Myocardial injury in COVID-19 patients is associated with the thickness of epicardial adipose tissue

Aim High sensitive troponin (hs-TnI) levels may increase secondary to Coronavirus disease-2019 (COVID-19), and this increase is associated with cardiovascular mortality in COVID-19 patients. Epicardial adipose tissue (EAT) is associated with myocardial injury directly as a reservoir tissue for coronavirus, and indirectly through mediators it secretes as an apocrine gland. We aimed to evaluate the relationship between myocardial injury secondary to COVID-19 infection and EAT thickness. Material and methods Thoracic computed tomography (CT) was performed in 73 consecutive patients diagnosed with COVID-19. EAT thickness and volume were calculated by two radiologists blind to the study data. We formed two groups according to hs-TnI concentrations, patients with myocardial damage (hs-TnI >= 11.6 ng/l) and without myocardial damage (hs-TnI<11.6 ng/dl). Results A total of 46 patients were women (63.0%). The mean age was 66.4 +/- 12.3 yrs in the myocardial injury group and 55.9 +/- 9.7 yrs in the group without myocardial injury (p<0.001). There were 20 hypertensive patients (68.9%) in the injury group, while there were 12 hypertensive patients (27.3%) in the group without injury (p=0.001). Glucose, C-reactive protein, D-dimer, white blood cell count, neutrophil, and neutrophil/lymphocyte ratio were higher in the injury group (p<0.05, for all variables). The mean EAT thickness was 5.6 +/- 1.6 mm in the injury group, whereas it was 4.8 +/- 1.8 mm in the group without injury (p=0.031). EAT thickness of 4.85 mm and above was associated with the myocardial injury with 65% sensitivity and 39% specificity (AUC=0.65, 95% CI: 0.52-078, p=0.031). Conclusion In patients with COVID-19 infection, higher rates of myocardial injury were observed as the EAT thickness increased. Epicardial adipose tissue, contributes to cytokine-mediated myocardial injury either directly or indirectly by acting as a reservoir for coronavirus. Increased EAT thickness is associated with myocardial injury in COVID-19 patients

COVID-19 hastalarında mitral anüler kalsifikasyonun mortalite ve miyokard hasarı ile ilişkisi

Coronavirus disease-2019 (COVID-19) can particularly affect the respiratory and cardiovascular systems and cause serious mortality. Mitral annular calcification (MAC) is a mitral valve pathology associated with cardiac mortality. We aimed to evaluate the effect of MAC on myocardial injury (MI) and mortality, which can develop secondary to COVID-19 infection. Materials and Methods After applying the exclusion criteria, thorax computed tomography (CT) images of the remaining 1151 consecutive COVID-19 patients were evaluated. Calculation of MAC scores was done by two expert radiologists blinded to the study data. MI was defined as those with hs-TnI level (≥34 ng/dl). Patients included in the study were classified as having mortality and not occurring. Results Male gender, advanced age (>65), hypertension, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease (CKD), coronary artery disease, heart failure and atrial fibrillation rates were statistically higher in the mortality group (p<0.05). The presence of MAC was 34.1% in the mortality group, while it was 16% in the survival group (p<0.001). MI was observed 49.3% in the mortality group, while it was 16.2% in the survival group (p<0.001). Presence of MAC was associated with MI (14.8% vs 38.7%, p<0.001). Age (OR=1.976, 95% CI 1.166-3.346, p=0.011), male gender (OR=1.784, 95% CI 1.101-2.892, p=0.019), CKD (OR=2.293, 95% CI 1.085-4.485, p=0.030), MI (OR=2.893, 95% CI 1.735-4.823, p<0.001) and advanced lung involvement on CT (OR=2.231, 95% CI 1.084-4.594, p=0.029) were the independent predictors of mortality Conclusion In terms of MI and mortality risk in COVID-19 patients, it may be recommended to evaluate MAC from the CT images.Koronavirüs hastalığı-2019 (COVID-19) özellikle solunum ve kardiyovasküler sistemleri etkileyerek mortaliteye ve ciddi morbiditelere neden olabilir. Mitral halka şeklindeki kalsifikasyon (MAC), kardiyak mortalite ile ilişkili bir mitral kapak patolojisidir. Bu çalışmada, MAC’ın COVID-19 enfeksiyonuna sekonder gelişebilen miyokard hasarı (MI) ve mortalite üzerine etkisini değerlendirmeyi amaçladık. Gereç ve Yöntemle Dışlama kriterleri uygulandıktan sonra geriye kalan 1151 ardışık COVID-19 hastasının toraks bilgisayarlı tomografi (BT) görüntüleri değerlendirildi. MAC puanlarının hesaplanması, çalışma verilerine kör olan iki uzman radyolog tarafından yapıldı. MI, hs-TnI düzeyi (≥34 ng/dl) olanlar olarak tanımlandı. Çalışmaya dahil edilen hastalar mortalitesi olan ve olmayan olarak sınıflandırıldı. Bulgular Mortalite grubunda erkek cinsiyet, ileri yaş (>65), hipertansiyon, diabetes mellitus, kronik obstrüktif akciğer hastalığı, kronik böbrek hastalığı (KKD), koroner arter hastalığı, kalp yetmezliği ve atriyal fibrilasyon oranları istatistiksel olarak daha yüksekti (p<0.05). Mortalite grubunda MAC varlığı %34.1, sağkalım grubunda ise %16 idi (p<0.001). Miyokardiyal hasar mortalite grubunda %49.3, sağkalım grubunda ise %16.2 olarak saptandı (p<0.001). MAC varlığı MI ile ilişkiliydi (%14.8’e karşılık %38.7, p<0.001).Yaş (OR=1.976, 95% CI 1.166-3.346, p=0.011), erkek cinsiyet (OR=1.784, 95% CI 1.101-2.892, p=0.019), kronik böbrek yetersizliği (OR=2.293, 95% CI 1.085-4.485, p=0.030), MI (OR=2.893, 95% CI 1.735-4.823, p<0.001) ve küçük hücreli akciğer tutulumu (OR=2.231, 95% CI 1.084-4.594, p=0.029) mortalitenin bağımsız belirleyicileri idi. Sonuç COVID-19 hastalarında MI ve mortalite riski açısından BT görüntülerinden MAC değerlendirilmesi önerilebilir

Determination of the morphometric characteristics of donkey (Equus asinus) populations reared in Turkey

This research aims to determine the morphometric characteristics of the donkey (Equus asinus) populations reared in Turkey. For this purpose, live weights and body measurements were collected from 500 donkeys. The donkeys were grouped according to the factors of color, age, sex, and province and the live weights (LW) (kg), withers heights (WH), rump heights (RH), body lengths (BL), chest circumferences (CC), chest depths (CD), front shank circumferences (FSC), head lengths (HL) and ear lengths (EL) (cm) of the donkeys were measured. In the study, the males were found to have higher values of live weight, withers height, rump height, and chest depth than the females (p < 0.05). Significant differences in the live weights of the donkeys were seen by province, age, color, and sex (p < 0.01 and p < 0.05). Significant differences were found among the age groups as well (p < 0.01). Accordingly, the least squares means of the animals aged 1???3 years, 4???5 years, 6???8 years, and 9 years and over for live weight were measured as 112.10 ?? 3.11 kg, 141.54 ?? 2.76 kg, 153.98 ?? 2.42 kg, and 152.95 ?? 2.34 kg, respectively. The least squares mean of live weights were also determined as significant between the female and male animals (138.08 ?? 1.96 kg) and (142.21 ?? 2.25 kg), respectively (p 0.05). The highest correlation coefficient was calculated between live weight and body length among the donkeys (r = 0.83). Furthermore, the classical method (CM) and the fixed object photo (FOP) method were compared for photographed animals in the study. No difference in WH, RH, CD or HL was seen between the two methods (p 0.05). In conclusion, the morphometric characteristics of the donkeys were determined and it was shown that the populations were not distinguished clearly from each other and that this was fundamentally due to the transitions among the donkey populations for long years

Evaluation of Vascular Involvement in Children with Celiac Disease

Aim:Celiac disease is associated with an increased risk of cardiovascular disease due to inflammation and autoimmunity involved in its pathophysiology. We aimed to evaluate vascular involvement in children with celiac disease based on their augmentation index, carotid pulse wave velocity, carotid intima-media thickness, echocardiographic findings, and blood pressure.Materials and Methods:This cross-sectional and controlled study was performed at a single center between 2018 and 2019. The study population consisted of 44 patients with celiac disease who had been on a gluten-free diet for at least one year.Results:We compared celiac patients with a healthy group. While the celiac patients had significantly higher carotid intima media thickness and carotid pulse wave velocity values, there was no difference in the augmentation index values. There was no significant difference in carotid artery intimal medial thickness, augmentation index and carotid pulse wave velocity values between the diet-compliant and non-compliant groups.Conclusion:Although hypertension was not detected, arterial stiffness and carotid intima media thickness measurements were higher in the celiac disease patients compared to the healthy controls. This showed that these parameters can be used in early vascular damage assessment. These measurements, which are non-invasive and repeatable, can be a guide for the monitoring of the development of preclinical atherosclerosis in the follow-up of the pediatric patients diagnosed with celiac disease

Schirmer’s Test I and Determination of Intraocular Pressure in Healthy Common Buzzards (Buteo buteo)

Background: The structure of the eye in wild birds is 45% larger than that in humans, which provides excellent visual capacity but also makes them vulnerable to eye trauma. Trauma, neoplasia, infectious diseases of the ocular surface, uveitis, glaucoma, and corneal diseases in wild birds, but mainly trauma, can cause a reduction in their tear production; therefore, determining the amount of tear production in the wild birds is very important. Studies have shown that the results of the Schirmer’s tear test (STT) and intraocular pressure (IOP) values differ among wild bird species, and that both anesthesia and sedation affects these parameters. The main objective of the present study was to determined IOP and STT I values in healthy common buzzards (Buteo buteo).Materials, Methods & Results: Thirty healthy common buzzards were selected for the study following clinical and ophthalmic examinations. Following physical and clinical examinations of all subjects, routine ophthalmologic examinations were conducted, including reflex examinations (pupillary, palpebral, menace, dazzle) and direct ophthalmoscopy for the eyelids, conjunctiva, cornea, iris, lens, and fundus. All examinations were conducted without anesthesia or sedation while the birds were in the dorsal recumbent position, and the results of STT I and IOP were recorded. Both tests were repeated for the right and left eyes. The mean ± SE STT I values for the right and left eyes were 12.63 ± 0.51 and 12.43 ± 0.54 mm/min, respectively. A comparison between STT I values of the right and left eyes revealed no statistically significant differences (P > 0.620). The means and ranges of the TonoVet® IOP results for the right and left eyes were 32.06 ± 1.58 and 32.60 ± 1.51 mmHg, respectively. There was no statistically significant difference between the results of the test on the two eyes (P > 0.05).Discussion: Tear production is either increased or decreased in wild birds as a result of several types of eye diseases or trauma (1, 6). The most common method by which to determine tear production is either STT I (3), which is conducted without topical anesthesia, or STT II, which is conducted with topical anesthesia. As in our study, previous studies have used STT I as their method by which to determine tear production of wild birds. In a study conducted on 20 common buzzards, STT I values were 12.47 ± 2.66 mm/min. In our study using 30 common buzzards, the STT I value was 12.63 ± 0.51 mm/min for the right eye and 12.43 ± 0.54 mm/min for the left eye. There was no statistically significant difference between the results of the tests on the two eyes. In previous study with 25 common buzzards, IOP measured rebound tonometry was 5-30 (35-60). In our study, rebound tonometry results for IOP of 30 common buzzards were 32.06 ± 1.58 mmHg (16-47) for the right eye and 32.60 ± 1.51 mmHg (17-50) for the left eye. There was no statistically significant difference in IOP values between right and left eyes. Given that there are few studies on tear production and IOP in common buzzard, we believe that the results of this study will provide valuable new information to the literature

Recurrent endometrioma in infertile patients has worse outcome than primary endometrioma in response to controlled ovarian hyperstimulation and intrauterine insemination

Objective: To investigate the difference in the effectiveness of controlled ovarian hyperstimulation and intrauterine insemination (COH + IUI) on pregnancy rates in patients with primary and recurrent endometriomas. Study Design: Multicenter, retrospective cohort study done in 3 tertiary referral centers. Included in the study were (1) primary infertility patients with endometriomas who had no other probable cause for infertility, (2) those who underwent 2 cycles of COH + IUI, provid- ed the sperm test was nor- mal, (3) those who had at least 1 patent fallopian tube, and (4) those whose ovarian reserve was normal with ovulatory cycles. Therapy for COH was hMG (menotropin) or recombinant follicle-stimulating hormone (follitropin alfa, beta) at 75 IU/d starting from day 3. Trigger was done by 5,000-10,000 human chorionic gonadotropin or choriogonadotropin alfa 250 mu g/0.5 mL when the dominant follicle size reached 18 mm. Results: The ongoing pregnancy rates in patients with primary endometrioma were 14.4% per patient and 8.06% per cycle. In patients with recurrent endometrioma, the ongoing pregnancy rates were 6.06% per patient and 3.4% per cycle. Ongoing pregnancy rates were significantly higher in patients with primary endometrioma than in recurrent endometrioma patients. CONCLUSION: COH + IUI may be recommended even before surgery for couples with primary endometriomas when there is no other infertility factor. COH + IUI treatment is not recommended for recurrent endometrioma patients

Management of ovulation induction and intrauterine insemination in infertile patients with hypogonadotropic hypogonadism

Aim: To investigate the effectiveness of ovulation induction and intrauterine insemination (OI + IUI) in female patients with hypogonadotropic hypogonadism (HH), and to compare the outcomes of different stimulation protocols and cycle characteristics. Material and methods: The outcomes of OI + IUI treatments in patients with HH diagnosed between 2010 and 2018 were retrospectively evaluated. Cycles using recombinant (rec) luteinizing hormone (LH) or human menopausal gonadotropin (hMG) as LH sources were compared with each other. The cycle characteristics and pregnancy rates of the first cycles were compared with those of the second cycles in patients who underwent 2 or more cycles. Results: Of 104 patients diagnosed with World Health Organization type 1 anovulation, 99 were treated with hMG or rec LH + rec follicle-stimulating hormone (FSH) in a total of 220 cycles. The mean age of the study patients was 27.8 +/- 4.6 years (range, 19-39 years). Rec FSH + rec LH was given in 37 cycles, and hMG was used in 183 cycles. The hormone values were as follows: FSH, 1.4 +/- 1.6 mIU/mL; LH, 0.7 +/- 1.2 mIU/mL; oestradiol, 13 (15.8 +/- 12.0) pg/mL; and anti-Mullerian hormone, 2.1 (2.6 +/- 1.2) ng/mL. A dominant follicle was observed in 85.7% of the first cycles and in 86.2% of the second cycles. The treatment lasted 17.2 +/- 5.0 and 15.5 +/- 3.8 days until the human chorionic gonadotropin (hCG) administration day in the first and second cycles, respectively, and the difference was statistically significant (p < 0.05). The cycle cancellation rate was 8.1% (n = 3) in cycles done using rec gonadotropins and 29% (n = 53) in patients stimulated with hMG, and the difference was statistically significant (p < 0.05). The pregnancy rates were 12.7% and 28.3% per cycle and per patient, respectively. The pregnancy rate in hCG-triggered patients (successful stimulation) was 17.1% per cycle in all patients. Conclusion: OI with gonadotropins and IUI is a safe, efficient, and relatively cost-effective treatment option in patients with HH, yielding reasonable pregnancy rates per cycle and per patient. The use of rec FSH + rec LH facilitates cycle management but does not positively contribute to pregnancy rates and is more expensive than some other feasible options. (C) 2019 Elsevier Masson SAS. All rights reserved