The relation between polycystic ovary syndrome and hemostatic, fibrinolytic and other risk factors of cardiovascular disease

YÖK Tez No: 282061Polikistik Over Sendromu (PKOS) insülin direnci, obezite, lipit profilibozukluğu, hipertansiyon ve hiperandrojenizm kardiyovasküler risk için bir kümeolu?turmaktadır. Çalı?mamızda PKOS'un hemostatik, fibrinolitik ve diğerkardiyovasküler risk faktörleriyle ili?kisini ara?tırmayı amaçladık.Çalı?maya ya? ve vücut kitle indeksleri benzer yeni te?his edilmi? 44 PKOShastası ve 41 sağlıklı gönüllü kadın dahil edildi. Grupların plazma fibrinojen, faktörVII, faktör VIII, plazminojen aktivatör inhibitör 1 (PAI-1), trombin ile aktiveedilebilen fibrinoliz inhibitorü (TAFI), homosistein seviyeleri, serum yüksek duyarlıC-Reaktif Protein (hsCRP), 17-OH progesteron, testosteron, folikül stimülan hormon(FSH), lütenizan hormon (LH), LH/FSH oranı, insülin, homeostasis modelassessment insulin resistance (HOMA-IR), dihidroepiandrosteron sülfat (DEHAS),prolaktin, progesteron, tiroit stimülan hormon (TSH), serbest T4 (sT4), östradiol(E2), trigliserit (TG), yüksek dansiteli lipoprotein (HDL), dü?ük dansiteli lipoprotein(LDL), total kolesterol (TK) ve karotis intima media kalınlığı (K?MK) ölçüldü.Testosteron, LH, LH/FSH oranı, insülin, HOMA-IR, E2, glikoz, TG, TKdeğerleri gruplar arasında istatistiksel olarak farklıydı (p<0,05). Kardiyovaskülerhastalığa yol açan aterosklerotik süreçte yükselen inflamasyon belirteçleri olanfibrinojen, faktör VII, faktör VIII, PAI-1, homosistein, hsCRP düzeylerinde gruplararasında anlamlı farklılık yoktu. Ayrıca TAFI, 17 OH Progesteron, FSH, DEHAS,prolaktin, progesteron, TSH, HDL, LDL ve ateroskleroz göstergesi kabul edilenK?MK değerleri arasında da istatistiksel olarak anlamlı fark bulunamadı.Yapılan bazı çalı?malarda PKOS'lu kadınlarda inflamatuar mediatörlerinseviyelerinin yükseldiği ve PKOS'un dü?ük dereceli kronik inflamasyonlakarakterize olduğu rapor edilmesine rağmen bizim çalı?mamızda yeni te?his edilenPKOS hastalarında inflamasyon belirteçleri ve koagülasyon aktivitesinde bir artı?olmadığı görüldü. Böylece hastalığın erken dönemlerinde inflamasyon olmamasıneticesinde prokoagülan aktivitenin ortaya çıkmayacağı söylenebilir.Polycystic ovary syndrome (PCOS) is associated with insulin resistance,obesity, lipid profile abnormalities, hypertension and hyperandrogenism which areall risk for cardiovascular disease. In our study, we aimed to investigate the relationof PCOS with the hemostatic, fibrinolytic and other cardiovascular risk factors.Forty-four newly diagnosed PCOS patients and 41 healthy volunteer womenadjusted for age and body mass index were included in the study. Plasma fibrinogen,factor VII, factor VIII, plasminogen activator inhibitor-1 (PAI-1), thrombinactivatablefibrinolysis inhibitor (TAFI), homocysteine levels, serum hsCRP, 17-OHProgesterone, testosterone, follicle-stimulating hormone (FSH), luteinizing hormone(LH), LH/FSH ratio, insulin, homeostasis model assessment insulin resistance(HOMA-IR), dehydroepiandrosterone sulfate (DEHAS), prolactin, progesterone,thyroid-stimulating hormone (TSH), free T4 (fT4), estradiol (E2), triglycerides (TG),high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL-C), totalcholesterol (TC), glucose and carotis intima media thickness (CIMT) measurementswere performed for both groups.Testosterone, LH, LH/FSH ratio, insulin, HOMA-IR, E2, glucose, TG, TCvalues were statistically different between the two groups (p<0,05). Factor VII,factor VIII, PAI-1, homocysteine, hsCRP which are markers of inflammation in thecourse of atherosclerosis did not differ between two groups. In addition there was nostatistical difference between the levels of TAFI, 17-OH Progesterone, FSH,DEHAS, prolactin, progesterone, TSH, HDL-C, LDL-C and CIMT which is anacknowledged atherosclerosis indicator.It has been previously reported that PCOS and it is characterized by lowgrade inflammation and increase in the inflammatory mediator levels. However, inthe present study inflammatory markers, hemostatic variables and fibrinolyticparameters were not significantly different from the healthy counterparts in earlyperiod of PCOS. The present study showed that procoagulant activity dose not arisesas a result of the lack of inflammation in the early stages of the disease

The test giving knowledge as well as renal biopsy: Routine urinalysis

İdrar analizi ucuz, zaman almayan, kolayca uygulanabilir ve böbrek fonksiyonları hakkında bununla ters orantılı olarak önemli bilgiler veren bir tanı aracıdır. Zaman zaman yanlış pozitif veya negatif test sonuçlarına rastlanmakta veya bazı sonuçları yorumlamakta güçlükler çekilmektedir. Bu derlemede idrar toplamada dikkat edilmesi gereken hususlar, rutin idrar analizinin kapsadığı testler, çalışma prensipleri ve yanlış sonuçlara neden olan durumlardan söz edilecektir.Urinalysis is inexpensive, no time consuming and easily applicable diagnoses means, and it gives important information about renal function. Occasionally, false positive or negative test results have been seeing, or it has been difficultly in comment of some results. It will mention that what should be noticed on urine collect, what cover routine urinalysis, these tests are performed with which principle, and what are cases the cause of false results, in this review

İDrar Yolu Enfeksiyonu Tan�S�Nda Striple Ve Mikroskopik Idrar Analizinin Performans öZellikleri

Aim: Although the urine culture is used as the reference standard to determine presence or absence of urinary tract infection, the culture is an expensive and time-consuming method. The objectives of the study were to compare dipstick urinalysis with microscopic urinalysis and to compare dipstick and microscopic urinalysis results with urine culture results, by calculating performance characteristics of these tests. Method: The 250 morning urine specimens were performed by using dipstick and microscopic urinalysis and cultured. Laboratory urinalysis included semi-automated dipstick reading by a Miditron-M Reflectance photometer and microscopic examination. Result: Thirty-five point six percent (89/250) of patients had urine cultures with 105 colonies/mL or greater. Sensitivity and specificity of microscopic urinalysis were 91% and 68%, whereas in dipstick urinalysis they were 80% and 60%, respectively. Negative predictive values were 84% for urine dipsticks and 93% for microscopic urinalysis. Positive predictive values were 52% and 61% for dipstick and microscopic urinalysis, respectively. Conclusion: The study has suggested that both urinalysis methods can be used for rapid diagnosis. Urine culture is an expensive test for routine use and should not be applied unless the result of the nitrite, leukocyte or bloods are positive in dipstick or leukocyte, erythrocyte or bacteria are positive in microscopic examination.Amaç: İdrar kültürü idrar yolu enfeksiyonunun saptanmasında referans test olarak kabul edilmekle beraber pahalı ve zaman gerektiren bir testtir. Çalışmamızın amacı, striple idrar analizi ve mikroskopik idrar analizini karşılaştırmak, strip ve mikrosopik idrar analizi sonuçları ile idrar kültür sonuçları arasındaki ilişkiyi bu testlerin performans özelliklerini ölçerek değerlendirmektir. Metod: İkiyüzelli hastadan sabah idrar örneği alındı. Laboratuarımızda idrar analizleri yapılıp kültür için ekimleri yapıldı. Laboratuar idrar analizi Miditron-M Reflektans fotometresi ile otomatik strip okuma ve mikroskopik çalışmayı içeriyordu. Bulgular:Hastaların %35.6 sı (89/250) idrar kültürleri 105 koloni/mL veya daha fazla organizma içeriyordu. Mikroskopik idrar analizinin sensitivite ve spesifitesi sırasıyla %91 ve %68, striple idrar analizinin %80 ve %60 idi. Negatif prediktör değer strip için %84, mikroskopik analiz için %93, pozitif prediktör değer strip ve mikroskopik analiz için sırasıyla %52 ve %61 hesaplandı. Sonuç: Bu çalışma her iki idrar analiz metodunun hızlı tanı için kullanılabileceğini gösterdi. Bu nedenle, idrar kültürü pahalı bir test olduğundan stripte nitrit, lökosit, kan testi pozitifliği veya mikroskopik incelemede lökosit, eritrosit veya bakteri pozitifliği yoksa tüm idrar örneklerinde idrar kültürü öneremeyiz

İdrar yolu enfeksiyonu tanısında striple ve mikroskopik idrar analizinin performans özellikler

Aim: Although the urine culture is used as the reference standard to determine presence or absence of urinary tract infection, the culture is an expensive and time-consuming method. The objectives of the study were to compare dipstick urinalysis with microscopic urinalysis and to compare dipstick and microscopic urinalysis results with urine culture results, by calculating performance characteristics of these tests. Method: The 250 morning urine specimens were performed by using dipstick and microscopic urinalysis and cultured. Laboratory urinalysis included semi-automated dipstick reading by a Miditron-M Reflectance photometer and microscopic examination. Result: Thirty-five point six percent (89/250) of patients had urine cultures with 105 colonies/mL or greater. Sensitivity and specificity of microscopic urinalysis were 91% and 68%, whereas in dipstick urinalysis they were 80% and 60%, respectively. Negative predictive values were 84% for urine dipsticks and 93% for microscopic urinalysis. Positive predictive values were 52% and 61% for dipstick and microscopic urinalysis, respectively. Conclusion: The study has suggested that both urinalysis methods can be used for rapid diagnosis. Urine culture is an expensive test for routine use and should not be applied unless the result of the nitrite, leukocyte or bloods are positive in dipstick or leukocyte, erythrocyte or bacteria are positive in microscopic examination

Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study

WOS: 000295212200020PubMed: 21620440Aim: Mean platelet volume (MPV) in the healthy population has not been studied before. Therefore, the aim of the study was to measure MPV in normal subjects in a large cohort of Turkish adults. Methods: A total of 2298 subjects with a mean age of 50 (age range 18 to 92) were interviewed. Subjects who had smoking habit, diabetes, hypertension, coronary artery disease, dyslipidemia, chronic obstructive pulmonary disease, cancer, chronic use of any drugs including antiplatelets, heavy drinkers, metabolic syndrome, ejection fraction 1.4 in men and > 1.1 in women, abnormal liver function tests and an abnormal TSH were excluded in a in a stepwise manner. Complete blood counts were done on the same day within 6 hours by a CELL-DYN 3700 SL analyzer (Abbott Diagnostics). Results: Three hundred twenty-six participants (204 females (63%) and 122 males (37%) with a mean age of 41 +/- 16) constituted the final healthy cohort. Mean MPV of the cohort was 8.9 +/- 1.4 fL. There was no significant difference among age groups regarding MPV. Conclusion: Ninety-five percent of the individuals had a MPV between 7.2 and 11.7 fL. A patient having a MPV beyond this range should be evaluated carefully especially for occlusive arterial diseases. (C) 2011 Elsevier Ltd. All rights reserved.Duzce University Office of Scientific InvestigationsDuzce UniversityThis work was supported by the Duzce University Office of Scientific Investigations

Pyrrolidine dithiocarbamate attenuates the development of monocrotaline-induced pulmonary arterial hypertension

Silan, Coskun/0000-0002-8352-6571; silan, coskun/0000-0002-8352-6571WOS: 000321090000006PubMed: 23582365We aimed to demonstrate the potential protective effects of pyrrolidine dithiocarbamate (PDTC) on monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). Adult male rats were randomly assigned to 4 groups: control group, MCT-treated rats only, MCT-injected rats treated with PDTC, and PDTC-treated rats only. Blood and tissue samples were collected after the sacrifice. Levels of malondialdehyde (MDA) were measured by using the thiobarbituric acid method. Total antioxidant status (TAS) was determined using a commercially available ImAnOx kit. A histopathological evaluation was accomplished by scoring the degree of severity. Endothelial damage of the main pulmonary artery was evaluated by immunohistochemical labeling of endothelial cells using anti-rat endothelial cell antigen 1 (RECA-1) antibody. MCT-induced right ventricular hypertrophy (RVH) was reduced significantly in the MCT + PDTC-treated group. MDA levels were significantly lowered in the MCT + PDTC-treated group. TAS was significantly higher in the MCT + PDTC-treated group when compared with the rats with PAH. Histopathological examination demonstrated that PDTC treatment reduced the development of inflammation, hemorrhage and congestion, and collagen deposition. In conclusion, PDTC attenuated PAH and protected pulmonary endothelium in rats administered MCT. These findings suggest that PDTC treatment may provide a new effective therapeutic approach in the treatment of PAH. (C) 2013 Elsevier GmbH. All rights reserved

Carotis intima media thickness in female patiens with subclinical hypothyroidism [Subklinik hipotiroidili kadin hastalarda karotis intima media kalinli?i]

Objective: Recent studies have shown that subclinical hypothyroidism (SCH) has similar cardiovascular risks with clinical hypothyroidism (CH). We evaluated carotis intima media thickness (CIMT)-indicator of early changes in atherosclerotic process- in female patients, who have either CH or SCH, with similar age and demographic features. Materials and Methods: In this study, we included 81 female patients admitted to internal medicine and endocrinology outpatient clinic, diagnosed with CH (30) or SCH (51) according to their laboratory findings and who have not previously received treatment and 38 healthy women. BMI (body mass index), sistolic and diastolic blood pressure, triglycerides (TG), total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), vitamin B-12, folate, homocysteine, high-sensitive C-reactive protein (Hs CRP), and CIMT were measured in all participants. Results: There was not a statistical difference between the groups in TG, TC, HDL-C, LDL-C, vitamin B-12, and folate levels (p>0.05). On the other hand, SCH and CH groups differed statistically significantly from the control group for Hs CRP (p=0.011), homocysteine (p<0.001), and CIMT values. Additionally, age was found to be the most important factor for increase in CIMT when multiple linear regression analysis was performed. Conclusions: Lack of difference between CH patients and SCH patients in respect to Hs CRP, homocystein, and CIMT shows that inflammation and increase in CIMT starts during SCH period. Hence, we think that the increase in CIMT in SCH patients when TSH levels are higher than the normal range is a clinically important sign of early cardiovascular diseases

Have the reference ranges of anemia parameters like iron, ferritin, vitamin B-12 and folate been correctly settled in Turkish adults living in western Black Sea Region?

WOS: 000314289700003Objective: Widespread causes of anemia are the deficiencies of iron, vitamin B-12 and folate. The exact diagnosis is based on the laboratory data determined according to the appropriate reference ranges along with clinical symptoms. International Federation of Clinical Chemistry (IFCC) and Clinical and Laboratory Standards Institute (CLSI) have suggested that each laboratory should determine their own reference values. In this study, we aim to determine reference intervals of anemia parameters in a large cohort of Turkish adults and to investigate whether these values confirm with data sheets of commercial kits. Methods: Healthy 1251 subjects were included in the study. Subjects were divided into six groups according to their ages. Levels of serum iron, unsaturated iron binding capacity (UIBC), ferritin, vitamin B-12 and folate, and complete blood counts of all participants were determined. Results: There were significant differences between genders in terms of serum iron, ferritin, UIBC, folate levels and mean corpuscular volume (MCV). While levels of iron, UIBC, ferritin, and MCV were higher in males, vitamin B-12 and folate levels were higher in females. MCV, folate and vitamin B-12 levels were higher in middle aged adults, and lower in the young and elderly. Conclusion: There wasn't much difference between our results and previous studies and manufacturers' ranges except the ferritin and iron levels. Therefore, reference ranges are not required to be determined again. It was concluded that, high upper limits of serum iron and ferritin levels may be caused by inflammation so that these levels is not appropriate as a reference range unless evaluated together with inflammatory markers such as CRP, but lower levels may be valuable

Evaluation of vitamin B12 level in middle-aged obese women with metabolic and nonmetabolic syndrome: case-control study

KARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882; Karabulut, Ismail/0000-0002-1339-5385WOS: 000308053300009Aim: To investigate the correlation between vitamin B12 and body mass index (BMI) along with insulin resistance (IR) in middle-aged obese women. Materials and methods: The study was designed as a case-control study. The study group included middle-aged obese women and the control group included aged-matched lean women. Weight, height, and hip and waist circumferences were measured. Biochemical parameters such as fasting and postprandial glucose, vitamin B12 and folic acid levels, and lipid profiles were assayed. Results: Enrolled in the study were 116 middle-aged obese and 103 aged-matched healthy lean women. The vitamin B12 level of the obese women was significantly lower than that of the lean women (244.1 +/- 131.5 pg/mL vs. 336.2 +/- 163.1 pg/mL, P = 0.002). However, there was no significant difference in folic acid levels between the groups (P > 0.05). The vitamin B12 level was similar in the obese women with metabolic syndrome and those without (245.1 +/- 145.3 pg/mL vs. 241.2 +/- 96.5 pg/mL, P > 0.05), but the level in the control group was significantly higher than that of patients with obesity and metabolic syndrome (P = 0.010 and P = 0.020, respectively). Vitamin B12 levels correlated with BMI (r = -0.259, P = 0.003) but not with IR (r = -0.053, P > 0.05). Conclusion: The vitamin B12 concentration was low in obese patients and this level negatively correlated with BMI, but not with homeostasis model assessment-estimated IR (HOMA-IR)

Związek galektyny-3 z liczbą blaszek miażdżycowych w tętnicach wieńcowych i stopniem ciężkości obturacyjnego bezdechu sennego

Background: Obstructive sleep apnoea syndrome (OSAS) is reported to be associated with hypertension, coronary artery disease, atrial fibrillation, and heart failure. Galectin-3 plays an important role in the regulation of inflammation, development of cardiac fibrosis, and remodelling. A significant relationship between galectin-3 and the total number of coronary plaques and the macrocalcified plaque structures of patients with type 2 diabetes mellitus has been reported. Aim: The aim of this study was to investigate the association between galectin-3 level and coronary plaque burden as well as OSAS severity in patients with OSAS. Methods: A total of 87 consecutive patients with a diagnosis of OSAS and 21 age- and gender-matched control subjects were recruited for the present study. The patients with OSAS were also categorised according to their apnoea hypopnoea index (AHI) as follows: mild (AHI = 5–15), moderate (AHI = 15–30), and severe (AHI &gt; 30). All study subjects underwent coronary computed tomography angiography to detect coronary atherosclerosis. Also, all participants of serum galectin-3 concentrations were measured. Results: Mean galectin-3 level was significantly higher in patients with OSAS compared to control subjects (p &lt; 0.001) and in the severe OSAS group, compared to the moderate and mild OSAS groups (p &lt; 0.001). Correlation analysis indicated significant positive relationships between galectin-3 concentrations and the total number of coronary plaques (p &lt; 0.001), high-sensitivity C-reactive protein (p = 0.001), and severity of OSAS (p &lt; 0.001). In multivariate analysis, galectin-3 (p = 0.01) and age (p = 0.025) were significant independent predictors of coronary atherosclerosis, after adjusting for other risk factors. Also, it has been found that galectin-3 concentration is a predictor of OSAS severity (p = 0.001). Conclusions: Galectin-3 is associated with coronary atherosclerosis and OSAS severity in OSAS patients.  Wstęp: Jak podają doniesienia, zespół obturacyjnego bezdechu sennego (OSAS) wiąże się z nadciśnieniem tętniczym, chorobą wieńcową, migotaniem przedsionków i niewydolnością serca. Galektyna-3 odgrywa istotną rolę w regulacji stanu zapalnego, rozwoju zwłóknienia serca i jego przebudowy. Opisywano istotne zależności między stężeniem galektyny-3 a całkowitą liczbą blaszek miażdżycowych w naczyniach wieńcowych i blaszek uwapnionych u chorych na cukrzycę typu 2. Cel: Celem niniejszego badania była ocena związku między stężeniem galektyny-3 a liczbą blaszek miażdżycowych i stopniem ciężkości OSAS u chorych z zespołem obturacyjnego bezdechu sennego. Metody: Do badania włączono 87 kolejnych pacjentów z rozpoznaniem OSAS i 21 dobranych pod względem wieku i płci osób kontrolnych. Chorych z OSAS dodatkowo podzielono na grupy ciężkości OSAS w zależności od wskaźnika stosunku bezdechów do spłyconych oddechów (AHI): łagodny (AHI = 5–15), umiarkowany (AHI = 15–30), ciężki (AHI &gt; 30). U wszystkich uczestników badania wykonano koronarografię metodą tomografii komputerowej w celu wykrycia miażdżycy tętnic wieńcowych oraz zmierzono stężenie galektyny-3 w surowicy. Wyniki: Średnie stężenie galektyny-3 było istotnie wyższe u chorych z OSAS niż u osób z grupy kontrolnej (p &lt; 0,001), a u pacjentów z ciężkim OSAS było istotnie wyższe niż w grupach z umiarkowanym i łagodnym OSAS (p &lt; 0,001). Wykazano istotne dodatnie korelacje między stężeniem galektyny-3 a całkowitą liczbą blaszek miażdżycowych w tętnicach wieńcowych (p &lt; 0,001), stężeniem białka C-reaktywnego mierzonego metodą wysokoczułą (p = 0,001) i stopniem ciężkości OSAS (p &lt; 0,001). W analizie wieloczynnikowej stężenie galektyny-3 (p = 0,01) i wiek (p = 0,025) były istotnymi niezależnymi czynnikami predykcyjnymi miażdżycy tętnic wieńcowych po skorygowaniu względem innych czynników ryzyka. Stwierdzono również, że stężenie galektyny-3 jest czynnikiem predykcyjnym stopnia ciężkości OSAS (p = 0,001). Wnioski: U chorych z OSAS stężenie galektyny-3 wiąże się z nasileniem zmian miażdżycowych i stopniem ciężkości OSAS