Assessment of Renal Function of Bodybuilders Using Anabolic Androgenic Steroids and Diet Supplements.

Introduction Anabolic androgenic steroids (AAS) and diet supplements (DS) are frequently used by bodybuilders. In this specific group, increased muscle mass, the acute effects of exercise, and the use of creatine may affect the creatinine-based estimated glomerular filtration rate (eGFRcr), potentially leading to an underestimation of the GFR. Cystatin C equations offer a more accurate prediction of GFR that is independent of muscle mass. We aimed to assess the renal functions of bodybuilders who use both AAS+DS, as well as those who only use DS, by calculating the GFR based on cystatin C (eGFRcys) and also using a combination of cystatin C and creatinine (eGFRcys/cr). Methods The study included 12 bodybuilders using AAS+DS and 12 bodybuilders using DS. In both groups, serum cystatin C levels, eGFRcys, eGFRcys/cr, urine albumin excretion rates, urine protein excretion rates, and routine tests were examined. Results In AAS+DS users, the average duration of AAS use was 3.08±2.02 years, while for DS users, the duration of supplement use was 3.67±2.49 years. The spot urine albumin/creatinine and protein/creatinine ratios were higher in AAS+DS users (p<0.001 and p=0.006, respectively). Although eGFRcr was found to be similar in the AAS+DS and DS groups (119.67 ± 24.12 ml/min and 122.08 ± 18.03 ml/min, respectively; p=0.426), eGFRcys and the eGFRcys/cr ratio were significantly lower in the AAS+DS group compared to the DS group (eGFRcys: 120.67 ± 19.48 ml/min vs. 122.08 ± 18.03 ml/min, p=0.039; eGFRcys/cr: 121.83 ± 20.62 ml/min vs. 126.33 ± 21.163 ml/min, p= 0.036, respectively). Conclusion Cystatin-based GFR values were found to be significantly lower in AAS+DS users, and urinary albumin and protein excretion were considerably higher compared to DS users. Although these findings suggest a potential link between early kidney damage and the direct use of AAS, the topic requires further investigation.

Association between depression scores and comprehensive geriatric assessment and frailty in geriatric outpatients with somatic complaints: an observational cross-sectional study.

BACKGROUND: Depression is the most common psychiatric problem in older individuals. In some countries, the common approach is to ignore psychiatric disorders. This study aimed to reveal the importance of newly diagnosed high depression scores in the geriatric population admitted to outpatient clinics with somatic complaints. METHODS: Patients who did not have a previous diagnosis of a psychiatric disorder and were not receiving treatment were included in the study. A comprehensive geriatric evaluation of 235 elderly patients was performed using established assessment tests. The time and quality of sleep and the Clinical Frailty Scores (CFSs) were documented. RESULTS: The mean age of the 235 patients was 73.6 ± 6.39 years, 65.5% (n = 154) were women, and 34.9% (n = 81) had a geriatric depression score ≥ 5. In the higher depression rating scores group, the Lawton-Brody, Mini-Mental State Examination (MMSE), and Mini Nutritional Assessment (MNA-SF) scores were low (p = 0.010, p < 0.001, p = 0.003). Sleep duration was short, and sleep quality was poor (p = 0.042, p = 0.006). The CFSs were high. (p = 0.035) According to the regression analysis results, the MMSE, MNA-SF and CFS predicted higher depression scores significantly (p = 0.048, ß = .892; p = 0.045, ß = .661; p = 0.045, ß = 1.245). DISCUSSION: Depression scores in older people may be associated with not only mood but also the functionality. As with other geriatric syndromes, symptoms in depression may be atypical rather than typical.

Pain Assessment in Hemodialysis Patients.

Background Pain is a common complaint among hemodialysis (HD) patients; however, most patients are not assessed for this aspect and are not sufficiently treated. In these patients, pain is reported to be associated with a range of parameters like increased depression and disrupted quality of life (QOL). Previously residual renal function (RRF) was not assessed for associations with pain. The primary aim of the study is to evaluate the pain frequency in the Turkish HD patient population. In addition, the type, origin, and severity of chronic pain, the pain treatment ratio, and the relationship between pain, QOL, and RRF were investigated during the study. Methods This study included 328 HD patients. Pain assessment used the McGill Pain Questionnaire and neuropathic pain assessment used the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale. The correlation of pain and quality of life was evaluated with the Short Form 36 (SF-36) quality of life scale. Results Of patients, 244 experienced pain (74.4%), and this pain had a neuropathic character in 61.8% of these patients. Patients with pain had a longer dialysis duration than those without pain (4.00 (2.00-8.00), 3.00 (2.00-4.75), p=0.01). The most common site of pain was the lower extremities. Pain was observed more often among females and with increasing age. Only 36.4% of patients used analgesics. The quality of life of patients with pain was found to be lower. The incidence of pain was higher among patients without RRF and had more neuropathic character. Conclusions Pain is a significant problem for the majority of HD patients and is not effectively managed. To increase the quality of life of patients, the care team should regularly question pain symptoms, and it should be treated effectively. In this context, RRF should be regularly monitored and efforts should be made to preserve it.

Efficacy of the Rotational Traction Method in the Assessment of Glenohumeral Cartilage Surface Area in Computed Tomography Arthrography.

OBJECTIVE: We aimed to investigate the efficacy of the rotational traction method in expanding the joint space and enabling the assessment of an extended surface area. METHODS: Sixty patients who underwent computed tomography arthrography were evaluated in the study: 30 with and 30 without the help of rotational traction. The subgroups consisted of patients with adhesive capsulitis, habitual luxation, or labral tears. Areas of obscured joint surface by coalescent cartilages were calculated using computer software, and those belonging to the traction and nontraction groups along with subgroups were compared statistically. RESULTS: There was a significant difference between the traction and nontraction group regarding the contact surface area (P < 0.001 for both observers). In patients with adhesive capsulitis, the contact surface area was larger compared with the other subgroups (P = 0.002 for observer 1 and P = 0.002 for observer 2). In patients with habitual luxation, the contact surface area was smaller compared with the other subgroups (P = 0.002 for observer 1 and P = 0.001 for observer 2). CONCLUSIONS: Expansion of joint distance is important for assessing the joint cartilage. The rotational traction method provides effective separation of the joint space. For this reason, rotational traction can be used effectively in patients in whom the joint cartilage is to be evaluated.

Assessment of posterior accessory great saphenous vein of the leg using ultrasonography: a preliminary study.

PURPOSE: To assess the frequency and anatomic distributions of the posterior accessory great saphenous vein of the leg (PAGSVL) and its insufficiency rate using ultrasonography (US) in patients who presented with clinical, etiologic, anatomic, and pathophysiologic (CEAP) scores of 1 and above. METHODS: A prospective US study on 200 limbs of 100 consecutive patients with CEAP scores of 1 and above. RESULTS: Right PAGSVL was seen in 45 % (45 cases), whereas left PAGSVL was seen in 54 % (54 cases) of the patients [49.5 % (99 limbs) in total] (p < 0.05). PAGSVL insufficiency was present in 6 % (6 cases) of the patients [6 limbs in total (6.06 %)]. The type of PAGSVL joining to the great saphenous vein (GSV) was above the knee level in 4 % (4 limbs), at the knee level in 14 % (14 limbs), and below the knee level in 74 % of patients (74 limbs). The relationship between posterior tibial perforators and PAGSVL was seen in 3.03 % of cases (3 limbs). There was no statistically significant relationship between PAGSVL insufficiency and the presence of posterior tibial perforators (p = 0.55) or between the presence of PAGSVL and the GSV insufficiency. CONCLUSION: PAGSVL was seen in half of the limbs with CEAP scores of 1 and above. The frequency of PAGSVL was more common in the left limbs than the right limbs. There was no statistically significant relationship between the presence of PAGSVL, GSV insufficiency, and different CEAP scores. The PAGSVL often joined to the GVS below the knee, but could also join above the knee.

Assessment of sustained effects of levosimendan and dobutamine on left ventricular systolic functions by using novel tissue Doppler derived indices in patients with advanced heart failure.

BACKGROUND: Previous studies comparing levosimendan vs. dobutamine have revealed that levosimendan is better in relieving symptoms. Echocardiographic studies have been done using second measurements immediately following a dobutamine infusion or while it was still being administered. The aim of our study was assessment of sustained effects of 24 h levosimendan and dobutamine infusions on left ventricular systolic functions. METHODS: A total of 61 patients with acutely decompensated heart failure with New York Heart Association (NYHA) class III or IV symptoms were randomized to receive either levosimendan or dobutamine 2:1 in an open label fashion. Before and 5 days after the initiation of infusions, functional class was assessed, N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels and left ventricular ejection fraction (LVEF), mitral inflow peak E and A wave velocity, and E/A ratios were measured; using tissue Doppler imaging, isovolumic myocardial acceleration (IVA), peak myocardial velocity during isovolumic contraction (IVV), peak systolic velocity during ejection period (Sa), early (E') and late (A') diastolic velocities, and E'/A' and E/E' ratios were measured. RESULTS: The NYHA class improved in both groups, but improvements were prominent in the levosimendan group. NT-proBNP levels were significantly reduced in the levosimendan group. Improvements in LVEF and diastolic indices were significant in the levosimendan group. Tissue Doppler-derived systolic indices of IVV and IVA increased significantly in the levosimendan group. CONCLUSIONS: Improvements in left ventricular systolic and diastolic functions continue after a levosimendan infusion.