Hüseyin Yaman

Background/Objective: Psoriasis is a chronic immune-mediated inflammatory disease with systemic involvement. Immature granulocytes (IGs) are potential inflammatory markers, but their role in psoriasis is unclear. We evaluated immature granulocyte count (IG#) and percentage (IG%) in plaque psoriasis, their associations with disease severity and treatment response, and their ability to distinguish patients from healthy controls. Methods: This retrospective study included 85 adults with plaque psoriasis and 85 healthy controls. Severity was assessed by the Psoriasis Area and Severity Index (PASI). IG#, IG%, and inflammatory markers were measured before treatment and after at least 3 months of systemic therapy. Group comparisons, correlations, and receiver operating characteristic (ROC) analyses were performed. Results: Pre-treatment IG# and IG% were higher in patients than in controls (both p < 0.001). IG# decreased after treatment (p = 0.004), whereas IG% did not (p = 0.072). Despite clinical improvement, post-treatment IG#, IG%, and C-reactive protein remained higher than controls. Pre-treatment IG# correlated weakly with PASI (r = 0.24, p = 0.020), whereas other PASI–IG correlations were non-significant. Discriminatory performance was modest for IG# (AUC = 0.697) and IG% (AUC = 0.658). Conclusions: IG# and IG% are elevated in plaque psoriasis. IG# decreases with treatment and may be a potential marker of inflammatory changes, while the persistence of elevated IG# and IG% levels after treatment relative to healthy controls may reflect residual inflammation. However, weak associations with disease severity and modest discriminatory performance do not support their use as standalone clinical tools. As these parameters are routinely available from complete blood counts, they may complement clinical assessment. Further prospective studies are required to establish their clinical relevance.

Objectives: Reference change value (RCV) is an objective tool that indicates whether the change between consecutive measurements is clinically significant. This study aimed to determine the instrument-specific RCVs of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), thyroglobulin (Tg), thyroglobulin antibody (Anti-Tg), and thyroperoxidase antibody (Anti-TPO) tests, which are routinely analyzed for the diagnosis, case-finding, and screening of thyroid diseases. Methods: This cross-sectional study was conducted between January 1 and December 31, 2018. The twelve-month mean analytical imprecision (CV _A ) was calculated from internal quality control data for each test on three different instruments. All tests’ individuality index (II) was calculated using the biological variation data. RCVs were determined by both conventional and logarithmic approaches. Results: It was shown that the II of all tests was 0.6 and below. Upward logarithmic RCVs were slightly higher than conventional RCVs, while downward logarithmic RCVs were lower (e.g., conventional RCV for TSH 39 %, whereas upward and downward RCVs 48 and 32 %, respectively). Conclusions: Due to high individuality, the results of thyroid-related biomarkers would be more appropriate to evaluate with RCV instead of reference interval. Instrument-specific RCVs should be determined because the analytical imprecision of analyzers may vary. Most presentations to the hospital are not healthy individuals, so logarithmic RCV could provide a more accurate assessment of significant change.

Carbon monoxide (CO) poisoning is among the main causes of poisoning‐related mortality and morbidity, primarily affecting the central nervous system and leading to delayed neurological sequelae. Idebenone exerts antioxidant and neuroprotective effects. In this study, we aimed to evaluate the specific neuroprotective effects of idebenone against CO poisoning. Forty female Wistar Albino rats were used in this study. Except the controls, the other rats inhaled 5000 ppm CO until a change in consciousness was observed. Rats with carboxyhemoglobin concentrations over 20% in blood samples collected from the tail vein were considered successful acute CO poisoning models. The rats were divided into five groups: healthy control (HC; group 1), CO + saline (CO‐S; group 2), CO + 100 mg/kg idebenone (CO‐I₁₀₀; group 3), CO + 200 mg/kg idebenone (CO‐I₂₀₀; group 4), and CO + 300 mg/kg idebenone (CO‐I₃₀₀; group 5). Pre‐determined doses of idebenon were orally administered to the rats at 24‐h intervals for 5 days. The rats were anesthetized and sacrificed 24 h after the last drug dose. Histopathological and biochemical parameters were examined in the blood and hippocampus samples of the rats. Histopathological grading of neurons in the hippocampus revealed that the CO‐S group exhibited the highest number of grade 1, 2, and 3 degenerative cells (all p = 0.001). Apoptotic index was the highest in the CO‐S group and significantly low in the idebenone‐treated groups (p = 0.001). Neuron‐specific enolase and malondialdehyde levels and oxidative stress index were significantly lower in both the hippocampus and serum samples of the idebenone‐treated groups than in those of the CO‐S group (all p values = 0.001). Overall, idebenone inhibited degeneration due to CO‐induced brain damage and exerted neuroprotective effects against oxidative stress in rats.

Study Objectives: This study aimed to evaluate and compare the effects of high and low-intensity expiratory muscle strength training (EMST) on disease severity, systemic inflammation, oxidative stress, respiratory muscle strength, exercise capacity, symptoms, daytime sleepiness, fatigue severity, and sleep quality in male patients with obstructive sleep apnea syndrome (OSAS). Methods: Thirty-one male patients diagnosed with moderate OSAS were included in this double-blind, randomized, parallel study. Patients were randomized into two groups: High-EMST and Low-EMST groups. EMST was used at home 7 days/week, once a day, for 25 breaths, 12 weeks. Respiratory muscle strength was measured using a mouth pressure device. Disease severity (Apnea–Hypopnea Index [AHI]) and, respiratory sleep events by polysomnography, total oxidant level(TOS), total antioxidant level(TAS), oxidative stress index (OSI), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels by blood serum were evaluated. Results: The percentage of AHI change in the high-EMST group(50.8%) was significantly higher than in the low-EMST group(6.3%; p = .002, d = 1.31). In general, as MEP increased by one unit, AHI decreased by 0.149 points (b = −0.149; CR = −3.065; p = .002), and as AHI increased by one unit, ODI increased by 0.746 points (b = 0.746; CR = 10.604; p < .001). TOS, OSI, TNF-α and IL-6 levels decreased at similar rates in both groups. Conclusions: EMST significantly reduces systemic inflammation and oxidative stress while improving expiratory muscle strength in male patients with moderate OSAS. High-EMST is more effective in enhancing the severity of disease than low-EMST. EMST is a practical, effective, and promising treatment for pulmonary rehabilitation in patients with moderate OSAS. Clinical Trials: Effect of EMST systemic inflammation and oxidative stress in patients with moderate OSAS, https://clinicaltrials.gov/study/NCT05242406, with the number NCT05242406.

Estimation of cardiovascular (CV) individual risk over a 10 year period was provide benefit most from preventive action in individual at high risk of CVD, and it evaluated by SCORE2 predictive model. Oxidative stress plays a critical role in all stages of atherosclerosis. It was examined the relationship between oxidative stress and SCORE2, and to investigate whether one of the oxidative stress parameters may represent a potential risk marker permitting more accurate high-risk prediction for CV risk calculation models. The study groups consisted of 71 coronary artery disease (CAD)(−) patients (27 normocholesterolemic and 44 hypercholesterolemic) and 12 CAD(+) patients. Ox-LDL, MDA, OSI, 3-NT, 8-OHdG, and total thiols were measured as oxidative stress parameters and TNF-α and IL-6 as inflammatory factors. The oxidative stress parameters were showed significant changes among study groups. ROC analysis identified ox-LDL levels as one of the highest values (AUC:0.998, p < 0.001). ox-LDL exhibited the highest odds ratio at 1.68 (CI = 1.26–2.14) with SCORE2. ox-LDL levels increased significantly and gradually from the low- to high-risk groups of SCORE2 and exhibited the strongest correlation with SCORE2 (r = 0.48, p < 0.001). We suggest that circulating ox-LDL levels may be considered as a candidate marker for more accurate high-risk prediction with SCORE2.