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Alterations of serum brain type natriuretic peptide (BNP) in patients with Crimean-Congo hemorrhagic fever
(E-CENTURY PUBLISHING CORP, 2015) Uysal, Elif Bilge; Sancakdar, Enver; Seker, Ayse; Deveci, Koksal; Tuzcu, Nevin; Karapinar, Hekim
Background: Crimean-Congo hemorrhagic fever (CCHF) is known to be associated with cardiac damage. Brain type natriuretic peptide (BNP) is secreted from stressed myocardium. Objectives: This study investigated that BNP levels in CCHF and its association with clinical course of disease. Methods: Consecutive CCHF diagnosis confirmed patients were enrolled to the study. Results of patients were compared with age-sex-matched healthy volunteers. Blood samples for BNP levels were collected from the patients during emergency room applications. Mortality, hospitalization duration and other disease severity predictors (thrombocyte count, hemoglobin, white blood cell count, alanine aminotransferase, aspartate aminotransferase, prothrombin time, lactate dehydrogenase, international normalized ratio, activated partial thromboplastin time) were recorded. These parameters' correlations with BNP levels were analyzed. Result: Forty-three CCHF patients and 28 control subjects recruited to the study. Groups were similar for age and gender. There was no mortality. Levels of BNP were found to be significantly higher in patients than control subjects (100.4 +/- 45.4 vs. 78.0 +/- 40.4, P=0.033). But BNP levels were not correlated with duration of hospitalization and disease severity predictors (P > 0.05). Conclusions: This study showed that BNP levels are modestly increased in CCHF but this increase does not correlated with disease severity predictors.
Bradycardia Seen In Children With Crimean-Congo Hemorrhagic Fever
(MARY ANN LIEBERT, INC, 2013) Oflaz, Mehmet Burhan; Kucukdurmaz, Zekeriya; Guven, A. Sami; Karapinar, Hekim; Kaya, Ali; Sancakdar, Enver; Deveci, Koksal; Gul, Ibrahim; Erdem, Alim; Cevit, Omer; Icagasioglu, F. Dilara
Introduction: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease with a high mortality rate. In clinical practice, we observed bradycardia in some pediatric patients with CCHF during the clinical course. So we aimed to report CCHF cases that presented bradycardia during the clinical course and the relation of bradycardia with the clinical findings and ribavirin therapy. Methods: Charts of all hospitalized pediatric CCHF patients were reviewed with respect to age, sex, history of tick bite or history of removing a tick, other risk factors for CCHF transmission, and interval between the tick bite and the onset of symptoms. Outcomes and clinical and laboratory findings and medications were recorded for each patient. We searched the patient records for information regarding the existence of bradycardia. Bradycardia was accepted as the heart rate 2 standard deviations (SD) lower than the suspected heart rate based on age. Results: Fifty-two patients (mean age 11.24.4 years, 31 female) were enrolled into the study. Bradycardia was seen in seven patients. Six patients with bradycardia were male and only one was female, and the mean age was 13.1 +/- 1.6 years. It was observed that male gender is frequent among patients with bradycardia, as compared with those without bradycardia (p=0.01). Bleeding was found to be more frequent in patients with bradycardia (p=0.02). There were significant differences between the bradycardia and nonbradycardia groups with regard to the requirements for fresh frozen plasma transfusion, the number of platelet suspension given, requirement for intravenous immune globulin (IVIG) and in the days of stay in hospital (p=0.01, p=0.03, p=0.03, p=0.04, respectively). Conclusion: Reversible bradycardia might be seen in the clinical course of pediatric CCHF patients, and the clinicians must be aware of this finding. The possibility that ribavirin may potentiate bradycardia cannot be assessed without a placebo-control study. So further studies may help to reveal the cause of the bradycardia, the disease itself, or the ribavirin therapy. Hence this study supports the need for a randomized, placebo-controlled study to assess intravenous ribavirin in treating CCHF and to support approval of the drug.
Do neutrophil gelatinase-associated lipocalin and interleukin-18 predict renal dysfunction in patients with familial Mediterranean fever and amyloidosis?
(TAYLOR & FRANCIS LTD, 2014) Deveci, Koksal; Korkmaz, Serdal; Senel, Soner; Deveci, Hulya; Sancakdar, Enver; Uslu, Ali U.; Deniz, Abdulkadir; Alkan, Filiz; Seker, Mehmet M.; Sencan, Mehmet
Background: The aim of this study was to evaluate whether neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) predict renal disfunction in patients with familial Mediterranean fever (FMF). Methods: This prospective study consisted of 102 patients with FMF in attack-free period, and 40 matched healthy controls. Of the patients, nine were diagnosed as amyloidosis. The patients were divided into two groups according to eGFR as below 120 mL per minute and above 120 mL per minute. Also, patients were divided into three groups according to the degree of urinary albumin excretion as normoalbuminuric, microalbuminuric, and macroalbuminuric. The serum levels of IL-18 (sIL-18) and NGAL (sNGAL), and urinary levels of IL-18 (uIL-18) and NGAL (uNGAL) were measured by using ELISA kits. Results: The levels of sIL-18, sNGAL, uIL-18, and uNGAL were detected significantly higher in FMF patients, particularly in patients with amyloidosis, when compared to controls. sNGAL, uIL-18, and uNGAL were significantly higher in patients with eGFR < 120 mL per minute than in patients with eGFR >= 120 mL per minute. sNGAL, uIL-18, and uNGAL were correlated significantly with urinary albumin excretion, additionally, were inverse correlated with eGFR. The most remarkable findings of this study are of the higher values of sIL-18, sNGAL, uIL-18, and uNGAL in both normoalbuminuric FMF patients and patients with eGFR >= 120 mL per minute. Conclusions: The results of this study suggest that sIL-18, uIL-18, sNGAL, and uNGAL are reliable markers of early renal disfunction in FMF patients, and may let us take measures from the early stage of renal involvement.
Evaluation of cytokines as Th1/Th2 markers in pathogenesis of children with Crimean-Congo hemorrhagic fever
(E-CENTURY PUBLISHING CORP, 2014) Sancakdar, Enver; Guven, Ahmet Sami; Uysal, Elif Bilge; Kaya, Ali; Deveci, Koksal; Karapinar, Hekim; Akkar, Ismail
Cytokine networks play a key role in the pathogenesis of the disease in Crimean-Congo Hemorrhagic Fever (CCHF) patients. Therefore, our aim was to study the effects of cytokine levels on the pathogenesis and severity of the disease in children with CCHF. Fifty-two patients diagnosed with CCHF and 34 healthy controls (HC) were included in the study. The patients with CCHF were divided into two groups (severe and non-severe). The levels of the Interleukin-10 (IL-10), IL-12, IL-6, Endothelin-1 (ET-1) and tumor necrosis factor-alpha (TNF-alpha) were measured in all groups. IL-12 levels did not show any difference between the CCHF and HC groups and among the severe, non-severe and HC groups. IL-10 and ET-1 levels were significantly higher in the severe group when compared to the non-severe group and the HC group. Moreover, IL-10 and ET-1 levels were significantly higher in the non-severe group when compared to the HC group. In terms of IL-6 and TNF-alpha levels, there was no difference between the severe and non-severe groups while the said levels were significantly higher in the severe group when compared to the HC group. The results of the present study showing significantly higher IL-10 and ET-1 levels in the severe group suggest that Th2-mediated humoral immunity is more effective in the pathogenesis and severity of CCHF in children.
Evaluation of Endothelium Functions by Flow-mediated Dilatation in Pediatric Patients With Crimean-Congo Hemorrhagic Fever
(LIPPINCOTT WILLIAMS & WILKINS, 2015) Karapinar, Hekim; Kaya, Ali; Uysal, Elif Bilge; Kucukdurmaz, Zekeriya; Deveci, Koksal; Guven, Ahmet Sami; Sancakdar, Enver; Yilmaz, Ahmet
Background: Crimean-Congo hemorrhagic fever (CCHF) is a systemic viral disease that also affects the endothelium. Thrombocytopenia and hemorrhage are seen in this disease. But, the cause of thrombocytopenia is not clear. We hypothesized that endothelium dysfunction may be the cause of thrombocytopenia. We evaluated the endothelium functions by flow-mediated dilatation (FMD) in CCHF. Methods: Consecutive children with suspected CCHF who applied to our hospital were evaluated for recruitment into the study. FMD analysis was done in the active and healing period of the disease. Diagnosis was confirmed or ruled out by polymerase chain reaction and/or ELISA test. Basal brachial artery diameter (BBAD) and dilated brachial artery diameter (DBAD) after ischemic period were measured and percent dilatations [(DBAD-BBAD)/BBAD, FMD%] were computed from all subjects. Results: Fifty-four children (40 male, mean age 12.4 +/- 4.4 years) were recruited into the study. CCHF diagnosis was confirmed in 28 children and ruled out in 26 children. Groups were similar for age and gender. FMD% was significantly decreased in CCHF patients when comparing this with the control patients in the active period (2.65 +/- 2.76 vs. 13.76 +/- 7.95, P < 0.001). FMD% was correlated with platelet count in the active period of the disease (r = 0.599, P = 0.004). FMD% was recovered in the healing period (2.65 +/- 2.76 vs. 14.72 +/- 2.66, P < 0.001) and was not significantly different from basal values of control patients (P > 0.05). Conclusions: FMD is significantly decreased in CCHF and recovers in the healing period. So, endothelium functions are disturbed, and disturbance is correlated with thrombocytopenia in CCHF.
Evaluation of nasal mucociliary activity in iatrogenic hypothyroidism
(SPRINGER, 2013) Uysal, Ismail Onder; Gokakin, Ali Kagan; Karakus, Canan Filiz; Deveci, Koksal; Hasbek, Zekiye; Sancakdar, Enver
Our aim was to evaluate the effects of iatrogenic, acute and deep hypothyroidism on nasal mucociliary clearance. A total of 46 patients undergoing total or near total thyroidectomy for differentiated thyroid cancer between March and June 2012, and scheduled to undergo radioactive iodine (I-131) ablation therapy followed with an induced hypothyroidism for routine screening were included in the study. Mucociliary clearance test was made during hypothyroid and euthyroid periods in all the patients included in the study. Of the 46 patients included in the study, 37 (%80.4) were females, 9 (%19.6) were males, and the average mucociliary clearance times were 16.78 and 9.58 min during hypothyroid and euthyroid periods, respectively. When the results were compared statistically, mucociliary clearance time measured during hypothyroidism period was found to be significantly longer than the one measured during euthyroid period. Mucociliary clearance time was found to be long during iatrogenic acute and deep hypothyroid periods. During these periods, patients should be followed closely for lower and upper respiratory tract infections.
Evaluation of Renal Involvement in Children with Crimean-Congo Hemorrhagic Fever
(NATL INST INFECTIOUS DISEASES, 2013) Deveci, Koksal; Uysal, Elif Bilge; Kaya, Ali; Sancakdar, Enver; Alkan, Filiz
The aim of the present study was to evaluate renal involvement in children with Crimean-Congo hemorrhagic fever (CCHF). Forty-four children infected with CCHF virus and 30 controls were enrolled in the study. Urine neutrophil gelatinase-associated lipocalin (uNGAL) and urine protein levels were measured in the patient and control groups. Clinical and laboratory findings of the patient and control groups were compared. uNGAL levels were higher in the patient group than that in the control group (P < 0.001). Of the 44 patients, 26 (59.1%) were proteinuric. uNGAL levels in proteinuric patients were higher than those in non-proteinuric patients (P = 0.035). There was a positive correlation between uNGAL and urine protein levels in the patient group. (R = 0.614, P < 0.001). Due to renal involvement, increased proteinuria and increased uNGAL levels were observed in children with CCHF. In these children, measuring urine total protein and uNGAL levels can be useful to monitor renal involvement due to CCHF.
Evaluation of Serum Perforin, Caspase-3, sFasL and M-30 Levels as Apoptotic Markers in Children With Crimean-Congo Hemorrhagic Fever
(LIPPINCOTT WILLIAMS & WILKINS, 2015) Guven, Ahmet S.; Sancakdar, Enver; Uysal, Elif B.; Kaya, Ali; Oflaz, Mehmet B.; Karapinar, Hekim; Bolat, Fatih; Tuzcu, Nevin; Deveci, Koksal; Cevit, Omer; Icagasioglu, Fusun D.
Background: Apoptosis is a main regulator in responses of cellular immunity throughout systemic viral infections. Perforin, soluble Fas ligand, caspase-3 and caspase-cleaved cytokeratin-18 (M-30) are mediators of apoptosis. The aim of this study is the evaluation of Crimean-Congo hemorrhagic fever (CCHF) disease changes in the levels of these apoptotic markers and the relation of these changes with disease severity. Methods: Forty-nine hospitalized children with CCHF and 36 healthy controls were enrolled in this prospective study. The CCHF patients were classified into 2 groups based on disease severity (severe group and nonsevere group). Demographic characteristics and clinical and laboratory findings of all patients were recorded on admission. Results: Serum perforin, caspase-3 and soluble Fas ligand levels were found to be significantly higher both in the severe and nonsevere CCHF groups than the healthy control group (P < 0.05), but there was no significant difference in these apoptotic markers between severe and nonsevere CCHF groups (P > 0.05). In addition, serum M-30 levels did not differ significantly among all groups (P > 0.05). There was a positive correlation between serum values for perforin, caspase-3 and M-30 and the disease's severity criteria such as aspartate aminotransferase and/or alanine aminotransferase. The serum levels of all these markers were negatively correlated with disease severity criteria such as the platelet count. Conclusions: In this study, we concluded that the interactions of cytolytic granules containing perforin and caspase cascade and Fas-FasL may play an important role in the pathogenesis of CCHF in children.
Evaluation of Serum Selenium Levels in Children with Recurrent Febal Convulsions
(Galenos Yayincilik, 2011) Berk, Erhan; Kaya, Ali; Deveci, Koksal; Guven, Ahmet Sami; Demir, Mevlut; Gunes, Hatice; Gultekin, Asim
Introduction: The febrile convulsion (FC) occurs in neurologically normal children aged between six months and five years and it is defined as convulsions occurred during fever and in the absence of central nervous system (CNS) infection, electrolyte imbalance, diseases affecting directly CNS, and history of afebrile convulsion. The aims of this study were to determine the serum levels of selenium in patients with recurrent FC and to compare them with those of healthy children. Materials and Methods: The study included 61 pediatric patients diagnosed with recurrent FC. At the same session, 54 healthy children who admitted to our pediatric clinic for routine controls without history of fever and convulsion, are assigned as control group. The serum level of selenium was measured by atomic absorption spectrometric method (hydride technique). Results: Mean level of selenium was determined as 67.10 +/- 8.87 mu g/L in patients and 81.99 +/- 13.13 mu g/L in control group; the difference was statistically significant (p< 0.05). Discussion: The lower serum levels of selenium in patients with recurrent FC may be the cause of triggering of convulsion or may contribute to its recurrence. Further studies are necessary to clarify this relationship.
Evaluation of the serum levels of soluble IL-2 receptor and endothelin-1 in children with Crimean-Congo hemorrhagic fever
(WILEY, 2014) Deveci, Koksal; Oflaz, Mehmet Burhan; Sancakdar, Enver; Uysal, Elif Bilge; Guven, Ahmet Sami; Kaya, Ali; Alkan, Filiz; Cevit, Omer
We aimed to assess the association between serum levels of soluble IL-2 receptor (sIL-2r) and endothelin-1 and severe infection in children with Crimean-Congo hemorrhagic fever (CCHF). Fifty-two patients under 18 years of age with a laboratory-confirmed diagnosis of CCHF and 38 healthy controls were enrolled in the study. Patients were classified into two groups based on disease severity (severe group and non-severe group). The sIL-2r and endothelin-1 levels were observed to be significantly higher in patients with severe CCHF compared with those with non-severe CCHF and the control group (p < 0.05). In addition, those with non-severe CCHF were also found to have a significantly higher sIL-2r level relative to the control group (p < 0.001). Although there was a positive correlation between sIL-2r and endothelin-1 levels, serum levels of both sIL-2r and endothelin-1 were negatively correlated with the platelets count. In children with CCHF, serum levels of sIL-2r and endothelin-1 were increased, and this increase is related to the severity of the disease. In this study, we concluded through prognosis that serum levels of sIL-2r and endothelin-1 might be related, and that hemophagocytic lymphohistiocytosis and endothelial injury might contribute to a pathogenesis of the disease.
Important of Angiopoietic System in Evaluation of Endothelial Damage in Children with Crimean-Congo Hemorrhagic Fever
(LIPPINCOTT WILLIAMS & WILKINS, 2015) Sancakdar, Enver; Guven, Ahmet S.; Uysal, Elif B.; Deveci, Koksal; Gulturk, Esra
Background: Crimean-Congo hemorrhagic fever (CCHF) causes endothelial activation and dysfunction by affecting the endothelium directly or indirectly. In maintaining the vascular integrity, vascular endothelial growth factor (VEGF-A) and its receptor (VEGFR1) and angiopoietin-2 (Ang-2) and its receptor (Tie-2) are very important mediators. For this reason, we aimed at studying the association of Ang-2 and VEGF and their receptors Tie-2 and VEGFR1 with CCHF infection. Methods: Thirty one CCHF patients and 31 healthy controls (HC) were included in the study. CCHF patients were classified into 2 groups in terms of disease severity (severe and nonsevere). VEGF-A, VEGFR1, Ang-2 and Tie-2 levels were measured in all groups. Result: Serum levels of Tie-2, Ang-2, VEGF-A and VEGFR1 were significantly increased in CCHF patients compared with the HC. Furthermore, serum Tie-2, Ang-2, VEGF and VEGFR1 levels were found to be significantly higher in the severe group than in the nonsevere and HC groups (P < 0.05 and P < 0.001, respectively). Also, Tie-2, Ang-2, VEGF-A and VEGFR1 levels were significantly higher in the nonsevere group than in the HC group (P < 0.05). Conclusion: Having statistically significant higher Ang-2, Tie-2, VEGF-A and VEGFR1 levels in the severe group when compared with the other groups suggested that VEGF-related Ang-2/Tie-2 system played a critical role in the pathogenesis of the disease, and these markers could be used as the severity criteria.
Is Neutrophil/Lymphocyte Ratio Associated with Subclinical Inflammation and Amyloidosis in Patients with Familial Mediterranean Fever?
(HINDAWI PUBLISHING CORPORATION, 2013) Uslu, Ali Ugur; Deveci, Koksal; Korkmaz, Serdal; Aydin, Bahattin; Senel, Soner; Sancakdar, Enver; Sencan, Mehmet
Background. The purpose of the present study is to determine the association between neutrophil/lymphocyte ratio and both subclinical inflammation and amyloidosis in familial Mediterranean fever. Methods. Ninety-four patients with familial Mediterranean fever and 60 healthy volunteers were included in the study. Of the patients, 12 had familial Mediterranean fever related amyloidosis. The neutrophil/lymphocyte ratio of the patients was obtained from the hematology laboratory archive. Results. The neutrophil/lymphocyte ratio was significantly higher among persons with familial Mediterranean fever compared to healthy individuals (P < 0.0001). Also, neutrophil/lymphocyte ratio was significantly higher in patients with amyloidosis than in amyloidosis-free patients (P < 0.0001). Since NLR was evaluated in nonamyloid and amyloid stages of the same patient population (type 1 phenotype), we obtained significant statistical differences (1.95 +/- 0.30 versus 2.64 +/- 0.48, P < 0.05, resp.). With the cutoff value of neutrophil/lymphocyte ratio >2.21 and AUC = 0.734 (P = 0.009), it was a reliable marker in predicting the development of amyloidosis. Conclusion. The neutrophil/lymphocyte ratio, an emerging marker of inflammation, is higher in patients with familial Mediterranean fever in attack-free periods. The neutrophil/lymphocyte ratio may be a useful marker in predicting the development of amyloidosis.
Oxidative stress markers in laparoscopic vs. open appendectomy for acute appendicitis: A double-blind randomized study
(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) Aktimur, Recep; Gokakin, Ali Kagan; Deveci, Koksal; Atabey, Mustafa; Topcu, Omer
Background: Oxidative stress is a complicated process, which was defined as an increase in prooxidants and decrease in antioxidants caused by various mechanisms, including inflammation and surgical trauma. The association between acute appendicitis and oxidative stress has been showed in previous studies. However, comparison of oxidative stress in laparoscopic or open appendectomy (OA) has not been established. Patients and Methods: Patients who were diagnosed as acute appendicitis between October 2012 and January 2013 were randomized to open (OA, n = 50) and laparoscopic appendectomy (LA, n = 50). Blood samples for oxidative stress markers (total oxidant status [TOS] and total antioxidant status [TAS]), C-reactive protein (CRP) and white blood cells (WBC's) were collected just before the surgery and 24 h after surgery. Results: There were no differences in preoperative values of WBC and CRP between LA and OA groups (P = 0.523 and 0.424), however, in postoperative 24(th) h, CRP was reduced in LA group (P = 0.031). There were no differences in preoperative levels of TOS, TAS, and oxidative stress index (OSI) between LA and OA groups. In the postoperative 24(th) h, TOS and OSI were found to be significantly higher in OA group when compared to LA group (P = 0.017 and 0.002) whereas no difference was detected in TAS level in the postoperative 24(th) h (P = 0.172). Conclusions: This double-blind, randomized clinical trial provides evidence that LA for uncomplicated appendicitis is associated with significantly lower oxidative stress compared with OA. Some of the advantages of LA may be attributed to the significant reduction of oxidative stress in these patients.
The Protective Effect of Naringin against Bleomycin-Induced Pulmonary Fibrosis in Wistar Rats
(HINDAWI LTD, 2016) Turgut, Nergiz H.; Kara, Haki; Elagoz, Sahende; Deveci, Koksal; Gungor, Huseyin; Arslanbas, Emre
The aim of the current study was to investigate the protective effect of naringin on bleomycin-induced pulmonary fibrosis in rats. Twenty-four Wistar rats randomly divided into four groups (control, bleomycin alone, bleomycin + naringin 40, and bleomycin + naringin 80) were used. Rats were administered a single dose of bleomycin (5mg/kg; via the tracheal cannula) alone or followed by either naringin 40 mg/kg (orally) or naringin 80mg/kg (orally) or water (1mL, orally) for 14 days. Rats and lung tissue were weighed to determine the lung index. TNF-alpha and IL-1 beta levels, hydroxyproline content, and malondialdehyde (MDA) levels were assayed. Glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities were determined. Tissue sections were stained with hematoxylin-eosin, Masson's trichrome, and 0.1% toluidine blue. TNF-alpha, IL-1 beta, and MDA levels and hydroxyproline content significantly increased (p < 0.01) and GPx and SOD activities significantly decreased in bleomycin group (p < 0.01). Naringin at a dose of 80mg/kg body weight significantly decreased TNF-alpha and IL-1 beta activity, hydroxyproline content, and MDA level (p < 0.01) and increased GPx and SOD activities (p < 0.05). Histological evidence supported the results. These results show that naringin has the potential of reducing the toxic effects of bleomycin and may provide supportive therapy for conventional treatment methods for idiopathic pulmonary fibrosis.
The protective effects of sildenafil in acute lung injury in a rat model of severe scald burn: A biochemical and histopathological study
(ELSEVIER SCI LTD, 2013) Gokakin, Ali Kagan; Deveci, Koksal; Kurt, Atilla; Karakus, Boran Cihat; Duger, Cevdet; Tuzcu, Mehmet; Topcu, Omer
Severe burn induces biochemical mediators such as reactive oxygen species that leads to lipid peroxidation which may have a key role in formation of acute lung injury (ALI). Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil preserves alveolar growth, angiogenesis, reduces inflammation and airway reactivity. The purpose of the present study was to evaluate the effects of different dosages of sildenafil in ALI due to severe scald burn in rats. Twenty-four rats were subjected to 30% total body surface area severe scald injury and were randomly divided into three equal groups as follow: control, 10 and 20 mg/kg sildenafil groups. Levels of malondialdehyde (MDA), activities of glutathione peroxidase (Gpx), catalase (Cat), total oxidative stress (TOS), and total antioxidative capacity (TAG) were measured in both tissues and serums. Oxidative stress index (OSI) was calculated. A semi-quantitative scoring system was used for the evaluation of histopatological findings. Sildenafil increased Gpx, Cat, TAG and decreased MDA, TOS and OSI. Sildenafil decreased inflammation scores in lungs. Our results reveal that sildenafil is protective against scald burn related ALI by decreasing oxidative stress and inflammation and the dosage of 10 mg/kg could be apparently better than 20 mg/kg. (C) 2013 Elsevier Ltd and ISBI. All rights reserved.
Red cell distribution width and hypertensive response to exercise in patients with type 2 diabetes mellitus
(TAYLOR & FRANCIS INC, 2014) Kucukdurmaz, Zekeriya; Karavelioglu, Yusuf; Karapinar, Hekim; Sancakdar, Enver; Deveci, Koksal; Gul, Ibrahim; Yilmaz, Ahmet
Objective: There is no study about hypertensive response to exercise (HRE), which is a marker of unborn hypertension (HT), and red cell distribution width (RDW) association, in diabetic normotensive patients. So, we aimed to investigate any correlation among RDW and HRE in normotensive type 2 diabetic patients. Methods: Consecutive type 2 diabetic patients without history of HT and with normal blood pressure (BP) on ambulatory BP monitoring were included to the study. We divided the patients into two groups depending on their peak systolic BP on exercise; HRE (Group 1) or normal response to exercise (Group 2). Results: Data of 75 diabetic patients (51.9 +/- 9.7) were analyzed (31 male (48%)). Their mean RDW was 13.11 +/- 0.46. Patients with HRE were significantly older than patients without HRE. Smoking was more frequent in Group 2. Gender distribution and body mass index were similar between the groups. Else hemoglobin, hematocrit, red blood cell count and RDW values were not significantly different. Office systolic BP and diastolic BP, daytime and 24-h systolic BP were significantly higher in Group 1 but heart rate was similar between the groups. Conclusions: This study revealed that RDW do not differ between diabetic normotensive patients with HRE or not.
The Relationship Among the Level of Serum Amyloid A, High-Density Lipoprotein and Microalbuminuria in Patients With Familial Mediterranean Fever
(WILEY, 2016) Uslu, Ali Ugur; Aydin, Bahattin; Icagasioglu, Ibrahim Serhat; Balta, Sevket; Deveci, Koksal; Alkan, Filiz; Yildiz, Gursel; Sahin, Ali
BackgroundSerum amyloid A (SAA), which is produced in the liver, acts as an apoprotein of high-density lipoprotein (HDL) accumulation in extracellular matrix of tissues and organs. SAA elevations play a significant role in the development of amyloidosis. Microalbuminuria (MAU) is the early period of amyloidosis in patients with familial Mediterranean fever (FMF). We assessed the association between SAA as an important factor for the development of amyloidosis in patients with FMF and cytokines, HDL, and MAU. MethodsA total of 40 FMF patients diagnosed with Tel-Hashomer criteria and making regular follow-up visits at the tertiary referral center from 2012 to 2013 were included in this study, besides 40 age- and sex-matched individuals as controls. ResultsCompared with controls, FMF patients had higher SAA (25.20 45.78 vs. 1.68 +/- 0.63 ng/ml; P = 0.002). Also, FMF patients had higher MAU than controls (23.20 +/- 39.86 vs. 9.40 +/- 5.32 mg/day; P = 0.036). HDL was significantly lower in the patient group than in controls (39.35 +/- 10.45 vs. 47.82 +/- 15.31 mg/dl; P = 0.023). Interleukin-1 beta (IL-1), IL-6, and tumor necrosis factor alpha (TNF-) levels were higher in the FMF group than in controls (P < 0.0001, P = 0.009, P = 0.003, respectively). ConclusionsOur results suggest that IL-1, IL-6, TNF-, SAA, and HDL may serve as markers of subclinical inflammation in FMF patients. Due to increased plasma HDL levels, antiinflammatory and antioxidant effects may elevate in FMF patients.
Role of ADDUCIN Gly460Trp, ACE I/D and AGT M235T Gene Polymorphisms in Genetic Susceptibility to Diabetic Nephropathy
(MODESTUM LTD, 2015) Sancakdar, Enver; Ates, Kadir; Kaman, Dilara; Deveci, Koksal; Ozkan, Yusuf; Ilhan, Necip
Diabetes mellitus is a metabolic disease with a high incidence of morbidity and mortality lowering the quality of life with acute and chronic complications and it needs to be followed up and treated throughout the lifespan. Concordant with the frequency of DM and the increase in the length of life frequency of DNP is also increased. The I allele of the ACE I/D polymorphism, AGT M235T's T allele and ADD G460W's W allele presence are purported to present a predisposition to DNP. In our study we aimed to investigate the effect of the AGT M235T, ACE I/D and ADD 460W polymorphisms in the development of DNP in patients with diabetes mellitus. The study group consisted of 194 patients with Diabetic nephropathy and the control group contained 100 DM patients. In the diabetic group the DD genotype of the ACE I/D polymorphism was 54 (54.0%) and the D allele was 69.0% and in the nephropathy group II genotype of the ID were 78 (40.2%) and 51 (26.3%) and the I allele was 46.4 respectively and the presence of the I allele was associated with the presence of nephropathy. There was no significance between the genotypes in the presence of a coexistence of AGT M235T and ACE I/D polymorphisms between the groups the MD alleles (42%) demonstrated significance in the diabetic and the T/I alleles (28.1) demonstrated significance in the nephropathy group. In the ADD G640W polymorphism on its own, subjects having GG (77.3%) and WW (7.7%) genotypes (p=0.025) might have been predisposed to nephropathy however when in combination with the ACE I/D, the presence of the DD/GG (45%) in the diabetic group and the presence of the ID/GG (29.9%) and II/GG (19.6%) combination in the DNP group were statistically significant. The D/G (64%) alleles were significant in the diabetic and the I/G (36.6) alleles were significant in the DNP groups respectively. As a conclusion we think that the II-ID/GG genotype and the I/G alleles in the presence of the ACE-ADD combination and TT/ID genotype and T/I alleles in the ACE-AGT combination may be effective in the predisposition of the diabetic patients to nephropathy.
Serum Levels of Angiopoietin-Related Growth Factor (AGF) Are Increased in Polycystic Ovary Syndrome
(LIPPINCOTT WILLIAMS & WILKINS, 2012) Boztosun, Abdullah; Deveci, Koksal; Kilicli, Fatih; Soylemez, Melike Sinem; Muhtaroglu, Sabahaddin; Muderris, Iptisam Ipek
Background: Polycystic ovary syndrome (PCOS) is a frequent reproductive and metabolic disorder associated with insulin resistance. Recently, angiopoietins were identified in the systemic circulation and have been designated angiopoietinlike proteins (ANGPTL). More recently, it is shown that angiopoietin-related growth factor (AGF, also called ANGPTL6) directly regulate lipid, glucose, and energy metabolism independent of angiogenic effects in animal studies. The aim of this study was to determine whether there is an association between AGF and PCOS. Methods: The study included 35 patients with PCOS and 30 healthy control women. We analyzed serum levels of AGF and other biochemical and anthropometric markers in all the subjects. Results: This study showed that serum AGF levels were significantly higher in the subjects with PCOS (102.28 ng/mL) than those in the healthy control group (63.08 ng/mL; P < 0.001). Body mass index (24.33 vs 22.11 kg/m(2); P = 0.017), free testosterone (2.81 vs 2.17 pmol/L; P = 0.009), androstenedione (3.28 vs 2.92 nmol/L; P = 0.033), 17-hydroxyprogesterone (2.72 vs 2.09 ng/mL; P = 0.039), homeostasis model of assessment-insulin resistance (2.65 vs 1.9; P = 0.016), and fasting glucose (107.09 vs 96.18 mmol/L; P = 0.001) were found significantly higher in PCOS group than in control group. But there was no correlation between AGF and these parameters in PCOS group. In addition, no correlation between the AGF and other distinctive features of PCOS was found. Conclusions: Serum AGF levels were paradoxically increased in patients with PCOS in comparison with data of animal experiments. Further studies are needed to better elucidate the physiologic significance of circulating AGF in human disease.
The effects of sildenafil in liver and kidney injury in a rat model of severe scald burn: A biochemical and histopathological study
(Turkish Association of Trauma and Emergency Surgery, 2014) Gökakin, Ali Kağan; Atabey, Mustafa; Deveci, Koksal; Sancakdar, Enver; Tuzcu, Mehmet; Duger, Cevdet; Topcu, Omer
Background: Severe burn induces systemic inflammation and reactive oxygen species leading to lipid peroxidation which may play role in remote organs injury. Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase- 5. Sildenafil reduces oxidative stress and inflammation in distant organs. The aim of the present study was to evaluate the effects of different dosages of sildenafil in remote organs injury.; Methods: A total of thirty-two rats were randomly divided into four equal groups. The groups were designated as follows: Sham, Control, 10, and T20 mg/kg sildenafil treatment groups. Levels of malondialdehyde (MDA), vascular endothelial growth factor (VEGF), VEGF receptor (Flt-1), activities of glutathione peroxidase (Gpx), levels of total antioxidative capacity (TAC), and total oxidant status (TOS) were measured in both tissues and serum, and a semi-quantitative scoring system was used for the evaluation of histopathological findings.; Results: Sildenafil increased levels of Gpx, and Flt-1, and decreased MDA and VEGF levels in tissues. Sildenafil also increased serum levels of TAC and Flt-1 and decreased TOS, OSI, and VEGF.; Conclusion: Sildenafil decreased inflammation scores in remote organs in histopathological evaluation. It has protective effects in severe burn-related remote organ injuries by decreasing oxidative stress and inflammation. © 2014, TJTES.

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