Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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8 results
Search Results
Item Predicting Teeth Extraction after Concurrent Chemoradiotherapy in Locally Advanced Nasopharyngeal Cancer Patients Using the Novel GLUCAR Index(2023) Somay, Efsun; Topkan, Erkan; Yilmaz, Busra; Besen, Ali Ayberk; Mertsoylu, Huseyin; Selek, Ugur; 0000-0001-8120-7123; 0000-0001-8251-6913; 38066835; AAG-2213-2021To evaluate the value of the newly created GLUCAR index in predicting tooth extraction rates after concurrent chemoradiotherapy (C-CRT) in locally advanced nasopharyngeal carcinomas (LA-NPCs). Methods: A total of 187 LA-NPC patients who received C-CRT were retrospectively analyzed. The GLUCAR index was defined as 'GLUCAR = (Fasting Glucose x CRP/Albumin Ratio) by utilizing measures of glucose, C-reactive protein (CRP), and albumin obtained on the first day of C-CRT. Results: The optimal GLUCAR cutoff was 31.8 (area under the curve: 78.1%; sensitivity: 70.5%; specificity: 70.7%, Youden: 0.412), dividing the study cohort into two groups: GLUCAR < 1.8 (N = 78) and GLUCAR >= 31.8 (N = 109) groups. A comparison between the two groups found that the tooth extraction rate was significantly higher in the group with a GLUCAR >= 31.8 (84.4% vs. 47.4% for GLUCAR < 31.8; odds ratio (OR):1.82; p < 0.001). In the univariate analysis, the mean mandibular dose >= 38.5 Gy group (76.5% vs. 54.9% for <38.5 Gy; OR: 1.45; p = 0.008), mandibular V55.2 Gy group >= 40.5% (80.3 vs. 63.5 for <40.5%, p = 0.004, OR; 1.30), and being diabetic (71.8% vs. 57.9% for nondiabetics; OR: 1.23; p = 0.007) appeared as the additional factors significantly associated with higher tooth extraction rates. All four characteristics remained independent predictors of higher tooth extraction rates after C-CRT in the multivariate analysis (p < 0.05 for each). Conclusions: The GLUCAR index, first introduced here, may serve as a robust new biomarker for predicting post-C-CRT tooth extraction rates and stratifying patients according to their tooth loss risk after treatment.Item Migraine and Subclinical Atherosclerosis: Endothelial Dysfunction Biomarkers and Carotid Intima-Media Thickness: A Case-Control Study(2019) Avci, Aynur Yilmaz; Akkucuk, Mehmet Husamettin; Torun, Ebru; Arikan, Serap; Can, Ufuk; Tekindal, Mustafa Agah; https://orcid.org/0000-0001-9004-9382; https://orcid.org/0000-0003-4569-1143; https://orcid.org/0000-0001-5752-3812; https://orcid.org/0000-0001-8689-417X; https://orcid.org/0000-0002-4060-7048; 30645751; F-6770-2019; AAJ-2828-2021; AAJ-1289-2021; AAJ-2999-2021; U-9270-2018Background Migraine is a common neurovascular disease associated with vascular risks, especially in young adult females, but the mechanism underlying these associations remains unknown. This study evaluated the relationships between plasma endothelial dysfunction biomarkers and carotid intima-media thickness (IMT) in young adult females with migraine. Methods This case-control study included 148 female patients (age range: 18-50years). Migraine was diagnosed according to the International Headache Society-IIIb criteria. Endothelial dysfunction biomarkers, such as von Willebrand factor (vWF), C-reactive protein (CRP), homocysteine, total nitrate/nitrite concentration, and thiobarbituric acid-reactive substances (TBARS), were evaluated in plasma. Carotid IMT was measured by a radiologist with sonography. Results The CRP, TBARS, vWF, and IMT levels were increased in the migraine compared with the control group (p<0.001, p=0.02, p<0.001, and p<0.001, respectively). After adjusting for confounders, multiple linear regression analysis revealed that systolic arterial blood pressure, CRP, vWF, TBARS, and right and left internal carotid artery (ICA) IMT were independently positively correlated with migraine (p<0.01, p=0.004, p=0.023, p=0.024, p=0.032, and p=0.048, respectively). Multiple logistic regression analysis revealed that right ICA IMT was independently associated with ergotamine and triptan and left ICA IMT was independently associated with ergotamine (p=0.013, p=0.026, and p=0.017, respectively). In addition, significant correlations were found between LDL lipoprotein and carotid IMT in the migraine group (p<0.05). Conclusions Carotid IMT enhancement and elevated TBARS, vWF, and CRP levels in migraine subjects during a migraine attack could be regarded as consequences of migraine attack pathophysiology. The independent associations between triptan and ergotamine consumption and enhanced carotid IMT suggest that repeated use of these vasoconstrictive antimigraine agents may have additional effects on carotid IMT.Item Role of Serum Procalcitonin Levels in Solid-Organ Transplant Patients(2016) Bozbas, Serife Savas; Dedekarginoglu, Balam Er; Ulubay, Gaye; Haberal, Mehmet; 0000-0002-7230-202X; 0000-0003-2478-9985; 0000-0002-3462-7632; 27805529; AAI-8064-2021; AAB-5064-2021; AAJ-8097-2021Objectives: Systemic infection is among the common complications after solid-organ transplant and is associated with increased mortality and morbidity. Because it has prognostic significance, timely diagnosis and treatment are crucial. Procalcitonin is a propeptide of calcitonin and has been increasingly used as a biomarker of bacterial infection. Here, we investigated procalcitonin's role in identifying infectious complications in solid-organ transplant recipients. Materials and Methods: We retrospectively evaluated the records of 86 adult patients who underwent solid-organ transplant (between 2011 and 2015) with procalcitonin levels determined at our center. Clinical and demographic variables and laboratory data were noted. Relation between C-reactive protein and procalcitonin serum levels were compared in patients who were diagnosed as having pneumonia on clinical, microbiologic, and radiologic findings. Results: Mean age of our patients was 45.5 +/- 13.4 years (range, 18-70 y), with 61 male patients (70.9%). We included 26 liver, 44 kidney, 14 heart, and 2 heart and renal transplant recipients. Procalcitonin was positive in 43 patients (50%). Of the 39 patients who were diagnosed with pneumonia, procalcitonin was positive in 18 patients (46.2%). There was a significant correlation between serum levels of procalcitonin and C-reactive protein (r = 0.45; P < .001) and neutrophil count (r = 0.24; P = .025). There was no correlation between mortality and procalcitonin level, CRP level, or leukocyte count (P > .05). Conclusions: Our findings indicate that procalcitonin is a promising biomarker to detect infectious complications in transplant recipients. Physical examination and radiologic findings of bacterial pneumonia may be nonspecific, and in a considerable number of immunocompromised patients the site of infection could not be identified. Serum levels of procalcitonin should not be used as sole criteria for clinical decision making; however, it can guide us in therapy of such conditions in addition to currently used serum markers of infection.Item Hypoxia and Inflammation Indicate Significant Differences in the Severity of Obstructive Sleep Apnea within Similar Apnea-Hypopnea Index Groups(2017) Avci, Aynur Yilmaz; Avci, Suat; Lakadamyali, Huseyin; Can, Tfuk; 0000-0001-9004-9382; 0000-0003-2155-8014; 0000-0003-2155-8014; 28271327; F-6770-2019; O-3636-2018; O-3636-2018Purpose We determined whether hypoxia parameters are associated with C-reactive protein (CRP), mean platelet volume (MPV), white matter hyperintensity (WMH), and the severity of obstructive sleep apnea (OSA), and also evaluated whether hypoxia parameters, CRP, MPV, and WMH differ in patients with similar apnea-hypopnea index (AHI) scores. Methods A total of 297 patients, who were evaluated using Polysomnography, were assessed retrospectively. The measured hypoxia parameters included total sleep time with oxygen saturation <90% (ST90), percentage of cumulative time with oxygen saturation <90% (CT90), and lowest oxygen saturation (min SaO(2)). The patients were divided into subgroups according to their CT90 values, and patients with different AHI severities were divided into subgroups according to their ST90 and min SaO(2) levels. Results Hypoxia parameters are associated with CRP, MPV, WMH, and the severity of OSA (P < 0.05). The hypoxia parameters differed in all subgroup analyses of similar AHI groups (P < 0.001), and CRP differed only in severe OSA (P < 0.008, P < 0.001). In subgroup analyses of similar AHI groups, MPV and. WMH were not significantly different (P > 0.05). Above the hypoxia threshold (CT90 >= 10%) of CRP, MPV increased significantly and the presence of WMH increased twofold. Conclusions These data suggest that increased hypoxia severity may mediate increased inflammation and activation of platelets and contribute to the pathogenesis of WMH in patients with OSA. In addition, patients with severe OSA may show significant variability in inflammation and vascular risk. Further prospective data are needed.Item Hand-Grip Strength Is Associated With Serum Testosterone and Albumin Levels in Male Kidney Transplant Recipients(2018) Demirci, Bahar Gurlek; Sezer, Siren; Tutal, Emre; Colak, Turan; Uyanik, Saliha; Haberal, Mehmet; 0000-0002-8372-7840; 0000-0002-3462-7632; 29527997; AAJ-8554-2021; AAJ-8097-2021Objectives: In kidney transplant recipients, reduced muscle mass and hand-grip strength are associated with impaired nutritional status. Serum testosterone is highly associated with muscle strength in the general population. Here, we aimed to determine the associations among serum testosterone, hand-grip strength, and nutritional and inflammatory parameters, as well as graft function. Materials and Methods: Our study included 144 stable male kidney transplant recipients from our renal transplant outpatient clinic. All patients were evaluated for clinical parameters (age, duration of hemodialysis, and posttransplant time), biochemical parameters (calcium, phosphorus, parathyroid hormone, C-reactive protein, albumin, creatinine), and serum testosterone levels. Body composition was analyzed with the bioimpedance spectroscopy analysis technique using a body composition monitor that estimates body mass index and percent fat. Hand-grip strength was analyzed by using a dynamometer (ProHealthcareProducts.com, Park City, UT, USA). We calculated estimated glomerular filtration rate using the Modification of Diet in Renal Disease-4 equation. Results: Demographic characteristics, duration of dialysis before transplant, biochemical parameters, and estimated glomerular filtration rates were similar among study patients. Mean (standard deviation) serum testosterone was 588.0 (55.5) ng/dL, mean body mass index was 26.8 (0.6) kg/m(2), and mean hand-grip strength was 42.2 (1.7) mm(2). Serum testosterone levels were positively correlated with hand-grip strength (r = 0.445; P = .033) and serum albumin (r = 0.399; P = .05) and negatively correlated with serum C-reactive protein (r = -0.454;P= .05) and age. In linear multiple regression analysis, serum albumin (P= .033) and testosterone levels (P = .038) were shown to be predictors of hand-grip strength. However, we could not show a significant correlation between graft function and testosterone. Conclusions: Serum testosterone level is correlated with hand-grip strength and C-reactive protein and albumin levels, which may indicate that testosterone affects nutritional status and inflammation in male renal transplant recipients.Item Peri-Implant Crevicular Fluid And Serum Levels Of Soluble ST2 In Peri-Implant Diseases: A Pilot Study(2023) Ozgur, Engin; Topcu, Deniz Ilhan; Bayraktar, Nilufer; Alptekin, Nilgun Ozlem; https://orcid.org/0000-0002-7911-198X; https://orcid.org/0000-0002-1219-6368; https://orcid.org/0000-0002-7886-3688; https://orcid.org/0000-0003-4104-6462; 36504319; E-3717-2019; Y-8758-2018; G-1816-2014Background and ObjectiveSoluble ST2 (sST2) is a current biomarker of cardiovascular disease. It is used to predict susceptibility to cardiovascular diseases and to analyze their prognosis. Serum sST2 level increases in inflammatory diseases such as periodontitis. However, the level of sST2 in peri-implant diseases and crevicular fluid has not been investigated yet. Thus, the aim of this cross-sectional study is to analyze the level of sST2 in peri-implant health and diseases. MethodsSixty-nine participants were divided into 3 groups as peri-implant health (PH), peri-implant mucositis (PM), and peri-implantitis (P-I). Peri-implant crevicular fluid (PICF) and serum samples were collected from each participant. The levels of sST2 and IL-6 in PICF and sST2, IL-6, and CRP in serum were compared between the groups. Pocket depth (PD), modified bleeding index (mBI), modified plaque index (mPI), keratinized mucosa index (KTW), and gingival/mucosal recession (REC) were recorded as clinical parameters. Biomarkers in the serum and PICF were analyzed by ELISA kit. ResultsSixty-nine patients were included in the study. The differences in the following parameters were statistically significant between groups: age (p = .009), implant function time (p = .027), PD (p < .001), mBI (p < .001), mPI (p < .001), and KTW (p = .043). The PICF volume of P-I and PM groups were statistically higher than PH (p < .001). The amount of sST2 in P-I and PM groups were higher than PH (p = .043). Serum CRP was higher in the P-I group than in other groups (p = .034). There were no significant differences in serum sST2 (p = .247) and IL-6 (p = .110) levels between groups. ConclusionThe PICF levels of sST2 were significantly higher in PM and P-I groups compared to the healthy group. However, no significant difference was observed between the groups in terms of serum sST2 level.Item High Levels of Circulating Endothelial Progenitor Cells Are Associated with Acrotism in Patients with Takayasu Arteritis(2017) Kozanoglu, Ilknur; Keskek, Sakir Ozgur; Bozkirli-Ersozlu, Emine Duygu; Yucel, Ahmet Eftal; 0000-0002-5268-1210; 27816980; AAE-1241-2021; I-6542-2012Objectives: To investigate the association between endothelial progenitor cells (EPCs) and Takayasu arteritis (TA). Subjects and Methods: A total of 39 subjects were included in this study: 12 subjects had been diagnosed with active TA, 11 had active Behcet disease (BD), and 16 were healthy controls. The EPCs, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels of all the subjects were measured. MedCalc 15.8 software (MedCalc, Belgium) was used for all statistical analyses. Results: The level of EPCs was higher in TA patients (4.25 +/- 2.56) than in the BD group (2.27 +/- 2.0) and the healthy controls (2.12 +/- 1.2) (p = 0.015). TA patients with acrotism (n = 4) had higher levels of EPCs compared to TA patients without acrotism (n = 8) (6.50 +/- 1.73 vs. 3.12 +/- 2.16, p = 0.02). A positive correlation was found between EPCs and the ESR (r = 0.723, p = 0.0079) and between EPCs and CRP in patients with TA (r = 0.769, p < 0.0034). Conclusion: High levels of circulating EPCs were correlated with the CRP level and the ESR in patients with TA. These cells could be a marker for acrotism and inflammation in patients with TA. (C) 2016 S. Karger AG, BaselItem Role of preoperative C-reactive protein value and neutrophil ratio in the determination of conversion from laparoscopic appendectomy to open appendectomy(2018) Aydin, Huseyin Onur; Avi, Tevfik; Tezcaner, Tugan; Kirnap, Mahir; Yildirim, Sedat; Moray, Gokhan; 0000-0003-3795-5794; 0000-0003-3795-5794; 0000-0003-2498-7287; 30394496; AAH-9198-2019; S-8185-2018; AAF-4610-2019; M-1422-2019BACKGROUND: In this study, we aimed to investigate the factors causing conversion from laparoscopic appendectomy (LA) to open appendectomy (OA) in patients with acute appendicitis and to investigate the role of preoperative C reactive protein (CRP) and neutrophil ratio in this conversion and determine a cut-off point for these parameters. METHODS: Records of patients who underwent LA due to acute appendicitis at our general surgery department between January 2011 and January 2017 were retrospectively evaluated. The preoperative American Society of Anesthesiology (ASA) scores, Alvarado scores, white blood cell count, C-reactive protein level, and neutrophil ratio were evaluated. RESULTS: LA was performed in 394 patients with an initial diagnosis of acute appendicitis. A conversion to OA (cOA) was performed in 17 patients (4.31%). A CRP value of >= 108.5 mg/L and a neutrophil ratio of >= 81.5% were found to be statistically significant for the cOA (p<0.001). CONCLUSION: Our study results showed that male gender, age, elevated neutrophil ratio, and CRP value were the main risk factors for cOA in patients who were scheduled for LA due to acute appendicitis.