A practical means of evaluating the prognosis of acute pancreatitis, as measurement of carotid artery intima-media thickness.

BACKGROUND AND STUDY AIMS: Factors such as age, obesity, diabetes mellitus and hyperlipidemia that cause adverse prognosis in acute pancreatitis also cause an increase in carotid intima-media thickness. In this study, we aimed to investigate the usability of the measurement of carotid intima-media thickness, which is an easy to apply, cost-effective means of measurement applied to the patients, in predicting AP prognosis, apart from the criteria currently utilized to predict AP prognosis. PATIENTS AND METHODS: 101 patients diagnosed with acute pancreatitis were prospectively enrolled into the study. Right and left common carotid artery intima-media thickness, right and left internal carotid artery intima-media thickness were measured with ultrasonographic images performed within the first 24 hours of hospitalization. local or systemic complications and organ failure development were monitored in the follow-up of the patients. RESULTS: After the ROC analysis was performed and the threshold value was determined. The patients with main and internal carotid artery intima-media thickness above 0.775 mm were seen to have a more severe AP (p = 0.000). Local and systemic complications and organ failure were also more common in these patients. CONCLUSIONS: Measurement of carotid intima-media thickness is a non-invasive method that can be used to predict the prognosis in patients with acute pancreatitis at presentation.

The effect of infliximab on depressive symptoms in patients with ankylosing spondylitis.

UNLABELLED:

OBJECTIVES: Ankylosing spondylitis is a chronic inflammatory disease which physically, psychologically, and socially affects the patient's life. Previous studies have reported a correlation between ankylosing spondylitis and depression. In this study we investigated the effect of infliximab on depression in ankylosing spondylitis patients. METHODS: A total of 29 patients with ankylosing spondylitis were enrolled in this prospective study. Infliximab was administered intravenously at a dose of 5 mg/kg at baseline, weeks 2 and 6. The measurements of morning stiffness, modified Schober's test, chest expansion, erythrocyte sedimentation rate, C-reactive protein, Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression inventory scores were compared with baseline and 12th week. RESULTS: The modified Schober's test and chest expansion increased, the morning stiffness duration, erythrocyte sedimentation rate and C-reactive protein levels decreased after infliximab treatment (p < 0.001, respectively). There was statistically significant decrease in Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression invantory scores of patients after 12 weeks (p < 0.001, respectively). CONCLUSION: Infliximab can improve depression and its symptoms in patients with ankylosing spondylitis.

Endogenous subclinical hyperthyroidism may not lead to bone loss in premenopausal women.

BACKGROUND: Osteoporosis is defined as the decrease in bone mineral density. It is a serious health problem showing the predisposed person with increased bone fracture risk. Hyperthyroidism is one of the major causes of secondary osteoporosis. The aim of this study was to assess bone mineral density in premenopausal women with endogenous subclinical hyperthyroidism. METHODS: A total of 168 subjects were included in this case-control study, of whom 86 and 82 participants were premenopausal women with subclinical hyperthyroidism and healthy premenopausal subjects, respectively. The patients with subclinical hyperthyroidism who were not receiving L-thyroxine treatment were included. The women in postmenopausal state or having chronic disease were excluded. The bone mineral densities of all subjects with dual energy X-ray absorptiometry were examined. RESULTS: The Z scores (femur and L1-4) of the study group were -0.15 ± 1.15 and -0.23 ± 1.03, respectively. The Z scores of the control group were -0.39 ± 1.08 and -0.55 ± 0.98, respectively. The differences between the groups were not statistically significant (p=0.14, 0.34, respectively). CONCLUSION: Our data suggest that contrary to exogenous subclinical hyperthyroidism, endogenous subclinical hyperthyroidism may not decrease bone mineral density in premenopausal women and it may not a risk factor for osteopenia or osteoporosis. Hippokratia 2014; 18 (3): 240-244.