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Introduction: During the 2019 novel coronavirus (COVID-19) pandemic period, all cases admitted to the emergency services have been evaluated primarily for COVID-19, and therefore other infectious diseases, especially Crimean Congo Hemorrhagic Fever (CCHF), which are endemic in our region, can be overlooked. In this study, it was aimed to determine the diagnostic power of the Hitit Index, which we developed from a panel consisting of clinical and laboratory findings of the cases with and without CCHF in previous years, to distinguish CCHF cases from COVID-19 cases. Materials and Methods: The study groups consisted of the COVID-19 cases (n= 116) admitted to the emergency service and the CCHF patients (n= 110) who were followed up in the Infectious Diseases and Clinical Microbiology Clinic of the same hospital between 2015-2020. Results: Hitit Index was found to be statistically significantly higher in patients with CCHF. For Hitit Index, sensitivity and specificity were 88% and 99%, while negative predictive value (NPV) and positive predictive value (PPV) were 90% and 99%, respectively. Conclusion: The Hitit Index is an example of artificial intelligence that we can use to distinguish patients with CCHF from patients with COVID-19.

For the purpose of providing a better quality of service for their students, higher education institutions develop both academic and social strategies that will meet students’ expectations, and they can monitor the performance of the related activities efficiently by integrating them into their strategic plans. Although students’ expectations from the institutions in which they are registered can be provided directly through feedback mechanisms, there is a need for a sustainable system through which students’ opinions on all of the services are gathered in a systematic way. In this regard, the objective of this study was to design an information system measuring the satisfaction level of the students about the services/ facilities provided by the university on a regular basis and reporting the results of the measurement to the university management in a certain format. In this descriptive research that was carried out within the scope of Dokuz Eylul University quality assessment, evaluation and assurance activities in higher education, an electronic form was developed which was integrated into the Dokuz Eylul University Information System. Through this form, particular questions were asked covering many service dimensions, i.e., infrastructure facilities, the provided services, educational and career development, approaches of the university towards the students, communication with students, attitudes of students towards the university, etc. The evaluations of students’ feedback were performed based on descriptive statistics, and an additional assessment scale was also generated to classify and order the overall satisfaction levels as primary priority to improve, secondary priority to improve, opportunities available, and the areas where the university is strong. This system helped to make decisions for the improvements in required fields, generated inputs to the strategic plan of Dokuz Eylul University for determining policies and goals to increase the quality of education, student satisfaction and provided a capability for performance evaluation in the achievement of these goals by systematic measurements.

The Bologna Process at National Higher Education Programs initiated a series of studies regarding the assessment and evaluation of quality in higher education. Dokuz Eylül University has taken this initiation into a primary concern to develop a methodology for the measurement of quality in undergraduate education. Besides the existing systems on this subject at Dokuz Eylül University, substantial progress was recently made by developing innovative sub-systems aiming further improvements. As one of the most important stakeholders, the feedback from students about the quality of the courses was selected as the major concern and a Student Course Feedback System was developed for this purpose. As an exemplary case study, this reveals how the Student Course Feedback System was designed, the process, the technologies used, the problems and constraints encountered, and the roadmap that can be followed by other universities. Dokuz Eylül University has interiorized this process as a corporate culture by directing instructors to make improvements in the courses with respect to the outputs of the evaluation forms, including questions about learning outcomes, instructors, and physical conditions. The integrated design of the Student Course Feedback System with the existing information systems has enabled management to implement a course evaluation system comprising the trilogy of students, instructors, and courses as a whole. The existence of such an assessment process supports the principles of continuous improvement and helps to establish the factual decision making process as an important milestone on the roadmap for a living quality assurance system.

Objective: The objective of this article is to introduce the e-PBL application experience of a medical faculty in undergraduate medical education program. Materials and methods: The special software for e-PBL application was developed and experienced. The application of e-PBL was carried out in the last two blocks of the Phase 3 program. During the last two blocks, third year students participated in the synchronized e-PBL sessions in small groups. After two years’ pilot studies, E-PBL was applied to all third-year students during the Multisystem and Life Cycle blocks in the years, 2015 and 2016. Students engaged in the phases of PBL steps, orally and in written forms. Sessions were student-centered and tutors only undertook the duty of assessment by monitoring the groups externally and making use of the session records and reports. Results: During the first year application, in light of students’ and tutors’ feedbacks, external motivation sources were identified to be crucial for effective sessions. During the second year application, performance of the groups increased compared to the first year through the implementation of summative assessment criteria and there was a decrease in technical problems. Conclusion: Considering the advantages and restrictions of e-PBL application, a plan was made to carry out the same synthesis blocks at the end of the third year program for consecutive years.

The reperfusion following liver ischemia results in hepatocyte damage and apoptosis. The aim of this study was to investigate the effects of two antioxiclant agents, carnosine and melatonin, in rat Liver ischemia-reperfusion injury. Five study groups were formed; I. sham, II. ischemia-reperfusion, III. ischemia-reperfusion+ melatonin, IV. ischemia-reperfusion+carnosine, V. ischemia-reperfusion+melatonin+ carnosine. Then 250mg/kg carnosine and 10mg/kg melatonin were administered intraperitoneally 30min before ischemia and immediately after the reperfusion. Sinusoidal dilatation, congestion and neutrophil. infiltration were observed in the ischemia-reperfusion group while these symptoms were less pronounced in the treatment groups. Atanine aminotransferase, aspartate aminotransferase and myeloperoxidase levels were increased in the ischemia-reperfusion group while they were towered in the treatment groups. Glutathione level was tow in the ischemia-reperfusion group while it tended to increase in the ischemia-reperfusion+carnosine administered and ischemia-reperfusion+carnosine+melatonin administered groups. There was an increase in the number of apoptotic cells in the ischemia-reperfusion group white this number was towered in the treatment groups. Carnosine was more effective than melatonin in the reversal of structural and biochemical alterations that resulted from ischemia-reperfusion injury. The administration of melatonin and carnosine together yielded better outcomes compared to the sole administration of each agent. (C) 2008 Elsevier GmbH. All rights reserved.

Background/aim: Low-density lipoproteins (LDLs) have been shown to be a major risk factor for coronary artery disease. Multiple distinct subspecies have been identified among LDL particles on the basis of differences in size, density, and chemical composition. Particles with a diameter of

Autoxidation of globin chains and iron overload are the suggested mechanisms for the increased oxidative stress in beta -thalassemia. The aim of this study was to evaluated the extend of lipid peroxidation and antioxidant status of patients with beta -thalassemia and iron deficiency anemia (IDA) and compare the results with healthy subjects. Oxidant and antioxidant status of the children with beta -thalassemia major (n = 22) and iron deficiency anemia (n = 19) were studied. Healthy controls (n=14) were age and sex matched. Fresh anticoagulant venous blood samples obtained from all children. Conjugated diene (CD) and thiobarbituric acid-reactive (TBARS) substances were analysed to indicate the oxidative parameters, whereas the erythrocyte superoxide dismutase (SOD) and gluthathione peroxidase (GPx) were measured to show the antioxidant status of the children. Plasma TBARS and CD concentrations in TBARs was significant. In the iron-deficiency group both TBARS and CD concentrations were elevated in beta -thalassemia compared to IDA. When compared to the controls, elevation in TBARS was significant. In the iron-deficiency group both TBARS and CD levels were decreased in TBARS was significant. In the iron-deficiency group both TBARS and CD levels were decreased compared to the controls. SOD and GPx activities were increased in the beta -thalassemia group. SOD in beta -thalassemia was higher than both IDA and the controls and GPx activity was higher than the IDA group. In vivo lipid peroxidation was increased in children with beta -thalassemia major. This leads to a compensatory increase in antioxidant enzymes, whereas IDA does not lead to lipid peroxidation with a normal antioxidant enzyme activity.

In the present study, the genotoxic, hematoxic effects, and their relation with pathological and biochemical parameters of hexane were investigated. Cytogenetic evaluation performed on the bone marrow indicated that chromosome aberrations increased at both hexane doses in relation to the negative controls. Decreased hematocrit, hemoglobin concentrations, and mean corpuscular volume were observed on the whole blood counts. Conjugated dienes (CD), glutathione (GSH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and catalase (CAT) were increased. Histological examinations showed intracytoplasmic vacuolisation, nuclei with lower chromatin, and parenchymatous degenerations in the dose groups. In the bone marrow slides, depletion of the erythroid series were observed. In conclusion, hexane seems to be a genotoxic and hematoxic agent leading to degeneration and lipid peroxidation in exposed groups. Teratogenesis Carcinog. Mutagen. 20:329-340, 2000. (C) 2000 Wiley-Liss, Inc.

The oxidative effects were investigated of exhausting exercise in smokers, and the possible protective role of 400 mg day(-1) vitamin E (Vit E) supplementation over a period of 28 days. The subjects exercised to exhaustion including concentric-eccentric contractions following maximal cycling. The haematocrit and haemoglobin, leucocyte (WBC), plasma lactic acid (La) and malondialdehyde (MDA), erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPx), serum Vit E and ceruloplasmin (CER) concentrations were measured pre and post exercise. Supplementation increased Vit E concentrations 28% and 31% in the controls and the smokers, respectively. Cigarette smoking and/or Vit E supplementation did not influence plasma lipid peroxidation or the antioxidant status at rest. Exercise caused significant haemoconcentration in all groups. When the post-exercise concentrations were adjusted for haemoconcentration, a significant elevation in La concentrations due to exercise was observed in all groups. Similarly, there were significant elevations in the adjusted WBC counts in all groups except the Vit E supplemented controls. The MDA concentrations on the other hand, when adjusted for haemoconcentration, did not exhibit any difference due to exercise. Exercise did not affect the GPx and CER activities either, while causing a SOD activity loss in all groups except the Vit E supplemented non-smokers. Serum Vit E concentrations diminished significantly in all groups after exercise. Post-exercise plasma MDA and blood antioxidant concentrations were not altered by smoking. The results would suggest that plasma volume changes should always be taken into account when assessing post-exercise plasma concentrations and that smoking and exercise do not have an additional collective effect on plasma lipid peroxidation and the dose of Vit E administered was insufficient to maintain the serum concentrations after exercise.

This study was undertaken to determine whether or not the prostanoid metabolism contributes to peritonitis-induced early liver oxidant stress, Lipid peroxidation products, malondialdehyde (MDA) and conjugated dienes (CD), were used to monitor oxidant stress, The rats mere given a 5-cc intraperitoneal (i.p.) injection of 25% rat feces suspension and then received either i.p. saline (peritonitis group, n = 11), vitamin E (n = 6), or diclofenac (n = 6), The liver and plasma MDA and CD levels n ere measured after Sh, The plasma and liver AIDA and CD levels mere significantly higher in the peritonitis group than in the control (n = 9), Prostaglandin synthetase inhibitor (diclofenac) kept the liver and plasma MDA and CD at control levels. Antioxidant alpha tacopherol (vitamin E) was thus found not to be effective in reducing these increased MDA and CD levels. Peritonitis-induced early oxidant stress in the liver seems to be mediated by the oxidant-independent activation of the cyclooxygenase pathway.

Backgrounds and aims: Paraoxonase 1 (PON1) is a novel marker that has been shown to exert protective functions on atherosclerosis by preventing oxidative modification of serum lipoproteins. In this study, we investigated the effects of PON1 on CA-IMT in renal transplant patients. Methods: A total of 98 adult renal transplant recipients was enrolled in the study. CA-IMT was determined by B-mode Doppler ultrasonography. PON1 activity was assessed by the rate of enzymatic hydrolysis of paraoxon to p-nitrophenol. Results: Mean age was 39.4 ± 9.6 years and 10% of the patients were diabetic. Time after transplant was 76 ± 59 months. Mean PON1 level was 62.1 ± 43.3 U/l. PON1 levels were negatively correlated with CA-IMT and positively with HDLcholesterol. Mean CA-IMT was 0.62 ± 0.10 mm (0.40-0.98). CA-IMT was positively correlated with age, male gender and negatively with proteinuria and PON1 levels. In linear regression analysis, PON1 levels were associated with CA-IMT. Conclusion: Reduced PON1 activity is significantly associated with increased carotid atherosclerosis in renal transplant patients. © 2013 Dustri-Verlag Dr. K. Feistle.

WOS: 000317361900003, PubMed ID: 23070631, Objective: Cardiovascular diseases (CVD) are the largest cause of morbidity and mortality in Turkey and in the World. Heart of Balcova Project is a community-based health promotion project that aims to reduce CVD incidence and prevalence through risk factor modification in the individual and population level. This paper presents results of the baseline survey that aimed to define CVD risk factors and risk of developing coronary heart disease (CHD) in the Balcova population. Methods: The study population included 36,187 people over 30 years of age residing in Balcova in 2007. Individuals were interviewed at their homes. Anthropometrics and blood pressure were measured and in total 12914 fasting blood samples were collected for lipid and glucose analyses. CHD risk was estimated using Framingham risk equation. Student's t test, Chi-square for trend test and ANOVA were used to compare mean levels and percentages of risk factors between age groups and gender. Results: In total 5552 men and 10528 women participated in the study. Smoking prevalence was 38.6% in men and 26.8% in women. The prevalence of obesity was 29.4% among men and 44.2% among women and obesity prevalence increased until the age group 75 years old. While 14.6% of men and 12.6% of women had diabetes, 39.8% of men and 41.8% of women had hypertension. The prevalence of high total cholesterol was 56.0% in men and 50.6% in women. Men had a higher risk of developing CHD compared to women in the following 10 years (13.4% vs 2.5%). Conclusion: The prevalence of preventable risk factors for CHD is very high in Balcova population. Community-based interventions should be planned and implemented targeting both the high-risk individuals and whole population. (Anadolu Kardiyol Derg 2013; 13: 9-17), Balcova MunicipalityBelediyeler; Dokuz Eylul University Research FundDokuz Eylul University [2007161], This study was supported jointly by Balcova Municipality and Dokuz Eylul University Research Fund (Grant no:2007161)

WOS: 000297673000008, PubMed ID: 21737961, Aim: Paraoxanase 1 (PON 1) has been shown to protect against atherosclerosis by modifying lipoproteins. Its activity decreases in dialysis patients but is restored after transplantation. Whether it affects arterial stiffness is unclear. In this study we aimed to investigate the effects of PON 1 on arterial stiffness in renal transplant patients. Methods: Seventy renal transplant recipients were enrolled. Arterial stiffness was measured using a Syphmocor device. PON-1 activity was assessed from the rate of enzymatic hydrolysis of paraoxon to p-nitrophenol. Results: Mean age was 39.0 +/- 9.6 years and 5.7% of the patients were diabetic. Post-transplant follow-up time was 46.7 +/- 37.9 months. Eighty-five percent received anti-hypertensive and 12.9% anti-hyperlipidemic medication. Mean PON1 activity was 75.9 +/- 52.4 U/L. PON1 activity was negatively correlated with systolic and diastolic blood pressure, mean arterial pressure, LDL-cholesterol and carotid-femoral pulse wave velocity (cf-PWV). Mean c-f PWV was 8.10 +/- 1.39 m/s. Cf-PWV was positively correlated with age, systolic and diastolic blood pressure, mean arterial pressure, proteinuria and negatively correlated with PON1, PON1/HDL ratio and creatinine clearance. In linear regression analysis, PON1 was a predictor of cf-PWV in a model that included age, gender, diabetes, mean arterial pressure, urine protein level, creatinine clearance and PON 1. Conclusions: Reduced PON1 activity is significantly associated with increased arterial stiffness. The results of this study show the possible role of PON1 for arterial stiffening in renal transplant recipients.

Paraoxonase-1 (PON-1) may play an important role in atherosclerosis. Atherosclerosis is an inflammatory disease and C-reactive protein is a marker for inflammation. The aim of this study was to determine serum PON-1 activity and high-sensitivity C-reactive protein (hs-CRP) levels and assess carotid intima-media thickness, a marker of early atherosclerotic changes, in patients with subclinical hypothyroidism.hs-CRP concentrations and PON-1 activity with respect to carotid intima-media thickness were evaluated in 38 subclinical hypothyroidism patients (normolipidemic, mean age: 49.79+/-10.04 years) before and after 3 months of stable euthyroidism and compared with those of 19 euthyroid normolipidemic healthy individuals (mean age: 49.95+/-8.12 years).At baseline, the patients with subclinical hypothyroidism had similar levels of PON-1 activity and hs-CRP and a similar lipid profile as the controls; however, the carotid intima-media thickness was greater than in the controls. Levothyroxine treatment had no effect on serum PON-1 activity and hs-CRP level, but it resulted in a significant reduction in carotid intima-media thickness in the subclinical hypothyroidism patients.PON-1 activity and hs-CRP levels did not significantly differ between subclinical hypothyroid patients and controls. Although levothyroxine treatment might have the potential to reverse the progression of atherosclerosis in subclinical hypothyroid patients, PON-1 activity and hs-CRP levels were not affected by this treatment. The reduction in carotid intima-media thickness was independent of the decrease in serum lipid profile or other variables.

Background Total hepatic vascular exclusion (THVE) leads to massive venous congestion below the level of diaphragm and may promote undesirable hemodynamic disturbances in some patients. Supraceliac aortic clamping during THVE may achieve hemodynamic stability at the price of arterial ischemia. However, the parenchymal injury of venous congestion has been a greater concern than of arterial ischemia in various settings. We hypothesized that supraceliac aortic occlusion during THVE may attenuate the reperfusion injury and improve the outcome that would be acquired after THVE alone. Material and methods Rats were randomly assigned to (1) THVE alone, (2) THVE plus aortic occlusion, (3) THVE plus celio-mesenteric arterial occlusion or (4) sham during 30, 45, or 60 min followed by 180 min reperfusion period. Serum enzymes (alanine aminotransferase, lactate dehydrogenase) and creatinine as well as tissue “thiobarbituric acid reactive substances” (TBARS) and histopathology were evaluated. Seven animals per group were followed for survival up to 7 d. Results After 30 min, no difference was found in serum enzyme, creatinine and tissue TBARS measures among the isolation methods used. In these, all rats survived to 7 d. However, after 45 and 60 min isolation, aortic occlusion resulted in significant rise in serum enzyme and tissue TBARS measures as well as poor survival (14% and 0%, respectively). In contrast, all rats survived even after 60 min of THVE. Conclusions THVE was tolerated up to 60 min with less reperfusion injury and better survival than celio-mesenteric arterial occlusion and supraceliac aortic occlusion in the rat, if needed, aortic clamping should not exceed 30 min. Beyond that, selective celio-mesenteric arterial occlusion may be considered.

To determine the validity of screening tests and markers suggested in the early detection of alcohol use disorders.Male patients aged 20-65 were recruited from a psychiatry clinic. They had been consuming alcohol at least once a week. They were not drug users and had no other diseases that affected the markers mentioned in this study. According to the DSM-IV diagnostic criteria, the diagnostic validity of screening tests [Michigan Alcoholism Screening Test (MAST), CAGE (Cut down, Annoyed, Guilty, Eye-opener), Alcohol Use Disorders Identification Test (AUDIT)] and markers [Mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT)] was investigated in alcohol dependent patients (n=29), alcohol abusers (n=28) and social drinkers (n=28).For the diagnosis of dependence, the sensitivity and specificity of the tests were respectively 69% and 100% for GGT, 41% and 93% for CDT, 100% and 57% for MAST, 97% and 86% for CAGE, and 100% and 75% for AUDIT. For the diagnosis of abuse, the sensitivity and specificity of the tests were respectively 32% and 100% for GGT, 32% and 93% for CDT, 86% and 57% for MAST, 75% and 85.7% for CAGE, and 89% and 75% for AUDIT. The widest area under the ROC curve belonged to GGT as a marker and AUDIT as a screening test.According to the results of this study, the marker that has the highest validity is GGT, while AUDIT and CAGE are the best screening tests.

Background: Antithrombin III (AT III) is a serine protease inhibitor and the mechanism of its anti-inflammatory action is still not understood. In the present study, we aimed to investigate the anti-inflammatory action of AT III on lung injury in a rat model of sepsis. Methods: Three groups of animals were used in this controlled study: the sham-operated group (sham, n = 3) which only underwent a laparotomy; the control group (control, n = 7) which underwent cecal ligation and perforation (CLP); and the AT III-treated group (AT III, n = 6) which underwent CLP and received intravenous (i.v.) 250 U/kg AT III 30 min before induction of sepsis. Rats were killed 24 h after induction of sepsis by needle aspiration of the right ventricle after a sternotomy, and the lungs and trachea were removed en bloc under ether anesthesia. Results: Pulmonary accumulation of polymorphonuclear leukocytes (PMN) was assessed by measuring lung tissue myeloperoxidase (MPO) activity. Lipid peroxidation in lung tissue was assessed by tissue thiobarbituric acid reactive substance (TBARS) levels. The plasma prostacyclin level was assessed by the plasma 6-keto prostaglandin F1α(6-keto-PGF1α) level, which is a stable derivative of prostacyclin. Histopathological changes in lung tissue were assessed by PMN count in the capillaries and alveolar spaces. The lung tissue TBARS level, MPO activity and PMN count in the control group were significantly higher than in the AT III group (P

To investigate the effects of acute fecal peritonitis on plasma and tissue lipid peroxidation and possible protective effects of vitamin E (Vit E) and cimetidine at 4 h in a rat peritonitis model, four groups were designated as: controls, peritonitis, Vit E and cimetidine. Plasma, liver, lung and kidney thiobarbituric acid reactive substances (TBARS) and conjugated diene (CD) levels were measured to monitor oxidative injury. The present fecal peritonitis model caused a significant elevation in liver TBARS; however, neither Vit E nor cimetidine was effective in preventing TBARS formation. Administration of Vit E and cimetidine caused significant decrements from the peritonitis value in liver and lung CD levels.