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Öğe Acil servise başvuran hastalarda sepsis ve bakteriyemi arasındaki klinik farklılıklar(Logos Yayıncılık, 2020) Gökdemir, Mehmet Tahir; Giden, Ramazan; Gökdemir, Gül ŞahikaÖz:Amaç: Acil servise yüksek ateş ile başvuran bakteriyemi ve sepsis tanısı alan hastaların, klinik velaboratuvar bulgularının karşılaştırmalı olarak inceleyerek, tanı ve tedavilerinin yönetimini, mortaliteleriüzerinde rol alan faktörleri araştırmaktır.Yöntem: Harran Üniversitesi Acil Servisine Ocak-2013 ile Aralık-2015 tarihleri arasında yüksekateş yakınması ile başvuran hastaların ateş etiyolojisine göre özellikleri dosyalarından incelendi.Bu hastalardan bakteriyemi ve sepsis tanısı alan toplam 200 hasta çalışmaya dahil edildi.Hastalar bakteriyemi ve sepsis hastaları şeklinde iki grupta toplanarak sonuçları retrospektifolarak değerlendirildi.Bulgular: Çalışmamıza dahil edilen yüksek ateşli hastaların %30’u sepsis, %70’i bakteriyemi hastasıdır.Bakteriyeli hastalarında ateş ortalaması 38,00±0,51, sepsis hastalarında 37,75±0,43 idi.Bakteriyemi hastalarında hastanede yatış süreleri ortalama 1,34±1,75 gün, sepsis grubunda iseortalama 13,98±8,75 idi. Bakteriyemi grubunda sistolik kan basıncı ortalaması 123,64±11,76mmHg, diastolik kan basıncı ortalaması 78,14±7,82 mmHg; sepsis grubunda 112,50±17,81mmHg ve 73,33±11,74 mmHg olarak bulundu. Bakteriyemi hastalarında Glaskow Koma Skalasıortalaması 15,00±0,00; sepsis grubunda 14,46±1,55 idi. Sepsisin kaynağı en sık solunum yoluenfeksiyonları olarak gözlemlendi. En sık eşlik eden hastalık diyabet idi. Taşikardi ve kan oksijensaturasyonu gibi değişkenlerin sepsiste düzeyleri düşmüş olduğu bulundu. Sepsis hastalarındakialbumin değerleri, tansiyon arteryel ve arteryel kan gazı satusasyonu daha düşük bulundu.Bunlara ek olarak kırmızı kan hücre sayısı, hematokrit ve trombosit sayısı gibi diğer hemogrambelirteçleri sepsiste bakteriyemiye göre daha düşük olduğu bulundu.Sonuç: Sepsis hastalarının önemli bir kısmı öldü. Sepsis hastaları daha fazla hastanede yatmışlardır.Hipertermi derecesi sepsiste mortalite ile ilişkili bulunmadı.Öğe The association between mean platelet volume and inflammation in geriatric patients with emergency hypertension(Emergency Medicine Association of Turkey, 2019) Gökdemir, Mehmet Tahir; Gökdemir, Gül Şahika; Tas, MahmutObjectives: We aimed to investigate the role of inflammation parameters and platelet activation in geriatric patients with hypertension. Therefore, we compared the levels of those parameters in patients with hypertensive urgency and emergency. We also investigated the potential relationship between those parameters. Methods: Ninety-six hypertensive (HT) patients (aged > 60) were included in the study in two groups: HT emergency (N = 48, group 1) and HT urgency (N = 48, group 2). Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and high-sensitive C reactive protein (hs-CRP) were compared between those groups. Optimum cut-off levels of each parameter were determined by the use of Receiver operating characteristic (ROC) curve analysis. Pearson correlation test was used to examine the relationship between variables. Results: The mean MPV and hs-CRP levels were significantly higher in patients with HT emergencies (both P < 0.001). Mean NLR was also significantly different between the two groups (P = 0.011). Pearson correlation analysis revealed a positive but weak correlation between the MPV and NLR (r = 0.245, P = 0.016), the hs-CRP level (r = 0.394, P < 0.001), and the WBC count (r = 0.362, P < 0.001). Conclusion: Increased platelet activity and inflammation are associated with the end organ failure. Levels of MPV and other inflammatory parameters may be useful in the management of geriatric patients with HT. © 2018 The Emergency Medicine Association of TurkeyÖğe The effects of rosuvastatin and pravastatin on bone metabolism in diabetic rats(İnönü Üniversitesi Tıp Fakültesi, 2021) Gökdemir, Gül Şahika; Gökdemir, Mehmet Tahir; Kayhan, Hacer; Yokuş, Beran; Taşdemir, Ezel; Gül, Cihan; Baylan, MukadderAim: In this study, the effects of rosuvastatin and pravastatin on bone metabolism were evaluated. Comparison of the positive or negative effects of two different statins on biochemical parameters related to bone metabolism in 20 mg / kg / day diabetic rats will be contribute to the enrichment of the literature on this subject. In addition, information will be obtained about whether the use of statins will be beneficial in bone metabolism disorders that may occur due to aging or diabetes in DM patients. Materials and Methods: In a diabetic rat model induced by Streptozotocin (STZ), the possible effects of Rosuvastatin and Pravastatin, both of which are hydrophilic, on biochemical parameters and histologycal examination related to bone metabolism (20 mg / kg) were examined in comparison with the control groups. Results: In the intergroup comparisons, Phosphate (P) level was lower in the Pravastatin group than the controls (P = 0.017). However, there was no difference in the P level in the Rosuvastatin group compared to the control group and the diabetes group. The calcium (Ca) level was increased in the Rosuvastatin group then the the controls (P = 0.002). However, there was no significant change in Ca level in the Pravastatin group. The vitamin D2 level of rats was similar in all groups and was not statistically significant. There was no significant difference between the groups in terms of both osteoblastic activity and bone marrow cellularity. Conclusion: In conclusion, although more extensive studies are needed, our study revealed that the serum Ca level was high in rats given rosuvastatin, and P levels were low in rats given pravastatin. But cytologically, there was no change in bone structure. Our study revealed that we should be a little more cautious about the information that statins have a positive effect on bone tissue.Öğe Importance of curcumin effect and asprosin level on glucose metabolism in diabetic rats(Effect Publishing Agency, 2023) Gökdemir, Gül Şahika; Gökdemir, Mehmet Tahir; Taşdemir, Ezel; Yokuş, Beran; Baylan, MukadderAsprosin is a new hormone secreted mainly from white adipose tissue. It may be associated with the pathogenesis of obesity, diabetes and some metabolic diseases. The changes in plasma asprosin levels of experimental diabetic rats and the relation of these changes with liver glucose metabolism and some diabetes parameters were investigated, and the effects of metformin, gliclazide or curcumin treatment on plasma asprosin levels were tried. The study was designed as an animal model in diabetic rats The albino rats were divided into five groups. To induce diabetes, a single dose of STZ was injected intraperitoneally. Diabetics rats were treated intragastrically with metformin (D+Metformin group), gliclazide (D+Giliclazide group) or 20 curcumin (D+Curcumin group) for eight weeks. Fasting blood glucose, insulin levels and other parameters were measured. Plasma asporsin levels of untreated diabetic rats increased significantly (P<.001). Although the plasma asprosin levels of diabetic rats treated with the rugs were significantly lower (P<.001). Fasting blood glucose levels of diabetic rats treated with the drugs were found to be remarkably lower than the diabetic control values (P<.001, respectively). There was no significant difference in the insulin levels and HOMA- IR between these three groups. Curcumin treatment provides significant improvements in plasma asprosin level and diabetes parameters. The increase in plasma asprosin level in diabetic rats may be one of the main reasons that facilitate the development of the disease or is responsible for its pathogenesis. Our findings support the idea that curcumin may be an important treatment option for diabetes.Öğe Prognostic significance of the chemerin level in coronavirus disease 2019 patients(Lippincott Williams and Wilkins, 2024) Gökdemir, Gül Şahika; Gökdemir, Mehmet Tahir; Araç, Songül; Yokuş, BeranIncreased serum chemerin levels have been reported in several inflammatory diseases. Few studies have investigated the relationship between chemerin and clinical features of COVID-19. Thus, chemerin may modulate the development and progression of COVID-19. We compared the serum chemerin concentration between patients with and without SARS-CoV-2 infection and its association with the severity and prognosis of COVID-19 pneumonia. This is a prospective, single-center, cross-sectional study. We enrolled COVID-19 patients who presented to our tertiary hospital and healthy controls. The COVID-19 patients were conducted and the dates of symptom onset were recorded. After admission to the hospital and stabilization, blood samples were obtained for routine hemogram, biochemistry, and chemerin. The chemerin level was 37.93?±?17.3 ng/mL in patients followed in the ICU, 29.41?±?12.79 ng/mL in inpatients, 30.48?±?10.86 ng/mL in outpatients, and 25.12?±?9.82 ng/mL in healthy controls. The difference between patients treated in the ICU and healthy controls was significant (P?Öğe Relation of neural tube defects with folic acid use during pregnancy(İnönü Üniversitesi Tıp Fakültesi, 2019) Çetin, Abdurrahman; Gökdemir, Mehmet Tahir; Nas, Cemal; Gökdemir, Gül ŞahikaAim: The objective of this study was to investigate the rate of neural tube defects (NTD) and the clinical features of newborns of mothers who did not use folic acid (FA) in their pregnancies. Material and methods: The data of a total of 82 newborns, who were diagnosed with meningomyelocele were operated and examined, retrospectively. The newborns were divided into two groups depending on whether their mothers used FA during pregnancy or not. Results: The mothers of 37 (45.1%) newborns used FA during the antenatal period, whereas those of 45 (54.9%) newborns did not. The mean birth weight of the newborns whose mothers did not use FA were lower. Furthermore 9 (25%) newborns whose mothers did not use FA were delivered via cesarean section.The incidence of meningomyelocele was 80% for 45 newborns with NTDs whose mothers did not use FA. Conclusion: Our results revealed that the mean birth weight was lower while the incidence of meningomyelocele was significantly higher in newborn infants whose mothers did not use FA.
