Browsing by Author "Turan, Hale"

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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.
Current Recommendations on Surgical Antimicrobial Prophylaxis
(2015) Turan, Hale
Being the most common nosocomial infections among hospitalized surgical patients, surgical site infections (SSIs) are also the third most common nosocomial infection among all hospitalized patients. These infections result in consumption of more antibiotics, an increase in the cost of care, and a prolongation of hospital stay. Antimicrobial prophylaxis is one of the most effective methods used in preventing SSIs. It is known that incorrect indication, incorrect application time of the antimicrobial drugs, unnecessarily long term application, and incorrect drug selection are some of the mistakes made during the application of surgical antimicrobial prophylaxis. In this review, epidemiological findings and risk factors of SSIs and surgical antimicrobial prophylaxis are discussed in the light of current guidelines.
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.
Is there a difference between two different skin disinfection methods in cardiac surgery in terms of isolated pathogens?
(2020) Gunday, Murat; Orhan, Atilla; Turan, Hale; Korez, Muslu Kazim; 32683356
Introduction: In this study, our aim was to prospectively compare the different methods of patient disinfections with scrubbing + iodine + alcohol, and the povidone iodine disinfection method, which can be described as classical, in terms of the pathogens isolated on skin and during early postoperative complications. Methodology: Eighty patients undergoing a coronary artery bypass operation were included in the study. The patients were divided into two groups: group 1 (n = 48) patients who underwent scrub, iodine, followed by skin disinfection with alcohol, and group 2 (n = 32) who were treated with povidone iodine three times. The samples were immediately sent to the microbiology laboratory. Specimens from the wounds were incubated under aerobic and anaerobic conditions, and isolates were identified using standard microbiological techniques. Results: In samples taken after disinfection in group 1, significantly less reproduction was observed compared to group 2 (p = 0.001). There was no difference in postoperative complications between the two groups except for pleural effusion (p = 0.040). S. epidermidis was the most frequently isolated pathogen in both groups. Conclusion: We did not find a study which compares scrub + alcohol + iodine and povidone iodine in our literature review. We think that our study is original in this respect. We can conclude that skin disinfection with scrub + alcohol + iodine was superior to using only povidone iodine in terms of the pathogens isolated afterwards from the wound.
Kikuchi-Fujimoto Disease in a Patient with Mediastinal Lymphadenopathy
(2014) Turan, Hale; Serefhanoglu, Kivanc; Apiliogullari, Burhan; Aribas, Olgun Kadir; Ekici, Zuhal; Timurkaynak, Funda; Arslan, Hande; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0003-3225-2686; https://orcid.org/0000-0002-5708-7915; ABG-7034-2021; AAV-4737-2021; AAD-5602-2021; ABG-7034-2021
Kikuchi-Fujimoto disease is a benign self-limited syndrome with distinct histopathologic characteristics. Clinical symptoms include cervical lymphadenopathy with tenderness, fever of medium grade, night sweats, nausea, vomiting, and a sore throat. It is a rare disease worldwide. Diagnosis is based on histopathologic findings from an excisional lymph node biopsy. We present the case of a 37-year-old male patient with a fever of 15 days' duration. Clinical examination revealed no other pathologic signs except for oral aphthous lesions and a fever of unknown origin. The patient's fever did not resolve after 15 days' follow-up, and the results of computed tomographic study of the thorax revealed several sites of mediastinal lymphadenopathy. The diagnosis of Kikuchi-Fujimoto disease (histiocytic necrotising lymphadenitis) was based on the results of pathologic examination of the biopsy specimen. The patient's signs and symptoms resolved without antibiotic therapy. This case report of a patient with a fever of unknown origin is presented because of the rare involvement of mediastinal lymphadenopathy without cervical lymphadenopathy. Kikuchi-Fujimoto disease should be considered in the differential diagnosis of the patient who presents with fever and mediastinal lymphadenopathy.
Successful Skin Homografting From an Identical Twin in a Severely Burned Patient
(2014) Turk, Emin; Karagulle, Erdal; Turan, Hale; Oguz, Hakan; Abali, Ebru Sakallioglu; Ozcay, Necdet; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-4766-3373; https://orcid.org/0000-0002-8522-4956; https://orcid.org/0000-0002-1298-7944; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 23811789; AAJ-5609-2021; C-6247-2017; AAE-8704-2021; AAE-1041-2021; AAJ-8097-2021
Flame burns are a serious condition and usually have high morbidity and mortality because they affect large areas of the body surface as well as the lungs. In these patients, it is especially difficult to find healthy skin for grafting if they have more than 70% third-degree burns. Repeated autografting or synthetic wound care materials are the only treatment options to cover burned areas. Partial-thickness skin grafting from the patient's identical twin sibling may be an alternative treatment option, if possible. Here, we report a patient with severe flame injury treated with skin from his identical twin. The patient had third-degree burns covering 70% of his body surface. Initial treatment consisted of fluid and electrolyte replacement, daily wound care, and surgical debridements, as well as nutritional support. After initial treatment, we performed a successful skin grafting from his identical twin. Skin grafting between identical twins might be an alternate method for severely burned patients. (J Burn Care Res 2014;35:e177-e179)
Treatment of ventilator-associated pneumonia (VAP) caused by Acinetobacter: results of prospective and multicenter ID-IRI study
(2020) Erdem, Hakan; Cag, Yasemin; Gencer, Serap; Uysal, Serhat; Karakurt, Zuhal; Harman, Rezan; Aslan, Emel; Mutlu-Yilmaz, Esmeray; Karabay, Oguz; Uygun, Yesim; Ulug, Mehmet; Tosun, Selma; Dogru, Arzu; Sener, Alper; Dogan, Mustafa; Hasbun, Rodrigo; Durmus, Gul; Turan, Hale; Batirel, Ayse; Duygu, Fazilet; Inan, Asuman; Akkoyunlu, Yasemin; Celebi, Guven; Ersoz, Gulden; Guven, Tumer; Dagli, Ozgur; Guler, Selma; Meric-Koc, Meliha; Oncu, Serkan; Rello, Jordi; 31502120
Ventilator-associated pneumonia (VAP) due to Acinetobacter spp. is one of the most common infections in the intensive care unit. Hence, we performed this prospective-observational multicenter study, and described the course and outcome of the disease. This study was performed in 24 centers between January 06, 2014, and December 02, 2016. The patients were evaluated at time of pneumonia diagnosis, when culture results were available, and at 72 h, at the 7th day, and finally at the 28th day of follow-up. Patients with coexistent infections were excluded and only those with a first VAP episode were enrolled. Logistic regression analysis was performed. A total of 177 patients were included; empiric antimicrobial therapy was appropriate (when the patient received at least one antibiotic that the infecting strain was ultimately shown to be susceptible) in only 69 (39%) patients. During the 28-day period, antibiotics were modified for side effects in 27 (15.2%) patients and renal dose adjustment was made in 38 (21.5%). Ultimately, 89 (50.3%) patients died. Predictors of mortality were creatinine level (OR, 1.84 (95% CI 1.279-2.657); p = 0.001), fever (OR, 0.663 (95% CI 0.454-0.967); p = 0.033), malignancy (OR, 7.095 (95% CI 2.142-23.500); p = 0.001), congestive heart failure (OR, 2.341 (95% CI 1.046-5.239); p = 0.038), appropriate empiric antimicrobial treatment (OR, 0.445 (95% CI 0.216-0.914); p = 0.027), and surgery in the last month (OR, 0.137 (95% CI 0.037-0.499); p = 0.003). Appropriate empiric antimicrobial treatment in VAP due to Acinetobacter spp. was associated with survival while renal injury and comorbid conditions increased mortality. Hence, early diagnosis and appropriate antibiotic therapy remain crucial to improve outcomes.
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.