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Öğe Distribution and evaluation of Vancomycin resistant Enterococci seen in Selcuk University Medical Faculty Hospital between 2012 and 2015(BILIMSEL TIP YAYINEVI, 2017) Torun, Ayse; Sumer, Sua; Ural, Onur; Aktug Demir, NazlimIntroduction: Prevailing at increasing rates as a cause of hospital infections in recent years, vancomycin resistant enterococcus (VRE) infections pose a serious problem in our country and across the world. This study aims at providing an overview of the VRE problem in our hospital. Materials and Methods: The data of 112 patients monitored in the clinics and intensive care units of Selcuk University Medical School Hospital between 1 January 2012 and 31 December 2015 and who had growth of VRE in their various cultures were reviewed retrospectively by going through patient files. Results: Looking at the distribution of VRE cases by years, it was seen that there were 13 cases in 2013 (11.6%), 23 cases in 2014 (20.5%) and 76 cases in 2015 (67.9%). Of these cases, 71 (63.4%) were colonized, 15 (13.4%) infected and 26 (23.2%) were both colonized and infected. The rate of infected cases was observed to be more in 2013, which was statistically significant (p< 0.001). From the 112 cases involving VRE, 36 (32.1%) were monitored in the clinics and 76 (67.9%) in the intensive care units. Thirty (83.3%) of the patients hospitalized in clinics were followed in the internal medicine clinics and 6 (16.7%) in surgical departments. The rate of colonization in patients treated in the intensive care units was higher than in those treated in clinics, which was statistically significant (p= 0.015). There was one or more underlying diseases in 109 (97.3%) of the 112 patients found to have VRE, a history of antibiotic use in 102 of them (91.1%), presence of urinary catheter in 102 (91.1%), and a history of hospitalization in 86 (76.7%). Therefore, history of hospitalization, history of underlying disease, history of antibiotic use, and presence of a urinary catheter were considered statistically significant risk factors for VRE infections (p values 0.01, 0.02, 0.01 and 0.01, respectively). E. faecium was found in 137 of the 141 isolates with VRE. Their susceptibility to antibiotics was 95.5% for linezolid and 99.2% for tigecycline. Their resistance to ampicillin and ciprofloxacin were 100%, to teicoplanin 95.7%, to trimethoprim sulfamethoxazole 89.2%, to high levels of gentamicin 87.5% and of tetracycline 80.4%. Conclusion: As a result of our study, risk factors for VRE infections were identified, which had become a growing problem in years in our hospital. It is to our belief that it would be useful, as a precaution, to take routine stool cultures from patients found to carry these risk factors.Öğe Evaluation of 48-week response of treatment-naive chronic hepatitis B patients to 0.5 mg/day entecavir(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2014) Kolgelier, Servet; Aktug Demir, Nazlim; Ozcimen, Serap; Sumer, SuaAim: The hepatitis B virus (HBV) is an important healthcare problem. Chronic hepatitis B infection may present with a wide range of manifestations from inactive carrier state to cirrhosis and hepatocellular cancer. Therefore, treatment is very important in chronic hepatitis B. In this study, the treatment results of 199 chronic hepatitis B patients taking entecavir 0.5 mg/day for 48 weeks were evaluated. Materials and methods: This study retrospectively evaluated data of 199 treatment-naive chronic hepatitis B patients who were treated with entecavir. Results: Of the 199 treatment-naive chronic hepatitis B patients, 141 (70.9%) were males and 58 (29.1%) were females, and mean age of the whole group was 37.5 +/- 12.1 years. HBeAg was positive in 91 (45.7%) and antiHBe was positive in 108 (54.3%) patients. Mean HBV DNA value was 666,449,365.5 +/- 2,759,013,996.9 IU/mL, mean ALT value was 112.1 +/- 95.7 U/L, and mean AST value was 95.3 +/- 71.2 U/L. At week 24 of the treatment, HBV DNA levels were below 50 IU/mL in 56% of the HBeAg-positive and 76% of the HBeAg-negative patients. At week 48 of the treatment, HBV DNA levels were below 50 IU/mL in 79% of the HBeAg-positive and 87% of the HBeAg-negative patients. At week 24, ALT had normalized in 72% of the HBeAg-positive and 79% of the HBeAg-negative patients. At week 48, ALT had normalized in 89% of the HBeAg-positive and 88% of the HBeAg-negative patients. AntiHBe seroconversion was seen in 2 of 91 patients (2.2%), but the loss of HBsAg was never observed. Conclusion: The 48-week entecavir treatment at a dose of 0.5 mg/day was shown to be effective both for HBeAg-positive and negative patients.Öğe Intracranial Giant Tuberculoma Mimicking Brain Tumor: A Case Report(TURKISH NEUROSURGICAL SOC, 2015) Sumer, Sua; Koktekir, Ender; Aktug Demir, Nazlim; Akdemir, GokhanTuberculomas are small tumor-like lumps that can be seen, usually in large numbers, in central nervous system involvement of tuberculosis. Giant tuberculomas that are big enough to cause symptoms of compression are also encountered, though rarely. When they are really large, tuberculomas may result in increased intracranial compression, neurologic deficits, or epileptic attacks. Giant tuberculomas may be confused with brain tumors on cranial magnetic resonance imaging. Cranial magnetic resonance imaging and histopathology examinations are used for diagnosis. Although magnetic resonance imaging is useful for diagnosing tuberculoma, histopathology examination is the gold standard for a final diagnosis. This paper presents a case involving a 66-year-old patient who complained of headache, imbalance and dizziness, and underwent an operation in the neurosurgery clinic with a pre-diagnosis of brain tumor, and was then diagnosed with intracranial giant tuberculoma.Öğe Isolated Cervical Spondylodiscitis Due to Brucellosis: A Case Report(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2013) Ural, Onur; Sumer, Sua; Aktug Demir, Nazlim; Dikici, Nebahat; Firat, VildanBrucellosis is a zoonotic disease, which has the potential to affect all organs and systems. It most commonly involves the musculoskeletal system and may result in sacroiliitis, spondylitis, spondylodiscitis, arthritis, osteomyelitis, tenosynovitis or bursitis. Lumbosacral region is the most commonly affected in cases of spinal complications. Involvement of the cervical region is very rare, however, when it does occur, the prognosis is worse than when it affects the lumbar region and more neurological damage. is observed. Brucellosis should always be considered in the differential diagnosis of patients presenting with musculoskeletal complaints in regions where brucellosis is endemic. We report an unusual case of brucellar spondylodiscitis involving the cervical region and discuss this with reference to the recent literature.