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Admission Tpe interval predicts reperfusion success in STEMI patients treated with fibrinolytic agents
(2020) Coner, Ali; Akinci, Sinan; Akkucuk, Mehmet Husamettin; Altin, Cihan; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0003-4569-1143; 0000-0001-5250-5404; 31974326; AAG-8233-2020; AAJ-2828-2021; AAD-5564-2021
Objective: Myocardial infarction is a leading cause of morbidity and mortality. Fibrinolytic administration is still a life-saving choice in ST-segment elevated myocardial infarction (STEMI), but the rate of successful reperfusion can be inconsistent. Failed reperfusion adds additional clinical risks to rescue percutaneous coronary intervention for STEMI patients. The interval between the peak of the T wave and the end of the T wave (Tpe) and the ratio of Tpe and a corrected measurement of the time from the start of the Q wave to the end of the T wave (Tpe/QTc ratio) are relatively new electrocardiogram (ECG) indices and have not yet been tested in STEMI patients treated with fibrinolytic agents. Methods: A total of 177 STEMI patients (mean age: 60.5 +/- 11.1 years; 138 men and 39 women) were enrolled in this retrospective study to evaluate ECG parameters. The Tpe interval and the Tpe/QTc ratio at baseline and at the 90th minute following the administration of fibrinolytic therapy were analyzed. The clinical and ECG findings of successful and failed reperfusion groups were compared. Results: Successful reperfusion was achieved in 119 patients (67.2%). The average Tpe interval on the admission ECG was shorter (91.7 vs. 100.9 milliseconds [ms]) (p<0.001) and shortened more in the successful reperfusion group (9.3 vs. 4.5 ms) (p<0.001). A cut-off value of 89.0 ms for the Tpe interval on the admission ECG was found to be related to reperfusion success with a sensitivity of 90.9%. Conclusion: The Tpe interval was a predictor for reperfusion success in STEMI patients treated with fibrinolytic agents.
Adrenal Myelolipoma: A Case Presentation
(2018) Kervancioglu, Enis; Hasirci, Eray; Dirim, Ayhan; Aygun, Yuksel Cem; 0000-0002-6232-4313; 0000-0002-4147-2966; 0000-0003-3465-9092; AAM-3015-2021; AAI-7997-2021; AAM-4475-2021
Adrenal myelolipomas are non-functional benign tumors of hematopoietic and mature adipose tissue. Adrenal myelolipomas, which are generally detected in post-mortem examinations, have become more detectable thanks to evolution and frequent use of imaging techniques. This presentation elaborates on a case of 35-year old male patient presenting with no complaint but diagnosed with adrenal myelolipoma in histopathological examination following surrenalectomy operation for an adrenal mass incidentally detected on ultrasonography and computed tomography work-up.
Adrenergic receptor behaviors of mesenchymal stem cells obtained from different tissue sources and the effect of the receptor blockade on differentiation
(2021) Maytalman, Erkan; Alizadeh Yegani, Arash; Kozanoglu, Ilknur; Aksu, Fazilet; 0000-0002-5268-1210; 34323168; AAE-1241-2021
In this study, it was aimed to analyze behavioral changes of adrenergic receptors (ARs) in first three passages and osteogenic/adipogenic differentiation of mesenchymal stem cells (MSCs) derived from placenta fetal membrane (FM) and bone marrow (BM). It was also aimed to evaluate effects of receptor blockade on differentiation. We obtained first three passages of MSCs from placenta and BM samples. For cell identification, the cells were analyzed by flow cytometry using CD34, CD45 and CD3, CD105 antibodies in each passage. The effects of propranolol and phenoxybenzamine at incremental doses were analyzed by MTT. In addition, cell cultures were separately maintained with the blockers or without after second passage. After each passage and differentiation, alpha 1A, alpha 1B, alpha 2A, alpha 2B, beta 1, beta 2, beta 3 AR-mRNA expressions analyzed by RT-qPCR technique. BMP6 and PPARG mRNA expressions only after differentiation and passage 3 were analyzed. A microscopic examination was also performed. Our results showed that AR expression behaviors were different in MSCs obtained from different tissue sources. In particular, alpha(1A)-AR and alpha(2A)-AR were expressed with considerably high coefficients in differentiation under blocker effect in BM-derived MSCs. No such coefficients were observed in any group of placental MSCs. In addition, it was found that the blockers stimulated adipogenesis in BM-derived MSCs during osteogenic differentiation. MSCs exhibit protein expressions that vary according to source of tissue and differentiation. Given that MSCs from different sources are used for repair and modulation, our study makes implications of this variable expression intriguing in the clinical practice.
Adult Still's disease: An unusual case with atypical skin and histopathological findings
(2020) Vural, Ayse Tuncer; Ozcan, Deren; Tepeoglu, Merih; 0000-0002-9894-8005; AAK-5222-2021
Adult Still's disease is a rare, acute systemic inflammatory disease characterized by a sudden rising fever, arthralgia/arthritis, neutrophilic leukocytosis and a typical salmon-colored macular or maculopapular rash associated elevated fever. Recently, atypical skin lesions with broad spectrum clinical features and distinctive histopathological findings have been reported in a rare case with active disease. Herein, we report an unusual case of Adult Still disease was presented and the characteristic features of atypical disease were highlighted.
An advanced human error assessment approach: HEART and AV-DEMATEL
(2019) Can, Guelin F.; Delice, Elif K.
Human error assessment and reduction technique (HEART) is one of the most commonly used human error assessment approaches which computes human error probability (HEP) to prioritize errors related to human actions. HEART is a powerful tool considering error producing conditions (EPCs) which increase the HEP for generalized task versions named as generic task types (GTTs). HEART can give a solution including prevention of human-related errors (HREs) and reduction of the HREs' impacts via implementing additional controls. However, it has many shortcomings for real-life error assessments. In this context, this study aims to improve effective usage of HEART through an advanced version of decision-making trial and evaluation laboratory (AV-DEMATEL). The reason to perform AV-DEMATEL is to show the complex effect relations between main tasks (MTs), subtasks (STs), and EPCs in a process. For this aim, an integrated effect relation matrix is proposed for DEMATEL and importance weights of MTs, STs, and EPCs are computed based on this matrix. In addition, not only HREs are considered but also machine-related errors (MREs) are taken into account to make error assessment for the process. The proposed approach also provides flexibility to categorize STs in different GTTs. Finally, a new term "process error probability" including HREs' probabilities and MREs' probabilities is recommended to compute error probability in an integrated manner for the process. To utilize the proposed approach, an example of a steam boiler daily control process is given.
The adverse effects of valproic acid on visual functions in the treatment of retinitis pigmentosa
(2017) Yuce, Aslihan; Totan, Yuksel; Guler, Emre; Dervisogullari, Mehmet Serdar; 29044065
Purpose: To evaluate the efficacy and safety of valproic acid (VPA) treatment in patients with retinitis pigmentosa (RP). Methods: A total of 48 eyes of 24 patients (13 males, 11 females) with RP prescribed VPA were included. The length of VPA treatment was 6-12 months (mean 9.4 months). Parameters evaluated were best-corrected visual acuity (BCVA) (logarithm of the minimum angle of resolution [logMAR]), visual field analyses (VFAs) with Humprey automated perimetry, multifocal electroretinography (ERG) with Roland-RETI scan, and VPA side effects. Results: Mean age was 34.3 +/- 10.3 years (range 18-56 years). Fifteen of the patients (30 eyes) had two ERG and VFA tracings, allowing comparison between baseline and follow-up (range 6-12 months). Mean BCVA before and after VPA therapy was 0.36 +/- 0.38 and 0.36 +/- 0.37 logMAR, respectively (P = 0.32). Quantitative perimetric indices including mean deviation and pattern standard deviation were not significantly changed after VPA therapy (P > 0.05). P1 amplitudes (in terms of nV/deg(2) and mV) of ERG waves were significantly decreased in the rings 1, 3, and 4 after VPA therapy (P < 0.05). Regarding the N1 amplitudes, the only significant decrease was observed in area 1 (P = 0.03). In addition, N1 latency was significantly increased in area 3 after VPA therapy (P = 0.04). Conclusions: VPA therapy did not have any significant benefit on BCVA and VFA. In addition, it may be associated with decline in some ERG parameters. Therefore, physicians should avoid prescribing VPA for RP until its safety and efficacy are appropriately evaluated.
After a Workshop on the Novel Antivirals for Treatment of Hepatitis C Virus Infection (4-6 December 2015, Istanbul)
(2016) Tekin, Suda; Aygen, Bilgehan; Aydin, Mehtap; Simsek, Funda
Age estimation in Turkish children and young adolescents using fourth cervical vertebra
(2020) Gulsahi, Ayse; Cehreli, Sevi Burcak; Galic, Ivan; Ferrante, Luigi; Cameriere, Roberto; 31915966
This study aimed to test radiographic projections of the posterior and anterior sides of the C4 vertebral body for age estimation in a cross-sectional sample of Turkish children and adolescents from the Baskent University Faculty of Dentistry. A sample of 232 x-rays from individuals aged between 5 and 15 years (101 boys and 131 girls) was analysed to investigate the correlation of age and changes in the projection ratio of the anterior and posterior sides of the body of the fourth cervical vertebra (Vba) in lateral cephalograms. The Normal Bayesian Calibration (NBC) model for age estimation was used to assess the relationship between Vba and age. The intra-observer repeatability and inter-observer agreement were 0.95 and 0.94, respectively. Age distribution gradually increased as Vba increased up to 14 years in both sexes. The difference between chronological and estimated ages did not increase with the increase in age. Calibration distributions of the dataset by the evaluation of Vba suggested mean absolute errors (MAEs) of 0.879 years and 0.906 years (mean interquartile ranges (MIQRs) 1.290 and 1.435 years)) in boys and girls, respectively. The biases of the estimates (beta(ERR)) were 0.013 and 0.027 for boys and girls, respectively. In conclusion, the NBC method on Vba variable appears to be suitable for age estimation in Turkish children and adolescents.
Age- and Gender-Related Variability in Nasal Tip Support
(2020) Koycu, Alper; Erol, Ozan; Buyuklu, Fuat Adnan; Jafarov, Sabuhi; Berker, Sinem; 0000-0003-1528-0036; 0000-0003-1290-3509; 0000-0002-7302-4199; 31834522; W-5941-2018; AAF-3650-2021; AAI-8044-2021
Background The age at which nasal tip support changes start to occur is unknown. Evaluation of nasal tip support is difficult, especially as the ideal nasal tip support pressure remains elusive. The aim of this study is to determine the nasal tip support pressure alterations relative to age and sex. Objectives The aim of this study is to determine the changers in resistance of the nasal tip support in relation to age and sex. Methods This prospective clinical study was conducted between January and April 2019 at a tertiary health facility. Nasal tip resistances were measured in four different age-groups (20-29, 30-39, 40-64, and > 65 years) with a digital Newton meter. A total of 159 patients with a minimum of 36 patients per group were included in the study. Nasal tip resistance measurements were compared among nasal tip displacement distances of 2, 3, and 4 mm, focusing on age and sex. Results The nasal tip resistance of the 20-29 age-group was significantly higher at 2, 3, and 4 mm nasal tip displacement distances, when compared with the 30-39 and 40-64 age-groups, whereas compared to the > 65 years group, it was significantly higher at 3 and 4 mm nasal tip displacement distances (p < 0.005). Nasal tip resistance of males was found to be significantly higher than that of females, at 3 and 4 mm nasal tip displacement distances (p < 0.001). Conclusions Nasal tip resistance is higher in males and universally decreases significantly after 30 years of age while remaining constant at later ages. Therefore, surgeons should prefer nasal tip resistance increasing techniques in the rhinoplasty operations that are performed on patients even from early years of age, in order to maintain and strengthen the nasal tip resistance.
Age-And Sex-Related Changes In Selected Hematological Parameters, Lipid Peroxidation And Erythrocytes Osmotic Fragility Of Turkish Angora Cats
(2022) Kabakci, R.; Yigit, A. A.; Kara, E.; Cinar, M.; Ekici, H.; Aluc, Y.
This study was conducted to investigate the changes in selected hematological parameters, lipid peroxidation and osmotic fragility of erythrocytes in Angora cats depending on age and gender. For this purpose, the blood samples were collected from vena saphena medialis of 9 young and 14 adult cats which were also classified as male (n=12) and female (n=11). Following hematological analysis, samples were washed with PBS by centrifugation and 10% hematocrit suspension was prepared from the erythrocytes pellet for the osmotic fragility test. The concentration of malondialdehyde (MDA) was also measured from lysed erythrocytes to determine lipid peroxidation level. Red blood cells (RBCs), hemoglobin, and hematocrit were significantly (P<0.001) high in adults while the mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly (P<0.05) high in young cats. Erythrocyte MDA level was also higher statistically (P<0.05) in adult cats than in young cats. There was no significance (P>0.05) in these parameters between male and female cats. Findings of fragility tests showed that erythrocytes of young and male cats were statistically more susceptible to hypotonic NaCl solutions than those of adult and female cats, respectively (P<0.01, P<0.05). It was concluded that erythrocytes related parameters in Angora cats changed depending on age rather than gender except for stability of RBCs.
Ageism During the Covid-19 Pandemic: Discussion and Recommendations
(2021) Madran, H. Andac Demirtas
The spread of the coronavirus disease 2019 (Covid-19) was labeled a "pandemic" by the World Health Organization on March 11, 2020. It has caused not only health-related issues but also economic, educational, psychological, and social problems. Further, discrimination associated with the pandemic has been observed around the globe. Besides the obvious negative consequences faced by the individuals targeted, pandemic-related discrimination has affected the spread of the virus by influencing public attitudes toward disease prevention and the restrictions imposed by authorities. Discrimination toward foreigners, minorities, and certain religious groups (e.g., Muslims) increased during this period. Additionally, the pandemic saw ageism spread rapidly to become more visible than ever. Acknowledging that Covid-19 poses a higher risk for individuals over a certain age, several countries implemented restrictions specific to those age groups. However, this practice resulted in the emergence of problems that were not considered initially, especially the escalation of ageism. This study examines ageism during the Covid-19 pandemic based on major theories and current research. First, discrimination and ageism are defined in detail. Then, pandemic-related ageism is discussed within the framework of basic theoretical approaches. Finally, recommendations for preventing ageism related to the pandemic and in general are presented.
Airfoil-slat arrangement model design for wind turbines in fuzzy environment
(2020) Atalay, Kumru Didem; Dengiz, Berna; Yavuz, Tahir; Koc, Emre; Ic, Yusuf Tansel
In this study, a multi-element wind turbine blade that consists of NACA 6411 and NACA 4412 leading-edge slat design is investigated computationally. Optimum design parameters of the slatted wind turbine blade leading to maximum value of C-L/C-D related to the turbine power are obtained. In the optimization process, a new fuzzy logic linear programming methodology integrating with fuzzy linear regression and 2D CFD analysis is proposed. The aerodynamic characteristics of the slatted blade are computed by using Incompressible Navier-Stokes equations and k-omega turbulence modeling. Results are compared with the results of linear programming method and direct search optimization method. The computational results reveal that the proposed methodology for performance optimization is more effective than other methods to obtain high-performance value of the C-L/C-D. The maximum value of the C-L/C-D is obtained as 25.1 leading the maximum efficiency of 0.52.
Alcohol- and Cigarette-Use-Related Behaviors Across Gender, Dysfunctional COVID-19 Anxiety, and the Presence of Probable ADHD During the Pandemic: A Cross-Sectional Study in a Sample of Turkish Young Adults
(2021) Evren, Cuneyt; Evren, Bilge; Dalbudak, Ercan; Topcu, Merve; Kutlu, Nilay
Objective: The objective of the study is to evaluate the alcohol-and cigarette-use-related behaviors among young adults during the COVID-19 pandemic restrictions in Turkey. The second objective was to evaluate whether the gender, dysfunctional COVID-19 anxiety, and presence of probable attention-deficit/hyperactivity disorder (ADHD) are associated with the increase in alcohol consumption and cigarette smoking while controlling the effects of current age and diagnosis of anxiety disorder before the COVID-19 pandemic. Method: The study was conducted with an online survey among volunteer participants of young adults. The Adult ADHD Self Report Scale (ASRS-v1.1) and the Coronavirus Anxiety Scale (CAS) were used to evaluate a group of university students. Results: A total of 1,042 respondents (mean age 26.9 +/- 10.9 years; 61.6% female) filled out the survey. Of these, 17.6% reported an increase and 7.7% reported reduced cigarette smoking, whereas 10.8% reported an increase and 8.5% reported reduced alcohol consumption during the pandemic. Both rates of increased cigarette smoking and alcohol consumption were higher among males and those with probable ADHD. In the logistic regression analyses, male gender, COVID-19 related dysfunctional anxiety, and presence of probable ADHD were related to the increase in alcohol consumption and cigarette smoking, while the current age and diagnosis of anxiety disorder before the COVID-19 pandemic were not. Conclusion: Findings of the current study may suggest that the pandemic period is related to both anv increase and a reduction of alcohol consumption and cigarette smoking. Males with probable ADHD and higher levels of COVID-19 related dysfunctional anxiety have a higher risk of increasing both alcohol consumption and cigarette smoking.
ALG1-CDG: Clinical and Molecular Characterization of 39 Unreported Patients
(2016) Alehan, Fusun; 26931382
Congenital disorders of glycosylation (CDG) arise from pathogenic mutations in over 100 genes leading to impaired protein or lipid glycosylation. ALG1 encodes a beta 1,4 mannosyltransferase that catalyzes the addition of the first of nine mannose moieties to form a dolichol-lipid linked oligosaccharide intermediate required for proper N-linked glycosylation. ALG1 mutations cause a rare autosomal recessive disorder termed ALG1-CDG. To date 13 mutations in 18 patients from 14 families have been described with varying degrees of clinical severity. We identified and characterized 39 previously unreported cases of ALG1-CDG from 32 families and add 26 new mutations. Pathogenicity of each mutation was confirmed based on its inability to rescue impaired growth or hypoglycosylation of a standard biomarker in an alg1-deficient yeast strain. Using this approach we could not establish a rank order comparison of biomarker glycosylation and patient phenotype, but we identified mutations with a lethal outcome in the first two years of life. The recently identified protein-linked xeno-tetrasaccharide biomarker, NeuAc-Gal-GlcNAc2, was seen in all 27 patients tested. Our study triples the number of known patients and expands the molecular and clinical correlates of this disorder. (C) 2016 Wiley Periodicals, Inc.
All the Dark Triad and some of the Big Five traits are visible in the face
(2021) Alper, Sinan; Bayrak, Fatih; Yilmaz, Onurcan; 0000-0001-6350-6234
Some of the recent studies suggested that people can make accurate inferences about the level of the Big Five and the Dark Triad personality traits in strangers by only looking at their faces. However, later findings provided only partial support and the evidence is mixed regarding which traits can be accurately inferred from faces. In the current research, to provide further evidence on whether the Big Five and the Dark Triad traits are visible in the face, we report three studies, two of which were preregistered, conducted on both WEIRD (the US American) and non-WEIRD (Turkish) samples (N = 880). The participants in both the US American and Turkish samples were successful in predicting all Dark Triad personality traits by looking at a stranger's face. However, there were mixed results regarding the Big Five traits. An aggregate analysis of the combined dataset demonstrated that extraversion (only female), agreeableness, and conscientiousness were accurately inferred by the participants in addition to the Dark Triad traits. Overall, the results suggest that inferring personality from faces without any concrete source of information might be an evolutionarily adaptive trait.
Alpha-Thalassemia Mutations in Adana Province, Southern Turkey: Genotype-Phenotype Correlation
(2015) Bozdogan, Sevcan Tug; Yuregir, Ozge Ozalp; Buyukkurt, Nurhilal; Aslan, Huseyin; Ozdemir, Zeynep Canan; Gambin, Tomasız; 25825562
To look over the distribution of the mutations in a large series from Adana province, Southern Turkey, and determine the genotype-phenotype correlation of the frequent mutations. Among the 2500 individuals with mild or moderate anemia, microcytosis, and normal iron levels that were referred to our Genetic Diagnosis Center, a population consisting of 539 individuals were included in the study and tested for alpha-thalassemia mutations by using reverse dot blot hybridization technique. Twelve different mutations were detected in 539 patients. Among the 12 different mutations found, the most frequent mutations were the -alpha(3.7) (63.3 %), --(MED) (11.7 %), --(20.5) (10.7 %), alpha 2(IVS1(-5nt)) (3.9 %), and alpha 2(polyA-2) (3.5 %). The most frequent genotypes were -alpha(3.7)/alpha alpha (35.8 %), -alpha(3.7)/-alpha(3.7)(18.9 %), -(20.5)/alpha alpha (11.5 %), and --(MED)/alpha alpha (10.4 %), respectively. There were statistically significant differences in hematological findings between -alpha(3.7)/-alpha(3.7) and --(MED)/alpha alpha, even though both have two mutated genes in the genotype. Our results show that alpha-thalassemia mutations are highly heterogeneous as well as deletional and -alpha(3.7) single gene deletion is particularly prevalent at Adana province in agreement to other studies from Turkey.
Altered pulmonary functions due to biomass smoke in a rural population of Turkish women: a descriptive study
(2018) Ozsancak Ugurlu, Aylin; Balcan, Baran; Akan, Selcuk; Ceyhan, Berrin; 30246655; A-4721-2018
Introduction: Wood or other organic sources of fuel are used as source of energy for heating or cooking particularly in developing countries. The aim of the current study was to evaluate the association between biomass exposure time and parameters of pulmonary function tests. Materials and Methods: Four hundred twenty-four consecutive women who lived and exposed to biomass smoke in a small province in Eastern Turkey were involved. This study was performed with women who had come to pulmonology out-patient clinic with symptom of dyspnea. Results: The independent variables assessed in the study patients were age, BMI, starting age of cooking, hours per day and weeks per month spent cooking, and cooking years; the dependent variables were PFT parameters. Ninety-two (21.6%) patients had an obstructive PFT pattern. Sixty-seven (73%) of these patients were classified as GOLD 2 and 25 (27%) patients were classified as GOLD 3. Seventy-five (17.6 %) of the patients had restrictive lung disease; 54 (72%) of these patients were found to have a mild and 21 (27%) had a moderate restrictive pattern. Increased number of years in cooking and to start cooking at younger ages were a risk factors for the development of obstructive and restrictive disease. There was a statistically significant and negative correlation between increased number of years and the value of FEV1 (r=-0.917; p=<0.001), FEV1/FVC (r=-0.739; p<0.001), and FVC (r=-0.906; p<0.001). The median time of cooking required was 23 years for the development of obstruction, and 25 years for restriction, respectively. Conclusion: Cumulative biomass exposure time is associated with impairment in PFT parameters; results in both obstructive and restrictive lung disease. Biomass exposure is a public health problem and pre-cautions should be taken in order to prevent impaired pulmonary functions.
An Alternative Low-Cost Solution for Tracking Laboratory Animals
(2020) Kiziltan, Erhan; Aydin, Leyla; 0000-0001-6029-3835; AAD-6090-2021
Objectives: Monitoring animal behavior under various conditions can provide important information on their neuropsychological status, including learning, memory, and cognitive activity. Several commercial tracking systems are available, but they may be too expensive for low-budget projects. This study developed an alternative solution for automated animal tracking in behavioral experiments. Methods: The proposed system was designed to analyze a set of images sampled from a recorded video file in chronological order. The instantaneous location of the animal in each image frame was defined automatically, using a feature-extraction algorithm. Distances traveled were calculated using the coordinates of the successive instantaneous locations. The algorithm was tested using two arenas: the Morris water maze and open field test. The calculated measures were compared with those obtained manually. The internal consistency of the dataset was checked using Cronbach's alpha. The accuracy of the results was evaluated using the paired samples t-test and Pearson correlation, with the level of statistical significance set at p<0.01. Results: A statistical comparison of the distances traveled, which were derived from the coordinates of successive locations, did not differ significantly between the manual and automatic methods (r=0.954 and p=0.792 for the Morris water maze; r=0.996 and p=0.024 for the open field test). Conclusions: These results suggest that the algorithm is reliable and valid for estimating coordinates and may serve as a high-resolution tool for animal behavior experiments. We intend to make this software freely available to interested readers and to open feedback channels for further development.
Alternative tumor markers in the diagnosis of ovarian cancer
(2016) Karakaya, Burcu Kisa; Baser, Eralp; Bildaci, Berk; Comert, Esra Cabuk; Bayraktar, Nilufer; Dursun, Polat; Kuscu, Esra; Ayhan, Ali; 0000-0002-0992-6980; 0000-0002-7886-3688; 27629130; AAI-8792-2021; Y-8758-2018; AAJ-5802-2021
Objective: The aim of the study was to assess the usefulness of various tumor markers (CA125, HE4, bcl2) measured in serum, urine and saliva in the differential diagnosis of adnexal masses. Material and methods: Our study was conducted at the Baskent University Medical School, Department of Obstetrics and Gynecology, Ankara, Turkey, between November 2010 and March 2011. Fifty patients with a suspicion of malignant adnexal mass and 30 controls were included in the study. Serum and urine CA-125, HE4, and bcl2 levels were evaluated for their role in the diagnosis of epithelial ovarian cancer (EOC). Results: Serum CA-125 and HE4 levels, and urine HE4 levels were significantly higher in malignant cases as compared to controls (p < 0.05). Mean levels of bcl2 in saliva and urine were similar in malignant cases and controls (p > 0.05). Conclusions: We demonstrated that serum CA125, serum HE4 and urine HE4 levels were elevated in patients with ovarian cancer. These findings should be assessed in future studies with larger sample sizes in order to reach more definite conclusions.
Ambulatory colonoscopy under sedoanalgesia in adult patients with and without irritable bowel syndrome: A prospective, cross-sectional, and double-blind comparison
(2018) Tuncali, Bahattin; Araz, Coskun; Celebi, Arzu; 29755018
Background/Aims: it is unclear whether patients with irritable bowel syndrome (IBS) require a high dose of sedatives during colonoscopy. In this study, we investigated the pre-procedural anxiety levels, sedative consumption, procedure times, complications, and patient's satisfaction between patients with IBS and controls for ambulatory colonoscopy under sedation. Materials and Methods: Rome III criteria were used in the diagnosis of IBS. Anxiety levels were measured using Spielberger's State-Trait Anxiety Inventory (STAI) and Beck Anxiety Inventory (BA/). Patients received a fixed dose of midazolam (0.02 mg/kg), fentanyl (1 mu g/kg), ketamine (0.3 mg/kg), and incremental doses of propofol under sedation protocol. Demographic data, heart rate, blood pressure, and oxygen saturation were measured. Procedure times, recovery and discharge times, drug doses used, complications associated with the sedation, and patient's satisfaction scores were also recorded. Results: The mean Trait (p=0.015), State (p=0.029), Beck anxiety scores (p=0.018), the incidence of disruptive movements (p=0.044), and the amount of propofol (p=0.024) used were significantly higher in patients with IBS. There was a decline in mean systolic blood pressure at the 6th minute in patients with IBS (p=0.026). No association was found between the sedative requirement and the anxiety scores. Conclusion: Patients with IBS who underwent elective colonoscopy procedures expressed higher pre-procedural anxiety scores, required more propofol consumption, and experienced more disruptive movements compared with controls. On the contrary, the increased propofol consumption was not associated with the increased pre-procedural anxiety scores.