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Öğe Cerebral MR Spectroscopy Evaluation of the Neuroprotective Effects of Lithium and Olanzapine in Bipolar Affective Disorder Patients(Universitatsverlag Ulm Gmbh, 2008) Cumurcu, Birgul Elbozan; Karlidag, Rifat; Sarac, Kaya; Unal, Suheyla; Ozcan, Cemal; Erkorkmaz, UnalAim: We used the NAA measurements obtained by cerebral magnetic resonance spectroscopy to evaluate the neuroprotective effects of lithium and olanzapine in bipolar affective disorder patients in remissions. Methods:Ten bipolar affective disorder patients on lithium treatment for the last six years and who had not experienced a manic or depressive attack for the last three years and were followed up at the psychiatry outpatients department were included in the study. The patients were evaluated while on lithium, 14 days after lithium was stopped and at the end of the 411 week following olanzapine initiation, for a total of three times. Each evaluation consisted of a psychiatric interview, the Hamilton Depression Rating Scale (HDRS) and the Bech-Rafaelson Mania Scale (BRMS) in addition to MR spectroscopy imaging. Results: The cases were compared with a control group consisting of 10 age- and sex-matched healthy subjects. We measured the N-acetyl aspartate (NAA) peak quantitatively in the right dorsolateral prefrontal cortex (DLPF) and left hippocampus areas on MR spectroscopy and checked the ratio to the creatine (Cr) peak. The values from all three imaging studies were compared with each other and with the control subjects. Conclusions: There was no statistically significant difference between the NAA/Cr ratios of the patients receiving lithium, those not on medications or those receiving olanzapine and the healthy subjects. We did not observe any change in cerebral NAA levels following lithium and olanzapine treatment in bipolar affective disorder patients in remission.Öğe Employee Safety and Biosafety Applications in Microbiology Laboratories; A Multicenter Evaluation in Turkey(Ankara Microbiology Soc, 2020) Koroglu, Mehmet; Altindis, Selma; Aydemir, Ozlem; Yuksel, Busra; Demiray, Tayfur; Erkorkmaz, Unal; Aslan, Ferhat GurkanMedical laboratory personnel may be exposed to various hazards, especially biological and chemical, during their routine activities. In this multicenter study, which could reflect the nation wide results, it was aimed to determine the safety and biosecurity practices of the employee working in medical microbiology laboratories and to reveal the current situation. A total of 1072 personnel working in the Medical Microbiology Laboratory of 23 hospitals (14 medical faculty hospitals, seven ministry of health training and research hospitals and two state hospitals) from different provinces were provided with a questionnaire consisting of 33 questions inquiring about the rules, opinions, attitudes and behaviors regarding safety and biosafety practices. Statistical analyses were made with institutions, age groups, gender, educational background, working time and occupational groups in terms of exposure to biological and chemical hazards. It was determined that approximately 50% personnel of the university/training and research hospitals and 2/3 of the state hospitals personnel consumed food and beverages in the laboratories (p< 0.05). Compared with other hospitals, it was determined that in state hospitals; the absence of separate resting room (35%), the personnel finding their own knowledge and practices inadequate (28.9%), laboratory coats washed at home (95%), educational organization and participation rates (90%) and medical waste information levels of the personnel were higher (p< 0.05). It was determined that as the age progresses, the rate of education, food and beverage consumption in the laboratory, not being outside the laboratory with protective equipment (gloves, masks and laboratory coats) and the history of laboratory acquired infections were increased (p< 0.05). It was observed that washing the laboratory coats at home was higher in the younger age group and hospital washing was higher in the elderly group (p< 0.05). There was no significant difference between the genders in terms of food and beverage consumption in the laboratory (p= 0.09). It was determined that periodic health checks were not performed in 1/3 of both sexes, but the use of gloves and compliance with medical waste rules was lower in men. Female employees find themselves inefficient in terms of knowledge and practices (p< 0.05). The rate of those who did not have their periodic checkups at regular intervals was higher in the high school and master of science education groups; While non-compliance with medical waste rules, food and beverage consumption in the laboratory was highest in the primary and high school graduates, the lowest rates were found in the master and doctorate groups (p< 0.05). The rate of those who had regular health checkups was higher in the group of specialist physicians and technicians (p< 0.05). It was observed that the rule of not going out of the laboratory with protective equipment was fully observed in the 35+ years working group, while compliance was 70-85% in other groups (p< 0.05), hepatitis B vaccination rate was highest in specialist doctors and lowest in cleaning and other personnel group (p< 0.05). Highest non-compliance rate with medical waste rules was observed in the cleaning personnel group (p< 0.05). As a result, although advances have been made in employee safety practices in medical microbiology laboratories in our country in recent years, it has been found that it is not yet sufficient. The results indirectly reflected the profile of medical laboratories in our country. In the laboratories, physical space and equipment deficiencies should be eliminated, periodic health checkups and vaccination should be provided, non-staff entrance to the laboratory and food, beverage and cigarette consumption should be prevented, laboratory coats should be washed in the hospital, in-service trainings, including medical waste training, should be conducted and these trainings should be developed through mechanisms that will change the behavior.Öğe Increased serum ferritin levels in patients with Crimean-Congo hemorrhagic fever: can it be a new severity criterion?(Elsevier Sci Ltd, 2010) Barut, Sener; Dincer, Fatma; Sahin, Idris; Ozyurt, Huseyin; Akkus, Mehmet; Erkorkmaz, UnalObjectives: Serum ferritin is one of the markers indicating hemophagocytosis that may have a role in the pathogenesis of Crimean-Congo hemorrhagic fever (CCHF). This study was designed to determine any correlation between serum ferritin and routine diagnostic laboratory markers of CCHF, and to investigate the relationship between serum ferritin levels and disease severity. Methods: Sixty-six patients with CCHF admitted to the hospital during the spring and summer months of 2006 and 2007 were included in the study. Serum ferritin levels were measured in sera obtained during the initial days of hospitalization. Data from 53 patients showing decreasing platelet counts over the first three days were used for further analysis and these patients were divided into two groups according to disease severity: group A included severe cases with lowest platelet counts <= 20 x 10(9)/l and group B included mild cases with lowest platelet counts > 20 x 10(9)/l. Results: Forty patients (60.6%) were male (mean age 43 +/- 17 years). Three patients died, thus the fatality rate was 4.5%. Fifty-one patients (77.3%) had abnormal serum ferritin levels, with levels above 500 ng/ml in 62.1%. There was a significant negative correlation between ferritin levels and concordant platelet counts (p < 0.001; r = -0.416) and ferritin was also found to be positively correlated with aspartate aminotransferase (p < 0.001; r = 0.625), alanine aminotransferase (p < 0.001; r = 0.479), and lactate dehydrogenase (p < 0.001; r = 0.684). Group A had higher ferritin levels than group B (p < 0.001). Receiver operating characteristic analysis revealed that a ferritin level of >= 1862 ng/ml had a sensitivity of 87.5% and a specificity of 83.8% in differentiating severe cases from mild ones. Conclusions: Increased serum ferritin levels may suggest a significant role of hemophagocytosis in the pathogenesis of CCHF and may be a useful marker for diagnosis, disease activity, and prognosis. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.Öğe The Relationship Between Boston Questionnaire and Electrophysiological Findings in Carpal Tunnel Syndrome(Galenos Yayincilik, 2010) Kurt, Semiha; Cevik, Betul; Kaplan, Yuksel; Karaer, Hatice; Erkorkmaz, UnalObjective: Boston Questionnaire (BQ) is a method, which is used for assessment of severity of symptoms and functional status in carpal tunnel syndrome (CTS). In this study, we aimed to investigate the relationship between electrophysiological findings and scores of BQ including functional capacity and severity of symptoms. In addition, the effect of body weight on this relationship was investigated. Methods: 98 consecutive patients, who were referred to our electrophysiology laboratory with prediagnosis of CTS and had no systemic disease such as diabetes mellitus, rheumatoid arthritis, and thyroid disease, were included this study. A detailed neurological examination was performed to all patients. Median and ulnar nerve conduction studies were carried out. The patients with Body Mass Index (BMI) exceeding 30 were considered obese. BQ was applied to all patients. Results: There was a weak but a significant correlation between the results of the nerve conduction studies and the functional capacity scores. This correlation was not found in obese patients. No correlation between symptom severity scores and the findings of nerve conduction studies was determined. Conclusion: In the literature, there are a small number of studies that investigated the relationship between BQ scores and electrophysiological findings. The relationship was detected at some of there where as was not at remainders. In our study, even though the results of the nerve conduction studies were found to be correlated with functional capacity scores, there was no correlation between symptom severity scores and nerve conduction study findings. Although this relationship was found to be more significant in the non-obese patients, no relationship was observed in obese patients. (Archives of Neuropsychiatry 2010;47:237-40)Öğe Risk Factors For Diabetic Polyneuropathy(Aves, 2014) Kaplan, Yuksel; Kurt, Semiha; Unaldi, Hatice Karaer; Erkorkmaz, UnalIntroduction: The aim of this study was to investigate the risk factors for distal symmetric sensory-motor polyneuropathy (DSP) in patients with type 2 diabetes mellitus (DM). Methods: Sixty seven patients with type 2 DM (33 males and 34 females) were included in the study. In addition to a detailed neurological examination, the Michigan Neuropathy Screening Instrument was administered to all patients and their total neuropathy scores were calculated. Nerve conduction examinations were performed for all patients. Results: The mean age of the patients was 52.83 +/-.87 years. The mean glycosylated hemoglobin (HbA1C) value was 8.56 +/- 2.07% (normal: 3-6.5%). The total neuropathy score significantly correlated with diabetes duration, hypertension, retinopathy, and HbA1C. Conclusion: This study confirms the previous reports regarding the association of neuropathy with poor glycaemic control and duration of the disease. The association of neuropathy with retinopathy and hypertension is important.
