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F Kara

Publications and source records attributed to F Kara.

13 recordsLinked to original sources
PubMed2006

Combination of caspofungin and an azole or an amphotericin B formulation in invasive fungal infections.

OBJECTIVES: Combination of caspofungin and another anti-fungal agent raise expectation of improved efficacy in severe fungal infections including failures to first line therapy. METHODS: We assessed the efficacy and safety of a combination therapy including caspofungin in 17 immunosuppressed or postoperative patients progressive despite standard anti-fungal therapy. RESULTS: The infections included aspergillosis (6), invasive candidiasis (9), mucormycosis (1) and Scedosporium pneumonia (1). Infections had failed one to four prior lines of treatment. The anti-fungal agent combined to caspofungin was either an amphotericin B formulation or an azole. There were 12 favourable responses (71%) and five failures. The survival rate at 3 months was 47%. Eleven patients died within 2-533 days. The causes of death included the initial fungal infection (4), relapse of the infection after switching to oral monotherapy (2), breakthrough aspergillosis (1), and the underlying condition (4). Clinical and renal tolerance were good. Significant hepatic abnormalities were recorded in eight (50%) of the 16 patients evaluable for biological tolerance. CONCLUSION: Caspofungin combined with an azole or with amphotericin B may be of interest in the treatment of serious fungal infections after failure of conventional therapy. Close monitoring of hepatic function is required. These approach should be evaluated in prospective trials.

Adolescent↗
PubMed2004

The use and safety of transoesophageal echocardiography in the general ICU -- a minireview.

BACKGROUND: The efficacy of transoesophageal echocardiography (TEE) has been evaluated predominantly in medical and cardiac surgical ICUs. This article reviews the pertinent literature and evaluates the impact of TEE in a general surgical ICU. METHODS: Twenty studies on TEE in the ICU were evaluated for complications, indications, diagnostic, therapeutic, and surgical impact on patient management. Diagnostic impact was defined as identification of the underlying cardiovascular pathology, therapeutic impact as changes in patient management and surgical impact as indication for operative procedures. In addition, we reviewed the TEE reports and patient charts of 216 critically ill patients in a 16-bed multidisciplinary surgical ICU at our university hospital, who underwent a TEE for differential diagnosis of hemodynamic instability from July 1995 to December 1998 to assess the impact of TEE on patient management in a general surgical ICU. RESULTS: The diagnostic, therapeutic and surgical impact in a total of 2,508 patients ranged from 44 to 99% (weighted mean 67.2%), 10-69% (36.0%), and 2-29% (14.1%), respectively. The complication rate was 2.6%, with no examination related mortality. In our series in a general surgical ICU, a diagnostic, therapeutic and surgical impact was inferred in 191 (88.4%), 148 (68.5%) and 12 (5.6%) patients, respectively. Adverse effects were observed in 5.6%. CONCLUSION: TEE is safe, well-tolerated and useful in the management of critically ill patients. This applies as well for hemodynamically unstable patients in a general surgical ICU.

Adolescent↗
PubMed2000

Acardiac twinning where the pump twin dies in utero due to thrombosis in the umbilical arteries.

A case of acardiac twinning where the pump twin dies in utero due to massive thrombotic occlusion of umbilical arteries at a site of umbilical cord stricture of the intact twin. In acardiac twinning the morbidity and mortality of the pump twin can be reduced by some invasive or medical approaches. The authors believe that in this interesting case the death of the pump twin could not be prevented by antenatal treatment.

Abnormalities, Severe Teratoid↗
PubMed1999

Is there another type of biventricular atrioventricular connection?

In evaluating a 9-year-old girl, we encountered the following cardiac anomalies: a left atrioventricular valve (the morphologic left atrium on the left side, connected with the morphologic left ventricle); concordant atrioventricular connections; a right atrioventricular valve (a morphologic right atrium on the right side, connected with the morphologic right ventricle); concordant atrioventricular connection; a "central" atrioventricular valve (separating the morphologic right atrium from the morphologic left ventricle); and discordant atrioventricular connection with intact interatrial and interventricular septa. A right-to-left shunt passed through the central valvular structure, which was situated at the atrioventricular septum. This was the only means of mixing pulmonary and systemic blood. We suggest that this case presents a newly recognized cardiac anomaly.

Child↗
PubMed1995

Emergency postpartum hysterectomy.

Twenty-two deliveries were followed by emergency postpartum hysterectomy among 109,842 deliveries in the last 10 years, an incidence of 1 in 4992 deliveries (20/100,000). The leading causes of emergency postpartum hysterectomy were uterine rupture in 8 (36.3%), uterine atony in 7 (31.8%), and abnormally adherent placenta in 6 (27.3%) patients. Five of the uterine rupture cases followed previous cesarean births, whereas the other 3 followed dystocia. Of the 7 patients with uterine atony, 4 were after vaginal delivery and 3 were after cesarean birth. Of the 6 patients with adherent placenta, 4 had repeat cesarean deliveries and the other 2 were subjected to cesarean section for postterm pregnancies. The maternal mortality rate was found to be 4.5% (1/22). The perioperative morbidity included blood transfusion in 72.2%, febrile morbidity in 40.9%, and wound infection in 13.6% of the patients. Fetal mortality rate was 45.4%.

Endometrium↗
PubMed1993

[Detection of herpes simplex virus 1 and 2 (HSV-1 and HSV-2) IgG and IgM by ELISA in cord blood and sera of mothers with pregnancy complications].

In this study, HSV-1 IgG, IgM and HSV-2 IgG, IgM antibodies by ELISA in the sera of the mothers who had different kinds of obstetrical problems like abortus, stillbirth, prematurity, postmaturity, intrauterine development retardation and in the newborns' cord sera who had congenital anomalies like anencephaly, cataract and dolichocephaly were investigated. In these mothers HSV-1 IgG positivity ratio was 71/73 (97.3%). There was no significant difference in the age group distribution of HSV-1 IgG. The HSV-1 IgG positivity ratios in mother sera were the same as in cord sera. It was found that HSV-1 IgG antibodies passed transplacentally. It was established that one of the subjects had premature baby and the other had stillbirth inspite of HSV-1 IgG negativity but in the risk group subjects. HSV-1 IgM was found positive in 7 mothers (9.6%) of the study group. This data was the sign of active or reactive infection. There were 3 abortus, 1 stillbirth and 3 anomalous baby in HSV-1 IgM seropositive mothers. In these mothers, 65/73 (89%) HSV-2 IgG and 6/73 (8%) HSV-2 IgM seropositivity were defined. In the cord sera these ratios were 65/73 (89%) and 2/73 (2.7%). IgM seropositivity of the material of the mothers who had abortus was explained by the effect of HSV-2 activity and the presence of HSV-2 IgM, 4 mothers were noted for the active or reactive infection sign. It was understood that HSV-2 IgG passed completely via placenta and there were no significant difference between the presence of the antibody and the age group.

Adult↗
PubMed1992

[Chlamydia trachomatis antigens in endocervical samples and serum IgG antibodies in sterile-infertile women using ELISA].

In this study, Ch.trachomatis antigen was investigated by ELISA, endocervical swab material of 35 infertile and sterile women, and 4 of them were antigen positive. All of these 4 cases were secondary sterile and 3 of them showed Ch.trachomatis IgG seropositivity. Chlamydia IgG seropositivity was seen in 8 of 35 cases. In this study, 68 patients were investigated for Ch.trachomatis IgG antibodies and 17 patients were found to be seropositive. These findings indicate the importance of Ch.trachomatis infections and the effect of recurrent infections on tubal factor infertility.

Adult↗
PubMed1992

[Determination of Toxoplasma IgM by ELISA in maternal blood and cord blood of infants born with abnormalities or fetal death].

In this study, Toxoplasma IgM antibodies in serum samples of 54 women who had maternal problems like abortion, preterm, fetal exitus, delivery with pediatric anomalies have been investigated with ELISA. In the cord sera of babies of these mothers, Toxo-IgM has been investigated too. Six mothers have been found to be Toxo-IgM seropositivity (11.11%). Toxo-IgM has been found negative in all of the cord samples. Three of Toxo-IgM positive mothers had fetal exitus and one of them had intrauterine growth retardation. One pregnancy has been terminated as abortion, the other as newborn with multiple anomalies. We have found out that active, latent or reactive toxoplasmosis have to be discriminated and for this purpose detection of Toxo-IgM levels is useful.

Abortion, Spontaneous↗