Yazar "Sumer, Sua" seçeneğine göre listele
Listeleniyor 1 - 17 / 17
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Are bone morphogenetic protein-7 (BMP-7) serum levels correlated with development of hepatic fibrosis?(J Infection Developing Countries, 2014) Demir, Nazlim Aktug; Kolgelier, Servet; Inkaya, Ahmet Cagkan; Sumer, Sua; Demir, Lutfi Saltuk; Pehlivan, Fatma Seher; Arslan, MahmureIntroduction: Bone morphogenetic protein-7 (BMP-7) is a key protein in organogenesis and liver development. The protein has been studied in the context of liver fibrosis and regeneration. The aim of the present study was to explore any possible association between fibrosis levels (as revealed by liver biopsy) and serum BMP-7 levels. Methodology: A total of 189 patients with chronic hepatitis B and 51 healthy controls were enrolled in the study. Results: The study group contained 120 (63.5%) males and 69 (36.5%) females, and the control group contained 25 males (49.0%) and 26 females (51%). In general, serum BMP-7 values of patients were higher than those of controls (p = 0.001). Serum BMP-7 values of patients with liver fibrosis of stages 1, 2, 3, or 4 were higher than control values (all p values = 0.01), but the serum BMP-7 levels of patients with stage 5 fibrosis were similar to that of controls. Associations between fibrosis stage and the serum levels of BMP-7, ALT, HBVDNA, platelets, and albumin were all statistically significant (p = 0.001). The AUROC for the BMP-7 level in advanced stage fibrosis was found to be 0.23. The data were analyzed using the binary logistic regression analysis (backward stepwise method) and BMP-7, HBVDNA, and platelet levels were found to be risk factors associated with fibrosis (p values 0.031, 0.040, and 0.001, respectively). Conclusions: BMP-7 may play anti-inflammatory and anti-fibrogenic roles in the pathogenesis of chronic hepatitis B infection.Öğe Association of sociodemographical features, antiviral treatment, and necroinflammatory activity with depression and anxiety in chronic hepatitis B patients(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2015) Celik, Mustafa; Demir, Nazlim Aktug; Sumer, Sua; Demir, Lutfi SaltukObjective: Psychiatric disorders like depression and anxiety are known to be more prevalent in patients with chronic hepatitis B than healthy individuals. This increased prevalence may be due to multiple factors such as psychological distress associated with having a chronic disease, necroinflammatory activity in liver, side effects of treatment with antiviral agents or interferons, and/or direct effect of hepatitis viruses on central nervous system. Purpose of this study was to evaluate several risk factors that may be associated with anxiety and depression in patients with chronic hepatitis B. Methods: This study included 195 chronic hepatitis B patients. A psychiatrist made clinical interviews with the patients and filled Sociodemographic Data Form, Hamilton Anxiety Rating Scale (HARS), and Hamilton Depression Rating Scale (HDRS). Needle biopsies were performed to 175 patients who met biopsy criteria of American Association for the Study of Liver Diseases. Knodell Histological Activity Index was used to evaluate biopsy materials. HBV DNA and ALT levels were measured from patients' sera. Findings: In the study sample, 119 patients were males and 76 were females. Mean HARS score was 7.3 +/- 6.2 and mean HDRS score was 8.8 +/- 6.6. Both HARS and HDRS scores were higher in females than males. HARS score was higher in patients with a family history of chronic hepatitis and both HARS and HDRS scores were higher in patients with comorbid medical illness. Alanine aminotransferase, HBV DNA levels, and level of fibrosis in liver biopsy didn't affect HARS or HDRS scores. Also, there wasn't a difference in HARS or HDRS scores according to patients' usage of pegylated interferon, or oral antiviral therapy. Conclusion: Multiple factors affect the relation between chronic hepatitis and psychiatric disorders like anxiety and depression. Results of our study suggest that female sex, presence of a family history for chronic hepatitis B, comorbidity of other medical diseases, and ethnic origin affect more than the level of necroinflammatory activity and cellular damage in the liver or antiviral treatments.Öğe B cell aplasia and hypogammaglobulinemia associated with levetiracetam(K Faisal Spec Hosp Res Centre, 2018) Ozdemir, Hulya; Sumer, Sua; Karabagli, Hakan; Akdemir, Gokhan; Caliskaner, A. Zafer; Artac, HasibeLevetiracetam (LEV) is a second-generation antiepileptic drug approved for the treatment of several types of epilepsy. We report a 45-year-old female who developed hypogammaglobulinemia and B cell aplasia during LEV treatment. The Naranjo probability score for an adverse drug reaction was 6. After LEV discontinuation, the number of B cells gradually increased and reached normal levels within two months. This case suggests that monitoring of immunoglobulin levels and lymphocyte subsets analysis is important in patients treated with LEV, especially in cases of prolonged infections.Öğe Clinical and Laboratory Characteristics of COVID-19 Cases Followed in Selcuk University Faculty of Medicine(Doc Design Informatics Co Ltd, 2020) Sumer, Sua; Ural, Onur; Aktug-Demir, Nazlim; Cifci, Seyma; Turkseven, Burcu; Kilincer, Abidin; Turk-Dagi, HaticeObjective: Understanding the natural course of COVID-19 and determining its clinical findings are essential for early diagnosis and treatment. In this study, we aimed to investigate clinical and laboratory characteristics of cases followed with a diagnosis of COVID-19 in Selcuk University Faculty of Medicine Department of Infectious Diseases and Clinical Microbiology. Methods: Among patients followed with a diagnosis of possible/definitive COVID-19, those with a positive SARS-CoV-2 RT-PCR test were evaluated retrospectively in terms of their clinical, laboratory and thorax computed tomography (CT) data. Results: Among 407 patients followed with a diagnosis of possible/definitive COVID-19, 149 (36.6%) were SARS-CoV-2 RT-PCR test-positive. 82 (55%) of the patients were female and 67 (45%) were male. Mean age was 49.3 +/- 7.6 years. 11 (7.4%) were health care workers. While the most common symptom was cough with 46.3%, fever was observed in 29.5%, sore throat in 27.5% and malaise in 26.8% of the patients. 94 (63.1%) of the patients had underlying diseases. Hypertension and diabetes mellitus were the most common underlying disease. Laboratory findings were leukopenia in 12 (8.1%), lymphopenia in 34 (22.8%), thrombocytopenia in 24 (16.1%), elevated D-dimer levels in 43 (28.9%), elevated lactate dehydrogenase levels in 73 (49%), and elevated C-reactive protein (CRP) levels in 45 (30.2%) patients. While 71 (47.6%) of the patients had normal thorax CT, 43 (28.9%) had mild pneumonia, and 35 (23.5%) moderate pneumonia. D-dimer and CRP levels were higher in those with pneumonia than those without pneumonia (p=0.001 and p=0.001, respectively). As the pneumonia level increased, the increase of D-dimer and CRP levels became evident (p=0.003 and p=0.001, respectively). Conclusions: The clinical course of COVID-19 patients varies. It is noteworthy that there is a positive correlation between the severity of pneumonia and the increase in D-dimer and CRP levels in COVID-19.Öğe Comparison of Parkinson?s patients with and without COVID-19 in terms of prognosis(Asean Neurological Assoc, 2023) Eren, Fettah; Dikmen, Yagizhan; Gur, Merve Nur; Ekmekci, Ahmet Hakan; Sumer, Sua; Ozturk, SerefnurBackground & Objectives: This study aimed to compare PD patients with and without COVID-19 and to evaluate the associated factors about prognosis.Methods: The data of 37 hospitalized PD patients associated with COVID-19 pneumonia were evaluated. It was compared with the data of 40 PD patients who did not have COVID-19 in the same period. Clinical findings, prognosis, mortality and other related factors were compared in PD patients with and without COVID-19.Results: Hypertension was higher comorbid disease in PD patients with COVID-19 (p = 0.005). The duration of PD was longer in patients without COVID-19 disease (6.02 +/- 2.80 vs 5.08 +/- 4.59) (p = 0.028). In PD patients with COVID-19, the most common symptoms were myalgia-arthralgia (73.0%) and fatigue (48.6%). Intensive care was required in 17 (45.9%) patients, and invasive mechanical ventilation (IMV) was required in 9 (24.3%) patients. The in-hospital mortality rate was 29.7% (n = 11). Mortality and IMV requirement were higher in patients whose initial symptom was diarrhea (p = 0.004, p = 0.008, respectively). No correlation was detected between PD stage, treatment options and prognosis (p < 0.05).Conclusion: Mortality rate and IMV requirement are higher in PD patients with COVID-19 pneumonia, particularly in patients with initial symptoms of diarrhea. These patients should be followed more carefully in terms of probable poor prognosis.Öğe Correlation of myeloid-derived suppressor cells with C-reactive protein, ferritin and lactate dehydrogenase levels in patients with severe COVID-19(Wiley, 2022) Emsen, Ayca; Sumer, Sua; Tulek, Baykal; Cizmecioglu, Hilal; Vatansev, Husamettin; Goktepe, Mevlut Hakan; Kanat, FikretThe novel coronavirus disease 2019 (COVID-19) remains a global health emergency, and understanding the interactions between the virus and host immune responses is crucial to preventing its lethal effects. The expansion of myeloid-derived suppressor cells (MDSCs) in COVID-19, thereby suppressing immune responses, has been described as responsible for the severity of the disease, but the correlation between MDSC subsets and COVID-19 severity remains elusive. Therefore, we classified patients according to clinical and laboratory findings-aiming to investigate the relationship between MDSC subsets and laboratory findings such as high C-reactive protein, ferritin and lactate dehydrogenase levels, which indicate the severity of the disease. Forty-one patients with COVID-19 (26 mild and 15 severe; mean age of 49.7 +/- 15 years) and 26 healthy controls were included in this study. MDSCs were grouped into two major subsets-polymorphonuclear MDSCs (PMN-MDSCs) and monocytic MDSCs-by flow cytometric immunophenotyping, and PMN-MDSCs were defined as mature and immature, according to CD16 expressions, for the first time in COVID-19. Total MDSCs, PMN-MDSCs, mature PMN-MDSCs and monocytic MDSCs were significantly higher in patients with COVID-19 compared with the healthy controls (P < .05). Only PMN-MDSCs and their immature PMN-MDSC subsets were higher in the severe subgroup than in the mild subgroup. In addition, a significant correlation was found between C-reactive protein, ferritin and lactate dehydrogenase levels and MDSCs in patients with COVID-19. These findings suggest that MDSCs play a role in the pathogenesis of COVID-19, while PMN-MDSCs, especially immature PMN-MDSCs, are associated with the severity of the disease.Öğe Diagnostic clues for spondylitis in acute brucellosis(Saudi Med J, 2014) Aktug-Demir, Nazlim; Kolgelier, Servet; Ozcimen, Serap; Sumer, Sua; Demir, Lutfi S.; Inkaya, Ahmet C.Objectives: To determine the diagnostic factors for brucellar spondylitis. Methods: This retrospective study included 227 consecutive brucellosis patients admitted to the Infectious Diseases and Clinical Microbiology clinics of Adiyaman State Hospital and Adiyaman 82nd Year State Hospital, Adiyaman, Turkey between January 2010 and December 2012. Acute brucellosis was diagnosed by standard tube agglutination test, and/or growth of Brucella spp. in appropriately prepared culture media (Bactec). Brucellar spondylitis was diagnosed and followed-up with contrast-enhanced magnetic resonance imaging. Results: Among the 227 brucellosis patients included, 88 (38.8%) were male, and 139 (61.2%) were female. Brucellar spondylitis was detected in 54 patients (23.7%). Brucellar spondylitis patients had higher mean age, higher fever, and higher blood culture positivity rate when compared with brucellosis patients (p=0.001, p=0.001, and p=0.001). Logistical regression analysis determined that male gender (OR: 3.006), older age (OR: 1.025), erythrocyte sedimentation rate (ESR) (OR: 1.067), high fever at the time of admission (OR: 2.550), and positive blood cultures for Brucella spp. (OR: 4.003) values were independently associated with brucellar spondylitis. However, high C-reactive protein (CRP) levels (OR: 0.971) were not found as a risk factor for brucellar spondylitis. Conclusions: The results of this study shows that the risk of developing brucellar spondylitis is high in patients with acute brucellosis, who are at advanced age, who have high fever, that have Brucella spp. growth in their blood culture that has a high ESR value, and who are male.Öğe Evaluation of Annexin-1 (ANXA-1), Annexin-2 (ANXA-2) and Bone Morphogenetic Protein-7 (BMP-7) Serum Levels in Patients Followed Up With A Diagnosis of COVID-19(Ankara Microbiology Soc, 2022) Ural, Onur; Kiratli, Hatice Esranur; Sumer, Sua; Aktug Demir, Nazlim; Yilmaz Kirik, Sema; Vatansev, Husamettin; Akyurek, FikretCoronavirus disease 2019 (COVID-19) is a global health problem caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 infection may present with clinical pictures ranging from asymptomatic or mild forms to respiratory failure requiring intensive care follow-up and mechanical ventilation. The course of this disease with different clinical presentations raises many immunological questions. This study aimed to evaluate the serum levels of Annexin-1 (ANXA-1), Annexin-2 (ANXA-2) and bone morphogenetic protein-7 (BMP-7) in patients diagnosed with COVID-19 and to investigate whether these markers are associated with lung involvement. The study was conducted in 173 patients who were followed and treated with the diagnosis of COVID-19 and 51 healthy control group. Patients were primarily divided into two groups based on the presence of typical lung involvement (ground glass opacities, consolidation, and both) in the thoracic computed tomography (CT) scans for COVID-19. Those who found to have involvement in thoracic CT scans were divided into three groups as mild (< 33%), moderate (34-66%), and severe (> 67%) according to the extent of their lesions. Of the 173 patients included in the study, 130 had typical thoracic CT involvement for COVID-19, while 43 did not. ANXA-1, ANXA-2 and BMP-7 values were found to be higher in the patients than the control group (p=0.001, p=0.001, p=0.001). ANXA-2 levels were higher in patients with thoracic CT involvement than those without thoracic CT involvement (p=0.023). In addition, when the patients were evaluated according to their thorax CT involvement levels, it was found that as the lung involvement levels increased, ANXA-2 increased, ANXA-1 decreased, and BMP-7 levels did not change. While the increase in ANXA-2 was statistically significant, the decrease in ANXA-1 was not found statistically significant. When the relationship between the laboratory parameters and the thorax CT involvement level was evaluated; it was found that, the lymphocyte and thrombocyte counts decreased as the thorax CT involvement increased, and lactate dehydrogenase (LDH), ferritin, procalcitonin (PCT), C-reactive protein (CRP), D-dimer and troponin levels were increased. While no significant correlation was found between ANXA-1 and BMP-7 and laboratory parameters, a positive correlation was found between ANXA-2 and leukocyte count, LDH, troponin, PCT, ferritin, D-dimer, and CRP. The data obtained in our study suggest that the ANXA-2 level at the time of admission was related with the lung involvement and the level of involvement of the disease. As a result, molecular studies are needed today to understand the pathogenesis of COVID-19 and to investigate new treatment targets. Evaluation of ANXA-2 level may be important in predicting the level of lung involvement due to COVID-19.Öğe Evaluation of Depression, Anxiety Level and Quality of Life in Patients With Chronic Hepatitis B and Inactive Hepatitis B Virus Carriers(Aves, 2017) Yigit, Ozge; Ural, Onur; Aktug-Demir, Nazlim; Sumer, Sua; Guler, Ozkan; Demir, Lutfi SaltukObjective: The objective of this study was to compare the anxiety, depression and quality of life scores of chronic hepatitis B (CHB) patients and inactive hepatitis B virus (HBV) carriers with healthy control subjects and to demonstrate the need for a multidisciplinary approach in the follow-up and treatment of patients with HBV infection. Methods: The study was carried out by comparing 200 subjects including 100 CHB patients and 100 inactive HBV carriers, who were admitted to the Outpatient Clinic of Infectious Diseases and Clinical Microbiology Department, Faculty of Medicine, Selcuk University between August 2013 and August 2014 with 100 healthy control subjects. All subjects were given Hospital Anxiety and Depression (HAD) Scale and Short Form-36 (SF-36) to assess their quality of life. Results: Based on the HAD Scale, anxiety risk among the carriers was higher than the control group (p=0.031). Depression risk in the patient (p=0.031) and carrier groups (p=0.046) were higher than the control group. There was no significant difference between the patient and carrier groups with regard to anxiety risk or depression risk (p>0.05). Females had higher anxiety risk in the patient (p=0.015), carrier (p=0.035) and control (p=0.001) groups. Depression risk was also higher in females in the patient (p=0.037) and carrier (p=0.038) groups. There were no significant relations between marital status, family type, place of living and anxiety and depression risks (p>0.05). Three quality of life parameters including general health, role limitations due to physical health and vitality scores in the inactive HBV carriers and CHB patients were lower than those of the control group (p<0.05). Conclusions: Psychological state of the patients who are chronically infected with HBV should not be neglected during treatment and follow-up. If a psychiatric disturbance is identified, effective treatment will increaseÖğe An evaluation of matrix metalloproteinase-9 (Mmp-9) and tissue inhibitor metalloprotein- ase-1 (Timp-1) Serum levels and the Mmp-9/Timp-1 Ratio in Covid-19 patients(Makerere Univ, Coll Health Sciences,Sch Med, 2023) Demir, Nazlim Aktug; Kirik, Sema Yilmaz; Sumer, Sua; Ural, Onur; Kiratli, Hatice Esranur; Vatansev, Husamettin; Hayatsal, Esra PaydasBackground: The progression of COVID-19 has different clinical presentations, which raises a number of immunological questions. Objectives: This study aimed to investigate MMP-9 and TIMP-1 levels in patients diagnosed with COVID-19 and whether the MMP-9/TIMP-1 ratio is associated with lung involvement in COVID-19.Methods: This study was conducted with 192 patients and 45 healthy controls. ELISA was used to measure the MMP-9 and TIMP-1.Results: The MMP-9 and TIMP-1 levels of the patients were found to be higher than those of the controls. MMP-9 and TIMP-1 were detected more in patients with lung involvement on chest CT scans than in those with no lung involvement on chest CT scans. A comparison of lung involvement levels revealed no difference was found between the groups. The MMP-9/TIMP-1 ratio was 5.8 in the group with lung involvement on chest CT scans and 6.1 in the group without lung involvement on chest CT scans. No difference was found between the two groups. A comparison with respect to lung involvement levels showed that the MMP-9/TIMP-1 ratio difference was found between the groups.Conclusion: Diagnostic and treatment methods targeting MMP-9 activity or neutrophil activation may be important in predict-ing lung involvement in COVID-19 and directing clinical outcomes.Öğe Evaluation of Patients Followed by COVID-19 After Quarantine(Bilimsel Tip Yayinevi, 2020) Ural, Onur; Sumer, Sua; Aktug Demir, Nazlim; Yalcinkaya, Emine; Ucan, Elif; Demir, Lutfi SaltukIntroduction: The COVID-19 pandemic continues to affect the world with serious number of cases and deaths. For this reason, knowing the clinical findings and course of the disease is important for early diagnosis and treatment. In this article, COVID-19 cases followed up after quarantine were discussed. Materials and Methods: In this study, the data of 99 patients who were followed up during travel and post-Umrah quarantine between 31 March and 15 April 2020 were retrospectively reviewed. Results: Of the 99 patients included in the study, 66 (66.7%) were females, 33 (33.3%) were males, and mean age was 59.8 +/- 11.4 years. SARS-CoV-2 RT-PCR test was positive at the time of admission in 97 (98.0%) of the 99 patients. Thirty-nine (39.4%) of the patients were symptomatic and 25.3% of the patients had cough, 8.1% had fever, and 7.1% had shortness of breath. While SARS-CoV-2 RT-PCR test was negative in 2 (3.3%) of the 60 patients without complaints, 58 (96.7%) of them were positive for SARS-CoV-2 RT-PCR test. Leukopenia was detected as 3%, lymphopenia 66.7%, D-dimer height 47.5%, LDH elevation 38.4%, CRP elevation 45.5%. Ground glass opacities were present in 81 (81.8%) of the patients with lung involvement, and consolidation areas were present in 40 patients (40.4%). Underlying disease was present in 38 (38.4%) of the patients. Hypertension and diabetes mellitus were the most common underlying diseases. It was observed that 89 (89.4%) of our cases had negative SARS-CoV-2 RT-PCR test on the 5th day. Conclusion: COVID-19 infection is an infectious disease that can present with many different clinics. In asymptomatic COVID-19 cases, lung involvement findings and disorders in laboratory parameters may be observed. It should be kept in mind that asymptomatic cases pose a risk in terms of transmission.Öğe Evaluation of the Relation Between Hepatic Fibrosis and Basic Laboratory Parameters in Patients With Chronic Hepatitis B Fibrosis and Basic Laboratory Parameters(Kowsar Publ, 2014) Demir, Nazlim Aktug; Kolgelier, Servet; Ozcimen, Serap; Gungor, Gokhan; Sumer, Sua; Demir, Lutfi Saltuk; Inkaya, Ahmet CagkanBackground: The hepatitis B virus is an important healthcare problem. According to current clinical practice, a liver biopsy is required for the diagnosis and treatment of chronic liver disease. However, a liver biopsy is an invasive, inconvenient procedure, which requires an expert pathologist opinion. Therefore requirement of biochemical tests, which are considered to indicate hepatic fibrosis and may be repeated easily, increases gradually today. Objectives: This study evaluated the correlation between hepatic fibrosis and routine laboratory values in patients with chronic hepatitis B. Patients and Methods: The files of 456 patients with CHB (chronic hepatitis B) who were referred to the infectious diseases and clinical microbiology clinic between January 2009 and March 2012 were screened retrospectively. Liver biopsy samples were examined according to Ishak scoring. Laboratory parameters and histopathology reports were recorded, and correlations between the fibrosis grade and laboratory parameters were analyzed. Results: There were 320 male and 136 female patients, with a mean age 36.7 +/- 12.1 years. According to liver biopsy results, a low fibrosis score (stage 0-2) was detected in 281 patients (61.6%), and a high fibrosis score ( stage 3-5) was detected in 175 patients (38.4%). Patients with a high fibrosis score had significantly higher ALT (alanine amino transferase), AST (aspartate aminotransferase), and HBV-DNA values and a significantly lower platelet count compared with those with a low fibrosis score (P=0.001, 0.001, 0.025, and 0.001, respectively). A positive correlation was detected between the fibrosis score and age, BMI, HAI, ALT, and AST values, and a negative correlation was detected between the fibrosis score and albumin and platelet counts. In the regression analysis performed to evaluate the factors associated with high-stage fibrosis, fibrosis was determined to be associated with thrombosis, ALT, and gender. The results of the regression analysis demonstrated that the risk of fibrosis was 4.6 fold higher in men. Conclusions: According to the results obtained in our study, advanced age, higher BMI, AST, ALT, and HBV-DNA levels, and low albumin and platelet levels are correlated with advanced fibrosis in patients with CHB.Öğe How should procalcitonin and C-reactive protein levels be interpreted in haemodialysis patients?(Wiley, 2018) Demir, Nazlim A.; Sumer, Sua; Celik, Gulperi; Afsar, Rengin E.; Demir, Lutfi S.; Ural, OnurBackground: Procalcitonin (PCT) and C-reactive protein (CRP) are used most widely in the diagnosis/treatment of bacterial infections. These are not infection-specific and may also show increases in other inflammation-causing cases. Aim: To establish a new cut-off value for PCT and CRP to eliminate confusion in the diagnosis and treatment of bacterial infections in haemodialysis (HD) patients. Methods: A total of 1110 patients, 802 with undocumented infection and 308 with documented infection, was included in the study. Results: A total of 802 patients with undocumented infection had a mean CRP value of 12.2 +/- 9.6 mg/dL and a mean PCT value of 0.51 +/- 0.96 ng/mL and the 308 patients with documented infection had a mean CRP value of 125.9 +/- 83.3 mg/dL and a mean PCT value of 13.9 +/- 26.9 ng/mL at the time of admittance. In HD patients, the cut-off values for CRP was determined as 19.15 mg/dL and for PCT as 0.685 ng/mL in the presence of infection. The use of these two parameters in combination (CRP = 19.15 mg/dL and PCT = 0.685 ng/mL) was found to have 95% positive predictive value (PPV) and 93% negative predictive value (NPV) for the diagnosis of infectious diseases in HD patients. When CRP = 100 mg/dL and PCT = 5 ng/mL, this was found to have 100% PPV and 94% NPV for the diagnosis of sepsis in HD patients. Conclusion: We specified PCT and CRP cut-off values with high PPV and NPV for revealing the presence of bacterial infection and sepsis in HD patients.Öğe Is serum high-mobility group box 1 (HMGB-1) level correlated with liver fibrosis in chronic hepatitis B?(Lippincott Williams & Wilkins, 2017) Inkaya, Ahmet Cagkan; Demir, Nazlim Aktug; Kolgelier, Servet; Sumer, Sua; Demir, Lutfi Saltuk; Ural, Onur; Pehlivan, Fatma SeherBackground: High-mobility group box 1 (HMGB1), identified as an alarmin molecule, was shown to have a role in virus-triggered liver injury. We aimed to evaluate the association between serum levels of HMGB1 and liver fibrosis. Method: This cross-sectional case-control study included 189 chronic hepatitis B (CHB) patients and 51 healthy controls. All patients underwent liver biopsy and modified Knodell scoring system used to determine the fibrosis level in CHB patients. Serum HMGB1 levels were determined with enzyme-linked immunosorbent assay (ELISA). Results: Mean serum HMGB1 levels of patients (58.1 +/- 54.7) were found to be higher than those of the control group (7.1 +/- 4.3) (P=. 001). HMGB1 levels of patients with advanced-stage fibrosis (stage 4 and 5) were detected to be higher than those of patients with early-stage fibrosis (stage 1-3). However, this difference was not statistically significant (P>. 05). Albumin levels of fibrosis 3 and 4 patients were lower than fibrosis 1 and 2 patients. ALT, HBV DNA, and AFP levels of fibrosis 5 patients were significantly higher than fibrosis 1 and 2 patients, and their platelet and albumin levels are lower than fibrosis 1 and 2 patients (P<. 001). In a logistic regression model, fibrosis levels were correlated with ALT values and inversely correlated with albumin levels. Conclusion: In this study, we demonstrated that serum HMGB1 levels increase in the early course of liver injury and this increase is not correlated with severity of the liver damage.Öğe Reduced Monocyte Subsets, Their HLA-DR Expressions, and Relations to Acute Phase Reactants in Severe COVID-19 Cases(Mary Ann Liebert, Inc, 2022) Cizmecioglu, Ahmet; Emsen, Ayca; Sumer, Sua; Ergun, Dilek; Akay Cizmecioglu, Hilal; Turk Dagi, Hatice; Artac, HasibeMonocytes are one of the principal immune defense cells that encounter infectious agents. However, an essential role of monocytes has been shown in the spread of viruses throughout the human body. Considering this dilemma, this study aimed to evaluate monocyte subsets and Human Leukocyte Antigen-DR isotype (HLA-DR) expressions in clinical coronavirus disease 2019 (COVID-19) cases. This prospective, multicenter, case-control study was conducted with COVID-19 patients and healthy controls. The patient group was divided into two subgroups according to disease severity (severe and non-severe). Three monocyte subsets (classical, CL; intermediate, INT; non-classical, NC) were analyzed with flow cytometry upon the patients' hospital admission. A total of 42 patients with COVID-19 and 30 controls participated in this study. The patients' conditions were either severe (n = 23) or non-severe (n = 19). All patients' monocyte and HLA-DR expressions were decreased compared with the controls (p < 0.05). Per disease severity, all monocyte subsets were not significant with disease severity; however, the HLA-DR expressions of CL monocytes (p = 0.002) and INT monocytes (p = 0.025) were more decreased in the severe patient group. In patients with various clinical features, NC monocytes were more affected. Based on these results, NC monocytes were more decreased in acute COVID-19 cases, though related various clinics decreased all monocyte subsets in these patients. Decreased monocyte HLA expressions may be a sign of immune suppression in severe patients, even when the percentage of monocyte levels has not decreased yet.Öğe Serum Levels of Annexin A2 as a Candidate Biomarker for Hepatic Fibrosis in Patients With Chronic Hepatitis B(Kowsar Publ, 2015) Kolgelier, Servet; Demir, Nazlim Aktug; Inkaya, Ahmet Cagkan; Sumer, Sua; Ozcimen, Serap; Demir, Lutfi Saltuk; Pehlivan, Fatma SeherBackground: Hepatologists have studied serologic markers of liver injury for decades. Annexins are a prominent group of such markers and annexin A2 (AnxA2) is one of the best characterized annexins. AnxA2 inhibits HBV polymerase among other functions. Its expression is up-regulated in regenerative hepatocytes. Objectives: To determine if serum AnxA2 level has a role in estimating liver damage in chronic HBV infection and investigate whether AnxA2 levels correlate with hepatic fibrosis. Patients and Methods: This study included 173 patients with chronic hepatitis B (CHB) and 51 healthy controls. Liver fibrosis was graded histologically on liver biopsy samples. Blood samples were taken from patients during biopsy and serum AnxA2 levels were measured with ELISA. Results: In a group of adult patients with CHB, AnxA2 values were far higher than those of the control group (P = 0.001). When we assessed AnxA2 levels based on fibrosis stages, serum AnxA2 levels of patients with early stage fibrosis (stages 1 - 3) were significantly higher than those of patients with advanced stage fibrosis (stages 4 - 5; P = 0.001). Conclusions: AnxA2 is a useful biomarker for early stage fibrosis in patients with CHB.Öğe Serum Neutrophil Gelatinase-Associated Lipocalin Levels in Acute Brucellosis and Brucellar Spondylodiscitis(Ankara Microbiology Soc, 2022) Sumer, Sua; Aktug Demir, Nazlim; Demir, Lutfi Saltuk; Findik, Duygu; Kolgelier, Servet; Ural, OnurBrucellosis is a zoonotic infectious disease caused by Brucella spp., an intracellular bacterium. The complications of acute Brucellosis may affect all organs and systems. The most common complication of the disease is musculoskeletal system involvement. The neutrophil gelatinase-associated lipocalin (NGAL) is a marker of neutrophil formation and acts as a siderophore-binding protein to prevent bacterial iron uptake and its use as a marker in the diagnosis and follow-up of bacterial infections is being investigated. The aim of this study was to measure the serum levels of NGAL in patients with acute Brucellosis and Brucellar spondylodiscitis, and to determine whether there is a correlation between NGAL levels and the progression and complications of the disease. This prospective case control study was conducted with 240 patients and 120 healthy controls. The diagnosis of acute Brucellosis was established when a person was asked to take an STA test due to clinical symptoms within the past eight weeks, and the test result that exceeded 1/160, or a 4-fold titer increase was found in the STA test after an interval of two weeks, and/or there was Brucella spp. growth in the blood culture. A contrasted lumbar magnetic resonance (MR) scan was performed on patients diagnosed with acute Brucellosis who had lower back pain. Presence of spondylodiscitis was assessed radiologically with contrasted lumbar MR images. NGAL levels were determined with ELISA assay. The median NGAL value was found to be 456.67 ng/L (101.41-5804.41 ng/L) in patients with acute Brucellosis and 113.84 ng/L (58.29-542.34 ng/L) in the control group. The median NGAL value was statistically higher in the patients than the control group (p= 0.001). Brucellar spondylodiscitis was detected in 57 (23.7%) of 240 patients diagnosed with acute Brucellosis. The median NGAL value was 1885.62 ng/L (143.21-5804.41 ng/L) in patients with Brucellar spondylodiscitis, and 356.87 ng/L (101.41-1874.07 ng/L) in those who did not have Brucellar spondylodiscitis. This difference was statistically significant (p= 0.001). Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were found to be higher in patients who had Brucellar spondylodiscitis. Blood cultures were drawn from 186 (77.5%) of the 240 patients diagnosed with acute Brucellosis. The blood culture positivity rate was 36.02%. Patients whose blood cultures were positive had higher NGAL levels (p= 0.001). The blood culture positivity rate was higher in patients who were diagnosed with Brucellar spondylodiscitis (p= 0.001). A regression analysis showed that female gender and high levels of NGAL, ESR, and alanine aminotransferase (ALT) could be used as predictors of Brucellar spondylodiscitis. The explanatoriness of the model was 82.3%. Although determination of NGAL levels is seen as a useful marker in the diagnosis of acute Brucellosis and predicting the presence of Brucellar spondylodiscitis, more comprehensive studies are required to be used in clinical practice in regions where Brucellosis is endemic.
