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Öğe The Change of Antituberculosis Drug Resistance Rate in Edirne Region in 1996 and 2006(Wolters Kluwer Medknow Publications, 2010) Perincek, Gokhan; Tabakoglu, Erhan; Otkun, Metin; Ozdemir, LeventObjective: To establish the change in the ratio of the a ntituherculosis drug resistance in Edirne region between 1996-2006. Materials and Methods: The patients, who were detected with Mycobacterium tuberculosis proliferation in the cultures, were enrolled to the study between 1996-2006. The patients, who were diagnosed with isoniazid, rifampisin, ethambutol, streptomycin and multi-drug resistance were selected and their data of was uploaded to SPSS software in order to perform statistical analysis. Results: We found the Mycobacterium tuberculosis proliferation of cultures in 70 patients in 1996, whew. 21 patients had isoniazid, 8 patients had rifampicin, 7 patients had ethambutol, r patients had streptomycin, and 5 patients had multi Burg resistance. En 2006, illyrobacterium tuberculosis proliferation was established in 47 patients. Of these, 11 patients had isoniazid, 8 had rifampisin, one patient had ethambutol, 2 patients had streptomycin and 3 patients had multi-durg resistance. We compared the changes in the resistance figures and found a decrease: of drug resistance as follows: in isoniazid, from 21 patients (301Y0) to 11 patients (23.4%); in rifampisin, from 8 patients (11%) to 4 patients (8.5%0; in ethambutol, from 7 patients (13'Yo) to one patient (2.1`,0; in streptomycin, from r patients (39%) to 2 patients (4.3%); in multi drug, from 5 patients (7%) to 3 patients (6.4`%). Conclusion: Although statistically significant decrease of drug resistance was not found in isoniazid, rifampisin, ethambutol and multi-drug, a significant drug resistance \vas estabished in streptomycin in Edirne region during the 10 years period.Öğe Chronic Necrotizing Pulmonary Aspergillosis in a Case with Ankylosing Spondylitis(Bilimsel Tip Publishing House, 2012) Perincek, Gokhan; Hatipoglu, Osman Nuri; Yoruk, Yener; Batmaz, Emrah; Ilgili, AysegulAnkylosing spondylits is a prototype of spondyloarthropathy tropates. During the progression of ankylosing spondylitis, which can destroy many systems, pleuroparanchymal involvement occurs rarely. The most commonly observed lesion is the fibrobullous disease on the upper lobes. Chronic aspergillus colonization has been reported in a quite significant percentage of the patients with ankylosing spondylits (50-65%). Pulmonary aspergilloma is the most observed clinical form in patients with ankylosing spondylitis. Invasive pulmonary aspergillosis occurs especially in patients with immunesupression. Here we shall present a case with ankylosing spondylitis complicated by chronic necrotizing pulmonary aspergillosis which is a form of invasive pulmonary aspergillosis.Öğe Effecting factors on survival in patients taking thrombolytic treatment due to massive pulmonary embolism(Turkish Assoc Tuberculosis & Thorax, 2010) Hatipoglu, Osman Nuri; Perincek, Gokhan; Edis, Ebru Cakir; Tabakoglu, Erhan; Altiay, GundenizMassive pulmonary embolism (MPE) is a life threatening disease, thrombolytic treatment could save lives. The aims of this study are to identify early and late mortality rates in patients with MPE who received thrombolytic treatment, and mortality related risk factors. All the hospital records for the MPE patients who received thrombolytic treatment between 1998 and 2006 were retrospectively investigated. Pulmonary embolism was diagnosed through computed tomografi scan and V/P scintigraphy. Due to MPE, 21 women total 41 patients who undergo tPA or streptokinase were included in the study. Kaplan-Meier for the survival analysis and cox regression analysis for determining the mortality related independent risk factors were used. Dying while staying in hospital was accepted as early or hospital mortality, after discharge from hospital as late mortality. Out of 41 patients, 12 of them died while they are hospitalized (hospital mortality; 29%) 6 of them died after they were discharged (late mortality; 21%). The average survival time among discharged patients was 2304 days (95% confidence interval: 1725-2884). Among those patients who took streptokinase or tPA, late or early mortality rates (p>0.05) and survival time did not show significant difference (p=0.8908). The presence of arrhythmia [p=0.01; odds rate (OR): 6.25] and jugular vein distention (JVD) (p=0.03; OR: 6.25) for hospital mortality and multiple ongoing health problems for the late mortality were identified as the independent risk factors. For the hospital mortality, the presence of JVD or arrhythmia, for prognostic sensitivity, specificity, positive predictive value and negative predictive value were recorded as 75%, 79%, 60% and 88% respectively. In conclusion, the presence of arrhythmia and/or JVD on a patient with MPE is a negative prognostic factor for hospital mortality. The presence of other ongoing health problems influences the survival time of the discharged patients.Öğe Factor V Leiden Mutation Accompanying Recurrent Massive Pulmonary Thromboembolism(Aves, 2012) Perincek, Gokhan; Hatipoglu, Osman Nuri; Ege, Turan; Kara, Ibrahim; Kul, SerefA 46-year-old female patient was admitted to the emergency department with the complaints of dyspnea, swelling of the right leg and and feeling of unwell. Deep venous thrombosis was detected at the lower extremity venous Doppler ultrasound and thrombi was detected at the left main pulmonary artery and at the segmental pulmonary arteries bilaterally with the computed tomography of thorax. As hypotension was developed, she was diagnosed with pulmonary thromboembolism and treated with streptokinase infusion. The patient's complaint of dyspnea decreased and her haemodynamic parameters improved after thrombolytic therapy, and subsequently she underwent anticoagulant therapy. On the fifth day of monotorization, while still under the anticoagulant therapy, the patient suddenly developed dyspnea, cyanosis and hypotension. The rt-PA therapy was adminestered with the pre-diagnosis of recurrent massive pulmonary thromboembolism. After the rt-PA therapy, the patient's haemodynamics improved, her cyanosis and complaints of dyspnea regressed. Heterozygote Factor V Leiden mutation was detected with examinations. Inferior vena cava filter was placed together with the anticoagulant therapy. The patient has been under our monitoring for 3 months.Öğe Massive Alveolar Hemorrhage During Wegener Granulomatosis: a Case Report(Galenos Publ House, 2011) Perincek, Gokhan; Tabakoglu, Erhan; Pamuk, Omer NuriThis is a presentation of Wegener Granulomatosis (WG) disease. Even though the lungs are rarely affected, massive alveolar hemorrhage is seen which leads to mortality. The patient was a 28 year old man. His illness was diagnosed as WG and glomerulonephritis a year previously and he was treated by administration of methylprednisolone orally. He had been treated irregularly. He applied to the emergency service with hemoptysis and asthma complaints two days earlier. After the results of his examination Hb: 3.6 gr/dl, Htc:10.3%, Ure:131 mg /dl, kreatini: 7.7 mg/di, pH: 7.41, pO2: 55 mmHg, pCO2:33 mmHg, and being diagnosed as alveolar consolidation on lung X-ray, he was taken to the intensive care unit with a diagnosis of a massive alveolar hemorrhagei. He was intubated and attached to mechanical ventilation. He was treated with parenteral 1 mg/kg/day methylprednisolone and, siklofosfamid 2 mg/kg/day. He was extubated on the 21(st) day. He was taken to the chest service department on 24(th) day. He is still being treated.Öğe Resistance Rates of Antituberculosis Drugs in Pulmonary Tuberculosis Patients Producing Mycobacterium Tuberculosis(Aves, 2011) Perincek, Gokhan; Tabakoglu, Erhan; Otkun, Metin; Ozdemir, Levent; Ozdemir, BurcuObjective: Determination of antituberculosis drug resistance rate in pulmonary tuberculosis patients producing Mycobacterium tuberculosis. Material and Method: 134 pulmonary tuberculosis patients producing Mycobacterium tuberculosis in cultures in the Trakya University Medical Faculty Hospital between the years 2005-2007 were enrolled in the study. Four major antituberculosis drugs (H, R, streptomycin (SM), ethambutol (EMB)) resistance and multidrug resistance rates were investigated. using the BACTEC 460 TB system. Results: 134 pulmonary tuberculosis patients producing Mycobacterium tuberculosis were detected and 31 female patients were found and 103 male patients. Acid resistant bacilli were found in 58.2% of the patients with EZN. Antituberculosis resistance rates were established as H 10.4%, R 3%, EMB 0.7%, SM 0.7%. Conclusion: It was determined that a follow up of drug resistance patterns in patients with pulmonary tuberculosis will be useful in determining treatment protocols and preventing drug resistance.
