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    Evaluation of management of postpneumonic empyema thoracis in children
    (Lippincott Williams & Wilkins, 2013) Sahin, Atalay; Meteroglu, Fatih; Eren, Sevval; Eren, Canan; Celik, Yusuf
    Background Empyema is a well-known sequelae of pneumonia, which is increasingly being reported in children despite strict management. The appropriate management remains controversial. The aim of this study was to evaluate different management options of postpneumonic empyema in children. Materials and methods A total of 330 patients were reviewed between 2002 and 2012; their ages ranged from 1.25 to 15 years, with a median age of 4.3 years. The various management procedures included thoracentesis (n=11), chest tube drainage (n=229), chest tube drainage with intrapleural fibrinolytic therapy (n=117), video-assisted thoracoscopic surgery (VATS) (n=35), and thoracotomy because of a trapped lung noted on admissions and failed procedures (n=94). Results Variable success rates were noted as follows: tube thoracotomy (48.24%), fibrinolytic treatment (68.37%), and VATS (85.71%). Postoperative complications (11.14%) included wound infection (n=10), atelectasis (n=18), delayed expansion (n=7), and need for reoperation (n=2). Four patients died (1.21%), two of them following thoracotomy, one patient after fibrinolysis, and one patient following VATS. Patients treated with thoracotomy recovered completely. Conclusion New therapeutic modalities had variable success rates in children with postpneumonic empyema. Thoracotomy is still needed as a last resort for cases unresponsive to chemical fibrinolysis and following failed thoracoscopy. (C) 2013 Annals of Pediatric Surgery.
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    Farklı gruplardaki immün-süprese bireylerde Cryptosporidium'un ELISA ve Modifiye asit-fast boyama yöntemi ile araştırılması
    (2016) Eren, Canan; Mete, Ömer
    GİRİŞ VE AMAÇ: Gastroenterit etkenlerinden birisi de, özellikle çocuklarda ve immunitesi yetersiz hastalarda etkili olan Cryptosporidium cinsi protozoonlardır. Klora dirençli olması, içme suyu süzgeçlerinden geçebilmesi dolayısıyla parazitin kaynak sularındaki prevalansının yüksek olması ve çok az sayıda parazitin bile enfeksiyona neden olabilmesi su kaynaklı epidemilerin nedenleri olarak gösterilmektedir. Bu çalışmada, Diyarbakır, Dicle Üniversitesi Tıp Fakültesi Araştırma Hastanesi, Tıbbi Mikrobiyoloji Anabilim Dalı Laboratuvarı'na; risk grubundaki immunsuprese hastalardan (Onkoloji ve diyaliz hastaları, malnütrisyonlu çocuklar) ve ishal şikâyeti nedeniyle, farklı yaş grubundaki non immunsuprese hastalardan gönderilen dışkılarda, Cryptosporidium sp. antijenleri ELISA yöntemiyle araştırılmış ve modifiye asit-fast boyama yöntemiyle Cryptosporidium ookistleri aranmıştır. MATERYAL VE METOD: Çalışmada; onkoloji (n=156), diyaliz (n=98) ve malnütrüsyonlu çocuklardan (n=21) oluşan toplam 275 immunsüprese hasta ve non-immunsuprese ancak gastroenterit şikayeti ile laboratuarımıza gönderilen gastroenteroloji hastaları (n=22) ve pediatri hastaları (n=178) olmak üzere 200 hastadan alınan dışkı örnekleri çalışıldı. Ayrıca farklı kliniklerden gönderilen, ishal şikayeti olmayan non-immunsuprese 55 hasta dışkı örneği kontrol grubu olarak çalışmaya dahil edildi. Dört farklı yaş grubundan oluşan toplam 530 hastadan alınan dışkı örnekleri çalışıldı. Çalışmada, 1. grup 0-5 yaş , 2. grup 6-15 yaş ,3. grup 16-40 yaş, 4. grup 40 yaş üstü kişilerden oluşturuldu. Makroskobik olarakta incelenen her dışkı örneğine lam-lamel arası preparasyon, modifiye asit-fast boyası ile boyama yapılarak Cryptosporodium ve diğer barsak parazitleri açısından incelendi. Ayrıca dışkı örneklerinde Prospect Cryptosporidium ELISA kiti (OXOID) ile Cryptosporidium sp. antijenleri arandı. BULGULAR VE SONUÇ: Çalışmada, toplam 530 dışkı örneğinin 17'sinde %(3. 2) modifiye asit-fast boyama yöntemi ile Cryptosporidium ookistleri saptandı. Cryptosporidium ookistleri en fazla immün süprese bireylerde tespit edildi (%70. 5). 530 dışkı örneğinin ELISA yöntemi ile yapılan çalışmasında toplam 31(%5. 8) hastanın dışkısında Cryptosporidium sp. antijeni tespit edildi. ELISA yöntemi ile, 40 yaş üstü immün süprese hastalar, asit-fast boyama yönteminde olduğu gibi Cryptosporidium ' un en fazla pozitif olduğu hastalardı. Modifiye asit-fast boyama yönteminin duyarlılığı %54. 83, Özgüllüğü %100; ELISA yönteminin duyarlılığı %100, Özgüllüğü de %100 olarak bulundu. Nativ- lugol preparasyon yöntemiyle örneklerin 61'inde (% 11,5) çeşitli protozoon kistleri ve 3'ünde de (%0. 5) Hymenolepis nana yumurtaları görüldü. En fazla parazit saptanan grup pediatri grubu idi. Sonuç olarak hem immun süprese hastalarda hem de gastroenterit şikayeti ile gelen normal hastalarda Cryptosporidiumun da araştırılması ve boyama yönteminin negatif olduğu durumlarda ELISA gibi ikinci bir yöntemin rutinde kullanılmasının uygun olacağı kanaatine varıldı. Anahtar Kelimeler: Crptosporodium ,immunsuprese,Modifiye asit-fast boyama,ELISA
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    Giant hydatid cysts of the lung: Analysis and surgical outcome of 67 cases
    (Medknow Publications & Media Pvt Ltd, 2013) Meteroglu, Fatih; Sahin, Atalay; Eren, Sevval; Eren, Canan
    Aims: We aimed to evaluate the results of surgical treatment of huge hydatid cysts diagnosed at our clinic. Ruptured cysts have caused severe complications. Perforation of very large cysts is always possible. These can result in fatal complications. We present our surgical experience with large hydatid cysts in this paper. Materials and Methods: We retrospectively reviewed 191 patients diagnosed as hydatid cysts who were treated surgically. Among these, 67 cases were studied with a dimension of 10 cm or more. Age, gender, symptom, ruptured or intact, dimension, quantity and radiologic findings of the cases were determined. Incipiency of complaint, postoperative morbidity and length of hospital stay for all cases were assessed. Results: The cases comprised 41 females and 26 males. The mean age was 20.20 +/- 16.13 (5-52) years. Hospital stay for the huge and ruptured cysts group was 11.21 +/- 4.04 days. The huge but unruptured cysts group had a hospital stay of 8.40 +/- 2.48 days. All patients underwent thoracotomy. Cystotomy plus capitonnage in 52 (77.61%), decortication in addition to cystotomy plus capitonage in seven (10.6%), cystotomy in six (8.6%), cystotomy plus enucleation in one and primer closure in one were carried out. Postoperative mortality was absent; however, 17 cases were complicated; atelectasis was found in five cases, prolonged air leakage in five cases, apical aseptic pleural space in three cases, empyema in two cases, hemopthisis in one case and diaphragmatic elevation in one. Conclusions: Immediate surgery is of choice in giant cysts. Possibility of complication and longer stay in the ruptured group is higher compared with simple cystic disease.
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    Investigation of the Cryptosporidium in Immune Suppressed Individuals by Using Modified Acid-Fast Stainnig and ELISA Methods
    (Ortadogu Ad Pres & Publ Co, 2012) Eren, Canan; Mete, Omer; Akpolat, Nezahat; Cicek, Mutallip
    Objective: Cryptosporidium sp. is a protozoon and one of the causes of gastroenteritis. Since it is resistant to chlorine and passes through the filters of the drinking water, it has a high prevalence in the water sources and it may cause water-borne epidemics due to its ability to cause infection even with only a few numbers of parasites. In this study, in Medical Microbiology Department Laboratory it was aimed to investigate Cryptosporidium antigens in the stools of immunocompromised patients who were in the risk group and in the stools of immunocompetent patients who were in different age groups and had diarrhea. In this study. Cryptosporidium sp. antigens were investigated by ELISA method and Cryptosporidium oocysts were searched for with modified acid-fast staining. The sensitivity and specificity of the methods used in the study were investigated. Material and Methods: In this study, fecal samples of 275 immunocompromised patients from oncology (n=156) and dialysis (n=98) departments as well as children with malnutrition (n=21) and fecal samples of 200 immunocompetent patients with the complaints of gastroenteritis from gastroenterology (n=22) and pediatrics departments (n=178) were studied. Stool samples of 55 immunocompetent patients without diarrhea from different clinics were enrolled as the control group in the study. Stool samples of each patient was prepared for macroscopic solid-la-mella preparation and stained with modified acid-fast stain and examined for Cryptosporidium and other intestinal parasites. In addition, Cryprosporidium sp. antigens were investigated with Prospect Cryptosporidium stool ELISA kit (OXOID). Results: In this study, Cryptosporidium sp. oocysts were detected using modified acid-fast staining in 17 (3.2%) and Cryptosporidium sp. antigen was detected in stools of 31 (5.8%) patients by using ELISA method among 530 stool samples. Most of the patients in whom Cryprosporidium sp. detected were immunosuppressed and older than 40 years. The sensitivity of modified acid-fast staining method was 54.83% and its specificity was 100% while both sensitivity and specificity of the ELISA method were detected as 100%. A variety of protozoan cysts were detected in 61(11.5%) and Hymenolepis nana eggs were detected in 3 (0.5%) of the samples by using Native-Lugol preparation. Conclusion: ELISA method together with modified acid fast staining would be suitable for routine use to investigate Cryptosporidium in immunosuppressed patients and also in normal patients suffering from gastroenteritis.