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    Adjunctive Hyperbaric Oxygen Therapy or Alone Antibiotherapy? Methicillin Resistant Staphylococcus aureus Mediastinitis in a Rat Model
    (Soc Brasil Cirurgia Cardiovasc, 2015) Kurt, Tolga; Vural, Ahmet; Temiz, Ahmet; Ozbudak, Ersan; Yener, Ali Umit; Sacar, Suzan; Sacar, Mustafa
    Objective: In the post-sternotomy mediastinitis patients, Staphylococcus aureus is the pathogenic microorganism encountered most often. In our study, we aimed to determine the efficacy of antibiotic treatment with vancomycin and tigecycline, alone or in combination with hyperbaric oxygen treatment, on bacterial elimination in experimental S. aureus mediastinitis. Methods: Forty-nine adult female Wistar rats were used. They were randomly divided into seven groups, as follows: non-contaminated, contaminated control, vancomycin, tigecycline, hyperbaric oxygen, hyperbaric oxygen + vancomycin and hyperbaric oxygen + tigecycline. The vancomycin rat group received 10 mg/kg/day of vancomycin twice a day through intramuscular injection. The tigecycline group rats received 7 mg/kg/day of tigecycline twice a day through intraperitoneal injection. The hyperbaric oxygen group underwent 90 min sessions of 100% oxygen at 2.5 atm pressure. Treatment continued for 7 days. Twelve hours after the end of treatment, tissue samples were obtained from the upper part of the sternum for bacterial count assessment. Results: When the quantitative bacterial counts of the untreated contaminated group were compared with those of the treated groups, a significant decrease was observed. However, comparing the antibiotic groups with the same antibiotic combined with hyperbaric oxygen, there was a significant reduction in microorganisms identified (P<0.05). Comparing hyperbaric oxygen used alone with the vancomycin and tigecycline groups, it was seen that the effect was not significant (P<0.05). Conclusion: We believe that the combination of hyperbaric oxygen with antibiotics had a significant effect on mediastinitis resulting from methicillin-resistant Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus mediastinitis can be treated without requiring a multidrug combination, thereby reducing the medication dose and concomitantly decreasing the side effects.
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    Are Fetuin-A levels beneficial for estimating timing of sepsis occurrence?
    (Saudi Med J, 2018) Altinisik, Hatice B.; Altinisik, Ugur; Uysal, Sema; Sacar, Suzan; Simsek, Tuncer; Demiraran, Yavuz
    Objectives: To evaluated Fetuin-A levels of patients admitted in the intensive care unit with a diagnosis of sepsis. Methods: This study was conducted at the Faculty of Medicine, Canakkale Onsekiz Mart University Hospital, Canakkal, Turkey, between February 2015 and October 2015. Forty septic patients were included in the study. Subsequent to clinical suspicion of sepsis, serum levels of C-reactive protein (CRP) and procalcitonin; and white blood cell (WBC) counts were evaluated at 3 time-points: 0 (basal), 24, and 72 hours. Results: The mean Fetuin-A levels at the 3 time-points were 58.5 +/- 29.2 ng/mL, 40.9 +/- 23.6 ng/mL, and 47.8 +/- 25.7 ng/mL, respectively. Fetuin-A levels at 24 hours were significantly lower than the basal level (p<0.05), where as no significant difference was observed between the basal levels and those at 72 hours (p>0.05). Correlation between the temporal changes in Fetuin-A levels and the changes in other inflammatory markers (CRP, procalcitonin and WBC) was examined. Fetuin A was found to have only a negative correlation with serum procalcitonin level (p<0.05). Conclusion: In this study, serum Fetuin-A levels in septic patients decreased significantly in the first 24 hours, followed by an insignificant increase at 72 hours. These findings suggest that monitoring of Fetuin-A levels may help predict the time of occurrence of sepsis and prognosis of sepsis.
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    Cutaneous Leishmaniasis Cases in Nizip, Turkey After the Syrian Civil War
    (Ankara Microbiology Soc, 2014) Salman, Ismail Serkan; Vural, Ahmet; Unver, Ahmet; Sacar, Suzan
    Cutaneous leishmaniasis (CL), seen endemically in many countries, is a widespread protozoon disease all around the world. The neighboring countries of Turkey namely Iran, Iraq and Syria are highly endemic regions for CL, and more than 98% of the cases in Turkey are reported from South and Southeastern Anatolian regions. The aim of this study was to detect the prevalence of CL in Nizip, a district of Gaziantep province of southeastern Turkey, for three and half year period and to call attention to the dramatic increase of CL cases observed after the Syrian civil war. A total of 416 samples obtained from clinically suspected CL patients (of them 341 were Syrian refugees) who were admitted to Nizip State Hospital between January 1(st) 2010 and March 19(th) 2013 were included in the study. Lesion samples were collected according to the notice issued by Turkish Ministry of Health and Giemsa-stained smears were examined under the microscope (x1000). Samples from 77 patients (18.5%) yielded positive results with the observation of Leishmania amastigote forms. Fourty-seven (61%) of patients were female and 30 (39%) were male. Of the positive patients 52 (67.5%) belonged to 0-19 age group, 13 (16.9%) 20-39 and 12 (15.6%) 40-60 age groups. In the evaluation of the lesion characteristics, 33 (43%) patients had single and 44 (57%) had multiple lesions with a distribution mainly on face, arm and lower extremities, in a decreasing order. The period of time for the development of the lesions varied from 1.5 month to one year with the mean value of 3.4 months. There was no statistically significant relationship between the age and gender of patients, and the characteristics (quantity, distribution and time of occurence) of lesions (p> 0.05). The number of domestic and Syrian CL cases detected in Nizip in the years of 2010, 2011, 2012 and 2013 (the first three months) were as follows; 1 and 0, 2 and 0, 7 and 0, 5 and 62, respectively. So a total of 62 (80.5%) and 15 (19.5%) of CL patients were found to be Syrian refugees and Turkish citizens, respectively. Since the number of the cases admitted to the hospital was significantly low in comparison to the total population of refugees living in the camps, it was assumed that the real incidence of CL was much higher than determined. The data obtained in this study revealed that Nizip and the surroundings which have already had favourable climate and vector potential for CL, exhibited a higher threat for the spread of the disease following the hosting of the refugees. Thus implementation of effective prevention and control measures should be taken into consideration implemented in that specific area.
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    Effects of Caffeic Acid Phenethyl Ester on Anastomotic Healing in Secondary Peritonitis
    (Informa Healthcare, 2012) Teke, Zafer; Bostanci, Erdal Birol; Yenisey, Cigdem; Kelten, Esra Canan; Sacar, Suzan; Simsek, Nilufer Genc; Duzcan, Suleyman Ender
    Purpose: We aimed to investigate the effects of caffeic acid phenethyl ester (CAPE) on wound healing in left colonic anastomoses in the presence of intraperitoneal sepsis induced by cecal ligation and puncture (CLP) in a rodent model. Methods: This experimental study was conducted on 48 male Wistar albino rats. The animals were randomly allocated into four groups and a left colonic anastomosis was performed on the day following sham operation or CLP in all rats: (i) sham-operated control group, laparatomy plus cecal mobilization (n = 12) (Group 1), (ii) sham + CAPE group, identical to Group 1 except for CAPE treatment (10 mu mol/kg, intraperitoneally, 30 min before construction of the colonic anastomosis) (n = 12) (Group 2), (iii) CLP group, cecal ligation and puncture (n = 12) (Group 3), and (iv) CLP + CAPE-treated group, 10 mu mol/kg, intraperitoneally, 30 min before the construction of colonic anastomosis (n = 12) (Group 4). On the postoperative day 7, the animals were subjected to relaparotomy for in-vivo measurement of the colonic anastomotic bursting pressure. A colonic segment including the anastomotic site was resected for histopathological evaluation and biochemical analyses of hydroxyproline (Hyp) contents, myeloperoxidase (MPO) acivity, malondialdehyde (MDA) levels, reduced glutathione (GSH) levels, and superoxide dismutase (SOD) activity. Body weight changes were examined. Results: CAPE treatment significantly increased colonic anastomotic bursting pressures (p < .05), colonic anastomotic tissue Hyp contents, and enzymatic and nonenzymatic antioxidant markers (p < .05), and significantly decreased oxidative stress parameters in colonic anastomotic tissues (p < .05). Histopathological scores were significantly better by CAPE administration (p < .05). Conclusion: This study clearly showed that CAPE treatment prevented the detrimental effects of intraperitoneal sepsis on colonic anastomotic wound healing. Further clinical studies are required to determine whether CAPE has a useful role in the enhancement of gastrointestinal anastomotic wound healing during particular surgeries in which sepsis-induced organ injury occurs.
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    Evaluation of healthcare providers’ approach towards pandemic influenza and their vaccination ratio
    (Prusa Medical Publishing, 2015) Asan, Ali; Kose, Sukran; Sacar, Suzan; Polat, Yusuf; Ugurcan, Dogac; Catak, Binali; Turgut, Huseyin
    Objectives. Pandemic influenza is a contagious disease caused by the new pandemic influenza A H1N1 virus, originated from the genetic combination of human, pig and avian influenza viruses. Our research aimed to determine the level of pandemic influenza vaccination in healthcare providers and the factors influencing this level. Methods. Doctors, midwives and nurses working in primary, secondary and tertiary health institutions in Denizli established the universe of the research. Four nurses visited these health institutions on five workdays between the 4th and 8th of April 2011, informed the healthcare providers that participation to the research was voluntary and handed over data collection forms in the institutions visited. Then, these data collection forms were collected by the same nurses. Research data were analyzed with SPSS package program. Frequency, percentage, chi-square and logistic regression analyses were used in the evaluation. Results. 44.7% of the healthcare providers participating in the study stated that they had been vaccinated with pandemic influenza vaccine. When factors effecting the vaccination decision with pandemic influenza vaccine of the individuals participating the study was evaluated; statistically significant difference between vaccination and occupation (p=0.001), sex (p=0.001), and age (p=0.026) was detected. The proportion of doctors, males and individuals older than 40 years was higher among the vaccinated professionals. Conclusions. It is important to make announcements about vaccination with determination and by taking support from media and non-governmental organizations. Statements and explanations should be released with this in mind and media, and nongovernmental organizations should also take responsibility regarding this matter.