The association between serum YKL-40 levels, mean platelet volume, and c-reactive protein in patients with cellulitis

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459; ERTURK, AYSE/0000-0001-6413-9165WOS: 000349843900013PubMed: 25657159Background: Lower limb cellulitis is an infectious disease that has serious complications unless it is treated. Objectives: in this pilot study, we evaluated whether levels of YKL-40, an acute-phase reactant, and mean platelet volume (MPV), which occurs secondary to inflammation in cellulitis, increase compared to healthy subjects. We also aimed to investigate the association between YKL-40 and MPV in the prognosis of the patients. Material and Methods: A total of 55 patients with cellulitis (23 men and 32 women) and a similar age group of 46 healthy individuals (22 men and 24 women) were included in the study. Cellulitis was diagnosed according to guideline. Serum YKL-40 levels, MPV, C-reactive protein (CRP), and other biochemical values of both groups were compared. Results: YKL-40 levels (52.2 +/- 34.5 ng/mL vs 34.6 +/- 18.0 ng/mL, P = 0.004), MPV (7.7 +/- 1.0 fL vs 6.9 +/- 0.7 fL, P < 0.001), and CRP (9.5 +/- 8.2 mg/dL vs 0.7 +/- 0.6 mg/dL, P < 0.001) were significantly higher in the patients with cellulitis than the control. the mean recovery time (RT) of the patients was 22.6 +/- 6.9 days. We found that YKL-40 (odds ratio [OR] 0.1, confidence interval [Cl] 0.028-0.191, P = 0.009) and MPV (OR 2.4, Cl 0.254-4.578, P = 0.029) have an independent association with RT. Conclusion: YKL-40 and MPV values were correlated with higher CRP in the cellulitis group than in controls. According to these results, increased YKL-40 and MPV levels might be a prognostic factor for cellulitis in patients

The cingulum: a central hotspot for the battle against chronic intractable pain?

Chronic pain causes a major burden on patient’s lives, in part due to its profound socioeconomic impact. Despite the development of various pharmacological approaches and (minor) invasive treatments, a subset of patients remain refractory, hence why alternative targeted neurosurgical interventions like cingulotomy and deep brain stimulation of the anterior cingulate cortex should be considered in the last resort. Despite clinical evidence supporting the potential of these treatments in the management of chronic intractable pain, physicians remain reluctant on its clinical implementation. This can be partially attributed to the lack of clear overviews summarizing existent data. Hence, this article aims to evaluate the current status of cingulotomy and deep brain stimulation of the anterior cingulate cortex in the treatment of chronic intractable pain, to provide insight in whether these neurosurgical approaches and its target should be reconsidered in the current era. In the current study, a literature searches was performed using the PubMed database. Additional articles were searched manually through reviews or references cited within the articles. After exclusion, 24 and 5 articles remained included in the analysis of cingulotomy and deep brain stimulation of the anterior cingulate cortex, respectively. Results indicate that various surgical techniques have been described for cingulotomy and deep brain stimulation of the anterior cingulate cortex. Cingulotomy is shown to be effective 51–53% and 43–64% of patients with neoplastic and non-neoplastic pain at ≤6 months follow-up, and 82% (9/11) and 76% (90/118) at ≥ 12months follow-up, respectively. With regard to deep brain stimulation of the anterior cingulate cortex, no data on neoplastic pain was reported, however, 59% (10/17) and 57% (8/14) of patients with non-neoplastic pain were considered responders at ≤ 6 months and ≥ 12months follow-up, respectively. The most reported adverse events include change in affect (>6.9%, >29/420) and confusion (>4.8%, >20/420) for cingulotomy, and infection (12.8%, 6/47), seizures (8.5%, 4/47) and decline in semantic fluency (6.4%, 3/47) for deep brain stimulation of the anterior cingulate cortex. It can be concluded that cingulotomy and deep brain stimulation of the anterior cingulate cortex are effective last resort strategies for patients with refractory non-neoplastic and neoplastic pain, especially in case of an affective emotional component. Future research should be performed on the cingulum as a neurosurgical target as it allows for further exploration of promising treatment options for chronic intractable pain

Investigation of surfactant protein-D and interleukin-6 levels in patients with blunt chest trauma with multiple rib fractures and pulmonary contusions: a cross-sectional study in Black Sea Region of Turkey

Cure, Medine Cumhur/0000-0001-9253-6459; cure, erkan/0000-0001-7807-135XWOS: 000391303200084PubMed: 27733410Objective: Multiple rib fractures (RFs) and pulmonary contusions (PCs), with resulting systemic lung inflammation, are the most common injuries caused by blunt chest trauma (BCT) in motor vehicle accidents. This study examined levels of the inflammation marker interleukin (IL)-6 and those of the acute-phase reactant surfactant protein (SP)-D in patients with BCT. Design: Prospective, cross-sectional, observational study. Setting: Single-centre, tertiary care hospital in the Black Sea Region of Turkey. Participants: the study included 60 patients with BCT who were hospitalised in our thoracic surgery department. Parameters measures: the SP-D and IL-6 serum levels of patients with RFs (two or more RFs) (n=30) and patients with PCs (n=30) were measured after 6 hours, 24 hours and 7 days, and compared with those of age-matched and gender-matched healthy participants. Results: the 6-hour serum SP-D levels of the RFs (p=0.017) and PCs (p<0.001) groups were significantly higher than those of the healthy controls. the 24-hour and 7-day SP-D levels of both groups were also higher than the control group. the serum IL-6 levels of both groups were significantly higher than those of the control group. We have found Injury Severity Score to be independently related to 6-hour IL-6 (beta=1.414, p<0.001) and 24-hour IL-6 levels (beta=1.067, p<0.001). the development of complications was independently related to 6-hour SP-D level (beta=0.211, p=0.047). Conclusions: RFs and PCs after BCT lead to local and systemic inflammation due to lung injury. the levels of the systemic inflammation marker IL-6 and those of the acute-phase reactant SP-D were elevated in the present study. the SP-D level may be used as a marker in the follow-up of BCT-related complications.Scientific Research Projects of Recep Tayyip Erdogan University [2013.106.02.2]This study was funded by Scientific Research Projects of Recep Tayyip Erdogan University (project number: 2013.106.02.2)

The impact of admission red cell distribution width on long-term cardiovascular events after primary percutaneous intervention: A four-year prospective study

Background: Red cell distribution width (RDW) is an indicator of erythrocyte in different size, and its prognostic value has been demonstrated in numerous cardiac and non-cardiac diseases. The purpose of this study was to evaluate the predictive value of RDW on the long- -term cardiovascular events in patients undergoing primary percutaneous coronary intervention (PCI). Methods: Ninety-six consecutive patients (mean age 60.6 ± 12.5 years, 77.1% male) with ST-segment elevation myocardial infarction (STEMI), who were treated with primary PCI, were analyzed prospectively. Baseline RDW and high sensitive C-reactive protein (hs-CRP) were measured. The patients were followed up for major adverse cardiac events (MACE) for up to 48 months after discharge. Results: There were 30 patients with long-term MACE (Group 1) and 66 patients without long-term MACE (Group 2). Age, admission RDW, hs-CRP and creatine kinase-MB levels, heart rate after PCI, previously used angiotensin converting enzyme inhibitor, left anterior descending artery lesion, and electrocardiographic no-reflow were higher in Group 1. Admission hemoglobin levels were lower in Group 1. An RDW level ≥ 13.85% measured on admission had 80% sensitivity and 64% specificity in predicting long-term MACE on receiver-operating characteristic curve analysis. In multivariate analyses, only admission RDW (HR 5.26, &lt; 95% CI 1.71–16.10; p = 0.004) was an independent predictor of long-term MACE. Conclusions: A high baseline RDW value in patients with STEMI undergoing primary PCI is independently associated with increased risk for long term MACE

The protective effect of infliximab against carbon tetrachloride-induced acute lung injury

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459WOS: 000380177400015PubMed: 27482351Objective(s): Carbon tetrachloride (CCl4) causes pulmonary toxicity. Infliximab (Ib) is a potent inhibitor of tumor necrosis factor-alpha (TNF-alpha). We aimed to investigate whether Ib has a protective effect on CCl4 induced lung injury. Materials and Methods: Rats were divided into control, CCl4, and CCl4+Ib groups. A single dose of 2 ml/kg CCI4 was administered to CCI4 group and a single dose of 7 mg/kg Ib was given to CCl4+Ib group 24 hr before applying CCI4. Results: TNF-alpha, malondialdehyde (MDA), nitric oxide (NO) and caspase-3 levels of the CCl4 group were markedly higher than both the control and CCl4+Ib groups. the CCI4+Ib group had lower histopathological injury than the CCl4 group. Conclusion: Ib as a strong TNF-alpha blocker decreases the production of proinflammatory cytokines, MDA, and oxidative stress leading to a protective effect against CCl4 induced lung tissue injury

Энергетическая дипломатия Китая - среднеазиатское и российское направление

В данной статье рассматривается феномен энергетической дипломатии Китая на современном этапе, его цели, свойства и основные направления. Также, в статье затрагивается актуальная тема российско-китайского энергетического сотрудничества (в частности подписание в 2014 году контракта на поставку российского трубопроводного газа в Китай) и его последствий для развития экономик обеих стран, перспективы обеспечения экономической безопасности Китая и Российской Федерации

Increased mean platelet volume associated with extent of slow coronary flow

Background: Slow coronary flow (SCF) is characterized by delayed opacification of epicardial coronary vessels. SCF can cause ischemia and sudden cardiac death. We investigated the association between presence and extent of SCF, and cardiovascular risk factors and hematologic indices. Methods: In this study, 2467 patients who received coronary angiography for suspected or known ischemic heart disease were retrospectively evaluated between April 2009 and November 2010. Following the application of exclusion criteria, our study population consisted of 57 SCF patients (experimental group) and 90 patients with age- and gender-matched subjects who proved to have normal coronary angiograms (control group). Baseline hematologic indices were measured by the automated complete blood count (CBC) analysis. The groups were evaluated for cardiovascular risk factors and medications. Patients were categorized based on the angiographic findings of vessels with or without SCF. Moreover, patients with SCF were divided into subgroups relative to the extent of SCF. Results: Among the 147 patients (mean age 52.7 &#177; 10.0, 53.7% male), mean platelet volume (MPV) ranged from 6.5 fL to 11.7 fL (median 7.9 fL, mean 8.1 &#177; 0.8 fL). Diabetes (OR = 3.64, 95% CI 1.15&#8211;10.43, p = 0.03), hypercholesterolemia (OR = 4.94, 95% CI 1.99&#8211;12.21, p = 0.001), smoking (OR = 3.54, 95% CI 1.43&#8211;8.72, p = 0.006), hemoglobin (OR = 1.69, 95% CI 1.22&#8211;2.36, p = 0.002), and MPV (OR = 2.52, 95% CI 1.43&#8211;4.44, p = 0.001) were found to be the independent correlates of SCF presence. Only MPV (OR = 2.13, 95% CI 1.05&#8211;4.33, p = 0.03) was identified as an independent correlate of extent of SCF. Conclusions: Elevated baseline MPV value was found to be an independent predictor of the presence and extent of SCF

Clinical applicability of signal heterogeneity and tumor border assessment on T2-weighted MR images to distinguish astrocytic from oligodendroglial origin of gliomas

Background and purpose: Radiological features on magnetic resonance imaging (MRI) were attributed to oligodendroglioma, although the diagnostic accuracy in a real-world clinical setting remains partially elusive. This study investigated the accuracy and robustness of tumor heterogeneity and tumor border delineation on T2-weighted MRI to distinguish oligodendroglioma from astrocytoma. Materials and methods: Eight readers from three different specialties (radiology, neurology, neurosurgery) with varying levels of experience blindly rated 79 T2-weighted MR images of patients with either oligodendroglioma or astrocytoma. After the first reading session, all readers were re-invited for a second reading session within three weeks. Diagnostic accuracy, including area under the receiver operator characteristics curve (AUC), and intra-observer variability and inter-observer variability were used as outcome measures. Results: Pooled sensitivity and specificity to distinguish oligodendroglioma from astrocytoma for the use of tumor heterogeneity were 59.9 % respectively 74.5 %, and 85.7 % respectively 40.1 % for tumor border. A second reading session did not result in a significant change in sensitivity or specificity for tumor heterogeneity (P = 0.752 and P = 0.733, respectively) or tumor border (P = 0.309 and P = 0.271, respectively). An AUC of 0.825 was achieved with regard to predicting oligodendroglial origin of gliomas. Intra-observer agreement ranged from moderate to very good for tumor heterogeneity (kappa-value 0.43–0.87) and tumor border (0.40–0.84). A moderate inter-oberserver agreement was achieved for tumor heterogeneity and tumor border (kappa-value of 0.50 and 0.45, respectively). Conclusion: This study demonstrates that tumor heterogeneity and tumor borders on T2-weighted MRI could be used with moderate Finter-observer agreement to non-invasively distinguish oligodendroglioma from astrocytoma.</p

Atherosclerosis burden and coronary artery lesion complexity in acute coronary syndrome patients

Background: Syntax score (SS) is a prognostic marker in patients with acute coronary sydromes (ACS). Carotid intima media thickness (CIMT) and cardio ankle vascular index (CAVI) are well known surrogate marker of atherosclerosis burden. But association between atherosclerosis burden and coronary artery disease (CAD) complexity in ACS patients has not been investigated yet. Methods and Results: Consecutive patients with first time diagnosis of ACS (n = 172) were enrolled. SS, a marker of CAD complexity, was assessed by dedicated computer software. CIMT was examined by B-mode ultrasound. CAVI was assessed by VaSera VS-1000 cavi instrument. SS for low, intermediate and high tertiles of CIMT value were 10.1 &#177; 8.2 vs 11.4 &#177; &#177; 7.9 and 15.2 &#177; 8.8; p = 0.02). SS for normal, borderline and abnormal CAVI values were 4 &#177; 3.7 vs 11.1 &#177; 7.2 and 14.1 &#177; 9.1, respectively p = 0.009). Also, there was independent association between SS and CIMT (95% coinfidence interval [CI] 2.1&#8211;19, p = 0.014) and CAVI (95% CI 15&#8211;29, p = 0.021]. Neither traditional cardiovascular risk factor nor thrombolysis in myocardial infarction (TIMI) risk score was independent determinant of SS. Conclusions: We have shown that patients with higher atherosclerosis burden have more complex coronary artery lesions. Also these patients may be identified early by using surrogate markers of atherosclerosis. Its clinical significance requires further research