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  • Küçük Resim
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    Evaluation of dual therapy in real life setting in treatment-naive turkish patients with hcv infection: A multicenter, retrospective study
    (GALENOS YAYINCILIK, 2016) Gürbüz, Yunus; Tülek, Necla Eren; Tütüncü, Emin Ediz; Koruk, Süda Tekin; Aygen, Bilgehan; Demirtürk, Neşe; Kınıklı, Sami; Kaya, Ali; Yıldırmak, Taner; Süer, Kaya; Korkmaz, Fatime; Ural, Onur; Akhan, Sıla; Günal, Özgür; Tuna, Nazan; Köse, Şükran; Gönen, İbak; Örmen, Bahar; Türker, Nesrin; Saltoğlu, Neşe; Batırel, Ayşe; Tuncer, Günay; Bulut, Cemal; Sırmatel, Fatma; Ulçay, Asım; Karagöz, Ergenekon; Tosun, Derviş; Şener, Alper; Aynıoğlu, Aynur; Altunok, Elif Sargın
    Background: Before the introduction of direct-acting antivirals in the treatment of chronic hepatitis C patients, the combination of peginterferon alpha and ribavirin was the standard therapy. Observational studies that investigated sustained virological response (SVR) rates by these drugs yielded different outcomes. Aims: The goal of the study was to demonstrate real life data concerning SVR rate achieved by peginterferon alpha plus ribavirin in patients who were treatment-naive. Study Design: A multicenter, retrospective observational study. Methods: The study was conducted retrospectively on 1214 treatment naive-patients, being treated with peginterferon alpha-2a or 2b plus ribavirin in respect of the current guidelines between 2005 and 2013. The patients' data were collected from 22 centers via a standard form, which has been prepared for this study. The data included demographic and clinical characteristics (gender, age, body weight, initial Hepatitis C virus RNA (HCV RNA) level, disease staging) as well as course of treatment (duration of treatment, outcomes, discontinuations and adverse events). Renal insufficiency, decompensated liver disease, history of transplantation, immunosuppressive therapy or autoimmune liver disease were exclusion criteria for the study. Treatment efficacy was assessed according to the patient's demographic characteristics, baseline viral load, genotype, and fibrosis scores. Results: The mean age of the patients was 50.74 (+/- 0.64) years. Most of them were infected with genotype 1 (91.8%). SVR was achieved in 761 (62.7%) patients. SVR rate was 59.1% in genotype 1, 89.4% in genotype 2, 93.8% in genotype 3, and 33.3% in genotype 4 patients. Patients with lower viral load yielded higher SVR (65.8% vs. 58.4%, p=0.09). SVR rates according to histologic severity were found to be 69.3%, 66.3%, 59.9%, 47.3%, and 45.5% in patients with fibrosis stage 0, 1, 2, 3 and 4, respectively. The predictors of SVR were male gender, genotype 2/3, age less than 45 years, low fibrosis stage, low baseline viral load and presence of early virological response. SVR rates to each peginterferon were found to be similar in genotype 1/4 although SVR rates were found to be higher for peginterferon alpha-2b in patients with genotype 2/3. The number of patients who failed to complete treatment due to adverse effects was 33 (2.7%). The number of patients failed to complete treatment due to adverse effects was 33 (2.7%). Conclusion: Our findings showed that the rate of SVR to dual therapy was higher in treatment-naive Turkish patients than that reported in randomized controlled trials. Also peginterferon alpha-2a and alpha-2b were found to be similar in terms of SVR in genotype 1 patients.
  • Küçük Resim
    Öğe
    Gümüşler (Denizli) yerleşim alanının jeolojik-jeoteknik özellikleri
    (Selçuk Üniversitesi Mühendislik-Mimarlık Fakültesi, 2007) Akyol, Erdal; Kaya, Ali; Taşdelen, Suat; Beyaz, Turgay; Şen, Gulmustafa
    Gümüşler Beldesi, Denizli şehir merkezinin kuzeybatı kısmındadır. Denizli ve çevresi sismik olarak aktif bir bölgede yer alır. İnceleme alanı, yaklaşık 18 km2 yüzölçümüne sahip olup genişleme tektoniğine bağlı bir morfoloji sunmaktadır. Gümüşler (Denizli) yerleşim alanında Neojen ve Kuvaterner olarak yaşlandırılan iki farklı birim gözlenmektedir. İnceleme alanındaki suların pH değerleri 6,5–7, sülfat içerikleri 150–200 mg/lt ve magnezyum içerikleri 75–100 mg/lt arasında değişmektedir. Elde edilen değerler betona uygunluk açısından kabul edilebilir sınırlar arasındadır. İnceleme alanındaki birimlerin likit limiti % 14–52 ve plastisite indisi % 1–24 arasında bulunmuştur. Menard Presiyometre cihazı kullanılarak elde edilen nihai taşıma gücü 120 kPa–4600 kPa, Menard Elastisite Modülü 6,7–316,7 MPa arasında değişmektedir. İçsel sürtünme açısı (?) 13º-40º ve kohezyon (c) değeri genel olarak 1–3 kPa arasındadır.
  • Küçük Resim
    Öğe
    Hepatosteatozun entekavir ve tenofovir tedavilerinde virolojik yanıta etkisi
    (AVES, 2019) Korkmaz, Pınar; Demirtürk, Neşe; Batırel, Ayşe; Tülek, Necla; Özgüler, Müge; Harman, Rezan; Çınar, Güle; Toka, Onur; Yörük, Gülşen; Hatipoğlu, Çiğdem Ataman; Sarıgül, Figen; Sırmatel, Fatma; İmre, Ayfer; Özatağ, Duru Mıstanoğlu; Karakeçili, Faruk; Ural, Onur; Sümer, Şua; Demir, Nazlım Aktuğ; Kadanalı, Ayten; Çomoğlu, Şenol; Üçer, Sengül; Saltoğlu, Neşe; Günal, Özgür; Özkaya, Hacer Deniz; Yenilmez, Ercan; Çetinkaya, Rıza Aytaç; Yüksel, Esma; Hakyemez, İsmail Necati; Meriç-Koç, Meliha; Tuncer-Ertem, Günay; Dursun, Zehra Beştepe; Çelik, İlhami; Yılmaz, Emel; Evik, Güliz; Kaya, Ali; Süer, Kaya
    Objective: Both chronic hepatitis B (CHB) and hepatosteatosis may lead to necroinflammation in liver. Therefore, the presence of hepatosteatosis might negatively affect the efficacy of antiviral therapy. We aimed to determine the effect of hepatosteatosis on virological response in patients with CHB receiving entecavir (ETV) and tenofovir (TDF) treatment. Methods: The study was designed retrospectively. All patients receiving antiviral therapy due to CHB in the departments of Infectious Diseases and Clinical Microbiology of 29 different hospitals between January 2012 and June 2017 were searched by examining medical records. Results: A total of 1069 patients were included. Six hundred and fifty of the patients had been receiving TDF and 419 of them had been receiving ETV. The rate of virological response obtained at the 48'h week of TDF was higher in patients with steatosis (p=0.029). Virological response at the 24th week and 48th week of ETV were higher in the patients without steatosis (p=0.001). TDF and ETV therapies were compared in the patients with hepatosteatosis and it was found that the virological response at 48th week was higher in the TDF group. Conclusion: Although steatosis has an effect on virological response in the short-term results of nucleos(t)ide therapy, it does not have any effect on virological response in the long-term results.