Parameters affecting the period for being euthyroid in newly-diagnosed Graves’ disease treated with antithyroid agent

Background: There are limited data about the factors affecting the response time to medical treatment in Graves’ disease (GD) although many studies examined the predictors of the relapse after drug withdrawal. The aim of the current study was to evaluate the time for becoming euthyroid under antithyroid drug (ATD) therapy and the parameters influencing this period in patients diagnosed as GD.Methods: Patients with newly-diagnosed GD and decided to treat with ATD initially between March 2017 and September 2018 were retrieved retrospectively. Sociodemographic features as well as laboratory parameters like thyroid function tests and thyroid-stimulating hormone-receptor antibody (TRab) at the time of diagnosis were recorded.Results: Out of 41 patients, 63.4% (n=26) were female. The mean age was 36.1±11.7 years and 43.9% (n=18) of them were smoking. The time between the initiation of treatment and the duration of becoming euthyroid was 2.4±1.8 months. No significant difference was noted between age, gender, and smoking status and the time to become euthyroid under ATD treatment. This period was significantly positively correlated with levels of free triiodothyronine, free thyroxine, and negatively correlated with thyroid-stimulating hormone. Response to ATD therapy was higher in patients with pre-treatment TRab levels <10 IU/l than TRab ≥10 IU/l (p=0.011).Conclusions: Pretreatment thyroid function tests and TRab levels may be taken into consideration before deciding treatment in patients with newly diagnosed GD. It would be useful to design more comprehensive studies so that this proposal can find a response in clinical practice

Acute Renal Failure due to Leukaemic Infiltration in Chronic Lymphocytic Leukaemia

Chronic lymphocytic leukemia (CLL) is a malignancy characterized by clonal proliferation and accumulation of B lymphocytes. Although leukaemic infiltration of the kidney is well recognized in CLL, acute renal failure (ARF) due to leukaemic infiltration is extremely rare. Here we present a case of ARF as the initial manifestation of CLL. The diagnosis was made by a kidney biopsy. Treatment with cyclophosphamide and prednisolone resulted in a completely improved renal function

D Vitamini Eksikliği ile Endotel Disfonksiyonu Göstergelerinden Serum Endocan ve Asimetrik Dimetilarjinin Düzeyleri Arasındaki İlişki

Amaç: Güncel çalışmalar D vitamini eksikliğinin Alzheimer hastalığı, Parkinson hastalığı, multipl skleroz, diyabet ve kardiyovasküler hastalıklar gibi birçok hastalığın oluşumunda rolü olabilece-ğini göstermektedir. Biz de bu çalışmada kronik hastalık öyküsü olmayan bireylerde D vitamini düzeyi ile erken kardiyovasküler risk belirteçleri olan serum endokan ve asimetrik dimetilarjinin (ADMA) düzeyleri arasındaki ilişkiyi araştırmayı amaçladık.Gereç ve Yöntemler: İki katılımcı grubu oluşturuldu: D vitamini düzeyi &lt;10 ng/ml olan bireyler-den oluşan Grup 1 (n=42) ve D vitamini düzeyi &gt;30 ng/ml olanlardan oluşan Grup 2 (n=35). İki grup beden kitle indeksi (BKİ) ile serum D vitamini, endokan ve ADMA düzeyleri bakımından karşılaştırıldı. Bulgular: İki grup arasında yaş, cinsiyet ve BKİ bakımından anlamlı fark olmadığı saptandı (sı-rasıyla p=0,67; p=0,69; p=0,052). Ortalama serum ADMA düzeyi Grup 1 için 104,5±44 μmol/L, Grup 2 için 90,42±29 μmol/L olarak tespit edildi (p=0,31). Ortalama endokan düzeyi ise Grup 1 için 549,5±245 ng/L, Grup 2 için 465,99±207 ng/L idi (p=0,12). Vitamin D düzeyi ile endokan düzeyi arasında anlamlı negatif korelasyon saptandı (r=-0,26; p=0,02).Tartışma ve Sonuç: D vitamini düzeyi düşük katılımcılarda anlamlı bir farklılık gözlenmemiştir. Buna göre, D vitamini eksikliğinin endotel disfonksiyonuna bir etkisinin saptanamadığı söyle-nebilir

The relationship between vitamin D deficiency and serum endocan and asymetric dimethylarginine levels, indicators of endothelial dsyfunction

Amaç: Güncel çalışmalar D vitamini eksikliğinin Alzheimer hastalığı, Parkinson hastalığı, multipl skleroz, diyabet ve kardiyovasküler hastalıklar gibi birçok hastalığın oluşumunda rolü olabilece-ğini göstermektedir. Biz de bu çalışmada kronik hastalık öyküsü olmayan bireylerde D vitamini düzeyi ile erken kardiyovasküler risk belirteçleri olan serum endokan ve asimetrik dimetilarjinin (ADMA) düzeyleri arasındaki ilişkiyi araştırmayı amaçladık.Gereç ve Yöntemler: İki katılımcı grubu oluşturuldu: D vitamini düzeyi &lt;10 ng/ml olan bireyler-den oluşan Grup 1 (n=42) ve D vitamini düzeyi &gt;30 ng/ml olanlardan oluşan Grup 2 (n=35). İki grup beden kitle indeksi (BKİ) ile serum D vitamini, endokan ve ADMA düzeyleri bakımından karşılaştırıldı. Bulgular: İki grup arasında yaş, cinsiyet ve BKİ bakımından anlamlı fark olmadığı saptandı (sı-rasıyla p=0,67; p=0,69; p=0,052). Ortalama serum ADMA düzeyi Grup 1 için 104,5±44 μmol/L, Grup 2 için 90,42±29 μmol/L olarak tespit edildi (p=0,31). Ortalama endokan düzeyi ise Grup 1 için 549,5±245 ng/L, Grup 2 için 465,99±207 ng/L idi (p=0,12). Vitamin D düzeyi ile endokan düzeyi arasında anlamlı negatif korelasyon saptandı (r=-0,26; p=0,02).Tartışma ve Sonuç: D vitamini düzeyi düşük katılımcılarda anlamlı bir farklılık gözlenmemiştir. Buna göre, D vitamini eksikliğinin endotel disfonksiyonuna bir etkisinin saptanamadığı söyle-nebilir

Non-invasive mechanical ventilation after the successful weaning: a comparison with the venturi mask

Abstract Background and objectives: This study compared the rates of acute respiratory failure, reintubation, length of intensive care stay and mortality in patients in whom the non-invasive mechanical ventilation (NIMV) was applied instead of the routine venturi face mask (VM) application after a successful weaning. Methods: Following the approval of the hospital ethics committee, 62 patients who were under mechanical ventilation for at least 48 hours were scheduled for this study. 12 patients were excluded because of the weaning failure during T-tube trial. The patients who had optimum weaning criteria after the T-tube trial of 30 minutes were extubated. The patients were kept on VM for 1 hour to observe the hemodynamic and respiratory stability. The group of 50 patients who were successful to wean randomly allocated to have either VM (n = 25), or NIV (n = 25). Systolic arterial pressure (SAP), heart rate (HR), respiratory rate (RR), PaO2, PCO2, and pH values were recorded. Results: The number of patients who developed respiratory failure in the NIV group was significantly less than VM group of patients (3 reintubation vs. 14 NIV + 5 reintubation in the VM group). The length of stay in the ICU was also significantly shorter in NIV group (5.2 ± 4.9 vs. 16.7 ± 7.7 days). Conclusions: The ratio of the respiratory failure and the length of stay in the ICU were lower when non-invasive mechanical ventilation was used after extubation even if the patient is regarded as &#8216;successfully weaned&#8217;. We recommend the use of NIMV in such patients to avoid unexpected ventilator failure

Mean Platelet Volume in Heterrozygous Beta Thallassaermia

Background/Aim: It is not known why cerebrovascular and cardiovascular ischaemic events are less frequently observed in heterozygous beta thalassaemia (HBT) patients than in the general population. However, we previously reported that serum levels of some platelet function markers, i.e. soluble CD40 ligand and soluble P-selectin, are lower in patients with HBT than in controls. A high mean platelet volume (MPV) is an indicator of in vivo platelet activation and may indicate a tendency to thrombosis. We investigated whether MPV is lower in HBT patients than in controls. Methods: Forty-eight patients with HBT were compared with 51 controls matched for gender, age, and BMI for MPV in a cross-sectional study. Results: The MPV was within the normal range and higher in the HBT group (9.64 +/- 1.20 vs. 9.07 +/- 082 fL, p = 0.006). The 2 groups were similar in terms of atherosclerosis risk factors and medications. After linear regression analysis, the MPV was correlated with HBT, sensitive CRP, and BMI. Conclusion: The higher MPV in patients with HBT could indicate platelet activation, and this may repre-sent a dilemma. Higher MPV in the HBT group might have resulted from higher sympathetic nervous system activity, mild ineffective erythropoiesis, and haemolysis. (C) 2017 S. Karger AG, Base