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Kerget F, Kerget B. Can Fractional Exhaled Nitric Oxide (FeNO) Serve as a Clinical Indicator for Patients Hospitalized with Crimean-Congo Hemorrhagic Fever? Jpn J Infect Dis 2023; 76:226-232. [PMID: 37005275 DOI: 10.7883/yoken.jjid.2022.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Crimean-Congo hemorrhagic fever (CCHF), a zoonotic disease spread by infected viruses, can be a significant cause of morbidity and mortality in endemic areas. This prospective study aimed to establish the relationship between fractional exhaled nitric oxide (FeNO) levels and clinical prognosis of CCHF. The study included 85 participants: 55 patients followed up for CCHF from May to August 2022, and 30 healthy controls. FeNO levels were measured upon hospital admission and were 7.6 ± 3.3 parts per billion (ppb) in patients with mild/moderate CCHF, 2.5 ± 2.1 ppb in patients with severe CCHF, and 6.7 ± 1.7 ppb in the healthy control group. There was no statistically significant difference in FeNO levels between the control group and patients with mild/moderate CCHF (P = 0.09), whereas patients with severe CCHF had lower FeNO levels than those in the control group and patients with mild/moderate CCHF (P < 0.001 for both). FeNO measurement may offer a noninvasive and easily applied approach for predicting the clinical course and prognosis of CCHF in the early stages of the disease.
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Affiliation(s)
- Ferhan Kerget
- Department of Infectious Diseases and Clinical Microbiology, Erzurum Regional Training and Research Hospital, University of Health Sciences, Turkey
| | - Buğra Kerget
- Department of Pulmonary Diseases, Faculty of Medicine, Ataturk University, Turkey
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2
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Kerget B, Kerget F, Tuna ME. A Rare Factor in the Etiology of Loffler's Pneumonia: Fasciola hepatica. Rev Soc Bras Med Trop 2023; 56:e02012023. [PMID: 37493748 PMCID: PMC10367213 DOI: 10.1590/0037-8682-0201-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/31/2023] [Indexed: 07/27/2023] Open
Affiliation(s)
- Buğra Kerget
- Ataturk University School of Medicine, Department of Pulmonary Diseases, Yakutiye, Erzurum, Turkey.Ataturk University School of MedicineDepartment of Pulmonary DiseasesYakutiyeErzurumTurkey
| | - Ferhan Kerget
- Health Sciences University, Erzurum Regional Education and Research Hospital, Depertmant of Infection Diseases and Clinical Microbiology, Erzurum, Turkey.Health Sciences UniversityErzurum Regional Education and Research HospitalDepertmant of Infection Diseases and Clinical MicrobiologyErzurumTurkey
| | - Mehmet Eren Tuna
- Ataturk University School of Medicine, Department of Pulmonary Diseases, Yakutiye, Erzurum, Turkey.Ataturk University School of MedicineDepartment of Pulmonary DiseasesYakutiyeErzurumTurkey
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Kerget F, Kerget B, Laloglu E. Evaluation of the role of serum DcR3 levels in the early clinical prognosis of patients with Crimean-Congo hemorrhagic fever. Clin Biochem 2023; 118:110574. [PMID: 37100109 DOI: 10.1016/j.clinbiochem.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease that is transmitted by Hyalomma ticks and is endemic in many parts of the world. This study aimed to determine the relationship between early serum Decoy receptor-3 (DcR3) level and clinical severity in patients with CCHF. METHODS The study included 88 patients hospitalized for CCHF between April and August 2022 and a control group of 40 healthy individuals. The patients were divided according to clinical course as those with mild/moderate (group 1, n=55) and severe (group 2, n=33) CCHF. DcR3 levels were measured by enzyme-linked immunosorbent assay of serum obtained at the time of diagnosis. RESULTS Fever, hemorrhage, nausea, headache, diarrhea, and hypoxia were significantly more common among patients with severe CCHF than patients with mild/moderate CCHF (p<0.001, <0.001, 0.02, 0.01, <0.001, and <0.001, respectively). Group 2 had higher serum DcR3 levels than both group 1 and the control group (p<0.001 for both). Serum DcR3 levels were also significantly higher in group 1 than in the control group (p<0.001). Using 98.4 ng/mL as the cut-off value, serum DcR3 had 99% sensitivity and 88% specificity in differentiating patients with severe CCHF from those with mild/moderate CCHF. CONCLUSION During the high season in our endemic region, CCHF can present with a severe clinical course independent of age and comorbidities, unlike other infectious diseases. Elevated DcR3 observed early in the disease may allow additional immunomodulatory therapies to be tried in addition to antiviral therapy in CCHF, for which treatment options are limited.
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Affiliation(s)
- Ferhan Kerget
- Depertmant of Infection Diseases and Clinical Microbiology, Health Sciences University, Erzurum Regional Education and Research Hospital, Erzurum, Turkey.
| | - Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Yakutiye, Erzurum, Turkey
| | - Esra Laloglu
- Department of Biochemistry, Ataturk University School of Medicine, 25240, Yakutiye, Erzurum, Turkey
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Karabulut Uzunçakmak S, Aksakal A, Kerget F, Aydın P, Halıcı Z. Evaluation of IGFBP5 expression and plasma osteopontin level in COVID-19 patients. Adv Med Sci 2023; 68:31-37. [PMID: 36427358 PMCID: PMC9640409 DOI: 10.1016/j.advms.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/07/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE The aim of this study is to investigate insulin-like growth factor binding protein 5 (IGFBP5) expression in coronavirus disease 2019 (COVID-19) patients and its relationships with COVID-19 laboratory findings and plasma osteopontin (OPN) levels. MATERIALS AND METHODS We enrolled 60 patients with COVID-19 and 30 healthy individuals in this study. mRNA expression of IGFBP5 was measured by RT-PCR. Plasma OPN levels were measured via the ELISA method. RESULTS Plasma OPN levels were higher and IGFBP5 expression levels were lower in COVID-19 patients than in the healthy individuals (p = 0.0057 and p = 0.0142, respectively). Critically ill patients had higher OPN and lower IGFBP5 than non-critically ill patients. Patients with affected lungs demonstrated increased OPN and decreased IGFBP5 (p = 0.00032 and p = 0.044, respectively). Receiver operating characteristic (ROC) analysis indicated that IGFBP5 expression and OPN levels can be used discriminate non-critically from critically ill patients (p = 0.049; p = 0.0016, respectively). CONCLUSION This study demonstrated that patients with a poor prognosis had increased OPN and decreased IGFBP5. High values of OPN and low values of IGFBP5 may be considered as signs of disease severity. Tissue-specific IGFBP5 expression may contribute to understanding the role of IGFBP5 in the lungs in COVID-19 cases.
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Affiliation(s)
- Sevgi Karabulut Uzunçakmak
- Health Services Vocational School, Bayburt University, Bayburt, Turkey,Corresponding author. Health Services Vocational School, Bayburt University, Gençosman Street, Bayburt, 69000, Turkey
| | - Alperen Aksakal
- Department of Chest Diseases, Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infectious and Clinical Microbiology Diseases, Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Pelin Aydın
- Department of Anesthesiology and Reanimation, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Zekai Halıcı
- Faculty of Medicine, Department of Pharmacology, Ataturk University, Erzurum, Turkey,Clinical Research, Development and Design Application and Research Center, Ataturk University, Erzurum, Turkey
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Baydar Toprak O, Akpolat T, Uzun O, Pınar Deniz P, Kokturk N, Varol A, Guzel E, Ercelik M, Gultekin O, Guner R, Turan S, Gökbulut Bektaş Ş, Coskun N, Bakan N, Nuri Yakar M, Eren Kutsoylu O, Ergan B, Argun Barış S, Başyiğit I, Boyacı H, Çetinkaya F, Çolak H, Aykac N, Baran Ketencioğlu B, Türe Yüce Z, Akkaya Isık S, Serap Yılmaz E, Karaoğlanoğlu S, Berik Safci S, Ozkan G, Kose N, Kizilirmak D, Havlucu Y, Nural S, Kerget F, Sunal Ö, Yuksel A, Bestepe Dursun Z, Deveci F, Kuluozturk M, Ataoglu O, Dursun M, Keskin S, Emin Sezgin M, Aktepe Sezgin EN, Eser F, Akyildiz L, Selim Almaz M, Kayaaslan B, Hasanoğlu I, Bayrak M, Gümüş A, Sağcan G, Cuhadaroglu C, Kucuk H, Onyilmaz T, Mete B, Kilinc O, Oya Itil B. COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission. Eur Rev Med Pharmacol Sci 2023; 27:2132-2142. [PMID: 36930513 DOI: 10.26355/eurrev_202303_31586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.
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Affiliation(s)
- O Baydar Toprak
- Department of Chest Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Kerget B, Kerget F, Özmen S. Endobronchial actinomycosis. Rev Soc Bras Med Trop 2022; 55:e03152022. [PMID: 36287474 PMCID: PMC9592104 DOI: 10.1590/0037-8682-0315-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Buğra Kerget
- Ataturk University School of Medicine, Department of Pulmonary Diseases, Yakutiye, Erzurum, Turkey
| | - Ferhan Kerget
- Health Sciences University Erzurum Regional Education and Research Hospital, Depertmant of Infection Diseases and Clinical Microbiology, Erzurum, Turkey
| | - Sevilay Özmen
- Ataturk University School of Medicine, Department of Pathology, Yakutiye, Erzurum, Turkey
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Karabulut Uzunçakmak S, Naldan ME, Dirican E, Kerget F, Halıcı Z. Preliminary investigation of gene expression levels of PAPP-A, STC-2, and HIF-1α in SARS-Cov-2 infected patients. Mol Biol Rep 2022; 49:8693-8699. [PMID: 35796937 PMCID: PMC9261127 DOI: 10.1007/s11033-022-07710-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/14/2022] [Indexed: 11/27/2022]
Abstract
Background Coronavirus-19 is still considered a pandemic that influences the world. Other molecular alterations should be clearer besides the increasing cytokine storm and pro-inflammatory molecules. Hypoxic conditions that induce HIF-1α lead to stimulate gene expression of STC-2 that targets PAPP-A expression. This study aimed to determine gene expression levels of PAPP-A, STC-2, and HIF-1α in COVID-19 infection. We also aimed to reveal the relationship of these genes with laboratory and clinical data of COVID-19 patients. Materials and Results We extracted RNA from peripheral blood samples of COVID-19(+) and COVID-19(−) individuals. The real-time PCR method was used to measure mRNA expression of PAPP-A, STC-2, and HIF-1α. Gene expression analysis was evaluated by the 2−ΔΔCt method. PAPP-A, STC-2, and HIF-1α mRNA expressions of severe patients were higher than healthy individuals (p = 0.0451, p = 0.4466, p < 0.0001, respectively). Correlation analysis of gene expression patterns of severe patients demonstrated a positive correlation between PAPP-A and STC-2 (p < 0.0001, r = 0.8638). Conclusion This is the first study that investigates the relation of PAPP-A, STC-2, and HIF-1α gene expression in patients with COVID-19 infection. Besides the routine laboratory findings, PAPP-A, STC-2, and HIF-1α mRNA expressions may be considered to patients’ prognosis as a sign of increased cytokines and pro-inflammatory molecules.
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Affiliation(s)
| | - Muhammet Emin Naldan
- Department of Anesthesia, Bilecik Seyh Edibali University, 11230, Bilecik, Turkey
| | - Ebubekir Dirican
- Health Services Vocational School, Bayburt University, 69000, Bayburt, Turkey
| | - Ferhan Kerget
- Department of Infectious and Clinical Microbiology Diseases, Erzurum Regional Education and Research Hospital, 25240, Erzurum, Turkey
| | - Zekai Halıcı
- Department of Pharmacology, Ataturk University, 25240, Erzurum, Turkey
- Clinical Research, Development and Design Application and Research Center, Ataturk University, 25240, Erzurum, Turkey
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Çelik M, Yayık AM, Kerget B, Kerget F, Doymuş Ö, Aksakal A, Özmen S, Hülya Aslan M, Uzun Y. High-Frequency Chest Wall Oscillation in Patients with COVID-19: A Pilot Feasibility Study. Eurasian J Med 2022; 54:150-156. [PMID: 35703523 PMCID: PMC9634896 DOI: 10.5152/eurasianjmed.2022.21048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: Coronavirus 2019 disease presents in a spectrum that can range from mild viral infection to pneumonia. Common symptoms of coronavirus disease 2019 pneumonia include cough, sputum, and shortness of breath. High-frequency chest wall oscillation is a pulmonary rehabilitation method used for the recovery of pulmonary functions and removal of secretions in the lungs. The aim of the study was to evaluate the efficacy of high-frequency chest wall oscillation on patients with coronavirus disease 2019 pneumonia. Materials and Methods: In this study, 100 patients, between 18 and 70 years old, with a positive polymerase chain reaction result for coronavirus disease 2019, were included. Standard medical treatment was applied to all patients. In group rehabilitation, high-frequency chest wall oscillation treatment was applied twice a day for 20 minutes for 5 days. No additional intervention was made to the control group. Pulmonary function tests and oxygenation were evaluated on the first and fifth days. Patients’ high-flow oxygen, non-invasive mechanical ventilation, and invasive mechanical ventilation needs were evaluated and recorded. Results: Compared with the control group, the forced expiratory volume in 1 second, forced vital capacity, and peak expiratory flow rates were statistically higher in the rehabilitation group on the fifth day (P < .05). On evaluating the oxygenation of patients, the fifth day to first-day oxygen saturation difference was significantly higher in rehabilitation group than in control group (P < .05). Furthermore, the number of patients who needed non-invasive mechanical ventilation was lower in the rehabilitation group (P < .05). Conclusion: This study demonstrated that pulmonary rehabilitation applied with the high-frequency chest wall oscillation device in patients with coronavirus disease 2019 in the early period contributed to the improvement of oxygenation by providing significant improvement as observed in the pulmonary function tests of the patients.
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Affiliation(s)
- Mine Çelik
- Department of Anesthesiology and Reanimation, Atatürk University Faculty of Medicine, Erzurum, Turkey
- Clinical Research, Development and Design Application and Research Center, Atatürk University Faculty of Medicine, Erzurum, Turkey
- Corresponding author: Mine Çelik E-mail:
| | - Ahmet Murat Yayık
- Department of Anesthesiology and Reanimation, Atatürk University Faculty of Medicine, Erzurum, Turkey
- Clinical Research, Development and Design Application and Research Center, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Buğra Kerget
- Department of Pulmonary Diseases, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Erzurum Regional Education and Research Hospital, University of Health Sciences, Erzurum, Turkey
| | - Ömer Doymuş
- Department of Anesthesiology and Reanimation, Erzurum Regional Education and Research Hospital, University of Health Sciences, Erzurum, Turkey
| | - Alperen Aksakal
- Department of Pulmonary Diseases, Erzurum Regional Education and Research Hospital, University of Health Sciences, Erzurum, Turkey
| | - Sevilay Özmen
- Clinical Research, Development and Design Application and Research Center, Atatürk University Faculty of Medicine, Erzurum, Turkey
- Department of Pathology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Mehtap Hülya Aslan
- Department of Medical Microbiology, Erzurum Regional Education and Research Hospital, Erzurum, University of Health Sciences, Turkey
| | - Yakup Uzun
- Department of Mechanical Engineering, Atatürk University Faculty of Engineering, Erzurum, Turkey
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9
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Kerget B, Çelik E, Kerget F, Aksakal A, Uçar EY, Araz Ö, Akgün M. Evaluation of 3-month follow-up of patients with postacute COVID-19 syndrome. J Med Virol 2022; 94:2026-2034. [PMID: 35001367 PMCID: PMC9015610 DOI: 10.1002/jmv.27579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/23/2021] [Accepted: 01/05/2022] [Indexed: 12/31/2022]
Abstract
In addition to the highly variable clinical presentation of acute COVID-19 infection, it can also cause various postacute signs and symptoms. This study aimed to evaluate patients with postacute COVID-19 over 12 weeks of follow-up. The study included 151 patients who were diagnosed with COVID-19 by real-time polymerase chain reaction of a nasopharyngeal swab 1 month earlier, had radiologic findings consistent with COVID-19 pneumonia, and presented to the post-COVID-19 outpatient clinic between May and August 2021. The patients were divided into three groups based on COVID-19 severity: nonsevere pneumonia (Group 1), severe pneumonia (Group 2), and severe pneumonia requiring intensive care (Group 3). Evaluation of laboratory parameters at 4 and 12 weeks showed that Group 3 had a higher lactose dehydrogenase (LDH) level and a lower mean platelet volume than the other groups at both time points (p = 0.001 for all). Group 3 also had lower percent predicted forced vital capacity (FVC%), percent predicted forced expiration volume in 1 s (FEV1%), and percent predicted diffusion capacity of the lungs for carbon monoxide divided by alveolar volume (DLCO/VA%) compared to Groups 1 and 2 at Week 4 (p = 0.001, 0.004, 0.001, respectively) and compared to Group 1 at 12 weeks (p = 0.002, 0.03, 0.001, respectively). Patients with persistent dyspnea at 12 weeks had significantly lower FEV1%, FVC%, DLCO/VA%, and saturation levels in room air and significantly higher LDH, pro-BNP, D-dimer, and heart rate compared to those without dyspnea (p = 0.001 for all). Although the lungs are most commonly affected after COVID-19 infection, vascular and endothelial damage also causes multisystem involvement. Our study indicates that laboratory values, radiological signs, and pulmonary functional capacity improved in most patients after 12 weeks of follow-up.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Eda Çelik
- Department of Pulmonary Diseases, Ağrı State Hospital, Ağrı, Turkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Alperen Aksakal
- Department of Pulmonary Diseases, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Elif Yılmazel Uçar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Ömer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Metin Akgün
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
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10
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Uzun O, Akpolat T, Varol A, Turan S, Bektas SG, Cetinkaya PD, Dursun M, Bakan N, Ketencioglu BB, Bayrak M, Baris SA, Guner R, Gunal O, Nural S, Deniz PP, Toprak OB, Ozkan G, Gumus A, Kerget F, Ercelik M, Ataoglu O, Yuksel A, Ates G, Kutsoylu OE, Kose N, Kizilirmak D, Keskin S, Gultekin O, Coskun N, Yilmaz ES, Uslu S, Basyigit İ, Ergan B, Deveci F, Yakar MN, Zuhur C, Sagcan G, Yuce ZT, Kuluozturk M, Sezgin ME, Sezgin ENA, Havlucu Y, Cuhadaroglu C, Kilinc O, Boyaci H, Altunay H, Akti M, Dursun ZB, Kalem AK, Isik SA, Akyildiz L, Aykac N, Almaz MS, Kokturk N, Itil O. COVID-19: vaccination vs. hospitalization. Infection 2022; 50:747-752. [PMID: 34984646 PMCID: PMC8725959 DOI: 10.1007/s15010-021-01751-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/21/2021] [Indexed: 12/20/2022]
Abstract
Objective Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19) pandemic, but vaccination rates remain below the target level in most countries. This multicenter study aimed to evaluate the vaccination status of hospitalized patients and compare two different booster vaccine protocols. Setting Inoculation in Turkey began in mid-January 2021. Sinovac was the only available vaccine until April 2021, when BioNTech was added. At the beginning of July 2021, the government offered a third booster dose to healthcare workers and people aged > 50 years who had received the two doses of Sinovac. Of the participants who received a booster, most chose BioNTech as the third dose. Methods We collected data from 25 hospitals in 16 cities. Patients hospitalized between August 1 and 10, 2021, were included and categorized into eight groups according to their vaccination status. Results We identified 1401 patients, of which 529 (37.7%) were admitted to intensive care units. Nearly half (47.8%) of the patients were not vaccinated, and those with two doses of Sinovac formed the second largest group (32.9%). Hospitalizations were lower in the group which received 2 doses of Sinovac and a booster dose of BioNTech than in the group which received 3 doses of Sinovac. Conclusion Effective vaccinations decreased COVID-19-related hospitalizations. The efficacy after two doses of Sinovac may decrease over time; however, it may be enhanced by adding a booster dose. Moreover, unvaccinated patients may be persuaded to undergo vaccination.
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Affiliation(s)
- Oguz Uzun
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
- Ondokuz Mayıs Üniversitesi Göğüs Hst, 55139, Samsun, Turkey.
| | - Tekin Akpolat
- Department of Internal Medicine and Nephrology, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | | | - Sema Turan
- Department of Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | | | | | | | - Nurten Bakan
- Şehit Prof Dr İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | | | | | - Serap Argun Baris
- Department of Pulmonary Disease, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Ozgur Gunal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, University of Medical Science, Samsun, Turkey
| | - Serkan Nural
- Department of Pulmonary Medicine, Training and Research Hospital, Hatay, İstanbul, Turkey
| | | | - Oya Baydar Toprak
- Department of Pulmonary Medicine, Faculty of Medicine, Cukuroca University, Adana, Turkey
| | - Gulcihan Ozkan
- Maslak Acibadem Hospital, Operating Room Services Department and Private Acıbadem Maslak Hospital, Vocational School, Nişantaşı University, İstanbul, Turkey
| | | | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Faculty of Medicine, Erzurum Regional Education and Research Hospital, Health Sciences University, Erzurum, Turkey
| | | | | | - Aycan Yuksel
- Department of Pulmonary Medicine, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - Gungor Ates
- Genesis Private Hospital, Diyarbakır, Turkey
| | - Oya Eren Kutsoylu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | | | - Deniz Kizilirmak
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | | | | | - Nilüfer Coskun
- Şehit Prof Dr İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | - Emine Serap Yilmaz
- Department of Pulmonary Medicine, Medical Faculty, Training and Research Hospital, Ordu University, Ordu, Turkey
| | - Selen Uslu
- Department of Pulmonary Medicine, Medical Faculty, Training and Research Hospital, Ordu University, Ordu, Turkey
| | - İlknur Basyigit
- Department of Pulmonary Disease, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Begüm Ergan
- Division of Intensive Care, Department of Pulmonary and Critical Care, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Figen Deveci
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg, Turkey
| | - Mehmet Nuri Yakar
- Division of Intensive Care, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | | | | | - Zeynep Ture Yuce
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University, Kayseri, Turkey
| | - Mutlu Kuluozturk
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg, Turkey
| | | | | | - Yavuz Havlucu
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | | | - Oguz Kilinc
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Hasim Boyaci
- Department of Pulmonary Disease, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | | | - Mehmet Akti
- Siirt Training and Research Hospital, Siirt, Turkey
| | - Zehra Bastepe Dursun
- Department of Infectious Diseases and Clinical Microbiology, Kayseri City Hospital, Health Science University, Kayseri, Turkey
| | - Ayse Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Sinem Akkaya Isik
- Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | | | | | | | - Nurdan Kokturk
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Oya Itil
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
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11
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Kerget B, Kerget F, Aydın M, Karaşahin Ö. Effect of montelukast therapy on clinical course, pulmonary function, and mortality in patients with COVID-19. J Med Virol 2021; 94:1950-1958. [PMID: 34958142 PMCID: PMC9015221 DOI: 10.1002/jmv.27552] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/13/2022]
Abstract
The inflammatory/anti‐inflammatory balance has an important role in the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) (coronavirus disease [COVID‐19]) infection, which has affected over 200 million people since it first appeared in China in December 2019. This study aimed to determine the effectiveness of montelukast, which has known anti‐inflammatory and bronchodilatory effects, in these patients. The prospective randomized controlled study included 180 patients who were hospitalized in the infectious diseases department of our hospital between May and July 2021 and were diagnosed with the delta variant of SARS‐CoV‐2 by real‐time polymerase chain reaction of nasopharyngeal swabs. The patients were divided into three groups and received only standard treatment according to national guidelines (Group 1) or standard treatment plus 10 mg/day montelukast (Group 2) or 20 mg/day montelukast (Group 3). Laboratory parameters and pulmonary function tests (PFTs) at admission and on Day 5 of treatment were compared. Comparison of laboratory parameters on Day 5 showed that Groups 2 and 3 had significantly lower levels of lactate dehydrogenase, fibrinogen, D‐dimer, C‐reactive protein, and procalcitonin compared with Group 1 (p = 0.04, 0.002, 0.05, 0.03, and 0.04, respectively). In the comparison between Groups 2 and 3, only fibrinogen was significantly lower in Group 3 (p = 0.02). PFT results did not differ between the groups at admission, while on Day 5, only Group 3 showed significant improvements in forced expiratory volume in 1 s, forced vital capacity, and peak expiratory flow 25–75 compared with admission (p = 0.001 for all). Montelukast may be beneficial in COVID‐19 patients to maintain the inflammatory/anti‐inflammatory balance, prevent respiratory failure through its bronchodilator activity, and reduce mortality. The study included 180 participants who were divided into three groups: Group 1 (n = 60) received standard treatment in accordance with our national COVID‐19 diagnosis and treatment guide, Group 2 (n = 60) received 10 mg/day oral montelukast in addition to standard treatment, and Group 3 (n = 60) received 20 mg/day oral montelukast in addition to standard treatment. We aimed to investigate the effect of treatment with varying doses of montelukast as an adjunct to standard antiviral therapy on pulmonary function tests and clinical courses in patients with COVID‐19.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Murat Aydın
- Department of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Ömer Karaşahin
- Department of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
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12
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Kerget F. Response for "Letter to editor: Evaluation of the relationship between TREM-1/TREM 2 ratio and clinical course in COVID-19 pneumonia". Int J Clin Pract 2021; 75:e14928. [PMID: 34965662 DOI: 10.1111/ijcp.14928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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13
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Kerget F, Kerget B, Kahraman ÇY, Araz Ö, Akgün M, Uçar EY, Sağlam L. Evaluation of the relationship between pentraxin 3 (PTX3) rs2305619 (281A/G) and rs1840680 (1449A/G) polymorphisms and the clinical course of COVID-19. J Med Virol 2021; 93:6653-6659. [PMID: 34314051 PMCID: PMC8426891 DOI: 10.1002/jmv.27238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/24/2021] [Indexed: 02/05/2023]
Abstract
Macrophage activation syndrome (MAS) is one of the main causes of morbidity and mortality in patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the relationship between the pentraxin 3 (PTX3) gene polymorphisms rs2305619 (281A/G) and rs1840680 (1449A/G) and the development of MAS in patients with COVID-19. The study included a total of 94 patients aged 18-45 who were diagnosed as having COVID-19 between June and December 2020. PTX3 281A/G and 1449A/G polymorphism frequencies were evaluated. PTX3 281A/G allele and genotype frequencies did not deviate from Hardy-Weinberg (HW) equilibrium in the MAS or non-MAS group (χ2 : 0.049, df: 2, p = 0.976, χ2 : 0.430, df: 2, p = 0.806). PTX3 1449A/G allele and genotype frequencies deviated significantly from HW equilibrium in the non-MAS group (χ2 : 6.794, df: 2, p = 0.033) but not in the MAS group (χ2 : 2.256, df: 2, p = 0.324). The AG genotype was significantly more frequent in the non-MAS group, while the AA genotype was significantly more frequent in the MAS group (χ2 : 11.099, df: 2, p= 0.004). Analysis of the PTX3 1449A/G polymorphism showed that individuals with the GG genotype had higher serum PTX3 levels than those with the AA and AG genotypes (p = 0.001 for both). Analysis of the PTX3 1449A/G polymorphism in patients with COVID-19 showed that those with the AG genotype were relatively more protected from MAS compared with individuals with the AA genotype. In addition, lower serum PTX3 levels are observed in patients carrying the A allele.
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Affiliation(s)
- Ferhan Kerget
- Depertmant of Infection Diseases and Clinical Microbiology, Erzurum Regional Education and Research HospitalHealth Sciences UniversityErzurumTurkey
| | - Buğra Kerget
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumYakutiyeTurkey
| | - Çiğdem Yüce Kahraman
- Department of Medical GeneticAtaturk University School of MedicineErzurumYakutiyeTurkey
| | - Ömer Araz
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumYakutiyeTurkey
| | - Metin Akgün
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumYakutiyeTurkey
| | - Elif Yılmazel Uçar
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumYakutiyeTurkey
| | - Leyla Sağlam
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumYakutiyeTurkey
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Kerget B, Kerget F, Koçak AO, Akbaş İ, Araz Ö, Uçar EY, Akgün M. Is endogenous carboxyhaemoglobin level a useful biomarker of clinical course and prognosis in COVID-19 patients? Int J Clin Pract 2021; 75:e14680. [PMID: 34331833 PMCID: PMC8420518 DOI: 10.1111/ijcp.14680] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/29/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE SARS-CoV-2 has caused nearly 4 million confirmed cases of COVID-19 worldwide in the approximately 4 months since it emerged in Wuhan, China in December 2019. Comorbidities increase morbidity and mortality in COVID-19, and many laboratory parameters have been associated with mortality. The aim of the present study was to identify the relationship between endogenous carboxyhaemoglobin (COHb) level and the clinical course and prognosis of COVID-19. METHODS The study included 48 non-smokers or ex-smokers aged 18 years or older who presented to the emergency department, were diagnosed with COVID-19 by real-time PCR analysis of nasopharyngeal swab sample and were treated in the pulmonary diseases ward of the Atatürk University hospital after 24 March 2020 and 15 April 2020. The patients' laboratory parameters and demographic data were analysed retrospectively. RESULTS Prothrombin time and C-reactive protein (CRP), troponin-I, and D-dimer levels decreased in COVID-19 patients during follow-up (P = .024, P = .001, P = .001, P = .001), while PaO2 /FiO2 ratio and COHb increased (P = .002, P = .001). COHb level at admission was significantly lower in patients who developed macrophage activation syndrome (MAS), acute respiratory distress syndrome (ARDS), and those who died compared with the other patients (P = .002, P = .001). COHb level on day 5 of treatment was significantly higher in patients with ARDS and patients who died (P = .001, P = .001). Significant correlations were detected between COHb level and CRP (r=-0.425, P = .001), ferritin (r = -.395, P = .001) and PaO2 /FiO2 ratio (r = .431, P = .001). CONCLUSIONS COHb level may be an easily accessible biomarker that guides early follow-up and treatment planning to avoid ARDS, MAS and mortality in COVID-19.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumTurkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical MicrobiologyHealth Sciences UniversityErzurum Regional Education and Research HospitalErzurumTurkey
| | - Abdullah Osman Koçak
- Department of Emergency MedicineAtaturk University School of MedicineErzurumTurkey
| | - İlker Akbaş
- Department of Emergency MedicineBingöl State HospitalBingölTurkey
| | - Ömer Araz
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumTurkey
| | - Elif Yılmazel Uçar
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumTurkey
| | - Metin Akgün
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumTurkey
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15
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Parlak E, Kerget F, Demirdal T, Şen P, Ulaş AB, Öztürk Durmaz Ş, Pekok U, Ertürk A, Akyol D, Kepenek Kurt E, Köksal Alay H, Pullukçu H, Taşbakan M, Erol S, Laloğlu E, Öztürk Engin D, Ağalar C, Parlak M. The Epidemiology, Clinical Manifestations, Radiology, Microbiology, Treatment, and Prognosis of Echinococcosis: Results of NENEHATUN Study. Vector Borne Zoonotic Dis 2021; 21:948-954. [PMID: 34647813 DOI: 10.1089/vbz.2021.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 ± 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important.
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Affiliation(s)
- Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infectious Diseases and Clinical Microbiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Tuna Demirdal
- Department of Infectious Diseases and Clinical Microbiology, Kâtip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Pınar Şen
- Department of Infectious Diseases and Clinical Microbiology, Saruhanlı State Hospital, Manisa, Turkey
| | - Ali Bilal Ulaş
- Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Şenay Öztürk Durmaz
- Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Umut Pekok
- Department of Infectious Diseases and Clinical Microbiology, VM Medical Park Pendik Hospital, İstanbul, Turkey
| | - Ayşe Ertürk
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
| | - Deniz Akyol
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Esma Kepenek Kurt
- Department of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Handan Köksal Alay
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Serpil Erol
- Infectious Diseases and Clinical Microbiology Clinic, Istanbul Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Esra Laloğlu
- Department of Biochemistry, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Derya Öztürk Engin
- Infectious Diseases and Clinical Microbiology Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Canan Ağalar
- Department of Infectious Diseases and Clinical Microbiology, Medıcana Ataşehir Hospital, İstanbul, Turkey
| | - Mehmet Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
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16
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Kerget B, Erol Afşin D, Aksakal A, Kerget F, Aşkın S, Yılmazel Uçar E, Sağlam L. Could VEGF-D level have a role in clinical risk scoring, estimation of thrombus burden, and treatment in acute pulmonary thromboembolism? Int J Clin Pract 2021; 75:e14601. [PMID: 34228874 DOI: 10.1111/ijcp.14601] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/02/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Pulmonary embolism (PE) is usually a complication of deep vein thrombosis and is an important cause of mortality and morbidity. Vascular endothelial growth factor D (VEGF-D) is a secretory protein that plays a role in the remodelling of blood vessels and the lymphatic system. This study aimed to determine the relationship between VEGF-D level and clinical risk scoring in patients with PE. METHODS The study included 117 patients admitted for PE that were divided into four groups: high-risk patients (n = 35), high-intermediate-risk patients (n = 30), low-intermediate-risk patients (n = 24), and low-risk patients (n = 28). Plasma VEGF-D was measured from peripheral venous blood samples (5 mL) using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Pulmonary Artery Obstruction Index (PAOI) was calculated from CT angiography imaging. RESULTS There was no significant difference in troponin-I and NT-proBNP levels between the high-intermediate-risk and high-risk PE patients (P = .134, .146). VEGF-D and PAOI levels were found to be statistically significantly higher in high-risk patients compared with high-intermediate-risk patients (P = .016, .001). VEGF-D level was moderately correlated with mean pulmonary artery pressure and PAOI (r = .481, P = .01; r = .404, P = .01). In ROC curve analysis, a cut-off of 370.1 pg/mL for VEGF-D had 91.4% sensitivity and 67% specificity in the differentiation of high-intermediate-risk and high-risk PE patients. CONCLUSION This study showed that plasma VEGF-D level was more reliable than troponin-I and NT-proBNP in clinical risk scoring and demonstrating thrombus burden. VEGF-D can be used as a biomarker in clinical risk scoring and estimation of thrombus burden in patients with acute PE.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Dursun Erol Afşin
- Department of Pulmonary Diseases, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Alperen Aksakal
- Department of Pulmonary Diseases, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Seda Aşkın
- Department of Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Elif Yılmazel Uçar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Leyla Sağlam
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
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17
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Kerget F, Kerget B, İba Yılmaz S, Kızıltunç A. Evaluation of the relationship between TREM-1/TREM-2 ratio and clinical course in COVID-19 pneumonia. Int J Clin Pract 2021; 75:e14697. [PMID: 34365706 PMCID: PMC8420347 DOI: 10.1111/ijcp.14697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/02/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE The inflammatory/anti-inflammatory balance has an important role in the clinical course of SARS-CoV-2 infection (COVID-19), which has affected over 100 million people since it first appeared in China in December 2019. The aim of this study was to investigate the relationship between triggering receptor expressed on myeloid cells (TREM)-1/TREM-2 ratio and COVID-19 severity. METHODS A total of 171 individuals were included in the study: 121 patients who were admitted to the chest diseases department and intensive care unit of our hospital and diagnosed with COVID-19 by real-time PCR of nasopharyngeal swab samples from December 2020 to March 2021 and a control group consisting of 50 asymptomatic health workers in our hospital who had negative real-time PCR results during routine COVID-19 screening. RESULTS TREM-1 level was significantly higher in patients with severe disease compared with the moderate and control groups (P = .003, P = .001). TREM-2 levels did not differ significantly in moderate and severe patients (P = .36) but were significantly higher in both patient groups compared with the control group (P = .001 for both). TREM-1/TREM-2 ratio was significantly higher in the severe patient group than in the moderate and control groups (P = .001 for both). In receiver operating characteristic curve analysis of TREM-1/TREM-2 ratio in patients with moderate and severe COVID-19, the area under the curve was 0.723. Using a cut-off value of 0.125 for TREM-1/TREM-2 ratio in the Youden index calculation, the sensitivity was 60% and specificity was 71%. CONCLUSION Experience with the positive effects of medical treatments to restore inflammatory balance in the course of COVID-19 is steadily increasing. TREM-1 and TREM-2 have an important role in inflammation and may serve as biomarkers and therapeutic targets in the early treatment and follow-up of COVID-19.
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Affiliation(s)
- Ferhan Kerget
- Depertmant of Infection Diseases and Clinical MicrobiologyHealth Sciences University Erzurum Regional Education and Research HospitalErzurumTurkey
| | - Buğra Kerget
- Depertment of Pulmonary DiseasesAtaturk University School of MedicineErzurumTurkey
| | - Sibel İba Yılmaz
- Depertmant of Infection Diseases and Clinical MicrobiologyHealth Sciences University Erzurum Regional Education and Research HospitalErzurumTurkey
| | - Ahmet Kızıltunç
- Depertment of BiochemistryAtaturk University School of MedicineErzurumTurkey
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18
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Aksakal A, Kerget B, Kerget F, Aşkın S. Evaluation of the relationship between macrophage migration inhibitory factor level and clinical course in patients with COVID-19 pneumonia. J Med Virol 2021; 93:6519-6524. [PMID: 34241898 PMCID: PMC8426684 DOI: 10.1002/jmv.27189] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 07/06/2021] [Indexed: 12/16/2022]
Abstract
The COVID‐19 pandemic, which has ravaged our world for more than a year, still shapes our agenda with a scale of intensity that fluctuates over time. In our study, we aimed to determine the correlation between serum migration inhibitory factor (MIF) level and disease severity in COVID‐19 with different prognoses. Between 15 October 2020 and 20 January 2021, 110 patients over the age of 18 who were diagnosed with COVID‐19 and 40 volunteer healthcare personnel were included in our study. MIF levels were measured by enzyme‐linked immunosorbent assay. In the comparison of serum MIF values in the patient and control group, it was observed that the MIF level was significantly higher in patients with both moderate and severe COVID‐19 levels compared to the control group (p = 0.001, 0.001). In the comparison of serum MIF values of moderate to severe COVID‐19 patients, it was observed that MIF level was higher in severe patients (p = 0.001). In the receiver operating characteristic curve analysis performed to differentiate between severe and moderate COVID‐19 patients with MIF levels, the area under the curve was observed as 0.78. When the cutoff value of the MIF level was taken as 4.455 ng/ml, the sensitivity was 83% and the specificity was 62%. Failure to adequately balance the pro‐inflammatory cytokines synthesized in COVID‐19 with anti‐inflammatory effect is the most important reason for the aggravation of the disease course. Playing a role in pro‐inflammatory cytokine synthesis, MIF can provide important information about the disease prognosis in the early period. Failure to adequately balance the proinflammatory cytokines synthesized in COVID‐19 with anti‐inflammatory effect is the most important reason for the aggravation of the disease course. Playing a role in proinflammatory cytokine synthesis, MIF can provide important information about the disease prognosis in the early period.
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Affiliation(s)
- Alperen Aksakal
- Department of Pulmonary Diseases, Health Sciences University Erzurum Regional Education and Research Hospital, Yakutiye, Erzurum, Turkey
| | - Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Yakutiye, Erzurum, Turkey
| | - Seda Aşkın
- Department of Biochemistry, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
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19
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Kerget B, Aksakal A, Kerget F. Evaluation of the relationship between laboratory parameters and pulmonary function tests in COVID-19 patients. Int J Clin Pract 2021; 75:e14237. [PMID: 33864318 PMCID: PMC8250304 DOI: 10.1111/ijcp.14237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/12/2021] [Accepted: 04/10/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The novel coronavirus SARS-CoV-2 (COVID-19) rapidly escalated from its origin in an animal market in Wuhan, China in December 2019 to a global pandemic, and the lungs are the most frequently affected organ. The aim of this study was to investigate the relationship between pulmonary function test parameters and laboratory parameters in COVID-19. METHOD A total of 60 patients who were admitted to the chest diseases department and intensive care unit of our hospital and were diagnosed with COVID-19 by real-time PCR analysis of nasopharyngeal swabs were evaluated. Pulmonary function tests and laboratory parameters at admission and on day 7 of treatment were analysed. RESULTS On day 7 of treatment, white blood cell count, CRP, and fibrinogen level were significantly lower than at admission (P = .002, 0.001, and 0.001, respectively), while forced expiratory volume in the first second (FEV1 ) and forced vital capacity (FVC) values were significantly higher compared with admitting values (P = .001 for both). Correlation analysis showed that the decrease in CRP from admission to day 7 of treatment correlated with the increase in FEV1 (r = 0.616, P = .01) and FVC (r = 0.51, P = .01) during the same period. A decrease in the fibrinogen level was also correlated with an increase in FEV1 (r = 0.345, P = .01) and FVC (r = 0.357, P = .01). CONCLUSION Fibrinogen and CRP levels are easily accessible parameters that may help identify improvement or deterioration in pulmonary function in COVID-19 patients during follow-up and discharge while reducing the risk of transmission.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumTurkey
| | - Alperen Aksakal
- Department of Pulmonary DiseasesHealth Sciences University Erzurum Regional Education and Research HospitalErzurumTurkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical MicrobiologyHealth Sciences University Erzurum Regional Education and Research HospitalErzurumTurkey
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Kerget B, Afşin DE, Kerget F, Koçak AO, Aksakal A, Kızıltunç A, Araz Ö, Yılmazel Uçar E, Akgün M. Association of plasma netrin-1 level with inflammatory balance and comorbidities in patients with acute exacerbation of COPD. Tuberk Toraks 2021; 69:30-38. [PMID: 33853303 DOI: 10.5578/tt.20219904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Chronic obstructive pulmonary disease (COPD) is a common lung disease characterized by airflow restriction and systemic inflammation. Netrin-1 is a protein mainly produced in the central nervous system and has proven anti-inflammatory activity. The aim of this study was to determine netrin-1 level and its relationship with comorbidities in patients with acute exacerbation of COPD. Materials and Methods The study included 232 patients aged over 40 years who were divided into 3 groups: Group 1: ex-smokers (≥ 20 pack-years) with COPD hospitalized for COPD exacerbation (n= 142), Group 2: current-smokers (≥ 20 pack-years) without COPD (n= 30), Group 3: a control group comprising healthy non-smokers (n= 60). Plasma netrin-1 levels were measured using commercial enzyme-linked immunosorbent assay (ELISA) kit. Result There were significant differences in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, C-reactive protein (CRP), and plasma netrin-1 levels between patients with acute exacerbation of COPD and current smokers without COPD, healthy controls (p= 0.001 for all). Netrin-1 levels at discharge were lower in COPD patients with diabetes mellitus (DM) compared to nondiabetic COPD patients (p= 0.01). Weak correlation was observed between netrin-1 level at admission and FEV1, FVC, partial pressure of oxygen, and CRP levels (r= 0.394, p= 0.01; r= -0.366, p= 0.01; r= -0.19, p= 0.05; r= 0.306, p= 0.01). Netrin-1 level at admission was also moderately correlated with smoking history (pack-years) (r= 0.579, p= 0.01). Conclusions Netrin-1 was elevated in acute exacerbation of COPD and may be an important element in inflammatory balance. Patients with both COPD and DM were found to have lower netrin-1 levels at discharge after resolution of the acute exacerbation.
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Affiliation(s)
- Buğra Kerget
- Department of Chest Diseases, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Dursun Erol Afşin
- Department of Chest Diseases, Erzurum Region Training and Research Hospital, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Erzurum Region Training and Research Hospital, Erzurum, Turkey
| | - Abdullah Osman Koçak
- Department of Emergency Medicine, Atatürk University Faculty of Medicine Hospital, Erzurum, Turkey
| | - Alperen Aksakal
- Department of Chest Diseases, Erzurum Region Training and Research Hospital, Erzurum, Turkey
| | - Ahmet Kızıltunç
- Department of Biochemistry, Atatürk University Faculty of Medicine Hospital, Erzurum, Turkey
| | - Ömer Araz
- Department of Chest Diseases, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Elif Yılmazel Uçar
- Department of Chest Diseases, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Metin Akgün
- Department of Chest Diseases, Atatürk University Faculty of Medicine, Erzurum, Turkey
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Kerget B, Kerget F, Aksakal A, Aşkın S, Uçar EY, Sağlam L. Evaluation of the relationship between KIM-1 and suPAR levels and clinical severity in COVID-19 patients: A different perspective on suPAR. J Med Virol 2021; 93:5568-5573. [PMID: 34019703 PMCID: PMC8242801 DOI: 10.1002/jmv.27099] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 12/21/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is one of the most pressing health problems of this century, but our knowledge of the disease is still limited. In this study, we aimed to examine serum-soluble urokinase plasminogen activator receptor (suPAR) and kidney injury molecule 1 (KIM-1) levels based on the clinical course of COVID-19. Our study included 102 patients over the age of 18 who were diagnosed as having COVID-19 between September 2020 and December 2020 and a control group of 50 health workers over the age of 18 whose severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR results were negative. KIM-1 was measured by ELISA and suPAR by suPARnostic™ assay. Analysis of previously identified variables of prognostic significance in COVID-19 revealed high neutrophil to lymphocyte ratio, lactose dehydrogenase, prothrombin time, C-reactive protein, PaO2 /FiO2 , D-dimer, ferritin, and fibrinogen levels in patients with severe disease (p < 0.05 for all). KIM-1 and suPAR levels were significantly higher in COVID-19 patients compared to the control group (p = 0.001 for all). KIM-1 level was higher in severe patients compared to moderate patients (p = 0.001), while suPAR level was lower (p = 0.001). KIM-1, which is believed to play an important role in the endocytosis of SARS-CoV-2, was elevated in patients with severe COVID-19 and may be a therapeutic target in the future. SuPAR may have a role in defense mechanism and fibrinolysis, and low levels in severe patients may be associated with poor prognosis in the early period.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Yakutiye, Erzurum, Turkey
| | - Alperen Aksakal
- Department of Pulmonary Diseases, Health Sciences University Erzurum Regional Education and Research Hospital, Yakutiye, Erzurum, Turkey
| | - Seda Aşkın
- Department of Biochemistry, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
| | - Elif Yılmazel Uçar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
| | - Leyla Sağlam
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
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22
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Kerget F, Kerget B. Frequency of interleukin-6 rs1800795 (-174G/C) and rs1800797 (-597G/A) polymorphisms in COVID-19 patients in Turkey who develop macrophage activation syndrome. Jpn J Infect Dis 2021; 74:543-548. [PMID: 33952771 DOI: 10.7883/yoken.jjid.2021.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
SARS-CoV-2 (COVID-19) has infected over 100 million people since it appeared in Wuhan, China just 1 year ago. This study aimed to evaluate the relationship between interleukin-6 (IL-6)gene polymorphisms -174G/C and -597G/A and COVID-19 course. The study included a total of 70 patients aged 18-45 years who were hospitalized in our hospital and diagnosed with COVID-19 in Turkey between March and November 2020. Of these, 40 patients required intensive care admission due to macrophage activation syndrome (MAS) and 30 patients did not develop MAS or acute respiratory distress syndrome. The frequency of IL-6-174G/C -and 597G/A polymorphisms was determined. There were statistically significant differences between the groups in terms of -174G/C allele and genotype frequency and comparison with Hardy-Weinberg distribution (χ2=10.029, df=1, p=0.002 and χ2=9.998, df=1, p=0.002, respectively). The frequency of the GG genotype was significantly higher in the MAS group compared to the non-MAS group (p=0.002). The G allele was also significantly more frequent in the MAS group compared to the non-MAS group (p=0.032). Analysis of the -174G/C polymorphism in patients with MAS showed that the G allele may be a risk factor for increased serum IL-6 levels and progression to MAS.
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Affiliation(s)
- Ferhan Kerget
- Depertmant of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Turkey
| | - Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Turkey
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23
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Kerget F, Kerget B, Çelik N, İba Yılmaz S. [Specific Tests and Inflammatory Biomarkers in the Evaluation of Brucellosis Disease]. MIKROBIYOL BUL 2021; 55:113-124. [PMID: 33882646 DOI: 10.5578/mb.20219901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Brusellosis is the world's most common bacterial zoonotic infection and is still endemic in many developing countries. The clinical appearance of brucellosis is not specific, but the course and severity of the infection varies. In this study, it was aimed to determine the relationship between laboratory parameters and clinical response and organ involvement in patients with Brucellosis diagnosed with specific diagnostic tests. In the study, 100 patients without previous diagnosis of Brucellosis who have admitted to the Department of Infectious Diseases and Clinical Microbiology and had positive Brucella tube agglutination tests and whose clinic was compatible with Brucellosis were evaluated prospectively. Patients were invited to be checked in the 1st, 2nd and 6th weeks . Patients with hip pain and low back pain were evaluated with sacroiliac magnetic resonance imaging (MRI) and lumbar MRI for sacroiliitis and spondylodiscitis. Patients with liver and bone marrow involvements, sacroiliitis, spondylodiscitis and orchitis were recorded as the patients with organ involvement. After six weeks, the decline of the complaints was considered as a clinical response. In the 6th week of the treatment, it was observed that platelet distribution width (PDW) and mean platelet volume (MPV) levels were lower in patients with a clinical response compared to the patients with no clinical response which was statistically significant (p= 0.01, p= 0.02). Platelet and platelet lymphocyte ratio (PLR) level in patients with organ involvement in the 1st and 6th weeks of the treatment, were observed to be lower than the patients without organ involvement which was statistically significant (week 1: p= 0.001, p= 0.01; week 6: p= 0.03, p= 0.01). Among patients with organ involvement and non-organ involvement, the area under the curve was 66% in the ROC curve analysis for PLR at the onset of the treatment. When the cut-off value was taken as 128.8%, the sensitivity was 55%, and the specificity was 78%. Depending on the level of platelet at the beginning of the treatment, in the ROC curve analysis carried out among patients with organ involvement and non-organ involvement, the area under the curve was 73% and when the cut off value was taken as 256000, the sensitivity was 71%, and the specificity was 68%. In the 6th week of the treatment, the area under the curve was observed as 67% in the ROC curve analysis of the PDW level among patients from whom clinical responses were received and not received. When the cut-off value was taken as 10.75%, the sensitivity was 65%, and the specificity was 70%. In the ROC curve analysis of the MPV value for clinical response, the area under the curve was 66%, and when the cut-off value was taken as 9.95, the sensitivity was observed as 52%, and the specificity was 74%. As a result, in the evaluation of the clinical response, which is important in the termination of the treatment in patients with Brucellosis, the use of MPV and PDW values in the evaluation of organ involvement and platelet level and PLO in the follow up, are cheap, easily accessible biomarkers that can be used clinically.
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Affiliation(s)
- Ferhan Kerget
- Health Sciences University Erzurum Regional Education and Research Hospital, Department of Infection Diseases and Clinical Microbiology, Erzurum, Turkey
| | - Buğra Kerget
- Ataturk University Faculty of Medicine, Department of Pulmonology, Erzurum, Turkey
| | - Neslihan Çelik
- Health Sciences University Erzurum Regional Education and Research Hospital, Department of Infection Diseases and Clinical Microbiology, Erzurum, Turkey
| | - Sibal İba Yılmaz
- Health Sciences University Erzurum Regional Education and Research Hospital, Department of Infection Diseases and Clinical Microbiology, Erzurum, Turkey
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24
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Celik M, Yayik AM, Kerget B, Kerget F, Doymus O, Aksakal A, Ozmen S, Aslan MH, Uzun Y. High-Frequency Chest Wall Oscillation in Patients with COVID-19: A Pilot Feasibility Study. Eurasian J Med 2021. [DOI: 10.5152/eurasianjmed.2021.21048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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25
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Kerget F, Demirdöğen ŞO, Kerget B. Case Report: A Rare Case of Crimean-Congo Hemorrhagic Fever Associated with Epididymo-Orchitis. Am J Trop Med Hyg 2021; 104:1055-1057. [PMID: 33399048 DOI: 10.4269/ajtmh.20-1143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/24/2020] [Indexed: 11/07/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is an acute infectious disease that affects multiple organ systems and is characterized by extensive ecchymosis, internal hemorrhage, and hepatic dysfunction. The reported case fatality rate varies between 8% and 80%. It is frequently transmitted by Hyalomma ticks, which are endemic in the Northeast Anatolia region of Turkey in spring and summer. Our patient presented from an endemic area with fever, malaise, joint pain, and scrotal pain following a tick bite, and real-time PCR analysis of venous blood was positive for CCHF. Based on Doppler ultrasound performed because of the patient's scrotal pain, he was diagnosed as having epididymo-orchitis, which was considered secondary to CCHF after ruling out other etiologies and resolved with scrotal elevation and anti-inflammatory treatment. Being a very rare complication, this report aimed to document this case of CCHF-associated epididymo-orchitis in the literature.
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Affiliation(s)
- Ferhan Kerget
- Depertmant of Infection Diseases and Clinical Microbiology, Health Sciences University, Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Şaban Oğuz Demirdöğen
- Depertmant of Urology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Buğra Kerget
- Depertmant of Pulmonology, Ataturk University, Erzurum, Turkey
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Kerget B, Kerget F, Kahraman ÇY, Aksakal A, Araz Ö. The relationship between NLRP3 rs10159239 and Vaspin rs2236242 gene variants and obstructive sleep apnea. Ups J Med Sci 2021; 126:7603. [PMID: 34349888 PMCID: PMC8276347 DOI: 10.48101/ujms.v126.7603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/22/2021] [Accepted: 05/04/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In obstructive sleep apnea (OSA), recurrent upper airway obstruction and apnea/hypopnea episodes result in endothelial dysfunction, which leads to the release of many proinflammatory cytokines and reactive oxygen species (ROS). ROS induces NLRP3, a protein involved in the synthesis of interleukin (IL)-1 and IL-18; vaspin is a serine protease inhibitor that has an important role in suppressing the activation of NLRP3 inflammasome. In this study, we aimed to investigate the effect of NLRP3 rs10159239 (rs9239) and vaspin rs2236242 (rs6242) single nucleotide polymorphisms (SNPs) on OSA development. METHODS This study included 220 individuals who underwent polysomnography (118 patients with OSA and 102 healthy controls). NLRP3 rs9239 and vaspin rs6242 mutation frequencies were analyzed. RESULTS The NLRP3 rs9239 SNP genotype analysis revealed no statistically significant differences between the OSA and control groups. In the vaspin gene analysis, the rs6242 AA genotype was significantly more frequent in the OSA group compared with the control group, while the AT genotype was more frequent in controls (P = 0.004, P = 0.02). Comparison of rs6242 allele levels showed that the A allele was significantly more frequent in OSA patients than in controls (P = 0.03). The AA genotype was significantly more frequent in patients with severe OSA than in patients with mild or moderate OSA and the control group (P = 0.001 for all). Serum vaspin levels were significantly lower in carriers of the AA genotype than those with AT and TT genotypes (P = 0.001). CONCLUSION The vaspin rs6242 SNP AA genotype increased susceptibility to OSA, while the AT genotype appeared to be protective. The lower plasma vaspin levels in OSA compared with the control group and in patients with the AA genotype suggest that vaspin may be a protective biomarker for OSA.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
- CONTACT Buğra Kerget
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Çiğdem Yüce Kahraman
- Department of Medical Genetics, Ataturk University School of Medicine, Erzurum, Turkey
| | - Alperen Aksakal
- Department of Pulmonary Diseases, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Ömer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
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27
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Kerget B, Kerget F, Kızıltunç A, Koçak AO, Araz Ö, Yılmazel Uçar E, Akgün M. Evaluation of the relationship of serum vitamin D levels in COVID-19 patients with clinical course and prognosis. Tuberk Toraks 2020; 68:227-235. [PMID: 33295720 DOI: 10.5578/tt.70027] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction SARS-CoV-2 (COVID-19), which emerged in Wuhan, China in December 2019, infected more than six million people in a short time. In COVID-19, the relationship of many laboratory parameters to morbidity and mortality has been defined. In our study, we aimed to determine the relationship of serum vitamin D level to clinical course and prognosis. Materials and Methods This study included 108 patients; 88 patients who stayed in Ataturk University and Erzurum City Hospital between March 24, 2020 and May 15, 2020, who were identified as COVID-19 by real-time PCR method from the nasopharyngeal swab and 20 asymptomatic voluntary medical personnel who tested negative for real-time PCR after routine check-up in our hospital. Result In statistical analysis conducted between healthy control group and vitamin D levels of patients admitted due to COVID-19, it was observed that patients infected with COVID-19 had a lower level (p= 0.004). In 20 patients developing MAS, a lower level of vitamin D was observed (p= 0.004) compared to 68 patients who did not develop. In the comparison of vitamin D levels of the patients (n= 8) who developed exitus in their follow up due to COVID-19, it was observed that vitamin D levels were statistically significantly lower compared to the living (p= 0.009). Conclusions Due to COVID-19, pandemic, long-running quarantines caused insufficient use of sunlight and worsening of vitamin D deficiency. We wanted to draw attention again with our study to vitamin D which can be responsible for the heavy clinical course of COVID-19 and whose replacement is easy to apply.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Health Science University, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Ahmet Kızıltunç
- Department of Biochemistry, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Abdullah Osman Koçak
- Department of Emergency Medicine, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Ömer Araz
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Elif Yılmazel Uçar
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Metin Akgün
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
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Kerget B, Kerget F, Aksakal A, Aşkın S, Sağlam L, Akgün M. Evaluation of alpha defensin, IL-1 receptor antagonist, and IL-18 levels in COVID-19 patients with macrophage activation syndrome and acute respiratory distress syndrome. J Med Virol 2020; 93:2090-2098. [PMID: 33038012 PMCID: PMC7675303 DOI: 10.1002/jmv.26589] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/22/2020] [Accepted: 10/07/2020] [Indexed: 01/10/2023]
Abstract
Background Many laboratory parameters have been associated with morbidity and mortality in SARS‐CoV‐2 (COVID‐19), which emerged in an animal market in Wuhan, China in December 2019 and has infected over 20 million people. This study investigated the relationship between serum interleukin (IL)‐18, IL‐1 receptor antagonist (IL‐1Ra), and alpha defensin levels and the clinical course and prognosis of COVID‐19. Materials and Methods This study included 100 patients who were admitted to the chest diseases department and intensive care unit of our hospital and diagnosed with COVID‐19 by real‐time polymerase chain reaction (PCR) of nasopharyngeal swab samples between March 24 and May 31, 2020. The control group consisted of 50 nonsymptomatic health workers with negative real‐time PCR results in routine COVID‐19 screening in our hospital. Results Serum alpha defensin, IL‐1Ra, and IL‐18 levels were significantly higher in patients who developed macrophage activation syndrome (MAS) and acute respiratory distress syndrome (ARDS) compared to patients who did not (p < .001 for all). Alpha defensin, IL‐1Ra, and IL‐18 levels were significantly higher in COVID‐19 patients with and without MAS or ARDS when compared to the control group (p < .001 for all). When the 9 patients who died were compared with the 91 surviving patients, IL‐1Ra and IL‐18 levels were found to be significantly higher in the nonsurvivors (p < .001). Conclusion Our findings of correlations between alpha defensin and levels of IL‐1Ra and IL‐18, which were previously shown to be useful in COVID‐19 treatment and follow‐up, indicates that it may also be promising in treatment.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
| | - Ferhan Kerget
- Depertmant of Infection Diseases and Clinical Microbiology, Health Sciences University, Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Alperen Aksakal
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
| | - Seda Aşkın
- Department of Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Leyla Sağlam
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
| | - Metin Akgün
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Yakutiye, Erzurum, Turkey
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Kerget B, Kerget F, Koçak AO, Kızıltunç A, Araz Ö, Uçar EY, Akgün M. Are Serum Interleukin 6 and Surfactant Protein D Levels Associated with the Clinical Course of COVID-19? Lung 2020; 198:777-784. [PMID: 32918573 PMCID: PMC7486805 DOI: 10.1007/s00408-020-00393-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/07/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE SARS-CoV-2 (COVID-19) has infected more than 7 million people worldwide in the short time since it emerged in Wuhan, China in December 2019. The aim of this study was to investigate the relationship between serum interleukin 6 (IL-6) and surfactant protein D (SP-D) levels and the clinical course and prognosis of COVID-19. MATERIALS AND METHODS The study included a total of 108 individuals: 88 patients who were diagnosed with COVID-19 by real-time PCR of nasopharyngeal swab samples and admitted to the Atatürk University Pulmonary Diseases and the Erzurum City Hospital Infectious Diseases department between March 24 and April 15, and 20 asymptomatic healthcare workers who had negative real-time PCR results during routine COVID-19 screening in our hospital. RESULTS Patients who developed macrophage activation syndrome had significantly higher IL-6 and SP-D levels at the time of admission and on day 5 of treatment compared to the other patients (IL-6: p = 0.001 for both; SP-D: p = 0.02, p = 0.04). Patients who developed acute respiratory distress syndrome had significantly higher IL-6 and SP-D levels at both time points compared to those who did not (p = 0.001 for all). Both parameters at the time of admission were also significantly higher among nonsurvivors compared to survivors (IL-6: p = 0.001, SP-D: p = 0.03). CONCLUSION In addition to IL-6, which has an important role in predicting course and planning treatment in COVID-19, SP-D may be a novel pneumoprotein that can be used in the clinical course, follow-up, and possibly in future treatments.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Yakutiye, Turkey.
| | - Ferhan Kerget
- Depertmant of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Abdullah Osman Koçak
- Department of Emergency Medicine, Ataturk University School of Medicine, 25240, Erzurum, Yakutiye, Turkey
| | - Ahmet Kızıltunç
- Department of Biochemistry, Ataturk University School of Medicine, 25240, Erzurum, Turkey
| | - Ömer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Yakutiye, Turkey
| | - Elif Yılmazel Uçar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Yakutiye, Turkey
| | - Metin Akgün
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Yakutiye, Turkey
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Kerget B, Afşin D, Kerget F, Araz Ö, Akgün M. IS VIMENTIN THE CAUSE OR EFFECT OF OBSTRUCTIVE SLEEP APNEA DEVELOPMENT? Chest 2020. [DOI: 10.1016/j.chest.2020.05.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Kerget B, Afşin DE, Kerget F, Aşkın S, Akgün M. Is Metrnl an Adipokine İnvolved in the Anti-inflammatory Response to Acute Exacerbations of COPD? Lung 2020; 198:307-314. [PMID: 31960164 DOI: 10.1007/s00408-020-00327-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/11/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Chronic obstructive pulmonary disease (COPD) is a common lung disease characterized by airflow limitation and systemic inflammation. Recently, there has been growing interest in adipose tissue-mediated inflammation in the pathogenesis of COPD. The aim of our study was to determine the relationships between a new adipocytokine, meteorin-like protein (Metrnl), and acute exacerbations of COPD, smoking, and comorbidities. MATERIALS AND METHODS The study included 313 patients aged 40-65 years in four groups: Group 1: ex-smokers (≥ 20 pack-years) with COPD hospitalized for COPD exacerbation (n = 133), Group 2: current-smokers (≥ 20 pack-years) without COPD (n = 60), Group 3: ex-smokers (≥ 20 pack-years) without COPD (n = 60), and Group 4: never-smokers without COPD (n = 60). Peripheral venous blood samples (5 cc) were collected from all participants. Plasma Metrnl levels were measured using commercial enzyme-linked immunosorbent assay (ELISA) kit. RESULTS Mean Metrnl levels were 28.45 ± 11.27 ng/ml in Group 1, 24.34 ± 4.38 ng/ml in Group 2, 18.84 ± 3.8 ng/ml in Group 3, and 19.44 ± 3.92 ng/ml in Group 4. Group 1 had significantly higher mean Metrnl level compared to the other groups (p = 0.006, p = 0.001, p = 0.001). Metrnl level was also significantly higher in Group 2 when compared with Groups 3 and 4 (p = 0.001, p = 0.005). Group 1 patients with diabetes mellitus and coronary artery disease showed significantly lower Metrnl levels compared to other patients in the group (p = 0.001, p = 0.001). CONCLUSION The high Metrnl level in COPD exacerbations and active smoking may be important in balancing the inflammatory response. However, plasma Metrnl levels were found to be lower in COPD patients with comorbidities.
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Affiliation(s)
- Buğra Kerget
- Depertmant of Pulmonary Diseases, Health Sciences University Erzurum Regional Education and Research Hospital, 25240, Yakutiye, Erzurum, Turkey.
| | | | - Ferhan Kerget
- Depertmant of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Seda Aşkın
- Department of Biochemistry, Ataturk University School of Medicine, 25240, Erzurum, Turkey
| | - Metin Akgün
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Turkey
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Kerget B, Araz Ö, Kerget F, Erol HS, Özmen S, Halıcı Z, Akgün M. Evaluation of the Roflumilast Effect Supplemented with Linezolid in Pleural Empyema in Rats Caused by Intrapleural Staphylococcus aureus Inoculation. Jpn J Infect Dis 2019; 73:1-7. [PMID: 31474702 DOI: 10.7883/yoken.jjid.2019.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In addition to tube drains, pleural empyema is treated with antibiotics and anti-inflammatory drugs. We aimed to evaluate the anti-inflammatory activity of roflumilast combined with linezolid in a rat model of pleural empyema induced by Staphylococcus aureus. A total of 40 rats were divided into 7 groups: sham (n = 4), S. aureus inoculation (n = 6), S. aureus + 10 mg/kg linezolid (n = 6), S. aureus + 5 mg/kg roflumilast (n = 6), S. aureus + 10 mg/kg linezolid + 5 mg/kg roflumilast (n = 6), S. aureus + 10 mg/kg roflumilast (n = 6), and S. aureus + 10 mg/kg linezolid + 10 mg/kg roflumilast (n = 6). Animals were administered linezolid 1 h before and 12 h after inoculation with S. aureus. Roflumilast was administered orally as a single dose 30 min before inoculation with S. aureus. Compared to linezolid treatment alone, linezolid combined with 5 mg/kg roflumilast significantly improved TNF-α, IL-1β, vasodilation/congestion, and tissue/pleural polynuclear leukocyte (PNL) infiltration (p < 0.05). Linezolid combined with 10 mg/kg roflumilast also provided a significant improvement in TNF-α, IL-1β, IL-6, endothelin-1, vasodilation/congestion, mesothelial cell damage, lung tissue PNL, and pleural PNL compared to linezolid alone (p < 0.05). Due to its anti-inflammatory effects and significant impact on recovery, roflumilast can be used in conjunction with antibiotherapy for the treatment of pleural empyema.
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Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, Health Sciences University Erzurum Regional Education and Research Hospital
| | - Ömer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine
| | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital
| | | | - Sevilay Özmen
- Department of Pathology, Ataturk University School of Medicine
| | - Zekai Halıcı
- Department of Pharmacology, Ataturk University School of Medicine
| | - Metin Akgün
- Department of Pulmonary Diseases, Ataturk University School of Medicine
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Kerget B, Yilmaz S, Kerget F, Afsin DE. Comparison of the Effectiveness of Salbutamol and Levalbuterol Combinations with İpratropium Bromide on FEV1, FVC, and Heart Rate in Stable COPD Patients: A Single-Center, Open-Label Study. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kerget F, Özkurt Z, Öztürk N, Yılmaz S. The relationship with clinical course and prognosis of serum endothelin-1, angiopoietin-2, and tie-2 levels in Crimean-Congo hemorrhagic fever. Turk J Med Sci 2019; 49:1192-1197. [PMID: 31293143 PMCID: PMC7018223 DOI: 10.3906/sag-1812-10] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background/aim Crimean-Congo hemorrhagic fever (CCHF) is a serious illness characterized by fever and hemorrhage. Endothelin-1 (ET-1), angiopoietin-2 (Ang-2), and endothelial cell-specific receptor tyrosine kinase (Tie-2) are believed to be important markers of the pathogenesis, clinical course, and prognosis of the disease. The aim of this study was to determine ET-1, Ang-2, and Tie-2 levels in adults with CCHF and investigate the associations between these markers and pathogenesis and disease course. Materials and methods Sixty CCHF patients were included in the study. The patients were classified according to disease severity criteria and Ang-2, Tie-2, and ET-1 levels were compared. Results Mean serum ET-1 level was 36.62 ± 27.99 pg/mL in the patient group and 3.70 ± 4.71 pg/mL in the control group (P = 0.001). Mean serum Ang-2 levels were 2511.18 ± 1018.64 pg/mL in the patient group and 3570.76 ± 209.52 pg/mL in the control group (P = 0.001). Mean serum Tie-2 levels were 7.35 ± 7.75 ng/mL in the patient group and 0.67 ± 1.26 ng/mL in the control group (P = 0.001). Conclusion Elevated ET-1 and Tie-2 levels were associated with more severe disease course, while Ang-2 level was negatively correlated with severity in adult CCHF patients. ET-1, Tie-2, and Ang-2 levels are important prognostic parameters in CCHF and may contribute significantly to treatment and follow-up.
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Affiliation(s)
- Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, University of Health Sciences, Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Zülal Özkurt
- Department of Infection Diseases and Clinical Microbiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Nurinnisa Öztürk
- Department of Biochemistry, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Sinan Yılmaz
- Department of Public Health, Atatürk University, School of Medicine, Erzurum, Turkey
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