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    Advancing ICU mortality prediction in community-
    (Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2025) Cetin, Ece Unal; Kurtkulagi, Ozge; Kamis, Fatih; Das, Murat; Simsek, Esen; Cetin, Adil Ugur; Beyazit, Yavuz
    Community-acquired pneumonia (CAP) is a leading cause of ICU admissions, with significant morbidity and mortality. Traditional risk stratification tools such as CURB-65, the Pneumonia Severity Index (PSI), and CT severity scores (CT-SS) are widely used for prognosis but could be improved by incorporating novel biomarkers. This retrospective study evaluated the fibrinogen-to-albumin ratio (FAR) as an additional predictor of 30-day mortality in ICU patients with CAP. A total of 158 CAP patients admitted to a tertiary care ICU were included. Baseline data encompassed demographic, clinical, laboratory, and radiological parameters, including FAR, CURB-65, PSI, and CT-SS. Logistic regression and ROC curve analyses were conducted to assess mortality predictors. The 30-day mortality rate was 70.88% (112/158). Higher FAR, PSI, CURB-65, CT-SS, and lactate levels were independently associated with increased mortality (p < 0.05). FAR demonstrated strong discriminatory power (AUROC: 0.704) and significantly improved the predictive accuracy of established models. Adding FAR to PSI increased the area under the receiver operating characteristic (AUROC) from 0.705 to 0.791 (p = 0.009), while combining FAR, CT-SS, and PSI yielded the highest predictive accuracy (AUROC: 0.844, p = 0.032). These findings suggest that FAR, which reflects both inflammation and nutritional status, complements traditional risk assessment tools by providing a dynamic perspective. Integrating FAR into existing models enhances the identification of high-risk patients, enabling timely interventions and more efficient resource allocation in the ICU.
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    Ankaferd hemostat (ABS) as a potential mucosal topical agent for the management of COVID-19 syndrome based on its PAR-1 inhibitory effect and oestrogen content
    (Churchill Livingstone, 2020) Beyazit, Fatma; Beyazit, Yavuz; Tanoglu, Alpaslan; Haznedaroglu, Ibrahim C.
    COVID-19 due to the SARS-CoV-2 infection is a multi-systemic immune syndrome affecting mainly the lungs, oropharyngeal region, and other vascular endothelial beds. There are tremendous ongoing efforts for the aim of developing drugs against the COVID-19 syndrome-associated inflammation. However, currently no specific medicine is present for the absolute pharmacological cure of COVID-19 mucositis. The re-purposing/re-positioning of already existing drugs is a very important strategy for the management of ongoing pandemy since the development of a new drug needs decades. Apart from altering angiotensin signaling pathways, novel drug candidates for re-purposing comprise medications shall target COVID-19 pathobiology, including pharmaceutical formulations that antagonize proteinase-activated receptors (PARs), mainly PAR-1. Activation of the PAR-1, mediators and hormones impact on the hemostasis, endothelial activation, alveolar epithelial cells and mucosal inflammatory responses which are the essentials of the COVID-19 pathophysiology. In this context, Ankaferd hemostat (Ankaferd Blood Stopper, ABS) which is an already approved hemostatic agent affecting via vital erythroid aggregation and fibrinogen gamma could be a potential topical remedy for the mucosal management of COVID-19. ABS is a clinically safe and effective topical hemostatic agent of plant origin capable of exerting pleiotropic effects on the endothelial cells, angiogenesis, cell proliferation and vascular dynamics. ABS had been approved as a topically applied hemostatic agent for the management of post-surgical/dental bleedings and healing of infected inflammatory mucosal wounds. The anti-inflammatory and proteinase-activated receptor axis properties of ABS with a considerable amount of oestrogenic hormone presence highlight this unique topical hemostatic drug regarding the clinical re-positioning for COVID-19-associated mucositis. Topical ABS as a biological response modifier may lessen SARS-CoV-2 associated microthrombosis, endothelial dysfunction, oropharyngeal inflammation and mucosal lung damage. Moreover, PAR-1 inhibition ability of ABS might be helpful for reducing the initial virus propagation and mocasal spread of COVID-19.
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    Comparison of different risk stratification systems for prediction of acute pancreatitis severity in patients referred to the emergency department of a tertiary care hospital
    (Turkish Assoc Trauma Emergency Surgery, 2022) Bardakci, Okan; Akdur, Gokhan; Das, Murat; Siddikoglu, Duygu; Akdur, Okhan; Beyazit, Yavuz
    BACKGROUND: Prognostic prediction and estimation of severity at early stages of acute pancreatitis (AP) are crucial to reduce the complication rates and mortality. The objective of the present study is to evaluate the predicting ability of different clinical and radiological scores in AP. METHODS: We retrospectively collected demographic and clinical data from 159 patients diagnosed with AP admitted to Canakkale Onsekiz Mart University Hospital between January 2017 and December 2019. Bedside index for severity AP (BISAP), and acute phys-iology and chronic health evaluation II (APACHE II) score at admission, Ranson and modified Glasgow Prognostic Score (mGPS) score at 48 h after admission were calculated. Modified computed tomography severity index (CTSI) was also calculated for each patient. Area under the curve (AUC) was calculated for each scoring system for predicting severe AP, pancreatic necrosis, length of hospital stay, and mortality by determining optimal cutoff points from the (ROC) curves. RESULTS: mGPS and APACHE II had the highest AUC (0.929 and 0.823, respectively) to predict severe AP on admission with the best specificity and sensitivity. In predicting mortality BISAP (with a sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 75.0%, 70.9%, 98.2%, and 12.0%, respectively, [AUC: 0.793]) and APACHE II (with a sensitivity, specificity, NPV and PPV of 87.5%, 86.1%, 99.2%, and 25.0%, respectively, [AUC: 0.840]). CONCLUSION: mGPS can be a valuable tool in predicting the patients more likely to develop severe AP and maybe somewhat better than BISAP score, APACHE II Ranson score, and mCTSI.
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    Diagnostic utility of hematological indices in predicting adverse outcomes and severity of acute pancreatitis based on BISAP and modified score
    (Turkish Assoc Trauma Emergency Surgery, 2022) Akdur, Gokhan; Bardakci, Okan; Das, Murat; Akdur, Okhan; Beyazit, Yavuz
    BACKGROUND: The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte-ratio (PLR), and red blood cell distribution width (RDW) are simple indicators of inflammatory status previously established as a severity indicator in distinct disease states. This study aimed to determine the impact of these simple hematologic indices with conventional inflammation markers such as C-reactive protein (CRP) and white blood cells in acute pancreatitis (AP) patients and their relationship with AP risk stratification scores including Bedside Index for Severity of Acute Pancreatitis (BISAP) and modified Glaskow Prognostic score (mGPS) scores. METHODS: This retrospective study was performed in the emergency department of Canakkale Onsekiz Mart University. A total of 171 patients (male/female: 68 [39.8%]/103 [60.3%]) with AP and 59 age and gender matched healthy subjects (male/female: 23 [39%]/36[61%]) as controls were enrolled in the present study. The patients were grouped according to severity and adverse outcomes according to BISAP and mGPS and a comparative analysis was performed to compare the NLR, PLR, and RDW between groups. RESULTS: The mean NLR values of AP patients and control group were 9.62 +/- 6.34 and 2.04 +/- 1.08, respectively (p<0.001), while the mean PLR values of AP patients and control group were 221.83 +/- 122.43 and 83.30 +/- 38.89, respectively (p<0.001). Except from RDW, all the other hematologic indices were found to be elevated (p<0.05 for WBC; NLR, PLR, and CRP) on both mild and severe disease at disease onset. NLR and PLR showed significant predictive ability for estimating serious complications associated with AP. CONCLUSION: The present study showed that NLR and PLR is increased in AP. Moreover, peripheral blood NLR and PLR values can predict disease severity and adverse outcomes associated with AP and can be used as an adjunctive marker for estimating disease severity.
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    Diagnostic utility of microhematuria in renal colic patients in emergency medicine: correlation with findings from multidetector computed tomography
    (2019) Daş, Murat; Bardakçı, Okan; Yurtseven, Ersan; Akman, Canan; Beyazit, Yavuz; Akdur, Okhan
    Although urine analysis is a simple and inexpensive method for the initial evaluation of renal colic patients presenting in emergency departments, it is regarded as unreliable for an exact diagnosis of urinary system stones. The aim of the present study is to assess the association between clinical demographics, and stone size and location, with the combined utility of urinalysis and unenhanced multidetector computed tomography (MDCT) in the emergency department. After gaining local Ethics Committee approval, a retrospective study was conducted with data from 186 patients who presented at our emergency service with flank pain and documented urolithiasis. Stone location and size was determined by MDCT, and the presence of microhematuria confirmed by urinalysis. The presence of hydronephrosis and clinical complaints were also recorded. A total of 186 patients were included in the present study, in which an absence of microhematuria was recorded in 24.7% patients. Urine density was found to be elevated in the microhematuria group (p=0.001). Upper urinary tract stones and hydronephrosis were found to be associated with the presence of microhematuria. Although statistically insignificant, an increased trend of microhematuria was observed with stones over 5 mm in size. Urinary stone size and location are directly associated with the incidence of microhematuria. Absence of microhematuria does not preclude MDCT imaging, however, especially in cases where stones are suspected in patients with renal colic.
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    Diagnostic utility of simple hematologic markers in acute gastroenteritis patients admitted to the emergency department
    (2020) Bardakçı, Okan; Daş, Murat; Akdur, Gökhan; Beyazit, Yavuz
    The contributions of hematologic parameters to the inflammatory response via different leukocyte and platelet pathways are well known. However, the diagnostic yield ofthese parameters in acute gastroenteritis (AGE) is not yet well understood. This study was planned to investigate the diagnostic value of simple hematological markers,including mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), platelet distribution width (PDW), and platelet-to-lymphocyteratio (PLR), in patients with AGE admitted to the emergency department. A total of 57 patients with AGE of either viral or bacterial origin and 69 age and sexmatchedcontrol subjects were studied. NLR, PLR, MPV, PDW, and RDW values in all patients were calculated and recorded from complete blood cell counts. A total of126 patients (57 men [45.2%] and 69 women [54.8%]) were included in the study. The mean NLR and PLR values of AGE patients were significantly higher than thoseof health controls (NLR = 4.44 ± 4.1 for AGE patients and 2.22 ± 1.2 for controls [P < 0.001]; PLR = 160.4 ± 102.4 for AGE patients and 113.8 ± 42.6 for controls [P =0.02]. ROC curve analysis suggested that the optimum NLR cut-off point for AGE was 2.08, with a sensitivity, specificity, PPV, and NPV of 70%, 65%, 62%, and 72%,respectively (AUC = 0.704). The optimum PLR cut-off point for AGE was 105.55, with sensitivity, specificity, PPV, and NPV of 71%, 50%, 54%, and 68%, respectively(AUC = 0.648). We demonstrated that NLR and PLR levels are elevated in AGE patients. Thus, NLR and PLR levels can be considered a valuable tool to differentiateacute gastroenteritis from other non-inflammatory emergent conditions.
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    Evaluation of clinical features, treatment options and complications in patients with inflammatory bowel disease
    (2022) Ugar, Mucahit; Kamış, Fatih; Beyazit, Yavuz
    Introduction: Inflammatory bowel diseases (IBD) form a group of inflammatory diseases occurring in genetically-susceptible people, which are characterized by chronic progression and whose cause is not fully known. The aim of this study is to determine the incidence of IBD in our region and examine the clinical characteristics, sociodemographic features, and treatment results of IBD patients. Methods: Our study retrospectively investigates 211 patients over 18 years of age who were monitored for an IBD diagnosis between January 2, 2013, and December 31, 2019, by the gastroenterology department of Canakkale Onsekiz Mart University’s Faculty of Medicine. The mean age, female-male ratio, smoking habits, disease severity, and localization sites were identified for included patients. Local and systemic complications of administered treatment types and reasons for surgical treatment were also assessed in patients. Results: Of the 211 patients with IBD diagnoses, 158 (74.9%) had Ulcerative Colitis (UC) and 53 (25.1%) had a diagnosis of Crohn’s disease (CD). The mean age at the time of diagnosis was 43.97±16.22 years for UC patients and 42.30±14.73 years for CD cases. The involvement sites for UC were distal colitis for 58.4% of patients, left colon for 24.1% of patients, pancolitis for 16.5% of patients, and backwash ileitis for 7% of patients. According to the treatment results, 152 (72.0%) patients took 5-aminosalicylate (5-ASA) alone, 48 (22.8%) took thiopurine, and 20 (9.5%) took anti-TNF. Conclusion: Knowing the demographic, clinical, and laboratory features of these diseases, which are frequently seen in our region, can support the early identification of probable complications that may occur and the selection of appropriate approaches during diagnosis, treatment, and follow-up monitoring of these diseases. Keywords: Inflammatory Bowel Diseases, Ulcerative Colitis, Crohn’s Disease, Severity of Illness Index, Abdominal Pain, Diarrhea
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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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    Haemogram indices are as reliable as CURB-65 to assess 30-day mortality in Covid-19 pneumonia
    (Scientific Scholar Llc, 2022) Bardakci, Okan; Das, Murat; Akdur, Gokhan; Akman, Canan; Siddikoglu, Duygu; Beyazit, Yavuz; Akdur, Okhan
    Background. Mortality due to Covid-19 and severe community-acquired pneumonia (CAP) remains high, despite progress in critical care management. We compared the precision of CURB-65 score with monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio ( NLR), platelet-to-lymphocyte ratio (PLR) in prediction of mortality among patients with Covid-19 and CAP presenting to the emergency department. Methods. We retrospectively analysed two cohorts of patients admitted to the emergency department of Canakkale University Hospital, namely (i) Covid-19 patients with severe acute respiratory symptoms presenting between 23 March 2020 and 31 October 2020, and (ii) all patients with CAP either from bacterial or viral infection within the 36 months preceding the Covid-19 pandemic. Mortality was defined as in-hospital death or death occurring within 30 days after discharge. Results. The first study group consisted of 324 Covid-19 patients and the second group of 257 CAP patients. The non-survivor Covid-19 group had significantly higher MLR, NLR and PLR values. In univariate analysis, in Covid-19 patients, a 1-unit increase in NLR and PLR was associated with increased mortality, and in multivariate analysis for Covid-19 patients, age and NLR remained significant in the final step of the model. According to this model, we found that in the Covid-19 group an increase in 1-unit in NLR would result in an increase by 5% and 7% in the probability of mortality, respectively. According to pairwise analysis, NLR and PLR are as reliable as CURB-65 in predicting mortality in Covid-19. Conclusions. Our study indicates that NLR and PLR may serve as reliable predictive factors as CURB-65 in Covid-19 pneumonia, which could easily be used to triage and manage severe patients in the emergency department.
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    Letter to the Editor: the effect of folic acid supplementation on oxidative stress is strictly related to serum homocysteine levels
    (Springer Heidelberg, 2022) Beyazit, Fatma; Pek, Eren; Beyazit, Yavuz
    [Anstract Not Available]
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    Oral High-Dose Ankaferd Administration Effects on Gastrointestinal System
    (Ivyspring Int Publ, 2013) Akbal, Erdem; Koklu, Seyfettin; Astarci, Hesna Muzeyyen; Kocak, Erdem; Karaca, Gokhan; Beyazit, Yavuz; Topcu, Guler
    Background and aims: Ankaferd Blood Stopper (ABS) is a herbal extract obtained from five different plants. It has a therapeutic potential for the management of external hemorrhage and controlling gastrointestinal bleeding. However, ABS's effects are not unknown on gastrointestinal systems. The aim of this study was to assess the effect of short-and long-term systemic exposure and gastrointestinal safety following the oral administration of high-dose ABS in rats. Methods: Eighteen healthy adult male rats were included into the study. The rats were divided into 4 groups: group A was fed with high dose ABS (2ml/Kg) for one week, group B for one month, group C for three months and group D's diet did not contain any ABS. On termination of the ABS treatment, the gastrointestinal system from the esophagus to the anus and the liver were surgically removed and histological investigated. Results: During the study period, there was no mortality; signs of intoxication in any of the studied groups. No gastrointestinal tissue fibrosis, dysplasia, or metaplasia was detectable in any of the groups. The stomach had a normal morphology in all groups. However, the other gastrointestinal tract sections showed mucosal inflammation, goblet cell decrements, and intra-epithelial lymphocyte infiltration. The most common changes were mucosal inflammation in all rats in group B and C. Frequency of inflammation was greater in groups B and C in comparison to group A (P=0.001). Loss of goblet cell and intra-epithelial lymphocyte infiltration were not significantly different between groups A and B (P=0.308 and P=0.189, respectively). However, there was significantly higher intra-epithelial lymphocyte infiltration in group C than in group A (P=0.04). Histopathological examination of the liver showed no inflammation, fibrosis, bile duct destruction or proliferation in any of the groups. However, each groups revealed vascular dilatation and erythrocyte accumulation at the sinusoidal structures of the liver. Conclusions: ABS seems to be a safe agent and it can be used for hemorrhage originated from gastric lesions. Further work needs to be done to establish whether ABS leads to be used to stop gastrointestinal bleeding.
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    Prediction of mortality with Charlson Comorbidity Index in super-elderly patients admitted to a tertiary referral hospital
    (Cukurova Univ, Fac Medicine, 2022) Das, Murat; Bardakci, Okan; Akdur, Gokhan; Kankaya, Imran; Bakar, Coskun; Akdur, Okhan; Beyazit, Yavuz
    Purpose: In most countries, there is an ever-increasing admission rate of the elderly population into emergency departments (EDs). In particular, these elderly patients differ from younger patients because they have multiple comorbidities that affect the functionality and quality of life. The goal of this study is to reveal whether the Charlson comorbidity index (CCI) foresee the short- and long-term prognosis of the super-elderly patient population. Materials and Methods: The study was a descriptive, retrospective analysis of emergency department (ED) admissions by patients over 85 years of age and admitted to the Canakkale Onsekiz Mart University (COMU) Hospital between 2013 and 2018. The demographic data of the patients were analyzed according to CCI. Cox-regression analyses were conducted to determine whether the variables affected mortality. Results: A total of 1142 patients aged 85 and older (507 men, 635 women) with a mean age of 86.96 +/- 2.49 were included in the study. According to the multivariable Cox regression analysis male gender, CCI >= 6 and ICU admission were significantly associated with increased mortality rates Conclusion: The CCI predicts short and long-term prognosis in acutely ill, hospitalized super-elderly patients. The CCI could be used to select super-elderly patients at admission as an indicator of improvement at hospital discharge.
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    Prognostic performance of peripheral perfusion index and shock index combined with ESI to predict hospital outcome
    (W B Saunders Co-Elsevier Inc, 2020) Das, Murat; Bardakci, Okan; Siddikoglu, Duygu; Akdur, Gokhan; Yilmaz, Musa Caner; Akdur, Okhan; Beyazit, Yavuz
    Introduction: Peripheral perfusion index (PPI) and shock index (SI) are considered valuable predictors of hospital outcome and mortality in various operative and intensive care settings. In the present study, we evaluated the prognostic capabilities of these parameters for performing emergency department (ED) triage, as represented by the emergency severity index (ESI). Methods: This prospective cross-sectional study included 367 patients aged older than 18 years who visited the ED of a tertiary referral hospital. The ESI triage levels with PPI, SI, and other basic vital sign parameters were recorded for each patient. The hospital outcome of the patients at the end of the ED period, such as discharge, admission to the hospital and death were recorded. Results: A total of 367 patients (M/F: 178/189) admitted to the ED were categorized according to ESI and included in the study. A decrease in diastolic BP, SpO2 and PPI increased the likelihood of hospitalization and 30-day mortality. Based on univariate analysis, a significant improvement in performance was found by using age, diastolic BP, mean arterial pressure, SpO2, SI and PPI in terms of predicting high acuity level patients (ESI < 3). In the multivariable analysis only SpO2 and PPI were found to predict ESI < 3 patients. Conclusion: Peripheral perfusion index and SI as novel triage instruments might provide useful information for predicting hospital admission and mortality in ED patients. The addition of these parameters to existing triage instruments such as ESI could enhance the triage specificity in unselected patients admitted to ED. (C) 2020 Elsevier Inc. All rights reserved.
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    Quality of Life in the Third Trimester of Pregnancy in Patients with Gastroesophageal Reflux Disease
    (Galenos Publ House, 2023) Beyazit, Fatma; Gungor, Aysenur Cakir; Beyazit, Yavuz; Unsal, Mesut Abduelkerim
    BACKGROUND/AIMS: Health-related quality of life (QoL) relating to mental, physical and social functioning in pregnant women with gastroesophageal reflux disease (GERD) may depend on several factors. The aim of this study was to investigate the impact of GERD on the QoL in the advanced stages of pregnancy.MATERIALS AND METHODS: A total of 53 pregnant women suffering from GERD (group 1) and 54 age, body mass index (BMI) and gestational age-matched pregnant controls (group 2) were enrolled. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was completed to measure of health-related QoL, and the Gastroesophageal Reflux Disease Questionnaire was used to assess the classical symptoms of reflux disease. Socio-demographic variables including age, gravidity, parity, BMI and previous history of GERD were noted.RESULTS: SF-36 scores were found to be significantly lower in the pregnant women with GERD in regard to the following domains: their general health (p<0.01), mental health (p<0.01), and their mental component score (p=0.01). Educational status and GERD symptoms before pregnancy were not found to have an impact on QoL in pregnant women with GERD.CONCLUSION: Pregnant women with GERD seem to have a poorer QoL in many respects.
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    Retrospective Analysis of demographic and laboratory characteristics of patients with liver cirrhosis: A single center experience
    (2023) Çelik, Zübeyir; Baştürk, Gizem; Beyazit, Yavuz
    Liver cirrhosis is a progressive, irreversible disease constituted by a decrease in normal hepatocytes, diffuse fibrosis, and regeneration nodules due to liver damage developed by the chronic inflammation process. This study aims to evaluate patients with liver cirrhosis who applied to Çanakkale Onsekiz Mart University (COMU) Hospital and met the criteria in terms of demographic, etiological, and laboratory values. Patient data were recorded from the hospital data recording system that was admitted to COMU hospital between January 1, 2013, and January 01, 2022. A total of 199 patients with liver cirrhosis were included in the study. Of these patients, 38.2% were female, and 61.8% were male. Their mean age was 63.43±10.73 years. When the patients were evaluated with regard to etiological distribution, the top three etiological causes of cirrhosis were cryptogenic, alcohol-induced, and HBV in 27.6%, 27.1%, and 25.1% of patients, respectively. In terms of complications, ascites were detected in 43.2% of the patients, esophageal varices in 56.3%, splenomegaly in 69.3% and hepatic encephalopathy in 7%. Over the years, the number of patients with cirrhosis due to viral hepatitis has decreased due to an increase in viral hepatitis vaccination campaigns and the spread of antiviral treatments. However, due to the rise in chronic alcohol use, alcohol appears more frequently as a significant risk factor for the etiology of liver cirrhosis.
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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 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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    To: Perfusion index for assessing microvascular reactivity in septic shock after fluid resuscitation
    (Associacao de Medicina Intensiva Brasileira - AMIB, 2019) Daş, Murat; Bardakci, Okan; Beyazit, Yavuz
    [No abstract available]