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1.
Pak J Med Sci ; 39(5): 1286-1290, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37680795

RESUMO

Objective: To examine the use of anti-cytokine treatment in critical COVID-19 patients and their association with the frequency of CMV cases, viral load level, and mortality in these patients. Methods: This is a retrospective study. A total of 170 critical and/or intensive care patients with COVID-19 admitted to Hisar Hospital Intercontinental from March 15, 2020, to December 31, 2021 were divided into the use of anti-cytokine treatment group and the no anti-cytokine treatment group. Furthermore, the relationship between CMV reactivation, mortality and anti-cytokine treatment in patients was also examined. Results: A total of 170 critical COVID-19 patients were included in the study, three of them were excluded. One hundred sixty seven were included in the study of which 38 (22.7%) were found to be CMV DNA positive. As an anti-cytokine treatment, it was observed that tocilizumab was used in 53 patients, anakinra was used in 27 patients, and no anti-cytokine treatment was used in 77 patients. CMV positivity in patients treated with anti-cytokines (31.11%) was found to be significantly higher than in patients who were not treated with it (16.88%) (p:0.033). Furthermore, it was determined that anti-cytokine treatment significantly decreased mortality (p: 0.003) and that there was no significant relationship between CMV reactivation and mortality (p: 0.399). Conclusion: Even though CMV reactivation was high in critical COVID-19 patients who received anti-cytokine treatment, decrease in mortality were observed with early diagnosis and effective treatment. Therefore, CMV infection should be considered in patients receiving immunosuppressive treatment.Clinical Trial Registration: HisarIH-101/NCT05419206.

2.
Medicine (Baltimore) ; 102(9): e33132, 2023 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-36862905

RESUMO

The primary aim of the current study is to analyze the clinical, laboratory, and demographic data comparing the patients with Coronavirus Disease 2019 (COVID-19) admitted to our intensive care unit before and after the UK variant was first diagnosed in December 2020. The secondary objective was to describe a treatment approach for COVID-19. Between Mar 12, 2020, and Jun 22, 2021, 159 patients with COVID-19 were allocated into 2 groups: the variant negative group (77 patients before December 2020) and the variant positive group (82 patients after December 2020). The statistical analyses included early and late complications, demographic data, symptoms, comorbidities, intubation and mortality rates, and treatment options. Regarding early complications, unilateral pneumonia was more common in the variant (-) group (P = .019), whereas bilateral pneumonia was more common in the variant (+) group (P < .001). Regarding late complications, only cytomegalovirus pneumonia was observed more frequently in the variant (-) group (P = .023), whereas secondary gram (+) infection, pulmonary fibrosis (P = .048), acute respiratory distress syndrome (ARDS) (P = .017), and septic shock (P = .051) were more common in the variant (+) group. The therapeutic approach showed significant differences in the second group such as plasma exchange and extracorporeal membrane oxygenation which is more commonly used in the variant (+) group. Although mortality and intubation rates did not differ between the groups, severe challenging early and late complications were observed mainly in the variant (+) group, necessitating invasive treatment options. We hope that our data from the pandemic will shed light on this field. Regarding the COVID-19 pandemic, it is clear that there is much to be done to deal with future pandemics.


Assuntos
COVID-19 , Serviços de Laboratório Clínico , Humanos , COVID-19/terapia , Estudos de Coortes , Pandemias , Progressão da Doença
3.
Univers Access Inf Soc ; : 1-18, 2023 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-36789138

RESUMO

Despite the media reports and governments promoting tourism as a fundamental right for everyone, traveling is still not accessible for disabled people. This study has highlighted the need to make tourists with disabilities accessable for inaccessible destinations. Cyborg products in the form of technological implants can make tourists with disabilities accessable for inaccessible destinations. Since tourists with a mobility disability (TMD) will be one of the primary beneficiaries of technological implants, little is known about their acceptance of technological implants during traveling.Therefore, this study assesses the willingness of TMD to use technological implants during traveling through a qualitative research approach. The results from thematic analysis identified two main themes: the use of assistive devices during traveling with four sub-themes (freedom of traveling, physical and attitudinal barriers, cost, and additional assistance and battery issues), and drivers of impaired cyborg tourists with seven sub-themes (independence, improved well-being, convenience/ease of use, social inclusion, positive emotions, motivation, and other issues). The study contributed to the literature by introducing drivers of impaired cyborg tourists along with previously identified concepts. The results also provided implications for the stakeholders of the tourism industry.

4.
Environ Sci Pollut Res Int ; 29(39): 59363-59373, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35386080

RESUMO

The tourism industry has long been accused of being the major driver of global warming as a result of the size of the industry and its subsequent high energy consumption, most of which comes from sources that emit carbon dioxide. However, in spite of the criticism directed towards tourism due to its negative effects on the environment, there is a scarcity of research that has aimed to ascertain its impact on the environment, thus revealing the existence of a gap in the literature. The current study uses a dynamic GMM model for 38 OECD countries from 2008 to 2019 for the purpose of filling the gap in the literature by investigating the effects of tourism development on the environment, as well as ascertaining the role of renewable energy in mitigating environmental impact. Unlike past studies that have alluded to the fact that tourism development exacerbates the emissions of carbon dioxide and hence global warming, the current research shows that in the OECD countries, tourism does not have any significant link with greenhouse gas emissions. This is because OECD nations have long started to shift from the use of fossil fuels to renewable sources of energy that do not exacerbate greenhouse gas emissions. However, the current research concurs with the findings of past studies that renewable energy consumption significantly decreases greenhouse gas emissions. The use of renewable energy sources instead of fossil fuels should continue to be encouraged in all nations for the purpose of achieving the carbon neutrality goal of the United Nations.


Assuntos
Desenvolvimento Econômico , Gases de Efeito Estufa , Dióxido de Carbono/análise , Análise de Dados , Poluição Ambiental/análise , Combustíveis Fósseis , Gases de Efeito Estufa/análise , Energia Renovável , Turismo
5.
Urologia ; 89(2): 149-152, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-33730959

RESUMO

OBJECTIVE: This research aimed at evaluating the changing conditions and experiences of urological practice during the COVID-19 pandemic. METHODS: The data of all patients who were admitted to outpatient clinics at Hisar Intercontinental Hospital or the hospital's online patient portal system between March 11th and May 30th, 2020 were analyzed retrospectively. Of all patients, 545 in outpatient clinics and 25 in online portal system, (17%) were hospitalized for medical treatment, and 53 underwent surgery. There were 1032 patients admitted to Urology Clinics and 104 patients who underwent surgery in the same period of 2019. The pre-operative assessment of patients who were candidates of urological surgery included certain criteria for COVID-19. RESULTS: Of patients included in this study, the median age was 41 years (18-90). The mean hospital stay was 1 day (1-12), and the mean duration of operation was 25 min (3-250). Thirty-seven patients (69.8%) underwent general anesthesia, while only 11(20.8%) underwent combined spinal epidural anesthesia. Four patients (7.5%) required local and only one patient (1.9%) underwent sedo-analgesia. Complications were encountered in six patients (11.4%), urosepsis in two, pneumonia in one, and urinary tract infection in three patients. Compared to last year's numbers, the number of patients admitted to the hospital's outpatient clinic and that of hospitalized patients decreased by 47.2% and 49.1%, respectively. CONCLUSION: Emergent surgeries in urological practices can be performed safely under routine preoperative testing for COVID-19 and with the use of adequate protective equipment for both the surgical team and the patient.


Assuntos
COVID-19 , Urologia , Adulto , COVID-19/epidemiologia , Teste para COVID-19 , Humanos , Pandemias , Estudos Retrospectivos , SARS-CoV-2
6.
Genet Test Mol Biomarkers ; 24(3): 165-170, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32167396

RESUMO

Aim: Pathogenic variants within mitochondrial tRNA and rRNA genes negatively affect protein synthesis function and cause oxidative phosphorylation defects. The majority of mitochondrial cytopathies are caused by pathogenic point variants within the mitochondrial tRNA gene for leucine (MT-TL1). This study was designed to evaluate a novel amplification-refractory mutation system (ARMS)-PCR based assay to screen patient samples with a clinical diagnosis of mitochondrial cytopathies. Methods: Tissue DNA samples from 219 affected individuals were screened for the pathogenic variants m.3271T>C, m.3291Ty >C, m.3303C>T, m.3256C>T, and m.3260A>G along with the most frequent m.3243A>G mutation in the MT-TL1 gene. The assay included a "High Resolution Melt curve analysis" to enhance detection limits. The precision of the assay was verified using synthetic controls with variant heteroplasmy ratios. Results: The screening identified the second reported m.3303C>T case as well as two patients with m.3243A>G variants and a rare variant exhibiting m.3290T>C. Conclusion: ARMS-PCR is superior to Sanger sequencing for the detection of variations exhibiting low heteroplasmy. These results provide "proof of concepts" for the implementation of this application for future screening of rare mtDNA variations in sample repositories.


Assuntos
Síndrome de Kearns-Sayre/genética , Miopatias Mitocondriais/genética , Reação em Cadeia da Polimerase/métodos , RNA de Transferência de Leucina/genética , DNA Mitocondrial/genética , Feminino , Humanos , Síndrome de Kearns-Sayre/diagnóstico , Masculino , Mitocôndrias/genética , Miopatias Mitocondriais/diagnóstico , Mutação/genética , Polimorfismo de Nucleotídeo Único/genética , Estudo de Prova de Conceito , RNA de Transferência de Leucina/análise , Sensibilidade e Especificidade
7.
J Pak Med Assoc ; 66(11): 1412-1417, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27812058

RESUMO

Objective: To determine the differences between the factors such as return of spontaneous circulation positivity, duration of cardiopulmonary resuscitation, and cardiac rhythm at first arrival affecting neurological outcomes in cardiac-arrest cases. Methods: This study was conducted at the Malatya State Hospital, Malatya, Turkey, from January to December 2014, and comprised patients who had received cardiopulmonary resuscitation. Patients were divided into two groups; in-hospital cardiac arrest and out-of-hospital cardiac arrest. The groups were compared in terms of gender, age, initial rhythm, cardiopulmonary resuscitation durations, cardiopulmonary resuscitation results (exitus, return), return of spontaneous circulation rates observed after cardiopulmonary resuscitation, and neurological outcome responses of the cases in which return of spontaneous circulation was observed. SPSS 22 was used for data analysis. RESULTS: Of the 321 cases, 88(27.41%) were in-hospital and 233(72.59%) were out-of-hospital cardiac arrest cases. Besides, 189(58.9%) of the patients were men and 132(41.1%) were women with an overall mean age of 67.21±15.25 years (range: 18-98 years). Moreover, 16(18.2%) in-hospital cases and 47(20.2%) out-of-hospital cases had shockable rhythms at the time of arrival. Cardiopulmonary resuscitation was applied to 74(23%) patients for less than 20 minutes and to 247(76.9%) for more than 20 minutes. Return of spontaneous circulation positivity was recorded in 134(41.7%) patients, of whom 62(70.5%) were in-hospital and 72(30.9%) were out-of-hospital cases. Moreover, 19(5.9%) patients were discharged with good neurological outcome. In cases where cardiopulmonary resuscitation was applied for less than 20 minutes, return of spontaneous circulation positivity was present in 43(100%) in-hospital and 31(100%) out-of-hospital cases. Return of spontaneous circulation positivity and good neurological outcome rate of the patients having shockable rhythms was 48(76.2%) and 8(12.7%), respectively. CONCLUSIONS: Return of spontaneous circulation positivity, favourable neurological outcome response and survival rates were significantly higher among in-hospital cardiac arrest cases.


Assuntos
Encéfalo/fisiopatologia , Reanimação Cardiopulmonar , Parada Cardíaca Extra-Hospitalar/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Serviços Médicos de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Turquia , Adulto Jovem
8.
Medicine (Baltimore) ; 95(26): e3937, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27367991

RESUMO

Our aim in this study was to determine soluble tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) and interleukin-17A (IL-17A) levels in celiac disease, and their association with the gluten diet and autoantibodies. Eighty patients with celiac diagnosis and 80 healthy control individuals with similar age, gender and body mass index to the patient group were included in the study. Serum sTWEAK and IL-17A levels were measured by the serum enzyme-linked immunosorbent assay kit. The median IL-17A (117.5 pg/mL vs. 56.7 pg/mL; P = 0.001) level in celiac patients was higher than in the control group, while the median sTWEAK (543 pg/mL vs. 643 pg/mL; P = 0.016) level in patients was determined to be lower. In the patient group, patients who complied with the gluten diet had a lower level of median IL-17A (98.1 pg/mL vs. 197.5 pg/mL; P = 0.034) and a higher level of sTWEAK (606 pg/mL vs. 522.8 pg/mL; P = 0.031) than those who did not adhere. Furthermore, the IL-17A level was higher and the sTWEAK level was lower in celiac patients with positive antibody than those with negative antibody. A positive correlation was determined among anti-gliadin antibody IgA, anti-gliadin antibody IgG, anti-tissue transglutaminase IgG levels and the IL-17A level, and a negative correlation was determined with the sTWEAK level. In celiac disease, the sTWEAK and IL-17A levels differ between patients who cannot adapt to the gluten diet and who are autoantibody positive, and patients who adapt to the diet and are autoantibody negative. We believe that sTWEAK and IL-17A are associated with the inflammation in celiac pathogenesis.


Assuntos
Doença Celíaca/etiologia , Interleucina-17/fisiologia , Fatores de Necrose Tumoral/fisiologia , Adulto , Autoanticorpos/sangue , Doença Celíaca/sangue , Estudos Transversais , Citocina TWEAK , Dieta , Feminino , Glutens , Humanos , Interleucina-17/sangue , Masculino , Fatores de Necrose Tumoral/sangue
9.
J Gastroenterol Hepatol ; 31(6): 1120-5, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26642816

RESUMO

BACKGROUND AND AIM: We aimed to identify ischemia-modified albumin (IMA) levels in inflammatory bowel disease (IBD) and IBD subgroups, and to examine its relation with disease activity index. METHODS: Sixty-eight patients with IBD (35 ulcerative colitis [UC] and 33 crohn disease [CD]) and 65 healthy volunteers were included in the study. Rachmilewitz scoring system (endoscopic activity index [EAI]) was used to determine UC activity, and as for CD activity, CD activity index (CDAI) scoring was used. IMA measurement was performed with ELISA kit. RESULTS: Ischemia-modified albumin levels in IBD, UC, and CD groups were comparably higher than the control group (37.7 ng/mL vs 42.4 ng/mL vs 36.4 ng/mL vs 21.8 ng/mL, respectively; P < 0.05). In IBD group, a positive correlation was identified between IMA level and CRP (r = 0.325, P = 0.011), EAI(r = 0.302, P = 0.020), and CDAI (r = 0.311, P = 0.013). In stepwise regression model; it was identified that IMA(OR = 1.496; P = 0.016) and CRP(OR = 3.457; P = 0.015) are predictors of IBD in comparison with the control group. In linear regression model, it was identified that risk factors such as log(IMA) and log(CRP) were independent predictors of log(CDAI) and log(EAI) levels. CONCLUSION: This is the first study showing that IMA levels in IBD were determined higher in comparison with the control group. Moreover, IMA being a predictor for IBD and being positively correlated with disease activity indexes were determined for the first time in the study. In accordance with these results, it is possible to say that IMA in IBD might be related with the pathogenesis of disease and correlated with the severity of the disease.


Assuntos
Colite Ulcerativa/sangue , Doença de Crohn/sangue , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/patologia , Colo/patologia , Colonoscopia , Doença de Crohn/diagnóstico , Doença de Crohn/patologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Mucosa Intestinal/patologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Razão de Chances , Valor Preditivo dos Testes , Prognóstico , Albumina Sérica , Albumina Sérica Humana , Índice de Gravidade de Doença , Regulação para Cima
10.
Inflamm Bowel Dis ; 22(3): 615-22, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26650150

RESUMO

BACKGROUND: We aimed to identify the levels of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and interleukin 17A (IL-17A) in inflammatory bowel disease (IBD) and to examine their relationship with disease activity. METHODS: A total of 92 patients with IBD, in which 54 patients were diagnosed with ulcerative colitis and 38 patients with Crohn's disease (CD), and 104 healthy controls were included in the study. The Rachmilewitz endoscopic activity index was calculated in ulcerative colitis, and the CD activity index was calculated in CD. RESULTS: sTWEAK (P < 0.001) and IL-17A (P = 0.006) levels were higher in the IBD group than in the control group. Both in the IBD group and ulcerative colitis and CD subgroups, in active patients, sTWEAK and IL-17A levels were found to be higher than in inactive and control groups. In the IBD group, a positive correlation was determined between sTWEAK and IL-17A, and C-reactive protein, endoscopic activity index, and CD activity index. In multivariable regression analysis, C-reactive protein and sTWEAK levels were determined to be an independent risk factor for both endoscopic activity index and CD activity index. In receiver operating curve analysis, the sTWEAK level was determined to predict IBD with high sensitivity and specificity with a value of >588.34 pg/mL and activity with a value of >669.28 pg/mL. CONCLUSION: Based on these results, we ascertain that sTWEAK has a role in etiopathogenesis of IBD. In addition, we believe that sTWEAK could be used as a marker for both disease activity criteria and treatment monitoring.


Assuntos
Biomarcadores/metabolismo , Doenças Inflamatórias Intestinais/etiologia , Doenças Inflamatórias Intestinais/patologia , Interleucina-17/metabolismo , Fatores de Necrose Tumoral/metabolismo , Adulto , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Citocina TWEAK , Feminino , Seguimentos , Humanos , Doenças Inflamatórias Intestinais/metabolismo , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Índice de Gravidade de Doença , Fator de Necrose Tumoral alfa/metabolismo
11.
Clin Appl Thromb Hemost ; 20(5): 524-9, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23288869

RESUMO

PURPOSE: The purpose of this study is to investigate the hispathological, biochemical, and clinical efficiency of Ankaferd Blood Stopper (ABS) in preventing postoperative intraabdominal adhesions. METHOD: A total of 40 Wistar albino species female rats were randomly separated into 4 groups. For the control group, 1 mL normal saline was administered; and for the second, third, and fourth groups 0.5, 1, and 2 mL, respectively, ABS was administered. Statistical analyses were evaluated with Tukey and analysis of variance test. FINDINGS: Significant increase was observed in fibroblast and vascularization microscopically with increasing amount of ABS used. Degree of adhesion in the group administered with normal saline was lower compared to the other groups. Adhesion thickness and prevalence macroscopically increased with the increasing amount of ABS used in groups. CONCLUSION: It was determined in our study that ABS is not efficient in preventing intraabdominal adhesions; on the contrary, adhesions were increased with the increased amount of ABS used.


Assuntos
Hemostáticos/farmacologia , Extratos Vegetais/farmacologia , Hemorragia Pós-Operatória/prevenção & controle , Aderências Teciduais/prevenção & controle , Animais , Feminino , Hemorragia Pós-Operatória/patologia , Ratos , Ratos Wistar , Aderências Teciduais/patologia
12.
Transfus Apher Sci ; 49(3): 494-8, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23545384

RESUMO

Snake bites are leading causes of morbidity and mortality worldwide, especially in rural areas. Therapeutic plasma exchange has been used in the treatment of many different conditions such as immunologic diseases, toxicologic disorders, and snake envenomation. The aim of this study is to evaluate the efficacy of plasma exchange treatment on clinical status, outcomes, and discharge of patients who were bitten by venomous snakes. The study was conducted retrospectively in the Emergency Department of Gaziantep University from January 2002 to December 2011. Thirty-seven patients were included in the present study. Routine biochemical and hematologic laboratory parameters were studied before and after plasma exchange. Demographic data, clinical status, and outcomes of patients were recorded. Plasma exchange was performed by using centrifugation technology via an intravenous antecubital or subclavian vein catheter access. Human albumin/fresh frozen plasma was used as replacement fluids. A significant correlation was seen between therapeutic plasma exchange and improvement of laboratory results. None of the study patients lost their limbs. Eight patients were sent to the intensive care unit. The mean length of the hospital stay was 12.2 days (4-28). All patients were discharged with good recovery. No complications were seen during the 3 months following discharge. Plasma exchange appears to be an effective treatment intervention for snake bite envenomations, especially in the management of hematologic problems and in limb preservation/salvage strategies. In addition to traditional treatment methods, plasma exchange should be considered by emergency physicians in cases of snake bite envenomation as a therapeutic approach to facilitate rapid improvement.


Assuntos
Troca Plasmática/métodos , Mordeduras de Serpentes/terapia , Adolescente , Adulto , Idoso , Animais , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
13.
Biomed Mater Eng ; 22(6): 333-49, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23114463

RESUMO

The research was investigated the effect of boron additions on sintering characteristics, mechanical, corrosion properties and biocompatibility of injection molded austenitic grade 316L stainless steel. Addition of boron is promoted to get high density of sintered 316L stainless steels. The amount of boron plays a role in determining the sintered microstructure and all properties. In this study, 316L stainless steel powders have been used with the elemental NiB powders. A feedstock containing 62.5 wt% powders loading was molded at different injection molded temperature. The binders were completely removed from molded components by solvent and thermal debinding at different temperature. The debinded samples were sintered at different temperature for 60 min. Mechanical property, microstructural characterization and electrochemical property of the sintered samples were performed using tensile testing, hardness, optical, scanning electron microscopy and electrochemical corrosion experiments. Sintered samples were immersed in a simulated body fluid (SBF) with elemental concentrations that were comparable to those of human blood plasma for a total period of 15 days. Both materials were implanted in fibroblast culture for biocompatibility evaluations were carried out. Results of study showed that sintered 316L and 316L with NiB addition samples exhibited high mechanical and corrosion properties in a physiological environment. Especially, 316L with NiB addition can be used in some bioapplications.


Assuntos
Materiais Biocompatíveis/química , Boro/química , Aço Inoxidável/química , Animais , Materiais Biocompatíveis/metabolismo , Boro/metabolismo , Linhagem Celular , Corrosão , Fibroblastos/citologia , Humanos , Teste de Materiais , Plasma/metabolismo , Ratos , Resistência à Tração
14.
Mikrobiyol Bul ; 46(3): 352-8, 2012 Jul.
Artigo em Turco | MEDLINE | ID: mdl-22951647

RESUMO

The aim of this study was to determine whether vancomycin resistant Staphylococcus aureus (VRSA) and vancomycin intermediate susceptible S.aureus (VISA) strains were present among methicillin-resistant S.aureus (MRSA) strains isolated from patients hospitalised at intensive care units (ICU) of hospitals located at different regions of Turkey and to determine the minimum inhibitory concentration (MIC) values of teicoplanin, linezolid, tigecycline, quinupristin-dalfopristin and daptomycin, which are alternative drugs for the treatment of MRSA infections. A total of 260 MRSA clinical strains (isolated from 113 lower respiratory tract, 90 blood, 24 wound, 17 catheter, 13 nasal swabs, two urine and one CSF sample) were collected from nine health-care centers in eight provinces [Ankara (n= 52), Konya (n= 49), Antalya (n= 40), Istanbul (n= 7), Izmir (37), Diyarbakir (n= 15), Van (n= 12), Trabzon (n= 48)] selected as representatives of the seven different geographical regions of Turkey. Methicillin resistance was determined by cefoxitin disk diffusion in the hospitals where the strains were isolated and confirmed by oxacillin salt agar screening at the Refik Saydam National Public Health Agency. Screening for VISA and VRSA was conducted using the agar screening test and E-test. Susceptibility of the MRSA strains to other antibiotics was also determined by E-test method. None of the 260 MRSA strains were determined to be VRSA or VISA. All were susceptible to teicoplanin and linezolid, and susceptibility rates to daptomycin, tigecycline and quinupristin-dalfopristin were 99.6%, 96.9%, and 95%, respectively. Absence of VISA and VRSA among the MRSA strains surveyed currently seemed hopeful, however, continuous surveillance is necessary. In order to prevent the development of VISA and VRSA strains the use of linezolid, tigecycline, quinupristin-dalfopristin and daptomycin should be encouraged as alternative agents of treatment of MRSA infections.


Assuntos
Antibacterianos/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Infecções Estafilocócicas/microbiologia , Vancomicina/farmacologia , Acetamidas/farmacologia , Daptomicina/farmacologia , Humanos , Unidades de Terapia Intensiva , Linezolida , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana/métodos , Minociclina/análogos & derivados , Minociclina/farmacologia , Oxazolidinonas/farmacologia , Infecções Estafilocócicas/tratamento farmacológico , Teicoplanina/farmacologia , Tigeciclina , Turquia , Resistência a Vancomicina , Virginiamicina/farmacologia
15.
BMJ Case Rep ; 20122012 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-22962387

RESUMO

Scorpion stings are common in many regions of the world, particularly in rural areas. While most of the stings are harmless and tend to be milder, some stings rarely have severe clinical course, including neurological, cardiovascular and respiratory system complications. Although there are many studies in the literature related to the scorpion sting, data on effects of scorpion stings in pregnant woman are very little. The authors have not come across any case report of eclampsia as a complication of scorpion sting. With this study, the authors aimed to discuss a scorpion sting lead to an unexpected complication, eclampsia.


Assuntos
Eclampsia/etiologia , Picadas de Escorpião/complicações , Adulto , Anticonvulsivantes/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Antivenenos/uso terapêutico , Cesárea , Eclampsia/tratamento farmacológico , Feminino , Humanos , Fatores Imunológicos/uso terapêutico , Sulfato de Magnésio/uso terapêutico , Nitroprussiato/uso terapêutico , Gravidez , Terceiro Trimestre da Gravidez , Picadas de Escorpião/tratamento farmacológico
16.
BMJ Case Rep ; 20122012 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-22802561

RESUMO

Medicinal leeches have been used in the treatment of many diseases for thousands of years. A 25-year-old man presented to our emergency department with bleeding from right and left side of his neck. He had applied leeches 10 h previously to both sides of his neck to treat acne. The bleeding was not controlled by applying pressure with sterile gauze upon the wounds. Homeostasis was achieved by primary suture under local anaesthesia. Prolonged bleeding can be seen following medical leech application. In such cases, bleeding can be controlled by primary suture.


Assuntos
Mordeduras e Picadas/complicações , Hemorragia/etiologia , Hirudo medicinalis , Aplicação de Sanguessugas/efeitos adversos , Pescoço , Suturas , Adulto , Animais , Hemorragia/terapia , Humanos , Masculino , Saliva/química , Resultado do Tratamento
17.
Rheumatology (Oxford) ; 48(11): 1388-91, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19717547

RESUMO

OBJECTIVES: There had been evidence that low-dose local IFN could be beneficial in the management of recurrent oral ulcers (OUs). We investigated the efficacy and collected initial data on the safety of low-dose natural human IFN-alpha administered by the oral mucosal route in Behçet's syndrome (BS) in a placebo controlled, double blind study. METHODS: Eighty-four (59 males and 25 females) patients with BS with mainly skin mucosa disease and a history of recurrent OU for > or = 1 year were studied. When they had at least two OUs with a total diameter of > or = 4 mm, they were randomly allocated to (i) 2000 IFN-alpha IU/day, (ii) 1000 IFN-alpha IU/day and (iii) placebo groups. Subjects were monitored weekly over an initial 4 weeks and bi-weekly for an additional 8 weeks of treatment. OU were counted and measured at each study visit. The primary efficacy end point was the difference in the total ulcer burden at Week 0 compared with that at Week 12. RESULTS: Out of the 84 patients enrolled, 72 completed the trial. There were no statistically significant differences between the treatment arms in terms of the primary endpoint. CONCLUSIONS: Low-dose natural human IFN-alpha did not have beneficial effects on reducing the total ulcer burden among BS patients from Turkey. The study also showed that counting the number of ulcers rather than measuring the size would be adequate in future studies. TRIAL REGISTRATION: ClinicalTrials.gov, NCT00483184, http://www.clinicaltrials.gov/ct2/results?term=NCT00483184.


Assuntos
Síndrome de Behçet/tratamento farmacológico , Interferon-alfa/administração & dosagem , Úlceras Orais/tratamento farmacológico , Administração Oral , Adolescente , Adulto , Idoso , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Interferon-alfa/efeitos adversos , Interferon-alfa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Úlceras Orais/patologia , Comprimidos , Resultado do Tratamento , Adulto Jovem
18.
Mod Rheumatol ; 18(5): 507-10, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18504527

RESUMO

Pulmonary artery involvement as the initial predominant clinical manifestation in Takayasu arteritis (TA) is rare. We describe a young adult female who presented with life-threatening complications of proximal pulmonary arterial involvement of Takayasu arteritis. In our case, atypical presentation of TA with pulmonary symptoms due to pulmonary artery involvement resulted in an erroneous initial diagnosis of sarcoidosis and then tuberculosis. The frequency of such a clinical form could be underestimated given the difficulties involved in its diagnosis and because its features are similar to those of pulmonary disease.


Assuntos
Erros de Diagnóstico , Artéria Pulmonar/patologia , Sarcoidose Pulmonar/diagnóstico , Arterite de Takayasu/diagnóstico , Tuberculose Pulmonar/diagnóstico , Adulto , Angiografia Coronária , Humanos , Masculino , Arterite de Takayasu/patologia
19.
BMC Cancer ; 4: 29, 2004 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-15217519

RESUMO

BACKGROUND: Serum leptin level is associated with appetite and energy expenditure in healthy individuals. We aimed to evaluate the serum leptin concentration and the other factors which may be associated with weight loss in patients with advanced gastrointestinal cancer. METHODS: Forty-four patients with advanced gastrointestinal cancer (25 gastric and 19 colorectal cancer) and 25 healthy controls were enrolled. Serum leptin levels were measured as ng/ml via enzyme linked immuno-sorbent assay (ELISA) method in all subjects. The difference in serum leptin concentration between cancer and control group, the factor associated with its serum level and the relationship between serum leptin concentration and weight loss was evaluated. RESULTS: Serum leptin concentration of cancer group was significantly lower than controls (p = 0.002). Female subjects had significantly higher serum leptin concentration than male subjects in control group (p = 0.01), while not in cancer group (p > 0.05). Serum leptin concentration was significantly related with gender in controls (p = 0.023, beta = 0.479), while no gender difference was observed in cancer group (p > 0.05). No relationship was found between serum leptin concentration and weight loss percentage in cancer group in linear regression analysis (p > 0.05). No significant difference was observed in serum leptin concentrations between colon and gastric cancer sub-groups (p > 0.05). CONCLUSION: Independently from the site of gastrointestinal tract, serum leptin concentration in advanced gastrointestinal cancer is lower than controls and it is not a determinant factor in weight loss. In contrast to healthy subjects, gender does not effect the serum leptin concentration in patients with advanced gastrointestinal cancer.


Assuntos
Índice de Massa Corporal , Neoplasias Colorretais/sangue , Leptina/sangue , Neoplasias Gástricas/sangue , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Análise de Regressão , Distribuição por Sexo , Redução de Peso
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