Omentum adiposity is linked with resistin gene expression

Background: This study demonstrated site-specific adipose tissue resistin gene expression differences in individuals with and without type 2 diabetes mellitus. The relationship between conventional drug therapy and adipose tissue resistin gene expression was also determined. Paired omental and subcutaneous adipose tissues were excised during elective surgery from morbidly obese and obese patients. Methods: Resistin mRNA expressions were determined by qPCR. All tissue sections also were also analyzed for their resistin and CD68 protein expressions by immunohistochemistry. Results: No significant difference for omental and subcutaneous adipose tissue resistin mRNA expression levels were found among morbidly obese and obese study groups. The omental adipocytes resistin mRNA expressions increased with macrophage number both in the omental and subcutaneus fat. Resistin mRNA expressions of the omental and subcutaneous fat were in positive correlation. As the omental adipocytes radius decreased, the macrophage number increased in subcutaneous fat. In the omentum the adipocytes diameter and areas increased, in correlation with macrophage number. The antidiabetic drug use was found to increase adipocyte size both in the omentum and subcutaneous fat. Conclusions: The higher resistin gene expression in the omental fat may induce the increase in size and number of adipocytes, thus leading to elavation in omental fat mass

A comparative ID migraine screener study in ophthalmology, ENT and neurology out-patient clinics

Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.Pfizer-Türkiy

COVID-19 ve ruh sağlığı

Because of their epidemic nature, infections such as coronavirus disease 2019 (COVID-19) pandemic cause neuropsychological and social problems which are significantly different from other known infections. Many studies on the COVID-19 pandemic have shown higher levels of mental problems such as anxiety, depression, panic disorder, and obsessive compulsive disorder especially in patients and individuals who are in the risk group. Due to biopsychosocial characteristics of people, infections, especially epidemic infections, seriously impair the quality of life by dramatically affecting these three structures, namely biology, psychology and social quality of life of a person. As numerous studies have shown, the entire human innate and adaptive immune system and the psychological and mental state of an individual are directly linked. Many studies have reported that quarantine and social restrictions can trigger depressive symptoms such as anxiety, obsession, and anhedonia. Some researchers have claimed that information from unknown sources on social media increases the psychological and psychosocial symptoms of obsession, anxiety and fear of death. Consequently, a multidisciplinary study is necessary in the treatment and prevention of coronavirus pandemic

COVID-19 ve romatizmal hastalıklar

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infectious agent affecting respiratory system the most and spreads rapidly due to large number of ACE2 receptors in the lung. Arthralgia and myalgia are the most common rheumatologic findings, but arthritis is rare. Hyperinflammatory condition called cytokine storm causes acute respiratory distress syndrome (ARDS) leading to death. Although coronavirus disease 2019 (COVID-19) is mild or asymptomatic in most cases, it may progress to pneumonia and ARDS, especially in elderly patients who have comorbidities. Drugs such as tocilizumab which suppress inflammatory response and reduce cytokine storm may be effective on treating COVID-19 pneumonia. Cytokine storm, the cause of which is not fully understood and in which many structures of immune system interact with each other, is quite complex and has different mechanisms contributing to it. Although antimalarial drugs such as hydroxychloroquine are used in the treatment, there is no definite evidence that they are effective. It has been shown that the prevalence and course of COVID-19 in rheumatic diseases is similar to the general population, and that increasing age and additional comorbid conditions increase the risk of mortality. It is recommended that anti-rheumatic drugs used in the treatment of rheumatic diseases should not be stopped unless the patient is infected with COVID-19.Şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) solunum sistemini en çok etkileyen ve akciğerdeki çok sayıda ACE2 reseptörü nedeniyle hızla yayılan bulaşıcı bir ajandır. Artralji ve miyalji en sık görülen romatolojik bulgulardır, ancak artrit nadirdir. Sitokin fırtınası adı verilen hiperinflamatuar durum, akut solunum sıkıntısı sendromu (acute respiratory distress syndrome, ARDS)’na neden olarak ölüme neden olur. Koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) çoğu durumda hafif veya asemptomatik olmasına rağmen, özellikle ileri yaş ve komorbiditeleri olan hastalarda pnömoni ve ARDS'ye ilerleyebilir. Enflamatuar yanıtı baskılayan ve sitokin fırtınasını azaltan tosiluzumab gibi ilaçlar, COVID-19 pnömonisinin tedavisinde etkili olabilir. Nedeni tam olarak anlaşılamayan ve bağışıklık sistemindeki birçok yapının birbiriyle etkileşime girdiği sitokin fırtınası oldukça karmaşıktır ve buna katkıda bulunan farklı mekanizmalara sahiptir. Tedavide hidroksiklorokin gibi antimalaryal ilaçlar kullanılsa da etkili olduklarına dair kesin bir kanıt yoktur. Romatizmal hastalıklarda COVID-19 sıklığının ve seyrinin genel popülasyona benzer olduğu, artan yaş ve ek komorbid durumların mortalite riskini artırdığı gösterilmiştir. Romatizmal hastalıkların tedavisinde kullanılan anti-romatizmal ilaçların, hasta COVID-19 ile enfekte olmadıkça kesilmemesi önerilmektedir

COVID-19 and Mental Health

Because of their epidemic nature, infections such as coronavirus disease 2019 (COVID-19) pandemic cause neuropsychological and social problems which are significantly different from other known infections. Many studies on the COVID-19 pandemic have shown higher levels of mental problems such as anxiety, depression, panic disorder, and obsessive compulsive disorder especially in patients and individuals who are in the risk group. Due to biopsychosocial characteristics of people, infections, especially epidemic infections, seriously impair the quality of life by dramatically affecting these three structures, namely biology, psychology and social quality of life of a person. As numerous studies have shown, the entire human innate and adaptive immune system and the psychological and mental state of an individual are directly linked. Many studies have reported that quarantine and social restrictions can trigger depressive symptoms such as anxiety, obsession, and anhedonia. Some researchers have claimed that information from unknown sources on social media increases the psychological and psychosocial symptoms of obsession, anxiety and fear of death. Consequently, a multidisciplinary study is necessary in the treatment and prevention of coronavirus pandemic

Primary And Secondary Prevention In Stroke: Approact To Diabetes Mellitus Cases

Microangiopathy and m acroangiopathy are induced by increased the tendency of atherosclerosis caused by metabolic impairment. The prerevalance of diabetes mellitus is 15 - 33 % in cases with ischemic stroke. Diabetes mellitus is an independent risk factor especially for stroke an d it can increase the relative risk (RR) 1.8 - 6 times for initial stroke. The risk of ischemic stroke is higher in women with diabetes. Individual adjustment of glycemic targets is performed but treatment regulation as to set ≤ 7.0 % of HbA1C is recommended for decreasing the microvascular and macrovascular complications if the history of stroke or TIA are present. The targeted fasting plasma glucose levels should be ranged from 4.0 to 7.0 mmol/L and the targeted plasma glucose levels at postprandial second hour should be ranged from 5.0 to 10.0 mmol/L. Daily physial activity, weight control, blood pressure control, lipid control and life style changes are recommended to all diabetic patients. Also, medical treatment is commonly needed for targeted HbA1C levels. In diabetic patients, Metformin is an effective first - line pharmacotherapy to decrease the stroke risk. Also, monotherapy with fibrates can be considered. It is proposed to set the blood preassure at < 130/80 mmHg with AC EI or ARB hypertension treatments in diabetic patients. Diabetic adults with additionally risk factors should be treated with statins to decrease the risk of initial stroke. The benefit of antiagregant usage to decrease the stroke risk is not clear yet, ho wever aspirin usage can suitable in diabetic patients with increased cardiovascular event risk

The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection

The coronavirus invades the nervous system with the spread we call neuroinvasion, and"cytokine storm" becomes an important factor affecting the course of the disease. Seriousdamage occurs in the brain and other organs as a result of cytokine storm. Evidence isaccumulating that the coronavirus, which infects millions of people all over the world, affectsboth the central and peripheral nervous system and muscles as well as the respiratory tract.Increasing evidence has revealed neurological involvement in 36-54% of the patients, whichcorresponds to almost one in every 2 or 3 patients. In severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) patients, we frequently encounter neurological symptoms suchas smell and taste disturbances, fatigue and muscle pain, headache, nausea, vomiting, impairedconsciousness, numbness in hands and feet. To a lesser extent, we encounter neurologicalhandicaps such as dizziness, inflammation of the meninges, loss of myelin in nerve tissue,muscle inflammation, and severe rhabdomyolysis. Some of the nervous system diseasesaccompanying SARS-CoV-2 disease recover with complete or partial sequelae. Observationof permanent dysfunction in patients with neurological findings draws attention to theimportance of a detailed neurological evaluation in the examination of these cases

The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection

The coronavirus invades the nervous system with the spread we call neuroinvasion, and"cytokine storm" becomes an important factor affecting the course of the disease. Seriousdamage occurs in the brain and other organs as a result of cytokine storm. Evidence isaccumulating that the coronavirus, which infects millions of people all over the world, affectsboth the central and peripheral nervous system and muscles as well as the respiratory tract.Increasing evidence has revealed neurological involvement in 36-54% of the patients, whichcorresponds to almost one in every 2 or 3 patients. In severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) patients, we frequently encounter neurological symptoms suchas smell and taste disturbances, fatigue and muscle pain, headache, nausea, vomiting, impairedconsciousness, numbness in hands and feet. To a lesser extent, we encounter neurologicalhandicaps such as dizziness, inflammation of the meninges, loss of myelin in nerve tissue,muscle inflammation, and severe rhabdomyolysis. Some of the nervous system diseasesaccompanying SARS-CoV-2 disease recover with complete or partial sequelae. Observationof permanent dysfunction in patients with neurological findings draws attention to theimportance of a detailed neurological evaluation in the examination of these cases

COVID-19 and Rheumatic Diseases

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infectious agent affecting respiratory system the most and spreads rapidly due to large number of ACE2 receptors in the lung. Arthralgia and myalgia are the most common rheumatologic findings, but arthritis is rare. Hyperinflammatory condition called cytokine storm causes acute respiratory distress syndrome (ARDS) leading to death. Although coronavirus disease 2019 (COVID-19) is mild or asymptomatic in most cases, it may progress to pneumonia and ARDS, especially in elderly patients who have comorbidities. Drugs such as tocilizumab which suppress inflammatory response and reduce cytokine storm may be effective on treating COVID-19 pneumonia. Cytokine storm, the cause of which is not fully understood and in which many structures of immune system interact with each other, is quite complex and has different mechanisms contributing to it. Although antimalarial drugs such as hydroxychloroquine are used in the treatment, there is no definite evidence that they are effective. It has been shown that the prevalence and course of COVID-19 in rheumatic diseases is similar to the general population, and that increasing age and additional comorbid conditions increase the risk of mortality. It is recommended that anti-rheumatic drugs used in the treatment of rheumatic diseases should not be stopped unless the patient is infected with COVID-19.Şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) solunum sistemini en çok etkileyen ve akciğerdeki çok sayıda ACE2 reseptörü nedeniyle hızla yayılan bulaşıcı bir ajandır. Artralji ve miyalji en sık görülen romatolojik bulgulardır, ancak artrit nadirdir. Sitokin fırtınası adı verilen hiperinflamatuar durum, akut solunum sıkıntısı sendromu (acute respiratory distress syndrome, ARDS)’na neden olarak ölüme neden olur. Koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) çoğu durumda hafif veya asemptomatik olmasına rağmen, özellikle ileri yaş ve komorbiditeleri olan hastalarda pnömoni ve ARDS'ye ilerleyebilir. Enflamatuar yanıtı baskılayan ve sitokin fırtınasını azaltan tosiluzumab gibi ilaçlar, COVID-19 pnömonisinin tedavisinde etkili olabilir. Nedeni tam olarak anlaşılamayan ve bağışıklık sistemindeki birçok yapının birbiriyle etkileşime girdiği sitokin fırtınası oldukça karmaşıktır ve buna katkıda bulunan farklı mekanizmalara sahiptir. Tedavide hidroksiklorokin gibi antimalaryal ilaçlar kullanılsa da etkili olduklarına dair kesin bir kanıt yoktur. Romatizmal hastalıklarda COVID-19 sıklığının ve seyrinin genel popülasyona benzer olduğu, artan yaş ve ek komorbid durumların mortalite riskini artırdığı gösterilmiştir. Romatizmal hastalıkların tedavisinde kullanılan anti-romatizmal ilaçların, hasta COVID-19 ile enfekte olmadıkça kesilmemesi önerilmektedir