Vitamin D deficiency in pregnancy may affect fetal thymus development

Objectives: The aim of our study was to evaluate the association of vitamin D deficiency (VDD) during pregnancy with thymus size in full-term fetuses. Material and methods: In this prospective study, we evaluated mid-pregnancy serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations. The fetal thymus size was measured by ultrasound in the third trimester. Neonatal 25(OH)D3 levels were evaluated by umbilical cord blood sampling. Correlation of maternal and neonatal vitamin D levels and association between thymus size and both, maternal and neonatal vitamin D concentrations were investigated. Results: Serum 25(OH) D3 concentrations were within the normal range in 48 (29.8%) mothers and 10 (13.1%) new­borns. A strong correlation between mid-pregnancy maternal and neonatal 25(OH)D3 concentration (r = 0.8, p < 0.001) was found. A significant linear correlation was observed between both, maternal and neonatal 25(OH)D3 concentrations and thymus perimeter length (r = 0.45, p = 0.04 and r = 0.43, p < 0.01, respectively). Both, maternal and fetal VDDs were associated with decreased thymus perimeter (p = 0.04, p = 0.03). Conclusions: Vitamin D deficiency during pregnancy may be associated with smaller fetal thymus. Our data suggest that VDD in pregnancy may lead to systemic inflammatory response in the fetus

A rare manifestation of achalasia: Huge esophagus causing tracheal compression and progressive dyspnea

Achalasia is a primary esophageal motility disorder characterized by the absence of primary peristalsis and a failure of the lower esophageal sphincter to relax, resulting in a dilated esophagus. Dysphagia is the classic and most common symptom. Respiratory obstruction due to tracheal compression caused by a massively dilated esophagus is a very rare but fatal complication. Herein, we report a case of a patient with long-stand- ing achalasia who had tracheal compression secondary to a markedly dilated, giant esophagus. These findings are documented with CT scans. His symptoms regressed after a Heller myotomy and fundoplication operation.Akalazya, özofagusta genişlemeye yol açan, alt özofageal sfinkterin gevşeme boukluğu ve özofagusta primer peristaltizm yokluğuyla karakterize özofageal motilite hastalığıdır.Disfaji en sık rastlanan yakınmadır. Massif olarak genişleyen özofagusun trakeaya basısı sonucu oluşan solunumsal obstrüksiyon, çok nadir ancak ölümcül bir komplikasyondur.Burada ileri derecede dilate, dev özofagusun yol açtığı trakeal kompresyonu olan uzun süredir akalazya tanısı alan olguyu sunuyoruz. Hastanın semptomları laparoskopik Heller myotomi operasyonu sonrasında gerilemiştir.Bulgular Bilgisayarlı Tomografi incelemesiyle dökümante edilmiştir

Effects of the Degree of Obesity on Achieving Target Blood Pressure and Metabolic Deterioration in Obese Individuals: A Population-Based Study

Background/Aims: This study aimed to evaluate the severity of obesity and its impact on achieving target blood pressure and metabolic derangement in obese individuals. Methods: This cross-sectional and population-based study was conducted between January and December 2012. A total of 1837 consecutive obese patients admitted to our outpatient clinic were enrolled. The anthropometric and blood pressure measurements, bioelectrical impedance fat analysis, blood sample analysis, impaired glucose status, metabolic syndrome, and insulin resistance of 1265 obese patients were compared between groups of patients separated by severity of obesity. Results: Only approximately one-third of patients with previous hypertension achieved normal blood pressure. In addition, the majority of patients without previous hypertension had higher blood pressure at the end of the study compared with baseline. The percent of patients with an impaired fasting blood glucose ≥100 mg/dL was 38.5%. The frequency of impaired glucose tolerance was 39.1% in the patients who underwent OGTT Body mass index (BMI) was associated with impaired blood glucose, hypertension, insulin resistance, and the development of metabolic syndrome. The incidences of metabolic syndrome, insulin resistance, impaired glucose tolerance, and uncontrolled blood pressure were significantly different between groups of differing obesity severity (ppp=0.041, and pConclusion: The severity of obesity was associated with the failure to achieve target blood pressure and metabolic syndrome. Based on our data, blood pressure and metabolic parameters in obese patients should be monitored frequently and treated with caution