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Orhan Baylan

Publications and source records attributed to Orhan Baylan.

9 recordsLinked to original sources
PubMed2006

The predictive value of serum procalcitonin levels in adult patients with active pulmonary tuberculosis.

The aim of our prospective study was to evaluate the predictive value of serum procalcitonin (PCT) level in comparison with C-reactive protein level and erythrocyte sedimentation rate for the diagnosis of pulmonary tuberculosis (PTB) on admission and 6 months after the administration of anti-tuberculous chemotherapy (ATCT). Seventy-five adult male patients with active PTB who were mycobacteriologically diagnosed (smear and culture positivity) were examined in this study. As a control group, 75 healthy adult males were enrolled. The measured serum PCT levels were within the normal range both in healthy individuals and in patients 6 months after ATCT. Serum PCT levels had been slightly high on admission in patients with PTB in comparison with controls (P = 0.01) and patients who had ATCT (P = 0.001), and this difference was statistically significant, but the PCT levels of most cases with PTB (58.7%) were below the usual cut-off level (0.5 ng/mL). We conclude from this study that the serum PCT level was not a reliable indicator in the diagnosis of active PTB because of its low sensitivity (41.3%), and in most cases it was not capable of overcoming the cut-off level even if statistically meaningful results were obtained. The PCT test for the presumptive diagnosis of PTB cannot be substituted for microbiological, epidemiological, clinical and radiological data.

Adult↗
PubMed2005

[Culture based diagnostic methods for tuberculosis].

Culture methods providing isolates for identification and drug susceptibility testing, still represent the gold standard for the definitive diagnosis of tuberculosis, although the delay in obtaining results still remains a problem. Traditional solid media are recommended for use along with liquid media in primary isolation of mycobacteria. At present, a number of elaborate culture systems are available commercially. They range from simple bottles and tubes such as MGIT (BD Diagnostic Systems, USA), Septi-Chek AFB (BD, USA) and MB Redox (Biotest Diagnostics, USA) to semiautomated system (BACTEC 460TB, BD, USA) and fully automated systems (BACTEC 9000 MB [BD, USA], BACTEC MGIT 960 [BD, USA], ESP Culture System II [Trek Diagnostics, USA], MB/BacT ALERT 3D System [BioMérieux, NC], TK Culture System [Salubris Inc, Turkey]). Culture methods available today are sufficient to permit laboratories to develop an algoritm that is optimal for patients and administrative needs. In this review article, the culture systems used for the diagnosis of tuberculosis, their mechanisms, advantages and disadvantages have been discussed under the light of recent literature.

Algorithms↗
PubMed2005

[Detection of primary drug resistance rates of Mycobacterium tuberculosis complex strains isolated between 2002-2003 years and comparison with the data of 1998-2001 period].

In this retrospective study, it was aimed to evaluate the primary drug resistance rates of 151 Mycobacterium tuberculosis complex (MTC) strains against primary anti-tuberculosis (anti-TB) drugs, isolated from 2213 tuberculosis suspected patients between January 2002 to December 2003 in our hospital, and also to compare these results with the data obtained from our previous results between January 1998 to December 2001. It has been detected that there was a significant decrease in the susceptibility rates of MTC isolates to all anti-TB drugs both yearly from 1998 to 2003 (p < 0.001), and for the total of 1998 and 2003 years period (p < 0.029). When only the years 1998 and 2003 were taken into consideration, significant increases were found in any (one or more) combination of the drugs with isoniazid (INH), and only INH resistance rates (p < 0.007 and p < 0.033, respectively). Thus, naturally there was also an increase in resistance to total any drug resistance (p < 0.029). We suggest that strict measures such as "directly observed therapy" should be undertaken in order to prevent development of drug resistance particularly against INH. Regular and continuous screening of anti-TB drug resistance should be accomplished to survey the presence of drug resistant strains in the nation, to define the suitable drug regimens and to evaluate the quality of tuberculosis control programs.

Adolescent↗
PubMed2005

Delayed diagnosis of tuberculous arthritis.

Monoarticular tuberculosis (TB) affecting the knee is rare in all forms of TB (0.1-0.3%). We present the case of a patient with tuberculous arthritis in whom the diagnosis was belated due to a lack of familiarity with the disease; here, we emphasize the difficulties associated with the diagnosing joint TB. A 20-year-old man was referred to our department due to swelling of the right knee and the presence of persistent, mild pain for 4 years. The lack of systemic evidence of this disease, the indolent course of disease, and the presence of non-specific symptoms renders early recognition of this disease difficult. Furthermore, in cases in which a diagnosis cannot be reached simply by culturing the synovial fluid, synovial biopsy cultures should be considered in the diagnostic process, due to the high rate of positivity of such cultures. The diagnosis and treatment of articular TB are both urgent matters; surgical debridement and strict adherence to antituberculous chemotherapy tend to yield a satisfactory functional outcome.

Adult↗
PubMed2005

A case of tuberculous pyomyositis that caused a recurrent soft tissue lesion localized at the forearm.

We present the case of a 20-year-old male who had a non-traumatic soft tissue lesion (4 x 3 cm) with recurrent discharge at his right posteromedial antebrachial muscles; the patient underwent surgery twice, and antibiotic therapy was administered, but no cure was achieved with these treatments. The patient underwent surgery at our medical center. There was no history of pulmonary, gastrointestinal, or genitourinary tuberculosis (TB). Due to suspected pulmonary, genitourinary, and gastrointestinal TB, radiography and computed tomography scans were performed, and these studies disclosed no evidence of a primary origin. The erythrocyte sedimentation rate and the results of purified protein derivate testing were normal. We also detected submandibular lymphadenopathy (LAP) (2 x 3 cm) localized at a submandibular site in our patient 4 months after his first visit to our clinic. Smears were stained with Ehrlich Ziehl Neelsen (EZN) stain and culture were grown for Mycobacterium tuberculosis complex (MTC); the samples used for these assays had been obtained by incisional biopsy of the forearm lesion and by aspiration of the submandibular lymph node, and they were found to be MTC-positive. Then, a culture for MTC, derived from an induced sputum sample, was found to be positive, despite the negative results obtained with a sputum smear subjected to EZN staining. According to these results, the primary focus of the tuberculous pyomyositis and the submandibular LAP was the lungs. The lesion and submandibular LAP were both treated successfully by the administration of antituberculous chemotherapy.

Adult↗
PubMed2005

Tuberculous meningitis with multiple intracranial tuberculomas mimicking neurocysticercosis clinical and radiological findings.

Central nervous system (CNS) tuberculosis (TB), the most dangerous form of TB, remains a public health problem, particularly in developing countries. In the differential diagnosis of intracranial tuberculomas (ICTs), images on radiological findings should be differentiated from other causes of space-occupying lesions. These lesions include malignant diseases such as glioma or lymphoma, pyogenic abscess, toxoplasmosis, neurocysticercosis (NC), sarcoidosis, hydatidosis and late syphilitic involvement of CNS. We present a case with multiple ICTs mimicking NC with similar clinical and imaging manifestations in a young immunocompetent patient. The diagnosis was based on brain magnetic resonance imaging findings. The definitive diagnosis was confirmed mycobacteriologically in cerebrospinal fluid and sputum specimens. Adequate response to anti-TB chemotherapy was achieved while multiple ICTs in the brain disappeared slowly. In the absence of appropriate therapy, these pathologies might be fatal; the possibilities of differential diagnosis would be of great clinical importance, particularly because of the different treatment protocols required for the NC and ICTs.

Adult↗
PubMed2003

The evaluation of FASTPlaqueTB test for the rapid diagnosis of tuberculosis.

FASTPlaqueTB (Biotec Laboratories Ltd., Ipswich, UK) is a rapid test which utilizes bacteriophage amplification technology for the detection of viable Mycobacterium tuberculosis in clinical specimens. We evaluated performance of the FASTPlaqueTB test by comparing with BACTEC 460 TB culture system (Becton Dickinson Co., Maryland, USA), polymerase chain reaction (PCR) and acid fast bacilli (AFB) smear methods. We investigated 192 sputum specimens collected from the patients suspected of having pulmonary TB by AFB smear, BACTEC 460 TB culture system, PCR and FASTPlaqueTB test. The sensitivity of AFB smear, PCR and FASTPlaqueTB test were 57.8%, 84.4% and 87.5% respectively when we accepted BACTEC 460 TB culture system as gold standard. We conclude that FASTPlaqueTB test has a good potential for rapid diagnosis of Mycobacterium tuberculosis as a result of the evaluation of these three tests by comparison to the BACTEC 460 TB culture system.

Bacteriophage Typing↗
PubMedDate not supplied

Lipid profile and anticardiolipin antibodies in Behcet's disease.

BACKGROUND: Behcet's disease (BD) is a multisystem disorder characterized by a relapsing inflammatory process of unknown etiology. It is well known that atherothrombosis in systemic inflammatory disorders is closely related to coagulation and lipid metabolism abnormalities. The purpose of this study was to investigate some parameters of lipid metabolism, lipoprotein (a) [Lp(a)] and anticardiolipin antibody (ACA) levels and the relationship of these parameters with the clinical activity of BD. METHODS: Thirty three patients with BD (15 active, 18 inactive cases) and 20 healthy controls participated in the study. After performing a detailed physical exam, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C), apoprotein A and B (apo-A, apo-B), Lp(a), and ACA levels (ACA-IgG and IgM) were measured in all participants. RESULTS: Patients with active BD had higher ESR, CRP and Lp(a) levels, and lower apo-A and HDL-C levels compared with the patients with inactive BD and healthy controls. ACA-IgG and IgM levels were higher in patients with active BD than healthy controls but not higher than patients with inactive BD. On the other hand, ACA-IgG level was higher in active and inactive cases with vascular involvement than in those of active and inactive cases without vascular involvement. In the analyses of correlation, in active BD patients we found a positive correlation between CRP and Lp(a) levels. CONCLUSIONS: Our findings suggest that Lp(a) behaves as an acute phase reactant and ACA levels are increased in patients with active BD. Data from patients with active BD may be compatible with the serum profile, which is accepted as a risk for the development of atherothrombosis.

Adult↗