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  • Küçük Resim
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    Impact of antimicrobial drug restrictions on doctors' behaviors
    (2016) Karabay, Oğuz; Hoşoğlu, Salih; Güçlü, Ertuğrul; Akalın, Şerife; Altay, Fatma Aybala; Aydın, Emsal; Ceylan, Bahadır; Çelik, Aygül; Çelik, İlhami; Demirdal, Tuna; Demirli, Keziban; Erben, Nurettin; Erkorkmaz, Ünal; Erol, Serpil; Evirgen, Ömer; Gönen, İbak; Güner, Ayşe Ebru; Güven, Tümer; Kadanalı, Ayten; Koçoğlu, Mücahide Esra; Kökoğlu, Ömer Faruk; Küçükbayrak, Abdulkadir; Sargın, Fatma; Sünnetçioğlu, Mahmut; Şenol, Şebnem; Işıkgöz Taşbakan, Meltem; Tekin, Recep; Turhan, Vedat; Yılmaz, Gürdal; Dede, Behiye
    Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics. Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician. Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had &#8804;5 years of occupational experience (junior specialists = JSs) and 942 (49.4%) of them were physicians. Specialists having >5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05). Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did.
  • Küçük Resim
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    Predictors of response to pegylated interferon treatment in HBeAg-negative patients with chronic hepatitis B
    (J Infection Developing Countries, 2014) Guclu, Ertugrul; Tuna, Nazan; Karabay, Oguz; Akhan, Sila; Bodur, Hurrem; Ceylan, Bahadir; Demirdal, Tuna
    Introduction: Although pegylated interferons (pegIFNs) alpha-2a and alpha-2b have been used in chronic hepatitis B (CHB) treatment for many years, there are few studies concerning predictors of sustained virologic response (SVR) to pegIFN therapy. In this study, we aimed to investigate the predictors of response to pegIFN treatment in cases with HBeAg-negative CHB infection. Methodology: Seventeen tertiary care hospitals in Turkey were included in this study. Data from consecutively treated HBeAg-negative CHB patients, who received either pegIFN alpha-2a or alpha-2b, were collected retrospectively. SVR is defined as an HBV DNA concentration of less than 2,000 IU/mL six months after the completion of therapy Results: SVR was achieved in 40 (25%) of the 160 HBeAg-negative CHB patients. Viral loads in patients with SVR were lower compared to those with no SVR, beginning in the third month of treatment (p < 0.05). The number of cases with a decline of 1 log(10) IU/mL in viral load after the first month of treatment and with a serum HBV DNA level under 2,000 IU/mL after the third month of treatment was higher in cases with SVR (p < 0.05). The number of patients who had undetectable HBV DNA levels at week 48 among responders was significantly greater than among post-treatment virological relapsers (p < 0.05). Conclusions: Detection of a 1 log(10) decline in serum HBV DNA level at the first month of treatment and a serum HBV DNA level < 2000 IU/mL at the third month of therapy may be predictors of SVR.
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    Prognostic significance of transforming growth factor-beta-1 in chronic hepatitis C virus infection
    (Academic Journals, 2012) Deveci, Ozcan; Agalar, Canan; Demirdal, Tuna; Demirturk, Nese; Yula, Erkan; Tekin, Alicem; Kaygusuz, Sedat
    Interferon treatment in hepatitis C virus (HCV) infection is expensive and has various adverse effects. Some markers may help in making decision to stop or maintain the treatment. The aim of this study was to evaluate the effectiveness of serum transforming growth factor beta-1 (TGF-beta 1) in assessing outcome of interferon treatment in patients with HCV infection. Twelve patients with chronic HCV infections included in the study as treatment group [Treatment group: anti-HCV (+), HCV RNA (+)] and 12 patients with anti-HCV positive, HCV-RNA negative and normal liver function tests included as control group. All patients in the treatment group were administered with peginterferon and ribavirin for 24 weeks. HCV-RNA levels were determined by realtime-PCR and TGF-beta 1 levels were measured with ELISA methods, at the beginning and 24th week of the treatment. Mann-Whitney U Test and Wilcoxon Test were used to compare variables within and between groups. Median age and male/female ratios were 46 years and 5/7, and 45 years and 3/9 for treatment groups and control group, respectively. Although no difference was found in TGF-beta 1 levels at the beginning of the treatment between groups (p>0.05), significantly decreased TGF-beta 1 levels were observed following 24 weeks of interferon treatment in treatment group (p=0.015). Despite limited number of patients, our data suggested that, TGF-beta 1 levels may be used as a prognostic marker for effectiveness of interferon treatment in patients with hepatitis C virus infection.