Effect of mud compress therapy on cartilage destruction detected by CTX-II in patients with knee osteoarthritis.

BACKGROUND/OBJECTIVE: The aim of this study is to investigate the effect of mud compress (MC) therapy compared to hot pack (HP) therapy on cartilage destruction and subchondral bone alterations detected by urine levels of C telopeptide fragment of collagen type-II (uCTX-II) in patients with knee osteoarthritis (OA). METHODS: Fifty-nine patients between 49-74 years of age with bilateral knee OA divided into 2 groups. Twenty-five patients (16 females, 9 males) and 34 patients (22 females, 13 males) were given HP versus local natural organic and mineral-rich MC therapy respectively for 2 weeks as a total of 12 sessions. uCTX-II, Visual Analog Scale (VAS), 15 m walking time, Western Ontario and McMaster Universities multifunctional (WOMAC) index were measured at baseline, after-treatment and 3 months after treatment. RESULTS: uCTX-II level did not show any difference between the two groups, however it decreased significantly in MC and HP groups 3 months after treatment (p< 0.017). WOMAC stiffness sore was significantly lower in MC group 3 months after treatment (p< 0.05). Both MC and HP therapies lowered VAS, WOMAC total and subscores significantly up to 3 months (p< 0.017). CONCLUSIONS: HP and MC therapies for OA of knee are not superior to one another with respect to the level of uCTX-II. MC may probably decrease the ongoing cartilage destruction and related subchonral bone interactions earlier compared to HP treatment in patients with knee OA as evidenced by decreased uCTX-II levels after-treatment.

Evaluation of serum NGAL and hepcidin levels in chronic kidney disease patients.

Cardiovascular disease is the major cause of death in chronic kidney disease (CKD) patients. The main underlying reason is inflammation. In CKD, interleukin-6 and hypersensitive C-reactive protein are known to be used for the evaluation of inflammation and serum levels increase with decreased creatinine clearance. Neutrophil gelatinase-associated lipocalin (NGAL) and hepcidin are also considered to be effective in the assessment of inflammatory conditions. The possible interactions of NGAL and hepcidin with inflammatory markers in CKD patients including the kidney transplants, which have not been thoroughly explained up to date wereevaluated in this study. Serum creatinine, iron, unsaturated iron binding capacity, interleukin-6, hypersensitive C-reactive protein, NGAL, hepcidin and pro-hepcidin levels were measured in a cohort of 163 CKD patients including transplant patients and 82 healthy volunteers. Clinical evaluation and classification of the patients were done according to the NFK/KDOQI guideline. Serum hepcidin, Prohepcidin, NGAL, hypersensitive C-reactive protein and interleukin-6 levels were higher in patient groups compared to the control group. In patient groups, while hepcidin, NGAL, interleukin-6, hypersensitive C-reactive protein levels were correlated with creatinine and glomerular filtration rate, iron metabolism parameters were not correlated with the inflammation biomarkers. Inflammation related hepcidin and NGAL weakly correlated with creatinine clearance. Our results demonstrated that serum NGAL and hepcidin levels might be valuable for the evaluation of inflammation in CKD, and these new inflammation parameters are not related through iron metabolism.

Evaluation of cardiac biomarkers and right ventricular dysfunction in patients with acute pulmonary embolism.

OBJECTIVE: Right ventricular dysfunction (RVD) with myocardial damage may lead to fatal complications in patients with acute pulmonary embolism (PE). Cytoplasmic heart-type fatty acid-binding protein (HFABP) and the N-terminal fragment of its prohormone (NT-proBNP) are sensitive and specific biomarkers of myocardial damage. We evaluated RVD and cardiac biomarkers for myocardial damage and short-term mortality in patients with acute PE. METHODS: We analyzed 41 patients (24 females, 17 males) with confirmed acute PE prospective. Three groups (massive, submassive, and non-massive) of patients were defined, based on systemic systolic blood pressure measured on admission and RVD by transthoracic echocardiography (TTE). Also, systolic (s) and mean (m) pulmonary artery pressures (PAPs) were recorded by TTE, and plasma concentrations of cardiac troponin T (cTn-T), NT-proBNP, and HFABP were evaluated 6 month follow-up. RESULTS: Seventeen (41.5%) patients experienced a complicated clinical course in the 6-month follow-up for the combined end-point, including at least one of the following: death (n=12, 29.3%; 3 PE-related), chronic PE (n=4, 9.8%), pulmonary hypertension (n=2, 4.9%), and recurrent PE (n=1, 2.4%). Multivariate hazard ratio analysis revealed HFABP, NT-proBNP, and PAPs as the 6-month mortality predictors (HR 1.02, 95% CI 1.01-1.05; HR 1.01, 95% CI 1.01-1.04; and HR 1.02, 95% CI 1.02-1.05, respectively). CONCLUSION: HFABP, NT-proBNP, and PAPs measured on admission may be useful for short-term risk stratification and in the prediction of 6-month PE-related mortality in patients with acute PE.

Effect of 10-Week Supervised Moderate-Intensity Intermittent vs. Continuous Aerobic Exercise Programs on Vascular Adhesion Molecules in Patients with Heart Failure.

OBJECTIVE: Abnormal expression of cellular adhesion molecules may be related to endothelial dysfunction, a key feature in chronic heart failure. This study compares the effects of 10-wk supervised moderate-intensity continuous aerobic exercise (CAE) and intermittent aerobic exercise (IAE) programs on markers of endothelial damage, disease severity, functional and metabolic status, and quality-of-life in chronic heart failure patients. DESIGN: Fifty-seven patients between 41 and 81 yrs with New York Heart Association class II-III chronic heart failure and with a left ventricular ejection fraction of 35%-55% were randomized into three groups: nonexercising control, CAE, and IAE, which exercised three times a week for 10 wks. Endothelial damage was assessed by serum markers of vascular cell adhesion molecule-1, serum intercellular adhesion molecule-1, and nitric oxide; disease severity was measured by left ventricular ejection fraction and N-terminal probrain natriuretic peptide; metabolic status was evaluated by body composition analysis and lipid profile levels; functional status was evaluated by cardiorespiratory exercise stress test and 6-min walking distance; quality-of-life was assessed with Left Ventricular Dysfunction-36 and Short-Form 36 questionnaires at the baseline and at the end of the 10th week. RESULTS: Significant decreases in serum vascular cell adhesion molecule-1 or serum intercellular adhesion molecule-1 in IAE and CAE groups after training were found, respectively. Resting systolic and diastolic blood pressure, peak systolic and diastolic blood pressure, 6-min walking distance, and the mental health and vitality components of Short-Form 36 improved in the CAE group, whereas left ventricular ejection fraction and 6-min walking distance improved in the IAE group compared with the control group. CONCLUSIONS: Both moderate-intensity CAE and IAE programs significantly reduced serum markers of adhesion molecules and prevented the change in VO2 in patients with chronic heart failure.

Investigation of hemorheological parameters at the diagnosis and follow up of children with iron deficiency anemia and mixed anemia.

OBJECTIVE: We aimed to investigate the effects of iron deficiency anemia (IDA) and vitamin B12 deficiency coexisting with IDA which is called as mixed anemia (MA) on hemorheological parameters, to compare them with each other and healthy controls, and to assess the changes in hemorheological parameters after treatment. MATERIALS AND METHODS: 32 IDA patients (mean age:6.3 ± 5.3 years), 30 MA patients (mean age:7.2 ± 5.4 years), and 31 healthy controls (mean age:7.1 ± 5.2 years) were enrolled. Erythrocyte deformability and aggregation were determined by an ectacytometer, plasma and whole blood viscosities by a cone-plate rotational viscometer. Differences between IDA and MA, and healthy controls were compared. Hemorheological parameters were repeated in the patient groups after treatment and compared with the initial results. RESULTS: In both of the patient groups, erythrocyte deformability, whole blood and plasma viscosities were found to be significantly decreased before treatment, compared with the controls. After treatment these parameters were found to be increased significantly. There were no significant differences in these parameters between the IDA and MA group. Additionally, no statistically significant alteration was found in erythrocyte aggregation measurements of both patient groups. CONCLUSION: This study indicates that IDA and MA have similar effects on hemorheological parameters. When vitamin B12 deficiency accompanies IDA which is called as MA, no further alterations occur in hemorheological parameters. The adequate treatment of these anemias not only corrects the hematological parameters, but also by helping to normalize the hemorheological parameters, may contribute to the regulation of microvascular perfusion.

Serum calcitonin gene-related peptide levels in women with polycystic ovary syndrome.

PURPOSE: Calcitonin gene-related peptide (CGRP) is an amino acid neuropeptide with widespread expression. It has potent effects on lipid and energy metabolism. It induces insulin resistance. This study was planned to determine CGRP levels in women with polycystic ovary syndrome (PCOS). METHODS: Forty-seven women with PCOS and 34 healthy controls were evaluated in this controlled clinical study. Serum lipid sub-fractions, postprandial and fasting glucose, insulin and other hormones (gonadotropins, androgens) and CGRP levels were measured. Homeostasis model assessment (HOMA-IR) was used to estimate insulin resistance. RESULTS: Waist measurements, postprandial and fasting glucose and fasting insulin levels and free androgen index and HOMA-IR were significantly higher in subjects with PCOS. However, the women with PCOS had considerably lower high-density lipoprotein cholesterol levels than healthy subjects. Serum CGRP levels were higher in study subjects than in controls, although it was statistically insignificant. CONCLUSIONS: Serum CGRP level was not related with insulin resistance, ovarian hyperandrogenism and dyslipidemia in abdominally obese women with PCOS. These outcomes propose that CGRP may not play a pivotal role in the pathogenesis of PCOS.

The effect of mud pack therapy on serum YKL-40 and hsCRP levels in patients with knee osteoarthritis.

The aim of this study was to evaluate the efficacy of treatment with mud pack in knee osteoarthritis (OA) and to determine whether mud pack effects serum levels of YKL-40 and high-sensitivity C-reactive protein (hsCRP) which are reported to be biological markers for articular damage or inflammation in patients with OA. Forty-four patients with the diagnosis of knee OA assigned into two groups were treated with local natural mineral-rich mud pack or hot pack. Treatments were applied for 6 days a week for 2 weeks as a total of 12 sessions. Patients were assessed at baseline, post-treatment, and 3 months after the treatment. VAS, range of motion, 15-m walking time, WOMAC index, Nottingham Health Profile, serum YKL-40, and hsCRP levels were the outcome measures. Pain intensity and joint stiffness decreased in both groups at all follow-ups. Physical activity status was found to persist for 3 months after treatment only in mud pack group. Serum mean YKL-40 and hsCRP levels of the patients were higher compared to healthy control group. Serum YKL-40 level increased significantly only in hot pack group 3 months after the treatment (P < 0.017). No significant change was observed in hsCRP levels in both groups during the whole follow-up periods (P > 0.05). Mud pack and hot pack therapy were both demonstrated to be effective in symptomatic treatment of knee OA until the end of the 2-week treatment period, whereas only mud pack therapy was shown to be effective in functional status over time. In the hot pack group, increased serum YKL-40 level 3 months after the treatment might indicate persistence of cartilage degradation. Maintenance of YKL-40 level in mud pack therapy seems to slow down the progression of knee OA.

[Evaluation of serum adiponectin levels in patients with obstructive sleep apnea syndrome]. / Tikayici uyku apnesi sendromlu hastalarin serum adiponektin düzeylerinin degerlendirilmesi.

OBJECTIVES: Serum adiponectin levels have been found to be lower in patients with obesity, hypertension, and coronary artery diseases. In this study, we aimed to evaluate serum adiponectin levels in patients with obstructive sleep apnea syndrome (OSAS) and to correlate these levels with the severity of OSAS. STUDY DESIGN: In 62 OSAS patients (39 males, 23 females) and 32 controls (23 males, 9 females) determined by polisomnography, serum adiponectin levels were analyzed by the ELISA method. Patients were classified as having either mild (apnea hypopnea index, AHI: 5-14), moderate (AHI: 15-29) or severe (AHI ≥30) OSAS, and controls were defined as AHI <5. Plasma fasting glucose, total cholesterol (TC), triglyceride (TG), and high (HDL-C) and low (LDL-C) density lipoprotein cholesterols were analyzed, and the results were compared between the groups. RESULTS: There was no significant difference in mean age (51.6±10.7 years for patients, 48.3±10.8 years for controls) or body mass index (32.9±6.0 kg/m2 for patients, 31.3±5.6 kg/m2 for controls, p>0.05) in our study population. There was no significant difference in the number of hypertensive, diabetics, or smokers between the patients and controls. While serum TC, TG, and HDL cholesterol levels were not significantly different between two groups, the serum adiponectin levels of patients (3.0±3.4 µg/dl) were significantly lower than those of the controls (5.2±5.2 µg/dl, p=0.01). While serum adiponectin levels showed a significantly negative correlation with AHI (r=-0.221, p=0.03), there was a significantly positive correlation with minimum and mean oxygen saturations (r=0.213, p=0.04 and r=0.205, p=0.05). CONCLUSION: Serum adiponectin levels were significantly lower in patients with OSAS, especially for those in the severe OSAS group. Serum adiponectin levels are related to the severity of OSAS and arterial oxygen saturation.

[A relationship between CRP, adiponectin and Gensini score in the patients with coronary artery disease]. / Koroner arter hastalarinda CRP, adiponektin ve Gensini skoru arasindaki iliski.

OBJECTIVE: We aimed to evaluate serum adiponectin and C-reactive protein (CRP) levels in the different groups of patients with angiographically defined coronary artery disease (CAD). METHODS: Overall 100 patients (80 males, 20 females) with CAD (≥ 50% stenosis) and 45 controls (25 males, 20 females) with normal coronary arteries were included in this cross-sectional observational study. Gensini score was used for evaluation of the severity of coronary lesions on the angiogram. A relationship between Gensini score and serum CRP and adiponectin levels was evaluated by a logistic regression analysis. RESULTS: Mean age of the patients (60.5±10.2 years) was significantly higher than of the controls (55.6±10.4 years, p=0.01). While serum adiponectin levels in CAD patients (2.1±1.2 µmg/dl) were significantly lower than in the controls (3.3±1.8 µmg/dl, p=0.01); serum CRP levels of the patients (2.8±1.5 mg/dl) were significantly higher than of the controls (0.9±0.4 mg/dl). Serum adiponectin and CRP levels were not significantly different between the CAD subgroups (p>0.05). Gensini score was related with serum CRP (odds ratio: 0.98, 95% CI: 1.05-1.35, p=0.01) and adiponectin levels (odds ratio: 1.15, 95% CI: 1.10-1.25, p=0.01) by a logistic regression analysis. CONCLUSION: While serum CRP levels are increased in CAD patients comparing with the controls; serum adiponectin levels are decreased significantly. Serum CRP and adiponectin levels are related to coronary lesions severity on the angiogram.

Preventive effects of vitamin E against oxidative damage in aged diabetic rat bladders.

OBJECTIVES: To examine the effects of aging and/or diabetes mellitus on oxidative stress and the protective effect of vitamin E in the bladder. It was proposed that the balance between oxidant and antioxidant species is important regarding the aging process and prevention of diabetic complications. METHODS: Young and aged rats were randomly allotted into six experimental groups: aged control, aged diabetic, aged diabetic and vitamin E-treated, young control, young diabetic, young diabetic and vitamin E-treated. Diabetes was induced by streptozotocin. Vitamin E was administered to the treated groups. Malondialdehyde and reduced glutathione levels were measured in all rat bladders, and histological changes were examined by electron microscopy. RESULTS: We found increased malondialdehyde and decreased glutathione levels in the young and aged diabetic groups compared with the nondiabetic control groups. Elevated malondialdehyde and reduced glutathione levels were observed in the aged compared with the young control groups. There were no significant differences in the malondialdehyde and glutathione levels between young and aged diabetic vitamin E-treated groups compared with the related control groups. Degeneration was greatest in the aged diabetic group. The protective effects of vitamin E were seen in young and aged diabetic groups, especially in the young diabetic group. CONCLUSIONS: Our results suggest that vitamin E supplementation prevents free radical damage in bladders of young and aged diabetic rats.

Effects of retinoic acid and zinc on the treatment of caustic esophageal burns.

PURPOSE: An experimental study was carried out to investigate the efficacy of an anti-inflammatory and antiproliferative agent all-trans retinoic acid (ATRA) and an antioxidant agent zinc sulphate (ZnSO(4)) in the prevention of stricture after caustic esophageal burn in rats. METHODS: Esophageal burn was induced using 50% NaOH. Rats were divided into four groups as follows: group A (sham; n = 8), group B (control; n = 8), group C (treated with ATRA; n = 8) and group D (treated with ZnSO(4); n = 8). All rats were killed on the 28th day and esophageal tissues were evaluated for histopathologic damage score, hydroxyproline (HP) content and TGF-beta1 expression. RESULTS: Significant difference was detected in terms of histopathologic damage score between groups B and C (p = 0.002). Although mean HP levels of groups C and D were lower than group B, statistical comparison was not significant. TGF-beta1 expression in group C was significantly lower than group B. CONCLUSION: Zinc has not been found effective in the prevention of stricture formation. The results indicate that ATRA has a preventive effect in the development of fibrosis in an experimental model of caustic esophageal burns in rats.

[Evaluation of serum adiponectin levels in patients with heart failure and relationship with functional capacity]. / Kalp yetersizligi olan hastalarda serum adiponektin düzeylerinin degerlendirilmesi ve fonksiyonel kapasite ile iliskisi.

OBJECTIVES: We aimed to evaluate serum adiponectin levels in relation to the NYHA functional capacity class in patients with heart failure (HF). STUDY DESIGN: The study included 49 patients (40 males, 9 females; mean age 63 years) with HF, whose functional capacity was NYHA class II to IV. Echocardiographic examination was performed and serum adiponectin levels were measured. The results were compared in relation to the NYHA classes and with those of 41 control subjects (24 males, 17 females; mean age 54.2 years) without HF. RESULTS: Functional capacity was NYHA class II in 13 patients (26.5%), class III in 23 patients (46.9%), and class IV in 13 patients (26.5%). Compared to the control group, the HF group exhibited a significantly higher mean age (p=0.001), lower body mass index (p=0.004), decreased left ventricular ejection fraction (EF) (33.2+/-7.7% vs. 64.9+/-4.3%; p=0.0001), and increased serum adiponectin level (4.0+/-3.2 micromg/dl vs. 2.4+/-2.3 micromg/dl; p=0.009). Both EF (p=0.001) and adiponectin level (p=0.004) showed significant differences between the NYHA groups, with the latter showing a sharp increase from 2.6+/-2.6 micromg/dl in class II to 6.8+/-3.7 micromg/dl in class IV. In all paired comparisons between the three NYHA groups, EF and serum adiponectin level exhibited significant differences except for the serum adiponectin level for NYHA class II and III (for NYHA class II and IV, p=0.003; for class III and IV, p=0.008). In correlation analysis, serum adiponectin level was in a significantly inverse correlation with EF (r=-0.380, p=0.0001), and a positive correlation with the NYHA class (r=0.423, p=0.0001). CONCLUSION: Serum adiponectin levels significantly increase in patients with HF, in parallel with deterioration in functional capacity and with significant decreases in EF.

[The association between serum adiponectin levels and the severity of coronary artery lesions on the angiogram]. / Serum adiponektin düzeyleri ile anjiyogramda koroner lezyon ciddiyeti arasindaki iliski.

OBJECTIVES: Decreased serum adiponectin levels have been shown in patients with coronary artery disease (CAD). We evaluated the association between serum adiponectin levels and CAD severity on the angiogram. STUDY DESIGN: The study included 86 patients (70 males, 16 females; mean age 60 years) with angiographically documented CAD (=/>50% stenosis). The patients were divided into three groups according to the number of vessels affected; thus, 18 had single-vessel, 16 had two-vessel, and 52 had multiple-vessel disease. The severity of coronary lesions was assessed using the modified Gensini score. Serum adiponectin levels were measured in the CAD group and in a control group of 33 subjects (16 males, 17 females; mean age 54.8 years) who were found to have normal coronary arteries on angiography. RESULTS: The mean age, the number of male patients, and the number of smokers were significantly higher in the CAD group (p=0.01). Patients with CAD exhibited significantly lower serum levels of adiponectin compared to the control group (2.0+/-2.0 micromg/dl vs. 3.2+/-2.7 micromg/dl; p=0.01). There were no significant differences in adiponectin levels between patients with single-, two, and multiple-vessel disease. Compared to the controls, patients with two- and multiple-vessel disease had significantly lower adiponectin levels (1.5+/-0.9 microg/dl and 2.0+/-2.0 microg/dl, respectively), whereas those with single-vessel disease (2.6+/-2.5 microg/dl) did not differ from the controls in this respect. The mean Gensini score was 3.8+/-1.7 in the CAD group. There was a weak inverse correlation between serum adiponectin levels and the Gensini score (r=-0.209; p=0.02). CONCLUSION: Serum adiponectin levels are decreased in CAD patients compared to controls. This decrease is more prominent with increasing levels of CAD severity, which may be a helpful clue of multivessel disease.

Serum total L-carnitine levels in non-obese women with polycystic ovary syndrome.

BACKGROUND: Carnitine plays essential roles in energy production, oxidative stress and glucose metabolism. This study was planned to determine serum total L-carnitine levels in non-obese women with polycystic ovary syndrome (PCOS). METHODS: There were 27 non-obese women with PCOS and 30 healthy, age- and body mass index (BMI) matched controls were evaluated in this controlled clinical study. Serum lipid sub-fractions, fasting glucose, insulin and other hormones (gonadotrophins, androgens) and total L-carnitine levels were measured. Homeostasis model assessment (HOMA-IR) was used to estimate insulin resistance. RESULTS: The women with PCOS had significantly higher serum dehydroepiandrosterone sulfate, total testosterone, free androgen index (FAI), luteinizing hormone (LH), low-density lipoprotein (LDL) cholesterol, non-high density lipoprotein (HDL) cholesterol, fasting insulin levels and HOMA-IR measurement and LH/FSH ratios than healthy women. However, total L-carnitine and sex hormone-binding globulin (SHBG) levels were significantly lower in women with PCOS. L-Carnitine level was negatively correlated with FAI, but positively correlated with SHBG. Multiple regression analysis revealed that SHBG was a strong predictor of serum total L-carnitine level. CONCLUSIONS: Decreased total L-carnitine levels may be associated with hyperandrogenism and/or insulin resistance in non-obese women with PCOS. Long-term studies are needed to evaluate carnitine metabolism in PCOS, especially with regard to the molecular basis.

Are C-reactive protein and homocysteine cardiovascular risk factors in obese children and adolescents?

BACKGROUND: Several prospective epidemiological studies have demonstrated that high-sensitivity C-reactive protein (hsCRP) and plasma homocysteine (hcy) are predictors of future coronary events among healthy men and women. The aim of the present study was therefore to investigate a possible relationship between hsCRP, hcy levels and body mass index (BMI), relative weight (RW), serum leptin levels, and cardiovascular risk factors in obese children and adolescents. METHODS: The study involved 28 obese children and adolescents (13 girls, 15 boys; BMI>95 per thousand for age and sex), 4.5-15 years of age (mean 10.7 +/- 0.6 years), who attended hospital for a basic obesity check-up. The association between hsCRP, hcy levels and BMI, RW, serum leptin levels, and cardiovascular risk factors such as blood pressure (BP), lipid profile, serum fasting insulin levels, and insulin resistance indexes, was investigated. RESULTS: Serum hsCRP level was positively correlated with BMI (r = 0.512, P < 0.01), RW (r = 0.438, P < 0.05), systolic and diastolic BP (r = 0.498, P < 0.01), serum leptin levels (r = 0.457, P < 0.05), but not with serum lipid, glucose, fasting insulin, plasma hcy levels or insulin resistance indexes. For hcy level, in contrast, no correlation was found with BMI, RW, systolic and diastolic BP, serum lipid levels, leptin, hsCRP, glucose, fasting insulin levels, or insulin resistance indexes. CONCLUSIONS: hsCRP is correlated with BMI, RW, BP and leptin, which are risk factors for coronary heart disease, which supports the relationship between obesity, inflammation and atherosclerosis. hsCRP in childhood obesity might be a useful index to predict possible atherosclerotic events.

The effects of diabetes mellitus, age, and vitamin E on testicular oxidative stress.

OBJECTIVE: To examine the effects of age and/or diabetes on oxidative stress and steroidogenesis, and the protective effect of vitamin E in testis tissue. DESIGN: Controlled experimental study. SETTING: Pamukkale University School of Medicine animal facility. ANIMAL(S): Male Wistar rats divided into six groups with six animals in each group: young control; young diabetic; young diabetic with vitamin E treatment; aged control; aged diabetic; and aged diabetic with vitamin E treatment. INTERVENTION(S): Diabetes was induced by a single intraperitoneal injection of 50 mg/kg streptozotocin and was confirmed by testing blood glucose levels 5 to 7 days after injection. Vitamin E was administered orally for 6 weeks. MAIN OUTCOME MEASURE(S): Serum testosterone and tissue malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH) levels were measured, and testis tissue was examined histopathologically. RESULT(S): Elevated malondialdehyde and reduced superoxide dismutase, glutathione, and serum testosterone levels were detected only in the young and aged-diabetic groups. Histopathologic change was not detected in the testis tissue in any of the groups. CONCLUSION(S): Age does not alter the effects of diabetes-induced free radical damage in testis tissue; improvement in this damage can be achieved by vitamin E treatment.

Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients.

The purpose of this study was to investigate the clinical effects of balneotherapy in the treatment of Fibromyalgia Syndrome (FMS) and to determine if balneotherapy influences serum levels of inflammation markers, IL-1, PGE2 and LTB4. 24 primary fibromyalgia female patients diagnosed according to American College of Rheumatology criteria were included to the study. Their ages ranged between 33 and 55 years. FMS patients were randomly assigned in two groups as, group 1 (n = 12) and group 2 (n = 12). Group 1 received 20-min bathing, once in a day for five days per week. Patients participated in the study for 3 weeks (total of 15 sessions) in Denizli. Group 2 did not receive balneotherapy. FMS patients were evaluated by tenderness measurements (tender point count and algometry), Visual Analogue Scale, Beck's Depression Index, Fibromyalgia Impact Questionnaire. Ten healthy women recruited group three as the controls. Serum PGE2, LTB4 and IL1-alpha levels were measured in all three groups. The biochemical measurements and clinical assessments were performed before and at the end of general period of therapy. Statistically significant alterations in algometric score, Visual Analogue score, Beck's Depression Index and PGE2 levels (P < 0.001), numbers of tender points (P < 0.01) and Fibromyalgia Impact Questionnaire score (P < 0.05) were found after the balneotherapy between group 1 and 2. Mean PGE2 level of FMS patients were higher compared to healthy control group (P < 0.0001) and decreased after the treatment period, only in group 1 (P < 0.05). As in the group 2 and 3, detectable IL-1 and LTB4 measurements were insufficient, statistical analysis was performed, only in group 1. After balneotherapy IL-1 and LTB4 significantly decreased in group 1 (P < 0.05). In conclusion, balneotherapy is an effective choice of treatment in patients with FMS relieving the clinical symptoms, and possibly influencing the inflammatory mediators.

Relationship of serum interleukin-6 and tumor necrosis factor alpha levels with abdominal fat distribution evaluated by ultrasonography in overweight or obese postmenopausal women.

BACKGROUND: The objective of this study was to measure associations of circulating interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) levels with anthropometric and abdominal fat distribution in overweight or obese postmenopausal women. METHODS: One hundred eight overweight or obese postmenopausal were evaluated. Demographic and anthropometric measurements were done. Serum IL-6, TNF-alpha, glucose, and insulin levels were measured. Insulin resistance was calculated by using homeostasis model assessment-insulin resistance (HOMA-IR). The assessment of abdominal fat distribution was performed by ultrasonography. Statistical analysis was made with Pearson and partial correlation analysis. RESULTS: There was a positive correlation between serum IL-6 and TNF-alpha (r = .19; p = .047). IL-6 was positively correlated with body mass index (BMI) (r = .43; p = .0001), waist circumference (r = .41; p = .0001), and visceral fat layer (r = .33; p = .0001) measurements and HOMA-IR index (r = .31, p = .001). A positive relationship between HOMA-IR and visceral fat layer thickness was observed (r = .320; p = .0001). TNF-alpha was positively associated with BMI but not with any measures of central obesity. When adjustment for BMI was performed, there were no significant relationships between the studied parameters. CONCLUSIONS: There are no significant correlations between abdominal fat distributions measured by ultrasonography and circulating IL-6 and TNF-alpha levels. BMI may have a stronger association with circulating inflammatory cytokine concentrations than with different measures of central obesity in overweight or obese postmenopausal women.

Effects of resistance or aerobic exercises on metabolic parameters in obese women who are not on a diet.

This longitudinal, controlled clinical study was conducted to compare the effects of resistance exercise (RE) and aerobic exercise (AE) on body mass index (BMI), weight, fat mass (FM), serum lipid profile, and insulin resistance in obese women who cannot adhere to energy-restricted diets. A total of 60 obese women with severe eating disorders were evaluated. Patients were randomly divided into 3 groups: control group with no exercise (n=20), group 1 with AE (n=20), and group 2 with RE (n=20). Demographic and anthropometric measurements were taken. Serum lipid fractions and fasting (FGlc) and postprandial glucose insulin (PGlc) levels were measured. Insulin resistance was calculated with use of homeostasis model assessment (HOMA-IR). Total body FM was measured by bioelectric impedance analysis. After 12 wk of exercise, significant decreases in BMI, waist and weight measurements, and FGlc, PGlc, triglyceride, and total cholesterol levels were noted in each of the study groups. Reduced low-density lipoprotein cholesterol level and FM and HOMA-IR measurements were observed only in group 1 (with AE). This study indicated that AE and RE training induces improvement in body fat composition and has a favorable metabolic effect in obese women with severe eating disorders.

Increased serum malondialdehyde levels in chronic stage of ischemic stroke.

Serum lipoperoxidation products such as malondialdehyde (MDA) reflect oxidative stress. There are contradictory results addressing the levels of lipoperoxidation products in chronic phase of ischemic stroke. In the present study, we aimed to determine the serum MDA levels in stroke patients 6 months after the cerebrovascular accident. We also compared serum MDA levels in two major groups of patients with ischemic stroke resulting from small vessel and large vessel diseases, respectively. Serum MDA levels of thirty-eight patients who had ischemic stroke (19 with atherothrombotic ischemic stroke and 19 with lacunar infarction) and 30 healthy volunteers were measured. While there was no significant difference in serum MDA levels between the chronic ischemic stroke subgroups (p = 0.795), the serum MDA levels of patients with atherothrombotic ischemic stroke (p < 0.001) or with lacunar infarction (p < 0.001) were significantly higher compared to the control group. We also demonstrated that serum MDA levels of the patients with and those without hypertension (p = 0.846), diabetes mellitus (p = 0.891), or dyslipidemia (p = 0.38) were not significantly different. In conclusion, serum MDA levels were elevated in chronic stroke patients with small or large vessel diseases. To the best of our knowledge, this is the first report showing that serum MDA levels of these two groups are not significantly different. Furthermore, serum MDA levels do not differ solely by the existence or nonexistence of hypertension, diabetes mellitus or hyperlipidemia.