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    Association between thiol-disulfide hemostasis and transient tachypnea of the newborn in late-preterm and term infants
    (Bmc, 2023) Demirtas, Mehmet Semih; Erdal, Huseyin; Kilicbay, Fatih; Tunc, Gaffari
    BackgroundTransient tachypnea of the newborn (TTN), which is the most common respiratory disease in the neonatal period, increases respiratory workload in newborns. We purposed to evaluate the oxidative stress (OS) status and thiol disulfide hemostasis in late preterm and term newborns with TTN in this study.MethodsThe study was carried out in a single-centre neonatal intensive care unit to investigate the effect of continuous airway positive pressure (CPAP) on the oxidative system in newborns with TTN. Thiol (native and total) and disulfide levels, total antioxidant and oxidant status (TAS/TOS) and Oxidative stress index (OSI) levels were measured.ResultsTotal thiol levels measured before treatment was 429.5 (369.5-487) mu mol/L in the late preterm group and 425 (370-475) mu mol/L in the term group (p = 0.741). We found significant changes in TOS, OSI and TAS levels after CPAP treatment in the late preterm group (p < 0.001, p < 0.001, p = 0.012 respectively). It was also found that the disulfide level, which was 26.2 (19.2-31.7) before the treatment, decreased to 19.5 (15.5-28.75) after the treatment (p = 0.001) in late preterms.ConclusionCPAP treatment reduced the OS status burden associated with TTN in neonates. The late preterm newborns with TTN are more affected by OS and increased OS levels decrease with CPAP treatment.
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    Evaluating Hematological Inflammatory Markers as Predictors of Preeclampsia
    (Imr Press, 2024) Genc, Serife Ozlem; Erdal, Huseyin
    Background: Preeclampsia, affecting 2-8% of pregnancies, is characterized by new-onset hypertension, proteinuria, and edema, stemming from placental dysfunction and subsequent inflammatory cascade activation. This study aimed to test the predictive ability of hematological indices in predicting preeclampsia. Therefore, predicting the diagnosis of preeclampsia earlier with higher accuracy could potentially preserve the lives of both the mother and the fetus, while also reducing the rates of complications. Methods: This retrospective study included two groups: patients with preeclampsia and a matched control group without additional medical conditions, both having undergone childbirth in the same gestational week. The primary difference between the groups was the preeclampsia diagnosis. Hematological parameters and inflammatory indices were compared for analysis. Results: Statistical significance was observed between derived neutrophil-lymphocyte ratio (dNLR), systemic immune-inflammation index (SIRI) and pan-immune inflammation value (PIV) between groups. The dNLR and PIV showed predictive relevance for preeclampsia (p < 0.05). However, their predictive performance was weak (under the curve (AUC) <0.5). A composite index (CoI) combining these indices achieved a higher AUC of 0.62, indicating limited better predictive performance capability. Conclusions: These findings affirm the correlation between preeclampsia and increased inflammation. Inflammatory markers like the dNLR, SIRI, and PIV showed statistical significance but were not practically useful in clinical settings due to their low sensitivity and specificity. The results highlight the necessity of exploring a CoI, which combines these markers, to enhance predictive accuracy and clinical utility.
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    Evaluation of Oxidative Stress Levels and Dynamic Thiol-disulfide Balance in Patients with Retinopathy of Prematurity
    (Taylor & Francis Inc, 2023) Erdal, Huseyin; Demirtas, Mehmet Semih; Kilicbay, Fatih; Tunc, Gaffari
    PurposeThe aim of this study is to evaluate both dynamic thiol-disulfide homeostasis and oxidative stress (OS) levels in patients with retinopathy of prematurity (ROP).MethodsA total of 129 infants of <34 weeks gestational age were enrolled in the present study. The thiol-disulfide homeostasis was determined by using the new, cost-effective and fully automated colorimetric method. Total antioxidant status (TAS), Total oxidant status (TOS) and Oxidative stress index (OSI) levels were evaluated.ResultsWe found serum TAS levels were lower while serum TOS and OSI levels were significantly higher in patients with ROP compare to the without ROP group (p < .05). However, native, total and disulfide values were not statistically significant between the groups (p > .05). In addition, we also evaluated the native, total and disulfide levels in patients with ROP according to grades and no statistically significant results were found (p > .05). Low birth weight (p = .001), gestational age (p = .001) and 5-min Apgar score were significantly lower in the ROP group.ConclusionThis study revealed that dynamic thiol-disulfide homeostasis was changed in patients with ROP. Increased TOS and decreased TAS levels may be associated with functional reduction of the antioxidant system due to increased OS. This indicate that ROP patients are highly sensitive to OS. The dynamic thiol-disulfide homeostasis may conduce to the pathophysiological mechanism and disease follow-up in patients with ROP. The results of this study show that ROP patients are highly sensitive to oxidative stress.
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    Gestational Oxidative Stress and OGTT: Are Pregnant Women's Fears Justified?
    (Dove Medical Press Ltd, 2024) Genc, Serife Ozlem; Erdal, Huseyin
    Purpose: Pregnancy induces significant metabolic, immunological, and endocrinological changes to support fetal growth. The 75gram oral glucose tolerance test (OGTT) is standard for gestational diabetes screening, but concerns exist about its potential to induce oxidative stress, affecting both maternal and fetal health. The aim of the study is examining changes in oxidative stress markers and thiol/disulfide homeostasis in pregnant women to evaluate these concerns. Patients and Methods: Thirty pregnant women undergoing gestational diabetes screening between the 24th and 28th weeks participated. Blood samples were collected at 0, 60, and 120 minutes as part of the OGTT protocol. Oxidative stress markers were analyzed only in samples from 0 and 120 minutes, while the 60-minute sample was used solely for glucose measurement. Results: Results showed a significant increase in TOS (p = 0.008) and OSI (p = 0.035) post-OGTT, indicating an acute oxidative stress response. Thiol and disulfide levels showed non-significant changes, suggesting that antioxidant mechanisms were largely unaffected. Conclusion: Further research is necessary to explore the long-term implications of these findings and develop strategies to mitigate oxidative stress during pregnancy. This study provides insights into the acute oxidative stress response caused by OGTT in pregnant women. Although the OGTT induces oxidative stress, it does not significantly disrupt the body's antioxidant capacity in the short term. These results highlight the need for more research to understand the effects of heightened oxidative stress on maternal and fetal health.
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    Oxidative Stress Levels and Dynamic Thiol-Disulfide Balance in Preterm Newborns with Bronchopulmonary Dysplasia
    (Oxford Univ Press, 2023) Demirtas, Mehmet Semih; Kilicbay, Fatih; Erdal, Huseyin; Tunc, Gaffari
    Objective The aim of this study was to assess the oxidative stress (OS) levels and dynamic thiol-disulfide balance in preterm newborns with bronchopulmonary dysplasia (BPD). Methods This prospective study included newborns separated into 2 groups, those with BPD (case) or without BPD (control). The 2 groups were compared by clinical and laboratory findings. The OS parameters total oxidant status (TOS), total antioxidant status (TAS), OS index (OSI), native thiol (NT), and total thiol were measured within the first day after birth. Oxygen requirements were measured using the fraction of inspired oxygen (FIO2) recorded in the first hour after birth/admission and the average FIO2 within 28 days of the birth. Results Infants diagnosed with BPD had a significantly lower gestational age and birth weight and a lower 5-min Apgar score (P < .05). Infants with BPD also had a higher rate of respiratory distress syndrome, rate of use of surfactant therapy, duration of ventilation therapy, and duration of hospital stay compared with control (P = .001, P = .001, P = .001, and P = .001, respectively). Plasma TAS and NT levels of newborns with BPD were significantly lower than newborns without BPD (P < .05). In the BPD group, plasma TOS and OSI levels were significantly higher than in the control group. Conclusion We found that OS was increased in newborns with BPD. The clinical significance of this study will provide the clinician with a different perspective on BPD by determining the dynamic thiol disulfide balance.
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    Rethinking the Risk: Evalution of the Malignant Potential of Non-16 and 18 HPV Types VIA Colposcopic Results
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Genc, Serife Ozlem; Kurt, Begum; Koç, Tulay; Erdal, Huseyin
    Introduction: The malignancy risks of high-risk HPV types like 16 and 18 are well-known. The oncogenic potential of other HPV types, however, remains unclear. This study reevaluates malignancy risks across HPV types, stressing comprehensive colposcopic evalu ations in cervical cancer screening. Materials and Methods: Conducted at a tertiary care center (January 2021-July 2023), this retrospective study included 138 women divided into two groups: those infected with HPV 16/18 and those with other HPV types. We analyzed and compared colposcopic a nd histopathological outcomes, correlating colposcopic results with biopsy outcomes to assess cervical neoplasia. Statistical analysis was performed using GraphPad Prism 10 (GraphPad Software Inc.; San Diego, CA, USA). Descriptive statisti cs, including means and standard deviations for continuous variables and frequencies and percentages for categorical variables, were calculated. The chi-square test was used to compare categorical variables between the two groups, and an independent t-test was employed to compare continuous variables. A p-value of less than 0.05 was considered statistically significant. Results: Significant differences were noted between groups. While HPV 16 and 18 are linked to higher cervical neoplasia incidences, non-16/18 HPV types were also frequently associated with smear abnormalities. The average age of first sexual intercourse was 20.49 ± 4.2 years. Forty-nine percent of the women were smokers, 8% had only primary school education, and 78% were homemakers. High rates of known risk factors like low educational and socioeconomic status, and smoking were also significant. Conclusion: Our findings suggest that non-16/18 HPV types might have a higher malignancy potential than HPV 16-18, highlighting their importance in cervical cancer screenings and colposcopic evaluations. The study's small sample size limits its conclusions, pointing to the need for larger studies to refine cervical cancer screening strategies globally. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.