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Öğe A COMPARATIVE REVIEW OF PEDIATRIC AND ADULT PATIENTS WITH MILIARY TUBERCULOSIS(Modestum Ltd, 2007) Tanrikulu, Cetin; Gurkan, Fuat; Dagli, Canan Eren; Gozu, Ayfer; Suner, AliAim: Miliary tuberculosis (MTB) is a serious and rare form of tuberculosis. Studies comparatively reviewed children and adults with MTB are lacking. Methods: We retrospectively evaluated 56 pediatric and 26 adult MTB patients at a university hospital, between 1990 and 2003 Results: The median age at presentation was 3.5 years for children and 38 years for adults. Thirtyeight of all patients of whom 86.8% were children had family history of tuberculosis Presenting symptoms and signs of adult and pediatric patients were loss of weight (51.8% vs. 61.5%), anorexia (76.9% vs. 57.8%), dyspnea (12.5% vs. 57.8%), diarrhea/ vomiting (35.0% vs. 27.0%), fever (53.8% vs. 17.9%), hepatomegaly (30.8% vs. 51.8%), pulmonary crepitations (42.3% vs. 42.9) and cough (46.2% vs. 35.7%), respectively. The presenting symptoms/signs and laboratory abnormalities were generally more frequent in adults. Detected laboratory abnormalities were leukocytosis (73.2%), increased sedimentation rate ( 73.2%), anemia (52.4%), hypoalbuminemia (47.6%), elevated liver transaminases (36.6%), elevated lactate dehydrogenase (50.0%) and hyponatremia (25.6%) in whole study group. The diagnosis was proven microbiologically in 15 (18.3%) patients. Among 56 pediatric cases, there were 8 (14.3%) children with positive BCG scar and only 16 (28.6%) children with positive reaction to 5TU tuberculin test. Radiological findings of all patients, either on chest X-ray or high resolution computerized tomography, were characteristic for MTB. One fourth of patients had accompanying tuberculous meningitis. Predisposing factors for TB were found in 13 patients (15.9%). No patients had HIV infection. Overall 6 (7.3%) patients had died. Conclusion: High rate of history of family contact and low rate of BCG vaccination in our patients with MTB were significant public health problems. Identifying different features in children and adults may contribute to early diagnosis of MTB, which is highly relevant to its outcome.Öğe The importance of serum and fluid Vascular Endothelial Growth Factor (VEGF) level and fluid/serum VEGF ratio in the differential diagnosis of Malign Pleural Mesothelioma (MPM).(Amer Soc Clinical Oncology, 2016) Kaplan, Muhammet Ali; Duzkopru, Yakup; Ulku, Refik; Tanrikulu, Cetin; Kucukoner, Mehmet; Onat, Serdar; Abakay, Abdurrahman[Abstract Not Available]Öğe Microorganisms Isolated from Respiratory Intensive Care Unit and the Change of Antibiotic Resistance Status By Years And Its Effect On Mortality(Harran Üniversitesi, 2023) Turan, Hamdiye; Sezgi, Cengizhan; Abakay, Abdurrahman; Tanrikulu, CetinBACKGROUND: Intensive care units (ICU) are multidisciplinary departments where patients with life-threatening diseases, major surgical interventions, respiratory failure, coma condition, hemodynamic insufficiency, and ?1 organ failure are admitted for relevant diagnoses and treatment. AIM: The present study sought to investigate pathogens causing infections in patients admitted to our respiratory ICU and their antibiotic resistance patterns. MATERİALS and METHOD: The antibiogram results and clinical data of all patient samples submitted between January 1, 2008, and December 31, 2010, were retrospectively reviewed. RESULT: In total, 248 patients with 561 culture results were included in the study. Microbial growth was detected in the following samples: blood, 336 (59.9%); deep tracheal aspirate, 104 (18.6%); urine, 89 (15.9%); wound drain, 12 (2.1%); central venous catheter liquid, 7 (1.3%); phlegm, 10 (1.8%); Foley tip liquid, 1 (0.2%); and pleural effusion, and 1 (0.2%). Rapid growth was most frequently noted in the cultures of coagulase-negative staphylococci (25.3%), Acinetobacter spp. (23.1%), and Escherichia coli (12.6%). STATISTICAL ANALYSIS Descriptive statistics for continuous variables were expressed as means and standard deviations. The intermittent variables were converted into cross-tables and analyzed using Fisher’s exact and Pearson’s chi-square tests. The normal distribution of the study data was assessed using Kolmogorov–Smirnov test. The mean values of the variables were analyzed using Student’s t-test. Bidirectional hypotheses were used, and a p-value of <0.05 was considered statistically significant. The IBM Statistical Package for the Social Sciences Ver. 18.0 for Windows (SPSS Inc., Chicago, IL, USA) software was used for statistical analyses. IN CONCLUSION, the present study revealed microorganisms’ resistance profiles similar to those of other relevant studies. The study provides important insights into the selection of empiric antibiotic therapy for patients admitted in intensive care unit. Keywords: respiratory intensive care unit, intensive care infections, antibiotic resistance, antibiotic susceptibilityÖğe Pulmonary Langerhans' Cell Histiocytosis and Diabetes Insipidus: On the occasion of two cases(Aves, 2012) Sezgi, Cengizhan; Abakay, Abdurrahman; Tanrikulu, Cetin; Sen, Hatice Selimoglu; Senyigit, AbdurrahmanPulmonary Langerhans' cell histiocytosis (PLCH) is an uncommon interstitial lung disease with an unknown etiology in smokers. Disease is usually seen with isolated lung involvement and central nervous system involvement is rare. Two PLCH cases, with central diabetes insipidus (DI) determined at diagnosis in one of the cases and during follow-up in the other, is being presented in this report. The patients' ages were 39 and 24, respectively and they were both male patients with a history of smoking. Widely cystic lesions were viewed at high-resolution computed tomography scans (HRCT) and PLCH was detected at the biopsies obtained by video-assisted thoracoscopic surgery (VATS), in both two cases. Therapy was started with 0.5 mg/kg methyl prednisolone for latter case, because of impairment in pulmonary function tests during follow up. On control, after one month therapy, partial improvement was seen for PLCH and the therapy was continued up to 6 months. At the end of the therapy complete remission was seen and corticotherapy was stopped. Desmopressin was started for both cases at 0.1 mg/day, orally. After one month of treatment clinical improvement was observed during control.Öğe Tuberculosis screening results made at primary schools in Cizre(Turkish Assoc Tuberculosis & Thorax, 2006) Tanrikulu, Cetin; Abakay, Abdurrahman; Abakay, Ozlem; Alp, AdilTuberculosis (Tbc) gained importance as a public health problem in the recent years. The course of the disease is more severe in childhood. Tbc screening was made by The Tuberculosis Control 11th Group Presidency on the primary school students in Cizre, in November 2005. A total of 2242 children have been taken to this study. Of the children, 1130 (50.4%) were boys and 1112 (49.6%) were girls. The mean age of the children was 6.9 +/- 0.8 (range, 4-14) years. Concerning Bacillus Calmette- Guerin (BCG) vaccine scar, 1676 (74.7%) children had no scar, 536 children (23.9%) had single scar, and 32 children (1.4%) had double scar. The mean diameter of the tuberculin skin test (TST) was 2.1 +/- 2.7 mm. Regarding sexuality and TST mean diameter, statistically significant relation was not detected between girls and boys (p= 0.3). The mean diameter of TST were 1.5 +/- 1.4 mm, 3.5 +/- 4.0 mm and 11.2 +/- 3.3 mm in the children with no BCG scar, in those with single BCG scar, and in those with double BCG scar, respectively. Of the TST results of all children, 2065 (92.1%) were negative, 101 (4.5%) were attributed to BCG, and 76 (3.4%) were positive, respectively. The rate of positiveness of TST was 1.2% in the children with no BCG scar, 8.9% in the children with single BCG scar, and 50% in the children with double BCG scar, respectively. A statistically significant correlation between the increase in the BCG scar number and the increase in the TST mean diameter was detected (p< 0.05). Of the children who were likely to have Tbc, 139 (6.2%) were advised to apply at the dispensary. Single BCG vaccination was inadequate in the children. We suggest encouraging the families about postpartal single BCG vaccination. Furthermore, school screenings should be paid greater attention.
