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    A Case of Brucellosis Presenting with Infarction in the Spleen
    (Doc Design Informatics Co Ltd, 2022) Alkan, Sevil; Guclu-Kayta, Safiye Bilge; Vurucu, Servan; Akca, Anil; Yuksel, Cihan; Onder, Taylan; Sener, Alper
    Brucellosis may present with different clinical pictures due to its ability to involve various organs. Although splenomeg-aly can be seen as a result of spleen involvement in brucellosis, splenic infarction is rare. However, left upper quadrant pain may be observed when splenic infarct occurs. This case report presents a case of brucellosis with splenic infarct.
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    CMV reactivation in immunocompetent critically ill intensive care unit patients: a retrospective study
    (Journal of Infection in Developing Countries, 2024) Onder, Taylan; Alkan, Sevil; Dogan, Ebru; Sener, Alper
    Introduction: Cytomegalovirus (CMV) reactivation is observed in immunosuppressive patients and causes adverse clinical outcomes. CMV reactivation in immunocompetent patients is less known. We aimed to retrospectively investigate CMV reactivation in immunocompetent critically ill patients with bacterial growth in lower respiratory tract; and investigate the relationship between reactivation and outcomes such as length of stay (LOS), mechanical ventilation duration, and mortality. Methodology: Intensive care unit (ICU) patients that were CMV IgG-positive, CMV IgM-negative immunocompetent, mechanically ventilated for over 48 hours, and were diagnosed with respiratory tract colonization with Acinetobacter baumannii or ventilator-associated pneumonia (VAP) were included. Reverse transcriptase polymerase chain reaction (RT-PCR) was performed on serum and endotracheal aspirate samples. The patients were divided into groups of those with and without VAP and sepsis. Reactivation rates and CMV DNA levels were compared between the groups. Results: CMV reactivation was seen in 27 of 34 patients (79.4%). CMV DNA level was 5.8 times higher in patients with VAP and sepsis than patients without, but the difference was not statistically significant (p = 0.717). LOS and mechanical ventilation duration were higher in patients with reactivation (p = 0.047 and 0.036). No relationship was found between reactivation and mortality (p = 0.774). Conclusions: The rate of CMV reactivation was 79.4%. This was the second-highest reactivation rate reported in the literature. The reactivation was associated with prolonged hospitalization and mechanical ventilation. Copyright © 2024 Onder et al.
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    Possible drug-drug interactions among elderly patients receiving antiviral therapy for chronic hepatitis B
    (Medicinska Naklada, 2024) Celik, Mehmet; Arslan, Yusuf; Onder, Taylan; Alkan, Sevil; Sahin, Ahmet; Akgul, Fethiye
    Aim To identify possible drug-drug interactions in patients taking medications for other comorbidities while on antiviral therapy for chronic hepatitis B. Methods The study enrolled patients with chronic hepatitis B aged >= 60 years who were treated with antiviral therapy in five hospitals in Turkey between January 1 and March 1, 2023. The Lexicomp (R) Drug Interactions program was used to identify possible drug-drug interactions. Results The study included 213 patients (119 [55.9%] men). The mean age was 68.5 years. A potential drug- drug interaction was identified in 112 patients (52.6%). The most common type of interaction was type C (follow the treatment) (71.54%). The number of potential drug-drug interactions increased with an increase in the number of drugs used by the patients. A robust and affirmative correlation was observed between the number of medications used and the number of possible drug-drug interactions (r = 0.791, P < 0.001). Adverse interactions (interactions of types C and D, 3.7% of cases) were limited to patients receiving tenofovir disoproxil fumarate. Conclusion Nonsteroidal anti-inflammatory medications should be used cautiously in elderly patients with chronic hepatitis B treated with tenofovir disoproxil fumarate due to the increased risk of renal toxicity.