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Öğe Efficacy of oral ribavirin treatment in Crimean-Congo haemorrhagic fever: A quasi-experimental study from Turkey(W B SAUNDERS CO LTD, 2009) Elaldi, Nazif; Bodur, Hurrem; Ascioglu, Sibel; Celikbas, Aysel; Ozkurt, Zulal; Vahaboglu, Haluk; Leblebicioglu, Hakan; Yilmaz, Neziha; Engin, Aynur; Sencan, Mehmet; Aydin, Kemalettin; Dokmetas, Ilyas; Cevik, Mustafa Aydin; Dokuzoguz, Basak; Tasyaran, Mehmet Ali; Ozturk, Recep; Bakir, Mehmet; Uzun, RamazanObjective: The aim of this study was to evaluate the efficacy of oral ribavirin treatment in patients with Crimean-Congo haemorrhagic fever (CCHF). Methods: In 2004, all patients diagnosed with CCHF were treated with oral ribavirin, however in 2003 none of the CCHF patients had been given treatment due to Lack of confirmatory diagnostic information at that time in Turkey. In this study, patients treated with ribavirin in 2004 (n = 126) were compared with ribavirin-untreated CCHF patients (n = 92) in 2003. Patients only with a definitive diagnosis of CCHF (clinical symptoms plus the presence of specific IgM antibodies against CCHF virus and presence of viral antigen) were included in this study. Results: There was no difference in the case-fatality rate between treated and untreated patients (7.1% vs. 11.9%; P > 0.05). A Cox Proportional Hazards regression analysis revealed that altered sensorium and prolonged international normalized ratio were independent predictors of mortality. Conclusion: Our results showed that oral ribavirin treatment did not improve the survival rate in CCHF patients. Ribavirin and supportive care are the only available choices for treatment of CCHF patients, but to ascertain the efficacy of ribavirin, more laboratory and observational studies are necessary and ultimately, to elucidate these conflicting results and evaluate the efficacy undoubtedly, a multicenter randomised controlled trial will be needed. (C) 2009 The British Infection Society. Published by Elsevier Ltd. All rights reserved.Öğe Evaluation of 2015-2016 MOTAKK HBV DNA and HCV RNA External Quality Assessment National Program Results(ANKARA MICROBIOLOGY SOC, 2018) Karatayli, Ersin; Soydemir, Ege; Aksoy, Zeynep Busra; Kizilpinar, Mehtap; Altay Kocak, Aylin; Karatayli, Senem Ceren; Yurdcu, Esra; Yildirim, Umut; Guriz, Haluk; Bozdayi, Gulendam; Yurdaydin, Cihan; Ilhan, Osman; Yildirim, Yasin; Bozdayi, A. Mithat; Oguz, Acelya Yalcintas; Baris, Ahmet; Alp, Alpaslan; Aksozek, Alper; Sayiner, Arzu; Karagul, Aydan; Ordu, Aylin; Istanbullu, Aye; Otlu, Baris; Aridogan, Buket; Aksu, Burak; Buruk, C. Kurtulus; Karahan, Ceren; Guney, Cakir; Toksoz, Devrim; Yildirim, Dilara; Colak, Dilek; Daglar, Duygu Eren; Findik, Duygu; Kas, Elif; Caliskan, Emel; Zeyrek, Fadile Yildiz; Arslan, Fatma; Demir, Feyza; Milletli, Fikriye; Kibar, Filiz; Ozdincer, Furkan; Dundar, Gulnur; Arslan, Hande; Agca, Harun; Aliskan, Hikmet Eda; Guducuoglu, Huseyin; Fidan, Isil; Akyar, Isin; Afsar, Ilhan; Kaleli, Ilknur; Donmez, Ismail; Yanik, Kemalettin; Midilli, Kenan; Cubukcu, Kivanc; Ozdemir, Mehmet; Acar, Melek; Yalinay, Meltem; Kuskucu, Mert Ahmet; Bakici, Mustafa Zahir; Aydin, Neriman; Yilmaz, Neziha; Ceken, Nihan; Ziyade, Nihan; Yilmaz, Nisel; Ozgumus, Osman Birol; Gitmisoglu, Ozlem; Demirgan, Recep; Kesli, Recep; Guckan, Ridvan; Sertoz, Ruchan; Akgun, Sadik; Aksaray, Sebahat; Tezcan, Seda; Kaygusuz, Sedat; Gokahmetoglu, Selma; Mese, Sevim; Bayik, Seyit Ahmet; Akcali, Sinem; Gurcan, Saban; Karsligil, Tekin; Us, Tercan; Ozekinci, Tuncer; Pilgir, Tulin; Aslan, Ugur; Dinc, Ugur; Coskun, Umut Safiye Say; Cetinkol, Yeliz; Keskin, Yusuf; Ayaydin, Zeynep; Toraman, Zulal AsciMOTAKK, as a national external quality control program has been launched to evaluate the molecular detection of viral infections including HBV DNA and HCV RNA in molecular microbiology diagnostic laboratories in Turkey. This program is prepared in compliance with ISO 17043:2010 (Conformity assessment general requirements for proficiency testing) standards, and aims to take the place of external quality control programs from abroad, contributing to standardization and accuracy of molecular diagnostic tests in our country. The aim of this study was to evaluate 2015 and 2016 results of the MOTAKK External Quality Control Program for HBV DNA and HCV RNA viral load. The calls were announced on the web page of MOTAKK (www.motakk.org). The quality control samples were sent to participating laboratories in 2015 and 2016. Main stocks were prepared from patients with chronic hepatitis B and C who had viral load detection with reference methods according to WHO reference materials for viral load studies to improve quality control sera. From these main stocks, samples with different viral loads were prepared from dilutions of plasma with HBV, HCV, HAV, HIV, Parvovirus B19 and CMV negative serologic markers. Quality control samples were sent to the participating laboratories along with the negative samples in the cold chain. The laboratories accomplished the related tests within 2-3 weeks and entered their results on the MOTAKK web page. These results were analysed according to ISO 13528 (Statistical methods for use in proficiency testing by interlaboratory comparison) and scoring reports were created by a software developed by MOTAKK and sent to participating labs. Each laboratory evaluated their own results in comparison with the other laboratory results, reassessed the tests via observing the distance from the mean result and the reference values. The number of laboratories participating in the HBV DNA and HCV RNA external quality control program was 70-73 in 2015-2016. Participants were able to comply with the program tools, registering, entering results and receiving the results reports problem. In HBV panel, 72.6-89.1% and 84.7-90.3% of the participant laboratories were in 1 standard deviation (SD) in 2015-2016, respectively. In HCV panel, 70.8-89.1% and 84.7-90.3% of the participant laboratories were in 1 SD in 2015-2016, respectively. A national external quality control program for HBV DNA and HCV RNA in Turkey has been prepared for the first time with this project and implemented successfully. All the data provided in the MOTAKK external quality control program final report, compensate all the data provided by the quality control program final reports from abroad; additionally, the report allows comparison of used technologies and commercial products.Öğe Exosome: an emerging participant in liver disease progression(Wiley, 2021) Kilgoz, Havva Ozgen; Ozcan, Seda Sabah; Gokcan, Hale; Yilmaz, Neziha; Ataseven, Hilmi; Akdogan, Meral; Kayacetin, Ertugrul[Abstract Not Available]Öğe Sequential determination of serum viral titers, virus-specific IgG antibodies, and TNF-alpha, IL-6, IL-10, and IFN-gamma levels in patients with Crimean-Congo hemorrhagic fever(BIOMED CENTRAL LTD, 2014) Kaya, Safak; Elaldi, Nazif; Kubar, Ayhan; Gursoy, Nevcihan; Yilmaz, Meral; Karakus, Gulderen; Gunes, Turabi; Polat, Zubeyde; Gozel, Mustafa Gokhan; Engin, Aynur; Dokmetas, Ilyas; Bakir, Mehmet; Yilmaz, Neziha; Sencan, MehmetBackground: Although there have been a number of studies on the pathogenesis of Crimean-Congo hemorrhagic fever (CCHF) recently, knowledge on this topic is still insufficient. This study aims to reveal the kinetics of serum CCHF virus (CCHFV) titers, serum levels of anti-CCHFV immunoglobulin (Ig) G, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-10, and interferon (IFN)-gamma in CCHF patients. Methods: In total, 31 CCHF cases (11 fatal) were studied. Serum samples were obtained daily from all patients from the time of admission and continued for a 7-day hospitalization period for serologic (ELISA), virologic (real-time PCR), and cytokine (ELISA) analysis. Results: The mean serum CCHFV titer at admission was 5.5E + 09 copies/mL in fatal cases and 5.7E + 08 copies/mL in survivors (p < 0.001). Compared to survivors, both the mean serum levels of IL-6 and TNF-alpha at admission were found to be significantly increased in fatal cases. The serum levels of IL-6, TNF-alpha and serum CCHFV titer at admission were significantly and positively correlated with disseminated intravascular coagulation (DIC) scores (r = 0.626, p = 0.0002; r = 0.461, p = 0.009; and r = 0.625, p = 0.003, respectively). When the data obtained from the sequential determination of CCHFV titer and levels of anti-CCHFV IgG, IL-6, TNF-alpha, IL-10 and IFN-gamma were grouped according to the days of illness, the initial serum CCHFV titer of a fatal patient was 5.5E + 09 (copies/mL) and it was 6.1E + 09 (copies/mL) in a survivor on the 2 day of illness. While significant alterations were observed in all cytokines during the monitoring period, IL-6 levels remained consistently higher in fatal cases and TNF-alpha levels increased in both in fatal and non-fatal CCHF cases. Conclusions: The increased CCHFV load and higher concentrations of IL-6 and TNF-alpha, the presence of DIC, and the absence of CCHFV specific immunity are strongly associated with death in CCHF.
