Obesity as a modifying factor of periodontal therapy outcomes: local and systemic adipocytokines and oxidative stress markers.

OBJECTIVES: Adipocytokines and oxidative stress (OS) are involved in the pathogenesis of both obesity and periodontitis. The aim of this study was to evaluate periodontal therapy outcomes in terms of serum and gingival crevicular fluid (GCF) levels of adipocytokines and OS markers in obese patients with periodontitis, in order to have an insight into the association between obesity and periodontitis. MATERIALS AND METHODS: A total of 39 patients (20 obese, 19 non-obese) with periodontitis were included in this study. Clinical periodontal parameters were assessed; serum and GCF levels of adipocytokines and OS markers were evaluated by ELISA at baseline and 3 months after non-surgical periodontal therapy. RESULTS: Significant improvements in clinical periodontal parameters were observed in both groups at 3 months (p < 0.01). While serum levels of TNF-α, leptin, and total oxidant status (TOS) in the obese group were higher at baseline (p < 0.01), leptin levels remained higher at 3 months despite a significant decrease (p < 0.01). Although NSPT improved GCF levels of total antioxidant status (TAS) and TOS in both groups, they were significantly different between the groups after therapy (p < 0.05). CONCLUSIONS: It seems that leptin, TNF-α, and TOS contribute to systemic inflammatory and oxidative state in patients with obesity. Despite improvements in clinical periodontal parameters, obesity might be a modulating factor in the development and progression of periodontal disease in terms of some adipocytokines and OS markers. CLINICAL RELEVANCE: Since the global burden of both obesity and periodontitis is continuously increasing, the management of these inflammatory diseases has become more important. The current study contributes to our understanding of the role of OS and adipocytokines on the relationship between obesity and periodontitis by response to periodontal treatment.

The Prevalence of Pain in the First 24 Hours After Surgery: A Multicenter Study.

PURPOSE: This study was conducted to determine the prevalence and severity of postoperative pain in the first 24 hours after surgery and to emphasize the importance of postoperative pain assessment. DESIGN: A descriptive study. METHODS: This study was carried out on May 21, 2019 with 898 patients who had completed the postoperative 24th hour in the surgical clinics of 10 training and research hospitals in Istanbul, the capital of Turkey. Point prevalence was used in the study. Data were collected using a questionnaire developed by the researchers and the Revised American Pain Society Patient Outcome Questionnaire. Descriptive statistics were presented as frequency, percentage, mean, and standard deviation. Nonparametric tests were used for data without normal distribution (Kolmogorov-Smirnov Test, P < .05). Two-group comparisons were performed using the Mann-Whitney U test. The Kruskal Wallis-H test was used for the comparison of three or more groups. Statistical significance was set as P < .05. FINDINGS: The three main types of surgery were general surgery with 31.8%, gynecologic surgery with 12.9%, and orthopedic surgery with 12.7%. The mean lowest level of pain felt by the patients included in the study in the first 24 hours was 3.90 ± 2.94, and the mean highest level of pain was 6.38 ± 4.45. CONCLUSIONS: Postoperative pain is a subjective phenomenon and may be affected by factors such as type of surgery, previous experience of surgery, duration of surgery, the length of the surgical incision, the type of anesthesia, the quality of postoperative care, individual characteristics and experiences, and fear anxiety; thus, the experience of pain may vary from person to person.

Evaluation of overactive bladder and nocturia as a risk factor for hip fracture in climacteric women: a matched pair case control study.

The aim of this study was to investigate whether overactive bladder (OAB) influences hip fractures in climacteric women by comparing the frequency of OAB and nocturia symptoms in patients with hip fractures and their age-matched controls in pre-fracture period. A total of 30 climacteric patients with a history of hip fracture were compared to a control group of 51 women in terms of OAB, nocturia and nocturia-QoL. A questionnaire composed of structured questions and Turkish validated versions of the specific questionnaires for OAB, OAB-Quality of Life (OAB-q) and nocturia-QoL was directed to the two groups. We did not detect statistically relevant differences between the groups for the presence or severity of OAB and OAB-q (p > .05). However, Nocturia-QoL was worse in the group with hip fracture (p = .022). Overactive bladder has no contribution to the overall risk of hip fracture, whereas, the severity of nocturia seems to play a role as a risk factor in the formation of hip fracture. Impact statement What is already known on this subject: Hip fracture is associated with high morbidity, mortality and the cost. Prevention of hip fracture is a high priority for the patients, physicians and the public health. Several studies and consensus opinions have investigated the risk factors for the hip fractures. What the results of this study add: Although urinary symptoms were not evaluated in previous studies as a risk factor, desire of urination makes people stand up and move to their toilet, and may put them in a hurry if it is sudden and uncontrollable one. Therefore, we hypothesised that overactive bladder (OAB) and nocturia may be a risk factor in the formation of hip fractures. Our study showed that Nocturia Quality of Life is worse in patients with the hip fracture. Therefore, overactive bladder may not have a role on the overall risk of hip fracture, but the severity of nocturia seems as a risk factor in the fracture process. What the implications are of these findings for clinical practice and/or further research: The getting up from the bed would probably be harder than getting up from a chair in elderly, and life style modifications such as illumination bedroom and organisation of living place may be helpful to minimise the risks.

Tissue reaction to urogynecologic meshes: effect of steroid soaking in two different mesh models.

INTRODUCTION AND HYPOTHESIS: Steroid soaking may decrease mesh-triggered inflammatory reaction in tissue. We aimed to investigate the tissue reaction to a steroid-soaked mesh material and an unsoaked mesh material in the rat model. METHODS: Neutral and steroid-soaked type I macroporous polypropylene (PP) monofilament and polyvinylidene fluoride (PVF) mesh materials were implanted on the rectus abdominis muscle of 20 mature Wistar albino rats. Animals were divided into four groups: PP mesh with steroid (PP-S), PP mesh without steroid, PVF mesh with steroid (PVF-S), and PVF mesh without steroid. The rats were killed after 12 weeks, and histologic, immunohistochemical and electron microscopic examinations were performed. For immunohistochemical analysis, polyclonal rabbit anti-mouse CD3, rabbit anti-mouse CD68, rabbit anti-mouse CD15, and rabbit anti-mouse CD34 antibodies were used for the detection of lymphocytes, macrophages, polymorphonuclear leukocyte foreign body giant cells, and fibromyocyte stem cells, respectively. Samples were stained with hematoxylin and eosin for the histologic evaluation of inflammation and with Masson's trichrome stain for the evaluation of collagen deposition. Pore size and mesh ultrastructure were evaluated by electron microscopy. RESULTS: Expression of CD3 was lower in the PVF, PVF-S and PP-S groups, and expression of CD34 was higher in the PVF-S and PP-S groups than in the PP groups (p < 0.05). Collagen deposition was lower in the PVF, PVF-S and PP-S groups (p < 0.05). Histologically, the intensity of inflammation was lower in the PVF-S and PP-S groups than in the PP mesh group (p < 0.05). There were no significant differences among the groups in terms of pore size and mesh ultrastructure on electron microscopic examination (p > 0.05). CONCLUSIONS: PVF mesh induces less inflammation than PP mesh, and in both mesh types steroid soaking further decreases inflammation without changing the pore size.

Effects of Electroconvulsive Therapy on Some Inflammatory Factors in Patients With Treatment-Resistant Schizophrenia.

OBJECTIVES: Electroconvulsive therapy (ECT) is the most effective option for several psychiatric conditions, including treatment-resistant schizophrenia. However, little is known about the molecular mechanism of action of ECT. The link between inflammatory system and schizophrenia is the focus of recent studies. However, the impact of ECT on inflammatory functioning in this disorder remains elusive. Whether ECT could modulate inflammatory factors in patients with schizophrenia was examined. METHODS: Plasma levels of interleukin-4 (IL-4), transforming growth factor-ß (TGF-ß), myeloperoxidase (MPO), and nuclear factor-κB (NF-κB) activation were analyzed in 20 schizophrenic patients, mainly with resistant to antipsychotic medication disorders, and in 20 sex- and age-matched healthy controls. Disease severity was evaluated using the Brief Psychiatric Rating Scale. All patients were followed with measurement of the inflammatory factors before and after ECT treatment and compared with the controls. RESULTS: Patients with schizophrenia had markedly raised NF-κB and but decreased TGF-ß levels compared with healthy controls. On the other hand, no significant differences were found for the levels of IL-4 and MPO levels. The clinical improvement during repeated ECT was accompanied by a gradual and significant increase in IL-4 and TGF-ß level, but MPO and NF-κB activation were left unaffected. Increases in TGF-ß were negatively correlated with the change in Brief Psychiatric Rating Scale scores after ECT. CONCLUSIONS: It is shown that ECT, while increasing the anti-inflammatory response such as the levels of IL-4 and TGF-ß, it did not affect the levels of MPO and NF-κB activation in this study.

Haemostatic disorders in reproductive age women with menorrhagia and effects on quality of life.

The aim of this study was to determine the frequency of haemostatic abnormalities in women with menorrhagia and to evaluate their effect on quality of life (QoL). The study population was composed of patients with menorrhagia seen in the outpatient clinic, having a score of >185 with a pictorial blood assessment chart. Structured questionnaires were used in the assessment of demographic characteristics and QoL, and patients were tested for bleeding disorders. Ninety women were recruited for the study. Bleeding disorders were detected in 40% of them: 11.1% had von Willebrand disease, 2.2% had low von Willebrand factor and 26.7% had platelet function disorders (PFD). In 22 (91.6%) cases with PFD the, defect was non-specific and impaired aggregation response to ristocetine (37.5%) was the most commonly detected problem. Bleeding disorders were not associated with any significant reduction in QoL (p > .05). Hereditary bleeding disorders may be the cause of unexplained menorrhagia even in the middle-aged women, but they had no prominent effect on QoL.

Coping with the Stress of Infertility. Males Versus Females.

OBJECTIVE: To investigate ways of coping with stress in infertile men and women. STUDY DESIGN: The study population was composed of 255 women and 238 men (total, 493) admitted to an infertility clinic between May 2012 and December 2012. A questionnaire was used to gather information and the Ways of Coping inventory was used for the evaluation of patients. RESULTS: The mean age of the study population was 28.33 ± 5.59 (mean ± SD) for females and 31.60 ± 5.64 for males. We found similar coping scores for men and women in all subscales (Self-confident, Desperate, Obedient, Optimistic, Social Support Seeking) (p > 0.05). The variables affected Coping with Stress Scores in a similar way for both women and men except for "age" and "the desire for psychological support." The Optimistic approach score was worse in men over age 35 and better in those desiring psychological support in both sexes (p < 0.05). CONCLUSION: Infertile men and women use similar coping strategies and have similar coping scores. They mainly use active strategies at a moderate level. Increasing age in the male group, and lack of desire for psychological support in both sexes, are the factors negatively affecting the Optimistic approach scores.

A late complication of transobturator tape procedure: vaginocutaneous fistula formation with vaginal mesh erosion.

Transobturator tape procedures are a common treatment modality in patients with stress urinary incontinence (SUI). Various complications have been reported related to this procedure. We present a rare case of vaginocutaneous fistula formation 5 years after transobturator tape surgery. A 56-year-old woman presented with complaints of increased vaginal discharge, difficulty in coitus, and serosanguineous discharge from the left groin 5 years after transobturator tape surgery for SUI. Pelvic examination revealed 2-3 cm of extruded mesh at the anterior vaginal wall. The vaginocutaneous fistula was detected at surgery. The suburethral tape was removed, and the fistula tract was excised and repaired primarily. Postoperative period was uneventful, and the patient was still continent 6 weeks postoperatively. With widespread use of mesh for treating SUI, we will likely see a variety of complications in the long term.

Serum vitamin B12 and folate concentrations and the effect of the Mediterranean diet on vulnerable populations.

Low vitamin B12 and folate levels in expectant mothers may lead to low stores in babies. The aim of this study was to determine the frequencies of vitamin B12 and folate deficiencies in pregnant women and neonates, and to assess the effect of maternal vitamin status on babies' vitamin levels in the Aegean region of Turkey, where the Mediterranean diet (mainly fresh fruits and vegetables) is adopted. We studied 72 pregnant women and their singleton-term babies. Venous blood samples of expectant mothers were collected 1 h before delivery and cord blood of babies were obtained at birth. The mean vitamin B12 in maternal and cord blood serum was 163.1 ± 72.0 pg/mL and 146.2 ± 102.5 pg/mL, and the mean folate, 9.8 ± 4.8 ng/mL and 15.8 ± 3.8 ng/mL, respectively. There were statistically significant correlation between maternal and cord blood serum vitamin B12 (r = 0.61, P = .04) and folate levels (r = 0.65, P < .001). 70.8% of the mothers and 83.9% of the babies were vitamin B12 deficient (<200 pg/mL). Neither group showed folate deficiency. The mean level of vitamin B12 in mothers significantly varied by the type of diet (241.6 (72.1) pg/mL versus 155.9 (68.2) pg/mL; P = .012). Vitamin B12 deficiency in pregnant women and neonates may be a public health problem in our community. The Mediterranean diet in these vulnerable groups may be an aggravating factor for vitamin B12 deficiency. Prenatal screening of all expectant mothers, prenatal supplementation of vitamin B12, and an increase in animal-source food intake may improve expectant mother's vitamin B12 level.

Effects of verapamil, nifedipine, and daflon on the viability of reverse-flow island flaps in rats.

Reverse-flow flaps are preferable in reconstructive surgery due to their several advantages. However, they may have venous insufficiency and poor blood flow. In this study, effects of various pharmacological agents on the viability of reverse-flow flaps were investigated. Forty Sprague-Dawley rats were used. Superficial epigastric artery- and superficial epigastric vein-based reverse-flow island flaps were preferred. The rats were divided into 4 groups. Group 1 was considered as the control group. Group 2 was given verapamil 0.3 mg/kg per day, group 3 nifedipine 0.5 mg/kg per day, and group 4 Daflon 80 mg/kg per day for 7 days. On day 7, viable flap areas were measured, angiography was performed, serum nitric oxide levels were evaluated, and histopathological examination was done.The mean flap viability rate was 67.59% (±13.12259) in group 1, 77.38% (±4.12506) in group 2, 74.57% (±3.44780) in group 3, and 85.39% (±4.36125) in group 4 (P = 0.001). The mean nitric oxide level was 31.66 µmol/dL (±2.42212) in group 1, 51.00 µmol/dL (±2.96648) in group 2, 34.00 µmol/dL (±2.96648) in group 3, and 47.66 µmol/dL (±2.80476) in group 4 (P = 0.001). On angiography, there were vessel dilations and convolutions in group 2; capillaries became noticeable, and anastomotic vessels extended toward the more distal part of the flaps in group 4. Histological examinations showed severe inflammation in group 3 and minimal inflammation and venous vasodilatation in group 2.Verapamil and Daflon in therapeutic doses significantly increased the viability of reverse-flow island flaps. However, nifedipine did not make a significant contribution to the flap viability. The results of this study will contribute to the literature about the hemodynamics of reverse-flow island flaps and guide further studies on the issue.

The effect of regular exercise and massage on oxidant and antioxidant parameters.

This experimental study aimed to determine the effects of the combined application of regular exercises and massage on the values of Malondialdehyde (MDA), Nitric Oxide (NOx), Glutathione (GSH), Adenosine Deaminase (ADA) and Superoxide Dismutase (SOD). Twenty five sedentary women (32-50 years) who did not have the habit of getting regularly massages or exercising and participated voluntarily in the study. The subjects were randomly separated into three groups: control group (CG, n = 9), exercise group (EG, n = 8), and massage and exercise group (MEG, n = 8). The basic result of this study was that a statistically significant decrease was observed in the post-test MDA values of both EG and MEG subjects. Moreover, when the GSH and SOD values are compared to CG, a statistically significant increase was determined in the values of both EG and MEG. As a result, the findings show that regular physical activities and massage manipulations significantly decrease MDA, increase SOD and GSH activities, and result in no change in NOx and ADA activities supports the assumption that regular physical activity has positive health effects.

Oxytocin and Vasopressin Blood Levels in People with Post-Traumatic Stress Disorder.

Background: The neuroendocrine system and the hypothalamic-pituitary-adrenal axis are among the possible neurobiological factors that may be involved in the emergence and persistence of post-traumatic stress disorder. Here, we determined the levels of vasopressin and oxytocin in the peripheral blood of people with post-traumatic stress disorder, investigating their correlation with post-traumatic stress disorder symptoms. Methods: The study included patients with post-traumatic stress disorder according to the Diagnostic and Statistical Manual of Mental Disorders Version 4 and healthy controls. People who accepted to participate in the study, who did not have any additional diseases, who had the ability to understand the questionnaires, and who did not use medications during the 3 months preceding the study onset were enrolled. The levels of vasopressin and oxytocin were measured using the enzyme-linked immunosorbent assay. Results: Twenty-eight subjects with post-traumatic stress disorder and 19 healthy controls were included. The 2 groups were not significantly different in terms of oxytocin blood levels (P = .481). However, subjects with post-traumatic stress disorder had a significantly lower vasopressin level than controls (P < .001). We found no significant correlations of trauma duration and scale scores with oxytocin or vasopressin levels. Conclusion: The findings of this study show that blood vasopressin may play a role in post-traumatic stress disorder. Prospective studies based on a larger number of participants are warranted to clarify how neuromodulators may affect the pathogenesis of post-traumatic stress disorder.

Effects of ethinyl estradiol-cyproterone acetate treatment on metabolic syndrome, fat distribution and carotid intima media thickness in polycystic ovary syndrome.

OBJECTIVE: To evaluate the effects of ethinyl estradiol-cyproterone acetate (EE-CA) treatment on metabolic and cardiovascular risk factors, and body fat distribution in polycystic ovary syndrome (PCOS) after 6-month treatment. SUBJECTS AND METHODS: Thirty women with PCOS were evaluated before and after 6 months of EE-CA treatment. Anthropometrical measurements, hormonal levels, lipid and glucose profile were evaluated. Body fat thickness in four regions and carotid intima media thickness (IMT) were measured. Interval change in antropometric measurements, glucose and lipid profile, carotid IMT and body fat distribution was evaluated before and after 6-month EE-CA treatment. RESULTS: Ferriman-Gallwey score and serum testosterone levels were significantly decreased after EE-CA treatment (p < 0.01). No significant effect was detected on insulin resistance, lipid profile and carotid artery IMT. The visceral, subcutaneous and preperitoneal fat thicknesses decreased, and mid-thigh fat thickness increased after treatment period. However, only the alteration in subcutaneous fat thickness achieved a statistical significance (p < 0.01). CONCLUSION: The EE-CA is an effective regimen in treatment of hirsutism and menstrual regulation. Although it provides significant decrease in subcutaneous fat thickness after 6-month treatment, it has no beneficial effect with respect to visceral fat thickness, metabolic and cardiovascular risk factors.

Evaluation of body fat distribution in PCOS and its association with carotid atherosclerosis and insulin resistance.

OBJECTIVE: The aim of this study was to compare body fat distribution in PCOS with healthy controls and to investigate the factors associated with carotid artery intima media thickness (IMT) and insulin resistance. SUBJECTS AND METHODS: A case control study was conducted in 46 women with PCOS and 43 age matched controls. Anthropometrical measurements, hormonal levels, lipid and glucose profile were evaluated. Body fat thickness in four regions and carotid IMT were measured. Body fat distribution was compared between groups. Correlation of these parameters with carotid artery IMT and insulin resistance was investigated. RESULT(S): Visceral and subcutaneous fat thickness and the mean carotid artery IMT were significantly higher in PCOS subjects (p < 0.01). In correlation analysis, age, body mass index (BMI) and waist hip ratio (WHR) showed correlation with carotid artery IMT (r = 0,55, p < 0,001; r = 0.41, p < 0.008 and r = 0.34 p = 0.03, respectively), whereas visceral fat thickness presented a correlation with HOMA-IR index as a sign of insulin resistance. CONCLUSION(S): Fat accumulation is more prominent in visceral and subcutaneous regions in PCOS. Increased BMI and abdominal type of obesity are closely related to the increased carotid artery IMT and insulin resistance. Weight control and regional weight loss are important part of the treatment for the future health of women with PCOS.

Long-term effects of orchiopexy and orchiectomy on the testes of rats with testicular torsion.

INTRODUCTION: Ischemia/reperfusion injury occurs after testicular torsion, levels of free oxygen radicals and inflammatory cytokines are increased in both the torsional and contralateral testis, leading to testicular injury. OBJECTIVE: The present study investigated whether orchiopexy or orchiectomy after testicular torsion was superior in terms of fertility potential in the long term. STUDY DESIGN: Following 720°, 4 h left testicular torsion, orchiectomy or orchiopexy was performed on 84 rats, which were then sacrificed and evaluated for testicular function at day 1, at 3 months and 6 months (n = 14 per group). An additional 14 rats were in the control group. RESULTS: Follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels were significantly lower in the orchiopexy group than the orchiectomy and control groups after 3 months. However, there were no significant differences in hormone parameters among the three groups after 6 months. The hormone levels, Johnsen score, seminiferous tubule diameter, and inducible nitric oxide synthase (iNOS) expression at 3 and 6 months were not significantly different between the orchiectomy group and controls. Histopathological analyses at 3 and 6 months indicated significant decreases in Johnsen score and seminiferous tubule diameter in the ipsilateral testis in the orchiopexy group. At 3 months, the level of iNOS expression in the contralateral testis was significantly lower in the orchiopexy group than in other groups. At 6 months, however, it was not significantly different between the orchiopexy and control groups. There were no significant differences in iNOS expression at 3 or 6 months in the orchiectomy group compared to controls. DISCUSSION: The ipsilateral testis in the orchiopexy group began to atrophy at 3 months, and the degree of atrophy became more evident at 6 months. The level of iNOS expression was low in the bilateral testis at 3 months in the orchiopexy group, and sperm in the contralateral testis were not yet functionally healthy. The level of iNOS expression in the ipsilateral testis decreased further at 6 months in the orchiopexy group, while that in the contralateral testis returned to the normal level. CONCLUSION: Testicular functions were restored faster after orchiectomy compared to orchiopexy following testicular torsion. However, follow-up of the rats for 6 months demonstrated that orchiopexy or orchiectomy procedures conducted on the testicular torsion had no effect on future fertility potential after 4 h of torsion.

Evaluation of asymmetric dimethylarginine, nitric oxide levels and associated independent variables in obese and lean patients with polycystic ovarian syndrome.

OBJECTIVE: To evaluate the asymmetric dimethylarginine (ADMA) and nitric oxide (NO) levels in obese and lean patients with polycystic ovarian syndrome (PCOS) and find out their relation with hormonal and metabolic parameters. METHODS: Twenty-two obese, 18 lean patients with PCOS and 11 obese, 24 lean healthy control patients were enrolled prospectively. Plasma ADMA and NO levels and arginine/ADMA ratio were evaluated on 3rd day of menstrual cycle after at least 10 h overnight fasting. RESULTS: Plasma ADMA, NO levels and arginine/ADMA ratio were similar in the groups. ADMA level did not correlate with the hormonal and metabolic parameters in patients with PCOS. However, NO correlated inversely with fasting insulin (r =  -0.353, p = 0.041) and homeostasis model of insulin resistance (HOMA-IR) (r =  -0.379, p = 0.027). Arginine/ADMA ratio also correlated inversely with fasting insulin (r =  -0.339, p = 0.050). In multinomial regression analysis the risk of low NO was associated independently with high fasting insulin (OR = 1.19, 95% CI 1.001-1.42, p = 0.049) and high HOMA-IR in patients with PCOS (OR = 2.26, 95% CI 1.03-4.98, p = 0.042). CONCLUSIONS: Insulin resistance may be the underlying mechanism of endothelial dysfunction through NO pathway in PCOS.

The effect of melatonin against FK506-induced renal oxidative stress in rats.

BACKGROUND: Nephrotoxicity is an important side effect of FK506 and oxidative stress has been considered as one of the possible mechanisms. The present investigation examines the ability of melatonin to protect against FK506-induced renal oxidative stress. METHODS: Thirty rats were divided into 3 groups (n = 10 each group). Group A was the sham group. Group B received 14 days FK506 (5 mg/kg/d, intraperitoneally [i.p.]) and group C received FK506 (5 mg/kg/d, i.p.) together with melatonin (4 mg/kg, i.p.) for 14 days. Kidney tissues were harvested to determine the tissue levels of malondialdehyde (MDA), total nitrite and nitric oxide (NO), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6). RESULTS: In group C, the levels of TNF-α, IL-6, and NO were lower than in the group B (P < .01, P < .03, and P < .04, respectively) and although MDA levels were lower than in group B, the differences were not statistically significant (P > .05). CONCLUSION: These results suggest that melatonin has protective effect against FK506-induced renal oxidative stress.

Evaluation of Serum Thiamine and Pyridoxine Levels in Patients Undergoing Liver Transplant: A Prospective Study.

OBJECTIVES: This prospective study aimed to compare changes in serum thiamine and pyridoxine levels of patients who underwent liver transplant or living donor hepatectomy. MATERIALS AND METHODS: Between January 2013 and November 2013, 35 patients with chronic liver disease who underwent liver transplant (the recipient group) and 30 healthy individuals who underwent living donor hepatectomy (the control group) during the same period were prospectively compared in terms of both preoperative and postoperative serum thiamine and pyridoxine levels. The groups were also subjected to intragroup analysis of preoperative and postoperative changes in serum vitamin levels to determine how a major surgical procedure affected serum vitamin levels. Mann-Whitney U test and Wilcoxon signed-rank test were used for intergroup comparisons and intragroup repeated measurements, respectively. RESULTS: The intergroup comparisons revealed significant differences in favor of the control group with respect to preoperative thiamine (P < .026) and postoperative thiamine (P < .017) levels, whereas there were statistically significant differences in favor of the recipient group with respect to the preoperative pyridoxine (P < .006) and postoperative pyridoxine (P < .001) levels. The intragroup comparisons showed significant increases in serum thiamine (P < .001) and pyridoxine (P < .031) levels compared with the preoperative serum levels of both vitamins at postoperative day 5 in the recipient group. In the control group, serum thiamine level (P < .001) at postoperative day 5 was significantly different from the preoperative level. On the other hand, a drop in serum pyridoxine level was detected at postoperative day 5, although this was not statistically significant (P < .21). CONCLUSIONS: This study showed a lower serum thiamine level but a higher serum pyridoxine level in patients with chronic liver disease versus healthy controls. This difference persisted into the early postoperative period. This study also showed significant increases in thiamine and pyridoxine levels after transplant surgery.

Examination of androgenetic alopecia with serum biomarkers.

BACKGROUND: Androgenetic alopecia (AGA) is the most common type of hair loss and affects approximately 50% of the male population. AIMS: In the present study, to investigate microinflammation, perifollicular fibrosis, and oxidative stress in AGA cases, some serum biomarker levels were measured and evaluated. PATIENTS/METHODS: Serum samples were drawn from patients (n = 58) and control (n = 30) groups referring to Atatürk Training and Investigation Hospital Dermatology Outpatient clinic. In serum samples, NF-κB, TNF-α, TGF-ß1, thioredoxin, nitric oxide, TOS, TAS, and thiol disulfide homeostasis (native thiol, total thiol, disulfide) were measured and evaluated. RESULTS: In patients with AGA, NF-κB (P = .005), TNF-α (P = .008), TGF-ß1 (P = .028), thioredoxin (P = .004), nitric oxide (P < .001), and TOS (P < .001) serum levels were found to be significantly higher than those in control group, while TAS (P = .003), native thiol (P < .001), total thiol (P < .001), and disulfide (P < .001) serum levels were found to be significantly lower. CONCLUSIONS: According to the results of the present study, it was concluded that in that AGA androgens lead to oxidative stress by increasing free oxygen radicals, which accelerates hair loss by causing microinflammation and fibrosis. The recognition of the effect of androgens and associated factors on the hair follicle cycle is essential for the development of new and effective treatment methods.

Gonadal dysfunction and pelvic sonographic findings in females with thalassaemia major.

OBJECTIVE: To investigate pubertal and menstrual problems and evaluate pelvic sonographic findings in patients with beta-thalassaemia major. MATERIAL AND METHODS: Twenty-five female patients followed for thalassaemia major constituted the study population. Sexual maturation and hormonal status were assessed. Pubertal and menstrual problems were investigated. RESULTS: There was one patient with delayed puberty and five patients with arrested puberty. Mean ferritin level in this group of patients was slightly but not significantly higher than patients with normal pubertal maturation (2620 +/- 994 ng/ml vs. 2409 +/- 1348 ng/ml, p > 0.05). There were 10 patients with primary amenorrhoea, three with secondary amenorrhoea, five with oligomenorrhoea and irregular menstruation and one with regular menstruation. Compared to menstruating patients, the mean uterine size was smaller (4.1 +/- 3.5 cm(3) vs. 52.8 +/- 14.5 cm(3)) in all patients with delayed and arrested puberty (p < 0.05). Ten patients were taking hormone replacement therapy (HRT). The mean uterine size in these patients was larger than that in patients with amenorrhoea who were not taking HRT, but smaller than that in menstruating patients (9.1 +/- 15.9 cm(3), 2.7 +/- 1.3 cm(3) and 52.8 +/- 14.5 cm(3), respectively) (p < 0.05). CONCLUSION: Thalassaemia major has important side effects on the hypothaloma-pituitary-gonadal axis resulting in pubertal and menstrual abnormalities. HRT should be given to provide normal sexual maturation in these patients.