Atrial Electromechanical Coupling in Patients with Lichen Planus

BACKGROUND AND OBJECTIVES: A chronic inflammatory disease, lichen planus may cause disturbance of atrial electromechanical coupling and increase the risk of atrial fibrillation. The aim of this study was to evaluate atrial electromechanical delay with both electrocardiography (ECG) and echocardiography in patients with lichen planus (LP). SUBJECTS AND METHODS: Seventy-two LP patients (43 males [59.7%], mean age: 44.0±16.7 years) were enrolled in this cross-sectional case-control study. The control group was selected in a 1:1 ratio from 70 patients in an age and sex matched manner. P wave dispersion was measured by ECG to show atrial electromechanical delay. All of the patients underwent transthoracic echocardiography for measuring inter- and intra-atrial electromechanical delays. RESULTS: The baseline characteristics of the patients and the control group were similar except for the presence of LP. P-wave dispersion measured by ECG was significantly higher in patients with LP (p<0.001). Patients with LP had significantly prolonged intra- and interatrial electromechanical delays when compared to the control group (p<0.001). In addition, all of these variables were significantly correlated with high sensitive C-reactive protein (hsCRP) levels. CONCLUSION: Atrial electromechanical coupling, which is significantly correlated with increased hsCRP levels, is impaired in patients with LP.

Effects of Trimetazidine on T Wave Alternans in Stable Coronary Artery Disease

BACKGROUND AND OBJECTIVES: Studies reveal that the microvolt T wave alternans (MTWA) test has a high negative predictive value for arrhythmic mortality among patients with ischemic or non-ischemic cardiomyopathy. In this study, we investigate the effects of trimetazidine treatment on MTWA and several echocardiographic parameters in patients with stable coronary artery disease. SUBJECTS AND METHODS: One hundred patients (23 females, mean age 55.6±9.2 years) with stable ischemic heart disease were included in the study group. Twenty-five age- and sex-matched patients with stable coronary artery disease formed the control group. All patients were stable with medical treatment, and had no active complaints. Trimetazidine, 60 mg/day, was added to their current treatment for a minimum three months in the study group and the control group received no additional treatment. Pre- and post-treatment MTWA values were measured by 24 hour Holter testing. Left ventricular systolic and diastolic functions were assessed by echocardiography. RESULTS: After trimetazidine treatment, several echocardiographic parameters related with diastolic dysfunction significantly improved. MTWA has been found to be significantly improved after trimethazidine treatment (63±8 µV vs. 53±7 µV, p<0.001). Abnormal MTWA was present in 29 and 11 patients pre- and post-treatment, respectively (p< 0.001). CONCLUSION: Trimetazidine improves MTWA, a non-invasive determinant of electrical instability. Moreover, several echocardiographic parameters related with left ventricular functions also improved. Thus, we can conclude that trimetazidine may be an effective agent to prevent arrhythmic complications and improve myocardial functions in patients with stable coronary artery disease.

Periodontopathogen profile of healthy and oral lichen planus patients with gingivitis or periodontitis / 国际口腔科学杂志·英文版

Oral lichen planus (OLP) is a chronic inflammatory disease that is frequently detected in oral tissues. The aim of our study was to identify the prevalence of the detection of periodontopathogenic microorganisms (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola in OLP patients and to compare with this prevalence of periodontopathogenic microorganisms in healthy non-OLP patients. Our study included 27 (18 chronic periodontitis (OLPP) and 9 gingivitis (OLPG)) patients diagnosed with OLP along with 26 (13 chronic periodontitis (HP) and 13 gingivitis (HG)) healthy non-OLP patients. The multiplex polymerase chain reaction (PCR) with subsequent reverse hybridization method (micro-IDent) was used for identifying periodontopathogenic microorganisms present in subgingival plaque samples. The percentages of detection for A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia and T. denticola in subgingival plaque samples taken from OLP patients (OLPG and OLPP) were 18.5%, 85.1%, 81.4%, 88.8% and 74%, respectively. Meanwhile, in the non-OLP patients (HG and HP), these values were 7.6%, 50%, 46.1%, 73% and 57.7%, respectively. Thus, comparing the non-OLP groups with the OLP groups, the periodontopathogens' percentages of detection in the OLP groups were higher than those in the non-OLP groups. According to our study results, OLP patients have higher levels of infection with A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia and T. denticola than non-OLP patients. We argue that the high percentages in patients with OLP may help identify the importance of periodontopathogenic microorganisms in the progress of periodontal diseases of OLP.

Long term tirofiban infusion before percutaneous coronary intervention in patients with angiographically massive intracoronary thrombus

To evaluate the impact of long term tirofiban infusion before percutaneous coronary intervention [PCI] on the angiographic results in the setting of visible intracoronary thrombus and compare this with conventional PCI performed without tirofiban. Out of 2835 PCI procedures performed in Gazi University Hospital, Ankara, Turkey between 1999 and 2006, 156 [5.5%] patients with massive thrombus in whom PCI were applied, were included in this retrospective study. Out of these 156 patients, 82 [53%] had PCI in the presence of angiographically apparent thrombus without tirofiban and named as group A. The remaining 74 [47%] received long term tirofiban infusion before PCI and were named as group B. Although the baseline thrombolysis in myocardial infarction [TIMI] 0-2 flow was no different between the groups, it is significantly lower in group B compared to group A after the PCI [8.1% versus 23.2%, p=0.015]. The decrease in thrombus burden in group B after tirofiban infusion was also statistically significant compared to pre-tirofiban levels [1.77 -/+ 1.05 versus 3.42 -/+ 0.76, p<0.001]. Group B had better flow characteristics with a 91.9% TIMI 3 flow after PCI. Intervention was successful in the majority technically, however, no reflow was observed in 17 patients [20.7%] in group A and in 2 patients [2.7%] in group B [p<0.001]. Major bleeding requiring transfusion was observed in both groups A [3 patients] and B [4 patients] due to gastrointestinal bleeding or access site hematomas [3.7% versus 5.4%, non significant]. Pre-PCI longterm tirofiban infusion strategy in thrombus containing lesions seems to be a safe and feasible approach in avoiding no re-flow and dissolving the massive thrombus

Plasma homocysteine level in cardiac syndrome X and its relation with duke treadmill score

To investigate the plasma homocysteine level and the relationship between plasma homocysteine level and duke treadmill score DTS in cardiac syndrome X CSX patients. Seventy-nine patients 36 male, 43 female, mean age: 50 +/- 8.8 years admitted to Gazi University Hospital, Ankara, Turkey with typical effort angina, positive stress test, and angiographically normal coronary arteries between January and September 2006 were included in this prospective and controlled study. Thirty asymptomatic patients 11 male, 19 female, mean age: 47.6 +/- 8.3 years with 2 cardiovascular risk factors were chosen as a control group. Plasma homocysteine level was measured in both groups and DTS was calculated in the CSX group. Plasma homocysteine was measured with the AxSYM homocysteine immunoassay method in both groups. Plasma homocysteine level was higher in the CSX group compared to the control group 16.5 +/- 4.9 ?mol/L, n=79, versus 12.4 +/- 4.1 ?mol/L, n=30, p<0.001. The DTS was -2.7 +/- 5.3 in the CSX group. There was a negative correlation between the DTS and homocysteine levels in the CSX group. r=-0.506, p<0.001. Plasma homocysteine level, which is known to cause endothelial dysfunction and microvascular ischemia were higher in CSX patients. Also, this increase in homocysteine level inversely correlated with the DTS, which represents the magnitude of ischemia

Pleuropulmonary and soft tissue Nocardia cyriacigeorgici infection in a patient with Behcet's disease

Infections with Nocardia species are generally seen in immunocompromised subjects. In this report, we present a case of pleuropulmonary and skin Nocardia cyriacigeorgici infection in a male patient with Behcet's disease who used corticosteroids and immunosupressives for a long period of time. He died before the diagnosis of Nocardia infection was made

Risk factors for nosocomial candiduria

To investigate the risk factors and the Candida species that cause candiduria in hospitalized patients via a case-control study. We evaluated the results of the urine analysis of the specimens sent to the laboratories of Central Microbiology and the Department of Clinical Bacteriology and Infectious Diseases of Selcuk University Medical School, Konya, Turkey between January and December 2004. The urinary specimens, sent from hospitalized patients, obtained within 72 hours were evaluated. A total of 51 patients above 17 years of age, without any bacterial growth in urine specimens, with fever above 38 degrees celcius and pyuria were included in this study. A control group of 153 patients without any bacterial growth at 72 hours after hospitalization was present. The average age of the patients, the hospitalization period, and clinics resemble each other in the 2 groups. Risk for candiduria was increased by 4 folds [p=0.001; OR=4.020] in abdominal surgery, by 1.4 folds [p=0.335; OR:1.478] in corticosteroid and immune suppressive therapies and by 12 folds [p=0.000; OR=12.408] in urinary catheterization, antibiotic use increased the risk of candiduria by 6 folds [p=0.000; OR=6.00]. The risk of candiduria was higher by 2 folds in diabetes mellitus patients than in the controls [p=0.044; OR=2.002]. Candida albicans [68.62%] was the most commonly isolated agent in candiduria patients. We should decrease the use of urinary catheters and avoid excess use of antibiotics as much as possible in hospitalized patients