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Biomedical subjects

Salih Cesur

Publications and source records attributed to Salih Cesur.

At least 19 recordsLinked to original sources

Serum neopterin concentrations in healthy healthcare workers compared with healthy controls and patients with pulmonary tuberculosis.

BACKGROUND: The aim of this study was to compare serum neopterin levels in patients with active pulmonary tuberculosis, healthy healthcare workers who had close contact with patients, and healthy volunteers. All of the healthy volunteers stated that they had not encountered possible risk factors for exposure to Mycobacterium tuberculosis infection. MATERIAL/METHODS: Thirty-nine patients, 39 healthy healthcare workers, and a control group of 39 healthy volunteers who had no infection or other diseases were included in this study. Neopterin assay was performed in accordance with the manufacturer's instructions. RESULTS: Serum neopterin levels were 18.6+/-14.2 nmol/l in patients, 9.8+/-2.9 nmol/l in healthy healthcare workers, and 3.4+/-5.2 nmol/l in healthy volunteers. Serum neopterin levels in each group were significantly different from each other (p<0.01). CONCLUSIONS: Levels of neopterin in patients and healthy healthcare workers significantly differ from the levels in healthy controls. The higher serum neopterin levels in healthy healthcare workers may be attributed to latent Mycobacterium tuberculosis infection, but it does not seem to be used in the diagnosis of latent Mycobacterium tuberculosis infection alone. However, more experiences are needed.

Adult↗

Serum adenosine deaminase enzyme and plasma platelet factor 4 activities in active pulmonary tuberculosis, HIV-seropositive subjects and cancer patients.

The aim of this study was to determine the serum adenosine deaminase (ADA) and plasma platelet factor (PF-4) activities in patients with active pulmonary tuberculosis, HIV seropositive subjects, cancer patients (acute and chronic type lymphoblastic leukaemia) and to compare them with the results of healthy individuals. Eighty-eight subjects were enrolled in this study, 24 patients with active pulmonary tuberculosis, 20 patients with HIV seropositive subjects, 24 patients with cancer, 12 patients with acute type lymphoblastic leukaemia, 12 patients with chronic type lymphoblastic leukaemia) patients and 20 healthy individuals. ADA activity was determined in serum samples using colorimetric method and plasma PF4 activity was measured by using a sandwich-type enzyme immunoassay. When all study groups were compared with the control group, mean serum ADA activities were found to be significantly (p<0.01) higher in the sera of patients with active pulmonary tuberculosis (median, range: 39 IU/l), HIV seropositive subjects (median, range: 31 IU/l) than in the sera of cancer patients (median, range: 15) and healthy controls (median, range: 32 IU/l). Plasma PF-4 activities in active pulmonary tuberculosis patients (median, range: 84 IU/ml) were found to be significantly elevated when compared to HIV seropositive subjects (median, range: 59 IU/ml), cancer patients (median, range 55 IU/ml) and healthy individuals (median, range: 56 IU/ml) (p<0.01). Serum ADA and plasma PF-4 activities showed significant alteration in patients with active pulmonary tuberculosis compared to patients with HIV seropositive subjects, cancer patients and healthy individuals. In conclusion, we suggest that serum ADA and PF-4 activities can be used in the diagnosis of tuberculosis as an supplementary laboratory test in combination with clinical and laboratory findings. Further controlled studies are necessary to determine the importance of the PF-4 and ADA activities in patients with active pulmonary tuberculosis, HIV seropositive subjects and cancer patients.

Adenosine Deaminase↗

Serum copper and zinc concentrations in patients with brucellosis.

The aim of this study was to measure the alterations in serum trace element concentrations, including zinc (Zn) and copper (Cu) in patients with brucellosis and to compare them with the results of healthy individuals. Seventy-five subjects, 60 patients with brucellosis and 15 healthy individuals were included in this study. The serum Zn and Cu concentrations were measured by using atomic absorbtion spectrophotometer in sera of patients with brucellosis and statistically compared with those of healthy individuals. Serum Cu concentration was found to be significantly higher in patients with brucellosis than that of healthy individual (130.5+/-24.7, 96+/-8.65 microg/dl, respectively) (p < 0.01). Serum Zn concentration was lower in patients with brucellosis than those of healthy subjects (79.5 +/-13.5 and 83+/-5.59 microg/dl, respectively) (p < 0.01). Serum trace element concentrations showed significant alterations in patients with brucellosis compared with healthy subjects.

Adult↗

Serum copper and zinc concentrations in patients with chronic hepatitis C.

The aim of this study was to measure the alterations in serum trace elements, including zinc and copper in patients with chronic hepatitis C and to compare them with the results of healthy individuals. Seventeen patients with chronic hepatitis C and 17 healthy individuals were included in this study. Serum zinc and cooper concentrations were measured by using atomic absorption spectrophotometer of patients with chronic hepatitis C and the results were statistically compared with those of healthy individuals. Serum zinc concentrations were 105.6+/-22.8 microg/dl in patients with chronic hepatitis C and 94.41+/-19 microg/dl in healthy controls, respectively. Serum copper concentrations were 103.17+/-20.8 microg/dl in patients with chronic hepatitis C and 90.8+/-14.3 microg/dl in healthy subjects, respectively. Serum zinc and copper concentrations were not found statistically different in patients with chronic hepatitis C compared with those of healthy individuals (p>0.05). In conclusion, serum trace element concentrations did not show statistical alterations in patients with chronic hepatitis C compared to healthy subjects.

Adult↗

Serum copper and zinc concentrations in patients with chronic hepatitis B.

The aim of this study was to measure the alterations in serum trace elements, including zinc and copper in patients with chronic hepatitis and to compare with the results of healthy individuals. The serum zinc and copper concentrations were measured by using atomic absorption spectrophotometer in sera of patients with chronic hepatitis and statistically compared with those of healthy individuals. One hundred and five subjects, 71 patients with chronic hepatitis B (46 asymptomatic carriers, 25 chronic active hepatitis B) and 34 healthy individuals were included in this study. Sera of patients with chronic hepatitis and statistically compared with those of healthy individuals. Serum zinc concentrations were 104+/-24.98 microg/dl in asymptomatic carriers, 97+/-16.03 microg/dl in chronic active hepatitis and 108+/-21.07 in healthy controls, respectively. Serum copper concentrations were 88+/-17.8 microg/dl in asymptomatic carriers, 86+/-20.02 microg/dl in patients with chronic active hepatitis B and 88+/-13.59 microg/dl in healthy controls, respectively. Serum zinc and copper concentrations were not statistically different in patients with chronic hepatitis B compared with those of healthy individuals (p>0.05). Serum trace element concentrations did not show statistical alterations in patients with chronic hepatitis B compared with healthy subjects.

Copper↗

In vitro susceptibility of Candida species isolated from blood culture to some antifungal agents.

Fungal infections are among the major causes of morbidity in cancer patients. In order to optimize the treatment of such patients, it is critical to determine the type of fungus causing infection as well as its susceptibility to antifungals. This study was undertaken to the study resistance of Candida spp. isolated from blood cultures of cancer patients to ketoconazole (KET), fluconazole (FLU), amphotericin B (AmpB), and flucytosine (FCU). A modified NCCLS M 27-A method was used to evaluate the activity of the species. Of the 56 Candida albicans isolates, 7 (12.5%) were resistant to FLU (MIC > or = 64 microg/ml), 6 (10.7%) were resistant to KET (MIC > or = 64 microg/ml) and 3 (5.3%) were resistant to FCU (MIC > or = 32 microg/ml). One (14.3%) of 7 C. parapsilosis isolates was resistant to FLU (MIC > or = 64 microg/ml). One (33.3%) of 3 C. tropicalis isolates was resistant to KET (MIC > or = 64 microg/ml). None of the C. guilliermondii or C. pelliculosa isolates was resistant to KET, FLU, AmpB, or FCU. Based on these results, AmpB is an effective antifungal agent that can be used against all Candida isolates.

Antifungal Agents↗

[Retrospective evaluation of Cobas Amplicor system in the rapid diagnosis of Mycobacterium tuberculosis complex].

The aim of this study was to evaluate the value of Cobas Amplicor Mycobacterium tuberculosis (MTB) polymerase chain reaction (PCR) system in the rapid diagnosis of tuberculosis. During the study period, the results of acid-fast stain (AFS), culture and Cobas Amplicor MTB system obtained from 937 clinical (158 respiratory and 779 non-respiratory) specimens were retrospectively evaluated. When culture results were accepted as the gold standard, the sensitivity, specificity, positive and negative predictive values of Cobas Amplicor MTB PCR system were found as 100% for smear-positive respiratory specimens, 75%, 91.7%, 40% and 98% for smear-negative respiratory specimens, and 89.5%, 91.8%, 65.4% and 98.1% for all of the respiratory specimens, respectively. These rates were found as follows for smear-positive, smear-negative and all of the non-respiratory specimens, respectively; 100%, 66.7%, 83.3% and 100%; 29.2%, 97.3%, 26.9% and 97.6%; and 50%, 97.1%, 44.7% and 97.6%. The overall inhibition rate for Cobas Amplicor MTB was 4.8%. In conclusion, Cobas Amplicor MTB PCR system was considered as a rapid and reliable method for the diagnosis of tuberculosis in smear positive pulmonary samples. However, in smear negative pulmonary samples and non-respiratory samples, test results should be evaluated together with clinical and other laboratory data.

Humans↗

[Evaluation of a commercial enzyme immunoassay for the detection of interferon gamma levels in active tuberculosis patients and vaccinated healthy subjects].

The detection of plasma interferon gamma (IFN-g) levels has an important value for the evaluation of cell mediated immune response to Mycobacterium tuberculosis. The aim of this study was to investigate the plasma IFN-g levels by a commercial enzyme immunoassay (ELISA) and to compare the levels between recently diagnosed culture positive lung tuberculosis patients and BCG vaccinated healthy controls. Twenty-three patients with active lung tuberculosis (13 males, 10 females) and 34 BCG vaccinated healthy adults (16 male, 18 female) have been included in the study. The control subjects were questioned about passed tuberculosis infection and/or a contact with tuberculosis patients. No risk factors for exposure to M. tuberculosis were found in the control group. IFN-g levels were measured by QuantiFERON-TB (Cellestis, Australia) kit, and 22 of patients and 17 of control subjects were found to be positive. As a result, the sensitivity of QuantiFERON-TB test was high (95.6%), however its specificity was quite low (50%). In conclusion, QuantiFERON-TB may be used as a supplementary diagnostic test in patients considered to have active tuberculosis, before treatment. As BCG is in routine vaccination programme and the number of active tuberculosis cases is high in our country, this test seems to be invalid for the diagnosis of latent tuberculosis. Therefore, more specific tests that are not affected by the vaccine response, are required for the diagnosis of latent tuberculosis.

Adult↗

[A case with fever of unknown origin during treatment for malaria: multi-drug resistant Salmonella typhi infection].

Typhoid fever is an acute infectious disease caused by Salmonella serotype Typhi, leading to endemic or epidemic outbreaks in tropical/ subtropical countries (especially in India, Southeast Asia, Central and South Africa). In this report, a 27 years old male patient with malaria has been presented. The patient was diagnosed to have malaria while working in Afghanistan, and received malaria treatment since one month. He admitted to our hospital because of still continuing high fever, and other complaints (weight loss, night sweats, weakness, anorexia). His fever was 39.5 degrees C at admission, and blood smears were negative for Plasmodium sp. On the third day of admission, rose spots were detected on the skin of the abdomen and chest, and group agglutination tests gave positive results for S. Typhi O (titer: 1/800), and S. Typhi H (titer: 1/3200). Blood cultures revealed growth of Salmonella enterica serotip Typhi. The isolate was found to be resistant to ampicillin, chloramphenicol, tetracyclin and trimethoprimsulfamethoxazole, and sensitive to ciprofloxacin. The patient was treated successfully with ciprofloxacin for 14 days.

Adult↗

[Neopterin: a marker used for monitoring infections].

Neopterin released by monocytes/macrophages upon activation by interferon-gamma secreted from T-lymphocytes, is a sensitive indicator of cell-mediated immune activation. Chemically, neopterin is a pyrazino-pyrimidine derivative, namely, 2-amino-4 hydroxy-(1',2',3' trihydroxypropyl)-pteridine. Biosynthetically, neopterin derives from guanosine triphosphate (GTP), and is a biologically stable cytokine. Increased concentrations of neopterin in serum and urine have been found in various infections (especially viral), autoimmune diseases, malignant disorders, and during allograft rejection episodes. In addition, there is a close relationship between high neopterin levels and systemic inflammatory diseases, septicemia and surgical stress. Measurement of neopterin concentration in human body fluids such as serum, urine, cerebrospinal fluid and pleural fluid, allows insight into a cell-mediated immune response. In recent years neopterin becomes an important laboratory parameter for clinical and therapeutical follow-up of diseases involving the cellular immune system. In this review article, the clinical use of neopterin as a marker in the diagnosis and monitorization of the infectious diseases has been discussed.

Biomarkers↗

[Microbiological evaluation of the cases prediagnosed as pulmonary tuberculosis based on clinical and radiological findings].

In the present study, 34 new pulmonary tuberculosis cases prediagnosed upon clinical and radiological findings, have been evaluated by means of microbiological aspects such as microscopy [Ehrlich-Ziehl Neelsen (EZN) and Auramin-Rhodamine (A-R) stains], culture [inoculation into Lowenstein-Jensen (LJ) media] and three different molecular methods [Cobas Amplicor Mycobacterium tuberculosis polymerase chain reaction (PCR), Gen-Probe amplified M. tuberculosis direct test and TaqMan Real Time ABI 5700 PCR]. M.tuberculosis positivity of the sputum samples were 55.8% (n: 19) with EZN staining, 52.9% (n: 18) with A-R staining and 58.8% (n: 20) with culture methods. Among molecular techniques, Cobas Amplicor and TaqMan PCR yielded positive results in 21 patients (61.7%), however, the positivity rate of Gen-Probe AMTD was 47.0% (n: 16). Of 34 samples, 10 (29.4%) were found to be positive with all of the methods used, while six (17.6%) of them were negative with all methods. It can be concluded that molecular methods may aid to the diagnosis of tuberculosis, in conjunction with clinical findings and bacteriological results.

DNA, Bacterial↗

In vitro susceptibility of Candida species isolated from cancer patients to some antifungal agents.

This study was undertaken to study the resistance of Candida species isolated from oropharyngeal swabs of cancer patients to ketoconazole (KET), fluconazole (FLU), amphotericin B (AmpB), and flucytosine (FCU). The most common species identified was C. albicans, followed by C. tropicalis, C. glabrata, C. famata, C. krusei, C. kefyr, and C. gulliermondii. The minimum inhibitory concentration (MIC) of the antifungal agents was evaluated by RPMI 1640 medium with microdilution method. There were no C. albicans strains resistant to KET, FLU and AmpB. All Candida isolates were found highly susceptible to AmpB (MIC AmpB < 1 microg/ml), followed by KET (MIC KET < or =8 microg/ml), FLU (MIC FLU < or =8 microg/ml) and FCU (MIC FCU < or =4 microg/ml). The main conclusion of this study is that prophylactic therapy planned according to typing and antifungal susceptibility will contribute to the prevention of invasive fungal infections in immunosuppressied oncology patients.

Amphotericin B↗

[Epidemiology of tuberculosis in the world and in Turkey].

Tuberculosis is the most important public health problem in all over the world. Currently, it is reported that 8 million new cases occur each year in the developing countries and 80% of these cases are between age 15-60 years old. It is estimated that there are about 2 million adult deaths annually from tuberculosis in developing countries, which accounts for a quarter of avoidable adult deaths and a prevalence of almost 16 million people with active tuberculosis, half of whom have significant disability as a result of the disease. The global epidemiologic pattern of tuberculosis have changed as a result of AIDS epidemic and development and spread of multiple drug resistant tuberculosis strains. In the developing world, the rates of tuberculosis patients show different patterns. In many locations, one third or more of the population are infected with tuberculosis and incidence rates of newly diagnosed tuberculosis are more than 300 cases per 100,000 subjects in a part of Africa. In the United States, 6% of the population is infected with tuberculosis bacilli and the number of tuberculosis cases were reported as 15,591 in 2001. In Turkey, between 1998-2003 the notification rate decreased from 30 to 25 cases per 100,000 subjects. In this review article, epidemiology of tuberculosis in the world and in Turkey has been summarized.

Developing Countries↗

[Comparison of protein profiles and antibiotic sensitivity of methicillin-resistant Staphylococcus aureus strains isolated from nasal cultures of polyclinic patients and hospital personnel].

In this study, the antibiotic susceptibilities and whole cell protein patterns of methicillin resistant Staphylococcus aureus (MRSA) strains which were isolated from nasal swabs of outpatients and healthy hospital staff, have been determined by disk diffusion test and sodium dodecyl sulfate polyacrylamide gel electrophoresis method, respectively. A total of 43 MRSA isolates of which 13 out of 500 outpatients and 30 out of 500 hospital personnel, showed the same protein profiles, and the antibiotic susceptibility patterns were found similar. These findings suggested that the strains isolated from the outpatients were originated from hospital environment.

Ambulatory Care↗

[Thrombocytopenia cases due to acute brucellosis].

The hematological manifestations of brucellosis include anemia, leucopenia, thrombocytopenia and clotting disorders. In this case report, two patients, with clinically and serologically proven brucellosis, manifesting with thrombocytopenia were presented. The first patient who was a 32 years old man, was admitted to the hospital with the complaints of fever, malaise and night sweats. His Brucella agglutination titer was 1/1280 and thrombocyte count was 41.000/mm3. The second case was a 46 years old man with the complaints of fever and rash. His Brucella agglutination titer was 1/640, thrombocyte count was 38.000/mm3. Following treatment with doxycycline and rifampisin the thrombocyte counts of the patients returned to normal (respectively, 176.000/mm3 and 162.000/mm3. The blood cultures of both of these patients did not yield Brucella. The antibiotic therapy of patients discontinued after 6 weeks, with full recovery.

Adult↗

[A case of acute pancreatitis due to Weil's disease].

Leptospirosis, the most common vasculitic zoonosis in the world, is characterized with jaundice and acute renal failure. However, pancreatitis is an uncommon complication of leptospirosis. In this report, an acute pancreatitis case due to Weil's disease has been presented. A 31-year-old female patient with high levels of glucose, blood urea nitrogen, creatinine, creatine kinase, bilirubin, amylase and lipase, has been diagnosed to have leptospirosis by the high positive result (1/800) of microscopic agglutination test against Leptospira interrogans serogroup icterohemorrhagiae. The patient has been treated with supportive and symptomatic therapy, and with penicillin G for leptospirosis. Following triple hemodialysis, all the blood biochemistry tests returned to normal on the tenth day of therapy. This case was reported to draw attention to Leptospira infections which should be considered in the differential diagnosis of patients with jaundice and pancreatitis.

Acute Disease↗

[Candida dubliniensis studies and isolation of Candida types in oropharyngeal specimens from oncologic patients].

Fungal opportunistic infections, and in particular those caused by the various Candida species, have gained considerable significance as a cause of morbidity and, often, mortality. Although Candida albicans remains to be the most frequently isolated fungal species as an opportunistic oral pathogen, other yeast species are often identified in immunocompromised patients. C. dubliniensis, the recently described species, has been recovered primarily from oropharyngeal candidasis in Human Immunodeficiency Virus (HIV)-infected patients. C. dubliniensis shares many phenotypic characteristics with, and is phylogenetically closely related to, C. albicans. The aim of the present study was to investigate the colonization rates of fungal species, and especially C. dubliniensis, in the oropharyngeal samples from cancer patients. The oropharyngeal swabs of 543 patients were collected during their visits to oncology clinic in 9 months period, and a total of 209 Candida species have been isolated. Of them, 147 isolates were found to be positive for germ tube and chlamydospore formation, and they were tested for the growth inability at 42 degrees C and 45 degrees C, colony morphology in Staib agar and the intracellular beta-glucosidase activity, in order to identify C. dubliniensis. The results of these tests and carbohydrate assimilation tests by API 20C AUX yeast identification system, yielded that all these 147 (70.3%) isolates were C. albicans. The other isolates were identified as follows; 16 C. parapsilosis (7.6%), 13 C. tropicalis (6.2%), 10 C. glabrata (4.7%), 5 C. guilliermondii (2.3%), 4 C. krusei (1.9%), 3 C. keyfr (1.4%), 3 C. famata (1.4%), 2 S. cerevisiae (0.9%), 2 C. pelliculosa (0.9%), 1 C. utiles (0.4%), 1 C. neoformans (0.4%) and 1 Hansenula polymorpha (0.4%), while no C. dubliniensis was isolated.

Candida↗