Silent myocardial ischemia and related risk factors in patients with type 2 diabetes mellitus

Objectives: The aim of this study was to investigate the frequency of silent myocardial ischemia (SMI) in patients with Type 2 diabetes mellitus (DM) who do not have ischemiccardiac disease.Materials and Methods: To examine the relationship between ischemic cardiac disease and related factors such as blood pressure, lipid profile, smoking, gender, family history, body mass index (BMI), microalbuminuria, hsCRP, 150 diabetic patients who have never had any known coroner artery disease, exertional or rest dyspnea and labored breathing, aged between 35 and 70 years were included. Effort testing (treadmill) were performed to examine the existence of SMI.Results: Effort testing gave positive result for SMI in 20 patients and negative in 130 patients. Coronary angiographywas performed in 20 patients with positive effort testing results. The frequency of SMI was found as %13.3 by effort testing. The frequency of SMI (including non-criticalpatients) was %10.6 (16 patients) by using coronary angiography, which 13(8.6%) had critical and 3(2%) had non-critical coronary stenosis. No significant differences were found in age, gender, diabetic duration, trigliserid, HDL- cholesterol, blood pressure, BMI and hsCRP levels between positive and negative SMI patients with Type 2 DM.Conclusion: We determined that high LDL-Cholesterol and HbA1c and existence of microalbuminuria indicated significant SMI risk for patients with Type 2 DM

Comparison of QT dispersion between subclinical hypothyroid and euthyroid patients

Objectives: The aim of this study was to investigate the relationship between subclinical hypothyroid and QTc dispersionindicating local heterogeneity in repolarization of myocardium, which is well known as independent cardiac risk factor for sudden death and ventricular arrhythmia.Materials and Methods: We compared QTc dispersion of subclinical hypothyroid patients, after treatment and healthy control group. We included a total of 50 patients with 41 women and 9 men in the study group. Electrocardiographywith 12 derivations, thyroid hormones, serum electrolytes and basic biochemical parameters were measured.The control group consisted of 25 healthy individuals.QT distances were calculated by using Bazet formula. The difference between the longest QTc and the shortest QTc distance was accepted as QTc dispersion (QTcd).Results: Comparison of subclinical hypothyroid patients, their euthyroidic period after treatment and healthy controlgroup, gave no significant differences in age, body weight, body mass index and free thyroxin values. However,significant difference was found in durations of QTd and QTcd between the subclinical hypothyroid, the control and the euthyroidic groups (p<0.001). No significant differenceswere found in QTc and QTcd durations between euthyroidic period and healthy subjects (p>0.05).Conclusion: Our results suggested that subclinical hypothyroidpatients had longer QTc dispersion compared to euthyroidic period and healthy subjects. However there was no QTcd difference between the euthyroidic period and healthy control group

Correlation between Left Ventricular Mass Index and Calcium Metabolism in Patients with Essential Hypertension

Objective: To determine the correlation between left ventricular mass index and calcium metabolism in patients with essential hypertension. Study Design: Cross sectional case-control study. Material and Methods: Twenty-seven patients with essential hypertension and 20 healthy individuals were compared with respect to calciotropic hormones, left ventricular mass index (LVMI), and urinary and serum biochemical parameters. The correlations between parathormone, vitamin D, and calcitonin levels and LVMI and blood pressure elevation were determined. Results: The parathormone level was significantly higher (p=0.006) and vitamin D level was significantly lower (p=0.01) in the patient group compared with the control group. However, the two groups were similar in terms of albumin-corrected calcium levels, which were within the normal range (p=0.988). The serum sodium (p=0.014) and urinary calcium (p=0.003) levels and LVMI (p<0.01) were also significantly higher in the patient group. No significant correlations were determined between ambulatory blood pressure and parathormone and vitamin D levels, but a significant correlation was found between LVMI and parathormone level (p=0.06) in hypertensive patients. Conclusion: Essential hypertension alters calcium metabolism, causing calciuresis by hypernatremia. Parathormone release increases to compensate for this, and leads to protein synthesis, which in turn provokes the development of myocardial hypertrophy

Stromal Stem Cells from Parathyroid Glands of Patients with Secondary Hyperparathyroidism Demonstrate Higher Telomerase Activity and Osteogenic Differentiation Ability than Normal Bone Marrow Derived Stromal Stem Cells

Aims: The aim of this study was to isolate and extensively characterize parathyroid gland stem cells (PT-SCs) from secondary hyperparathyroidism cases. For this purpose, proliferation capacity, phenotypic properties, differentiation characteristics and gene expression profiles were analyzed and compared with mesenchymal stem cells from bone marrow (BM-MSCs) of the human. Methods: Stem cells isolated from PT and BM were analyzed by flow cytometry, RTPCR, Real Time-PCR, and immunocytochemistry. Both cell lines were directionally differentiated towards adipogenic, osteogenic and neurogenic cell lineages. Results: The isolated hPT-SCs share similar characteristics of hBM-MSCs by immunophenotypic, histological and molecular analyses. Both cells were shown to differentiate successfully into adipogenic and osteogenic cell lines. Embryonic stem cell markers Pou5F1, Zpf42, FoxD3, Sox2 and Nanog were also expressed beside 5 fold higher telomerase activity in hPT-SCs that could indicate the regenerative ability of the human parathyroid gland. The osteogenic cell markers were expressed by hPT-SCs, which transformed efficiently into osteogenic cell lines, both at the level of genes (BMP2, BMP4, BGLAP, Coll11a1, Runx2, Sparc) and of proteins (BMP2, BMP4, Osteocalcin, Osteonectin, Osteopontin). Higher alkaline phosphatase (ALP) activity indicating osteogenic differentiation was determined in hPT-SCs from secondary hyperparathyroidism patients. Conclusion: PT-SCs might responsible for the calcified parathyroid glands and other ectopic calcifications including the vascular ones, observed in the secondary hyperparathyroidism cases, beside parathyroid hormone-dependent hypercalcemia leading diffusion of calcium phosphate precipitation in tissues

Evaluation of the Effects of COVID-19 Pandemic Among Patients with Inflammatory Bowel Diseases

Objective: The Coronavirus Disease-2019 (COVID-19) pandemic continues to be a concern, especially to people with chronic diseases across the entire world. During this pandemic, we undertook an investigation to assess how the disease state and medical treatments of inflammatory bowel disease (IBD) are affecting the IBD patients, their risky perceptions, as well as the frequency and course of COVID-19. Methods: During the pandemic, the information on the course of the disease, medical treatment status of the patients with IBD, and the course of the disease in IBD patients who had COVID-19 were collected via telephonic interview. Results: A total of 102 IBD patients, including 62 with ulcerative colitis and 40 with Crohn’s disease were included in the study. Of these, 52.9% of the patients believed that having IBD was a risk for COVID-19. During the pandemic, 18.6% of the patients did not take their medication regularly for various reasons. Of all, 64.28% of the patients with active disease could not go to the hospital to avoid the risk of acquiring COVID-19 and 4.90% acquired COVID-19. Conclusion: During the pandemic, both the regular consumption of medicines and the reservations regarding admission to hospitals affect the course of IBD. Therefore, the development of strategic action plans to support and manage changes experienced during the course of this disease is expected to facilitate the management of the disease process in a healthier way for both the physicians and the patients

Preoperative Serum Il-6 Levels: Clinical Importance In Gastric Carcinoma With Lymph Node Metastasis

Aim: The interleukin-6 (IL-6) pathway is one of the mechanisms that link inflammation and angiogenesis. The purpose of this study was to investigate the preoperative serum levels of IL-6 in gastric carcinoma with lymph node metastasis, and to correlate them with disease status. Method: A total of 100 patients who underwent gastrectomy were enrolled in this study. Serum levels of IL-6 were assessed enzyme linked immunosorbent assay (ELISA). Histological findings included tumor size, depth of tumor invasion, lymph node (LN) metastasis, and TNM stage. Result: Increases in cancer invasion and staging are generally associated with increases in preoperative serum IL-6 levels. IL-6 levels were correlated with invasion depth (p<0.001), LN metastasis (p<0.001), and TNM stage. The presence of peritoneal seeding metastasis is associated with IL-6 levels (p<0.001). Conclusion: Preoperative serum IL-6 levels might be markers of tumor invasion, LN metastasis, and TNM stage. These results suggest that IL-6 levels are potential molecular markers that predict lymphatic involvement in gastric carcinoma

Effects of mesenchymal stem cells and VEGF on liver regeneration following major resection

The study aims to determine the effects of mesenchymal stem cell (MSC) therapy and a combination therapy of MSCs transfected with vascular endothelial growth factor (VEGF) for liver regeneration after major resection