Delirium in patients with acute ischemic stroke admitted to the non-intensive stroke unit: Incidence and association between clinical features and inflammatory markers

Background Stroke patients with development of delirium have unfavorable outcomes, higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Studies suggest that delirium is associated with abnormal immunological responses and a resultant increase in inflammatory markers. Objective Our aim was to determine whether there is an entity relationship between delirium, inflammation and acute ischemic stroke (AIS). Methods Sixty AIS patients admitted to the hospital were consecutively recruited. Delirium was diagnosed with the clinical assessment according to the Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of Interleukin-1 beta (IL-1 beta), Interleukin 18 (IL-18), Tumor Necrosis Factor-alpha (TNF-alpha), Brain-Derived Neurotrophic Factor (BDNF), and Neuron Specific Enolase (NSE) at admission. Results Eleven (18.3%) of 60 patients were diagnosed with delirium, and the majority (n=8, 72.7%) was the hypoactive type. Delirious and non-delirious patients had similar demographic and clinical features. Delirious patients had significantly higher lengths of hospital stay, National Institutes of Health Stroke Scale (NIHSS) at admission and discharge compared to non-delirious patients. In addition, there was no significant statistical difference between delirious and non-delirious patients with AIS in respect of levels of TNF-alpha, IL-1 beta, IL-18, BDNF and NSE. This study suggests that delirium is not scarce in patients with AIS admitted to the non-intensive stroke unit, and that delirium developing after AIS seems not to be associated with serum TNF-alpha, IL-1 beta, IL-18, BDNF and NSE but is associated with length of hospital stay and stroke severity

Investigation of dietary miRNA presence in biological fluids of mothers living in Konya region

Amaç: Bu çalışmada, emziren annelerden eş zamanlı alınmış olan plazma ve anne sütü gibi biyolojik sıvılarda, annelerin günlük diyetlerinde tükettikleri gıdalara ait miRNA varlığı araştırılmıştır. Yöntem: Laktasyonunun 1-12 aylarındaki, sağlıklı ve gönüllü 11 emziren anne çalışmaya dahil edilmiştir. Annelerden alınan plazma örnekleri ile süt örneklerinin lipid ve lipid altı kısımlarında besinsel miRNA varlığı RT-PCR yöntemi ile araştırılmıştır. Ardından varlığı tespit edilen miRNA'ların insanda etki edebileceği mRNA ve yolaklar veri tabanlarından araştırılmıştır. Bulgular: Mdm-miR171i, mdm-miR7121d, sly-miR169c, sly-miR156a, osa-miR168a-5p, tae-miR167a, gma-miR1520d ve gma-miR156b için hem plazma, hem de süt örneklerinde anlamlı ekspresyon tespit edilmiştir. Sly-miR169b, osa-miR168a-3p, osa-miR156a ve taemiR159b için plazmada anlamlı miktarda ekspresyon tespit edilirken, süt örneklerinde anlamlı ekspresyon gözlenmemiştir. Mdm-miR858, mdm-miR399a, tae-miR167b ve taemiR159a için hiçbir örnekte anlamlı ekspresyon gözlenmemiştir. Veri tabanlarında yapılan karşılaştırma sonucu, plazmada tespit edilen besinsel miRNA'ların bazı insan mRNA'larının 3' UTR bölgesi ile yüksek oranda baz eşleşmesi gösterdiği tespit edilmiştir. Sonuç: Besinsel miRNA'nın insan plazması ve anne sütüne geçtiği, ancak bu geçişin miRNA'ların bazıları için gerçekleşmediği tespit edilmiştir. Yine bu miRNA'ların insanda pek çok yolak üzerine etkili olabileceği tespit edilmiştir. Öte yandan miRNA'ların geçiş mekanizmalarının tespiti ve insan metabolizmasındaki rollerinin kesin olarak gösterilebilmesi için çok daha kapsamlı çalışmalar yapılması gerekmektedir.Aim: In this study, the presence of food-borne miRNAs that mothers consume on their daily diet has been investigated in biological fluids such as plasma and milk which are taken simultaneously. Material and Method: Healthy and voluntary 11 lactating mothers from 1-12 months of lactation were included in the study. The presence of nutritional miRNAs in plasma and milk (milk lipid and skim milk fractions) samples was investigated by RT-PCR. Then, mRNAs and pathways in which the presence of miRNAs that have been identified can act in the human body were searched from databases. Results: Significant expression was detected in both plasma and milk samples for mdmmiR171i, mdm-miR7121d, sly-miR169c, sly-miR156a, osa-miR168a-5p, tae-miR167a, gma-miR1520d and gma-miR156b. Significant amounts of expression were detected in the plasma for sly-miR169b, osa-miR168a-3p, osa-miR156a and tae-miR159b, but no significant expression was observed in milk samples. No significant expression was observed in any of the samples for mdm-miR858, mdm-miR399a, tae-miR167b and taemiR159a. As a comparison with the databases, it was determined that the nutritional miRNAs detected in the plasma showed high base matching with the 3 'UTR region of some human mRNAs. Conclusion: It has been determined that nutritional miRNA passes to human plasma and breast milk, but this transition does not occur for some miRNAs. It has also been found that these miRNAs can be effective on many pathways in humans. On the other hand, much more comprehensive studies needs to be done in order to detection of miRNA transition mechanisms and to clearly demonstrate their role in human metabolism

Bir Üniversite Hastanesinde Hemoglobinopati ve Talasemi Verilerinin Değerlendirilmesi

Amaç: Hemoglobinopatiler, globin fonksiyonlarını bozan bir grup hastalıktır. HPLC, hemoglobinopati taramalarında tüm dünyada en sık kullanılan tekniktir. Çalışmada, Türkiye'de bir üçüncü basamak hastane laboratuvarında 3 yıllık retrospektif hemoglobinopati sıklığı değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Üniversite hastanemize başvuran 2461 hastanın 3 yıllık laboratuvar ve hastane kayıtları incelenmiştir. Hemoglobinopati taramasında Tosoh G8 HPLC cihazı kullanılmıştır Bulgular: HbA2%3,5 olan 668, %3,5HbA2%4 olan 19 sonuç saptanmıştır.19 sonuçtan 10'u betatalasemi minör olarak kabul edilmiştir. HbA2 %4 olan 649 sonuç vardır ve sonculara göre 602 hasta beta-talassemi minör olarak kabul edilmiştir. HbA2 düzeylerine göre, hastaların %25'i beta-talasemi minör olarak değerlendirilmiştir. HbF%2 olan 391 hasta saptanmış ve HbA2%3,5 olan 138 kayıt ayrıntılı incelemeye alınmıştır. Varyant analizi veri kümesi, 53 hasta içermektedir. HbA2%3,5 ve HbF%2 olan, varyant pikleri mevcut kayıtlar incelenmiş ve 28 vaka saptanmıştır. En sık görülen Hb varyantları sırasıyla HbH, HbS, HbD, HbC, HbE ve HbO-Arab'dır. Sonuç: Çalışmada en sık varyantlar sırasıyla HbH, HbAS, HbAD, HbAC, HbAE ve HbO-Arab olarak bulunmuştur. Beta talasemi minör sıklığı ülkemizin gelen popülasyonundan yüksek olarak %25 bulunmuştur. Özellikle hematolojik malignensiler, herediter sferositoz ve demir eksikliği anemisi gibi eşlik eden durumlar hemoglobinopati değerlendirmesinde akılda tutulmalıdır.Objective: Hemoglobinopathies are an array of disorders that affect hemoglobin (Hb) function. HPLC is by far the most common technique used for detection of hemoglobinopathies worldwide. The aim of this study is to evaluate 3-year retrospective data of a tertiary hospital in Turkey according to prevalence of hemoglobinopathies. Material and Methods: A three-year data of 2461 patients admitted to our university hospital laboratory were assessed by scanning laboratory and hospital records. Tosoh G8 HPLC instrument was used for screening. Results: 668 results with HbA23.5% and 19 results with 3.5% HbA2 4% were detected. 10 of 19 patients were considered as beta-thalassemia. Number of patients with HbA2 4% were 649 and 602 of them were assessed as beta-thalassemia-minor. 25% of patients were assessed as beta-thalassemiaminor, based on HbA2 levels. 391 patient results were found to be HbF2% and 138 of them with HbA23.5% were further investigated. Variant analysis dataset contains 53 patients. Samples with HbA23.5% and HbF2% showing variant peaks were scanned and 28 cases were detected. The most common variants were found to be HbH, HbS, HbD, HbC, HbE and HbO-Arab, respectively. Conclusion: In this study, the most common variants were found to be HbH, HbAS, HbAD, HbAC, HbAE and HbO-Arab, respectively. Moreover, the frequency of beta-thalassemia minor was found as 25% which is higher than general population prevalence of our country. Accompanying diseases especially hematological malignancies, hereditary spherocytosis and IDA should be kept in mind during evaluating hemoglobinopathy analysis

Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome

Aim: The aim was to evaluate the levels of serum pentraxin-3 (PTX-3) and neutrophil gelatinase-associated lipocalin (NGAL) and the efficiency of making a diagnosis and to estimate the prognosis in patients with chest pain.Materials and Methods: The study was conducted in the Necmettin Erbakan University Meram Medicine School Emergency Department. Patients who had chest pain and met the inclusion criteria were accepted. They were divided into the following groups: acute coronary syndrome (ACS), a diagnosis other than ACS (non-ACS), and control. The patients in theACS and non-ACS groups were divided into five sub-group -groups: ST Elevated Myocardial Infarction (STEMI) Non- ST Elevated Myocardial Infarction (NSTEMI), Unstable Angina Pectoris (USAP), stable angina, and pulmonary embolus. For all patients, serum PTX-3, serum NGAL, troponin I, and creatine kinase-MB fraction (CK-MB) levels were measured.Results: There were 199 patients in the ACS and non-ACS groups and 30 patientsin the control group. There was no significant difference among the study groups in terms of age and PTX-3 and NGAL levels. When comparing survival and non-survival in terms of in-hospital death, CK-MB and troponin I levels were significantly higher in the ACS and non-ACS groups than in the control groups, whereas there was no significant difference in terms of PTX-3 and NGAL levels.Conclusion: The results of our study demonstrated that PTX-3 and NGAL are not effective biomarkers in the differential diagnosis and the determination of in-hospital mortality in ACS. However, the limitations of the study should be considered. The results confirmed that CK-MB and Troponin I can be safely used in the differential diagnosis and the prediction of mortality