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    Argyrophilic nucleolar organizer regions as a promising biomarker for the detection of brain hypoxia levels caused by different doses of carbon monoxide poisoning
    (Academia Nacional de Medicina de México, 2021) Yeşildağ, Kerim; Kokulu, Kamil; Mutlu, Hüseyin; Eröz, Recep; Taha Sert, Ekrem; Sarıtaş, Ayhan
    The purpose of the study is to investigate whether there is any relationship between mean argyrophilic nucleolar organizing regions (AgNOR) number and total AgNOR area/total nuclear area (TAA/TNA) ratio and the levels of brain hypoxia after exposure to different acute doses of carbon monoxide (CO) gas. Methods: Each experimental group was exposed to CO gas (concentrations of 1,000, 3,000 and 5,000 ppm). Then, the rats were anesthetized, and blood samples were taken from the right jugular vein for carboxyhemoglobin levels detection. The rats were sacrificed on seventh day. AgNOR staining was applied to brain tissues. TAA/TNA and mean AgNOR number were detected for each nucleus. Results: Significant differences were detected among the all groups for TAA/TNA ratio, mean AgNOR number and carboxyhemoglobin level. According to double comparison of groups, the differences between control and 1000ppm, control and 3000ppm, control and 5000ppm and 1000 and 5000ppm were significant for TAA/TNA ratio. When mean AgNOR number to be considered, significant differences were detected between control and 1000ppm, control and 3000ppm, control and 5000ppm and 1000 and 3000ppm. Conclusion: AgNOR proteins may be used for early detection of the duration, intensity and damage of brain injury caused by CO intoxication. Thus, effective treatment strategies for the prevention of hypoxic conditions may be developed.
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    Performance of the systemic immune-inflammation index in predicting survival to discharge in out-of-hospital cardiac arrest
    (Elsevier B.V., 2023) Taha Sert, Ekrem; Kokulu, Kamil; Mutlu, Hüseyin; Gül, Murat; Uslu, Yakup
    To investigate whether the systemic immune-inflammatory index (SII) could be used as a prognostic marker of out-of-hospital cardiac arrest (OHCA). Methods: We evaluated patients aged 18 years and older, who presented to the emergency department (ED) due to OHCA between January 2019 and December 2021 and achieved the return of spontaneous circulation after successful resuscitation. Routine laboratory tests were obtained from the first blood samples measured following the patients’ admission to ED. The neutrophil–lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were calculated by dividing the neutrophil and platelet counts by the lymphocyte count. SII was calculated as platelets × neutrophils / lymphocytes. Results: Among the 237 patients with OHCA included in the study, the in-hospital mortality rate was 82.7%. The SII, NLR, and PLR values were statistically significantly lower in the surviving group than in the deceased group. The multivariate logistic regression analysis revealed that SII [odds ratio (OR): 0.68, 95% confidence interval (CI): 0.56–0.84, p = 0.004] was an independent predictor of survival to discharge. In the receiver operating characteristic analysis, the power of SII to predict survival to discharge [area under the curve (AUC): 0.798] was higher than either NLR (AUC: 0.739) or PLR (AUC: 0.632) alone. SII values below 700.8% predicted survival to discharge with 80.6% sensitivity and 70.7% specificity. Conclusion: Our findings showed that SII was more valuable than NLR and PLR in predicting survival to discharge and could be used as a predictive marker for this purpose.