Background: Endocan is a newly identified proteoglycan released from endothelium, stimulating angiogenesis and when increased, indicates endothelial activation (inflammation). Our aim was to examine the association between serum endocan levels and urine albumin-creatinine ratio (UACR). Method: One hundred and thirty-seven patients with type 2 diabetes mellitus and normal serum creatinine who had no co-morbidities other than hypertension, diabetic nephropathy, retinopathy, or neuropathy were divided into normoalbuminuria (G1), microalbuminuria (G2), and macroalbuminuria (G3) groups and compared cross-sectionally regarding serum endocan levels. Result: There were 55, 47, and 35 patients in G1, G2, and G3, respectively. The groups were comparable in terms of gender, age, duration of diabetes, diabetic neuropathy/retinopathy, fasting glucose, HbA1c, serum creatinine level, and eGFR. Patients in G3 had significantly higher blood pressure but lower serum albumin and endocan levels. UACR showed a negative bivariate correlation with serum endocan levels (r ¼ À.282, p ¼ .001). There was bivariate positive correlation between endocan and systolic blood pressure (r¼.185, p ¼ .030). In linear regression analysis, UACR was negatively correlated with endocan while positively correlated with systolic blood pressure, duration of diabetes, and platelet distribution width. Conclusion: Patients with macroalbuminuria had lower endocan levels, and increasing UACR was associated with decreasing serum endocan levels. Despite the occurrence of angiogenesis and glomerular hypertrophy in the early phase of diabetic nephropathy, ensuing significant renal injury over time may reduce the expression of endocan. Serum endocan levels may represent a novel marker for nephropathy progression.
Essential thrombocythemia (ET) is an entity of classic Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs), characterized by thrombocytosis with megakaryocytic hyperplasia and thrombocytes are increased with abnormal functions. Discovery of the protein tyrosine kinase JAK2 V617F allele contributed to better understanding of the pathogenetic mechanisms of MPNs. Acquired single point mutation in the JAK2 V617F was determined approximately 50-60 % of patients with ET. In this study we aimed to investigate the relationship between JAK2 V617F gene mutation, hematologic, biochemical markers and the complications in the ET patients. A total of 268 patients diagnosed with ET and 219 of those studied for JAK2 gene mutation were followed at the hematology clinics of three major hospitals between 2008 and 2013 were screened retrospectively. Laboratory, clinical and hematologic parameters were compared for JAK2 V617F positive and JAK2 V617F negative patients with ET. 102 (46 %) patients were positive with the JAK2 V617F mutation. The complications were observed in 61 (28 %) patients and 38 (62 %) of them had JAK2 V617F mutation. The levels of white blood cells, neutrophil, basophil, red blood cells, hemoglobin, hematocrit, mean platelet volume, thrombocytes, eosinophil; urea, creatinine were significantly different in patients with the JAK2 V617F mutation (P < 0.05). Presence of the JAK2 V617F mutation supports the diagnosis of ET. It would be useful to investigate the JAK2 V617F mutation and the hematologic and biochemical markers at diagnosis with respect to consider the risk of developing complications and to take the precautions against these complications.
Background/Aims: Obesity is an epidemic and its prevelance and number of patients underwent bariatric surgery continue to increase worldwide. This study aimed to evaluate endoscopic findings and co-morbidities, to investigate the prevelance of Helicobacter pylori (H. pylori) infection and the relationship between body mass index (BMI) and gastroesophageal sphincter incompetency in obese patients. Materials and Methods: An upper gastrointestinal system endoscopy and mucosal sampling were performed in all patients hospitalized for bariatric surgery. Age, gender, BMI, co-morbidities and endoscopic findings were recorded. Gastroesophageal sphincter incompetency was classified according to Hill classification. The patients were divided into two groups: group I, endoscopically normal and group II, endoscopically abnormal. Results: Total 127 patients were enrolled into prospective study. Of these, 93 (%73.2) were female and the mean age was 38.9±12.5 years (range: 16-68). Abnormal endoscopic findings and H. pylori were detected in 80.4% and 44.9% of patients, respectively. In group II, patients were older, BMI higher and H. pylori more prevalent (all statistically significant). Diabetes mellitus, hypertension and dyslipidemia were the most frequent common co-morbidities. Rate of multiple co-morbidities were more common in group II. Gastroesophageal sphincter incompetency in total group was observed in a rate of 46.5% and was weakly correlated with BMI. Conclusion: Four-fifths of obese patients have at least one endoscopic abnormal finding, three fourth at least one co-morbidity and half H. pylori positivity. Upper gastrointestinal system endoscopy should be performed routinely in all patients to predict and prevent complications following bariatric surgery.
Diffüz alveoler hemoraji, Sistemik Lupus Eritematozus (SLE) tanılı hastalarda nadir görülen ve katastrofik seyir gösteren bir klinik süreçtir. Olguda lupus nefriti tanısı ile takip edilirken diffüz alveoler hemoraji gelişen hasta anlatıldı. Ani gelişen nefes darlığı ile hastaneye başvuran hastada akut solunum yetmezliği ve böbrek yetmezliği bulguları lupus alevlenmesi olarak değerlendirildi. Pulse metilprednizolon, immunsüpresan tedavi ve intravenöz immunglobulin tedavisine rağmen iyileşme görülmedi. Double Filtrasyon Plazmaferez uygulaması ile altı seans sonunda alveoler hemoraji bulgularının klinik ve radyolojik olarak düzeldiği görüldü. Hasta altıncı gün sonunda ekstübe edildi. Olgumuz özellikle diffüz alveoler hemoraji ile birliktelik gösteren sistemik lupus eritematozus hastalarında tedavide double filtrasyon plazmaferez kullanımının akılda tutulması açısından önem taşımaktadır.
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