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Acute-Phase Vitamin B12 and Folic Acid Levels in Patients with Ischemic and Hemorrhagic Stroke: İs There a Relationship with Prognosis?
(Maney Publishing, 2010) Bayır, Ayşegül; Ak, Ahmet; Özdinç, Şerife; Seydanoglu, Abdüsselam; Köstekçi, Şenol Kadir; Kara, Fatih
Objective: The aim of this study was to investigate blood folic acid and vitamin B12 levels in patients with ischemic and hemorrhagic stroke patients and correlate these levels with prognosis. Methods: Patients presenting within 3 hours of onset of ischemic or hemorrhagic strokes were approached for participation in the study. Diagnosis was made by clinical examination and head computed tomography scan. Venous blood samples were taken for determination of blood folic acid and vitamin B12 levels. Parameters were evaluated with respect to stroke type and according to Glasgow coma scale (<= 8 or >= 9). Results: Eighty-seven patients with ischemic stroke (mean age: 65 +/- 10 years, 53% male) and 27 patients with hemorrhagic stroke (mean age: 60 +/- 10 years, 56% male) were included in the study. A significant direct correlation was found between Glasgow coma scale and mean plasma B12 levels in ischemic, but not hemorrhagic, stroke (r=112.75 and p=0.007, respectively). A significant direct correlation was found between Glasgow coma scale and mean plasma folic acid levels in hemorrhagic, but not ischemic, stroke (r=1.03 and p=0.017, respectively). In patients with Glasgow coma scale <= 8 (either hemorrhagic or ischemic stroke), a significant direct correlation was found between Glasgow coma scale and blood vitamin B12 levels. Vitamin B12 levels were significantly lower in patients with Glasgow coma scale (8 than in patients with Glasgow coma score >= 9 (p=0.04). Conclusions: In patients with ischemic stroke, low vitamin B12 levels, and in patients with hemorrhagic stroke, low blood folic acid levels, are associated with lower Glasgow coma scale values and higher hospital mortality.
Are sleep and life quality of family caregivers affected as much as those of hemodialysis patients?
(ELSEVIER SCIENCE INC, 2012) Celik, Gulperi; Annagur, Bilge Burcak; Yilmaz, Mumtaz; Demir, Tarik; Kara, Fatih
Objective: The purpose of this study was to determine and compare the quality of sleep, quality of life, and anxiety and depression symptoms reported by hemodialysis (HD) patients and family caregivers of HD patients. Methods: The study included 142 pairs of HD patients and their caregivers. To assess quality of sleep, quality of life, and anxiety and depressive symptoms, the 36-item Short Form, Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale, respectively, were used. Results: For the patients, 73.9% were poor sleepers. Low Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were found in 89.1% and 76.3% of HD patients, respectively. For the caregivers, 88% were poor sleepers. Low PCS and MCS scores were found in 62% and 70.4% of the caregivers, respectively. Mean PSQI scores, subjective sleep quality scores, sleep latency, sleep efficiency, sleep disturbance, use of sleep medications, and daytime dysfunction scores of the caregivers were significantly higher than the scores of the HD patients (P<.001). Conclusions: Caregivers of dialysis patients experience adverse effects on their quality of sleep and quality of life. Educational, social, and psychological support interventions should be considered to improve their ability to cope. (C) 2012 Elsevier Inc. All rights reserved.
Assessment of effects of pre- and post-training programme for healthcare professionals about breastfeeding
(I C D D R B-CENTRE HEALTH POPULATION RESEARCH, 2007) Kutlu, Ruhusen; Kara, Fatih; Durduran, Yasemin; Marakoglu, Kamile; Civi, Selma
This retrospective study assessed the effects of pre- and post-training programme for healthcare professionals about breastfeeding. The study included 3,114 mothers who had children aged 1-72 month(s). Their knowledge and behaviours relating to breastfeeding were evaluated. The mothers were randomly divided into two groups: the 'before' group included 2,000 women who were not informed about breastfeeding, and the 'after' group comprised 1,114 women who had been informed about breastfeeding. 56.2% and 66.1% of the mothers started breastfeeding within 30 minutes after delivery, respectively, in the before and the after group (chi(2)=29.31, p<0.001). 16.7% and 36.5% gave exclusive breastfeeding for six months (chi(2) =72.85, p<0.001), and 28.5% and 23.7% stopped breastfeeding within the first five months (chi(2)=17.20, p=0.002). Ninety-four percent delivered in a hospital or in a primary healthcare centre. Therefore, prenatal and postnatal breastfeeding education and support courses may improve a woman's chance of starting and continuing to breastfeed her baby. In terms of the number of antenatal check-ups, since the differences between the two groups were significant (chi(2)=390.67, p=0.000), the importance of the training programme about breastfeeding was highlighted. Follow-up interventions after training are suggested.
Association of vesicoureteral reflux and renal scarring in urinary tract infections
(SOC ARGENTINA PEDIATRIA, 2018) Yilmaz, Isa; Peru, Harun; Yilmaz, Fatma H.; Sekmenli, Tamer; Ciftci, Ilhan; Kara, Fatih
Introduction. The aim was to investigate the relationship between vesicoureteral reflux (VUR) and renal damage in non-febrile, febrile for the first time and recurrent urinary tract infection (UTI) patients. The secondary aim was to determine whether C-reactive protein (CRP) in febrile UTIs could be a predictor of renal scarring. Population and methods. This prospective study included non-febrile, febrile for the first time and recurrent pediatric UTI cases. The routine lab analyses comprised a complete blood count, urea, creatinine, fully automated urinalysis, urine culture and CRP analyses. All the participants were examined using urine ultrasonography subsequent to their UTI diagnosis, voiding cystourethrography (VCUG) after six weeks and Tc-99m dimercaptosuccinic acid (DMSA) static renal scintigraphy after six months. Results. There were included 47 children with non-febrile UTIs, 48 with fist febrile UTIs and 61 with recurrent UTIs. A statistically significant difference was found among the groups in terms of VUR and renal scarring (p = 0.001 and p = 0.011, respectively). A statistically significant difference was also found in terms of renal scarring between patients with and without VUR (p = 0.001). Moreover, a statistically significant difference was also present in relation to renal scarring (p<0.05)in patients with five-fold lower or higher CRP values than the accepted cut-off value (5mg/dl). Conclusion. The ratio of renal scars detected was found to be parallel to the VUR frequency. The higher the VUR grade, the more renal damage was found. A positive correlation between elevated CRP and renal scarring was determined, indicating the presence of scarring during the diagnosis of pyelonephritis.
Babaların bebek bakımı konusundaki özgüvenleri ve etkileyen faktörler
(2017) Kara, Fatih; Uçan, Sabriye; Güzel, Aysun
Amaç: Bu çalışmanın amacı, ilk kez bebek sahibi olan babaların bebek bakımı konusundaki özgüvenlerini ve etkileyen faktörleri belirlemektir.Yöntem: Bu kesitsel araştırma bir ilçede yaşayan 120 baba ile Mart-Mayıs 2015 tarihinde gerçekleştirilmiştir. Araştırmanın verileri, Pharis Özgüven Ölçeği ve babaların sosyodemografik özelliklerini içeren sorulardan oluşan anket formuyla toplanmıştır. Veriler SPSS 16.0 programında yüzdelik, tek yönlü varyans analizi, post-hoc testleri (Tukey HSD ve Games Howell çoklu karşılaştırma testi) ve bağımsız örneklem t-testi kullanılarak analiz edilmiş; p0,05 olan değerler anlamlı kabul edilmiştir.Bulgular: Babaların Pharis Özgüven Ölçeği ortalaması 37,039,4'dür. 31-36 yaşındaki babaların özgüven puan ortalamalarının, 19-24 yaş arasındaki babalara göre istatistiksel olarak anlamlı derecede yüksek olduğu saptanmıştır (p0,01). Bebek bakımı bilgisine sahip olan babaların özgüven puan ortalamalarının bebek bakımı bilgisine sahip olmayan babalara göre istatistiksel olarak anlamlı derecede yüksek olduğu saptanmıştır (p0,01).Sonuç: Babaların özgüvenleri düşük bulunmuştur. Yaş ve bebek bakımı konusunda edinilen bilgi babaların özgüvenlerini açısından önemlidir.
Brusellozdan Korunmada Toplumun Bilgi Düzeyi
(2000) Bodur, Said; Küçükçalık, Adnan; Altındiş, Mustafa; Kara, Fatih
Ülkemizde son on yılda morbidite hızı 10 kat artan brusellozun bulaşma yolları ve brusellozdan korunma ile ilgili olarak toplumun bilgi düzeyinin belirlenmesi amaçlandı. Araştırma evreni, bruselloz yönünden riskli bölgelerden olan Konya ilinde yaşayan halk olarak seçildi. Çalışmaya alınacak haneler, yerleşim birimleri (mahalle ve köy) bazında nüfusa ağırlıklı küme örnekleme yöntemi ile belirlendi. Her kümede 7 hane ve her haneden bir kişi olmak üzere 143 kümede 1000 kişiye ulaşıldı. Bilgiler yüz yüze görüşerek elde edildi. Bulaşma ya da korunma ile ilgili en az bir doğru yanıt verenlerin konuya duyarlı olduğu ve konuyu bildiği kabul edildi. Görüşülen 1000 kişinin (368 erkek, 632 kadın) % 43.6'sı bulaşma yollarından en az birini doğru olarak bilmekteydi. % 14.0'ü konu hakkında bilgisi olduğunu ifade ettiği halde, verdiği yanıt yanlıştı. % 32.4'ünde ise konu ile ilgili sorulara yanıt alınamadı. Konu hakkında bilgi sahibi olma ile öğrenim düzeyi arasında ilişki saptandı. Bruselloz yönünden risk altında bulunan toplumumuz, bu hastalıktan korunmayı yeterince bilmemekte, ya da yanlış bilmektedir. Toplumun bu konuda yeterli ve doğru bilgilendirilmesi, bruselloz morbiditesini azaltmanın en önemli adımı olabilir.
Comparison of apparent diffusion coefficient values among different MRI platforms: a multicenter phantom study
(AVES, 2013) Kivrak, Ali Sami; Paksoy, Yahya; Erol, Cengiz; Koplay, Mustafa; Ozbek, Seda; Kara, Fatih
PURPOSE We aimed to compare apparent diffusion coefficient (ADC) values among magnetic resonance imaging (MRI) scanners from different vendors. MATERIALS AND METHODS We used a custom-made phantom solution consisting of distilled water, 0.9% NaCl, 25% NaCl, and shampoo for diffusion-weighted MRI (DW-MRI) examinations. DW-MRI was performed with similar sequence parameters using six different 1.5 Tesla MR scanners (scanners A F). ADC maps were automatically constructed for all DW-MR images (b factors of 0 and 1000 s/mm(2)). ADC measurements were performed using regions of interest and seven different software programs, including four different postprocessing workstations, two different picture archiving and communication systems, and operator console software for each MR scanner. RESULTS The ADC values generated by scanners A and F were higher and those of scanner B were lower than those generated by the other scanners (P = 0.002). The intravendor difference in the ADC values averaged from scanners D, E, and F was statistically significant (P < 0.001). The difference between the ADC values obtained by scanners C and E was not statistically different (P = 0.15). CONCLUSION ADC values may differ among different MRI systems used for DW-MRI. Thus, the MRI vendor should be considered when using DW-MRI in a clinical setting.
Comparison of Effects of Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis on Health-Related Quality of Life, Sleep Quality, and Depression
(Wiley-Blackwell, 2010) Güney, İbrahim; Solak, Yalçın; Atalay, Hüseyin; Yazıcı, Raziye; Altıntepe, Lütfullah; Kara, Fatih; Yeksan, Mehdi; Türk, Süleyman
Few studies investigating the effects of automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) on health-related quality of life (HRQoL), depression, and sleep quality exist in the literature. We aimed to determine differences between APD and CAPD modalities with respect to these parameters. Twenty APD and 48 CAPD patients were included in this crosssectional study. Biochemical values were measured at outpatient evaluation. A modified postsleep inventory was used to evaluate sleep quality. Health-related quality of life and depression were evaluated by the Short Form of Medical Outcomes Study and Beck Depression Inventory, respectively. Automated peritoneal dialysis and CAPD patients were compared in terms of sleep quality, HRQoL, and depression. Our results showed that there were no significant differences between APD and CAPD in any of the studied parameters. Moderate or severe sleep problems were found in 60% and 69% of the APD and CAPD patients, respectively. Mean HRQoL scores for any of the 8 Short Form of Medical Outcomes Study-36 domains were similar in the 2 groups. The mean physical component score was 51.1 +/- 21.2 and 48.9 +/- 18.2 in APD and CAPD patients, respectively (P=0.672). The mean mental component score was 47.5 +/- 20.1 in APD patients, whereas it was 42.4 +/- 19.5 in CAPD patients (P=0.291). Depression was detected in 70% of APD and 62.5% of the CAPD patients. The mean Beck Depression Inventory scores were also similar in the 2 groups. This study showed that HRQoL, sleep quality, and depression were similar in APD and CAPD patients.
Determining the prevalence of depression among older adults living in Burdur, Turkey, and their associated factors
(WILEY, 2019) Guzel, Aysun; Kara, Fatih
Background This study aimed to determine the prevalence of depression among older adults living in Burdur, Turkey, and their associated factors. Methods This analytical cross-sectional study was conducted between May 1, 2015 and August 20, 2015 comprising 35 339 subjects aged >= 65 years living in Burdur; the sample was 770 subjects identified using a population-weighted cluster sampling method. Data were collected by using personal information forms, Geriatric Depression Scale, and the Older People's Quality of Life Scale of the World Health Organization. The statistical analysis was performed by using t-test for independent samples, one-way analysis of variance and post hoc multiple comparison tests, Pearson correlation, and regression analysis. P < 0.05 was considered as significant. Results Of the study population, 51.8% had a score of >= 14 (definite depression). According to the regression model, the prevalence of depression was higher in older adults aged >= 85 years than in older adults aged 65-74 years (P < 0.01), in females than in males (P < 0.01), in individuals who never consumed alcohol than in those who consumed alcohol (P = 0.04), and in older adults who perceived their health as poor than in those who were unsure about their health and perceived their health as good (P < 0.01). Correlation analysis showed a poor, negative, and significant correlation (r = -0.38; P < 0.01) between the total scores of Older People's Quality of Life Scale of the World Health Organization and Geriatric Depression Scale. Conclusions The prevalence of depression is high among older adults aged >= 65 years. Age, gender, alcohol consumption, health perception, and quality of life are important predictors of depression.
Early surgical abortion: Safe and effective
(INFORMA HEALTHCARE, 2013) Kara, Fatih; Dogan, Nasuh Utku; Bati, Serap; Demir, Senay; Durduran, Yasemin; Celik, Cetin
Objectives To evaluate patients' characteristics and complications of surgical abortion performed at an early gestation, compared to later gestations. Methods A total of 4310 women with unintended pregnancies attending the family planning unit of a government maternity hospital in Konya, Turkey, were included retrospectively. Abortions were carried out from 6 weeks' up to 10 weeks gestation. Results The gestational age in 62% of the cases was between 6 weeks and 6 weeks + 6 days. Only 8.5% of the 4310 women had used a modern contraceptive method, and 16% had had a surgical abortion for an unplanned pregnancy previously. These women were younger, had more siblings, and a shorter time had elapsed since their last pregnancy when compared to women who never had an abortion. There were four failures (0.09%). The rate of retained products of conception (RPCs) was 1.9% in women aborted between six and six(+6) weeks' gestation, and 6.2% (p < 0.001) in those aborted later. Women who had had a surgical abortion previously more often had RPCs than those who never had (16% vs. 1%, respectively, p < 0.001). Of the 151 women with RPCs, 65 (43%) had been using an intrauterine device prior to surgical abortion. Conclusion Early surgical abortion (at six-six(+6) weeks' gestation) generates few complications. Delaying surgical abortion until a somewhat later gestation causes complication rates (particularly RPCs) to increase.
The effects of antioxidants on blood Gas Parameters in the acute organic phosphorus toxicity of rabbits
(ELSEVIER IRELAND LTD, 2008) Bayir, Aysegul; Kara, Hasan; Yildiz, Mesut; Ak, Ahmet; Kara, Fatih
[Abstract not Available]
Epidemiologic evaluation of patients with major burns and recommendations for burn prevention
(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2012) Çiftçi, İlhan; Arslan, Kemal; Altunbaş, Zeynep; Kara, Fatih; Yılmaz, Hüseyin
BACKGROUND Burns are an important health problem in our country and in the world. In our study, we aimed to epidemiologically analyze the patients who were hospitalized in a burn unit that serves 3 million individuals in Central Anatolia. METHODS Records of 457 patients who had been hospitalized in the burn unit during the period 2008-2010 were analyzed retrospectively. Patients were assessed in terms of gender, age, burn area, burn depth, admission time to the health center, burn region, and factors causing burns. RESULTS Most (44.6%) of the patients were in the 0-5 age group. Burn surface area was detected as 11.6 +/- 8.5%. Patients had reached the health center in 252.8 +/- 892.5 minutes. While 82.7% of the patients had second degree burns, 17.3% had third degree burns. Most burns were on the extremities (39.6%). The most common burn agent was scalds with hot liquids (54.1%). CONCLUSION In our study, children in the 0-5 age group were found to be the most commonly affected group with respect to indoor burns. The basic contributing factor is that children spend more time in the house and are more active. Scalding burns may be prevented when greater care is taken when using hot liquids that may lead to indoor burns. Informing parents on this issue is of first priority.
The evaluation of carotid intima-media thickness in children with familial Mediterranean fever
(SPRINGER LONDON LTD, 2008) Peru, Harun; Altun, Bülent; Doğan, Mustafa; Kara, Fatih; Elmacı, Ahmet Midhat; Oran, Bülent
The aim is to investigate whether pediatric familial Mediterranean fever (FMF) patients have an increased risk of premature atherosclerosis and to determine the possible strength of association between atherosclerosis and Mediterranean fever (MEFV) gene mutation gene type. Demographic characteristics and MEFV mutations were defined in 49 children diagnosed with FMF (26 female, 23 male; mean age, 10.71 +/- 3.69 years). Twenty-six age-, sex-, and body-mass-index-matched healthy children constituted the control group. We evaluated the blood counts and acute-phase proteins during attack-free periods. Mean C-reactive protein (CRP), serum amyloid-A (SAA), homocysteine (Hcy), lipoprotein-a (Lp-a), and common carotid artery intima-media thickness (CCA-IMT) were 10.75 +/- 15.29 vs 4.03 +/- 1.20, 23.22 +/- 1.94 vs 3.53 +/- 1.04, 10.36 +/- 3.36 vs 8.64 +/- 3.15, 20.84 +/- 23.89 vs 8.56 +/- 7.48, and 0.038 +/- 0.007 vs 0.032 +/- 0.004, respectively, and significantly higher than the mean values of control group (p < 0.05). However, no correlation was found between CCA-IMT and CRP, SAA, Hcy, and Lp-a. Twenty-nine patients had M694V mutation, and 13 patients had other mutations. There was no correlation between CCA-IMT and MEFV mutation subgroups. In conclusion, because of the nature of the disease, FMF patients should be considered to have an increased risk of early vascular alteration and atherosclerosis. For this reason, CCA-IMT measurement can be recommended as a noninvasive and early diagnostic method.
Evaluation of FDG Uptake in Pulmonary Hila with FDG PET/CT and Contrast-Enhanced CT in Patients with Thoracic and Non-Thoracic Tumors
(Springer, 2010) Kara Gedik, Gonca; Özcan Kara, Pelin; Kara, Taylan; Sarı, Oktay; Kara, Fatih
Objective Fluorine-18 fluorodeoxyglucose (FDG) uptake is frequently observed in lung hilus. This finding causes difficulties during the interpretation. Our objective was to evaluate the features of FDG uptake in lung hilus associated with benign or malignant etiology in patients with thoracic and non-thoracic tumors. Methods We retrospectively evaluated the files of 1172 patients who had undergone FDG positron emission tomography (PET)/computed tomography (CT) examination between January 2008 and June 2009. Forty-eight patients (21 males, 27 females, age range 12-80 years, mean 60.9 +/- 15.82 years) with either unilateral or bilateral hilar FDG uptake and who had thorax contrast-enhanced computed tomography (CECT) performed within 1 month of the FDG PET/CT scan were enrolled in the study. Characteristics of FDG uptake were classified according to the pathology and CECT or PET/CT follow-up over 12 months. Results The characteristics of 71 hilar regions with FDG uptake could be classified. In 30 of 71 (42.3%) hilar regions, FDG uptake was considered to be physiological because no lymph node was observed on CECT. In 19 of 71 (26.8%), FDG uptake was secondary to benign lymph nodes and in 22 (30.9%) to malignant lymph nodes. Significant differences were observed between benign and malignant lymph nodes for SUVhilus and SUVhilus/SUVliver ratio. Using 4.49 as the cut-off value for SUVhilus, a sensitivity of 85.7% and a specificity of 86.4% were achieved (area under curve, AUC: 0.956). For SUVhilus/SUVliver ratio, sensitivity and specificity to detect malignant lymph nodes were 77.6 and 77.3% (AUC: 0.885), respectively, at a cut-off value of 1.75. Conclusion SUVhilus and SUVhilus/SUVliver ratio were found to be significant parameters for determining malignancy in lung hilus. Combined interpretation with CECT is warranted during the evaluation of lung hilus with FDG PET/CT.
The Evaluation of Primary School Readiness Levels of the Children Aged 66-72 Months with the Denver II Test
(KOWSAR CORP, 2018) Yorulmaz, Alaaddin; Sert, Sadiye; Yilmaz, Fatma Hilal; Kara, Fatih; Cinarlidere, Serife
Background: Primary school can lead to compatibility problems in children without an early childhood education because they experience separation from their families for the first time. Objectives: In order to detect developmental delays that may arise at the school and to plan the necessary support, it was aimed to determine primary school readiness levels of the children aged 66 -72 months. Methods: This study included 91 children aged 66 - 72 months who were admitted to the Pediatric Outpatient Clinic of Beyhekim State Hospital between June 2016 and August 2016. The Denver Developmental Screening Test II which consists of 134 items was performed. The Test items are divided into four main sections and surveys whether the chilren are ready for the first grade of primary school. The test results were interpreted as normal, suspect and abnormal. Results: 36 (39.6%) of 91 patients were female and 55 (60.4%) were male. There was no statistically significant difference between the test results in terms of gender. When examining the distribution of children according to months, there was no statistically significant difference. Data for the child's age, the mother's age, the father's age, duration of breastfeeding, the age (month) at which the child started talking, walking or completed toilet training was expressed as mean +/- standard deviation. When these values were examined and also the mean values containing normal and abnormal results were compared, there was a statistically significant difference only between the months when the children started talking. When examining the results of the Denver II test, it was found that 64 (70.3%) children had abnormal development and 27 (29.7%) normal development. Conclusion: In the study evaluating primary school readiness levels of the children aged 66 -72 months, the substantial proportion of the children who were admitted to the hospital, had a developmental delay. In light of this study, all pre-school children should be evaluated before admission to primary school.
Findings of multidimensional instruments for determining psychopathology in diabetic and non-diabetic hemodialysis patients
(E-CENTURY PUBLISHING CORP, 2012) Celik, Gulperi; Annagur, Bilge Burcak; Yilmaz, Mumtaz; Kara, Fatih
Objective: The aim of this study was to expand the research on psychiatric complications of end-stage renal disease (ESRD), as well as to examine the prevalence of a broad range of psychopathology in diabetic and nondiabetic hemodialysis (HD) patients. Methods: One hundred nineteen HD patients were invited to enter the cross-sectional study. To assess quality of life, quality of sleep, mental status and depression and anxiety symptoms, the 36-item Short Form, Pittsburgh Sleep Quality Index (PSQI), Mini-Mental State Examination and Hospital Anxiety and Depression Scale, respectively, were used. Results: The mean age of all patients was 56.9 +/- 16.1 years; 54 (45.4%) were female. In the diabetic patients group, 84.8% of the patients had low MCS scores, and 89.2% patients had low PCS scores; 73.9% were poor sleepers; 63.0% had cognitive decline; 62.0% patients were depressive symptoms; and 28.3% had symptoms of anxiety. When comparing the diabetic and non-diabetic patients, the diabetic patients had lower role-emotional, sleep duration, and sleep efficiency scores. Conclusions: Incorporating a standard assessment and, eventually, treatment of psychopathologic symptoms into the care provided to diabetic and hemodialysis patients might improve quality of life and sleep, depressive symptoms and, reduce mortality risk.
Henoch Schonlein purpura in childhood: clinical analysis of 254 cases over a 3-year period
(SPRINGER LONDON LTD, 2008) Peru, Harun; Soylemezoglu, Oguz; Bakkaloglu, Sevcan Azime; Elmas, Sefika; Bozkaya, Davut; Elmaci, Ahmet Midhat; Kara, Fatih
We aimed to evaluate the patients who were diagnosed as Henoch Schonlein purpura (HSP) for disease characteristics and prognosis of those with joint, gastrointestinal (GI), and renal involvement. Two hundred and fifty-four children who were followed up with the diagnosis of HSP in the Pediatric Nephrology Clinics of Meram Medical Faculty of Selcuk University and Medical Faculty of Gazi University between January 2003 and June 2006 were retrospectively evaluated. The clinical follow-up and treatment regimens of patients in whom renal biopsy was performed were evaluated in detail. The study group consisted of 254 children, 147 boys (57.8%) and 107 girls (42.2%), and the ratio of boys to girls was 1.37. The percentages of skin, joint, GI, and renal manifestations were 100%, 66%, 56%, and 30%, respectively. Eight patients had intussusception. Five of them recovered with steroid treatment only while three patients were operated on. Sixty-four patients (44%) with GI involvement had severe disease and were successfully treated with steroids. Renal biopsy was performed in 26 patients. Among those 26 patients, two of them recovered spontaneously within 3 and 4 weeks. Ten patients improved with only steroid treatment while 12 patients recovered with steroid and cyclophosphamide treatment. Two patients were resistant to steroid and cyclophosphamide treatment and were treated with cyclosporine A. We believe that steroid therapy given to the HSP patients with GI manifestations might be helpful to prevent probable complications such as GI bleeding and intussusception. In addition, combined therapy with steroid and cyclophosphamide can usually be an appropriate treatment for patients with nephrotic proteinuria.
Inferior Vena Cava Diameter as a Marker of Early Hemorrhagic Shock: A Comparative Study
(Turkish Assoc Trauma Emergency Surgery, 2010) Akıllı, Belgin; Bayır, Ayşegül; Kara, Fatih; Ak, Ahmet; Cander, Başar
BACKGROUND We determined the value of the inferior vena cava (IVC) diameter for predicting acute blood loss in control and blunt trauma patients and compared this with other parameters of hemorrhagic shock. METHODS Fifty volunteers and 28 consecutive hemorrhagic shock patients were recruited prospectively to participate in the study. Vital signs, blood lactate, and serum bicarbonate were measured, and shock index and base excess were calculated. Anteroposterior (AP) and mediolateral (ML) IVC diameters during inspiration and expiration were measured in the right subcostal region. IVC diameters in hemorrhagic shock patients were compared with those of controls and were also compared with other hemorrhagic shock parameters. RESULTS A significant relationship was determined between mean IVC AP and ML diameters during expiration and inspiration on admission in the study group and in the control group (p=0.000, p=0.000, p=0.000, p=0.000). Serum lactate levels correlated significantly with all IVC diameters (r=55), especially the IVC ML diameter during expiration. CONCLUSION IVC diameter, as measured by transabdominal ultrasound, was more accurate than the shock index and other commonly used non-invasive predictors of acute blood loss (blood pressure, heart rate per minute, serum lactate level, base deficit).
Investigation of antibiotic resistance and virulence factors of enterococcus faecium and enterococcus faecalis strains Isolated from clinical samples
(Ankara Mıcrobıology Soc, 2020) Gök, Şerife Merve; Türk Dağı, Hatice; Kara, Fatih; Arslan, Uğur; Fındık, Duygu
Enterococci, which are commonly found in the environment, cause serious infections despite the absence of well-defined virulence factors and toxins. Knowing the virulence properties of enterococci is important to understand the complex pathogenic structures. In this study, we aimed to investigate the virulence factors (asa1, hyl, cylA, efa, ebp, ace, esp, gelE, sprE, fsrA, fsrB, fsrC genes, gelatinase activity, hemolysin, hydrogen peroxide and biofilm production) and antibiotic resistance of Enterococcus faedum and Enterococcus faecalis strains isolated from clinical specimens. A total of 110 enterococcus isolates which were accepted as infectious agents were included in the study. The polymerase chain reaction method was used to identify the isolates and to detect virulence genes. Characteristics of hemolysis, biofilm formation, hydrogen peroxide production and gelatinase activity were investigated by phenotypic methods. The antibiotic susceptibility test was performed with VITEK 2 automated system. E.faecalis ATCC 29212 standard strain was used as a quality control in all tests. Of the 110 enterococci isolates included in the study, 61 were identified as E.faecium and 49 as Efaecalis. The efa gene was the most frequently detected virulence gene (92.7%), followed by ace (83.6%), esp (66.4%), ebp (60.0%), cylA (50.9%), hyl (46.4%), asal (45.5%), gelE, sprE, fsrC (33.6%), fsrA (12.7%) and fsrB (11.8%). All genes except hyl were higher in E.faecalis isolates and the difference was statistically significant (p< 0.05). Twenty-five (51%) Efaecalis and 1 (1.6%) E.faecium isolates had beta-hemolysis and the difference was statistically significant (p= 0.000). Seven (11.5%) E.faecium and 4 (8.2%) Efaecalis isolates formed biofilm, but the difference was not statistically significant (p> 0.05). Two (3.3%) E.faecium and 14 (28.6%) E.faecalis isolates exhibited gelatinase activity and the difference between the two species was statistically significant (p= 0.000). Hydrogen peroxide production was not detected in any of the isolates. The highest resistance rate was determined against ciprofloxacin (70.9%). The resistance to ampicillin was 69.1%, high level streptomycin 65.1%, high level gentamicin 39.4%, vancomycin and teicoplanin 4.5%, and linezolid 1.8%. In conclusion, our data indicated that virulence factors except hyl gene and biofilm production were higher in E.faecalis isolates but E.faecium isolates were more resistant to antibiotics. In order to prevent infection of such virulent or resistant isolates in the hospital setting, infection control measures must be followed. In vivo studies are needed for the better understanding of the virulence of enterococci.
Is Maternal Depressive Symptomatology Effective on Success of Exclusive Breastfeeding During Postpartum 6 Weeks?
(MARY ANN LIEBERT, INC, 2013) Annagur, Ali; Annagur, Bilge Burcak; Sahin, Akkiz; Ors, Rahmi; Kara, Fatih
Aim: The aim of this prospective study was to examine the relationship between success of exclusive breastfeeding and postpartum depressive symptomatology. Our hypothesis was that mothers with depressive symptoms initially fail exclusive breastfeeding. Subjects and Methods: One hundred ninety-seven mothers were enrolled in the study. The participants were interviewed twice. The first visit was within the first 48 hours after birth. The Edinburgh Postnatal Depression Scale (EPDS) was completed by the participants. The second interview was performed at 6 weeks. Participants answered questions regarding methods of breastfeeding for 6 weeks, any methodological problems, and nipple pain. The EPDS was again completed by the participants at 6 weeks. All newborns were term infants. Results: All the participants were divided into two groups: exclusive breastfeeding and mixed-feeding (partial breastfeeding and/or bottle feeding). Both groups were compared in terms of features, such as mode of delivery, parity, prevalence of depressive symptomatology (at 48 hours and 6 weeks), and delayed onset of lactation within the first 48 hours. Statistical significance was found for only three variables: delayed onset of lactation within the first 48 hours, gestational age, and the problems related to breastfeeding methods. Conclusions: Clinicians should pay special attention to any lactation difficulty during the first week postpartum. Early lactation difficulties are associated with greater risk of early termination of breastfeeding and lower breastfeeding success.

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