Kemal Turker Ulutas

Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus

Objective Leukocytosis is thought to be directly associated with the pathogenesis of atherosclerosis and metabolic syndrome. Increased white blood cell (WBC) count is related to cardiovascular disease in patients with type 2 diabetes mellitus; raised neutrophil lymphocyte ratio (NLR) is associated with metabolic syndrome. There is little information, however, concerning a correlation between glycosylated haemoglobin (HbA1c) and NLR. The aim of the present study was to investigate the relationship between NLR and blood glucose regulation. Methods This retrospective study was conducted in patients with type 2 diabetes mellitus, divided into two groups according to HbA1c levels: group 1, HbA1c levels ≤ 7%; group 2, HbA1c levels > 7%. Venous WBC, neutrophil and lymphocyte counts were determined. Results Of 71 patients included, fasting serum glucose, neutrophil and WBC counts were significantly higher in group 2 compared with group 1. NLR had a positive correlation with HbA1c. Conclusion There may be a significant relationship between NLR and blood glucose regulation. The authors propose that increased NLR may be associated with elevated HbA1c in patients with type 2 diabetes mellitus.

Effects of ebselen on radiocontrast media-induced hepatotoxicity in rats

Oxidative stress is accepted as a potential responsible mechanism in the pathogenesis of radiocontrast media (RCM)-induced hepatotoxicity. Therefore, we aimed to investigate the protective effects of ebselen against RCM-induced hepatotoxicity by measuring tissue oxidant/antioxidant parameters and histological changes in rats. Wistar albino rats were randomly separated into four groups consisting of eight rats per group. Normal saline was given to the rats in control group (group 1). RCM was given to the rats in group 2, and both RCM and ebselen were given to the rats in group 3. Only ebselen was given to the rats in group 4. Liver sections of the killed animals were analyzed to measure the levels of malondialdehyde (MDA) and activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px), as well as histopathological changes. In RCM group, SOD and CAT levels were found increased. In RCM-ebselen group, MDA, SOD and CAT levels were found decreased. In RCM-ebselen group, however, GSH-Px activities of liver tissue increased. All these results indicated that ebselen produced a protective mechanism against RCM-induced hepatotoxicity and took part in oxidative stress.

Comparison of Platelet Distribution Width and CA19-9 in Resectable Pancreas Cancer

Background: Platelets are considered an important source of prothrombotic agents associated with inflammation in cancer related diseases. We aimed to compare the diagnostic accuracy of the platelet distribution width (PDW) and CA19-9 in resectable pancreas cancer. Method: A total of 83 stage-1 and 2 pancreatic adenocarcinoma (PAC) patients, and 85 age and sex-matched healthy participants were included in the study. All preoperative patient data, including PDW and CA19-9 were analyzed in terms of sensitivity, specificity, positive and negative predictive values, likelihood ratios, and diagnostic accuracy. Results: Demographic features were not significantly different among the groups. Platelet distribution width and CA19-9 were significantly higher in PAC compared to control group (p= 0.0001). Diagnostically, the sensitivity and specificity were 79% and 85% for PDW, while 78% and 91% for CA19-9. Diagnostic accuracy was measured by the area under the ROC curve, and PDW differs significantly (p<0.001), with a value of 0.874 (95% CI: 0.804-0.929). Conclusion: Platelet distribution width indicated similar sensitivity and specificity with CA19-9 in patients with resectable PAC. This result strongly advice that PDW, which has more routine option and cost-effectivity than CA19-9, can be used for diagnosis of resectable PAC as a strong alternative.

Comparison of platelet rich plasma versus fibrin glue on colonic anastomoses in rats

PURPOSE To compare platelet rich plasma (PRP) and fibrin glue about the effect of anastomotic healing. METHODS Thirty six Wistar-Albino male rats diveded into 3 groups according to control(Group1), PRP (Group 2) and fibrin glue(Tisseel VH) (Group 3). The colon was transected with scissor and subsequently an end to end anastomosis was performed using continuous one layer 6/0 vicryl sutures. Postoperative 7th day effect of anastomotic healing measuring with tissue hydroxyproline(TH) level and anastomotic bursting pressure(ABP); moreover comparison of cytokine (IL-6 and IL-10) and procalcitonin levels on 1st,3rd and 7th days. RESULTS There was no statistically significant difference of the ABP and hydroxyproline levels between PRP and fibrin glue on the 7th day. There was no statistically significant difference between levels of proinflammatory cytokine (IL-6) (P=0.41), anti-inflammatory cytokine (IL-10) (P=0.35), and procalcitonin levels (P=0.63) on 1, 3 and 7 days. CONCLUSION Fibrin glue and platelet rich plasma are shown to be effective in healing intestinal anastomoses without superior to each other.

Yoğun bakımda geniş ilaç direnci bulunan Pseudomonas aeruginosa pnömonisi için kolistin tedavisi: olgu sunumu

Pseudomonas aeruginosa kokenleri penisilin baglayan proteinlerde degisiklik, porin mutasyonlari, DNA giraz mutasyonlari ve aktif disa atim mekanizmalari gibi yontemlerle antibiyotiklere direnc mekanizmalari gelistirmektedir. Pseudomonas aeruginosa ozellikle yogun bakim unitelerinde takip edilen hastalarda ciddi enfeksiyonlara yol acmasi ve coklu antibiyotik direnci gostermesi nedeniyle ozel dikkat gosterilmesi gereken bir mikroorganizmadir. Bu raporda, 6 yil paraplejisi oykusu olan 1 haftadir devam eden bulanti, gogus agrisi, oksuruk, balgam, halsizlik, hiriltili solunum, genel durum bozuklugu ile acil servise getirilen 67 yasindaki erkek hasta sunulmustur. Hastada her iki akcigerde orta ve alt zonlara kadar yaygin krepitanraller yaninda CRP yuksekligi, hiperurisemi, akciger grafisinde sag akciger alt zonda konsolide infiltrasyon ile uyumlu opasite artisi, sag akciger ust zonda retikulonoduler tarzda opasite artisi tespit edildi. Derin trakeal aspirat kulturunde gram negatif, oksidaz pozitif, non-fermentatif basil uredigi goruldu. Pseudomonas aeruginosa oldugu tespit edilen basil, disk difuzyon yontemi ile yapilan antibiyogrami neticesinde kolistin disindaki tum antibiyotiklere direncli bulundu. Kolistin tedavisi baslanmasina karsin tedavinin 3. gununde kardiyak arrest olan hasta eksitus kabul edildi. Bu olgu, hastanemizde kolistin haricinde tum antibiyotiklere direnc gosteren Pseudomonas aeruginosa infeksiyonu vakasinin ilk defa gorulmesi ve tedavinin antibiyotik duyarliligina gore duzenlenmesinin vurgulanmasi amaciyla sunuldu.