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Öğe Causes of high erythrocyte sedimentation rates in elderly patients(2013) Uğuz, Nihal; Çelik, Hüseyin Tuğrul; Torun-Güngör, Oya; Bal, Ceylan Demir; Bakır, Fatih; Kazanci, Fatma; Yiğitoğlu, RamazanObjective: The erythrocyte sedimentation rate (ESR) determination is a simple and inexpensive laboratory test that is frequently ordered in clinical medicine. The test measures the distance that erythrocytes have fallen after one hour in a vertical column of anticoagulated blood under the influence of gravity. In this study it was aimed to determine the frequency of diseases which ESRs were over 100 mm/h in patients aged 65 and over. Method: In this study patients aged 65 and over who were treated in Turgut Özal University Hospital were retrospectively examined. Patients whose ESRs were over 100 mm/h were analyzed recording their ages, genders, ESRs and diagnoses. Diagnoses were divided into five groups: (i) infection; (ii) malignancy; (iii) inflammatory/connective tissue diseases; (iv) renal diseases; (v) miscellaneous diseases. Results: Two hundred five patients aged 65 and over whose ESRs were over 100 mm/h were analyzed. 115 of patients were women (56%) and 90 of them were men (44%). Age means of patients were 74.9 ± 6.45 and ESR means were 114.9 ± 14.8. When distribution according to disease groups was assessed, infection took the first rank (37.5%), malignancy took the second rank (21.9%), miscellaneous diseases took the third rank (21.4%), renal diseases took the forth rank (15.1%). The frequency of inflammatory/connective tissue diseases was 3.9%. Conclusion: In elderly, the most common cause of extreme elevation of ESR is infection. Different from other age groups, malignancy was found as the second common reason causing elevation of ESR. When etiology was researched in patients with extreme elevation of ESR, the age factor must be taken into consideration. © 2013 Elsevier B.V., All rights reserved.Öğe Effect of different selenium levels on thyroid hormone synthesis(Refik Saydam National Public Health Agency (RSNPHA) turkhijyen@rshm.gov.tr, 2015) Bal, Ceylan Demir; Büyükşekerci, Murat; Ercan, Müjgan; Hocaoğlu, Asim; Çelik, Hüseyin Tuğrul; Abuşoğlu, Sedat; Tutkun, EnginObjective: As an essential element, selenium is very important for thyroid functions. Iodothyronine deiodinase-I is a selenium containing enzyme that is responsible for production of triiodothyronine (T3) from thyroxin (T4) in peripheral tissues. The aim of this study is to investigate the effect of different levels of selenium on thyroid hormone synthesis. Methods: 303 participants who had admitted to several clinics of Ankara Occupational Diseases Hospital and whose serum thyroid hormone and selenium levels were determined between years 2012 and 2014 were separated into 3 groups according to serum selenium levels. Group 1: 50-75?g/L, group 2: 75,1-100?g/L, group 3: 100,1-125?g/L. The thyroid stimulating hormone (TSH), free T3 (FT3) and free T4 (FT4) levels of groups were compared with each other. Results: There was statistically non-significant difference among 3 groups concerning the serum TSH and FT3 levels (p=0,91; p=0,18). Group 3 serum FT4 levels were lower than other groups. FT4 levels of group 3 were significantly different from group 1 (p= 0,005). T3/T4 ratio was significantly higher in group 3 than other groups (p=0,004). There was a negative correlation between selenium and FT4 levels (r=-0,184; p=0,001), whereas a positive correlation existed between selenium and T3/T4 ratio (r=0,178, p=0,002). Conclusion: Selenium has an important role in thyroid functions and FT4 levels increase in selenium deficiency. High FT4 levels should be considered in low selenium levels. © 2015 Elsevier B.V., All rights reserved.Öğe Increased serum interleukin-33 levels in patients with Graves' disease(2013) Çelik, Hüseyin Tuğrul; Abuşoğlu, Sedat; Burnik, S. F.; Sezer, Sevilay; Serdar, Muhittin A.; Ercan, Müjgan; Uğuz, Nihalobjective. Interleukin-33 (IL-33), a 30 kDa cytokine, is a member of IL-1 family. It is considered to be an autoimmune biomarker associated with T helper 2 (T 2) response. ?-interferon is also produced by T helper 1 (T 1) cells to induce cellular responses. ?-interferon is a 143-amino acid residue glycoprotein with several biological functions including potent anti-viral activity, stimulation of macrophage activity, modulation of Major Histocompatibilty Complex class I/class II expression, and regulation of a diversity of specific immune responses. Te aim of this study was to investigate the serum levels of IL-33 and ?-interferon in different thyroid disorders. Methods. Twenty patients with Graves' disease, 21 patients with Hashimoto hypothyroidism, 21 euthyroid Hashimoto patients, and 27 control subjects were recruited to this study. Blood samples were drawn and IL-33 and ?-interferon tests were analyzed from 89 participants. Serum IL-33 and ?-interferon analyses were performed by enzyme-linked immunosorbent assay. results. Tere was no statistically significant difference between groups for serum ?-interferon levels. Serum IL-33 concentrations were significantly higher in Graves' disease group compared to the other groups (p<0.000) There was a positive correlation between serum IL-33 and free triiodothyronine (fT3) and thyroxine (fT4). Also, negative correlation between serum IL-33 and thyroid-stimulating hormone (TSH) was statistically significant (p<0.000). Conclusions. Te correlation of serum IL-33 with thyroid hormone levels may be a useful indicator for Graves' disease. These findings may help to make evident the pathophysiologic processes of the autoimmune thyroid diseases and improve therapeutic methods. © 2013 Elsevier B.V., All rights reserved.; MEDLINE® is the source for the MeSH terms of this document.Öğe Is vitamin D supplementation a new hope for the therapy of the septic shock?(2013) Yilmaz, Hakki; Şahiner, Enes Seyda; Darçın, Tahir; Çelik, Hüseyin Tuğrul; Bilgiç, Mukadder Ayşe; Akçay, Ali T.Vitamin D is mainly known for its traditional role in the bone mineralization and calcium homeostasis. Recent studies have shown that vitamin D receptors (VDR) are present in almost all the tissues and cells in the human body. In addition, several studies have revealed that vitamin D is important in immunomodulation, regulation of inflammation and cytokines, cell proliferation, cell differentiation, apoptosis, angiogenesis, muscle strength, and muscle contraction. Patients with sepsis have high mortality rate and high deficiency in vitamin D. In addition, septic patients have decreased vitamin D binding-protein (DBP) levels which further exacerbate the vitamin D deficiency. The role of vitamin D treatment in sepsis syndrome has been evaluated in animal model of sepsis where 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] administration was associated with improved blood coagulation parameters in sepsis associated with a disseminated intravascular coagulation. Vitamin D treatment in vitro has also been demonstrated to modulate levels of the systemic inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-?) and interleukin 6 (IL-6), as well as inhibit the lipopolysaccharide (LPS)-induced activation and vasodilation of vascular endothelium. Vitamin D may enhance the induction of the antimicrobial peptides, cathelicidin and b-defensin, which have been described on mucosal and epithelial surfaces acting as the body's first line of defense against viral and bacterial pathogens. Vitamin D supplementation may divert attention from relatively simple, natural, and low-costmethods of preventing severe sepsis and septic shock. Further prospective, randomized and controlled clinical trials of adjunctive vitamin D therapy in patients who are vitamin D deficient are needed in the management of human sepsis syndrome. © 2014 Elsevier B.V., All rights reserved.; MEDLINE® is the source for the MeSH terms of this document.
