Endothelial function in patients with familial Mediterranean fever-related amyloidosis and association with cardiovascular events

Objectives. Secondary amyloidosis is the most important complication of FMF and endothelial function is more severely impaired. Elevated asymmetric dimethyl arginine (ADMA) may mediate the excess cardiovascular disease (CVD) risk of this group. We aimed to compare endothelial function characteristics, including ADMA, in patients with FMF-related amyloidosis and primary glomerulopathies and to define risk factors for a CVD event. Methods. We undertook a cross-sectional study with prospective follow-up including consecutive patients with FMF-related amyloidosis (n = 98) or other non-diabetic glomerulopathies (n = 102). All patients had nephrotic-range proteinuria and normal glomerular filtration rate. Flow-mediated dilatation (FMD) was assessedand ADMA levels, CRP and pentraxin 3 (PTX3) were determined. Patients were followed for cardiovascular events. Results. Amyloidosis patients secondary to FMF showed higher levels of ADMA, CRP and PTX3 and lower FMD as compared with patients with other glomerulopathies. Cardiovascular events (n = 54) were registered during 3 years of follow-up. Increased ADMA levels and lower FMD were observed in patients with cardiovascular risk in both groups, but especially in individuals with amyloidosis.Conclusion. Patients with FMF-related amyloidosis have increased CVD event risk, probably related to the high ADMA levels, elevated inflammatory markers and decreased FMD measures observed in these patients

Processing forced vibration test records of structural systems using the analytic signal

This article presents the use of the analytic signal procedure for processing the large volume of structural vibration data recorded in forced vibration tests. The analytic signal facilitates the computationally laborious task of extracting the steady-state amplitude for each response measure of interest from the recorded accelerations throughout the building at each operated frequency of the forced vibration source. The implementation of the signal processing procedure introduced here is illustrated in deriving the acceleration-frequency response curves from the forced vibration test of the first permanently instrumented building in Turkey. This reinforced concrete building, subsequently strengthened with cast-in-place reinforced concrete infill shear walls, is located in close proximity to the North Anatolian Fault. Later, system identification of the building yields the in situ structural system dynamic properties for the first translational and torsional vibration modes, which are compared with those identified from the ambient vibrations of the building recorded following its forced vibration test. The analytic signal procedure is a convenient tool for the rapid and correct derivation for mode shapes and associated frequencies and damping ratios from forced vibration testing of structural systems

Performance limits for structural walls: An analytical perspective

Recently proposed changes to modeling and acceptance criteria in seismic regulations for both flexure and shear dominated reinforced concrete structural walls suggest that a comprehensive examination is required for improved limit state definitions and their corresponding values. This study utilizes nonlinear finite element analysis to investigate the deformation measures defined in terms of plastic rotations and local concrete and steel strains at the extreme fiber of rectangular structural walls. Response of finite elements models were calculated by pushover analysis. We compare requirements in ASCE/SEI 41, Eurocode 8 (EC8-3) and the Turkish Seismic Code (TSC-07). It is concluded that the performance limits must be refined by introducing additional parameters. ASCE/SEI 41 limits are observed to be the most accurate yielding conservative results at all levels except low axial load levels. It is shown that neither EC8-3 nor TSC-07 specifies consistent deformation limits. TSC-07 suggests unconservative limits at all performance levels, and it appears to fall short of capturing the variation reflected in the calculated values. Likewise EC8-3 seems to fail to represent the variation in plastic rotation in contrast to several parameters employed in the calculation. More accurate plastic rotation limits are proposed

Sarcophaga’nın Neden Olduğu İki Orta Kulak Miyazı Olgusu

Miyazis, omurgalı canlıların dokularında sinek larvalarının yerleşmesiyle oluşan infektif bir durumdur. Bu sunuda orta kulak miyazı ve etken sineklerin türlerinin belirlenmesi amaçlanmıştır. Laboratuara % 10 formaldehit ve serum fizyolojik içerisinde gönderilen larvalar stereo-mikroskop (Olympus 10X) ile incelenmiştir. Canlı larvaların bir kısmı erişkin hale getirilerek larva evresindeki ve erişkin haldeki özelliklerinden yararlanılarak tanımlanmıştır. Larvaların ve erişkin hale getirilen sineğin Sarcophaga sp. olduğu belirlenmiştir. Her iki hastada da orta kulak miyazına neden olan sinek türünün Sarcophaga sp. olduğu saptanmıştır

Dynamic thiol-disulfide homeostasis is disturbed in hepatitis B virus-related chronic hepatitis and liver cirrhosis

WOS:000452889200014PubMed ID: 30384565Background/aim: Thiol-disulfide homeostasis is an important antioxidant defense mechanism. This study was conducted to investigatedynamic thiol-disulfide homeostasis in patients with hepatitis B virus-related chronic hepatitis and liver cirrhosis.Materials and methods: Seventy-one treatment-naive patients with chronic hepatitis B (CHB), 50 patients with hepatitis B virusassociated liver cirrhosis, and 45 healthy controls were included in the study. Serum total and native thiol concentrations and serumdisulfide concentrations were measured using an automated method.Results: Mean serum total thiol concentrations in the control, CHB, and cirrhosis groups were 481.64 37.87 µmol/L, 438.50 71.35µmol/L, and 358.07 80.47 µmol/L, respectively (P 0.001), and mean serum native thiol concentrations in the control, CHB, andcirrhosis groups were 452.92 36.43 µmol/L, 400.16 65.92 µmol/L, and 328.15 74.91 µmol/L, respectively (P 0.001). Mean serumdisulfide concentrations in the control, CHB, and cirrhosis groups were 14.38 3.38 µmol/L, 19.19 6.16 µmol/L, and 14.98 5.53µmol/L, respectively (P 0.001). There was a progressive decrease in both mean serum native and total thiol concentrations parallel tothe liver fibrosis stage.Conclusion: : Thiol-disulfide homeostasis is disturbed in patients with hepatitis B virus-related chronic hepatitis and liver cirrhosis

Comparison of a Newly Developed Automated and Quantitative Hepatitis C Virus (HCV) Core Antigen Test with the HCV RNA Assay for Clinical Usefulness in Confirming Anti-HCV Results

Hepatitis C virus (HCV) is a global health care problem. Diagnosis of HCV infection is mainly based on the detection of anti-HCV antibodies as a screening test with serum samples. Recombinant immunoblot assays are used as supplemental tests and for the final detection and quantification of HCV RNA in confirmatory tests. In this study, we aimed to compare the HCV core antigen test with the HCV RNA assay for confirming anti-HCV results to determine whether the HCV core antigen test may be used as an alternative confirmatory test to the HCV RNA test and to assess the diagnostic values of the total HCV core antigen test by determining the diagnostic specificity and sensitivity rates compared with the HCV RNA test. Sera from a total of 212 treatment-naive patients were analyzed for anti-HCV and HCV core antigen both with the Abbott Architect test and with the molecular HCV RNA assay consisting of a reverse transcription-PCR method as a confirmatory test. The diagnostic sensitivity, specificity, and positive and negative predictive values of the HCV core antigen assay compared to the HCV RNA test were 96.3%, 100%, 100%, and 89.7%, respectively. The levels of HCV core antigen showed a good correlation with those from the HCV RNA quantification (r = 0.907). In conclusion, the Architect HCV antigen assay is highly specific, sensitive, reliable, easy to perform, reproducible, cost-effective, and applicable as a screening, supplemental, and preconfirmatory test for anti-HCV assays used in laboratory procedures for the diagnosis of hepatitis C virus infection

Duodenal varices diagnosed by endoscopic ultrasound: A case report

Portal hypertension and associated complications cause significant morbidity and mortality in cirrhotic patients. Variceal development is the most important portal hypertension related complication. Varices most commonly occur around the gastroesophageal junction, but ectopic varices may develop in many gastrointestinal and extra-gastrointestinal localizations. Duodenum is one of the most common localizations for ectopic varices. Diagnosis of duodenal varices is usually made by upper gastrointestinal endoscopy, but endoscopic appearance is not diagnostic and usually further investigations are required in order to make accurate diagnosis. Endoscopic ultrasound is the gold standard method for the examination of gastrointestinal submucosal lesions therefore it is alsouseful in the work up of suspected duodenal varices. Here we present a patient with cryptogenic liver cirrhosis followed in our clinic, whom duodenal lesions suspected of duodenal varices were noticed during upper gastrointestinal endoscopic examination and endoscopic ultrasound was used to confirm the presence of duodenal varices

Transfusion Related Acute Lung Injury After Iatrogenic Intrabdominal Bleeding: A Case Report

Birçok hastanın çeşitli nedenlerle kan transfüzyonuna ihtiyacı olmaktadır. Transfüzyonla ilişkili akut akciğer hasarı (TRALI) hayati risk taşıyabilen önemli bir komplikasyon olup transfüzyonla ilişkili ölümlerin en sık nedenidir. TRALI bir tür akut non-kardiyojenik akciğer ödemi tablosudur. TRALI tanısı Ulusal Kalp-Akciğer ve Kan Enstitüsü Çalışma Gurubu (NHLBI) ya da Kanada Konsensus Toplantısı Kriterleri'ne göre konur. Tanı için akut hipoksi gelişimini gösteren parsiyel arteryel oksijen basıncının, solunan havanın fraksiyonel oksijen konsantrasyonuna oranının 300 mmHg'nın altında olması ya da oda havası solurken oksijen satürasyonunun %90 olması parametreleri ile akciğer grafisinde bilateral infiltrasyon varlığı ve volüm yüklenmesi bulgularının olmaması gereklidir. Burada, tanısal parasentez sonrası iyatrojenik intra-abdominal kanama gelişen ve taze donmuş plazma transfüzyonuna bağlı TRALI ortaya çıkan bir olgu sunulmuştur.Many patients need transfusion of blood products for various reasons. Transfusion-related acute lung injury (TRALI) is an important and potentially fatal complication which is the leading cause of transfusion-related deaths. It is a form of acute non-cardiogenic pulmonary edema. It can be diagnosed according to the National Heart Lung and Blood Institute (NHLBI) Working Group or the Canadian Consensus Conference criteria. Diagnosis requires an acute onset of hypoxemia with a ratio of partial pressure of arterial oxygen to fractional inspired oxygen concentration (PaO2/FiO2) less than 300 mmHg or oxygen saturation of >90% in room air associated with bilateral infiltrates on frontal chest radiograph in the absence of signs of circulatory overload. Herein, we present a 59-year-old male case with iatrogenic intraabdominal bleeding due to paracentesis who developed TRALI following fresh frozen plasma transfusion