Problematic Internet Use in Turkish High School Students: Prevalence and Related Factors.

Objectives: In this study, we sought to determine the prevalence of problematic Internet use (PIU) among high school students and identify demographic and socioeconomic factors related to PIU. Methods: Using a cross-sectional design, we conducted this study between November 2017 and January 2018 of 1412 students attending high schools in the Silivri District of Istanbul in Turkey. We administered a questionnaire inquiring about sociodemographic information, Internet use, and Young's Internet Addiction Test to participating students. Results: Among participants, 18.5% (male = 17.2%; females = 19.8%) were found to show PIU. PIU rates were higher among those with a high household income and lower among those who studied in science high schools, performed physical activities at least 2 days a week, and read at least one book a month. PIU rates were also higher among those who had their own bedrooms, phones, smartphones, Internet connections at home, and social networking accounts. Conclusion: The prevalence of PIU among the participants was 18.5%. Female sex, high household income, low physical activity, grade level, school type, reading fewer than one book per month, and Internet use experience were risk factors for PIU. PIU is considered a significant public health concern across the world, including in Turkey.

Assessment of treatment efficacy of diphenylcyclopropenone (DPCP) for alopecia areata

Background/aim: Alopecia areata (AA) is an inflammatory disease with a genetic and autoimmune basis. Herein, it was aimed to study the efficacy and safety of an immunomodulatory therapeutic agent, diphenylcyclopropenone, while manifesting its association with histopathological features, prognostic factors, and side effects. Materials and methods: In this retrospective study, 98 patients (60 males, 38 females) with alopecia, who were referred to the Hair Disease Polyclinic at the Department of Dermatology, between 2011 and 2015, were included. Together with medical histories and dermatological examinations, a skin biopsy for histopathological examination was conducted for all of the patients prior to therapy. Therapeutic success was evaluated on the basis of the hair regrowth percentage. Results: Regarding the overall treatment success, 33 (34%) patients had complete response, 16 (16%) had partial response (between 50% and 99%), 27 (28%) had minimal response (between 1% and 49%), and 22 (22%) were nonresponders. Both sexs were equally represented in the outcome. Conclusions: There was a significant relation between the severity of alopecia and the treatment outcome (P = 0.038). Patients with AA had significantly better response when compared to those with alopecia totalis and universalis. There was no statistically significant relation with other parameters, such as disease duration, age, sex, atopy history, age of onset, and histopathological features.

The relationship between cardiometabolic risks and vitamin D levels with the degree of obesity.

AIM: The aim of this study was to evaluate the cardiometabolic risk factors including vitamin D levels according to the degree of obesity in adolescents. MATERIAL AND METHODS: This is a retrospective cross-sectional study. A total of 363 overweight/obese adolescents aged between 11 and 18 years who were evaluated in our clinic from January 2012 to December 2015 were included in the study. The degree of obesity was calculated as the body mass index standard deviation. Hypertension, dyslipidemia, hyperinsulinemia, hyperglycemia, insulin resistance, and vitamin D deficiency were defined as cardiometabolic risk factors. Mann-Whitney U, Chi-square, Spearman and Pearson's correlation tests, and linear regressions analyses were used for statistical analyses. RESULTS: Of the 319 (n=319/363) adolescents, all of whose cardiometabolic risk factors were known, 267 (85.7%) had at least one cardiometabolic risk factor. The body mass index standard deviation had a positive correlation with the number of cardiometabolic risk factors (p<0.001). In the linear regression models in which sex and age were considered as covariates, an increase of one unit in the body mass index standard deviation led to an increase of 6.085 mm Hg in systolic blood pressure, 4.4 mm Hg in diastolic blood pressure, 1.59 points in HOMA-IR, 13% in insulin level, and a decrease of 2.16 ng/mL in vitamin D levels. CONCLUSION: In adolescents, the number of cardiometabolic risk factors increases as the degree of obesity increases. The determination of the severity of obesity can help to identify individuals at greater risk for higher blood pressure, impaired glucose metabolism, and lower serum vitamin D levels. On the other hand, the degree of obesity may not reflect the presence of abnormal lipid and glucose levels.

Assessment of Ambient Air Pollution in Istanbul during 2003-2013.

BACKGROUND: We investigated the air quality changes from 2003-2013 in Istanbul, Turkey. METHODS: We studied SO2, CO and PM concentration patterns in 10 districts of Istanbul. The data was obtained from air pollution monitoring stations of Istanbul Metropolitan Municipality Environmental Protection Department. We compared the variations of mean concentrations monthly, yearly and seasonally. The winter season was accepted from Oct to Mar and the summer season from Apr to Sep. RESULTS: The highest monthly average values for all measurements of sulfur dioxide and CO were 12.61, 949.19 µg/m3 in Sarachane respectively. The Highest value of the monthly average of the Particulate Matter was 72.07 µg/m3 in Kartal district. During the period between 2003-2013, monthly mean concentration values of different districts differed significantly in levels of SO2 (P=0.012), CO (P=0.029), and PM (P=0.024). CONCLUSION: The emissions of air pollutants (SO2, PM, and CO) decreased considerably from 2003 to 2013.

Correlation of Neck Circumference with Difficult Mask Ventilation and Difficult Laryngoscopy in Morbidly Obese Patients: an Observational Study.

PURPOSE: Mask ventilation and laryngoscopy can be challenging in morbidly obese patients because of excessive fat tissue. There are studies suggesting that neck circumference is associated with difficult mask ventilation, difficult laryngoscopy, and difficult intubation. The primary aim of our study is to evaluate predictive value of neck circumference for difficult mask ventilation and difficult laryngoscopy in female and male morbidly obese patients separately. METHODS: This observational cross-sectional study was performed in the period between March 2015 and December 2015. One hundred and twenty (37 male and 83 female) patients undergoing elective surgery were included. Neck circumference, BMI, Mallampati scores, neck movements, dentition, upper lip bite test, breast, thorax, waist, hip circumferences, mouth opening, and sternomental and thyromental distances were evaluated preoperatively. Mask ventilation was graded using four-grade classification. Laryngoscopy was evaluated by Cormack Lehane score. RESULTS: The incidence of difficult mask ventilation was 13.5% in male and 3.6% in female patients. Mouth opening ≤ 6.5 cm and inadequate flexion were found as significant predictors for difficult mask ventilation in male patients. The incidence of difficult laryngoscopy was 10.8% in male and 4.8% in female patients. Mallampati score > II was found as a significant predictor for difficult laryngoscopy in both male and female patients. Sternomental distance ≤ 16 cm and inadequate flexion were also significant predictors for difficult laryngoscopy in male patients. Neck circumference was not found statistically significant predictor for difficult mask ventilation and laryngoscopy in morbidly obese patients in our study. CONCLUSION: Neck circumference is not a statistically significant predictor for difficult mask ventilation and laryngoscopy in morbidly Turkish obese male and female patients. CLINICAL TRIALS REGISTRATION NUMBER: NCT02589015.

Athlete presentations and injury frequency by sport at a sports medicine university clinic.

BACKGROUND: We aimed to investigate the profile of athletes by determining the branch of sports, type, and area of sustained sports injury, and the frequencies through athletes' presentations to the largest university clinic in one of the most crowded and athlete-populated cities of Turkey, Istanbul. METHODS: The study population comprised 1302 athletes who presented to the sports medicine clinic between the dates of July 1st, 2014, and June 30th, 2015. This record-based study examined all athlete presentations using the physical examination cards. RESULTS: Eight hundred and sixty-five of the athletes were male. The median age of applicants was 21 years (interquartile range 16-30 years), the median body mass index was 22.23 kg/m2 (range, 20.01-24.67 kg/m2), and the median years of sports activity was 5 years (range, 0-10 years). Presentations to the clinic were significantly higher in April (p=0.003). The most commonly injured body part was the knee and soccer was the leading sport among the patients; anterior cruciate ligament injury was the most common pathology among soccer players. CONCLUSIONS: Athletes who presented to our clinic most commonly sustained a lower extremity injury. It was notable that ligament injuries were seen as commonly as muscle injuries.

The Effect of Urinary Catheters on Microbial Biofilms and Catheter Associated Urinary Tract Infections.

PURPOSE: The aims of this study were to determine relationship between biofilm producer microorganisms attached to urinary catheters (UCs) and urinary catheter-associated urinary tract infections (CAUTIs), to determine the rate of CAUTI development and the relationship between CAUTI and catheterization period in catheterized patients. MATERIALS AND METHODS: Urinary catheters from 143 inpatients who were hospitalized in Abant Izzet Baysal University Hospital Urinary Service, and urine samples of these patients before and after catheterization of urinarycatheter were collected. Culture-based microbiological evaluation of urinary catheters removed from inpatient and urine samples collected from inpatients were performed before and after catheterization of urinary catheter to identify various organisms and determine biofilm production by them. RESULTS: The incidence of CAUTIs was 13% (18/143) in catheterized inpatients. Biofilm producer microorganisms such as Escherichia coli (E. coli ), Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis that were isolated from UCs removed from inpatients were found to cause CAUTI (P < .001). CONCLUSION: Incidence of CAUTIs is increased by the usage of UCs and prolonged catheterization period.

Outpatient admissions and hospital costs of Syrian refugees in a Turkish university hospital.

OBJECTIVES: To examine the most frequent admitted polyclinics, diagnoses, and the costs of Syrian refugee patient in a Turkish university hospital in the metropolitan city of Istanbul, Western part of Turkey.  METHODS: Research methodology consist of analyzing outpatient admissions to the Hospital Polyclinics of Faculty of Medicine, Istanbul University, Cerrahpasa, Istanbul, Turkey from January-June 2014. We carried out diagnosis groups as classified in the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification, and analyzed the hospital cost of first admission through records based in the hospital information system.  RESULTS: Median age of 251 Syrian refugee patients is 19 years, inter quartile rate 7-34 years. Patients aged 65 and older compared with those until 18 years and 19 to 64 years aged groups have made statistically significant (p less than 0.001) less hospital admissions. The Most frequented clinic was the emergency clinic. On June there have been significantly (p less than 0.001) more admissions compared with other months. The most common diagnoses were diseases of the respiratory system. The costs of per admission was estimated nearly 48 US Dollar/per patient and the total amount of hospital admissions was 12,031.93 US Dollar.  CONCLUSION: On the specified dates, the clinics were mostly frequented from Syrian refugees until 18 years group. The most common presenting symptoms are respiratory diseases and most frequented clinic is emergency.

The effect of single dose etomidate during emergency intubation on hemodynamics and adrenal cortex.

BACKGROUND: The study aimed to evaluate and compare the effects of a single dose of etomidate and the use of a steroid injection prior to etomidate during rapid sequence intubation on hemodynamics and cortisol levels. METHODS: Sixty patients were divided into three groups (n=20). Before intubation, and at 4 and 24 hours, blood samples were taken for cortisol measurements and hemodynamic parameters (systolic-diastolic-mean arterial pressure, heart rate), and SOFA scores were recorded. Intubation was achieved with 0.3 mg/kg etomidate IV in Group I, 0.3 mg/kg etomidate following 2 mg/kg methylprednisolone IV in Group II, and 0.15 mg/kg IV midazolam in Group III. RESULTS: Mean arterial pressure values were lower in Group I at the 24th hour when compared to Groups II and III. In Group I, heart rate values were higher compared to the other Groups. Cortisol levels were lower in Group I at the 4th and at the 24th hour in Groups II and III. CONCLUSION: Administration of methylprednisolone 2-4 minutes prior to etomidate use in emergency situations can prevent adrenal insufficiency in patients undergoing rapid sequence intubation. Moreover, midazolam can be used in low induction doses as an alternative to etomidate.

The effects of intravenous, enteral and combined administration of glutamine on malnutrition in sepsis: a randomized clinical trial.

Our aim was to compare the effects of intravenous, enteral, and enteral plus intravenous supplemented glutamine on plasma transferrin, nitrogen balance, and creatinine/height index in septic patients with malnutrition. Blood and urine samples were collected for transferrin, urea and creatinine measurements. Samples, SOFA score and protein-calorie intake values were repeated on days 7 and 15. Patients (n:120) were randomly divided into 4 groups. Group I received 30 g/day IV glutamine, group II received 30 g/day enteral glutamine, group III received 15 g/day IV and 15 g/day enteral glutamine. Group IV received only enteral feeding as a control group. Transferrin levels decreased in group IV (p<0.01 0-7 days, p<0.01 7-15 days, p<0.01 0-15 days). Nitrogen balance levels were highest in group IV when compared with group I (p<0.05, p<0.001), group II (p<0.001), and group III (p<0.05, p<0.001) on days 7-15. Creatinine/height indexes increased in group I (p<0.001), group II (p<0.001), group III (p<0.001), and group IV (p<0.05) on day 15. In group III the creatinine/height index was higher than in groups I and II (p<0.05). In group IV, creatinine/height index was lower than in group I (p<0.01) and group II (p<0.001). Protein-calorie intake in group IV was higher than others on day 7 (p<0.05). SOFA scores of group IV were higher than the other groups on day 15 (p<0.05). This study demonstrated, that combined route of gln supplementation resulted in the most positive outcome to transferrin, creatine/height index and nitrogen balance (on days 7 and 15) during the catabolic phase of septic patients with malnutrition.

Assessment of knowledge, behaviour and sun protection practices among health services vocational school students.

There has been a significant increase in the cases of skin cancer throughout the world in the last few decades. Although the mortality rate of skin cancer is relatively low, its impact on other health aspects is high and the treatment of undesired aesthetic damage is costly. According to disability-adjusted life year rates (DALY), 1.5 million days are estimated to be lost from people's lives every year worldwide due to ultraviolet (UV) radiation. The purpose of this study was to raise sun health awareness levels among health services vocational school students. A total of 414 students were included in the analysis. A questionnaire form was used to evaluate knowledge, attitudes and behaviours among the survey sample. The average level of knowledge concerning the effects of the sun was found to be 8.64 ± 2.5 out of 15 points. All socio-demographic factors were analysed, but the only significant variables found were age and the possible presence of skin cancer within the immediate family (p < 0.05).

The prevalence and the age at the onset of menopause in Turkish women in rural area.

OBJECTIVE: To find out the prevalence of natural menopause among Turkish women according to age and certain demographic variables in a specific rural area. METHODS: This cross sectional study was carried out in Silivri district of Istanbul, Turkey between January and May 2000. Included in the study were 845 women between the ages of 30-60 years, not undergoing any hormonal replacement, living in the villages of Silivri district, Istanbul, Turkey. The participants were asked for their ages, level of education, number of pregnancies, age at menarche, presence of menstruation, age at the onset of menopause, physical activity outside home and the use of oral contraceptives. Females declaring at least one year of amenorrhea were accepted as being in menopause. RESULTS: The median age for menopause was 47 years. Of the total 845 participants, 326 women were found to be in natural menopause. The prevalence of menopause was estimated as 8.6% for females younger than 40 years, 31.8% for females between the ages 40-45 years and 80.9% among females older than 45 years. Any of the variables questioned in our study have an effect on premature onset of menopause, but we found that never been pregnant (p=0.037, odd ratio (OR)=2.221, 95% confidence interval (CI)=1.048, 4.707) reduces the reproductive period, and the age at menarche younger than 13 prevents early menopause (p=0.000, OR=0.336, 95% CI=0.195, 0.579). Furthermore, both lead to early onset of menopause. Hazard ratios of the variables that have an effect on the onset of early menopause are calculated as 2:10 (95% CI=1.01, 4.39) for those who were never been pregnant and 1:10 for those with the menarche ages over 13 years (95% CI=0.68, 1.78). CONCLUSION: There was a noticeably high percentage of females (8.6%) younger than 40 years who were entering menopause. On the other hand, an early onset of natural menopause among Turkish women living in this rural area was found to be associated with never been pregnant and their age of menarche.

Metformin does not prevent DNA damage in lymphocytes despite its antioxidant properties against cumene hydroperoxide-induced oxidative stress.

Metformin (1-(diaminomethylidene)-3,3-dimethyl-guanidine), which is the most commonly prescribed oral antihyperglycaemic drug in the world, was reported to have several antioxidant properties such as the inhibition of advanced glycation end-products. In addition to its use in the treatment of diabetes, it has been suggested that metformin may be a promising anti-aging agent. The present work was aimed at assessing the possible protective effects of metformin against DNA-damage induction by oxidative stress in vitro. The effects of metformin were compared with those of N-acetylcysteine (NAC). For this purpose, peripheral blood lymphocytes from aged (n=10) and young (n=10) individuals were pre-incubated with various concentrations of metformin (10-50microM), followed by incubation with 15microM cumene hydroperoxide (CumOOH) for 48h, under conditions of low oxidant level, which do not induce cell death. Protection against oxidative DNA damage was evaluated by use of the Comet assay and the cytokinesis-block micronucleus technique. Changes in the levels of malondialdehyde+4-hydroxy-alkenals, an index of oxidative stress, were also measured in lymphocytes. At concentrations ranging from 10microM to 50microM, metformin did not protect the lymphocytes from DNA damage, while 50microM NAC possessed an effective protective effect against CumOOH-induced DNA damage. Furthermore, NAC, but not metformin, inhibited DNA fragmentation induced by CumOOH. In contrast to the lack of protection against oxidative damage in lymphocyte cultures, metformin significantly protected the cells from lipid peroxidation in both age groups, although not as effective as NAC in preventing the peroxidative damage at the highest doses. Within the limitations of this study, the results indicate that pharmacological concentrations of metformin are unable to protect against DNA damage induced by a pro-oxidant stimulus in cultured human lymphocytes, despite its antioxidant properties.

Ranking countries by dental status using the DMFT and FS-T indices.

AIM: To test the hypothesis that the DMFT index does not adequately reflect the dental status as well as the FS-T index by comparing the country rankings of the DMFT and the FS-T indices in 18 and 35-44 year-olds in a range of countries. The FS-T is the number of filled or sound teeth and is a measure of functional status. METHOD: The DMFT data from WHO for 18-year-olds and 35-44-year-olds was used and FS-T index values were estimated for the 18-year-olds for 12 countries and for 35-44 age groups for 30 countries. RESULTS: The ranking by DMFT index scores was lower for developed countries than for developing countries. Despite the relatively high DMFT index in developed countries, their FS-T index was higher and therefore the developed countries ranked higher by FS-T compared to their ranking by DMFT. CONCLUSIONS: These findings suggest that it may be more useful to use the FS-T index with the DMFT index in studies comparing dental status between countries.

Hyperhomocysteinemia: an additional risk factor in white coat hypertension.

The association between homocysteine and sustained hypertension (HT) has been studied. The aim of this study was to assess homocysteine levels in white coat hypertension (WCH) as an indicator of increased risk in the development of cardiovascular diseases. WCH was defined as clinical hypertension and a daytime ambulatory blood pressure of < 135/85 mmHg. Plasma levels of homocysteine were determined in patients with WCH, hypertension, and normotension (NT). The study group included 100 subjects, 33 with WCH (16 males, 17 females) aged 49.1 +/- 1.9; 35 sustained hypertensives (17 males,18 females) aged 48.5 +/- 1.7 and 32 normotensive control subjects (15 males, 17 females) aged 48.8 +/- 2.2. The subjects were matched for age, gender, and body mass index. Patients with a smoking habit, dyslipidemia, or diabetes mellitus were not included in the study. Homocysteine levels were analyzed by ELISA. Plasma homocysteine levels were significantly higher in the WCH group compared to the controls (12.32 +/- 1.07 versus 5.35 +/- 1.38 micromol/L; P < 0.001) and the WCH group had significantly lower homocysteine values than the hypertensives (19.03 +/- 0.76 micromol/L P < 0.001). Total cholesterol and tri-glycerides were not different among the groups. There were no statistically significant differences in urinary albumin excretion (UAE) or creatinine clearance between the three groups. Hypertensive retinopathy was observed in the WCH group, but was less severe and less frequent compared to HTs. LVMI was greater in the WCH group compared to the NTs, but significantly less than HTs. The data demonstrate that WCH is associated with high levels of homocysteine. The increase in homocysteine level in WCH is not as high as in SHT. Since an elevated plasma homocysteine level is a strong risk factor for coronary artery disease and there was target organ damage in our WCH group, we conclude that WCH should not be considered to be an innocent trait.

Potential effects of L-NAME on alcohol-induced oxidative stress.

AIM: Nitric oxide (NO) is a highly reactive oxidant synthesized from L-arginine by nitric oxide synthase (NOS). NO may cause injury through the generation of potent radicals. Nw- nitro-L-arginine methyl ester (L-NAME) is a non-selective inhibitor of NOS. We aimed to evaluate whether L-NAME treatment had protective effects against oxidative stress in rats intragastrically fed with ethanol during a 4 wk-period. METHODS: Thirty-six male Wistar rats were divided into 3 equal groups: group 1 (control group-isocaloric dextrose was given), group 2 (6 g/kg.d ethanol-induced group) and group 3 (both ethanol 6 g/kg.d and L-NAME 500 mg/L in drinking water-given group). Animals were sacrificed at the end of 4 wk-experimental period, and intracardiac blood and liver tissues were obtained. Biochemical measurements were performed both in plasma and in homogenized liver tissues. Alanine amino transferase (ALT), aspartate amino transferase (AST), malondialdehyde (MDA), NO, superoxide dismutase (SOD), catalase (CAT) and glutathione (GSH) levels were measured by spectrophotometry. RESULTS: ALT and AST in group 2 (62 U/L and 128 U/L, respectively) were higher than those in group 1 (24 U/L and 38 U/L) and group 3 (37 U/L and 81 U/L) (P<0.001 for both). Plasma and tissue levels of MDA in group 2 (4.66 micromol/L and 0.55 nmol/mg protein) were higher than in group 1 (2.65 micromol/L and 0.34 nmol/mg protein) and group 3 (3.43 micromol/L and 0.36 nmol/mg protein) (P<0.001 for both). Plasma and liver tissue levels of NO in group 2 (54.67 micromol/L and 586.50 nmol/mg protein) were higher than in group 1 (34.67 micromol/L and 435.33 nmol/mg protein) and group 3 (27.50 micromol/L and 412.75 nmol/mg protein) (P<0.001 for both). Plasma and liver tissue SOD activities in group 2 (15.25 U/mL and 5.38 U/ mg protein, respectively) were lower than in group 1 (20.00 U/mL and 8.13 U/ mg protein) and group 3 (19.00 U/mL and 6.93 U/ mg protein) (P<0.001 for both). Plasma and liver tissue CAT activities in group 2 (145 U/mL and 37 U/ mg protein, respectively) were lower than in group 1 (176 U/mL and 73 U/mg protein) and group 3 (167 U/mL and 61 U/mg protein) (P<0.001 for both). Meanwhile, erythrocytes and liver tissue levels of GSH in group 2 (4.12 mg/g Hb and 5.38 nmol/mg protein, respectively) were lower than in group 1 (5.52 mg/g Hb and 4.49 nmol/mg protein) and group 3 (5.64 mg/g Hb and 4.18 nmol/mg protein) (P<0.001 for both). CONCLUSION: Our findings show that L-NAME may produce a restorative effect on ethanol-induced liver damage via decreasing oxidative stress and increasing antioxidant status.

The effect of hormone replacement therapy on oxidized low density lipoprotein levels and paraoxonase activity in postmenopausal women.

Oxidized low-density lipoproteins (oxLDL) are involved in initiation of atherosclerosis. Paraoxonase 1 (PON1), the isoenzyme of PON, is located on high-density lipoprotein (HDL) and protects against the oxidative modification of both HDL and LDL by hydrolysing lipid peroxides. Postmenopausal women have a higher risk of cardiovascular events compared with premenopausal women. The aim of this clinical study was to evaluate the effects of hormone replacement therapy (HRT) on oxLDL and PON1 activity in menopausal status. The subjects included 45 healthy postmenopausal women, aged 43 to 57 years, and 30 premenopausal women with regular cycles, aged 31 to 40 years. None of the participating women had a history of hypertension, diabetes mellitus or medications known to affect the cardiovascular system. Twenty five of the postmenopausal women received conjugated estrogens at dose of 0.625 mg/day per oral (P.O.) and medroxyprogesterone acetate (MPA) (1 mg/d P.O.) for 10 days. Twenty of the postmenopausal women received 17-beta estradiol (2 mg/day) and norethysterone acetate (NETA) (5 mg/day P.O.) for 10 days. Fasting blood samples were taken from premenopausal women (baseline) and postmenopausal women after HRT of 6 months to determine serum malondialdehyde (MDA), oxLDL, and PON1 activity. After 6-month therapy, MDA and oxLDL levels showed a statistically significant reduction in the treated groups versus baseline (p <0.05), whereas PON1 activities were increased (p <0.05). Increase in oxidative status may be one of the factors leading to reduction in PON1 activity and increased oxLDL in menopause. HRT may be effective on oxidative stress and lipoprotein metabolism in apparently healthy postmenopausal women.