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Introduction: Although patients with myocardial infarction (MI) history exhibit individual differences, several psychological problems can be observed in these patients. The present study aimed to investigate the correlation between defence mechanisms and other clinical and sociodemographic data in the early period in patients with MI history. Material and methods: Sixty patients diagnosed with MI and hospitalized in the cardiology department were included in the study. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Defence Styles Questionnaire (DSQ) were applied. Results: It was determined that the mean BDI score of the participants was 15.9 ±11.2, and the mean BAI score was 15.98 ±10.9. There was a positive correlation between the depression and immature defence mechanism scores of the patients, and there was a negative correlation between the depression and mature defence mechanism scores of the patients (p = 0.001, r = 0.412; p = 0.005, r = -0.359). A negative correlation was determined between anxiety scores and mature defence mechanism scores (p = 0.002, r = -0. 397). Conclusions: The findings demonstrated that depressive complaints of the post-MI patients increased as the immature defence mechanism score increased, and depressive complaints decreased as the maturity defence mechanism score increased. The correlation between the defence mechanisms adopted by MI patients and depression and anxiety symptoms should not be neglected.
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Objective: To compare the health anxiety and healthy lifestyle behavior experienced by psychiatric patients due to the coronavirus disease 2019 (COVID-19) pandemic with that of a control group.Methods: The study included 120 outpatients (aged 18-65 years) diagnosed with a psychiatric illness (DSM-5 criteria) who presented to a psychiatry outpatient clinic between June and August 2020. The control group included 120 healthy individuals with a similar age and sex distribution as the patient group. Data were collected with a questionnaire developed by the authors to determine the participants' adherence to COVID-19 hygiene rules and associated behavioral norms. The Health Anxiety Scale-Short Form, Health Perception Scale, and Health-Promoting Lifestyle Profile were completed by all participants.Results: The mean Health Anxiety Scale score was significantly lower in the patient group compared to the control group (P < .01). Health anxiety was high in 8% of the patients and 32% of the controls. Also, the mean Health-Promoting Lifestyle Profile score was statistically significantly lower in the patient group compared to the control group (P < .01). There was no significant difference between the groups based on health perception scores and adherence to hygiene rules.Conclusions: As expected, the healthy lifestyle behavior of individuals without psychiatric illness was higher compared to those with mental disorders. However, health anxiety about COVID-19 was higher among healthy individuals compared to those with a psychiatric disorder. Thus, it could be suggested that individuals without a psychiatric illness prior to the pandemic could need psychiatric assistance after the pandemic.
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COVID-19 , Ansiedade/psicologia , Depressão/psicologia , Estilo de Vida Saudável , Humanos , Pandemias , Percepção , SARS-CoV-2RESUMO
AIM: Although the effects of pregnancy on the cardiovascular system have been covered by many studies, permanent changes in the hearts of multiparous women have not been investigated. This study therefore aimed to examine the permanent structural changes in the cardiac structure of multiparous women via transthoracic echocardiography (TTE). METHOD: This case-control study included 366 females who had given birth to 1-21 children, and 218 females with no previous deliveries. Anamnesis, physical examination, electrocardiography (ECG), TTE, and exercise stress tests were used to determine whether the cases had additional systemic pathologies. The structural cardiac parameters of all cases were recorded with TTE. RESULTS: The study revealed that LV mass, LV mass index, left ventricular end diastolic volume (LVEDV), left ventricular end diastolic volume index (LVEDVI) were observed higher in women with five or more deliveries when compared to nulliparous women. On the other hand, ejection fraction (EF) was significantly lower in the same group. Receiver operating curve (ROC) analysis demonstrated that the prediction sensitivity for the presence of eccentric hypertrophy was 74% among women who had given >10.5 births, and its specificity was 97.8% (AUC: 0.949, 95% CI 0.905-0.993; p < 0.0001). CONCLUSION: The results showed that women with recurrent births had increased left ventricular end diastolic volume, left ventricular total mass in myocardium and decreased EF due to increased end diastolic volume. The results also showed delivering at frequent intervals (especially the birth of 11 or more) may be one of the causes of eccentric hypertrophy, in women of the low-to-middle income countries.
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Coração , Função Ventricular Esquerda , Estudos de Casos e Controles , Criança , Feminino , Humanos , Paridade , Gravidez , Volume SistólicoRESUMO
Objective: To investigate the frequency of suicidal ideation and its correlation with other clinical variables in patients with pulmonary arterial hypertension.Methods: Fifty patients with pulmonary arterial hypertension who presented to the cardiology department between 2018 and 2019 and 50 healthy controls were included in the study. A sociodemographic and clinical data form was completed by both the patients and controls, and the Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Rosenberg Self-Esteem Scale (RSE), and Suicide Probability Scale (SPS) were administered. SPSS version 22 software was used in the statistical analysis.Results: The mean ± SD systolic pulmonary pressure of the patients was 47.48 ± 18.86 and the pulmonary artery pressure was 33.32 ± 19.69. BHS, BDI, and SPS total scores were statistically significantly higher in the patient group compared to the control group (P < .001, P = .001, P = .026, respectively). RSE scores were also higher in the patient group compared to the control group (P = .017).Conclusions: It is important to identify pulmonary arterial hypertension patients with intense feelings of hopelessness and depressive symptoms and to provide psychiatric treatment and psychotherapeutic interventions to improve their self-esteem.
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Hipertensão Arterial Pulmonar , Suicídio , Humanos , Escalas de Graduação Psiquiátrica , Autoimagem , Ideação SuicidaRESUMO
OBJECTIVE: Acute myocardial infarction (AMI) is the most common type of coronary artery disease. The irisin hormone encoded by the fibronectin type III domain-containing protein-5 (FNDC5) gene is synthesized in muscle, heart, and fat tissues. The present study aims to investigate serum irisin concentrations and FNDC5 genetic variants in patients with AMI through comparison with controls. METHODS: This study included 225 patients with AMI and 225 healthy subjects. Blood samples were obtained from patients during the first 1-24 hours after AMI. Serum irisin concentration was measured with enzyme-linked immunosorbent assay (ELISA). The variants of rs16835198, rs3480, and rs726344 in the FNDC5 gene were genotyped with real time polymerase chain reaction (RT-PCR). RESULTS: Compared with control serum irisin concentrations were significantly lower in patients with AMI. Serum irisin concentrations of patients with AMI showed a significant and gradual decrease from 6 hours up to 24 hours (p<0.05). There were no significant differences between the patient and control groups based on genotype and allele frequencies of rs16835198, rs3480, and rs726344 in the FNDC5 gene (p>0.05). However, the frequency of the TT genotype in male patients with AMI (6.4%) was significantly lower compared with control male subjects (16.2%). In addition, the GGT haplotype was identified as the protective haplotype against the risk of AMI (p<0.001; odds ratio=0.107). CONCLUSIONS: The findings of the study suggest that serum irisin concentration could serve as a novel biological marker for the early diagnosis of AMI.
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Infarto do Miocárdio , Polimorfismo de Nucleotídeo Único , Estudos de Casos e Controles , Fibronectinas/genética , Frequência do Gene , Genótipo , Humanos , Masculino , Infarto do Miocárdio/genéticaRESUMO
Sumac is an herbal product, commonly consumed as a spice and was used for medical treatment for centuries. The phytochemical structure of Sumac was studied extensively, and it was established that the herb contained tannins, polyphenols, flavonoids, organic acids, and essential oils. Various scientific studies demonstrated that Sumac had a free oxygen radical-scavenging effect, a protective effect against liver damage, antihemolytic, leukopenia, and antifibrogenic effects, along with its antiviral, antimicrobial, anti-inflammatory, and antioxidant properties. Recently, several scientific studies described the pathophysiology, clinical course, and the treatment of COVID-19 infection. The examination of the characteristics of COVID-19 infection revealed via the clinical studies suggests that Sumac extract could be useful in the treatment of COVID-19. Given the scientific studies focusing on the beneficial effects of Sumac, the present review aims to provide an encouraging viewpoint to investigate whether Sumac is effective in treating COVID-19 infection.
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Tratamento Farmacológico da COVID-19 , Rhus , Antioxidantes/farmacologia , Humanos , Extratos Vegetais , SARS-CoV-2RESUMO
OBJECTIVES: The pathophysiology of isolated coronary artery ectasia (CAE) involves atherosclerosis and inflammation. Eosinophils and lymphocytes have been found to play a significant role in inflammation, atherosclerosis and endothelial dysfunction. Many studies have explored the relationship between isolated CAE and systemic inflammation. However, there are no data regarding the relationship between eosinophil-to-lymphocyte ratio (ELR) and isolated CAE. Therefore, this study analysed the relationship between ELR and isolated CAE. METHODS: All patients who underwent coronary angiography between January 2009 and June 2018 were investigated retrospectively. Of 16 240 patients, 232 patients with isolated CAE (141 males) and 247 age- and gender-matched control subjects (130 males) with normal coronary angiography (NCA) were enrolled in this study. Baseline demographic and laboratory data were obtained from the hospital database. The severity of isolated CAE was determined according to the Markis classification, vessel count and diffuseness of ectasia. RESULTS: Patients with angiographic isolated CAE had significantly elevated white blood cell (WBC) and eosinophil counts and ELR values compared to patients with NCA [8.11 ± 1.75 vs 7.49 ± 1.80 × 109 cells/l, p < 0.0001; 0.22 (0.13-0.32) vs 0.19 (0.12-0.28) × 109 cells/l, p = 0.02; 0.11 (0.06-0.17) vs 0.08 (0.05-0.12), p < 0.0001. The ELR value for Markis I was significantly higher than for Markis IV (p = 0.04), and three-vessel isolated CAE was significantly higher than onevessel isolated CAE (p = 0.04). Additionally, the ELR value for diffuse ectasia (Markis class I, II and III) was significantly higher compared to focal (Markis class IV) ectasia (p = 0.02). In receiver operating characteristics (ROC) analyses, it was determined that an ELR value > 0.099, measured in isolated CAE patients at application, had a predictive specificity of 60.3% and a sensitivity of 56.5% (area under the curve: 0.604, 95% confidence interval: 0.553-0.655, p < 0.0001). CONCLUSIONS: Patients with isolated CAE had higher blood eosinophil counts and ELR. Furthermore, the ELR was significantly correlated with severity of isolated CAE. These findings demonstrate that ELR may have a significant role in the aetiopathogenesis of isolated CAE.
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Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/patologia , Eosinófilos , Linfócitos , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/patologia , Vasos Coronários/diagnóstico por imagem , Bases de Dados Factuais , Dilatação Patológica , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: A limited number of studies have investigated QT wave dispersion (QTd) in depressive disorder. The objective of this study was to investigate whether QTd differed in patients diagnosed with depression compared to a control group and whether the difference correlated with the depression and anxiety scores. METHODS: Forty patients diagnosed with major depressive disorder (DSM-5 criteria) who did not receive their first treatment after the first episode were included in the study. Forty healthy individuals with similar sociodemographic characteristics were included in the control group. A sociodemographic and clinical data form, the Beck Depression Inventory, and the Beck Anxiety Inventory were given to all patients. Electrocardiograms were evaluated in a single-blind setting by the same cardiologist. The longest QT interval (QTmax) and the shortest QT interval (QTmin) were calculated. Heart rate-corrected QTmax (QTcmax) and QTmin (QTcmin) were calculated using the Bazett formula (QT[ms]/âR-R). The difference between QTcmax and QTcmin was accepted as the corrected QT dispersion (QTcd). The study was conducted from December 2018-March 2019. RESULTS: No statistically significant difference was found between patient and control groups on the basis of age, sex, body mass index, or smoking. Beck Anxiety Inventory and Beck Depression Inventory scores of the patient group (28.48 ± 12.39 and 32.2 ± 11.58, respectively) were significantly higher compared to the control group (2.7 ± 3.41 and 2.75 ± 3.2, respectively). The patient group QTcmax (419.8 ± 24.46) and QTcd (42.55 ± 17.47) values were significantly higher compared to the QTcmax (405.2 ± 24.54) and QTcd (30.48 ± 9.25) values of the control group. There was a positive correlation between QTcd, QTcmax, and anxiety and depression scores. CONCLUSIONS: QTcd values of depressed patients were higher than those of the healthy controls, and there was a positive correlation between QTcd and depression and anxiety scores.
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Arritmias Cardíacas/etiologia , Transtorno Depressivo Maior/fisiopatologia , Adulto , Ansiedade/complicações , Ansiedade/fisiopatologia , Estudos de Casos e Controles , Transtorno Depressivo Maior/complicações , Eletrocardiografia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Índice de Gravidade de DoençaRESUMO
INTRODUCTION: The present study was intended to investigate the effect of levosimendan on high-sensitivity C-reactive protein (hsCRP) levels in hospitalized patients with decompensated heart failure. MATERIAL AND METHODS: The present study was designed as a prospective controlled clinical trial. A total of 50 patients with decompensated heart failure who were admitted to our hospital were included in the present study. Patients with stage III-IV heart failure based on the New York Heart Association, with systolic blood pressure > 100 mm Hg and with left ventricular ejection fraction of < 35%, were selected for the study population. The selected patients were divided into groups, levosimendan and furosemide. RESULTS: There was no significant difference between the groups based on demographics, basal echocardiographic and basal laboratory data. No difference was determined in basal hsCRP (mg/l) levels between the group admitted levosimendan infusion and the furosemide group (9.99 ±6.2, 9.23 ±6.4, p = 0.66). However, the hsCRP levels measured at the 24th h (38.34 ±32.1 vs. 12.97 ±12.3, p < 0.001), the 48th h (31.13 ±29.9 vs. 12.44 ±10.1, p = 0.003) and the 72nd h (27.41 ±26.9 vs. 9.89 ±8.4, p = 0.002) were significantly higher in the levosimendan infusion group than the furosemide group. CONCLUSIONS: It was found that hsCRP levels were significantly higher in the levosimendan infusion group than the furosemide group. Such an outcome could be related to myocyte injury and/or the amplification of the inflammatory response due to levosimendan.
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Heart failure is a chronic disease that impairs the quality of life and leads to several psychiatric disorders, especially depression and anxiety. The present study intended to investigate suicide risk and its association with depression, hopelessness and self-esteem in patients with chronic heart failure. 32 patients with chronic heart failure and 32 healthy control subjects with similar sociodemographic attributes were included in the present case control study. Sociodemographic data form, Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSE) and Suicide Probability Scale (SPS) were applied to all subjects. It was determined that the BHS (11.4⯱â¯3.74 vs. 4.8⯱â¯4.02, pâ¯<â¯0.001), BDI (22.2⯱â¯11.9 vs 9.2⯱â¯7.6, pâ¯<â¯0.001) and SPS (67.6⯱â¯15.9 vs 59.2⯱â¯10.9, pâ¯=â¯0.018) scores were statistically higher in the patient group when compared to the control group. It was also established that the self-esteem of subjects in the patient group was lower when compared to the control (pâ¯<â¯0.001). A positive correlation was determined between the SPS and BHS, and BDI and RSE scores (pâ¯<â¯0.001). Suicide risk was higher among the patients with heart failure when compared to the control group. This increase in suicide risk significantly correlated with high levels of hopelessness, depression, and low self-esteem in the patient group. Heart failure is one of the chronic diseases that increases suicidal ideation. The identification of suicidal ideation in the present patient group facilitated both the prevention of suicidal behavior and positive contribution to treatment.
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Depressão/etiologia , Insuficiência Cardíaca/psicologia , Autoimagem , Ideação Suicida , Adulto , Estudos de Casos e Controles , Doença Crônica/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , SuicídioRESUMO
BACKGROUND AND AIM: Patients with bipolar disorder (BD) are at increased risk for cardiovascular diseases and complications. This increased risk is considered to be associated with the autonomic nervous system (ANS) abnormalities. However, there is little or no documentation of the relationship between this increased risk and the phases of BD. In this study, we aimed to compare the changes in the QT dispersion (QTd) and P-wave dispersion (Pd), which are predictors of sudden cardiac death and atrial fibrillation, between the patients with manic BD and healthy controls. PARTICIPANTS AND METHODS: The study included a patient group of 44 patients (26 female and 18 male) that were hospitalized due to a diagnosis of manic BD and met the inclusion criteria, and a control group of 34 age- and gender-matched healthy individuals (21 female and 13 male) with no history of psychiatric and neurological disorders. The QTd and Pd values were determined in each participant by performing the standard 12-lead body surface electrocardiography (ECG). RESULTS: The principal electrocardiographic indicators including corrected maximum QT interval, corrected QT dispersion, and minimum P-wave duration significantly increased in the patient group compared to the control group (t=2.815, p<0.01; t=4.935, p<0.001; t=3.337, p<0.001, respectively). CONCLUSION: The results indicated that patients with manic BD are at increased risk for cardiovascular autonomic dysfunction. Therefore, clinicians should be more careful about ECG changes and related possible cardiac conduction problems such as cardiac arrthythmias in patients with manic BD. Further longitudinal studies are needed to investigate BD and its phases (depression, mania, and hypomania) with regard to ANS and cardiac abnormalities.
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Kounis syndrome is defined as the clinical development of acute coronary syndrome caused by the activation of inflammatory cells due to an allergy, hypersensitivity, anaphylaxis, or anaphylactic reaction. Corticosteroids that are used in the treatment of many inflammatory conditions may paradoxically cause allergic reactions and even anaphylaxis. This article is a description of the case of a 52-yearold female patient who had a non-ST elevation myocardial infarction after the administration of triamcinolone that was relieved with antihistaminic treatment. The patient had been diagnosed with dermatitis at another medical center and injected with 40 mg/mL (intramuscular [IM]) of triamcinolone acetonide and developed chest pain 15 minutes after the first dose. Despite a normal physical examination and echocardiogram, laboratory tests revealed troponin positivity and an inferolateral ST depression was present on an electrocardiogram (ECG). The ECG findings and clinical symptoms resolved completely after conservative anti-ischemic treatment and antihistaminic therapy (pheniramine maleate 45.5 mg/2 mL, Avil ampoule, IV; Sanofi-Aventis, Paris, France) and coronary angiography evaluation of the arteries was normal. The heart, and in particular the coronary arteries, are among the organs that are most damaged during hypersensitivity reactions and anaphylaxis. Although Kounis syndrome is not a rare condition, few cases have been reported in clinical practice. The failure to recognize Kounis syndrome due to inadequately defined cases may lead to unwanted medical results. Kounis syndrome should be kept in mind in order to make a rapid and accurate diagnosis.
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Anti-Inflamatórios/efeitos adversos , Dermatite/tratamento farmacológico , Síndrome de Kounis , Triancinolona/efeitos adversos , Anti-Inflamatórios/uso terapêutico , Eletrocardiografia , Feminino , Humanos , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/etiologia , Síndrome de Kounis/fisiopatologia , Pessoa de Meia-Idade , Triancinolona/uso terapêuticoRESUMO
BACKGROUND: The relationship between increased mean platelet volume (MPV) and atherosclerosis is well known. In the present study, MPV in patients with coronary slow flow (CSF) and in cases with normal coronary anatomy (NCA) was investigated and compared with the aim of identifying the relationship between CSF and MPV. PATIENTS AND METHODS: We studied 40 patients previously determined via coronary angiography as having NCA and 40 patients with CSF in the coronary blood stream, as identified by thrombolysis in myocardial infarction square. Thus, a total of 80 patients from the Elazig Education and Research Hospital (Elazig, Turkey) were included in the present study retrospectively and laboratory and anamnesis information was scanned into their files. The relationship between MPV and CSF was studied. RESULTS: MPV levels were observed to be significantly higher in the CSF group compared to the NCA group (10.05±1.3 and 8.6±0.6, p<0.001). In receiver operating characteristics analyses, it was determined that an MPV >9.05 measured in CSF patients at application had a predictive specificity of 77.5% and sensitivity of 77.5% for CSF (area under the curve: 0.825, 95% confidence interval [CI]: 0.726-0.924, p<0.0001). It was found that MPV level was an independent predictor of CSF (ß=-600, p<0.001, 95% CI: -0.383 to -0.176). CONCLUSION: MPV is increased in patients with CSF when compared to patients with NCA. This finding supports the fact that MPV could be a predictor of CSF.
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Doença da Artéria Coronariana/diagnóstico , Circulação Coronária , Volume Plaquetário Médio , Adulto , Área Sob a Curva , Velocidade do Fluxo Sanguíneo , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de RiscoRESUMO
The objective of the present study is to determine the somatosensory amplification, anxiety, and depression levels in patients with normal coronary arteries. Thirty-five patients with normal coronary arteries and 35 healthy individuals of similar age and gender as the patient group were included in the study. Somatosensory Amplification Scale (SSAS), Health Anxiety Inventory (HAI-18), Penn State Anxiety Scale (PSWQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were applied to all participants. Comparison of the patient group with the control group demonstrated that SSAS (22.7±8.2; 18.5±5.98; p=0.018), BAI (15.4±9.43; 9.4±7.3; p=0.004), BDI (24.9±13.5; 13.7±7.5; p<0.001), PSWQ (55.3±13.7; 33.8±6.7; p<0.001), and HAI-18 (18.8±8.7; 12.3±7.1; p=0.001) scores were statistically significantly higher in the patient group. Furthermore, a positive correlation was found between SSAS, BAI, BDI, PSWQ, and HAI-18 scores. It was found that concerns about disease prevailed in patients having normal coronary arteries, the patients continued to amplify their somatic sensations, and their anxiety and depression scores were higher than those of healthy individuals. Thus, the necessity of these interventions should be assessed in detail in the future.
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Ansiedade/psicologia , Angiografia Coronária/psicologia , Doença da Artéria Coronariana/psicologia , Depressão/psicologia , Distúrbios Somatossensoriais/psicologia , Adolescente , Adulto , Ansiedade/etiologia , Estudos de Casos e Controles , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Estudos Transversais , Depressão/etiologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Testes Psicológicos , Distúrbios Somatossensoriais/etiologia , Escala de Ansiedade Frente a Teste , Adulto JovemRESUMO
The objective of the study was to scrutinize in detail the changes that occur in left ventricle (LV) systolic and diastolic functions using echocardiography in patients with at least 5 years of history and 40 healthy volunteers matching the patients in age and gender, who were enrolled in a cross-sectional study. All cases were examined with Tei Index, an index that could assess LV systolic and diastolic functions in conjuction, and with LV ejection fraction (LVEF) that assesses systolic function. In addition, Mitral E and A wave velocities, Isovolemic relaxation time (IVRT), Tissue Doppler Em (peak early motion) and Am (peak after motion) waves, which evaluate diastolic functions were measured. Tei Index was calculated as 0.61±0.19 in the patient group, and as 0.39±0.10 in the control group and the difference was statistically significant (p<0.001). LVEF was measured as 58%±5 in the patient group, and as 62%±3 in the control group and the difference was statistically significant (p<0.001). Also the IVRT values were significantly different between the tissue Doppler Em and Em/Am ratio among the groups (p<0.001). Echocardiographic myocardial performance, LV systolic and diastolic functions in schizophrenia patients was found to be worse than those of the control group.
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Ventrículos do Coração/fisiopatologia , Esquizofrenia/fisiopatologia , Função Ventricular Esquerda/fisiologia , Adulto , Estudos Transversais , Diástole/fisiologia , Ecocardiografia Doppler , Feminino , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Esquizofrenia/diagnóstico por imagem , Sístole/fisiologiaRESUMO
Objective To determine whether neutrophil/lymphocyte ratio (NLR) differed between patients with isolated coronary artery disease (CAD), isolated coronary artery ectasia (CAE), coronary slow flow and normal coronary anatomy. Methods Patients who underwent coronary angiography were consecutively enrolled into one of four groups: CAD, coronary slow flow, CAE and normal coronary anatomy. Results The CAD ( n = 40), coronary slow flow ( n = 40), and CAE ( n = 40) groups had similar NLRs (2.51 ± 0.7, 2.40 ± 0.8, 2.6 ± 0.6, respectively) that were significantly higher than patients with normal coronary anatomy ( n = 40; NLR, 1.73 ± 0.7). Receiver operating characteristics demonstrated that with NLR > 2.12, specificity in predicting isolated CAD was 85% and sensitivity was 75%, with NLR > 2.22 specificity in predicting isolated CAE was 86% and sensitivity was 75%. With NLR > 1.92, specificity in predicting coronary slow flow was 89% and sensitivity was 75%. Multivariate logistic regression analyses identified NLR as an independent predictor of isolated CAE (ß = -0.499, 95% CI -0.502, -0.178; P < 0.001), CAD (ß = -0.426, 95% CI -1.321, -0.408; P < 0.001), and coronary slow flow (ß = -0.430, 95% CI -0.811, -0.240; P = 0.001 Table 2 ). Conclusions NLR was higher in patients with CAD, coronary slow flow and CAE versus normal coronary anatomy. NLR may be an indicator of CAD, CAE and coronary slow flow.
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Aneurisma Coronário/diagnóstico por imagem , Doença da Artéria Coronariana/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Linfócitos/patologia , Neutrófilos/patologia , Idoso , Velocidade do Fluxo Sanguíneo , Estudos de Casos e Controles , Aneurisma Coronário/imunologia , Aneurisma Coronário/patologia , Angiografia Coronária , Doença da Artéria Coronariana/imunologia , Doença da Artéria Coronariana/patologia , Vasos Coronários/imunologia , Vasos Coronários/patologia , Feminino , Humanos , Contagem de Leucócitos , Modelos Logísticos , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Neutrófilos/imunologia , Prognóstico , Estudos Prospectivos , Curva ROC , Índice de Gravidade de DoençaRESUMO
PURPOSE: Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency. METHODS: All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb) and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of <13 g/dL and nonpregnant female patients with an Hb level of <12 g/dL were considered as anemic. FINDINGS: Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%), followed by generalized anxiety disorder patients (32%), and obsessive-compulsive disorder patients (26%). Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients. RESULTS: The prevalence of anemia among chronic psychiatry patients is more frequent than the general population. Thus, the study concluded that it would be beneficial to consider the physical symptoms and to conduct the required examinations to determine anemia among this patient group.
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OBJECTIVES: To compare the mean platelet volume (MPV; a general marker of platelet activation) in groups of patients with and without hypertension and to analyse its relationship with left ventricular mass index (LVMI). METHODS: This cross-sectional, observational study enrolled newly diagnosed patients with untreated stage I-II hypertension and healthy control subjects without hypertension. MPV was measured using a haematology analyser. Echocardiography was performed on all of the study participants. RESULTS: A total of 50 newly diagnosed patients with hypertension and 50 healthy control subjects were enrolled in the study. The majority of the demographic characteristics and laboratory findings were not significantly different between the two groups. The mean ± SD MPV was significantly higher in the hypertensive group compared with the control group (10.3 ± 1.4 fl versus 9.2 ± 1.8 fl, respectively). The mean ± SD LVMI was significantly higher in the hypertensive group compared with the control group (115.9 ± 23.0 g/m(2) versus 95.7 ± 23.4 g/m(2), respectively). There was no significant correlation between MPV and LVMI. CONCLUSION: In patients with untreated hypertension, despite elevated MPV levels there was no correlation between LVMI and MPV.
Assuntos
Plaquetas/patologia , Hipertrofia Ventricular Esquerda/patologia , Volume Plaquetário Médio , Idoso , Pressão Sanguínea , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico por imagem , Hipertensão/patologia , Hipertrofia Ventricular Esquerda/complicações , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Ativação Plaquetária , UltrassonografiaRESUMO
Elevated plasma levels of asymmetric dimethylarginine (ADMA) are prevalent in patients with hypercholesterolemia and coronary artery disease. A total of 83 patients with hypercholesterolemia and angiographically documented mild coronary artery stenosis were randomized to rosuvastatin treatment (20 mg) or atorvastatin treatment (40 mg) once daily for 6 weeks after a 4-week dietary lead-in phase. Both statins decreased total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride levels effectively. Only rosuvastatin increased high-density lipoprotein cholesterol (HDL-C) levels. Both rosuvastatin and atorvastatin decreased plasma ADMA levels; rosuvastatin had a significantly greater effect. The reduction in ADMA levels were correlated with the reduction in TC and LDL-C levels as well as LDL-C-HDL-C ratio. Treatment with rosuvastatin or atorvastatin in patients with hyperlipidemia with mild coronary artery stenosis may lead to a decrease in ADMA levels, which may contribute to improved endothelial function.