Assessment of Health-Related Quality of Life in Patients with Idiopathic Hirsutism Compared to Patients with Polycystic Ovary Syndrome

Objective

Hirsutism affects 5-15% of women of reproductive age. Health-related quality of life (HQOL) is a multidimensional assessment of well-being that considers the physical, social, and emotional aspects associated with a specific disease. The aim of this study is to evaluate HQOL in patients diagnosed with idiopathic hirsutism (IH) and compare it with patients diagnosed with polycystic ovary syndrome (PCOS).

Methods

This cross-sectional observational study was performed on 183 female individuals, consisting of 51 patients diagnosed with idiopathic hirsutism, 76 patients diagnosed with PCOS, and 56 healthy volunteers. Participants with a history of neuropsychiatric disorders, under 18 and over 45 years of age, during pregnancy and lactation, with any chronic disease that could interfere with diagnostic laboratory tests, and who had previously been treated for IH or PCOS were excluded from the study. Demographic, anthropometric, laboratory, and clinical data on the cases were recorded. The Short Form-36 (SF-36) questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were administered in a face-to-face interview by related authors involved in the study.

Results

The mean age, level of education, lifestyle, and marital status of all three groups were similar. There were no significant differences in body mass index (BMI) or waist circumference between the groups. Mean modified Ferriman-Gallwey (mFG) scores were similar in the IH and PCOS groups. In the IH patients, the general health and mental health domains of the SF-36 questionnaire scores were significantly lower than in the control group (p<0.001 and p=0.026, respectively). When the SF-36 questionnaire scores were compared between the IH and PCOS groups, the general health and role emotional domains were significantly lower in the PCOS group (p=0.013 and p<0.001, respectively), and the other domains were similar. All SF-36 questionnaire domains were significantly and negatively correlated with BMI and waist circumference measurements in IH patients. Both BDI and BAI scores were significantly and positively correlated with BMI (r=0.348, p<0.001, and r=0.162, p=0.012, respectively) and waist circumference (r=0.326, p<0.001, and r=0.344, p<0.001, respectively). Six out of eight domains of the SF-36 QOL scores were significantly and negatively correlated with the mFG scores.

Conclusion

Patients diagnosed with IH have impaired HQOL, similar to patients diagnosed with PCOS. Improving HQOL should be a goal when deciding on a management approach for hirsutism, which is one of the most common reasons for referral to endocrinology and dermatology outpatient clinics.

The Role of Serum Inflammation-Based Scores in Diagnosis and Assessing Remission in Cushing's Disease

Objectives

Chronic hypercortisolism causes diverse alterations in the immune system and inflammatory disruptions. Serum inflammation-based scores (SIBS) are indicators of systemic inflammatory status. This study aims to determine the role of SIBS in the diagnosis and evaluation of remission in patients with Cushing's disease (CD).

Methods

This retrospective cross-sectional study was conducted on 195 participants; 52 patients diagnosed and followed up after treatment with CD, 65 patients with subclinical Cushing's syndrome (SCS), and 78 healthy individuals whose complete blood counts (CBC) were obtained for analysis. Participants with additional diseases or drug use that could affect CBC were excluded from the study. SIBS of the three groups were compared. Scores considered were neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). The correlations between SIBS and initial diagnostic tests for hypercortisolism were analyzed. The SIBS of patients with CD at the diagnosis were compared with those after remission. In addition, receiver operator characteristic curve analyses were used to determine the diagnostic accuracy, specificity, and sensitivity of the scores significantly high in the CD group.

Results

MLR and SII values were significantly higher in CD patients than in the healthy group (p<0.01). NLR and SII were significantly higher in patients with CD than those with SCS (p<0.05). There were no significant differences between the SCS and the control groups in all SIBS. We determine significant, positive, and moderately correlated findings between SIBS and initial diagnostic tests for hypercortisolism in the CD group (0.30

Conclusion

The SIBS, which can be easily calculated with the data obtained from CBC and do not have additional costs, can contribute to the diagnosis and assessment of remission in patients with CD.

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Key Words

• Cushing’s disease
• monocyte-to-lymphocyte ratio
• neutrophil-to-lymphocyte ratio
• platelet-to-lymphocyte ratio
• serum inflammation-based scores
• systemic immune-inflammation index

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Affiliation(s)

Muhammed Masum Canat Department of Endocrinology and Metabolism, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
Ceren Yarkutay Turkkan Department of Internal Medicine, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
Hazan Erhan Department of Internal Medicine, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
Feyza Yener Ozturk Department of Endocrinology and Metabolism, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
Yuksel Altuntas Department of Endocrinology and Metabolism, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye

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Identification of emotion in a dichotic listening task: event-related brain potential and behavioral findings

The lateralization of emotion perception has been examined using stimuli in both auditory and visual modalities. Studies using dichotic stimuli have generally supported the hypothesis of right-hemisphere dominance for emotion perception, whereas studies of facial and verbal emotion perception have provided evidence for the right-hemisphere and valence hypotheses. A dichotic target detection task was developed to enable acquisition of event-related potentials (ERP) from subjects engaged in emotion detection. Nonsense syllables (e.g., ba, pa) stated in seven different emotional intonations were dichotically presented to 24 young adults, in a target detection task during four separate blocks (target emotions: happiness, interest, anger, or sadness). Accuracy and reaction time and ERP measures were also collected. ERPs were recorded from 14 scalp electrodes with a nose reference and quantified for N100, sustained negativity, late positivity, and slow wave. Significantly greater left- than right-ear accuracy was obtained for the identification of target prosodic emotion. Hemispheric asymmetries of N100 and sustained negativity were found, with left-hemisphere amplitudes greater than right-hemisphere amplitudes. These ERP asymmetries were not significantly correlated with the left-ear dichotic advantage and may be related more to early phonetic processing than to emotion perception. Since the behavioral evidence supports the right-hemisphere hypothesis for emotion perception, behavioral and ERP asymmetries evident in this task reflect separable patterns of brain lateralization.

Endogenous event-related potentials in obsessive-compulsive disorder

Brain event-related potentials (ERPs) were used to investigate central nervous system (CNS) correlates of cognitive function in obsessive-compulsive disorder (OCD). ERPs of 10 unmedicated OCD patients and 10 normal controls were measured in an auditory "oddball" task. Increasing task difficulty resulted in longer N200 and P300 latencies in normal subjects, but not in OCD patients. Moreover, OCD patients displayed shorter P300 latency than normal controls for the more difficult discrimination conditions. This replicates prior findings of Beech et al. (1983) for a visual task. For both levels of task difficulty, OCD patients also showed greater negativity than normal controls in the N200 region, which extended into the subsequent slow wave region. Negativities in the N200 and slow wave regions were larger at sites over the left hemisphere than the right hemisphere. The enhanced negativities and reduced P300 latency in OCD patients are discussed in terms of current theories postulating cortical hyperarousal and left hemisphere involvement in OCD.