Total testosterone cut-off value indicating androgen-secreting tumor in premenopausal women with hirsutism

OBJECTIVE

There is insufficient data on which cut-off value must be used to measure the increase in total testosterone (TT) compared to the upper limit of normal (CULN) in the diagnosis of androgen-secreting tumor (ASTM) in female individuals with premenopausal hirsutism (FIPH).

PATIENTS AND METHODS

A total of 413 FIPH over 18 years of age who were admitted to the endocrinology clinic between May 2013 and 30 April 2018 were eligible for the study. Hormone profiles of the participants in the follicular phase and other information were obtained from their files. The androgen suppression ratio (ASR) was analyzed after 48 hours of low-dose dexamethasone suppression test (LDDST) in those whose TT CULN (nmol/L) increased two-fold.

RESULTS

Idiopathic hirsutism was found in 193 participants (46.73%) and polycystic ovary syndrome (PCOS) in 200 (48.43%) and other sources of hirsutism; non-classical congenital adrenal hyperplasia (NCCAH) in 10 patients (2.42%), hyperprolactinemia in 6 patients (1.45%), ASTM of ovarian origin in 2 patients (0.48%), Cushing's disease in 1 patient (0.24%), and adrenal ASTM in 1 patient (0.24%). A cut-off value of two-fold CULN increase for TT sensitivity of 100% and a specificity of 99.5% in indicating an ASTM source, and ASR above 49% in LDDST sensitivity of 80% and a specificity of 100% in excluding an ASTM source, was used.

CONCLUSIONS

At the TT level, a two-fold increase CULN in FIPH indicates an ASTM source. In addition, ASR after LDDST is a useful parameter in the exclusion of ASTM sources in the same patient population.

Psychometric Properties of the Turkish Version of the Coronavirus-Related Health Literacy Scale

Background

This study aims to assess the validity and reliability of the Coronavirus-Related Health Literacy Questionnaire adapted to Turkey and examine the levels of coronavirus-related health literacy among the adults.

Methods

This cross-sectional study was carried out in Turkey. The tools were applied to a total sample population of 452 people. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were calculated to determine the construct validity of the questionnaire with the IBM SPSS Amos program version 24.0.

Results

The validity and reliability analyses of the Coronavirus-Related Health Literacy (HLS-COVID-Q22) questionnaire were adapted to Turkish. Internal consistency was very high (α = 0,963) and construct validity suggests a sufficient model fit, making HLS-COVID-Q19 a feasible tool for assessing coronavirus-related health literacy in population surveys. The findings show that the questionnaire is a valid and reliable tool consisting of 19 items and 3 subdivisions. The mean coronavirus-related health literacy score of the participants was found to be 2.92 (±0.51), meaning that it was on average. The coronavirus-related health literacy level of 18.8% of the participants was found to be ‘inadequate’ while 37.8% had ‘problematic’ and 43.4% ‘sufficient’ health literacy. The HLS-COVID-Q19-TR scores of those in the young age group (18-29 years old), married, employed, university graduates, and vaccinated against COVID-19 were found to be higher, and a statistically significant difference was found (p = 0.049, p = 0.009, p = 0.029, p = 0.012 and p = 0.051, respectively).

Conclusions

The results of the research reveal that the HLS-COVID-Q19-TR is a valid and reliable tool. In this study, more than half of the participants were found to have “inadequate” or “problematic” coronavirus-related health literacy levels. For this reason, studies aimed at improving society's coronavirus-related health literacy should be conducted.

Key messages

Leptin Accelerates Endothelial Wound Healing: Role of Endothelial Nitric Oxide Synthase Expression

Background:

The endothelium is crucial for the control of vascular homeostasis and plays a role in angiogenesis. Leptin, a protein released mainly by adipose tissue, plays a key role in the regulation of energy balance and angiogenesis. We aimed to investigate the changes of endothelial nitric oxide synthetase expression on human umbilical vein endothelial cells wound healing model after leptin treatment.

Methods:

In this study, 5 groups were planned as Group 1: control (untreated), Group 2: treated with 0.1 ng/mL leptin, Group 3: treated with 1 ng/mL leptin, Group 4: treated with 10 ng/mL leptin, and Group 5: treated with 100 ng/mL leptin. Closure rates of wound areas were calculated by the Image J program after 24 hours of leptin treatment. The WST-1 assay was used to calculate the cell viability. Immunocytochemical analysis was performed for endothelial nitric oxide synthase expression and H-Score was calculated.

Results:

The closure rates of wound areas were calculated as 80.24%, 89.73%, 87.40%, 90.73%, and 93.70%, respectively. When all groups treated with leptin were compared with the control group, there was a statistically significant difference (P < .05). The WST-1 results showed that the most increasing levels of viable cells were found in the groups treated with 0.1 ng/mL leptin and 100 ng/mL leptin when compared to the control group. H-Score values of each group were calculated as 284.8 ± 15.22, 288.6 ± 8.41, 291 ± 8.16, 295.2 ± 11.60, and 308.8 ± 4.32, respectively. The difference between the control group and the group treated with 100 ng/mL leptin was statistically significant (P < .05).

Conclusions:

Endothelial nitric oxide synthase expression in human umbilical vein endothelial cells increased depending on the leptin dose and the highest increase was in the group treated with 100 ng/mL leptin.

In vivo application of poly-3-hydroxyoctanoate as peripheral nerve graft

OBJECTIVE

This study aims to investigate the degree of biocompatibility and neuroregeneration of a polymer tube, poly-3-hydroxyoctanoate (PHO) in nerve gap repair.

METHODS

Forty Wistar Albino male rats were randomized into two groups: autologous nerve gap repair group and PHO tube repair group. In each group, a 10-mm right sciatic nerve defect was created and reconstructed accordingly. Neuroregeneration was studied by sciatic function index (SFI), electromyography, and immunohistochemical studies on Days 7, 21, 45 and 60 of implantation. Biocompatibility was analyzed by the capsule formation around the conduit. Biodegradation was analyzed by the molecular weight loss in vivo.

RESULTS

Electrophysiological and histomorphometric assessments demonstrated neuroregeneration in both groups over time. In the experimental group, a straight alignment of the Schwann cells parallel to the axons was detected. However, autologous nerve graft seems to have a superior neuroregeneration compared to PHO grafts. Minor biodegradation was observed in PHO conduit at the end of 60 d.

CONCLUSIONS

Although neuroregeneration is detected in PHO grafts with minor degradation in 60 d, autologous nerve graft is found to be superior in axonal regeneration compared to PHO nerve tube grafts. PHO conduits were found to create minor inflammatory reaction in vivo, resulting in good soft tissue response.