C-reactive protein and homocysteine levels are associated with abnormal heart rate recovery in women with polycystic ovary syndrome

Objective: To determine heart rate recovery (HRR) in patients with polycystic ovary syndrome (PCOS) and its relation to C-reactive protein (CRP) and homocysteine (Hcy) levels. Design: Prospective clinical study. Setting: University hospital. Patient(s): Sixty-eight women with PCOS and 68 healthy women were included this study. Intervention(s): Heart rate recovery was evaluated. We measured serum levels of CRP and Hcy. The presence of insulin resistance was investigated using homeostasis model assesment (HOMA-IR). Main Outcome Measure(s): Heart rate recovery, CRP, Hcy. Result(s): Heart rate recovery was significantly decreased in women with PCOS compared with control group women. Subjects with abnormal HRR had significantly greater levels of CRP and Hcy. The PCOS patients with HRR in the top tertile compared with the bottom quartile tended to have lower mean CRP and Hcy levels. The HRR was significantly and negatively correlated with age, CRP, Hcy, HOMA-IR, and body mass index. C-reactive protein and Hcy are independent determinants of HRR. Conclusion(s): The CRP and Hcy levels may affect the development and progression of abnormal HRR in PCOS

Esansiyel trombositemide koroner baypas cerrahisi

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Mikrobiološka, fizikalno-kemijska i senzorska svojstva kefira proizvedenog sekundarnom fermentacijom

In this study, the microbiological, physicochemical, and sensory properties and volatile aromatic compounds of kefir produced by secondary fermentation were investigated. Cow milk samples containing 1.5 % fat were fermented with kefir grains until the pH reached certain levels (pH 5.0-5.5), and then each of them was inoculated with a different starter culture (thermophilic, probiotic, mesophilic aromatic, and yeast) for secondary fermentation. In kefir samples produced traditionally or by secondary fermentation, the pH values, carbon dioxide levels, and tyrosine and lactic acid contents increased during storage. However, the counts of lactococcus, lactobacillus, leuconostoc, and yeasts decreased. Acetaldehyde and ethanol increased during storage, but diacetyl decreased in kefir samples produced traditionally or by secondary fermentation. The butanone contents changed very little but they showed an upward trend within the storage period. Kefir samples produced by secondary fermentation found greater acceptance during sensory testing than samples produced by the traditional method. Kefir inoculated with mesophilic aromatic and yeast cultures were the most preferred by panelists.U ovom istraživanju ispitivana su mikrobiološka, fizikalno-kemijska i senzorska svojstva te sastav hlapljivih aromatskih tvari kefira proizvedenog sekundarnom fermentacijom. Uzorci kravljeg mlijeka s 1,5 % mliječne masti fermentirani su pomoću kefirnih zrnaca do postizanja odgovarajuće pH vrijednosti (5,0-5,5), nakon čega su inokulirani različitim starter kulturama (termofilna, probotička, mezofilna aromatska i kvasci) u svrhu provođenja sekundarne fermentacije. Tijekom skladištenja u svim je uzorcima kefira došlo do porasta pH vrijednosti, udjela ugljičnog dioksida, tirozina i količine mliječne kiseline. Međutim, zabilježen je pad broja živih stanica laktokoka, laktobacila, leukonostoka i kvasaca. Također, bez obzira na način proizvodnje (tradicionalno ili sekundarnom fermentacijom) u svim uzrocima je tijekom skladištenja zabilježen porast količine acetaldehida i etanola, dok je količina diacetila opadala. Sadržaj butanona vrlo se malo mijenjao, no pokazao je rastući trend tijekom razdoblja skladištenja. Prilikom provođenja senzorskog ocjenjivanja uzorci kefira proizvedeni sekundarnom fermentacijom okarakterizirani su boljom prihvatljivošću u odnosu na kefir proizveden tradicionalnom metodom. Kefir inokuliran mezofilnom aromatskom kulturom i kulturom kvasaca pokazao se najpoželjnijim prilikom senzorskog ocjenjivanja od strane panela

Deaf athlete: is there any difference beyond the hearing loss?

Regular physical activity and sport is important for enhanced physical fitness and skill performance of deaf athletes. However there are few data in the literature about their medical considerations. In this study we aimed to determine the morphological findings and cardiac status of the deaf athletes and compare them with the normal ones. Thirty deaf and twenty-two normal male athletes without cardiovascular diseases participated in the study. Transthoracic echocardiography and exercise stress testing were performed. Tissue Doppler imaging (TDI)-derived myocardial performance index (MPI) was also evaluated. VO2 max and heart rate recovery were calculated after exercise stress testing. Total cholesterol, LDL and trigliseride levels were significantly increased in the deaf athletes, but they were still found to be in normal ranges according to age and risk factor profile (p< 0.05). End-diastolic diameter and left ventricular mass index were found to be significantly increased in the controls when compared with the deaf athletes (p< 0.001). Heart rate recovery at 1 minute did not show any difference in the deaf group when compared with the control group (p> 0.05). MPI calculated from TDI-derived variables was found to be 0.41±0.073 in the deaf group and 0.46±0.061 in the controls respectively and significantly decreased in the deaf (p < 0.05). Beyond having a hearing loss, the deaf athletes have many cardiac structural and functional differences from their normal counterparts. The factors that give rise to these differences have to be revealed by further research

25-Hydroxy vitamin d levels and endothelial vasodilator function in normotensive women

Introduction: Vitamin D was shown to be related to endothelial function and bloodpressure. Reactive hyperaemia index (RHI) measurement by pulse arterial tonometryis a new method to evaluate vasodilator function of endothelium. We aimedto evaluate the relationship between vitamin D levels and RHI in women.Material and methods: We enrolled 56 normotensive, nonsmoker, normolipidemicand normoglycemic women, (23 with 25-OH-vita min D levels > 20 µg/l,and 33 with values lower than 20 µg/l). The cardiologist who was blind for vitaminD results executed measurements by pulse arterial tonometry. The measurementwas performed on the lying patient with pre- and post-occlusion measurementsof RHI by digital sensors placed on each index finger, by 5 minintervals. Pulse amplitudes were recorded, pre-occlusion and post-occlusionratio was compared by the software of device. Stepwise linear regression andmultiple regression analyses were performed to evaluate predictors of endothelialfunction.Results: The low vitamin D group had a lower RHI value than the normal vitaminD group (p = 0.042). In regression analysis, positive predictors of RHI wereserum 25-OHD (ß = 0.401; 95% CI 0.010-0.042, p = 0.002), serum albumin(ß = 0.315; 95% CI 0.286-2.350, p = 0.013), and, inversely, serum calcium(ß = –0.247; 95% CI (–1.347)-(–0.010), p = 0.047).Conclusions: Serum 25-hydroxy vitamin D was significantly related to endothelialfunctions measured as RHI, even in healthy non-smoker women

Association of total serum antioxidant capacity with the Tei index in echocardiography in patients with microvascular angina

Objectives Cardiac syndrome X (CSX) is a conditioncharacterized by exercise-induced chest pain that occursconsidering a normal coronary angiogram. We aimed toinvestigate the total serum antioxidant capacity (TAC) andbiventricular global functions using echocardiography inpatients with CSX.Patients and methods The study population included 55patients with typical anginal symptoms and a positiveexercise stress test, or ischemia in myocardial perfusionscintigraphy and normal coronary arteries detectedangiographically, and 49 healthy volunteers with atypicalchest pain and a negative stress test. TAC was assessedfrom blood samples. Transthoracic echocardiography wasperformed for the entire study population. The Tei index wascalculated using the formula IVCT+IVRT/ET.Results TAC was found to be significantly lower in the CSXgroup compared with the control group (0.70 ± 0.37 vs.1.5± 0.30, respectively, P1.77 mmol/l), it was found that the Tei indexwas higher in the decreased TAC group compared with theother groups (0.66 ± 0.18 vs. 0.49 ± 0.10 and0.46± 0.13 mmol/l, P<0.001, respectively).Conclusion Our study suggested that TAC wassignificantly decreased in CSX patients and decreasedantioxidant levels were related to impaired Tei index inechocardiography in patients with microvascularangina. Coron Artery Dis 26:620–625 Copyright © 2015Wolters Kluwer Health, Inc. All rights reserved

BhCG as a Rupture Marker in Ectopic Pregnancy: A Retrospective Study

Objective:To find effective criteria in determining the risk of ectopic pregnancy rupture in patients with ectopic pregnancy.Method:The data of 101 patients who were hospitalized with the diagnosis of ectopic pregnancy in the tertiary center between January 2018 and January 2021 were analyzed retrospectively. Demographic data of the patients, the month of admission, the patients’ beta-human corionic gonadotropin (BhCG) values at the time of admission, blood type, endometrial thickness measured with transvaginal ultrasound, presence of adnexal mass suggestive of ectopic pregnancy and treatments applied to the patients were recorded. These data were compared between patients who had surgery for ectopic pregnancy rupture and those whose treatment was completed without it.Results:In the statistical analysis of the data, ectopic pregnancy rupture was found significantly more frequent for a threshold value of BhCG >4000 IU/L. Other data were not statistically significant.Conclusion:In cases of ectopic pregnancy, if the BhCG value at the time of admission exceeds the threshold value, the possibility of surgical approach increases. Medical treatment may be more successful at lower BhCG levels

Nutritional status and severity of coronary artery disease

Objective The aim of this study is to evaluate the association between Nutritional Risk Index (NRI), a simple tool to assess nutritional status, and coronary artery disease severity and complexity in patients undergoing coronary angiography. Methods This study is a retrospective analysis of 822 patients undergoing coronary angiography. Patients with previous revascularization were excluded. Gensini and SYNTAX scores were calculated according to the angiographic images to determine atherosclerosis severity. NRI was calculated as follows: NRI = [15.19 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. In patients ≥65 years of age, Geriatric NRI (GNRI) was used instead of NRI. GNRI was calculated as follows: GNRI = [14.89 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. Patients were then divided into three groups as previously reported: NRI < 92, NRI 92–98 and NRI > 98. Gensini and SYNTAX scores were compared between three groups. Results The mean age of study population was 61.9 ± 11.1 years. NRI 98 was measured in 212, 321 and 289 patients, respectively. There was no difference regarding to sex, BMI, smoking, hypertension and diabetes mellitus between three groups. Patients with NRI < 92 had the highest mean Gensini score than the patients with NRI 92–98 and NRI > 98 (38.0 ± 40.6 vs. 31.17 ± 42.4 vs. 25.8 ± 38.4, P = 0.005). Also patients with NRI < 92 had the highest mean SYNTAX score than the patients with NRI 92–98 and NRI > 98 (11.8 ± 12.9 vs. 9.3 ± 12.4 vs. 7.7 ± 11.8, P = 0.001). Also, Gensini score of ≥20 and high SYNTAX score of ≥33 were associated with lower NRI (P < 0.001 and P < 0.001, respectively). Conclusion In our study, nutritional status evaluated by the NRI was associated with more extensive and complex coronary atherosclerosis in patients undergoing coronary angiography