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Yayın Alzheimer hastalığına tip ııı diyabet denilebilir mi?(Hücre Ölümü Araştırma Derneği, 2018) Şahin, Şevki; Karşıdağ, Sibel; Çınar, Nigün; Ateş, Miruna Florentina; Özünal, Zeynep GüneşAmaç: Güncel araştırmalarda, Alzheimer Hastalığı (AH) patojenezinden sorumlu tutulan amiloid beta ve hiperfosforile tau birikiminde, beyin insülin sinyalizasyonundaki bozulmanın katkısı olduğuna dair bilimsel kanıtlara ulaşılmıştır. Bu nedenle son yıllarda Tip III Diyabet (TIII D) kavramı altında toplanan bilgiler AH tedavisine yeni bir bakış açısı getirmiştir. Bu çalışmada konuya dair güncel bilgiler gözden geçirilerek bu kavramı destekleyen kanıta dayalı verilere ulaşılması amaçlanmıştır. Gereç ve Yöntem: İnsülin, Alzheimer, diyabet kelimelerinin İngilizce yazılışı ile Pubmed® araması sonucunda elde edilen makaleler gözden geçirilmiştir. Bulgular: Anahtar kelimeleri içeren ilk makalenin 1983 yılında yayınlandığı görüldü. Nisan 1983-Nisan 2018 tarih aralığındaki toplam 1192 (461’i derleme) makaleye ulaşıldı. 1983 ve 2015, 2016, 2017 yıllarına ait makale sayısı sırası ile; 1, 129, 98, 152 idi. Makalelerde en sık patofizyoloji vurgulanırken (a. Beyin insülin düzeyinde ve reseptörlerinde azalma b. Beyin glukoz kullanımında azalmaya bağlı nöron endoplazmik retikulumundaki protein sentezinde bozulma c. İnsülin direncine bağlı öncelikle hipokampal nöron mitokondrilerinde başlayan artmış oksidatif stres), son iki yılda tedaviye yönelik araştırmalar ön plana çıkmıştır. Tedavi araştırmalarında a. Glukagon benzeri peptit (GBP) reseptör agonistleri b. İntranazal insülin c. Beyin natriüretik faktör ve d. Leptin ile yapılan çalışmalar bulunmaktadır. Sonuç: AH’nin patojenejizindeki diyabete benzer mekanizmaya dair bilgiler 1983 yılından itibaren hızla artış göstermiştir. Bu bilgiler AH’ye TipIII D denebileceğini destekler niteliktedir. İnsülinin nöronal sinyalizayondaki ve endoplazmik retikulumdaki protein sentezi üzerindeki etkisini daha net aydınlatacak -genetik ve çevresel etkileri de içeren- ileri çalışmaların tedaviye büyük katkıları olabilir.Yayın Amantadine might be used as a drug for SARS-Cov-2 treatment?(Bentham Science, 2021) Özünal, Zeynep Güneş; Şahin, ŞevkiCoronavirus Disease 2019 (COVID-19) infection, the pandemics, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has no known effective radical pharmacotherapy and just supportive approach at present. Amantadine is a drug used in Parkinson’s disease and other parkinsonisms; and is known to increase indirectly dopamine by antagonistic effects at the N-methyl-Daspartate (NMDA) receptor by increasing the release and blocking the reuptake of dopamine. Initially, amantadine was approved as an antiviral drug. We hypothesize that if amantadine is considered its antiviral, immunological and neurostimulant effects might be useful in the supportive treatment of SARSCoV-2 cases, especially those who developed acute respiratory failure with decreased vigilance and are being monitored in the intensive care unit. Further phase III clinical trials are needed.Yayın Can Cytokines be used as an Activation Marker in Rheumatoid Arthritis?(Bentham Science, 2021) Kaya, Fatih Öner; Ceylan, Yeşim; Öngen İpek, Belkız; Özünal, Zeynep Güneş; Sezgin, Gülbüz; Nalbant, SelimAims: The etiopathogenesis of Rheumatoid Arthritis (RA) is not clearly understood. However, the role of the cytokines play an important part in this mechanism. We aimed to bring a new approach to the concept of 'remission' in patients with RA. Background: RA is a chronic, autoimmune, inflammatory disease that involves small joints in the form of symmetrical polyarthritis and progresses with exacerbations and remissions. Pain, swelling, tenderness and morning stiffness are typical of the joints involved. Although it is approached as primary joint disease, a wide variety of extra-articular involvements may also occur. It is an interesting pathophysiological process, the exact cause of which is still unknown, with many environmental, genetic and potentially undiscovered possible factors in a chaotic manner. Objective: In this cross-sectional study, sedimentation rate (ESR), C- Reactive protein (CRP), Tumor necrosis factor (TNF)-?, soluble-TNF-? receptor (TNF-R), Interleukin (IL)-1B and IL-10 were measured in three groups which were healthy volunteers, patients with RA in the active period, and patients with RA in remission. Disease activity score-28 (DAS-28) was calculated in active RA and RA in remission. Methods: This study included 20 healthy volunteers, 20 remission patients with RA and 20 active RA patients. Venous blood samples were collected from patients in both healthy and RA groups. Results: RA group consisted 43 (71.6%) female and 17 (28.4%) male. Control group consisted 11 (55%) female and 9 (45%) male. TNF-R was significantly high only in the active group according to the healthy group (p=0.002). IL-10 was significantly high in active RA, according to RA in remission (p=0.03). DAS-28 was significantly high in active RA, according to RA in remission (p=0.001). In the active RA group, ESR and TNF-R had a positive correlation (r:0.442; p=0.048). In the active RA group, there was also a positive correlation between TNF-R and CRP (r:0.621; p=0,003). Both healthy and active RA group had significant positive correlation between ESR and CRP (r: 0.481; p=0.032 and r: 0,697; p=0,001 respectively). Conclusion: TNF-R can be the main pathophysiological factor and a marker showing activation. TNF-R can be very important in revealing the effect of TNF on the disease and the value of this effect in the treatment and ensuring the follow-up of the disease with CRP instead of ESR in activation.Yayın A case with ataxia, optic neuropathy and polyneuropathy: is there any association with imatinib or natural course of chronic myeloid leukemia?(Maltepe Tıp Dergisi, 2018) Özünal, Zeynep Güneş; Cam, Özlem; Şahin, Şevki; Sağlam, Esra; Karşıdağ, SibelImatinib is a tyrosine kinase inhibitor as a antineoplastic agent which is indicated in chronic myeloid leukemia (CML), various hematologic and nonhematologic malignancies. Forty-seven years old male, with CML diagnosis 15 years ago and had stem cell transplantation 2 years ago and receiving radiotherapy and chemotherapy. After then, imatinib 400 mg daily is prescribed on for 12 months by the physician but patient himself continued for 15 months until he suspected drug when he has newly onset walking, swallowing difficulties and blurry vision. Imatinib and possible adverse drug reactions are discussed in the case presentation.Yayın E-cigarettes and smoking cessation(Maltepe Üniversitesi, 2019) Öğütman, Çağlar; Sağlam, Esra; Özünal, Zeynep Güneş; Tüfekçi, Kübra; Kılınç, Burak; Dirik, Gökçe; Kıray, SeraySigara ve elektronik sigarayı bırakma üzerine bir sunum.Yayın The expression of CD44, CD90 and CD133 in response to cisplatin in hepatocellular cancer cells(Uniwersytet Rzeszowski, 2021) Dönmez Çakıl, Yaprak; Özünal, Zeynep Güneş; Gökçeoğlu Kayalı, Damla; Aktaş, Ranan GülhanIntroduction. Cancer is a leading cause of mortality. Hepatocellular cancer is one of the malignancies associated with poor outcome and resistance to pharmacotherapy. Cancer stem cells (CSCs) contribute to resistance to therapy and hence lead to the treatment failure of tumors. Aim. This study aims to explore the expression of CSCs in response to cisplatin treatment in HepG2 hepatocellular cancer cell line. Material and methods. Cell proliferation test, CCK-8, was used to evaluate the cell proliferation following cisplatin treatment for 72 hours. The expressions of CSC markers CD44, CD90, and CD133 were assessed by flow cytometric analysis. Results. The results showed a dose-dependent decrease in cell proliferation and increased expression of CSC markers CD44 and CD90 in response to cisplatin. Conclusion. Understanding the roles of CSC markers may point to new targets and therapeutic strategies to predict and overcome cisplatin resistance.Yayın Flow cytometric evaluation of cancer stem cell markers in HepG2 cells following sorafenib treatment(Association of Clinical Biochemistry Specialists, 2021) Dönmez Çakıl, Yaprak; Sitar, Mustafa Erinç; Özünal, Zeynep Güneş; Gökçeoğlu Kayalı, Damla; Aktaş, Ranan GülhanObjectives: Liver cancer is a leading cause of mortality. Sorafenib resistance and cancer stem cells (CSCs) are among the factors that contribute to a poor prognosis. Different drugs enrich different CSC populations with a variety of CSC markers. This study investigated the expression of CSC markers in HepG2 cells in response to low doses of sorafenib using flow cytometry. Methods: The cytotoxicity of sorafenib was determined using a cell counting kit-8 assay. The expressions of the CSC markers CD44, CD90, and CD133 were measured with flow cytometry after treatment with sorafenib for 72 hours. Results: Sofranib inhibited cell proliferation in a dose-dependent manner. Low-dose sorafenib treatment increased CD44 expression; however, there was a decrease in the expression of CD133. An increasing trend was also seen in CD90 expression, but the difference was not significant. Conclusion: The results indicate that CSC expression varied according to the sorafenib dose administered, which supports the role of CSCs as novel pharmacological targets and highlights the importance of their characterization and the ability to identify them.Yayın Follow-up of favipiravir-induced nail fluorescence: implications for nail and drugs(International Dermoscopy Society, 2023) Güder, Hüsna; Özünal, Zeynep GüneşIntroduction: Favipiravir creates fluorescence on nails, which can be seen with Wood's light. Objectives: The objectives of this study are to examine the properties of fluorescence in the nail due to favipiravir and to observe whether other drugs also produce fluorescence in the nail. Methods: The research is descriptive, prospective, and quantitative. This study recruited 30 healthcare workers who received favipiravir treatment and 30 volunteers who took or did not take any medication except favipiravir from March 2021 to December 2021. Fingernails of the patients and control groups were examined under Wood's light in the darkroom. If fluorescence was observed in the fingernails, we followed up once a month until the fluorescence disappeared. We calculated the nail growth rate by dividing the distance of nail fluorescence from the proximal nail fold by the number of days since favipiravir was started. Results: We found nail fluorescence in all patients receiving a loading dose of favipiravir. The fluorescence in the nail decreased and disappeared in the 3rd month. The average nail growth rate at the first visit was 0.14 mm/day. The nail growth rate at the second visit was 0.10 mm/day. A statistically significant difference was found between the first and second visit nail growth rates (z: -2.576; p=0.010<0.05). We found that other drugs did not produce any fluorescence in the nail. Conclusions: Nail fluorescence induced by favipiravir is dose-dependent and decreases in intensity over time. Nail fluorescence due to favipiravir is likely due to the active ingredient of the drug.Yayın Investigation of Drug Dose Calculation Skills and Self-Ratings Among Nursing Students(Yerküre Tanıtım & Yayıncılık Hizmetleri, 2020) Özünal, Zeynep Güneş; Boran, Tuğce; Saglam, EsraObjective: Medication errors are important concerns in terms of patient safety. Dose calculation skills contribute to medication errors. The aim of this study is to evaluate the calculation skills and self-ratings of nursing students. Method: Four multiple-choice questions with five alternative responses were asked and an electronic questionnaire form was used for the assessment of their perceptions of their self-competencies. Results: The rates of correct answers to the questions varied between 20% and 63%. In their self-assessments, 26.4% of them stated that they had sufficient dose calculation skills. Conclusion: The results of the study showed that skills should be improved. Drug dose calculation skills should be improved, and further education should be provided on this issue.Yayın Management of skin of soft tisssue infection(Maltepe Üniversitesi, 2018) Öğütman, Çağlar; Sağlam, Esra; Özünal, Zeynep Güneş; Güllüoğlu, Muhammed Ali; Kaya, Mert; Ünal, Mehmet Ali; Bozayla, Sait Taha; Karadeniz, Aslı; Güder, HüsnaYumuşak doku enfeksiyonu yönetimi üzerine bir olgu sunumu.Yayın Management of stable coronary artery disease(Maltepe Üniversitesi, 2019) Öğütman, Çağlar; Sağlam, Esra; Özünal, Zeynep Güneş; Cingözbay, Bekir Yılmaz; Vural, Seray; Çoruh, Canan Halidenur; Erölmez, Hande Nur; Karaaslan, Atahan HüseyinStabil koroner arter hastalığının tedavisi üzerine bir sunum.Yayın Management of type 2 diabetes, Glycemic management in a patient with type 2 diabetes, Cardiac and renovascular complications in type 2 diabetes(Maltepe Üniversitesi, 2019) Öğütman, Çağlar; Sağlam, Esra; Özünal, Zeynep Güneş; Şanlı, Gözde; Bektaş, Öykü Ilgın; Yavuz, Ayşenur; Değer, ElifTip 2 diyabet hastalığı hakkında bir sunum.Yayın Mild persistment asthma(Maltepe Üniversitesi, 2019) Öğütman, Çağlar; Sağlam, Esra; Özünal, Zeynep Güneş; Tepe, Sinem Buse; Göklü, Meltem Elif; Nehma, Mohammed; Aydın, Ayşenur; Sarıman, NesrinHafif astım üzerine bir olgu sunumu.Yayın Obesity and management of overweight(Maltepe Üniversitesi, 2018) Öğütman, Çağlar; Sağlam, Esra; Özünal, Zeynep Güneş; Şakacı, Uğurcan; Başak Gören, Selinsu Ezgi; Karaağaç, Yeliz; Kuğu, EdaObezite ve yönetimi üzerine bir olgu sunumu.Yayın Pharmacology apprenticeship programme: Hepatitis C(Maltepe Üniversitesi, 2018) Öğütman, Çağlar; Sağlam, Esra; Özünal, Zeynep Güneş; Yücel, Cemile Gaye; Şahin, Ezgi; Varoğlu, Emrullah; Günenç, Meryem GökçeHepatit C üzerine bir olgu sunumu.Yayın Sertralin ve sorafenibin karaciğer kanseri hücrelerinde P-glikoprotein gen ekspresyonuna ve rodamin 123 birikimine etkileri(Mersin Üniversitesi, 2022) Çakıl, Yaprak Dönmez; Altun, İlayda; İşlerel, Elif Tekin; Özünal, Zeynep GüneşAmaç: Hepatoselüler karsinom (HCC), tüm dünyada görülme sıklığı giderek artan, en yaygın ölümcül kanser türleri arasında yer almaktadır. Vakaların büyük çoğunluğunda ileri evrede tanı ve ilaç direnci hayatta kalma oranını sınırlayan temel sorunlardır. ATP bağımlı bir efluks (dışa atım) pompası olan P-glikoprotein (P-gp), kanserde çok sayıda ilaç direnci modeli ile ilişkilidir. Rodamin 123 (rh123) floresan bir boyadır ve bir referans P-gp substratı olarak birçok araştırmada P-gp aktivitesini incelemek amacıyla kullanılmaktadır. Sorafenib, HCC tedavisi için onaylanmış ilk sistemik tedavidir. Etkinliğini artırmak ve ilaç direncini azaltmak için farklı ilaçlarla beraber kullanımları araştırılmaktadır. Bu kapsamda, daha önce sorafenib ve antidepresan sertralinin HepG2 hücre proliferasyonu ve ölümü üzerinde sinerjistik etkileri gösterilmiştir. Yöntem: Bu çalışmada, HepG2 hücrelerinde, sorafenib ve sertralinin tek başına veya birlikte uygulanması sonrası, qPCR ve akış sitometrisi ile P-gp gen ekspresyonu ve rh123 birikimi/efluks araştırılmıştır. Bulgular: Sorafenib uygulaması hem P-gp gen ekspresyonu hem de hücrelerde rh123 birikimini anlamlı olarak azaltırken, sertralin tek başına kullanıldığında Pgp mRNA seviyelerini arttırmış, rh123 birikiminde ise anlamlı bir değişikliğe yol açmamıştır. İki ilacın birlikte uygulanması ise, kontrol grubuna kıyasla P-gp gen ekspresyonunda ve rh123 birikiminde herhangi bir değişikliğe neden olmamıştır. Sonuç: Sonuçlar, sorafenib ve sertralinin antiproliferatif sinerjistik etkilerinde P-gp ile ilişkili etkenlerden ziyade farklı mekanizmaların rol alabileceğini göstermiştir.Yayın Statins(Maltepe Üniversitesi, 2019) Öğütman, Çağlar; Sağlam, Esra; Özünal, Zeynep Güneş; Cingözbay, Bekir Yılmaz; Burgut, Hüseyin Refik; Küçükolcay, Zeynep; Sağlam, Nuri Oğuzhan; Özdemir, Kaan Utku; Aka, Bahaeddin UmurStatinler hakkında bir sunum.Yayın Therapeutic drug monitoring characteristics in a tertiary university hospital in 2019(Cureus Inc., 2020) Özünal, Zeynep Güneş; İpek, Belkız ÖngenIntroduction Therapeutic drug monitoring (TDM) is defined as measuring drug concentration in a biological sample to optimize pharmacotherapy. This study aims to evaluate TDM requests in a tertiary university hospital retrospectively. Materials and methods TDM requests were evaluated retrospectively for lithium, valproic acid, carbamazepine, and digoxin in 2019. The age and gender of the patient, requesting department, and measurement results were evaluated. Lower levels than the reference values were considered as subtherapeutic, while levels higher than the reference were considered as toxic. Results A total of 415 drug level measurement records were found. The pediatric age sample ratio was 13.7%, and the elderly age sample ratio was 11.8%. When all samples were evaluated according to the relevant laboratory cut-off values, 72.8% of samples were within the therapeutic level range, 21.9% of samples were subtherapeutic, and 5.3% were toxic. The pediatric age group had a higher ratio of toxic levels for the four drugs studied (54.5%). Conclusions Tests for lithium, valproic acid, carbamazepine, and digoxin would not be considered sufficient for TDM. Multidisciplinary teamwork might be appropriate for further implementation and interpretation of TDM.
