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1.
Angiology ; : 33197231200029, 2023 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-37694576

RESUMO

Coronary artery perforation (CAP) is a potentially fatal complication of percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS). This study aimed to investigate in-hospital, 1-year, and 3-year clinical outcomes of type III CAP during PCI in patients with ACS. The study retrospectively evaluated 118 patients with CAP and 43,226 case-control patients. Clinical, angiographic, and procedural characteristics, management, and outcomes were analyzed retrospectively at 1-year and 3-year follow-ups. The mean age of the patients was 66.5 ± 11.9 years (61.8% males). There was no significant difference in hospital mortality between the type III CAP and non-CAP groups. The all-cause mortality was 33.3% in the CAP group vs 1.8% in the non-CAP group at 1 year, and 28.3% in CAP group vs 6.9% in non-CAP group at 3 years (p = .001 for both comparisons). The procedural, clinical, and 1 and 3-year outcomes of type III CAP showed a relatively high risk of myocardial infarction, coronary artery bypass graft, cerebrovascular event, stent thrombosis, and major bleeding at the 1 and 3-year follow-ups. In addition, non-CAP ACS patients had better survival (log-rank: p < .001, 34.29 months 95% Confidence Interval [33.58-35.00]) than type III CAP ACS patients (29.53 months 95% Confidence Interval [27.28-31.78]) at the 3-year follow-up visit.

2.
Clin Lab ; 68(11)2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36377995

RESUMO

BACKGROUND: Obesity may also develop due to a viral infection caused by adenovirus 36. We aimed to detect the presence of neutralizing antibodies against Ad-36 in adult patients who developed type 2 diabetes due to obesity (BMI ≥ 30 kg/m2). METHODS: The patient group (PG) was composed of 80 obese people with type 2 diabetes, the patient control group (PCG) was composed of 40 non-obese people with type 2 diabetes, and the healthy control group (HCG) was com-posed of 40 non-obese people without type 1 or type 2 diabetes in this case-control study. The presence of Ad-36 neutralizing antibodies was studied by serum neutralization assay. RESULTS: A significant difference was found between the PG and HCG in terms of Ad-36 antibody positivity (p < 0.0001) but no significant difference was detected between the PG and the PCG (p > 0.05). BMI, serum leptin, adiponectin, and triglyceride levels were significantly higher in the PG (p < 0.05). Conversely, TNF-α and IL-6 levels were significantly lower in the PG (p < 0.0001). When the two groups were compared, the mean levels of total cho-lesterol and LDL in the PG were found to be high, although not significant (p > 0.05). In type 2 diabetes patients (n = 120), age, BMI, HDL, LDL, triglyceride, total cholesterol, Ad-36 presence, leptin, adiponectin, TNF-α, and IL-6 parameters were taken as independent variables for logistic regression. While BMIs was found to be significant (odds ration [OR] = 2.358; p = 0.0001, 95% Cl 1.507 - 3.690, Ad-36 presence was found to be a significant (OR = 27.352; p = 0.003, 95% Cl 3.157 - 236.961). Our study showed that BMI and Ad-36 increase type 2 diabetes risk by 2.3 and 27.3-fold in the PG and PCG (type 2 diabetes patients) versus the HCG. There was also a significant difference between PCG and HCG. CONCLUSIONS: We suggest that Ad-36 seropositivity is also a risk factor for the development of type 2 diabetes independent of being obese.


Assuntos
Infecções por Adenoviridae , Diabetes Mellitus Tipo 2 , Adulto , Humanos , Leptina , Adiponectina , Adenoviridae , Fator de Necrose Tumoral alfa , Diabetes Mellitus Tipo 2/complicações , Estudos de Casos e Controles , Interleucina-6 , Índice de Massa Corporal , Obesidade/complicações , Triglicerídeos , Anticorpos Neutralizantes
3.
J Diabetes Metab Disord ; 21(2): 1359-1368, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36404809

RESUMO

Purpose: There are conflicting reports regarding the abundance of short-chain fatty acids producing bacteria in the gut microbiota in patients with type 1 and type 2 diabetes. We aimed to determine the amount of Akkermansia muciniphila, Anaerobutyricum hallii, Bifidobacterium adolescentis, Bifidobacterium longum, Collinsella aerofaciens, Faecalibacterium prausnitzii, Lacticaseibacillus rhamnosus, and Parabacteroides distasonis in the gut microbiota in patients with type1 and type2 diabetes, compared with the healthy controls and analyze the correlation between the gene expression levels of two short-chain fatty acids receptors GPR41 and GPR43. Methods: Forty type 1, 40 type 2 stool and blood samples of diabetes patients, and 40 healthy control samples were studied. DNA and RNA were extracted, and bacteria were detected using a Microbial DNA qPCR Assay kit. Gene expressions were detected with GPR41 and GPR43 primers via in-house qPCR. Results: Compared with healthy controls, B.longum and F.prausnitzii abundance were significantly decreased in patients with type1 and type2 diabetes, A.hallii abundance was increased in patients with type1 and decreased in type2 diabetes contrarily A.muciniphila abundance was decreased in patients with type1 and increased in type2 diabetes. GPR43 gene expression was upregulated in both patients group, however GPR41 was upregulated only in patients with type2 diabetes. Conclusions: Elevated B. longum and F. prausnitzii abundances were detected in the gut microbiota of patients with type1 and type2 diabetes and compared with healthy controls. B. longum and F.prausnitzii abundances were also correlated with the GPR43 gene expression level in type1 diabetes patients. Extensive studies determining bacteria producing short-chain fatty acids in gut microbiota, and their contribution in the pathogenesis of diabetes, are needed to understand better the mechanism of these diseases.

4.
Clin Lab ; 68(9)2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36125145

RESUMO

BACKGROUND: COVID-19 causes clinical manifestations ranging from asymptomatic infection to multi-organ failure. It is reported that those with severe disease have higher anti-SARS-CoV-2 antibody titers compared to asymptomatic or mild cases. We evaluated the correlation of antibody responses with laboratory and clinical indicators in COVID-19 patients. METHODS: Seventy-nine male and 66 female patients (mean age: 39) with at least one positive SARS-CoV-2 RT-PCR test and SARS-CoV-2 IgG antibody result after acute infection were included. RESULTS: Seventy-six (52%), 45 (31%), and 24 (17%) patients had mild, moderate, and severe clinical findings, respectively. Patients with high body mass index and advanced age had significantly more severe disease (p < 0.001). A significant correlation was found between the increase in lymphopenia, C-reactive protein, ferritin, D-dimer, and lactate dehydrogenase and the severity of clinical findings (p = 0.0001). SARS-CoV-2 IgG antibody test was positive in 128 (88.3%) patients. A significant correlation was found between disease severity and antibody levels in the comparison of all groups (p < 0.001). CONCLUSIONS: Long-term monitoring of immune responses will be required to determine the appropriate time for the administration of new vaccines.


Assuntos
COVID-19 , Adulto , Proteína C-Reativa , COVID-19/diagnóstico , Feminino , Ferritinas , Humanos , Imunoglobulina G , Lactato Desidrogenases , Masculino , SARS-CoV-2
5.
Clin Lab ; 68(9)2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36125161

RESUMO

BACKGROUND: The aim of this study was to determine the Firmicutes/Bacteroidetes ratio in the gut microbiota and IL-1ß, IL-6, IL-8, TLR2, TLR4 and TLR5 gene expression levels in the blood of adult type 2 diabetes (T2D) patients and compare it with that of adult nondiabetic healthy controls (HC). METHODS: Between May 2016 and April 2017, 99 T2D patients and 99 HCs were enrolled in the study. Bacteroidetes and Firmicutes levels were assessed from stool sample DNA and IL-1ß, IL-6, IL-8, TLR2, TLR4, and TLR5 gene expression levels assesed from blood sample RNA via qPCR from both T2D patients and healthy controls. RESULTS: The Firmicutes/Bacteroidetes ratio detected in the stool of type 2 diabetes patients was found to be higher with a statistically significant difference (p < 0.0001). Gene expression levels of IL-1ß, IL-6, IL-8, TLR2, TLR4, and TLR5 were found to be upregulated. CONCLUSIONS: The highest upregulation was detected in IL-6 with 11 fold in T2D patients comparing with HCs. F/B ratio and gene expression levels were elevated in T2D patients. Firmicutes were positively correlated with studied gene expressions. A better understanding of the complex interaction between gut microbiota, environment, and diabetes will allow for more effective prevention and treatment strategies for T2D.


Assuntos
Diabetes Mellitus Tipo 2 , Microbioma Gastrointestinal , Adulto , Bacteroidetes/genética , Bacteroidetes/metabolismo , Diabetes Mellitus Tipo 2/genética , Firmicutes/genética , Firmicutes/metabolismo , Microbioma Gastrointestinal/genética , Expressão Gênica , Humanos , Interleucina-1beta/metabolismo , Interleucina-6/genética , Interleucina-8/genética , RNA , Receptor 2 Toll-Like/genética , Receptor 2 Toll-Like/metabolismo , Receptor 4 Toll-Like/genética , Receptor 4 Toll-Like/metabolismo , Receptor 5 Toll-Like/genética
6.
Angiology ; 73(6): 565-578, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35104154

RESUMO

We assessed the effect of thrombus aspiration (TA) during percutaneous coronary intervention (PCI) on in-hospital and 3-year mortality in consecutive non-ST segment elevation myocardial infarction (n = 189) and unstable angina pectoris (n = 148) patients (n = 337) between 2011 and 2016. In total, 153 patients (45.4%) underwent TA. The number of patients with postoperative thrombolysis in terms of myocardial infarction grade 3 blood flow (P < .001) and myocardial blush grade 3 (P < .001) were significantly higher in all TA groups. At 6-, 12- and 24-month post-PCI, the mean left ventricular ejection fraction was significantly higher in the all TA groups versus the stand alone PCI group (P < .001). Thrombus aspiration was associated with a significant improvement both in epicardial flow, myocardial perfusion and left ventricular ejection fraction. Thrombus aspiration during PCI in all acute coronary syndrome (except ST segment elevation) patients was associated with better survival compared with stand alone PCI group at 3-year follow-up (P = .019).


Assuntos
Síndrome Coronariana Aguda , Trombose Coronária , Intervenção Coronária Percutânea , Síndrome Coronariana Aguda/terapia , Angiografia Coronária , Trombose Coronária/complicações , Trombose Coronária/terapia , Humanos , Volume Sistólico , Trombectomia/efeitos adversos , Resultado do Tratamento , Função Ventricular Esquerda
7.
Clin Rheumatol ; 41(5): 1523-1533, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35044502

RESUMO

OBJECTIVE: We aimed to find out the asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence among pediatric patients with rheumatic diseases and healthy children and to compare them with each other. METHODS: Patients with familial Mediterranean fever (FMF), juvenile idiopathic arthritis (JIA), and juvenile systemic lupus erythematosus (jSLE) and healthy children as healthy control (HC) group who remained asymptomatic during the pandemic are examined by ELISA immunoglobulin (Ig) A and IgG tests in this cross-sectional study. RESULTS: Overall, 149 subjects (90 females) were included in the study. While IgA was positive in 15 subjects (10%) (HC: 8, jSLE: 3, FMF: 2, JIA: 2; p = 0.196), IgG was positive in 14 subjects (9.4%) (HC: 7, JIA: 5, FMF: 1, jSLE: 1; p = 0.156). Nineteen subjects (12.75%) were IgA or IgG positive (HC: 8, JIA: 5, jSLE: 3, FMF: 3; p = 0.644). Although not significant, seropositivity was more often in HC group. Both IgA and IgG positivity were not found to be related to age, sex, underlying rheumatic diseases, and received treatments of the patients. CONCLUSION: We revealed that patients with childhood-onset rheumatic diseases, even if they receive immunosuppressive medication such as biologic or conventional disease-modifying anti-rheumatic drugs, might have an asymptomatic SARS-CoV-2 infection, similarly to their healthy peers. Key points • Although it has been already known that children are most likely to have asymptomatic SARS-CoV-2 infection, there is a lack of data on the disease course of children with rheumatic disease. • There was no significant difference regarding the asymptomatic SARS-CoV-2 seropositivity rates between healthy children and the patients with childhood-onset rheumatic diseases. • Patients with childhood-onset rheumatic diseases, even if they receive immunosuppressive medication, might have asymptomatic SARS-CoV-2 infection, similarly to their healthy peers.


Assuntos
Artrite Juvenil , COVID-19 , Lúpus Eritematoso Sistêmico , Doenças Reumáticas , Artrite Juvenil/tratamento farmacológico , Criança , Estudos Transversais , Feminino , Humanos , Imunoglobulina A , Imunoglobulina G , Masculino , Doenças Reumáticas/epidemiologia , SARS-CoV-2 , Estudos Soroepidemiológicos
8.
Langmuir ; 37(14): 4355-4369, 2021 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-33789039

RESUMO

Water droplet impacting on a slanted dusty hydrophobic surface is examined in relation to dust mitigation from surfaces. Impacting droplet characteristics including droplet spreading/retraction rates, slipping length, and rebound heights are analyzed via high-speed recording and a tracker program. The environmental dust characteristics in terms of size, shape, elemental composition, and surface free energy are evaluated by adopting the analytical methods. The findings reveal that the dynamic characteristics of the impacting droplet on the slanted hydrophobic surface are significantly influenced by the dust particles. The maximum droplet spreading over the dusty surface becomes smaller than that of the nondusty surface. The presence of the dust particles on the slanted hydrophobic surface increases energy dissipation, and the water droplet slipping length over the surface becomes less than that corresponding to the nondusty surface. Impacting droplet fluid infuses over the dust particle surface, which enables mitigation of dust from the surface to the droplet fluid. A dust-mitigated area on the slanted surface is larger than that corresponding to the horizontal surface; in which case, the area ratio becomes almost six-fold, which slightly reduces with increasing Weber number. The optical transmittance of the dust-mitigated surface by the impacting droplet remains high.

9.
Andrologia ; 53(3): e13985, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33474739

RESUMO

The study aimed to investigate the effects of dexmedetomidine against ischaemia-reperfusion injury occurring after priapism in a model of induced-priapism in rats. A total of 18 male rats were randomised into three groups. Group 1 was the control group. A priapism model was performed rats in Group 2 and then ischaemia-reperfusion injury was evaluated. Group 3 had similar procedures to the rats in Group 2. Rats in Group 3 additionally had 100 µg/kg dexmedetomidine administered intraperitoneally immediately after reperfusion. Blood and tissue samples were analysed. Biochemical analysis of blood samples revealed a decrease in the levels of the pro-inflammatory cytokines including interleukin-1 beta (IL-1 Beta), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-alpha) in Group 3 compared to Group 2 (p:.04, p:.009 and p:.009, respectively). Similarly, the highest malondialdehyde (MDA) level was in Group 2 (p:.002). The levels of antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities were significantly higher in Group 3 than that of Group 2 (p:.037 and p:.045, respectively). Direct microscopic examinations revealed positive changes in desquamation, oedema, inflammation and vasocongestion scores in Group 3 compared to Group 2 (p:.007, p:.008, p:.007 and p:.006, respectively). Dexmedetomidine has a protective effect against ischaemia-reperfusion injury in penile tissue.


Assuntos
Dexmedetomidina , Priapismo , Traumatismo por Reperfusão , Animais , Dexmedetomidina/farmacologia , Dexmedetomidina/uso terapêutico , Humanos , Masculino , Malondialdeído , Priapismo/etiologia , Ratos , Traumatismo por Reperfusão/prevenção & controle , Superóxido Dismutase
10.
J Obstet Gynaecol ; 41(5): 803-806, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33063572

RESUMO

Burch urethropexy is one of the earliest and most effective surgeries for stress urinary incontinence. Minimally invasive robotic surgery is becoming more popular in the field of urogynecology. Herein, we present the safety and efficacy of a large case series of robotic-assisted Burch urethropexy. A retrospective chart review was performed on robotic-assisted Burch urethropexy cases performed between 2013 and 2019. Patient characteristics, perioperative data and follow-up outcomes were collected at a single teaching institution. A total of 76 women underwent robotic-assisted Burch urethropexy for pure stress urinary incontinence. Fifty of them had concomitant robotic procedures at the time of the Burch. We performed the robotic-assisted Burch urethropexy alone on 26 patients. The mean age was 55 years old. The overall treatment success rate was 85% with a mean follow-up time of 134 (±157.8) days. Complications included cystotomy (3%), urinary tract infection (16%) and postoperative voiding dysfunction (10%). Our study reveals that robotic-assisted Burch urethropexy is a feasible option in the treatment of stress urinary incontinence in terms of operative outcomes and short-term efficacy.Impact statementWhat is already known on this subject? Minimally invasive robotic surgery is becoming more popular in the field of urogynecology. Surgical repairs for stress urinary incontinence will likely increase in the coming years secondary to an aging population. Burch urethropexy is one of the earliest and most effective surgeries for stress urinary incontinence and can be performed abdominally, laparoscopically and now, using robotic assistance.What do the results of this study add? This study reveals that robotic-assisted Burch urethropexy is a feasible option in the treatment of stress urinary incontinence in terms of intraoperative outcomes with good short-term efficacy.What are the implications of these findings for clinical practice and/or further research? Lately, interest in colposuspension procedures has been rekindled as physicians seek alternative stress urinary incontinence treatment options. Robotic-assisted Burch urethropexy will continue to gain popularity with its efficacy and safety.


Assuntos
Cistoscopia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Uretra/cirurgia , Incontinência Urinária por Estresse/cirurgia , Cistoscopia/efeitos adversos , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Resultado do Tratamento
11.
Sci Rep ; 10(1): 14746, 2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32901081

RESUMO

Water droplet cleaning of a dusty hydrophobic surface is examined. Environmental dust are used in the experiments and cloaking velocity of a dust layer by a droplet fluid is measured and hemi-wicking conditions for the dust layer are analyzed adopting the pores media wick structure approach. A droplet motion on dusty and inclined hydrophobic surface is analyzed using a high speed digital imaging system. Influences of dust layer thickness, droplet volume, and surface inclination angle on the mechanisms of dust removal by a rolling droplet are evaluated. The findings revealed that dust cloaking velocity decreases exponentially with time. The droplet fluid can cloak the dust layer during its transition on the dusty surface. The transition period of droplet wetted length on the dusty surface remains longer than the cloaking time of the dust layer by the droplet fluid. Translational velocity of rolling droplet is affected by the dust layer thickness, which becomes apparent for small volume droplets. Small volume droplet (20 µL) terminates on the thick dust layer (150 µm) at low surface inclination angle (1°). The quantity of dust picked up by the rolling droplet increases as the surface inclination angle increases. The amount of dust residues remaining on the rolling droplet path is relatively larger for the thick dust layer (150 µm) as compared to its counterpart of thin dust layer (50 µm).

12.
Langmuir ; 36(35): 10504-10518, 2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32787027

RESUMO

Carbonated water droplets can ease the difficulties faced by distilled water droplets mitigating dust particles from hydrophobic surfaces. Rising of CO2 bubbles in carbonated water droplets and their interaction with the flow structure, created by Marangoni and buoyancy possessions, in droplets are investigated. Spreading and infusion (cloaking) of carbonated water on dust surfaces are analyzed, and the rate at which bubbles formed inside the carbonated water droplet, as placed on a dusty hydrophobic surface, is examined. Flow structures formed inside the carbonated water droplet are simulated, and findings are compared to those corresponding to the distilled water droplet. Dust mitigation from the hydrophobic surface toward droplet liquid inside is evaluated using the high-speed recording system, and the results are compared with those of predictions. It is found that carbonated water spreads and infuses onto dust particles at a higher rate than that at which distilled water does. The rising bubble generates wake-like flow in the fluid while modifying the flow structure inside the droplet; hence, the number of circulating structures increases from two to four in droplet fluid. The dust particles picked up by flow currents are redistributed over the entire carbonated water droplet, while mitigated dust particles remain in the lower region of the distilled water droplet. Bubbles formed inside the carbonated water droplet improve dust lifting and rate of dust mitigation from the surface.

13.
Curr Microbiol ; 77(9): 2093-2103, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32504323

RESUMO

Helicobacter pylori is a gram negative, spiral-shaped, and microaerophilic bacteria which can cause life-threatening diseases. It is known that more than 55% of the human population in the world is already infected by this bacterium. The traditional treatment of H. pylori infection consists of a combination of two or more antibiotics. However, H. pylori has evolved to turning its shape from spiral to coccoid form in the presence of antibiotics and this decreases the therapeutic efficacies of conventional antibiotic applications. Resuscitation promoter factor (RPF) is a protein secreted by Micrococcus luteus have significant resuscitation effects on some bacteria especially in the group of viable but non-culturable (VBNC) pathogens. However, there is no study in the literature investigating the resuscitation effects of RPF derived from M. luteus on H. pylori in order to change its form from coccoid to spiral. The purpose of this study is to investigate the resuscitation effect of RPF-containing metabolites isolated from M. luteus on the morphological transformation of H. pylori coccoid forms to spiral forms in order to increase their susceptibilities to antibiotic treatments. Rpf-containing metabolites were primarily obtained from M. luteus culture supernatants. H. pylori was exposed to five different conditions such as prolonged culture, incubation at + 4 °C, incubation at + 22 °C, cultivation in PBS and treatment with kanamycin in order to induce transformations of bacteria to coccoid forms. Induced H.pylori coccoids were characterized by inverted microscope, UV spectrophotometer, SEM imaging, and flow-cytometer. As a result, it was found that the most suitable condition for inducing coccoid forms was cultivation of bacteria with kanamycin. Followingly, different concentrations of RPF-containing metabolites were applied on H. pylori coccoids induced by kanamycin. For the first time in this study, it was determined that the Rpf-containing metabolites obtained from M. luteus demonstrated very high resuscitation effect on kanamycin-induced H. pylori coccoid forms. This new approach for resuscitation of H. pylori coccoids is thought to play an important role in increasing the treatment effectiveness of the conventional antibiotics against the infection.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Antibacterianos/farmacologia , Humanos , Micrococcus luteus , Microscopia
14.
Sci Rep ; 10(1): 4594, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32165714

RESUMO

Enhancement of heating of a droplet on a hydrophobic surface is investigated. A vertical metal (column) pin is introduced in the droplet and the fluid heating, due to the column pin, is examined. The droplet heating is initiated at the hydrophobic surface and the column pin located in the droplet. The effect of the flow currents on the thermal fields inside the droplet fluid is assessed. An experiment is conducted to assure the velocity simulation results while using the particle image velocimetry (PIV). We demonstrated that the velocity simulations are in good agreement with the data obtained from PIV measurements. Two circulating structures are observed inside the droplet, which are related to the buoyancy and the Marangoni currents. The presence of the column pin changes the number of circulations cells to four inside the droplet. Heated fluid in region of the droplet-solid interface is transferred by the buoyancy current towards the droplet sides and heat diffusion increases temperature rise in the droplet central region. The Nusselt number attains larger values for the droplet with column pin configuration than that of the free droplet, which becomes apparent for the large droplet volumes. The Bond number improves with the presence of the column pin in the droplet; but, the Bond number values become smaller than unity for all the droplets with and without column pin configurations considered.

15.
J Matern Fetal Neonatal Med ; 33(8): 1288-1294, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30153762

RESUMO

Objectives: Ductus venosus (DV) Doppler examinations in pregnancy have a widespread use for several important indications and play a crucial role in order to determine the fetal well-being. DV is usually visualized by the color Doppler mapping. We observed the instantaneous spectral flow type changes in pulsed Doppler examinations in spite of performing with the correct technique published by several authors. The variability of the pattern makes the sonographer/physician to be unsure for the correct placements of the sample gate despite fulfilling the all the criteria required for the vessel sampling. It is aimed in the study to define variations of the normal DV spectral flow types in the duration of the pulsed Doppler examinations instead of in a single cardiac cycle in normal pregnancies.Methods: This prospective study was conducted between January 2016 and February 2017. Wide-band Doppler technique was used for color mapping of the DV. Normal spectral Doppler waveforms in pregnancies are classified as types. When DV spectral flow pattern was not in the standard type, the spectral flow patterns were obtained from not only the umbilical artery and/or middle cerebral artery. Maximum and minimum blood flow velocities in the umbilical vein are measured. All Doppler examinations are performed by a single experienced specialist (CG), who had been certificated for DV flow and Doppler examinations by the Fetal Medicine Foundation.Results: A total of seven types of flow patterns were recorded during the study period and DV flow patterns were divided into two main categories as classic flow pattern and the other patterns. The classic pattern was observed in 160 (99.4%) cases in the first trimester, 495 (94.1%) cases in the second trimester and 206 (60.8%) cases in the third trimester.Conclusions: We think that the fetal circulation is complicated more than estimated. There might be some endocrine agents released in the instantaneous physiologic reactions and changing the venous return abruptly or due to decreasing of the cardiac output directed to the placenta after 34 weeks influence the volume of the circulating blood in the fetus and so thereby the flow velocities instantaneously. The spectral waveform recognition approach is not reliable to identify if the DV spectral Doppler pattern is not the classic (standard) type and the DV should be visualized by wide-band color Doppler techniques particularly in the third trimester for the pulsed Doppler examinations. Studies are needed to evaluate the normal spectral variants of the flows correlated with the physiological compensatory mechanisms.


Assuntos
Canal Arterial/fisiologia , Ultrassonografia Doppler em Cores/métodos , Veias Umbilicais/irrigação sanguínea , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Canal Arterial/diagnóstico por imagem , Feminino , Humanos , Gravidez , Estudos Prospectivos , Ultrassonografia Pré-Natal , Veias Umbilicais/diagnóstico por imagem
16.
J Diabetes Complications ; 34(2): 107449, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31677982

RESUMO

AIM: The aim of this study was to determine and compare the levels of both Bacteroidetes and Firmicutes in the gut microbiota and TLR2/TLR4 gene expression in the blood of patients with type 1 diabetes mellitus (T1DM) and healthy individuals. These results may serve as a preliminary assessment to guide future research. METHOD: Between January and October 2014, stool and blood samples were collected from 53 adult T1DM patients and 53 age- and gender-matched healthy individuals. Bacteroidetes and Firmicutes levels were assessed from stool sample DNA and TLR2 and TLR4 expression levels were analyzed via qPCR using RNA from EDTA blood samples from both patients and healthy controls. RESULTS: The amounts of Bacteroidetes and Firmicutes were statistically significantly higher and lower, respectively, in the T1DM group than in the healthy control group (p < 0.001 and p < 0.001, respectively). In addition, the Firmicutes/Bacteroidetes ratios in patients with T1DM were significantly lower than in healthy controls. The TLR4 and TLR2 gene expression levels in T1DM patients were significantly upregulated and downregulated, respectively, compared to those in the control group. CONCLUSION: Our data are the first to show a relationship between T1DM and gut microbiota in our country. In addition, our results provide information about the connections between T1DM, gut microbiota, and TLR2 and TLR4 expression. We believe that Bacteroidetes and Firmicutes in the gut microbiota may play a role in the autoimmune process of T1DM and that these findings should be further investigated in the future.


Assuntos
Bacteroidetes/imunologia , Diabetes Mellitus Tipo 1 , Firmicutes/imunologia , Microbioma Gastrointestinal , Receptor 2 Toll-Like/genética , Receptor 4 Toll-Like/genética , Adulto , Bacteroidetes/isolamento & purificação , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/imunologia , Diabetes Mellitus Tipo 1/microbiologia , Feminino , Firmicutes/isolamento & purificação , Microbioma Gastrointestinal/genética , Microbioma Gastrointestinal/imunologia , Trato Gastrointestinal/imunologia , Trato Gastrointestinal/microbiologia , Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Receptor 2 Toll-Like/imunologia , Receptor 4 Toll-Like/imunologia , Turquia , Adulto Jovem
17.
Infez Med ; 27(3): 290-298, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31545773

RESUMO

Mediastinal fat has been suggested to be associated with cardiovascular diseases such as carotid stiffness, atherosclerosis and coronary artery calcification. We investigated the possible role of Ad-36-induced obesity in the pathogenesis of the coronary artery disease (CAD). Ad-36 DNA was investigated in the anterior mediastinal fat tissue samples of obese adults with CAD. Seventy-five obese adults with left main coronary artery (LMCA) disease, 28 non-obese adults with valvular heart diseases, and 48 healthy individuals without cardiovascular problems were included as the obese patient group (OPG), non-obese patient group (NOG) and healthy control group (HCG), respectively. We also simultaneously investigated Ad-36 antibodies by serum neutralization test (SNA), and measured leptin and adinopectin levels. Ad-36 antibodies were detected only in 10 patients (13.3%) within the 75 OPG. A statistically significant difference was detected between OPG, NOG and HCG in terms of Ad-36 antibody positivity (p>0.05). Ad-36 DNA was not detected in mediastinal tissue samples of OPG and NOP without PCR inhibitors. We suggest that Ad-36 may not have an affinity for mediastinal adipose tissue in obese patients with left main CAD and valvular heart diseases. Ad-36 antibody positivity results are not sufficient to reach a causal relationship.


Assuntos
Adenovírus Humanos/imunologia , Adipogenia , Tecido Adiposo/virologia , Anticorpos Antivirais/sangue , Doença da Artéria Coronariana/etiologia , Obesidade/virologia , Adenovírus Humanos/genética , Adiponectina/sangue , Adulto , Estudos de Casos e Controles , Doença da Artéria Coronariana/virologia , Estudos Transversais , DNA Viral/isolamento & purificação , Feminino , Doenças das Valvas Cardíacas/virologia , Humanos , Leptina/sangue , Masculino , Mediastino/virologia , Pessoa de Meia-Idade , Obesidade/complicações , Calcificação Vascular , Relação Cintura-Quadril
18.
Clin Lab ; 64(7): 1269-1277, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30146848

RESUMO

BACKGROUND: Parapneumonic effusions usually occur secondary to an infection and produce pus (empyema) that accumulates in the pleural space. We aimed to evaluate the prevalence of anerobes in patients with empyema and to assess their resistance patterns for seven antimicrobials. METHODS: Pleural fluid specimens from 236 patients were inoculated on Schaedler agar. Anaerobic bacteria were identified via API 20 A. Susceptibility testing for penicillin, ampicillin + sulbactam, amoxicillin + clavulanate, cefoxitin, clindamycin, metronidazole, and imipenem were performed with the E-test. RESULTS: There were 118 anaerobic bacterial strains detected in 66 (27.9%) of the 236 specimens. Gram-positive anaerobic cocci were detected in 54.23% and the predominant cocci were 41 Peptostreptococcus spp, (34.75%) followed by 17 P. acnes (14.41%) and 6 C. tertium (5.08%). The Gram-negative anaerobes were B. fragilis (28, 23.73%), P. melaninogenica (8, 6.78%), P. intermedia (4, 3.39%), F. nucleatum (6, 5.08%), F. mortiferum (5, 4.24%), and P. asaccharolytica (3, 2.54%). All anaerobic strains were susceptible to ampicillin + sulbactam, amoxicillin + clavulanate, and imipenem. The highest MIC was found to be > 256 µg/mL for penicillin in B. fragilis strains, 128 µg/mL for cefoxitin in P. melaninogenica strains, 32 µg/mL for clindamycin and 64 µg/mL for metronidazole in P. acnes strains. Clindamycin resistance was detected in 46.6% B. fragilis, and 17.6% for P. acnes. Thirty-eight (32.2%) strains produced beta-lactamase. CONCLUSIONS: The use of antimicrobial agents for thoracic empyema should be based on the isolated pathogens and their resistance profiles. Clinicians should be aware of the wide diversity of anaerobic genera and species in cases of pleural empyema.


Assuntos
Antibacterianos/farmacologia , Bactérias Anaeróbias/fisiologia , Infecções Bacterianas/microbiologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Empiema Pleural/microbiologia , Bactérias Anaeróbias/classificação , Bactérias Anaeróbias/isolamento & purificação , Infecções Bacterianas/epidemiologia , Feminino , Bactérias Gram-Negativas/classificação , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Negativas/fisiologia , Bactérias Gram-Positivas/classificação , Bactérias Gram-Positivas/efeitos dos fármacos , Bactérias Gram-Positivas/fisiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Derrame Pleural/microbiologia , Prevalência , Estudos Retrospectivos , Turquia/epidemiologia
19.
Wien Klin Wochenschr ; 130(11-12): 408, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29736900

RESUMO

Correction to: Wien Klin Wochenschr 2015 https://doi.org/10.1007/s00508-015-0854-z The original version of this article unfortunately contained a mistake. The first names of Dr. Ismail Dogu Kilic were interchanged.

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