Endothelial-specific molecule 1 (endocan) is expressed in endothelial cells. We investigated the relationship between acute coronary syndrome (ACS) and serum endocan levels. We included 30 individuals as a control group and 53 patients diagnosed with ACS. The severity of coronary artery disease was assessed by a modified Gensini stenosis and SYNTAX scoring system. There was a significant difference in serum endocan levels between the control group and the ACS group (0.75 ± 0.13 vs 0.86 ± 0.25 ng/mL, P = .014). There was also a significant difference in serum endocan levels between diabetic patients with ACS and nondiabetic patients with ACS (1.02 ± 0.33 vs 0.81 ± 0.21 ng/mL, P = .016). There was no significant correlation between serum endocan level, Gensini, and SYNTAX score (r = .11, P = .53 and r = .16, P = .37). Endocan, a new biomarker of endothelial pathology, is significantly increased in patients with ACS.

Endothelial-specific molecule 1 (endocan) is expressed by endothelial cells and may have a major role in the regulation of cell adhesion and in the pathogenesis of inflammatory disorders. We aimed to assess change in endocan levels after 3 months of lifestyle change recommendations and guideline-based treatment. Diabetic patients (n = 77) who had neither chronic kidney disease nor chronic inflammatory disease were included. After baseline evaluation, the patients were advised lifestyle changes, and their medical treatment was determined individually according to recommendations of the American Diabetes Association (ADA) guidelines. At the end of third month patients were reevaluated. Baseline endocan levels were significantly increased in the study group compared with the control group. The third-month laboratory workup showed significant reductions in hemoglobin A1c, urinary albumin-to-creatinine ratio (UACR), and endocan levels. Only δ-UACR was independently correlated with δ-endocan in multivariate linear regression analysis. Our findings suggest that serum endocan concentrations are elevated in patients with type 2 diabetes and decrease following anti-hyperglycemic treatment. Furthermore, decrease in endocan concentrations might be associated with improved glycemic control and reductions in UACR.

Antihypertensive therapies were individualized, as suggested by the consensus report. However, there are proposals still to be considered in special patient groups.

Objective: Activated macrophages (M1-type macrophages) in adipose tissue secrete many proinflammatory cytokines that induce insulin resistance (IR). Oncostatin M (OSM), a member of the interleukin-6 (IL-6) family of Gp130 cytokines, plays an important role in a variety of biological functions, including the regulation of inflammatory responses. Proinflammatory cytokines released in patients with IR trigger a chronic, low-grade inflammatory reaction in blood vessel walls. This inflammator response leads to endothelial damage, which is the main mechanism for atherosclerosis and many cardiovascular diseases. Animal studies have reported a relationship between OSM and IR. To the best of our knowledge, however, few clinical studies have examined this topic. Therefore, we studied the relationship between serum levels of OSM and IR. Subjects and methods: This prospective cross-sectional case-control study enrolled 50 people with IR (according to the HOMA-IR and QUICKI indices) and 34 healthy controls. The fasting blood concentrations of insulin, glucose, blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, total cholesterol, C-reactive protein (CRP), and OSM were determined. Results: There were no significant differences between the two groups in age, sex, and HbA1c levels. Univariate analyses showed that waist circumference (WC) and levels of fasting glucose, insulin, CRP, HDL-C, OSM, HOMA-IR, and QUICKI differed between the two study groups. In multivariate analyses, both IR indices (QUICKI and HOMA) and OSM differed between the two groups. Conclusion: OSM was correlated with the IR indices (QUICKI and HOMA). For simplicity, it might replace the other IR indices in the future. Further detailed studies are needed to confirm this.

Objectives: When adult health is considered in our country and all over the world, preventive medicine applications, such as vaccination, remain important. With this study, we aimed to raise awareness about physician approaches and practices in adult vaccination. Methods: For this study, the current literature on adult vaccination was examined, and an awareness questionnaire consisting of 22 multiple choice questions was prepared. After the approval of the local ethics committee, 200 physicians were asked questions. The responses were evaluated as a percentage according to the frequency calculation. Results: According to the information obtained from the physicians, the Hepatitis B vaccine was the most common vaccine in adults. The rate of doctors recommending vaccination to their patients was 90% , which found to be quite high. Only 20% of the physicians were involved in vaccination-related training after graduation, and only 30% of them said they attach the necessary importance to adult vaccination in their daily practice. With a rate of 88.5%, most physicians wanted to have a practical reminder system. Conclusion: When the accuracy of the theoretical information and answers were examined, that the findings suggest that the theoretical knowledge of physicians was sufficient. However, we should note that the current knowledge about vaccination applications and travel health should be updated in risky groups.

Objective: Patients may develop kidney failure because of the contrast agent given during coronary angiography. Renal dysfunction and heart failure were previously shown to be associated with the development of contrast nephropathy. In our study, we aimed to investigate whether there is a relationship between subclinical renal (indicated by microalbuminuria) and/or cardiac (indicated by the height of the BNP) dysfunction between the development of contrast-induced nephropathy on patients undergoing angiography due to acute coronary syndrome. Methods: This is an observational prospective cohort study. A total of 170 patients hospitalized with a diagnosis of acute coronary syndrome in the coronary care unit were included in this study. Blood samples were collected from 145 patients without microalbuminuria and 25 patients with microalbuminuria to determine their BNP levels before coronary angiography. The patients' urea and creatinine levels were examined before and 72 h after coronary angiography. Statistical analysis was performed using Kolmogorov-Smirnov test, Mann-Whitney U test, independent samples t-test and the chi-square test. Results: The study subjects included 82 females and 88 males (average age, 64.4±14.5 years). The BNP levels and height distribution of the 145 patients without microalbuminuria were compared between those with and without contrast agent-induced nephropathy, but no significant difference was found (205.6±280.6, 198.0±310.0, p=0.817). Similarly, no relationship between the microalbumin level and contrast agent-induced nephropathy was found in 25 patients. Conclusion: A relationship between BNP, microalbuminuria, and contrast agent-induced nephropathy was not found in patients hospitalized in a coronary care unit with a diagnosis of acute coronary syndrome who were scheduled for coronary angiography. Additional multicenter studies with larger patient groups should be conducted to obtain more data. (Anadolu Kardiyol Derg 2014; 14: 505-10)

Omentin-1, an adipocytokine that increases the insulin sensitivity, has been determined to be reduced in patients with insulin resistance, impaired glucose tolerance, and Type-2 diabetes mellitus. In this study, we have investigated the alterations in Omentin-1 levels with the blood glucose regulation in diabetic patients having poor glycemic control. By this way, we aimed to determine the role of Omentin-1 as a marker in follow-up and monitoring progression of diabetes. Totally 58 patients with type 2 diabetes mellitus, older than 18 years of age who were having poor glycemic control (HbA1c≥9) were included in this study. In the first visit, all clinical and biochemical parameters of patients were recorded. After baseline evaluation, the patients were advised life style changes, and their medical treatment was determined individually according to the recommendations of the American Diabetes Association guidelines. At the end of the third month patients were re-evaluated. Serum Omentin-1 levels were measured with ELISA. In patients using only oral antidiabetic agents, after exchanging the treatment with insulin, on 3 month of treatment, there was a significant decrease in serum C-peptide and Omentin-1 levels compared with the initial results (p=0.034, p=0.048, respectively). On the other hand, in patients using insulin treatment from the beginning of the study, there was not any significant alterations in serum C-peptide or Omentin-1 levels compared with the initial results (p>0.05). Serum Omentin-1 levels may change with insulin and metformin treatments in Type-2 diabetic patients. In patients with poor glycemic control, Omentin-1 levels do not change with the regulation of blood glucose levels. A decrease in Omentin-1 and C-peptide levels has been determined after the initiation of insulin therapy. This suggests that, Omentin-1 levels are closely associated with the endogenous insulin reserve and may be used in follow-up of patients.

Vitamin D is a hormone that affects various systems of the body. In addition to the known effect of vitamin D on the musculoskeletal system, recent epidemiologic studies associate low serum vitamin D levels with an increased risk for numerous diseases, including cancers (breast and colorectal cancers), autoimmune diseases (multiple sclerosis and type 1 DM), skin diseases (psoriasis, vitiligo, morphea, hyperkeratotic palmoplantar eczema, and acanthosis nigricans), infectious diseases (tuberculosis, otitis media, upper/lower respiratory tract infections, and influenza infection), type 2 DM, hypertension, cardiovascular diseases, and obesity. This is probably because of the anti-inflammatory and immunomodulatory characteristics of vitamin D, and its possible effects on cytokine levels. Presence of vitamin D receptors in the thymus and peripheral T cells shows vitamin D has important effects on T-cell development and activity. Active vitamin D has a direct effect on T cells and antigen-presenting cells, and it also suppresses the differentiation of B cells to plasma cells and inhibits immunoglobulin production (1, 2).Although numerous studies have investigated the clinical role of vitamin D in chronic infectious diseases, there are few studies that reflect the importance of vitamin D, particularly for the prognosis of inflammatory diseases that acutely affect the liver such as acute toxic, ischemic, or viral hepatitis. It is not known how serum 25-hydroxy (OH) vitamin D levels are affected in acute liver injuries. In addition, it is unknown whether serum vitamin D levels change parallel to the recovery of clinical and biochemical test parameters in patients with acute hepatitis. This study aimed to detect serum vitamin D levels in patients with acute hepatitis and determine whether serum vitamin D levels are associated with acute toxic, ischemic, or viral hepatitis. We also investigated whether serum vitamin D levels contributed to prognosis and/or mortality of patients with acute hepatitis. Objective: Vitamin D is a key regulator of calcium homeostasis and has anti-inflammatory and immunomodulatory effects. Active vitamin D has a direct effect on T cells and antigen-presenting cells. It also suppresses the differentiation of B cells to plasma cells and inhibits immunoglobulin production. Vitamin D supplementation is associated with a favorable outcome in chronic inflammatory diseases. In this study, we aimed to determine serum vitamin D levels in patients with acute toxic, ischemic, or viral hepatitis and whether the levels had an effect on clinical progression or mortality in patients with acute hepatitis. Methods:Forty-eight patients (26 men and 22 women) and 35 controls (16 men and 19 women) aged >18 years who were diagnosed as having acute hepatitis and hospitalized in the Internal Medicine Department were enrolled. To determine serum 25-hydroxy (OH) vitamin D levels, two fasting blood samples, first in the initial 24-48 h following hospitalization and second on the day of discharge, were obtained from the part...