Mustafa Öztürk

Hemostatic parameters in Behçet's disease: a reappraisal.

Abstract. Behçets disease (BD) is a relapsing vasculitis in which orogenital ulceration is a prominent feature. The disease presents a tendency to thrombosis. The prevalence of venous or arterial thrombosis in BD reaches 40% in some series. Molecular markers of imbalance have been extensively studied in BD. The aim of this paper is to review current data on essential hemostatic parameters. The precise pathogenetic mechanism(s) underlying the prothrombotic state of BD is unknown. Thrombophilic factors could contribute to thrombosis in BD. Vasculitic endothelial injury may trigger or enhance the pathological hemostatic process.

Osteomalacia Associated with Carbamazepine/Valproate

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Serum beta 2-microglobulin reflects disease activity in Behçet's disease.

Abstract. Behçets disease (BD) is a systemic remitting vasculitis characterized by orogenital ulceration and uveitis. The disease is not associated with specific laboratory abnormalities. Hence, the activity of BD is generally assessed by clinical findings and – to some extent – by nonspecific markers of inflammation. This study was performed to investigate the relative efficiency of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum amyloid A protein (SAA), and beta 2-microglobulin (beta 2-m) levels as markers of disease activity in patients with BD. The study population consisted of 20 patients with active BD, 23 patients with inactive BD, and 27 healthy adults serving as the control group. Serum beta 2-m, SAA, ESR, and CRP levels of patients with BD were found to be significantly higher than those in the healthy control group. They were also higher in patients with active disease than in those in remission and controls. The levels of SAA, ESR, and CRP in inactive patients were also significantly higher than the controls. No statistically significant difference was noted between beta 2-m levels of patients with inactive BD and healthy controls. Serum beta 2-m levels can be regarded as a more discriminative marker of activation in BD. The high diagnostic value of SAA levels indicate that it can also be accepted as a marker of disease activity in BD.

Global Fibrinolytic Capacity in Colorectal Cancer: A New Clue to Occult Fibrinolysis

Hemostatic disorders in cancer patients range from asymptomatic laboratory changes to massive thromboembolism or hemorrhage. Routine laboratory tests often fail to identify patients at high risk for hemostatic complications. The postoperative risk of thromboembolic events in colorectal cancer was reported as approximately 2% to 5%. A new diagnostic test was used to assess global fibrinolytic activity, which may detect occult fibrinolysis or disseminated intravascular coagulation in patients with colorectal cancer. Twenty patients with colorectal cancer and 20 healthy control subjects were involved. Using standard silicated fibrin pellets and tissue plasminogen activator, the fibrinolytic capacity of the plasma samples was detected with the amount of D-dimer produced before the reaction was stopped by adding aprotinin to the medium. Mean global fibrinolytic capacity was increased in patients before and after surgery when compared to controls (p=0.002, p=0.001, respectively). In conclusion, a hemostatic imbalance was detected toward primary fibrinolysis in the preoperative period and low-grade disseminated intravascular coagulation postoperatively.

Selectins in normal pregnancy, pre-eclampsia and missed abortus.

Selectins, are known to be increased in the serum of patients with pre-eclampsia, indicating that these molecules are possible markers of endothelial cell injury. In this study, we investigated P, E and L selectin levels in normal pregnancy, pre-eclampsia, and missed abortus. Plasma P and L selectins levels were significantly higher in normal pregnancy and pre-eclampsia than healthy controls; but plasma concentrations of E selectins were not different between these groups. Plasma P selectin was significantly higher in pre-eclampsia than normal pregnancy. Plasma concentrations of all selectins were significantly higher in missed abortus than healthy control. L selectin levels were higher in pre-eclampsia and missed abortus than normal pregnancy. We found the levels of selectins were increased in pre-eclampsia and missed abortus. Although selectins were suspected to play a role in the pathogenesis of pre-eclampsia, in conjunction with previous studies, we thought that elevated selectin levels are a non-specific consequence of endothelial injury rather than being a cause.

Increased erythropoietin levels in reactive thrombocytosis.

Erythropoietin, the major humoral regulator of red cell production, was reported to stimulate various levels of megakaryocytopoiesis. We investigated levels of thrombopoietin (TPO) and erythropoietin (EPO) in patients with reactive thrombocytosis (RT) and clonal thrombocytosis (CT). 17 patients with RT and 18 patients with CT and 15 healthy subjects were enrolled into the study. TPO levels were higher in both patient groups than the controls. EPO levels were significantly higher than these in reactive thrombocytosis and in controls (p < 0.05). We suggest that besides TPO, EPO may play an important role in the pathogenesis of RT.

The Effects of the Macroeconomic Determinants on Sovereign Credit Rating of Turkey

The effects of the main macroeconomic determinants on the sovereign credit rating of Turkey assigned by Standard & Poor’s are analyzed in this paper. As the main macroeconomic determinants, inflation rate, economic growth rate, foreign direct investment, external debt, current account debt and savings are taken into account in this study. The data related to Turkey in this study covers between 1992-2016. In this study, the Granger causality test and the OLS regression model are used for that correlations of the variables. Outcomes of the analysis show that just two in six macroeconomic determinants are effective on the sovereign credit rating. According to the results of the study, external debt and inflation rate have a statistically significant relationship with the sovereign credit rating of Turkey. The outcomes show that external debt and the inflation rate have negative effects on the sovereign credit rating of the country. The coefficient of the external debt and the inflation is negative which means that if the inflation or external debt increases the rating decreases in appropriate with the theory. On the other hand, the effects of the other four macroeconomic variables are not significant. The results of the study indicate that some factors other than the primary macroeconomic determinants are effective on the sovereign credit ratings of Turkey. The results also unveil the door for the criticism that the decisions of the credit rating agencies are biased.