Metronidazole resistance in Trichomonas vaginalis determined by molecular and conventional methods.

Trichomonas vaginalis (T. vaginalis) is a protozoan parasite that infects the urogenital tract of both women and men worldwide. Trichomoniasis can cause serious symptoms if untreated. Metronidazole is the drug of choice for the treatment of trichomoniasis. In recent years metronidazole-resistant T. vaginalis has often been mentioned in clinical isolates. The aim of this study was to determine the conventional and molecular methods to determine metronidazole-resistant T. vaginalis, which is seen commonly and to discuss the possible reasons for this. Samples taken from patients diagnosed with T. vaginalis from the gynaecology and obstetrics clinic between April 2015 and June 2016 were evaluated for metronidazoleresistance using molecular and conventional methods. A total of 170 patients were examined and T. vaginalis was determined in 6 (3.5%) patients. Metronidazole resistance was determined in 2 (33.3%) of the 6 clinical isolates as a result of the molecular and conventional tests applied. Metronidazole resistance was determined using nitroreductase genes ntr4Tv and ntr6Tv. These findings suggest that metronidazole-resistance T. vaginalis strains can be determined in laboratory samples of cases with trichomoniasis. This may be an important underlying factor in the unsuccessful management of recurrent cases seen in routine gynecological practice.

Evaluation of serum vitamin D levels in patients with X syndrome.

OBJECTIVE: Cardiac X syndrome is defined in patients with normal coronary angiogram who has typical chest pain and objective myocardial ischemia evidence. Recent studies have evaluated the association between vitamin D deficiency (vit D def) and cardiovascular diseases. Our aim of this study was to compare serum vit D levels in patients with syndrome X and controls. PATIENTS AND METHODS: We included 66 patients (49 women, 17 men) with syndrome X and 47 (30 women, 17 men) healthy controls. All of the patients' demographic features, laboratory analysis and medications are recorded. Vit D is measured quantitatively by paramagnetic particle chemiluminescence method. RESULTS: Mean age of the syndrome X group was higher than controls (56 ± 9.2 vs. 49 ± 9.6 years p < 0.001). Body mass index was higher in the patient group than controls (31.2 ± 5.6 vs. 29.1 ± 4.7 kg/m2 p: 0.011). Vit D levels were significantly lower in the syndrome X group than controls (6 ± 5.2 vs. 11.9 ± 7 ng/ml, p < 0.001). Parathormone levels were significantly higher in the syndrome X group than the control group (38.3 ± 23.4 vs. 28 ± 17.2 pg/ml, p: 0.014). hsCRP levels were higher in the syndrome X group than controls (3.1 ± 5.4 vs. 1.8 ± 2.4 mg/L, p: 0.042). CONCLUSIONS: Our study demonstrated significantly lower vit D levels in patients with CSX. This finding is correlated with previous studies showing an inverse correlation with lower serum vit D levels and different types of cardiovascular diseases. Vit D def may be a risk factor for syndrome X. Vit D def related increased inflammation may lead to the development of endothelial dysfunction and microvascular angina.

Apical hypertrophic cardiomyopathy--case report and review of the literature.

Hypertrophic cardiomyopathy is a well-known clinical entity. Hypertrophy engraving the left ventricular apex, so called, apical hypertrophic cardiomyopathy (characterized by the giant negative T waves at ECG and a "spade-like" view of left ventricle) is very rare variant of the pathology. In this report, we present a 51-year-old patient with apical hypertrophic cardiomyopathy together with a brief review of the literature. It was concluded that in patients presenting to the clinic with typical or atypical chest pain or dyspnea, in whom ECG indicating negative giant T waves, before an early invasive strategy, the diagnosis of ApHCM should be kept in mind and an echocardiography should be performed to confirm the diagnosis. Additionally; not only the ApHCM can easily mimic the life threatening condition of acute coronary syndrome but also these two may be seen simultaneously but independently in the same patient. For this reason before making the final diagnosis the physicians always exclude the conditions, which may lead to acute coronary syndromes.

The relationship between ischemia modified albumin and oxidative stress parameters in patients with cardiac syndrome X.

BACKGROUND: The objective of this study was to evaluate the serum levels of ischemia modified albumin and oxidative stress parameters in patients with cardiac syndrome X. METHODS: A total of 61 patients, composed of 32 consecutive patients (24 female, 8 male, average age: 47.63 +/- 9.49 years) diagnosed with cardiac syndrome X by coronary angiography (initially performed following the identification of ischemia by exercise stress test or myocardial perfusion scintigraphy) and a control group of 29 consecutive patients (15 female, 14 male, average age: 49.59 +/- 11.68 years) with similar features without cardiac syndrome X were included in the study. The levels of the ischemia modified albumin (IMA), ferric reducing antioxidant power (FRAP), prooxidant-antioxidant balance (PAB), and advanced protein oxidation products (AOPP) were determined by colorimetric methods. RESULTS: Patients have significantly higher PAB, AOPP, and IMA levels in the patient group than in the control group (p < 0.01, p < 0.001, and p < 0.02, respectively). Also, serum triglyceride (p < 0.005) and hs-CRP (p < 0.0001) levels were significantly higher in the patient group (p < 0.01, p < 0.001, and p < 0.02, respectively). We found that there was a significant correlation between hs-CRP, plasma PAB (r: 0.258; p < 0.05), AOPP (r: 0.459; p < 0.001), and triglyceride levels (r: 0.404; p < 0.01). Plasma AOPP levels were also significantly positive correlated with triglyceride levels (r: 0.463; p < 0.001). In addition, during the correlation analysis performed on the patient group, a positive correlation was observed between the levels of IMA with the levels of plasma PAB and plasma AOPP (r: 0,994; p < 0.01 and r: 0.857; p < 0.05, respectively) In a multiple linear regression analysis, AOPP levels were significantly related with hs-CRP and triglyceride (R2: 0.380, p < 0.0001 and p < 0.05). Simple linear regression analysis was performed between plasma PAB (as dependent variable) and hs-CRP levels. Plasma PAB levels were related with hs-CRP (R2: 0.258, p < 0.05). Using the receiver-operator characteristic (ROC) curve, the best cut-off values for predicting cardiac syndrome X of PAD, AOPP, IMA, and hs-CRP levels were 88.1 arbitrary units, 68.5 kloramin T micromol/L, 7.17 U/mL, and 1.09 mg/dL, respectively. CONCLUSIONS: Based on the results of our study, the increase in oxidative stress during cardiac syndrome X appears to be related to elevated levels of IMA. Treatment modalities that decrease oxidative stress might be beneficial for the treatment of cardiac syndrome X.

Assessment of QT interval duration and dispersion in athlete's heart.

An athlete's heart is characterized by morphological and functional changes occurring as a consequence of regular physical exercise. We sought to determine if these physiological changes lead to ventricular repolarization abnormalities in trained athletes. Forty-four trained athletes and 35 sex- and age-matched healthy sedentary controls were included in the study. A 12-lead surface electrocardiogram (ECG) was obtained from all participants. Maximum QT (QTmax) and minimum QT (QTmin) interval durations, QT dispersion (QTd) and corrected QT dispersion (QTcd) were calculated for each ECG record. Heart rate, systolic and diastolic blood pressure values were found to be identical in both groups. QTmax and QTmin interval durations were not statistically different between the athletic and control groups. Similarly, QTd and QTcd did not differ significantly between the two groups. No association was observed between an athlete's heart and ventricular heterogeneity compared with healthy sedentary controls, despite physiological and structural changes.