52 research outputs found

    Hastane personeli ile sağlıklı bireylerde burun kültürlerinden ve subklaviyen kateterlerden elde edilen stafilokokların beta-laktamaz, slime yapma özellikleri ve antibiyotik duyarlılıklarının araştırılması

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    Yakın zamanlara kadar vücutta kommensal olduğu sanılan KNS'ların son zamanlarda yapılan çalışmalarda extrasellüler bir slime maddesi meydana getirerek, vücuda implante edilen yabancı yüzeylere (intravenöz kateterler, vcntrikUlopcriloncal santiar, pcys-meykır vb.) yapışarak infeksiyona yol açtıkları belirlendi. Çalışmamızda hastane personelinin burun kültürlerinden ve i.v. kaleterlerden izole etliğimiz slafilokoklarda slime maddesini araştırdık. Hastane personelinden izole ettiğimiz suşlarla, kontrol grubunun özelliklerini karşılaştırdık. Toplam 186 kişi ile yaptığımız bu çalışmada, elde ettiğimiz 160 stafilokok susunda slime maddesi ile birlikte, beta-laktamaz yapma oranlarını ve 14 adet antibiyotiğe duyarlılıklarını belirledik. Beta-laktamaz yapma oranını S. aurcus'larda % 47, KNS'larda % 43, slimc pozitifliğini de S. aurcus'larda % 23, KNS'larda % 62 olarak bulduk. 14 antibiyotik içinde vanko- misin, siprofloksasin ve sefoperazon/sul baklam en duyarlı ilk Uç antibiyotikti. Sonuçlar Chi-square testi ile değerlendirildi. Hastane personeli ve i.v. kaleterlerden elde edilen KNS'lar ile kontrol grubun dan izole edilenler arasında slime yapma oranları açısından islalistiki olarak fark anlam lı idi (p0,05). Çalışmada elde ettiğimiz sonuçlar literatür bilgileri ışığı altında tartışıldı. Sonuçların uyumluluk gösterdiği görüldü.İl has been understood thai coagulasc-ncgativc staphylococci (CNS) which have been known as commensal organisms until recently can cause infections by producing slime substance which enables them to attach to the surfaces of foreign materials (such as intravenous cateters, ventriculo-periloncal shunts, pace-makers etc). In this study, wc investigated the slime substance in staphylococcus obtained from both nasal cultures of hospital staff and intravenous cateters. In addition, we compared the species from both hospital staff and controls. Of totally 186 subjects, 160 samples were investigated in terms of slime substance, the ratio of beta-lactamase posilivincss and the sensitivity to 14 different antibiotics. Wc found the ratio of P-laclamasc production to be 47 % in S. aureus and 48 % in CNS, and the slime posilivcncss to be 25 % in S. aureus and 62 % CNS. Of 14 antibiotics, Vancomicin, Ciprofloxacin and Ccfopcrason/sulbaclam were the most sensitive ones. The result were evaluated with Chi -square test. The difference in the amount of slime produced between control and study group samples was beta-lactamase production (p0,05). Our results were discussed in the light of literature. It was found that the results were in agreement with those of literature

    Association of male pattern baldness with angiographic coronary artery disease severity and collateral development

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    Objective We aimed to investigate whether there is an association between male pattern baldness and angiographic coronary artery disease (CAD) severity and collateral development, which has not been reported previously. Methods Coronary arteriograms, CAD risk factors, lipid parameters and presence and severity of baldness in 511 male patients were prospectively evaluated. Baldness was classified into five groups. Severity of CAD was evaluated with the Gensini scoring system and collateral development with Rentrop scores. Results Although subjects with a higher Gensini score had more frequent and severe baldness, they were older than the group with lower Gensini scores. Bald patients had a higher Gensini score when compared with their non-bald counterparts. In univariate analysis, age more than 60, body mass index more than 30, smoking and baldness were predictors of high Gensini scores. In multivariate analysis, only age more than 60, body mass index more than 30 and smoking were independent predictors of a high Gensini score. There were no differences in terms of presence and severity of baldness in subjects with and without adequate collateral development. Conclusions There was no relation between presence, severity and age of occurrence of male pattern baldness and Gensini and Rentrop scores, which are important measures of presence and severity of CAD

    Evaluation of right atrial volumes and functions by real-time three-dimensional echocardiography in patients after acute inferior myocardial infarction

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    Background Methods Right ventricle (RV) involvement causes acute systolic and diastolic functional alterations in the RV in patients after inferior myocardial infarction (IMI), which may result in an increase in left ventricle (LV) end-diastolic and right atrial (RA) pressure. In our study, we sought to evaluate RA volumes and mechanical functions using real-time three-dimensional echocardiography (RT3DE) in IMI patients with or without RV involvement. Ninety-six consecutive patients with IMI (mean age: 59.7 +/- 10.2 years, 60 female) were included. RV myocardial involvement (RVMI) was defined as the presence of a culprit lesion at the proximal portion of the first RV marginal branch in coronary angiography. The study population was divided into two groups: IMI (58.3%) and IMI + RVMI (41.7%). Patients were evaluated using conventional two-dimensional echocardiography (2DE) and RT3DE. Results Conclusions In RT3DE measurements, IMI + RVMI patients had significantly higher RA phasic volumes and worse conduit mechanical function. A receiver operating characteristic (ROC) curve analysis revealed that an RT3DE RA maximum volume (Vmax) index > 27.9 mL/m(2) was an independent predictor of RV involvement in patients after acute IMI, with a sensitivity of 80.0% and a specificity of 89.3%. Right ventricle involvement may cause an increase in RA phasic volumes and deterioration of conduit function in patients with acute IMI

    Subclinical Atherosclerosis in Systemic Sclerosis: Not Less Frequent Than Rheumatoid Arthritis and Not Detected With Cardiovascular Risk Indices

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    Objective. To determine the frequency of subclinical atherosclerosis in patients with systemic sclerosis (SSc; scleroderma) compared to healthy subjects (HS) and rheumatoid arthritis (RA) patients and to determine the ability of cardiovascular (CV) risk indices in detecting SSc patients with subclinical atherosclerosis. Methods. A total of 110 SSc patients (102 females and 8 males, mean +/- SD age 50.5 +/- 11.9 years), 110 age-and sex-matched RA patients, and 51 HS without CV disease were examined with ultrasonography (US). Carotid intima-media thickness (cIMT) >0.90 mm and/or carotid plaques were used as the gold standard for subclinical atherosclerosis (US+). Systematic Coronary Risk Evaluation (SCORE), QRisk II, and 2013 American College of Cardiology (ACC)/American Heart Association (AHA) CV risk indices were calculated. Results. Twenty-one (19.1%) SSc patients, 24 (21.8%) RA patients, and 3 (5.9%) HS had subclinical atherosclerosis (SSc versus RA: P=0.62, SSc versus HS: P=0.029). cIMT in SSc was higher compared to HS (0.68 +/- 0.15 mm versus 0.61 +/- 0.10 mm; P=0.008) but similar to RA patients (0.66 +/- 0.14 mm; P=0.82). Subclinical atherosclerosis in SSc was associated with age (odds ratio [OR] 1.07, P=0.013), elevated erythrocyte sedimentation rate (OR 3.4, P=0.045), and pulmonary arterial hypertension (OR 4.27, P=0.012). Concerning CV risk indices, of the 21 US+ SSc patients only 0, 3 (14.2%), and 6 (28.6%) were classified as high CV risk according to SCORE, QRisk II, and ACC/AHA risk indices, respectively. Conclusion. Subclinical atherosclerosis in SSc patients is more frequent than in HS, but is as frequent as in RA patients in which accelerated atherosclerosis is clearly defined. CV risk indices for the general population are considerably insufficient to detect SSc patients with atherosclerosis

    Right ventricular and atrial functions in systemic sclerosis patients without pulmonary hypertension Speckle-tracking echocardiographic study

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    Background. Systemic sclerosis (SSc) is a systemic connective tissue disease and cardiac involvement is one of the most important causes of death. Right ventricular (RV) systolic dysfunction is a poor prognostic finding in SSc patients. Assessment of RV function has some difficulties because of its crescent shape and extensive trabeculations. Two-dimensional (2D) speckle-tracking echocardiography (STE) is an angle-independent quantitative technique to evaluate myocardial function. The aim of this study was to assess the RV and right atrial (RA) functions of SSc patients without pulmonary hypertension by using 2D STE. Patients and methods. A total of 40 patients with SSc (mean age 48.5 +/- 11.4 years, 28 female) and 40 healthy volunteers (mean age 45.9 +/- 7.6 years, 21 female) were included in the study. All subjects underwent transthoracic echocardiography for evaluation of RV and RA functions with 2D STE. Results. Although left ventricular systolic and diastolic functions, systolic pulmonary artery pressure (PAP), and RA measurements were similar in both groups, tricuspid annular plane systolic excursion (TAPSE) and maximum systolic myocardial velocity (S') were decreased in SSc patients. The RV free wall global longitudinal strain (GLS) of SSc patients was lower than the controls (-18.5 +/- 4.9% vs. -21.8 +/- 2.4%, p< 0.001) and the RA reservoir and conduit functions were also decreased in SSc patients compared with controls (34.4 +/- 9.9% vs. 39.7 +/- 11.2%, p= 0.027 and 15.0 +/- 5.7% vs. 18.7 +/- 6.4%, p= 0.009, respectively). Disease duration was inversely correlated with RVGLS and TAPSE (r: -0.416, p= 0.018 and r: -0.383, p= 0.031, respectively). Conclusion. The use of 2D STE can be helpful in the detection of impairment in RV and RA functions in SSc patients with normal PAP
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