Banu Kale Köroğlu

Pro‐inflammatory cytokine levels in association between periodontal disease and hyperlipidaemia

AIM The aim of this study was to evaluate serum and gingival crevicular fluid (GCF) pro-inflammatory cytokine levels in association between periodontal disease and hyperlipidaemia. MATERIAL AND METHODS One hundred and twenty-three subjects with hyperlipidaemia and 68 systemically healthy controls (C) were included in the study. Hyperlipidaemic groups were divided into two groups as suggested diet (HD) and prescribed statin (HS). Both groups were divided into three subgroups as healthy (h), gingivitis (g) and periodontitis (p). The clinical periodontal parameters, fasting venous blood and GCF samples were obtained, and serum tumour necrosis factor-alpha (TNF-α), interleukin (IL)-1β (IL-1β) and IL-6 levels were evaluated. RESULTS The ratio of total cholesterol to high-density lipoprotein (TC/HDL) was associated with gingival index and percentage of bleeding on probing (BOP%) in both hyperlipidaemic groups. In HS group, GCF and serum IL-6 were positively correlated with BOP% and TC/HDL. GCF TNF-α was positively associated with probing pocket depth and clinical attachment level, whereas serum TNF-α was associated with BOP% in the HD group. Serum and GCF TNF-α and IL-1β were significantly associated with TC/HDL in the HD group. CONCLUSIONS Serum pro-inflammatory cytokines may play an important role in the association between periodontal disease and hyperlipidaemia.

Dietary vitamin C and E modulates oxidative stress induced-kidney and lens injury in diabetic aged male rats through modulating glucose homeostasis and antioxidant systems.

Diabetes induces oxidative stress in aged human and rat, although daily supplementation of vitamins C and E (VCE) can be beneficial to aged diabetic rats by reducing free radical production. The aim of the present study was to evaluate whether dietary VCE supplementation relieves oxidative stress in streptozotocin (STZ)‐induced diabetic in aged rats. Thirty aged rats were randomly divided into three groups. The first group was used as a control. The second group was made diabetic using a single dose of intraperitoneal STZ. VCE‐supplemented feed was given to aged diabetic rats constituting the third group. On the 21st day of the experiment, blood, lens and kidney samples were taken from all animals. Glutathione peroxidase (GSH‐Px) activity in lens and kidney, reduced glutathione (GSH), vitamin E and β‐carotene concentrations in kidney were lower in the diabetic group than in the control whereas plasma glucose, urea and creatinine, and kidney and lens peroxidation (LP) levels were higher in the diabetic group than in the control. However, kidney and lens LP levels, and plasma glucose, urea and creatinine values were decreased by VCE supplementation. Lens and kidney GSH‐Px activity, kidney GSH, vitamin E and β‐carotene concentrations and erythrocyte counts were increased by VCE treatment. Kidney weights, vitamin A, haemoglobin, hematocrit, leukocyte and platelets values were not changed by diabetes and/or VCE supplementation. VCE ameliorated also diabetes‐induced histopathological changes in kidney. In conclusion, we observed that VCE supplementation is beneficial towards kidney and lens of aged diabetic rats by modulating oxidative and antioxidant systems. Copyright

Impact of chronic fluorosis on left ventricular diastolic and global functions.

Sixty three patients with endemic fluorosis (36 males/27 females; mean age 33.9+/-8.6years) and 45 age, sex and body mass index (BMI) matched healthy controls (30 males/15 females; mean age 32.7+/-8.8years) were included in this study. Basic echocardiographic measurements, left ventricular diastolic parameters and left ventricular myocardial performance index (MPI) were measured. The left ventricular MPI was calculated as (isovolumic contraction time+isovolumic relaxation time)/aortic ejection time by Doppler. The urine fluoride levels of fluorosis patients were significantly higher than control subjects as expected (1.9+/-0.1mg/l vs 0.4+/-0.1mg/l respectively; P<0.001). Isovolumic relaxation time (IVRT) and deceleration time (DT) were significantly higher in fluorosis patients than in controls (for IVRT 106.9+/-15.6ms vs 96.7+/-12.2ms; P<0.001 and for DT 211.7+/-30.7ms vs 188.0+/-30.0ms; P<0.001, respectively). MPI was significantly higher in fluorosis patients than in controls (0.62+/-0.15ms vs 0.49+/-0.10ms; P<0.001, respectively). We have shown that chronic fluorosis patients had left ventricular diastolic and global dysfunctions.

Serum Lipoprotein-Associated Phospholipase A2 and C-Reactive Protein Levels in Association With Periodontal Disease and Hyperlipidemia

BACKGROUND The aim of this study is to evaluate the levels of serum lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) and high-sensitivity C-reactive protein (hsCRP) in association with periodontal disease and hyperlipidemia. METHODS A total of 123 subjects with hyperlipidemia and 68 systemically healthy controls were included in the study. Subjects with hyperlipidemia were divided into two groups: the suggested-diet (HD) and prescribed-statin (HS) groups and then into three subgroups: the healthy (HDh and HSh), gingivitis (HDg and HSg), and periodontitis (HDp and HSp) groups. Periodontal parameters were recorded and included the plaque index, gingival index (GI), probing depth (PD), clinical attachment level (CAL), and percentage of sites with bleeding on probing (BOP). Fasting venous blood samples were obtained, and serum lipid, Lp-PLA(2), and hsCRP levels were evaluated. RESULTS Median values for the GI, PD, BOP(%), and CAL in the HSg group were statistically significantly higher than those in the HDg and systemically healthy with gingivitis (Cg) groups. The HSp group had higher percentages of BOP compared to those of the chronic periodontitis and HDp groups. The HDg group had higher serum Lp-PLA(2) and hsCRP levels compared to those of the Cg and HSg groups. The ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL) was significantly associated with the GI, PD, and BOP(%) in both groups with hyperlipidemia. Serum Lp-PLA(2) and hsCRP levels were significantly correlated with TC/HDL, the GI, PD, and BOP(%) in the HD group. CONCLUSIONS Serum Lp-PLA(2) and hsCRP levels may play an important role in the association between periodontal disease and hyperlipidemia, and the control of these mediators may affect the inflammatory control of patients with hyperlipidemia and periodontal disease.

Evaluation of serum sCD40L and homocysteine levels with subclinical atherosclerosis indicators in patients with psoriasis: a pilot study

Psoriasis is a chronic inflammatory process associated with an increased risk of cardiovascular risk factors. sCD40L has been suggested to have a possible role in the pathogenesis, of psoriasis and is known to be associated with inflammation, atherogenesis and cardiovascular events. This study investigated cardiovascular risk factors (sCD40L and homocysteine) as well as subclinical atherosclerosis indicators in psoriatic patients and control subjects. The study included 56 consecutive patients with chronic plaque‐type psoriasis and 53 age and gender matched healthy controls admitted to a university hospital. Serum sCD40L and homocysteine levels were measured by ELISA. Carotid artery intima‐media thickness and brachial artery flow mediated dilatation (FMD) measurements were determined ultrasonographically. Subjects who had a history of cardiovascular diseases and cardiovascular risk factors and receiving any systemic treatment were excluded from the study. Plasma sCD40L levels were significantly higher in psoriasis patients compared with healthy controls (1.33 ± 0.72 vs. 0.98 ± 0.70 ng/ml P = 0.012), whereas plasma homocysteine levels did not differ significantly between the two groups. FMD was significantly reduced in the psoriasis group compared to the controls (3.83 ± 5.03 vs. 8.45 ± 7.27% P = 0.0001). Multiple linear regression analyses indicated a significant association between psoriasis, sCD40L, and FMD. Psoriatic patients had higher sCD40L levels than healthy controls, which may lead to an increase in cardiovascular diseases. sCD40L may be a more reliable and early predictive marker of cardiovascular events in psoriatic patients. New treatment options that will be developed over sCD40L will benefit in prevention of psoriasis and its cardiovascular comorbidities.

Hepatic cystic echinococcosis: Percutaneous treatment as an outpatient procedure

OBJECTIVE To demonstrate utility and safety of the puncture aspiration injection and reaspiration (PAIR) technique for outpatients. METHODS Percutaneous treatment with US guidance was applied to 33 patients for 44 cysts. Patients treated with the PAIR technique, were outpatients. PAIR and catheterization technique were evaluated for efficacy and safety of procedure and complication rates. RESULTS Thirty-five of 44 cysts were treated with the PAIR and 9 of 44 were treated with the catheterization technique. The success rate of the cysts Gharbi type 1 (CE1) and type 2 (CE3a) treated with the PAIR technique was 100%. In the follow up of 9 cysts treated with the catheterization technique, 2 of them (22%) developed cyst infection and 1 (11%) developed a biliary fistula. CONCLUSIONS The PAIR technique was found to be an effective and safe approach in order to treat Gharbi type 1 and type 2 cysts percutaneously for outpatients. It has a very low complication rate in comparison with the catheterization technique. So every effort should be made to finish the treatment with PAIR technique.

Complete Resolution of an Alveolar Echinococcosis Liver Lesion Following Percutaneous Treatment

Herein we present a 63-year-old male patient with a solid hepatic alveolar echinococcosis diagnosed by surgical biopsy. His liver lesion, which was infected, was drained by percutaneous catheterization. The lesion surprisingly disappeared completely after the treatment. The patient was followed-up without any symptoms for 20 months after the drainage. As alveolar echinococcosis of the liver behaves like a slow-growing liver cancer, the disappearance of our patient’s lesion was a very unusual and rare outcome, which, to the best of our knowledge, has never been published in the literature.

Lipoxin A4 and Neutrophil/Lymphocyte Ratio: A Possible Indicator in Achieved Systemic Risk Factors for Periodontitis

Background The aim of this study was to evaluate the serum lipoxin A4 (LXA4) and neutrophil/lymphocyte (Ne/Ly) ratio in individuals with achieved systemic risk factors for periodontitis. Material/Methods One hundred and eighty volunteers (69 male, 111 female) who were categorized as systemically healthy control, diabetes, hyperlipidemia, obese and menopause were recruited for this cross-sectional study. Sociodemographic characteristics and oral health behaviors were recorded via questionnaire. Clinical periodontal parameters, including plaque index (PI), gingival index (GI), probing pocket depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI) and decayed, missing, and filled teeth index (DMFT), were assessed. Systemic parameters and LXA4 levels were evaluated in serum samples. Results Clinical periodontal parameters and DMFT were higher in subjects with achieved systemic risk factors than in healthy subjects. The systemically healthy with periodontitis group had higher serum LXA4 levels than the systemically healthy with non-periodontitis group (P<0.05). The Ne/Ly ratio was higher in the hyperlipidemic group with periodontitis than in the hyperlipidemic group with non-periodontitis (P<0.05). In the control group, serum LXA4 levels were positively correlated with the PD, CAL and SBI. Conclusions In the presence of periodontitis, an increase in LXA4 levels and the Ne/Ly ratio in hyperlipidemic patients could contribute to the hypothesis that these parameters could be an indicator in periodontitis and its systemic risk factors.

Association of inflammation with atrial fibrillation in hyperthyroidism.

Objectives The aim of this study was to evaluate the relationship between inflammation and development of atrial fibrillation (AF) in patients with hyperthyroidism. Methods A total of 65 patients with newly diagnosed hyperthyroidism, 35 of whom were in sinus rhythm and 30 of whom in AF. Thirty five age- and gender-matched patients in a control group were included in the study. Factors associated with the development of AF were evaluated by multivariate regression analysis. Results Factors associated with AF in multivariate analysis included high sensitivity C reactive protein (HsCRP) [odds ratio (OR): 11.19; 95% confidence interval (95% CI): 1.80-69.53; P = 0.003], free T4 (OR: 8.76; 95% CI: 2.09–36.7; P = 0.003), and left atrial diameter (OR: 1.25; 95% CI: 1.06–1.47; P = 0.008). Conclusions The results of the present study suggest that HsCRP, an indicator of inflammation, free T4 and left atrial diameter are associated with the development AF in patients with hyperthyroidism.