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Öğe Brucellosis with Cholecystitis and Pancytopenia: A Case Report and Review of the Literature(Aves, 2011) Hakyemez, Ismail Necati; Tursun, Irfan; Akkoyunlu, YaseminBrucellosis is an endemic disease in our country and a common problem worldwide. It can affect all organ systems. It is a zoonosis which is sometimes difficult to diagnose due to its various clinical forms. Liver involvement is usually seen, but cholecystitis and liver abscess are rare clinical forms of brucellosis. Hematological involvements are leukopenia, anemia and occasionally pancytopenia. In cases with pancytopenia and cholecystitis, brucellosis should be borne in mind in order to avoid unnecessary operations. In this article, we report a 64-year-old female with pancytopenia and cholecystitis due to acute brucellosis.Öğe A Case of Giant Hepatic Hydatid Cyst Infected with Morganella morganii and the Literature Review(Hindawi Ltd, 2012) Hakyemez, Ismail Necati; Sit, Mustafa; Aktas, Gulali; Tas, Tekin; Mengeloglu, Firat Zafer; Kucukbayrak, AbdulkadirHydatid cyst disease is a common worldwide zoonosis. Most of the cysts are located in the liver. Abscess formation due to infection of the cyst is an important complication. M. morganii, a Gram-negative Bacillus, is a quite rare cause of liver abscess. A 77-year-old woman was admitted to hospital with complaints of fever, chills, nausea, vomiting, loss of appetite, and abdominal pain located in the right-upper quadrant. Her history was positive for hepatic hydatid cyst disease ten years ago. Physical examination revealed a painful mass filling the right-upper quadrant and extending down to umbilicus. Indirect hemagglutinin test for hydatid cyst was positive at a titer of 1/320. Giant liver abscess due to infected hydatid cyst was found in computed tomography scan. Surgeons performed cystectomy and cholecystectomy. Cefazoline, cefuroxime, and metronidazole were administered empirically, but all the three agents were replaced with intravenous ceftriaxone after M. morganii was isolated from the cultures of the abscess material. Clinical signs of the patient resolved at the second week of treatment, and she was discharged.Öğe Determining immunoassay cutoff value using Western blot results to predict hepatitis C infection in blood donors with low-titer anti-HCV reactivity(Springer, 2013) Küçükbayrak, Abdulkadir; Çakmak, Saadet; Hakyemez, Ismail Necati; Taş, Tekin; Akdeniz, HayrettinSince the 1990s, blood donors have been scanned for anti-hepatitis C virus (anti-HCV) antibodies, which can be defined by enzyme immunoassay as a screening test. In this population, false-reactive ratios have been high. Recently, some authors have aimed to find a cutoff value for anti-HCV different from those established by test manufacturers to predict HCV infection. In this study, 321 patients, after two repeating tests, had reactive results in s/co < 10 titers on anti-HCV test. The patients were 29.6 % (n=95) in women and 70.4 % (n=226) in men. The patients were classified into three groups by Western blot (WB) results (PS, positive; NG, negative; and ID, indeterminate). The average anti-HCV titer of the whole group was 2.61 +/- 1.96. Anti-HCV titers of subgroups were 2.43 +/- 1.95 in NG, 4.93 +/- 2.53 in PS, and 2.50 +/- 1.65 in ID (p< 0.001). There was a significant difference between NG and PS and between PS and ID subgroups (p< 0.001). There was a positive correlation between WB and anti-HCV titers in all patients (r=0.298, p< 0.001), in women (r=0.282, p< 0.001), and in men (r=0.337, p=0.002). According to receiver operator characteristic curve analysis, the cutoff value of anti-HCV titer to predict hepatitis C infection was > 2.61 s/co, with 74.1 % sensitivity and 71.6 % specificity (area under the curve, 0.820; 95 % confidence interval, 0.753 to 0.887). We suggest that an effective cutoff value for anti-HCV other than that established by the manufacturer cannot be assigned to predict hepatitis C infection for blood donors in low-prevalence areas.Öğe Retrospective Analysis of 596 Adult Patients with Acute Hepatitis(Galenos Publ House, 2012) Yontem, Burcak; Hakyemez, Ismail Necati; Aksu, Ali; Simsek, Funda; Kanturk, Arzu; Yildirmak, Mustafa TanerObjective: The purpose of this study is to retrospectively analyze etiological, epidemiological, clinical and laboratory findings of adult patients with acute hepatitis hospitalized in our clinic. Materials and Methods: This study included 596 adult patients who were hospitalized with a preliminary diagnosis of acute hepatitis between 2001-2005. The age, gender, etiology, transmission routes, prodromal period, physical examination and laboratory findings were evaluated. ELISA and PCR methods have been used in detection of viral hepatitis markers. Results: Acute hepatitis B (53.5%) and hepatitis A (35.9%) were the most common types in our patients aged between 16-85. Dental treatment (5.7%) was found as the most common risk factor in view of transmission. However, transmission route could not been determined in the majority of cases (83.3%). The most common complaints were jaundice, fatigue, nausea and vomiting, darkening of urine, respectively. The most common findings were jaundice, hepatomegaly and fever, respectively. Acute liver failure developed in eight patients with cases of acute hepatitis B and mortality rate was determined as 0.3%. Conclusion: Viral pathogens especially HBV is in the first place in acute hepatitis,. Although dental treatment is considered as important for the transmission, the source of exposure is not known in most of the cases. Hepatic failure and mortality is more frequently seen in acute hepatitis B compared with other hepatitis viruses.
