Recurrent births (multiparity) lead to permanent changes in cardiac structure

AIM

Although the effects of pregnancy on the cardiovascular system have been covered by many studies, permanent changes in the hearts of multiparous women have not been investigated. This study therefore aimed to examine the permanent structural changes in the cardiac structure of multiparous women via transthoracic echocardiography (TTE).

METHOD

This case-control study included 366 females who had given birth to 1-21 children, and 218 females with no previous deliveries. Anamnesis, physical examination, electrocardiography (ECG), TTE, and exercise stress tests were used to determine whether the cases had additional systemic pathologies. The structural cardiac parameters of all cases were recorded with TTE.

RESULTS

The study revealed that LV mass, LV mass index, left ventricular end diastolic volume (LVEDV), left ventricular end diastolic volume index (LVEDVI) were observed higher in women with five or more deliveries when compared to nulliparous women. On the other hand, ejection fraction (EF) was significantly lower in the same group. Receiver operating curve (ROC) analysis demonstrated that the prediction sensitivity for the presence of eccentric hypertrophy was 74% among women who had given >10.5 births, and its specificity was 97.8% (AUC: 0.949, 95% CI 0.905-0.993; p < 0.0001).

CONCLUSION

The results showed that women with recurrent births had increased left ventricular end diastolic volume, left ventricular total mass in myocardium and decreased EF due to increased end diastolic volume. The results also showed delivering at frequent intervals (especially the birth of 11 or more) may be one of the causes of eccentric hypertrophy, in women of the low-to-middle income countries.

Role of telocytes in the pathogenesis of ectopic pregnancy

OBJECTIVE

The aim of this study is to investigate the effect of telocytes on tubal motility in ectopic pregnancies.

PATIENTS AND METHODS

This study included patients with ectopic pregnancy (EP) (n=10) and control patients (n=10) (partial salpingectomy for contraception). Immunohistochemical staining for c-Kit, vimentin, CD34 and S100A was performed to quantify telocytes in the mucosa, muscular layer and serosa of fallopian tubes of control and EP group. Spontaneous and KCl- (80 mM) induced contraction and cumulative progesterone dose-relaxation (10-11-10-5 M) and cumulative oxytocin dose-contraction (10-10-10-4 M) responses were recorded.

RESULTS

The groups were comparable in terms of age, gravida, parity, delivery type and gestational week (p>0.05). The homogenous distribution of telocytes in the mucosa and muscular layers of the control group, changed to heterogeneous localization the EP group. Immunohistochemical staining with vimentin, S100A, c-Kit and CD34, revealed increased telocyte counts in the muscular layer and serosa of the tubal tissues of EP. The frequency of the spontaneous contractions was higher in the control group (p<0.001); contrarily, the amplitude of the contractions was higher in ectopic pregnancies (p<0.001). Although the cumulative oxytocin dose-contraction curves were similar at all concentrations (p>0.05), the cumulative progesterone dose-relaxation curves exhibited higher relaxation response in the EP group at all concentrations (p<0.001).

CONCLUSIONS

Increased telocyte count in the fallopian tube may decrease tubal motility and may affect the transfer of the blastocyst to the uterus and possibly contribute to the pathogenesis of EP.

Suicidal Ideation, Self-esteem, and Hopelessness in Patients With Pulmonary Arterial Hypertension

Objective: To investigate the frequency of suicidal ideation and its correlation with other clinical variables in patients with pulmonary arterial hypertension.

Methods: Fifty patients with pulmonary arterial hypertension who presented to the cardiology department between 2018 and 2019 and 50 healthy controls were included in the study. A sociodemographic and clinical data form was completed by both the patients and controls, and the Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Rosenberg Self-Esteem Scale (RSE), and Suicide Probability Scale (SPS) were administered. SPSS version 22 software was used in the statistical analysis.

Results: The mean ± SD systolic pulmonary pressure of the patients was 47.48 ± 18.86 and the pulmonary artery pressure was 33.32 ± 19.69. BHS, BDI, and SPS total scores were statistically significantly higher in the patient group compared to the control group (P < .001, P = .001, P = .026, respectively). RSE scores were also higher in the patient group compared to the control group (P = .017).

Conclusions: It is important to identify pulmonary arterial hypertension patients with intense feelings of hopelessness and depressive symptoms and to provide psychiatric treatment and psychotherapeutic interventions to improve their self-esteem.

Common single nucleotide polymorphisms in the FNDC5 gene and serum irisin levels in acute myocardial infarction

OBJECTIVE

Acute myocardial infarction (AMI) is the most common type of coronary artery disease. The irisin hormone encoded by the fibronectin type III domain-containing protein-5 (FNDC5) gene is synthesized in muscle, heart, and fat tissues. The present study aims to investigate serum irisin concentrations and FNDC5 genetic variants in patients with AMI through comparison with controls.

METHODS

This study included 225 patients with AMI and 225 healthy subjects. Blood samples were obtained from patients during the first 1-24 hours after AMI. Serum irisin concentration was measured with enzyme-linked immunosorbent assay (ELISA). The variants of rs16835198, rs3480, and rs726344 in the FNDC5 gene were genotyped with real time polymerase chain reaction (RT-PCR).

RESULTS

Compared with control serum irisin concentrations were significantly lower in patients with AMI. Serum irisin concentrations of patients with AMI showed a significant and gradual decrease from 6 hours up to 24 hours (p<0.05). There were no significant differences between the patient and control groups based on genotype and allele frequencies of rs16835198, rs3480, and rs726344 in the FNDC5 gene (p>0.05). However, the frequency of the TT genotype in male patients with AMI (6.4%) was significantly lower compared with control male subjects (16.2%). In addition, the GGT haplotype was identified as the protective haplotype against the risk of AMI (p<0.001; odds ratio=0.107).

CONCLUSIONS

The findings of the study suggest that serum irisin concentration could serve as a novel biological marker for the early diagnosis of AMI.

Psychiatric symptoms of wife of military personel who died in combat: The role of meaning in life and attachment styles

Introduction

Traumatic experiences has a key role on the mental health of individuals. Turkish Armed Forces has been involved in various combat in and out of the country over the years. Individuals who are able to find meaning after a negative life events are better overcome their issues and return to their positive functioning. Unhealthy attachment styles has been observed more in clinical samples than healthy attachment styles.

Objectives

The aim of this study was to investigate the predictive role of attachment styles and meaning in life on psychiatric symptoms among wife of military personel who lost their lifes.

Methods

74 women who lost their husband in combat to the study. Their age was between 21 and 74, with the mean of 46.93. 60 (75.9%) participants had a child when they lost their husband. 63 (79.7%) of them hasn’t been married again. Brief Symptom Inventory, Meaning in Life Scale and Relationship Scales Questtionnare were used to collect the data. Five different regression analysis was conducted.

Results

Finding meaning in life, dismissing and preoccupied attachment sytles predicted depression (R²= 51.8%). Finding meaning in life and fearful attachment styles predicted anxiety (R²= 46.2%). Finding meaning in life and fearful attachment styles predicted negative identity (R²= 51.1%). Finding meaning in life and dismissing attachment styles predicted hostility (R²= 50.4%) and somatization (R²= 57%).

Conclusions

Meaning in life has a protective role in the development of any psychopathologies whereas insecure attachment styles are risk factor.

Disclosure

No significant relationships.

Online counseling experience of Turkish counselor candidates throughout COVID-19 pandemic

Introduction

As in many areas of life, the covid-19 epidemic has had a great impact on psychological counselor training. Although studies and practices on online counseling are increasing every day in the world, there has not been a psychological counseling method preferred by experts in Turkey, which comes from community culture and, where physical contact is important, until the pandemic.

Objectives

The examination of the opinions of the students studying in the last year of the psychological counseling and guidance undergraduate program during the pandemic regarding online counseling, where they perform their first psychological counseling experience.

Methods

The study was conducted with 10 counseling students, 9 women and 1 Man. The age range of the students is 22-24 and the average age is 20.6. The students’ opinions are taken with open-ended questions such as “Can you share your views on online counseling before online counseling?“ The reflection letter that the students responded to was subjected to content analysis.

Results

The findings of the study show that there are four themes: Emotions before the counseling process, Thoughts before the counseling process, Therapeutic relationship, Online counseling in professional life. For example; in online counseling, negative emotions such as anxiety, excitement, fear, anxiety, stress, anxiety, as well as feeling comfortable and safe are among the positive feelings they experience in their therapeutic relationships.

Conclusions

As a result, although students have a positive view of online counseling, they mainly prefer to do it face-to-face. The findings were discussed taking into account Turkish culture.

Disclosure

No significant relationships.

A new inflammatory marker: elevated eosinophil-tolymphocyte ratio associated with presence and severity of isolated coronary artery ectasia

OBJECTIVES

The pathophysiology of isolated coronary artery ectasia (CAE) involves atherosclerosis and inflammation. Eosinophils and lymphocytes have been found to play a significant role in inflammation, atherosclerosis and endothelial dysfunction. Many studies have explored the relationship between isolated CAE and systemic inflammation. However, there are no data regarding the relationship between eosinophil-to-lymphocyte ratio (ELR) and isolated CAE. Therefore, this study analysed the relationship between ELR and isolated CAE.

METHODS

All patients who underwent coronary angiography between January 2009 and June 2018 were investigated retrospectively. Of 16 240 patients, 232 patients with isolated CAE (141 males) and 247 age- and gender-matched control subjects (130 males) with normal coronary angiography (NCA) were enrolled in this study. Baseline demographic and laboratory data were obtained from the hospital database. The severity of isolated CAE was determined according to the Markis classification, vessel count and diffuseness of ectasia.

RESULTS

Patients with angiographic isolated CAE had significantly elevated white blood cell (WBC) and eosinophil counts and ELR values compared to patients with NCA [8.11 ± 1.75 vs 7.49 ± 1.80 × 10⁹ cells/l, p < 0.0001; 0.22 (0.13-0.32) vs 0.19 (0.12-0.28) × 10⁹ cells/l, p = 0.02; 0.11 (0.06-0.17) vs 0.08 (0.05-0.12), p < 0.0001. The ELR value for Markis I was significantly higher than for Markis IV (p = 0.04), and three-vessel isolated CAE was significantly higher than onevessel isolated CAE (p = 0.04). Additionally, the ELR value for diffuse ectasia (Markis class I, II and III) was significantly higher compared to focal (Markis class IV) ectasia (p = 0.02). In receiver operating characteristics (ROC) analyses, it was determined that an ELR value > 0.099, measured in isolated CAE patients at application, had a predictive specificity of 60.3% and a sensitivity of 56.5% (area under the curve: 0.604, 95% confidence interval: 0.553-0.655, p < 0.0001).

CONCLUSIONS

Patients with isolated CAE had higher blood eosinophil counts and ELR. Furthermore, the ELR was significantly correlated with severity of isolated CAE. These findings demonstrate that ELR may have a significant role in the aetiopathogenesis of isolated CAE.

Could Sumac Be Effective on COVID-19 Treatment?

Sumac is an herbal product, commonly consumed as a spice and was used for medical treatment for centuries. The phytochemical structure of Sumac was studied extensively, and it was established that the herb contained tannins, polyphenols, flavonoids, organic acids, and essential oils. Various scientific studies demonstrated that Sumac had a free oxygen radical-scavenging effect, a protective effect against liver damage, antihemolytic, leukopenia, and antifibrogenic effects, along with its antiviral, antimicrobial, anti-inflammatory, and antioxidant properties. Recently, several scientific studies described the pathophysiology, clinical course, and the treatment of COVID-19 infection. The examination of the characteristics of COVID-19 infection revealed via the clinical studies suggests that Sumac extract could be useful in the treatment of COVID-19. Given the scientific studies focusing on the beneficial effects of Sumac, the present review aims to provide an encouraging viewpoint to investigate whether Sumac is effective in treating COVID-19 infection.

QT Wave Dispersion in Patients With Major Depressive Disorder

Objective

A limited number of studies have investigated QT wave dispersion (QTd) in depressive disorder. The objective of this study was to investigate whether QTd differed in patients diagnosed with depression compared to a control group and whether the difference correlated with the depression and anxiety scores.

Methods

Forty patients diagnosed with major depressive disorder (DSM-5 criteria) who did not receive their first treatment after the first episode were included in the study. Forty healthy individuals with similar sociodemographic characteristics were included in the control group. A sociodemographic and clinical data form, the Beck Depression Inventory, and the Beck Anxiety Inventory were given to all patients. Electrocardiograms were evaluated in a single-blind setting by the same cardiologist. The longest QT interval (QTmax) and the shortest QT interval (QTmin) were calculated. Heart rate-corrected QTmax (QTcmax) and QTmin (QTcmin) were calculated using the Bazett formula (QT[ms]/√R-R). The difference between QTcmax and QTcmin was accepted as the corrected QT dispersion (QTcd). The study was conducted from December 2018-March 2019.

Results

No statistically significant difference was found between patient and control groups on the basis of age, sex, body mass index, or smoking. Beck Anxiety Inventory and Beck Depression Inventory scores of the patient group (28.48 ± 12.39 and 32.2 ± 11.58, respectively) were significantly higher compared to the control group (2.7 ± 3.41 and 2.75 ± 3.2, respectively). The patient group QTcmax (419.8 ± 24.46) and QTcd (42.55 ± 17.47) values were significantly higher compared to the QTcmax (405.2 ± 24.54) and QTcd (30.48 ± 9.25) values of the control group. There was a positive correlation between QTcd, QTcmax, and anxiety and depression scores.

Conclusions

QTcd values of depressed patients were higher than those of the healthy controls, and there was a positive correlation between QTcd and depression and anxiety scores.

THE EFFECT OF GLUCOVANCE THERAPY ON BIOMECHANICAL DETERIORATION OF BONE IN STREPTOZOTOCIN-INDUCED DIABETIC RATS

AIM

Is to evaluate the influence of glucovance therapy on biomechanical properties of bone in streptozotocin - induced diabetes mellitus (DM) in rats.

MATERIALS AND METHODS

A total of 28 male Wistar-Albino rats (12-week-old; 210-300 g) were divided into 4 groups including control (C; no treatment; n=7), sham [Sh; distilled water (gavage, for 8 weeks); n=7], diabetes [DM; streptozotocin (45 mg/kg, single i.p injection); n=7] and diabetes+ Glucovance treatment [DM+G; streptozotocin (45 mg/kg, single i.p injection) + Glucovance (Glucovance, 500/5 mg/kg/day/rat, gavage, for 8 weeks); n=7] groups. Body weight, blood glucose levels (BGLs), bone mineral density (BMD) and geometric/mechanical properties of bone tissue were evaluated. BGLs in diabetic rats were significantly increased compared to non-diabetic rats, while the body weights were decreased (p<0.05).

RESULTS

A significant difference was not detected between groups with regard to cross-sectional area of diaphyseal femur (p>0.05). Maximum load, energy absorption capacity, ultimate stress, ultimate strain, toughness and displacement were shown to decrease and stiffness was shown to increase in DM rats (p<0.05). Ultimate stress and maximum load were significantly increased in DM+G groups compared to DM groups (p<0.05).

CONCLUSION

Glucovance treatment seems to be effective in restoration of biomechanical deterioration of bone specific to STZ-induced DM.

THE EFFECT OF ANTITHYROID DRUGS ON OSTEOPONTIN AND OXIDATIVE STRESS IN GRAVES' DISEASE

OBJECTIVE

The aim of the present study is to evaluate the effects of methimazole (MTZ) and propylthiouracil (PTU) treatments on osteopontin (OPN) and oxidative stress in Graves' disease (GD).

MATERIAL AND METHODS

The study included 60 cases with GD in hyperthyroid state and taking no antithyroid treatment, and 30 healthy volunteers. GD patients were randomly separated into two groups; 30 of them took PTU, and the other 30 took MTZ treatments. Blood samples were taken from the patients with GD before the treatment, and three months after the treatment was begun, when they were in the euthyroid state; blood samples of the healthy control subjects were also taken at these times.

RESULTS

TAS and OSI levels before treatment were significantly higher in the GD group, when compared to the control group (p<0.001, for each). GD subjects taking PTU treatment had significantly higher TAS levels (p=0.001), and significantly lower TOS and OSI levels (p=0.008 and p=0.001, respectively). TAS levels significantly decreased in the patients taking MTZ treatment (p=0.029), but TOS and OSI levels did not change significantly (p>0.05). Pretreatment OPN levels were significantly higher in GD patients, when compared to the control group (p=0.014). OPN level significantly decreased in the GD group taking PTU treatment; however OPN levels in the group taking MTZ treatment did not change significantly when compared to the pretreatment value.

CONCLUSION

PTU treatment is more effective in decreasing OPN and oxidative stress in GD patients, when compared to the MTZ treatment.

QT and P-wave dispersion during the manic phase of bipolar disorder

BACKGROUND AND AIM

Patients with bipolar disorder (BD) are at increased risk for cardiovascular diseases and complications. This increased risk is considered to be associated with the autonomic nervous system (ANS) abnormalities. However, there is little or no documentation of the relationship between this increased risk and the phases of BD. In this study, we aimed to compare the changes in the QT dispersion (QTd) and P-wave dispersion (Pd), which are predictors of sudden cardiac death and atrial fibrillation, between the patients with manic BD and healthy controls.

PARTICIPANTS AND METHODS

The study included a patient group of 44 patients (26 female and 18 male) that were hospitalized due to a diagnosis of manic BD and met the inclusion criteria, and a control group of 34 age- and gender-matched healthy individuals (21 female and 13 male) with no history of psychiatric and neurological disorders. The QTd and Pd values were determined in each participant by performing the standard 12-lead body surface electrocardiography (ECG).

RESULTS

The principal electrocardiographic indicators including corrected maximum QT interval, corrected QT dispersion, and minimum P-wave duration significantly increased in the patient group compared to the control group (t=2.815, p<0.01; t=4.935, p<0.001; t=3.337, p<0.001, respectively).

CONCLUSION

The results indicated that patients with manic BD are at increased risk for cardiovascular autonomic dysfunction. Therefore, clinicians should be more careful about ECG changes and related possible cardiac conduction problems such as cardiac arrthythmias in patients with manic BD. Further longitudinal studies are needed to investigate BD and its phases (depression, mania, and hypomania) with regard to ANS and cardiac abnormalities.

[Kounis syndrome: a paradoxal non-ST elevation myocardial infarction case after triamcinolone treatment for dermatitis]

Kounis syndrome is defined as the clinical development of acute coronary syndrome caused by the activation of inflammatory cells due to an allergy, hypersensitivity, anaphylaxis, or anaphylactic reaction. Corticosteroids that are used in the treatment of many inflammatory conditions may paradoxically cause allergic reactions and even anaphylaxis. This article is a description of the case of a 52-yearold female patient who had a non-ST elevation myocardial infarction after the administration of triamcinolone that was relieved with antihistaminic treatment. The patient had been diagnosed with dermatitis at another medical center and injected with 40 mg/mL (intramuscular [IM]) of triamcinolone acetonide and developed chest pain 15 minutes after the first dose. Despite a normal physical examination and echocardiogram, laboratory tests revealed troponin positivity and an inferolateral ST depression was present on an electrocardiogram (ECG). The ECG findings and clinical symptoms resolved completely after conservative anti-ischemic treatment and antihistaminic therapy (pheniramine maleate 45.5 mg/2 mL, Avil ampoule, IV; Sanofi-Aventis, Paris, France) and coronary angiography evaluation of the arteries was normal. The heart, and in particular the coronary arteries, are among the organs that are most damaged during hypersensitivity reactions and anaphylaxis. Although Kounis syndrome is not a rare condition, few cases have been reported in clinical practice. The failure to recognize Kounis syndrome due to inadequately defined cases may lead to unwanted medical results. Kounis syndrome should be kept in mind in order to make a rapid and accurate diagnosis.

A RARE CAUSE OF PITUITARY APOPLEXY: CABERGOLINE THERAPY

Pituitary apoplexy (PA) is a life-threatening clinical syndrome. Dopamine receptor agonists are the drugs of choice in the treatment of prolactinomas. The use of cabergoline is reported to cause an increased risk of PA, particularly in macroprolactinomas of cystic nature. In this report, we present a patient with a cystic macroprolactinoma who developed PA on the 16th week of cabergoline treatment.

Focusing on a complete blood cell parameter: mean platelet volume levels may be a predictor of coronary slow flow

Background

The relationship between increased mean platelet volume (MPV) and atherosclerosis is well known. In the present study, MPV in patients with coronary slow flow (CSF) and in cases with normal coronary anatomy (NCA) was investigated and compared with the aim of identifying the relationship between CSF and MPV.

Patients and methods

We studied 40 patients previously determined via coronary angiography as having NCA and 40 patients with CSF in the coronary blood stream, as identified by thrombolysis in myocardial infarction square. Thus, a total of 80 patients from the Elaziğ Education and Research Hospital (Elaziğ, Turkey) were included in the present study retrospectively and laboratory and anamnesis information was scanned into their files. The relationship between MPV and CSF was studied.

Results

MPV levels were observed to be significantly higher in the CSF group compared to the NCA group (10.05±1.3 and 8.6±0.6, p<0.001). In receiver operating characteristics analyses, it was determined that an MPV >9.05 measured in CSF patients at application had a predictive specificity of 77.5% and sensitivity of 77.5% for CSF (area under the curve: 0.825, 95% confidence interval [CI]: 0.726–0.924, p<0.0001). It was found that MPV level was an independent predictor of CSF (β=−600, p<0.001, 95% CI: −0.383 to −0.176).

Conclusion

MPV is increased in patients with CSF when compared to patients with NCA. This finding supports the fact that MPV could be a predictor of CSF.

Auditory changes in acromegaly

OBJECTIVE

The aim of this study is to determine the changes involving auditory system in cases with acromegaly.

MATERIALS AND METHODS

Otological examinations of 41 cases with acromegaly (uncontrolled n = 22, controlled n = 19) were compared with those of age and gender-matched 24 healthy subjects. Whereas the cases with acromegaly underwent examination with pure tone audiometry (PTA), speech audiometry for speech discrimination (SD), tympanometry, stapedius reflex evaluation and otoacoustic emission tests, the control group did only have otological examination and PTA. Additionally, previously performed paranasal sinus-computed tomography of all cases with acromegaly and control subjects were obtained to measure the length of internal acoustic canal (IAC).

RESULTS

PTA values were higher (p < 0.001 for right ears and p = 0.001 for left ears), and SD scores were (p = 0.002 for right ears and p = 0.002 for left ears) lower in acromegalic patients. IAC width in acromegaly group was narrower compared to that in control group (p = 0.03 for right ears and p = 0.02 for left ears). When only cases with acromegaly were taken into consideration, PTA values in left ears had positive correlation with growth hormone and insulin-like growth factor-1 levels (r = 0.4, p = 0.02 and r = 0.3, p = 0.03). Of all cases with acromegaly 13 (32%) had hearing loss in at least one ear, 7 (54%) had sensorineural type and 6 (46%) had conductive type hearing loss.

CONCLUSION

Acromegaly may cause certain changes in the auditory system in cases with acromegaly. The changes in the auditory system may be multifactorial causing both conductive and sensorioneural defects.

Determination of health anxiety, anxiety, and somatosensory amplification levels in individuals with normal coronary angiography

The objective of the present study is to determine the somatosensory amplification, anxiety, and depression levels in patients with normal coronary arteries. Thirty-five patients with normal coronary arteries and 35 healthy individuals of similar age and gender as the patient group were included in the study. Somatosensory Amplification Scale (SSAS), Health Anxiety Inventory (HAI-18), Penn State Anxiety Scale (PSWQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were applied to all participants. Comparison of the patient group with the control group demonstrated that SSAS (22.7±8.2; 18.5±5.98; p=0.018), BAI (15.4±9.43; 9.4±7.3; p=0.004), BDI (24.9±13.5; 13.7±7.5; p<0.001), PSWQ (55.3±13.7; 33.8±6.7; p<0.001), and HAI-18 (18.8±8.7; 12.3±7.1; p=0.001) scores were statistically significantly higher in the patient group. Furthermore, a positive correlation was found between SSAS, BAI, BDI, PSWQ, and HAI-18 scores. It was found that concerns about disease prevailed in patients having normal coronary arteries, the patients continued to amplify their somatic sensations, and their anxiety and depression scores were higher than those of healthy individuals. Thus, the necessity of these interventions should be assessed in detail in the future.

Thiol/disulfide homeostasis in postmenopausal osteoporosis

AIM

To evaluate the impact of postmenopausal osteoporosis on thiol/disulfide homeostasis.

MATERIALS AND METHODS

A total of 75 participants were divided into two groups: Group 1 (n = 40) was composed of healthy postmenopausal women, and group 2 (n = 35) was composed of women with postmenopausal osteoporosis. Clinical findings and thiol/disulfide homeostasis were compared between the two groups.

RESULTS

The disulfide/native thiol ratio was 8.6% ± 3.6 in group 1 and 12.7% ± 8.4 in group 2 (p = 0.04). The disulfide/native thiol percent ratio was significantly higher in group 2 after adjustment for the years since menopause and age (p < 0.05). The native thiol/total thiol percent ratio was 85.6% ± 4.8 in group 1 and 73.8% ± 24.9 in group 2 (p = 0.01). The native thiol/total thiol percent ratio was significantly lower in group 2 after adjustment for the years since menopause and age (p < 0.05).

CONCLUSION

Thiol/disulfide homeostasis shifted to the disulfide side independent of age and years since menopause in postmenopausal osteoporosis.

Could neutrophil/lymphocyte ratio be an indicator of coronary artery disease, coronary artery ectasia and coronary slow flow?

Objective

To determine whether neutrophil/lymphocyte ratio (NLR) differed between patients with isolated coronary artery disease (CAD), isolated coronary artery ectasia (CAE), coronary slow flow and normal coronary anatomy.

Methods

Patients who underwent coronary angiography were consecutively enrolled into one of four groups: CAD, coronary slow flow, CAE and normal coronary anatomy.

Results

The CAD (n = 40), coronary slow flow (n = 40), and CAE (n = 40) groups had similar NLRs (2.51 ± 0.7, 2.40 ± 0.8, 2.6 ± 0.6, respectively) that were significantly higher than patients with normal coronary anatomy (n = 40; NLR, 1.73 ± 0.7). Receiver operating characteristics demonstrated that with NLR > 2.12, specificity in predicting isolated CAD was 85% and sensitivity was 75%, with NLR > 2.22 specificity in predicting isolated CAE was 86% and sensitivity was 75%. With NLR > 1.92, specificity in predicting coronary slow flow was 89% and sensitivity was 75%. Multivariate logistic regression analyses identified NLR as an independent predictor of isolated CAE (β = −0.499, 95% CI −0.502, −0.178; P <  0.001), CAD (β = −0.426, 95% CI −1.321, −0.408; P <  0.001), and coronary slow flow (β = −0.430, 95% CI −0.811, −0.240; P = 0.001 Table 2).

Conclusions

NLR was higher in patients with CAD, coronary slow flow and CAE versus normal coronary anatomy. NLR may be an indicator of CAD, CAE and coronary slow flow.

Assessment of left ventricle systolic and diastolic functions in schizophrenia patients

The objective of the study was to scrutinize in detail the changes that occur in left ventricle (LV) systolic and diastolic functions using echocardiography in patients with at least 5 years of history and 40 healthy volunteers matching the patients in age and gender, who were enrolled in a cross-sectional study. All cases were examined with Tei Index, an index that could assess LV systolic and diastolic functions in conjuction, and with LV ejection fraction (LVEF) that assesses systolic function. In addition, Mitral E and A wave velocities, Isovolemic relaxation time (IVRT), Tissue Doppler Em (peak early motion) and Am (peak after motion) waves, which evaluate diastolic functions were measured. Tei Index was calculated as 0.61±0.19 in the patient group, and as 0.39±0.10 in the control group and the difference was statistically significant (p<0.001). LVEF was measured as 58%±5 in the patient group, and as 62%±3 in the control group and the difference was statistically significant (p<0.001). Also the IVRT values were significantly different between the tissue Doppler Em and Em/Am ratio among the groups (p<0.001). Echocardiographic myocardial performance, LV systolic and diastolic functions in schizophrenia patients was found to be worse than those of the control group.

Macrophage Infiltration into Subcutaneous Adipose Tissue is Associated with Local Levels of 11BHSD1

The present study aimed to evaluate the infiltration of macrophages in form of crown-line structures (CLS) in subcutaneous adipose tissue (SAT) of obese individuals, and to investigate the effect of these on both metabolic parameters and adipose tissue 11-beta-hydroxysteroid dehydrogenase type 1 (11BHSD1) enzyme levels. A total of 53 obese (10 men, 43 woman) enrolled in the study. Body mass index (BMI), waist circumference (WC), hip circumfrence, and systolic (SBP) and diastolic blood pressures (DBP) of all subjects were recorded. Insulin resistance was determined using the homeostasis model assessment (HOMA). The concentration of SAT, tumor necrosis factor (TNF)-α, interleukin (IL)-6, 11BHSD1 were performed by enzyme-linked immunosorbent assay (ELISA) method. The infiltration of macrophages in form of CLS in adipose tissue were determined using cell-specific stains against CD68. There was no significant difference between the CLS⁺group and the CLS^- group in terms of age, gender, BMI, WC, waist-to-hip circumference ratio (WHR), SBP and DBP levels. Fasting plasma glucose (FPG), HOMA-IR, insulin and SAT TNF-α levels were higher in the CLS⁺group compared to the CLS^- group. FPG and SAT TNF-α levels were significantly higher in participants with high CLS density compared to participants with low density CLS. SAT 11BHSD1 levels was significant higher in the CLS⁺group compare to the CLS^- group and in the high CLS density group compared to the low density group. In conclusion, the infiltration of macrophages in the form of CLS in SAT is associated with increased 11BHSD1 levels. It may be an important mechanism in the development of metabolic disorders.

Subcutaneous Adipose Tissue Type II Deiodinase Gene Expression Reduced in Obese Individuals with Metabolic Syndrome

The present study aimed to evaluate the role of subcutaneous adipose tissue (SAT) type II deiodinase enzyme gene (DIO2) expression in developing metabolic syndrome (MetS). A total of 51 obese patients with MetS and without MetS and 13 healthy subjects enrolled in the study. Body mass index (BMI), waist circumference (WC), waist-to-hip circumference ratio (WHR), hip circumference, and systolic (SBP) and diastolic blood pressures (DBP) of all subjects were recorded. Fasting plasma glucose (FPG), fasting plasma insulin, high density lipoprotein- cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) and triglyceride (TG) of all subjects were analyzed. Expression of the DIO2 gene in adipose tissue was determined by reverse transcription polymerase chain reaction (qRT-PCR). BMI, WC and WHR were not significantly difference between obese with and without MetS. SBP, DBP, FPG and TG were significantly higher in obese with MetS group than obese without MetS group. While the free triiodothyronine (T3) level was in the normal range in all group, it was significantly lower in the obese with MetS than both obese without MetS and control group. DIO2 expression was significantly lower in the obese with MetS group compared to the control. In correlation analysis, DIO2 expression was negatively correlated with DBP, TG and homeostasis model assessment of insulin resistance (HOMA-IR) levels and positively correlated with free T3. In conclusion, the reduction of SAT DIO2 expression is negatively correlated with DBP and TG levels that are associated with the MetS. This might have an effect on developing MetS. We believe that DIO2 gene may be an important molecular target for future studies in developing targeted treatment options for obese people with MetS.

High Prolidase Levels may be a Marker of Irreversible Extracellular Matrix Changes in Controlled Acromegaly Patients?

The present study aimed to evaluate the activity of prolidase in controlled acromegaly patients and its association with oxidative stress. 25 acromegalic patients in remission who were followed in our outpatient clinic and 31 healthy controls were enrolled in the study. Serum growth hormone (GH), insulin-like growth factor 1 (IGF-1), total antioxidative status (TAS), total oxidative stress (TOS), total free sulfhydryl (-SH), paraoxonase (PON), arylesterase (ARE), lipid hydroperoxide (LOOH) and prolidase activity levels were measured. Percent ratio of TOS to TAS level was accepted as oxidative stress index (OSI). Serum prolidase activity, TOS, OSI, and LOOH levels were significantly higher in acromegaly patients compared to the healthy control group (p<0.001, p=0.001, p<0.001, and p<0.001, respectively). SH levels were significantly lower in the acromegaly patients compared to the healthy control group (p=0.002). Prolidase activity were positively correlated with TOS, OSI, LOOH and negatively correlated with -SH in patients with acromegaly (r=0.471, p<0.001; r=0.527, p<0.001; r=0.717, p<0.001; r=- 0.516, p<0.001, respectively). These associations were confirmed in the multiple regression analysis (R(2)=0.502, p<0.001). In conclusion, serum prolidase activity and oxidative stress levels were high in controlled acromegaly patients. These results suggest that extracellular matrix changes continue eventhough the disease is controlled, and elevated oxidative stress is involved in the increased prolidase activity in acromegaly patients.

Serum prolidase levels in Graves' disease without ophthalmopathy and its association with oxidative status

OBJECTIVE

The aim of this study was to evaluate serum prolidase levels and its association with oxidative stress in autoimmune thyroid disease (AITD).

MATERIALS AND METHODS

25 with Hashimoto thyroiditis (HT) and 25 patients Graves' disease (GD), and 27 healthy controls were enrolled in the study. The patients with signs of Graves' ophthalmopathy were excluded from the study. Serum samples were obtained in euthyroid period at the third month of treatment. Serum prolidase, total antioxidant status (TAS), total oxidative stress (TOS), and total free sulfhydryl (-SH) levels were measured.

RESULTS

Serum prolidase levels were significantly higher in the patients with GD compared to the HT and the healthy control group. Oxidative stress index (OSI) and TOS levels of the patients with both GD and HT were significantly higher compared to those of the control group (p < 0.001, for each), while -SH levels were significantly lower (p < 0.001, for each). There was no significant difference between the patients with HT and healthy control group in terms of prolidase levels (p = 0.580). Prolidase levels were positively correlated with TOS and OSI and negatively correlated with -SH (r = 0.565, p = 0.003; r = 0.604, p = 0.001; r = -0.532, p = 0.006).

CONCLUSION

Serum prolidase activity is increased in GD patients without signs of ophthalmopathy, and showed a positive correlation with oxidative stress parameters.

Elevated red blood cell distribution width in healthy smokers

OBJECTIVES

Red blood cell distribution width (RDW) has been reported to be a marker of morbidity and mortality for some cardiovascular and pulmonary diseases. We aimed to evaluate RDW values in otherwise healthy smokers.

STUDY DESIGN

Two hundred and twenty consecutive subjects with current smoking and 230 age- and gender-matched healthy subjects without smoking history were enrolled. Number of cigarettes smoked per day and duration of smoking, evaluated as pack years, were recorded. Complete blood count, high-sensitivity C-reactive protein (hs-CRP) levels and lipid profile were analyzed in all study participants.

RESULTS

The mean RDW values were higher in smokers than in nonsmokers (13.9±1.2 vs. 13.1±0.8, p<0.0001). The mean leukocyte count, mean platelet volume and hs-CRP levels were also significantly greater in smokers when compared to nonsmokers (8440±1.750 vs. 7090±1550, p<0.0001; 8.7±0.8 fL vs. 8.3±0.6 fL, p<0.0001; 2.42±0.53 mg/L vs. 1.46±0.52 mg/L, p<0.0001, respectively). Significant positive correlations between RDW and number of cigarettes smoked per day and between RDW and duration of smoking were identified (r=0.565 and r=0.305, respectively).

CONCLUSION

Elevated RDW is associated with cigarette smoking and may be a useful indicator of inflammatory activity in smokers.

Serum calprotectin: a new potential biomarker for thyroid papillary carcinoma

The aim of this study was to evaluate serum calprotectin levels and oxidative stress status in patients with papillary thyroid carcinoma (PTC) and the changes in their levels after total thyroidectomy. The study involved 30 patients with PTC and 30 healthy controls. Blood samples were obtained from the PTC patients before and 1 month after the operation. Preoperative and postoperative serum samples from PTC patients and healthy controls were analysed for calprotectin, total antioxidant status (TAS), total oxidant status (TOS) and lipid hydroperokside (LOOH). The preoperative calprotectin, TOS, OSI and LOOH levels of the patients with PTC were significantly higher compared to those of the control group (p < 0.001, for each). The levels of calprotectin decreased significantly in patients with PTC after the operation (p < 0.001), while TAS, TOS and OSI levels remained unchanged (p = 0.313, p = 0.085 and p = 0.163, respectively). Preoperative serum calprotectin levels were positively correlated with TOS, OSI and LOOH levels and negatively correlated with TAS levels in patients with PTC. In conclusion, serum calprotectin levels is increased in patients with PTC, and calprotectin is positively correlated with TOS and LOOH. Serum calprotectin levels is significantly decreased after total thyroidectomy.

Frequency of anemia in chronic psychiatry patients

PURPOSE

Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency.

METHODS

All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb) and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of <13 g/dL and nonpregnant female patients with an Hb level of <12 g/dL were considered as anemic.

FINDINGS

Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%), followed by generalized anxiety disorder patients (32%), and obsessive-compulsive disorder patients (26%). Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients.

RESULTS

The prevalence of anemia among chronic psychiatry patients is more frequent than the general population. Thus, the study concluded that it would be beneficial to consider the physical symptoms and to conduct the required examinations to determine anemia among this patient group.

Association of Rho/Rho-kinase gene polymorphisms and expressions with obesity-related metabolic syndrome

OBJECTIVE

The metabolic syndrome (MetS) is a common multicomponent condition including abdominal obesity, dyslipidemia, hypertension and hyperglycemia. The aim of this study was to investigate the associations of Rho GTPase and Rho-kinase (ROCK) gene polymorphisms and expressions with MetS in a Turkish population.

PATIENTS AND METHODS

A total of 141 obese MetS patients and 163 healthy controls with similar age and sex were included to this study. Polymorphisms were analyzed in genomic DNA using a BioMark 96.96 dynamic array system. mRNA from blood samples was extracted, and real-time polymerase chain reaction was performed for gene expressions.

RESULTS

We observed that genotype (CC, 18.1%; CA, 13.4%, and AA, 68.5%) and allele (C, 24.8%; A, 75.2%) frequencies for the rs35996865 polymorphism of the ROCK1 gene in patients were markedly different from controls (CC, 84.2%; CA, 2.9%, and AA, 12.9%; C, 85.6%; A, 14.4%, p < 0.0001). In the rs2230774 (Thr431Asn) polymorphism of the ROCK2 gene, there were increases in the CC genotype (16.5%) and C allele frequencies (20.4%) in MetS patients when compared with the control group (CC, 6.0%, p = 0.0009, and C, 6.7%, p < 0.0001). However, no associations with the other 18 polymorphisms studied were found. Although there were an increase in peripheral blood mRNA RhoH expressions, marked decreases in RhoC, RhoBTB1, RhoV, Rnd1, and CDC42 gene expressions were noted in MetS patients.

CONCLUSIONS

This is the first study to provide evidence that ROCK gene polymorphisms and gene expressions of the Rho GTPase proteins may modify individual susceptibility to MetS in the Turkish population.

Effects of fish oil on cell proliferation and liver injury in an experimental model of acute hepatic injury induced by carbon tetrachloride

OBJECTIVE

We aimed to investigate the effect of fish oil on the hepatic injury and cell cycle phases as well as cellular proliferation- regeneration in a rat model of acute hepatic injury induced by carbon tetrachloride.

BACKGROUND

Compensatory cell proliferation and tissue regeneration occurs as an endogenous response following chemical damage to the liver and enable animals to over come the injury. Data related to effect of fish oil on liver injury induced by chemical hepatotoxicants are controversial.

METHOD

60 male Wistar-albino rats were fed either with a diet supplemented with 20% fish oil or standard rat feed for 2 weeks. After an overnight fast, rats in each group were administered either 1 ml/kg carbon tetrachloride or saline intraperitoneally.

RESULTS

Fish oil enriched diet significantly enhanced the carbon tetrachloride - associated necroinflammatory damage, ballooning degeneration and the elevation of serum transaminases induced by carbon tetrachloride. Furthermore fish oil diet prevented cell proliferation, increased the proportion of cells in the G0/G1phase concomitant with a decrease in the proportion of cells in the S phase cells.

CONCLUSION

Fish oil diet exacerbates the hepatic injury and prevents cell proliferation-regeneration in normal and injured liver cells. Suppression of tissue regeneration by fish oil may lead to progression of the hepatic injury (Tab. 3, Fig. 4, Ref. 31).

Relationship between mean platelet volume elevation and left ventricular mass index in hypertensive patients

Objectives:

To compare the mean platelet volume (MPV; a general marker of platelet activation) in groups of patients with and without hypertension and to analyse its relationship with left ventricular mass index (LVMI).

Methods:

This cross-sectional, observational study enrolled newly diagnosed patients with untreated stage I–II hypertension and healthy control subjects without hypertension. MPV was measured using a haematology analyser. Echocardiography was performed on all of the study participants.

Results:

A total of 50 newly diagnosed patients with hypertension and 50 healthy control subjects were enrolled in the study. The majority of the demographic characteristics and laboratory findings were not significantly different between the two groups. The mean ± SD MPV was significantly higher in the hypertensive group compared with the control group (10.3 ± 1.4 fl versus 9.2 ± 1.8 fl, respectively). The mean ± SD LVMI was significantly higher in the hypertensive group compared with the control group (115.9 ± 23.0 g/m2 versus 95.7 ± 23.4 g/m2, respectively). There was no significant correlation between MPV and LVMI.

Conclusion:

In patients with untreated hypertension, despite elevated MPV levels there was no correlation between LVMI and MPV.

Comparision of Effects of Rosuvastatin Versus Atorvastatin Treatment on Plasma Levels of Asymmetric Dimethylarginine in Patients With Hyperlipidemia Having Coronary Artery Disease

Elevated plasma levels of asymmetric dimethylarginine (ADMA) are prevalent in patients with hypercholesterolemia and coronary artery disease. A total of 83 patients with hypercholesterolemia and angiographically documented mild coronary artery stenosis were randomized to rosuvastatin treatment (20 mg) or atorvastatin treatment (40 mg) once daily for 6 weeks after a 4-week dietary lead-in phase. Both statins decreased total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride levels effectively. Only rosuvastatin increased high-density lipoprotein cholesterol (HDL-C) levels. Both rosuvastatin and atorvastatin decreased plasma ADMA levels; rosuvastatin had a significantly greater effect. The reduction in ADMA levels were correlated with the reduction in TC and LDL-C levels as well as LDL-C–HDL-C ratio. Treatment with rosuvastatin or atorvastatin in patients with hyperlipidemia with mild coronary artery stenosis may lead to a decrease in ADMA levels, which may contribute to improved endothelial function.

Impaired heart rate variability in patients with mitral annular calcification: an observational study

OBJECTIVE

The aim of the present study was to study time indices of heart rate variability (HRV) in patients with mitral annular calcification (MAC).

METHODS

A cross-sectional observational study was performed. Fifty patients with echocardiographic evidence of MAC and 50 age- and gender-matched control subjects without echocardiographic evidence of MAC were included. All the study participants underwent 2-dimensional echocardiographic examinations and 24-hour Holter monitoring for HRV analysis. Student-t, Mann-Whitney U and Chi-square tests were used for statistical analysis.

RESULTS

Hypertension and coronary artery disease were more common in the MAC group than in the control group. All HRV parameters including mean RR interval, SDNN, SDANN, SDNN index, pNN50 and RMSSD were reduced in the MAC group when compared with the control group (p<0.05 for all). In hypertensive subgroup, all HRV parameters except mean RR interval were diminished in patients with MAC when compared with those without MAC (p<0.05 for all). In non-hypertensive subgroup, all HRV parameters were also diminished in patients with MAC when compared with those without MAC. In the subgroup of patients with coronary artery disease, patients had lower HRV parameters except mean RR interval, pNN50 and RMSSD in comparison to those without MAC (p<0.05 for all). In the subgroup of patients without coronary artery disease, all HRV parameters were depressed in patients with MAC in comparison to those without MAC (p<0.05 for all).

CONCLUSION

Our findings indicate that MAC was associated with reduced heart rate variability which possibly reflects decreased parasympathetic tone with a predominant activity of the sympathetic tone.