Aortic valve sclerosis is a sign of increased arterial stiffness in clinically asymptomatic subjects

Background: Classic risk scores may under estimate the risk of cardiovascular (CV) events in specific risk groups requiring appropriate medical and interventional treatment. Arterialstiffness has been known as a sign of CV risk and has a predictive value for CV events beyond classic CV risk factors. The purpose of this study was to investigate the relation between thecardio-ankle vascular index (CAVI) that has been recently reported as a new surrogate marker of arterial stiffness and aortic valve sclerosis (AVS).Methods: Eighty patients with AVS and 80 control subjects were enrolled to the study. Arterial stiffness was evaluated by VaSera-1000 CAVI instrument and AVS was defined by echocardiography as thickening and calcification of the normal trileaflet aortic valve without obstruction to the left ventricular outflow.Results: CAVI was significantly higher in patients with AVS compared to the control subjects (10.5 ± 2.7 vs. 8.6 ± 1.4, p < 0.001). Higher frequency of AVS was detected in patients with abnormal than borderline and normal CAVI values (69% vs. 27% and 20%, respectively, p < 0.001). In univariate analysis, there was a significant association between AVS and CAVI (95% confidence interval [CI] 1.44–2.48, p < 0.001]. Multivariate analysis demonstrated CAVI (95% CI 1.39–2.44, p < 0.001) as an independent determinant of AVS.Conclusions: Detection of increased arterial stiffness could prevent patients from being mistakenly classified as at low or moderate risk, when they actually are at high risk. Assessment of aortic valve during echocardiography examination may offer the opportunity to identify these subjects

Akut Egzersizin Futbolcularda Antioksidan Sistem Parametrelerine Etkisi

The objective of this study was to investigate the effects of acute physical activity on antioxidant stress parameters including SOD (superoxide dismutase), and CAT (catalase) activities, the amount of MDA (malondialdehyde) and vitamin E and the hemogram values of football players. The research was performed on 18 football players (aged 14-17 years) of Altay football club in Turkey. Measurements were taken before and after a 90 min. football match and results compared. The maximum VO2 (ml/kg/min) and average fat mass (%) of players was 53.12 +/- 9.88 and 10.9 +/- 2.9. Significant increases in the levels of erythrocyt, hemoglobin, hematocrit and MCV were observed after acute exercise as compared to their levels before exercise, but leukocyt level did not change significantly. Acute exercise significantly increased SOD activity but did not change CAT activity significantly (p;lt;0.05). The MDA level declined significantly after acute exercise relative to the level at resting period. Decline in the MDA levels showed the decrease of lipid peroxidation and free radicals as a result of reinforcement of antioxidant defence system by exercise. However, the vitamin E level showed no significant change after acute exercise. (p;gt;0.05). The results suggest that aerobic exercise develops the ability to adapt to the oxidative stress by reducing lipid peroxidation.Bu çalışma, akut fiziksel aktivitenin, antioksidan sistem parametreleri üzerine olan etkisinin incelenmesi amacıyla planlanmıştır. Bunun için araştırmaya 14-17 yaşları arasında Altay spor kulübünde düzenli antrenman yapan gönüllü 18 sporcu katılmıştır. Futbolcuların ilk gün antropometrik ölçümleri alınmış üç gün dinlendirildikten sonra 45’er dakikalık iki devreli maç yaptırılmıştır. Antioksidan sistem parametrelerinden SOD (Süperoksiddismutaz), CAT (Katalaz); lipid peroksidasyon sonucu oluşan MDA (Malondialdehid), E vitamini aktiviteleri ve hemogram değerleri egzersiz öncesi ve egzersiz sonrası alınan kan örneklerinden incelenmiştir. Futbolcuların % yağ oranı 10.9 $pm$ 2.9, indirekt maxVO2 değerleri 53.12 $pm$ 9.88 ml./kg./ dk. olarak tespit edilmiştir. Eritrosit, hemoglobin, Hematokrit, MCV düzeyinde egzersiz öncesine göre artış bulunmuştur. Bu artış istatistiksel olarak anlamlıdır (p0.05). Lökosit düzeyi artmış olmasına rağmen istatistiksel olarak anlamlı değildir (p >0.05 ). Akut egzersiz sonrasında istirahat durumuna göre SOD enzim aktivitesinde artış gözlenmiştir ve bu artış istatistiksel olarak anlamlıdır (p0.05). CAT enzim aktivitesinde ise dinlenme durumuna göre normal sınırlar içinde artış gözlenmiştir ancak bu artış istatistiksel anlamlı değildir (p>0.05). Bu çalışmada akut egzersiz sonrasında MDA düzeyinde azalma meydana gelmiştir. Bu azalma istatistiksel olarak anlamlı bulunmuştur (p0.05). MDA düzeylerinde saptanan düşüklük, antrenmanla antioksidan savunma sistemin güçlenmesi sonucunda serbest radikalleri ve buna bağlı olarak lipid peroksidasyonunu azalttığını düşündürmüştür. E vitamini düzeyinde akut egzersiz sonrasında ise dinlenme durumuna göre normal sınırlar içinde artış gözlenmiş, ancak bu artış istatistiksel olarak anlamlı değildir (p>0.05). Bu sonuçlar aerobik antrenmanın oksidatif strese adaptasyon yeteneğini geliştirdiğini ve bunun da lipid peroksidasyon düzeylerini azalttığını gösterebilir

Surgical Management of Breast Cancer in Turkey: a 30-Year Single-Center Retrospective Study of 2531 Patients

Mastectomy and lumpectomy are well-established surgical methods for the surgical treatment of breast cancer. The comparison of these methods within the 30-year period in terms of clinicopathological characteristics, recurrence, and survival patterns is required in order to provide aid in clinical decision-making. A total of 2531 women who underwent mastectomy or lumpectomy between 1982 and 2012 for primary invasive breast tumors were compared. Starting from 2003, similar variables for patients with primary invasive breast tumors who underwent sentinel node biopsy (SNB) were presented. Mastectomy was performed in 1870 patients and lumpectomy in 661. The median follow-up was 38 months for all patients. The ratio of mastectomy was lower for the patients who underwent SNB. There was no significant difference in breast cancer-related survival or disease-free survival between lumpectomy and mastectomy even after adjusting for the clinicopathological variables. Lumpectomy and mastectomy demonstrate similar survival rates for patients with invasive breast carcinoma. Tumor grade, stage, hormone receptor status, lymphovascular invasion, and distant recurrence have an impact on breast cancer-related survival