Akif Acay

Atherogenic index as a predictor of atherosclerosis in subjects with familial Mediterranean fever

BACKGROUND AND OBJECTIVE Numerous inflammatory and innate immune pathways are involved in atherogenesis. We aimed to investigate the atherogenic index and other lipid parameters in individuals with familial Mediterranean fever (FMF), as a predictor of atherosclerosis. MATERIALS AND METHODS A total of 60 patients with FMF and 60 healthy age- and sex-matched controls were included in this study. The patients with acute infection, chronic metabolic and rheumatic diseases, use of drugs other than colchicine and smoking history were excluded. CRP, ESR, total cholesterol, triglycerides, LDL-C, and HDL-C levels of patients and the control group were measured. Atherogenic index (TG/HDL-C) was calculated. RESULTS We found that the atherogenic index values of the patients were significantly higher than those of the control group. HDL-C levels were lower and ESR and TG levels were higher in patients. Total cholesterol, LDL-C and CRP levels did not differ significantly between the two groups. There was no significant difference in the values of total cholesterol, LDL-C, triglycerides (TG), HDL-C, and atherogenic indexes between the groups of patients with and without M694V mutation. CONCLUSIONS Elaboration of clinical models of inflammation-induced atherogenesis may further advance our knowledge of multiple inflammatory pathways implicated in atherogenesis and provide a useful tool for cardiovascular prevention. We believe that the atherogenic index also be used as a preliminary indication of accelerated atherosclerosis in FMF. However, large-scale prospective studies on this issue are needed.

Assessment of Thyroid Disorders and Autoimmunity in Patients with Rheumatic Diseases

We investigated whether there was a significant increase in thyroid autoimmunity, and disorders in patients with rheumatic diseases (RDs). We enrolled 201 patients with RDs (41 with ankylosing spondylitis, 15 with systemic lupus erythematosus, 80 with rheumatoid arthritis [RA], 65 with familial Mediterranean fever), and 122 healthy controls. Serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), C-reactive protein, and thyroid autoantibodies (anti-thyroglobulin and anti-thyroid peroxidase) were measured in all participants. There were no significant differences between the ages of the patients and controls. The mean TSH values of the patients with RDs and the controls were 3.1 ± 2.68 mIU/L and 1.9 ± 0.83 mIU/L, respectively (P = 0.004). The mean fT4 value of the patients with RDs was 1.43 ± 0.67 ng/dL whereas that of the controls was 1.58 ± 0.68 ng/dL (P <0.001). Subclinical hypothyroidism was detected in 24 patients with RDs. Thyroid antibodies were detected in 16 of 201 (8%) patients with RDs. Three of these patients had subclinical hypothyroidism, while the others were euthyroid. Thyroid autoantibodies were significantly higher in patients with RDs (P <0.001). Additionally, thyroid disorders were observed more frequently in patients with RDs than in the healthy controls. Based on our findings, we recommend that thyroid function tests should better be included in the clinical evaluation of patients with RDs.

Assessment of the Frequency of Autoantibodies in Chronic Viral Hepatitis.

Objective: To examine the occurrence frequency of auto-antibodies and autoimmune diseases in patients with chronic hepatitis B or C. Methods: A total of 67 patients diagnosed with chronic hepatitis B and 77 patients diagnosed with chronic hepatitis C infection based on HBs Ag, Anti HCV, HBe Ag, Anti HBe Ag, HBV DNA, HCV RNA, liver ultrasound, and liver biopsy results as well as 48 healthy individuals were included in this study. ANA, anti dsDNA, anti LKM, Anti-SMA, AMA, C-ANCA, P-ANCA, anti-SSA, anti-SSB, anti-Scl-70, anti Jo-1, anti-U1snRNP, anti-centromere, anti-Jo-1, anti tpo, and anti tg were studied in all individuals in each study group. Results: ANA positivity was detected in 8 (12%), 15 (19%) and 2 (4%) individuals in HBV, HCV and control groups, respectively. The difference between the groups was significant (P=0.04). Similarly, anti Tg was positive in one subject in HBV group, in 6 subjects (7%) in HCV group, and in one subject among controls, the difference being significant (P=0.04). There were no significant differences between the study groups in the frequency of other auto-antibodies. Conclusion: Similar to studies involving patients who received interferon and/or antiviral agents, an increased frequency of auto-antibodies was also detected in our patient group consisting of interferon and anti-viral naive subjects. The increase in the frequency of auto-antibodies reached statistical significance among individuals with HCV infection. Thus, pre-treatment assessment of auto-antibodies in newly diagnosed cases of chronic hepatitis B or hepatitis C infection may provide beneficial information on the future occurrence of auto-immune responses in these patients.

New Predictor of Atherosclerosis in Subjects With COPD: Atherogenic Indices

BACKGROUND: We aimed to investigate the predictor role of the plasma levels of lipid parameters and atherogenic indices on development of atherosclerosis in subjects with COPD. METHODS: We retrospectively analyzed 104 male subjects diagnosed with stable COPD in hospital records. We excluded subjects with exacerbation, with known cardiovascular diseases and other chronic diseases, receiving anti-hyperlipidemic treatment, without sufficient past medical history, and lacking needed laboratory data. Additionally, 40 age-matched male healthy controls were also enrolled. C-reactive protein, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels of COPD and the control group were analyzed. Atherogenic indices (atherogenic index of plasma, cardiogenic risk ratio, and atherogenic coefficient) were calculated. RESULTS: C-reactive protein, triglyceride, atherogenic index of plasma, cardiogenic risk ratio, and atherogenic coefficient values were significantly higher in subjects with stable COPD than in control subjects (P < .05 for all). High-density lipoprotein cholesterol level was significantly lower in subjects with COPD than in the control group (P < .001). C-reactive protein, lipid profiles, and atherogenic indices were similar in lower-risk (stage A and B) and higher-risk (stage C and D) subjects with COPD. Cardiogenic risk ratio and atherogenic coefficient were negatively correlated with FEV1 in all stable subjects with COPD and in higher-risk subjects with COPD (r = −0.27, P = .01 and r = −0.35, P = .01, respectively). CONCLUSIONS: We concluded that atherogenic indices (atherogenic index of plasma, cardiogenic risk ratio, atherogenic coefficient) could be considered as a useful predictor for atherosclerosis and cardiovascular diseases in stable COPD patients. Nevertheless, further prospective investigations on this issue are warranted.

Anterior Mediasten Yerleşimli Ektopik Paratiroid Adenomuna Bağlı Primer Hiperparatiroidizm Olgusu

Amac: Paratiroid adenomlarinin %5-10’u ektopik yerlesimlidir ve sirasiyla %95’i timus icinde, % 5’i ise mediastende lokalizedir. Burada, primer hiperparatiroidi klinigi ile basvurmus on mediasten yerlesimli ektopik paratiroid adenomu olan bir olguyu sunmayi amacladik. Olgu: Kirkalti yasinda kadin hastanin yapilan kan tetkiklerinde, kalsiyum: 11,6 mg/dl (8.5-11.0), fosfor: 1,4 mg/dl (2.8-5.0), 25-OH D Vitamin duzeyi 4,5 ng/ml, Parathormon: 696 pg/ml (12-72) saptandi. Ayrica, hastaya cekilen paratiorid sintigrafisinde; on mediasten orta hatta paratiroid adenomuyla uyumlu yogun patolojik aktivite tutulumu ve cekilen toraks BTsinde ayni lokalizasyonda 28x20 mm boyutlarinda ektopik paratiroid adenomu tespit edildi. Tedavi olarak video endoskopik yontemle paratiroid adenomunun lokalizasyonu tespit edilip, adenom sternum disina timus ile birlikte cikarildi (Ektopik paratiroidektomi ve timektomi). Sonuc: Paratiroid adenomlarinda cerrahi en etkili tedavi secenegidir ve nadir de olsa glandlarin ektopik yerlesebilecegi goz ardi edilmemelidir. Cerrahi basari ise buyuk oranda bezin lokalizasyonunun preoperatif belirlenmesine baglidir.

Platelet values measurement. What we know about it

1 In this paragraph, the authors should have specified which blood samples were collected in which collecting tube (this is achieved with either ethylenediaminetetraacetic acid [EDTA] or sodium citrate as standard substances-EDTA cause more swelling on platelets than sodium citrate; e.g. Na-EDTA as an anticoagulant results in less pronounced swelling than K-EDTA). 2 At this point, platelets undergo swelling when stored in EDTA and, to a lesser extent, in citrate-containing solutions. This makes determination of MPV timedependent. Over time, platelet swelling can increase the measured volume by an additional 20–25%. Suggestions for using time-dependent reference ranges or alternative anticoagulants for MPV determination have been made to resolve this issue. But the authors did not specify the study time of MPV. 3 There are four different principles of platelet counting and MPV measurement: (i) manual counting by phase contrast microscopy; (ii) impedance counting; (iii) optical light scatter counting; and (iv) immunological flow cytometry techniques.