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The Distribution and Antimicrobial Susceptibility Profiles of Etiologic Agents Isolated From Bacteremia Episodes Among Immunocompromised Patients
Get PDFObjective: Bacteremia is the leading cause of morbidity and mortality among immunocompromised patients. The aim of this study is to evaluate the etiology of bacteremia and the antibiotic susceptibilities of etiologic agents among immunocompromised patients followed up from January 1, 2012 to July 30, 2013.
Methods: Immunocompromised patients, both inpatient and outpatient treated in our hospital, were followed prospectively. The definition of "immunocompromised patients" consisted of solid organ (kidney, liver) transplantation recipients and hemato-oncologic malignancy patients with a history of chemotherapy in the previous month before bacteremia.
Results: This prospective study comprised of 167 bacteremia episodes of 130 consecutive immunocompromised patients. The most isolated group of bacteria was Gram-negative bacteria. Escherichia coli was the most commonly (30.8%) isolated bacteria and the second was coagulase-negative staphylococci (15.1%). Fifty one percent of the E. coli isolates were extended-spectrum beta-lactamasepositive. Acinetobacter baumannii was the second most common bacteria of Gram-negative agents and the ratio of multiple drug-resistant (MDR) isolates among Acinetobacter isolates was 73%.
Conclusions: Gram-negative bacteria are the most common causative agents of bacteremia in immunocompromised patients in our hospital. The rising ratio of MDR A. baumannii is a striking problem which causes difficult-to-treat infections
HUMAN PAPILLOMA VIRUS (HPV) PREVALENCE AND GENOTYPE DISTRIBUTION
Get PDFAssessment of Human papillomavirus (HPV) prevalence and genotype distribution is important for monitoring the impact of prophylactic HPV vaccination. This study aimed to demonstrate the HPV prevalence and type distribution in women from the Baskent University Adana Dr. Turgut Noyan Practice and Research Center. Cervical specimens from 268 women aged 22-68 years were collected between April 2014 and November 2015. Histopathological examinations were performed for 146 women. HPV DNA was amplified by PCR and HPV and genotyping was undertaken using the Roche (R) linear array detection kit. In total. 124 out of 268eligible samples (46.31%) tested positive for HPV. with the majority of these [84/124 (67.7%1] having high-risk (HR) HPV infection: 20.9% were positive for HPV16 (n=261, and 4% for HPV18 (n=5) HPV type-specific prevalence was 63.9% 53.39 and 80% among cervical intraepithelial neoplasias (CIN) Grades respectively. The coverage of other HR-HPV genotypes apart from 16. included HPV31. 45. 51, 53, and 56 in high-grade cervical lesions. In conclusion, HPV-16 was identified as the main HPV genotype associated with cervical disease in our hospital. The study reports the identification of high-and low-risk HPV genotypes as well as the prevalence of multiple HPV infections
The Effect of Pycnogenol (R) on Spatial Learning and Memory in Rats with Experimental Closed Head Injury
No full textAim: Trauma is a leading cause of emergency admissions. In this study, we investigated the effect of Pycnogenol (R) on spatial learning and memory (SLM) function in rats subjected to closed head injury.
Methods: The study was a randomized, experimental study of four groups, each containing six rats. Pycnogenol (R) was administered to rats in two groups (group three and four) daily for five days starting on day one. A Barnes maze was used to test SLM in the rats in all four groups. Group 1: These rats did not have a closed head injury and were not administered Pycnogenol (R). Group 2: On the day three, closed head trauma was inflicted. Group 3: Pycnogenol (R) was administered to the rats. On day three, closed head trauma was inflicted. Group 4: Only Pycnogenol (R) was administered. At the end of day five, the brain tissue of the 24 rats was removed.
Results: There were no significant differences between the groups in mean SLM durations on days one through five. No significant differences were detected in the pathological examination between of the four groups.
Conclusion: Future studies that employ biochemical markers and free radical levels in the brain are needed
Duodenitis caused by Sarcina ventriculi in a case with Celiac disease and selective IgA deficiency
No full textSarcina ventriculi is a gram-positive, obligate anaerobic bacteria first documented in the human gastrointestinal tract in 1842. Sarcina ventriculi are found to be associated with delayed gastric emptying and gastric outlet obstruction Up to date numerous cases of fatal disease have been attributed to this organism in the veterinary literature, but only a few human cases have been documented. Herein we report a case of a 10-year-old girl patient who was diagnosed Celiac disease, selective IgA deficiency and Sarcina ventriculi duodenitis. To the best of our knowledge the association Celiac disease and Sarcina ventriculi duodenitis has not been previously reported in children. Therefore, in the present study we want to draw attention to the importance of a rare coexistance of Celiac disease and Sarcina ventriculi duodenitis
High Prolactin Level as a Predictor of Vasospasm in Aneurysmal Subarachnoidal Hemorrhage
No full textBackground: Aneurysmal subarachnoid hemorrhage (aSAH) is a destructive syndrome with a mortality rate of 50%. Recent studies have also suggested a high pervasiveness of hypothalamic-pituitary insufficiency in up to 45% of patients after aSAH. Prolactin has been associated with the pathogenesis of hypertensive irregularities that are linked to pregnancy.
Material/Methods: We identified a group of 141 patients with spontaneous SAH due to a ruptured cerebral aneurysm; these patients were operated on at our institution's Neurosurgery and Interventional Radiology Department between 2011 and June 2015. All of the data were obtained retrospectively from medical records.
Results: The hormonal abnormalities observed in the initial 24 h after ictus in subjects with subarachnoid SAH were caused by stressful stimulation aggravated by intracranial bleeding.
Conclusions: The elevated prolactin levels that occur in patients with aSAH can be used in conjunction with other auxiliary factors that we believe may be beneficial to vasospasm
A rare large mutation involving two exons of the SP-B gene in an infant with severe respiratory distress
No full textHereditary surfactant protein-B (SP-B) deficiency is a rare autosomal recessive disease of newborn infants causing severe respiratory failure and death within the first year of life. The most common cause of SP-B deficiency is a frameshift mutation in exon 4 (121ins2) in the gene encoding SP-B. We report a term infant with unremitting respiratory distress who was unresponsive to all treatment modalities. The parents were consanguineous and a term sibling of the infant had died due to respiratory failure without a certain diagnosis. In the first step of the diagnostic work-up, common genetic mutations for SP-B, surfactant protein C and ATP-binding cassette s3 were absent, however sequencing of SP-B gene revealed a large homozygous genomic deletion covering exon 8 and 9.
In this case report, we aimed to emphasize further genetic evaluation in all cases suggestive of surfactant dysfunction, even if common mutations are absent
Effect of Graft Weight to Recipient Body Weight Ratio on Hemodynamic and Metabolic Parameters in Pediatric Liver Transplant: A Retrospective Analysis
No full textObjectives: To analyze how graft-weight-to-body-weight ratio in pediatric liver transplant affects intraoperative and early postoperative hemodynamic and metabolic parameters. Materials and
Methods: We reviewed data from 130 children who underwent liver transplant between 2005 and 2015. Recipients were divided into 2 groups: those with a graft weight to body weight ratio > 4% (large for size) and those with a ratio <= 4% (normal for size). Data included demographics, preoperative laboratory findings, intraoperative metabolic and hemodynamic parameters, and intensive care follow-up parameters.
Results: Patients in the large-graft-for-size group (>4%) received more colloid solution (57.7 +/- 20.1 mL/kg vs 45.1 +/- 21.9 mL/kg; P = .08) and higher doses of furosemide (0.7 +/- 0.6 mg/kg vs 0.4 +/- 0.7 mg/kg; P = .018). They had lower mean pH (7.1 +/- 0.1 vs 7.2 +/- 0.1; P = .004) and PO2 (115.4 +/- 44.6 mm Hg vs 147.6 +/- 49.3 mm Hg; P = .004) values, higher blood glucose values (352.8 +/- 96.9 mg/dL vs 262.8 +/- 88.2 mg/dL; P .05).
Conclusions: High graft weight-to-body-weight ratio is associated with adverse metabolic and hemodynamic changes during the intraoperative and early postoperative periods. These results emphasize the importance of using an appropriately sized graft in liver transplant
The adverse effects of valproic acid on visual functions in the treatment of retinitis pigmentosa
No full textPurpose: To evaluate the efficacy and safety of valproic acid (VPA) treatment in patients with retinitis pigmentosa (RP). Methods: A total of 48 eyes of 24 patients (13 males, 11 females) with RP prescribed VPA were included. The length of VPA treatment was 6-12 months (mean 9.4 months). Parameters evaluated were best-corrected visual acuity (BCVA) (logarithm of the minimum angle of resolution [logMAR]), visual field analyses (VFAs) with Humprey automated perimetry, multifocal electroretinography (ERG) with Roland-RETI scan, and VPA side effects. Results: Mean age was 34.3 +/- 10.3 years (range 18-56 years). Fifteen of the patients (30 eyes) had two ERG and VFA tracings, allowing comparison between baseline and follow-up (range 6-12 months). Mean BCVA before and after VPA therapy was 0.36 +/- 0.38 and 0.36 +/- 0.37 logMAR, respectively (P = 0.32). Quantitative perimetric indices including mean deviation and pattern standard deviation were not significantly changed after VPA therapy (P > 0.05). P1 amplitudes (in terms of nV/deg(2) and mV) of ERG waves were significantly decreased in the rings 1, 3, and 4 after VPA therapy (P < 0.05). Regarding the N1 amplitudes, the only significant decrease was observed in area 1 (P = 0.03). In addition, N1 latency was significantly increased in area 3 after VPA therapy (P = 0.04). Conclusions: VPA therapy did not have any significant benefit on BCVA and VFA. In addition, it may be associated with decline in some ERG parameters. Therefore, physicians should avoid prescribing VPA for RP until its safety and efficacy are appropriately evaluated
The role of delineation education programs for improving interobserver variability in target volume delineation in gastric cancer
No full textObjective: To assess whether delineation courses for radiation oncologists improve interobserver variability in target volume delineation for post-operative gastric cancer radiotherapy planning.
Methods: 29 radiation oncologists delineated target volumes in a gastric cancer patient. An experienced radiation oncologist lectured about delineation based on contouring atlas and delineation recommendations. After the course, the radiation oncologists, blinded to the previous delineation, provided delineation for the same patient.
Results: The difference between delineated volumes and reference volumes for pre-and post-course clinical target volume (CTV) were 19.8% (-42.4 to 70.6%) and 12.3% (-12.0 to 27.3%) (p = 0.26), respectively. The planning target volume (PTV) differences pre-and post-course according to the reference volume were 20.5% (-40.7 to 93.7%) and 13.1% (-10.6 to 29.5%) (p = 0.30), respectively. The concordance volumes between the pre-and post-course CTVs and PTVs were 467.1 +/- 89.2 vs 597.7 +/- 54.6cm(3) (p < 0.001) and 738.6 +/- 135.1 vs 893.2 +/- 144.6 cm(3) (p < 0.001), respectively. Minimum and maximum observer variations were seen at the cranial part and splenic hilus and at the caudal part of the CTV. The kappa indices compared with the reference contouring at pre- and post-course delineations were 0.68 and 0.82, respectively.
Conclusion: The delineation course improved interobserver variability for gastric cancer. However, impact of target volume changes on toxicity and local control should be evaluated for further studies.
Advances in knowledge: This study demonstrated that a delineation course based on current recommendations helped physicians delineate smaller and more homogeneous target volumes. Better target volume delineation allows proper target volume irradiation and preventing unnecessary normal tissue irradiation
Placental elasticity on patients with gestational diabetes: Single institution experience
No full textBackground: Gestational diabetes is defined as glucose intolerance which is first recognized in pregnancy. Oral glucose tolerance test (OGTT) is the cornerstone in diagnosing gestational diabetes. Placental elasticity evaluation is relatively new concept and is principally used for research purposes. We aimed to find any relation between placental elasticity evaluation and patients of gestational diabetes diagnosed by 75 g OGTT.
Methods: There were 91 patients took part in study, forming two groups as gestational diabetic patients (21 patients) and control group (70 patients). Elasticity of placenta was determined by acoustic radiation force impulse technology utilized by two blinded radiology specialists.
Results: We were not able to find any correlation between 75 g OGTT values and placental elasticity measurements (p > .05). Also placental elasticity was not found to be significantly different in two groups (p > .05).
Conclusion: Placental elasticity measurement on the 24th-28th weeks does not seem to be a marker for identification of gestational diabetes. Copyright (C) 2017, the Chinese Medical Association. Published by Elsevier Taiwan LLC