Sexual dysfunction and anxiety levels of type 2 male diabetics.

AIM: This descriptive study aims to identify sexual dysfunction and anxiety levels of male patients with type 2 diabetes. METHOD: The sample is composed of 150 patients who were seen at the Endocrinology and Diabetes Clinic of one university hospital in Istanbul, Turkey. The data were collected using an "Information Form", the "International Index of Erectile Function", and the "State-Trait Anxiety Inventory (STAI)". RESULTS: The mean age of the sample was 56.2±8.71, the sexual dysfunction total score was on average 46.44±15.66, and 82% of the sample experienced erectile dysfunction. According to the STAI, the patients had "mild" anxiety on average, whereas according to the TAI, they had "moderate" anxiety levels. There were no statistically significant differences between the sexual dysfunction total scores and the State Anxiety Scores (p>0.05), whereas there was a negative weak correlation between the trait anxiety levels (p<0.05). CONCLUSION: These results show that the sexual function and anxiety of diabetic patients should be evaluated at regular intervals.

Outcomes of Primary Transsphenoidal Surgery in Cushing Disease: Experience of a Tertiary Center.

BACKGROUND: To report the initial and long-term remission rates and related factors, secondary treatments, and outcomes of a series of patients with Cushing disease (CD). METHODS: We included 147 consecutive adult patients with CD who underwent primary transsphenoidal surgery (TSS) between 1998 and 2014 in this study. Eighty-two were followed up in the Cerrahpasa Medical Faculty Endocrinology and Metabolism outpatient clinic. Patients were requested to attend a long-term remission assessment; 55 could be contacted, and data for the remaining 27 patients' last visit to the outpatient clinics were reviewed for early and late remission. Six patients were excluded from the study. Magnetic resonance imaging (MRI) findings and pathologic results including mitosis, Ki-67 levels, and P53 in immunostaining of all patients were evaluated. RESULTS: Data of 82 patients with CD with an average age of 36 years [interquartile range: 29-47] were analyzed with a mean follow-up of 7.5 years [interquartile range: 5-10]. Overall initial remission rates were 72.3% after TSS. Among the 82 patients, 16 patients had Gamma Knife radiosurgery and 7 patients underwent adrenalectomy. After these additional treatments, the long-term remission rate was found as 69.7%. The highest remission rates were with microadenomas. Recurrence was most frequently seen in patients without tumor evidence on MRI. Patients with high Ki-67 levels had higher recurrence rates in long-term follow-up (P = 0.02). CONCLUSION: Life-long follow-up for patients with CD seems essential. Undetectable tumors on MRI before TSS and high Ki-67 immunopositivity were found as risk factors for tumor recurrence.

Adjuvant effects of Astragalus saponins macrophyllosaponin B and astragaloside VII.

AIM OF THE STUDY: The present study was undertaken to evaluate the hemolytic activities of two immunomodulator Astragalus saponins [Macrophyllosaponin B (MacB) from Astragalus oleifolius DC. and Astragaloside VII (Ast VII) from Astragalus trojanus Stev.], and their adjuvant potentials on the cellular and humoral immune responses of Swiss albino mice against BSA. MATERIALS AND METHODS: The hemolytic activity of Mac B and Ast VII was determined using 0.5% rabbit red blood cell. For adjuvant activity, Swiss albino mice were immunized subcutaneously with BSA 100 µg alone or with BSA 100 µg dissolved in saline containing Ast VII (30, 60, 120 and 240 µg), Mac B (30, 60, 90 and 120 µg) or Freund's adjuvant on Days 1 and 15. Sera and splenocytes were collected 2 weeks after the last immunization for concanavalin A (Con A)-, lipopolysaccharide (LPS)- and BSA-stimulated splenocyte proliferation assay and measurement of BSA-specific antibodies in serum. RESULTS: Mac B and Ast VII showed a slight hemolytic effect, with 0.42% and 0.54% values, respectively, at the highest concentration of 500 µg/ml. Mac B and Ast VII significantly enhanced the Con A-, LPS-, and BSA-induced splenocyte proliferation in the BSA-immunized mice especially at 120 and 240 µg (P<0.001), and 60, 90 and 120 µg (P<0.05, P<0.01 or P<0.001) doses, respectively. BSA-specific IgG, IgG1 and IgG2b antibody titers in serum were also significantly enhanced by Ast VII (120 µg), Mac B (90 µg) and Freund's as compared to the control group (P<0.01 or P<0.001). Moreover, the IFN-γ and IL-4 levels in the sera were detected using ELISA two weeks after the last immunization. Ast VII and Mac B were also found to stimulate IFN-γ production such as Freund's, two weeks after the last immunization at doses of 120 µg and 90 µg, respectively, as compared to the control. CONCLUSION: Results show that Ast VII and Mac B generate important specific antibody and cellular response against BSA in mice, proving their potentials as a new class saponin adjuvant.