Lipoprotein-associated phospholipase A2 levels are associated with erectile dysfunction in patients without known coronary artery disease

Endothelial dysfunction and microvascular damage play a crucial role in the pathogenesis of erectile dysfunction (ED). Lp-PLA2 is a calcium-independent member of the phospholipase A2 family and hydrolyses oxidised phospholipids on low-density lipoprotein (LDL) particles that plays a pivotal role in ox-LDL-induced endothelial dysfunction. The purpose of the current study was to determine the association between Lp-PLA2 levels and ED in patients without known coronary artery disease (CAD). All patients were evaluated for ED and divided into two groups: 88 patients suffering from ED for >1 year were enrolled as an experimental group and 88 patients without ED were enrolled as a control group in this study. Diagnosis of ED was based on the International Index of Erectile Function Score-5. Levels of Lp-PLA2 were measured in serum by colorimetric assay. The relationship between Lp-PLA2 levels and ED in patients was evaluated statistically. The mean age of patients with ED group was 59.4 ± 11.32 and 55.8 ± 9.67 in the control group. Plasma Lp-PLA2 levels were significantly higher in ED than in the control group (220.3 ± 66.90 and 174.8 ± 58.83 pg ml(-1) , respectively, P < 0.001). The Lp-PLA2 levels were negatively correlated with score of ED (r = -0.482, P < 0.05). In logistic regression analysis, enhanced plasma Lp-PLA2 levels result in approximately 1.2-fold increase in ED [1.22 (1.25-2.76)]. In this study, serum Lp-PLA2 levels were found to be associated with endothelial dysfunction predictive of ED. Serum Lp-PLA2 level appears to be a specific predictor of ED, and it may be used in early prediction of ED in the male population.

[Nutritional prevention of urological tumours]

Through the last decade considerations on the role of vitamins and antioxidants in the primary prevention of genitourinary tumors have changed dramatically. In spite of all efforts, the efficacy of a specific compound has not been proven so far. In consequence, recommendations to use vitamins or other supplements for the primary prevention of urological tumors should be avoided. However, there is some evidence that moderate food consumption, reduction of dairy products and an Asian or Mediterranean diet may not only prevent prostate cancer (PCA) but also harbour additional beneficial effects on general health. Although quantification of these findings may be difficult, it becomes evident that these measures will have additional synergistic effects on cardiovascular diseases. Considering the large number of PCA patients dying not cancer-related but from concomitant diseases, primary prevention in particular of PCA should always also consider the general health of the target population. More recent studies suggest a potential effect of nutritional compounds on biochemical tumour recurrence in PCA patients after definite therapy. These observations may serve as a starting point for validation within controlled clinical trials.

Evaluation of oxidative stress using exhaled breath 8-isoprostane levels on chronic kidney disease

BACKGROUND

There have been limited numbers of studies on patients with chronic kidney disease (CKD) to determine oxidative stress in exhaled breath condensate (EBC). Those two studies have been carried out on hemodialysis patients, and hydrogen peroxide and nitric oxide have been studied in order to show oxidative stress on EBC.

AIMS

We investigated oxidative stress in EBC evaluating 8-isoprostane levels on different stages of CKD.

MATERIALS AND METHODS

A total of 81 patients with 2-4 CKD stages have been evaluated prospectively. The patients have been categorized into three groups according to their CKD stages. For biochemical analysis, blood and breathing air samples were taken. 8-isoprostane has been measured using immunoassay method as the indicator of oxidative stress in EBC.

RESULTS

8-isoprostane values were 8.19 ± 4.56, 13.89 ± 8.70, and 14.20 ± 10.68 pg/min group 1, 2, and 3, respectively; and the EBC 8-isoprostane levels increased significantly as CKD stages advanced (P0 = 0.018). There was a statistically significant reverse correlation between 8-isoprostane and glomerular filtration rate (GFR; r = -0.275; P = 0.014), but not between 8-isoprostane and C-reactive protein (r = -0.183; P = 0.177).

CONCLUSIONS

We determined the level of 8-isoprostane in EBC of patients with different stages of CKD and showed that the level of 8-isoprostane significantly increased through the progress of CKD. We consider that our study is important because there have been limited number of studies that evaluate oxidative stress in CKD using EBC which is a noninvasive method.

Plasma levels of growth arrest specific protein 6 are increased in idiopathic recurrent pregnancy loss

AIM

The aim of this study was to determine plasma Growth Arrest Specific Protein 6 (GAS6) protein levels in patients with unexplained recurrent pregnancy loss (RPL) and compare them to those of pregnant and to healthy non-pregnant women with a history of at least one live delivery.

PATIENTS AND METHODS

A total of 205 women were included in the study. Of these, 68 were diagnosed with unexplained RPL and were not pregnant at the time of the study. The second group consisted of 67 pregnant women in the third trimester of pregnancy. The third group constituted the control group of 70 healthy non-pregnant women who had at least one live birth. Plasma levels of GAS6 protein were measured by ELISA.

RESULTS

Mean plasma GAS6 levels were found to be different between RPL group and healthy non-pregnant women (12.17 ± 4.39 µg/L  and 9.18 ± 4.65, respectively, p = 0.0013). Although it was not statistically significant, plasma levels of GAS6 in the third trimester pregnant group (10.65 ± 3.74 µg/L) were found to be slightly higher than non-pregnant controls, and slightly lower than RPL group. In comparison of those with 2 or more than 2 pregnancy losses in the RPL group, there was no difference between these two subgroups in terms of GAS6 levels (12.39 ± 4.27 µg/L and 11.83 ± 4.63 µg/L, respectively, p = 0.62).

CONCLUSIONS

Our findings revealed that plasma GAS6 levels were increased in patients with RPL. The prothombotic and proinflammatory nature of the GAS 6 protein makes it a likely culprit involved in the pathologic process in patients with RPL. Further studies are warranted to determine the possible role of GAS6 protein in the pathophysiology of idiopathic RPL.

Microencapsulation of wheat germ oil

Wheat germ oil (WGO) is beneficial for health since it is a rich source of omega-3, omega-6 and tocopherol. However, as it contains polyunsaturated fatty acids, it is prone to oxidation. The aim of this study was to encapsulate wheat germ oil and determine the effects of core to coating ratio, coating materials ratio and ultrasonication time on particle size distribution of emulsions and encapsulation efficiency (EE) and surface morphology of capsules. Maltodextrin (MD) and whey protein concentrate (WPC) at different ratios (3:1, 2:2, 1:3) were used as coating materials. Total solid content of samples was 40 % (w/w). Five core to coating ratios (1:8, 1:4, 1:2, 3:4, 1:1) were tried. Ultrasound was used at 320 W and 20 kHz for 2, 5, 10 min to obtain emulsions. Then, emulsions were freeze dried to obtain microcapsules. It was observed that, increasing WPC ratio in the coating resulted in higher encapsulation efficiency and smaller particle size. Microcapsules prepared with MD:WPC ratio of 1:3 were found to have higher EE (74.35-89.62 %). Increase in oil load led to decrease in EE. Thus 1:8 core to coating ratio gave better results. Increasing ultrasonication time also had a positive effect on encapsulation efficiency.

Erectile dysfunction in patients with psoriasis: potential impact of the metabolic syndrome

BACKGROUND

Psoriasis is a chronic inflammatory skin disease that affects up to 5.5% of world population and is associated with erectile dysfunction (ED). Aim of the present study was to investigate impact of metabolic syndrome (MetS) on association between psoriasis and ED as well as to improve our understanding of this association via studying other possible causes of ED such as psychological factors and disease effects.

PATIENTS AND METHODS

The patient group included 37 male psoriasis patients and control group 28 healthy men. Severity of psoriasis was determined using Psoriasis Area and Severity Index (PASI), and ED was evaluated using International Index of Erectile Function (IIEF) Scale. Psychiatric state of the patients were determined using Beck Depression Inventory (BDI). MetS was diagnosed using the National Cholesterol Education Program Adult Treatment Panel III criteria.

RESULTS

MetS, ED prevalence and BDI score were significantly higher in psoriasis patient group (p = 0.032, p = 0.018 and p < 0.001). Average IIEF score of psoriasis patients with and without MetS, on the other hand, was not different (p = 0.073). IIEF score had negative correlations with age, BDI and PASI scores. In multiple linear regression analysis, BDI score, old age and smoking (but not MetS) were found to be independent predictors of ED.

CONCLUSIONS

ED, MetS and depression frequencies were significantly higher in psoriasis patient group. In addition, psoriasis severity and ED parameters were closely associated. Depression, old age and smoking were found to be independent risk factors for ED.

Cause of a rare acute renal insufficiency: Rupture aortocaval fistula

Introduction

Abdominal aortic aneurysms can be complicated by some conditions and aortocaval fistula is one of them. Aortocaval fistula is an unusual entity.

Case Report

A male patient was admitted to the hospital for abdominal pain and leg oedema of three days duration. In addition, severe anuria was also noted. We determined a fistula from the right lateral wall of aneurysm to the distal of vena cava inferior. The aortocaval fistula was closed with pledged-reinforced 4/0 polypropylene suture in the aneurysmal wall. At the postoperative 10th day, he was discharged with normal renal function.

Discussion

After a long-term untreated fistula, right-sided heart failure, acute renal and hepatic insufficiency, deep vein thrombosis and pulmonary thrombo-embolism can be seen in these patients. Increased venous pressure should be the reason for decreased arterial flow results in renal insufficiency. Emergency intervention in these patients saves the patient’s life as well as prevents irreversible organ failure.