Evaluation of atherosclerotic risk in rosacea patients through serum fetuin-A and carotid intima media thickness

BACKGROUND

The link between rosacea and various systemic conditions has been growing in prominence, even though the relationship between rosacea and cardiovascular disease remains a subject of debate in current research.

AIMS

Detecting the connection between rosacea and subclinical atherosclerosis using laboratory and ultrasonographic parameters.

METHODS

Fifty rosacea patients and 49 control were included in the study. Demographic, clinical, and laboratory data, including serum high sensitivity C-reactive protein (hs-CRP), fetuin-A (FA), and matrix gla protein levels were assessed. Carotid intima-media thickness (CIMT) was measured by carotid ultrasonography.

RESULTS

Serum hs-CRP levels (p = 0.009) and mean CIMT (p = 0.001) were significantly higher, while serum FA levels were significantly lower (p < 0.001) in the rosacea patients compared with control. The number of patients with mean CIMT>75th percentile according to age and sex were significantly higher in the rosacea group (p = 0.001). Rosacea patients with ocular involvement exhibited significantly higher hs-CRP values in comparison to those without ocular involvement (p = 0.008). No significant correlation was detected between disease duration, severity, subtype and the study parameters.

CONCLUSIONS

This study results suggest that rosacea poses an independent risk for subclinical atherosclerosis regardless of its severity, duration, or subtype. Therefore, individuals diagnosed with rosacea should receive careful evaluation and monitoring to detect possible cardiovascular complications promptly. Furthermore, our study hints at a potential elevated risk of subclinical inflammation in rosacea patients with ocular involvement, warranting additional attention and further investigation.

Relationship between psoriasis and urolithiasis

The aim of the present study was to investigate whether patients with psoriasis are prone to urolithiasis. Prospective analysis of 67 patients diagnosed as psoriasis (PS group) and 65 volunteers who had never been diagnosed as psoriasis (NPS group) was performed. The levels of oxalate, citrate, calcium, uric acid, magnesium, creatinine, and sodium were evaluated by analyzing the 24-h urine samples. Stone events were detected in 13 patients (19.4%) in the PS group and in five participants (7.7%) in the NPS group, respectively (P < 0.05). The median value of 24-h citrate was significantly lower in the PS group than in the NPS group (P = 0.029). The median value of 24-h urine uric acid was significantly higher in the PS group than the NPS group (P = 0.005). Hypernatriuria was significantly higher in the PS group (P = 0.027). Hyperuricosuria was detected in the 10.4% and 1.5% of patients who had severe and mild disease, respectively (P = 0.027). Patients with psoriasis are more prone to urolithiasis. Hypocitraturia, hyperuricosuria, and hypernatriuria were the main metabolic abnormalities detected in psoriasis. Hyperuricosuria has been associated with the severity of the disease.

Melamine exposure during the weaning period negatively affects ovarian reserve

In this study, it was aimed to investigate the effects of melamine exposure since the weaning period on ovarian tissue and ovarian reserve. Melamine is illegally added to milk and formula to provide high false protein positivity. Female rats (the weaning period = 21 days old, n = 18) were divided into 3 groups. 0.1 mL saline was applied to the control group by gavage for 21 days. Fifty mg/kg and seventy-five mg/kg melamine was dissolved in 0.1 mL of saline and applied by gavage for 21 days, respectively. At the end of the experiment, plasma anti-Mullerian hormone (AMH) was measured, follicle count and ovarian diameter measurement were performed in the right ovaries, and flow cytometric analysis for apoptosis was performed in the left ovaries. While a statistically significant decrease was not observed in the number of the follicle and ovarian diameter between the control and melamine-treated groups (p > 0.05), a significant decrease in the corpus luteum and a significant increase in the number of atretic follicles were observed (p < 0.05). Apoptosis (Annexin V) increased in both melamine groups and AMH plasma level decreased significantly in the 75 mg/kg group (p < 0.05). Melamine exposure from the weaning (early postnatal) period may cause a decrease in ovarian reserve in parallel with a dose increase.

Biological Variations of Seven Clinical Chemistry Analytes and Trolox Equivalent Antioxidant Capacity within Salivary Constituents

BACKGROUND

Data on biological variation in saliva samples are quite limited. This study aimed to obtain well-defined biological variation data for seven common clinical chemistry analytes and Trolox equivalent antioxidant capacity (TEAC) in saliva.

METHODS

Unstimulated whole saliva and blood samples were collected from thirty-two healthy volunteers of both genders without any history of disease or metabolic syndrome under standard conditions at six different times within three weeks. The seven clinical chemistry analytes and TEAC, analyzed by photometric methods using automated analyzers, were planned for biological variation analysis. The components of nested analysis of variance were used to perform the biological variation data analysis.

RESULTS

The within-subject and between-subject biological variations (CVG and CVI, respectively) for unstimulated whole saliva samples, respectively, were determined to be 19.3% and 25.1% for α-amylase, 25.1% and 51.1% for aspartate aminotransferase, 31.0% and 22.3% for lactate dehydrogenase, 19.0% and 20.8% for uric acid, 16.6% and 23.4% for total calcium, 12.9% and 13.7% for inorganic phosphate, 13.1% and 19.7% for total protein, and 14.9% and 20.0% for TEAC. In addition, the CVI and CVG were 3.4% and 6.3% for serum TEAC.

CONCLUSIONS

Considering the evidence that saliva samples can be used to diagnose and monitor oral or non-oral diseases, these biological variation data will contribute to how to use subject-based reference values or population-based reference intervals of these analytes and TEAC.

A New Insight Into Pathophysiological Mechanism of Abdominal Aortic Aneurysm With Novel Parameters Salusin-β and Arterial Stiffness

BACKGROUND

Abdominal aortic aneurysm (AAA) has risk factors similar to those of atherosclerosis. Salusin-β and arterial stiffness are novel parameters that have been shown to predict atherosclerosis and related cardiovascular disorders. However, their predictive value for detecting AAA remains unclear.

METHODS

Forty-eight patients with AAA and 47 age- and sex-matched participants without AAA were enrolled in the study. Arterial stiffness parameters were obtained via an oscillometric Mobil-O-Graph PWA Monitor device (IEM GmbH) with integrated ARCSolver software (Australian Institute of Technology). Plasma salusin-β levels were analyzed using an enzyme-linked immunosorbent assay reagent kit (Abbkine, Inc). The measured salusin-β levels and arterial stiffness parameters of the AAA and control groups were compared.

RESULTS

Salusin-β levels were significantly lower in patients with AAA (P = .014). There was a significant negative correlation between salusin-β levels and abdominal aorta diameter. No significant difference was detected between AAA and control groups in terms of arterial stiffness parameters (P > .05). In backward multiple regression analysis, the presence of AAA, platelet count, and augmentation index were found to be independent predictors of salusin-β levels (P = .006 and P = .023, respectively).

CONCLUSION

Arterial stiffness parameters were not found to be associated with AAA. Contrary to previous results regarding atherosclerosis and related cardiovascular disorders, salusin-β levels were found to be lower in patients with AAA. Although AAA is thought to have similar risk factors as atherosclerosis, the exact pathophysiologic mechanism remains unclear.

MO830: Evaluation of Physical and Emotional Symptoms in Chronic Hemodialysis Patients

BACKGROUND AND AIMS

Hemodialysis patients experience physical and psychosocial symptoms caused by comorbid illnesses and the psychosocial impacts of living with end-stage renal disease. The Dialysis Symptom Index (DSI) is the most frequently used instrument to assess symptoms of end-stage renal disease. The aim of this study was to evaluate the frequency and severity of symptoms experienced in patients on maintanence hemodialysis.

METHOD

Data were collected using a face-to-face interview method with a dialysis symptom index. Laboratory tests were recorded from the patients’ file.

RESULTS

A total of 97 patients from our dialysis unit were enrolled. Clinical findings and laboratory findings were shown in Figures 1 and 2. Prevalance and severity of symptoms were shown in Figure 3.

CONCLUSION

Physical and emotional symptoms are prevalent, can be severe, and are correlated directly with impaired quality of life and depression in maintenance hemodialysis patients.

Investigating Fetuin-A and Paraoxonase-1 Activity as Markers in Polycystic Ovary Syndrome Based on Body Mass Index: A Prospective Case-Control Study

Introduction Polycystic ovary syndrome (PCOS) may have an increased risk for the development of systemic and metabolic pathogenesis such as cardiovascular diseases, insulin resistance (IR), diabetes mellitus (DM) and dyslipidemia. However, there is no reliable marker to show the relation. Fetuin-A is an adipokine whereas paraoxonase-1 (PON-1) is a high-density lipoprotein-linked enzyme to demonstrate oxidative stress. This study aimed to evaluate serum fetuin-A and PON-1 levels in infertile PCOS women based on body mass index (BMI). Methods A prospective case-control study in a university setting was designed. A total of 88 patients admitted to the Giresun University Faculty of Medicine Gynecology Clinic between February and April 2021 were included in the study. The subjects were divided as follows: PCOS-low-BMI (BMI≤25) vs. Controls-low-BMI (BMI≤25) and PCOS-high-BMI (BMI>25) vs. Controls-high-BMI (BMI>25). Those who had at least two criteria of the 2003 Rotterdam Consensus were diagnosed with PCOS. Serum fetuin-A and PON-1 levels were compared. Results The mean levels of fetuin-A were not significantly different in the groups (p=0.955). Serum PON-1 levels were lower in the PCOS group (109.1±61.4 vs. 140.1±80.0; p=0.040), but it lost significance with adjusted values for covariants as age and BMI. Although PON-1 was not significantly different in the PCOS group of BMI<25 kg/m² subgroup, it was significantly lower in the PCOS group of BMI≥25 kg/m² subgroup (p=0.820 vs. p=0.048). Conclusion Serum fetuin-A activity did not differ with PCOS. Serum PON-1 might be a promising and research-worthy marker, especially for obese PCOS patients.

Association of increased levels of omentin-1 and carotid intima-media thickness with early signs of cardiovascular risk in patients with polycystic ovary syndrome: A prospective case control study

AIM

Omentin-1, an adipokine primarily secreted from visceral adipose tissue, regulates metabolic homeostasis, whereas carotid intima-media thickness (CIMT) is a valid marker for early diagnosis of atherosclerosis. We aimed to investigate whether polycystic ovary syndrome (PCOS) is related to levels of omentin-1 and CIMT and demonstrate the association with cardiovascular risk.

METHODS

A prospective case-control study was performed on 47 PCOS patients and 35 healthy subjects. Hormonal and metabolic parameters, levels of serum omentin-1, and CIMT were evaluated in the two groups.

RESULTS

The right, left, total CIMT, and levels of serum omentin-1 were significantly higher in the PCOS group than in the healthy controls (p = 0.015, p = 0.009, p = 0.021, and p = 0.002, respectively). Using multiple linear and backward elimination regression analyses, serum omentin-1 was found to be independently associated with age and Ln-transformed homeostasis model assessment of insulin resistance, and cardiovascular parameters were independently associated with body mass index (BMI). In the PCOS group, the means of right, left, and total CIMT were significantly higher in the subgroup with BMI levels ≥25 kg/m² compared to the subgroup with BMI levels <25 kg/m² (p < 0.001 for all comparisons).

CONCLUSION

A significant increase in CIMT is associated with cardiovascular risk in patients with PCOS. Levels of serum omentin-1 were found to be significantly higher in early PCOS cases at a younger age, acting as a protective acute-phase reactant.

The impact of Coronavirus Disease 2019 (COVID-19) on urinalysis parameters

BACKGROUND

Creatinine elevation and changes in urinalyse parameters may be seen due to acute kidney injury during COVID-19. In the present study, we aimed to investigate the changes in urinalysis of COVID-19 patients with normal kidney function.

METHODS

The data of COVID-19 patients with normal renal functions were retrospectively analyzed. Urinalysis parameters of these patients were recorded. The patients were divided into three groups as mild, moderate and severe with respect to the clinical course of the disease. It was examined whether the urine analysis values in the groups were different from normal reference values and whether these values were different between the groups. In addition, possible relationship between the urinalysis parameters and the clinical severity of the disease was investigated.

RESULTS

There are three groups; mild (n:40), moderate (n:38) and severe (n:42). Mean age were significantly higher in the severe group, while gender distribution of the groups was similar. (p=0.033) (p=0.091) Creatinine values of all patients were normal. There were 6.7% glucose positivity, 13.4% protein positivity, 5.8% urobilinogen positivity and 7.5% ketone positivity in urine dipstick analysis and these changes were all significantly higher than the reference values. (p=0.008, p<0.0001, p=0.016, p=0.016) Pyuria and hematuria were detected in 8.3% and 9.2%, respectively. The urinalysis parameters and urine microscopy findings were not affected by the severity of the disease.

CONCLUSIONS

Glycosuria, proteinuria, pyuria and hematuria may occur during COVID-19 disease, regardless of comorbidity and renal dysfunction. However, these urine parameters were not correlated with the severity of the disease.

MO392ACUTE KIDNEY INJURY IN HOSPITALIZED PATIENTS WITH COVID-19: A SINGLE-CENTER EXPERIENCE

Background and Aims

Preliminary reports indicate that AKI (acute kidney injury) seem to be associated with coronavirus disease 2019 (COVID-19) severity and outcomes. Although the reported incidence of AKI among hospitalized patients with COVID-19 varies widely, AKI among hospitalized patients is associated with poor prognosis. The aim of this study was to evaluate the clinical characteristics and outcomes in our COVID-19 patients who developed AKI during intensive care unit hospitalization.

Method

In our retrospective, observational study COVID-19 PCR positive 49 patients who were hospitalized with COVID-19 pnumoniae in intensive care unit and developed AKI were evaluated with demographics, laboratory data, treatment and outcome. The prognostic nutritional index (PNI), which is calculated using the serum albumin concentration and total lymphocytic count were also evaluated. All patients were treated with favipiravir+low molecular weight heparin; laboratory tests were recorded before and after favipiravir treatment.

Results

Of 49 patients; 28 were male. A total of 9/49 (18.4%) patients survived. All patients were treated with favipiravir; laboratory tests were recorded before and after favipiravir treatment. The clinical parameters of patients are shown in Table-1 and Table-2. Mean PNI of the patients who survived was higher than patients who were exitus.

Conclusion

AKI in hospitalized patients with COVID-19 was associated with high mortality. Of all patients with AKI, only 18.4% survived.

Does melamine exposure during infancy cause rhabdomyolysis?

We investigated the possible toxic effects of melamine on muscle tissue in rats using biochemical, hematological and histopathological methods. We used three groups of female albino Wistar rats. The first group was given 0.1 ml saline. The second and third groups were given 50 and 75 mg/kg melamine dissolved in 0.1 ml saline, respectively, daily for 21 days. On day 45, all rats were sacrificed, and whole blood and plasma were analyzed for hematologic and biochemical characteristics. Muscle samples were stained with hematoxylin and eosin for histopathological investigation. Other sections were immunostained for matrix metalloproteinase-9 (MMP-9) and type IV collagen. We found a significant increase in the lymphocytosis-compliant leukocyte number in the 75 mg/kg melamine group compared to the other groups. We also found significant decreases in the hemoglobin levels and hematocrit values in the 75 mg/kg compared to the other groups. We found that the 75 mg/kg melamine group exhibited a significant increase in plasma aspartate aminotransferase (AST) activity compared to the other groups. Changes in plasma creatine kinase and lactate dehydrogenase activity were not statistically significant. Plasma AST activity and mean corpuscular hemoglobin levels were correlated with the lymphocyte:neutrophil ratio. We found mononuclear cell infiltration at the periphery of muscle bundles and in the connective tissue bundles in the melamine treated group. We found MMP-9 expression in muscle cell membranes and type IV collagen expression in degenerative connective tissue fibers. Whole blood, plasma and muscle tissue analysis indicated that the 75 mg/kg melamine group exhibited rhabdomyolysis that was associated with lymphocytosis and anemia. The underlying mechanisms by which melamine causes rhabdomyolytic effects remain unclear.

The value of plasma SCUBE1 and oxidative stress parameters in the early diagnosis of acute ovarian torsion

AIM

The purpose of our study was to determine the diagnostic value of plasma SCUBE1, malondialdehyde (MDA), superoxide dismutase (SOD) and total antioxidant status (TAS) investigated on the 4th hour of ovarian torsion, and at the same time to determine the relation between these markers and histopathological damage occurring in the ovary.

MATERIALS AND METHODS

Sixteen rats were included, eight in the torsion group and eight in the control group. The right ovaries of the rats in the torsion group were rotated clockwise 720 degrees, after which they were fixed and attached to the abdominal wall. The abdominal walls of the control group rats were opened for 1 min and then closed. Relaparotomy was performed 4 h after surgery in both groups, blood specimens were collected for biochemical analyses, and the right ovaries were surgically extracted.

RESULTS

No statistically significant difference was determined in the control and torsion groups' plasma SCUBE1, SOD and TAS values (p = 0.987, p = 0.33, and p = 0.244, respectively). Torsion group plasma MDA values were significantly higher than those of the control group (p = 0.039). At histopathological evaluation, histological score, apoptotic index and Caspase-3 index values of the torsion group were significantly higher compared to the control group.

CONCLUSION

Plasma SCUBE1 is not useful in the early diagnosis of ovarian torsion. Similarly, use of the oxidative stress markers SOD and TAS does not appear useful in early diagnosis, although MDA may be considered for that purpose (Tab. 2, Fig. 3, Ref. 23).

Evaluation of the Relation Between Omentin-1 and Vitamin D in Postmenopausal Women With or Without Osteoporosis

INTRODUCTION

Crosstalk between bone and adipose tissues is implicated in several pathologic conditions related to bone metabolism. Omentin-1, a 34-kD protein, is released from omental adipose tissue. A few studies indicated the effect of omentin-1 on bone health and bone mineral density (BMD) and the interaction of omentin-1 with vitamin D. Therefore, this study aimed to investigate the relationship between omentin-1, vitamin D, and BMD in postmenopausal women with osteoporosis compared with non-osteoporotic counterparts.

MATERIALS AND METHODS

Forty postmenopausal women with osteoporosis (OP), 40 counterparts without OP, and 30 premenopausal women were enrolled. Dual-energy X-ray Absorptiometry results, body mass index, and some demographic and biochemical data were recorded. Vitamin D (25-hydroxyvitamin D₃) levels were measured using liquid chromatography-tandem mass spectrometry. Serum omentin-1 was determined using an enzyme-linked immunosorbent assay.

RESULTS

Omentin-1 levels tended to increase in both postmenopausal women groups compared with the control group, but this increase was significant only in women with osteoporosis. Vitamin D levels were not different between the groups. When women were categorized according to vitamin D levels, women with normal vitamin D levels had significantly higher omentin-1 levels. A positive correlation was found between omentin-1 and vitamin D levels in all groups (r=0.197, p=0.041, n=110).

CONCLUSION

The tendency to an increase in omentin-1 levels in postmenopausal women with osteoporosis may be due to a physiologic compensation against bone loss after menopause. The linear relationship between omentin-1 and vitamin D suggests that adipose tissue is one of the target tissues for the vitamin D effect.

Assessment of average of normals (AON) procedure for outlier-free datasets including qualitative values below limit of detection (LoD): an application within tumor markers such as CA 15-3, CA 125, and CA 19-9

Average of normals (AON) is a quality control procedure that is sensitive only to systematic errors that can occur in an analytical process in which patient test results are used. The aim of this study was to develop an alternative model in order to apply the AON quality control procedure to datasets that include qualitative values below limit of detection (LoD). The reported patient test results for tumor markers, such as CA 15-3, CA 125, and CA 19-9, analyzed by two instruments, were retrieved from the information system over a period of 5 months, using the calibrator and control materials with the same lot numbers. The median as a measure of central tendency and the median absolute deviation (MAD) as a measure of dispersion were used for the complementary model of AON quality control procedure. The u_bias values, which were determined for the bias component of the measurement uncertainty, were partially linked to the percentages of the daily median values of the test results that fall within the control limits. The results for these tumor markers, in which lower limits of reference intervals are not medically important for clinical diagnosis and management, showed that the AON quality control procedure, using the MAD around the median, can be applied for datasets including qualitative values below LoD.

The effect of extremely high glucose concentrations on 21 routine chemistry and thyroid Abbott assays: interference study

INTRODUCTION

Extremely high glucose concentrations have been shown to interfere with creatinine assays especially with Jaffe method in peritoneal dialysate. Because diabetes is the fastest growing chronic disease in the world, laboratories study with varying glucose concentrations. We investigated whether different levels of glucose spiked in serum interfere with 21 routine chemistry and thyroid assays at glucose concentrations between 17-51 mmol/L.

MATERIALS AND METHODS

Baseline (group I) serum pool with glucose concentration of 5.55 (5.44-5.61) mmol/L was prepared from patient sera. Spiking with 20% dextrose solution, sample groups were obtained with glucose concentrations: 17.09, 34.52, and 50.95 mmol/L (group II, III, IV, respectively). Total of 21 biochemistry analytes and thyroid tests were studied on Abbott c8000 and i2000sr with commercial reagents. Bias from baseline value was checked statistically and clinically.

RESULTS

Creatinine increased significantly by 8.74%, 31.66%, 55.31% at groups II, III, IV, respectively with P values of < 0.001. At the median glucose concentration of 50.95 mmol/L, calcium, albumin, chloride and FT4 biased significantly clinically (-0.85%, 1.63%, 0.65%, 7.4% with P values 0.138, 0.214, 0.004, < 0.001, respectively). Remaining assays were free of interference.

CONCLUSION

Among the numerous biochemical parameters studied, only a few parameters are affected by dramatically increased glucose concentration. The creatinine measurements obtained in human sera with the Jaffe alkaline method at high glucose concentrations should be interpreted with caution. Other tests that were affected with extremely high glucose concentrations were calcium, albumin, chloride and FT4, hence results should be taken into consideration in patients with poor diabetic control.

Joubert syndrome and related disorders: a rare cause of intrahepatic portal hypertension in childhood

OBJECTIVE

Joubert syndrome (JS) and related disorders (JSRD) (OMIM #213300) are a group of developmental delay/multiple congenital anomalies syndromes in which the pathognomonic "the molar tooth sign" (MTS) is present, is caused by the defects in the structure or function of the primary cilium. Liver disease is observed in minority of JSRD, usually manifesting as congenital hepatic fibrosis (CHF). In this paper we report a child with JSRD in whom signs of portal hypertension and chronic liver disease appeared and in the follow-up nephrologic features were added to her clinical signs.

CONCLUSIONS

The physicians must be aware of this disorder in the differential diagnosis of portal hypertension of unknown origin.

Effectiveness and safety of topical emollients in the treatment of PUVA-induced pruritus

BACKGROUND

In this study we tried to assess the efficacy of topical emollients in the treatment of patients with PUVA-induced pruritus.

MATERIAL AND METHODS

41 patients over 18 years of age, who received PUVA treatment in the phototherapy unit, were included in the study. Patients were randomly divided into two groups; Group I was administered with a 4% urea lotion and Group II was administered with liquid petrolatum. The follow-up period was minimum 4 weeks. During the first 2 weeks, patients were administered topical emollients and received PUVA treatment together. The next 2 weeks, they continued PUVA treatment without any medication.

RESULTS

When time-dependent changes in the visual analogue scale scores for pruritus of both groups were considered, both treatment methods were found to be remarkably successful (p < 0.0001). In addition, an insignificant group-time interaction was identified (p = 0.753).

CONCLUSIONS

Topical emollients were found to be effective in the treatment of PUVA-induced pruritus. Both forms of medication can be successfully administered and increase the patient's compliance with medication.

Unfavorable lipid profile and higher frequency of hot flashes during perimenopausal years after fallopian tube ligation

AIM

We sought to study the effect of tubal ligation on lipid profile, ovarian reserve and hot flashes during perimenopausal years.

METHODS

A total of 210 perimenopausal women complaining of abnormal vaginal bleeding were enrolled for the study. Subjects' menstrual, reproductive and medical histories were recorded. Serum FSH, LH and estradiol levels were screened in all women to determine menopausal status. In order to rule out any gynecologic pathology, all subjects underwent transvaginal sonography. Women were divided into two groups according to presence (study group, n = 68) or absence (control group, n = 142) of tubal ligation history. Lipid profiles and ovarian reserve tests were compared between groups.

RESULTS

Mean age, parity, serum hemoglobin (Hb), high density lipoprotein (HDL-C), triglyceride, estradiol levels, endometrial thickness and frequency of hot flashes were significantly different between groups (p < 0.05). Mean age was 42.8 ± 1.9 years in women with tubal ligation and 45.9 ± 3.5 years in control group. Mean serum estradiol level was lower in group with tubal ligation (41.4 versus 92.5 pg/ml). Mean endometrial thickness was higher in control group (10.2 versus 7.5 mm). Age-adjusted serum Hb, HDL-C, triglyceride, estradiol, FSH level, endometrial thickness and frequency of hot flashes remained significantly different between groups (p < 0.05).

CONCLUSION

Tubal ligation is associated with unfavorable lipid profile and higher frequency of hot flashes during perimenopausal years.

Oxidant and antioxidant parameters in patients with Brucella canis

OBJECTIVES

The aim of this study was to evaluate the oxidative status in patient with Brucella canis (B. canis) and healthy controls by measurement of total antioxidant capacity (TAC) and total oxidant capacity (TOS), and calculation of oxidative stress index (OSI).

DESIGN AND METHODS

Six patients with B. canis and 6 healthy control subjects were included in this study. Diagnosis of B. canis was made by rapid slide agglutination test (RSAT) and Modified Plate Agglutination Test (MPAT). The serum samples of B. canis positive patients and controls were used for measurement of TAC and TOS levels.

RESULTS

The TOS and OSI index were significantly higher in brucellosis positive patients than control group (p<0.001 and p<0.0001, respectively), while TAC level was found similar in patient and control groups.

CONCLUSION

Findings of this study have shown that B. canis generate low TOS and OSI index in man compared with smooth Brucella species infection. This difference may help to provide understanding about the pathogenesis of B. canis infection in man.

Serum paraoxonase-1 activities and oxidative status in patients with plaque-type psoriasis with/without metabolic syndrome

OBJECTIVE

Psoriasis is a chronic immune-mediated inflammatory skin disease associated with metabolic syndrome, which is made up of a cluster of disorders, including obesity, diabetes mellitus, dyslipidemia, and cardiovascular disease. The aim of this study was to investigate serum paraoxonase-1 activities and oxidative status parameters in patients with plaque-type psoriasis with or without metabolic syndrome.

METHODS

In this study, patients with plaque-type psoriasis with (n=25) or without (n=27) metabolic syndrome, according to the criteria of the International Diabetes Federation (IDF), were matched for age and sex to an equally sized control group (n=25).

RESULTS

In patients without metabolic syndrome, serum paraoxonase and arylesterase activities showed mean decreases of 29 and 6%, respectively, whereas in patients with metabolic syndrome, the mean decreases in the enzymes' activities were 35 and 11%, respectively, compared with those in the control group. Serum total antioxidant capacity and total oxidant status were not statistically significant in any of the three groups. Multiple linear regression analysis revealed that HDL cholesterol and log-transformed triglyceride were independent variables for serum arylesterase activity and that fasting glucose and diastolic blood pressure were independent variables for serum paraoxonase activity.

CONCLUSIONS

These results suggest that according to the criteria of the IDF, the significant decrease observed in serum paraoxonase activity was independent of the metabolic syndrome in patients with mild-to-moderate plaque-type psoriasis, whereas the significant decrease in serum arylesterase activity was associated with the metabolic syndrome.

Evaluation of oxidative stress, the activities of paraoxonase and arylesterase in patients with subclinic hypothyroidism

INTRODUCTION

In subclinical hypothyroidism (SH), serum lipid and lipoprotein concentrations are frequently changed. Compared to the normal population, the levels of oxidized low-density lipoprotein (LDL) cholesterol are higher and the levels of high density lipoprotein (HDL) cholesterol are lower. In SH patients, the mechanism of atherosclerosis may be attributed to the lipid abnormalities. There is evidence showing that, oxidation plays an important role during the process of atherosclerosis, preventing the lipid peroxidation of paraoxonase 1 and thereby, acting against the atherosclerosis. In this study, we evaluated the activity of paraoxonase and arylesterase in subclinical hypothyroidism and investigated its relation with oxidative stress.

METHOD

The study enrolled 25 cases with SH and 20 healthy controls. The patient group and the control group were compared in terms of the activity of paraoxonase and arylesterase and the oxidative stress index.

RESULTS

Between two groups, no significant difference was found in terms of age, gender, total cholesterol, low-molecular weighted lipoprotein, high-molecular weighted lipoprotein. In SH group, the activity ofparaoxonase was significantly lower than that observed in the control group (p=0.01). Also, the activity of arylesterase was significantly lower in the group with subclinical hypothyroidism (p=0.03). Oxidative stress index was found to be significantly higher in the group with subclinical hypothyroidism compared to the healthy controls (p<0.01). Oxidative stress index showed a strong positive correlation with the levels of TSH in all cases (r=0.60, p<0.01.

CONCLUSION

Consequently, in SH, the activity of paraoxonase and arylesterase were significantly low and oxidative stress was significantly high. Lower activities ofparaoxonase and arylesterase indicated increased oxidative damage in SH. This may be useful to elucidate the mechanism of atherosclerosis in SH. In addition, these findings suggested that the activities of paraoxonase and arylesterase may be used for the determination of therapeutical response and during the follow-up. (www.actabiomedica.it).

Verifying reference intervals for coagulation tests by using stored data

OBJECTIVE

The purpose of the study was to verify the reference intervals for prothrombin time (PT) and activated partial thromboplastin time (APTT), using stored data of ambulatory pre-op subjects with exclusion of certain clinics, according to age and sex.

MATERIALS AND METHODS

Results of test requests (13,600 PT and 14,083 APTT) of subjects aged 15?80 made from outpatient clinics of surgical departments before surgical interventions in 2008 were retrieved from the electronic medical record. Thromborel S and Actin (Dade Behring, Germany) were used on the Sysmex® CA-1500 coagulation analyzer. Extreme values were determined by using Horn's algorithm after Box-Cox transformation, and the upper and lower reference limits were determined as the 2.5th and 97.5th percentiles of the cleaned data.

RESULTS

The values outside the interval of PT data 10.5-17.0 seconds and the interval of APTT data 20.6-35.8 seconds were excluded from the analysis. There were significant differences among age subsets of PT measurements ( p < 0.0001) and of APTT measurements ( p < 0.0001). Accordingly, the data were tested for gender differences and a significant difference was found in PT ( p = 0.002). APPT results did not differ statistically between men and women.

CONCLUSION

Although we found values different from the limits stated in the kit insert, it would be better to confirm our findings with the direct method, especially in APTT for patients under the age of 40 and over the age of 59, and also for sex differences in PT.

Vascular endothelial function assessed by a noninvasive ultrasound method and serum asymmetric dimethylarginine concentrations in mild-to-moderate plaque-type psoriatic patients

OBJECTIVES

Our aim was to evaluate vascular endothelial function assessed by serum asymmetric dimethylarginine (ADMA) concentrations and noninvasive ultrasonographic parameters such as flow-mediated dilatation (FMD) and nitroglycerin-induced dilatation (NID) in mild-to-moderate plaque-type psoriatic patients, as rated by the Psoriasis Area and Severity Index.

DESIGN AND METHODS

Plaque-type psoriatic patients (n = 29) diagnosed with clinical and/or histopathological findings and control subjects (n = 25) without skin and systemic metabolic diseases were included in the study.

RESULTS

There was no statistically significant difference between patients and control subjects in respect to FMD (p = 0.441), NID (p = 0.557), or serum ADMA concentrations (p = 0.225). Also, among the acute-phase reactants, serum C-reactive protein and plasma fibrinogen levels were moderately higher in patients when compared to control subjects (p = 0.008 and p = 0.011, respectively).

CONCLUSIONS

Mild-to-moderate plaque-type psoriatic patients with low-to-medium grade systemic inflammation did not have evidence of vascular endothelial function.

Influence of using a roller mixer on rejected samples in coagulation tests

INTRODUCTION

The influence of using a roller mixer just after blood collection on the ratio of rejected samples in coagulation tests was investigated retrospectively.

METHODS

Numbers of blood samples collected in centralized units of outpatient clinics for prothrombin time (PT) were 24,050 in group I and 24,500 in group II (H. Aral, unpublished data). In group I, the tubes were inverted manually. In group II, the tubes were left standing on roller mixer with 30 rpm. The ratios of rejected samples of the two groups were compared statistically with ki-square analysis.

RESULTS

Using a roller mixer, rate of rejection decreased from 0.79% (group I) to 0.20% (group II) (P<0.001).

CONCLUSION

We suggested using roller mixer to improve the reliability of coagulation testing. Such standardization in preanalytical phase may be helpful in preventing laboratory errors and obtaining correct test results in coagulation tests.

Varicocele-Induced Testicular Dysfunction May Be Associated with Disruption of Blood-Testis Barrier

The objective of this study was to examine E-cadherin and alpha-catenin expression at the junctions between adjacent Sertoli cells in testicular specimens from patients with varicocele in order to determine the presence of a possible link between blood-testis barrier and pathophysiology of varicocele. A total of 51 testicular biopsies were obtained from 28 infertile men with unilateral or bilateral varicocele. Twenty-three patients had bilateral and 5 had unilateral varicocele, Grade I varicocele was detected in 30 (59%), grade II in 15 (29%) and grade III in 6 (12%) patients. Abnormal expression of E-cadherin and alpha-catenin at the junctions between adjacent Sertoli cells was demonstrated in 100% and 90% of the patients with varicocele, respectively. In those with grade I-III varicocele, the mean E-cadherin and alpha-catenin expression were 7.6 +/- 11.4 and 39 +/- 36; 7.6 +/- 0.0 and 49 +/- 30; 8.3 +/- 9.3 and 58 +/- 33, respectively, but the difference was not significant. Reduced E-cadherin and alpha-catenin expression at the junctions between adjacent Sertoli cells may be associated with disruption of blood-testis barrier in varicocele.

Aspergillus pneumonia in renal transplant recipients at a medical center in Turkey

Pulmonary aspergillosis is a devastating disease. Early diagnosis allowing early treatment may improve the prognosis. However, this goal remains difficult to achieve. When the diagnosis is confirmed, it is often already too late. Despite antifungal treatment, the mortality rate is high. Patients with immunosuppression show a high mortality rate. We present five patients of ages ranging between 34 and 43 years who displayed aspergillus pneumonia between 1991 and 2000. All patients received cyclosporine, azathioprine, and prednisone for maintenance immunosuppressive therapy. Their ages ranged from 34 to 43 years with the onset of infection between 1 to 25 months posttransplant. In all cases, the infection was localized to the lungs. Standard methods of fungal culture and identification were used. No coinfections with tuberculosis or other fungi or bacteria were identified. Three cases were successfully treated but two patients showed deterioration despite appropriate therapy and died. Among patients with solid organ transplantation, lung, liver, and renal transplant patients are at the highest risk of developing aspergillus lung infections. A high degree of awareness and efforts for early diagnosis and therapy may improve the poor prognosis.

A renal transplant recipient with pulmonary tuberculosis and visceral leishmaniasis: review of superimposed infections and therapy approaches

Visceral leishmaniasis (VL) is an acute or subacute disease that is almost invariably fatal if untreated. It is a rare disease in renal transplant recipients and frequently reported together with other infectious agents. A 39-year-old renal transplant patient was admitted to hospital for elective coronary surgery. In the post-operative period, he developed spiking fever and non-productive cough and his general condition deteriorated. While he was taking medication for non-specific pneumonia, a cavitary lesion occurred in his lung, and he had the diagnosis of pulmonary tuberculosis and antituberculous treatment was started. Despite treatment, his fever continued. As the patient developed pancytopenia and splenomegaly, a bone marrow aspiration was done. Evaluation of bone marrow aspirate indicated Leishmania parasites. He was successfully treated with a more intensive liposomal amphotericin (L-AmB). Complete cure was achieved during follow-up period of 10 months without clinical relapse. In the existence of fever and long-standing pancytopenia, VL should be suspected although the patient had another proved infection and did not live or visit an endemic area. L-AmB usage can be safely preferred for treatment of selected renal transplant recipients with VL as first-line therapy.

Potential role of reactive oxygen species on testicular pathology associated with infertility

AIM

To investigate the level of malondialdehyde (MDA), a direct indicator of lipid peroxidation-induced injury by reactive oxygen species (ROS), in testicular biopsy specimens from infertile patients.

METHODS

Levels of MDA were measured in testicular biopsy specimens from 29 consequent-randomized infertile men, aged 29.58+/-4.76 (21 to approximately 45) years. All patients were evaluated by a complete medical and reproductive history, physical examination, semen analysis (at least two), serum follicle-stimulating hormone and free testosterone levels, testicular biopsy and contact imprint. Scrotal colour Doppler ultrasonography was used to confirm suspected varicocele. The testicular MDA level was measured using the thiobarbituric acid test and the results were expressed per unit tissue weight.

RESULTS

As a causal factor in infertility, varicocele was identified in 17 (58.6 %) patients, and idiopathic infertility, testicular failure and obstruction in 4 (13.8 %) patients each. The testicular MDA level was 13.56 (6.01), 49.56 (24.04), 58.53 (48.07), and 32.64 (21.51), 32.72 (13.61), 23.07 (7.82), 42,12 (34.76) pmol/mg tissue in the normal spermatogenesis (control), late maturation arrest, Sertoli cell only (SCO) and hypospermatogenesis (mild, moderate, severe) groups, respectively. The elevation of MDA levels was significant in the testicular tissue from SCO and maturation arrest groups compared with the controls (P<0.05). In addition, the elevation in testicular MDA levels between the SCO and the moderate hypospermatogenesis, and the moderate hypospermatogenesis and the maturation arrest groups was significant (P<0.05).

CONCLUSION

Severe pathologic changes in the testicular tissue are associated with a high level of lipid peroxidation. These findings suggest that overproduction of ROS may play a role in the mechanism of testicular degeneration associated with infertility.

Survival analysis of the factors affecting in mortality in injured patients requiring dialysis due to acute renal failure during the Marmara earthquake: survivors vs non-survivors

BACKGROUND

We reviewed medical records of dialyzed patients admitted to our hospital after the Marmara earthquake and evaluated the factors affecting mortality in survivors and non-survivors according to the survival times.

PATIENTS AND METHODS

Crush syndrome (CS) was diagnosed in 110 patients. Dialysis treatment was initiated in 60 patients; 21 of all died. The patients were divided into 2 groups which consisted of 39 survivors (Group A, 25 male, 14 female, mean age: 31 +/- 2.2 years) and 21 non-survivors (Group B, 9 male, 12 female, mean age: 27 +/- 3.0 years). Victims treated by any form of renal replacement therapy, including daily or intermittant hemodialysis and/or continuous venovenous hemodiafiltration. Clinical and laboratory findings were recorded regularly. Statistical analysis was performed with Kaplan-Meier method, log rank test and Cox regression analysis for the survival functions.

RESULTS

APACHE II scores were 13.5 +/- 0.5 for Group A and 13 +/- 0.9 for Group B. Dialysis support was started to patients in Group A in a mean period of 2.8 +/- 0.2 days and in Group B in a mean period of 3.7 +/- 0.6 days after the earthquake (p > 0.05). The most frequent site of trauma was lower extremity (61.5%) and upper + lower extremities (23%) in Group A, and lower extremity (38.1%) and trunk + lower extremity (23.8%) in Group B. The frequencies of abdominal trauma, pelvic fracture and thoracic trauma in Group B were 23.8%, 19% and 14.2%, respectively. Multiple trauma was more frequent in Group B than in Group A (42.8% vs 2.5%). The rates of fasciotomy, amputation and surgery were similar in both groups. The frequency of sepsis was higher in non-survivors. In our center, the overall mortality rate was 8%, mortality rate in CS was 21% and in dialyzed patients it was 35%. Mortality was mainly associated with sepsis. Survival periods (52.3 +/- 4.0 days) in Group A were longer than in Group B (17.3 +/- 2.5 days). With Cox regression analysis, the parameters such as systolic hypotension on admission, female gender, high serum peak creatine kinase (> 20,000 U/l) and multiple trauma including thoracic and abdominal regions, were factors increasing risk of mortality.

CONCLUSION

As a result, sepsis, multiple trauma and severe crush injury were the main factors increasing mortality risk in dialyzed injuries after the earthquake.

Efficacy of losartan in patients with primary focal segmental glomerulosclerosis resistant to immunosuppressive treatment

OBJECTIVES

Angiotensin II may play an important role in the progression of renal disease. Currently, angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists are commonly used for renoprotection. To our knowledge, there is no study investigating this effect of angiotensin II receptor antagonists in patients with primary focal segmental glomerulosclerosis (FSGS) in the literature. The aim of this study was to evaluate the effects of losartan on proteinuria and renal function in patients with FSGS refractory to immunosuppressive treatment.

DESIGN

Twenty-three normotensive patients with FSGS proven through renal biopsy were included in the study. Thirteen of them, five men and eight women, were given losartan in a dose of 50 mg day(-1) during 12 months, and 10, four men and six women, were in the control group. Mean arterial blood pressure (MAP), 24-h urine protein excretion, serum total protein and albumin levels were determined just before the start of treatment as well as after 1, 6 and 12 months of the study. In addition, serum creatinine, creatinine clearance (CrCl), cholesterol and triglyceride levels were determined at the beginning and end of the study.

RESULTS

Age, gender and baseline levels of proteinuria, serum albumin, total protein, creatinine, CrCl and MAPs were similar in the two groups. Nephrotic range of proteinuria was present in five of 13 patients (38.4%) in the losartan group and in four of 10 patients (40%) in the control group. In the losartan group, 24-h proteinuria had decreased from 3.6 +/- 0.5 g to 2.3 +/- 0.5 g after 1 month, to 2.4 +/- 0.7 g after 6 months and to 1.9 +/- 0.7 g after 12 months. In the control group, a significant increase in proteinuria compared with the baseline value was noticed after 12 months. Proteinuria levels were significantly higher in the control group than in the losartan group after 6 and 12 months. Whilst total protein and albumin levels increased in the losartan group, they did not change significantly in the control group. The total protein levels after 6 and 12 months, and albumin levels after 6 months were significantly higher in the losartan group than in the control group. No significant change was observed between the baseline and the 12-month creatinine and CrCl levels of the groups when intra- and inter-group comparisons were made. Furthermore, serum cholesterol levels of the losartan group were reduced significantly. The changes in MAP values did not reach significant levels in either of the groups. There was no correlation between the percentage changes in MAP and in proteinuria of the losartan group after 12 months.

CONCLUSIONS

Angiotensin II receptor antagonists may be an alternative therapy in FSGS patients who are resistant to immunosuppressive therapy.

Behavior and properties of neat and filled gelatins

The purpose of this study was to determine the mechanical properties and the atomistic structures of various gelatin hydrogels as a preliminary to using these in bioengineering applications. The hydrogels were investigated as neat materials and as particulate-reinforced composites both in the as-formed state and following cross-linking with formaldehyde and/or glutaraldehyde. The compressive modulus obtained using alumina particulates as the reinforcement was found to be enhanced significantly more than expected on the basis of considering a gel matrix to be similar to a thermoplastic one. From the electron paramagnetic resonance of a Cu(2+) probe ion implanted in these materials it was determined that the variation in the compressive moduli with Bloom indices results from a gradation in the relative weightings of two discrete coordination configurations. The cross-linking led to different coordinations following the formaldehyde vs. the glutaraldehyde treatments.

Effect of experimental varicocele in rats on testicular oxidative stress status

The present experiments were undertaken to determine the levels of MDA, SOD and catalase in the testis of adolescent rats with experimental left varicoceles. Male Wistar rats, 7 weeks old and weighing 160-170 g, were randomly allocated into three groups. The first group of rats underwent partial ligation of the left renal vein (n = 15). The second group of rats underwent a sham operation (n = 7) and the third group acted as controls (n = 7). Animals were sacrificed 6 weeks after surgery and dilatation of the internal spermatic veins was observed. Levels of MDA, SOD and catalase activity were measured in testis. The experimental left varicocele group showed severe testicular changes compared to other groups. The mean MDA (SEM) levels in right and left testicular tissues of varicocele bearing rats, sham-operated rats, and control rats were 0.48 +/- 0.24 and 0.31 +/- 0.11, 0.22 +/- 0.02 and 0.35 +/- 0.12, 0.62 +/- 0.29 and 0.13 +/- 0.05, respectively (P > 0.05). The mean SOD (SEM) levels in right and left testicular tissues of varicocele bearing rats, sham-operated rats, and control rats were 7,790 +/- 606 and 6,974 +/- 574, 7,475 +/- 1,517 and 7020 +/- 1,106, 8,727 +/- 1,188 and 9,019 +/- 1,129, respectively (P > 0.05). The mean catalase (SEM) levels in right and left testicular tissues of varicocele bearing rats,sham-operated rats, and control rats were 75.77 +/- 11.5 and 53.82 +/- 10.1, 91.94 +/- 14 and 94.90 +/- 32, 65.40 +/- 5.7 and 90.93 +/- 16.4, respectively (P > 0.05). Our results suggest that oxidative status, which reflects a relative balance between reactive oxygen species (ROS) generated and ROS scavenged, may not be responsible for the testicular dysfunction associated with experimentally induced varicocele during adolescence in rats.

A family with IgA nephropathy and hereditary lymphoedema praecox

Immunoglobulin A (IgA) nephropathy is the most common primary glomerulonephritis worldwide. The pathogenesis is still unknown and treatment has not yet been established. Rarely it can be associated with other disorders. Its association with hereditary lymphoedema is not reported before. We report four patients, a 60-year-old father, his two sons and his daughter, with hereditary lymphoedema. The family had nine members and in four of them lymphoedema was evident. The other members had neither lymphoedema nor IgA nephropathy. This is the first report of IgA nephropathy in association with hereditary lymphoedema.