The role of 'soluble uroki̇nase plasmi̇nogen acti̇vator receptor' (supar) as an i̇ndi̇cator i̇n maki̇ng di̇agnosi̇s and esti̇mati̇ng prognosi̇s

Çalışmamızda, değişik hastalıklarda inflamatuar sistemin yanıt düzeyini gösterdiği belirtilen biyobelirteç olarak 'SuPAR' kullanılarak, akut pankreatit hasta grubunda çalışılacaktır. Bu çalışmada akut pankreatit hasta grubunda SuPAR serum seviyelerinin;tanı koyma ve prognozu belirlemedeki etkinliği; CRP ve diğer rutin laboratuvar sonuçları ile Ranson Kriterleri, Balthazar Kriterleri, Rapid Acute Physiologic Score (RAPS) skoru, Modifiye Glaskow (Imrie) Kriterleri ile kıyaslanarak faydalı olup olmadığı; hastaneye yatış süresini ve hastane içi mortalite ile ilişkisi olup olmadığının araştırılması amaçlanmaktadır. Yöntem: Bu prospektif araştırma çalışması, Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Hastanesi Acil Tıp Servisine başvuran 18 yaş üstü, travmakaynaklı olmayan karın ağrısı olan ve çalışmaya katılmayı kabul eden başvuruları içermektedir. Bu başvurular, laboratuvar ve radyolojik tetkikler sonucunda akut pankreatit tanısı alıp almadıklarına göre 'hasta ve kontrol grubu'na ayrıldı.Kontrol grubu, belirtilen yaş aralığında olan, acil servise travma kaynaklı olmayan karın ağrısı ile başvurmuş, ayırıcı tanıda düşünülmesine rağmen akut pankreatit dışı karın içi patoloji tespit edilen hastalardan oluştu. Tüm vakaların demografik özellikleri, iletişim bilgileri, acil serviste acil hekimi tarafından planlanan laboratuvar ve görüntüleme tetkik parametreleri kaydedildi. Hasta grubunda yer alan hastaların bu parametreleri kullanılarak Ranson Kriterleri, Balthazar Şiddet İndeksi, Rapid Acute Physiologic Score (RAPS) skoru, Modifiye Glaskow (Imrie) Kriterleri hesaplanarak kaydedildi. Hasta grubu Ranson Kriterlerine göre 4 ve 4'ün üzerindeki skorlar şiddetli pankreatit, diğerleri hafif pankreatit olmak üzere iki gruba ayrıldı. Bulgular: Belirlenen çalışma süresi içerisinde %62,1 (n=59) hasta ve %37,9 (n=36) kontrol kişinin bilgileri alındı. Hasta grubu Ranson Kriterleri'ne göre hastalığın şiddet derecesine göre sınıflandırıldığında %10,2 (n=6) 'nun şiddetli, %89,8 (n=53) 'inin ise hafif olduğu görüldü. Hastalığın etiyoloji sorgulamasında %67,8 (n=40)'i bilyer, %32,2 (n=19) ise non-bilyer hastalıklardı. Çalışmaya alınan kişilerin %44,2'si (n=42) erkek ve %55,8'i (n=53) kadındı. Akut pankreatit grubu ve kontrol grubu arasında suPAR seviyeleri arasında istatistiki olarak anlamlı fark mevcut. suPAR seviyesinin Akut Pankreatit hastalığında ayırıcı tanısı için uygun olup olmadığının tespit edilmesi için ROC analizi yapıldı. Eğri altında kalan alan istatistiksel olarak anlamlı olsa da %50'nin üzerinde bir alan değeri bulunmadığından (AUC=0,254; p3 points) or mild (having score <3 points) disease according to score of Ranson's Criteria. Findings: The study had data for 59 (62.1%) person in patient group and 36 (37.9%) in control group during the study period. There were 55.8% (n=53) of all who were women. When the patients were reclassified according to severity of disease in association with Ranson's Criteria, there were 10,2% (n=6) of patients with severe disease. If the etiology was questioned, 67.8% (n=40) patients had biliary disease. The difference between study groups were important statistically for serum levels of suPAR. ROC analysis was performed to determine whether suPAR was suitable for differential diagnosis or not. Although the area vi under curve (AUC) was important statistically, suPAR was shown not to be enough to make diagnosis of acute pancreatitis since AUC wasn't below 50% (AUC=0.254; p<0.001). Spearman's Rho Correlation Analysis was performed to determine correlation between suPAR and other parameters. There were statistically important correlations in positive direction between suPAR levels and Glaskow Score, Ranson Score and RAPS (Rho=0.79; 0.689 and 0.593 respectively, p<0.001). There were also important correlation in positive direction between suPAR level and length of stay in hospital (Rho=0.376; p=0.003). The difference between severe and mild disease groups was statistically for serum levels of suPAR. ROC analysis was performed to determine whether suPAR was suitable to differentiate severity of diases or not. Although the area under curve (AUC) was important statistically, suPAR was shown not to be enough to make diagnosis of severe disease since AUC wasn't below 50% (AUC=0.107; p=0.002). Results: The study was first one investigating about efficiency of suPAR to make diagnosis and estimate prognosis of acute pancreatitis. The results of suPAR were different between patient and control groups having non traumatic abdominal pain, suPAR was shown to be insufficient to make diagnosis of acute pancreatitis. In similar way, the levels of suPAR were different between sever and mild disease groups having acute pancreatitis, suPAR was shown to be insufficient to make diagnosis of severe disease. There weren't enough data about power of suPAR to estimate prognosis due to number of pateints and mortality rate in patient group

The impact of body mass index values on the quality of cardiopulmonary resuscitation: A manikin study

WOS:000681330400012Küçükceran, K. , Ayrancı, M. Özer, M. R. (2021). The impact of body mass index values on the quality of cardiopulmonary resuscitation: A manikin study. Clinical and Experimental Health Sciences , 11 (2) , 269-272

Roles of CRP and neutrophil-to-lymphocyte ratio in the prediction of readmission of COVID-19 patients discharged from the ED

WOS:000972110800001PubMed ID:36761852Background: Patient admissions beyond the capacity of emergency departments (EDs) have been reported since the coronavirus disease (COVID-19) pandemic. Thus, laboratory parameters to predict the readmission of patients discharged from the ED are needed. For this purpose, we investigated whether C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) could predict the readmission of patients with COVID-19. Methods: Patients aged >18 years who visited the ED in October 2020 and had positive polymerase chain reaction test results were evaluated. Among these patients, those who were not hospitalized and were discharged from the ED on the same day were included in the study. The patients' readmission status within 14 days after discharge, age, sex, complaint on admission, comorbidity, systolic blood pressure, diastolic blood pressure, fever, pulse, oxygen saturation level, CRP level, blood urea nitrogen level, creatinine level, neutrophil count, lymphocyte count, and NLR were recorded. Data were compared between the groups. Results: Of the 779 patients who were included in the study, 359 (46.1%) were male. The median age was 41 years (range, 31-53 years). Among these patients, those who were not hospitalized and were discharged from the ED on logistic regression analysis, age, CRP level, NLR, loss of smell and taste, and hypertension had odds ratios of 2.494, 2.207, 1.803, 0.341, and 1.879, respectively. Conclusions: The strongest independent predictor of readmission within 14 days after same-day ED discharge was age > 50 years. In addition, CRP level and NLR were the laboratory parameters identified as independent predictors of ED readmission

The Diagnostic Value of Soluble Urokinase Plasminogen Activator Receptor in Crimean-Congo Hemorrhagic Fever Disease in the Emergency Department

Aim: The urokinase-type plasminogen activator (uPA) system consists of a protease, a receptor(urokinase-type plasminogen activator receptor, uPAR), and inhibitors that can be expressed onvarious cell types. Previous literature shows that the amount of soluble urokinase-typeplasminogen activator receptor (suPAR) secreted from affected cells is higher in Crimean-Congohemorrhagic fever (CCHF) patients than in healthy controls. Thus, we aimed to investigate thediagnostic value of suPAR in the differential diagnosis of CCHF in emergency services.Material and Methods: Individuals over 16 years old with a preliminary diagnosis of CCHFdisease were divided into two groups as real time-polymerase chain reaction (RT-PCR) and/orIgM positive (CCHF group) and RT-PCR and/or IgM negative (control group).Results: Eighty patients were included in this study. Forty patients with CCHF virus PCRand/or CCHF virus IgM were identified as CCHF group and 40 patients included as negativecontrol group. The median age of the patients was 45 (range, 16-91) years, and 49 patients(61.3%) were male. Leukocyte, platelet, and fibrinogen levels were significantly lower, whilecreatinine kinase, aPTT, and D-dimer levels were significantly higher in CCHF group. Therewas no statistically significant difference between the control group and CCHF group forSuPAR (p=0.386). In addition, control group patients not diagnosed with CCHF wereexamined, brucellosis, influenza, and pneumonia were found to be the most common.Conclusion: The use of suPAR as a biomarker in the differentiation of patients with similarfindings in emergency services was investigated and found to have no diagnostic value

The role of soluble urokinase plasminogen activator receptor (SuPAR) as an indicator of the severity of acute pancreatitis

WOS:000452890300015PubMed ID: 30541244Background/aim: Soluble urokinase plasminogen activator receptor (suPAR) has been reported to have a positive correlation with theactivation degree of the immune system. This study’s aim is to investigate the efficiency of SuPAR serum levels in acute pancreatitis (AP)patients in determining the severity of disease.Materials and methods: This prospective research involves patients who arrived at the emergency service, were over 18 years old, hadnontraumatic abdominal pain and diagnosis of AP, and agreed to join the study. Demographic characteristics, contact information,laboratory and imaging test parameters, Ranson’s criteria, the Balthazar Severity Index, the Rapid Acute Physiologic Score (RAPS), andthe modified Glasgow (Imrie) score of all patients were recorded. Two study groups were created as score of 3 (mild, Group I) and 3(severe, Group II) for pancreatitis according to Ranson’s criteria.Results: During the study period, 59 sequential patients with AP were included in the study. It was seen that 79.7% of the study group(n 47) were in Group I. Etiologically 67.8% (n 40) cases were biliary and 32.3% (n 19) were nonbiliary diseases. According to theresults, suPAR level was effective in distinguishing the severity of AP (AUC 0.902, P 0.001 (95% CI: 0.821–0.984)). With regardto determining severe disease, suPAR had an optimum cutoff value of 6.815 ng/mL, sensitivity of 91.66%, specificity of 82.97%, andnegative predictive value of 97.5%.Conclusion: Our study was performed the determine the efficiency of suPAR level in predicting severe disease in AP patients. We foundit significant in indicating the severity of disease according to the study results