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- ItemExploring Cognitive Enhancements and Default Mode Network Connectivity in Relapsing-Remitting Multiple Sclerosis: Insights from a Prospective Study Investigating the MIND Diet(Sage, 2024-09) Demirel, Mert; Daşgın, Hacer; Acar, Nazire Pınar; Özçelik-Eroğlu, Elçin; Atabilen, Büşra; Ertuğrul, Aygün; Akdevelioğlu, Yasemin; Oğuz, Kader Karlı; Tuncer, Meryem Aslı; 396621The potential therapeutic impact of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet on relapsing-remitting multiple sclerosis (RRMS) remains an underexplored area. Objectives/Aims: This study aims to evaluate the influence of the MIND diet on RRMS by examining neurological, cognitive, and functional magnetic resonance imaging (fMRI) parameters. Methods: Seventeen early-stage RRMS patients (aged 20-40, disease duration < 10 years, Beck Depression Inventory Score < 17) underwent MRI at baseline and following a 9-month adherence to the MIND diet. They were matched with 10 healthy controls. Diet adherence was assessed using the MIND Diet scale score. MRI encompassed structural and resting-state fMRI (RS-fMRI) sequences. Neurological evaluation (Expanded Disability Status Scale [EDSS], Timed 25-Foot Walk [T25W], 9-Hole Peg Test [9HPT]), and cognitive assessments (Mini-Mental State Examination [MMSE], Rey Auditory Verbal Learning Test [AVLT], phonemic and semantic fluency, forward and backward digit span tests [FDST, BDST]) were conducted. Functional connectivity was assessed using seed-based correlation (SBC) and global correlation by general linear model (GLM), focusing on Default Mode Network (DMN), Central Executive Network (CEN), Dorsal Attention Network (DAN), Salience Network (SN), Visual Network (VN), and Sensorimotor Network (SMN). Results: Patients exhibited high adherence to the diet throughout the 9-month period. Significant improvements were observed in dominant hand 9-HPT (p=0.023) and AVLT parameters (p<0.001), except delayed recall (p=0.982), following the intervention. Increased connectivity within the whole brain was noted in the left frontal orbital cortex of the 9th-month group compared to healthy controls (p=0.000005). Moreover, RRMS patients in the 9th-month group displayed enhanced functional connectivity in the bilateral caudate, bilateral pallidum, and right putamen within the DMN compared to baseline (p=0.000034). Conclusion: The findings of this study suggest potential cognitive benefits of the MIND diet, as evidenced by improvements in AVLT scores. Furthermore, the observed alterations in Default Mode Network (DMN) connectivity in RRMS patients following the dietary intervention indicate a promising avenue for further investigation into cognitive deficit management in this population
- ItemInvestigation of pepsin levels in bronchial lavage in patients with interstitial lung disease and chronic cough(Elsevier, 2024-11) Ala Çitlak, Fatma Selen; Köksal, Nurhan; Avci, Bahattin; Tibel Tuna, Nazmiye; Güllü, Yusuf Taha; 156045Aim: Pepsin is an enzyme that helps digest protein secreted only from the gastric chief cell in an inactive state. Pepsin is a good marker for acidic gastroesophageal reflux (GER). Its presence in sputum or saliva is considered pathologic. In GER, cough is stimulated by broncho-esophageal neurogenic reflex and aspiration of gastric contents into the airways. GER is the most common cause of cough. Gastric acid reflux is also thought to play a role in Interstitial Lung Disease (ILD) etiology. In many studies, pepsin and bile acid levels in bronchial lavage were high in patients with interstitial lung disease and chronic cough. In our study, we aimed to evaluate pepsin levels in bronchial lavage in patients with ILD and chronic cough and to investigate the relationship between symptoms and reflux treatment. Methods: Between January 2021 and February 2022, 212 patients who underwent bronchoscopy in our tertiary clinic were evaluated. These patients were divided into three groups: 52 patients with interstitial lung disease, 81 patients with chronic cough, and 79 patients who underwent bronchoscopy with a pre-diagnosis of lung cancer as the control group. Bronchial lavage obtained by bronchoscopy was analyzed for pepsin levels. Results: Shortness of breath and cough were the most common symptoms in all three groups. Pepsin levels were 16.71 ± 8.6 ng/ml in the chronic cough group, 15.6 ± 8.9 ng/ml in the ILD group, and 10.58 ± 5.4 ng/ml in the lung cancer (control) group. Pepsin levels in the ILD and chronic cough group were statistically significantly higher than in the lung cancer group (p:0.00). There was no statistical difference between the ILD group and the chronic cough group regarding pepsin levels. It was found that pepsin levels were lower in the three groups who received anti-reflux treatment. There was no difference in pepsin levels between ILD subgroups. Conclusion: Pepsin levels in bronchial lavage were higher in the ILD and chronic cough groups. This suggests that reflux may be involved in the etiology of chronic cough and ILD. Low pepsin values in patients receiving antireflux therapy have shown that occult reflux may occur. In our study, the high level of pepsin in bronchial lavage, especially in the chronic cough and ILD group, may be instructive in the etiology and treatment planning of the disease.
- ItemMulti-inflammatory index as a novel predictor of new-onset atrial fibrillation after off-pump coronary artery bypass grafting(Polish Cardiac Soc, 2024-05) Yüksel, Ahmet; Velioğlu, Yusuf; Atasoy, Mustafa Selçuk; Müdüroğlu, Ayhan; Deşer, Serkan Burç; Gürbüz, Orçun; Aldemir, Mustafa; Çetintaş, Demir; Kılıç, Ali Önder; Badem, SerdarBackground: To our knowledge, a possible predictive relationship of the multi-inflammatory index (MII) with new-onset atrial fibrillation (AF) after off-pump coronary artery bypass grafting (CABG) has not yet been studied in the literature. Aims: We aimed to investigate whether the MII is a novel group of hematological markers for predicting postoperative new-onset AF in patients undergoing off-pump CABG. Methods: A total of 427 patients undergoing isolated off-pump CABG between October 2021 and December 2023 were enrolled in this retrospective observational cohort study and allocated to two groups: the AF group (n = 108) and the non-AF group (n = 319). The groups were compared in terms of baseline clinical patient characteristics, laboratory parameters, and operative and postoperative data. Results: The median values of age, length of hospital stay, platelet and neutrophil count, C-reactive protein level, systemic immune-inflammation index, MII-1, MII-2, and MII-3 were significantly greater in the AF group compared to the non-AF group in univariate analyses. In multiple explanatory variable logistic regression analysis, MII-1, MII-2, and MII-3 were determined to be significant hematological variables, and thereby these indices were considered the independent predictors of postoperative new-onset AF. Receiver operating characteristic curve analyses showed that to predict postoperative new-onset AF, MII-1 of 22.47 constituted the cut-off value with 62.0% sensitivity and 57.0% specificity, MII-2 of 141.77 constituted the cut-off value with 43.5% sensitivity and 76.8% specificity, and MII-3 of 5669 constituted the cut-off value with 63.8% sensitivity and 58.3% specificity. Conclusion: This study demonstrated for the first time that all MIIs predicted new-onset AF after off-pump CABG.
- ItemThe Relationship between Resistant Hypertension and Advanced Glycation End-Product Levels Measured Using the Skin Autofluorescence Method: A Case–Control Study(MDPI, 2023-10) Peker, Tezcan; Boyraz, Bedrettin; 313898Resistant hypertension is hypertension that cannot be controlled despite the use of three antihypertensive drugs, one of which is a diuretic. Resistant hypertension often coexists with advanced age, obesity, smoking, and diabetes. Advanced glycation end products (AGEs) are substances that are generated as a result of the glycation of proteins, lipids, and nucleic acids due to conditions such as hyperlipidemia, oxidative stress, and hyperglycemia. There are studies showing the relationships between AGE levels and aortic stiffness, hypertension, and microvascular and macrovascular complications in diabetes. In our study, we examined the relationship between resistant hypertension and AGE levels. Our study was planned as a case–control study, and 88 patients with resistant hypertension were included in the focus group, while 88 patients with controlled hypertension were included in the control group. The AGE levels of the patients were measured using the skin autofluorescence method. AGE levels were found to be significantly higher in patients with resistant hypertension than those recorded in the control group. A significant increase in AGE levels was also observed in patients with resistant hypertension and without diabetes compared with the control group. The levels of AGEs, which can be measured cheaply, noninvasively, and quickly with the skin autofluorescence method, may provide benefits in identifying these patients with resistant hypertension.
- ItemThe Role of Advanced Glycation End Products in Saphenous Vein Graft Failure(Karger, 2024-10) Akgümüş, Alkame; Boyraz, Bedrettin; Balun, Ahmet; 313898Objective: We aimed to investigate the relationship between advanced glycation end product (AGE) levels in patients with saphenous vein graft (SVG) failure and in patients without SVG failure. Subjects and Methods: In our study, 55 patients with a history of previous coronary artery bypass grafting (CABG) surgery, who subsequently underwent coronary angiography for any reason and were found to have either SVG occlusion or significant lesions, were included as study patients. Additionally, 55 patients who have had CABG surgery without SVG failure for at least 1 year served as the control group. AGE values of the patients were measured using the skin autofluorescence method. Results: In our study results, we observed a significant difference in AGE levels between the two groups of patients with similar demographic characteristics (SVG failure groups AGE 3.2 [2.8–3.6] vs. control groups AGE 2.4 [2.1–2.7] p < 0.001). In the receiver operating characteristic curve analysis, we determined the ability of AGE levels to detect SVG failure with an area under the curve of 0.869. We found that in patients with AGE >3, it could detect SVG failure with a sensitivity of 70.9% and a specificity of 87.3%. Conclusions: Our results demonstrate that AGE levels can predict SVG failure risk inexpensively, easily, and quickly.
