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Öğe Differentiation of rheumatoid arthritis from HCV infection: Rheumatoid factor, anti-cyclic citrullinated peptide or anti-mutated citrullinated vimentin?(Aves Yayincilik, 2010) Kaptano?lu, Ece; Nadir, Işilay; Bakici, Zahir; Hayta, Emrullah; Türkmen, Mehmet; Sezer, Hafize; Hizmetli, SamiObjective: Differentiation of rheumatoid arthritis (RA) from other diseases with joint involvement such as hepatitis-C virus (HCV) infection represents a diagnostic problem. In addition to the rheumatoid factor (RF), more specific and sensitive auto-antibodies are under evaluation in recent years with conflicting results. In this study, we tested the diagnostic value of rheumatoid factor, anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin (anti-MCV) in distinguishing RA from hepatitis C patients. Materials and Methods: Sera of 34 RA patients and 30 hepatitis C patients were tested for RF, anti-CCP anti-MCV. Disease activity was determined by disease activity score (DAS-28) 28 in RA and by modified Knodell score in hepatitis C patients. Extra-articular involvement in RA and rheumatologic involvement in hepatitis C patients were documented. Results: In roc analysis, area under curve (AUC) was the highest in anti-CCP. Sensitivity and specificity was 82% and 53%, 79%, and 96% and 70%, and 73% for RF, anti-CCP and anti-MCV respectively. DAS-28 has a weak correlation with RF (r=0.406), anti-CCP (r=0.433), and anti-MCV (r=0.453). There was no difference between the patients in autoantibody levels regarding extra-articular involvement and DAS-28 in RA, and joint involvement in hepatitis C patients. Conclusion: Anti-MCV antibodies may be useful in distinguishing RA however it seems to have no additional value over anti-CCP or RF in hepatitis C patients. Anti-CCP antibodies are more reliable in diagnosis of RA due to their high specificity.Öğe Differentiation of Rheumatoid Arthritis From HCV Infection: Rheumatoid Factor, Anti-Cyclic Citrullinated Peptide or Anti-Mutated Citrullinated Vimentin?(AVES YAYINCILIK, IBRAHIM KARA, 2010) Kaptanoglu, Ece; Nadir, Isilay; Bakici, Zahir; Hayta, Emrullah; Turkmen, Mehmet; Sezer, Hafize; Hizmetli, Sami; Elden, HasanObjective: Differentiation of rheumatoid arthritis (RA) from other diseases with joint involvement such as hepatitis-C virus (HCV) infection represents a diagnostic problem. In addition to the rheumatoid factor (RF), more specific and sensitive auto-antibodies are under evaluation in recent years with conflicting results. In this study, we tested the diagnostic value of rheumatoid factor, anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin (anti-MCV) in distinguishing RA from hepatitis C patients. Materials and Methods: Sera of 34 RA patients and 30 hepatitis C patients were tested for RF, anti-CCP anti-MCV. Disease activity was determined by disease activity score (DAS-28) 28 in RA and by modified Knodell score in hepatitis C patients. Extra-articular involvement in RA and rheumatologic involvement in hepatitis C patients were documented. Results: In roc analysis, area under curve (AUC) was the highest in anti-CCP. Sensitivity and specificity was 82% and 53%, 79%, and 96% and 70%, and 73% for RF, anti-CCP and anti-MCV respectively. DAS-28 has a weak correlation with RF (r=0.406), anti-CCP (r=0.433), and anti-MCV (r=0.453). There was no difference between the patients in autoantibody levels regarding extra-articular involvement and DAS-28 in RA, and joint involvement in hepatitis C patients. Conclusion: Anti-MCV antibodies may be useful in distinguishing RA however it seems to have no additional value over anti-CCP or RF in hepatitis C patients. Anti-CCP antibodies are more reliable in diagnosis of RA due to their high specificity. (Turk J Rheumatol 2010; 25: 19-23)Öğe Investigation of Carbapenemases in Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae Strains Isolated in 2014 in Turkey(ANKARA MICROBIOLOGY SOC, 2016) Cakar, Asli; Akyon, Yakut; Gur, Deniz; Karatuna, Onur; Ogunc, Dilara; Baysan, Betil Ozhak; Coplu, Nilay; Cagatay, Mustafa; Kilic, Abdullah; Baysallar, Mehmet; Bakici, Zahir; Celik, Cem; Gulay, Zeynep; Aydemir, Sohret; Tunger, Alper; Kilic, Huseyin; Ercal, Baris Derya; Toraman, Zulal Asci; Zer, Yasemin; Buyuktas, Ayse; Ay, Selma; Aktas, Zerrin; Kayacan, Cigdem; Bayramoglu, Gulcin; Aydin, Faruk; Dundar, Devrim; Hasdemir, Ufuk; Ayas, Ramazan; Yanik, Keramettin; Gunaydin, Murat; Guducuoglu, Huseyin; Parlak, MehmetCarbapenems are the choice of treatment in infections caused by multidrug resistant Enterobacteriaceae. In recent years carbapenem-resistant Enterobacteriaceae isolates due to carbapenemases have been increasingly reported worldwide. Multicenter studies on carbapenemases are scarce in Turkey. The aim of this study was to determine the distribution of carbapenemases from different parts of Turkey as a part of the European Survey of Carbapenemase Producing Enterobacteriaceae (EuSCAPE) project. Beginning in November 2013, carbapenem-resistant isolates resistant to at least one of the agents, namely imipenem, meropenem, and ertapenem were sent to the coordinating center. Minimum inhibitory concentrations for these carbapenems were determined by microdilution tests following EUCAST guidelines. Production of carbapenemase was confirmed by combination disk synergy tests. Types of carbapenemases were investigated using specific primers for VIM, IMP; NDM, KPC and OXA-48 genes by multiplex polymerase chain reaction. In a six month period, 155 suspected carbapenemase-positive isolates were sent to the coordinating center of which 21 (13.5%) were E.coli and 134 (86.5%) were K.pneumoniae. Nineteen (90.5%) strains among E.coli and 124 (92.5%) strains among K.pneumoniae were shown to harbour at least one carbapenemase gene by molecular tests, with a total of 92.3% (143/155). Carbapenemases were determined as a single enzyme in 136 strains (OXA-48: 84.6%; NDM: 6.3%; VIM: 2.8%; IMP: 1.4%) and as a combination in seven isolates (OXA-48 + NDM: 2.1%; OXA-48 + VIM: 2.1%; VIM + NDM: 0.7%). KPC was not detected in any of the isolates. According to the microdilution test results, resistance to imipenem, meropenem and ertapenem in OXA-48 isolates were 59.5%, 52.9% and 100%, respectively. The combination disk synergy test was 100% compatible with the molecular test results. As most of the OXA-48 producing isolates were susceptible to meropenem but all were resistant to ertapenem, ertapenem seems to be the most sensitive agent in screening carbapenemases in areas where OXA-48 is prevalent and phenotypic combination tests can be useful in centers where molecular tests are not available.Öğe Investigation of the normal values of some haematological parameters of the adults living in the central region of Sivas(2003) Şanli Yilmaz, Filiz; Erdal, Sena; Bakici, Zahir; Çinar, ZiynetPurpose: In this study, normal values of haematological parameters in healthy male and female individuals between 25-64 years of age in the central region of Sivas were investigated. Materials and Methods: This study was performed on 530 healthy adult males and females who have been living in central Sivas. The individuals evaluated as healthy using the applied questionnaire results were included in the study. Haematological parameters (eritrocyte, leukocyte, thrombocyte, mean thrombocyte volume, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and percentage neutrophil, lymphocyte, monocyte, eosinophil, basophil) were measured in the blood samples. Results: Normal values of studied haematological parameters of Sivas populace were determined by this study and the values obtained were evaluated according to sex and age groups. Conclusion: Obtained haematological values of adults who lived in Sivas were in accordance with the values reported as normal by other studies in the literature. Differences in some parameters could be originated from the methodology, geographical conditions, feeding habits of Sivas populace and the manner of lives.