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Biomedical subjects

Z Gülay

Publications and source records attributed to Z Gülay.

11 recordsLinked to original sources
PubMed2001

The association of HLA-DR4 antigen with juvenile chronic arthritis and slipped capital femoral epiphysis.

Seventeen children who met the criteria for juvenile chronic arthritis (JCA) were reviewed. Throughout the study, the clinical examination, HLA phenotyping, and radiological assessment of the hips were performed by separate authors who were blinded to other data. At the end of the study, the results were also compared with 25 healthy, age- and sex-matched children. Six of the children with JCA also had radiological signs of slipped capital femoral epiphysis (SCFE; five with minimal slip pattern, one with moderate slip), and five of them had DR4 in their genotypes, in contrast to the remaining 11 patients who did not (p < 0.001). On the other hand, only 2 of 25 children in the control group had DR4 (p < 0.01). The difference was not significant when the patients without SCFE were compared with the control group (p = 1.0). The relative risk of cases with DR4 antigen for SCFE was 57.5, while it was below I for the other antigens. These results suggest that although DR4 is not specific for JCA, it is the common HLA antigen for those who have SCFE, and patients with JCA and HLA-DR4 antigen should be examined for evidence of SCFE, which was not reported before to exist with JCA.

Adolescent↗
PubMed2001

Vancomycin-resistant enterococci in neonates.

Fecal-oral transmission of vancomycin-resistant strains of Enterococci (VRE), which colonize the human gastrointestinal tract, has led to nosocomial epidemics in recent years. The aim of this study was to establish the incidence and associated factors of fecal colonization with VRE in neonates. In our hospital 110 rectal swab specimens collected in the neonatal intensive care unit (NICU) were examined for VRE. For comparison, rectal swabs collected from 42 healthy neonates on the obstetrics ward were also analyzed. Of the NICU patients, 8 had VRE MICs of 8-64 microg/ml for vancomycin and 2-32 microg/ml for teicoplanin, whereas none of the healthy newborns, had VRE (p < 0.05). All patients positive for VRE had factors known to be associated with VRE carriage, such as low birth weight or long-term antibiotic therapy.

Cross Infection↗
PubMed2001

Clonal spread of imipenem-resistant Pseudomonas aeruginosa in the intensive care unit of a Turkish hospital.

Pseudomonas aeruginosa may cause life-threatening infections, especially in nosocomial settings. Although carbapenems are considered as one of the most effective alternatives in antipseudomonal therapy, resistance to the carbapenem group of antibacterials is a growing problem. In the first 6 months of 1997, P. aeruginosa isolates that were resistant to almost all antipseudomonal agents including imipenem were recovered from various specimens from intensive, care unit (ICU) patients. Isolates with the same antibiogram profile caused a small outbreak in May 1997. A retrospective case-control study revealed that the major risk factors for infection/colonization with multiresistant P. aeruginosa were prolonged stay in the ICU (p<0.001), previous and lengthy imipenem usage (p<0.001 and p<0.0001, respectively), and mechanical ventilation (p<0.001). Analytical isoelectric focusing of the sonicates prepared from the isolates showed that each isolate produced 1-5 beta-lactamases, enzymes with isoelectric points (pIs) of 5.1, 6.4, 8.5-8.7 being the most prevalent. DNA macrorestriction patterns of imipenem-resistant isolates were distinct from those of the imipenem-sensitive isolates recovered from ICU patients during the same interval and from the environmental isolates (controls). Thus, our results indicate that colonized patients appear to be the major source for cross-contamination of other patients and if imipenem is selected for empirical therapy, emergence of resistant strains should be anticipated and appropriate precautions taken.

Adolescent↗
PubMed2000

In-vitro synergistic effect of fluconazole with nonsteroidal anti-inflammatory agents against Candida albicans strains.

The in-vitro interaction and synergistic activity of the combination of fluconazole with some nonsteroidal anti-inflammatory drugs (sodium salicylate, piroxicam, tenoxicam and diclofenac sodium) were investigated in Candida albicans strains (n=7) by the microdilution checkerboard assay. The results were evaluated visually and by a spectrophotometric microplate reader at 492 nm wavelength. Fractional inhibitory index was calculated for every strain and combination according to the minimal inhibitory concentration (MICs). The combination of fluconazole with sodium salicylate, tenoxicam and diclofenac sodium showed synergy against 5, 5 and 3 of the C. albicans strains, respectively. The effect of fluconazole with piroxicam was synergistic against one strain but indifferent/additive against the others. These data suggest that combinations of sodium salicylate, tenoxicam and diclofenac sodium with fluconazole may prove to be useful as chemotherapeutic agents for the treatment of C. albicans infections caused by especially fluconazole-resistant strains. However, additional preclinical work and in vivo studies are necessary to determine their definite clinical use.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1998

Transferable trimethoprim resistance in Shigella strains.

The susceptibility patterns of 35 Shigella isolates (16 S. flexneri, 14 S. dysenteriae and 5 S. sonnei) to trimethoprim (Tp) and various antibiotics including amoxycillin, amoxycillin-clavulanic acid, nalidixic acid, ciprofloxacin, ceftazidime and ceftriaxone, were investigated. Twenty-two (62.8%) strains were resistant to Tp with a minimal inhibitory concentration (MIC50) value of 512 mg/L. Only six isolates were amoxycillin resistant, to which clavulanic acid restored sensitivity in all of them. None of the isolates were resistant either to extended spectrum cephalosporins or to quinolones. Resistance to Tp was transferred from 7 of the 22 isolates (31.8%) to the recipient Escherichia coli K12. Tp MIC values of the transconjugants were 512 mg/L. In no strain could amoxycillin resistance be transferred. Our results indicate that as the prevalence of transferable Tp resistance in Shigella isolates in Izmir is substantially high, alternative antimicrobial agents should be considered for empirical antibiotic therapy.

Amoxicillin↗
PubMed1996

Anti-candidial activity of natural killer (NK) and lymphokine activated killer (LAK) lymphocytes in vitro.

The natural cytotoxic effects of peripheral blood lymphocytes (PBL) on Candida stellatoidea and several other Candida species were examined by a colony forming inhibition (CFI) assay. Peripheral blood mononuclear cells (PBMC), were incubated with C. stellatoidea yeast cells. After the incubation period the colony-forming ability of the yeast was significantly reduced. In similar experiments, six different Candida species (C. albicans, C. krusei, C. stellatoidea, C. tropicalis, C. pseudotropicalis, C. guillermondii) were used as target cells. There was no statistically significant difference in the anticandidial activities of PBL against the Candida species used. It was demonstrated that a fraction of lymphocytes, natural killer cells (NK), had the major natural anti-candidial activity by using anti-Leu M1 (CD 15) and anti-Leu 11b (CD 16) monoclonal antibodies (mAbs) plus complement (C'). It was observed that inhibition of colony-forming ability of C. stellatoidea was significantly (78-96%) reduced when anti-Leu 11b plus C' were used. In addition, the colony formation inhibition capacity of NK cells was increased by recombinant human interleukin-2 (rhIL-2) while anti-interferon-gamma (IFN-gamma) had no effect. Besides the fact that NK cells are among those responsible for natural immunity against Candida species, this colony-forming inhibition assay performed with C. stellatoidea yeast cells as target and monocyte-depleted PBMC as effector cells, is a simple method to assess NK cell activity.

Adult↗
PubMed1995

Juvenile rheumatoid arthritis and renal amyloidosis (case report).

Clinical renal abnormalities, including haematuria, proteinuria, abnormal urinary sediment, decreased renal functions and hypertension are relatively common in children with juvenile rheumatoid arthritis (JRA). These findings may be due to renal amyloidosis or administration of drugs that are potentially nephrotoxic. The case of an 11 years old boy diagnosed as JRA at 4.5 months of age and treated with steroids for 10 years is presented. In his history he had hypertension for 5 years and cataract for one year. Renal biopsy was done to evaluate the aetiology for proteinuria, which was overlooked before his admission to our Department. Secondary renal amyloidosis due to JRA was found at biopsy. The importance of investigation for amyloidosis during the long-term follow-up of JRA is reemphasized.

Amyloidosis↗
PubMedDate not supplied

The comparison of the efficacy of fluticasone propionate with cetirizine in perennial allergic rhinitis.

BACKGROUND: Allergic rhinitis is an IgE mediated hypersensitivity reaction of the nasal mucosa characterised by nasal discharge, obstruction, and pruritus. PATIENTS AND METHODS: In this study, 43 patients with perenneal allergic rhinitis were enrolled in order to compare the efficacy of Fluticasone Propionate (FP), a corticosteroid nasal spray, with Cetirizine, a systemic oral antihistaminic preparation, which is supposed to have nonsteroidal antiinflammatory activity. Cetirizine (10 mg daily as a single dose) was administered to 22 patient for 45 days. On the other hand, FP (400 micrograms/day) was administered into each nostril twice a day in the remaining 21 patients for 45 days. Skin test was obtained from each patient before therapy. Total eosinophil count, eosinophil count in nasal smear, electrorhinomanometric investigation, PGE2 and ratio of LTC4 to LTD4 both in the serum and in the nasal secretions were determined before and after therapy. In addition, percentage of eosinophils, and mast cells count in the biopsy specimens taken from anterior edge of middle choncha were evaluated before and after therapy, and than the results were graded for each patients. RESULTS: When we compared the eosinophil count in nasal smear, eosinophil percentage and total eosinophil parameters between two groups, it was shown that FP was more effective than Cetirizine. On the other hand, when we compared the ratio of LTC4 to LTD4 in serum and nasal smear, level of PGE2 and mast cell and nasal airway resistance measured by ERM, there were non statistical difference between two groups. CONCLUSION: These results suggest that FP and Cetirizine may be used alternatively in case of an adverse reaction to any of them.

Administration, Intranasal↗
PubMedDate not supplied

Stenotrophomonas maltophilia pneumonia in a premature infant.

Stenotrophomonas (Xanthomonas) maltophilia is an aerobic, non-fermentative, gram-negative bacillus that is generally considered an opportunistic pathogen. Infections due to S. maltophilia have become increasingly important in the hospital environment. Patients compromised by debilitating illnesses, surgical procedures or indwelling vascular catheters are most prone to S. maltophilia infections. To our knowledge, we report the first case of S. maltophilia pneumonia in a premature infant of 31 weeks gestational age. Although the therapy of choice for severe infections caused by S. maltophilia remains to be decided, this patient was successfully treated by amikacin.

Amikacin↗
PubMedDate not supplied

[Mutations of gyrA in ciprofloxacin resistant Escherichia coli strains].

In this study, the relationship between gyrA mutations and ciprofloxacin minimum inhibitory concentration (MIC) values was investigated in Escherichia coli strains. For this purpose, ciprofloxacin MIC values of 46 E. coli strains, isolated from out-patients and hospitalized patients, were determined by the agar dilution method. The "Quinolone Resistance Determining Region" (QRDR) of gyrA gene was amplified and restricted by Hinf-I enzyme. Ser-83 mutation was observed in all strains that have ciprofloxacin MIC values of 0.062 mg/L and higher. Afterwards, eight strains, that were found susceptible (MIC < 1 mg/L, n: 1), intermediate (MIC: 1-4 mg/L, n: 1) and high level resistant (MIC > 4 mg/L, n: 6) to ciprofloxacin, were chosen and mutations in QRDRs of these strains investigated by DNA sequence analysis. Ser 83 Leu mutation was found in all the chosen strains and Asp 87 Tyr or Asp 87 Asn mutations were also observed except the ciprofloxacin susceptible (MIC: 0.062 mg/L) one. In addition, base substitutions that don't lead to aminoacid changes were detected. The strain in which only Ser 83 Leu mutation was observed, showed high level nalidixic acid resistance (MIC > 256 mg/L). This fact was in favour of that, one mutation is enough to develop high level resistance to nalidixic acid. It was concluded that high level ciprofloxacin resistance requires at least two mutations in the QRDR of gyrA gene.

Anti-Infective Agents↗