Browsing by Author "Yaman, Gorkem"

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An Analysis on the Roles of Angiogenesis-Related Factors Including Serum Vitamin D, Soluble Endoglin (Seng), Soluble Fms-Like Tyrosine Kinase 1 (Sflt1), and Vascular Endothelial Growth Factor (Vegf) in the Diagnosis and Severity of Late-Onset Preeclampsia
(Taylor & Francis Ltd, 2017) Cim, Numan; Kurdoglu, Mertihan; Ege, Serhat; Yoruk, Ibrahim; Yaman, Gorkem; Yildizhan, Recep
Aim: The aim of this study was to evaluate the roles of proangiogenic factors including serum vitamin D and vascular endothelial growth factor (VEGF) and anti-angiogenic factors including soluble endoglin (sEng) and soluble fms-like tyrosine kinase 1 (sFlt1) in the diagnosis and severity of late-onset preeclampsia. Materials and methods: The study was conducted at Yuzuncu Yil University Research and Education Hospital Department of Gynecology and Obstetrics. The study included a patient group of 40 women with late-onset preeclampsia who were pregnant at >= 32 weeks of gestation according to the last menstrual period (LMP) or ultrasonographic fetal biometric measurement and a control group of 40 healthy pregnant women who presented to our clinic for routine pregnancy examination and were at the same age and gestational period with those in the patient group. The two groups were compared in terms of maternal age, gravida, parity, week of gestation, systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, white blood cell (WBC), hemoglobin (Hgb), platelet count, urea, creatinine, liver function tests (AST, ALT, LDH), vitamin D-3, 25(OH) vitamin D-3, 1,25(OH) vitamin D-3, sEng, sFlt1, and VEGF levels, mode of delivery, the infant APGAR score at 1 and 5 min after delivery, and infant weight at delivery. Results: The groups were similar in terms of age, gravida, parity, week of gestation, serum vitamin D-3, 25(OH) vitamin D-3, 1,25(OH)(2) vitamin D-3 and VEGF levels, and infant weight at delivery (p > 0.05). Systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, WBC, Hgb, serum urea, creatine, AST, ALT, and LDH were significantly higher in the preeclamptic group compared to the healthy group (p < 0.05). However, thrombocyte level and the APGAR score at 1 and 5 min after delivery were significantly lower in the preeclamptic group compared to the healthy group (p < 0.05). No significant correlation was found between serum sEng, sFlt1, VEGF, vitamin D-3, 25(OH) vitamin D-3, and 1,25(OH)(2) vitamin D-3 levels. The sEng level was higher in the women with severe preeclampsia compared to the women with mild preeclampsia (p < 0.05) and no significant difference was observed in serum sFlt1, VEGF, vitamin D-3, 25(OH) vitamin D-3, and 1,25(OH)(2) vitamin D-3 levels between the subgroups of preeclampsia (p > 0.05). Conclusion: Both sEng and sFlt1 levels are remarkably high in patients with late-onset preeclampsia; however, only sEng may be a useful tool in the determination of the severity of preeclampsia.
Assessment of Directigen™ Ez Flu a Plus B Rapid Antigen Diagnostic Test for Pandemic Influenza a (H1n1)
(Ortadogu Ad Pres & Publ Co, 2011) Berktas, Mustafa; Cikman, Aytekin; Yaman, Gorkem; Guducuoglu, Huseyin
Objective: Pandemic influenza A (H1N1) cases that has begun to be seen in Southern hemisphere at the beginning of summer 2009 is gradually increasing also in Northern hemisphere nowadays, at the beginning of winter. A few diagnostic tests have been developed for diagnosis of this viral disease that is difficultly detected due to its novel antigenic structure. Although sensitivity and specifity of these molecular tests are high, they may not commonly be used as they are expensive. Rapid tests that have been developed alternatively to these tests are criticized because of their low sensitivity although they are cheap. In this study, effectiveness of Directigen EZ Flu A+B test, one of the rapid tests, was investigated for diagnosis of pandemic influenza A (H1N1). Material and Methods: In the study, nasopharyngeal and pharyngeal smears concurrently obtained from 52 patients who were admitted to our hospital with suspicion of pandemic influenza were examined using Infl/H1 LC/RG Real Time-PCR test (Kit, Qiagen, Rotor-gene Q Japan) together with rapid Directigen EZ Flu A+B antigen test (Becton Dickinson, USA). Results: Positivity was detected with Directigen TM EZ Flu A+B in 17 (33%) out of 52 patients included in the study and in 35 (67%) with RT-PCR. Influenza A was detected to be positive with rapid diagnostic test in 17 (49%) of 35 patients in whom H1N1 was detected to be positive with PCR and rapid test results were negative for all patients whose results were negative with PCR. Sensitivity of Directigen TM EZ Flu A+B test for H1N1 was found as 49% and specifity was found as 100%. Conclusion: According to these results, we may conclude that Directigen TM EZ Flu A+B may be used as a screening and prediagnosis test for diagnosis of pandemic influenza A (H1N1). Although positive results are diagnostic, negative results should be confirmed with molecular microbiologic methods.
Evaluation of Hbv-Dna in Patients With Different Serologic Markers
(Galenos Yayincilik, 2005) Guducuoglu, Huseyin; Bozkurt, Hamza; Yaman, Gorkem; Kutluay, Nihat; Berktas, Mustafa
In this study, patients infected with HBV with uncharacteristic serologic markers were interpreted and their probable clinical stages were determined. With this purpose, 75 patients were evaluated for HBV-DNA and hepatitis serologic markers. HBV-DNA results were obtained using bDNA-Bayer kits and serologic markers were detected using microparticle enzyme immunoassay (MEIA) kits. From 75 patients, 54 (72%) were HBV-DNA positive, and 35 (64.8%) of them were HBeAg positive. From 21 (28%) patients who are HBV-DNA negative, only 1 (4.8%) patient was HBeAg positive. HBsAg, HBeAg, anti-HBe, anti-HBc IgM and anti-HBc IgG of 46 patients were compared with HBV-DNA results simultaneously and 31 (67.4%) patients were HBV-DNA positive and HBsAg, HBeAg, anti-HBe, anti-HBc IgM, anti-HBc IgG results were positive in 29 (63%), 22 (48%), 7 (15%), 1 (2%), and 29 (63%) patients respectively. In 15 (33%) patients with negative HBV-DNA results, HBsAg in 14 (30%), HBeAg in 1 (2%), anti-HBe in 13 (28%), anti-HBc IgG in 14 (30%) were positive, and none of them were positive for anti-HBc IgM.
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.
Evaluation of Pandemic Influenza a (H1n1) Cases in Van Region
(Nobel Ilac, 2014) Cikman, Aytekin; Berktas, Mustafa; Parlak, Mehmet; Bayram, Yasemin; Yaman, Gorkem
Objective: Influenza viruses have retained their importance throughout history by creating pandemics since the segmental structure of the RNA undergo frequent genetic changes. The purpose of this study was to investigate the pandemic influenza A (H1N1) cases detected our region. Material and Method: Totally 570 patients were registered with pre-diagnosis of Pandemic Influenza A (H1N1) infection in five different hospitals located in Van region between 15 October 2009 - 15 January 2010. After nasopharyngeal/throat swab samples were taken from patients, they were sent to Refik Saydam Hygiene Center (RSHC) in accordance with the rules of biosafety, and specimens were investigated for Pandemic Influenza A(H1N1) 2009 by using Real-Time PCR method. Results: Pandemic Influenza A (HI NI) was determined by RSHC as positive for 220 patients. 36 of these patients were in intensive care conditions, 85 were hospitalized and 16 passed away. 109 patients, who were diagnosed with Pandemic Influenza A (H1N1), were within range of 6-25 years. All patients in this age range were treated and discharged. The most common symptoms of patients who were hospitalized were defined as cough and fever In these patients, the most common risk factors were as follows; being <5 years, having the cardiovascular disease, using immunosuppressive drugs and having lung disease. Conclusion: Pandemic influenza A (H1N1) infections are more frequent in young adults and patients without risk factor, unlike seasonal flu. When examining its effect on the society, Pandemic Influenza A (H1N1) 2009 constitutes a good opportunity in terms of preparation of inevitable struggling with pandemics in the future.
In Vitro Effects of Sulbactam Combinations With Different Antibiotic Groups Against Clinical Acinetobacter Baumannii Isolates
(Maney Publishing, 2012) Deveci, Aydin; Coban, Ahmet Yilmaz; Acicbe, Ozlem; Tanyel, Esra; Yaman, Gorkem; Durupinar, Belma
Treatment of multidrug resistant (MDR) Acinetobacter baumannii infections causes some problems as a result of possessing various antibacterial resistance mechanisms against available antibiotics. Combination of antibiotics, acting by different mechanisms, is used for the treatment of MDR bacterial infections. It is an important factor to determine synergy or antagonism between agents in the combination for the constitution of effective therapy. The study aimed to determine in vitro interactions interpreted according to calculated fractional inhibitory concentration (FIC) index between sulbactam and ceftazidime, ceftriaxone, cefepime, ciprofloxacin, gentamicin, meropenem, tigecycline, and colistin. Ten clinical isolates of A. baumannii were tested for determination of synergistic effects of sulbactam with different antimicrobial combinations. Minimal inhibitory concentration (MIC) values of both sulbactam and combined antibiotics decreased 2- to 128-fold. Synergy and partial synergy were determined in combination of sulbactam with ceftazidime and gentamicin (FIC index: <= 0.5 or >0.5 to <1) and MIC values of both ceftazidime and gentamicin for five isolates fell down below the susceptibility break point. Similarly, MIC value of ciprofloxacin for six ciprofloxacin resistant isolates was determined as below the susceptibility break point in combination. However, all isolates were susceptible to colistin and tigecycline, MIC values of both were decreased in combination with sulbactam. Although synergistic and partial synergistic effects were observed in the combination of sulbactam and ceftriaxone, all isolates remained resistant to ceftriaxone. The effect of cefepime-sulbactam combination was synergy in five, partial synergy in one and indifferent in four isolates. Meropenem and sulbactam showed a partial synergistic effect (FIC index: >0.5 to <1) in three, an additive effect (FIC index: 1) in one and an indifferent effect (FIC index: >1-2) in six isolates. Antagonism was not determined in any combination for clinical A. baumannii isolates in the study. In conclusion, sulbactam is a good candidate for combination treatment regimes for MDR A. baumannii infections.
Mycobacterium Tuberculosis Strains Isolated From Van Region Four Different Sensitivity Detection Method Antimycobacterial Agents
(Turkish Assoc Tuberculosis & Thorax, 2014) Baykal, Elif Sanem; Guducuoglu, Huseyin; Yaman, Gorkem; Berktas, Mustafa
Introduction: The purpose of this study is detecting the susceptibility rates of 58 Mycobacterium tuberculosis complex strains which were isolated from patient specimens sent to our mycobacteriology laboratory, for major anti-tuberculosis drugs like streptomycin, isoniazid, rifampicin and ethambutol with three different systems and agar proportion method and compare the accessibility, speed, specificity and sensitivity of these three systems. Materials and Methods: With this purpose, 58 (96.6%) strains out of 60 which were isolated from the patients attended to the mycobacteriology laboratory were identified as M. tuberculosis complex with conventional methods. These strains susceptibilities to four major anti-tuberculosis drugs were detected with Manuel MGIT AST SIRE system, BacT/ALERT 3D system MB/BacT SIRE, TK anti-TB system and compared with reference method in Middlebrook 7H10 media. Results: As a result, INH resistance in Van province with agar proportion method was detected as 12%, followed by INH + RIF resistance of 1.7% and INH + SM resistance of 1.7%. These result compared with other studies conducted country wide are in median range. The systems included in our study were determined to have 100% sensitivity for all of the drugs for detecting resistance and sensitivity rates. Specificities for INH for TK anti-TB, MGIT and MB/BacT were detected as 98%, 96% and 95% respectively. Multidrug resistance rates were detected in 100% sensitivity and specificity with all of the three systems. Only MB/BacT system gave a false negative RIF resistance for 1 strain. Fastest system according to resistance determination times is found to be the MGIT system. Conclusion: However, presence of INH + RIF resistance pattern, indicates inadequate treatment programs in our region. As a result these three systems are fast and reliable systems for antimicrobial susceptibility testing of Mycobacterium spp. to be used in routine mycobacteriology laboratories.
Prevalence of Hdv-Rna in Hbv-Dna Positive Patients
(Galenos Yayincilik, 2012) Berktas, Mustafa; Parlak, Mehmet; Cikman, Aytekin; Yuce, Metin; Yaman, Gorkem
Objective: Hepatitis D virus (HDV) requires Hepatitis B virus(HBV) for replication and may cause to severe acute and chronic hepatitis. HDV is more frequently detected in our region In this study, HDV-RNA frequency was investigated in HBVDNA-positive acute hepatitis B, chronic hepatitis B and HBsAg carriers. Materials and Methods: Results of 145 serum samples were examined for HDVRNA that was detected as HBV-DNA positive in our laboratory from September 2009 to June 2010. After isolation in serum samples using magnetic particle isolation technology (Easy One), the HBV-DNA (HBV Rotor Gene PCR Kit, Qiagen((R)), Hilden) and HDV-RNA (Primer Design, UK) were examined. Results: From a total of 145 patients with HBV-DNA positive serum samples, HDVRNA positivity was found in 15 (10.3%). Conclusion: Ratio that was obtained as 10.3% in this study is compatible with the data obtained from previously studies. Considering the presence of HBV DNA negative, delta IgG positive and HDV RNA negative cases with chronic Hepatitis D, it should be addressed that the given rate would further rise. Routine HDV screening in patients presenting with findings of acute or chronic liver diseases, implementation of appropriate isolation precautions for HBV and community-wide vaccination against HBV are crucial to combat with HDV infection.
Seroprevalence of Coxiella Burnetii Antibodies in High Risk Groups in Eastern Turkey
(Ortadogu Ad Pres & Publ Co, 2011) Berktas, Mustafa; Ceylan, Ebubekir; Yaman, Gorkem; Ciftci, I. Hakki
Objective: The objective of this study is to estimate and evaluate the prevalence of antibodies of Coxiella burner]] (C. burned]) in people considered to be at risk; such as farmers, slaughterhouse-workers and butchers in Eastern region of Turkey. The number of relevant studies concerning the subject is inadequate especially in our region. Material and Methods: Five hundred fifty two serum samples were collected from the people considered to be at risk of contacting with C. burned], such as farmers, abattoir workers and butchers in four cities and their 14 districts in the Eastern Turkey. Serum samples were centrifuged and stored at -20 degrees C. The serum samples were tested with an ELISA kit to detect IgG antibodies against C. burnetii phase II antigen in order to determine the prevalence of Qfever. Results: The mean seropositivity rate across the region was detected as 36.6%. Among different high risk professions, the highest prevalence rates were detected in abattoir workers (65.9%), followed by butchers (42.9%), and farmers (32.8%). The prevalence rates among butchers were detected as 63.2% in Bitlis, 39.1% in Van and 25% in Mu. Among farmers, the prevalence rates were 36.6% in Bitlis, 34% in Van, and 18.2% in Mus. Conclusion: Significantly high seropositivity rates among the people with high risk professions in the Eastern Anatolia is reported for the first time in this study. It is essential to identify the reservoirs in order to diagnose C. burner]] infection correctly. It is essential to take the necessary control and prevention precautions in high-risk occupations due to high seropositivity rates determined in this study.
Vanc Gene-Related Intrinsic Teicoplanin Resistance Detected in Enterococcus Casseliflavus and E-Gallinarum Strains by the Bd Phoenix Automated Microbiology System
(Amer Soc Microbiology, 2008) Berktas, Mustafa; Yaman, Gorkem; Ozturk, Oznur