4 research outputs found
Non-alkolik karaciğer yağlanması ve homa indeks ilişkisinin retrospektif olarak araştırılması
06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.ÖZET Giriş ve Amaç: Çalışmamızda non-alkolik karaciğer yağlanması tespit edilen hastalarda, insülin direnci Homa IR, (Homeostatic Model Assesment İnsülin Resistant) ve klinik biyokimyada rutinde kullanılan diğer karaciğer yağlanması parametreleri geriye dönük (retrospektif) olarak taranacaktır. Amacımız; giderek yaygınlaşan non-alkolik karaciğer yağlanmasının etiyolojisine ışık tutmak ve ilgili klinisyenlere yeni bakış açıları sunmaktır. Gereç ve Yöntem: Tez çalışmamız; 1.5.2015 ve 1.5.2016 tarihleri arasında, Sakarya Üniversitesi Eğitim ve Araştırma hastanesinde non-alkolik karaciğer yağlanması tanısı konulan hastalara ait verilerin, geriye dönük taranması ile yapılmıştır. Çalışmada, radyoloji ve biyokimya kliniği HBYS verileri (otomasyon) ortaklaşa kullanılmıştır. Çalışmanın radyoloji ayağında, NAYKH (Non-alkolik yağlı karaciğer hastalığı) tanılı hastaların geriye dönük Doppler Usg sonuçlarının incelenmiş ve grade'lerine göre sınıflandırılmıştır. Çalışmanın biyokimya ayağında ise, Homa Indeks ve bununla ilgili olduğu düşünülen diğer test parametreleri HBYS üzerinden alınmıştır. Ayrıca, çalışmaya dâhil edilen tüm hastaların; yaş ve cinsiyetleri tespit edilmiştir. Bulgular: Çalışmada, dâhil edilme kriterlerimize uyan 870 hastanın sonuçları incelenmiştir. Non alkolik karaciğer yağlanması erkek hastalarda kadın hastalara göre daha fazla çıkmıştır. Bu duruma paralel olarak serum ALT, AST, ALP, GGT parametreleri de erkek hastalarda yüksek çıkmıştır. HOMA İndeksi çocuklarda erişkilerden yüksek çıkmıştır. HOMA İndeksi 2,5'in üzerinde olduğunda insülin direnci lehine bir bulgudur. Fakat yapılan bazı çalışmalar çocuklarda HOMA indeksi değerinin kesim değerini erişkinlerden daha yüksek olarak belirlenmiştir. Sonuç: Non alkolik karaciğer yağlanmasının belirgin olarak etkileyen parametrelerden cinsiyet, yaş ve HOMA indeksi öne çıkmaktadır. Bir birim HOMA indeksindeki artış karaciğer yağlanmasının evresini 1,35 kat arttırmaktadır. Erkek olmak karaciğer yağlanmasını yaklaşık 2 kat arttırmaktadır. ANAHTAR KELİMELER: Non-alkolik karaciğer yağlanması,İnsülin Direnci, Hastane Bilgi Yönetimi Sistemi(HBYS), Homa İndeks,Çocuklarda Karaciğer YağlanmasıSUMMARY INTRODUCTION AND PURPOSE: In our study, In patients with non-alcholic fatty liver, insulin resistance (Homa IR, Homeostatic Model Assesment Insulin Resistant) and routine liver parameters used in clinical biochemistry will be screened retrospectively. Our aim; to shed light on the etiology of increasingly extensive non-alcoholic liver fat, and to present new perspectives to the clinicians. MATERIALS AND METHODS: Our thesis study; The data of the patients diagnosed with non-alcoholic fatty liver in Sakarya University Education and Research Hospital between the period of 1.5.2015 and 1.5.2016 were retrospectively screened. In the study, radiology and biochemistry clinic HIMS data (Hospital Information Management System) was used jointly. In the radiology part of the study, retrospective Doppler Usg results of patients with NAFLD (Non-Alcoholic Fatty Liver Disease) were examined and classified according to their grade. In the part of biochemistry, Homa index and other related test were taken from HIMS. In addition, all patients' age and sex were determined included in the study. RESULT: In this study, the results of 870 patients who met our inclusion criteria were examined. Non-alcoholic fatty liver syndrome has been detected higher in male patients than female patients. In parallel with this situation, serum ALT, AST, ALP and GGT parameters were also higher in male patients. The HOMA Index was higher in children than in adults. When the HOMA index is above 2,5, it is a finding in favor of insulin resistance. However, some studies have shown that the HOMA index is higher in children than in adults. CONCLUSIONS: Sex, age and HOMA index are prominent parameters that significantly affect non-alcoholic fatty liver. The increase in 1 unit of HOMA index increased the stage of fatty liver by 1.35 fold. Being a man increases the fatty liver about 2 times. KEYWORDS: Hospital Information Management System, Non-Alcoholic Fatty Liver Disease, Homa Index, Insülin Resistance, NAFDL in the Childre
Cytoreductive Surgery For Intestinal Cancer Patients Metastatic To Ovaries Presenting As Primary Ovarian Cancer
Colorectal cancer accounts for one third of non-genital tumors metastasize to the ovaries. We aimed to investigate the role of cytoreductive surgery in colon and small intestinal cancer patients with adnexal metastases, which were operated as primary epithelial ovarian cancer. This analysis included 26 patients with adnexal metastasis from colon and distal ileum, patients presented as primary ovarian cancer cases and were operated upon in Zekai Tahir Burak Women's Health Hospital, Gynecologic Oncology Unit between 2008 and 2014. Patients with history of intestinal cancers were not included in the study. The median age of patients was 54 (range= 26-77). Among all patients, 63% were premenopausal and 37% were postmenopausal. Most common presenting symptom was abdominal distention (80%). Optimal cytoreduction was performed in 21 patients. Right hemicolon was the primary site of tumor in 8 patients, while recto-sigmoid and appendiceal tumors were present in 7 and 7 patients, respectively. Isolated ovarian metastases were found in 6 patients, the remaining 20 patients had peritoneal carcinomatosis. Median follow-up was 25 months (ranging 3-59). In total, 11 patients died, of them, two patients had isolated ovarian metastasis, while the remaining nine patients had peritoneal carcinomatosis. Estimated median overall survival was 36.8 months (95% CI= 28.6-45.1 months). Median overall survival of patients who underwent cytoreductive surgery was not reached (36.8+ months), compared with 18.3 (95% CI= 0.0-46.4) months for patients with suboptimal cytoreductive surgery (p= 0.008). This retrospective study showed that cytoreductive surgery might have beneficial effect in selected patients with intestinal cancer metastatic to the adnexal.WoSScopu
Altered expression of micro-RNA 199a and increased levels of cardiac SIRT1 protein are associated with the occurrence of atrial fibrillation after coronary artery bypass graft surgery
WOS: 000375860400011PubMed ID: 26952538Background: Postoperative atrial fibrillation (POAF) is a potentially life-threatening complication after coronary artery bypass graft (CABG) surgery. The expression of the cardioprotective SIRT1 protein with its antioxidant activity is increased in cardiac tissue of patients suffering from POAF. So far, information is lacking about the relationship between SIRT1 regulating micro RNAs (miRs), SIRT1 protein and the occurrence of POAF. Methods: A total of 63 patients undergoing CABG were recruited, and biopsies were obtained from the right atrial appendage during cannulation. Postoperative, all patients were rhythm-monitored until discharge and randomized to POAF (n= 20) or sinus rhythm (n= 43). The expression of the micro RNAs miR-199a and miR-195 was quantified by real-time PCR. SIRT1 protein was detected by western blot analysis. Results: The relative expression of miR-199a in the POAF group was significantly decreased compared to the control group (0.77 +/- 0.27 vs. 1.11 +/- 0.69, P=. 022) Accordingly, SIRT 1 protein was significantly induced in tissue probes of patients with POAF (P<. 001). Conclusion: Altered expression of the SIRT1 protein regulating miR-199a in human atrial tissue was found to be related to the occurrence of POAF, indicating its usefulness as a biomarker for cardiac surgery management.Science Foundation BAP of the Bezmialem Vakif University (BAP) [3.2015/28]This research received funding from the Science Foundation BAP of the Bezmialem Vakif University (BAP number 3.2015/28)