Vildan Sumbuloglu

Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients

BACKGROUND The aims of this study were to test the validity, test-retest reliability, and internal consistency of Turkish version of FIS; the variables affecting FIS score. MATERIALS AND METHODS 71 MS patients and 68 healthy subjects were included to the study. RESULTS Total FIS score and subscale scores were different statistically between MS patients and healthy volunteers in both first and second FIS applications (p<0.001). These results showed that FIS is validated in divergent direction. BDI score was higher in MS patients than healthy volunteers (p<0.001). There was no statistically significant difference between two study groups for cognitive subscale scores, after the effect of depression was eliminated (p>0.05). To assess the test-retest reliability, the scores of two FIS applications did not differ statistically (cognitive t=1.948 p>0.05, physical t=1.420 p=0.160, social t=1.470 p=0.146, total t=1.990 p=0.05). Intraclass correlation coefficients were 0.89 (99% confidence interval: 0.79-0.94) for cognitive, 0.95 (0.91-0.97) for physical, 0.91 (0.83-0.95) for social, and 0.93 (0.86-0.96) for total FIS scores (p<0.001). EDSS correlated with physical subscores in both applications of FIS. CONCLUSION Turkish version of FIS, which is valid and reliable, seems an appropriate tool for the assessment of the effects of fatigue in Turkish MS population.

Levels of Oxidized LDL, Estrogens, and Progesterone in Placenta Tissues and Serum Paraoxonase Activity in Preeclampsia

In vitro literature studies have suggested that atherosclerotic oxidized low density lipoprotein (OxLDL) inhibits trophoblast invasion. The objective of this study was to determine the levels of OxLDL and to examine the relationship between antioxidative estradiol, estriol, and prooxidative progestin in normal and preeclamptic placental tissues and measure the serum activity of antioxidative paraoxonase (PON1). The study included 30 preeclamptic and 32 normal pregnant women. OxLDL was determined with ELISA, estradiol, unconjugated estriol, and progesterone that were determined with chemiluminescence method in placental tissues. Serum PON1 activity was determined with spectrophotometric method. Levels of OxLDL (P = 0.027), estriol (P < 0.001), estradiol (P = 0.008), and progesterone (P = 0.009) were lower in the placental tissues of preeclamptic group compared to the normal pregnant women. Serum PON1 activity was higher in preeclamptic group (P = 0.040) and preeclamptic group without intrauterine growth restriction (P = 0.008) compared to normal pregnant women. Tissue estriol of preeclamptic group without/with IUGR (P < 0.001, P = 0.002) was lower than the normal group. Results of our study suggest that the events leading to fetoplacental insufficiency lead to a reduction in the levels of estriol limit deposition of OxLDL in placental tissues. The serum PON1 activity is probably important in the inhibition of OxLDL in preeclampsia.

Quality of life of Turkish patients with depression in Ankara and in Berlin

BACKGROUND AND OBJECTIVES Quality of life (QOL) of immigrant groups with mental disorders should be compared with similar patients in the country of origin. Therefore, this study evaluated the QOL in Turkish patients who were in treatment because of depressive disorders in Ankara and Berlin. SUBJECTS AND METHODS Patients with depressive disorders were recruited from services in Ankara and Berlin. The same researcher interviewed all patients and assessed socio-demographic characteristics, symptomatology, psychiatric diagnosis and QOL. RESULTS QOL of patients in Ankara was significantly higher than that of patients in Berlin. Satisfaction with specific life domains also showed significant differences between the two groups. Factors positively associated with QOL in Berlin were marital status, shorter duration of marriage, fewer occupants per household, a relaxed religious attitude, being informed about the illness by the physician, and lower levels of symptoms. In Ankara, only initial help seeking behavior and level of depressive symptoms were associated with QOL. CONCLUSION QOL of Turkish patients with depression in Berlin appears lower than that of similar patients in Ankara. Different factors may influence QOL of Turkish patients with depression living in the place of origin and having emigrated to Germany.

Is direct method of low density lipoprotein cholesterol measurement appropriate for targeting lipid lowering therapy

OBJECTIVES The aim of this study was to compare the Friedewald Formula with direct homogeneous low density lipoprotein cholesterol (LDL-C) assay for the detection of LDL-C levels. METHODS Fasting serum samples were obtained for lipid analysis from 1001 patients. Total cholesterol (TC) and triglyceride (TG) levels were measured with enzymatic methods and the measurements of high density lipoprotein cholesterol (HDL-C) and LDL-C levels were detected using direct methods. RESULTS The mean levels of serum TC, TG, HDL-C and LDL-C were detected with in the reference range. The LDL-C estimated by the Friedewald formula was significantly correlated (P<0.01) with the direct method but there was a negative bias among them. CONCLUSION Laboratories cannot use direct method as a substitute for Friedewald formula because direct method has not been standardized in large populations and increase cholesterol assay costs.

Experimental bile-duct ligation resulted in accumulation of oxidized low-density lipoproteins in BALB/c mice liver.

Background and Aim:  Oxidized low‐density lipoproteins (LDL), which are produced during oxidative stress by the process of lipid peroxidation, have also been proposed to have complex roles in many other immuno‐inflammatory mechanisms. It has been shown that bile‐duct ligation results in oxidative stress in the liver of animals. The aim of this study was to investigate if oxidized LDL are produced in the liver tissues of bile‐duct‐ligated mice.

Relationship of apoE polymorphism with lipoprotein(a), apoA, apoB and lipid levels in atherosclerotic infarct

BACKGROUND AND PURPOSE Apolipoprotein E (apoE) polymorphism is suggested to be a risk factor in stroke in some populations, either by affecting lipid parameters or independently. Its effect on lipoprotein(a) [Lp(a)] is not known. The roles of apoE polymorphism and of high Lp(a) levels in atherosclerotic stroke (AS) in the Turkish population are unclear. Our aim was to investigate the relationship of apoE alleles and Lp(a) level with AS and the relationship of apoE alleles with Lp(a) and other lipid parameters. METHODS ApoE polymorphisms and lipid parameters were prospectively evaluated in 85 patients and 77 controls with normal brain imaging. RESULTS Only hypertension, diabetes mellitus, associated vascular diseases and decreased high-density lipoprotein cholesterol levels were found to be independent risk factors for stroke. However, in the presence of apoE/E4 allele, increased low-density lipoprotein cholesterol (LDL-chol), apolipoprotein B (apoB) and Lp(a) levels and in the presence of apo E/E3 allele, only Lp(a) levels were determined as risk factors. CONCLUSION This study showed that while apoE polymorphism was not a risk factor itself, high Lp(a), LDL-chol and apoB were determined to be risk factors in E3 or E4 carriers.

Evaluation of the prevalence of enterotoxigenic Bacteroides fragilis and the distribution bft gene subtypes in patients with diarrhea.

The aim of this study was to determine the prevalence of enterotoxigenic Bacteroides fragilis (ETBF) in the patients with diarrhea in our region and to assess the association between diarrhea and bft gene subtypes. The presence of ETBF and bft gene subtypes were investigated in 200 stool samples from patients with diarrhea, diagnosed as gastroenteritis, which were sent to Clinical Microbiology Laboratory at Zonguldak Karaelmas University, Training and Research Hospital and in 200 stool samples from age-matched healthy subjects between April 14, 2009 and October 28, 2009. Nested - polymerase chain reaction was used to detect the presence of bft gene directly from stool samples. The bft gene subtypes were determined by PCR in case of ETBF detection. The presence of bft gene was detected in 29 (15%) of patients and 27 (14%) of control group. bft-1 and bft-2 were found in 24 and five stool samples from 29 diarrheic patients with ETBF, respectively. Among 27 control patients with ETBF, bft-1 and bft-2 were found in 24 and three samples, respectively. No bft-3 subtypes were identified in our study. ETBF was found as a single pathogen in 9% of the patients with diarrhea, while there was an accompanying pathogen in 6% of the patients. The proportion of coinfection with another pathogen among ETBF positive patients was 38%. Cooccurance with ETBF was present in nine of 18 patients with Rotavirus and two of five patients with Entamoeba histolytica. In conclusion; there was no statistically significant difference between the prevalence of ETBF in diarrheal patients and that of the control group. When the patients and controls were compared for each age group, no statistically significant difference in ETBF rates was found. There was no significant difference between groups with respect to bft subtypes; bft-1 was identified as the most common subtype. The rate of coinfection of ETBF and Rotavirus was high.

Apoptosis and necrosis in the circumventricular organs after experimental subarachnoid hemorrhage as detected with annexin V and caspase 3 immunostaining

Abstract Objectives : The circumventricular organs (CVOs) are essential for most autonomic and endocrine functions. Trauma and bleeding can affect their function. The aim of this study was to investigate apoptosis and necrosis in CVOs in the early period after experimental subarachnoid hemorrhage (SAH) in rats, using annexin V affinity and caspase 3 immunostaining. Methods : Three experimental groups were used: Days 1 and 2 after SAH, and a control group, seven Wistar albino rats each. Subarachnoid hemorrhage was accomplished by transclival basilar artery puncture. Rats were perfused with 0·9% NaCl and 0·1M phosphate buffer pH 7·4 until heart stoppage. Apoptosis and necrosis in CVOs were measured by flow cytometry with annexin V staining, and by caspase 3 immunostaining. Results : Apoptosis in the organum vasculosum lamina terminalis (OVLT), median eminence (ME), and area postrema (AP) was significantly higher in the Day 1 group than in the control group. Apoptosis in the subfornicial organ (SFO), OVLT, ME, and AP was significantly higher in the Day 2 group than in the control group. There were significant differences between the Day 1 and Day 2 groups, except for AP. Necrosis in SFO and OVLT was significantly higher in the Day 2 group than in the Day 1 or control groups, whereas necrosis in the ME and AP did not differ between the three groups. Caspase 3-positive cell density was more intense in the Day 2 group than in the Day 1 and control groups. Discussion : Prevention of apoptosis may potentially improve impaired functions of CVOs after SAH.

Thrombocyte and Erythrocyte Indices in Sepsis and Disseminated Intravascular Coagulation

Thrombocyte and Erythrocyte Indices in Sepsis and Disseminated Intravascular Coagulation Sepsis is the inflammatory response against infection. The existence of DIC during sepsis indicates a poor prognosis and coagulation abnormalities and thrombocytopenia may exist. The aim of this study was to investigate platelet and erythrocyte indices in sepsis patients with DIC and without DIC. In both groups coagulation tests, platelet count and indices, erythrocyte count and indices were retrospectively analysed. In the sepsis plus DIC patients the prothrombin time and D-dimer values were found significantly higher and fibrinogen, platelet and plateletcrit were found significantly lower than in the sepsis without DIC group. The analysis of mean platelet volume, platelet distribution width, erythrocyte count and indices revealed no significant differences between the two groups. These results showed us that the depression of bone marrow in septic patients with DIC and without DIC did not differ. The activation of the coagulation system might probably be the cause of thrombocyte depletion in DIC. Trombocitni i Eritrocitni Indeksi u Sepsi i Diseminovanoj intravaskularnoj Koagulaciji Sepsa predstavlja inflamatorni odgovor na infekciju. Prisustvo diseminovane intravaskularne koagulacije (DIK) tokom sepse ukazuje na lošu prognozu, a mogu se javiti i poremećaji u koagulaciji i trombocitopenija. Cilj ove studije bio je da se ispitaju trombocitni i eritrocitni indeksi kod pacijenata sa sepsom i DIK, odnosno sepsom bez DIK. U obe grupe retrospektivno su analizirani testovi koagulacije, broj i indeks trombocita i broj i indeks eritrocita. Kod pacijenata sa sepsom i DIK, protrombinsko vreme i vrednosti D-dimera bili su značajno povišeni, dok su fibrinogen, trombociti i trombocitokrit bili značajno niži nego u grupi sa sepsom bez DIK. Prilikom analize srednje zapremine trombocita, širine distribucije trombocita i broja i indeksa eritrocita nisu otkrivene značajne razlike između dve grupe. Ovakvi rezultati ukazuju na to da kod pacijenata sa sepsom i DIK i pacijenata sa sepsom bez DIK nema razlika u depresiji koštane srži. Aktivacija koagulacijskog sistema predstavlja mogući uzrok manjka trombocita u DIK.

COMPARISON OF THE CALCULATED AND MEASURED OSMOLALITY IN INTRACRANIAL BLEEDING AND HEAD INJURY PATIENTS

Not all clinical laboratories have an osmometer, and calculations for osmolality are a frequently used method for determining osmolality. The purpose of this study was to evaluate the performance of four formulas for the estimation of osmolality, with cryoscopic measurement as the reference standard in intracranial hemorrhage (ICH) and head injury (HI) patients who were not treated with mannitol. Forty HI and 31 ICH patients treated in the Neurosurgery Department were included in the study. Every 6 h over a period of 24 h, serum samples were collected from patients and osmolality was measured. In conclusion, our study shows that only formulas F1 [Osmolality = 1.86(Na) + 1.86(K) + Glucose + Urea] and F4 [Osmolality = 1.86(Na) + Glucose + Urea + Ethanol + 9] can be used to evaluate osmolality in ICH patients who were not treated with mannitol. In HI patients, none of the formulas should be used to calculate osmolality.