Mucahit Yemisen

Istanbul University, İstanbul, Istanbul, Turkey

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Publications (43)105.19 Total impact


  • No preview · Article · Jan 2016 · The Lancet Infectious Diseases
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    Resat Ozaras · Mucahit Yemisen · Ilker Inanc Balkan
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    ABSTRACT: We have read the case report of Nihon-Yanagi et al. The patient they described developed hepatic granuloma two times and the granulomatous lesion was surrounding metal staples/clips suggesting that the granuloma was due to surgical staples/clips. Hepatic granulomas (HGs) are reported in around 5 % of patient who undergo a liver biopsy and caused by several diseases including sarcoidosis, tuberculosis, hydatid cyst, brucellosis, typhoid fever, chronic hepatitis B and C and primary biliary cirrhosis (PBC). Chronic hepatitis B and C infections are the most common and serious causes of liver damage in patient with renal failure. Their prevalence is a higher than people without renal failure. We have previously reported that the prevalences of HGs in patients with chronic hepatitis B and C are 1.5 and 1.3 % respectively. The described patient was on hemodialysis for 12 years. The other causes of HG seem excluded; however hepatitis B and C infections and PBC should have been tested and excluded before ascribing the HGs to surgical staples/clipping material.
    Full-text · Article · Dec 2015 · Diagnostic Pathology

  • No preview · Article · Oct 2015 · The Netherlands Journal of Medicine
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    ABSTRACT: Objective: The significance of mannose binding lectin (MBL) and H-ficolin deficiency in febrile neutropenic (FN) patients and the correlation of these markers along with consecutive C-reactive protein (CRP) and procalcitonin (PCT) levels during the infectious process are investigated. Patients and methods: Patients with any hematological malignancies who were defined to have "microbiologically confirmed infection" or "clinically documented infection" or "fever of unknown origin" were included in this single-center prospective observational study. Serum levels of CRP, PCT, MBL and H-ficolin were determined on three separate occasions; at initial (between hospital admission and chemotherapy), at the onset of fever and at the 72nd hour of fever. Results: Forty-six patients (54% male, mean age 41.7) with 61 separate episodes of FN were evaluated. Eleven patients (23.9%) had "microbiologically confirmed infection", 17(37%) had "clinically documented infection", and 18(39.1%) had "fever of unknown origin". Fourteen (30.4%) patients had low (<500 ng/ml) initial MBL levels and 7 (15.21%) had low (<12,000 ng/ml) H-ficolin levels. Baseline MBL and H-ficolin levels did not significantly change on the first and third days of fever(p=0,076). Gram negative bacteremia more frequently occured in those with low initial MBL levels (p=0.006). PCT levels were significantly higher in those with microbiologically documented infections. Mean and median PCT levels were significantly higher in cases with bacteremia.There was no significant difference between hemoculture positive and negative patients in terms of CRP levels. Conclusions: Monitoring serum H ficolin levels was shown to be of no benefit in terms of predicting severe infection. Low baseline MBL levels were correlated with high risk of gram negative bacteremia, however no significant correlation was shown in the follow up. Close monitoring of PCT levels is warranted to provide more accurate and specific data while monitoring cases of bacteremia.
    Full-text · Article · Sep 2015

  • No preview · Article · Sep 2015 · Journal of gastrointestinal and liver diseases: JGLD

  • No preview · Article · Sep 2015 · Journal of Clinical Virology
  • R. Ozaras · B. Mete · M. Yemisen · I.I. Balkan · M. Alkan · F. Tabak

    No preview · Article · Sep 2015 · Journal of gastrointestinal and liver diseases: JGLD
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    Full-text · Article · May 2015 · International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases
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    ABSTRACT: Idiopathic granulomatous mastitis (IGM) is a benign rare inflammatory pseudotumor. Bilateral involvement of IGM has been reported in a few cases. To our knowledge, this study is the largest series of bilateral cases to date. The goals of this study were to present clinical features of bilateral IGM and to evaluate the results of treatments. We performed a retrospective review of the idiopathic granulomatous mastitis database from 2010 to 2013. Ten female patients who met required histologic and clinical criteria of IGM in both breasts were included in study. Demographic data, clinical findings, medication history, and radiologic findings are presented. The mean age at onset of the disease was 38.4 ± 8.3 years (range: 29-52 years). Nine patients had no recurrence during a mean follow-up period of 21 months (range: 11-26 months). Additionally, the median time to second breast involvement was 15.6 months. Bilateral IGMs have a higher rate of more relapse and greater resistance to medical therapies than do unilateral IGMs. Surgical management should be avoided unless all medical treatment options have been exhausted. Nevertheless, expectant management seems a rational option for the treatment of bilateral IGM. Copyright © 2015. Published by Elsevier Taiwan.
    Full-text · Article · May 2015
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    ABSTRACT: We aimed to investigate the predictors for the limb loss among diabetic patients with complicated skin-soft tissue infections. In this observational study, consecutive patients with diabetic foot infection (DFI) from 17 centers in Turkey, between May 2011 and May 2013 were included. The Turkish DFI Working Group performed the study. Predictors of limb loss were investigated by multivariate analysis. In total 455 patients with DFI were included. Median age was 61 years, 68% were male, 65% of the patients were hospitalized, 52% of the patients used antibiotics within the last month, and 121(27%) had osteomyelitis. Of the 208 microorganisms isolated, 92(44.2%) were Gram-positive cocci and 114(54.8%) were Gram-negative rods(GNR).The most common GNR was Pseudomonas; the second was E. coli, with ESBL positivity of 33%. Methicillin resistant Staphylococcus species were found in 14% (29/208). Amputations were performed in 126/455 (28%) patients, 44/126 (34%) of these major amputations. In multivariate analysis, significant predictors for limb loss were, male gender (OR; 1.75, 95% CI; 1.04-2.96, p=0.034), duration of DM>20 years (OR; 1.9, 95% CI; 1.18-3.11, p=0.008), infected ulcer vs cellulitis (OR; 1.9, 95% CI; 1.11-3.18, p=0.019), history of peripheral vascular disease (OR; 2, 95% CI; 1.26-3.27, p=0.004), retinopathy (OR; 2.25, 95% CI; 1.19-4.25, p=0.012), ESR>70 mm/hr (OR;1.6, 95% CI; 1.01-2.68, p=0.05), and infection with GNR (OR; 1.8, 95% CI;1.08-3.02; p=0.02). Multivariate analysis revealed that, besides the known risk factors such as male gender, duration of DM>20 years, infected ulcers, history of peripheral vascular disease, and retinopaty, detection of GNR predicted limb loss significantly. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Apr 2015 · Clinical Microbiology and Infection
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    ABSTRACT: Objective We aimed to compare community-onset healthcare-associated (CO-HCA) and hospital-acquired (HA) urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in terms of epidemiology, clinical outcomes and antimicrobial activities.Methods Patients from both groups with ESBL-producing E. coli detected by urine culture between January 2009 and January 2011 were included in this retrospective study. Relevant demographical, microbiologic and clinical data were obtained from case records.ResultsA total of 173 patients (mean age of 58 years, 74% female) were included, of whom 75 (43.4%) had a CO-HCA UTI and 98 (56.6%) had an HA UTI. Eighty (46.2%) patients had more than one comorbid disease, of whom 57 (32.5%) had urological problems. The most common clinical manifestations were pyelonephritis (43.9%) and urosepsis (16.2%). An age of > 65 years (p = 0.005) in addition to urinary catheterisation (p = 0.001), urosepsis (p = 0.001) and mortality (p = 0.001) were significantly more common in the HA UTI group. Acute cystitis (p = 0.027), complicated cystitis (p = 0.001) and non-urologic neoplasm (p = 0.032) were significantly more common in the CO-HCA UTI group. No isolate was resistant to carbapenems or fosfomycin. Sensitivities to nitrofurantoin, amikacin, trimethoprim sulfamethoxazole-trimoxazole and quinolones were 97.6%, 89%, 29.4% and 17.9% respectively. Both groups showed similar rates of antibiotic resistance.ConclusionESBL-producing E. coli should be taken into consideration in patients with a CO HCA UTI, not only in hospital settings but also in outpatient settings. We suggest ertapenem as a first-line empirical treatment for patients with an upper UTI and fosfomycin and nitrofurantoin for those with a lower UTI when ESBL-producing E. coli is suspected.
    Full-text · Article · Feb 2015 · International Journal of Clinical Practice
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    ABSTRACT: Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria, Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13 variables. Age, nausea, vomiting, altered consciousness, hydrocephalus, vasculitis, immunosuppression, diabetes mellitus and neurological deficit remained in the final model. Scores 1-3 were assigned to the variables in the severity scale, which included scores of 1-6. The distribution of mortality for the scores 1-6 was 3.4, 8.2, 20.6, 31, 30 and 40.1 %, respectively. Altered consciousness, diabetes mellitus, immunosuppression, neurological deficits, hydrocephalus, and vasculitis predicted the unfavorable outcome in the scoring and the cumulative score provided a linear estimation of prognosis.
    Full-text · Article · Jan 2015 · Journal of Neurology
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    H Erdem · N Elaldi · O Ak · S Gulsun · R Tekin · M Ulug · F Duygu · M Sunnetcioglu · N Tulek · S Guler · [...] · F Bozkurt · O Deveci · A Inan · A Kadanali · M S Sayar · B Cetin · M Yemisen · H Naz · L Gorenek · C Agalar ·
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    ABSTRACT: This study reviewed the clinical, laboratory, therapeutic and prognostic data on genitourinary involvement of brucellosis in this largest case series reported. This multicentre study pooled adult patients with genitourinary brucellar involvement from 34 centres treated between 2000 and 2013. Diagnosis of the disease was established by conventional methods. Overall 390 patients with genitourinary brucellosis (352 male, 90.2%) were pooled. In male patients, the most frequent involved site was the scrotal area (n = 327, 83.8%), as epididymo-orchitis (n = 204, 58%), orchitis (n = 112, 31.8%) and epididymitis (n = 11, 3.1%). In female patients, pyelonephritis (n = 33/38, 86.8%) was significantly higher than in male patients (n = 11/352, 3.1%; p< 0.0001). The mean blood leukocyte count was 7530 AE 3115/mm 3 . Routine laboratory analysis revealed mild to moderate increases for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The mean treatment duration and length of hospital stay were significantly higher when there were additional brucellar foci (p< 0.05). Surgical operations including orchiectomy and abscess drainage were performed in nine (2.3%) patients. Therapeutic failure was detected in six (1.5%), relapse occurred in four (1%), and persistent infertility related to brucellosis occurred in one patient. A localized scrotal infection in men or pyelonephritis in women in the absence of leucocytosis and with mild to moderate increases in inflammatory markers should signal the possibility of brucellar genitourinary disease.
    Full-text · Article · Nov 2014

  • No preview · Article · Nov 2014 · Annals of hepatology: official journal of the Mexican Association of Hepatology
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    ABSTRACT: Background: Rashes in febrile neutropenic patients present an important problem in differential diagnosis for their physicians. In these patients, rashes may be the first and only evidence of a serious and life-threatening infection. In this study, we aimed to retrospectively report the etiology of skin lesions in febrile neutropenic patients with hematologic malignancies. Methods: In our study, hospitalized febrile neutropenic patients with hematologic malignancy, aplastic anemia, or bone marrow transplantation were included. Patient files were screened retrospectively and patients with skin lesions during febrile neutropenic episodes were selected. Patients with febrile neutropenia were initiated an antipseudomonal beta-lactam therapy according to IDSA guidelines. Skin lesions of these patients during febrile neutropenic episode, consulted and evaluated with infectious disease and dermatology specialists Results: A total of 50 patients were included in our study. Twenty six (52%) of the patients were male and the average age was 45.8 (± 15), respectively. The most common underlying disease was acute myeloid leukemia with 29 (48%) patients. The most frequently observed type of lesion was maculopapular eruption (40%) whilst it was followed by erythematous necrotic nodule (18%). The most common cause of skin lesions were infections and drug eruptions with 26 (52%) and 16 (32%) patients, respectively. Ecthyma gangrenosum in 8 patients, skin involvement of oppurtunistic fungal infections in 7 patients and herpes labialis in 5 patients were most common causes of skin lesions in infection group. In 16 (32%) patients the skin lesions were found to be related to drugs; piperacillin/tazobactam, co-trimaxazol and etoposid were the most common cause of drug related skin lesions. Of the patients, 6 patients died during or soon after the development of skin lesions and in 5 of 6 patients, the skin lesions were found to be related with infectious causes. Conclusion: Infections were found to be the most common cause of skin lesions in febrile neutropenic patients.
    Full-text · Conference Paper · Oct 2014
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    ABSTRACT: Background: Rate of coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) varies in different countries. This may be attributable to common transmission routes as well as social, economic, and cultural factors. Objectives: The purpose of this study was to investigate the prevalence and risk factors of HCV infection among HIV-positive patients in Istanbul, Turkey. Patients and Methods: Since January 2006 to November 2013, 949 HIV-positive patients that were enrolled in this study by ACTHIV-IST (Action Against HIV in Istanbul) Study Group, which consists of five centers to follow up HIV-positive patients in Istanbul. Epidemiologic and clinical data were collected retrospectively from medical records and were transferred to an HIV database system. Results: Among 949 patients, 84% were men and the mean age was 37.92 ± 11.54 years (range, 17-79). The most frequent route of transmission was heterosexual intercourse (48.8%), followed by men having sex with men (30.5%). Only nine patients (0.9%) had history of injection drug use (IDU). The prevalence of HIV/HCV coinfection was 0.9% (9:949). The IDU rate was 44.4% (4:9) in patients with HIV/HCV coinfection (three of them were not Turkish citizens), whereas this rate was only 0.6% (5:881) in patients with only HIV infection (P < 0.01). Genotypes 1b, 2a/2c, and 3 were determined in five, one, and two patients, respectively. Genotype could not be determined in one patient. History of residence in a foreign country (P < 0.01) and imprisonment (P < 0.01) were also considered as risk factors in terms of HIV/HCV coinfection. Conclusions: Prevalence of HIV/HCV coinfection is considerably low in Turkey. The extremely rare prevalence of IDU might have a role in this low prevalence.
    Full-text · Article · Aug 2014 · Hepatitis Monthly
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    ABSTRACT: Purpose: Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast. It can mimic breast carcinoma clinically and radiologically, and usually affects females of childbearing age. There is no commonly accepted optimal treatment for IGM. In this study, we present the clinical and histopathological features and outcomes of the therapeutic management of IGM, as well as the clinical course of the disease when patients were treated with oral corticosteroids. Methods: This retrospective study included 49 of 87 patients who met the required histological criteria for IGM who were followed up between January 2009 and December 2011. All patients had a disease-free follow-up period of at least 6 months. The data regarding the clinical features at presentation, laboratory values and the treatment modalities were obtained from the medical records of the patients. Results: The mean age of the patients was 34.3 ± 4.37 years. Forty patients were treated with prednisolone, five were started on antituberculosis treatment, two received non-steroidal anti-inflammatory drugs, one received antibiotics and one underwent wide excision. All patients who received steroids responded well to the therapy. Conclusion: Systemic therapy with corticosteroids is an effective and appropriate treatment option for IGM. It can provide complete disease resolution and prevent recurrence in the long term. A multidisciplinary approach including specialists in the fields of both general surgery and infectious diseases is essential for the diagnosis, treatment and follow-up of IGM.
    Full-text · Article · Jul 2014 · Surgery Today
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    Resat Ozaras · Ilker Inanc Balkan · Mucahit Yemisen · Fehmi Tabak
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    ABSTRACT: The natural history of hepatitis B virus infection is not uniform and affected from several factors including, HBV genotype. Genotype D is a widely distributed genotype. Among genotype D, several subgenotypes differentiate epidemiologically and probably clinically. D1 is predominant in Middle East and North Africa, and characterized by early HBeAg seroconversion and low viral load. D2 is seen in Albania, Turkey, Brazil, western India, Lebanon, and Serbia. D3 was reported from Serbia, western India, and Indonesia. It is a predominant subgenotype in injection drug use-related acute HBV infections in Europe and Canada. D4 is relatively rare and reported from Haiti, Russia and Baltic region, Brazil, Kenya, Morocco and Rwanda. Subgenotype D5 seems to be common in Eastern India. D6 has been reported as a rare subgenotype from Indonesia, Kenya, Russia and Baltic region. D7 is the main genotype in Morocco and Tunisia. D8 and D9 are recently described subgenotypes and reported from Niger and India, respectively. Subgenotypes of genotype D may have clinical and/or viral differences. More subgenotype studies are required to conclude on subgenotype and its clinical/viral characteristics.
    Full-text · Article · Jul 2014 · Gastroentérologie Clinique et Biologique
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    ABSTRACT: This study reviewed the clinical, laboratory, therapeutic, and prognostic data on genitourinary involvement of brucellosis in this largest case series reported. This multi-centre study pooled adult patients with genitourinary brucellar involvement from 34 centres treated between 2000 and 2013. Diagnosis of the disease was established by conventional methods. Overall 390 patients with genitourinary brucellosis (352 males, 90.2%) were pooled. In males, the most frequent involved site was scrotal area (n=327, 83.8%) as epididymo-orchitis (n=204, 58%), orchitis (n=112, 31.8%), and epididymitis (n=11, 3.1%). In females pyelonephritis (n=33/38, 86.8%) was significantly higher than males (n=11/352, 3.1%; p<0.0001). The mean blood leukocyte count was 7530±3115/mm(3) . Routine laboratory analysis revealed mild to moderate increases for erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). The mean treatment duration and length of hospital stay was significantly higher when there were additional brucellar foci (p<0.05). Surgical operations including orchiectomy and abscess drainage were performed in nine (2.3%) patients. Therapeutic failure was detected in six (1.5%), relapse occurred in four (1%), and persistent infertility related to brucellosis occurred in one patient. A localized scrotal infection in males or pyelonephritis in females in the absence of leucocytosis and with mild to moderate increases in inflammatory markers should alert for brucellar genitourinary disease. This article is protected by copyright. All rights reserved.
    Full-text · Article · May 2014 · Clinical Microbiology and Infection
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    ABSTRACT: The aim of the study was to report the epidemiological profile of HIV-1 positive patients from, Istanbul, Turkey, which has one of the lowest HIV-1/AIDS prevalences in Europe. The patients were followed by ACTHIV-IST group which was established by the Infectious Diseases Departments of five teaching hospitals (three university hospitals and two public hospitals) in Istanbul, Turkey. The HIV-1positive patients were added to the standard patient files in all of the centers; these files were then transferred to the ACTHIV-IST database in the Internet. A total of 829 naiv-untreated HIV-1 positive patients were chosen from the database. The numbers of male patients were 700 (84.4%) and the mean age of the patients was 37 years (range, 17-79). In our study group 348 (42%) of the patients were married, 318 (38.7%) of the patients were single. The probable route of transmission was heterosexual intercourse in 437 (52.7%) patients and homosexual intercourse in 256 (30.9%) patients. In 519 (62.6%) patients the diagnose was made due to a screening test and in 241 (29.1%) patients, the diagnose was made due to an HIV-related/non-related disease. the mean CD4+ T cell number in 788 of the patients was 357.8/mm3 (±271.1), and the median viral load in 698 of the patients was 100,000 copies/mL (20-9,790,000). In Turkey, the number of HIV-1 positive patients is still low and to diagnose with a screening test is the most common way of diagnostic route.
    No preview · Article · Apr 2014 · Current HIV research

Publication Stats

124 Citations
105.19 Total Impact Points

Institutions

  • 2004-2015
    • Istanbul University
      • • Department of Infectious Diseases and Clinical Microbiology
      • • Department of Infectious Diseases
      • • Department of Family Medicine (Cerrahpasa Faculty of Medicine)
      İstanbul, Istanbul, Turkey
  • 2009
    • Nisa Hospital, Turkey
      İstanbul, Istanbul, Turkey