Can myocardial dysfunction be detected in patients with rheumatoid arthritis with no cardiac symptoms?

OBJECTIVE: The aim of our study was to investigate the role of tissue Doppler and Myocardial Performance Index (MPI) in evaluating cardiac involvement in patients with rheumatoid arthritis (RA) with no cardiac symptoms, to determine whether these measurements differ between healthy controls and RA patients, and whether they can be used to determine the risk of cardiovascular disease and predict prognosis. PATIENTS AND METHODS: 50 RA patients fulfilling the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RA criteria and 50 healthy volunteering controls were included in the study. All patients and controls were assessed using electrocardiography (ECG), echocardiography, conventional Doppler echocardiography and tissue Doppler echocardiography. MPI values were calculated. In addition, RA patients were compared after being divided into two subgroups: seropositive and seronegative RA. Disease activity levels of the patients were determined based on Disease Activity Score in 28 Joints (DAS28). RESULTS: The control group and RA group were compared in terms of PR interval, left atrial diameter, E/A, E/e', and MPI values. Comparisons between the groups yielded statistically significant differences in left atrial diameter, E/A, E/e', and MPI values and no significant difference in PR intervals. These parameters were also compared between seropositive and seronegative patients. Left atrial diameter was significantly higher in seronegative patients than in seropositive patients. There was no significant difference in the other values. DAS28 scores had no correlation with cardiac parameters. CONCLUSIONS: Early detection of ventricular dysfunction in RA may be useful in clinical practice when predicting prognosis and optimizing treatment. The present study found that RA patients had impaired tissue Doppler measurements and MPI results compared to controls. MPI and tissue Doppler may be useful in early detection of ventricular dysfunction.

Relationship of hemoxygenase-1 and prolidase enzyme activity with oxidative stress in papillary thyroid cancer.

AIM: Recent studies associate thyroid cancer with oxidative stress. We aim to clarify the relation between papillary thyroid cancer, oxidative stress, hemoxygenase-1, prolidase enzymes and investigate the availability of these enzymes as markers for diagnosis, success of treatment, and follow-up. METHODS: Thirty-one patients with papillary thyroid carcinoma and 25 healthy control subjects were included in this study. Hemoxygenase-1, prolidase (oxidant stress indicator), malondialdehyde, protein carbonyl, and superoxide dismutase (an indicator of antioxidant defense system) were measured pre-operatively and 30 days after thyroidectomy. RESULTS: There was a significant decrease in serum levels of malondialdehyde and superoxide dismutase (p <0.001 for both) after thyroidectomy in papillary thyroid carcinoma group. In addition, there was a significant difference in the postoperative serum levels of prolidase, malondialdehyde, protein carbonyl, and superoxide dismutase between papillary thyroid carcinoma and control groups (p =0.024, p <0.001, p =0.002, and p =0.016, respectively) beside significant difference of malondialdehyde, protein carbonyl, hemoxygenase-1, and superoxide dismutase pre-operative serum levels (p <0.001, p =0.003, p =0.006, and p =0.025, respectively). CONCLUSION: When the unquestionable role of oxidative stress in the pathogenesis of cancer is considered, in the future it is expected to associate parametric changes in the serum of patients caused by oxidative stress to papillary thyroid cancer. Hippokratia 2016, 20(1): 55-59.

Use of infliximab in treatment of acute pancreatitis.

OBJECTIVE: The aim of this study was to investigating the effects of infliximab in severe necrotizing pancreatitis. METHODS: Forty male Wistar rats were randomly divided into five groups evenly. Necrotizing pancreatitis was induced in group I and II by retrograde injection of 3% taurocholate into common pancreaticobiliary duct. In group III and IV saline was introduced instead of taurocholate to mimic pressure effect. Infliximab (8mg/kg) was infused through tail vein in group I and III and saline was infused in group II and IV just before laparotomy. Group V underwent sham laparotomy. Serum amylase activity, serum and tissue sialic acid, carbonyl content, malondialdehyde, total antioxidant activity (TAA) and pancreatic histopathology were assessed. RESULTS: In group I serum sialic acid, malondialdehyde, carbonyl content and amylase activity were significantly lower than in group II (p<0.01). There were no significant differences for serum TAA between group I and II (p>0.05). Tissue sialic acid and malondialdehyde in group I were significantly lower than in group II (p<0.01). But tissue TAA in group I was significantly higher than in group II (p<0.01). Carbonyl content of group I was not significantly different from group II (p>0.05). Histopathologically, pancreatic sections of group II demonstrated extensive acinar and fat necrosis, hemorrhage, and inflammation. In group I Infliximab improved histopathological changes (p0.05). CONCLUSION: Administration of infliximab resulted in a significant improvement in biochemical and histopathological alterations in acute necrotizing pancreatitis(Tab. 3, Ref. 43).

Consumption of pistachio nuts beneficially affected blood lipids and total antioxidant activity in rats fed a high-cholesterol diet.

Although nuts are typically high in dietary fat, novel studies have shown that regular consumption of these heart-healthy foods might confer a beneficial effect on cardiovascular disease risk. In the present study, we aimed to analyse the effects of pistachio consumption on blood lipids, antioxidant activity, oxidative stress and sialic acid levels in high-fat-fed rats for 8 weeks. The oxidant-antioxidant status was evaluated by the determination of lipid peroxidation (thiobarbituric acid-reactive substances), total antioxidant activity, reduced glutathione content, activity of superoxide dismutase and total thiol levels. Furthermore, tissue damage was evaluated by total sialic acid levels in serum. Total cholesterol, triglycerides, sialic acid and thiobarbituric acid-reactive substances significantly increased whereas total antioxidant activity, reduced glutathione, total thiol levels significantly decreased in the hyperlipidaemic group compared to the control group. Pistachio consumption significantly decreased triglycerides and thiobarbituric acid-reactive substance levels and significantly increased total antioxidant activity in the hyperlipidaemic group. In conclusion, pistachio supplementation may improve blood lipids and ameliorate oxidative stress in experimental hyperlipidaemia, which may have beneficial applications in the prevention of cardiovascular diseases. However, its antioxidant mechanisms remain to be investigated.

Investigation of zinc and copper levels in methimazole-induced hypothyroidism: relation with the oxidant-antioxidant status.

Thyroid hormones are associated with the oxidative and antioxidative status of the organism. Depression of metabolism by hypothyroidism has been reported to decrease oxidant production and thus protect tissues against oxidant damage. The purpose of the present study was to investigate Zn and Cu levels in MMI-induced hypothyroidism and to show whether there is a connection between these trace elements and the oxidant-antioxidant status in experimental hypothyroidism. 3-Nitrotyrosine was measured as a marker of nitro-oxidative stress. In order to examine the antioxidant status of MMI-induced hypothyroidism in rats, GSH and SOD levels were determined as well. Significantly decreased 3-nitrotyrosine, Cu and Zn levels were observed in our experimental model when compared with the controls. On the other hand, GSH and SOD levels remained constant. It may be suggested that Cu and Zn serve as antioxidant molecules and exert their effects in an indirect manner to reduce oxidative stress in experimental hypothyroidism.

The effects of ageing on brain tissue sialic acid contents following cold trauma.

BACKGROUND: There is a prominent difference between the responses of young and aged patients to brain injury in the clinical setting, but the exact cause of this condition is not well known. METHODS: Young (3-4 months) and aged (36-40 months) Wistar albino male rats were used as subjects, and they were divided into four groups: young and aged study groups, and young and aged control groups. In all groups, craniectomies were performed over the left hemispheres, and in the study groups, cold injuries were inflicted. Brain tissue sialic acid contents were determined in all groups. FINDINGS: Brain tissue sialic acid content was higher in aged control rats than young control ones, but the difference was not statistically significant. Tissue sialic acid content was significantly increased in young rats after trauma. On the contrary, it was significantly decreased in aged rats after trauma. INTERPRETATION: In young rats, brain tissue sialic acid content was significantly increased 24 hours after cold injury unlike in the aged ones. This may be a finding related to decreased regeneration capability of aged brain.

Adrenomedullin in cirrhotic and non-cirrhotic portal hypertension.

AIM: Adrenomedullin (ADM) is a potent vasodilator peptide. ADM and nitric oxide (NO) are produced in vascular endothelial cells. Increased ADM level has been linked to hyperdynamic circulation and arterial vasodilatation in cirrhotic portal hypertension (CPH). The role of ADM in non-cirrhotic portal hypertension (NCPH) is unknown. plasma ADM levels were studied in patients with NCPH, compensated and decompensated cirrhosis in order to determine its contribution to portal hypertension (PH) in these groups. METHODS: There were 4 groups of subjects. Group 1 consisted of 27 patients (F/M: 12/15) with NCPH due to portal and/or splenic vein thrombosis (mean age: 41+/-12 years), group 2 consisted of 14 patients (F/M: 6/8) with compensated (Child-Pugh A) cirrhosis (mean age: 46+/-4), group 3 consisted of 16 patients (F/M: 6/10) with decompensated (Child-Pugh C) cirrhosis (mean age: 47+/-12). Fourteen healthy subjects (F/M: 6/8) (mean age: 44+/-8) were used as controls in Group 4. ADM level was measured by ELISA. NO was determined as nitrite/nitrate level by chemoluminescence. RESULTS: ADM level in Group 1 (236+/-61.4 pg/mL) was significantly higher than that in group 2 (108.4+/-28.3 pg/mL) and group 4 (84.1+/-31.5 pg/mL) (both P<0.0001) but was lower than that in Group 3 (324+/-93.7 pg/mL) (P=0.002). NO level in group 1 (27+/-1.4 micromol/L) was significantly higher than that in group 2 (19.8+/-2.8 micromol/L) and group 4 (16.9+/-1.6 micromol/L) but was lower than that in Group 3 (39+/-3.6 micromol/L) (for all three P<0.0001). A strong correlation was observed between ADM and NO levels (r=0.827, P<0.0001). CONCLUSION: Adrenomedullin and NO levels were high in both non-cirrhotic and cirrhotic portal hypertension and were closely correlated, Adrenomedullin and NO levels increased proportionally with the severity of cirrhosis, and were significantly higher than those in patients with NCPH. Portal hypertension plays an important role in the increase of ADM and NO. Parenchymal damage in cirrhosis may contribute to the increase in these parameters.

The influence of hemodialysis on serum sialic acid levels in chronic renal failure.

Background. It has been observed that there is an increase in serum sialic acid level in chronic renal diseases and endstage renal failure requiring hemodialysis, and the hemodialysis procedure causes increased cytokine production. Thus, it is expected that hemodialysis causes increases in the serum levels of acute phase reactants and sialic acid. Nevertheless, the changes in serum sialic acid level in hemodialysis have not been examined sufficiently. In our study, we examined the effect of hemodialysis on serum sialic acid level. Methods. A total of 54 patients on hemodialysis therapy for chronic renal failure (32 men; 22 women) were examined. The patients were evaluated in four groups according to their age, sex, duration of hemodialysis, and whether they were diabetic. Serum sialic acid levels before and after hemodialysis, done with a hemophane membrane, were measured by the thiobarbituric acid method described by Warren. Results. The serum sialic acid levels of chronic renal failure patients requiring hemodialysis were increased with respect to the healthy control group, independent of age, duration of therapy, and whether there was accompanying diabetes. Hemodialysis did not provide clearance of sialic acid; to the contrary, it caused an insignificant increase in serum sialic acid levels. Conclusions. In chronic renal failure, the improved serum sialic acid level probably reaches a definite value, and this value is not affected by factors such as diabetes, age, or sex. Serum sialic acid level is minimally influenced by hemodialysis performed with a hemophane membrane.

Influence of pentoxifylline and interferon-alpha on prevention of stricture due to corrosive esophagitis. An experimental study in the rat.

The effects of pentoxifylline (PTX) and interferon alpha (IFN-alpha) in the prevention of strictures due to corrosive esophagitis in rats were investigated. Forty rats were randomly divided into four equal groups. Corrosive esophagitis was induced in all groups by application of 37.5% NaOH to the distal esophagus for a period of 90 s followed by saline rinse. Histopathologic damage was significantly lower in the PTX and IFN-alpha-treated groups than in the untreated group. During the study period, PTX and INF-alpha-treated animals showed a significant increase in body weight when compared to controls. However, PTX provided more significant prevention of stricture formation than IFN-alpha. In the PTX-treated group, the wall thickness and quantity of hydroxyprolin were significantly lower than in the untreated and IFN-alpha-treated groups. Stenosis index in the PTX group was significantly reduced compared to the control group. PTX prevents the stricture formation due to corrosive esophagitis in this experimental model. IFN-alpha was also shown to prevent stricture formation when considering amelioration of histopathologic damage and increase in body weight.

Evaluation of salivary sialic acid level and Cu-Zn superoxide dismutase activity in type 1 diabetes mellitus.

In this study, our aim was to determine whether or not type 1 diabetes mellitus affects salivary sialic acid level and SOD activity. For this purpose, unstimulated saliva specimen was collected. Saliva sialic acid level and SOD activity were measured by the methods of Warren and Sun, respectively. We found significantly decline in salivary sialic acid level and SOD activity. The decrease of salivary sialic acid level in type 1 diabetes may be due to changes in the activities of the enzymes taking part of in the synthesis and catabolism of sialic acid. The main reason for the decrease of salivary SOD activity may be increased glycation of the enzyme and/or deleterious effect of increased free oxygen radicals by glycated proteins on SOD activity in diabetes. We conclude the decline both in sialic acid and SOD in saliva may be a possible factor leading to oral complications of diabetes mellitus.

Sialic acid levels in various types of cancer.

Serum or plasma total sialic acid (TSA) and lipid bound sialic acid (LSA) are useful markers for human cancer. In this study, sialic acid levels have been demonstrated in various types of human cancer including brain, thyroid and Hodgkin's. TSA was found to be significantly elevated in various human brain tumors, especially in the microsomal fraction. Also serum and tissue LSA levels indicated significant increases when compared to the normals in various brain and thyroid tumors. TSA levels were significantly higher in the plasma and leucocyte in patients with Hodgkin's. The results show that sialic acid can be advisable as a beneficial marker for detecting malignancies. But it can not be used as a criteria for identifying tumor types.

Serum and tissue total sialic acid as a marker for human thyroid cancer.

In this study, serum and tissue sialic acid levels in various histopathological types of thyroid cancer were measured and were found to be significantly higher than those measured in the control group. The amount of sialic acid in tissue was 2.8 +/- 1.42 mg/100 mg protein while the serum level was 79.2 +/- 6.6 mg per dl. The rise in tissue and serum sialic acid levels was relatively non-specific with respect to type of cancer as they depend on the tumor burden only. Neither were they related to age, sex or duration of cancer. The serum sialic acid levels increased during the few days following thyroidectomy and returned to normal thereafter. The sialic acid determination appeared to be an important criterion in patient follow-up and evaluating therapeutic response.