Peripapillary retinal nerve fibre layer thickness in women with iron deficiency anaemia

WOS: 000349116500011PubMed: 25476798Objective To evaluate peripapillary retinal nerve fibre layer (RNFL) thickness in adult women with iron deficiency anaemia and healthy control subjects. Methods Women with iron deficiency anaemia and age- and sex-matched healthy control subjects were sequentially recruited and underwent detailed ophthalmic examination, including spectral-domain optical coherence tomography (OCT). Serum haemoglobin (Hb), iron and ferritin concentrations, total iron-binding capacity (TIBC) and mean corpuscular volume were determined. Results Peripapillary RNFL thicknesses in the nasal and inferior quadrants were significantly smaller in patients (n=40) than in controls (n=40). in the patient group, there were significant correlations between inferior quadrant RNFL thickness and Hb, and between nasal quadrant RNFL thickness and serum iron and ferritin concentrations, and TIBC. Conclusion Iron deficiency anaemia reduces RNFL thickness in adult women

COVID-19 cases with acute necrotizing pancreatitis

COVID-19 is a multisystemic condition that presents with different signs and symptoms. Studies conducted have shown that it shows its effect on different tissues through Angiotensin Converting Enzyme 2 receptors. In particular, gastrointestinal system symptoms have started to attract more attention. We present two COVID-19 cases, aged 82 and 70, presenting with acute pancreatitis without any other risk factors. An 82-year-old female patient had a fatal outcome despite the treatment, while a 70-year-old female patient was discharged for outpatient follow-up. While COVID-19 patients are typically admitted with symptoms of respiratory system, some patients may have symptoms such as nausea-vomiting, diarrhoea and abdominal pain

Syncope in a patient with spontaneous hemorrhage into a thyroid nodule

cure, erkan/0000-0001-7807-135X; Belice, Tahir/0000-0001-7957-3423WOS: 000341562700017PubMed: 25336885Background: Spontaneous hemorrhage into a thyroid nodule occurs exceedingly rare and rarely a neck hematoma can develop. We report a case of syncope due to spontaneous hemorrhage into a thyroid nodule during anticoagulant and antithrombotic therapy. Case presentation: A 64-year-old man was transferred to the emergency department of our hospital because of syncope. His physical examination revealed a 7 x 5 cm hard and painless mass at the left neck region. the neck MRI confirmed a heterogeneous, hyperintense mass in the left lobe of thyroid compressing the trachea and left common carotid artery, internal jugular vein, and vagus nerve bundle. He did not require a surgery in the follow-up. As the hematoma underwent subtotal shrinkage, he remained well without syncope. Conclusion: Hemorrhage into a thyroid nodule should always be considered in patients presenting with neurally mediated syncope

The perspective of emergency department professionals on patients rights

Amaç: Hasta hakları; insan haklarının bir alt başlığını oluşturur ve insanoğlunun doğumdan itibaren kazandığı temel haklar arasında yer almaktadır. Bu çalışmada, sağlık hizmetlerinin kalitesi ve hasta memnuniyetinde önemli yeri olan hasta hakları konusunda, Rize ilinde ikinci basamak sağlık hizmeti veren hastanelerin acil servislerinde görev yapan tüm personelin bilgi düzeyi ve tutumlarının değerlendirilmesi amaçlanmıştır. Yöntem: Çalışma, Temmuz-Ağustos 2009 tarihleri arasında Rize ili genelinde ikinci basamak sağlık hizmeti veren hastanelerin acil servislerinde hizmet veren 390 personelin 235’nin (%60,2) gönüllü olarak katılımı ile ‘Hasta Hakları Yönetmeliği’ temel alınarak hazırlanan anket formunun doldurulması ile gerçekleştirildi. Elde edilen veriler ‘SPSS for Windows 17’ bilgisayar programına aktarılarak ortalama, frekans, standart sapma ve ki-kare istatistiksel analiz yöntemleri kullanılmıştır. İstatistiksel olarak p<0,05 değeri anlamlı olarak kabul edildi. Bulgular: Çalışmaya katılan grubunun %62,1’i (n=146) erkek cinsiyette ve %35,7’si (n=84) 26-30 yaş grubuna dâhildi. Çalışma sürelerine bakıldığında %34,5’i (n=82) 13-36 aydır acil serviste hizmet verdiği ve personelin %72,3’ünün (n=170) acil serviste isteyerek çalıştığı tespit edilmiştir. Hasta hakları ile ilk karşılaşmaları sorgulandığında %48,9’u (n=115) hizmet içi eğitim olarak görüş bildirmiştir. Hasta hakkı denildiğinde çalışanların aklına ilk gelen hasta hakkı hizmete ulaşılabilme eşitliği %40,4 (n=95) olarak tespit edilmiştir. Sonuç: Hasta hakları, kaliteli sağlık hizmetlerinin sunumuna olanak sağlayacak daha iyi bir ortamın sağlanması için hasta, hastane personeli ve hastane yönetiminin birlikte sahip çıkması gereken haklardır.Objective: Patient rights are a sub-heading of human rights and are one of the fundamental rights of human beings gained from birth. The aim of this study was to evaluate knowledge and attitudes of all personnel working in emergency departments of second healthcare hospitals of Rize province towards patient rights, which is an important aspect of the quality of healthcare and patient satisfaction. Methods: The study was conducted in July-August 2009 in the emergency departments of the second healthcare hospitals of Rize province by participation of 390 professionals 235 (60.2%) of them were volunteer to fill a survey performed in the basis of Patient Rights Directive. The obtained data were analyzed with the SPSS for Windows 17.0 software program; statistical analytic methods were used such as average, frequency, standard deviation and k-square, p<0.05 was accepted as statistically significant. Results: A total of 62.1% (n=146) of the study participants were males and 35.7% (n=84) were included in the 26-30 years age group. Regarding the period of working 34.5% (n=82) of the subjects were working for 13-36 months in the emergency department and 72.3% (n=170) of them was found to be willingly working in this department. When questioned about their first encounter with the patient rights 48.9% (n=115) of them answered as in-service training. When asked about the first to come to mind regarding patient rights 40.4% (n=95) of the subjects answered as equality of access to services Conclusion: Patient rights should be defended by patients, hospital staff and hospital management to allow the provision of quality health services to ensure a better environment for patients

The impact of fasting during Ramadan on the glycemic control of patients with type 2 diabetes mellitus

WOS: 000325635000004PubMed: 23934679Background: Millions of Muslims fast from dawn until dusk during the annual Islamic holy month of Ramadan. Most of the studies evaluating biochemical changes in diabetic patients during Ramadan showed little changes in the glycemic control. in this study, our aim was to assess the impact of fasting during Ramadan on glycemic control in patients with type 2 diabetes. Methods and design: We examined 122 patients with type 2 diabetes (82 female, 40 male, age 56.93 +/- 9.57 years) before and after the Ramadan. 66.4% of the patients were treated with oral antidiabetic (OAD) alone, 6.5 % with a combination of insulin plus OAD and 19.7 % with insulin alone. 88 of 122 patients fasted during Ramadan (26.98 +/- 5.93 days). Weight, body mass index (BMI), waist circumference, blood pressure, fasting plasma glucose (FPG), postprandial glucose (PPG), fructosamine, HbA1c, fasting insulin and lipid parameters were measured. Results: the frequencies of both severe hyperglycemia and hypoglycemia were higher in the fasting group, but the difference was not significant (p = 0.18). Weight, BMI, waist circumference, blood pressure, FPG (143.38 +/- 52.04 vs. 139.31 +/- 43.47 mg/dl) PPG (213.40 +/- 98.56 vs. 215.66 +/- 109.31 mg/dl), fructosamine (314.18 +/- 75.40 vs. 314.49 +/- 68.36 mu mol/l), HbA1c (6.33 +/- 0.98 vs. 6.22 +/- 0.92 %) and fasting insulin (12.61 +/- 8.94 vs. 10.51 +/- 6.26 mu U/ml) were unchanged in patients who fasted during Ramadan. Microalbuminuria significantly decreased during Ramadan (132.85 +/- 197.11 vs. 45.03 +/- 73.11 mg/dl). Conclusions: in this study, we concluded that fasting during Ramadan did not worsen the glycemic control of patients with type 2 diabetes

Serum macrophage migration inhibitory factor levels in Hashimoto's thyroiditis; a case control study

Objective: The cell-mediated immune process by CD4+ and CD8+ lymphocyte subsets of T-cells has a major role in the pathogenesis of Hashimoto's thyroiditis (HT). However, the exact mechanisms of initiation and progression of thyroid autoimmunity have not been completely clarified yet. Macrophage migration inhibitory factor (MIF) is commonly recognized as playing vital roles in various autoimmune diseases. Ee aimed to investigate serum MIF levels in subjects with HT and correlate them with the level of thyroid hormones and autoantibodies. Materials and methods: This study included 93 patients with untreated Hashimoto's thyroiditis and 53 healthy controls. We measured serum levels of TSH, free T4 (FT4), free T3 (FT3), anti-Thyroglobulin autoantibody (TGAb) and anti-Thyroid peroxidase autoantibody (TPOAb) in all patients and thyroid ultrasonography was performed. The concentration of MIF was measured using enzyme-linked immunosorbent assay (ELISA) method. Results: We enrolled 93 patients with HT (mean age; 31.3 ± 11.1 years), and 53 healthy control group (mean age; 29.3 ± 8.5 years) in the current study. The patient group consisted of 52 with euthyroid autoimmune thyroiditis, 31 with subclinical hypothyroidism and 10 with overt hypothyroidism. Serum levels of MIF were higher in patients with overt hypothyroidism (6300.9 ± 2504.3 pg/ml) than the euthyroid patients (3955.2 ± 3013.6 pg/ml) (p = 0.036). Conclusion: MIF increases in overt hypothyroidism due to the Hashimoto's thyroiditis. Further investigations are needed to explore the role of MIF in pathogenesis of Hashimoto's thyroiditis. © 2014 Ayaz et al

The relationship of plasma catestatin concentrations with metabolic and vascular parameters in untreated hypertensive patients: Influence on high-density lipoprotein cholesterol

Objective: Catestatin has several cardiovascular actions, in addition to diminished sympatho-adrenal flow. Decreased plasma catestatin levels may reflect a predisposition for the development of hypertension and metabolic disorders. We planned to investigate the possible roles of catestatin in untreated hypertensive patients. As a secondary objective, we compared catestatin concentrations of healthy subjects with those of hypertensive patients in order to understand whether catestatin is increased reactively or diminished at onset. Methods: Our study was cross-sectional and observational. The patient group, comprising 109 consecutive untreated hypertensive patients without additional systemic or coronary heart disease, underwent evaluations of plasma catestatin, waist circumference, lipid parameters, left ventricular mass, carotid intima-media thickness, and flow-mediated dilation of the brachial artery. Additionally, we measured catestatin con- centrations of 38 apparently healthy subjects without any disease using a commercial enzyme-linked immunosorbent assay kit. Results: We documented increased catestatin concentrations in previously untreated hypertensive patients compared to healthy controls (2.27±0.83 vs. 1.92±0.49 ng/mL, p=0.004). However, this association became insignificant after adjustments for age, gender, height, and weight. Within the patient group, catestatin levels were significantly higher in females. Among all study parameters, age, high-density lipoprotein cholesterol (HDL-C) corre- lated positively to plasma catestatin, whereas triglycerides, hemoglobin, and left ventricular mass correlated negatively to plasma catestatin. We could not detect an association between vascular parameters and catestatin. Catestatin levels were significantly elevated with increasing HDL-C (1.91±0.37, 2.26±0.79, and 3.1±1.23 ng/mL in patients with HDL-C 60 mg/dL, respectively). Multiple linear regression analysis revealed age (beta: 0.201, p=0.041) and HDL-C (beta: 0.390, p<0.001) as independent correlates of plasma catestatin concentration. Additionally, male gender (beta:-0.330, p=0.001) and plasma catestatin (beta: 0.299, p=0.002) were significantly associated with HDL-C concentrations. Conclusion: We documented that plasma catestatin is an independent predictor of high-density lipoprotein cholesterol. In addition to antihy- pertensive effects, catestatin appears to be related to improved lipid and metabolic profiles. Coexistence of low catestatin levels with low HDL-C may provide a probable mechanism for the predictive value of low HDL-C for increased hypertension and cardiovascular events

Plasma catestatin concentration is independently correlated with high-density lipoprotein cholesterol levels in untreated hypertensive patients

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYCetin, Mustafa/0000-0001-6342-436X; Durakoglugil, Emre/0000-0001-5268-4262WOS: 000329858400426Purpose Catestatin (CST), a novel peptide derived from Chromogranin A, has diverse cardiovascular actions in addition to diminished sympathoadrenal flow. We intended to investigate metabolic and vascular associations of CST.Turkish Soc Cardio

Relationship between MPV and paraoxonase-1 activity, brachial artery diameter and IMT in patients with diabetes mellitus

Aims: Higher mean platelet volume (MPV) in diabetic patients has been considered as an emerging risk factor for diabetes related micro- and macrovascular complications. Human paraoxonase 1/arylesterase (PON1), which has antioxidant and antiatherogenic properties, is documented in high oxidative stress conditions like uncontrolled diabetes. The present study aimed to evaluate the relationship between mean platelet volume (MPV) and paraoxonase-1 (PON-1) activity, brachial artery diameter (BAd) and intima media thickness (BA-IMT), in diabetic patients with regard to obesity and diabetic complications.Methods: Two-hundred and one diabetic patients (mean age: 52.4 ± 13.4 years, 73.6% females) were grouped according to obesity and diabetic complications (microvascular and macrovascular). Data on demographics, anthropometrics, diabetic complications, MPV levels, BAd and BA-IMT, and serum paraoxonase and arylesterase activities were recorded. The correlation of MPV values to paraoxonase and arylesterase activities, BAd and BA-IMT was evaluated.Results: Paraoxonase and arylesterase values were 119.8 ± 37.5 U/L and 149.0 ± 39.9 U/L, respectively, with no significant difference in respect of obesity and macrovascular complications. Significantly lower values for paraoxonase (107.5 ± 30.7 vs. 123.9 ± 38.8 U/L, p = 0.007) and arylesterase (132.1 ± 30.2 vs. 154.7 ± 41.2, U/L, p = 0.001) were noted in patients with microvascular complications. MPV values were 9.10 ± 0.87 fL, with no significant difference across the groups and no significant correlation with other parameters.Conclusion: In conclusion, PON-1 activity is more significantly decreased in diabetic patients with microvascular than macrovascular complications with no effects on MPV values. On the other hand, no relationship was found between thrombogenic activity and PON-1 activity, BAd and BA-IMT regardless of obesity and diabetic complications.Keywords: cardiovascular, diabetes, insulin resistance, obesity, vasculatur

Alterations of thyroid volume, levels of thyroid hormone and autoantibody in women with hashimoto's thyroiditis

INECIKLI, MEHMET FATIH/0000-0002-9796-8223WOS: 000215587000011Aim: Our aim was to investigate the changes in thyroid volume, thyroid hormone and autoantibody levels after 2 years in newly diagnosed euthyroid women with Hashimoto's thyroiditis (HT) and women with HT treated with levothyroxine (L-T4). Material and Method: We enrolled 60 women with HT (mean age 39.6 +/- 10.8 years) in this study. 27 patients were newly diagnosed and euthyroid (euthyroid group) and L-T4 group (n=33) consisted of women with HT treated with levothyroxine. Thyroid ultrasonography was performed and free T3 (fT3), free T4 (fT4), TSH, anti-thyroglobulin autoantibody (anti-TG) and anti-thyroid peroxidase autoantibody (anti-TPO) levels were measured. Thyroid volume was calculated with ellipsoid formula: (Volume (ml) = Length (cm) x Width(cm) x Thickness (cm) x 1/6 (sic)). Results: Median thyroid volume increased in all subjects (8.6 (1.8-46) vs 10.8 (3.9-54.5) ml, p=0.008). While serum fT3 levels decreased (2.9 +/- 0.5 vs 2.5 +/- 0.3 pg/ml, p0.05). the change in thyroid volume was negatively associated with thyroid volume at basal (r= - 0.290, p=0.027) and TSH (r=-0.271, p=0.039) and positively correlated with fT3 (r= 0.356, p=0.006). While thyroid volume increased in euthyroid group (9.8 (6.6-35.1) vs 12.5 (6.9-54.5) ml, p=0.006), there was not a change in L-T4 group (7.5 vs 8.3 ml, p=0.428). Discussion: Thyroid volume increased in euthyroid women with HT, however did not change in patients treated with levothyroxine in two years. While thyroid autoantibodies did not change in two groups, hypothyroidism developed in 7.4% of euthyroid subjects