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    The effect of the HMGB1/RAGE/TLR4/NF-?B signalling pathway in patients with idiopathic epilepsy and its relationship with toxoplasmosis
    (Wiley, 2024) Soyturk, Hayriye; Onal, Cansu; Kilic, Umit; Turkoglu, Sule Aydin; Ayaz, Erol
    This study aims to investigate the relationship between toxoplasmosis and this pathway, which may be effective in the formation of epilepsy by acting through the HMGB1/RAGE/TLR4/NF-kappa B signalling pathway in patients with idiopathic epilepsy. In the study, four different experimental groups were formed by selecting Toxoplasma gondii IgG positive and negative patients with idiopathic epilepsy and healthy controls. Experimental groups were as follows: Group 1: Epilepsy+/Toxo- (E+, T-) (n = 10), Group 2: Epilepsy-/Toxo- (E-, T-) (n = 10), Group 3: Epilepsy-/Toxo+ (E-, T+) (n = 10), Group 4: Epilepsy+/Toxo+ (E+, T+) (n = 10). HMGB1, RAGE, TLR4, TLR1, TLR2, TLR3, IRAK1, IRAK2, IKBKB, IKBKG, BCL3, IL1 beta, IL10, 1 L8 and TNF alpha mRNA expression levels in the HMGB/RAGE/TLR4/NF-kappa B signalling pathway were determined by quantitative simultaneous PCR (qRT-PCR) after collecting blood samples from all patients in the groups. Statistical analysis was performed by one-way ANOVA followed by LSD post-hoc tests, and p < 0.05 was considered to denote statistical significance. The gene expression levels of HMGB1, TLR4, IL10, IL1B, IL8, and TLR2 were significantly higher in the G1 group than in the other groups (p < 0.05). In the G3 group, RAGE and BCL3 gene expression levels were significantly higher than in the other groups (p < 0.05). In the G4 group, however, IRAK2, IKBKB, and IKBKG gene expression levels were significantly higher than in the other groups (p < 0.05). HMGB1, TLR4, IRAK2, IKBKB, IL10, IL1B, IL1B, and IL8 in this signalling pathway are highly expressed in epilepsy patients in G1 and seizures occur with the stimulation of excitatory mechanisms by acting through this pathway. The signalling pathway in epilepsy may be activated by HMGB1, TLR4, and TLR2, which are considered to increase the level of proinflammatory cytokines. In T. gondii, this pathway is activated by RAGE and BCL3.
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    Effectiveness of the Situation-Background-Assessment-Recommendation method in emergencies with simulation-based education for nursing and paramedic students
    (Elsevier Sci Ltd, 2025) Erbas, Atiye; Kiziltepe, Selin Keskin; Kilic, Umit
    Introduction: Effective handover skills play a crucial role in communication between pre-hospital and hospital staff. However, nursing and paramedic students rarely have the opportunity to practice them. Objective: Our study aimed to evaluate the effectiveness of the Situation-Background-AssessmentRecommendation (SBAR) method in emergency settings using simulation-based education for nursing and paramedic students. Methods: We conducted a single-group quasi-experimental study involving 39 nursing and 42 paramedic students. The students' patient handover skills were evaluated through simulation-based training using a structured handover method. Data were collected using the Personal Data Form, Patient Handover Information Form, Patient Handover Skill Evaluation Form, and Video Observation and Evaluation Form. For data analysis, we used the Mann-Whitney U test, the Friedman test, the Cohen's kappa coefficient, and the Pearson correlation test. Results: The knowledge scores of nursing (N) and paramedic (P) students (N: 16 [11-20]; P: 15 [10-19] pretraining) increased post-training (N: 18 [15-20]; P: 18 [10-21]), post-simulation (N: 18 [14-21]; P: 17 [13-20]), and one-month after the post-simulation (N: 18 [14-21]; P: 17 [14-20]). The group participants, 50%, received scores between 12.50 and 16.25 and acquired medium handover skills. Conclusion: We found that theoretical education and simulation-based applications were effective in enhancing students' knowledge level of handover processes, which are critical for patient safety, and that simulation supported their learning. It is recommended that patient handover training be conducted using simulation-based methods with different student groups, integrated into educational curricula, and updated regularly.
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    Investigation of the Effects of Acute and Chronic PTZ Model Epilepsy in Rats Exposed to Neonatal Hyperoxia on Bdnf, Ngf, Cyt c, Bax, and Bcl-2 Gene Expression Levels in the Brain
    (Galenos Publ House, 2023) Onal, Cansu; Kilic, Umit; Soyturk, Hayriye
    Objective: The aim of this study was to investigate the relationship between acute and chronic epilepsy that may occur in adulthood, gene expression levels, and the possible mechanism of neuronal loss in rats exposed to hyperoxia in the postnatal period. Methods: The study was started with 12 female rats (mother rat). Two main groups were formed: six control and six hyperoxia groups. At the end of the experiment, brain tissue samples were collected and Bdnf, Ngf, Cyt c, Bax, and Bcl-2 gene expressions were studied by quantitative polymerase chain reaction. Bax (Bcl-2 associated X-protein) and Cytochrome (Cyt) c gene expression levels were found to be significantly higher in the hyperoxia-epilepsy groups, especially in the male group, than in the other groups (p<0.05). Results: While the Ngf gene expression level increases significantly in females due to epilepsy, it is independent of hyperoxy (p<0.05). Bdnf gene expression levels were found to be affected by hyperoxia in both males and females (p<0.05). In our study, a significant increase in Bax and Cyt c gene expression levels was observed in the neonatal hyperoxia and epilepsy group. Conclusion: It is thought that this increase in gene expression levels molecularly supports neuronal loss, but the related pathways will be better clarified with further studies.
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    Modulation of Brain-derived Neurotrophic Factor and Nerve Growth Factor Gene Expression in the Hippocampus and Cortex Regions of Rats with Penicillin-induced Experimental Epilepsy: The Effect of Adenosine Triphosphate-sensitive Potassium Channels
    (Wolters Kluwer Medknow Publications, 2025) Kilic, Umit; Soyturk, Hayriye; Yildiz, Aysegul; Onal, Cansu
    Objective:The objective is to investigate the effect of adenosine triphosphate (ATP)-sensitive potassium (KATP) channels on brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) gene expression in the hippocampus and cortex regions using a penicillin-induced epilepsy model. Materials and Methods:The study included four groups, control (C), epilepsy (E), epilepsy-opener (E-O), and epilepsy-blocker (E-B), and three subgroups, 1st day, 4th day, and 8th day after the seizure. The hippocampus and cortex were dissected from all animals and BDNF and NGF messenger ribonucleic acid (mRNA) expression levels were quantified using quantitative polymerase chain reaction (qPCR). Results:The relative gene expression of the NGF gene evaluated in hippocampal tissues was found to be significantly higher in the epilepsy 1st-day group compared with the C group (P < 0.05). The relative gene expression of the NGF gene in cortex tissues was found to be significantly higher in the epilepsy 8th-day group compared with the C group (P < 0.05). The relative gene expression of the BDNF gene in hippocampal tissues was also significantly higher in the epilepsy 1st-day group compared with the C group (P < 0.05). BDNF gene expression levels in the cortex region were significantly higher in the E group on the 8th day, in the E-O group on the 1st, 4th, and 8th days, and in the E-B group on the 1st day; BDNF gene expression level was also significantly higher in the E-B group on the 8th day compared with the C group (P < 0.05). Conclusion:KATP channels play a modulatory role in the expression levels of BDNF and NGF genes in the cortex over an extended period of 8 days, parallel to their efficacy observed in the hippocampus on day 1. These mechanisms need to be thoroughly investigated and emphasized due to their importance.