Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Role of Calprotectin and Alpha-Defensin in the Diagnosis of Pneumonia in Ventilated Patients(2023) Kuscu, Ozlem Ozkan; Bayrakci, Sinem; Etiz, Pinar; Karakoc, Emre; Ozturk, Ozlem Gorurolu; Ozyilmaz, Ezgi; Candevir, AslihanIntroduction: Hospital-acquired pneumonia and ventilator-associated pneumonia are the major causes of death in hospitalized patients, particularly in the intensive care unit, and early diagnosis may contribute to the survival of the patients. Our aim in this study was to contribute to the rapid treatment of ventilator-associated pneumonia by providing an early diagnosis of pneumonia with alfa-defensin, and calprotectin as inflammation biomarkers. Materials and Methods: The study was designed as a single-center, prospective observational study involving mechanically ventilated patients who were admitted to the Internal Medicine Intensive Care Unit at cukurova University Hospital between May 2018 and July 2019 and were above 18 years of age. Patients' demographics and clinical parameters were noted. Serum alpha-defensin levels were measured with the Human Alpha-defensin ELISA kit (Bioassay Technology Laboratory, Jiaxing, China). Serum calprotectin levels were measured with the Human Calprotectin ELISA kit (Bioassay Technology Laboratory, Jiaxing, China). Deep tracheal aspirates (DTA) and blood specimens were collected on the day of ventilation, as well as on the first, third, and seventh days, prospectively. The patients were monitored for the development of ventilator-associated pneumonia (VAP). Infections other than ventilator-associated pneumonia were also noted. Results: During the study period, 822 patients were admitted to the intensive care unit, accumulating 5101 patient days and 1966 ventilator days. Of the included 88 patients who were intubated and mechanically ventilated, 59.1% were male and the mean age was 59.9 +/- 18.4. Mean alpha defensin levels were higher in patients with pneumonia than those without (1679.21 +/- 3398.17 vs 552.32 +/- 243.67 respectively, p= 0.012). As for the ROC curve analysis, the area under the curve for alpha-defensin in pneumonia patients was 0.583 (p= 0.239). Mean calprotectin levels were higher in patients with pneumonia than those without (230.40 +/- 150.6819 ng/ mL vs 163.80 +/- 73.5819 ng/mL, p= 0.001). As for the ROC curve analysis, the area under the curve for calprotectin in pneumonia patients was 0.621 (p= 0.086). Conclusion: Serum and bronchoalveolar fluid levels of alpha defensin and calprotectin exhibited higher values in patients with pneumonia compared to those without pneumonia. However, due to the absence of statistical significance, larger-scale studies are necessaryto ascertain the clinical utility and benefits. In conclusion, it is recommended to plan a study with a larger number of patients, in which serum and bronchoalveolar fluid alpha defensin levels are measured simultaneously and molecular methods are used for more accurate diagnosis.Item High Pre-Chemoradiotherapy Pan-Immune-Inflammation Value Levels Predict Worse Outcomes in Patients with Stage IIIB/C Non-Small-Cell Lung Cancer(2023) Topkan, Erkan; Kucuk, Ahmet; Ozkan, Emine Elif; Ozturk, Duriye; Besen, Ali Ayberk; Mertsoylu, Huseyin; Pehlivan, Berrin; Selek, Ugur; 0000-0001-8120-7123; 38091179; AAG-2213-2021Background and objectives We explored the prognostic usefulness of the pan-immune-inflammation value (PIV) in patients with stage IIIB/C non-small-cell lung cancer (NSCLC) who underwent concurrent chemoradiotherapy (CCRT).Methods and patients For all patients, the PIV was calculated using platelet (P), monocyte (M), neutrophil (N), and lymphocyte (L) measures obtained on the first day of CCRT: PIV = P x M x N divided by L. Using receiver operating characteristic (ROC) curve analysis, we searched for the existence of an ideal cutoff that may partition patients into two groups with unique progression-free- (PFS) and overall survival (OS) results. The primary endpoint of this retrospective cohort research was to determine whether there were any significant relationships between pretreatment PIV measures and post-CCRT OS outcomes.Results The present research included a total of 807 stage IIIB/C NSCLC patients. According to ROC curve analysis, the ideal PIV cutoff was 516 [area under the curve (AUC): 67.7%; sensitivity: 66.4%; specificity: 66.1%], which divided the whole cohort into two: low PIV (L-PIV: PIV < 516; N = 436) and high PIV (H-PIV: PIV >= 516; N = 371). The comparisons between the PIV groups indicated that either the median PFS (9.2 vs. 13.4 months; P < 0.001) or OS (16.7 vs. 32.7 months; P < 0.001) durations in the H-PIV group were substantially inferior to their L-PIV counterpart. Apart from the H-PIV (P < 0.001), the N-3 nodal stage (P = 0.006), IIIC disease stage (P < 0.001), and receiving only one cycle of concurrent chemotherapy (P = 0.005) were also determined to be significant predictors of poor PFS (P < 0.05, for each) and OS (P < 0.05, for each) outcomes in univariate analysis. The multivariate analysis findings revealed that all four variables had independent negative impacts on PFS (P < 0.05, for each) and OS (P < 0.05, for each).Conclusions The findings of this hypothesis-generating retrospective analysis claimed that the novel PIV was an independent and steadfast predictor of PFS and OS in stage IIIB/C NSCLC patients.Item The Effect Of Topiramate On Nitrosative Stress, Inflammation And Apoptosis In Non-Alcoholic Fatty Liver Disease(2023) Kilinc, Sevtap; Sahin, Pelin; Sevgili, Ayse Meltem; 0000-0002-4162-1554; ISP-2968-2023Item The Role of Oxidative Stress and Inflammatory Response in High-Fat Diet Induced Peripheral Neuropathy(2014) Ozay, Rafet; Uzar, Ertugrul; Aktas, Abit; Uyar, Mehtap Erkmen; Gurer, Bora; Evliyaoglu, Osman; Cetinalp, Nuri Eralp; Turkay, Cansel; 24407112Objective: Earlier studies suggest that high-calorie diet is an important risk factor for neuronal damage resulting from oxidative stress of lipid metabolism. In our experimental study of rats under high-fat diet, oxidative stress markers and axonal degeneration parameters were used to observe the sciatic nerve neuropathy. The aim of this study is to evaluate the pathophysiology of neuropathy induced by high-fat diet. Methods: A total of 14 male rats (Wistar albino) were randomly divided into two experimental groups as follows; control group (n = 7) and the model group (n = 7); while control group was fed with standard diet; where the model group was fed with a high-fat diet for 12 weeks. At the end of 12 weeks, the lipid profile and blood glucose levels, interleukin-1 beta (IL-1), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and transforming growth factor-beta (TGF-beta) levels were studied. Tissue malondialdehyde (MDA), nitric oxide (NO) levels and super-oxide dismutase (SOD), paraoxonase-1 (PON-1) and glutathione peroxidase (GPx) activities were studied. The distal blocks of the left sciatic nerves were evaluated for histomorphological analysis (including mean axon area, axon numbers, nerve fiber diameters, axon diameters, and thickness of myelin sheets). Results: Body weights, serum glucose and high-density lipoprotein (HDL) levels of rats were found not statistically significantly different compared between the model and the control groups (p > 0.05). Serum cholesterol, triglyceride, TGF-beta and TNF-alpha levels were significantly higher in the model group when compared with the control group (p < 0.05). IL-1 and IL-6 levels were not statistically significantly different compared between the model group and the control group (p > 0.05). The MDA and NO levels and the SOD and GPx activities of the sciatic nerves in model group were statistically significantly higher than the control group (p < 0.05). In addition, the activities of PON-1 were statistically significantly lower in the model group when compared with the control group (p < 0.05). The difference in the total number of myelinated axons between the control group and the model group was not statistically significant (p > 0.05). The nerve fiber diameter and the thickness of the myelin sheet were statistically significantly lower in the model group when compared with the control group (p < 0.05). The axon diameter and area were significantly decreased in the model group when compared with the control group (p < 0.05). Conclusion: Our results support that dyslipidemia is an independent risk factor for the development of neuropathy. In addition, we postulated that oxidative stress and inflammatory response may play an important role in the pathogenesis of high-fat diet induced neuropathy. (C) 2014 Elsevier B.V. All rights reserved.Item The Effects of Niacin on Inflammation in Patients with Non-ST Elevated Acute Coronary Syndrome(2015) Karacaglar, Emir; Atar, Ilyas; Altin, Cihan; Yetis, Begum; Cakmak, Abdulkadir; Bayraktar, Nilufer; Coner, Ali; Ozin, Bulent; Muderrisoglu, Haldun; 0000-0002-2538-1642; 0000-0002-5711-8873; 0000-0003-3821-412X; 0000-0002-7886-3688; 0000-0002-9635-6313; 27122858; ABI-6723-2020; ABD-7321-2021; AAD-9938-2021; Y-8758-2018; AAG-8233-2020Background: In this study, we aimed to evaluate the effects of niacin on high sensitivity C reactive protein (hs-CRP) and cholesterol levels in non-ST elevated acute coronary syndrome (NSTE-ACS) patients. Methods: In this prospective, open label study, 48 NSTE-ACS were randomized to niacin or control group. Patients continued their optimal medical therapy in the control group. In the niacin group patients were assigned to receive extended-release niacin 500 mg/day. Patients were contacted 1 month later to assess compliance and side effects. Blood samples for hs-CRP were obtained upon admittance to the coronary care unit, in the third day and in the first month of the treatment. Fasting blood samples for cholesterol levels were obtained before and 30 days after the treatment. The primary end point of the study was to evaluate changes in hs-CRP, cholesterol levels, short-term cardiovascular events, and the safety of niacin in NSTE-ACS. Results: Baseline demographic, clinical and laboratory characteristics were similar between the two groups. Logarithmic transformation of baseline and 3rd day hs-CRP levels were similar between the groups; but 1 month later, logarithmic transformation of hs-CRP level was significantly lower in the niacin group (0.43 +/- 0.39 to 0.83 +/- 0.91, p = 0.04). HDL-C level was significantly increased in the niacin group during follow-up. Drug related side effects were seen in 7 patients in the niacin group but no patients discontinued niacin. Conclusions: Our findings demonstrate that lower dose extended release niacin can be used safely and decreases hs-CRP and lipid parameters successfully in NSTE-ACS patients.Item Low Serum Levels of Vitamin D in Metastatic Cancer Patients: A Case-Control Study(2014) Sumbul, Ahmet Taner; Sezer, Ahmet; Kavvasoglu, Gamze; Batmaci, Celal Yucel; Yengil, Erhan; Yagiz, Abdullah Erman; Gultepe, Ihami; Abali, Huseyin; Ustun, Ihsan; Gokce, Cumali; https://orcid.org/0000-0002-6445-1439; https://orcid.org/0000-0001-5596-0920; 24493144; AAD-2667-2020; D-7660-2016Accompanying comorbidities observed during the cancer treatment usually affect the course and outcome of the therapy. Hypovitaminosis D, which is one of these conditions, is a resolvable problem, if recognized. In this study, we investigated whether the serum 25(OH) D levels of the patients who were presented to our outpatient clinic were different from the serum levels of the healthy population living in the same area. Our study included 90 patients who were presented to the Medical Oncology outpatient clinic and 90 age, gender, body mass index and ethnic origin matched controls without a known disease, who were presented to the outpatient clinics of the Departments of Internal Diseases and Family Medicine for routine controls. Blood count tests, detailed biochemistry tests (including serum levels of Cr, Ca and P), measurement of serum 25(OH) D levels and C-reactive protein were performed in serum samples of all of the patients and controls. Mean serum levels of 25(OH) D were 13.5 ng/ml (SD 5.1) in all cancer patients, 13.1 ng/ml (SD 4.2) in the patients who were presented for adjuvant therapy, 13.8 ng/ml (SD 5.5) in the patients who were presented at metastatic stage and 18.4 ng/ml (SD 12.5) in the controls. Mean serum CRP levels were 5.4 mg/dl (SD 1.2) in the control group, 8.4 mg/dl (SD 4.3) in the adjuvant therapy group and 20.3 (SD 16.8) in the patients with metastatic disease. Generally, all cancer patients (p 0.003) and the patients with metastatic cancer (p 0.004) had lower serum 25(OH) D levels compared to controls, and there was an inverse correlation between serum 25(OH) D and CRP levels in patients with metastatic cancer (p 0.036). In metastatic cancer patients, hypovitaminosis D may be a comorbidity and it is recommended to consider during initial evaluation and follow-up. Because it might improve these patients quality of life and chemotherapy adherence.Item Relationship between Neutrophil-to-Lymphocyte Ratio and Impaired Myocardial Perfusion in Cardiac Syndrome X(2015) Okyay, K.; Yilmaz, M.; Yildirir, A.; Eroglu, S.; Sade, E.; Sahinarslan, A.; Aydinalp, A.; Muderrisoglu, H.; 0000-0001-8750-5287; 0000-0001-6134-8826; 0000-0002-3761-8782; 0000-0002-9635-6313; 0000-0003-3737-8595; 0000-0003-3055-7953; 26044235; A-4947-2018; AAK-7355-2020; AAD-5841-2021; ABG-1582-2021; AAG-8233-2020; AAQ-7583-2021OBJECTIVE: Myocardial tissue perfusion is decreased in patients with cardiac syndrome X (CSX). Systemic inflammation appears to be an important contributor to the diseased microvascular network of these patients. The neutrophil-to-lymphocyte ratio (NLR) is a surrogate marker of inflammation. Accordingly, we evaluated this biomarker concerning the microvascular circulation of CSX patients. PATIENTS AND METHODS: This study included 60 consecutive patients (54.1 +/- 7.8 years of age, 49 females) with CSX (typical chest pain, positive exercise stress test results, and normal coronary angiograms) and 60 consecutive age- and sex-matched control subjects. In all coronary territories, epicardial coronary flow was assessed by the Thrombolysis In Myocardial Infarction frame count (TFC) method, and myocardial tissue perfusion was assessed by the myocardial blush grade (MBG) method. Normal myocardial perfusion was accepted as an MBG score of 3 in all coronary territories. RESULTS: Patients with CSX had higher NLRs than those of control subjects (1.98 +/- 0.77 vs 1.72 +/- 0.55, respectively; p = 0.04). Among patients with CSX, those with impaired myocardial perfusion had higher NLRs than those with normal myocardial perfusion (2.13 +/- 0.82 vs 1.71 +/- 0.59, respectively; p = 0.028). There was a negative correlation between the NLR and total MBG score (p = 0.027, r = -0.29). Logistic regression analysis showed that the NLR was an independent and negative predictor of myocardial tissue perfusion (p = 0.027; Beta, -1.057; odds ratio, 2.878; 95% confidence interval, 1.129-7.335). CONCLUSIONS: Patients with CSX have high NLRs, and inflammation seems to be associated with distorted myocardial perfusion in these patients.Item Lack of Association of Matrix Metalloproteinase-9 Promoter Gene Polymorphism in Obstructive Sleep Apnea Syndrome(2015) Yalcinkaya, Mustafa; Erbek, Selim S.; Babakurban, Seda Turkoglu; Kupeli, Elif; Bozbas, Serife; Terzi, Yunus K.; Sahin, Feride Iffet; 0000-0001-5612-9696; 0000-0001-5067-4044; 0000-0003-4825-3499; 0000-0002-5826-1997; 0000-0001-7308-9673; 0000-0002-7230-202X; 26169999; B-4372-2018; AAI-8856-2021; B-7604-2019; AAB-5345-2021; AAC-7232-2020; AAI-8064-2021Purpose: Obstructive sleep apnea syndrome (OSAS) is a public health problem. There is an effort to establish the genetic contributions to the development of OSAS. One is matrix metalloproteinases, extracellular matrix degrading enzymes related to systemic inflammation. However, the impact of matrix metalloproteinase-9 (MMP-9) genotypes on the development of OSAS is unknown. Our aim was to determine whether MMP-9 single nucleotide polymorphism (SNP) (MMP-9 -1562C > T) is related to susceptibility to OSAS. Material and methods: A total of 106 patients with a history of sleep apnea and 88 controls without a history of sleep apnea were enrolled in this study. Genotypes were determined by restriction fragment length polymorphism analyses after polymerase chain reaction. Results: Genotypes and allele frequencies of the MMP-9 -1562C > T SNP was not statistically different between the patient and control groups (p > 0.05). There was a statistical association between apnea -hypopnea index (AHI) and body mass index (BMI), and also between AHI and neck circumference (p < 0.001). There was no association among the genotypes and AHI, neck circumference, or BMI (p > 0.05). Conclusions: We found no association between MMP-9 -1562C > T SNP and OSAS. Studies to investigate the role of other polymorphisms and expression of MMP-9 gene will provide more information. (C) 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.Item Diagnosis and Treatment of Xanthogranulomatous Cholecystitis(2014) Yabanoglu, H.; Aydogan, C.; Karakayali, F.; Moray, G.; Haberal, M.; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0003-1547-1297; https://orcid.org/0000-0002-1874-947X; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24817291; AAJ-7865-2021; AAJ-5296-2021; AAB-3888-2021; AAE-1041-2021; AAJ-8097-2021BACKGROUND: The aim of this study was to review our case load of the treatment and outcomes of patients with xanthogranulomatous cholecystitis (XGC). PATIENTS AND METHODS: Data about 21 patients were reviewed retrospectively to determine age, clinical symptoms and findings, preoperative screening, operative findings, surgical history, length of hospital stay, and postoperative complications. RESULTS: There were 14 men and 7 women (mean age, 65 +/- 11.3 yr). Preoperative ultrasonography of 17 patients showed a gallbladder stone in 14 patients, adenomyomatosis plus stones in 2 patients, and a polyp in 1 patient. There were 5 patients with acute cholecystitis and 16 patients with chronic cholecystitis. Gallbladder wall thickening was noted in 3 of the 12 patients who had abdominal computed tomography. Frozen section examinations were done in 5 patients. Radical cholecystectomy was done in 1 patient because of suspected carcinoma. CONCLUSIONS: It is difficult to diagnose XGC preoperatively or intraoperatively, and the definitive diagnosis depends exclusively on pathologic examination.Item Periaortic Fat Tissue: A Predictor of Cardiac Valvular Calcification, Malnutrition, Inflammation, and Atherosclerosis Components in Hemodialysis Patients(2015) Genctoy, Gultekin; Eldem, Olcay; Ergun, Tarkan; Arikan, Serap; 0000-0002-5145-2280; 0000-0001-5752-3812; 25940595; AAJ-5551-2021; AAM-4084-2021; AAJ-1289-2021Cardiac valvular calcification (CVC) in end-stage renal disease is shown to be a component of malnutrition, inflammation, atherosclerosis, calcification (MIAC) syndrome. Thoracic periaortic fat tissue (T-PAFT) is shown to be increased in patients with end-stage renal disease (ESRD), and has positive correlation with MIAC. Negative correlation between CVC and vitamin D is shown in hemodialysis (HD) patients. In this study, we investigated a relationship between body composition, T-PAFT, metabolic and inflammatory parameters, and CVC in HD patients. Seventy-six HD patients (49M) were included. CVC is defined as bright echoes of >1mm on one or more cusps on echocardiography. Results were expressed as the number of calcified valves (0,1,2). Calcium, phosphorus, parathyroid hormone (PTH), C-reactive protein (CRP), albumin and 25-hydroxy vitamin D levels were studied from predialysis blood samples. T-PAFT was calculated using a method with manual definition of borders on images from multislice computed tomography. Basal metabolic rate, muscle mass, total and truncal fat mass were measured by bioimpedance analysis. There were 65.8% of patients who had CVC. Patients with CVC were older (63.5 +/- 14.6 +/- 17, P=0.02). T-PAFT (1599 +/- 596, 739.7 +/- 179mm(2), P=0.001) and CRP (15.8 +/- 11; 11.1 +/- 13.2mg/dL; P=0.04) were higher in the group with CVC. T-PAFT had positive correlations with CRP, MIAC, body mass index (BMI) and number of calcified valves, negative correlation with left ventricular ejection fraction, and no correlation with albumin, calcium, phosphorus, and PTH. The logistic regression analysis revealed that T-PAFT was a significant predictor of CVC. In this study, T-PAFT showed a positive correlation with inflammation, CVC, and MIAC score in HD patients. T-PAFT was a significant predictor of CVC.
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