosp, Dept Neurol, Istanbul, Turkey -- [Kilicoglu, G.] Haydarpasa Numune Training & Res Hosp, Dept Radiol, Istanbul, Turkey -- [Al-Mahdawi, A.] Baghdad Teaching Hosp, Dept Neurol, Baghdad, Iraq -- [Nemli, S. A.] Katip Celebi Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Izmir, Turkey -- [Vahaboglu, H.] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, N.] Cumhuriyet Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Sivas, Turkey, Ghaydaa, Shehata -- 0000-0002-3631-893X, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Kanj, Souha -- 0000-0001-6413-3396, Beraud, Guillaume -- 0000-0002-4705-0916, Gunst, Jesper -- 0000-0002-3787-0259, Stahl, Jean Paul -- 0000-0002-0086-3557, johansen, isik somuncu -- 0000-0002-2189-9823, Larsen, Lykke -- 0000-0002-4113-4182, Karabay, Oguz -- 0000-0003-0502-432X, OMÜ, Cag, Y, Erdem, H, Leib, S, Defres, S, Kaya, S, Larsen, L, Poljak, M, Ozturk-Engin, D, Barsic, B, Argemi, X, Sorensen, SM, Bohr, AL, Tattevin, P, Gunst, JD, Bastakova, L, Jereb, M, Johansen, IS, Karabay, O, Pekok, AU, Sipahi, OR, Chehri, M, Beraud, G, Shehata, G, Fontana, R, Maresca, M, Karsen, H, Sengoz, G, Sunbul, M, Yilmaz, G, Yilmaz, H, Sharif-Yakan, A, Kanj, S, Parlak, E, Pehlivanoglu, F, Korkmaz, F, Komur, S, Kose, S, Ulug, M, Bolukcu, S, Coskuner, SA, Stahl, JP, Ince, N, Akkoyunlu, Y, Halac, G, Sahin-Horasan, E, Tireli, H, Kilicoglu, G, Al-Mahdawi, A, Nemli, SA, Inan, A, Senbayrak, S, Vahaboglu, H, Elaldi, N, Sakarya Üniversitesi/İlahiyat Fakültesi/Temel İslam Bilimleri Bölümü, Kaya, Süleyman, Karabay, Oğuz, and Çukurova Üniversitesi

Subjects
Male, Pathology, [SDV]Life Sciences [q-bio], encephalitis, Electroencephalography, medicine.disease_cause, Polymerase Chain Reaction, 0302 clinical medicine, Cerebrospinal fluid, 030212 general & internal medicine, Cerebrospinal Fluid, Aged, 80 and over, medicine.diagnostic_test, Atypical presentation, Brain, meningitis, General Medicine, Middle Aged, Magnetic Resonance Imaging, 3. Good health, Infectious Diseases, medicine.anatomical_structure, results of a multinational study-, Clinical Microbiology And Infection, cilt.22, ss.568-569, 2016 [Akkoyunlu Y., Çağ Y., -Managing atypical and typical herpetic central nervous system infections], Female, Presentation (obstetrics), Encephalitis, Adult, Microbiology (medical), medicine.medical_specialty, Adolescent, Central nervous system, Microbiology, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Journal Article, Humans, Aged, Retrospective Studies, managing, Diagnostic Tests, Routine, business.industry, Magnetic resonance imaging, medicine.disease, herpes simplex virus, Herpes simplex virus, Concomitant, DNA, Viral, Encephalitis, Herpes Simplex, business, 030217 neurology & neurosurgery
Abstract

WOS: 000379252100027, PubMed ID: 27085724, There have been many studies pertaining to the management of herpetic meningoencephalitis (HME), but the majority of them have focussed on virologically unconfirmed cases or included only small sample sizes. We have conducted a multicentre study aimed at providing management strategies for HME. Overall, 501 adult patients with PCR-proven HME were included retrospectively from 35 referral centres in 10 countries; 496 patients were found to be eligible for the analysis. Cerebrospinal fluid (CSF) analysis using a PCR assay yielded herpes simplex virus (HSV)-1 DNA in 351 patients (70.8%), HSV-2 DNA in 83 patients (16.7%) and undefined HSV DNA type in 62 patients (12.5%). A total of 379 patients (76.4%) had at least one of the specified characteristics of encephalitis, and we placed these patients into the encephalitis presentation group. The remaining 117 patients (23.6%) had none of these findings, and these patients were placed in the nonencephalitis presentation group. Abnormalities suggestive of encephalitis were detected in magnetic resonance imaging (MRI) in 83.9% of the patients and in electroencephalography (EEG) in 91.0% of patients in the encephalitis presentation group. In the nonencephalitis presentation group, MRI and EEG data were suggestive of encephalitis in 33.3 and 61.9% of patients, respectively. However, the concomitant use of MRI and EEG indicated encephalitis in 96.3 and 87.5% of the cases with and without encephalitic clinical presentation, respectively. Considering the subtle nature of HME, CSF HSV PCR, EEG and MRI data should be collected for all patients with a central nervous system infection. (C) 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Published
2016
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2. Results of a multinational study suggest the need for rapid diagnosis and early antiviral treatment at the onset of herpetic meningoencephalitis

Author

Pierre Tattevin, Salih Atakan Nemli, Hasan Karsen, Mustafa Sunbul, Rosa Fontana Del Vecchio, Akram Al-Mahdawi, Mahtab Chehri, Süheyla Kömür, Sylviane Defres, Bruno Baršić, Signe Maj Sørensen, Seniha Senbayrak, Ghaydaa A. Shehata, Nevin Ince, Abdullah Umut Pekok, Selçuk Kaya, Yasemin Akkoyunlu, Gulden Yilmaz, Jean-Paul Stahl, Lykke Larsen, Lenka Baštáková, Gonul Sengoz, Jesper Damsgaard Gunst, Guillaume Béraud, Emine Parlak, Hakan Erdem, Sukran Kose, Oğuz Reşat Sipahi, Hava Yilmaz, Filiz Pehlivanoglu, Xavier Argemi, Asuman Inan, Hulya Tireli, Haluk Vahaboglu, Elif Sahin-Horasan, Souha S. Kanj, Gamze Kilicoglu, Fatime Korkmaz, Anne Lisbeth Bohr, Oguz Karabay, Mehmet Ulug, Gulistan Halac, Derya Ozturk-Engin, Seher Ayten Coskuner, Mario Poljak, Mauro Maresca, Sibel Bolukcu, Ahmad Sharif-Yakan, Yasemin Cag, Isik Somuncu Johansen, Matjaž Jereb, Ege Üniversitesi, AKKOYUNLU, YASEMİN, Erdem, H, Cag, Y, Ozturk-Engin, D, Defres, S, Kaya, S, Larsen, L, Poljak, M, Barsic, B, Argemi, X, Sorensen, SM, Bohr, AL, Tattevin, P, Gunst, JD, Bastakova, L, Jereb, M, Johansen, IS, Karabay, O, Pekok, AU, Sipahi, OR, Chehri, M, Beraud, G, Shehata, G, Del Vecchio, RF, Maresca, M, Karsen, H, Sengoz, G, Sunbul, M, Yilmaz, G, Yilmaz, H, Sharif-Yakan, A, Kanj, SS, Parlak, E, Pehlivanoglu, F, Korkmaz, F, Komur, S, Kose, S, Ulug, M, Bolukcu, S, Coskuner, SA, Ince, N, Akkoyunlu, Y, Halac, G, Sahin-Horasan, E, Tireli, H, Kilicoglu, G, Al-Mandawi, A, Nemli, SA, Inan, A, Senbayrak, S, Stahl, JP, Vahaboglu, H, Sakarya Üniversitesi/İlahiyat Fakültesi/Temel İslam Bilimleri Bölümü, Kaya, Süleyman, Karabay, Oğuz, Çukurova Üniversitesi, and OMÜ

Subjects
Adult, Male, medicine.medical_specialty, Referral, Antiviral Agents, Internal medicine, medicine, ERDEM H., CAG Y., OZTURK-ENGIN D., Defres S., KAYA S., LARSEN L., POLJAK M., BARSIC B., ARGEMI X., SORENSEN S. M. , et al., -Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis-, ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, cilt.59, ss.3084-3089, 2015, Confidence Intervals, Humans, Pharmacology (medical), Pharmacology & Pharmacy, Antiviral treatment, Retrospective Studies, Pharmacology, business.industry, Herpetic meningoencephalitis, Glasgow Coma Scale, Retrospective cohort study, Odds ratio, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Surgery, Infectious Diseases, Treatment Outcome, Female, Encephalitis, Herpes Simplex, business, Encephalitis
Abstract

WOS: 000358623200015, PubMed ID: 25779579, Data in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome.

Published
2015
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3. Epicardial Fat Thickness in Patients with Prediabetes and Correlation with Other Cardiovascular Risk Markers

Author

Murat Akçay, Abdullah Nabi Aslan, Burcak Polat Ugurlu, Dilek Arpaci, Bekir Cakir, Reyhan Ersoy, Arpaci, D, Ugurlu, BP, Aslan, AN, Ersoy, R, Akcay, M, Cakir, B, Sakarya Üniversitesi/İlahiyat Fakültesi/Temel İslam Bilimleri Bölümü, and Akçay, Mustafa

Subjects
Adult, Blood Glucose, Male, medicine.medical_specialty, Waist, endocrine system diseases, Blood Pressure, Body Mass Index, Impaired glucose tolerance, Prediabetic State, chemistry.chemical_compound, High-density lipoprotein, Risk Factors, Diabetes mellitus, Internal medicine, General & Internal Medicine, Glucose Intolerance, Internal Medicine, Medicine, Humans, Prediabetes, Triglycerides, Aged, Glycated Hemoglobin, business.industry, nutritional and metabolic diseases, General Medicine, Middle Aged, medicine.disease, Impaired fasting glucose, Postprandial, chemistry, Cardiovascular Diseases, Echocardiography, Cardiology, Female, Waist Circumference, business, Body mass index, Pericardium
Abstract

OBJECTIVE Prediabetes is a condition between a normal metabolic state and diabetes mellitus, which includes impaired glucose tolerance (IGT), impaired fasting glucose (IFG), or both. Prediabetes is related with undesirable cardiovascular outcomes. Epicardial fat thickness (EFT) has been correlated with cardiovascular risk factors. We herein aimed to assess EFT in prediabetic patients. METHODS We evaluated 64 patients with prediabetes and 30 age- and gender-matched healthy subjects. Demographic and anthropometric characteristics [age, sex, height, weight, body mass index (BMI), and waist circumference (WC)] and laboratory findings [fasting plasma glucose (FPG), postprandial plasma glucose (PPG), hemoglobin A1c (HbA1c), low density lipoprotein (LDL), high density lipoprotein (HDL), and triglycerides (TG)] were assessed. Transthoracic echocardiography was used to evaluate EFT. RESULTS There were no significant differences between the case and control groups in terms of age, gender, height, HDL, WC, systolic and diastolic blood pressure (SBP/DBP), or TG (p>0.05). Body weight, BMI, FPG, LDL, and, in particular, EFT were found to be significantly higher in the case group than control group (p

Published
2015

4. Liver involvement in patients with brucellosis: results of the Marmara study

Author

D. Ozturk-Engin, H. Erdem, S. Gencer, S. Kaya, A. I. Baran, A. Batirel, R. Tekin, M. K. Celen, A. Denk, S. Guler, M. Ulug, H. Turan, A. U. Pekok, G. Mermut, M. Tasbakan, N. Tulek, Y. Cag, A. Inan, A. Yalci, C. Ataman-Hatipoglu, I. Gonen, A. Dogan-Celik, F. Bozkurt, S. Gulsun, M. Sunnetcioglu, T. Guven, F. Duygu, E. Parlak, H. Sozen, S. Tosun, T. Demirdal, E. Guclu, O. Karabay, N. Uzun, O. Gunal, H. Diktas, A. Haykir-Solay, A. Erbay, C. Kader, O. Aydin, A. Erdem, N. Elaldi, A. Kadanali, Z. Yulugkural, L. Gorenek, M. Altındis, S. Bolukcu, C. Agalar, N. Ormeci, Ozturk-Engin, D, Erdem, H, Gencer, S, Kaya, S, Baran, AI, Batirel, A, Tekin, R, Celen, MK, Denk, A, Guler, S, Ulug, M, Turan, H, Pekok, AU, Mermut, G, Tasbakan, M, Tulek, N, Cag, Y, Inan, A, Yalci, A, Ataman-Hatipoglu, C, Gonen, I, Sakarya Üniversitesi/İlahiyat Fakültesi/Temel İslam Bilimleri Bölümü, Kaya, Süleyman, [Ozturk-Engin, D. -- Inan, A. -- Bolukcu, S.] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erdem, H. -- Gorenek, L.] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Gencer, S. -- Batirel, A. -- Cag, Y.] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kaya, S. -- Gulsun, S.] Diyarbakir Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Baran, A. I. -- Sunnetcioglu, M.] Yuzuncu Yil Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Van, Turkey -- [Tekin, R. -- Celen, M. K. -- Bozkurt, F.] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Denk, A.] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Guler, S.] Yenisehir State Hosp, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Ulug, M.] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Turan, H.] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Pekok, A. U.] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Mermut, G. -- Tosun, S.] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Kaya, S.] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Tasbakan, M.] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Tulek, N. -- Ataman-Hatipoglu, C.] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Yalci, A.] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Gonen, I.] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Dogan-Celik, A. -- Yulugkural, Z.] Trakya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Edirne, Turkey -- [Guven, T.] Yildirim Beyazit Univ, Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Duygu, F. -- Gunal, O.] Gaziosmanpasa Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Tokat, Turkey -- [Parlak, E.] Ataturk Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Erzurum, Turkey -- [Sozen, H.] Sitki Kocman Univ, Sch Med, Dept Anesthesiol & Reanimat, Mugla, Turkey -- [Demirdal, T.] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Guclu, E. -- Karabay, O.] Sakarya Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Sakarya, Turkey -- [Uzun, N.] Sisli Etfal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Diktas, H.] Tatvan Mil Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Haykir-Solay, A.] Igdir State Hosp, Dept Infect Dis & Clin Microbiol, Igdir, Turkey -- [Erbay, A. -- Kader, C.] Bozok Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Yozgat, Turkey -- [Aydin, O.] Medeniyet Univ, Dept Infect Dis & Clin Microbiol, Goztepe Training & Res Hosp, Istanbul, Turkey -- [Erdem, A.] Medeniyet Univ, Dept Pathol, Goztepe Training & Res Hosp, Istanbul, Turkey -- [Elaldi, N.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Kadanali, A.] Umraniye Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Altindis, M.] Sakarya Univ, Sch Med, Dept Clin Microbiol, Sakarya, Turkey -- [Agalar, C.] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ormeci, N.] Ankara Univ, Sch Med, Dept Gastroenterol, TR-06100 Ankara, Turkey, Gencer, Serap -- 0000-0002-3217-6305, Altindis, Mustafa -- 0000-0003-0411-9669, GENCER, SERAP -- 0000-0002-3217-6305, Elaldi, Nazif -- 0000-0002-9515-770X, and Karabay, Oguz -- 0000-0003-0502-432X

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, Anemia, Gastroenterology, Brucellosis, Hepatitis, Young Adult, Internal medicine, medicine, Animals, Humans, Leukocytosis, Transaminases, Retrospective Studies, Doxycycline, Leukopenia, business.industry, Bilirubin, General Medicine, Middle Aged, medicine.disease, Pancytopenia, Surgery, Anti-Bacterial Agents, Infectious Diseases, Treatment Outcome, Female, medicine.symptom, business, Rifampicin, medicine.drug
Abstract

WOS: 000336986700024, PubMed ID: 24557334, Brucellosis is a zoonotic disease that primarily affects the reticuloendothelial system. But, the extent of liver damage in due course of the disease is unclear. This study included 325 brucellosis patients with significant hepatobiliary involvement identified with microbiological analyses from 30 centers between 2000 and 2013. The patients with a parts per thousand yen5 times of the upper limit of normal for aminotransferases, total bilirubin level a parts per thousand yen2 mg/dl or local liver lesions were enrolled. Clinical hepatitis was detected in 284 patients (87.3 %) and cholestasis was detected in 215 (66.1 %) patients. Fatigue (91 %), fever (86 %), sweating (83 %), arthralgia (79 %), and lack of appetite (79 %) were the major symptoms. Laboratory tests showed anemia in 169 (52 %), thrombocytopenia in 117 (36 %), leukopenia in 81 (25 %), pancytopenia in 42 (13 %), and leukocytosis in 20 (6 %) patients. The most commonly used antibiotic combinations were doxycycline plus an aminoglycoside (n = 73), doxycycline plus rifampicin (n = 71), doxycycline plus rifampicin and an aminoglycoside (n = 27). The duration of ALT normalization differed significantly in three treatment groups (p < 0.001). The use of doxycycline and an aminoglycoside in clinical hepatitis showed better results compared to doxycycline and rifampicin or rifampicin, aminoglycoside, doxycycline regimens (p < 0.05). However, the length of hospital stay did not differ significantly between these three combinations (p > 0.05). During the follow-up, treatment failure occurred in four patients (1 %) and relapse was seen in three patients (0.9 %). Mortality was not observed. Hepatobiliary involvement in brucellosis has a benign course with suitable antibiotics and the use of doxycycline and an aminoglycoside regimen seems a better strategy in select patients.

Published
2014

5. The Impact of Membrane Permeability and Dialysate Purity on Cardiovascular Outcomes

Author

Gulay, Asci, Huseyin, Tz, Mehmet, Ozkahya, Soner, Duman, Meltem Sezis, Demirci, Mustafa, Cirit, Savas, Sipahi, Hamad, Dheir, Devrim, Bozkurt, Fatih, Kircelli, Ebru Sevinc, Ok, Sinan, Erten, Muhittin, Ertilav, Timur, Kose, Ali, Basci, Jochen G, Raimann, Nathan W, Levin, Ercan, Ok, Meral, Kayikcioglu, Asci, G, Toz, H, Ozkahya, M, Duman, S, Demirci, MS, Cirit, M, Sipahi, S, Dheir, H, Bozkurt, D, Kircelli, F, Ok, ES, Erten, S, Ertilav, M, Kose, T, Basci, A, Raimann, JG, Levin, NW, Ok, E, Sakarya Üniversitesi/İlahiyat Fakültesi/Temel İslam Bilimleri Bölümü, Duman, Soner, Sipahi, Savaş, Dheir, Hamad, and Ege Üniversitesi

Subjects
Adult, Male, medicine.medical_specialty, Heart Diseases, Membrane permeability, medicine.medical_treatment, Urology, Arteriovenous fistula, Lower risk, Disease-Free Survival, law.invention, Diabetes Complications, Arteriovenous Shunt, Surgical, Randomized controlled trial, Clinical Research, Renal Dialysis, Risk Factors, law, Diabetes mellitus, Prevalence, medicine, Humans, Dialysis, Aged, Proportional Hazards Models, business.industry, Proportional hazards model, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Membranes, Artificial, General Medicine, Middle Aged, Urology & Nephrology, medicine.disease, Hemodialysis Solutions, Surgery, ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, ComputingMethodologies_PATTERNRECOGNITION, Cardiovascular Diseases, Nephrology, Kidney Failure, Chronic, Female, Hemodialysis, InformationSystems_MISCELLANEOUS, business, Follow-Up Studies
Abstract

WOS: 000319784600020, PubMed ID: 23620396, The effects of high-flux dialysis and ultrapure dialysate on survival of hemodialysis patients are incompletely understood. We conducted a randomized controlled trial to investigate the effects of both membrane permeability and dialysate purity on cardiovascular outcomes. We randomly assigned 704 patients on three times per week hemodialysis to either high- or low-flux dialyzers and either ultrapure or standard dialysate using a two-by-two factorial design. The primary outcome was a composite of fatal and nonfatal cardiovascular events during a minimum 3 years follow-up. We did not detect statistically significant differences in the primary outcome between high- and low-flux (HR=0.73, 95% CI=0.49 to 1.08, P=0.12) and between ultrapure and standard dialysate (HR=0.90, 95% CI=0.61 to 1.32, P=0.60). Posthoc analyses suggested that cardiovascular event-free survival was significantly better in the high-flux group compared with the low-flux group for the subgroup with arteriovenous fistulas, which constituted 82% of the study population (adjusted HR=0.61, 95% CI=0.38 to 0.97, P=0.03). Furthermore, high-flux dialysis associated with a lower risk for cardiovascular events among diabetic subjects (adjusted HR=0.49, 95% CI=0.25 to 0.94, P=0.03), and ultrapure dialysate associated with a lower risk for cardiovascular events among subjects with more than 3 years of dialysis (adjusted H R=0.55, 95% CI=0.31 to 0.97, P=0.04). In conclusion, this trial did not detect a difference in cardiovascular event-free survival between flux and dialysate groups. Posthoc analyses suggest that high-flux hemodialysis may benefit patients with an arteriovenous fistula and patients with diabetes and that ultrapure dialysate may benefit patients with longer dialysis vintage., Fresenius Medical Care, Turkey, The study was supported by Fresenius Medical Care, Turkey, with an unrestricted grant.

Published
2013

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