Gamze Varol Saraçoğlu

Osteoprotegerin, leptin and IL-6: Association with silent myocardial ischemia in type 2 diabetes mellitus

Background: Diabetic patients often exhibit severe, asymptomatic coronary artery disease (CAD). The relationship between osteoprotegerin (OPG), inflammatory markers and silent myocardial ischemia remains to be elucidated. Methods: We recruited 45 type 2 diabetic patients and 33 healthy controls and assessed them for silent myocardial ischemia (SMI) by myocardial perfusion imaging. Patient blood was tested for OPG, IL-6 and leptin concentrations. Results: OPG, leptin and IL-6 levels were found significantly elevated in diabetic patients (p < 0.001, p < 0.01, p < 0.05). Based on our classification of presence/absence of SMI in our diabetic group, we found that there was a significant association between SMI and the biomarkers IL-6 (p < 0.001), leptin (p < 0.001) and OPG (p < 0.05). In multivariate regression analyses, OPG was found to be significantly related to diabetes mellitus and to SMI. Age, sex and smoking increased the association between OPG and SMI. Conclusion: High OPG, leptin and IL-6 levels are associated with the presence and severity of SMI in type 2 diabetic patients.

How Different Methodologies of Harvesting and Analysing the Samples Affect the Test Results in Determining Joint Mediators

Purpose. This study has researched the affect of different methodologies of harvesting and analysing the samples in determining the mediators emerging after the rat articular cartilage injury. Materials and Methods. One hundred and forty-four male wistar rats were divided into 2 groups. Synovial fluid samples were taken from all of the rats. We entered into the right knees of the rats in group I (n = 36) under anaesthesia and took cartilage tissue samples from their distal femur. Samples were taken as reference values for enzyme linked immunosorbent assay (ELISA) and histopathological evaluations. We entered into the right knees of the rats in group II (n = 108) and formed complete layer of cartilage injury in their medial femoral condyles. At the end of the 15th day, the rats were sacrificed after taking synovial fluid samples from their right knees creating defect in the rats in group II. The molecular markers in the synovial fluid and cartilage tissue samples which were taken from the experimental and control groups (MMP-9, MMP-13, TIMP-1, TNF-α, and NO) were analysed by direct or indirect methodologies. SPSS 18.0 Package program was used in the statistical evaluation. Students t-test where the measurement variables between the experimental and control groups were compared was applied. Receiver Operating Characteristics (ROC) curves were used in the determination of the diagnostic sufficiency from the tissue. Results. No difference was found between TIMP-1 (P = 0.67) and MMP-9 (P = 0.28) levels in synovial fluid and cartilage tissue. From the molecular markers, when MMP-9, MMP-13, NO, TIMP-1, TNF-α′, the area under ROC curve, and P values were examined, MMP-13 (P < 0.0001, 95% CI: 0.70–0.85), NO (P < 0.0001, 95% CI: 0.72–0.86), and TNF-α (P < 0.0001, 95% CI: 0.91–0.98) results were found to be statistically significant. Inferences. The indirect ELISA protocol which we apply for the cartilage tissue as an alternative to synovial lavage fluid is a reliable method which can be used in the determination of articular cartilage injury markers.

Are treatment guides and rational drug use policies adequately exploited in combating respiratory system diseases

The aim of the present study was to increase awareness regarding the rational use of medicines. The data were obtained via the Material Resources Management System Module of the Ministry of Health. For the appropriateness of treatments, the Global Initiative for Asthma, the Global Initiative for Chronic Obstructive Lung Disease, and the guidelines for the rational use of medicines were used. We also investigated whether any de-escalation method or physical exercise was performed. Statistical analyses were performed using descriptive statistics to determine the mean, standard deviation, and frequency. The results showed that healthcare providers ignored potential drug reactions or adverse interactions, and reflecting the lack of adherence to the current treatment guides, 35.8% irrational use of medicines was recorded. Thus, de-escalation methods should be used to decrease costs or narrow the antibiotic spectrum, antibiotic selection should consider the resistance patterns, culturing methods should be analyzed, and monotherapy should be preferred over combination treatments.

Do we really need to coat the novel silicone intranasal splints with antibiotics

PURPOSE The novel silicone intranasal splints are suggested to resist biofilm formation due to their surface characteristics. We aimed to ascertain the necessity of coating these splints with antibiotics to prevent splint associated infections, in vitro. MATERIALS AND METHODS Pieces of Doyle II airway nasal splints made of medical grade silicone were divided into two test groups, treated with either (i) 0.2% nitrofurazone solution or (ii) 0.2% nitrofurazone containing ointment, and a control group, treated with (iii) 0.9% saline. Splint pieces were then incubated with Staphylococcus aureus solutions at 37°C for 48 and 96h. Following this, the splint pieces were incubated in 20ml Mueller Hinton agar and appearing colonies were counted. RESULTS Following 48and 96h of incubation, the colonization rates in the saline group were significantly higher than the nitrofurazone ointment group (p<0.001). The colonization rates in the liquid nitrofurazone group were significantly lower in comparison to the nitrofurazone ointment group (p<0.001 and p=0.019 respectively). CONCLUSIONS The method of coating the splints with antibiotic was superior to using uncoated splints in terms of preventing S. aureus colonization. The rather smooth surfaces of the splints were insufficient to block bacterial colonization and coating them with antibiotics seems to be beneficial for the prevention of infections.

Evaluation of neutrophil-to-lymphocyte ratio as a marker of inflammatory response in septic arthritis

Is neutrophil-to-lymphocyte ratio high in patients with septic arthritis? Septic arthritis may lead to higher rates of morbidity or even mortality if not diagnosed on time. This study was planned to answer the question that “Could neutrophil-to-lymphocyte ratio be utilized to help to diagnose septic arthritis?” The cohort of the study consisted of 39 patients diagnosed with septic arthritis. After ruling out the patients who did not meet the research’s inclusion criteria, the data of 26 patients were evaluated. The control group was collected from healthy volunteers who were admitted to the internal medicine outpatient clinic for a routine medical checkup at the same period (n = 26). Complete blood count (CBC) parameters, C-reactive protein, erythrocyte sedimentation rate, and neutrophil-to-lymphocyte ratios of the septic arthritis and control groups were compared statistically. In comparison, neutrophil-to-lymphocyte ratios of the septic arthritis group were significantly higher than the control group. In conclusion, neutrophil-to-lymphocyte ratio can be utilized in the emergency department or in outpatient clinics to support the diagnosis of septic arthritis.

The assessment of penetration cognitions and sexual functionality of women with sexual pain disorder in a Turkish sample: a comparative study

Objective: The aim of this investigation is to compare vaginal penetration cognitions and general sexual func-tionality in women with vaginismus and dyspareunia and healthy controls. Methods: A sample of 210 women (70 women with lifelong vaginismus, 70 women with dyspareunia and 70 women without painful sexual activity) com-pleted a series of validated questionnaires. All participant received Structured Assessment Questionnaire, Golom-bok-Rust Sexual Satisfaction Scale, and Vaginal Penetration Cognition Questionnaire (VPCQ). Results: It was found that when compared to dyspareunia and control group, women with vaginismus have higher cognitive scores of loss of control during penetration in VPCQ. Moreover, vaginismus group have lower level of sexual knowledge, cannot penetrate their fingers into their vaginas, and do not use tampons. Both women with vaginismus and dyspa-reunia were reported to have more level of negative self-cognitions, catastrophe/pain and genital incompatibility cognitions than those women with no sexual complaints. Moreover, women with vaginismus and women with dyspa-reunia have more anorgasmia, non-sensuality and sexual dysfunctions than the control group. Conclusion: Our results revealed that Turkish women with sexual pain disorder have similar vaginal penetration cognitions with women living in Western societies. In addition, according to our results it will be beneficial to define another sub group consisting of women who have never experienced sexual intercourse under the title of genito-pelvic pain/ penetration disorder because there are noteworthy differences between vaginismus and dyspareunia.

Frequency of daytime sleepiness and risk of anxiety and depression among shift workers in two selective factories

Objective: In this study, determining the “daytime sleepiness” and the relation of this with depression and anxiety risk, among shift workers was aimed. Methods: The study population has been constituted of 307 workers who has been working in shifts, in two factories. 289 workers have accepted to participate to the study and The Personal Information Form, the Epworth Sleepiness Scale (ESS), and the Hospital Anxiety Depression Scale (HADS) had been implemented to them. 246 of them who thoroughly completed the forms have included to the study. After excluding confounding factors, statistical analyses have been done with the data of 201 workers. Results: The frequency of daytime sleepiness is 10.4% in the study population. The mean score of anxiety subscale (28.6%) of HADS among workers who had daytime sleepiness is significantly higher than the workers did not have daytime sleepiness (11.7%), (p=0.043). No statistically significant difference was determined between the depression subscale of HADS of the two groups (p=0.470). In the logistic regression analyses, it has been determined that daytime sleepiness was increased anxiety risk 3.20 times but did not affect depression risk and shift working did not make any impact on depression and anxiety risk. Conclusions: Anxiety risk was found higher among workers who had daytime sleepiness. Referring the problematic workers to the hospital for differential diagnosis has been suggested. Wide-ranging studies that analyze shift working, daytime sleepiness and anxiety relations should be done.

Prevalence of smoking and factors affecting smoking behaviour during pregnancy: A sample from Tekirdağ/Gebelikte sigara içme prevalansı ve sigara içme davranışını etkileyen etmenler: Tekirdağ örneği

Amac: Gebelikte sigara kullanimi anne ve bebekte ciddi saglik sorunlarina yol acar. Calismamizin amaci Tekirdag ilinde gebelikte sigara kullanim prevalansini ve gebelerde sigara kullanimini etkileyen etmenleri belirlemektir. Yontem: Kesitsel tipte olan calisma Tekirdag ilinde 2009 yilinda gerceklestirildi. Calismada orneklem buyuklugu 762 gebe olarak belirlendi. Orneklem grubu secilirken olasilikli ornekleme yontemleri kullanildi. Anket geri donus hizi %98.3’tu. Bulgular: Gebelikleri sirasinda her gun en az bir ve gunde birden az sigara icme hizi sirasiyla %8.0 ve %2.8’di. Gebelik suresince sigara icme prevalansi %10.8 bulundu. Sigara icmeyen gebelerin %35.8’inin evlerinde pasif sigara dumanina maruz kaldiklari belirlendi. Kadinlarin %17.5’i gebelik nedeniyle sigarayi birakmisti, bunlarin %61.8’i tibbi destek almadigini belirtti. Calismada ek olarak esin sigara icme durumunun ve hane halki toplam gelirinin gebe kadinlarin sigara icme davranisini etkiledigi bulundu. Sonuc: Birinci basamak saglik kurumlari gebe kadinlari gebelikte sigara icmenin tehlikeleri konusunda bilgilendirmeli, sigarayi birakma yonunde cesaretlendirmeli ve desteklemelidir. Sigarayi birakmis gebelere de farkindalik egitim ve programlari ile dogum sonrasi yeniden baslamayi engelleyecek yonde yardimci olunmalidir