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Öğe BRUCELLAR SPONDYLODISCITIS IN THE CERVICAL REGION(Professional Medical Publications, 2010) Evirgen, Omer; Altas, Murat; Davran, Ramazan; Motor, Vicdan Koksaldi; Onlen, YusufDiagnosis of brucella infection may be difficult, because it can mimic many other diseases. We report a 57-year old man who had presented with the complaints of radiculopathy, and was diagnosed as cervical spondylodiscitis. The spondylodiscitis was diagnosed via rose bengal test, positive serology, and positive culture results after the initial suspicion with magnetic resonance imaging. Streptomycin for 14 days and doxycycline rifampicin for tree months were used for the treatment. Brucellar spondylodiscitis in the cervical region is a rare presentation, beside that prognosis with early diagnosis and adequate treatment is good.Öğe Brucellar spondylodiscitis in the cervical region(2010) Evirgen, Omer; Altas, Murat; Davran, Ramazan; Motor, Vicdan Koksaldi; Onlen, YusufDiagnosis of brucella infection may be difficult, because it can mimic many other diseases. We report a 57-year old man who had presented with the complaints of radiculopathy, and was diagnosed as cervical spondylodiscitis. The spondylodiscitis was diagnosed via rose bengal test, positive serology, and positive culture results after the initial suspicion with magnetic resonance imaging. Streptomycin for 14 days and doxycycline rifampicin for tree months were used for the treatment. Brucellar spondylodiscitis in the cervical region is a rare presentation, beside that prognosis with early diagnosis and adequate treatment is good.Öğe The Dowling-Orlando technique in a giant primary cerebral hydatid cyst: a case report(Via Medica, 2010) Altas, Murat; Serarslan, Yurdal; Davran, Ramazan; Evirgen, Omer; Aras, Mustafa; Yilmaz, NebiHydatid cyst disease is a parasitic illness that is rarely located in the brain. We present a case of a 26-year-old female who complained of headache, nausea, and vomiting. The diagnosis was intracranial hydatid cyst disease and was confirmed with radiological and serological tests. Neurological examination revealed papilloedema and left-sided pyramidal signs. She was operated on using the Dowling-Orlando technique. The cyst was removed without rupture, and therapy was completed with albendazole for a period of four weeks. In this article, we discuss the application of the Dowling-Orlando technique, microsurgery, the Valsalva manoeuvre and the positioning of the patient such that gravity could facilitate surgical removal of a giant cerebral hydatid cyst.Öğe Effect of Thymoquinone on Oxidative Stress in Escherichia coli-Induced Pyelonephritis in Rats(Elsevier Science Inc, 2011) Evirgen, Omer; Gokce, Ahmet; Ozturk, Oktay Hasan; Nacar, Emel; Onlen, Yusuf; Ozer, Burcin; Motor, Vicdan KoksaldiBACKGROUND: Recurrent urinary tract infections are important in children and adults with diabetes mellitus and/or incontinence due to risk of pyelonephritis (PYN) and renal damage. There is a positive correlation released free radicals during PYN and renal damage. Experimental studies showed that antioxidant agents improve renal damage when used immediately after bacterial inoculation. OBJECTIVE: The aim of the present study was to evaluate whether treatment by thymoquinone (TQ) before or during Escherichia coli inoculation prevents oxidative damage in acute pyelonephritis (PYN) in an ascending obstructive rat model. METHODS: In this study, 42 Wistar rats were grouped as follows: control, PYN (24, 48, and 72 hours), and TQ-PYN (24, 48, and 72 hours). E. coli (1 x 10(9) colony forming units) was inoculated into the bladder via urethral catheterization in both the PYN and TQ groups. TQ injections were performed 24 hours before bacteria inoculation and repeated at 24-hour intervals during the indicated time at a dose of 10 mg/kg body weight intraperitoneally in TQ groups. RESULTS: Superoxide dismutase activity was statistically lower in the TQ-PYN-48 and -72 groups than the PYN-48 and -72 groups (P < 0.001, P = 0.004, respectively). Catalase activity was significantly higher in PYN-24, -48, and -72 groups than the control group (P < 0.001). In addition, there was a significant difference between the TQ-PYN-24, -48, and -72 groups and PYN groups in terms of glutathione peroxidase activity (P < 0.001, P = 0.026, P = 0.046, respectively). When the TQ-PYN-72 group was compared with the PYN-72 group, malondialdehyde levels were significantly lower in the TQ-PYN-72 group than in the PYN-72 group (P = 0.033). A histologic examination also confirmed the protective effect of TQ. In statistical analysis of histopathologic findings, there were significant differences between the PYN-24 and TQ-PYN-24, PYN-48 and TQ-PYN-48, and PYN-72 and TQ-PYN-72 groups (P = 0.008, P < 0.001, P < 0.001, respectively). CONCLUSIONS: The results indicate that TQ administration attenuated the oxidative damage that occurred in PYN and, therefore, could be used as a supportive agent to protect the kidneys from oxidative damage caused by PYN. (Curr Ther Res Clin Exp. 2011;72:204-215) (C) 2011 Elsevier HS Journals, Inc. All rights reserved.Öğe An evaluation of knowledge, attitudes, and behaviors of employees of a university hospital in an H1N1 influenza pandemic(J Infection Developing Countries, 2014) Evirgen, Omer; Savas, Nazan; Motor, Vicdan Koksaldi; Onlen, Yusuf; Yengil, ErhanIntroduction: In this study, we aimed to evaluate the knowledge, attitudes, and behaviors concerning the transmission routes of an H1N1 pandemic and the protective measures of health professionals at a university hospital in Turkey. Methodology: A stratified systematic sampling method was used to select the sample size of the study group. A total of 22 professors, 29 researchers, and 26 nurses were included in the study. Results: The mean scores of the individuals were 8.4 +/- 2.5 (over 20) for knowledge about H1N1 transmission, 27.6 +/- 4.0 (over 60) for knowledge about protection against H1N1, 25.8 +/- 4.2 (over 45) for correct or appropriate attitudes, and 33.6 +/- 8.9 (over 60) for correct behaviors. A negative correlation between total knowledge and behavior was found (p < 0.001, r = -0.543). Conclusions: In epidemics, standard protection measures should be known and applied. Regarding this topic, the web page of the Ministry of Health comes to the forefront as a reliable source of information in addition to scientific explanations.Öğe The Evaluation of the Seroprevalence of HBV and HCV Infections in Patients with Hemodialysis in Hatay City and the Assessment of Antibody Response to Hepatitis B Vaccination(Galenos Publ House, 2010) Evirgen, Omer; Onlen, Yusuf; Motor, Vicdan Koksaldi; Mahsereci, Erkan; Inci, Melek; Sahin, SulePatients with end stage renal disease (ESRD) being treated with hemodialysis (HD) usually require frequent blood transfusions and hospitalizations. Therefore, they are at high risk of hepatitis. Because of infection control programs and regular vaccinations in dialysis centers, a decrease in the prevalence of hepatitis due to HBV and HCV infections is observed in these units. The present study aimed to investigate the seroprevalence of HBV and HCV infections in patients with HD in dialysis centers of Hatay city and to assess antibody response to hepatitis B vaccination. A total of 801 HD patients were included in the study between January 01 and December 31, 2009 from seven HD centers. Data were obtained from the files retrospectively. HBsAg, anti-HBs and anti-HCV seropositivity of the patient's samples were analyzed by enzyme immunoassay method. Of the 801 HD patients included, 480 (59.9%) were male and 321 (40.1%) were female. The mean age of the patients was 58.2 +/- 14.9 years (range, 10-98 years). HBsAg was positive in 29 (3.6%) patients and anti-HCV was positive in 76 (9.5%) patients. Five (0.6%) patients had both HBsAg and anti-HCV positivity. Of the 712 patients whose anti-HBs data were available, 578 (72.2%) patients were anti-HBs positive, whereas 134 (16.7%) were not. In the present study, although a lower hepatitis B and C prevalence was found in Hatay city compared with the previous studies conducted in Turkey, our results were similar reported for European countries. However, viral hepatitis is still an important health problem in HD patients. Infection control programs, vaccination, the education of the patients and health staff may decrease the incidence ofnewinfections.Öğe Investigating virulence factors of clinical Candida isolates in relation to atmospheric conditions and genotype(Tubitak Scientific & Technological Research Council Turkey, 2012) Inci, Melek; Atalay, Mustafa Altay; Koc, Ayse Nedret; Yula, Erkan; Evirgen, Omer; Durmaz, Suleyman; Demir, GoncaAim: To investigate some virulence factors in Candida species isolated from patients with suspected invasive fungal infection and to identify their relationship with Candida genotypes. Materials and methods: Overall 45 isolates (20 Candida albicans and 25 non-albicans Candida spp.) genotyped by rep-PCR were included in this study. Virulence factors were studied in both aerobic and anaerobic conditions. In isolates, egg yolk agar was used for determining phospholipase activity, while bovine serum albumin agar was used for proteinase activity, Tween-80 medium for esterase activity, and Sabouraud dextrose agar with sheep blood for hemolysin activity. Biofilm formation was detected by the microplate method. Results: In both Candida spp., it was found that hemolytic activity and proteinase activity were higher in aerobic conditions, whereas biofilm formation was higher in anaerobic conditions. It was also found that phospholipase and esterase activity were only detected in C. albicans isolates, which were found to be higher in aerobic conditions. No difference was found in virulence factors evaluated among the C. albicans genotypes. Conclusion: The amount of oxygen in the atmosphere may affect the virulence of Candida spp. Further comprehensive studies are needed in order to identify the relationship between Candida genotypes and virulence factors.Öğe Investigation of Parvovirus B19 Seroprevalence, Endothelin-1 Synthesis, and Nitric Oxide Levels in the Etiology of Essential Hypertension(Taylor & Francis Inc, 2012) Motor, Vicdan Koksaldi; Arica, Secil; Motor, Sedat; Yilmaz, Nigar; Evirgen, Omer; Inci, Melek; Gokce, CumaliBackground and Aims: Many studies have focused on the role of pathogen infection in hypertension (HT). It has been postulated that increased vascular tonus in HT is basically related to the imbalance between vasodilator, such as nitric oxide (NO), and vasoconstrictor, such as endothelin-1 (ET-1), substances secreted by endothelium. The aim of the present study was to investigate the seroprevalence of human parvovirus B19 (HPV B19) in the etiology of essential HT and the effect of HPV B19 on ET-1 and NO levels in this disorder. Materials and Methods: A total of 135 participants were enrolled in the study (90 patient and 45 controls). Antibodies to HPV B19 and ET-1 were measured by enzyme-linked immunosorbent assay method. Nitric oxide levels were calculated according to the Griess reaction. Results: Of the total participants, 27 patients (30%) and 7 control subjects (15.6%) had IgM positive (P = .068), whereas 27 patients (30%) and 14 control subjects (31.1%) had IgG positive (P = .895). There was no statistical difference between patients and control subjects in terms of serum ET-1 and NO levels. Conclusions: The role of HPV B19 in the etiology of essential HT was not shown in the present study. A larger sample may be needed for the investigation of these relations.Öğe Investigation of vitamin D levels in patients with inactive hepatitis B virus carrier(Acta Medica Mediterranea, 2014) Motor, Sedat; Koksaldi-Motor, Vicdan; Dokuyucu, Recep; Ustun, Ihsan; Evirgen, Omer; Yilmaz, Nigar; Onlen, YusufObjective: The purpose of the present study was to investigate vitamin D levels in inactive hepatitis B virus carriers. Materials and methods: A total of 81 patients with inactive hepatitis B virus carrier state were enrolled at the study. Serum calcium (Ca++), phosphorus (PO4), total protein, albumin, parathormone (PTH) and 25-hydroxy vitamin D (25OHD) were determined. Serum vitamin D concentration was classified as lacking when it was less than 50 nmol/l (20 ng/ml), insufficient when it was 52.5-72.5 nmol/l (21-29 ng/ml), and sufficient when it was more than 75 nmol/l (30-100 ng/ml). Results: The mean 25OHD level was found to be 131.7±50.0 nmol/l. Deficiency and insufficiency was seen in one (1.2 %) and nine (11.1 %) inactive hepatitis B virus carriers, respectively. All the patients have normal serum PTH and albumin levels. Total Ca++ and PO4 were low in ten and eight patients, respectively (p<0.05). Conclusion: Vitamin D may cause the stimulation of antiviral immune response and a preventive effect on necroinflammation and liver fibrosis. Therefore, it may affect course of HBV infection. The new studies with larger sample are needed to research the role of vitamin D in the course of chronic HBV infection, liver failure, cirrhosis, and hepatocellular carcinoma.Öğe INVESTIGATION OF VITAMIN D LEVELS IN PATIENTS WITH INACTIVE HEPATITIS B VIRUS CARRIER(Carbone Editore, 2014) Motor, Sedat; Koksaldi-Motor, Vicdan; Dokuyucu, Recep; Ustun, Ihsan; Evirgen, Omer; Yilmaz, Nigar; Onlen, YusufObjective: The purpose of the present study was to investigate vitamin D levels in inactive hepatitis B virus carriers. Materials and methods: A total of 81 patients with inactive hepatitis B virus carrier state were enrolled at the study. Serum calcium (Ca++), phosphorus (PO4), total protein, albumin, parathormone (PTH) and 25-hydroxy vitamin D (25OHD) were determined. Serum vitamin D concentration was classified as lacking when it was less than 50 nmolll (20 ng/ml), insufficient when it was 52.5-72.5 nmol/l (21-29 ng/ml), and sufficient when it was more than 75 nmol/l (30-100 ng/ml). Results: The mean 25OHD level was found to be 131.7 +/- 50.0 nmol/l. Deficiency and insufficiency was seen in one (1.2 %) and nine (11.1 %) inactive hepatitis B virus carriers, respectively. All the patients have normal serum PTH and albumin levels. Total Ca++ and PO4 were low in ten and eight patients, respectively (p<0.05). Conclusion: Vitamin D may cause the stimulation of antiviral immune response and a preventive effect on necroinflammation and liver fibrosis. Therefore, it may affect course of HBV infection. The new studies with larger sample are needed to research the role of vitamin D in the course of chronic HBV infection, liver failure, cirrhosis, and hepatocellular carcinoma.Öğe Lamivudine Experience in Acute Hepatitis B Developing in a Patient Under Chemotherapy(Aves, 2014) Bal, Tayibe; Onlen, Yusuf; Isitemiz, Feride; Koksaldi-Motor, Vicdan; Evirgen, Omer; Kokoglu, Omer Faruk; Ocak, SabahattinAcute hepatitis B (AHB) results 90% in spontaneous healing and often does not require antiviral therapy. It may rarely result in severe liver damage as fulminant hepatitis. The possibility of fulminant hepatitis is high in immunosuppressed patients than in immunocompetent patients. Although the exact cause is unexplained, immunosuppression associated with chemotherapy may increase the possibility of fulminant hepatitis by increasing hepatitis B virus replication in immunosuppressed patients. According to this hypothesis, in immunosuppressed patients with AHB, maintaining viral load suppression with lamivudine therapy may cause less host response and may be effective in preventing risk of fulminant hepatitis. A case in which AHB developed while receiving maintenance chemotherapy for haematological malignancy is presented. Based on similar cases in the literature, the patient was treated with lamivudine and maintenance chemotherapy was continued. In the fourth week of treatment, transaminase levels were normal and anti-HBs was positive. In immunocompromised patients in whom AHB develops, many questions such as the effectiveness of lamivudine treatment, duration of treatment, whether or not to suspend the chemotherapy and when to continue the chemotherapy are still unanswered. Lamivudine experience in this case is reported because there is no guide for this subject in the literature except few case reports.Öğe Liver hydatid cyst leading to bilateral pulmonary artery embolism and bilateral multiple pulmonar echinococcosis via inferior vena cava: report of a case(Elsevier Science Inc, 2013) Bayarogullari, Hanifi; Davran, Ramazan; Cavus, Yeliz; Yetim, Tulin Durgun; Evirgen, OmerHydatid disease (HD) is a worldwide parasitic disease. Echinococcosis may involve many organs but affect most commonly liver and lungs. The location of echinococcal cysts inside pulmonary artery is extremely rare. Radiologic findings range from purely cystic lesions to a completely solid appearance. Hydatid cysts (HC) can be solitary or multiple and varies size. Pulmonary artery embolism of HC can be symptomatic or asymptomatic. When symptomatic, we see the chest pain, dyspnea, cough, hemoptysis and sometimes acute cor pulmonale or sudden death secondary to massive giant pulmonary artery embolism of HC. (C) 2013 Elsevier Inc. All rights reserved.Öğe Neurobrucellosis as a rare complication of brucellosis: three pediatric case reports(Aves, 2012) Arica, Vefik; Silfeler, Ibrahim; Altas, Murat; Tutanc, Murat; Arica, Secil Gunher; Evirgen, Omer; Davran, RamazanBrucellosis is a major worldwide zoonosis. The disease is endemic in developing countries, particularly in the Mediterranean basin. Brucellosis is frequently seen in Eastern and South-Eastern Anatolia regions in Turkey. Around 18 000 new cases are reported annually in Turkey. Any organ or system of the body can be involved. Brucellosis is an infection due to Brucella species and is characterized by acute febrile illness, sweating, weakness, and headache. Involvement of the central nervous system is rare in brucellosis. Brucella is continuing to be an important health problem especially who live in the countryside. The clinicians usually rule out neurobrucellosis in the differential diagnosis of brucellosis. The three neurobrucellosis cases presented in this paper referred with various non-specific symptoms. Only the first patient was found to have hydrocephalus on CT imaging, while the CT images of the other patients were normal. The second case had a history of consumption of fresh herby cheese, however the other cases had no such history. These three patients were found to have recovered without sequela during their long term follow up. The aim of this presentation is to draw attention to the importance of neurobrucellosis especially in endemic regions including our country. (Turk Arch Ped 2012; 47: 218-21)Öğe Pediatric neurobrucellosis associated with hydrocephalus(Medknow Publications & Media Pvt Ltd, 2010) Altas, Murat; Evirgen, Omer; Arica, Vefi K.; Tutanc, MuratBrucellosis is an infectious disease, frequently encountered in developing countries. It may involve multiple organ systems of the human body. However, neurobrucellosis is a rare complication of brucellosis. The most frequent events of cranial involvement are meningitis and meningoencephalitis. In the present case, a 10-year-old girl was referred to our clinic with fever, headache, nausea, and vomiting. The patient's blood and cerebrospinal fluid cultures were found positive for brucellosis. Communicating hydrocephalus was also present in the cranial computed tomography as a complication of neurobrucellosis. The patient was successfully treated by external ventricular drainage and triple antibiotic therapy. There was no need to insert a ventriculo-peritoneal shunt.Öğe Seropositivity of Hepatitis B and Hepatitis C in women who were admitted to Hatay Maternity and Children's Hospital(Galenos Yayincilik, 2010) Motor, Vicdan Koksaldi; Evirgen, Omer; Aksakal, Mehmet; Inci, Melek; Onlen, Yusuf; Ocak, SabahattinThe aim of this study was to investigate the rates of HBsAg and anti-HCV seropositivity in women in reproductive age group who were applied to our provincial maternity hospital between January 01 and December 31, 2009. Levels of HBsAg and anti-HCV determined with chemiluminescence immunoassay (Architect i2000, Abbott, USA) method were evaluated retrospectively. A total of 5410 women out of 13065 women included in the study were followed-up for pregnancy. For HBsAg, 12969 samples were analyzed and 203 (1.6%) of these samples were positive; for anti-HCV, 12784 samples were analyzed and 55 (0.4%) of these samples were positive. HBsAg and anti-HCV serology were positive in 81 (1.5%) and in 16 (0.3%) of the pregnant women, respectively. Among age groups, a significant difference was determined for HBsAg positivity, but a significant difference was not observed for anti-HCV positivity. In conclusion, all pregnant women with positive serology should be educated for precaution during delivery. Hospitals should be controlled regularly.Öğe The Seropositivity of Parvovirus B19 in Patients with Ankylosing Spondylitis(Aves, 2014) Motor, Vicdan Koksaldi; Ustun, Nilgun; Evirgen, Omer; Inci, Melek; Yula, Erkan; Onlen, YusufObjective: Parvovirus B19 is one of the most common causes of viral arthritis, which suggests that it can be a significant factor in the pathogenesis of chronic inflammatory diseases, such as rheumatoid arthritis. The aim of the present study was to investigate the seropositivity of parvovirus B19 in patients with ankylosing spondylitis (AS). Material and Methods: The patient group consisted of 43 patients with ankylosing spondylitis; the control group consisted of 70 subjects who did not have any bone joints complaints. Anti-parvovirus B19 IgM and IgG antibodies were measured by ELISA. Results: Parvovirus B19 IgM antibody positivity in patients with AS was significantly higher than that in the control group (p<0.001). Conclusion: The high frequency of anti-parvovirus B19 IgM positivity in patients with AS suggests that the virus reactivates or persists in these patients due to immuno deficiency.
