40 results on '"Özaras, Reşat"'
Search Results
2. Early Viral Kinetics in Patients with Chronic Hepatitis C Treated with Direct-Acting Antivirals
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Garashova, Dilruba, primary, Balkan, İlker İnanç, additional, Özaras, Reşat, additional, Kuşkucu, Mert Ahmet, additional, Özdil, Ayşenur, additional, Mustafayev, Khalis, additional, Yıldız Kaya, Sibel, additional, Karaali, Rıdvan, additional, Mete, Bilgül, additional, Aygün, Gökhan, additional, Saltoğlu, Neşe, additional, and Tabak, Ömer Fehmi, additional
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- 2023
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3. Discontinuation of Nucleos(t)ide Analog treatment in HBeAg-Negative Non-Cirrhotic Chronic Hepatitis B Patients: Real-Life Data of 20 Years.
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Mete, Bilgül, Yıldız Kaya, Sibel, Kaya, Abdurrahman, Kurt, Ahmet Furkan, Bayramlar, Osman Faruk, Karaali, Rıdvan, Balkan, İlker İnanç, Yemişen, Mücahit, Özaras, Reşat, Saltoğlu, Neşe, and Tabak, Fehmi
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- 2023
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4. COVID 19 and febrile neutropenia: Case report and systematic review
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Kaya, Taner, Dilek, Ahmet, Özaras, Reşat, Balçık, Özlem Şahin, Leblebicioğu, Hakan, İstinye Üniversitesi, Hastane, Ahmet Dilek / 0000-0001-7111-2438, and Dilek, Ahmet
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Objectives: In pandemic conditions, patients with febrile neutropenia are also at risk of COVID-19. Aim of this systematic review is to evaluate COVID-19 cases presented with febrile neutropenia and provide information regarding incidence, clinical course and prognosis. Methods: We systematically searched on COVID-19 and febrile neutropenia cases in PubMed, SCOPUS and Web of Science. Results: A total of 19 febrile neutropenic patients were analyzed. A male predominance was noted. Eleven cases had hematological malignancies. Fourteen of the cases were previously received chemotherapy. Five patients had severe neutropenia: 3 had hematologic cancer and none died. 17 (89.5%) cases have pulmonary involvement and seven of them had severe disease with acute respiratory distress syndrome (ARDS). Three cases with ARDS were died. 12 of them received G-CSF for treatment. Five cases were developed respiratory failure after G-CSF use. Overall mortality was 15.8%, while death was not observed in patients without malignancy and solid organ tumors, the mortality rate was 27% in cases with hematological malignancies. Conclusion: In ongoing pandemic, febrile neutropenic patients should be precisely evaluated for COVID-19 disease. It should be remembered that there may not be typical signs and symptoms and laboratory findings of COVID-19 disease because of the immunosuppression. © 2022 Elsevier Ltd
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- 2022
5. The Effect of the Administration of Interferon and Steroids on Regulatory T-cells in the Liver, Spleen, and Bone Marrow of Mice.
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Zerdali, Esra, Özpınar, Esra, Akdoğan, Ecem, Mete, Bilgül, Saltoğlu, Neşe, Tabak, Fehmi, and Özaras, Reşat
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IMMUNOLOGICAL tolerance ,FLOW cytometry ,STEROIDS ,LIVER ,ANIMAL experimentation ,REGULATORY T cells ,IMMUNOMODULATORS ,MACROPHAGES ,INTERFERONS ,PORTAL vein ,ABDOMINAL surgery ,SPLEEN ,BONE marrow ,MICE - Abstract
Copyright of Viral Hepatitis Journal / Viral Hepatit Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2022
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6. COVID-19-associated mucormycosis: case report and systematic review
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Dilek, Ahmet, Özaras, Reşat, Özkaya, Şevket, Sünbül, Mustafa, Sen, Elif Itir, Leblebicioglu, Hakan, İstinye Üniversitesi, and Dilek, Ahmet
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Coronavirus ,Fungal Infections ,Mucor ,COVID-19 ,Mucormycosis - Abstract
Background: Increasing number of patients with COVID-19-associated mucormycosis have been reported, especially from India recently. We have described a patient with COVID-19-associated mucormycosis and, searched and analyzed current medical literature to delineate the characteristics of COVID-19-associated mucormycosis. Method: We reported a patient developed mucormycosis during post-COVID period. We searched literature to describe the incidence, clinical features, and outcomes of COVID-19-associated mucormycosis. Demographic features, risk factors, clinical features, diagnostic methods, treatment and outcome were analyzed. Results: We describe a 54-year-old male, hospitalized due to severe COVID-19 pneumonia. He was given long-term, high doses of systemic steroids. He developed maxillo-fascial mucormycosis and died of sepsis. Our literature search found 30 publications describing 100 patients including present case report. The majority (n = 68) were reported from India. 76% were male. The most commonly seen risk factors were corticosteroid use (90.5%), diabetes (79%), and hypertension (34%). Also, excessive use of broad-spectrum antibiotics were noted in cases. Most frequent involvements were rhino-orbital (50%), followed by rhino-sinusal (17%), and rhino-orbito-cerebral (15%). Death was reported as 33 out of 99 patients (33,3%). Conclusions: Steroid use, diabetes, environmental conditions, excessive use of antibiotics, and hypoxia are main risk factors. Despite medical and surgical treatment, mortality rate is high. A multidisciplinary approach is essential to improve the conditions facilitating the emergence of COVID-19-associated mucormycosis. WOS:000703570700003 34454090 Q1
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- 2021
7. The Prevalence and Etiology of Hepatic Granulomas in Turkey: A Systematic Review
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URAZ, Süleyman, primary, ZERDALİ, Esra, additional, DEMİREL, Aslıhan, additional, METE, Bilgül, additional, TABAK, Fehmi, additional, and ÖZARAS, Reşat, additional
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- 2020
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8. Recommendations for Intra-abdominal Infections “Consensus Report”
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AVKAN-OĞUZ, Vildan, primary, BAYKAM, Nurcan, additional, SÖKMEN, Selman, additional, GÜNER, Rahmet, additional, AĞALAR, Fatih, additional, ALP, Emine, additional, DOĞRUL, Ahmet, additional, TURHAN, Özge, additional, AĞALAR, Canan, additional, KURTARAN, Behice, additional, GEÇİM, İbrahim Ethem, additional, ÖZARAS, Reşat, additional, YILMAZ, Gürdal, additional, AKBULUT, Ayhan, additional, and KÖKSAL, İftihar, additional
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- 2018
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9. Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study
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Işlak Mutcalı, Sibel, primary, Saltoğlu, Neşe, additional, Balkan, İlker İnanç, additional, Özaras, Reşat, additional, Yemişen, Mücahit, additional, Mete, Bilgül, additional, Tabak, Fehmi, additional, Mert, Ali, additional, Öztürk, Recep, additional, Öngören, Şeniz, additional, Başlar, Zafer, additional, Aydın, Yıldız, additional, Ferhanoğlu, Burhan, additional, and Soysal, Teoman, additional
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- 2016
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10. Hastaneye yatırılan hastalarda poliserozit etyolojisi: 40 hastanın değerlendirilmesi
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TABAK, Ömür, ŞENATEŞ, Ebubekir, ARSLAN, Ferhat, and ÖZARAS, Reşat
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Poliserozit,malignite,kollajen hastalıklar,enfeksiyon ,Polyserositis,malignancy,collagen vascular diseases,infection - Abstract
Background and aims: Polyserositis is defined as inflammation of more than one serous membrane. In this retrospective study, we aimed to investigate the patients diagnosed with polyserositis who were hospitalized. Materials and Methods: Between 1 January 2001 and 31 December 2004, 12,485 patients were hospitalized in the Internal Medicine Services of Istanbul University, Cerrahpasa Medical Faculty. Forty patients with polyserositis were determined, and these patients were carefully examined with respect to demographic, clinical and etiologic characteristics. Results: Totally, 40 (22 female, 18 male) of 12,485 patients were diagnosed with polyserositis (0.3%). The most frequent etiology of polyserositis was malignancy (15 patients) (4 patients were diagnosed with non-Hodgkin lymphoma, 2 with ovarian cancer, 2 with sarcoma, and 1 patient each with lung, breast, gastric, cervical, endometrial cancer, Burkitt's lymphoma, metastatic adenocarcinoma to the liver of unknown primary origin and hepatocellular cancer developed from liver cirrhosis due to chronic hepatitis B and C). The second most frequent cause of polyserositis was collagen vascular disease, determined in 9 patients (22.5%) (7 with Behçet's disease, 2 with systemic lupus erythematosus). The other etiologies of polyserositis in order of frequency were tuberculosis (8 patients), idiopathic (3 patients) and other (2 with portal venous thrombosis, 2 with peritonitis with background of chronic renal failure and hypothyroid and 1 with peritonitis with background of congestive heart failure). The most frequent presenting symptom was malaise and the most frequent finding was edema. Conclusions: The most frequent etiology of polyserositis in our study was malignancy. The other causes were collagen vascular diseases, infections and idiopathic causes. We suggest that it will be useful to evaluate patients with polyserositis in light of these data., Giriş ve Amaç: Poliserozit birden fazla seröz zarın inflamasyonuna verilen addır. Poliserozite değişik hastalıklar neden olabilmektedir. Biz bu çalışmada hastaneye yatırılan ve poliserozit saptanan olgularımızı ayrıntılı olarak incelemeyi amaçladık. Gereç ve Yöntem: Cerrahpaşa Tıp Fakültesi, İç Hastalıkları Anabilim Dalı'nda 1 Ocak 2001 ve 31 Aralık 2004 tarihleri arasında yatırılarak tetkik edilen toplam 12,485 hastanın dosyası ayrıntılı şekilde incelendi. Poliserozit saptanan 40 olgu demografik, klinik ve etyolojik açıdan ele alındı. Bulgular: Toplam 12,485 hastanın 40'ı (%0.3) poliserozit tanısı almıştı (22 kadın, 18 hasta). Bu hastalarda poliserozitin en sık nedeni 15 hasta (%37.5) ile maligniteler idi (4 hastada Non-Hodgkin Lenfoma, 2'sinde over kanseri, 2'sinde sarkom, birer hastada ise akciğer, meme, mide, serviks ve endometrium kanseri, Burkitt lenfoması, primeri bilinmeyen karaciğere metastaz yapmış adenokanser ve Hepatit B ve Hepatit C zemininde gelişen hepatosellüler kanser). İkinci en sık neden ise 9 hasta ile (%22.5) kollajen bağ dokusu hastalıkları idi (7 hastada Behçet hastalığı ve 2 hastada sistemik lupus eritematozus). Diğer poliserozit nedenleri ise sıklık sırasıyla tüberküloz (8 hasta, %20), idyopatik (3 hasta, %7.5) ve diğer nedenler (2 hastada portal ven trombozu, 2 hastada kronik böbrek yetmezliği ve hipotiroidi zemininde peritonit, 1 hastada konjestif kalp yetmezliği ve peritonit) idi. En sık başvuru semptomu halsizlik, en sık fizik muayene bulgusu ise ödem idi. Sonuç: Çalışmamızda poliserozitin en sık nedeni maligniteler idi. Diğer nedenler ise sıklık sırasıyla bağ dokusu hastalıkları, enfeksiyonlar ve idyopatik nedenler idi. Poliserozitli bir hasta ile karşılaşıldığında bu bulgular ışığında değerlendirmenin yararlı olacağını düşünmekteyiz.
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- 2015
11. Herpes simplex virus encephalitis: clinical manifestations, diagnosis and outcome in 106 adult patients
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Sili, Uluhan, Kaya, Abdurrahman, Mert, Ali, Özaras, Reşat, Midilli, Kenan, Albayram, Sait, Kenangil, Gülay, Demirci, Onat, Kapmaz, Mahir, Kart Yaşar, Kadriye, Özyavuz Alp, Şehnaz, and Ünal Kayaaslan, Bircan
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Adult ,Male ,medicine.medical_specialty ,Pathology ,Adolescent ,Acyclovir ,Disease ,medicine.disease_cause ,Antiviral Agents ,Polymerase Chain Reaction ,Interviews as Topic ,Young Adult ,Virology ,Internal medicine ,Case fatality rate ,Viral Encephalitis ,medicine ,Humans ,Simplexvirus ,Young adult ,Aged ,Cerebrospinal Fluid ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Viral encephalitis ,Brain ,Retrospective cohort study ,Odds ratio ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Prognostic Factorsa ,Herpes Simplex Virus ,Radiography ,Infectious Diseases ,Herpes simplex virus ,Treatment Outcome ,DNA, Viral ,Female ,Encephalitis, Herpes Simplex ,business ,Encephalitis - Abstract
WOS: 000335738000006 PubMed ID: 24768322 Background: Herpes simplex virus (HSV) is one of the most common causes of sporadic encephalitis worldwide. Objective: We aimed to determine clinical characteristics and prognosis of HSV encephalitis (HSVE) cases reviewed retrospectively from several collaborating centers. Study design: We searched hospital archives of the last 10 years for patients with HSVE diagnosis, i.e. clinical presentation compatible with encephalitis and brain involvement on magnetic resonance imaging (MRI) and/or detection of HSV DNA in the cerebrospinal fluid by polymerase chain reaction (PCR). Clinical characteristics were noted and patients were phone-interviewed. HSVE cases were grouped and analyzed as proven and probable, based on virological confirmation by PCR. Univariate and multivariate analyses were used to determine factors associated with prognosis. Results: A total of 106 patients (63 males and 43 females; mean age, 44 years; range, 18-83 years) were included. Most common symptoms were changes in mental status, fever, headache, and seizure. HSV PCR was positive in 69% of patients tested, while brain involvement was detected on MRI in 95%. Acyclovir was started mostly within five days of main symptom and continued for >= 14 days. Case fatality rate was 8%, while 69% of patients recovered with sequelae. Favorable prognosis was observed in 73% of patients. Multivariate analysis identified the duration of disease before hospital admission (odds ratio (OR) = 1.24) and the extent of brain involvement on MRI at the time of admission (OR = 37.22) as two independent risk factors associated with poor prognosis. Conclusions: Although HSVE fatality regressed considerably with acyclovir treatment, many patients survive with sequelae. Our results emphasize the importance of early diagnosis and prompt treatment of HSVE.
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- 2014
12. Comparison of cellular immunity in patients with chronic hepatitis B, inactive hepatitis B surface antigen carriers and spontaneously recovered individuals
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Arslan, Ferhat, Mert, Ali, Sili, Uluhan, Tabak, Fehmi, Öztürk, Recep, and Özaras, Reşat
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Interferon Gamma ,ELISPOT Assay ,virus diseases ,Chronic Hepatitis B ,digestive system diseases - Abstract
WOS: 000346326500036 PubMed ID: 25699376 Different clinical outcomes of acute HBV infection have been partially explained by individual differences in immune response. In this study We investigated interferon gamma (IFN-gamma) secretion of peripheral blood mononuclear cells (PBMC) in vitro against specific (Hepatitis B core antigen; recombinant HBcAg) and non-specific (CMV, EBV, Influenza peptide pool; CTL CFF peptide pool "plus") antigens using enzyme linked immunospot (ELISPOT) assay in 7 patients with chronic hepatitis B (CHB group), 8 inactive carriers of HBV (carrier group) and 8 subjects who spontaneously recovered from acute HBV infection as detected by anti-HBs positivity (immune group). Phytohemaglutinin served as the positive test control. Response against recombinant HBcAg was 88 +/- 35, 50 +/- 110, 105 +/- 150 spot forming cell (SFC) /10(5) PBMC, in CHB, carrier and immune groups, respectively. HBeAg-specific T-cell response was slightly higher in the immune group; however, statistically there was no significant difference between the groups. Assessment of cellular immunity by IFN-gamma ELISPOT was not sufficient to explain the various outcomes of HBV infection such as resolution, chronicity and carriership.
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- 2014
13. The Changing Epidemiology of Bloodstream Infections and Resistance in Hematopoietic Stem Cell Transplantation Recipients
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Yemişen, Mücahit, primary, Balkan, İlker İnanç, additional, Salihoğlu, Ayşe, additional, Eskazan, Ahmet Emre, additional, Mete, Bilgül, additional, Ar, M. Cem, additional, Öngören, Şeniz, additional, Başlar, Zafer, additional, Özaras, Reşat, additional, Saltoğlu, Neşe, additional, Mert, Ali, additional, Ferhanoğlu, Burhan, additional, Öztürk, Recep, additional, Tabak, Fehmi, additional, and Soysal, Teoman, additional
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- 2016
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14. Pelvic and retroperitoneal hydatid cysts superinfected with Brucella sp and review of infected hydatid cysts
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Arslan, Ferhat, Zengin, Kağan, Mert, Ali, Özaras, Reşat, and Tabak, Fehmi
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Pelvic and Retroperitoneal ,parasitic diseases ,digestive system diseases ,Hydatid Cysts ,Brucella Sp. and Review - Abstract
WOS: 000316804600012 PubMed ID: 23665713 Hydatid disease is a zoonotic infection resulting from the tissue infestation of the larval stage of the parasite Echinococcus granulosus. Hydatid cysts superinfected with pyogenic organisms have been reported previously. Brucellosis is more prevalent in people with close contact to animals and those consuming fresh milk or fresh milk products. Although these two disorders have some similar epidemiological features, we did not encounter any hydatid cyst cases superinfected with Brucella species (sp.) in a search of medical literature (Pubmed). Here, we present a case of hydatid cyst disease superinfected with Brucella and review the literature on other hydatid cyst cases superinfected with pyogenic organisms. We conclude that in regions where brucellosis and hydatid cysts are endemic, cysts may be infected with Brucella sp.
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- 2013
15. Aspergillus fumigatus infection as a delayed manifestation of prosthetic knee arthroplasty and a review of the literature
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Yılmaz, Mesut, Mete, Bilgül, Özaras, Reşat, Kaynak, Gökhan, Tabak, Fehmi, Tenekecioğlu, Yüksel, and Öztürk, Recep
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Aspergillus Fumigatus ,Total Knee Arthroplasty ,Amphotericin B ,Prosthetic Infection - Abstract
WOS: 000292777800002 PubMed ID: 21526903 Fungal infection after total joint arthroplasty is a very rare but serious complication and a challenge to the treating and consulting physicians. The literature includes little information about the treatment protocol for Aspergillus infection after total knee arthroplasty, since only 3 cases have been reported. We describe the case of a non-immunocompromised patient who lacked predisposing risk factors and presented with pain and swelling. An aspiration under sterile conditions revealed Aspergillus fumigatus. The patient was treated successfully with a 2-stage exchange reimplantation and 6-week course of liposomal amphotericin B. At 4 y after reimplantation, the patient had no evidence of infection or pain.
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- 2011
16. Secondary Infections in Febrile Neutropenia in Hematological Malignancies: More Than Another Febrile Neutropenic Episode
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Demirel, Aslıhan, primary, Tabak, Fehmi, additional, Ar, M. Cem, additional, Mete, Bilgül, additional, Öngören, Şeniz, additional, Yemişen, Mücahit, additional, Özaras, Reşat, additional, Eşkazan, Emre, additional, Başlar, Zafer, additional, Mert, Ali, additional, Soysal, Teoman, additional, Ferhanoğlu, Burhan, additional, Aydın, Yıldız, additional, and Öztürk, Recep, additional
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- 2015
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17. Blood stream infections due to OXA-48-like carbapenemase-producing Enterobacteriaceae: treatment and survival
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Balkan, Ilker Inanç, primary, Aygün, Gökhan, additional, Aydın, Selda, additional, Mutcalı, Sibel Islak, additional, Kara, Zehra, additional, Kuşkucu, Mert, additional, Midilli, Kenan, additional, Şemen, Vicdan, additional, Aras, Şükrü, additional, Yemişen, Mücahit, additional, Mete, Bilgül, additional, Özaras, Reşat, additional, Saltoğlu, Neşe, additional, Tabak, Fehmi, additional, and Öztürk, Recep, additional
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- 2014
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18. Akut viral hepatit'te N-asetilsistein tedavisi
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Gündüz, Hüseyin, Tabak, Ö. Fehmi, Tamer, Ali, Özaras, Reşat, Mert, Ali, BAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, and Gündüz, Hüseyin
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N-asetilsistein (NAS) ,Akut Viral Hepatit (AVH) - Abstract
Amaç: Akut viral hepatit (AVH) sık, uzun seyirli ve seyrek olmayarak ciddi sorunlara yol açabilen önemli bir hastalıktır. Ülkemizin de aralarında bulunduğu gelişmekte olan ülkeler için bir toplum sağlığı sorunu niteliğindedir AVH olgularında hastalık süresini kısaltabilen bir tedaviye gereksinim açık iken bu alandaki boşluk henüz doldurulabilmiş değildir. Çalışmamızın amacı hücre içi glutatyon miktarını arttırarak potansiyel toksik ajanlar olan serbest oksijen radikalleri ile reaksiyona girip hücresel bütünlüğü koruyabilen N-asetilsistein (NAS)in AVH tedavisindeki etkisini araştırmaktır. Gereç ve Yöntem: Bu amaçla AVH tanısıyla yatırılarak izlenen hastalari iki gruba ayırıp çalışma grubunda günde üç kez 200 mg (600 mg/gün), oral NAS; kontrol grubunda ise plasebo kapsüller uyguladık. Hastaların çalışmaya dahil edilmelerinden itibaren serum total ve direkt bilirubin, ALT, AST, alkali fosfataz, albümin ve globulin seviyeleri, protrombin aktiviteleri haftada iki kere ölçüldü. Bu izlem serum total bilirubin seviyesinin 2 mg/dl'ye, ALT düzeyinin 100 U/L'nin altına inmesine kadar sürdürülerek hastalar taburcu edildi. Bulgular: İ.Ü Cerrahpaşa Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Enfeksiyon Hastalıkları Bilim Dalı'na AVH tanısıyla yatırılan 41 olgu çalışmaya alındı. Olguların 13 (%31.7)'ü kadın, 28 (%68.3)'i erkekti. Tüm olgularda ortanca yaş 24 (sınırlar:15-52) olup A tipinde ortanca yaş 17 (sınırlar:16-28), B tipinde ise ortanca yaş 26 (sınırlar:15-52) bulundu. Çalışma grubunda ortanca yaş 23 (sınırlar:15-48) kontrol grubunda ise ortanca yaş 24 (sınırlar:16-52) bulundu. HAV ile enfekte hastaların yaşı belirgin olarak küçüktü. Olguların serolojik ayırımında A tipi 9 (%22), B tipi 32 (%78) olguda bulundu. Çalışma grubunda A tipi 4 (%20), B tipi 16 (%80), kontrol grubunda ise A tipi 5 (%23.7), B tipi 16 (%76.4) idi. ALT nin normale dönüş süresi çalışma grubunda 19.7±6.9 gün (A tipi 11.2±6.1 gün, B tipinde 21.8±6.1gün), kontrol grubunda ise 20.4±6.5 gün (A tipi 16±7.4 gün, B tipi 21.8 ±6.7 gün) bulundu. Total bilirubin'in normale dönüş süresi çalışma grubunda 13.7±8.5 gün (A tipi 7.9± 4.9 gün, B tipi 15.2±8.6 gün), kontrol grubunda ise 16.9±7.8 gün (A tipi 12±6.3 gün, B tipi 18.4 ± 8.1 gün) olarak bulundu. Sonuç: NAS kullandığımız hastaların ALT ve total bilirubin değerlerinin normale dönme süresi dolayısıyla hastanede yatış süresi kısalmamış veya olumsuz yönde etkilenip uzamamıştır. Bu bulguların ikterli AVH'in tedavisi için NAS'in önerilemeyeceği sonucu çıkartılabilmektedir. Ayrıca bu ilacın AVH olgularında zararlı olmadığı da anlaşılmıştır. Objective: Acute viral hepatitis (AVH) that may cause serious problems, is a frequent disease with along course. It is a public health problem among developing countries such as our country. The need for a treatment to shorten duration of AVH is obvious, but it has not been solved yet. We thought this problem may be solved with NAS which protects the cellular architecture by increasing the amount of intracellular glutathion that reacts with toxic free oxygen radicals. Material and Method: For this purpose, we administered 200 mg orally NAS three times daily (600 mg/day) to the study group and placebo capsules to those in the control group, who are hospitalized and followed with the diagnosed of AVH. This patient's blood total and direct bilirubin, ALT, AST, alkalen phosphotase, albumin and globulin levels are measured twice weekly. This follow up is continued until total bilirubin level becomes 2mg/dl, ALT level becomes 100 U/L and then the patients are discharged from hospital. Results: 41 cases of AVH patients included our study in I.U Cerrahpaşa Medical Faculty, The Department of Internal Medicine, Infectious Disease Unit. 13 patients (%31.7) were female, 28 patients (%68.3) were male. The median age among was 24 (range:15-52), in A type the median age was 17 (range:16-28), in B type it was 26 (range:15-52). In the study group median age was 23 (range:15-48), in the control group it was 24 (range:16-52). Patients with HAV infection were younger than those with HBV infection. In the serological distinction of the cases, A type was detected in 9 (%22) and B type in 32 (%78), in study group A type was in 4 (%20), B type was in 16 (%80), in control group A type was in 5 (%23.7) and B in 16 (76.4). The period for normalization of ALT in study group was 19.7±6.9 days (A type 11.2±6.1 days, B type 21.8±6.1 days), while in the control group it was 20.4±6.5 days (A type 16±7.4 days, B type 21.8±6.7 days). The period for normalization of total bilirubin in study group was 13.7±8.5 days (A type 7.9±4.9 days, B type 15.2±8.6 days), in control group was 16.9±7.8 days (A type 7.9±4.9 days, B type 18.4±8.1 days). Conclusion: As a result, NAS administeration effected neither the time necessary for normalization of ALT and total bilirubin values nor duration of hospitalization, so we could not suggest the of NAS for the treatment of icteric AVH cases. However our results showed that to this drug was not harmful to the patients with AVH.
- Published
- 2003
19. Alkolün sıçanlarda oksidatif strese etkisi ve oksidatif hasarın , N-asetil sistein ile azaltılması
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Özaras, Reşat, Şentürk, Hakan, and İç Hastalıkları Ana Bilim Dalı
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Gastroenteroloji ,Endocrinology and Metabolic Diseases ,Clinical Microbiology and Infectious Diseases ,Endokrinoloji ve Metabolizma Hastalıkları ,Gastroenterology ,Klinik Bakteriyoloji ve Enfeksiyon Hastalıkları - Abstract
ÖZET Alkolik karaciğer hastalığı, önemli bir sağlık problemidir. Kronik alkol kullanımı, steatohepatit, alkolik hepatit ve siroza yolaçabilir. Alkolün yolaçtığı karaciğer hastalıklarından korunmada en önemli adım alkolün kesilmesi olsa da, alkolün karaciğer hasan oluşturma mekanizmaları daha iyi anlaşıldıkça, yeni tedavi yaklaşımları mümkün olacaktır. Alkolik karaciğer hastalığının oluşumunda, oksidatif stres artışının rolü olabileceğine dair veriler artmaktadır. N-asetilsistein, parasetamol toksikasyonu yanında karbon tetraklorür ve kloroform intoksikasyonlannda da kullanılan glutatyon depolarını dolduran, antioksidan, indirgeyici ve şelasyon yapıcı bir ajandır. Bu çalışmada intragastrik olarak etanol uygulanan sıçanlarda karaciğer hasarının gelişiminde n-asetilsisteinin serbest radikalleri bağlayıcı etkisinin araştırılması amaçlanmıştır. Otuz iki sıçan üç gruba ayrıldı; birinci gruba etanol, ikinci gruba etanol ile birlikte n- asetilsistein ve üçüncü gruba (kontrol grubu) alkol ile eş kaloride dekstoz 4 hafta süreyle uygulandı. İntragastrik olarak etanol verilen grupta, kontrol grubuna göre lipid peroksidasyonunun bir göstergesi olan malondialdehid düzeyi daha yüksek, antioksidan enzimler olan glutatyon peroksidaz ve süperoksit dismutaz düzeyleri daha düşük ve serum aminotransferaz düzeyleri daha yüksek bulundu. Buna karşılık, etanol yanında n-asetilsistein uygulanan sıçanlarda, etanol alan gruba oranla, malondialdehid ve aminotransferaz düzeyleri daha düşük ve antioksidan enzim düzeyleri daha yüksek bulundu. Bu değerler, sadece dektroz alan konrtol grubundan istatistiksel olarak farksızdı. Bu çalışma, etanolun yolaçtığı karaciğer hasarının büyük ölçüde oksidatif stresle ilişkili olduğunu ve n-asetilsiteinin bu hasan sıçan modelinde etkili bir şekilde azalttığını ortaya koymuştur. 19 SUMMARY Alcoholic liver disease is one of the most common forms of serious liver diseases. Chronic alcohol consumption may lead to steatohepatitis, alcoholic hepatitis, and cirrhosis. Although withdrawal remains the main step in avoding alcohol-induced liver diseases, better understanding of the pathogenesis of alcohol-induced damages provide new clues for therapeutic trials. There is increasing evidence that alcohol-induced liver damage may be associated with increased oxidative stress. N-acetylcysteine is commonly used to reduce the toxic effects of acetaminophen in overdose as well as poisonings with carbon tetrachloride and chloroform acting as an antioxidant, reducing and chelating agent. It repletes glutathione stores. We aimed to investigate free-radical scavenger effect of n-acetylcysteine in the development of liver damage in rats intragastrically fed with ethanol. Thirty two rats divided into three groups were fed with ethanol, ethanol and n-acetylcysteine, or isocaloric dextrose (control group) for 4 weeks. Rats fed intragastrically with ethanol developed a higher level of lipid peroxidation as measured by malondialdehyde, lower levels of antioxidant enzymes of glutathione peroxidase and superoxide dismutase and higher levels of aminotransferase levels compared to control group. In rats fed with n-acetylcysteine and ethanol, malondialdehyde and aminotransferase levels were lower and antioxidative enzymes were higher significantly than the ethanol-fed group, in levels comparable to those of control group. This study clearly reveals that ethanol-induced liver damage is associated with oxidative stress, and n-acetylcysteine drug attenuates this damage effectively in rat model. 20 28
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- 2000
20. Ecthyma Gangrenosum-like Lesions in a Febrile Neutropenic Patient with Simultaneous Pseudomonas Sepsis and Disseminated Fusariosis
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Uludokumacı, Seven, primary, İnanç Balkan, İlker, additional, Mete, Bilgül, additional, Özaras, Reşat, additional, Saltoğlu, Neşe, additional, and Soysal, Teoman, additional
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- 2013
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21. Hemipleji ile Başvuran HIV Enfeksiyonu: Üç Toksoplazma Ensefaliti Olgusu
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Demirel, Aslıhan, primary, Özaras, Reşat, additional, Hakko, Elif, additional, Mete, Bilgül, additional, Yemişen, Mücahit, additional, Mert, Ali, additional, Öztürk, Recep, additional, and Tabak, Fehmi, additional
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- 2013
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22. Recommendations for intra-abdominal infections consensus report.
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Avkan-Oğuz, Vildan, Baykam, Nurcan, Sökmen, Selman, Güner, Rahmet, Agalar, Fatih, Alp, Emine, Doğrul, Ahmet, Turhan, Özge, Ağalar, Canan, Kurtaran, Behice, Geçim, İbrahim Ethem, Özaras, Reşat, Yılmaz, Gürdal, Akbulut, Ayhan, and Koksal, İftihar
- Abstract
Guidelines include the recommendations of experts from various specialties within a topic in consideration of data specific to each country. However, to date there has not been a guideline standardizing the nomenclature and offering recommendations for intra-abdominal infections (IAIs) in Turkey. This is mainly due to the paucity of laboratory studies regarding the clinical diagnosis and treatment of IAIs or the sensitivity of microorganisms isolated from patients with IAIs. However, due to the diversification of host characteristics and advancements in technological treatment methods, it has become imperative to ‘speak a common language’. For this purpose May 2015, a group of 15 experts in intra-abdominal infections, under the leadership of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey (EKMUD) and with representatives from the Turkish Surgical Association, Turkish Society of Colon and Rectal Surgery, Hernia Society, Turkish Society of Hepato-pancreato-biliary Surgery, and the Turkish Society of Hospital Infections and Control, was formed to analyze relevant studies in the literature. Ultimately, the suggestions for adults found in this consensus report were developed using available data from Turkey, referring predominantly to the 2010 guidelines for diagnosing and managing complicated IAIs in adults and children by the Infectious Diseases Society of America (IDSA) and the Surgical Infection Society. The recommendations are presented in two sections, from the initial diagnostic evaluation of patients to the treatment approach for IAI. This Consensus Report was presented at the EKMUD 2016 Congress in Antalya and was subsequently opened for suggestions on the official websites of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey and Turkish Surgical Association for one month. The manuscript was revised according to the feedback received. [ABSTRACT FROM AUTHOR]
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- 2016
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23. Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study.
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Mutcalı, Sibel Işlak, Saltoğlu, Neşe, Balkan, İlker İnanç, Özaras, Reşat, Yemişen, Mücahit, Mete, Bilgül, Tabak, Fehmi, Mert, Ali, Öztürk, Recep, Öngören, Şeniz, Başlar, Zafer, Aydın, Yıldız, Ferhanoğlu, Burhan, and Soysal, Teoman
- Abstract
Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2016
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24. A Primary Giant Hydatid Cyst of the Ovary
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Kaya, Abdurrahman, primary, Yildiz, Sibel, additional, Özaras, Reşat, additional, and Mert, Ali, additional
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- 2012
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25. Aspergillus fumigatus infection as a delayed manifestation of prosthetic knee arthroplasty and a review of the literature
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Yilmaz, Mesut, primary, Mete, Bilgül, additional, Özaras, Reşat, additional, Kaynak, Gökhan, additional, Tabak, Fehmi, additional, Tenekecioğlu, Yüksel, additional, and Öztürk, Recep, additional
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- 2011
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26. An unusual cause of prosthetic joint infection: Mycobacterium tuberculosis.
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Mete, Bilgül, Yemişen, Mücahit, Aydın, Selda, Babacan, Muharrem, Özaras, Reşat, Erdoğan, Fahri, Mert, Ali, Tabak, Fehmi, and Öztürk, Recep
- Subjects
INFECTION - Abstract
Copyright of Journal of Microbiology & Infectious Diseases is the property of Journal of Microbiology & Infectious Diseases and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2012
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27. Kronik Lenfositer Lösemili Hastada Nocardia Beyin Apsesi.
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Vanlı, Ersin, Sili, Uluhan, Saltoğlu, Neşe, Mete, Bilgül, Özaras, Reşat, Mert, Ali, Tabak, Fehmi, Hondur, Ayşe Nur, Kaynar, Mehmet Yaşar, Haşıloğlu, Zehra Işık, and Öztürk, Recep
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NOCARDIA ,ABSCESSES ,IMMUNODEFICIENCY ,ANTIBIOTICS ,LYMPHOCYTIC leukemia ,DISEASE exacerbation - Abstract
Copyright of Klimik Journal / Klimik Dergisi is the property of DOC Design & Informatics Co. Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2010
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28. Daptomisin.
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Özaras, Reşat and Tabak, Fehmi
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ANTIBACTERIAL agents , *GRAM-positive bacteria , *DRUG resistance in microorganisms , *PEPTIDES , *BACTERIAL diseases , *METHICILLIN resistance , *STAPHYLOCOCCUS aureus , *VANCOMYCIN resistance , *DRUG toxicity - Abstract
Infections due to Gram-positive microorganisms are increasing all over the world. Treatment options in infections caused by resistant Gram-positive bacteria are limited. Daptomycin is the first member of cyclic lipopeptide agents. Its spectrum of activity is the Gram-positive organisms, including resistant species such as methicillin-resistant Staphylococcus aureus, vancomycin-intermediate S. aureus, vancomycin-resistant S. aureus, and vancomycin- resistant enterococci. Daptomycin has been approved for the treatment of complicated skin and soft tissue infections, S. aureus bacteremia and right-sided infective endocarditis. The recommended dosing regimen is 4-6 mg/kg IV once daily. Dose adjustment is necessary in renal failure. Primary toxicity of daptomycin is reversible dose-related myalgias and weakness. [ABSTRACT FROM AUTHOR]
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- 2010
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29. Oxygen-Dependent Bactericidal Activity of Leukocytes in Patients with Type 2 Diabetes Mellitus.
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Kanat, Mustafa, Donma, Orkide, Aygün, Cem, Sardoğan, Emine, Ekmekçi, Özlem, Sipahioğlu, Murat Hayri, and Özaras, Reşat
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LEUCOCYTES ,BLOOD cells ,KILLER cells ,CARBOHYDRATE intolerance ,TREATMENT of diabetes ,THERAPEUTICS - Abstract
Copyright of Turkish Journal of Endocrinology & Metabolism is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2009
30. An unusual presentation of sixth nerve palsy: neurobrucellosis
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Mergen, Burak, Sarici, Ahmet M., Baltu, Fatih, Ozaras, Resat, and Adaletli, Ibrahim
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neurobrucellosis ,abducens nerve palsy ,meningitis ,Ophthalmology ,RE1-994 - Abstract
Abducens nerve palsy is generally seen in older patients with diabetes and hypertension. It is relatively rare in young and otherwise healthy patients. An extensive differential diagnosis is considered in patients younger than 50 years of age who develop a sixth nerve palsy. We report here a 25-year-old patient from Turkey who was admitted with sixth nerve palsy as a component of neurobrucellosis. She was referred to our clinic because she had double vision and restricted right eye abduction. During the ophthalmic examination, both pupils were round and reactive to light and accommodation. Extraocular movements were intact with the exception that the right eye was unable to abduct. Magnetic resonance imaging revealed no pathology. She also had a diagnosis of brucellosis and her abducens nerve palsy was a form of clinical manifestation of neurobrucellosis. We conclude that neurobrucellosis should be considered in patients with sixth cranial nerve palsy especially in areas where brucellosis is endemic.
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- 2019
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31. Relapsing deep neck infection may indicate a coexisting esophagus cancer.
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Karaman, Emin, Duman, Cihan, Mercan, Hasan, Özaras, Reşat, and Cansız, Harun
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- 2009
32. Tekrarlayan derin boyun enfeksiyonu yandaş bir özofagus karsinomunu işaret edebilir
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KARAMAN, Emin, DUMAN, Cihan, MERCAN, Hasan, ÖZARAS, Reşat, and CANSIZ, Harun
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Deep neck infection,esophagus,neck abscess,squamous cell carcinoma ,Boyun apseleri,özofagus,derin boyun enfeksiyonu,karsinom - Abstract
Boyun apseleri ve derin boyun enfeksiyonları sık görülen hastalıklardır. Primer baş boyun kanserleri, ilk olarak derin boyun enfeksiyonu veya boyun apse- si şeklinde kendini gösterebilir. Bu durum altta yatan kanserin tanısında gecikmeye yol açabilir. İlk olarak derin boyun enfeksiyonları ile kendini gösteren baş- boyun kanserleri nadir olarak tanımlanmıştır. Bu yazıda daha sonradan proksimal özofagus skuamöz karsinomu tanısı konan ve relapslarla seyreden derin boyun apseli bir olgu sunuldu, Neck abscess and deep neck infections are common diseases. Primary head and neck cancers may present initially with neck abscesses or deep neck infections. This presentation leads to delay of the diagnosis of underlying cancer. Head and neck cancers which present with deep neck infection initially have rarely been described. We report a case with relapsing deep neck infection who was diagnosed as proximal esophagus squamous cell carcinoma thereafter.
33. Paradoxical Reactions Associated with Muscle Abscess.
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KAYA, Abdurrahman, MUTCALI, Sibel IŞLAK, YEMİŞEN, Mücahit, and ÖZARAS, Reşat
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- 2013
34. Sarkoidoz Hastalarında Hepatit B Aşılaması Sonuçları.
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Bilir, Muammer, Mert, Ali, Sipahi, Sevtap, Tabak, Fehmi, Karayel, Tuncer, Özaras, Reşat, and Şentürk, Hakan
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- 2000
35. Investigation of the relationship between hbsag kinetics and other viral parameters in patients with hepatitis B
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Uludokumaci, Seven, Özaras, Reşat, and Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
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Hepatitis B virus ,Hepatitis-viral-human ,Hepatitis B surface antigens ,Mikrobiyoloji ,Clinical Microbiology and Infectious Diseases ,virus diseases ,Hepatitis B ,Microbiology ,Hepatitis B antibodies ,digestive system diseases ,Hepatitis ,Virology ,Hepatitis B antigens ,Klinik Bakteriyoloji ve Enfeksiyon Hastalıkları - Abstract
Giriş ve AmaçKronik hepatit B (KHB) ülkemizde ve tüm dünyada önemli bir sağlık sorunudur. Etkili tedavi, karaciğer yetmezliği, siroz ve hepatoselüler karsinom gibi ciddi komplikasyonları önemli ölçüde azalmaktadır. Kantitatif HBsAg (qHBsAg), cccDNA'nın transkripsiyonel aktivitesini yansıtan bir belirteçtir. Bu testin tedaviye başlama ya da tedaviyi sonlandırma kararını vermede önemi artmaktadır. Çalışmamızda, HBV enfeksiyonu nedeni ile tedavi edilen 335 hastanın tedavi öncesi ve tedavinin 1.-6.-12.-18. aylarında alınan toplam 942 adet serum örneğinde HBsAg kantitasyonunun yapılması ve diğer parametrelerle ilişkisinin belirlenmesi amaçlanmıştır.Hastalar ve MetodTemmuz 2008 - Temmuz 2014 tarihleri arasında, 18 merkezin dâhil olduğu çalışmaya, yeni tanılı KHB hastaları, HBeAg pozitif ve negatif hastalar ayrılmaksızın dâhil edildi. Bilgilendirilmiş ve yazılı olur izni alınan hastalardan başlangıç serum örneklerinin alınmasının ardından hastaya, endikasyon dâhilinde hekiminin uygun gördüğü bir tedavi başlandı. Tedavinin 1., 6., 12. ve 18. aylarında kontrol tetkikler yapıldı. Serum örnekleri laboratuvarımızda -80 °C'de muhafaza edildi. Başlangıç tetkiklerini hastanın serum HBV DNA, HBeAg, ALT, AST, albumin, hemogram ve diğer biyokimya testleri oluşturdu. Bütün hastaların HBsAg, HBeAg, Anti-HBe testleri ELISA yöntemiyle çalısılırken, HBV-DNA TaqMan polimeraz zincir reaksiyonu (PCR) yöntemiyle çalışıldı. Tam kan sayımı, AST, ALT, albumin biyokimya laboratuvarında standart yöntemlerle çalışıldı. HBsAg kantitatif ölçümü için Elecsys HBsAg II assay (Roche Diagnostics GmbH, Mannheim) kiti kullanıldı. SonuçlarÇalışmamızda tüm hastalar üzerinden yapılan ölçümlerde, başlangıç ve 18. ay düzeyleri karşılaştırıldığında HBV DNA'da gözlenen değişim istatistiksel olarak anlamlı bulunurken, qHBsAg düzeylerinde ise istatistiksel olarak anlamlı bir değişiklik saptanmadı.Tüm tedavi gruplarındaki hastaların başlangıç ve 18. Aydaki ALT ve AST düzeylerinin anlamlı derecede azaldığı, albümin düzeyinin ise arttığı saptandı. Bu veriler karaciğer enflamasyonunun tedavi ile azalma göstermesine ve fonksiyonel olarak düzelmesine bağlandı.Bütün tedavi gruplarındaki hastalar ele alındığında, HBeAg negatif ve pozitif grup hastalar arasındaki başlangıç qHBsAg değerlerinde anlamlı fark saptanmıştır.Nükleoz(t)id analogu alan hastalarda, HBV-DNA'da anlamlı bir azalma saptanırken, qHBsAg'de anlamlı bir değişiklik gözlenmemiştir. Yalnızca, tenofovir alan HBeAg pozitif hastalarda, başlangıç ve 18. aydaki qHBsAg düzeyleri arasındaki fark istatistiksel olarak anlamlı bulunmuştur. Buna karşılık, interferon alan hastaların qHBsAg değerlerinde progresif bir düşüş gözlenmiş, ancak bu düşüş istatistiksel olarak anlamlı bulunmamıştır. Birçok çalışma, NA tedavileri ile özellikle ilk bir yıl içinde, qHBsAg düzeylerinde belirgin düşme sağlanamaması konusunu vurgulayan veriler sunmaktadır. Bunun yanı sıra PEG-IFN ile tedavi daha hızlı bir düşüş ile sonuçlanmaktadır. Bunun nedeninin, PEG-IFN nin, HBV transkripsiyonu ve kapsid degradasyonu üzerine doğrudan etki ederek, enfekte konak hücrelerin temizlenmesini ve HBsAg ekspresyonunun azalmasını sağlaması olduğu düşünülmektedir. NA bazlı tedavilerin ise, HBsAg'nin azalmasını, mRNA'dan transkripsiyonunu sağlayan cccDNA miktarını azaltarak dolaylı bir yoldan sağladığı bilinmektedir. Bu sonuçlar ile NA bazlı tedavilerin ancak uzun sureli kullanımları ile cccDNA üzerinde uzamış bir supresyon ve saptanamayacak düzeylere ulaşmış HBsAg sağlayabileceğini göstermektedir. Bizim çalışmamızda, NA tedavisi alan hastalarda, başlangıç ve 18. aya kadar olan izlemde qHBsAg düzeyinin belirgin bir düşüş eğrisi göstermemesi, HBV DNA düzeylerindeki düşüş ile korelasyon göstermemesi, hastaların 18 ay gibi NA açısında kısa süreli sayılacak bir tedavi süresi içinde değerlendirilmiş olmasından kaynaklandığı düşünülebilir. Introduction and AimsChronic Hepatitis B is an important health problem both globally and in our country. Effective treatments help decrease serious complications such as hepatic failure, chirrhosis, and hepatocellular carcinoma. qHBsAg is a marker which reflects the transcriptional activity of cccDNA. Today, quantitative HBsAg plays an increasingly important role, when deciding to start or to end the treatment. In our study, we intended to quantify HBsAg levels in 942 sera samples obtained from 335 patients receiving therapy for chronic hepatitis B, in their initial pre-treatment evaluation, and 1., 6., 12. and 18. month follow-up examinations. We also aim to observe the relationship of qHBsAg levels with other viral parameters.Patients and MethodRecently diagnosed CHB patients from 18 medical facilities -both HBeAg negative and positive- were included in the study between July, 2008 and July 2014.Following the sampling of the initial sera from patients who give informed consent, a appropriate treatment within clinical indication was ordered by his/her physician. Control tests were applied in the 1st, 6th, 12th, and 18th month appointments. Sampled sera were stored in -80°C.Initially HBV DNA, HBeAg, ALT, AST, albumin, complete blood count and other biochemistry tests were performed. ALT, AST, albumin, and complete blood count were executed in biochemistry laboratory with standard methods. HBsAg, HBeAg and anti-HBe tests of all patients were performed by ELISA, whereas HBV DNA levels were studied by TaqMan polymerase chain reaction (PCR) method. For HBsAg quantification Elecsys HBsAg II assay (Roche Diagnostics GmbH, Mannheim) were utilized.ResultsMeasurements carried out on all patients in our study indicate that the difference in HBV DNA levels between the initial and 18-month values is statistically significant, unlike the change in qHBsAg. The difference between the initial and the 18-month levels both for AST and ALT is found to be have decreased in a statistically important degree.A statistically important increase between the initial and the 18th month levels of serum albumin was detected. These data are thought to be related to the decrease of liver inflammation with therapy and the improvements in liver function. Regarding all patients in all therapy groups together, initial qHBsAg levels exhibited a statistical distinction between HBeAg positive and negative patients Levels in HBV DNA in patients receiving nucleos(t)id analogues exhibited a statistically important decrease. There was no statistically important change in qHBsAg levels.Only in HBeAg positive patients receiving tenofovir, we have observed a statistically important change in qHBsAg levels between the initial and the 18th month measurements.On the other hand, qHBsAg levels exhibited a progressive decrease in patients receiving interferon, however the changes were not statistically important. Numerous studies provide data emphasizing that a remarkable decrease in HBsAg levels with NA therapies cannot be observed, especially in the first year of therapy. In addition a therapy with PEG-IFN results in a faster decline. The reason is thought to be that, pegylated interferon exhibits an antiviral effect on HBV transcription reduction and the degradation of capsid, which results in the decrease of infected cells and reduced HBsAg expression. On the other hand NAs reduce HBsAg by reducing the amount of available cccDNA template for hepatitis B surface mRNA transcription.Data from studies like these suggest that NA therapy should be given on a long-term interval to obtain prolonged suppression of cccDNA and diminishing of HBsAg.In our study, the fact that qHBsAg levels did not show a remarkable decline between the initial and the 18th month follow-up tests, and the fact that a correlation with HBV DNA levels was not observed, may be due to the follow up time for patients being relatively short, regarding NA therapy. 78
- Published
- 2016
36. Herpes simpleks ensefaliti: Morbiditeye ve mortaliteye etki eden faktörlerin belirlenmesi
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Kaya, Abdurrahman, Özaras, Reşat, and Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
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Herpes simplex ,Clinical Microbiology and Infectious Diseases ,Klinik Bakteriyoloji ve Enfeksiyon Hastalıkları ,Acyclovir ,Encephalitis ,Mortality ,Morbidity ,Virus diseases - Abstract
Giriş ve Amaç: Herpes Simplex Virüsü (HSV) bir DNA virüsüdür. HSV-1 ve HSV-2 olmak üzere iki tipi mevcuttur. HSV-1 sporadik ensefalitin en sık nedenidir. Genellikle virüsün latent enfeksiyonunu takiben reaktivasyonu sonucunda gelişmektedir. Tanıda klinik şüphe, BOS incelenmesi ve kranial MR değerlendirilmesi önemlidir. BOS'ta PCR ile HSV-DNA saptanması ve/veya MR ile temporal loblardaki tutulumunun gösterilmesiyle kesin tanı konur. Asiklovir herpes simpleks ensefaliti (HSE) olgularında mortaliteyi ve morbiditeyi önemli oranda düşürmektedir. Biz bu çalışmada 12 yıl geriye giderek merkezimizde ve diğer merkezlerdeki kesin HSE olgularını bir araya getirip hastaların klinik özelliklerini, tanısal yaklaşımlarını, tedavi yönetimlerini ve prognozlarını belirlemeyi amaçladık.Hastalar ve Yöntem: Çalışmamızda 12 sene geriye doğru tarama yapılarak merkezimizde ve diğer merkezlerdeki kesin HSE tanılı (ensefalitle uyumlu klinik + MRG'de tipik tutulum ve/veya BOS'ta pozitif HSV-DNA) hastalar belirlendi. Dosyalarından klinik özellikleri, laboratuvar ve görüntüleme sonuçları daha önce hazırlamış olduğumuz forma kaydedildi. Telefonla aranarak son durumları öğrenildi. Standart istatistik metodlar ile prognozlarını etkileyen bağımlı ve bağımsız değişkenler saptandı.Bulgular: Toplam 80 hastaya ulaşıldı. En sık klinik belirtiler arasında bilinç bulanıklığı (%81), başağrısı (%79) ve ateş (%76) vardı. BOS'ta PCR pozitifliği %62 iken MRG'de tutulum %95 oranında saptandı. Çoğu hastaya tedavi ortalama kliniğinin ilk 5 günü içinde başlanmış ve ?14 gün verilmişti. Olguların %8'i mortalite, %80'i sekel ve %20'si tam iyileşme ile sonuçlanmıştı.Sonuç: HSE asiklovir ile etkin tedavi edilebilmesine karşın, günümüzde hâlâ ciddi mortalite ve morbidite nedenidir. Hastalarımızın ~ 3/4'ü iyi prognozla (tam iyileşme veya hafif/orta morbidite) sonuçlanmıştır. Bu çalışma sonuçları daha önce yapılan diğer çalışmalara benzer bulunmuştur. Çalışmamız HSE'de ana problemin tedavinin erken başlanmaması olduğunu tekrar gözler önüne sermiştir. Pratik yaşamda ensefaliti düşündüren belirti ve bulgularla gelen tüm hastalara tetkik sonuçları beklenirken antiviral başlanması gerekmektedir. Bu çalışmada da ana yakınmanın ortaya çıkması ile tedavinin başlanması arasındaki sürenin prognozu etkileyen bir faktör olduğu saptanmıştır. Introduction: Herpes Simplex Virus (HSV) is a DNA virus. There are two types of HSV such as HSV-1 and HSV-2. HSV-1 is the most common cause of sporadic encephalitis which usually develops following reactivation of latent virus infection. Clinical suspicion in the diagnosis, evaluation of BOS and MRG are important. HBV-DNA detection by PCR in CSF and / or demonstrating temporal lobes involvement on MRI are diagnostic factors for herpes simplex encephalitis (HSE). Acyclovir significantly reduces mortality and morbidity in patients with HSE. In this study, We retrospectively searched the archives for the last 12 years, patients in our center and other centers to determine diagnostic approaches, treatment management, clinical features and the prognosis in definite cases of HSE.Method: We retrospectively searched the archives for the last 10 years to include patients with confirmed HSE diagnosis, i.e. clinical presentation compatible with encephalitis and involvement in MRI or positive HSV-DNA in CSF. Clinical features, laboratory and imaging results was noted to form which prepared previously. Learned the last condition by calling. Dependent and independent variables that affect the prognosis was detected by Standard statistical methods.Bulgular: A total of 80 patients were reached. Most common presenting symptoms were changes in mental status (81%), headache (79%) and fever (76%). Positivite PCR in CSF was 62% and involvement on MRI was 95%. In most cases, treatment was started within the first 5 days of clinic and received ?14 days of treatment. Mortality rate was 8% and sequel was 72% of patients. Complete recovery was resulted in only 15%.Conclusion: HSE has high mortality and morbidity although asiklovir treatment. In our clinical study, ~ 3/4 of the case recovered with favorable prognosis (complete recovery or mild/moderate morbidity). The results of this study were similar to other studies previously published. It appears that the most important factor that affects the prognosis is the delay of treatment. In practical life, the antiviral should be started in all patients with having clinic of encephalitis while waiting for test results. In this study, we determined that the interval between the emergence of the main complaint and the initiation of treatment is a factor which affect the prognosis. 36
- Published
- 2013
37. Farelerde interferon ve steroid uygulamasının karaciğer, dalak ve kemik iliğindeki regulatuar T hücrelerine etkisi
- Author
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Zerdali, Esra, Özaras, Reşat, and Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
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Liver ,Clinical Microbiology and Infectious Diseases ,T lymphocytes ,Klinik Bakteriyoloji ve Enfeksiyon Hastalıkları ,Steroids ,Bone marrow ,Interferons ,Allergy and immunology ,Spleen - Abstract
T-reg'ler immün sistemde görevli bir çok hücre çeşidine etki ederek immünolojik toleransı sağlayan hücrelerdir. Otoimmün hastalıklar, greft rejeksiyonunun önlenmesi ve enfeksiyon hastalıklarında önemli role sahiptirler. Steroidler, immün sistemi baskılarlar; özellikle T lenfositlerin sitokin salgılamasını ve hücresel immünolojik yanıtın başlamasını önlerler ve T-reg'leri de stimule ederer. Diğer yandan interferonlar immünmodülator, antiviral ve antiproliferatif etkiye sahiptirler. Makrofajları ve sitotoksik T hücrelerini aktive ederler ve T-reg'lerin diferansiyasyonunu uyarırlar.Biz bu çalışmamızda interferon ve steroidin karaciğer, dalak ve kemik iliğindeki T-reg'lere etkisini, bilinen immünosüpresif/ immündüzenleyici etkilerini T-reg'ler üzerinden yapıp yapmadıklarını değerlendirmeyi amaçladık. Bunun için 24 fareye 5 gün boyunca intraperitoneal (ip) enjeksiyon yapıldı. Kontrol grubuna 0,1 cc serum fizyolojik (SF) her gün uygulandı. İnterferon grubuna interferon alfa 2b 20000 IU 0,1 cc olacak şekilde SF ile sulandırılarak gün aşırı 3 kez diğer günler 0,1 cc SF uygulandı. Steroid grubuna deksametazon 5 mg/kg 0,1 cc olacak şekilde SF ile sulandırılarak her gün uygulandı. Enjeksiyonlar bittikten sonra 2 gün beklendi. Farelere ip genel anestezi uygulandı, laparotomi yapılıp portal ven açığa çıkarıldı, portal venden 5 ml bovine serum albümin (BSA) verildi, inferior vena cava kesilerek karaciğerin BSA ile perfüzyonu sağlandı, fareler feda edilmiş oldu. Karaciğer, dalak ve kemik ilikleri elde edildikten sonra T-reg'lerin ayrımı yapıldı ve flow sitometri ile sayıldı. Flow sitometri ile sayımda interferon, steroid ve kontrol grubunda istatiksel olarak anlamlı bir sonuç bulunamadı.İnterferon ve steroid kullanımının T-reg'lerin miktarına etki etmediği düşünüldü. T-regs maintain immune tolerance by effecting other cells of the immune system. They play an important role in autoimmune diseases, and prevention of greft rejection. Steroids suppress the immune system; they especially inhibit cytokine secretion of T lymphocytes and beginning of cell-mediated immune response, and also stimulate T-regs. Furthermore, interferons have immunomodulatory, antiviral and antiproliferative effects. They activate macrophages and cytotoxic T-cells, and stimulate differantiation of T-regs.In this study we aimed to evaluate the effects of interferon and steroid on T-regs in liver, spleen, and bone marrow, and if they achieve their well-known immunesuppresive/immunomodulatory effects by T-regs. For this purpose 24 mice received intraperitoneal (ip) injection for five days. Control group received 0.1 ml saline every day. Interferon group received interferon alfa-2b 20000 IU on the first, third and fifth days, and only 0.1 ml saline on the other days. Steroid group received 5mg/kg dexametasone in 0.1 ml saline every day. Two days after the end of therapy, each mouse was given ip anesthesia, portal vein was explored via laparotomy. Five ml of bovine serum albumin (BSA) was given through portal vein. By cutting inferor vena cavae, liver was provided to be perfused with BSA. Then the mice were sacrificed. Liver, spleen and bone marrow were obtained; T-regs were distinguished, and counted by flow cytometry. In flow cytometry counts interferon, steroid and control groups did not show significant difference.Interferon and steroid use do not seem to affect the quantity of T-regs. 38
- Published
- 2012
38. Kronik aktif Hepatit B, inaktif Hepatit B ve kendiliğinden bağışıklık kazanan Hepatit B olgularında hücresel immünitenin fonksiyonlarının in vitro koşullarda ELİSPOT testi ile değerlendirilmesi ve karşılaştırılması
- Author
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Arslan, Ferhat, Özaras, Reşat, and Klinik Mikrobiyoloji ve Enfeksiyon Hastalıkları Ana Bilim Dalı
- Subjects
Enzyme-linked immunosorbent assay ,Cells ,Tests ,Clinical Microbiology and Infectious Diseases ,Immunity ,Klinik Bakteriyoloji ve Enfeksiyon Hastalıkları ,Hepatitis B ,Hepatitis - Abstract
Uzun yıllar boyunca her yeni antiviral ilaçla umutların tazelendiği kronik hepatit B (KHB) tedavisindeki başarısızlığın temelinde hastalığın immün patogenezinin tam olarak aydınlatılmamasının önemli bir yeri vardır. Bu örnekte olduğu gibi hastalığın patogenezi ve bireysel immünite farklılıkları aydınlatıldıkça HBV enfeksiyonlu hastalara yaklaşımımız değişecek, kişisel farklılıkları temel alan tedavi yaklaşımları geliştirilerek KHB tedavisinde daha başarılı sonuçlar alınabilecektir.Bu çalışmamızda 7 KHB, 8 inaktif taşıyıcı ve 8 HBV enfeksiyonun geçirmiş (Anti HBs pozitif) kişilerde periferik mononükleer hücrelerinin in vitro ortamda spesifik (Hepatit B kor antijeni; rekombinan HBcAg) ve nonspesifik (CMV, EBV, İnfluenza peptid havuzu; CTL CEF peptid pool `'plus'') antijenlere karşı oluşturdukları interferon gama (IFN- ? ) salınımlarını enzyme linked immonospot (ELISPOT) yöntemi ile karşılaştırdık. Pozitif test kontrol olarak fitohemaglutinin (PHA) kullandık. Üç grubun sürekli değişkenleri, Analysis of Variance (ANOVA) testi ile karşılaştırıldı; post-hoc test olarak Scheffe kullanıldı. p
- Published
- 2010
39. Efficacy of tigecycline in experimental catheter releated ınfection
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Aybar Bilir, Yeşim, Özaras, Reşat, and Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
- Subjects
Clinical Microbiology and Infectious Diseases ,Klinik Bakteriyoloji ve Enfeksiyon Hastalıkları - Abstract
Damar içi kateterler modern tıp tedavisinin önemli, vazgeçilmez araçlarındandır. Hastalarda santral venöz kateter kullanımının artmasıyla beraber enfeksiyonlarında da önemli artış gözlenmiştir. Kateter enfeksiyonlarında en sık karşılaşılan etkenlerden biri koagülaz negatif stafilokoklardır. Antibiyotik dirençleri ve kateter lümeni içerisinde ?slime faktör? etkisi ile oluşturduğu biyofilm tabakası tedaviyi daha zor hale getirir. Mikroorganizmanın patojenitesi ile slime oluşumu arasında doğrudan bir ilişki mevcuttur.Tigesiklin, tetrasiklin türevi olan minosiklinlerin yarı-sentetik derivesidir. Yapılan in vitro ve in vivo çalışmalarda, tigesiklinin biyofilm tabakası üzerine etkili olduğu gösterilmiştir.Bu çalışmada tigesiklinin kateter ilişkili enfeksiyonlarda etkinliğinin araştırılması amaçlandı. Çalışmada 24 adet tavşan sekizerli üç gruba ayrılarak, tavşanların tümüne polietilen kateter takıldı. Kateterlerden 108 koloni oluşturan birim/ml S. epidermidis inoküle edildi. İnokulasyondan 72 saat sonra tedavi başlandı; Grup I'e (Heparin kontrol grubu) kateter takıldıktan sonra hergün 0,5 ml heparin (100 IU/ml), Grup II'ye (Vankomisin-heparin grubu) 0,5 ml vankomisin-heparin solusyonu (3 mg vankomisin + 100 IU heparin), Grup III'e (Tigesiklin-heparin grubu) ise 0,5 ml tigesiklin-heparin solusyonu (14 mg/kg günde iki kez + 100 IU heparin) 5 gün süre ile uygulandı. Tedavi öncesinde ve sonrasında kateter-perifer kan kültürleri alındı. Tedavi bitiminde kan kültürleri tekrar edildi, kateter uçları mikrobiyolojik olarak ve tarama (scanning) elektron mikroskopisi ile değerlendirildi.Çalışmanın sonucunda, tigesiklinin tedavide en az vankomisin kadar etkili görüldü. Tigesiklin verilen grupta kateterde oluşan biyofilm tabakasının vankomisin ile tedavi edilen gruba göre daha az olduğu belirlendiÇalışmada elde edilen sonuçlara göre, yeni bir ilaç olan tigesiklinin, seçeneklerin az ve etkinliklerinin sınırlı olduğu kateterle ilişkili enfeksiyon tedavisinde, önemli ve etkili bir alternatif olacağı düşünülmektedir. Central venous catheters are critical devices in medical practice. As catheter use increases, the rate of catheter-related infections (CRI) increases. One of the most frequent etiologies CRI in is coagulase-negative staphylococci (CNS). The treatment of CRI is challenging due to resistance to antibiotics and the emergence of the biofilm over the lumen of catheter. The virulence of the microorganism is associated with the emergence of the biofilm.Tigecycline is a semi-synthetic derivative of minocycline. In vivo and in vitro studies show its effect on strains producing biofilm.In this study, in a rabbit model of CRI, 24 rabbits were divided into 3 groups and were inserted polyethylene catheters. Single dose of Staphylococcus epidermidis was given through the catheters. After 72 hours, they were treated: Group I (Heparin-control ) was given 100 IU/mL heparin . Group II (Vancomycin-heparin) was given mixed solution of vancomcyin-heparin (3 mg vancomcyin and 100 IU heparin), and Group III (Tigecycline-heparin) was given mixed solution of tigecycline-heparin (tigecycline 14 mg/kg bid and 100 IU heparin) for 5 days. Before, after the treatment and after the end of therapy, peripheral and catheter lumen blood cultures were obtained. Catheter tips were studied by microbiological methods and scanning electron microscopy.We noted that tigecycline will be as effective as vancomycin, and its activity on the biofilm layer is more effective.This study suggests that tigecycline, can be a promising agent for the treatment of CRI which is a therapeutic challenge with limited number of effective drugs. 61
- Published
- 2008
40. Recommendations for intra-abdominal infections consensus report.
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Avkan-Oğuz V, Baykam N, Sökmen S, Güner R, Agalar F, Alp E, Doğrul A, Turhan Ö, Ağalar C, Kurtaran B, Geçim İE, Özaras R, Yılmaz G, Akbulut A, and Koksal İ
- Abstract
Guidelines include the recommendations of experts from various specialties within a topic in consideration of data specific to each country. However, to date there has not been a guideline standardizing the nomenclature and offering recommendations for intra-abdominal infections (IAIs) in Turkey. This is mainly due to the paucity of laboratory studies regarding the clinical diagnosis and treatment of IAIs or the sensitivity of microorganisms isolated from patients with IAIs. However, due to the diversification of host characteristics and advancements in technological treatment methods, it has become imperative to 'speak a common language'. For this purpose May 2015, a group of 15 experts in intra-abdominal infections, under the leadership of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey (EKMUD) and with representatives from the Turkish Surgical Association, Turkish Society of Colon and Rectal Surgery, Hernia Society, Turkish Society of Hepato-pancreato-biliary Surgery, and the Turkish Society of Hospital Infections and Control, was formed to analyze relevant studies in the literature. Ultimately, the suggestions for adults found in this consensus report were developed using available data from Turkey, referring predominantly to the 2010 guidelines for diagnosing and managing complicated IAIs in adults and children by the Infectious Diseases Society of America (IDSA) and the Surgical Infection Society. The recommendations are presented in two sections, from the initial diagnostic evaluation of patients to the treatment approach for IAI. This Consensus Report was presented at the EKMUD 2016 Congress in Antalya and was subsequently opened for suggestions on the official websites of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey and Turkish Surgical Association for one month. The manuscript was revised according to the feedback received.
- Published
- 2016
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