Publications by authors named "Recep Ozturk"

102 Publications

A Simple Bone Cyst of the Acromion: Case Report.

Rev Bras Ortop (Sao Paulo) 2021 Apr 22;56(2):263-267. Epub 2020 Sep 22.

Departamento de Ortopedia e Traumatologia, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ancara, Turquia.

Simple bone cysts rarely occur in the scapula, and, to our knowledge, they have not been reported in the acromion. In the present report, we present the case of a 24-year-old female patient who was successfully treated by curettage and grafting using xenografting. No recurrence findings were observed during the follow-up six months postoperatively, the patient had recovered full range of motion, and she was able to perform all routine activities satisfactorily.
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http://dx.doi.org/10.1055/s-0040-1715516DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075636PMC
April 2021

Primary Angiosarcomas Of The Bone: An Evaluation Of 4 Cases.

J Ayub Med Coll Abbottabad 2021 Jan-Mar;33(1):150-154

Department Of Orthopaedics And Traumatology, Dr Abdurrahman Yurtaslan Ankara Oncology Training And Research Hospital, Turkey.

Angiosarcoma is a rare mesenchymal neoplasm that may arise from vascular or lymphatic tissue. Angiosarcoma of bone is a rare high-grade malignant vascular tumour, representing less than 1% of all angiosarcomas. The most common locations of unifocal tumour are the long and short tubular bones, followed by the pelvis, and trunk. The literature regarding treatment and outcome of patients with this tumour is limited. We performed a retrospective study to analyse treatment and survival of four patients with angiosarcoma of bone.
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March 2021

The Effectiveness of Tranexamic Acid in Patients With Proximal Femoral Tumor Resection Prosthesis.

Cureus 2020 Aug 29;12(8):e10105. Epub 2020 Aug 29.

Orthopedics, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, TUR.

Aim: The aim of this study is to evaluate the risk of thromboembolic events and amount of postoperative blood loss and transfusion in patients who received preoperative tranexamic acid (TXA) administration in proximal femoral resection and endoprosthesis of proximal femur malignant lesion.

Methods: In this study, the data of 46 patients who underwent extensive resection and proximal femoral tumor prosthesis for proximal femoral bone malignancies were retrospectively reviewed. Patients were divided into two groups according to preoperative 15 mg/kg bolus intravenous administration of TXA. These patients were compared in terms of postoperative blood loss, postoperative bleeding, and transfusion requirements.

Results: There were 46 patients (18 female, 28 male) with a mean age of 60.7±14.7 (19-89) years. Fifteen patients (32.6%) were treated with iv TXA. In the TXA group (46.7%), there was a statistically significant decrease in the need for transfusion compared to the patient group (93.5%) without TXA (p=0.001). Postoperative 24th hour, 48th hour,and total drainage blood loss values were found to be significantly lower in the TXA group (p=0.047, p=0.015, and p=0.019, respectively). There was no thromboembolic event observed.

Conclusion: Because of proximal femoral malignancy, extensive tumor resection and preoperative bolus 15 mg/kg TXA administration in proximal femoral prosthesis surgery significantly decreased the amount of postoperative bleeding and transfusion requirement without increasing the risk of thromboembolic event.

Level Of Evidence: Level III - retrospective comparative study.
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http://dx.doi.org/10.7759/cureus.10105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526757PMC
August 2020

Are Daily Life Activities of Patients with Proximal Femoral Tumor Resection Prosthesis as Good as those of Patients Undergoing Total Hip Prosthesis for Non-Tumor Causes?

Folia Med (Plovdiv) 2020 Sep;62(3):497-502

Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey.

Introduction: The Barthel Index of Activities of Daily Life (ADL) is a scale used to evaluate performance in daily life activities and investigate the reason and resulting relationships in a comprehensive, non-biased manner.

Aim: The aim of this study was to compare the daily life activities of patients who underwent proximal femoral tumor resection prosthesis assessed by the Barthel Index with the activities of daily living of patients with a total hip prosthesis performed for non-tumor reasons.

Materials And Methods: Twenty-eight patients were included in the study. Sixteen patients underwent hip prosthesis for reasons other than tumor (femur proximal avascular necrosis, coxarthrosis, etc.) and 12 underwent wide resection and femur proximal tumor resection prosthesis due to primary malignant bone tumor or metastasis in the proximal femur. The Barthel Index was used to evaluate their life quality at 3 months.

Results: A total of 28 patients (mean age 60.9±1.4 yrs, range 19.0-84.0, 17 female and 11 male patients) were included into the study. Mean ADL score was 84.5±20.6 (5-100.0). While only one patient was totally dependent in terms of daily life activities, 8 other patients were totally independent. When the patient groups were categorized by degree of dependency according to the ADL scores, it was found that dependency states of the two surgery groups were similar in distribution (p=0.212, p=0.703, and p=1.000 respectively).

Conclusion: Functional recovering levels were good in the patients who underwent a surgery for proximal femoral tumor resection prosthesis; there was no significant difference when we compared the functional level after total hip prosthesis applied for non-tumor reasons.
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http://dx.doi.org/10.3897/folmed.62.e47150DOI Listing
September 2020

Change in species distribution and antifungal susceptibility of candidemias in an intensive care unit of a university hospital (10-year experience).

Eur J Clin Microbiol Infect Dis 2021 Feb 15;40(2):325-333. Epub 2020 Sep 15.

Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Istanbul Medipol University, Istanbul, Turkey.

Candidemia is a nosocomial infection mostly found in critically ill patients. Our objectives were to evaluate the change in distribution and resistance profile of Candida spp. isolated from candidemic patients in our intensive care unit over two 5-year periods spanning 15 years and to evaluate the risk factors. Records from the microbiology laboratory were obtained, from January 2004 to December 2008 and from January 2013 to December 2017, retrospectively. Antifungal susceptibility was performed by E-test and evaluated according to EUCAST breakpoints. A total of 210 candidemia cases occurred; 238 Candida spp. were isolated in 197 patients (58.8% male; mean age, 59.2 ± 19.6 years). The most predominant risk factor was central venous catheter use. Species distribution rates were 32%, 28%, 17%, and 11% for C. albicans (n = 76), C. parapsilosis (n = 67), C. glabrata (n = 40), and C. tropicalis (n = 27), respectively. Resistance rate to anidulafungin was high in C. parapsilosis over both periods and increased to 73% in the second period. Fluconazole showed a remarkable decrease for susceptibility in C. parapsilosis (94 to 49%). The prevalence of MDR C. parapsilosis (6%/33%) and C. glabrata (0%/44%) increased in the second period. We observed a predominance of non-albicans Candida spp., with C. parapsilosis being the most frequent and C. glabrata infections presenting with the highest mortality. High level of echinocandin resistance in C. parapsilosis and increasing prevalences of MDR C. parapsilosis and C. glabrata seem emerging challenges in our institution.
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http://dx.doi.org/10.1007/s10096-020-03994-6DOI Listing
February 2021

Comparison of the Sensititre YeastOne antifungal method with the CLSI M27-A3 reference method to determine the activity of antifungal agents against clinical isolates of Candidaspp.

Turk J Med Sci 2020 12 17;50(8):2024-2031. Epub 2020 Dec 17.

Department of Microbiology, Medical School, Namık Kemal University, Tekirdağ, Turkey

Background And Aim: Infections caused by Candida species are significantly increasing today, and invasive Candida infections are generally associated with high mortality. Early diagnosis and identification of Candida spp. is important for the determination of antifungal agents that will be used for treatment. The aim of the present study was to provide a better regimen for Candida infections in the future.

Materials And Methods: TheSensititre YeastOne (SYO) method was compared with The Clinical Laboratory Standards Institute (CLSI) reference broth microdilution (BMD) testing method. Endpoints of minimal inhibitory concentrations (MICs) were determined for both methods.

Results: By using both methods, MIC values of micafungin, caspofungin, voriconazole, and fluconazole were lower than amphotericin B. The values obtained with the SYO method were in high categorical agreement for ecinocandins and amphotericin B. The results of voriconazole and fluconazole were in low categorical agreement. The categorical agreement between the SYO and the BMD results at 24 h was 82.1% for VORI and 98.4% for AMB. Values obtained with SYO method for all antifungal agents were in high essential agreement with the data of the CLSI reference BMD method. The essential agreement between the SYO and the BMD results at 24 h was 94.0% for MFG and 99.0% for AMB.

Conclusions: The SYO method was ready-to use, so it appeared to be easier and more efficient for Candida isolates.
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http://dx.doi.org/10.3906/sag-1909-97DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775692PMC
December 2020

Epidemiology, incidence, and survival of synovial sarcoma subtypes: SEER database analysis.

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020936009

Department of Orthopedics and Traumatology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.

Background: Synovial sarcoma (SyS) is a rare malignancy that is typically located on the limbs and occurs predominantly in adolescents. A study in a large population for SyS comparing subtypes has not yet been reported.

Methods: National Cancer Institute's Surveillance, Epidemiology, and End Results database was queried for patients diagnosed with SyS between January 1975 and December 2016. Patients were classified demographically according to gender, age, race/ethnicity, and marital status, and they were also classified by tumors, subtypes, localization, grade, year of diagnosis, laterality, type of treatment, and follow-up results.

Results: A total of 3228 patients were included, with a mean age of 39.3 ± 18.8 (range: 1-94), of which 1521 (47.1%) were females and 1707 (52.9%) were males. According to its subtypes, 47.2% were SyS not otherwise specified, 32.3% were spindle cell, 19.9% were biphasic, and 0.6% were epithelioid type. The overall survival period is 138.0 (95% confidence interval: 113.2-162.8) months. Survival duration was found to be significantly different between groups according to gender (log-rank test; < 0.001), age groups (log-rank test; < 0.001), race (log-rank test; = 0.001), marital status (log-rank test; < 0.001), tumor subtypes (log-rank test; < 0.001), tumor location (log-rank test; < 0.001), tumor laterality (log-rank test; < 0.001), date of diagnosis (log-rank test; = 0.025), tumor grade (log-rank test; < 0.001), historic stage (log-rank test; < 0.001), state of chemotherapy (log-rank test; < 0.001), state of radiotherapy (log-rank test; < 0.001), presence of metastasis (log-rank test; < 0.001), and total number of malignant tumors (log-rank test; < 0.001).

Conclusion: Male gender, being colored individual, being over 35 years at the time of diagnosis, epithelioid type, non-head and neck region localization is associated with poor prognosis. While radiotherapy improves survival, benefit of chemotherapy is unclear.

Level Of Evidence: III retrospective analysis.
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http://dx.doi.org/10.1177/2309499020936009DOI Listing
March 2021

Epidemiological Study of Adamantinoma from US Surveillance, Epidemiology, and End Results Program: III Retrospective Analysis.

J Oncol 2020 16;2020:2809647. Epub 2020 Jun 16.

Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, Suite D, Newark, NJ 07103, USA.

Objective: Adamantinomas are rare low-grade malignant bone tumors. This study aims to describe the demographic characteristics and survival rates of patients suffering from adamantinomas.

Methods: The National Institute of Cancer Surveillance, Epidemiology, and Recent Results (SEER) database was used, and patients diagnosed with adamantinoma between 1973 and 2016 were screened. Patients were classified according to sex, age, race/ethnicity, and marital status, and also tumors were classified according to year of diagnosis, laterality, type of treatment, and follow-up.

Results: The mean age of patients was 30.8 ± 16.7 (range: 4-75). A total of 92 patients were identified; of these, 43 were females and 49 were males. The mean follow-up period was 138.1 ± 90.3 (range: 1-156) months. Mean survival duration was 287.8 ± 15.4 (95% CI: 257.7-317.9) months. Five- and ten-year survival rates were 98.8% and 91.5%, respectively. Besides, survival time was also observed to be independent of gender, age groups, race, marital status, tumor location, and year of diagnosis.

Conclusion: Adamantinoma is a very rare bone tumor that affects the long bones in lower extremities and is more common in men. Five- and 10-year survival prognoses are reasonably satisfactory. Also, survival time is independent of variables such as gender, age, and tumor location.
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http://dx.doi.org/10.1155/2020/2809647DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315319PMC
June 2020

Management and retrospective analysis of pelvic ramus tumors and tumor-like lesions: Evaluation with 31 cases.

Jt Dis Relat Surg 2020 26;31(2):184-192. Epub 2020 Mar 26.

Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, 06200 Yenimahalle, Ankara, Türkiye.

Objectives: This study aims to investigate the characterization, treatment approaches, and follow-up results of tumors and tumor-like lesions located in the pelvic ramus.

Patients And Methods: Thirty-one patients (9 males, 22 females; mean age 48.9 years; range, 7 to 79 years) with benign and malignant tumors or tumor-like lesions in the pelvic ramus region treated and followed-up in our clinic between January 2005 and January 2019 were evaluated retrospectively. Surgical procedures were performed with anterior approach or inner-thigh approach. Twelve patients were diagnosed with malignant tumors, 12 patients with benign tumors, and seven patients with tumor-like lesions.

Results: Seventeen patients who underwent surgical treatment were followed-up for a mean period of 61.7 months. The diameters of benign and malignant tumors were similar (p=0.425). Of all lesions, 64.5% were located in the pubis. Ischium location was significantly higher in patients with malignant lesions than tumor-like lesions. The most common complication was diffuse subcutaneous edema in the inguinal region and thigh (8.3%).

Conclusion: There are many different tumoral lesions in the pelvic ramus. Pelvic ramus tumors tend to settle more frequently in pubic ramus, whereas ramus ischium tumors are more likely to be malignant. In addition, the diagnosis of insufficiency fracture should be considered primarily in pathologic fractures of pubic ramus in females over 50 years of age. In the postoperative follow-up of pelvic ramus tumors, diffuse edema may occur even if there is no intraoperative vascular damage.
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http://dx.doi.org/10.5606/ehc.2020.72762DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489152PMC
November 2020

COVID-19: pathogenesis, genetic polymorphism, clinical features and laboratory findings

Turk J Med Sci 2020 04 21;50(SI-1):638-657. Epub 2020 Apr 21.

Department of Medical Genetics, Medical School, Istanbul Medipol University, İstanbul, Turkey

COVID-19 caused by a novel agent SARS-CoV-2 progressed to a pandemic condition and resulted in a major public health concern worldwide, leading to social and economic issues at the same time. The pathogenesis of COVID-19 starts with the bonding of the virus to ACE2 receptors expressed in many tissues, and the triggered excessive immune response plays a critical role in the course of the disease. The cytokine storm that occurs upon excessive production of pro-inflammatory cytokines is considered responsible for the severe progression of the disease and the organ damage. However, the accurate pathophysiological mechanism of the disease, which progresses with various clinical presentations, is still substantially unknown. While various studies have been conducted on the effect of genetic polymorphism on the course and severity of the disease, the presence of a significant effect has not been proven yet. The clinical course of the disease is variable, with clinical representation ranging from 81% mild course to 14% severe course along with 5% critical course in patients. Asymptomatic course is considered to be higher than expected, although its frequency is not known exactly. Older adults and those with comorbidities are exposed to a more severe disease course. The disease progress with various symptoms, such as fever, cough, dyspnea, malaise, myalgia, taste and smell dysfunctions, diarrhea, and headache. A range of complications (acute respiratory distress syndrome, thromboembolic conditions, arrhythmia and cardiac events, secondary infections) could be seen during the course of the disease. Varied laboratory tests are vital to determine these verity and prognosis of the disease, along with the condition and exposure of the affected systems during thecourse of COVID-19.
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http://dx.doi.org/10.3906/sag-2005-287DOI Listing
April 2020

A prospective pharmacovigilance study in the infectious diseases unit of a tertiary care hospital.

J Infect Dev Ctries 2019 07 31;13(7):649-655. Epub 2019 Jul 31.

Infectious Diseases and Clinical Microbiology Department, Istanbul Medipol University Medical Faculty, Istanbul, Turkey.

Introduction: The frequency, causality, severity, preventability and risk factors of ADRs (adverse drug reactions) in infectious disease units are not well defined in the literature. Thus, the aim of this study was to determine the characteristics of the ADRs encountered in an infectious disease unit of a tertiary teaching hospital.

Methodology: The patients who were admitted to the infectious disease unit of a tertiary teaching hospital longer than 24 hours between January and December of 2016 were followed prospectively. Patients were observed and questioned for any sign of ADRs. The proportion of ADRs and patient characteristics were investigated. Causality was evaluated by the Naranjo algorithm, severity was determined using the Hartwig classification, and preventability was assessed using the Schumock and Thornton scale.

Results: 210 patients were admitted to the unit during the study period, of whom 44 patients (20.9%) experienced 51 ADRs. 5.9% of ADRs were found to be serious according to the Hartwig severity classification. In addition, 88.1% of ADRs were not preventable. The most frequently detected ADR was skin and subcutaneous tissue reactions (33.3%), and systemic antimicrobials were the most common type of drugs that caused an ADR. Prolonged hospitalization (p < 0.001) and usage of an increased number of drugs (p < 0.001) were found to be significant risk factors for ADR development.

Conclusions: Prolonged hospital stay and polypharmacy are significant risk factors that increase the incidence of ADRs in infectious disease units. The likelihood of unavoidable ADRs should arouse the attention of clinicians when prescribing antimicrobials.
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http://dx.doi.org/10.3855/jidc.11503DOI Listing
July 2019

Epidemiology of urological infections: a global burden.

World J Urol 2020 Nov 10;38(11):2669-2679. Epub 2020 Jan 10.

Department of Internal Medicine, Nephrology Unit, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey.

Introduction: Urinary tract infections (UTIs) are among the most frequent infections in clinical practice worldwide. Their frequency and burden must be higher than available data suggest because they are not among mandatory diseases to be notified.

Classification Of Urinary Infections: Although there are many different proposals for classifying UTIs, classifications based on acquisition settings and complication status are more widely used. These include community- acquired UTIs (CAUTIs) or healthcare-associated UTIs (HAUTIs) and uncomplicated or complicated UTIs.

Epidemiology Of Urological Infections And Global Burden: As the most frequently seen infectious disease, CAUTIs affect more than 150 million people annually. Complicated UTIs in particular constitute a huge burden on healthcare systems as a frequent reason for hospitalization. The prevalence of HAUTIs ranges between 1.4% and 5.1%, and the majority of them are catheter-related UTIs. Community-onset HAUTIs have gained importance in recent years.

Conclusion: As frequent infectious diseases, UTIs create clinical and economic burdens on healthcare systems, and they also affect quality of life determinants.
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http://dx.doi.org/10.1007/s00345-019-03071-4DOI Listing
November 2020

Primary aneurysmal bone cyst of the scapula in adult patient: two case reports and a review of the literature.

Arch Orthop Trauma Surg 2020 Oct 20;140(10):1367-1372. Epub 2019 Dec 20.

Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Mehmet Akif Ersoy Neighborhood, 13. Street, No: 56, 06200, Ankara, Turkey.

Aneurysmal bone cyst (ABC) is a rare, benign but locally aggresive bone tumor of unknown origin tumor. It commonly affects children and usually occurs at the metaphysis of long bones. Scapula is a very rare location and ABCs of the scapula have been sparsely described in the literature. Differential diagnosis can be challenging as it shares common radiological and clinicopathological features with other benign and malignant bone tumors. The degree of diagnostic difficulty increases even more when an unusual tumor site has to be taken into account. Here, we describe rare and challenging cases of a primary ABC located at the scapula that was surgically treated. This is the first case report of ABC involving the scapula in adult patient.
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http://dx.doi.org/10.1007/s00402-019-03327-zDOI Listing
October 2020

Place of orthopedic surgery in gout.

Eur J Rheumatol 2019 10 5;6(4):212-215. Epub 2019 Sep 5.

Department of Orthopaedics and Traumatology, Ankara Oncology Training and Research Hospital, Ankara, Turkey.

Objective: To evaluate the indications, surgical results, and complications related to tophaceous gout surgery in the orthopedics and traumatology clinic of our hospital.

Methods: A retrospective analysis of all patients who underwent surgery for topical gout in our orthopedics and traumatology clinic between January 2008 and December 2017 was carried out. Their history, physical examination, and radiological and laboratory tests were examined. Surgical indications, surgical results, and complications were analyzed.

Results: Total 18 lesions in 15 patients with gout tophi were operated (60% males). The most common lesion was in the elbow (6; 33%). All patients underwent total excision, and the mean mass size was 4.0 cm. Only one patient had a delayed wound healing. All other patients had no complications.

Conclusion: The results of surgical procedures which were performed to confirm the diagnosis, to reduce mechanical problems due to tophaceous and to alleviate pain were excellent, and complication risk was acceptable. Comorbidities and sepsis were the predictors of surgical complications.
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http://dx.doi.org/10.5152/eurjrheum.2019.19060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812903PMC
October 2019

Talus localized osteochondromas: Treatment management and mid-term outcomes - Case series.

Eklem Hastalik Cerrahisi 2019 Dec;30(3):309-15

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200 Yenimahalle, Ankara, Turkey.

Objectives: This study aims to define the demographic and clinical findings of patients with talus localized osteochondroma, to present treatment management and mid-term results.

Patients And Methods: The study included 10 patients (4 males, 6 females; mean age 31.9+19.5 years; range, 11 to 70 years) with osteochondroma of the talus who were admitted to our center between January 2008 and December 2015. Clinical findings, treatment methods, and clinical outcomes were retrospectively evaluated. All patients were followed-up for at least two years.

Results: The most frequent localization was anterior of the talus (70%, n=7). The mean tumor size was 2.4±1.4 cm (range, 1-5 cm). When the relationship between tumor diameter and age was analyzed, no statistically significant correlation was detected (p=0.973). Besides, no statistically significant difference was found between the genders in terms of tumor diameters (p=0.584). The most common symptoms were pain, swelling, and restricted movements. The mean duration of postoperative follow-up was 48.1±27.7 months (range, 24-114 months). All patients underwent complete surgical excision. None of the patients developed recurrence or complication related to the treatment of osteochondroma.

Conclusion: Talus localized osteochondromas are often symptomatic and more common in adults. Also, they are more common in females. The ideal treatment approach is resection of the tumor. When rigorous surgical excision is performed, recurrence rates are low with satisfactory outcomes.
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http://dx.doi.org/10.5606/ehc.2019.66769DOI Listing
December 2019

Distribution and evaluation of bone and soft tissue tumors operated in a tertiary care center.

Acta Orthop Traumatol Turc 2019 May 11;53(3):189-194. Epub 2019 Apr 11.

Department of Orthopaedics and Traumatology, Dr Abdurrahan Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.

Objective: The aim of this study was to retrospectively evaluate the patients who were operated in our orthopedics and traumatology clinic with the suspection of bone and soft tissue tumors.

Methods: A total of 3133 patients (1146 (46.5%) female and 1318 (53.5%) male) who presented to our tertiary clinic from different regions of Turkey between January 2002 and July 2013 with the presumed diagnosis of bone and soft tissue tumors were analyzed according to age, gender, bone/soft tissue localization, tumoral localization, histopathological diagnosis, tumor size and incidence.

Results: Of all operated patients, 2464 (78%) were diagnosed with tumor, while non-tumoral causes were found in 669 (22%) patients. Of the cases diagnosed with tumor, 1139 were bone localized, 1004 soft tissue localized, and 321 metastasis. The most common benign bone tumors were osteochondroma (130, 20%), enchondroma (96, 15%), and simple bone cysts (90, 14%), while the most common malignant bone tumors were osteosarcoma (241, 44%), ewing's sarcoma (89, 16%), and chondrosarcoma (77, 14%); respectively. The most common benign soft tissue tumors were lipoma (141, 22%), giant cell tumors (108, 16%) and ganglion (107, 16%), while the most common malignant soft tissue tumors were liposarcoma (55, 16%), synovial sarcoma (53, 16%) and malignant mesenchymal tumors (45, 13%); respectively.

Conclusion: Musculoskeletal tumors are rare, but descriptive data in any region are important in order to reduce mortality and improve treatment. No significant difference was found between the data of our hospital regarding epidemiology of the musculoskeletal system tumors and those from the other regions around the world.

Level Of Evidence: Level IV, Therapeutic study.
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http://dx.doi.org/10.1016/j.aott.2019.03.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599414PMC
May 2019

Malignant tumors of the shoulder girdle: Surgical and functional outcomes.

J Orthop Surg (Hong Kong) 2019 May-Aug;27(2):2309499019838355

Department of Orthopaedics and Traumatology, Ankara Oncology Training and Research Hospital, Ankara, Turkey.

Background: Large resection and reconstruction of the malignant tumors of the shoulder girdle are used to provide maximum protection of the soft tissues with sufficient surgical margin. However, these have their own difficulties. The goals of this study were to review demographic data of 187 patients diagnosed with the malignant tumors located around shoulder between 2001 and 2016 in our clinic, to evaluate the functional outcomes and surgical outcomes, and to classify the resection methods according to new classification systems.

Methods: There were 187 patients (108 male and 79 female) and the mean age at surgery was 47.9 (range 2-87). Fifty-one of these patients underwent biopsy only: 8 partial/total claviculectomy, 10 partial/total scapulectomy, 80 proximal humeral resection, 5 total humeral resection, 6 shoulder girdle resection, and 13 amputations. Eighty-six had prosthetic implants, five had fibula transpositions, and one had a massive homologous bone graft. Seventy-one of the 136 patients were followed for an average of 40.3 months.

Results: When the bone resections were evaluated, the best results were obtained while the rotator cuff function is preserved in glenoid preserving partial scapulectomy, partial/total claviculectomy, and proximal humerus intercalary resection. In total, scapulectomy and proximal/total humeral resection operations' results were moderate because of partial or total injury of the abductor mechanism.

Conclusions: As a result, malignant tumors of the shoulder girdle and soft tissue can be treated with limb-sparing surgery procedures. Reconstructive procedures and reconstructive methods such as prosthetic replacement, auto-allograft, and soft tissue reconstructions should be specified in each case. These resection and reconstruction methods are reliable and applicable procedures for local tumor control, pain control, and functional outcomes. More rarely, amputation/disarticulation can be performed.
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http://dx.doi.org/10.1177/2309499019838355DOI Listing
April 2020

Determination of Seasonal Vitamin and Mineral Contents of Sea Bream (Sparus aurata L., 1758) Cultured in Net Cages in Central Black Sea Region.

Biol Trace Elem Res 2019 Feb 12;187(2):517-525. Epub 2018 May 12.

Faculty of Fisheries and Aquatic Science, Department of Aquaculture, Sinop University, Sinop, Turkey.

This study aimed to determine the seasonal vitamin and mineral contents of sea bream (Sparus aurata) cultured in net cages in Central Black Sea region. The average seasonal A, D, and E vitamins values in fish meat were between 0.27 ± 0.02-0.60 ± 0.00, 0.98 ± 0.01-1.70 ± 0.00, and 3.10 ± 0.14-6.00 ± 0.21 mg/kg, respectively (p < 0.05). The average seasonal Ca, Fe, K, Mg, Na, P, Zn, and Se values in fish meat were between 276.90 ± 0.99-1788.50 ± 51.27 (p < 0.05), 3.50 ± 0.12-4.47 ± 0.18 (p > 0.05), 4244.50 ± 8.84-4761.50 ± 1.06 (p < 0.05), 251.55 ± 2.55-312.65 ± 11.42 (p < 0.05), 56.49 ± 0.04-128.75 ± 0.18 (p < 0.05), 2234.50 ± 15.20-2619.00 ± 7.07 (p < 0.05), 5.62 ± 0.10-15.30 ± 0.22 (p < 0.05), and 0.30 ± 0.00-0.38 ± 0.01 mg/kg (p > 0.05), respectively. As a result, it can be concluded that sea bream cultured in the Central Black Sea region is a rich source of nutrients in terms of vitamins and mineral matters, and fish size, feed quality, and the environmental factors are influential on the contents of vitamin and mineral substances in the fish tissue.
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http://dx.doi.org/10.1007/s12011-018-1382-2DOI Listing
February 2019

Management of solitary fibrous tumors localized in extremity: case series and a review of the literature.

Eklem Hastalik Cerrahisi 2017 Aug;28(2):121-7

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200 Yenimahalle, Ankara, Turkey.

Objectives: This study aims to evaluate the clinical characteristics and treatment results of patients with a diagnosis of solitary fibrous tumor localized in extremity.

Patients And Methods: Clinical findings, treatment methods, clinical outcomes and treatment failures of seven patients (3 males, 4 females; mean age 49.7±20.7 years; range 22 to 79 years) diagnosed as solitary fibrous tumor localized in extremity between January 2005 and December 2016 were evaluated retrospectively.

Results: Most frequent localization was the thigh (42.8%, n=3). Mean tumor size was 10.8±2.4 cm (range 8-15 cm). All patients applied with painless mass and all had primary tumor. All patients had localized disease at the time of diagnosis. Postoperative mean follow-up duration was 44.4 months (range 13-121 months). Marginal resection was performed in two patients at low risk group while wide resection was performed in other patients at moderate and high risk groups. Patients who underwent marginal resection were performed adjuvant radiotherapy. No recurrence or metastasis was detected in any of the patients during follow-up.

Conclusion: In the treatment of solitary fibrous tumors localized in extremity, marginal resection together with radiotherapy may be an alternative treatment method for patients in low risk group according to risk stratification model, for whom wide resection is not possible. Wide resection is recommended in moderate and high risk groups to decrease local recurrence and metastasis risks.
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http://dx.doi.org/10.5606/ehc.2017.52092DOI Listing
August 2017

Prognostic Value of QRS Fragmentation in Patients with Acute Myocardial Infarction: A Meta-Analysis.

Ann Noninvasive Electrocardiol 2016 Nov 28;21(6):604-612. Epub 2016 Mar 28.

Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.

Aims: Fragmented QRS has emerged as a novel electrocardiographic parameter associated with adverse clinical events in various diseases. The aim of this study was to investigate the association of fQRS with in-hospital and long-term cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI).

Methods And Results: We searched PubMed, Embase, Web of Science, and Cochrane Library up to October 2015 for eligible studies. We selected studies with fQRS defined with 12-lead ECG during the index hospitalization of STEMI/NSTEMI. Primary outcomes were in-hospital and long-term cardiovascular events. In-hospital mortality was significantly higher in fQRS (+) group (99/733; 13.5%) compared to fQRS (-) group (47/1293; 3.6%) (OR 4.03 95% CI 1.81-8.94; P = 0.0006). Long-term mortality rate was higher in fQRS (+) group (89/473; 18.8%) compared to fQRS (-) group (54/1009; 5.3%) (OR 3.93 95% CI 1.92-8.05; P = 0.0002). In addition the frequency of long-term MACE was higher in fQRS (+) group (46.9%) compared to fQRS (-) group (14.6%) (OR 5.13 95% CI 2.77-9.51; P < 0.00001) CONCLUSION: Presence of fQRS on admission ECG was found to be predictor of mortality, MACE, deterioration of LV function, and presence of multivessel disease in patients with STEMI and NSTEMI.
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http://dx.doi.org/10.1111/anec.12357DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931668PMC
November 2016

Response to letter to the editor: Prognostic value of QRS fragmentation in patients with acute myocardial infarction: a meta-analysis.

Ann Noninvasive Electrocardiol 2016 09 16;21(5):534. Epub 2016 Aug 16.

Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.

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http://dx.doi.org/10.1111/anec.12396DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931436PMC
September 2016

Association of contrast-induced nephropathy with bare metal stent restenosis in STEMI patients treated with primary PCI.

Ren Fail 2016 Sep 19;38(8):1167-73. Epub 2016 Jul 19.

a Department of Cardiology , Siyami Ersek Cardiovascular and Thoracic Surgery Center , Istanbul , Turkey ;

Background: Contrast induced nephropathy (CIN) has been proven as a clinical condition related to adverse cardiovascular outcomes. However, relationship between CIN and stent restenosis (SR) remains unclear. In this study, we aimed to investigate the association of CIN with SR rates after primary percutaneous coronary intervention (PCI) and bare metal stent (BMS) implantation.

Methods: A total number of 3225 patients who had undergone primary PCI for STEMI were retrospectively recruited. The medical reports of subjects were searched to find whether the patients had a control coronary angiogram (CAG) and 587 patients with control CAG were included in the study. The laboratory parameters of 587 patients were recorded and patients who developed CIN after primary PCI were defined. Contrast induced nephropathy was defined as either a 25% increase in serum creatinine from baseline or 0.5 mg/dL increase in absolute value, within 72 h of intravenous contrast administration.

Results: The duration between primary PCI and control CAG was median 12 months [8-24 months]. The rate of SR was significantly higher in CIN (+) group compared to CIN (-) group (64% vs. 46%, p < 0.01). In multivariate Cox regression analysis, male gender, stent length, admission WBC levels and presence of CIN (HR 1.39, 95% CI 1.06-1.82, p < 0.01) remained as the independent predictors of SR in the study population.

Conclusion: Gender, stent length, higher serum WBC levels and presence of CIN are independently correlated with SR in STEMI patients treated with BMS implantation.
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http://dx.doi.org/10.1080/0886022X.2016.1209024DOI Listing
September 2016

Identification of Candida species and susceptibility testing with Sensititre YeastOne microdilution panel to 9 antifungal agents.

Saudi Med J 2016 Jul;37(7):750-7

Department of Cardiovascular Surgery, Istanbul University Cardiology Institute, Istanbul, Turkey. E-mail.

Objectives: To determine the species incidence and susceptibility pattern to 9 antifungal agents of yeasts isolated from various clinical specimens of colonized or infected patients treated in the coronary and surgical intensive care units (ICU). 

Methods: A total of 421 ICU patients were treated at the Cardiology Institute, Istanbul University, Istanbul, Turkey between June 2013 and May 2014, and 44 Candida species were isolated from blood, urine, endotracheal aspiration fluid, sputum, and wounds of 16 ICU patients. Identification of Candida was performed using CHROMagar. Antifungal susceptibility was determined by a Sensititre YeastOne colorimetric microdilution panel. 

Results: Candida albicans (C. albicans) was the most commonly observed microorganism 23 (54%); the other microorganisms isolated were Candida tropicalis 12 (27%), Candida glabrata 5 (11%), Candida parapsilosis 1 (2%), Candida lusitaniae 1 (2%), Candida sake 1 (2%), and Geotrichum capitatum 1 (2%). All isolates were susceptible to amphotericin B and 5-flucytosine. Geotrichum capitatum excepted, the other isolates were also susceptible to anidulafungin, micafungin, and caspofungin. Candida parapsilosis was found to be susceptible to all the studied antifungals. High MIC rates for azole group of antifungal drugs were found for C. albicans, C. tropicalis, and C. glabrata. The rate of colonisation was 3.8% (16/421). Only 0.7% (3/421) patients out of a total of 421 developed candidemia. 

Conclusion: We found that the yeast colonization and infection rates of patients in our ICUs are very low. Candida albicans is still the most common species. We detected a decreasing susceptibility to azole compounds.
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http://dx.doi.org/10.15537/smj.2016.7.13412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5018638PMC
July 2016

The Syrian conflict and infectious diseases.

Expert Rev Anti Infect Ther 2016 06 27;14(6):547-55. Epub 2016 Apr 27.

a Department of Infectious Diseases and Clinical Microbiology , Istanbul University, Cerrahpasa Medical School , Istanbul , Turkey.

The conflict in Syria is a big humanitarian emergency. More than 200,000 Syrians have been killed, with more than half of the population either having been displaced or having immigrated. Healthcare has been interrupted due to the destruction of facilities, a lack of medical staff, and a critical shortage of life-saving medications. It produced suitable conditions leading to the re-emergence of tuberculosis, cutaneous leishmaniasis, polio, and measles. Lebanon and Jordan reported increased rates of tuberculosis among Syrian refugees. Cutaneous leishmaniasis outbreaks were noted not only in Syria but also in Turkey, Jordan, and Lebanon. After a polio-free 15 years, Syria reported a polio outbreak. Ongoing measles outbreaks in the region was accelerated by the conflict. Iraq declared a cholera outbreak among the Syrian refugees. The healthcare facilities of the countries hosting immigrants, mainly Turkey, Lebanon, Jordan, Iraq, and Egypt, are overburdened. The majority of the immigrants live in crowded and unsanitary conditions. Infectious diseases are big challenges for Syria and for the countries hosting immigrants. More structured support from international organizations is needed for the prevention, control, diagnosis, and treatment of infectious diseases.
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http://dx.doi.org/10.1080/14787210.2016.1177457DOI Listing
June 2016

Changes in the prevalence of HBV infection in pregnant women in Turkey between 1995 and 2015: a 20-year evaluation.

Postgrad Med J 2016 Sep 3;92(1091):510-3. Epub 2016 Mar 3.

Department of Infectious Diseases, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.

Objective: To determine changes in hepatitis B virus (HBV) prevalence across three different time periods in pregnant women.

Methods: This was a retrospective study of pregnant women attending four healthcare centres between January 1995 and May 2015. Data for serum hepatitis B surface antigen (HBsAg) and anti-HBs levels were collected from routine antenatal screening records. The 20-year study was divided into three periods: 1995-2001, 2002-2008 and 2009-2015. The results are presented by the women's age and gravidity as possible determinants of HBV infection.

Results: 7605 pregnant women (56.0% primigravidae) (mean age 23.4±4.8 years) were tested for markers of HBV infection. 3010 pregnant women were screened between 1995 and 2001, 2995 between 2002 and 2008, and 1600 between 2009 and 2015. The overall prevalence of HBsAg and anti-HBs positivity in the 7605 pregnant women was 1.5% (n=114) and 11.5% (n=877), respectively. Regarding temporal change in the prevalence of HBV markers, HBsAg decreased significantly from 2.6% to 0.8% (p<0.01), while anti-HBs increased significantly from 9.5% to 17.5% (p<0.01), between the first and last study periods. Multigravidae and older women had higher HBsAg and anti-HBs positivity compared to primigravidae.

Conclusions: The data suggest that the prevalence of HBsAg positivity is gradually decreasing among pregnant women, while the level of HBsAg antibody seropositivity is lower than expected. HBV carrier rate increases with increasing age and gravidity. In addition to the national HBV immunisation programme, the prevention of perinatal transmission should also be prioritised to decrease the HBV pool of infection.
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http://dx.doi.org/10.1136/postgradmedj-2015-133876DOI Listing
September 2016

Mortality predictors of Staphylococcus aureus bacteremia: a prospective multicenter study.

Ann Clin Microbiol Antimicrob 2016 Feb 9;15. Epub 2016 Feb 9.

Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bağcılar, 34214, İstanbul, Turkey.

Background: Staphylococcus aureus is one of the causes of both community and healthcare-associated bacteremia. The attributable mortality of S. aureus bacteremia (SAB) is still higher and predictors for mortality and clinical outcomes of this condition are need to be clarified. In this prospective observational study, we aimed to examine the predictive factors for mortality in patients with SAB in eight Turkish tertiary care hospitals.

Methods: Adult patients with signs and symptoms of bacteremia with positive blood cultures for S. aureus were included. All data for episodes of SAB including demographics, clinical and laboratory findings, antibiotics, and outcome were recorded for a 3-year (2010-2012) period. Cox proportional hazard model with forward selection was used to assess the independent effect of risk factors on mortality. A 28-day mortality was the dependent variable in the Cox regression analysis.

Results: A total of 255 episodes of SAB were enrolled. The median age of the patients was 59 years. Fifty-five percent of the episodes were considered as primary SAB and vascular catheter was the source of 42.1 %. Healthcare associated SAB was defined in 55.7 %. Blood cultures yielded methicillin-resistant S. aureus (MRSA) as a cause of SAB in 39.2 %. Initial empirical therapy was inappropriate in 28.2 %. Although overall mortality was observed in 52 (20.4 %), 28-day mortality rate was 15.3 %. Both the numbers of initial inappropriate empirical antibiotic treatment and the median hours to start an appropriate antibiotic between the cases of fatal outcome and survivors after fever onset were found to be similar (12/39 vs 60/216 and 6 vs 12 h, respectively; p > 0.05). High Charlson comorbidity index (CCI) score (p = 0.002), MRSA (p = 0.017), intensive care unit (ICU) admission (p < 0.001) and prior exposure to antibiotics (p = 0.002) all were significantly associated with mortality. The Cox analysis defined age [Hazard Ratio (HR) 1.03; p = 0.023], ICU admission (HR 6.9; p = 0.002), and high CCI score (HR 1.32; p = 0.002) as the independent predictive factors mortality.

Conclusions: The results of this prospective study showed that age, ICU stay and high CCI score of a patient were the independent predictors of mortality and MRSA was also significantly associated with mortality in SAB.
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http://dx.doi.org/10.1186/s12941-016-0122-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748515PMC
February 2016

CHA2DS2-VASc Score is a Predictor of No-Reflow in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Intervention.

Angiology 2016 10 17;67(9):840-5. Epub 2015 Dec 17.

Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.

Thrombosis and distal embolization play crucial role in the etiology of no-reflow. CHA2DS2-VASc score is used to estimate the risk of thromboembolism in patients with atrial fibrillation. We tested the hypothesis that CHA2DS2-VASc can predict no-reflow among patients who underwent primary percutaneous coronary intervention (PCI). A total number of 2375 consecutive patients with ST-segment elevation myocardial infarction were assessed for the study. Patients were divided into 2 groups as no-reflow (n = 111) and control (n = 1670) groups according to post-PCI no-reflow status. CHA2DS2-VASc scores were calculated for all patients. CHA2DS2-VASc scores were significantly higher in the no-reflow group compared to the control group. After a multivariate regression analysis, CHA2DS2-VASc score remained as an independent predictor (odds ratio: 1.58, 95% confidence interval: 1.33-1,88, P < .001) of no-reflow. Receiver-operating characteristics analysis revealed the cutoff value of CHA2DS2-VASc score ≥2 as a predictor of no-reflow with a sensitivity of 66% and a specificity of 59%. Moreover, in-hospital mortality was also associated with significantly higher CHA2DS2-VASc scores. In conclusion, CHA2DS2-VASc score is associated with higher risk of no-reflow and in-hospital mortality rates in patients who underwent primary PCI.
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http://dx.doi.org/10.1177/0003319715622844DOI Listing
October 2016

Surgical management of bone metastases from urological malignancies: an analysis of 70 cases.

Acta Orthop Traumatol Turc 2015 ;49(6):634-40

Ankara Oncology Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.

Objective: The purpose of this study was to evaluate symptomatic bone metastases from urological malignancies and the efficacy of surgical treatment of bone metastases in achieving local tumor control.

Methods: This was a retrospective observational study of patients diagnosed with bone metastases from urological malignancies who died from their diseases between 2002 and 2013. Data on clinicopathology, number and sites of bone metastasis, time to first and subsequent metastasis, survival after metastasis, nature of metastasis (blastic, mixed, lytic), type of surgical reconstruction, systemic affections, and visceral organ metastasis for 70 bone metastases from deceased urological malignancies patients (55 male, 15 female) with evidence of bone metastasis were statistically analyzed.

Results: Forty-three patients (61.42%) had renal cell carcinoma (RCC), 15 patients (21.43%) had prostate cancer, and 12 patients (17.15%) had bladder carcinoma as primary diagnosis. Osteolytic lesions were most prevalent (n=61; 87%). The most common surgical modality for extremities was wide resection with prosthetic replacement (42 patients), followed by wide resection or wide resection with bone cement application with internal fixation (21 patients); 65 patients were treated with limb salvage procedures, and 2 patients were treated with amputation. Overall median survival was 13 months for RCC, 16 months for prostate carcinoma, and 11 months for bladder carcinoma patients.

Conclusion: Detection of bone metastases in patients with urological malignancies influences the treatment strategy. Diagnosis of bone metastases may be delayed in urologic malignities; thus, these patients receive long-term clinical follow-up.
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http://dx.doi.org/10.3944/AOTT.2015.14.0340DOI Listing
August 2016

Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study.

Turk J Haematol 2016 Dec 6;33(4):304-310. Epub 2015 Aug 6.

İstanbul University Cerrahpaşa Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İstanbul, Turkey, Phone: +90 212 414 30 00, E-mail:

Objective: The significance of mannose-binding lectin (MBL) and H-ficolin deficiency in febrile neutropenic (FN) patients and the correlation of these markers along with consecutive C-reactive protein (CRP) and procalcitonin (PCT) levels during the infectious process are investigated.

Materials And Methods: Patients with any hematological malignancies who were defined to have "microbiologically confirmed infection", "clinically documented infection", or "fever of unknown origin" were included in this single-center prospective observational study. Serum levels of CRP, PCT, MBL, and H-ficolin were determined on 3 separate occasions: at baseline (between hospital admission and chemotherapy), at the onset of fever, and at the 72nd hour of fever.

Results: Forty-six patients (54% male, mean age 41.7 years) with 61 separate episodes of FN were evaluated. Eleven patients (23.9%) had "microbiologically confirmed infection", 17 (37%) had "clinically documented infection", and 18 (39.1%) had "fever of unknown origin". Fourteen (30.4%) patients had low (<500 ng/mL) initial MBL levels and 7 (15.21%) had low (<12,000 ng/mL) H-ficolin levels. Baseline MBL and H-ficolin levels did not significantly change on the first and third days of fever (p=0.076). Gram-negative bacteremia more frequently occurred in those with low initial MBL levels (p=0.006). PCT levels were significantly higher in those with microbiologically documented infections. Mean and median PCT levels were significantly higher in cases with bacteremia. There was no significant difference between hemoculture-positive and-negative patients in terms of CRP levels.

Conclusion: Monitoring serum H-ficolin levels was shown to be of no benefit in terms of predicting severe infection. Low baseline MBL levels were correlated with high risk of gram-negative bacteremia; however, no significant correlation was shown in the follow-up. Close monitoring of PCT levels is warranted to provide more accurate and specific data while monitoring cases of bacteremia.
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http://dx.doi.org/10.4274/tjh.2014.0385DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5204185PMC
December 2016

Hepatic apoptotic markers are not predictors for the virological response to interferon-based therapy in chronic hepatitis C patients.

Eur J Gastroenterol Hepatol 2015 Sep;27(9):1057-62

Departments of aInfection bGastroenterology cPathology dMicrobiology, Cerrahpasa Medical School, Istanbul University eOkmeydani Research and Education Hospital fPathology Department gGastroenterology Department, Marmara University Medical School hPathology Department iInfection Department, Istanbul Research and Education Hospital, Istanbul, Turkey.

Introduction: Chronic hepatitis C virus (HCV) infection is a major health problem worldwide. The majority of cases involving HCV infection develop into chronic hepatitis because of a failure to develop an effective immune response. Apoptosis of the hepatocytes plays a significant role in the pathogenesis of HCV infection: the interaction between the Fas antigen on hepatocytes and the Fas ligand on T cells corresponds to the main mechanism for hepatocyte damage. Interferon (IFN)-α has antiviral, immunoregulatory, and antiproliferative properties, and apoptosis seems to be a critical event in the action mechanisms of both IFNs. In this study, we aimed to detect any relationship between apoptotic markers in the liver and the response to the treatment.

Materials And Methods: The study included 180 chronic HCV patients treated with IFN and ribavirin in four centers. Apoptotic markers (Fas, Fas ligand, Fas-associated death domain, caspases 3, 8, and 9, and in-situ apoptosis) were studied in the liver. The age, sex of the patients, response to therapy, ALT level, viral load, and genotype were recorded.

Results: The results of the study showed that the histological activity index and fibrosis correlated with CD95 staining density, caspase-8 intensiveness, and portal and parenchymal Fas ligand scores. The apoptotic parameters of the responsive cases were not significantly different from those of the unresponsive cases.

Conclusion: The apoptotic parameters studied in liver tissue are associated with inflammation and fibrosis; however, these parameters may not predict response to treatment.
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http://dx.doi.org/10.1097/MEG.0000000000000397DOI Listing
September 2015