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Item Antimicrobial activity of five endemic Asperula species from Turkey(Brieflands, 2009) Kalyoncu F.; Minareci E.; Minareci O.In this study, methanol and ether extracts of five endemic Asperula species (Rubiaceae) from Turkey (A. antalyensis, A. brevifolia, A. pseudochlorantha, A. purpurea subsp. apiculota and A. serotina), used in the traditional system of medicine, were tested for antimicrobial activity by the agar well diffusion method and the broth dilution method. The most active species were Asperula brevifolia and A. serotina which showed broad-spectrum antimicrobial activity against Gram-positive and Gram-negative bacteria and maximum inhibition was shown by methanol extract of A. antalyensis against Candida albicans as 32 mm. Methanol extracts of Asperula species were among the most active with the MIC values ranging from 7.6 to 14.8 mg/mL. Copyright © 2009 by School of Pharmacy Shaheed Beheshti University of Medical Sciences and Health Services.Item Activity of some plant extracts against multi-drug resistant human pathogens(Brieflands, 2009) Oskay M.; Oskay D.; Kalyoncu F.Plants used for traditional medicine contain a wide range of substances which can be used to treat various infectious diseases. Hence, antibacterial activities of ethanolic extracts of 19 plant species were studied against multi-drug resistant clinical isolates using agar well diffusion method. Extracts of Liquidambar orientalis, Vitis vinifera, Rosmarinus officinalis, Punica granatum, Cornus sanguinea, Euphorbia peplus, Ecballium elaterium, Inula viscosa and Liquidambar orientalis showed broad-spectrum antibacterial activity with inhibition zones ranging from 8 to 26 mm. The most resistant organisms were Escherichia coli (E. coli) (Ampicillin-, amoxycillin- and sulfamethoxazole- resistant), Stenotrophomonas maltophilia (S. maltophilia) (Amoxycillin- and nalidixic acid-resistant) and Klebsiella pneumoniae (K. pneumoniae) (Ampicillin-, amoxycillin- and aztreonarn-resistant), and the most susceptible species were Staphylococcus aureus (S. aureus) (Penicillin G- and oxacillin-resistant), Streptococcus pyogenes (S. pyogenes) (Penicillin G-, eiythromycin- and clindamycin-resistant) and Pseudomonas aeruginosa (P aeruginosa) (Sulfamethoxazole- and novobiocin-resistant), respectively. Minimum Inhibitory Concentrations (MIC) of crude extracts were determined for the seven highly active plants showing activity against methicillin resistant S. aureus (MRSA), E. coli, P aeruginosa, S. pneumoniae and the reference bacteria (E. coli ATCC 11229 and Kocuria rhizophila ATCC 9341 NA). MICs of active extracts ranged from 8 to 14.2 mg/mL against one or other test bacteria. Copyright © 2009 by School of Pharmacy Shaheed Beheshti University of Medical Sciences and Health Services.Item Pediatric ureteroceles: Diagnosis, management and treatment options(Brieflands, 2010) Günşar C.; Mir E.; Şencan A.; Ertan P.; Özcan C.U.Objective: The aim of the study was to evaluate clinical characteristics of ureteroceles particularly for diagnostic and treatment challenges. Methods: Data about patients treated for ureterocele in the two hospital clinics during 1996- 2009 are retrospectively evaluated. Findings: There were 12 girls and 7 boys. Symptomatic urinary tract infection was found in twelve cases. Ureterocele was associated with duplex systems in eleven cases. Vesicoureteral reflux was detected in 4 patients. Bladder diverticulum complicated with ureterocele in 1 patient. Ultrasonography diagnosed ureterocele in 12 patients. Renal scarring was detected in 6 patients at the side of ureterocele. Fifteen patients showed varying degrees of hydroureteronephrosis. Surgical therapy included upper pole nephrectomy in 3 cases. Bladder level reconstruction was performed in 11 cases. Five patients were treated only by endoscopic incision. In the follow up period 4 patients showed long term urinary tract infections whereas 3 of them were treated endoscopically. Postoperative reflux was still present in two patients who were treated by endoscopic incision. Conclusion: Ureterocele diagnosis and treatment show challenges. Urinary tract infection is important marker for urinary system evaluation. Preoperative management generally depends on a combination of diagnostic methods. Endoscopic incision needs serious follow up for postoperative problems. © 2010 by Pediatrics Center of Excellence.Item Association of fas -670a/g and fasl -843c/t gene polymorphisms on allograft nephropathy in pediatric renal transplant patients(Brieflands, 2010) Ertan P.; Mir S.; Ozkayin N.; Berdeli A.Objective: FAS and FASL polymorphisms are suggested to play an important role in tubulitis that is a major component of acute rejection. The aim of this study was to investigate the role of FAS-670A/G and FASL-843C/T gene polymorphisms on allograft nephropathy in pediatric renal transplant patients Methods: Fifty three patients (22 males 31 females) aged 2 to 20 years (mean 12.3±0.6) who had renal transplantation and fifty healthy control subjects (25 males 25 females) were enrolled in the study. Pearson's Chi Square test was used for the statistical analysis. Survival rates were estimated with the Kaplan Meier method. Age, sex, chronic renal failure etiology, treatment modality and duration and donor type were recorded. FAS-670A/G and FASL- 843C/T gene polymorphisms were compared between renal transplant patients and normal healthy population as well as between renal transplant patients with and without acute rejection. Findings: FAS-670A/G genotypes or alleles were not significantly different between control and transplant patients and among transplant patients with and without acute rejection (P>0.05 for all). FASL-843C/T genotypes and alleles were not different between transplantation and control groups (P>0.05 for all). However, FASL-843C/T alleles were significantly different between patients with and without AR (P=0.02). The percentages of Callele were higher in children with acute rejection (68.8% vs 44.6%). Conclusion: FASL gene polymorphisms may play a major role in acute rejection while FAS polymorphisms have not been found to be different between patients with and without acute renal graft rejection. © 2010 by Pediatrics Center of Excellence.Item Should a booster dose be administered in children after mass immunization for hepatitis B?(Brieflands, 2011) Tosun S.; Deveci S.; Kaplan Y.; Kasirga E.Background: Hepatitis B virus infection is a global health problem and vaccine-preventable disease, but the duration of the effects of HBV vaccination in infants is unknown. Objectives: The aim of this trial, which comprised children who had received 3 doses as part of the universal HBV immunization program and no additional doses, was to investigate anti-HBs titers and HBsAg status after 9 years. Patients and Methods: We performed a descriptive, cross-sectional field research study. The study sample, based on sociodemographics and minimum seroprevalence, was analyzed based on 10.00% ± 1.50 (95% confidence interval) (1150 individuals); trial was realized in a total of 1279 children (623 females and 656 males). Anti-HBs titers were measured by micro-EIA (Dia Sorin-Italy); titers < 10 IU/mL were negative, 10-49 IU/mL were low-positive, and > 50 IU/mL were high-positive. For anti-HBs titers below protective levels, HBsAg was measured by micro-EIA. Results: In approximately half of the children (48.5% in those living in semiurban areas and 42.3% in urban areas), antibody titers were below protective levels. Conclusions: Mass HBV vaccination, which was implemented in Turkey in 1998, significantly decreases HBsAg positivity in childhood. Nevertheless, it might be necessary to administer a booster dose after 8-9 years in children, especially those in low socioeconomic areas or in whom irregular/insufficient immunization is suspected. © 2011 Kowsar M.P.Co. All rights reserved.Item A case of henoch-schönlein purpura with P369S mutation in MEFV gene(Brieflands, 2011) Ertan P.; Tekin G.; Şahin G.E.; Kasirga E.; Taneli F.; Kandioǧlu A.R.; Sözeri B.Background: Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. HSP can affect multiple organs presenting with a characteristic rash in most of the patients. Familial Mediterranean Fever (FMF) is an inherited inflammatory disease common in mediterranean populations. HSP is the most common vasculitis seen in children with FMF. Case Presentation: A 16 year old boy was referred with history of abdominal pain lasting for 20 days. He was hospitalized and had appendectomy. Due to the persistence of his abdominal pain after surgery he was admitted to our hospital. His physical examination showed palpable purpuric rashes symmetrically distributed on lower extremities. Abdominal examination revealed periumbilical tenderness. Laboratory tests showed elevated erythrocyte sedimentation rate, C-reactive protein and fibrinogen. Urinalysis revealed microscopic hematuria and severe proteinuria. The fecal occult blood testing was positive. Based on these clinic findings, the patient was diagnosed as HSP with renal, gastrointestinal tract and skin involvement. We performed DNA analysis in our patient because he had diagnosis of vasculitis with severe symptoms and found that he was carrying heterozygote P369S mutation. Conclusion: Our case is noteworthy as it indicates that it may be important not to overlook presence of FMF mutations in patients with a diagnosis of severe vasculitis. © 2011 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved.Item Is there any relationship between hyperbilirubinemia and pelvicaliceal dilatation in newborn babies?(Brieflands, 2011) Akil T.; Avci M.; Ozturk C.; Akil I.; Kavukcu S.Objective: A recent study reported association of high bilirubin concentrations with decrease in basal vesical tonicity and relaxation of pre-contracted ureteral and vesical smooth muscles in vitro, and authors discussed that recovery of antenatal hydronephrosis might partly be associated with decreased bladder resistance to the urine flow due to hyperbilirubinemia. We aimed to investigate whether any relationship between serum bilirubin levels and antero-posterior renal pelvic diameters or pelvicaliceal dilatations exist during newborn period.Methods: Neonates with hyperbilirubinemia (group 1) and healthy neonates (group 2) were randomly selected to the study. Capillary blood samples were used to measure micro-bilirubin. Urinary system ultrasound (US) was performed in both groups by an experienced radiologist.Findings: Group 1 (31 neonates, 16 males, 15 females) and group 2 (22 neonates, 11 males, 11 females) were identical by means of postnatal age, gender and weight (P>0.05). Mean serum bilirubin levels were 11.1±3.1 mg/dl and 1.4±0.2 mg/dl in group 1 and 2, respectively. Renal length and renal pelvis antero-posterior (AP) diameters were not different between study groups. Pelvis AP diameters of right kidney were 2.1+0.7 mm in group 1 and 1.9+0.7 mm in group 2, and of left kidney were 2.4±0.8 mm in group 1 and 2.3±0.6 mm in group 2. There was no correlation between bilirubin levels and renal length and renal pelvis AP diameters (P>0.05).Conclusion: In this study we were not able to demonstrate any relationship between serum bilirubin levels and renal pelvic diameters and pelvicaliceal dilatation in hyperbilirubinemic neonates. So, it is thought that hyperbilirubinemia might not have a direct effect on outcome of the pelvicaliceal dilatation. © 2011 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved.Item A patient with cystinosis presenting like bartter syndrome and review of literature(Brieflands, 2012) Ertan P.; Evrengul H.; Ozen S.; Emre S.Background: Nephropathic cystinosis is an autosomal recessively inherited metabolic disorder presenting with metabolic acidosis, Fanconi syndrome and renal failure. Case Presentation: We present a 6-year-old girl with severe growth failure, hyponatremia and hypokalemia. Her parents were 4th degree relatives. Two relatives were diagnosed as end stage renal failure. She also had persistant hypokalemic hypochloremic metabolic alkalosis. Her renal function was normal at presentation. She was thought to have Bartter syndrome with supporting findings of elevated levels of renin and aldosterone with normal blood pressure, and hyperplasia of juxtaglomerular apparatus. Her metabolic alkalosis did not resolve despite supportive treatment. At 6th month of follow-up proteinuria, glucosuria and deterioration of renal function developed. Diagnosis of cystinosis was made with slit lamp examination and leukocyte cystine levels. At 12th month of follow-up her metabolic alkalosis has converted to metabolic acidosis. Conclusion: In children presenting with persistant metabolic alkalosis, with family history of renal failure, and parental consanguinity, cystinosis should always be kept in mind as this disease is an important cause of end stage renal failure which may have features mimmicking Bartter syndrome. © 2012 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved.Item Effects of Hesperidin and Diosmin on Necrotizing Enterocolitis: An Experimental Study(Brieflands, 2023) Şenel U.; Tanriverdi H.I.; Tanriverdi S.; Sapmaz H.I.; Akbaş A.; Gevrek F.; Uysal M.; Taş U.Background: Necrotizing enterocolitis (NEC) is a serious intestinal illness in newborns. Objectives: We aimed to investigate the potential protective effects of hesperidin (Hsd) and diosmin on NEC. Methods: Thirty newborn rats were divided into 3 groups: the control group (n = 10), the NEC group (n = 10), and the treatment group (n = 10). The treatment group was given 100 mg/kg of the flavonoid by oral gavage twice daily. On day 5 of the study, animals were sacrificed under anesthesia. After laparotomy, the tissue samples were obtained from the stomach, cecum, and ileum. NEC scoring was performed histopathologically. Apoptotic changes were evaluated by TUNEL (terminal deoxynucleotidyl transferase–mediated biotin–deoxyuridine triphosphate nick-end labeling) staining. Furthermore, levels of oxidants and antioxidants were determined by biochemical analyzes of the tissues. Results: Glutathione peroxidase (GSH-Px) activity and malondialdehyde (MDA) levels were significantly higher in the NEC group than in the control group in all gastrointestinal tract regions examined. Similar to the control group, GSH-Px and MDA were found to be low only in the cecum in the group treated with flavonoids. NEC damage score and apoptotic index in all 3 regions examined were significantly higher in the NEC group than in the control and treatment groups. The apoptotic index values in the treatment group were similar in the stomach and cecum, and the NEC damage score was similar to those in the control group only in the cecum. Conclusions: Hsd and diosmin treatment significantly reduces the severity of NEC-induced damage and apoptotic cell death, especially in the cecum. © 2023, Author(s).Item Normal Values of Echocardiographic Parameters Indicating Right Ventricular Systolic Functions in 607 Healthy Children(Brieflands, 2023) Yılmaz M.; Çetin M.; Dundar P.E.; Coşkun Ş.Background: This study aimed to define the normal ranges of echocardiographic parameters that are used to evaluate right ventricular systolic functions. Methods: A total of 607 children within the age range of 0-18 years without any cardiac pathology or chronic disorders were included in the study. The study population was categorized into different age groups and underwent transthoracic echocardiog-raphy. In this study, tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity (TAPSV), and right ventricular myocardial performance index (RVMPI) values were measured. Results: There was no statistically significant difference between the mean TAPSE and TAPSV values of male and female subjects. The mean RVMPI was higher in females than in males. The study population was categorized into nine groups according to their age. The TAPSE, TAPSV, and RVMPI values were calculated for each group. Additionally, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, and ± 2 standard deviation (SD) and ± 3 SD values of TAPSE measurements were calculated for each age group. The study population was divided into eight groups according to their body surface area (BSA). Moreover, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of TAPSE measurements were calculated. There was a strong positive correlation between TAPSE and BSA. The TAPSE was also positively correlated with TAPSV but not with RVMPI. Conclusions: This study determined the normal values for TAPSV and RVMPI. It is important to have knowledge of the normal ranges of these parameters to recognize right ventricular dysfunction early in various cardiac disorders. © 2023, Author(s).Item Comparison of Four Different DNA Isolation Methods from MGIT Culture for Long-Read Whole Genome Sequencing of Mycobacterium tuberculosis(Brieflands, 2024) Arslan N.; Demiray-Gurbuz E.; Ozkutuk N.; Esen N.; Özkütük A.A.Background: Tuberculosis (TB) remains a global health challenge, particularly due to drug resistance and limitations in rapid diagnosis. Next-generation sequencing (NGS), especially long-read whole genome sequencing (WGS), shows promise for rapidly detecting TB and drug resistance, but it requires high-quality DNA, which is difficult to extract from Mycobacterium tuberculosis due to its complex cell wall. Objectives: This study evaluated four DNA isolation methods for extracting pure DNA from M. tuberculosis, aiming to standardize protocols for long-read WGS. Methods:Mycobacterium tuberculosis H37RV colonies were grown in BACTEC MGIT liquid medium. Two pellets were prepared as the initial material for the DNA extraction protocol: Pellets from 1 mL McFarland 2 suspensions and all growing colonies from two MGIT liquid cultures. Four DNA extraction methods were used: The cetyltrimethylammonium bromide (CTAB) method, GeneJET Genomic DNA Purification Kit, Quick-DNA Fecal/Soil Microbe Kit, and Genematrix Tissue/Bacterial DNA Purification Kit, with some modifications. DNA quality was assessed based on concentration, purity, and integrity. Results: Among the tested methods, the Quick-DNA Fecal/Soil Kit yielded approximately 85 ng/mL of DNA and a purity of 1.9 at 260/280 nm from the colonial pellet of two MGIT tubes. However, lower intact DNA [DNA integrity number (DIN) ~ 6.8] was obtained with this kit. The CTAB method provided the highest intact DNA (DIN ~ 9.5), although the purity of the DNA was not sufficient. Conclusions: Based on three repetitions of McF-2 and colonial pellet extractions, the Quick-DNA Fecal/Soil Kit yielded the highest DNA quantity and purity but showed lower integrity compared to other methods, indicating the need for adjustments. A pellet from two MGIT cultures (~ 100 µL) is suitable for long-read WGS with this kit. However, a larger sample size is required to generalize these findings. For effective long-read sequencing of M. tuberculosis, DNA extraction protocols must be optimized to balance yield, fragment size, and purity for accurate sequencing and drug resistance analysis. © 2024, Arslan et al.