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OBJECTIVE: A limited number of studies have investigated QT wave dispersion (QTd) in depressive disorder. The objective of this study was to investigate whether QTd differed in patients diagnosed with depression compared to a control group and whether the difference correlated with the depression and anxiety scores. METHODS: Forty patients diagnosed with major depressive disorder (DSM-5 criteria) who did not receive their first treatment after the first episode were included in the study. Forty healthy individuals with similar sociodemographic characteristics were included in the control group. A sociodemographic and clinical data form, the Beck Depression Inventory, and the Beck Anxiety Inventory were given to all patients. Electrocardiograms were evaluated in a single-blind setting by the same cardiologist. The longest QT interval (QTmax) and the shortest QT interval (QTmin) were calculated. Heart rate-corrected QTmax (QTcmax) and QTmin (QTcmin) were calculated using the Bazett formula (QT[ms]/âR-R). The difference between QTcmax and QTcmin was accepted as the corrected QT dispersion (QTcd). The study was conducted from December 2018-March 2019. RESULTS: No statistically significant difference was found between patient and control groups on the basis of age, sex, body mass index, or smoking. Beck Anxiety Inventory and Beck Depression Inventory scores of the patient group (28.48 ± 12.39 and 32.2 ± 11.58, respectively) were significantly higher compared to the control group (2.7 ± 3.41 and 2.75 ± 3.2, respectively). The patient group QTcmax (419.8 ± 24.46) and QTcd (42.55 ± 17.47) values were significantly higher compared to the QTcmax (405.2 ± 24.54) and QTcd (30.48 ± 9.25) values of the control group. There was a positive correlation between QTcd, QTcmax, and anxiety and depression scores. CONCLUSIONS: QTcd values of depressed patients were higher than those of the healthy controls, and there was a positive correlation between QTcd and depression and anxiety scores.
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Arritmias Cardíacas/etiologia , Transtorno Depressivo Maior/fisiopatologia , Adulto , Ansiedade/complicações , Ansiedade/fisiopatologia , Estudos de Casos e Controles , Transtorno Depressivo Maior/complicações , Eletrocardiografia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Índice de Gravidade de DoençaRESUMO
Atherosclerosis plays an important role in the etiopathogenesis of coronary artery ectasia (CAE). The relationship between total bilirubin (TBil) and carotid intima media thickness (cIMT) in patients with CAE has not been fully investigated. Hence, we evaluated the relationship between TBil levels and cIMT in 142 consecutive eligible patients with CAE, newly diagnosed coronary artery disease (CAD), and normal coronary arteries. There were no significant differences in TBil (P = .772) and cIMT (P = .791) between the CAE and CAD groups. Bilirubin levels were significantly lower in both CAE and CAD groups compared to the controls (P < .01). The cIMT was significantly higher in both CAE and CAD groups compared to control participants (P < .01). A negative correlation between cIMT and TBil was found in all the groups (P < .01, r = .354). We show for the first time that patients with CAE and CAD have lower TBil and greater cIMT compared to controls with normal coronary angiograms.
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Bilirrubina/sangue , Espessura Intima-Media Carotídea , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/patologia , Adulto , Dilatação Patológica/sangue , Dilatação Patológica/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Heart failure is a chronic disease that impairs the quality of life and leads to several psychiatric disorders, especially depression and anxiety. The present study intended to investigate suicide risk and its association with depression, hopelessness and self-esteem in patients with chronic heart failure. 32 patients with chronic heart failure and 32 healthy control subjects with similar sociodemographic attributes were included in the present case control study. Sociodemographic data form, Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSE) and Suicide Probability Scale (SPS) were applied to all subjects. It was determined that the BHS (11.4⯱â¯3.74 vs. 4.8⯱â¯4.02, pâ¯<â¯0.001), BDI (22.2⯱â¯11.9 vs 9.2⯱â¯7.6, pâ¯<â¯0.001) and SPS (67.6⯱â¯15.9 vs 59.2⯱â¯10.9, pâ¯=â¯0.018) scores were statistically higher in the patient group when compared to the control group. It was also established that the self-esteem of subjects in the patient group was lower when compared to the control (pâ¯<â¯0.001). A positive correlation was determined between the SPS and BHS, and BDI and RSE scores (pâ¯<â¯0.001). Suicide risk was higher among the patients with heart failure when compared to the control group. This increase in suicide risk significantly correlated with high levels of hopelessness, depression, and low self-esteem in the patient group. Heart failure is one of the chronic diseases that increases suicidal ideation. The identification of suicidal ideation in the present patient group facilitated both the prevention of suicidal behavior and positive contribution to treatment.
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Depressão/etiologia , Insuficiência Cardíaca/psicologia , Autoimagem , Ideação Suicida , Adulto , Estudos de Casos e Controles , Doença Crônica/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , SuicídioRESUMO
OBJECTIVE: Benign joint hypermobility syndrome refers to hypermobile individuals with musculoskeletal symptoms in the absence of any systemic rheumatic disease; its prevalence is approximately 0.5%. In animal studies, bilirubin has been shown to reduce fibrosis induced by bleomycin. It has been suggested that bilirubin leads to hypermobility that affects the structure or function of collagen. In addition, our observation is that hypermobility occurs more often in patients with indirect hyperbilirubinemia. In this study, we aimed to evaluate hypermobility in patients with indirect hyperbilirubinemia. MATERIAL AND METHODS: We recruited 120 consecutive patients with indirect hyperbilirubinemia from a tertiary gastroenterology outpatient clinic and examined them for hypermobility. Hypermobility was evaluated using the Beighton criteria, and other relevant clinical findings were recorded. In addition, a group of healthy individuals (n=107) without hyperbilirubinemia were included as controls. RESULTS: The mean ages of the patients and controls were 33.4±12.9 and 36.2±11.2 years, respectively (p=0.09). In total, 100 (83%) patients and 78 (73%) controls were male (p=0.075). The mean indirect bilirubin levels were 1.44±0.66 mg/dL in the patient group and 0.37±0.18 mg/dL in the control group. Based on the Beighton score, 23 patients (19.2%) in the patient group and 3 (2.8%) individuals in the control group had joint hypermobility. The difference between the groups was statistically significant (p<0.001). CONCLUSION: According to the results of our study, findings of joint hypermobility are more frequent in patients with indirect hyperbilirubinemia than in controls.
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OBJECTIVE: Because of the ongoing and recurring inflammatory state in familial Mediterranean fever (FMF), patients may experience a high risk of cardiovascular events. Our aim was to investigate the arterial stiffness and associated factors in patients with FMF. METHODS: Sixty-nine consecutive FMF patients (including 11 females) and 35 controls (including 5 females) were enrolled in the study. The demographical, clinical, and laboratory data and genetic mutations of the patients were recorded. In the study, FMF patients according to the Tel-Hashomer criteria were included, whereas patients with other known inflammatory rheumatologic disease, atherosclerotic cardiovascular disease, hypertension, diabetes, those under the age of 18 years, or those refusing to participate in the study were excluded. Arterial stiffness measurements were performed using the TensioMed device (TensoMed Ltd, Budapest, Hungary). RESULTS: The patient and control groups were similar in terms of the mean ages, BMIs, gender, systolic blood pressures, and smoking. FMF patients had a higher pulse wave velocity (PWV) (7.73±1.3 and 7.18±1.1 m/s; p=0.03) and lower brachial and aortic augmentation indexes (-64.6±14.6% and -54.6±25.9%, p=0.041 and 4.9±7.4% and 14.0±11.5%, p=0.025, respectively) compared with the controls. Thirty-one (45%) patients were in the "during-attack" state and had higher PWV (8.17±1.6 and 7.38±0.9 m/s; p=0.027) compared with the asymptomatic patients. PWV was correlated to serum CRP, WBC, ESR, fibrinogen, and neutrophil/lymphocyte ratios (r=0.666, 0.429, 0.441, 0.388, and 0.460, respectively). The genetic mutation and predominant attack type had no effect on arterial stiffness. CONCLUSION: FMF patients have increased arterial stiffness during attacks compared with asymptomatic patients and controls. The impaired arterial stiffness is correlated to the severity of the inflammatory state rather than to the attack type or genetic mutations.
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Aterosclerose/fisiopatologia , Artéria Braquial/fisiopatologia , Febre Familiar do Mediterrâneo/fisiopatologia , Adulto , Aterosclerose/sangue , Estudos de Casos e Controles , Estudos Transversais , Febre Familiar do Mediterrâneo/sangue , Feminino , Humanos , Masculino , Fluxo Pulsátil , Estudos Retrospectivos , Turquia , Rigidez Vascular , População BrancaAssuntos
Anticorpos Anticitoplasma de Neutrófilos/imunologia , Granulomatose com Poliangiite/tratamento farmacológico , Fatores Imunológicos/uso terapêutico , Mieloblastina/imunologia , Pancreatite/tratamento farmacológico , Rituximab/uso terapêutico , Anticorpos Anticitoplasma de Neutrófilos/sangue , Biomarcadores/sangue , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/diagnóstico , Granulomatose com Poliangiite/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/diagnóstico , Pancreatite/imunologia , Resultado do TratamentoRESUMO
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.
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OBJECTIVES: For the purpose of flight safety military aircrew must be healthy. P-wave dispersion (PWD) is the p-wave length difference in an electrocardiographic (ECG) examination and represents the risk of developing atrial fibrillation. In the study we aimed at investigating PWD in healthy military aircrew who reported for periodical examinations. MATERIAL AND METHODS: Seventy-five asymptomatic military aircrew were enrolled in the study. All the subjects underwent physical, radiologic and biochemical examinations, and a 12-lead electrocardiography. P-wave dispersions were calculated. RESULTS: The mean age of the study participants was 36.15±8.97 years and the mean p-wave duration was 100.8±12 ms in the whole group. Forty-seven subjects were non-pilot aircrew, and 28 were pilots. Thirteen study subjects were serving in jets, 49 in helicopters, and 13 were transport aircraft pilots. Thirty-six of the helicopter and 11 of the transport aircraft aircrew were non-pilot aircrew. P-wave dispersion was the lowest in the transport aircraft aircrew, and the highest in jet pilots. P-wave dispersions were similar in the pilots and non-pilot aircrew. Twenty-three study subjects were overweight, 19 had thyroiditis, 26 had hepatosteatosis, 4 had hyperbilirubinemia, 2 had hypertension, and 5 had hyperlipidemia. The PWD was significantly associated with thyroid-stimulating hormone (TSH) levels. Serum uric acid levels were associated with p-wave durations. Serum TSH levels were the most important predictor of PWD. CONCLUSIONS: When TSH levels were associated with PWD, uric acid levels were associated with p-wave duration in the military aircrew. The jet pilots had higher PWDs. These findings reveal that military jet pilots may have a higher risk of developing atrial fibrillation, and PWD should be recorded during periodical examinations.
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Fibrilação Atrial/diagnóstico , Militares , Pilotos , Adulto , Medicina Aeroespacial , Eletrocardiografia , Humanos , Masculino , Fatores de Risco , Tireotropina/sangue , Turquia , Ácido Úrico/sangueRESUMO
OBJECTIVES: The aim of this study was to evaluate the reliability and validity of the Turkish translation of the Beliefs about Medicines Questionnaire (BMQ-T, ©Prof. Rob Horne) for patients with Behçet's disease. METHODS: This methodological study enrolled a sample of 125 patients. The scale was adapted to Turkish through a process including translation, comparison with versions in other languages, back translation, and pretesting. Construct validity was evaluated by factor analysis. Medication adherence evaluated as poor, moderate and good according to the Morisky Medication Adherence Scale (MMAS). BMQ-T scores compared along medication adherence status groups. RESULTS: In our study, as in the original scale, the factor analysis confirmed that the BMQ-T had a four-factor structure explaining 54.73% of the total variance. The BMQ-T had acceptable internal consistency (Cronbach's alpha coefficient: Specific Necessity=.812; Specific Concerns=.672; General Harm=.677; General Overuse=.656), adequate test-retest reliability (intraclass correlation coefficients: Specific Necessity=.715; Specific Concerns=.680; General Harm=.678; General Overuse=.327). Specific Necessity and Specific Concerns scores were significantly different between medication adherence status groups. CONCLUSIONS: The psychometric properties of the BMQ-T were consistent with those reported in the original study. The BMQ-T was found to be a valid and reliable tool for evaluating beliefs about medicines in patients with Behçet's disease.
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Síndrome de Behçet/tratamento farmacológico , Características Culturais , Conhecimentos, Atitudes e Prática em Saúde , Imunossupressores/uso terapêutico , Adesão à Medicação , Inquéritos e Questionários , Adulto , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/psicologia , Compreensão , Análise Fatorial , Feminino , Humanos , Imunossupressores/efeitos adversos , Masculino , Psicometria , Reprodutibilidade dos Testes , Tradução , TurquiaRESUMO
ObjectiveThere 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 methodsSixty 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.ResultsFasting 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 (β coefficient: 0.092, p = 0.358; and β coefficient: 0.189, p = 0.362, respectively).ConclusionPrediabetes 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.
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Proteína C-Reativa/análise , /metabolismo , Selectina E/sangue , Endotélio Vascular/metabolismo , Estado Pré-Diabético/metabolismo , Rigidez Vascular/fisiologia , Biomarcadores/sangue , Glicemia/análise , Estudos de Casos e Controles , /fisiopatologia , Endotélio Vascular/fisiopatologia , Jejum/sangue , Teste de Tolerância a Glucose , Microcirculação , Análise de Onda de Pulso , Estado Pré-Diabético/fisiopatologia , Fatores de RiscoRESUMO
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.
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Proteína C-Reativa/análise , Diabetes Mellitus Tipo 2/metabolismo , Selectina E/sangue , Endotélio Vascular/metabolismo , Estado Pré-Diabético/metabolismo , Rigidez Vascular/fisiologia , Adulto , Idoso , Biomarcadores/sangue , Glicemia/análise , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/fisiopatologia , Endotélio Vascular/fisiopatologia , Jejum/sangue , Feminino , Teste de Tolerância a Glucose , Humanos , Masculino , Microcirculação , Pessoa de Meia-Idade , Estado Pré-Diabético/fisiopatologia , Análise de Onda de Pulso , Fatores de RiscoAssuntos
Artérias/fisiopatologia , Hiperglicemia/fisiopatologia , Rigidez Vascular , Feminino , Humanos , MasculinoRESUMO
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.
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Aorta/fisiopatologia , Arginina/análogos & derivados , Hipertensão/diagnóstico , Rigidez Vascular , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/efeitos adversos , Arginina/sangue , Pressão Arterial , Biomarcadores/sangue , Proteína C-Reativa/análise , Feminino , Humanos , Hipertensão/sangue , Hipertensão/etiologia , Hipertensão/fisiopatologia , Mediadores da Inflamação/sangue , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Análise de Onda de Pulso , Fatores de Risco , Fatores Sexuais , Fumar/efeitos adversosRESUMO
OBJECTIVES: Following ischemia/reperfusion injury, antioxidant defense mechanisms may remain insufficient depending on the duration of ischemia which is caused by any reason (MI, after percutaneous coronary intervention, during cardiac surgery). After that, free oxygen radicals increasing within the cell cause structural deterioration. Cytokines which activate a series of reactions that cause tissue damage and inflammatory response are released during reperfusion of ischemic tissues. In this study, we aimed to compare the effects of dexmedetomidine and ketamine in cardiac ischemia/reperfusion injury. MATERIAL AND METHODS: The study included 18 rats randomly divided into three groups. Group I/R (n = 6): control, Group I/R-K (n = 6): ketamine, and Group I/R-D (n = 6): dexmedetomidine. Before the 10 min surgery, after the 20 min ischemia and 20 min reperfusion period, hemodynamic parameters were compared among the three groups. After the 45 min ischemia and 120 min reperfusion period, tissue samples were obtained from the rat hearts, and MDA, SOD, GSH-Px, IL-1ß and TNF-α levels were compared. RESULTS: MDA and GSH-Px levels were significantly higher in the control group compared to the ketamine and dexmedetomidine groups. However, both levels were similar in the ketamine and dexmedetomidine groups. SOD levels were significantly lower in the ketamine and dexmedetomidine groups compared to the control group, but they were similar in the ketamine and dexmedetomidine groups. IL-1ß levels were similar in all groups. TNF-α levels were significantly lower in the ketamine and dexmedetomidine groups compared to the control group. They were similar in the ketamine and dexmedetomidine groups. CONCLUSIONS: According to our study, it can be concluded that dexmedetomidine and ketamine have similar effects on reducing myocardial ischemia reperfusion injury. Dexmedetomidine provides better heart rate control but causes hypotension, so, because of cardiac depression, we think that its clinical use may necessitate further investigation.
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Neutrophils and lymphocytes (N/L) ratio and carotid intima-media thickness (C-IMT) value have been studied as new predictors of cardiovascular risk. We aimed to investigate N/L ratio and C-IMT value in patients with cardiac syndrome X (CSX) and compare patients with coronary artery disease (CAD) and normal participants. A total of 288 participants were enrolled in the study. The N/L ratio and C-IMT value were compared among the 3 groups. There were no statistically significant differences in N/L levels between CSX and CAD groups. The N/L ratio was found significantly increased in patients with CSX and CAD, compared to the control group. Patients with CAD and CSX had significantly higher C-IMT value compared to control participants. Significant positive correlation was found between C-IMT value and plasma level of N/L ratio. The relationship among CSX and higher N/L ratio level and C-IMT suggests that endothelial dysfunction may contribute to the etiopathogenesis of the CSX.
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Doenças Cardiovasculares/sangue , Espessura Intima-Media Carotídea , Doença da Artéria Coronariana/sangue , Linfócitos/patologia , Neutrófilos/patologia , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/patologia , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/patologia , Feminino , Humanos , Linfócitos/metabolismo , Masculino , Pessoa de Meia-Idade , Neutrófilos/metabolismo , Estudos ProspectivosRESUMO
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.