Impact of Myocardial Acceleration during Isovolumic Contraction in Evaluating Subclinical Right Ventricular Systolic Dysfunction in Type 2 Diabetes Mellitus Patients

Aim: In diabetes mellitus (DM) patients, left ventricular dysfunction is widely evaluated and established by conventional diagnostic methods, whereas right ventricular (RV) function is not as sufficiently evaluated. The aim of this study is to assess the preclinical effects of DM on RV function by using novel Tissue Doppler Imaging (TDI)‐derived indices. Methods: The study included 96 patients with type II DM [60 with DM only and 36 patients with coexisting DM and hypertension (DMHT)] and 40 healthy controls. Conventional parameters and TDI‐derived systolic velocities of tricuspid annulus [isovolumic myocardial acceleration (IVA), peak myocardial velocity during isovolumic contraction (IVV), peak systolic velocity during ejection period (Sa), RV Tei index] were measured. Results: TDI‐derived RV IVA was significantly lower in both DM and DMHT patients compared to controls indicating subclinical impairment in RV systolic function in the study patients (P = 0,0001). However RV IVA was similar in DM and DMHT subgroup supporting RV systolic impairment in DM was independent from HT. In correlation analysis, RV IVA was significantly correlated with the existence of diabetic nephropathy (r =?0,38; P = 0,003), retinopathy (r =?0,35; P = 0,006), insulin resistance (r =?0,52; P = 0,0001). Conclusions: Diabetes is associated with subclinical RV systolic dysfunction, regardless of coexisting hypertension. Tissue Doppler‐derived IVA; is a novel, non‐invasive parameter which may be used in early detection of RV systolic dysfunction in patients with DM. (Echocardiography 2010;27:1211‐1218)     

Can we use CT pulmonary angiography as an alternative to echocardiography in determining right ventricular dysfunction and its severity in patients with acute pulmonary thromboembolism?

Purpose

Our aim was to investigate the role of computed tomography pulmonary angiography (CTPA) in the diagnosis of right ventricular dysfunction (RVD) and massive pulmonary thromboembolism (PTE).

Materials and methods

We retrospectively involved a total of 61 patients. In CTPAs, pulmonary arterial obstruction index (PAOI), right ventricular/left ventricular diameter ratio (RV/LV), and superior vena cava (SVC) diameters were calculated, followed by echocardiography (ECHO), and clinical results were evaluated based on the reports available.

Results

CTPA findings that included PAOI, RV/LV ratio, and SVC diameter were, respectively, 54.9 ± 22.7 %, 1.58 ± 0.51, and 20.3 ± 0.2 mm in patients with RVD on ECHO, whereas corresponding values were, respectively, 37.8 ± 24.2 %, 1.32 ± 0.47, and 18.4 ± 3.3 mm in those without RVD (respectively, p = 0.006, p = 0.038, and p = 0.026). PAOI was 63.3 ± 22.0 % in patients among whom massive PTE was detected and 43.1 ± 23.9 % in the group without massive PTE (p = 0.01). As for mortality; given an RV/LV ratio >1.0, this ratio had 100 % sensitivity and 35.6 % specificity, whereas given a PAOI of ≥50 %, sensitivity and specificity were 83.3 % and 57.8 %, respectively.

Conclusion

We concluded that in the patients with PTE, PAOI ≥50 % and RV/LV >1.0 in CTPA could be helpful to demonstrate RVD.     

Predicting long-term sickness absence from sleep and fatigue

Disturbed or shortened sleep is prospectively related to disease. One might also expect that sickness absence would be another consequence but very little data seem to exist. The present study used 8300 individuals in a national sample to obtain information on reports of disturbed sleep and fatigue one [corrected] year and merged this with data on long-term sickness absence two [corrected] years later. A logistic regression analysis was applied to the data with adjustments for demographic and work environment variables. The results showed that individuals without registered sickness absence at the start had a higher probability of entering a period of long-term (>/=90 days, odds ratio [OR] = 1.24 with 95% Confidence Interval [CI] = 1.09[corrected]-2.18[corrected]) sickness absence two [corrected] years later if they reported disturbed sleep at the start. The value [corrected] for fatigue was OR = 1.69[corrected] (CI = 1.23[corrected]-2.33[corrected]). When fatigue or disturbed sleep was separately excluded the OR increased to OR = 1.90[corrected] and OR = 1.86[corrected], respectively. Intermediate sickness absence (14-89 days) showed similar but slightly weaker results. The results indicate that disturbed sleep and fatigue are predictors of long-term absence and it is suggested that impaired sleep may be part of a chain of causation, considering its effects on fatigue.     

Effects of hot air and freeze drying methods on antioxidant activity, colour and some nutritional characteristics of strawberry tree (Arbutus unedo L) fruit

Antioxidant activity, colour and some nutritional properties of hot air and freeze-dried strawberry tree (Arbutus unedo L.) fruits were investigated. Additionally, the effects of two pre-treatments, namely ethyl oleate and water blanching, were compared in terms of drying characteristics. For determination of antioxidant activities in ethanol extracts, two different analytical methods were used: 1,1-diphenyl-2-picrylhydrazyl scavenging activity and β-carotene bleaching activity. As a result, the ethyl oleate pre-treatment shortened the drying time by hot air method and gave a higher 1,1-diphenyl-2-picrylhydrazyl scavenging activity (82.16?±?0.34%), total phenolic content (7.62?±?1.09?μg GAE/g extract), ascorbic acid content (236.93?±?20.14?mg/100?g), besides hydromethylfurfural was not observed. Freeze-dried fruits exhibited higher ascorbic acid content (368.63?±?17.16?mg/100?g) than those fresh fruits (231.33?±?19.51?mg/100?g) and nearly 1,1-diphenyl-2-picrylhydrazyl activity (93.52?±?0.41 %) to fresh fruits (94.03?±?1.18%). Colour characteristics, sugar content and mineral contents of fruits were significantly affected by pre-treatments and drying methods (p?相似文献   

The prevalence of Helicobacter pylori and related factors among university students in Turkey

The frequency and risk factors for contamination of Helicobacter pylori infection was investigated among Sakarya University students. Two-hundred students randomly chosen from among those who volunteered for the study and met its criteria were included. Data were obtained by a questionnaire. H. pylori positivity was checked with the monoclonal H. pylori stool antigen test. Statistical analysis was done with chi-square test. The average age of the subjects was 21.14 +/- 2.06, and 76% of them were female. Monthly family income was below 575 Euros in 69.5% of them, and 56% were living in state dormitories. H. pylori positivity was found to be as high as 63% in our group. According to the qustionnaire (age, gender, blood groups, family income, crowded family living conditions, smoking, alcohol and caffeine consumption, the presence of gastric symptoms, family history, and hygienic behaviors), no statistical differences were found between the H. pylori positive and negative students. These data support the finding that personal and environmental conditions in adults did not affect H. pylori infectivity, and that H. pylori might be acquired in childhood.