Nuclear Factor Erythroid 2-Related Factor (NRF2), Heme Oxygenase 1 (HO-1) and Total Oxidant-Antioxidant Status in Patients with COVID-19 / Factor nuclear relacionado con el eritroide 2 (NRF2), hemo oxigenasa 1 (HO-1) y estado oxidante-antoxidante total en pacientes con COVID-19

Introduction: Studies on nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) levels in COVID-19 patients are limited. This study aimed to investigate the relationship between some biomarkers of oxidant-antioxidant status with COVID-19 disease. Material and methods: The patients older than 18 years of age who tested positive for SARS CoV-2 PCR (polymerase chain reaction) with clinical symptoms and signs were included in this study. Total antioxidant status (TAS), total antioxidant status (TOS), oxidative stress index (OSI) and HO-1 and Nrf2 levels were analyzed from serum samples taken before and after treatment. Results: In this study, 16 patients followed up with the diagnosis of COVID-19 were included. 9 (56.3%) of the patients were female and 7 (43.8%) were male. The mean age was 33.75 ± 17.03 years. All patients were symptomatic and were hospitalized to be followed up. It was determined that Nrf2 and HO-1 values increased significantly after treatment. Moreover, there was a significant positive correlation between Nrf2 and TAS values and TAS increases significantly in parallel to an increase in Nrf2, and there was a significant but negative correlation between Nrf2 and TOS and OSI values, and thus an increase in Nrf2 led to a decrease in TOS and OSI values. There was a significant positive correlation between HO-1 and TAS, and TAS increased significantly, as HO-1 increased. Conclusions: The decrease in TOS and OSI and the increase in Nrf2 and HO-1 during the follow-up period in COVID-19 patients suggest that the body tries to prevent ROS-related oxidative stress via Nrf2 and HO-1 and that oxidative stress may have a key role in the pathophysiology of COVID-19. (AU)

Introducción: Los estudios sobre los niveles del factor 2 relacionado con el factor nuclear eritroide 2 (Nrf2) y la hemo oxigenasa-1 (HO-1) en pacientes con COVID-19 son limitados. Este estudio tuvo como objetivo investigar la relación entre algunos biomarcadores del estado oxidante-antioxidante con la enfermedad COVID-19. Material y métodos: Se incluyeron en este estudio los pacientes mayores de 18 años que dieron positivo a PCR (reacción en cadena de la polimerasa) de SARS CoV-2 con síntomas y signos clínicos. Se analizaron el estado antioxidante total (TAS), el estado antioxidante total (TOS), el índice de estrés oxidativo (OSI) y los niveles de HO-1 y Nrf2 a partir de muestras de suero tomadas antes y después del tratamiento. Resultados: En este estudio se incluyeron 16 pacientes seguidos con diagnóstico de COVID-19. 9 (56,3%) de los pacientes eran mujeres y 7 (43,8%) eran hombres. La edad media fue 33,75 ± 17,03 años. Todos los pacientes presentaban síntomas y fueron hospitalizados para seguimiento. Se determinó que los valores de Nrf2 y HO-1 aumentaron significativamente después del tratamiento. Además, hubo una correlación positiva significativa entre los valores de Nrf2 y TAS y TAS aumenta significativamente en paralelo a un aumento en Nrf2, y también hubo una correlación significativa pero negativa entre Nrf2 y los valores de TOS y OSI y, por lo tanto, un aumento en Nrf2 condujo a una disminución en los valores TOS y OSI. Hubo una correlación positiva significativa entre HO-1 y TAS, y TAS aumentó significativamente a medida que aumentaba HO-1. Conclusiones: La disminución de TOS y OSI y el aumento de Nrf2 y HO-1 durante el período de seguimiento en pacientes con COVID-19 sugieren que el cuerpo intenta prevenir el estrés oxidativo relacionado con ROS a través de Nrf2 y HO-1 y que el estrés oxidativo puede tener un papel clave en la fisiopatología de COVID-19. (AU)

Validity and reliability evaluation of the Turkish version of the Clinical Interpersonal Reactivity Index.

AIM: This study was conducted to evaluate the validity and reliability of the Turkish version of the Clinical Interpersonal Reactivity Index, an instrument to assess nurses' empathy. BACKGROUND: A practical empathic approach is valuable for planning nursing interventions suitable for the patient's conditions and needs and increasing patient satisfaction. DESIGN: This is a methodological study. METHODS: The study was carried out at Mugla Sitki Koçman University Training and Research Hospital, recruiting a total of 358 nurses between January and February 2023. Exploratory and confirmatory factor analyses were used to determine and validate the factor structure of the Clinical Interpersonal Reactivity Index. RESULTS: The exploratory factor analysis extracted three factors. According to the confirmatory factor analysis, all goodness of fit measures were within acceptable limits. Cronbach's α values were 0.89 for the total scale with 17 items and between 0.73 and 0.81 for the factors. In test-retest analyses, all intra-class correlation coefficients were higher than 0.7, and the correlations between the first and second applications of the scale were between 0.61 and 0.73. CONCLUSION: The Turkish version of the Clinical Interpersonal Reactivity Index can be applied as a valid and reliable measurement tool to evaluate empathy in Turkish nurses.

Evaluation of liver and spleen stiffness measurement with shear wave elastography in brucellosis.

BACKGROUND: Human brucellosis, which is endemic in the eastern region of Turkey, infects the reticulo-endothelial system. Acute brucellosis may cause hepatomegaly or splenomegaly. AIMS: The main purpose of this study was to investigate the effectiveness of the point shear wave elastography (pSWE) method in identifying and detecting liver and spleen stiffness in acute brucellosis. METHODS: This case-control study included 40 patients with acute brusellosis and 60 healthy individuals as a control group. The demographic data, abdominal ultrasonography (USG) and pSWE results of the patient and control groups were evaluated. Statistical and ROC analyses were performed. RESULTS: The liver pSWE value was 3.8395 ± 1.171 kPa in the patient group and 1.6619 ± 0.495 kPa in the control group. The spleen pSWE value was 3.2431 ± 1.803 kPa in the patient group and 1.3793 ± 0.622 kPa in the control group. The mean liver and spleen pSWE values were statistically significantly higher in the patient group than in the control group (p < 0.001). Cut-off values were determined as 2.524 for the liver pSWE and 1.62667 for the spleen pSWE. From the AUC values (0.959, 0.903), the diagnostic performance of liver and spleen pSWE values were seen to be excellent in distinguishing between patient and control groups. CONCLUSIONS: The study results showed that liver and spleen stiffness were high in acute brucellosis patients and had predictive significance above certain cut-off values. It can be considered that pSWE, which evaluates liver and spleen stiffness in acute brucellosis, may provide diagnostic benefit as a reliable, non-invasive technique.