Turkey Yuksek Ihtisas Training and Research Hospital

Ankara, Turkey

Turkey Yuksek Ihtisas Training and Research Hospital

Ankara, Turkey

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PubMed | Ankara Numune Training and Research Hospital and Turkey Yuksek Ihtisas Training and Research Hospital
Type: Journal Article | Journal: Journal of gastroenterology and hepatology | Year: 2016

We aimed to identify ischemia-modified albumin (IMA) levels in inflammatory bowel disease (IBD) and IBD subgroups, and to examine its relation with disease activity index.Sixty-eight patients with IBD (35 ulcerative colitis [UC] and 33 crohn disease [CD]) and 65 healthy volunteers were included in the study. Rachmilewitz scoring system (endoscopic activity index [EAI]) was used to determine UC activity, and as for CD activity, CD activity index (CDAI) scoring was used. IMA measurement was performed with ELISA kit.Ischemia-modified albumin levels in IBD, UC, and CD groups were comparably higher than the control group (37.7ng/mL vs 42.4ng/mL vs 36.4ng/mL vs 21.8ng/mL, respectively; P<0.05). In IBD group, a positive correlation was identified between IMA level and CRP (r=0.325, P=0.011), EAI(r=0.302, P=0.020), and CDAI (r=0.311, P=0.013). In stepwise regression model; it was identified that IMA(OR=1.496; P=0.016) and CRP(OR=3.457; P=0.015) are predictors of IBD in comparison with the control group. In linear regression model, it was identified that risk factors such as log(IMA) and log(CRP) were independent predictors of log(CDAI) and log(EAI) levels.This is the first study showing that IMA levels in IBD were determined higher in comparison with the control group. Moreover, IMA being a predictor for IBD and being positively correlated with disease activity indexes were determined for the first time in the study. In accordance with these results, it is possible to say that IMA in IBD might be related with the pathogenesis of disease and correlated with the severity of the disease.


PubMed | Afyon Kocatepe University, Ankara University, Frat University and Turkey Yuksek Ihtisas Training and Research Hospital
Type: Journal Article | Journal: Oncology letters | Year: 2017

Urinary bladder cancer is one of the most common malignancies of the urinary tract. Ion channels and calcium homeostasis are involved in almost all basic cellular mechanisms. The transient receptor potential cation channel subfamily M (TRPM) takes its name from the melastatin protein, which is classified as potential tumor suppressor. To the best of our knowledge, there have been no previous studies in the literature investigating the role of these ion channels in bladder cancer. The present study aimed to determine whether bladder cancer is associated with mRNA expression levels of TRPM ion channel genes, and whether there is the potential to conduct further studies to establish novel treatment modalities. The present study included a total of 47 subjects, of whom 40 were bladder cancer patients and 7 were controls. Following the histopathological evaluation for bladder carcinoma, the mRNA and protein expression of TRPM were examined by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry in tumor and normal tissues, in order to determine whether there is a difference in the expression of these channels in tumor and normal tissues. Immunoreactivity for TRPM2, TRPM4, TRPM7 and TRPM8 was observed in epithelial bladder cells in the two groups. RT-qPCR revealed a significant increase in TRPM7 expression in bladder cancer tissue compared to the controls (healthy bladder tissue), whereas no differences in TRPM2 or TRPM4 expression levels were observed. There were significant reductions in the expression levels of TRPM5 and TRPM8 in bladder cancer tissues. In the present study, the effects of TRP ion channels on the formation of bladder cancer was investigated. This study is instructive for TRPM2, TRPM4, TRPM5, TRPM7 and TRPM8 and their therapeutic role in bladder cancer. The results support the fact that these gens can be novel targets and can also be tested for during the treatment of bladder cancer.


PubMed | Ataturk Training and Research Hospital, Yildirim Beyazit University, Afyon Kocatepe University and Turkey Yuksek Ihtisas Training and Research Hospital
Type: Journal Article | Journal: Genetics and molecular research : GMR | Year: 2016

Prostate cancer (PCa) is the most common type of neoplasm in European males. Genetic and epigenetic factors contribute to PCa development and progression. In this study, we aimed to assess the relationship between PCa and polymorphisms in the genes encoding endothelial nitric oxide synthase (eNOS), catalase (CAT), and myeloperoxidase (MPO). In total, 193 patients were included in the study. Patients were divided into three groups: PCa (78), benign prostate hyperplasia (40), and control males (75). The parameters assessed included body mass index (BMI), smoking habits, presence of prostatism, prostate-specific antigen (PSA) levels, Gleason scores of prostate specimens, as well as polymorphisms in eNOS-G894T, CAT- 262T, and MPO G-463T genes. BMI and smoking status of controls and patient groups showed no significant difference. CAT-262T gene polymorphism was found to be homozygous in 35.4% of PCa patients, which was 4.02-fold that in the controls (P = 0.006). There was no statistically significant difference in eNOS-G894T and MPO G-463T gene polymorphisms between any of the groups. In conclusion, we found catalase levels to be associated with PCa diagnosis and PSA value. We did not find any significant differences between groups for other polymorphisms, but we believe that further studies with a large sample size may be needed before drawing definite conclusions.


PubMed | Afyon Kocatepe University, Ankara Nuclear Research And Training Center and Turkey Yuksek Ihtisas Training and Research Hospital
Type: Journal Article | Journal: Current urology | Year: 2016

To determine whether there is a correlation between high Gleason score and free/total (f/t) prostate specific antigen (PSA) in patients newly diagnosed with prostate carcinoma.The study included 272 prostate biopsy patients whose total PSA value ranged from 4-10 ng/ml. The patients were divided into 2 groups according to the f/t PSA ratio: Group 1 15% and Group 2 > 15%. Furthermore, the groups were also compared to each other in terms of mild ( 6), moderate (= 7), and high ( 8) Gleason score.Group 1 consisted of 135 (49.6%) patients and Group 2 consisted of 137 (50.4%) patients. While 27 (20%) patients had a high Gleason score in Group 1, only 10 (7.3%) patients had a high Gleason score in Group 2 (p = 0.008). Using Spearmans correlation test, we found that the f/t PSA ratios were observed to decrease significantly in all patients with increased Gleason scores (p = 0.002, r = -0.185).According to our study, there is a relationship between higher Gleason score and decreased f/t PSA ratio. Therefore, f/t PSA can be an indicator for predicting the Gleason score.


PubMed | Adana Numune Training and Research Hospital, Yozgat State Hospital and Turkey Yuksek Ihtisas Training and Research Hospital
Type: | Journal: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc | Year: 2016

T-wave peak to T-wave end interval (Tp-e) correlates with dispersion of ventricular repolarization. The purpose of this study was to assess the ability of Tp-e to predict appropriate implantable cardioverter defibrillator (ICD) shocks and all-cause mortality in patients who underwent ICD implantation for primary prophylaxis.Two hundred twenty-eight patients with left ventricular ejection fraction 35% and an ICD implanted were followed-up prospectively. Patients divided into two subgroups according to presence of appropriate ICD shocks (Group 1: 112 patients with ICD shocks, Group 2: 116 patients without shocks). End points were appropriate ICD therapy due to ventricular tachycardia (VT)/ventricular fibrillation (VF), death, and a combined end point of VT/VF or death.During a mean follow-up of 22.3 7.7 months, appropriate ICD shocks were observed in 112 of 228 patients (49.1%). The mean duration of the Tp-e Group 1 was significantly longer than Group 2 (115.3 22.2 vs 104.7 20.2 ms, P < 0.001). Ischemic etiology and Tp-e duration were found to be independent predictors of ICD therapy. When the patients were divided into two groups based on Tp-e interval, there was no significant difference regarding the mortality between groups (21.2% vs 21.8%, P: 0.186). However, appropriate ICD shocks due to VT/VF (37.5% vs 58.8%, P < 0.001) and combined end point (39.4% vs 64.5%, P: 0.002) were significantly higher in patients with longer Tp-e group.Tp-e interval independently predicts appropriate ICD shocks in patients with systolic dysfunction and ICDs implanted for primary prevention.


PubMed | Hacettepe University and Turkey Yuksek Ihtisas Training and Research Hospital
Type: | Journal: Thrombosis research | Year: 2016

The interaction of platelets with leukocytes is a well-known process both in progression and prognosis of acute pulmonary embolism (PE). Recently, platelet to lymphocyte ratio (PLR) is emerged as an indirect inflammatory indicator which was shown to be associated with adverse cardiovascular events in various clinical conditions, including acute PE. However, the long-term prognostic value of PLR in acute PE has not been investigated thoroughly. Therefore, we aimed to assess the impact of PLR on both in-hospital and long-term adverse outcomes in acute PE.A total of 459 patients with definite diagnosis of acute PE between January 2009 and January 2016 were enrolled. On admission, blood sampling to calculate PLR and detailed clinical data were obtained. Patients were divided into tertiles according to the admission PLR levels. Simplified PE severity index (sPESI) score and computerized tomography (CT) based pulmonary artery obstruction index were calculated for each patient.Mean sPESI score of the study population was 1.6. A total of 34 patients (7.4%) died during index hospitalization. At median 28.8months follow-up, all-cause mortality was observed in 81 patients (1.9%). Patients in the highest tertile of PLR revealed a higher rate of in-hospital adverse events including cardiogenic shock, the necessity for thrombolytic therapy and in-hospital mortality as well as long-term all-cause mortality. In multivariate analysis, the PLR was found to be a significant predictor of both in-hospital adverse events (OR: 1.588, 95% CI:1.116-2.154, p=0.004) and long-term all-cause mortality (OR:1.746, 95% CI:1.211-2.865, p=0.001).The PLR, as a simple, inexpensive and available marker of inflammatory and prothrombotic status, seemed to be a novel predictor of in-hospital and long-term adverse outcomes in patients with acute PE.


PubMed | Istanbul University and Turkey Yuksek Ihtisas Training and Research Hospital
Type: | Journal: Heart, lung & circulation | Year: 2016

Antegrade cerebral perfusion in aortic surgery is a well-established brain protection method. Open distal anastomosis during aortic surgery has some well-known advantages. Antegrade cerebral perfusion allows repair to some extent of the aortic arch, even in isolated ascending aortic aneurysm. The present study aims to investigate the adequacy of contralateral perfusion with novel oxidative stress parameters during unilateral antegrade cerebral perfusion.The study included 30 consecutive patients undergoing thoracic aortic surgery with unilateral antegrade cerebral perfusion (uACP) under moderate hypothermia (28 C). Blood samples from right and left jugular vein were obtained at four time intervals during surgery (after the anaesthetic induction - Phase 1, at the beginning of cardiopulmonary bypass - Phase 2, 15Mean unilateral antegrade cerebral perfusion time was observed to be 16.45.9min (9 - 46min). No significant differences between right and left hemispheres were observed in novel oxidative parameters or biochemical values. There was only one temporary neurological deficit (3.3%) in the patient group.The present study demonstrated that open distal anastomosis for hemiarch repair can be performed safely with unilateral antegrade cerebral perfusion under moderate hypothermia with both clinical outcome and novel biomarkers.


PubMed | Turkey Yuksek Ihtisas Training and Research Hospital
Type: Journal Article | Journal: Inflammatory bowel diseases | Year: 2016

We aimed to identify the levels of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and interleukin 17A (IL-17A) in inflammatory bowel disease (IBD) and to examine their relationship with disease activity.A total of 92 patients with IBD, in which 54 patients were diagnosed with ulcerative colitis and 38 patients with Crohns disease (CD), and 104 healthy controls were included in the study. The Rachmilewitz endoscopic activity index was calculated in ulcerative colitis, and the CD activity index was calculated in CD.sTWEAK (P < 0.001) and IL-17A (P = 0.006) levels were higher in the IBD group than in the control group. Both in the IBD group and ulcerative colitis and CD subgroups, in active patients, sTWEAK and IL-17A levels were found to be higher than in inactive and control groups. In the IBD group, a positive correlation was determined between sTWEAK and IL-17A, and C-reactive protein, endoscopic activity index, and CD activity index. In multivariable regression analysis, C-reactive protein and sTWEAK levels were determined to be an independent risk factor for both endoscopic activity index and CD activity index. In receiver operating curve analysis, the sTWEAK level was determined to predict IBD with high sensitivity and specificity with a value of >588.34 pg/mL and activity with a value of >669.28 pg/mL.Based on these results, we ascertain that sTWEAK has a role in etiopathogenesis of IBD. In addition, we believe that sTWEAK could be used as a marker for both disease activity criteria and treatment monitoring.


PubMed | Turkey Yuksek Ihtisas Training and Research Hospital
Type: | Journal: International braz j urol : official journal of the Brazilian Society of Urology | Year: 2016

A 34 year-old woman was admitted to our hospital with left flank pain. A non-contrast enhanced computerized tomography (NCCT) revealed a 1.5x2cm left proximal ureter stone. Patient was scheduled for ureterorenoscopy (URS) and stone removal. She was submitted to retrograde intrarenal surgery (RIRS). At the postoperative 1st day, the patient began to suffer from left flank pain. A NCCT was taken, which revealed a subcapsular hematoma and perirenal fluid. The patient was managed conservatively with intravenous fluid, antibiotic and non-steroidal anti-inflammatory drug therapy and was discharged at the postoperative 6th day. Two weeks after the discharge the patient was admitted to emergency department with severe left flank pain, palpitation and malaise. KUB (kidney-ureter-bladder) radiography showed double-J stent (DJS) to be repositioned to the proximal ureter. Patient was evaluated with contrast enhanced CT which revealed an 8cm intraparenchymal hematoma/abscess in the middle part of the kidney. A percutaneous drainage catheter was inserted into the collection. The percutaneous drainage catheter and the DJS were removed at the 10th day of second hospitalization. RIRS surgery is an effective and feasible choice for renal stones with high success and acceptable complication rates. However, clinician should be alert to possible complications.


PubMed | Ankara Ataturk Training and Research Hospital, Ataturk Heart Diseases and Thoracic Surgery Training and Research Hospital, Diskapi Yildirim Beyazit Training and Research Hospital and Turkey Yuksek Ihtisas Training and Research Hospital
Type: | Journal: The clinical respiratory journal | Year: 2016

The relationship between inflammation and mortality after acute pulmonary embolism (APE) has previously been investigated with different variables (platelet/lymphocyte ratio, etc).We investigated the predictive value of lymphocyte to monocyte ratio (LMR) for mortality in first 30 days after APE.The study population included 264 APE patients of which 230 patients were survivors, 34 patients were non-survivors.LMR was significantly lower in non-survivors after APE (P<.001). Neutrophil-to-lymphocyte ratio (NLR) was higher in non-survivors after APE (P<.001). Platelet-to-lymphocyte (PLR) had no significance between both groups (P: .241). Simplified pulmonary embolism severity index and LMR were independent predictors of mortality in patients with APE (P: .008 and P: .001, respectively).LMR as a novel marker of inflammation seemed to be an independent predictor of short-term mortality in patients with APE.

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