Fakülteler / Faculties
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Item Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Inflammatory Markers in Schizophrenia: A Comparative Analysis of Drug-Naive Schizophrenia Patients, Remitted Patients, and Healthy Controls(JOURNAL OF PSYCHIATRIC RESEARCH, 2024) Ciftci, Hatice; Asut, Gonca; Kaya, Hasan; Cakmak, Isik Batuhan; Yilmaz, Meltem Aydiner; Copur, Ahmet; Calci, Esin; Oguz, Esra Firat; Turhan, Turan; Goka, ErolThis study aims to examine the plasma concentrations of NGAL and other inflammatory parameters, including TNF-alpha, IL-1 beta, and IFN-gamma, in schizophrenia patients and healthy volunteers. It also investigates potential associations between these biomarkers and symptom severity in schizophrenia and the utility of NGAL as a potential diagnostic and monitoring biomarker for schizophrenia. The study included 49 drug-naive schizophrenia patients (DNS), 59 patients with schizophrenia in remission (REM) on antipsychotic treatment, and 58 healthy volunteers (HC). The Positive and Negative Symptoms Evaluation Scale (PANSS) was utilized to assess the severity of symptoms in schizophrenia patients. Plasma levels of TNF-alpha, IL-1 beta, IFN-gamma, and NGAL were measured for all participants. NGAL levels were significantly lower in the DNS group than in HC. Significantly lower TNF-alpha levels were observed in both the DNS and REM groups compared to the HC group. Notably, a statistically significant positive correlation was detected between TNF-alpha and NGAL levels. The findings of this study are noteworthy, as they demonstrate that drug-naive individuals with schizophrenia exhibit significantly diminished levels of NGAL and TNF-alpha compared to healthy controls. These identified biomarkers hold promise for providing valuable insights into the complex and evolving pathophysiology of schizophrenia.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 Systemic Inflammation Score for Predicting Radiation-Induced Trismus and Osteoradionecrosis of the Jaw Rates in Locally Advanced Nasopharyngeal Carcinoma Patients(2023) Somay, Efsun; Sezen, Duygu; Selek, Ugur; Besen, Ali Ayberk; Mertsoylu, Huseyin; Topkan, Erkan; 0000-0001-8120-7123; AAG-2213-2021We sought to determine the predictive value of the systemic inflammation score (SIS) for radiation-induced trismus (RIT) and osteora-dionecrosis of the jaw (ORNJ) in locally advanced nasopharyngeal carcinoma (LA-NPC) patients treated with concurrent chemoradio-therapy (C-CRT). LA-NPC patients (n= 188) who underwent C-CRT and pre-and post-C-CRT oral examinations from August 2010 to January 2022 were included. The three-tiered SIS groups were created using the serum albumin and lymphocyte-to-monocyte ratio (LMR) measures obtained on the first day of C-CRT: SIS-0: Albumin >= 40 g/dL and LMR >= 4.44); SIS-1: Albumin < 40 g/dL and LMR < 4.44 or albumin >= 0 g/dL and LMR >= 4.44; and SIS-2: Albumin < 40 g/dL and LMR <4.44. The primary objective was to ascertain whether there were irrefutable associations between pretreatment SIS groups and the respective post-C-CRT RIT and ORNJ rates. RIT and ORNJ were diagnosed in 33 (17.6%) and 21 (11.1%) patients, respectively. There were 12 (32.4%), 13 (12.7%), and 18 (45.0%) cases diagnosed with RIT in the respective SIS-0, SIS-1, and SIS-2 groups (p< 0.001). Similarly, there were 1 (2.7%), 11 (9.9%), and 9 (22.5%) cases with ORNJ diagnoses in the corresponding SIS groups (p< 0.001). The multivariate analysis's findings revealed that the SIS grouping was an independent predictor of RIT (p< 0.001) and ORNJ incidence rates (p< 0.001). Our study's findings indicate that the novel pretreatment SIS grouping is a dependable biomarker-based system, which can accurately predict the rates of RIT and ORNJ in LA-NPC patients who receive definitive C-CRT.Item Effect of Left Ventricular Assist Devices on Red Blood Cell Distribution Width(2015) Ersoy, Ozgur; Gultekin, Bahadir; Ozkan, Murat; Akkaya, Ilknur; Umaroglu, Sevi; Sezgin, Atilla; 26640934; ABA-7388-2021Objectives: Red blood cell distribution width is a measure of the variability in the size of circulating erythrocytes, which is calculated by automated blood cell counters as part of a routine blood cell count analysis. Our aim was to examine whether continuous flow left ventricular assist devices affected red blood cell distribution width. Materials and Methods: Our study included 16 of 24 patients who received a HeartWare HVAD Pump (HeartWare Inc, Framingham, MA, USA) implant (continuous flow left ventricular assist device) between April 2012 and February 2015 at our institution. The mean age of the patients was 46.6 years. We compared patient erythrocyte, leucocyte, and platelet counts, hemoglobin and hematocrit levels, mean corpuscular volume, and red blood cell distribution width values before and 6 months after implant. Results: Hemoglobin level (P=.008), hematocrit level (P=.027), and mean corpuscular volume (P=.003) were significantly decreased; however, we observed no significant change in red blood cell distribution width. Conclusions: Although we did not find significant results in our group of patients with left ventricular assist device implant, a larger group of patients may show more significant results, and an increase in red blood cell distribution width can be used as an indicator of a negative prognosis in these patients.Item High pretreatment systemic immune-inflammation index values are associated with diminished short-term success after temporomandibular joint arthrocentesis procedure(2021) Somay, Efsun; Yilmaz, Busra; 0000-0003-0633-5648; 0000-0001-8251-6913; 34654426Background The systemic immune-inflammation index (SII) has been demonstrated to be a valid biomarker of a patient's immunological and inflammatory state, with the ability to accurately predict outcomes in a variety of disease conditions. In the absence of comparable studies, we intended to examine the relevance of pretreatment SII in predicting the success rates of temporomandibular joint arthrocentesis (TMJA) at 1-week, 1-month, and 6-month periods, defined as maximum mouth opening (MMO) > 35 mm and VAS <= 3. Methods A sum of 136 patients with disc displacement without reduction (DDwo-red) who underwent TMJA was included. For each patient, pre-TMJA SII was calculated as; SII = Platelets x neutrophils/lymphocytes. Additionally, baseline MMO and VAS measurements were recorded for each patient. The success criteria of TMJA included MMO > 35 mm and VAS <= 3. The optimal pre-TMJA SII cutoff that predicts TMJA success was determined using receiver operating characteristic (ROC) curve analysis. The primary endpoint was the link between the pre-treatment SII and TMJA success (simultaneous achievement of MMO > 35 mm and VAS <= 3). Results The median pre-TMJA jaw locking duration, maximum mouth opening (MMO), and visual analog score (VAS) were 7 days, 24 mm, and 8, respectively. The overall TMJA success rates were determined as 80.1%, 91.9%, and 69.1% at 1-week, 1-month, and 6-months, respectively. The results of ROC curve analysis exhibited the optimal SII cutoff at 526 (AUC: 67.4%; sensitivity: 66.7%; specificity: 64.2%) that grouped the patients into two subgroups: Group 1: SII <= 526 (N = 81) and SII > 526 (N = 55), respectively. Spearman correlation analysis revealed a strong inverse relationship between the pretreatment SII values and the success of TMJA 1-week (r(s): - 0.83; P = 0.008) and 1-month, (r(s): - 0.89; P = 0.03). Comparative analyses displayed that TMJA success rates at 1-week (87.7% vs. 69.1%; P = 0.008) and 1-month (96.2% vs. 80%; P = 0.03) were significantly higher in the SII <= 526 than SII > 526 group, respectively, while the 6-month results favored the SII <= 526 group with a trend approaching significance (P = 0.084). Conclusion The current study's findings suggested the SII as a unique independent prognostic biomarker that accurately predicts treatment outcomes for up to 6 months. Trial registration The results of this research were retrospectively registered.Item Serum and placental periostin levels in women with early pregnancy loss(2020) Eroglu, Semra; Colak, Eser; Erinanc, Ozgur Hilal; Ozdemir, Duygu; Ceran, Mehmet Ufuk; Tasdemir, Umit; Kulaksizoglu, Sevsen; Ozcimen, Emel Ebru; 0000-0003-1401-6356; 0000-0002-7613-2240; 0000-0002-9959-9433; 32460058; AAL-1268-2021; AAI-8932-2021Objectives: Periostin is secreted from the placenta in the embryonic period and it is emphasized that it may be involved in endometrial implantation. In this study, we aimed to investigate periostin serum levels and placental tissue expression in first trimester pregnancy losses. Study design: In this prospective case-control study, 30 patients who underwent dilatation and curettage with first trimester spontaneous abortion (< 10 weeks of gestation) were included in the study group and 30 patients who had voluntary pregnancy termination (< 10 gestational weeks) were included in the control group. Serum samples collected from the study and control groups were analyzed usingenzyme-linkedimmunosorbent assay (ELISA), and trophoblastic and decidual tissues were examined using immunohistochemical staining with streptavidin-biotin-peroxidase techniques. Results: There were no significant differences between the groups in terms of age, gravida status, parity number, gestational week, and number of previous abortions. In the spontaneous abortion group, the serum level of periostin was significantly lower than in the voluntary termination group (6.56 +/- 4.16 pg/mLvs. 9.51 +/- 4.52 pg/mL, p = 0.03). There was no significant difference between the two groups in terms of periostin expression in decidual and trophoblastic tissue (p = 0.617, p = 0.274, p = 0.497). Conclusion: Periostin serum levels were significantly reduced in patients with spontaneous pregnancy loss. Periostin can be used as a predictive marker for the success of endometrial implantation.Item Effect of platelet-rich plasma on serum and urine biomarkers in patients with knee osteoarthritis(2020) Kuculmez, Ozlem; Sirin, Fevziye Burcu; Sarikaya, Nese Olmez; Kocyigit, Hikmet; 0000-0002-8900-0060; AAM-4037-2021Background: Biomarkers may reflect changes in cartilage metabolism and could be used in diagnosis and evaluation of treatment response in knee osteoarthritis. The aim of this study is to determine the effect of platelet rich plasma (PRP) injections on serum and urine biomarkers in patients with knee osteoarthritis (OA). Methods: The study included 26 patients who were diagnosed as grade III knee OA according to ACR criteria and Kellgren-Lawrence classification. One cc of PRP was obtained from 20 cc of venous blood after double centrifugations at 400 g for 10 minutes. The patients received 3 injections of PRP at 3-weeks intervals. Serum Procollagen II N-terminal propeptide (PIINP), osteocalcin (OC), cartilage oligomeric matrix protein (COMP) and urine collagen-II telopeptide (U-CTX-II) were examined in all patients before treatment and at 3 and 6 months. Clinical outcome was evaluated using Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire, SF-36 and visual analog scale (VAS) in all patients before injection and at 3 and 6 months follow-up visits. Results: There was no statistically significant difference in cartilage Type II collagen (CII) degradation markers (CTX-II, COMP) and biosynthesis marker of PIINP (P>0.05). Significant increase was determined in serum OC levels (P<0.05) which reflects CII biosynthesis. Statistically significant improvement in all WOMAC parameters (P<0.05) and subscores of SF-36 (P<0.05) was noted. Conclusion: We found significant clinical improvements in knee OA patients treated with PRP injections. Our results suggest that PRP injection does not affect cartilage breakdown but effects CII biosynthesis, which is reflected by increased OC levels. However further studies are needed.Item Proadrenomedullin determining clinical severity and analyzing prognostic value for pneumonia(2019) Demirsoy, Sedat; Okutan, Oguzhan; Kartaloglu, Zafer; Tas, Dilaver; Ayten, Omer; Canoglu, KadirAIMS: In pneumonia patients, we need practical biomarkers that can contribute to the diagnosis, prognosis and the prediction of mortality, and that can direct therapy and treatment setting. In this study, the diagnostic importance and value to predict prognosis and mortality are investigated for plasma proadrenomedullin (proADM) levels in pneumonia patients. MATERIALS AND METHODS: Sixty-three consecutive patients who had been diagnosed with pneumonia, as well as 54 volunteers as the control group, making 117 in total, enrolled in this study. The participants' ProADM, leukocyte count, erythrocyte sedimentation rate, C-reactive protein, and procalcitonin levels were measured, and their pneumonia severity index (PSI) and CURB-65 scores were calculated. RESULTS: Plasma proADM levels were higher in the controls. When we compare patients' proADM levels in the initiation, and after the treatment, patients' proADM levels were lower on the 7th day after the treatment. No significant supremacy was identified over the other markers. The ProADM levels were significantly correlated with PSI stages, but in deciding of the site of care, the distribution of proADM levels for the PSI and CURB-65 risk groups (as low and high risk) were statistically irrelevant. The mean proADM levels among the patients who developed complications were slightly higher than the others, but not to a statistically significant degree. A relationship was identified between the clinical severity scores and complications, and short-term mortality was 7.93%. The plasma proADM levels among the nonsurvivors were 0.7 nmol/L and 0.90 nmol/L in the survivors. Given these data, proADM failed to predict mortality while PSI and CURB-65 were superior predictors. CONCLUSION: Using proADM levels alone to predict pneumonia prognosis and mortality and deciding upon a therapy setting makes no sense, although in consideration of previous studies, proADM would be useful as a supplementary contributor to clinical severity scores.