barış ertunç - Academia.edu (original) (raw)

Papers by barış ertunç

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

Amaç: Günlük pratiğimizde sıklıkla karşılaştığımız selülit vakalarında kullanımı önerilmekte olan... more Amaç: Günlük pratiğimizde sıklıkla karşılaştığımız selülit vakalarında kullanımı önerilmekte olan seftriaksonun, yarı ömrünün uzun olması nedeni ile kılavuzlarda günde tek doz olarak kullanılabileceği belirtilmekle birlikte zaman zaman tedavide sorunlar ile karşılaşabilmekteyiz. Bu nedenle günde tek doz seftriakson tedavisinin etkinliğinin diğer ajanlarla karşılaştırılarak değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Çalışmamıza 2017-2019 yılları arasında hastanemizde tedavi edilmiş ve komplike olmayan 46 selülit hastası dahil edilmiştir. Hastalara ait demografik, klinik ve laboratuvar verileri hasta dosyalarından elde edildi. Mann-Whitney U ve Kruskal-Wallis testleri ile veriler değerlendirildi. p<0.05 olan değerler istatistiksel olarak anlamlı kabul edildi.

The Eurasian Journal of Medicine, 2017

Objective: The aim of this study was to examine clinico-epidemiological properties of HIV/AIDS pa... more Objective: The aim of this study was to examine clinico-epidemiological properties of HIV/AIDS patients. Materials and Methods: For this purpose, 115 HIV/AIDS patients monitored in our clinic between January 1, 1998, and December 31, 2013, were retrospectively evaluated. Results: For the 115 patients with a diagnosis of HIV/AIDS that we monitored, the mean age at the time of presentation was 34.5±13.21 (10-79) years. Eighty-nine (76.5%) patients were male and 27 (23.5%), female. In this study, HIV/AIDS was the most prevalent in the young male population with a low educational and sociocultural level. The most common mode of transmission in our patients was heterosexual relations: approximately 1 patient in 3 had a history of traveling to countries with a high prevalence of HIV/AIDS, namely, Russia and Ukraine. The examination of diagnosis with respect to years showed an increase in new cases since 2008. Only 21 (18.3%) of our patients were diagnosed through clinical symptoms, while 91 (81.7%) during routine scanning. At first presentation, 68% of our patients were stage A; 4.7%, stage B; and 27.3%, stage C. The mean length of the monitoring of our patients was 2.74 years (2-180 months). Thirteen (11.3%) patients died due to opportunistic infections and malignities. The most common opportunistic infection was tuberculosis (16.5%), followed by syphilis and HBV. Malignity, most commonly intracranial tumor, was seen in 8.6% patients. Conclusion: The disease was generally seen in the young male population with a low sociocultural level, and it was most frequently transmitted by heterosexual sexual contact. This clearly shows the importance of sufficient, accurate information, and education on the subject of the disease and its prevention. The fact that many of our patients were diagnosed in the late stage due to stigma and that diagnosis was largely made through scanning tests confirms the importance of these tests in early diagnosis.

Journal of Clinical Virology, 2012

Background: Crimean Congo Hemorrhagic Fever (CCHF) is a potentially fatal tick-borne viral diseas... more Background: Crimean Congo Hemorrhagic Fever (CCHF) is a potentially fatal tick-borne viral disease, the course of which may accompanied by various clinical findings. Objectives: We describe a picture of non-suppurative parotitis developing in association with CCHF virus. Study design: A 48-year-old patient presenting to our hospital with lethargy, hemorrhage and pain and swelling below the left ear was diagnosed with CCHF through IgM antibody and polymerase chain reaction positivity in serum investigated for CCHF virus. A picture of non-suppurative parotitis developed on the 3rd day of admission. Results: Other causes of parotitis were excluded with the help of serological tests, and the case was regarded as one of CCHF-associated parotitis. The patient was put on adjuvant therapy, an improvement in clinical findings was observed and he was discharged in a healthy condition on the 8th day. Conclusions: Ours is the first case in the literature of parotitis seen during CCHF. CCHF should be considered in differential diagnosis in addition to other frequently encountered viral agents in patients from endemic regions presenting with a picture of non-suppurative parotitis.

Open Forum Infectious Diseases, 2016

Background. For reasons such as the increasing need for both broad-spectrum antibiotic use and to... more Background. For reasons such as the increasing need for both broad-spectrum antibiotic use and total parenteral nutrition and the prolongation of life spans of patients with malignancies, candidemias are becoming a growing problem. The fact that, despite all technological advances, Candida spp. are seen in 50% of blood cultures shows that the problem is more serious than expected. The purpose of our study was to evaluate patients with candidemia and determine the importance of scoring systems. Methods. Patients with Candida spp. growth in blood cultures at our hospital between 2009 and 2014 were investigated retrospectively. Patients' demographic and clinical characteristics, laboratory results, time to start of appropriate treatment, Charlson comorbidity index (CCI), SOFA and Pitt scores and prognoses were recorded from medical files. The data obtained were analyzed on SPSS 13.0. Results. One hundred fifteen patients were enrolled. Mean CCI score was 4.2 ± 2.2, mean SOFA score was 7.4 ± 4.1 and mean Pitt score was 4.8 ± 3.2. Agents were C. albicans in 41.7%, C. guillermondi in 20%, C. parapsilosis in 17.4% and other non-Candida spp. in 20.9%. The crude mortality rate in the patients enrolled in the study was 65.2%. CCI, SOFA and Pitt scores were significantly high in the non-surviving patients (table 1). Ten of the non-surviving patients were not started on antifungal therapy, 32 patients were started on appropriate antifungal therapy after 3 days and 8 of the surviving patients were started on appropriate antifungal therapy after 3 days (p = 0.026). Multivariate analysis of the risk factors affecting mortality showed that a 1-unit increase in a patient's CCI, SOFA and Pitt scores increased mortality 1.6, 1.3, and 2.0 fold, respectively, and that failure to start appropriate antifungal therapy in the first 3 days increased mortality 4.6-fold (table 2). A CCI score above 4, a SOFA score above 7, and a Pitt score above 3 predict mortality in patients with candidemia with high specificity and sensitivity (table 3). Conclusion. Growth generally occurs after 3 days, leading to delays in treatment and increased mortality rates. Greater care is therefore required in the evaluation of atrisk patients in particular. At such evaluation, the use of CCI, SOFA, and Pitt scoring systems in patients with risk factors and prompt initiation of antifungal therapy in patients with scores above cutoff values can be life-saving. Disclosures. All authors: No reported disclosures.

Hemophagocytic Lymphohistiocytosis (HLH) is an indicator of an exaggerated immune response and ev... more Hemophagocytic Lymphohistiocytosis (HLH) is an indicator of an exaggerated immune response and eventually adverse outcomes. This study aimed to investigate the clinical and laboratory features and outcomes of patients with HLH. The medical records of 26 HLH adult patients (≥ 16 years of age) were retrospectively analyzed. Gender, age, the duration of fever, time to diagnosis, etiology and laboratory data were extracted from the records. The mean age was 38 ± 18 years, and 15 (58%) patients were female. A total of nine cases had infectious diseases; four cases had rheumatologic diseases, three cases had hematological malignancies while nine cases could not have a definitive diagnosis. The median time to detection of HLH was 20 days (IQR: 8–30 d). Of the 25 patients, 11 (44%) died. The erythrocyte sedimentation rates of the surviving and non-surviving patients were 39 ± 22 mm/h and 15 ± 13 mm/h, respectively. When a long-lasting fever is complicated by bicytopenia or pancytopenia (esp...

Pakistan Journal of Medical Sciences

Objectives: To evaluate the diagnostic value of the rtRT-PCR test and CT in patients presenting w... more Objectives: To evaluate the diagnostic value of the rtRT-PCR test and CT in patients presenting with typical clinical symptoms of COVID-19. Methods: The study with the participation of four center in Turkey was performed retrospectively from 20 March-15 April 2020 in 203 patients confirmed for COVID-19. The initial rtRT-PCR test was positive in 142 (70.0%) of the patients (Group-I) and negative in 61 patients (Group-II). Results: The mean age of the patients in Group-I was 49.7±18.0 years and the time between the onset of symptoms and admission to the hospital was 3.6±2.0 days; whereas the same values for the patients in Group-II were 58.1±19.9 and 5.3±4.2, respectively (p=0.004; p=0.026). Initial rtRT-PCR was found positive with 83.5% sensitivity and 74.1% PPV in patients with symptom duration of less than five days. It was found that rtRT-PCR positivity correlated negatively with the presence of CT findings, age, comorbidity, shortness of breath, and symptom duration, while rtRT-P...

Acta Medica Mediterranea, 2021

Aim: Hepatitis-A virus (HAV) is a disease that can be seen all over the world and spread easily d... more Aim: Hepatitis-A virus (HAV) is a disease that can be seen all over the world and spread easily due to the fact that it can be transmitted by the fecal-oral route. Because it is a disease that can be easily prevented by correcting vaccination and sanitation conditions, it is important to follow up on current seroprevelans and sanitation conditions and take local vaccination policies and other measures in this direction. In our study, we aimed to determine the sensitive population by revealing the current Seroprevalence of HAV in different geographical regions of our country. Material and methods: Between January 2015-December 2020, data of patients who received anti-HAV IgG in 5 education and research hospital from 4 different geographical regions were retrospectively examined. Anti-HAV IgG values were determined by ELISA method. Results: The study included 54 374 patients. The total seronegativity rate in our patients was 37.6 %. Seronegativity rates by age were 44.6% between the ages of 8-17; 39.1% between the ages of 18-45 and 30.5% over the ages of 45. Of the 985 patients who were health workers, 913 (92.7%) were seronegative (sensitive). Discussion: In our study, the height of seronegativity rates in young people was remarkable. HAV vaccine has been included in the routine childhood vaccination program in Turkey since 2012. Especially due to the fact that the rates of seronegativity in the young population are starting to increase and this group is ignored, a kind of lost generation occurs. This suggests that HAV may be an important public health problem in the coming years. In order to gain this lost generation, screening of these people and especially young people who are studying or working in the field of Health and vaccination of those who are seronegative should be provided.

Revista da Associação Médica Brasileira

Annals of Thoracic Medicine

Journal of Infection and Chemotherapy, 2013

The aim of this study was to evaluate the effectiveness of daptomycin in left-sided infective end... more The aim of this study was to evaluate the effectiveness of daptomycin in left-sided infective endocarditis (IE) patients. Fourteen patients with left heart endocarditis, monitored with a diagnosis of IE based on modified Duke criteria between July 2010 and May 2011, and receiving daptomycin as monotherapy, were enrolled. The success of daptomycin in these patients was revealed with improvements in microbiological, biochemical, and radiologic findings, as well as physical examination findings. Patient average age was 63.5 ± 14.2 years (36-80 years); 8 (57 %) were men and 6 (43 %) women. The pathogens methicillin-resistant Staphylococcus aureus (71.5 %), Streptococcus mutans (21.5 %), and methicillin-sensitive Staphylococcus aureus (7 %) were isolated from our patients. Daptomycin was used in initial treatment in 5 (36 %) patients; treatment was subsequently modified to daptomycin in 9 (64 %) patients as a consequence of drug serum level insufficiency, agent sensitivity to the drug administered, or drug side effects. Thirteen patients were discharged in a healthy condition, with successful surgical treatment in 5 (36 %). Only 1, an 80-year-old IE patient, was lost from advanced cardiac failure. No significant side effects were seen in any patient receiving daptomycin. The most frequent side effects were minimal rises in serum CPK levels during treatment; these values returned to normal after treatment. Daptomycin can be used successfully in left heart endocarditis with no significant side effects. Studies involving a wider patient series are now needed to support the use of daptomycin in left heart endocarditis.