The relationship between apelin and cardiac parameters in patients on peritoneal dialysis: is there a new cardiac marker?

BACKGROUND: Many markers have been proposed for CVD risk assessment in dialysis population. Apelin is a peptide that has roles in cardiovascular functions and volume regulation namely vasodilation, decreased blood pressure (BP), positive inotropic effect and inhibition of antidiuretic hormone release. The aim of this study was to examine relationship of apelin levels with echocardiographic findings and laboratory parameters related with cardiovascular function and bone mineral metabolism among peritoneal dialysis (PD) patients. METHODS: This is a cross-sectional study in which chronic PD patients aged between 18 and 80 without active cardiac, infectious or malignant diseases and hypervolemia have been included. Apelin-36 levels and echocardiographic findings were recorded as well as clinical and laboratory data. RESULTS: Of the 53 patients, the mean age and female/male ratio was 52.8 ± 15.3 years and 30/23, respectively. Mean apelin level was 1.45 ± 0.37 ng/ml. Gender, drugs (renin-angiotensin-aldosteron inhibitors, statins), presence of left ventricular hypertrophy, diabetes mellitus, hypertension, hyperlipidemia and significant residual renal function did not affect apelin-36 levels. Apelin-36 was correlated negatively with age and left atrium diameter; and positively with diastolic BP, ejection fraction (EF), total cholesterol, LDL-cholesterol, HDL-cholesterol, parathyroid hormone and alkaline phosphatase (ALP) levels. Diastolic BP, LDL-cholesterol, ALP and EF were found to be the independent determinants of apelin-36 levels with linear regression analysis. CONCLUSIONS: Apelinergic system has important roles in volume regulation, cardiovascular functions, lipid metabolism and bone mineral disorders in PD patients. Prospective studies with large population are required.

Seroprevalence of coronavirus disease 2019 (COVID-19) among health care workers from three pandemic hospitals of Turkey.

COVID-19 is a global threat with an increasing number of infections. Research on IgG seroprevalence among health care workers (HCWs) is needed to re-evaluate health policies. This study was performed in three pandemic hospitals in Istanbul and Kocaeli. Different clusters of HCWs were screened for SARS-CoV-2 infection. Seropositivity rate among participants was evaluated by chemiluminescent microparticle immunoassay. We recruited 813 non-infected and 119 PCR-confirmed infected HCWs. Of the previously undiagnosed HCWs, 22 (2.7%) were seropositive. Seropositivity rates were highest for cleaning staff (6%), physicians (4%), nurses (2.2%) and radiology technicians (1%). Non-pandemic clinic (6.4%) and ICU (4.3%) had the highest prevalence. HCWs in "high risk" group had similar seropositivity rate with "no risk" group (2.9 vs 3.5 p = 0.7). These findings might lead to the re-evaluation of infection control and transmission dynamics in hospitals.

Advanced oxidation protein products as an oxidative stress marker in allergic rhinitis.

OBJECTIVES: This study was designed to compare the levels of dityrosine-containing protein cross-link products, also known as advanced oxidation protein products (AOPP); in patients with allergic rhinitis with those in healthy individuals considering the fact that AOPP has the potential to be a marker of oxidative stress specific to proteins in mammalian systems. PATIENTS AND METHODS: This study was performed on 40 patients (18 males, 22 females; mean age 29 years; range 10 to 53 years) with allergic rhinitis admitted to our clinic between December 2008 and January 2009 and on 40 healthy volunteers (16 males, 24 females; mean age 31 years; range 13 to 48 years). Skin prick test was performed to establish a diagnosis of allergic rhinitis in patients with major symptoms and allergic sensitization was also supported with serum IgE levels. Blood samples were obtained and examined in all patients to determine AOPP. RESULTS: Serum AOPP levels were significantly higher in patients with allergic rhinitis (169.0+/-14.2 micromol/L) compared to controls (43.9+/-3.5 micromol/L; p<0.001). In addition, mean serum IgE levels of patients with allergic rhinitis (308.2+/-38.5 IU/ml) were found to support the presence of allergic sensitization. CONCLUSION: Determining the levels of serum AOPP, a well-known marker of protein oxidation, appears to be a useful method in determining the role of oxidative stress in the etiopathogenesis of allergic rhinitis.

N-Terminal pro-B-Type Natriuretic Peptide Levels are Linked with Modified Child-Pugh Classification in Patients with Nonalcoholic Cirrhosis [NT-ProBNP and Liver Cirrhosis].

Excess N-terminal pro-brain natriuretic peptide secretion has been linked to cirrhosis in previously studies. The relationship of plasma N-terminal pro-brain natriuretic peptide levels and cardiac dysfunction determined by echocardiography were investigated in patients with nonalcoholic cirrhosis and a control group of chronic hepatitis. This study was designed as a cross-sectional study. Thirty-two men and thirty-three women who gave informed consent who were followed-up for chronic liver failure were enrolled. All patients gave clinical history, physical examination was carried out and information about ongoing medication has been obtained. Serum N-terminal pro-brain natriuretic peptide level was measured in all patients. The same cardiologist determined ejection fraction, end-diastolic left ventricular diameter, interventricular septum, and posterior wall on transthoracic echocardiography. Patients with extensive liver disease according to Child-Pugh classification from A to C had increasing N-terminal pro-brain natriuretic peptide levels in association (P < .001). According to the Child-Pugh classification there were no significant difference between groups for echocardiographic measurements (P > .05). N-terminal pro-brain natriuretic peptide may be an important marker for cardiac dysfunction in patients with chronic liver failure in accordance with Child-Pugh stage.

Serum adenosine deaminase and its isoenzyme activities in pregnancy.

OBJECTIVE: ADA is widely distributed in human tissues, which may contribute to the maturation of the immunological system, especially the proliferation and differentiation of lymphoid cells, and seems to be critical at different stages of the maturation process. The activity of ADA changes in diseases characterized by the alteration of cell-mediated immunity. In this study we examined changes in serum total ADA activity and the patterns of two ADA isoenzymes, ADA-1 and ADA-2, in healthy pregnant women, and evaluated the possible role of the alteration of cell-mediated immunity during pregnancy as causes of changes in ADA activity. MATERIALS AND METHODS: We measured serum activities of total ADA, ADA-1 and ADA-2 in healthy pregnant women (n=129) and age-matched healthy nonpregnant women (n=42). We divided the study group into three different subgroups: first trimester, second trimester and third trimester. RESULTS: Serum ADA, ADA-1 and ADA-2 activities in healthy pregnant women were significantly lower than in nonpregnant women (p<0.001, p<0.001 and p<0.01 respectively). ADA (p<0.001) and ADA-2 (p<0.001) activities in the first trimester were significantly lower than in the control group. However, there were no significant differences between the first trimester and control group according to their ADA-1 activities (p=0.016). ADA (p<0.001), ADA-1 (p<0.001) and ADA-2 (p<0.008) activities in the second trimester were significantly lower than in the control group. Combined trisomy 21 risk, biochemical trisomy 21 risk, age risk and trisomy 18 + Nuchal translucency (NT) risk were calculated using a first trimester screening test in 63 pregnant women. Furthermore, trisomy 21 risk, age risk and trisomy 18 risk were calculated by triple test in 52 pregnant women. ADA, ADA-1 and ADA-2 activities were not significantly correlated with risks in the first trimester screening test. ADA-1 activity was slightly significantly negative correlated with age risk (r= -0.314, p<0.05) and trisomy 18 risk (p<0.05) in the triple test. ADA (p<0.05) and ADA-2 (p<0.05) activities were slightly significantly correlated with gestational age, while there was no significant correlation between ADA-1 activity and gestational age. CONCLUSION: Serum ADA activity may be useful for clinical diagnosis and observation of high-risk pregnancies in which cell-mediated immunity has been altered.