Browsing by Author "Kiraz, Kemal"

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    Antibiotic Use in Pediatric and Neonatal Intensive Care Units; Multicenter Point Prevalence Study
    (2014) Tolunay, Orkun; Celik, Umit; Yucel, Gulperi; Celik, Tamer; Mert, Mustafa Kurthan; Resitoglu, Salim; Ozdemir, Ulas; Narli, Nejat; Hanta, Deniz; Yapicioglu, Hacer; Gulcan, Hande; Ozcan, Kenan; Yildizdas, Dincer; Tolunay, Ilknur; Gokay, Naime; Kiraz, Kemal
    Objective: Identifying antibiotic use in pediatric and neonatal intensive care units with a point prevalence study in Adana, Turkey's sixth largest city. Material and Methods: In this point prevalence study, demographic information and antibiotic treatment data were taken on the same day from patients in pediatric and neonatal intensive care units of 6 hospitals located in Adana's city center. Results: Four pediatric intensive care units (two university, one research and training hospital, and one public hospital) and six neonatal intensive care units (two university, one research and training hospital, one public hospital, and two private hospital) were included in the study; 220 patients were at the intensive care units at the time of the study-44 (20%) of the patients were in the pediatric intensive care units, and 176 (80%) of them were at the neonatal intensive care units. Also, 146 (66.4%) of the patients were using antibiotics. The frequency of antibiotic use was 72.7% in the pediatric intensive care units and 64.8% in neonatal intensive care units. There was a pediatric infectious disease physician at the university and research and training hospital. Antibiotic usage was lower (p= 0.002) in clinics where pediatric infectious disease physician consultations could be done. Dual antibiotic combination was applied most frequently. Mostly, ampicillin was preferred at neonatal intensive care units. Clarithromycin was used as a second choice because of seasonal lower respiratory tract infections. Vancomycin was the most preferred antibiotic in pediatric intensive care units, and meropenem and linezolid were the second and third choices. At both intensive care units, use of empiric antibiotic treatment was more frequent. Empiric treatment was applied in 22 (68.7%) patients in the pediatric intensive care units and 95 (83.3%) in neonatal intensive care units. Antibiotics were given to 14.3% of the patients in line with the resulting cultures. Conclusion: Intensive care units are services where antibiotics are used most frequently both in Turkey and in the world. In our opinion, protocols need to be established in clinics, national and international guides should be followed; and pediatric infectious disease physician consultations should be increased in order to reduce the frequency of antibiotic use, inappropriate indications, and inappropriate doses.
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    Hypertension Alters Phosphorylation of VASP In Brain Endothelial Cells
    (2015) Arlier, Zulfikar; Basar, Murat; Kocamaz, Erdogan; Kiraz, Kemal; Tanriover, Gamze; Kocer, Gunnur; Arlier, Sefa; Giray, Semih; Nasircilar, Scher; Gunduz, Filiz; Senturk, Umit K.; Dernir, Necdet; 0000-0003-2645-648X; 24894047; ACE-7635-2022
    Hypertension impairs cerebral vascular function. Vasodilator-stimulated phosphoprotein (VASP) mediates active reorganization of the cytoskeleton via membrane ruffling, aggregation and tethering of actin filaments. VASP regulation of endothelial barrier function has been demonstrated by studies using VASP(-/-) animals under conditions associated with tissue hypoxia. We hypothesize that hypertension regulates VASP expression and/or phosphorylation in endothelial cells, thereby contributing to dysfunction in the cerebral vasculature. Because exercise has direct and indirect salutary effects on vascular systems that have been damaged by hypertension, we also investigated the effect of exercise on maintenance of VASP expression and/or phosphorylation. We used imnnunohistochemistry, Western blotting and immunocytochemistry to examine the effect of hypertension on VASP expression and phosphorylation in brain endothelial cells in normotensive [Wistar-Kyoto (WKY)] and spontaneously hypertensive (SH) rats under normal and exercise conditions. In addition, we analyzed VASP regulation in normoxia- and hypoxia-induced endothelial cells. Brain endothelial cells exhibited significantly lower VASP immunoreactivity and phosphorylation at the Ser157 residue in SHR versus WKY rats. Exercise reversed hypertension-induced alterations in VASP phosphorylation. Western blotting and immunocytochemistry indicated reduction in VASP phosphorylation in hypoxic versus normoxic endothelial cells. These results suggest that diminished VASP expression and/or Ser157 phosphorylation mediates endothelial changes associated with hypertension and exercise may normalize these changes, at least in part, by restoring VASP phosphorylation.