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Öğe Osteomiyelit uygulanan rat modelinde rifaksiminli spacer uygulamasının teikoplaninli ve antibiyotiksiz spacer uygulaması ile etkinlik yönünden karşılaştırılması(Düzce Üniversitesi, 2019) Yücel, Mücahid Osman; Turhan, YalçınGiriş: Akut ve kronik osteomiyelit, uzun süreli antibiyotik tedavisi ve cerrahi debridman gerektiren tedavisi zor bir hastalıktır. Özellikle Metisiline dirençli staphylococcus aureus (MRSA) suşlarından kaynaklanan ve implant ile ilişkili osteomiyelitin tedavisi oldukça güçtür. Rifaksimin etki spektrumu ve farmakolojik özellikleri bakımından osteomiyelit tedavisinde etkili olabilecek rifamisin türevi bir antibiyotiktir. Amaç: Deneysel olarak planlanan bu çalışmada rifaksiminin MRSA etkenli ve implant ilişkili osteomiyelit oluşturulan rat modellerinde etkinliğinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Çalışmamızda 40 adet erişkin dişi Wistar Albino cinsi rat kullanıldı. Tüm ratlar 10'arlı 4 gruba ayrıldı. Norden'in modifiye deneysel osteomiyelit modeli ile tüm ratların sağ tibia metafizlerinde MRSA etkenli, implant ilişkili osteomiyelit geliştirildi. 4 hafta sonra tüm grupların implantları çıkartılarak debridman uygulandı ve grup 1'e rifaksiminli, grup 2'ye teikoplaninli ve grup 3'e de antibiyotiksiz çimento tedavisi uygulandı. Kontrol grubu olarak ayrılan grup 4'e ise debridman dışında bir tedavi uygulanmadı. 4 hafta sonra tedavi sonlandırılarak ötenazi uygulandı ve klinik, histopatolojik ve mikrobiyolojik sonuçlar kıyaslandı. Bulgular: Tedavi sonrası klinik skorlamada gruplar arasında istatiksel olarak anlamlı bir fark görülmemiştir. Grup 1 ve grup 2'nin histopatolojik skorları ile grup 3 ve grup 4'ün histopatolojik skorları arasında istatiksel olarak anlamlı düzeyde farklılık saptanmıştır. Grup 1 ve grup 2'nin histopatolojik skorları grup 3 ve grup 4'ten daha iyi bulunmuştur. Tedavi öncesi ve sonrası koloni sayıları karşılaştırıldığında, grup 3 ve grup 2 arasında istatiksel olarak anlamlı fark bulunmasına rağmen, grup 4 ve grup 1'in sonuçları arasında istatiksel olarak anlamlı farklılık bulunmamıştır. Sonuç: Geniş etki spektrumlu olması nedeniyle seçilen rifaksiminin osteomiyelit tedavisinde yeteri kadar etkinliği gösterilememiştir. Bu çalışma; ileride yapılacak olan ve enfeksiyon belirteçlerinin de çalışmaya dahil edildiği daha kapsamlı, karşılaştırmalı çalışmalara ışık tutma özelliği göstermektedir.Öğe Rifaximine spacer application is not superior to local teicoplanin treatment in a rat model of osteomyelitis(2022) Yücel, Mücahid Osman; Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan; Sağlam, Sönmez; Tekçe, Yıldıray; Gamsızkan, MehmetOBJECTIVE: Acute and chronic osteomyelitis generally require long-term antibiotic therapy and surgical debridement. Implant- associated osteomyelitis, particularly from methicillin-resistant Staphylococcus aureus (MRSA) strains, is difficult to treat. Rifaximin is an antibiotic derived from rifamycin which may be effective in the treatment of osteomyelitis in terms of its wide spectrum of action and pharmacological properties. The aim of this experimental study was to investigate the local efficacy of rifaximin in rat models with MRSA and implant associated osteomyelitis. METHODS: This study was carried out with 40 adult Wistar albino rats. The rats were randomly divided into 4 equal groups with 10 rats in each. An implant related MRSA osteomyelitis was created in the right tibia metaphysis of each rat by Norden’s experimental osteomyelitis model. After 4 weeks, the implants of each tibia were removed and debridement was applied. Group 1 was designed as control group and no other treatment was applied other than debridement. Bone cement without any antibiotic was applied to Group 2, bone cement with teicoplanin was applied to Group 3 and bone cement with rifaximin was applied to Group 4. After 4 weeks from the second surgery, euthanasia was performed to the rats and the clinical, histopathological and microbiological results were compared. RESULTS: There was no statistically significant difference between the groups in clinical scoring. A statistically significant difference was found between the histopathological scores of Group 1 and Group 2 and the histopathological scores of Groups 3 and 4; the histopathological scores of Group 1 and Group 2 were found to be higher than Group 3 and Group 4. When the pre-and post-treatment colony numbers were compared, although there was a statistically significant difference between Group 3 and Group 2, no statistically significant difference was found between Group 4 and Group 1 results. CONCLUSION: In spite of its wide spectrum, the local efficacy of rifaximin in the treatment of osteomyelitis could not be demonstrated. This study shows the ability to shed light on some future comprehensive studies with the inclusion of infection markers.Öğe Rifaximine spacer application is not superior to local teicoplanin treatment in a rat model of osteomyelitis(Kare Publ, 2022) Yücel, Mücahid Osman; Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan; Sağlam, Sönmez; Tekçe, Yıldıray; Gamsızkan, MehmetOBJECTIVE: Acute and chronic osteomyelitis generally require long-term antibiotic therapy and surgical debridement. Implant-associated osteomyelitis, particularly from methicillin-resistant Staphylococcus aureus (MRSA) strains, is difficult to treat. Rifaximin is an antibiotic derived from rifamycin which may be effective in the treatment of osteomyelitis in terms of its wide spectrum of action and pharmacological properties. The aim of this experimental study was to investigate the local efficacy of rifaximin in rat models with MRSA and implant associated osteomyelitis.METHODS: This study was carried out with 40 adult Wistar albino rats. The rats were randomly divided into 4 equal groups with 10 rats in each. An implant related MRSA osteomyelitis was created in the right tibia metaphysis of each rat by Norden's experimental osteomyelitis model. After 4 weeks, the implants of each tibia were removed and debridement was applied. Group 1 was designed as control group and no other treatment was applied other than debridement. Bone cement without any antibiotic was applied to Group 2, bone cement with teicoplanin was applied to Group 3 and bone cement with rifaximin was applied to Group 4. After 4 weeks from the second surgery, euthanasia was performed to the rats and the clinical, histopathological and microbiological results were compared.RESULTS: There was no statistically significant difference between the groups in clinical scoring. A statistically significant difference was found between the histopathological scores of Group 1 and Group 2 and the histopathological scores of Groups 3 and 4; the histopathological scores of Group 1 and Group 2 were found to be higher than Group 3 and Group 4. When the pre-and post-treatment colony numbers were compared, although there was a statistically significant difference between Group 3 and Group 2, no statistically significant difference was found between Group 4 and Group 1 results.CONCLUSION: In spite of its wide spectrum, the local efficacy of rifaximin in the treatment of osteomyelitis could not be demonstrated. This study shows the ability to shed light on some future comprehensive studies with the inclusion of infection markers.