Hayvansal gıdalarda bulunan vitamin B12; insan vücudunda iki enzim sisteminde kofaktör olarak görev alır. Vitamin B12 fizyolojik etkilerinin çoğunluğunu homosistein metiyonin döngüsüne sağladığı katkı yoluyla gösterir. Vitamin B12 yetmezliği çoğunlukla emilim mekanizmaları ile ilişkili bozukluklardan kaynaklanır ve öncelikle nörolojik ve hematolojik hastalıklar olmak üzere pek çok hastalıkla ilişkilendirilir. Ölçüm belirsizliğinin geniş olması nedeniyle serum vitamin B12 seviyesinin tespit edilmesinin yanında homosistein seviyesine de bakılması gereklidir. Son olarak vitamin B12 yetersizliğinde paranteral tedavi yaklaşımı daha doğru bir yöntem olarak kabul görmektedir.

Amaç: Yağ asit katabolizmasında rol alması ve serum lipitleri ile ilişkisinin gösterilmiş olması sebebiyle vitamin B12 takviyesinin serum lipit seviyelerini etkileyebileceğini düşünüyoruz. Bu çalışmada, vitamin B12 tedavisi alan hastalarda serum lipit ve glikoz değerlerinin etkilenip etkilenmediği araştırılmıştır. Yöntemler: Bu çalışma retrospektif gözlemsel bir araştırmadır. Bu çalışmada, aile hekimliği polikliniğine başvurmuş hastaların kayıtları geriye dönük incelenmiş, glikoz, lipit ve vitamin B12 gibi serum parametreleri ile yaş ve cinsiyet gibi demografik veriler değerlendirilmiştir. Vitamin B12 eksikliği sebebiyle tedavi alan, altı ay içinde tekrar lipit profili baktırmış olan ve herhangi bir antihiperlipidemik kullanmayan 21 hasta çalışmaya dahil edilmiştir. Bulgular: Serum kolesterol değerlerinin ortalaması tedavi öncesi 209,6±30,1 mg/dL, tedavi sonrası 195,6±31,7 mg/dL bulundu (p=0,002). Serum trigliserit değerlerinin ortalaması tedavi öncesi 196,2±117,8 mg/dL, tedavi sonrası 142,1±81,4 mg/dL bulundu (p=0,001). Sonuç: Sonuç olarak vitamin B12 ile serum lipit parametreleri arasında bir ilişkinin olduğunu ve özellikle serum trigliserit seviyelerinin vitamin B12 tedavisinden etkilendiğini söyleyebiliriz.

Comparison of serum alpha-1-antitrypsin and vitamin B12

SummaryEndoluminal techniques such as laser therapy, radiofrequency therapy and sclerotherapy are increasingly replacing classic stripping for the treatment of incompetent saphenous veins. Interim results of the ongoing international, multicentre BRITTIV study to investigate the effectiveness and tolerability of the minimally invasive bipolar radiofrequency-induced thermal therapy (RFITT) are presented. Patients, methods: A flexible bipolar RFITT applicator is passed under ultrasound control into the affected vein of patients with varicosis of the great saphenous vein (GSV) or small saphenous vein (SSV). The vein is occluded by impedance-controlled release of radiofrequency energy as the RFITT applicator is slowly and smoothly withdrawn. The effectivness and tolerability of RFITT is checked over a one-year period by regular follow-ups. Results: To date a total of 345 saphenous veins (90% GSV, 10% SSV) in 271 patients (average age 50 years, 63% women, mean CEAP score 2.8) have been treated with RFITT in eight European hospitals. 72% of patients underwent general anaesthesia (18% spinal, 11% local) and tumescent anaesthesia was also used in 83% of the veins (mean length 45 cm). The average application time was 1.4 s/cm with a mean power output of 24 Watt. At the interim analysis after an average follow-up of 103 days, 90% of 335 treated veins were occluded. Differential analysis showed that partial (P) and complete (C) recurrences occurred significantly less often when longer application times had been used, whereby complete recurrences showed a greater reduction in frequency than partial. The total recurrence rate with an application time < 1 s/cm was 22% (P = 10%, C = 12%); with an application time between 1.0 and 1.4 s/cm it had already fallen to 9% (P = 6%, C = 3%) and with a time greater than 1.4 s/cm it was only 4% (P = 3%, C = 1%). According to subjective pain assessment on a visual analogue scale (VAS) of 0 to 10 (corresponding to no pain up to the strongest conceivable pain), by the first day after treatment already 74% of those questioned had only slight remaining pain or none at all (VAS 0–2). This generally low subjective pain sensation continued to fall at subsequent followups and at the 6-month follow-up, 99% of patients reported a VAS score of 0. Nearly all patients (99%) were satisfied with the treatment and would recommend it to others. Conclusions: With the same power output, even a minor increase in the application time to more than 1.4 s/cm can markedly reduce recurrence rate. In summary, the ongoing BRITTIV study illustrates the potential of RFITT for use in phlebology as it combines a spatially-defined obliteration of incompetent saphenous veins with overall moderate side effects and impressive results.

Introduction: In recent years, there has been a surge in research focusing on the link between smoking and insulin resistance in the context of obesity and diabetes. In this study, our objective was to investigate the relationship between smoking and insulin resistance. Materials and Methods: This is a case-control study. The case and control groups were formed using the hospital patient information database and clinically randomized using data obtained, including age, gender, height, and weight. The case group for this study consisted of smokers, whereas the control group consisted of non-smokers. Chi-square tests were used to compare numbers and rates, and independent sample t-tests were used for the averages. Binary logistic regression analysis was performed between the case and control groups. Results: According to logistic regression analysis, the odds ratio for non-smokers was 0.59 (0.31-1.14). The risk of insulin resistance is decreased by 41% non-significantly in non-smokers. The odds ratio for age was 1.03 (1.01-1.05). When the age variable increases by one unit, the risk of insulin resistance increase by 1.03 times. Conclusion: Our study found no significant relationship between smoking and insulin resistance in healthy individuals. The relationship between smoking and insulin resistance, as reported in the scientific literature, may be suggestive of an association in which smoking exacerbates insulin resistance as a result of other contributing factors rather than serving as a direct causal factor. Further studies are warranted to elucidate the potential mechanisms underlying this association fully.