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Biomedical subjects

Mustafa Altindis

Publications and source records attributed to Mustafa Altindis.

12 recordsLinked to original sources
PubMed2005

The effect of a restriction policy on the antimicrobial consumption in Turkey: a country-wide study.

BACKGROUND: The total annual expenditure of antimicrobials in Turkey in 2002 was 24% of all drug spending. In order to reduce the cost of drug expenditure, the Turkish government introduced a new restriction policy on the prescription of antimicrobials in June 2003. This new policy is based on the justification that the physicians specializing in infectious diseases should be primarily responsible for the prescription of antimicrobials. OBJECTIVES: Compare and contrast the usage of antimicrobials at hospitals before and after the implementation of the new restriction policy. METHODS: The data was collected from the same departments in two different periods in 2003 at 15 hospitals throughout Turkey. The first set of data was collected a few days before the new policy was implemented in May 2003 and the second data set 6 months after that. Antimicrobial usage was calculated as defined daily doses (DDDs) per 100 patient days according to ATC-DDD index. The change in antimicrobial consumption was determined by comparing the mean DDD values before and after the implementation of the new policy. RESULTS: Before the intervention, the mean antimicrobial use density was 71.56 DDD/100 patients-day at the hospitals in the study. Six months after the implementation, the mean antimicrobial use density was 52.64 DDD/100 patients-day. There was a 26.4% decrease in the antimicrobial usage between that prior to and that after the intervention (P < 0.025). CONCLUSIONS: The study shows that the implementation of the new policy resulted in a significant reduction in the prescription of antimicrobials.

Anti-Bacterial Agents↗
PubMed2004

Comparison of dio-bacit, bacitracin-trimethoprim/ sulphamethoxazole and latex agglutination in the diagnosis of Group A beta-hemolytic streptococci.

Not only is Group A beta-hemolytic Streptococcus (GAS) the most frequent cause of bacterial pharyngitis, it is also the culprit in various skin and systemic infections, acute rheumatic fever, post streptococcal glomerulonephritis, and other disorders and complications. A new, ready-to-use media, Dio-Bacit, in a two section plate containing 5% sheep blood agar on one side and sheep blood agar with bacitracin (2 microg/ml) on the other was compared for its efficiency in identifying GAS with bacitracin and bacitracin + sulphamethaxazole / trimethoprim disk tests applied after isolation of beta-hemolytic colonies. We also used the latex-agglutination test as the gold standard method for differentiating GAS from streptococci belonging to other groups. Compared with the latex-agglutination test, we found the sensitivity and specificity of the Dio-Bacit method to be 92.0% and 96.9%, respectively. Dio-Bacit plates provide an easy and very useful way to identify GAS within one day, saving time, labor, and money for routine diagnostic microbiology laboratories.

Adult↗
PubMed2004

Sequential periods of preconditioning decrease laparoscopy-related elevations in hepatic TNF-alpha and IL-6 levels in rats.

BACKGROUND: Laparoscopy induces an ischemia/reperfusion (I/R) injury that elicits the production of inflammatory cytokines. The aim of this study was to test whether laparoscopic preconditioning (LP) could change hepatic inflammatory response. MATERIALS AND METHODS: Twenty-four male Spraque Dawley rats were assigned into one of three experimental groups: the control group (C) was subjected to sham operation; the I/R group was subjected to 60 minutes of pneumoperitoneum followed by 45 minutes of desufflation; and the ischemic preconditioning (IP) group was subjected to preconditioning prior to the induction of I/R. Preconditioning was defined as two cycles of 5 minutes of pneumoperitoneum followed immediately by 5 minutes of desufflation. Hepatic tumor necrosis factor alpha (TNF-alpha) and interleukin (IL)-6 levels were evaluated as an inflammatory response. RESULTS: Hepatic TNF-alpha levels increased in the I/R group compared with the C group (9.64 +/- 0.77 pg/mg protein vs. 6.53 +/- 0.48 pg/mg protein, P < 0.01). The decreased TNF-alpha levels in the IP group were not statistically significant when compared to the I/R group (8.09 +/- 0.74 pg/mg protein). Hepatic IL-6 levels increased in the I/R group compared to the C group (4.17 +/- 0.31 pg/mg protein vs. 2.93 +/- 0.20 pg/mg, P < 0.05). IP reduced the hepatic IL-6 levels significantly compared to the I/R group (3.31 +/- 0.22 pg/mg protein vs. 4.17 +/- 0.31 pg/mg protein, P <0.05). CONCLUSION: Laparoscopy induces cytokine response in various organs including the liver. LP could alter the production of cytokines prior to sustained laparoscopic procedures. Preconditioning may be advisable, especially for elderly or other patients with hepatic, renal, or cardiac dysfunction. Further studies are needed to adapt this concept to clinical settings.

Animals↗
PubMed2004

Investigation of the incidence of hepatitis E virus among pregnant women in Turkey.

AIM: The aim of our study was to determine the prevalence of hepatitis E virus (HEV) among pregnant and non-pregnant women in Middle Anatolia, identify the factors that affect being HEV positive and to study the effects of HEV positivity on mother and fetus. METHODS: The study included 245 pregnant women who applied to various health centers and 76 cases in the same age range as the control. Blood samples taken from the cases were tested in terms of anti-HEV, IgM and IgG using the microELISA method. RESULTS: None of the blood samples tested revealed anti-HEV IgM positive, an indicator of acute infection, while 31 pregnant women (12.6%) and nine cases in the control group (11.8%) were found to have anti-HEV IgG positive (P > 0.05). It was seen that in pregnant women such factors as advanced age, lower educational and income levels and rural residence were correlated with higher anti-HEV IgG positive values (P < 0.05). HEV infection is endemic in Afyon and its vicinity. There were no statistical differences between pregnant women and non-pregnant women at similar ages in terms of HEV seropositivity. CONCLUSION: It can be suggested that pregnancy does not constitute a predisposition to HEV infection.

Adolescent↗
PubMed2004

Efficient and non-invasive method for investigating Helicobacter pylori in gravida with hyperemesis gravidarum: Helicobacter pylori stool antigen test.

AIM: To investigate the relationship between Helicobacter pylori infection and severe hyperemesis gravidarum (H. Gravidarum) by using Helicobacter pylori Stool Antigen (HpSA) and other serologic test results. METHODS: Twenty-seven pregnant women with H. Gravidarum and 97 asymptomatic pregnant women of matching gestational age without gastric problems were enrolled in a prospective study. Serum samples collected from cases were investigated in terms of specific antibodies for H. pylori (immunoglobulin-IgG, IgA) and feces samples were investigated for HpSA. Statistical analysis of the data obtained from the groups was made by appropriate chi2 tests. RESULTS: Rate of HpSA positivity in patients with H. Gravidarum was 40.7%, while the same rate was 12.4% in the control group. The difference between the two groups was significant (P = 0.001). Rates of positivity for specific IgG formed against H. pylori in gravida with H. Gravidarum and in the asymptomatic gravida were 85.2% and 73.2%, respectively, and the rates for IgA were 48.1% and 41.2%, respectively. There was no difference between groups in terms of specific Igs formed against H. pylori (P > 0.05). CONCLUSION: The HpSA scan showed a statistically significant relation between H. pylori infection and H. Gravidarum. HpSA test gives more efficient, reliable and realistic results than specific Igs formed against H. pylori in the identification of H. pylori positivity in gravida with H. Gravidarum.

Antigens, Bacterial↗
PubMed2004

Rotavirus infection in children with acute diarrhea as detected by latex agglutination, ELISA and polyacrylamide gel electrophoresis.

We examined prospectively, stool specimens from 135 children, 0 to 3 years old, referred for fever, abdominal pain, vomiting and/or acute diarrhea. Rotavirus antigens were detected from fecal samples by latex agglutination (LA), ELISA and polyacrylamide gel electrophoresis (PAGE). Rotavirus antigen positivity by Latex, ELISA and PAGE were 15, 55%, 12.59% and 11.85%, respectively. With PAGE test as reference, the sensitivity and specificity of LA and ELISA tests was 93.75%, 94.96% and 100%, 99.16%, respectively, The positivity ratio between 13-24 months group was meaningful with all tests (P = 0.042 for LA; P = 0.05 for ELISA; P = 0.031 for PAGE). ELISA and LA use found to be as sensitive and specific as PAGE in the diagnosis of rotavirus diarrhea.

Acute Disease↗
PubMed2003

Hormone replacement therapy, C-reactive protein, and fibrinogen in healthy postmenopausal women.

OBJECTIVE: To investigate short-term and long-term effects of combined hormone replacement therapy (HRT) on C-reactive protein (CRP) and fibrinogen plasma concentrations in healthy postmenopausal women. METHODS: In this cross-sectional study 241 healthy postmenopausal women were enrolled. A total of 81 women were receiving the following treatments for 3 months; transdermal 17beta-estradiol (17beta-E2) + medroxyprogesterone acetate (MPA) (n = 21), oral 17beta-E2 + norethisterone acetate (NETA) (n = 27), and conjugated equine estrogens (CEE) + MPA (n = 33). The same combined therapies were implemented in another 58 women for 12 months; transdermal 17beta-E2 + MPA (n = 10), oral 17beta-E2 + NETA (n = 16), and CEE + MPA (n = 32). Control group included 102 healthy postmenopausal women not receiving HRT. The effect of the type and the duration of HRT regimens on plasma levels of CRP, fibrinogen and lipids were investigated. RESULTS: Median CRP concentrations were significantly higher in women receiving oral 17beta-E2 + NETA (P = 0.037) and CEE + MPA (P = 0.0001) for 3 months than in women taking the same types of HRT for 12 months and of those were not on HRT. Median CRP levels were similar in women taking transdermal 17beta-E2 + MPA for 3 and 12 months, compared with controls. Fibrinogen levels were not different between nonusers and any group of HRT users. CONCLUSIONS: These elevated levels of CRP, which appears very recently as a crucial marker for cardiovascular disease, may be responsible for the early increased cardiovascular risk after starting oral combined HRT. But this increased risk in the early period seems to decrease with long-term use. Transdermal 17beta-E2 + MPA had insignificant effect on CRP both in short-term or in long-term use.

Administration, Cutaneous↗
PubMed2003

A national survey of surgical antibiotic prophylaxis in Turkey.

OBJECTIVE: To assess the quality of antibiotic prophylaxis for clean and clean-contaminated elective surgical procedures. DESIGN: A cross-sectional, country-wide survey. SETTING: Thirty-six hospitals in 12 cities in Turkey. PARTICIPANTS: Four hundred thirty-nine surgeons from 6 different specialties who performed selected procedures of interest. METHODS: A random sample of surgeons from different hospitals was selected. A standardized data collection form was used to record the type of procedure, the names, doses, timing of the first doses, and duration of antibiotics, important decisive factors, and problems in the management of prophylactic antibiotic use for surgical procedures. RESULTS: Fifty-five percent of surgeons addressed completed the survey. For clean-contaminated procedures, 6% of surgeons did not use antibiotic prophylaxis, whereas 88% used more than a single dose. Inappropriate antibiotics were chosen for 32% of procedures. In 39% of procedures, the first dose of antibiotics was not administered during induction of anesthesia. Duration of prophylaxis was longer than 24 hours in 80% and longer than 48 hours in 46% of all procedures. Only 112 surgeons (26%) were using definitely appropriate prophylaxis in all ways. Multivariate analysis revealed that surgeons in university hospitals (OR, 2.353; CI95, 1.426-3.884; P = .001) and general surgeons (OR, 4.986; CI95, 2.890-8.604; P < .001) used antibiotic prophylaxis more appropriately. Patients not covered by health insurance (OR, 0.417; CI95 0.225-0.772; P < .001) were associated with inappropriate prophylaxis. CONCLUSION: Given the high frequency of antibiotics prescribed for surgical prophylaxis in Turkey, adherence to surgical prophylaxis guidelines is urgently needed.

Antibiotic Prophylaxis↗
PubMedDate not supplied

Usefulness of the Helicobacter pylori stool antigen test for detection Helicobacter pylori infection.

Several diagnostic tests are available for evaluating Helicobacter pylori (H. pylori) infection: histological examination, culture of gastric biopsy specimens, rapid urease test, urea breath test and serology. In this study, we assessed the reliability of a newly developed enzyme immunoassay HpSA (H. pylori Stool Antigen) kit for detecting H. pylori antigen in stool. Eighty-five patients (50 males, 35 females; mean age 41.6 +/- 9.8 years) with dyspeptic symptoms who were examined by upper gastrointestinal endoscopy. The patients with a history of previous treatment with proton pump inhibitors, bismuth compounds or antibiotics were excluded. During the endoscopic examination biopsies were taken from antrum and corpus for rapid urease test and histological examination. Stool specimens were submitted to the laboratory and HpSA test was performed. H. pylori was considered in condition with rapid urease test and histopathological examination for H. pylori positive. Forty-six of 85 patients were positive and remaining 39 patients were negative for H. pylori with the rapid urease test and pathologic evaluation. When 0.160 was adopted as the cut-off value, in accordance with the manufacturer's recommendations; stool antigen has been detected in 45 of the 46 H. pylori positive patients. The sensitivity and specificity of HpSA test were 97.8%, 94.9% respectively. These results indicate that HpSA is a highly reliable diagnostic method for H. pylori infection.

Adult↗
PubMedDate not supplied

Octenidine hydrochloride in hydatid disease.

Hydatid disease is still endemic in many devoloping countries and continues to be an important cause of morbidity. The objective of this study was to determine the in vitro scolicidal effects of octenidine hydrochloride in different concentrations using different exposure times. After hydatid cyst liquid was left to precipitate for 1 h to obtain cystic sand, various concentrations of octenidine (undiluted, 1% and 0.1% diluted) were added to concentrated hydatid cyst sediments for 5, 10, 15, 20, 25, 30, 45, and 60 min, and scolicidal effects of octenidine were compared with 20% saline and control group for the same times. It was found that undiluted octenidine had a strong scolicidal effect at 15 min compared to saline at 20%. One percent octenidine had a scolicidal effect at 30 min. However, 0.1% octenidine did not have enough scolicidal effect in 1 h. It was concluded that undiluted and 1% diluted octenidine might be used for scolicidal purpose in the treatment of hydatid disease.

Animals↗
PubMedDate not supplied

Antifungal susceptibilities of dermatophytic agents isolated from clinical specimens.

The aim of this study was to investigate the susceptibility to four antifungal agents: ketoconazole, terbinafine, itraconazole and fluconazole, of the different species of dermatophyte strains isolated from clinical specimens. A total of 128 specimens were collected from toe nail, foot, inguinal region, trunk, hands and head. The dermatophytes tested included Trichophyton rubrum 108 (84.4%), Trichophyton mentagrophytes 11 (8.6%), Epidermophyton floccosum 5 (3.9%), Microsporum canis 2 (1.5%) and Trichophyton tonsurans 2 (1.5%). The mean minimum inhibitory concentrations (MIC) for the five species of dermatophytes ranged between 0.09-1.12 microg/mL for ketoconazole, 0.04-0.27 microg/mL for terbinafine, 0.08-0.43 microg/mL for itraconazole and 16.18-24.0 microg/mL for fluconazole. In vitro analysis of antifungal activity of these agents would also allow for the comparison between different systemic antifungals, which in turn may clarify the reasons for the lack of clinical response or serve as an effective therapy for patients with chronic infection.

Administration, Cutaneous↗