Yazar "Demir, Fidel" seçeneğine göre listele

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    Does oxidative status affect serum sclerostin levels in patients with type 2 diabetes mellitus?
    (Medical University of Plovdiv, 2023) Sabancılar, İlhan; Unsal, Velid; Demir, Fidel; Toprak, Gülten; Pekkolay, Zafer
    Introduction: Sclerostin is a glycoprotein known as a negative regulator of bone formation, predominantly expressed by mature osteocytes. There is no causative evidence information on the role of sclerostin in the pathogenesis of type 2 diabetes mellitus (T2DM) in humans. Aim: This study aimed to investigate the relationship between serum sclerostin levels and oxidative status and biochemical parameters in T2DM patients and healthy people. Materials and methods: This cross-sectional study, conducted in a clinical trial center, included 45 subjects with T2DM and 45 subjects as controls. Results: Serum sclerostin, total oxidative status (TOS), albumin, and ferritin levels were significantly higher in T2DM patients than in the control group (p<0.05). Total antioxidant status (TAS) was significantly higher in the control group (p<0.05). There was a weak positive correlation between sclerostin and TOS (r=0.23, p=0.03) and a weak negative correlation between sclerostin and TAS (r=−0.28, p=0.03). Conclusions: We have demonstrated that serum sclerostin levels increase in patients with T2DM and that the increased sclerostin levels are associated with oxidative stress.
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    The Effect of Apomorphine Therapy in the Coexistence of Parkinson's Disease and Myasthenia Gravis: A Case Report and Review of the Literature
    (Erciyes Univ Sch Medicine, 2024) Demir, Fidel; Acar, Abdullah; Akkus, Sema
    Background: The simultaneous occurrence of Parkinson's disease (PD)-a progressive neurodegenerative disorder marked by the loss of monoaminergic neurons in the substantia nigra-and Myasthenia gravis (MG)-a neuromuscular junction disease-is exceptionally rare. Although these conditions have different pathophysiological foundations, literature reports at least 29 cases of individuals diagnosed with both disorders. Case Report: We present the case of a 66-year-old patient treated for Parkinson's disease for four years before being diagnosed with MG, following the onset of dysphagia and bilateral ptosis. Apomorphine infusion, an advanced treatment option, was safely initiated. Conclusion: This case highlights the coexistence of PD and MG and illustrates the potential benefits of apomorphine infusion therapy. Apomorphine was effective in reducing symptoms, improving motor function, and enhancing the patient's quality of life.
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    Fingolimod ve glatiramer asetat kullanan ile koruyucu ilaç kullanmayan multiple skleroz hastalarında SOCS1, SOCS3, stat3 ve stat6 genlerinin mrna düzeyleri ile IL-13 ve IL-22 sitokin düzeylerinin hastalık aktivitesi, prognoz ve tedaviye yanıt üzerine olan etkilerinin araştırılması
    (Dicle Üniversitesi, Tıp Fakültesi, 2021) Demir, Fidel; Aluçlu, Mehmet Ufuk
    Amaç: Amacımız inflamatuar yanıtın oluşmasında ve regülasyonunda kilit rol oynayan janus kinaz proteinleri (JAK) / Sinyal iletimi ve transkripsiyon aktivatör proteinleri (STAT) / Sitokin sinyal inhibitor proteinleri (SOCS) yolağının bileşenlerinden olan SOCS1, SOCS3, STAT3 ve STAT6 genlerinin messenger ribonükleik asid (mRNA) düzeyleri ile interlökin-13 (IL-13) ve interlökin-22 (IL-22) sitokin düzeylerinin kronik inflamatuar bir hastalık olan multiple skleroz (MS) patogenezindeki rollerini ve terapötik yanıtı takip etmek için biyobelirteç olabilme potansiyellerini araştırmaktır. MS inflamasyon, demiyelinizasyon ve akson hasarı ile karakterize otoimmün bir santral sinir sistemi (SSS) hastalığıdır. Genetik, çevresel ve immünolojik faktörlerin kompleks interaksiyonundan dolayı MS' in patogenezi tam olarak anlaşılmamıştır. MS patogenezinde rol alan birçok sitokin JAK/STAT sinyal yolağını kullanmaktadır. MS hastalarında SOCS proteinleri ve ilişkili oldukları STAT yolakları hem MS etiyolojisi açısından hem de terapötik açıdan daha fazla araştırılması gerekmektedir. MS' de immünolojik faktörler üzerine yoğun çalışmalar yapılmasına rağmen, inflamatuar yanıtın oluşması ve regülasyonu ile ilişkili olan SOCS1, SOCS3, STAT3 ve STAT6 genlerinin mRNA düzeyleri ile IL-13 ve IL-22 sitokin düzeylerinin hastalık patogenezindeki rolleri, prognozun ve özellikle fingolimod (FTY720) veya glatiramer asetat (GA) kullanan hastalarda tedavi etkinliğinin test edilmesinde biyobelirteç olarak kullanılabilme potansiyelleri bilinmemektedir. Bu nedenle bu projede SOCS1, SOCS3, STAT3 ve STAT6 genlerinin mRNA ekspresyon düzeyleri ile IL-13 ve IL-22 sitokin düzeylerinin MS' de prognozu ve tedavide etkinliğini gösteren bir biyobelirteç ve terapötik hedef olarak kullanılıp kullanılamayacağının belirlenmesi amacı oldukça önemlidir. Gereç ve Yöntemler: Araştırmamıza Dicle Üniversitesi Tıp Fakültesi Hastanesinde Nöroloji Anabilim Dalına başvuran 2017 Revize McDonald kriterlerine göre relapsing remitting MS (RRMS) tanısı konulmuş hastalar dahil edildi. Katılımcılar; RRMS tanısı konulmuş 18-55 yaş aralığında olan en az 6 aydır FTY720 kullanan 25 hasta, en az 6 aydır GA kullanan 25 hasta, en az 6 aydır herhangi bir koruyucu MS ilacı kullanmayan veya henüz koruyucu ilaç başlanmamış yeni tanı 25 hasta ile herhangi bir kronik hastalığı olmayan 25 sağlıklı insandan oluşmaktadır. Tüm hastalara kan alınma işleminden 30 dakika önce detaylı nörolojik muayne yapıldı ve genişletilmiş özürlülük durum ölçeği (EDSS) skoru hesaplandı. Tüm hastaların cinsiyet, aile öyküsü, ilk atak şikayeti, ilk atak başlangıç yaşı, hastalık süresi, kullandığı ilaç süresi, son 1 yıldaki toplam atak sayısı, optik nörit (ON) öyküsü, oligoklonal band (OKB), immünglobulin-G (İgG) indexi, görsel uyandırılmış potansiyel (VEP), vücut kitle indexi (BMI) kaydedildi. Tüm katılımcılara D vitamini, B12 vitamini, ferritin, folat, albümin, sedimentasyon (ESR), hemoglobin (HG), lenfosit sayısı çalışıldı. Sigara ve alkol kullanımı sorgulandı. Polimeraz zincir reaksiyonu (PCR) sonucu belirlenen mRNA değerleri ile enzim bağlantılı immünosorbent testi (ELİSA) sonucu belirlenen sitokin düzeyleri bu parametrelerle karşılaştırıldı. Bulgular: Çalışmamızda SOCS-1 düzeyleri için en yüksek ortalamanın G grubundaki hastalarda olduğu ve G grubunun diğer gruplardan anlamlı farklılık gösterdiği tespit edilmiştir (sırasıyla p: 0.002, p: 0.0.002 ve p:0.028)). Ayrca sigara içenlerde SOCS-1 düzeylerinin daha düşük seyrettiği belirlenmiştir (p: 0.025). F grubunda tedavi etkinliği düşük olmayan grupta SOCS-1 ortalaması (0.0476) ve SOCS-3 ortalaması (0.2477), tedavi etkinliği düşük olan gruptaki SOCS-1 ortalamasından (0.0111) ve SOCS-3 ortalamasından (0.0953) anlamlı olarak daha yüksektir (p değeri sırasıyla SOCS-1 için 0.002, SOCS-3 için 0.003). SOCS-3 düzeyleri son 1 yıl içinde atak geçirmeyen hastalarda anlamlı oranda daha yüksek iken, 1 atak geçirenlerde daha düşük ve 2 atak geçiren hastalarda ise en düşük seviyede saptanmıştır (p: 0.016). Yapılan korelasyon analizlerinde SOCS-1 düzeyleri ile SOCS-3 düzeyleri arasında anlamlı, pozitif ve kuvvetli bir korelasyon olduğu belirlenmiştir. IL-13 düzeyinin kontrol grubunda (52.5 ± 28.33), hasta grubuna(29.22 ± 26.27) göre anlamlı oranda daha yüksek olduğu belirlendi. VEP Testi P100 latansında uzama varlığı ile çalışma parametreleri arasındaki ilişki de incelendiğinde STAT-6 düzeyleri sağ gözde latans uzaması olan hastalarda (n: 7) anlamlı oranda daha yüksek saptanmıştır (p: 0.028). Çalışmamızda SOCS1, SOCS3, STAT3, STAT6 genlerinin mRNA düzeyleri ile IL-13 sitokin düzeyleri diğer klinik, laboratuar ve demografik özellikler ile karşılaştırıldığında anlamlı bir farklılık izlenmedi. Sonuç: Çalışmamız SOCS1, SOCS3, STAT3 ve STAT6 genlerinin mRNA düzeyleri ile IL-13 sitokin düzeylerinin MS patogenezinde rol oynadığını ve tedavi etkinliğinin bir göstergesi olarak kullanılabileceğini göstermektedir.
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    A novel predictor in endovascular treatment patients for cerebral perfusion and prognosis: CHA2DS2-VASC
    (Churchill Livingstone, 2022) Özbek, Mehmet; Arık, Baran; Demir, Muhammed; Bilik, Mehmet Zihni; Akıl, Mehmet Ata; Demir, Fidel; Gültekin, Hamza; Akıl, Eşref
    Objective: Thrombolysis in Cerebral Infarction(TICI) score is used to objectively evaluate cerebral perfusion after intervention in acute stroke with mechanical thrombectomy. In our study, we aimed to compare the results of patients with successful TICI perfusion score (TICI ≥ 2c) with the results of patients with poor TICI perfusion score (TICI < 2c) and to investigate the relationship of the CHA2DS2-VASc scoring system with the final TICI perfusion score and other endpoints. Methods: For this retrospective, single-center, cross-sectional study, 278 patients who underwent endovascular thrombectomy were screened consecutively by the interventional neurology department of hospital. The primary endpoint of the study was in-hospital and 1-year all-cause death. All patients underwent cranial imaging to evaluate hemorrhagic transformation after the procedure. Results: It was observed that CHA2DS2-VASc score was significantly higher in the poor cerebral perfusion group than in the succesful cerebral perfusion group (3.19 ± 1.8 vs 2.72 ± 1.73, p = 0.046). According to Kaplan Meier's analysis, a significant difference was observed in the group with a CHA2DS2-VASc score > 2.5 in terms of all-cause mortality at follow-up compared to the group with a low CHA2DS2-VASc score (p = 0.002). According to Kaplan Meier's analysis, a significant difference was observed in the group with a poor TICI score compared to the group with a succesful one in terms of all-cause mortality at follow-up (p < 0.001). Cox regression model showed that poor TICI score group, Age ≥ 75 years, lower glomerular filtariton rate (GFR), higher high-sensitive C-reactive protein (Hs-CRP), and higher admission NIHSS score were independent predictors of 1-year all-cause mortality. Conclusion: High CHA2DS2-VASc score has been shown to be a predictor of unsuccessful cerebral perfusion score and 1-year mortality after mechanical thrombectomy in stroke patients. As a result of our research, it has been shown that complete or nearly complete reperfusion has more positive results than partial reperfusion.
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    Prognostic importance of nutritional assessment in patients with acute ischemic stroke undergoing endovascular thrombectomy
    (Verduci Editore s.r.l, 2023) Özbek, Mehmet; Akıl, Mehmet Ata; Demir, Muhammed; Arık, Baran; Demir, Fidel; Akıl, Eşref
    OBJECTIVE: The prevalence of malnutrition in patients with acute ischemic stroke (AIS) can range from 8% to 34%. It has been shown that prognostic nutritional index (PNI) and control nutritional status (CONUT) scores can provide an opportunity to make prognostic predictions in some disease groups. Previous studies have shown a close relationship between malnutrition scores and stroke prognosis. We evaluated the effect of nutritional scores on in-hospital and long-term mortality in AIS patients undergoing endovascular therapy (EVT). PATIENTS AND METHODS: 219 patients who underwent EVT for the AIS were included in this retrospective design and cross-sectional study. The primary endpoint of the study was accepted as all-cause death including in-hospital death, 1-year death, and 3-years death. RESULTS: A total of 57 patients died in the hospital. In-hospital mortality rate was higher in the high CONUT group [36 (49.3%), 10 (13.7%), 11 (15.1%), p<0.001]. A total of 78 patients died within one year, and 1-year mortality was higher in the high CONUT group [43 (58.9%), 21 (28.8), 14 (19.2), p<0.001]. At the end of the 3-year follow-up, 90 patients had died, and the 3-year mortality rate was significantly higher in groups with a high CONUT score than in those with a low CONUT score (p<0.001). CONCLUSIONS: A higher CONUT score, calculated easily by simple scoring with parameters studied from peripheral blood before the EVT procedure, is an independent predictor of in-hospital, 1-year, and 3-years all-cause mortality.
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    A Rare Complication of Diabetes Mellitus: Bruns-Garland Syndrome (Diabetic Amyotrophy)
    (Erciyes Univ Sch Medicine, 2023) Demir, Fidel; Akil, Esref
    Background: Diabetic amyotrophy, also known as diabetic proximal neuropathy, is a rare neuropathic complication of diabetes mellitus. It is most commonly characterized by severe pain in the hip and thigh, followed by asymmetric weakness and wasting of the proximal muscles of the lower limbs.Case Report: This paper presents the case of a 68-year-old man with an 8-month history of poorly controlled Type-2 diabetes mellitus who developed progressive asymmetrical weakness and atrophy in his left thigh. After a physical examination, magnetic resonance imaging, and electrophysiological studies, diabetic amyotrophy was diagnosed. Conclusion: Physicians should consider the possibility of diabetic amyotrophy in patients with diabetes mellitus who exhibit primary involvement of proximal muscles of the lower limbs, marked by pain, weakness, and atrophy.
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    Total oxidant/antioxidant status, copper and zinc levels in acute ischemic stroke patients after mechanical thrombectomy
    (Elsevier B.V., 2023) Karaaslan, Fırat; Demir, Fidel; Yılmaz, Reşit; Akıl, Eşref
    Background and purpose: We aimed to identify the relationship of total antioxidant status, total oxidant status, and copper (Cu) and zinc (Zn) situations with the short-term prognostic and stroke severity in acute ischemic stroke cases who were successfully recanalized by mechanical thrombectomy. Methods: A study of 36 acute ischemic stroke patients and 22 controls were prospectively studied. Tube samples were attained at admission and 24 h after recanalization. In patients who were successfully recanalized (thrombolysis in cerebral infarction ≥ 2b), a 3-month modified Rankin scale (mRS) score of 0–2 was considered a good prognosis, and a score of 3–6 was considered a poor prognosis. Results: Admission Cu levels were significantly higher in the poor prognosis group (p = 0.031). In the multivariate logistic regression analysis, Cu was not associated with poor prognosis (p = 0.357). Cu and Zn levels were lower in the patients group compared to controls (p = 0.014 and p = 0.010, respectively). There was no correlation between National Institute of Health Stroke Scale and biomarkers (p > 0.05). The temporal variation of biomarkers did not differ significantly between the good prognosis and poor prognosis groups (p interaction > 0.05). Conclusions: High admission Cu levels were associated with poor prognosis, but this association was limited. In addition, Cu and Zn levels were statistically lower in patients. There was no relationship between total antioxidant/oxidant status and short-term prognosis or stroke severity .