Volume 48, Issue 4

Periodontal diseases are chronic diseases of oral cavity comprising of inflammatory conditions which effect the supporting structures of dentition. It is a multifactorial disease which is also known to be affected by genetic and environmental factors. However, some of the clinical parameters such as probing depth, attachment level, plaque index, bleeding on probing and radiographic assessment of alveolar bone are known to assess the severity of disease, although the disease activity is not measured. In the current scenario the salivary diagnostic markers for diagnosis of periodontal diseases have included the salivary enzymes, immunoglobulins, bacterial components or products, phenotypic markers such as epithelial markers. Also, saliva is a mirror of oral and systemic health and a valuable source to find out the physiological aspects of periodontal diseases. The present review thus highlights various salivary biomarkers which are quick, easy and reliable method for assessing and monitoring periodontal disease that improves and speeds treatment decisions and moves the field closer to individualized point-of-care diagnostics.

Objectives Long noncoding RNAs (lncRNAs) plays important role in disease spread and its invasion. Overexpression of prostate cancer antigen 3 gene (PCA3gene) is reported in prostate cancer. To analyze the PCA3 lncRNA expression in chronic myeloid leukemia (CML) patients. Methods The study included clinically confirmed 100 CML patients and 100 healthy subjects. Relative quantification using Sybr Green dye was used to calculate the PCA3 lncRNAs expression. Total RNA was extracted by TRIzol method and quantitative real-time polymerase chain reaction. Results In CML patients, 9.96 ± 4.77-folds increased noncoding PCA3 lncRNA expression was observed compared to healthy subjects. Patients of chronic phase, accelerated phase, and blast crisis phase had 4.46 ± 1.36, 7.31 ± 3.10, and 12.91 ± 4.85-fold PCA3 lncRNA expression compared to healthy subjects (p<0.0001), respectively. CML patients who have a complaint of splenomegaly had higher PCA3 lncRNA expression than those who did not complain splenomegaly compared to healthy subjects (12.04 ± 5.02-fold vs. 6.09 ± 3.39-fold, p<0.0001). Patients who had ≤20,000 TLC showed fewer PCA3 lncRNA expression than those who had >20 thousand of TLC (4.45 ± 1.84 vs. 11.25 ± 5.05, p<0.0001). Receiver operating characteristic showed correlation of PCA3 lncRNA expression with severity of cancer. Conclusions lncRNA PCA3 expression to be linked with different stages of the disease and a prognostic indicator for disease in CML patients.

Objectives Gene expression changes during embryonic stem cell (ESC) differentiation is regulated by epigenetic mechanisms. Understanding these can help uncover how cell fate decisions are made during early embryonic development. Comparison of chromatin of ESCs with lineage-committed cells can implicate chromatin factors functional in exit from pluripotency and the choice of proper lineages. Therefore, we quantitatively analyzed histone modifications in mouse ESC differentiation towards neuroectoderm and endoderm. Methods We cultured mouse ESCs (mESCs) and differentiated them towards neuroectoderm or endoderm lineages and performed mass spectrometry on total histones. Subsequent Western blots verified significantly altered H3K36me2. RT-qPCR analyses showed changes in H3K36-specific methyltransferases, demethylases and readers at mESC stage or during neuroectoderm/endoderm commitment. Results We presented quantitative histone modification levels in mESCs and lineage-committed cells. H3K36me2 increased specifically in neuroectoderm compared to mESCs or endoderm-committed cells. Regulation of H3K36 methylation might have a role in pluripotency exit and/or differentiation. Nsd2 , Dnmt3b and Zmynd11 increased during differentiation regardless of lineage. Conversely, mESCs had higher Kdm4c and Msh6 expression than differentiated cells. Comparing neuroectoderm and endoderm-committed cells, we revealed Nsd1 , Setd5 and Dnmt3a had lineage specific expression pattern. Conclusions Our results show quantitative changes in histone modifications during mESC lineage commitment and implicate H3K36me2 regulation for not only pluripotency exit but also lineage choice. Its regulatory proteins show stage (mESC vs. committed) or lineage (neuroectoderm vs. endoderm) dependent expression changes. Further work will be needed to discover their possible involvement in cell fate decisions and target genes.

Objectives The present study investigates the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the vaginal swabs of female patients diagnosed with coronavirus disease 2019 (COVID-19) based on a positive real-time reverse transcription polymerase chain reaction (RT-PCR) test on a combined throat and nasopharyngeal swab. Methods This study included 48 female patients hospitalized in two tertiary hospitals diagnosed with COVID-19 based on a positive RT-PCR test of the combined throat and nasopharyngeal swab samples, along with clinical and radiological findings. The IBM SPSS software package was used for the statistical analysis of the study data. Results SARS-CoV-2 positivity was detected in only one patient (2.08 %) in the present study from RT-PCR tests of vaginal swab samples. This patient was a 64-year-old, postmenopausal woman who tested positive for SARS-CoV-2 in a RT-PCR test of a vaginal swab sample six days after having tested positive in an RT-PCR test of a combined throat and nasopharyngeal swab. The patient’s partner also tested positive for SARS-CoV-2 in an RT-PCR of a combined throat and nasopharyngeal swab. Conclusions The present study is the first to report the presence of SARS-CoV-2 in vaginal secretions in Türkiye. The authors believe there is a need for studies investigating the presence of SARS-CoV-2 in the semen samples of the male partners of female patients to establish whether the presence of SARS-CoV-2 in vaginal secretions can play a role in the transmission of the virus.

Objectives Roles of thrombospondin-1 (TSP-1) and thrombospondin-2 (TSP-2) in tissue repair and inflammation are well-documented, but the association of their serum expressions with the pathogenesis of COVID-19 remains unclear. We investigate the roles of TSP-1 and TSP-2 in COVID-19. Methods 106 SARS-CoV-2 infected patients and 23 healthy people were enrolled in our study. COVID-19 patients were divided into two groups as non-severe and severe. TSP-1 and TSP-2 concentrations were measured with an enzyme-linked Immunosorbent Assay, and blood markers were analyzed with routine laboratory techniques. Results COVID-19 patients had significantly higher TSP-1 and TSP-2 levels than healthy controls. TSP-1 and TSP-2 positively correlated with inflammatory markers, including ESR, CRP, PCT, ferritin, and biochemical parameters such as ALT, AST, BUN, CK, and LDH. In addition, TSP-1 and TSP-2 were negatively correlated with hematological markers such as LYM, EOS, and HGB. Receiver operating characteristic analyses revealed that COVID-19 may be predicted with TSP-1 levels over 189.94 ng/mL and TSP-2 levels higher than 0.70 ng/mL. Conclusions Our analysis suggests that TSP-1 and TSP-2 expressions at the systemic level may have clinical importance for COVID-19.

Objectives Centrifugation is a time-consuming step which increases the turnaround time (TAT) in laboratories. A few studies have addressed the effect of altering centrifugation settings on analytical quality for clinical chemistry analytes, and most of these studies have used collection tubes with gel separators. However, gel separator tubes may be unsuitable for some laboratories because they are slightly more expensive than tubes without gel separators and are not appropriate for some special tests. The aim of this study was to investigate the effect of centrifugation conditions on clinical chemistry analytes. Methods We compared centrifugation times of 7 min at 2,200× g and 5 min at 2,750× g with the manufacturer’s protocol of 10 min at 1,300× g as the reference condition. Twenty general chemistry analytes were studied in lithium heparin plasma tubes without gel separators. Results For all analytes except carbon dioxide (CO 2 ), no significant differences in analyte results were observed when the centrifugation time was reduced. Deming regression and Bland–Altman plots demonstrated an acceptable clinical concordance within the limits of total allowable error for all analytes between the two rapid centrifugation conditions with the reference centrifugation condition. Conclusions Our results confirmed that alternate centrifugation conditions for either 7 min at 2,200× g or 5 min at 2,750× g of samples collected in lithium heparin tubes without gel are acceptable for clinical chemistry analytes. Our data support using centrifugation at higher speeds for shorter times to improve TAT without altering the quality of the analytical results.

Objectives The reference interval is the primary tool used to interpret laboratory test results. Each laboratory should determine reference intervals (RIs) that reflect their population. In this study, it was aimed to determine the RIs of hemogram routine and advanced clinical test parameters for our hospital and region by indirect method and to compare these calculated RIs with the limits recommended by the current manufacturer and the literature. Methods The hemogram results of patients aged 18–65 years who applied to Kastamonu Training and Research Hospital between July 2020 and June 2022, were included in the study. Hemogram analyzes were performed on Sysmex XN-1000 (Kobe, Japan) hematology auto analyzers. The RIs were determined by indirect method from the obtained data using the non-parametric percentage estimation method. Harris-Boyd method was used to decide on subgroup separation based on gender. Results All parameters had non-parametric distribution. RBC, HGB, HCT, MCH, MCHC, PLT, RDW-CV, RDW-SD, PCT, monocytes count, eosinophils count, monocytes % and macroR parameters which required gender-spesific RIs were determined separately for genders. Conclusions When the results are evaluated, it shows that the manufacturer’s recommendations together with the studies in the literature do not fully reflect the RIs of our population. Therefore, it is very important for each laboratory to determine its own RIs due to the differences in population, diet, technical equipment used and reference group. In addition, we think that our study will make a significant contribution to the literature, since there is insufficient data in the literature on RIs for advanced clinical parameters.

Objectives We aimed to investigate the usability of pleural pyruvate kinase (PK), total antioxidant status (TAS), and total oxidant status (TOS) as an alternative to Light’s criteria in exudate-transudate differentiation. Methods This prospective study was conducted among 84 patients (42 transudates and 42 exudates) with pleural effusion. The levels of PK, TAS, and TOS were measured by using ELISA kits, and the ROC analysis was used to evaluate the diagnostic efficiency . Results PK (p=0.001), TAS (p=0.027), and TOS (p=0.002) levels in pleural fluids were found to be significantly higher in the exudate group. The cut-off values for PK, TAS, and TOS were 10.64 U/L, 13.54 mmol trolox equivalent/L, and 13.88 μmol H 2 O 2 equivalent/L, respectively. While the sensitivity values were 97.62 % for PK, 66.67 % for TAS, and 64.29 % for TOS, the specificity values were 80.95 % for PK, 52.38 % for TAS, and 57.14 % for TOS. Conclusions PK levels in pleural effusion can be useful in suspected cases to differentiate between exudate and transudate in addition to Light’s criteria. However, pleural TOS and TAS parameters could not be as sensitive and specific as Light’s criteria.

Objectives We aimed to establish the relationship between pre-operatively measured mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) values and early anesthetic complications like bronchospasm & laryngospasm and hypotension in patients undergoing adenotonsillar surgery and non-adenotonsillar surgeries in both pediatric and adult population. Methods Patients from both sexes aged 1–63 years, and the American Society of Anesthesiology (ASA) physical status I–II were included in the study with elective adenotonsillectomy and non-adenotonsillar surgeries. Results In total, we included 330 patients in our study. The respiratory complications observed significantly more frequent in pediatric adenotonsillar surgery group (p=0.001). When the post-operative complications were compared with the MPV, NLR and PLR values, it was observed that the MPV values were significantly higher in patients who had hypotension (p=0.01) and PLR values were significantly higher in pediatric adenotonsillectomy group who developed bronchospasm and laryngospasm. There was no relationship between other complications and the laboratory values of the groups. Conclusions In the study, we found that PLR values were significantly high in the pediatric patients having hypoxia who underwent adenotonsillectomy. MPV values were significantly high in the patients who had hypotension in the early post-operative period. Based on these findings, it has been suggested that pre-operative PLR value can be a predicting guide for bronchospasm, laryngospasm. On the other hand, MPV values can be used as a guide in terms of predicting hypotension.

Objectives This study aimed to examine the effects of chronic periodontitis and essential hypertension on serum and salivary cartonectin (CTRP3) and procalcitonin (ProCT) levels. Methods Sixty non-smokers were seperated into four groups as; 15 people with essential hypertension (EH) and chronic periodontitis (CP) (HT+ CP+), 15 with EH (HT+ CP−), 15 with CP (HT− CP+), 15 control (HT− CP−). PPD, CAL, PI and GI were measured. All groups had their serum and saliva samples collected. Serum and saliva procalcitonin (ProCT) were measured using an electroluminescence method, and cartonectin (CTRP3) levels were determined by enzyme-linked immunosorbent assay. Results When compared to the control group, serum and saliva cartonectin (CTRP3) levels were considerably lower in all groups (respectively p<0.0001, p<0.0001). The serum cartonectin (CTRP3) levels were substantially higher in the HT− CP+ group than in the HT+ CP− group (p=0.002). Serum procalcitonin (ProCT) concentrations were found to be lowest in the HT− CP− group and highest in the HT+ CP+ group. Serum ProCT concentrations did not vary significantly across groups (p=0.110). Salivary procalcitonin (ProCT) levels were below the detection limit in all groups. Conclusions When periodontitis coexist with hypertension in individuals, they may have adversely affect each other due to the same sathways in the pathogenesis of these two disorders. So we can suggest that, serum and saliva cartonectin (CTRP3) may play a role during hypertension and periodontal inflammation and represent a novel future therapeutic target.

Objectives Oxidative stress is closely associated with atherosclerosis and acute coronary syndromes. The purpose of this study was to evaluate well-known and proportional oxidative stress biomarkers in ST-Elevation Myocardial Infarction (STEMI) patients. Methods In this single center, prospective and cross-sectional study, 107 individuals (63 patients) were studied. Total oxidative status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), ischemia modified albumin (IMA), myeloperoxidase (MPO), paraoxonase-1 (PON-1) and arylesterase (AREase) enzyme activities as well as MPO/PON-1, MPO/AREase and MPO/HDL-C ratios were studied. As short-term in-hospital prognosis biomarkers; in-hospital mortality, early systolic dysfunction and spontaneous complete revascularization were investigated. Results Our results indicated that TOS, OSI, IMA, MPO, MPO/PON-1 and MPO/HDL ratios were significantly higher, PON-1 and AREase were significantly lower in STEMI patients compared to the control group. However, in the regression analysis performed by adjusting the differences between the groups, only IMA was found as an independent risk factor (OR=2.711, 95 % CI=1.094–6.719, p=0.031). In terms of in-hospital short-term prognostic biomarkers, a significant relationship was found only between OSI and spontaneous complete revascularization. The OSI value was higher in the group with TIMI grade 3 flow than in the group with TIMI grade 0–2 flow (2.42 [0.81–4.49] vs. 1.63 [0.33–6.07], p=0.016). Conclusions In STEMI patients, both the well-known (TOS, OSI, and MPO) and proportional (MPO/PON-1 and MPO/HDL cholesterol ratios) oxidative stress markers were elevated and can be considered as having a role in the pathogenesis of STEMI.

Objectives Advanced heart failure is the last stage of heart failure in which the life expectancy of patients is significantly reduced. Many mortality markers have been identified in advanced heart failure. Although the nesfatin-1 molecule is known as a satiety hormone, it has also been shown to be associated with many cardiovascular diseases. This study aims to elucidate the association between in-hospital mortality and nesfatin-1 level in advanced heart failure patients. Methods The research included 74 cases of advanced heart failure. During the coronary intensive care surveillance of these patients, 22 patients had in-hospital mortality. The cases, divided into groups with and without in-hospital mortality, were compared using laboratory data, echocardiography, and demographic properties. Results The age of the cases with in-hospital mortality was older than the cases without mortality [(74 (66–95) vs. 67 (26–90); p=0.019)]. Serum nesfatin-1 level and tricuspid annular plane systolic excursion (TAPSE) were statistically lower in the in-hospital mortality group (43.8 ± 5.5 vs. 40.5 ± 6.1; p=0.027, 13.5 ± 1.9 vs. 16.2 ± 2.6 p=0.001, respectively). Serum nesfatin-1 level and TAPSE were detected as independent predictors for in-hospital mortality in advanced heart failure via multivariate analysis using parameters that were significant in the univariate analysis. Receiver operator characteristic curve analysis showed that the optimum cut-off level for nesfatin-1 in determining in-hospital mortality was ≤23.57 (pg/mL) with a specificity of 73.1 % and a sensitivity of 77.3 % (AUC=0.763, 95 % CI=0.647–0.879, p<0.001). Conclusions This research revealed that in advanced heart failure patients, serum nesfatin-1 amounts are associated with mortality and seem to be an independent predictor of mortality.

Objectives Our study aimed to investigate the role of endoplasmic reticulum stress (ER) in brain damage following hepatic ischemia-reperfusion (HIR) injury. Specifically, we characterized the expression of markers of ER stress and histopathologic changes in the brain following HIR. Methods Twelve adults female Wistar rats were divided into two experimental groups equally. Group 1 was designed as the control group, and Group 2 was designed as the HIR group. Blood, liver, and brain tissue samples were collected during the sacrifice. The quantitative ELISA kits were used to detect glucose-regulated protein 78 (GRP-78), activating transcription factor 4 (ATF-4), eukaryotic initiation factor 2 alpha (EIF2-A), caspase-3, caspase-9, and CCAAT/enhancer-binding protein (CEBP) in plasma. Histopathological examination was performed for liver and brain tissues. Results Higher levels of GRP-78 (p=0.006), ATF4 (p=0.001), and EIF2-Α (p=0.007) were detected in group 2. More damage was detected in liver and brain samples in the histopathological examination of group 2 than in group 1. Conclusions Our results demonstrate that ER stress is involved in developing brain damage following hepatic ischemia-reperfusion injury, as evidenced by increased expression of markers of ER stress and neuronal injury.

Objectives Leukemoid Reaction (LR) signifies leukocytosis characterized by mature neutrophils. The incidence of LR is about 1 % among hospitalized patients. Mucormycosis is a rare, aggressive, fatal fungal infection that afflicts immune-compromised patients. This study discusses the case of concomitant leukemoid reaction and mucormycosis in a patient with severe COVID-19 infection. Case presentation A 45-year-old female patient was presented to the hospital with confirmed SARS-CoV-2 and was given supplemental oxygen and placed on mechanical ventilation. Her skin biopsy revealed non-septate hyphae with wide-angle branching. Her blood tests also revealed the presence of LR. Conclusions Severe COVID-19 infection causes new-onset hyperglycemia, which can lead to metabolic acidosis, toxic metabolite accumulation in the body due to renal failure, the release of stress hormones and inflammatory cytokines, and the occurrence of secondary bacterial and opportunistic fungal infections. The study has shown that LR in severe COVID-19 may be associated with severe infections (bacterial or fungal) and other pathophysiological changes in the body.

Objectives The aim of this study is to determine the opinions of midwives and nurses about the efficiency and effectiveness of the biochemistry courses they took during their undergraduate education, in the education process and in their fields of study. Methods Two hundred eighty-four students studying in the department of midwifery and nursing (1–4 classes) participated in this research voluntarily. A questionnaire consisting of 10 multiple-choice questions compiled by the authors with the support of the sociodemographic data form, including age, gender, type of lycee school graduated, and the department they studied, and the literature on biochemistry education were applied to the students. Results The mean age of the students was 21.25 ± 0.12. 58.2 % of midwifery department students and 69.1 % of nursing department students reported that biochemistry education is necessary. 64.1 % of midwifery department students and 59.7 % of nursing department students stated that they thought that the biochemistry application course should be absolutely necessary. There was a significant difference between nursing and midwifery students in favor of nursing students in terms of finding the biochemistry course interesting and loving the biochemistry course. A significant difference was found between the two groups in favor of midwifery students in terms of their desire to pursue postgraduate education in biochemistry and to increase biochemistry course hours (p<0.05). Conclusions It is thought that the results of this study, which include students’ opinions, will contribute to the efficiency of biochemistry education and help the lecturer provide a new perspective.