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Biomedical subjects

M Doğanay

Publications and source records attributed to M Doğanay.

At least 19 recordsLinked to original sources

Maternal serum levels of dehydroepiandrosterone sulfate and labor induction in postterm pregnancies.

OBJECTIVES: To study the relationship between maternal endogenous dehydroepiandrosterone sulfate (DHEAS) levels, success of labor induction, and Bishop scores in postterm pregnancies. METHODS: There were 65 postterm pregnancies. Group 1 consisted of women spontaneously in the active phase of labor, and group 2 of women with hypotonic uterine contractions whose labor was inducted by oxytocin. Levels of DHEAS were studied from venous blood samples. Demographic data and Bishop scores were recorded. RESULTS: The demographic characteristics of patients were similar, but DHEAS levels were higher in group 1 than in group 2 (P<0.001). Linear regression analysis showed a significant relationship between DHEAS and Bishop scores. DHEAS levels in women delivered vaginally were significantly higher than in women delivered by cesarean section. From the receiver operating characteristics (ROC) curve, DHEAS levels might determine the mode of delivery and success of labor induction; however, Bishop scores do not. CONCLUSIONS: DHEAS levels may be an important factor influencing the efficiency of labor and the success of labor induction in postterm pregnancies.

Adult↗

Bloodstream infections caused by Staphylococcus aureus in a university hospital in Turkey: clinical and molecular epidemiology of methicillin-resistant Staphylococcus aureus.

In total, 177 patients with bloodstream infections caused by Staphylococcus aureus (BSISA) were investigated prospectively between June 1999 and June 2001. Of these, 19.8% had community-acquired BSISA, while 80.2% had nosocomial BSISA. Surgical intervention, foreign body, mechanical ventilation, total parenteral nutrition, and previous antibiotic treatment were found to be important risk factors for the nosocomial BSISA group. Secondary BSISA formed a greater proportion (62.9%) of community-acquired infections than of nosocomial infections (26.8%; p 0.0001). Catheter-related nosocomial BSISA was observed in 72.1% of patients. The suppurative complication rate was significantly higher among community-acquired infections (22.9%) than among nosocomial infections (6.3%; p 0.008). Of the nosocomial BSISA, 65.5% were methicillin-resistant. Analysis of 80 methicillin-resistant S. aureus isolates by pulsed-field gel electrophoresis identified ten main clones (A-J), but 61 (76.3%) of the 80 isolates belonged to clone A.

Adult↗

Truncal ligation of the inferior thyroid arteries does not affect the incidence of hypocalcaemia after thyroidectomy.

OBJECTIVE: To assess the effect of truncal ligation of the inferior thyroid arteries during bilateral subtotal thyroidectomy on the incidence of hypocalcaemia after thyroidectomy. DESIGN: Prospective non-randomised study. SETTING: Teaching hospital, Turkey. SUBJECTS: 216 patients who had bilateral subtotal thyroidectomy for non-toxic nodular goitre between 1990 and 1996. INTERVENTIONS: The trunk of the each inferior thyroid artery was simply ligated during bilateral subtotal thyroidectomy. MAIN OUTCOME MEASURES: Clinical examination, and measurement of serum calcium, ionised calcium, and inorganic phosphate concentrations before and after operation. RESULTS: Four patients (2%) had low concentrations of total and ionised calcium during the postoperative period. On physical examination three of them had spasms of the facial nerve, as seen in tetany. They were given calcium supplements orally and their laboratory results returned to reference ranges within 180 days. No patients developed permanent hypocalcaemia. CONCLUSION: Truncal ligation of the inferior thyroid arteries during bilateral subtotal thyroidectomy has no effect on the incidence of hypocalcaemia after thyroidectomy.

Adolescent↗

A surveillance study of antimicrobial resistance of gram-negative bacteria isolated from intensive care units in eight hospitals in Turkey.

This study was carried out with the participation of eight hospitals in Turkey to determine the frequency of gram-negative bacteria isolated in intensive care units (ICU) and to compare their resistance rates to selected antibiotics. Aerobic gram-negative bacteria isolated from ICUs during 1996 were studied. Antibiotic susceptibilities to imipenem, ceftazidime, ceftazidime-clavulanate, ceftriaxone, cefotaxime, cefepime, cefodizime, cefuroxime, piperacillin/tazobactam, amoxycillin-clavulanate, gentamicin, amikacin and ciprofloxacin were determined by Etest. A total of 748 isolates were obtained from 547 patients. The majority of organisms were isolated from the respiratory (38.8%) and urinary tracts (30.9%). Pseudomonas spp. were the most frequently isolated gram-negative species (26.8%), followed by Klebsiella spp. (26.2%). Escherichia coli, Acinetobacter spp. and Enterobacter spp. were the other commonly isolated organisms. High resistance rates were observed for all antibiotics studied. Imipenem appeared to be the most active agent against the majority of isolates. Although resistance rates exceeded 50%, ciprofloxacin, cefepime and amikacin were found to be relatively effective. Extended-spectrum beta-lactamase (ESBL) production appeared to be a major mechanism of resistance to beta-lactam antibiotics. In contrast to ceftazidime-clavulanate, piperacillin/tazobactam showed poor activity against organisms thought to produce ESBL, suggesting the presence of an enzyme resistant to tazobactam action. This study has yielded high rates of resistance in aerobic gram-negative isolates from ICUs in Turkey. High resistance rates to all the other antibacterials studied leave imipenem as the only reliable agent for the empirical treatment of ICU infections in Turkey.

Drug Resistance, Microbial↗

Prostatitis and hepatitis due to Brucella melitensis: a case report.

A case is reported of a 43-year-old man who presented prostatitis and hepatitis due to Brucella melitensis. His symptoms were icterus, weakness, anorexia, fever, and urinary discomfort. Physical examination revealed icterus and hepatosplenomegaly. Lymphomonocytosis, elevated erythrocyte sedimentation rate and abnormal liver functions had been detected in laboratory tests. Brucella melitensis was isolated from prostatic fluid and blood cultures.

Adult↗

The effects of vagotomy on bacterial translocation: an experimental study.

The effects of truncal vagotomy and proximal gastric vagotomy on bacterial translocation in rats were investigated in this experiment. The rats were divided into three groups. Only esophageal and gastric manipulations were performed in the control group (Group I). The anterior and posterior vagi were found and 0.5- to 1-cm pieces were taken out in the truncal vagotomy + pyloric dilatation group. In addition, pyloric dilatation was performed using a Fogarty catheter (Group II). The branches of the vagi, which lead to the rumen and corpus, were first tied with 5/O silk and then resected in the proximal gastric vagotomy group (Group III). All animals were sacrificed on the 7th day. Qualitative and quantitative tissue cultures of cecum, liver, spleen, mesenteric lymph node, and blood from vena cava were taken and a tissue sample from the ileum was obtained for histopathological examination with light microscopy. At the end of microbiologic study, the bacterial concentration on the cecal wall was 10.68 x 10(8) in the truncal vagotomy group, while it was 0.53 x 10(8) in the proximal gastric vagotomy group. Bacterial translocation was observed more in vagotomy groups than in control groups on the mesenteric lymph node, liver, and spleen. Bacterial translocation was greater in the truncal vagotomy group than in the proximal gastric vagotomy group (P < 0.05). Bacterial translocation was observed mostly in the liver, spleen, and mesenteric lymph node in the proximal gastric vagotomy group. No microorganisms could be cultured on systemic blood cultures. Cultures were positive only for one rat in the proximal gastric vagotomy group and for two rats in the truncal vagotomy group. At the end of histopathologic examination, when histopathologic parameters given for each rat were calculated, they were 5.44 +/- 2.12 in the truncal vagotomy group and 4.77 +/- 2.12 the in proximal gastric vagotomy group. The difference between these two groups was statistically significant (P < 0.05). Thus, there was damage to the intestinal wall in vagotomy groups, and it was greater in the truncal vagotomy group than in the proximal gastric vagotomy group. It was observed that bacterial translocation occurs after vagotomy, that this translocation occurs more after truncal vagotomy than after proximal gastric vagotomy, and that the translocation that occurred after vagotomies was not effective enough to create bacteremia.

Animals↗

Adrenal functions in patients with sepsis.

The basal cortisol level and cortisol response to ACTH stimulation test were assessed in patients with sepsis, the results being compared to a control group of 30 healthy persons. The study group included 49 patients with sepsis and 30 healthy subjects as a control group. The mean age in the study group was 42.6 +/- 18.7 years and 41.4 +/- 12.1 years in the control group. Fifteen of the 49 (30.6%) patients had hospital-acquired and 34 (69.4%) patients community-acquired sepsis. Etiological agent was isolated in 35 (71.4%) patients (57.1% gram negative bacteria and 34.3% gram positive bacteria, plus 8.6% polymicrobial). Fourteen of 49 (28.6%) patients died. Mean basal cortisol level was 597.1 +/- 304.6 nmol/l (range 217.8-1667.9) in the study group and 460.2 +/- 180.8 nmol/l (range 253.6-988.9) in the control group. Mean basal cortisol level in the study group was significantly higher than that of the control group (p < 0.05). Mean basal cortisol level was found to be 725.5 +/- 448.9 nmol/l in the patients who died and 545.8 +/- 210.9 nmol/l in the patients who recovered. The difference between the two groups was found to be significant (p < 0.05). ACTH stimulation test was performed in 43 of the patients and 30 healthy subjects. Cortisol response was significantly lower (mean 277.7 +/- 216.9 nmol/l) in the patients than that detected in the control group (mean 519.6 +/- 279.2) (p < 0.001). Mean cortisol response in the patients who died was 227.2 +/- 224.5 nmol/l and 302.1 +/- 212.7 nmol/l in the patients who recovered (p > 0.05). Adrenocortical insufficiency was detected in 16.3% of the patients and 42.9% of these patients died. In conclusion, sepsis is characterized by high basal cortisol level which may show a poor prognosis and a blunted cortisol response to ACTH stimulation. A small percentage of patients with sepsis may develop adrenocortical insufficiency.

Adolescent↗

Leiomyosarcoma of the parotid gland.

A 36-year-old patient with a primary leiomyosarcoma of the left parotid gland is presented. To our knowledge this is only the second case of a parotid leiomyosarcoma in the world according to the literature review.

Adult↗

Treatment of tuberculous meningitis in Turkey.

A prospective study was performed on 72 cases of tuberculous meningitis studying various treatments. 37 patients were treated with a combination of isoniazid, rifampicin, pyrazinamide and streptomycin for 2 months, followed by a combination of isoniazid and rifampicin for 6 months. 35 patients were treated with various combinations of antituberculous drugs for 12-16 months. Disappearance of symptoms took (mean) 17 days. Mean duration of therapy for the hospitalized patients was 36 +/- 4 days. Seven (9.7%) patients died, 5 in the short-course therapy group and 2 in the long-course therapy group. Sequelae persisted in 18 (31%) cases, 8 of which cases were in the short-course therapy group and 10 in the long-course therapy group. No relapse was observed in either of the groups.

Adolescent↗

Postoperative endophthalmitis caused by an Enterobacter species.

Six patients (aged 8 to 75 years) who were operated upon during the same day developed bacterial endophthalmitis on the following day; seven eyes were affected. Two patients had intracapsular cataract extraction, one extracapsular lens extraction, two extracapsular cataract extraction with intraocular lens implantation and one repair of bilateral scleral or corneoscleral perforations. Vitreous cultures taken from six eyes were positive for an Enterobacter sp. Despite antibiotic treatment systemically, subconjunctivally and intravitreally, four eyes had to be eviscerated, while two eyes showed evidence of shrinkage (phthisis); only one eye retained useful vision (9/10). Cotton swabs used during surgery, prepared manually from cotton wool moistened with saline, were identified as the source of infection; the batch had not been subjected to the prescribed autoclaving process. The importance of proper sterile procedures in association with surgery is emphasized.

Adolescent↗

The nonsurgical management of a penetrating orbitocranial injury reaching the brain stem: case report.

Penetrating and perforating periorbital puncture wounds by lead pencils are not rare, but ones that reach the brain stem are extremely unusual. We recently treated a patient with of this type of injury. A newly sharpened lead pencil was accidentally introduced through the subconjunctiva at the inner canthus of the right eye. It passed along the medial border of the globe transorbitally and went through the superior orbital fissure into the temporal fossa, then continued through the lateral side of the sella and posterior clinoid, reaching the brain stem. The entire pencil was removed inch by inch without incident under CT control. Meanwhile, the operative team remained ready in case of emergency bleeding. The patient's postoperative course was uneventful, but the initial neurologic deficit of the patient remained fixed.

Brain Injuries↗

[Comparison of HBsAg, anti-HCV and anti-HDV positivity in diverse groups].

Three hundred eighty three serum samples obtained from various patient groups and health care personnel were tested for HBsAg, Anti-HCV and Anti-HDV by ELISA technique. Anti-HCV antibodies were found 32.4% of chronic haemodialysis patients, 23% of the patients with chronic viral hepatitis and cirrhosis, 8.3% of health care personnel and less frequently detected in other groups. Anti-HDV antibodies were found 23% of the patients with chronic viral hepatitis and cirrhosis, 2.7% of blood donors, 8.1% of chronic haemodialysis patients and 1.3% of the patients who have malignancy. Anti-HDV antibodies were not detected in other groups.

Blood Donors↗

Antimicrobial susceptibility of Bacillus anthracis.

22 Bacillus anthracis isolates were tested for susceptibility to 27 antimicrobial agents by agar dilution. All isolates were sensitive to penicillins and did not produce beta-lactamase. Although all isolates were sensitive to cefazolin, cephalothin, cephradine and cefoperazone 19 isolates were resistant to cefuroxime, 18 to cefotaxime, 18 to ceftizoxime, 9 to ceftriaxone and 21 to ceftazidime. All isolates were also found to be sensitive to other antimicrobials tested. The new antimicrobial agents, ofloxacin and ciprofloxacin showed very good activity with MICs of 0.03-0.06 mg/l.

Anti-Bacterial Agents↗

[The histopathological effects of different treatments on lung tissue of mice pretreated with cyclophosphamide and steroids in experimental E. coli sepsis].

The incidence of gram-negative bacteremia is significantly increasing in recent years by the wide-spread use of cytotoxic and immunosuppressive drugs. Although, the effective antimicrobial drugs are being used in treatment, the mortality rate is still high. In this study, we searched for the histopathological changes occurring on lung tissue in E. coli sepsis, and their severity in different models. Microscopically, all the specimens were examined by the presence of interstitial and peribronchiolar inflammation, congestive atelectasis, and emphysema. The differences between the ratios of histopathological changes in treatment subgroups were not statistically significant. However, the ratio of interstitial and peribronchiolar inflammation and emphysema was significantly decreased in mice received cyclophosphamide, when compared with control group. Besides, the ratio of peribronchiolar inflammation was significantly increased in mice received steroid when compared with control group.

Animals↗

[Asymptomatic bacteriuria in patients with diabetes mellitus].

The prevalence of asymptomatic bacteriuria and the relation of bacteriuria to pyuria, glycosuria and HbA1c in patients with diabetes mellitus were investigated. The study population included 110 diabetic patients and 100 healthy persons (control group). The ratio of bacteriuria was found as 25.5% (31.3% in women, 17.4% in men) in the diabetic group and as 9% (16% in women, 0% in men) in the control group. The prevalence of asymptomatic bacteriuria was significantly higher in the diabetic patients than in the control group (p less than 0.05). There was a significant relation between bacteriuria, pyuria and HbA1c levels (p less than 0.05). But, there wasn't any important correlation between bacteriuria and glycosuria.

Bacteriuria↗