RESUMEN
BACKGROUND: Adolescent pregnancy is defined as pregnancy occurring in young women between the ages of 10 and 19 years. Adolescent pregnancies, which are among the social healthcare concerns in developed and developing countries, have negative effects on maternal and infant health. Pregnancy in adolescence puts the health of both the mother and child at risk, as adolescent pregnancies have higher rates of eclampsia, systemic infection, low birth weight, and preterm delivery compared to other pregnancies. In this study, the effects of education level, smoking, and marital status on maternal and foetal outcomes in adolescent pregnancies were evaluated. METHODS: The records of a total of 960 pregnant women (480 pregnant adolescents aged 15-19 years and 480 pregnant adult women aged 20-26 years) were examined retrospectively. The demographic data of the groups and maternal and foetal outcomes of the pregnancies were compared. A logistic regression model was established as a statistical method for reducing confounding effects. RESULTS: Unmarried women were statistically significantly more prevalent in the adolescent group (38.3% vs. 7.3%). Among the considered risk factors, preeclampsia (2.9% vs. 0.8%) and smoking (29.8% vs. 9.8%) were statistically significantly more common in the adolescent group. When the groups were compared in terms of risk factors in pregnancy, it was found that pregnancy in adolescence was associated with a 3.04-fold higher risk of smoking, 5.25-fold higher risk of being unmarried, 3.50-fold higher risk of preeclampsia, and 1.70-fold higher risk of intrauterine growth retardation (IUGR). CONCLUSIONS: This study demonstrates an increased risk of preeclampsia, IUGR, and smoking during pregnancy in adolescent pregnant women. These findings can be used to identify adolescent pregnancies requiring specific assistance and to take measures to reduce the probability of adverse outcomes.
In this study, we examine the risks of adolescent pregnancies. Adolescent pregnancy is a public health problem, and it is more common in underdeveloped or developing countries. We believe that non-governmental organisations and governments should take precautions regarding adolescent pregnancies and protect this legally vulnerable sociodemographic group from pregnancy. For healthier and more conscientious pregnancy experiences, mothers must be of appropriate age, having passed the period of adolescence. Adolescent pregnancies, which come with many risks, and especially risks of preeclampsia, premature birth, and maternal death, should be minimised or prevented.
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Resultado del Embarazo , Embarazo en Adolescencia , Fumar , Humanos , Femenino , Embarazo , Embarazo en Adolescencia/estadística & datos numéricos , Adolescente , Estudios Retrospectivos , Adulto Joven , Turquía/epidemiología , Adulto , Factores de Riesgo , Fumar/epidemiología , Fumar/efectos adversos , Resultado del Embarazo/epidemiología , Preeclampsia/epidemiología , Estado Civil/estadística & datos numéricos , Escolaridad , Complicaciones del Embarazo/epidemiologíaRESUMEN
BACKGROUND: We aimed to compare the level of hepatic FIB-4 scores between COVID-19 patients who had pneumonia and COVID-19 patients who had no pneumonia in an attempt to develop a risk assessment after the treatment and recovery of active COVID-19 infection. METHODS: The study included 80 patients who were consecutively selected and admitted to an internal medicine outpatient clinic for a control examination after COVID-19 infection. Chest tomography was performed on all patients during the COVID-19 infection. Patients were divided into two groups as those with and without lung involvement on CT. COVID-19 infection was diagnosed using real-time reverse transcription-polymerase chain reaction (RT-PCR). The hepatic fibrosis 4 (FIB-4) index score was calculated for each patient. The statistical analyses were performed using Student's t-test and chi-squared tests. RESULTS: We found that the increased hepatic FIB-4 index score in patients with pneumonia group was statistically significant compared to the control group (p < 0.001). The regression analysis showed that the hepatic FIB-4 index has significant prognostic efficiencies in both uni- and multivariate models (p < 0.05). CONCLUSIONS: The hepatic FIB-4 index appears to be a simple parameter with a good prognostic value in patients with COVID-19 infection.
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COVID-19 , COVID-19/diagnóstico , Humanos , Pronóstico , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , SARS-CoV-2 , Tomografía Computarizada por Rayos X/métodosRESUMEN
BACKGROUND: Hashimoto thyroiditis (HT) is one of the most prevalent autoimmune diseases. The intestine microbiota is strongly associated with autoimmune diseases. Zonulin, a modulator of tight junctions that controls the selective permeability of the intestine can induce an elevation in gut permeability. We aimed to investigate the association of plasma zonulin levels with HT. METHODS: We compared 77 HT patients with 66 age-gender and BMI-matched healthy individuals in the case of plasma zonulin levels. Plasma zonulin levels were measured by ELISA. The statistical analyses were performed using Student's t-test and chi-square tests. The predictive power was investigated using univariate and multivariate logistic regression analysis. RESULTS: We found that the increase in plasma zonulin levels in the HT group was statistically significant compared to the control group (p < 0.001). The regression analysis showed that urea, anti-thyroid peroxidase, aspartate aminotransferase, thyroid-stimulating hormone, free T3, and serum zonulin levels were found to be associated with HT in both univariate and multivariate models (p < 0.05). DISCUSSION: Zonulin is a possible biomarker candidate that may link intestinal permeability with the etiology of autoimmune diseases.
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Enfermedades Autoinmunes , Microbioma Gastrointestinal , Enfermedad de Hashimoto , Humanos , Precursores de Proteínas , Enfermedades Autoinmunes/complicacionesRESUMEN
The aim of this study was to evaluate serum interleukin (IL)-17A levels in patients with coronary artery ectasia (CAE), the relationship between IL and 17A and CAE, and to determine the relationship between the severity of coronary ectasia and the level of IL-17A. In total, 41 patients (19 female and 22 male) with ischemic symptoms whose non-invasive cardiac tests were positive for myocardial ischemia, and in whom coronary artery ectasia were detected after coronary angiography, and 45 patients (32 female and 13 male) with normal coronary arteries were included in this study. Echocardiographic assessments were performed. Serum IL-17A levels of all patients were evaluated using an enzyme-linked immunosorbent assay. IL-17A levels of the group with isolated coronary artery ectasia were significantly higher compared with the control group (4.86⯱â¯3.24 and 1.37⯱â¯1.56â¯ng/ml, respectively; pâ¯<â¯0.001). There was no correlation between the levels of IL-17A and the extension of the CAE, but IL-17A levels were high in both groups. CAE patients have significantly increased levels of IL-17A, fibrinogen, and RDW compared to patients with normal coronary arteries. It was demonstrated that increased levels of IL-17A were associated with ectasia formation in CAE patients.
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Enfermedad de la Arteria Coronaria/metabolismo , Vasos Coronarios/metabolismo , Dilatación Patológica/metabolismo , Interleucina-17/metabolismo , Angiografía Coronaria/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/metabolismoRESUMEN
BACKGROUND: Both the extracellular matrix molecule tenascin-C (Tn-C) and tissue inhibitors of metalloproteinases (TIMPs) have a role in tissue injury, inflammation, and remodeling. In this pilot study, we tried to evaluate the role of these markers in acute kidney injury (AKI). METHODS: A total of 52 subjects were enrolled in this study. Group 1 consisted of 27 patients with AKI (stage 1, 2, and 3), and Group 2 consisted of 25 age- and gender-matched healthy subjects. Serum and urine samples (to determine Tn-C and TIMP-1) were obtained from the participants at the beginning of the study. Second samples were obtained from Group 1 patients when renal function improved (at discharge). RESULTS: Serum TIMP-1 concentrations (admission and discharge) were higher in Group 1 than Group 2 (p = 0.0001 for both comparisons). Tn-C excretion in spot urine was significantly higher in healthy controls than at the admission levels of the patient group (p = 0.036). However, TIMP-1 excretion in spot urine was lower in healthy controls than in admission and discharge levels of the patient group (p = 0.0001 for both comparisons). CONCLUSIONS: Our results show that these biomarkers (especially TIMP-1) may have a role in the pathophysiology of AKI. Further studies are needed in this field.
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Lesión Renal Aguda/patología , Biomarcadores/análisis , Tenascina/análisis , Inhibidor Tisular de Metaloproteinasa-1/análisis , Lesión Renal Aguda/sangre , Lesión Renal Aguda/orina , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Biomarcadores/orina , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Índice de Severidad de la Enfermedad , Tenascina/sangre , Tenascina/orina , Inhibidor Tisular de Metaloproteinasa-1/sangre , Inhibidor Tisular de Metaloproteinasa-1/orina , Adulto JovenRESUMEN
BACKGROUND: Definition of Cardiac Syndrome X (CSX) refers to groups of patients with positive exercise stress test and normal epicardial coronary arteries on coronary angiography accompanied by chest pain. Although the etiology of CSX is not completely understood, there is a common consensus that its pathophysiology may be associated with endothelial dysfunction resulting in impaired coronary flow. Some polymorphisms observed on the MTHFR gene cause inactivation of the MTHFR enzyme, leading to hyperhomocysteinemia and homocysteinuria, which are prominent risk factors of cardiovascular and cerebrovascular diseases. It was aimed to explain the association of the endothelial dysfunction, which is thought to play a role in the pathophysiology of CSX, with C677T polymorphism on MTHFR gene based on genetic basis. METHODS: A total of 176 CSX patients and 196 healthy subjects with similar age and clinical features were compared in terms of C677T polymorphism of the MTHFR gene. RESULTS AND CONCLUSION: There was no significant difference in terms of MTHFR gene C677T polymorphism between CSX patients and controls. When genotypic distribution was compared based on gender in both patients and controls, no significant difference was found between male and female subjects (P>.05). As fasting blood sugar and urea values were significantly higher, alanine aminotransferase and gamma-glutamyl transferase levels were significantly lower in the patients than the controls (P<.05). Described family story of the patients was significantly higher than the controls (P<.05). These suggest that homocysteine metabolism in CSX is not directly related to the endothelial dysfunction and thus the effect on the microvascular circulation.
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Predisposición Genética a la Enfermedad/epidemiología , Predisposición Genética a la Enfermedad/genética , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Angina Microvascular/epidemiología , Angina Microvascular/genética , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo Genético/genéticaRESUMEN
Objective: To determine the differences between the factors such as return of spontaneous circulation positivity, duration of cardiopulmonary resuscitation, and cardiac rhythm at first arrival affecting neurological outcomes in cardiac-arrest cases. Methods: This study was conducted at the Malatya State Hospital, Malatya, Turkey, from January to December 2014, and comprised patients who had received cardiopulmonary resuscitation. Patients were divided into two groups; in-hospital cardiac arrest and out-of-hospital cardiac arrest. The groups were compared in terms of gender, age, initial rhythm, cardiopulmonary resuscitation durations, cardiopulmonary resuscitation results (exitus, return), return of spontaneous circulation rates observed after cardiopulmonary resuscitation, and neurological outcome responses of the cases in which return of spontaneous circulation was observed. SPSS 22 was used for data analysis. RESULTS: Of the 321 cases, 88(27.41%) were in-hospital and 233(72.59%) were out-of-hospital cardiac arrest cases. Besides, 189(58.9%) of the patients were men and 132(41.1%) were women with an overall mean age of 67.21±15.25 years (range: 18-98 years). Moreover, 16(18.2%) in-hospital cases and 47(20.2%) out-of-hospital cases had shockable rhythms at the time of arrival. Cardiopulmonary resuscitation was applied to 74(23%) patients for less than 20 minutes and to 247(76.9%) for more than 20 minutes. Return of spontaneous circulation positivity was recorded in 134(41.7%) patients, of whom 62(70.5%) were in-hospital and 72(30.9%) were out-of-hospital cases. Moreover, 19(5.9%) patients were discharged with good neurological outcome. In cases where cardiopulmonary resuscitation was applied for less than 20 minutes, return of spontaneous circulation positivity was present in 43(100%) in-hospital and 31(100%) out-of-hospital cases. Return of spontaneous circulation positivity and good neurological outcome rate of the patients having shockable rhythms was 48(76.2%) and 8(12.7%), respectively. CONCLUSIONS: Return of spontaneous circulation positivity, favourable neurological outcome response and survival rates were significantly higher among in-hospital cardiac arrest cases.
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Encéfalo/fisiopatología , Reanimación Cardiopulmonar , Paro Cardíaco Extrahospitalario/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Servicios Médicos de Urgencia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Resultado del Tratamiento , Turquía , Adulto JovenRESUMEN
PURPOSE: The aim of this study is to evaluate the correlation between epicardial adipose tissue thickness and oxidative stress parameters in patients with polycystic ovarian syndrome. METHODS: The study included 35 patients with PCOS and 35 healthy women. Transthoracic echocardiography was used to measure the epicardial adipose tissue thickness (EATT) of all patients. For all patients, serum TOS, TAS, hs-CRP, and insulin levels were measured according to the literature, and the HOMA-IR values were calculated. Independent samples t-test, Pearson's correlation analysis, multivariate logistic regression analysis, and receiver operator characteristic curve (ROC) analysis were used in the statistical analysis. RESULTS: Between the patient group and the control group, EATT was significantly higher in the PCOS group compared to the control group (5.4 ± 1.4 mm and 3.9 ± 1.6 mm, respectively; p < 0.001). Similarly, TOS, TAS, and hs-CRP levels were significantly higher in the PCOS group compared to the control group (p < 0.01 for all). The correlation analysis showed a significant positive correlation between EATT and TAS and hs-CRP (r = 0.349, p < 0.01 and r = 0.352, p < 0.01, respectively). Multivariate regression analysis showed a significant correlation between PCOS and EATT, TAS, and diastolic blood pressure (p < 0.05 for all). CONCLUSIONS: Epicardial adipose tissue may play a major role in PCOS pathogenesis by leading to an increase in oxidative stress.
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Tejido Adiposo/diagnóstico por imagen , Estrés Oxidativo/fisiología , Pericardio/diagnóstico por imagen , Síndrome del Ovario Poliquístico/sangre , Síndrome del Ovario Poliquístico/diagnóstico por imagen , Adolescente , Adulto , Femenino , Humanos , Ultrasonografía , Adulto JovenRESUMEN
AIMS: In the Islamic religion, Ramadan is a month in the year that is passed by fasting. Healthy adult individuals are prohibited to eat, drink, and smoke from sunrise to sunset. In the present study, our aim was to assess the relation of Ramadan fasting with fetal development and maternal-fetal Doppler indices in pregnant women. METHODS: This is a prospective case-control study carried out in the month of Ramadan in 2013 (9 July-7 August). One hundred and six pregnant women at the second and third trimesters of pregnancy were enrolled into the study. The sample size of the fasting group was 83 and the non-fasting group sample size was also 83. Fetal biometric measurements, such as biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, amniotic fluid index, and Doppler indices of both uterine and umbilical arteries were evaluated by gray scala and color Doppler ultrasound at the beginning and end of Ramadan. RESULTS: At the end of the Ramadan, increase in biparietal diameter, head circumference, and femur length showed a statistically significant difference from initial measurements (P<0.05). When fasting and non-fasting groups were compared separately, an increase in amniotic fluid index was statistically significant in the non-fasting group (P<0.05). CONCLUSION: We demonstrated some adverse effects of Ramadan fasting on fetal development. In the Islamic religion, pregnant individuals have the privilege of not fasting; therefore, they should consider postponing fasting to the postpartum period, especially in the summer season. If they are willing to do so, an appropriate nutritional program should be recommended.
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Ayuno/efectos adversos , Desarrollo Fetal , Islamismo , Embarazo/fisiología , Adulto , Estudios de Casos y Controles , Ayuno/fisiología , Femenino , Humanos , Estudios Prospectivos , Estaciones del Año , Ultrasonografía Prenatal , Adulto JovenRESUMEN
BACKGROUND: The aim of this study was to evaluate the serum soluble CD40 ligand (sCD40L) levels, serum uroten- sin II levels, and serum leptin levels as an indirect indicator of endothelial dysfunction, inflammation, and atherosclerosis at the microvascular level, and the comparison of those values with those of the control group with a nor- mal coronary flow pattern. METHODS: The study included 35 consecutive patients (17 women, 18 men; average age: 51.20 ± 10.93 years) in our hospital who underwent coronary angiography due to objective myocardial ischemia and in whom slow coronary flow was detected. The control group included 34 consecutive patients with normal coronary flow pattern (18 women, 16 men; average age: 54.59 ± 12.40 years). The coronary flow rates of all patients and control subjects were documented by the thrombolysis in myocardial infarction (TIMI) frame count. Serum sCD40L concentrations, serum urotensin II concentrations and serum leptin concentrations were measured by an enzyme-linked immunosorbent assay method using commercially available kits. RESULTS: The corrected TIMI frame count for LAD, Cx, RCA, and mean TIMI frame count were significantly higher in patients with slow coronary flow (SCF), compared to subjects with normal coronary flow (43.8 ± 1.7 vs. 17.7 ± 4.7, p < 0.001; 27.9 ± 6.9 vs. 11.9 ± 4.8, p < 0.001; 25.4 ± 8.4 vs. 11.1 ± 3.1, p < 0.001; and 32.3 ± 6.4 vs. 13.7 ± 5, p < 0.001, respectively). The serum soluble CD40 ligand and serum urotensin II levels were significantly higher in the slow coronary flow group compared to the control group (12.00 ± 5.43 ng/mL--6.49 ± 5.03 ng/mL, p < 0.001; and 50.94 ± 34.28 pg/mL--26.91 ± 11.52 pg/mL, p < 0.001, respectively). In addition, there was no statistically significant difference between the slow coronary flow group and the control group with regard to serum leptin levels and hs-CRP levels (both p > 0.05). CONCLUSIONS: This study suggests that soluble CD40 ligand and urotensin II likely play a role in the pathogenesis of slow coronary flow.
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Ligando de CD40/sangre , Circulación Coronaria , Fenómeno de no Reflujo/sangre , Receptores Acoplados a Proteínas G/sangre , Adulto , Biomarcadores/sangre , Estudios de Casos y Controles , Angiografía Coronaria , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Leptina/sangre , Masculino , Persona de Mediana Edad , Fenómeno de no Reflujo/diagnóstico , Fenómeno de no Reflujo/fisiopatología , Estudios Prospectivos , Regulación hacia ArribaRESUMEN
Because of its anatomic position, the orbit is frequently subject to trauma, leading to functional and cosmetic problems. After blunt trauma, orbital fractures can cause functional problems by trapping the periocular tissues without affecting the anatomic integrity of the globe. In comparison, high-energy penetrating injuries can cause serious consequences such as disrupting the lacrimal drainage system and causing loss of vision. In rare cases, however, penetration of the orbit by a foreign body can result in a treatable injury that causes no functional or cosmetic problems.This article presents a patient in whom a nail penetrated the orbit from the inferomedial margin and reached the maxillary sinus without damaging the globe, extraocular muscles, or lacrimal duct system. Reports of similar injuries are reviewed, focusing on the anatomic structures that might be traumatized, to guide the readers in considering the diagnosis and treatment of such injuries.
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Cuerpos Extraños en el Ojo/etiología , Lesiones Oculares Penetrantes/etiología , Seno Maxilar/lesiones , Fracturas Orbitales/etiología , Industria de la Construcción , Humanos , Masculino , Persona de Mediana Edad , Fracturas Craneales/etiologíaRESUMEN
PURPOSE: Fetuin-A is a multifunctional hepatic secretory protein that inhibits dystrophic vascular and valvular calcification. Our aim was to evaluate the relationship among fetuin-A levels, heart valve calcification and other biomarkers of inflammation in patients with acute coronary syndrome (ACS). METHODS: The associations among serum fetuin-A concentrations, mitral annular (MAC) and aortic valve calcification and other biomarkers of inflammation (hs-CRP, ferritin, fibrinogen, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), albumin levels) were evaluated in ACS patients and healthy controls. The study included 95 patients (mean age 61.8 ± 12.10 years) and 81 healthy controls (mean age 48.33 ± 9.19 years). RESULTS: Fetuin-A levels were significantly lower in patients with ACS than in healthy controls (0.76 ± 0.23 and 1.10 ± 0.45 g/L, respectively; p < 0.001). Fetuin-A was lower in patients with mitral annular calcification (p = 0.007) and aortic (p = 0.001) valve calcification. In patients with ACS, there was a negative correlation among serum urea (r = -0.377; p < 0.001) and creatinine (r = -0.232; p = 0.024) levels and fetuin-A, and a negative correlation among WBC (r = -0.156; p = 0,132), ESR (r = -0.214; p = 0.037), hs-CRP (r = -0.220; p = 0.032) levels and fetuin-A. A positive correlation was seen between albumin and fetuin-A (r = 0.362; p < 0.001). Multivariate logistic regression analysis revealed that fetuin-A was the variable that had a significant effect on ACS (p = 0.020 OR = .015; (95% CI)(0.000-0.520). CONCLUSION: Fetuin-A levels decrease in patients with acute coronary syndromes, independent of heart valve calcification. Fetuin-A may therefore act as a negative acute phase protein after myocardial infarction.
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Síndrome Coronario Agudo/sangre , Calcinosis/sangre , Cardiomiopatías/sangre , Enfermedades de las Válvulas Cardíacas/sangre , alfa-2-Glicoproteína-HS/metabolismo , Síndrome Coronario Agudo/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Calcinosis/complicaciones , Cardiomiopatías/complicaciones , Femenino , Enfermedades de las Válvulas Cardíacas/complicaciones , Humanos , Inflamación/sangre , Inflamación/complicaciones , Mediadores de Inflamación/sangre , Masculino , Persona de Mediana Edad , Infarto del Miocardio/sangre , Infarto del Miocardio/complicacionesRESUMEN
BACKGROUND: Our aim was to determine the effect of single endometriomas ≤3 cm in diameter per se on ovarian reserve in intracytoplasmic sperm injection (ICSI) cycles. METHODS: We enrolled 19 consecutive infertile patients (29 cycles) who had unilateral single endometriomas ≤3 cm in diameter and who underwent ICSI. RESULTS: The mean age of the patients was 33.3 ± 4.9 years. The mean diameter of endometriomas was 21.8 ± 4.9 mm. Left- and right-sided endometriomas were 34.5 and 65.5%, respectively. The number of oocytes retrieved from ovaries with endometriomas and contralateral normal ovaries was comparable (5.9 ± 4.3 vs. 5.4 ± 3.8). CONCLUSION: Endometriomas ≤3 cm in diameter per se did not have a deleterious effect on ovarian reserve in ICSI cycles.
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Endometriosis/complicaciones , Infertilidad Femenina/terapia , Recuperación del Oocito , Enfermedades del Ovario/complicaciones , Ovario/fisiología , Adulto , Endometriosis/patología , Femenino , Humanos , Infertilidad Femenina/complicaciones , Enfermedades del Ovario/patología , Inyecciones de Esperma IntracitoplasmáticasRESUMEN
A 67-year-old male patient with an eight-month history of operation for mitral valve repair and secundum atrial septal defect (ASD) presented with complaints of fatigue and shortness of breath. Transthoracic echocardiography showed a residual ASD resulting from separation of a pericardial patch. Qp/Qs rate was 3.2. The diameter of the residual defect measured by transesophageal echocardiography was 18 mm. During right heart catheterization, pulmonary artery pressure was estimated to be 50 mmHg. Using the percutaneous method accompanied by transesophageal echocardiography guidance, the residual defect was successfully closed with a 21-mm Occlutech Figulla device. Postprocedural echocardiographic control showed no leaks. The patient was discharged with 300 mg/day aspirin treatment.
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Defectos del Tabique Interatrial/cirugía , Complicaciones Posoperatorias/cirugía , Dispositivo Oclusor Septal , Anciano , Diagnóstico Diferencial , Disnea/etiología , Fatiga/etiología , Defectos del Tabique Interatrial/complicaciones , Defectos del Tabique Interatrial/diagnóstico por imagen , Humanos , Masculino , Prolapso de la Válvula Mitral/cirugía , Complicaciones Posoperatorias/diagnóstico por imagen , UltrasonografíaRESUMEN
BACKGROUND: Significant portion of trauma-related deaths occur in the 1st h; therefore, rapid diagnosis and adequate resuscita-tion in trauma patients are essential preventing mortality. In this study, we aimed to evaluate the role of lactate-to-hematocrite ratio (LHR) score for predicting mortality in patients with severe thoracoabdominal trauma. METHODS: In this retrospective, cross-sectional study, we evaluated patients who applied to the emergency room between January 1, 2016, and December 31, 2019, due to multiple trauma. We measured the blood gas analysis values and LHR score of patients with severe thoracoabdominal trauma included in the study and investigated the effectiveness of the LHR score in predicting mortality. RESULTS: 106 patients with severe thoracoabdominal trauma were included in the study. The 30-day mortality rate of the patients was 42.5% (n=45). Considering the 30-day mortality rates, the initial hematocrit, lactate, base deficit, and LHR score were statistically different between patients who died and survived. When the cutoff value for the LHR score was taken as 0.187 on the ROC curve to distinguish mortality, the sensitivity was found to be 77.8%, specificity to be 90.2%. CONCLUSION: LHR score is an effective parameter with high sensitivity and specificity in predicting mortality in patients with severe thoracoabdominal trauma.
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Ácido Láctico , Estudios Transversales , Hematócrito , Humanos , Pronóstico , Estudios RetrospectivosRESUMEN
BACKGROUND: It has been shown that interleukin-35 (IL-35) subunits are strongly expressed in atherosclerotic plaques in humans. Therefore, it is considered to play a role in atherosclerosis. OBJECTIVES: In this study, IL-35 levels were compared with the control group in patients with stable coronary artery disease (CAD), and the association between IL-35 levels and the lesion type, lesion severity and extension was investigated with the Gensini score (GS) and the Syntax score (SS) in the patient group. METHODS: Sixty patients (18 female and 42 male) with CAD diagnosed by coronary angiography, who presented with typical chest pain and positive noninvasive cardiac stress test, and 46 patients (18 female and 28 male) with normal coronary lumenogram, were included in this study. Gensini and Syntax scores were calculated in the patient group, and these values were compared with IL-35 levels. Non-normally distributed variables were analyzed by the Mann-Whitney U test, whereas normally distributed parameters were assessed by Student's t-test. The difference between categorical variables were evaluated by the Chi-square or Fisher test. P-values<0.05 were considered as statistically significant. RESULTS: No significant differences were observed between patients and the control group in terms of demographic characteristics and laboratory findings. Compared to the control group, IL-35 levels of the CAD group were considerably lower (36.9±63.9 ng/ml vs. 33.2±13.2 ng/ml, p<0.008). Although not statistically significant, IL-35 levels were higher in patients with low SS than among those with high SS (33.2±13.7 vs. 31.8±8.9, p=0.51). The IL-35 values of the patients with high GS were significantly lower than in patients with low GS (35±17.4 vs. 30.7±8.6, p=0.043). CONCLUSION: It has been shown that IL-35 levels can be a new biomarker for stable CAD, and IL-35 is associated with the extension of CAD.
FUNDAMENTO: Foi demonstrado que as subunidades de interleucina-35 (IL-35) estão fortemente expressas nas placas ateroscleróticas em humanos. Assim, considera-se que elas têm um papel na aterosclerose. OBJETIVOS: Neste estudo, os níveis de IL-35 foram comparados com o grupo controle em pacientes com doença arterial coronariana (DAC) estável, e a associação entre os níveis de IL-35 e o tipo, gravidade e extensão da lesão foram investigadas com o escore Gensini (GS) e o escore Syntax (SS) no grupo de pacientes. MÉTODOS: Sessenta pacientes (18 mulheres e 42 homens) com DAC, diagnosticados por meio da angiografia coronária, que apresentaram dor no peito típica e teste de esforço não invasivo positivo, e 46 pacientes (18 mulheres e 28 homens) com luminograma normal, foram incluídos no estudo. Tanto o GS quanto o SS foram calculados para o grupo de pacientes, e esses valores foram comparados com os níveis de IL-35. Variáveis com distribuição não normal foram avaliadas com o teste U de Mann-Whitney, enquanto os parâmetros com distribuição normal foram analisados com o teste t de Student. A diferença entre as variáveis categóricas foi avaliada pelo teste de qui-quadrado ou de Fisher. Os valores de p<0,05 foram considerados como estatisticamente sinificativos. RESULTADOS: Não foram observadas diferenças significativas entre pacientes e o grupo controle em termos de características demográficas e achados laboratoriais. Em comparação ao grupo controle, os níveis de IL-35 no grupo com DAC foram consideravalmente menores (36,9±63,9 ng/ml vs. 33,2±13,2 ng/ml, p<0,008). Embora não tenha sido estatisticamente significativo, os níveis de IL-35 foram maiores em pacientes com SS mais baixo do que nos com SS mais alto (33,2±13,7 vs. 31,8±8,9, p=0,51). Os valores de IL-35 em pacientes com GS alto foram significativamente mais baixos do que em pacientes com GS baixo (35±17,4 vs. 30,7±8,6, p=0,043). CONCLUSÃO: Demonstrou-se que os níveis de IL-35 podem ser um novo biomarcador para a DAC estável, e que a IL-35 está associada à extensão da DAC.
Asunto(s)
Aterosclerosis , Enfermedad de la Arteria Coronaria , Interleucinas , Aterosclerosis/diagnóstico , Biomarcadores , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico , Femenino , Humanos , Interleucinas/sangre , Masculino , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: In most of primary ovarian insufficiency (POI) cases, etiologic factors have not been fully elucidated. Recent studies have revealed that inflammatory agents play an important role in the etiopathogenesis of POI. Therefore, the aim of this study was to investigate the role of inflammatory markers of hemogram parameters in POI. MATERIALS AND METHODS: The study compared 47 healthy women and 47 women diagnosed as having POI retrospectively by scanning electronic and written recording systems. Complete blood counts, day-3 hormone profiles levels of all subjects were analyzed. The neutrophil-lymphocyte ratio (NLR), red cell distribution width (RDW), platelet ratio (RPR), platelet lymphocyte ratio (PLR), and mean platelet volume (MPV) mean platelet lymphocyte ratio (MPLR) were calculated from the complete blood count parameters. RESULTS: White blood cell and MPV values, platelet, and lymphocyte counts were significantly higher in the POI patients (p<0.001, p=0.042, p=0.038, p=0.049, respectively), RPR was significantly lower than the control group (p=0.011), but there were no significant differences in hemoglobin, RDW, NLR, PLR, and MPLR (p=0.454, p=0.057, p=0.635, p=0.780, p=0.126, respectively). The neutrophil count of the study group was higher than in the control group (p=0.057). Bivariate correlation analyses showed no correlations between blood parameters and hormone levels. The area under the receiver operating characteristic curve for RPR in POI was 0.652, with a threshold value 0.053, sensitivity=63% and specificity=63. CONCLUSION: Inflammatory markers of hemogram detected higher in patients with POI then control subjects.
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OBJECTIVE: Although the underlying mechanism is not yet fully understood, Cardiac Syndrome X (CSX) is defined as microvascular dysfunction. Prolidase plays a role in collagen synthesis. Increased serum prolidase activity (SPA) has been shown to correlate with collagen turnover. Augmented collagen turn-over may be associated with vascular fibrosis and microvascular dysfunction. In this study, we assessed whether there was a correlation between CXS and prolidase activity. METHODS: This case-control study included 45 consecutive CSX patients (mean age 50.7±6.5 years, 27 women) and 40 healthy controls (mean age 51.2±6.5 years, 25 women). Prolidase activity was determined with the Human Xaa-Pro Dipeptidase/Prolidase enzyme-linked immunosorbent assay kit (Cusabio Biotech Co. Ltd, China). RESULTS: Mean prolidase activity was 898.8±639.1 mU/mL in the CSX group and 434.1±289.8 mU/mL in the control group (p<0.001). In ROC analysis, it was found that the SPA value above 350 mU/mL sympathizes with the diagnosis of CSX. CONCLUSION: Increased SPA in CXS patients may play an essential role in the pathophysiology of CSX, leading to augmented oxidative stress and vascular fibrosis, endothelial dysfunction, and increased microvascular resistance.
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BACKGROUND AND OBJECTIVE: Coronary bypass operations are commonly performed for the treatment of ischemic heart diseases. Coronary artery bypass surgery with autologous human saphenous vein maintains its importance as a commonly used therapy for advanced atherosclerosis. Vascular inflammation-related intimal hyperplasia and atherosclerotic progress have major roles in the pathogenesis of saphenous vein graft disease. METHODS: In our study, we investigated the effect of anacardic acid (AA), which is a bioactive phytochemical in the shell of Anacardium occidentale, on atherosclerosis considering its inhibitory effect on NF-κB. We observed relative ICAM-1 and NF-κB mRNA levels by qRT-PCR method in a TNF-α- induced inflammation model of saphenous vein endothelial cell culture after 0.1, 0.5, 1 and 5 µM of AA were applied to the cells. In addition, protein levels of ICAM-1 and NF-κB were evaluated by immunofluorescent staining. The results were compared between different concentrations of AA, and also with the control group. RESULTS: It was found that 5 µM, 1 µM and 0.5 µM of AA had toxic effects, while cytotoxicity decreased when 0.1 µM of AA was applied both alone and with TNF-α. When AA was applied with TNF-α, there was a decrease and suppression in NF-κB expression compared with the TNF-α group. TNF-α-induced ICAM-1 expression was significantly reduced more in the AA-applied group than in the TNF-α group. CONCLUSION: In accordance with our results, it can be said that AA has a protective role in the pathogenesis of atherosclerosis and hence in saphenous vein graft disease.