Increased incidence of malignancy in patients with primary hyperparathyroidism

Background/aimPrimary hyperparathyroidism (PHPT) is a disease that is diagnosed more frequently and generally in the asymptomatic period, with widely available biochemical tests. Evidence suggesting an association between PHPT and malignancy risk is increasing. Clarification of this association will be useful in PHPT for malignancy screening and management of patients with PHPT. In this study, we aimed to investigate the frequency of cancer in PHPT patients.Materials and methodsA total of 775 PHPT patients were included in the retrospective study. Demographic, clinical and laboratory data of the patients were evaluated retrospectively.ResultsMalignancy was detected in 128 (16.50%) of 775 PHPT patients (female/male: 625/150). The mean age at diagnosis of PHPT was 57.99 ± 10.86 years, and the mean age at diagnosis of malignancy was 57.46 ± 11.17 years. Of the 128 patients with malignancy, 53 (41.40%) were diagnosed in the same year as PHPT. In terms of malignancy types, 51 (6.50%) of 775 PHPT patients had thyroid cancer. Thyroid cancer was followed by breast cancer (2.30%) and stomach cancer (1%) in order of frequency.ConclusionWe think that PHPT patients should be examined more carefully in terms of cancer risk, especially thyroid cancer. More comprehensive studies are needed to clarify the relationship between PHPT and cancer.     

Assessment of fragmented QRS formation and its relationship with left ventricular hypertrophy in nonhypertensive acromegaly patients

Background/aim It is known that the presence of fragmented QRS (fQRS) on electrocardiography (ECG) is associated with cardiovascular events. The aim of this study was the evaluation of fQRS formation and its relationship with the left ventricular hypertrophy (LVH) parameters in acromegaly patients. Materials and methods In total, 47 previously diagnosed with non-hypertensive acromegaly patients and 48 control subjects were included in the study. ECG and transthoracic echocardiography (TTE) were performed for each participant. Acromegaly patients were divided into two groups according to the fQRS formation on the ECG. Left ventricular wall thicknesses, and left atrial diameter (LAD), left ventricular mass (LVM), left ventricular mass index (LVMi), and relative wall thickness (RWT) were obtained. Results In control group 5 (10.4%) and in acromegaly group 17 (36.2%) patients had fQRS on ECG (p = 0.003). LAD [36.0 (34.0–38.0) vs. 38.0 (35.0–41.0) mm, p < 0.001], LVM [155.27 ± 27.00 vs. 173.0 (153.0–235.0) g, p < 0.001], LVMi [83.12 ± 13.19 vs. 92.0 (83.0–118.0) g/m², p < 0.001] and RWT [0.39 ± 0.03 vs. 0.43 (0.41–0.45), p = 0.001] were significantly higher in patients with acromegaly. Disease duration was significantly higher (11.59 ± 1.3 vs. 8.2 ± 1.8 years, p < 0.001) in the fQRS (+) group. LAD [41.0 (39.0–42.5) vs. 37.0 (34.7–38.0) mm, p < 0.001], LVM [219.0 (160.5–254.5) vs. 164.0 (153.0–188.0) g, p = 0.017], LVMi [117.0 (92.5–128.5) vs. 86.0 (82.0–100.2) g/m², p = 0.013] and RWT [0.44 (0.42–0.49) vs. 0.43 (0.40–0.44), p = 0.037] were significantly higher in fQSR (+) acromegaly patients. In multivariate logistic regression analysis, disease duration (odds ratio: 10.05, 95% CI: 1.099–92.012, p = 0.041) and LAD (odds ratio: 2.19, 95% CI: 1.030–4.660, p = 0.042) were found to be the independent predictors of fQRS formation.Conclusion The results of our study revealed that fQRS (+) acromegaly patients had increased LVH parameters compared to fQRS (-) patients.     

Vasculogenic Erectile Dysfunction and Metabolic Syndrome

IntroductionErectile dysfunction (ED), defined as the inability to achieve and/or maintain a penile erection sufficient for sexual intercourse, is a health problem affecting more than one-half of men between the age of 40 and 70 years.AimThe aim of the present study was to determine the potential factors affecting penile vascular flow and predictability of vascular flow in patients with ED.MethodsTotally 163 male patients between 29 and 82 years of age who were admitted to our outpatient clinic with complaints of ED were included. After a detailed medical history was obtained, all patients were asked to complete the International Index of Erectile Function (IIEF) questionnaire. Blood samples were obtained for measurements of serum cholesterol, triglycerides, and fasting blood glucose (FBG), and the body mass index (BMI) was calculated.Main Outcome MeasuresPenile color Doppler ultrasonography (PDU) was performed to evaluate flow patterns, Mann–Whitney U-test and Spearman correlation analyses were used to assess the relationship of PDU findings with hypertension, obesity (BMI ≥ 25 kg/m²), FBG, and cholesterol levels measurements.ResultsThe mean age, IIEF score, and BMI of the study population was 51.3 ± 12.1 years, 11.9 ± 6.1 and 28.5 ± 4.0 kg/m², respectively. When the vascular pathologies detected with PDU and the presence of risk factors were compared, no significant correlation was determined between arterial insufficiency and metabolic syndrome (MS), whereas there was a significant correlation between veno-occlusive dysfunction and MS.ConclusionThe prevalence of ED increases with advanced age and with the presence of a systemic disease. Basic evaluations may not always be sufficient for assessment of ED. In the presence of MS, the use of penile Doppler ultrasonography should be considered for the evaluation of penile vascular structures in ED patients. Koca O, Çal??kan S, Öztürk M?, Güne? M, K?l?ço?lu G, and Karaman MI. Vasculogenic erectile dysfunction and metabolic syndrome.     

The Influence of Different Nonsteroidal Anti-Inflammatory Drugs on Alveolar Bone in Rats: An Experimental Study

The aim

The aim of this study was to investigate the effect of dexketoprofen trometamol, meloxicam, diclofenac sodium on any untreated alveolar bone when they are used as drugs for another indication.

Materials and Methods

Twenty eight male Spraque-Dawley rats were randomized into four groups as dexketoprofen trometamol (Group I), meloxicam (Group II), diclofenac sodium (Group III) and control group. Nonsteroidal anti-inflammatory drugs (NSAID) were administered after a fibula fracture for 10 days. Untreated alveolar bone was histopathologically examined for spongious bone density, osteoclastic density and osteoblastic density.

Results

Spongious bone density was lower in study groups (Group I, group II and group III) than the control group (p<0.05). In contrast, the increase in osteoclastic density was observed in other groups apart from the control group (p<0.05). Osteoblastic density was evaluated and it was determined that group II and group III had lower results than the control group (p<0.05) but group I was equal to the control group.

Conclusion

This study showed that systemically administrated NSAIDs have the potential to affect untreated alveolar bone. This should also be considered in long term use of NSAIDs.Key Words: Non-steroidal anti-inflammatory agents, bone remodeling, osteoblast, osteoclast, maxillary bone     

Clinical,angiographic and procedural characteristics of longitudinal stent deformation

Recently, longitudinal stent deformation (LSD) has been reported increasingly. Even though the reported cases included almost all stent designs, most cases were seen in the Element? stent design (Boston Scientific, Natick, MA, USA). It is considered that stent design, lesion and procedural characteristics play a role in the etiology of LSD. Yet, the effect of LSD on long-term clinical outcomes has not been studied well. Element stents implanted between January 2013 and April 2015 in our hospital were examined retrospectively. Patients were grouped into two according to the presence of LSD, and their clinical, lesion and procedural characteristics were studied. Twenty-four LSD’s were detected in 1812 Element stents deployed in 1314 patients (1.83?% of PCI cases and 1.32?% of all Element stents). LMCA lesions (16.7?% vs 1.6?%, p?<?0.001), complex lesions (75?% vs 35.1?%, p?<?0.001), bifurcation lesions (37.5?% vs 18.3?%, p?=?0.017), ostial lesions (33.3?% vs 12.8?%, p?=?0.003), using of extra-support guiding catheter (54.2?% vs 22.3?%, p?<?0.001) and extra-support guidewire (37.5?% vs 16.2?%, p?=?0.005) were found to be more frequent in cases with LSD than in cases without it. In addition, the number of stents, stent inflation pressure and the use of post-dilatation were significantly different between the two groups. Two patients had an adverse event during the follow-up period. LSD is a rarely encountered complication, and is more common in complex lesions such as ostial, bifurcation and LMCA lesions. The use of extra-support guiding catheter, extra-support guidewires and low stent inflation pressure increases the occurrence of LSD. Nevertheless, with increased awareness of LSD and proper treatment, unwanted long-term outcomes can be successfully prevented.     

Effect of blood donation-mediated volume reduction on regional right ventricular deformation in healthy subjects

Strain (S) and strain rate (SR) are known to be altered in diseases associated with right ventricular (RV) pressure/volume overload and RV myocardial dysfunction; however determinants of S/SR are incompletely understood. The aim of this study was to examine the effect of blood donation-mediated volume reduction on regional RV deformation in healthy young adults. Study population was composed of 61 consecutive healthy subjects who were volunteers for blood donation. All underwent standard echocardiography and two-dimensional S and SR imaging by speckle tracking before and after 450 mL blood donation. We found no change in RV lateral wall SR in all three segments. However, the S in the apical and mid segments of the RV lateral wall immediately decreased after blood donation [?26.2 ± 3.3 vs. ?23.2 ± 3.3 % (p < 0.0001) and ?28.2 ± 3.4 vs. ?27.1 ± 3.2 % (p = 0.009), respectively], whereas no change was observed in the basal segment. Moreover, changes in systolic S on the apical segment of the RV lateral wall before and after blood donation were significantly correlated with the changes in the RV size [end-diastolic area index, r = ? 0.369 (p = 0.003) and end-systolic area index, r = ? 0.319 (p = 0.012)] and changes in the stroke volume index [r = ? 0.436 (p < 0.001)]. Blood donation-mediated volume reduction in healthy subjects caused a regional difference in RV longitudinal deformation with the lower mid and apical S that was related to parameters of volume load severity. However, RV systolic SR was found to be resistant to the effects of volume depletion.     

The association of <Emphasis Type="Italic">Helicobacter pylori</Emphasis> with choroidal and retinal nerve fiber layer thickness

Purpose

To investigate the effect of Helicobacter pylori (H. pylori) infection on choroidal thickness (CT) and retinal nerve fiber layer thickness (RNFLT).

Methods

The study included 25 patients with H. pylori infection and 25 healthy individuals as the control group. Helicobacter pylori patients were classified as the pre-treatment (Group 1; n: 25) and the post-treatment (Group 2; n: 25). RNFLT and CT were measured before and after treatment of H. pylori infection, using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany). The axial length and intraocular pressure were also measured.

Results

The mean subfoveal CT was 320.96 ± 29.15 μm in Group 1 and 287.48 ± 49.17 in the control group (p = 0.007), while the mean subfoveal CT did not show any difference between Group 2 and the control group (p > 0.05). No statistically significant difference was determined between the H. pylori patients and the control group in respect of RNFLT values (p > 0.05).

Conclusions

CT increases during H. pylori infection and returns to the normal range within 6 weeks of treatment. RNFLT does not show any change during H. pylori infection. The data related to the subfoveal CT may be useful in understanding the pathogenesis of central serous chorioretinopathy developing in H. pylori patients.