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Öğe Andiscriminated aseptic meningitis case between rickettsia and leptospiral meningitis(2008) Özdemir, Davut; Şencan, İrfan; Yıldırım, Mustafa; Güçlü, Ertuğrul; Yavuz, Tevfik; Karabay, OğuzRickettsial meningitis and leptospiral meningitis should be included in the differential diagnosis of aseptic meningitis in patients exposed to endemic areas. In this report we describe a case of aseptic meningitis in which neither a rickettsial nor leptospiral etiology could be established.Öğe Comparison of colistin monotherapy and non-colistin combinations in the treatment of multi-drug resistant Acinetobacter spp. bloodstream infections: A Multicenter retrospective analysis(Medknow Publications & Media Pvt Ltd, 2015) Balkan, İlker İnanç; Batırel, Ayşe; Karabay, Oğuz; Ağalar, Canan; Akalın, Şerife; Alıcı, Özlem; Yılmaz, HavaObjectives: To compare the efficacy of colistin (COL) monotherapy versus non-COL based combinations in the treatment of bloodstream infections (BSIs) due to multidrug resistant Acinetobacter spp.(MDR-A) . Materials and Methods: Retrospective data of 107 MDR-A BSI cases from 27 tertiary centers in Turkey were included. Primary End-Point: 14-day mortality. Secondary End-Points: Microbial eradication and clinical improvement. Results: Thirty-six patients in the COL monotherapy (CM) group and 71 in the non-COL based combinations (NCC) group were included in the study. Mean age was 59.98 20 years (range: 18-89) and 50.5% were male. Median duration of follow-up was 40 days (range: 9-297). The 14-day survival rates were 52.8% in CM and 47.23% in NCC group (P = 0.36). Microbiological eradication was achieved in 69% of CM and 83% of NCC group (P = 0.13). Treatment failure was detected in 22.9% of cases in both CM and NCC groups. Univariate analysis revealed that mean age (P = 0.001), Charlson comorbidity index (P = 0.03), duration of hospital stay before MDR-A BSI (P = 0.04), Pitt bacteremia score (P = 0.043) and Acute Physiology and Chronic Health Evaluation II score (P = 0.05) were significant in terms of 14-day mortality. Advanced age (P = 0.01) and duration of hospital stay before MDR-A BSI (P = 0.04) were independently associated with 14-day mortality in multivariate analysis. Conclusion: No significant difference was detected between CM and non-COL based combinations in the treatment of MDR-A BSIs in terms of efficacy and 14-day mortality.Öğe Comparison of colistin-carbapenem, colistin-sulbactam, and colistin plus other antibacterial agents for the treatment of extremely drug-resistant Acinetobacter baumannii bloodstream infections(Springer, 2014) Batırel, Ayşe; Balkan, İlker İnanç; Karabay, Oğuz; Ağalar, Canan; Akalın, Şerife; Alıcı, Özlem; Yılmaz, HavaThe purpose of this investigation was to compare the efficacy of colistin-based therapies in extremely drug-resistant Acinetobacter spp. bloodstream infections (XDR-ABSI). A retrospective study was conducted in 27 tertiary-care centers from January 2009 to August 2012. The primary end-point was 14-day survival, and the secondary end-points were clinical and microbiological outcomes. Thirty-six and 214 patients [102 (47.7 %): colistin-carbapenem (CC), 69 (32.2 %): colistin-sulbactam (CS), and 43 (20.1 %: tigecycline): colistin with other agent (CO)] received colistin monotherapy and colistin-based combinations, respectively. Rates of complete response/cure and 14-day survival were relatively higher, and microbiological eradication was significantly higher in the combination group. Also, the in-hospital mortality rate was significantly lower in the combination group. No significant difference was found in the clinical (p = 0.97) and microbiological (p = 0.92) outcomes and 14-day survival rates (p = 0.79) between the three combination groups. Neither the timing of initial effective treatment nor the presence of any concomitant infection was significant between the three groups (p > 0.05) and also for 14-day survival (p > 0.05). Higher Pitt bacteremia score (PBS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Charlson comorbidity index (CCI), and prolonged hospital and intensive care unit (ICU) stay before XDR-ABSI were significant risk factors for 14-day mortality (p = 0.02, p = 0.0001, p = 0.0001, p = 0.02, and p = 0.01, respectively). In the multivariable analysis, PBS, age, and duration of ICU stay were independent risk factors for 14-day mortality (p < 0.0001, p < 0.0001, and p = 0.001, respectively). Colistin-based combination therapy resulted in significantly higher microbiological eradication rates, relatively higher cure and 14-day survival rates, and lower in-hospital mortality compared to colistin monotherapy. CC, CS, and CO combinations for XDR-ABSI did not reveal significant differences with respect to 14-day survival and clinical or microbiological outcome before and after propensity score matching (PSM). PBS, age, and length of ICU stay were independent risk factors for 14-day mortality.Öğe Comparison of Four Different Body Region to Fever Measurement and Investigation of Patient Preference(Düzce Üniversitesi, 2009) İlçe, Arzu; Karabay, OğuzAims: The aim of this study is to compare the tympanic thermometer with mercury thermometer and to determine patient preferences using four different body regions (oral, axillar, rectal and tympanic).Materials and methods: This descriptive type of study was carried out with 95 adult patients who went into A.I.B.U Bolu State Hospital between the dates March and April in 2004 and they are volunter to participate in the research. Temperature was measured using tympanic, mercury thermometer in the four different body regions and the patients are asked to evaluate each method.Results: It’s determined difference between oral and aksillar 0.19 0C (oral gt; aksillar), between oral and right ear was 0.07 0C (right ear gt; oral), between oral and rectal was 0.45 0C (rektal gt; oral), between aksillar and right ear was 0.26 0C (right ear gt; aksillar). It is stated that the best method is tympanic with 73.40%, the good method is axillar with 52.12% the moderate method is oral with 72.34%, the worst method is rectal with complete.Conclusion: At the end of this study, evident temperature differences can be determined according to fever measurement region of the body and the equipment used to measure fever. Although it is found that rectal thermometers are more effective in fixing fever, as especially adults don't prefer this method it is determined that using tympanic thermometers for adults is more suitableÖğe COMPARISON OF HCV RNA AND HCV CORE ANTIGEN IN GENOTYPE 1 CHRONIC HEPATITIS C PATIENTS(Carbone Editore, 2014) Karabay, Oğuz; Öğütlü, Aziz; Ankaralı, Handan; Özdemir, Fatma; Karabay, Meltem; Gözdaş, Hasan TahsinBackground: Anti-HCV test is currently used in the diagnosis of hepatitis C, while hepatitis C virus ribonucleic acid (HCV RNA) is used in the determination of viral load. Recently developed hepatitis C virus core antigen (HCV Ag) test is also used in the diagnosis of hepatitis C. The aim of this study was to compare HCV Ag and quantitative HCV RNA in terms of sensitivity and specificity as well as pharmacoeconomic footprint. Patients and methods: Sixty patients with positive anti-HCV were enrolled to this study. Quantitative HCV RNA was studied by ready commercial kits (Qiagen, lower limit of <12 IU/ml). HCV Ag test was studied with microparticule chemiluminiscent immunoassay method using ready commercial kits (Architect HCV Ag, Abbott). Conclusions: HCV Ag and HCV RNA levels were measured in the sera of chronic hepatitis C patients. Quite high correlation was found between the two tests (r = 0.83). According to our results, HCV Ag test may be an alternative to quantitative reverse transcription polymerase chain reaction (PCR) test. Thus, use of HCV Ag in place of HCV RNA will be more cost-effective for countries with limited sources.Öğe Decreasing risk of Staphylococcus aureus infections(W B Saunders Co-Elsevier Inc, 2007) Karabay, Oğuz; Yıldırım, Mustafa; Özdemir, Davut…Öğe Development and validation of a modified quick SOFA scale for risk assessment in sepsis syndrome(Public Library Science, 2018) Çağ, Yasemin; Karabay, Oğuz; Sipahi, Oğuz Reşat; Aksoy, Firdevs; Durmuş, Gül; Batırel, Ayşe; Vahaboğlu, HalukSepsis is a severe clinical syndrome owing to its high mortality. Quick Sequential Organ Failure Assessment (qSOFA) score has been proposed for the prediction of fatal outcomes in sepsis syndrome in emergency departments. Due to the low predictive performance of the qSOFA score, we propose a modification to the score by adding age. We conducted a multicenter, retrospective cohort study among regional referral centers from various regions of the country. Participants recruited data of patients admitted to emergency departments and obtained a diagnosis of sepsis syndrome. Crude in-hospital mortality was the primary endpoint. A generalized mixed-effects model with random intercepts produced estimates for adverse outcomes. Model-based recursive partitioning demonstrated the effects and thresholds of significant covariates. Scores were internally validated. The H measure compared performances of scores. A total of 580 patients from 22 centers were included for further analysis. Stages of sepsis, age, time to antibiotics, and administration of carbapenem for empirical treatment were entered the final model. Among these, severe sepsis (OR, 4.40; CIs, 2.35-8.21), septic shock (OR, 8.78; CIs, 4.37-17.66), age (OR, 1.03; CIs, 1.02-1.05) and time to antibiotics (OR, 1.05; CIs, 1.01-1.10) were significantly associated with fatal outcomes. A decision tree demonstrated the thresholds for age. We modified the quick Sequential Organ Failure Assessment (mod-qSOFA) score by adding age (> 50 years old = one point) and compared this to the conventional score. H-measures for qSOFA and mod-qSOFA were found to be 0.11 and 0.14, respectively, whereas AUCs of both scores were 0.64. We propose the use of the modified qSOFA score for early risk assessment among sepsis patients for improved triage and management of this fatal syndrome.Öğe EFFICACY OF COLISTIN AND NON-COLISTIN MONOTHERAPIES IN MULTI-DRUG RESISTANT ACINETOBACTER BAUMANNII BACTEREMIA/SEPSIS(Carbone Editore, 2014) Karabay, Oğuz; Batırel, Ayşe; Balkan, İlker İnanç; Ağalar, Canan; Akalın, Şerife; Alıcı, Özlem; Yılmaz, HavaObjective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB). Materials and methods: Cases with MDR-AB from 27 tertiary-referral hospitals between January 2009 and December 2012 were included. Patients' data that were on either colistin monotherapy (CM) or non-colistin monotherapy (NCM) were compared. Mortality on Day 14 was the primary endpoint, whereas microbiological eradication and clinical outcome were the secondary ones. Results: Eighty-four cases were included in the study with 36 being in the CM group and 48 in the NCM group. Thirty-eight (452%) cases were male and the mean age was 602 years. The mean durations of pre-MDR-AB hospital stay and intensive care unit stay were 25.8 days and 20.9 days, respectively. All of the cases had fever (>38 degrees C). The mean Pitt bacteremia score (PBS) of the patients was calculated as 6.8, APACHE 2 score as 18.9 and the Charlson co-morbidity index (CCI) as 3.7 (CM: 3.6 vs. NCM: 3.9). Twenty (55.6%) cases in the CM group and 26 cases in the NCM group (542%) (p=0.81) died; 9 cases in the CM group (25%) and 16 cases in the NCM group (33 3%) had treatment failure (P=0.55). Bacteriological eradication was achieved in 20 (55.6%) cases in the CM group and in 36 cases (75%) in the NCM group (P=0.061). Conclusions: No significant difference could be identified between the colistin monotherapy and non-colistin monotherapy options in MDR-AB cases with respect to the results of efficacy and 14-day mortality.Öğe Famotidine in COVID-19 treatment(Düzce Üniversitesi, 2021) Taşdemir, Canatan; Güçlü, Ertuğrul; Devran Muharremoğlu, Zeynep; Hotschka, El Medina; Aydemir, Yusuf; Öğütlü, Aziz; Karabay, OğuzObjective: Famotidine is an H2 receptor antagonist (H2RA) and has been shown to have antiviral properties in in-vitro studies. Pantoprazole is one of the proton pump inhibitors (PPI). In this study, it was aimed to compare the efficacy of Famotidine with Pantoprazole in the treatment of COVID-19.Material-method: Patients who were hospitalized and given famotidine and pantoprazole treatment for at least 48 hours were included in the study. Demographic, clinical and laboratory findings of the patients were analyzed retroprospectively from the patient files. While the primary endpoints were the need for an intensive care unit (ICU) and death, the secondary endpoints were the absence of the need for oxygen support, fever to normal levels, and length of hospital stay.Results: A total of 179 Covid-19 patients (85 (47.5%) famotidine, 94 (52.5%) pantoprazole) were included in the study. Demographic findings and other symptoms except dyspnea were similar in both groups (p> 0.05). Dyspnea, chronic diseases, and the number of patients given steroids were higher in those who were given pantoprazole (p 0.05). The number of days with fever, duration of hospitalization, and the number of days requiring oxygen support was less in those given famotidine (pÖğe Frequency of nasal helicobacter pylori carriage among cooks(Pakistan Medical Assoc, 2013) Karabay, Oğuz; Güçlü, Ertuğrul; Kocoğlu, Esra; Özdemir, Davut; Şencan, İrfan; Karabay, Meltem; Gözdaş, Hasan TahsinObjective: To investigate the frequency of nasal helicobacter pylori carriage among cooks living in Bolu, Ardahan and Sakarya province of Turkey. Methods: A total of 54 cooks (10 from Bolu, 29 from Ardahan and 15 from Sakarya) were enrolled. Nasal helicobacter was tested using polymerase chain reaction. Results: Helicobacter pylori was detected in only one cook. Conclusion: Nasal Helicobacter pylori colonisation ratio in cooks in Turkey was found to be very low. Presumably hand hygiene compliance lowered the frequency.Öğe Investigation of Chlamydia pneumoniae and Mycoplasma pneumoniae Antibodies in Patient with Acute Tonsillopharyngitis(Düzce Üniversitesi, 2008) Yılmaz, Fahrettin; Karabay, Oğuz; Köybaşı, SerapAim: This study was aimed to investigate the sero-provelence of Chlamydia pneumoniae and Mycoplasma pneumoniae in patiens admitted to the ENT outpatient clinic with symptoms of acute tonsillopharangitis, and without Group A B hemolytic streptococci in throat culture. Material and Method: A total 32 subjects (aged 16 to 59, 12 male and 20 woman mean age; 34.2), who had no Group A B hemolytic streptococci in their throat culture,were included in the study. Blood was taken from patients, and serum Mycoplasma pneumoniae and Chlamydia pneumoniae antibodies were studied by ELISA with commercial tests. Result: Mycoplasma pneumoniae Ig M antibody was not detected in any subject while Chlamydia pneumoniae antibodies were positive in 6 (18.75%) subjects. Mycoplsma and Chlamydia Ig G tests were found to be positive in 6 (18.75%) and 19(59.375%) subjects, respectively. Conclusion: These results indicate that Chlamydia pneumoniae and Mycoplasma pneumoniae should be considered in patients with tonsillopharyngitisÖğe The investigation of nasal MRSA carriage and colonization of nasopharyngeal pathogens at a primary school in Duzce(Tubitak Scientific & Technical Research Council Turkey, 2007) Yıldırım, Mustafa; Şahin, İdris; Başak, Semra; Öksüz, Şükrü; Özaydın, Çiğdem; Acar, Selda; Karabay, OğuzAim: The aim of the study was to investigate nasopharyngeal colonization of respiratory tract pathogens and nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) in healthy schoolchildren (6-14 years old). Materials and Methods: The present study was conducted at Konuralp Primary School by Duzce University and 484 healthy children were included. Isolates obtained from nasal and nasopharyngeal cultures were identified by conventional microbiological procedures and Api 20 strep, NH. Results: 56.6% of healthy schoolchildren had at least one nasopharyngeal potential bacteria[ pathogen. Isolated bacteria species were as follows: 6% group A streptococcus (GAS), 5.0% S. pneumoniae, 33.1% M. catarrhalis, and 34.9% H. influenzae. All of the isolated GAS species were susceptible to penicillin. 8.3% of S. pneumoniae isolates were intermediately resistant to penicillin. Beta-lactamase test was found positive for M. catarrhalis and H. influenzae in 90.3 and 8.3%, respectively. There was a significant relationship between nasopharyngeal colonization of M. catarrhalis and antibiotic usage in the past six months (P=0.018) and nasopharyngeal colonization of H. influenzae and antibiotic usage in the household (P=0.001). The rate of nasal MRSA carriage in healthy children was 5%. This rate was found higher in the 6-10 age group compared to the 11-14 age group (P=0.012). Conclusions: Our data showed that nasopharyngeal carriage of potential respiratory pathogens in schoolchildren should not be underestimated. More comprehensive surveillance studies should be performed to obtain correct information about the carriage.Öğe Kadın Hastalıkları ve Doğum Hekimlerinin HIV (+) Gebe Yönetimindeki Bilgi, Tutum ve Davranışlarının İncelenmesi(2020) Yuvacı, Hilal Uslu; Toptan, Hande; Kaya, Tuğba; Altındiş, Mustafa; Karabay, Oğuz; Cevrioğlu, SerhanAmaç: HIV (Human Immunodeficiency Virus) (+) gebe yönetiminde, tarama testleri ve viral yük incelemeleri, etkiliantiretroviral tedavi, sezaryen ile doğum ve emzirmeden kaçınma en güncel konulardır. Bu çalışmada kadın hastalıklarıve doğum (KD) hekimlerinin HIV (+) gebe yönetimi konusundaki bilgi, tutum ve davranışlarının incelenmesiamaçlanmıştır.Gereç ve Yöntemler: Demografik bilgiler ve literatürden destek alınarak HIV (+) gebe yönetimine yönelik hazırlananonline/dijital anket ile KD hekimlerine ulaşılarak konu ile alakalı bilgi, tutum ve davranışları belirlenmeye çalışıldı.Bulgular: Toplam 125 katılımcının 52’si (%41,6) erkek, 86’sı (%68,8) uzman hekim, 13’ü (%10,4) araştırma görevlisi,34’ü (%27,2) 20 yıl ve üzeri mesleki deneyime sahip, 115’i (%92) gebelerden düzenli olarak Anti-HIV testi istemekteolup 77’sinin (%61,6) en az bir kez Anti-HIV pozitif gebe hastası olmuş, 49’u (%39,2) bugüne kadar Anti-HIV pozitifgebe takibi yapmış, 51’i (%40,8) ise Anti-HIV pozitif en az bir gebeye doğum yaptırmıştı. Hekimlerin 121’i (%96,8)Anti-HIV pozitif gebeleri doğrulama testlerine yönlendirirken 19’u (%15,2) Anti-HIV pozitif anneye emzirmemesikonusunda bilgi vermediğini belirtti. Doğum sırasında HIV RNA düzeyleri >1000 kopya/mL veya viral yükübilinmeyen Anti-HIV pozitif gebede IV zidovudin uygulanmasının bebeğe bulaş riskini azalttığını bilenler 79 (%63,2)iken HIV (+) anneden doğana profilaksi amaçlı altı hafta zidovudin kullananlar 55’tir (%44). Anti-HIV (+) annenindoğum şekli için “Viral yükü <50 kopya/ml olan gebelerde vajinal doğum yapabilir” diyenler 35 (%28), “Her halükârdasezaryen” diyenler 43’tür (%34,4). Ante, intra ve postpartum dönemlerde Antiretroviral tedavi (ART) ile HIV'invirolojik baskılanmasıyla, yenidoğana perinatal HIV bulaşı %1’lerin altına düşebilir diyenler 47’dir (%37,6).Sonuç: KD hekimlerine, emzirmeme konusu başta olmak üzere tarama testleri/proflaksi konusu hatırlatılmalı veeğitimlerin düzenliliği sağlanmalıdır.Öğe Lamivudine therapy in HBeAg negative chronic hepatitis B patients(Elsevier Sci Ltd, 2014) Güçlü, Ertuğrul; Batırel, Ayşe; İnce, Nevin Koç; Öğütlü, Aziz; Durmaz, Y.; Özdemir, Davut; Karabay, Oğuz…Öğe A Multicenter Evaluation of Blood Culture Practices, Contamination Rates, and the Distribution of Causative Bacteria(Ahvaz Jundishapur Univ Med Sci, 2016) Altındiş, Mustafa; Köroğlu, Mehmet; Demiray, Tayfur; Dal, Tuba; Özdemir, Mehmet Emin; Şengil, Ahmet Zeki; Karabay, OğuzBackground: The prognostic value of blood culture testing in the diagnosis of bacteremia is limited by contamination. Objectives: In this multicenter study, the aim was to evaluate the contamination rates of blood cultures as well as the parameters that affect the culture results. Materials and Methods: Sample collection practices and culture data obtained from 16 university/research hospitals were retrospectively evaluated. A total of 214,340 blood samples from 43,254 patients admitted to the centers in 2013 were included in this study. The blood culture results were evaluated based on the three phases of laboratory testing: the pre-analytic, the analytic, and the post-analytic phase. Results: Blood samples were obtained from the patients through either the peripheral venous route (64%) or an intravascular catheter (36%). Povidone-iodine (60%) or alcohol (40%) was applied to disinfect the skin. Of the 16 centers, 62.5% have no dedicated phlebotomy team, 68.7% employed a blood culture system, 86.7% conducted additional studies with pediatric bottles, and 43.7% with anaerobic bottles. One center maintained a blood culture quality control study. The average growth rate in the bottles of blood cultures during the defined period (1259 -26,400/year) was 32.3%. Of the growing microorganisms, 67% were causative agents, while 33% were contaminants. The contamination rates of the centers ranged from 1% to 17%. The average growth time for the causative bacteria was 21.4 hours, while it was 36.3 hours for the contaminant bacteria. The most commonly isolated pathogens were Escherichia coli (22.45%) and coagulase-negative staphylococci (CoNS) (20.11%). Further, the most frequently identified contaminant bacteria were CoNS (44.04%). Conclusions: The high contamination rates were remarkable in this study. We suggest that the hospitals' staff should be better trained in blood sample collection and processing. Sterile glove usage, alcohol usage for disinfection, the presence of a phlebotomy team, and quality control studies may all contribute to decreasing the contamination rates. Health policy makers should therefore provide the necessary financial support to obtain the required materials and equipment.Öğe A new effect of acetylsalicylic acid ? Significantly lower prevalence of nasal carriage of Staphylococcus aureus among patients receiving orally administered acetylsalicylic acid(Univ Chicago Press, 2006) Karabay, Oğuz; Arınç, Hüseyin; Gündüz, Hüseyin; Tamer, Ali; Özhan, Hakan; Uyan, CihangirWe aimed to evaluate effect of acetylsalicylic acid on the prevalence of nasal carriage of Staphylococcus aureus. Patients were orally administered a prophylactic dose of acetylsalicylic acid and then were compared with control subjects. The prevalence of nasal carriage of S. aureus was significantly lower among patients who received acetylsalicylic acid than among the control subjects (P < .001).Öğe Ofloxacin plus Rifampicin versus Doxycycline plus Rifampicin in the treatment of brucellosis: a randomized clinical trial [ISRCTN11871179](Biomed Central Ltd, 2004) Karabay, Oğuz; Şencan, İrfan; Kayaş, Derya; Şahin, İdrisBackground: The combination therapies recommended by the World Health Organization for treatment of brucellosis are doxycycline plus rifampicin or doxycycline plus streptomycin. Although highly successful results have been obtained with these two regimens, relapse rates as high as 14.4%. The most effective and the least toxic chemotherapy for human brucellosis is still undetermined. The aim of the present study was to investigate the efficacy, adverse effects and cost of ofloxacin plus rifampicin therapy, and doxycycline plus rifampicin therapy and evaluate in the treatment of brucellosis. Methods: The open trial has been carried out prospectively by the two medical centers from December 1999 to December 2001 in Duzce region Turkey. The diagnosis was based on the presence of signs and symptoms compatible with brucellosis including a positive agglutination titre (greater than or equal to1/160) and/or a positive culture. Doxycycline and rifampicin group consisted of 14 patients who were given doxycycline 200 mg/day plus rifampicin 600 mg/day during 45 days and this group Ofloxacin plus rifampicin group was consisted of 15 patients who were given ofloxacin 400 mg/day plus rifampicin 600 mg/day during 30 days. Results: Regarding clinical and/or demographic characteristics no significant difference was found between two groups of patients that underwent two different therapeutic regimens. At the end of the therapy, two relapses were seen in both groups (p=0.695). Although duration of therapy was two weeks shorter in group treated with rifampicin plus ofloxacin, the cure rate was similar in both groups of examinees. Fever dropped more rapidly in the group that treated with rifampicin plus ofloxacin, 74+/-30 (ranges 48-216) vs. 106+/-26 (ranges 48-262) hours (p=0.016). Conclusions: Ofloxacin plus rifampicin therapy has advantages of shorter treatment duration and provided shorter course of fever with treatment than in doxycycline plus rifampicin therapy. However, cost of ofloxacin plus rifampicin treatment is higher than doxycycline plus rifampicin treatment. Because of the similar effects, adverse effects and relapses rates between two regimens, we still advice doxycycline plus rifampicin for the treatment of brucellosis for countries, which have limited resources.Öğe An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side(Yonsei Univ College Medicine, 2009) Şencan, İrfan; Şahin, İdris; Kaya, Demet; Öksüz, Şükrü; Özdemir, Davut; Karabay, OğuzPurpose: We describe the epidemiological and clinical characteristics and the efficacy of a delayed initiation to therapy in an oropharyngeal tularemia outbreak in Duzce, Turkey. Materials and Methods: Between March and June 2000, 22 patients with tularemia were diagnosed by microagglutination tests. Results: Oropharyngeal and ulceroglandular forms of the disease were discovered. Most of the cases were oropharyngeal (19 cases). The most common symptoms were sore throat (95.4%) and fever (90.9%). Lymphadenopathy (95.4%) and pharyngeal hyperemia (81.8%) were usually observed signs. The lymphadenopathies were localized especially in the left cervical region (66.7%), a finding that has not been previously reported in the literature. The time between the onset of the symptoms and diagnosis was 40.7 +/- 22.8 (10-90) days. The patients were treated with streptomycin plus doxycycline and ciprofloxacin. The patients' recoveries took up to 120 days. Conclusion: This report describes the first outbreak of tularemia in northwest Turkey. Tularemia may occur in any region where appropriate epidemiological conditions are found and should be kept ill mind for differential diagnosis in oropharyngeal symptoms. Late initiation of therapy may delay complete recovery. In this outbreak, cervical lymph nodes predominantly localized on the left side were found, which had not been previously reported.Öğe Predictors of response to pegylated interferon treatment in HBeAg-negative patients with chronic hepatitis B(J Infection Developing Countries, 2014) Güçlü, Ertuğrul; Tuna, Nazan; Karabay, Oğuz; Akhan, Sıla; Bodur, Hürrem; Ceylan, Bahadır; Tütüncü, EdizIntroduction: Although pegylated interferons (pegIFNs) alpha-2a and alpha-2b have been used in chronic hepatitis B (CHB) treatment for many years, there are few studies concerning predictors of sustained virologic response (SVR) to pegIFN therapy. In this study, we aimed to investigate the predictors of response to pegIFN treatment in cases with HBeAg-negative CHB infection. Methodology: Seventeen tertiary care hospitals in Turkey were included in this study. Data from consecutively treated HBeAg-negative CHB patients, who received either pegIFN alpha-2a or alpha-2b, were collected retrospectively. SVR is defined as an HBV DNA concentration of less than 2,000 IU/mL six months after the completion of therapy Results: SVR was achieved in 40 (25%) of the 160 HBeAg-negative CHB patients. Viral loads in patients with SVR were lower compared to those with no SVR, beginning in the third month of treatment (p < 0.05). The number of cases with a decline of 1 log(10) IU/mL in viral load after the first month of treatment and with a serum HBV DNA level under 2,000 IU/mL after the third month of treatment was higher in cases with SVR (p < 0.05). The number of patients who had undetectable HBV DNA levels at week 48 among responders was significantly greater than among post-treatment virological relapsers (p < 0.05). Conclusions: Detection of a 1 log(10) decline in serum HBV DNA level at the first month of treatment and a serum HBV DNA level < 2000 IU/mL at the third month of therapy may be predictors of SVR.Öğe Prevalance and risk factors for yeast colonization in adult diabetic patients(Ethiopian Med Assn, 2005) Şahin, İdris; Öksüz, Şükrü; Şencan, İrfan; Gülcan, Aynur; Karabay, Oğuz; Gülcan, Erim; Yıldız, Özcan…
