Halis Akalin

Uludag University, Bursa, Bursa, Turkey

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Publications (37)60.62 Total impact

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    ABSTRACT: Pneumonia is an important cause of morbidity and mortality in recipients of solid-organ transplant. We aimed to determine risk factors for development of pneumonia and associated deaths in kidney transplant recipients.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 06/2014; 12(3):205-211. · 0.59 Impact Factor
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    Nephrology Dialysis Transplantation. 05/2014; 29:iii528-iii538.
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    ABSTRACT: Introduction and Aims: IgA nephropathy, the most common primary glomerulonephritis worldwide, can lead to end-stage renal disease and kidney transplantation. Disease recurrence frequently occurs after transplantation. We investigated the predictive value of three markers including galactose-deficient (Gd) IgA1, IgG anti-IgA autoantibodies, IgA-soluble (s) CD89 complexes for IgA nephropathy recurrence. The efficacy of intravenous pulse steroid administration for treatment of recurrent IgA nephropathy was evaluated.Methods: The IgA nephropathy recurrent group (R group, n=11) was compared to matched patients transplanted for IgA nephropathy but without recurrence (NR group, n=13) and healthy subjects (n=22) for proportions of serum Gd-IgA1, IgA-IgG complexes and IgA-sCD89 complexes. Efficacy of pulse steroid therapy in reducing proteinuria was analysed in kidney transplant recipients R group.Results: Pre-transplantation serum proportion of Gd-IgA1 and IgA-IgG complexes were higher in R group compared to NR g
    Nephrology Dialysis Transplantation. 01/2014; 29(suppl 3):iii528-iii538.
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    ABSTRACT: Introduction and Aims: IgA nephropathy, the most common primary glomerulonephritis worldwide, can lead to end-stage renal disease and kidney transplantation. Disease recurrence frequently occurs after transplantation. We investigated the predictive value of three markers including galactose-deficient (Gd) IgA1, IgG anti-IgA autoantibodies, IgA-soluble (s) CD89 complexes for IgA nephropathy recurrence. The efficacy of intravenous pulse steroid administration for treatment of recurrent IgA nephropathy was evaluated.Methods: The IgA nephropathy recurrent group (R group, n=11) was compared to matched patients transplanted for IgA nephropathy but without recurrence (NR group, n=13) and healthy subjects (n=22) for proportions of serum Gd-IgA1, IgA-IgG complexes and IgA-sCD89 complexes. Efficacy of pulse steroid therapy in reducing proteinuria was analysed in kidney transplant recipients R group.Results: Pre-transplantation serum proportion of Gd-IgA1 and IgA-IgG complexes were higher in R group compared to NR g
    Nephrology Dialysis Transplantation. 01/2014; 29(suppl 3):iii528-iii538.
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    ABSTRACT: Diagnosing GABHS (Group A-beta Hemolytic Streptococcus) tonsillopharyngitis by clinical scoring is a recommended approach in developed countries, but there is still much controversy for low resource settings. We aimed to assess the impact of Centor criteria with the support of practical laboratory tests. We prospectively included patients complaining sore throat (N = 282). We evaluated them in terms of Centor scoring and performed white blood cell count (WBC), C-reactive protein (CRP), rapid antigen detecting test, and throat culture. In GABHS cases (N = 32, 11·3%), two of the criteria were observed to be positive in more than half of the cases (N = 19, 59·3%), while 13 (40·7%) cases met three/four criteria. The specificity of having two criteria was found to be 65·5% and increased to 91·5% after including CRP and WBC. Centor criteria could be safely used to reduce unnecessary antibiotic usage for tonsillopharyngitis in developing countries.
    Journal of chemotherapy (Florence, Italy) 01/2013; 25(3):148-55. · 0.83 Impact Factor
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    ABSTRACT: The incidence of invasive aspergillosis has increased after solid organ transplant. However, aspergillus osteomyelitis in vertebrae is rare. We report a case of aspergillus spondylodiskitis after pulmonary aspergillosis in a renal transplant recipient. He was treated by antifungal therapy and surgical intervention. The transplantist should be alert for a diagnosis of aspergillus spondylodiskitis in recipients who developed back pain after aspergillosis infection in other sites.
    Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation. 08/2011; 9(4):265-9.
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    ABSTRACT: Acute invasive fungal rhinosinusitis (AIFRS) is a serious disease with a high mortality and morbidity rate, which almost always affects immunocompromised patients and/or patients with diabetes mellitus. Our purpose was to present the diagnostic and therapeutic management and outcome of these patients. Case series with chart review. Tertiary care university hospital. Twenty-six patients, who were operated on because of AIFRS between September 1999 and June 2009, were retrospectively evaluated in this study. Endoscopic surgery was used in 19 patients, and open surgical debridement was performed in seven patients. Overall survival rate of the patients in the open surgery group (4 of 7; 57.1%) was similar to that of the endoscopically treated group (9 of 19; 47.3%). Thirteen patients (50%) died of complications related to the underlying disease (9 of 13; 69.2%) and AIFRS (4 of 13; 30.7%). AIFRS-specific survival rate is 76.5 percent; 90 percent (9 of 10) and 57.1 percent (4 of 7) for endoscopic and open surgery groups, respectively. Four patients who died had pathological diagnosis of mucormycosis (P = 0.52). AIFRS can be successfully treated with a combination of endonasal surgical debridement and antifungal medications. Endonasal approach is suitable for patients diagnosed in the early stages of the disease and provides a less traumatic option in those patients who already have a poor health status. Open surgery should be preferred in the presence of intraorbital extension, palatinal, and/or intracerebral involvement. Reversing the underlying disease process and immunosuppression is as important as the surgical and antifungal treatment.
    Otolaryngology Head and Neck Surgery 11/2010; 143(5):614-20. · 1.73 Impact Factor
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    ABSTRACT: The incidence of nosocomial candidaemia was evaluated in a retrospective study in a Turkish tertiary-care hospital. Over a 12-year period (1996-2007), a total of 743 episodes of candidaemia occurred in 743 patients, accounting for an average incidence of 1.9 episodes/1000 admissions and 2.9 episodes/10 000 patient-days per year. The annual incidence was almost constant during the study period except for 1996 when it was significantly higher in comparison with other years (P<0.05). The most common species isolated was Candida albicans (45%), followed by C. parapsilosis (26%), C. tropicalis (7%), C. krusei (7%), and C. glabrata (3.5%). A significant increase in C. albicans isolates causing candidaemia linked to a decrease in C. parapsilosis isolates in adult patients and C. krusei isolates in children was found between the two 6-year study periods. This trend reflects improved infection control at Uludağ University Hospital. Ninety percent of isolates were susceptible to fluconazole (8 microg/ml) and resistance was found only in C. glabrata and C. parapsilosis isolates. Regular local surveillance of Candida spp. is important in order to develop empirical treatment protocols to reduce the incidence and mortality of candidaemia.
    Epidemiology and Infection 09/2010; 138(9):1328-35. · 2.87 Impact Factor
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    ABSTRACT: Background: Because of high morbidity of the brucellosis in humans and the potential use of the microorganism as an agent of biologic warfare, protection of effective vaccines and specific diagnostic reagents become necessary to eradicate brucellosis. Objective: In this study we aimed to investigate the cytokine responses and changes in peripheral blood lymphocyte subgroups of acute brucellosis patients in response to L7/L12 and glyceraldehyde 3-phosphate dehydrogenase (GAPDH) recombinant proteins derived from Brucella abortus. Methods: levels of IFN-γ, IL-4 and IL-10 secreted from PBMCs of 25 acute brucellosis patients and 15 healthy controls, stimulated with Phytohemagglutinin (PHA), L7/L12 or GAPDH were measured by ELISA. Furthermore alterations in lymphocyte subgroups in response to these Brucella antigens were determined by flow cytometry. Results: Extracellular IFN-γ levels were found to be elevated after stimulation with L7/L12 in patients with acute brucellosis, whereas no significant changes were found in IL-4 and IL-10 levels. Similar data was also obtained with GAPDH, but the stimulation of IFN-γ production was not observed in all patients and was not as strong as that observed for L7/L12. Moreover, when the distribution of lymphocytes subgroups (CD3+, CD3+CD4+, CD3+CD8+, CD4+CD25+, CD3+CD69+ and CD3+CD152+) was evaluated, it was found that the stimulation with L7/L12 and GAPDH only led to an increase in the percentage of CD3+CD69+ lymphocytes. Conclusion: These data indicate that Brucella abortus L7/L12 or GAPDH induce a Th1 type immune response in acute brucellosis patients. Additionally, these recombinant proteins, especially L7/L12, may be used in new vaccine preparations and diagnostic tests.
    Iranian journal of immunology: IJI 09/2010; 7(3):132-41.
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    ABSTRACT: Objectives: Mediterranean spotted fever (MSF) is an acute febrile, zoonotic disease caused by Rickettsia conorii and endemic infectious disease in Mediterranean countries.Patients and Methods: In this study, a retrospective examination of 16 cases (4 females, 12 males; mean age 38.9±13.0; range 18 to 64 years) that were diagnosed with rickettsioses between 1987-2007 was performed. Diagnosis of MSF was based upon epidemiological and clinical features, indirect immunofluorescence antibody (IFA), as well as response to doxycycline therapy.Results: High fever and maculopapular rash were present in all cases. Palmar and plantar rash were evident in 13 (81.3%) and eschar in eight (50%) cases. All cases responded to treatment within 2±0.9 days, and no death was observed.Conclusion: Mediterranean spotted fever should be considered in the differential diagnosis of all patients admitting with fever, maculopapular rash, headache and/or musclejoint pain during spring, summer and autumn.
    Balkan Journal of Medical Genetics 06/2010; 27(2):167-71. · 0.08 Impact Factor
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    ABSTRACT: Four tularemia epidemics were reported from three different regions of Turkey between 1936 and 1953. After a long interval, a new tularemia epidemic was reported from the area around Bursa in the northwestern part of Turkey in 1988. Following this first epidemic in Bursa, small epidemics occurred in areas around Bursa between 1988 and 2002. Other tularemia epidemics in different regions of Turkey were reported between 1988 and 2005. Almost all of the cases involved the oropharyngeal form of the disease. However, ulceroglandular and oculoglandular forms were detected in the Bursa epidemics; all of the ulceroglandular cases had dermatitis on their hands. To date, 1300 cases have been serologically confirmed. We reviewed one of the biggest tularemia epidemics in Europe.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 09/2009; 13(5):547-51. · 2.17 Impact Factor
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    ABSTRACT: We present a case of multiple intracranial abscesses caused by Cryptococcus neoformans in a patient who presented with no symptoms of immunodeficiency.
    Medical mycology: official publication of the International Society for Human and Animal Mycology 09/2009; 48(2):398-401. · 2.13 Impact Factor
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    ABSTRACT: Clostridium difficile (C. difficile) is a well-established cause of nosocomial diarrhea. The aim of our study was to define the incidence of nosocomial diarrhea in our hospital and to determine the role of C. difficile. Additionally, the risk factors for nosocomial diarrhea and Clostridium difficile associated diarrhea (CDAD) were investigated. We included all patients, 18 years of age or more, who were admitted to the Uludag Teaching Hospital between October 1, 2004 and February 1, 2005, and developed diarrhea at least three days after hospital admission. A case-control study was performed. The total incidence of nosocomial diarrhea was 0.6 per 1,000 hospitalization-days and 5 per 1,000 patients' admissions. Previous use of chemotherapy was found to be an important predisposing factor for nosocomial diarrhea. The incidence of CDAD was 0.26 per 1,000 hospitalization-days and 2.1 per 1,000 admissions, comparable with incidence rates in Europe. CDAD was diagnosed in 43% of patients with nosocomial diarrhea. No severe cases of CDAD were diagnosed. A correlation was found between CDAD and antibiotic use before admission and during admission in univariate analysis. PCR ribotyping revealed four strains of PCR ribotype 002 and 1 strain of ribotype 012 out of 5C. difficile strains available for extensive identification. The incidence rates of nosocomial diarrhea and CDAD are not different than the usual incidence rates in Europe. C. difficile was the causative agent in 43% of patients with nosocomial diarrhea.
    Médecine et Maladies Infectieuses 04/2009; 39(6):382-7. · 0.75 Impact Factor
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    ABSTRACT: In recent years there has been an increase in life-threatening infections caused by Acinetobacter baumannii with multiple antibiotic resistance, which has lead to the use of polymyxins, especially colistin, being reconsidered. The aim of this study was to investigate the colistin sensitivity of A. baumannii isolates with multiple antibiotic resistance via different methods, and to evaluate the disk diffusion method for colistin against multi-resistant Acinetobacter isolates, in comparison to the E-test and Phoenix system. The study was carried out on 100 strains of A. baumannii (colonization or infection) isolated from the microbiological samples of different patients followed in the clinics and intensive care units of Uludağ University Medical School between the years 2004 and 2005. Strains were identified and characterized for their antibiotic sensitivity by Phoenix system (Becton Dickinson, Sparks, MD, USA). In all studied A. baumannii strains, susceptibility to colistin was determined to be 100% with the disk diffusion, E-test, and broth microdilution methods. Results of the E-test and broth microdilution method, which are accepted as reference methods, were found to be 100% consistent with the results of the disk diffusion tests; no very major or major error was identified upon comparison of the tests. The sensitivity and the positive predictive value of the disk diffusion method were found to be 100%. Colistin resistance in A. baumannii was not detected in our region, and disk diffusion method results are in accordance with those of E-test and broth microdilution methods.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 03/2009; 13(5):e217-20. · 2.17 Impact Factor
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    ABSTRACT: We investigated the risk factors for community acquired/onset urinary tract infections due to extended spectrum beta-lactamase (ESBL)-positive Escherichia coli or Klebsiella pneumoniae in 62 patients who were followed-up from August 1, 2003 to September 1, 2006. Sixty patients with community-acquired urinary tract infections caused by ESBL-negative E. coli or K. pneumoniae who were followed-up during the same dates were included as a control group. Age (> or =65 or <65 years old), sex, bladder cancer, benign prostate hypertrophy (BPH), prostate cancer, urolithiasis, urethral catheter, previous urological operation, diabetes mellitus, use of antibiotics during the last 3 months and hospitalization during the last 3 months were investigated as risk factors. The presence of previous urological operation and quinolone or cephalosporin use for any infection during the last 3 months were found to be independent risk factors. Knowing the risk factors for community acquired/onset urinary tract infections caused by ESBL-positive E. coli or K. pneumoniae is of great importance in planning empirical antibiotic therapy.
    Journal of chemotherapy (Florence, Italy) 11/2008; 20(5):581-5. · 0.83 Impact Factor
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    International Journal of Infectious Diseases 06/2008; 12(3):335-8. · 2.36 Impact Factor
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    ABSTRACT: Invasive Aspergillosis occurs in almost every human organ, most commonly in the lungs. Bone involvement classically has been considered exceedingly rare for both immunocompromised and immunocompetent hosts, however, there are limited data in transplant recipients. We report an unusual case of osteomyelitis and joint infection of the ankle caused by Aspergillus fumigatus in a renal transplant recipient.
    Transplantation Proceedings 07/2007; 39(5):1662-3. · 0.95 Impact Factor
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    ABSTRACT: We present the cases of two patients with cryptococcal meningitis who were predisposed to fungal infection because of diabetes mellitus (Case 1) and systemic lupus erythematosus (Case 2). Both patients were tested negative for anti-HIV antibodies.
    Mycoses 06/2007; 50(3):235-8. · 1.28 Impact Factor
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    ABSTRACT: In this study, the clinical and laboratory features of 26 infectious mononucleosis (IMN) cases who have been diagnosed between the years of 1984-2005 were evaluated retrospectively. The mean age of the patients was 26+/-11 years, the rate of being hospitalized was 65%, and mean hospitalization period was 9.2+/-6 days. Fever (81%), weakness (50%), sore throat (50%), headache (50%) and swollen neck (35%) were the most common symptoms, while in the physical examination cervical lymphadenopathy (81%), splenomegaly (69%), hyperemic pharynx (65%), hepatomegaly (54%) and tonsillitis (50%) were observed. Laboratory results yielded leukocytosis in 21%, leucopenia in 12%, anemia in 44%, thrombocytopenia in 5% and elevated transaminase levels in 84% of the patients. Of the patients 15 (57.7%) had the history of using antibiotics before the diagnosis. Serological diagnosis was performed by Paul-Bunnel test and/or IgM positivity against Epstein-Barr virus (EBV) viral capsid antigen (VCA). Tonsillo-pharyngitis secondary to edema and respiratory distress due to lymphadenopathy pressure were detected in four patients, whereas pancytopenia was established only in one patient, as complications. This study emphasized that, although IMN is a self-limited infection, the diagnostic difficulties may arise when the clinical course is atypical, and rarely seen life-threatening complications may also develop during IMN course.
    Mikrobiyoloji bülteni 02/2007; 41(1):95-100. · 0.61 Impact Factor
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    ABSTRACT: Between April 2000 and May 2005, 350 bacteraemic episodes occurred among patients treated in our haematology unit. Two hundred and twenty-eight of these episodes were caused by Gram-positive pathogens, most commonly coagulase-negative staphylococci and Staphylococcus aureus. One hundred and twenty-two episodes were due to Gram-negative pathogens, with a predominance of Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa. Bacillus bacteraemias constituted 12 of these episodes occurring in 12 patients, and accounted for 3.4% of all bacteraemic episodes. Of the 12 strains evaluated, seven were Bacillus licheniformis, three were Bacillus cereus and two were Bacillus pumilus. Seven episodes presented with bloodstream infection, three with pneumonia, one with severe abdominal pain and deterioration of liver function, and one with a catheter-related bloodstream infection. B. licheniformis was isolated from five patients who had been hospitalized at the same time. This outbreak was related to non-sterile cotton wool used during skin disinfection. B. cereus and B. licheniformis isolates were susceptible to cefepime, carbapenems, aminoglycosides and vancomycin, but B. pumilus isolates were resistant to all antibiotics except for quinolones and vancomycin. Two deaths were observed. In conclusion, Bacillus spp. may cause serious infections, diagnostic and therapeutic dilemmas, and high morbidity and mortality in patients with haematological malignancies. Both B. cereus and B. licheniformis may be among the 'new' Gram-positive pathogens to cause serious infection in patients with neutropenia.
    Journal of Hospital Infection 11/2006; 64(2):169-76. · 2.86 Impact Factor