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Öğe Boğaz gargarası ile yapılan hızlı antijen testinin grup A beta-hemolitik streptokokları saptamadaki etkinliği(2008) Yılmaz, Fahrettin; Karabay, Oğuz; İnce, Koç Nevin; Ekerbiçer, Hasan; Koçoğlu, Mücahide EsraAmaç: Grup A beta-hemolitik streptokok (BHS) tanısında kullanılan hızlı antijen testlerinin (HAT) en önemli dezavantajı düşük duyarlılıklarıdır. Bu çalışmada, boğaz gargarası ile yapılan HAT'nin duyarlılık, özgüllük, pozitif ve negatif kestirim değerleri araştırıldı. Hastalar ve Yöntemler: Çalışmaya tonsillofarenjit öntanısı konan 106 hasta (53 kadın, 53 erkek, ortalama yaş 22±12; dağılım 16-65) alındı. Boğaz kültürü için steril pamuklu çubuk ile farenks arka duvarı ve tonsil yüzeyinden sürüntü örneği alındı. Daha sonra hastalara 10 saniye süreyle steril %0.9 NaCl ile gargara yaptırılarak örnek alındı. Bu örnekler HAT ile grup A BHS pozitifliği açısından değerlendirildi. Boğaz kültürleri standart yöntemlerle yapıldı. Bulgular: Boğaz kültürü 12 hastada (%11.3) pozitif, 94 hastada (%88.6) negatif idi. Boğaz gargarasıyla yapılan HAT beş hastada (%4.7) pozitif, 101 hastada (%95.2) negatif bulundu. Boğaz gargarasıyla yapılan hızlı antijen testinin duyarlılığı ve özgüllüğü sırasıyla %41.7 ve %100, pozitif kestirim değeri %100, negatif kestirim değeri %93.1 idi. Sonuç: Grup A BHS tanısında boğaz gargarasıyla yapılan HAT’nin özgüllüğü, pozitif ve negatif kestirim değerleri tatmin edici bulunmasına rağmen, duyarlılığı tatmin edici bulunmadı.Öğe Effectiveness of rapid antigen test with throat gargle in detecting group A beta-hemolytic streptococci(2008) Yilmaz, Fahrettin; Karabay, O?uz; Ince, Nevin Koç; Ekerbiçer, Hasan; Koço?lu, EsraOBJECTIVES: The most important disadvantage of rapid antigen tests (RAT) is low sensitivity for the diagnosis of group A beta-hemolytic streptococci (BHS). We determined the sensitivity, specificity, positive and negative predictive values of RAT in gargling samples. PATIENTS AND METHODS: The study included 106 patients (53 females, 53 males, mean age 22+/-12 years; range 16-65 years) with an initial diagnosis of tonsillopharyngitis. Swab samples were taken from the posterior pharyngeal wall and tonsil surface with a sterile cotton swab. Then, gargle samples were obtained by gargling for 10 seconds with sterile 0.9% NaCl to be examined by the RAT for group A BHS. Throat cultures were processed using standard microbiologic techniques. RESULTS: Throat cultures were positive in 12 patients (11.3%) and negative in 94 patients (88.6%). Rapid antigen test yielded five positive (4.7%) and 101 negative (95.2%) results. The sensitivity and specificity rates of RAT with throat gargling were 41.7% and 100%, with positive and negative predictive values of 100% and 93.1%, respectively. CONCLUSION: Despite satisfactory specificity, positive and negative predictive rates of RAT with throat gargling, its low sensitivity limits its use for the diagnosis of group A BHS.Öğe The impact of incubating the throat culture for 72 h on the diagnosis of group a beta-hemolytic streptococci(Elsevier Sci Ltd, 2006) Koçoğlu, Esra; Karabay, Oğuz; Yılmaz, Fahrettin; Ekerbiçer, HasanObjective: The accurate detection and treatment of group A beta-hemolytic streptococcal pharyngitis is important to prevent the potential sequels. Throat culture remains the gold standard for the diagnosis of streptococcal pharyngitis. Many authors recommended 48 It incubation time for the isolation of group A Streptococcus (GAS). In this study the diagnostic efficacy of prolonging the incubation time of throat cultures to 72 It for isolation of GAS was researched. Methods: Throat swab specimens were inoculated to 5% sheep blood agar plate and incubated at 37 degrees C, and evaluated at the 24th hour. GAS negative plates were incubated again for another 24 h and read at the 48th hour. Negative plates at 48 It were incubated again, read at the 72nd hour, and positive results of all measurements were evaluated. Results: A total of 367 cultures were examined. At the 24th hour evaluation 34 (9.3%) cultures were positive for GAS. Evaluation of 333 cultures that were found to be negative in the first 24th hour evaluation revealed 44 (13.6%) positive cultures at 48th hour evaluation. Out of 289 cultures that were negative during the 48th hour evaluation, an additional 13 (4.7%) cultures were found to be positive during the 72nd hour evaluation. The agreement between 24th-48th and 24th and 72nd were both moderate (kappa 0.54 and 0.46, respectively), and between 48th and 72nd hour was very good (kappa: 0.90). Conclusion: Throat cultures that are negative for GAS at 24 h should be incubated for second day. We conclude that, to confirm the throat cultures GAS negative. results of throat cultures need to be incubated for 72 h, since 72nd hour evaluations revealed additional 5% positive results.Öğe Relation between middle ear pressure changes and postoperative nausea and vomiting in pediatric strabismus surgery(Elsevier Science Inc, 2007) Karaaslan, Kazım; Koçoğlu, Hasan; Yılmaz, Fahrettin; Köybaşı, Serap; Çelebi, Serdal; Ekerbiçer, HasanStudy Objective: To investigate the effects of tympanometric changes on the frequency of postoperative nausea and vomiting (PONV). Design: Prospective, observational study. Setting: University hospital. Patients: 49 ASA physical status 1, nonpremedicated children undergoing elective strabismus surgery. Interventions: Frequency of PONV was assessed at various time intervals (0-2, 2-6, and 6-24 hours) with a 4-point scale (0, no nausea; 1, nausea but no vomiting; 2, one episode of vomiting; 3, two or more episodes of vomiting), and correlation with tympanometric data was investigated. Measurements: Tympanogram was obtained before induction of standardized anesthesia and after full recovery. Fourteen (28.6%) patients had nausea, and 10 (20.4%) patients vomited. The tympanic gradient, compliance, and pressure values were found to be significantly higher in postoperative measurements than their preoperative counterparts (P < 0.05). The volumes of both ears increased postoperatively, but these differences were not statistically significant (P > 0.05). Changes in middle car pressure, volume, compliance, and gradient did not correlate with PONV (P > 0.05). Conclusions: Gradient, compliance, volume, and pressure changes in middle ears were not found to be related to the frequency of nausea and vomiting after strabismus surgery. (c) 2007 Elsevier Inc. All rights reserved.Öğe Staphylococcus aureus nasal carriage and associated factors in type 2 diabetic patients(Natl Inst Infectious Diseases, 2006) Tamer, Ali; Karabay, Oğuz; Ekerbiçer, HasanWe aimed to compare the rate of nasal carriage of Staphylococcus aureus (NCSA) between type 2 diabetic patients and non-diabetic ones and also to reveal the associated risk factors. Type 2 diabetic subjects were selected from outpatient diabetes clinics and control subjects were selected from outpatient internal medicine clinics in the same hospital. The subjects were divided into 3 groups. Group I included 68 subjects on insulin therapy and dietetic treatment, Group II included 80 subjects on oral anti-diabetic agents and dietetic treatment and Group III included 150 age- and sex-matched non-diabetic subjects. The rates of NCSA for Group I, II and III subjects were found to be 24 (35.3%), 11 (13.8%), and 16 (10.7%), respectively. Whereas there was no significant difference in NCSA positivity between Group II and Group III, a significant difference was found between Groups I and III (P <0.01). Univariate analysis revealed that the following were significant risk factors for NCSA in our diabetic patients: insulin use, hospital admission within the last 6 months, being diabetic for more than 6 years, fasting glucose level above III mg/dl and antibiotic usage within the last 6 months. Furthermore, insulin use (odds ratio 3.32) and antibiotic usage within the last 6 months (odds ratio 5.75) were defined as significant risk factors for NCSA in diabetic subjects by the logistic regression method. Our results suggested that the rate of NCSA was significantly higher in type 2 diabetic patients who used insulin or antibiotics within the last 6 months.
