Blood count parameters can predict the severity of coronary artery disease.

BACKGROUND/AIMS: Because of the inflammatory nature of coronary artery disease (CAD), both platelets and white blood cells have been investigated for years. The aim of this study was to investigate the relationships between some prominently hematologic blood count parameters (mean platelet volume [MPV], neutrophil to lymphocyte ratio [NLR]) and the severity of CAD by using Gensini scores. METHODS: A total of 194 patients, who had undergone coronary angiography, enrolled in this study. The control group consisted of 42 patients who had normal coronary arteries. Remaining CAD patients were divided into two groups according to their Gensini scores. RESULTS: NLR and MPV were higher in the severe atherosclerosis group compared with the mild atherosclerosis group (p = 0.007, p = 0.005, respectively). The Gensini score showed significant correlations with NLR (r = 0.20, p = 0.011), MPV (r = 0.23, p = 0.004) and high density lipoprotein cholesterol (r = -0.161, p = 0.047). Using a cut-off level of 2.54, NLR predicted severe atherosclerosis with a sensitivity of 74% and specificity of 53% (area under curve [AUC], 0.627; 95% confidence interval [CI], 0.545 to 0.704; p = 0.004). MPV values above 10.4 predicted severe atherosclerosis with a sensitivity of 39% and specificity of 90% (AUC, 0.631; 95% CI, 0.549 to 0.708; p = 0.003). In the multiple logistic regression analysis, high levels of NLR (odds ratio [OR], 1.450; 95% CI, 1.080 to 1.945; p = 0.013) and MPV (OR, 1.622; 95% CI, 1.147 to 2.295; p = 0.006) were found to be independent predictors of severe atherosclerosis. CONCLUSIONS: Our study suggests that both NLR and MPV are predictors of severe atherosclerosis and may be used for the prediction and identification of cardiac risks in CAD patients.

[The effect of losartan on the intima-media thickness of carotid artery]. / Losartanin karotid arter intima-media kalinligina etkisi.

OBJECTIVE: There are findings about negative effects of angiotensin 1 (AT1) receptor stimulation at every stage of atherosclerosis formation. Recently, AT1 receptors, especially the effects of AT1 receptor antagonists on the regression of atherosclerosis, are being researched intensively. Measurement of carotid artery thickness has been accepted as a marker of atherosclerosis. In our study, we investigated the effect of AT1 receptor antagonist, losartan, on the carotid artery intima-media thickness of newly diagnosed hypertensive patients. METHODS: We reached to 450 individuals by the stratified and random sampling method and measured their blood pressure to find out undiagnosed hypertensive patients. Fifty-one patients (mean age 54+/-9 years) were accepted to participate in our study. Forty-nine of them (33 women and 16 men) completed the study. After the measurements of the carotid artery intima-media thicknesses by B-mode Doppler ultrasonography, their blood tests were performed and arterial blood pressures were measured. Soon after, treatment with losartan as an antihypertensive agent was begun. All measurements were repeated on the eighth month of this therapy. RESULTS: The mean systolic and diastolic blood pressure of the cases were 167+/-14 mmHg and 102+/-8 mmHg, respectively. At the end of the eighth month these measurements regressed to 139+/-11 mmHg and 84+/-8 mmHg, respectively (p<0.05). Meaningful regression of carotid artery intima-media thickness was established. The mean regression was 0.10+/-0.19 mm (p=0.004) for women, 0.18+/-0.29 mm (p=0.007) for men and 0.13+/-0.23 mm (p<0.001) for the study population. No relation was seen between the carotid artery intima-media thickness and first systolic and diastolic blood pressure measurements of the patients (r=0.122, p=0.403 and r=0.032, p=0.828, respectively). CONCLUSION: We think that losartan should be recommended to use for protection against atherosclerosis at the young aged individuals that have multiple risks for atherosclerosis, other than hypertension.

[Relationship of the blood pressure's level and skinfold thickness]. / Kan basinci düzeyi ile deri kivrim kalinliginin iliskisi.

OBJECTIVE: Hypertension is an important problem of the public health. Insufficient education of the people along with insufficient physical examination also plays a role in the poor success of the diagnosis and treatment of the hypertension. We investigated whether the skinfold thickness has an importance in the prediction of blood pressure or not. METHODS: In Aydin City area 110 women and 100 men selected by randomized sampling method were included into our study. Body mass index, blood pressure and skinfold thickness were measured according to the international guidelines. RESULTS: There was a moderate correlation between the skinfold and body mass index (r= 0.494, p=0.000) and there was a mild correlation between the body mass index and systolic and diastolic blood pressures (r=0.225, p=0.000 and r=0.300, p=0.000, respectively). There was no correlation between the skinfold thickness and systolic and diastolic blood pressures (r=0.058, p=0.400 and r=0.090, p=0.194, respectively). CONCLUSION: It is concluded that body mass index, not skinfold thickness, can be used for the prediction of the blood pressure. Some other factors independent from the body mass index might be the determinants of the skinfold thickness.

Treatment of blastic phase chronic myeloid leukemia with mitoxantrone, cytosine arabinoside and high dose methylprednisolone.

Fourteen patients with blastic phase chronic myelogenous leukemia received combination chemotherapy with mitoxantrone 5 mg/m2 intravenously daily for 3 days, cytosine arabinoside 100 mg/m2 intravenously over 2 hours bid for 7 days and high dose methylprednisolone 1000 mg/day intravenously for 5 days. The patients' mean age was 52 +/- 10 (range 34-64) and Philadelphia chromosome was positive in all. Five patients (35%) achieved complete remission and four patients (28%) had a partial remission. Overall remission rate was 64%. The mean survival was 11.1 +/- 8.6 months (median 13) for all patients, 19.4 +/- 4.0 months (median 19) for those achieving a complete remission, 12.50 +/- 5.7 months (median 14) for patients with partial remission and 1.8 +/- 1.8 months (median 2) for the unresponsive patients. Two of 5 unresponsive patients died early after the second course of remission induction. The treatment regimen was generally well tolerated. Marrow hypoplasia was observed in 9 (64%) patients and 7 (50%) had febrile episodes. Non-myelosupressive toxicity of the regimen was acceptable. Nausea and vomiting were observed in 8 (57%) patients and 3 (21%) patients developed flushing due to cytosine arabinoside. These results suggest that the regimen with mitoxantrone, cytosine arabinoside and high dose methylprednisolone in remission-induction of blastic phase chronic myelogenous leukemia may be a valid option that may also improve overall prognosis.

Lead exposure and urinary N-acetyl beta D glucosaminidase activity in adolescent workers in auto repair workshops.

PURPOSE: To investigate levels of lead (Pb) exposure and renal tubular damage among adolescent workers in auto repair workshops in Turkey. METHODS: The study was conducted on 39 adolescent workers (mean age: 16.18 +/- 3.19 years) in auto repair workshops (8 autoelectrician, 10 motor repairman, 8 auto painter, 5 turner, 8 bonnet straighter). Thirteen adult employees of battery production in the workshops (mean age: 32.08 +/- 10.94 years) and 29 healthy rural adolescent (mean age: 14.78 +/- 2.68 years) constituted the control groups. The level of blood Pb was investigated by an atomic absorption spectrophotometer and urinary N-acetyl beta- D glucosaminidase (NAG) activity was measured by a colorimetric method. Mann-Whitney U test was performed to examine group differences. RESULTS: All subjects and controls had normal blood urea, creatinine, uric acid, sodium, potassium levels, normal routine urine examination and tubular phosphorus reabsorption. Blood Pb levels in auto repair workers (8.13 +/- 7.41 mug/dL) were significantly higher than the rural control group (3.49 +/- 1.39 mug/dL) but lower than the battery workers (25.27 +/- 9.82 mug/dL). Urinary NAG (U/gr creatinine) (4.71 +/- 2.11) was lower than the battery workers (7.39 +/- 4.37), however significantly higher than the normal control group (3.07 +/- 1.20). In addition, auto painters had higher levels of Pb exposure and urinary NAG activity than the other workers (p <.05). CONCLUSION: Chronic low dose Pb exposure was found to cause renal tubular injury in children workers of auto repair workshops.