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Yayın A case of urinary tract infection caused by Flavimonas oryzihabitans [Flavimonas oryzihabitans'in etken oldugu bi·r üri·ner si·stem enfeksi·yonu olgusu](2007) Eren Topkaya, Aynur; Özakkaş, Fatma; Benli Aksungar, Fehime; Tülbek, YaşarFlavimonas oryzihabitans is an uncommon bacterial species isolated from clinical specimens. In this report, a 53 years old female patient who had been followed up with the diagnosis of rectum cancer and renal failure for five and two years, respectively, was presented. F.oryzihabitans was isolated from the urine culture of the patient, and the clinical response to ofloxacin therapy was excellent even the urinary catheter has not been removed. Although this pathogen is mostly community aquired, it was found resistant to most of the antimicrobial agents tested. Since it was susceptible to fluoroquinolones and carbapenems, these antibiotics could be the drug of choice for the treatment of infections caused by F.oryzihabitans. The aim of this presentation was to withdraw attention to this bacterium which is thought to be the first urine isolate in our country.Yayın In vitro yüksek sıcaklıkların biyokimyasal tiroid fonksiyon testleri üzerine etkisi(De Gruyter, 2005) Benli Aksungar, Fehime; Eren, Aynur; Kengil, Işıl; Özcan, EsraSerum serbest triiodotironin (sT3), serbest tiroksin (sT4) ve tiroidi uyarıcı hormon (TSH) düzeyleri biyokimyasal olarak tiroid fonksiyonlarını araştırmak için majör testlerdir. Bu çalışmada in vitro yüksek sıcaklıkların (39°C) total T3, total T4, sT3, sT4 ve TSH düzeyleri üzerine etkisi araştırılmıştır. Çalışmaya tiroid fonksiyonları normal olan 97 hasta dahil edilmiştir. Her hastadan 3 ayrı tüp örnek alınmıştır. Örnekler 15 dakika 3000 g’de 25°C’de (grup I), 39°C’de (grup II) santrifüj edilmiştir. Üçüncü tüpler ise pıhtılaşma sonrasında, 20 dakika 39°C sıcaklıkta sıcak su banyosunda bekletilmiştir (grup III). Grup I, II ve III örneklerinde ELFA ve kemilüminesans yöntemleriyle serum total T3, total T4, sT3, sT4 ve TSH düzeyleri ayrı ayrı çalışılmıştır. Çalışılan Grup II ve Grup III örnekleri, +4°C’de 2 saat bekletildikten sonra aynı testler, tekrar iki ayrı yöntemle çalışılmıştır. Tüm gruplarda serum total T3, total T4, sT4 ve TSH düzeylerinde sıcaklık değişikliklerine bağlı olarak istatistiksel anlamda fark bulunamamıştır. Ancak serum sT3 düzeyleri yüksek sıcaklıktan etkilenmiştir. Sonuçlarımızda gördüğümüz in vitro sıcaklık artışıyla serum sT3 düzeylerinin değişim mekanizması, in vivo olarak vücudun yüksek ısıya maruz kaldığı durumlardaki ile aynı olabilir. Yüksek ateşle seyreden infeksiyonlarda tiroksin bağlayıcı globulinin T4’e olan afinitesinde azalma olduğu gösterilmiştir. Bu şekilde serbestlenen T4’ün, antibakteriyel amaçlarla iodin kaynağı olarak kullanıldığı düşünülmektedir. Bir iyodunu bırakan T4 ise serbest sT3 halini almaktadır. Bu bulgularla serum sT3 ölçümlerinde sıcaklığın çok iyi kontrol edilmesi gerektiği sonucuna varılmıştır.Yayın An infectious mononucleosis case(ORTADOGU AD PRES & PUBL CO, 2007) Eren Topkaya, Aynur; Benli Aksungar, Fehime; Oezakkas, Fatma; Capan Akinci, NurverEpstein-Barr virus (EBV) is transmitted through intimate contact and the portal of entry is usually the lympho-epithelial cells lining the oral cavity where a persistent infection is established. The virus-host interaction is usually sub-clinical in young children. A 20-month-old male presented with long-lasting high fever of unknown origin. Generalized lymphadenopathy and an exantematous rash on the back of the patient were detected on physical examination. Antibodies against EBV, rubella, CMV and HSV were detected in the initial blood samples and the avidity of IgG class antibodies was evaluated. Low avidity of EBV-VCA IgG was detected and, other serological tests for EBV were performed. Infectious mononucleosis was diagnosed upon positive test results. Previous studies reporte that, during infections by viruses that may cause latent infections, polyclonal B lymphocytes are activated, producing antibodies against other viruses. As a result, in patients with exanthematous rash, IgM and IgG class antibodies along with avidity tests should be evaluated for differential diagnosis.Yayın The paradigm of autoimmunity: is vitamin D the new player?(Maltepe Tıp Dergisi, 2016) Sezgin, Gülbüz; Özer, Eşref; Uygur Bayramiçli, Oya; Akgün, F. Sinem; Benli Aksungar, Fehime; Nalbant, SelimAim: Vitamin D is necessary for the bone and mineral homeostasis and has also immune regulatory and anti-inflammatory functions. It has been hypothesized that there is a relation between vitamin D deficiency or insufficiency and autoimmune thyroiditis. We aim that to show any relationship between vitamin D deficiency and thyroid autoimmunity. Material and Methods: This prospective study is performed between August 2010 and May 2011 at the Department of Internal Medicine, Endocrinology and Emergency Medicine of Maltepe University, School pof Medicine Hospital. The Ethics Committee of Maltepe University Medical Faculty approved the study.274 patients with Hashimoto’s thyroiditiswere evaluated prospectively for vitamin D, TSH, anti-thyroid peroxidase antibody (anti-TPO) and anti-thyroglobulin (anti-Tg).The correlation between vitamin D and autoimmune parameters is analyzed. Results: According to vitamin D levels there is a statistically significant difference between anti- TPO levels (p=0.024; p<0.05). Anti-TPO levels of patients with a vitamin D level between 4-10 ng/ml are higher than that of the patients with a vitamin D level of 10.01-20 ng/ml and 20 ng/ml and over. Anti-Tg and TSH levels are not statistically significantly different according to vitamin D levels (p=0.550; p=0.554; p>0.05). There is also no difference in TSH levels according to vitamin D subgroups (p=0.177; p>0.05). Conclusion: In patients with Hashimoto’s thyroiditis there is a positive correlation between vitamin D level and anti-TPO but not anti-Tg.Yayın Plasma BNP and homocysteine levels in patients with or without congestive heart failure(Turkish Society of Cardiovascular Surgery, 2007) Sekban, Ahmet; Benli Aksungar, Fehime; Şahin, Müslüm; Eren Topkaya, Aynur; Akyıldız, MahmutBackground: We investigated the relationship between brain natriuretic peptide (BNP), a marker for congestive heart failure, and plasma homocysteine levels. Methods: The study included seven patients (3 females, 4 males) with congestive heart failure and 36 patients (17 females, 19 males) without a history of previous myocardial infarction or congestive heart failure. Plasma BNP and homocysteine levels were measured. All the patients were assessed by transthoracic echocardiography.Results: In 19 patients (44%) plasma BNP and homocysteine levels were lower than 15 pg/ml and 7.91 mol/l, respectively, whereas in 24 patients, the corresponding levels were higher than 68.4 pg/ml and 8.84 mol/l. There was a significant positive correlation between plasma BNP and homocysteine levels (r=0.92, p<0.001, 95% confidence interval 0.86-0.95). No significant differences existed between male and female patients with respect to plasma BNP and homocysteine levels. The mean BNP and homocysteine levels were 369.9±75.4 pg/ml and 13.6±4.6 mol/l in patients with congestive heart failure; and 78.3±24.3 pg/ml and 8.9±2.5 mol/l in patients without a history of previous myocardial infarction or congestive heart failure, respectively. The two groups exhibited significantly different plasma BNP and homocysteine levels. Echocardiographic assessments showed left ventricular diastolic dysfunction in 11 patients without congestive heart failure, having a BNP level above 100 pg/ml. These patients also had higher homocysteine levels.Conclusion: Our results demonstrate that the risk for congestive heart failure may be more reliably assessed if BNP and homocysteine levels are incorporated into diagnostic screening of patients with myocardial infarction and of high-risk patients such as those with diabetes or hypertension.
