ABSTRACT
This awareness study aimed to determine the ultrasound (US) examination rates in relation to US-confirmed metabolic dysfunction-associated fatty liver disease (MAFLD) diagnosis in internal medicine outpatients with type 2 diabetes (T2D) across Türkiye. A total of 6283 T2D patients were included in this multicenter retrospective cohort study conducted at 17 internal medicine clinics across Türkiye. The presence and indications for US performed within the last 3 years were recorded along with US-confirmed MAFLD rates, laboratory findings on the day of US, and referral rates. Fibrosis-4 (FIB-4) index was calculated to estimate the risk of advanced liver fibrosis (FIB-4 index ≥ 1.3). Overall, 1731 (27.6%) of 6283 patients had US examination, which revealed MAFLD diagnosis in 69.9% of cases. In addition, 24.4% of patients with US-confirmed MAFLD were at risk of advanced fibrosis (FIB-4 index ≥ 1.3), and the referral rate was 15.5%. In conclusion, our findings emphasize an insufficient MAFLD awareness among clinicians and the likelihood of most of T2D patients to be at risk of living with an unknown status regarding their MAFLD and advanced fibrosis risk.
Subject(s)
Diabetes Mellitus, Type 2 , Internal Medicine , Liver Cirrhosis , Ultrasonography , Humans , Diabetes Mellitus, Type 2/complications , Retrospective Studies , Male , Female , Middle Aged , Liver Cirrhosis/complications , Liver Cirrhosis/etiology , Turkey/epidemiology , Aged , Non-alcoholic Fatty Liver Disease/complications , AdultABSTRACT
Amidst the COVID-19 pandemic, hydroxychloroquine (HCQ) was widely administered despite limited data on its safety and efficacy. This study assesses the acute and chronic impacts of HCQ on electrocardiography (ECG) parameters alongside the effects of azithromycin and levofloxacin coadministration in patients with COVID-19. A comprehensive analysis was conducted on 109 COVID-19 patients receiving HCQ, with or without Azithromycin and/or Levofloxacin, and 51 long-term HCQ-treated Sjogren's syndrome (SS) patients. ECG parameters, including QTc interval, were meticulously evaluated against a control group of 109 COVID-19 patients without HCQ treatment. HCQ monotherapy, in combination with Levofloxacin, significantly prolonged the QTc interval in COVID-19 patients compared to controls. Notably, the combination of HCQ and Azithromycin demonstrated a mitigated impact on QTc prolongation. Long-term HCQ use in SS patients did not significantly affect QTc intervals, illustrating a distinct safety profile from short-term use in COVID-19 treatment. HCQ's impact on QTc prolongation is influenced by therapeutic context, coadministered drugs, and patient demographics. The findings underscore the necessity of cautious HCQ use, particularly in acute settings like COVID-19, where monitoring and consideration of drug interactions and patient-specific factors are critical.
Subject(s)
Azithromycin , COVID-19 Drug Treatment , Electrocardiography , Hydroxychloroquine , Long QT Syndrome , Humans , Hydroxychloroquine/adverse effects , Hydroxychloroquine/therapeutic use , Hydroxychloroquine/administration & dosage , Electrocardiography/drug effects , Female , Male , Middle Aged , Azithromycin/therapeutic use , Azithromycin/adverse effects , Azithromycin/administration & dosage , Long QT Syndrome/chemically induced , Aged , Sjogren's Syndrome/drug therapy , Drug Therapy, Combination , Levofloxacin/therapeutic use , Levofloxacin/administration & dosage , Levofloxacin/adverse effects , Adult , SARS-CoV-2 , COVID-19ABSTRACT
BACKGROUND: To evaluate the impact of concomitant use of probiotic BB-12 in metformin-treated patients with type 2 diabetes or prediabetes on glycemic control, metformin-related gastrointestinal side effects, and treatment compliance. METHODS: A total of 156 patients (mean [standard deviation] age: 50.9 [9.9 years], 74.4% females) with newly diagnosed type 2 diabetes or prediabetes were randomly assigned to receive either metformin alone (n = 84, MET group) or metformin plus Bifidobacterium animalis subsp. lactis (BB-12) probiotic (n = 72, MET-PRO group). Data on body mass index (kg/m2), fasting blood glucose (mg/dL), blood lipids, and glycated hemoglobin (HbA1c) levels were recorded at baseline and at the third month of therapy. Data on gastrointestinal intolerance symptoms and treatment noncompliance were also recorded during post-treatment week 1 to week 4. RESULTS: MET-PRO versus MET therapy was associated with a significantly higher rate of treatment compliance (91.7% vs 71.4%, P = .001), greater reduction from baseline HbA1c values (0.9 [0.4-1.6] vs 0.4 [0-1.6] %, P < .001) and lower likelihood of gastrointestinal intolerance symptoms, including abdominal pain (P = .031 to <.001), diarrhea (P = .005 to <.001) and bloating (P = .010 to <.001). Noncompliance developed later (at least 15 days after the therapy) in a significantly higher percentage of patients in the MET group (P = .001 for 15-21 days and P = .002 for 22-28 days). CONCLUSION: In conclusion, the present study proposes the benefit of combining probiotics with metformin in the treatment of patients with T2D or prediabetes in terms of improved glycemic control and treatment adherence rather than correction of dyslipidemia or weight reduction.
Subject(s)
Bifidobacterium animalis , Diabetes Mellitus, Type 2 , Metformin , Prediabetic State , Probiotics , Female , Humans , Middle Aged , Male , Metformin/adverse effects , Diabetes Mellitus, Type 2/drug therapy , Glycated Hemoglobin/analysis , Glycated Hemoglobin/therapeutic use , Prediabetic State/chemically induced , Prediabetic State/drug therapy , Hypoglycemic Agents/adverse effects , Glycemic Control , Blood Glucose/analysis , Patient Compliance , Probiotics/adverse effects , Drug Therapy, Combination , Double-Blind MethodABSTRACT
ABSTRACT Objectives: Diabetic nephropathy is a microvascular complication of diabetes and the most common cause of end-stage renal failure throughout the world. Videocapillaroscopy is a simple and noninvasive method that can display capillaries in the nail bed at the micron level. A few studies have been conducted on detecting retinopathy, another important diabetic microvascular complication, with videocapillaroscopy; however, no comprehensive study has been performed on diabetic nephropathy. We aimed to determine the relationship between nephropathy and capillaroscopic changes. Subjects and methods: Capillaroscopic findings of 144 patients with type 2 diabetes and 88 healthy controls were assessed prospectively by nailfold videocapillaroscopy. Twelve capillaroscopic findings were evaluated in all subjects. Results: Patients with albuminuria had more capillary aneurysms (15.5%), more microhemorrhages (15.5%), greater tortuosity (76.3%), more neoformations (29.9%), more bizarre capillaries (49.5%) and more bushy capillaries (20.6%) than the control group. In logistic regression analysis, tortuosity was significantly correlated with albuminuria (OR: 2.451, p = 0.048). Conclusions: Our findings show that the application of nailfold videocapillaroscopy can detect microvascular abnormalities in the nail bed that occur in diabetes mellitus patients compared to healthy people. Although there was no difference in the microvascular changes among the stages of diabetic nephropathy, a relationship between tortuosity and albuminuria was identified by logistic regression analysis. Nailfold videocapillaroscopy may be a new application that can be used to screen the microvascular changes that occur in diabetes mellitus.
ABSTRACT
Objective: Diabetic nephropathy is a microvascular complication of diabetes and the most common cause of end-stage renal failure throughout the world. Videocapillaroscopy is a simple and noninvasive method that can display capillaries in the nail bed at the micron level. A few studies have been conducted on detecting retinopathy, another important diabetic microvascular complication, with videocapillaroscopy; however, no comprehensive study has been performed on diabetic nephropathy. We aimed to determine the relationship between nephropathy and capillaroscopic changes. Methods: Capillaroscopic findings of 144 patients with type 2 diabetes and 88 healthy controls were assessed prospectively by nailfold videocapillaroscopy. Twelve capillaroscopic findings were evaluated in all subjects. Results: Patients with albuminuria had more capillary aneurysms (15.5%), more microhemorrhages (15.5%), greater tortuosity (76.3%), more neoformations (29.9%), more bizarre capillaries (49.5%) and more bushy capillaries (20.6%) than the control group. In logistic regression analysis, tortuosity was significantly correlated with albuminuria (OR: 2.451, p = 0.048). Conclusion: Our findings show that the application of nailfold videocapillaroscopy can detect microvascular abnormalities in the nail bed that occur in diabetes mellitus patients compared to healthy people. Although there was no difference in the microvascular changes among the stages of diabetic nephropathy, a relationship between tortuosity and albuminuria was identified by logistic regression analysis. Nailfold videocapillaroscopy may be a new application that can be used to screen the microvascular changes that occur in diabetes mellitus.
ABSTRACT
BACKGROUND: Metformin is widely used for the treatment of type-2 diabetes (T2D) but was shown to cause vitamin-B12 deficiency. H pylori infection was also suggested to cause vitamin-B12 deficiency. This study aimed to elucidate the relationships in this triad by investigating vitamin-B12 deficiency and H pylori infection in T2D patients using metformin. MATERIALS AND METHODS: This descriptive cross-sectional study recruited T2D patients using metformin from a primary care center and examined their socioeconomic status, accompanying complaints, medication use, and hemogram parameters such as serum vitamin B12 , calcium, and hemoglobin. The presence of H pylori infection was determined through stool antigen test. RESULTS: Study included 421 T2D patients on metformin regimen: 213 (50.6%) males and 208 (49.4%) females. The mean duration of diabetes was 9.88 ± 7.32 years, and the total metformin dose was 1925.5 ± 236.7 mg/d. Almost half of the participants (n = 199, 47.3%) had H pylori infection, and more than half (n = 222, 52.7%) had vitamin-B12 deficiency. The rate of vitamin-B12 deficiency was significantly higher among those with H pylori infection. No significant relationship was found between the daily metformin dose and vitamin-B12 deficiency. CONCLUSIONS: This study supported the role of H pylori infection in vitamin-B12 deficiency. However, the effects of increased metformin dose and H pylori infection on vitamin-B12 levels were not additive. It is recommended that vitamin-B12 levels in T2D patients are monitored and those with vitamin-B12 deficiency, regardless of metformin dose, are screened for H pylori and, if necessary, treated.
Subject(s)
Diabetes Mellitus, Type 2 , Helicobacter Infections , Metformin/administration & dosage , Vitamin B 12 Deficiency/etiology , Vitamin B 12/blood , Aged , Cross-Sectional Studies , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Female , Helicobacter Infections/complications , Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Humans , Male , Middle AgedABSTRACT
BACKGROUND/AIMS: Several studies have shown that a change in microbiota plays an important role in the pathogenesis of inflammatory bowel disease (IBD). Furthermore, with the emergence in recent studies of differences according to the subtype of IBD and whether the disease is active or in remission, there has started to be research into the relationship between IBD and several microorganisms. Blastocystis hominis is primary among these organisms. The aim of the present study was to determine the role of B. hominis in the acute flare-up of ulcerative colitis (UC). MATERIALS AND METHODS: A total of 114 patients with UC were included in the study, with 52 in the active phase. The Mayo scoring system was used for the activity index. Patients determined with a flare-up agent other than B. hominis were excluded from the study. Fecal samples of the patients were examined by the polymerase chain reaction method for the presence of B. hominis. RESULTS: B. hominis positivity was determined in 37 (34%) patients with UC. Of the patients, 17 (32.6%) were in the acute flare-up phase, and 20 (32.2%) were in remission (p=0.961). In 11 (64.7%) of the B. hominis positive patients, the disease severity was determined as mild-moderate (p<0.001). CONCLUSION: The results of the present study showed that while there was no difference between the active and remission phases in respect of B. hominis presence, there was milder involvement in those determined with B. hominis.
Subject(s)
Blastocystis Infections/complications , Blastocystis hominis , Colitis, Ulcerative/parasitology , Symptom Flare Up , Adult , Feces/parasitology , Female , Humans , Male , Middle Aged , Remission InductionABSTRACT
BACKGROUND: Malnutrition results in functional changes in the liver and pancreas that negatively affect carbohydrate metabolism. The aim of this study was to evaluate whether insulin hormone and glycated hemoglobin A1c (HbA1c) could serve as predictors of hunger-related malnutrition/undernutrition without disease in adults. METHODS: The Malnutrition Universal Screening Tool (MUST) was used to assess malnutrition in this single-center, cross-sectional study. The malnourished group (n = 67) comprised patients with a MUST score of ≥ 2, and the control group (n = 31) included subjects with a MUST score of 0 - 1. Serum albumin, prealbumin, C-reactive protein (CRP), fasting glucose, fasting insulin, hemoglobin and HbA1c levels, body mass index (BMI), and homoeostatic model for insulin resistance (HOMA-IR) scores were compared between the two groups. RESULTS: No significant difference was determined between the control and malnourished groups in respect of age or gender. HbA1c [5.5% (5 - 6.2) vs. 5.2% (3.9 - 6.7), p = 0.001], insulin levels [7.37 (2.36 - 52.16) vs. 3.91(1.17 - 30.08) µIU/mL, p < 0.001], and BMI [21.7 (14.1 - 34.0) vs. 17.8 (12.0 - 26.6) kg/m2, p < 0.001] were significantly lower in the malnourished group. Logistic regression analysis revealed that BMI was the only significant parameter (odds ratio [95% confidence interval] 0.680 [0.543 - 0.852]). CONCLUSIONS: Plasma insulin and HbA1c levels were significantly decreased in young adult malnourished patients without disease who had normal fasting glucose levels. These two parameters are known to be unaffected by inflammatory states, and therefore warrant further research on larger and different age sub-populations to assess if they might be early predictors of hunger-related malnutrition without disease.
Subject(s)
Glycated Hemoglobin/analysis , Hunger , Insulin/blood , Malnutrition/blood , Adolescent , Adult , Aged , Blood Glucose/analysis , C-Reactive Protein/analysis , Cross-Sectional Studies , Fasting/blood , Female , Humans , Male , Malnutrition/diagnosis , Middle Aged , Serum Albumin/analysis , Young AdultABSTRACT
BACKGROUND: Proton pump inhibitor (PPI) induced hypomagnesemia is a completely unexplained issue and cases are still being reported. Long-term use is the main factor, but there are a few articles stating that it may also emerge with short-term use. We aimed to evaluate the changes of serum and urine magnesium levels during shortterm high dose pantoprazol treatment. METHODS: The serum and 24-hour urine magnesium levels of 58 patients were evaluated during the course of 2 days. Of 58 patients, 25 were allowed oral intake on the 3rd day of hospitalization and thus, 24-hour urine for 3 days was collected from 33 patients. RESULTS: There were no significant differences in the mean levels of serum magnesium and the median levels of urine magnesium. When the magnesium levels were evaluated by age over and under 60 years, the baseline serum magnesium level was significantly higher than the 1st level in patients aged ≥ 60 years (p = 0.029). The 3rd day serum magnesium level was significantly higher than the baseline and 1st day levels in those aged < 60 years (p = 0.049). CONCLUSIONS: We showed that plasma levels and urinary excretion of magnesium did not change significantly during high-dose pantoprazol treatment. It can be hypothesized that magnesium levels are not affected by PPIs in short-term usage. Age and other contributing factors may have more impact on PPI induced hypomagnesemia. Patients aged over 60 years might be handled carefully under proton pump inhibitors treatment.
Subject(s)
Hospitalization/statistics & numerical data , Magnesium/blood , Magnesium/urine , Pantoprazole/therapeutic use , Dose-Response Relationship, Drug , Female , Gastrointestinal Hemorrhage/blood , Gastrointestinal Hemorrhage/drug therapy , Gastrointestinal Hemorrhage/urine , Humans , Hypercalciuria/blood , Hypercalciuria/diagnosis , Hypercalciuria/urine , Male , Middle Aged , Nephrocalcinosis/blood , Nephrocalcinosis/diagnosis , Nephrocalcinosis/urine , Pantoprazole/administration & dosage , Proton Pump Inhibitors/administration & dosage , Proton Pump Inhibitors/therapeutic use , Renal Tubular Transport, Inborn Errors/blood , Renal Tubular Transport, Inborn Errors/diagnosis , Renal Tubular Transport, Inborn Errors/urine , Time FactorsABSTRACT
BACKGROUND: Patients with systemic lupus erythematosus (SLE) have an increased risk of thrombotic events. Platelets become more active and they enlarge to release proteins from alpha granules for aggregation during the plaque formation period. Beta-thromboglobulin is one of the proteins released from alpha-granules when platelets are activated and used as a marker of platelet activation in vivo. OBJECTIVES: The aim of this study was to evaluate the plasma levels of beta-thromoglobulin and mean platelet volume as markers of the presence of platelet activation in systemic lupus erythematosus patients compared with healthy controls. MATERIAL AND METHODS: Thirty-seven SLE patients with a mean disease duration of 4.96 years and without any organ involvement as well as 30 healthy volunteers were included in the study. All patients were in remission of SLE. RESULTS: The mean beta-thromboglobulin level was 97.36 ±55.8 ng/mL in the SLE group and 72.67 ±33.5 ng/mL in the control group (p = 0.029). The mean platelet volume level was 8.27 ±1.68 fL in the SLE group and 9.16 ±1.52 fL (p = 0.031) in the controls. CONCLUSIONS: Elevated beta-thromboglobulin levels in systemic lupus erythematosus patients may be associated with platelet activation in the early stages of disease, whereas lower mean platelet volume levels in the same population may be due to the effects of hydroxychloroquine and the inactivity of SLE.
Subject(s)
Lupus Erythematosus, Systemic/blood , Mean Platelet Volume , Platelet Activation , beta-Thromboglobulin/metabolism , Blood Platelets , Case-Control Studies , HumansABSTRACT
AIM: The aim of this study was to compare thyroid function and complete blood count parameters in pregnant women with versus without gestational diabetes mellitus (GDM). METHODS: A total of 269 pregnant women patients with (n = 110, GDM group) or without (n = 159, non-GDM group) GDM were included in this study. Data on age, rate of cesarean section, birthweight of neonate, hemogram, and thyroid function tests were collected. Multivariate analysis was performed to determine factors predicting increased risk of GDM. RESULTS: Rate of cesarean section (70.9 vs 57.2%, P = 0.022), median (max-min) age (33.0 [26.0] vs 26.0 [20.0] years, P < 0.001), platelet count (246.7 ± 68.3 vs 227.8 ± 64.2 ×103 /µL, P = 0.021) and thyroid-stimulating hormone (1.3 [97.6] vs 1.0 [4.1] µIU/mL, P = 0.028) were significantly higher in the GDM than in the non-GDM group; whereas mean platelet volume (10.4 [5.3] vs 10.6 [5.6] fL, P = 0.031) and free triiodothyronine (FT3) (2.9 [3.6] vs 3.1 [3.0] pg/mL, P < 0.001) levels were significantly lower in the GDM than in the non-GDM group. Older age (odds ratio, 1.281; 95% confidence interval, 1.182-1.389, P < 0.001) and lower FT3 levels (odds ratio, 0.295; 95% confidence interval, 0.149-0.586, P < 0.001) were independently associated with increased risk of GDM. CONCLUSION: Our findings revealed that lower FT3 levels and older age predict the likelihood of developing GDM in euthyroid pregnant women, with no influence of other thyroid hormones or blood counts on the risk of GDM.
Subject(s)
Diabetes, Gestational/blood , Mean Platelet Volume/statistics & numerical data , Thyrotropin/blood , Triiodothyronine/blood , Adult , Age Factors , Blood Cell Count , Diabetes, Gestational/epidemiology , Female , Humans , Pregnancy , Thyroid Function Tests , Young AdultABSTRACT
BACKGROUND/AIMS: To evaluate the effect of probiotics administered as an adjuvant to sequential Helicobacter pylori (H. pylori) eradication therapy on treatment outcome and patient compliance. MATERIALS AND METHODS: In total, 159 patients with H. pylori infection receiving sequential H. pylori eradication therapy were included in this randomized placebo-controlled study. Starting from day 0 of sequential eradication therapy (ERA), patients in the ERA+probiotic group [n=53, mean (SD) age: 47.7 (14.0) years, 54.7% were females] also received a probiotic supplement with Bifidobacterium animalis subsp. lactis B94 (1 capsule/day), patients in the ERA+placebo group [n=52, mean (SD) age: 46.4 (13.4) years, 51.9% were males] received placebo treatment (1 capsule/day), and patients in the ERA-only group [n=54, mean (SD) age: 46.3 (11.9) years, 55.6% were females] received no additional treatments. Eradication rates, patient compliance, and side effects of eradication therapy were recorded in each treatment group. RESULTS: Significantly higher eradication rates were noted in the ERA+probiotic group (86.8% vs. 70.8%, p=0.025) than in the combined ERA (ERA-only and ERA-placebo) group. Non-compliance with anti-H. pylori treatment was noted in 24 (15.1%) of 159 patients. Lower rates of first week treatment non-compliance due to diarrhea (1.88% vs. 12.26%, p=0.036) were noted in the ERA+probiotic group than in the combined ERA (ERA-only and ERA-placebo) group. Treatment resistance (p: 0.389) was similar between the groups, indicating pure antibiotic resistance without any compliance problems. The number needed to treat for an additional beneficial outcome (NNTB) was 6.2 (CI 95%, 3.5 to 28.9) for probiotic use. CONCLUSION: In conclusion, adjuvant administration of probiotic (B. animalis subsp. lactis) in 2-week sequential H. pylori eradication therapy is associated with a higher H. pylori eradication rate, lower first week diarrhea-related treatment discontinuation rates, less common self-reported side effects, and higher treatment compliance.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Helicobacter Infections/drug therapy , Helicobacter pylori , Probiotics/therapeutic use , 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use , Abdominal Pain/etiology , Adult , Amoxicillin/therapeutic use , Anorexia/chemically induced , Anti-Bacterial Agents/adverse effects , Bifidobacterium animalis , Clarithromycin/therapeutic use , Diarrhea/chemically induced , Dizziness/chemically induced , Drug Eruptions/etiology , Drug Resistance/drug effects , Drug Therapy, Combination , Female , Headache/chemically induced , Humans , Male , Medication Adherence , Metronidazole/therapeutic use , Middle Aged , Nausea/chemically induced , Numbers Needed To Treat , Pantoprazole , Probiotics/adverse effects , Proton Pump Inhibitors/therapeutic use , Symptom Assessment , Treatment OutcomeABSTRACT
OBJECTIVES: To describe brucellosis and its possible complications according to clinical, laboratory and radiological findings. METHODS: We describe a case of Brucella pericarditis visualized at transthoracic echocardiography with clinical manifestations. RESULTS: Clinical manifestations, imaging and laboratory findings provided the correct diagnosis of Brucella pericarditis. The patient recovered fully following doxycycline and rifampin therapy. CONCLUSION: Brucellosis should be considered in the differential diagnosis of disorders that affect the pericardium in endemic areas. LEARNING POINTS: Brucella pericarditis should be considered in case of disorders that affect the pericardium in endemic areas such as the Mediterranean region.When a patient has been diagnosed with brucellosis, oral doxycycline 100 mg twice daily plus oral rifampin 600 mg once daily must be given immediately.
ABSTRACT
CONTEXT: Impact of gestational diabetes mellitus (GDM) on the coagulation system, dynamics involved at a pathophysiological level and the exact mechanism remain unclear. AIMS: To evaluate the association between diabetes-related parameters and hemostatic factors to search for a tendency of thrombosis in GDM. SETTINGS AND DESIGN: Nineteen pregnant women who had GDM, 16 healthy pregnant and 13 healthy nonpregnant controls admitted to the Endocrinology outpatient clinics were enrolled in the study. SUBJECTS AND METHODS: Fasting and postprandial glucose, hemoglobin A1c and insulin levels, and insulin resistance; fructosamine, thrombin activatable fibrinolysis inhibitor (TAFI), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor Type-1 (PAI-1), tissue-type plasminogen activator (t-PA), fibrinogen, plasminogen and hemoglobin levels, platelet counts, prothrombin time (PT), and activated partial thromboplastin time (aPTT) were studied. STATISTICAL ANALYSIS USED: One-way analysis of variance, Kruskal-Wallis, and post hoc Tukey honestly significant difference or Conover's nonparametric multiple comparison tests for comparison of the study groups. RESULTS: PT and aPTT were significantly lower in GDM patients compared to controls (P < 0.05), whereas fibrinogen and plasminogen levels were significantly higher in this group compared to both nonpregnant and healthy pregnant controls (P < 0.05 for each). TAFI, TFPI, PAI-1, and tissue t-PA levels were not significantly different among groups. CONCLUSIONS: Our findings indicate tendency to develop thrombosis in GDM similar to diabetes mellitus; but more comprehensive studies with larger sample size are needed to determine the relationship between GDM and hemostasis.
ABSTRACT
Background and Objectives. Nailfold capillaroscopy is an easy and noninvasive technique used to investigate dermal microvasculature. Traditional investigations of vascularity do not detect changes until they are well-established in type 2 diabetics. The objective of the current study was to evaluate nailfold capillaries in type 2 diabetes mellitus patients and to determine the association of retinopathy with changes in the nailfold capillaries. Materials and Methods. Capillaroscopic findings by nailfold capillaroscopy and fundoscopic examinations were assessed in 216 patients with type 2 diabetes mellitus and 101 healthy controls included in this prospective study. Results. Retinopathy was detected in 43.05% of diabetic patients (n = 93). Capillaroscopic findings including tortuosity (p < 0.001), bushy capillary (p < 0.001), neoformation (p < 0.001), bizarre capillary (p < 0.001), microhemorrhage (p = 0.001), capillary ectasia (p = 0.002), and aneurysm (p = 0.004) were significantly higher in diabetic group than control group. In logistic regression analysis, only tortuosity was shown significant (OR, 2.16; p = 0.036). There was also a significant relation between diabetes duration and most of the capillaroscopic findings. Conclusion. Capillaroscopic changes were found to be correlated with diabetic retinopathy, in particular with longer disease duration in our study. Capillaroscopic imaging could be a useful new technique for assessment of diabetic microvascular changes.
Subject(s)
Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/physiopathology , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/physiopathology , Nails/blood supply , Aged , Capillaries/physiopathology , Case-Control Studies , Female , Fundus Oculi , Humans , Male , Microcirculation , Middle Aged , Multivariate Analysis , Nails/diagnostic imaging , Prospective Studies , ROC CurveABSTRACT
BACKGROUND/AIMS: To determine the role of serum procalcitonin levels and ascites/subcutaneous echogenicity ratio (ASER) in predicting ascites infection in hospitalized cirrhotic patients. MATERIALS AND METHODS: A total of 50 patients hospitalized because of cirrhosis-related ascites were included in this study. In these patients, 44% of ascites were infected (peritonitis), whereas 56% of ascites were sterile. These two groups were compared in terms of procalcitonin levels and ASER for predicting ascites infection. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of ASER, and the predicting outcome of ASER was compared with procalcitonin levels. RESULTS: The ASER values of the patients with the diagnosis of infected ascites were significantly higher than in those with the diagnosis of sterile ascites (p<0.001). ROC analysis was performed to determine the diagnostic ASER value for infected ascites. An ASER greater than 0.0019 determined peritonitis with 95.5% sensitivity and 100% specificity. A procalcitonin level greater than 0.05 determined peritonitis with 86.4% sensitivity and 75% specificity. Using ROC analysis, an ASER greater than 0.0019 [area under curve (AUC): 0.974, 95% confidence interval (CI) (0.884-0.999, p<0.001)] was a significantly better diagnostic marker than a procalcitonin level >0.5 mg/dL [AUC: 0.860, 95% CI (0.884-0.999, p<0.001) (p<0.045)]. CONCLUSION: According to our findings, the determination of ASER and serum procalcitonin levels seems to provide satisfactory diagnostic accuracy in differentiating ascites infections in hospitalized cirrhotic patients. ASER values significantly differentiate ascites infections better than procalcitonin levels.
Subject(s)
Ascites/blood , Calcitonin/blood , Liver Cirrhosis/blood , Peritonitis/diagnostic imaging , Protein Precursors/blood , Subcutaneous Tissue/diagnostic imaging , Aged , Area Under Curve , Ascites/diagnostic imaging , Ascites/microbiology , Calcitonin Gene-Related Peptide , Female , Hospitalization , Humans , Liver Cirrhosis/diagnostic imaging , Liver Cirrhosis/microbiology , Male , Middle Aged , Peritonitis/blood , Peritonitis/microbiology , Predictive Value of Tests , Prognosis , ROC Curve , Reproducibility of Results , Ultrasonography/methodsABSTRACT
The activation of the platelets plays a key role in the formation of thrombosis. The variables such as mean platelet volume, platelet factor 4 and ß-thromboglobulin have been used in the demonstration of the platelet activation. However, when the literature was reviewed, there was not found any study investigating the level of ß-thromboglobulin in patients with rheumatoid arthritis. Our goal is to evaluate the ß-thromboglobulin levels together with mean platelet volume in patients with arthritis. This study is a clinical study which has a control group that has been designed prospectively, and in this study, Rheumatology Outpatient Clinic follow-up patients with rheumatoid arthritis and healthy control group were studied. All patients and healthy volunteers were examined ß-thromboglobulin and mean platelet volume. Twenty-two patients with rheumatoid arthritis and 21 healthy volunteers participated in the study. ß-Thromboglobulin mean was found as 98.00 ± 60.49 ng/mL in rheumatoid arthritis group and it was 62.38 ± 30.41 ng/mL in healthy control group. The differences between these groups were significant in terms of the levels of ß-thromboglobulin (p = 0.02). We found significant differences between the groups in terms of mean platelet volume (p = 0.049). In this study, the level of ß-thromboglobulin was found significantly higher in patients with rheumatoid arthritis, which is a chronic inflammatory disease. This result could be an indicator, such as platelet activation in patients with rheumatoid arthritis, or it may be a helper marker in the follow-up and treatment of developing cardiovascular risk.
Subject(s)
Arthritis, Rheumatoid/blood , Platelet Activation , beta-Thromboglobulin/analysis , Adolescent , Adult , Biomarkers/blood , Case-Control Studies , Chi-Square Distribution , Female , Humans , Lipids/blood , Middle Aged , Platelet Count , Predictive Value of Tests , Prognosis , Prospective Studies , Up-Regulation , Young AdultABSTRACT
BACKGROUND: Many studies have shown that subclinical inflammation persisted during remission period of Familial Mediterranean Fever (FMF) patients but long term effects of subclinical inflammation in these patients aren't clearly known. Besides, a few of the recent studies revealed that risk of atherosclerosis had increased in FMF patients. ß-Thromboglobulin (ß-TG) is considered as a sensitive marker of platelet activation. In this study Mean Platelet Volume (MPV) and ß-TG levels were evaluated in FMF patients. METHODS: Following the Local Ethics Committee's consent, 25 FMF patients were included in the study. Twenty eight age and sex matched healthy volunteers were recruited as a control group. Lipid profile, inflammatory parameters, hemogram, ß-TG, MPV were assessed. Statistical analysis was performed with SPSS for Windows 16.00. RESULTS: Group I consisted of 25 FMF cases (16 females, 9 males; mean age: 35.72 ± 12.34 years), Group II consisted of 28 cases (22 females, 6 males; mean age 31.78 ± 10.31 years). There was no statistically significant difference between the groups in terms of age and gender distribution, smoking status, total cholesterol, triglyceride, LDL and MPV (p>0.05). HDL levels were found to be statistically lower in Group I (p:0.04). Median ß-TG levels was significantly higher in Group II than Group I (129.50 (range:372.00) ng/mL versus 104.00 (range:212.80) ng/mL respectively; p:0.03). CONCLUSION: In this study MPV and ß-TG were evaluated for FMF cases and healthy controls, ß-TG levels were found significantly lower among patients; we hypothesized that this difference may have resulted from the effect of colchicine use on platelet functions.