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    Doublecortin-like kinase 1 levels and oxidant status in Alzheimer's disease
    (Cukurova Univ, Fac Medicine, 2017) Guzel, Savas; Yildiz, Ozlem; Unal, Aysun; Kiziler, Ali Riza; Gulyasar, Tevfik; Guzel, Eda Celik; Fidan, Cigdem
    Purpose: Alzheimer disease (AD) is a progressive neurodegenerative disease that affects the neurons in various parts of the central nervous system. Recently discovered protein Doublecort like kinase-1 (DCLK-1) is one of the microtubule-associated protein. Our goal is to investigate the relationship of the role of the DCLK-1 in AD disease and oxidative stress. Material and Methods: The study included Alzheimerdisease- diagnosed 60 patients admitted to the clinic with memory disorders, and 30 healthy subjects. In the serum of patient and control group, DCLK-1, tau protein and zinc levels were measured. To assess the presence of oxidative stress, malondialdehyde (MDA), protein carbonyl group (PCG), protein thiol groups (PTG), glutathione (GSH) and catalase levels were detected. Dementia level was staged with Mini-Mental State Examination (MMSE) and Dementia Clinical Staging Scale (CDR). Results: Serum DCLK-1 and tau levels were determined significantly higher in AD compared to the control group). In the group with AD, levels of MDA, and PCG levels were significantly higher and GSH, catalase levels were determined significantly lower. DCLK-1 and MDA levels were determined significantly higher in the group with severe AD compared to the group with mild AD. In AD group, a positive correlation between DCLK-1 and, CDR and MDA; and negative correlation was found between MMSE and B12 vitamin Conclusions: The presence of a relation with increase in DCLK1 levels in AD and risk factors shows that it can be a new marker in assessing the disease.
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    What are the independent parameters associated with increased mortality risk in patients with severe sepsis or septic shock in the intensive care unit?
    (2022) Yildiz, Ozlem; Tabakoglu, Erhan
    Objective: Determining the factors associated with prognosis in patients with sepsis admitted to the intensive care unit who were treated according to international guidelines. Patients were evaluated with respect to treatment results, morbidity and mortality rates, infection foci and pathogens. Materials and Methods: A total of 43 patients with severe sepsis who were treated in Trakya University Medical Faculty, Department of Medical Intensive Care, between July 2009 and December 2009, were enrolled in thisprospective observational study. Patients were grouped as survivors and non-survivors. Clinical characteristics and APACHE II, SAPS II, SOFA scores were recorded. Factors associated with mortality were analyzed by Cox regression. Results: Overall mortality rate was 23.2%. Patients with failure in three or more organs had higher mortality (p = 0.001). Also, mortality rates were higher in patients with cardiovascular, renal, hematological and neurological failure in the first day (p = 0.002, p = 0.011, p = 0.020, p = 0.019, respectively). All scores at the 24th and 72nd hours were significantly higher in the non-survivor group compared to survivors (p <0.05, for all). While the initial SOFA and APACHE II values were higher in non-survivors compared to survivors (p = 0.013 and p = 0.017, respectively), initial SAPS II scores were similar (p = 0.107). The diagnosis of septic shock (HR: 0.080, 95%CI: 0.007-0.961), chronic heart failure (HR: 0.133, 95%CI: 0.032-0.558), inappropriate empirical antibiotic use (HR: 0.106, 95%CI: 0.034- 0.326), the number of organs failing on the first day of admission (HR: 17.091, 95%CI: 2.877-101.529), cardiovascular failure (HR: 0.427, 95%CI: 0.201-0.906) and renal insufficiency (HR: 0.075, 95%CI: 0.016-0.348) were found to be associated with mortality. Conclusion: The presence of chronic heart failure, inappropriately administered empirical antibiotherapy, renal and cardiac failure on the first day of admission were the notable independent factors that increased the mortality risk of patients with severe sepsis and septic shock. In addition, SOFA, APACHE II, and SAPS II scores were higher in sepsis patients who ultimately died. Initiating correct antibiotherapy in the early period and applying appropriate measures against organ failure may increase survival in cases with severe sepsis.