Baseline Characteristics of a Patient Cohort and Predictors of In-hospital MORtality in CORonary Care Units (MORCOR-TURK) Trial in Türkiye.

OBJECTIVE: The MORtality in CORonary Care Units in Türkiye (MORCOR-TURK) trial is a national registry evaluating predictors and rates of in-hospital mortality in coronary care unit (CCU) patients in Türkiye. This report describes the baseline demographic characteristics of patients recruited for the MORCOR-TURK trial. METHODS: The study is a multicenter, cross-sectional, prospective national registry that included 50 centers capable of 24-hour CCU service, selected from all seven geographic regions of Türkiye. All consecutive patients admitted to CCUs with cardiovascular emergencies between September 1-30, 2022, were prospectively enrolled. Baseline demographic characteristics, admission diagnoses, laboratory data, and cardiovascular risk factors were recorded. RESULTS: A total of 3,157 patients with a mean age of 65 years (range: 56-73) and 2,087 (66.1%) males were included in the analysis. Patients with arterial hypertension [1,864 patients (59%)], diabetes mellitus (DM) [1,184 (37.5%)], hyperlipidemia [1,120 (35.5%)], and smoking [1,093 (34.6%)] were noted. Non-ST elevation myocardial infarction (NSTEMI) was the leading cause of admission [1,187 patients (37.6%)], followed by ST elevation myocardial infarction (STEMI) in 742 patients (23.5%). Other frequent diagnoses included decompensated heart failure (HF) [339 patients (10.7%)] and arrhythmia [272 patients (8.6%)], respectively. Atrial fibrillation (AF) was the most common pathological rhythm [442 patients (14%)], and chest pain was the most common primary complaint [2,173 patients (68.8%)]. CONCLUSION: The most common admission diagnosis was acute coronary syndrome (ACS), particularly NSTEMI. Hypertension and DM were found to be the two leading risk factors, and AF was the most commonly seen pathological rhythm in all hospitalized patients. These findings may be useful in understanding the characteristics of patients admitted to CCUs and thus in taking precautions to decrease CCU admissions.

Novel styryl-thiazole hybrids as potential anti-Alzheimer's agents.

In this study, combining the thiazole and cinnamoyl groups into the styryl-thiazole scaffold, a series of novel styryl-thiazole hybrids (6a-p) was rationally designed, synthesized, and evaluated by the multi-target-directed ligands strategy as potential candidates for the treatment of Alzheimer's disease (AD). Hybrids 6e and 6i are the most promising among the synthesized hybrids since they are able to significantly increase cell viabilities in Aß1-42-exposed-human neuroblastoma cell line (6i at the concentration of 50 µg mL-1 and 6e at the concentration of 25 µg mL-1 resulted in ∼34% and ∼30% increase in cell viabilities, respectively). Compounds 6e and 6i exhibit highly AChE inhibitory properties in the experimental AD model at 375.6 ± 18.425 mU mL-1 and 397.6 ± 32.152 mU mL-1, respectively. Moreover, these data were also confirmed by docking studies and in vitro enzyme inhibition assays. Compared to hybrid 6e and according to the results, 6i also has the highest potential against Aß1-42 aggregation with over 80% preventive activity. The in silico prediction of the physicochemical properties confirms that 6i possesses a better profile compared to 6e. Therefore, compound 6i presents a promising multi-targeted active molecular profile for treating AD considering the multifactorial nature of AD, and it is reasonable to deepen its mechanisms of action in an in vivo experimental model of AD.

Non-alcoholic faty liver disease and liver fibrosis score have an independent relationship with the presence of mitral annular calcification.

Non-alcoholic faty liver disease (NAFLD) and liver fibrosis score (FIB 4) are associated with increased mortality from cardiovascular causes. NAFLD and cardiac diseases are different manifestations of systemic metabolic syndrome. In this study, we aimed to reveal the relationship between NAFLD and FIB 4 liver fibrosis scores and mitral annular calcification (MAC). One hundred patients were included in the study. Blood samples and echocardiography measurements were obtained from each subject. The two groups were compared in terms of demographic and echocardiographic characteristics. Thirty-one men and 69 women with a mean age of 48.6 ± 13.1 years were included in the analysis. The patients were divided into two groups as those with MAC (n = 26) and those without (n = 74). The baseline demographic and laboratory data for the two groups were compared. In the group with MAC (+) age, serum creatinine levels, FIB4 and NAFLD Scores; HL, DM rates, angiotensin converting enzyme (ACE) inhibitor and statin usage rates were higher, with statistical significance. NAFLD and FIB 4 liver fibrosis scores have an independent relationship with MAC.

The relationship between epicardial adipose tissue thickness and coronary artery disease progress.

BACKGROUND: The relationship between epicardial adipose tissue and inflammatory events has been shown in many studies. Because it is an inflammatory process in coronary progression, it is aimed to examine the relationship between coronary artery disease progression and epicardial adipose tissue thickness. MATERIALS AND METHODS: Our research was conducted with 50 patients (33 men, 17 women) who underwent planned or emergency coronary angiography, by evaluating the coronary artery disease progression from the coronary angiography images together with the echocardiographic epicardial adipose tissue thickness measurement. Patients were examined in two groups according to their tissue thickness, 17 patients with less than 0.55 cm were defined as group 1 and 33 patients with ≥ 0.55 were determined as group 2. RESULTS: There was no significant difference between the groups in terms of gender, diabetes, age, hypertension. In addition, a significant relationship was found with epicardial adipose tissue thickness (> 0.5 cm), ejection fraction and smoking in the group with coronary progression. Patients without stenotic changes were found to be statistically significantly lower p < 0.005. CONCLUSION: An independent relationship was found between epicardial adipose tissue and coronary artery progression. In the light of these findings, it can be concluded that epicardial adipose tissue residue is effective in the development of coronary artery stenosis and calcific-atherosclerotic changes in the coronary arteries. In the light of the information obtained, a positive correlation was determined between epicardial adipose tissue thickness and coronary artery disease (Tab. 3, Fig. 2, Ref. 15). Text in PDF www.elis.sk Keywords: coronary artery disease, epicardial adipose tissue, progression.

Serum fibrinopeptide A is increased in patients with acute coronary syndrome.

OBJECTIVE: Acute coronary syndrome (ACS) is one of the leading causes of mortality, globally. Atherosclerosis is an underlying factor in ACS process and coagulative cascade is activated secondary to atherosclerotic plaque rupture. Fibrinopeptide A (FPA) takes an active role in thrombus formation and is an indicator of coagulative process. We aimed to evaluate serum FPA level in patients with ACS. METHODS: Patients diagnosed with ACS and chronic coronary syndrome (CCS), with non-obstructive coronary artery disease as a control group, were included in the study. Blood samples and demographic data of all patients were obtained at admission. Obtained data were compared between ACS and control groups. RESULTS: The study consisted of 107 patients with ACS and 69 patients with CCS. ACS group was older (p<0.001) with male preponderance (p<0.001), more likely to had hypertension (p<0.001), and had a higher smoking rate (p<0.001). Serum FPA level was highest in the ST elevated myocardial infarction group (p<0.001). FPA>3.38 ng/mL predicted ACS with 89.7% sensitivity and 78% specificity (AUC: 0.825, 95% CI 0.745-0.905; p<0.001). CONCLUSION: Serum FPA may be used for the differential diagnosis of ACS. In addition, patients with increased FPA may be considered to be given more aggressive antithrombotic medication.

Increased visinin-like protein-1, YKL-40, lipocalin-2, and IL-23 levels in patients with migraine.

BACKGROUND: Migraine is a type of primary headache caused by changes in the trigeminal system and has been reported to be associated with neurovascular inflammation of cerebral and extracerebral vessels. OBJECTIVE: It is known that inflammation is an important process in the pathogenesis of migraine. It has been shown that the molecules of visinin-like protein 1 (Vilip-1), YKL-40, lipocalin-2 and interleukin (IL)-23 play a role in the inflammatory process. Our aim is to investigate the role of this molecule in the metabolic pathway of migraine disease. METHODS: Fifty migraine patients with and without aura in the interictal period were included in the study. Vilip-1, YKL-40, lipocalin-2, and IL-23 levels were measured by ELISA method. RESULTS: Serum vilip-1, YKL-40, lipocalin-2, and IL-23 levels were found to be significantly higher in migraine patients compared to the control group. We found that this molecule increased significantly in migraine subgroups compared to the control group (p < 0.001). A positive significant correlation was found between vilip-1 level and YKL-40 and lipocalin-2 levels in migraine patients. In addition, a positive correlation was observed between visual analogue scale score, number of days with pain and vilip-1 level (p < 0.01). The results of our study showed that activation of inflammatory mediators may play a role in the pathogenesis of migraine disease. In addition, our study is valuable in that inflammatory molecules are high in the interictal period and these biomarkers have never been analyzed in migraine patients. However, we still believe that larger studies are needed to explain the role of vilip-1, YKL-40, lipocalin-2, and IL-23 in the molecular mechanism of migraine disease.

The efficacy of liraglutide combined with intragastric balloon on weight loss

SUMMARY OBJECTIVE: Intragastric balloon placement is an effective method for weight reduction. The aim of this study was to evaluate the efficacy of combining liraglutide with intragastric balloon. METHODS: Initially, demographic data of patients such as age, gender, comorbid diseases, adverse events, initial weight, height, body mass index, percent body fat, and waist-hip ratio were collected. Weight, body mass index, percent body fat, and waist-hip ratio were measured in the second, third, fourth, fifth, and sixth months. Then, intragastric balloon was removed and liraglutide was stopped. RESULTS: A total of 50 patients were included in the study, of whom 28 (56%) were in Group A (intragastric balloon) and 22 (44%) were in Group B (plus liraglutide). Weight change at the time of balloon removal was higher in Group B [median weight change 13.8 (7.8 min to 16.8 max) versus 7.9 (4.8 min to 11.8 max); p<0.01]. When the weight, percent body fat, body mass index, and waist-hip ratio changes were compared according to gender, no significant difference was observed in the groups. Comorbid diseases were hypertension in 7 patients (4 in Group A and 3 in Group B) and diabetes in 9 patients (5 in Group A and 4 in Group B). No statistical significance was found. CONCLUSION: Liraglutide has benefits in terms of weight, percent body fat, and body mass index reduction when administered with intragastric balloon.

Three Different Strategies for Repair of Symptomatic or Aneurysmatic Aberrant Right Subclavian Arteries.

INTRODUCTION: In this study, we aimed to present three different methods for symptomatic aberrant right subclavian artery (ARSA) surgery. METHODS: We identified 11 consecutive adult patients undergoing symptomatic and/or aneurysmal ARSA repair between January 2016 and December 2020. Symptoms were dysphagia (n=8) and dyspnea + dysphagia (n=3). Six patients had aneurysm formation of the ARSA (mean diameter of 4.2 cm [range 2.8 - 6.3]). All data were analyzed retrospectively. RESULTS: Median age of the patients (7 females/4 males) was 55 years (range 49 - 62). The first four patients (36.4%) underwent hybrid repair using thoracic endovascular aortic repair (TEVAR) and bilateral carotid-subclavian artery bypass (CScBp). Three patients (27.2%) were treated by open ARSA resection/ligation with left mini posterolateral thoracotomy (LMPLT) and right CScBp. And the last four patients (36.4%) underwent ARSA resection/ligation with LMPLT and ascending aorta-right subclavian artery bypass with upper mini sternotomy (UMS). Two of the four patients who underwent TEVAR + bilateral CScBp had continuing dysphagia cause of persistent esophageal compression. Brachial plexus injury developed in one of three patients who underwent LMPLT + right CScBp. Pleural effusion treated with thoracentesis alone was observed in one of four patients who underwent UMS + LMPLT. CONCLUSION: Among the symptomatic and/or aneurysmal ARSA treatment approaches, surgical and hybrid methods are used. There is still no consensus on how to manage these patients. In our study, we recommend the UMS + LMPLT method, since the risk of complications with anatomical bypass is less, and we have more successful surgical results.

Radiation Shielding Tests of Crosslinked Polystyrene-b-Polyethyleneglycol Block Copolymers Blended with Nanostructured Selenium Dioxide and Boron Nitride Particles.

In this work, gamma-ray shielding features of crosslinked polystyrene-b-polyethyleneglycol block copolymers (PS-b-PEG) blended with nanostructured selenium dioxide (SeO2) and boron nitride (BN) particles were studied. This research details several radiation shielding factors i.e., mass attenuation coefficient (µm), linear attenuation coefficient (µL), radiation protection efficiency (RPE), half-value layer (HVL), tenth-value layer (TVL), and mean free path (MFP). The irradiation properties of our nanocomposites were investigated with rays from the 152Eu source (in the energy intervals from 121.780 keV to 1408.010 keV) in a high-purity germanium (HPGe) detector system, and analyzed with GammaVision software. Moreover, all radiation shielding factors were determined by theoretical calculus and compared with the experimental results. In addition, the morphological and thermal characterization of all nanocomposites was surveyed with various techniques i.e., nuclear magnetic resonance (NMR), Fourier-transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and transmission electron microscopy (TEM). Acceptable compatibility was revealed and observed in all nanocomposites between the experimental and theoretical results. The PS-b-PEG copolymer and nanostructured SeO2 and BN particles exerted a significant effect in enhancing the resistance of the nanocomposites, and the samples with high additive rates exhibited better resistance than the other nanocomposites. From the achieved outcomes, it can be deduced that our polymer-based nanocomposites can be utilized as a good choice in the gamma-irradiation-shielding discipline.

In vitro transcriptome response to propolis in differentiated SH-SY5Y neurons.

Propolis is the extract of a resinous compound that protects plants from both cold and microorganism attack and has gained a strong and sticky property because it is transformed after being collected by honey bees. Up to date, many studies have shown that propolis exhibited various beneficial biological activities, such as antifungal, antibacterial, antiviral, antioxidant, antimutagenic, and antitumor effects. Recent reports propounded the in vitro and in vivo neuroprotective effect of propolis; however, the exact molecular genetic mechanisms are still unclear. Therefore, we aimed to investigate the toxicogenomic and beneficial properties, including cytotoxic, antioxidant, apoptotic/necrotic as well as genotoxic effects of propolis (1.56-200 µg/ml) on differentiated SH-SY5Y neuronal cells. Additionally, microarray analysis was conducted on cell cultures following propolis application to explore gene differentiation. Differentially expressed genes were further analyzed using string software to characterize protein-protein interactions between gene pathways. Our results revealed that propolis applications could not have a prominent effect on cell viability even at concentrations up to 200 µg/ml. The highest propolis concentration induced apoptotic rather than necrotic cell death. The alterations in gene expression profiles, including CYP26A1, DHRS2, DHRS3, DYNC1I1, IGF2, ITGA4, SVIL, TGFß1, and TGM2 could participate in the neuroprotective effects of propolis. In conclusion, propolis supplementation exerted remarkable advantageous; thus, it may offer great potential as a natural component in the prevention and treatment of neurodegenerative disorders. Whole-genome gene expression pattern following propolis application was investigated for the first time in neuronal cell culture to fill a gap in the literature about propolis toxicogenomics. PRACTICAL APPLICATIONS: Propolis is a very rich product in terms of benefits. In addition to its antibacterial, antiviral, antifungal, and anti-inflammatory content, it is known to have preventive and therapeutic properties for many different ailments. On the other hand, molecular mechanisms of propolis on gene expression differentiations haven't been investigated until now. Moreover, gene expression pattern is vital for all living organisms to maintain homeostasis. Thus, we conduct an experiment series for analyzing gene expression differentiation effects on neuronal cells to understand beneficial properties of propolis. Hence, it could be possible to comment on the use of propolis as a nutritional factor and beneficial diet.

Gamma Irradiation and the Radiation Shielding Characteristics: For the Lead Oxide Doped the Crosslinked Polystyrene-b-Polyethyleneglycol Block Copolymers and the Polystyrene-b-Polyethyleneglycol-Boron Nitride Nanocomposites.

This work aimed to research the efficiency of gamma irradiation and shielding characteristics on the lead oxide (PbO) doped the crosslinked polystyrene-b-polyethyleneglycol (PS-b-PEG) block copolymers and polystyrene-b-polyethyleneglycol-boron nitride (PS-b-PEG-BN) nanocomposites materials. The crosslinked PS-b-PEG block copolymers and PS-b-PEG-BN nanocomposites mixed with different percentage rates of PbO were used to research gamma-ray shielding characteristics. The synthesis of the copolymer was done by emulsion polymerization methods. The characterization and morphological analyses of irradiated samples were explored handling with the Nuclear Magnetic Resonance (NMR), Fourier Transform Infrared Spectroscopy (FTIR), Gel Permeation Chromatography (GPC), Thermogravimetric Analysis (TGA), and Scanning Electron Microscope (SEM) methods. The gamma-rays that were emitted from the E 152u source were observed with a High Purity Germanium (HPGe) detector system and examined with a GammaVision computer program. Our samples, including the different percentage rates of the PS-b-PEG (1000, 1500, 10,000), BN, and PbO, were irradiated in various gamma-ray photon energy regions (from 121.78 keV to 1408.01 keV). Then, Linear-Mass Attenuation Coefficients (LACs-MACs), Half-Tenth Value Layer (HVL), Mean Free Path (MFP), and Radiation Protection Efficiency (RPE) values of the samples were calculated. Via crosschecking the acquired data from samples with and without PbO and BN, it was observed that, if the different percentage rates by weight nano-powder of PbO and BN are added in the polymer mixture, it can be used as a convenient shielding material against gamma rays.

Investigation of serum vaspin, visfatin, chemerin and IL-18 levels in migraine patients / Investigação dos níveis séricos de vaspina, visfatina, quemerina e IL-18 em pacientes com migrânea

Abstract Background: Migraines are headaches caused by changes in the trigeminovascular metabolic pathway. Migraine headache attacks are associated with neurovascular inflammation, but their pathophysiological mechanisms have not been fully explained. Objective: To investigate the relationship between serum vaspin, visfatin, chemerin and interleukin-18 (IL-18) levels and the frequency of attacks in migraine headache. Methods: Three groups were established: migraine with aura (n = 50), migraine without aura (n = 50) and control group (n = 50). The migraine diagnosis was made in accordance with the International Classification of Headache Disorders-III beta diagnostic criteria. The analyses on serum vaspin, visfatin, chemerin and IL-18 levels were performed using the enzyme-linked immunosorbent assay method. Results: The serum vaspin, visfatin, chemerin and IL-18 levels were found to be significantly higher in the migraine patients than in the control group (p < 0.01). No statistically significant differences in serum vaspin, visfatin, chemerin and IL-18 levels were found among the migraine patients during attacks or in the interictal period (p>0.05). The serum visfatin and chemerin levels of the migraine patients were positively correlated with their serum IL-18 levels (p < 0.01), while their serum chemerin and visfatin levels were positively correlated with their serum vaspin levels (p < 0.05). Conclusions: This study showed that these biomarkers may be related to migraine pathogenesis. Nonetheless, we believe that more comprehensive studies are needed in order to further understand the role of vaspin, visfatin, chemerin and IL-18 levels in the pathophysiology of migraine headaches.

Resumo Introdução: A migrânea é causada por alterações nas vias metabólicas do sistema trigeminovascular. Crises de migrânea estão associadas à inflamação neurovascular, mas seus mecanismos patofisiológicos ainda não são totalmente explicados. Objetivo: Investigar a relação entre níveis séricos de vaspina, visfatina, quemerina e interleucina-18 (IL-18) e a frequência de crises de migrânea. Métodos: Três grupos foram formados: migrânea com aura (n = 50), migrânea sem aura (n = 50) e grupo controle (n = 50). A migrânea foi diagnosticada de acordo com os critérios da Classificação Internacional das Cefaleias (ICHD-III). As análises dos níveis séricos de vaspina, visfatina, quemerina e IL-18 foram realizadas utilizando-se o método imunoenzimático (ELISA). Resultados: Os níveis séricos de vaspina, visfatina, quemerina e interleucina-18 (IL-18) foram significativamente mais elevados em pacientes com migrânea do que no grupo controle (p < 0.01). Nenhuma diferença estatisticamente significativa foi observada nos níveis séricos de vaspina, visfatina, quemerina e interleucina-18 (IL-18) entre os pacientes com migrânea durante crises ou no período interictal (p>0,05). Os níveis séricos de visfatina e quemerina em pacientes com migrânea se correlacionaram positivamente com os níveis séricos de IL-18 (p < 0,01), ao passo que os níveis séricos de quemerina e visfatina se correlacionaram positivamente com os níveis séricos de vaspina (p < 0,05). Conclusões: Este estudo demonstrou que estes biomarcadores podem estar relacionados à patogênese da migrânea. Contudo, acreditamos que estudos mais abrangentes são necessários a fim de melhor compreendermos o papel dos níveis de vaspina, visfatina, quemerina e IL-18 na fisiopatologia da migrânea.

Prospective Statewide Study of Universal Screening for Hereditary Colorectal Cancer: The Ohio Colorectal Cancer Prevention Initiative.

Hereditary cancer syndromes infer high cancer risks and require intensive surveillance. Identification of high-risk individuals among patients with colorectal cancer (CRC) needs improvement. METHODS: Three thousand three hundred ten unselected adults who underwent surgical resection for primary invasive CRC were prospectively accrued from 51 hospitals across Ohio between January 1, 2013, and December 31, 2016. Universal Tumor screening (UTS) for mismatch repair (MMR) deficiency was performed for all, and pathogenic germline variants (PGVs) were identified using multigene panel testing (MGPT) in those who met at least one inclusion criterion: MMR deficiency, diagnosed < 50 years, multiple primary tumors (CRC or endometrial cancer), or with a first-degree relative with CRC or endometrial cancer. RESULTS: Five hundred twenty-five patients (15.9%) had MMR deficiency. Two hundred thirty-four of 3,310 (7.1%; 16% of the 1,462 who received MGPT) had 248 PGVs in cancer susceptibility genes. One hundred forty-two (4.3%) had a PGV in an MMR gene, and 101 (3.1%) had a PGV in a non-MMR gene. Ten with Lynch syndrome (LS) also had a non-MMR PGV and were included in both groups. Two (0.06%) had constitutional MLH1 hypermethylation. Of unexplained MMR-deficient patients, 88.4% (76 of 86) had double somatic MMR mutations. Testing for only MMR genes in MMR-deficient patients would have missed 18 non-MMR gene PGVs (7.3% of total PGVs identified). Had UTS been the only method used to screen for hereditary cancer syndromes, 38.6% (91 of 236) would have been missed, including 6.3% (9 of 144) of those with LS. These results have treatment implications as 5.3% (175 of 3,310) had PGVs in genes with therapeutic targets. CONCLUSION: UTS alone is insufficient for identifying a large proportion of CRC patients with hereditary syndromes, including some with LS. At a minimum, 7.1% of individuals with CRC have a PGV and pan-cancer MGPT should be considered for all patients with CRC.

Systemic immune-inflammation index is associated with increased carotid intima-media thickness in hypertensive patients.

BACKGROUND: Arterial hypertension causes cardiovascular adverse events mainly through endothelial dysfunction, atherosclerosis, and inflammation. Carotid intima-media thickness (CIMT) is a marker of subclinical atherosclerosis and endothelial dysfunction. Systemic immune-inflammation index (SII) reflects systemic inflammatory and immunity status. This index has strong prognostic value in malignancy and recently was demonstrated to be associated with adverse events in cardiovascular diseases. We aimed to interrogate the relationship between SII and CIMT in patients with hypertension. METHODS: A total of 215 consecutive hypertensive patients were included in the study. CIMT of all patients was obtained by B-mode arterial doppler ultrasound. SII was obtained by the following formula: (platelet × neutrophil/lymphocyte ratio) from admission complete blood count. Patients were divided into two groups by means of CIMT is above or below the value of 0.9 mm. SII and demographic characteristics of patients were compared between groups. RESULTS: Increased CIMT was detected in 55 (25.6%) of hypertensive patients. The patients with increased CIMT were older and had higher neutrophil count (p < .001), neutrophil to lymphocyte ratio (NLR) (p < .001), C-reactive protein (CRP) (p = .047), CRP to albumin ratio (CAR) (p = .044) and SII (p < .001) Advanced age (OR: 1.054; 95% CI: 1.015-1.095; p = .006), NLR (OR: 3.213; 95% CI: 1.577-6.546; p = .001), and SII (OR: 3.906; 95% CI: 1.887-8.086; p < .001) were independent predictors of increased CIMT in multivariable logistic regression analysis. CONCLUSION: SII was an independent predictor of elevated CIMT in hypertensive patients. Preventive approaches for future atherosclerotic cardiovascular diseases can be developed in those with higher SII level.

Prognostic nutritional index is related to myocardial performance index in newly diagnosed nondiabetic hypertensive patients.

Background: Arterial hypertension (AH) leads to systolic and/or diastolic dysfunction of the left ventricle (LV) by causing structural changes in the myocardium. Myocardial performance index (MPI) provides the evaluation of LV systolic and diastolic functions together. Prognostic nutritional index (PNI) is an indicator of immunonutritional status. PNI was studied in patients with malignancy, malnutrition, and cardiovascular diseases so far. It was aimed to investigate the relationship between PNI and MPI in hypertensive patients.Methods: A total of 91 consecutive patients with newly diagnosed AH were included in the study. PNI was calculated according to the following formula: ((10 × serum albumin (g/dL))+(0.005 × total lymphocyte count)). MPI was obtained by dividing the sum of isovolumetric relaxation time (IVRT) and isovolumetric contraction time (IVCT) by the ejection time (ET) ((IVRT+IVCT)/ET). Patients were divided into two groups according to MPI is above or below the value of 0.5. The demographic characteristics and PNI values of patients were compared between two groups.Results: There were 65 patients in the higher and 26 patients were in the normal MPI group. Higher MPI group had male predominance (p = .002). Diastolic blood pressure (p = .021), interventricular septum thickness (p = .005), posterior wall thickness (PWT) (p = .001), serum albumin concentration (p = .045), and PNI (p = .013) were differed between groups. Multivariate logistic regression analysis revealed that PWT [OR = 1.835, 95% CI: 1.126-2.992, p = .015] and PNI [OR = 1.161, 95% CI: 1.004-1.343, p = .018] predicted higher MPI.Conclusion: Higher PNI was an independent predictor of LV dysfunction in newly diagnosed hypertensive patients. Immunonutritional status may be used as an indicator of the left ventricular function in patients with AH.

Evaluation of the snowing-like ultrasonographic features of intraosseous jaw pathologies.

Aim of the study: Ultrasonographic examination of intraosseous jaw pathologies may reveal interesting incidental, mobile hyperechoic particles ("snowflakes") in anechoic areas. Purpose of this study is to explain and discuss this snowing-like ultrasonographic feature of intraosseous jaw pathologies. Material and methods: This study included 113 patients admitted to our clinic for examination: 43 (38.05%) males and 70 (61.9%) females with a mean age of 34.9 ± 17.2 years (range: 6-72 years). A total of 120 intraosseous lesions were evaluated prior to surgery using ultrasonography; these included non-neoplastic, odontogenic, and non-odontogenic lesions. Results: In total, 5 (4.1%) of the 120 lesions exhibited snowing-like feature on ultrasonography, including 2 (1.6% of total) of 3 incisive canal cysts, 2 (1.6% of total) of 7 dentigerous cysts, and 1 (0.8% of total) of 19 odontogenic keratocysts. Conclusions: Snowflakes evident on ultrasonography of intraosseous jaw lesions may be specific to certain pathologies. Future studies correlating radiologic and pathologic features of intraosseous jaw lesions should focus on ultrasonographic snowing-like appearance in different types of lesions and explore why they occur.

Double somatic mismatch repair gene pathogenic variants as common as Lynch syndrome among endometrial cancer patients.

OBJECTIVE: Lynch syndrome is the most common cause of inherited endometrial cancer, attributable to germline pathogenic variants (PV) in mismatch repair (MMR) genes. Tumor microsatellite instability (MSI-high) and MMR IHC abnormalities are characteristics of Lynch syndrome. Double somatic MMR gene PV also cause MSI-high endometrial cancers. The aim of this study was to determine the relative frequency of Lynch syndrome and double somatic MMR PV. METHODS: 341 endometrial cancer patients enrolled in the Ohio Colorectal Cancer Prevention Initiative at The Ohio State University Comprehensive Cancer Center from 1/1/13-12/31/16. All tumors underwent immunohistochemical (IHC) staining for the four MMR proteins, MSI testing, and MLH1 methylation testing if the tumor was MMR-deficient (dMMR). Germline genetic testing for Lynch syndrome was undertaken for all cases with dMMR tumors lacking MLH1 methylation. Tumor sequencing followed if a germline MMR gene PV was not identified. RESULTS: Twenty-seven percent (91/341) of tumors were either MSI-high or had abnormal IHC indicating dMMR. As expected, most dMMR tumors had MLH1 methylation; (69, 75.8% of the dMMR cases; 20.2% of total). Among the 22 (6.5%) cases with dMMR not explained by methylation, 10 (2.9% of total) were found to have Lynch syndrome (6 MSH6, 3 MSH2, 1 PMS2). Double somatic MMR PV accounted for the remaining 12 dMMR cases (3.5% of total). CONCLUSIONS: Since double somatic MMR gene PV are as common as Lynch syndrome among endometrial cancer patients, paired tumor and germline testing for patients with non-methylated dMMR tumor may be the most efficient approach for LS screening.

Serum Endocan Levels Predict Angiographic No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Coronary Intervention.

No-reflow phenomenon (NRP) is an important problem in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). Endocan is synthesized and secreted by activated vascular endothelium, and it has been shown to be related to endothelial dysfunction and inflammation. We aimed to evaluate the relationship between endocan levels and NRP. Consecutive patients (n = 137) with STEMI who had undergone coronary angiography and pPCI were enrolled into the study. The clinical characteristics of the patients were obtained and endocan levels were measured. Endocan levels were significantly higher in the NRP (+) group compared with the NRP (-) group (P < .001). In multivariate analysis, endocan (P < .001, OR = 2.39, 95% CI = 1.37-4.15) was found to be an independent predictor of NRP. An endocan value of >2.7 ng/mL has 89.6% sensitivity and 74.2% specificity for the prediction of the NRP (area under the curve: 0.832, P < .001). The present study demonstrated that the endocan level is an independent predictor of the NRP in patients with STEMI who underwent pPCI. Endocan levels may be helpful in detecting patients with a higher risk of insufficient myocardial perfusion and worse clinical outcome.

Examination of Giardia intestinalis with Direct Microscopy and Direct Fluorescent Antibody in Patients with Diarrhea.

OBJECTIVE: In this study, our objective was to compare direct microscopic examination and direct fluorescence antibody (DFA) method for Giardia diagnosis in stool samples and to evaluate the possible risk factors related to Giardia infections. METHODS: Stool samples of 185 patients with diarrhoea collected between June 2019 and July 2019 in Erzurum Yakutiye Research Hospital were included in the study. Microscopic examination of the samples was performed with native-lugol, and they were subsequently scanned by the indirect fluorescent assay microscope using the DFA method at 100-200X magnification. In addition, all patients filled a questionnaire prepared to determine the possible risk factors related to Giardia infection. RESULTS: The age of the 185 participating patients who belonged to different groups was between 0 and 94 years. Giardia spp. cysts were detected in five stool samples (2.7%) using direct microscopic examination. Nine samples (4.9%) were DFA-positive. The incidence of giardiasis was noted to be 7.5% in children, 3.8% in adults, 7.3% in people living in rural areas, 2.9% in people living in urban areas, 10% in people having pets and 4.2% in people who do not have pets. CONCLUSION: By taking the DFA method as a reference, the sensitivity and specificity of the microscopic examination were found to be 44.4% and 99.4%, respectively. The Giardia positivity rate was higher in children, those living in rural areas, those having pets and those using well water as drinking water.

Chimeric antigen receptor-engineered natural killer cells for cancer immunotherapy.

Natural killer (NK) cells are a critical component of the innate immune system. Chimeric antigen receptors (CARs) re-direct NK cells toward tumor cells carrying corresponding antigens, creating major opportunities in the fight against cancer. CAR NK cells have the potential for use as universal CAR cells without the need for human leukocyte antigen matching or prior exposure to tumor-associated antigens. Exciting data from recent clinical trials have renewed interest in the field of cancer immunotherapy due to the potential of CAR NK cells in the production of "off-the-shelf" anti-cancer immunotherapeutic products. Here, we provide an up-to-date comprehensive overview of the recent advancements in key areas of CAR NK cell research and identify under-investigated research areas. We summarize improvements in CAR design and structure, advantages and disadvantages of using CAR NK cells as an alternative to CAR T cell therapy, and list sources to obtain NK cells. In addition, we provide a list of tumor-associated antigens targeted by CAR NK cells and detail challenges in expanding and transducing NK cells for CAR production. We additionally discuss barriers to effective treatment and suggest solutions to improve CAR NK cell function, proliferation, persistence, therapeutic effectiveness, and safety in solid and liquid tumors.