Comparison of the results of sleeve gastrectomy, gastric pilication and liragulitide in obese rats

Obesity, which is generally seen in adults, is a serious health problem. Diseases caused by obesity are among the leading causes of death worldwide. Liraglutide (LG) is an analogue of glucagon-like peptide-1, which slows gastrointestinal motility, resulting in decreased food consumption. Gastric plication (GP) and sleeve gastrectomy (SG) is the reduction of stomach volume by surgical means. We examined and compared the body mass index (BMI) changes, metabolic changes and changes in gastric histology in obese rats after LG injection with surgical methods such as SG and GP. In this research, 35 Wistar Albino female rats were used. Rats were divided into 5 groups with 7 rats in each group. Group (G) 1: The control group, fed with a normal calorie diet for 8 weeks. G 2: Sham group, G 3: SG group, G 4: GP group and G 5: LG group, fed with high-calorie feed for 4 weeks. At the end of the 4th week, the study was terminated by making appropriate interventions for the groups. When the blood glucose (BG) levels measured at the beginning, 4th week and 8th week of the experiment were evaluated, it was monitored that the BG level at the 8th week was the lowest in the LG group (p<0.05). It was observed that the preop Ghrelin and Leptin levels of the LG group were lower than those of the SG and GP groups (p<0.05). As a consequenc As a consequence of our metabolic investigations, we observed that the use of LG is at least as effective as SG.

The Effect of Sleep Disorders on Sexual Function in Bipolar Disorder in the Remission Period

Introduction

Bipolar Disorder(BD) is a common,severe and recurrent disease with significant effects on functionality. Residual symptoms such as sleep disturbance and sexual dysfunction are defined as predictors of poor functioning in remission.

Objectives

The aim of this study was to investigate the correlation between sleep disorder and severity of sexual dysfunction in patients with BD in remission.

Methods

The study was conducted with 100 female and 100 male BD patients in remission. The sociodemographic and clinical characteristics were recorded by interview with the patients and the patients were given the Young Mania Rating Scale(YMRS),Hamilton Depression Rating Scale(HAM-D),Pittsburg Sleep Quality Index(PSQI),Epworth Sleepiness Scale(ESS),Female Sexual Function Scale(FSFI) and International Index of Erectile Function(IIFF-15)for the assesment of symptom severity.

Results

The frequency of “sleep disorder” was 45.5% and the frequency of ’’daytime sleepiness’’ was 5.5%.In women the mean FSFI score was 26.06±5.14 and sexual dysfunction frequency was 48%.In men,the mean IIEF score was 59.63±8.34 and erectile dysfunction frequency was 56%. There was a statistically significant negative correlation between total FSFI score with HAM-D(r=-0.592, p <0.001),ESS (r=-0.330, p=0.001)and PSQI(r=-0.557, p<0.001)and between total IIEF score with HAM-D(r=-0.509, p<0.001),ESS(r=-0.361, p<0.001)and PSQI(r=-0.511,p<0.001). Sexual function scores in both women and men with sleep problems were significantly lower than those without sleep problems(23.56±4.71vs.28.56±4.31and53.88±7.10vs.63.80±6.56 respectively). Multiple linear regression analysis also showed that total sleep quality scores were an effective factor on sexual function in women(OR:2.74,%95CI[0,799-0,127];p=0,007) and men(OR:2.45, %95CI[1.577-0.164];p=0,016) with BD.

Conclusions

There was an increased incidence of sexual dysfunction in bipolar patients with sleep disorders.Treatment of sleep disorders is important for improving sexual function in bipolar patients for both genders.

Disclosure

No significant relationships.

A Case of Ruminative Hypomania Induced by High Dose Venlafaxine

Introduction

Obsessive phenomena, when present, are usually seen in the depressive phase of bipolar disorder.

Objectives

The peculiar case with aggravation in ruminative and obsessive thinking with simultaneous hypomania may widen our understanding of the phenomenology of antidepressant induced hypomanic symptoms.

Methods

We present a case of ruminative hypomania induced by high dose venlafaxine. Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D) and Yale Brown Obsessive Compulsive Scale (YBOCS) were used for symptom ratings.

Results

The patient was 30 years old and she had treatment history of depression for 3 months. She had two consecutive suicide attempts with drugs in the week before she was hospitalized for suicidal risk. She was using venlafaxine 300 mg/day and olanzapin 2,5 mg/day; continuous ruminative thinking about the past and imaginary sexual affairs with former friends were apparent with an unremitting pattern, leading to intense psychomotor agitation and suicide attempts. Irritable mood, and increased energy was observed with continuous ruminations. She was diagnosed with bipolar-II-disorder, with mixed features and anxious distress (YMRS:17, HAM-D:22, YBOCS:34). After discontinuing venlafaxine and starting anti-manic treatment with haloperidol 10 mg/day in the first week, both affective symptoms and ruminations were improved (YMRS:2, HAM-D:4, YBOCS:8). Aripiprazol 20 mg/day and quetiapine 100 mg/day which were given for continuation treatment were also effective for preserving full remission.

Conclusions

When prescribing high dose venlafaxine for treatment resistant depression, it should be remembered that this may induce hypomanic symptoms and prominent ruminative thinking which can be ameliorated with anti-manic treatment.

Disclosure

No significant relationships.

The Comparison of Melphalan Administration on Day −3 With Administration on Day −1 on Neutrophil and Platelet Engraftment in Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation

Background: High dose chemotherapy followed by ASCT is the most important step of MM treatment. Melphalan, an alkylating agent, is the most preferable drug for conditioning regimens and dosage and timing is important with regard to side effects or engraftment timing. Engraftment time is determinative on infections and hospitalization duration. Aim: To compare of the neutrophil and thrombocyte engraftment time in patients with multiple myeloma who received melphalan 200 mg/m2 single dose on day −3 and day −1 as conditioning regimen. Methods: We compared the neutrophil and thrombocyte engraftments retrospectively in patients with multiple myeloma who received melphalan 200 mg/m2 single dose on day −3 and day −1 as conditioning regimen. There were 29 patient receiving melphalan on day −1 and 42 patient on day −3. Results: Administration of melphalan on day −3 was better than on day. Neutrophil engraftment time and hospitalization duration was shorter in patients who received melphalan on day −3 than patients who received melphalan on day −1. In day −3 group, there was no failure neither in neutrophil nor in thrombocyte engraftment but 1 patient could just get thrombocyte engraftment on day 33. In day −1 group, 2 patients could not get engraftment. Conclusion: Administration of melphalan on day −3 is better than on day −1 in terms of neutrophil engraftment and hence in terms of hospitalization duration.