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Can ADMA play a role in determining pulmonary hypertension related to chronic obstructive pulmonary disease

Asymmetric dimethylarginine (ADMA) decreases the levels of nitric oxide by inhibiting nitric oxide synthases. In this study, the possible role of ADMA in determining pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) patients was investigated.

Asymmetric dimethylarginine (ADMA), 4-OH-nonenal and Vitamin E levels in chronic schizophrenic patients.

Schizophrenia is a severe neurodegenerative brain disorder characterized by hallucinations, delusions, disorganized thoughts and cognitive disabilities. The disease affects 1% of the world population and is thought to have multiple etiologies (Akiibinu et al., 2012; Rich and Caldwell, 2015). Oxidative stress is believed to be an essential component in the schizophrenia pathophysiology (Ciobica et al., 2011). Nitric oxide (NO) is a free oxygen radical which carries out roles such as neuromodulator and neurotransmitter in peripheral and central nervous systems. It is considered that NO has a major role in the pathogenesis of schizophrenia and several neuropsychiatric disorders (Zincir et al., 2014). NO is known to have effects on the storage, uptake and/or release of neurotransmitters such as acetylcholine, dopamine, noradrenaline, GABA, glutamate, taurine and glycine in the central nervous system (CNS) (Bernstein et al., 2005). NO is produced by Nitric Oxide Synthase (NOS) (Zincir et al., 2014). NOS catalyzes the formation of nitric oxide from L-arginine (Jorgensen et al., 2015). Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of NOS. ADMA and N-monomethyl-L-arginine (L-NMMA) are analogs of the NO precursor L-arginine and they act as endogenous inhibitors for all NOS isoforms. These endogenous inhibitors are synthesized by the methylation of residues of protein arginine in various proteins by arginine methyl transferase (PRMT) (Pope et al., 2007; Yildirim et al., 2006). ADMA and L-NMMA are converted to L-citrulline and methylamine by dimethylarginine dimethylaminohydrolase enzyme (DDAH). PRMT enzyme is involved in the formation of ADMA, while DDAH is involved in the degradation of ADMA

Relationship Between Leptin and Neopterin Levels and Disease Activation Parameters in Patients With Rheumatoid Arthritis

Objectives This study aims to determine serum leptin and neopterin levels in patients with rheumatoid arthritis (RA) and investigate the relationship between clinical and laboratory parameters of disease activity and radiographic progression. Patients and methods The study included 33 RA patients (9 males, 24 females; mean age 52.5±12.3 years; range 29 to 75 years) and age- and sex-matched 24 healthy controls (11 males, 13 females, mean age 42.5±14.8; range 18 to 75). RA patients were divided into three groups based on Disease Activity Scores in 28 joints (DAS28) as low disease activity, moderate disease activity, and high disease activity groups. Of the patients, 13 (39.4%) had low disease activity (DAS28=2.6-3.2), 12 (36.4%) had moderate disease activity (DAS28=3.2-5.1), and eight (24.2%) had high disease activity (DAS28≥5.1). Results Mean serum leptin and neopterin levels in the RA group were 23.98±18.88 ng/mL and 1.88±1.84 nmol/L, respectively. Mean serum leptin and neopterin levels in the control group were 19.40±13:42 ng/mL and 1.13±0.55 nmol/L, respectively. There was no statistically significant difference in the levels of serum leptin (p=0.674) and neopterin (p=0.078) between RA patients and control group. Serum leptin (p=0.574) and neopterin (p=0.921) levels in RA patients and control group showed no correlation with body mass index levels. Besides, there was no correlation between age and plasma leptin and neopterin levels and rheumatoid factor positivity, anti-cyclic citrullinated peptide antibodies, disease duration, erythrocyte sedimentation rate, and C-reactive protein levels in RA group. In RA patients, there was no correlation between serum leptin and neopterin levels and clinical and laboratory parameters indicating the disease activity. In RA patients, there was also no correlation between radiographic joint damage and serum leptin and neopterin levels. A positive correlation was shown in RA patients between disease duration and modified Larsen score (p=0.01). Conclusion In our study, no correlation was detected between serum leptin and neopterin levels and disease activity parameters in RA patients. Therefore, leptin and neopterin levels may not be considered as beneficial inflammation parameters to be used in the diagnosis of RA and disease activation tracking.

Serum Cystatin C Levels in COPD: Potential Diagnostic Value and Relation Between Respiratory Functions

Background The predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with cholecystitis has not been established. The aim of this study was to investigate preoperative NLR in patients with cholecystitis and to identify a relevant NLR value that discriminates between simple and severe cholecystitis. Methods This study included 136 patients who under went laparoscopic cholecystectomy due to cholecystitis. The Receiver Operating Characteristic (ROC) analysis was performed to identify the most useful NLR cut-off value in relation to the severity of cholecystitis. The patients were di vided into two groups according to the cut-off NLR value: high NLR group (≥4.18, n=23) and low NLR group (<4.18, n=113). Severe cholecystitis was defined as a state which includes inflammation, empyema, gangrene, perforation of gallbladder, adhesions or difficulty in dissecting Calots triangle. Results In the high NLR group, severe cholecystitis (p<0.0001) and higher C-reactive protein level (CRP) and white blood cells count (WBC) (p<0.0001) were significantly more frequent. There was no difference in homeostatic model assessment-insulin resistance index (HOMA-IR) between both groups before the operation (p<0.634). The incidence of severe cholecystitis was 16.9%. The NLR of 4.18 could predict severe cholecystitis with 78.3% sensitivity and 74.3% specificity. Spearmans correlation revealed significant association between the preoperative NLR and HOMA-IR on day 1, (r=0.254, p=0.030) and between preoperative NLR and CRP on day 1 (ρ=0.355; p<0.0001). Conclusions NLR ≥4.18 was significantly associated with severe cholecystitis. The preoperative NLR in patients under going cholecystectomy due to cholecystitis could be a useful surrogate marker of severe cholecystitis.Summary Background: The aim of this study was to determine the level of serum cystatin C (CysC) in patients with Chronic Obstructive Pulmonary Disease (COPD) during exacerbation and stable periods and to investigate its potential diagnostic value and the relationship between CysC levels and the pulmonary function test (PFT). Methods: One hundred twenty-six patients with COPD (68 in stable periods, 58 during exacerbation periods) and 50 healthy subjects were included in the study. PFT, body mass index (BMI), white blood cell counts, C-reactive protein (CRP), serum urea and creatinine levels were evaluated in both groups of patients. CysC levels were measured in all participants. Results: Serum CysC levels were statistically higher in both COPD groups than the control group (p<0.001 for both) although there was no statistically significant difference between COPD groups (p>0.05). CysC levels showed negative correlation with forced expiratory volume in 1 second (FEV1) and a positive correlation with C-reactive protein (CRP) levels in patients with stable COPD. There was a positive correlation between serum CysC levels and serum urea, creatinine, CRP levels in patients with COPD exacerbation (r=0.333, p=0.011; r=0.260, p=0.049; r=0.414, p<0.01 respectively). When stable COPD and control groups were evaluated, serum CysC had an area under the curve (AUC) in the receiver operating characteristic (ROC) curve of 0.951 (0.909–0.994 95% CI: p<0.001). Conclusions: Our results showed that CysC levels increased in both COPD groups. Increased CysC levels may be related with lung function decline and inflammation in COPD patients. In addition, CysC levels may be a potential indicator for the diagnosis of COPD.

Does platelet indices play a role in the distinction of pulmonary embolism clinical forms

Aim: The aim of this study is to investigate the changes in platelet indexes, including mean platelet volume (MPV), platelet distribution width (PDW) and platelet count (PC), in patients with acute pulmonary embolism (PE), in addition to evaluating the diagnostic value in clinical forms. Material and methods: The study consisted of 84 patients with PE and the control group consisted of 40 healthy subjects. PE patients were divided into two groups in accordance with the clinical forms as 60 submassive and 24 nonmassive. The differences in platelet count, MPV, PDW, PC, D-dimer, and other indicators were analyzed between the two groups. Venous peripheral blood samples to measure the MPV, PDW and PC were acquired on admission. Results: MPV levels were found to be statistically higher in the submassive group compared to the nonmassive group and the control group (p<0.01 and p<0.001, respectively). PDW levels were found to be statistically higher in the submassive group compared to the non-massive group and control group (p=0.027 and p<0.001, respectively). PC was significantly lower in the submassive group compared to the non-massive group and control group (p=0.022 and p<0.001, respectively). It was determined that a positive correlation existed between the MPV and right ventricular diameter (RVD) (r=0.27, p<0.01). Conclusion: High MPV and PDW levels and low PC may be indicators of the severity of acute PE. Also, the correlation between the MPV and RVD suggests that MPV can be used as a marker of right ventricular function.

The Incidence and Related Risk Factors of Chronic Thromboembolic Pulmonary Hypertension after Acute Pulmonary Embolism

OBJECTIVES More than half of (> 50%) the patients with choronic thromboembolic pulmonary hypertension (CTEPH) have no acute pulmonary embolism history with clinical signs, so determining the actual incidence and prevalence of CTEPH is difficult. This study aimed to investigate the incidence of CTEPH and the risk factors that may be associated with CTEPH in patients with acute pulmonary thromboembolism (PTE). MATERIAL AND METHODS Three hundred and eighteen patients with acute pulmonary embolism diagnosed by thorax CT or ventilation/perfussion scintigraphy in our clinic were included into this study. Patients with risk factors for pulmonary hypertension other than thromboembolic disease were excluded from the study. Patients with pulmonary hypertension (PHT) (systolic PAB > 35 mmHg) determined by echocardiography performed in the 6th month were enrolled into the study. RESULTS Fifty-seven of the 112 patients were female, and the mean age was 57.09 ± 17.30 (16-86) years. Presence of PHT was determined in the 6th month in 45 of the 112 patients (8 of them were symptomatic) and CTEPH incidence (symptomatic + asymptomatic) was identified as 40.16%. Symptomatic CTEPH incidence was calculated as 7.14%. When we searched about the risk factors that may have a role in the development of CTEPH; we determined that CTEPH risk was increased 4.59 times by only being male (95% CI 1.071-19.683, p= 0.040), 218 times by previous history of DVT (95% CI 1.235-38543.073, p= 0.041), and 56.903 times by PaO2 < 80 mmHg (95% CI 2.656-1219.228, p= 0.010). CONCLUSION CTEPH development after PTE is a situation that can occur in many patients. If probable risk factors are known, patients can be closely monitorized for CTEPH development.

Illicit substance use among persons admitted to probation polyclinic of a regional mental hospital in the Eastern Anatolia, Turkey

Objectives: To investigate the illicit substance use trends by gender and year in Eastern Turkey, Elazığ. Methods: This is a retrospective study designed to assess the drug use prevalence in persons who admitted to the Probation Policlinic of Elazig Mental Health Hospital between January 2011 and December 2014 in Eastern Turkey, Elazığ. Laboratory screening tests for drugs were studied using the cloned enzyme donor immunoassay technique in urine. Results: The study consisted of 10267 males (95.3%) and 510 females (4.7%), with a mean age of 30.42±10.83 years. Overall prevalence was 32.1% for cannabis, 3.8% for opiate, 0.35% for cocaine and 1.2% for polydrug usage. The prevalence of cannabis was significantly higher in males (32.7%, p=0.000). The prevalence of cannabis use was the lowest in the age group of 50-59 while it was significantly higher in the age groups of 20-29 and 30-39 (p=0.000). The prevalence of opiate use showed a significant difference among the years (p=0.000). There was a significant difference in the prevalence of cocaine use among the years (p=0.02). The prevalence of polysubstance use showed a significant difference among years (p=0.000). Conclusion: Cannabis was the most common illicit drug in the east of the Turkey. Further studies are required for comparing the results of various regions of the country and developing early interventions and treatment facilities.

Is 4-Hydroxynonenal a Predictive Parameter for the Development of Joint Erosion in Patients With Rheumatoid Arthritis?

Objectives This study aims to evaluate serum 4-hydroxynonenal (4-HNE) levels and its clinical and radiological significance in patients with rheumatoid arthritis (RA). Patients and methods The study included 40 patients (8 males, 32 females; mean age 51.4±11.2 years; range 24 to 72 years) with RA and 30 healthy controls (8 males, 32 females; mean age 53.0±11.7 years; range 24 to 72 years. Serum 4-HNE levels were measured using sandwich enzyme-linked immunosorbent assay method. Patients with disease activity score 28 ≤3.2 and >3.2 were allocated into low and high/moderate disease activity groups, respectively. Additionally, patients were divided into two groups as early RA (disease duration ≤2 years) and established RA (disease duration ≥2 years). Functional disability was evaluated using health assessment questionnaire. Radiographs were scored using the modified Larsen scoring. Results Serum 4-HNE levels in patients with RA were significantly higher than controls (p=0.001). Serum 4-HNE levels did not correlate with laboratory or clinical parameters of disease activity including erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, and health assessment questionnaire. Serum 4-HNE levels were higher in patients with established RA than patients with early RA (r=0.487, p=0.001). Besides, modified Larsen score which indicates structural damage correlated significantly with serum 4-HNE levels (p=0.001). Conclusion These results indicate that serum 4-HNE levels may be used as an indicator for structural damage such as erosions in the early stage of RA; however, they are not efficient to monitor disease activity.