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    Plevra sıvısı PGE2 düzeyinin akciğer kanserli hastalarda tanısal değeri ve transüda-eksuda ayırımındaki yeri
    (2003) Aydemir, Yusuf; Gök, Mehmet
    Bu çalışmaya 2001-2002 yılları arasında, Selçuk Üniversitesi Meram Tıp Fakültesi Göğüs Hastalıkları ve Tüberküloz Kliniğinde yatırılarak tetkik edilen 100 plörezi olgusu ve kontrol grubu olarak seçilen 22 sağlıklı birey dahil edildi. Plevra sıvıları, tanılarına göre transüda-eksuda, malign-benign ve spesifik tanı grupları olmak üzere 3 gruba ayrıldı ve olgular bu üç grupta incelendi. Olguların plevra sıvısı ve plazma PGE2 düzeyleri eş zamanlı olarak EIA yöntemi ile belirlendi. Transüda-eksuda grupları arasında plevra sıvısı PGE2 seviyeleri açısından istatistiki olarak anlamlı fark bulundu (p=0.005). Eksudatif sıvıların ayırt edilmesinde sınır değer 112.7 pg/ml olarak alındığında, plevra sıvısı PGE2 düzeyinin tanısal değeri, sensitivitesi % 63.5, spesifitesi % 80 olarak belirlendi. Benign-malign grup arasında plevra sıvısı PGE2 seviyeleri açısından fark bulunamadı. Akciğer kanseri grubu ile tüberküloz grubu hariç, diğer tüm gruplar arasında plevra sıvısı PGE2 seviyeleri açısından anlamlı fark bulundu. Akciğer kanseri tanısında plevra sıvısı PGE2 düzeyinin tanısal değeri, sınır değer 210 pg/ml olarak alındığında sensitivitesi % 70.8, spesifitesi % 76.3 olarak saptandı. Plazma PGE2 konsantrasyonları karşılaştırıldığında transüda-eksuda ve benign-malign gruplar arasında fark bulunamadı. Sonuç olarak plevra sıvısında PGE2 düzeyinin transüda-eksuda ayırımında ve malign-benign ayırımında kullanılmasının uygun olmadığı, akciğer kanseri tanısında ise şüphede kalman durumlarda yararlı olabileceği kanaatine varıldı.
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    The role of multiplex PCR test in identification of bacterial pathogens in lower respiratory tract infections
    (Professional Medical Publications, 2014) Aydemir, Ozlem; Aydemir, Yusuf; Ozdemir, Mehmet
    Objectives: Lower respiratory tract infection is one of the most important causes of morbidity and mortality. However establishing a microbial diagnosis for patients with lower respiratory tract infection is still challenging and is often achieved in only half of cases by conventional methods. This study was designed to compare the fast responsive PCR method with the culture method in lower respiratory tract infections and to evaluate the reliability of multiplex PCR method. Methods: One hundred ninety seven patients with the symptoms of acute lower respiratory tract infection, and diagnosed with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease and exacerbations of bronchiectasis were included in the study. Both culture and PCR methods was performed for the isolation of most commonly seen bacteria, from sputum, nasopharyngeal swabs and bronchoalveolar lavage fluid samples. Results: While at least one bacterial isolation was determined in 62 (31.5%) of all patients with culture method, this number increased to 125 (63.5%) with multiplex PCR. The bacteria most commonly identified by PCR were S. pneunnoniae (32%) and H. influenzae (31%). There was a significant difference between PCR and culture in terms of multi-factor detection rates (p < 0.005). Multiple bacteria were detected in only two cases in cultures; however, multiple pathogens were detected in 47 cases with PCR. Conclusions: Conventional methods, such as culture and serology are not always adequate to detect the pathogens in lower respiratory tract. Real-time PCR assays proved highly sensitive and rapid. The prevalence of bacteria and multiple agent detected by real-time PCR compared with culture was substantially higher. Widespread use of PCR methods, by providing the immediate and appropriate agent specific antibiotic treatment of LRTI, will help reduce failure and contributes to a reduction in antibiotic resistance.
  • Küçük Resim Yok
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    Value of multiplex PCR to determine the bacterial and viral aetiology of pneumonia in school-age children
    (Taylor & Francis Ltd, 2017) Aydemir, Yusuf; Aydemir, Ozlem; Pekcan, Sevgi; Ozdemir, Mehmet
    Background: Conventional methods for the aetiological diagnosis of community-acquired pneumonia (CAP) are often insufficient owing to low sensitivity and the long wait for the results of culture and particularly serology, and it often these methods establish a diagnosis in only half of cases. Aim: To evaluate the most common bacterial and viral agents in CAP using a fast responsive PCR method and investigate the relationship between clinical/laboratory features and aetiology, thereby contributing to empirical antibiotic selection and reduction of treatment failure. Methods: In children aged 4-15 years consecutively admitted with a diagnosis of CAP, the 10 most commonly detected bacterial and 12 most commonly detected viral agents were investigated by induced sputum using bacterial culture and multiplex PCR methods. Clinical and laboratory features were compared between bacterial and viral pneumonia. Results: In 78 patients, at least one virus was detected in 38 (48.7%) and at least one bacterium in 32 (41%). In addition, both bacteria and viruses were detected in 16 (20.5%) patients. Overall, the agent detection rate was 69.2%. The most common viruses were respiratory syncytial virus and influenza and the most frequently detected bacteria were S. pneumoniae and H. influenzae. PCR was superior to culture for bacterial isolation (41% vs 13%, respectively). Fever, wheezing and radiological features were not helpful in differentiating between bacterial and viral CAP. White blood cell count, CRP and ESR values were significantly higher in the bacterial/mixed aetiology group than in the viral aetiology group. Conclusion: In CAP, multiplex PCR is highly reliable, superior in detecting multiple pathogens and rapidly identifies aetiological agents. Clinical features are poor for differentiation between bacterial and viral infections. The use of PCR methods allow physicians to provide more appropriate antimicrobial therapy, resulting in a better response to treatment, and it may be possible for use as a routine service if costs can be reduced.