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Öğe 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, MustafaObjective: 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.Öğe Akut Gastroenteritli Çocuklarda Rotavirüs Sıklığı(Çanakkale Onsekiz Mart Üniversitesi, 2014) Tekin, Mustafa; Topaloğlu, Naci; Yıldırım, Şule; Binnetoğlu, Köksal; Kaymaz, Nazan; Aylanç, Hakan; Battal, Fatih; Vural, Ahmet; Başer, EsraViral gastroenteritlerin ve özellikle rotavirüse bağlı ishallerin epidemiyolojik ve klinik özelliklerinin takip edilmesi ve buna göre korunma ve tedavi stratejilerinin geliştirilmesi önemlidir. Bu nedenle biz de kliniğimize akut ishal nedeniyle başvuran olgularda rota virüs ishallerini araştırdık. 2011-2013 tarihleri arasında ÇOMÜ Tıp Fakültesi Hastanesi çocuk polikliniği ve acil servisine akut ishal nedeniyle baş vuran ve dışkı örnekleri incelenen 263 olgunun hastane kayıt verileri geriye dönük olarak tarandı. Dışkı örnekleri, kalitatif monoklonal antikorlarla kaplanmış kromatografik immunoassay yöntemi ile çalışan ticari bir test kiti (Rota-Adeno Virus Combo Test Device, Ecotest, Çin) ile incelenmişti. Toplam 263 akut ishalli olgu dosyası incelendi. Rota antijen pozitifliği bütün olguların 62’sinde (%23,6) saptandı. 2 yaş altı çocuklarda sıklık %34,5 olarak saptandı. Rota pozitifliğinin mevsimlere göre sıklığı sırasıyla ilkbaharda %27,8, yazın %14,6, sonbaharda %26,3 ve kışın %21,4 idi. Sonuç olarak akut ishalli olgu yönetimi yaşa ve mevsime göre yapılmalıdır. Bu tür ishalli olgularda gerekirse hızlı tanı testleri kullanılarak gereksiz antibiyotik kullanımından kaçınılmalıdır.Öğe Are patients, who were previously diagnosed with coronary artery disease by coronary angiography, on optimal medical treatment?(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Temiz, Ahmet; Yener, Ali Umit; Barutcu, Ahmet; Gazi, Emine; Altun, Burak; Bekler, Adem; Vural, AhmetBackground: This study aims to detect the drug usage rate of patients who had coronary artery disease (CAD) diagnosis by coronary angiogram (CAG). Methods: Reports of 1,549 patients (993 males, 556 females; mean age 62.9 +/- 10.9 years; range 20 to 87 years) (184 normal CAG, 1,365 CAD) who were performed CAG between October 2009 and February 2012 were retrospectively analyzed. Medication data were collected between August 2013 and November 2013 from patients' pharmacy refill data. Usage of aspirin, tienopiridine, statin, angiotensin converting enzyme inhibitor, beta blocker (BB), warfarin, angiotensinogen receptor blocker, nitrate, trimetazidine, calcium channel blocker, and diuretic were recorded. Results: Usage rates of angiotensinogen receptor blocker, trimetazidine, calcium channel blocker, warfarin, diuretic, and fibrate were not statistically different between patients with CAD and normal CAG. Rates of using aspirin (50.3% vs. 39.1%, p=0.005), tienopiridine (25.6% vs. 9.8%, p<0.001), angiotensin converting enzyme inhibitor (38.0% vs. 21.7%, p<0.001), statin (48.5% vs. 30.6%, p<0.001), BB (56.8% vs. 40.2%, p<0.001) and nitrate (15.1% vs. 6.0%, p<0.001) were higher in patients with CAD. Rate of patients using all four drugs, antiplatelet agent, statin, angiotensin converting enzyme inhibitor, and BB was only 13.1% in CAD group. Only 25.8% of patients with CAD used all three of antiplatelet agent, statin, and BB. Conclusion: Patients with CAD are not on optimal medical treatment. These patients should be questioned in every visit in terms of the status of their treatment to administer the optimum medications to reduce cardiovascular mortality and morbidity.Öğe Bacterial Contamination of Needles Used for Intravitreal Injections: Comparison between 27-gauge and 30-gauge Needles(Informa Healthcare, 2013) Tufan, Hasan Ali; Vural, Ahmet; Gencer, Baran; Kara, Selcuk; Arikan, Sedat; Yuksel, ErdemPurpose: To compare the contamination rate between 27-gauge and 30-guage needles used for intravitreal injection (IVT). Methods: Patients undergoing IVT injections were enrolled prospectively. Injections were performed with 27- or 30-gauge needles. All needle tips were collected and placed in brain-heart infusion broth. The contamination rates of needles were compared. Results: A total of 109 patients participated in the study and a total of 126 IVT injections were performed. Injections were performed by 27-gauge (49%) and 30-gauge (51%) needle. No patient developed endophthalmitis. The overall contamination rate of the used needles were 13% for 27-guage and 29% for 30-guage (p = 0.022). However, this difference was nonsignificant after Bonferroni's correction was applied. The most common bacteria isolated from the used needles are coagulase-negative Staphylococcus (CNS). Conclusion: The results suggest that the needle bore size seems not to be a risk factor for contamination during IVT injection.Öğe Çanakkale Onsekiz Mart Üniversitesi Sağlık Uygulama ve Araştırma Merkezi Mikrobiyoloji Laboratuvarı’na Gelen Dışkı Kültürlerinin Değerlendirilmesi(Çanakkale Onsekiz Mart Üniversitesi, 2013) Vural, Ahmet; Akçalı, Alper; Ünver, Ahmet; Otkun, Müşerref TatmanBu çalışmada, Kasım 2008 ile Temmuz 2012 tarihleri arasında Çanakkale Onsekiz Mart Üniversitesi Sağlık Uygulama ve Araştırma Hastanesi Mikrobiyoloji Laboratuvarı’na gönderilen dışkı kültüründen Salmonella ve Shigella türlerinin izolasyonu ve izole edilen suşların antibiyotik duyarlılıklarının belirlenmesi amaçlanmıştır. İncelenen 1182 örneğin 22’sinde Salmonella izole edilmiş ve Shigella izole edilmemiştir. Salmonella’ların 15 tanesi Salmonella Enteritidis yedi tanesi de Salmonella spp. olarak tanımlanmıştır. S. Enteritidis suşlarından üç tanesinde ampisilin direnci belirlenmiştir. Salmonella spp. suşlarının iki tanesinde trimetoprim-sulfametoksazol direnci saptanmış, izolatların hiçbirinde levofloksasin ve siprofloksasin direnci saptanmamıştır. Hastanemizdeki gastroenterit ve ishal vakalarının tedavi seçenekleri bu sonuçlar göz önünde bulundurularak değerlendirilmelidirÖğe Cutaneous Leishmaniasis Cases in Nizip, Turkey After the Syrian Civil War(Ankara Microbiology Soc, 2014) Salman, Ismail Serkan; Vural, Ahmet; Unver, Ahmet; Sacar, SuzanCutaneous 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.Öğe Developing of health perception and psychosocial skills in disadventaged students: A school based interventional study from çanakkale(Gulhane Military Medical Academy, 2015) Cevizci, Sibel; Uludağ, Ayşegül; Babaoğlu, Ülken Tunga; Karaahmet, Elif; Vural, Ahmet; Şahin, Erkan Melih; Özdemir, HamideAIM: The aim of this study was to develop health perception and psychosocial skills in disadvantaged students in a primary school. METHOD: This interventional study was conducted in a primary school between May 2012 and June 2012 in Kepez, Canakkale within the context of “Consultancy Application in Primary Schools”as the first step of “From Local to Cambridge and NASA: Development of Canakkale Values and Promotional Awareness in Disadvantaged Students” (TR22.11.SK01.0111) project. Fifteen students with different disadvantages at the 5th,6th,7th,and 8th grades in the second semester were included in the study. Training studies were performed to develop psychosocial skills and health perception of students. These studies were performed at the school library twice a week for three weeks. In this study, socio-demographic, health perception evaluation and psychosocial skill evaluation forms were used as material. Study data were analyzed using by SPSS, 15.00 version. RESULTS: Most students (66.6%) were female. Statistically significant difference was defined in psychosocial skill developments of students between the median values measured three weeks apart (p<0.001). When examined responses of students to the health perception scale, it was observed that favorable attitudes of students were increased, whereas unfavorable attitudes were decreased in the measurements during the training. CONCLUSION: Students with disadvantages gained physical, psychological and social skills (being interactive; sharing, communicating, enterprising) features of leadership and social supporting as well as the development of health perception. Two students, who successfully completed these training activities in our study group, were chosen to the project camp. One of these two students, who successfully completed the activities in the project camp and past the final exam was accepted by science trip in the United Kingdom. In conclusion, professional group trainings at early ages may be helpful for developing characteristics of health perception, psychosocial skills, enterprising in disadvantaged students. © 2015, TAF Preventive Medicine Bulletin. ALL RIGHTS RESERVED.Öğe Dezavantajlı öğrencilerde sağlık algısının ve psikososyal becerilerin geliştirilmesi: okul tabanlı bir müdahale çalışması(2015) Cevizci, Sibel; Uludağ, Ayşegül; Babaoğlu, Ülken Tunga; Karaahmet, Elif; Vural, Ahmet; Şahin, Erkan Melih; Özdemir, HamideAMAÇ: Bu çalışmada, Çanakkale'de bir ilköğretim okulunda dezavantajlı öğrencilerde sağlık algısının ve psikososyal becerilerin geliştirilmesi amaçlandı. YÖNTEM: Müdahale tipteki bu çalışma, \"Yerelden Cambridge ve NASA'ya: Dezavantajlı Öğrencilerde Çanakkale Değerleri ve Girişimcilik Bilinci Geliştirme\" (TR22.11.SK01.0111) projesinin ilk basamağı olan \"İlköğretim Okullarına Danışmanlık Uygulaması\" kapsamında 18 Mayıs 2012-18 Haziran 2012 tarihleri arasında Çanakkale Kepez'de bir İlköğretim okulunda yürütüldü. Bahar yarıyılında 5., 6., 7., ve 8. sınıflarda okuyan farklı dezavantajlara sahip 15 öğrenci çalışma grubumuzu oluşturdu. Öğrencilerin psikososyal becerilerini ve sağlık algılarını geliştirecek eğitim çalışmaları yapıldı. Bu çalışmalar 3 hafta boyunca haftada 2 kez okul kütüphanesinde yapıldı. Çalışmada materyal olarak sosyodemografik bilgi formu, sağlık algısı ölçeği ve psikososyal beceri değerlendirme formu kullanıldı. Çalışma verileri, SPSS 15,0 sürümü ile değerlendirildi. BULGULAR: Çalışma grubumuzun %66,6'sı (n=10) kızdı. Öğrencilerin psikososyal beceri gelişimleri incelendiğinde 3 haftalık ölçümlerde ortanca puanlar arasında istatistiksel olarak anlamlı bir fark saptandı (p<0,001). Öğrencilerin sağlık algısı ölçeğine verdikleri yanıtlar incelendiğinde, eğitim süresince yapılan ölçümlerde öğrencilerin olumlu tutumlarında bir artış, buna karşılık olumsuz tutumlarında da bir azalma olduğu gözlendi. SONUÇ: Dezavantajlı öğrencilerle yapılan bu destekleyici eğitim çalışmaları ile öğrenciler interaktif olma, paylaşımcı olma, iletişimci ve girişimci olma, lider olma, sosyal destek sunma, sağlık algısının gelişmesi gibi konularda fiziksel, ruhsal ve sosyal kazanımlar elde etmişlerdir. Çalışma grubumuzda yer alan ve eğitim aktivitelerini başarıyla tamamlayan öğrencilerden 2'si proje kampına seçilmiştir. Proje kampındaki aktiviteleri ve yapılan sınavı başarıyla tamamlayan bir öğrencimiz İngiltere'ye bilimsel gezi programına katılmıştır. Sonuç olarak, sağlık algısının, psikososyal becerilerin ve girişimcilik gibi özelliklerin erken yaşlarda gelişmesi için ilköğretim çağındaki dezavantajlı öğrencilere yönelik profesyonel grup eğitimleri yararlı olabilirÖğe [Evaluation of anti-Toxoplasma gondii antibody distribution and risk factors among pregnant women admitted to obstetrics polyclinic of Canakkale Onsekiz Mart University Hospital].(2014) Gencer, Meryem; Cevizci, Sibel; Saçar, Suzan; Vural, Ahmet; Cakir Güngör, Ayşe Nur; Uysal, Ahmet; Hacivelio?lu, Servet ÖzdenIn this study, we aimed to investigate Toxoplasma gondii seroprevalence and risk factors in pregnant women. A total of 196 patients, admitted to the clinic in the first trimester and with ongoing pregnancy follow-up of between May 2012 and January 2013, were included in the study. Toxoplasma IgG and IgM antibodies were detected by ELISA test in blood samples obtained from patients during routine screening. SPSS statistical software, version 19.0 was used to analyze the data. Descriptive statistics were used to present the data, percentage, mean, and standard deviation. Chi-square test was used for categorical variables. p-value for statistical significance was defined as p<0.05. The mean age was 29.07±5.3 years in our study group. Anti-Toxoplasma IgG and IgM antibodies were found in 28.8% and 2.7%, respectively; 58.9% of pregnant women in the study reported that they had done at least one risky behavior during their pregnancy. However, there was no significant association between T. gondii IgG antibody positivity and risk factors, such as pregnancy, feeding animals in the past years, and consumption of raw food products (p>0.05). We found that Toxoplasma IgG antibody seropositivity (28.8%) was similar to that found in the other studies from western Turkey.Öğe Fibrin sealant as a carrier for sustained delivery of antibiotics(2014) Kara, Selçuk; Vural, Ahmet; Ünver, Ahmet; Gencer, Baran; Tufan, Hasan Ali; Arıkan, Sedat; Ersan, İsmailAmaç: Sık görülen oküler bakteri suşlarında antibiyotiklerin fibrin yapıştırıcıda etkinlik ve sürekli salınımlarının değerlendirilmesi.Yöntemler: Vankomisin, seftazidim, moksilofloksasin ve lomeflokasasin disk şeklinde fibrin yapıştırıcılara katıldı. Her bir antibiyotik diski ve ilaçsız kontrol fibrin diski in-vitro olarak Stafilokok aureus, Stafilokok epidermidis, Streptokok Pnömonia ve Psödomonas aeruginosa standart bakteri suşlarında test edildiler. 37°C'de 24 saatlik inkübasyon sonrasında diskler yeni bakteri pleytlerine transfer edildiler ve bu işlem her antibiyotik için üç kez tekrarlandı.Bulgular: 24 saat sonra tüm antibiyotik diskleri saptanabilir etkinlik gösterdiler. Streptokok Pnömonia'nın ürediği pleytte vankomisin en uzun sureli (4 gün) etkinliğe sahipti. Moksilofloksasin diskleri S. aureus ve S. pnömonia için 3 gün ve diğer suşlara 2 gün uzamış inhibisyon etkisi göstermiştir.Sonuç: Fibrin yapıştırıcılar uzun süreli ilaç dağılımı sağlamaktadırlar. Bu özellik antibiyotik yüklü fibrin pıhtıların erken postoperatif koruma ve tedavi için kullanışlı olabileceğini göstermektedir.Öğe In vitro evaluation of antimicrobial features of sugammadex(Elsevier Science Inc, 2014) Hanci, Volkan; Vural, Ahmet; Hanci, Sevgi Yilmaz; Kiraz, Hasan Ali; Omur, Dilek; Unver, AhmetBackground: Drugs administered by intravenous routes may be contaminated during several stages of production or preparation. Sugammadex is a modified gamma cyclodextrin. While research into the antibacterial effects of varieties of cyclodextrin is available, there are no studies focusing on the antibacterial effects of sugammadex. This study investigates the in vitro antimicrobial activity of sugammadex. Materials and methods: The in vitro antimicrobial activity of sugammadex was investigated using the broth microdilution method. The pH of the test solution was determined using a pH meter. The test microorganisms included Staphylococcus aureus ATCC 29213, Enterococcus fecalis ATCC 29212, Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853. In the second phase of the study 100 mg/mL sugammadex (54 mu g) was contaminated with test microorganisms (50 mu g), including S. aureus ATCC 29213, E. fecalis ATCC 29212, E. cob ATCC 25922 and P aeruginosa ATCC 27853, Left to incubate for 24 h and then the bacterial production in sugammadex was evaluated. Results: The pH of the test solutions ranged between 7.25 and 6.97. Using the microdilution method, sugammadex had no antibacterial effect on S. aureus, E. fecalis, E. coli and P aeruginosa at any concentration. In the second phase of the study bacterial production was observed after 24h in 100 mg/mL sugammadex contaminated with the test microorganisms S. aureus, E. fecalis, E. coli and P. aeruginosa. Conclusions: Sugammadex had no antimicrobial effect on the test microorganisms, S. aureus, E. fecal's, E. coli and P aeruginosa. Care should be taken that sterile conditions are maintained in the preparation of sugammadex; that the same sugammadex preparation not be used for more than one patient; and that storage conditions are adhered to after sugammadex is put into the injector. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rightsÖğe Is hyperbaric oxygen or ozone effective in experimental endocarditis?(Academic Press Inc Elsevier Science, 2016) Ozkan, Muhammed Turgut Alper; Vural, Ahmet; Cicek, Omer Faruk; Yener, Ali Umit; Ozcan, Sedat; Toman, Huseyin; Unver, AhmetBackground: Infective endocarditis, a disease with high mortality and morbidity, is most commonly caused by Staphylococcus aureus; mortality and morbidity further increase in the presence of methicillin-resistant strains of S. aureus. Linezolid is the first of the oxazolidinones, a new antibiotic group that has been approved for the treatment of infections caused by gram-positive cocci. Linezolid reduces the quantity of microorganisms in vegetation to some extent; in addition, the use of hyperbaric oxygen (HBO) and ozone (O-3) therapies is likely to improve targeted antibacterial effect. Materials and methods: Fifty-six adult male Wistar rats weighing 300-350 g were used. The subjects were divided into groups as follows: Group 1 (n = 8): control group that was not inoculated with microorganisms and was untreated; Group 2 (n = 8): control group that was inoculated with microorganisms but was untreated; Group 3 (n = 8): linezolid treatment group; Group 4 (n = 8): O-3 therapy group; Group 5 (n = 8): HBO therapy group; Group 6 (n = 8): linezolid + O-3 therapy group; Group 7 (n = 8): linezolid + HBO therapy group. Results: In terms of reducing the number of colonies in the aortic valve, linezolid + HBO therapy was found to be the most effective treatment. Then, respectively linezolid + O-3, linezolid, HBO, and O-3 were found to be effective. Conclusions: We found that linezolid significantly reduced the number of bacteria in the vegetation in the experimental endocarditis model, and HBO therapy increases the effectiveness of linezolid and makes this better than O-3. (C) 2016 Elsevier Inc. All rights reserved.Öğe Polikliniğine Müracaat Eden Gebelerde Anti-Toxoplasma gondii Antikorlarının Dağılımı ve Risk Faktörlerinin İrdelenmesi(2014) Gencer, Meryem; Cevizci, Sibel; Saçar, Suzan; Vural, Ahmet; Çakır, Ayşe Nur Güngör; Uysal, Ahmet; Hacıvelioğlu, Servet ÖzdenAmaç: Çalışmamızda, hastanemize başvuran gebe kadınlarda Toxoplasma gondii seroprevalansını saptamayı ve risk faktörlerini incelemeyi amaçladık.Yöntemler: Mayıs 2012-Ocak 2013 tarihleri arasında polikliniğe başvuran ve rutin gebelik takibine alınan 196 hasta çalışmaya dahil edildi. Gebelere risk faktörlerini incelemek için anket uyguladı ve rutin tarama için kan örnekleri alındı. Analiz için ELISA ile değerlendirilen serum anti-Toxoplasma gondii IgG ve IgM antikor sonuçları kullanıldı. Verilerin analizinde SPSS 19,0 istatistik paket programı kullanıldı. Tanımlayıcı verilerin sunumunda yüzde, ortalama, standart sapma, kategorik değişkenlerin analizinde ki-kare testi kullanıldı. İstatistiksel olarak p<0,05 düzeyi anlamlı kabul edildi. Bulgular: Çalışmaya katılanların yaş ortalaması 29,07±5,3 yıldı. IgG ve IgM antikor pozitifliği sırasıyla %28,8 ve %2,7 saptandı. Çalışmada yer alan gebelerin %58,9'u gebelikleri süresince en az bir riskli davranışta bulunduklarını bildirdi. Hamilelik süresince riskli davranışta bulunma, geçmiş yıllarda hayvan besleme, çiğ süt, çiğ yumurta, çiğ et tüketimi gibi risk faktörleri ile IgG pozitifliği arasında anlamlı bir ilişki saptanmadı (p>0,05).Sonuç: Çalışmamızda Toxoplasma IgG antikor seropozitifliğinin (%28,8), Türkiye'nin batısında yapılan çalışma sonuçları ile benzer olduğunu bulduk.Öğe Protective Effect of Possible Olive Oil, Olive Leaves and Olive Seeds on Ethanol Induced Experimental Ulcer Model in Rats(Wiley-Blackwell, 2015) Vural, Zehra; Kahraman, Mustafa; Sehitoglu, Hilal; Vural, Ahmet; Arik, Kasim; Simsek, Tuncer; Cetiner, Sule[Anstract Not Available]Öğe Same-day Detection of Methicillin Resistance in Staphylococcus aureus Isolates by StaResMet® Kit(Ahvaz Jundishapur Univ Med Sci, 2017) Sezgin, Fikriye Milletli; Vural, Ahmet; Kiraz, Asli; Cayci, Yeliz Tanriverdi; Coban, Cagri; Bozdogan, Bulent; Coban, Ahmet YilmazBackground: Staphylococcus aureus is an important cause of hospital-acquired infections. The most important issue with S. aureus is that the isolates are getting increasingly methicillin-resistant. Rapid differentiation between methicillin-resistant and methicillin-susceptible S. aureus species is necessary to optimize treatment and minimize costs. Objectives: The current study aimed at evaluating the StaResMet (R) kit for rapid detection of methicillin resistance in S. aureus isolates. Methods: A total of 217 methicillin-resistant S. aureus (MRSA) and 252 methicillin-susceptible S. aureus (MSSA) isolates were tested using the StaResMet (R) kit. The test was performed according to the manufacturer's instructions. Results: The kit identified the MRSA isolates with 100% accuracy, and found that the minimum inhibitory concentrations (MICs) was > 32 mu g/mL cefoxitin for 133 of the isolates, 32 mu g/mL cefoxitin for 49, 16 mu g/mL cefoxitin for 8, and 8 mu g/mL cefoxitin for 11 of the isolates. Likewise, all 177 MSSA isolates were correctly identified using the kit, and the MICs against them were determined within the range of 1 to 4 mu g/mL cefoxitin. The MIC of cefoxitin can be determined in 6 hours using the StaResMet (R) kit. Conclusions: The obtained results indicated that the StaResMet (R) kit allowed the detection of MRSA isolates rapidly and reliably, and could be a valuable tool for microbiology laboratories with limited facilities. Authors believed that the routine use of this timesaving and easy-to-use test contributes to rapid clinical diagnoses and treatments.Öğe Serum Fetuin-A Level in Patients With Ankylosing Spondylitis and its Relationship With Clinical Parameters(Turkish League Against Rheumatism, 2015) Gokmen, Ferhat; Akbal, Ayla; Gunes, Fahri; Turkon, Hakan; Vural, Ahmet; Binnetoglu, Emine; Komurcu, ErkamObjectives: This study aims to investigate the association of serum fetuin-A levels with disease activation and clinical parameters in ankylosing spondylitis (AS) patients. Patients and methods: Forty-seven AS patients (30 males, 17 females; mean age 39.7 +/- 11.1 years; range 20 to 69 years) and 30 healthy controls (14 males, 16 females; mean age 42.0 +/- 11.5 years; range 19 to 63 years) were included in the study. Erythrocyte sedimentation rate, C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Radiology Index, and Bath Ankylosing Spondylitis Metrology Index were used in the assessment of AS. Serum fetuin-A levels were measured using ELISA. Results: Mean serum fetuin-A values in AS patients (984 +/- 203 ng/mL) were significantly lower compared to controls (1156 +/- 218 ng/mL) (p=0.001). While a statistically significant negative correlation was detected in AS patients between fetuin-A values and C-reactive protein (p=0.009, r=-0.377), no significant correlation was detected between erythrocyte sedimentation rate, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index or Bath Ankylosing Spondylitis Radiology Index parameters and fetuin-A. Conclusion: Serum fetuin-A levels in AS patients were lower than the control group. However, further research is required to establish the role of serum fetuin-A levels as a surrogate marker of disease activity.Öğe Serum H-FABP levels in patients with hypothyroidism(Springer Wien, 2014) Gunes, Fahri; Asik, Mehmet; Temiz, Ahmet; Vural, Ahmet; Sen, Hacer; Binnetoglu, Emine; Bozkurt, NeslihanHypothyroidism (HT) has an increased risk for cardiovascular mortality and morbidity due to increased atherosclerosis. Heart-type fatty acid binding protein (H-FABP) is abundant in the cytosol of cardiomyocytes, and transports fatty acids into these cells. Although H-FABP has been shown to increase in several atherosclerotic and inflammatory conditions, there is no literature data indicating an alteration in other atherosclerotic processes such as HT. A total of 39 patients with subclinical hypothyroidism (SCH), 26 patients with overt hypothyroidism (OH), and 29 healthy subjects were enrolled in this study. Carotid artery intima media thickness (CIMT) was measured by high resolution B mode ultrasonography. H-FABP levels, thyroid function test, and biochemical tests of all subjects were measured. The associations between H-FABP and thyroid test and CIMT were examined with correlation and regression analysis. OH patients had higher H-FABP levels (mean, 6.18 +/- A 3.08 ng/mL) than both the SCH (mean, 3.81 +/- A 2.16 ng/mL) and the controls (mean, 2.12 +/- A 1.27 ng/mL) (P < 0.01 and < 0.001, respectively). SCH patients had increased serum H-FABP levels compared with control subjects (P < 0.01). CIMT of both OH and SCH patients was also significantly greater compared with control subjects (both of p < 0.01). H-FABP was significantly and positively correlated with age, systolic blood pressure, thyroid stimulating hormone (TSH) levels, and CIMT, and negatively correlated with fT4 levels. The H-FABP levels retained an independent and positive association with systolic blood pressure, and a negative association with fT4 levels. Serum H-FABP levels progressively increased from the control group to the OH group. This suggests that H-FABP may be an indicator of low-level myocardial damage in HT, especially when used together with CIMT. Decreasing serum fT4 levels seem also to have an effect on H-FABP levels.Öğe Suriye savaşı sonrası Nizip’te kutanöz iç leyşmanyazis olguları(2014) Salman, İsmail Serkan; Vural, Ahmet; Ünver, Ahmet; Saçar, SuzanKutanöz leyşmanyazis (KL) birçok ülkede endemik olarak görülen, dünya genelinde yaygın bir proto- zoon hastalığıdır. Türkiye’nin komşuları olan İran, Irak ve Suriye gibi ülkeler ise KL için yüksek endemik bölgelerdir. Ülkemizde KL olgularının %98’inden fazlası Güney ve Güneydoğu Anadolu bölgelerinden bildirilmektedir. Bu çalışmada, üç buçuk yıllık dönemde Nizip bölgesinde KL prevalansının belirlenmesi ve Suriye iç savaşı sonrası KL olgularında saptanan dramatik artışa dikkat çekilmesi amaçlanmıştır. Çalışmaya, 01.01.2010-19.03.2013 tarihleri arasında Nizip Devlet Hastanesi Mikrobiyoloji Laboratuvarına klinik KL şüphesi ile gönderilen 341’i Suriye mültecisi olmak üzere toplam 416 hasta örneği dahil edilmiştir. Hastalardan lezyon örnekleri Sağlık Bakanlığı genelgesine uygun olarak alınmış ve hazırlanan yayma preparatlar Giemsa ile boyanarak ışık mikroskobu (x1000) ile incelenmiştir. Mikroskopik incelemede Leishmania amastigot şekilleri görülen toplam 77 (%18.5) hastaya KL tanısı konulmuştur. Hastaların 47 (%61)’si kadın, 30 (%39)’u erkek olup; 52 (%67.5)’sinin 0-19 yaş, 13 (%16.9)’ünün 20-39 yaş ve 12 (%15.6)’sinin 40-60 yaş grubunda olduğu izlenmiştir. Lezyonların dağılımı incelendiğinde; 33 (%43) hastada tekli, 44 (%57) hastada ise çoklu lezyon varlığı tespit edilmiş; lezyonların sıklık sırasıyla yüz, kol ve alt ekstremitelerde bulunduğu gözlenmiştir. Lezyonların ortaya çıkma süresinin ortalama 3.4 ay (minimum 1.5 ay, maksimum 1 yıl) olduğu saptanmıştır. Kutanöz leyşmanyazisli hastalar yaş, cinsiyet ve lezyon özellikleri (sayısı, dağılımı, oluşum süresi) bakımından karşılaştırıldığında istatistiksel olarak anlamlı bir ilişki saptanmamıştır (p> 0.05). Çalışmamızda 2010, 2011, 2012 ve 2013 (ilk üç ay) yıllarında Nizip’te saptanan yerli ve Suriye kökenli KL olgu sayıları sırasıyla; 1 ve 0, 2 ve 0, 7 ve 0, 5 ve 62 olarak belirlenmiştir. Buna göre KL tanısı alan hastaların 15 (%19.5)’inin Türk, 62 (%80.5)’sinin Suriye kökenli olduğu gözlenmiştir. Ayrıca, hastaneye başvuran hastaların oranının çadır kentlerdeki mülteci nüfusuna göre oldukça az olması, hastalık insidansının belirlenenden çok daha fazla olabileceğini düşündürmüştür. Sonuç olarak verilerimiz, KL için iklim ve vektör potansiyeli açısından zaten elverişli olan Nizip ve çevresinin, Suriye iç savaşı sonrası mültecilerin yerleşimiyle, hastalığın yayılımında daha da büyük bir sağlık tehdidi oluşturduğunu göstermiş; etkin korunma ve kontrol yöntemlerinin alınması gerekliliğini ortaya koymuştur.Öğe The effect of amifostine on bacterial translocation after radiation induced acute enteritis(Acta Cirurgica Brasileira, 2016) Tas, Sukru; Ozkul, Faruk; Arik, Muhammet Kasim; Kiraz, Asli; Vural, AhmetPURPOSE: To investigate the effects of amifostine on bacterial translocation and overgrowth in colonic flora after acute radiation enteritis in a rat model. METHODS: Thirty-two female Wistar albino rats were divided into four groups: Group-1 (n = 8): only normal saline was administered intraperitoneally. Group-2 (n = 8): first serum saline was administered intraperitoneally and 30 minutes later 20 Gy radiation was applied to abdominopelvic region. Group-3 (n = 8): only amifostine 200 ml/kg was administered intraperitoneally and radiation was not applied. Group-4 (n = 8): first amifostine 200 ml/kg was administered intraperitoneally and 30 minutes later 20 Gy radiation was applied to abdominopelvic region. On the 5th day after radiation, samples of mesenteric lymph tissues and cecal contents were taken by laparotomy for microbiological culture. RESULTS: Intraperitoneal amifostine administration significantly decreased the bacterial overgrowth related to radiation in colon but did not significantly decrease the bacterial translocation. CONCLUSION: Although not providing a full protection on the damaged mucosal barrier, amifostine significantly decreased the bacterial overgrowth in the cecal content after high dose radiation. There is a need to find out appropriate amifostine dose under different radiation applications avoiding bacterial translocation in gastrointestinal system.Öğe The Efficacy of Boric Acid Used to Treat Experimental Osteomyelitis Caused by Methicillin-Resistant Staphylococcus aureus: an In Vivo Study(Humana Press Inc, 2016) Guzel, Yunus; Golge, Umut H.; Goksel, Ferdi; Vural, Ahmet; Akcay, Muruvvet; Elmas, Sait; Turkon, HakanWe explored the ability of local and systemic applications of boric acid (BA) to reduce the numbers of methicillin-resistant Staphylococcus aureus (MRSA) in a rat model of tibial osteomyelitis (OM), and compared boric acid with vancomycin (V). Implant-associated osteomyelitis was established in 35 rats. After 4 weeks, at which time OM was evident both radiologically and serologically in all animals, the rats were divided into five groups of equal number: group 1, control group (no local application of BA or other medication); group 2, V group; group 3, local BA + V group; group 4, local BA group; and group 5, local + systemic BA group. Serum total antioxidant status, and the levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6, were measured. Pathological changes attributable to bone OM were evaluated using a grading system. Bacterial colony-forming units (CFUs) per gram of bone were counted. The lowest bacterial numbers were evident in group 3, and the bacterial numbers were significantly lower than that of the control group in all four test groups (p < 0.001). Group 3 also had the least severe bone infection (OM score 1.7 +/- 1.1, p < 0.05). Upon histological and microbiological evaluation, no significant difference was evident between groups 2 and 3. Total antioxidant levels were significantly different in all treatment groups compared to the control group. Microbiological and histopathological evaluation showed that systemic or local application of BA was effective to treat OM, although supplementary V increased the effectiveness of BA.
