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Öğe Antiviral Treatment Results and Side Effects During Treatment in Chronic Hepatitis B Patients(Doc Design Informatics Co Ltd, 2021) Bulut, Rukiyye; Kurt, Esma Kepenek; Kandemir, Bahar; Erayman, Ibrahim; Bitirgen, MehmetObjective: Hepatitis B virus is an important health problem leading to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. This study aimed to compare the efficacy and side effects of antiviral drugs used in chronic hepatitis B (CHB). Methods: Five hundred seventy-two patients who were followed and treated with CHB in our clinic were evaluated retrospectively. Results: Fifty-six point five of 572 patients were male, 43.5% were female, and the mean age of the patients was 43.4 +/- 12.4. Of the patients, 153 (26.8%) used tenofovir disoproxil fumarate (TDF), 134 (23.4%) telbivudine (LdT), 114 (20%) entecavir (ETC), 92 (16%) lamivudine (LAM), 26 (4.5%) adefovir (ADV), 27 (4.7%) pegylated interpheron alpha (PEG-IFN-alpha), and 26 (4.6%) used PEG-IFN-alpha + nucleoside analogue (NA). No significant difference was detected between the treatment groups in terms of age, sex ratio, fibrosis, histological activity index (HAI) score, baseline platelet, international normalized ratio (INR), alpha-fetoprotein (AFP) values (p>0.05). Seventy (12.3%) of 568 patients were HBeAg (+), 498 (87.7%) were HBeAg (-). At the end of the first year, the virological response rates were 92.5% in LdT, 82.6% in LAM, 72.8% in ETV, 60.7% in TDF, 26.9% in ADV, 22.2% in PEG-IFN-alpha, 65.3% in PEG-IFN-alpha+NA groups. Twenty-three point eight of the patients had treatment changes, and 76.3% of these patients preferred TDF as a new treatment. Virological breakthrough was observed at 43.5% in LAM, 13.4% in LdT, 7% in ETV and 0.6% in TDF groups. At the end of 3, 4, and 5 years without treatment change, all patients who continued TDF, ETV, LdT, ADV, and LAM treatment were HBV DNA negative. HBsAg clearance developed in 13 (2.3%) patients. At least one side effect was observed in 169 (29.5%) of all patients, and the group with the most frequent side effects was PEG-IFN-alpha+NA (92.3%) and PEG-IFN-alpha (77.8%). Amylase increase in LAM (%3.2), CPK increase in LdT (%27.6), CPK increase in TDF (%3.2) groups were the most common side effects. Conclusions: The drug with the lowest virological response rate and the most common side effect is PEG-IFN-alpha, so its use should be limited to selected patient groups. Treatments with the lowest incidence of side effects and development of resistance were found to be with TDF and ETV. Considering the high virological response rates, TDF and ETV should be preferred in the treatment of CHB. When all treatments are evaluated, HBsAg loss and cure rates are inadequate.Öğe Association of Tumor Necrosis Factor Alpha -238G/A and -308G/A Promotor Polymorphisms with Clearance of Hepatitis B Virus Infection in Turkish Population(2019) İnkaya, Ahmet Çağkan; Türk Arıbaş, Emel; Erayman, İbrahim; Kandemir, Bahar; Acar, Hasan; Bitirgen, MehmetObjectives: Acute viral hepatitis B may lead to chronic hepatitis in 6% of adultpopulation. We compared the frequency of Tumor necrosis factor alpha promotor polymorphisms in chronic hepatitis B patients and people with natural immunity against hepatitis B.Materials and Methods: Chronic hepatitis B patients and age matched control cases with natural immunity to hepatitis B virus were recruited 1:1 in this study. Tumornecrosis factor alpha -238G/A and -308G/A polymorphisms were studied withPCR-RFLP. ?2 test was performed in statistical analysis.Results: A total of 101 volunteers enrolled in two study groups. Thirty-eight menand 12 women constituted the chronic hepatitis B patient group and 40 men and11 women recruited in natural immunity group. Frequency of -238G allele was87.5% and 97% in chronic hepatitis B and natural immunity groups, respectively.Frequency of -308G allel was 93% and 92.1% in chronic hepatitis B and natural im-munity groups, respectively. Frequencies of polymorphisms at positions -238 and-308 in the promotor of tumor necrosis factor alpha gene were not different be-tween chronic hepatitis B and natural immunity groups.Discussion: Tumor necrosis factor alpha promoter polymorphisms at -238 and-308 positions do not effect the outcome hepatitis B infection in Turkish population. Clearance of hepatitis B virus infection is multifactorial. Thus, further studiesneeded to identify genetic predisposition to chronic hepatitis B infection.Öğe Brucellosis: Evaluation of Two Hundred and Ten Cases with Different Clinical Features(Acad Medicine Singapore, 2020) Eroglu, Esma; Kandemir, BaharIntroduction: Brucellosis is an important zoonotic disease and a major cause of morbidity worldwide presenting with varying clinical manifestations. We aimed to investigate the epidemiological characteristics and complications of brucellosis at the Van Training and Research Hospital from January 2018 to December 2018. Materials and Methods: 210 patients with brucellosis were assessed retrospectively. The clinical histories and signs, laboratory findings, therapeutic features and complications of these patients were obtained by examining their medical files. results: Of the 210 patients, the most common symptoms were myalgia (87.6%), arthralgia (76.2%) and fever (72.4%). The most frequent clinical signs mere fever (72.4%) and arthritis (21.9%). Out of 210 patients, standard tube agglutination (STA) tests werepositive in 208 (99%). Osteoarticular involvement (34.3%) was common; and a combination of rifampicin and doxycycline was the most frequently used antimicrobial regimen. Conclusion: It should be kept in mind that brucellosis may occur in patients presenting with fever, sweating, arthralgia and leukopenia, especially in endemic areas where dairy livestock is prevalent. People living in these areas should be educated about proper animal care and the handling of dairy products.Öğe A case-control study on the temperament and Psychological mood of patients with chronic Hepatitis B(Modestum Ltd, 2017) Findikli, Ebru; Ates, Selma; Kandemir, Bahar; Karaaslan, Mehmet Fatih; Camkurt, Mehmet Akif; Izci, Filiz; Durduran, YaseminObjective: To evaluate the personality and temperament traits in patients with chronic hepatitis B in comparison to healthy subjects and to determine whether there is a relation between personality trait and level of anxiety or depression. Materials/Subjects and Method: This was a case-control study in which 67 patients who had been under follow-up with diagnosis of chronic hepatitis B and 103 aged-matched healthy subjects were included. Study participants were asked to complete three self-report questionnaires-Temperament and Character Inventory (TCI) to define personality traits, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) to evaluate presence and severity of depression and anxiety. Results: Total and sub-scale scores of five out of seven dimensions of TCI-reward dependence, persistence, self-directedness, cooperativeness, and self-transcencewere significantly higher in Group 1 than Group 2. Total BDI and BAI scores were significantly higher in Group 1 than Group 2. Significantly more patients had a BDI score of 17 or over in Group 1 than Group 2. There was no significant correlation between total scores of TCI dimensions and total BAI or BDI scores except weak correlations between harm avoidance or self-directedness and total BAI or BDI scores. Conclusion: In terms of personality trait, patients with chronic hepatitis B exhibit higher reward dependence, persistence, self-directedness, cooperativeness, and self-transcendence from healthy population. The personality traits of patients should be considered during the management of hepatitis B in order to optimize treatment outcome and to prevent development of new mental health problems during the course of the disease.Öğe Comparison of Clinical and Laboratory Findings and Computed Tomography Findings of SARS-CoV-2 Infected Patients Followed-up in a Tertiary University Hospital(Galenos Publ House, 2021) Kurt, Esma Kepenek; Kandemir, Bahar; Erayman, Ibrahim; Vatansev, Hulya; Zamani, Adil; Yosunkaya, Sebnem; Demirbas, SonerIntroduction: The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection is a pandemic, a major global health concern. In this study, it was aimed to compare the clinical, laboratory and computed tomography (CT) findings of patients with SARS-CoV-2 infection followed up in our hospital. Materials and Methods: In this study, reverse transcriptase-polymerase chain reaction (RT-PCR) positive patients hospitalized between 01.03.2020-31.05.2020 were retrospectively analyzed. Computed tomography images of the patients were grouped as typical, indeterminate, atypical, and no pneumonia based on the Radiological Society of North America. After recording patient information on SPSS, clinical and laboratory findings of the patients were analyzed by comparing them to CT findings. Results: Among 237 RT-PCR positive patients, 104 (43.9%) were female and 133 (56.1%) were male. The mean age of the patients was 50.46 +/- 17.26 (18-92) years and the mean symptom onset time of the patients was 3.75 +/- 2.72 (median: 3) days. Eighty-seven of the patients (36.7%) had contact stories. Twenty-three (9.7%) patients were healthcare professionals. Of the patients, 49.8% had a comorbid disease. The most common referral complaint was cough with 66.7%. The most common treatment that patients received was hydroxychloroquine (96.2%). Anemia was detected in 61 (25.7%) patients, leukopenia in 104 (43.9%), lymphopenia in 25 (10.5%) and thrombocytopenia in 14 (5.9%). High rates were detected for C-reactive protein (CRP) in 221 (84%) patients, ferritin in 190 (80.2%) patients, D-dimer in 144 (60.8%) patients, fibrinogen in 147 (62%) patients and sedimentation (SED) in 172 (72.6%) patients. Headache was detected higher in patients with typical pneumonia findings in thorax CT (p=0.006). A statistically significant difference wasn't detected between other symptoms and CT findings. Leukocyte and neutrophil counts, SED, CRP, ferritin, D-dimer, fibrinogen, aspartate aminotransferase, and lactate dehydrogenase (p=0.001) levels were observed to be higher in patients with typical pneumonia findings on thorax CT. Conclusion: Some laboratory parameters, especially acute phase reactants, were found to be higher in patients with typical pneumonia on thorax CT compared to patients without pneumonia. In this viral infection, patients should be evaluated together with clinical, laboratory and CT findings.Öğe Crimean-Congo Haemorrhagic Fever and the Role of the Migrating Birds(Aves, 2019) Kepenek-Kurt, Esma; Kandemir, Bahar; Erayman, Ibrahim; Bulut, Rukiyye; Bitirgen, MehmetObjective: We aimed to analyse patients with Crimean-Congo haemorrhagic fever (CCHF) followed in our clinic. Methods: Clinical features, laboratory findings and treatments of 12 patients with CCHF followed between 2009 and 2018 were analysed retrospectively. Results: Mean age of the patients was 37.6 +/- 13.7 (ranges 17-59); 5 (42%) were female and 7 (58%) were male. All had a history of visit to the rural areas. Fever in 10 (83%) and fatigue in 6 (50%) patients were the most common symptoms. 11 (92%) patients were from Konya and its surroundings, and 1 (8%) from Gumushane, endemic for CCHE Tick exposure was detected in 10 (83%) cases. Diagnosis was made by CCHF virus (CCHFV) RNA positivity by polymerase chain reaction (PCR) in 10 patients, while anti-CCHFV IgM antibodies by enzyme-linked immunosorbent assay were positive in two PCR-negative patients. Four patients received blood and blood products for bleeding and five patients received oral ribavirin. Eleven patients were cured and one died. There was not any nosocomial transmission in our hospital. Conclusions: In prevention of CCHE personal protection and prevention from the tick bites should be ensured. Training about transmission routes and prevention methods of CCHF should be provided to health care personnel and persons especially living in rural areas. Because Beysehir Lake which lies in the Beysehir province of Konya, is on the migration routes of migratory birds, it should be considered that inhabitants living in the region are at risk for CCHE CCHF should be considered in the differential diagnosis of patients with fever, fatigue, thrombocytopenia and elevated liver enzymes.Öğe THE EFFECT OF ULTRASOUND GUIDANCE ON CENTRAL VENOUS CATHETER-ASSOCIATED BLOODSTREAM INFECTION IN CRITICAL CARE PATIENTS(Carbone Editore, 2013) Gok, Funda; Kilicaslan, Alper; Sarkilar, Gamze; Kandemir, Bahar; Yosunkaya, AlperBackground and aims: The central venous catheterization can be performed according to anatomical references points or by using ultrasound guidance. In this study, our aim was to perform a comparison between the application of these two methods for internal vein catheterization, especially with regards to the incidence of catheter-related bloodstream infections. Materials and methods: 97 critical care patients who underwent real-time USG-guided cannulation (Grup 1) of the internal jugular vein were prospectively compared with 97 critical care patients in whom the landmark technique (Grup 2) was used. The parameters studied included average access time, time for insertion, attempts required, mechanical complications and catheter-related bloodstream infections. Results: There was no difference between the two groups with regards to demographic data (p>0.05). The mean skin-vein period, the total period of insertion, the number of attempts, the rate of mechanical complications, and the incidence of catheter-related bloodstream infections were significantly lower in Group 1 in comparison to Group 2 (p<0.0.5). Conclusions: USG-guided internal jugular vein catheterization reduced the number of attempts, and was more advantageous than the conventional method in terms of allowing a lower incidence of mechanical complications and catheter-related bloodstream infections.Öğe Evaluation of Patients Infected with Human Immunodeficiency Virus Followed in Our Clinic(Bilimsel Tip Yayinevi, 2020) Kurt, Esma Kepenek; Kandemir, Bahar; Erayman, Ibrahim; Bulut, Rukiyye; Bitirgen, MehmetIntroduction: The number of people infected with human immunodeficiency virus (HIV) in our country is increasing day by day. In this study, epidemiological, clinical, laboratory features, treatment regimens and side effects of HIV/AIDS cases followed in our clinic were evaluated. Materials and Methods: Fifty-four patients who were followed up with HIV infection in our clinic between 2000-2018 were examined retrospectively. Results: Of the 54 patients, 18 (33.3%) were females and 36 (66.7%) were males. Mean age was 42.0 +/- 15.2 (18-70) years. Mean duration of the disease was median 3 (0.5-28) and the duration of clinical follow-up was 3.3 +/- 2.7 (0.5-10) years. A total of 44 (88%) patients had risky sexual contact, and nine women were infected by her husband. The first complaint of the patients for admission to our clinic was weakness (22.2%) and fever (9.3%). Patients were diagnosed most frequently during routine examinations (48%). Mean CD4 count of the patients at the time of admission was 317.2 +/- 247.7 (7-918) cell/mm(3), and HIV-RNA was median 61000 (0-30000000) copy/mL. The most frequent treatment was tenofovir disoproxil fumarate-emtricitabine and lopinavir/ritonavir (TDF-FTC and LPV/r) in 24.4% of the patients. Treatment was changed in 14 (25.9%) patients. In five patients, noncompliance to treatment and in five patients, side effects were encountered, and treatment was changed. Hyperlipidemia was the most common side effect (52.9%) in patients receiving treatment. Prophylaxis was given to 50% of the patients in terms of opportunistic infections at the beginning of treatment. One patient had gonococcal urethritis and one patient had HPV infection in the cervix. Four patients discontinued treatment and 46 patients continued treatment. One female patient was exitus. Conclusion: The number of HIV/AIDS patients, a chronic disease, is increasing also in our country. Early diagnosis of these patients should be made, and the disease should be controlled by providing access to treatment and suppression of viral load.Öğe The Evaluation of the Relation Between Drug Compliance and Psychometric Tests in Chronic B Hepatitis Patients Who are Treated with Oral Antivirals(Galenos Yayincilik, 2019) Kurt, Esma Kepenek; Kandemir, BaharObjectives: Hepatitis B is a viral infection that causes acute and chronic hepatitis and serious complications such as cirrhosis and hepatocellular cancer. Several psychiatric symptoms and depression, particularly anxiety, can be seen in patients. Evaluation of the relation between medication adherence and psychometric tests in patients with Chronic hepatitis B (CHB) who are treated with oral antivirals is aimed in this study. Materials and Methods: Two hundred and fifty-nine patients were included in this study. Sociodemographic data form, Morisky 8 scale, Beck Anxiety scale (BAS) and Beck Depression scale (BDS) have been applied to the patients. Results: The age of the patients vary from 17 to 80, average age of the patients is foud as 46.04. A hundred eleven of the patients were women (42.9%). Two hundred and seven patients had no sign of depression (79.9%) and 52 of the patients (20.1%) had depression. The drug compliance was low in patients whose BDS scores were decreased. It has been found out that 195 of the patients had low-grade of anxiety (75.3%), 26 of the patients had midgrade of anxiety (10%), and 38 of the patients had high-grade of anxiety (14.7%). The medication adherence was low in patients whose BAS scores were decreased. Conclusion: Anxiety and depression are frequent in CHB patients. Therefore, CHB patients should be followed up psychiatrically and should be addressed to the psychiatry specialist when necessary. Depression and anxiety influences the drug compliance. Further studies are required for evaluation the relation between the medication adherence and the level of anxiety and depression in CHB patients.Öğe The Factors Related with Behaviors and Approaches of Mothers in Avoiding Children from Gastroenteritis(Georg Thieme Verlag Kg, 2019) Durduran, Yasemin; Kandemir, Bahar; Pekcan, Sevgi; Evci, ReyhanGastrointestinal infection is an important public health problem in children and is frequently seen in developing countries due to low socioeconomic status and education levels, not obeying hygiene rules, and lack of environmental sanitation. Prevention of diarrheal diseases and raising the awareness of the mothers about diarrhea/gastroenteritis is a very important subject. The aim of this study was to evaluate the knowledge and attitude of the mothers, who attended a pediatric outpatient clinic for any reason, about the management and prevention of gastroenteritis in children. This cross-sectional study was performed in Konya, Turkey. The study was carried out with mothers who attended the pediatric outpatient clinic of a faculty of medicine and who had a baby between 0 and 2 years of age. Surveys prepared according to the literature, were used for collecting data. Descriptive statistics, chi-square test, and independent t-test were used for data analysis. Ap-value of < 0.05 was considered to be significant. The mean age of mothers was 31.7 +/- 7.2 years. Of all the mothers, 97.2% had short nails, 76.3% regularly cleaned their nails once a week, and 92.2% used soap for hand washing every time. A mean score of 8.7 +/- 2.8 for a question giving 12 situations where hand washing was necessary was obtained. Of the mother's babies, 40.3% had had diarrhea at least once. In terms of giving baby water and changing feeding behavior during diarrhea/gastroenteritis, significant differences were found between mothers whose babies had diarrhea/gastroenteritis previously and those whose babies had not experienced diarrhea/gastroenteritis. 83.6% of mothers had never heard about vaccination against rotavirus. Washing hands correctly and mothers' knowledge about proper water and food hygiene are important points in protecting children against diarrheal and gastroenteritis diseases. However, there is lack of knowledge and good practice, both in protecting children from, and managing children with, diarrhea. Thus, we believe that it would be beneficial to inform and educate mothers with little children, regularly about these issues.Öğe GPER-1 in chronic hepatitis B(Elsevier, 2020) Kandemir, Bahar; Ates, Selma; Kurutas, Ergul Belge; Durduran, Yasemin; Erayman, Ibrahim; Bitirgen, MehmetEstrogen has a significant role in regulating cell proliferation, growth, migration, aging, and many disease states. Estrogen shows its effects through estrogen receptors alpha, beta, and G protein-coupled estrogen receptor 1 (GPER1). The aim of this study is to evaluate serum GPER1 levels and its relationship with fibrosis score in chronic hepatitis B patients. The cases were selected from two university hospitals and consisted of patients who had not previously been treated for hepatitis B, were over 18. Quantitative sandwich enzyme immunoassay technique was used for measuring the serum levels of GPER1. The data evaluated were analyzed by using the statistical tests. Out of the 65 cases; 26 (40%) had hepatitis B, 39 (60%) were controls. Patients underwent liver biopsy. GPER1 levels were significantly high in Hepatitis B group (p < 0.001). Out of the 26 hepatitis B patients; 21(80,8%) had low-stage fibrosis, 5(19,2%) had high-stage fibrosis. When the GPER1 level was >= 017600000 the sensitivity, specificity, positive predictive value, and negative predictive value for the hepatitis B patients were found to be 96%, 87,7%, 96%, and 92,8%, respectively. GPER levels have shown high expression in patients with chronic hepatitis B.Öğe Investigating Hepatitis C, D and HIV Prevalance in Cases with Positive Hepatitis B Virus Antigen in a Tertiary Hospital and Examining Anti-HDV Positive Cases(Galenos Publ House, 2021) Kurt, Esma Kepenek; Bulut, Rukiyye; Kandemir, Bahar; Erayman, Ibrahim; Bitirgen, Mehmet; Tasbent, Fatma EsenkayaObjectives: Hepatitis B infection has a faster and more progressive course in the presence of hepatitis C virus (HCV), HDV and human immunodeficiency virus (HIV) infections. The aim of this study was to determine anti-HCV, anti-HDV and anti-HIV prevalance in hepatitis B surface antigen (HBsAg) (+) positive patients and to examine patients with positive anti-HDV. Materials and Methods: Data were obtained through scanning hepatitisB patient follow-up files and the hospital automation system. Descriptive data was expressed in numbers and percentages (%). Results: Mean age of 1829 HBsAg positive patients was 42.65 +/- 14.83 (7-95) and 1099 (60.1%) were male and 730 (39.9%) were female. 30 patients (1.64%) had anti-HCV and 28 patients (1.53%) had anti-HDV while 1 patient (0.055%) had positive anti-HIV. The mean age of the patients with positive anti-HDV was 53.16 +/- 15.46 and 12 of these (42.9%) were female and 16 (57.1%) were male. Fifteen HDV positive patients were given peginterferon and 10 patients had relapse and 4 patients had hepatocellular cancer during the follow-up. A patient died due to the quick progression of the disease after deciding upon transplantation. Conclusion: Patients should also be scanned for hepatitis C, D and HIV in the presence of hepatitis B infection and the patient should be followed up and treated accordingly if coinfection is detected.Öğe Neutropenia Due to Very Long Time Propylthiouracil Usage in Toxic Multinodular Goiter(2016) Turan, Elif; Kaya, Ahmet; Mustafa, Kulaksızoğlu; Kandemir, Bahar; Erayman, İbrahimTirotoksikoz çeşitli yollarla hemtopoezi etkiler ve tionamidlerle birlikte miyelosupresyona neden olabilir. Toksik multinodüer guatra bağlı 20 yıl gibi uzun bir süre propiltiourasil kullanan ve febril nötropeni nedeniyle hastaneye yatışı yapılan hipertirodili bir hasta sunduk. Total tiroidektomi olduktan sonra hasta ötiroid iken nötropenisi düzeldi. Postoperatif patoloji ise mikropapiller tiroid karsinomu olarak değerlendirildi.Öğe A rare cause of pleural effusion: adult onset Still's disease(2015) Demirbaş, Soner; Kutlu, Orkide; Kandemir, Bahar; Sakin, AbdullahAdult onset Stills disease is a rare systemic inflammatory disorder. At the onset of the disease sore throat, pharyngitis; which does not respond to antibiotics, one or two times peaking febrile episodes, marked salmoncolored rash on the trunk and extremities, arthralgia, arthritis, myalgia, fatigue, loss of appetite with nausea and weight loss; hepatosplenomegaly and lymphadenopathy can be seen. Among laboratory examinations levels of ferritin and other acute phase reactants distinctly rise, and neutrophilic leukocytosis; ANA and RF negativity are detected. Pleural and pericardial effusions, transient pulmonary infiltration, and rarely myocarditis can be seen during the course of the disease. Here we report a patient who was examined for fever of unknown origin and diagnosed with adult onset Stills disease which is a rare etiology of pleural effusion.Öğe Relationship between Selective IgA Deficiency and COVID-19 Prognosis(Natl Inst Infectious Diseases, 2022) Colkesen, Fatih; Kandemir, Bahar; Arslan, Sevket; Colkesen, Fatma; Yildiz, Eray; Korkmaz, Celalettin; Vatansev, HulyaThe prevalence and mortality rates of coronavirus disease 2019 (COVID-19) widely vary among populations. Mucosal immunity is the first barrier to the pathogen's entry into the body. Immunoglobulin A (IgA) is the primary antibody responsible for mucosal immunity. We explored the relationship between selective IgA deficiency (SIgAD) and COVID-19 severity. We included 424 patients (203 women) with COVID-19. Eleven patients had SIgAD. Laboratory data of patients with SIgAD and normal IgA levels were compared. The relationship between SIgAD and severe COVID-19 infection was explored using logistic regression analysis. In the univariate logistic regression analysis, the risk of severe COVID-19 disease in patients with SIgAD was approximately 7.7 -fold higher than that in other patients (odds ratio [OR], 7.789; 95% confidence interval [CI], 1.665-36.690, P = 0.008), while it was 4-fold (OR, 4.053; 95% CI, 1.182-13.903, P = 0.026) higher in the multivariate logistic regression analysis. Serum IgA levels were positively correlated with total lymphocyte counts and negatively correlated with C-reactive protein levels, which was a risk factor for severe COVID-19. In patients with SIgAD, the number of severe acute respiratory coronaviruses 2 that pass through mucosal membranes may be increased, leading to complications such as cytokine storm syndrome and acute respiratory distress syndrome.Öğe Role of Neopterin in Determining the Efficacy of Interferon Therapy in Chronic Hepatitis B and C(Modestum Ltd, 2015) Ozcimen, Serap; Bitirgen, Mehmet; Kandemir, BaharNeopterin (NP) is a pteridine derivative that is secreted as a response to gamma interferon stimulation. The purpose in this study was to investigate the relationship between the NP levels and the disease and determining the efficacy of an interferon (IFN) therapy in patients with chronic hepatitis B (CHB) and C (CHC). The study was conducted on 49 cases with CHB, 30 cases with CHC and 72 healthy individuals. Serum samples were taken from the patients receiving treatment at the beginning and at the end of the treatment and only once from the healthy individuals in the control group. The NP levels were found significantly higher in the patients with CHB and CHC than those in the control group. When the pre and post-treatment serum NP levels of the patients who received an interferon therapy were compared, the post-treatment NP levels of the patients who responded to the treatment were significantly higher. When a comparison was made before and after treatment, a decrease was seen in the NP levels in most of the infections due to decreased activation of the immune system. However, when the disease was treated with an IFN therapy, which is a treatment stimulating the immune system, the post-treatment NP level remained high.Öğe Role of Neopterin in Determining the Efficacy of Interferon Therapy in Chronic Hepatitis B and C(Modestum Ltd, 2015) Ozcimen, Serap; Bitirgen, Mehmet; Kandemir, BaharNeopterin (NP) is a pteridine derivative that is secreted as a response to gamma interferon stimulation. The purpose in this study was to investigate the relationship between the NP levels and the disease and determining the efficacy of an interferon (IFN) therapy in patients with chronic hepatitis B (CHB) and C (CHC). The study was conducted on 49 cases with CHB, 30 cases with CHC and 72 healthy individuals. Serum samples were taken from the patients receiving treatment at the beginning and at the end of the treatment and only once from the healthy individuals in the control group. The NP levels were found significantly higher in the patients with CHB and CHC than those in the control group. When the pre and post-treatment serum NP levels of the patients who received an interferon therapy were compared, the post-treatment NP levels of the patients who responded to the treatment were significantly higher. When a comparison was made before and after treatment, a decrease was seen in the NP levels in most of the infections due to decreased activation of the immune system. However, when the disease was treated with an IFN therapy, which is a treatment stimulating the immune system, the post-treatment NP level remained high.Öğe Social Attitude Towards COVID-19 Vaccine 1 Year After the Pandemic(Doc Design Informatics Co Ltd, 2022) Durduran, Yasemin; Aktug-Demir, Nazlim; Demir, Lutfi Saltuk; Kandemir, Bahar; Duman, Ipek; Yucel, MehtapObjective: To increase vaccine awareness, we aimed to determine individuals' knowledge and behavioral approach to the COVID-19 vaccine. Methods: The data of this cross-sectional study were obtained online between June and July 31, 2021. One thousand one hundred seventy-six people over the age of 18 were included in the study. The researchers developed a data collection form consisting of 27 questions. Mean +/- standard deviation and median (1st quarter-3rd quarter) values, numbers, and percentages were used to summarize the data. Chi-square (chi(2)) test was used to show the relationship between categorical variables. Independent predictors of participants' vaccine hesitancy/rejection were analyzed using logistic regression. Statistically, data with p<0.05 were considered significant. Results: A total of 1176 people, 55.7% of whom were women, with a mean age of 39.75 +/- 11.27 years, were included in the study. 71.6% of the participants were married, and 78.9% had a university/postgraduate degree. 9.7% of the participants stated that they were hesitant about the COVID-19 vaccine, and 7.1% refused the COVID-19 vaccine or would not be vaccinated when it was their turn. According to the logistic regression model established to examine the factors that may affect vaccine rejection; Age, the resources used to obtain information about the vaccine, the thought that it would not protect for two years, or the vaccine side effects were high, and the most effective way to get rid of the pandemic was not vaccination, were determined as the factors affecting vaccine rejection. Conclusion: As a result of the research, it was found that the participants had a positive attitude towards the COVID-19 vaccine. It was determined that 9.7% of the study group had vaccine hesitancy, and 7.1% had vaccine rejection.Öğe Unnoticed Adverse Effect of Isoniazid during Childhood Tuberculosis Preventive Treatment: Hyperuricemia(Georg Thieme Verlag Kg, 2021) Kandemir, Bahar; Duman, Ipek; Durduran, Yasemin; Metin Akcan, Ozge; Selver, Muhammed Burak; Pekcan, SevgiObjective Isoniazid for 6 to 9 months is the most widely used form of tuberculosis (TB) preventive treatment. We aimed to assess the adverse effects of isoniazid by using the serum levels of aspartate transaminase (AST), alanine transaminase (ALT), and uric acid (SUA) in children and adolescents receiving long-term isoniazid for latent TB infection. Methods The study included children <= 18 years of age who underwent TB preventive treatment with isoniazid (IPT) between 2015 and 2019 at a university hospital. Serum transaminase, SUA, urea, and creatinine levels of patients were measured before the initiation of IPT, 15th day, and once a month during treatment. Patients with ALT, AST, or SUA results above cut-off levels during treatment were evaluated. The final values in follow-up were included in the data analysis. Results A total of 141 children who underwent IPT were included. In total, 70 children had family members with confirmed TB disease, and 71 children had a positive tuberculin skin test. SUA increased above cut-off values in 16 children (11.3%), and half of them had uric acid levels over 7 mg/dL. The median duration of the development of hyperuricemia was 4.0 months. ALT or AST increased above cut-off values in 23 children (16.3%). ALT was above cut-off values in seven patients, AST was high in 20 patients. The median duration to the development of AST and/or ALT levels above cut-off was 4.0 months. Two patients had hepatotoxic transaminase levels. Three patients had both elevated transaminases and SUA levels. Conclusion Isoniazid may also cause hyperuricemia besides elevation in transaminases in children.
