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Öğe A case of unresolved skin lesion in a cobbler(2024) Mert, Ali; Kaya, Abdurrahman; Yıldız Kaya, Sibel[Abstract Not Available]Öğe A man with recurrent axillary abscess(2025) Durmaz, Gamze; Beycan, Esin; Kaya, Abdurrahman; Mert, Ali...Öğe A multi-center retrospective analysis of healthcare workers after COVID-19: Epidemiological and clinical features(Marmara University, 2022) Derin, Okan; Aksoy, Nilay; Çaydaşı, Özge; Yılmaz, Mesut; Mert, AliObjective: Concerns regarding the high-level risk of infection among healthcare workers (HCWs) increased after COVID19 was declared as a pandemic in March 2020. Inadequate infection control owing to a shortage of personal protective equipment or an inconvenient usage of infection control measures may play a significant role in transmission to/among healthcare personnel. The study aimed to determine the characteristics and outcomes of COVID-19 patients who are healthcare workers along with possible transmission routes of COVID-19 in four different healthcare facilities in Istanbul. Methods: All hospital records were reviewed retrospectively. Demographic and clinical characteristics of HCWs were documented, and all infected HCWs were subjected to a phone-based mini-questionnaire and three-dimensional test (TDT). All statistical analyses were done using statistical packages SPSS Demo Ver 22 (SPSS Inc. Chicago, IL, USA).Results: Clinical features of COVID-19 were similar to the general public's characteristics. The most frequent symptoms were cough, fever, and headache. HCWs with the O blood group tend to have asymptomatic COVID-19 infection. Hospital workers other than medical professionals have a lack of convenience of infection control measures. The median duration of PCR negativity was 9 days. HCWs who had a sore throat at the beginning of COVID-19 have a longer PCR-positive duration.Conclusion: Understanding the clinical features or characteristics of asymptomatic COVID-19 carriers may aid in the implementation of a feasible screening program for early detection. It is strongly advised that proper infection control precautions, education, and auditing of nonclinical staff be implemented. As a result, transmission among healthcare workers can be avoided.Öğe A single center cohort of 40 severe COVID-19 patients who were treated with convalescent plasma(Tübitak Scientific & Technical Research Council Turkey, 2020) Gemici, Aliihsan; Bilgen, Hülya; Erdoğan, Cem; Kansu, Abdullah; Olmuşçelik, Oktay; Beköz, Hüseyin Saffet; Dinleyici, Rümeysa; Mert, Ali; Sevindik, Ömür GökmenBackground/aim: A SARS-Cov2 infection which was first arised from Wuhan in December 2019 and named as COVID-19. Still there lacks either a specific treatment or a vaccine to treat COVID-19. Convalescent plasma (CP) was previously used successfully to treat SARS-CoV-1 and MERS infections. Health authority in Turkey has published a guideline to integrate this promising option in the treatment process of patients who are prone to high risk of developing severe COVID-19.Materials and Methods: Forty consecutive patients who had received CP at our center were included in the study. Demographics, COVID-19 specific parameters, biomarkers to detect the severity of COVID-19 infection and outcome variables were collected retrospectively. The correlation between outcome variables and the independent predictors of the outcome were reported.Results: Median age of the patients was 57.5 and 72.5% were male. At least one COVID-19 PCR test was confirmed to be positive in 75% of patients. Remaining 25% had a Chest-CT which was reported to be compatible with an ongoing COVID-19. All patients (100%) were classified as having severe COVID-19 infection. Over a half of the patients harbored an oxygen saturation of less than 90 despite of a continuous 5 L/min support of O-2. 82.5% of the patients had a need for mechanical ventilation and 45.5% had a need for invasive mechanical ventilation. Nine out of 10 patients who have received CP outside ICU have totally recovered from COVID-19 at a median of 9 days, and a half of the patients who needed invasive mechanical ventilation were successfully free of mechanical ventilation support and managed to recover from COVID-19.Conclusion: According to the results of this study, CP is an efficient conjunct to conventional therapy against COVID-19 with a favorable safety profile.Öğe Acute acalculous cholecystitis due to hepatitis b virus reactivation: a case report and review of the literature(2024) Kaya, Abdurrahman; Beycan, Esin; Kaya, Sibel Yıldız; Özdemir, Gülhan; Zerdali, Hasan; Mert, AliWe report a 52-year old man presenting with acute acalculous cholecystitis triggered by hepatitis B virus infection. The patient developed protective antibodies and cleared the infection. The relevant data is also discussed.Öğe Allogeneic stem cell transplantation in a blast-phase chronic myeloid leukemia patient with carbapenem-resistant Klebsiella pneumoniae tricuspid valve endocarditis: A case report(Spandidos Publications, 2016) Kantarcıoğlu, Bülent; Beköz, Hüseyin Saffet; Olgun, Fatih Erkam; Çakal, Beytullah; Arkan, Burak; Türkoğlu, Halil; Mert, Ali; Sargın, DenizIn chronic myeloid leukemia (CML), the occurrence of blastic transformation is rare. Treatment outcome is generally poor. Allogeneic stem cell transplantation (allo-SCT) is the only potentially curative treatment option for advanced-phase CML. Infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates are associated with high morbidity and mortality rates, particularly in patients with haematological malignancies. Infection and colonization by these multiresistant bacteria may represent a challenge in SCT recipients for the management of post-transplantation complications, as well as for the eligibility to receive a transplant in patients who acquire the pathogen prior to the procedure. We herein report the case of a blast-phase CML patient with a highly resistant, CRKP-associated tricuspid valve endocarditis, who was treated with a combination of systemic antimicrobial therapy and surgical valve repair, and subsequently underwent a successful allo-SCT.Öğe An unnoticed origin of fever: Periapical tooth abscess. Three case reports and literature review(EDIMES Edizioni Medico Scientifiche, 2016) Arslan, Ferhat; Karagöz, Ergenekon; Arslan Yiğit, Birsen; Mert, AliDental infections may lead to severe local or systemic infections such as endocarditis, brain abscesses and mediastinitis. Fever may be the only symptom. We aim to highlight dental/odontogenic abscesses as the occult source of unexplained fever by reporting on three cases and reviewing the relevant literature. Early dental evaluation and referral of patients with persistent fever (even without any oral symptoms) to a dentist plays a critical role in preventing unnecessary, time-consuming and high-cost further diagnostic tests and invasive procedures. A simple panoramic dental radiography may suffice to establish the diagnosis.Öğe Analysis of the involvement of the thyroid gland using computed tomography in patients with suspected SARS-CoV-2 infection: A retrospective study(Verduci Editore s.r.l, 2021) Akkoyunlu, Yasemin; Kalaycıoğlu, Bora; Yurtsever, İsmail; Eren, Abdulkadir; Bayram, Merve; Mert, Ali; Akkoyunlu, Muhammed EminOBJECTIVE: SARS-CoV-2 primarily infects the respiratory tract and leads to severe pneumonia by binding to the ACE-2 receptor. The virus can also interact with ACE-2 receptors expressed in other tissues as in thyroid. This study predicted the complications involving the thyroid in patients with suspected SA RS-CoV-2. PATIENTS AND METHODS: Patients with suspected SARS-CoV-2 infection between March 11, 2020-May 31, 2020 were retrospectively evaluated. Sixty-nine patients who were radiologically diagnosed as COVID-19 according to thoracic CT and had previously performed thoracic CT before November 2019 were included in the study according to the exclusion and inclusion criteria. Age and gender-matched controls (No. 69) were selected with normal thoracic CT whose PCR tests were also negative. Thyroid densities of participants were calculated and compared from the previous and current thoracic CTs. Results were also compared with the control group. RESULTS: Participants were composed of 69 patients (39 male, mean age 64.35 years). Thyroid densities were significantly decreased from 89HU to 76HU for whole gland, from 88HU to 76HU for right lobes and from 87.5HU to 75.5HU for left lobes at current thoracic CTs performed during COVID-19 (p<0.001, p<0.001, p<0.001 respectively). The decrease in densities of the whole thyroid gland. both left and right lobes. was correlated with mortality (p<0.001). The changes in thyroid densities were not correlated with age nor gender. The decreases in HU values of thyroid densities for whole gland, left and right lobes, were correlated with mortality (p<0.001, p<0.001. and p<0.001 respectively). CONCLUSIONS: COVID-19 is a multi-systemic disease that threatens vital organs, including the thyroid. Future studies are needed to investigate the association between SARS-CoV-2 and other complications.Öğe Can artificial intelligence detect type 2 diabetes in women by evaluating the pectoral muscle on tomosynthesis: diagnostic study(Springer Science and Business Media Deutschland GmbH, 2024) Yashar, Meltem; İzci, İlayda Begüm; Güngören, Fatma Zeynep; Eren, Abdulkadir; Mert, Ali; Durur Subaşı, IrmakObjectives This retrospective single-center analysis aimed to evaluate whether artificial intelligence can detect type 2 diabetes mellitus by evaluating the pectoral muscle on digital breast tomosynthesis (DBT).Material method An analysis of 11,594 DBT images of 287 consecutive female patients (mean age 60, range 40-77 years) was conducted using convolutional neural networks (EfficientNetB5). The inclusion criterion was left-sided screening images with unsuspicious interpretation who also had a current glycosylated hemoglobin A1c (HBA1c) % value. The exclusion criteria were inadequate imaging, history of breast cancer, and/or diabetes mellitus. HbA1c values between 5.6 and 6.4% were categorized as prediabetic, and those with values >= 6.5% were categorized as diabetic. A recorded HbA1c <= 5.5% served as the control group. Each group was divided into 3 subgroups according to age. Images were subjected to pattern analysis parameters then cropped and resized in a format to contain only pectoral muscle. The dataset was split into 85% for training and 15% for testing the model's performance. The accuracy rate and F1-score were selected as performance indicators.Results The training process was concluded in the 15th epoch, each comprising 1000 steps, with an accuracy rate of 92% and a loss of only 0.22. The average specificity and sensitivity for all 3 groups were 95%. The F1-score was 0.95. AUC-ROC was 0.995. PPV was 94%, and NPV was 98%.Conclusion Our study presented a pioneering approach, applying deep learning for the detection of diabetes mellitus status in women using pectoral muscle images and was found to function with an accuracy rate of 92%.Critical relevance statement AI can differentiate pathological changes within pectoral muscle tissue by assessing radiological images and maybe a potential diagnostic tool for detecting diabetes mellitus and other diseases that affect muscle tissues.Key points center dot AI may have an opportunistic use as a screening exam for diabetes during digital breast tomosynthesis. center dot This technique allows for early and non-invasive detection of diabetes mellitus by AI. center dot AI may have broad applications in detecting pathological changes within muscle tissue.Key points center dot AI may have an opportunistic use as a screening exam for diabetes during digital breast tomosynthesis. center dot This technique allows for early and non-invasive detection of diabetes mellitus by AI. center dot AI may have broad applications in detecting pathological changes within muscle tissue.Key points center dot AI may have an opportunistic use as a screening exam for diabetes during digital breast tomosynthesis. center dot This technique allows for early and non-invasive detection of diabetes mellitus by AI. center dot AI may have broad applications in detecting pathological changes within muscle tissue.Öğe Candida glabrata pneumonia in a patient with chronic obstructive pulmonary disease(Hindawi Ltd., 2016) Yazıcı, Onur; Çörtük, Mustafa; Casim, Hasan; Çetinkaya, Erdoğan; Mert, Ali; Benli, Ali RamazanPneumonia remains an important cause of morbidity and mortality among infectious diseases. Streptococcus pneumoniae and viruses are the most common cause of pneumonia. Candidiasis in such patients has been associated with haemodialysis, fungal colonization, exposure to broad-spectrum antibiotics, intensive care unit (ICU) hospitalization, and immunocompromised patients. The most common cause of infection is C. albicans. The case presented here is of a 66-year-old male patient diagnosed with C. glabrata. The patient suffered from chronic obstructive pulmonary disease.Öğe Candida urinary tract infections in adults(Springer, 2020) Odabaşı, Zekaver; Mert, AliCandiduria is commonly seen in hospitalized patients and most of the patients are asymptomatic, but it may be due to cystitis, pyelonephritis, prostatitis, epididymo-orchitis or disseminated candidiasis. Major risk factors are diabetes mellitus, indwelling urinary catheters, use of broad-spectrum antibiotics, urinary obstruction, and admission to intensive care units. Candida urinary tract infections can be caused by hematogenous spread following candidemia, or retrograde route via the urethra. The presence of Candida species in urine in asymptomatic patients does not warrant antifungal therapy except neutropenic patients, very low-birth-weight infants and patients undergoing urologic procedures. Fluconazole is the treatment of choice for symptomatic infections, it achieves high urinary levels. The other azole antifungals and echinocandins do not reach sufficient urine levels. Amphotericin B deoxycholate is the alternative antifungal agent if fluconazole can not be used because of resistance, allergy or failure.Öğe Ceftazidime-avibactam versus polymyxin-based combination therapies: a study on 30-day mortality in carbapenem-resistant enterobacterales bloodstream infections in an oxa-48-endemic region(2024) Dumlu, Rıdvan; Şahin, Meyha; Derin, Okan; Gül, Özlem; Başgönül, Sedef; Zengin, Rehile; Mert, AliBackground: Ceftazidime–avibactam (CAZ-AVI) is recommended as first-line treatment for Oxacillinase-48 (OXA-48) β-Lactamase-producing carbapenem-resistant Enterobacterales (CRE) infections, while polymyxin-based combination therapies (PBCTs) are used as a last resort when CAZ-AVI is unavailable. Research comparing the effectiveness of CAZ-AVI and PBCT in CRE blood stream infections (CRE-BSIs) is limited, mostly focusing on Klebsiella pneumoniae carbapenemase (KPC)-producing isolates. In Turkey, OXA-48 is endemic and OXA-48-Like is common. Therefore, our study aimed to compare the impact of these treatments on 30-day mortality in patients with CRE-BSIs in endemic regions. Methods: Retrospective data from January 2019 to May 2023 were collected from four tertiary healthcare centers in Istanbul. Demographic, clinical, and outcome data of ICU patients treated with CAZ-AVI monotherapy or PBCT for CRE-BSIs were analyzed. The effect on 30-day survival was evaluated using Cox regression analysis post propensity score matching (PSM). Results: Out of 151 patients, 44.4% (n: 67) received CAZ-AVI and 55.6% (n: 84) received PBCT. All-cause mortality rates were 20% (n: 13) with CAZ-AVI and 36.9% (n: 31) with PBCT. Cox regression analysis post PSM indicated CAZ-AVI monotherapy significantly reduced the mortality risk compared to PBCT (HR: 0.16, 95%CI: 0.07–0.37, p < 0.001), while age increased the risk (HR: 1.02 per year, 95% CI 1.0–1.04, p: 0.01). Conclusions: In OXA-48-predominant areas, CAZ-AVI demonstrated significantly lower mortality in patients with CRE-BSIs compared to PBCT. The results were attributed to the pharmacokinetic and pharmacodynamic disadvantages of polymyxins compared to CAZ-AVI, and the impact of age-related physical conditions. Therefore, CAZ-AVI should be the preferred treatment for CRE-BSIs in OXA-48-endemic regions.Öğe Clinical and microbiological characteristics of Aeromonas bacteremia in Turkey(Akademiai Kiado Zrt, 2021) Kaya, Abdurrahman; Yıldız Kaya, Sibel; Zerdali, Esra; Koç, Alper; Çağlar, Bilge; Ertürk, Ümran Şümeyse; Yılmaz, Mesut; Aygün, Gökhan; Balkan, İlker İnanç; Mete, Bilgül; Saltoğlu, Neşe; Mert, Ali; Tabak, Ömer FehmiWe investigated the cases with Aeromonas bacteremia in terms of clinical and microbiological characteristics, underlying disease and mortality rates. Patients with positive blood cultures were included in this research. Aeromonas bacteremia was diagnosed as at least one positive blood culture for Aeromonas species. The bacteremia was defined as community origin if the onset was in the community or within 72 hours of hospital admission. The others were considered as nosocomial. All bacteria were defined as Aeromonas with conventional method. Species identification was verified by VITEK system. Antibiotic susceptibility tests were analyzed with the disc diffusion, E-test method or VITEK system. Thirty-three patients were diagnosed with bacteremia due to Aeromonas spp. Hematologic and solid tumors were the leading underlying conditions, followed by cirrhosis. Two patients (6%) had community-acquired infections. Aeromonas hydrophila was the most common isolated bacterium. The crude mortality rate was 36%. 12 patients died and 6 deaths and 4 deaths were detected in patients with bacteremia caused by A. hydrophila and Aeromonas sobria respectively. All strains were resistant to ampicillin and more than 90% of the strains were susceptible to trimethoprim-sulfamethoxazole, fluoroquinolone, third generation cephalosporins, and carbapenems. Aeromonas sp. is not a frequent cause of bacteremia however, it may lead to high mortality rates, especially in the immunocompromised hosts and patients with liver cirrhosis. Nosocomial Aeromonas bacteremia is not uncommon in these populations. Broad-spectrum cephalosporins, piperacillin-tazobactam, fluoroquinolones, and carbapenems remain as effective antimicrobial agents for therapy of Aeromonas bacteremia.Öğe Clinical follow-up of patients with HBeAg positive chronic hepatitis B infection: A long-term observational study(Kare Publishing, 2022) Arslan, Ferhat; Batirel, Ayşe; Baysal, Naciye Betül; Vahaboğlu, Haluk; Mert, AliBackground and Aim: We aimed to analyze the demographic, laboratory, and clinical characteristics of patients with HBeAg positive chronic hepatitis B infection in tertiary care centers in Istanbul. Materials and Methods: We conducted an observational cohort with >= 18-year-old patients with HBeAg positive chronic hepatitis B infection, who were followed up in three tertiary care centers in Istanbul between January 2000 and August 2018, were evaluated by reviewing electronic and recorded files. The Ethical Committee of Istanbul Medipol University approved this study (Protocol no: 10840098-604.01.01-E.44136). During the polyclinic interview, consent was obtained from patients for analysis and publication. Results: The mean age of the 64 patients was 30 (range 18-39) years, and 50% (32) of them were males. The mean follow-up period of the patients was 67 (18-180) months. Twenty-four patients were treated with at least one antiviral in their follow-up, and only 2 (3.1%) of these patients developed HBeAg seroconversion without antiviral treatment. HBeAg (+) chronic hepatitis B developed in 4 of the patients after the immune-active period. None of the patients and first-degree relatives had hepatocellular carcinoma (HCC). Conclusion: The rationality of antiviral treatment and HCC development risk in these patients still remains elusive.Öğe Clinical presentation and cranial mri findings of listeria monocytogenes encephalitis a literature review of case series(Lippincott Williams & Wilkins, 2018) Arslan, Ferhat; Ertan, Gülhan; Emecen, Ahmet Naci; Fillatre, Pierre; Mert, Ali; Vahaboğlu, HalukBackground: Listeria monocytogenes-associated encephalitis is a severe clinical condition that can also be seen in immunocompetent patients. Clinical manifestation and radiologic features of this entity need to be elaborated. Review Summary: We searched the medical literature during the period spanning from 1991 to 2017 using the keyword "listeria AND [abscess odds ratio (OR) brainstem OR encephalit* OR magnetic* OR imaging*]." We included in the review well-documented adult cases with a definitive diagnosis and having magnetic resonance imaging data. Confusion, hemiparesis, cerebellar ataxia, facial paralysis, and gait disturbance were the most frequent findings, detected in >30% of patients during admission. The high rate of facial paralysis was of particular interest. T2 hyperintensity (80/82), contrast enhancement (60/82), and ring-enhancing lesions, which are considered as brain abscess, were found in 46/82 patients. The mortality and neurological sequel rates were 20% and 68%, respectively. Conclusions: Listeria encephalitis is a severe disease and should be remembered in cases admitted with symptoms related to the brainstem and cranial nerve dysfunction. Cranial magnetic resonance imaging with brainstem and cerebellum involvements and contrast enhancement with or without abscess are particularly suggestive of the listeria-related infection.Öğe Colistin nephrotoxicity increases with age(Informa Healthcare, 2014) Balkan, İlker İnanç; Doğan, Mustafa; Durdu, Bülent; Batırel, Ayşe; Hakyemez, İsmail Necati; Çetin, Birsen; Karabay, Oğuz; Gönen, İbak; Özkan, Ahmet Selim; Uzun, Sami; Demirkol, Muhammed Emin; Akbaş, Sedat; Kaçmaz, Asiye Bahar; Aras, Sükrü; Mert, Ali; Tabak, FehmiBackground: Colistin (COL) has become the backbone of the treatment of infections due to extensively drug-resistant (XDR) Gram-negative bacteria. The most common restriction to its use is acute kidney injury (AKI). Methods: We conducted a retrospective cohort study to evaluate risk factors for new-onset AKI in patients receiving COL. The cohort consisted of 198 adults admitted to 9 referral hospitals between January 2010 and October 2012 and treated with intravenous COL for >= 72 h. Patients with no pre-existing kidney dysfunction were compared in terms of risk factors and outcomes of AKI graded according to the RIFLE criteria. Logistic regression analysis was used to identify associated risk factors. Results: A total of 198 patients met the inclusion criteria, of whom 167 had no pre-existing kidney dysfunction; the mean patient age was 58.77 (+/- 18.98) y. Bloodstream infections (34.8%) and ventilator-associated pneumonia (32.3%) were the 2 most common indications for COL use. New-onset AKI developed in 46.1% of the patients, graded as risk (10%), injury (15%), and failure (21%). Patients with high Charlson co-morbidity index (CCI) scores (p = 0.001) and comparatively low initial glomerular filtration rate (GFR) estimations (p < 0.001) were more likely to develop AKI, but older age (p = 0.001; odds ratio 5.199, 95% confidence interval 2.684-10.072) was the major predictor in the multivariate analysis. In-hospital recovery from AKI occurred in 58.1%, within a median of 7 days. Conclusions: COL-induced nephrotoxicity occurred significantly more often in patients older than 60 y of age and was related to low initial GFR estimations and high CCI scores, which were basically determined by age.Öğe Community acquired chronic arthritis due to pseudomonas aeruginosa in a previously healthy pregnant woman(Hindawi Publishing Corporation, 2014) Yılmaz, Mesut; Arslan, Ferhat; Mert, AliSeptic arthritis caused by Pseudomonas aeruginosa is uncommon in the immunocompetent population, despite its occurrence in younger patients with open injuries and in intravenous drug abusers. Here we report a case of septic arthritis caused by P. aeruginosa. This case is unique for several reasons. First, it is a case of septic arthritis in a pregnant woman with no traditional risk factors reported in the literature including history of prior traumatic events, hospitalisation, or chronic underlying disease. She was suspected of having transient osteoporosis associated with pregnancy to involve both hip joints. Second, this is the first reported case of a community acquired chronic septic arthritis due to P. aeruginosa involving large joints of both upper and lower extremities. The patient was treated successfully with a combination of ceftazidime and amikacin for 4 weeks followed by oral ciprofloxacin 750 mg twice daily for 8 weeks.Öğe Community-acquired left-sided pseudomonas aeruginosa endocarditis in a patient without intravenous drug use(Springer, 2013) Yılmaz, Mesut; Sunar, Hasan; Mert, AliWe present a case of community-acquired left-sided Pseudomonas aeruginosa endocarditis in a person without intravenous drug use. The patient presented with facial numbness and did not have any predisposing condition for endocarditis. He was treated successfully with valvular surgery, along with combination antibiotics.Öğe Comparable efficacy of tenofovir versus entecavir and predictors of response in treatment-naive patients with chronic hepatitis B: A multicenter real-life study(Elsevier, 2014) Batırel, Ayşe; Güçlü, Ertu?rul; Arslan, Ferhat; Koçak, Funda; Karabay, Oğuz; Özer, Serdar; Turanlı, Münevver; Mert, AliObjective: To compare responses to tenofovir (TDF) and entecavir (ETV) therapy. Methods: This was a multicenter retrospective study including treatment-naïve patients with chronic hepatitis B (CHB) who received TDF or ETV. The primary end-points were undetectable HBV-DNA at 48 weeks and serological and biochemical responses. Results: Out of 195 CHB patients, 90 (46%) received TDF and 105 (54%) received ETV; 72% were male, their mean age was 43. ±. 12 years, and the mean duration of treatment was 30.2. ±. 15.7 months. Hepatitis B e antigen (HBeAg) seropositivity was 32% in the TDF group and 34% in the ETV group. HBeAg seroconversion rates in HBeAg-positive patients were 24% in the TDF group and 39% in the ETV group; the difference was not significant (. p=. 0.2). The mean time to alanine aminotransferase (ALT) normalization and rates of ALT normalization at 3, 6, 12, 18, and 24 months were similar in the two groups (. p > 0.05). The mean time to undetectable HBV-DNA levels in the TDF and ETV groups was 11.5. ±. 8.9 and 12.9. ±. 10.8 months, respectively (. p=. 0.32). A significantly greater decline in HBV-DNA levels at 12 and 18 months was observed in the TDF group (. p=. 0.02 and p=. 0.03, respectively). Seven (7%) patients on ETV therapy had virological breakthrough (. p=. 0.01). Only one patient in each group had hepatitis B surface antigen (HBsAg) clearance. None of the patients developed decompensation or hepatocellular carcinoma during treatment. Conclusions: The two drugs appear to have similar efficacy in CHB patients. However, 7% of patients on ETV therapy had virological breakthrough, while none of the patients on TDF therapy did.Öğe Comparison of cellular immunity in patients with chronic hepatitis B, inactive hepatitis B surface antigen carriers and spontaneously recovered individuals(H G E Update Medical Publishing S A, 2014) Arslan, Ferhat; Mert, Ali; Sili, Uluhan; Tabak, Fehmi; Öztürk, Recep; Özaras, ReşatDifferent 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.
