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Öğe Acinetobacter baumannii suşlarında tigesiklin için disk difüzyon yöntemiyle elde edilen zon çaplarının iki farklı kritere göre değerlendirilmesi(Antibiyotik ve Kemoterapi Derneği, 2009) Gülhan, Barış; Nergiz, Şebnem; Meşe, Sevim; Özekinci, Tuncer; Atmaca, SelahattinÇalışmada disk difüzyon yöntemiyle 71 Acinetobacter baumannii suşunda alınan tigesiklin zon çapları iki farklı kritere göre değerlendirilmiş, bunun yanı sıra MİK değerlerine göre karbapenem dirençleri de araştırılmıştır. Tigesiklin için FDA’in Enterobacteriaceae için belirlediği disk difüzyon kriterleri (≥19 mm ve ≤14 mm) kullanıldığında 2 suş (% 3) dirençli, 35 suş (% 49) orta duyarlı, 34 suş (% 48) duyarlı olarak bulunmuş; Jones ve ark.’nın kriterleri olan ≥16 mm ve ≤12 mm kabul edildiğinde ise 1 suş (% 1) dirençli, 1 suş (% 1) orta duyarlı, 69 suş (% 97) ise duyarlı olarak bulunmuştur. Bölgemize ait Acinetobacter baumannii suşlarının % 56’sında imipenem, % 39’unda ise meropenem direnci saptanmıştır.Öğe Anti-HCV pozitif hemodiyaliz hastalarında hepatit G virus prevalansı(2015) Nergiz, ŞebnemHGV, 1995 yılında moleküler klonlama ile tanımlanmış, Flaviviridae ailesi içerisinde yer alan bir RNA virusudur. Tüm dünyada yaygın olarak bulunan HGV, temel olarak parenteral yolla bulaşır. Virus nedeni bilinmeyen hepatit olguları, kan aktarımı yapılan hastalar, damar içi uyuşturucu kullananlar ve hemodiyaliz tedavisi alan hastalarda yüksek sıklıkta saptanmaktadır. Bu çalışmada, Anti-HCV pozitif hemodiyaliz hastalarında HGV prevalansı araştırıldı. Bu amaçla Anti-HCV pozitif 100 hemodiyaliz hasta grubu, Anti-HCV negatif 50 hemodiyaliz hastadan oluşan kontrol grubuyla karşılaştırıldı. Çalışmamızda gerçek HGV prevalansının belirlenebilmesi için HGV RNA ve HGV Anti E2 antikor düzeyleri birlikte değerlendirildi. Anti-HCV pozitif grupta HGV RNA ve HGV Anti E2 oranları sırasıyla %30 ve %1 olarak bulundu. Gerçek prevalans %31 olarak değerlendirildi. Kontrol grubunda ise HGV RNA oranı %12 ve HGV Anti E2 oranı %2 olarak saptandı ve prevalans oranı %14 olarak bulundu. Anti-HCV pozitif hemodiyaliz hasta grubunda HGV prevalansı, Anti-HCV negatif kontrol grubuna göre anlamlı olarak yüksek bulundu (P=0.040). Ayrıca hemodiyalize giriş süresi, ALT düzeyi ve yaş faktörleriyle HGV prevalansı arasında anlamlı ilişki saptanmadı (P>0.05).Öğe “The association between HALP score and infection in acute ischemic stroke patients”(W.B. Saunders, 2024) Öztürk, Ünal; Nergiz, Şebnem; Öztürk, ÖnderBackground and purpose: Stroke-associated infection (SAI) is related to increased mortality in acute ischemic stroke (AIS) cases. The HALP index is used to evaluate nutrition and inflammation. Our research aimed to assess the relation between HALP scores and infection risk in AIS cases. Materials and methods: 132 cases of acute ischemic stroke were registered. 77 cases were male and 55 cases were female. The median age of the attending cases was 66 (35–104) years. Laboratory variables were assessed within 24 h after hospitalization in the neurology care unit. The HALP score is evaluated utilizing the formula “Hemoglobin (g/dL) × Albumin (g/dL) × Lymphocyte (/10^3/uL) / Platelet (/10^3/uL)”. Results: Cases were separated into two groups according to their corresponding HALP score. Group-1 cases have a low HALP score (HALP score ≤ 18227,93). Group-2 cases have a high HALP score (HALP score > 18227,93). 26 (19.6 %) cases were diagnosed with various infections after hospitalization in the neurology care unit. Urinary tract infections were frequent infection causes in AIS cases (13 cases, 50 %). Pneumonia was observed in 8 cases, making up 30 % of the total cases. Another infection was seen in 5 (20 %) of the cases. The frequently encountered bacteria were Escherichia coli ESBL + (n = 7, 27 %) and Staphylococcus aureus (n = 6, 23 %). The mortality ratio was higher in Group-1 cases than in Group-2 cases (34 % vs 7 %). Conclusions: This investigation has suggested a relationship between infection and HALP score in AIS patients.Öğe Boğaz kültürlerinden izole edilen A grubu beta hemolitik streptokokların penisilin ve eritromisine karşı duyarlılıkları(Dicle Üniversitesi Tıp Fakültesi, 2008) Gülhan, Barış; Meşe, Sevim; Bilek, Heval; Onur, Arzu; Nergiz, Şebnem; Gül, KadriBu çalışmada amacımız akut tonsillofarenjit tanısı alan hastaların boğaz kültürlerinden izole edilen A grubu beta hemolitik streptokokların antibiyotik duyarlılığını değerlendirmektir. 2006 yılı şubat ve haziran ayları arasında akut tonsillofarenjit tanısıyla gönderilen 334 hastanın boğaz kültürlerinden izole edilen 75 adet A grubu beta hemolitik streptokok suşunun penisilin ve eritromisine duyarlılıkları Kirby-Bauer disk diffüzyon yöntemi ile araştırılmıştır. Suşların tamamı penisiline karşı duyarlı bulunmuş, ancak eritromisine karşı %8 oranında direnç tespit edilmiştir.Öğe Çeşitli klinik örneklerden izole edilen metisiline dirençli koagülaz negatif stafilokoklarda fusidik asit direnci(Antibiyotik ve Kemoterapi Derneği, 2007) Nergiz, Şebnem; Özekinci, Tuncer; Gülhan, Barış; Meşe, Sevim; Atmaca, SelahattinOcak 2007-Temmuz 2007 tarihleri aras›nda çeflitli klinik örneklerden izole edilen metisiline dirençli koagülaz negatif stafilokok (MRKNS) sufllar›nda fusidik asit direncinin disk-difüzyon yöntemi ile araflt›r›lmas› amaçlanm›flt›r. Toplam 88 MRKNS suflunun 28’i (% 32) fusidik aside dirençli bulunmufltur. Bulunan direnç oran› ile MRKNS kökenlerinin yapt›¤› infeksiyonlarda fusidik asidin etkili bir antibiyotik olabilece¤i sonucuna var›lm›flt›r.Öğe The changes in Hoffbauer and syncytiotrophoblast cells in serious preeclampsia complicated with hellp syndrome (Ultrastructural and immunohistochemical study)(INESEG Yayıncılık, 2022) Nergiz, Yusuf; Nergiz, Şebnem; Aşır, Fırat; Deveci, Engin; Sak, Erdal; Evsen, Sıddık; Tunik, Selçuk; Şeker, UğurHELLP syndrome is a syndrome characterized by hemolytic anemia, increased liver enzymes, and thrombopenia and can be seen in 1% of all pregnancies, 10-20% of pregnancies with pain, preeclampsia, and eclampsia. HELLP syndrome usually develops in the third trimester and its pathogenesis is not clear. Human placental villus stroma contains macrophages called Hoffbauer cells (HC), which are thought to be involved in many processes. HC is also called placental macrophage and has a role in many placental events. This study aimed to evaluate the immunohistochemistry and ultrastructural of syncytiotrophoblast and Hoffbauer cells in the placental villi of HELLP syndrome patients. In our study, placental tissues obtained from human normal and HELLP syndrome pregnancies were prepared for light and transmission electron microscopy (TEM) studies. Immunohistochemistry techniques were applied to placenta sections. HC localizations were determined with CD68 (Hoffbauer cell marker). Fine structure properties of HC and syncytiotrophoblasts were examined by TEM. When the HELLP group fetal placental sections were examined under the light microscope, intracytoplasmic edema in syncytiotrophoblast, degenerative vacuoles, and degenerative findings on cell surface membranes were observed. Moreover, villous edema was remarkable. The increase in the number of Hoffbauer cells per villus in the HELLP group was statistically significant (p<0.00). Compared with the control group, there was a significant increase in the number of Hoffbauer cells and syncytiotrophoblast in HELLP group, and also degenerative changes were observed in the ultrastructural structure of these cells.Öğe The effect of prognostic nutritional index on infection in acute ischemic stroke patients(MDPI, 2023) Nergiz, Şebnem; Öztürk, ÜnalObjectives: Malnutrition is frequently seen in stroke patients. Malnutrition worsens the prognosis and increases the mortality rate in acute ischemic stroke patients. Malnutrition is a significant factor not only in the initiation of infection but also in its progression. The prognostic nutritional index (PNI) is a new index that evaluates the nutrition and inflammatory status. This study aims to investigate the relationship between PNI and stroke-related infection (SRI) development during hospitalization in patients with acute ischemic stroke. Materials and Methods: Acute ischemic stroke was the primary diagnosis for 158 patients who were admitted to the neurology intensive care unit. Patients’ demographic, clinical, and laboratory parameters were recorded. PNI was calculated according to the formula given below. PNI: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (mm3 ). PNI > 380 normal, PNI: 350–380 moderate malnutrition risk, PNI < 350 severe malnutrition risk. Results: A total of 158 patients with acute ischemic stroke were included in the study. There were 70 male and 88 female patients, whereas the mean age of the patients was 67.79 ± 14.0 years. Nosocomial infection developed in 34 (21%) of the patients. Compared to high PNI scores, patients with low PNI scores were generally older, and the National Institutes of Health Stroke Scale (NIHSS) score, atrial fibrillation, infection, mortality rate, and hospitalization rates were all significantly higher. Conclusions: In this study, we discovered that patients with poor PNI had a considerably increased rate of infection development. It is vital to evaluate the nutritional status of patients with acute ischemic stroke during hospitalization.Öğe The impact of prognostic nutritional index on mortality in patients with COVID-19(Emerald Publishing, 2023) Nergiz, Şebnem; Öztürk, ÖnderPurpose: Malnutrition has a significant effect on the onset and progression of infective pathology. The malnutrition status in COVID-19 cases are not understood well. Prognostic Nutritional Index (PNI) is a new and detailed assessment of nutrition and inflammation cases. This study aims to investigate the effect of PNI on mortality in COVID-19 patients. Design/methodology/approach: In total, 334 patients (males, 142; females, 192; 64.5 ± 12.3 years of age) with COVID-19 bronchopneumonia were enrolled in this investigation. Cases were divided into two groups with respect to survival (Group 1: survivor patients, Group 2: non-survivor patients). Demographic and laboratory variables of COVID-19 cases were recorded. Laboratory parameters were calculated from blood samples taken following hospital admission. PNI was calculated according to this formula: PNI = 5 * Lymphocyte count (109/L) + Albumin value (g/L). Findings: When the patients were assessed with respect to laboratory values, leukocytes, neutrophils, CRP, ferritin, creatinine and D-Dimer parameters were significantly lower in Group 1 patients than Group 2 patients. Nevertheless, serum potassium value, lymphocyte count, calcium and albumin values were significantly higher in Group 1 cases than in Group 2 cases. PNI value was significantly lower in Group 2 cases than in Group 1 cases (39.4 ± 3.7 vs 53.1 ± 4.6). Originality/value: In this retrospective study of COVID-19 cases, it can be suggested that PNI may be a significant risk factor for mortality. In conclusion of this research, high-risk patients with COVID-19 can be determined early, and suitable medical therapy can be begun in the early duration.Öğe Investigation of placental hofbauer cells byimmunohistochemistry methods in complicated pregnancies(International Engineering, Science and Education Group, 2021) Nergiz, Yusuf; Nergiz, Şebnem; Aşır, Fırat; Şahin, Ayşe; Ağaçayak, ElifDevelopment of the placenta without any complication is essential for normal pregnancy.The placenta is a multifunctional organ that plays a vital role in fetal development. Hofbauer cells areone of the most important groups of placental cells. These cells are placental macrophages and have arole in many placental events. The aim of this study is to investigate the placental distribution anddensity of Hofbauer cells and to contribute to the understanding of the causes and pathogenesis ofcomplicated pregnancies. In this study, 60 full-term placentas were divided into 4 equal groups: control,preeclampsia, gestational diabetes (GDM), and ( hemolysis, elevated liver enzymes, low platelet) HELLP group. The placenta was dissected and the samples were fixed 10% neutral buffered formalin.Following routine paraffin wax procedure, 5 µm sections were stained with CD68 for marking Hofbauercells. In immunohistochemical evaluation, Hofbauer cells in villous stroma showed positive CD68expression. Immunostaining Findings: CD68 showed a granular staining pattern in the cytoplasm ofHofbauer cells. The group with the highest CD68 positive cell number was HELLP group and thenumber of cells per cell (1.46 ± 0.25) was significantly different from all groups. CD68 positive cellcount in the placental villus was the highest in HELLP group and the number of Hofbauer cells pervillus was significantly different from the other groups.Öğe Kolesistektomi yapılan hastaların safra örneklerinin mikrobiyolojik değerlendirilmesi(Antibiyotik ve Kemoterapi Derneği, 2011) Nergiz, Şebnem; Akpolat, Nezahat; Gül, KadriKolesistektomi, genel cerrahi kliniklerinde uygulanan en yaygın gastrointestinal operasyonlardan biridir. Bu çalışmada akut veya kronik kolesistit nedeniyle kolesistektomi yapılan hastalardan alınan safra örneklerinde üreyen mikroorganizmaların saptanması ve antibiyotik duyarlılıklarının belirlenmesi amaçlanmıştır. Üreyen aerob bakterilerin identifikasyonu ve antibiyotik duyarlılıkları Phoenix (Becton Dickinson Diagnostic Instrument Systems, Spark, Md, USA) otomatize sisteminde; anaerob bakterilerin identifikasyonu ise mini API (bioMerioux-Fransa) sisteminde gerçekleştirilmiştir. İncelenen 108 safra örneğinin 36’sında (% 33) üreme saptanmıştır. Bu 36 örneğin 26’sında (% 72) Gram negatif çomaklar (12 Escherichia coli, 8 Klebsiella pneumoniae, 4 Pseudomonas aeruginosa, 2 Enterobacter cloacae); 8’inde (% 22) Gram pozitif koklar (4 koagülaz negatif stafilokok, 2 Enterococcus faecalis, 2 Staphylococcus aureus) ve 2’sinde (% 6) anaerob bakteri (Bacteroides fragilis) üremiştir. Hiçbir örnekte mantar ürememiş ve miks infeksiyon görülmemiştir. İzole edilen Gram negatif bakterilere karşı amikasin (% 100), Gram pozitif bakterilere karşı ise vankomisin (% 100) en etkili antibiyotikler olarak bulunmuştur. Kolesistektomi sırasında alınan örneklerin mikrobiyolojik incelenmesi, post-operatif gelişen infeksiyonların tanı ve tedavisini kolaylaştırmaktadır. Safra kültürünün değerlendirilmesi ve izole edilen etkene uygun antibiyotiğin başlanması tedavi süresini kısaltacaktır.Öğe Primary PCI in a patient with congenitally corrected transposition of the great arteries(Elsevier B.V., 2016) Öztürk, Önder; Öztürk, Ünal; Nergiz, Şebnem; Karahan, Mehmet Zülkif; 0000-0002-0166-9668Congenitally corrected transposition of the great arteries (CCTGA) is a rare disease in which there is both ventriculoarterial and atrioventricular discordance. The systemic ventricle is of right morphology and patients are at high risk of developing systemic ventricular dysfunction. We report on a 41 year old male patient with primary PCI and congenitally corrected transposition of the great arteries.Öğe Relationship between catheter related cerebrospinal fluid infections and systemic immune-inflammation index(PeerJ Inc., 2023) Nergiz, Şebnem; Öztürk, Pınar AydınBackground. This study investigated the relationship between the systemic immune inflammation index (SII) and catheter-related infections and their effects on prognosis in pediatric patients. Methods. A total of 56 pediatric patients diagnosed with ventriculoperitoneal (VP) shunt infection between January 2017 and October 2019 were included. V-P shunt infection diagnosis was made based on clinical findings. All cerebrospinal fluid (CSF) samples were subjected to direct microscopic examination and culture. Protein, glucose, and sodium levels in CSF, CSF leukocytes, and hematological and biochemical parameters were measured. Results. Fifty-six patients with growth in CSF culture were included in this study. 55.4% of the cases were female and 44.6% male. V-P shunt was detected in 82.1% of the cases and external ventricular drainage (EVD) catheter-related infection in 17.9%. The CSF/blood glucose ratio was significantly lower (p = 0.046), and SII was significantly increased (p = 0.002) in non-coagulase-negative staphylococci. Conclusions. Early and appropriate antibiotic therapy reduces morbidity and mortality in catheter-related infections. However, it is important to start empirical antibiotherapy until culture results are expected. Therefore, further research on the estimation of possible factors is needed.Öğe Relationship between systemic immune inflammation index and prognosis in patients with COVID-19(Dicle Üniversitesi Tıp Fakültesi, 2022) Nergiz, Şebnem; Öztürk, ÖnderObjectives: Inflammation and coagulation perform a substantial act in the pathophysiology of COVID-19 cases. The systemic immune-inflammation index (SII) is a novel prognosis and inflamation index. In this study, we aimed to research the relation between SII and prognosis in COVID-19 patients. Methods: 315 cases (males, 136 ; females, 179 ; 63.2 ± 11.4 years) with positive PCR and lung tomography evidences compatible with COVID-19 pneumonia were recorded in the research. Patients were separated into 2 groups according to the mortality (Group 1; Surviving patients, Group 2; Ex patients). Clinical, demographic, and laboratory datas for whole patients were registered Laboratory datas were measured from blood parameters taken during hospitalization. The SII was calculated as “ SII = neutrophil count × platelet count / lymphocyte count ”. Results: The mean hospital stay of the patients is 12 (5-26) days. When the patients were assessment of according to clinical features, an important distinction was found between the two groups according to age, gender, cardiovascular disease, chronic renal failure, neurolvascular disease, and diabetes mellitus. When the patients were evaluated according to laboratory parameters, white blood cells, neutrophils, creatinine, D-Dimer, ferritin, CRP values were observed to be significantly higher in Group 2 patients than Group-1 patients. However, lymphocyte count, serum potassium level, albumin and calcium levels were observed to be significantly lower in Group-2 patients than in Group-1 patients. SII level was significantly higher in Group 2 patients than Group-1 patients (1813.4 ±118.7 vs 978.2 ± 93.1, p<0.001). Conclusions: Our results suggested that a relation between a higher SII value and a death in COVID-19 patients. As a simple parameter, SII is a significantly estimating of death in COVID-19 patients.Öğe Severe preeclampsia complicated by HELLP syndrome alters the structure of Hofbauer and syncytiotrophoblast cells: ultrastructural and immunohistochemical study(Sciendo, 2023) Nergiz, Yusuf; Deveci, Engin; Sak, Erdal; Evsen, Sıddık; Tunik, Selçuk; Nergiz, Şebnem; Aşır, Fırat; Şeker, UğurBackground: Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is generally considered to be a variant or complication of preeclampsia. It is a life-threatening obstetric complication. Objectives: To evaluate the immunohistochemistry and ultrastructural of syncytiotrophoblastand Hoffbauer cells in placental villi of patients with HELLP syndrome. Methods: Two groups of patients with a total of 50 full-term human placentas (n = 25 in each group) were assigned as the control (normotensive) and HELLP syndrome. Placental tissue samples were fixed in 10% neutral formalin and paraffin-embedding protocol was performed. We prepared 5 μm sections for histological and immunohistochemical staining. Sections were immunostained with Hoffbauer cell marker CD68. For transmission electron microscopy (TEM), placental tissue samples were fixed in 2.5% buffered glutaraldehyde and then, in 1% osmium tetroxide for routine ultrastructural examinations. Results: When the HELLP group fetal placental sections were examined, intracytoplasmic edema in syncytiotrophoblast, degenerative vacuoles, and degenerative findings on cell surface membranes were observed. Moreover, villous edema was remarkable. The number of CD68-positive Hoffbauer cells per villus control group sections was 0.23 ± 0.02 and the number of CD68-positive cells per villus in HELLP group placenta sections was 0.83 ± 0.12. The increase in the number of Hoffbauer cells per villus in the HELLP group was significant (P < 0.001). Compared with the control group, there was a significant increase in the number of Hoffbauer cells and syncytiotrophoblasts in the HELLP group, and degenerative changes were also observed in the ultrastructure of these cells. Conclusions: Pathology of the HELLP syndrome is in relation to CD68-positive placental macrophages.
