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Öğe A New Predictor for Insulin Resistance in Polycystic Ovary Syndrome: InsuTAG(Bentham Science Publ Ltd, 2024) Omma, Tulay; Gokce, Aksanur; Celik, Mustafa; Karahan, Irfan; Culha, Cavit; Gulcelik, Nese ErsozBackground: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among women of reproductive age. PCOS leads to metabolic dysfunction such as dyslipidemia, obesity, and glucose intolerance based on hyperandrogenemia, hyperinsulinemia, and dysregulated adipokine secretion.Objective: The aim of this study was to investigate whether a new marker, InsuTAG (fasting insulinxfasting triglycerides) could predict insulin resistance (IR) in patients of PCOS.Methods: In this study, retrospective data of 300 female patients diagnosed with PCOS were analyzed. The relationship between InsuTAG and HOMA-IR, TyG, and TG/HDL-C scores related to insulin resistance was evaluated. In addition, the distribution of the cases according to the cut-off values was determined.Results: Log-transformed forms of InsuTAG and HOMA-IR, TyG and TG/HDL-C results were positively correlated, respectively. (r = 0.85, p < 0.001; r = 0.78, p < 0.001; r = 0.72, p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive values for InsuTAG were calculated as 85%, 85%, 82% and 88%, respectively.Conclusion: This study is the first to compare the InsuTAG, another predictor of insulin resistance, with other IR markers in women with PCOS. InsuTAG is a novel biomarker based on plasma sampling of insulin and triglyceride, with minimally invasive, inexpensive and orientally accessible features.Öğe Are Lipoprotein Levels and Ratios Able to Predict Mortality due to Sepsis?(Coll Physicians & Surgeons Pakistan, 2020) Karahan, Irfan; Cifci, AydinObjective: To compare lipoprotein levels, and non-HDL to high-density lipoprotein (HDL) ratios of survivors and nonsurvivors of sepsis, and to determine the predictivity levels of specified parameters in mortality. Study Design: Descriptive study. Place and Duration of Study: Department of Internal Medicine, Kirikkale University, School of Medicine, Training and Research Hospital, Kirikkale, Turkey, from December 2017 to December 2018. Methodology: The study subjects included 37 non-survivors and 32 survivors of sepsis with similar ages, comorbidities, and disease activities. The total lipoprotein levels, and non-HDL to HDL ratios of the participants were compared retrospectively. Results: HDL and non-HDL to HDL ratios were found to be different between the two groups. The cut-off levels of these values were determined as 32 and 3.4, respectively. The cut-off levels found in the study suggest that the low HDL levels and high non-HDL to HDL ratios significantly increase the mortality risk for patients (OR=1.8 and 3.45, respectively). Conclusion: Non-HDL to HDL ratio may be used as a useful tool for predicting sepsis mortality. These values may also be included as a part of scoring systems. Further investigations are needed to clarify the role of lipoproteins in sepsis.Öğe The COVID-19 anxiety of hospitalised patients in a palliative care unit(MARK ALLEN GROUP, 2020) Karahan, Irfan[Özet Yok]Öğe Dietary Acid Load Associated with Hypertension and Diabetes in the Elderly(Bentham Science Publishers, 2022) Omma, Tulay; Gulcelik, Nese Ersoz; Zengin, Fatmanur Humeyra; Karahan, Irfan; Culha, CavitBackground: Diet can affect the body's acid-base balance due to its content of acid or base precursors. There is conflicting evidence for the role of metabolic acidosis in the development of cardiometabolic disorders, hypertension (HT), and insulin resistance (IR). Objective: We hypothesized that dietary acid load (DAL) is associated with adverse metabolic risk factors and aimed to investigate this in the elderly. Methods: A total of 114 elderly participants were included in the study. The participants were di-vided into four groups, such as HT, diabetes (DM), both HT and DM, and healthy controls. An-thropometric, biochemical, and clinical findings were recorded. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) results were obtained for three days, 24-hour dietary records via a nutrient database program (BeBiS software program). Results: The groups were matched for age, gender, and BMI. There was a statistically significant difference between the groups regarding NEAP (p =0.01) and no significant difference for PRAL (p = 0.086). The lowest NEAP and PRAL levels were seen in the control group while the highest in the HT group. Both NEAP and PRAL were correlated with waist circumference (r = 0,325, p = 0.001; r=0,231, p =0,016, respectively). Conclusion: Our data confirmed that subjects with HT and DM had diets with greater acid-forming potential. High NEAP may be a risk factor for chronic metabolic diseases, particularly HT. PRAL could not be shown as a significantly different marker in all participants. Dietary content has a significant contribution to the reduction of cardiovascular risk factors, such as HT, DM, and obesity. © 2022 Bentham Science Publishers.Öğe Does Subclinical Hypothyroidism Affect Dynamic Thiol/Disulfide Homeostasis and ischemia-modified Albumin Levels in Children?(COLL PHYSICIANS & SURGEONS PAKISTAN, 2020) Tursun, Serkan; Alpcan, Aysegul; Ergur, Ayca Torel; Karahan, Irfan; Neselioglu, Salim; Erel, OzcanObjective: To determine the effects of subclinical hypothyroidism on oxidative stress in children. Study Design: A cross-sectional study. Place and Duration of Study: Department of Paediatrics, Paediatric Endocrinology, and General Outpatient Clinics, Kirikkale University, School of Medicine, from May 2017 to October 2018. Methodology: This study included 92 subjects aged between 2 and 18 years. The subjects were divided into two groups. Forty-seven children with subclinical hypothyroidism and 45 healthy controls were evaluated. In order to evaluate oxidative damage, native thiol, total thiol, disulfides, their ratios, and ischemia-modified albumin (IMA) levels were compared between the two groups. The relationship between TSH and IMA levels was assessed. Results: Age and gender were not significantly different in the two groups. Native thiol, total thiol, disulfides and their ratios were similar in the two groups. lschemia-modified albumin levels were significantly higher in the patient group than the controls (p<0.001). There was no correlation between TSH and IMA levels in the patient group (r=0.069 p=0.645). Conclusion: Subclinical hypothyroidism may be related to the impairment of IMA, and have a neutral effect on thiol/disulfide balance. Further research is needed to explain the effects of oxidative stress in subclinical hypothyroidism.Öğe Effects of Comorbidities, Inflammation and Glycaemic Control on Length of Hospital Stay/Potentially Avoidable Readmission Risk in Type 2 Diabetic Patients- A Retrospective Analysis(Journal Evolution Medical & Dental Sciences, 2019) Karahan, IrfanBACKGROUND Patients with diabetes can have long hospitalization and frequent readmissions for different reasons. Predicting the duration of hospitalization and readmission risk may be helpful for management. We wanted to identify factors that affect the length of hospital stay and potentially avoidable readmission risk. METHODS 102 type 2 adults with diabetes that were hospitalized and discharged between July 2017 and July 2018 in Kirikkale University, Department of Internal Medicine, were investigated retrospectively. HOSPITAL score was calculated for detecting 30-day readmission risk. Haemoglobin A1c for glycaemic control, C-reactive protein/serum albumin ratio (CAR) for inflammation, Charlson comorbidity score for multimorbidities, and age were researched as factors that affect the length of stay/ HOSPITAL score. RESULTS There were 70 female and 32 male patients. The median age of participants was 69. Median HbA1c was 9.2%, median Charlson comorbidity score was 6, median CAR was 3.33, median HOSPITAL score was 4. Significant positive correlation was detected between age, Charlson comorbidity score, CAR, HbA1c level and both hospital length of stay/HOSPITAL score by Spearman's correlation analysis. However, Charlson comorbidity score and CAR had significant values with both length of hospital stay/ HOSPITAL score according to the linear regression model. CONCLUSIONS Identifying the factors that affect readmission and length of stay, benefits hospitalized diabetes patient management. This can have favourable impact on costs, sources and approach. Type 2 diabetes patients can have multiple comorbidities and inflammatory conditions. Inflammation and comorbidity presence have negative effects on length of stay and avoidable readmission. Presence of these indices' in high levels should be considered high risk for readmission and these patients should be evaluated carefully.Öğe Evaluation of peripheral olfactory pathways in chronic autoimmune thyroiditis(Springer, 2022) Inal, Mikail; Asal, Nese; Karahan, Irfan; Gungunes, Askin; Durmaz, Senay ArikanPurpose In this study, we aimed to radiologically evaluate the olfactory bulb (OB) volume and olfactory sulcus (OS) depth of adult patients diagnosed with chronic autoimmune thyroiditis. Methods Sixty-eight patients over 18 years of age with Hashimoto's thyroiditis and 66 healthy controls with normal thyroid function tests were included in the study. OB volume and OS depth measurements were performed using cranial magnetic resonance imaging (MRI) obtained from coronal T2-weighted images. The relationship between thyroid function tests, autoantibodies, and measurements of the OB and OS were evaluated. Results The right and left OB volumes were significantly lower in the patients with Hashimoto's thyroiditis than in the control group (p < 0.05). No significant difference was found between the patient and control groups in terms of OS depth (p > 0.05). There were significantly negative correlations among TSH, thyroid antibodies, and the bilateral OB volume measurements. In the Bonferroni post hoc analysis, when people with euthyroid Hashimoto's thyroiditis and the control group were compared, there was no statistically significant difference between bilateral OB volumes and thyroid function tests. Conclusion Diminished bilateral OB volumes were found in our patients with chronic autoimmune thyroiditis. Interestingly, the OB volumes were not affected in patients with euthyroid Hashimoto's thyroiditis. When a decrease in OB volume is detected on MRI, it should be kept in mind that odor dysfunction in hypothyroid patients with Hashimoto's thyroiditis may occur and patients should be clinically evaluated.Öğe Interobserver Agreement in the Analysis of Different Radiological Classifications of COVID-19 on Computed Tomography(Galenos Publ House, 2021) Ozdemir, Adnan; Yilmaz, Sevda; Erol, Ozlem Ozluk; Kaygusuz, Sedat; Goncuoglu, Alper; Erkmen, Selmin Perihan Komurcu; Karahan, IrfanIntroduction: Computed tomography (CT) has approximately 98% sensitivity for Coronavirus disease-2019 (COVID-19). Various algorithms were designed using CT images. However, the interobserver agreement of different radiological classifications of COVID-19 is not yet known. Thus, this study aimed to investigate the interobserver agreement of different radiological classifications of COVID-19. Materials and Methods: This study included 212 patients who were positive on the polymerase chain reaction test and eligible for CT. Four radiologists examined all CT images simultaneously. They reached a consensus that CT images can provide definite findings of COVID-19. The Radiological Society of North America (RSNA) consensus statement, the British Society of Thoracic Imaging (BSTI) structured reporting statement, and COVID-19 Reporting and Data System (CO-RADS) were used. Fleiss' Kappa was used to detect interobserver agreement. Kappa values of 0.000.20 were considered as slight, 0.21-0.40 as fair, 0.41-0.60 as moderate, 0.61-0.80 as substantial, and 0.81-1.00 as near-perfect agreement, and p<0.05 was accepted as significant. Results: A total of 137 patients did not have any pathological CT findings. The most prevalent radiological findings were ground-glass opacities and consolidations. The agreements on all classifications were at near-perfect levels: RSNA, 0.86 (0.82-0.90); BSTI, 0.83 (0.79-0.87), and CO-RADS, 0.82 (0.79-0.86). The RSNA classification has the highest consistency rate, followed by BSTI and CO-RADS. However, substantial and moderate agreements were found in the subcategories of each classification. Conclusion: In this study, some subcategories had a lower agreement, despite the high consistency rates for COVID-19 radiological classification systems in the literature. Therefore, improving the items without consensus can lead to the development of better radiological diagnostic approaches.Öğe Is C-Reactive Protein/Albumin Ratio of Advanced-Stage Non-small Cell Lung Cancer Patients Able to Predict Mortality in the Admission for Palliative Care?(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2020) Karahan, Irfan; Yalcin, SelimContext: Lung cancer is frequent and mortal cancer. The predicting mortality may be helpful for cancer management. Aim: The purpose of the study was to evaluate the role of baseline C-reactive protein (CRP)/albumin ratio (CAR) in relation to hospital mortality, the setting of advanced stage non-small cell lung cancer (NSCLC). Materials and Methods: The present study is a retrospective analysis and included 77 adult patients with Stage IV NSCLC who were hospitalized for supportive care. All patients are divided into two groups as survivors and nonsurvivors. CAR on the admission was compared between groups. The correlation between CAR and the death time was investigated. The cutoff level of CAR was calculated, and patients with a high level were described in two groups. Results: For all participants, the mean age was 63.0 +/- 9.9 years, and the median values of CRP and albumin levels were 15.3 mg/dl (1-51.5) and 5.7 g/dl (0.02-22.7), respectively. CAR was significantly lower in the survivor group. By receiver operation curve analysis, the cutoff levels of CRP and CAR were determined as 10.8 and 3.5, respectively. The odds ratio of mortality was 3.85 (1.49-9.94 95% confidence interval [CI], P = 0.006) for higher than cutoff levels of CAR. The odds ratio was 3.38 (1.32-8.65 95% CI, P = 0.01) for higher CRP levels. There was a significant but weak negative correlation between the time of death and both CRP and CAR in the nonsurvivor group (r = -0.46, P = 0.002; r = -0.48, P = 0.001, respectively). Conclusion: The present study showed that CAR was significantly increased in nonsurvivors. CAR may be a cheap, easy, and effective tool for predicting the death and its time of hospitalized NSCLC patients.Öğe Is YouTube a quality source of information on sarcopenia?(SPRINGER, 2020) Akyol, Ahmet; Karahan, IrfanBackground While sarcopenia is a prevalent disorder that affects muscle mass and quality, patients have limited knowledge of it. On the other hand, patients often use social media to obtain health-specific information. Therefore, the aim of this study was to investigate the YouTube videos about sarcopenia in terms of the knowledge value of what they present and to identify which of them can be considered as the quality sources of such information. Methods The descriptive study included 53 videos retrieved by searching the keywords 'sarcopenia', 'loss of muscle strength', 'sarcopenia treatment,' 'sarcopenia physiotherapy,' and'sarcopenia rehabilitation' on YouTube. The instructive characteristics of the videos were assessed with the Global Quality Scale, by which three quality groups were identified: poor-, moderate-, and high-quality videos. The DISCERN score was utilized to determine reliability. The sources of upload were identified as physicians, non-physician health personnel, health-related websites, universities and academic organizations, patients, and independent users. Finally, the lengths of videos, the number of views, likes, dislikes, and comments, and the DISCERN scores of the videos were compared using group comparisons. Results The results suggested that there were 18 poor-quality, 16 moderate-quality, and 19 high-quality videos. Considering the sources of upload, physicians had the highest ratio in the high-quality group (83.3%). The lengths of videos and the DISCERN scores showed significant differences (p < 0.01). The numbers of views, likes, dislikes, and comments were similar in both quality and source groups. Conclusion Most parts of the videos uploaded by physicians and academic organizations were included in the high-quality group. Overall, according to the results of the study, it can be asserted that high quality may be related to reliability. Furthermore, healthcare professionals and academics should consider using YouTube for increasing knowledge and raising awareness of patients about sarcopenia. Key summary pointsAim To determine the quality and source groups of YouTube videos about sarcopenia knowledge. Findings The most qualified and reliable videos were from physicians and academic organizations. Message The professionals should consider posting videos for increasing awareness about sarcopenia.Öğe Non-functioning adrenal incidentalomas may increase toxic metabolites(Springer Wien, 2022) Karahan, Irfan; Ceylan, Senay Durmaz; Gungunes, Askin; Cifci, Aydin; Eker, Fatih; Kisa, UclerBackground Non-functioning adrenal incidentaloma (NFAI) is a frequent diagnosis with increasing radiological tests. The emerging shreds of evidence showed that they might have negative cardiometabolic effects. The study aimed to investigate whether the toxic metabolites, asymmetric dimethylarginine (ADMA) levels, were altered in NFAI patients. Methods We included 43 NFAI patients and 41 controls with similar ages and body mass indices in the study. We compared plasma ADMA levels of both groups and noted the radiological features of NFAIs. Results The ADMA levels were significantly higher in NFAI patients than in the control group (307.04 ng/ml, range 81.89-577.7 ng/ml vs 192.54 ng/ml, range 70.61-440.26 ng/ml, p = 0.001). Nevertheless, we could not reach a significant correlation between ADMA levels and mass size. Conclusion The ADMA is known as a toxin and is increased in NFAI patients. NFAIs may not be innocent and may be considered a potential risk for the body. Further investigations were needed for more explanations.Öğe Prognostic effects of SuPAR and Neopterin Levels on Patients with Lung Cancer(WALTER DE GRUYTER GMBH, 2020) Yalcin, Selim; Demir, Mehmet Emin; Ozturk, Reyhan; Kilinc, Aytun Sadan; Suer, Hatice; Karahan, IrfanBackground: Two unique biomarkers, soluble form of the urokinase-type plasminogen activator receptor (suPAR) and neopterin, play a crucial role in inflammatory processes. This study aimed to reveal whether it is possible to utilize these biomarkers in predicting tumor prognosis in patients with lung cancers. Methods: The present study was designed as a single center, prospective, and controlled research. The study was conducted with forty patients with lung cancer (case group) and 41 healthy individuals (control group) in Kirikkale University, Faculty of Medicine between 2016-2020. The case group was also divided into two of the early and advanced stages. The blood samples were drawn to evaluate suPAR and neopterin levels, and these parameters were compared between the case and control groups. Also, the prognostic effects of age, stage of the tumor, and the levels of mentioned parameters were investigated with the survival analysis. Results: The median duration of the follow-up was 32 (4-75) months. suPAR and neopterin levels were found to be higher in the case group than in the control group. Cox regression showed that the high levels of neopterin and suPAR increased mortality risk [1)=0.002, HR: 1.25 (1.081.45 95%CI) and p=0.023, HR:1.07 (1.01-1.13), respectively]. Finally, age and stage of the tumor were found to have no relationship with survival. Conclusion: suPAR and neopterin as members of the inflammatory pathway were found to be higher in cancer cases. Furthermore, both suPAR and neopterin levels were found to be predictive for the mortality of patients with lung cancers; therefore, they are thought to be used for the management of cancer.Öğe The role of cancer-related inflammation for prediction of poor survival in postmenopausal female patients with stage II/III colon cancer(ELSEVIER, 2020) Zengin, Mehmet; Karahan, IrfanObjective: Cancer-related inflammation (CRI) is thought to be a successful predictor of prognosis in colon cancers (CC), but opinions on how to use it are highly variable. In this study, the role of CRI cells in survival for CC patients was investigated by considering gender and menopausal status. Methods: 163 stage II/III CC patients who underwent curative surgery between 1995 and 2015 were included in the study. The relationship between CRI cells was examined using a standard methodology. Results: High neutrophil-lymphocyte ratio (NLR) had a better relationship with prognostic factors, especially in postmenopausal women (gender, p = 0.037, positive surgical margin, p = 0.001; MSI, p < 0.001; Crohn's-like reaction, p = 0.001, etc). Also, the reproducibility of the study was better in postmenopausal women (intraobserver agreement = 0.72, intra-class correlation = 0.722, correlation of estimates = 0.718). In univariate analysis, 5-year survival was worse in postmenopausal women with high NLR (OS, p= 0.001; RFS, p < 0.001). In multivariate analysis, high NLR was independently a worse biomarker for OS (hazard ratio [HR], 1.29; 95% CI, 1.18-2.12; p = 0.001) and RFS (HR, 1.30; 95% CI, 1.21-2.59; p < 0.001) in postmenopausal women. Conclusions: NLR had an independent poor prognostic significance in postmenopausal female patients, and the use of a standard approach for methodology improved successful results.Öğe The prediction of lung cancer prognosis with blood lipid levels and ratios at the time of diagnosis(Wolters Kluwer Medknow Publications, 2022) Arslan, Ferhat; Yalcin, Selim; Karahan, IrfanBackground: Emerging evidence has linked lipid metabolism disorder with lung diseases, but the relationship between blood lipid profile and lung cancer risk is controversial and inconclusive. It was aimed to investigate the relationship of lipid levels and ratios at the time of diagnosis to the prognosis prediction of lung cancer. Methods: Sociodemographic and disease-related clinical characteristics of 92 patients diagnosed with lung cancer were reviewed retrospectively. Patients with available lipid parameters at the time of diagnosis were evaluated. Hemogram parameters of the patients included in the study, creatinine and estimated glomerular filtration rate, alanine aminotransferase level, albumin level, C-reactive protein level, as well as total cholesterol (TC)/high-density cholesterol (HDL) ratio, non-HDL/HDL ratio, low-density lipoprotein/HDL ratio, and triglyceride/HDL ratios were examined. Results: The mean age at presentation was 64.2 +/- 9.1 years. The distribution of lung cancers is 6 (6.5%) for small cell lung cancer (SCLC) and 86 (93.5%) for non-SCLC. The median follow-up period of the patients is 12 months. During the follow-up, 63 (68.5%) of the patients died. In the univariate analysis, increased non-HDL/HDL ratio was related to mortality. In multivariate analysis, disease stage, albumin level, and TC level were found to be variables affecting the mortality. Conclusion: TC levels at the time of diagnosis can be a guide in determining the prognosis. More experimental studies are needed to elucidate the relationship between the lipid metabolism and lung cancer etiology and to determine the role of lipid levels and ratios in prognosis prediction.
