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Hayatın çeşitli alanlarında radyofrekans elektromanyetik alanlara (RF-EMA) maruziyet giderek artmaktadır. Çalışmamızda, 5G (6 GHz, 0.08 W/kg SAR) RF-EMA’nın sıçan kan hücrelerinde canlılık, apoptotik (erken, geç) ve nekrotik oranlarına etkilerini araştırdık. Çalışmamızda, ağırlıkları 250-300g arasında değişen 10 adet Wistar Albino türü erişkin erkek sıçan kullanıldı. RF-EMA uygulama öncesi tüm sıçanlardan kardiyak ponksiyon yöntemi ile kan alınarak (2cc) kontrol grubu olarak seçildi. Aynı sıçanlar özel uygulama kafesine yerleştirilerek 6 hafta boyunca 4 saat/gün 6 GHz RF-EMA’ya maruz bırakıldı. RF-EMA uygulama sonrası aynı sıçanlardan 2.kez kan alımı (2cc) yapılarak radyofrekans radyasyon (RFR) grubu olarak seçildi. Sıçan kan hücrelerinde canlı, erken/geç apopitotik ve nekrotik hücre yüzde oranları anneksin-V kiti kullanılarak flow sitometrik yöntemle analiz edildi. RFR grubunda canlı hücrelerin % oranı, kontrol grubuna kıyasla artış gösterirken, erken apopitotik ve nekrotik hücrelerin % oranları azaldığı ve iki grup arasındaki farklılıkların istatistiksel olarak anlamlı olduğu tespit edildi (p

Objective The factors affecting the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies from mother to newborn and the duration of seropositivity rates in these infants have not yet been clearly demonstrated. The objectives of this study were (1) to assess the levels of SARS-CoV-2 spike–specific immunoglobulin G (IgG) in women infected in the pregnancy period and newborns born to these women and (2) to search the transplacental transfer ratio of spike-specific IgG. Methods Seventy pregnant women with symptomatic SARS-CoV-2 infection and their newborns were prospectively followed. Anti–SARS-CoV-2 immunoassay was used for the detection of the in vitro quantitative determination of total antibodies to the SARS-CoV-2 spike protein. Discussion Spike-specific IgG was demonstrated in 89.1% (44 of 46) of pregnant women infected more than 14 days before delivery and in 92.6% (43 of 44) of their newborns. Median transfer ratio of spike-specific Ig was 0.87 (interquartile range [IQR], 0.34–0.90), 1.0 (IQR, 0.9–0.29), and 0.81 (IQR, 0.02–1.0) in first trimester (n = 4), second trimester (n = 14), and third trimester (n = 28) pregnant women, respectively. Antibody transfer ratio was correlated with time elapsed from infection (p Conclusion Timing from infection to delivery and severity of maternal infection are critical in assessing the antibody generation and transport. Higher antibody transfer ratio can be detected in neonates when SARS-CoV-2 infection is present for more than 60 days before birth. Maternally derived antibody can persist for 3 months after birth.

Background/aim HIV infection increase the risk of serious disease resulting from common vaccine-preventable infections. Vaccinations are particularly important for HIV infected adults. We aimed to investigate the immunity rates against measles, mumps, rubella, hepatitis A, B, and tetanus in newly diagnosed HIV patients. Materials and methods Patients who admitted to outpatient clinics of three centers with newly diagnosed HIV infection, between 1 January 2015 and 31 June 2017 were included. Measles, mumps, rubella, varicella zoster virus, hepatitis A, hepatitis B, and tetanus antibody levels were measured by commercial diagnostic kits. Demographical and laboratory data of the patients were recorded. Results Five hundred and twenty-three patients were enrolled in the study. Of the patients 87% were male (n = 455) and the mean age was 38 ± 13 years. Serology was available for measles 74.2% (388/523), mumps 73.8% (386/523), rubella 77.8% (407/523), hepatitis A 88.5% (463/523), hepatitis B 97.7% (511/523), tetanus 8.6% (45/523), and VZV 79.9% (418/523). Seropositivity was 82% for measles, 75.6% for mumps, 92.1% for rubella. Of the patients whom all three of the components of the MMR vaccine was tested, 37.7% (127/337) were susceptible at least one and needed the vaccine. Mean age was lower in patients who are nonimmune to measles and mumps (p = 0.008). Younger patients were also nonimmune for hepatitis A, while older patients were nonimmune for hepatitis B. Conclusion In our study we found that rates of nonimmunity can increase up to one third of the patients even though there is a national vaccination program. Nonimmune individuals should be detected and vaccinated in line with recent guidelines and response should be monitored because of the possibility of impaired immunity and possible suboptimal response. National campaigns can be launched for adult immunization and physicians should be aware of the importance of adult immunization.

PubMedID: 31651120 Background/aim: Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation. The study aimed to assess serum 14-3-3eta, anti-CarP, and anti-Sa in seronegative RA (SNRA) patients who were treatment-naïve as well as in healthy subjects. This is the first study in the literature to examine these autoantibodies together in SNRA patients. Materials and methods: Forty-five treatment-naïve SNRA patients and 45 healthy subjects were recruited. Drugs change the levels of autoantibodies; therefore, patients who took any medication had been excluded from our study. Anti-carbamylated protein, anti-Sa, and 14-3-3eta were measured by using three different ELISA kits. Results: Median serum concentration of healthy controls in 14-3-3eta was 0.02 (0.02–0.27) ng/mL. Median serum concentration of SNRA patients in 14-3-3eta was 1.00 (0.48–1.28) ng/mL. Data were analyzed with Mann–Whitney U tests; the P-value was

BackgroundFor a sustained and essential protective antibody response, it is important to understand how long the humoral immune response induced by the SARS-CoV-2 inactivated vaccine persists.AimsThis study aimed to detect the first and third-month concentrations and seroconversion rates of the antibodies induced by the inactivated vaccine.Study DesignThis is a vaccine efficacy study.MethodsThe study included 272 health workers who were vaccinated at days 0 and 28 by the inactivated SARS-CoV-2 vaccine (3μg/0.5ml). Anti-S-RBD-IgG and total anti-spike/anti- nucleocapsid-IgG antibody concentrations and seroconversion rates were examined in vaccinated health workers at the 1st and 3rd months after the vaccination. The test method used for the qualitative detection and differentiation of IgG antibodies (indirect method) to SARS-CoV-2 is a chemiluminescence reaction (CLIA).ResultsThe mean age of the health workers was 38.93±10.59 (min:21-max:64). A total of 45(16.5%) participants declared to have had COVID-19 before the first dose of the inactivated vaccine. The participants were found to be reactive for anti-S-RBD-IgG antibodies by 98.2% and 97.8% at the first and third months, respectively, after the administration of the second dose. The decrease in the mean plasma concentrations of anti-S-RBD IgG was observed as 56.7% in the cohort with only two doses of the vaccine (1st month:42.4AU/ml versus 3rd month: 18.2AU/ml). In the cohort with a history of COVID-19 prior to the vaccination, the decrease was observed as 25.1% (1st month:58.29 versus 3rd month:43.64 AU/ml) and at a mean of 57.4 (0-90) days prior to vaccination, the decrease was of 43.1% (1st month:55.05 AU/ml versus 3rd month:31.28 AU/ml), keeping more stable in participants infected at a mean of 183.1 (91-330) days prior to vaccination (a decrease of 5.2%; with 62.34 AU/ml at 1st and 59.08 AU/ml at 3rd months). Anti-S-RBD concentrations were observed to increase 10-fold (30.44 AU/ml at 1st and 310.64 AU/ml at 3rd months) in participants infected after the vaccination and to decrease among people aged 50 years and older.ConclusionAntibody concentrations at the 1st and 3rd months after the vaccination with two doses of the inactivated SARS-CoV-2 vaccine were found to be decreased, but still detectable (except in one participant). As participants who had COVID-19 at a mean of 181 (90-330) days before the vaccination presented with a more stable antibody level, it can be concluded that a booster at months 6-12, resulting in a schedule of 0-1-6 months, is recommended for the inactive SARS-CoV-2 vaccination.

Aims: Limited information is available about the efficacy and adverse events of COVID-19 vaccines introduced into public use with Emergency Usage Licences without completing phase-3 trials. Data refer to healthy and mostly younger people, with lacking evidence about the protectivity. This study aimed determining seroconversion rates and levels specific to anti-S-RBD IgG and total anti-spike/anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 after the administration of two doses of the inactivated SARS-CoV-2 vaccine in Turkey, comparing three types of antibodies. It was also aimed to assess short-term adverse events due to the vaccine. It is intended to answer the questions about efficacy and safety, which lack in phase trials, especially at community level. It is also aimed to collect data, which will form the basis for assessing whether antibodies are protective at different community settings. Methods: The study carried out in Turkey, comprised 282 healthcare workers who received two doses of the inactivated SARS-CoV-2 vaccine administered in two 3µg doses, 28 days apart. In day-28 after the second dose, anti-S-RBD IgG and total anti-spike/anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 were detected by in-vitro chemiluminescence immunoassay. Results: At day 28 after the second dose, the seroconversion rates were found to be 92.9% for total anti-spike/anti-nucleocapsid IgG and 15.2% for IgM and 98.2% for anti-S-RBD IgG antibodies. The immunogenicity was affected by pre-vaccination natural COVID-19 history and age. The incidence of at least one adverse event was found as 29.8% after the first dose and 24.1% after the second dose, with the most common events being pain at the injection site, weakness, fatigue and headache. Conclusion: A high rate of seroconversion was observed with no serious adverse events. Prior natural COVID-19 history and age significantly contributed to strong immunogenicity. A booster dose appears required for older ages and individuals without immune response.

Background/aim Various COVID-19 vaccines are being developed around the world. Important questions to be answered regarding vaccines are efficacy, safety, and whether antibodies are protective when used in different communities. This study aimed to determine seroconversion rates of the inactivated SARS-CoV-2 vaccine in healthcare workers in a hospital and short-term adverse events due to the vaccine. Materials and methods The study carried out in Cukurova University, Turkey, comprised 282 healthcare workers who received two doses of the inactivated SARS-CoV-2 vaccine administered in two 3 µg doses, 28 days apart. On day 28 after the second dose, anti-S-RBD IgG and total anti-spike and anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 were detected by using in vitro chemiluminescence immunoassay method. Results The mean age of participants was 39.06±10.65 (min 21; max 65) with 43.6% males and 56.4% females. On day 28 after the second dose, the seroconversion rates were found to be 92.9% for total anti-spike and anti-nucleocapsid IgG and 15.2% for IgM and 98.2% for anti-S-RBD IgG antibodies and having natural COVID-19 prior to vaccination, age and comorbidity were found to be significant factors for immunogenicity. The incidence of at least one adverse event was found as 29.8% after the first dose and 24.1% after the second dose, with the most common events being pain at the injection site, weakness, fatigue and headache. Conclusion On day 28 after the second dose of 3 ?g of the inactivated SARS-CoV-2 vaccine administration, a high rate of seroconversion was observed with no serious adverse event. Prior natural COVID-19 history, age and comorbidity were significant contributors to the formation of a strong immune response. It can be concluded that a third dose may be considered in people aged 50 years and older and those with comorbidities.

BACKGROUND This study assessed pancreatic functions by investigating fecal elastase-1 (FE-1) levels in stool specimens in children with primary and secondary malnutrition. METHODS A total of 139 malnourished children who were hospitalized and followed up at a tertiary care pediatrics clinic and 23 healthy children with no known systemic disease or malnutrition were included in this study. Malnourished patients were divided into four groups according to underlying diagnosis including primary malnutrition (n=51), cystic fibrosis (n=44), celiac disease (n=12) and secondary malnutrition (n=32; remaining patients with various diagnoses). Patient's demographic characteristics and laboratory data were investigated. FE-1 levels of the patients and healthy subjects were evaluated. RESULTS FE-1 levels in patients with cystic fibrosis, primary malnutrition, and celiac disease, and other patients with secondary malnutrition were significantly lower than those in the control group. CONCLUSIONS Pancreatic enzymes are used due to pancreatic failure in cases of cystic fibrosis, and patients benefit considerably from treatment. This study shows that pancreatic failure may also occur in cases of primary and secondary malnutrition apart from cystic fibrosis, emphasizing the likelihood of pancreatic enzyme support to be useful in terms of pancreatic failure developing secondarily in cases of primary malnutrition.

Purpose: The aim of this study is to examine the relationship between Pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections (PANDAS) and Human Leukocyte Antigen (HLA) alleles. Materials and Methods: HLA alleles of 41 children patients, whom are diagnosed with rapid onset of obsessive compulsive disorder (OCD), and 88 healthy children are analyzed by using PCR. Results are evaluated by using univariate and multivariate logistic regression analysis.Results: DRB8, DRB5.2 and DQ5 alleles increase risk of disease while A1, B18 and B35 alleles decrease risk of disease. Conclusion: Findings of this study will help researchers to examine related genes in PANDAS and the effects of gene products on development of the disease. Presentation of exogenic antigens to T-helper cells by HLA class II loci is determined in different autoimmune diseases. Similarity of these findings with PANDAS etiology and risk increasing alleles found in this study being HLA class II is remarkable., Amaç: Bu çalışmada Streptokok enfeksiyonları ile ilişkili pediyatrik otoimmün nöropsikiyatrik bozukluklar (PANDAS) ve İnsan Lökosit Antijen (HLA) allelleri arasındaki ilişkinin incelenmesi amaçlanmıştır.Gereç ve Yöntem: Ani başlangıçlı obsesif kompulsif bozukluğu (OKB) olan 41 çocuk hastanın ve 88 sağlıklı çocuğun HLA alelleri PCR kullanılarak analiz edildi. Sonuçlar univariate ve multivariate lojistik regresyon analizi kullanılarak değerlendirildi.Bulgular: A1, B18 ve B35 allellerinin hastalık riskini azaltırken, DRB8, DRB5.2 ve DQ5 allellerinin hastalık riskini artırdığı saptanmıştır.Sonuç: Bu çalışmanın bulguları, araştırmacıların PANDAS'taki ilgili genleri ve gen ürünlerinin hastalığın gelişimine olan etkilerini incelemelerine yardımcı olacaktır. HLA sınıf II lokusları tarafından T-yardımcı hücrelere ekzojenik antijenlerin tanıtımı farklı otoimmün hastalıklarda belirlenmiştir. Bu bulguların PANDAS etiyolojisi ile benzerliği ve bu çalışmada bulunan hastalık riskini artıran allellerin, HLA sınıf II’de bulunması dikkat çekicidir.

PubMedID: 29946872 Aim: The aim of the present study is to investigate the frequency of celiac disease in children with peptic ulcers and to compare it with that of non-celiac peptic ulcers in terms of clinical and laboratory values. Methods: Upper gastrointestinal endoscopy was performed in 1769 patients at the Department of Pediatric Gastroenterology, The Faculty of Medicine, Cukurova University, Turkey, between January 2012 and January 2017. These cases consisted of subjects presenting with various GIS symptoms and indicated for endoscopy (with chronic diarrhea, delayed growth and development, abdominal pains, GIS bleeding, etc.). The levels of immunoglobulin A (IgA) serum anti-tissue transglutaminase antibodies, IgA anti-endomysial antibodies (EMA), and IgA serum were estimated in the patients with peptic ulcers. Results: Celiac disease was diagnosed with serology, endoscopy, and histopathology in 250 (14%) of all cases undergoing endoscopy. Peptic ulcers were diagnosed in 74 patients (4.2%) of all cases undergoing endoscopy. tTGA and EMA (+) levels were determined in 22 (29%) of the 74 patients with peptic ulcers, and then the presence of peptic ulcers was investigated in the upper gastrointestinal system using gastrointestinal endoscopy, followed by histopathological confirmation of celiac disease. HP infection was present in 14 (63%) of the patients with celiac disease and in 23 (44%) of non-celiac peptic ulcers; the difference was not statistically significant (p = 0.12). In the total ulcer group, 10.8% (8/74) of patients with celiac peptic ulcers were negative for HP infection, whereas 21% (8/37) of HP-negative patients with ulcers had celiac disease. Conclusion: There exists a high risk of celiac disease in children with peptic ulcers. We thus recommend celiac disease to be investigated, particularly in HP-negative patients with peptic ulcers but with no history of NSAID use. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Objective: Cystic fibrosis is the most common autosomal recessive inherited disorder seen in the white populations. It develops in result of mutations of cystic fibrosis transmembrane regulator (CFTR) gene. Rate of these mutations vary in different geographical regions. In this study, we aimed to determine the frequency of CFTR gene mutations in Adana. Methods: DNA samples of 63 subjects (21 women, 42 men) who were diagnosed as cystic fibrosis at Balcalı Hospital of Çukurova University, were studied for 19 different CFTR mutations by the strip assay method which is based on reverse hybridization. Results: In cystic fibrosis diagnosed patients, 19 mutations were observed of which 9 were homozygous and 10 were heterozygous. ∆F508 frequency was found as 11.9%, and rate of homozygous was found as 66.7%. Mutation frequencies of W1282X and N1303K were found as 2.40% and 4.80% respectively and rate of homozygous mutations were 50% for both. I148T mutation frequency was found as 3.20% and all were heterozygous. For the whole 19 mutations, frequency of mutation in 63 subjects was 22.3%. Conclusion: Detection of CFTR gene mutations by the strip assay method by reverse hybridization is an easy, fast and informative method. However, due to improvability of the common mutations in probable cystic fibrosis patients because of heterogenity in this region, it is still a major problem and does not exclude cystic fibrosis diagnosis. But this problematic issue can be overcome by evaluating the whole exons of CFTR mutations by advanced molecular tecniques. Key words: CFTR, cystic fibrosis, molecular diagnosis, reverse hibridisationKey words, ÖZET Amaç: Kistik fibrozis (KF) beyaz ırkta en sık gözlenen otozomal resesif özellik gösteren kalıtımsal bir hastalıktır. Bu hastalık kistik fibrozis transmembran regulator (CFTR) genindeki mutasyonlara bağlı olarak gelişir. Mutasyonlardaki dağılım oranları değişik ülke ve bölgelere göre farklılık göstermektedir. Bu çalışmada Adana İlinde CFTR geni mutasyonlarının değerlendirilmesi amaçlanmıştır. Yöntem: Çalışmada KF tanısı alan (21 kadın, 42 erkek) toplam 63 hastanın DNA örnekleri 19 farklı CFTR mutasyonu açısından ters hibridizasyona dayalı "strip assay" yöntemi ile incelenmiştir. Bulgular: KF tanılı hastaların 19"unda (9"unda homozigot, 10"unda heterozigot mutasyon) saptanmıştır. ∆F508 sıklığı %11.90, homozigotluk oranı ise %66.7 olarak bulunmuştur. W1282X mutasyon sıklığı %2.40 ve N1303K mutasyon sıklığı %4.80 bulunmuş olup homozigotluk oranları %50" dir. I148T mutasyonu %3.20 olarak saptanmıştır ve hepsi heterozigottur. Taradağımız 19 mutasyon için hastaların toplam mutasyon oranı ise % 22.3 olarak bulunmuştur. Sonuç: CFTR geni mutasyonlarının rutin laboratuarlarda saptanabilmesi için ters hibridizasyona dayalı "strip assay" tekniği hızlı, kolay ve bilgi verici bir yöntemdir. Bununla birlikte sonuçlarımızdaki heterojenite, şüpheli bir KF vakasında, yaygın bulunan mutasyonların kanıtlanamaması durumu, halen potansiyel bir sorun olarak kalmaya devam etmektedir ve bu durum tanıyı dışlamamaktadır. Bu sorun CFTR mutasyonunun bulunduğu ekzonların tamamının daha ileri moleküler teknikler ile incelenmesiyle ortadan kaldırılabilir.

Objective:Kidney transplantation is an important treatment option in end stage renal failure. Tissue death may be an important problem when a kidney is removed from a cadaver and transported to a donor a long distance away. The purpose of this study is to determine the critical time point for apoptotic cell death in a renal ischemia/reperfusion model and determine the effects of N-acetylcystein on apoptosis induced by ischemia injury.Methods:Apoptotic cell death after induced renal ischemia followed by reperfusion, was estimated in a group of Wistar albino rats by immunoflourescence and ELISA techniques. N-acetylcystein, an antioxidant agent, was given to the rats to study the effect on apoptosis. Tissues were examined immunohistochemically at 0, 1 h, 24 h, 5 days and 10 days for detection of apoptotic cells.Results:Our results showed that an ischemia for 60 min followed by reperfusion for 60 min triggered apoptosis. Moreover, N-acetylcystein significantly diminished both the ischemia/reperfusion damage and apoptosis.Conclusion:We anticipate our results would be important for kidney transplantation in estimating the critical time point for apoptosis and administration of N-acetylcystein prior to removal of the organ may be important in delaying the onset of apoptosis.

PubMedID: 28342642 The study has evaluated the performance of HCV core antigen (Cag) test by comparing HCV RNA PCR assay which is considered the gold standard for management of HCV infection. Totally, 132 samples sent for HCV RNA (real-time PCR) test were included in the study. Anti-HCV antibody test and HCV Cag test were performed by chemiluminescent enzyme immunoassay (CMEI). Anti-HCV test was positive in all samples. HCV RNA was detected in 112/132 (84.8%) samples, and HCV Cag in 105/132 (79.5%). The most common HCV genotype was genotype 1 (86%). Considering the HCV RNA test as gold standard; the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Cag test were found to be 93.75%, 100%, 100%, 74.07% and 94.69%, respectively, and paired test results were detected as highly concordant. A high level of correlation was seen between HCV RNA and Cag tests, however, the concordance between the two tests appeared to be disrupted at viral loads lower than 103 IU/mL. On the contrary, the correlation reached significance for the values higher than 103 IU/mL. Viral loads were in the 17–2500 IU/mL range for the negative results for Cag test. Pearson's correlation coefficient revealed a considerably high correlation. The concordance between HCV RNA and Cag tests was disrupted under a viral load lower than 103 IU/mL. Therefore, it would be appropriate to consider cost effectiveness, advantages and limitations of the HCV RNA and Cag tests during the decision on which method to use for patient management. © 2017 Elsevier Ltd

The objective of this study was to evaluate the relationship between humoral and cell-mediated immune response parameters and impairment of immune functions in children with Down syndrome (DS). The patient group was consisted of cytogenetically documented 32 children with DS. Lymphocyte subsets and natural killer cells were counted by flow-cytometry system. Levels of interleukin (IL)-1beta, IL-2, IL-4, IL-6, IL-8, IL-10 and tumour necrosis factor-alpha (TNF-alpha) were detected by enzyme-linked immunosorbent assay method. Serum IgG, IgM, IgA levels were measured by turbidimetric methods. The percentage of CD8+ lymphocytes and CD56+ cells of patients with DS were significantly higher, whereas CD20+ lymphocytes were lower than that of controls (P 0.05). Levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-alpha levels were decreased in children with DS (P 0.05, for all). Serum IgG, IgM and IgA levels were found to be similar between the groups (P > 0.05). It has been known that IL-4 and IL-10 are anti-inflammatory molecules which inhibit the synthesis of proinflammatory cytokines such as IL-6 and TNF-alpha. In this study, levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-alpha levels were decreased in children with DS. These results may suggest that continuing anti-inflammatory state in DS and this process may explain the cause of recurrent infection of the disease. On the other hand, in contrast to the low percentage of CD20+ cells, high percentage of CD8+ and CD56+ cells were found. Our findings may demonstrate that the cell-mediated and humoral immune system parameters in children with DS were altered according to healthy children.

WOS: 000232883400009 PubMed ID: 16257843 Objective. Cardiovascular complications due to atherosclerosis ( AS) are the major cause of mortality in hemodialysis (HD) patients. Inflammation may play an important role in the development of AS. Several studies have demonstrated an association between AS and acute-phase proteins and cytokines in the general population and in HD patients. Interleukin-10 (IL-10) is an anti-inflammatory cytokine. The aim of this study was to compare serum levels of inflammatory and anti-inflammatory indicators in HD patients according to the presence or absence of AS. Material and methods. A total of 33 HD patients were studied. AS was defined as the presence of plaques as detected by Doppler ultrasonography. The patients were subgrouped according to the presence or absence of plaques. Serum levels of IL-1, -2, -6 and -10, C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-alpha) were measured. Risk factors for AS, such as age, gender, hypertension, hyperlipidemia and duration of HD, were also evaluated. Results. Patients with AS had significantly higher high sensitivity (hs)-CRP and lower IL-10 levels. Blood pressure was also elevated in patients with AS. There was an inverse correlation between CRP and IL-10 levels in patients with AS. Conclusion. Patients with AS undergoing HD had low serum levels of the anti-inflammatory cytokine IL-10 and high serum levels of hs-CRP. These results may suggest that limitation of the anti-inflammatory response in atherosclerotic uremic patients is a triggering or contributory factor for AS.

Background Patients who have diabetes and chronic wounds are more prone to tetanus than the other populations. The prevalence of diabetes among patients diagnosed with tetanus was 15%, nearly three times the average expected prevalence of diabetes in the United States. In this study, we aimed to evaluate the tetanus immunization status of the patients with diabetic foot wounds (DFW) and to determine the factors, which may predict to immunity against tetanus. Methods Patients who admitted to outpatient clinics with DFW were included between 1 January and 31 December 2016. Tetanus antibody levels were measured by a commercial Clostridium tetani 5S IgG ELISA kit. Antibody levels below 0.1 IU/ml were defined as “No reliable protection” and levels above 0.1 IU/ml were defined as “Reliable protection”. A questionnaire applied to all patients for detailed diabetes and vaccinating history about tetanus. Results Ninety-one patients were enrolled to the study, 66 (72.5%) of them were male and 25 (%27.5) of them were female. Mean age was 62 ± 11 years. Sixty-five (71.4%) of the patients had no reliable protection while 26 (28.6%) of them had reliable protection. Tetanus IgG titers were decreasing by the age (Figure). Univariate analysis results between the immune and non-immune groups were demonstrated in Table: In the logistic regression analysis, only patients’ age was found statistically significant predictive factor for immunity against tetanus (OR: 1,114 95% CI: 1,047–1,185). Conclusion We found that elderly patients with DFW have very low rate of immunization against tetanus. Therefore, tetanus vaccination should be given particularly to the elderly patients with DFW without any serological control. Characteristics Immune patients (n = 26) None-immune patients (n = 65) P Age (year) (Mean ± SD) 53.3 ± 12.1 65.1 ± 8.6 0.0001 Age of diabetes (year) (Mean ± SD) 12.6 ± 8.1 16.4 ± 8.1 0.043 GEND ER Male, n (%) 21 (31.8) 45 (68.2) 0.265 Female, n (%) 5 (20) 20 (80) Residency status Urban, n (%) 24 (34.3) 46 (65.7) 0.028 Rural, n (%) 2 (9.5) 19 (90.5) Educational status Primary–Secondary School, n (%) 20 (24.7) 61 (75.3) 0.029 High School-University, n (%) 6 (60) 4 (40) Knowledge about vaccination history Full covered, n (%) 3 (50) 3 (50) 0.461 Not covered, n (%) 4 (30.8) 9 (69.2) Unknown, n (%) 19 (26.4) 53 (73.6) Disclosures All authors: No reported disclosures.

PubMedID: 14669860 Arteriosclerosis is characterized by stiffening of arteries. The incremental elastic modulus (Einc) measurement is a good marker of arterial wall stiffness. Metabolic, inflammatory and hemodynamic alterations cause structural changes and vascular complications in end stage renal disease. The aim of the present study was to evaluate the factors that may affect the development of arteriosclerosis by measurement of Einc in hemodialysis (HD) patients. Thirty-two patients (16 men; 16 female) on chronic HD with a mean age of 42.2 ± 19.3 (range: 15-80) were included in the study. The carotid Einc was measured to determine arteriosclerosis by high-resolution echo-tracking system (Acuson Aspen, Acuson Corp., Mountain View, California, USA). Einc measurement was calculated from transcutaneous measurements of common carotid arterial (CCA) internal diameter and wall thickness and carotid pulse pressure. Common carotid compliance and distensibility were determined from changes in carotid artery diameter during systole and simultaneously measured carotid pulse pressure. Common carotid artery stuffiness (Einc) was influenced by age, systolic blood pressure (SBP), pulse pressure (PP), calcium (Ca) and alkaline phosphatase (ALP). The distensibility of CCA was correlated with age, SBP, diastolic blood pressure (DBP), PP, Ca, ALP, and parathormone (PTH). The inflammatory parameter, hs-CRP, was increased with Einc. The mean Einc measurement was found significantly increased in patient receiving vitamin D. In conclusion, the stiffening of carotid artery in HD patients is related not only to hemodynamic changes (increased SBP, PP) but also to metabolic (increased Ca) and to inflammation (increased hs-CRP). Carotid Einc is accepted independent risk factor for cardiovascular mortality. Because of the positive correlation between Einc and serum Ca, vitamin D and Ca containing phosphorus (P) binders should be used carefully.

Objective: It has been aimed to investigate the Galectin-3 (GAL-3) levels and clinical responses after addition of spironolactone as a mineralocorticoid receptor antagonist (MRA) to the current treatment in patients with heart failure with low ejection fraction who received no aldosterone antagonist therapy previously. Patients and methods: The study included 112 patients with Heart Failure (HF) who showed left ventricular Ejection Fraction (EF) of 35% or below, New York Heart Association (NYHA) Class II-IV symptoms and did not receive MRAs in their current treatment. Serum Gal-3 levels, serum BNP level, 6-minute walk test and class level of NYHA were examined before and 6 months after treatment of spironolactone in all patients. Results: Mortality developed in 10 of 112 patients. Baseline and 6th month follow-up data obtained from 102 of 112 patients. Mean LVEF (%), BNP levels, Gal-3 levels, NYHA class of functional capacity and mean 6-minute walking test distance of the patients before treatment of spironolactone were 31.3 ± 3.2%, 451,4 ± 50.3 pg/ml, 39 ± 21 ng/ml, 2,8 ± 0.59 and 305 ± 61 m respectively whereas, the same variables were found 32.1 ± 2,8% (p=0.21), 443.6 ± 49 pg/ml (p=0.23), 33 ± 22 ng/ml (p=

PubMedID: 28205271 Background: Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. Methods: The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems. The laboratory turnaround time for individual tests, total delay time in the sample reception area, and percentage of steps involving risks of medical errors and biological hazards in the overall process are measured. Results: The pre-analytical process in the reception area was improved by eliminating 3 h and 22.5 min of non-value-adding work. Turnaround time also improved for stat samples from 68 to 59 min after applying Lean. Steps prone to medical errors and posing potential biological hazards to receptionists were reduced from 30% to 3%. Conclusion: Successful implementation of Lean Six Sigma significantly improved all of the selected performance metrics. This quality-improvement methodology has the potential to significantly improve clinical laboratories. © 2017 Wiley Periodicals, Inc.

PubMedID: 22813662 Cytogenetic analysis is an important stage in understanding the genetic background of manic depression (MD), and may provide a valuable clue to the identification of target loci and successful search for major genes. In order to identify chromosomal regions we aimed to detect the relationships between chromosomal aberrations (CAs) and immunological markers in a family with MD and psoriasis. We used the cell cultivation and conventional G-banding. We found predominantly numerical aberrations. The most common aneuploidy was chromosome 8, followed by chromosome 22, 21, 15, X and Y. However, structural aberrations consisted of duplications, deletions, translocations and breaks, with a focus on: loci on del(1)(q12-q23), del(1)(q21.1-q24), del(1)(q21.1-q23), del(10)(p11.2-pter), der(2)t(2;4)(p25;p12), t(2;22)(p14;p13), t(19;Y)? and dup(10)(q26). The susceptibility genes of MD or psoriasis may be located on these loci. Numerical sex CAs included 4(5.8%) with 45,X, 3(4.3%) with 47,XXY, and 4(5.8%) with structural chromosome X; del(X)(q13); del(X)(p11-pter) del(X)(q21.3) and inv(Y)(q11.2). We also conducted an immunological study. According results of this study, the percentage of CD2+, CD4+ and CD8+ lymphocytes of the father were significantly higher, whereas CD4+ lymphocytes were decreased in the mother, when compared the healthy persons. The percentage of CD4 level of the son was decreased, whereas CD8+ lymphocytes were higher. The CD4/CD8 ratio of the father and the son was found to be significantly high. These results may suggest that MD and psoriasis have a significant impact on both genetic and immunological parameters. © 2012 Elsevier B.V.

PubMedID: 20824388 We investigated the effect of extremely low-frequency electromagnetic field (ELF-EMF) with pulse trains exposure on lipid peroxidation, and, hence, oxidative stress in the rat liver tissue. The parameters that we measured were the levels of plasma alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase as well as plasma albumin, bilirubin, and total protein levels in 30 adult male Wistar rats exposed to ELF. We also determined the percentage of apoptotic and necrotic cells of the kidney extracts from the animals by flow cytometry method. Apoptotic cell death was further characterized by monitoring DNA degradation using gel electrophoresis. The results showed an increase in the levels of oxidative stress indicators, and the flow cytometric data suggested a possible relationship between the exposure to magnetic field and the cell death. We showed significantly lower necrotic cell percentages in experimental animals compared to either unexposed or sham control groups. However, DNA ladder analyses did not differentiate between the groups. Our results were discussed in relation to the response of biological systems to EMF. © 2010 Springer Science+Business Media, LLC. Acknowledgment The authors acknowledge with thanks the support provided by the Biochemistry department of Cukurova Medical School by way of valuable contributions in the determination of oxidative stress parameters.

The non-invasive detection of P-glycoprotein (Pgp) and multidrug resistance related proteins in vivo, will represent the greatest challenge in overcoming multidrug resistance. Although 99mTc tetrofosmin has been used previously as a myocardial perfusion agent, it is now also being used in the imaging of various tumours. In the current study, Tc tetrofosmin was used in the investigation of acute leukaemia.To show the uptake pattern of 99mTc tetrofosmin in the bone marrow of patients with acute leukaemia, and to ascertain the relationship between 99mTc tetrofosmin uptake and the level of Pgp expression and their relation to the response to chemotherapy. In addition, CD95, which is an indicator of apoptosis (programmed cell death), has also been assessed.Pgp and CD95 were detected by using flow cytometry. Of the 27 acute leukaemia patients assessed, nine had previously received chemotherapy, and 18 had had an initial diagnosis. All patients had undergone 99mTc tetrofosmin scintigraphy, and their Pgp and CD95 levels had been determined. The same parameters were studied again for 14 patients. The responses to chemotherapy were assessed by patients' clinicians. A control group of 37 patients without bone marrow pathology was also studied in order to provide comparisons for the scintigraphy results. The control images were assessed only qualitatively.In leukaemia patients the uptake of 99mTc tetrofosmin into bone marrow was found to be considerably higher than in control patients (P=0.000). An analysis of the relationship between Pgp, CD95, and the qualitative and quantitative tetrofosmin uptake ratios (URs) showed that there was an inverse correlation only between Pgp and the quantitative uptake ratio (P=0.016, r=-0.461). When the patients were grouped as 'good' and 'poor', as related to the chemotherapy response, there were no meaningful differences between these two groups regarding Pgp, CD95 and tetrofosmin URs (P0.05). By evaluating the scintigraphic findings of the 'repeated' 14 patients, we showed that if the 99mTc tetrofosmin UR in the second imaging test was reduced by0.08, the response to chemotherapy tended to be good. This method, based on follow-up scanning with tetrofosmin, showed a sensitivity of 83% and a specificity of 62% in the prediction of a 'good' response, if a decrease of 0.08 was taken into consideration.In this study, patients with acute leukaemia showed significant uptake of tetrofosmin into the bone marrow. The addition of basal and repeated 99mTc tetrofosmin scintigraphy to the management protocol for leukaemia could lead to the preferential determination of responses to chemotherapy, by evaluating whole bone marrow non-invasively. This method seems promising, but it needs further support from various similar investigations comprising more patients in order to confirm our results.

The aim of this study was to determine the reference ranges of lymphocyte subsets in serologically HIV-negative healthy adults in Turkey. Materials and Methods: Blood samples from 220 healthy adults, 105 female and 115 male, collected into tubes containing EDTA were investigated for lymphocyte subsets using flow cytometry. The age range was 18–80 years (44.80 ± 16.69). Results: The mean percentage and absolute values of the lymphocyte subsets were as follows: CD3: 72.70 ± 8.44%, 1,680 ± 528 cells/µl; CD4: 47.37 ± 9.10%, 1,095 ± 391 cells/µl; CD8: 28.99 ± 5.99%, 669 ± 239 cells/µl; CD19: 10.96 ± 4.44%, 254 ± 122 cells/µl and CD56: 7.03 ± 3.26%, 161 ± 92 cells/µl, respectively. The ratio of CD4/CD8 was 1.68 ± 0.43. There was no statistically significant difference in the percentages and absolute values of lymphocyte subsets between the genders (p > 0.05). Conclusion: Immunophenotyping has been used to establish reference values of lymphocyte subsets in normal healthy adults in Turkey.

Type 1 diabetes mellitus (DM) develops as a result of autoimmune destruction of the pancreatic beta-cells. The aim of this study was to explore possible associations between serum levels of cytokines, IL-1, IL-2, TNFalpha and INFgamma and metabolic parameters in children with type 1 DM and their non-diabetic siblings to determine whether these cytokines could be indicators of disordered immune regulation. The study population consisted of 41 children with type 1 DM, 32 non-diabetic siblings, and 28 healthy controls. Children with DM were divided into three subgroups: 1) newly diagnosed patients with diabetic ketoacidosis (ND + DKA), 2) newly diagnosed patients without DKA (ND - DKA), and 3) previously diagnosed patients (PD). The highest serum IL-1alpha level was found in the ND - DKA group, which was significant compared to both the ND + DKA (p < 0.05) and the siblings (S) (p < 0.005). IL-2 levels were similar among all groups. The highest TNFalpha level was observed in the ND + DKA group, which was significant against the ND - DKA (p < 0.05), PD (p < 0.001), S (p < 0.05), and control (C) (p < 0.005) groups. TNFalpha concentration in the PD group was significantly lower than those of S (p< 0.005) and C (p < 0.001) groups. The ND - DKA group had the highest INFgamma and this was statistically significant when compared with the S (p < 0.005) and C (p < 0.05) groups. Both the newly diabetics and all diabetics as a group had statistically significantly higher INFgamma levels than both the S (p < 0.01 for both) and C (p < 0.05 for both) groups. In the diabetics as a whole group, TNFalpha showed correlations with INFgamma (r = 0.370, p < 0.05). IL-1 showed correlation with TNFalpha (r = 0.368, p < 0.05) INFgamma (r = 0.796, p < 0.001) and IL-2 (r = 0.862, p < 0.001) in the all diabetics group. IL-2 was correlated with TNFalpha (r = 0.320, p < 0.05) and INFgamma (r = 0.754, p < 0.01) in the all diabetics group. In conclusion, our results suggest that proinflammatory cytokines TNFalpha, INFgamma, IL-1alpha and IL-2 may play important roles alone or in combination in the pathogenesis of type 1 diabetes mellitus.

Tumor necrosis factor-alpha (TNF-alpha) is thought to be an important mediator in the pathogenesis of neonatal septicemia. To assess the role of TNF-alpha in neonatal sepsis, serum levels of TNF-alpha were measured in a group of neonates with septicemia and compared with the levels of gestational-postnatal, age-matched healthy controls. The relationships between severity of infection, the nature of causative microorganisms, and TNF-alpha levels were also investigated in this prospective study. A total of 49 infants (25 full-term, 24 preterm) with proven sepsis and 40 healthy infants (20 full-term, 20 preterm) were included. Serum TNF-alpha levels were measured using the TNF-alpha immunoradiometric assay. The median level of TNF-alpha was found to be significantly higher in infants suffering from sepsis (154 pg/mL) particularly in those with septic shock (242.5 pg/mL) as compared to healthy controls (61.5 pg/mL) (p < 0.001). No correlation was found between TNF-alpha and postnatal ages, gestational ages or birth weights of the infants. TNF-alpha levels were not different in surviving and terminal neonates. Although serum, TNF-alpha levels were found to be slightly higher in gram-negative septicemia, the difference was not significant. These findings suggest that TNF-alpha plays an important role in the pathophysiology of neonatal septicemia, but its importance as a prognostic factor is not yet clear.

Objective. Cardiovascular complications due to atherosclerosis (AS) are the major cause of mortality in hemodialysis (HD) patients. Inflammation may play an important role in the development of AS. Several studies have demonstrated an association between AS and acute-phase proteins and cytokines in the general population and in HD patients. Interleukin10 (IL-10) is an anti-inflammatory cytokine. The aim of this study was to compare serum levels of inflammatory and antiinflammatory indicators in HD patients according to the presence or absence of AS. Material and methods. A total of 33 HD patients were studied. AS was defined as the presence of plaques as detected by Doppler ultrasonography. The patients were subgrouped according to the presence or absence of plaques. Serum levels of IL-1, -2, -6 and -10, C-reactive protein (CRP) and tumor necrosis factor-a (TNF-a) were measured. Risk factors for AS, such as age, gender, hypertension, hyperlipidemia and duration of HD, were also evaluated. Results. Patients with AS had significantly higher high sensitivity (hs)-CRP and lower IL-10 levels. Blood pressure was also elevated in patients with AS. There was an inverse correlation between CRP and IL-10 levels in patients with AS. Conclusion. Patients with AS undergoing HD had low serum levels of the antiinflammatory cytokine IL-10 and high serum levels of hs-CRP. These results may suggest that limitation of the antiinflammatory response in atherosclerotic uremic patients is a triggering or contributory factor for AS.

Objective: Cystic fibrosis is the most common autosomal recessive inherited disorder seen in the white populations. It develops in result of mutations of cystic fibrosis transmembrane regulator (CFTR) gene. Rate of these mutations vary in different geographical regions. In this study, we aimed to determine the frequency of CFTR gene mutations in Adana. Methods: DNA samples of 63 subjects (21 women, 42 men) who were diagnosed as cystic fibrosis at Balcali Hospital of Cukurova University, were studied for 19 different CFTR mutations by the strip assay method which is based on reverse hybridization. Results: In cystic fibrosis diagnosed patients, 19 mutations were observed of which 9 were homozygous and 10 were heterozygous. ∆F508 frequency was found as 11.9%, and rate of homozygous was found as 66.7%. Mutation frequencies of W1282X and N1303K were found as 2.40% and 4.80% respectively and rate of homozygous mutations were 50% for both. I148T mutation frequency was found as 3.20% and all were heterozygous. For the whole 19 mutations, frequency of mutation in 63 subjects was 22.3%. Conclusion: Detection of CFTR gene mutations by the strip assay method by reverse hybridization is an easy, fast and informative method. However, due to improvability of the common mutations in probable cystic fibrosis patients because of heterogenity in this region, it is still a major problem and does not exclude cystic fibrosis diagnosis. But this problematic issue can be overcome by evaluating the whole exons of CFTR mutations by advanced molecular tecniques. Key words: CFTR, cystic fibrosis, molecular diagnosis, reverse hibridisation [Cukurova Med J 2013; 38(2.000): 202-208]

Background/Aims: Procalcitonin (PCT) has been described as a new marker of severe infection and sepsis. In this study, we investigated the serum levels of PCT during the hemodialysis (HD) in chronically hemodialyzed patients and whether the PCT levels were correlated with other cytokines. Methods: We measured pre- and post-HD PCT, interleukin (IL-1), IL-2, IL-6, IL-10, tumor necrosis factor-α (TNF-α) concentrations in 24 stable patients undergoing chronic HD [11 males and 13 females; age 41.2 ± 18.0 years, 12 h/week, with a Kt/V of 1.41 ± 0.35, polysynthane (PSN) membrane being used in all patients, without reuse]. Pre- and post-HD PCT concentrations were compared with cytokines such as IL-1, IL-2, IL-6, IL-10, TNF-α, and clinical parameters including age, blood pressure, leukocyte, hemoglobin levels, C-reactive protein (CRP), epoetin (EPO) doses, BUN, creatinine, parathormone (PTH), ferritin, and transferrin levels. Results: Pre- and post-HD serum PCT levels were similar (0.77 ± 0.40 and 0.83 ± 0.61 ng/mL), and higher than upper normal level of 0.5 ng/mL. The levels of IL-2 and IL-10 decreased and the levels of IL-1 and TNF-α increased. Post-HD PCT correlated with PTH, IL-1, IL-2, and IL-10. Conclusion: About 60% of patients had elevated PCT levels, HD with low-flux PSN membrane did not change serum PCT and IL-6. While IL-1 and TNF-α increased, IL-2 and IL-10 decreased by PSN membrane during HD. So that PCT levels can be measured just after HD as do prior to start of HD. Is there any relationship between PCT and PTH? PCT may be important in uremic bone disease.

Arteriosclerosis is characterized by stiffening of arteries. The incremental elastic modulus (Einc) measurement is a good marker of arterial wall stiffness. Arteriosclerosis is characterized by stiffening of arteries. Metabolic, inflammatory, and hemodynamic alterations cause structural changes and vascular complications in end-stage renal disease. The aim of the present study was to evaluate the factors that may affect the development of arteriosclerosis by measurement of Einc in hemodialysis (HD) patients. Thirty-two patients (16 men and 16 women) on chronic HD with a mean age of 42.2 ± 19.3 (range, 15–80) were included in the study. The carotid Einc was measured to determine arteriosclerosis by high-resolution echo-tracking system. Einc measurement was calculated from transcutaneous measurements of carotid arterial internal diameter and wall thickness and carotid pulse pressure. Common carotid compliance (CCC) and distensibility (CCD) were determined from changes in carotid artery diameter during systole and simultaneously measured carotid pulse pressure. Serum levels of calcium (Ca), phosphorus (P), parathormone (PTH), ferritin, C-reactive protein (CRP), predialysis systolic blood pressure (SBP), predialysis diastolic blood pressure (DBP), pulse pressure (PP), age, HD duration, CCC, and CCD were correlated with Einc in all patients. A significant positive correlation was found between Einc and age (r = 0.40, p

Immune profile in 29 cases with chronic lymphocytic leukemia (CLL) and I case with Richter's Syndrome was evaluated and compared with other prognostic parameters including disease stage, organomegaly, hematocrit, WBC count, platelet, bone marrow Involvement pattern, serum albumin and globulin profile and response to therapy. Monoclonal antibody panel included CD2, CD3, CD4, CD5, CD7, CD8, CD10, CD11b, CD13, CD14, CD19, CD20, CD22, CD23 and CD33. Surface antigenic expressions were as follows: CD2; in 5 of 16 cases (31%), CD3; in 2 of 23 cases (9%), CD4; in 2 of l6 cases (13%), CD5; in 24 of 27 cases (89%), CD7; in 11 of 26 cases (42%), CD8; in 1 of 17 cases (6%), CDl0; in 1 of 24 cases (4%-who was the case of Richter's Syndrome), CD11b; in none of the 11 cases, CD13; in 10 of 19 cases (53%) CD14; in none of 12 cases, CD19; in 27 of 29 cases (93%), CD20; in 5 of 15 cases (33%), CD22; in 5 of 8 cases (63%) and CD33; in 1 of 15 cases (6%). Between surface antigenic expressions, CD2 and CD7 expressions were associated with higher frequency of CD5 negativity as compared cases not expressing these antigens. When compared antigenic expressions and with other parometers, it bas been found that: CD2 expressions were associated wilh lower WBC Count, lower incidence of thrombocytopenia and splonemegaly and higher globulin value and higher incidence of thrombocytopenia and advanced stage disease. CD4 expression was associated with poorer response to therapy CD7 was associated with higher incidence of hepatomegaly, CD8 was associated with lower Hct value. CDl3 expression was associated with higher WBC count and more advanced stage disease. CD19 was associated with low risk of hepatomegaly, CD20 was assosiated with low risk of lymphadenopathy. CD22 was associated with lower incidence of hepatomegaly and well response to therapy.