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Beclin-1, an autophagy-related protein, is associated with the disease severity of COVID-19
(Pergamon-Elsevier Science Ltd, 2021) Okuyan, Hamza Malik; Dogan, Serdar; Bal, Tayibe; Cabalak, Mehmet
Aims: Coronavirus disease 2019 (COVID-19), which is a highly contagious disease, is an ongoing outbreak worldwide with high morbidity and mortality. The approaches targeting the autophagy processes might have promising diagnostic and therapeutic values against Coronavirus infection. Here, we aimed to investigate the relationship of Beclin-1 (BECN1), an autophagy-related protein, with blood parameters and the clinical severity in patients with COVID-19. Materials and methods: We enrolled 108 patients with COVID-19 and 21 healthy controls in this study, from September 2020 to January 2021 and divided all patients into two groups according to the severity of the disease: The non-severe group and the severe group. BECN1 levels and blood parameters were measured with Enzyme-Linked Absorbent Assay and routine techniques, respectively. Key findings: Serum BECN1 levels were increased in patients with COVID-19 compared to the healthy controls, and its concentrations were significantly higher in the severe group than in the non-severe group (p < 0.001). BECN1 levels showed a significantly positive correlation with coagulation markers such as D-dimer and Fibrinogen (FIB) and inflammation markers such as C-reactive protein (CRP), Procalcitonin (PCT), Ferritin and biochemical markers such as Blood urea nitrogen and Lactate dehydrogenase (p < 0.001). We detected that areas under the ROC curve for BECN1, D-dimer, FIB, PCT, CRP and Ferritin were 0.8662, 0.9110, 0.8278, 0.9996 and 0.9284, respectively (p < 0.0001). Significance: BECN1 may serve as a predictive biomarker in evaluating the disease severity of COVID-19. Our data suggest that BECN1 mediated-autophagy modulation might have a promising value in improving the clinical outcomes of COVID-19.
Comparison of Immunological and Virological Recovery with Rapid, Early, and Late Start of Antiretroviral Treatment in Naive Plwh Real-World Data
(Dove Medical Press Ltd, 2023) Yildirim, Figen Sarigul; Candevir, Aslihan; Akhan, Sila; Kaya, Selcuk; Cabalak, Mehmet; Ersoz, Gulden; Inan, Dilara
Background: Rapid initiation of antiretroviral therapy (ART) reduces the transmission of HIV infection in the community. This study aimed to determine whether rapid ART initiation is effective compared to standard ART treatment in our country. Methods: Patients were grouped based on time to treatment initiation. HIV RNA levels, CD+4 T cell count, CD4/CD8 ratio, and ART regimens were recorded at baseline and follow-up visits for 12 months. Results: There were 368-ART naive adults (treatment initiated at the time of HIV diagnosis; 143 on the first day, 48 on the secondseventh day, and 177 after the seventh day). Although virological suppression rates at 12th months were higher in all groups, over 90% on average, there were no statistically significant differences in HIV-1 RNA suppression rates, CD+4 T cell count, and CD4/CD8 ratio normalization in the studied months but in multivariate logistic regression analysis; showed a significant correlation between both virological and immunological response and those with CD4+ T <350 cells/mL at 12th month in total patients. Conclusion: Our findings support the broader application of recommendations for rapid ART initiation in HIV patients.
Direct-acting antiviral therapy may help restore HCV-induced impaired redox balance and liver fibrosis process
(Walter De Gruyter Gmbh, 2023) Bal, Tayibe; Dogan, Serdar; Ozcan, Oguzhan; Cabalak, Mehmet; Cirkin, Berfin
Objectives: The aim of this study was to investigate the changes in thiol/disulfide balance, pro-fibrotic mediators (transforming growth factor-beta [TGF-beta] and periostin) and a potential biomarker for the prediction of HCV-induced HCC (3 beta-hydroxysterol Delta 24-reductase [DHCR24]) during direct-acting antiviral (DAA) therapy in chronic hepatitis C (CHC) patients. Methods: This prospective cohort study included 56 non-cirrhotic, treatment-naive CHC patients who were treated with DAAs between January and June 2020. Laboratory tests, including serum total/native thiol, TGF-beta, periostin, DHCR24, total bilirubin and albumin levels were measured and disulfide levels were calculated at baseline, then at 1 month and at the end of therapy (EOT). Results: Of the 56 patients, all achieved a sustained virological response after DAA therapy. There was a significant decrease in serum levels of disulfide and TGF-beta, (p=0.020 and p<0.001, respectively) and a significant increase in serum levels of native thiol compared with baseline levels (p=0.010). There was no significant change in levels of total thiol, DHCR24 and periostin levels. Serum TGF-beta levels were found to be positively correlated with total bilirubin levels (r(s)=0.470, p=0.001) and negatively with albumin levels (r(s)=-0.483, p<0.001). Asignificant moderate positive correlation was determined between baseline serum DHRC24 and disulfide levels (r(s)=0.356, p=0.007). Conclusions: The study results suggest that the DAA therapy may help to restore the impaired thiol/disulfide balance and reduce the pro-fibrotic process in CHC patients by markedly decreasing serum levels of TGF-beta, a key player in HCV-induced liver fibrosis.
The Effects of Antivirals for Human Immunodeficiency Virus Treatment on Renal Functions
(Galenos Publ House, 2022) Cabalak, Mehmet; Bal, Tayibe; Turgut, Faruk Hilmi
Objective: Turkey is among the countries with a low incidence of the human immunodeficiency virus (HIV) infections. When HIV cases are decreasing worldwide, our country is among the countries where the number of patients is rapidly increasing. Tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF), and abacavir are the drugs used for HIV treatment in Turkey. The estimated glomerular filtration rate (eGFR) is widely used as a kidney function indicator. This study aimed to investigate the effects of TDF and TAF-based regimens on renal function. Materials and Methods: During the study period, 104 patients who are HIV-positive underwent treatment with an antiretroviral therapy (ART) regimen, of whom 60 fulfilled the inclusion criteria and were included in the study. This study retrospectively examined the effects of TAF and TDF-based regimens on eGFR and other routine parameters. Results: Patients receiving TDF-based regimens revealed significantly increased serum creatinine and decreased eGFR levels compared to pretreatment levels. Conversely, patients receiving a TAF-based regimen did not show significant changes in eGFR or serum creatinine levels. Conclusion: Our data indicate that eGFR levels decrease with a TDF-based regimen. Thus, with TDF as a component of the ART regimen, eGFR levels should be carefully monitored. TDF-free regimens should be used in patients who are predicted to have impaired renal function and those with renal function changes during treatment.
Efficacy and Safety of Direct-Acting Antivirals in Elderly Patients with Chronic Hepatitis C: A Nationwide Real-Life, Observational, Multicenter Study from Turkey
(Aves, 2022) Onlen, Yusuf; Bal, Tayibe; Cabalak, Mehmet; Oztoprak, Nefise Cuvalci; Sari, Nagehan Didem; Kurtaran, Behice; Senates, Ebubekir
Background: The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C. Methods: In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (>= 65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups. Results: The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P =.879, P =.508 for modified evaluable population and P =.058, P =.788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir + ribavirin had a significantly lower sustained virological response 12 rates (P <.001, P =.047, P =.013, and P =.025, respectively). Conclusion: Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.
Efficiency and safety of direct acting antivirals in chronic hepatitis C patients infected with genotype 2 and 3 in Turkey
(Elsevier, 2019) Kurtaran, Behice; Sarigul, Figen; Cabalak, Mehmet; Kaya, Sibel; Sari, Nagehan Didem; Karsen, Hasan; Zerdali, Esra
[Abstract Not Available]
Electrocardiographic findings and cardiac safety of hydroxychloroquine+azithromycin in hospitalized patients with COVID-19
(Cukurova Univ, Fac Medicine, 2021) Akkus, Oguz; Bal, Tayibe; Yagoobi, Hasibullah; Bekler, Ozkan; Akkus, Gamze; Cabalak, Mehmet
Purpose: The aim of this study was to determine the novel arrhythmia markers (Tpe, cTpe, cTpe/cQT) in addition to standard evaluation of 12-derived electrocardiography (ECG) and effects of therapy in patients with COVID-19. Materials and Methods: We evaluated 12-derived ECG in 51 patients with COVID-19 at the pre-treatment stage and on the 2nd and 5th days of the treatment, retrospectively. Patients were treated by either hydroxychloroquine (HCQ) + azithromycin or HCQ alone. Severe COVID-19 patients were defined with the presence of clinical signs and symptoms of pneumonia plus SpO2<90%, or respiratory rate > 30 breathe/minute. Results: While 68.6% of patients received HCQ + azithromycin combination therapy, 31.4% of patients received HCQ monotherapy. On the 2nd day of the treatment, heart rate was the only statistically significant variable either on the treatment of HCQ + azithromycin or HCQ alone. On the 5th day of treatment, in addition to the heart rate, Tpe and cTpe levels were also statistically significant among the whole treatment regimens. Although Tpe statistically significantly increased in both treatment strategies during treatment, increasing relative Tpe ratios were similar between both of the treatment strategies. Conclusion: The results of our study suggests that those off-label drugs (HCQ/azithromycin) have an acceptable cardiac safety profile in COVID-19 disease during short hospitalization.
Examination of the Reasons for Change in Treatment in Patients Infected with Human Immunodeficiency Virus
(Galenos Publ House, 2023) Cabalak, Mehmet; Bal, Tayibe; Polat, Eda Selin; Ocak, Sabahattin; Onlen, Yusuf
Introduction: Highly active antiretroviral therapy (HAART) has significantly reduced morbidity and mortality in patients infected with Human immunodeficiency virus (HIV). Despite this success, the sustainability of the initial treatment regimen has become difficult as patients continue the treatment for life. Highly active antiretroviral therapy regimen change may often be necessary due to intolerance/toxicity, pregnancy, comorbidities, difficulty in patient compliance and failure to achieve virological suppression. In this study, it was aimed to examine the reasons for HAART change in patients followed up for HIV/AIDS in Hatay Mustafa Kemal University, Tayfur Ata Sokmen Faculty of Medicine Hospital. Materials and Methods: In this retrospective, cross-sectional, single-center study, 151 patients followed up at Hatay Mustafa Kemal University, Tayfur Ata Sokmen Medical Faculty Hospital for HIV between January 2018 and December 2020 were included in the study. Results: One hundred-seventeen (77.5%) of the cases were male and 34 (22.5%) were female. The mean age was 39.08 +/- 14.2 years (20-83). Treatment changes were made in 35 (23.2%) of the cases. The most common reason for treatment change was intolerance/toxicity (19) in 12.6% of cases. Other reasons for change; pregnancy was six (4%), treatment non-compliance was four (2.6%), patient request was three (2%), and physician decision was three (2%). No drug changes were detected in the cases due to virological failure. Conclusion: There is generally little data available in Turkey on the reasons for regime change in HIV patients using HAART. Therefore, the data we will obtain in this study can help draw a long-term plan for HAART drug management.
Frequency of Hepatitis B Virus Screening in Patients with Systemic Lupus Erythematosus
(Galenos Yayincilik, 2020) Cabalak, Mehmet; Kimyon, Gezmis; Bal, Tayibe
Introduction: Immunosuppressive drug use is common in the treatment of systemic lupus erythematosus (SLE). In cases receiving immunosuppressive therapy, screening for hepatitis B reactivation risk is also recommended. In this study, we aimed to investigate the frequency of hepatitis B screening in cases diagnosed as having SLE, who were followed up in the Rheumatology Clinic of Hatay Mustafa Kemal University. Materials and Methods: We included 93 patients who were followed-up in the Rheumatology Clinic of Hatay Mustafa Kemal University with the diagnosis of SLE between July 2017-December 2019 in our study. The screening rates of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core protein antibody (anti-HBc IgG) of the cases and the immunosuppressive drugs used by them were analyzed retrospectively. Results: The mean age of the cases was 38 years (minimum-maximum: 18-79), and 91.4% were women. Of the cases, 43 (46.2%) were determined to be never screened for hepatitis B, 34 (36.6%) screened inadequately, and only 16 (17.2%) screened fully. In 22 cases receiving high-risk immunosuppressive therapy, the rate of full screening of hepatitis B was 27.3%. Conclusion: In patients with SLE, even those who used high-risk immunosuppressive therapy, screening rates were found low. We think that awareness should be increased in this regard by performing joint training with clinics that start immunosuppressive therapy, a periodic repetition of these trainings should be done, and also multi-center studies should be conducted.
Incidence and predictors of direct-acting antiviral treatment failure in Turkish patients with chronic hepatitis C genotype 1b infection
(Sage Publications Inc, 2020) Cabalak, Mehmet; Bal, Tayibe; Onlen, Yusuf; Demir, Mehmet
Evaluation of the incidence and predictors of failure of direct-acting antiviral treatment for hepatitis C virus genotype 1b patients is important. Our retrospective cohort study assessed 172 Turkish patients who had received a full course of such treatment and could be checked for sustained virologic response. The overall treatment failure rate was 2.9% (5/172), all of whom relapsed. In three of these cases with sequencing data available, all had NS5A resistance-associated substitution. Multivariate analysis revealed that a 1 mg/dL increase in pre-treatment total bilirubin level was associated with a sevenfold increased likelihood of treatment failure. The baseline level of total bilirubin was the only significant independent predictor of direct-acting antiviral treatment failure.
Lymphocyte-to-C-reactive protein ratio may serve as an effective biomarker to determine COVID-19 disease severity
(Walter De Gruyter Gmbh, 2021) Bal, Tayibe; Dogan, Serdar; Cabalak, Mehmet; Dirican, Emre
Objectives: We aimed to evaluate the ability of lymphocyte-C-reactive protein ratio (LCR) to discriminate between different levels of severity of COVID-19 disease. Methods: This retrospective observational single-center study was performed on 61 confirmed (PCR positive) COVID-19 patients between March and June 2020. The study population was separated into three groups: mild/moderate (n=24), severe (n=25) and critically ill (n=12). The optimal cutoff values of the LCR and neutrophil-to-lymphocyte ratio (NLR) in discriminating between patients with different severity levels were calculated by applying the receiver operating curve (ROC) analysis. Results: At baseline, the LCR decreased significantly across the three severity groups (mild/moderate > severe > critically ill). ROC analysis showed that a mean LCR of 43.21 was the cut-off value which best discriminated patients with the critically ill disease from severe patients (sensitivity: 84% and specificity: 69%). The discriminative performance of LCR (ROC AUC 0.820) was better than that of NLR (0.751) in this regard. LCR, unlike NLR was able to distinguish severe patients from mild/moderate patients, with a cut off value of 458.19 (sensitivity: 80% and specificity: 45%). Conclusion: LCR was observed to be able to distinguish COVID-19 infected patients of different severity (mild/moderate, severe and critically ill) and was superior to NLR in this regard.
NS5A resistance - associated substitutions in chronic hepatitis C patients with direct acting antiviral treatment failure in Turkey
(Elsevier Sci Ltd, 2020) Sayan, Murat; Yildirim, Figen Sarigul; Akhan, Sila; Yildirim, Arzu Altuncekic; Sirin, Goktug; Cabalak, Mehmet; Demir, Mehmet
Objectives: Chronic hepatitis C (CHC) is now a more curable disease with new direct acting antivirals (DAA). Although high sustained virologic response rates, failures still occur in DAA regimens. Our objective in this study was to characterize the real-life presence of clinically relevant resistance - associated substitutions (RASs) in the HCV NS5A gene in CHC patients whose DAA regimen has failed. Methods: The study enrolled 53 CHC patients who experienced failure with DAA regimen as the prospective longitudinal cohort between 2017-2019. Genotypic resistance testing was performed via the viral population sequencing method and The Geno2pheno HCV tool was used for RAS analysis. Results: The most frequent failure category was relapse (88%) followed by non-responder (12%). For a total of 36% of patients, RASs was detected in NS5A, Y93H was the most detected RAS in GT1b infected patients (89%). Conclusions: This study establishes an HCV failure registry for Turkey in which samples were combined with clinical, virologic and molecular data of adult patients whose DAA therapy failed. RASs can occur in CHC patients with DAA treatment failures. Evaluation of RAS after DAA failure is very important before retreatment is initiated to prevent virologic failure. (C) 2020 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
Occult hepatitis B infection in Turkish HIV-infected patients: A multicentre, retrospective, cross-sectional study, Schindler study
(Wiley-Hindawi, 2021) Unlu, Gulten; Yildiz, Yesim; Oren, Meryem Merve; Cabalak, Mehmet; Mete, Ozlem; Komur, Suheyla; Yildirim, Figen
Objective Occult hepatitis B infection (OHBI) appears to have a higher prevalence in populations at high risk for hepatitis B virus (HBV) infection with concomitant liver disease. The aim was to assess the prevalence of OHBI in a sample of human immunodeficiency virus -1 positive and HBV surface antigen-negative (HIV-1+/HBsAg-) Turkish patients. Methods Ten centres in Turkey were included in the study. Patients were selected on the basis of a power calculation with a known population size of HIV-positive patients and a reported prevalence of OHBI. Gender, age, occupation, place of residence, treatment and clinical status, and laboratory results, including immunodeficiency panel, antibody tests, hemogram, biochemistry, and coagulation studies were evaluated retrospectively. Results The number of HIV-infected patients followed in these centres was 3172 and the sample population numbered 278. All 278 were HBsAg negative. The mean age of the sample was 37.2 +/- 13.1 years and 235 (84.5%) were male. All but one patient (99.6%) had been treated with antiretroviral therapy. Of the 278 patients, 169 (60.6%) were positive for Anti-HBs and 125 (44.8%) were positive for Anti-HBc IgG. HIV RNA was detected in 203/278 (73%) of the patients. Four HBV DNA (1.4%) were diagnosed with OHBI. There was no significant difference in hemogram, hemoglobin or bilirubin concentrations in those with OHBI compared with the other patients. Conclusion In a representative sample of HIV+ patients from 10 Turkish centres, the prevalence of OHBI was found to be 1.4%. In HIV positive patients, it is important to identify those with OHBI for optimal clinical management and prognosis.
Oxidative stress index can be a new marker related to disease severity in COVID-19
(Walter De Gruyter Gmbh, 2021) Dogan, Serdar; Bal, Tayibe; Cabalak, Mehmet; Dikmen, Nursel; Yaqoobi, Hasibullah; Ozcan, Oguzhan
Objectives: The aim of this study was to evaluate the relationship between systemic oxidative balance, and the severity of the disease in patients with COVID 19. Methods: Sixty-four patients were divided into three groups according to the severity of the disease: mild (n=28), moderate (n=11) and severe (n=25). Twenty-four healthy controls included to the study. Proinflammatory cytokines (IL-6 and TNF-alpha), D-dimer, fibrinogen, total oxidative status (TOS), total antioxidant status (TAS) were measured and oxidative stress index (OSI) was calculated. Results: The mean age of severe group was significantly higher than the other groups (p=0.001). TAS levels were significantly decreased in all patient groups compared to controls, while serum TOS and OSI levels were significantly different in all three stages of the disease. Serum IL-6 and TNF-alpha levels were significantly elevated in severe group compared to other groups. TOS and OSI levels were also significantly correlated with IL-6, CRP, ferritin, fibrinogen, LDH and D-dimer. Conclusions: TOS and OSI levels are an indicator of systemic oxidative balance in COVID-19 and related to the disease severity. They can be an important marker for evaluating the disease severity and used in the management of patients with COVID-19.
Pentraxin-3: A Novel Marker for Indicating Liver Fibrosis in Chronic Hepatitis B Patients?
(Aves, 2021) Balin, Safak Ozer; Cabalak, Mehmet; Tartar, Ayse Sagmak; Kazanci, Ulku; Telo, Selda; Demirdag, Kutbeddin; Akbulut, Ayhan
Background: Pentraxin-3 (PTX-3) is an important marker that plays a role in suppressing inflammation and tissue repair. The aim of this study is to investigate the diagnostic and prognostic characteristics of PTX-3 in chronic hepatitis B (CHB) patients and the relationship between PTX-3 levels and fibrosis. Methods: A total of 52 CHB patients and 40 healthy subjects were included in the study. All of the CHB patients underwent liver biopsy and were then scored using an Ishak histologic scoring system. Blood samples were collected to evaluate the PTX-3 levels. Results: Of the subjects who participated in the study, 53% were female. The PTX-3 levels were determined as 5.63 ng/mL in the control group, and as 0.88 ng/mL in the CHB patient group. PTX-3 levels were found to be 1.19 ng/mL in stage 1, 0.89 ng/mL in stage 2, 0.68 ng/mL in stage 3, and 0.55 ng/mL in stage 4. Of the CHB patients, 44.2% had significant fibrosis, while 55.7% were identified as not having significant fibrosis. The PTX-3 values were 0.64 and 1.0 ng/mL in patients with and without significant fibrosis, respectively. The cut-off value for PTX-3 in predicting the absence of significant fibrosis was estimated as 0.9 ng/mL. Conclusion: The CHB patients were found to have lower serum PTX-3 levels compared to the control group, and these levels decreased even further as the stage of fibrosis progressed. In addition, the significant decrease in PTX-3 levels in patients with stage 1 fibrosis compared to the control group shows that PTX-3 can be used as a non-invasive marker for the early detection of fibrosis (P <.001).
Real-life Data of Glecaprevir/Pibrentasvir in Chronic Hepatitis C Patients: A Single-center Study
(Briefland, 2023) Cabalak, Mehmet; Bal, Tayibe; Ocak, Sabahattin; Bal, Isa Ahmet; Onlen, Yusuf
Background: Glecaprevir/pibrentasvir (G/P) is a pangenotypic direct-acting antiviral (DAA) drug with a high resistance barrier. It has been used in patients with chronic hepatitis C in Turkey since March 2019. This drug's efficacy and safety data in Turkey are very limited, and there are not enough studies on real-life data.Objectives: In this study, we aim to present real-life data, efficacy, and safety for our patients. Methods: In this retrospective, observational, single-center study, 116 patients who were started on G/P (100mg/40mg) oral therapy at the infectious diseases clinic between March 2019 and December 2021 due to HCV were included. Of the 116 patients included in the study, 92 were analyzed. Demographic data of the patients, previous treatment experience, drug use, viral load (HCV RNA levels at the 4th week of treatment and 12th week after treatment), and viral genotype data were obtained retrospectively from the automation system. Statistical analysis IBM SPSS version 21.0 statistical package program was used.Results: Seventy-one (77.2%) of the patients were male, and 21 (22.8%) were female, with a mean age of 47.4 (18 -89). Genotype dis-tribution of patients 8.7% (n = 8) type 1a, 31.5% (n = 29) type 1b, 26.1% (n = 24) type 2, 22.9% (n = 21) type 3,10.9% (n = 10) were type 4, 8.7% (n = 8) of the patients were treatment-experienced. In our study, there were no patients with cirrhosis. SVR-12 could not be obtained from a patient infected with only genotype 1a. In addition, this patient was co-infected with Hepatitis B. No side effects were observed in any of the patients that required treatment discontinuation. The SVR-12 rate was 98.6% with patients per protocol analysis (PP), but the SVR-12 rate was 77.2% with intention to treat analysis (ITT).Conclusions: In conclusion, this study suggested that G/P therapy in Turkey is used in real life with very high efficacy and tolerability. In addition, a significant change was observed in the genotype distribution previously reported in Turkey in the patient group we treated.
Relationship of Thrombospondin-1 and Thrombospondin-2 with hematological, biochemical and inflammatory markers in COVID-19 patients
(Walter De Gruyter Gmbh, 2023) Dogan, Serdar; Okuyan, Hamza Malik; Bal, Tayibe; Cabalak, Mehmet; Begen, Mehmet A.
Objectives: Roles of Thrombospondin-1 (TSP-1) and Thrombospondin-2 (TSP-2) in tissue repair and inflammation are well-documented, but the association of their serum expressions with the pathogenesis of COVID-19 remains unclear. We investigate the roles of TSP-1 and TSP-2 in COVID-19. Methods: 106 SARS-CoV-2 infected patients and 23 healthy people were enrolled in our study. COVID-19 patients were divided into two groups as non-severe and severe. TSP-1 and TSP-2 concentrations were measured with an enzyme-linked Immunosorbent Assay, and blood markers were analyzed with routine laboratory techniques. Results: COVID-19 patients had significantly higher TSP-1 and TSP-2 levels than healthy controls. TSP-1 and TSP-2 positively correlated with inflammatory markers, including ESR, CRP, PCT, ferritin, and biochemical parameters such as ALT, AST, BUN, CK, and LDH. In addition, TSP-1 and TSP-2 were negatively correlated with hematological markers such as LYM, EOS, and HGB. Receiver operating characteristic analyses revealed that COVID-19 may be predicted with TSP-1 levels over 189.94 ng/mL and TSP-2 levels higher than 0.70 ng/mL. Conclusions: Our analysis suggests that TSP-1 and TSP-2 expressions at the systemic level may have clinical importance for COVID-19.
Serum periostin levels in COVID-19: Is it useful as a new biomarker?
(Wiley-Hindawi, 2021) Cabalak, Mehmet; Dogan, Serdar; Bal, Tayibe; Dikmen, Nursel
Objectives Severe disease characterised by interstitial pneumonia may develop in some cases of coronavirus disease (COVID-19). Periostin has been associated with many respiratory diseases. In this study, we aimed to investigate whether periostin could be a useful new biomarker in the follow-up and severity assessment of the disease in patients with COVID-19 pneumonia. Methods In the study, 32 patients followed up during May to July 2020 because of COVID-19 and 24 healthy controls were included. The patients were divided into two groups, namely, mild/moderate and severe, according to the severity of the disease. Serum periostin and transforming growth factor beta (TGF-beta) levels were tested using an enzyme-linked immunosorbent assay (ELISA) method using commercially available ELISA kits. Results It was observed that the periostin level was significantly higher in both mild/moderate cases and severe cases compared with the control group at first presentation. However, TGF-beta levels at first presentation were similar between the groups. Conclusions The current manuscript may be the first one performing periostin ELISA on COVID serum, and we believe that periostin can be used as a new biomarker.
Two Travel-Related Dengue Fever Cases
(Bilimsel Tip Yayinevi, 2023) Yaqoobi, Hasibullah; Cabalak, Mehmet; Onlen, Yusuf; Bal, Tayibe; Ocak, Sabahattin
Denguefever is a viral disease seen as imported cases in Turkiye. Mosquitoes of the genus Aedes (A. aegytiand, A. alboptticus) serve as vectors. The flaviviridea a family is a RNA virus in the genus flavivirus. The incubation period is 3-14 days. There are four different serotypes: DENV-1, DENV-2, DENV-3, and DENV-4. Infection with any serotype can occur. It is the most important step for diagnosis, especially, in cases traveling to endemic regions in Turkiye. Warning symptoms such as fever, headache, retrobulbar pain, myalgia, jointpain, rash (macular, papular, petechiae, purpura) are important in early diagnosis. RT-PCR from serum makes a definitive diagnosis. DENV IgM positivity and four-fold increase in DENV IgG also make the diagnosis. The main treatment is supportive treatment. There is no specific antiviral treatment. There is a vaccine licensed as Dengvaxia for people in the risk group. In our study, we wanted to share our two cases of Dengue fever, which is likely to be confused with malaria, in the Hatay region, where imported malaria cases are common.
What is the Current Situation of HBV, HCV and HIV Seroprevalence Among Syrian Refugees? Patients Evaluated Preoperatively Over Ten Years
(Galenos Publ House, 2022) Comez, Mehmet Selim; Bal, Tayibe; Cabalak, Mehmet
Objectives: Migration can change the demographic dynamics of host populations in terms of communicable diseases in destination countries. This is a potential public health challenge for the health authorities. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections can lead to the development of chronic liver diseases, cirrhosis and hepatocellular carcinoma, whereas human immunodeficiency virus (HIV) infection can lead to the development of serious opportunistic diseases. The aim of this study was to evaluate the seroprevalence of HBV, HCV and HIV in Syrian refugees and Turkish patients who were evaluated preoperatively in our hospital.Materials and Methods: Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B core antibody, anti-HCV and anti-HIV results of Syrian refugee and Turkish patients who applied to surgical clinics approximately 2011-2021 were retrospectively reviewed.Results: The study comprised 54,446 patients: Turkish patient group (n=20569) and Syrian refugee patient group (n=33877). The Syrian refugee patients had a significantly higher HBsAg seropositivity rate and a significantly lower anti-HBs seropositivity rate than the Turkish patients (p=0.002 and p<0.001, respectively). The anti-HCV and anti-HIV seropositivity rates were similar. The annual preoperative prevalence of HBsAg seropositivity in the Syrian refugee patients tended to significantly decrease gradually from 2011 to 2021 (p<0.001 for <= 30 and p=0.001 for >30 years old).Conclusion: Although HBV seroprevalence gradually decreases and HCV and HIV seroprevalence is low; screening, information and treatment programs should be given due importance because of the serious disease potential and preventable conditions with precautions. Additionally, preoperative screening of refugee patients coming for major surgery may be important for the safety of healthcare professionals.

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