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    Angiotensin II and angiotensin II receptor 2 levels can predict shock and mortality in septic patients
    (Edizioni Minerva Medica, 2022) Ozer, Ayse B.; Bicakcioglu, Murat; Baykan, Seyma; Bulut, Nilufer; Kalkan, Serkan; Demircan, Selcuk; Korkmaz Disli, Zeliha
    BACKGROUND: The aim of this study was to evaluate the place of angiotensin II and its receptors in the prognosis of septic patients. METHODS: Patients with sepsis and septic shock were included in the study group. The control group consisted of patients who were followed up in the ICU and had no sepsis/septic shock. Plasma angiotensin II, angiotensin receptor-1 and 2 (AT-1, AT-2) levels were evaluated first and third days.RESULTS: Angiotensin II levels were significantly lower in the septic shock and non-survivor. AT-1 levels were lower in all septic patients on the first day compared to the control. While AT-1 levels on the third day decreased in the septic shock group, it increased in the sepsis group. AT-2 levels were significantly higher in sepsis, and lower in septic shock compared to controls on the first day. Angiotensin II (95%, 82%) and AT-2 levels (100%, 87%) were observed to have high sensitivity and specificity in demonstrating the presence of shock in septic patients. Angiotensin II and AT-1/AT-2 ratios were observed to have high sensitivity and low specificity in the development of mortality.CONCLUSIONS: In septic patients, angiotensin II, AT-2 and AT-1/AT-2 levels can predict the probability of shock development and mortality. (Cite this article as: Ozer AB, Bicakcioglu M, Baykan S, Bulut N, Kalkan S, Demircan S, et al. Angiotensin II and angio-tensin II receptor 2 levels can predict shock and mortality in septic patients. Minerva Anestesiol 2022;88:1021-9. DOI: 10.23736/S0375-9393.22.16566-1)
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    Effect of troponin I and coagulation parameters on mortality in COVID-19 patients
    (Marmara Univ, Fac Medicine, 2023) Dag, Meral; Bulut, Nilufer; Taskapan, M. Cagatay
    Objective: Our aim is to determine the levels of troponin-I and some coagulation markers (D-dimer, fibrinogen and International Normalized Ratio (INR)) in coronavirus disease 2019 (COVID-19) patients and to investigate the effects of these markers on mortality.Patients and Method: It is planned as a descriptive, cross-sectional and analytical study. The study was conducted by retrospectively scanning the files of COVID-19 patients who applied to Inonu University Turgut Ozal Medical Center between 01.03.2020 and 31.12.2020. Levels of cardiac troponin I markers and coagulation parameters (D-dimer, fibrinogen and INR) were detected.Results: The results of a total of 1858 patients were obtained. One thousand, three hundred and twenty-six patients with only troponin I and D-dimer results (Group 1), 606 patients with only troponin I and fibrinogen results (Group 2), and 1308 patients with only troponin I and INR results (Group 3) were included. Troponin I levels were significantly higher in all patients who died. 96.6% of the patients with high D-dimer levels died in Group 1, 85.5% of the patients with high fibrinogen levels died in Group 2 and 77.3 % of the patients with high INR levels died in Group 3.Conclusion: Measurements of troponin-I and coagulation markers such as D-dimer, fibrinogen and INR can help predict clinical severity and mortality in COVID-19 patients.
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    Hydrocortisone may act through the angiotensin II receptor-2 level in patients with catecholamine-resistant septic shock
    (Edizioni Minerva Medica, 2023) Baykan, Seyma; Bicakcioglu, Murat; Bulut, Nilufer; Yucel, Neslihan; Ersoy, Yasemin; Uysal, Nermin Kibrislioglu; Ozer, Ayse B.
    BACKGROUND: This study aimed to compare the serum angiotensin II and its receptor levels (AT1, AT2) in septic patients with catecholamine-responsive or resistant. The effect of hydrocortisone treatment on angiotensin II levels in the catecholamine-resistant septic patients was evaluated.METHODS: This prospective observational study enrolled 40 patients diagnosed with septic shock based on sepsis-3 cri-teria. Patients were divided into two groups according to the noradrenalin infusion rate required to keep the mean arterial pressure above 65 mmHg: control group and hydrocortisone group (control group: below 0.5 mu g/kg/min, hydrocortisone group: above 0.5 mu g/kg/min). Serum angiotensin II, AT1, AT2 levels were measured at the time of diagnosis (A), one hour after hydrocortisone treatment (B), and three days later (C).RESULTS: In the catecholamine-resistant group, angiotensin II and AT1 levels were higher than the catecholamine-responder group in all periods. The sensitivity and specificity of AT-1 was observed to be high in all periods. AT2 levels decreased after hydrocortisone treatment in the catecholamine-resistant group and cut-off value was found 11%.CONCLUSIONS: It was concluded that angiotensin II and AT1 can be used as a biomarker of refractory septic shock and hydrocortisone may provide their blood pressure correcting effect by reducing AT2 level in these patients. AT2 can be a therapeutic target in the catecholamine-resistant septic shock patients.
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    Quercetin Exhibits Nephroprotective Properties Against Tartrazine-Induced Nephrotic Injury: Effects on Oxidative Stress, Kidney Function, Inflammation, Renal Tissue Morphology, and Apoptotic Pathway
    (Wiley, 2026) Erdemli, Zeynep; Gul, Mehmet; Bulut, Nilufer; Zayman, Emrah; Demirtas, Sezin; Karaaslan, Ezgi; Aylaz, Bulent
    We investigated first time in the literature the effects of tartrazine, a common industrial dye, and quercetin, a possible protective, on the kidneys. The rats were randomly assigned to the control, tartrazine, quercetin, and tartrazine + quercetin groups, with each group consisting of eight Wistar albino rats. The trials lasted for 1 month, after which kidney tissues and blood samples were collected. In the tartrazine group, increases were observed in malondialdehyde (MDA), superoxide dismutase (SOD), total oxidant status (TOS), oxidative stress index (OSI), tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), glomerular diameter and damage, histopathological damage score, glomerular and tubular caspase-3 immunoreactivity H-score, as well as serum urea, uric acid, and creatinine levels in the kidney tissue. Additionally, kidney tissue histopathology and apoptotic deteriorated in the same group. The deteriorated biochemical and histopathological parameters improved with quercetin administration. Tartrazine led to nephrotoxicity in rats, as indicated by kidney tissue oxidant capacity, inflammation, apoptosis, increased kidney function tests, and deterioration in histopathology. Quercetin exhibited strong antioxidant, antiapoptotic, and anti-inflammation activity and can be used as a protective agent against tartrazine-induced nephrotoxicity.