The effects of sildenafil on smoke induced lung inflammation in rats.

OBJECTIVE: Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5 and has anti-inflammatory effects. The aim of the study was to evaluate the effects of sildenafil on smoke-induced lung inflammation. MATERIAL AND METHODS: Twenty-nine Wistar-Albino rats were enrolled into 3 groups as control, smoker and sildenafil groups. Smoker and sildenafil groups were exposed to cigarette smoke for 2 hours per day for 8 weeks. Sildenafil 10 mg/kg/day was administered to the sildenafil group by nasogastric lavage after smoke exposure. The degree of lung inflammation was scored histopathologically for each group. RESULTS: The inflammation score was 7.25±0.93 in the control group, 8.18±1.21 in the smoker group and 7.08±1.66 in the sildenafil group. There was a non-significant decrease of inflammation score in sildenafil group with respect to control or smoker groups. While there was no significant difference of oedema, hyperemia, hemorrhage and mononuclear cell infiltration scores among the groups, it was found that the thickness of interalveolar septum and alveolar distortion was decreased in sildenafil group. However this decrease was not statistically significant. CONCLUSION: This study suggests that sildenafil might reduce smoke-induced inflammation in rat lungs. Future studies are needed in order to investigate the clinical effectiveness of this finding in smoking related lung diseases.

Evaluation of microvascular complications in patients with new diagnosis type 2 diabetes.

OBJECTIVE: The incidence of microvascular complications such as diabetic retinopathy, diabetic nephropathy and diabetic neuropathy has increased in newly diagnosed diabetes patients. The aim of this study was to determine the factors affecting the incidence of microvascular complications in newly diagnosed patients with type 2 diabetes. PATIENTS AND METHODS: This study was conducted on 97 newly diagnosed type 2 DM patients who applied to Malatya Training and Research Hospital Endocrinology outpatient clinic between September 2021 and July 2022. The patient files were reviewed retrospectively and their age, height, weight, body mass index (BMI), fasting/postprandial blood glucose measurements, serum HDL cholesterol, LDL cholesterol, total cholesterol, triglyceride, HbA1c levels, glomerular filtration rate (GFR) and complications of retinopathy, nephropathy, and neuropathy were recorded. Mann-Whitney U, t-test, Kruskal-Wallis, Binary logistic regression analysis, and Chi-square analysis were used to analyze the data. RESULTS: The mean age of the patients included in the study was 47.40±7.78 (min: 23 - max: 62). Non-proliferative retinopathy was observed in 74.2% of patients, proliferative retinopathy in 25.8%, diffuse neuropathy in 49.5% and mononeuropathy was detected in 9.3% of them. Fasting blood glucose, postprandial blood glucose and HbA1c values were found to be higher in patients with proliferative retinopathy than in patients without retinopathy. Fasting blood glucose, postprandial blood glucose and HbA1c values were found to be higher in patients with neuropathy than in patients without neuropathy. In addition, patients with mononeuropathy had statistically significantly higher HbA1c values than patients with diffuse-type neuropathy. It was found that the urine protein values of patients with mononeuropathy were significantly higher than those without neuropathy and those with diffuse neuropathy. Each 0.677-unit increase in HbA1c increases the risk of proliferative retinopathy 1.98-fold, and every 1.018-unit increase increases the risk of neuropathy 2.76-fold. Proliferative retinopathy and mononeuropathy rates were discovered to be higher in patients with a family history. CONCLUSIONS: Microvascular complications are common in newly diagnosed T2DM patients and an increase in HbA1c is a significant risk factor. Every newly diagnosed T2DM patient should be screened for microvascular complications.

Multiple factors influencing mortality in hemodialysis patients.

OBJECTIVE: Both decreased food intake and elevated inflammation contribute to malnutrition in hemodialysis (HD) patients. Malnutrition, inflammation, anthropometric measurements, and other comorbidity factors were investigated in this study as potential indicators of mortality in HD patients. PATIENTS AND METHODS: By measuring geriatric nutritional risk index (GNRI), malnutrition inflammation score (MIS), and prognostic nutritional index (PNI), 334 HD patients' nutritional status was assessed. Through the use of four different models and logistic regression analysis, the predictors of each individual's survival status were examined. The models were matched using the Hosmer-Lemeshow test. On the survival of patients, the effects of malnutrition indices in Model 1, anthropometric measurements in Model 2, blood parameters in Model 3, and sociodemographic characteristics in Model 4 were investigated. RESULTS: Five years later, 286 individuals were still on hemodialysis. Patients who had a high GNRI value had a lower mortality rate in Model 1. The body mass index (BMI) value of the patients was found to be the best predictor of mortality in Model 2, and it was found that patients with high muscle percentage had a lower mortality risk. The difference in urea level measured at the beginning and end of hemodialysis was found to be the most potent predictor of mortality in Model 3, although C-reactive protein (CRP) level was also discovered to be one of the best predictors for this model. The final model, Model 4, revealed that mortality was lower in women than in men and that income status was a reliable predictor of mortality estimation. CONCLUSIONS: The best indicator of mortality in hemodialysis patients is the malnutrition index.

Galectin-1 as a potential diagnostic biomarker in polycystic ovary syndrome.

OBJECTIVE: This study was aimed at comparing the routine laboratory parameters and Galectin-1 levels of control and polycystic ovarian syndrome patients. PATIENTS AND METHODS: 88 patients diagnosed with polycystic ovary syndrome and 88 healthy controls were considered for the study. Age groups of the patients ranged from 18 to 40. Serum TSH, Beta HCG, glucose, insulin, HOMA-IR, Hb1A1c, triglyceride, total cholesterol, LDL FSH, LH, E2, prolactin, testosterone, SHBG, DHESO4, HDL, Gal-1 levels were analyzed for each subject. RESULTS: FSH, LH, LH/FSH, E2, prolactin, testosterone, SHBG, DHESO4, HDL and Gal-1 values of the subjects included in the study were statistically significantly different between the groups (p<0.05). Gal-1 and DHESO4 showed a strong positive connection (p=0.05). The sensitivity of Gal-1 level in PCOS patients was calculated as 0.997 and specificity as 0.716. CONCLUSIONS: High levels of Gal-1 in PCOS patients suggest that it increases due to overexpression in response to inflammation.

Outcome of photodynamic therapy in choroidal neovascularization due to pathologic myopia and related factors.

To evaluate the outcome of photodynamic therapy (PDT) and the factors influencing its outcome in patients with subfoveal choroidal neovascularization (CNV) due to pathologic myopia. Twenty-three eyes of 21 consecutive patients who received PDT for subfoveal CNV due to pathologic myopia and who were followed for >12 months were included in the study. The relationship between the factors that might affect the treatment outcome were evaluated. Mean age was 48.7 ± 16.0 years (23-74 years). Mean follow-up was 23.2 ± 7.7 months (15-41 months). Mean logMAR visual acuity was 0.85 ± 0.24 before treatment, 0.89 ± 0.37 at 12 months, and 0.92 ± 0.46 at the final visit. Mean logMAR visual acuity did not change significantly at 12 months or at the final visit (P = 0.47 and 0.36, respectively). The baseline visual acuity strongly correlated with the final visual acuity (P = 0.001). Age showed an inverse correlation with change in logMAR visual acuity at 12 months (P = 0.01). PDT prevented significant visual loss in eyes with subfoveal CNV due to pathologic myopia. Better initial visual acuity resulted in better final visual acuity. Younger age was correlated with better treatment outcome at 12 months.

Comparison of the effect of liraglutide and metformin therapy on the disease regulation and weight loss in obese patients with Type 2 diabetes mellitus.

OBJECTIVE: Obesity and Type 2 diabetes mellitus are growing health problems all over the world. The aim of this study is the comparison of 3 mg liraglutide and metformin combination, metformin monotherapy on the blood glucose regulation, weight loss and lipid panel in the patients with Type 2 diabetes mellitus whose BMI is ≥ 30 kg/m2. PATIENTS AND METHODS: 276 patients included in the study were divided into two groups (1:1); liraglutide (3 mg) + metformin combination (L+M) and metformin monotherapy (M) (2x1,000 mg) (exercise and diet were regulated in both groups). Patients' body composition measurements were performed and fasting blood glucose, postprandial blood glucose, HbA1c, triglyceride, total cholesterol, LDL, HDL levels were measured by TANITA device prior to the therapy and in the week 12 of the therapy. RESULTS: The average age of 276 patients included in the study was 49.70±7.93 years. A statistically significant decrease was noted in weight, BMI, fasting blood glucose, postprandial blood glucose, HbA1c values of both groups at the end of the third month. 11.3 kg of weight was lost on average in L+M group (-12.3%); 4.5 kg of weight was lost in the monotherapy group (-4.9%). A decrease of 14.3% was seen in the body fat mass, 2.1% in the muscle mass in L+M group and a decrease of 4.4% in the body fat mass and 6.1% in the muscle mass in the monotherapy group. The decrease in the body fat was higher at a statistically significant level in L+M group and the decrease in the muscle mass was higher in the monotherapy group. HbA1c decreased by 17.9% in L+M group (-1.49±0.46, Cohen's d=2.68), 5.3% in the monotherapy group (-0.37±0.26, Cohen's d=0.90). The decrease in TG, total cholesterol, LDL was higher at a statistically significant level in L+M group. The increase in HDL level was higher in the monotherapy group (L+M=22.7%, M=35.4%). A weight loss that was over 10% occurred in 4.3% of the patients in the monotherapy group and 68.1% of the combined therapy group at the end of 12 weeks (95% C.I. OR=19.49-121.65). CONCLUSIONS: The effect of the combination of liraglutide 3 mg and metformin on blood glucose regulation, weight loss (fat loss, muscle conservation) was found to be superior to the metformin monotherapy in the obese patients with Type 2 diabetes mellitus according to the early period results.

25-Gauge sutureless vitrectomy with oblique sclerotomies for the management of retinal detachment in pseudophakic and phakic eyes.

PURPOSE: To evaluate the anatomic and functional outcomes of 25-gauge sutureless vitrectomy in primary treatment of noncomplex retinal detachments (RD) in pseudophakic and phakic eyes. METHODS: In this interventional clinical case series, 23 pseudophakic and 13 phakic eyes with total RDs with proliferative vitreoretinopathy grade A/B underwent primary 25-gauge sutureless vitrectomy with oblique sclerotomies and gas endotamponade. Eyes with minimum follow-up of 6 months were evaluated. Main outcome measures were single surgery and final reattachment rates, complications, and changes in visual acuity (VA). RESULTS: Mean duration of visual loss was 14.65+/-12.57 and 22.46+/-18.95 days in pseudophakic and phakic eyes, respectively. Eighteen (78.26%) pseudophakic eyes and 12 (92.30%) phakic eyes had macular detachment. In all eyes, 25-gauge sutureless vitrectomy was completed without complication. Mean follow-up period was 11.00+/-6.63 months. Single surgery and final retinal attachment rates were 91.30% and 95.65% in pseudophakic eyes and 61.53% and 84.61% in phakic eyes, respectively (p=0.073, p=0.539). In both groups, mean VA increased significantly at postoperative month 1 (p<0.05) and at the last visit (p<0.001). Transient hypotony was detected in 2 pseudophakic and 3 phakic eyes with spontaneous resolution. Two (15.38%) phakic eyes had cataractous changes. CONCLUSIONS: In this study, 25-gauge sutureless vitrectomy resulted in higher single surgery and final anatomic success rates in primary treatment of noncomplex RDs in pseudophakic versus phakic eyes, with commensurate increase in VA.

The effects of sildenafil on smoke induced lung inflammation in rats

Objective: Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5 and has anti-inflammatory effects. The aim of the study was to evaluate the effects of sildenafil on smoke-induced lung inflammation. Material and Methods: Twenty-nine Wistar-Albino rats were enrolled into 3 groups as control, smoker and sildenafil groups. Smoker and sildenafil groups were exposed to cigarette smoke for 2 hours per day for 8 weeks. Sildenafil 10 mg/kg/day was administered to the sildenafil group by nasogastric lavage after smoke exposure. The degree of lung inflammation was scored histopathologically for each group. Results: The inflammation score was 7.25±0.93 in the control group, 8.18±1.21 in the smoker group and 7.08±1.66 in the sildenafil group. There was a non-significant decrease of inflammation score in sildenafil group with respect to control or smoker groups. While there was no significant difference of oedema, hyperemia, hemorrhage and mononuclear cell infiltration scores among the groups, it was found that the thickness of interalveolar septum and alveolar distortion was decreased in sildenafil group. However this decrease was not statistically significant. Conclusion: This study suggests that sildenafil might reduce smoke-induced inflammation in rat lungs. Future studies are needed in order to investigate the clinical effectiveness of this finding in smoking related lung diseases.