scholarly journals Acute chest syndrome may not have an atherosclerotic background in sickle cell diseases

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
Mehmet Rami Helvaci ◽  
Hasan Yilmaz ◽  
Atilla Yalcin ◽  
Orhan Ekrem Muftuoglu ◽  
Abdulrazak Abyad ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Chronic Renal Disease ◽  
Endothelial Damage ◽  
Male Gender ◽  
Acute Chest Syndrome ◽  
Chronic Obstructive ◽  
Leg Ulcers ◽  
Obstructive Pulmonary Disease ◽  
Digital Clubbing ◽  
Inflammatory Processes

Background: We tried to understand whether or not there is a significant relationship between acute chest syndrome (ACS) and atherosclerosis in sickle cell diseases (SCD). Methods: All patients with the SCD were included. Results: The study included 434 patients (222 males) with similar mean ages in male and female genders (30.8 versus 30.3 years, respectively, p>0.05). Smoking (23.8% versus 6.1%, p<0.001) and alcohol (4.9% versus 0.4%, p<0.001) were higher in males, significantly. Transfused units of red blood cells (RBC) in their lives (48.1 versus 28.5, p=0.000) were also higher in males, significantly. Similarly, disseminated teeth losses (<20 teeth present) (5.4% versus 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p<0.001), ileus (7.2% versus 1.4%, p<0.001), cirrhosis (8.1% versus 1.8%, p<0.001), leg ulcers (19.8% versus 7.0%, p<0.001), digital clubbing (14.8% versus 6.6%, p<0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p<0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p<0.05), and stroke (12.1% versus 7.5%, p<0.05) were all higher in males but not ACS (2.7% versus 3.7%, p>0.05) in the SCD. Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened RBC into the tissues. Although the higher smoking and alcohol-like strong atherosclerotic risk factors and disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, and stroke-like obvious atherosclerotic consequences in male gender, ACS was not higher in them, significantly. In another definition, ACS may not have an atherosclerotic background in the SCD. Key words: Sickle cell diseases, chronic endothelial damage, atherosclerosis, acute chest syndrome, male gender, smoking, alcohol

scholarly journals AVASCULAR NECROSIS MAY NOT HAVE AN ATHEROSCLEROTIC BACKGROUND IN SICKLE CELL DISEASES

2021 ◽  
Vol 15 (3) ◽  
Author(s):  
Mehmet Rami Helvaci ◽  
Hasan Yilmaz ◽  
Atilla Yalcin ◽  
Orhan Ekrem Muftuoglu ◽  
Abdulrazak Abyad ◽  
...  
Keyword(s):  
Avascular Necrosis ◽  
Sickle Cell ◽  
Chronic Renal Disease ◽  
Endothelial Damage ◽  
Male Gender ◽  
Chronic Obstructive ◽  
Leg Ulcers ◽  
Obstructive Pulmonary Disease ◽  
Digital Clubbing ◽  
Inflammatory Processes

Background: We tried to understand whether or not there is a significant association between avascular necrosis (AVN) and atherosclerosis in sickle cell diseases (SCD). Methods: All patients with the SCD were included. Results: The study included 434 patients (212 females) with similar mean ages in male and female genders (30.8 versus 30.3 years, respectively, p>0.05). Smoking (23.8% versus 6.1%, p<0.001) and alcohol (4.9% versus 0.4%, p<0.001) were higher in male gender, significantly. Transfused units of red blood cells (RBC) in their lives (48.1 versus 28.5, p=0.000) were also higher in male gender, significantly. Similarly, disseminated teeth losses (<20 teeth present) (5.4% versus 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p<0.001), ileus (7.2% versus 1.4%, p<0.001), cirrhosis (8.1% versus 1.8%, p<0.001), leg ulcers (19.8% versus 7.0%, p<0.001), digital clubbing (14.8% versus 6.6%, p<0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p<0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p<0.05), and stroke (12.1% versus 7.5%, p<0.05) were all higher in male gender but not AVN (24.3% versus 25.4%, p>0.05), significantly. Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened RBC into the tissues. Although the higher smoking and alcohol-like strong atherosclerotic risk factors and disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, and stroke-like obvious atherosclerotic consequences in male gender, AVN was not higher in them, significantly. In another definition, AVN may not have an atherosclerotic background in the SCD. Key words: Sickle cell diseases, chronic endothelial damage, atherosclerosis, avascular necrosis, male gender, smoking, alcohol

scholarly journals August 2021 - Volume 15, Issue 3 AUTOSPLENECTOMY MAY NOT HAVE AN ATHEROSCLEROTIC BACKGROUND IN SICKLE CELL DISEASES

2021 ◽  
Vol 15 (3) ◽  
Author(s):  
Mehmet Rami Helvaci ◽  
Hasan Yilmaz ◽  
Atilla Yalcin ◽  
Orhan Ekrem Muftuoglu ◽  
Abdulrazak Abyad ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Chronic Renal Disease ◽  
Endothelial Damage ◽  
Male Gender ◽  
Chronic Obstructive ◽  
Leg Ulcers ◽  
Obstructive Pulmonary Disease ◽  
Digital Clubbing ◽  
Inflammatory Processes ◽  
Atherosclerotic Risk Factors

Background: We tried to understand whether or not there is a significant relationship between autosplenectomy and atherosclerosis in sickle cell diseases (SCD). Methods: All patients with the SCD were included. Results: The study included 434 patients (222 males and 212 females) with similar mean ages in male and female genders (30.8 versus 30.3 years, respectively, p>0.05). Smoking (23.8% versus 6.1%, p<0.001) and alcohol (4.9% versus 0.4%, p<0.001) were higher in males, significantly. Transfused units of red blood cells (RBC) in their lives (48.1 versus 28.5, p=0.000) were also higher in males, significantly. Similarly, disseminated teeth losses (<20 teeth present) (5.4% versus 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p<0.001), ileus (7.2% versus 1.4%, p<0.001), cirrhosis (8.1% versus 1.8%, p<0.001), leg ulcers (19.8% versus 7.0%, p<0.001), digital clubbing (14.8% versus 6.6%, p<0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p<0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p<0.05), and stroke (12.1% versus 7.5%, p<0.05) were all higher in males but not autosplenectomy (50.4% versus 53.3%, p>0.05) in the SCD. Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened RBC into the tissues. Although the higher smoking and alcohol-like strong atherosclerotic risk factors and disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, and stroke-like obvious atherosclerotic consequences in male gender, autosplenectomy was not higher in them, significantly. In another definition, autosplenectomy may not have an atherosclerotic background in the SCD. Key words: Sickle cell diseases, chronic endothelial damage, atherosclerosis, autosplenectomy, male gender, smoking, alcohol

Worse Prognosis of Sickle Cell Diseases in Males even in the Absence of Smoking and Alcohol

2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Mehmet Rami Helvaci ◽  
Mustafa Yaprak ◽  
Ramazan Davran ◽  
Zeki Arslanoglu ◽  
Abdulrazak Abyad ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Total Bilirubin ◽  
Chronic Renal Disease ◽  
Dominant Role ◽  
Endothelial Damage ◽  
The Body ◽  
Chronic Obstructive ◽  
Leg Ulcers ◽  
Digital Clubbing ◽  
Male Sex

Background: We tried to understand the prognosis of sickle cell diseases (SCD) in both genders. Methods: All cases with the SCD in the absence of smoking and alcohol were included. Results: The study included 368 patients (168 males and 200 females). Mean age (29.4 versus 30.2 years), associated thalassemia minors (72.0% versus 69.0%), and body mass index (BMI) (21.7 versus 21.6 kg/m2) were similar in males and females, respectively (p>0.05 for all). Whereas total bilirubin value of the plasma (5.2 versus 4.0 mg/dL, p=0.011), transfused units of red blood cells (RBC) in their lives (46.8 versus 29.2, p=0.002), disseminated teeth losses (4.7% versus 1.0%, p<0.001), chronic obstructive pulmonary disease (COPD) (20.8% versus 6.0%, p<0.001), ileus (5.3% versus 2.0%, p<0.01), cirrhosis (5.9% versus 1.5%, p<0.001), leg ulcers (16.0% versus 7.5%, p<0.001), digital clubbing (13.0% versus 5.5%, p<0.001), and chronic renal disease (CRD) (10.7% versus 6.5%, p<0.05) were all higher in males, significantly. Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of the hardened RBC into tissues. Although the similar mean age, associated thalassemia minors, and BMI and absence of smoking and alcohol, the higher total bilirubin value of the plasma, transfused units of RBC in their lives, disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, and CRD in males may be explained by the dominant role of male sex in life according to the physical power that may accelerate systemic atherosclerotic process all over the body. Key words: Sickle cell diseases, male sex, chronic endothelial damage, atherosclerosis, metabolic syndrome, early aging, premature death

Atherosclerotic Background of Cirrhosis in Sickle Cell Patients

2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Mehmet Rami Helvaci ◽  
Alper Sevinc ◽  
Celaletdin Camci ◽  
Ali Keskin ◽  
Abdulrazak Abyad ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Inflammatory Process ◽  
Chronic Obstructive ◽  
Leg Ulcers ◽  
Key Words Atherosclerosis ◽  
Obstructive Pulmonary Disease ◽  
Digital Clubbing ◽  
Male Predominance ◽  
The Mean

Background: We tried to understand the presence of any atherosclerotic background of cirrhosis in patients with sickle cell diseases (SCDs). Methods: The study was performed in the Hematology Service of the Mustafa Kemal University on SCDs patients between March 2007 and June 2012. Results: The study included 256 patients with SCDs (127 females). Their mean age was 29.3 years. Cirrhosis was detected in 5.8% (15) of the SCDs patients without any gender difference (6.2% of females versus 5.4% of males, p>0.05). There were 15 (5.8%) patients with chronic obstructive pulmonary disease with a highly significant male predominance (3.1% versus 8.5%, p<0.001). Digital clubbing and pulmonary hypertension were also higher in males, but the differences were nonsignificant in between (4.7% versus 6.2% and 11.0% versus 12.4%, respectively). Similarly, the leg ulcers were significantly higher in males, too (5.5% versus 16.2%, p<0.001). The significant male predominance was also observed in stroke and smoking (3.1% versus 6.2%, p<0.05 and 3.9% versus 11.6%, p<0.001, respectively). There were 14 (5.4%) mortal patients during the five-year follow-up period (6.2% of females and 4.6% of males, p>0.05), and the mean ages were 31.0 and 26.8 years, respectively (p>0.05). Conclusion: Probably cirrhosis is a systemic inflammatory process prominently affecting the hepatic vasculature, and an eventual accelerated atheroscerotic process is the main underlying cause of characteristics of the disease. SCDs are accelerated systemic atherosclerotic processes, too, and the higher prevalence of cirrhosis in SCDs patients may indicate the underlying atherosclerotic background of cirrhosis. Key words: Atherosclerosis, metabolic syndrome, cirrhosis, sickle cell diseases

scholarly journals Up-Regulation of Mir-21 and Mir-130a and Serum Leptin Levels on Leg Ulcers Development in Sickle Cell Anemia

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 975-975
Author(s):  
Thais Helena Chaves Batista ◽  
Rodrigo Marcionilo Santana ◽  
Marcondes José de Vasconcelos Costa Sobreira ◽  
Gabriela da Silva Arcanjo ◽  
Diego Arruda Falcao ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Leg Ulcer ◽  
Acute Chest Syndrome ◽  
Control Group ◽  
Blood Collection ◽  
Leg Ulcers ◽  
Serum Leptin ◽  
Ulcer Group ◽  
And Control

Introduction: Leg ulcers (LUs) are a cutaneous complication of sickle cell anemia (SCA), whose etiology is considered multifactorial. In the search for new candidates for modulators of SCA clinical events, recent evidence suggests the significant role of mechanisms related to post-transcriptional regulation, especially microRNAs (miRNAs). Thus, the analysis of miRNAs miR-21 and miR-130a differential expression in patients with SCA becomes an interesting approach, since both act in the regulation of several biological mechanisms related to the pathophysiology of LU, especially the tissue repair process. In addition, these miRNAs have already been related to the regulation of serum leptin levels, a strong angiogenic pleiotropic hormone that acts in the healing process of skin lesions. Therefore, the aim of the study was to investigate the influence of miR-21 and miR-130a and serum leptin levels on the development of LUs in SCA patients. Methods: After analyzing medical records, 60 SCA patients were selected. Patients who presented some of the main clinical manifestations that may have etiology due to the underlying disease (for example: osteonecrosis, stroke, priapism and acute chest syndrome) were not included. Patients with a history of LU were considered cases, and those who did not develop this complication (n=20), were considered control (median age: 26 years, range: 19-61, 50% males). The control group was called "HbSS-Control" and the case group was divided into two subgroups: Active leg ulcer group, composed of 19 patients with active LU at the time of blood collection (median age: 35 years, range: 24-56, 68% males), and healed leg ulcer group, composed of 21 patients with healed LU at the time of blood collection (median age: 34 years, range: 22-52, 43% males). In addition, it was analyzed a group of 10 donors with normal hemoglobin profile (median age: 25 years, range: 20-30, 50% males), identified as "HbAA-Control". Expression levels of miRNAs extracted from peripheral blood, using mirVanaTM PARIS Kit (Invitrogen™) were evaluated by RT-qPCR technique utilizing TaqMan® probes. Serum leptin levels of the patients were evaluated employing the ELISA method (Human Leptin ELISA Kit, Millipore®). Mann-Whitney and Kruskal-Wallis tests were applied to compare continuous variables. Results: Up-regulation of both miRNAs was observed in the active leg ulcer group in contrast to the healed leg ulcer (miR-21: P&lt;0.0001, Figure 1A, Fold change [FC]=14,2; miR-130a: P=0.0004, FC=18,8, Figure 1B) and Control-HbSS groups (miR-21: P&lt;0.0001, FC=34,4, Figure 1A; miR-130a: P=0.0006, FC=15,3, Figure 1B) and the HbAA-Control group (miR-21: P&lt;0.0001, FC=5,8, Figure 1C; miR-130a: P=0.0009, FC=10,9, Figure 1D). However, there was no significant difference between the healed leg ulcer, HbSS-Control and HbAA-Control groups (miR-21: P=0.1829, Figure 1E; miR-130a: P=0.3537; Figure 1F). Furthermore, the active leg ulcer group had lower serum leptin levels when compared to the healed leg ulcer and Control-HbSS groups (P=0.0058; Figure 2A). The levels of leptin in the healed leg ulcer group did not differ from the Control-HbSS group (P=0.5929; Figure 2B). Conclusion: Our results demonstrated an inverse relation between the miRNAs miR-21 and miR-130a expression with serum leptin levels, suggesting that the up-regulation of these miRNAS may be related to the chronicity and healing of LUs in individuals with SCA through decreased of serum leptin levels. Disclosures No relevant conflicts of interest to declare.

scholarly journals Arginine Therapy for Lung Diseases

2021 ◽  
Vol 12 ◽  
Author(s):  
Jeremy A. Scott ◽  
Harm Maarsingh ◽  
Fernando Holguin ◽  
Hartmut Grasemann
Keyword(s):  
Nitric Oxide ◽  
Lung Development ◽  
Lung Diseases ◽  
Muscle Tone ◽  
Therapeutic Strategies ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Nos Inhibitors ◽  
Inflammatory Processes ◽  
Vascular Smooth Muscle Tone

Nitric oxide (NO) is produced by a family of isoenzymes, nitric oxide synthases (NOSs), which all utilize L-arginine as substrate. The production of NO in the lung and airways can play a number of roles during lung development, regulates airway and vascular smooth muscle tone, and is involved in inflammatory processes and host defense. Altered L-arginine/NO homeostasis, due to the accumulation of endogenous NOS inhibitors and competition for substrate with the arginase enzymes, has been found to play a role in various conditions affecting the lung and in pulmonary diseases, such as asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), pulmonary hypertension, and bronchopulmonary dysplasia. Different therapeutic strategies to increase L-arginine levels or bioavailability are currently being explored in pre-clinical and clinical studies. These include supplementation of L-arginine or L-citrulline and inhibition of arginase.

scholarly journals Incidence of wound dehiscence after colorectal cancer surgery: results from a national population-based register for colorectal cancer

2019 ◽  
Vol 34 (10) ◽  
pp. 1757-1762 ◽  
Author(s):  
Harald Söderbäck ◽  
Ulf Gunnarsson ◽  
Anna Martling ◽  
Per Hellman ◽  
Gabriel Sandblom
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inflammatory Disease ◽  
Wound Dehiscence ◽  
Male Gender ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
History Of

Abstract Background Patient-related risk factors for wound dehiscence after colorectal surgery remain obscure. Methods All open abdominal procedures for colorectal cancer registered in the Swedish Colorectal Cancer Registry (SCRCR, 5) 2007–2013 were identified. Potential risk factors for wound dehiscence were identified by cross-matching between the SCRCR and the National Patient Register (NPR). The endpoint in this study was reoperation for wound dehiscence registered in either the SCRCR or NPR and patients not reoperated were considered controls. Results A total of 30,050 patients were included in the study. In a multivariable regression analysis, age > 70 years, male gender, BMI > 30, history of chronic obstructive pulmonary disease, history of generalised inflammatory disease, and duration of surgery less than 180 min were independently and significantly associated with increased risk for wound dehiscence. A history of diabetes, chronic renal disease, liver cirrhosis, and distant metastases was not associated with wound dehiscence. The hazard ratio for postoperative death was 1.24 for patients who underwent reoperation for wound dehiscence compared with that for controls. Discussion Patients reoperated for wound dehiscence face a significantly higher postoperative mortality than those without. Risk factors include male gender, age > 70 years, obesity, history of chronic obstructive pulmonary disease, and history of generalised inflammatory disease. Patients at high risk for developing wound dehiscence may, if identified preoperatively, benefit from active prevention measures implemented in routine surgical practice.

COPD: Die wichtigsten Komorbiditäten

2019 ◽  
Vol 144 (01) ◽  
pp. 28-33
Author(s):  
Carmen Pizarro ◽  
Dirk Skowasch
Keyword(s):  
Quality Of Life ◽  
Physical Inactivity ◽  
Chronic Obstructive ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease ◽  
Inflammatory Processes ◽  
Diagnostic Approaches ◽  
Common Risk Factors ◽  
Current Guidelines

AbstractPatients with chronic obstructive pulmonary disease (COPD) are frequently afflicted by comorbidities. In terms of quality of life, health status and prognosis, comorbid conditions negatively impact the lives of the sufferers. The link between these diseases is complex and comprises manifold considerations: it may be mediated by common risk factors, notably smoking, or by sequelae of COPD, like physical inactivity. Moreover, systemic inflammatory processes and mechanistic considerations seem to play a central role. As symptomatology is frequently overlapping, comorbid diseases tend to be overlooked. In consequence, they require proactive diagnostic approaches. Treatment should adhere to current guidelines, irrespective of the presence of COPD.

scholarly journals Iron Overload in Sickle Cell Disease

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
Radha Raghupathy ◽  
Deepa Manwani ◽  
Jane A. Little
Keyword(s):  
Sickle Cell Disease ◽  
Iron Overload ◽  
Sickle Cell ◽  
Organ Damage ◽  
Endothelial Damage ◽  
Red Cells ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Treatment And Prevention ◽  
Oxygen Carrying Capacity

In sickle cell disease transfusions improve blood flow by reducing the proportion of red cells capable of forming sickle hemoglobin polymer. This limits hemolysis and the endothelial damage that result from high proportions of sickle polymer-containing red cells. Additionally, transfusions are used to increase blood oxygen carrying capacity in sickle cell patients with severe chronic anemia or with severe anemic episodes. Transfusion is well-defined as prophylaxis (stroke) and as therapy (acute chest syndrome and stroke) for major complications of sickle cell disease and has been instituted, based on less conclusive data, for a range of additional complications, such as priapism, vaso-occlusive crises, leg ulcers, pulmonary hypertension, and during complicated pregnancies. The major and unavoidable complication of transfusions in sickle cell disease is iron overload. This paper provides an overview of normal iron metabolism, iron overload in transfused patients with sickle cell disease, patterns of end organ damage, diagnosis, treatment, and prevention of iron overload.

scholarly journals The usefulness of Shock Index and Modified Shock Index in predicting outcome of COVID-19 patients

2021 ◽  
pp. 1-16
Author(s):  
Erdem KURT ◽  
Suphi BAHADIRLI
Keyword(s):  
Hospital Mortality ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Male Gender ◽  
Chronic Obstructive ◽  
Shock Index ◽  
Obstructive Pulmonary Disease ◽  
Predicting Outcome ◽  
The Mean ◽  
Artery Disease

Abstract Objective: The aim of this study is to investigate the accuracy of shock index (SI) and modified shock index (mSI) in predicting intensive care unit (ICU) requirement and in-hospital mortality among COVID-19 patients who admitted to the emergency department (ED). Likewise, the effects of patients’ conditions such as age, gender and comorbidity on prognosis will be analyzed. Methods: The files were retrospectively scanned for all COVID-19 patients over the age of 18 who were admitted to the ED and hospitalized between January 1, 2021 and March 15, 2021. The area under the receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to assess each scoring system discriminatory for predicting in-hospital mortality and ICU admission. Results: There were 464 patients included in this study. The mean age of the patients was 62.4±16.7, of which 245 were men and 219 were women. The most common comorbidity in patients was hypertension 200 (43.1%), followed by chronic obstructive pulmonary disease 174 (37.5%) and coronary artery disease 154 (33.2%). In terms of in-hospital mortality, the AUC of SI, and mSI were 0.719, and 0.739, respectively. In terms of ICU requirement, the AUC of SI, and mSI were 0.704, and 0.729, respectively. Conclusions: In this study, it was concluded that SI and mSI are useful in predicting in-hospital mortality and ICU requirement in COVID-19 patients. In addition, it is another important result of the study that advanced age, male gender and hypertension may be associated with poor prognosis.

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