Diagnostic value of neutrophil to lymphocyte ratio to rule out chronic obstructive pulmonary disease exacerbation from acute heart failure in the emergency department

INTRODUCTION: This study was performed to determine whether neutrophil-lymphocyte ratio (NLR) optimizes the differential diagnosis of acute chronic obstructive pulmonary disease (COPD) exacerbation and acute heart failure (AHF) in patients admitting to the emergency department (ED) with dyspnoea.  MATERIAL AND METHODS: The study group included 241 patients (135 males and 106 females) who were admitted to the ED with a complaint of dyspnoea between January 2016 November 2018 and were hospitalized with diagnosis of acute COPD exacerbation or AHF.  RESULTS: White blood cell count, neutrophil, haemoglobin, haematocrit, NLR, and C-reactive protein values in patients with COPD exacerbation were significantly higher compared to those with AHF (p < 0.05). The largest areas under the ROC curve were obtained with NLR. The cut-off value for NLR was 9.39, with a sensitivity of 71% and a specificity of 61%.  CONCLUSIONS: In conclusion, the NLR has diagnostic value to the conventional clinical assessment in patients with acute dyspnoea at ED, especially with acute COPD exacerbation requiring inpatient management. This may be an additional tool during the differential diagnosis of dyspnoea for emergency physicians in hospitals without advanced laboratory facilities

Do the advances in information technologies complicate the conduct of monetary policy?

The conduct of monetary policy is getting complicated due to the impacts of IT on monetary policy. In this study, it is examined how the advances in the IT complicate the conduct of monetary policy and concluded that some main factors are to be taken into consideration by monetary policy makers in conducting monetary policy. These factors include the difficulty in distinguishing permanent changes from transitory ones, the increased role of intangible goods and services in economy, and the changes in the usage of electronic money and reserve requirements.Bilgi teknolojileri para politikası üzerindeki etkilerine bağlı olarak para politikasının yönetimi zorlaşmaktadır. Bu çalışmada bilgi teknolojilerindeki ilerlemelerin para politikası yönetimini nasıl zorlaştırdığı incelenmiş ve para politikası yapıcıları tarafından para politikasının yönetiminde bazı temel faktörlerin göz önüne alınması gerektiği sonucuna varılmıştır. Bu faktörler verimlilik büyümesinde geçici ve sürekli değişmelerin ayırt edilmesinin zorlaşması, fiziksel olmayan mal ve hizmetlerin ekonomideki ağırlığının artması ve elektronik para ve zorunlu karşılık kullanımlarındaki değişmelerdir

Evaluation of thiol disulfide balance in adolescents with vitamin B12 deficiency

Background: Vitamin B12 is an important vitamin for metabolism and affects many mechanisms in the body including neuronal migration, DNA synthesis, neurotransmitter synthesis, brain and cognitive development. Increased oxidative stress in the body leads to the damage of the child development, but also plays a crucial role in the pathogenesis of many diseases encountered in the childhood period. Our aim is to investigate whether or not B12 deficiency is associated with dynamic thiol/disulfide homeostasis in adolescent patients. Methods: This is a case-controlled observational study consisting of 45 adolescent patients with vitamin b12 deficiency and a control group consisting of 45 healthy adolescent. Patients between 11 and 18 ages who applied to the outpatient clinic for the first time with one of the complaints of headache were selected due to their decreased school performance, dizziness, and fatigue. Hemogram, vitamin B12, homocysteine levels and oxidative stress parameters such as native and total thiol disulfide levels and ratios of disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol were measured from the patients. Results: Vitamin B12 level was found to be significantly lower in vitamin B12 deficiency group (p < 0.001). The serum disulfide level was found to be 27.5 ± 8.38 in the case group and 20.5 ± 8.36 in the control group (p < 0.001). In the multiple linear regression analysis, it was determined that the independent variables of native thiol, homocysteine and disulfide levels effected of vitamin B12 levels (p < 0.001, p < 0.001, p < 0.005 respectively; R2 = 0.62). Conclusion: The results obtained in terms of the effect of vitamin B12 deficiency on oxidative stress in adolescents are remarkable. The increase in oxidative stress parameters in the patient group may also suggest that oxidative stress plays a vital role in vitamin B12 deficiency in adolescence

Is platelet to monocyte ratio a useful inflammatory determinant of ST-elevation myocardial infarction?

INTRODUCTION: The main factors in the development of ST-segment elevation myocardial infarction (STEMI) are inflammatory processes and pathophysiological changes due to oxidant stress. The aim of this study is to evaluate the association of prevalent STEMI with markers of inflammatory and oxidative stress. The platelet to monocyte ratio (PMR) was evaluated as a new hematological inflammatory marker.   MATERIAL AND METHODS: The study is a retrospective observational study conducted in the emergency department between January 2018 and January 2019. In the study, all patients who were diagnosed with STEMI were considered in the study group. Evaluations of inflammatory and oxidant stress markers, PMR value of STEMI patients were performed.   RESULTS: Neutrophil to lymphocyte ratio (NLR) value of 5.63 (3.35–7.84), Monocyte count to high-density lipoprotein cholesterol ratio (MHR) value of 16.10 (12.73–19.52), gamma-glutamyl transferase (GGT) value of 31.00 (21–39) and CRP value of 5.10 (2.77–9.34) were significantly higher in STEMI cases (p &lt; 0.005). The lymphocyte to monocyte ratio (LMR) value of 2.57 (2.00–3.61) and the PMR value of 24.52 ± 7.60 in STEMI cases were significantly lower (p &lt; 0.001, p = 0.014).   CONCLUSIONS: In STEMI patients NLR, GGT, and MHR rates increase significantly and LMR decreases. PMR values were also lower in STEMI cases. This shows us that PMR is a new determinant that can be used in inflammatory events. However, none of these inflammatory markers and oxidant stress markers can be used as diagnostic tests, rather they should be considered as surrogate markers for disease

Association between thiol-disulfide hemostasis and transient tachypnea of the newborn in late-preterm and term infants

Transient tachypnea of the newborn (TTN), which is the most common respiratory disease in the neonatal period, increases respiratory workload in newborns. We purposed to evaluate the oxidative stress (OS) status and thiol disulfide hemostasis in late preterm and term newborns with TTN in this study. Methods: The study was carried out in a single-centre neonatal intensive care unit to investigate the effect of continuous airway positive pressure (CPAP) on the oxidative system in newborns with TTN. Thiol (native and total) and disulfide levels, total antioxidant and oxidant status (TAS/TOS) and Oxidative stress index (OSI) levels were measured. Results: Total thiol levels measured before treatment was 429.5 (369.5–487) µmol/L in the late preterm group and 425 (370–475) µmol/L in the term group (p = 0.741). We found significant changes in TOS, OSI and TAS levels after CPAP treatment in the late preterm group (p < 0.001, p < 0.001, p = 0.012 respectively). It was also found that the disulfide level, which was 26.2 (19.2–31.7) before the treatment, decreased to 19.5 (15.5–28.75) after the treatment (p = 0.001) in late preterms. Conclusion: CPAP treatment reduced the OS status burden associated with TTN in neonates. The late preterm newborns with TTN are more affected by OS and increased OS levels decrease with CPAP treatment

Consumers’ Bread Consumption Habits and Waste Status: Hatay/Turkey Example

In this study, it was aimed to determine the reasons for the waste of bread among consumers in Hatay province and what should be taken for the elimination of these causes. The subjects of this study were the data obtained from 406 consumers selected from the city center. The data were obtained through face to face interviews during the period of May-2017. In the questionnaire, there were questions towards determining the bread consumption habits, consumption preferences and bread waste levels along with the socio-demographic characteristics of the consumers. Cross tabulation and chi-square analysis were used in the evaluation and comparison of the data. It was determined that the amount of bread consumed per person was 278 g/day and 7% of the total family consumption of bread was wasted without any consumption. While the most consumed types of bread are traditional white bread and flatbread, bakeries and groceries are the most common places to buy bread. Consumers usually buy bread twice a day and the main considerations in the consumers’ preference for bread purchase are that the establishments comply with hygiene requirements and that quality materials are used in the bread making process. Staling and bad taste are among the significant issues in bread wastage. Taking future trends in the sector into consideration, producers should pay attention to product quality, production according to health conditions and longer shelf life on bread; depending on consumer awareness. The producers should diversify their production of bread and other bakery products

Apoptosis biomarkers (Apaf-1, sFa s, sFa s-L, and caspase-9), albumin, and fetuin-A levels in pulmonary thromboembolic patients

INTRODUCTION: Pulmonary thromboembolism (PE) is the third most common medical emergency with mortality due to ischemia and reperfusion lung injury. Lung ischaemia-reperfusion injury. Lung reperfusion damage is believed to cause cellular damage and apoptosis. The aim of the present study was to evaluate the levels of fetuin-A, albumin, and apoptosis biomarkers (Apaf-1, sFas, and sFasL) among pulmonary thromboembolic patients. MATERIAL AND METHODS: Blood samples were collected from 45 volunteer patients and 40 healthy control volunteers. Human apoptosis biomarkers (Apaf-1, sFas, sFasL, and caspase-9) and fetuin-A values were measured by ELISA device. Student’s t-test or Mann-Whitney U test were used for continuous variables, and categorical variables were compared with the chi-square test to assess the significance of intergroup differences. The mean values of apoptosis biomarkers and acute phase reactants between dead and survival patients were also compared. RESULTS: While the apoptosis mean values of Apaf-1, sFas, sFasL, and caspase-9 for the control group were 0.12 ± 0.01, 332.1 ± 28.0, 130.4 ± 34.6, and 74.3 ± 2.6, for the patient group they were 0.14 ± 0.02, 509.1 ± 67.6, 139.9 ± 23.7, and 79.4 ± 2.8, respectively. The group differences were significant for all the biomarkers (p = 0.01, p = 0.001, p = 0.19, and p = 0.01, respectively). The negative acute phase fetuin- A and albumin levels decreased significantly in the patient groups (p = 0.01 and p = 0.01, respectively). CONCLUSİONS: Intrinsic and extrinsic apoptosis pathways are stimulated during pulmonary embolism, and negative acute phase reactants are decreased. There was a correlation with the mortality and Apaf-1, sFas, caspase-9, fetuin, and albumin levels

Anesthetic management in endovascular treatment of aortic pathologies

Objective: In this study we aimed to compare the anesthesia methods we used in the endovascular treatment of thoracic and abdominal aorta pathologies and to discuss accompanied by literature. Methods: Our study was carried out be retrospectively assessing a total of 20 patients on whom we had administered endovascular treatment for aortic aneurism and aortic dissection. The demographic features of the patients, their American Anesthesia Association (ASA) scores, laboratory findings, accompanying diseases, whether they smoke, their ejection fraction and the place and type of aortic pathology was recorded. Also the surgical procedure, anesthesia method, the amounts of crystalloids, colloids and blood products used during the surgery, the anesthesia and surgery durations, complications and interventions, duration of stays in intensive care and the hospital in general and the mortality rates were recorded. All cases were provided with standard anesthesia monitoring. Results: A total of 20 (M=15, F=5) cases were included in our study. 16 of our cases were in ASA 3 risk group and 4 were in ASA 4 risk group. While patients who had been administered with thoracic endovascular aortic repair (TEVAR) were all given general anesthesia, seven patients who had been administered with abdominal endovascular aortic repair (EVAR) were given regional and 6 were given general anesthesia and one case was only given sedoanalgesia. While 8 of the patients administered with EVAR had hypertension all of the patients administered with TEVAR had hypertension. No significant differences were found in blood and blood product transfusions, preoperative and postoperative hemoglobin, hematocrit, urea and creatinine values between two groups. Conclusion: In EVAR and TEVAR applications general anesthesia, regional anesthesia, sedoanalgesia accompanied by local anesthesia can be successfully administered depending on the patient’s status and the location of the procedure