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

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 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

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 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 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.

scholarly journals Allosterism vs. Orthosterism: Recent Findings and Future Perspectives on A2B AR Physio-Pathological Implications

2021 ◽  
Vol 12 ◽  
Author(s):  
Elisabetta Barresi ◽  
Claudia Martini ◽  
Federico Da Settimo ◽  
Giovanni Greco ◽  
Sabrina Taliani ◽  
...  
Keyword(s):  
Adenosine Receptor ◽  
Chronic Obstructive ◽  
Receptor Subtypes ◽  
Allosteric Modulators ◽  
Future Perspectives ◽  
Obstructive Pulmonary Disease ◽  
Protein Receptor ◽  
Inflammatory Processes ◽  
Positive Allosteric Modulators ◽  
Orthosteric Ligands

The development of GPCR (G-coupled protein receptor) allosteric modulators has attracted increasing interest in the last decades. The use of allosteric modulators in therapy offers several advantages with respect to orthosteric ones, as they can fine-tune the tissue responses to the endogenous agonist. Since the discovery of the first A1 adenosine receptor (AR) allosteric modulator in 1990, several efforts have been made to develop more potent molecules as well as allosteric modulators for all adenosine receptor subtypes. There are four subtypes of AR: A1, A2A, A2B, and A3. Positive allosteric modulators of the A1 AR have been proposed for the cure of pain. A3 positive allosteric modulators are thought to be beneficial during inflammatory processes. More recently, A2A and A2B AR allosteric modulators have also been disclosed. The A2B AR displays the lowest affinity for its endogenous ligand adenosine and is mainly activated as a consequence of tissue damage. The A2B AR activation has been found to play a crucial role in chronic obstructive pulmonary disease, in the protection of the heart from ischemic injury, and in the process of bone formation. In this context, allosteric modulators of the A2B AR may represent pharmacological tools useful to develop new therapeutic agents. Herein, we provide an up-to-date highlight of the recent findings and future perspectives in the field of orthosteric and allosteric A2B AR ligands. Furthermore, we compare the use of orthosteric ligands with positive and negative allosteric modulators for the management of different pathological conditions.

scholarly journals Interleukin-36 Cytokines in Infectious and Non-Infectious Lung Diseases

2021 ◽  
Vol 12 ◽  
Author(s):  
Hernán F. Peñaloza ◽  
Rick van der Geest ◽  
Joel A. Ybe ◽  
Theodore J. Standiford ◽  
Janet S. Lee
Keyword(s):  
Infectious Diseases ◽  
Lung Diseases ◽  
Skin Diseases ◽  
Inflammatory Diseases ◽  
Lymphoid Cells ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Inflammatory Conditions ◽  
Inflammatory Processes

The IL-36 family of cytokines were identified in the early 2000’s as a new subfamily of the IL-1 cytokine family, and since then, the role of IL-36 cytokines during various inflammatory processes has been characterized. While most of the research has focused on the role of these cytokines in autoimmune skin diseases such as psoriasis and dermatitis, recent studies have also shown the importance of IL-36 cytokines in the lung inflammatory response during infectious and non-infectious diseases. In this review, we discuss the biology of IL-36 cytokines in terms of how they are produced and activated, as well as their effects on myeloid and lymphoid cells during inflammation. We also discuss the role of these cytokines during lung infectious diseases caused by bacteria and influenza virus, as well as other inflammatory conditions in the lungs such as allergic asthma, lung fibrosis, chronic obstructive pulmonary disease, cystic fibrosis and cancer. Finally, we discuss the current therapeutic advances that target the IL-36 pathway and the possibility to extend these tools to treat lung inflammatory diseases.

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