Clinical utility of serum cystatin C in predicting coronary artery disease

Background: There is limited data regarding the clinical utility of cystatin C in patients with stable coronary artery disease (CAD). The aim of this study was to determine the predictive value of cystatin C for the presence and severity of CAD and the association between this protein and other biochemical risk factors for atherosclerosis in patients with suspected CAD. Methods: Ninety-four patients with CAD, and 92 patients without CAD but with cardiovascular risk factors, were included in this study. Echocardiography and other pertinent laboratory examinations were performed. Subjects were divided into four groups according to their cystatin C quartile. Cystatin C groups were analyzed for the association with CAD characteristics. Results: The number of patients with CAD increased as the quartile of cystatin C increased, and there was a remarkable difference between quartiles (p < 0.001). Logistic regression analysis revealed independent predictors of incident CAD as cystatin C, hs-CRP, eGFR, HDL cholesterol and SBP (p = 0.005, p = 0.027, p = 0.017, p = 0.014 and p = 0.001, respectively). Moreover, cystatin C concentration was significantly correlated with CAD severity score (b = 0.258, p < 0.01). A cut-off value of 0.82 mg/L for cystatin C predicted incident CAD with a sensitivity and specificity of 75.5% and 75.0% respectively. Cystatin C concentration also correlated well with the atherosclerotic biochemical risk factors like homocysteine, creatinine and hs-CRP. Conclusions: Cystatin C could be a useful laboratory tool in predicting the presence and severity of CAD in daily practice. It also correlates significantly with biochemical risk factors for CAD, namely homocysteine, low HDL and CRP. (Cardiol J 2010; 17, 4: 374-380

Diyot Lazerle Yapılan Ofis Beyazlatma Tedavisi Sonrası Ozon Uygulamasının Sınıf V Kavitelerde Mikrosızıntı Üzerine Etkisi

Objective: This study investigated the effect of ozone treatment on the microleakage of class V composite restorations after using two different bleaching agents with laser activation. Materials and Methods: Forty non-carious maxillary central incisor teeth extracted for periodontal disease were used and randomly divided into two main groups. Group 1: Bleaching agent including 40% H2O2 was activated with laser (Diode 980 nm, Gigaa Dental Laser Cheese, China). Group 2: Bleaching agent including 35% H2O2 was activated with the same laser. Then, the teeth were randomly divided into two subgroups (n=10). Ten specimens in each subgroup were subjected to ozone treatment (Ozonytron XP-OZ, MIO International, Germany) for 30 seconds, while the remaining left untreated/remainings were control group. After class V cavity preparation on the buccal surfaces, all cavities were filled with composite resin (Filtek Z550, 3M ESPE, USA). Following thermal cycling (5–55°C, 5000×), the specimens were subjected to dye penetration within 0.5% basic fuchsine for 24h. Then, the teeth were sectioned longitudinally to evaluate staining and the depth of staining along with the tooth-restoration interface was recorded with a stereomicroscope.  Results: There were no significant differences between the two bleaching agents in microleakage of restorations (p &gt; 0.05). The ozone treatment didn’t decrease the microleakage values (p &gt; 0.05). There were significant differences among the scores of microleakage at the enamel and gingival margins  (p &lt; 0.05). Conclusion: Ozone treatment did not affect microleakage values of class V composite restorations after dental bleaching

Diyot Lazerle Yapılan Ofis Beyazlatma Tedavisi Sonrası Ozon Uygulamasının Sınıf V Kavitelerde Mikrosızıntı Üzerine Etkisi

Objective: This study investigated the effect of ozone pretreatment on the microleakage of class V composite restorations after using two different bleaching agents with laser activation. Methods: Forty non-carious maxillary central incisor teeth extracted for periodontal disease were included and randomly divided into two main groups (n=20). Group 1: Bleaching agent including 40% H2O2 was activated with laser (Diode 980 nm, Gigaa Dental Laser Cheese, China). Group 2: Bleaching agent including 35% H2O2 was activated with the same laser. Then, the teeth were randomly divided into two subgroups (n=10). Ten specimens in each subgroup were subjected to ozone treatment (Ozonytron XP-OZ, MIO International, Germany) for 30 s, while the remaining untreated specimens were left as control group. Class V cavities were prepared on the buccal surfaces and restored with composite resin (Filtek Z550, 3M ESPE, USA). Following thermal cycling (5–55°C, 5000×), the specimens were kept in 0.5 % basic fuchsine for dye penetration within a period of 24h. Then, the teeth were sectioned longitudinally. The depth of staining along with the tooth-restoration interface was examine under a stereomicroscope and recorded. Results: There were no significant differences between the two bleaching agents in terms of microleakage of restorations (p > 0.05). The ozone pre-treatment didn’t decrease the microleakage values (p > 0.05). Significantly higher microleakage scores were determined at gingival margins compared to occlusal margins (p 0,05). Ozon tedavisi mikrosızıntı değerlerini azaltmadı (p> 0,05). Okluzal marjinlerde, gingival marjinlere oranla anlamlı düzeyde daha fazla mikrosızıntı tespit edildi (p <0,05). Sonuç: Beyazlatma sonrası ozon tedavisi sınıf V kompozit restorasyonların mikrosızıntı değerlerini etkilemedi

Evaluation of Doxorubicin Cardiomyopathy by Signal Averaged Electrocardiography

BACKGROUND: Signal-averaged electrocardiography detects low-amplitude signals designated as late potentials which are strongly related to myocardial damage. We aimed to search for the possible relation between the myocardial effects of doxorubicin and signal-averaged electrocardiographic parameters. METHODS: Fortyeight patients who received doxorubicin included chemotherapy were enrolled. Signal-averaged electrocardiographic parameters were detected by using 3 parameters; filtered QRS (fQRS), the square root of the voltage obtained during the last 40 milliseconds of the duration of fQRS (RMS40), the duration starting from the last 40 miliseconds of fQRS till the decrease of voltage under 40 microvolts. (HFLA40). Ejection fractions of the patients were measured by echocardiographic evaluation. RESULTS: Median age was 44 (27-70) years. Mean cumulative doxorubicin dosage was 475.56&#177;98.45 mg. Mean values of the measured signal-averaged electrocardiographic parameters were as follows; fQRS: 78.27&#177;10.74 miliseconds, RMS40:115.10&#177;50.23 and HFLA was 21.95&#177;8.39 microvolts . The doses of doxorubicin showed a positive correlation with fQRS (r=0.28, p=0.02) and a negative correlation with RMS40 (r=-.31,p=0.03). There was no correlation between the doxorubicin dosage and the ejection fraction of the patients (r=.18, p=0.22). CONCLUSION: Our results suggested that significant correlations are present between fQRS and RMS40 and cumulative doxorubicin dosages. Therefore, signal-averaged electrocardiographic parameters may be of value for predicting the prognosis of the patients who have received doxorubicin included chemotherapy. [Cukurova Med J 2013; 38(2.000): 241-249

Yüksek duyarlıklı C-reaktif protein düzeyleri ve safen ven greft hastalığı arasındaki ilişkinin değerlendirilmesi

Amaç: Bu çalışmada safen ven greft hastalığı (SVGH) ile yüksek duyarlıklı C-reaktif protein (hs-CRP) seviyeleri arasındaki ilişki değerlendirildi. Çalışma planı: Çalışmaya koroner arter baypas greft ameliyatı öyküsü olan, önceden belirlenen objektif kriterlere göre koroner anjiyografi yapılan toplam 78 hasta (54 erkek, 24 kadın; ort. yaş 60.4±9.4 yıl; dağılım 37-78 yıl) dahil edildi. Ateroskleroza neden olan risk faktörleri sorgulandı ve tüm hastaların biyokimyasal testleri çalışıldı. Safen ven greftlerden herhangi birinde %50 ve daha fazla darlık olması SVGH olarak tanımlandı. Hastalar SVGH olan (grup 1) ve SVGH olmayanlar (grup 2) olmak üzere iki gruba ayrıldı. Bulgular: Her iki grubun demografik özellikleri ve laboratuvar değerleri karşılaştırıldığında, grup 1’de vücut kütle indeksi (VKİ), total kolesterol/yüksek yoğunluklu lipoprotein (HDL) kolesterol, ürik asit (ÜA) ve hs-CRP düzeyleri anlamlı oranda yüksek olup, HDL kolesterol düzeyi anlamlı oranda düşüktü. Yapılan çok değişkenli lojistik regresyon analizinde VKİ, ÜA ve hs-CRP düzeylerinin SVGH’yi öngörmede bağımsız belirteçler olduğu tespit edildi (hs-CRP OR: 1.522, p<0.01, ÜA OR: 1.48, p=0.01, VKİ OR: 1.31, p=0.04). Yapılan ROC analizinde hs-CRP düzeyi 0.8 mg/dL ‘‘kesim değeri’’ olarak alındığında %80 duyarlılık ve %85 özgüllük oranı ile SVGH’yi belirlediği bulundu. Sonuç: Çalışmamızda SVGH’yi öngördüren en güçlü belirtecin hs-CRP olduğu saptandı. Yüksek duyarlıklı C-reaktif protein, SVGH varlığını öngörme ve izleminde noninvaziv, güvenilir ve yararlı bir belirteçtir.Background: In this study, we aimed to evaluate the relationship between the levels of high-sensitivity C-reactive protein (hs-CRP) and saphenous venous graft disease (SVGD). Methods: A total of 78 patients (54 males, 24 females; mean age 60.4&plusmn;9.4 years; range 37 to 78 years) with previous history of coronary artery bypass graft (CABG) surgery who underwent coronary angiography based on predetermined objective clinical criteria were included. Risk factors leading to atherosclerosis were questioned and biochemical tests were studied in all patients. A 50% or more stenosis in at least one of the saphenous vein grafts was defined as SVGD. The patients were divided in two groups according to the presence of SVGD (group 1), and the absence of SVGD (group 2). Results: When we compared the demographic characteristics and laboratory findings of both groups, body mass index (BMI), total cholesterol/high-density lipoprotein (HDL) cholesterol ratio, uric acid (UA) and hs-CRP levels were significantly higher, while HDL cholesterol level was significantly lower in group 1. Multivariate logistic regression analysis showed that BMI, UA and hs-CRP levels were independent predictors of SVGD (hs-CRP OR: 1.522, p&lt;0.01, UA OR: 1.48, p=0.01, BMI OR: 1.31, p=0.04). The ROC analysis demonstrated that a 0.8 mg/dL hs-CRP cut-off value indicated SVGH with a 80% sensitivity and 85% specificity rate. Conclusion: In our study, hs-CRP was found to be the most powerful predictor of SVGD. High-sensitivity-C-reactive protein is a noninvasive, reliable and useful parameter in the prediction and monitoring of SVGD