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    A meta-analyses on the role of IL-6 associated JAK/STAT3 signaling pathway modulation in the inflammatory bowel disease complicated colonic cancer development
    (Nizameddin KOCA, 2021) Çetin, Ece Ünal; Beyazıt, Yavuz
    The signalling pathway of Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) is suggested to be involved in various pathophysiological processes, including immune function, cell growth, differentiation, hematopoiesis and more importantly oncogenesis of distinct tumoral conditions. Interleukin (IL) 6 is a proinflammatory cytokine produced by antigen-presenting cells and non-hematopoietic cells in response to external stimuli and considered to be a key player in the development of the microenvironment of malignancy by promoting tumor growth and metastasis by acting as a bridge between chronic inflammation and cancerous tissue. Recent studies suggest that aberrant interleukin IL6/JAK/STAT3 signaling pathway exists in both IBD and inflammation-related gastrointestinal cancers. In the present meta-analysis we aimed to analyze the relationship between IL-6/JAK/STAT3 and IBD associated colorectal carcinogenesis and the effect of the inhibition of this system on disease follow-up and management.In light of the small number of studies able to be included in the meta-analysis evidence strongly proposed that JAK/STAT3 signaling, especially via the IL-6/STAT3 axis is involved in the transition of inflammatory lesions to tumoral diseases and leading to ulcerative colitis associated colorectal cancer. For this reason, based on the evidence presented in this meta-analysis it is reasonable to suggest that targeting components of the IL-6/JAK/STAT3 signalling pathway can inhibit tumour cell growth and relieve immunosuppression in the UC associated colonic tumoral microenvironment.
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    An Unforgettable Pre-Diagnosis for an Elderly Patient with Renal Failure and Back Pain: Multiple Myeloma
    (Nizameddin KOCA, 2021) Çetin, Ece Ünal; Çetin, Adil Uğur
    Multiple myeloma is a malignant disease that can result in organ damage due to abnormal plasma cell growth and immunoglobulin or light chain overproduction in the bone marrow. It is the second most common hematologic cancer after lymphomas. Approximately half of the patients have kidney failure. Bone involvement is one of the most common organ damage in myeloma. Bone involvement is a feature that has diagnostic and prognostic value, shows tumor burden, organ damage, and affects the patient's quality of life. With the recent advances in Multiple Myeloma treatment, the survival of patients has increased dramatically. Although new agents contribute positively to total survival and disease-free life span, they cannot prevent disease recurrence. Therefore, it should be considered in patients with back pain, anemia, and kidney failure, and treatment delay should be avoided.
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    Comparison of plasma levels of Pre?1-HDL with EAT thickness in patients with chronic kidney disease
    (Turkish Society of Nephrology, 2021) Bakırdöğen, Serkan; Çakır, Dilek Ülker; Akşit, Ercan; Çetin, Ece Ünal
    Objective: The levels of plasma preβ-HDL increase as the stages of chronic kidney disease (CKD) progress. Epicardial adipose tissue (EAT) increases the risk of cardiovascular incidents in patients with moderate to severe CKD. The aim of our study was to compare the levels of plasma preβ1-HDL with the EAT thickness on transthoracic echocardiography in patients with CKD (stage 3-5). Methods: Forty-four patients with CKD and 44 healthy volunteers (control group) were included in the study. Plasma preβ1-HDL was measured with ELISA (enzyme-linked immunosorbent assay) method in both groups. EAT thickness (both systole and diastole) was evaluated by the same cardiologist on the transthoracic echocardiographic method only in the patient group. P < .05 was accepted as statistically significant. Results: The mean plasma preβ1-HDL level was higher in the patient group compared to the control group but did not reach statistical significance. It was determined that the level of mean preβ1-HDL was increased in CKD patients as the stages progress but the result was not statistically significant. When the level of mean plasma preβ1-HDL and EAT thickness of CKD patients were compared, a statistically significant and negative correlation was determined (P = .013, r = −0.398; P = .006, r = −0.441, respectively, for systole and diastole). Conclusion: We determined a statistically significant and negative relationship between the levels of plasma preβ1-HDL and EAT thickness in CKD patients.
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    Evaluation of the hematologic indices in patients with thyrotoxicosis with distinct etiologies: a case-control study
    (2021) Çetin, Ece Ünal; Kamış, Fatih; Karakılıç, Ersen; Arslan, Mehmet; Beyazit, Yavuz
    Aim: Thyrotoxicosis is a clinical state of inappropriately high levels of free T4 (thyroxine) and/or free T3 (tri-iodothyronine)in the body caused by distinct etiologies including Graves’ disease (GD), subacute thyroiditis (SAT), toxic adenoma and toxicmultinodular goiter (TMNG). Simple hematologic indices such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyteratio (PLR) and mean platelet volume (MPV) have increasingly been mentioned as measures of presence and severity ofthyrotoxicosis. In this study, we aimed to analyze whether there is a link between these peripheral blood parameters and thepresence of thyrotoxicosis.Material and Method: A total of 46 GD, 46 TMNG, 39 TA and 45 SAT patients and 45 healthy controls were included.Laboratory parameters and NLR, PLR, and MPV values were recorded from peripheral blood complete blood cell counts foreach patient.Results: This study showed that NLR and PLR levels are elevated in patients with SAT in comparison with other thyrotoxicpatient groups and controls. The post hoc analysis of comparison of NLR and PLR in each study groups revealed that NLRand PLR were statistically different in the SAT group in comparison to the GD, TMNG, TA, and healthy controls. A significantdecrease in the level of MPV was demonstrated in thyrotoxicosis patients (p<0.001).Conclusion: NLR, PLR and MPV that is routinely and automatically calculated from complete blood count plays an importantdiagnostic role in thyrotoxicosis.
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    False-positive results of lupus anticoagulant tests should be kept in mind in pregnant patients receiving low molecular weight heparin
    (Galenos Publishing House, 2021) Beyazit, Fatma; Çetin, Ece Ünal; Beyazit, Yavuz
    We read the article by Dr Izhar et al. (1), entitled “Antiphospholipid antibodies in women presenting with preterm delivery because of preeclampsia or placental insufficiency”, in the last issue of your journal with great interest. The authors observed a high prevalence of anti-phospholipid antibodies (APLA) in women who have preterm delivery due to preeclampsia or placental insufficiency (PREPI), corroborating the results of previous reports. Their findings are of great interest and finally shed some more light on this interesting topic. Therefore, we would like to commend the authors for addressing this issue. However, several points caught our attention while reading this paper and we would like to highlight these to the reader.
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    Primary Membranous Glomerulonephritis in a Young Patient with Proteinuria
    (Nizameddin KOCA, 2021) Çetin, Ece Ünal; Çetin, Adil Uğur
    Membranous nephropathy is a common form of glomerulonephritis that typically presents with nephrotic syndrome between the 3rd and 5th decades and one-third of patients experience spontaneous remission. Here, a patient with primary membranous nephropathy is presented.
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    Retrospective analysis of patients underwent colonoscopic polypectomy: A two-center study
    (2020) Kamış, Fatih; Tanoğlu, Alpaslan; Çetin, Ece Ünal; Beyazıt, Yavuz; Yazgan, Yusuf
    Colonoscopy is a widely used modality for detecting colonic pathologies nearly all over the world. In this retrospective analysis, we aimed to determine the prevalence ofcolonic polyps and their histopathological results based on colonoscopies performed in the gastroenterology unit in Çanakkale Onsekiz Mart University Health Practiceand Research Hospital and Istanbul Sultan Abdulhamidhan Training and Research Hospital. Patients underwent colonoscopic examination due to lower gastrointestinalsystem complaints between 01/01/2014 and 01/12/2019 were evaluated. Patient age, gender, indications, colonoscopic findings, polyp number, size and histopathologicresults of the lesions were recorded. A total of 1040 polyps were detected from 839 polypectomy operations performed according to the colonoscopic evaluation of 9044patients between January 2014 and January 2019. Bleeding after polypectomy was observed in 8 (0.95%) patients and all of the bleedings were controlled with sclerotherapyand/or heater probe coagulation. According to the polyp detection sites, rectosigmoid region (49.7%) was followed by transverse colon (17.3%), descending colon(17.5%), ascending colon (10.5%) and caecum (5%). Adenomatous polyps were the most encountered histopathologic type followed by hyperplastic polyps (19.6%).Thirteen (1.25%) polyps were reported as adenocarcinoma. Polypectomy is an effective procedure of colonoscopy when performed by expert hands. In this retrospectiveanalysis, our results was found to be consistent with those of the literature in terms of polyp number, size and histopathologic characteristics.
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    Retrospective evaluation of patients with non-varicose upper gastrointestinal bleeding
    (2021) Çetin, Ece Ünal; Kamış, Fatih; Çetin, Adil Uğur; Beyazit, Yavuz
    Upper gastrointestinal tract (GIS) bleeding refers to any bleeding originates from the area from upper esophagus to the proximal of the treitz ligament. It has a wide rangeof clinical manifestations ranging from hypovolemic shock to death. Bleeding from peptic ulcer (PU) is one of the major cause of upper GIS bleeding. Despite improvementsin therapeutic endoscopy and angiography, gastrointestinal bleeding is still an important source of morbidity and mortality. Although approximately 80-85% ofupper GIS bleeding stops spontaneously, supportive treatment is required. In this study, we aimed to determine the clinical, laboratory and demographic characteristics ofpatients with upper GIS bleeding and their relationship with major scoring systems. Two hundred thirteen patients over 18 years old that were admitted to Çanakkale OnsekizMart University Training and Research Hospital between January 2016 and March 2020 with a diagnosis of non-variceal GIS bleeding were retrospectively enrolledto this study. Age, gender, blood group, comorbid conditions, endoscopic findings, laboratory values and medications were recorded for each patient. Prognostic scoringswere calculated for each patient. The mean age of patients was 68.67±14.8 years (Male/Female: 156/57). In overall, 90.7% of patients were discharged and 7.5% of patientswere transferred to intensive care unit. The mortality rate was 1.8%. Endoscopic evaluation revealed that 31.9% of patients had duodenal ulcer and 19.2% of patientshad gastric ulcer. Medical treatment was applied to 84.8% of patients and 13.4% of patients received endoscopic treatments. Length of stay was significantly correlatedwith Rockall and Glasgow Blatchford scores. This study revealed that age, comorbid conditions and prior drug history were related to predisposition to GIS bleeding.Early diagnosis and intervention might reduce the mortality in these patients. Despite early endoscopic interventions and the improvements in endoscopic techniques GISbleeding still associated with increased rates of morbidity and mortality.
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    The diagnostic value of calcium binding protein S100A8/A9 and S100A12 in acute pancreatitis
    (MediHealth Academy Yayıncılık, 2022) Bardakcı, Okan; Daş, Murat; Şehitoğlu, Hilal; Çetin, Ece Ünal; Atalay, Ünzile; Küçük, Uğur; Kamış, Fatih
    Background: S100A8/A9 and S100A12 which are the major calcium-binding proinflammatory proteins secreted by granulocytes, has been proposed to be related to distinct disease states of inflammatory origin. This study aims to explore the circulating levels of S100A8/A9 and S100A12 in acute pancreatitis (AP) and reveal their relationship with conventional inflammatory markers. Material and Method: Serum S100A8/A9 and S100A12 were determined in AP patients (male/female: 17/13) by using a specific enzyme-linked immunosorbent assay (ELISA) method at both onset and remission and in 30 healthy controls (male/female: 17/13). Results: Significantly higher S100A8/A9 and S100A12 levels were found in AP patients compared to healthy controls (p
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    The pathobiological harmony between the local pulmonary/ bone marrow RAS and its management via tissue-RAS modulating agents in COVID-19
    (MediHealth Academy Yayıncılık, 2022) Çetin, Ece Ünal; Beyazıt, Yavuz; Beyazıt, Fatma; Tanoğlu, Alpaslan; Haznedaroğlu, İbrahim Celaleddin
    Coronavirus disease 2019 (COVID-19) outbreak, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses an unprecedented threat to public health and healthcare systems. It presents unusual pathophysiological effects mainly characterized by immune-inflammatory response and prothrombotic state causing acute respiratory distress syndrome and multiple organ failure. SARS-CoV-2 enters target cells after binding to the angiotensin-converting enzyme 2 (ACE2) receptor and therefore has a direct effect on the renin-angiotensin system (RAS). Apart from affecting numerous organs including lungs, heart, gastrointestinal system, spleen, brain and kidneys, the spike protein of SARS-CoV-2 could attack hematopoietic stem cells and hematopoietic progenitor cells in bone marrow (BM) microenvironment together with the precursor and mature blood cells. Within this hematopoietic viral spread context, it is crucial to search the clinicopathological correlations of COVID-19 in order to develop specific potential therapeutics against pleiotropic SARS-CoV-2 actions. Therefore, pharmacological disruption of the pathological cross-talk of local BM RAS and pulmonary RAS via administration of the tissue-RAS modulating agents such as soluble ACE2, angiotensin (1-7), TXA127 and MAS receptor agonists may prevent the clinical progression of the COVID-19 syndrome via reducing the hematopoietic virus propagation and systemic multi-organ spread.
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    The role of serum tenascin-c and procalcitonin in predicting the severity of acute pancreatitis
    (2021) Çetin, Adil Uğur; Kamış, Fatih; Çetin, Ece Ünal; Arslan, Mehmet; Beyazit, Yavuz
    Acute pancreatitis (AP) constitutes an activation of a variety of enzymes secreted by the pancreas and is a continuing inflammatory process where the pancreas damages itself. Although a variety of factors reported to have an association with disease severity, the role of Tenascin-C and procalcitonin in the pathophsiology of the disease has not been clearly elucidated yet. Therefore, this study aimed to assess whether tenascin-C and procalcitonin would be useful in predicting disease severity and prolonged hospital stay in conjunction with several prognostic scoring systems. A total of 44 AP patients (male/female: 24/20), and 40 healthy subjects (male/female: 20/20) were enrolled in this study. Tenascin-C and procalcitonin levels with other markers of inflammation were measured for all study participants. Prognostic scoring systems were used as to predict the disease severity in AP patients. Serum tenascin-C levels was higher in AP patients at onset of the disease compared with healthy controls. There were statistically significant and positive differences identified between serum Tenascin-C with Atlanta (p=0.000 r=0.538), Ranson (p=0.041 r=0.310) and Imrie (p=0.039 r=0.312) scoring systems. There was a statistically significant and positive correlation between CRP with serum tenascin-C (p=0.015 r=0,366) levels. Serum tenascin-C levels had high sensitivity (76.5%) and specificity (77.8%) for prediction of severe pancreatitis according to the Atlanta scoring system (AUC:0.809). The present study demonstrated that tenascin-C and procalcition levels are elevated in AP. Moreover, the appraisal of tenascin-C levels in patients with AP in conjunction with other markers of inflammation may provide additional information in estimating AP severity
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    Varis dışı üst gastrointestinal sistem kanaması nedeniyle hospitalize edilen hastaların prognozunu etkileyen faktörlerin retrospektif değerlendirilmesi
    (Çanakkale Onsekiz Mart Üniversitesi, 2020) Çetin, Ece Ünal; Beyazit, Yavuz
    Giriş ve Amaç: Üst gastrointestinal sistem (GİS) kanaması, üst özofagustan treitz ligamentinin proksimaline kadar olan bölgeden kaynaklanan kanama anlamına gelir. Hipovolemik şoktan ölüme kadar çok çeşitli klinik bulgulara sahiptir. Peptik ülser (PÜ) kanaması, üst GIS kanamasının ana nedenlerinden biridir. Terapötik endoskopi ve anjiyografideki gelişmelere rağmen, gastrointestinal kanama hala önemli bir morbidite ve mortalite kaynağıdır. Üst GİS kanamasının yaklaşık% 80-85'i kendiliğinden dursa da, destekleyici tedavi gereklidir. Bu çalışmada, üst GİS kanaması olan hastaların klinik, laboratuvar ve demografik özelliklerini ve majör skorlama sistemleri ile ilişkilerini belirlemeyi amaçladık. Materyal-Metod: Ocak 2016 ile Mart 2020 arasında Çanakkale Onsekiz Mart Üniversitesi Eğitim ve Araştırma Hastanesi'ne varis dışı GİS kanaması tanısı ile başvuran 18 yaşın üzerindeki 213 hasta retrospektif olarak çalışmaya dahil edildi. Her hasta için yaş, cinsiyet, kan grubu, eşlik eden durumlar, endoskopik bulgular, laboratuvar değerleri ve ilaçlar kaydedildi. Her hasta için prognostik skorlar hesaplandı. Bulgular: Hastaların ortalama yaşı 68,67±14,8 yıl idi(Erkek/Kadın: 156/57) Genel olarak hastaların %90,7'si taburcu edildi ve %7,5'i yoğun bakım ünitesine transfer edildi. Mortalite oranı %1,8 idi. Endoskopik değerlendirmede hastaların %31,9'unda duodenal ülser, %19,2'sinde mide ülseri olduğu saptandı. Hastaların %84,8'ine tıbbi tedavi uygulandığı ve %13,4'üne endoskopik tedavi uygulandığı saptandı. Yatış süresi Rockall ve Glasgow Blatchford skorları ile anlamlı derecede korele idi. Sonuç: Bu çalışma yaş, komorbid durumlar ve önceki ilaç öyküsünün GİS kanamasına yatkınlıkla ilişkili olduğunu ortaya koymuştur. Erken tanı ve müdahale bu hastalarda mortaliteyi azaltabilir. Erken endoskopik müdahalelere ve endoskopik tekniklerdeki gelişmelere rağmen, GİS kanaması hala artan morbidite ve mortalite oranları ile ilişkilidir. Anahtar Kelimeler: Üst Gastrointestinal sistem kanaması, Glasgow-Blatchford skoru, Rockall sınıflaması, Tedavi