A rare cause of stridor in infancy: congenital laryngocele

A five months old male infant was presented with difficulty in breathing and stridor since birth. Chest radiography showed clear lung fields with prominent peribronchial markings. The patient underwent flexible bronchospic procedure which showed a large, anteriorly located, laringeal cystic dilatation above the vocal cords. Subsequent imaging with ultrasonography and MR confirmed the diagnosis of congenital laryngocele. His airway was secured by tracheotomy and decompression of the cyst was accomplished by needle aspiration. Congenital laryngocele is an extremely rare disorder of the larynx causing various degree of upper airway obstruction and a neck mass. The disorder may be associated with hoarseness, dysphagia, difficulty in breathing and aspiration. [Cukurova Med J 2016; 41(3.000): 581-583

Talc pleurodesis in the management of persistent pleural effusion in an infant

Pleural effusion is excessive fluid that accumulates in the pleural cavity. It predominantly occurs by infectious agents. Other various causes include congestive heart diseases, malignancies, viral diseases, trauma, hypoalbuminemia, connective tissue diseases and chromosomal abnormalities. Treatment strategies should target the responsible cause. Herein, we present a 16-month old male infant with persistent pleural effusion occuring after uncomplicated Morgagni hernia surgery who had no response to antibiotics, parenteral nutritional support and octreotide therapy that was eventually treated by pediatric surgery with talc pleurodesis. No significant advers effect was observed after administration of talc as a sclerozing agent for pleurodesis. This procedure has been rarely reported at this age group. [Cukurova Med J 2016; 41(2.000): 390-392

Multilayer global longitudinal strain assessment of subclinical myocardial dysfunction related to insulin resistance

Myocardial tissue is sensitive to insulin resistance (IR) due to its interactions with insulin levels. Previous studies demonstrated that heart failure prevalence was higher in IR patients. Evaluation of myocardial deformation by multilayer global longitudinal strain (MGLS) might provide more information about IR related left ventricular dysfunction. In this study, we aimed to investigate subclinical LV dysfunction with MGLS in patients with IR. The study was designed as a prospective cross-sectional study. The present study included 64 patients with IR (+), and 54 subjects without IR (-) prospectively. The homeostasis model of insulin resistance (HOMA-IR) was used to quantify insulin resistance. Specific analysis for endocardial, mid-myocardial and epicardial layers were performed by two-dimensional (2D) speckle tracking echocardiography (STE) for multilayer global longitudinal strain. MGLS (Endocard-Mid-myocard-Epicard) values were significantly lower in the IR (+) group compared to IR (-) group ((GLS-endocard; - 15.1 +/- 1.5 vs. - 18.7 +/- 1.3, p < 0.001), (GLS-mid-myocard; - 16.0 +/- 2.0 vs. - 18.0 +/- 2.0, p < 0.001), (GLS-epicard; - 17.0 +/- 1.7 vs. - 18.01 +/- 1.94, p = 0.004)). GLS-endocard levels were significantly and positively correlated with HOMA-IR levels (r = 0.643, p < 0.001). HOMA-IR and age were found to be independent factors in detecting a decrease in GLS-endocard level in regression analysis. In conclusion, our data reveal that IR (+) patients had significantly lower strain values compared to IR (-) group. Besides, we presented that the HOMA-IR value was an independent predictor of subclinical left ventricular dysfunction

Correlation of glycemic regulation and endotrophin in patients with type 2 Diabetes; pilot study

Background Endotrophin is one of the extracellular matrix proteins secreted by adipose tissue. In this study, we aimed to investigate the effects of changes in blood glucose levels on serum endotrophin levels secreted by adipose tissue and thus on diabetes. Methods In this prospective pilot study included 78 patients with type 2 diabete (T2D) with hemoglobin A1c level > 9 %. Lifestyle changes were recommended and appropriate medical treatment was initiated to all patients in order to reach the target HbA1c level. Data of anthropometric measurements, urinary albumin creatinine ratio (UACR), serum lipid parameters and endotrophin were collected in patients; all examinations were repeated after 3 months. Analysis was performed using Paired-Samles T test and Spearman tests. Results Of patients, 23 were female (54.8 %) and 19 were male (45.2 %). Mean age was 55.2 years, with mean diabetes age of 8.14 +/- 5.35 years. After 3 months follow-up, HbA1c, fasting glucose, C-reactive protein(CRP), UACR and endotrophin levels were observed to clearly reduce. The variation in serum endotrophin levels examined at the start of the study and in the 3rd month was identified to have a positive correlation with the variation in HbA1c and UACR levels (r = 0.342, p = 0.02; r = 0.484, p = 0.001). Multiple linear regression analysis showed percentage variation values (delta)-endotrophin levels were only independently correlated with (delta)-UACR (model r(2) = 0.257, p value = 0.00). Conclusions Endotrophin levels decreased significantly with the decrease in HbA1c. Unexpectedly, this reduction in endotrophin levels is closely related to the decrease in UACR, regardless of blood glucose regulation. We think that studies targeting endotrophin will contribute to the diagnosis, treatment and follow-up of diabetic nephropathy in the future

Can the endotrophin level in pulmonary fibrosis be a biomarker with differential diagnosis

Aim: In this study, we aimed to investigate the possible role of endotrophin, a profibrotic byproduct of collagen VI, in the complex process of fibrosis development in the disease group with pulmonary fibrosis among interstitial lung diseases

Serum 25-Hydroxy Vitamin D Levels in Patients with Acute Hepatitis (Ischemic, Toxic, and Viral): Association With Clinical Progression and Mortality

WOS: 000398932800005Objective: Vitamin D is a key regulator of calcium homeostasis and has anti-inflammatory and immunomodulatory effects. Active vitamin D has a direct effect on T cells and antigen-presenting cells. It also suppresses the differentiation of B cells to plasma cells and inhibits immunoglobulin production. Vitamin D supplementation is associated with a favorable outcome in chronic inflammatory diseases. In this study, we aimed to determine serum vitamin D levels in patients with acute toxic, ischemic, or viral hepatitis and whether the levels had an effect on clinical progression or mortality in patients with acute hepatitis. Methods: Forty-eight patients (26 men and 22 women) and 35 controls (16 men and 19 women) aged > 18 years who were diagnosed as having acute hepatitis and hospitalized in the Internal Medicine Department were enrolled. To determine serum 25-hydroxy (OH) vitamin D levels, two fasting blood samples, first in the initial 24-48 h following hospitalization and second on the day of discharge, were obtained from the participants. The SPSS Statistics v21.0 software was used for the quantitative evaluation of data. Results: Serum vitamin D levels were significantly lower in the patient group (10.0+/-8.7) than in the control group (31.5+/-12.2), but no significant difference was detected in serum vitamin D levels among the patients. Serum vitamin D levels, except in patients with viral hepatitis, were low at discharge. Serum vitamin D levels were lower than the cutoff values in two patients with early mortality. Conclusion: We demonstrated that serum vitamin D levels had no effect on clinical progression of acute hepatitis. Other prospective studies with large sample sizes are required to determine whether serum vitamin D levels can be used to predict clinical progression or mortality

Evaluation of cognitive functions and the related factors in 50-80 year type 2 diabetic subjects

To study cognitive functions in 50-80 year aged type 2 diabetic patients. Cognitive performance was evaluated through a mini mental test (MMT) in 131 patients between 50 and 80 years (100 type 2 diabetics and 31 non-diabetics). Relation analysis were carried out for different parameters. Scores in registration and recall were significantly lower in diabetic group. The effect of HbA1c, body mass index (BMI) and age variables on MMT score was statistically significant. A negative linear correlation was estimated between MMT score and age, HbA1c level and BMI value. HbA1c, age and BMI were inversely related to cognitive functions. MMT scores were 24.98 +/- 3.10 in diabetic group and 25.35 +/- 3.22 in control group and statistically no significant difference was found. No significant difference was between type 2 diabetics and non-diabetics in terms of cognitive functions. But performance of diabetic patients in relation to the registration and recall was lower. Poor glycemic control and obesity in diabetics negatively affect cognitive performance

THE RELATIONSHIP OF VITAMIN D LEVELS WITH EARLY MORTALITY IN PATIENTS WITH ACUTE CORONARY SYNDROME AND VALUE OF VITAMIN D LEVELS AS A CARDIOVASCULAR RISK FACTOR

Objective: Acute coronary syndrome (ACS) is the main cause of mortality and morbidity worldwide. This study aims to determine the serum vitamin D level in patients with ACS, determine whether the serum 25-hydroxy-vitamin D level is associated with the ACS and to investigate whether serum vitamin D level is effective on early (first 30 days after diagnosis) mortality in patients with ACS, or not