Use of Ozone Therapy and Thymoquinone in the Prevention of Formaldehyde Toxicity by Inhalation: An Experimental Study.

INTRODUCTION: The study determined the damage caused by formaldehyde (FA) exposure in blood and liver samples using biochemical markers. Histopathological analysis was performed using the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) method and measurement of CD68 cell density. To what extent the antioxidant molecules thymoquinone (TQ) and ozone (O3) reversed the damage caused by FA exposure was investigated, both when used alone and combined. METHODS: Fifty-six Sprague-Dawley male rats of eight to ten weeks of age were used in the experiment. The rats were divided into eight groups, with seven rats in each group: the untreated control group, the group treated with TQ (10 mg/kg/day), the group treated with O3 (150 µg/kg/day), the group treated with TQ+O3, the group exposed to FA (10 ppm 8 h/day), the group receiving FA+TQ, the group receiving FA+O3, and the group receiving FA+TQ+O3. Serum aspartate transaminase (AST), alanine transaminase (ALT), total antioxidant (TAS, U/mL), and total oxidant (TOS, nmol/mL) levels were analyzed. TAS and TOS levels, CD68 cell density, and apoptotic cells were determined in liver tissues. RESULTS: FA exposure caused an increase in serum AST and ALT levels of (p<0.05) experimental animals, a decrease in TAS levels in serum (p=0.03) and liver (p>0.05) and an increase in TOS levels (p>0.05), TUNEL positivity (p<0.001), and CD68 cell density (p=0.004). Administration of TQ and O3 as antioxidants significantly reversed biochemical and histopathological alterations in the serum and liver. CONCLUSION: TQ and ozone therapy suppressed oxidative stress caused by FA exposure and reversed the emerging histopathological deteriorations. Ozone therapy did not suppress the effects of TQ. Therefore, ozone therapy can be given as a supportive therapy along with the main therapeutic agents. We think TQ and ozone therapy may be useful to protect individuals exposed to FA.

Gensini Score's Severity and Its Relationship with Risk Factors for Coronary Artery Disease Among Patients Who Underwent Angiography in Somalia's Largest PCI Centre.

Aim: Coronary artery diseases (CAD) are chronic disorders in which atherosclerosis plays a major role in their pathogenesis. Their severity is directly related to cardiovascular outcomes. The assessment of Coronary Artery severity is quite complex, in which different parameters are used, such as the gensini score, syntax score, etc. Methods: This was a retrospective study of adult (≥18 years) patients who underwent angiography in Mogadishu Somali Türkiye Training and Research Hospital from June 2022 to September 2023. Gensini scores were calculated to determine the extent and severity of atherosclerosis among patients with coronary artery disease. Results: A total of 278 participants (78% male and 22%% women) were analyzed. Their risk factors were assessed with hypertension being the leading risk factor (48%). While a significant relationship was found between gensini score and dyslipidemia in patients with chronic ischemic heart disease (p 0.035), no significance was found with other risk factors On the other hand, the Gensini score had a significant correlation with the final decision of management (medical, PCI vs CABG). Conclusion: This study indicated that the Gensini score can be used as a guide for CAD decisions.

Comparison of Two Different Positions for Ultrasound-Guided Intervertebral Distance Evaluation.

Objective: During neuraxial anaesthesia, correct patient positioning is key for increased block success and (patient) comfort. The aim of this prospective study was to compare the lateral fetal decubitus (LFD) position with the sitting fetal lotus (SFL) regarding interspinous distance, transverse diameters of paravertebral muscles measured with ultrasonography, and patient comfort. Methods: Fifty adult participants who could sit cross-legged and had no lumbar anomalies were included in our prospective study. In both SFL and LFD positions, measurements were performed with ultrasonography; in the axial plane, interspinous distance at the level of L4-L5, in the sagittal plan, with the probe slightly tilted, subcutaneous tissue-spinous process depth, and transverse diameters of paravertebral muscles were measured. Stretcher, waist position, and abdominal comfort were scored on a scale of 1 (very bad) to 7 (perfect) with a verbal numeric satisfaction scale. Results: Interspinous distance was significantly larger in the SFL position than in the LFD position (P < 0.05). There was no significant difference between the two positions (P > 0.05) regarding patient comfort. Paravertebral muscle diameters were significantly broader in the SFL position than in the LFD position. The diameter of the left paravertebral muscle in the SFL position (45.8±8.8 mm) was larger than that in the LFD position (43±7.8 mm; P < 0.001). The diameter of the right paravertebral muscle in the SFL position was (47±9 mm) larger than that in the LFD position (43.4±7.6 mm; P < 0.001). Conclusion: Although there was no difference regarding the comfort between the two positions, the interspinous distance was larger in the SFL position than in the LFD position.

Relationship of Main Pulmonary Artery (Truncus Pulmonalis) Diameter With Hospital Stay and Mortality in Pulmonary Hypertension Patients Admitted to the Emergency Department.

INTRODUCTION: Pulmonary hypertension (PH) is a haemodynamic and pathophysiological disease significantly associated with morbidity and mortality. The increase in pulmonary vascular resistance, high pulmonary artery pressure and wall tension that occurs in PH results in dilatation of the main pulmonary artery (truncus pulmonalis), one of the largest and most important vessels in the body. The aim of this study is to investigate the relationship between the diameter of the truncus pulmonalis and hospitalization, length of hospital stay, and mortality in patients diagnosed with PH. METHODS: Demographic characteristics, number of Emergency Department (ED) admissions, post-admission status, treatment, truncus pulmonalis diameter, and mortality were evaluated statistically through the patient files of 115 PH patients who presented to the ED of Firat University Faculty of Medicine, Elazig, Türkiye, between January 2022 and December 2022. RESULTS: Of the 115 PH patients who came to the ED, 70 (60.8%) were women and 45 (39.2%) were men, with a mean age of 78.77±8.72 years. Fifty-one of these patients were discharged from the ED after treatment, and 64 were hospitalized. The mean length of hospital stay was two (min=0, max=38) days. Thoracic CT scans demonstrated that the mean diameter of the truncus pulmonalis of the patients was 34.874±3.288 mm (35.20±3.6509 mm in women, 34.367±2.5836 mm in men; p₌0.351) and there was no statistically significant relationship with mortality (p=0.496), hospitalization (p=0.806), and length of hospital stay (p=0.416). There was a statistically significant relationship between mortality rate and male gender (p=0.02) and comorbidity (p=0.001). CONCLUSION: It was determined that there was no statistically significant relationship between the truncus pulmonalis diameter and gender, comorbidity, hospitalization, length of hospital stay, and mortality in this study in which single-centre one-year admissions of PH, which differ in aetiology, epidemiology, and demographic features were examined. However, among the patient demographics, a significant relationship was determined between gender and the number of comorbidities and mortality.

Can the Second and Fourth Finger (2D: 4D) Ratio Guide Physicians in Choosing Internal Medicine or Surgical Branch? / ¿Puede la proporción del Segundo y Cuarto Dedo (2D: 4D) Guiar a los Médicos en la Elección de Medicina Interna o Rama Quirúrgica?

SUMMARY: This study investigates the relationship between the second and fourth finger ratio (2D:4D), physicians' propensity to choose an internal or surgical branch, and sex differences. On a voluntary basis, 177 physicians working in Elazig, 122 men and 55 women were enrolled in the study. Their hands were measured for 2D and 4D lengths, and the 2D:4D ratio was computed. In female doctors, the left hand's 2D:4D ratio is 1.01, compared to the right hand's 1.00. Male doctors' right 2D:4D ratio is 0.99, while their left 2D:4D ratio is 1.00. Male physicians' 2D:4D ratios were different from those of men in the general population, whereas female physicians' 2D:4D ratios were comparable to those of women in the general population. As a result, this study was the first to examine the relationship between the ratio of the second and fourth fingers (2D:4D), physicians' tendency to choose an internal medicine or surgical branch, and sex differences. While the 2D:4D ratio was higher than 0.98 in all physicians, it was low in women who disliked their profession and branch. Since there aren't many studies on this subject, data from in-depth studies that will be conducted in the future will help physicians who choose internal medicine and surgery make more informed decisions.

Este estudio investiga la relación entre la proporción de los dedos segundo y cuarto (2D:4D), la propensión de los médicos a elegir una rama interna o quirúrgica y las diferencias de género. De forma voluntaria, se inscribieron en el estudio 177 médicos que trabajaban en Elazig, 122 hombres y 55 mujeres. Sus manos se midieron en longitudes 2D y 4D, y se calculó la relación 2D:4D. En las médicos mujeres, la relación 2D:4D de la mano izquierda es 1,01, en comparación con 1,00 de la mano derecha. La relación 2D:4D derecha de los médicos hombres fue 0,99, mientras que la relación 2D:4D izquierda fye 1,00. Las proporciones 2D:4D de los médicos hombres fueron diferentes de las de los hombres en la población general, mientras que las proporciones 2D:4D de las mujeres médicas fueron comparables a las de las mujeres en la población general. Como resultado, este estudio fue el primero en examinar la relación entre la proporción del segundo y cuarto dedo (2D:4D), la tendencia de los médicos a elegir una rama de medicina interna o quirúrgica y las diferencias de sexo. Mientras que la relación 2D:4D fue superior a 0,98 en todos los médicos, fue baja en las mujeres que no les gustaba su profesión y rama. Dado que no hay muchos estudios sobre este tema, los datos de estudios en profundidad que se realizarán en el futuro ayudarán a los médicos que eligen medicina interna y cirugía a tomar decisiones más informadas.

Morphometrics of Facies Patellaris Femoris in Dry Bones.

INTRODUCTION: The aim of this study was to investigate the morphological features of the distal femur, with a specific focus on the facies patellaris femoris. METHODS: A total of 45 dry femurs from adult individuals (24 right, 21 left) were used for the study. Measurements were taken using a calibrated digital vernier caliper and a contour gauge. RESULTS: Anteroposterior (AP) measurements were taken for the medial and lateral condyles of the femur, as well as the articular surfaces of the facies patellaris, sulcus height (51.186±3.81mm), trochlear depth (7.436±1.19mm), and trochlear index (2.295±0.06mm). The results showed that the width of the facies patellaris had a significant positive correlation with the trochlear depth and trochlear index. The length of the facies patellaris was positively correlated with the AP length of the medial condyle and sulcus height, although it was not statistically significant. Additionally, there was a statistically significant positive correlation between the length, width, and medial and lateral articular surfaces of the facies patellaris (p<0.005). CONCLUSION: Understanding the relationship between the morphometry of the medial and lateral condyles of the distal femur and the morphometry of the facies patellaris, sulcus height, trochlear depth, and trochlear index and examining the anatomy of the distal femur and patella in individuals are crucial factors for determining appropriate medical treatment and implant selection and compatibility. The findings of this study are expected to contribute to clinicians' interventions in this region (total knee arthroplasty/replacement operation etc.). These data can also be used by implant designers and forensic experts during investigations.

Evaluation of distance and face-to-face anatomy education from the perspective of students during the COVID-19 pandemic period / Evaluación de la educación anatomía a distancia y presencial desde la perspectiva de los estudiantes durante el período de pandemia del COVID-19

SUMMARY: During the COVID-19 pandemic, a questionnaire was administered to the students who took anatomy courses through distance education in the Faculties of Medicine and Dentistry. Through the questionnaire, the aim was to figure out whether the infrastructure of Firat University was ready and adequate for distance education, how efficient the distance theoretical and practical anatomy classes were, and in what proportions the students would prefer to take face-to-face and distance anatomy classes when the pandemic is over. A questionnaire of 35 questions was applied to 555 students studying at the Medicine and Dentistry Faculties of Firat University. The students widely accepted the opinion that Firat University successfully implemented the distance education system, and distance education offered the opportunity to receive the lessons repeatedly regardless of time and place. In addition, it has been determined as a common opinion that anatomy classes given via distance education were equally beneficial as face-to-face education in terms of duration, content, and efficiency. Despite these advantages, the lack of face-to-face interaction and weak information permanence were reported as the negative aspects of distance education. The students emphasized that applied anatomy classes and especially cadaver studies should be conducted face to face. Anatomy education is quite substantial in the acquisition and development of professional skills. It is considered that distance anatomy education will be inadequate to provide this gain. The high demand for face-to-face practical classes by students also backs this up.

Durante la pandemia de COVID-19, se administró un cuestionario a los estudiantes que cursaban asignaturas de anatomía a distancia en las Facultades de Medicina y Odontología. A través del cuestionario, se pretendía conocer si la infraestructura de la Universidad de Firat estaba preparada y era adecuada para la educación a distancia, ¿qué tan eficientes eran las clases teóricas y prácticas de anatomía a distancia? y ¿en qué proporciones los estudiantes preferirían tomar clases presenciales? y clases de anatomía a distancia cuando termine la pandemia. Se aplicó un cuestionario de 35 preguntas a 555 estudiantes de las Facultades de Medicina y Odontología de la Universidad de Firat. Los estudiantes aceptaron ampliamente la opinión de que la Universidad de Firat implementó con éxito el sistema de educación a distancia, y la esta manera de enseñar ofreció la oportunidad de recibir lecciones repetidamente, independientemente de la hora y el lugar. Además, se ha determinado como opinión común que las clases de anatomía impartidas a distancia fueron igualmente beneficiosas que las presenciales en términos de duración, contenido y eficiencia. A pesar de estas ventajas, la falta de interacción cara a cara y la débil permanencia de la información fueron reportadas como los aspectos negativos de la educación a distancia. Los estudiantes enfatizaron que las clases de anatomía aplicada y en especial los estudios de cadáver deben ser presenciales. La educación en anatomía es bastante sustancial en la adquisición y desarrollo de habilidades profesionales. Se considera que la educación anatómica a distancia será inadecuada para proporcionar esta ganancia. La alta demanda de clases prácticas presenciales por parte de los estudiantes también lo avala.

Endothelial dysfunction in patients with acromegaly and It's association with Endocan.

OBJECTIVE: This study aims to assess endocan levels in patients with acromegaly who have active disease or disease in remission and to investigate a relation between endocan levels and endothelial dysfunction in these patients. DESIGN: The study is a case-control study. Study was conducted at Istanbul Medeniyet University Goztepe Training and Research Hospital between 2013 and 2019. Patients who were older than 18 years with acromegaly diagnosis were recruited if they agreed to participate. Patients with uncontrolled diabetes (DM), hypertension (HT), hyperlipidemia, decompensated heart failure, immune or infectious diseases, moderate-severe valve disease and stage 3 or more advanced chronic kidney disease were excluded. There were 30 healthy control subjects who agreed to participate to the study. Patients with acromegaly were divided into two groups as: disease active patients and patients in remission. Serum endocan levels were measured with enzyme linked immunosorbent assay (ELISA) method endothelial function was assessed with flow mediated dilatation (FMD). RESULTS: There were 85 patients included to the study. Twenty-three patients had active disease, 31 were in remission and 31 were healthy controls. FMD was higher in controls compared to patients in active disease and patients in remission (p < 0.001). There was no difference between patients with active disease for FMD and patients in remission (p = 0.088). There was statistically significant correlation between FMD and endocan and insulin like growth hormone-1 (IGF-1) levels of patients with acromegaly. As FMD increased endocan and IGF-1 decreased. A moderate negative relation between FMD and endocan was identified (p < 0.001, r:-0.409) as well as FMD and IGF-1 levels (p:0.011, r:-0.377). Along with endocan and IGF-1, DM, HT, sex, body mass index, age and uric acid were associated with changes in FMD. CONCLUSIONS: Endocan levels and endothelial function measured with FMD have an inverse relationship. Endocan may prove to be a marker for endothelial dysfunction in acromegaly.

Investigation of Bosentan's Effects on Pulmonary Contusion Created by Blunt Thoracic Trauma in Rats.

INTRODUCTION: Bosentan is an endothelin-1 receptor antagonist with anti-inflammatory, antioxidant, and antiproliferative effects. We aimed to evaluate its effects on lung tissue in a pulmonary contusion (PC) model. MATERIALS AND METHODS: The rats were randomly divided into five groups: PC3: PC evaluated on the 3rd day (n = 8), PC-B3: PC enteral bosentan 100 mg/kg/day, for 3 days (n = 8), PC7: PC evaluated on the 7th day (n = 7), PC-B7: PC 7 days bosentan 100 mg/kg/day, for 7 days (n = 8), C: control (n = 6). Unilateral lung contusion was created by dropping a metal weight onto the chest. The rats were sacrificed on the 3rd or the 7th days. The lung tissue was evaluated histopathologically for alveolar edema, congestion, and leukocyte infiltration, biochemically for malondialdehyde (MDA), superoxide dismutase (SOD), and nitric oxide (NO) levels, and immunohistochemically for inducible nitric oxide synthase (iNOS), endothelial nitric oxide synthase (eNOS), and apoptosis scores. RESULTS: Alveolar edema, congestion, and leukocyte infiltration scores were increased in all groups compared with the control group (p < 0.05) and decreased in bosentan-treated groups compared with the relevant nontreated groups (p < 0.05). Fibrosis was observed only in PC7 and PC-B7 groups. Bosentan did not have any effect on fibrosis development. iNOS and eNOS levels were higher in all groups compared with the control (p < 0.05) without a difference in the nontreated versus treated groups (p > 0.05). Bosentan treatment caused decreased MDA and increased SOD levels in comparison to the nontreated groups (p < 0.05). Tissue NO levels did not show any significant difference among groups. PC groups had higher levels of apoptosis compared with the control group (p < 0.05). The degree of apoptosis decreased in bosentan-treated groups compared with the nontreated groups (p < 0.05). CONCLUSION: PC causes progressive lung tissue damage. Bosentan reduced leukocyte infiltration and alveolar edema and congestion caused by PC. It also decreased MDA levels and increased SOD levels. Bosentan prevents tissue damage by inhibiting acute inflammatory response and reduces oxidative stress secondary to inflammation. It has therapeutic effects on apoptosis.

Morning blood pressure surge is associated with carotid intima-media thickness in prehypertensive patients.

OBJECTIVE: Morning blood pressure (BP) surge (MBPS) is defined as an excessive increase in the morning BP from the lowest systolic BP during sleep and is reported as a risk factor for cardiovascular events in current clinical studies. In this study, we aimed to investigate the relationship between MBPS and carotid intima-media thickness (C-IMT) in prehypertensive patients. PATIENTS AND METHODS: We evaluated the association between the rate of BP variation derived from ambulatory BP monitoring and C-IMT in patients with prehypertension. RESULTS: One hundred and seventy patients with prehypertension were included in the study. All office BP measurements and ambulatory 24-h, day-time, and night-time measurements were similar between each group. C-IMT [0.60 (range: 0.57-0.65) vs. 0.55 (range: 0.50-0.60) cm; P<0.001] and the mean platelet volume [8.7 (range: 7.9-9.1) vs. 7.9 (range: 7.3-8.8) fl; P=0.002] were significantly higher in the greater MBPS group than the lower group. In multivariate analysis, male sex [odds ratio (OR): 2.271, confidence interval (CI): 1.011-5.100, P=0.047], greater MBPS (OR: 8.474, CI: 3.623-19.608, P<0.001), and elevated mean platelet volume levels (OR: 3.359, CI: 1.978-5.705, P<0.001) were found to be independent predictors of greater C-IMT in prehypertensive patients. CONCLUSION: Our study suggests that greater MBPS is associated independently with C-IMT in prehypertensive patients.

Chemerin as a marker of subclinical cardiac involvement in psoriatic patients.

BACKGROUND: Chemerin has been associated with psoriasis and inflammation, but there are no studies demonstrating an association between chemerin and subclinical cardiac involvement in psoriatic patients. Therefore, the present study aimed to evaluate whether psoriatic patients with increased epicardial fat tissue, impaired flow-mediated dilatation, and diastolic dysfunction have higher serum chemerin levels than a healthy control group. METHODS: The study included 60 psoriatic patients and 32 healthy controls. Echocardiographic parameters, epicardial fat tissue, flow-mediated dilatation, and chemerin levels were recorded for both groups. RESULTS: The serum levels of chemerin in the psoriatic patients were significantly higher than in the control group. The diastolic function parameters, including isovolumic contraction and relaxation time, E'/A' (early diastolic mitral annular velocity/late diastolic mitral annular velocity), and E/E' (early diastolic peak velocity of mitral inflow/early diastolic mitral annular velocity) values, differed significantly between the groups. Epicardial fat tissue was significantly higher and flow-mediated dilatation was significantly lower in psoriatic patients than in the controls. Chemerin was significantly positively correlated with age, body mass index, systolic and diastolic blood pressures, waist circumference, E/E', and epicardial fat tissue. Serum chemerin was significantly negatively correlated with E', E'/A', and flow-mediated dilatation. A multiple linear regression analysis showed that chemerin was independently correlated with E/E'. CONCLUSIONS: Psoriatic patients exhibit early subclinical atherosclerosis and diastolic dysfunction. Chemerin can be used as a marker to screen for patients with subclinical cardiac involvement.

Is activation in inflammatory bowel diseases associated with further impairment of coronary microcirculation?

BACKGROUND: Inflammatory bowel disease [IBD] includes a number of chronic relapsing diseases. In IBD intestinal microvascular endothelial cells are damaged by an abnormal immune response. Several studies have shown that IBD may cause increment in risk of developing atherosclerosis. IBD in activation was related to enhanced risks of worse cardiovascular [CV] outcome, on the other hand no risk increment was seen in remission comparing to control group in those studies. Coronary Flow Reserve [CFR] reflects coronary microvascular circulation. Coronary microvascular dysfunction may be defined as a predictor of CV outcome combined with previous described atherosclerotic risk factors. The present study was purposed to further evaluate whether or not CFR in the left anterior descending artery [LAD] is disturbed in IBD patients with activation in comparison to remission and healthy subjects. METHODS: 62 patients with IBD and 39 healthy volunteers were enrolled into the study. Patients' demographics were recorded. CFR evaluation of patients with IBD in both activation and remission period and control group were performed with transthoracic echocardiography. RESULTS: CFR was significantly lowest in the active period of the IBD [2.26 [2.08-2.55] vs. 2.55 [2.18-3.00] and 3.10 [2.85-3.29] p<0.001]. CFR is negatively correlated with disease activity scores of IBD. CONCLUSION: This study showed that CFR is more prominently disturbed in patients with IBD in activation. The activation of disease may have a major role in the progression of coronary microcirculatory dysfunction and future cardiovascular events.

Imparied retrobulbar blood flow and increased carotid IMT in patients with Crohn's disease.

Crohn's Disease [CD] is one of the Inflammatory Bowel Diseases that are chronic relapsing inflammatory diseases. Despite the major affected organ is intestine in CD, extra intestinal organs and tissues including cardiovascular system are also affected. Several studies have demonstrated that CD patients may have a higher risk of advancing atherosclerosis. The microvascular endothelial dysfunction plays an essential role for developing coronary atherosclerosis. Microvascular structural abnormalities in the retinal circulation may predict macrovascular events such as stroke and coronary heart disease. In order to assess the the microvascular circulation of the retina; retrobulbar blood flow velocities and resisitive indices [RI] of retrobulbar arteries are measured. The carotid intima media thickness [CIMT] correlates strongly with CV risk in the future. We aimed to investigate whether calculation of RI of retrobulbar arteries can be used as novel, easy and reproducible method to define atherosclerotic risk in CD patients along with CIMT. Thirty CD patients with remission period and thirty healthy volunteers were enrolled in the study. Measurement of carotid intima-media thickness and retrobulbar blood flow velocities were obtained with ultrasound scanner and colour Doppler ultrasonography. The RI of the OA [0.77 ± 0.06 vs. 0.65 ± 0.06, p < 0.001] and CIMT 0.52 [0.50-0.60] vs. 0.40 [0.40-0.50] in patients with CD was significantly higher than the control group. Increased OARI and CIMT values may reflect an increased risk of atherosclerosis and OARI measurement may be used as a screening test for microvascular circulation evaluation in patients with CD.

Evaluation of Cardiovascular Risk Factors, Haematological and Biochemical Parameters, and Serum Endocan Levels in Patients with Lichen Planus.

BACKGROUND AND OBJECTIVE: The current study aimed to evaluate cardiovascular risk factors, haematological and biochemical parameters, and serum endocan concentrations in lichen planus (LP) patients. METHODS: This study was conducted with 86 cases, including 43 LP patients and 43 healthy controls. Cardiovascular risk factors, haematological and biochemical parameters, and endocan levels were evaluated. RESULTS: The serum endocan concentrations of LP patients were not significantly different from those of the healthy controls (p > 0.05). There were no significant differences in the serum endocan levels according to classification by cardiovascular risk factors and smoking history (p > 0.05). In the LP group, white blood cell count, platelet distribution width and monocyte count/high-density lipoprotein cholesterol ratios were significantly higher when compared to the healthy controls (p < 0.05). The LP group had a lower mean platelet volume than the healthy controls (p < 0.05). CONCLUSIONS: Serum endocan levels did not change significantly in patients with LP, and there were significant differences in haematological and biochemical parameters.

Is the presence of AA amyloidosis associated with impaired coronary flow reserve?

BACKGROUND AND AIMS: Systemic amyloid A protein (AA) amyloidosis may occur as a complication of many chronic inflammatory disorders. Patients receiving inadequate anti-inflammatory and immunosuppressive therapies have an increased risk of developing systemic AA amyloidosis. Inflammation plays a role in all stages and the thrombotic complications of atherosclerosis. In the absence of epicardial coronary stenosis, coronary flow reserve (CFR) reflects coronary microvascular dysfunction. In the present study, we hypothesized that amyloid advanced subclinical inflammation in chronic inflammatory diseases (CID) patients may further affect coronary microcirculation. METHODS: Thirty-two patients with biopsy-diagnosed renal AA, 73 patients with non-amyloid CID, and a group of healthy volunteers were included in the study. The measurements of coronary flow velocity were performed by a single investigator with expertise in transthoracic Doppler harmonic echocardiography (TTDE). RESULTS: The AA amyloidosis subgroup had significantly lower CFR values than other non-amyloid CID patients and the control individuals (1.8 (1.5-2.1) vs. 2.1 (2.0-2.4) and 3.0 (2.8-3.2), p < 0.001). Multivariate logistic regression analysis indicated that the presence of AA amyloidosis and elevated hs - CRP independently predict impairment of the CFR (p < 0.05). CONCLUSIONS: The presence of AA amyloidosis is related to decreased CFR values and the presence of AA amyloidosis and elevated hs - CRP independently predict impairment of the CFR. Therefore, patients with AA amyloidosis may have an increased risk of developing coronary artery diseases.

The Influence of On-pump Versus Off-pump Surgery on Short- and Medium-term Postoperative Coronary Flow Reserve After Coronary Artery Bypass Grafting.

BACKGROUND: Although several clinical trials have compared surgical outcomes between off-pump and on-pump coronary artery bypass grafting (CABG), whether there is a difference in the early- and medium-term postoperative coronary microvascular functions is not fully understood. We compared short- and medium-term coronary microvascular function after off-pump and on-pump CABG. METHODS: A prospective study of patients undergoing off-pump and on-pump CABG. Eighty-two patients scheduled for CABG were recruited: 38 underwent off-pump surgery and 44 on-pump surgery. Each participant's coronary flow reserve (CFR) and diastolic function were measured with transthoracic Doppler echocardiography six and 12 months after surgery. RESULTS: Baseline and hyperaemic diastolic peak flow velocity in the left anterior descending artery were similar in both groups, as was CFR (2.22±0.66) in the off-pump group compared with (2.13±0.61) in the on-pump group, (P=0.54). Coronary flow reserve was significantly and inversely correlated with high sensitivity C-reactive protein concentration (r=-0.416; P<0.001) and positively correlated with mitral E/A-wave velocity ratio (r=0.247; P=0.02). Stepwise linear regression analysis revealed that only high sensitivity C-reactive protein concentration was independently correlated with CFR (ß=-0.272, P=0.02). CONCLUSIONS: Heart-lung bypass technique had no medium-term influence on the coronary microcirculation, despite a possible initial unfavourable effect. Serum hs-CRP concentration was an independent predictor of medium-term coronary microvascular dysfunction.

Antioxidant and renoprotective effects of sphingosylphosphorylcholine on contrast-induced nephropathy in rats.

Contrast induced nephropathy (CIN) is a major cause of morbidity, and increased costs as well as an increased risk of death. This study was evaluated effects of exogenous sphingosylphosphorylcholine (SPC) administration on CIN in rats. Eight animals were included in each of the following eight groups: control, control phosphate-buffered solution (PBS), control SPC 2, control SPC 10, CIN, CIN PBS, CIN SPC 2 and CIN SPC 10. The induced nephropathy was created by injected with 4 g iodine/kg body weight. SPC was administered 3 d at a daily two different doses of 2 µm/mL and 10 µm/mL intraperitoneally. The severity of renal injury score was determined by the histological and immunohistochemical changes in the kidney. Malondialdehyde (MDA), nitric oxide (NO) and superoxide dismutase (SOD) were determined to evaluate the oxidative status in the renal tissue. Treatment with 2 and 10 µM SPC inhibited the increase in renal MDA, NO levels significantly and also attenuated the depletion of SOD in the renal injuryCIN. These data were supported by histopathological findings. The inducible nitric oxide synthase positive cells and apoptotic cells in the renal tissue were observed to be reduced with the 2 and 10 µM SPC treatment. These findings suggested that 2 and 10 µM doses can attenuate renal damage in contrast nephropathy by prevention of oxidative stress and apoptosis. The low and high dose SPC may be a promising new therapeutic agent for CIN.

Does Lichen Planus Cause Increased Carotid Intima-Media Thickness and Impaired Endothelial Function?

BACKGROUND: Lichen planus (LP) has been associated with cardiovascular disease (CVD) risk factors, but there are no studies on the association between LP and subclinical atherosclerosis. We investigated the presence of subclinical atherosclerosis in patients with LP not known to have CVD using carotid intima-media thickness (CIMT) and flow-mediated dilatation (FMD). METHODS: The study included 30 patients with LP and 30 controls. High-resolution ultrasonography was used to assess CIMT and FMD. Participants' biochemical parameters, body mass index (BMI), and waist circumference were recorded in both groups. RESULTS: FMD was significantly lower (7.45% ± 3.63% vs 11.01% ± 5.34%; P = 0.004) and CIMT was higher (0.8 mm [range, 0.7-0.9 mm] vs 0.6 mm [0.4-0.6 mm]; P < 0.001) in the LP group compared with the control group. After adjustment for age, sex, BMI, high-density lipoprotein cholesterol levels, and C-reactive protein levels, the presence of LP was associated with impairment of FMD (ß = -0.441; 95% CI, -9.336 to -0.321; P = 0.037) and an increase in CIMT (ß = 0.459; 95% CI, 0.057 to -0.351; P = 0.008). CONCLUSIONS: Reduced FMD and increased CIMT levels are sensitive indicators of target-organ damage and display increased risk for cardiovascular morbidity and mortality. Our study found that patients with LP showed a tendency toward impaired levels of FMD and increased CIMT. LP may be a novel predictor of early vascular dysfunction and structural changes.

Is Low Serum Klotho Level Associated with Alterations in Coronary Flow Reserve?

BACKGROUND: The Klotho gene, described as an "aging suppressor" gene, encodes a single-pass transmembrane protein. The extracellular part of Klotho is cleaved and released into the circulation where it may function as a vasculoprotective hormone. Coronary flow reserve (CFR) is accepted as a marker of coronary microvascular dysfunction when epicardial coronary stenosis is absent. There are no data regarding the relationship between serum Klotho levels and disorders in coronary microcirculation in healthy adults. We aimed to investigate the association between serum Klotho levels and alterations in coronary microcirculation in healthy adults using echocardiographic measurements of CFR. METHODS: Thirty-four healthy volunteers (median age: 34 [27-39], 14 males) were enrolled in this study. The study population was divided into two subgroups according to the median value of serum Klotho levels: a high Klotho (HK) group (n = 17, median age: 34 [30-38]; 6 males) and a low Klotho (LK) group (n = 17, median age: 32 [26-39]; 8 males). The analysis of coronary flow velocities was performed by transthoracic Doppler echocardiography. RESULTS: Hyperemic diastolic peak flow velocities and CFR were significantly higher in the HK group than in the LK group (70 [66-92] versus 61 [47-66], P = 0.003 and 3.0 [2.6-3.8] versus 2.2 [1.7-2.8], respectively, P = 0.001). Serum Klotho levels were positively correlated with CFR (P < 0.001). CONCLUSION: Serum Klotho levels correlate with CFR in a healthy population. Low serum Klotho levels may potentially identify patients with impaired CFR.

Is triglyceride/HDL ratio a reliable screening test for assessment of atherosclerotic risk in patients with chronic inflammatory disease?

OBJECTIVE: The term chronic inflammatory disease (CID) refers to a category of inflammatory diseases that includes Ankylosing spondylitis (AS) and familial Mediterranean fever (FMF). The incidence of adverse cardiovascular events is greater among patients with CID, though they may not have conventional atherosclerotic risk factors. Endothelial dysfunction is one of the underlying fundamental mechanisms that trigger development of atherosclerotic alterations in arteries, and flow-mediated dilatation (FMD) is a noninvasive method to determine endothelial dysfunction. Recent studies have shown a relationship between high triglyceride high-density lipoprotein cholesterol (TG/HDL-C) ratio and coronary atherosclerosis. Many studies have demonstrated that patients with CID have lower FMD values compared to healthy population, indicating endothelial dysfunction. However TG/HDL ratio and its relationship to FMD in patients with CID has not been investigated. The present study investigated whether TG/HDL ratio in CID patients differs from that of healthy population, and its relationship to FMD in patients with CID. METHODS: A total of 58 patients with CID and a group of 58 healthy volunteer individuals were enrolled in the study. FMD measurements were taken with high resolution ultrasound (US), and TG/HDL ratios were calculated. RESULTS: Patients with CID had significantly higher TG/HDL-C ratio (2.5 [2.2-2.8] vs 2.3 [2.1-2.5]; p=0.03) and lower FMD values (5.2 [4.2-6.3] vs 6.7 [6.3-9.7]; p<0.001), compared to healthy group, and a negative correlation was found between FMD levels and TG/HDL ratio of the study population. CONCLUSION: Higher TG/HDL ratio and lower FMD values found in CID patients may reflect increased atherosclerotic risk.