Serum fetuin-A levels are associated with carotid intima–media thickness in patients with normotensive chronic obstructive pulmonary disease

Background: There are contradictory reports about the relationship between fetuin-A and atherosclerotic process. Coronary artery disease is the most important cause of mortality in patients with chronic obstructive pulmonary disease (COPD). We aimed to investigate the association of serum fetuin-A level with mean carotid intima–media thickness (cIMT) and ankle-brachial index (ABI) in COPD. Methods: We evaluated the association of serum fetuin-A level, mean cIMT and ABI in normotensive subjects with COPD (n = 65) and with non-COPD (n = 50). Results: Fetuin-A level was significantly lower (63.5 ± 19.8 ng/mL, 72.9 ± 16.2 ng/mL, p = 0.035) and C-reactive protein level higher (4 [1–10] vs. 3 [1–12] mg/dL, p = 0.034) in COPD patients than the control group. Compared to controls, fetuin-A level was significantly lower (63.5 ± 19.8 ng/mL, 72.9 ± 16.2 ng/mL, p = 0.035) and mean cIMT higher (0.69 [0.50–0.98] vs. 0.62 [0.44–0.98] mm, p = 0.034, respectively) in the COPD group. There was a significant negative correlation between mean cIMT and fetuin-A levels (r = –0.320, p = 0.032). Age (b ± SE: 0.002 ± 0.001, p = 0.008) and fetuin-A (b ± SE: –0.002 ± 0.001, p = 0.035) were decisive for the mean cIMT. Conclusions: There are increased cIMT values, decreased fetuin-A levels, but unchanged ABI values in patients with normotensive COPD. Age and fetuin-A were predictors for cIMT, while fetuin-A was negatively correlated with cIMT

Serum fetuin-A levels are associated with carotid intima-media thickness in patients with normotensive chronic obstructive pulmonary disease

Background: There are contradictory reports about the relationship between fetuin-A and atherosclerotic process. Coronary artery disease is the most important cause of mortality in patients with chronic obstructive pulmonary disease (COPD). We aimed to investigate the association of serum fetuin-A level with mean carotid intima-media thickness (cIMT) and ankle-brachial index (ABI) in COPD. Methods: We evaluated the association of serum fetuin-A level, mean cIMT and ABI in normotensive subjects with COPD (n = 65) and with non-COPD (n = 50). Results: Fetuin-A level was significantly lower (63.5 +/- 19.8 ng/mL, 72.9 +/- 16.2 ng/mL, p = 0.035) and C-reactive protein level higher (4 [1-10] vs. 3 [1-12] mg/dL, p = 0.034) in COPD patients than the control group. Compared to controls, fetuin-A level was significantly lower (63.5 +/- 19.8 ng/mL, 72.9 +/- 16.2 ng/mL, p = 0.035) and mean cIMT higher (0.69 [0.50-0.98] vs. 0.62 [0.44-0.98] mm, p = 0.034, respectively) in the COPD group. There was a significant negative correlation between mean cIMT and fetuin-A levels (r = -0.320, p = 0.032). Age (beta +/- SE: 0.002 +/- 0.001, p = 0.008) and fetuin-A (beta +/- SE: -0.002 +/- 0.001, p = 0.035) were decisive for the mean cIMT. Conclusions: There are increased cIMT values, decreased fetuin-A levels, but unchanged ABI values in patients with normotensive COPD. Age and fetuin-A were predictors for cIMT, while fetuin-A was negatively correlated with cIMT

The association of TSH-receptor antibody with the clinical and laboratory parameters in patients with newly diagnosed Graves’ hyperthyroidism: experience from a tertiary referral center including a large number of patients with TSH-receptor antibody-negative patients with Graves’ hyperthyroidism

Introduction: Although the TSH-receptor antibody (TRAb) plays a central role in the pathogenesis of Graves’ disease (GD), the association between TRAb at first diagnosis and clinical and laboratory parameters is not well known. On the other hand, a minority of patients with GD may be TRAb negative, and there is a lack of adequate evidence to demonstrate the clinical and laboratory characteristics of these patients. Therefore, we aimed to investigate the association of TRAb at the initial diagnosis of GD with the clinical and laboratory parameters in a large number of patients with GD and to compare the clinical and laboratory parameters between patients with high TRAb levels and TRAb-negative patients. Material and methods: This study included 440 patients [326 (74%) female, 114 (26%) male]. All patients were classified according to gender, age, smoking habit, and TRAb levels. Results: TRAb levels were significantly higher in male compared to female patients and in smokers compared to non-smokers. Smoking male patients had the highest TRAb levels. In regression analysis, goiter size, male gender, cigarette smoking, Graves’ orbitopathy, fT3, and anti-TPO antibody levels were independently associated with high TRAb levels, while age at diagnosis and fT4 levels were not independently associated with high TRAb levels. TRAb-negative GD was diagnosed in 80 (18%) patients. TRA-negative patients had markedly less severe clinical and laboratory hyperthyroidism compared to patients with high TRAb levels. Moreover, the smoking habit was significantly lower in patients with TRAb-negative GD. Conclusions: According to our study results, TRAb levels at the initial diagnosis of GD are differently associated with clinical and laboratory parameters. Male patients and smoking patients with GD tended to have markedly higher TRAb levels and more severe clinical hyperthyroidism. Therefore, besides other contributing factors, male gender and smoking may affect TRAb levels and consequently the severity of hyperthyroidism in patients with GD. Furthermore, male gender and smoking may have a synergistic effect on TRAb levels and consequently on the severity of hyperthyroidism in patients with GD

B-mode ultrasound assessment of carotid artery structural features in patients with normocalcaemic hyperparathyroidism

Introduction: Normocalcaemic hyperparathyroidism is a condition first defined in 2008, characterized by normal serum calcium and high parathormone levels. Although normocalcaemic hyperparathyroidism is considered to have a milder clinical picture compared to asymptomatic primary hyperparathyroidism, recent studies have shown that it may be associated with osteoporosis, insulin resistance, metabolic syndrome, and cardiovascular risk factors. Considering that normocalcaemic hyperparathyroidism may pose a cardiovascular risk in the setting of carotid atherosclerosis, we sought to examine the structural features of the carotid artery in patients with normocalcaemic hyperparathyroidism compared to a control group. Material and methods: After excluding patients with hypertension, diabetes, and dyslipidaemia (other factors contributing to atherosclerosis), 37 (32 females, 5 males) patients with normocalcaemic hyperparathyroidism with a mean age of 51.2 ± 8 (min: 32, max: 66) years and 40 controls (31 females, 9 males) with a mean age of 49.3 ± 7.5 (min: 34, max: 64) years with normal serum albumin-corrected calcium and parathyroid hormone levels were included in the study. Structural features of the carotid artery including intima-media thickness (mean and maximum), lumen diameter, and the presence of plaque were assessed using B-mode ultrasound. Results: On ANCOVA analysis corrected for atherosclerotic factors (body mass index, waist circumference, fasting plasma glucose, serum cholesterol, lipid, and blood pressure), greater mean intima-media thickness was found in patients with normocalcaemic hyperparathyroidism than in controls (0.65 mm vs. 0.59 mm, respectively) (p = 0.023). Maximum carotid intima-media thickness was also greater in patients with normocalcaemic hyperparathyroidism compared to controls (0.80 mm vs. 0.75 mm, respectively) (p = 0.044). The study groups did not show a significant difference in lumen diameter and the presence of carotid plaque. In addition, a negative correlation was found between parathormone (PTH) level and lumen diameter. Conclusion: The findings of this study show that as with asymptomatic primary hyperparathyroidism, normocalcaemic hyperparathyroidism may be associated with increased cardiovascular risk by predisposing to atherosclerosis

The effect of gender on response to antithyroid drugs and risk of relapse after discontinuation of the antithyroid drugs in patients with Graves’ hyperthyroidism: a multicentre study

Introduction: The outcome of medical treatment in patients with Graves’ disease (GD) is generally difficult to predict. In this study, we examined the hypothesis that gender may affect the outcome of treatment with antithyroid drugs (ATDs). Material and methods: This is a retrospective multicentre study including 717 (514 female and 203 male) patients with the first episode of GD treated for at least 12 months. Patients were classified as relapse, poorly controlled (several episodes of hyperthyroidism followed by euthyroidism and rarely hypothyroidism, occurring after titration of ATDs), and remission. Results: During the mean follow-up time of 26.75 ± 21.25 months (between 1 and 120 months), 269 (37.5%), 176 (24.5%), and 272 (37.9%) patients experienced a relapse, a poorly controlled disease, and remained in remission, respectively. During the follow-up time, 223 (43.4%) of the female and only 49 (24%) of the male patients remained in remission. Relapse and poorly controlled disease (non-remitting GD) were more common in male compared to female patients with GD (hazard ratio 1.26, 95% CI: 1.03–1.53, p = 0.025). Graves’ disease in male patients tended to relapse earlier, and male patients tended to have larger goiter sizes at diagnosis as well. The smoking habit wasalso significantly more frequent in males compared to female patients with GD. Conclusion: Male patients with GD have a markedly higher frequency of relapse and poorly controlled disease, as compared to female patients. Larger goiter sizes and higher frequency of smoking may contribute to the higher frequency of relapse and poorly controlled disease in male patients.

Hypertension management: what is the role of case management?

ABSTRACT Objective The aim of this study was to determine the effect of case management on hypertension management and on adherence to antihypertensive medication and chronic disease care of patients with hypertension. Method This study was conducted as an experimental and randomized controlled study. The sample of the study consisted of randomly selected patients with hypertension who did not have communication problems, who used antihypertensive medication treatment and whose treatment had been continuing for at least six months. The study group was given individual training (Hypertension causes, the risk factors, significance, unwanted side effects, medication treatment, changes in life style) and was applied case management model in hypertension – joint care protocol but no intervention was offered to the control group. Data was collected using the adherence to antihypertensive medication scale, the patient assessment of chronic illness care in the first and six months later interview. Results There was no significant difference between the study and control group according to adherence to antihypertensive medication and patient assessment of chronic illness care in the first interview. Otherwise, there were significant differences between the study and control group according to blood pressure, adherence to antihypertensive medication and patient assessment of chronic illness care in the six months later interview. The adherence to antihypertensive medication total score and the patient assessment of chronic illness care total score were significantly higher in the study group compared with control group in the six months later interview. Conclusion The case management plays an important role the in control of hypertension, and can improve adherence to antihypertensive medication and chronic illness care

Epiretinal Membrane Surgery with 23-Gauge Transconjunctival Sutureless Vitrectomy Using Double Staining Technique

Objective: To evaluate the 23-gauge (23-G) transconjunctival sutureless vitrectomy (TSV) results for epiretinal membranes (ERM) using double-staining technique with trypan blue (TB) and brilliant blue (BB). Material and Methods: In this study, 15 eyes of 15 patients who underwent 23-G TSV for primary ERM were retrospectively reviewed. TB was used for ERM removal and BB was used for inner limiting membrane (ILM) removal, consecutively. Main outcome measures were visual acuity, intraocular pressure, and intraoperative and postoperative complications. Wilcoxon test was used for statistical analysis. Results: Median follow-up was 4 months (range, 111 months). ERM, which was present in preoperative optical coherence tomography scanning, was not detected postoperatively in any of the eyes. Preoperative visual acuity was between counting fingers from 2 meters and 2/10, whereas it was between 1/10 and 9/10 postoperatively. Median log-MAR visual acuity was 0.5 (0.30-1.60) preoperatively and 0.40 (0.10-1.18) postoperatively (p=0.039, Wilcoxon test). Median intraocular pressure was 15 (11-16) mmHg preoperatively, and 14 (8-21) mmHg postoperatively (p=0.685, Wilcoxon testi). While visual acuity improved by 2 or more lines in 9 eyes (60%), it remained within +/- 2 lines in 6 eyes (40%). Cataract developed in one eye (6.7%) and rhegmatogenous retinal detachment developed in another eye (6.7%). Postoperative ERM recurrence did not develop. Conclusion: 23-G TSV with double-staining technique seems to be effective and safe in ERM surgery. The effectiveness of this method can be assessed better with prospective studies including large number of patients

Epiretinal Membrane Surgery with 23-Gauge Transconjunctival Sutureless Vitrectomy Using Double-Staining Technique

Objective: To evaluate the 23-gauge (23-G) transconjunctival sutureless vitrectomy (TSV) results for epiretinal membranes (ERM) using double-staining technique with trypan blue (TB) and brilliant blue (BB). Material and Methods: In this study, 15 eyes of 15 patients who underwent 23-G TSV for primary ERM were retrospectively reviewed. TB was used for ERM removal and BB was used for inner limiting membrane (ILM) removal, consecutively. Main outcome measures were visual acuity, intraocular pressure, and intraoperative and postoperative complications. Wilcoxon test was used for statistical analysis. Results: Median follow-up was 4 months (range, 111 months). ERM, which was present in preoperative optical coherence tomography scanning, was not detected postoperatively in any of the eyes. Preoperative visual acuity was between counting fingers from 2 meters and 2/10, whereas it was between 1/10 and 9/10 postoperatively. Median log-MAR visual acuity was 0.5 (0.30-1.60) preoperatively and 0.40 (0.10-1.18) postoperatively (p=0.039, Wilcoxon test). Median intraocular pressure was 15 (11-16) mmHg preoperatively, and 14 (8-21) mmHg postoperatively (p=0.685, Wilcoxon testi). While visual acuity improved by 2 or more lines in 9 eyes (60%), it remained within +/- 2 lines in 6 eyes (40%). Cataract developed in one eye (6.7%) and rhegmatogenous retinal detachment developed in another eye (6.7%). Postoperative ERM recurrence did not develop. Conclusion: 23-G TSV with double-staining technique seems to be effective and safe in ERM surgery. The effectiveness of this method can be assessed better with prospective studies including large number of patients

Helikobakter pilori pozitif bireylerde endotel disfonksi serum CRP ve B12 vitamin düzeyleri arasındaki ilişki

Amaç: Çalışmanın amacı Helicobacter pylori HP seropozitif ve negatif bireylerde, endotel fonksiyon parametrelerini, C- reaktif protein CRP ve vitamin B12 düzeylerini ölçmek ve endotel fonksiyon parametreleri ile CRP ve vitamin B12 arasında ilişki olup olmadığını ortaya koymaktı. Materyal ve metod: Dispeptik yakınmaları olan110 kişide HP immünglobulin G antikor düzeyleri, CRP ve B12 vitamini düzeyleri ölçüldü. Brakiyal arter endotel-bağımlı akım aracılı vazodilatasyon ve endotel bağımsız nitrogliserin bağlı vazodilatasyon yanıtı ölçümleri yüksek frekanslı ultrasonografik görüntüleme ile yapıldı. Bulgular: HP immünglobulin G antikoru 70 kişide pozitif, 40 kişide ise negatifti. HP negatif bireylere kıyasla HP pozitif bireylerde brakiyal arter akım aracılı dilatasyon yanıtı azalmış, CRP düzeyi yüksek, vitamin B12 düzeyi ise düşüktü. HP pozitif bireylerde akım aracılı vazodilatasyon yanıtı ile yaş ve CRP arasında ters yönlü ilişki varken vitamin B12 ile aynı yönde ilişki vardı. Endotel bağımsız vazodilatasyon her iki grupta da benzerdi. Sonuç: Kronik HP enfeksiyonunda, sistemik ve vasküler inflamasyon artışı ve vitamin B12 eksikliği endotel disfonksiyonu gelişmesinde etkili olabili

The effects of onion (Allium cepa) extract on doxorubicin-induced apoptosis in aortic endothelial cells

The aim of this study was to investigate the effects of onion (Allium cepa) extracts (ACE) on doxorubicin (DOX)-induced apoptosis in aortic endothelial cells. The rats in the ACE-pretreated group were given a daily dose of 1ml ACE for 14days. To induce aortic endothelial cell apoptosis, DOX (30mgkg1 body weight) was injected intraperitoneally by a single dose and the rats were sacrificed after 48h. To date, no such studies have been performed on antiapoptotic potential of ACE on DOX-induced apoptosis in aortic endothelial cells. Our data indicate a significant reduction in the activity of in situ identification of apoptosis using terminal dUTP nick end-labeling in aortic endothelial cells of the DOX-treated group with ACE therapy. DOX-treated with ACE groups showed a significant decrease in malondialdehyde levels and increased levels of glutathione in comparison with the DOX-treated group. Data from our study show that prevention of endothelial cell apoptosis by ACE may contribute to the restoration of aortic endothelial dysfunction that is associated with DOX treatment. Copyright (c) 2011 John Wiley & Sons, Ltd