Effects of vitamin E in a glucocorticoid induced cataract model in chicken embryos

We investigated the antioxidant effects of vitamin E on a glucocorticoid (GC) induced model of cataracts in chick embryos. We used 70 fertilized eggs divided into seven groups as follows: phosphate-buffered saline (PBS) group, olive oil treatment (OO) group, hydrocortisone treatment (HC) group, olive oil and hydrocortisone treatment (OO + HC) group, 50 mg/kg vitamin E and hydrocortisone treatment (HC + VE (50)) group, 25 mg/kg vitamin E and hydrocortisone treatment (HC + VE (25)) group and 15 mg/kg vitamin E and hydrocortisone treatment (HC + VE (15)) group. On day 17, chick embryos were removed from the eggs and lens and liver tissues were excised. Cataract formation was evaluated and total antioxidant status (TAS), total oxidant status (TOS), malondialdehyde (MDA) and glutathione peroxidase (GPx) were measured in lens and liver tissues; MDA was measured only in liver. The lenses in the HC + VE (50) group exhibited significantly higher levels of GPx and TAS, and lower levels of TOS than for HC and OO + HC groups. The livers of the HC + VE (50) group exhibited significantly higher levels of GPx and lower levels of MDA than for the HC and OO + HC groups. The HC + VE (50) group lenses were evaluated as grade 1, because the nuclei were completely free of cataracts, likely due to the antioxidative effect of high dose VE. VE is an effective antioxidant agent that exhibits a dose-response effect, for ameliorating the negative effects of GCs.

The effect of diclofenac sodium on neural tube development in the early stage of chick embryos

BACKGROUND

Neural tube defects are congenital malformations of the central nervous system. Genetic predisposition and some environmental factors play an important role in the development of neural tube defects. This study aimed to investigate the effects of diclofenac sodium on the neural tube development in a chick embryo model that corresponds to the first month of vertebral deve- lopment in mammals.

MATERIALS AND METHODS

Seventy-five fertile, specific pathogen-free eggs were incubated for 28 h and were divided into five groups of 15 eggs each. Diclofenac sodium was administered via the sub-blastodermic route at this stage. Incubation was continued till the end of the 48th h. All eggs were then opened and embryos were dissected from embryonic membranes and evaluated morphologically and histopathologically.

RESULTS

It was determined that the use of increasing doses of diclofenac sodium led to defects of midline closure in early chicken embryos. There were statistically significant differences in neural tube positions (open or close) among the groups. In addition; crown-rump length, somite number were significantly decreased in high dose experimental groups compared with control group.

CONCLUSIONS

This study showed that development of neurons is affected in chi- cken embryos after administration of diclofenac sodium. The exact teratogenic mechanism of diclofenac sodium is not clear; therefore it should be investigated.

Clinical outcomes and resource use after 24 months of insulin therapy in Turkish patients with type 2 diabetes: subgroup analysis of the TREAT study

PURPOSE

This study evaluated levels of metabolic control, resource use and quality of life in Turkish patients with type 2 diabetes initiated on insulin in routine care.

PATIENTS AND METHODS

The prospective, observational TREAT study evaluated patients from five different countries who were initiated on insulin and followed for 24 months. In this paper, we present the results of a cohort analysis specific to Turkish patients from the study.

RESULTS

A total of 211 patients in the Turkish multicenter cohort [male patients 50.2%, age 56.5 year±8.9 SD, body mass index (BMI) 30.6 kg/m2±5.4 SD, diabetes duration 9.7 year±5.9 SD] initiated insulin at baseline. Oral antidiabetic drugs had been used by 93.4% of patients prior to insulin initiation, and 65.9% had used more than one regimen. Pre-existing metformin therapy was continued by 68.7% of patients after insulin initiation. In the three most common insulin regimens, glycosylated haemoglobin (HbA1C) declined over 24 months from 10.27% to 7.82% (long/intermediate acting), from 10.82% to 7.52% (premixed) and from 10.42% to 7.67% (basal-bolus). Less than 25% achieved a glycaemic goal of HbA1C≤7.0% and changes in insulin dose or regimen rarely occurred. Premixed insulin regimens were associated with greatest weight gain. Hypoglycaemic episodes were reported by more patients at 3, 6 and 12 months than at baseline or at 18 or 24 months. Healthcare use increased over baseline levels in the first 6 months, but was closer to baseline levels at subsequent assessments. Patient recorded health profiles improved after initiating insulin, particularly quality of life scores related to psychological distress and pain/discomfort. Morisky scores predictive of medication adherence and treatment persistence also improved.

CONCLUSIONS

In Turkish patients with type 2 diabetes, metabolic control remained suboptimal after initiating insulin as part of routine care even after 24 months of insulin treatment. Apparent shortcomings in routine care in most patients included a high baseline HbA1C because of delayed insulin initiation and an unwillingness to individualise insulin regimens.

Prenatal diagnosis of an uncommon syndrome: thrombocytopenia absent radius (TAR)

The prenatal diagnosis of the thrombocytopenia absent radius (TAR) syndrome using ultrasound and cordocentesis at the 34th week of gestation is established. Two basic components of the syndrome, bilateral absence of radius and thrombocytopenia at a level 12.000/mm3 were detected. No complication during the cordocentesis and delivery occurred due to thrombocytopenia. This case report, to our knowledge, is one of a limited number of cases emphasized on prenatal diagnosis of TAR syndrome in the world.

Clomiphene citrate-resistant polycystic ovary syndrome. Preventing multifollicular development

OBJECTIVE

To determine the efficiency and comparison of two different protocols, human menopausal gonadotropin (hMG) plus gonadotropin-releasing hormone analog (GnRH-a) and low-dose hMG to reduce multifollicular development in clomiphene-resistant polycystic ovary syndrome (PCOS) patients.

STUDY DESIGN

Prospective comparative and pilot study in 20 patients for 31 cycles. The first group (n = 10) was treated with buserelin acetate, 600 micrograms/d, for six weeks before ovulation induction with hMG in conventional doses for 14 cycles. The other group (n = 10) was treated only with low-dose hMG for 17 cycles. All cycles were compared in terms of the number of follicles per cycle, cycles human chorionic gonadotropin withheld, estradiol level on ovulation day, treatment duration and number of ampules used per cycle. In addition, the outcome of cycles and complications of multifollicular development, ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy were determined.

RESULTS

As compared with the GnRH-a + hMG protocol, the low-dose hMG protocol yielded less multifollicular (57.1% vs. 17.6%) and more monofollicular (35.7% vs. 70.6%) development. Consequently, less OHSS (21.4% vs. 0%) and multiple pregnancy (10% vs. 0%) occurred in the low-dose group.

CONCLUSION

Low-dose hMG therapy has distinct advantages in eliminating multifollicular development and related complications in clomiphene citrate-resistant PCOS patients. The addition of GnRH-a to gonadotropins does not change the incidence of multifollicular development.