Visible light nearly perfect absorber: an optimum unit cell arrangement for near absolute polarization insensitivity.

In this work, we propose an optimum unit cell arrangement to obtain near absolute polarization insensitivity in a metal-insulator-metal (MIM) based ultra-broadband perfect absorber. Our findings prove that upon utilizing this optimum arrangement, the response of the absorber is retained and unchanged over all arbitrary incidence light polarizations, regardless of the shape of the top metal patch. First, the impact of the geometry of the top nanopatch resonators on the absorption bandwidth of the overall structure is explored. Then, the response of the MIM design for different incidence polarizations and angles is scrutinized. Finally, the proposed design is fabricated and characterized.

Susceptible bacteria can survive antibiotic treatment in the mammalian gastrointestinal tract without evolving resistance.

Antibiotic resistance and evasion are incompletely understood and complicated by the fact that murine interval dosing models do not fully recapitulate antibiotic pharmacokinetics in humans. To better understand how gastrointestinal bacteria respond to antibiotics, we colonized germ-free mice with a pan-susceptible genetically barcoded Escherichia coli clinical isolate and administered the antibiotic cefepime via programmable subcutaneous pumps, allowing closer emulation of human parenteral antibiotic dynamics. E. coli was only recovered from intestinal tissue, where cefepime concentrations were still inhibitory. Strikingly, "some" E. coli isolates were not cefepime resistant but acquired mutations in genes involved in polysaccharide capsular synthesis increasing their invasion and survival within human intestinal cells. Deleting wbaP involved in capsular polysaccharide synthesis mimicked this phenotype, allowing increased invasion of colonocytes where cefepime concentrations were reduced. Additionally, "some" mutant strains exhibited a persister phenotype upon further cefepime exposure. This work uncovers a mechanism allowing "select" gastrointestinal bacteria to evade antibiotic treatment.

Toll-like receptor expression in monocytes in patients with chronic kidney disease and haemodialysis: relation with inflammation.

BACKGROUND: Inflammation is one of the main contributors to atherosclerosis in haemodialysis (HD) patients. Activation of Toll-like receptors (TLRs) leads to inflammatory response. In this study, we aimed to evaluate the expression of TLRs on monocytes and relate their expression with inflammation in chronic kidney disease (CKD) and HD patients. METHODS: Thirty-four age- and gender-matched controls and stage 3-4 CKD patients and thirty-two HD patients were included in each study group. The effect of HD on the expression of Toll-like receptor-2 (TLR-2) and Toll-like receptor-4 (TLR-4) on CD14( +) monocytes was determined at the beginning (baseline), during (120 min) and following (300 min and 24 h) HD and compared with control and stage 3-4 CKD groups. The HD procedure was performed by using low-flux polysulphone dialysers. In addition, serum IL-6 levels were evaluated in both groups at baseline and after a HD session. RESULTS: The percentage of CD14( +) monocytes expressing TLR-2 were similar in all of the study groups, whereas the percentage of CD14( +) monocytes expressing TLR-4 were significantly lower in both stage 3-4 CKD and HD patients at baseline than in controls. The mean fluorescence intensities (MFI) of TLR-2 were significantly lower in controls than in stage 3-4 CKD and HD patients at baseline. The MFI of TLR-4 was similar in all of the groups. The percentage of CD14( +) monocytes expressing TLR-2 did not change during and after HD. The MFI of TLR-2 decreased at 120 min of HD compared with baseline (1837 ± 672 vs 1650 ± 578, P < 0.05), and recovered back to baseline values at 300 min and at 24 h post-HD. MFI of TLR-4 increased at 24 h compared with baseline (941 ± 294 vs 1087 ± 441, P < 0.05). Serum IL-6 levels correlated with MFI of TLR-2 and TLR-4 in stage 3-4 CKD patients and in HD patients at baseline and after HD in univariate analysis. Stepwise multiple regression analysis revealed that MFI of TLR-2 was an independent determinant of serum IL-6 concentrations in stage 3-4 CKD and in HD patients at baseline, at 300 min and at 24 h post-HD. Conclusions. Our study demonstrates that TLR-2 is associated with the inflammatory response of non-dialysed and dialysed CKD patients.

C-reactive protein is an independent predictor for carotid artery intima-media thickness progression in asymptomatic younger adults (from the Bogalusa Heart Study).

BACKGROUND: Conflicting information exists regarding the association between hsCRP and the progression of early stages of atherosclerosis. The purpose of the study was to investigate the association of high sensitiviy c-reactive protein (hsCRP) along with major cardiovascular (CV) risk factors on early carotid atherosclerosis progression in a large, population-based cohort study. METHODS: The study cohort included 839 young adults (aged 24 to 43 years, 70% white, 42% men) enrolled in Bogalusa Heart Study, who in 2001-2002 attended baseline examination with measurements of CV risk factors. Progression of carotid artery intima-media thickness (IMT) was assessed during a mean follow-up of 2.4 years. RESULTS: Carotid artery IMT progression rates were as follows: composite carotid artery = 9.2 ± 52 µm/y, common carotid artery = 0.0 ± 51 µm/y, carotid bulb = 8.8 ± 103 µm/y, and internal carotid artery = 18.9 ± 81 µm/y. Elevated baseline hsCRP, reflecting an inflammatory state, showed independent association with composite carotid artery IMT progression. Increased age, systolic blood pressure, fasting glucose, LDL cholesterol, and current smoking were other risk associates of carotid artery IMT progression in young adults, indicating an underlying burden on the CV system by multiple risk factors. CONCLUSION: In this population-based study, we observed independent categorical association of increased hsCRP with carotid artery IMT progression in young adults. This study underlines the importance of assesssing hsCRP levels along with smoking and traditional CV risk factor profiles in asymptomatic young adults.

Prediction of Potential MicroRNA-Disease Association Using Kernelized Bayesian Matrix Factorization.

MicroRNA (miRNA) molecules, which are effective in the formation and progression of many different diseases, are 18-22 nucleotides in length and make up a type of non-coding RNA. Predicting disease-related microRNAs is crucial for understanding the pathogenesis of disease and for diagnosis, treatment, and prevention of diseases. Many computational techniques have been studied and developed, as the experimental techniques used to find novel miRNA-disease associations in biology are costly. In this paper, a Kernelized Bayesian Matrix Factorization (KBMF) technique was suggested to predict new relations among miRNAs and diseases with several information such as miRNA functional similarity, disease semantic similarity, and known relations among miRNAs and diseases. AUC value of 0.9450 was obtained by implementing fivefold cross-validation for KBMF technique. We also carried out three kinds of case studies (breast, lung, and colon neoplasms) to prove the performance of KBMF technique, and the predictive reliability of this method was confirmed by the results. Thus, KBMF technique can be used as a reliable computational model to infer possible miRNA-disease associations.

Prediction of miRNA-disease associations based on Weighted [Formula: see text]-Nearest known neighbors and network consistency projection.

MicroRNAs (miRNA) are a type of non-coding RNA molecules that are effective on the formation and the progression of many different diseases. Various researches have reported that miRNAs play a major role in the prevention, diagnosis, and treatment of complex human diseases. In recent years, researchers have made a tremendous effort to find the potential relationships between miRNAs and diseases. Since the experimental techniques used to find that new miRNA-disease relationships are time-consuming and expensive, many computational techniques have been developed. In this study, Weighted [Formula: see text]-Nearest Known Neighbors and Network Consistency Projection techniques were suggested to predict new miRNA-disease relationships using various types of knowledge such as known miRNA-disease relationships, functional similarity of miRNA, and disease semantic similarity. An average AUC of 0.9037 and 0.9168 were calculated in our method by 5-fold and leave-one-out cross validation, respectively. Case studies of breast, lung, and colon neoplasms were applied to prove the performance of our proposed technique, and the results confirmed the predictive reliability of this method. Therefore, reported experimental results have shown that our proposed method can be used as a reliable computational model to reveal potential relationships between miRNAs and diseases.

Correlates of common carotid artery lumen diameter in black and white younger adults: the Bogalusa Heart Study.

BACKGROUND AND PURPOSE: Vascular remodeling as depicted by increases in arterial lumen diameter occurs in response to development of atherosclerosis. However, data on the correlates of arterial lumen diameter in younger adults by race and sex are limited. METHODS: The study cohort included 734 white and 306 black subjects, aged 20 to 43 years, enrolled in the Bogalusa Heart Study. The common carotid artery lumen diameter at diastole and intima media thickness (IMT) were measured by M- and B-mode ultrasonography, respectively. RESULTS: As a group, blacks versus whites (3.44 mm/m versus 3.37 mm/m, P=0.002) and males versus females (3.45 mm/m versus 3.35 mm/m, P<0.001) had greater height-adjusted lumen diameter. In multivariate analyses of total sample, body mass index, mean arterial pressure, heart rate, and carotid IMT were independent predictors of height-adjusted lumen diameter. The magnitude of the effects of mean arterial pressure and carotid IMT on height-adjusted lumen diameter was significantly different between races with blacks showing greater slopes (difference in slopes: P=0.011 for mean arterial pressure; P=0.033 for IMT); interaction effects of body mass index and mean arterial pressure with sex on height-adjusted lumen diameter were also noted with males showing steeper slopes (difference in slopes: P=0.003 for body mass index; P=0.005 for mean arterial pressure). In addition, the lumen diameter-carotid IMT relationship was stronger in hypertensives than in normotensives (difference in slopes: P=0.038). CONCLUSIONS: Common carotid artery lumen diameter is influenced by carotid artery IMT, adiposity, and blood pressure in a race- and sex-specific manner in asymptomatic younger adults, which may have implications for preventive cardiology.

Prehypertension and black-white contrasts in cardiovascular risk in young adults: Bogalusa Heart Study.

OBJECTIVE: The aim of this study was to examine the association of prehypertension with measures of cardiovascular disease risk in a biracial (black-white) population of young adults. METHODS: As part of the Bogalusa Heart Study, echocardiography and carotid ultrasonography were performed along with cardiovascular risk factor measurements in 1379 young adult participants (age range 20-44 years, average 36 years; 43% men, 70% white). Participants were categorized as normotensives (60%), prehypertensives (27%) and hypertensives (13%). RESULTS: The prevalence of prehypertension was significantly higher among men than women (35 vs. 22%) and among blacks than whites (29 vs. 27%). Compared with normotensives, prehypertensives had a greater adverse cardiovascular risk factor profile. Male sex and BMI equally and significantly contributed to the prehypertension status in both whites [odds ratio (OR) and 95% confidence interval 2.66 (1.88-3.74) and 1.10 (1.07-1.14)] and blacks [OR: 2.56 (1.51-4.33) and 1.05 (1.01-1.09)]. Additionally, prehypertensives compared with normotensives had significantly higher left ventricular (LV) mass index, LV internal diameter, and carotid artery intima-media thickness. CONCLUSION: The condition of prehypertension in young adults shows men>women and black women>white women, and participants with prehypertension already have adverse profiles of risk factors and indices of subclinical cardiovascular disease. A greater percentage of blacks at a relatively young age fall into the hypertensive category. These findings underscore the need for aggressive management of cardiovascular risk in youth at levels below those considered as hypertension.

Plasma homocysteine is adversely associated with glomerular filtration rate in asymptomatic black and white young adults: the Bogalusa heart study.

That plasma homocysteine is elevated markedly in renal dysfunction is well recognized. But whether the increased homocysteine is an independent correlate of glomerular filtration rate, a marker of renal function, in asymptomatic younger individuals is not clear. The aim of this study was to determine the association between plasma homocysteine and renal function in a biracial (black-white) community-based cohort of asymptomatic young adults. Plasma homocysteine along with cardiovascular disease risk factor variables were measured in 805 white and 330 black subjects, ages 24-44 years, enrolled in the Bogalusa Heart Study. Modification of Diet in Renal Disease Study equation was used to calculate the estimated glomerular filtration rate (eGFR) from serum creatinine level. Males versus females showed higher homocysteine levels (8.83 +/- 3.16 vs. 7.35 +/- 2.84 micromol/L, p < 0.0001) and lower eGFR (99.1 +/- 17.6 vs. 102.5 +/- 21.0 mL/min/1.73 m(2), p = 0.024). Whites versus blacks had lower eGFR (97.3 +/- 18.0 vs. 110.0 +/- 20.6 mL/min/1.73 m(2), p < 0.0001). In a multivariate regression analysis that included age, race, sex, body mass index, blood pressure, lipoprotein variables, insulin resistance index and homocysteine, white race, age and homocysteine, in that order, were independently and negatively associated with eGFR. The odds ratio (95% confidence interval) of individuals in the homocysteine quintiles II, III, IV and V vs. I for having the risk of impaired eGFR defined as <10th percentile was 2.28 (0.95-5.50, p = 0.065), 2.97 (1.24-7.12, p = 0.015), 3.32 (1.45-7.60, p = 0.005) and 6.99 (3.06-15.94, p < 0.0001), respectively. Homocysteine is an independent correlate of renal function in asymptomatic black and white young adults.

P wave dispersion increases during hemodialysis sessions.

BACKGROUND/AIMS: Atrial fibrillation (AF) is common among hemodialysis (HD) patients and is associated with high mortality. P wave dispersion (PWD) is a noninvasive electrocardiographic marker of paroxysmal AF. Our aim was to evaluate the effect of HD session on PWD. METHODS: Twenty-five patients (mean age 63 years, 10 males) with sinus rhythm and undergoing chronic HD treatment were included. Blood samples were drawn and 12-lead electrocardiograms were recorded immediately before HD session, at the 2nd hour during HD and at the end of the HD session. The difference between maximum and minimum P wave durations was calculated as PWD. RESULTS: PWD significantly increased during HD sessions compared with predialysis values (41 +/- 12 vs. 21 +/- 10 ms, respectively, p < 0.001), then decreased to a value of 24 +/- 7 ms at the completion of HD, which was not significantly different from the predialysis values. PWD during HD was significantly correlated with predialysis systolic and diastolic blood pressure (r = 0.42, p = 0.037, and r = 0.59, p = 0.002, respectively) and predialysis serum potassium level (r = 0.44, p = 0.031). Linear regression model revealed that predialysis diastolic blood pressure (p = 0.002), predialysis serum potassium level (p = 0.037) and the amount of ultrafiltration (p = 0.048) were the significant predictors of prolonged PWD during HD. CONCLUSION: PWD increases significantly during HD sessions. This may increase the risk of AF episodes during HD. High diastolic blood pressure and serum potassium level before HD and ultrafiltration amount may predict prolonged PWD during HD.

Perindopril decreases P wave dispersion in patients with stage 1 hypertension.

INTRODUCTION: Angiotensin-converting enzyme inhibitors prevent atrial fibrillation episodes by effective control of blood pressure and improving electrical and structural remodelling in the atria. Increased P wave dispersion (PWD) is a non-invasive electrocardiographic marker for paroxysmal atrial fibrillation. The aim of the study was to evaluate the effect of perindopril treatment on PWD in hypertensive patients. METHODS: Forty-eight hypertensive patients (mean age 57.4+/-11.8 years, 18 men) were included. Blood pressure values were determined and 12-lead electrocardiograms were recorded at the beginning and at the first week, first month, third month and sixth month of the perindopril treatment.The difference between maximum and minimum P wave durations was calculated as PWD. RESULTS: PWDs were significantly shortened at the first, third and sixth months (41.7+/-8.8 ms, 39.1+/-6.9 ms and 38.3+/-7.1 ms, respectively) compared with baseline and first-week measurements (54.3+/-9.2 ms and 49.0+/-9.1 ms, respectively, p<0.001). Baseline PWD was correlated with body mass index (r=0.32, p=0.026), while PWD at the sixth month of treatment was significantly correlated with left atrial volume index (r=0.30, p=0.042). Multiple linear regression analysis revealed that PWD at the sixth month was related to baseline PWD (p=0.001). CONCLUSION: Perindopril treatment significantly reduced PWD in hypertensive patients.

Relation of childhood risk factors to left ventricular hypertrophy (eccentric or concentric) in relatively young adulthood (from the Bogalusa Heart Study).

Left ventricular (LV) structural alterations were associated with increased cardiovascular morbidity and mortality in a middle-aged and older population. The aim of this study was to determine childhood and adulthood cardiovascular risk predictors of LV geometric remodeling in a biracial (black-white) population of young adults. As part of the Bogalusa Heart Study, echocardiographic examinations of the heart were performed in 824 adults (age range 24 to 44 years, average 36; 41% men, 69% white) who had risk-factor variables in their childhood. Eccentric LV hypertrophy and concentric remodeling were the most commonly encountered LV geometric changes in this young adult population (4.7% vs 1.8% for concentric LV hypertrophy). In adulthood, subjects with eccentric and/or concentric LV hypertrophy compared with normal geometry were more likely to be obese and/or diabetic and had significantly increased body mass index, waist circumference, systolic and diastolic blood pressures, glucose, insulin, hemoglobin A1c, total/high-density lipoprotein cholesterol ratio, triglycerides, and urinary albumin-creatinine ratios. In multinomial logistic regression analyses, both adulthood and childhood body mass index were significant determinants of eccentric LV hypertrophy (odds ratios [ORs] 1.15 and 1.19). The presence of diabetes mellitus in adulthood (OR 8.25) and diastolic blood pressure in childhood (OR 1.14) were significant predictors of concentric LV hypertrophy. In adults, blacks had higher ORs for concentric LV hypertrophy and related to diabetes and systolic blood pressure. In conclusion, in this community-based study of young adults, eccentric LV hypertrophy was more frequent and obesity since childhood was the only consistent and significant determinant of this type of adverse cardiac remodeling.

Diurnal blood pressure abnormalities are related to endothelial dysfunction in patients with non-complicated type 1 diabetes.

Patients with diabetes have an increased cardiovascular morbidity and mortality despite interventions to prevent these outcomes. Abnormalities in diurnal blood pressure patterns are also associated with excess cardiovascular mortality. The aim of this study was to determine the effects of diurnal blood pressure patterns on endothelial function and oxidative stress in patients with uncomplicated type 1 diabetes mellitus. Thirty-two normotensive and normoalbuminuric type 1 diabetic patients (21 dipper and 11 nondipper) and 37 healthy (27 dipper and 10 nondipper) volunteers underwent 24-h ambulatory blood pressure monitoring. Their endothelial functions were evaluated using flow mediated dilatation (FMD) and by measuring nitric oxide and thiobarbituric acid reactive substances (TBARS). Dippers were defined as subjects who exhibited an average reduction in both systolic and diastolic blood pressure of greater than 10% between day and night periods. Nondipper type 1 diabetic patients and controls had nighttime systolic and diastolic blood pressure values that were significantly higher than those of dipper diabetic patients (p<0.05) and dipper controls (p<0.01). Values of FMD for nondipper diabetic patients (5.12+/-2.2%) were significantly lower than those in dipper diabetic patients (10.19+/-2.5%, p<0.01), nondipper (10.08+/-2.9%, p<0.001) and dipper controls (11.76+/-3.8%, p<0.001). Additionally, levels of TBARS in the dipper diabetic group and dipper controls were significantly lower than those in the nondipper diabetic group (p<0.05). In conclusion, only type 1 diabetic patients with a nondipping pattern of blood pressure exhibited changes that may lead to endothelial dysfunction and atherosclerosis. (Hypertens Res 2008; 31: 2065-2073).

Exogenous subclinical hyperthyroidism impairs endothelial function in nodular goiter patients.

BACKGROUND: Exogenous subclinical hyperthyroidism is associated with cardiovascular and metabolic changes. The aim of this study was to evaluate the effect of levothyroxine (LT4) suppression on endothelial function and insulin sensitivity in euthyroid nodular goiter patients. METHODS: Twenty-two euthyroid patients with multinodular goiter (MNG) and 22 matched healthy controls were studied. LT4 was administered in doses ranging from 50 to 150 microg/day to reach target serum thyroid-stimulating hormone (TSH) levels <0.5 mIU/L. Patients were studied before and after 8 weeks after the target TSH level <0.5 mIU/L. The control group was studied twice, 16 weeks apart. Flow mediated vasodilatation (FMD), insulin sensitivity index (ISI), lipid peroxidation, and high-sensitivity C-reactive protein (hsCRP) were the outcome measures. RESULTS: LT4 treatment significantly suppressed TSH levels to 0.2 +/- 0.1 mIU/L (minimum and maximum range was 0.05-0.3 mIU/L). FMD decreased from 10.7 +/- 2.7% to 5.4 +/- 1.7% (p < 0.001) and mean ISI decreased from 2.56 +/- 1.10 to 1.41 +/- 0.50 (p < 0.001) with LT4 treatment in the MNG group. Lipid peroxidation measured as thiobarbituric acid reactive substances (Tbars) (p < 0.05), and hsCRP (p < 0.001) levels significantly increased compared to the baseline in the MNG group. FMD measurement inversely correlated with free T4 (p = 0.008) and Tbars (p = 0.004), and positively correlated with ISI (p = 0.004). Serum Tbars and hsCRP were independent predictors of FMD (p = 0.004) in multivariate analysis. All results expressed as mean +/- SD. CONCLUSIONS: TSH suppression therapy with LT4 leading to subclinical hyperthyroidism may cause impaired endothelial function, increased oxidative stress, and decreased insulin sensitivity in euthyroid nodular goiter patients.

The acute effect of cardiac pacing mode on endothelial vasodilation: prospective, double-blind, cross-over, comparative clinical study.

BACKGROUND: Compared to atrioventricular sequential pacing, ventricular demand pacing is known to have somewhat more deleterious hemodynamic effects, which probably arise from increased sympathetic tonus and inappropriate baroreceptor activation. Endothelial function is affected by various local and systemic factors including baroreceptor activity. The aim of this study was to explore whether cardiac pacing would have any effect on endothelial functions. METHODS: Twelve patients (six male, mean age: 75 +/- 9 years) with previously implanted DDD or VDDcardiac pacemakers were included. All patients had stable atrial rhythms during the study. Patients were randomized to either atrial-based pacing mode (VDD or DDD) or ventricular demand pacing mode (VVI) first, and then cross-over was performed with the other pacing mode. Endothelial function was assessed by brachial artery ultrasonography. Basal diameter of the brachial artery, and both flow-mediated dilation (FMD) and endothelium-independent vasodilation with nitroglycerin were measured 1 hour after each pacing mode. RESULTS: Compared to atrial-based pacing mode, ventricular demand pacing was associated with a significantly worse FMD both as absolute and percentage values (0.17 +/- 0.09 mm vs 0.28 +/- 0.11 mm, P = 0.015 and 4.84 +/- 2.37 % vs 7.00 +/- 2.88 %, P = 0.028, respectively). However, there was no significant difference in nitroglycerin-mediated vasodilation values between the two pacing sessions. CONCLUSIONS: Acute ventricular demand pacing (VVI pacing) is clearly associated with attenuation of FMD in patients with atrial-based pacing systems. The attenuation of endothelial vasodilation might have a role in hemodynamic and clinical deterioration in patients with VVI pacemakers.

Echocardiographic evaluation of cardiac diastolic function in patients with rheumatoid arthritis: 5 years of follow-up.

Rheumatoid arthritis (RA) is associated with increased cardiovascular mortality. However, cardiovascular findings are mostly subtle, and diastolic function abnormalities are one of the earliest manifestations. The aim of this study was to determine diastolic function abnormalities in RA patients and to make a reevaluation of diastolic function after 5 years of follow-up. Seventy-two RA patients (mean age: 48+/-11 years, F/M: 62/10) without any known cardiac disease and 67 controls (mean age: 46+/-11 years; F/M: 53/14) were recruited. Disease activity score (DAS), lipid values, and C-reactive protein (CRP) levels were determined. Left ventricular mass, isovolumetric relaxation time, mitral annular early (E), and late (A) diastolic filling rate were determined by M-mode two-dimensional color Doppler echocardiography. Mitral annular early (E') and late (A') diastolic velocities were also evaluated by tissue Doppler echocardiography. Twenty-four RA patients were reevaluated after 5 years of follow-up with DAS, biochemical variables, and echocardiography. Fifty five of 72 (76%) RA patients and 12 of the 67 (18%) controls had diastolic dysfunction (DD). Seven of ten patients with DD at baseline continued to have DD, whereas three did not show DD at 5 years. Six of 14 patients without DD at baseline developed DD at follow-up, while eight patients sustained normal diastolic function. Although DAS and lipid values were not altered during the course of 5 years, CRP levels decreased significantly (P<0.05). In conclusion, RA patients have diastolic function abnormalities compared to healthy controls. Five-year follow-up of a subgroup of our patients showed that, although clinical response was unsatisfactory, cardiac function was conserved without a major deterioration. Moreover, DMARDs, such as anti-TNFalpha agents, do not seem to have a major adverse effect on cardiac findings in these patients.

Cross-validation of the Turkish version of the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ 25).

PURPOSE: To test the validity and reliability of the Turkish version of the self-administered form of the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ 25). METHODS: Patients with no limitations to respond to a health status interview and affected by a chronic eye disease were enrolled. The Turkish versions of the abbreviated form of World Health Organization Quality of Life (WHOQOL-BREF) and the NEI-VFQ 25 instruments were administered to all participants. RESULTS: The mean (SD) age of the participants was 60.9 (14.5) years. There were 61 patients with one of the following conditions: Cataract (57.4%), diabetic retinopathy (13.2%), age related macular degeneration (ARMD) (11.4%), glaucoma (9.8%) and degenerative myopia (8.2%). The Cronbach alpha of the overall scale was 0.97; the Cronbach alpha ranged from 0.94 to 0.78 for the subscales. The physical, psychological, environmental and social domains of the WHOQOL-BREF had fair to good correlations with the NEI-VFQ 25 (r = 0.68 to r = 0.26), which indicated a sufficient convergent validity. Patients with lower visual acuity (VA) had lower index scores than those with higher VA (p = 0.001), which showed a sufficient responsiveness. CONCLUSION: Statistical analysis showed that Turkish version of the NEI-VFQ is a valid and reliable instrument to measure vision-related quality of life in patients with chronic eye diseases.

Effects of restoration of the euthyroid state on epicardial adipose tissue and carotid intima media thickness in subclinical hypothyroid patients.

Epicardial adipose tissue (EAT) thickness is a novel cardiovascular risk indicator, whereas carotid intima media thickness (CIMT) is a known marker of subclinical atherosclerosis. The aim of this study was to measure EAT thickness and CIMT in subclinical hypothyroid (SCH) patients and to determine the effect of restoration of the euthyroid state on these variables. The study included 43 patients with SCH (mean age: 35.2±10.7 years; F-M ratio: 42:1) and 30 healthy controls (mean age: 34.5±8.2 years; F-M ratio: 25:5). EAT thickness and CIMT were measured via conventional echocardiography and ultrasonography. Among the patients, 23 were followed up with L-thyroxine replacement until restoration of the euthyroid state and re-evaluated 6 months after baseline. Basal EAT thickness was higher in the SCH patients than in the controls (3.2±0.7 vs. 2.3±0.3 mm-p<0.0001), whereas CIMT was similar in both groups (0.50±0.09 vs. 0.48±0.04 mm). EAT thickness was correlated with CIMT in the patient group (r=0.39, p=0.01), but this correlation was not evident based on multivariate analysis when corrected for age and body mass index (r2=0.47 and p=0.0001 for the model). In the follow-up patient subgroup, both EAT thickness and CIMT decreased significantly following L-thyroxine treatment, when normal TSH levels were attained (3.4±0.7 vs. 2.3±0.5 mm-p=0.007 and 0.51±0.09 vs. 0.46±0.07 mm-p=0.01, respectively). EAT thickness was greater in the SCH patients than in controls, whereas CIMT was similar in both groups. Restoration of the euthyroid state with L-thyroxine treatment was associated with significant decreases in EAT thickness and CIMT in the group of patients that received L-thyroxine treatment and, as such, might reduce the cardiovascular risk associated with SCH.

Tear function changes of postmenopausal women in response to hormone replacement therapy.

OBJECTIVE: The goal of this study was to search the effect of hormone replacement therapy (HRT) on tear function changes in postmenopausal women. METHODS: Following initial ophtalmic evaluation and tear sample collection, the subjects were given daily 0.625 mg conjugated estrogen, and either continuous combined or cyclic 5 mg medroxyprogesterone acetate was added. Eye examination included visual acuity, slit-lamp examination, fundus examination, tonometry, Schirmer's test, and break up time (BUT) evaluation. Six months later, control examination was done and repeat tear samples were obtained. Tear immune globulin A (IgA) and lysozyme levels were measured by gel electrophoresis. The pictures of the bands were evaluated by digital image analysis with Scion Image program. RESULTS: Conjunctival vascular congestion, laxity and corneal desquamation did not change before and after HRT (P>0.05). A significant improvement was noted in meibomian gland inflammation (P=0.034). We have not observed any significant difference in burning, foreign body sensation, and tearing (P>0.05). In addition, no significant difference was noted in BUT (P=0.370) and Schirmer's test values (P=0.271). Though both lysozyme and IgA levels were elevated following the therapy, only IgA levels increased significantly (P=0.04). CONCLUSION: HRT decreased meibomian gland inflammation and increased tear lysozyme and IgA levels in postmenopausal women.