Assessment of the relationship between endocan and obstructive sleep apnea severity.

INTRODUCTION: Obstructive sleep apnea (OSA) and endothelial dysfunction are associated with cardiovascular risk factors and the development of atherosclerosis. Endocan is a marker of endothelial dysfunction, while obstructive sleep apnea is one of the causes of endothelial dysfunction. In this study, we investigated the relationship between endocan and obstructive sleep apnea severity. MATERIAL AND METHODS: A total of 179 patients with snoring complaints were included. All patients underwent polysomnography, and based on the results, the participations were allocated to the control group (n = 39) or to the obstructive sleep apnea group (n = 140). The OSA group was classified as having mild (apnea-hypopnea index (AHI) = 5-15; n = 43), moderate (AHI = 15-30; n = 42), or severe OSA (AHI > 30; n = 55). All participations had their endocan levels measured. RESULTS: Endocan levels in OSA patients were significantly higher than in the control group (11.8 (3.13-200) vs 3.13 (3.13-23) ng/ml, p < 0.001). Also, endocan levels were significantly higher in the severe OSA group than moderate and mild obstructive OSA (13.2 (3.13-200), 12.6 (3.13-200) and 8.44 (3.13-50.5) ng/ml, p = 0.015, respectively). Multiple logistic regression analysis showed that smoking, age and endocan levels were independent predictors of OSA severity (p = 0.024, p = 0.037, p = 0.004, respectively). CONCLUSIONS: Endocan seems to be a potential risk stratification marker in this patient population.

Galectin-3 is associated with coronary plaque burden and obstructive sleep apnoea syndrome severity.

BACKGROUND: Obstructive sleep apnoea syndrome (OSAS) is reported to be associated with hypertension, coronary artery disease, atrial fibrillation, and heart failure. Galectin-3 plays an important role in the regulation of inflammation, development of cardiac fibrosis, and remodelling. A significant relationship between galectin-3 and the total number of coronary plaques and the macrocalcified plaque structures of patients with type 2 diabetes mellitus has been reported. AIM: The aim of this study was to investigate the association between galectin-3 level and coronary plaque burden as well as OSAS severity in patients with OSAS. METHODS: A total of 87 consecutive patients with a diagnosis of OSAS and 21 age- and gender-matched control subjects were recruited for the present study. The patients with OSAS were also categorised according to their apnoea hypopnoea index (AHI) as follows: mild (AHI = 5-15), moderate (AHI = 15-30), and severe (AHI > 30). All study subjects underwent coronary computed tomography angiography to detect coronary atherosclerosis. Also, all participants of serum galectin-3 concentrations were measured. RESULTS: Mean galectin-3 level was significantly higher in patients with OSAS compared to control subjects (p < 0.001) and in the severe OSAS group, compared to the moderate and mild OSAS groups (p < 0.001). Correlation analysis indicated significant positive relationships between galectin-3 concentrations and the total number of coronary plaques (p < 0.001), high-sensitivity C-reactive protein (p = 0.001), and severity of OSAS (p < 0.001). In multivariate analysis, galectin-3 (p = 0.01) and age (p = 0.025) were significant independent predictors of coronary atherosclerosis, after adjusting for other risk factors. Also, it has been found that galectin-3 concentration is a predictor of OSAS severity (p = 0.001). CONCLUSIONS: Galectin-3 is associated with coronary atherosclerosis and OSAS severity in OSAS patients.

Comparison of effects on the oxidant/antioxidant system of sevoflurane, desflurane and propofol infusion during general anesthesia / Comparação dos efeitos da perfusão de sevoflurano, desflurano e propofol sobre o sistema oxidante/antioxidante durante anestesia geral / Comparación de los efectos de la perfusión de sevoflurano, desflurano y del propofol sobre el sistema oxidante/antioxidante durante la anestesia general

BACKGROUND AND OBJECTIVES: Desflurane and sevoflurane are frequently used for maintenance of anesthesia and studies have shown that these anesthetics cause a variety of changes to the oxidative stress and antioxidative defense mechanisms. This study aims to compare the effects of sevoflurane, desflurane and propofol infusion anesthesia on the oxidant and antioxidant systems of patients undergoing laparoscopic cholecystectomy. METHODS: 45 patients between 18 and 50 years with planned laparoscopic cholecystectomy under general anesthetic were included in the study. Patients were divided into three groups on the way to surgery: propofol (group P n: 15), sevoflurane (group S n: 15) and desflurane (group D n: 15). All groups were given hypnotic 2 mg/kg propofol IV, 1 mcg/kg fentanyl IV and 0.1 mg/kg vecuronium IV for induction. For maintenance of anesthesia group S were ventilated with 2% sevoflurane, group D cases were given 6% desflurane and group P were given propofol infusions of 12 mg/kg/h for the first 10 min, 9 mg/kg/h for the second 10 min and 6 mg/kg/h after that. Before induction and after the operation venous blood samples were taken to evaluate the levels of glutation peroxidase, total oxidants and antioxidants. RESULTS AND CONCLUSIONS: The 45 patients included in the study were 22 male and 23 female patients. The demographic characteristics of the groups were similar. In the postoperative period we observed that while sevoflurane and propofol increased antioxidants by a statistically significant level, desflurane increased the total oxidants level by a significant amount compared to levels before the operation. .

JUSTIFICATIVA E OBJETIVOS: Desflurano e sevoflurano são usados com frequência para a manutenção da anestesia e estudos mostraram que esses anestésicos causam alterações variadas nos mecanismos de defesa antioxidante contra o estresse oxidativo. Este estudo teve como objetivo comparar os efeitos de anestesias com perfusão de sevoflurano, desflurano e propofol sobre os sistemas oxidante/antioxidante de pacientes submetidos à colecistectomia laparoscópica. MÉTODOS: Foram incluídos no estudo 45 pacientes entre 18 e 50 anos, agendados para colecistectomia laparoscópica sob anestesia geral. Os pacientes foram divididos em três grupos para receberem propofol (Grupo P, n = 15), sevoflurano (Grupo S, n = 15) e desflurano (Grupo D, n = 15). Todos os grupos receberam 2 mg/kg de propofol IV, 1 mcg/kg de fentanil IV e 0,1 mg/kg de vecurônio IV para indução. Para manutenção da anestesia, o Grupo S recebeu ventilação com sevoflurano a 2%, o Grupo D recebeu desflurano a 6% e o Grupo P recebeu propofol em perfusões de 12 mg/kg/h nos primeiros 10 minutos, 9 mg/kg/h nos 10 minutos seguintes e 6 mg/kg/h subsequentemente. Antes da indução e depois da cirurgia, amostras de sangue venoso foram colhidas para avaliar os níveis de glutationa peroxidase e o total de oxidantes e antioxidantes. RESULTADOS E CONCLUSÕES: Dos 45 pacientes incluídos no estudo, 22 eram do sexo masculino e 23 do feminino. As características demográficas dos grupos eram semelhantes. No período pós-operatório, observamos que enquanto sevoflurano e propofol aumentaram os antioxidantes a um nível de significância estatística, desflurano aumentou o nível total de oxidantes em quantidade significativa, em comparação com os níveis pré-operação. .

JUSTIFICACIÓN Y OBJETIVOS: El desflurano y el sevoflurano son usados a menudo para el mantenimiento de la anestesia, y hay estudios que mostraron que esos anestésicos causan diversas alteraciones en los mecanismos de defesa antioxidante contra el estrés oxidativo. El objetivo de este estudio es comparar los efectos de las anestesias con perfusión de sevoflurano, desflurano y propofol sobre los sistemas oxidante/antioxidante de pacientes sometidos a colecistectomía laparoscópica. MÉTODOS: Fueron incluidos en el estudio 45 pacientes entre 18 y 50 años programados para colecistectomía laparoscópica bajo anestesia general. Los pacientes fueron divididos en 3 grupos para recibir propofol (grupo P, n = 15), sevoflurano (grupo S, n = 15) y desflurano (grupo D, n = 15). Todos los grupos recibieron 2 mg/kg de propofol IV, 1 µg/kg de fentanilo IV y 0,1 mg/kg de vecuronio IV para inducción. Para el mantenimiento de la anestesia, el grupo S recibió ventilación con sevoflurano al 2%, al grupo D se le administró desflurano al 6% y el grupo P recibió propofol en perfusiones de 12 mg/kg/h en los primeros 10 min, 9 mg/kg/h en los 10 min siguientes y 6 mg/kg/h subsecuentemente. Antes de la inducción y después de la cirugía, fueron extraídas muestras de sangre venosa para evaluar los niveles de glutatión peroxidasa y el total de oxidantes y antioxidantes. RESULTADOS Y CONCLUSIONES: De los 45 pacientes incluidos en el estudio, 22 eran del sexo masculino y 23 del femenino. Las características demográficas de los grupos eran similares. En el período postoperatorio observamos que mientras el sevoflurano y el propofol aumentaron los antioxidantes a un nivel de significación estadística, el desflurano aumentó el nivel total de oxidantes en una cantidad significativa, en comparación con los niveles preoperatorios. .

[Comparison of effects on the oxidant/antioxidant system of sevoflurane, desflurane and propofol infusion during general anesthesia]. / Comparação dos efeitos da perfusão de sevoflurano, desflurano e propofol sobre o sistema oxidante/antioxidante durante anestesia geral.

BACKGROUND AND OBJECTIVES: Desflurane and sevoflurane are frequently used for maintenance of anesthesia and studies have shown that these anesthetics cause a variety of changes to the oxidative stress and antioxidative defense mechanisms. This study aims to compare the effects of sevoflurane, desflurane and propofol infusion anesthesia on the oxidant and antioxidant systems of patients undergoing laparoscopic cholecystectomy. METHODS: 45 patients between 18 and 50 years with planned laparoscopic cholecystectomy under general anesthetic were included in the study. Patients were divided into three groups on the way to surgery: propofol (group P, n=15), sevoflurane (group S, n=15) and desflurane (group D, n=15). All groups were given hypnotic 2mg/kg propofol IV, 1mcg/kg fentanyl IV and 0.1mg/kg vecuronium IV for induction. For maintenance of anesthesia group S were ventilated with 2% sevoflurane, group D cases were given 6% desflurane and group P were given propofol infusions of 12mg/kg/h for the first 10minutes, 9mg/kg/h for the second 10minutes and 6mg/kg/h after that. Before induction and after the operation venous blood samples were taken to evaluate the levels of glutation peroxidase, total oxidants and antioxidants. RESULTS AND CONCLUSIONS: The 45 patients included in the study were 22 male and 23 female patients. The demographic characteristics of the groups were similar. In the postoperative period we observed that while sevoflurane and propofol increased antioxidants by a statistically significant level, desflurane increased the total oxidants level by a significant amount compared to levels before the operation.

Simvastatin reduces VEGF and NO levels in acute stages of experimental traumatic brain injury.

This study was undertaken to evaluate the effect of simvastatin, a cholesterol-lowering agent, on vascular endothelial growth factors (VEGFs), nitric oxide (NO) levels and neuroprotection, in rats with experimentally induced traumatic brain injury (TBI). Forty Wistar albino rats were categorized into four groups: sham operated (S), trauma (T), trauma + vehicle (T + V) and trauma + simvastatin (T + S). The T, T + V and T + S groups were subjected to TBI. The T + V group was administered vehicle [ethanol:saline (1/2)] and the T + S group was administered 1 mg/kg of simvastatin 3 h after the injury insult. Blood and brain tissue specimens were obtained 24 h after the trauma to measure VEGFs and NO levels and perform histopathological examinations. The histopathological injury scores of brain tissues were significantly higher in the T group, and simvastatin significantly prevented brain injury in the T + S group. In the T group, significant increases of VEGF levels in serum and brain tissues were noted, which were prevented with simvastatin treatment in the T + S group. The markedly high levels of NO in brain tissues of the T group were decreased by simvastatin treatment in the T + S group. It can be concluded that, as evidenced by histopathological findings, simvastatin treatment improves neuropathology in acute stages of TBI.

Pyrrolidine dithiocarbamate attenuates the development of monocrotaline-induced pulmonary arterial hypertension.

We aimed to demonstrate the potential protective effects of pyrrolidine dithiocarbamate (PDTC) on monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). Adult male rats were randomly assigned to 4 groups: control group, MCT-treated rats only, MCT-injected rats treated with PDTC, and PDTC-treated rats only. Blood and tissue samples were collected after the sacrifice. Levels of malondialdehyde (MDA) were measured by using the thiobarbituric acid method. Total antioxidant status (TAS) was determined using a commercially available ImAnOx kit. A histopathological evaluation was accomplished by scoring the degree of severity. Endothelial damage of the main pulmonary artery was evaluated by immunohistochemical labeling of endothelial cells using anti-rat endothelial cell antigen 1 (RECA-1) antibody. MCT-induced right ventricular hypertrophy (RVH) was reduced significantly in the MCT+PDTC-treated group. MDA levels were significantly lowered in the MCT+PDTC-treated group. TAS was significantly higher in the MCT+PDTC-treated group when compared with the rats with PAH. Histopathological examination demonstrated that PDTC treatment reduced the development of inflammation, hemorrhage and congestion, and collagen deposition. In conclusion, PDTC attenuated PAH and protected pulmonary endothelium in rats administered MCT. These findings suggest that PDTC treatment may provide a new effective therapeutic approach in the treatment of PAH.

Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study.

AIM: Mean platelet volume (MPV) in the healthy population has not been studied before. Therefore, the aim of the study was to measure MPV in normal subjects in a large cohort of Turkish adults. METHODS: A total of 2298 subjects with a mean age of 50 (age range 18 to 92) were interviewed. Subjects who had smoking habit, diabetes, hypertension, coronary artery disease, dyslipidemia, chronic obstructive pulmonary disease, cancer, chronic use of any drugs including antiplatelets, heavy drinkers, metabolic syndrome, ejection fraction <55%, creatinine >1.4 in men and >1.1 in women, abnormal liver function tests and an abnormal TSH were excluded in a in a stepwise manner. Complete blood counts were done on the same day within 6 hours by a CELL-DYN 3700 SL analyzer (Abbott Diagnostics). RESULTS: Three hundred twenty-six participants (204 females (63%) and 122 males (37%) with a mean age of 41 ± 16) constituted the final healthy cohort. Mean MPV of the cohort was 8.9 ± 1.4 fL. There was no significant difference among age groups regarding MPV. CONCLUSION: Ninety-five percent of the individuals had a MPV between 7.2 and 11.7 fL. A patient having a MPV beyond this range should be evaluated carefully especially for occlusive arterial diseases.