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Öğe Clearance of Intravitreal Daptomycin in Uveitis-Induced Rabbit Model(Taylor & Francis Inc, 2015) Ozcimen, Muammer; Sakarya, Yasar; Ozcimen, Serap; Sakarya, Rabia; Goktas, Sertan; Iyisoy, Sinan; Alpfidan, IsmailPurpose: To investigate the elimination rate of daptomycin after intravitreal injection in uveitis-induced rabbits. Materials and methods: Intravitreal injection of the single dose of 200 mu g/0.05mL daptomycin was administered to rabbits starting 24 h after induction of uveitis by an intravitreal endotoxin injection. Aqueous humor and vitreous humor samples of eight eyes per time point were collected at selected time intervals (1, 3, 6, 24, 48, 72 and 96 h), and the in vitreous half-life was calculated. Daptomycin concentrations in vitreous and aqueous humor were assayed with high-performance liquid chromatography. Results: The vitreous concentration was noted to decline slowly with time. The mean vitreous concentration was 23.25 +/- 10.99 mu g/mL and 11.10 +/- 3.33 mu g/mL at 96 h in inflamed and normal eyes, respectively. The vitreous daptomycin concentration showed an exponential decay with a half-life of 25.67 h in normal eyes and 34.6 h in inflamed eyes. The aqueous levels of daptomycin in normal eyes were low but remained significantly higher than those of inflamed eyes. Conclusions: Given that the injected dose corresponds to several times the minimum inhibitory concentrations of organisms most involved in endophthalmitis, and that therapeutic levels are present up to 96 h after injection, intravitreal daptomycin should be considered for the treatment of endophthalmitis caused by Gram-positive bacteria.Öğe Daptomycin versus Vancomycin in an Enterococcus faecalis Endophthalmitis Rabbit Model(Taylor & Francis Inc, 2016) Ozcimen, Muammer; Kurtoglu, Muhammet G.; Goktas, Sertan; Omeroglu, Ethem; Sakarya, Yasar; Alpfidan, Ismail; Ozcimen, SerapPurpose: To compare bactericidal activities of daptomycin (DAP) and vancomycin (VAN) in an experimental rabbit model of Enterococcus faecalis endophthalmitis. Materials and methods: The right vitreous cavities of 24 New Zealand rabbits were inoculated with 100 colony-forming units of E. faecalis; and after 24 h, rabbits were randomly divided into three groups. DAP group (n = 8, 0.2 mg/0.05 ml intravitreally), VAN group (n = 8, 1 mg/0.05 ml intravitreally) and balanced salt solution group (BSS, n = 8, 0.05 ml intravitreally). Clinical examination scores were recorded, and vitreous aspirates were obtained for microbiological analysis on days 0, 1, 2, 3 and 4. Rabbits were sacrificed, and the eyes were enucleated for histopathological assessment. Results: There was no difference between the DAP, VAN and BSS groups in terms of the clinical grading of endophthalmitis 24 h after the inoculation. The bacterial counts were similar between the VAN and DAP groups except on day 1, where it was significantly lower than those in the VAN group (p = 0.003). On day 4, 62% of the eyes treated with DAP, and 50% of the eyes treated with VAN were sterilized. All of the eyes from the BSS group showed increasing bacterial growth from day 0 to day 4. There was no difference between the DAP and VAN groups in terms of the histopathological and clinical examination scores, while they were significantly lower than those in the BSS group. Conclusions: This study demonstrates evidence of the effectiveness of DAP for the treatment of experimental E. faecalis endophthalmitis.Öğe Diagnostic clues for spondylitis in acute brucellosis(Saudi Med J, 2014) Aktug-Demir, Nazlim; Kolgelier, Servet; Ozcimen, Serap; Sumer, Sua; Demir, Lutfi S.; Inkaya, Ahmet C.Objectives: To determine the diagnostic factors for brucellar spondylitis. Methods: This retrospective study included 227 consecutive brucellosis patients admitted to the Infectious Diseases and Clinical Microbiology clinics of Adiyaman State Hospital and Adiyaman 82nd Year State Hospital, Adiyaman, Turkey between January 2010 and December 2012. Acute brucellosis was diagnosed by standard tube agglutination test, and/or growth of Brucella spp. in appropriately prepared culture media (Bactec). Brucellar spondylitis was diagnosed and followed-up with contrast-enhanced magnetic resonance imaging. Results: Among the 227 brucellosis patients included, 88 (38.8%) were male, and 139 (61.2%) were female. Brucellar spondylitis was detected in 54 patients (23.7%). Brucellar spondylitis patients had higher mean age, higher fever, and higher blood culture positivity rate when compared with brucellosis patients (p=0.001, p=0.001, and p=0.001). Logistical regression analysis determined that male gender (OR: 3.006), older age (OR: 1.025), erythrocyte sedimentation rate (ESR) (OR: 1.067), high fever at the time of admission (OR: 2.550), and positive blood cultures for Brucella spp. (OR: 4.003) values were independently associated with brucellar spondylitis. However, high C-reactive protein (CRP) levels (OR: 0.971) were not found as a risk factor for brucellar spondylitis. Conclusions: The results of this study shows that the risk of developing brucellar spondylitis is high in patients with acute brucellosis, who are at advanced age, who have high fever, that have Brucella spp. growth in their blood culture that has a high ESR value, and who are male.Öğe Evaluation of the Relation Between Hepatic Fibrosis and Basic Laboratory Parameters in Patients With Chronic Hepatitis B Fibrosis and Basic Laboratory Parameters(Kowsar Publ, 2014) Demir, Nazlim Aktug; Kolgelier, Servet; Ozcimen, Serap; Gungor, Gokhan; Sumer, Sua; Demir, Lutfi Saltuk; Inkaya, Ahmet CagkanBackground: The hepatitis B virus is an important healthcare problem. According to current clinical practice, a liver biopsy is required for the diagnosis and treatment of chronic liver disease. However, a liver biopsy is an invasive, inconvenient procedure, which requires an expert pathologist opinion. Therefore requirement of biochemical tests, which are considered to indicate hepatic fibrosis and may be repeated easily, increases gradually today. Objectives: This study evaluated the correlation between hepatic fibrosis and routine laboratory values in patients with chronic hepatitis B. Patients and Methods: The files of 456 patients with CHB (chronic hepatitis B) who were referred to the infectious diseases and clinical microbiology clinic between January 2009 and March 2012 were screened retrospectively. Liver biopsy samples were examined according to Ishak scoring. Laboratory parameters and histopathology reports were recorded, and correlations between the fibrosis grade and laboratory parameters were analyzed. Results: There were 320 male and 136 female patients, with a mean age 36.7 +/- 12.1 years. According to liver biopsy results, a low fibrosis score (stage 0-2) was detected in 281 patients (61.6%), and a high fibrosis score ( stage 3-5) was detected in 175 patients (38.4%). Patients with a high fibrosis score had significantly higher ALT (alanine amino transferase), AST (aspartate aminotransferase), and HBV-DNA values and a significantly lower platelet count compared with those with a low fibrosis score (P=0.001, 0.001, 0.025, and 0.001, respectively). A positive correlation was detected between the fibrosis score and age, BMI, HAI, ALT, and AST values, and a negative correlation was detected between the fibrosis score and albumin and platelet counts. In the regression analysis performed to evaluate the factors associated with high-stage fibrosis, fibrosis was determined to be associated with thrombosis, ALT, and gender. The results of the regression analysis demonstrated that the risk of fibrosis was 4.6 fold higher in men. Conclusions: According to the results obtained in our study, advanced age, higher BMI, AST, ALT, and HBV-DNA levels, and low albumin and platelet levels are correlated with advanced fibrosis in patients with CHB.Öğe Knowledge Level of Hepatitis B and its Prevalance in Policemen Working in Adiyaman(Modestum Ltd, 2015) Kolgelier, Servet; Demir, Nazlim Aktug; Demir, Lutfi Saltuk; Ozcimen, Serap; Inkaya, Ahmet CagkanAim of this study to investigate the level of knowledge about hepatitis B and prevalence of HBsAg carriage in police and other security staff. Hepatitis B knowledge of police and other staff working for Adiyaman police department were measured using a questionnaire. This questionnaire was prepared after a literature search and was applied to 683 subjects before an education seminar. Fully and regularly filled 437 questionnaires were selected for evaluation. HBsAg and Anti HBs values of subjects were measured. Data were recorded to SPSS 16.0 package program. Chi square test was used for data analyses. Of all the study subjects 406 (92.9%) were males and 31 (7.1%) were females. Three hundred sixty subjects (82.3%) were police staff, 60 (13.7%) were public serveants, 15 (3.4%) were commissaries and 2 (0.05%) were nightmen. Mean age was 34.5 +/- 7. Fifty four subjects gave correct answers to the question about transmission ways of hepatitis B. Three hundred eighty four subjects didn't have enough knowledge about transmission ways of this virus. HBsAg positivity was detected in 34 (7.7%) subjects. Three hundred twenty five (51,4%) subjects had adequate antibody level for immunity. As a result, we detected that knowledge level was inadequate and increased risk for infection in this profession. It was concluded that security staff should be educated regarding risks and screened for bloodborne diseases.Öğe Role of Neopterin in Determining the Efficacy of Interferon Therapy in Chronic Hepatitis B and C(Modestum Ltd, 2015) Ozcimen, Serap; Bitirgen, Mehmet; Kandemir, BaharNeopterin (NP) is a pteridine derivative that is secreted as a response to gamma interferon stimulation. The purpose in this study was to investigate the relationship between the NP levels and the disease and determining the efficacy of an interferon (IFN) therapy in patients with chronic hepatitis B (CHB) and C (CHC). The study was conducted on 49 cases with CHB, 30 cases with CHC and 72 healthy individuals. Serum samples were taken from the patients receiving treatment at the beginning and at the end of the treatment and only once from the healthy individuals in the control group. The NP levels were found significantly higher in the patients with CHB and CHC than those in the control group. When the pre and post-treatment serum NP levels of the patients who received an interferon therapy were compared, the post-treatment NP levels of the patients who responded to the treatment were significantly higher. When a comparison was made before and after treatment, a decrease was seen in the NP levels in most of the infections due to decreased activation of the immune system. However, when the disease was treated with an IFN therapy, which is a treatment stimulating the immune system, the post-treatment NP level remained high.Öğe Role of Neopterin in Determining the Efficacy of Interferon Therapy in Chronic Hepatitis B and C(Modestum Ltd, 2015) Ozcimen, Serap; Bitirgen, Mehmet; Kandemir, BaharNeopterin (NP) is a pteridine derivative that is secreted as a response to gamma interferon stimulation. The purpose in this study was to investigate the relationship between the NP levels and the disease and determining the efficacy of an interferon (IFN) therapy in patients with chronic hepatitis B (CHB) and C (CHC). The study was conducted on 49 cases with CHB, 30 cases with CHC and 72 healthy individuals. Serum samples were taken from the patients receiving treatment at the beginning and at the end of the treatment and only once from the healthy individuals in the control group. The NP levels were found significantly higher in the patients with CHB and CHC than those in the control group. When the pre and post-treatment serum NP levels of the patients who received an interferon therapy were compared, the post-treatment NP levels of the patients who responded to the treatment were significantly higher. When a comparison was made before and after treatment, a decrease was seen in the NP levels in most of the infections due to decreased activation of the immune system. However, when the disease was treated with an IFN therapy, which is a treatment stimulating the immune system, the post-treatment NP level remained high.Öğe Serum Levels of Annexin A2 as a Candidate Biomarker for Hepatic Fibrosis in Patients With Chronic Hepatitis B(Kowsar Publ, 2015) Kolgelier, Servet; Demir, Nazlim Aktug; Inkaya, Ahmet Cagkan; Sumer, Sua; Ozcimen, Serap; Demir, Lutfi Saltuk; Pehlivan, Fatma SeherBackground: Hepatologists have studied serologic markers of liver injury for decades. Annexins are a prominent group of such markers and annexin A2 (AnxA2) is one of the best characterized annexins. AnxA2 inhibits HBV polymerase among other functions. Its expression is up-regulated in regenerative hepatocytes. Objectives: To determine if serum AnxA2 level has a role in estimating liver damage in chronic HBV infection and investigate whether AnxA2 levels correlate with hepatic fibrosis. Patients and Methods: This study included 173 patients with chronic hepatitis B (CHB) and 51 healthy controls. Liver fibrosis was graded histologically on liver biopsy samples. Blood samples were taken from patients during biopsy and serum AnxA2 levels were measured with ELISA. Results: In a group of adult patients with CHB, AnxA2 values were far higher than those of the control group (P = 0.001). When we assessed AnxA2 levels based on fibrosis stages, serum AnxA2 levels of patients with early stage fibrosis (stages 1 - 3) were significantly higher than those of patients with advanced stage fibrosis (stages 4 - 5; P = 0.001). Conclusions: AnxA2 is a useful biomarker for early stage fibrosis in patients with CHB.
