-wave dispersion (PD) is defined as the difference between the minimum (P min) and maximum (P max) P-wave durations on standard 12-lead electrocardiography (ECG). PD is a measure of heterogeneity of atrial refractoriness and prolongation of PD shows the intra-atrial and inter-atrial non-uniform conduction. 1 In previous studies it was shown that PD prolongation is an independent risk factor for development of atrial fibrillation (AF). 2,3 AF is the most frequently encountered rhythm disturbance in clinical practice and its frequency increases 2-fold in every decade after 55 years old. 4 Although AF is often associated with structural heart diseases, there is no detectable heart disease in a substantial portion of the cases. 5 It was shown in epidemiological studies that the rate of development of AF in diabetic cases is higher than normal cases. 6 The pathological mechanisms related to initiation and maintainance of AF in patients with diabetes mellitus (DM) has not been well described. In diabetic cases it is thought that myocardial ischemia as a result of coronary microcirculation disorders or metabolic stress on atrium can play a role. Hypertension and coronary artery diseases, which are important factors in development of AF, often accompany DM. No study evaluating PD in diabetic cases without hypertension and coronary artery disease has yet been published.In the current study we planned to investigate PD in noncomplicated diabetic patients. MethodsSeventy-six diabetic patients who had no coronary artery disease or hypertension (group1; mean age 48±9 years) and 40 healthy volunteer individuals (group2; mean age 46±13 years) were enrolled in the study. Patients with DM history, taking anti-diabetic medicine and patients whose fasting glucose level is 126mg/dl or above were accepted as diabetic. 7 Of the diabetic cases, 25 (33%) were receiving insulin (mean 26±6U/day) and 51 (67%) of the cases were receiving oral anti-diabetic treatment. The cases whose fundus examination showed retinopathy were not included in the study. Cases with history of myocardial infarction, angina pectoris or other clinical findings of coronary artery diseases were not included in the study. Resting 12-lead ECG and maximal treadmill exercise test (according to Bruce protocol) were performed in every case. Cases who had right bundle-branch block, left bundle-branch block, Wolff-Parkinson-White syndrome, intraventricular conduction defect in resting ECG and anginal chest pain or ischemic ECG changes during the exercise test were excluded from the study. Patients with a history of AF, having a permanent pacemaker, taking anti-arrhythmic medicine, having a thyroid disease, left ventricular hypertrophy, and/or left ventricular dysfunction were also excluded. The 24-h Holter ECG records of the cases were obtained. Holter WIN-PV plus program was used for these records.We paid attention to the patient's renal and hepatic functions and monitored the levels so they were kept in normal Background P-wave dispersion (PD), a measure of heterogeneit...

Circ J 2009; 73: 899 -904 lood pressure (BP) shows diurnal variation, reaching the highest level during the morning and then declining to reach a trough value at about midnight. In the early morning, an abrupt and steep acceleration in BP occurs, coincident with arousal and arising from overnight sleep. 1 However, there is considerable variation in the diurnal rhythm of BP in different individuals.In several studies of hypertensives, it has been shown that several abnormalities in BP circadian rhythm such as nondipping status (NDS), increased morning BP (MBP) and increased MBP surge (MBPS) have an association with cardiovascular (CV) target organ damage (TOD). [2][3][4][5] In normotensives, the relation between the abnormalities in BP circadian rhythm and TOD has not been examined sufficiently. 6,7 Therefore, in the present study, we have attempted to determine each effect of these abnormalities on TOD separately and to determine which abnormality in BP circadian rhythm (NDS, increased MBP or increased MBPS) is more closely related to TOD in normotensives. MethodsBetween December 2005 and December 2007, among the normotensives applying at the Cardiology Clinic of Meram Medical Faculty of Selcuk University who did not exhibit any significant cardiac pathology, 47 dipper subjects (28 women, mean age 45.8±9.3 years) and 32 non-dipper subjects (25 women, mean age 49.1±8.3 years) were included in the present study according to following criteria: (1) office BP <140/90 mmHg; and (2) average 24-h ambulatory BP <130/80 mmHg. 8 None of the subjects selected took antihypertensive medication or had a history of hypertension. Subjects with renal dysfunction (serum creatinine ≥2 mg/dl or macroalbuminuria >300 mg/24 h), hepatic failure, a history of coronary artery disease, stroke, heart failure, arrhythmia, diabetes mellitus, and/or those currently smoking were excluded. Those not smoking for at least last 2 years were accepted to be non-smokers. Subjects who reported in our post-ABPM questionnaire that their sleep was severely disturbed when wearing the ABPM were also excluded. Each was adequately informed about the aim of the present study before he/she was accepted to be enrolled.Office BP was measured using a calibrated mercury sphygmomanometer in an office setting after the subjects had rested at least 5 min in a seated position. Three measurements were taken at 2-min intervals, and the average of these measurements was used to define office systolic BP (SBP) and diastolic BP (DBP). Dyslipidemia was defined by a total cholesterol level >240 mg/dl or taking lipid-lowering agents. Body mass index (BMI) was calculated as weight (kg)/height (m) 2 . The body surface area was calculated according to the following formula in square meters: 0.007184 × weight (kg) 0.425 × height (cm) 0.725 . (Received October 6, 2008; revised manuscript received November 30, 2008; accepted December 25, 2008; released online March 18, 2009

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<b><i>Objectives:</i></b> Human papillomavirus (HPV) is a well-known oncogenic virus associated with anogenital carcinomas. Despite the anatomical proximity of the bladder and the anogenital region, the relationship between HPV and urothelial carcinoma of the bladder (UCB) is still a controversial issue. This study aimed to test the urethral swabs and first-void urine samples of patients with UCB for HPV-Deoxyribonucleic acid (DNA) using polymerase chain reaction (PCR) assay and to compare the results with a control group. <b><i>Materials and Methods:</i></b> Sixty-nine patients who were diagnosed with UCB between January and December 2018 were included in this case-control study. Sixty-nine patients who visited the urology outpatient clinic for non-oncological reasons within the study period were designated as the control group. Urethral swab and first-void morning urine samples were collected from each patient. HPV-DNA presence was investigated using a PCR kit that can detect a total of 22 HPV genotypes, of which 18 are high-risk and 3 are low-risk genotypes. <b><i>Results:</i></b> The mean age of the patients included in the study was 63.2 ± 12.6 years and the male to female ratio was 5.3. HPV-DNA was detected in 28.9% (20/69) of the patients in the case group and in 8.7% (6/69) of the patients in the control group. HPV-DNA positivity was significantly higher in the case group (OR 4.24; 95% CI 1.63–12.34). No statistically significant relationship was found between HPV-DNA positivity and tumor grade (<i>p</i> = 0.36). <b><i>Conclusion:</i></b> A statistically significant relationship exists between HPV infection and UCB, regardless of the tumor grade.

enopause is a critical period in a woman's life, during which many physiologic and pathologic changes occur. Women spend one-third of their lifetime in this period and the hormonal changes that occur during this period have significant influences on several organs and systems. The cardiovascular system is among the most dramatically affected systems. Changes in cardiovascular risk factors due to estrogen deficiency and subsequent increase in cardiovascular morbidity and mortality have been demonstrated in several studies. [1][2][3] Structural and functional changes in the heart can also occur during the postmenopausal period. The effects of menopause on cardiac structure and function have not been investigated adequately. Interpretation of the results of the few previous studies 4-6 comparing pre-and postmenopausal women comprises some difficulties, owing to significant age differences and small sample sizes. Moreover, cardiac functions have been evaluated only by conventional 2-dimensional (D) and M-mode echocardiography in these studies, thus the extent of influence on more recent echocardiographic parameters after menopause have not been adequately analyzed.Tissue Doppler echocardiography (TDE) is a relatively new technique, which is partially utilized in recent years to evaluate cardiac functions via measurement of myocardial velocities. 7 Also, myocardial performance index (MPI) has been recognized as a parameter that reflects ventricular systolic and diastolic functions. 8,9 To our knowledge, no literature exists on how myocardial velocities, as measured by TDE, which have some advantages over standard echocardiographic methods, and MPI, which provides a more quantitative and global evaluation of left ventricular (LV), are affected by menopause. The present study was designed to investigate how myocardial velocities measured by TDE and MPI, which together provide more quantitative data on regional and global ventricular functions, are affected by menopause. Methods Study PopulationSubjects were selected from healthy women admitted to the gynecology and obstetrics, and cardiology outpatient departments between 2001 and 2006. After informed consent was obtained, a prospective analysis was performed. Body weight and height of all subjects were measured and body mass index was calculated. Fasting blood samples were drawn for biochemical and hematological investigations and ECGs were done. An exercise stress test using Bruce protocol and subsequent echocardiographic evaluations were performed. Postmenopausal status was confirmed as being in menopause for at least 12 months with serum follicle-stimulating hormone (FSH) levels of >30 mU/ml and estrogen levels of <20 pg/ml, and premenopausal status Effects of Menopause on the Myocardial Velocities and Myocardial Performance IndexMehmet Akif Düzenli, MD; Kurtulus Ozdemir, MD; Abdullah Sokmen, MD**; Ahmet Soylu, MD; Nazif Aygul, MD; Kazim Gezginc, MD*; Mehmet Tokac, MD Background Although menopause is known to increase cardiovascular risk and mortality, the effect ...