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Öğe Delta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?(De Gruyter Poland Sp Z O O, 2025) Cumaoglu, Mustafa Oguz; Ayan, Durmus; Vural, Abdussamed; Dolanbay, Turgut; Ozbey, Caner; Kulu, Abdul RidvanAim- This study investigates the diagnostic accuracy of five inflammatory biomarkers - delta neutrophil index (DNI); C-reactive protein/albumin ratio (CAR); procalcitonin (PCT); immature granulocytes count (IGc); and hemoglobin, albumin, lymphocyte, platelet score (HALPs) - in detecting acute appendicitis (AA) and identifying the most reliable marker for distinguishing complicated from non-complicated cases. Materials and methods- A prospective, cross-sectional study was conducted in a tertiary hospital emergency department, including 100 histopathologically confirmed AA patients and 100 healthy controls. Biomarker levels were analyzed using receiver operating characteristic curves. Sensitivity, specificity, and optimal cut-off values were determined via the Youden index, while logistic regression identified independent predictors of complicated appendicitis (CA). Results- DNI exhibited the highest diagnostic accuracy for AA (AUC: 0.87, 95% CI: 0.821-0.919, p < 0.001) with 92% specificity and 69% sensitivity at a cut-off of 71.88. CAR (AUC: 0.853) and PCT (AUC: 0.852) showed similar performance, whereas IGc (AUC: 0.695) and HALPs (AUC: 0.627) were less effective. DNI also outperformed the Alvarado score in predicting CA (AUC: 0.698 vs 0.626) and was an independent predictor (OR: 3.18, 95% CI: 1.40-7.24, p = 0.006). Conclusions- DNI demonstrated superior diagnostic performance for AA and was the most reliable marker for identifying CA. Its integration into clinical practice may enhance early diagnosis and reduce unnecessary surgeries, improving outcomes.Öğe Demographic, Sociocultural, and Time-Related Patterns of Violent Suicide Attempts(Int Scientific Information, Inc, 2025) Cumaoglu, Mustafa Oguz; Vural, Abdussamed; Dolanbay, Turgut; Dogan, Mustafa; Sekme, SabriBackground: Violent suicide attempts (VSAs), characterized by high-lethality methods such as hanging, firearms, and sharpobject injuries, are a significant public health concern. While VSAs are widespread globally, research on their associated factors remains limited. This study investigated demographic, sociocultural, and environmental factors influencing VSAs in Turkey's southern region, emphasizing time-related and seasonal patterns, to guide public health strategies. Material/Methods: Data were retrospectively collected from 86 VSA patients admitted to Nigde University Hospital between January 1 and December 31, 2023. Parameters assessed included demographics, marital status, education, psychiatric history, suicide methods, time of day, weekday trends, and seasonal environmental factors like temperature, precipitation, and wind speed. Statistical analyses revealed meaningful associations between sociodemographic characteristics, clinical features, and environmental factors and patterns of violent suicide attempts. Results: VSAs were more frequent among men, single people, and divorced individuals. Gender differences emerged in suicide methods: men predominantly used hanging and firearms, while women favored sharp objects. Psychiatric disorders were significantly less common among married individuals compared to single people and divorcees. VSAs were more prevalent on weekdays, peaking in the morning, with fatality rates highest in the afternoon. Seasonal analysis revealed spring as the peak period for VSAs, correlated with higher precipitation and wind speeds. Conclusions: The findings show the role of demographic, psychiatric, and environmental factors in VSA patterns. High-risk groups include single and divorced individuals and those with psychiatric disorders. Tailored interventions addressing seasonal and time-related patterns and enhancing support networks could mitigate VSA risks. Improved mental health services and targeted public health policies are essential for effective suicide prevention.Öğe Enhanced stroke prediction after transient ischemic attack: the role of triglycerides and free thyroxine: A retrospective cohort study(Lippincott Williams & Wilkins, 2025) Cumaoglu, Mustafa Oguz; Vural, Abdussamed; Dolanbay, Turgut; Ozguner, Hilal; Avcuoglu, EmrahTransient ischemic attack (TIA) carries a substantial risk of early ischemic stroke, particularly within the first 48 hours. Although the ABCD(2) scoring system is widely used for short-term risk stratification, its exclusion of laboratory markers may limit predictive accuracy. To investigate whether selected biochemical markers - thyroid function tests, lipid profiles, and Hemoglobin A1c - hold prognostic value for early post-TIA stroke, and whether their integration enhances the predictive performance of the ABCD(2) scoring system. This retrospective cohort included 130 first-ever TIA patients admitted between March 2022 and 2024. ABCD(2) scores and laboratory parameters were recorded at admission. Patients were followed for 30 days and categorized based on stroke timing: early (<= 48 hours), intermediate (3-7 days), and late (8-30 days). Receiver operating characteristic (ROC) curve analysis and binary logistic regression were utilized to assess predictive performance and determine independent risk factors. Ischemic stroke occurred in 52 patients (40%) within 30 days, with 65% of events arising in the first 48 hours. Patients who developed stroke had significantly elevated triglyceride (TG) levels (P = .038), while those with early stroke exhibited significantly lower free thyroxine (fT4) levels (P < .001). ROC analysis identified TG >= 152 mg/dL (area under the curve (AUC): 0.607) and fT4 <= 1.17 ng/dL (AUC: 0.708) as critical thresholds. Integration of these biomarkers into the ABCD(2) model significantly improved its performance: the AUC rose from 0.647 (ABCD(2) alone) to 0.751 (with TG) and 0.775 (with fT4). Notably, fT4 demonstrated a high negative predictive value (88.6%) for ruling out early stroke. Elevated TG and reduced fT4 levels were independently associated with increased stroke risk after TIA. Incorporating these biomarkers into the ABCD(2) scoring system significantly enhanced early stroke prediction. In particular, low fT4 may serve as a robust marker to exclude high-risk cases. These findings support a multimodal risk stratification strategy incorporating clinical, biochemical, and imaging data. Validation through prospective multicenter studies is recommended.Öğe Hospitalized Recurrent Deep Vein Thrombosis: Demographic, Clinical, and Laboratory Insights from a Single-Center Retrospective Study(Kafkas Üniversitesi, 2025) Cumaoglu, Mustafa Oguz; Dolanbay, Turgut; Vural, Abdussamed; Yüceer, Ömer; Tuncar, Alpay; Yanmaz, Seyyid Rasim[Abstract Not Available]Öğe IMPACT OF HEMOGLOBIN-ALBUMIN-LYMPHOCYTE-PLATELET (HALP) SCORE ON MORTALITY IN ABOVE-ANKLE AMPUTATION OF DIABETIC FOOT INFECTION(Dokuz Eylul Univ Inst Health Sciences, 2025) Yagar, Hilal; Vural, Abdussamed; Dolanbay, TurgutPurpose: Diabetic foot ulcers are one of the important reasons for amputations. The hemoglobin-albumin-lymphocyte-platelet (HALP) score is a marker of the inflammatory and nutritional status of the individual. Aim of this study is to investigate the relationship between the HALP score and mortality in patients undergoing above-ankle amputation due to diabetic foot infection. Material and Methods: The demographic data (age, sex), deaths during hospitalization, laboratory values and mortality through 3-6-9-12 months were recorded. Chi square and t test were used for categorical comparison and logistic regression tests were used for mortality risk estimation. Results: The mortality rates in hospital and in the 3rd, 6th, 9th, and 12th months were 13.1%, 37.7%, 48.5%, 53.8%, and 56.2% respectively. HALP score below 21.55 was associated with a 2.975 times higher risk for 1-year mortality (odds ratio: 2.975; 95% CI: 1.252-7.069; p = 0.014). Female gender, HALP score below 21.55, and age over 65 predict 20.2% overall 1-year mortality risk (Nagelkerke R2 = 0.202). Conclusion: The HALP score is a novel risk factor for mortality in patients undergoing amputation for diabetic foot ulcers. Also; older age and female gender are independent risk factors for 1-year mortality.Öğe Inflammatory indices as independent predictors of in-hospital mortality in acute upper gastrointestinal bleeding(Bmc, 2026) Cumaoglu, Mustafa Oguz; Vural, Abdussamed; Alpaslan, Mustafa; Dolanbay, Turgut; Kulu, Abdul Ridvan; Sezgin, Ercan; Yanmaz, Seyyid RasimBackground Acute upper gastrointestinal bleeding (UGIB) remains a high-risk emergency with non-negligible in-hospital mortality. Inflammatory indices derived from routine admission tests may provide additional bedside information reflecting inflammatory burden and physiologic reserve, but their prognostic value in UGIB is not well defined. Methods In this retrospective single-center observational study, 502 consecutive adults admitted via the emergency department with UGIB (December 2022-2024) were analyzed. Demographic, clinical (including melena/hematemesis), comorbidity, bleeding etiology (variceal vs. non-variceal), endoscopy-related variables when available, transfusion status, and laboratory data were extracted from electronic records. Platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), and neutrophil-to-albumin ratio (NAR) were calculated at admission. Predictors of in-hospital mortality were assessed using ROC analysis and logistic regression; two multivariable models were reported to address overlap between melena and hematemesis. Results Overall in-hospital mortality was 9.4% (47/502). Non-survivors had lower admission hemoglobin, albumin, and platelet counts and higher INR. PLR, PNI, and NAR were associated with mortality in univariable analyses. In multivariable Model 1 (including melena), low PLR (OR = 4.734, 95% CI = 2.352-9.529; p < 0.001), low PNI (OR = 3.041, 95% CI = 1.488-6.216; p = 0.002), lower hemoglobin (OR = 0.896 per 1 g/dL increase, 95% CI = 0.809-0.992; p = 0.035), and melena (OR = 2.318, 95% CI = 1.131-4.747; p = 0.022) were independently associated with mortality. In Model 2 (melena replaced by hematemesis), low PLR (OR = 3.890, 95% CI = 1.894-7.989; p < 0.001), hematemesis (OR = 4.922, 95% CI = 2.385-10.157; p < 0.001), and lower hemoglobin (OR = 0.900 per 1 g/dL increase, 95% CI = 0.811-0.998; p = 0.046) remained significant, whereas PNI and NAR were not independently associated. ROC discrimination for PLR/PNI/NAR was modest (AUC 0.612/0.604/0.594, respectively), indicating limited stand-alone predictive performance. Conclusion Admission PLR showed the most consistent independent association with in-hospital mortality across alternative multivariable models, while the independent contribution of PNI appeared model-dependent. Given the modest AUCs, these indices should be interpreted as adjunctive markers alongside clinical and endoscopic assessment rather than as stand-alone predictors. Prospective multicenter studies with standardized data capture are warranted to evaluate their incremental value within established UGIB risk stratification pathways.Öğe Metabolic risk factors associated with premature myocardial infarction in adults ≤ 35 years: a case-control study(Bmc, 2026) Vural, Abdussamed; Dolanbay, Turgut; Cumaoglu, Mustafa Oguz; Elbasan, Zafer; Yuceer, Omer; Sekme, SabriBackground Acute myocardial infarction (AMI) in very young adults (<= 35 years) represents a distinct clinical entity with limited evidence. This study aimed to characterize metabolic risk factors differentiating young AMI patients from clinic-based controls. Methods This single-center retrospective case-control study included 62 consecutive young adults (aged 18-35 years) with confirmed AMI and 60 clinic-based controls selected from cardiology outpatient clinics during the same study period. Controls were selected using age (+/- 2 years) and sex restrictions to ensure group-level comparability with the AMI cohort. Metabolic parameters, including body mass index (BMI), LDL cholesterol, and blood glucose, were compared between groups. Effect sizes (Cohen's d) were calculated to assess clinical significance. Multivariable logistic regression was performed to identify independent predictors of AMI. Correlation analyses (Pearson or Spearman, as appropriate) were performed to examine relationships between metabolic markers. Results Young AMI patients demonstrated a significantly more unfavorable metabolic profile than controls: median BMI (26.5 vs. 23.9 kg/m & sup2;, p < 0.001), LDL cholesterol (136.5 vs. 108.0 mg/dL, p = 0.002), and blood glucose (120.0 vs. 95.0 mg/dL, p < 0.001). All three metabolic parameters showed large effect sizes (d > 1.0), indicating clinically substantial differences. In multivariable analysis, BMI (adjusted OR 1.28 per kg/m & sup2;, 95% CI 1.08-1.52), LDL cholesterol (adjusted OR 1.14 per 10 mg/dL, 95% CI 1.01-1.29), and blood glucose (adjusted OR 1.16 per 10 mg/dL, 95% CI 1.05-1.29) remained independently associated with AMI risk. LDL cholesterol showed a statistically significant, albeit weak, positive association with peak troponin levels (rho = 0.296, p = 0.020). Among AMI cases, STEMI patients exhibited higher acute glucose levels than NSTEMI patients (p = 0.004). Conclusion Very young adults (<= 35 years) with AMI exhibit markedly elevated BMI, LDL cholesterol, and glucose levels compared to age- and sex-comparable controls with large effect sizes supporting clinical significance. Multivariable analysis confirmed independent associations for all three metabolic parameters. These traditional modifiable risk factors continue to be strongly associated with early myocardial infarction, emphasizing the importance of aggressive metabolic screening and early prevention strategies in very young populations.Öğe Saddle pulmonary embolism in a patient with atypical clinical presentation: a case report(Kuwait Medical Assoc, 2026) Vural, Abdussamed; Dolanbay, Turgut; Ozcelik, MustafaSaddle pulmonary embolism (PE), which is a rare form of acute PE, can cause sudden hemodynamic deterioration and death. In this case, we present a female patient who presented to the emergency department with complaints of back pain and was found to have sinus bradycardia on electrocardiogram, ultimately diagnosed with saddle PE. A chest computed tomography was ordered to evaluate for a possible lung infection. Although no evidence of pneumonia was found, the imaging showed an enlarged diameter of the pulmonary artery measuring 3.22 cm. Saddle PE is a condition that should be considered in the diagnosis in the Emergency Department as it can lead to serious mortality and morbidity, and may not always present with typical symptoms. In cases with atypical presentation where PE is not initially suspected, the high diameter of the main pulmonary artery detected on chest CT scans should be associated with diseases with right ventricular overloading such as PE.
