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Research Article | DOI: https://doi.org/CCSRR-RA-25-34

Acarbose In the Treatment of Chronic Renal Disease

Mehmet Rami Helvaci 1*, Yusuf Aydin 1, Leyla Yilmaz Aydin 2, Alper Sevinc 1, Celaletdin Camci 1, Abdulrazak Abyad 3, Lesley Pocock

1 Specialist of Internal Medicine, MD, Turkey

2 Specialist of Pulmonary Medicine, MD, Turkey

3 Middle-East Academy for Medicine of Aging, MD, Lebanon

4 Medi-WORLD International, Australia

*Corresponding Author: Mehmet Rami Helvaci, Specialist of Internal Medicine, MD, Turkey

Citation: Mehmet Rami Helvaci, Yusuf Aydin, Leyla Yilmaz Aydin, Alper Sevinc, Celaletdin Camci (2025). Acarbose In the Treatment of Chronic Renal Disease, J Clinical Case Studies and Review Reports. 2(5) 34, DOI: CCSRR-RA-25-34

Copyright: Mehmet Rami Helvaci, et al © (2025). This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 15 June 2025 | Accepted: 22 June 2025 | Published: 30 June 2025

Keywords: sickle cell diseases; chronic renal disease; acarbose; capillary endothelial inflammation; excess fat tissue; systemic atherosclerosis; smoking

Abstract

Background: Probably systemic atherosclerosis is the main cause of aging and death.

Methods: All patients with sickle cell diseases (SCD) were taken into the study.

Results: We studied 222 males and 212 females with mean ages of 30.8 vs 30.3 years, p>0.05, respectively. Smoking (23.8% vs 6.1%, p<0.001), alcohol (4.9% vs 0.4%, p<0.001), transfused red blood cells (RBC) in their lifespans (48.1 vs 28.5 units, p=0.000), disseminated teeth losses (5.4% vs 1.4%, p<0.001), ileus (7.2% vs 1.4%, p<0.001), chronic renal disease (CRD) (9.9% vs 6.1%, p<0.05), cirrhosis (8.1% vs 1.8%, p<0.001), chronic obstructive pulmonary disease (25.2% vs 7.0%, p<0.001), coronary heart disease (18.0% vs 13.2%, p<0.05), leg ulcers (19.8% vs 7.0%, p<0.001), digital clubbing (14.8% vs 6.6%, p<0.001), and stroke (12.1% vs 7.5%, p<0.05) were all higher in males, significantly.

Conclusion: As an accelerated systemic atherosclerotic process, hardened RBC-induced capillary endothelial damage initiated at birth terminates with multiorgan failures in early decades of life in the SCD. Excess fat tissue may be much more significant than smoking and alcohol for atherosclerosis since excess weight-induced diabetes mellitus is the most common cause of the CRD. The efficacy of acarbose to lower blood glucose by preventing breakdown of starch into sugar in the small intestine is obvious. Because acarbose is a safe, cheap, oral, long-term used, and effective drug for excess weight, it should be prescribed even in the CRD since there are nearly 33 kg of excess fat tissue even between the lower borders of normal weight and obesity in adults.

References

  1. Widlansky ME, Gokce N, Keaney JF Jr, Vita JA. The clinical implications of endothelial dysfunction. J Am Coll Cardiol 2003; 42(7): 1149-1160.
    View at Publisher | View at Google Scholar
  2. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365(9468): 1415-1428.
    View at Publisher | View at Google Scholar
  3. Franklin SS, Barboza MG, Pio JR, Wong ND. Blood pressure categories, hypertensive subtypes, and the metabolic syndrome. J Hypertens 2006; 24(10): 2009-2016.
    View at Publisher | View at Google Scholar
  4. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106(25): 3143-3421.
    View at Publisher | View at Google Scholar
  5. Helvaci MR, Aydin LY, Aydin Y. Digital clubbing may be an indicator of systemic atherosclerosis even at microvascular level. HealthMED 2012; 6(12): 3977-3981.
    View at Publisher | View at Google Scholar
  6. Anderson RN, Smith BL. Deaths: leading causes for 2001. Natl Vital Stat Rep 2003; 52(9): 1-85.
    View at Publisher | View at Google Scholar
  7. Helvaci MR, Gokce C, Davran R, Akkucuk S, Ugur M, Oruc C. Mortal quintet of sickle cell diseases. Int J Clin Exp Med 2015; 8(7): 11442-11448.
    View at Publisher | View at Google Scholar
  8. Platt OS, Brambilla DJ, Rosse WF, Milner PF, Castro O, Steinberg MH, et al. Mortality in sickle cell disease. Life expectancy and risk factors for early death. N Engl J Med 1994; 330(23): 1639-1644.
    View at Publisher | View at Google Scholar
  9. Helvaci MR, Yaprak M, Abyad A, Pocock L. Atherosclerotic background of hepatosteatosis in sickle cell diseases. World Family Med 2018; 16(3): 12-18.
    View at Publisher | View at Google Scholar
  10. Helvaci MR, Kaya H. Effect of sickle cell diseases on height and weight. Pak J Med Sci 2011; 27(2): 361-364.
    View at Publisher | View at Google Scholar
  11. Helvaci MR, Aydin Y, Ayyildiz O. Hydroxyurea may prolong survival of sickle cell patients by decreasing frequency of painful crises. HealthMED 2013; 7(8): 2327-2332.
    View at Publisher | View at Google Scholar
  12. Mankad VN, Williams JP, Harpen MD, Manci E, Longenecker G, Moore RB, et al. Magnetic resonance imaging of bone marrow in sickle cell disease: clinical, hematologic, and pathologic correlations. Blood 1990; 75(1): 274-283.
    View at Publisher | View at Google Scholar
  13. Helvaci MR, Aydin Y, Ayyildiz O. Clinical severity of sickle cell anemia alone and sickle cell diseases with thalassemias. HealthMED 2013; 7(7): 2028-2033.
    View at Publisher | View at Google Scholar
  14. Fisher MR, Forfia PR, Chamera E, Housten-Harris T, Champion HC, Girgis RE, et al. Accuracy of Doppler echocardiography in the hemodynamic assessment of pulmonary hypertension. Am J Respir Crit Care Med 2009; 179(7): 615-621.
    View at Publisher | View at Google Scholar
  15. Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013; 187(4): 347-365.
    View at Publisher | View at Google Scholar
  16. Davies SC, Luce PJ, Win AA, Riordan JF, Brozovic M. Acute chest syndrome in sickle-cell disease. Lancet 1984; 1(8367): 36-38.
    View at Publisher | View at Google Scholar
  17. Vandemergel X, Renneboog B. Prevalence, aetiologies and significance of clubbing in a department of general internal medicine. Eur J Intern Med 2008; 19(5): 325-339.
    View at Publisher | View at Google Scholar
  18. Schamroth L. Personal experience. S Afr Med J 1976; 50(9): 297-300.
    View at Publisher | View at Google Scholar
  19. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999; 341(15): 1097-1105.
    View at Publisher | View at Google Scholar
  20. Helvaci MR, Aydin Y, Gundogdu M. Smoking induced atherosclerosis in cancers. HealthMED 2012; 6(11): 3744-9.
    View at Publisher | View at Google Scholar
  21. Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med 1999; 340(2): 115-126.
    View at Publisher | View at Google Scholar
  22. Ridker PM. High-sensitivity C-reactive protein: Potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 2001; 103(13): 1813-188.
    View at Publisher | View at Google Scholar
  23. Danesh J, Collins R, Appleby P, Peto R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA 1998; 279(18): 1477-1482.
    View at Publisher | View at Google Scholar
  24. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA 1999; 282(22): 2131-2135.
    View at Publisher | View at Google Scholar
  25. Zhou B, Wu Y, Yang J, Li Y, Zhang H, Zhao L. Overweight is an independent risk factor for cardiovascular disease in Chinese populations. Obes Rev 2002; 3(3): 147-156.
    View at Publisher | View at Google Scholar
  26. Zhou BF. Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases--report for meta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults. Biomed Environ Sci 2002; 15(3): 245-252.
    View at Publisher | View at Google Scholar
  27. Helvaci MR, Kaya H, Yalcin A, Kuvandik G. Prevalence of white coat hypertension in underweight and overweight subjects. Int Heart J 2007; 48(5): 605-613.
    View at Publisher | View at Google Scholar
  28. Heilbronn LK, Ravussin E. Calorie restriction and aging: review of the literature and implications for studies in humans. Am J Clin Nutr 2003; 78(3): 361-369.
    View at Publisher | View at Google Scholar
  29. Fodor JG, Tzerovska R, Dorner T, Rieder A. Do we diagnose and treat coronary heart disease differently in men and women? Wien Med Wochenschr 2004; 154(17-18): 423-425.
    View at Publisher | View at Google Scholar
  30. Helvaci MR, Aydin LY, Aydin Y. Chronic obstructive pulmonary disease may be one of the terminal end points of metabolic syndrome. Pak J Med Sci 2012; 28(3): 376-379.
    View at Publisher | View at Google Scholar
  31. Helvaci MR, Kayabasi Y, Celik O, Sencan H, Abyad A, Pocock L. Smoking causes a moderate or severe inflammatory process in human body. Am J Biomed Sci & Res 2023; 7(6): 694-702.
    View at Publisher | View at Google Scholar
  32. Grunberg NE, Greenwood MR, Collins F, Epstein LH, Hatsukami D, Niaura R, et al. National working conference on smoking and body weight. Task Force 1: Mechanisms relevant to the relations between cigarette smoking and body weight. Health Psychol 1992; 11: 4-9.
    View at Publisher | View at Google Scholar
  33. Helvaci MR, Camci C, Nisa EK, Ersahin T, Atabay A, Alrawii I, Ture Y, Abyad A, Pocock L. Severity of sickle cell diseases restricts smoking. Ann Med Medical Res 2024; 7: 1074.
    View at Publisher | View at Google Scholar
  34. Walker JF, Collins LC, Rowell PP, Goldsmith LJ, Moffatt RJ, Stamford BA. The effect of smoking on energy expenditure and plasma catecholamine and nicotine levels during light physical activity. Nicotine Tob Res 1999; 1(4): 365-370.
    View at Publisher | View at Google Scholar
  35. Hughes JR, Hatsukami DK. Effects of three doses of transdermal nicotine on post-cessation eating, hunger and weight. J Subst Abuse 1997; 9: 151-159.
    View at Publisher | View at Google Scholar
  36. Miyata G, Meguid MM, Varma M, Fetissov SO, Kim HJ. Nicotine alters the usual reciprocity between meal size and meal number in female rat. Physiol Behav 2001; 74(1-2): 169-176.
    View at Publisher | View at Google Scholar
  37. Froom P, Melamed S, Benbassat J. Smoking cessation and weight gain. J Fam Pract 1998; 46(6): 460-464.
    View at Publisher | View at Google Scholar
  38. Helvaci MR, Kaya H, Gundogdu M. Gender differences in coronary heart disease in Turkey. Pak J Med Sci 2012; 28(1): 40-44.
    View at Publisher | View at Google Scholar
  39. Prescott E, Hippe M, Schnohr P, Hein HO, Vestbo J. Smoking and risk of myocardial infarction in women and men: longitudinal population study. BMJ 1998; 316(7137): 1043-1047.
    View at Publisher | View at Google Scholar
  40. Helvaci MR, Kabay S, Gulcan E. A physiologic events’ cascade, irritable bowel syndrome, may even terminate with urolithiasis. J Health Sci 2006; 52(4): 478-481.
    View at Publisher | View at Google Scholar
  41. Helvaci MR, Dede G, Yildirim Y, Salaz S, Abyad A, Pocock L. Smoking may even cause irritable bowel syndrome. World Family Med 2019; 17(3): 28-33.
    View at Publisher | View at Google Scholar
  42. Helvaci MR, Algin MC, Kaya H. Irritable bowel syndrome and chronic gastritis, hemorrhoid, urolithiasis. Eurasian J Med 2009; 41(3): 158-161.
    View at Publisher | View at Google Scholar
  43. Kamimura D, Loprinzi PD, Wang W, Suzuki T, Butler KR, Mosley TH, et al. Physical activity is associated with reduced left ventricular mass in obese and hypertensive African Americans. Am J Hypertens 2017; 30(6): 617-623.
    View at Publisher | View at Google Scholar
  44. Bhatia LS, Curzen NP, Calder PC, Byrne CD. Non-alcoholic fatty liver disease: a new and important cardiovascular risk factor? Eur Heart J 2012; 33(10): 1190-1200.
    View at Publisher | View at Google Scholar
  45. Pacifico L, Nobili V, Anania C, Verdecchia P, Chiesa C. Pediatric nonalcoholic fatty liver disease, metabolic syndrome and cardiovascular risk. World J Gastroenterol 2011; 17(26): 3082-3091.
    View at Publisher | View at Google Scholar
  46. Mawatari S, Uto H, Tsubouchi H. Chronic liver disease and arteriosclerosis. Nihon Rinsho 2011; 69(1): 153-157.
    View at Publisher | View at Google Scholar
  47. Bugianesi E, Moscatiello S, Ciaravella MF, Marchesini G. Insulin resistance in nonalcoholic fatty liver disease. Curr Pharm Des 2010; 16(17): 1941-1951.
    View at Publisher | View at Google Scholar
  48. Mostafa A, Mohamed MK, Saeed M, Hasan A, Fontanet A, Godsland I, et al. Hepatitis C infection and clearance: impact on atherosclerosis and cardiometabolic risk factors. Gut 2010; 59(8): 1135-1140.
    View at Publisher | View at Google Scholar
  49. Helvaci MR, Ayyildiz O, Gundogdu M, Aydin Y, Abyad A, Pocock L. Hyperlipoproteinemias may actually be acute phase reactants in the plasma. World Family Med 2018; 16(1): 7-10.
    View at Publisher | View at Google Scholar
  50. Parfrey NA, Moore W, Hutchins GM. Is pain crisis a cause of death in sickle cell disease? Am J Clin Pathol 1985; 84(2): 209-212.
    View at Publisher | View at Google Scholar
  51. Helvaci MR, Ayyildiz O, Gundogdu M. Hydroxyurea therapy and parameters of health in sickle cell patients. HealthMED 2014; 8(4): 451-456.
    View at Publisher | View at Google Scholar
  52. Helvaci MR, Tonyali O, Yaprak M, Abyad A, Pocock L. Increased sexual performance of sickle cell patients with hydroxyurea. World Family Med 2019; 17(4): 28-33.
    View at Publisher | View at Google Scholar
  53. Helvaci MR, Atci N, Ayyildiz O, Muftuoglu OE, Pocock L. Red blood cell supports in severe clinical conditions in sickle cell diseases. World Family Med 2016; 14(5): 11-18.
    View at Publisher | View at Google Scholar
  54. Helvaci MR, Ayyildiz O, Gundogdu M. Red blood cell transfusions and survival of sickle cell patients. HealthMED 2013; 7(11): 2907-2912.
    View at Publisher | View at Google Scholar
  55. Helvaci MR, Cayir S, Halici H, Sevinc A, Camci C, Abyad A, Pocock L. Red blood cell transfusions may have the strongest analgesic effect during acute painful crises in sickle cell diseases. Ann Clin Med Case Rep 2024; V13(12): 1-12.
    View at Publisher | View at Google Scholar
  56. Miller ST, Sleeper LA, Pegelow CH, Enos LE, Wang WC, Weiner SJ, et al. Prediction of adverse outcomes in children with sickle cell disease. N Engl J Med 2000; 342(2): 83-89.
    View at Publisher | View at Google Scholar
  57. Balkaran B, Char G, Morris JS, Thomas PW, Serjeant BE, Serjeant GR. Stroke in a cohort of patients with homozygous sickle cell disease. J Pediatr 1992; 120(3): 360-366.
    View at Publisher | View at Google Scholar
  58. Cole TB, Sprinkle RH, Smith SJ, Buchanan GR. Intravenous narcotic therapy for children with severe sickle cell pain crisis. Am J Dis Child 1986; 140(12): 1255-1259.
    View at Publisher | View at Google Scholar
  59. Miller BA, Platt O, Hope S, Dover G, Nathan DG. Influence of hydroxyurea on fetal hemoglobin production in vitro. Blood 1987; 70(6): 1824-1829.
    View at Publisher | View at Google Scholar
  60. Platt OS. Is there treatment for sickle cell anemia? N Engl J Med 1988; 319(22): 1479-1480.
    View at Publisher | View at Google Scholar
  61. Helvaci MR, Aydogan F, Sevinc A, Camci C, Dilek I. Platelet and white blood cell counts in severity of sickle cell diseases. Pren Med Argent 2014; 100(1): 49-56.
    View at Publisher | View at Google Scholar
  62. Charache S. Mechanism of action of hydroxyurea in the management of sickle cell anemia in adults. Semin Hematol 1997; 34(3): 15-21.
    View at Publisher | View at Google Scholar
  63. Charache S, Barton FB, Moore RD, Terrin ML, Steinberg MH, Dover GJ, et al. Hydroxyurea and sickle cell anemia. Clinical utility of a myelosuppressive
    View at Publisher | View at Google Scholar
  64. Steinberg MH, Barton F, Castro O, Pegelow CH, Ballas SK, Kutlar A, et al. Effect of hydroxyurea on mortality and morbidity in adult sickle cell anemia: risks and benefits up to 9 years of treatment. JAMA 2003; 289(13): 1645-1651.
    View at Publisher | View at Google Scholar
  65. Lebensburger JD, Miller ST, Howard TH, Casella JF, Brown RC, Lu M, et al; BABY HUG Investigators. Influence of severity of anemia on clinical findings in infants with sickle cell anemia: analyses from the BABY HUG study. Pediatr Blood Cancer 2012; 59(4): 675-678.
    View at Publisher | View at Google Scholar
  66. Toghi H, Konno S, Tamura K, Kimura B, Kawano K. Effects of low-to-high doses of aspirin on platelet aggregability and metabolites of thromboxane A2 and prostacyclin. Stroke 1992; 23(10): 1400-1403.
    View at Publisher | View at Google Scholar
  67. Baigent C, Blackwell L, Collins R, Emberson J, Godwin J, Peto R, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009; 373(9678): 1849-1860.
    View at Publisher | View at Google Scholar
  68. Algra AM, Rothwell PM. Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials. Lancet Oncol 2012; 13(5): 518-527.
    View at Publisher | View at Google Scholar
  69. Macdonald S. Aspirin use to be banned in under 16 year olds. BMJ 2002; 325(7371): 988.
    View at Publisher | View at Google Scholar
  70. Schrör K. Aspirin and Reye syndrome: a review of the evidence. Paediatr Drugs 2007; 9(3): 195-204.
    View at Publisher | View at Google Scholar
  71. Pugliese A, Beltramo T, Torre D. Reye’s and Reye’s-like syndromes. Cell Biochem Funct 2008; 26(7): 741-746.
    View at Publisher | View at Google Scholar
  72. Hurwitz ES. Reye’s syndrome. Epidemiol Rev 1989; 11: 249-253.
    View at Publisher | View at Google Scholar
  73. Meremikwu MM, Okomo U. Sickle cell disease. BMJ Clin Evid 2011; 2011: 2402.
    View at Publisher | View at Google Scholar
  74. Mohamed S, Fong CM, Ming YJ, Kori AN, Wahab SA, Ali ZM. Evaluation of an initiation regimen of warfarin for international normalized ratio target 2.0 to 3.0. J Pharm Technol 2021; 37(6): 286-292.
    View at Publisher | View at Google Scholar
  75. Chu MWA, Ruel M, Graeve A, Gerdisch MW, Ralph J, Damiano Jr RJ, Smith RL. Low-dose vs standard warfarin after mechanical mitral valve replacement: A randomized trial. Ann Thorac Surg 2023; 115(4): 929-938.
    View at Publisher | View at Google Scholar
  76. Crowther MA, Douketis JD, Schnurr T, Steidl L, Mera V, Ultori C, et al. Oral vitamin K lowers the international normalized ratio more rapidly than subcutaneously vitamin K in the treatment of warfarin-associated coagulopathy. A randomized, controlled trial. Ann Intern Med 2002; 137(4): 251-254.
    View at Publisher | View at Google Scholar
  77. Brown DG, Wilkerson EC, Love WE. A review of traditional and novel oral anticoagulant and antiplatelet therapy for dermatologists and dermatologic surgeons. J Am Acad Dermatol 2015; 72(3): 524-534.
    View at Publisher | View at Google Scholar
  78. Delaney JA, Opatrny L, Brophy JM, Suissa S. Drug drug interactions between antithrombotic medications and the risk of gastrointestinal bleeding. CMAJ 2007; 177(4): 347-351.
    View at Publisher | View at Google Scholar
  79. Dahal K, Kunwar S, Rijal J, Schulman P, Lee J. Stroke, major bleeding, and mortality outcomes in warfarin users with atrial fibrillation and chronic kidney disease: a meta-analysis of observational studies. Chest 2016; 149(4): 951-959.
    View at Publisher | View at Google Scholar
  80. Chai-Adisaksopha C, Lorio A, Hillis C, Siegal D, Witt DM, Schulman S, et al. Warfarin resumption following anticoagulant-associated intracranial hemorrhage: A systematic review and meta-analysis. Thromb Res 2017; 160: 97-104.
    View at Publisher | View at Google Scholar
  81. Ferro JM, Coutinho JM, Dentali F, Kobayashi A, Alasheev A, Canhao P, et al. Safety and efficacy of dabigatran etexilate vs dose-adjusted warfarin in patients with cerebral venous thrombosis: A randomized clinical trial. JAMA Neurol 2019; 76(12): 1457-1465.
    View at Publisher | View at Google Scholar
  82. Meade TW. Low-dose warfarin and low-dose aspirin in the primary prevention of ischemic heart disease. Am J Cardiol 1990; 65(6): 7C-11C.
    View at Publisher | View at Google Scholar
  83. Singer DE, Hughes RA, Gress DR, Sheehan MA, Oertel LB, Maraventano SW, et al. The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. N Engl J Med 1990; 323(22): 1505-1511.
    View at Publisher | View at Google Scholar
  84. Levine M, Hirsh J, Gent M, Arnold A, Warr D, Falanya A, et al. Double-blind randomised trial of a very-low-dose warfarin for prevention of thromboembolism in stage IV breast cancer. Lancet 1994; 343(8902): 886-889.
    View at Publisher | View at Google Scholar
  85. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014; 383(9921): 955-962.
    View at Publisher | View at Google Scholar
  86. Vinogradova Y, Coupland C, Hill T, Hippisley-Cox J. Risks and benefits of direct oral anticoagulants versus warfarin in a real world setting: cohort study in primary care. BMJ 2018; 362: k2505.
    View at Publisher | View at Google Scholar
  87. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361(12): 1139-1151.
    View at Publisher | View at Google Scholar
  88. Helvaci MR, Cayir S, Halici H, Sevinc A, Camci C, Abyad A, Pocock L. Terminal endpoints of systemic atherosclerotic processes in sickle cell diseases. World Family Med 2024; 22(5): 13-23.
    View at Publisher | View at Google Scholar
  89. Helvaci MR, Daglioglu MC, Halici H, Sevinc A, Camci C, Abyad A, Pocock L. Low-dose aspirin plus low-dose warfarin may be the standard treatment regimen in Buerger's disease. World Family Med 2024; 22(6): 22-35.
    View at Publisher | View at Google Scholar
  90. Helvaci MR, Erden ES, Aydin LY. Atherosclerotic background of chronic obstructive pulmonary disease in sickle cell patients. HealthMED 2013; 7(2): 484-488.
    View at Publisher | View at Google Scholar
  91. Rennard SI, Drummond MB. Early chronic obstructive pulmonary disease: definition, assessment, and prevention. Lancet 2015; 385(9979): 1778-1788.
    View at Publisher | View at Google Scholar
  92. Schoepf D, Heun R. Alcohol dependence and physical comorbidity: Increased prevalence but reduced relevance of individual comorbidities for hospital-based mortality during a 12.5-year observation period in general hospital admissions in urban North-West England. Eur Psychiatry 2015; 30(4): 459-468.
    View at Publisher | View at Google Scholar
  93. Singh G, Zhang W, Kuo YF, Sharma G. Association of Psychological Disorders With 30-Day Readmission Rates in Patients With COPD. Chest 2016; 149(4): 905-915.
    View at Publisher | View at Google Scholar
  94. Mannino DM, Watt G, Hole D, Gillis C, Hart C, McConnachie A, et al. The natural history of chronic obstructive pulmonary disease. Eur Respir J 2006; 27(3): 627-643.
    View at Publisher | View at Google Scholar
  95. Mapel DW, Hurley JS, Frost FJ, Petersen HV, Picchi MA, Coultas DB. Health care utilization in chronic obstructive pulmonary disease. A case-control study in a health maintenance organization. Arch Intern Med 2000; 160(17): 2653-2658.
    View at Publisher | View at Google Scholar
  96. Anthonisen NR, Connett JE, Enright PL, Manfreda J; Lung Health Study Research Group. Hospitalizations and mortality in the Lung Health Study. Am J Respir Crit Care Med 2002; 166(3): 333-339.
    View at Publisher | View at Google Scholar
  97. McGarvey LP, John M, Anderson JA, Zvarich M, Wise RA; TORCH Clinical Endpoint Committee. Ascertainment of cause-specific mortality in COPD: operations of the TORCH Clinical Endpoint Committee. Thorax 2007; 62(5): 411-415.
    View at Publisher | View at Google Scholar
  98. Trent JT, Kirsner RS. Leg ulcers in sickle cell disease. Adv Skin Wound Care 2004: 17(8); 410-416.
    View at Publisher | View at Google Scholar
  99. Minniti CP, Eckman J, Sebastiani P, Steinberg MH, Ballas SK. Leg ulcers in sickle cell disease. Am J Hematol 2010; 85(10): 831-833
    View at Publisher | View at Google Scholar
  100. Yawn BP, Buchanan GR, Afenyi-Annan AN, Ballas SK, Hassell KL, James AH, et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members. JAMA 2014; 312(10): 1033-1048.
    View at Publisher | View at Google Scholar
  101. Helvaci MR, Aydogan F, Sevinc A, Camci C, Dilek I. Platelet and white blood cell counts in severity of sickle cell diseases. HealthMED 2014; 8(4): 477-482.
    View at Publisher | View at Google Scholar
  102. Myers KA, Farquhar DR. The rational clinical examination. Does this patient have clubbing? JAMA 2001; 286(3): 341-347.
    View at Publisher | View at Google Scholar
  103. Toovey OT, Eisenhauer HJ. A new hypothesis on the mechanism of digital clubbing secondary to pulmonary pathologies. Med Hypotheses 2010; 75(6): 511-513.
    View at Publisher | View at Google Scholar
  104. Nassiri AA, Hakemi MS, Asadzadeh R, Faizei AM, Alatab S, Miri R, et al. Differences in cardiovascular disease risk factors associated with maximum and mean carotid intima-media thickness among hemodialysis patients. Iran J Kidney Dis 2012; 6(3): 203-208.
    View at Publisher | View at Google Scholar
  105. Helvaci MR, Gokce C, Sahan M, Hakimoglu S, Coskun M, Gozukara KH. Venous involvement in sickle cell diseases. Int J Clin Exp Med 2016; 9(6): 11950-11957.
    View at Publisher | View at Google Scholar
  106. Xia M, Guerra N, Sukhova GK, Yang K, Miller CK, Shi GP, et al. Immune activation resulting from NKG2D/ligand interaction promotes atherosclerosis. Circulation 2011; 124(25): 2933-2943.
    View at Publisher | View at Google Scholar
  107. Hall JE, Henegar JR, Dwyer TM, Liu J, da Silva AA, Kuo JJ, et al. Is obesity a major cause of chronic kidney disease? Adv Ren Replace Ther 2004; 11(1): 41-54.
    View at Publisher | View at Google Scholar
  108. Nerpin E, Ingelsson E, Risérus U, Helmersson-Karlqvist J, Sundström J, Jobs E, et al. Association between glomerular filtration rate and endothelial function in an elderly community cohort. Atherosclerosis 2012; 224(1): 242-246.
    View at Publisher | View at Google Scholar
  109. Stengel B, Tarver-Carr ME, Powe NR, Eberhardt MS, Brancati FL. Lifestyle factors, obesity and the risk of chronic kidney disease. Epidemiology 2003; 14(4): 479-487.
    View at Publisher | View at Google Scholar
  110. Bonora E, Targher G. Increased risk of cardiovascular disease and chronic kidney disease in NAFLD. Nat Rev Gastroenterol Hepatol 2012; 9(7): 372-381.
    View at Publisher | View at Google Scholar
  111. Helvaci MR, Cayir S, Halici H, Sevinc A, Camci C, Sencan H, Davran R, Abyad A, Pocock L. Acute chest syndrome and coronavirus disease may actually be genetically determined exaggerated immune response syndromes particularly in pulmonary capillaries. World Family Med 2024; 22(3): 6-16.
    View at Publisher | View at Google Scholar
  112. Tonelli M, Wiebe N, Culleton B, House A, Rabbat C, Fok M, et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol 2006; 17(7): 2034-2047.
    View at Publisher | View at Google Scholar
  113. Helvaci MR, Aydin Y, Aydin LY. Atherosclerotic background of chronic kidney disease in sickle cell patients. HealthMED 2013; 7(9): 2532-2537.
    View at Publisher | View at Google Scholar
  114. DeBaun MR, Gordon M, McKinstry RC, Noetzel MJ, White DA, Sarnaik SA, et al. Controlled trial of transfusions for silent cerebral infarcts in sickle cell anemia. N Engl J Med 2014; 371(8): 699-710.
    View at Publisher | View at Google Scholar
  115. Majumdar S, Miller M, Khan M, Gordon C, Forsythe A, Smith MG, et al. Outcome of overt stroke in sickle cell anaemia, a single institution's experience. Br J Haematol 2014; 165(5): 707-713.
    View at Publisher | View at Google Scholar
  116. Kossorotoff M, Grevent D, de Montalembert M. Cerebral vasculopathy in pediatric sickle-cell anemia. Arch Pediatr 2014; 21(4): 404-414.
    View at Publisher | View at Google Scholar
  117. Charache S, Terrin ML, Moore RD, Dover GJ, Barton FB, Eckert SV, et al. Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. Investigators of the Multicenter Study of Hydroxyurea in Sickle Cell Anemia. N Engl J Med 1995; 332(20): 1317-1322.
    View at Publisher | View at Google Scholar
  118. Rosak C, Mertes G. Critical evaluation of the role of acarbose in the treatment of diabetes: patient considerations. Diabetes Metab Syndr Obes 2012; 5: 357-367.
    View at Publisher | View at Google Scholar
  119. Salvatore T, Giugliano D. Pharmacokinetic-pharmacodynamic relationships of acarbose. Clin Pharmacokinet 1996; 30(2): 94-106.
    View at Publisher | View at Google Scholar
  120. DiNicolantonio JJ, Bhutani J, O’Keefe JH. Acarbose: safe and effective for lowering postprandial hyperglycaemia and improving cardiovascular outcomes. Open Heart 2015; 2(1): e000327.
    View at Publisher | View at Google Scholar
  121. Leonhardt W, Hanefeld M, Fischer S, Schulze J. Efficacy of alpha-glucosidase inhibitors on lipids in NIDDM subjects with moderate hyperlipidaemia. Eur J Clin Invest 1994; 24(3): 45-49.
    View at Publisher | View at Google Scholar
  122. Li FF, Fu LY, Xu XH, Su XF, Wu JD, Ye L, et al. Analysis of the add-on effect of alpha-glucosidase inhibitor, acarbose in insulin therapy: A pilot study. Biomed Rep 2016; 5(4): 461-466.
    View at Publisher | View at Google Scholar
  123. Heine RJ, Balkau B, Ceriello A, Del Prato S, Horton ES, Taskinen MR. What does postprandial hyperglycaemia mean? Diabet Med 2004; 21(3): 208-213.
    View at Publisher | View at Google Scholar
  124. Standl E, Schnell O, Ceriello A. Postprandial hyperglycemia and glycemic variability: should we care? Diabetes Care 2011; 34(2): 120-127.
    View at Publisher | View at Google Scholar
  125. Wettergreen SA, Sheth S, Malveaux J. Effects of the addition of acarbose to insulin and non-insulin regimens in veterans with type 2 diabetes mellitus. Pharm Pract (Granada) 2016; 14(4): 832.
    View at Publisher | View at Google Scholar
  126. Van De Laar FA, Lucassen PL, Akkermans RP, Van de Lisdonk EH, Rutten GE, Van Weel C. Alpha-glucosidase inhibitors for patients with type 2 diabetes: results from a Cochrane systematic review and meta-analysis. Diabetes Care 2005; 28(1): 154-156.
    View at Publisher | View at Google Scholar
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Harry Brooks

journal of Clinical Case Studies and Review Reports. I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office.the reviewer board were accurate and helpful regarding anu modifications for my manuscript,and the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help.it was my pleasure to contribute with your promising journal and i am looking forward for more collaboration.

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Testimonial for the Journal of Biomedical Research and Clinical Advancements It was a truly rewarding experience publishing our study, "Single-Surgeon Outcomes of Left Ventricular Aneurysm Repair in Wartime Syria: A 10-Year Retrospective Study at Damascus University Cardiac Surgery Hospital," with the Journal of Biomedical Research and Clinical Advancements. The editorial and peer-review process was both rigorous and efficient, demonstrating a high standard of academic integrity and scientific scrutiny. The journal’s commitment to open access and global health equity is evident in its support of research emerging from conflict-affected and resource-limited settings—making our work not only visible but impactful. The professionalism of the editorial team, the speed of communication, and the clarity of submission guidelines all contributed to a smooth publication process. We were particularly impressed by the quality of the publication layout and the prompt indexing of our article, which enhances its accessibility to clinicians, researchers, and policymakers worldwide. We are proud to have contributed to this journal and highly recommend it to fellow researchers seeking a reputable platform to disseminate clinically significant and globally relevant findings.