Browsing by Author "Togan, Turhan"

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Can Preoperative Erythrocyte Sedimentation Rate Serve as an Indicator for Midterm Adverse Events after Coronary Bypass Grafting?
(2015) Togan, Turhan; Gunday, Murat; Ciftci, Ozgur; Bingol, Hakan; 0000-0002-6463-6070; 25924030; A-7318-2017
Objective: Erythrocyte sedimentation rate (ESR) may serve as a reasonably-good indicator for coronary heart disease as usually ESR is elevated in these patients. The measurement of ESR is a very simple and cheap laboratory test that can he performed in routine blood examinations. In this study, we investigated the association between preoperative erythrocyte sedimentation rate and postoperative midterm adverse events after coronary artery bypass grafting (CABG). Methods: In the study, only male patients were included. The patients were divided into two groups: group 1 (preoperative sedimentation rate [<20 mm/h] normal [n = 232, 63.9%]) and group 2 (preoperative sedimentation rate [>20 mm/h] above normal [n = 131, 36.1%]). The hemogram and biochemistry panel values were measured one day before operation, on the postoperative first day, on the postoperative seventh day, and on the postoperative third month. Results: Among the laboratory values, there was a statistically significant difference between the two groups with respect to postoperative first-day ESR and postoperative third-month high-sensitivity C-reactive protein (P < .05). In terms of postoperative morbidity, there was also a statistically significant difference (P < .05) between the two groups with regard to pleural effusion, infection of the soft tissue over the sternum, pulmonary infection, return to the intensive care unit, rehospitalization, and mortality. Conclusion: Elevated preoperative sedimentation rate is associated with postoperative adverse events in patients who undergo CABG. For this purpose, we suggest that patients with higher sedimentation rates undergo detailed examination to prevent mortality and morbidity.
A Case with Multifocal Pyomiyositis Due to Staphylococcus Aureus
(2016) Ozden, Hale Turan; Coban, Gokcen; Duman, Enes; Togan, Turhan; https://orcid.org/0000-0002-4010-2883; P-7533-2014
Primary pyomyositis, a pyogenic infection of the skeletal muscle, is often seen in tropical and subtropical regions. In this article, we present a 16 years-old male patient, who applied to the emergency department with fever, hip pain, and inability to walk without history of trauma. The Multifocal pyomyositis diagnosis was made on the basis of clinical, laboratory and radiologic evaluation of gluteus maximus, medius and minimus, priformis and ilipsoas muscles. Meticilin sensitive Staphylococcus aureus was grown in patient's blood cultures. The patient was successfully treated with intravenous antibiotics (Sulbactam-ampicillin and ciprofloxacin) and ultrasonography guided drainage of abscesses. Although this infectious disease is rare, primary pyomyositis should be considered in the differential diagnosis of patients with fever, hip pain and claudication.
Comparative Evaluation of Cases with Community-Acquired Infective Endocarditis and Health Care-Associated Infective Endocarditis
(2015) Kursun, Ebru; Turunc, Tuba; Demiroglu, Yusuf Ziya; Togan, Turhan; Tekin, Goknur; Arslan, Hande
Purpose: The present study aimed to comparatively evaluate the cases with health care-associated infective endocarditis and the cases with community-acquired infective endocarditis. Material and Methods: Of the cases followed for infective endocarditis (IE), 21 (40 %) had health care-associated infective endocarditis and 31 (60 %) community-acquired infective endocarditis. Results: Comparing the cases with community acquired infective endocarditis and the cases with health care-associated infective endocarditis, it was determined that advanced age (58.0 +/- 15.1 years vs. 41.3 +/- 14.4 years, P=0.000), presence of chronic renal insufficiency (P=0.001) and diabetes mellitus (P=0.016) as concomitant diseases, being previously hospitalized (P=0.0001), hemodialysis in terms of diagnostic and therapeutic interventions (P=0.022), presence of central venous catheter (P=0.022), and undergone intervention for gastrointestinal system (P=0.060), as well as laboratory results including positive blood culture growth for S. aureus and Enterococcus (P=0.037), and complications such as development of embolic event (P=0.008), spondylodiscitis (P=0.034) and stroke (P=0.007) were statistically significantly more common in health care-associated infective endocarditis cases. Whilst mortality was higher in health care-associated infective endocarditis cases (28.6 %), it was determined that there was no statistically significant difference between the groups. Conclusion: Health care-associated infective endocarditis is a disease that is more common in the patients at advanced age, with concomitant disease and the history of exposing invasive procedures in the past for diagnostic and therapeutic purpose, and it is a disease with high morbidity and mortality that courses with serious complications.
Could there be an association between chronic brucellosis and endothelial damage?
(2015) Togan, Turhan; Ciftci, Ozgur; Turan, Hale; Narci, Huseyin; Gullu, Hakan; Arslan, Hande; 25596571
Introduction: In this study, we examined the effects of Brucella infection on endothelial dysfunction. Flow-mediated dilatation (FMD) measurement is indicator of the endothelial function, and abnormal values indicating endothelial dysfunction are accepted as the first stage of atherosclerosis. Methodology: Twenty-four patients who had been treated for acute brucellosis two years before, and who had had no relapses in the follow-up, were prospectively included in the study, along with 30 healthy individuals in the control group. Results: While the highly sensitive Creactive protein (hs-CRP) value was 2.42 +/- 1.45 in the patient group, it was 1.72 +/- 0.61 in the control group (p = 0.025). While the FMD value was 3.50 +/- 1.58 in the patient group, it was 5.88 +/- 1.88 in the control group (p < 0.001). While the percentage increase in FMD was 9.88 +/- 4.92 in the patient group, it was 17.49 +/- 6.3 in the control group (p < 0.001). It was observed that FMD value, the percentage increase in FMD, and basal radius were correlated with hs-CRP (r = -0.644, p < 0.001; r = -0.558, p = 0.002; r = 0.444, p = 0.018, respectively). The carotid artery intima media thickness (IMT) value was found to be 0.61 +/- 0.17 in the patient group and 0.49 +/- 0.12 in the control group (p = 0.004). Conclusions: The abnormal FMD and IMT values observed in brucellosis patients might be an indicator of more frequent arterial dysfunction, increased cardiovascular risk, and atherosclerosis.
A Cutaneous Infection Due to Mycobacterium Fortuitum
(2015) Ozden, Hale Turan; Dursun, Recep; Togan, Turhan
Cutaneous infections caused by non-tuberculous mycobacteria are uncommon and are so difficult to diagnose. Rapidly growing mycobacteria can cause skin and soft tissue infections in immunocompromised patients. Mycobacterium fortuitum is one of the rapidly growing mycobacterium. In this article, in an immuncompetent patient, we present a case of cutaneous infection in which M. fortuitum is isolated. Our patient recovered completely by clarithromycin and ciprofloxacin treatment given perorally for 12 weeks.
A Different Marker to Determine Arrhythmia Potential Between Elite Active Cyclists and Veterans: T Peak T End
(2015) Gormus, Z. Isik Solak; Isik, Bulent; Ciftci, Ozgur; Icli, Abdullah; Togan, Turhan; Aslan, Huseyin; Kutlu, Selim; 0000-0002-6463-6070; A-7318-2017
Does Brucellosis Cause Arterial Stiffness and Ventricular Remodelling Through Inflammation?
(2015) Togan, Turhan; Ciftci, Ozgur; Gunday, Murat; Narci, Huseyin; Arslan, Hande; 0000-0002-6636-9391; 0000-0002-5708-7915; 0000-0002-6463-6070; 26148379; L-7182-2015; ABG-7034-2021; A-7318-2017
Background Like other acute and chronic infections, Brucella infection leads to endothelial dysfunction. Furthermore, it has been suggested that the chronic inflammatory state present in chronic infectious diseases leads to an acceleration in atherosclerosis. For the prediction of CAD, it is possible to use epicardial fat thickness (EFT) as an adjunctive marker beside the classical risk factors, as it is easily and non-invasively evaluated by transthoracic echocardiography. The purpose of this study was to investigate the presence of impaired myocardial performance as well as of increased arterial stiffness and EFT in patients who had been infected with brucellosis in the past. Methods Included in the study were twenty-seven brucellosis patients and twenty-six healthy volunteers. Using EFT and transthoracic echocardiography, which included Doppler echocardiography in combination with tissue Doppler imaging (TDI), all the patients were examined to measure their aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values. Results A statistically significant increase was observed in hs-CRP, aortic stiffness index, aortic elastic modulus and EFT in brucellosis patients when compared with the controls (2.46 +/- 1.40 vs 1.71 +/- 0.61, P=0.016; 9.69 +/- 6.99 vs 2.14 +/- 0.72, P < 0.001; 11.17 +/- 8.60 vs 2.18 +/- 0.90, P < 0.001; 0.76 +/- 0.08 vs 0.63 +/- 0.10, P < 0.001). On the other hand, there was a significant decrease in aortic strain and aortic distensibility (7.41 +/- 6.82 vs 18.26 +/- 5.83, P < 0.001; 1.83 +/- 1.71 vs 5.22 +/- 1.72, P < 0.001, respectively). No difference was observed between the two groups with respect to the left ventricular myocardial performance index (MPI) (0.62 +/- 0.15 vs 0.61 +/- 0.13, P=0.859). Conclusions In this study, we demonstrated for the first time in the literature that there was impaired aortic elasticity and increased EFT in patients with brucellosis, while the myocardial performance index remained unaffected. We also determined that these effects had a significant correlation with inflammation.
The Impact of Acute Brucellosis on Mean Platelet Volume and Red Blood Cell Distribution
(2015) Togan, Turhan; Narci, Huseyin; Turan, Hale; Ciftci, Ozgur; Kursun, Ebru; Arslan, Hande; 25825650
Background: Brucellosis is an inflammatory disease which may infect any organs or systems in the body. Mean Platelet Volume (MPV) is one of the most frequently used surrogate markers of platelet function. It reveals the presence of disease activity in many inflammatory diseases. Red blood cell distribution width (RDW) is a parameter that measures variation in red blood cell size or red blood cell volume. Its predictive value approves inflammatory and infectious diseases. Objectives: The current study aimed to determine the assessment levels of red blood cell distribution in cases with acute brucellosis. Patients and Methods: The current study investigated whether MPV and RDW played any roles in acute brucellosis diagnosis. The study was conducted from 2008 to 2014 through prospective examination of the inflammatory markers found in adult patients with acute brucellosis. Results: The follow-up within the year after treatment was examined. The values of age, gender, leukocyte count, C-reactive protein, RDW and MPV were recorded. The study included 351 subjects, 250 of them in the acute brucellosis group and 101 in the control group. The mean MPV levels were 7.64 +/- 1.30 fL, and 7.67 +/- 1.29 fL in the acute brucellosis and control groups, respectively (P > 0.05). The mean CRP levels were 32.57 +/- 53.20 mg/dL, and 4.81 +/- 4.89 mg/dL in the acute brucellosis and control groups, respectively (P < 0.05). There was no statistically significant difference between the two groups regarding the RDW level and the mean leukocyte count (P > 0.05). Conclusions: While the CRP value was in patients with acute brucellosis in the current study, the MPV, RDW and leukocyte counts were within the normal range. CRP value remains the most valuable inflammatory marker in cases of acute brucellosis.
In vitro Susceptibility of Tigecycline against Multidrug-Resistant Gram-Negative Strains: Etest versus Agar Dilution
(2014) Ozkok, Sezen; Togan, Turhan; Yesilkaya, Aysegul; Timurkaynak, Funda; Azap, Ozlem Kurt; Arslan, Hande; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; 25791941; A-8902-2013; AAK-4089-2021; ABG-7034-2021
Background and Aim: Tigecycline is a semi-synthetic tetracycline with activity against most multidrug-resistant (MDR) bacteria. Methods: We studied in vitro activity of tigecycline by agar dilution (AD) and Etest methods to evaluate their correlation. The study included 206 isolates of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli, Klebsiella pneumoniae and MDR Acinetobacter baumannii recovered from blood cultures of patients of Baskent University between 2008 and 2010. Results: ESBL-producing E. coli had MIC50 /MIC90 values of 0.5/0.5 mu g/ml by AD and 0.25/0.5 mu g/ml by Etest. ESBL-producing K. pneumoniae had MIC50 /MIC90 values of 1/2 mu g/ml by AD and 0.75/2 mu g/ml by Etest, whereas MDR A. baumannii had MIC50 /MIC90 values of 4/4 mu g/ml by AD and 2/4 mu g/ml by Etest. The correlation between AD and Etest was weak for ESBL-producing E. coli and strong for ESBL-producing K. pneumoniae and MDR A. baumannii. Tigecycline MIC values for ESBL-producing E. coli were lower than the tigecycline concentration, while they were higher than the concentrations attainable by treatment doses for A. baumannii. Conclusion: Tigecycline is an appropriate agent in the treatment of E. coli bacteremia, but it is not for treating A. baumannii bacteremia. Tigecycline could be used for K. pneumoniae bacteremia treatment after determining its MIC value. Determining the MIC value by gold-standard methods is more appropriate due to the correlation between Etest and AD at high MIC values. (C) 2015 S. Karger AG, Basel
In Vitro Susceptibility of Tigecycline and Colistin Against Stenotrophomonas maltophilia
(2018) Turan Özden, Hale; Togan, Turhan; Azap, Özlem
Introduction: Gram-negative bacillus Stenotrophomonas maltophilia is resistant to drugs (multi-drug resistance-MDR) and it can be isolated from nature. Treatment of the infections resulting from S. maltophilia could be problematic due to multi-resistance. Materials and Methods: 72 S. maltophilia strains isolated from clinical samples were included into the study. Sensitivity was determined using Tigecycline and Colistin E-test MIC method performed in the Clinical Microbiology laboratory of Baskent University, Medical Faculty between 2010 and 2014. Results: In our study, colistin MIC range was found as 0.016-8 mg/L. MIC50 and MIC90 values were determined respectively as 1.5 mg/L and 12 mg/L. Tigecycline MIC range was 0-96 mg/L, and MIC50 was 0.19 mg/L and MIC90 was 1.5 mg/L. Furthermore, one tigecycline resistant strain was detected. Conclusion: We believe that the determination of novel treatments and protocols and their standardization using multidisciplinary approaches can facilitate to cope with problematic and resistant nosocomial infections developed by S. maltophilia.
Intravesical BCG Immunotherapy: Sepsis and Multiorgan Failure Developed After Traumatic Catheterization
(2014) Cicek, Tufan; Togan, Turhan; Erinanc, Hilal; Ugur, Murat; Gonulalan, Umut; Cifci, Egemen; 0000-0003-1401-6356; AAL-1268-2021
Intravesical Bacillus Calmette-Guerin (BCG) instillation is a prophylactic therapy using for treating bladder cancer to prevent tumour progression and recurrence. Both local and systemic complications can arise after the installation. Although local complications are common, this therapy is generally well tolerated. Systemic complications are rarely than local complications but can be fatal. We report a case who died from severe complications such as sepsis, pneumonia, renal failure and granulomatous hepatitis after receiving the first maintanence installation of intravesical BCG immunotherapy for bladder transitional cell carcinoma.
Osteoarticular Involvement among Brucellosis Cases in Konya City
(2015) Ozden, Hale Turan; Togan, Turhan
Purpose: Brucellosis is a systemic disease that can affect many organs and tissues. Musculoskeletal system is one of the most commonly affected systems. Disease may present itself with sacroiliitis, peripheral arthritis, spondylitis, paraspinal abscess, bursitis or osteomyelitis. The objective of the present study was to determine the frequency, types and clinical features of osteoarticular involvement among cases with brucellosis in Konya city and to establish the differences between patients with and without osteoarticular involvement. Material and Methods: Three hundred and sixteen patients with Brucellosis who presented between June 2003 and June 2014 were included in the study. Brucellosis was diagnosed by positive Bruce Ila Standard Agglutination Test (1/160 titer) and/or growth of Bruce Ila spp. in blood culture in addition to the presence of clinical signs and findings. Diagnosis of osteoarticular system complications was established by physical examination and radiological findings obtained by diagnostic imaging tools. Magnetic resonance images of the thoracic, lumbar or sacral vertebrae were acquired in patients with back pain, low back pain and sacro-iliac joint pain. Results: Osteoarticular involvement was noted in 129 patients (40.8%) (females: 52% and males: 48%). The most common route of transmission was employment in farming and/or consumption of un-pasteurized milk or dairy products, especially fresh cheese, in 97 (75%) cases. Mean age was 46 18 years. Sacroiliitis was the most frequent osteoarticular involvement (n: 68, 52.7%), 70.5% of which were bilateral. Sacroiliitis was followed by spondylodiscitis in 35 (38.7%), peripheral arthritis in 20 (15.5%), bursitis in 1 (0.8%) cases. Patients with osteoarticular involvement received medical treatment for at least three months. Discussion: Ratio and anatomical region of osteoarticular involvement in brucellosis shows variability among areas. In the present study, we demonstrated that sacroiliitis was the most common form in Konya city. This disease should be included in differential diagnosis in patients with symptoms of sacroiliitis, spondylodiscitis or those with articular pain. Key words: Brucellosis, osteoarticular involvement
The Prevalence, Etiologic Agents and Risk Factors for Urinary Tract Infection Among Spinal Cord Injury Patients
(2014) Togan, Turhan; Azap, Ozlem Kurt; Durukan, Elif; Arslan, Hande
Background: Urinary tract infections (UTIs) are important causes of morbidity and mortality in patients with spinal cord injury and 22% of patients with acute spinal cord injury develop UTI during the first 50 days. Objectives: The aim of this study was to determine the prevalence, etiologic agents and risk factors for asymptomatic bacteriuria and symptomatic urinary tract infections in patients with spinal cord injury. Patients and Methods: This was a prospective investigation of spinal cord injury patients with asymptomatic bacteriuria and symptomatic urinary tract infections in Baskent University Medical Faculty Ayas Rehabilitation Center and Ankara Physical Therapy and Rehabilitation Center between January 2008 and December 2010. The demographic status, clinical and laboratory findings of 93 patients with spinal cord injury were analyzed in order to determine the risk factors for asymptomatic or symptomatic bacteriuria Results: Sixty three (67.7%) of 93 patients had asymptomatic bacteriuria and 21 (22.6%) had symptomatic urinary tract infection. Assessment of the frequency of urinary bladder emptying methods revealed that 57 (61.3%) of 93 patients employed permanent catheters and 24 (25.8%) employed clean intermittent catheterization. One hundred and thirty-five (48.0%) of 281 strains isolated form asymptomatic bacteriuria attacks and 16 (66.6%) of 24 strains isolated from symptomatic urinary tract infection attacks, totaling 151 strains, had multidrug resistance (P > 0.05). One hundred (70.4%) of 142 Escherichia coli strains and 19 (34.5%) of 55 Klebsiella spp strains proliferated in patients with asymptomatic bacteriuria; 8 (80%) of 10 E. coli strains and 4 (80%) of 5 Klebsiella spp. strains were multidrug resistant. Conclusions: The most common infectious episode among spinal cord injury patients was found to be urinary tract infection. E. coli was the most common microorganism isolated from urine samples. Antibiotic use in the previous 2 weeks or 3 months, hospitalization during the last one-year and previous diagnosis of urinary tract infection were the risk factors identified for the development of infections with multi-drug resistant isolates. Urinary catheterization was found to be the only independent risk factor contributing to symptomatic urinary tract infection.
The Role of Pneumococcal Pneumonia among CommunityAcquired Pneumonia in Adult Turkish Population: TurkCAP Study
(2021) Senol, Esin; Cilli, Aykut; Gunen, Hakan; Sener, Alper; Dumlu, Ridvan; Odemis, Ayse; Topcu, Ayse Fusun; Yildiz, Yesim; Guner, Rahmet; Ozhasenekler, Ayhan; Mutlu, Birsen; Kokturk, Nurdan; Sevimli, Nurgul; Baykam, Nurcan; Yapar, Derya; Ekin, Selami; Polatli, Mehmet; Gok, Sebnem Eren; Kilinc, Oguz; Sayiner, Abdullah; Karasahin, Omer; Cuhadaroglu, Caglar; Kocagoz, Ayse Sesin; Togan, Turhan; Arpag, Huseyin; Kati, Hakan; Koksal, Iftihar; Aksoy, Firdevs; Hasanoglu, Canan; 35110252
OBJECTIVE: To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients. MATERIAL AND METHODS: This multicenter, non-interventional, prospective, observational study included adult CAP patients (age = 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia. RESULTS: Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P =.007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P =.235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P =.002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group. CONCLUSION: The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.
Should We Remember Adrenal Insufficiency in Acute Gastroenteritis?
(2016) Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Ozgur, Gulsum Teke; Togan, Turhan; https://orcid.org/0000-0003-0182-002X
Introduction: Cortisol, which is released from the adrenal cortex, is a steroid hormone with vital functions. Its daily release is regulated by the hypothalamic-hypophyseal-adrenal axis. In healthy people, an adequate amount of endogenous corticosteroids is synthesized in the adrenal gland in response to stressful events, but in patients with adrenal insufficiency, there is a steroid synthesis defect that prevents the patient's requirements from being met. It may be challenging to diagnose corticosteroid deficiency in some circumstances, which can lead to catastrophic consequences, including death. Case presentation: In this article, we report a patient who had been using prednisolone 5mg/day for 10 years for rheumatoid arthritis with acute gastroenteritis whose clinical condition deteriorated despite appropriate therapy for 1 week and who was subsequently diagnosed with secondary adrenal insufficiency. Conclusion: On the basis of this case report, we remind clinicians of the necessity of rearranging steroid therapy during the course of an infectious disease in patients previously treated with prolonged steroid therapy.
Spinal kord yaralanması olan hastalarda gelişen üriner sistem infeksiyonu sıklığı, etken dağılımı ve risk faktörlerinin belirlenmesi
(Başkent Üniversitesi Tıp Fakültesi, 2009) Togan, Turhan; Kurt Azap, Özlem
Spinal kord yaralanması olan hastalarda görülen tıbbi sorunların basında üriner sistem infeksiyonları gelmektedir. Çalısmamızda spinal kord yaralanması olan hastalarda görülen üriner sistem infeksiyonlarının sıklığının, etken dağılımının ve risk faktörlerinin belirlenmesi amaçlanmıstır. Çalısmaya 15 Subat 2008 ile 30 Haziran 2009 tarihleri arasında Baskent Üniversitesi Ayas Rehabilitasyon Hastanesi’nde ve Ankara Fizik Tedavi ve Rehabilitasyon Merkezi’nde takip edilen 18-65 yas arasındaki toplam 93 hasta dahil edilerek prospektif olarak izlendi. Hastaların 78’i (%83.9) erkek ve 15’i (%15.1) kadın idi. Spinal kord yaralanmasının en sık nedeni trafik kazası olarak belirlendi. Takip edilen 93 hastanın 63’ünde (%67.7) asemptomatik bakteriüri, 21’inde (%22.6) semptomatik üriner sistem infeksiyonu saptandı. Dokuz (%9.7) hastanın yatısı süresince yapılan takiplerinde alınan idrar kültüründe üreme olmadı. Asemptomatik bakteriüri tanısı ile izlenen 63 hastanın mesane bosaltım yolu 34’ünde (%53.9) kalıcı sonda, 20’sinde (%31.7) temiz aralıklı kateterizasyon, 9’unda (%14.4) spontan idrar yapma seklinde idi. Semptomatik üriner sistem infeksiyonu ile izlenen 21 hastanın 17’sinde (%80.9) kalıcı sonda, 4’ünde (%19.1) temiz aralıklı kateterizasyon yöntemiyle mesane bosaltımı sağlanıyordu. Semptomatik ÜSĐ ile izlenen hastalar arasında idrarını spontan yapan yoktu. Üremesi olmayan 9 hastanın 6’sı (%66.7) kalıcı sonda ile izlenirken, 3’ü (%33.3) idrarını spontan olarak yapmaktaydi. Kateterizasyon türü ile asemptomatik bakteriüri veya semptomatik üriner sistem infeksiyonu gelismesi arasında istatistiksel olarak anlamlı bir iliski saptanmadı. Takip süresince toplam 30 sistemik infeksiyon atağı tespit edildi. Bu atakların 24’ü semptomatik üriner sistem infeksiyonu idi. Bakteriürisi olan hastalardan izole edilen toplam 305 etkenin %49.9’u E.coli, %19.7’si Klebsiella spp., %8.2’si Enterococcus spp. olarak belirlendi. E.coli ve Klebsiella spp. suslarında kinolona direnç oranı %56.8, trimetoprim sulfametoksazole direnç oranı %61.3 idi. Çok ilaca dirençlilik oranı asemptomatik bakteriüri ataklarından izole edilen etkenlerde %48 ve semptomatik üriner sistem infeksiyonu ataklarından izole edilen etkenlerde %66.6 olarak saptandı. Semptomatik üriner sistem infeksiyonu gelisimi yönünden saptanan tek bağımsız risk faktörü üriner kateterizasyon idi. Spinal kord yaralanması olan hastalarda gelisen üriner sistem infeksiyonlarının tedavisi planlanırken etkenlerde giderek artan direnç oranları göz önünde bulundurulmalıdır.
An Unexpected Pseudomonas Luteola Bacteremia: Case Report
(2015) Turan, Hale; Togan, Turhan
Pseudomonas luteola has rarely been reported as a human pathogen. It was showed in previous studies showed that P. luteola may cause septicemia, bacteremia, peritonitis, and endocarditis in patients with underlying disease or with indwelling devices. In this article we report a case of P. luteola bacteremia without any source. We successfully treated our patient with ceftriaxone and ciprofloxacin combination.
The value of serum mean platelet volume in testicular torsion
(2015) Cicek, Tufan; Togan, Turhan; Akbaba, Kaan; Narci, Huseyin; Aygun, Cem; 25762515
Objective To compare the serum mean platelet volume (MPV) in patients with testicular torsion and healthy control subjects. Methods This retrospective study compared clinical and demographic data from patients who underwent surgery for testicular torsion and healthy controls. Testicular torsion was diagnosed with a physical examination and Doppler ultrasonography. Age, leukocyte count, platelet count and MPV were recorded for all participants. Results A total of 50 patients with testicular torsion and 51 healthy control subjects were enrolled. There was no significant difference in age and platelet count between the two groups. Patients with testicular torsion had a significantly higher leukocyte count and MPV, compared with controls. According to receiver operating characteristic curve analysis performed for the prediction of testicular torsion, the best cut-off point for MPV was 7.7fl (sensitivity 62%, specificity 96%), and the best cut-off point for leukocyte count was 9.5x10(9)/l (sensitivity 58%, specificity 80%). Conclusions The MPV may be useful as an ancillary test for the diagnosis of testicular torsion. Further studies are needed in order to confirm these preliminary results.