Hilal Bektas Uysal

Is Blastocystis hominis a new etiologic factor or a coincidence in iron deficiency anemia

Iron deficiency anemia (IDA) is a frequent health problem. Gut parasites such as N. americanus and A. duodenale are known to cause blood loss, but the role of Blastocystis hominis is uncertain. In this study, 212 patients (193 female, 19 male, mean age 41 SD 15 yrs) with IDA were enrolled and 90 persons without IDA (78 female, 12 male, mean age 45 SD 17 yrs). Microscopic examination of stools for B. hominis using the native lugol method was done three times on each subject. If any specimen contained five or more cysts per ×400 field, the person was considered positive. B. hominis was found in 48 out of 212 subjects with IDA (22.6%) and in five of 90 (5.6%) subjects without IDA. This difference is highly statistically significant (P < 0.001). Few subjects had other gut parasites and there was no statistical difference in the ir frequencies between IDA and non‐IDA subjects. Blastocystis hominis may play a role in the development of IDA either on its own or in conjunction with some other agent.

Autoimmunity affects health-related quality of life in patients with Hashimoto's thyroiditis

Hashimotos thyroiditis (HT) is the most common endocrine disorder leading to hypothyroidism. HT is characterized by the presence of elevated circulating antibodies, especially anti‐thyroid peroxidase (anti‐TPO) and anti‐thyroglobulin (anti‐Tg). In our study, we aimed to reveal the effects of autoimmunity on health‐related quality of life of euthyroid HT patients. Patients who were admitted to the Adnan Menderes University Outpatient Clinic were enrolled. The medical records of the patients were surveyed and their demographical data were collected. By using communication data, the patients were invited to our clinic, to inform them about our study and to fill out the health‐related quality of life questionnaire. A total of 84 euthyroid HT patients older than 18 years who completed the short form‐36 questionnaire, were enrolled. As all patients were euthyroid, there was a significant negative correlation between each domain score and the antibody levels, individually. Patients who had higher anti‐TPO and anti‐Tg levels had significantly lower quality of life domain scores (p < 0.001). There was statistically no significant correlation between the antibody levels and thyroid function tests (p > 0.05). Additionally, all dimension scores were significantly higher both in the anti‐Tg and anti‐TPO negative groups, indicating a better quality of life than that in the antibody positive groups. Our study revealed that higher thyroid antibody levels were negatively correlated with life quality scores. Thus, patients who had higher anti‐TPO and anti‐Tg levels had significantly lower quality of life domain scores. We believe that apart from hypothyroidism, a high antibody level was one of the contributing factors for the development of HT‐associated symptoms, leading to a lower quality of life. Other probable contributing factors such as selenium deficiency, thyroid hormone fluctuation, and disease awareness should keep in mind.

Blood count parameters can predict the severity of coronary artery disease

Background/Aims Because of the inflammatory nature of coronary artery disease (CAD), both platelets and white blood cells have been investigated for years. The aim of this study was to investigate the relationships between some prominently hematologic blood count parameters (mean platelet volume [MPV], neutrophil to lymphocyte ratio [NLR]) and the severity of CAD by using Gensini scores. Methods A total of 194 patients, who had undergone coronary angiography, enrolled in this study. The control group consisted of 42 patients who had normal coronary arteries. Remaining CAD patients were divided into two groups according to their Gensini scores. Results NLR and MPV were higher in the severe atherosclerosis group compared with the mild atherosclerosis group (p = 0.007, p = 0.005, respectively). The Gensini score showed significant correlations with NLR (r = 0.20, p = 0.011), MPV (r = 0.23, p = 0.004) and high density lipoprotein cholesterol (r = –0.161, p = 0.047). Using a cut-off level of 2.54, NLR predicted severe atherosclerosis with a sensitivity of 74% and specificity of 53% (area under curve [AUC], 0.627; 95% confidence interval [CI], 0.545 to 0.704; p = 0.004). MPV values above 10.4 predicted severe atherosclerosis with a sensitivity of 39% and specificity of 90% (AUC, 0.631; 95% CI, 0.549 to 0.708; p = 0.003). In the multiple logistic regression analysis, high levels of NLR (odds ratio [OR], 1.450; 95% CI, 1.080 to 1.945; p = 0.013) and MPV (OR, 1.622; 95% CI, 1.147 to 2.295; p = 0.006) were found to be independent predictors of severe atherosclerosis. Conclusions Our study suggests that both NLR and MPV are predictors of severe atherosclerosis and may be used for the prediction and identification of cardiac risks in CAD patients.

Biochemical and Histological Effects of Thiamine Pyrophosphate against Acetaminophen-Induced Hepatotoxicity.

The aim of this study was to investigate whether thiamine pyrophosphate (TPP) has biochemical and histological preventive effects on oxidative liver damage induced by paracetamol (APAP). Rats were divided into the following groups: healthy control (HG), APAP (AG, 1500 mg/kg, orally), thiamine pyrophosphate (TPPG, 100 mg/kg, intraperitoneally), APAP+NAC (ANAC, 100 mg/kg, intraperitoneally), APAP+TPP (ATPG) and APAP+NAC+TPP (ANTG). Oxidant, antioxidant parameters, liver function tests and histological assessment were performed between groups. Malondialdehyde levels in the AG, HG, TPPG, ANAC, ATPG and ANTG groups were 0.470 ± 0.210, 0.213 ± 0.004, 0.194 ± 0.001, 0.197 ± 0.06, 0.199 ± 0.008 and 0.173 ± 0.010 μmol/g protein, respectively. Total glutathione levels were 7.787 ± 0.395, 14.925 ± 0.932, 13.200 ± 0.984, 13.162 ± 0.486, 13.287 ± 0.787 and 13.500 ± 0.891 μm/g protein, respectively. In the AG group, marked liver damage occurred with the elevation of liver function tests and oxidative stress markers, such as malondialdehyde, myeloperoxidase and nitric oxide (p < 0.05). Biochemical results were congruent with the histological changes of oxidative damage. Compared to the AG group (p < 0.05), TPP significantly reduced oxidant parameter levels in the ATPG group and simultaneously increased the antioxidant parameter levels of catalase and glutathione. The histological changes were improved to almost normal hepatic structure. Moreover, TPP had nearly the same hepatoprotective effect as NAC, and there was statistically no additional benefit with NAC co‐treatment. There was no statistically significant difference (p > 0.05) among the ANAC, ANTG and ATPG groups in terms of oxidant/antioxidant levels. TPP proved to be as efficacious as standard therapy and may be beneficial in APAP‐induced hepatotoxicity.

Comparison of different methods for measurement of electrolytes in patients admitted to the intensive care unit

Objectives: To investigate whether electrolyte levels measured by using blood gas analyzers (ABG) and auto-analyzers (AA) are equivalent and can be used interchangeably. Methods: This observational prospective study was conducted in 100 patients admitted to the Intensive Care Unit, Adnan Menderes University School of Medicine, Aydin, Turkey, between March and August 2014. Samples for both AA and ABG analyzers were collected simultaneously from invasive arterial catheters of patients. The electrolyte levels were measured by using 2 methods. Results: The mean sodium level measured by ABG was 136.1±6.3 mmol/L and 137.8±5.4 mmol/L for AA (p=0.001). The Pearson’s correlation coefficient was 0.561 (p<0.001). The Bland-Altman 95% limits of agreement were -9.4 to 12.6 mmol/L. The mean potassium levels measured by ABG was 3.4±0.7 mmol/L and AA was 3.8±0.7 mmol/L (p=0.001). The Bland-Altman comparison limits were -0.58 to 1.24 and the associated Pearson’s correlation coefficient was 0.812 (p<0.001). Conclusion: The results of the 2 analyzing methods, in terms of sodium, were not equivalent and could not be used interchangeably. However, according to the statistical analyses results, by including, but not blindly trusting these findings, urgent and vital decisions could be made by the potassium levels obtained from the BGA, but a simultaneous follow-up sample had to be sent to the central laboratory for confirmation.

Protective effect of dexpanthenol (vitamin B5) in a rat model of LPS-induced endotoxic shock

Abstract Objectives This study investigated the protective effect of dexpanthenol (DEX) in the septic shock model of rats with biochemical parameters. Methods 12–15 weeks old male 32 Wistar rats has been used for this study. Sepsis was induced by a single intraperitoneal injection of lipopolysaccharide (LPS) (5 mg/kg) and treatment groups received single intraperitoneal injection of DEX (500 mg/kg) just 30-min before. The blood and tissue samples were obtained 16 h later of LPS intervention under the ketamine and xylasine (50 and 5 mg/kg, respectively) anesthesia. Results Giving alone DEX did not alter any physiologic levels of biochemical markers. Induction of sepsis resulted in a marked increase in ALT, AST, urea, creatinine, lactate, procalcitonin, TNF-α, IL-1β levels to show the tissue damage. In all serum parameters, liver’s GSH, CAT levels and kidney’s CAT, GSH, MDA and NO levels have ameliorated by DEX treatment in sepsis group. Conclusion Along with the standard therapy of sepsis, DEX can be used as a safe way of restoring (anti)oxidant status of kidney and liver tissues. It can be effective to control cytokine pathway, to decrease procalcitonin and regulate the metabolic process of sepsis, such as lactate.