The potential role of BMI, plasma leptin, nesfatin-1 and ghrelin levels in the early detection of pancreatic necrosis and severe acute pancreatitis: a prospective cohort study.

BACKGROUND: Early prediction of disease severity in acute pancreatitis (AP) is crucial. The aim of this study was to investigate the body-mass index (BMI), plasma leptin, nesfatin-1 and ghrelin levels as potential markers predicting peripancreatic necrosis and severity in acute pancreatitis. METHODS: In the study period, 97 consecutive patients with AP were prospectively analysed. Severe AP was defined according to the Atlanta Criteria. BMI was also calculated. To measure plasma Leptin, Nesfatin-1 and Ghrelin concentrations, the blood samples were obtained from patients within 24 hours of admission. RESULTS: Out of 97 patients, 92(70 females, 22 males) were considered eligible for analysis. Of the 92 patients, 30 patients (32.6%) were assessed as severe pancreatitis. BMI and leptin levels were significantly higher in patients with severe pancreatitis. The pooled sensitivity and specificity of BMI as a predictor for the development of pancreatic necrosis were 0.90(95%CI = 0.56-0.99) and 0.70(95%CI = 0.58-0.79), respectively; with an overall area under curve value of 0.78.The pooled sensitivity and specificity of leptin levels as a predictor for development of pancreatic necrosis were 1(95%CI = 0.69-1) and 0.73(95%CI = 0.62-0.82),respectively; with an overall area under curve value of 0.82.Nesfatin-1 and ghrelin levels showed no significant difference in patients with mild pancreatitis (6.97 ± 0.84 ng/ml and 2.3(1.0-9.9);respectively) and severe pancreatitis (6.74 ± 0.65 ng/ml and 2.0(1.9-9.9); respectively) (p = 0.1923 and 0.8531;respectively). CONCLUSION: BMI and plasma leptin levels both were correlated with the severity of pancreatitis. Leptin levels showed better area under the curve, sensitivity and specificity values compared to BMI in prediction of pancreatic necrosis.Nesfatin-1 and ghrelin levels were not found to be predictors of the severity of disease.

Evaluation of post-graduate training effect on smoking cessation practice and attitudes of family physicians towards tobacco control.

OBJECTIVE: Family physicians (FPs) are cornerstone for tobacco control. It was aimed to compare the effect of training on their smoking cessation practice, knowledge level and attitudes towards smoking and tobacco control. METHODS AND MATERIALS: The cross-sectional and multi-centered study was carried out using structured survey modified WHO based questionnaire. It was delivered to 1500 FPs randomly selected among approximately 23000 family physicians across the country. The study survey was self-reported by FPs, assessing their knowledge, attitudes, status of post-graduate training, and practice about tobacco control. Participants were assigned into two groups as non-trainee groups (Group 1) and post-graduate trainee (Group 2). RESULTS: The mean age was 38.4 ± 7.1 years-old. The percentage of male and female FPs in the study was 53.1% and 46.9%. The ratio of family physicians who participated in training program Group 2) was 26.5% (n = 327). The ratio of female FPs who participated the SCP training course was significantly higher than that of male FPs (27.3% versus 22.5%, p = 0.035). There was no significant difference for smoking status between groups (p = 0.686). When the number FPs whose consulted by the smokers over ≥ 5 a week was compared, the ratio of FPs was significantly higher in group 2 than group 1 (p < 0.001), but overall ratio of FPs (2.8%) who consulted within a week smokers was considerably lower Statements of Competence and confidence items stated by all FPs were 24.2% and 32.2%, respectively. Physicians who had attended post-graduate training on SCP were more competent and confident, compared to non-trained FPs (p = 0.002 and p = 0.001). CONCLUSION: Post-graduate training on tobacco control improved self-confidence and competence of FPs. With post-graduate training, significant improvement was seen in practical skills of physicians. A continuing training program should be introduced to FPs, to engage them for smoking cessation practice.

Effects of enuresis nocturna on parents of affected children: case-control study.

BACKGROUND: Enuresis nocturna (EN) is a chronic medical disorder that may cause a parent to question their parenting ability and contribute to an inability to perform the parental role. The aim of the study was to investigate the effects of EN on the relationship between parents, and the effect of mood changes in the couples on the children. METHODS: Forty children with EN (group 1) were enrolled in the study, and 44 consecutive healthy children (group 2) were randomly selected from the same school. The clinical diagnosis for the patient group was based on a careful history. Spielberg's State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and Dyadic Adjustment Scale (DAS) were applied to all parents, and the answers were recorded. RESULTS: STAI scores differed between the mothers in the two groups in terms of trait anxiety, while significant differences between the fathers in terms of both state and trait anxiety were observed. The BDI scores were similar between the two groups. The scores of dyadic consensus were lower in the mothers, while the affectional expression scores were lower in the EN study group fathers compared with controls. The total DAS scores were significantly lower in the parents of the children with EN. CONCLUSION: The parents of children with EN seem to experience increased levels of anxiety. Their desire to continue the marital relationship, the overall quality of their marital relationship and their comfort as a family may also be negatively affected by having a child with EN.

Low fetuin-A level in migraine: a case-control study.

Migraine is a type of primary headache which is caused by the alterations in trigeminovascular system. Migraine attacks are associated with neurovascular inflammation of the cerebral and extracerebral vessels, but its pathophysiological mechanisms have not still been fully delineated. Also, migraine has been found to be associated with higher risks for various metabolic disorders. Thus, we aimed to investigate the matrix metalloproteinases (MMP), fetuin-A, ghrelin, and omentin levels which have important roles in metabolic disorders and inflammation, and to examine their relationship with migraine subtypes and attack frequency. Forty-nine migraine patients and 30 age- and sex-matched healthy control subjects were enrolled. Migraine diagnosis was confirmed according to the International Classification of Headache Disorders-II diagnostic criteria. Analyses of MMP9,MMP3, ghrelin, omentin, and fetuin-A were performed by the ELISA method. Fetuin-A, MMP-9, and MMP-3 levels were significantly lower in migraine than controls (p < 0.05). There were no significant differences between groups with respect to omentin and ghrelin (p > 0.05). In migraine patients, serum fetuin-A levels were positively correlated with MMP-9 and negatively correlated with MMP-3. MMP-3, MMP-9, fetuin-A, omentin and ghrelin levels did not correlate with age, disease duration, or frequency of migraine headache (p > 0.05). Migraine patients have lower fetuin-A, MMP-3 and MMP-9 levels than healthy individuals. Migraine patients have low fetuin-A levels, which may be related to the pathogenesis of migraine. The importance and impact of our findings on the pathogenesis, characteristics, and treatment of migraine needs to be investigated in further detailed studies.

Protective effects of beta glucan and gliclazide on brain tissue and sciatic nerve of diabetic rats induced by streptozosin.

There have not been yet enough studies about effects of beta glucan and gliclazide on oxidative stress created by streptozotocin in the brain and sciatic nerve of diabetic rats. The aim of this paper was to investigate the antioxidant effects of gliclazide and beta glucan on oxidative stress and lipid peroxidation created by streptozotosin in brain and sciatic nerve. Total of 42 rats were divided into 6 groups including control, diabetic untreated (DM) (only STZ, diabetic), STZ (DM) + beta glucan, STZ (DM) + gliclazide, only beta glucan treated (no diabetic), and only gliclazide treated (no diabetic). The brain and sciatic nerve tissue samples were analyzed for malondialdehyde (MDA), total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and paraoxonase (PON-1) levels. We found a significant increase in MDA, TOS, and OSI along with a reduction in TAS level, catalase, and PON-1 activities in brain and sciatic nerve of streptozotocin-induced diabetic rats. Also, this study shows that in terms of these parameters both gliclazide and beta glucan have a neuroprotective effect on the brain and sciatic nerve of the streptozotocin-induced diabetic rat. Our conclusion was that gliclazide and beta glucan have antioxidant effects on the brain and sciatic nerve of the streptozotocin-induced diabetic rat.