NEUTROPHIL-LYMPHOCYTE RATIO AND PLATELET-LYMPHOCYTE RATIO AS MORTALITY PREDICTORS IN CRITICALLY ILL COPD PATIENTS

Volume 74, Apr 2018
doi: 10.21506/j.ponte.2018.4.20
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Abstract: Introduction: Acute exacerbation of COPD (AECOPD) significantly increases the hospitalization in intensive care unit and also to mortality among patients with COPD. Acute predictors of mortality and morbidity following AECOPD can manipulate the treatment modality. We investigated the predictive value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients that are hospitalized due to AECOPD in intensive care unit (ICU). Material and methods: This study was performed between June 2011 to 2015 in an in ICU of a tertiary hospital by including the patients that are hospitalized in ICU and diagnosed as AECOPD. Results: The mortality rate was 34.8% (n=46). Apache-II score was higher and Glasgow coma scale (GCS) was lower in non-survivors. Lower FEV1% predicted is associated with mortality. Among co-morbidities, cardiac arrhythmia, renal failure and lung cancer were associated with increased mortality. Length of stay in the ICU stay time was longer in non-survivors. The mean values of NLR and PLR was greater in non-survivors but the differences were not statistically significant (p=0.655 and 0.261 respectively). The NLR was correlated with WBC and CRP (with WBC p<0.001 r=0.397 and with CRP p=0.028 r=0.190); but PLR has no correlation with WBC and CRP (with WBC p=0.164 r=0.122 and with CRP p=0.728 r=0.030). Discussion: NLR and PLR are the new biomarkers that are widely used prognostic markers in various diseases especially cardiovascular diseases but they are not good markers of mortality for patients that are hospitalized in intensive care unit due to AECOPD.

Author(s): Recai Ergun, Begum Ergan


PROGNOSTIC VALUE OF SERUM URIC ACID LEVEL FOR SHORT TERM SURVIVAL IN PATIENTS NEEDING \\r\\nMECHANICAL VENTILATION DUE TO CHRONIC OBSTRUCTIVE PULMONARY DISEASE EXACERBATIONS\\r\\n

Volume 74, Apr 2018
doi: 10.21506/j.ponte.2018.4.22
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Abstract: Background: This study aimed to investigate the relationship between serum uric acid (UA) \\r\\nlevels and long term survival after hospitalization for a severe exacerbation in chronic \\r\\nobstructive pulmonary disease (COPD) patients. \\r\\nMethods and Material: The study was designed as retrospective cohort study and performed \\r\\nintensive care unit (ICU). \\r\\nDatabase for COPD patients with an exacerbation with the diagnosis of acute respiratory \\r\\nfailure and required either noninvasive or invasive ventilation were reviewed and patients� \\r\\ndemographic and clinical characteristics and laboratory data were recorded. Patients were \\r\\ndivided into two groups according to their serum UA levels. \\r\\nStatistical analysis used: In the multivariable analysis, independent factors in predicting \\r\\nsurvival were investigated by Cox regression analysis with Backward selection using probable \\r\\nfactors determined in the previous analyses. \\r\\nResults: Among 103 COPD patients, the serum UA level was <6.9 mg/dL in 54 (52.4%) \\r\\npatients (low UA group) and ?6.9 mg/dL in 49 (47.6%) patients (high UA group). The groups \\r\\ndid not differ regarding 28-, 90-, 180-, and 365-day survival rates; the median duration of \\r\\nsurvival was 90 days in the low UA group and 51 days in the high UA group (p=0.584). The \\r\\nmultivariate Cox regression analysis revealed that high serum UA level (?6.9 mg/dL) was \\r\\nassociated with increased mortality risk in COPD patients hospitalized for acute exacerbation \\r\\n(hazard ratio=1.97, 95% confidence interval=1.10-3.51, p=0.022). \\r\\nConclusions: Serum UA level may be a beneficial biomarker in predicting mortality risk in \\r\\nCOPD patients with acute respiratory failure and required either noninvasive or invasive \\r\\nventilation.

Author(s): Recai Ergun, Dilek Ergün


AN EXPERIMENTAL DEMONSTRATION OF THE MATRIX EFFECT ASSOCIATED WITH THE USE OF HEPATITIS B IMMUNOGLOBULIN ON IMMUNOSUPPRESSANT LEVELS MEASURED WITH THE LC-MS/MS METHOD

Volume 74, May 2018
doi: 10.21506/j.ponte.2018.5.4
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Abstract: Some of the liver transplant patients need to use hepatitis B immunglobulin (HBIG) preparations due to hepatitis B reinfections. Blood level measurement of immunosuppressants used to prevent rejection is performed by immunoassay methods and LC-MS/MS reference method. It is known that immunoassay methods are influenced by immunoglobulins. Therefore, the LC-MS/MS method should be preferred in order to minimize the risk of organ rejection. Although LC-MS/MS is the reference method, some molecules in the serum may cause incorrect measurement of the analyte through matrix effect that is changing ionization efficiency. The aim of this article is to investigate the exposure of immunosuppressant blood level to the matrix effect with HBIG drug used in liver transplant patients Experimentally, it was observed that low and medium blood concentrations of tacrolimus, everolimus, sirolimus and cyclosporin were significantly increased in the interference study by adding HBIG (Hepatect CP 50 IU) to the control materials. Amount of increase is between 15,38% - 35,61%. Incorrect laboratory results may lead clinicians to adjust the wrong blood drug dose. It is vital to keep the immunosuppressive drug levels in the therapeutic index in organ transplant patients. Immunosuppressants should be measured from blood sample that is taken prior to HBIG administration, since incorrect measurements caused by the matrix effect would increase the risk of liver rejection.

Author(s): Ataman GONEL, ismail KOYUNCU


ASSESSMENT OF THE IMPACT OF EXTERNAL CONDITIONS ON THE DEVELOPMENT OF RUSSIAN PHARMACEUTICAL PRODUCTION

Volume 74, May 2018
doi: 10.21506/j.ponte.2018.5.6
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Abstract: Today the Russian pharmaceutical industry is one of the high-tech industries of economy. The state industrial policy has encouraged high investment and innovative activity in the industry. Russian companies are actively involved in the implementation of the import substitution strategy, which will reduce the dependence of the Russian economy on imports and develop its own production. The objective of this research is identification of external environment factors influencing development of the entities of pharmaceutical industry for the evolvement of strategic directions for further development. This article carries out assessment of external factors which influence the entities of pharmaceutical industry. The correlation model is constructed and the actual factors influencing development of pharmaceutical production are revealed. The regression model reflecting the dependence of amounts of release of pharmaceutical products on the change of factors of an external environment in dynamics from 2006 to 2016 is constructed. The realistic scenario of the production scope change for major pharmaceutical groups is constructed. The interrelation between macrofactors of the Russian pharmaceutical industry development and the amounts of its production are confirmed and measured in the research. This research is a reason for discussion and further studying of development of reasonable recommendations in order to change or refine the state industrial policy. The directions of further researches are connected with deeper studying of causes of relationships between production volumes and macrofactors, as well as with the assessment of time distribution of macroeconomic consequences of purposeful impact on a size of the considered factors.

Author(s): N. Borscheva, Y.Fedorova, M.Glukhova, E. Fedorov


ASSESSMENT OF PROTECTIVE EFFECT OF WATER EXTRACT PROPOLIS AND BIOCHEMICAL PARAMETERS OF DROSHOPHYLA MELANOGASTER EXPOSED UV IRRADIATION

Volume 74, May 2018
doi: 10.21506/j.ponte.2018.5.3
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Abstract: Levels of transaminase enzymes are influenced by environmental factors. These enzymes commonly measured as biomarkers for life health. The main aim of this study was to determine the effects of ultraviolet irradiations on serum levels of aspartate transaminase, alanine transaminase and alkaline phosphatase in Droshophyla melanogaster and was to evaluate the effect of water extract of propolis against UV treated D. melanogaster. Propolis biological activities have principally been attributed to its phenolic compounds, notable for significant antioxidant properties responsible for reducing the toxic effects of free radicals. UVA irradiation caused significant changes in both total soluble protein and transaminase enzymes as compared to control. The results indicated that level of aspartate transaminase has a significant decrease. Exposure to ultraviolet irradiations may lead to side effects. The data showed that propolis at 25 mg/ml concentrations exerted a certain influence on biochemical parameters studied. Treatment group (Propolis then UV irradiation) demonstrated the anticytotoxic properties of water extract of propolis on cross. The water extract of propolis exhibited protective effect against UVA irradiations. Poliphenols in propolis can reduce UV irradiation induced DNA damage.

Author(s): Meltem Maras, A. Kekillioglu, Y. Saygili, Selda Bahadir


PREVALENCE AND CAUSES OF SEEING DISABILITY (BLINDNESS)

Volume 74, Apr 2018
doi: 10.21506/j.ponte.2018.4.8
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Abstract: Vision impairment, including blindness, is a major public health concern in adults worldwide, associated with diminished quality of life and increased risk of falls and death. Globally, 36.0 million people were estimated to be blind in 2015, whereas 216.6 million people had moderate or severe vision impairment. According to the Turkey Disability Survey, seeing disability rate was 0.60% in Turkey. The aim of this study is to determine the prevalence and causes of seeing disability (blindness). This study was a cross-sectional study. The universe was composed of all households in Gumushane province. No sampling method was used. All households in Gumushane province were included in the survey. The fieldwork was carried out between 01 January 2015 and 31 December 2015. Necessary permissions were taken before starting the fieldwork. Data was collected through a questionnaire developed by the researchers for this study. The questionnaire was applied to the ones who had seeing disability (blindness). All of the data obtained was recorded to the computer. Data was analyzed with statistical package program on computer. During the study 1415 seeing disabled was identified. Prevalence of seeing disability was found to be 0.93% in Gumushane province (Turkey) in 2015. The great majority (79.4%) of the seeing disabled has never been married. The majority (86.8%) of the seeing disabled were illiterate. Still the vast majority (91.0%) of disabled were not working. These findings also show us that visually impaired people need more social support. Only 23.4% of the seeing disabled were receiving home care and only 21.8% of the seeing disabled were taking disability support payment. 59.7% of the seeing disabled can get out of their home on their own. It has been found out that only 9.6% of the seeing disabled were using any kind of device. These data indicates us that disabled cannot benefit enough from the rights granted to them and further studies need to be conducted about this problem. The first five causes of seeing disability was cataract (28.4%), senility (age-related macular degeneration) (5.8%), refractive error (5.5%), optic atrophy (4.8%) and fitizis bulbi (4.4%) respectively. It is seen that most of the causes of seeing disability is preventable and treatable causes. Screening, early diagnosis and treatment should be done to prevent these cases.

Author(s): Turgut SAHINOZ, Nazli HACIALIOGLU, Saime SAHINOZ


THE ROLE OF ULTRASONICATION AND ROSE WATER ADDITION ON THE PRESERVATION OF A NOVEL COMPLEMENTARY FOOD FROM PERSIMMON PUREE AND HAZELNUT FLOUR: CERTAIN CHEMICAL, PHYSICAL AND MICROBIOLOGICAL PROPERTIES

Volume 74, May 2018
doi: 10.21506/j.ponte.2018.5.5
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Abstract: Complementary feeding practices are fundamental to infant's nutrition, health, and survival during the first two years of life, as well as the elder in the last. In this study, a novel complementary food, produced from persimmon fruit (Diospyros kaki L.) and hazelnut (Corylus spp.) flour treated with ultrasonication and rose water (eau de rose) is developed to support the nutrition and life of the beings mentioned above. Persimmon fruit is an important source of phenolic compounds, vitamin C, antioxidants, glucose, dietary fiber, and carotenoids and has been shown to have the positive impact on cardiovascular and immune systems, decrease certain type of cancers and help maintain a healthy vision. On the other hand, hazelnut flour is a good source of protein, dietary fiber, and fat. Ultrasonication, a non-thermal method, solely or in combination with rose water displayed antimicrobial properties in a previous study conducted in our laboratories on fruit juices. According to our study, no pathogenic microorganisms were observed by the combination of ultrasound and rose water on the complementary food and this treatment positively affects the development of the consumer in terms of biochemical and nutritional composition. When compared to control, there were no significant differences in the treatment groups in terms of pH, fat, sugar, and total nitrogen. Moreover, no allergen and aflatoxin were detected. The taste panel showed that there were no significant differences between the treatment groups.

Author(s): H. Dilek ULUSAN, Seyhun YURDUGUL, Hulya YAMAN


DIALOGUE COMMUNICATIVE STRUCTURES IN TEACHING FOREIGN LANGUAGE

Volume 74, Apr 2018
doi: 10.21506/j.ponte.2018.4.23
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Abstract: This paper represents a study of the aspects of developing effective dialogic models with due consideration of their communicative structures in the process of teaching a foreign language. The main communicative strategies and approaches applied to different multinational groups and groups with mixed age at different stages of teaching are described here. A concept of a simulated dialogue is proposed in this study. The concept means controlled conversational interaction (dialogic interaction) between persons being taught, which is composed of different dialogue partners\\\\\\\\\\\\\\\' personal intentions implemented in coordination. Unsymmetrical contacts affect the dialogue development, where tactic forms choice limitations get involved, wider prospect of a dialogue is provided due to the equal social roles of participants interested in the perception of information communicated, and dialogue simulation ensures necessary volume of a speech interaction act. The results of a linguistic experiment conducted using the elements of conscious effect on the process of natural lingual interaction were used as material for study. The process was controlled by means of unexpected introduction of a new incentive (stimulus). The pseudo-communicativeness of such interaction was eliminated due to the availability of incentives aimed at expanding the elementary cycle through the introduction of new structural strategic components, a new aim, or a new script. Several students learning Russian as a foreign language took part in the experiment. As a result of studies undertaken a corpus of extracted dialogues was compiled. Applying the communicative tactics as a basis for teaching a foreign language the use of a simulated dialogue can promote the optimization of the teaching process and supplementary motivation in learning a foreign language as a communication tool, because the choice of an optimal way of expressing intentions is the communicative need of any person learning a language.

Author(s): Mikheeva Tatiana B., Shapovalova Elena Yu, Ereshchenko Margarita Vl., Antibas Irina Al.


ANTI-PCA/YO AND ANTI-GAD LEVELS IN AUTISM SPECTRUM DISORDER AND ATTENTION DEFICIT HYPERACTIVITY DISORDER

Volume 74, Apr 2018
doi: 10.21506/j.ponte.2018.4.4
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Abstract: Compelling evidences suggest that dysfunction in the cerebellar region of the brain plays has a significiant association with the etiology of autism spectrum disorders (ASD) and attention deficit hyperactivity disorders (ADHD). This study aims to investigate should there is the association between degeneration of the cerebellum and the etiologies of ASD and ADHD. The study recruited participants comprising of 40 children with ASD and 39 children with ADHD. 40 healthy children were recruited as the control group. The participants were analysed for an increase in anti-purkinje cell autoantibodies, called as Yo (anti-PCA/Yo) antibodies and anti-glutamic acid decarboxylase (GAD) antibody levels during cerebellar damage. Each child with ASD was evaluated using the autism behavior checklist (ABC), aberrant behavior checklist (AbBC) and childhood autism rating scale (CARS). The Conners’ Parent and Teacher Rating Scales-Revised Long Form (CPRS and CTRS) screening questionnaires were completed by the parents and teachers of children with ADHD. The anti-PCA/Yo and anti-GAD levels were determined using 10 ml venous samples from the participants. No significant sociodemographical differences were observed between the groups. Significant differences were found in the anti-Yo levels between children with ADHD and healthy subjects (p=0.002). Additionally, a positive correlation was observed between GAD levels and children age. This was the first study that evaluated levels of anti-Yo and anti-GAD levels in ADHD and ASD, and compared it to a control group. It found association between anti-Yo levels and ADHD. Further studies with larger samples and follow-up periods are necessary in order to investigate possible etiological factors among subjects with neuropsychiatric disorders.

Author(s): Cagatay Ugur, Ozden Sukran Uneri, Esra Yurumez


EVALUATION OF THE PSYCHOLOGICAL PROBLEMS THE CHILDREN DIAGNOSED WITH PRECOCIOUS PUBERTY SUFFER FROM: A CASE CONTROL STUDY

Volume 74, Apr 2018
doi: 10.21506/j.ponte.2018.4.5
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Abstract: Background: One of the most common and difficult to diagnose condition is Precocious Puberty which is prevalent in pediatric patients with endocrinology disorders. The plethora of information available in open sources makes the families concern about their child’s pubertal development. These patients undergo a tremendous psychological turmoil. Hence, the current study was planned with the aims to evaluate children in terms of psychiatric illness who were diagnosed with pubertaprecocs. Methodology: The present study was undertaken in \\\"University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital\\\" Child and Adolescent Psychiatry Department and Child Endocrinology Clinic. There were total 120 samples where in 56 were suffering from Precocious puberty and 64 were control. The patients included those who visited pediatric endocrine polyclinic with complaints of early adolescence and the control group included patients without the disorder with same age and gender. The children were interviewed using DSM-V tool and thereafter assessed on scales like SCARED, CPRS, CTRS, CDQ, Body Perception scale and Piers Harris self-concept scale measurement for children. Results: The two groups were similar in terms of CPRS, CTRS, CDS and Pier-Harris scales distributions (p> 0.05). Body Sensitivity Scale scores of the pubertas praecox group were significantly lower (median 175 vs. 185.5, z = -2.537, p = 0.011). At least one psychiatric disorder was found to be significantly higher in the puberty precox group (32.1% vs. 10.9%), x2 = 8.143, p = 0.004. CPRS-POSITIVE was significantly higher in the pubertas praecox group (67.9% vs. 48.4%), x2 = 4.609, p = 0.032. Similarly, internalization or externalization impairment was found to be higher in pubertal precox cases than control group cases. Conclusion: The psychiatric disorders are more prevalent in children pubertaprecocsthan their healthy counterparts. These patients thus, need to be treated keeping in mind their psychiatric condition. The patients with Precococious puberty thus are more prone to various psychiatric problems. Hence, apart from endocrinologic follow-up and treatment of these patients the psychiatric support must be given to these patients.

Author(s): Cagatay Ugur, Seyit Ahmet Ucakturk, Eda Mengen, Mehmet Sertcelik