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1.
Turk J Emerg Med ; 24(1): 1-7, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38343522

RESUMO

Diabetic ketoacidosis (DKA) is the most common emergency complication of diabetes. Euglycemic DKA (EDKA), on the other hand, has been known for many years but is a rare and under-recognized condition and constitutes a very small proportion of DKA cases. However, in recent years, an increase in the incidence of EDKA has been observed with the widespread use of sodium-glucose co-transporter 2 inhibitors, which have proven benefits in the treatment of diabetes mellitus and its cardiorenal complications, heart failure, and chronic kidney disease. Unlike classical DKA, these patients without significant hyperglycemia can easily be missed in emergency departments. EDKA should be kept in mind in patients with diabetes presenting with DKA but with a blood glucose level <250 mg/dL. The diagnostic and therapeutic approach after clinical suspicion in these patients is similar to classical DKA and is briefly summarized in this review. The most important point in treatment is that these patients are normoglycemic but have a significant insulin deficiency (relative or absolute). Therefore, insulin is the mainstay of the treatment and should be given together with dextrose solutions to avoid hypoglycemia.

2.
Cancer Manag Res ; 15: 311-317, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36994110

RESUMO

Background: We aimed to investigate the prognostic significance of insulin resistance (IR) markers fasting triglyceride-glucose (TyG) index and triglyceride high-density lipoprotein cholesterol (TG/HDL-C) ratio in HER2-positive breast cancer (BC) patients with brain metastasis (BM). Methods: In this single-center study, 120 patients who met the criteria were included. TyG and TG/HDL-C at the time of diagnosis were computed retrospectively. For TyG and TG/HDL-C, the median values of 9.32 and 2.95 were taken as the cut-off, respectively. TyG values <9.32 and <2.95 were considered low, and TG/HDL-C values ≥9.32 and ≥2.95 were considered high. Results: The median overall survival (OS) was 47 months (95% CI: 40.54-53.45). Time to BM was 22 months (95% CI: 17.22-26.73). The median time to BM was 35 months (95% CI: 20.90-49.09) in the low TyG group and 15 months (95% CI: 8.92-21.07) in the high TyG group (p < 0.001). The time to BM was 27 months (95% CI: 20.49-33.50) in the low TG/HDL-C group and 20 months (95% CI: 16.76-23.23) in the high TG/HDL-C group (p=0.084). In the multivariate Cox regression analysis, the TyG index (HR: 20.98, 95% CI: 7.14-61.59, p < 0.001) was an independent risk factor for time to BM. Conclusion: These findings suggest that the TyG index could be used as a predictive biomarker at the time of diagnosis for risk of time BM in patients with HER2-positive BC. The TyG index can be used as a standard potential marker with prospective studies confirming these data.

3.
Endokrynol Pol ; 74(1): 63-66, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36704977

RESUMO

INTRODUCTION: The effect of vitamin D status on steatosis has not been fully elucidated. In this study, we planned to investigate this interaction using a large-scale population-based cohort. MATERIAL AND METHODS: Patients diagnosed with simple steatosis (K76.0) and non-alcoholic steatohepatitis (NASH) (K75.8) by using the International Classification of Diseases 10th Revision (ICD-10) coding system, and who had 25-hydroxyvitamin D (25OHD) measurements at the diagnosis, were included in the study. Control group comprised subjects without liver diseases. Age, gender, alanine aminotransferase (ALT) and 25OHD levels, and the date of the measurements were recorded. RESULTS: We compared ALT and 25OHD measurements between the patient and control groups, and between the simple steatosis and NASH subgroups. 25OHD levels were lower and ALT levels were higher in the patient group (p < 0.001, effect size = 0.028, and p < 0.001, effect size = 0.442, respectively). Logistic regression analysis showed that when 25OHD levels decrease by 1 ng/dL, it increases the risk of being in the patient group by 3.7%. CONCLUSION: Our results suggest that vitamin D status may be related to the development of non-alcoholic fatty liver disease (NAFLD). Although this relationship is weak, it may be important in the pathogenesis of steatosis.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Deficiência de Vitamina D , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Vitamina D , Deficiência de Vitamina D/complicações , Fígado
4.
Turk J Med Sci ; 52(4): 1093-1102, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36326390

RESUMO

BACKGROUND: There are not many studies conducted to detect and recognize the symptoms during the prediabetes period. In our study, we aimed to determine the symptoms that can be seen in prediabetes and diabetes and their prevalence and to determine the similarities and differences between the two groups. METHODS: Individuals who were diagnosed with prediabetes or diabetes, over the age of 18, literate, and accepted to collaborate were included in our study. The "Diabetes Symptoms Checklist Scale" was used by interviewing 321 participants, 161 prediabetic and 160 diabetic, face-to-face. RESULTS: It has been found that the most common symptom in both the prediabetes and the diabetes group is "fatigue" (88.2% prediabetes, 89.4% diabetes). The symptoms seen in the dimensions of neurology and hyperglycemia are more common in individuals with diabetes than in individuals with prediabetes [neurology score: 1.85 ± 0.84 vs. 1.66 ± 0.64 (p = 0.02), respectively; hyperglycemia score: 2.39 ± 0.94 vs. 2.08 ± 0.83 (p = 0.002), respectively]. It was observed that the symptom burden increased in all subdimensions with the long duration of illness, being a female, not working, having a family history, and not doing exercise, and high fasting blood glucose and high HbA1c values. The level of education, family history, accompanying hyperlipidemia, neurology, and hyperglycemia symptoms are associated with diabetes; and it has been determined that cardiology symptoms are associated with prediabetes. DISCUSSION: Especially; during the follow-up of patients with prediabetes who have a low education level and diabetic family history and concomitant hyperlipidemia, there may be an increase in neurological and hyperglycemic symptoms at the point of development of type 2 diabetes. In this respect, we recommend that these factors, which we found to be predictive of diabetes compared to prediabetes, should be questioned more carefully during patient visits.


Assuntos
Diabetes Mellitus Tipo 2 , Hiperglicemia , Estado Pré-Diabético , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobinas Glicadas/análise , Glicemia
5.
Endokrynol Pol ; 73(1): 64-70, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35156704

RESUMO

INTRODUCTION: In a performed study, selenium levels were detected to be lower in subacute thyroiditis (SAT). This outcome suggests that the oxidant-antioxidant system may play a role in the aetiopathogenesis of SAT, as is the case for many other diseases. The aim of the present study was to detect whether any association exists between SAT and oxidative stress, and to determine the factors of a possible association. MATERIAL AND METHODS: Twenty-five patients who were newly diagnosed with SAT and 30 healthy volunteers were enrolled in the study. Total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), paraoxonase 1 (PON1), and dynamic thiol/disulphide [native thiol (NT), total thiol (TT), disulphide (DS), DS/TT, DS/NT, and NT/TT] levels of the participants were evaluated. RESULTS: Total thiol and NT levels were found to be lower in the SAT group (p < 0.001). DS/NT and DS/TT levels were significantly higher in the patients with SAT, whereas NT/TT levels were lower (p < 0.05). A negative correlation was detected between C-reactive protein (CRP) and TAS, whereas a positive correlation was detected between CRP and OSI. There was a negative association between TSH and TAS only in the partial correlation analysis by adjusting for age, white blood cell count, neutrophil (Neu) level, CRP, and erythrocyte sedimentation rate (ESR) (r = -0.481, p = 0.043). CONCLUSIONS: Thiol levels are significantly decreased and thiol/disulphide homoeostasis is disrupted in patients with SAT. The present study has presented for the first time that there may be an association between SAT and oxidative stress.


Assuntos
Tireoidite Subaguda , Antioxidantes/metabolismo , Arildialquilfosfatase/metabolismo , Dissulfetos , Humanos , Oxidantes , Estresse Oxidativo
6.
Clin Exp Hypertens ; 43(4): 373-377, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-33602005

RESUMO

Background: The association between cystatin C (CysC) and atherosclerosis has been shown in numerous studies in hypertensive patients and in various patient groups with high cardiovascular risk. The study examining the association between renal volume and atherosclerosis is very limited. This study aimed to investigate whether there is an association between the presence of atherosclerosis with CysC and renal volume in hypertensive patients.Methods: 133 hypertensive patients and 80 healthy volunteers were evaluated. CysC level was studied in the blood sample taken from all participants. Carotid intima media thickness (CIMT) and renal volume were measured with ultrasound always by the same radiologist. Laboratory findings, CysC, CIMT, and renal volume measurements of the groups were compared statistically.Results: There was no significant difference in mean renal volume values between hypertension and control groups. There was no significant correlation between renal volume with albuminuria and proteinuria. CIMT was significantly higher in hypertension group than in control group (p = .003). There was a significant correlation between renal volume and CIMT, which is an indicator of subclinical atherosclerosis (r = 0.213, p = .001). Renal volume was found to be an independent predictor of CIMT when corrected with variables such as age, BMI, serum LDL-cholesterol level, creatinine, CysC, and albumin-to-creatinine ratio.Conclusion: Ultrasonographic renal volume measurement, which is easy to perform and does not take a long time, can be a useful method for predicting the presence of atherosclerosis in hypertensive patients with GFR >60 ml/min.


Assuntos
Aterosclerose/fisiopatologia , Taxa de Filtração Glomerular/fisiologia , Hipertensão/fisiopatologia , Rim/patologia , Rim/fisiopatologia , Adulto , Aterosclerose/sangue , Aterosclerose/diagnóstico por imagem , Espessura Intima-Media Carotídea , Estudos de Casos e Controles , Cistatina C/sangue , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Tamanho do Órgão , Ultrassonografia
7.
J Med Biochem ; 39(2): 231-239, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-33033457

RESUMO

BACKGROUND: In this study, we aimed at determining the dynamic thiol/disulfide homeostasis and oxidant balance, and investigating the relation of these parameters to the severity of the disease and the serum calcium levels. METHODS: 55 patients with iatrogenic hypoparathyroidism follow-ups and 40 healthy volunteers were included in the study. The blood dynamic thiol/sulfide balance, Total Antioxidant Status (TAS), Total Oxidant Status (TOS), Paraoxonase Enzyme Activity (PON) levels were measured in serum samples. RESULTS: In our study, it was found that the disulfide, disulfide/native thiol, disulfide/total thiol levels were higher in the hypoparathyroidism group. A negative correlation was found between 25-hydroxy vitamin D (25-OH vitamin D) and disulfide, disulfide/native thiol and disulfide/total thiol, and a positive correlation was found between native thiol and total thiol ratio; and the corrected calcium levels and PON levels were negatively correlated. CONCLUSIONS: Consequently, a change in favour of disulfide was found in the dynamic thiol-disulfide homeostasis in the hypoparathyroidism group in our study.

8.
Arch. endocrinol. metab. (Online) ; 64(4): 374-382, July-Aug. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1131115

RESUMO

ABSTRACT Objective The aim of the present study was to evaluate whether arterial stiffness is affected in the patients with hypoparathyroidism through pulse wave analysis (PWA). Subjects and methods Sixty-three patients diagnosed with hypoparathyroidism and sixty volunteers were evaluated for the study. When 21 patients were excluded in the hypoparathyroidism group due to exclusion criteria, the research continued with 42 patients and 60 volunteers who are similar to the patients in terms of age, gender and body mass index (BMI). Fasting plasma glucose after 10 hours of fasting, creatinine, thyroid stimulating hormone (TSH), free thyroxine (fT4), albumin, calcium, phosphorus, magnesium, 25-OH vitamin D, parathormone (PTH) and urine calcium results in 24-hour urine for the patients in the hypoparathyroidism group were recorded. Evaluation of arterial stiffness was performed by Mobil-O-Graph 24h PWA device. Results Systolic blood pressure (SBP) (p = 0.01), diastolic blood pressure (DBP) (p = 0.005), mean blood pressure (p = 0.009), central SBP (p = 0.004), central DBP (p = 0.01) and pulse wave velocity (PWV) (p = 0.02) were found higher in the hypoparathyroidism group. A positive correlation was detected between phosphorus level and SBP [(p = 0.03. r = 0.327)], central SBP [(p = 0.04, r = 0.324)] and PWV [(p = 0.003, r = 0.449)]. We detected that age and serum phosphorus levels were independent predictor variables for PWV (B = 0.014, p < 0.001 and B = 0.035, p < 0.001, respectively). Conclusion We detected that hypoparathyroidism causes an increase in blood pressure and arterial stiffness. The most significant determinant factors were detected as advanced age and hyperphosphatemia. The patients diagnosed with hypoparathyroidism should be closely monitored and treatment planning should include to prevent the patients from hyperphosphatemia.


Assuntos
Humanos , Rigidez Vascular , Hipoparatireoidismo , Pressão Sanguínea , Índice de Massa Corporal , Análise de Onda de Pulso
9.
J Med Biochem ; 39(1): 7-12, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-32549771

RESUMO

BACKGROUND: In our study, we aimed to evaluate changes in the neutrophil and lymphocyte series and investigate whether the neutrophil/lymphocyte ratio (NLR) is indicative of inflammations in patients with hyperthyroidism. METHODS: A total of 161 patients were enrolled, 121 of which had hyperthyroidism (71 Graves' Disease (GD) and 50 non-Graves hyperthyroidism (NGH) patients) and 40 of which were control group members. Retrospectively, patients' neutrophil and lymphocyte counts were taken, and the NLR was calculated. RESULTS: While the number of neutrophils was significantly lower in the GD group (p = 0.003), there was no significant difference between the NGH and the control group. In the GD group, NLR values were significantly lower than the other two groups (median 1.39 for GD, median 1.84 for NGH and median 1.83 for the control group, p < 0.001). Only three patients in the GD group had neutropenia. There was also a significant negative correlation between free T3 and neutrophil count and NLR in hyperthyroid patients (r = -0.28, p = 0.001 and r = -0.34, p < 0.001, respectively). CONCLUSIONS: In our study, we found that NLR did not in crease in hyperthyroid patients and that this ratio decreased due to the decrease in neutrophil levels in GD. We thus concluded that NLR is not a suitable indicator of hyperthyroidism.

10.
Arch Endocrinol Metab ; 64(4): 374-382, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32267362

RESUMO

Objective The aim of the present study was to evaluate whether arterial stiffness is affected in the patients with hypoparathyroidism through pulse wave analysis (PWA). Subjects and methods Sixty-three patients diagnosed with hypoparathyroidism and sixty volunteers were evaluated for the study. When 21 patients were excluded in the hypoparathyroidism group due to exclusion criteria, the research continued with 42 patients and 60 volunteers who are similar to the patients in terms of age, gender and body mass index (BMI). Fasting plasma glucose after 10 hours of fasting, creatinine, thyroid stimulating hormone (TSH), free thyroxine (fT4), albumin, calcium, phosphorus, magnesium, 25-OH vitamin D, parathormone (PTH) and urine calcium results in 24-hour urine for the patients in the hypoparathyroidism group were recorded. Evaluation of arterial stiffness was performed by Mobil-O-Graph 24h PWA device. Results Systolic blood pressure (SBP) (p = 0.01), diastolic blood pressure (DBP) (p = 0.005), mean blood pressure (p = 0.009), central SBP (p = 0.004), central DBP (p = 0.01) and pulse wave velocity (PWV) (p = 0.02) were found higher in the hypoparathyroidism group. A positive correlation was detected between phosphorus level and SBP [(p = 0.03. r = 0.327)], central SBP [(p = 0.04, r = 0.324)] and PWV [(p = 0.003, r = 0.449)]. We detected that age and serum phosphorus levels were independent predictor variables for PWV (B = 0.014, p < 0.001 and B = 0.035, p < 0.001, respectively). Conclusion We detected that hypoparathyroidism causes an increase in blood pressure and arterial stiffness. The most significant determinant factors were detected as advanced age and hyperphosphatemia. The patients diagnosed with hypoparathyroidism should be closely monitored and treatment planning should include to prevent the patients from hyperphosphatemia.


Assuntos
Hipoparatireoidismo , Rigidez Vascular , Pressão Sanguínea , Índice de Massa Corporal , Humanos , Análise de Onda de Pulso
11.
Arch. endocrinol. metab. (Online) ; 63(3): 258-264, May-June 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1011162

RESUMO

ABSTRACT Objective The aim of this study is to evaluate and compare arterial stiffness, which is an independent risk indicator for cardiovascular diseases (CVDs), between patients with overt hyperthyroidism, subclinical hyperthyroidism, euthyroidism by antithyroid therapy and healthy volunteers with pulse wave analysis (PWA). Subjects and methods A total of 102 volunteers were included in the study (30 in the overt hyperthyroid group, 28 in the subclinical hyperthyroid group and 14 with euthyroidism by antithyroid therapy and 30 healthy). The arterial stiffness measurements of the participants in the study were performed with the Mobil-O-Graph PWA device (I.E.M. GmBH, Stolberg, Germany), which makes cuff based oscillometric measurement from the brachial artery. Results Systolic blood pressure, pulse rate, central systolic blood pressure, cardiac output, heart rate-corrected augmentation index (Aix@75) and pulse wave velocity (PWV) measurements were significantly higher in the hyperthyroid group than in the control group. The heart rate and PWV in the subclinical hyperthyroid group were significantly higher than the control group. In the euthyroid group, systolic blood pressure, central systolic blood pressure, cardiac output, cardiac index and PWV were found significantly higher than the control group. There was also a negative correlation between Aix@75 and thyroid-stimulating hormone (TSH), and a positive correlation between Aix@75 and free thyroid hormones. Conclusion In our study, we observed that the arterial stiffness was adversely affected by an overt or subclinical increase in thyroid hormones and this correlated with thyroid hormone levels. We recommend that PWV measurement, which is a simple method for detecting CVD risk, can be used in these patients.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Tireotropina/efeitos adversos , Doenças Cardiovasculares/etiologia , Rigidez Vascular/fisiologia , Hipertireoidismo/fisiopatologia , Turquia , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Estudos de Casos e Controles , Fatores de Risco , Análise de Onda de Pulso , Hipertireoidismo/sangue
12.
Arch Endocrinol Metab ; 63(3): 258-264, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31066760

RESUMO

OBJECTIVE: The aim of this study is to evaluate and compare arterial stiffness, which is an independent risk indicator for cardiovascular diseases (CVDs), between patients with overt hyperthyroidism, subclinical hyperthyroidism, euthyroidism by antithyroid therapy and healthy volunteers with pulse wave analysis (PWA). SUBJECTS AND METHODS: A total of 102 volunteers were included in the study (30 in the overt hyperthyroid group, 28 in the subclinical hyperthyroid group and 14 with euthyroidism by antithyroid therapy and 30 healthy). The arterial stiffness measurements of the participants in the study were performed with the Mobil-O-Graph PWA device (I.E.M. GmBH, Stolberg, Germany), which makes cuff based oscillometric measurement from the brachial artery. RESULTS: Systolic blood pressure, pulse rate, central systolic blood pressure, cardiac output, heart rate-corrected augmentation index (Aix@75) and pulse wave velocity (PWV) measurements were significantly higher in the hyperthyroid group than in the control group. The heart rate and PWV in the subclinical hyperthyroid group were significantly higher than the control group. In the euthyroid group, systolic blood pressure, central systolic blood pressure, cardiac output, cardiac index and PWV were found significantly higher than the control group. There was also a negative correlation between Aix@75 and thyroid-stimulating hormone (TSH), and a positive correlation between Aix@75 and free thyroid hormones. CONCLUSION: In our study, we observed that the arterial stiffness was adversely affected by an overt or subclinical increase in thyroid hormones and this correlated with thyroid hormone levels. We recommend that PWV measurement, which is a simple method for detecting CVD risk, can be used in these patients.


Assuntos
Doenças Cardiovasculares/etiologia , Hipertireoidismo/fisiopatologia , Tireotropina/efeitos adversos , Rigidez Vascular/fisiologia , Adulto , Idoso , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Hipertireoidismo/sangue , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Fatores de Risco , Turquia , Adulto Jovem
13.
Endocr Pract ; 24(9): 815-822, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29975581

RESUMO

OBJECTIVE: Nonfunctioning pituitary adenoma (NFPA) accounts for 30% of all pituitary adenomas, and its incidence has been increasing compared to previous years. Increased risk of cardiovascular effects shown in recent studies is noteworthy in patients with NFPA diagnosis, but the number of studies on the subject is limited. In this study, we aimed to assess possible cardiovascular effects and risk via arterial stiffness measurements in patients diagnosed with NFPA. METHODS: We performed arterial stiffness measurements for 30 patients diagnosed with NFPA and 30 healthy volunteers and compared the results to explore the relationship between arterial stiffness parameters, hormone levels, and adenoma size. RESULTS: Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), central SBP, central DBP, augmentation index corrected for a heart rate of 75 beats per minute (AIx@75), and pulse wave velocity (PWV) values of the patients with NFPA diagnosis were significantly higher than the control group. PWV was found to have a significant and negative correlation with growth hormone and insulin-like growth factor 1 (IGF-1). A significant and positive correlation was found between adenoma median short-axis length and PWV. IGF-1 was found to have a significant and negative correlation with adenoma median long- and short-axis length. In multivariate linear regression analysis, we found that IGF-1 was an independent predictor of PWV. CONCLUSION: Both arterial stiffness parameters such as AIx@75 and PWV and peripheral SBP, DBP, and MBP values were found to be high in NFPA patients with no cardiovascular risk factors. Our findings suggest increased cardiovascular effect and risk in patients with NFPA diagnosis, and therefore, we recommend that patients are monitored closely in this respect. ABBREVIATIONS: ACTH = adrenocorticotropic hormone; AIx@75 = augmentation index corrected for a heart rate of 75 beats per minute; BMI = body mass index; CVD = cardiovascular disease; DBP = diastolic blood pressure; FSH = follicle-stimulating hormone; GH = growth hormone; HT = hypertension; IGF-1 = insulin-like growth factor 1; LH = luteinizing hormone; MBP = mean blood pressure; MRI = magnetic resonance imaging; NFPA = nonfunctioning pituitary adenoma; PP = pulse pressure; PWA = pulse wave analysis; PWV = pulse wave velocity; SBP = systolic blood pressure; TSH = thyroid-stimulating hormone.


Assuntos
Adenoma/fisiopatologia , Doenças Cardiovasculares/etiologia , Neoplasias Hipofisárias/fisiopatologia , Rigidez Vascular , Adolescente , Adulto , Estudos Transversais , Feminino , Hormônio do Crescimento Humano/sangue , Humanos , Fator de Crescimento Insulin-Like I/análise , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Fatores de Risco , Adulto Jovem
14.
Endocrine ; 58(3): 513-520, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29043559

RESUMO

PURPOSE: Recently, cardiovascular risk is thought to be increased in patients with nonfunctioning adrenal incidentaloma (NFAI). There are no sufficient studies in the literature to evaluate this situation in NFAI patients without cardiovascular risk. The objective of this study is to compare peripheral and central blood pressure and arterial stiffness between patients with NFAI and healthy volunteers (of a similar age, gender and body mass index as the NFAI group) who have no traditional cardiovascular risk factors and autonomous cortisol secretion, with pulse wave analysis (PWA). METHODS: In this cross-sectional study, we evaluated 35 NFAI patients who have no traditional cardiovascular risk factors and 35 healthy volunteers. PWA was performed in the participants of similar gender, age and body mass index, with a Mobil-O-Graph PWA/ABPM (I.E.M. GmBH, Stolberg, Germany) device. Radiological and biochemical data were obtained retrospectively in the NFAI group. RESULTS: In our study, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), central SBP, central DBP, peripheral vascular resistance, augmentation pressure (AP), heart rate-corrected augmentation index (Aix@75) and pulse wave velocity (PWV) values were significantly higher in the NFAI group compared to the control group. In addition, peripheral and central blood pressure and arterial stiffness parameters were correlated with age and duration of NFAI diagnosis of more than 1 year. CONCLUSIONS: NFAIs are known as cardiometabolically innocent, but in our study, both peripheral and central blood pressure values and arterial stiffness parameters were negatively affected in patients diagnosed with NFAI who have no traditional cardiovascular risk factors. These patients are at risk of cardiovascular diseases.


Assuntos
Neoplasias das Glândulas Suprarrenais/fisiopatologia , Pressão Sanguínea , Rigidez Vascular , Adolescente , Adulto , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Estudos Retrospectivos , Fatores de Risco , Resistência Vascular , Adulto Jovem
16.
Eur J Gastroenterol Hepatol ; 27(7): 769-75, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25919773

RESUMO

BACKGROUND AND AIM: Mercury exposure is encountered most commonly in individuals with amalgam fillings. The toxic, bactericidal, and immunosuppressive effects of mercury are well known. Furthermore, multiple antibiotic resistance can be transferred, together with mercury resistance. The aim of this study was to investigate the frequency of Helicobacter pylori infection in dyspeptic patients with amalgam fillings and the effect of the amalgam fillings on H. pylori eradication rates in these patients. PATIENTS AND METHODS: Four hundred and seventy-five patients who presented with dyspeptic complaints and underwent upper gastrointestinal endoscopy and gastric biopsy were included in this study. One hundred and sixty-nine (35.6%) patients were negative and 306 (64.4%) patients were positive for H. pylori. All of the participants underwent dental examinations in a blinded manner. The participants were divided into two groups on the basis of the presence of amalgam fillings. The H. pylori-positive patients were divided randomly into three subgroups: patients who received concomitant therapy (CT) (rabeprazole-amoxicillin-clarithromycin-metronidazole for 14 days; n=122); patients who received quadruple therapy (QT) (rabeprazole-tetracycline-metronidazole-colloidal bismuth subcitrate for 10 days; n=97); and patients who received levofloxacin-based therapy (LT) (rabeprazole-amoxicillin-levofloxacin for 10 days; n=87). Eradication success was detected by a urea breath test 6 weeks after the end of treatment. RESULTS: The frequency of H. pylori infection was significantly lower in the filling group compared with the nonfilling group (53.7 and 78.8%, respectively; P<0.001). The eradication rates in the CT, QT, and LT groups were 65.5, 67.0, and 58.6%, respectively, in the intention-to-treat (ITT) analysis and 69.6, 70.7, and 62.2%, respectively, in the per-protocol (PP) analysis. In all of the H. pylori-positive patients and separately in the CT and LT groups, the eradication rates were significantly lower in the filling group compared with the nonfilling group. However, in the QT group, there was no significant difference between the patients with and without fillings (P=0.001, 0.003, 0.012, 0.14, respectively). Logistic regression analysis showed that the absence of amalgam filling exerts independent effects on the increased frequency of H. pylori infection and increased rate of H. pylori eradication. CONCLUSION: This is the first study to show a lower frequency of H. pylori colonization in patients with amalgam fillings than without and that H. pylori eradication rates are lower in patients with amalgam fillings compared to those without.


Assuntos
Antibacterianos/uso terapêutico , Amálgama Dentário/efeitos adversos , Restauração Dentária Permanente/efeitos adversos , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Levofloxacino/administração & dosagem , Ureia/metabolismo , Adulto , Amoxicilina/administração & dosagem , Antiulcerosos/administração & dosagem , Testes Respiratórios , Claritromicina/administração & dosagem , Erradicação de Doenças , Quimioterapia Combinada , Feminino , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/patogenicidade , Humanos , Incidência , Masculino , Metronidazol/administração & dosagem , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Estudos Prospectivos , Rabeprazol/administração & dosagem , Tetraciclina/administração & dosagem , Resultado do Tratamento , Turquia/epidemiologia
17.
J Clin Hypertens (Greenwich) ; 16(11): 790-3, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25264297

RESUMO

Arterial hypertension is one of the physical complications of chronic lead exposure. Hypertension has effects on aortic elastic properties. The aim of this study was to evaluate the aortic elastic properties in workers occupationally exposed to lead. Forty-one workers who were exposed to lead and 39 healthy controls were included in the study. All patients underwent transthoracic echocardiography for detecting aortic elastic parameters. There were no differences in baseline characteristics between the lead-exposure group and controls. Aortic strain (9.4% ± 4.5% vs 12.4% ± 4.2%, P = .004) and aortic distensibility (0.45 ± 0.21 cm(2) /dyn vs 0.55 ± 0.20 cm(2) /dyn, P = .046) were decreased in patients with lead exposure compared with controls. There was a negative significant weak correlation between aortic strain and (r = -0.294, P = .008) lead levels. There was no significant correlation between aortic distensibility and any other echocardiographic parameters. This study suggests that chronic exposure to lead is related to impairment of aortic elasticity parameters.


Assuntos
Hipertensão/induzido quimicamente , Chumbo/toxicidade , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Rigidez Vascular , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Ecocardiografia Doppler , Humanos , Hipertensão/diagnóstico por imagem , Chumbo/sangue , Lipídeos/sangue , Masculino , Doenças Profissionais/diagnóstico por imagem
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