Makale Koleksiyonu

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

2014-01-01T00:00:00Z

Liver involvement in patients with brucellosis: results of the Marmara study D. Ozturk-Engin; H. Erdem; S. Gencer; Kaya, Süleyman; A. I. Baran; A. Batirel; R. Tekin; M. K. Celen; A. Denk; S. Guler; M. Ulug; H. Turan; A. U. Pekok; G. Mermut; Kaya, Süleyman; M. Tasbakan; N. Tulek; Y. Cag; A. Inan; A. Yalci; C. Ataman-Hatipoglu; I. Gonen; A. Dogan-Celik Brucellosis is a zoonotic disease that primarily affects the reticuloendothelial system. But, the extent of liver damage in due course of the disease is unclear. This study included 325 brucellosis patients with significant hepatobiliary involvement identified with microbiological analyses from 30 centers between 2000 and 2013. The patients with a parts per thousand yen5 times of the upper limit of normal for aminotransferases, total bilirubin level a parts per thousand yen2 mg/dl or local liver lesions were enrolled. Clinical hepatitis was detected in 284 patients (87.3 %) and cholestasis was detected in 215 (66.1 %) patients. Fatigue (91 %), fever (86 %), sweating (83 %), arthralgia (79 %), and lack of appetite (79 %) were the major symptoms. Laboratory tests showed anemia in 169 (52 %), thrombocytopenia in 117 (36 %), leukopenia in 81 (25 %), pancytopenia in 42 (13 %), and leukocytosis in 20 (6 %) patients. The most commonly used antibiotic combinations were doxycycline plus an aminoglycoside (n = 73), doxycycline plus rifampicin (n = 71), doxycycline plus rifampicin and an aminoglycoside (n = 27). The duration of ALT normalization differed significantly in three treatment groups (p < 0.001). The use of doxycycline and an aminoglycoside in clinical hepatitis showed better results compared to doxycycline and rifampicin or rifampicin, aminoglycoside, doxycycline regimens (p < 0.05). However, the length of hospital stay did not differ significantly between these three combinations (p > 0.05). During the follow-up, treatment failure occurred in four patients (1 %) and relapse was seen in three patients (0.9 %). Mortality was not observed. Hepatobiliary involvement in brucellosis has a benign course with suitable antibiotics and the use of doxycycline and an aminoglycoside regimen seems a better strategy in select patients.

Epicardial Fat Thickness in Patients with Prediabetes and Correlation with Other Cardiovascular Risk Markers

2015-01-01T00:00:00Z

Epicardial Fat Thickness in Patients with Prediabetes and Correlation with Other Cardiovascular Risk Markers Dilek Arpaci; Burcak Polat Ugurlu; Abdullah Nabi Aslan; Reyhan Ersoy; Akçay, Mustafa; Bekir Cakir Conclusion We found the EFT levels to be increased in all subgroups of prediabetic patients regardless of FPG and HbA1c. Furthermore, EFT directly correlated with the patients' BMI and WC.

Achalasia secondary to lung adenocarcinoma

2015-01-01T00:00:00Z

Achalasia secondary to lung adenocarcinoma Burak Can; Fatih Balli; Ugur Korkmaz; Yılmaz, Hayati; Fatma Inci Can; Çelebi, Ahmet

Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis

2015-01-01T00:00:00Z

Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis Hakan Erdem; Yasemin Cag; Derya Ozturk-Engin; Sylviane Defres; Kaya, Süleyman; Lykke Larsen; Mario Poljak; Bruno Barsic; Xavier Argemi; Signe Maj Sorensen; Anne Lisbeth Bohr; Pierre Tattevin; Jesper Damsgaard Gunst; Lenka Bastakova; Matjaz Jereb; Isik Somuncu Johansen; Karabay, Oğuz; Abdullah Umut Pekok; Oguz Resat Sipahi; Mahtab Chehri; Guillaume Beraud; Ghaydaa Shehata; Rosa Fontana Del Vecchio Data in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome.