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Öğe Acute abdomen caused by brucellar hepatic abscess(Elsevier Singapore Pte Ltd, 2007) Ibis, Cem; Sezer, Atakan; Batman, Alli K.; Baydar, Serkan; Eker, Alper; Unlu, Ercument; Kuloglu, FigenBrucellosis is a zoonotic infection that is transmitted from animals to humans by ingestion of infected food products, direct contact with an infected animal, or aerosol inhalation. The disease is endemic in many countries, including the Mediterranean basin, the Middle East, India, Mexico, Central and South America and, central and southwest Asia. Human brucellosis is a systemic infection with a wide clinical spectrum. Although hepatic involvement is very common during the course of chronic brucellosis, hepatic abscess is a very rare complication of Brucella infection. We present a case of hepatic abscess caused by Brucella, which resembled the clinical presentation of surgical acute abdomen.Öğe Community-Based Seroepidemiology of Diphtheria and Tetanus in Edirne, Turkey(Natl Inst Infectious Diseases, 2009) Tansel, Ozlem; Ekuklu, Galip; Eker, Alper; Kunduracilar, Hakan; Yulugkural, Zerrin; Yuksel, PelinThe aim of this study was to evaluate the seroprevalence and correlates of diphtheria and tetanus in Edirne, Turkey. Tetanus and diphtheria antitoxin levels were determined by enzyme-linked immunosorbent assay. Among 99 participants, a diphtheria antitoxin level of >= 0.1 IU/mL was found in 97 (98%), while 2 (2%) had antitoxin levels of 0.011-0.099 IU/mL. The geometric mean titers (GMTs) in men were statistically higher. Among 295 participants, a tetanus antitoxin level of >= 0.1 IU/mL was found in 291 (98.6%), while 4 (1.4%) had antitoxin levels of 0.011-0.099 IU/mL. Participants who had completed secondary school or higher education showed higher GMT values. Additionally, participants vaccinated within the previous 5 years had higher GMT values and the percentage of participants who had completed secondary school or higher education was higher among them. GMTs decrease with increasing age and increase as the poverty index increases. The average socioeconomic status index of the participants was high for both diphtheria and tetanus seroepidemiology. In this community-based study, antitoxin levels of diphtheria and tetanus were high. However, revaccination of adults with tetanus-diphtheria toxoids at every opportunity (military service, pregnancy, post-injury prophylaxis, etc.) together with a single booster every 10 years should be considered as an immunization policy.Öğe Edirne'de erişkinlerde hepatit E virus enfeksiyonu epidemiyolojisi(2009) Eker, Alper; Tansel, Özlem; Kunduracılar, Hakan; Tokuç, Burcu; Yuluğkural, Zerrin; Mayda, Pelin YükselHepatit E virusu (HEV), asemptomatik seyirden gebe kadınlarda sıklıkla görülen fulminant hepatite kadar değişen klinik tablolara neden olabilmektedir. Hepatit E epidemilerinin çoğu kirli su kaynaklıdır ve virus fekal-oral yolla bulaşmaktadır. Yaygınlığı, toplumun sosyoekonomik düzeyi ile yakından ilişkilidir. Edirne'de ilk kez yapılan bu toplum tabanlı çalışmada, il merkezinde HEV seroprevalansının ve risk faktörlerinin saptanması amaçlanmıştır. Çalışmaya, Edirne il merkezinden nüfusu yansıtacak şekilde seçilen 15 yaş üzeri 582 kişi (273 erkek, 309 kadın) alınmış ve bu bireylerin serumlarında HEV IgC antikorları EUSA yöntemiyle araştırılmıştır. Çalışmamızda 3'ü erkek 11'i kadın olmak üzere toplam 14 kişide HEV-lgG antikor pozitifliği bulunmuş ve ilimiz için HEV seroprevalansı %2.4 olarak saptanmıştır. Seropozitif olan olguların yaş ortalaması 50.9 ± 16.8 yıl iken, seronegatif grubun yaş ortalaması 40.7 ± 16.9 yıl olarak belirlenmiş ve bu fark istatistiksel olarak anlamlı bulunmuştur (p= 0.027). Bu durumun, ilimizde su temini ve çevre sanitasyon koşullarının Türkiye'nin diğer bölgelerine göre daha iyi olması nedeniyle HEV sero- pozitifliğinin ileri yaşlara kaymasından kaynaklandığı düşünülmüştür. Seropozitif ve seronegatif olgular arasında sosyoekonomik düzey açısından anlamlı bir fark gözlenmemiş ve her iki grubun da yüksek sosyoekonomik düzeyde olduğu izlenmiştir. Risk faktörlerinin analizi sonünda; sebze ve meyvelerin yıkanmadan tüketilmesi (p= 0.015), yaşanılan evin betonarme olmaması (p= 0.044) ve hayvancılık ile uğraş (p= 0.046), seropozitif grupta istatistiksel olarak anlamlı düzeyde yüksek saptanmış, diğer faktörler (evde ya¬şayan kişi sayısı, hanede şebeke suyunun ya da kanalizasyonun olmaması, tuvaletin hane dışında olması, el yıkama alışkanlığının olmaması, ortak eşya kullanımı, çiğ sebze tüketimi, kan transfüzyonu, tıbbi operasyon, diş tedavisi, sarılık geçirme, sarılıklı kişi ile temas, düşük/ölü doğum, şüpheli cinsel ilişki öyküsü) için gruplar arasında anlamlı bir fark belirlenmemiştir (hepsi için p> 0.05). Edirne'de saptanan HEV sero- pozitiflik oranı (%2.4), ülke ortalamasından (yaklaşık %6) düşük bulunmuş olup, ülkemizin batı illerinden bildirilen sonuçlarla uyumludur. Sonuç%olarak, sebze/meyveyi yıkamadan tüketme alışkanlığı olanlarda seropozitifliğin yüksek olması hijyen kurallarına bireysel olarak uyulmamasının HEV ile karşılaşmada önemli bir risk oluşturduğunu göstermekte, hayvancılıkla uğraşanlarda seropozitifliğin anlamlı olarak yüksek olması ise ilimizdeki sporadik olgularda, kontamine sularla bulaşma dışında da bulaşma yolları olabileceğini düşündürmektedir.Öğe Edirne'de erişkinlerde hepatit e virüs infeksiyonu epidemiyolojisi Hepatitis e virus epidemiology in adult population of edirne(2006) Eker, Alper; Tansel, ÖzlemÖZET Hepatit E virüsü, hepatit A virüsünden sonra fekal oral yolla bulaşan hepatitin en sık görülen ikinci sebebidir. Hepatit E virüsü, akut ve kendini sınırlayan hepatite neden olur. Hepatit E epidemilerinin çoğu kirli su kaynaklıdır. Hastalık asemptomatik seyirden fulminan hepatite kadar değişen klinik tablolara neden olabilir. Fulminan hepatit E daha sıklıkla gebe kadınlarda rapor edilmiştir. Yaygınlığı, ekonomik gelişme ile yakından ilişkilidir. Edirne, Türkiye'nin kuzeybatı sınırında yer alan bir il olup Trakya Bölgesi'nde yer almaktadır. Trakya Bölgesi'ndeki ilk çalışma özelliği taşıyan bu çalışmada Edirne il merkezindeki nüfusu yansıtacak şekilde seçilen 582 kişinin hepatit E virüs immunglobulin G antikor pozitifliği araştırılmıştır ve Hepatit E virüsü seropozitifliği %2.4 olarak bulunmuştur. Bu oran ülke ortalamasından oldukça düşük olup, ülkemizin batı illerinden bildirilen sonuçlarla uyumludur. Seropozitif olan olguların yaş ortalaması 50.86±16.76 olarak saptanırken, seronegatif grubun yaş ortalaması 40.70±16.92 olarak saptandı (p<0.05). Seropozitif olan 14 olgunun 4'ünün evi betonarme değildi. Seronegatif olan olgularla karşılaştırıldığında yaşanılan evin betonarme olmaması seropozitif grupta istatistiksel olarak anlamlı şekilde yüksekti (p<0.05). Seropozitif 4 olgunun hayvancılık ile uğraştığı belirlendi. Hayvancılık ile uğraşı seropozitiflerde istatistiksel olarak anlamlı bir şekilde yüksek bulundu (p<0.05). Seropozitif 14 olgunun 3'ü sebzeleri her zaman yıkamadığını belirtirken, bu durum Hepatit E virüsü için risk teşkil etti. Edirne'de su temini ve çevre sanitasyon koşullarının daha iyi olması nedeniyle Hepatit E virüsü seropozitifliği ileri yaşlara kaymıştır. Bununla birlikte sebze, meyveyi yıkamadan tüketme alışkanlığı olanlarda seropozitifliğin yüksek olması hijyen kurallarına bireysel olarak uyulmamasının hepatit E virüs infeksiyonuyla karşılaşmada önemli bir risk oluşturduğunu göstermektedir. Hayvancılıkla uğraşanlarda seropozitifliğin anlamlı olarak yüksek olması ise ilimizdeki sporadik vakalarda, kontamine sularla bulaşma dışında da bulaşma yolları olabileceğini düşündürmektedir. Anahtar Kelimeler: Seroprevalans, Risk faktörleri, Epidemiyoloji, Hepatit E virüsü.Öğe Evaluation of Patients with Acute Viral Hepatitis(Galenos Yayincilik, 2005) Eker, Alper; Tansel, Ozlem; Kuloglu, Figen; Akata, FilizThirty-eight patients with acute viral hepatitis were admitted to Trakya University Hospital from January 2001 to June 2004. These patients were evaluated according to their complaints, clinical findings and laboratory results, retrospectively. Twenty-one (55.3%) of the patients were acute viral hepatitis A; 17 (44.7%) were acute viral hepatitis B. In SPSS software, clinical findings were evaluated with Fisher's exact test and laboratory results were evaluated in independent groups with non parametric t-test. The symptoms of the patients were weakness (85.7%, 88.2%), jaundice (85.7%, 88.2%), anorexia (76.2%, 52.9%), nausea (76.2%, 64.7%), darkening of urine color (71.4%, 76.5%), vomitting (57.1%, 41.2%) in hepatitis A and B, respectively. the signs of the patients were icterus (95.2%, 100%), hepatomegaly (28.6%, 47.1%), splenomegaly (9.5%, 23.5%) in hepatitis A and B, respectively. The-re was no significant difference in clinical findings. The mean age was 21.5 in hepatitis A and 33 in hepatitis B. In hepatitis A, mean aspartate aminotransferase (AST) value was 1345 U/L and mean alanine aminotransferase (ALT) value was 1910 U/L; in hepatitis B mean AST value was 1475 U/L, mean ALT was 2445 U/L. The level of ALT in hepatitis B cases was significantly higher than hepatitis A. In hepatitis A, mean total bilirubin value was 5.9 mg/dL, direct bilirubin was 3.5 mg/dL. In hepatitis B, total bilirubin was found 11.4 mg/dL, direct bilirubin was 7.7 mg/dL. Bilirubin levels in hepatitis B cases were significiantly higher than hepatitis a cases. There was no significant difference between two groups in the other laboratory findings. Although ALT and bilirubin levels in hepatitis B is higher than hepatitis A, the etiology of acute viral hepatitis can not be determined with the initial clinical and laboratory results.Öğe Evaluation of Twelve Patients with Tuberculous Meningitis(Ortadogu Ad Pres & Publ Co, 2008) Eker, Alper; Tansel, Oezlem; Yuksel, Pelin; Celik, Ayguel DoganObjective: To assess the presentation, diagnosis and treatment of patients with tuberculous meningitis (TM). Material and Methods: Clinical and laboratory findings of 12 patients with TM, followed-up between 2000 and 2004, were evaluated retrospectively. Results: Seven male and five female patients were enrolled in this study. The mean age of the patients was 34.5 years. Culture of cerebrospinal fluid (CSF) in 10 cases revealed Mycobacterium tuberculosis. None of the CSF samples was positive for acid-fast bacteria (AFB) by Ehrlich-Ziehl-Neelsen (EZN) staining. M. tuberculosis was also isolated from the sputum sample of one patient. Isoniasid (INH) resistance was detected in two isolates. The most frequent finding on cranial computerized tomography (CT) and magnetic resonance imaging (MRI) was tuberculoma. Hydrocephalus was observed in 4 cases. Five patients had pulmonary lesions on chest radiographs. One patient had cavitation on the right upper zone, one patient had bilateral apical hyperdensity, and three patients had miliary involvement. Liver toxicity due to anti-tuberculosis drugs developed in 2 patients. Paradoxical enlargement of tuberculomas was detected during therapy in one case. Cranial MRI appeared to be more sensitive than CT in detecting intracranial lesions of four patients. Three patients died and neurological sequels developed in three patients. Conclusion: Early diagnosis and treatment is of major importance in TM, which is the most serious form of extrapulmonary tuberculosis. However, some problems such as drug toxicity and resistance, and occurrence of paradoxical response during follow up cause problems in treatment course.Öğe Hastane kökenli pnömonilerde etken tespitinin tedavi başarısına etkisi(2010) Edis, Ebru Çakır; Hatipoğlu, Osman Nuri; Yılman, İlker; Eker, Alper; Tansel, Özlem; Süt, NecdetAmaç: Bu çalışmada hastanemizde yoğun bakım dışında gelişen hastane kökenli pnömonili (HKP) olgularda etken tespit edilip edilememesinin, spesifik tedavi alıp alamamanın, erken veya geç uygun antibiyoterapi almanın tedavi başarısına olan etkilerini saptamayı amaçladık.Gereç ve Yöntem: 2005-2006 tarihleri arasında yoğun bakım dışında gelişen HKP nedeniyle prospektif olarak çalışmaya alınan ardışık 154 erişkin hastanın verileri çalışmanın amacına uygun bir şekilde analiz edildi. Etkenin tespit edilip edilememesinin, etkenin erken tespitinin, kültür antibiyogram sonucuna göre spesifik tedavi alıp alamamanın, başlangıçta uygun antibiyotik tedavisi almanın klinik başarı oranları ile ilişkisi x2 yöntemiyle karşılaştırıldı.Bulgular: Spesifik tedavi verilen grup (n=78) ile sadece ampirik tedavi verilebilen grup karşılaştırıldığında (n=76) klinik başarı oranları arasında anlamlı fark saptanmadı. Başlangıçta uygun antibiyoterapi verilen grup (n=42) ile etken tespit edildikten sonra kültür antibiyograma göre başlangıç tedavisi değiştirilen (n=36) grup karşılaştırıldığında klinik başarı oranları arasındaki fark anlamsız bulundu. Başlangıçta uygun antibiyoterapi verilen grup (n=42) ile diğer tüm hastalar karşılaştırıldığında da (n=112) klinik başarı oranları arasında fark anlamsız bulundu. Çalışmanın en ilginç sonucu ise etkenin tespit edilemediği grupta (n=66) tespit edilen gruba göre (n=88) tedavi başarısının anlamlı biçimde yüksek bulunmasıydı (p=0.022).Sonuç: Acinetobacter spp. ve Pseudomonas spp. gibi çok ilaca direnç potansiyeli taşıyan ve hızlı direnç geliştirebilme özelliğine sahip mikroorganizmalarla oluşan HKP'lerde spesifik tedavi verilse dahi klinik başarı oranları düşüktür. Bu sonuç, bu tip özelliklere sahip mikroorganizmalarla oluşacak enfeksiyonları önlemenin, tedaviden daha önemli olduğuna işaret etmektedir.Öğe HEPATITIS E VIRUS EPIDEMIOLOGY IN ADULT POPULATION IN EDIRNE PROVINCE, TURKEY(Ankara Microbiology Soc, 2009) Eker, Alper; Tansel, Oezlem; Kunduracilar, Hakan; Tokuc, Burcu; Yulugkural, Zerrin; Yusel, PelinHepatitis E virus (HEV) clinical presentations range from asymptomatic infection to fulminant hepatitis which is frequently seen in pregnant women. Epidemics due to HEV mostly originate from contaminated water and the virus is transmitted by fecal oral way. Its frequency is closely related to the socioeconomical status of the community. The aim of this first community-based study performed in Edirne province (located at Trace region of Turkey) was to determine the seroprevalence of HEV and the risk factors in the city center. Five hundred eighty two people (273 men, 309 women) over age 15 years, representing the population of Edirne city center were included in the study. Anti-HEV IgG antibodies were investigated in the serum samples by ELISA method. Anti-HEV antibodies were detected in a total of 14 cases (11 women, 3 men) and HEV infection prevalence was found to be 2.4%. The mean age of seropositive people was 50.86 +/- 16.76 years while it was 40.7 +/- 16.9 years in seronegative people (p= 0.027). This result was attributed to the better water supply and sanitation conditions in Edirne province in comparison to other parts of Turkey and shift of HEV seropositivity in older ages. No statistically significant difference was detected between seropositive and seronegative cases in terms of socioeconomical conditions, both groups being in high socioeconomical level. The analysis of the risk factors revealed that the rate of people living in houses built with materials other than reinforced concrete (p= 0.044), dealing with stockbreeding (p= 0.046) and consuming fruits and vegetables without proper washing (p= 0.015) were significantly higher in the seropositive group. No statistically significant difference was detected for the other risk factors such as the number of household, presence of city water supply and sewage system in the house, location of the water closet outside house, lack of hand-washing habits, sharing utensils, consumption of raw vegetables, history of blood transfusion, surgery, dental intervention, jaundice, contact with a case of hepatitis, abortion/stillbirth and suspicious sexual contact. While the HEV seropositivity rate (2.4%) detected in Edirne was lower than the average of Turkey (6%), it was similar to the results reported from western part of the country. High rates of seropositivity among people with individual incompatibility to the hygiene rules denotes that personal hygiene is an important factor for prevention from HEV infection. High rate of seropositivity among people dealing with stockbreeding also suggests that there may be different ways of HEV transmission other than contaminated water in sporadic cases.Öğe Hospital-Acquired Pneumonia Developed in Non-Intensive Care Units(Karger, 2009) Edis, Ebru Cakir; Hatipoglu, Osman N.; Yilmam, Ilker; Eker, Alper; Tansel, Ozlem; Sut, NecdetBackground: There are few studies about hospital-acquired pneumonia (HAP) developing in non-intensive care units (non-ICUs). Objectives: The aim of this study was to determine the incidence rate of non-ICU HAP, the risk factors associated with mortality and the survival rates of HAP patients at 6 weeks and 1 year. Patients and Methods: Between March 2005 and February 2006, 154 adult patients (97 males) with HAP were prospectively evaluated. Immunocompromised patients who were developing pneumonia were excluded from the study. The HAP incidence was calculated and survival was noted at 6 weeks and 1 year later. Kaplan-Meier methods were used for survival analysis; Cox regression was used to identify the risk factors associated with HAP-induced mortality. Results: During the study, and not counting those in the ICU, 45,679 adult patients were hospitalized. Of these, 154 patients developed HAP (incidence 3.3 cases/1,000 patients). The mean age of those developing HAP was 64.53 +/- 14.92 years (range 15-98). Survival rates at the 3rd, 7th, 14th, 42nd and 365th day were 91, 89, 69, 49 and 29%, respectively. Independent risk factors associated with 6-week mortality were: age [relative risk (RR) 1.026; 95% confidence interval (CI) 1.008-1.045], chronic renal failure RR 1.8; 95% CI 1.087-3.086), aspiration risk (RR 2.86; 95% CI 1.249-6.564), steroid use (RR 2.35; 95% CI 1.306-4.257), and multilobar infiltration (RR 2.1; 95% CI 1.102-4.113). Conclusion: HAP - even if it develops in non-ICU environments-is hard to treat and has a higher mortality rate. Copyright (C) 2009 S. Karger AG, BaselÖğe Hospital-acquired pneumonia in patients receiving immunosuppressive therapy(Galenos Publ House, 2010) Edis, Ebru Cakir; Hatipoglu, Osman Nuri; Yilmam, Ilker; Eker, Alper; Tansel, Ozlem; Sut, Necdet; Tekgunduz, EmreObjective: The aims of this study were to determine the clinical success rates, effect of neutropenia on treatment success rates, risk factors related to mortality, and survival in patients who developed hospital-acquired pneumonia (HAP) while receiving immunosuppressive therapy. Materials and Methods: Forty-three adult patients receiving immunosuppressive therapy who developed HAP were included in this prospective study. Transplantation patients and human immunodeficiency virus (HIV)-positive patients were not included. Antibiotic treatment was managed by a multidisciplinary team. The Kaplan Meier method was used for the survival analysis and Cox regression was used for the identification of mortality-related independent risk factors. The relationship between neutropenia and the clinical success rate was determined using the chi-square test. Results: Although anti-pseudomonal antibiotics were started empirically in 40 of the 43 patients (93%) at the beginning of the treatment, the most frequently isolated pathogens were Acinetobacter spp. and Escherichia coli. The success rate at the end of the treatment was 65.1%. The survival rates for the 3(rd), 14(th), 42(nd), and 365(th) days were 97%, 86%, 58%, and 19%, respectively. Elevated levels of urea [Hazard Ratio=1.01 (95% Cl: 1.00-1.02)] and blood glucose [HR=1.01 (95% Cl: 1.00-1.02)] were found to be independent risk factors affecting survival. The treatment success rate was higher in patients without neutropenia (n=23) than in those with neutropenia (n=20) (p=0.05). Conclusion: The treatment success rate was low in patients who developed HAP while receiving immunosuppressive therapy. (Turk J Hematol 2010; 27: 20-4)Öğe The Importance of Pathogen Identification in the Success of Treatment of Hospital Acquired Pneumonias(Aves, 2010) Edis, Ebru Cakir; Hatipoglu, Osman Nuri; Yilmam, Ilker; Eker, Alper; Tansel, Ozlem; Sut, NecdetObjective: The aim of this study was to determine the effects of identification of the pathogens and specific and appropriate treatments, and the success of these treatments for subjects who acquired HAP non-ICU. Material and Method: The analyzed data was obtained from the records of 154 consecutive HAP patients who acquired pneumonia non-ICU. We investigated whether the factor was identified, whether patients received a specific therapy according to the results of a culture antibiogram, and whether the patients received appropriate antibiotics therapy initially. Results: When the groups treated specifically (n=78) and empirically (n=76) were compared, there were no significant differences between the clinical success rates. The difference was not significant between the group given an appropriate antibiotherapy initially (n=42) and the group whose initial therapy was changed according to the culture antibiogram after the factor was found (n=36). When the group given appropriate initial antibiotherapy (n=42) was compared with all the other patients (n=112), the difference between the clinical success rates was not significant. The most remarkable result of the study was the success rate being significantly higher in the group in which the pathogen could not be identified (n=66) compared with the group in (n=88) which the pathogen was identified (p=0.022). Conclusion: The clinical success rate was low in microorganism-caused HAPs with a potential for drug resistance and having the characteristic of developing rapid resistance, such as Acinetobacter spp. and Pseudomonas spp, even though specific treatment was administered. These results indicate that the prevention of infections that occur with such microorganisms is more important than the treatment.Öğe A patient with brucellar cervical spondylodiscitis complicated by epidural abscess(Elsevier Sci Ltd, 2011) Eker, Alper; Uzunca, Ilkay; Tansel, Ozlem; Birtane, MuratBrucellar cervical spondylodiscitis and epidural abscess are serious medical conditions that can cause permanent neurological deficits. Fortunately, they are rare. We report a 34-year-old male patient, complaining of fever and neck pain and stiffness, with increased deep tendon reflexes. A lumbar puncture was normal. Brucella species organisms were isolated from blood cultures, and the Rose-Bengal test and the standard tube agglutination (STA) test were positive. The diagnosis was made on MRI. The patient was treated with doxycycline and rifampin daily for 16 weeks. On day 51 of treatment, the patient had no symptoms and his physical and neurological examinations were normal. His repeat cervical MRI was almost normal. The STA test was negative at week 20. It is important to consider brucellar cervical spondylodiscitis with epidural abscess in endemic regions. (C) 2010 Elsevier Ltd. All rights reserved.Öğe Seroepidemiology of Toxoplasmosis and the Theoretical Incidence of Congenital Toxoplasmosis in Women of Reproductive Age in Edirne, Turkey. A Community Based Study(Ortadogu Ad Pres & Publ Co, 2009) Tansel, Ozlem; Ekuklu, Galip; Kunduracilar, Hakan; Eker, Alper; Yulugkural, Zerrin; Yuksel, PelinObjective: The aims of this community-based study were to determine the seroprevalence of toxoplasmosis in women of reproductive age, to identify the risk factors, and to estimate theoretical incidence of congenital toxoplasmosis in Edirne city center. Material and Methods: Sera from 96 women representing the female population in the city center were tested for toxoplasma IgG antibody using the ELISA technique, For each participant, a questionnaire was completed to provide information on socio-demographic data, obstetrical history, and life style parameters. The relation between toxoplasma positivity and probable risk factors was investigated with chi-square and independent samples t test during statistical analysis. Results: The ages of the study population ranged from 15 to 49 years with a mean age of 31.2 years. 33 (34.4%) of 96 women were positive for toxoplasma IgG antibody. The mean age of women with seropositive samples was 34.2 +/- 10.4 years. The mean age of seronegative women was 29.7 +/- 9.2 years. Although the mean age was higher in seropositive women when compared with seronegative, the rates of seropositivity were not significantly different between age groups (p = 0.246). Toxoplasma seropositivity was 85.7% for women with high income and 100% for women with low income. This difference was statistically significant (p = 0.025). The other risk factors were not significantly different between seropositive and seronegative cases. The mean theoretical incidence of congenital toxoplasmosis was 0.7% in our study and it decreased from 1.3% to 0.2% as the person aged. Conclusion: Approximately two out of every three reproductive age women in Edirne city center is at risk of toxoplasmosis. The risk of congenital toxoplasmosis is higher for babies of women aged 15-24 years. These results underline the necessity of promoting preventive measures for toxoplasmosis in reproductive age women.Öğe Yoğun bakım dışı koşullarda takip edilen entübe hastalardaki ventilatör ilişkili pnömonilerin değerlendirilmesi(2010) Edis, Çakır Ebru; Hatipoğlu, Osman Nuri; Yılmaz, İlker; Eker, Alper; Tansel, Özlem; Süt, NecdetAralık 2006 tarihine kadar hastanemizde sadece 7 yatak kapasiteli, genellikle postoperatif hastaların izlendiği yoğun bakım ünitesi (YBÜ) mevcuttu. Yatak kapasitesi yetersiz olduğundan dolayı invaziv mekanik ventilasyon ihtiyacı olan hastalar servislerin içinde ideal olmayan koşullarda takip edilmekteydi. Biz bu çalışmada YBÜ dışında, ideal olmayan koşullarda servislerde takip edilmek zorunda kalan ventilatör ilişkili pnömonilerde (VIP) izole edilen etkenleri, tedavi başarısını ve sağkalım oranlarını saptamayı amaçladık.Biz bu çalışmada; YBÜ dışında servislerde invaziv mekanik ventilasyon uygulanan hastalarda geli- şen VIP'li ardışık 43 erişkin hastayı prospektif olarak değerlendirdik. Tüm hastalar tedavi başar ısı açısından Göğüs Hastalıkları, İnfeksiyon Hastalıkları ve hastadan sorumlu klinisyenden oluşan bir ekip tarafından izlendi. Hastaların yaşam sürelerinin analizinde Kaplan Meier yöntemi uygulandı.Bu hastalarda en sık izole edilen etken Acinetobacter spp. (n= 17) olarak saptandı. Tedavi sonu klinik başarı (kür+iyileşme) oranı %20.9 iken bu oran takip sonunda (altı hafta) %16.3'e geriledi. Kaplan Meier sürvi analizine göre 3,14, 42 ve 365. gün sürvi oranları sırasıyla %72, 34, 16, 11 olarak bulundu.VIP ide al yoğun bakım koşullarında yönetilse dahi mortalitesi yaklaşık %50'dir. Gerçek yoğun bakım koşulları dışında ise mortalite %80'lere yükselmektedir. İnvaziv mekanik ventilasyon gereksinimi olan hastalar mutlaka ideal yoğun bakım koşullarında yönetilmelidir.
