Browsing by Author "Akdeniz, Hayrettin"

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Activity of Interferon Alfa 2b+ Lamivudine Combination Therapy in Chronic Hepatitis B Patients
(2008) Kırıkçı, Aziz Dursun; Akdeniz, Hayrettin
Kırıkçı A.D, Kronik hepatit B hastalarında interferon alfa 2b+ lamivudin kombinasyon tedavisinin etkinliği, Y.Y.Ü. Tıp Fakültesi Enfeksiyon Hastalıkları ve KlinikMikrobiyoloji, Uzmanlık Tezi, VAN, 2008Bu çalışmada, kronik hepatit B infeksiyonu tedavisinde, interferon alfa-2b ile nukleozid/nükleotid analoğu olan lamivudin kombinasyon tedavisinin etkinliği retrospektif olarak araştırılmıştır.Çalışma grubu serolojik ve histolojik olarak kronik hepatit B infeksiyonu tanısı konulan 7'si kadın 17'si erkek 24 hastadan oluşmaktaydı. Hastaların 13'ü HBeAg pozitif, 11'i anti-HBe pozitif kronik hepatit B hastasıydı.Hastalara 6 ay, haftada 3 kez 10 milyon ünite interferon alfa 2b ve oniki ay 100 mg/gün lamivudin verilmişti.Tedavi sonunda HBe Ag pozitif hastaların 5'inde serokonversiyon gelişirken, 1 hastada HBsAg/anti-HBs serokonversiyonu oluştu. Tedavi sonunda tüm hastaların ALT düzeylerinde istatiksel olarak anlamlı düzeylerde normalizasyon saptanmıştır. Anti HBe pozitif hastalarda tedavi sonrası HBV-DNA negatifleşmesini % 54,5, ALT normalizasyonunu ise % 72.7 olarak tespit ettik.Tedavi süresince hiçbir hastada tedaviyi yarıda bıraktıracak ya da doz azaltımı gerektirecek düzeyde yan etki oluşmadı. Bu yönüyle kombinasyon tedavisinin güvenli ve tolere edilebilen bir tedavi şekli olduğu sonucuna varılmıştır.Sonuç olarak uyguladığımız interferon alfa-2b ile lamivudin kombinasyon tedavisinin güvenli ve tolere edilebilir olduğu, ancak etkinlik açısından yeterli olmadığı görülmektedir. Bu nedenle interferonun başka nükleozid/nukleotid analogları ile yapılacak kombinasyon tedavileri araştırılmalıdır.
Akut Batın Tablosunu Taklit Eden Bir Bruselloz Olgusu
(2005) Akdeniz, Hayrettin; Arat, Murat Ersöz; Karsen, Hasan
GIS tutulumu ile seyrederek akut batın tablosunu taklit eden 17 yaşındaki brusellozlu olguya ait klinik bulgular sunuldu. Brucella serolojisi 1:10240 titrede pozitif bulundu. Rifampisin, doksisiklin ve sefriakson başlanan hastanın, bir hafta sonra cerrahi müdahale yapılmaksızın semptom ve bulguları düzeldi.
Akut Lösemili Hastalarda Notropenik Ateş Ataklarının Değerlendirilmesi
(2002) Demir, Cengiz; Dilek, İmdat; Akdeniz, Hayrettin; Buzğan, Turan; Evirgen, Ömer; Irmak, Hasan; Demiröz, A. Pekcan
Amaç: Bu çalışmada akut lösemili hastalarda nötropenik ateşe neden olan etkenler belirlenerek, uygulanan tedavi protokolleri ve tedavi sonuçları tartışıldı. Yöntem: Bu amaçla Temmuz 1997 - Şubat 2002 tarihleri arasında Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Hematoloji Kliniğinde akut lösemi tanısı ile tedavi edilen 40 hastada (33 AML, 7 ALL) toplam 84 febril nötropenik atak prospektif ve retrospektif olarak değerlendirildi. Bulgular: Mikrobiyolojik tanı, 7'si bakteriyemili, 6'sı bakteriyemisiz olmak üzere 13 atakta (%15.4) kültür yöntemleri ile konuldu. Kan kültürlerinin 4'ünde gram pozitif, 3'ünda gram negatif bakteriler izole edildi. Gram pozitif bakterilerden en sık etkenin koagülaz-negatif stafilokoklar (4/13), gram negatif bakterilerden ise en sık etkenin Escherichia coli (4/13) olduğu görüldü. Ateş nedeni araştırıldığında; 40 atakta (%47.6) olası infeksiyon odağı klinik bulgulara dayanarak saptanırken, 31 atakta (%36.9) infeksiyon odağı saptanamadı. Başlangıç tedavisi olarak 44 (%52.4) atakta sefepim + amikasin, 25 (%29.8) atakta seftazidim+ amikasin, 15 (%17.8) atakta imipenem + amikasin kullanıldı. 37 atakta (%44) tedaviye vankomisin, llatakta (%13.1) teikoplanin, 11 atakta (%13.1) amfoterisin-B eklendi. Başlangıç tedavisine cevap oranları sırasıyla; %41, %40 ve %33.3 iken, modifiye tedavilere cevap oranları, sırasıyla %75, %72 ve %71.4 olarak gerçekleşti. Sonuç: Akut lösemili hastalarda gelişen nötropenik ateş ataklarında, uygun ampirik tedavi başlanması ve sonrasında yakın klinik takip ile uygun modifikasyonların yapılması, tedaviye cevabı büyük oranda arttırmaktadır.
Apparent Vaccine-Thimerosal Induced Hypersensitivity, Myelodysplastic Syndrome and Pancytopenia
(J infection developing Countries, 2007) Karsen, Hasan; Akdeniz, Hayrettin; Karahocagil, Mustafa K.; Baran, Ali I.; Erten, Remzi
A case of hypersensitivity reaction, myelodysplastic syndrome and pancytopenia, which developed after an administration of thimerosal-containing tetanus vaccine, is presented and discussed.
Avian Influenza a (H5n1) Infection in Eastern Turkey in 2006
(Massachusetts Medical Soc, 2006) Oner, Ahmet Faik; Bay, Ali; Arslan, Sukru; Akdeniz, Hayrettin; Sahin, Huseyin Avni; Cesur, Yasar; Ceyhan, Mehmet
Background: An outbreak of highly pathogenic avian influenza A (H5N1) that had previously been detected throughout Asia, with major economic and health repercussions, extended to eastern Turkey in late December 2005 and early January 2006. Methods: We documented the epidemiologic, clinical, and radiologic features of all cases of confirmed H5N1 virus infection in patients who were admitted to Yuzuncu Yil University Hospital in Van, Turkey, between December 31, 2005, and January 10, 2006. Results: H5N1 virus infection was diagnosed in eight patients. The patients were 5 to 15 years of age, and all eight had a history of close contact with diseased or dead chickens. The mean (+/- SD) time between exposure and the onset of illness was 5.0 +/- 1.3 days. All the patients had fever, and seven had clinical and radiologic evidence of pneumonia at presentation; four patients died. Results of enzyme-linked immunosorbent assay and rapid influenza tests were negative in all patients, and the diagnosis was made by means of a polymerase-chain-reaction assay. Conclusions: H5N1, which causes a spectrum of illnesses in humans, including severe and fatal respiratory disease, can be difficult to diagnose.
Bone Marrow Biopsy Findings in Brucellosis Patients With Hematologic Abnormalities
(Lippincott Williams & Wilkins, 2012) Demir, Cengiz; Karahocagil, Mustafa Kasim; Esen, Ramazan; Atmaca, Murat; Gonullu, Hayriye; Akdeniz, Hayrettin
Background Brucellosis can mimic various multisytem diseases, showing wide clinical polymorphism that frequently leads to misdiagnosis and treatment delay, further increasing the complication rates. In this study, we aimed to examine bone marrow biopsy findings in brucellosis cases presenting with hematologic abnormalities. Methods Forty-eight brucellosis cases were prospectively investigated. Complaints and physical examination findings of patients were recorded. Patients' complete blood count, routine biochemical tests, erythrocyte sedimentation rate, C-reactive protein and serological screenings were performed. Bone marrow biopsy and aspiration was performed in patients with cytopenia, for bone marrow examination and brucella culture, in accordance with the standard procedures from spina iliaca posterior superior region of pelvic bone. Results Of the 48 patients, 35 (73%) were female and 13 (27%) were male. Mean age was (34.8 15.4) years (age range: 15-70 years). Anemia, leukopenia, thrombocytopenia and pancytopenia were found in 39 (81%), 28 (58%), 22 (46%) and 10 patients (21%), respectively. In the examination of bone marrow, hypercellularity was found in 35 (73%) patients. Increased megacariocytic, erythroid and granulocytic series were found in 28 (58%), 15 (31%) and 5 (10%) patients, respectively. In addition, hemophagocytosis was observed in 15 (31%) patients, granuloma observed in 12 (25%) and increased eosinophil and plasma cells observed in 9 (19%) patients. Conclusion According to the results of our series, hemophagocytosis, microgranuloma formation and hypersplenism may be responsible for hematologic complications of brucellosis. Chin Med J 2012;125(11):1871-1876
A Brucellosis Case Presenting With Mass Formation Suggestive for Tumor in Soft Tissue
(Lippincott Williams & Wilkins, 2007) Karsen, Hasan; Akdeniz, Hayrettin; Irmak, Hasan; Buzgan, Turan; Karahocagil, M. Kasim; Kocak, Zeliha; Suennetcioglu, Mahmut
We report here a 70-year-old female patient who was diagnosed with brucellosis and presented with mass formation resembling a tumor. The mass was protuberant, 10 cut from the skin surface with a diameter of 15 cm, located at the inferior-lateral region of the left scapula. Brucella melitensis was yielded from culture of mass fluid. The patient responded to ceftriaxone, rifampin and doxycycline therapy and recovered without any sequela at the end of surgery and 3 months of medical treatment.
Brucellosis in Pregnancy: a 6-Year Clinical Analysis
(Springer Heidelberg, 2010) Kurdoglu, Mertihan; Adali, Ertan; Kurdoglu, Zehra; Karahocagil, Mustafa Kasim; Kolusari, Ali; Yildizhan, Recep; Akdeniz, Hayrettin
To review our experience with brucellosis in pregnancy and to characterize the risk factors, clinical presentations, the rates of possible perinatal complications, and the effect of hospitalization on pregnancy outcomes. We reviewed the medical records of 21 pregnant women at a tertiary care hospital and 12 at a maternity hospital, who presented with acute, subacute, chronic, or relapsing brucellosis. Their risk factors and clinical presentations were defined. The reproductive outcomes of 29 cases were compared within themselves according to the hospitals they were managed and with the outcomes for all women followed in the maternity hospital for the period from January 2008 through December 2008. Consumption of unpasteurized dairy products had occurred in 92.3% of the cases. Spontaneous abortion, intrauterine fetal death, and preterm delivery rates were 24.14, 3.45, and 6.9%, respectively. Only spontaneous abortion rate substantially exceeded that among the general population of pregnant women in our maternity hospital (P < 0.05). Hospitalization did not affect pregnancy outcomes significantly (P > 0.05). Brucellosis in pregnancy is associated with increased incidence of spontaneous abortion without an association with the magnitude of serum agglutination titer, the clinical type of brucellosis and hospitalization. In endemic areas with habitants of low socioeconomic class and low educational level, educating women of childbearing age about brucellosis may help to prevent the disease and its complications in pregnancy.
Bruselloz Olgularında Yüksek Ferritin Düzeyleri:3 Olgu Sunumu
(2007) Karahocagil, Mustafa Kasım; Akdeniz, Hayrettin; Dilek, İmdat; Efe, Servet
Bruselloz bir infeksiyon hastalığı olması nedeniyle, C-reaktif protein ve ferritin gibi akut faz reaktanlarını yükseltmektedir. Çalışmamızda; bruselloz tanısı konan ve çok yüksek ferritin değerleri olan 3 olgu sunuldu. Üçü de erkek olan olguların yaşları sırasıyla 17, 40 ve 45 idi. Her üç olgu da semptomatik olup brusella aglütinasyon titreleri 1/1280’in üzerindeydi. Olguların ferritin değerleri sırasıyla 1500 ng/mL, 893 ng/mL ve 816 ng/mL bulundu. Olgulardan ilk ikisi doksisiklin, streptomisin ve rifampisin, diğeri ise doksisiklin, gentamisin ve siprofloksasin ile tedavi edildi. Bruselloz tedavisi sonrası, klinik tablo düzeldi ve ferritin düzeyleri normal sınırlara geriledi. Sonu olarak, bu üç olgu bruselloz hastalarında ferritinin çok yüksek düzeylere çıkabileceğini göstermektedir.
A Case of Brucellosis Presenting as High Titer Negative Result by Standard Tube Agglutination Test
(Ankara Microbiology Soc, 2007) Buzgan, Turan; Karsen, Hasan; Karahocagil, M. Kasim; Akdeniz, Hayrettin; Sunnetcioglu, Mahmut
Since prozone is a well known phenomenon in the serologic diagnosis of Brucella infections, it is necessary to prepare higher serum dilutions in the standard tube agglutination (STA) test for the brucellosis suspected patients. However, due to limited economical support, the serum dilutions generally last at 1/320-1/640 titers in some laboratories in Turkey. In this report, a brucellosis case whose STA test was found negative until the titer of 1/1280, has been presented. A 36-year-old female was admitted to our hospital with the complaints of fever, sweating, fatigue, generalized arthralgia and weight loss, lasting for 45 days. Hepatosplenomegaly was detected in the physical examination, and laboratory tests yielded anemia, leucopenia, elevated erythrocyte sedimentation rate and high C-reactive protein levels. Although brucellosis was suspected, Brucella STA test was found negative at 1/640 titer. On the sixth day of admission, Brucella melitensis was isolated from her blood culture. Since a positive result at 1/40 titer was detected in Brucella STA test with the use of Coombs antiserum, the patient's serum was retested at higher dilutions than 1/640, and positive result was obtained starting from 1/1280 dilution and extended to 1/5120 titer. The patient was treated with rifampin and doxycyline and discharged with complete cure. In conclusion, in countries endemic for brucellosis, STA test should be performed at 1/1280 or higher titrations in suspected patients especially in the presence of negative culture results, for the prevention of false negative results due to prozone phenomenon.
A Case of Neurobrucellosis With Coma
(Aves, 2006) Ersoz-Arat, Muret; Karsen, Hasan; Bakirci, Ayegul; Akdeniz, Hayrettin
A case of neurobrucellosis with coma. A case of brucellosis with coma, focal epileptic seizure, encephalopathy, depression, parkinsonism and pancreatic involvement is presented. The 25-year-old male patient was succesfully treated with rifampin, doxycycline and ceftriaxone.
A Case of Typhoid Fever Presenting With Multiple Complications
(Modestum Ltd, 2007) Buzgan, Turan; Evirgen, Omer; Irmak, Hasan; Karsen, Hasan; Akdeniz, Hayrettin
An 18-year old female patient was admitted to the Emergency Department with complaints of fever and fatigue beginning 15 days ago associated with headache, weakness, palpitation, abdominal pain, and diarrhea a week later. The patient who apathic confused and discordant was transferred to the Department of Infectious Diseases. There was also hypocalcemia, hypopotassemia, pancytopenia, intestinal hemorrhage, and hepatic involvement. S. typhi was grown in the blood culture. The patient was discharged with full recovery after ciprofloxacin treatment in addition to electrolyte replacement. Typhoid fever is a widespread infectious disease in our country and should be taken into consideration in differential diagnosis of many diseases because it may involve a number of systems and may present with a variety of complications.
Cerebrospinal Fluid Leukocyte, Protein, Ferritin and CRP Levels Determination in Meningitis.
(2007) Bakırcı, Ayşegül; Akdeniz, Hayrettin
Menenjitli Hastalarda Beyin Omurilik Sıvısındaki Beyaz Küre Sayısı, Protein, Ferritin ve CRP Düzeylerinin Belirlenmesi Vücutta büyük yıkımlara yol açan bakteriyel menenjit gibi hastalıklarda mortalite ve morbiditeyi en aza indirmek için erken tanı ve uygun tedavinin büyük önemi vardır. Menenjitlerin tanısı için birçok yöntemler gelitirilmitir. Semptom ve klinik bulgular tanıda önemli olmakla birlikte beyin omurilik sıvısının rutin biyokimyasal ve mikrobiyolojik tetkikleri tanıyı koydurabilir. Ancak bazen beyin omurilik sıvısının rutin tetkikleri tanı için yeterli olmayabilir. O halde erken ve uygun bir tedaviye balamada mikrobiyolojik sonuçları beklemeden hekime yol gösterebilecek; erken tanıda daha çabuk ve güvenilir laboratuvar yöntemlerinin gelitirilmesinin gereklilii ortaya çıkmaktadır. Bu yöntemler arasında beyin omurilik sıvısı C-reaktif protein ve ferritin ölçümü sayılabilir. Bakteriyel infeksiyonlarda beyin omurilik sıvısı C-reaktif protein artıının saptanması, erken tanıda güvenilir ve pratik bir metot olarak gösterilmitir. nflamasyona uramı meninkslerden, pasif difüzyon eklinde serumdan beyin omurilik sıvısına geçen C-reaktif proteinin tesbiti, menenjitin bakteriyel kaynaklı olduunun göstergesidir. Günümüzde akut faz cevap çalımalarında ferritin de önemli bir marker olarak göze çarpmaktadır. Son çalımalarda, infeksiyon hastalıklarının seyri esnasında ferritinin serum ve dier vücut sıvılarındaki miktarının önemi belirtilmitir. Özellikle menenjitin erken tanısında beyin omurilik sıvısında ölçülen ferritin düzeyinin faydalı olabilecei bildirilmektedir.
Clinical Manifestations and Complications in 1028 Cases of Brucellosis: a Retrospective Evaluation and Review of the Literature
(Elsevier Sci Ltd, 2010) Buzgan, Turan; Karahocagil, Mustafa Kasim; Irmak, Hasan; Baran, Ali Irfan; Karsen, Hasan; Evirgen, Omer; Akdeniz, Hayrettin
Introduction: Brucellosis is the most prevalent bacterial zoonosis worldwide. In this study, we aimed to compare our 1028 brucellosis cases with other big series in the literature in view of epidemiological, clinical, and laboratory findings and therapeutic features. Methods: A total of 1028 brucellosis cases admitted to the Department of Infectious Diseases and Clinical Microbiology over a 10-year period were included in the study. A retrospective analysis was undertaken and patient files were reviewed for history, clinical and laboratory findings, and therapeutic features, as well as complications. Results: Of the 1028 patients, 539 (52.4%) were female and 489 (47.6%) were male. The mean age of patients was 33.7 +/- 16.34 years and 69.6% of cases were aged 13-44 years. Four hundred and thirty-five cases (42.3%) had a history of raising livestock and 55.2% of the cases were found to have no occupational risk for brucellosis. Six hundred and fifty-four of the cases (63.6%) had a history of raw milk and dairy products consumption. The most frequently seen symptoms were arthralgia (73.7%) and fever (72.2%), while the most common clinical findings were fever (28.8%) and hepatomegaly (20.6%). The most frequent laboratory finding was a high C-reactive protein level (58.4%). The standard tube agglutination (STA) test + Coombs STA test was positive in 1016 cases (98.8%). Focal involvement was present in 371 (36.1%) cases. The most frequent involvement was osteoarticular involvement with 260 cases (25.3%). The overall relapse rate for patients with brucellosis was 4.7%. The highest relapse rate, 8.5%, was observed in the group of patients with osteoarticular involvement. Regimens including doxycycline and streptomycin with or without rifampin appeared more effective than other regimens in osteoarticular involvement. Conclusions: In humans, brucellosis may lead to serious morbidity, and it continues to be a major health problem in Turkey. There is no recommended treatment protocol for complicated brucellosis. Large multicenter studies are needed to determine the most appropriate treatment choices and durations in complicated brucellosis. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Comparison of Intramuscular and Intradermal Applications of Hepatitis B Vaccine in Hemodialysis Patients
(Taylor & Francis inc, 2006) Karahocagil, M. Kasim; Buzgan, Turan; Irmak, Hasan; Karsen, Hasan; Akdeniz, Hayrettin; Akman, Nevzat
This study compared the application of intramuscular recombinant hepatitis B vaccine in hemodialysis patients with the application of accelerated intradermal recombinant hepatitis B vaccine, which can be applied with one-tenth of the standard dose. Sixty seronegative patients for hepatitis B were randomly separated into two groups. Twenty mu g of the recombinant hepatitis B vaccine was intramuscularly applied at 0-, 1-, 2-, and 6-month intervals to the first group (32 cases). One more dose was applied at month 12 to those whose anti-HBs titers remained below 100 mIU/mL at month 7. The same vaccine was intradermally applied at 2 mu g dose six times with one-month intervals to the second group (28 cases). Vaccine applications were continued in those whose anti-HBs titers remained below 100 mIU/mL at month 7 until antibody titers reached above this value or until the dose number became 12. Measurements of antibody titers were repeated at month 13 in both groups. As a result, in the vaccination of hemodialysis patients against hepatitis B, the accelerated ID application of hepatitis B vaccine with a dose reduced to one-tenth is more cost-effective than the standard dose vaccination schedules. Especially for hemodialysis patients, the time has come for routine application of ID hepatitis B vaccine as an alternative vaccination method.
Cutaneous Anthrax Resulting in Renal Failure With Generalized Tissue Damage
(Taylor & Francis Ltd, 2013) Akdeniz, Necmettin; Calka, Omer; Ozkol, Hatice Uce; Akdeniz, Hayrettin
Anthrax is a zoonotic infection caused by Bacillus anthracis which can be clinically present in a cutaneous, gastrointestinal or inhalational form depending on the entry site of the agent. The most frequent clinical type with the mildest clinical course is cutaneous anthrax. In this report, a patient with cutaneous anthrax which begins at the dorsal hand and progresses up to the proximal forearm resulting in massive tissue damage is presented. Prerenal azotemia developed due to massive tissue damage and patient was sent to hemodialysis twice.
The Effect of Brucellosis on Women's Health and Reproduction
(Aras Part Medical int Press, 2015) Kurdoglu, Mertihan; Cetin, Orkun; Kurdoglu, Zehra; Akdeniz, Hayrettin
Due to its potential harmful effects on the general health and reproductive life of the women, in the light of available literature, it was aimed to review the effect of human brucellosis on women's health and reproduction. Data from 75 reports belonging to the years 1917 through 2015, obtained via a search on various internet sources by the words "Brucella", "brucellosis," "women's health," "human pregnancy," "human reproduction," "abortion," "preterm birth," "intrauterine fetal demise," and "intrauterine fetal death" were used to characterize basic microbiological features together with the risk factors, clinical presentations and complications of the human brucellosis related to various aspects of reproductive well-being. A high rate of spontaneous abortion was a more consistent finding rather than high rates of preterm delivery and intrauterine fetal death in pregnant women with brucellosis. The occurrence of abortion was not associated with the magnitude of serum agglutination titre or the clinical type of disease. The novel replication profiles of Brucella in human trophoblasts give insights into the pathogenesis of infectious abortion. Brucellosis is a risk factor for women's general health and reproduction as well as for many obstetric complications during pregnancy, of which spontaneous abortion is the mostly known. In order to prevent the disease and these complications, education of the women, especially the poor ones of childbearing age with low educational level is strongly advised. When the infected women present for medical care, an appropriate antimicrobial therapy should be started promptly.
Evaluation of Nosocomial Infections.and Antibiotic Resistance Profiles in the Anesthesiology Intensive Care Unit
(Galenos Yayincilik, 2010) Goktas, Ugur; Yaman, Gorkem; Karahocagil, Mustafa Kasim; Bilici, Adnan; Kati, Ismail; Berktas, Mustafa; Akdeniz, Hayrettin
Objective: We aimed to determine the etiological agents of nosocomial infections and susceptibility patterns in our intensive care unit (ICU). Materials and methods: The study included 341 patients (mean age 47.8-122.7 years) who were admitted to our ICU longer than 72 hours between May 2007 and July 2008. All the patients were followed-up daily together with infectious disease specialists. Nosocomial infections were defined according to the CDC criteria (Centers for Disease Control and Prevention). Blood cultures and cultures from infectious foci were taken from patients who were thought to have a nosocomial infection. Results: A total of 141 episodes of nosocomial infection developed in 57 patients (16.7%), including ventilator-associated pneumonia (74 episodes, 52.5%), primary bacteremia (n=49, 34.8%), urinary system infections (n=15, 10.6%), and surgical site infections (n=3, 2.1%). Isolated bacteria were as follows: S. aureus (22%), P. aeruginosa (15.6%), Acinetobacter spp. (14.2%), E. coli (14.2%), Klebsiella spp (11.4%), coagulase-negative staphylococcus (CNS) (7.8%), Enterococcus spp. (5%), Enterobacter spp. (4.3%), S. pneumoniae (2.8%), and S. maltophilia (2.1%). Resistance rates to oxacillin were 90.3% in S. aureus and 81.8% in CNS isolates. In Enterococcus spp., resistance to ampicillin was 71.4%, high-level aminoglycoside resistance was 85.7%, with no resistance to vancomycin. Extended-spectrum beta-lactamase-positive strains accounted for 70% for E. coil and 93.7% for Klebsiella species. Conclusion: Monitoring of nosocomial infections and infectious agents together with resistance rates in the ICU has great importance in both the prevention of infections and rational antibiotic use.
Hematological Complications in 787 Cases of Acute Brucellosis in Eastern Turkey
(Tubitak Scientific & Technological Research Council Turkey, 2008) Dilek, Imdat; Durmus, Ahmet; Karahocagil, M. Kasim; Akdeniz, Hayrettin; Karsen, Hasan; Baran, Ali Irfan; Evirgen, Oemer
Aim: In this paper, we present the hematological findings of 787 cases diagnosed with acute brucellosis. Materials and Methods: Records of the cases seen between 1994 and 2006 were retrospectively investigated regarding hematological changes. Results: Three hundred sixty-five (46%) patients were male and 422 (54%) were female. Mean age was 32 (range: 11-78 years). Mean hematological values were as follows: Hb 12 g/dl (4-19), Htc 36% (12-56), leukocyte 6.9 x 10(9)/L. (0.5-25) and platelets 213 x 10(9)/L (9-617). According to differential counts, 34% and 14% of patients had mononuclear cell and neutrophil dominance, respectively. Fifty-six percent of patients were found to have anemia, alone or in combination with leukopenia or thrombocytopenia. Fourteen percent of patients had thrombocytopenia, 12% leukopenia, 5% pancytopenia, 4% leukopenia + thrombocytopenia, 0.5% acute hemolysis, and 0.1% disseminated intravascular coagulation. Restoration of thrombocytopenia and leukopenia and improvement in clinical situation were seen within one week and recovery of anemia occurred within 3-4 weeks. Conclusions: Hematological complications such as anemia and leukopenia are more frequently seen in acute brucellosis cases. However, acute brucellosis should also be considered in the differential diagnosis in the presence of other hematological abnormalities such as severe thrombocytopenia, pancytopenia, acute hemolytic anemia, and disseminated intravascular coagulation.
Hepatit B İmmünizasyonunda Düşük Doz İntradermal ve Subkutan Aşı ile Klasik İntramüsküler Aşı Uygulama Sonuçlarının Karşılaştırılması
(2006) Karsen, Hasan; Karahocagil, Mustafa Kasım; Akdeniz, Hayrettin
Amaç: Klasik 20 µg hepatit B aşısının İM uygulanmasına göre sırasıyla 1/10 ve 1/4 oranında düşük doz ve maliyetle uygulanabilen alternatif intradermal (İD) ve subkutan (SK) aşı uygulama yöntemlerinin, yeterli koruyucu antikor titresi oluşturup oluşturmadığının araştırılmasıdır. Yöntem: Sağlık personeli, öğrenci ve risk gruplarından oluşan, 3 doz aşı sonrası (3. ay) antikor ölçümü yapılan 597 kişi çalışmaya alındı. 4 doz aşı sonrası (13. ay) antikor ölçümü yapılan 483 kişi çalışmayı tamamladı. İM gruba 20 µg, İD gruba 2 µg, SK gruba 5 µg rekombinant hepatit B aşısı (Euvax B) 0, 1, 2 ve 12. aylarda uygulandı. 3, ve 13. aylarda antikor ölçümleri yapıldı. Bulgular: 3. ayda koruyucu antikor (Seroproteksiyon-Sp) geliştirme oranları; İM, İD ve SK gruplar için sırasıyla %96.6, %91.9, %88.2 iken, 13. ay Sp oranları; %98.8, %95.6, %92.5 bulundu. Yan etki açısından en emin uygulama yolu SK yol olarak görünürken, en fazla lokal yan etki İD grupta, en fazla sistemik yan etki İM grupta görüldü. Yan etkilerin hiç biri aşılamayı kesmeyi gerektirmedi. Sonuç: İD hepatit B aşı uygulama yolu, klasik İM aşı uygulama yoluna alternatif ve aşı maliyetini 9/10 oranında azaltan etkili bir yöntem olup; SK yol ise uygulama kolaylığı nedeniyle, aşı maliyetini İM aşı uygulama yoluna göre 3/4 oranında azaltan etkili bir yöntem olarak gözükmektedir.