1
|
Kaya B, Mete B, Balal M, Seyrek N, Karayaylali I. Is aortic knob width a novel predictor of mortality in hemodialysis patients? Eur Rev Med Pharmacol Sci 2024; 28:2805-2816. [PMID: 38639520 DOI: 10.26355/eurrev_202404_35909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
OBJECTIVE: Identifying reliable predictors of mortality in end-stage renal disease patients is crucial for patient outcomes. Aortic knob width is a radiographic parameter used to assess cardiovascular diseases and atherosclerosis. This study investigated the association between aortic knob width and mortality in hemodialysis patients. PATIENTS AND METHODS: The study included data collected between 2007 and 2022 from 103 patients aged between 18 and 85 who had been undergoing hemodialysis treatment for at least one year. Patients were divided into two groups: survivors and deceased. The aortic knob width was measured using a posterior-anterior chest radiograph after midweek hemodialysis. The relationship between aortic knob width and mortality was investigated. RESULTS: Deceased patients had significantly larger aortic knob widths compared with survivors. The deceased group's hemodialysis (HD) duration was shorter, median age was older, Kt/V, hemoglobin, and albumin levels were lower, and the frequency of patients with hypertension, diabetes, and aortic wall calcification was higher. Aortic knob width greater than 37.98 mm was identified as a predictor of mortality in hemodialysis patients. Survival rates for aortic knob width <37.98 mm are 98.1% for 1 year and 64.9% for 15 years. For aortic knob width larger than 37.98 mm, survival rates are 88% for three years, 68% for five years, 45.2% for ten years, and 25% for fifteen years. The most important risk factors for increased aortic knob width were age, male sex, aortic calcification, and hypertension. CONCLUSIONS: Age, male gender, aortic calcification, and hypertension are the primary risk factors for increased aortic knob width in hemodialysis patients. Aortic knob width greater than 37.98 mm, which can be measured simply and rapidly using posterior-anterior chest radiography, may be a predictor of mortality. Graphical Abstract https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-10.jpg.
Collapse
Affiliation(s)
- B Kaya
- Department of Nephrology, Faculty of Medicine, Çukurova University, Adana, Turkey.
| | | | | | | | | |
Collapse
|
2
|
Bayram E, Selvi O, Köşeci T, Mete B, Yaslıkaya Ş, Paydaş S. Comparison of different cyclin-dependent kinase inhibitors and KI-67 levels on survival and toxicity in breast cancer treatment. Eur Rev Med Pharmacol Sci 2023; 27:5230-5239. [PMID: 37318497 DOI: 10.26355/eurrev_202306_32641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE As cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors, which play a crucial role in the cell cycle, palbociclib and ribociclib are two novel drugs that are recently being used in the treatment of breast cancer. Despite targeting the same pathway, these agents have different molecular activities and processes. KI-67 is known to play a significant role in cell proliferation that has been related to prognosis. This study investigated the impact of palbociclib, ribociclib, and KI-67 on toxicity and survival in breast cancer treatment. PATIENTS AND METHODS The study included 140 breast cancer patients in total. Patients were divided into groups based on the use of different CDK inhibitors and KI-67 values. Mortality, progression, treatment response rates, frequency, and severity of adverse events were assessed retrospectively. RESULTS The patients in our study had an average age of 53.62±12.71 years, and 62.9% of them were diagnosed at an early stage. 34.3% (n=48) of the patients progressed after receiving treatment, while 19.3% (n=27) of the patients died. The median follow-up time was 576 days, the maximum follow-up time was 1,471 days, and the median time to progression was 301 days (min=28-max=713). Mortality, progression, and treatment response rate between two different CDK inhibitors or KI-67 groups revealed no statistically significant differences. CONCLUSIONS Our data show a comparison between the effectiveness of palbociclib and ribociclib, and no noticeable difference is found in breast cancer patients' survival, progression, or severity of adverse effects. Likewise, there is no meaningful difference in KI-67 expression subgroups between progression and survival following treatment.
Collapse
Affiliation(s)
- E Bayram
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | | | | | | | | | | |
Collapse
|
3
|
Mete B, Utuk FA, Demirhindi H, Inaltekin A, Tanır F, Kara E, Nazlıcan E. Human papillomavirus vaccine administration among women in the Eastern Mediterranean region of Turkey: prevalence and barriers. Eur Rev Med Pharmacol Sci 2023; 27:3526-3533. [PMID: 37140303 DOI: 10.26355/eurrev_202304_32126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Human papillomavirus (HPV) vaccines are very effective in preventing HPV infection and related diseases. This study aimed to determine the prevalence of the HPV vaccine administration and barriers to vaccination among women aged 15-49 years. SUBJECTS AND METHODS This cross-sectional study was conducted on 401 women aged 15-49 years. The prevalence of women who received the HPV vaccine, their knowledge about HPV in general, HPV screening tests, HPV vaccine and the current HPV vaccination program were evaluated. Barriers to getting the HPV vaccine were questioned. RESULTS The mean age of women who had received the HPV vaccine was 30.87±8.89 and the mean age at the first sexual intercourse was 22 years. 3.2% of women received HPV vaccine. The most important factor impeding the vaccination was unawareness of the HPV vaccine and the high cost of the vaccine. If the vaccine was free, most (81.2%) of the participants stated that they would vaccinate themselves and their children (72.8%). The highest lack of information was observed about the vaccination program and vaccinated women were more informed about HPV, HPV screening tests, HPV vaccine and the vaccination program. The increase in the knowledge about the HPV vaccination program increased the probability of getting vaccinated by an odds ratio (OR) of 4.43 times. CONCLUSIONS The most important barriers to HPV vaccination were the lack of public funding for vaccines and the lack of information. We recommend increasing educational activities on the HPV vaccination program and public funding of vaccination.
Collapse
Affiliation(s)
- B Mete
- Department of Public Health, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | | | | | | | | | | | | |
Collapse
|
4
|
Baydar Toprak O, Akpolat T, Uzun O, Pınar Deniz P, Kokturk N, Varol A, Guzel E, Ercelik M, Gultekin O, Guner R, Turan S, Gökbulut Bektaş Ş, Coskun N, Bakan N, Nuri Yakar M, Eren Kutsoylu O, Ergan B, Argun Barış S, Başyiğit I, Boyacı H, Çetinkaya F, Çolak H, Aykac N, Baran Ketencioğlu B, Türe Yüce Z, Akkaya Isık S, Serap Yılmaz E, Karaoğlanoğlu S, Berik Safci S, Ozkan G, Kose N, Kizilirmak D, Havlucu Y, Nural S, Kerget F, Sunal Ö, Yuksel A, Bestepe Dursun Z, Deveci F, Kuluozturk M, Ataoglu O, Dursun M, Keskin S, Emin Sezgin M, Aktepe Sezgin EN, Eser F, Akyildiz L, Selim Almaz M, Kayaaslan B, Hasanoğlu I, Bayrak M, Gümüş A, Sağcan G, Cuhadaroglu C, Kucuk H, Onyilmaz T, Mete B, Kilinc O, Oya Itil B. COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission. Eur Rev Med Pharmacol Sci 2023; 27:2132-2142. [PMID: 36930513 DOI: 10.26355/eurrev_202303_31586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.
Collapse
Affiliation(s)
- O Baydar Toprak
- Department of Chest Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Kösek O, Mete B, Öcal I, Yar K, Demirhindi H, Tokuş M. Relationship between low-frequency electromagnetic field and computer vision syndrome. Eur Rev Med Pharmacol Sci 2023; 27:1801-1807. [PMID: 36930473 DOI: 10.26355/eurrev_202303_31541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE This study aimed to determine the prevalence of computer vision syndrome (CVS) among secretaries working in different departments of a university hospital in Turkey and its relationship with low-frequency electromagnetic field (LF-EMF) exposure. SUBJECTS AND METHODS This cross-sectional study included 143 secretaries working in different departments of the hospital. Besides eye examinations, CVS Syndrome Questionnaire (CVS-Q) Scale and Ocular Surface Disease Index Scale (OSDI) were applied to the participants. LF-EMF of the work environment were measured with a 6010 Gauss/Teslameter device and the light intensity with an LX-1102 Device. RESULTS The mean age of participants was 39.6 years, with a male-to-female ratio of 25.2% to 74.8%. CVS-Q scale revealed 83.9% of computer vision syndrome among participants. A weak positive correlation was found between CVS-Q and LF-EMF, while a moderately strong, negative correlation was found between LF-EMF and Schirmer test of both eyes. The work environment LF-EMF values were significantly higher among the participants diagnosed with CVS (p<0.05). The risk of CVS was found to increase 3.27 times when the ambient LF-EMF was >1,725 µT and an increase of 0.004 units in the CVS-Q score was calculated for each one-unit increase in the LF-EMF of the environment. CONCLUSIONS A relationship between CVS, dry eye and EMF was observed among people exposed to LF-EMF. Regular measurement of EMF in work environments, and developing protective behaviours (work-break intervals, 20-20-20 rule, etc.) can be recommended.
Collapse
Affiliation(s)
- O Kösek
- Department of Public Health, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | | | | | | | | | | |
Collapse
|
6
|
Mete B, Kurt AF, Urkmez S, Demirkiran O, Can G, Dumanli GY, Bozbay S, Arsu HY, Otlu B, Karaali R, Balkan II, Saltoglu N, Dikmen Y, Tabak F, Aygun G. The Bad Bug is Back: Acinetobacter Baumannii Bacteremia Outbreak during the COVID-19 Pandemic in an Intensive Care Unit. Niger J Clin Pract 2022; 25:702-709. [PMID: 35593616 DOI: 10.4103/njcp.njcp_2001_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Epidemiology of nosocomial infections may show variability because of under-estimation of infection control measures (ICMs) in coronavirus disease 19 (COVID-19) outbreak. Aim To investigate the Acinetobacter bacteremia outbreak developed in an intensive care unit (ICU) between March 20 to May 15, 2020, examine the risk factors, and re-evaluate ICM retrospectively. Material and Methods A retrospective cohort analysis was conducted to determine the risk factors, pulsed field gel electrophoresis (PFGE) was performed for analysis of the outbreak, ICM practices were observed by a team, and infection control interventions were undertaken. Results Acinetobacter bacteremia developed in 17 patients (21.5%) within 79 COVID-19 patients included in the study. The mean age of the bacteremic patients was 67.3 (SD = 14.82) years, and 82.4% of them were male; of these, 15 died, leading to 88.2% mortality. The bacteremia rate was higher compared with a 14-month period preceding the COVID-19 pandemic (17/79 versus 12/580 patients, respectively). PFGE revealed that the outbreak was polyclonal. On multi-variate analysis, the bacteremia development rate was 13.7 and 5.06 times higher with central venous catheter (CVC) use and in patients with chronic obstructive pulmonary disease (COPD), respectively. The mortality rate was higher in bacteremic patients (p = 0.0016). It was observed that ICMs were not followed completely, especially change of gloves and hand hygiene. Contamination of A. baumannii was observed in 38% of the gloves. Conclusion COPD and CVC use were determined as risk factors for Acinetobacter bacteremia development, and failures in ICM may have led to cross-contamination of endemic A. baumannii. The outbreak could be controlled within 3 weeks of interventions.
Collapse
Affiliation(s)
- B Mete
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasa caddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - A F Kurt
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasa caddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - S Urkmez
- Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasacaddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - O Demirkiran
- Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasacaddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - G Can
- Department of Public Health, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasa caddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - G Y Dumanli
- Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasacaddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - S Bozbay
- Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasacaddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - H Y Arsu
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasa caddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - B Otlu
- Department of Medical Microbiology, Inonu University Medical Faculty, Elazig yolu 15. Kilometre, 44280-Battalgazi, Malatya, Turkey
| | - R Karaali
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasa caddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - I I Balkan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasa caddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - N Saltoglu
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasa caddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - Y Dikmen
- Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasacaddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - F Tabak
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasa caddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| | - G Aygun
- Department of Medical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Kocamustafapasa caddesi No: 53, Cerrahpasa, 34098-Fatih, Istanbul, Turkey
| |
Collapse
|
7
|
Erturk US, Mete B, Ozaras R, Saltoglu N, Balkan II, Mert A, Kacmaz B, Saglam O, Guney B, Sayman OA, Tabak F. Plasma and Breast Milk Pharmacokinetics of Tenofovir Disoproxil Fumarate in Nursing Mother with Chronic Hepatitis B-Infant Pairs. Antimicrob Agents Chemother 2021; 65:e0111021. [PMID: 34310204 PMCID: PMC8448110 DOI: 10.1128/aac.01110-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/13/2021] [Indexed: 11/20/2022] Open
Abstract
Tenofovir use is associated with lower risk of mother-to-infant transmission of the virus, and discontinuation of the treatment is not safe. However, the safety of the drug during pregnancy and breastfeeding is not clear. In this study, we aimed to determine the tenofovir concentration in plasma of mother-infant pairs along with breast milk in chronic hepatitis B patients during the lactation period. A total of 11 mother-infant pairs were enrolled in the study. All the mothers received tenofovir disoproxil fumarate (TDF) 245 mg/day for at least 1 month because of chronic hepatitis B infection. Maternal blood, breast milk, and infant blood samples were obtained concomitantly. Tenofovir concentrations were determined by liquid chromatography-tandem mass spectrometry. The median concentrations of tenofovir in maternal plasma and breast milk samples were 88.44 (interquartile range [IQR], 62.47 to 116.17) ng/ml and 6.69 (IQR, 4.88 to 7.03) ng/ml, respectively. Tenofovir concentrations were undetectable (<4 ng/ml) in all of the infant plasma samples. The ratio of tenofovir concentration in breast milk to that in maternal plasma was 0.07. Tenofovir disoproxil fumarate passes through the breast milk in a small amount. Infants had no detectable tenofovir level in their plasma. Our study suggests that tenofovir disoproxil fumarate treatment is safe during the breastfeeding period in chronic hepatitis B patients.
Collapse
Affiliation(s)
- U. S. Erturk
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - B. Mete
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - R. Ozaras
- Medilife Health Group, Department of Infectious Diseases, Istanbul, Turkey
| | - N. Saltoglu
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - I. I. Balkan
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - A. Mert
- Istanbul Medipol University, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - B. Kacmaz
- American Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - O. Saglam
- Novagenix Bioanalytical Drug R&D Center, Ankara, Turkey
| | - B. Guney
- Novagenix Bioanalytical Drug R&D Center, Ankara, Turkey
| | - O. A. Sayman
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Department of Public Health, Istanbul, Turkey
| | - F. Tabak
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| |
Collapse
|
8
|
Mete B, Deger MS, Zoroglu G, Pehlivan E. Examining the relationship between inflammation markers and anthropometric values in primary care. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In recent studies, adipose tissue appears to be associated with inflammation. In this study, it was aimed to determine the relationship between inflammation markers and anthropometric measurement values and blood lipid values for purpose in primary health units.
Methods
The universe of this study has comprised healthy adults admitted to a community health units' diet clinic in a city of eastern Turkey in the city in 2019. Blood analyzes were done in the family medicine laboratory, those with high leukocyte values were excluded and 274 adults were included in the study. The relationship between blood lipid values, complete blood count, inflammation markers, neutrophil lymphocyte ratio (NLO), platelet lymphocyte ratio (PLO) and lymphocyte monocyte ratio (LMO) and anthropometric measurements of adults were investigated. Spearman correlation test, Kruskal Wallis test, Multiple Linear Regression test were used in the analysis of the data.
Results
The average age of 274 people participating in the study is 34.07 ± 9.92. According to BMI, no significant difference was found between NLO, PLO and MLO ratios. Significantly weak negative correlation between PLO and skeletal muscle, basal metabolic rate, body fluid amount and lean mass; a negative correlation between HDL and BMI, amount of body fat and amount of internal lubrication were found (p < 0,003). The increase in the amount of skeletal muscle causes a decrease in the level of total cholesterol, while the increase in the amount of internal lubrication causes an increase in the level of total cholesterol. A positive weak correlation was found between NLO and LDL(p < 0,001), a very weak positive correlation between NLO and total cholesterol and a very weak positive correlation between LMO and LDL(p < 0,014).
Conclusions
It was observed that there was a very weak correlation between anthropometric values and cholesterol levels and inflammation markers, and moderate levels of blood lipid values in healthy individuals.
Key messages
In primary care, measuring the body composition of healthy people at least once a year appears to be a valuable practice. Exercises that increase skeletal muscle and reduce the amount of internal fat should be recommended to patients with high cholesterol or healthy people at risk.
Collapse
Affiliation(s)
- B Mete
- Public Health Department, Cukurova University, Balcalı, Adana, Turkey
| | - MS Deger
- Community Health Center, Health Directorate, Bingol, Turkey
| | - G Zoroglu
- Community Health Center, Health Directorate, Bingol, Turkey
| | - E Pehlivan
- Public health department, Inonu University, Battalgazi, Malatya, Turkey
| |
Collapse
|
9
|
Buzgan B, Mete B, Pehlivan E. Evaluation of chronic disease follow-up training of family physicians in primary care units. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chronic diseases are a major cause of morbidity and mortality due to late diagnosis and insufficient treatment. This study deals with the training on chronic diseases organized by the Ministry of Health in the provinces. The aim of this study was to measure the effectiveness of training programs for family physicians in a province.
Methods
This semi experimental study was carried out during the training held in Bingöl that is eastern city of Turkey, on 22-26 October 2018 and 19-20 December 2018. The universe of the study consisted of family physicians working in the province. Of the 90 family physicians working in the province, 75 participated in the study. The training was conducted by the researchers and (before-after) 16-question test to the participants were used. The trainings cover the sub-heading Cardiovascular Risk Assessment and Diagnosis and Treatment of Hypertension. The family physicians were divided into 7 groups and were given 7-hour training. SPSS 25 program was used to analyze the data. In the analysis of data, Wilcoxon test, Cochran’s Q test and Bayesian approach samples t test were used.
Results
The average number of correct before training was 7.33 (min: 2 - max: 13), after training 12.64 (min: 7- max: 16; p < 0.001). After the training, participants’ correct answers to 15 questions increased (p < 0.001). Increase rate is 71%. Bayesian factor was found to be < 0.001 according to the results of Bayesian approach t test. There is definite evidence against the H0 hypothesis. According to the results of this quasi-experimental study, training is very effective.
Conclusions
In this study, it was shown that the education of the family physicians about the chronic diseases of the Ministry of Health is effective in increasing the knowledge level of family physicians.
Key messages
The training of the family physicians in charge of the primary health care is important. This study showed that education is very effective accorging to the pre-training.
Collapse
Affiliation(s)
- B Buzgan
- Provincial Health Directorate, Mother and Child Department, Bingöl, Turkey
| | - B Mete
- Provincial Health Directorate, Public Health Department, Bingöl, Turkey
| | - E Pehlivan
- Inonu University, School of Medicine, Battalgazi, Malatya, Turkey
| |
Collapse
|
10
|
Mete B, Pehlivan E, Söyiler V. Smoking and substance abuse prevalence in adolescents in a city of Turkey. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The aim of this study was to determine the prevalence of smoking and abuse of substance among young people aged 14-18 in a city of Turkey and to determine the relationship between smoking and substance abuse risk.
Methods
This cross-sectional study was conducted on high school students studying in Bingöl city center. The universe of the study consists of 14000 students studying in 14 high schools. The minimum sample size required to be reached in the sample size analysis with reference to 80% power and 99% confidence interval was found to be 1235. According to the stratified sampling method, the students were randomly reached in schools and questionnaires were conducted under supervision by taking their consent. Chi-square test, Binary Logistic Regression test were used for data analysis.
Results
The mean age of the students was 15.71 ± 1.16 (min-max: 14-18) and 49.5% were male. The prevalence of smoking among all students is 15.8%, addictive substance use / trial frequency 5% except smoking. The prevalence of smoking among male students is 24.1%, in female students 7.7%. The rate of using addictive substance was found to be 8.2% for male students and 1.9% for female students except smoking. According to the results of Logistic Regression; substance abuse increases 8 (95% CI:3,32-19,95) fold in smokers (p = 0,001) and 2.5 (95% CI:1,10-5,38) fold in men (p = 0,027). The risk of substance use increases 1.05 (95% CI:1,02-1,08) fold as the number of cigarettes smoked daily (p = 0,001). Substance abuse risk of 18-year-olds shows increase 1.5 (95% CI:1,06-1,93) fold according to 14 years old (p = 0,021).
Conclusions
Smoking and addictive substance use in adolescents are particularly remarkable in male students (8.2%). This result is higher than the data reflecting Ä°stanbul (7%). This may be due to the fact that the province is located at the crossing point of drug traffic. Smoking increases the risk of other addictive substances (marijuana, heroin, etc.).
Key messages
Smoking and substance abuse is an important health problem in adolescents according to this study. Male students smoke are at risk of substance abuse more than female.
Collapse
Affiliation(s)
- B Mete
- Provincial Health Directorate, Department of Public Health, Bingöl, Turkey
| | - E Pehlivan
- Inonu University, School of Medicine, Battalgazi, Malatya, Turkey
| | - V Söyiler
- Provincial Health Directorate, Department of Public Health, Bingöl, Turkey
| |
Collapse
|
11
|
Pehlivan E, Mete B, Söyiler V. Distribution of Cancer cases and survival analysis results: A retrospective cohort study. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cancer was the second leading cause of death in Turkey. The aim of this study is to examine the changes in the incidence of cancer cases and survival analysis in a region.
Methods
This retrospective cohort study was carried out on data of 977 people had been diagnosed with cancer between the years 2013-2015 in Bingol province located in the east of Turkey. All cancer cases are included in the study. The data of the patients were obtained from the Ministry of Health Cancer Registry System and International Disease Classification Oncology (ICD-O) codes published by World Health Organization were used. Patients were evaluated topographically (tissue originating from the lesion) in 41 categories. Kruskal Wallis, Mann Whitney U test, Chi-square test and Cox regression analysis were used to analyze the data.
Results
The mean age of the patients was 58.73 ± 16.80 (min: 1-max: 107). It was observed that 28.7% of the patients died during the follow-up period and 71.3% of the patients were alive. 30% of the cancer cases digestive system, 11% respiratory system, 23% female breast- genitalia, 15% blood-lymph-thyroid, 11.8% muscle-bone, 15,4% other cancer species. In men, lung, stomach, colon, prostate; breast, thyroid and skin cancers are more common in women respectively. The incidence rate for all age groups was 97 per hundred thousand in 2013, 161 per hundred thousand in 2015. The increase trend did not differ by gender. The mean follow-up period of the patients who died was 388 days and 1541 days for the living patients. The risk of death is increased significantly in patients who cannot be operated (RR = 2.779, HR = 3.048). In patients not receiving chemotherapy, the risk of death is reduced significantly (RR = 0.656, HR = 0.340).
Conclusions
The incidence of cancer increases in the study area. Survival times vary according to treatment efficacy. Broad-based cohort studies evaluating the effects of treatment types on survival may be recommended.
Key messages
Cancer in the study area shows a significant increase from year to year. The average 5-year survival period of cancer patients was found is 71% as a good result.
Collapse
Affiliation(s)
- E Pehlivan
- Inonu University, School of Medicine, Battalgazi/Malatya, Turkey
| | - B Mete
- Provincial Health Directorate, Public Health Department, Bingöl, Turkey
| | - V Söyiler
- Provincial Health Directorate, Public Health Department, Bingöl, Turkey
| |
Collapse
|
12
|
Pehlivan E, Mete B, Firinci B, Ekinci Z. Relation to orthorexia prevalance and health literacy of college students in the east of Turkey. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E Pehlivan
- Public Health Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| | - B Mete
- Public Health Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| | - B Firinci
- Public Health Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| | - Zafer Ekinci
- Inonu University Medical School, Battalgazi/Malatya, Turkey
| |
Collapse
|
13
|
Mete B, Pehlivan E, Gulbas G, Gunen H. Stages of COPD, pulmonary function test, anthropometric measurements and relationship with nutrition. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Mete
- Public Health Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| | - E Pehlivan
- Public Health Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| | - G Gulbas
- Chest Diseases Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| | - H Gunen
- Sureyya Pasa Research and Training Hospital, Health Science University, Istanbul, Turkey
| |
Collapse
|
14
|
Pehlivan E, Mete B, Firinci B, Ozer A. Depression of 50 and over years old individuals and related factors in a city of eastern Turkey. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Pehlivan
- Public Health Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| | - B Mete
- Public Health Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| | - B Firinci
- Public Health Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| | - A Ozer
- Public Health Department, Inonu University Medical School, Battalgazi/Malatya, Turkey
| |
Collapse
|
15
|
Ozaras R, Kepil N, Mete B, Demirel A, Tabak F. Jaundice and fever in a patient with psoriasis. Neth J Med 2018; 76:381. [PMID: 30362950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- R Ozaras
- Infection Department, Medilife Hospital, Istanbul, Turkey
| | | | | | | | | |
Collapse
|
16
|
Idilman R, Baykam N, Kaymakoğlu S, Tabak F, Bahçecioğlu HI, Bektaş A, Bulut C, Günşar F, İnan D, Karaosmanoğlu HK, Karasu Z, Kuşçu F, Mete B, Özbakır Ö, Özdoğan OC, Parlak M, Sırmatel F, Topalak Ö, Ünsal B, Guidelines Study Group VH. Turkey 2017 Clinical Practice Guidelines on recommendations for screening diagnosing and managing hepatitis C virus. Turk J Gastroenterol 2018; 28:90-93. [PMID: 29303105 DOI: 10.5152/tjg.2017.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present guideline updates the Turkish recommendations for the screening, diagnosis and management of Hepatitis
C virus (HCV) infection prepared by the Turkish Association for the Study of the Liver (TASL) and Viral Hepatitis
Society (VHS). The aim of this guidance was to provide updates recommendations to physicians, who are interested
in HCV care on the optimal screening, diagnosis and pre-treatment management for patients with HCV infection
in Turkey. These recommendations, produced by panel experts, were aimed to addresses the management issues
ranging from diagnosis and linkage to care, to the optimal treatment regimen in patients with HCV infection. Recommendations
are based on evidence and opinions of more than 70% of the panelists. This guidance is supported by
the memberships of two societies and not by pharmaceutical companies. This guidance will be updated frequently
as new data become available.
Collapse
Affiliation(s)
- Ramazan Idilman
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nurcan Baykam
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Sabahattin Kaymakoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fehmi Tabak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Halil I Bahçecioğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ahmet Bektaş
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Cemal Bulut
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fulya Günşar
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Dilara İnan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Hayat K Karaosmanoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Zeki Karasu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ferit Kuşçu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Birgül Mete
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Özbakır
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Osman C Özdoğan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Mehmet Parlak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fatma Sırmatel
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Topalak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Belkis Ünsal
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | | |
Collapse
|
17
|
Pehlivan E, Mete B, Caliskan D, Nacar E. Risky workplace environment assessment of intern doctors at school and their exposure to mobbing. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E Pehlivan
- Inonu University, Medical Faculty, Department of Public Health, Malatya, Turkey
| | - B Mete
- Inonu University, Medical Faculty, Department of Public Health, Malatya, Turkey
| | - Deniz Caliskan
- Inonu University, Medical Faculty, Department of Public Health, Malatya, Turkey
| | - Erkay Nacar
- Inonu University, Medical Faculty, Department of Public Health, Malatya, Turkey
| |
Collapse
|
18
|
Mete B, Pehlivan E, Caliskan D, Tekin C, Cakmak EE. The frequency of domestic violence and the relevant Influential factors in adult women in Malatya. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Mete
- Inonu University, Medical Faculty, Departmen of Public Health, Malatya, Turkey
| | - E Pehlivan
- Inonu University, Medical Faculty, Departmen of Public Health, Malatya, Turkey
| | - D Caliskan
- Inonu University, Medical Faculty, Departmen of Public Health, Malatya, Turkey
| | - C Tekin
- Inonu University, Medical Faculty, Departmen of Public Health, Malatya, Turkey
| | - EE Cakmak
- Inonu University, Medical Faculty, Departmen of Public Health, Malatya, Turkey
| |
Collapse
|
19
|
Pehlivan E, Tekin C, Mete B, Nacar E. Job stress status and the influencing factors of staff working at a medical center in Malatya Turkey. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
20
|
Affiliation(s)
- R Ozaras
- Infectious Diseases Department, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - B Vatankulu
- Nuclear Medicine Department, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - B Mete
- Infectious Diseases Department, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - B Kacmaz
- Infectious Diseases Department, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - M Halac
- Nuclear Medicine Department, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
| |
Collapse
|
21
|
Sayan M, Kumbasar Karaosmanoğlu H, Mete B, Gündüz A, Aydın O, Yemişen M, Uzun N, Tabak F. [Molecular Epidemiological Analysis of HIV-1 pol Gene Sequences Isolated in Istanbul, Turkey]. MIKROBIYOL BUL 2016; 47:87-97. [PMID: 23390906 DOI: 10.5578/mb.4099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human immunodeficiency virus (HIV) characterized by a high genetic variability includes two genotypes namely HIV-1 and HIV-2. A major proportion of the infections worldwide is caused by HIV-1 which includes four groups (M, N, O and P). Group M being responsible for the HIV pandemic is further divided into nine genetically distinct subtypes (A, B, C, D, F, G, H, J, and K). Additionally, more than 49 circulating recombinant forms (CRFs) have been recognized up to now. The aim of this study was to determine the subtype characterization and prevalence of HIV strains isolated from patients inhabiting in Istanbul, Turkey. The study was carried out between June 2009 and June 2012 and a total of 72 patients [58 male, 14 female; age range: 20-57 (median: 37) years; CD4+ T cell count range: 3-813 (median: 243)/mm3; HIV-RNA load range: 1.5+E3-1.0+E7 (median: 5.8+E5) IU/ml] were included in the study. Fortysix of the patients (64%) have acquired the infection via heterosexual and 23 (32%) via homosexual contact. Of the patients 57 were newly diagnosed and antiretroviral (ARV) therapy-naïve patients, while 15 were under different ARV therapies. For HIV-1 subtyping the most widely known algorithm (HIVdb-Stanford University Genotypic Resistance Interpretation Algoritm) was used. The population-based sequencing of the reverse transcripta ise region (pol) of HIV-1 indicated that CRFs (36/72; 50%) were the most commonly identified strains, followed by subtype B (31/72; 43%) among Turkish patients. Sub-subtypes A1 (3/72; 4.2%) and F1 (2/72; 2.8%) were also detected as low prevalent. The recombinant forms of HIV-1 circulated in Istanbul, Turkey were found as follows, respectively; CRF02_AG [%25 (18/72), West Africa, Central Africa and Middle East/North Africa origin], CRF12_BF [%12.5 (9/72), South America origin], CRF03_AB [%9.7 (7/72), Eastern Europe and Central Asia origin] and CRF01_AE [%2.8 (2/72), South-East Asia, East Asia and Central Africa origin]. Since molecular epidemiologic studies are important tools for tracking the transmission and spread patterns, and for the control of the HIV infections, HIV molecular studies should be expanded in HIV-1 infected Turkish patients. Furthermore, the determined subtypes and CRFs of HIV-1 in Turkey may be expected to contribute to global HIV surveillance systems.
Collapse
Affiliation(s)
- Murat Sayan
- Kocaeli University Medical Faculty Hospital, Central Laboratory, PCR Unit, Kocaeli, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Taner Z, Bahar Tokman H, Velidedeoglu M, Göksoy E, Çelik V, Demirci M, Dal F, Küçük Y, Mete B, Yemişen M, Vehid S, Kocazeybek B, Günaydın M, Kiraz N. Aerobic bacteria in infected breast of Turkish woman: Prevalence and antimicrobial resistance evaluated in cases with lactational mastitis, periductal mastititis and granulomatous mastitis. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
23
|
Yuksel P, Caliskan R, Kuskucu M, Islak Mutcali S, Kosan E, Kırkoyun Uysal H, Habip Z, Abdelkerem A, Mete B, Saribas S, Bonabi E, Birinci I, Dinc O, Midilli K, Kocazeybek B. Current problems in serologically based diagnostic algorithm of HIV 1/2: The re-evaluation of immunodot blot assays in HIV 1/2 verification in Turkey. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
24
|
Batirel A, Erdem H, Sengoz G, Pehlivanoglu F, Ramosaco E, Gülsün S, Tekin R, Mete B, Balkan II, Sevgi DY, Giannitsioti E, Fragou A, Kaya S, Cetin B, Oktenoglu T, Celik AD, Karaca B, Horasan ES, Ulug M, Senbayrak S, Kaya S, Arslanalp E, Hasbun R, Ates-Guler S, Willke A, Senol S, Inan D, Güclü E, Ertem GT, Koc MM, Tasbakan M, Ocal G, Kocagoz S, Kusoglu H, Güven T, Baran AI, Dede B, Karadag FY, Yilmaz H, Aslan G, Al-Gallad DA, Cesur S, El-Sokkary R, Sirmatel F, Savasci U, Karaahmetoglu G, Vahaboglu H. The course of spinal tuberculosis (Pott disease): results of the multinational, multicentre Backbone-2 study. Clin Microbiol Infect 2015; 21:1008.e9-1008.e18. [PMID: 26232534 DOI: 10.1016/j.cmi.2015.07.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 01/09/2023]
Abstract
We aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae.
Collapse
Affiliation(s)
- A Batirel
- Dr Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - H Erdem
- Gulhane Medical Academy, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
| | - G Sengoz
- Haseki Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - F Pehlivanoglu
- Haseki Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - E Ramosaco
- Infectious Diseases Hospital, University Hospital Center "Mother Teresa", Tirana, Albania
| | - S Gülsün
- Diyarbakir Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Diyarbakir, Turkey
| | - R Tekin
- Dicle University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Diyarbakir, Turkey
| | - B Mete
- Istanbul University Cerrahpasa School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - I I Balkan
- Istanbul University Cerrahpasa School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - D Y Sevgi
- Sisli Etfal Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - E Giannitsioti
- Department of Internal Medicine, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - A Fragou
- Department of Internal Medicine, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - S Kaya
- Karadeniz Technical University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Turkey
| | - B Cetin
- Koc University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - T Oktenoglu
- Koc University School of Medicine, Department of Neurosurgery, Istanbul, Turkey
| | - A D Celik
- Trakya University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Edirne, Turkey
| | - B Karaca
- Izmir Bozyaka Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - E S Horasan
- Mersin University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mersin, Turkey
| | - M Ulug
- Private Umit Hospital, Department of Infectious Diseases and Clinical Microbiology, Eskisehir, Turkey
| | - S Senbayrak
- Haydarpasa Numune Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - S Kaya
- Diyarbakir Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Diyarbakir, Turkey
| | - E Arslanalp
- Kocaeli University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Kocaeli, Turkey
| | - R Hasbun
- The University of Texas Health Science Center at Houston, Medical School, Department of Infectious Diseases, Turkey
| | - S Ates-Guler
- Sutcu Imam University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Kahramanmaras, Turkey
| | - A Willke
- Kocaeli University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Kocaeli, Turkey
| | - S Senol
- Celal Bayar University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Manisa, Turkey
| | - D Inan
- Akdeniz University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - E Güclü
- Sakarya University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sakarya, Turkey
| | - G T Ertem
- Ankara Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - M M Koc
- Kocaeli University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Kocaeli, Turkey
| | - M Tasbakan
- Ege University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - G Ocal
- Dr Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - S Kocagoz
- Acibadem University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - H Kusoglu
- Acibadem University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - T Güven
- Ankara Atatürk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - A I Baran
- Yuzuncuyil University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Van, Turkey
| | - B Dede
- Umraniye Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - F Y Karadag
- Medeniyet University, Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - H Yilmaz
- Ondokuz Mayis University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
| | - G Aslan
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | | | - S Cesur
- Ankara Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - R El-Sokkary
- Medical Microbiology and Immunology, Infection Control Unit, Zagazig University, Zagazig, Egypt
| | - F Sirmatel
- Izzet Baysal University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bolu, Turkey
| | - U Savasci
- Gulhane Medical Academy, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - G Karaahmetoglu
- GATA Haydarpasa Training Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - H Vahaboglu
- Medeniyet University, Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| |
Collapse
|
25
|
Saltoglu N, Karali R, Yemisen M, Ozaras R, Balkan II, Mete B, Tabak F, Mert A, Hondur N, Ozturk R. Comparison of community-onset healthcare-associated and hospital-acquired urinary infections caused by extended-spectrum beta-lactamase-producing Escherichia coli and antimicrobial activities. Int J Clin Pract 2015; 69:766-70. [PMID: 25683907 DOI: 10.1111/ijcp.12608] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We aimed to compare community-onset healthcare-associated (CO-HCA) and hospital-acquired (HA) urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in terms of epidemiology, clinical outcomes and antimicrobial activities. METHODS Patients from both groups with ESBL-producing E. coli detected by urine culture between January 2009 and January 2011 were included in this retrospective study. Relevant demographical, microbiologic and clinical data were obtained from case records. RESULTS A total of 173 patients (mean age of 58 years, 74% female) were included, of whom 75 (43.4%) had a CO-HCA UTI and 98 (56.6%) had an HA UTI. Eighty (46.2%) patients had more than one comorbid disease, of whom 57 (32.5%) had urological problems. The most common clinical manifestations were pyelonephritis (43.9%) and urosepsis (16.2%). An age of > 65 years (p = 0.005) in addition to urinary catheterisation (p = 0.001), urosepsis (p = 0.001) and mortality (p = 0.001) were significantly more common in the HA UTI group. Acute cystitis (p = 0.027), complicated cystitis (p = 0.001) and non-urologic neoplasm (p = 0.032) were significantly more common in the CO-HCA UTI group. No isolate was resistant to carbapenems or fosfomycin. Sensitivities to nitrofurantoin, amikacin, trimethoprim sulfamethoxazole-trimoxazole and quinolones were 97.6%, 89%, 29.4% and 17.9% respectively. Both groups showed similar rates of antibiotic resistance. CONCLUSION ESBL-producing E. coli should be taken into consideration in patients with a CO HCA UTI, not only in hospital settings but also in outpatient settings. We suggest ertapenem as a first-line empirical treatment for patients with an upper UTI and fosfomycin and nitrofurantoin for those with a lower UTI when ESBL-producing E. coli is suspected.
Collapse
Affiliation(s)
- N Saltoglu
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - R Karali
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - M Yemisen
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - R Ozaras
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - I I Balkan
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - B Mete
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - F Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - A Mert
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - N Hondur
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - R Ozturk
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| |
Collapse
|
26
|
Mete B, Aybar Bilir Y, Aygun G, Yilmaz M, Urkmez S, Dilmen Y, Ozturk R. Klebsiella oxytoca outbreak in an intensive care unit: a probable link to common insulin vial use. Anaesth Intensive Care 2013; 41:266-268. [PMID: 23530799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
27
|
Erdem H, Kilic S, Sener B, Acikel C, Alp E, Karahocagil M, Yetkin F, Inan A, Kecik-Bosnak V, Gul H, Tekin-Koruk S, Ceran N, Demirdal T, Yilmaz G, Ulu-Kilic A, Ceylan B, Dogan-Celik A, Nayman-Alpat S, Tekin R, Yalci A, Turban V, Karaoglan I, Yilmaz H, Mete B, Batirel A, Ulcay A, Dayan S, Seza Inal A, Ahmed S, Tufan Z, Karakas A, Teker B, Namiduru M, Savasci U, Pappas G. Diagnosis of chronic brucellar meningitis and meningoencephalitis: the results of the Istanbul-2 study. Clin Microbiol Infect 2013; 19:E80-6. [DOI: 10.1111/1469-0691.12092] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Revised: 10/15/2012] [Accepted: 10/31/2012] [Indexed: 11/29/2022]
|
28
|
Ozgur N, Seyahi N, Sili U, Oruc M, Mete B, Ataman R, Pekmezci S. Candidal psoas abscess following persistent pyuria in a renal transplant recipient. Int Urol Nephrol 2012; 46:269-73. [PMID: 23136029 DOI: 10.1007/s11255-012-0316-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 10/04/2012] [Indexed: 11/26/2022]
Abstract
Candidal infections occur commonly in renal transplant recipients especially in genitourinary system. Although the epidemiology of candiduria has not been well characterized in renal transplant population, it is the most common cause of fungal infections. However, candidal psoas abscess is very rare in the literature. We report a 42-year-old male renal transplant recipient with prolonged pyuria and candiduria followed by candidal psoas abscess formation. The treatment consisted of prolonged antifungal therapy along with percutaneous drainage. However, eventually, a surgical drainage had to be performed for the successful eradication.
Collapse
Affiliation(s)
- Nurgul Ozgur
- Division of Nephrology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | | | | | | | | | | | | |
Collapse
|
29
|
Nazik H, Öngen B, Mete B, Aydin S, Yemişen M, Keleşoğlu FM, Ergul Y, Tabak F. Coexistence of blaOXA48 and aac(6′)-Ib-cr Genes in Klebsiella Pneumoniae Isolates from Istanbul, Turkey. J Int Med Res 2011; 39:1932-40. [DOI: 10.1177/147323001103900538] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study evaluated the presence of carbapenem hydrolysing β-lactamase genes and plasmid-mediated quinolone resistance (PMQR) determinants in 22 Klebsiella pneumoniae isolates collected from the Istanbul Medical Faculty, Turkey, which reduced the susceptibility or resistance to carbapenem. The VITEK® 2 system and E-tests were used to determine the minimum inhibitory concentrations needed to inhibit bacterial growth. Genes were screened by polymerase chain reaction, and gene transferability was evaluated by transconjugation. Strain clonality was investigated by pulsed-field gel electrophoresis (PFGE). All strains were OXA-48 β-lactamase producers and three (13.6%) were also positive for the aac(6′)-Ib-cr gene. Most of the strains harboured other b-lactamase (bla) genes such as blaTEM, blaSHV, blaCTX-M and blaVEB-1. The transconjugants mostly harboured blaOXA-48 and other β-lactamases separately. PFGE revealed eight pulsotypes among the isolates. The coexistence of blaOXA-48 and PMQR in K. pneumoniae isolates may present a significant threat to health, especially in the nosocomial setting.
Collapse
Affiliation(s)
- H Nazik
- Department of Microbiology and Clinical Microbiology, Istanbul University, Istanbul, Turkey
| | - B Öngen
- Department of Microbiology and Clinical Microbiology, Istanbul University, Istanbul, Turkey
| | - B Mete
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - S Aydin
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - M Yemişen
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - FM Keleşoğlu
- Department of Paediatrics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Y Ergul
- Department of Paediatrics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - F Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey
| |
Collapse
|
30
|
Abstract
Ophthalmomyiasis externa is mainly caused by the sheep botfly Oestrus ovis; therefore, it is usually seen in rural areas. We report here a case of ophthalmomyiasis externa in a young man from Istanbul. The patient had no known history of exposure to farm animals or rural areas.
Collapse
Affiliation(s)
- Ferhat Arslan
- Cerrahapaşa Medical Faculty, Department of Infectious Diseases, Istanbul University, Cerrahapaşa, Istanbul 34098, Turkey.
| | | | | | | |
Collapse
|
31
|
Ozaras R, Polat E, Aygun G, Yemisen M, Mete B, Goksugur N, Tabak F. A family with skin lesions. Neth J Med 2010; 68:41-44. [PMID: 20103823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- R Ozaras
- Department of Infectious Diseases, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
| | | | | | | | | | | | | |
Collapse
|
32
|
Yemisen M, Demirel A, Mete B, Kaygusuz A, Mert A, Tabak F, Ozturk R. Comparative in vitro antimicrobial activity of tigecycline against clinical isolates of vancomycin-resistant enterococcus. Indian J Med Microbiol 2009; 27:373-4. [PMID: 19736414 DOI: 10.4103/0255-0857.55455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
Tabak F, Murtezaoglu A, Ozaras R, Mete B, Tabak O, Mert A, Ozturk R. P1138 Rash and fever in adults: the aetiology and clinical features. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70978-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Aygün G, Demirkiran O, Utku T, Mete B, Urkmez S, Yilmaz M, Yaşar H, Dikmen Y, Oztürk R. Environmental contamination during a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit. J Hosp Infect 2002; 52:259-62. [PMID: 12473469 DOI: 10.1053/jhin.2002.1300] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
During a three-month period in 1999, 25 strains of carbapenem resistant Acinetobacter baumannii were isolated from 12 of 170 hospitalized intensive care unit (ICU) patients, of which 16 were considered to be clinically significant. These strains were indistinguishable by biotyping and antibiograms, but genotyping was not performed. Appropriate antibiotic treatment, isolation precautions, and infection control education of the staff failed to halt the outbreak. Environmental contamination was therefore investigated, and A. baumannii was found out in 22 (39.3%) of 56 environmental samples obtained by swabbing. Different antibiotic sensitivity patterns were obtained in the majority of these isolates, but four (7.1%) of the strains were found to have the same sensitivity pattern as the strain causing the outbreak. As a result the ICU was closed, equipment and the environment cleaned, with hypochlorite and terminal disinfection carried out. No bacteria were grown on repeat environmental cultures. Environmental contamination has an important reservoir role in outbreaks of A. baumannii in ICUs and must be eradicated in order to overcome such outbreaks.
Collapse
Affiliation(s)
- G Aygün
- Department of Microbiology and Clinical Microbiology, Cerrahpaşa Medical Faculty, University of Istanbul 34303, Aksaray, Istanbul, Turkey.
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Abstract
Incubation of rat striatal slices in the absence of oxygen (anoxia), glucose (aglycemia), or oxygen plus glucose (ischemia) caused significant increases in dopamine (DA) release. Whereas anoxia decreased extracellular 3,4-dihydroxyphenylacetic acid levels by 50%, aglycemia doubled it, and ischemia returned this aglycemia-induced enhancement to its control level. Although nomifensine, a DA uptake blocker, completely protected the slices against anoxia-induced DA depletion, aglycemia- and ischemia-induced increases were not altered. Moreover, hypothermia differentially affected DA release stimulated by anoxia, aglycemia, and ischemia. Involvement of glutamate in DA release induced by each experimental condition was tested by using MK-801 and also by comparing the glutamate-induced DA release with that during anoxia, aglycemia, or ischemia. MK-801 decreased the anoxia-induced DA depletion in a dose-dependent manner. This treatment, however, showed a partial protection in aglycemic conditions but failed to improve ischemia-induced DA depletion. Like anoxia, DA release induced by exogenous glutamate was also sensitive to nomifensine and hypothermia. These results indicate that anoxia enhances DA release by a mechanism involving both the reversed DA transporter and endogenous glutamate. Partial or complete lack of effect of nomifensine, hypothermia, or MK-801 in the absence of glucose or oxygen plus glucose also suggests that experimental conditions, such as the degree of anoxia/ischemia, may alter the mechanism(s) involved in DA depletion.
Collapse
Affiliation(s)
- R L Büyükuysal
- Department of Pharmacology and Clinical Pharmacology, Uludağ University Medical School, Bursa, Turkey
| | | |
Collapse
|