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The presence of live SARS-CoV-2 viruses in the fecal specimens and the positive results for SARS-CoV-2 RNA in gastrointestinal samples after respiratory specimens had become negative indicate that there may be a risk of transmission of the disease not only through the respiratory tract but also through the fecal-oral route. The study aim is to determine the time period that the SARS-CoV-2 virus remains in the fecal specimens of discharged COVID-19 patients to reveal the time interval in which the risk of transmission continues.

Background: Type II Diabetes Mellitus(T2DM) is the most frequent endocrin disease. Elevated HbA1c level is reported as a risk factor in cardiovascular diseases whereas cardiovascular diseases cause death and disability among diabetic patients. The aim of the study is to compare the immunoturbidimetry and high performance liquid chromatography(HPLC) methods and determine the HbA1c status among patients who were admitted to our hospital and policlinics to select the best method for determining HbA1c in order to meet the needs of the patients. Materials-Methods: HbA1c levels from 20.503 patients (12288 females and 8215 males) were collected from the Laboratory Information system(LIS) retrospectively. Patients were admitted to our Cardiology and Cardiovascular Surgery Hospital for cardiovascular reasons and to our Internal Medicine policlinics for non-cardiovascular reasons between 2011 and 2012, whereas HbA1c levels were analyzed with high performance liquid chromatography (HPLC). Also venous blood samples obtained in EDTA containing tubes from 237 in-and-out patients of our hospital (155 females and 82 males) were analyzed in Premier Hb 9210(Trinity Biotech -USA) and Cobas c501(Roche -Germany) using HPLC and immunoturbidimetry respectively. This two methods were compared. Results: Patients with HbA1c level ≤6 % were 47,5 %, ≤7 were 74,5 %, ≤8 were 85,2% and ≥8 were 14,8 % of all patients. After the comparison of the two methods there was found a strong correlation from all patients (n= 237)(r2=0.90) and from patients with HbA1c level ≥6.0 % (n=125) (r2=0.88). Conclusion: The importance of HbA1c in patients with cardiovascular diseases and the HbA1c levels among our patients indicate that HPLC represents a better choice to determine HbA1c in our hospital. But immunoturbidimetry can be the choice of the method in laboratories with low number of patients. Each laboratory should consider which method is the best. [ABSTRACT FROM AUTHOR]

Context. The effects of COVID-19 on the adrenocortical system and its hormones are not well known. Objectives. We studied serum cortisol, serum adrenocorticotropic hormone (ACTH), and their ratio in hospitalized non-critically ill COVID-19 patients. Design. A prospective case-control study. Methods. The study participants were divided into 2 groups. Group 1 consisted of 74 COVID-19 patients. The second group consisted of 33 healthy persons. Early admission above hormones levels was determined and compared between the study groups. Besides that, COVID-19 patients were grouped according to their Glasgow Coma Score (GCS), CURB-65 score, and intensive care unit (ICU) requirement, and further sub-analyses were performed. Results. There were no significant differences in the mean age or gender distribution in both groups. In the patients' group, the serum ACTH concentration was lower than in the healthy group (p<0.05). On the other hand, the serum cortisol levels and cortisol/ACTH ratio of the patients' group were significantly higher than of the healthy controls (p<0.05, all). Further analyses showed that, although serum cortisol and ACTH levels were not high, the cortisol/ACTH ratio was higher in COVID-19 patients with low GCS (<15) than patients with normal GCS (=15) (p<0.05). In COVID-19 in patients with different CURB-65 scores, the cortisol/ACTH ratio was significantly different (p<0.05), while serum cortisol and ACTH were not different in groups (p>0.05). Serum cortisol levels and cortisol/ACTH ratio were higher but ACTH level was lower in the ICU needed COVID-19 patients than in patients who do not need ICU (p<0.05). Conclusion. Our pilot study results showed that the cortisol/ACTH ratio would be more useful than serum cortisol and/or ACTH levels alone in evaluating the adrenocortical system of COVID-19 patients. Still, further detailed studies are needed to confirm these. [ABSTRACT FROM AUTHOR]

Background: Carbonyl stress, a metabolic state characterized by elevated production of reactive carbonyl compounds (RCCs), is closely related to oxidative stress and has been implicated in various diseases. This study aims to investigate carbonyl stress parameters in drug-free bipolar disorder (BD) patients compared to healthy controls, explore their relationship with clinical features, and assess the effect of treatment on these parameters., Methods: Patients with a primary diagnosis of a manic episode of BD and healthy controls were recruited. Exclusion criteria included intellectual disability, presence of neurological diseases, chronic medical conditions such as diabetes mellitus and metabolic syndrome, and clinical signs of inflammation. Levels of serum carbonyl stress parameters were determined using high-performance liquid chromatography., Results: Levels of glyoxal (GO) and methylglyoxal (MGO) did not differ between pre- and post-treatment patients, but malondialdehyde (MDA) levels decreased significantly post-treatment. Pre-treatment MGO and MDA levels were higher in patients compared to controls, and these differences persisted post-treatment. After adjusting for BMI and waist circumference, only MDA levels remained significantly higher in patients compared to controls., Limitations: The study's limitations include the exclusion of female patients, which precluded any assessment of potential gender differences, and the lack of analysis of the effect of specific mood stabilizers or antipsychotic drugs., Conclusions: This study is the first to focus on carbonyl stress markers in BD, specifically GO, MGO, and MDA. MDA levels remained significantly higher in patients, suggesting a potential role in BD pathophysiology. MGO levels were influenced by metabolic parameters, indicating a potential link to neurotoxicity in BD. Further research with larger cohorts is needed to better understand the role of RCCs in BD and their potential as therapeutic targets., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: The aim of this study was to evaluate the physical structure, design, management, and organization of two emergency hospitals built in Istanbul within 45 days in the COVID-19 pandemic and the role played by these hospitals during the pandemic. A further aim was to determine the advantages and disadvantages of the emergency hospitals by comparing them with similar organizational models in other countries., Methods: The pandemic hospitals established for the COVID-19 pandemic in Istanbul were investigated in a multi-faceted manner. The parameters investigated were physical structure, bed, and intensive care capacity, mechanics and infrastructure, medical equipment, personnel, organizational structures and management, and the medical services provided by both emergency hospitals during the outbreak., Results: The pandemic hospitals were built on an open area of 125.000 m 2 as a hospital building of 75.150 m 2 . Each hospital has a total bed capacity of 1008, with 576 being clinical and 432 being intensive care beds. The management of the pandemic hospitals is connected to two different hospital management structures, which are experienced in disasters and have all kinds of training, research clinics and academic personnel in this regard., Conclusion: The healthcare services provided by both the pandemic hospitals fulfilled the purpose of those hospitals during the pandemic. As it is most likely that the world will face other serious disasters and epidemics in the future, the construction of multi-purpose and permanent emergency hospitals instead of emergency temporary hospitals would be more advantageous in terms of economy, medical service, and environment.

Mammography is one of the gold standard screening tests for breast cancer. The effects of mammography procedure on blood parameters are not known. This study aimed to investigate whether the procedure-associated breast compression affects the widely and simultaneously performed blood measurements of C-reactive protein (CRP), carcinoembryonic antigen (CEA), and cancer antigen (CA) 15-3. According to breast ultrasound examination results, participants were divided into 3 groups as follows: group 1 (participants with breast mass size ≥20.0 mm, n=48); group 2 (participants with breast mass size <20.0 mm, n=17); and group 3 (participants with no breast mass, n=23). In groups 1 and 2, on the day of the mammographic imaging study, serum CRP, CEA, and CA 15-3 levels were measured before and after the imaging study. Participants in group 3 had their blood parameters measured without mammography and/or any breast compression. Post-mammography blood measurements displayed a significant increase in serum CRP levels, and a significant decrease in serum CEA and CA 15-3 levels in group 1 (in comparison with the same day pre-mammography blood sampling levels; p<0.05 all). Although pre-mammography serum CEA levels in group 1 participants were significantly higher than those in group 2 and 3 participants, this significant elevation became nonsignificant at post-mammography measurements (p<0.05 and p>0.05, respectively). On the day of the mammographic imaging study, the optimal time of blood sampling for testing CRP, CEA and CA 15-3 levels in persons with a breast mass is before, but not after the mammographic imaging procedure. This issue requires additional detailed studies., (Sestre Milosrdnice University Hospital.)

Background and Aims: We aimed to assess N-terminal pro brain-type natriuretic peptide (NT-proBNP) levels in acute ischemic stroke (AIS) patients according to clinical and radiological features and to investigate its relationship with short term clinical outcomes., Methods: In our study, 107 patients with AIS were evaluated prospectively. Of all, 56 patients had no evidence of atrial fibrillation (AF) (sinus rhythm [SR] group) (52.3%), 24 patients had paroxysmal AF (pAF group) (22.4%), and the other 27 patients had chronic AF (cAF group) (25.3%). Demographic datas, clinical characteristics, laboratory and radiological findings, CHA2DS2 -VASc scores, NIHSS (National Institute of Health Stroke Scale) and modified Rankin Scale (mRS) scores on admission and at the third month evaluations were recorded. Good functional outcome at 3 months was defined as modified Rankin score (mRS) 2 or less. According to the TOAST (Trial of Org 10172 in Acute StrokeTreatment) and OCSP (Oxfordshire Community Stroke Project) study, ischemic stroke subtyping was performed. Serum NT-proBNP levels were estimated in 107 stroke patients and 24 age- and sex-matched control subjects. Venous blood samples were obtained for serum NT-proBNP measurement within the first 48 hours of the patient group., Results: Mean age of the 107 AIS patients was 68 ± 15.22 years and 58.9% of them were women. Compared to controls, the SR, pAF and cAF groups had higher plasma NT-proBNP levels (P < 0.001) and also NT-proBNP values were significantly higher in the pAF and cAF group than SR groups (P < 0.001). NT-proBNP values were significantly higher in cardioembolic (CE) (n = 57) group than in large artery atherosclerosis (LAA) (n = 20) and small vessel disease (SVD) (n = 30) groups (P < 0.001). NT-proBNP levels of noncardioembolic SR (n = 49) (P = 0.080), LAA and SVD groups (P = 0.103) were higher than the control group but the difference was not statistically significant. There was a positive correlation between NT-proBNP level and third month mRS scores in CE group (r = 0.491)., Conclusions: NT-proBNP will contribute to predict cardioembolic and pAF groups and estimate the prognosis., Competing Interests: None

The epigenetic features contribute to variations in host susceptibility to SARS-CoV-2 infection and severity of symptoms. This study aimed to evaluate the relationship between the relative expression of microRNAs (miRNAs) and the severity of the disease in COVID-19 patients. The miRNA profiles were monitored during the different stages of the disease course using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The expression levels of the selected 11 miRNAs were measured in the blood samples collected from 73 patients (moderate, n = 37; severe, n = 25; critically ill, n = 11, a total of 219 longitudinal samples) on hospitalization day and days 7 and 21. Expression changes were expressed as "fold change" compared to healthy controls ( n = 10). Our study found that several miRNAs differed according to disease severity, with the miR-155-5p the most strongly upregulated ( p = 0.0001). A statistically significant negative correlation was observed between the expression of miR-155-5p and its target gene, the suppressor of cytokine signaling 1 ( SOCS1 ). The relative expression of miR-155-5p was significantly increased and SOCS1 was significantly decreased with the disease progression (r = -0.805 p = 0.0001, r = -0.940 p = 0.0001, r = -0.933 p = 0.0001 for admission, day 7, and day 21, respectively). The overexpression of miR-155-5p has significantly increased inflammatory cytokine production and promoted COVID-19 progression. We speculated that microRNA-155 facilitates immune inflammation via targeting SOCS1 , thus establishing its association with disease prognosis.

The diagnostic role of serum cytokines depends on the etiology and pathogenesis of acute appendicitis but the clinical significance of these cytokines in the differential diagnosis of complicated acute appendicitis remains unclear. To investigate the prediction of progression and diagnostic values of interleukin-6, interleukin-1 beta, and tumor necrosis factor-alpha in complicated acute appendicitis. This study was conducted in 100 patients with a definitive diagnosis of acute appendicitis and 20 individuals assigned for the control group. Venous blood was collected to assess biochemical tests, as well as interleukin-6, interleukin-1β, and tumor necrosis factor-α levels. Serum levels of all parameters were dramatically higher in the complicated group compared with uncomplicated. Duration of hospitalization, rates of postoperative infection, intraabdominal abscess, and re-hospitalization were higher in complicated group. Cut-off points of WBC, CRP, NLR, interleukin-6, interleukin-1β and tumor necrosis factor-α were 13.5x103/µL, 1.92 mg/dL, 6.09, 23.4 pg/mL, 5.6 pg/mL and 24 pg/mL (p=0.0014, p<0.001, p=0.009, respectively and p<0.001 for the rest). AUC of interleukin-6 was larger than AUCs of all other parameters, suggesting the highest predicting power of interleukin-6 among other parameters. Serum interleukin-6, interleukin-1β, and tumor necrosis factor-α levels are valuable diagnostic parameters to predict a complicated acute appendicitis.

The main culprit behind most cancers is the accumulation of reactive oxygen species. Glyoxal (GO) and methylglyoxal (MGO) are reactive intermediates created by food processing and they are precursors of advanced glycation end products (AGE) that cause glycative stress. We aimed to evaluate the relationship between AGE levels of healthy volunteers and treatment-naive patients diagnosed with colorectal cancer. The study consisted of patients diagnosed with colorectal cancer and healthy volunteers who underwent routine colonoscopy. The study was conducted with a total of 42 cases, 47.6% ( n  = 20) female. The ages of the participants in the study ranged from 41 to 82 years, and the mean was 60.57 ± 10.78 years. The GO and MGO values of the patient group were found to be significantly higher than those of the control group ( p  = 0.007, p  = 0.001, respectively). The risk of colorectal cancer was 22 and 57 times higher in individuals with GO and MGO values above 1.25 μg/mL and 0.0095 μg/mL, respectively. The blood AGE level is closely related to diet, and it can be decreased through the appropriate improvement of diet. Thus, the measurement of AGE can be used to predict whether a person's nutrition is healthy or unhealthy and prevent increased risk of colorectal cancer.

Objective: The prevalence of diabetes mellitus is growing worldwide, as well as in the aging population, and its comorbidity and mortality rates are higher in aging people than they are in young people. It has been observed that the number of drugs used increases in aging patients, especially in diabetic patients. This study aimed to investigate the relationship between polypharmacy and modified Charlson Comorbidity Index (CCI) and Katz Index of Independence in Activities of Daily Living (Katz ADL) scores in aging diabetic and non-diabetic patients., Materials and Methods: This prospective study included 184 diabetic and 62 non-diabetic subjects who were ≥65 years old. Comorbidity was determined with CCI, and dependency on daily basic activities was assessed with Katz ADL., Results: CCI and the number of drugs were significantly higher in diabetic groups ( P = .001). In all subjects and in the diabetic group, there was a negative correlation between CCI and Katz ADL (r = -0.343, P = .001; r = -0.383, P = .001, respectively); there was a positive correlation between CCI and number of drugs (r = 0.430, P = .001; r = 0.248, P = .001, respectively)., Conclusion: We found an increase in the number of drugs taken by the aging patients, positively correlated with the CCI score. The increase in the number of drugs used is closely related to the insufficiency in daily life activity and comorbidity, and this predicts 10-year survival. Patients should be directed to special centers or physicians who will be scheduled for multidisciplinary treatment for the prevention of polypharmacy, especially in the aging., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (©Copyright 2021 by the Atatürk University School of Medicine - Available online at www.eurasianjmed.com.)

Background: Coronavirus disease 2019 (COVID-19) has quickly turned into a global pandemic with close to 5 million cases and more than 320,000 deaths. Cancer patients constitute a group that is expected to be at risk and poor prognosis in COVID pandemic. We aimed to investigate how cancer patients are affected by COVID-19 infection, its clinical course and the factors affecting mortality., Methods: In our single-center retrospective study, we included cancer patients with laboratory confirmed COVID-19 in our hospital. Demographic, clinical, treatment, and laboratory data were obtained from electronic medical records. Logistic regression methods were used to investigate risk factors associated with in-hospital death., Results: In the hospital, 4489 patients were hospitalized with COVID infection and 77 were cancer patients. The mean age of cancer patients was 61.9 ± 10.9 and 44 of them were male (62%). While the mortality rate in non-cancer patients was 1.51% (n = 68), this rate was significantly higher in cancer patients, 23.9% (n = 17). The stage of the disease, receiving chemotherapy in the last 30 days also lymphopenia, elevated troponin I, D-dimer, CRP, and CT findings were associated with severe disease and mortality. Severe lung involvement (OR = 22.9, p = 0.01) and lymphopenia (OR = 0.99, p = 0.04) are the most important factors influencing survival in logistic regression., Conclusions: The disease is more severe in cancer patients and mortality is significantly higher than non-cancer patients. These data show that it may be beneficial to develop dynamic prevention, early diagnosis and treatment strategies for this vulnerable group of patients who are affected by the infection so much.

Background: To see the relationship of early admission parameters with the type of stroke and/or with the 30-days mortality from this disease., Methods: Stroke patients at their early hyperacute phase (n = 180) were enrolled in this study (156 ischemic strokes and 24 hemorrhagic strokes). Blood levels of C-reactive protein (CRP), testosterone, and estradiol were determined at admission, before any specific intervention. Patients' clinical data, including the above-mentioned laboratory parameters, were compared between the above two stroke types (in total and between sexes)., Results: The mean age of the patients was 69.55 ± 12.03 years old (69.92 ± 11.94 years old in ischemic stroke and 67.12 ± 12.54 years old in hemorrhagic stroke). Serum estradiol levels of both males of ischemic stroke and females of hemorrhagic stroke patients were significantly higher than the females of the ischemic stroke. Serum CRP levels of both females and males of the hemorrhagic group were higher than their peers of the opposite group. Early admission serum CRP level ≥ 0.74 mg/dL in males helped predict hemorrhagic stroke while a serum estradiol level ≥ 14.07 ng/mL helped predict the same type of stroke in females., Conclusions: Our study results show that simple early laboratory measures (such as CRP and estradiol) may help in the early phase management of stroke. Further studies are needed to confirm our findings.

Introduction: Although most ischaemic strokes are due to cardioembolism, about 25-40% of strokes are cryptogenic. Patent foramen ovale has been associated with cryptogenic stroke; however, the precise mechanism of this association has not been demonstrated. The aim of this study was to evaluate the association between inflammatory markers and cryptogenic stroke in patients with patent foramen ovale., Material and Methods: We included 206 patients with patent foramen ovale. Ninety-four (45.63%) out of 206 patients had had stroke, and 112 (54.37%) had not had stroke. The ratio of the total neutrophil count to the total lymphocyte count was defined as the neutrophil to lymphocyte ratio, and the ratio of the absolute platelet count to the absolute lymphocyte count was determined as the platelet to lymphocyte count., Results: The neutrophil to lymphocyte ratio was significantly higher in patients who had stroke than in those who did not (2.41 ±1.69 vs. 2.19 ±1.74, p = 0.047). Although the platelet to lymphocyte count was also higher in patients who had had stroke than in those who had not, it was not statistically significant (120.94 ±55.45 vs. 118.01 ±52.21, p = 0.729). 1.62 was the cut-off value for neutrophil to lymphocyte ratio to be associated with stroke with 73.4% sensitivity and 45.05% specificity ( p = 0.042)., Conclusions: This study demonstrated that elevated neutrophil to lymphocyte ratio and platelet to lymphocyte count could be associated with cryptogenic stroke in patients with patent foramen ovale., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Termedia & Banach.)

The aim of this study is to evaluate the therapeutic effect of mesenchymal stem cells (MSCs) in a severe case of brain and multiple organ involvement in a patient with COVID-19. Here, a 51-year-old male patient with multi-organ involvement due to COVID-19 infection and developing cardiac arrest is presented. MSCs were transplanted to the patient four times systematically and once intrathecally. As a result, the application of MSCs has been found to have a healing effect on organs in this patient with severe COVID-19 infection. In addition, transplantation of MSCs both systematically and intrathecally is considered to be effective in the treatment of the central nervous system (Tab. 2, Fig. 2, Ref. 24). Keywords: mesenchymal stem cell, COVID-19, organ involvement.

Aim: Atrial septal aneurysm (ASA) is one of the congenital heart defects. The underlying pathophysiology of ASA has not been fully understood yet. Alpha-1 antitrypsin (A1AT) is a serine protease inhibitor glycoprotein, which is held responsible from tissue wall proteolysis if it is deficient in the body. The aim of this study was to investigate A1AT serum levels and the rs1303 (Pi*M3) variant in A1AT gene in patients with ASA., Material and Methods: Thirty patients (7 male and 23 female) with isolated ASA and 33 patients (11 male and 22 female) with normal atrial septum on echocardiography were included in this study. A1AT serum levels of study patients were measured quantitatively by the enzyme-linked immune sorbent assay (ELISA) method. The A1AT gene mutation rs1303 was analyzed by genotyping, which is performed on genomic DNA extracted from circulating mononuclear blood cells. Single-nucleotide polymorphism was evaluated on polymerase chain reaction using commercial kits., Results: A1AT serum levels were not statistically different among patients with and without ASA (9.52 ± 4.33 µg/mL vs 9.83 ± 5.27 µg/mL, respectively, P = .80). A1AT homozygote mutation (PiM3M3) was significantly higher in the ASA group than the control group (21 vs 11, OR (95% CI): 6.68 [2.09-21.40], P = .001). A1AT serum levels were similar among patients with normal A1AT allele (PiMM), homozygote variant (PiM3M3), and heterozygote variant (PiMM3) (P = .79)., Conclusion: This preliminary study revealed that homozygote A1AT rs1303 (PiM3M3) variant is significantly higher in patients with isolated ASA and may be associated with ASA development. Large scale comprehensive studies are needed to validate these results., (© 2019 Wiley Periodicals, Inc.)

Background: Early diagnosis of anastomotic leakage is the most important factor in reducing its morbidity and mortality. Anastomotic integrity monitoring of the leukocyte count (WBC), C-reactive protein (CRP), and neutrophil-lymphocyte ratio (NLR) are commonly used laboratory parameters. The availability of follow-up presepsin anastomotic integrity was investigated in this study., Materials and Methods: This study included patients who had gastrointestinal anastomosis due to major abdominal surgery between January 2016 and February 2017. Blood samples were collected to determine the WBC, CRP, NLR, and presepsin values before the anastomosis was performed and then taken on postoperative days 1, 3, and 5., Results: This is a prospective nonrandomized study with 100 consecutive patients enrolled in the anastomosis group (male/female, 42:58). WBC, CRP, NLR, and presepsin values are based on certain days in the complication group, and the complication group increased with statistical significance. Presepsin had a specificity of 98.63% in determining anastomotic leak., Conclusions: Presepsin can be used as a supplemental marker with CRP and NLR for anastomotic integrity., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: Survivin is one of the apoptosis inhibitor proteins, and it plays a key role in tumor angiogenesis and cancer progression. This study was conducted to investigate the serum level of survivin to determine its diagnostic value in cancer patients., Materials and Methods: Blood samples were taken from cancer patients (n = 67) prior to surgery or chemo/radiotherapy and age-matched healthy volunteers (n = 23). The serum levels of survivin were analyzed by enzyme-linked immunosorbent assays. The difference in serum levels between patients and control was evaluated by using statistical methods. Correlation between the serum levels of survivin and clinicopathological features of cancer patients were also evaluated., Results: The diagnoses of patients were breast cancer (49.3%), colon cancer (25.4%), ovarian cancer (14.9%), and other cancers (10.4%). Serum survivin levels were significantly higher in cancer patients than healthy subjects (196.23 pg/ml vs. 117.73 pg/ml, respectively, P = 0.019). No significant relations were found between serum survivin level and demographic characteristics of cancer. The optimal cut-off value of serum survivin was determined at >120.8 pg/ml, and its serum levels above this cut-off value were associated with 4.198 times increased risk of cancer., Conclusion: Our study results may suggest that high serum survivin levels can show 4 times increased risk of cancer in a subject with a high suspicion of cancer. Furthermore, survivin level was not influenced with demographic characteristics of breast, gastric, colorectal, prostate, ovarian cancer, and glioblastome multiforme., Competing Interests: There are no conflicts of interest

Introduction: Hypertension (HT) is a common serious condition associated with cardiovascular morbidity and mortality. The pathogenesis of HT is multifactorial and has been widely investigated. Besides the vascular, hormonal, and neurological factors, inflammation plays a crucial role in HT. Many inflammatory markers such as C-reactive protein, cytokines, and adhesion molecules have been studied in HT, which supported the role of inflammation in the pathogenesis of HT. Presepsin (PSP) is a novel biomarker of inflammation. Therefore, the potential relationship between PSP and HT was investigated in this study., Methods: Forty-eight patients with controlled HT and 48 controls without HT were included in our study. Besides routine clinical and laboratory data, PSP levels were measured in peripheral venous blood samples from all the participants., Results: PSP levels were significantly lower in patients with HT than in controls (144.98 ± 75.98 versus 176.67 ± 48.12 pg/mL, p = 0.011). PSP levels were positively correlated with hsCRP among both the patient and the control groups ( p = 0.015 and p = 0.009, resp.). However, PSP levels were not correlated with WBC among both groups ( p = 0.09 and p = 0.67, resp.)., Conclusions: PSP levels are not elevated in patients with well-controlled HT compared to controls. This result may be associated with anti-inflammatory effects of antihypertensive medicines.

[Purpose] To compare two platelet-rich plasma kits with different platelet concentrations for treatment of knee osteoarthritis. [Subjects and Methods] Male and female patients with knee osteoarthritis who had confirmed diagnosis with X-ray and magnetic resonance imaging were included in this retrospective study. Eligible patients were divided into two groups: Group I, which received platelet-rich plasma kit I, and Group II, which received platelet-rich plasma kit II. Platelet concentrations of both kits were measured by manual counting. For each group, platelet-rich plasma kit was injected twice with a one-month interval between injections. The Western Ontario and McMaster Universities Osteoarthritis Index and the Visual Analog Scale were applied for clinical evaluation before the first injection and one, three and six months after the second injection. [Results] Kits I and II contained 1,000,000 and 3,000,000 platelets/µl respectively. In both groups, initial Western Ontario and McMaster Universities Osteoarthritis Index and Visual Analog Scale scores were significantly higher compared to the latter evaluations. However, no significant difference was observed between groups in terms of clinical evaluations. [Conclusion] Similar clinical results were found in groups receiving different platelet concentrations, therefore, a concentration of 1,000,000 platelet/µl is considered sufficient for pain relief and functional recovery.

Introduction: Acute myocardial infarction (AMI) could be considered to be a state of inflammation. Many inflammatory markers have been evaluated in the AMI setting so far. Presepsin (PSP) is a novel biomarker for diagnosis and prognosis of systemic inflammation that has not been studied in the AMI setting to date. In this study, we aimed to examine serum PSP levels in patients with acute ST elevation myocardial infarction (STEMI)., Material and Methods: Forty-eight patients with STEMI and fifty healthy controls without coronary artery disease, verified by coronary angiography, were included in the study. Together with routine laboratory tests needed for STEMI, plasma concentrations of PSP were measured in peripheral venous blood samples of the participants., Results: Plasma PSP and troponin levels were significantly higher in patients with STEMI than controls (1988.89 ±3101.55 vs. 914.22 ±911.35 pg/ml, p = 0.001 and 3.46 ±3.39 vs. 0.08 ±0.43 ng/ml, p = 0.001, respectively). The cut-off value for PSP of 447 pg/ml was found to detect STEMI with 87.5% sensitivity, 44% specificity, 60% positive predictive value and 78.5% negative predictive value., Conclusions: In this study, PSP levels were found to be significantly elevated in patients with STEMI together with high-sensitivity troponins. The PSP may be a new marker for AMI detection. Large scale studies are needed to reveal the importance of PSP in the diagnosis and prognosis of AMI.

Breast cancer is the most frequently diagnosed cancer type in women. Tumor markers have been widely used for assessing the treatment response and early diagnosis of recurrence. Human epididymis protein 4 (HE4) is expressed in ductal carcinoma of the breast tissue; however, its serum levels and their diagnostic and prognostic potential in breast cancer have not been investigated, which was therefore the aim of the present study. The serum levels of HE4 were determined in 36 breast cancer patients, 11 ovarian cancer patients and 16 healthy volunteers. The association between clinicopathological characteristics of breast cancer and serum HE4 levels was investigated. A significant difference in the median serum levels of HE4 was identified between breast cancer patients, ovarian cancer patients and healthy volunteers (P=0.013). The cutoff value for the prediction of breast cancer was determined at >13.24 pmol/l for HE4, with a sensitivity of 61.11%, specificity of 68.75%, positive predictive value of 81.48%, negative predictive value of 44.0% and accuracy of 63.46%. Furthermore, a positive correlation between the serum levels of HE4 and cancer antigen 15-3 was determined (r=0.399, P=0.026). To the best of our knowledge, the present study was the first to determine the diagnostic value of serum HE4 for breast cancer. A significant elevation of serum HE4 levels in patients with breast cancer compared with that in healthy controls was identified. HE4 may serve as a novel biomarker for the diagnosis of breast cancer.

Several publications have pointed out the importance of coagulation and fibrinolysis in the occurrence of chronic urticaria (CU), but only a few indicated the direct role of platelets. We assessed platelet aggregation and evaluated parameters of coagulation and fibrinolysis in patients with CU. Patients (n = 34) diagnosed as having CU and 36 healthy controls were enrolled. Platelet aggregation was assayed using an impedance aggregometer and adenosine diphosphate, arachidonic acid, thrombin receptor-activating peptide (TRAP), and ristocetin as agonists. In patients with CU, significantly decreased platelet aggregation to some agonists (ristocetin and TRAP) was observed. The D-dimer levels were elevated, mean platelet volume was decreased, but no alteration was observed in other coagulation assays. Elevated D-dimer levels indicated that coagulation and fibrinolysis are activated in the patients with CU. Evaluation of platelet function may contribute to identify the role of these cells in the pathogenesis of CU., (© The Author(s) 2014.)

Unlabelled: Abstract Objective: Patients with a lack of nocturnal decline in blood pressure (BP) are at an increased risk for cardiovascular events. Mean platelet volume (MPV) and soluble CD40 ligand (sCD40L) are accepted biomarkers of platelet activation and considered as a risk factor for cardiovascular disease. The aim of this study was to determine whether MPV and sCD40L levels are higher in non-dipper hypertensive (NDHT) patients than in dipper hypertensive (DHT) patients and healthy controls., Methods: 124 consecutive patients were included to this study. Patients were divided into three groups: NDHT patient group [n = 43; mean age 51.8 ± 6.6; 31 males (72.1%)]; DHT patient group [n = 41; mean age 50.2 ± 7.3; 22 males (53.7%)]; and normotensive group [n = 40; mean age 49.9 ± 6.7; 22 males (55%)]. Physical examination, laboratory work-up and 24-h ABPM were performed for all participants., Results: The sCD40L and MPV levels were significantly higher in the NDHT group than in the DHT and normotensive groups (p < 0.05). In correlation analysis, MPV, 24-h systolic blood pressure (SBP), 24-h diastolic blood pressure (DBP), night-time SBP and night-time DBP were positively correlated with sCD40L., Conclusion: Our study demonstrated that MPV and sCD40L levels were significantly higher in NDHT patients compared to DHT and normotensive patients. sCD40L levels were positively correlated with MPV, 24-h SBP, 24-h DBP, night-time SBP and night-time DBP.

The aim of this study was to evaluate the prevalence of aspirin resistance (AR) in patients undergoing hemodialysis (HD) and to assess the effect of HD on the results of the Multiplate test. A total of 54 patients undergoing HD were included in this study. Blood samples were taken just before and after the HD session. To determine AR, we used Multiplate test. Platelet aggregation values of the study population were 363.01 ± 225.69 aggregation unit (AU) × minutes before and 375.33 ± 254.05 AU × minutes after the HD (P = .597). There was strong correlation between the values before and after HD (R = .755, P < .0001). The AR status was changed in 9 (16.6%) patients after HD. Agreement of AR status before and after HD was substantial (κ coefficient = .667, P < .0001). The prevalence of AR in patients undergoing HD seems higher than in most of the studied populations, and this study has shown that the AR statuses of a significant number of patients undergoing HD change after an HD session., (© The Author(s) 2013.)

Coronary artery ectasia (CAE) is characterized by inappropriate dilatation of the coronary vasculature. The mechanisms of CAE are not well known. Insulin-like growth factor-1 (IGF-1) may make endothelial cells and smooth muscle cells more sensitive to the effects of growth hormone. In the present study, we hypothesized that IGF-1 may have an impact on the formation of ectasia and aneurysm in arterial system, and aimed to investigate the associations between the presence of CAE and serum IGF-1 levels in patients undergoing coronary angiography. The study included 2.980 subjects undergoing elective diagnostic coronary angiography. We selected 40 patients diagnosed with CAE as CAE group and 44 subjects with absolutely normal coronary arteries were assigned as normal control group. IGF-1 levels were measured in both groups of patients. Groups were similar in terms of age, sex and coronary artery disease risk factors. The serum IGF-1 levels were significantly higher in CAE patients with 109.64 ± 54.64 ng/mL than in controls with 84.76 ± 34.01 ng/mL (p=0.016). HDL levels were lower in ectasia group with 41.5 ± 10.7 mg/dL than controls with 47.7 ± 10.4 mg/dL (p=0.018). By means of logistic regression analysis, high IGF-1 and low HDL levels were found to be independent risk factors for the presence of CAE (p<0.02, p<0.016, respectively). The study revealed that there was a positive correlation between serum IGF-1 levels and presence of CAE, and high IGF-1 levels and low HDL levels were independent risk factors for the presence of CAE. Future studies are needed to confirm these results.

Aims: The objective of this study is to determine the effect of intravenous (i.v.) or oral N-acetylcysteine (NAC) in preventing contrast-induced nephropathy (CIN) in patients with moderate-to-severe renal insufficiency undergoing intra-arterial interventions., Materials and Methods: We studied 307 patients with estimated glomerular filtration rate of less than 60 ml/min/1.73 m undergoing an elective intra-arterial procedure. Patients were assigned randomly to three groups according to the prophylactic regimen used. In group 1, patients were administered an i.v. infusion of 0.9% saline (n=103); in group 2, patients were administered oral NAC in addition to an i.v. saline infusion (n=102); and in group 3, patients were administered i.v. NAC in addition to an i.v. saline infusion (n=102). Serum creatinine (SCr) and cystatin C levels were measured at baseline and 4, 24, and 48 h after the application of contrast media. The primary endpoint was defined as an increase in the SCr or cystatin C concentration of at least 0.5 mg/dl and/or of at least 25% from the baseline value at 48 h after administration of the contrast dye., Results: The overall incidence of SCr-based CIN was 11.1%: 6.8% in the saline group, 13.7% in the oral NAC group, and 12.7% in the i.v. NAC group (P=0.231). That of cystatin C-based CIN was 8.1%: 6.8% in the saline group, 6.9% in the oral NAC group, and 10.8% in the i.v. NAC group (P=0.491)., Conclusion: In this study, there was no detectable benefit of either high-dose oral or i.v. NAC over an aggressive hydration protocol in patients with moderate-to-severe renal insufficiency.

Background: Uric acid (UA) is an independent risk factor for the development of coronary heart disease. Serum UA levels have been correlated with all major forms of death from cardiovascular disease, including acute, subacute, and chronic forms of coronary artery disease (CAD), heart failure, and stroke. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the prognostic value of UA in patients with STEMI undergoing primary percutaneous coronary intervention (PCI)., Methods: We prospectively enrolled 434 consecutive Turkish STEMI patients (mean age 55.4 ± 12.4 years, 341 male, 93 female) undergoing primary PCI. The study population was divided into tertiles based on admission UA values. The high UA group (n = 143) was defined as a value in the third tertile (> 5.7 mg/dl), and the low UA group (n = 291) included those patients with a value in the lower two tertiles (≤ 5.7 mg/dl). Clinical characteristics, in-hospital and six-month outcomes of primary PCI were analyzed., Results: Compared to the low UA group, only Killip class > 1 at admission was more prevalent in the high UA group (3.4% vs. 17.5%, p < 0.001, respectively). Higher in-hospital cardiovascular mortality and six-month all-cause mortality rates were observed in the high UA group than in the lower group (12.6% vs. 1.7%, respectively, p < 0.001) and (19.6% vs. 4.1%, respectively, p < 0.001). In Cox multivariate analysis; a high admission UA value (> 5.7 mg/dl) was found to be a powerful independent predictor of six-month all-cause mortality (hazard ratio: 5.57, 95% confidence interval: 1.903-16.3, p = 0.002)., Conclusions: These results suggest that a high level of UA on admission was associated with increased in-hospital cardiovascular mortality, and six-month all-cause mortality in Turkish patients with STEMI undergoing primary PCI., Key Words: Primary angioplasty; ST elevation myocardial infarction; Uric acid.

Coronary artery ectasia (CAE) is characterized by inappropriate dilation of the coronary vasculature. The underlying mechanisms of CAE formation are not yet entirely known. A polymorphism in the endothelial nitric oxide synthase (eNOS) gene, which reduces eNOS activity, might be a risk factor for coronary heart diseases. However, its role in CAE is unknown. One of the most studied eNOS gene polymorphisms is a c.894G>T polymorphism that results in the conversion of Glu (GAG) to Asp (GAT) at position 298. In this study, we investigated the potential association between the c.894G>T (Glu298Asp) polymorphism and CAE. The present study included 84 subjects from 2,980 consecutive patients in whom elective diagnostic coronary angiography was performed. Forty patients with isolated CAE and 44 subjects with normal coronary arteries were enrolled. The frequencies of the G allele were 78.4% in the control and 57.5% in CAE patients. The TT genotype was more frequent in patients with CAE than that in the controls (20% vs. 4.5%, p = 0.013). Furthermore, the risk of developing CAE in the presence of the homozygous TT genotype was significantly higher in the patients than that in the controls (OR = 7.7, 95% CI = 1.44-41.3). The presence of an 894T allele increased the risk of CAE 2.8-fold (95% CI = 1.15-6.73; p = 0.027). The frequencies of the T allele were 65% in CAE patients and 38.6% in the controls. In conclusion, the c.894G>T polymorphism in the eNOS gene may be a risk factor for CAE.

Introduction: Insulin-like growth factor-1 (IGF-1) has atheroprotective effects via reduction in oxidative stress, cellular apoptosis, pro-inflammatory signaling, and endothelial dysfunction., Aim: We hypothesized that low levels of IGF-1 may be associated with the severity and extent of coronary artery disease and development of the coronary no-reflow phenomenon in patients with acute ST-elevation myocardial infarction (STEMI) and investigated the role of the IGF-1 molecule in the coronary no-reflow phenomenon and severity of coronary artery disease (CAD) in patients with acute STEMI in a tertiary hospital., Material and Methods: The study was conducted among 113 patients undergoing primary percutaneous coronary intervention (PPCI) for STEMI, of whom 49 patients developed the no-reflow phenomenon. Coronary no-reflow was defined as Thrombolysis In Myocardial Infarction (TIMI) flow grade 2 or less after intervention. Insulin-like growth factor-1 levels were measured in both groups. The severity and extent of CAD were evaluated according to the Gensini and Syntax scores., Results: Although IGF-1 levels were lower in the no-reflow group, there was not a statistically significant difference between the no-reflow group and the control group (116.65 ±51.72 vs. 130.82 ±48.76, p = 0.130). Gensini and Syntax scores were higher in the no-reflow group. There was no association between Gensini and Syntax scores and IGF-1 levels (r = -0.071, r = 0.479, r = -0.158, p = 0.113)., Conclusions: In this study, IGF-1 levels were not statistically different between patients developing the no-reflow phenomenon and controls. There was no association between development of the no-reflow phenomenon and severity of CAD or IGF-1 levels. Nevertheless, large scale studies are needed to verify these results.

The aim of this study was to evaluate the prognostic value of D-dimer in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). The prognostic value of D-dimer has been documented in patients with acute coronary syndrome without ST-segment elevation. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. We prospectively enrolled 453 consecutive STEMI patients (mean age 55.6 ± 12.4 years, 364 male, 89 female) undergoing primary PCI. The study population was divided into tertiles based on admission D-dimer values. The high D-dimer group (n = 151) was defined as a value in the third tertile [>0.72 ug/ml fibrinogen equivalent units (FEU)], and the low D-dimer group (n = 302) included those patients with a value in the lower two tertiles (≤0.72 ug/ml FEU). Clinical characteristics, in-hospital and 6-month outcomes of primary PCI were analyzed. The patients of the high D-dimer group were older (mean age 60.1 ± 13.5 versus 52.4 ± 10.6, P < 0.001). Higher in-hospital cardiovascular mortality and 6-month all-cause mortality rates were observed in the high D-dimer group (7.2 versus 0.6%, P < 0.001 and 13.9 versus 2%, P < 0.001, respectively). In Cox multivariate analysis; a high admission D-dimer value (>0.72 ug/ml FEU) was found to be a powerful independent predictor of 6-month all-cause mortality (odds ratio: 10.1, 95% confidence interval: 1.24-42.73, P = 0.03). These results suggest that a high admission D-dimer, level was associated with increased in-hospital cardiovascular mortality and 6-month all-cause mortality in patients with STEMI undergoing primary PCI.

Background: Oxytocin (OXY) is a well-known nonapeptide that functions in reproduction. It is also known as an antioxidant in several organs. However, little is about its role in the protection of tissue against ischemia/reperfusion injury in skeletal muscle. The aim of this study was to evaluate the protective and therapeutic antioxidant effect of oxytocin in skeletal muscle during ischemia/reperfusion (I/R) injury., Methods: Rats were divided into 4 groups. Hindlimb ischemia was achieved by clamping the common femoral artery in 3 of the groups, but not a control group. OXY was injected before ischemia in the preoperative (preop) I/R + OXY group and after the onset of ischemia in the postoperative (postop) I/R + OXY group. Saline solution was injected in the I/R group. Limbs were rendered ischemic for 90 min. At the end of 90-min reperfusion period, skeletal muscle tissue samples were taken from the ischemic muscle for evaluation at light and transmission electron microscopic levels. Biochemical analysis was done for malonedialdehyde and glutathione levels. Caspase immunohistochemistry was applied for apoptosis., Results: The light- and electron-microscopic scores of the OXY-treated groups were significantly lower than in the I/R group. The degree of tissue damage was ameliorated in the OXY-treated groups. The number of apoptotic cells was decreased in the OXY-treated groups compared with the I/R group. In OXY-treated groups, the malonedialdehyde level was lower than in the I/R group. Glutathione levels were found to be increased in the OXY-treated groups compared with the I/R group., Conclusions: Oxytocin has a protective effect against I/R injury in skeletal muscle and may reduce the incidence of compartment syndrome., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Hypothesis: We examined the hypothesis that a specific myocardial injury marker, namely high sensitive cardiac troponin-I (HsTn-I), is elevated in patients with slow coronary flow (SCF) pattern., Aim: To examine the above hypothesis by studying a group of patients who had undergone coronary angiography for the detection of their chest pain aetiology with SCF pattern despite an angiographically normal coronary arteriogram., Methods: We evaluated and performed coronary angiography (CAG) of 97 patients with chest discomfort. The indication forCAG was at least Canada class 3 angina and/or proven myocardial ischaemia according to noninvasive diagnostic tests. We further divided patients into three subgroups according to CAG images and compared HsTn-I plasma levels in 39 patients with SCF pattern, 28 patients with coronary artery disease (CAD), and 30 patients with normal coronary arteries. We researched the association between qualitative HsTn-I positivity and demographic features including cardiovascular risk factors, inflammation markers and TIMI frame count for each of the epicardial coronary arteries., Results: TIMI frame count for each epicardial coronary artery was significantly higher in patients with SCF pattern than in patients with CAD and normal coronary arteries (p < 0.001). HsTn-I positivity was not statistically different between patients with SCF pattern and normal coronary arteries (p = 512), but it was significantly higher in the CAD group than the other two group of patients (p < 0.001)., Conclusions: In patients with SCF, HsTn-I may be detectable, but it is not elevated as in patients with normal coronary arteries.

Objective: It is well known that changes in cerebral hemodynamics occur after traumatic brain injury (TBI). Osmo-regulation in the brain is important for maintaining a constant milieu in the central nervous system. Nevertheless, to our knowledge, early osmolarity changes after minor head injury have not been studied until now., Methods: In this study, serum osmolarity was measured in 99 patients with minor head trauma. As a control group, blood samples were drawn from 99 patients who had a minor trauma in an extremity. Serum osmolarity was estimated using a fully automatic biochemical autoanalyzer within the first 3 hours after the trauma., Results: The mean serum osmolarity levels were 286.08+/-10.17 mOsm/L in the study group and 290.94+/-5.65 mOsm/L in the control group (p<0.001). However, after age adjustment between the study and control groups, this statistical significance was found to be valid only for patients over 30 years of age., Conclusion: It was noted that serum osmolarity levels decrease in the first 3 hours following minor head trauma in patients over 30 years of age. Further studies into this area could provide guidance for the management/treatment of elderly patients.