Dilek Kilic

The Effect of Hyperbaric Oxygen Treatment on the Renal Functions in Septic Rats: Relation to Oxidative Damage

PurposeTo investigate the effects of hyperbaric oxygen (HBO) treatment on renal functions and damage in septic rats.MethodsThe animals were divided into four groups, each containing ten animals: control, hyperbaric oxygen, sepsis, and sepsis/hyperbaric oxygen. One milliliter of saline containing live Escherichia coli cells (2.1 × 109) was injected intraperitoneally to induce sepsis. The groups treated with HBO were given five sessions of 2 atmospheres absolute of 100% oxygen at intervals of 6 h. Blood, urine, and tissue samples were then collected, and the functional renal parameters, malondialdehyde (MDA) levels, and superoxide dismutase (SOD) and catalase activities were examined.ResultsThe reduced glomerular filtration rate and urine flow returned to normal levels after HBO treatment; however, the increase in fractionated sodium excretion continued. The increased MDA levels in the renal cortex and medulla also decreased to the level of the control group. In the sepsis group, both the SOD and catalase activities decreased in the renal cortex, while a reduction was observed only in the catalase activity in the medulla. The reduced enzyme activities significantly increased in the sepsis/hyperbaric oxygen group.ConclusionHBO treatment has a beneficial effect on renal dysfunction in sepsis. The probable reason for this effect is the reduction in oxidative damage because of the increase in antioxidative capacity.

A case of brucellar septic arthritis of the knee with a prolonged clinical course.

Brucellosis is a systemic infectious disease with a broad spectrum of clinical manifestations. Arthritis is frequently observed in its course and may be one of the main presenting clinical features of the disease. We report a case of brucellar monoarthritis of the knee with a prolonged clinical course despite efficient antibiotic treatment.

Effect of 23 Valent Pneumococcal Polysaccharide and Haemophilus influenza Conjugated Vaccines on the Clinical Course of Otitis Media With Effusion

Objective To determine if there is any clinical effect of 23‐valent pneumococcal and Haemophilus influenza type B conjugate vaccine on prognosis of otitis media with effusion.

Seroprevalence of tetanus immunity among noninsulin-dependent diabetes mellitus patients

Tetanus is a preventable disease that continues to affect people in both developing and developed countries. The aim of the present study was to evaluate the immunity profile to tetanus in patients with Type II diabetes mellitus (DM) and to compare them with healthy controls. The tetanus antitoxin levels in 310 diabetic patients (104 males and 206 females) and in 200 healthy controls (72 males and 128 females) were measured by ELISA (Virotech, Germany). The mean antitoxin concentration in patient and control groups were 0.8238+/-1.61 and 0.9978+/-1.49 IU/ml, respectively. There was a statistically significant difference between the two groups (z=-3.520, P=.0001 and odds ratio was 2.367). There was a definitive inverse correlation between the duration of diabetes and tetanus antibody titers (Spearmans correlation analysis, r=-.155, P=.006). A gender-dependent difference in the susceptibility to tetanus was present in the diabetic group with antibody titers being significantly higher in males compared with females (z=-2.267, P=.023). For both of control (chi(2)=20.207, P=.003) and patient (chi(2)=43.532, P=.0001) groups, there was a significant inverse correlation between the tetanus immunity levels and age. Statistically, a significant drop in antibody titers of both groups was found as the period past from the last immunization increased (Pearson correlation analysis: for patient group r=-.364, P=.0001; for control group r=-.143, P=.044). The tetanus antitoxin levels were significantly increased in individuals who had primary immunization during childhood (for patient group chi(2)=17.191, P=.0001; for control group chi(2)=9.911, P=.007). A significant reduction in the level of antitoxin immunity to tetanus in association with an increased susceptibility to infections in patients with diabetes may implicate the need for improving vaccination rates in this patient group.

C-reactive protein in early detection of bacteriemia and bacteriuria after extracorporeal shock wave lithotripsy.

OBJECTIVES To evaluate the value of plasma C-reactive protein (CRP) levels in early detection of bacteriuria and bacteriemia after extracorporeal shock wave lithotripsy (ESWL) of calcium and infection stones. METHODS A total of 75 patients who had infection stones (n = 27) and calcium stones (n = 48) were included in the study. All patients had sterile urine before ESWL. The mean age was 41.6 +/- 4.85 and male/female ratio was 2.12. Blood cultures were obtained within 1 hour post-ESWL period. Urine cultures were obtained 3 times just after and on the first and seventh day of ESWL. RESULTS Post-ESWL evaluations showed 3 positive blood cultures with 2 (2.66%) patients in infection stone and 1 (1.33%) patient in calcium stone groups, whereas urine cultures revealed 6 (8%) positive results in infection stones and 4 (5.33%) in calcium stones. The patients who had positive cultures also had elevated plasma CRP levels when compared to the levels in patients with negative cultures (p = 0.000). CONCLUSIONS Bacteriuria and bacteriemia after ESWL have been well-identified entities and may be responsible from some of the post-ESWL complications. CRP can be useful for early detection of such complications.

Inhibition of Staphylococcus Epidermidis Colonization with Fusidic Acid-Impregnated Catheters

The aim of this study was the preparation and characterization of fusidic acid-impregnated peripheral catheters. In the first part of the study, in vitro drug release studies were performed, and the effect of fusidic acid impregnation on adherence of slime positive Staphylococcus epidermidis to catheters was evaluated as in vitro studies. Fusidic acid-impregnated and naïve catheters were incubated with 108 colony forming unit/mL (cfu/mL) slime positive S. epidermidis during the in vitro experiment. After incubation for 2, 4, 6, 8, 12, 24, 48, and 72 h, the number of colonies were determined in an aliquot and adhered to the catheter. During the in vivo experiment, contaminated naïve and fusidic acid-impregnated catheters (n = 10 rats in both groups) were implanted subcutaneously in the back of the rats. Rats were killed at the end of the seventh day and catheters were removed. Microbiologic assessments from the explanted catheter segments were performed. Fusidic acid impregnation decreased the number of adherent bacteria to the catheters and the number of free bacteria within the liquid medium significantly. There were 3 positive catheter cultures out of 10 in rats implanted with fusidic acid-impregnated catheters, whereas all explanted catheters from naïve group yielded bacterial growth. The mean cfu counts were significantly less in the fusidic acid-impregnated catheter group. In vitro release studies and antibacterial activity studies correlated well. Additionally, morphological evaluations by scanning electron microscopy showed that fewer bacteria were evident on the fusidic acid-impregnated catheters compared with naïve catheters. As a conclusion, catheter impregnation with fusidic acid is effective in preventing colonization in these in vitro and in vivo sets of experiments, with slime-producing S. epidermidis.

Neopterin levels in nonreplicative HBV carriers

The aim of this study was to determine the existence of immune activation by measuring neopterin in HBV (Hepatitis B virus) carriers with viral load (HBV DNA) less than 5 pg/ml. Forty-three subjects and 56 healthy controls were included in the study. Neopterin levels of were compared. ALT and ALP levels in one patient and AST levels in two patients were found minimally higher than upper limit, and GGT levels were within the reference range in all patients. Neopterin levels in the patient group and in the controls were 159.97+/-13.39 and 84.10+/-11.45 nmol/l, respectively (P<0.0001). The difference between the two groups was statistically significant (P<0.0001). In conclusion, the increased neopterin levels of HBV carriers might be the indicators of the effect of cellular immunity. This increase might also implicate a background inflammation based on mainly cellular immunity that exists within the liver.