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Aim: In this study, we aimed to compare copeptin with N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I for predicting severity and 3-month mortality in acute PE in the emergency department (ED). Material and Methods: All ED patients older than 18 years who were confirmed to have acute PE within six hours of diagnostic work-up were enrolled and prospectively screened. Risk stratification was made according to the 2014 European Society of Cardiology guideline on PE. The study endpoints were defined as 3-month mortality, presence of non-low risk PE, and presence of right ventricular (RV) dysfunction. The Mann-Whitney Ll test was used for the comparison of medians. Receiver operating characteristic curves were generated and the area under the curve (AUC) was calculated to determine the best cut-off values of copeptin and NT-proBNP. A P value < 0.05 was considered statistically significant. Results: The study enrolled 82 patients. Twelve patients who died during 3 months had higher concentrations of NT-proBNP and copeptin, but not troponin I. The AUCs of NT-proBNP and copeptin to accurately predict the 3-month mortality were 0.73 +/- 0.09 (95% CI, 0.62 - 0.82; p = 0.013) and 0.78 +/- 0.09 (95% CI, 0.68 - 0.86; p = 0.003), respectively. Low-risk patients, according to Pulmonary Embolism Severity Index, had lower concentrations of copeptin and NT-proBNP compared to intermediate-high risk patients. All three markers discriminated the presence of RV dysfunction truly. Discussion: Copeptin correlates with NT-proBNP and appears beneficial for early risk stratification of acute pulmonary embolism in the ED.

Purpose: The blink reflex (BR) is a useful electrodiagnostic method for evaluating neuropathies. The aim of our study was to investigate the role of the BR in the early diagnosis of neuropathy in simple steatosis. Material and Methods: A total of 86 subjects were enrolled in this study: 56 patients (29 female, 27 male) with simple steatosis and 30 healthy controls (17 female, 13 male). After the electrical stimulation of the supraorbital nerve, two responses in the orbicularis oculi muscle occur, the early ipsilateral response and the late bilateral response latencies, which were recorded. Results: The triglyceride levels and lipid accumulation products were higher in the patients with steatosis than in the controls. When compared to the control group, the patient group had early right ipsilateral latency, late right ipsilateral latency, late right contralateral latency, early left ipsilateral latency, late left ipsilateral latency, and late left contralateral latency. Conclusion: There is a slowdown of the BR in the steatosis stage; therefore, by performing the BR, neuropathy can be detected at an early stage in patients with steatosis., Amaç: Blink refleks (BR) nöropatileri değerlendirmek için kullanılan yararlı bir elektrodiagnostik yöntemdir. Biz bu çalışmada basit steatozda nöropatinin erken tanısında BR’in rolünü incelemeyi amaçladık. Materyal ve Metod: Çalışmaya basit steatozlu 56 hasta (29 kadın, 27 erkek) ve 30 sağlıklı kontrol (17 kadın, 13 erkek) olmak üzere toplam 86 kişi dahil edildi. Supraorbital sinirin elektriksel uyarımından sonra orbikularis okuli kasında ortaya çıkan iki cevap, erken ipsilateral cevap ve geç bilateral cevap gecikme zamanları kaydedildi. Bulgular: Trigliserid düzeyi ve lipid akümülasyon skoru steatozlu hastalarda kontrol grubundan daha yüksekti. Kontrol grubuyla karşılaştırıldığında hasta grubunda erken sağ ipsilateral gecikme, geç sağ ipsilateral gecikme, geç sağ kontralateral gecikme, erken sol ipsilateral gecikme, geç sol ipsilateral gecikme ve geç sol kontralateral gecikme zamanı uzundu. Sonuç: Steatoz aşamasında BR’de yavaşlama vardır. Steatozlu hastalarda BR ölçülerek nöropati gelişimi erken aşamada tespit edilebilir

Purpose: The protective effect of bilirubin on atherosclerotic heart disease in Gilbert\s syndrome (GS) is well known. The aim of the study was to evaluate whether the atherosclerotic risk factors such as uric acid (UA), insulin resistance, glucose and lipid profiles are reduced in patients with GS compared with healthy subjects. Material and Methods: Thirty-four male and 38 female a total of 72 GS patients and a similar age group of 72 healthy individuals (34 males and 38 females) were included in the study. Both groups were between 16-45 years old and all patients were were non-smokers and drinkers. The levels of UA, lipids, glucose, insulin and C-reactive protein (CRP) were examined. HOMA-IR index were estimated. Results: Even insignificantly, GS patients had lower levels of total cholesterol whereas high-density lipoprotein was found to be higher. Conclusion: Our results shown that in GS patients, increased bilirubin levels are associated with decrease in UA, insulin, LDL, TG, and increased HDL. In GS patients, low level of UA, insulin and lipid profile may be contributed to cardioprotective effect. [Cukurova Med J 2014; 39(3.000): 443-450]

We aimed to investigate whether CDT and 25-hydroxyvitamin D (25OHD) level are predictors for sun exposure and walking duration, and aimed to investigate whether CDT is reliable in low educated (LE) elderly. Material and Methods: A total of 185 LE patients without dementia above the age of 65 who had applied to internal medicine clinic were included in the study. The patients’ demographic data, sun exposure, walking duration, a history of coronary artery disease (CAD) and the number of falls were recorded. Clock drawing was measured using Manos scoring system. Results: The study population included 127 (68.6%) males with a mean age of 73 ± 6 years and 58 (31.4%) females with a mean age of 70 ± 5 years. According to Manos scoring system a total of 90 (48.6%) subjects had a CDT score of 0, 70 (37.9%) subjects had a CDT score of 1-9 and 25 (13.5%) subjects had a CDT score of 10. The mean vitamin D level of the patients was 18.4 ± 7.3 ng/mL. Vitamin D levels and CDT scores were predictive for sun exposure, duration of walking, number of falls and CAD. Conclusion: CDT scores of LE subjects were unreliable to demonstrate cognitive functions. This study has shown that vitamin D levels to be more potent predictor than CDT scores to demonstrate sun exposure, walking duration, numbers of falls and the incidence of CAD in LE subjects., Amaç: Saat çizme testi (SÇT) kognitif fonksiyonları değerlendirmede kullanılan kısa, pratik ve güvenli bir testtir. Biz SÇT ile 25-hidroksivitamin D seviyesinin güneşe maruziyet ve yürüme süresi için prediktif olup olmadığını ve SÇT’nin düşük eğitim düzeyli (DE) yaşlılarda güvenilir olup olmadığını araştırmayı amaçladık.Materyal ve Metod: İç hastalıkları kliniğine başvuran 65 yaş üzeri demansı olmayan 185 DE hasta bu çalışmaya dahil edildi. Hastaların demografik verileri, güneş maruziyetleri, yürüme süreleri, koroner kalp hastalığı (KKH) öyküsü ve düşme sayısı kaydedildi. SÇT, Manos skorlama sistemi kullanılarak ölçüldü. Bulgular: Çalışma populasyonu yaş ortalaması 73 ± 6 yıl olan 127 (%68.6) erkek ve yaş ortalaması 70 ± 5 yıl olan 58 (%31.4) kadın hastayı içeriyordu. Manos skorlama sistemine göre, 90 (%48.6) kişinin CDT skoru 0, 70 (%37.9) kişinin CDT skoru 1-9 arası ve 25 (%13.5) kişinin CDT skoru 10 idi. Hastaların ortalama D vitamin düzeyi 18.4 ± 7.3 ng/mL idi. D vitamin seviyesi ve SÇT skorları güneş maruziyeti, yürüme süresi ve düşme sayısı ve KKH için tahmin edici değerdeydi.Sonuç: DE kişilerin SÇT skorları bilinç fonksiyonlarını göstermede güvenilir değildir. Bu çalışma gösterdi ki DE bireylerde D vitamin seviyeleri güneş maruziyeti, yürüme süresi, düşme sayısı ve KKH sıklığını göstermede SÇT skorundan daha güçlüdür.

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459 WOS: 000355275200009 PubMed: 25957427 Introduction. Methotrexate, an antagonist of folic acid used in the treatment of many cancers and inflammatory diseases, is associated with side effects that limit its usage. Infliximab has been reported to have a protective effect against nephrotoxicity induced by some drugs and ischemic reperfusion. We aimed to investigate whether infliximab has a protective effect against methotrexate-induced nephrotoxicity. Materials and Methods. We administered methotrexate at a dose of 20 mg/kg as a single intraperitoneal injection in 10 rats (methotrexate group). Another group of 10 rats received a single dose of infliximab, 7 mg/kg, intraperitoneally (infliximab group). the methotrexate and infliximab group received a similar single injection of infliximab 72 hours prior to methotrexate injection. After 72 hours a single dose of methotrexate, 20 mg/kg, was administered intraperitoneally. Five days after methotrexate injection, blood samples were collected and the kidney tissues were removed for biochemical and histological examination. Results. the methotrexate group had significantly higher tissue levels of tumor necrosis factor-alpha (P =.008), interleukin-1 beta (P = .036), nitric oxide (P < .001), and adenosine deaminase (P < .001) than the methotrexate and infliximab group after the 5-day study. the methotrexate group also had significantly higher total histological scores (P < .001) and carbonic anhydrase-II activity (P < .001) when compared to the methotrexate and infliximab group. Conclusions. Infliximab has a strong protective effect against methotrexate-induced nephrotoxicity by suppressing cytokines release. It may decrease methotrexate-induced nephrotoxicity by regulating carbonic anhydrase-II enzyme activities and slowing down purine metabolism. RTEU Bilimsel Arastirmalar Proje birimiRecep Tayyip Erdogan University [2012.106.01.6] This project was supported by the RTEU Bilimsel Arastirmalar Proje birimi (Project No, 2012.106.01.6).