Outcomes of standart heparin treatment in deep vein thrombosis

Amaç: Kliniğimizde derin venöz tromboz tanısıyla sürekli unfraksiyone (standart) heparin kullanılarak tedavi edilen olgulara ait sonuçların retrospektif olarak incelenmesi. Yöntem:KliniğimizdeOcak 2002-Nisan 2005 tarihleri arasında derin venöz tromboz tanısıyla tedavi ve takipleri yapılan 44 olgu çalışmaya dahil edildi. Tedavi protokolünde tüm hastalara en az 1 hafta süreyle olmak üzere mutlak yatak istirahati uygulandı. Sürekli intravenöz heparin infüzyonu başlanarak doz a PTT değerlerine göre titre edildi. Oral antikoagülan tedavi başlanarak INR değeri 2'nin üzerine çıkıncaya kadar intravenöz heparin tedavisine devam edildi. Olguların tümünde klinik bulguların yanı sıra tanısal olarak renkli doppler USGtetkiki kullanıldı. Bulgular: Yaş ortalamaları 43,2 olan olguların, 27'si erkek (% 61,3) ve 17'si kadın (%38,7) idi. Olguların % 4.5'inde pulmoner emboli saptandı. Pulmoner emboli gelişen olgularda mortalite gözlenmedi.Heparin tedavisine olguların%45'inde 5-6. gün,%36'sında 7-10. gün devamedildi. 24 hastada yatışının 0-3. gününde, 20 hastada da 4-7. gününde oral antikoagülan tedaviye başlandı. Tedavi süresince hiçbir olguda majör kanama komplikasyonu ya da mortalite gözlenmedi. 3 aylık takipte hiçbir olguda rekürren tromboembolizm ile karşılaşılmadı. Sonuç: Derin venöz trombozda devamlı unfraksiyone heparin tedavisinin güvenle uygulanabilecek bir yöntem olduğu görüşündeyiz.Aim: In this retrospective study we aimed to investigate the outcomes of continuous unfractioned ( standart ) heparin treatment for deep vein thrombosis. Methods: 44 patients who were hospitalized between January 2002 and April 2005 with the diagnosis of deep vein thrombosis are included in this study. Strict bed rest was applied in treatment protocol to all cases. Continious intravenous heparin infusion was started and the dosage was titrated regardinga PTT values. Patients were put on oral anticoagulant therapy and intravenous heparin was continued until the INR value is greater than 2. Besides clinical findings colour Doppler USG was used diagnostically. Results: The mean age of the patients was 43.2 and 27 were male ( % 61.3 ) and 17 were female ( %38.7 ). Pulmonary embolism was detected in 4.5 % of cases. There was no mortality in patients who had pulmonary embolism. Heparin treatment was continued for 5-6 days in 45 % of cases and for 7-10 days in 36 % of cases. In 24 of cases oral anticoagulant therapy was started on0 - 3 rd day of hospitalization while in 20 of them therapy was started on4 - 7 th day of hospitalization. No mortality or major bleeding complication ocuured during the course of therapy. Neither of the cases faced reccurent thromboembolism in 3 months follow up. Conclusion: Unfractioned heparin treatment can be suggested asa reliable method for the treatment of deep vein thrombosis

Curcumin Prevents High Fat Diet Induced Insulin Resistance and Obesity via Attenuating Lipogenesis in Liver and Inflammatory Pathway in Adipocytes

Background: Mechanisms underlying the attenuation of body weight gain and insulin resistance in response to high fat diet (HFD) by the curry compound curcumin need to be further explored. Although the attenuation of the inflammatory pathway is an accepted mechanism, a recent study suggested that curcumin stimulates Wnt signaling pathway and hence suppresses adipogenic differentiation. This is in contrast with the known repressive effect of curcumin on Wnt signaling in other cell lineages. Methodology and Principal Findings: We conducted the examination on low fat diet, or HFD fed C57BL/6J mice with or without curcumin intervention for 28 weeks. Curcumin significantly attenuated the effect of HFD on glucose disposal, body weight/fat gain, as well as the development of insulin resistance. No stimulatory effect on Wnt activation was observed in the mature fat tissue. In addition, curcumin did not stimulate Wnt signaling in vitro in primary rat adipocytes. Furthermore, curcumin inhibited lipogenic gene expression in the liver and blocked the effects of HFD on macrophage infiltration and the inflammatory pathway in the adipose tissue. Conclusions and Significance: We conclude that the beneficial effect of curcumin during HFD consumption is mediated by attenuating lipogenic gene expression in the liver and the inflammatory response in the adipose tissue, in the absence o

Serotonin synthesis, release and reuptake in terminals: a mathematical model

<p>Abstract</p> <p>Background</p> <p>Serotonin is a neurotransmitter that has been linked to a wide variety of behaviors including feeding and body-weight regulation, social hierarchies, aggression and suicidality, obsessive compulsive disorder, alcoholism, anxiety, and affective disorders. Full understanding of serotonergic systems in the central nervous system involves genomics, neurochemistry, electrophysiology, and behavior. Though associations have been found between functions at these different levels, in most cases the causal mechanisms are unknown. The scientific issues are daunting but important for human health because of the use of selective serotonin reuptake inhibitors and other pharmacological agents to treat disorders in the serotonergic signaling system.</p> <p>Methods</p> <p>We construct a mathematical model of serotonin synthesis, release, and reuptake in a single serotonergic neuron terminal. The model includes the effects of autoreceptors, the transport of tryptophan into the terminal, and the metabolism of serotonin, as well as the dependence of release on the firing rate. The model is based on real physiology determined experimentally and is compared to experimental data.</p> <p>Results</p> <p>We compare the variations in serotonin and dopamine synthesis due to meals and find that dopamine synthesis is insensitive to the availability of tyrosine but serotonin synthesis is sensitive to the availability of tryptophan. We conduct <it>in silico </it>experiments on the clearance of extracellular serotonin, normally and in the presence of fluoxetine, and compare to experimental data. We study the effects of various polymorphisms in the genes for the serotonin transporter and for tryptophan hydroxylase on synthesis, release, and reuptake. We find that, because of the homeostatic feedback mechanisms of the autoreceptors, the polymorphisms have smaller effects than one expects. We compute the expected steady concentrations of serotonin transporter knockout mice and compare to experimental data. Finally, we study how the properties of the the serotonin transporter and the autoreceptors give rise to the time courses of extracellular serotonin in various projection regions after a dose of fluoxetine.</p> <p>Conclusions</p> <p>Serotonergic systems must respond robustly to important biological signals, while at the same time maintaining homeostasis in the face of normal biological fluctuations in inputs, expression levels, and firing rates. This is accomplished through the cooperative effect of many different homeostatic mechanisms including special properties of the serotonin transporters and the serotonin autoreceptors. Many difficult questions remain in order to fully understand how serotonin biochemistry affects serotonin electrophysiology and vice versa, and how both are changed in the presence of selective serotonin reuptake inhibitors. Mathematical models are useful tools for investigating some of these questions.</p