Chemerin as a marker of subclinical cardiac involvement in psoriatic patients

Background: Chemerin has been associated with psoriasis and inflammation, but there are no studies demonstrating an association between chemerin and subclinical cardiac involvement in psoriatic patients. Therefore, the present study aimed to evaluate whether psoriatic patients with increased epicardial fat tissue, impaired flow-mediated dilatation, and diastolic dysfunction have higher serum chemerin levels than a healthy control group. Methods: The study included 60 psoriatic patients and 32 healthy controls. Echocardiographic parameters, epicardial fat tissue, flow-mediated dilatation, and chemerin levels were recorded for both groups. Results: The serum levels of chemerin in the psoriatic patients were significantly higher than in the control group. The diastolic function parameters, including isovolumic contraction and relaxation time, E’/A’ (early diastolic mitral annular velocity/late diastolic mitral annular velocity), and E/E’ (early diastolic peak velocity of mitral inflow/early diastolic mitral annular velocity) values, differed significantly between the groups. Epicardial fat tissue was significantly higher and flow-mediated dilatation was significantly lower in psoriatic patients than in the controls. Chemerin was significantly positively correlated with age, body mass index, systolic and diastolic blood pressures, waist circumference, E/E’, and epicardial fat tissue. Serum chemerin was significantly negatively correlated with E’, E’/A’, and flow-mediated dilatation. A multiple linear regression analysis showed that chemerin was independently correlated with E/E’. Conclusions: Psoriatic patients exhibit early subclinical atherosclerosis and diastolic dysfunction. Chemerin can be used as a marker to screen for patients with subclinical cardiac involvement

Acute torsion of the gallbladder: a case report

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Problems encountered in conventional HIV 1/2 Algorithms: lack of necessity for immunoblot assays to confirm repeated ELISA reactive results

Background: The use of conventional (serologically based) HIV 1/2 diagnostic algorithms has become controversial in recent years.Objectives: Sera from patients who underwent verification tests were evaluated because repeated ELISA-reactive results demonstrated a HIV1+HIV2 positive band pattern.Methods: The line immunoassay (LIA) test was used for repeated HIV enzyme immunoassays (EIA)-reactive sera in patients at three centers. The Bio-Rad Geenius™ HIV 1/2 and the HIV-1 RNA tests were used. HIV-1 and RNA HIV-2 were investigated using PCR.Results: LIA was used to evaluate 3,224 out of 10,591 samples with repeated ELISA reactivity (30%). We found that 32 (1%) of the sera, along with HIV1 bands and HIV2 gp36 bands, were positive. Only 28 of the 32 verified serum samples with gp36 bands were repeated, and no gp36 band positivity was detected using the Bio-Rad Geenius™ HIV-1/2 confirmatory assay in these serum samples. The HIV-2 proviral DNAs were also negative. Therefore, we excluded the possibility of HIV1+2 co-infection. All samples from the 32 patients were positive for HIV-1 RNA.Conclusion: Our findings highlight the need to exclude confirmatory tests like the LIA test from the current diagnostic HIV algorithm and replace it with rapid HIV-1 and HIV-2 confirmatory immunochromotographic tests.Keywords: HIV, AIDS, HIV-2

Problems encountered in conventional HIV 1/2 Algorithms: lack of necessity for immunoblot assays to confirm repeated ELISA reactive results

Background: The use of conventional (serologically based) HIV 1/2 diagnostic algorithms has become controversial in recent years. Objectives: Sera from patients who underwent verification tests were evaluated because repeated ELISA-reactive results demonstrated a HIV1+HIV2 positive band pattern. Methods: The line immunoassay (LIA) test was used for repeated HIV enzyme immunoassays (EIA)-reactive sera in patients at three centers. The Bio-Rad Geenius\u2122 HIV 1/2 and the HIV-1 RNA tests were used. HIV-1 and RNA HIV-2 were investigated using PCR. Results: LIA was used to evaluate 3,224 out of 10,591 samples with repeated ELISA reactivity (30%). We found that 32 (1%) of the sera, along with HIV1 bands and HIV2 gp36 bands, were positive. Only 28 of the 32 verified serum samples with gp36 bands were repeated, and no gp36 band positivity was detected using the Bio-Rad Geenius\u2122 HIV-1/2 confirmatory assay in these serum samples. The HIV-2 proviral DNAs were also negative. Therefore, we excluded the possibility of HIV1+2 co-infection. All samples from the 32 patients were positive for HIV-1 RNA. Conclusion: Our findings highlight the need to exclude confirmatory tests like the LIA test from the current diagnostic HIV algorithm and replace it with rapid HIV-1 and HIV-2 confirmatory immunochromotographic tests

Brief Report: Deficiency of Complement 1r Subcomponent in Early-Onset Systemic Lupus Erythematosus: The Role of Disease-Modifying Alleles in a Monogenic Disease

Objective: To identify a genetic cause of early-onset systemic lupus erythematosus (SLE) in a large consanguineous family from Turkey and to study the mechanisms of the disease. Methods: We performed whole-exome sequencing and single-nucleotide polymorphism array genotyping in family members with and without SLE. Protein and gene expression, cytokine profile, neutrophil extracellular trap (NET) formation, and presence of low-density granulocytes were evaluated in patient primary cells and serum samples. Results: We identified a novel, homozygous, loss-of-function mutation (p.Pro445Leufs*11) in the C1R gene. Using the Sanger method of DNA sequencing in 14 family members, we confirmed the presence of the mutation in 4 patients with SLE and in an asymptomatic 9-year-old girl. Complement levels were low in sera from patients with truncated C1r protein. Two siblings with SLE who were available for detailed evaluation exhibited strong type I interferon (IFN) inflammatory signatures despite their disease being clinically inactive at the time of sampling. The type I IFN transcriptional signature in the patients’ blood correlated with disease expressivity, whereas the neutrophil signature in peripheral blood mononuclear cells was likely associated with disease severity. The female patient with SLE with the most severe phenotype presented with a stronger neutrophil signature, defined by enhanced NET formation and the presence of low-density granulocytes. Analysis of exome data for modifying alleles suggested enrichment of common SLE-associated variants in the more severely affected patients. Lupus-associated HLA alleles or HLA haplotypes were not shared among the 4 affected subjects. Conclusion: Our findings revealed a novel high-penetrance mutation in C1R as the cause of monogenic SLE. Disease expressivity in this family appears to be influenced by additional common and rare genetic variants

Beginning Spring

Get up to speed quickly with this comprehensive guide toSpring Beginning Spring is the complete beginner's guide toJava's most popular framework. Written with an eye towardreal-world enterprises, the book covers all aspects of applicationdevelopment within the Spring Framework. Extensive samples withineach chapter allow developers to get up to speed quickly byproviding concrete references for experimentation, building askillset that drives successful application development byexploiting the full capabilities of Java's latest advances. Spring provides the exact toolset required to build anen

The Effect of the Use of Synthetic Mesh Soaked in Antibiotic Solution on the Rate of Graft Infection in Ventral Hernias: A Prospective Randomized Study

Wound infections and seroma formations are important problems in ventral hernia repair operations using synthetic mesh grafts. The aim of this study was to investigate the effect of the use of synthetic mesh soaked in vancomycin solution on the rate of graft infection. The total number of subjects was 52. The subjects were randomized into 2 groups using a software program. Group 1 (n = 26) was the control group. In group 2 (n = 26), synthetic mesh was soaked in a Vancomycin solution before it was implanted. The patients were compared with respect to demographic characteristics and preoperative, intraoperative, and postoperative variables. There were no significant differences between the groups with respect to the available variables. Seroma development was significantly more common in group 2 (P < 0.041). Three patients (5.7%) developed superficial wound infection, and 9 (17%) developed surgical site infection 2-type wound-site infection. No significant difference was found between the groups in terms of infection. The use of synthetic mesh soaked in vancomycin solution had no beneficial effects on the rate of wound-site infection. Future randomized, controlled, large-scale studies using the same mesh and suture types, and meshes soaked in larger spectrum antibiotics are needed

Can red cell distribution width be used as a predictor of acute cholecystitis?

Objective: Acute cholecystitis is a common disease requiring accurate markers for diagnosis and proper treatment. The aim of this study was to investigate the role of red cell distribution width (RDW) in acute cholecystitis. Material and Methods: 299 were included in the study. The subjects were divided into 2 groups; group 1 (n: 46) acute cholecystitis group and group 2 (n:253) chronic cholecystitis group. The patients were compared with respect to demographic characteristics, white blood cell count, C-reactive protein, and red cell distribution width. Results: A statistically significant difference was observed between groups with respect to gender, white blood cell count, C-reactive protein, and red cell distribution width level (p<0.05). The mean red cell distribution width level of group 1 and 2 was 14.19 +/- 2.02% and 15.03 +/- 2.51%, respectively. Conclusion: Red cell distribution width level can be used as a predictor of acute cholecystitis. Multicenter prospective studies should be performed to elucidate the exact role of RDW level in acute cholecystitis

Laparoscopic Repair of Morgagni Hernia

Morgagni hernia is a congenital herniation of abdominal contents into the thoracic cavity through a retrosternal diaphragmatic defect and make up about 1 % - 5 % of all types of congenital diaphragmatic hernias. Surgical repair of Morgagni hernias is usually indicated when patients are symptomatic and have a high risk of strangulation or incarceration of the contained viscera. 71-year-old male patient admitted to emergency department with a 2-day history of abdominal pain, vomiting and obstipation. Laparoscopic repair for Morgagni hernia was performed. Laparoscopic repair for Morgagni hernia with mesh repair is secure, satisfactory and easily performed

Long-term results of retromuscular hernia repair: a single center experience

Introduction: Incisional hernia (IH) is one of the most frequent postoperative complications after abdominal surgery. There are multiple surgical techniques described for IH repair. The aim of the study is to evaluate the effect of primary fascial closure on long-term results in retromuscular hernia repair (RHR) for incisional hernias. Methods: A total of 132 patients underwent RHR for IH were included in our study. 109 patients were evaluated in 2009 and 55 patients in 2015 for short and long-term results. Results: Among 132 patients perfromed RHR, fascia was closed in 107 (81%) and left open in 25 (19%) patients. The mean age of patients was 57.9 +/- 11.8 years. Average mesh area was 439.8 +/- 194.6 cm(2), hernia area was 112 +/- 77.5 cm(2) and open area after repair was 40.8 +/- 43.3 cm(2). Mean follow-up of 104 patients regarding postoperative complications evaluated in 2009 was 30.7 +/- 14.1 months. Recurrent IH was observed in 6 (4.5%) patients according to data collected in 2009. Long-term results were; mean follow-up period was 91 +/- 20.2 months (20-112 months) and recurrent IH was observed in 4 (7.3%) patients. Conclusion: Retromuscular repair for incisional hernia regardless of the fascial closure gives high patient satisfaction, less recurrence rates and complications in long-term follow-up