Evaluation of the effect of 9.5/11.5-fr ureteral access sheath use on acute kidney injury with the myo-inositol oxygenase biomarker in patients undergoing retrograde intrarenal surgery: a prospective, randomized, and controlled study.

INTRODUCTION: We aimed to investigate whether a low intrarenal pressure provided by ureteral access sheath (UAS) use had a positive effect on the prevention of acute kidney injury through the evaluation of the myo-inositol oxygenase (MIOX). MATERIAL AND METHODS: The patients were divided into two groups according to whether a 9.5/11.5-Fr UAS was used during retrograde intrarenal surgery (RIRS): UAS group and non-UAS group. RIRS was performed under gravity irrigation and manual pumping was not used. For the measurement of MIOX, 5 cc blood samples were taken from the patients preoperatively and four hours postoperatively. RESULTS: Operation time and hospital stay were significantly longer in the UAS group. The mean preoperative and postoperative MIOX values were 0.77 ± 0.36 ng/ml and 0.74 ± 0.38 ng/ml, respectively, in the UAS group, and 0.74 ± 0.31 ng/ml and 0.83 ± 0.40 ng/ml, respectively, in the non-UAS group. The mean MIOX change was -0.29 ± 0.36 in the UAS group and 0.08 ± 0.44 in the non-UAS group, indicating no significant difference between the groups. CONCLUSION: Even if UAS is not used, significant acute kidney injury is not observed under gravity irrigation and therefore, if we avoid manual pumping, the intrarenal pressure remains low, thus potentially rendering the use of 9,5/11,5-Fr UAS unnecessary.

The Relationship Between Vitamin-D Deficiency and Protein Oxidation Among Obese Children.

Aim: The aim of the study is to examine the relationship between obesity, Vitamin-D deficiency, and protein oxidation. Methods: Thiol-disulfide homeostasis, Vitamin-D, ischemia modified albumin, insulin, and lipid levels were compared among obese, pre-obese and normal-weight healthy children. Results: A total of 136 children (69 boys and 67 girls) were included in the study. The vitamin-D levels of obese children were lower than those of pre-obese and normal weight (p < 0.05). In the normal weight group, total thiol and native thiol were lower in the pubertal period than in adolescence; were higher in those with sufficient Vitamin-D level than those with insufficient and deficient Vitamin-D (p < 0.05). Vitamin-D level was lower in pre-obese girls than boys (p < 0.05). Those with high triglycerides had high disulfide/total thiol, disulfide, and disulfide/native thiol and low native thiol/total thiol (p < 0.05). Conclusion: Thiol-disulfide homeostasis is negatively affected by low vitamin D levels, pubertal period and high triglyceride levels.

How do routine laboratory tests change in coronavirus disease 2019?

How the routine laboratory tests change in terms of coronavirus disease 2019 (COVID-19) was retrospectively analyzed in a large group of patients. Biochemical, hematological and inflammatory variables of a totaly 555 (n = 532 in non-intensive care unit (non-ICU), n = 23 in ICU) patients diagnosed with COVID-19 were analyzed accessing them through the laboratory information system. White blood cell (WBC), neutrophil (NEU), platelet large cell ratio, neutrophil to lymphocyte ratio (NLR), derived NLR (d-NLR), aspartate aminotransferase, urea, creatine kinase (CK) myocardial band (CK-MB), procalcitonin (PCT) values were high whereas lymphocyte (LYM), eosinophil, red blood cells (RBC), hemoglobin, lymphocyte to monocyte ratio, estimated glomerular filtration rate values were low in the ICU group when compared with non-ICU. WBC, NEU, red cell distribution width, alanine transaminase, creatinine, urea, CK-MB, CK, direct bilirubin, lactate dehydrogenase, glucose, C-reactive protein, erythrocyte sedimentation rate, ferritin, D-dimer, PCT and international normalized ratio values increased while RBC, hemoglobin, hematocrit, mean corpuscular volume and total bilirubin values decreased in a significant proportion of patients in both groups based on the normal reference ranges. LYM count was found to be low in a significant number of patients (57.5%) especially in the ICU group and as an important risk factor and diagnostic parameter on admission to ICU (OR: 125, AUC: 0.74). Routine laboratory tests provide important information in terms of both diagnosis and severity of COVID-19. Lymphopenia is a condition that should be monitored which indicates the severity of the disease.

Serum SCUBE-1 levels in patients with diabetic retinopathy.

PURPOSE: Signal peptide-CUB-Epidermal growth factor-like domain-containing protein 1 (SCUBE-1) is a protein expressed on the cell surface of endothelial cells and platelets. We aimed to determine the alterations in SCUBE-1 levels in patients at different stages of diabetic retinopathy (DR). MATERIALS AND METHODS: Participants were grouped into 4 regarding the presence and stage of diabetic retinopathy as follows: control group (n 32), patients without DR (n 39), patients with background DR (n 42) and patients with proliferative DR (n 55). Age, gender, duration of diabetes, fasting blood glucose levels, serum hemoglobin A1c (HbA1c), SCUBE-1 and malondialdehyde (MDA) levels of the patients were recorded. Central macular thickness and central macular volume were recorded and compared between groups. RESULTS: Totally 136 patients with diabetes mellitus and 32 control cases were included in the study. There is a significant increase in SCUBE-1 and MDA levels with an advance in DR. In correlation analysis, there was only a significant correlation present between serum SCUBE-1 and MDA levels (p 0.001) but not with other parameters. CONCLUSION: For the first time in literature, we determined a significant increase in SCUBE-1 levels in patients with DR. Moreover, with an advance in DR, SCUBE-1 levels were also increasing.

Could interleukin-33 and its suppressor of tumorigenicity 2 (ST2) receptor have a role in cervical human papillomavirus (HPV) infections?

Why most women can clear human papillomavirus (HPV) infections while others can develop permanent infections. The stimulation of immunotolerance of the immune system of the host by the persistent HPV infection may be the answer to this question. Interleukin-33 (IL-33) may play a role in the pathogenesis of HPV infection, this hypothesis was thought to be due to the rapid release of IL-33 from damaged cells following tissue damage, necrosis, and activation of the inflammasome. Thus, in this study, the role of IL-33/suppressor of tumorigenicity 2 (ST2) was emphasized in HPV positive and HPV negative cervical tissues. A total of 80 were assessed. The reduced levels of IL-33 and ST2 are associated with cervical HPV infections. There was a statistically significant 42% positive correlation between IL-33 and ST2 in the HPV-positive group. Surprisingly, our data showed no significant difference between the expression levels of IL-33 or ST2 and working status, type of delivery, pre- and post-operative pathology, cigarette, educational status, locality, birth control method, gynecological, and colposcopic findings. We found that as a result of our study; low IL-33 and ST2 levels were associated with HPV infections.

Thiol-Disulfide Homeostasis, Serum Ferroxidase Activity, and Serum Ischemia Modified Albumin Levels in Childhood Iron Deficiency Anemia.

Aim: The aim is to compare the markers of oxidative stress in iron deficient children to that of non-anemic children. Method: Serum thiol-disulfide level, ferroxidase activity and ischemia-modified albumin (IMA) levels were compared between iron deficiency anemia (IDA) and non-anemic children. Results: A total of 117 children, 66 with IDA and 51 non-anemic children were included in the study. Disulfide, disulfide/native thiol, and disulfide/total thiol levels were significantly higher in the IDA group (p: 0.001). Serum ferroxidase levels were significantly lower in the IDA group (p: 0.04); but there was no significant difference between the two groups regarding serum IMA levels (p: 0.42). There was a weak negative correlation between disulfide and serum hemoglobin (p: 0.004), iron (p: 0.041), and ferritin (p: 0.023) levels while there was a weak positive correlation between ferroxidase activity and these parameters. Conclusion: There is an increased protein oxidation in children with IDA compared with non-anemic controls.

Thiol-Disulfide Homeostasis, Serum Ferroxidase Activity, and Serum Ischemia Modified Albumin Levels in Neonatal Jaundice.

AIM: Hyperbilirubinemia causes oxidative stress. METHOD: We evaluated three oxidative stress markers in hyperbilirubinemic neonates (native/total thiol levels, serum ferroxidase activity and ischemia modified albumin (IMA), comparing these levels to levels in a control group to determine which indicators were the most sensitive. RESULTS: Serum from 124 term infants (67 with pathologic jaundice and 57 controls) were evaluated. Native/total thiol ratio was significantly lower (p:0.021) while disulfide levels were significantly higher (p:0.001) in the jaundiced group. There was no significant difference in ferroxidase (p:0.603) or IMA (p:0.251) levels. CONCLUSION: Altered thiol/disulfide homeostasis in the favor of disulfide indicates augmented oxidative stress in jaundiced term infants. The lack of alteration in ferroxidase or IMA levels suggests these latter alterations take more time or more severe oxidative stress to become altered or are not as sensitive as the thiol/disulfide ratio to detect oxidative stress states.

Could Endocan, a Marker of Inflammation and Endothelial Dysfunction, be a New Diagnostic Marker for Fibromyalgia?

BACKGROUND: Although the pathophysiology of fibromyalgia has not yet been fully clarified, inflammation and endothelial dysfunction have been suggested to occur in patients with fibromyalgia. In recent years, endocan has been reported as an important biomarker for inflammation and endothelial dysfunction. In this study, we investigated this mechanism by measuring the serum endocan levels in fibromyalgia patients. METHODS: The serum samples collected from 37 female patients diagnosed with fibromyalgia for the first time and 43 healthy women were analysed in terms of the endocan levels and laboratory parameters, and the values from the two groups were compared. RESULTS: In the patient group, the serum endocan level was found to be higher (p < 0.0001). Endocan had a significantly high sensitivity and specificity for the diagnosis of fibromyalgia (area under curve: 0.897, cutoff value: 9.81 ng/mL, sensitivity: 88.5%, specificity: 89.7%). CONCLUSIONS: Subclinical inflammation and endothelial dysfunction are important in the pathophysiology of fibromyalgia. Increased endocan not only elucidates this mechanism but also presents as an important potential marker for fibromyalgia.

Does myo-inositol oxygenase, the only enzyme to catalyze myo-inositol in vivo, play a role in the etiology of polycystic ovarian syndrome?

In polycystic ovary syndrome (PCOS), myo-inositol (MI) supplements have shown many beneficial effects. In this study, therefore, we aimed to investigate the serum level of myo-inositol oxygenase (MIOX), which is the only enzyme catalyzing MI in vivo, in patients with PCOS. Serum MIOX enzyme levels and other laboratory parameters were compared between sixty patients, who were diagnosed with PCOS for the first time, and sixty healthy individuals at similar age and sex. MIOX serum levels were not different between two groups (p = 0.7428). MIOX median and 95% CI were 19.4 and 10.6-39.1 in the control group and 16.4 and 7.6-46.2 in the patient group respectively. Demographic data, biochemical and hematological parameters, hormone parameters were not different except from the lymphocyte count between the two groups. Lymphocyte count was higher in the patient group. Although the ratio of LH/FSH was higher in the patient group, it was not statistically significant. Our results suggest that serum MIOX levels do not change in PCOS. It was, therefore, concluded that MI deficiency observed in PCOS was not related to the level of MIOX enzyme which cleaves MI.

Vitamin D supplementation does not improve plasma thiol/disulfide homeostasis.

BACKGROUND: Impairment of thiol/disulfide homeostasis, as well as vitamin D deficiency, are responsible for the pathophysiology of many acute and chronic diseases. This study examined the relationship between thiol/disulfide homeostasis and vitamin D level and supplementation. METHODS: A total of 203 healthy children were included in the study. The participants were divided into four groups according to 25-hydroxyvitamin D (25(OH)D) level: group 1, severe deficiency (<10 ng/mL); group 2, deficiency (10-20 ng/mL); group 3, insufficiency (20-30 ng/mL); and group 4, sufficiency (≥30 ng/mL). Furthermore, group 5 was defined as being on vitamin D supplementation. RESULT: Native thiol was lower in group 5 than in groups 2-4 (P = 0.003). Disulfide was higher in groups 1, 4 and 5 than groups 2 and 3 (P < 0.001). Total thiol was lower in group 5 than in group 4 (P = 0.032). The ratio of native thiol/total thiol was lower in groups 1 and 5 compared with groups 2 and 3, and in group 4 compared with group 3 (P < 0.001). The ratios of disulfide/total thiol and disulfide/native thiol were higher in groups 1 and 5 than in groups 2 and 3 whereas only the disulfide/total thiol ratio was higher in group 4 than in group 3 (P < 0.001). CONCLUSIONS: In healthy children, severe deficiency of vitamin D causes impairment of thiol/disulfide homeostasis and increases protein oxidation, which cannot be reversed by external vitamin D supplementation.

The Effect of the 50 g Glucose Challenge Test on The Thiol/Disulfide Homeostasis in Pregnancy.

AIM: A 50 g glucose challenge test (GCT) is recommended for screening all pregnant women for gestational diabetes mellitus. In this study, the effect of GCT on the thiol/disulfide balance was investigated. METHODS: One-hundred women that underwent a 50 g GCT at 24-28 weeks of gestation (63 positive and 37 negative results) were evaluated in terms of thiol/disulfide in serum samples at test hours 0 and 1. RESULTS: Compared to the baseline values (hour 0), after the glucose load (hour 1), the thiol and native thiol/total thiol (p < 0.0001) of the GCT-positive women were reduced whereas the values of glucose, disulfide, disulfide/native thiol, disulfide/total thiol (p < 0.0001) and total thiol increased (p = 0.018). CONCLUSION: In GCT-positive pregnant individuals, the glucose load increases oxidative stress by changing the thiol/disulfide homeostasis. Such an effect is not observed in healthy pregnancies.

Evaluation of the effect of Retrograde Intrarenal Surgery with Myo-Inositol Oxygenase.

OBJECTIVE: To investigate the effect of retrograde intra-renal surgery (RIRS) on kidneys using the myo-inositol oxygenase (MIOX) enzyme. MIOX is a renal tubular-specific novel marker for the early diagnosis of acute kidney injury. METHODS: A total of twenty seven individuals that had undergone RIRS to treat kidney stones were included in the study. Biochemical tests were performed on serum samples collected immediately before RIRS (hour 0) and at the 6th and 24th hours after the surgery. RESULTS: The creatinine value at hour 6 was lower than the baseline (hour 0) value (p = 0.0305). Cystatin C at hour 6 was lower than the value measured at hour 24 (p = 0.0142). Similarly, MIOX was lower at hour 6 compared to hour 24 (p = 0.0214). MIOX/creatinine at hour 6 was lower than the value calculated at hour 24 (p = 0.0348). The basal values of MIOX and creatinine were found to have a positive correlation (correlation coefficient r = 0.5946, p = 0.0035). CONCLUSIONS: Similar to the serum creatinine, the serum MIOX level provides information about kidney functions. RIRS was confirmed to be a safe procedure for the treatment of acute kidney injury with no negative effects on the kidneys.

Does extracorporeal shockwave lithotripsy therapy affect thiol-disulfide homeostasis?

OBJECTIVE: Extracorporeal Shockwave Lithotripsy (ESWL) is a non-invasive method that is effective at crushing stones in the upper urinary tract. Disturbance of the thiol/disulfide homeostasis, in favor of the disulfide, has been shown to be involved in the disease pathogenesis. METHODS: A total of 36 individuals that underwent ESWL had blood samples collected before ESWL (0hrs), 6hrs, and one week after the ESWL. Sera native and total as wells as disulfide amount was measured using an automated method sodium borohydrate (NaBH4) reduction. In addition, Ischemia Modified Albumin (IMA) levels were measured using colorimetric assay method. RESULTS: Native thiol level was reduced at the 6th hour following ESWL compared to baseline. While the ratios of disulfide level, Disulfide/Total Thiol (DTT), Disulfide/Native Thiol (DNT) and IMA level were increased at the 6th hour following ESWL compared to baseline, they were found to be similar with their baseline values at the end of 1st week. Total thiol and native /total thiol did not show any significant change. CONCLUSIONS: ESWL treatment disrupts thiol/disulfide homeostasis and the structure of albumin at the acute term. Therefore, it increases protein oxidation and leads to increased oxidative stress. However, this state is transient and returns to normal within the proceeding days.

Analysis of Isotretinoin-Induced Alterations in the Levels of Plasma Trace Elements: Investigation of the Relationship Between Magnesium, Phosphorus, Potassium, Zinc, and Treatment-Related Side Effects.

Isotretinoin is an effective treatment against acne vulgaris, but it also causes many side effects during and after the treatment. The relationship between the changes in the levels of plasma trace elements of patients with AV after 3 months of isotretinoin treatment and the side effects was investigated in the study. Plasma samples of 35 patients were collected before and after isotretinoin treatment. Samples were analyzed by Inductively Coupled Plasma-Mass Spectrometer. After treatment, the levels of phosphorus, magnesium, and zinc in plasma increased statistically, while the level of potassium decreased (p < 0.05). The treatment had differing effects on zinc levels based on the gender of the individuals. With treatment, the levels of zinc in the plasma of men showed a greater increase compared to women (p = 7.3e-04). Additionally, the correlation matrix analysis revealed a strong correlation (R > 0.8) between magnesium and calcium. According to the study results, the change in phosphorus and potassium levels shows that isotretinoin affects kidney functions. The results suggest that phosphorus, potassium, magnesium, and zinc are associated with fatigue, dry skin and chapped lips, hair loss, and sebum secretion, respectively. Consequently, the study emphasizes the need for a comprehensive pre-treatment assessment, including monitoring of liver and kidney function as well as the levels of phosphorus and potassium in patients.

Comparison of serum Kim-1 and Miox levels in patients that underwent percutaneous nephrolithotomy and flexible ureterorenoscopy.

OBJECTIVE: Percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) are common surgical methods in the treatment of kidney stones. Possible effects on kidneys are an important factor in determining the surgical procedure and the surgical method. In our study, kidney injury molecule-1 (KIM-1) and myo-inositol oxygenase (MIOX) were used to compare acute kidney injury in patients that underwent PNL and RIRS. MATERIAL AND METHOD: Eighty patients aged 20-75, who underwent PNL or RIRS in our urology clinic between November 2018 and February 2020 were included in the study. In this prospective study, the demographic characteristics, stone size, operation time, preoperative and postoperative hemoglobin and biochemistry values of the patients were recorded. About 5 cc blood samples taken from the patients before the operation and at the fourth hour after the operation were centrifuged and kept at -80°C, and the KIM-1 and MIOX levels were measured in the biochemistry department. RESULTS: There was no difference between the groups in terms of demographic data; however, the operation time and length of hospital stay were significantly longer in the PNL group. The mean increase in MIOX was 10.583 ± 9.73 and 7.501 ± 16.46 ng/ml in the PNL and RIRS groups, respectively. Although there was a statistically significant increase in both groups, this increase was greater in the PNL group. A significant increase was observed only in the PNL group in the postoperative period (p = 0.003). DISCUSSION AND CONCLUSION: The findings of the study suggest that the PNL procedure causes more damage to the kidneys than RIRS.

Assessing the nitric oxide and asymmetric dimethylarginine levels in lifelong premature ejaculation: A prospective study.

OBJECTIVE: To evaluate nitric oxide (NO) and asymmetric dimethylarginine (ADMA) levels in men with premature ejaculation (PE), which is a common condition that adversely affects quality of life. MATERIAL AND METHOD: Of the 20-50-year old men presenting to the urology clinic, who were married or had regular sexual intercourse, 40 that were diagnosed with lifelong PE according to the Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculation latency time (IELT) measured by a stopwatch were included in the study. The results of the PE group were compared to those of the control group formed with 40 healthy hospital personnel. Venous blood samples were centrifuged and stored at -80°C. The NO and ADMA values were compared between the individuals with and without PE. RESULTS: There was no statistically significant difference between the groups in terms of age, body mass index (BMI), and The International Erectile Dysfunction Index-5 (IIEF-5) questionnaire scores. The NO and ADMA values were significantly lower in the PE group than in the control group (29.76±13.26µmol/L vs. 48.27±22.71µmol/L; p<0.001 and 1.01±0.49nmol/ml vs. 1.83±1.06nmol/ml; p<0.001, respectively). There was a significant correlation between IELT and NO levels (r=0.407, p=0.001). CONCLUSION: Our study can contribute to the explanation of the pathophysiology of PE having unclear etiology and treatment. Further studies on these molecules with larger case series are required for the diagnosis and treatment of PE.

What is the impact and efficacy of routine immunological, biochemical and hematological biomarkers as predictors of COVID-19 mortality?

It remains important to investigate the changing and impact of routine blood values (RBVs) in order to predict mortality and follow an appropriate treatment in COVID-19 patients. In the study, the importance of RBVs in the mortality of patients with COVID-19 was investigated. The changes in the biochemical, hematological, and immunological parameters of patients who recovered (n = 4364) and died (n = 233) from COVID-19 over time and their relationship with the mortality of the disease were evaluated retrospectively. Odds ratios of the parameters affecting one-month mortality were calculated by running multiple-logistic-regression analysis. The cut off values and diagnostic efficiencies of the parameters that posed a risk for mortality were obtained via receiver operating curve analysis. It was determined that the C-reactive protein (CRP), D-dimer, procalcitonin, erythrocyte-sedimentation-rate (ESR), troponin values were at abnormal levels until death occurred in the patients who died. In addition, the procalcitonin levels were consistently high in patients who died. The patients who died generally had a sustained increase in their leukocyte and neutrophil levels and biochemical variables, and an ongoing decrease in lymphopenia and eosinopenia levels. Although significant changes were observed in liver function tests, cardiac troponin, hemogram values, kidney function tests and parameters related to inflammation in deceased patients, high ESR, international-normalized-ratio (INR), prothrombin-time (PT), CRP, D-dimer, ferritin and red-cell-distribution width (RDW) values, respectively, were the most effective predictive mortality risk biomarkers of COVID-19. In addition, neutrophilia, leukocytosis, thrombocytopenia, erythrocytopenia were other risk predictors of mortality. Indicators was found in this study can be successfully used to predict mortality from COVID-19.

COVID-19 is more dangerous for older people and its severity is increasing: a case-control study.

Coronavirus disease 2019 (COVID-19) triggers important changes in routine blood tests. In this retrospective case-control study, biochemical, hematological and inflammatory biomarkers between March 10, 2020, and November 30, 2020 from 3969 COVID-19 patients (3746 in the non-intensive care unit (non-ICU) group and 223 in the ICU group) were analyzed by dividing into three groups as spring, summer and autumn. In the non-ICU group, lymphocyte to monocyte ratio was lower in autumn than the other two seasons and neutrophil to lymphocyte ratio was higher in autumn than the other two seasons. Also, monocyte and platelet were higher in spring than autumn; and eosinophil, hematocrit, hemoglobin, lymphocyte, and red blood cells decreased from spring to autumn. In the non-ICU group, alanine aminotransferase and gamma-glutamyltransferase gradually increased from spring to autumn, while albumin, alkaline phosphatase, calcium, total bilirubin and total protein gradually decreased. Additionally, C-reactive protein was higher in autumn than the other seasons, erythrocyte sedimentation rate was higher in autumn than summer. The changes in routine blood biomarkers in COVID-19 varied from the emergence of the disease until now. Also, the timely changes of blood biomarkers were mostly more negative, indicating that the disease progresses severely. The study was approved by the Erzincan Binali Yildirim University Non-interventional Clinical Trials Ethic Committee (approval No. 86041) on June 21, 2021.

Investigation of Serum Calcium and 25-Hydroxy Vitamin D Levels in Benign Paroxysmal Positional Vertigo Patients.

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is characterized by recurrent attacks of vertigo caused by head movements. It occurs as a result of otoconia falling into the semicircular canal. Calcium and 25 hydroxyvitamin D [25(OH)D] metabolism in the inner ear play an important role in otoconia formation and degeneration. Our aim in this study was to investigate the relationship between 25(OH)D levels and BPPV. METHODS: This retrospective, case-controlled study included 52 patients with posterior canal BPPV and 52 controls aged 18 to 80 years. Age, sex, serum calcium, corrected calcium, and 25(OH)D levels of the BPPV and control group were compared. RESULTS: Twenty-three of the patients were male (44.2%) and 29 were female (55.8%). The average age was 55.6 years. The 25(OH)D level was 15.3 ng/mL in the BPPV group and 20.2 ng/mL in controls. There was no significant difference in 25(OH)D and albumin-corrected calcium values (P = .394; P = .084, respectively). In 80.7% of the BPPV group and 61.5% of the controls, 25(OH)D levels were 20 ng/mL and below. 25 hydroxyvitamin D deficiency was found statistically significantly more frequently in patients with BPPV (P = .030). CONCLUSION: In our study, serum 25(OH)D levels were found to be lower in patients with BPPV, and the rate of vitamin D deficiency was higher in these patients. Based on these results, it is recommended to examine the 25(OH)D levels of patients with BPPV at the time of diagnosis.

The role of protein oxidation in the development of diabetic microvascular complications.

OBJECTIVE: The role of protein oxidation in the development of diabetic microvascular complications was investigated. METHODS: In total, 266 participants were split into five groups: Group 1; diabetes mellitus for at least 10 years without any complications, Group 2; diabetic nephropathy, Group 3; diabetic neuropathy, Group 4; diabetic retinopathy, and Group 5; control group. Thiol, disulfide, ferroxidase, and ischemia-modified albumin (IMA) levels were analyzed in the serum. RESULTS: Native thiol, total thiol, and native thiol/total thiol were lower in Group 4 than Groups 1, 3, and 5 (p<0.001). However, disulfide/native thiol and disulfide/total thiol were higher in Group 4 than all other groups (p<0.001). IMA was higher in Groups 3 and 4 than all other groups (p<0.001). Ferroxidase was lower in Groups 3 and 4 than Group 2 (p<0.001). CONCLUSION: Thiol-disulfide homeostasis impairment in favor of disulfide may have a function in the progress of diabetic retinopathy. Furthermore, the disruptions of IMA and ferroxidase levels involve in the development of diabetic retinopathy and neuropathy.