Requests for tumor marker tests in Turkey without indications and frequency of elevation in benign conditions

Cure, Medine Cumhur/0000-0001-9253-6459; cure, erkan/0000-0001-7807-135XWOS: 000326406300099PubMed: 23464479Aims: To investigate the incidence of ordering tests for tumor markers which are used in cancer diagnosis, follow-up treatment and detection of recurrence, the rate of elevation in benign diseases and which clinics order them frequently. Materials and Method: Data for the tumor markers carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125), cancer antigen 15-3 (CA 15-3) and alpha-fetoprotein (AFP) that were ordered by all the clinics in our Hospital between 2010 and 2011 were screened. When excluding repeated orders the results of 3,416 patients were available. It has been determined that in which benign diseases were the tumor markers frequently ordered and which of these conditions had high levels of them. Results: CA 19-9 was ordered for 1,858 patients 191 (10.3%) were malignant while 1667 (89.7%) were ordered in benign diseases. For CEA the total was 1,710, 226 (13.2%) malignant and 1484 (86.8%) benign, and for CA 125 1267, 111 (8.8%) malignant and 1156 (91.2%) benign. AFP was ordered for 1687 cases, 80 (4.7%) malignant but 1607 (95.3%) benign. CA 15-3 was ordered 1449 times, 174 (12%) for malignant and 1275 (88%) for benign diseases. in all cases, considerable proportions were positive. Conclusions: It was shown that clinicians frequently order tumor markers for benign conditions. the findings of this study has shown that tumor markers are used widely without indications as cancer screening tests

QT ve P dalga dispersiyonu üzerine Gilbert sendromunun etkisi: gözlemsel bir çalışma

Amaç: Gilbert sendromu (GS) aterosklerotik kalphastalığı sıklığını azaltır. Bu çalışmanın amacı P dalga dispersiyonu (Pd), QT dispersiyonu (QTd) gibi aritmi risk belirteçlerinin sağlıklı bireylerle kıyaslandığında GS’li hastalarda azalmış olup olmadığını değerlendirmektir. Yöntemler: Hastanemiz iç hastalıkları polikliniğine başvuran toplam 61 GS hastası (31 kadın, 30 erkek) kesitsel gözlemsel bu çalışmaya dahil edildi. Sigara içmeyen 61 sağlıklı (31 kadın, 30 erkek) kişi çalışmaya alındı. İki grup da 16-45 yaş grubu arasındaydı. Antropometrik ölçümler, laboratuvar ve elektrokardiyografik bulguların sonuçları her katılımcı için kaydedildi. Veri analizi için bağımsız örneklem t-testi ve kümelenmiş ANOVA kullanıldı. Bulgular: GS grubunda Pd 36±16,7 msec, QTd 48,7±10,7 msec ve kalp hızı (KH) 74±8 atım/dk idi. Kontrol grubunda Pd 51±28 msec, QTd 53±12 msec ve KH 78±10 atım/dk idi. Hasta grubunda Pd (p<0,001), QTd (p=0,038) ve KH (p=0,021) kontrol grubundan anlamlı düşük bulundu. Sonuç: Bizim çalışmamızın sonuçlarına göre, bu hastalarda artmış bilirubin düzeyi, KH, Pd ve QTd’de azalma ile ilişkilidir, bunun sonucu olarak kardiyak aritmi ve koroner arter hastalığı insidansı azalabilir. Bu kategorideki hastalarda aritmi riskinde bilirubinin koruyucu rolünü göstermek için daha kapsamlı çalışmalara ihtiyaç vardır.Objective: Gilbert's syndrome (GS) decreases the incidence of atherosclerotic heart disease. The aim of the study was to evaluate whether the arrhythmia risk markers such as P-wave dispersion (Pd), QT dispersion (QTd) are reduced in patients with GS compared with healthy subjects. Methods: Sixty-one patients diagnosed with GS (31 females, 30 males) who had applied to the internal medicine outpatient clinic in the hospital were included in this cross-sectional, observational study. A control group of 61 healthy persons (31 females, 30 males), who were non-smokers and drinkers, were included. Both groups were between 16-45 years old. Results of anthropometric measurements, laboratory assays and electrocardiographic findings were recorded for each participant. Independent sample t-test and nested ANOVA were used for data analysis. Results: In the GS group were Pd value 36±16.7 msec, QTd 48.7±10.7 msec and heart rate (HR) 74±8 beat/min. In the control group were Pd 51±28 msec, QTd 53±12 msec and HR 78±10 beat/min. The Pd of patients group (p<0.001), QTd (p=0.038) and HR (p=0.021) were significantly lower than the control group. Conclusion: According to our study's results, in these patients, increased bilirubin levels are associated with decrease in HR, Pd and QTd, which consequently might decrease the incidence of cardiac arrhythmias and coronary artery disease. Further studies are needed to clarify the protective role of bilirubin in risk of arrhythmias in this category of patients

Gilbert sendromlu hastalarda aort sertliğinin değerlendirilmesi: Artmış bilirubin düzeyinin koruyucu etkisi

Amaç: Gilbert sendromu (GS) indirekt bilirubin artışıyla karakterize otozomal resesif bir hastalıktır. Gilbert sendromunda aterosklerotik kalp hastalığı insidansı azalmıştır. Biz bu çalışmada GS’nin varlığı ve nabız dalga hızı (NDH) arasındaki ilişkiyi incelemeyi amaçladık. Yöntemler: Bu çalışmaya hastanemiz iç hastalıkları kliniğine başvuran 32 kadın (yaş: 27.12±7.27) ve 26 erkek (yaş: 26.63±5.84) olmak üzere toplam 58 GS’li hasta alındı. Kontrol grubu olarak benzer yaş grubunda olan 35 kadın (yaş: 27.33±8.06, p=0.716) ve 23 erkek (yaş: 27.38±6.91, p=0.923) olmak üzere 58 sağlıklı katılımcı çalışmaya dahil edildi. Her iki grubun NDH’si sağ karotis ve femoral arterlerden ölçüldü. Bulgular: Gilbert sendromu grubunun yaş ortalaması 26.03±8.22 yıl ve sağlıklı grubun yaş ortalaması 26.60±5.84 yıl idi. Gilbert sendromu grubunun diyastolik kan basıncı (67.76±8.59 mmHg) ve NDH’si (5.63±1.12 m/s) kontrol grubundan (71.72±7.28 mmHg, p=0.008; 6.18±1.22 m/s, p=0.014) anlamlı olarak daha düşüktü. Gilbert sendromu gru- bunun yüksek yoğunluklu lipoprotein düzeyi (1.4±0.3 mmol/L) kontrol grubundan (1.2±0.3 mmol/L mmol/L, p=0.029) anlamlı şekilde daha yüksekti. Sonuç: Biz bu çalışmada, GS’li hastaların NDH değerlerini sigara içmeyen, yaş uyumlu sağlıklı bireylerden düşük bulduk.Objective: Gilbert’s syndrome (GS) is an autosomal reces- sive disease that is characterized by an increase in indirect bilirubin (IB). The incidence of atherosclerotic heart disease is decreased in GS. This study aimed to investigate the relation between pulse wave velocity (PWV) and the presence of GS. Methods: The study included 58 GS patients (32 females, age; 27.12±7.27 years, 26 males, age; 26.63±5.84 years) admitted to the internal medicine clinic of the hospital. The control group included 58 healthy individuals (35 females [27.33±8.06 years old, p=0.716] and 23 males [27.38±6.91 years old, p=0.923]). PWV of both groups was measured from the right carotid and femoral arteries. Results: Mean age of the GS group was 26.03±8.22 years, while that of the healthy group was 26.60±5.84 years. The GS group’s diastolic blood pressure and PWV were significantly lower than those of the control group: 67.76±8.59 mmHg vs 71.72±7.28 mmHg; p=0.008, and 5.63±1.12 m/s vs 6.18±1.22 m/s; p=0.014 respectively. The GS group’s high density lipo- protein (HDL) level was significantly higher than that of the control group: 1.4±0.3 mmol/L vs 1.2±0.3 mmol/L, p=0.029. Conclusion: This study found PWV among GS patients to be lower than that among non-smoking and aged-matched healthy controls

Mean platelet volume and vitamin D level

Cure, Medine Cumhur/0000-0001-9253-6459; cure, erkan/0000-0001-7807-135XWOS: 000332681100003PubMed: 24624344Background: Vitamin D deficiency and a high mean platelet volume (MPV) are related to cardiovascular disease. We investigated whether vitamin D deficiency is associated with high MPV. Methods: This study included 434 patients without chronic disease who were not taking vitamin D or calcium supplements. Vitamin D was measured by chemiluminescent microparticle immunoassay on the Architect-I2000 system (Abbott Diagnostics, USA), and MIN was measured on the Cell-Dyn Ruby analyzer (Abbott Diagnostics). Patients were divided into Groups 1 (138 [men/women, 46/92]), 2 (148 [men/women, 54/94]), and 3 (148 [men/women, 50/98]) according to vitamin D levels of 20 ng/mL, respectively. Results: the vitamin D level in Group 1 (7.7 +/- 1.9 ng/mL) was lower than that in Group 2 (15.1 +/- 1.6 ng/mL, P<0.001) and Group 3 (25.6 +/- 6.3 ng/mL, P<0.001). the MPV in Group 3 (7.5 +/- 1.0 fL) was lower than that in Group 1 (8.1 +/- 1.1 fL, P<0.001) and Group 2 (7.9 +/- 1.0 fL, P=0.009). Linear regression analysis showed that low levels of vitamin D (beta = -0.109, P = 0.019) was independently associated with increased MPV. Conclusions: There was a strong association between a low vitamin D level and a high MPV; therefore, vitamin D deficiency may be associated with increased MPV

The association between serum YKL-40 levels, mean platelet volume, and c-reactive protein in patients with cellulitis

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459; ERTURK, AYSE/0000-0001-6413-9165WOS: 000349843900013PubMed: 25657159Background: Lower limb cellulitis is an infectious disease that has serious complications unless it is treated. Objectives: in this pilot study, we evaluated whether levels of YKL-40, an acute-phase reactant, and mean platelet volume (MPV), which occurs secondary to inflammation in cellulitis, increase compared to healthy subjects. We also aimed to investigate the association between YKL-40 and MPV in the prognosis of the patients. Material and Methods: A total of 55 patients with cellulitis (23 men and 32 women) and a similar age group of 46 healthy individuals (22 men and 24 women) were included in the study. Cellulitis was diagnosed according to guideline. Serum YKL-40 levels, MPV, C-reactive protein (CRP), and other biochemical values of both groups were compared. Results: YKL-40 levels (52.2 +/- 34.5 ng/mL vs 34.6 +/- 18.0 ng/mL, P = 0.004), MPV (7.7 +/- 1.0 fL vs 6.9 +/- 0.7 fL, P < 0.001), and CRP (9.5 +/- 8.2 mg/dL vs 0.7 +/- 0.6 mg/dL, P < 0.001) were significantly higher in the patients with cellulitis than the control. the mean recovery time (RT) of the patients was 22.6 +/- 6.9 days. We found that YKL-40 (odds ratio [OR] 0.1, confidence interval [Cl] 0.028-0.191, P = 0.009) and MPV (OR 2.4, Cl 0.254-4.578, P = 0.029) have an independent association with RT. Conclusion: YKL-40 and MPV values were correlated with higher CRP in the cellulitis group than in controls. According to these results, increased YKL-40 and MPV levels might be a prognostic factor for cellulitis in patients

Investigation of surfactant protein-D and interleukin-6 levels in patients with blunt chest trauma with multiple rib fractures and pulmonary contusions: a cross-sectional study in Black Sea Region of Turkey

Cure, Medine Cumhur/0000-0001-9253-6459; cure, erkan/0000-0001-7807-135XWOS: 000391303200084PubMed: 27733410Objective: Multiple rib fractures (RFs) and pulmonary contusions (PCs), with resulting systemic lung inflammation, are the most common injuries caused by blunt chest trauma (BCT) in motor vehicle accidents. This study examined levels of the inflammation marker interleukin (IL)-6 and those of the acute-phase reactant surfactant protein (SP)-D in patients with BCT. Design: Prospective, cross-sectional, observational study. Setting: Single-centre, tertiary care hospital in the Black Sea Region of Turkey. Participants: the study included 60 patients with BCT who were hospitalised in our thoracic surgery department. Parameters measures: the SP-D and IL-6 serum levels of patients with RFs (two or more RFs) (n=30) and patients with PCs (n=30) were measured after 6 hours, 24 hours and 7 days, and compared with those of age-matched and gender-matched healthy participants. Results: the 6-hour serum SP-D levels of the RFs (p=0.017) and PCs (p<0.001) groups were significantly higher than those of the healthy controls. the 24-hour and 7-day SP-D levels of both groups were also higher than the control group. the serum IL-6 levels of both groups were significantly higher than those of the control group. We have found Injury Severity Score to be independently related to 6-hour IL-6 (beta=1.414, p<0.001) and 24-hour IL-6 levels (beta=1.067, p<0.001). the development of complications was independently related to 6-hour SP-D level (beta=0.211, p=0.047). Conclusions: RFs and PCs after BCT lead to local and systemic inflammation due to lung injury. the levels of the systemic inflammation marker IL-6 and those of the acute-phase reactant SP-D were elevated in the present study. the SP-D level may be used as a marker in the follow-up of BCT-related complications.Scientific Research Projects of Recep Tayyip Erdogan University [2013.106.02.2]This study was funded by Scientific Research Projects of Recep Tayyip Erdogan University (project number: 2013.106.02.2)

Is the mean platelet volume predictive of hip fractures in the elderly?

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459WOS: 000324085300011PubMed: 24003430Mean platelet volume (MPV) reflects the size of platelets and is accepted as a marker of platelet function. Platelets secrete and express a large number of substances that are crucial mediators of coagulation, inflammation, thrombosis, and atherosclerosis [1

High dose zoledronic acid increases ischemia-reperfusion damage of the liver

OBJECTIVE: Zoledronic acid (ZA), a nitrogen-containing bisphosphonate, has been reported to exhibit a protective effect against cancers and prevent bone fractures. It also induces apoptosis by increasing proinflammatory cytokines and oxidative stress. Oxidative stress increases significantly during ischemia-reperfusion (IR) injury. The liver is highly sensitive to IR injury. In this study, we aim to investigate whether high-dose ZA treatment affects the liver during IR. MATERIALS AND METHODS: We used twenty-one Sprague-Dawley male rats in our study. and they were subdivided randomly into three groups, each containing seven rats. A single dose of 100 pg/kg ZA was administered via the intraperitoneal route in the ZA group. Forty-eight hours after the ZA administration, infrarenal abdominal aortic cross ligation was performed on the ZA and IR groups. After 2 hours of ischemia, 2 hours of reperfusion was applied. RESULTS: The malondialdehyde (MDA) level of the control group was significantly lower than the IR (p = 0.006) and ZA (p<0.001) groups. However, the superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) values of the control group were significantly higher than the values of the IR group (p<0.05. p<0.001, and p<0.05) and ZA group (p = 0.002, p<0.001, and p<0.001). Caspase-3 activity was significantly higher in the IR group as compared to the control group (p<0.001). The caspase-3 activity in the ZA group, on the other hand, was higher than both the control (p<0.001) and IR groups (p<0.001). CONCLUSIONS: High-dose ZA may exacerbate liver injury during IR by increasing reactive oxygen species production and apoptosis

Biochemical and histopathological effects on the rat testis after exposure to electromagnetic field during fetal period

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459WOS: 000358458900007PubMed: 26179793OBJECTIVES: Electromagnetic radiation (ER) emitted from cell phones may exert a detrimental influence on human health and may affect the man reproductive system. We aimed to study the biological and morphological effects on the testes of 60-day-old male rats after ER exposure (900 MHz), which was applied continuously throughout embryogenesis. METHODS: A total of six pregnant Sprague Dawley rats were included in the study Three pregnant rats (experimental group) were exposed to radiation from a cell phone set to talking mode for 24 hours a day for 20 days, and the other 3 pregnant rats (control group) were not to exposed to radiation. Newborn male rats were included from the experimental group (n=7) and the control group (n=7). At the end of 60 days, the rats' testes were excised, and testis length, width, depth, and weight were measured. Histopathological examinations were compared and serum testosterone (T) levels were assayed biochemically RESULTS: While serum T level (3.51 +/- 0.21 ng/ml) of ER Exposed group was significantly lower than the control group (4.04 +/- 0.47 ng/ml, p=0.018), Caspase-3 enzyme activity (2.00 +/- 0.88) was significantly higher than the control group control (1.00 +/- 0.63, p=0.026). Johnsen score (8.4 +/- 0.5) of ER group was fairly lower than the control group (9.4 +/- 0.5, p= 0.010). CONCLUSION: Our study demonstrated that ER exposure throughout embryogenesis may cause reductions in serum total T levels and in the size and weight of the testes of male rats, while causing modest increase in apoptosis

Syncope in a patient with spontaneous hemorrhage into a thyroid nodule

cure, erkan/0000-0001-7807-135X; Belice, Tahir/0000-0001-7957-3423WOS: 000341562700017PubMed: 25336885Background: Spontaneous hemorrhage into a thyroid nodule occurs exceedingly rare and rarely a neck hematoma can develop. We report a case of syncope due to spontaneous hemorrhage into a thyroid nodule during anticoagulant and antithrombotic therapy. Case presentation: A 64-year-old man was transferred to the emergency department of our hospital because of syncope. His physical examination revealed a 7 x 5 cm hard and painless mass at the left neck region. the neck MRI confirmed a heterogeneous, hyperintense mass in the left lobe of thyroid compressing the trachea and left common carotid artery, internal jugular vein, and vagus nerve bundle. He did not require a surgery in the follow-up. As the hematoma underwent subtotal shrinkage, he remained well without syncope. Conclusion: Hemorrhage into a thyroid nodule should always be considered in patients presenting with neurally mediated syncope