Nursah Basol

The importance of association between angiotensin-converting enzyme (ACE) Gene I/D polymorphism and diabetic peripheral neuropathy.

BACKGROUND Diabetic peripheral neuropathy (DPN) is a microvascular complication of diabetes mellitus (DM) due to decreasing quality of life. In the present study, it is aimed to evaluate angiotensin-converting enzyme (ACE) Gene I/D polymorphism in Turkish population. MATERIALS AND METHODS Two hundred and thirty-five DPN patients and two hundred and eighty-one controls were enrolled in this study. Genomic DNA was isolated and genotyped using polymerase chain reaction (PCR) analyses for the ACE gene I/D polymorphism. RESULTS Baseline characteristics of the DPN patients according to ACE genotypes were similar, except for history of hypertension. The frequency of II genotype was significantly higher in patients with positive history of hypertension than the patients with negative history of hypertension (p=0.013). DD genotype of I/D polymorphism was found to be a susceptibility factor for DPN in homozygous form (p=0.032). According to allele frequencies, D allele of I/D polymorphism was found to be a susceptibility factor for DPN (p=0.031). CONCLUSION ACE gene I/D polymorphism may research in DM patients to determine genetic predisposition for DPN. It can be useful for taking early measures and avoiding DPN in a Turkish population.

High Association of IL-4 Gene Intron 3 VNTR Polymorphism with Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy (DPN) is a common disease. It is one of the late complications of diabetes mellitus. DPN can lower the quality of life by causing severe painful clinic symptoms. The aim of this study is to evaluate interleukin (IL)-4 gene variable number of tandem repeat (VNTR) polymorphism on DPN in Turkish population. Two hundred and twenty-seven DPN patients and 241 controls were enrolled in this study. Genomic DNA was isolated and genotyped using polymerase chain reaction analyses for the IL-4 gene intron 3 VNTR polymorphism. The distribution of genotype frequencies of IL-4 gene intron 3 VNTR polymorphism was statistically different between DPN patients and control group (p = 0.001). The frequency of P1 and P2 alleles was statistically different between DPN patients and control group (p = 0.00009). The results of this study suggested that intron 3 VNTR polymorphism of the IL-4 gene plays an important role in the occurrence of DPN in the Turkish population.

The Integration of Palliative Care into the Emergency Department

SUMMARY Palliative care (PC) is a new and developing area. It aims to provide the best possible quality of life for patients with life-limiting diseases. It does not primarily include life-extending therapies, but rather tries to help patients spend the rest of their lives in the best way. PC patients often are admitted to emergency departments during the course of a disease. The approach and management of PC include differences with emergency medicine. Thus, there are some problems while providing PC in the ED. With this article, the definition, main features, benefits, and problems of providing PC are presented, with the primary aim of emphasizing the importance of PC integration into the ED.

The effects of diltiazem and metoprolol in QTc prolongation due to amitriptyline intoxication

Background and objective: Amitriptyline, a frequently used tricyclic antidepressant agent, has powerful cardiotoxic effects especially in high doses. Serum and urine levels of amitriptyline dosages are not correlated with severity of toxicity; therefore, it increases the importance of electrocardiography (ECG) abnormalities. The prolongation of QTc can be a predictive marker for cardiotoxicity. Hence, in this study, it is aimed to evaluate possible effects of metoprolol and diltiazem in amitriptyline toxicity. Materials and methods: The rats were separated into four groups. First one was control group, the second was the amitriptyline + saline group, third one was the amitriptyline + metoprolol group, and forth one was the amitriptyline + diltiazem group. ECG were recorded on rats under anesthesia. Results: In amitriptyline group, QTc duration was prolonged compared with all other groups. The prolongation of QTc was shorter in amitriptyline + metoprolol group and amitriptyline + diltiazem group than amitriptyline group (p < 0.01 and p < 0.01, respectively). Conclusion: According to the results, it is possible to report ameliorating effects of both metoprolol and diltiazem on QTc prolongation related with amitriptyline intoxication. With further studies, these agents may be used for amitriptyline toxicity and besides, they may be used for patients in cardiovascular risk groups who take amitriptyline treatment regularly.

Beneficial effects of agomelatine in experimental model of sepsis-related acute kidney injury.

BACKGROUND Sepsis-related acute kidney injury (AKI) is a serious complication of sepsis. Problems persist regarding early diagnosis and treatment of AKI. The aim of the present study was to evaluate the efficacy of agomelatine, which is primarily known for its positive effects on depressive and anxiety disorders in sepsis-related AKI. METHODS Sepsis model was created with cecal ligation puncture (CLP). Rats were separated into 4 groups of 8 each: the control group, the sham-operated group, the CLP+saline group, and the CLP+agomelatine group. Agomelatine was administered intraperitoneally in doses of 20 mg/kg. RESULTS In the agomelatine group, reductions were observed in levels of tumor necrosis factor α (TNF-α), malondialdehyde (MDA), blood urea nitrogen (BUN), and creatinine, as well as in histological kidney scores, compared to the non-treated group. In addition, it was demonstrated that agomelatine treatment had positive effect on sepsis-induced morphological damage to renal and tubular tissues. CONCLUSION Agomelatine showed strong efficacy in sepsis-related AKI, demonstrated with histological and biochemical results in an experimental model. It is believed that antioxidant and pro-inflammatory effects of agomelatine are responsible for the improvement in kidneys.

The evaluation of two genetic polymorphisms of paraoxonase 1 in patients with pulmonary embolism

Pulmonary embolism (PE) is caused by some genetic factors for more than half patients. Paraoxonase 1 (PON1) has significant anti‐oxidative and anti‐inflammatory effects. According to our knowledge, there is no study researching the relation between PON 1 gene polymorphisms and PE in the literature. Therefore, it is aimed to research possible impacts of PON 1 Q192R and L55M polymorphisms on PE, considering anti‐inflammatory and anti‐oxidative effects of PON 1 in Turkish population.

Güçlü antikosidan kurkuminin sisplatinin neden olduğu karaciğer ve böbrek hasarında önemli etkileri

Amac: Sisplatin (CIS) siklikla kullanilan oldukca guclu bir anti kanser ajandir. Sisplatinin toksik etkileri kullanimini sinirlandirmaktadir. Sunulan bu deneysel calismada, sisplatinin nefrotoksik ve hepatotoksik yan etkilerine karsi kurkuminin (CUR) etkilerinin incelenmesi amaclanmistir. Yontem: Sicanlar her biri 7’serli toplam 3 gruba ayrildi. Ilk grup, control grubu olarak, ikinci grup CIS (6 mg/kg, i.p)+ salin grubu ve 3. grup CIS (6 mg/kg, i.p) + CUR (100 mg/kg i.p) olarak belirlendi. Sisplatin tek doz olarak ve kurkumin ise 3 gun boyunca sicanlara verildi. 3 gun sonra, karaciger ve bobrek dokulari ve kan ornekleri histopatolojik ve biyokimyasal tekniklerle analiz edildi. Bulgular: Sisplatin+ kurkumin gurubunda BUN ve ALT degerleri sadece sisplatin uygulanan gruba gore daha dusuk bulundu. Bunun yaninda, SOD ve GSH duzeyleri sadece sisplatin verilen grupta CIS+CUR grubuna gore daha yuksekti. Karaciger ve bobrek dokusunda histopatolojik olarak kurkuminin yararli etkileri gozlendi. Sonuc: Sisplatin bobrek ve karaciger dokulari uzerinde guclu bir toksik etkiye sahiptir. Sunulan bu calisma; kurkuminin, nefrotoksik ve hepatotoksik yan etkileri iyilestirmede onemli bir etkisi oldugunu one surmektedir.

Evaluation of Protein C Gene Polymorphism in Patients with Diagnosis of Pulmonary embolism in Turkish Population

Objective: Pulmonary embolism is usually a complication of deep vein thrombosis (DVT) and develops as a result of obstruction of pulmonary artery and/or branches with pieces that ruptured from the DVT of the leg. Pulmonary embolism and DVT is also referred as venous thrombo-embolism (VTE), because two events often remain together. In the studies, it was found that protein C (PROC) deficiency is a risk factor for pulmonary embolism. In this study, we aimed to evaluate the association between pulmonary embolism and PROC gene -1654C>T polymorphism in Turkish population. Methods: The DNAs of 114 pulmonary embolism cases and 120 healthy controls have been analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) to evaluate the relation between PROC gene -1654C>T polymorphism and pulmonary embolism in our study. Statistical analyses were performed by using chi-square and analysis of variance tests. Results: The proportion of individuals with CT genotype carrying polymorphic T allele as heterozygous form was 38.7% in the control group and 21.9% in the pulmonary embolism cases (p=0.047). When demographic and clinical characteristics of cases compared with PROC gene -1654C>T polymorphism, it was observed that the changes in chest CT ratios could be associated with -1654C>T polymorphism (p=0.017). Conclusion: As a result, individuals with CT genotypes carrying the polymorphic T allele as heterozygous form have a lower risk of developing pulmonary embolism.