1
|
Francisco A, Goler AMY, Navarro CDC, Onder A, Yildiz M, Kendir Demirkol Y, Karademir Yilmaz B, Seven Menevse T, Güran T, Castilho RF. Lack of NAD(P)+ transhydrogenase activity in patients with primary adrenal insufficiency due to NNT variants. Eur J Endocrinol 2024; 190:130-138. [PMID: 38261461 DOI: 10.1093/ejendo/lvae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/10/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Pathogenic variants in the nicotinamide nucleotide transhydrogenase gene (NNT) are a rare cause of primary adrenal insufficiency (PAI), as well as functional impairment of the gonads. OBJECTIVE Despite the description of different homozygous and compound heterozygous NNT variants in PAI patients, the extent to which the function and expression of the mature protein are compromised remains to be clarified. DESIGN The activity and expression of mitochondrial NAD(P)+ transhydrogenase (NNT) were analyzed in blood samples obtained from patients diagnosed with PAI due to genetically confirmed variants of the NNT gene (n = 5), heterozygous carriers as their parents (n = 8), and healthy controls (n = 26). METHODS NNT activity was assessed by a reverse reaction assay standardized for digitonin-permeabilized peripheral blood mononuclear cells (PBMCs). The enzymatic assay was validated in PBMC samples from a mouse model of NNT absence. Additionally, the PBMC samples were evaluated for NNT expression by western blotting and reverse transcription quantitative polymerase chain reaction and for mitochondrial oxygen consumption. RESULTS NNT activity was undetectable (<4% of that of healthy controls) in PBMC samples from patients, independent of the pathogenic genetic variant. In patients' parents, NNT activity was approximately half that of the healthy controls. Mature NNT protein expression was lower in patients than in the control groups, while mRNA levels varied widely among genotypes. Moreover, pathogenic NNT variants did not impair mitochondrial bioenergetic function in PBMCs. CONCLUSIONS The manifestation of PAI in NNT-mutated patients is associated with a complete lack of NNT activity. Evaluation of NNT activity can be useful to characterize disease-causing NNT variants.
Collapse
Affiliation(s)
- Annelise Francisco
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP 13083-888, Brazil
- Department of Biochemistry, Faculty of Medicine, Genetic and Metabolic Diseases Research Center, Marmara University Faculty of Medicine, Istanbul 34854, Turkey
| | - Ayse Mine Yilmaz Goler
- Department of Biochemistry, Faculty of Medicine, Genetic and Metabolic Diseases Research Center, Marmara University Faculty of Medicine, Istanbul 34854, Turkey
| | | | - Asan Onder
- Department of Pediatric Endocrinology and Diabetes, Medeniyet University Goztepe Training and Research Hospital, Istanbul 34722, Turkey
| | - Melek Yildiz
- Pediatric Genetic Diseases, Umraniye Training and Research Hospital, Istanbul 34764, Turkey
| | - Yasemin Kendir Demirkol
- Department of Pediatric Genetics, Umraniye Research and Training Hospital, University of Health Sciences, Istanbul 34764, Turkey
| | - Betul Karademir Yilmaz
- Department of Biochemistry, Faculty of Medicine, Genetic and Metabolic Diseases Research Center, Marmara University Faculty of Medicine, Istanbul 34854, Turkey
| | - Tuba Seven Menevse
- Department of Pediatric Endocrinology and Diabetes, Marmara University Faculty of Medicine, Istanbul 34854, Turkey
| | - Tülay Güran
- Department of Pediatric Endocrinology and Diabetes, Marmara University Faculty of Medicine, Istanbul 34854, Turkey
| | - Roger Frigério Castilho
- Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP 13083-888, Brazil
| |
Collapse
|
2
|
Garcia-Beltran C, Malpique R, Andersen MS, Bas F, Bassols J, Darendeliler F, Díaz M, Dieris B, Fanelli F, Fröhlich-Reiterer E, Gambineri A, Glintborg D, López-Bermejo A, Mann C, Marin S, Obermayer-Pietsch B, Ødegård R, Ravn P, Reinehr T, Renzulli M, Salvador C, Singer V, Vanky E, Torres JV, Yildiz M, de Zegher F, Ibáñez L. SPIOMET4HEALTH-efficacy, tolerability and safety of lifestyle intervention plus a fixed dose combination of spironolactone, pioglitazone and metformin (SPIOMET) for adolescent girls and young women with polycystic ovary syndrome: study protocol for a multicentre, randomised, double-blind, placebo-controlled, four-arm, parallel-group, phase II clinical trial. Trials 2023; 24:589. [PMID: 37715279 PMCID: PMC10503102 DOI: 10.1186/s13063-023-07593-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/17/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most prevalent, chronic endocrine-metabolic disorder of adolescents and young women (AYAs), affecting 5-10% of AYAs worldwide. There is no approved pharmacological therapy for PCOS. Standard off-label treatment with oral contraceptives (OCs) reverts neither the underlying pathophysiology nor the associated co-morbidities. Pilot studies have generated new insights into the pathogenesis of PCOS, leading to the development of a new treatment consisting of a fixed, low-dose combination of two so-called insulin sensitisers [pioglitazone (PIO), metformin (MET)] and one mixed anti-androgen and anti-mineralocorticoid also acting as an activator of brown adipose tissue [spironolactone (SPI)], within a single tablet (SPIOMET). The present trial will evaluate the efficacy, tolerability and safety of SPIOMET, on top of lifestyle measures, for the treatment of PCOS in AYAs. METHODS In this multicentre, randomised, double-blind, placebo-controlled, four-arm, parallel-group, phase II clinical trial, AYAs with PCOS will be recruited from 7 clinical centres across Europe. Intention is to randomise a total of 364 eligible patients into four arms (1:1:1:1): Placebo, PIO, SPI + PIO (SPIO) and SPI + PIO + MET (SPIOMET). Active treatment over 12 months will consist of lifestyle guidance plus the ingestion of one tablet daily (at dinner time); post-treatment follow-up will span 6 months. Primary endpoint is on- and post-treatment ovulation rate. Secondary endpoints are clinical features (hirsutism, menstrual regularity); endocrine-metabolic variables (androgens, lipids, insulin, inflammatory markers); epigenetic markers; imaging data (carotid intima-media thickness, body composition, abdominal fat partitioning, hepatic fat); safety profile; adherence, tolerability and acceptability of the medication; and quality of life in the study participants. Superiority (in this order) of SPIOMET, SPIO and PIO will be tested over placebo, and if present, subsequently the superiority of SPIOMET versus PIO, and if still present, finally versus SPIO. DISCUSSION The present study will be the first to evaluate-in a randomised, double-blind, placebo-controlled way-the efficacy, tolerability and safety of SPIOMET treatment for early PCOS, on top of a lifestyle intervention. TRIAL REGISTRATION EudraCT 2021-003177-58. Registered on 22 December 2021. https://www.clinicaltrialsregister.eu/ctr-search/search?query=%092021-003177-58 .
Collapse
Affiliation(s)
- Cristina Garcia-Beltran
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain
| | - Rita Malpique
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain
| | - Marianne S Andersen
- Department of Gynaecology and Obstetrics and Department of Endocrinology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Firdevs Bas
- Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), Girona, Spain
| | | | - Marta Díaz
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain
| | - Barbara Dieris
- Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, Datteln, Germany
| | - Flaminia Fanelli
- Department of Medical and Surgical Science-DIMEC, Division of Endocrinology and Diabetes Prevention and Care, University of Bologna - S. Orsola-Hospital, Bologna, Italy
| | - Elke Fröhlich-Reiterer
- Division of General Paediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Alessandra Gambineri
- Department of Medical and Surgical Science-DIMEC, Division of Endocrinology and Diabetes Prevention and Care, University of Bologna - S. Orsola-Hospital, Bologna, Italy
| | - Dorte Glintborg
- Department of Gynaecology and Obstetrics and Department of Endocrinology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Abel López-Bermejo
- Paediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), Paediatrics, Dr. Josep Trueta Hospital, Department of Medical Sciences, University of Girona, Girona, Spain
| | | | - Silvia Marin
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Rønnaug Ødegård
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Centre for Obesity Research, St. Olavs Hospital, Trondheim University Hospital, Torgarden, Trondheim, Norway
| | - Pernille Ravn
- Department of Gynaecology and Obstetrics and Department of Endocrinology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Thomas Reinehr
- Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, Datteln, Germany
| | - Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Cristina Salvador
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
| | - Viola Singer
- Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, Datteln, Germany
| | - Eszter Vanky
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynaecology, St. Olavs Hospital, Trondheim University Hospital, 7006, Trondheim, Norway
| | | | - Melek Yildiz
- Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| | - Francis de Zegher
- Leuven Research & Development, University of Leuven, 3000, Louvain, Belgium
| | - Lourdes Ibáñez
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain.
| |
Collapse
|
3
|
Adrovic A, Karatemiz G, Esatoglu SN, Yildiz M, Sahin S, Barut K, Ugurlu S, Hatemi G, Kasapcopur O, Seyahi E. Juvenile and adult-onset scleroderma: different clinical phenotypes. Semin Arthritis Rheum 2023; 60:152197. [PMID: 37031645 DOI: 10.1016/j.semarthrit.2023.152197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES Systemic sclerosis (SSc) represents extremely rare disease with majority of data coming from adults. Studies comparing juvenile- (jSSc) and adult-onset (aSSc) patients are limited. We aimed to compare clinical features, treatment modalities and survival rates of jSSc and aSSc patients. METHODS A retrospective study among pediatric and adult Scl patients has been performed. Demographic characteristics, clinical features, autoantibody profiles, and treatment data were retrieved from the databases. Survival analysis was done using Kaplan-Meier plot and factors associated with mortality were identified with multiple regression analysis. RESULTS A total of 158 adults and 58 juvenile Scl patients were identified. The mean age at the disease onset was 37±14.7 vs. 8.8 ± 4.1 years, mean age at diagnosis 42±15.2 vs. 10.4 ± 3.8 years and mean follow-up duration was 6.3 ± 4.9 years vs. 6.6 ± 4.9 years for aSSc and jSSc patients, respectively. The frequency of interstitial lung disease (ILD) (50.9% vs 30%, p<0.001) and systemic hypertension (17.9% vs 0, p = 0.009) was significantly higher among aSSc. While aSSc patients had presented mostly with limited cutaneous subset (74.1%), diffuse cutaneous subset was the dominant subset among jSSc (76.7%), (p<0.001). The mortality rate was significantly higher among adults (p = 0.005). The ILD (p = 0.03) and cardiac insufficiency (p = 0.05) were independent risk factors of mortality in both aSSc and jSSc patients. CONCLUSION Juvenile and adult-onset Scl represent rarely seen conditions with different clinical phenotypes. Pediatric patients with LS are more commonly seen by pediatric rheumatologists, in contrary to adults. Diffuse disease subset is the dominant form among juvenile patients, whereas limited form is the main disease subset among adults. On the other hand, juvenile-onset patients have a better survival than those with adult-onset.
Collapse
|
4
|
Kotan LD, Yildiz M, Turan I, Celiloglu C, Yuksel B, Topaloglu AK. A novel homozygous nonsense NDNF variant in Kallmann syndrome. Am J Med Genet A 2023; 191:831-834. [PMID: 36454653 DOI: 10.1002/ajmg.a.63066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/01/2022] [Accepted: 11/21/2022] [Indexed: 12/04/2022]
Abstract
Kallmann syndrome (KS) is a rare genetic disease characterized by pubertal failure and olfactory defects. Although many genes associated with KS have been reported, most are rare. Recently, heterozygous inactivating mutations in the neuron-derived neurotrophic factor gene (NDNF) were reported to cause KS. Here, we present a 14-year-old Kurdish boy with KS who has a novel homozygous nonsense c.1251C>A (p.Tyr417Ter) variant in NDNF. The variant was not observed in reference population databases and was predicted to be deleterious. Segregation analysis performed with Sanger sequencing indicated the autosomal recessive inheritance of the clinical phenotype. His heterozygous parents have experienced timely pubertal development and normal reproductive features. This study reported the first homozygous truncating NDNF variant, enabling the direct observation of the clinical consequences of predictively absent NDNF function. These results support the contention that the inactivating mutations in NDNF cause KS, and provide additional evidence for the complex inheritance of KS.
Collapse
Affiliation(s)
- Leman Damla Kotan
- Division of Pediatric Endocrinology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Melek Yildiz
- Division of Pediatric Endocrinology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ihsan Turan
- Division of Pediatric Endocrinology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Can Celiloglu
- Division of Pediatric Endocrinology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Bilgin Yuksel
- Division of Pediatric Endocrinology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ali Kemal Topaloglu
- Division of Pediatric Endocrinology, Harvard Medical School, Massachusetts General Hospital for Children, Boston, Massachusetts, USA
| |
Collapse
|
5
|
Tutar MS, Sekmenli N, Erol G, Karaarslan E, Yildiz M, Kozanhan B. Does the menstrual phase affect gastric emptying? Prospective, observational study. Eur Rev Med Pharmacol Sci 2023; 27:1989-1995. [PMID: 36930497 DOI: 10.26355/eurrev_202303_31564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Pulmonary aspiration of gastric content is a serious complication of anesthesia. It is unclear what effects different parts of the menstrual cycle have on how long it takes for the stomach to empty. This prospective observational study assessed the relationship between menstrual cycle phases and gastric emptying using ultrasonography (USG) in volunteers of reproductive age. PATIENTS AND METHODS Between days 8-10 of the menstrual cycle in the follicular phase and days 18-20 of the luteal phase, a total of 24 healthy volunteers received four stomach USG procedures. In both phases, the gastric antrum was evaluated with USG in the right lateral decubitus position after fasting for 10 hours, followed by 2 hours of fasting after liquid intake and 6 hours of fasting after solid food intake. The gastric content, gastric antrum area, and estimated gastric volume determined whether the stomach was full or empty. RESULTS A full stomach was detected in 8 (8.3%) out of 96 measurements performed on the volunteers. After liquid food intake, a full stomach was detected in 2 subjects in the luteal phase, while all the subjects had an empty stomach during the follicular phase (p=0.500). After solid food intake, a full stomach was detected in 6 subjects in the luteal phase, and again, all subjects had an empty stomach during the follicular phase (p=0.031). CONCLUSIONS Ultrasound assessment of gastric volume in volunteers of reproductive age has shown that gastric emptying of solid foods is slowed during the luteal phase of the menstrual cycle.
Collapse
Affiliation(s)
- M S Tutar
- Department of Anesthesiology and Reanimation, Department of Radiology, University of Health Sciences, Konya City Hospital, Konya, Turkey.
| | | | | | | | | | | |
Collapse
|
6
|
Yildiz M, Onal Z, Yesil G, Kabil TG, Toksoy G, Poyrazoglu S, Bas F, Durmaz O, Darendeliler F. A Rare Cause of Hypergonadotropic Hypogonadism: Transaldolase Deficiency in Two Siblings. J Clin Res Pediatr Endocrinol 2023. [PMID: 36825476 DOI: 10.4274/jcrpe.galenos.2023.2022-10-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Transaldolase deficiency is a rare inborn autosomal recessive disorder caused by biallelic mutations in the TALDO1 gene. It is characterized by intrauterine growth restriction, dysmorphism, abnormal skin, cytopenia, hepatosplenomegaly, liver cirrhosis, endocrine problems, renal and cardiac abnormalities. We present two siblings of Turkish origin with early-onset form of transaldolase deficiency and hypergonadotropic hypogonadism in both sexes. The girl (index) was followed-up with cryptogenic cirrhosis, leukopenia and thrombocytopenia, skin abnormalities, congenital heart defects, hypercalciuria, nephrolithiasis, proteinuria, chronic kidney disease throughout childhood. She developed hypergonadotropic hypogonadism in adolescence period. Whole exome sequencing due to the multisystemic involvement revealed a previously described homozygous inframe deletion in TALDO1 gene. Her brother was born as a small for gestational age baby and was also followed-up with cryptogenic cirrhosis since his infancy, together with cytopenia, congenital heart defects, bilateral cryptorchidism, short stature, hypercalciuria, proteinuria and chronic kidney disease in childhood. He presented with testicular microlithiasis and hypergonadotropic hypogonadism in adolescence. Sanger sequencing of TALDO1 gene confirmed the presence of the same homozygous deletion with his sister. The mother was found to be a heterozygous carrier for this deletion. We describe two patients with multisystemic involvement since neonatal period who presented with an additional hypergonadotropic hypogonadism in adolescence. The diagnosis of transaldolase deficiency should be kept in mind for these patients, and they must be evaluated for gonadal functions especially during puberty.
Collapse
Affiliation(s)
- Melek Yildiz
- Department of Pediatric Endocrinology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Zerrin Onal
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Gozde Yesil
- Department of Medical Genetics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tugce Goksu Kabil
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Guven Toksoy
- Department of Medical Genetics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Sukran Poyrazoglu
- Department of Pediatric Endocrinology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Firdevs Bas
- Department of Pediatric Endocrinology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ozlem Durmaz
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Feyza Darendeliler
- Department of Pediatric Endocrinology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
7
|
Arikan MN, Yildiz M, Sen Z, Erel O, Tutar MS, Tire Y, Kaplevatsky R, Kozanhan B. Effect of Remote Ischemic Preconditioning in Total Knee Arthroplasty on Thiol-Disulfi de Balance: a Randomized Controlled Study. Acta Chir Orthop Traumatol Cech 2023; 90:314-322. [PMID: 37898494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/30/2023]
Abstract
PURPOSE OF THE STUDY The purpose of this study was to minimize tourniquet-induced ischemia-reperfusion injury (IRI) in total knee arthroplasty (TKA) surgery using the remote ischemic preconditioning (RIPC) model, as well as to assess antioxidant balance with thioldisulfi de homeostasis (TDH). The secondary goal is to evaluate the impact of RIPC on TKA clinical outcomes. MATERIAL AND METHODS Patients in the ASA I-III group who underwent elective TKA were enrolled in this prospective, randomized, double-blind clinical research. TDH parameters were measured individually in groups with (Group I) and without (Group K) RIPC at the following times: preoperative (T0), right before the pneumatic tourniquet was opened (T1), 1 (T2), 6 (T3), and 24 (T4) hours after it was opened. In addition, at 3-hour intervals, the postoperative pain level was assessed using a visual analog scale (VAS). RESULTS This study included 60 cases (Group K; n=30, Group I; n=30). Both groups had equal native thiol, total thiol, disulfi de levels, disulfi de/native thiol, disulfi de/total thiol, and native thiol/total thiol ratios (p>0.05 for each). The change in native thiol, total thiol, and disulfi de values at T0 and T4 periods, however, was not statistically signifi cant for Group K (p=0.049, p=0.047, p=0.037, and p=0.217, p=0.191, p=0.220, respectively). At the 15th hour, VAS values in group I were considerably lower than in Group K (p=0.002). DISCUSSION This prospective, randomized, controlled trial examined how RIPC affected tourniquet-induced IRI-induced oxidative stress in TKA surgery. Lower native, total, and disulfi de levels at each postoperative time point were signifi cant. RIPC may reduce tourniquet-induced IRI-induced oxidative stress and TDH in TKA surgery. RIPC also reduced postoperative discomfort. CONCLUSIONS Our fi ndings suggest that RIPC may protect against the oxidative stress caused by IRI during limb surgery with a tourniquet and improve postoperative clinical outcomes. Key words: remote ischemic preconditioning, ischemia-reperfusion injury, thiol-disulfi de balance, oxidative stress, total knee arthroplasty.
Collapse
Affiliation(s)
- M N Arikan
- Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Science, Konya, Turkey
| | - M Yildiz
- Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Science, Konya, Turkey
| | - Z Sen
- Baskent University, Department of Orthopedics and Traumatology, Konya, Turkey
| | - O Erel
- Ankara Yildirim Beyazit University, Department of Clinical Biochemistry, Ankara, Turkey
| | - M S Tutar
- Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Science, Konya, Turkey
| | - Y Tire
- Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Science, Konya, Turkey
- Outcomes Research Consortium, Cleveland Clinic, OH, USA
| | - R Kaplevatsky
- Ohio University Heritage College of Osteopathic Medicine, Cleveland Campus, OH, USA
| | - B Kozanhan
- Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Science, Konya, Turkey
| |
Collapse
|
8
|
Quesada O, Pico M, Palmer C, Yildiz M, Miranda R, Malhotra R, Setegn E, Legreaux S, Moore B, Philip R, Shrivastava P, Takla R, Henry T. Magnetocardiography as a noninvasive diagnostic strategy for suspected coronary microvascular dysfunction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Coronary microvascular dysfunction (CMD) is increasingly recognized as an independent predictor of mortality with a 4-fold higher risk. However current diagnostic modalities are limited by the need for an invasive procedure, access, cost, and exposure of ionizing radiation.
Purpose
To investigate the ability of magnetocardiography (MCG) to identify CMD in patients with suspected ischemia and no obstructive coronary artery disease (INOCA).
Methods
This is an observational, prospective pilot study of patients scheduled for coronary functional angiography (CFA), gold standard for evaluation for CMD (defined as coronary flow reserve (CFR) ≤2). 13 patients underwent both CFA and a noninvasive 36-channel MCG scan. A machine learning model was developed to characterize the presence of CMD in these patients against age matched controls (AMCs). The model consists of a logistic regression classifier which takes features representing the relative strengths of the “characteristic dipoles” of the MCG scan as input. The characteristic dipoles are parameterizations of the three strongest magnetic field map components resulting from a singular value decomposition of the MCG signal. A total of 37 patients were included in this analysis including 13 patients who completed CFA (7 had CMD and 6 had CFR >2 and included in the AMCs group). An additional 24 asymptomatic, healthy patients that did not undergo CFR were also included in the AMC group.
Results
The mean age for AMCs was 57 years (70% women) and mean age for CMD patients was 54 years (100% women). The performance of the model was evaluated using repeated stratified cross-validation with 5 folds and 3 repeats, resulting in 15 different 80%/20% train/test splits. Figure 1 shows the distribution of samples belonging to the CMD and AMC groups in a 2-dimensional representation of the feature space. The clear separation of the two groups and the clustering of the AMCs demonstrates the ability of the model to identify patients with CMD. We found that MCG had a mean accuracy of 94.8% (±6.4%), sensitivity of 100% (±0.0%) and specificity of 93.3% (±8.2%) for the detection of CMD using gold standard CFR ≤2 as reference.
Conclusion(s)
First study to show that MCG can be used with 94.8% accuracy to identify CMD among patients suspicious for INOCA with no exposure to ionization, 90 seconds of scan time and minimal cost. The use of this noninvasive modality to identify CMD warrants further investigation.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Genetesis
Collapse
Affiliation(s)
- O Quesada
- The Christ Hospital, Women's Heart Center, The Christ Hospital Heart and Vascular Institute , Cincinnati , United States of America
| | - M Pico
- The Christ Hospital, Women's Heart Center, The Christ Hospital Heart and Vascular Institute , Cincinnati , United States of America
| | - C Palmer
- The Christ Hospital, Women's Heart Center, The Christ Hospital Heart and Vascular Institute , Cincinnati , United States of America
| | - M Yildiz
- The Christ Hospital, The Carl and Edyth Lindner Center for Research and Education , Cincinnati , United States of America
| | - R Miranda
- Genetesis , Cincinnati , United States of America
| | - R Malhotra
- Genetesis , Cincinnati , United States of America
| | - E Setegn
- Genetesis , Cincinnati , United States of America
| | - S Legreaux
- Genetesis , Cincinnati , United States of America
| | - B Moore
- Genetesis , Cincinnati , United States of America
| | - R Philip
- Genetesis , Cincinnati , United States of America
| | | | - R Takla
- Genetesis , Cincinnati , United States of America
| | - T Henry
- The Christ Hospital, The Carl and Edyth Lindner Center for Research and Education , Cincinnati , United States of America
| |
Collapse
|
9
|
Yildiz M, Kozanhan B. Transcutaneous electric acupoint stimulation reduces rocuronium injection-related pain: a prospective randomized controlled study. Eur Rev Med Pharmacol Sci 2022; 26:6215-6220. [PMID: 36111922 DOI: 10.26355/eurrev_202209_29639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Various approaches have been suggested to reduce the pain and discomfort associated with rocuronium injection. This randomized controlled trial aimed at exploring the effectiveness of transcutaneous electrical acupoint stimulation (TEAS), a non-invasive modality to reduce the pain associated with rocuronium injection. PATIENTS AND METHODS 60 patients undergoing elective general anesthesia were recruited and randomly allocated to the TEAS or placebo TEAS (no electrical output) groups. TEAS consisted of 30 min of stimulation at a frequency of 2/100 Hz and an intensity of 6-9 mA on Hegu (LI4) and Neiguan (PC6) before anesthesia induction. A blinded observer evaluated the pain using a 4-point pain scale. RESULTS The overall incidence of rocuronium injection-related pain was significantly lower in the TEAS group than that in the placebo TEAS group (40% and 86.7%, respectively). The incidence of no or mild pain was significantly higher in the TEAS group (100%, p<0,001) group than that in the placebo TEAS group (50%). CONCLUSIONS Pretreatment with TEAS effectively reduced the frequency and severity of pain associated with rocuronium injection.
Collapse
Affiliation(s)
- M Yildiz
- Anesthesiology and Reanimation Department, University of Health Science, Konya City Hospital, Konya, Turkey.
| | | |
Collapse
|
10
|
Sahin C, Rastgeldi Dogan T, Yildiz M, Sofuoglu SC. Indoor environmental quality in naturally ventilated schools of a dusty region: Excess health risks and effect of heating and desert dust transport. Indoor Air 2022; 32:e13068. [PMID: 35904387 DOI: 10.1111/ina.13068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/24/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Indoor air quality (IAQ) is impacted by polluted outdoor air in naturally ventilated schools, especially in places where both anthropogenic and natural sources of ambient air pollution exist. CO2 , PM2.5 , PM10 , temperature, relative humidity (RH), and noise were measured in five naturally ventilated primary schools in City of Sanliurfa, in a dusty region of Turkey, Southeast Anatolia. Excess risk levels were estimated for particulate matter. Investigation was conducted through an educational year including two seasons in terms of anthropogenic effect, that is, heating/non-heating, and natural effect, that is, desert dust transport/non-dust transport. The median CO2 concentration was measured to be >1000 ppm in all seasons/schools. Temperature and RH fell out of the comfort zone in October-December, during which pollutant concentrations were considerably increased, specifically in November, that heating and dust transport periods coincide. The overall mean indoor PM10 and PM2.5 levels were 58 and 31.8 μg/m3 , respectively. Risk assessment indicate that both short (incidence of asthma symptoms in asthmatic children) and long-term (prevalence of bronchitis) effects are considerable with 10.9 (2.4-19.6)% and 19.5 (2.2-38.8)%, respectively. The findings suggest that mechanical ventilation retrofitting with particle filtration is needed to mitigate potential negative health consequences on children.
Collapse
Affiliation(s)
- Cagri Sahin
- Department of Environmental Engineering, Izmir Institute of Technology, Izmir, Turkey
| | | | - Melek Yildiz
- Department of Environmental Engineering, Harran University, Sanliurfa, Turkey
| | - Sait C Sofuoglu
- Department of Environmental Engineering, Izmir Institute of Technology, Izmir, Turkey
| |
Collapse
|
11
|
Yildiz M, Bayram A, Bas F, Karaman V, Toksoy G, Poyrazoglu S, Soysal FG, Onder S, Uyguner ZO, Darendeliler F. Ovarian and paraovarian adrenal rest tumors are not uncommon in gonadectomy materials of historical congenital adrenal hyperplasia cases in childhood. Eur J Endocrinol 2022; 187:K13-K18. [PMID: 35550562 DOI: 10.1530/eje-21-0913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 05/12/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to assess the prevalence of ovarian and paraovarian adrenal rest tumors (ARTs) in gonadectomy materials of a subgroup of congenital adrenal hyperplasia (CAH) patients. METHODS A total of 20 historical cases with clinical/molecular diagnosis of classical CAH were included in the study. All patients had 46,XX karyotype and underwent gonadectomy because of being raised as male. RESULTS Median age at diagnosis of CAH was 5.7 years and was markedly delayed. All patients revealed severe virilization. Bone age was significantly advanced, and bone age/chronological age ratio was increased with a median ratio of 1.8. Median age at the time of gonadectomy was 9.2 years. Ovarian and paraovarian ARTs were detected during the pathological evaluation of gonadectomy materials in four patients (20%) (two with simple virilizing 21-hydroxylase and two with 11-beta-hydroxylase deficiency) with previously normal pelvic imaging. In three cases with ARTs, paraovarian area was composed of medium-sized polygonal cells, with round or oval monomorphic nuclei and abundant granular eosinophilic cytoplasm which is characteristic of adrenocortical tissue. The fourth case had bilateral ovarian 'steroid cell tumors, not otherwise specified', and the tumor was accepted as benign. Except for the ARTs, heterotopic prostate and bilateral paratubal epididymis tissue were detected in a patient. CONCLUSIONS Ovarian and paraovarian ARTs might be more common than previously described, especially among patients with excessive and prolonged adrenocorticotropic hormone exposure. These tumors could be detected histopathologically even if not detected by classical imaging methods.
Collapse
Affiliation(s)
- Melek Yildiz
- Department of Pediatric Endocrinology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Aysel Bayram
- Department of Pathology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Firdevs Bas
- Department of Pediatric Endocrinology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Volkan Karaman
- Department of Medical Genetics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Guven Toksoy
- Department of Medical Genetics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Sukran Poyrazoglu
- Department of Pediatric Endocrinology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Feryal Gun Soysal
- Department of Pediatric Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Semen Onder
- Department of Pathology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Zehra Oya Uyguner
- Department of Medical Genetics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Feyza Darendeliler
- Department of Pediatric Endocrinology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
12
|
Weiss PF, Brandon TG, Aggarwal A, Burgos-Vargas R, Colbert RA, Horneff G, Joos R, Laxer R, Minden K, Ravelli A, Ruperto N, Smith J, Stoll ML, Tse SM, Van den Bosch F, Lambert RG, Biko DM, Chauvin NA, Francavilla ML, Jaremko JL, Herregods N, Kasapcopur O, Yildiz M, Hendry AM, Maksymowych WP. POS0173 DATA-DRIVEN MRI DEFINITIONS FOR ACTIVE AND STRUCTURAL SACROILIAC JOINT LESIONS IN JUVENILE SPONDYLOARTHRITIS TYPICAL OF AXIAL DISEASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundFor classification in juvenile spondyloarthritis (JSpA), it is important to develop cut-offs for active and structural lesions typical of axial disease on MRI that are readily and consistently interpreted. Since the maturing sacroiliac joint (SIJ) looks different from the adult SIJ, the criteria developed for positive MRI in adults may not be applicable in JSpA.ObjectivesAs part of a study developing classification criteria for axial disease in JSpA, we aimed to determine quantitative SIJ imaging lesion cut-offs for inflammatory and structural lesions typical of axial JSpA using majority imaging expert decision as the reference criterion.MethodsSubjects were a retrospective cohort of children with SpA who met the provisional Pediatric Rheumatology International Trials Organization criteria for enthesitis/spondylitis-related juvenile idiopathic arthritis or had a rheumatologist JSpA diagnosis. All subjects had symptom onset prior to age 18 years and underwent MRI as part of a diagnostic evaluation for axial disease. To enable SIJ quadrant-based scoring, all MRIs included semi-coronal slices through the cartilaginous part of the joint on fluid sensitive sequences and on T1-weighted sequences for the assessment of inflammation and structural lesions, respectively. MRIs were reviewed by 6 musculoskeletal imaging experts who were blinded to clinical details. MRI evaluation of the SIJ was based on standardized lesion definitions that were decided by consensus of the central imaging team and represented a mix of definitions from ASAS and the Juvenile Arthritis MRI Score Outcome Measures in Rheumatology working group. Using a web-based interface, raters globally assessed the presence or absence of lesions typical of axial SpA and performed SIJ quadrant or joint based scoring. Lesion scores were generated by averaging the scores of all raters. Sensitivity and specificity of lesion cut-offs were calculated using rater majority (≥4/6 raters) on a global assessment of the presence/absence of active or structural lesions typical of axial SpA with high confidence (confidence of ±3 or stronger on confidence scale from -5, “Definitely No”, to +5, “Definitely Yes”) as the reference standard.ResultsImaging from 243 subjects, 61% male, median age 14.9 years, had sequences available for detailed MRI scoring. Active inflammatory lesion typical of axial disease in JSpA was defined as bone marrow edema (BME) in at least 3 SIJ quadrants (sensitivity 98.6%, specificity 96.5%). For structural lesion typical of axial JSpA, the optimal cut-off was erosion in at least 3 quadrants or at least one of the following lesions in at least 2 SIJ quadrants: sclerosis, fat lesion, backfill, ankylosis (sensitivity 98.6%, specificity 95.5%).ConclusionWe propose data-driven cut-offs for active inflammatory and structural lesions on MRI typical of axial disease in JSpA that have high specificity and sensitivity using central imaging global assessment as the reference standard.Table 1.Performance of cut-offs for inflammatory and structural lesions of axial diseaseCut-offs for number of SIJ quadrants (any location)Sensitivity (95% CI)Specificity (95% CI)Definite active lesionBME score ≥2100 (95.0-100)93.5 (88.7-96.7)BME score ≥398.6 (92.5-100)96.5 (92.5-98.7)BME, same location on ≥3 consecutive slices88.6 (78.7-94.9)98.8 (95.8-99.9)Definite structural lesionErosion ≥295.7 (88-99.1)96.8 (92.7-99)Erosion, same location on ≥2 consecutive slices94.3 (86-98.4)98.1 (94.5-99.6)Erosion ≥391.4 (82.3-96.8)98.7 (95.4-99.8)Sclerosis ≥262.9 (50.5-74.1)98.1 (94.5-99.6)Fat lesion ≥222.9 (13.7-34.4%)98.7 (95.4-99.8%)Backfill ≥220 (11.4-31.3)100 (97.7-100)Ankylosis ≥21.3 (0.2-4.7)100 (94.9-100)ANY of the following in ≥2 SIJ quadrants: erosion, sclerosis, fat lesion, backfill, ankylosis98.6 (92.3-100)93.6 (88.5-96.9)Erosion ≥3 quadrants OR ≥2 quadrants of at least one of the following lesions: sclerosis, fat, backfill, ankylosis98.6 (92.3-100.0)95.5 (91.0-98.2)Disclosure of InterestsPamela F. Weiss Consultant of: PfizerNovartisBiogenLilly(All <$5K in the past fiscal year), Timothy G. Brandon: None declared, Amita Aggarwal: None declared, Ruben Burgos-Vargas Speakers bureau: Not in the last three years.Novartis, Consultant of: Not in the last four years.BMS, Lilly, Novartis, Robert A. Colbert: None declared, Gerd Horneff Speakers bureau: Pfizer, Novartis, Janssen, Chugai, Abbvie, Grant/research support from: Pfizer, Novartis, MSD, Chugai, Roche, Abbvie, Rik Joos Speakers bureau: Galapagos, Pfizer, AbbVie, Novartis, Amgen, BMS, Lilly, Grant/research support from: Pfizer, AbbVie, Roche, Ronald Laxer Consultant of: Abbvie, Novartis, Sobi, Sanofi, Eli Lilly Canada, Eli Lilly, Kirsten Minden Speakers bureau: Pfizer, Novartis, Consultant of: Pfizer, Novartis, Angelo Ravelli Speakers bureau: Abbvie, Novartis, SOBI, Angelini, Reckitt-Benkiser, Roche, Pfizer, Alexion, Grant/research support from: Novartis, Pfizer, Nicolino Ruperto Speakers bureau: NR has received honoraria for consultancies or speaker bureaus from the following pharmaceutical companies in the past 3 years: 2 Bridge, Amgen, AstraZeneca, Aurinia, Bayer, Brystol Myers and Squibb, Celgene, inMed, Cambridge Healthcare Research, Domain Therapeutic, EMD Serono, Glaxo Smith Kline, Idorsia, Janssen, Eli Lilly, Novartis, Pfizer, Sobi, UCB., Consultant of: NR has received honoraria for consultancies or speaker bureaus from the following pharmaceutical companies in the past 3 years: 2 Bridge, Amgen, AstraZeneca, Aurinia, Bayer, Brystol Myers and Squibb, Celgene, inMed, Cambridge Healthcare Research, Domain Therapeutic, EMD Serono, Glaxo Smith Kline, Idorsia, Janssen, Eli Lilly, Novartis, Pfizer, Sobi, UCB., Grant/research support from: The IRCCS Istituto Giannina Gaslini (IGG), where NR works as full-time public employee has received contributions from the following industries in the last 3 years: Bristol Myers and Squibb, Eli-Lilly, F Hoffmann-La Roche, Novartis, Pfizer, Sobi. This funding has been reinvested for the research activities of the hospital in a fully independent manner, without any commitment with third parties., Judith Smith Consultant of: Consulting panel of pediatric rheumatologists identifying issues in juvenile spondyloarthritis for Novartis. Paid < $5000, Matthew L. Stoll Consultant of: Currently consulting for Novartis, Shirley ML Tse: None declared, Filip van den Bosch Speakers bureau: Abbvie, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, UCB, Paid instructor for: Amgen, Eli Lilly, Consultant of: Abbvie, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, UCB, Robert G Lambert Paid instructor for: Novartis, Consultant of: CARE Arthritis, Calyx, Image Analysis Group, Novartis, David M. Biko Employee of: Merck (1998-2000), Nancy A. Chauvin Employee of: Forest Pharmaceuticals - Research scientist (1996) and Novartis - Pharmaceutical sales representative (1997), Michael L. Francavilla: None declared, Jacob L Jaremko: None declared, Nele Herregods: None declared, Ozgur Kasapcopur Speakers bureau: Pfizer, Abbvie, Novartis and Roche, Mehmet YILDIZ: None declared, Alison M. Hendry: None declared, Walter P Maksymowych Speakers bureau: Abbvie, Eli-Lilly, Janssen, Novartis, Pfizer, UCB Pharma, Consultant of: AbbVie, Boehringer Ingelheim, Celgene, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, UCB Pharma, Grant/research support from: Abbvie, Novartis, Pfizer
Collapse
|
13
|
Seven Menevse T, Kendir Demirkol Y, Gurpinar Tosun B, Bayramoglu E, Yildiz M, Acar S, Erisen Karaca S, Orbak Z, Onder A, Sobu E, Anık A, Atay Z, Bugrul F, Derya Bulus A, Demir K, Dogan D, Cihan Emeksiz H, Kirmizibekmez H, Ozcan Murat N, Yaman A, Turan S, Bereket A, Guran T. Steroid Hormone Profiles and Molecular Diagnostic Tools in Pediatric Patients With non-CAH Primary Adrenal Insufficiency. J Clin Endocrinol Metab 2022; 107:e1924-e1931. [PMID: 35028661 DOI: 10.1210/clinem/dgac016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT There is a significant challenge of attributing specific diagnoses to patients with primary adrenal insufficiency of unknown etiology other than congenital adrenal hyperplasia (non-CAH PAI). Specific diagnoses per se may guide personalized treatment or may illuminate pathophysiology. OBJECTIVE This work aimed to investigate the efficacy of steroid hormone profiles and high-throughput sequencing methods in establishing the etiology in non-CAH PAI of unknown origin. METHODS Pediatric patients with non-CAH PAI whose etiology could not be established by clinical and biochemical characteristics were enrolled. Genetic analysis was performed using targeted-gene panel sequencing (TPS) and whole-exome sequencing (WES). Plasma adrenal steroids were quantified by liquid chromatography-mass spectrometry and compared to that of controls. This study comprised 18 pediatric endocrinology clinics with 41 patients (17 girls, median age: 3 mo, range: 0-8 y) with non-CAH PAI of unknown etiology. RESULTS A genetic diagnosis was obtained in 29 (70.7%) patients by TPS. Further molecular diagnosis could not be achieved by WES. Compared to a healthy control group, patients showed lower steroid concentrations, most statistically significantly in cortisone, cortisol, and corticosterone (P < .0001, area under the receiver operating characteristic curve: .96, .88, and .87, respectively). Plasma cortisol of less than 4 ng/mL, cortisone of less than 11 ng/mL, and corticosterone of less than 0.11 ng/mL had a greater than 95% specificity to ensure the diagnosis of non-CAH PAI of unknown etiology. CONCLUSION Steroid hormone profiles are highly sensitive for the diagnosis of non-CAH PAI of unknown etiology, but they are unlikely to point to a specific molecular diagnosis. TPS is an optimal approach in the molecular diagnosis of these patients with high efficacy, whereas little additional benefit is expected from WES.
Collapse
Affiliation(s)
- Tuba Seven Menevse
- Department of Pediatric Endocrinology and Diabetes, Marmara University, School of Medicine, 34899, Ustkaynarca/Pendik Istanbul, Turkey
| | - Yasemin Kendir Demirkol
- Department of Pediatric Genetics, Umraniye Research and Training Hospital, University of Health Sciences, 34764 Istanbul, Turkey
| | - Busra Gurpinar Tosun
- Department of Pediatric Endocrinology and Diabetes, Marmara University, School of Medicine, 34899, Ustkaynarca/Pendik Istanbul, Turkey
| | - Elvan Bayramoglu
- Department of Pediatric Endocrinology, Haseki Training and Research Hospital, 34096 Istanbul, Turkey
| | - Melek Yildiz
- Department of Pediatric Endocrinology and Diabetes, Istanbul University, School of Medicine, 34093 Istanbul, Turkey
| | - Sezer Acar
- Department of Pediatric Endocrinology and Diabetes, Behcet Uz Education and Research Hospital, 35210 Izmir, Turkey
| | - Seda Erisen Karaca
- Department of Pediatric Pediatrics, Duzce University, School of Medicine, 81620 Bolu, Turkey
| | - Zerrin Orbak
- Department of Pediatric Endocrinology and Diabetes, Ataturk University, School of Medicine, 25030 Erzurum, Turkey
| | - Asan Onder
- Department of Pediatric Endocrinology and Diabetes, Medeniyet University, School of Medicine, 34722 Istanbul, Turkey
| | - Elif Sobu
- Department of Pediatric Endocrinology, Kartal Training and Research Hospital, 34865 Istanbul, Turkey
| | - Ahmet Anık
- Department of Pediatric Endocrinology, Aydin Adnan Menderes University, School of Medicine, 09010 Aydin, Turkey
| | - Zeynep Atay
- Department of Pediatric Endocrinology and Diabetes, Istanbul Medipol University, School of Medicine, 34810 Istanbul, Turkey
| | - Fuat Bugrul
- Department of Pediatric Endocrinology and Diabetes, Selcuk University, School of Medicine, 42250 Konya, Turkey
| | - Ayse Derya Bulus
- Department of Pediatric Endocrinology and Diabetes, Ankara Kecioren Research and Training Hospital, University of Health Sciences, 06000 Ankara, Turkey
| | - Korcan Demir
- Department of Pediatric Endocrinology and Diabetes, Dokuz Eylul University, School of Medicine, 35340 Izmir, Turkey
| | - Durmus Dogan
- Department of Pediatric Endocrinology and Diabetes, Onsekiz Mart University, School of Medicine, 17110 Canakkale, Turkey
| | - Hamdi Cihan Emeksiz
- Department of Pediatric Endocrinology and Diabetes, Medeniyet University, School of Medicine, 34722 Istanbul, Turkey
| | - Heves Kirmizibekmez
- Department of Pediatric Endocrinology and Diabetes, Umraniye Research and Training Hospital, University of Health Sciences, 34764 Istanbul, Turkey
| | - Nurhan Ozcan Murat
- Department of Pediatric Endocrinology and Diabetes, Derince Research and Training Hospital, 41900 Kocaeli, Turkey
| | - Akan Yaman
- Department of Pediatrics, Gungoren Hospital, 34164 Istanbul, Turkey
| | - Serap Turan
- Department of Pediatric Endocrinology and Diabetes, Marmara University, School of Medicine, 34899, Ustkaynarca/Pendik Istanbul, Turkey
| | - Abdullah Bereket
- Department of Pediatric Endocrinology and Diabetes, Marmara University, School of Medicine, 34899, Ustkaynarca/Pendik Istanbul, Turkey
| | - Tulay Guran
- Department of Pediatric Endocrinology and Diabetes, Marmara University, School of Medicine, 34899, Ustkaynarca/Pendik Istanbul, Turkey
| |
Collapse
|
14
|
Yildiz M, Buyuk B, Kanbur S. The Effect of Chronic Intermittent Cold Exposure on Gastrin-, Somatostatin-, Secretin-, and Serotonin-Containing Cells in the Small Intestine of Rats. BIOL BULL+ 2022. [DOI: 10.1134/s1062359022010174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
15
|
Uygur B, Demir AR, Sancar K, Yildiz M, Erturk M. The role of coronary sinus in the risk stratification and the prognostic evaluation of idiopathic pulmonary arterial hypertension. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Coronary sinus (CS) is a venous structure draining into the right atrium, therefore it can reflect the pressure and the volume load of the right heart chambers. Idiopathic pulmonary arterial hypertension (IPAH) is a progressive, life-threatening disease in which the risk assessment plays a critical role.
Purpose
We aimed to evaluate the correlation of CS diameter with the well-known risk assessment parameters in IPAH patients and to search the utility of CS diameter in the prediction of mortality and hospitalization.
Methods
A total of 25 IPAH patients were enrolled in our retrospective study. All patients underwent detailed echocardiographic examination, laboratory examination, 6 minutes walking test and cardiopulmonary exercise test at the same day. The patients were followed-up for a mean 16.8 ± 10.1 months. Primary endpoint was mortality or hospitalization. The relationship between CS diameter and well-known risk parameters and the prognosis were analyzed.
Results
Mean CS diameter was 9.9 ± 3.7 mm. CS diameter had moderate positive correlation with age (r:0.560, p:0.004), NT-proBNP (r:0.625, p:0.001) and weak positive correlation with functional class (r:0.483, p:0.017) and moderate negative correlation with 6 minutes walking distance (r:-0.553, p:0.005) and peak oxygen uptake (r:-0.506 p:0.038). Six (24%) patients were hospitalized, and three patients (12%) died during mean 16.8 ± 10.1 months follow-up. The CS diameter > 9 mm predicted mortality and hospitalization with a sensitivity of 77.8%, specificity of 75.0% (Area under curve (AUC): 0.788; 95% CI: 0.580-0.996; P = 0.019).
Conclusion
CS which is a noninvasive, cheap and readily available echocardiographic parameter, might be used in the risk assessment and the evaluation of prognosis in IPAH patients. Abstract Figure. Coronary sinus measurement Abstract Figure. Basal features
Collapse
Affiliation(s)
- B Uygur
- Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - AR Demir
- Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - K Sancar
- Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - M Yildiz
- Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - M Erturk
- Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| |
Collapse
|
16
|
Patel KA, Ozbek MN, Yildiz M, Guran T, Kocyigit C, Acar S, Siklar Z, Atar M, Colclough K, Houghton J, Johnson MB, Ellard S, Flanagan SE, Cizmecioglu F, Berberoglu M, Demir K, Catli G, Bas S, Akcay T, Demirbilek H, Weedon MN, Hattersley AT. Systematic genetic testing for recessively inherited monogenic diabetes: a cross-sectional study in paediatric diabetes clinics. Diabetologia 2022; 65:336-342. [PMID: 34686905 PMCID: PMC8741690 DOI: 10.1007/s00125-021-05597-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/02/2021] [Indexed: 11/04/2022]
Abstract
AIMS/HYPOTHESIS Current clinical guidelines for childhood-onset monogenic diabetes outside infancy are mainly focused on identifying and testing for dominantly inherited, predominantly MODY genes. There are no systematic studies of the recessively inherited causes of monogenic diabetes that are likely to be more common in populations with high rates of consanguinity. We aimed to determine the contribution of recessive causes of monogenic diabetes in paediatric diabetes clinics and to identify clinical criteria by which to select individuals for recessive monogenic diabetes testing. METHODS We conducted a cross-sectional study of 1093 children from seven paediatric diabetes clinics across Turkey (a population with high rates of consanguinity). We undertook genetic testing of 50 known dominant and recessive causes of monogenic diabetes for 236 children at low risk of type 1 diabetes. As a comparison, we used monogenic diabetes cases from UK paediatric diabetes clinics (a population with low rates of consanguinity). RESULTS Thirty-four children in the Turkish cohort had monogenic diabetes, equating to a minimal prevalence of 3.1%, similar to that in the UK cohort (p = 0.40). Forty-one per cent (14/34) had autosomal recessive causes in contrast to 1.6% (2/122) in the UK monogenic diabetes cohort (p < 0.0001). All conventional criteria for identifying monogenic diabetes (parental diabetes, not requiring insulin treatment, HbA1c ≤ 58 mmol/mol [≤7.5%] and a composite clinical probability of MODY >10%) assisted the identification of the dominant (all p ≤ 0.0003) but not recessive cases (all p ≥ 0.2) in Turkey. The presence of certain non-autoimmune extra-pancreatic features greatly assisted the identification of recessive (p < 0.0001, OR 66.9) but not dominant cases. CONCLUSIONS/INTERPRETATION Recessively inherited mutations are a common cause of monogenic diabetes in populations with high rates of consanguinity. Present MODY-focused genetic testing strategies do not identify affected individuals. To detect all cases of monogenic paediatric diabetes, it is crucial that recessive genes are included in genetic panels and that children are selected for testing if they have certain non-autoimmune extra-pancreatic features in addition to current criteria.
Collapse
Affiliation(s)
- Kashyap A Patel
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK.
| | - Mehmet N Ozbek
- Department of Paediatric Endocrinology, Gazi Yasargil Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Melek Yildiz
- Department of Paediatric Endocrinology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
- Department of Paediatric Endocrinology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tulay Guran
- Department of Paediatric Endocrinology and Diabetes, Marmara University Hospital, Istanbul, Turkey
| | - Cemil Kocyigit
- Department of Paediatric Endocrinology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Sezer Acar
- Department of Paediatric Endocrinology, Dokuz Eylul University, Izmir, Turkey
- Division of Paediatric Endocrinology, Dr Behcet Uz Child Disease and Paediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Zeynep Siklar
- Department of Paediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey
| | - Muge Atar
- Department of Paediatric Endocrinology, Kocaeil University Hospital, Izmit, Turkey
- Department of Paediatric Endocrinology, Suleyman Demirel University, Isparta, Turkey
| | - Kevin Colclough
- Department of Molecular Genetics, Royal Devon and Exeter National Health Service Foundation Trust, Exeter, UK
| | - Jayne Houghton
- Department of Molecular Genetics, Royal Devon and Exeter National Health Service Foundation Trust, Exeter, UK
| | - Matthew B Johnson
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Sian Ellard
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK
- Department of Molecular Genetics, Royal Devon and Exeter National Health Service Foundation Trust, Exeter, UK
| | - Sarah E Flanagan
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Filiz Cizmecioglu
- Department of Paediatric Endocrinology, Kocaeil University Hospital, Izmit, Turkey
| | - Merih Berberoglu
- Department of Paediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey
| | - Korcan Demir
- Department of Paediatric Endocrinology, Dokuz Eylul University, Izmir, Turkey
| | - Gonul Catli
- Department of Paediatric Endocrinology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Serpil Bas
- Department of Paediatric Endocrinology and Diabetes, Marmara University Hospital, Istanbul, Turkey
| | - Teoman Akcay
- Department of Paediatric Endocrinology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
- Department of Paediatric Endocrinology, Istinye University, Gaziosmanpasa Medical Park Hospital, Istanbul, Turkey
| | - Huseyin Demirbilek
- Department of Paediatric Endocrinology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Michael N Weedon
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Andrew T Hattersley
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK
| |
Collapse
|
17
|
Mihalj M, Ferro C, Yildiz M, Nucera M, Mosbahi S, Heinisch PP, Schoenhoff F. Right ventricular function in Marfan patients remains stable despite (multiple) cardiac interventions. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left-sided heart lesions, namely aortic root aneurysm, mitral valve prolapse and intrinsic left ventricular (LV) dysfunction are an essential part of the cardiovascular phenotype of Marfan syndrome (MFS). While recent data stresses the need for concomitant tricuspid valve repair (TVR) when addressing left-sided heart lesions in non-MFS patients, data on tricuspid valve disease and right ventricular (RV) function in MFS is scarce.
Purpose
We sought to determine changes in RV function, tricuspid valve regurgitation and need for TVR in MFS patients throughout their lifetime, from day of first contact.
Methods
We retrospectively analyzed 183 MFS patients fulfilling Ghent criteria seen at our institution between 1995 and 2019. In this patient population, 136 patients (74%) underwent 170 procedures with cardioplegic arrest. Aortic root surgery was performed in 90% and mitral valve surgery (MVR) in 19% of patients undergoing surgery. TVR was performed in 3.7% of all patients undergoing surgery and 18.5% of patients undergoing MVR. Mean age at time of first intervention was 37.8±14.4 years. Mean age in the group of patients without history of surgery was 20.6±17.5 years. Right ventricular function was evaluated using tricuspid annular plane systolic excursion (TAPSE) by echocardiographic assessment at baseline (defined as most recent exam before surgery, or first available exam in patients without history of surgery), and at last available follow-up (defined as last available exam after surgery, or last available exam prior to subsequent surgery). Mean follow-up (FU) was 7.2±7.1 years.
Results
Patients that underwent surgery with cardioplegic arrest did not experience a significant decrease in RV function over time (mean TAPSE at baseline 22.3±4.7 mm, mean difference −4.0±6.7 mm at last FU after surgery). The same was true for patients undergoing MVR with a mean TAPSE at baseline of 21.5±5.2 mm and a mean difference of −5.6±8.05 mm at last available FU (p=0.664). Freedom from impaired RV function (defined as TAPSE ≤15mm) at 5-, 10- and 15-years FU was 78%, 77%, 73%, respectively. Freedom from severe TR was 100% up to 15 years, and freedom from TVR at 5-, 10- and 15-years FU was 96%. Actuarial survival of all patients at 5-, 10- and 15-years FU was 95.6%, 94.5%, and 91.8%, respectively.
Conclusions
Current data suggests that right-sided heart lesions in MFS patients are rare. RV function remains stable over time despite (multiple) cardiac interventions. Furthermore, the need for TVR is low, independently of whether MVR was performed or not.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- M Mihalj
- University Hospital Bern, Bern, Switzerland
| | - C Ferro
- University Hospital Bern, Bern, Switzerland
| | - M Yildiz
- University Hospital Bern, Bern, Switzerland
| | - M Nucera
- University Hospital Bern, Bern, Switzerland
| | - S Mosbahi
- University Hospital Bern, Bern, Switzerland
| | | | | |
Collapse
|
18
|
Yildiz M, Senel MU, Kavurgaci S, Ozturk FE, Ozturk A. The prognostic significance of vitamin D deficiency in patients with COVID-19 pneumonia. ACTA ACUST UNITED AC 2021; 122:744-747. [PMID: 34570577 DOI: 10.4149/bll_2021_119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Vitamin D has anti-inflammatory and immunomodulatory effects via the downregulation of pro-inflammatory cytokines. We aimed to demonstrate the effect of vitamin D levels on survival in COVID-19 patients. MATERIALS AND METHODS 207 COVID-19 patients were included in the study. Serum vitamin D levels were measured, and patients with levels <20 ng/ml or 21 to 30 ng received a single 300.000 IU dose of vitamin D. RESULTS Of 207 patients, 37 received vitamin D, while 170 did not. Demographic, radiologic and mean laboratory values were similar between the groups. The mean plasma vitamin D level without vitamin D support (n=170) was 50.82±16.12 ng/ml (30.28-81.35) vs. 16.98±6.2 ng/ml (4.20-28.30) in vitamin D group. The most remarkable finding were the mortality rates; while only 1 patient (2.7 %) died in the vitamin D group, 24 patients (14.1 %) died in no vitamin D supplementation group (p=0.038). CONCLUSION Although a few retrospective studies put forth a relation between vitamin D deficiency and COVID-19 course severity there is still paucity of data about the efficacy of vitamin supplementations in COVID-19 patients. A single 300.000 IU dose of vitamin D seems to represent a useful, practical, and safe adjunctive approach for the treatment or prevention of COVID-19 (Tab. 1, Fig. 1, Ref. 30).
Collapse
|
19
|
Yildiz M, Isik E, Abali ZY, Keskin M, Ozbek MN, Bas F, Ucakturk SA, Buyukinan M, Onal H, Kara C, Storbeck KH, Darendeliler F, Cayir A, Unal E, Anik A, Demirbilek H, Cetin T, Dursun F, Catli G, Turan S, Falhammar H, Baris T, Yaman A, Haklar G, Bereket A, Guran T. Clinical and Hormonal Profiles Correlate With Molecular Characteristics in Patients With 11β-Hydroxylase Deficiency. J Clin Endocrinol Metab 2021; 106:e3714-e3724. [PMID: 33830237 DOI: 10.1210/clinem/dgab225] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Given the rarity of 11β-hydroxylase deficiency (11βOHD), there is a paucity of data about the differences in clinical and biochemical characteristics of classic (C-11βOHD) and nonclassic 11βOHD (NC-11βOHD). OBJECTIVE To characterize a multicenter pediatric cohort with 11βOHD. METHOD The clinical and biochemical characteristics were retrospectively retrieved. CYP11B1 gene sequencing was performed. Seventeen plasma steroids were quantified by liquid chromatography-mass spectrometry and compared to that of controls. RESULTS 102 patients (C-11βOHD, n = 92; NC-11βOHD, n = 10) from 76 families (46,XX; n = 53) had biallelic CYP11B1 mutations (novel 9 out of 30). Five 46,XX patients (10%) were raised as males. Nineteen patients (19%) had initially been misdiagnosed with 21-hydroxylase deficiency. Female adult height was 152 cm [-1.85 SD score (SDS)] and male 160.4 cm (-2.56 SDS).None of the NC-11βOHD girls had ambiguous genitalia (C-11βOHD 100%), and none of the NC-11βOHD patients were hypertensive (C-11βOHD 50%). Compared to NC-11βOHD, C-11βOHD patients were diagnosed earlier (1.33 vs 6.9 years; P < 0.0001), had higher bone age-to-chronological age (P = 0.04) and lower adult height (-2.46 vs -1.32 SDS; P = 0.05). The concentrations of 11-oxygenated androgens and 21-deoxycortisol were low in all patients. The baseline ACTH and stimulated cortisol were normal in NC-11βOHD. Baseline cortisol; cortisone; 11-deoxycortisol; 11-deoxycorticosterone and corticosterone concentrations; and 11-deoxycortisol/cortisol, 11-deoxycorticosterone/cortisol, and androstenedione/cortisol ratios were higher in C-11βOHD than NC-11βOHD patients (P < 0.05). The 11-deoxycortisol/cortisol ratio >2.2, <1.5, and <0.1 had 100% specificity to segregate C-11βOHD, NC-11βOHD, and control groups. CONCLUSION NC-11βOHD can escape from clinical attention due to relatively mild clinical presentation. However, steroid profiles enable the diagnosis, differential diagnosis, and subtyping of 11βOHD.
Collapse
Affiliation(s)
- Melek Yildiz
- Department of Pediatric Endocrinology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
- Department of Pediatric Endocrinology and Diabetes, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Emregul Isik
- Clinics of Pediatric Endocrinology, Gaziantep Children's Hospital, Gaziantep, Turkey
| | - Zehra Yavas Abali
- Department of Pediatric Endocrinology and Diabetes, Marmara University, Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Keskin
- Department of Pediatric Endocrinology and Diabetes, Gaziantep University, School of Medicine , Gaziantep, Turkey
| | - Mehmet Nuri Ozbek
- Department of Pediatric Endocrinology and Diabetes, SBU Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey
| | - Firdevs Bas
- Department of Pediatric Endocrinology and Diabetes, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Seyit Ahmet Ucakturk
- Department of Pediatric Endocrinology, Ankara City Hospital, Children's Hospital, Ankara, Turkey
| | - Muammer Buyukinan
- Department of Pediatric Endocrinology, Konya Training and Research Hospital, Konya, Turkey
| | - Hasan Onal
- Department of Pediatric Endocrinology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Cengiz Kara
- Department of Pediatrics, Division of Pediatric Endocrinology, Altinbas University, Faculty of Medicine, Istanbul, Turkey
| | - Karl-Heinz Storbeck
- Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa
| | - Feyza Darendeliler
- Department of Pediatric Endocrinology and Diabetes, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Atilla Cayir
- Department of Pediatric Endocrinology and Diabetes, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Edip Unal
- Department of Pediatric Endocrinology and Diabetes, SBU Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey
| | - Ahmet Anik
- Department of Pediatric Endocrinology and Diabetes, Adnan Menderes University, School of Medicine , Aydin, Turkey
| | - Huseyin Demirbilek
- Department of Pediatric Endocrinology and Diabetes, Hacettepe University, School of Medicine , Ankara, Turkey
| | - Tugba Cetin
- Department of Pediatric Endocrinology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Fatma Dursun
- Department of Pediatric Endocrinology and Diabetes, Istanbul University of Health Science, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Gonul Catli
- Department of Pediatric Endocrinology, Izmir Katip Celebi University, School of Medicine , Izmir, Turkey
| | - Serap Turan
- Department of Pediatric Endocrinology and Diabetes, Marmara University, Faculty of Medicine, Istanbul, Turkey
| | - Henrik Falhammar
- Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Tugba Baris
- Gelisim Genetik Tani Merkezi, Istanbul, Turkey
| | - Ali Yaman
- Department of Biochemistry, Marmara University, Faculty of Medicine, Istanbul, Turkey
| | - Goncagul Haklar
- Department of Biochemistry, Marmara University, Faculty of Medicine, Istanbul, Turkey
| | - Abdullah Bereket
- Department of Pediatric Endocrinology and Diabetes, Marmara University, Faculty of Medicine, Istanbul, Turkey
| | - Tulay Guran
- Department of Pediatric Endocrinology and Diabetes, Marmara University, Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
20
|
Yildiz M, Ozturk Ergur F, Uzel Senel M, Kavurgaci S, Sciences AOH, Chest AA. The use of prone positioning in severe COVID-19 outside the intensive care unit. ACTA ACUST UNITED AC 2021; 122:590-593. [PMID: 34282626 DOI: 10.4149/bll_2021_094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES It was aimed to demonstrate the applicability of the prone position with high-flow oxygen to COVID-19 patients with severe respiratory failure in the service in September when the number of cases and the need for intensive care were increased. MATERIAL AND METHODS The prone position was applied for a minimum of 30-minute periods for at least four hours a day. The patients' oxygen saturation levels and respiration rates were monitored before and 30 minutes after prone positioning. RESULTS Ten patients, nine males (9/1, M/F), were included in the study. Mean oxygen saturation at baseline was 75.8±12.14 (min: 50 %; max: 90 %) and all patients had high oxygen demand. The oxygen saturation of the patients differed significantly before and after (83.4±6.38 %; 90±5.31 %, p <0.001) prone positioning. Similarly, respiration rates differed significantly before and after (23.9±6; 21.4±4.97, p <0.001) prone positioning. Two patients died during treatment. CONCLUSION This study highlights the promise of prone positioning performed in ward conditions for improving oxygenation in COVID-19. While the study contains a small group, it may provide guidance for the clinical management of COVID-19 patients to prevent the need for intensive care in the challenging course of therapy (Tab. 2, Fig. 2, Ref. 15).
Collapse
|
21
|
Poyrazoglu S, Bas F, Karaman B, Yildiz M, Basaran S, Darendeliler F. Growth and relationship of phenotypic characteristics with gonadal pathology and tumour risk in patients with 45, X/46, XY mosaicism. Clin Endocrinol (Oxf) 2021; 94:973-979. [PMID: 33550653 DOI: 10.1111/cen.14437] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/02/2021] [Accepted: 02/01/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate the growth data, gonadal functions and tumour risk in children with 45, X/46, XY mosaicism. DESIGN We reviewed retrospectively the records of 45 patients with 45, X/46, XY mosaicism or variants presented to our Unit from 1989 to 2019. RESULTS The age at diagnosis ranged from 0.03 to 17.5 years. Twenty-eight patients had genital anomaly, 14 patients had female external genitalia and 3 patients had normal male genitalia. Patients showed normal height under 2 years of age. Mean height standard deviation score (HSDS) of 19 patients diagnosed before 2 years of age was -0.9 ± 0.6 and that of 26 patients diagnosed after 2 years of age was -2.6 ± 1.5. Ten patients diagnosed before 2 years of age showed growth deceleration after 2 years of age (HSDS decreasing from -0.6 ± 0.7 to -1.4 ± 0.9). Twenty-one patients reached adult height (AH). Growth hormone (GH) treatment was initiated in 10 patients. Although AHSDS of GH-treated patients was significantly greater than their mean HSDS before GH therapy (p =.013), it was not significantly different from AHSDS of the untreated group. Seventeen (37.8%) patients exhibited phenotypical features of Turner syndrome (TS) other than short stature. Two patients with genital anomaly had gonadoblastoma and germ cell neoplasia in situ, and one patient with female external genitalia had gonadoblastoma. CONCLUSIONS GH therapy seems to improve AH of patients. Both patients with genital anomaly and female external genitalia have increased risk of germ cell tumours.
Collapse
Affiliation(s)
- Sukran Poyrazoglu
- Istanbul Faculty of Medicine, Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| | - Firdevs Bas
- Istanbul Faculty of Medicine, Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| | - Birsen Karaman
- Istanbul Faculty of Medicine, Department of Medical Genetics, Istanbul University, Istanbul, Turkey
- Child Health Institute, Pediatric Basic Sciences, Istanbul University, Istanbul, Turkey
| | - Melek Yildiz
- Istanbul Faculty of Medicine, Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| | - Seher Basaran
- Istanbul Faculty of Medicine, Department of Medical Genetics, Istanbul University, Istanbul, Turkey
| | - Feyza Darendeliler
- Istanbul Faculty of Medicine, Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| |
Collapse
|
22
|
De Franco E, Lytrivi M, Ibrahim H, Montaser H, Wakeling MN, Fantuzzi F, Patel K, Demarez C, Cai Y, Igoillo-Esteve M, Cosentino C, Lithovius V, Vihinen H, Jokitalo E, Laver TW, Johnson MB, Sawatani T, Shakeri H, Pachera N, Haliloglu B, Ozbek MN, Unal E, Yıldırım R, Godbole T, Yildiz M, Aydin B, Bilheu A, Suzuki I, Flanagan SE, Vanderhaeghen P, Senée V, Julier C, Marchetti P, Eizirik DL, Ellard S, Saarimäki-Vire J, Otonkoski T, Cnop M, Hattersley AT. YIPF5 mutations cause neonatal diabetes and microcephaly through endoplasmic reticulum stress. J Clin Invest 2021; 130:6338-6353. [PMID: 33164986 PMCID: PMC7685733 DOI: 10.1172/jci141455] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022] Open
Abstract
Neonatal diabetes is caused by single gene mutations reducing pancreatic β cell number or impairing β cell function. Understanding the genetic basis of rare diabetes subtypes highlights fundamental biological processes in β cells. We identified 6 patients from 5 families with homozygous mutations in the YIPF5 gene, which is involved in trafficking between the endoplasmic reticulum (ER) and the Golgi. All patients had neonatal/early-onset diabetes, severe microcephaly, and epilepsy. YIPF5 is expressed during human brain development, in adult brain and pancreatic islets. We used 3 human β cell models (YIPF5 silencing in EndoC-βH1 cells, YIPF5 knockout and mutation knockin in embryonic stem cells, and patient-derived induced pluripotent stem cells) to investigate the mechanism through which YIPF5 loss of function affects β cells. Loss of YIPF5 function in stem cell–derived islet cells resulted in proinsulin retention in the ER, marked ER stress, and β cell failure. Partial YIPF5 silencing in EndoC-βH1 cells and a patient mutation in stem cells increased the β cell sensitivity to ER stress–induced apoptosis. We report recessive YIPF5 mutations as the genetic cause of a congenital syndrome of microcephaly, epilepsy, and neonatal/early-onset diabetes, highlighting a critical role of YIPF5 in β cells and neurons. We believe this is the first report of mutations disrupting the ER-to-Golgi trafficking, resulting in diabetes.
Collapse
Affiliation(s)
- Elisa De Franco
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Maria Lytrivi
- ULB Center for Diabetes Research and.,Division of Endocrinology, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Hazem Ibrahim
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hossam Montaser
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Matthew N Wakeling
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Federica Fantuzzi
- ULB Center for Diabetes Research and.,Endocrinology and Metabolism, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Kashyap Patel
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | | | - Ying Cai
- ULB Center for Diabetes Research and
| | | | | | - Väinö Lithovius
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Helena Vihinen
- Electron Microscopy Unit, Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Eija Jokitalo
- Electron Microscopy Unit, Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Thomas W Laver
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Matthew B Johnson
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | | | | | | | | | | | - Edip Unal
- Dicle University, Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakır, Turkey
| | - Ruken Yıldırım
- Dicle University, Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakır, Turkey
| | | | - Melek Yildiz
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Banu Aydin
- Kanuni Sultan Suleyman Training and Research Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Angeline Bilheu
- Institute of Interdisciplinary Research (IRIBHM), ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Ikuo Suzuki
- Institute of Interdisciplinary Research (IRIBHM), ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium.,VIB-KU Leuven Center for Brain & Disease Research, Leuven, Belgium.,Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Sarah E Flanagan
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Pierre Vanderhaeghen
- Institute of Interdisciplinary Research (IRIBHM), ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium.,VIB-KU Leuven Center for Brain & Disease Research, Leuven, Belgium.,Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium.,Welbio, Université Libre de Bruxelles, Brussels, Belgium
| | - Valérie Senée
- Université de Paris, Faculté de Médecine Paris-Diderot, U958, Paris, France
| | - Cécile Julier
- Université de Paris, Faculté de Médecine Paris-Diderot, U958, Paris, France
| | - Piero Marchetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Decio L Eizirik
- ULB Center for Diabetes Research and.,Welbio, Université Libre de Bruxelles, Brussels, Belgium.,Indiana Biosciences Research Institute, Indianapolis, Indiana, USA
| | - Sian Ellard
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| | - Jonna Saarimäki-Vire
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Timo Otonkoski
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Miriam Cnop
- ULB Center for Diabetes Research and.,Division of Endocrinology, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Andrew T Hattersley
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom
| |
Collapse
|
23
|
Alexiadis A, Albano A, Rahmat A, Yildiz M, Kefal A, Ozbulut M, Bakirci N, Garzón-Alvarado DA, Duque-Daza CA, Eslava-Schmalbach JH. Simulation of pandemics in real cities: enhanced and accurate digital laboratories. Proc Math Phys Eng Sci 2021; 477:20200653. [PMID: 33633493 PMCID: PMC7897638 DOI: 10.1098/rspa.2020.0653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/14/2020] [Indexed: 12/28/2022] Open
Abstract
This study develops a modelling framework for simulating the spread of infectious diseases within real cities. Digital copies of Birmingham (UK) and Bogotá (Colombia) are generated, reproducing their urban environment, infrastructure and population. The digital inhabitants have the same statistical features of the real population. Their motion is a combination of predictable trips (commute to work, school, etc.) and random walks (shopping, leisure, etc.). Millions of individuals, their encounters and the spread of the disease are simulated by means of high-performance computing and massively parallel algorithms for several months and a time resolution of 1 minute. Simulations accurately reproduce the COVID-19 data for Birmingham and Bogotá both before and during the lockdown. The model has only one adjustable parameter calculable in the early stages of the pandemic. Policymakers can use our digital cities as virtual laboratories for testing, predicting and comparing the effects of policies aimed at containing epidemics.
Collapse
Affiliation(s)
- A Alexiadis
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - A Albano
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - A Rahmat
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - M Yildiz
- Faculty of Engineering and Natural Sciences, Sabanci University, 34956 Tuzla, Istanbul, Turkey
| | - A Kefal
- Faculty of Engineering and Natural Sciences, Sabanci University, 34956 Tuzla, Istanbul, Turkey
| | - M Ozbulut
- Faculty of Engineering, Piri Reis University, 34940 Istanbul, Turkey
| | - N Bakirci
- School of Medicine, Acibadem University, lçerenköy, Kayışdağı 32, 34684 Istanbul, Turkey
| | - D A Garzón-Alvarado
- Department of Mechanical and Mechatronic Engineering, Universidad Nacional de Colombia, Cra 30 No 45-03. Bogotá, Colombia
| | - C A Duque-Daza
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,Department of Mechanical and Mechatronic Engineering, Universidad Nacional de Colombia, Cra 30 No 45-03. Bogotá, Colombia
| | - J H Eslava-Schmalbach
- School of Medicine, Universidad Nacional de Colombia, Hospital Universitario Nacional de Colombia, Cra 30 No 45-03. Bogotá, Colombia
| |
Collapse
|
24
|
Kozanhan B, Yildiz M. Questionnaire translation and questionnaire validation are not the same. Int J Obstet Anesth 2020; 45:165. [PMID: 33408045 DOI: 10.1016/j.ijoa.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/01/2020] [Accepted: 12/04/2020] [Indexed: 02/04/2023]
Affiliation(s)
- B Kozanhan
- University of Health Sciences, Konya Education and Research Hospital, Anesthesiology and Reanimation Clinic, Konya, Turkey.
| | - M Yildiz
- University of Health Sciences, Konya Education and Research Hospital, Anesthesiology and Reanimation Clinic, Konya, Turkey
| |
Collapse
|
25
|
Orhan C, Seyhan B, Baykara O, Yildiz M, Kasapcopur O, Buyru N. Vitamin D binding protein genotype frequency in familial Mediterranean fever patients. Scand J Rheumatol 2020; 49:484-488. [PMID: 32940108 DOI: 10.1080/03009742.2020.1762922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by recurrent short episodes (1-3 days) of inflammation and fever. FMF is associated with MEFV gene mutations but some patients with FMF symptoms do not have a mutation in the coding region of the MEFV gene. Vitamin D binding protein (VDBP) has important functions, including transporting vitamin D and its metabolites to target cells. Circulating levels of vitamin D are decreased in several inflammatory conditions, including FMF. Thus, we hypothesize that VDBP may play a crucial role in FMF pathogenesis, in addition to the MEFV gene. Method: VDBP genotyping was performed by polymerase chain reaction (PCR)-restriction fragment length polymorphism in 107 FMF patients and 25 healthy individuals without FMF or family history. For this, after amplification of genomic DNA, PCR products were digested with restriction enzymes HaeIII and StyI and evaluated electrophoretically. Results: We observed a statistically significant difference in the frequency of the 1F-2 genotype. The frequency of allele 2 was significantly higher and allele 1S was significantly lower compared to the [MEFV(-)] group and healthy controls (p = 0.034, 0.001, and 0.012, respectively). We observed a significant association between the presence of allele 2 and amyloidosis (p = 0.026) and arthritis (p = 0.044) in the [MEFV(-)] group. Conclusion: Our results suggest that FMF symptoms in the absence of MEFV gene mutations may be due to the presence of VDBP allele 2. Therefore, VDBP genotype may explain the symptoms in FMF [MEFV(-)] patients.
Collapse
Affiliation(s)
- C Orhan
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - B Seyhan
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - O Baykara
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - M Yildiz
- Department of Pediatric Rheumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - O Kasapcopur
- Department of Pediatric Rheumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - N Buyru
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| |
Collapse
|
26
|
Yildirim S, Yildiz M, Aliyeva A, Haslak F, Koker O, Adrovic A, Sahin S, Barut K, Kasapcopur O. FRI0455 IS THERE AN INCREASE IN THE FREQUENCY OF INFLAMMATORY DISEASES IN THE FAMILIES OF PATIENTS WITH FMF? Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Familial Mediterranean Fever (FMF) is the most common periodic fever syndrome in childhood with an autosomal recessive inheritance pattern and is characterized by unprovoked fever attacks, serositis episodes. The causative gene of the disease is MEFV that encodes pyrin protein. The pyrin protein takes a role in pathways related to inflammation, and mutations of it lead to increased inflammation. It is already shown that frequencies of some certain diseases like PAN, HSP increase in patients with FMF. Nevertheless, frequencies of inflammatory diseases in families of patient with FMF haven’t been investigated.Objectives:In this study, we have aimed to evaluate the comorbid disorders in a large cohort of families of patients with FMF.Methods:Four hundred and ninety-eight children with FMF, one hundred and forty patients with JIA and ninety-two healthy children were interviewed between December 2019 and January 2020. In JIA group and healthy control group, patients who have family history for FMF were excluded from the study. Patients were asked about characteristics of their disease attacks and if there is a relative with any inflammatory diseases who does not have FMF in patient’s 1stand 2th degree relatives.Results:Demographic features of study group have shown in Table 1. The most common MEFV mutations in patients with FMF were: M694V homozygotes (13.2 %), M694V heterozygotes (12 %), M694V homozygotes and R202Q homozygotes (6,8 %). Type II diabetes, asthma and hypothyroidism were the most commonly detected diseases in all cohorts. Frequency of Behçet’s disease, allergic rhinitis and type II diabetes were significantly higher in families of patients with FMF than other groups (p<0.05) (Table 2).Table 1.Demographic features of study population.FMF†JIA††Healthy Controln: 498 (%)mean +/- SDn: 140 (%)mean +/- SDn: 92 (%)mean +/- SDFemale284 (57)91 (65)55 (59.8)Age (years)12.9 ± 8.211.7 ± 5.17.4 ± 4.6Age at Onset (years)4.3 ± 3.35.4 ± 4.1-Age at Diagnosis (years)6.3 ± 3.66.3 ± 4.5-Delay in Diagnosis (months)23.8 ± 29.211.3 ± 28.2-Follow-up Duration (years)6.9 ± 8.35.3 ± 4.0-Consanguinity100 (20)25 (17.8)8 (8.6)Family History of FMF282 (56.6)0 (0)0 (0)JIA subgroup-- Oligoarticular72 (51.4) Polyarticular (RF negative)16 (11.4) Polyarticular (RF positive)3 (2.1) Enthesitis Related Arthritis14 (10) Psoriatic Arthritis7 (5) Systemic23 (16.4) Other5 (3.5)Clinical Findings-- Fever392 (78.1) Abdominal Pain429 (86.1) Chest Pain102 (20.5) Arthralgia334 (67.1) Arthritis157 (31.5) Extremity Pain64 (12.8) Heel Pain44 (8.8) Myalgia43 (8.6) *ELE13(2.6) Serositis10 (2)†Familial Mediterranean Fever††Juvenile Idiopathic Arthritis*Erysipelas like erythemaTable 2.Comparison of frequencies of diseases detected among families of patient groups (shortened).DiseasesFMFJIAHealthy Controlp1Type II Diabetes284 (57)64(45.7)44 (47.8)0.02Asthma139 (27.9)30 (21.4)20 (21.7)0.19Hypothyroidism122 (24.4)27 (19.2)14 (15.2)0.09Eczema68 (13.6)14 (10)5 (5.4)0.06Psoriasis49 (9.8)6 (4.2)7 (7.6)0.10Allergic Rhinitis49 (9.8)3 (2.1)1 (1)0.001Hyperthyroidism40 (8)9 (6.4)3 (3.2)0.24Behçet’s Disease31 (6.2)1 (1)2 (2.1)0.01Rheumatic Fever30 (6)10 (7.1)2 (2.1)0.25Conclusion:In this study, we have reported increased frequencies of Behçet’s disease, allergic rhinitis and type II diabetes in families of patients with FMF. Our results suggest that possible increased mutation load among families of patients with FMF may cause increased inflammatory diseases.References:[1]Yildiz M, Adrovic A, Tasdemir E, et al. Evaluation of co-existing diseases in children with familial Mediterranean fever.Rheumatol Int. 2020;40(1):57–64. doi:10.1007/s00296-019-04391-9Disclosure of Interests:None declared
Collapse
|
27
|
Ugurlu S, Egeli BH, Adrovic A, Barut K, Sahin S, Yildiz M, Kasapcopur O, Ozdogan H. AB1325-HPR THE TRANSITION FROM PEDIATRIC TO ADULT RHEUMATOLOGY OF 347 PATIENTS AT A SINGLE CENTER. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Pediatric to adult rheumatology transition can be a challenge for both the patient and the clinician, especially in rheumatology as it includes chronic diseases with close follow-up.Objectives:The objective of this study is to understand our tertiary rheumatology center patient demographic transitioning from pediatric to adult rheumatology in order to design prospective studies enhancing the evidence of transition recommendations.Methods:Patients included in this study are regularly followed-up in our adult rheumatology clinic and were regularly followed up in our pediatric rheumatology clinic in the past. They were all diagnosed with a rheumatologic condition receiving treatment. The patient files were assessed to have a better understanding of their demographic, disease and treatment information.Results:Our cohort includes 347 patients diagnosed with a variety of conditions that are Familial Mediterranean Fever (FMF) (n=216), Juvenile Idiopathic Arthritis (JIA) (n=56), Juvenile Spondyloarthritis (jSPA) (n=39), Systemic Lupus Erythematosus (SLE) (n=20), Behçet’s Disease (n=7) and the rest of the rheumatologic conditions with less than 5 patients each. The mean age of the patients during transition, mean age of diagnosis, and follow-up duration are 21.34±1.7, 10.4±4.18, and 10.82±4.4 in respective order. The treatment regimens the patients received are summarized in Table 1.Table 1.Current Treatment Information of the PatientsCurrent Treatment InformationDMARD26Colchicine23Adalimumab21Etanercept10NSAID4Tocilizumab3Cyclophosphamide3Rituximab2Prednisolone7Mycophenolate Mofetil1Canakinumab1Seven patients had FMF related attacks. In addition to attacks, one FMF patient had bilateral ankle pain and one patient had leg pain. One patient out of three diagnosed with Takayasu’s disease was still symptomatic. One patient had uveitis-related symptoms. One patient diagnosed with SLE had skin dryness. Furthermore, there were patients with sequelae formation. One patient diagnosed with oligoarticular JIA (oJIA) had bilateral hip sequela with the additional left hip prosthesis. One oJIA patient had micrognathia, and one had left knee sequela. One pJIA patient had small joint sequelae. One sJIA patient had bilateral hip sequelae. One jSPA patient had enthesopathy. One FMF patient had proteinuria due to amyloidosis formation. Another FMF patient had hip surgery due to sequela.Conclusion:Our center had patients with a variety of conditions with different natures of diseases. EULAR recommends the transition process to start no later than 14 years of age; however, this process started at the mean age of 21 in our patients. In most of these patients, especially the ones diagnosed with FMF, the control of disease activity was maintained. The transition of these different clinical entities might require certain amendments to the standard of care. For future references, we will be able to understand more about the adulthood prognosis of these clinical entities.Disclosure of Interests:None declared
Collapse
|
28
|
Karabacak M, Kaymaz Tahra S, Sahin S, Yildiz M, Adrovic A, Barut K, Direskeneli H, Kasapcopur O, Alibaz-Oner F. THU0308 COMPARISON OF CHILDHOOD-ONSET VERSUS ADULT-ONSET TAKAYASU ARTERITIS: A STUDY OF 141 PATIENTS FROM TURKEY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Childhood-onset Takayasu Arteritis (c-TAK) may differ from adult-onset Takayasu Arteritis (a-TAK) in clinical maaifestations and treatment.Objectives:To compare c-TAK with a-TAK patients for vascular involvement, disease activity, damage, and treatment.Methods:Patient charts from two tertiary-care centers of a pediatric and adult clinic were reviewed. Adult patients diagnosed before the age of 18 were included in the c-TAK group. The activity was assessed with the physician’s global assessment (PGA) and Indian Takayasu Clinical Activity Score (ITAS). The damage was evaluated with Takayasu Arteritis Damage Score (TADS) and Vasculitis Damage Index (VDI).Results:Twenty four c-TAK and 121 a-TAK patients were compared. 21 (88%) of the c-TAK group and 104 (89%) of the a-TAK group were female. Age at symptom onset was 14 (IQR: 9-15) for c-TAK and 30 (IQR: 24-43) for a-TAK patients. Diagnostic delay in months was shorter for c-TAK patients [c-TAK: 3 (1-10) vs. a-TAK: 12 (5-58)]. Follow-up duration was similar [53 months (IQR: 16-131) vs. 68 (IQR: 30-102), p=0.763].ITAS was comparable for c-TAK and a-TAK patients on the first visit [14 (SD: 7) vs. 13 (SD: 5), p=0.362, respectively]. However, the PGA score was higher in the c-TAK group compared to the a-TAK group [9 (IQR 7-10) vs. 7 (IQR 6-8), p<0.001].14 (64%) of c-TAK patients and 10 (9%) of a-TAK patients received pulse glucocorticoids, p= 0.002. Cumulative glucocorticoid dose was 10 grams (IQR: 6-13) for c-TAK patients and 7 grams (IQR: 4-12) for a-TAK patients (p=0.128).After diagnosis, children had more vascular interventions than the adults did [9 (38%) vs. 20 (18%), p=0.031, respectively].Rates of achieving at least one remission were lower for c-TAK patients [c-TAK: 12 (50 %) vs. a-TAK: 94 (82%), p=0.001]. c-TAK patients had a PGA score of 6 (IQR 3-8), the PGA score in a-TAK patients was 1 (IQR 1-3), p<0.001. Still, ITAS was similar for both groups [c-TAK: 1 (IQR 0-3) vs. a-TAK: 0 (IQR 0-2), p= 0.579]. 9 (38%) of c-TAK patients had at least one relapse, and the 43 (38%) of a-TAK patients had at least one relapse (p=0.960).TADS was similar [c-TAK: 8 (IQR 4-12), a-TAK: 8 (IQR 6-10), p=0.919]. However, VDI of the a-TAK patients was higher than the c-TAK patients [c-TAK: 4 (IQR 2-5), a-TAK: 5 (IQR 3-7), p=0.017]. Glucocorticoid related damage was higher in a-TAK patients (Diabetes: 8% vs. 4%, avascular necrosis: 6% vs. 0, and cataracts: 11% vs. 0)Conclusion:Aorta involvement, biologic agent use, and vascular interventions were more common in c-TAK patients. However, cumulative damage was not increased for c-TAK patients which may be partly explained by more common corticosteroid related side-effects in adults.Table 1.Baseline symptoms, physical examination findings*c-TAK (n= 24)a-TAK (n= 117)pSYMPTOMSStroke1 (4)8 (7)1Carotidynia019 (16)0.044Upper Extremity Claudication5 (21)72 (62)<0.001Hypertension13 (54)22 (19)<0.001Pulse loss (Radial)8/23 (35)62 (58)0.043BRUITSubclavian8 (35)62 (57)0.054Renal9 (39)15 (14)0.014Abdominal Aorta11 (48)9 (8)<0.001*Values denote the number (%) of patientsFigure 1.Comparison of involved arteries* * Numbers in bars represent percentage of patients in each groupFigure 2.Angiographic classification types according to Hata* * Numbers in bars represent percentage of patients in each group. Type 2a and Type 2b are combined. a-TAK group had no patient with Type 3 diseaseTable 2.Medical treatment*First TreatmentTreated Everc-TAK (n=22)a-TAK (n=115)pc-TAK(n=24)a-TAK (n=114)pMethotrexate5 (23)69 (60)0.00112 (50)76 (67)0.123Azathioprine8 (36)38 (33)0.76321 (88)79 (69)0.070Leflunomide01 (1)13 (13)35 (31)0.070Cyclophosphamide†6 (27)6 (5)0.00412 (50)10 (9)<0.001Biologics10 (42)16 (14)0.004Anti-TNF---4 (17)18 (16)-Tocilizumab---7 (29)4 (4)-*Values denote the number (%) of patients.Disclosure of Interests:None declared
Collapse
|
29
|
Yildiz M, Altun I, Yilmaz G, Aliyeva A, Haslak F, Koker O, Adrovic A, Sahin S, Barut K, Kasapcopur O. AB1011 LONG TERM FOLLOW-UP of THE PATIENTS WITH ANTI NUCLEAR ANTIBODY POSITIVITY WHO HAD INITIALLY NO IDENTIFIABLE RHEUMATIC DISEASES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Anti-nuclear antibodies (ANA) are a group of the antibodies that develop against intracellular components of the cells. It is usually useful for diagnosing some of the connective tissue diseases like systemic lupus erythematosus, mixed connective tissue disease. But it is reported that its positivity rate is about %20 in healthy individuals. Therefore, it can be confusing to check ANA test, if there is not really high suspicion for connective tissue diseases or juvenile idiopathic arthritis.Objectives:We aimed to evaluate results of long-term follow-up of the patients with ANA positivity who had initially no identifiable rheumatic diseases.Methods:Six hundred and ninety-four patients with ANA positivity who did not diagnosed as any of the rheumatic diseases at the first examination were found in database. Two hundred and eighty- two patients of them were called so far and questioned about their demographic features and symptoms that are related with rheumatic diseases.Results:Mean age of the patients at the time of study and at the time of testing were 13.4± 4.5 and 9.1±4.0 years. The female: male ratio was 1.05. Mean follow-up duration was 4.3±2.8 years. Most common reasons for the request for ANA test were arthralgia and skin eruptions. ANA testing was most commonly requested by a general pediatrists. Demographic features of the patients were summarized in Table 1.Table 1.Demographic features of the patients.n (%)Age (years)13.4± 4.5Female145 (51.4)Age at the time of testing (years)9.1±4.0Follow-up Duration (years)4.3±2.8Reason for testing Arthralgia99 (44.1)Skin Eruption54 (24.1)Check-Up20 (8.9)Arthritis13 (5.8)Gait abnormalities7 (3.1)Hair Loss6 (2.6)Fever5 (2.2)Uveitis2 (0.8)Recurrent abdominal pain2 (0.8)Who suggested testing?Pediatrician196 (87.5)Parents13 (5.8)Dermatologist7 (3.1)Ophthalmologist3 (1.3)Rheumatologist2 (0.8)Other3 (1.3)Positivity of acute phase reactants15 (5.3)History of infection before testing56 (24.3)History of drug-using before testing39 (17)Most of the diseases were diagnosed in patients with ANA positivity were not related with autoimmune mechanisms that associated with ANA positivity therefore, these diseases are thought to be coincidence. Only in 1 patients, systemic lupus erythematosus that has certain association with ANA positivity were diagnosed. All diseases that are diagnosed were shown in Table 2.Table 2.All diseases that are diagnosed in patients during the follow-up period.n (%)Hypermobility Syndrome29 (10.2)Urticaria7 (2.4)Hypothyroidism6 (2.1)Transient synovitis4 (1.4)Chronic ITP*4 (1.4)Scoliosis4 (1.4)Familial Mediterranean Fever3 (1)Cryopyrin associated periodic Syndrome2 (0.7)PFAPA syndrome**2 (0.7)Celiac Disease2 (0.7)Acute Rheumatic Fever2 (0.7)Fibromyalgia1 (0.3)Bone Tumor1 (0.3)Juvenile Idiopathic Arthritis1 (0.3)Henoch-Shöenlein Purpura1 (0.3)Myastenia Graves1 (0.3)Sever Disease1 (0.3)Vitiligo1 (0.3)Systemic Lupus Erythematosus1 (0.3)*Idiopathic Thrombocytopenic Purpura, **Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome.Conclusion:We are reporting that in only 0.3% of patients with ANA positivity who don’t have any diseases diagnosed initially, were diagnosed as rheumatologic diseases during to the follow-up period. Since positivity of ANA is also common in the healthy population, requesting this test in only patients with high suspicion for connective tissue disease will reduce confusion in terms of diagnosis.References:[1]Kasapcopur O, Ozbakir F, Arisoy N, Ingol H, Yazici H, Ozdogan H. Frequency of antinuclear antibodies and rheumatoid factor in healthy Turkish children. Turk J Pediatr 1999;41:67-71.Disclosure of Interests:None declared
Collapse
|
30
|
Guran T, Kara C, Yildiz M, Bitkin EC, Haklar G, Lin JC, Keskin M, Barnard L, Anik A, Catli G, Guven A, Kirel B, Tutunculer F, Onal H, Turan S, Akcay T, Atay Z, Yilmaz GC, Mamadova J, Akbarzade A, Sirikci O, Storbeck KH, Baris T, Chung BC, Bereket A. Revisiting Classical 3β-hydroxysteroid Dehydrogenase 2 Deficiency: Lessons from 31 Pediatric Cases. J Clin Endocrinol Metab 2020; 105:5707567. [PMID: 31950145 DOI: 10.1210/clinem/dgaa022] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 01/13/2020] [Indexed: 02/10/2023]
Abstract
CONTEXT The clinical effects of classical 3β-hydroxysteroid dehydrogenase 2 (3βHSD2) deficiency are insufficiently defined due to a limited number of published cases. OBJECTIVE To evaluate an integrated steroid metabolome and the short- and long-term clinical features of 3βHSD2 deficiency. DESIGN Multicenter, cross-sectional study. SETTING Nine tertiary pediatric endocrinology clinics across Turkey. PATIENTS Children with clinical diagnosis of 3βHSD2 deficiency. MAIN OUTCOME MEASURES Clinical manifestations, genotype-phenotype-metabolomic relations. A structured questionnaire was used to evaluate the data of patients with clinical 3βHSD2 deficiency. Genetic analysis of HSD3B2 was performed using Sanger sequencing. Novel HSD3B2 mutations were studied in vitro. Nineteen plasma adrenal steroids were measured using LC-MS/MS. RESULTS Eleven homozygous HSD3B2 mutations (6 novel) were identified in 31 children (19 male/12 female; mean age: 6.6 ± 5.1 yrs). The patients with homozygous pathogenic HSD3B2 missense variants of > 5% of wild type 3βHSD2 activity in vitro had a non-salt-losing clinical phenotype. Ambiguous genitalia was an invariable feature of all genetic males, whereas only 1 of 12 female patients presented with virilized genitalia. Premature pubarche was observed in 78% of patients. In adolescence, menstrual irregularities and polycystic ovaries in females and adrenal rest tumors and gonadal failure in males were observed. CONCLUSIONS Genetically-documented 3βHSD2 deficiency includes salt-losing and non-salt-losing clinical phenotypes. Spared mineralocorticoid function and unvirilized genitalia in females may lead to misdiagnosis and underestimation of the frequency of 3βHSD2 deficiency. High baseline 17OHPreg to cortisol ratio and low 11-oxyandrogen concentrations by LC-MS/MS unequivocally identifies patients with 3βHSD2 deficiency.
Collapse
Affiliation(s)
- Tulay Guran
- Department of Pediatric Endocrinology and Diabetes, School of Medicine, Marmara University, Istanbul, Turkey
| | - Cengiz Kara
- Department of Pediatric Endocrinology and Diabetes, Ondokuz Mayis University, Samsun, Turkey
| | - Melek Yildiz
- Department of Pediatric Endocrinology and Diabetes, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Eda C Bitkin
- Department of Pediatric Endocrinology and Diabetes, Ondokuz Mayis University, Samsun, Turkey
| | - Goncagul Haklar
- Department of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey
| | - Jen-Chieh Lin
- Institute of Molecular Biology, Academia Sinica, Taipei, Taiwan
| | - Mehmet Keskin
- Department of Pediatric Endocrinology and Diabetes, Gaziantep University, Gaziantep, Turkey
| | - Lise Barnard
- Department of Biochemistry, Stellenbosch University, Western Cape, South Africa
| | - Ahmet Anik
- Department of Pediatric Endocrinology and Diabetes, School of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Gonul Catli
- Department of Pediatric Endocrinology and Diabetes, School of Medicine, Katip Celebi University, Izmir, Turkey
| | - Ayla Guven
- Pediatric Endocrinology, Health Science University, Faculty of Medicine, Zeynep Kamil Women and Children Diseases Education and Research Hospital, Istanbul, Turkey
| | - Birgul Kirel
- Department of Pediatric Endocrinology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Filiz Tutunculer
- Department of Pediatrics, Division of Pediatric Endocrinology, Trakya University School of Medicine, Edirne, Turkey
| | - Hasan Onal
- Department of Pediatric Endocrinology and Diabetes, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Serap Turan
- Department of Pediatric Endocrinology and Diabetes, School of Medicine, Marmara University, Istanbul, Turkey
| | - Teoman Akcay
- Department of Pediatric Endocrinology and Diabetes, Istinye University Medical Park Gaziosmanpasa Hospital, Istanbul, Turkey
| | - Zeynep Atay
- Department of Pediatric Endocrinology and Diabetes, School of Medicine, Marmara University, Istanbul, Turkey
| | - Gulay C Yilmaz
- Department of Pediatric Endocrinology and Diabetes, Ondokuz Mayis University, Samsun, Turkey
| | - Jamala Mamadova
- Department of Pediatric Endocrinology and Diabetes, Ondokuz Mayis University, Samsun, Turkey
| | - Azad Akbarzade
- Department of Pediatric Endocrinology and Diabetes, School of Medicine, Marmara University, Istanbul, Turkey
| | - Onder Sirikci
- Department of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey
| | - Karl-Heinz Storbeck
- Department of Biochemistry, Stellenbosch University, Western Cape, South Africa
| | - Tugba Baris
- Gelisim Genetik Tani Merkezi, Istanbul, Turkey
| | - Bon-Chu Chung
- Institute of Molecular Biology, Academia Sinica, Taipei, Taiwan
| | - Abdullah Bereket
- Department of Pediatric Endocrinology and Diabetes, School of Medicine, Marmara University, Istanbul, Turkey
| |
Collapse
|
31
|
Ekingen E, Yilmaz M, Yildiz M, Atescelik M, Goktekin MC, Gurger M, Alatas OD, Basturk M, Ilhan N. Utilization of glial fibrillary acidic protein and galectin-3 in the diagnosis of cerebral infarction patients with normal cranial tomography. Niger J Clin Pract 2019; 20:433-437. [PMID: 28406123 DOI: 10.4103/1119-3077.187311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE It was aimed to determine whether levels of glial fibrillary acidic protein (GFAP) and Galectin-3 contribute to the diagnosis of cerebral infarction in clinically suspected ischemic stroke patients with normal computerized cranial tomography (CCT) in the emergency department. MATERIALS AND METHODS In this study, patients above the age of 18 years who presented to emergency department of Firat University between December 2011-November 2012 and were diagnosed with cerebral infarction were included. Exclusion criteria were as follows: symptom onset exceeding 24 hours, trauma, pregnancy, acute myocardial infarction, acute pulmonary embolism, chronic renal insufficiency and steroid therapy. RESULTS A total of 90 participants, forty patients with ischemic infarction who were diagnosed by CCT and clinical findings (Normal CCT in 17 patients and CCT with an area of infarction in 23 patients) and fifty healthy controls, were included in this study. Compared with the control group, levels of Galectin-3 and GFAP were found to be significantly increased in patients with ischemic infarction (P <0.001 and P = 0.01, respectively). It was found that levels of Galectin-3 and GFAP were significantly increased in ischemic stroke patients with normal CCT compared to the control group (P = 0.04 and P = 0.025, respectively). In ROC curve analysis, we detected %70.59 sensitivity and 70% specificity (AUC = 0.684, P = 0.0213, 95% CI: 0,558-0.792) with a cutoff value of 33.24 ng/ml for GFAP and 76.47% sensitivity and 68% specificity (AUC = 0.734, P = 0.0048, 95% CI: 0.611-0.834) with a cutoff value of 0.84 ng/ml for Galectin-3. No correlation was found between National Institutes of Health Stroke Scale (NIHSS) scores and Galectin-3 and GFAP (r = 0.251, P = 0.118 and r = 0.164, P = 0.311, respectively). CONCLUSION The levels of Galectin-3 and GFAP were increased in acute ischemic stroke patients.
Collapse
Affiliation(s)
- E Ekingen
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M Yilmaz
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M Yildiz
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M Atescelik
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M C Goktekin
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M Gurger
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - O D Alatas
- Department of Emergency Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - M Basturk
- Department of Emergency Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - N Ilhan
- Department of Biochemistry, School of Medicine, Firat University, Elazig, Turkey
| |
Collapse
|
32
|
Ünsal C, Ünsal H, Ekici M, Koç Yildirim E, Üner AG, Yildiz M, Güleş Ö, Ekren Aşici GS, Boyacioğlu M, Balkaya M, Belge F. The effects of exhaustive swimming and probiotic administration in trained rats: Oxidative balance of selected organs, colon morphology, and contractility. Physiol Int 2018; 105:309-324. [PMID: 30565473 DOI: 10.1556/2060.105.2018.4.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The duration and intensity of exercise are significant factors in oxidative, morphological, and functional changes of the gastrointestinal tract. This study aimed to investigate the effects of both exhaustive swimming and probiotic VSL#3 on rats that had been previously trained with moderate swimming. The rats were divided into four groups labeled: control (C), probiotic (P), exercise (E), and probiotic-exercise (PE). Groups P and PE were fed with probiotic mixture VSL#3. Groups E and PE had a 5-week moderate swimming program (1 h/day for 5 days/week), followed by a 1-week exhaustive swimming program (trained like in moderate program but 3 times with 150 min resting sessions, for 5 days/week). At the end of the program, the rats were euthanized. Malondialdehyde, superoxide dismutase, catalase, and reduced glutathione levels were measured in tissue samples from the gastrocnemius muscle, heart, liver, kidney, and colon. In vitro contractile activity and histomorphology of the colon were also determined. Exercise and/or probiotic decreased the oxidative stress and also increased the level of one or more of the antioxidant enzymes in some of the organs. Probiotics had more pronounced effects on colon morphology than exercise but unexpectedly this effect was non-trophic. In the colon, the thickness of the tunica muscularis and the number of goblet cells were not affected; however, probiotic administration decreased the crypt depth and tunica mucosa thickness. Exercise increased the Emax value of acetylcholine (ACh), while decreased its sensitivity. These findings suggest that exhaustive swimming does not cause oxidative stress and that probiotic consumption improves oxidative balance in trained rats. The probiotic intake does not alter the effect of exercise on the contractile activity of the colon. Colon mucosal changes induced by probiotics are independent of exercise.
Collapse
Affiliation(s)
- C Ünsal
- 1 Department of Physiology, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| | - H Ünsal
- 1 Department of Physiology, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| | - M Ekici
- 1 Department of Physiology, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| | - E Koç Yildirim
- 1 Department of Physiology, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| | - A G Üner
- 1 Department of Physiology, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| | - M Yildiz
- 2 Department of Occupational Health and Safety, Çan School of Applied Sciences, Çanakkale Onsekiz Mart University , Çanakkale, Turkey
| | - Ö Güleş
- 3 Department of Histology and Embryology, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| | - G S Ekren Aşici
- 4 Department of Biochemistry, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| | - M Boyacioğlu
- 5 Department of Pharmacology, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| | - M Balkaya
- 1 Department of Physiology, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| | - F Belge
- 1 Department of Physiology, Faculty of Veterinary Medicine, Adnan Menderes University , Aydin, Turkey
| |
Collapse
|
33
|
Peters S, Sinecen M, Kizilkaya K, Yildiz M, Garrick D, Thomas M. PSXIV-37 Accuracies of genomic breeding values for growth and carcass traits in Brangus beef cattle using K-means clustering for cross-validation. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Peters
- Berry College,Mount Berry, GA, United States
| | - M Sinecen
- Adnan Menderes University,Aydin, Turkey
| | | | - M Yildiz
- Adnan Menderes University,Aydin, Turkey
| | - D Garrick
- Massey University,Palmeston North, Auckland, New Zealand
| | - M Thomas
- Department of Animal Sciences, Colorado State University,Fort Collins, CO, United States
| |
Collapse
|
34
|
Peters S, Sinecen M, Kizilkaya K, Yildiz M, Garrick D, Thomas M. PSXIV-36 Robust Bayesian inference based on birth, weaning and yearling weight data in Brangus beef cattle using normal/independent distributions. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Peters
- Berry College,Mount Berry, GA, United States
| | - M Sinecen
- Adnan Menderes University,Aydin, Turkey
| | | | - M Yildiz
- Adnan Menderes University,Aydin, Turkey
| | - D Garrick
- Massey University,Palmerston North, Auckland, New Zealand
| | - M Thomas
- Department of Animal Sciences, Colorado State University,Fort Collins, CO, United States
| |
Collapse
|
35
|
Weger M, Weger BD, Görling B, Poschet G, Yildiz M, Hell R, Luy B, Akcay T, Güran T, Dickmeis T, Müller F, Krone N. Glucocorticoid deficiency causes transcriptional and post-transcriptional reprogramming of glutamine metabolism. EBioMedicine 2018; 36:376-389. [PMID: 30266295 PMCID: PMC6197330 DOI: 10.1016/j.ebiom.2018.09.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/07/2018] [Accepted: 09/13/2018] [Indexed: 01/12/2023] Open
Abstract
Background Deficient glucocorticoid biosynthesis leading to adrenal insufficiency is life-threatening and is associated with significant co-morbidities. The affected pathways underlying the pathophysiology of co-morbidities due to glucocorticoid deficiency remain poorly understood and require further investigation. Methods To explore the pathophysiological processes related to glucocorticoid deficiency, we have performed global transcriptional, post-transcriptional and metabolic profiling of a cortisol-deficient zebrafish mutant with a disrupted ferredoxin (fdx1b) system. Findings fdx1b−/− mutants show pervasive reprogramming of metabolism, in particular of glutamine-dependent pathways such as glutathione metabolism, and exhibit changes of oxidative stress markers. The glucocorticoid-dependent post-transcriptional regulation of key enzymes involved in de novo purine synthesis was also affected in this mutant. Moreover, fdx1b−/− mutants exhibit crucial features of primary adrenal insufficiency, and mirror metabolic changes detected in primary adrenal insufficiency patients. Interpretation Our study provides a detailed map of metabolic changes induced by glucocorticoid deficiency as a consequence of a disrupted ferredoxin system in an animal model of adrenal insufficiency. This improved pathophysiological understanding of global glucocorticoid deficiency informs on more targeted translational studies in humans suffering from conditions associated with glucocorticoid deficiency. Fund Marie Curie Intra-European Fellowships for Career Development, HGF-programme BIFTM, Deutsche Forschungsgemeinschaft, BBSRC.
Collapse
Affiliation(s)
- Meltem Weger
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.
| | - Benjamin D Weger
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Benjamin Görling
- Institute for Organic Chemistry and Institute for Biological Interfaces 4 - Magnetic Resonance, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Gernot Poschet
- Centre for Organismal Studies (COS), Heidelberg University, 69120 Heidelberg, Germany
| | - Melek Yildiz
- Kanuni Sultan Süleyman Education and Research Hospital, Küçükçekmece, Istanbul, Turkey
| | - Rüdiger Hell
- Centre for Organismal Studies (COS), Heidelberg University, 69120 Heidelberg, Germany
| | - Burkhard Luy
- Institute for Organic Chemistry and Institute for Biological Interfaces 4 - Magnetic Resonance, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Teoman Akcay
- Istinye University Gaziosmanpasa Medical Park Hospital Gaziosmanpasa, Istanbul, Turkey
| | - Tülay Güran
- Marmara University, Department of Pediatric Endocrinology and Diabetes, Pendik, Istanbul, Turkey
| | - Thomas Dickmeis
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Ferenc Müller
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Nils Krone
- Department of Oncology & Metabolism, University of Sheffield, Sheffield S10 2TH, UK; Department of Biomedical Science, The Bateson Centre, Firth Court, Western Bank, Sheffield S10 2TN, UK..
| |
Collapse
|
36
|
Affiliation(s)
- O Gules
- Department of Histology and Embryology, Faculty of Veterinary Medicine, Adnan Menderes University, Aydin, Turkey
| | - M Yildiz
- Department of Occupational Health and Safety, Çan School of Applied Sciences, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Z Naseer
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Medicine, Adnan Menderes University, Aydin, Turkey
| | - M Tatar
- Department of Veterinary, Burdur Food Agriculture and Livestock Vocational School, Mehmet Akif Ersoy University, Burdur, Turkey
| |
Collapse
|
37
|
Yildiz M, Akcay T, Aydin B, Akgun A, Dogan BB, De Franco E, Ellard S, Onal H. Emergence of insulin resistance following empirical glibenclamide therapy: a case report of neonatal diabetes with a recessive INS gene mutation. J Pediatr Endocrinol Metab 2018; 31:345-348. [PMID: 29305569 DOI: 10.1515/jpem-2017-0325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/16/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND As KATP channel mutations are the most common cause of neonatal diabetes mellitus (NDM) and patients with these mutations can be treated with oral sulfonylureas, empiric therapy is a common practice for NDM patients. CASE PRESENTATION A non-syndromic, small for gestational age baby born to first-degree consanguineous parents was diagnosed with NDM. Because of hypo- and hyperglycemic episodes and variability in insulin requirement, we initiated a trial of glibenclamide, with a presumptive diagnosis of NDM caused by a KATP channel mutation. However, this empiric sulfonylurea trial did not improve the patient's glycemic control and resulted in resistance to exogenous insulin. Genetic testing identified a previously reported homozygous INS promoter mutation (c.-331C>G), which was not responsive to sulfonylurea therapy. CONCLUSIONS In light of our results, we recommend to confirm the genetic diagnosis as soon as possible and decide on sulfonylurea treatment after a genetic diagnosis is confirmed.
Collapse
Affiliation(s)
- Melek Yildiz
- Istanbul Saglık Bilimleri Universitesi Kanuni Sultan Suleyman Egitim ve Arastırma Hastanesi, Cocuk Endokrinoloji Bolumu, 34303, Küçükçekmece, Istanbul, Turkey
| | - Teoman Akcay
- Department of Pediatric Endocrinology and Metabolism, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Banu Aydin
- Department of Pediatric Endocrinology and Metabolism, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Abdurrahman Akgun
- Department of Pediatric Endocrinology and Metabolism, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Beyza Belde Dogan
- Department of Pediatric Endocrinology and Metabolism, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Elisa De Franco
- Molecular Genetics University of Exeter Medical School, Exeter, Devon, UK
| | - Sian Ellard
- Molecular Genetics University of Exeter Medical School, Exeter, Devon, UK
| | - Hasan Onal
- Department of Pediatric Endocrinology and Metabolism, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
38
|
Askin H, Yilmaz B, Gulcin I, Taslimi P, Bakirci S, Yildiz M, Kandemir N. Antioxidant Activity of the Aqueous Extract of Iris taochia and Identification of its Chemical Constituents. Indian J Pharm Sci 2018. [DOI: 10.4172/pharmaceutical-sciences.1000425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
39
|
Demir K, Yildiz M, Bahat H, Goldman M, Hassan N, Tzur S, Ofir A, Magen D. Clinical Heterogeneity and Phenotypic Expansion of NaPi-IIa-Associated Disease. J Clin Endocrinol Metab 2017; 102:4604-4614. [PMID: 29029121 DOI: 10.1210/jc.2017-01592] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 09/22/2017] [Indexed: 12/21/2022]
Abstract
CONTEXT NaPi-IIa, encoded by SLC34A1, is a key phosphate transporter in the mammalian proximal tubule and plays a cardinal role in renal phosphate handling. NaPi-IIa impairment has been linked to various overlapping clinical syndromes, including hypophosphatemic nephrolithiasis with osteoporosis, renal Fanconi syndrome with chronic kidney disease, and, most recently, idiopathic infantile hypercalcemia and nephrocalcinosis. OBJECTIVES We studied the molecular basis of idiopathic infantile hypercalcemia with partial proximal tubulopathy in two apparently unrelated patients of Israeli and Turkish descent. DESIGN Genetic analysis in two affected children and their close relatives was performed using whole-exome sequencing, followed by in vitro localization and trafficking analysis of mutant NaPi-IIa. RESULTS Mutation and haplotype analyses in both patients revealed a previously described homozygous loss-of-function inserted duplication (p.I154_V160dup) in NaPi-IIa, which is inherited identical-by-descent from a common ancestor. The shared mutation was originally reported by our team in two adult siblings with renal Fanconi syndrome, hypophosphatemic bone disease, and progressive renal failure who are family members of one of the infants reported herein. In vitro localization assays and biochemical analysis of p.I154_V160dup and of additional NaPi-IIa mutants harboring a trafficking defect indicate aberrant retention at the endoplasmic reticulum in an immature and underglycosylated state, leading to premature proteasomal degradation. CONCLUSIONS Our findings expand the phenotypic spectrum of NaPi-IIa disruption, reinforce its link with proximal tubular impairment, enable longitudinal study of the natural history of the disease, and shed light on cellular pathways associated with loss of function and impaired trafficking of NaPi-IIa mutants.
Collapse
Affiliation(s)
- Korcan Demir
- Division of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylül University, Turkey
| | - Melek Yildiz
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children's Hospital, Turkey
| | - Hilla Bahat
- Department of Pediatrics, Assaf Harofeh Medical Center, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Michael Goldman
- Department of Pediatrics, Assaf Harofeh Medical Center, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Nisreen Hassan
- Laboratory of Molecular Medicine, Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Israel
| | - Shay Tzur
- Laboratory of Molecular Medicine, Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Israel
- Genomic Research Department, Emedgene Technologies, Israel
| | - Ayala Ofir
- Laboratory of Molecular Medicine, Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Israel
| | - Daniella Magen
- Laboratory of Molecular Medicine, Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Israel
- Pediatric Nephrology Institute, Ruth Children's Hospital, Rambam Health Care Campus, Israel
| |
Collapse
|
40
|
Sagsoz O, Karatas O, Turel V, Yildiz M, Kaya E. Effectiveness of Jigsaw learning compared to lecture-based learning in dental education. Eur J Dent Educ 2017; 21:28-32. [PMID: 26547392 DOI: 10.1111/eje.12174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 06/05/2023]
Abstract
AIM The objective of this study was to evaluate the success levels of students using the Jigsaw learning method in dental education. METHOD Fifty students with similar grade point average (GPA) scores were selected and randomly assigned into one of two groups (n = 25). A pretest concerning 'adhesion and bonding agents in dentistry' was administered to all students before classes. The Jigsaw learning method was applied to the experimental group for 3 weeks. At the same time, the control group was taking classes using the lecture-based learning method. At the end of the 3 weeks, all students were retested (post-test) on the subject. A retention test was administered 3 weeks after the post-test. Mean scores were calculated for each test for the experimental and control groups, and the data obtained were analysed using the independent samples t-test. RESULTS No significant difference was determined between the Jigsaw and lecture-based methods at pretest or post-test. The highest mean test score was observed in the post-test with the Jigsaw method. In the retention test, success with the Jigsaw method was significantly higher than that with the lecture-based method. CONCLUSION The Jigsaw method is as effective as the lecture-based method.
Collapse
Affiliation(s)
- O Sagsoz
- Restorative Dentistry, Ataturk University, Erzurum, Turkey
| | - O Karatas
- Restorative Dentistry, Ataturk University, Erzurum, Turkey
| | - V Turel
- Restorative Dentistry, Ataturk University, Erzurum, Turkey
| | - M Yildiz
- Restorative Dentistry, Ataturk University, Erzurum, Turkey
| | - E Kaya
- Biology, Education Faculty, Ataturk University, Erzurum, Turkey
| |
Collapse
|
41
|
Colmenares M, Simon U, Yildiz M, Arndt S, Schomaecker R, Thomas A, Rosowski F, Gurlo A, Goerke O. Oxidative coupling of methane on the Na2WO4-MnxOy catalyst: COK-12 as an inexpensive alternative to SBA-15. CATAL COMMUN 2016. [DOI: 10.1016/j.catcom.2016.06.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
42
|
Erdim I, Akcay T, Yildiz M. Misunderstood about Obesity, Sleep Apnea and Metabolic Syndrome in Adolescents. J Clin Sleep Med 2016; 12:935. [PMID: 27092705 DOI: 10.5664/jcsm.5914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 03/07/2016] [Indexed: 11/13/2022]
Affiliation(s)
- Ibrahim Erdim
- Otorhinolaryngologist, Erbaa Government Hospital, Erbaa, Tokat, Turkey
| | - Teoman Akcay
- Pediatric Endocrinologist, Kanuni Sultan Suleyman Education and Research Hospital, Kucukcekmece, Istanbul, Turkey
| | - Melek Yildiz
- Pediatric Endocrinologist, Kanuni Sultan Suleyman Education and Research Hospital, Kucukcekmece, Istanbul, Turkey
| |
Collapse
|
43
|
Eren U, Kum S, Nazligul A, Gules O, Aka E, Zorlu S, Yildiz M. The several elements of intestinal innate immune system at the beginning of the life of broiler chicks. Microsc Res Tech 2016; 79:604-14. [PMID: 27115541 DOI: 10.1002/jemt.22674] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 03/16/2016] [Accepted: 04/07/2016] [Indexed: 12/27/2022]
Abstract
Functional capacity of digestive system and intestinal adaptive immunity are immature at hatching of broiler chicks. Therefore, intestinal innate immunity after hatching is vital to young chicks. The purpose of this study was to investigate expression and tissue distributions of several elements of the innate immune system (i.e., TLR2, TLR4, CD83, and MHC class II expressing cells) in the intestine of one-day-old chicks. For this purpose, ileum and cecum were examined the under different conditions, which included the control and 1, 3, 6, 12, or 24 h after injection of lipopolysaccharide (LPS) and phosphate buffered saline. The findings indicated that regardless of the antigenic stimulation, Toll-like receptor (TLR) 2 and TLR4 expressing cells were present in the intestinal tissues of one-day-old chicks. We noticed that the intestinal segments have different TLR expression levels after LPS stimulation. Dendritic cells were identified, and they left the intestinal tissue after LPS treatment. MHC class II molecules were diffusely present in both the ileum and cecum. This study demonstrates that the intestinal tissue of one-day-old chicks has remarkable defensive material, including histological properties and several elements of the innate immune system. Microsc. Res. Tech. 79:604-614, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- U Eren
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Adnan Menderes, Aydin, Turkey
| | - S Kum
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Adnan Menderes, Aydin, Turkey
| | - A Nazligul
- Department of Animal Sciences, Faculty of Veterinary Medicine, University of Adnan Menderes, Aydin, Turkey
| | - O Gules
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Adnan Menderes, Aydin, Turkey
| | - E Aka
- Department of Histology and Embryology, Enstitute of Health Sciences, University of Adnan Menderes, Aydin, Turkey
| | - S Zorlu
- Department of Histology and Embryology, Enstitute of Health Sciences, University of Adnan Menderes, Aydin, Turkey
| | - M Yildiz
- Gynecology-Obstetrics and Pediatrics Hospital, Aydin, Turkey
| |
Collapse
|
44
|
Kocakaya H, Celikbas Z, Yildiz M, Songur E, Batmaz S. Ziprasidone Associated Sexual Hyperarousal: a Case Report. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30728-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
45
|
|
46
|
Karakaya M, Çiçek A, Ucun F, Yildiz M. Investigations on stabilities and intermolecular interactions of different naphthalene derivatives dimers by using B3LYP and M06-2X density functional calculations. Russ J Phys Chem 2014. [DOI: 10.1134/s0036024414120127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
47
|
Bozcuk H, Yildiz M, Uçar S, Mutlu H, Coşkun H. The Correlates of Dose Reduction in Chemotherapy for Patients with Common Cancers. a Prospective Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
48
|
Yildiz M, Simon U, Otremba T, Aksu Y, Kailasam K, Thomas A, Schomäcker R, Arndt S. Support material variation for the MnxOy-Na2WO4/SiO2 catalyst. Catal Today 2014. [DOI: 10.1016/j.cattod.2013.12.024] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
49
|
Yildiz M, Aksu Y, Simon U, Kailasam K, Goerke O, Rosowski F, Schomäcker R, Thomas A, Arndt S. Enhanced catalytic performance of MnxOy–Na2WO4/SiO2 for the oxidative coupling of methane using an ordered mesoporous silica support. Chem Commun (Camb) 2014; 50:14440-2. [PMID: 25302934 DOI: 10.1039/c4cc06561a] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The oxidative coupling of methane is a highly promising reaction for its direct conversion.
Collapse
Affiliation(s)
- M. Yildiz
- Technische Universität Berlin
- Institut für Chemie
- 10623 Berlin, Germany
- Gebze Institute of Technology
- Department of Chemistry
| | - Y. Aksu
- Akdeniz University
- Faculty of Engineering
- Department of Material Science and Engineering
- 07058 Antalya, Turkey
| | - U. Simon
- Technische Universität Berlin
- Institut für Werkstoffwissenschaften und -technologien
- Fachgebiet Keramische Werkstoffe
- 10623 Berlin, Germany
| | - K. Kailasam
- Technische Universität Berlin
- Department of Chemistry
- Functional Materials
- 10623 Berlin, Germany
| | - O. Goerke
- Technische Universität Berlin
- Institut für Werkstoffwissenschaften und -technologien
- Fachgebiet Keramische Werkstoffe
- 10623 Berlin, Germany
| | - F. Rosowski
- UniCat BASF JointLab
- Fakultät II
- 10587 Berlin, Germany
| | - R. Schomäcker
- Technische Universität Berlin
- Institut für Chemie
- 10623 Berlin, Germany
| | - A. Thomas
- Technische Universität Berlin
- Department of Chemistry
- Functional Materials
- 10623 Berlin, Germany
| | - S. Arndt
- Technische Universität Berlin
- Institut für Chemie
- 10623 Berlin, Germany
- PCK Raffinerie GmbH
- 16303 Schwedt/Oder, Germany
| |
Collapse
|
50
|
Kalcik M, Gursoy M, Astarcioglu M, Gokdeniz T, Karakoyun S, Cakal B, Yesin M, Kahveci G, Yildiz M, Ozkan M, Cresti A, Cesareo F, Guerrini F, Capati E, Miracapillo G, Severi S, Ternacle J, Lellouche N, Gallet R, Deux JF, Dubois-Rande JL, Teiger E, Lim P, Polizzi V, Pino P, Luzi G, Fiorilli R, Buffa V, Visconti C, Bellavia D, Violini R, Musumeci F, Saura Espin D, Oliva Sandoval M, Gonzalez Carrillo J, Caballero Jimenez L, Espinosa Garcia M, Garcia Navarro M, Lopez Ruiz M, Valdes Chavarri M, De La Morena Valenzuela G. Oral Abstract session * Imaging in structural interventions: 13/12/2013, 08:30-10:00 * Location: Bursa. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|