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Öğe Changes in blood biochemistry thrombosis parameters 24 hours after stent-assisted endovascular treatment of intracranial aneurysms(Sage Publications Inc, 2024) Cinar, Celal; Oran, Ismail; Ozdemir, Halil Ibrahim; Kusbeci, Mahmut; Kavakli, Ramazan Kaan; Tobu, Mahmut; Parildar, ZuhalBackground and purpose This study aims to elucidate the early changes in blood biochemistry thrombosis parameters following stent-assisted endovascular treatment of intracranial aneurysms.Methods Consecutive patients with unruptured aneurysms undergoing stent implantation during endovascular treatment were included in this prospective study with approval from the local ethics committee. Blood samples were collected immediately before and 24 h after the procedure for biochemical analysis, including basic thrombosis indicators, bleeding tests, and a complete blood count.Results The study included 80 patients (60 women, 20 men) with 134 aneurysms. A total of 135 stents (110 flow-diverting, 25 standard) were used. Additionally, intrasaccular coiling was utilized in 28 aneurysms among 27 patients. Following the procedure, there was a significant decrease in activated partial thromboplastin time, fibrinogen, hemoglobin, and platelet levels, and a significant increase in prothrombin time, D-dimer, von Willebrand factor (vWF) activity/antigen ratio, and leukocyte levels in all patients. Correlation analyses revealed significant positive associations between platelet and fibrinogen levels, and a negative association between D-dimer and fibrinogen levels in the coil (-) group. Additionally, there was a significant negative correlation between aneurysm volume and vWF activity/antigen ratio, and procedure duration and thrombocyte count, while a positive association was found between aneurysm number and leukocyte count in the coil (-) group.Conclusions Analysis of blood chemistry alterations indicates that intravascular thrombosis occurs in the intracranial circulation following stent-assisted endovascular treatment of intracranial aneurysms. This thrombotic process is more pronounced in patients whose aneurysms were left open (i.e. flow-diverting stent alone).Öğe The detection of left ventricular diastolic dysfunction in hypertensive patients: Performance of N-terminal probrain natriuretic peptide(Taylor & Francis Ltd, 2010) Barutcuoglu, Burcu; Parildar, Zuhal; Basol, Guenes; Gurgun, Cemil; Tekin, Yesim; Bayindir, OyaAim. Diastolic dysfunction (DD) results in increased cardiovascular risk in hypertensives. We studied the performance of N-terminal probrain natriuretic peptide (NT-proBNP) in detecting DD. Materials and methods. 241 hypertensive patients admitted to cardiology polyclinics were included in this study. They were grouped according to the presence of DD. Group 1: Essential hypertensive patients without DD (n=119); group 2: essential hypertensive patients with DD (n=122). All underwent trans-thoracic echocardiography for the evaluation of transvalvular flow, morphology, left ventricular wall motion abnormalities and ejection fraction. NT-proBNP levels were measured by an electrochemiluminescence immunoassay. Results. The systolic blood pressure (BP) (mean +/- SD) was 140 +/- 12 mmHg in group 1 and 144 +/- 16 mmHg in group 2 (p=0.049), the diastolic BP (mean +/- SD) was 88 +/- 10 mmHg in group 1 and 90 +/- 14 mmHg in group 2 (p=0.043). The median (1st-3rd quartile) NT-proBNP level in group 2 was significantly higher than group 1 [121.05 (61.03-207.66) and 31.17 (17.07-54.09) pg/ml, respectively (p<0.001)]. In the receiver operating characteristics analysis, the area under the curve was 0.862 (95% CI 0.816-0.908). At the cut-off of 45 pg/ml, sensitivity was 86.9%, specificity was 62.4%, and at the cut-off 65 pg/ml, sensitivity was 74.6%, specificity was 83.8%. Conclusion. Plasma NT-proBNP levels may be useful for identifying patients with DD and it is conceivable to use a cut-off level 65 pg/ml as a "rule in" test.Öğe Effect of telmisartan on vascular endothelium in hypertensive and type 2 diabetic hypertensive patients(Tubitak Scientific & Technical Research Council Turkey, 2010) Barutcuoglu, Burcu; Parildar, Zuhal; Mutaf, M. Isil; Ozmen, Dilek; Alioglu, Emin; Habif, Sara; Bayindir, OyaAim: Hypertension and type 2 diabetes mellitus (DM) cause endothelial dysfunction and may result in cardiovascular disease. The aim of this study was to assess endothelial dysfunction in essential hypertensives, and normotensive and hypertensive type 2 diabetics and to evaluate the effect of telmisartan on endothelium in hypertensives. Materials and methods: Eighteen essential hypertensives (group 1), 16 type 2 diabetic hypertensives (group 2), 10 type 2 diabetic normotensives (group 3), and 10 control subjects (group 4) were included in this study Groups 1 and 2 received 40 mg/day telmisartan for 12 weeks and were evaluated at the beginning and end. Groups 3 and 4 were evaluated once by serum nitrate (NO), vascular cell adhesion molecule-1 (VCAM-1), platelet endothelial cell adhesion molecule-1 (PECAM-1), thrombomodulin (TM), plasminogen activator inhibitor-1 (PAI-1), paraoxonase (PON1), urine microalbumin (MAU), and endothelium dependent flow mediated dilation (FMD). Results: In groups I, 2, and 3, PAI-1 (P < 0.001, for all) and MAU (P = 0.012, P = 0.006, P = 0.004, respectively) were significantly higher than they were in group 4. In group 2, PON1 was significantly lower than it was in groups 4 and 1 (P = 0.028, P < 0.001 respectively), and NO was significantly lower than it was in groups I, 3, and 4 (P < 0.001, for all). Brachial artery FMD was significantly lower in groups 1 and 2 than it was in group 4 and EMD in group 2 was lower than it was in group 3. After telmisartan treatment there were significant increases in PON1 in groups 1 and 2, and in TM in group 2. Conclusion: Type 2 DM and essential hypertension result in endothelial dysfunction. Telmisartan decreases blood pressure to normal ranges in hypertensives, but it has a minimal role in improvement of endothelial dysfunction.Öğe Effects of percutaneous transhepatic biliary drainage on renal function in patients with obstructive jaundice(Aves, 2011) Parildar, Zuhal; Cinar, Celal; Barutcuoglu, Burcu; Basol, Gunes; Parildar, MustafaPURPOSE We assessed the effects of percutaneous transhepatic biliary drainage on renal function in patients with obstructive jaundice using the estimated glomerular filtration rate (eGFR) and evaluated the factors associated with renal dysfunction. MATERIALS AND METHODS Between July 2007 and September 2009, 108 consecutive patients (69 men 39 women; median age, 59 years; range, 29-87 years) with obstructive jaundice (20 benign, 88 malignant) that were unsuitable for endoscopic retrograde cholangiopancreticography were evaluated at admission and at follow-up exams five and thirty days after percutaneous transhepatic biliary drainage. Two patients with suspected contrast-induced nephropathy were excluded. Renal function was assessed by measuring levels of urea, creatinine and electrolytes and evaluating the modification of diet in the renal disease formula for eGFR. RESULTS eGFR was <60 mL/min/1.73 m(2) before percutaneous transhepatic biliary drainage in 27 patients (25%) and increased significantly 30 days after percutaneous transhepatic biliary drainage (P = 0.008). In the malignant external drainage subgroup, there was a significant increase in eGFR on the fifth day after percutaneous transhepatic biliary drainage (P = 0.038). The procedure-related mortality rate was zero. Nine malignant patients (8.49%) died within thirty days due to underlying diseases. On the fifth day, eGFR was significantly lower in these patients than in surviving patients (P = 0.049), and bilirubin levels were significantly higher before the intervention than in surviving patients (P = 0.04). Multiple logistic regression analysis showed that serum direct bilirubin is a significant predictor of renal function (P. 0.049). CONCLUSION Obstructive jaundice is associated with renal dysfunction, and serum direct bilirubin is a significant predictor of renal function. Percutaneous transhepatic biliary drainage improves renal function and is crucial for prognosis of obstructive jaundice.Öğe Fibroblast Growth Factor-19 Levels in Type 2 Diabetic Patients with Metabolic Syndrome(Assoc Clinical Scientists, 2011) Barutcuoglu, Burcu; Basol, Gunes; Cakir, Yasemin; Cetinkalp, Sevki; Parildar, Zuhal; Kabaroglu, Ceyda; Ozmen, Dilek; Mutaf, Isil; Bayindir, OyaThis study aimed to examine fibroblast growth factor-19 (FGF-19) in type 2 diabetic (T2DM) patients with metabolic syndrome (MetS) and to evaluate the relationship between FGF-19 and other cardiovascular risk factors, such as atherogenic index of plasma (AIP) and hsCRP. 26 T2DM patients with MetS and 12 healthy controls were enrolled in the study. Serum FGF-19 levels were measured by sandwich ELISA, and compared with other cardiovascular risk factors; lipid profile, AIP, glucose, HbA1c, and hsCRP. AIP was calculated as log (TG/HDL-c). The median (1-3.quartile) FGF-19 levels in T2DM patients with MetS and healthy controls were 122.90 (108.63-237.60) pg/ml and 293.45 (153.64-370.31) pg/ml, respectively (P=0.003). Patients were also grouped by body mass index (BMI) <30 kg/m(2) (n=13) and >= 30 kg/m(2) (n=13) with median (1-3.quartile) FGF-19 values 168.70 (113.54-275.77) pg/mL and 115.89 (97.94-200.40) pg/mL, respectively (P=0.007). Significant negative correlations were found between FGF-19 and BMI, triglyceride, log (TG/HDL-c), hsCRP, and HbA1c (r=-0.526, P=0.001; r=-0.327, P=0.05; r=-0.312, P=0.05; r=-0.435, P=0.006; r=-0.357, P=0.028, respectively). We showed that FGF-19 levels are low in T2DM patients with MerS. The negative relationship between FGF-19 and several known cardiovascular risk factors such as TG, log (TG/HDL-c), hsCRP and HbA1c in diabetic patients with MetS suggests that FGF-19 can be used as a contributing marker.Öğe Increased serum neopterin levels in women with polycystic ovary syndrome(Assn Clinical Scientists, 2006) Barutcuoglu, Burcu; Bozdemir, A. Erkin; Dereli, Didem; Parildar, Zuhal; Mutaf, M. Isil; Ozmen, Dilek; Bayindir, OyaPolycystic ovary syndrome (PCOS) occurs in 5-10% of premenopausal women. Studies suggest that PCOS is associated with increased risk of coronary heart disease (CHD). To investigate this relationship, 15 PCOS women (group 1) and 10 healthy women (group 2) were studied. Blood leukocyte counts (white blood cells, WBC) and serum levels of total cholesterol, HDL-cholesterol, LDL-cholesterol, sensitive C-reactive protein (sCRP), and neopterin were measured in the 2 groups. There were no significant differences in serum total cholesterol, HDL-cholesterol, or LDL-cholesterol concentrations between groups 1 and 2. Blood WBC counts and serum levels of neopterin and sCRP were significantly higher in group I than group 2. The median (min-max) levels were: WBC, group 1: 8.05 (5.10-9.70) cells x 10(9)/L, group 2: 6.25 (4.70-9.70) cells x 109/L (p < 0.01); neopterin, group 1: 10.6 (7.5-49.5) nmol/L, group 2: 9.6 (6.5-12.9) nmol/L (p < 0.05); and sCRP, group 1: 7.0 (1.2-12.0) mg/L, group 2: 2.0 (0.1-12.0) mg/L (p < 0.01). This study shows that blood WBC counts and serum sCRP and neopterin levels are significantly elevated in women with PCOS. These findings support an increased risk for early-onset cardiovascular disease in women with PCOS. This is the first report that women with PCOS have higher serum neopterin levels than healthy women with regular menstrual cycles.Öğe Plasma steroid panel with liquid chromotographymass spectrometry (LC/MS-MS) method: utilization in differential diagnosis of hyperandrogenism(Karger, 2021) Ucar, Mert; Ata, Aysun; Barutcuoglu, Burcu; Ak, Gunes; Habif, Sara; Parildar, Zuhal; Goksen, Damla[No Abstract Available]Öğe Pleural fluid neopterin levels in tuberculous pleurisy(Pergamon-Elsevier Science Ltd, 2007) Cok, Gursel; Parildar, Zuhal; Basol, Gunes; Kabaroglu, Ceyda; Bayindir, Ulku; Habif, Sara; Bayindir, OvaObjectives: Neopterin is produced by stimulated macrophages under the influence of gamma interferon of lymphocyte origin. It is regarded as a biochemical marker of cell-mediated immune response. This study was designed to assess the diagnostic value of pleural fluid neopterin levels in tuberculous pleurisy in comparison with adenosine deaminase activity. Design and methods: Pleural fluid adenosine deaminase (ADA) activity and neopterin levels were measured in 16 patients with tuberculous pleurisy (TP) and 19 patients with malignant pleurisy (MP). ADA activity was determined by a colorimetric method, whereas neopterin levels were determined by a reversed-phase liquid chromatography technique. All values were given as median (min-max). Results: The mean age was 45.43 +/- 20.39 years in the TP group and 60.42 +/- 11.02 years in the MP group (p = 0.026). The median pleural fluid ADA activity was 51.75 U/L (3.50-62.40 U/L) in the TP group and was 2.30 U/L (1-8.20 U/L) in the MP group. The difference was statistically significant (p < 0.001). The median pleural fluid neopterin levels were 13.15 nmol/L (1.86-59.50 nmol/L) and 2.44 nmol/L (0.92-27.60 nmol/L) in the TP group and the NIP group, respectively (p 0.021). In order to evaluate the diagnostic value of pleural fluid neopterin concentrations, receiver-operating-characteristic curve analysis was performed. Conclusion: Pleural fluid neopterin concentration is significantly higher in TP when compared to MP, however when compared, its clinical use as a diagnostic marker is not valuable as ADA. (c) 2007 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.Öğe Prognostic Utility of Serum Neopterin in Obstructive Jaundice Secondary to Malignant Lesions Treated by Percutaneous Transhepatic Biliary Drainage(Elsevier Science Inc, 2013) Yilmaz, Betul; Parildar, Zuhal; Bozkaya, Halil; Barutcuoglu, Burcu; Cinar, Celal; Basol, Gunes; Parildar, Mustafa; Ozmen, DilekPurpose: To perform biochemical profiles before and after percutaneous transhepatic biliary drainage (PTBD) and investigate the potential utility of measuring C-reactive protein (CRP); circulating cytokines, and neopterin, a marker Of cell-mediated immunity, to predict outcomes of patients with obstructive jaundice. Materials and Methods: In a prospective study, 47 patients with obstructive jaundice secondary to malignant lesions were evaluated before, at the fifth hour after, and on the fifth day after PTBD for neopterin, nitrate, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-10, CRP levels, and liver function. Results: Neopterin levels on day 5 after PTBD were significantly higher than the levels before treatment bent and at the fifth hour. However, nitrate, cytokine, white blood cell, albumin, and creatinine levels were not significantly different. On the fifth day after PTBD, CRP levels were significantly higher and total bilirubin, direct bilirubin, alkaline phosphatase, aspartate transaminase, and alanine transaminase values were lower than the before-treatment values. Seven patients (15%) died within 30 days after drainage. On the fifth day after PTBD, neopterin, IL-6, IL-10, and creatinine levels were significantly higher and albumin levels were lower in the early mortality group. The performance characteristics of neopterin and creatinine were statistically significant in predicting mortality. Conclusions: Neopterin levels increased after PTBD, indicating cellular immune activation. The nonsignificant change in cytokine levels may be related to low enduring release in malignancy. The extremely elevated level a of neopterin and creatinine after PTBD might serve as harbingers of early death in patients with cholestasis secondary to malignant lesions.Öğe The relationship between nutritional status and Fetuin-A in Inflammatory Bowel Disease patients(Kuwait Medical Assoc, 2021) Barutcuoglu, Burcu; Unal, Nalan Gulsen; Ak, Gunes; Parildar, Zuhal; Oruc, Nevin; Ozutemiz, Ahmet OmerObjective: To investigate the relationship between fetuin-A and nutritional index parameters body mass index (BMI), fat mass (FM), fat free mass (FFM) and mini nutritional assessment (MNA (R)) in inflammatory bowel disease (IBD) patients. Design: Randomized, prospective study Setting: Department of Clinical Biochemistry and Gastroenterolgy, Medical School, Ege University, Izmir, Turkey Subjects: Seventy-six consecutive IBD out-patients and 24 healthy volunteers were enrolled in this study. IBD patients were grouped into: 1. BMI<18.5 kg/m(2); 2. BMI=18.5-24.9 kg/m(2); and 3. BMI >= 25 kg/m(2) and according to MNA (R) score as: 1. MNA (R) <17, 2. MNA (R)=17.5-23.5 and 3. MNA (R)>= 24. Interventions: Demographical data and nutritional index parameters (BMI, FM, FFM) were evaluated. MNA was assessed by a questionnaire. Main outcome measures: Fasting serum levels of albumin, glucose, total cholesterol, triglyceride, C-reactive protein (CRP), vitamin B12, folic acid, ferritin, fetuin-A, hemoglobin and white blood cell count were measured. Results: The level of CRP was significantly higher and fetuin-A was significantly lower (both P<.001) in IBD patients than in healthy subjects. Age (P<.001), MNA (R) total score (P=.001), FM (P<.001), FFM (P=.003) and fetuin-A (P=.012) were significantly different between the BMI groups. There was a significant difference in BMI (P<.001), FM (P<.001), FFM (P<.001), levels of Fetuin-A (P=.030) and CRP (P=.030) between MNA (R) groups. There was a weak correlation between fetuin-A and BMI (r=0.249,P=.030). Conclusion: in this study, fetuin-A, a negative acute phase protein is shown to be related to BMI in IBD patients. Serum fetuin-A levels were the lowest both in MNA<17 and BMI<18.5 kg/m(2), which showed us that it can predict nutritional status in IBD patients.Öğe Serum N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) levels in hyperthyroidism and hypothyroidism(Taylor & Francis Inc, 2007) Oezmen, Bilgin; Oezmen, Dilek; Parildar, Zuhal; Mutaf, Isil; Bayindir, OyaNatriuretic peptides represent a novel diagnostic tool in the assessment of heart failure. N-terminal-pro-B-type natriuretic peptide (NT-proBNP), a member of the natriuretic peptid family, is produced and released from cardiac ventricles. Changes in cardiac functions are observed in thyroid dysfunctions. The aim of this study was to assess the changes in serum NT-proBNP levels and to evaluate impact of thyroid hormones on serum NT-proBNP in patients with hyperthyroidism and hypothyroidism. Serum NT-proBNP levels were measured in 21 patients with hyperthyroidism and in 24 patients with hypothyroidism and compared with 20 healthy control subjects. Patients without cardiac disease were included into the study as well. Serum NT-proBNP levels were measured by electrochemiluminescence immunoassay. Serum NT-proBNP levels were higher in hyperthyroid patients than in hypothyroid patients and in control subjects, with mean values of 239.03 +/- 47.33, 45.97 +/- 13.48, 55.57 +/- 13.01 pg/ml, respectively (p < 0.0001). Serum NT-proBNP and thyroid hormones were correlated in all patients. Moreover, there was a significant positive correlation between serum NT-proBNP and serum free T4 (FT4) levels (r = 0,549, p = 0.012) in hyperthyroidic patients. Multiple regression analyses demonstrated that increasing FT4 was independently associated with a high serum NT-proBNP levels, whereas heart rate was not in hyperthyroid patients. Serum NT-proBNP levels are higher in the hyperthyroid state as compared with the hypothyroid and euthyroid state. Thyroid dysfunction affects serum NT-proBNP levels, possibly influencing the secretion of the peptide. Therefore, thyroid function has to be considered when evaluating high serum NT-proBNP levels in patients without cardiac dysfunction.
