The relationship between vitamin D deficiency and metabolic syndrome in obese individuals

Introduction: Decreased vitamin D levels may have a role in the development of metabolic syndrome due to its effect on the metabolic syndrome components or because of insulin resistance. Objectives: The aim of this study was to investigate the prevalence of vitamin D deficiency in obese individuals and to determine the relationship between deficiency of vitamin D with metabolic syndrome in obese people with metabolic syndrome and healthy individuals. Patients and Methods: In this descriptive-analytical study, samples were selected among obese individuals admitted to Hajar and Kashani hospitals in Shahrekord. Metabolic indices of the samples were measured and recorded along with information such as demographic characteristics. According to the indices, the subjects (n=192) were divided into two equal groups of healthy obese and obese people with metabolic syndrome. Vitamin D levels were measured in both groups followed by determination of relationships between the vitamin D levels with metabolic syndrome and its indices. Results: The mean ages of the patients and healthy groups were 50.09 +/- 1.95 years and 52.57 +/- 2.05 years, respectively. The average serum vitamin D levels in the two groups showed a significant difference with significantly lower vitamin D levels in the metabolic syndrome group than those in the obese subjects (P 0.05)

Serum concentration of hs-CRP in obese individuals with and without metabolic syndrome and its association with parameters of metabolic syndrome

Introduction: Serum level of high sensitivity C-reactive protein (hs-CRP), as an inflammatory marker, can play a role in development of metabolic syndrome in obese individuals. Objectives: This study aimed to determine serum concentration of hs-CRP in obese patients with metabolic syndrome and determine the association of this factor with factors involved in the progression of metabolic syndrome. Patients and Methods: In this study, samples were selected by convenient method from obese patients, admitted to Kashani and Hajar hospitals (Shahrekord, Iran). First, based on NCEP-ATPIII-defined metabolic syndrome, parameters of metabolic syndrome and serum levels of vitamin D were measured and a questionnaire containing demographics was completed for each participant. Accordingly, the samples (n=192) were divided into two identical groups; obese individuals without metabolic syndrome (controls) and obese individuals with metabolic syndrome (case group). Hs-CRP levels were measured in both groups. Results: Serum level of hs-CRP in the case group was 17.58 +/- 1.40 mu g/mL and in the control group was 9.04 +/- 1.26 mu g/mL, which was significantly higher in the case group than the control group (P 0.05). Conclusion: Hs-CRP can be used for prognosis and early detection of patients at risk of metabolic syndrome

Porównanie liczby niepodwiązanych gałęzi bocznych w przypadku pobierania tętnicy piersiowej wewnętrznej metodami endoskopową i tradycyjną

Background: In an effort to minimise access in cardiac surgery, endoscopic vessel harvesting has become more popular. Theendoscopic approach, however, allows for only the harvest of the mid to distal internal mammary artery (IMA), leaving themore proximal branches of the conduit available for collateral flow away from the coronary bed.Aim: To compare the number and anatomic variation of remaining side branches in thoracoscopic vs. conventional IMAharvesting.Methods: 199 fresh cadavers were randomly divided into two groups. Group A (n = 100) underwent endoscopic IMA harvesting. In Group B (n = 99), IMAs were harvested using an open conventional approach. In both groups during surgery, sidebranches of the IMA were isolated and identified.Results: The two groups were comparable with regard to mean age and age distribution, male sex (56% vs. 63%, respectively),cause of death and coronary risk factors including smoking, diabetes, dyslipidaemia and hypertension. 24 of 199 cadavers(12%) had a lateral costal branch. The left IMA arose from the third part of the subclavian artery in 6%, and from the thyrocervical trunk in 7% of the cadavers. There were significantly more unligated side branches in Group B compared toGroup A (14 branches vs. 3 branches, p < 0.01). The first intercostal artery and lateral costal artery were found unligated in3% and 5% of cadavers in Group B, whereas no side branch remained unligated in Group A. There was no subclavian arteryor IMA injury in either group. Internal mammary vein was damaged in 2% of cadavers in Group B.Conclusions: Thoracoscopic left IMA harvesting is more accurate in finding and ligating the side branches of IMA.Wstęp: W związku z ograniczaniem dostępu kardiochirurgicznego coraz bardziej popularne staje się endoskopowe pobieranie naczyń krwionośnych. Metoda endoskopowa umożliwia jednak pobieranie tylko środkowego lub dalszego odcinka tętnicypiersiowej wewnętrznej (IMA), pozostawiając położone proksymalnie gałęzie konduitu dostępne dla krążenia obocznegopoza łożyskiem wieńcowym.Cel: Celem niniejszego badania było porównanie liczby i zmienności anatomicznej pozostałych gałęzi bocznych w przypadku pobierania IMA metodą torakoskopii i tradycyjną metodą otwartą.Metody: Na dwie grupy losowo podzielono 199 świeżych zwłok. W grupie A (n = 100) pobrano IMA endoskopowo, a w grupie B (n = 99) do pobrania IMA zastosowano tradycyjną metodę otwartą. W obu grupach podczas zabiegu wyizolowano i zidentyfikowano boczne gałęzie IMA.Wyniki: Grupy A i B były porównywalne pod względem średniej wieku i rozkładu płci (mężczyźni stanowili odpowiednio56% i 63%), przyczyny zgonu i czynników ryzyka wieńcowego, takich jak palenie tytoniu, cukrzyca, dyslipidemia i nadciśnienie tętnicze. W przypadku 24 spośród 199 zwłok (12%) stwierdzono występowanie bocznej gałęzi żebrowej. Lewa tętnica piersiowa wewnętrzna (LIMA) odchodziła od trzeciej części tętnicy podobojczykowej u 6% osób i od pnia tarczowo-szyjnego u 7% osób. W grupie B stwierdzono istotnie więcej niepodwiązanych gałęzi bocznych niż w grupie A (odpowiednio 14 gałęzii 3 gałęzie; p < 0,01). Pierwsza tętnica międzyżebrowa i tętnica żebrowa boczna były niepodwiązane w przypadku 3%i 5% zwłok w grupie B, natomiast w grupie A nie stwierdzono ani jednego przypadku niepodwiązania tych naczyń. W żadnej z grup nie doszło do uszkodzenia tętnicy podobojczykowej ani piersiowej wewnętrznej. Żyła piersiowa wewnętrzna była uszkodzona w przypadku 2% zwłok w grupie B.Wnioski: Zastosowanie torakoskopii do pobierania LIMA ułatwia znalezienie i podwiązanie bocznych gałęzi tętnicy piersiowej wewnętrznej

Role of Biatrial Pacing in Prevention of Atrial Fibrillation after Coronary Artery Bypass Surgery

Background: Atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG) constitutes the most common sustained arrhythmia and results in prolonged hospitalization. The purpose of this study was to assess simultaneous right and left atrial pacing as prophylaxis for postoperative atrial fibrillation. Methods and Results: From July 2003 to May 2004, 120 patients without structural heart disease and who underwent CABG were randomly classified into one of the following 3 groups: biatrial pacing (BAP), left atrial pacing (LAP), and no pacing (control). Atrial pacing was performed for 4 days. Post-CABG AF was significantly reduced in BAP group compared to single-site and control group (BAP, 17.5%; LAP, 30%; control, 45%; p=0.02). The mean length of hospital stay was significantly reduced in BAP group. Hospital charges were not significantly different between three groups. The mean length of hospital stay was most significantly reduced in BAP group (6.1±1.2 versus 9.0±4.1 days in the control groups; p=0.002, and 8.7±1.3 days in LAP groups; p=0.01). The mean length of stay in the intensive care unit was also significantly reduced in the BAP group (2.8±0.7 versus 4.6±4.5 days in control group; p=0.04, and 4.2±3.2 days in LAP group; p=0.01). Conclusions: Simultaneous right and left atrial pacing is well tolerated and is more effective in preventing post-CABG AF than single-site pacing, and, results in a shortened hospital stay. Identifying patients at risk for developing postoperative AF and using this prophylactic method may be the optimal effective strategy

Association of serum miR-375, miR-155 and miR-146b levels with distinguish of papillary thyroid cancer from benign thyroid masses among Iranian patients

Background and aim: Certain serum levels of microRNAs (miRNAs) throughout the body can be helpful for cancer diagnosis and prognosis. The miRNAs can be secreted from the papillary thyroid cancer (PTC) into the circulatory system. Accordingly, this study aimed to measure the serum levels of miR-146b, miR-155 and miR-375 to evaluate their diagnostic potentials in distinguish of benign from malignant lesions. Materials and methods: The serum levels of miRNAs were measured by real-time quantitative RT-PCR among100 patients with benign thyroid nodules and 30 patients with PTC. Results: The mean miR-375 and miR-155 expression levels in the PTC group were greater when compared with the benign group. The area under the ROC curve (AUC) was estimated at 0.81 for the miR-375 with 0.76% sensitivity and 0.80% specificity to distinguish between benign and PTC lesions. The AUC was calculated to be 0.75 for the miR-155 with 0.69% sensitivity and 0.90% specificity. Conclusion: According to the results of this study, the serum levels of miR-155 and miR-375 were increased in the patients with PTC, which may be useful as alternative seromarkers for the PTC