The relationship between carotid atherosclerosis and platelet aggregation in elderly.

The aim of this study is to assess the relationship between the carotid wall intima media thickness (IMT) and atheroma plaques due to atherosclerosis and platelet aggregation among elderly. The first stage of the study was performed by analyzing platelet aggregation in a total of 28 elderly patients divided into two groups. The first group consisted of 14 cases with carotid atheroma plaque (Patient group I) and the second group of patients were without carotid atheroma plaque (Control group I). At the second stage of the study, the cases were regrouped according to the carotid IMT. Patients with IMT above 1 mm (Patient group II, n=10) and under 1 mm (Control group II, n=14) were compared regarding platelet aggregation. Platelet aggregation was induced in the platelet-rich plasma using 5 micro M ADP, 0.2 mg/ml collagen and 1.2 mg/ml ristocetin. Between patients with and without atheroma, no difference was noted in terms of platelet aggregation. Between platelet aggregation results of patients with intimal thickness above and under 1 mm, no significant difference was also noted. Between elderly cases with or without atherosclerosis, there was no difference with respect to platelet aggregation. Platelet aggregation measurements cannot be used as a marker of atherosclerosis in elderly population.

Detection of Helicobacter pylori colonization in dental plaques and tongue scrapings of patients with chronic gastritis.

OBJECTIVE: It has been suggested that the oral cavity and dental plaque might be a reservoir for Helicobacter pylori (Hp). In this study, our aims were to detect the prevalence of Hp colonization in dental plaque and tongue scrapings of patients with chronic gastritis and to investigate the effect of systemic treatment upon this colonization and eradication of Hp from gastric mucosa. METHOD AND MATERIALS: Eighty-one patients (49 men, 32 women) were included in the study. Dental plaque and tongue scraping specimens were obtained and assessed with Campylobacter-like organism (CLO) test, prior to endoscopic examination. By endoscopy, 2 antral and 1 corpus biopsy samples were taken for histologic examination, and 1 antral biopsy sample was taken for CLO test examination. RESULTS: Chronic gastritis was diagnosed in 63 (77.7%) of 81 patients. Dental plaque samples of 64 (79%) patients and tongue scraping samples of 48 (59.2%) patients were urease positive. Of the 63 patients with chronic gastritis, dental plaque and tongue scrapings were urease positive in 52 (83%) and 37 (59%) patients, respectively. After 14 days of triple drug therapy (omeprazole, clarithromycin, and amoxicillin), Hp was eradicated from the gastric mucosa of almost all of the patients, whereas no changes were detected in dental plaque and tongue scrapings by CLO test examination. CONCLUSION: Helicobacter pylori colonization, which seemed to be high in dental plaque and on the tongue, might play an important role in the pathogenesis of the reinfection process. In order to eradicate Hp from both the oral cavity and the gastric mucosa, studies should be performed to assess the effects of plaque control procedures in addition to present treatment modalities.

Fulminant hepatic failure as the initial manifestation of primary hepatocellular carcinoma.

A 20-year-old male, with no history of chronic liver disease, presented with fulminant hepatic failure. The cause was not established until post mortem when it was found that he had a primary hepatocellular carcinoma in a non-cirrhotic liver. To our knowledge, this is the third report of hepatocellular carcinoma presenting in this manner. Although rare, primary malignancies of the liver should be considered in the differential diagnosis of fulminant hepatic failure, especially when other more common causes are excluded.

CA-125; a new marker for diagnosis and follow-up of patients with tuberculous peritonitis.

BACKGROUND: Most malignancies with peritoneal infiltration, especially ovarian cancers and chronic liver diseases associated with ascites give rise to high serum CA-125 levels. Tuberculous peritonitis is another cause for high serum CA-125 levels. AIM: To investigate the relation between serum CA-125 level and response to treatment in tuberculous peritonitis patients. PATIENTS: Ten patients with tuberculous peritonitis were enrolled in the study. METHOD: Definite diagnosis of tuberculous peritonitis was made by acid-fast smears, specific culture, and polymerase chain reaction. Serum CA-125 levels were measured before and at the fourth month of treatment. RESULTS: Before antituberculous treatment, serum CA-125 levels of all patients were very high (mean+/-SD: 475. 80+/-106. 19 U/ml) and comparable with those of patients with ovarian cancers. At the end of the fourth month of treatment, serum CA-125 levels in all patients decreased to within normal limits (<35 U/ml)(20.80:+/-5.18 U/ml) in parallel with the clinical improvement. The differences in CA125 levels before and after treatment were statistically significant (p<0.001). CONCLUSIONS: Results of our study suggest that serum CA-125 levels in patients with tuberculous peritonitis are as high as ovarian cancers associated with peritoneal infiltration. By the end of the fourth month of antituberculous therapy, serum CA-125 levels have returned to normal. We, therefore, suggest that serum CA-125 can be used to evaluate the efficacy of therapy in tuberculous peritonitis.