The Relationship of Vitamin B12 Deficiency and Red Cell Distribution Width-Platelet Ratio
Nigar Yılmaz, Mustafa Yılmaz
J Clin Exp Invest 2016;7(3):211-215.
https://doi.org/10.5799/jcei.328604
Research Article
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ABSTRACT
Objective: We aimed to investigate the relationship between vitamin B12 deficiency and red cell distribution width- platelet ratio (RPR), and the variations in the parameters on vitamin B12 treatment. Methods: One hundred fifty-four patients with untreated vitamin B12 deficiency (56% men, mean age: 50 ± 12.7 years) (untreated group), 86 patients with vitamin B12 deficiency (62% men, mean age: 42 ± 20.7 years) on vitamin B12 treat- ment (treated group), and 92 age- and sex-matched control group (54% men, mean age: 45 ± 15.1 years) were included in the study. Hematological parameters were evaluated by the method of laser-based flow cytometric impedance, using an automated blood cell counter (ABX Pentra 120 Hematology Blood Analyzer). Results: RPR was significantly reduced in treated group compared with untreated group (4.88 ± 1.06; 6.13 ± 1.27; p<0.001, respectively). RPR, red cell distribution width (RDW) and mean platelet volume (MPV) were significantly differ- ent in untreated group compared to controls (p<0.05). There were no differences in platelet count in the three groups (p>0.05). Conclusion: We proposed that vitamin B12 deficiency has effects on RPR and supplementation with vitamin B12 cor- rects the RPR levels.
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Investigation of Predictive Potential of TPH1 Common Polymorphism in Idiopathic Scoliosis
Svetla Todorova Nikolova, Vasil Tsankov Yablanski, Evgeni Nedev Vlaev, Alexey Slavkov Savov, Ivo Marinov Kremensky
J Clin Exp Invest 2016;7(3):216-221.
https://doi.org/10.5799/jcei.328607
Research Article
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Objectives: The association studies are the predominant type of studies on genetics of the common diseases. The pre-sent case-control study aims to investigate the association between the promoter polymorphism TPH1 (rs10488682 T/A) and the predisposition to idiopathic scoliosis (IS) in a Bulgarian population sample.
Methods: A total of 105 patients and 210 healthy gender-matched controls were included. The TPH1 promoter poly-morphism was genotyped by amplification followed by restriction. The statistical analysis was performed by the Pear-son's chi-squared test and the Fisher’s exact test. A value of p less than 0.05 was considered statistically significant.
Results: The results indicated that TPH1 (rs10488682) is not associated with the susceptibility to IS, the onset of the disease, the family history or the gender. Based on these preliminary results, the examined polymorphic variant could not be considered as a predisposing factor for IS in Bulgarian patients.
Conclusions: Much larger case-control studies will be needed to examine the role of this TPH1 functional genetic vari-ant in the etiology and pathogenesis of IS in Caucasian population. The identification of molecular markers for IS could be useful for early detection of the predisposition among the relatives and for more accurate prognosis of the risk for a rapid progression of the curve in the affected children.
Keywords: Idiopathic, scoliosis, TPH1, polymorphism, association
Analyzing the Effect of c-myc Oncogene and Matrix Mettalloproteinase-2 Enzyme Ekspression on Metastasis and Prognosis of Malignant Melanoma
Abdulcebbar Siyer, Yasemin Yuyucu Karabulut, Şakir Ünal, Didem Derici
J Clin Exp Invest 2016;7(3):222-228.
https://doi.org/10.5799/jcei.328612
Research Article
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Objectives: The aim of this study is to measure the effect of c-myc oncogene and matrix metalloproteinase-2 enzyme expression on metastasis and prognosis of malignant melanoma. At the end of this study, we hope to get information about the prognosis of melanoma, to be helpful for choosing the treatment strategy.
Methods: Sixty-three patients treated in our hospital during 2006-2015 were included in this study. All clinical and histological parameters were collected from each patient’s records and survival rate is assessed. Forty-seven suitable tumor specimens were assessed by immunohistochemical stains and analyzed for the c-myc and MMP-2 positivity. All results were evaluated statistically for the effect on melanoma metastasis and survival rate.
Results: C-myc positivity and MMP-2 positivity decreases the survival rate of melanoma. MMP-2 positivity increases the risk of death four more times.
Conclusions: So this study confirms that we can evaluate c-myc and MMP-2 as a prognostic factor.
Keywords: Malignant, melanoma, C-myc, Matrix metalloproteinase 2, oncogene, metastasis
The Association Between MGP Gene Polymorphisms and Coronary Artery Disease
Mehmet Zihni Bilik, Ali Fuad Kara, Bülent Göğebakan, Mehmet Ata Akıl, Ferhat Özyurtlu, Halit Acet, Sait Alan
J Clin Exp Invest 2016;7(3):229-236.
https://doi.org/10.5799/jcei.328614
Research Article
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Objectives: Coronary artery calcification (CAC) is associated with coronary atherosclerosis. There is a significant relation between coronary artery wall calcification and coronary artery disease (CAD). The measure of coronary artery calcification is an indicator of subclinical atherosclerosis. In some studies, it has been shown that coronary artery calcification is independent from conventional cardiovascular risks, which suggests data about prognosis. Matrix Gla protein (MGP) is an important protective modulator against calcification since it is an inhibitor of tissue calcification. In this respect, we aimed to establish the relationship between the distributions of nucleotide alterations found in promoter and coding regions of the MGP gene in patients with CAD and patients with normal coronary.
Methods: DNA samples (n=115) were obtained from 58 patients with CAD and 57 healthy controls. The DNA samples obtained were analyzed by a Polymerase Chain Reaction (PCR) method using three sets of primer pairs, which cover the coding (Thr83Ala in exon 4) and promoter regions (T-138C and G-7A) of the MGP gene. Amplified regions were analyzed by a Restriction Fragment Length Polymorphism (RFLP) method for possible polymorphisms.
Results: The chi-square analysis of the results revealed that there is no relationship between the observed polymorphisms and CAD.
Conclusions: In this study, we investigated the relationship between MGP gene polymorphism and CAD. However, according to our findings, there was no statistically significant difference between the CAD and the control group.
Keywords: Coronary artery disease, vascular calcification, matrix Gla Protein, genetic polymorphism
Failure of Therapy at Premortem Diagnosed Pulmonary Thromboembolism
Aysun Yakar, Fatih Yakar, Sibel Çağlar Atacan, Muhlis Yıldız, İbrahim Üzün
J Clin Exp Invest 2016;7(3):237-243.
https://doi.org/10.5799/jcei.328615
Research Article
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Objectives: We analyzed patients diagnosed premortem with pulmonary thromboembolism (PTE), focusing on causes of failure of therapy together with clinical characteristics.
Methods: This was a retrospective study of 25 cases. We classified PTE as massive, submassive and nonmassive.
Results: Of the 25 cases, 76% (19/25) had two or more risk factors for PTE. The point of origin of PE could be determined in only 44% of 25 cases. In 20 % (5/25) of cases diagnosed with PTE a maximum 3 months prior to death, the main cause of death was unknown. Of 10/20 (50%) massive and 8/20 (40%) submassive PTE cases, 5 and 3 underwent thrombolysis therapy, respectively. Both of 2/20 (10%) non-massive PTE cases underwent LMWH; in 1 of these cases, autopsy showed thrombus of a large pulmonary artery at 25 days after therapy. Submassive PTE cases were older and had a greater number of risk factors than did massive PTE cases. The point of origin of PTE was a right heart thrombus in six (24%) cases. Surgeries were performed in 3/6 (50 %) cases with right atrial thrombus. The survival duration after therapy in those who underwent surgery was longer than those who received thrombolysis and LMWH therapies.
Conclusions: Physicians may provide appropriate information to patients who have certain risk factors (trauma, surgery, pregnancy, etc.) to predict acute PE at a preventable stage. If risk factors are present for a prolonged period, or if new risk factors for PTE are identified, patients should be followed up carefully because of the risk of progression of thrombosis.
Keywords: Causes of Failure of Treatment of PTE, Clinical Features at Fatal PTE
An Easy-to-Use, Rapid and Inexpensive Method to Determine Methicillin Resistance In Staphylococcus aureus
Julide Sedef Göçmen, Osman Cağlayan, Alpay Azap
J Clin Exp Invest 2016;7(3):244-252.
https://doi.org/10.5799/jcei.328616
Research Article
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Objectives: We aimed to report a new turbidimetric method to identify methicillin resistance in S. aureus strains just two hours after identification of the microorganism, and to analyze diagnostic and discrimination abilities of this new method.
Methods: A total of 319 S. aureus isolates were included in the study. Identification of bacteria was done by the colony morphology, and conventional biochemical methods. The turbidimetric method we developed is based on different growth rates of S. aureus in two media, with or without oxacillin. The growth rates of MRSA and MSSA are similar in normal media; however, the MRSA grows significantly faster in the media containing oxacillin. Therefore, after 2 hours of incubation, the difference of turbidity produced by bacteria in the media with or without oxacillin is less in case of MRSA, and more in case of MSSA. The absorbances of the microplates were measured before incubation, and at 2nd and 3rd hours of incubation. The “absorbance rate” was calculated for each bacteria based on those absorbance values measured. The bacteria were classified as MRSA or MSSA based on the absorbance rate.
Results: All MRSA and MSSA strains were correctly discriminated via our turbidimetric method, when an absorbance rate of 1.900 was taken as cut-off value. The new method could diagnose MRSA with 100% specificity and 100% sensitivity in just 2 hours.
Conclusions: The turbidimetric method is a rapid, easy and cheap method that does not require any specific equipment. It can be easily performed in every microbiology laboratory.
Keywords: Turbidimetric method, MRSA, MSSA
Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations
Serdar Başaranoğlu, Ayşegül Deregözü, Nadiye Köroğlu, Mehmet Kalkan, Coşkun Şahin, Sedat Kadanalı
J Clin Exp Invest 2016;7(3):252-257.
https://doi.org/10.5799/jcei.328617
Research Article
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Objectives: We aimed to present urinary tract injuries occurring during obstetric and gynecological operations and their clinical consequences.
Methods: Twenty-three patients had urological organ injury during obstetric and gynecological operations in a tertiary care center between January 2010 and June 2016, were analyzed retrospectively. Etiologies, type of injury, diagnostic process, treatment methods and complications of urologic injuries and success rate have been investigated. Injuries were categorized into two groups as intra-operative early injuries and post-op late injuries. Early injuries were laceration, rupture, ligation and late injuries were hydronephrosis, contrast material leakage or fistula.
Results: Eight patients were diagnosed during operation period or post-op early period and 15 patients who were referred from other hospitals. Thirteen of the injuries were gynecologic and 10 of them were obstetric. Mean age of operated patients was 34.2±9.4 (23-65) years. Ureteral injury and bladder injury was detected respectively in six and two patients getting early diagnosis. Fistula (5/15), hydronephrosis secondary to urethral stricture (3/15) and vaginal erosion (3/15) were detected as late diagnosed injuries. In a patient whom ureter was ligated non-functioning kidney has developed.
Conclusions: To reduce rate of urinary system injuries a sound knowledge of anatomy is required and corrected surgical techniques should be used. Early diagnosis and therapy may prevent complications and loss of organs that may lead to morbidity.
Keywords: Bladder injury, ureteral injury, obstetric and gynecologic surgery, iatrogenic diseases
Opinions about the future of Clinical Trial in Turkey
Nüket Büken
J Clin Exp Invest 2016;7(3):258-264.
https://doi.org/10.5799/jcei.328618
Review
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Even though all the rights and obligations of all parties of clinical trial – the researching physician, the volunteering patient, the industry, research institutions- have been assured with ethico-legal regulations, there still exist many problems in the world of clinical research, and suggestions of solutions to the said problems.
As a medical ethicist who has been a permanent member of the Hacettepe University Ethical Committee since 2000, I have decided to write a short report that is a general look at the world of clinical research in Turkey. I wanted this report to be one that talks about some of the issues I believe are important about this subject, which include expectations and predictions on it.
All of the headlines in this report are without doubt, issues that can be researched and written about widely and with much more details. Especially the process of adjustment to the new regulation of the EU (No 536/2014 of The European Parliament), the condition of non-medicational/non interventional clinical research, transparency in clinical research and budget issues are to me controversial subjects that should be especially and primarily discussed.
Keywords: Clinical research, non-interventional clinical research, regulation