Impaired global and segmental myocardial deformation assessed by two-dimensional speckle tracking echocardiography in patients with vitamin B12 deficiency

Background: Contrary effects of vitamin B12 deficiency have been shown on the cardiovascular system. Aim of our study was to analyze left ventricular (LV) myocardial deformation, by using the two dimensional (2D) speckle tracking echocardiography (STE) in patients with vitamin B12 deficiency and normal LV ejection fraction.Methods: Twenty-five patients with vitamin B12 deficiency (B12 levels < 200 pg/mL; meanage: 29.6 ± 8.2 years, 15 female), and 27 healthy controls (B12 levels > 200 pg/mL; meanage: 30.1 ± 6.9 years, 13 female) were included in the study. 2D echocardiography images were transferred to a workstation for further offline analysis. Longitudinal peak systolic (LPSS) and global strain (LGS) was obtained from 4 chamber and apical long axis (APLAX) views.Results: Standard echocardiographic parameters and tissue Doppler imaging (TDI) velocities were compared between the groups. All LPSS values in the patient group except for apical 4C septal wall longitudinal strain were significantly decreased than those in the control group. There was a positive correlation between B12 levels and strain values except apical 4C septal wall strain values.Conclusions: We found that in patients with vitamin B12 deficiency, global and segmental myocardial deformation was impaired and this impairment was correlated with the levels of vitamin B12

Günlük pratikte tanıdan tedaviye amiloid kardiyomiyopati

Amyloidosis is a disease caused by the accumulation of amyloid fibril in the extracellular space of organs and soft tissues. Amyloidosis classification is made according to the type of precursor protein. Although amyloid accumulation can be observed in various organs such as heart, kidney, liver, gastrointestinal and/or autonomic nervous system; the worst prognosis type of organ involvement is cardiac amyloidosis. Among many types of amyloidosis, almost all clinical cases of cardiac amyloidosis are caused by transtiretin amyloidosis (ATTR) or light chain amyloidosis (AL or primary systemic). Cardiac ATTR can be hereditary (ATTRm) or wild type (ATTRwt). The frequency of cardiac involvement and prognosis of cardiomyopathy varies between the types of amyloidosis and clinical symptoms vary depending on the organ involvement pattern. Variable clinical phenotype and often non-specific clinical features can cause delays in diagnosis and a multidisciplinary (hematology, pathology, radiology, nuclear medicine, neurology, nephrology, cardiology, rheumatology, gastroenterology) approach is required in diagnosis. The developing diagnostic methods give the clinician early diagnosis of cardiac amyloidosis. Amyloid accumulation should be demonstrated by imaging methods and tissue biopsy is necessary in patients with suspected cardiac amyloidosis. Once the precursor protein that causes amyloidosis has been identified, treatment of the underlying disease and heart failure is performed in symptomatic patients. It has been shown that prognosis can be corrected with early diagnosis and treatment approaches. In this review, it is aimed to raise awareness about cardiac amyloidosis disease, current diagnostic methods and treatment approaches that we can use in our daily practice will be discussed

Amyloid cardiomyopathy from diagnosis to treatment in daily practice

Amyloidosis is a disease caused by the accumulation of amyloid fibril in the extracellular space of organs and soft tissues. Amyloidosis classification is made according to the type of precursor protein. Although amyloid accumulation can be observed in various organs such as heart, kidney, liver, gastrointestinal and/or autonomic nervous system; the worst prognosis type of organ involvement is cardiac amyloidosis. Among many types of amyloidosis, almost all clinical cases of cardiac amyloidosis are caused by transtiretin amyloidosis (ATTR) or light chain amyloidosis (AL or primary systemic). Cardiac ATTR can be hereditary (ATTRm) or wild type (ATTRwt). The frequency of cardiac involvement and prognosis of cardiomyopathy varies between the types of amyloidosis and clinical symptoms vary depending on the organ involvement pattern. Variable clinical phenotype and often non-specific clinical features can cause delays in diagnosis and a multidisciplinary (hematology, pathology, radiology, nuclear medicine, neurology, nephrology, cardiology, rheumatology, gastroenterology) approach is required in diagnosis. The developing diagnostic methods give the clinician early diagnosis of cardiac amyloidosis. Amyloid accumulation should be demonstrated by imaging methods and tissue biopsy is necessary in patients with suspected cardiac amyloidosis. Once the precursor protein that causes amyloidosis has been identified, treatment of the underlying disease and heart failure is performed in symptomatic patients. It has been shown that prognosis can be corrected with early diagnosis and treatment approaches. In this review, it is aimed to raise awareness about cardiac amyloidosis disease, current diagnostic methods and treatment approaches that we can use in our daily practice will be discussed

Artemis message exchange framework: semantic interoperability of exchanged messages in the healthcare domain

One of the most challenging problems in the healthcare domain is providing interoperability among healthcare information systems. In order to address this problem, we propose the semantic mediation of exchanged messages. Given that most of the messages exchanged in the healthcare domain are in EDI (Electronic Data Interchange) or XML format, we describe how to transform these messages into OWL (Web Ontology Language) ontology instances. The OWL message instances are then mediated through an ontology mapping tool that we developed, namely, OWLmt. OWLmt uses OWL-QL engine which enables the mapping tool to reason over the source ontology instances while generating the target ontology instances according to the mapping patterns defined through a GUI. Through a prototype implementation, we demonstrate how to mediate between HL7 Version 2 and HL7 Version 3 messages. However, the framework proposed is generic enough to mediate between any incompatible healthcare standards that are currently in use. 1

The clinical efficiency of acupuncture in preventing migraine attacks and its effect on serotonin levels

Objectives: This study aims to investigate the efficacy of acupuncture in preventing migraine attacks

Diagnostic accuracy of P-wave dispersion in prediction of maintenance of sinus rhythm after external cardioversion of atrial fibrillation

WOS: 000287018600007PubMed: 21183416Objective: P-wave dispersion (PWD) is an electrocardiographic measurement, which reflects a disparity in an atrial conduction. In this study, we aim to demonstrate the diagnostic accuracy of PWD in predicting recurrence of atrial fibrillation (AF) in patients with sinus rhythm restoration after external cardioversion. Methods: This prospective, observational study consists of 26 patients, who underwent external cardioversion for non-valvular persistent AF and successfully cardioverted to sinus rhythm (13 men, mean age 58.1+/-11 years). Twelve-lead surface electrocardiogram of each patient was recorded immediately after the external cardioversion process to measure the P-wave duration. Recurrent AF was assessed for each patient during the 12-month follow-up after restoring the sinus rhythm. Patients were divided into the 2 groups with respect to the AF recurrence (recurrent AF group, (n=19), and sinus rhythm group, (n=7)) and variables that can affect AF development were compared between the two groups. Stepwise logistic regression analysis was used to identify the independent predictors of AF recurrence and ROC curve analysis was performed to determine the cut-off value of independent factors. Results: The two groups have similar demographic, clinical and echocardiographic features. Patients with recurrent AF had significantly higher PWD than those who continued to have a sinus rhythm (80+/-21 msec vs 53+/-11 msec, p=0.001, respectively). There is a positive correlation observed between the increase in PWD and the risk of AF recurrence (r=0.643; p<0.001). In logistic regression analysis, PWD was found to be an independent predictor of AF recurrence (OR 1.192 (95% Cl 1.032-1.375), p=0.013). Receiver operating characteristic analysis revealed that the best cut-off value of PWD for maintenance of sinus rhythm was 58 msec (sensitivity: 86%, specificity: 95%, AUC=0.917, 95% CI=0.785-1.05, p=0.001). Conclusion: This study suggests that PWD analysis after successful external cardioversion has diagnostic accuracy to predict the recurrence of AF (Anadolu Kardiyol Derg 2011 1: 34-8

The Effects of Resistance and Aerobic Exercises on Adiponectin, Insulin Resistance, Lipid Profile and Body Composition in Adolescent Boys with Obesity

Introduction: This present study aimed to examine the effectsof long-term resistance exercise (REG) and aerobic exercise(AEG) on the adiponectin, insulin resistance, lipid profile andbody composition in adolescent boys with obesity.Methods: Sixteen obese adolescent boys (age: 16.81±0.91 years)who studied at high school in İstanbul voluntarily participatedin the study. The participants were randomly divided into twogroups of (REG; n=8) and (AEG; n=8). The participants followedtheir exercise schedule for six months (3 days/wk, 60 min/day).The serum lipid profile, adiponectin, glucose, insulin resistance(HOMA-IR) levels and body composition of the participantswere evaluated at the beginning and end of the study. AWilcoxon matched-pairs signed-rank test and Mann-WhitneyU test were used for analyses, and the criterion for statisticalsignificance was set at p<0.05.Results: HOMA-IR, insulin, glucose and serum lipid levelsdecreased in both groups (p<0.05). Adiponectin and highdensity lipoprotein increased only in the AEG (p<0.05). Lowdensity lipoprotein level was statistically decreased only in theREG (p<0.05).Conclusion: These results indicated that both types of exerciseshad positive effects on insulin resistance, per cent body fat,weight and fat-free body mass. Long-term (6 months) aerobicand REG had different positive effects on adiponectin and thelipid profile. Although the effects of long-term aerobic exerciseon biochemical parameters are higher than REG, it wasremarkable that REG proved to be an alternative model to AEG.Amaç: Bu çalışma obezitesi olan erkek adolesanlarda, uzun süreli direnç egzersizin (DEG) ve aerobik egzersizin (AEG), adiponektin, insülin direnci, lipid profili ve vücut kompozisyonu üzerindeki etkilerinin incelenmesi amacıyla yapılmıştır. Yöntemler: Çalışmaya, İstanbul ilindeki liselerde öğrenim gören 16 obez erkek adolesan (yaş: 16,81±0,91 yıl) gönüllü katılmıştır. Katılımcılar, (DEG; n=8) ve (AEG; n=8) egzersiz grupları olmak üzere ikiye ayrılarak, altı ay boyunca (3 gün/hafta, 60 dakika/gün) egzersiz programlarını takip etmiştir. Çalışmanın başlangıcında ve sonunda gönüllülerin vücut kompozisyonları ölçülmüş; ayrıca alınan kan örneklerinden, serum lipid profili, adiponektin, glikoz, insülin direnci (HOMA-IR) düzeyleri ve vücut kompozisyonu değerlendirilmiştir. Analizler için Wilcoxon eşlenik-çift testi ve Mann-Whitney U testi kullanıldı ve istatistiksel anlamlılık kriteri p<0,05 olarak belirlenmiştir. Bulgular: Her iki grupta da HOMA-IR, insülin, glikoz ve vücut yağ düzeyleri azaldı (p<0,05). Adiponektin ve yüksek yoğunluklu lipoprotein artışının sadece AEG’de olduğu gözlenmiştir (p <0,05). Düşük yoğunluklu lipoprotein düzeyi sadece DEG’de istatistiksel olarak azaldığı belirlenmiştir (p<0,05). Sonuç: Bu sonuçlar, her iki egzersiz türünün de insülin direnci, vücut ağırlığı ağırlık ve yağsız vücut kütlesi ve vücut yağ yüzdesi üzerinde olumlu etkileri olduğunu göstermiştir. Uzun süreli (6 ay) aerobik ve DEG’nin adiponektin ve lipid profili üzerinde farklı pozitif etkileri vardır. Uzun süreli AEG’nin biyokimyasal parametreler üzerindeki etkileri, DEG’den daha fazla olmasına rağmen, DEG’nin AEG’ye alternatif bir model olduğu dikkat çekmektedir.WOS:00053566650000