Blood total carbon dioxide content and bicarbonate can be used together to predict blood pH correctly in venous blood samples.

Blood gas analyses are needed to reveal any kind of acid-base imbalance in some patients. Traditionally, arterial punctures are performed to obtain the blood samples for blood gas analyses. Arterial puncture is not a completely safe procedure. It may cause serious problems including arterial thrombosis, arteriovenous fistula, pseudoaneurysms and hematoma. In this retrospective reviewing, it was aimed to yield novel formulations to predict the blood pH only from CtCO2 and HCO3 values which can easily be measured in venous blood samples obtained for other diagnostic and follow-up purposes.

Investigation of the aortic pulse wave velocity in patients with Gilbert's syndrome.

Arterial stiffness is currently the "gold standard" measure of aortic (carotid-femoral) pulse wave velocity (PWV), which is an important independent predictor of risk of developing a cardiovascular event. Gilbert's syndrome is a congenital disorder characterized by intermittent and non-hemolytic elevation of indirect bilirubin levels due to the deficiency of the enzyme UDP-glucuronyl transferase in the liver and many prospective studies found an inverse relationship between bilirubin levels and cardiovascular events in these patients. We aimed to investigate serum bilirubin levels and arterial stiffness parameters in patients with Gilbert's syndrome in this study. A total of 53 cases, consisting of 26 patients with a diagnosis of Gilbert's syndrome and 27 healthy control subjects, were included in the study. Serum bilirubin levels, other routine blood chemistry, and arterial stiffness measurements were recorded. The mean ages of Gilbert's syndrome and the control group were 31.5 ± 9.7 and 36.8 ± 11.1 years, respectively. PWV measurements were significantly lower in Gilbert syndrome patients (6.68 and 7.3 m/s in patients and controls; respectively) (P < .05). In correlation analysis in Gilbert's syndrome patients, PWV had a significant correlation with total and indirect bilirubin levels (r = -0.370, P = .009/r = -0.495, P = .003, respectively). Gilbert's syndrome patients have lower PWV measurements compared to healthy subjects, and the total and indirect bilirubin levels are also associated with PWV measurements. These findings may indicate the decreased atherosclerotic disease incidence in Gilbert's syndrome patients.

The comparative effects of valsartan and amlodipine on vWf levels and N/L ratio in patients with newly diagnosed hypertension.

High levels of circulating Von Willebrand factor (vWf) and increased neutrophil to lymphocyte (N/L) ratio may reflect vascular inflammation in hypertensive patients. In present study, we aimed to investigate the effects of valsartan as an angiotensin II receptor antagonist and amlodipine as a calcium channel blocker on the vWf levels and N/L ratio in patients with essential hypertension. Patients were randomized to one of the following intervention protocols: calcium channel blocker (amlodipine, 5-10 mg/day) as group A (n = 20 mean age = 51.85 ± 11.32 y) and angiotensine II receptor blocker (valsartan, 80-320 mg/day) as group B (n = 26 mean age = 49.12 ± 14.12 y). Endothelial dysfunction and vascular inflammation were evaluated with vWf levels and N/L ratio in hypertensive patients before treatment and after treatment in the 12th week. No statistically significant differences were found among the groups in terms of age, sex, and body mass index (BMI). There was a significant decrease in vWf levels (P < .001) and N/L ratio after treatment (P = .04, P < .001, respectively) in both the groups. Von Willebrand factor levels and N/L ratio are very important markers having a role in vascular inflammation and antihypertensive treatment with amlodipine and valsartan may improve cardiovascular outcomes by decreasing these biomarkers.

An additional LDL-lowering effect of amlodipine; not only an antihypertensive?

Hypertension is a modifiable risk factor for cardiovascular diseases and is associated with several metabolic disorders like dyslipidemia. Higher levels of triglyceride and low-density lipoprotein (LDL) are quite strong factors for the development of cardiovascular diseases. In this study, we investigated the effects of valsartan and amlodipine on the lipid profile in patients with newly diagnosed essential hypertension. We observed a beneficial effect of amlodipine on the lipid profile with a significant reduction of LDL compared to valsartan. In the treatment of hypertension, prior knowledge of the plasma cholesterol levels can be important in antihypertensive drug choice.

Findings of biopsy-proven chronicity and end-stage renal failure associated with oral sodium phosphate solution.

Bowel purgatives containing oral sodium phosphate (OSP) solution are used frequently in general practice and they have the potential of causing acute kidney injury especially in patients with some identified risk factors. Kidney injury may lead to chronicity and end-stage renal disease. Here we present, with renal biopsy findings, an elderly patient suffering from end-stage renal failure due to OSP solution.

High-dose dual therapy is effective as first-line treatment for Helicobacter pylori infection.

BACKGROUND/AIMS: Although many regimens, including quadruple, sequential, and concomitant treatment, are used and recommended as first-line or rescue therapies for Helicobacter pylori infection, eradication rates are still below 90% in intention-to-treat analyses. Treatment protocols with substantially high eradication rates and low antibiotic resistance are needed. In this study, we investigated the efficacy of high-dose dual therapy as first-line treatment in a Turkish population. MATERIALS AND METHODS: All patients underwent upper gastrointestinal endoscopy for the initial H. pylori status because of dyspeptic symptoms. All patients received a 14-day, high-dose dual therapy comprising rabeprazole (20 mg t.i.d.) and amoxicillin (1 g t.i.d.) for H. pylori eradication. H. pylori stool antigen tests of eradication were administered to all participants at least 4 weeks after the completion of the treatment. RESULTS: The high-dose dual therapy demonstrated a 91.3% rate of successful eradication of H. pylori infection. Per-protocol success was 94.4% among female patients (n=51) and 89.6% among male patients (n=86); in terms of gender, the differences were not significant (p=0.310). No side effects were observed during the study in any patient. Six other patients did not take adequate doses of the treatment protocol. CONCLUSION: High-dose dual therapy with rabeprazole and amoxicillin was highly effective and well tolerated as a first-line therapy for H. pylori eradication.

Relation between unconjugated bilirubin and RDW, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio in Gilbert's syndrome.

BACKGROUND: Unconjugated bilirubin (UCB) plays a protective role in coronary artery disease. Red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are inflammatory biomarkers and higher levels are related to atherosclerosis and adverse cardiovascular events. AIM: We aimed to investigate the relation between UCB levels and RDW, NLR, PLR in people with Gilbert's syndrome (GS). MATERIALS AND METHODS: We selected 2166 subjects (1082 with GS and 1084 healthy controls) from a database having 33,695 people. RDW, NLR and PLR were investigated in the subjects with GS and compared with the healthy controls. Linear regression analysis was used to evaluate the relation between variables. RESULTS: NLR and PLR were higher in the subjects with GS compared to the controls (p < 0.001). RDW was similar in both groups (p = 0.318). UCB was negatively correlated with lymphocyte counts (p = 0.040), and positively correlated with RDW (p < 0.001) and PLR (p = 0.037) in the subjects with GS. There was no significant correlation between UCB and NLR (p = 0.078). RDW (p < 0.001) and lymphocyte counts (p = 0.030) were significantly associated with UCB levels in the regression analysis conducted in the subjects with GS. CONCLUSION: There is a negative association between UCB and NLR, PLR due to low amounts of lymphocyte counts, which causes increased risk of CVD. These results suggest that the cardio-protective effect of UCB is due to both anti-oxidative and anti-inflammatory ways indirectly.

Arterial stiffness and endothelial inflammation in prediabetes and newly diagnosed diabetes patients.

OBJECTIVE: There is a growing body of data supporting the association between diabetes and microcirculatory disfunction. We aimed to study e-selectin levels, and their associations with serum markers of inflammation and arterial stiffness in prediabetes and newly diagnosed diabetes patients in this study. SUBJECTS AND METHODS: Sixty patients (25 females) with a newly established elevated fasting serum glucose [20 impaired fasting glucose (IFG), 20 impaired glucose tolerance (IGT), 20 newly diagnosed diabetes (T2DM)] and 17 healthy controls (13 females) were included in the study. Serum e-selectin and hs-CRP levels, and arterial stiffness parameters of the patients were studied. RESULTS: Fasting serum glucose was the most important predictor of serum e-selectin levels. Pulse wave velocity and central aortic pressures were significantly higher in IFG, IGT and T2DM groups, compared to controls (p = 0.001, < 0.001, 0.013 and 0.015, 0.002, 0.009, respectively). The mean arterial pressure did not show any significant association with serum e-selectin and hs-CRP levels (ß coefficient: 0.092, p = 0.358; and ß coefficient: 0.189, p = 0.362, respectively). CONCLUSION: Prediabetes patients have increasing e-selectin levels through the diagnosis of T2DM. E-selectin is associated with serum glucose levels. Prediabetic and newly diagnosed diabetics have higher arterial stiffness measurements. Serum e-selectin may be a good marker of endothelial inflammation and dysfunction increasing in parallel with serum glucose levels, predicting future cardiovascular events.

Asymmetric dimethylarginine and augmentation index in newly diagnosed patients with hypertension.

Pulse wave velocity (PWV), augmentation index (Aix), and central aortic pressure (CAP) are arterial stiffness markers of endothelial dysfunction (ED). We investigated the relationship between arterial stiffness parameters and asymmetric dimethylarginine (ADMA; a marker of ED), in newly diagnosed patients with hypertension (n = 101; 61 females). These patients were investigated in accordance with the recommendations of hypertension guidelines. Arterial stiffness was measured, and serum ADMA and C-reactive protein (CRP; a marker of inflammation) levels were determined. In both women and men, there was no difference in terms of age, body mass index, systolic and diastolic blood pressures, PWV, CAP and the levels of ADMA, while Aix and CRP levels were significantly higher in women (P = .004, P = .046, respectively). In the whole group, ADMA levels correlated with Aix (Pearson r = .237, P = .024). Our findings provide further evidence of a link between arterial stiffness and ED in newly diagnosed patients with hypertension.

Aortic arterial stiffness is a moderate predictor of cardiovascular disease in patients with psoriasis vulgaris.

Psoriasis is associated with an increased risk of atherosclerosis. Endothelial dysfunction is the critical early step in the process of atherogenesis, and it is commonly investigated by measuring arterial stiffness. We aimed to investigate the relationship between arterial stiffness and high-sensitivity C-reactive protein (hsCRP) in patients with psoriasis. A total of 32 patients with psoriasis and 35 patients with other skin diseases were included in the study. The hsCRP levels and arterial stiffness measurements were compared. Arterial stiffness was significantly different between the 2 groups (P = .01). Arterial stiffness was not associated with the duration of the disease or the disease activity (P = .34 and .64, respectively). In patients with psoriasis, arterial stiffness correlated positively with age, sex, body mass index, diastolic blood pressure, and hsCRP level (P < .05). These findings provide further evidence of a link between inflammation, premature atherosclerosis, and psoriasis.