Serumske razine prolaktina u diferencijalnoj dijagnostici pedijatrijskih epileptičnih i neepileptičnih (pseudo-)napadaja

The aim was to determine diagnostic value of serum prolactin levels in the diff erential diagnosis of epileptic and nonepileptic seizures in children. The study included 100 patients aged one month to 18 years, admitted to the hospital for seizure complaints. All patients underwent electroencephalography in the postictal period and their serum prolactin levels were measured at 10 min and 60 min of the postictal period. The mean 10-min serum prolactin level was 37.1±20.09 ng/mL and 16±14.59 ng/mL (p<0.01) in patients with epileptic and nonepileptic seizures, respectively. After grouping of patients with nonepileptic seizures, the mean 10-min serum prolactin level in patients with epileptic seizures and those with syncope was 37.1±20.09 ng/mL and 30.52±19.21 ng/mL (p>0.05), respectively. The mean 10-min prolactin level in patients with epileptic seizures and those with non-syncope epileptic seizures (night terror, conversion and breath holding spells) was 37.1±20.09 ng/mL and 10.9±5.95 ng/mL (p<0.01), respectively. In conclusion, serum prolactin level in the postictal period is an important marker in the diff erential diagnosis of epileptic and nonepileptic seizures. There was no signifi cant diff erence between serum prolactin levels in the diff erential diagnosis of epileptic seizures and syncope, but it had an important role in diff erentiating nonepileptic cases such as breath holding spells, night terror and hysterical conversions from epileptic seizures and syncope.Cilj ovoga ispitivanja bio je utvrditi dijagnostičku vrijednost serumskih razina prolaktina u diferencijalnoj dijagnostici epileptičnih i neepileptičnih napadaja u djece. U ispitivanje je bilo uključeno 100 djece u dobi od jednog mjeseca do 18 godina, primljenih u bolnicu zbog konvulzija. U svih bolesnika učinjena je elektroencefalografi ja u postiktalnom razdoblju, dok su njihove serumske razine prolaktina mjerene u 10. i 60. minuti postiktalnog razdoblja. Srednja 10-minutna razina prolaktina u serumu bila je 37,1±20,09 ng/mL i 16±14,59 ng/mL (p<0,01) u bolesnika s epileptičnim odnosno neepileptičnim napadajima. Nakon grupiranja bolesnika s neepileptičnim napadajima 10-minutna srednja serumska razina prolaktina u bolesnika s epileptičnim napadajima i onih sa sinkopom bila je 37,1±20,09 ng/mL odnosno 30,52±19,21 ng/mL (p>0,05). U bolesnika s epileptičnim napadajima i onih s ne-sinkopnim epileptičnim napadajima (noćne more, konverzija i epizode zadržavanja daha) srednja 10-minutna razina prolaktina bila je 37,1±20,09 ng/mL odnosno 10,9±5,95 ng/mL (p<0,01). Zaključuje se kako je serumska razina prolaktina u postiktalnom razdoblju važan biljeg u diferencijalnoj dijagnostici epileptičnih i neepileptičnih napadaja. Nije bilo značajne razlike među serumskim razinama prolaktina u diferencijalnoj dijagnostici epileptičnih napadaja i sinkope, ali je ta razina imala važnu ulogu u razlikovanju neepileptičnih slučajeva kao što su epizode zadržavanja daha, noćne more i histerične konverzije od epileptičnih napadaja i sinkope

Endotelyal nitrik oksit sentaz geni 4. nitron 27 bç vntr polimorfizmi ve koroner arter hastalığı ile ilişkisi

TEZ4971Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2004.Kaynakça (s. 58-72) var.xi,72 s. ; 30 cm.

Vitamin D levels in Çukurova Region

Amaç: Çukurova Üniversitesi Balcalı Hastanesi’nde son 13 yıldaki 25-hidroksi D vitamin istemine artan talebi ve hastanemize başvuran bölge halkında erişkinlerde 25-hidroksi D vitamin düzeylerini, varsa eksikliğini ve yaygınlığını değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamızda, Çukurova Üniversitesi Balcalı Hastanesi bilgi işlem sistemi üzerinde elektronik olarak kayıtlı laboratuvar verileri kullanılarak 2003-2015 tarihleri arasındaki, hem poliklinik hem yatan hastalardan, tüm yaş grupları alınarak, 25-hidroksi D vitamin istem sayıları ve bireylerin; tanı, yaş, cinsiyet, istem tarihi, numune kabul tarihi, onay tarihi, plazma 25-hidroksi D vitamin düzeyleri değerlendirildi. Bulgular: Hastanemizde, son 13 yıllık 25-hidroksi D vitamin istem sayısı 77569 idi. 2003-2013 yılları arasında 25-hidroksi D vitamin istem sayıları karşılaştırıldığında % 6785 oranında bir artış görüldü. Çalışma grubumuzda cinsiyete göre, plazma ortalama 25-hidroksi D vitamin düzeyleri değerlendirildiğinde, erkeklerin ortalama düzeyleri (52,95 ± 0,92 nmol/L) kadınlara (48,42 ± 0,54 nmol/L) göre yüksek bulundu (p<0,001). Çalışmaya alınan 6198 bireyin %24,65’inde 25-hidroksi D vitamin eksikliği, %35,95’inde ise yetersizliği bulundu. Bireylerin sadece %15,62’nde uzmanlar tarafından önerilen optimal 25-hidroksi D vitamin düzeyi tespit edildi. Sonuç: Oldukça güneşli olmasına rağmen bölgemizde D vitamin eksikliğinin yaygın ve toplumsal bir sağlık sorunu olduğunu göstermektedir. Bunun için toplumun tavsiyelere uygun olarak güneşten yararlanma konusunda eğitilmesi, D vitamini eksikliği açısından riskli gruplara diyet takviyesi yapılması ile birçok hastalık ve durumun ortaya çıkması engellenebilir.Purpose: The aim of ths study was to evaluate the increase in the request of plasma 25-hydroxy vitamin D level assay tests in Balcalı Hospital of the Çukurova University during last 13 years and levels of 25-hydroxy vitamin D to determine the frequency of deficiency among the regional adult population admitting this hospital. Material and Methods: This study was performed by using pre-recorded electronic files and laboratory results of patients admitted to Balcalı Hospital of the Çukurova University between 2003 and 2015. The number of 25-hydroxy vitamin D tests assayed of all ages between 2003-2015 and the diagnoses, age, gender, sampling, request, acceptance, confirmation times of tests, plasma 25-hydroxy vitamin D were evaluated. Results: The number of 25-hydroxy vitamin D tests assayed in the last 13 years was 77,569. When compared between years 2003-2013, number of 25-hydroxy vitamin D tests was increased 6785%. Mean plasma 25-hydroxy vitamin D levels were found to be higher in men (52.95 ± 0.92 nmol/L) than women (48.42 ± 0.54 nmol/L) (p<0.001). Among 6,198 patients included, 24.65% had 25-hydroxy vitamin D insufficiency and 35.95% had 25-hydroxy vitamin D deficiency. Only 15.62% of patients had optimal 25-hydroxy vitamin D levels. Conclusion: Although it is an extremely sunny environment, vitamin D insufficiency is a common and public health problem in Çukurova region. Many diseases may be prevented by education of how to benefit from sunrays and dietery supplements of vitamin D in risky population

Gene-Gene Interaction of ACE I/D, Endothelial Nitric Oxide Synthase 4 a/b and ApoE does not Affect Coronary Artery Disease Severity

Objectives. Previous studies have shown the impact of angiotensin converting enzyme (ACE) insertion/deletion (I/D), endothelial nitric oxide synthase (eNOS) polymorphisms and ApoE genotypes on coronary artery disease (CAD). The aim of this study is to investigate the relationship between the genetic polymorphisms and the severity of CAD and to evaluate their potential interactions. Material and Methods. All patients underwent coronary angiography; coronary score (CS) and severity score (SS) were calculated for them. ACE I/D, eNOS and ApoE polymorphisms were detected by polymerase chain reaction (PCR). Results. Neither CS nor SS showed a direct relationship with eNOS and ApoE genotypes. CS and SS were found to be high in patients carrying the ACE DD allele (p = 0.034 and p = 0.009). In the gene interactions, there was an increase in the SS only in patients with coexisting eNOS b/b genotype and ACE DD allele (p = 0.043). Conclusions. The interactions of the gene polymorphisms investigated don’t play an important role in determining an individual’s risk for the severity of CA

Comparison of the cardioprotective effects of dexmedetomidineand remifentanil in cardiac surgery

Background/aim: Myocardial protection is an important factor of open heart surgery and biological biomarkers (lactate, CKMB, cardiac troponin I, and pyruvate) are used to assess myocardial damage. This study compares the effects of dexmedetomidine and remifentanil on myocardial protection during coronary artery bypass grafting (CABG) surgery. Materials and methods: Patients scheduled for elective CABG surgery (n = 60) were included in this study. Anesthesia induction was introduced with propofol, fentanyl, and vecuronium bromide. Anesthesia was maintained with remifentanil infusion and sevoflurane in the remifentanil group (Group R) and with dexmedetomidine infusion and sevoflurane in the dexmedetomidine group (Group D). Blood samples for biochemical markers were taken from the coronary sinus catheter before cardiopulmonary bypass (T1), 20 min after aortic cross-clamping (T2), 20 min after removal of the aortic cross-clamping (T3), and 10 min after separation from cardiopulmonary bypass (T4). Results: Demographic data were similar between the groups. Lactate level at the T2 period and CKMB levels during the study period were lower in Group D than in Group R. In both groups, all values except pyruvate significantly increased over time. Conclusion: The dexmedetomidine-sevoflurane combination may improve the cardioprotective effect in comparison with remifentanilsevoflurane in CABG surgery.Background/aim: Myocardial protection is an important factor of open heart surgery and biological biomarkers (lactate, CKMB, cardiac troponin I, and pyruvate) are used to assess myocardial damage. This study compares the effects of dexmedetomidine and remifentanil on myocardial protection during coronary artery bypass grafting (CABG) surgery. Materials and methods: Patients scheduled for elective CABG surgery (n = 60) were included in this study. Anesthesia induction was introduced with propofol, fentanyl, and vecuronium bromide. Anesthesia was maintained with remifentanil infusion and sevoflurane in the remifentanil group (Group R) and with dexmedetomidine infusion and sevoflurane in the dexmedetomidine group (Group D). Blood samples for biochemical markers were taken from the coronary sinus catheter before cardiopulmonary bypass (T1), 20 min after aortic cross-clamping (T2), 20 min after removal of the aortic cross-clamping (T3), and 10 min after separation from cardiopulmonary bypass (T4). Results: Demographic data were similar between the groups. Lactate level at the T2 period and CKMB levels during the study period were lower in Group D than in Group R. In both groups, all values except pyruvate significantly increased over time. Conclusion: The dexmedetomidine-sevoflurane combination may improve the cardioprotective effect in comparison with remifentanilsevoflurane in CABG surgery

ACE gene polymorphism in Turkish children with acute post streptococcal glomerulonephritis

Amaç: 1990'lu yıllann başlarından itibaren birçok böbrek ve kalp hastalığının genetik zemininde, ACE geni ve polimorfizmleri başta olmak üzere birçok gen çalışılmaktadır. Akut poststreptokokkal glomerulonefrit (APSGN) beta hemolitik streptokokların neden olduğu iyi huylu bir böbrek hastalığıdır. Bu çalışmada ACE gen polimorfîzminin APSGN patojenezindeki yeri araştırılmıştır. Gereç ve Yöntem: Çalışmaya ortalama yaşlan 97±33 ay arasında değişen 29'u (%56) erkek, 23'ü (%44) kız toplam 52 APSGN tanılı hasta ile, ortalama yaşlan 42±13 yıl olan 83'ü (59%) erkek, 57'si (%41) kız olmak üzere toplam 140 sağlıklı kişi alınmıştır. Bulgular: Hasta ve kontrol gruplan ACE genotipi esas alınarak karşılaştınldığında istatistiksel olarak anlamlı fark vardı (p0,05). Çıkarımlar: Akut poststreptokokkal glomerulonefrit seyrinde görülen hipertansiyonda ve klinik değişkenlerde, D/D polimorfizmi bir risk etmeni olarak saptanmadı.Aim: The role of angiotensin converting enzyme (ACE) gene polymorphism in various renal and cardiac diseases have been discussed since 1990s. Acute poststreptococcal glomerulonephritis (APSGN) is a benign inflammatory renal disease of beta hemolytic streptococcus. The aim of this study is to investigate whether the ACE gene polymorphism is associated with susceptibility to APSGN and it's clinical and laboratory features. Material and Method The study comprised 52 pediatric patients with acute postlstreptoccal glomerulonephritis; 29 males (56%) and 23 females (44%) with a mean age of 97±33 months. The control group consisted of 140 healthy individuals including 83 males (59%) and 57 females (41%) with a mean age of 42±13 years. Results: AÇE genotypes were significantly different between the patients and the control group (<0.05). Mean systolic blood pressure, mean diastolic blood pressure z scores were significantly lower in D/D genotype group compared to non- D/D genotype group (<0.05). There were no statistically significant difference among groups in terms of age at onset of disease, sex, C3 level, GFR; BUN, creatinine, macroscopic hematuria, edema, and duration of the oliguric period. Conclusions: Our results show that D/D polymorphism of ACE gene is not a risk factor for APSGN and hypertension of APSGN