The effect of levothyroxine replacement therapy on lipid profile and oxidative stress parameters in patients with subclinical hypothyroid.

The purpose of this present study is to investigate the levels of oxidative stress parameters in patients with subclinical hypothyroidism (SH) and the effects of levothyroxine (LT4) replacement therapy on these parameters and lipid profile. At the beginning of the study blood samples were collected from the patients in order to analyse oxidative stress parameters, lipid profile and biochemical markers. After replacement therapy with LT4, in the third month, same tests were performed again. At the baseline superoxide dismutase (SOD) levels were found to be higher in SH patients, compared to the euthyroid group. After LT4 therapy, statistically significant decreases in SOD and catalase levels and increase in HDL-C levels were noticed. LT4 treatment was found to have positive effects on oxidative stress indicators and HDL-C levels.

Correlation between body mass index and quadrupled hamstring tendon autograft size in ACL reconstruction.

PURPOSE: the aim of this study was to assess the relationship of patient weight, height and body mass index (BMI) with the size of the quadrupled hamstring tendon used in anterior cruciate ligament (ACL) reconstruction. METHODS: from patient records, we retrospectively assessed the weight, height, BMI and graft sizes of 126 patients who underwent ACL reconstruction using a quadrupled hamstring tendon autograft between January 2010 and January 2013 at our institution. The data obtained from perioperative measurements were studied using correlation analysis. RESULTS: statistically significant relationships were found between patient height and graft diameter (p = 0.033, r = 0.19) and between patient weight and graft diameter (p < 0.0001, r = 0.33). No statistically significant relationships were found between graft diameter and BMI or between graft length and patient height, weight and BMI (p > 0.05). CONCLUSIONS: patient height and weight were found to be related to quadrupled hamstring graft diameter in our patient population. BMI was not related to the quadrupled hamstring graft size. The exact size of the graft cannot be predicted preoperatively on the basis of these variables. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Serum Pentraxin-3 Level in Patients Who Underwent Coronary Angiography and Relationship with Coronary Atherosclerosis.

OBJECTIVES: To evaluate the role of pentraxin-3 (PTX-3) in determining the presence and severity of coronary atherosclerosis in patients with coronary artery disease (CAD). SUBJECTS AND METHODS: Ninety-five patients (77 males and 18 females) who underwent elective coronary angiography were enrolled in this study. Patients with heart failure, renal failure, diabetes and thyroid disease were excluded. The study population was divided into 3 groups: individuals with normal coronary arteries, patients with critical CAD (n = 35) and patients with noncritical CAD (n = 36). The association of PTX-3 levels with the presence and severity of CAD and the number of involved vessels were analyzed. RESULTS: The mean age was 53.40 ± 10.25 years. The PTX-3 levels were significantly higher in patients with CAD than without CAD (146.48 ± 48.52 vs. 109.83 ± 49.06 pg/ml, p < 0.001). A statistically significant difference was found among the 3 groups regarding the severity of CAD (165.66 ± 49.10, 127.83 ± 40.51 and 109.83 ± 49.06 pg/ml, p < 0.001, respectively). The serum PTX-3 levels in normal arteries were 110.4 ± 48.11 pg/ml, in single-vessel disease 132.35 ± 32.96 pg/ml, in 2-vessel disease 142.57 ± 55.88 pg/ml, in 3-vessel disease 156.07 ± 50.53 pg/ml, and in 3-vessel disease 160.50 ± 30.41 pg/ml. After adjusting for baseline confounders, older age (OR = 1.107, 95% CI = 1.027-1.193, p = 0.008) and higher PTX-3 levels (OR = 1.017, 95% CI = 1.003-1.032, p = 0.021) were detected as significant predictors for the presence of CAD. CONCLUSIONS: Higher PTX-3 levels were associated with the presence of CAD and its increased severity in clinically stable patients. Higher PTX-3 levels may be regarded as a novel diagnostic predictor and may offer therapeutic options in the clinic.

Narrowband ultraviolet B phototherapy starting and incremental dose in patients with psoriasis: comparison of percentage dose and fixed dose protocols.

BACKGROUND/PURPOSE: It was aimed to investigate the ideal narrowband ultraviolet B (NB UVB) phototherapy protocol that has the maximal efficacy, minimal side effect profile, minimal cumulative UVB dose, and a shorter duration of therapy. METHODS: Fifty-one patients with psoriasis vulgaris were included in the study. The patients were divided into the percentage dose (group 1) and the fixed dose groups (group 2). In group 1, the initial NB UVB dose was 50% of the minimal erythema dose and 20% of the previous dose increase made in the next sessions, and in group 2, the starting dose and the dose increases were determined based on the skin types and applied with fixed doses. RESULTS: Psoriasis Area and Severity Index (PASI) 90 was achieved in 22 out of 27 (81.5%) patients in group 1, and in 19 out of 24 (79.2%) patients in group 2. The difference was not statistically significant (P = 0.82). No statistically significant difference was found between the two regimens in the cumulative NB UVB dose, side effect profile, and the number of sessions with improvement of the initial PASI score by 90% (for all data, P > 0.05). CONCLUSION: These two treatment protocols were not superior to each other in terms of cumulative NB UVB dose, efficacy, total number of treatment sessions, and side effect profiles.

Piriformis syndrome: a case with non-discogenic sciatalgia.

Piriformis syndrome is a clinical picture of non-discogenic sciatica caused by compression of the sciatic nerve by the piriformis muscle. It has variable etiologies and the patho-physiology is not fully understood. The major etiology was known to be the spasm, edema and inflammation of the piriformis muscle and sciatic nerve compression of the muscle later on. Patients can be diagnosed immediately with a comprehensive clinical examination and early diagnosis makes the treatment much easier. Diagnosis of the piriformis syndrome, a very rare cause of low back pain, first requires that this syndrome is remembered, and then a differential diagnosis should be performed. A case of piriformis syndrome diagnosed in a patient who presented with low back pain is reported in this study.

The effect of valsartan and nebivolol treatment on ADMA and pentraxin-3 levels in hypertensive patients.

Long pentraxin 3 (PTX3) is a recently discovered multimeric inflammatory mediator that is structurally linked to short pentraxins, such as C-reactive protein (CRP) and serum amyloid P component. PTX3 is produced by a variety of tissues and cells, including vascular endothelial cells and macrophages. Because of its extrahepatic synthesis (in contrast to CRP), the PTX3 level is believed to be a true independent indicator of disease activity because PTX3 is produced at sites of inflammation and is intimately linked to endothelial dysfunction. PTX3 also has key functions in innate immunity and has been identified in atherosclerotic lesions. Previously, PTX3 was associated with myocyte damage in myocardial infarction (MI), mortality after MI, and unstable angina. Because PTX3 release is likely a specific response to vascular damage, PTX3 levels may provide more explicit information on development and progression of atherosclerosis than nonspecific markers like CRP and interleukin-6. Asymmetric dimethylarginine (ADMA) is a naturally occurring component of human blood plasma. More than one decade ago ADMA was first reported to exert biological effects by inhibiting nitric oxide synthesis. Many researchers today agree that ADMA may play a prominent role in the pathogenesis and in the progression of cardiovascular diseases. In this study PTX3 and ADMA levels investigated of valsartan and nebivolol's effect on newly diagnosed hypertensive patients.

Elevated pentraxin-3 levels are related to blood pressure levels in hypertensive patients: an observational study.

OBJECTIVE: In this study, relationship between systolic and diastolic blood pressure and pentraxin-3 (PTX3) levels in hypertensive patients was investigated. METHODS: Overall, 80 patients with stage 1 hypertension between 40-61 years of age without any disease and 80 healthy volunteers were included to the study. Blood samples obtained to measure PTX3 levels and biochemical analysis. Relationship between PTX3 levels and clinical and biochemical parameters were analyzed using multivariate regression analysis. RESULTS: Although systolic and diastolic blood pressures were significant different, there were no differences regarding age and gender between hypertensives and normotensives. In each group, significant statistical differences were found between PTX3 and CRP levels (PTX3 (ng/mL) 35.25±5.45 and 0.27±0.24, p<0.001; CRP (mg/dL) 10.03±5.81 and 4.30±3.38, p<0.001; in hypertensive and normotensive groups respectively). It was observed that increase in PTX3 levels accompanies the increase in systolic and diastolic blood pressures (r2=0.78). It was observed that PTX3 levels are not effected from CRP, lipid levels and body mass index (p>0.05). On multivariate regression analysis PTX3 was found to strongly affect blood pressure (beta=0.82, 95% CI 0.644-0.799, p<0.001, and beta=0.84, 95% CI 0.422-0.799, p<0.001, respectively for systolic and diastolic blood pressures), CRP and total cholesterol are found to affect moderately (beta=0.115-0.265, 95% CI 0.101-0.572, p<0.05 and beta=0.107-0.141, 95% CI 0.041-0.110, p<0.05, respectively). CONCLUSION: This study showed that PTX3 levels are higher in newly diagnosed hypertensive patients than in healthy individuals. In addition, it was noticed that increased PTX3 levels causes increase in systolic and diastolic blood pressures.

Comparison of different preoperative sublingual misoprostol regimens for surgical termination of first trimester pregnancies: a prospective randomized trial.

OBJECTIVE: To determine the appropriate dose of sublingual misoprostol administration before dilation and curettage (D&C) of the uterus in first trimester pregnancies. STUDY DESIGN: Ninety nulliparous women who underwent surgical termination of first trimester pregnancy were analyzed prospectively. The first group (n = 30) received a single 200-microg dose, and the second (n = 30) and third (n = 30) groups were administered 2x 200 microg (400 microg) and 3 x 200 microg (600 microg) doses of misoprostol sublingually, respectively, with 1-hour intervals. The main outcomes evaluated were the degree of difficulty of cervical dilation, adverse effects of misoprostol according to dose administered, and participant satisfaction rate with the procedure. RESULTS: The improvement in cervical dilation and the ease of the D&C procedure were more significant in the 600-microg misoprostol arm (p = 0.008). Because the prevalence and severity of the side effects of misoprostol were increased in a dose-dependent manner, the 400-microg arm was found to be the most efficient dose of the study with its high satisfaction rate (p < 0.001). CONCLUSION: Premedication with misoprostol makes the D&C procedure easier by leading to cervical ripening. By sublingual route 400 microg of misoprostol regimen seems to be appropriate for planned first trimester surgical pregnancy termination under local anesthesia. Misoprostol should be administered only to select and hospitalized patients.