Meral Ekim

Roles of the Oxidative Stress and ADMA in the Development of Deep Venous Thrombosis

Venous thromboembolism has multifactorial origin and occurs in the context of complex interactions between environmental and genetic predisposing factors. Oxidative stress plays an important role in the physiopathology of venous thrombosis. Current study examined the role of oxidative stress and asymmetric dimethylarginine in the development of DVT with the parameters such as serum malondialdehyde (MDA), glutathione peroxidase (GSH-Px), catalase, ADMA, homocysteine, folic acid, vitamin B6, and vitamin B12 levels. Serum MDA levels were found significantly (P < 0.005) high in patients with DVT compared with control group. Additionally, serum B6 levels were found significantly (P < 0.009) low in patients with DVT compared with healthy volunteers. There were no significant differences between the groups in terms of the other parameters (P > 0.05). This study showed that patients with DVT have increased oxidative stress compared with the healthy volunteers whereas there was no significant difference between the groups in terms of serum ADMA levels. Thus serum ADMA levels seemed to be not related with development of DVT.

Study on relationships among deep vein thrombosis, homocysteine & related B group vitamins

Objectives: Hyperhomocysteinemia has been considered as a potential risk factor for deep venous thrombosis (DVT) but it is still controversy. We aimed to evaluate the prevalence of hyperhomocysteinemia in patients with DVT. Our second objective was to document the prevalence of folate, Vitamin B6, and Vitamin B12 level in this patient population. Methods: Sixty patients with DVT aged from 23 to 84 years, were assessed regarding demographic characteristics, serum levels of homocysteine, folate, vitamin B12, and vitamin B6. The diagnosis of DVT was based upon Wells scoring system and serum D-dimer level and confirmed by deep venous Doppler ultrasonography of the lower limbs. Results: Mean serum homocysteine levels were found significantly higher in patients over the age of 40 years (10.81±4.26 µmol/L vs 9.13±3.23 µmol/L). Of all the patients, 9 patients had homocysteine level above the 15µmol/L, 26 had folic acid level below 3 ng/ml, one had vitamin B12 level below 150 pmol/L, and two had vitamin B6 level below 30 nmol/L. In the hyperhomocysteinemic group, five patients had low folic acid level, one had low vitamin B12 level, and two had low vitamin B6 level. Conclusions: Hyperhomocysteinemia, in women older than 40 years, may be a risk factor for DVT. Folic acid deficiency may also influence serum homocysteine concentrations. Folate therapy may be offered to the patients with DVT. However further studies are required to clarify the underlying molecular mechanisms.

Arterial Stiffness, Distensibility, and Strain in Asthmatic Children.

Background We hypothesized that since asthma is a chronic inflammatory disease, it could lead to the early development of atherosclerosis in childhood-onset asthma. The aim of this study was to investigate arterial stiffness, distensibility, and strain of different peripheral arteries, the parameters of which can be used to detect atherosclerosis in asthmatic children. Material/Methods We studied 22 pediatric patients with asthma and 18 healthy children. Fasting blood glucose and cholesterol levels were evaluated to exclude children with diabetes and hyperlipidemia, which are risk factors for atherosclerosis. Renal, carotid, and brachial arteries diameters were measured. Using the measured data, stiffness, distensibility, and strain of the arteries of all children were calculated. Results Pulse pressure, systolic and diastolic blood pressure, heart rate, cholesterols, and glucose levels of the obese individuals were similar to the controls. In carotid arteries there were no statistical differences regarding stiffness, distensibility, and strain. According to multiple ANCOVA analysis, distensibility and strain of right and left brachial arteries and right renal artery were higher, whereas right renal artery stiffness was lower in asthmatic children than in controls. Approximately one-fifth of the change in the left and right brachial arteries and right renal artery distensibility and strain and a small portion of the change in the right renal artery stiffness were associated with asthma. In contrast, left renal artery distensibility, strain, and stiffness were not associated with asthma. Conclusions Peripheral arteries had higher distensibility and strain, and lower stiffness in asthmatic children than in controls.

DERİN VEN TROMBOZUNDA TOTAL KOLESTEROL VE TRİGLİSERİD SEVİYELERİNİN ARAŞTIRILMASININ ÖNEMİ

Objective: Deep venous thrombosis (DVT) is a serious clinic problem and leads to severe complications such as pulmonary embolism, post-thrombotic syndrome and pulmonary hypertension. High serum lipoprotein and lipid levels have an effect on atherogenesis and also trigger the development of DVT. Our study aimed to investigate the total cholesterol and triglyceride levels in patients with DVT. Material and Methods:Between October 2012 and July 2014, 63 of the patients diagnosed to our hospital with deep venous thrombosis were included in our study. The diagnosis of DVT was based upon Wells scoring system and serum D-dimer level and confirmed by deep venous Doppler ultrasonography. Fasting total cholesterol, low-density lipoproteins (LDL), high density lipoproteins (HDL) and triglyceride levels were measured before starting the treatment of DVT. Also, biochemical parameters including creatinine phosphokinase (CPK) were regularly tested for avoiding severe complications in patients using lipid lowering drugs. Results: There were 32 male and 31 female patients ranging in age from 17 to 83 years, with a mean age of 53.57 years. Twenty five (39.7%) patients had elevated total cholesterol levels. Twenty five (39.7%) patients had elevated triglyceride levels of whom 12 (48%) had also increased total cholesterol levels. All patients gave a positive response to anticoagulant therapy and improved clinically. Cholesterol and triglyceride levels were gradually decreased to normal serum levels with proper treatment. There were no recurrences during the follow-up period.Conclusion:Our data suggest that in contrast to elevated HDL levels, elevated cholesterol or triglyceride levels may play a contributing role in the occurrence of DVT. Also, in addition to anticoagulant therapy, the adjustment of cholesterol and triglyceride levels to the normal limits may be useful to avoid recurrence of DVT. However, further investigations are required to clarify the relation among the high total cholesterol and triglyceride levels and DVT

İZOTERMİK HİPERKALEMİK KAN KARDİYOPLEJİSİNİN MYOKARD KORUNMASINDA ÖNEMİ

Although there is no consensus regarding the selection of cardioplegia type, adequate myocardial protection may be offered by antegrade and retrograde combined use of isothermic blood cardioplegia during open heart surgery. Delivery of retrograde cardioplegia with a volume pump may be harmful due to increased pressure during the surgical manipulation. Thus, passive continuous infusion of retrograde cardioplegic solution by gravitational force alone should be preferred. Nowadays, even though hyperkalemic cardioplegia is being used as the gold standard mondial; it has also harmful effects associated with ionic imbalance involving sodium and calcium overload of the myocyte induced by depolarization of the cell membrane. However, until the development of an ideal cardioplegic method providing non-depolarized cardiac arrest, isothermic hyperkalemic cardioplegia (modified by Kosuyolu Heart Center) may be used