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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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    Does COVID-19-related viral sepsis stimulate angiotensin II levels more than bacterial sepsis?
    (Bayrakol Medical Publisher, 2023) Demircan, Selcuk; Bulut, Niluefer; Kalkan, Serkan; Duzenci, Deccane; Bicakcioglu, Murat; Ozden, Mehmet; Dogan, Zafer
    Aim: Angiotensin II and its receptors play a role in both COVID and bacterial sepsis. The aim of this study was to compare the levels of serum angiotensin II and its receptors in viral sepsis due to COVID-19 with the levels in bacterial sepsis.Material and Methods: The study included 62 sepsis patients (n=31 COVID and n=31 non-COVID) with similar disease severity in the tertiary ICU. The serum angiotensin II, angiotensin II receptors 1 and 2 (ATR1, ATR2) and other inflammatory parameters were measured. Demographic data and 28-day mortality were recorded.Results: Angiotensin II level was significantly higher in COVID patients than in non-COVID patients (p<0.05). ATR1 and ATR2 did not differ between the two groups. There was a negative correlation between angiotensin II and procalcitonin levels in all patients, and a positive correlation between ATR1 and procalcitonin, APACHE II score, and SOFA score in COVID patients (p<0.05).Discussion: Observation showed that angiotensin II levels were higher in patients with COVID-19 compared to those with bacterial sepsis, and ATR1 level was higher in COVID-19 patients who died. It was thought that the renin-angiotensin cascade could be stimulated differently in bacterial sepsis compared to viral sepsis due to COVID.
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    The effect of plasmapheresis therapy on management of patients with snakebite
    (2023) Bıcakcıoğlu, Murat; Kalkan, Serkan; Doğan, Zafer; Togal, Turkan; Yucel, Neslihan; Demircan, Selcuk; Duzenci, Deccane
    Aim: The aim of the study was to evaluate the effectiveness of plasmapheresis therapy in patients with snakebite who were admitted to intensive care unit in the setting of tertiary referral hospital. Materials and Methods: The retrospective study involved 114 adult patients with snakebite who were admitted to a referral hospital’s intensive care unit between January 2012 and December 2022. The patients were divided into four groups according to the treatments. Group AV performed antivenom (Group AV) alone. Group PP performed plasmapheresis alone. Group AV+PP performed antivenom and plasmapheresis. Group GST performed only general supportive therapy. Results: Fifty two of 114 were included in Group GST, 31 in Group AV, 18 in Group PP and 13 in Group AV+PP. APACHE score, SOFA score, GCS, stage of the bite, length of stay in the intensive care unit, acute kidney injury, and hematological disorders were higher while the platelet count at admission was lower in Group PP and Group AV+PP compared to Group AV and Group GST (p< 0.05). Conclusion: Antivenom and plasmapheresis are not alternatives to each other, antivenom should be performed to patients according to the severity of the bite, and plasmapheresis should be performed without delay in those with severe hematological effects.
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    Effects of Vitamin D on adropine and apoptosis in kidney tissue
    (2019) Onalan, Erhan; Demircan, Selcuk; Aydin, Suleyman; Kuloglu, Tuncay; Yalcin, Mehmet Hanifi; Gozel, Nevzat; Donder, Emir
    Aim: This study aims to investigate the effects of vitamin D on adropin and apoptosis in rat kidney tissue in the context of the experimental diabetes model created using streptozotocin (STZ).Material and Methods: 41 male Wistar-albino breed rats of 8-10 weeks were distributed into 5 groups, which consisted of 3 groups with 7 animals each and 2 groups with 10 animals each. No treatments were applied to the control group. The Buffer group was administered with single-dose 0.1 M sodium buffer intraperitoneally (ip). The Vitamin D group was orally administered 200 IU/day vitamin D. The Diabetes group was injected ip with single-dose 50 mg/kg STZ by dissolving the material in 0.1 M sodium buffer.Results: The biochemical and histological investigations revealed similar serum TOS and TAS levels, and TUNEL positivity and Adropin immunoreactivity for the Control, Buffer, and Vitamin D groups. While TOS levels and TUNEL positivity were significantly higher in the Diabetes group compared to the Control group, TAS levels and Adropin immunoreactivity were significantly lower. The TOS levels and TUNEL positivity were significantly reduced in the Diabetes+Vitamin D group compared to the diabetic group, and TAS levels, adropin immunoreactivity were significantly higher. Conclusion: In conclusion; it was determined that experimental diabetes increased TOS and apoptotic cells and decreased TAS and adropin levels in the kidney tissue in experimental diabetes, and that Vitamin D administered as treatment decreased TOS and apoptotic cells and increased TAS and Adropin levels. It was concluded that in order to uncover the role of diabetes in the pathophysiology of its effect on kidney tissue, future studies that consider various experimental diabetes times were necessary.