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Öğe Delays in reporting critical values from clinical laboratories to responsible healthcare staff(Walter De Gruyter Gmbh, 2017) Ozcan, Oguzhan; Cakirca, Gokhan; Motor, Sedat; Yonden, ZaferObjective: We aimed to investigate the frequency of delayed notifications and probable causes of delays for critical value notification in clinical laboratory of university hospital. Materials and methods: All data was obtained from critical value reporting forms and laboratory information system. The frequency and location of critical and delayed results, latencies throughout a working day and the professional status who received the critical callbacks were shown as percentages. Results: A total of 2018 (1.02%) critical values were reported and 13.1% of them were delayed notifications. Most of them were observed in laboratory tests ordered from patients of service and polyclinics compared to ICU and emergency department (26.7%, 26%, 6.2% and 4.9%, respectively, p < 0.01). Delayed notifications were significantly higher for biochemical parameters (19.7%, p < 0.001) and observed particularly in morning hours (06: 00 a. m.-10: 00 a. m.), lunch break time (12: 00-14: 00) and end of the working day (16: 00-18: 00). Latencies of mild-delayed reporting were 18.5 +/- 4.4 min for 62.8% and advanced-delayed reporting were 47.1 +/- 11.3 min for 37.2% of total delayed notifications. Most of the critical results were reported to the health care staff other than physician (55.6%). Conclusion: Laboratory professionals should work in collaboration with responsible clinician and healthcare staff in critical value reporting process.Öğe Diagnostic accuracy of angiopoietin-like protein 2 and atherosclerotic variables in psoriasis vulgaris using ROC analysis(Bayrakol Medical Publisher, 2021) Celik, Ebru; Celik, Yusuf; Burakgazi, Gulen; Cakirca, Gokhan; Ucgul, GokhanAim: Psoriasis vulgaris is a chronic inflammatory skin disease associated with various comorbidities such as metabolic syndrome and cardiovascular disease. The disease is affected by many variables. Angiopoietin-like protein 2 (ANGPTL2) is a proinflammatory cytokine, and increased serum levels are associated with inflammation, obesity, dyslipidemia, metabolic syndrome, and atherosclerosis. The aim of this study was to determine the diagnostic accuracy of the new variable ANGPTL2 and other atherosclerotic variables for psoriasis, using Receiver Operating Characteristic (ROC) analysis. Material and Methods: The study included 41 psoriasis patients and 43 healthy volunteers. Ultrasound examination of the carotids and carotid intima-media thickness (CIMT) measurements were performed in all participants. Serum ANGPTL2 levels, lipid levels/ratios and anthropometric measurements were recorded. A ROC curve of multivariate statistical methods was used for statistical evaluation. Results: According to the results of the ROC curves, seven diagnostic variables (ANGPTL2, BMI, weight, systolic blood pressure, waist circumference for females, uric acid and LDL-cholesterol) were found to be significant. The highest Area Under the Curve (AUC) value was found for ANGPTL2; AUC=0.721, 95% CI: 0.595-0.847, p=0.002. There was no significant difference in the lipid ratios and CIMT measurements between psoriasis patients and healthy controls. Discussion: This study revealed that increased ANGPTL2 levels in psoriasis patients are evidence of the strong relationship between the disease and atherosclerosis. Therefore, the measurement of serum ANGPTL2 level may be a new marker that can be used to determine the risk of early atherosclerosis and metabolic complications in psoriasis patients.Öğe THE EFFECT OF PNEUMATIC TUBE SYSTEMS ON THE HEMOLYSIS OF BIOCHEMISTRY BLOOD SAMPLES(Elsevier Science Inc, 2017) Cakirca, Gokhan; Erdal, HuseyinIntroduction: Pneumatic tube systems (PTSs) are widely used in many hospitals because they lead to reduced turnaround times and cost efficiency. However, PTSs may affect the quality of the blood samples transported to the laboratory. The aim of this study was to investigate the effect of the PTS used in our hospital on the hemolysis of the biochemical blood samples transported to the laboratory. Methods: A total of 148 samples were manually transported to the laboratory by hospital staff, 148 samples were transported with the PTS, and 113 were transported with the PTS without use of sponge-rubber inserts (PTSws). Hemolysis rates and the levels of biochemical analytes for the different transportation methods were compared. Results: No significant difference was found between the samples transported manually and with the PTS with regard to hemolysis rate and the levels of biochemical analytes. However, the samples transported with the PTSws showed a significant difference compared with the samples transported manually and with the PTS with regard to hemolysis rate and potassium and lactate dehydrogenase levels. The percentages of the samples that exceeded the permissible threshold for the hemolysis among the samples transported manually, with the PTS, and with the PTSws were 10%, 8%, and 47%, respectively. Discussion: A PTS can be used safely for transporting biochemistry blood samples to the laboratory. However, a sponge-rubber insert that holds sample tubes must be used with the PTS to prevent the hemolysis of blood samples.Öğe Evaluation of Gas6 and sAxl levels during attacks and attack-free periods of familial Mediterranean fever(Walter De Gruyter Gmbh, 2018) Cakirca, Gokhan; Celik, Muhammet MuratObjectives: We aimed to assess the growth arrest specific protein 6 (Gas6) and soluble Axl (sAxl) levels in the familial Mediterranean fever (FMF) patients, and to investigate the correlation between the levels of these with the inflammatory markers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and fibrinogen. Materials and methods: Seventy nine FMF patients (35 in attack period and 44 in attack-free period) and 40 healthy controls were involved in the study. The levels of serum Gas6 and sAxl were measured by enzyme-linked immuno-sorbent assay (ELISA) method. Results: Gas6 levels of the FMF patients with attack were significantly lower than both the attack-free patients and the healthy controls (p = 0.007 and p = 0.003, respectively). However, no significant difference was detected between the Gas6 levels of the attack-free patients and the healthy controls (p > 0.05). sAxl levels of the FMF patients with attack were significantly lower than the healthy control (p = 0.007). A positive correlation was found between the Gas6 and CRP levels of the FMF patients with attack (r = 0.379, p = 0.025). Conclusions: This study indicates that decreased serum Gas6 and sAxl levels may be associated with FMF attack period. Further studies on the role of the Gas6/Axl system in FMF are needed.Öğe Investigation of thiol/disulfide homeostasis in familial mediterranean fever patients(Derman Medical Publ, 2018) Cakirca, Gokhan; Celik, Muhammet Murat; Erdal, Huseyin; Neselioglu, Salim; Erel, Ozcan; Basarali, Mustafa Kemal; Cakirca, Tuba DamarAim: To determine the thiol/disulfide homeostasis in patients with familial Mediterranean fever (FMF) and its correlation with the levels of inflammatory markers consisting of white blood cell count, erythrocyte sedimentation rate, C-reactive protein and fibrinogen. Material and Method: This study was performed in the internal Medicine department of Mustafa Kemal University Hospital in Turkey. A total of 27 FMF patients in the attack period (AP), 33 FMF patients in the attack-free period (AFP), and 36 healthy controls participated in this study. Thiol/disulfide profile parameters were detected using the novel method of Erel and Neselioglu. Results: Total and native thiol levels of the FMF-AP group were markedly lower than those of healthy controls, while the difference in disulfide level was not statistically significant. Thiol/disulfide levels in the FMF-AFP group were similar to the levels in both the FMF-AP group and healthy controls. Correlation analysis showed a negative correlation between fibrinogen levels and total and native thiol levels, while there was a positive correlation between white blood cell count and disulfide levels in the FMF-AP group. Discussion: The findings suggest that decreased concentrations of total and native thiol in patients with FMF-AP are likely to be an outcome of inflammation-induced oxidative stress.Öğe Lipid disorders in Familial Mediterranean Fever patients: Is inflammation the only cause? Reply(Turkish Soc Cardiology, 2018) Cakirca, Gokhan; Celik, Muhammet Murat[Abstract Not Available]Öğe Lipid profile and atherogenic indices and their association with platelet indices in familial Mediterranean fever(Turkish Soc Cardiology, 2018) Cakirca, Gokhan; Celik, Muhammet MuratObjective: The aim of this study was to investigate lipid profiles and atherogenic indices and their association with platelet indices in Familial Mediterranean Fever (FMF) patients. Methods: A total of 63 FMF patients and 51 healthy individuals were included in this retrospective study. Inflammatory marker values (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP] and fibrinogen), platelet indices (mean platelet volume, plateletcrit value, platelet large cell ratio, and platelet distribution width), lipid profiles (levels of total cholesterol, triglycerides, high-density lipoprotein [HDL] cholesterol, and low-density lipoprotein cholesterol) were recorded. Atherogenic indices (atherogenic index of plasma [AIP], atherogenic coefficient [AC], Castelli's risk indices I and II [CRI I and II]) were calculated using lipid parameters. Results: In FMF patients, while AIP, AC, and CRI I and II values were significantly higher than in the healthy control group, the HDL cholesterol level was significantly lower (all p<0.05). However, no significant difference was determined in terms of the other studied parameters (all p>0.05). In male FMF patients, whereas AIP, AC, and CRI I and II values were significantly higher than in female FMF patients, the platelet count, ESR, and HDL cholesterol levels were significantly lower (all p<0.05). The level of CRP was negatively correlated with HDL cholesterol (r=-0.275; p=0.032) and total cholesterol level (r=-0.313; p=0.014) in FMF patients. HDL cholesterol level was negatively correlated with disease duration (r=-0.269; p=0.049). Conclusion: The use of atherogenic indices may be recommended to identify patients with an increased risk of atherosclerotic cardiovascular disease in FMF, especially in male patients.Öğe Protective effect of alpha lipoic acid on cisplatin induced hepatotoxicity in rats(Taylor & Francis Ltd, 2020) Pinar, Neslihan; Cakirca, Gokhan; Hakverdi, Sibel; Kaplan, MahirWe investigated the protective effect of alpha lipoic acid (ALA) against cisplatin (CIS) induced hepatotoxicity in rats. ALA is an antioxidant and anti-inflammatory agent that exhibits free radical scavenger properties and direct antioxidant effects on recycling of other cellular antioxidants. We used four equal groups of rats. The control group: saline solution (0.9%) was administered intraperitoneally (i.p.); ALA group: administered a single dose 100 mg/kg ALA i.p. for 10 days; CIS group was administered a single dose 5 mg/kg CIS i.p. on the first day of the study; CIS + ALA group was administered a single dose 5 mg/kg CIS i.p. on the first day of study, then 100 mg/kg ALA i.p. for 10 days. In the CIS group, Bax, caspase3, malondialdehyde (MDA), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were increased, whereas Bcl-2, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) levels were decreased compared to the control group. In the CIS + ALA group, Bax, caspase 3, MDA, AST and ALT levels were decreased, whereas Bcl-2, SOD, CAT and GPx levels were increased compared to the CIS group. In the CIS group we found intense perivenule sinusoid dilation, karyomegaly, pyknotic and karyolytic cells, central vein congestion, parenchymal inflammation, mild bile duct proliferation and periportal sinusoid dilation. Histological liver damage was reduced in the CIS + ALA group. ALA may useful for treating CIS induced hepatotoxicity owing to its antioxidant and anti-inflammatory effects.Öğe The protective effects of alpha lipoic acid on methotrexate induced testis injury in rats(Elsevier France-Editions Scientifiques Medicales Elsevier, 2018) Pinar, Neslihan; Cakirca, Gokhan; Ozgur, Tumay; Kaplan, MahirMethotrexate (MTX) is frequently used in the treatment of several diseases including cancers, rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, and dermatomyositis. Previously, chemotherapeutic agents have been reported to cause permanent azoospermia and infertility in men. Methotrexate has been also shown to damage the seminiferous tubules of the testicles, lower the sperm count, and cause genetic mutations (in DNA) in sperm. In this study, we aimed to investigate the protective effects of alpha lipoic acid (ALA) on MTX-induced testicle damage in a rat model. A total of 40 male Wistar Albino rats were used in this study. The rats were divided into four groups including 10 rats in each. The first group (control group) received only saline intraperitoneal (i.p.); the second group (ALA group) was given ALA 100 mg/kg i.p.; the third group (MTX group) received single dose MTX 20 mg/kg i.p.; and the fourth group (MTX+ALA group) received single dose MTX 20 mg/kg i.p. and ALA 100 mg/kg i.p. Malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), myeloperoxidase (MPO) levels in the testicular tissue and serum testosterone, serum total antioxidant status (TAS) and total oxidant status (TOS) levels were biochemically evaluated. Testicular tissues histopathologically evaluated. In the MTX group, the MDA, TAS and TOS levels were higher, while the SOD, CAT, GPx, MPO and serum testosterone levels decreased. Compared to the MTX group, the MDA, TAS and TOS levels were lower and the SOD, CAT, GPx, MPO and serum testosterone levels increased in the MTX+ALA group. In the histopathological examination, the mean seminiferous tubule length (MSTD), germinal epithelial cell thickness (GECT), and mean testicular biopsy score (MTBS) were found to significantly decrease in the MTX group, compared to the control group. These values were significantly higher in the MTX+ ALA group, compared to the MTX group (p < 0.05). In our experimental study, MTX caused severe tissue destruction in testicles by increasing the formation of free oxygen radicals. Based on our study results, we suggest that, as a potent free radical scavenger, ALA can reduce MTX-induced testicular tissue damage thanks to its antioxidant and anti-inflammatory properties.Öğe Serum matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 and matrix metalloproteinase-9/ neutrophil gelatinase-associated lipocalin complex levels in patients with early-stage diabetic nephropathy(Iranian Society of Nephrology, 2018) Cakirca, Gokhan; Turgut, Faruk HilmiIntroduction. This study was aimed to investigate the efficacy of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), and the neutrophil gelatinase-associated lipocalin (NGAL)-bound form of MMP-9 (MMP-9/NGAL complex) markers in the determination of early nephropathy in patients with type 2 diabetes mellitus. Materials and Methods. Twenty-five type 2 diabetic patients with normoalbuminuria, 27 type 2 diabetic patients with microalbuminuria, and 23 healthy controls were recruited. Serum levels of MMP-9, TIMP-1, and MMP9/NGAL complex were measured in all participants. Results. The MMP-9 level and MMP-9/TIMP-1 ratio were higher in patients with microalbuminuria when compared to the controls, while TIMP-1 level was lower (P =.005, P =.006, and P =.02, respectively). The MMP-9 level and MMP-9/TIMP-1 ratio were significantly higher in the patients with normoalbuminuria when compared to the controls (P =.005 and P =.02, respectively). In the normoalbuminuric patients, MMP-9 levels were negatively correlated with estimated GFR (r =-0.553, P =.008) and positively correlated with glucose (r = 0.449, P =.04), creatinine (r = 0.454, P =.03), and MMP9/NGAL complex (r = 0.575, P =.005). In the microalbuminuric patients, MMP-9 levels were positively correlated with total cholesterol (r = 0.430, P =.03), and MMP9/NGAL complex (r = 0.650, P =.001). Conclusions. The levels of MMP-9, TIMP-1, and MMP9/NGAL complex were similar in microalbuminuric and normoalbuminuric patients with type 2 diabetes mellitus. However, there was a significant MMP-9/TIMP-1 imbalance in both groups which may reflect impaired extracellular matrix homeostasis. © 2018, Iranian Society of Nephrology. All rights reserved.Öğe Serum Matrix Metalloproteinase-9, Tissue Inhibitor of Metalloproteinase-1 and Matrix Metalloproteinase-9/Neutrophil Gelatinase-associated Lipocalin Complex Levels in Patients with Early-stage Diabetic Nephropathy(Iranian Soc Nephrolgy, 2018) Cakirca, Gokhan; Turgut, Faruk HilmiIntroduction. This study was aimed to investigate the efficacy of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), and the neutrophil gelatin-aseassocia ted lipocalin (NGAL)-bound form of MMP-9 (MMP-9/NGAL complex) markers in the determination of early nephropathy in patients with type 2 diabetes mellitus. Materials and Methods. Twenty-five type 2 diabetic patients with norinoalbuminuria, 27 type 2 diabetic patients with microalbuminuria, and 23 healthy controls were recruited. Serum levels of MMP-9, TIMP-1, and MMP9/NGAL complex were measured in all participants. Results. The MMP-9 level and MMP-9/TIMP-1 ratio were higher in patients with microalbuminuria when compared to the controls, while TIMP-1 level was lower (P = .005, P = .006, and P = .02, respectively). The MMP-9 level and MMP-9/TIMP-1 ratio were significantly higher in the patients with normoalbuminuria when compared to the controls (P = .005 and P = .02, respectively). In the normoalbuminuric patients, MMP-9 levels were negatively correlated with estimated GFR (r = -0.553, P = .008) and positively correlated with glucose (r = 0.449, P = .04), creatinine (r = 0.454, P = .03), and MMP9/NGAL complex (r = 0.575, P = .005). In the microalbuminuric patients, MMP-9 levels were positively correlated with total cholesterol (r = 0.430, P = .03), and MMP9/NGAL complex (r = 0.650, P = .001). Conclusions. The levels of MMP-9, TIMP-1, and MMP9/NGAL complex were similar in microalbuminuric and normoalbuminuric patients with type 2 diabetes mellitus. However, there was a significant MMP-9/TIMP-1 imbalance in both groups which may reflect impaired extracellular matrix homeostasis.
