PubMed İndeksli Yayınlar Koleksiyonu

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Ability of Cha2ds2-vasc/R2cha2ds2-vasc Scores To Predict Complications Related To Cardiac Implantable Electronic Devices
(Wiley, 2025) Soner, Serdar; Aktan, Adem; Aktan, Adem; Kilic, Raif; Guzel, Hamdullah; Tastan, Ercan; Oksul, Metin; Guzel, Tuncay; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
BackgroundGlobally, the number of cardiac implantable electronic devices (CIEDs) is increasing. In our study, we aimed to investigate whether CHA(2)DS(2)-VASc and R(2)CHA(2)DS(2)-VASc scores are predictive of CIED-related complications. MethodsOur investigation was carried out with a multicenter retrospective design. Patients who underwent CIED surgery at two cardiac centers in Turkey between January 2011 and May 2023, 1676, were evaluated. The patients were divided into two groups according to their R(2)CHA(2)DS(2)-VASc scores. Patients with R(2)CHA(2)DS(2)-VASc >= 5 were included in group 1 (380 patients), and patients with R(2)CHA(2)DS(2)-VASc < 5 (1296 patients) were included in group 2. The primary outcome was defined as the cumulative events. Each component of cumulative events, such as hematoma, pericardial effusion, pneumothorax, and infection, was also defined as a secondary outcome. ResultsThe study's patient population had an average age of 62.9 +/- 14 years. Pneumothorax (1.8% vs. 1.3%, p = 0.444), pericardial effusion or tamponade (0.35% vs. 0.2%, p = 0.659), and clinically significant hematoma (1.1% vs. 0.6%, p = 0.376) were comparable between the groups. Infection-related devices and cumulative events classified as primary outcomes were higher in the R(2)CHA(2)DS(2)-VASc >= 5 group (6.1% vs. 1.2%, p < 0.001; 7.6% vs. 3.2%, p < 0.001, respectively). Modeling analyses showed that the CHA(2)DS(2)-VASc score and HT were also independent predictors of device-related infection and cumulative events. ConclusionIn the R(2)CHA(2)DS(2)-VASc >= 5 groups, infection related to the device system and cumulative events were higher. Patients with an R(2)CHA(2)DS(2)-VASc score of 5 or more and a high CHA(2)DS(2)-VASc score should be evaluated more carefully regarding infection and cumulative events before and after the operation.
Acute Cyanide Intoxication Due To Apricot Seed Ingestion
(Soc Argentina Pediatria, 2024) Talay, Mehmet Nur; Orhan, Özhan; Orhan, Ozhan; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Introduction : Cyanide poisoning, whether it be accidental or intentional, remains a significant danger to adults and children, especially in societies where agriculture is a primary source of income. We examined the clinical follow-up, complications, and results of cyanide poisoning cases that occurred after eating the pits and seeds of plants containing cyanide glycosides, such as apricot kernels and almonds. Methods : Between 01/01/2017 and 01/08/2022, 14 children aged 1-18 years who were followed up with a prediagnosis of cyanide poisoning in our Paediatric Intensive Care Unit (PICU) were retrospectively analysed. Results : Eight of the patients followed with a preliminary diagnosis of cyanide poisoning were female and six were male. The most common admission month was July (42.8%) coinciding with the agricultural season. The most common symptoms at presentation were weakness and fatigue (n = 7). In the PICU, 4 patients presented lip cyanosis; 3, altered level of consciousness. Vomiting, seizure, headache, dizziness and palpitatons were less frequent. Four patients were treated with hydroxocobalamin (Cyanokit (R) ) as an antidote due to acidosis in their blood gases. All patients treated for cyanide poisoning were discharged. Conclusions : Cyanide poisoning should be considered in paediatric patients with suspicious findings, sudden loss of consciousness, increased anion gap acidosis and lactic acidosis. The history of eating the seeds of plants such as apricot and almonds should be investigated .
Citation - WoS: 2
Citation - Scopus: 2
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(Springer, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background: In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥ 75 years) than in younger (< 75 years) patients. Methods: This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results: The overall sample included 1923 patients (1419 < 75 years and 504 aged ≥ 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the ≥ 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age ≥ 75 years and infection related to the device system. Conclusion: Infection rates were relatively higher in the patient group aged ≥ 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
Citation - WoS: 3
Citation - Scopus: 3
An Examination of the Effects of Propolis and Quercetin in a Rat Model of Streptozotocin-Induced Diabetic Peripheral Neuropathy
(Mdpi, 2024) Şeker, Uğur; Celik, Hakim; Dagli, Seyda Nur; Taskin, Seyhan; Seker, Ugur; Deniz, Mustafa; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
The purpose of this study was to reveal the combined effects of propolis (P) and quercetin (Q) against diabetic peripheral neuropathy developing with streptozotocin-induced diabetes in rats. Sixty-four adult male rats were divided into eight equal groups: control, P (100 mg/kg/day), Q (100 mg/kg/day), P + Q (100 mg/day for both), diabetes mellitus (DM) (single-dose 60 mg/kg streptozotocin), DM + P, DM + Q, and DM + P + Q. The rats were sacrificed, and blood and sciatic nerve tissues were collected. Blood glucose and malondialdehyde (MDA) levels increased, while IL-6 and total antioxidant status decreased in the DM group (p = 0.016 and p = 0.047, respectively). Ultrastructural findings showed degeneration of the axon and myelin sheath. The apoptotic index (AI %), TNF-alpha, and IL-1 beta immunopositivity increased significantly in the DM group (p < 0.001). Morphological structures approaching those of the controls were observed in the DM + P, DM + Q, and DM + P + Q groups. Morphometric measurements increased markedly in all treatment groups (p < 0.001), while blood glucose and MDA levels, AI (%), TNF-alpha, and IL-1 beta immunopositivity decreased. In conclusion, the combined effects of propolis and quercetin in diabetic neuropathy may provide optimal morphological protection with neuroprotective effects by reducing hyperglycemia, and these may represent a key alternative supplement in regenerative medicine.
Citation - WoS: 1
Citation - Scopus: 1
Antibiotic Resistance and Mortality in Icu Patients: a Retrospective Analysis of First Culture Growth Results
(Mdpi, 2025) Kılınç, Metin; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Objectives: This study aimed to analyze the antibiotic resistance patterns of microorganisms isolated from intensive care unit (ICU) patients and evaluate their impact on mortality and length of ICU stay. Given the increasing prevalence of multidrug-resistant (MDR) pathogens in critically ill patients, understanding their resistance profiles is crucial for optimizing empirical antibiotic therapy and improving patient outcomes. Methods: This retrospective study included 237 ICU patients admitted between 1 July 2022, and 1 January 2024. The initial culture growth results from blood and urine samples were analyzed. Microorganism identification was performed using VITEK 2 Compact and conventional bacteriological methods, while antibiotic susceptibility testing followed CLSI 2022 and EUCAST 2022 guidelines. Results: A total of 237 ICU patients were included in this study. The most frequently isolated microorganisms were Escherichia coli (E. coli) (44.3%), Klebsiella pneumoniae (K. pneumoniae) (35.0%), and Pseudomonas aeruginosa (P. aeruginosa) (25.3%), with Acinetobacter baumannii (A. baumannii) (31.2%) being the most resistant pathogen. Among Gram-positive bacteria, methicillin-resistant Staphylococcus aureus (MRSA) (12.2%) and vancomycin-resistant enterococci (VRE) (21.5%) were the most frequently identified multidrug-resistant (MDR) pathogens. Regarding antimicrobial resistance, carbapenem resistance was highest in A. baumannii (55%), followed by P. aeruginosa (40%) and K. pneumoniae (30%). Additionally, ESBL-producing E. coli (43.2%) and K. pneumoniae (38.5%), as well as carbapenemase-producing K. pneumoniae (18.6%) and E. coli (9.2%), were identified as key resistance mechanisms impacting clinical outcomes. Patients with MDR infections had significantly longer ICU stays (p < 0.05) and higher mortality rates. The Kaplan-Meier survival analysis revealed that A. baumannii infections were associated with the highest mortality risk (HR: 4.6, p < 0.001), followed by MRSA (HR: 3.5, p = 0.005) and P. aeruginosa (HR: 2.8, p = 0.01). Among laboratory biomarkers, elevated procalcitonin (>= 2 ng/mL, OR: 2.8, p = 0.008) and CRP (>= 100 mg/L, OR: 2.2, p = 0.01) were significantly associated with ICU mortality. Additionally, patients who remained in the ICU for more than seven days had a 1.4-fold increased risk of mortality (p = 0.02), further emphasizing the impact of prolonged hospitalization on adverse outcomes. Conclusions: MDR pathogens, particularly A. baumannii, MRSA, P. aeruginosa, and K. pneumoniae, are associated with longer ICU stays and higher mortality rates. Carbapenem, cephalosporin, fluoroquinolone, and aminoglycoside resistance significantly impact clinical outcomes, emphasizing the urgent need for antimicrobial stewardship programs. ESBL, p-AmpC, and carbapenemase-producing Enterobacterales further worsen patient outcomes, highlighting the need for early infection control strategies and optimized empirical antibiotic selection. Biomarkers such as procalcitonin and CRP, alongside clinical severity scores, serve as valuable prognostic tools for ICU mortality.
Antidepressant-Like Effects of Ashwagandha (Withania Somnifera) on Chronic Unpredictable Mild Stress-Induced Depression in Adolescent Rats
(Springer, 2025) Gökdemir, Gül Şahika; Şeker, Uğur; Gökdemir, Mehmet Tahir; Baylan, Mukadder; Demirtas, Berjan; Gokdemir, Mehmet Tahir; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
RationaleAdolescent depression is often linked to biological changes associated with stress. However, new approaches and treatment strategies for early intervention and prevention of depression in children and adolescents are still limited. Ashwagandha is an Ayurvedic herb widely used in the management of anxiety and stress. However, there is no information in the current literature on its potential effect on adolescent depression.ObjectivesThis study aimed to investigate the effects of depression on proapoptotic proteins and neuroinflammation and the antidepressant effect of Ashwagandha on depression-like symptoms in adolescent rats exposed to the Chronic Unpredictable Mild Stress (CUMS) model.MethodsIn the study, CUMS model was used to induce depression in adolescent rats. Rats were treated with Ashwagandha or Sertraline. To evaluate the antidepressant effects, behavioral tests as well as biochemical and histological analyses were performed. Forced Swim Test (FST), Sucrose Test and Elevated Plus Maze Test were performed as behavioral tests. Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were measured by the ELISA method in the fronto-parietal cortex. Proapoptotic proteins (Bax and Caspase-3) and inflammatory markers (TNF-alpha and IL-1 beta), as well as glial fibrillary acidic protein (GFAP), were evaluated immunohistochemically in the fronto-parietal cortex.ResultsProapoptotic proteins (Bax and Caspase-3) and inflammatory markers (TNF-alpha and IL-1 beta) were increased in the CUMS group. BDNF and GFAP levels were decreased. Ashwagandha treatment was more effective than Sertraline in reducing the levels of these proteins and markers. Additionally, Ashwagandha prevented weight loss.ConclusionsAshwagandha showed antidepressant-like effects in adolescent rats, reducing apoptosis, inflammation, and neuroinflammation, suggesting potential for treating adolescent depression.
Citation - WoS: 1
Citation - Scopus: 1
Assessing the Prognostic Value of Halp Score in Peripheral Artery Disease: Correlation With Lesion Severity and Long-Term Mortality
(Sage Publications Ltd, 2025) Aktan, Adem; Aktan, Adem; Kilic, Raif; Yalcin, Abdulaziz; Ozbek, Mehmet; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Introduction Peripheral artery disease (PAD) poses a growing clinical challenge due to an aging population, despite advances in treatment methods. Various scoring systems have emerged to predict high-risk patients, including the HALP (hemoglobin, albumin, lymphocyte, and platelet) score, known for predicting prognosis in cancers and stroke. This study assesses the HALP score's relation to lesion severity and long-term mortality in PAD patients. Methods We retrospectively analyzed 305 symptomatic PAD patients undergoing endovascular intervention. The following formula was used to calculate the HALP score: hemoglobin (g/L) x albumin (g/L) x lymphocyte count (/L) / platelet count (/L). Lesion severity was classified by TASC-II: TASC AB and TASC CD. Mortality data were obtained from hospital and social security records. Results The study involved 305 patients (mean age 64.4 +/- 11.8 years; 72.1% male), divided into survivors (208) and non-survivors (97). ROC analysis identified HALP score as the strongest predictor of long-term mortality (AUC: 0.736; 95% CI: 0.679-0.793; p < .001). HALP score (HR, 0.087; 95% CI, 0.025-1.300; p < .001), age (p < .001), DM (p = .007), and CRP (p = .013) independently predicted mortality. Kaplan-Meier analysis showed higher HALP scores linked to lower long-term mortality (Log-rank: 20.102, p < .001), with an average follow-up of 48 +/- 18 months. Conclusion The HALP score emerged as a robust predictor of PAD prognosis, surpassing individual components and other parameters. Lower HALP scores correlated with more severe lesions and reduced life expectancy.
Citation - WoS: 1
Citation - Scopus: 1
Assessment of Iron Metabolism and Inflammation in Children With Cerebral Palsy
(Mdpi, 2025) Orhan, Özhan; Gökdemir, Gül Şahika; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background/Objectives: Cerebral palsy (CP) is a motor disorder resulting from brain damage that is common in childhood. Iron is vital for the body's basic functions. Iron metabolism disorders and inflammation contribute to the neurological complications seen in CP. The purpose of this research was to ascertain the association and correlation between markers of inflammation and iron metabolism in children with CP. Methods: A total of 181 children diagnosed with CP and 111 typically developing children were retrospectively included in the study. Demographic data, blood parameters, C-reactive protein, iron, total iron binding capacity, and inflammation markers were evaluated. Results: C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and systemic immuno-inflammatory index (SII) levels of CP children were found to be statistically significantly higher than those of control group children (p < 0.05). Iron (Fe) and ferritin levels were lower in the CP group, while total iron binding capacity (TIBC) was higher. Spearman correlation analysis showed significant correlations between iron, ferritin and TIBC and SII. Conclusions: Iron deficiency and chronic inflammation are associated with the pathophysiology of CP in patients with CP, and therefore it is important to monitor markers of iron metabolism and inflammation in these patients.
Association Between Abo Blood Group, Peripheral Artery Disease Lesion Severity, and Coronary Artery Disease Coexistence
(Elsevier Science inc, 2025) Aktan, Adem; Aktan, Adem; Kilic, Raif; Ozbek, Mehmet; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background: This study aims to investigate the relationship between ABO blood groups and the severity of peripheral artery disease (PAD) lesions, the coexistence of coronary artery disease (CAD) with PAD, and to identify which blood groups may be more predisposed to these conditions. Methods: This study, which has a single-center and retrospective design, includes 305 patients diagnosed with peripheral artery disease (PAD) between 2015 and 2021. The patients were selected from those with at least 50% stenosis detected by computed tomography (CT) angiography. The severity of PAD lesions was evaluated according to the TransAtlantic Inter-Society Consensus (TASC-II) classification, and the presence of CAD was determined by simultaneous conventional coronary angiography. Demographic data, comorbidities, and laboratory results were collected, and statistical analyses were performed using chi-square tests, logistic regression, and t-tests. All of these patients were divided into 2 groups based on their ABO blood types: O and non-O blood groups. Results: This study demonstrates a significant relationship between blood group classification and both the severity of PAD and the prevalence of CAD. Patients with non-O blood groups exhibited a higher likelihood of having severe PAD lesions (TASC-C and TASC-D) compared to those with O blood groups, who more frequently had milder lesions (TASC-A and TASC-B) (P < 0.001). The prevalence of CAD was also significantly higher among patients with non-O blood groups than those with the O blood group (54.4% vs. 36.4%; P = 0.003). In the logistic regression analysis, non-O blood groups, alongside age, hypertension (HT), and chronic kidney disease (CKD), emerged as independent predictors of severe PAD (P < 0.001 for non-O blood groups). Similarly, older age and non-O blood group status were identified as significant independent predictors of CAD (P = 0.004). These findings suggest that blood group classification, particularly non-O groups, may influence the severity and coexistence of PAD and CAD. Conclusion: Our study reveals a significant association between ABO blood groups and both the severity of PAD and the association of CAD, and shows that non-O blood groups are linked to more severe forms of these conditions. These findings highlight the potential role of ABO blood groups in cardiovascular risk stratification, suggesting a need for further research to confirm these associations and understand their clinical implications.
Citation - WoS: 1
Citation - Scopus: 1
Association Between the Triglyceride-Glucose Index and Contrast-Induced Nephropathy in Chronic Total Occlusion Patients Undergoing Percutaneous Coronary Intervention
(Bmc, 2025) Aktan, Adem; Aktan, Adem; Kilic, Raif; Guzel, Hamdullah; Tastan, Ercan; Oksul, Metin; Guzel, Tuncay; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Objective The triglyceride glucose (TyG) index is a biomarker of insulin resistance and is associated with an increased risk of cardiovascular events. Contrast-induced nephropathy (CIN) is an important complication that causes poor outcomes in patients undergoing percutaneous coronary intervention (PCI). In this study, we aimed to investigate the relationship between the TyG index and CIN and mortality in patients who underwent PCI due to chronic total coronary occlusion (CTO). Methods Two hundred eighteen individuals from three separate medical centers who underwent procedural PCI between February 2010 and April 2012 and had a CTO lesion in at least one coronary artery were recruited. According to the TyG index, patients were divided into two groups. Patients with a TyG index >= 8.65 were included in Group 1, and patients with a TyG index < 8.65 were included in Group 2. Patients were followed up for 96 months. The main outcome was the development of CIN and mortality. Results The mean age of the patients (65.8 +/- 10.94 vs. 61.68 +/- 11.4, P = 0.009), diabetes mellitus (60 [44.8%] vs. 11 [13.1%], P < 0.001), and dyslipidemia rates (52 [38.8%] vs. 21 [25%], P = 0.036) were higher in group 1. In multivariable logistic regression analysis, it was seen that age (OR = 1.04, 95% CI = 1.01-1.08, P = 0.020), chronic kidney disease (OR = 2.34, 95% CI = 1.02-5.33, P = 0.044), peripheral artery disease (OR = 5.66, 95% CI = 1.24-25.91, p = 0.026), LVEF (OR = 0.95, 95% CI = 0.92-0.99, P = 0.005), LDL cholesterol levels (OR = 1.00, 95%CI = 1.00-1.02, P = 0.024) and TyG index (OR = 2.17, 95% CI = 1.21-3.89, P = 0.009) were independent predictors of the development of CIN. Conclusion Our study demonstrates a correlation between the TyG index and the prevalence of CIN in patients with CTO undergoing PCI. Adding the TyG index to the routine clinical evaluation of patients with CTO undergoing PCI may help protect patients from the development of CIN.
Citation - WoS: 6
Citation - Scopus: 5
The association of allergic rhinitis severity with neutrophil-lymphocyte and platelet-lymphocyte ratio in children
(Northern Clinics of İstanbul, 2022) Sarı, Neslihan; Sarı, Neslihan; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Objective: The aim of the study was to investigate the relationship between the severity of allergic rhinitis (AR) and neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in pediatric patients. Methods: This study is a retrospective, cross-sectional, and observational study including 200 AR patients and 160 healthy controls. Of the patients, 39% were boys with a mean age of 10.5 years. The study included children with persistent and intermittent AR. Of the controls, 50.6% were boys with a mean age of 10.3 years. We compared NLR and PLR from blood test between study and control groups. They were also compared according to AR severity within the patient group. Results: The NLR was 1.64±1.29 in the study group whereas 1.18±0.31 in the control group. The PLR was 102.72±31.20 in the study group whereas 79.36±11.72 in the control group. When NLR and PLR were compared between groups, we found statistically significant differences in both NLR and PLR (p=0.003, p=0.001, respectively). We found a statistically significant difference when comparing both NLR and PLR in patients with intermittent and persistent AR. These rates increased with disease severity (p=0.000, p=0.000, respectively). Conclusion: Both NLR and PLR are useful markers for the diagnosis and severity of AR. Clinicians can use these markers to assess disease severity in pediatric patients at the beginning of the diagnostic process.
Citation - WoS: 2
Citation - Scopus: 2
Association of Inflammatory and Metabolic Markers With Mortality in Patients With Postoperative Femur Fractures in the Intensive Care Unit
(Mdpi, 2025) Akelma, Hakan; Celik, Enes; Kılınç, Metin; Aydemir, Semih; Akelma, Hakan; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background and Objectives: Postoperative femur fracture in elderly patients is associated with high morbidity and mortality, especially in the intensive care unit (ICU). Various factors, including demographic and laboratory parameters, may influence mortality in this population. The aim of this study was to evaluate the association of inflammatory and metabolic markers with mortality in ICU patients with postoperative femur fractures and to identify key predictors to enhance risk stratification and improve patient outcomes. Materials and Methods: In this retrospective single-center study, we analyzed 121 patients aged over 65 years with postoperative femur fractures who were admitted to the ICU between January 2023 and January 2024. Demographic and clinical data, including comorbidities, Charlson Comorbidity Index (CCI), and Acute Physiology and Chronic Health Evaluation (APACHE II) score, were collected. Laboratory parameters such as white blood cell count (WBC), albumin, C-reactive protein (CRP), D-dimer, Pan-Immune-Inflammation Value (PIV), CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and others were analyzed. Linear regression, logistic regression, and Receiver Operating Characteristic (ROC) analyses were performed to determine the predictive value of these markers for ICU mortality. Results: The mean age of the patients was 76.3 +/- 9.6 years, and 52.1% were female. The most common comorbidities were hypertension (67.8%) and diabetes (49.6%). ICU mortality occurred in 24 patients (20%). Significant predictors of mortality included higher CRP (>62.8 mg/L), NLR (>10.0), PIV (>450), and APACHE II scores (>23) (p < 0.001 for all). Lower albumin levels (<2.5 g/dL) were strongly associated with increased mortality (p < 0.001). ROC analysis demonstrated that the APACHE II score had the highest predictive accuracy for mortality (AUC = 0.83), followed by albumin (AUC = 0.79) and PIV (AUC = 0.76). Extended ICU stay (>10 days) was also significantly correlated with increased mortality (p < 0.001). Conclusions: This study successfully demonstrates the utility of combining traditional clinical markers, such as APACHE II score, with novel inflammatory markers, such as PIV, CAR, and NLR, in predicting mortality in ICU patients following femur fracture surgery. The integration of emerging biomarkers with well-established scoring systems offers enhanced predictive accuracy and provides valuable insights into patient management.
Citation - WoS: 9
Citation - Scopus: 8
Biosensors for the Detection of Pathogenic Bacteria: Current Status and Future Perspectives
(Taylor and Francis Ltd., 2024) Dicle, Yalçın; Karamese, M.; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Pathogenic microorganisms pose significant threats to human health, food safety and environmental integrity. Rapid and accurate detection of these pathogens is essential to mitigate their impact. Fast, sensitive detection methods such as biosensors also play a critical role in preventing outbreaks and controlling their spread. In recent years, biosensors have emerged as a revolutionary technology for pathogen detection. This review aims to present the current developments in biosensor technology, investigate the methods by which these developments are used in the detection of pathogenic bacteria and highlight future perspectives on the subject. © 2024 Expert Publishing Medicine Ltd trading as Taylor & Francis.
Citation - Scopus: 2
Bronchiectasis in Türkiye: Data from a Multicenter Registry (Turkish Adult Bronchiectasis Database)
(Galenos Publ House, 2024) Kabak, Mehmet; Cilli, Aykut; Kızılırmak, Deniz; Coşkun, Ayşın Şakar; Güler, Nurcan; Çiçek, Sedat; Researchers, Tebveb; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background: Bronchiectasis is a chronic lung disease characterized by permanent bronchial wall dilatation. Although it has been known as an orphan disease, it has recently gained attention because of registry-based studies and drug research. Aims: We aimed to use a multicenter database to analyze and compare data regarding the etiology, associated comorbidities, microbiological characteristics, and preventive strategies of bronchiectasis in Türkiye to those of other countries. Study Design: A multicenter prospective cohort study. Methods: The multicenter, prospective cohort study was conducted between March 2019 and January 2022 using the Turkish Adult Bronchiectasis Database, in which 25 centers in Türkiye participated. Patients aged > 18 years who presented with respiratory symptoms such as cough, sputum, and dyspnea and were diagnosed with non-cystic fibrosis bronchiectasis using computed tomography were included in the study. Demographic information, etiologies, comorbidities, pulmonary functions, and microbiological, radiological, and clinical data were collected from the patients. Results: Of the 1,035 study participants, 518 (50%) were females. The mean age of the patients was 56.1 ± 16.1 years. The underlying etiology was detected in 565 (54.6%) patients. While postinfectious origin was the most common cause of bronchiectasis (39.5%), tuberculosis was identified in 11.3% of the patients. An additional comorbidity was detected in 688 (66.5%) patients. The most common comorbidity was cardiovascular disease, and chronic obstructive pulmonary disease (COPD) and bronchiectasis was identified in 19.5% of the patients. The most commonly detected microbiological agent was Pseudomonas aeruginosa (29.4%). Inhaled corticosteroids (ICS) were used in 70.1% of the patients, and the frequency of exacerbations in the last year was significantly higher in patients using ICS than in nonusers (p < 0.0001). Age [odds ratio (OR): 1.028; 95% confidence interval (CI): 1.005-1.051], cachexia (OR: 4.774; 95% CI: 2,054-11,097), high modified medical research council dyspnea scale score (OR: 1,952; 95% CI: 1,459-2,611), presence of chronic renal failure (OR: 4,172; 95% CI: 1,249-13,938) and use of inhaled steroids (OR: 2,587; 95% CI: 1,098-6,098) were significant risk factors for mortality. Mortality rates were higher in patients with COPD than in those with no COPD (21.7-9.1%, p = 0.016). Patients with bronchiectasis and COPD exhibited more frequent exacerbations, exacerbation-related hospitalizations, and hospitalization in the intensive care unit in the previous year than patients without COPD. Conclusion: This is the first multicenter study of bronchiectasis in Türkiye. The study results will provide important data that can guide the development of health policies in Türkiye on issues such as infection control, vaccination, and the unnecessary use of antibiotics and steroids.
Can Serum Biomarker Values from Second-Trimester Aneuploidy Screening Predict the development of Retinopathy of Prematurity in Premature Infants?
(Kare Publishing, 2024) Sabanci, S.; Savaş, Hasan Basri; Kucuk, M.F.; Savas, H.B.; Suren, E.; Erol, M.K.; Yavuz, A.; Sipahioglu, H.; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Objectives: This study aimed to evaluate serum biomarker values measured during second-trimester aneuploidy screening in terms of their predictive ability for the development of retinopathy of prematurity (ROP) in premature infants. Methods: This retrospective cohort study evaluated the data of 1985 idiopathic premature infants who underwent ROP screening from 2016 to 2022. The infants were divided into two groups according to the presence of ROP, and those with ROP were further evaluated in two subgroups based on the presence of proliferation. Comparisons were made concerning the serum multiple of the median values of unconjugated estriol (uE3), human chorionic gonadotropin (hCG), and alpha-fetoprotein (AFP) among aneuploidy screening biomarkers. Results: While 1628 premature infants were in the non-ROP group, 357 were in the ROP group. Of the infants with ROP, 72 were in the proliferative ROP group and 285 in the non-proliferative ROP group. There was no significant difference in the multiple of the median values of the evaluated serum biomarkers (uE3, hCG, and AFP) between the ROP and non-ROP groups or between the proliferative ROP, non-proliferative ROP, and non-ROP groups. Conclusion: The multiple of the median values of second-trimester aneuploidy screening serum biomarkers were not able to predict the development of ROP in premature infants. This result may have been caused by the fact that the blood tests were taken only once and in the same weeks. © 2024 Kare Publishing. All rights reserved.
Citation - WoS: 2
Citation - Scopus: 3
Clinical and Genetic Spectrum of Myotonia Congenita in Turkish Children
(Sage Publications inc, 2023) Tuncer, Gokcen Oz; Özgün, Nezir; Sanri, Aslihan; Aydin, Seren; Herguner, Ozlem M.; Ozgun, Nezir; Komur, Mustafa; Aksoya, Ayse; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background: Myotonia congenita is the most common form of nondystrophic myotonia and is caused by Mendelian inherited mutations in the CLCN1 gene encoding the voltage-gated chloride channel of skeletal muscle. Objective: The study aimed to describe the clinical and genetic spectrum of Myotonia congenita in a large pediatric cohort. Methods: Demographic, genetic, and clinical data of the patients aged under 18 years at time of first clinical attendance from 11 centers in different geographical regions of Turkiye were retrospectively investigated. Results: Fifty-four patients (mean age:15.2 years (+/- 5.5), 76% males, with 85% Becker, 15% Thomsen form) from 40 families were included. Consanguineous marriage rate was 67%. 70.5% of patients had a family member with Myotonia congenita. The mean age of disease onset was 5.7 (+/- 4.9) years. Overall 23 different mutations (2/23 were novel) were detected in 52 patients, and large exon deletions were identified in two siblings. Thomsen and Becker forms were observed concomitantly in one family. Carbamazepine (46.3%), mexiletine (27.8%), phenytoin (9.3%) were preferred for treatment. Conclusions: The clinical and genetic heterogeneity, as well as the limited response to current treatment options, constitutes an ongoing challenge. In our cohort, recessive Myotonia congenita was more frequent and novel mutations will contribute to the literature.
Citation - WoS: 1
The Clinical and Laboratory Features of Patients With Triple a Syndrome: a Single-Center Experience in Turkey
(Springer, 2023) Özbek, Mehmet Nuri; Unal, Edip; Tekmenuray-Unal, Aysel; Tas, Funda Feryal; Ozalkak, Servan; Cayir, Atilla; Ozbek, Mehmet Nuri; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Aim Triple-A Syndrome (TAS) is a rare autosomal recessive disorder characterized by adrenal insufficiency, achalasia, and alacrimia. This disorder is caused by mutations in the AAAS gene. The aim of this study is to discuss the clinical, laboratory and molecular genetic analysis results of 12 patients with TAS. Method We evaluated 12 patients from 8 families. Clinical and laboratory data were retrospectively collected from the medical records of the patients in the database for the period 2015-2020. All exons and exon-intron junctions of the AAAS gene were evaluated by next-generation sequencing method. Detected variants were classified according to American Collage of Medical Genetics criteria. Results Alacrimia was found in all patients (100%); achalasia was found in 10 patients (83.3%) and adrenal insufficiency was found in 10 patients (83.3%). In addition, hyperreflexia(6/12), learning disability(5/12), hypernasal speech(5/12), muscle weakness(8/12), delayed walking(7/12), delayed speech(6/12), excessive sweating(7/12), optic atrophy(1/12), epilepsy(1/12), palmoplantar hyperkeratosis(5/12), multiple dental caries(9/12), atrophy of the thenar/hypothenar muscles(4/12) and short stature(4/12) were detected. The DHEA-S levels were measured in 10 patients and were found to be low in 8 of them. In all patients, the sodium and potassium levels were found to be normal. AAAS gene sequencing revealed four previously reported c.1066_1067del (p.Leu356fs*8), c.1432 C > T (p.Arg478*), c.688 C > T (p.Arg230*), and c.1368_1372del (p.Gln456fs*38) variants and two novel homozygous c.1250-1 G > A and c.398_399 + 2del variants in the AAAS gene. Conclusion We detected two novel variants in the AAAS gene. While the classic triad is present in 66.7% of the cases, neurological dysfunction, skin and dental pathologies also occur quite frequently. The earliest and most common finding of TAS is alacrimia. Therefore, adrenal insufficiency should be investigated in all patients with alacrimia and if necessary, genetic analysis should be performed for TAS. In addition, TAS should be followed up with a multidisciplinary approach since it involves many systems.
Citation - WoS: 13
Citation - Scopus: 10
Clinical features of generalized lipodystrophy in Turkey: a cohort analysis
(Wiley Online Library, 2023) Özbek, Mehmet Nuri; Yildirim Simsir, Ilgin; Tuysuz, Beyhan; Tanrikulu, Seher; Celik Guler, Merve; Akinci, Baris; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Aim: To describe the Turkish generalized lipodystrophy (GL) cohort with the frequency of each complication and the death rate during the period of the follow-up. Methods: This study reports on 72 patients with GL (47 families) registered at different centres in Turkey that cover all regions of the country. The mean ± SD follow-up was 86 ± 78 months. Results: The Kaplan-Meier estimate of the median time to diagnosis of diabetes and/or prediabetes was 16 years. Hyperglycaemia was not controlled in 37 of 45 patients (82.2%) with diabetes. Hypertriglyceridaemia developed in 65 patients (90.3%). The Kaplan-Meier estimate of the median time to diagnosis of hypertriglyceridaemia was 14 years. Hypertriglyceridaemia was severe (≥ 500 mg/dl) in 38 patients (52.8%). Seven (9.7%) patients suffered from pancreatitis. The Kaplan-Meier estimate of the median time to diagnosis of hepatic steatosis was 15 years. Liver disease progressed to cirrhosis in nine patients (12.5%). Liver disease was more severe in congenital lipodystrophy type 2 (CGL2). Proteinuric chronic kidney disease (CKD) developed in 32 patients (44.4%) and cardiac disease in 23 patients (31.9%). Kaplan-Meier estimates of the median time to diagnosis of CKD and cardiac disease were 25 and 45 years, respectively. Females appeared to have a more severe metabolic disease, with an earlier onset of metabolic abnormalities. Ten patients died during the follow-up period. Causes of death were end-stage renal disease, sepsis (because of recurrent intestinal perforations, coronavirus disease, diabetic foot infection and following coronary artery bypass graft surgery), myocardial infarction, heart failure because of dilated cardiomyopathy, stroke, liver complications and angiosarcoma. Conclusions: Standard treatment approaches have only a limited impact and do not prevent the development of severe metabolic abnormalities and early onset of organ complications in GL.
Comparison of Different Fixatives Effects in Histochemical Stainings of Peripheral Nerve Tissue
(Cellular and Molecular Biology Association, 2024) Şeker, Uğur; Demircioğlu, M.; Şeker, U.; Demircioğlu, İ.; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
A pathological condition in the peripheral nerve tissue, which provides the connection between the organism and the external environment, negatively affects the standard of living. The nerve tissue histotechnology is of serious importance both for scientific studies and for clinical diagnosis. The fixation, which is one of the leading procedures for histological examination of tissues, aims to preserve tissue morphology. Another essential part of the histological examination is staining process. This study, it was aimed to determine the fixative that provides optimal histological appearance in peripheral nerve tissue. Therefore, various histochemical stainings of tissues fixed with some fixatives used in practice were compared. Sciatic nerves from each rat (n=7) used in the study were fixed with different fixatives and histochemical staining was performed. In histological examination, cellular (nucleus-cytoplasm) and intercellular morphological details, staining intensity and distribution were evaluated. At the end of the study, formaldehyde was found to be the most ideal fixing agent for all stains. Although Bouin and Carnoy fixatives differed according to the staining type, their fixation quality was similar in general. Glutaraldehyde did not give as good results as other fixatives in all stainings. This study is an important technical reference for clinical and experimental studies. © 2024 Cellular and Molecular Biology Association. All rights reserved.
Citation - WoS: 1
Citation - Scopus: 1
Comparison of Evolut-R 34 Mm Valve and Smaller Evolut-R Valves in Patients Undergoing Transcatheter Aortic Valve Implantation and Determination of Mild Paravalvular Leak Predictors
(Kare Publ, 2024) Aktan, Adem; Kilic, Raif; Kılıç, Raif; Guzel, Tuncay; Aktan, Adem; Günlü, Serhat; Demir, Muhammed; Gunlu, Serhat; Arslan, Bayram; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Objective: The main purpose of this study was to evaluate and compare the in -hospital, 1 -month and 1 -year post -procedure outcomes of patients treated with Evolut-R 34 mm and Evolut-R 23/26/29 mm devices. Additionally, the study aimed to identify factors that could predict the occurrence of >= mild paravalvular leaks (PVL). Methods: Between April 2015 and May 2022, 269 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with Evolut-R 34 mm (n = 66, 24.5%) and Evolut-R 23/26/29 mm (n = 203, 75.5%) devices in a single center were retrospectively analyzed. Results: Patients in the Evolut-R 34 mm group had a lower female sex ratio (16.7% vs. 66.5%, P < .001, respectively), ejection fraction (50.7 +/- 10.1% vs. 54.5 +/- 9.3%, P = .016, respectively), and mean aortic gradient (7.4 +/- 3.3 vs. 9.2 +/- 5.0, P = .026, respectively) compared to the Evolut-R 23/26/29 mm group. The groups did not exhibit any statistically significant distinctions with regard to technical success, the need for a permanent pacemaker, occurrences of stroke, major vascular complications, PVL, major adverse cardiovascular and cerebrovascular events, or mortality. Peak velocity was confirmed as a significant pre- dictor of >= mild PVL in both patient groups in the receiver operating characteristic curve analysis. In logistic regression analysis; In patients with Evolut-R 34 mm valve, pre-TAVI aortic valve peak velocity (odds ratio (OR) = 23.202; P = .019) and calcium volume 800 Hounsfield Units (mm(3)) (OR = 1.017; P < .001) were independent predictors of >= mild PVL. Conclusion: The Evolut-R 34 mm valve has shown comparable in -hospital results with smaller valve sizes. Pre-TAVI aortic valve peak velocity and calcium volume predicted >= mild PVL in Evolut-R 34 mm patients.

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