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Biomedical subjects

M Ceyhan

Publications and source records attributed to M Ceyhan.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Shigella serotypes and drug resistance patterns of strains isolated in Etimesgut, Turkey, in 1987].

Drug resistance patterns of shigella strains were investigated in a prospective manner in Etimesgut district during a period of 1 year. Thirty strains shigella were isolated, belonged to three subgroups with preponderance of Sh. flexneri (70%), followed by Sh. sonnei (27%) and Sh. boydii (3%). The resistance was highest with streptomycin (80%), followed by trimethoprim-sulfamethoxazole (TMP-SMZ) (53%) and ampicillin (43%). Only three strains (10%) were sensitive to all eight antibiotics tested. Sixteen (53%) were resistant to three or more antibiotics. The data showed an increase in resistance to the commonly used antimicrobial agents--namely IMP-SMZ and ampicillin. IMP-SMZ is no longer the drug of choice in severe shigellosis, at least in this region of Turkey.

Ampicillin Resistance↗
PubMed1985

[Importance of vaccination and bacteriological studies in diphtheria epidemics].

The Ouchterlony - Elek gel diffusion test was performed in twenty-nine patients having a positive culture result for diphtheria bacilli on Loeffler and tellurite agars in January and February, 1984 and toxin production was detected in 20 of them. Except one adult patient, the cases ranged in age 2 and 12 years. In 14 patients who have received at least one immunization with diphtheria vaccine had no complication, besides three patients without immunization in whom two received antibiotics plus antitoxin therapy had carditis and soft palate paralysis. Five patients in the non-immunized group and 6 patients in the group received at least one immunization had diphtheritic membrane. In spite of three patients with cardiac and neural complications, with early diagnosis and beginning therapy with antibiotics and antitoxin before the result of in vitro toxigenicity test, O% mortality rate was obtained.

Antibody Formation↗
PubMed1984

[The hyperglycemic effect of N-methylglucamine antimonate (glucantime)].

We applied meglumine antimonate (Glucantime) to 10 albino mice in a dose of 15-30 mg/kg for first three days and then 60 mg/kg for twelve days intramuscularly, and double dose to another 10 mice. No drug was administered to 9 mice which were control group. On 16th day, there were hyperglycemia, parenchymal degeneration and inflammation in liver which were more marked in double dose group. The monitoring of blood glucose of the patients with kala-azar receiving Glucantime, was suggested.

Animals↗
PubMed1984

[Campylobacter jejuni gastroenteritis].

Acute gastroenteritis is a major cause of hospital admission with attendant morbidity and occasional mortality. Campylobacter jejuni recently has been recognized as a common cause of acute bacterial gastroenteritis in children and adults. Its frequency of isolation is comparable to and in many studies exceeds that of Salmonella isolations from diarrheal stools of hospitalized patients. Medical workers in many parts of the world confirmed that Campylobacter jejuni was found more commonly in feces in diarrheic than in non-diarrheic people. The feces is loose to watery and commonly contains blood and leukocytes. Although, Campylobacter jejuni has been isolated from feces and gallbladder of healthy and diarrheic animals, until now, to our knowledge, there is no report on the isolation of the microorganism from healthy or diarrheic subjects in Turkey. This paper reports three human infections found to have Campylobacter jejuni in their stools as part of our ongoing investigation of the incidence of diarrheal disease due to this organism.

Campylobacter fetus↗
PubMed1983

[Salmonella meningitis].

A four - month old boy with Salmonella Typhimurium meningitis is presented. This patient was admitted to the hospital with a diagnosis of staphylococcal pneumonia, pyo-pneumothorax, cardiac failure and anemia. He has been treated for 18 days and he was discharged in good condition. Two days after discharge patient was readmitted with a fever, vomiting and feeding problem. In physical examination, stiff neck and bulging of the fontanel were remarkable. Examination of cerebrospinal fluid (CSF) has revealed meningitis and cultures of blood and CSF specimens were positive for S. typhimurium. It was sensitive only to trimethoprim sulphamethoxazole and netilmicin. Trimethoprim sulphamethoxazole (IM) and netilmicin (IV) were given. At the fifth day of this treatment patient expired. Postmortem examination has revealed the same agent in both meninges tissue and CSF cultures.

Autopsy↗
PubMedDate not supplied

Pyogenic granuloma with multiple dissemination in a burn lesion.

Pyogenic granuloma is a common vascular lesion in childhood. The occurrence of pyogenic granulomas after various kinds of trauma to the skin is quite common; however, multiple lesions secondary to a burn are very rare. For this reason, an 18-month-old girl with multiple pyogenic granulomas following a second-degree burn is reported.

Burns↗
PubMedDate not supplied

Necrotizing otitis externa, otitis media, peripheral facial paralysis, and brain abscess in a thalassemic child after allogeneic BMT.

Severe infection is one of the major complications in the early and late post-bone marrow transplantation period. The authors report a thalassemic child who developed necrotizing otitis externa and otitis media, a very rare complication after bone marrow transplantation, and then peripheral facial nerve paralysis and brain abscess in the early period of bone marrow transplantation despite antibacterial and antifungal prophylaxis. Necrotizing otitis media is characterized by necrosis and sloughing of considerable areas in the middle ear and adjacent tissues and is an unusual disorder because of today's antibiotics. Granulocytopenia and background ear tissue exposed to previous repeated otitis media attacks may be the predisposing factors in this case. The authors conclude that the children with previous histories of recurrent otitis media should be prepared and monitored very carefully during bone marrow transplantation because of the risk of necrotizing otitis media, especially in the granulocytopenic period.

Anti-Bacterial Agents↗
PubMedDate not supplied

Safety, tolerability and immunogenicity of a Haemophilus influenzae type b vaccine containing aluminum phosphate adjuvant administered at 2, 3 and 4 months of age.

The primary aim of this study was to assess the tolerability and immunogenicity of a new Haemophilus influenzae type b (Hib)/AlPO4 (CHIRON, SpA) vaccine, in two-month-old healthy infants. Twenty-three subjects were enrolled and administered the new Hib vaccine containing AlPO4 adjuvant at two, three and four months of age concomitantly with diphtheria-pertussis-tetanus (DPT) and hepatitis B vaccines according to the local program. Children were observed for 30 minutes after each immunization for any immediate local and systemic reactions. An active surveillance for side effects was performed on the 2nd and 7th days following each immunization by telephone. Families also filled out diaries for the first seven days. From the 2nd day to the next immunization only data about adverse events necessitating a physician's visit or about serious adverse events were collected. Blood samples were obtained before the first immunization and one month after the third dose for evaluation of anti-polyribosylribitol phosphate (PRP) antibody response. Local reactions at the Hib site were mild and less frequent compared to those observed at the DPT site. Systemic reactions noted after the three immunizations were fever in 70 percent, irritability in 48 percent, persistent crying in 26 percent, change in eating habits in 22 percent, diarrhea in 17 percent, sleepiness in 17 percent, vomiting in 9 percent, and unusual crying in 4 percent of the cases. There was no serious adverse event. One hundred percent and 95 percent of children achieved an anti-PRP antibody response over 0.15 microg/ml and 1.0 microg/ml, respectively. The geometric mean titer was 15 microg/ml and the geometric mean ratio 84. It was concluded that the new (Hib)/AlPO4 vaccine is safe and well tolerated, and induced a good PRP antibody response in healthy two-month-old infants.

Adjuvants, Immunologic↗
PubMedDate not supplied

Leukocytoclastic vasculitis in a child with epidermolysis bullosa simplex.

A 10-year-old boy with epidermolysis bullosa simplex (Weber-Cockayne variant) together with leukocytoclastic vasculitis is presented. He was admitted to the hospital with the provisional diagnoses of infected epidermolysis bullosa simplex or drug eruption. On the sixth day of hospitalization he developed palpable purpura, abdominal pain and bloody diarrhea, together with hematuria and proteinuria. A generalized tonic-clonic convulsion, changes in mental status, fluctuations in arterial blood pressure and intractable pain in his extremities occurred during the course of hospitalization. Systemic pulse steroid therapy, antibiotics, and antihypertensive and anticonvulsive drugs were given. On the 30th day of hospitalization, a skin graft was performed to replace a large tissue defect on his left hand. Despite high dose steroid therapy, his hematuria, proteinuria and hypertension continued after his discharge, suggesting a steroid-resistant renal pathology, such as focal glomerulosclerosis, that occurred secondary to leukocytoclastic vasculitis.

Anti-Bacterial Agents↗
PubMedDate not supplied

Epidemiology and antibiotic resistance of gram-negative urinary pathogens in pediatric patients.

In order to determine the etiological agents and the rate of resistance to various antibiotics, 209 consecutive gram-negative bacteria isolated from children admitted to Hacettepe University Children's Hospital with urinary tract infections were investigated over a three-month period. Of these, 46 (22%) were nosocomial isolates. The most frequently isolated organism was E.coli (n: 141) followed by Klebsiella spp. (39), Proteus spp. (19), Pseudomonas spp. (8) and Enterobacter spp. (2). In vitro susceptibilities were evaluated by microbroth dilution method, following NCCLS guidelines. Overall, 75 percent of the isolates were resistant to ampicillin, 52 percent were resistant to TMP/SMX and 25 percent to cefuroxime. Amikacin was the most active aminoglycoside; 93 percent of the isolates were susceptible to this agent, while resistance to gentamicin was 21 percent. Resistance to ceftazidime and ceftriaxone was 12 percent and 19 percent, respectively. Overall, resistance to imipenem was one percent and to ciprofloxacin three percent. These in vitro results should be taken into account before initiating empirical therapy; broad spectrum antibiotics should not be used if the isolate is susceptible to the older drugs in order to prevent the increase in resistance.

Child↗
PubMedDate not supplied

Antibiotic susceptibilities of Salmonella serogroups isolated from Turkish children.

This study is performed to show the serogroup distribution and in-vitro antibiotic susceptibilities of Salmonella species that cause either gastroenteritis with/without bacteremia or enteric fever at Hacettepe University Ihsan Doğramaci Children's Hospital. Of the 309 Salmonella strains evaluated, serogroup B was the most common isolate (56%) followed by serogroup D (33%). Antibiotic susceptibility tests using the disk diffusion technique revealed resistance rates of 43 percent for ampicillin, 41 percent for chloramphenicol, 29 percent for trimethoprim-sulfamethoxazole (SXT) and 32 percent for ceftriaxone among Salmonella serogroup B. The same rates were 10, eight, seven and zero percent for Salmonella serogroup D, and seven, 14, and zero percent for serogroup C, respectively. S.thypi strains susceptible to all antibiotics studied except tetracycline (33% resistant). No resistance was detected against the quinolones. The antibiotic resistance of Salmonella species isolated from children seems to be important, especially in serogroup B. Susceptibility tests should be considered in the antimicrobial therapy of Salmonella infections where indicated.

Child↗
PubMedDate not supplied

Antibiotic susceptibilities of enterococci isolated from Turkish children.

To evaluate the antibiotic resistance rates of enterococci isolated at Hacettepe Children's Hospital, in vitro antibiotic susceptibility tests were performed in 77 enterococci (32 hospital, 45 nonhospital strains) isolated from various clinical specimens in 1994. Microbroth dilution tests against ampicillin, vancomycin, gentamicin and streptomycin were performed according to the NCCLS standards. High-level resistance to aminoglycosides was investigated. Ampicillin resistance rates were 21.9 percent and 2.2 percent for hospital and nonhospital strains, respectively (p < 0.01). The same rates were 46.9 and 13.3 percent for gentamicin (p < 0.01), and 15.6 and 13.3 percent for streptomycin (p = 0.25). No resistance was detected against vancomycin. Six strains (7.8%) showed high-level resistance to both aminoglycosides studied. Special attention should be paid to enterococci isolated from hospitalized patients. Appropriate antibiotic use in serious infections can only be achieved by choosing an appropriate regimen according to antibiotic susceptibility tests. Periodic evaluation of the antibiotic susceptibility patterns of enterococci is necessary for the empirical treatment of infections due to these microorganisms.

Child↗
PubMedDate not supplied

Clinical trial to evaluate immunogenicity and safety of inactivated hepatitis A vaccination starting at 2-month-old children.

Active immunization with hepatitis A vaccine has been shown to provide long-term protection against hepatitis A virus (HAV) infection. However, few data are available regarding use of the hepatitis A vaccine in children under two years of age. The present study was conducted to test the safety and immunogenicity of inactivated hepatitis A vaccine administered to infants, and to evaluate the correlation between mother and infant anti-HAV antibodies. A total of sixty healthy children, two months of age, were enrolled in this study and immunized with 360 EU of inactivated hepatitis A vaccine (Havrix) according to the two, four and six months of age schedule. Blood sampling was performed prior to the first vaccination and one month after the third vaccination at seven months. Venipuncture was also done on mother on admission. The reactogenicity was expressed as the percentage of reported local and systemic reactions. The most common side effects were erythema on the injection site and fever. Infants with passively transferred maternal anti-HAV antibodies had a reduced anti-HAV GMT after vaccination. On admission, only one infant and his mother were seronegative and seroconversion was only detected in this infant. One month after the third dose seven infants (12.3%) were found to be seronegative. The infant without passively acquired maternal anti-HAV had the protective levels with a GMT of 3176 mIU/ml one month following the third dose. There was a significant positive correlation between the titers of mother and infant anti-HAV antibodies (n = 0.96, p < 0.001) on admission. Hepatitis A vaccine showed no immunogenicity in infants with presence of maternal antibodies. Hepatitis A vaccine is safe but it should be used after the disappearance of maternal antibodies.

Age Factors↗
PubMedDate not supplied

Reactogenicity and immunogenicity of a new measles-mumps-rubella vaccine containing RIT 4385 mumps virus strain in healthy Turkish children.

A total of 44 children aged between 15-18 months were randomly vaccinated either with a new measles-mumps-rubella (MMR) vaccine (Priorix, SmithKline Beecham) or a commercially available MMR vaccine (MMR-II, Merck) to compare the reactogenicity and immunogenicity. No local symptoms or fever was reported. Seroconversion rates of the study vaccine were 100, 95 and 100 percent for measles, mumps and rubella, respectively. The seroconversion rates for the control vaccine were 100, 94.7 and 95.5 percent, respectively. The geometric mean titers (GMT's) for the study and control groups were 1695, 95, 58; and 2198, 1183 and 47; respectively. In conclusion, the new MMR vaccine containing RIT 4385 mumps strain derived from the Jeryl Lynn strain was shown to be immunogenic and safe in healthy Turkish children. Further post-marketing surveillance should be conducted.

Antibody Formation↗
PubMedDate not supplied

Monotherapy with meropenem versus combination therapy with piperacillin plus amikacin as empiric therapy for neutropenic fever in children with lymphoma and solid tumors.

The purpose of this study was to compare meropenem monotherapy with combination therapy for empirical treatment of neutropenic fever in children with lymphoma and solid tumors. Ninety episodes of neutropenic fever in children (0.7-16.0; mean age 7.7 years) with solid tumors in a single center were randomized to receive either meropenem (50 mg/kg/dose-maximum 1 g, every 8 hours) or piperacillin (200 mg/kg/dose, every 6 hours) plus amikacin (15 mg/kg daily). Failure was defined as treatment modification. Non-Hodgkin's lymphoma (NHL) accounted for 62.2 percent of all episodes, and solid tumors (37.8%) for the rest. Blood cultures were positive in 23 percent of all episodes. Sixty-seven percent of all isolated microorganisms stained Gram-positive. Overall success was 70.0 percent (63/90). The success with meropenem was comparable to that seen with piperacillin plus amikacin: 76.6 versus 64.6 percent (p = 0.25). The failure rate was 33 percent with Gram-positive culture and 78 percent with Gram-negative or mixed cultures. The solid tumor group had significantly less bacteremia (4/34 versus 17/56; p < 0.05) and treatment failure (3/34 versus 24/56; p < 0.001) than the NHL group. No serious drug-related adverse event was noticed. Meropenem monotherapy was as effective as piperacillin plus amikacin combination in the empirical treatment of neutropenic fever in children with lymphoma and solid tumors.

Adolescent↗
PubMedDate not supplied

Primary hemophagocytic lymphohistiocytosis in Turkish children.

Nineteen children with hemophagocytic lymphohistiocytosis (HLH) were studied in the Department of Pediatric Hematology, Hacettepe University. Patients were divided into two groups. Group 1: Thirteen patients were classified as having a genetic etiology (7 familial, 6 presumed familial) on the basis of an affected sibling and consanguinity. There was a history of consanguineous marriage in 13 of the families. Seven of them had a history of a sibling with HLH. Group 2: Six patients were diagnosed with sporadic HLH. The age at presentation for familial patients was 0.7-84 months (mean 21.9 +/- 24.9 months), and for sporadic cases it was 2.5-48 months (mean 22.7 +/- 19.8 months). The clinical and laboratory data of these two groups were similar at diagnosis. Thirteen cases were diagnosed premortem by bone marrow aspiration. Splenic biopsy was performed in 2 patients. Four patients were diagnosed by postmortem examination. Elevated LDH levels were found in all patients tested. No significant differences for clinical and laboratory data were found between the two groups.

Bone Marrow↗