Maternal serum xenin-25 levels in gestational diabetes mellitus.

OBJECTIVE: Xenin-25 is a polypeptide having an insulinotropic effect via increasing the insulin-releasing action of glucose-dependent insulinotropic polypeptide (GIP) and promoting beta cell survival and proliferation. We aimed to assess serum xenin-25 levels in euglycemic pregnancies vs. pregnancies complicated with gestational diabetes mellitus (GDM). PATIENTS AND METHODS: Forty pregnancies complicated with GDM and 40 healthy pregnancies with gestational age between 24 and 28 weeks were included. Following eight hours of fasting, blood samples were drawn from the participants, and subsequently, 75 g of glucose was administered orally. Blood was drawn again 120 minutes after the glucose challenge. Serum xenin-25 levels were detected by ELISA. Statistical analysis was performed, and p<0.05 was considered statistically significant. RESULTS: There was no significant difference in maternal age, gestational age, BMI, fasting glucose, and insulin levels between the groups. Both fasting and 120th-minute xenin-25 levels were significantly higher in the GDM group when compared to the control group (p<0.05). Both the fasting and 120th-minute serum xenin-25 levels were significantly higher in women with GDM compared to healthy pregnant women. CONCLUSIONS: High levels of xenin-25 were associated with gestational diabetes, and xenin-25 might be a potential marker for detecting GDM in the future.

Systemic inflammation response index is associated MACE in patients with NSTEMI.

OBJECTIVE: Non-ST segment elevation myocardial infarction (NSTEMI) poses a significant health concern. The systemic inflammation response index (SIRI), an emerging inflammatory marker linked to conditions like stroke and cancer, has shown potential relevance. Inflammation's pivotal role in acute coronary syndromes is well-established, yet its specific association with NSTEMI and SIRI remains unexplored. This study aims to elucidate the correlation between SIRI and major adverse cardiovascular events (MACE) in patients with NSTEMI. PATIENTS AND METHODS: A cohort of 935 consecutive NSTEMI patients who underwent percutaneous intervention was recruited. MACE was defined to encompass all-cause death, malignant arrhythmia, and unplanned percutaneous coronary intervention. The systemic inflammation response index, a composite metric involving three distinct inflammatory cell counts, was computed as the product of neutrophil count and monocyte count divided by lymphocyte count. A receiver operator characteristic (ROC) curve analysis was used to define a cut-off level of SIRI to predict MACE. Then, the study population was divided into two groups according to the cut-off SIRI level in ROC curve analysis. The 12-month follow-up results of the patients were recorded retrospectively. RESULTS: The participants exhibited a mean age of 64.12. Notably, the mean SIRI level registered at 1.98 among patients experiencing MACE and 4.97 among others. Through rigorous multivariate logistic regression analysis, SIRI emerged as an independent predictor of MACE. Further analysis via ROC curve yielded a sensitivity of 68% and specificity of 76% for MACE detection, with a SIRI cut-off of 2.3. CONCLUSIONS: In the context of NSTEMI, SIRI emerges as a robust independent predictor of MACE. These findings underscore the potential utility of SIRI as a prognostic indicator for adverse cardiovascular events, enhancing our understanding of the disease's pathophysiological mechanisms and potential avenues for improved clinical management.

Association of CABG SYNTAX score with long term clinical outcomes in patients with acute myocardial infarction undergoing SVG PCI.

OBJECTIVE: The CABG SYNTAX score (CSS) has been recommended as an objective and quantitative evaluation tool for coronary anatomic complexity after CABG. We aimed at evaluating the long-term prognostic value of the CSS and its relationship with the composite criteria of all-cause death, cerebrovascular accident (CVA) and/or non-fatal myocardial infarction (MI) in patients who underwent percutaneous coronary intervention (PCI) of saphenous vein graft (SVG). PATIENTS AND METHODS: We retrospectively evaluated 232 patients who were admitted with MI and underwent PCI of SVGs, between 2012 and 2018. The study population was divided into two groups according to the results of the median pre-PCI CSS. RESULTS: The composite criteria of all-cause death/CVA/non-fatal MI were observed in 107 patients (46.1%). The incidence of the primary endpoint was significantly higher among the patients with a high pre-PCI CSS (p < .001). Multivariable Cox regression analyses demonstrated that both pre-PCI CSS (HR = 1.678, 95% CI = 1.082-2.602, p = .021) and post-PCI CSS (HR = 1.663, 95% CI = 1.066-2.596, p = .025) were significantly associated with the primary endpoint. The Kaplan-Meier cumulative curves divided by the median of the pre-PCI CSS demonstrated that, compared with the low pre-PCI CSS group, the high-score group was associated at five years with higher composite criteria of all-cause death/CVA/non-fatal MI (low, 40.3%; high, 57.8%; p = .015). CONCLUSIONS: Pre-PCI CSS is a significant prognostic factor for the long-term clinical outcomes in patients with previous CABG who underwent PCI of SVG.

Expression of Glutamate Transporters in Alcohol Withdrawal.

INTRODUCTION: The study aimed to investigate the expression of glutamate transporters during withdrawal in the alcohol-dependent patients. METHOD: The study consisted of 20 male inpatient alcoholics during the withdrawal period and 20 healthy controls. Expressions of glutamate transporters, namely the excitatory amino acid transporter 2 (EAAT2) and EAAT3, in white blood cells were measured with the real-time polymerase chain reaction (RT-PCR) method in early (first day) and late (28(th) day) withdrawal in alcoholic patients and once in the controls. RESULTS: EAAT2 and EAAT3 expressions in the patients during both early and late withdrawal were higher than those of the controls. There was no difference in the EAAT2 and EAAT3 levels of the patients between early and late abstinence. DISCUSSION: The study revealed an upregulation of glutamate transporters EAAT2 and EAAT3 during early and late withdrawal in patients with alcohol withdrawal.

Comparison of automatical thoughts among generalized anxiety disorder, major depressive disorder and generalized social phobia patients.

OBJECTIVE: Automatic thoughts are measurable cognitive markers of the psychopathology and coping styles of individuals. This study measured and compared the automatic thoughts of patients with generalized anxiety disorder (GAD), major depressive disorder (MDD), and generalized social phobia (GSP). PATIENTS AND METHODS: Fifty-two patients with GAD, 53 with MDD, and 50 with GSP and 52 healthy controls completed the validated Automatic Thoughts Questionnaire (ATQ) and a structured psychiatric interview. Patients with GAD, MDD, and GSP also completed the validated Generalized Anxiety Disorder-7 questionnaire, the Beck Depression Inventory (BDI), and the Liebowitz Social Anxiety Scale (LSAS) to determine the severity of their illnesses. All scales were completed before treatment and after diagnosis. The ATQ scores of all pairs of groups were compared. RESULTS: The ATQ scores of the GAD, MDD, and GSP groups were significantly higher than were those of the control group. We also found significant correlations among scores on the GAD-7, BDI, and LSAS. The mean age of patients with GSP was lower than was that of the other groups (30.90 ± 8.35). CONCLUSIONS: The significantly higher ATQ scores of the MDD, GAD, and GSP groups, compared with the control group, underscore the common cognitive psychopathology characterizing these three disorders. This finding confirms that similar cognitive therapy approaches should be effective for these patients. This study is the first to compare GAD, MDD, and GSP from a cognitive perspective.

Automatic lung tumor segmentation with leaks removal in follow-up CT studies.

PURPOSE: In modern oncology, disease progression and response to treatment are routinely evaluated with a series of volumetric scans. The number of tumors and their volume (mass) over time provides a quantitative measure for the evaluation. Thus, many of the scans are follow-up scans. We present a new, fully automatic algorithm for lung tumors segmentation in follow-up CT studies that takes advantage of the baseline delineation. METHODS: The inputs are a baseline CT scan and a delineation of the tumors in it and a follow-up scan; the output is the tumor delineations in the follow-up CT scan; the output is the tumor delineations in the follow-up CT scan. The algorithm consists of four steps: (1) deformable registration of the baseline scan and tumor's delineations to the follow-up CT scan; (2) segmentation of these tumors in the follow-up CT scan with the baseline CT and the tumor's delineations as priors; (3) detection and correction of follow-up tumors segmentation leaks based on the geometry of both the foreground and the background; and (4) tumor boundary regularization to account for the partial volume effects. RESULTS: Our experimental results on 80 pairs of CT scans from 40 patients with ground-truth segmentations by a radiologist yield an average DICE overlap error of 14.5 % ([Formula: see text]), a significant improvement from the 30 % ([Formula: see text]) result of stand-alone level-set segmentation. CONCLUSION: The key advantage of our method is that it automatically builds a patient-specific prior to the tumor. Using this prior in the segmentation process, we developed an algorithm that increases segmentation accuracy and robustness and reduces observer variability.

[Signs of diabetic cardiomyopathy in patients with controlled arterial hypertension and early postprandial hyperglycemia].

AIM: To study signs of diabetic cardiomyopathy (DCM) in nondiabetic patients with controlled arterial hypertension (AH) and glycemic response during first hour of glucose tolerance test (GTT). MATERIAL AND METHODS: Patients (n = 47) with controlled AH were divided into 2 groups according to results of GTT with 75 g of glucose: patients of group 1 (n = 22) had glucose level ≤ 200 mg/dl during 1-st hour of GTT; other patients (n = 25) composed group 2. Examination of all patients included transthoracic echocardiography, ultrasound Dopplerography, tissue Doppler (TD) and 24-hour Holter ECG monitoring. Using data of these methods we calculated left ventricular (LV) mass and the following characteristics of mitral ring: E/A, TD e', TD a', TD s', TD e'/a'/. The following characteristics of heart rate variability were obtained: standard deviation of normal RR intervals (SDNN), low and high frequency (LF, HF) power, LF/HF ratio. RESULTS: Patients of group 2 had higher LV mass (229.5 ± 58.2 vs. 192.1 ± 50.6 g; p = 0.036), more pronounced changes of TD e'/a' (0.71 ± 0.25 vs. 1.06 ± 0.58; p = 0.011), lower SDNN both during day (85.4 ± 14.1 vs. 112.5 ± 31.3 ms, p = 0.007) and night (82.2 ± 22.1 vs. 105.9 ± 28.5 ms, p = 0,004) time, higher nocturnal LF/HF ratio (3.75 ± 4.02 vs. 1.72 ± 0.81, p = 0,029). CONCLUSION: In patients with controlled arterial hypertension (AH) and glycemic response during first hour of GCT we revealed various pronounced manifestations of DCM. These data constitute a basis for further studies.

Total anonychia congenita: a rare heterogeneic disorder.

Total anonychia congenita is a very rare disorder in which all the finger nails and the toenails are absent without significant bone anomalies. This condition is reported to have an autosomal dominant inheritance pattern. There are a variety of syndromes or conditions associated with anonychia congenita. In this study we present a monozygotic twin with isolated anonychia congenita totals. Interestingly there is no family history of anonychia and this condition seems to be caused by a sporadic mutation.

Sporadic familial polydactyly.

Polydactyly is one of the most common congenital deformities of the hands. It can occur as an Isolated disorder, in association with other malformations of the hands or feet, or as part of a syndrome. It can occur sporadically but it can also be inherited with a mainly autosomal dominant inheritance. We present a family with three out of four members of the last generation with no previous history of polydactyly. Although the affected children presented different phenotypes of polydactyly, probably all three cases were the result of the same mutation seen in one of the parents. In addition no syndromic association could be found. Our experience with the management of this family's members is presented and possible etiological factors and treatment modalities are discussed.

Report of two cases with Van der Woude syndrome: a child and her mother.

Report of two cases with Van der Woude syndrome: a child and her mother: Congenital pits of the lower lip are rare malformations. They are closely associated with cleft lip (CL), cleft lip/palate (CL/CP) or isolated cleft palate (CP) and if so this condition is known as Van der Woude syndrome, which is inherited in an autosomal dominant fashion with high penetrance. Two individuals, one with lower lip pits and cleft palate and the other with isolated lower lip pit from the same family are described. Autosomal dominant pattern of inheritance was observed in this family and treatment consisted of complete removal of sinus tracts in one patient. Pathological features of sinus tracts consisted of stratified nonkeratinized squamous epithelium and a lamina propria of dense connective tissue. Importance of genetic counseling is emphasized as at least half of gene carriers have some kind of clefting.