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Öğe Acil Pandemi Polikliniğine Başvuran ve COVID-19 Şüphesiyle Değerlendirilen Hastaların Retrospektif Analizi(2021) Altınsoy, Hasan Baki; Naldemir, İbrahim Feyyaz; Çalışkan, Emel; Şahin, İbrahim Ethem; Karadağ, Mehmet; Boğan, MustafaAmaç: SARS-CoV-2 olarak adlandırılan yeni tip korona virüsün neden olduğu COVID-19 pandemisi halen tüm dünyada etkisini sürdürmektedir. COVID-19 etkeninin neden olduğu semptomlar diğer solunum yolu etkenlerine benzese de toplumsal etkileri oldukça şiddetli ve farklı seyretmektedir. Bu çalışma hastanemizin acil servis girişinde oluşturulan acil pandemi polikliniğine başvuran ve COVID-19 ön tanısıyla tetkik edilen hastaların analizinin yapılması amacıyla planlanmıştır.Gereç ve Yöntemler: Acil pandemi polikliniğine başvurmuş 16 yaş ve üzeri hastalardan, ateş, öksürük, nefes darlığı şikayetleri olup COVID-19 şüphesiyle polimeraz zincir reaksiyonu (PZR) testi için üst solunum yolundan sürüntü örneği alınmış ve Toraks bilgisayarlı tomografisi (TBT) yapılmış olanlar dahil edilmiştir. Bulgular: PZR testi pozitif ve negatif olan hastaların geliş şikayetleri karşılaştırıldığında, iki grubun da benzer şikayetlere sahip olduğu görülmüştür. PZR testi pozitif hastaların WBC sayıları (5748,39 ± 1547,01), nötrofil sayıları (3650,32 ± 1355,58), lenfosit sayıları (1467,74 ± 472,3) ve platelet sayıları (224,65 ± 76,01); PZR testi negatif olan hastalardan daha düşük bulunmuştur.Sonuç: COVID-19 PZR testi pozitif hastalarda daha düşük WBC, nötrofil ve lenfosit sayısı tespit edilmiştir. Toraks bilgisayarlı tomografi bulguları olan PZR pozitif vakalarda platelet sayısı daha düşük ve CRP değeri daha yüksek izlenmiştir. Bu verilerin özellikle ileri tanı testlerinin olmadığı veya geç sonuçlandığı sağlık kuruluşları için hastalıktan şüphelenme ve erken izolasyon için yol gösterici olabileceğini düşünmekteyiz.Öğe Alterations in thyroid hormones in brain-dead patients are related to non-thyroidal illness syndrome(Via Medica, 2018) Akbaş, Türkay; Şahin, İbrahim Ethem; Öztürk, AyhanIntroduction: Alterations in thyroid hormone levels occur in patients with acute neurological disease states. The aim of this study is to study changes in thyroid hormones in patients with brain death (BD). Material and methods: Eleven brain-dead patients were studied prospectively. Thyroid hormones were measured on admission to the intensive care unit, the day before BD diagnosis (BD before), and the day after BD diagnosis (BD day). Results: Thyroid stimulating hormone (TSH) and free triiodothyronine (fT3) concentrations were found to be significantly low on admission, BD before, and BD day compared to age-matched healthy controls. TSH levels were shown to be increasing on BD day. Free thyroxine (fT4) levels were within normal limits in all cases except in one case having low fT4 levels with normal TSH levels. No statistically significant changes were encountered between admission thyroid hormone levels and BD-before and BD-day thyroid hormone levels. Six patients were on steroid therapy when BD-before blood samples were drawn, and no difference in thyroid hormone levels was encountered between steroid users and non-users. Correlation analysis showed a positive correlation between GCS and TSH, but a negative association between fT3 and APACHE II. Conclusion: We have shown that patients with BD have altered thyroid hormones days before BD diagnosis, and these alterations continue until the diagnosis of BD. The changes in thyroid hormones are compatible with non-thyroidal illness syndrome.Öğe Altered serum levels of vascular endothelial growth factor and glial-derived neurotrophic factor but not fibroblast growth factor-2 in treatment-naive children with attention deficit/hyperactivity disorder(Taylor & Francis Ltd, 2019) Yurteri, Nihal; Şahin, İbrahim Ethem; Tufan, Ali EvrenBackground and aim: Recent evidence suggests that growth factors might be involved in the pathophysiology of attention deficit hyperactivity disorder (ADHD). The aim of this study was to determine whether serum levels of brain-derived neurotrophic factor (BDNF), glial-derived neurotrophic factor (GDNF), neurotrophin-3 (NT-3), nerve growth factor (NGF), fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factor (VEGF) were altered in children with ADHD.Methods: Serum levels of BDNF, GDNF, NT-3, NGF, VEGF and FGF-2 were analyzed in 49 treatment- naive children with ADHD and age, gender matched 36 healthy controls using enzyme-linked immunosorbent assay. ADHD symptoms were scored by Du Paul ADHD Rating Scale and Strengths and Difficulties Questionnaire.Results: We found that serum VEGF levels were significantly lower (p<0.001) and GDNF levels were significantly higher in ADHD group compared to control group (p=0.003). However, we found no correlations between ADHD symptoms and serum VEGF or GDNF levels. Furthermore, we observed no significant alterations in serum BDNF, NT-3, NGF, FGF-2 levels in children with ADHD.Conclusion: To our knowledge, the present study is the first to examine serum VEGF and FGF-2 levels in children with ADHD. Our results indicate that VEGF and GDNF might be involved in the etiology of ADHD. Further studies are required to determine the role of growth factors in the etiology and consequently in the treatment of ADHD.Öğe Comparison of Type I Diabetes Frequency in Children with Cesarean and Normal Vaginal Delivery(2020) Şahin, İbrahim Ethem; Hacıoğlu, Ceyhan; Alpay, Merve; Kılıçaslan, ÖnderAim: The effect of type 1 diabetes mellitus over the world is rising day after day. There arecontroversial results that may be related to cesarean delivery that has become widespread inrecent years and the risk of type 1 diabetes mellitus. In this study, we aimed to investigate thefrequency of type 1 diabetes mellitus in children born by cesarean delivery or normal vaginaldelivery, considering that there may be an association between mode of birth way and diabetesmellitus.Material and Methods: The study was organized with 368 children who were diagnosed astype 1 diabetes mellitus between 8-16 ages that applied to the diabetes outpatient clinic in2019. The patients were grouped according to the mode of delivery. Descriptive data such asage, gender, HBA1c, and BMI were evaluated retrospectively.Results: The children with type 1 diabetes mellitus, cesarean delivery show 33.2% more thannormal vaginal delivery (p<0.001). While 9.0% of children with cesarean delivery hadmother's diabetes mellitus, this rate was 5.7% in children with normal vaginal delivery.Similarly, 5.3% of children with cesarean delivery had diabetes mellitus in their father, whilethis rate was 8.9% in children with normal vaginal delivery.Conclusion: According to the results of this study, cesarean delivery may have a significanteffect on the risk for type 1 diabetes mellitus in childhood either adolescence. Even if parentswith diabetes were not included, it was found that cesarean delivery have meaningful relationby diabetes mellitus stimulation. Regarding this, further studies are needed.Öğe Decreased serum levels of total and high molecular weight adiponectin in treatment-naïve children with ADHD(2020) Yurteri, Nihal Çetin; Şahin, İbrahim EthemObjective: Attention deficit hyperactivity disorder (ADHD) is considered to be one of the most common childhood psychiatric disorders. The aim of this study was to examine serum levels of total and High Molecular Weight (HMW)adiponectin, and also HMW/total adiponectin ratio with respect to ADHD symptomatology in children. Methods: Serum levels of total adiponectin and HMW adiponectin were measured by commercial enzyme-linked immunesorbent assay kits in 44 treatment-naïve children with ADHD and age, gender matched 44 healthy controls. ADHD symptoms were scored by Conners’ Parent Rating Scale-Revised Short (CPRS-RS) and ADHD Rating Scale (ADHD-RS). Body Mass Index-Standart Deviation Scores (BMI-SDS) of all children were evaluated. Results: There were no significant difference in terms of gender, age and BMI-SDS between ADHD and healthy control groups (respectively, p=1, p=0.475, p=0.097). We found that serum total, HMW adiponectin levels and HMW adiponectin/ total adiponectin ratio were significantly lower in ADHD group compared to controls (p<0.001). In logistic regression analysis, adjusting for age, gender and BMI-SDS, we observed that serum total and HMW adiponectin levels as well as HMW/total adiponectin ratio were associated with ADHD (p<0.001). Additionally, in partial correlations adjusting for age and BMI-SDS in ADHD group, we detected significantly negative correlations between total adiponectin, HMW adiponectin, HMW/total adiponectin ratio and CPRS-RS hyperactivity (p=0.031, p=0.016, p=0.007, respectively), ADHD-RS hyperactive-impulsive (p<0.001), ADHD-RS total symptom scores (p=0.015, p=0.010, p=0.005, respectively). Discussion: To our knowledge, the present study is the first to examine serum HMW adiponectin levels in ADHD children and also to investigate the relationship between ADHD symptoms and serum levels of total and HMW adiponectin. The results of our study indicate that total and HMW adiponectin may be associated with ADHD.Öğe EVALUATION OF LEPTIN LEVEL AND VITAMIN D RELATIONSHIP IN OBESE PATIENTS Obez Hastalarda Leptin Düzeyinin ve D Vitamini İlişkisinin Değerlendirilmesi(Yozgat Bozok University, 2020) Şahin, İbrahim Ethem; Alpay, MerveÖZET Amaç: Adiposit kaynaklı hormon olarak bilinen Leptin, beslenme ve enerji homeostazinda önemli rol oynamaktadır. Leptin, reseptörleri aracılığıyla merkezi veya periferik kompleks biyolojik etkileri düzenler. Obezite ve ilişkili Leptin direncini bağlayan mekanizmalar büyük ölçüde belirsizliğini korumaktadır. Ayrıca vitamin D'nin kalsemik olmayan etkileri, glikoz metabolizmasının hormonal regülasyonu ve adipokinlerin yağ dokusu ile sentezi üzerinde perspektif rol oynar. Çalışmamızın amacı, vitamin D düzeylerinin obezite üzerindeki rolünü ve obez hastalarda D vitamini farklılaşması sırasındaki Leptin düzeylerinin aktivitesini göstermektir. Gereç ve Yöntemler: Vitamin D düzeylerini analiz etmek için 40 obez ve sağlıklı hasta bu çalışmaya dâhil edildi. Düşük vitamin D düzeyi görülen bireylerde, 4 hafta vitamin D tedavisi uygulandı. Leptin ölçümü için tüm deney gruplarından kan alındı. Bulgular: D vitamini düzeyi düşük olan hasta grubunda, Leptin ekspresyonunun azaldığı görülürken; D vitamini takviyesi sırasında, obez hastalarda Leptin seviyeleri anlamli duzeyde artmıştır. Bu, Leptinin, vitamin D düzeyi ile doğrudan ilişkisi olan obeziteyi tespit etmek için önemli bir belirleyici olduğu anlamına gelir. Sonuç: Bu sonuçlar serum vitamin D seviyelerinin arttırılmasının Leptin duyarlılığında iyileşme sağladığını göstermektedir. Gelecekteki klinik denemeler test edilmelidir. Vitamin D değişikliği, Leptin salgılanmasına bağlı obezite için tanısal bir faktör olabilir. Anahtar Kelimeler: Beden Kitle Indeksi; Leptin Ekspresyonu; Obezite; Vitamin D ABSTRACT Objective: Adipocyte-induced hormone Leptin, nutrition and energy play an important role in homeostasis. Leptin regulates central or peripheral complex biological effects through its receptors. The mechanisms linking obesity and associated Leptin resistance remain largely unclear. Also noncalcaemic effects of vitamin D, perspective role is played on hormonal regulation of glucose metabolism and synthesis of adipokines by fat tissue. The aim of our study is to show the role of vitamin D levels on obesity and the activity of Leptin levels during vitamin D differentiation on obese patients. Material and Methods: Fourty obese and healthy patients were included this research to analyze vitamin D levels. While seen low-vitamin D level in individuals, 4 weeks vitamin D treatment has been completed. Whole experimental groups were taken blood for Leptin measurement. Results: Our findings were indicated that Leptin expression was decreased when vitamin D level in low. However, during vitamin D uptake, Leptin levels in obese patients were increased correlated to deficiency. That means, Leptin is known significant marker to detect obesity which has direct relation with vitamin D level. Conclusion: These results highlight that reduction serum vitamin D levels leads to improved Leptin sensitivity. Future clinical trials should be tested vitamin D alteration might be diagnostic factor for obesity treatment to Leptin secretion. Keywords: Body Mass Index; Leptin Expression; Obesity; Vitamin D LevelÖğe Perilipin-5 as a potential new biomarker in patients with liver disease and impaired De Ritis ratio(Cukurova Univ, Fac Medicine, 2021) Şahin, İbrahim Ethem; Hacıoğlu, Ceyhan; Davran, Fatih; Alpay, MervePurpose: Liver dysfunctions are one of the most prevalent and deadly diseases worldwide. The De Ritis ratio, which is obtained by proportioning serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT), has been suggested to be a precious marker to assess the prognosis of liver diseases. This study was to investigate the relationship between perilipin 5 (PLIN5) levels and De Ritis ratio in patients with liver disease. Materials and Methods: There were 3 groups: control (Group1; n=20), hepatic patients with normal De Ritis ratio (Group2; n=35) and hepatic patients with impaired De Ritis ratio (Group3; n=35). De Ritis rates of all patients were determined according to the serum aspartate aminotransferase (AST)/serum alanine aminotransferase (ALT) results. Additionally, PLIN5 was spectrophotometrically analyzed from serum samples. Results: There is no significant difference between the groups in terms of age and gender. PLIN5 levels increased by 2.6 and 3.8 times in Group2 and Group3, respectively. De Ritis ratio was significantly increased in the Group3 compared the control, and enhanced PLIN5 levels was correlated with De Ritis ratio in the Group3. There was a significant positive correlation between De Ritis ratio and PLIN5 levels. Conclusion: PLIN5 levels together with De Ritis rate in liver patients may be used as a prognostic marker. Furthermore, this relationship could be a useful method in the follow-up of liver diseases.Öğe Renal fonksiyonları normal tip 2 diyabetli hastalarda serum ürik asit düzeyleri(2007) Memişoğulları, Ramazan; Yüksel, Hatice Kurt; Coşkun, Abdurrahman; Şahin, İbrahim Ethem; Yavuz, ÖzlemBu çalışmanın amacı ürik asidin henüz nefropati gelişmemiş diyabetli hastalarda artıp artmadığını ve serum ürik asit düzeyleri ile hipertansiyon ve renal bozukluk haricinde diyabette glisemi kontrolü ve başka parametrelerle ilişkili olup olmadığını araştırmaktı. Çalışmaya 55 yeni tanı konulmuş tip 2 diyabet hastası ve 41 sağlıklı gönüllü dahil edildi. Diyabetli grupla kontrol grubu arasında serum kreatinin düzeyleri, total kolesterol düzeyleri, düşük dansiteli lipoprotein-kolesterol düzeyleri, vücut kitle indeksi, yaş ve arteriyel kan basınçları arasında istatistiksel olarak fark bulunmadı (p0.05). Ancak diyabetli grubun ortalama serum ürik asit düzeyleri (4.6 1.5 mg/dL) kontrol grubundan (5.3 1.7 mg/dL) anlamlı şekilde düşük bulundu (p0.05). Ayrıca diyabet grubunda, serum ürik asit düzeyi ile çalışılan diğer parametreler arasında anlamlı korelasyon bulunamazken, kontrol grubunda serum ürik asit düzeyi ile sistolik kan basıncı, diyastolik kan basıncı, açlık kan glukozu, hemoglobin A1C ve vücut kitle indeksi arasında pozitif korelasyonlar bulundu (p0.05). Diyabette azalmış ürik asit düzeylerinin pek çok faktöre bağlı olduğunu düşünmekteyiz. Ayrıca diyabetteki oksidatif strese ürik asit azalmasının da katkısı olabilir.Öğe Serum clara cell protein-16 level in non-smoker obstructive sleep apnea syndrome patients(European Respiratory Soc Journals Ltd, 2019) Balbay, Ege Güleç; Ataoğlu, Özlem; Erçelik, Merve; Şahin, İbrahim Ethem; Admış, Özlem; Arbak, Peri Meram…Öğe Serum Clara cell secretory protein (CC-16) in non-smoking patients with obstructive sleep apnea(Springer, 2020) Balbay, Ege Güleç; Ataoğlu, Özlem; Erçelik, Merve; Şahin, İbrahim Ethem; Admış, Özlem; Arbak, Peri MeramObjective: This study aimed to determine the association between the severity of obstructive sleep apnea (OSA) and serum Clara cell protein (CC16) levels in non-smoking patients with OSA. Methods: This prospective study included non-smoking patients who presented with sleep-related disturbances and underwent polysomnography (PSG). The serum CC16 level was measured and its relationship to PSG parameters was investigated. Results: The study included 128 patients (83 men) with a mean age of 48.4 ± 11.9. OSA was detected in 66 men (70%) and 29 women (30%) (p = 0.051). The severity of OSA was mild in 32 (25%), moderate in 28 (22%), and severe in 35 (27%) of the patients. There was no significant difference in CC16 levels between the OSA group (1746 ± 1006) and the OSA negative group (1721 ± 1201, p = 0.91) levels. There was no significant difference between the CC16 levels of the each four groups. Mean serum CC16 levels were significantly lower in OSA negative men than OSA positive men (777 vs 1462, p = 0.005). No significant difference was observed in CC16 values according to OSA severity in women. Conclusion: The serum CC16 level does not differ between non-smoking OSA patients and OSA negative patients. © 2020, Springer Nature Switzerland AG.Öğe Serum neopterin, YKL-40, IL-6, and TNF-? in patients with obstructive sleep apnea(2023) Admış, Özlem; Şahin, İbrahim Ethem; Balbay, Ege Güleç; Cangur, ŞengülObjective: Obstructive Sleep Apnea (OSA) is characterized by recurrent episodes of complete or partial upper airway obstruction during sleep. The role of locally increased inflammation in the upper respiratory tract is known in the pathogenesis of OSA. This study aimed to examine the role of some inflammatory markers in OSA. Materials and Methods: Adult patients who underwent diagnostic polysomnography (PSG) for the first time, were evaluated in this prospective study. Serum levels of neopterin, human cartilage glycoprotein 39 (YKL-40), interleukin-6 (IL-6), and tumor necrosis factor- alpha (TNF-?) were examined in the study group. Results:The study included 165 adult patients. Individuals of 56 who were did not have OSA were taken as the control group. Patients diagnosed with OSA (n=109) were included in the study and divided into two groups mild-moderate and severe based on the OSA apnea-hypopnea index (AHI). The study groups were divided into 3 cathegories: AHI <5 (control) Group 1, AHI 5-15 (mild), and AHI 15-30 (moderate) Group 2, AHI>30 (severe) Group 3. Individuals of 165 who completed the study [Group 1 (n=56), Group 2 (n=69), Group 3 (n=40)] were included in the statistical evaluation. There was a significant difference between the groups in terms of neopterin, YKL-40, and IL-6 values (p<0.05). The median value of IL-6 and neopterin measured in the severe group was significantly higher than the value measured in the control and mild- moderate groups (p<0.001). The mean value of YKL-40 measured in the severe group was significantly higher than the value measured in the control group (p=0.012). No significant difference was observed in TNF-? serum levels of groups. Conclusion: Serum levels of neopterin, YKL-40, and IL-6 were found to be elevated in OSA patients (especially in the severe group).Öğe Serum uric acid levels in patients with type 2 diabetes Mellitus who have normal renal function(Walter De Gruyter Gmbh, 2007) Memişoğulları, Ramazan; Yüksel, Hatice Kurt; Coşkun, Abdurrahman; Şahin, İbrahim Ethem; Yavuz, ÖzlemThe aim of this study was to investigate whether serum uric acid levels increase in Diabetes Mellitus and if serum uric acid levels were related to factors apart from hypertension and renal failure. Fifty-five newly diagnosed patients with type 2 Diabetes Mellitus and 41 healthy volunteers were included in the study. Serum creatinin level, total cholesterol level, low density lipoprotein-cholesterol level, body mass index, age, and arterial blood pressure was not different in diabetic group, when compared with the control group. However, serum uric acid level (4.6 +/- 1.5 mg/dL) was significantly lower than those of the control group (5.3 +/- 1.7 mg/dL) (p<0.05). In addition, uric acid in the diabetic group did not significantly correlate with the biochemical and clinical variables, whereas in the control group, serum uric acid level was significantly correlated with systolic blood pressure, diastolic blood pressure, fasting blood glucose level, hemoglobin A(1C) level and body mass index. We think that decreased serum uric acid level in diabetes is dependent on many factors. In addition, the decrease of serum uric acid level may be contributed to oxidative stress in diabetes.Öğe Thyroid Hormone Levels in Brain Death Patients(Lippincott Williams & Wilkins, 2017) Akbaş, Türkay; Öztürk, Ayhan; Şahin, İbrahim Ethem…
