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    The acquisition time of infection: a determinant of the severity of hepatitis C virus-related liver disease in renal transplant patients
    (Wiley-Blackwell Publishing, Inc, 2009) Toz, H.; Nart, D.; Turan, I.; Ersoz, G.; Sezis, M.; Asci, G.; Ozkahya, M.; Zeytinoglu, A.; Erensoy, S.; Ok, E.
    Background: The aim of this study was to compare the clinical and histopathological course of HCV infection acquired before and during or after renal transplantation. Methods: According to HCV status, 197 RT patients were divided into three groups. At the time of RT, anti-HCV antibody was positive in 47 patients (pre-RT HCV group). In 27 patients, in whom anti-HCV negative at the time of RT, anti-HCV and/or HCV RNA was found to be positive following an ALT elevation episode after RT (post-RT HCV group). Both anti-HCV and HCV RNA were negative at all times in remaining 123 patients (control group). Results: Liver biopsy was performed in 31 of 47 patients in pre-RT and 24 of 27 in post-RT HCV group after RT. Duration of follow-up was similar in all groups with a mean of 7.1 +/- 4.0 yr. Ascites and encephalopathy were seen in only post-RT HCV group (22%). Histological grade (6.5 +/- 2.7 vs. 4.1 +/- 1.4) and stage (2.0 +/- 1.5 vs. 0.8 +/- 0.8) was significantly severe in post-RT HCV group (p < 0.01). Three patients died due to liver failure in post-RT HCV group. Conclusions: HCV infection acquired during or after RT shows a severe and rapidly progressive clinicopathological course, which is significantly different from pre-transplant anti-HCV positive patients.
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    The acquisition time of infection: a determinant of the severity of hepatitis C virus-related liver disease in renal transplant patients
    (Wiley-Blackwell Publishing, Inc, 2009) Toz, H.; Nart, D.; Turan, I.; Ersoz, G.; Sezis, M.; Asci, G.; Ozkahya, M.; Zeytinoglu, A.; Erensoy, S.; Ok, E.
    Background: The aim of this study was to compare the clinical and histopathological course of HCV infection acquired before and during or after renal transplantation. Methods: According to HCV status, 197 RT patients were divided into three groups. At the time of RT, anti-HCV antibody was positive in 47 patients (pre-RT HCV group). In 27 patients, in whom anti-HCV negative at the time of RT, anti-HCV and/or HCV RNA was found to be positive following an ALT elevation episode after RT (post-RT HCV group). Both anti-HCV and HCV RNA were negative at all times in remaining 123 patients (control group). Results: Liver biopsy was performed in 31 of 47 patients in pre-RT and 24 of 27 in post-RT HCV group after RT. Duration of follow-up was similar in all groups with a mean of 7.1 +/- 4.0 yr. Ascites and encephalopathy were seen in only post-RT HCV group (22%). Histological grade (6.5 +/- 2.7 vs. 4.1 +/- 1.4) and stage (2.0 +/- 1.5 vs. 0.8 +/- 0.8) was significantly severe in post-RT HCV group (p < 0.01). Three patients died due to liver failure in post-RT HCV group. Conclusions: HCV infection acquired during or after RT shows a severe and rapidly progressive clinicopathological course, which is significantly different from pre-transplant anti-HCV positive patients.
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    The burden and epidemiology of community-acquired central nervous system infections: a multinational study
    (Springer, 2017) Erdem, H.; Inan, A.; Guven, E.; Hargreaves, S.; Larsen, L.; Shehata, G.; Pernicova, E.; Khan, E.; Bastakova, L.; Namani, S.; Harxhi, A.; Roganovic, T.; Lakatos, B.; Uysal, S.; Sipahi, O. R.; Crisan, A.; Miftode, E.; Stebel, R.; Jegorovic, B.; Feher, Z.; Jekkel, C.; Pandak, N.; Moravveji, A.; Yilmaz, H.; Khalifa, A.; Musabak, U.; Yilmaz, S.; Jouhar, A.; Oztoprak, N.; Argemi, X.; Baldeyrou, M.; Bellaud, G.; Moroti, R. V.; Hasbun, R.; Salazar, L.; Tekin, R.; Canestri, A.; Calkic, L.; Pratico, L.; Yilmaz-Karadag, F.; Santos, L.; Pinto, A.; Kaptan, F.; Bossi, P.; Aron, J.; Duissenova, A.; Shopayeva, G.; Utaganov, B.; Grgic, S.; Ersoz, G.; Wu, A. K. L.; Lung, K. C.; Bruzsa, A.; Radic, L. B.; Kahraman, H.; Momen-Heravi, M.; Kulzhanova, S.; Rigo, F.; Konkayeva, M.; Smagulova, Z.; Tang, T.; Chan, P.; Ahmetagic, S.; Porobic-Jahic, H.; Moradi, F.; Kaya, S.; Cag, Y.; Bohr, A.; Artuk, C.; Celik, I.; Amsilli, M.; Gul, H. C.; Cascio, A.; Lanzafame, M.; Nassar, M.
    Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012 and 2014. A total of 2583 patients with CA-CNS infections were included from 37 referral centers in 20 countries. Of these, 477 (18.5%) patients survived with sequelae and 227 (8.8%) died, and 1879 (72.7%) patients were discharged with complete cure. The most frequent infecting pathogens in this study were Streptococcus pneumoniae (n = 206, 8%) and Mycobacterium tuberculosis (n = 152, 5.9%). Varicella zoster virus and Listeria were other common pathogens in the elderly. Although staphylococci and Listeria resulted in frequent infections in immunocompromised patients, cryptococci were leading pathogens in human immunodeficiency virus (HIV)-positive individuals. Among the patients with any proven etiology, 96 (8.9%) patients presented with clinical features of a chronic CNS disease. Neurosyphilis, neurobrucellosis, neuroborreliosis, and CNS tuberculosis had a predilection to present chronic courses. Listeria monocytogenes, Staphylococcus aureus, M. tuberculosis, and S. pneumoniae were the most fatal forms, while sequelae were significantly higher for herpes simplex virus type 1 (p < 0.05 for all). Tackling the high burden of CNS infections globally can only be achieved with effective pneumococcal immunization and strategies to eliminate tuberculosis, and more must be done to improve diagnostic capacity.
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    Correlation of immunohistochemistry on liver biopsy and serum HBVDNA levels
    (Elsevier Science Bv, 2008) Yilmaz, F.; Nart, D.; Vardar, R.; Gunsar, F.; Ersoz, G.; Karasu, Z.; Sertoz, R.; Erensoy, S.; Ilter, T.; Batur, Y.; Akarca, U. S.
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    DELTA VIRUS COINFECTION DOES NOT INCREASE, BUT HCV COINFECTION INCREASE THE HBSAG LOSS, IN CHRONIC HBV INFECTION
    (Elsevier Science Bv, 2011) Yapali, S.; Bayrakci, B.; Gunsar, F.; Ersoz, G.; Karasu, Z.; Akarca, U. S.
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    Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 11 adult intensive care units from 10 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)
    (Springer Heidelberg, 2013) Leblebicioglu, H.; Yalcin, A. N.; Rosenthal, V. D.; Koksal, I.; Sirmatel, F.; Unal, S.; Turgut, H.; Ozdemir, D.; Ersoz, G.; Uzun, C.; Ulusoy, S.; Esen, S.; Ulger, F.; Dilek, A.; Yilmaz, H.; Turhan, O.; Gunay, N.; Gumus, E.; Dursun, O.; Yylmaz, G.; Kaya, S.; Ulusoy, H.; Cengiz, M.; Yilmaz, L.; Yildirim, G.; Topeli, A.; Sacar, S.; Sungurtekin, H.; Ugurcan, D.; Geyik, M. F.; Sahin, A.; Erdogan, S.; Kaya, A.; Kuyucu, N.; Arda, B.; Bacakoglu, F.
    Purpose To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey. Methods A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach. Results In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42-0.7; P value, 0.0001.) Conclusions The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey.
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    EFFECTS OF ERYTHROPOIETIN IN THIOACETAMIDE INDUCED FULMINANT HEPATIC FAILURE IN RATS
    (Elsevier Science Bv, 2009) Oruc, N.; Ersoz, G.; Yilmaz, F.; Akarea, U. S.; Gunsar, F.; Karasu, Z.; Ozutemiz, O.
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    FIBROSIS SHOULD BE INCLUDED INTO THE NONALCOHOLIC STEATOHEPATITIS SCORING SYSTEM FOR BEING MORE PROGNOSTICATIVE
    (Elsevier Science Bv, 2009) Gunsar, F.; Yilmaz, F.; Unal, N. G.; Bayrakci, B.; Karasu, Z.; Nart, D.; Ersoz, G.; Akarca, U. S.
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    Ileal obstruction after duodenal metallic stent placement
    (Georg Thieme Verlag Kg, 2007) Ozutemiz, O.; Tekin, F.; Oruc, N.; Ersoz, G.; Guler, A.
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    Impact of a multidimensional infection control strategy on catheter-associated urinary tract infection rates in the adult intensive care units of 15 developing countries: findings of the International Nosocomial Infection Control Consortium (INICC)
    (Springer Heidelberg, 2012) Rosenthal, V. D.; Todi, S. K.; Alvarez-Moreno, C.; Pawar, M.; Karlekar, A.; Zeggwagh, A. A.; Mitrev, Z.; Udwadia, F. E.; Navoa-Ng, J. A.; Chakravarthy, M.; Salomao, R.; Sahu, S.; Dilek, A.; Kanj, S. S.; Guanche-Garcell, H.; Cuellar, L. E.; Ersoz, G.; Yalcin, A. Nevzat; Jaggi, N.; Medeiros, E. A.; Ye, G.; Akan, O. A.; Mapp, T.; Castaneda-Sabogal, A.; Matta-Cortes, L.; Sirmatel, F.; Olarte, N.; Torres-Hernandez, H.; Barahona-Guzman, N.; Fernandez-Hidalgo, R.; Villamil-Gomez, W.; Sztokhamer, D.; Forciniti, S.; Berba, R.; Turgut, H.; Bin, C.; Yang, Y.; Perez-Serrato, I.; Lastra, C. E.; Singh, S.; Ozdemir, D.; Ulusoy, S.
    We aimed to evaluate the impact of a multidimensional infection control strategy for the reduction of the incidence of catheter-associated urinary tract infection (CAUTI) in patients hospitalized in adult intensive care units (AICUs) of hospitals which are members of the International Nosocomial Infection Control Consortium (INICC), from 40 cities of 15 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, Philippines, and Turkey. We conducted a prospective before-after surveillance study of CAUTI rates on 56,429 patients hospitalized in 57 AICUs, during 360,667 bed-days. The study was divided into the baseline period (Phase 1) and the intervention period (Phase 2). In Phase 1, active surveillance was performed. In Phase 2, we implemented a multidimensional infection control approach that included: (1) a bundle of preventive measures, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CAUTI rates, and (6) feedback of performance. The rates of CAUTI obtained in Phase 1 were compared with the rates obtained in Phase 2, after interventions were implemented. We recorded 253,122 urinary catheter (UC)-days: 30,390 in Phase 1 and 222,732 in Phase 2. In Phase 1, before the intervention, the CAUTI rate was 7.86 per 1,000 UC-days, and in Phase 2, after intervention, the rate of CAUTI decreased to 4.95 per 1,000 UC-days [relative risk (RR) 0.63 (95 % confidence interval [CI] 0.55-0.72)], showing a 37 % rate reduction. Our study showed that the implementation of a multidimensional infection control strategy is associated with a significant reduction in the CAUTI rate in AICUs from developing countries.
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    Intraductal papillary neoplasm of the bile duct: clinicopathological characteristics and insulin-like growth factor II mRNA binding protein 3 (IMP3) expression in 24 cases
    (Springer, 2019) Buyuktalanci, E.; Damirli, A.; Tekin, F.; Uguz, A.; Unalp, V.; Zeytunlu, M.; Nart, D.; Ersoz, G.; Ozutemiz, O.; Yilmaz, F.
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    Is telbivudine-induced polyneuropathy/myopathy reversible in liver transplant recipients?
    (Lippincott Williams & Wilkins, 2018) Turan, I.; Yapali, S.; Bademkiran, F.; Gunsar, F.; Zeytunlu, M.; Ersoz, G.; Akarca, U.; Karasu, Z.
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    Lamivudine monoprophylaxis prevents HBV infection in recipients undergoing live donor liver transplantation because of non-HBV related diseases, having their grafts from core-antibody positive donors
    (Elsevier Science Bv, 2007) Karasu, Z.; Akyildiz, M.; Ozacar, T.; Yilmaz, F.; Akarca, U. S.; Ersoz, G.; Gunsar, F.; Aydin, U.; Kilic, M.; Ilter, T.
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    Living donor liver transplantation from hepatitis B core antibody positive donors
    (Elsevier Science Inc, 2007) Kobak, A. Celebi; Karasu, Z.; Kilic, M.; Ozacar, T.; Tekin, F.; Gunsar, F.; Ersoz, G.; Yuzer, Y.; Tokat, Y.
    Liver allografts from donors previously exposed to hepatitis B virus (HBV) carry the risk of transmission of HBV infection to immunosuppressed recipients. However, exclusion of donor candidates with the serologic evidence of resolved hepatitis B-HBV surface antigen (HbsAg) negative and HBV core antibody (anti-HBc) positive-is not feasible in countries endemic for HBV. Aim. Our aim was to assess the safety of living donor liver transplantation from anti-HBc positive donors. Materials and Methods. In our institution, 152 transplants were performed between June 1999 and April 2004. Fifty-six (37%) of the living donors were anti-HBc positive. Twenty of these liver grafts were transplanted to HbsAg-negative recipients. We excluded four HBsAg negative recipients who died because of early complications after transplantation. Lamivudine (100 mg/day) was given for prophylaxis of de novo HBV infection. Results. The mean follow-up time for 16 HBsAg-negative recipients was 21.7 (7-48) months. None of them experienced de novo HBV infection. Conclusion. The use of liver allografts from anti-HBc-positive living donors is reasonably safe in HBsAg-negative recipients under lamivudine prophylaxis.
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    A new endoscopic treatment method for a symptomatic duodenal duplication cyst
    (Georg Thieme Verlag Kg, 2009) Tekin, F.; Ozutemiz, O.; Ersoz, G.; Tekesin, O.
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    A new endoscopic treatment method for a symptomatic duodenal duplication cyst
    (Georg Thieme Verlag Kg, 2009) Tekin, F.; Ozutemiz, O.; Ersoz, G.; Tekesin, O.
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    A novel technique for biliary strictures that cannot be passed with a guide wire
    (Georg Thieme Verlag Kg, 2007) Ersoz, G.; Tekin, F.; Ozutemiz, O.; Tekesin, O.
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    A Pilot Study: Longer Duration of Posttransplant Hepatitis C Virus Therapy May Increase the Sustained Response Rate
    (Elsevier Science Inc, 2009) Karasu, Z.; Akay, S.; Yilmaz, F.; Akarca, U.; Ersoz, G.; Gunsar, F.; Kilic, M.
    Background. Although end of treatment virological responses are similar in posttransplant patients with recurrent chronic hepatitis C virus infection and nontransplant patients, the sustained virological response rate is lower in the posttransplant setting. We investigated the efficacy of a longer duration (3 years) of therapy. Methods. Thirteen patients with biopsy-proven recurrent hepatitis C were included in the study. In the first year of therapy, all patients were treated with a standard regimen of interferon alpha 2b 3MU 3 times in a week plus ribavirin (800 to 1000 mg/d). After the availability of pegylated interferon, patients were converted to pegylated interferon (1.5 mu g/kg body weight). Hepatitis C virus RNA was evaluated at months 3, 6, 9, 12, 24, 36, and 42. If hepatitis C virus RNA was negative at month 12, the patients continued treatment for 36 months. Results. Hepatitis C virus RNA was negative in six patients at 12 months, including two who became hepatitis C virus RNA negative after 3 months; two, after 6 months; and two, after 12 months of therapy. Those six continued treatment completing 3 years of treatment with a sustained virological response. Four of those six patients with sustained virological response required colony-stimulating factors during treatment. Conclusion. Although the hepatitis C virus RNA status of patients at 12 weeks is a good marker to predict a sustained virological response in the nontransplant setting, it is not valid in posttransplant patients. A prolonged duration of therapy for patients who are viral responders at 12 months may prevent recurrence and increase the sustained virological response rate.