Plasma levels of oxysterols 7-ketocholesterol and cholestane-3ß, 5α, 6ß-triol in patients with allergic asthma.

The prevalence of allergic asthma is increasing on a global scale, reflecting changes in air pollution, climatic changes, and other environmental stimulants. In allergic conditions, oxidative stress occurs as a result of immune system activation. Oxidation of cholesterol leads to the formation of oxysterols. The main purpose of the study was to compare plasma levels of two oxysterols, namely 7-ketocholesterol (7-KC) and cholestane-3ß, 5α, 6ß-triol (C-triol), and a lipid peroxidation product, malondialdehyde (MDA) in allergic asthma patients with those of healthy controls, in order to provide information about the involvement of lipid peroxidation in allergic asthma.Oxysterols were quantified by LC-MS/MS in plasma samples of 120 asthma patients (90 females + 30 males) and 120 healthy controls (matched by age and sex). Plasma MDA level was analyzed by a spectrophotometric method.Plasma 7-KC (39.45 ± 20.37 ng/mL) and C-triol (25.61 ± 10.13 ng/mL) levels in patients were significantly higher than in healthy subjects (17.84 ± 4.26 ng/mL and 10.00 ± 3.90 ng/mL, respectively) (P < 0.001). Plasma MDA levels were also higher in asthmatic patients (4.98 ± 1.77 nmol/mL) than in healthy controls (1.14 ± 0.31 nmol/mL) (P < 0.001). All data support that lipid peroxidation products are involved in allergic asthma.Oxysterols were quantified for the first time in allergic asthma. Since the high plasma 7-KC and C-triol levels of allergic asthma patients correlate with high IgE levels, detection of these oxysterols by LC-MS/MS may be helpful in the clinical monitoring of allergic asthma. Current data may also lead to new approaches for the prevention, diagnosis, and treatment of the disease.Supplemental data for this article is available online at at.

Early Neurologic Complications and Long-term Neurologic Outcomes of Extracorporeal Membrane Oxygenation Performed in Children.

BACKGROUND: We aimed at evaluating acute neurologic complications (ANC) and clinical outcome at a 2-year follow-up in children after extracorporeal membrane oxygenation (ECMO). METHODS: We conducted a single-center, retrospective review of our patient cohort aged between 1 month and 18 years at the time of ECMO support (between June 2014 to January 2017). Outcome analysis included ANC and their clinical consequences.The Pediatric Overall Performance Category (POPC) and Pediatric Cerebral Performance Category (PCPC) were used for neurologic assessment performed at discharge from the hospital and at 2nd year follow-up. RESULTS: There were 35 children who required ECMO. The median ECMO time was 9 days (range 2-32 days). Decannulation from ECMO was achieved in 68.6% of patients, and overall, 42.8% survived (15 patients), The incidence of ANC in the surviving patients was 40% (6 children). ANC were intracranial hemorrhage, seizures, cerebral infarction, which occurred in one, two and three of the 15 surviving patients respectively (6.6, 13.3 and 20%). A higher rate of organ failure was related to death (p=0.043), whereas duration on ECMO was a risk factor for the development of ANC (p<0.05). At hospital discharge, the 14 patients evaluated had normal development or -mild disability in 73.2%, and at the 2-year follow-up, 93.4% had these scores. CONCLUSION: Children who receive ECMO have a risk to develop ANC, which was related to the length of ECMO treatment, while survival was related to less organ failure, Long-term neurological outcome was good in our patient cohort.

Effects of treatment with haloperidol and clozapine on the plasma concentrations of thyroid hormones in rats.

OBJECTIVES: Psychoactive drugs are group of compounds used to treat severe mental problems, including psychosis, as well as other conditions. This study assessed clinically relevant side effects of haloperidol and clozapine on the thyroid hormones. METHODS: Haloperidol (0.05 and 2 mg/kg) or clozapine (0.5 and 20 mg/kg) was intraperitoneally injected to male Wistar rats for 28 days. The control group received 2 ml of physiological saline. A chemiluminescent immunoassay was used to measure the plasma levels of thyroid hormones. RESULTS: Plasma concentrations of thyroxine (T4) in rats treated with high-dose (2 mg/kg) of haloperidol decreased significantly compared to the control group (p=0.001). However, both low (0.5 mg/kg) and high clozapine (20 mg/kg) doses did not have a significant effect on the plasma concentrations of T4 and triiodothyronine (T3) (p>0.05). Neither of the compound had a significant effect on T3 plasma concentration levels (p>0.05). CONCLUSIONS: Haloperidol and clozapine act via different mechanisms and may have dissociable effects on thyroid hormones. Following treatment with haloperidol, significant changes in T4, but not in T3, serum levels were observed. Haloperidol and clozapine had different effects on the thyroid hormone levels. These results indicate that antipsychotic treatment can contribute to the thyroid dysfunction. Therefore, greater caution should be applied to the antipsychotics use. The thyroid function of the patients should be closely monitored, while using these drugs.

Validity, Discriminative Ability, and Reliability of the Turkish Hearing-Related Quality of Life Questionnaire for Children and Adolescents.

PURPOSE: The aim of this study was to translate the versions of the Hearing Environments and Reflection on Quality of Life (HEAR-QL) into Turkish and investigate the validity and reliability of the Turkish 26-item HEAR-QL (HEAR-QL-26) for children and Turkish 28-item HEAR-QL (HEAR-QL-28) for adolescents. METHOD: The protocol included translation into Turkish and linguistic adaptation. The HEAR-QL-26 and HEAR-QL-28, respectively, were administered to 249 children (130 with hearing loss, 119 without hearing loss) and 249 adolescents (140 with hearing loss, 109 without hearing loss) between the ages of 8 and 18 years. To determine the internal consistency (reliability) of the Turkish HEAR-QL scale, Cronbach's alpha coefficient (α) was calculated for the subcategories and the total score. We measured the construct validity of the Turkish HEAR-QL-26 and HEAR-QL-28 using Pearson r correlation coefficients comparing the Turkish HEAR-QL and the Turkish Child and Adolescent Quality of Life Scale (PedsQL). RESULTS: The reliability for both children and adolescents (Cronbach's alpha = .973 for HEAR-QL-26 and .977 for HEAR-QL-28) was high, and test-retest reliability showed strong to excellent correlations (intraclass correlation coefficient = .980 and .979, respectively) for the total scores. In terms of known-group validity, the total HEAR-QL mean scores were lower for participants with hearing loss than for children/adolescents with normal hearing (p < .05). Confirmatory factor analysis showed that the number of original items was sufficient in the Turkish version. Both HEAR-QL versions provided a higher area under the curve (AUC = .984 and .972, respectively) than the PedsQL (AUC = .773 and .581, respectively). CONCLUSION: The Turkish versions of the HEAR-QL-26 child and HEAR-QL-28 adolescent questionnaires are sensitive, reliable, and valid measurement tools to evaluate the hearing-related quality of life in children and adolescents aged between 8 and 18 years.

Developing the computer-based auditory training program for adults with hearing impairment.

Although it is known that auditory training is essential for hearing-impaired individuals, patients do not willingly participate in auditory training sessions, because individual training is a time-consuming and costly process. Computer-based auditory training programs are under development for reducing the cost and time. The aim of this study is to develop a computer-based auditory training program and to evaluate the usability of the program by applying it to adults with normal hearing indifferent age groups and professions. The developed auditory training program consists of nine modules: identification, discrimination, recognition, auditory closure, comprehension, auditory sequencing, phonological awareness, auditory memory, and attention. Forty adults (age ranges of 25-34, 35-44, 45-54, and 55-65 years), nine audiologists, and one software engineer were included in this study. The computer-based auditory training program was applied to all individuals. An evaluation form was filled out by the participants to evaluate the usability of and satisfaction with the program, and the average performances of the individuals were calculated for each module. The form measures five usability subscales: ease of use, comprehensibility, design, satisfaction, and motivation. The professionals evaluated the program and found it to be quite positive in terms of design, ease of use, motivation, and comprehensibility, and positive in terms of the satisfaction subscale. The participants evaluated all factors and found them to be quite positive. There were no statistically significant differences between the gender, age, and computer use groups in terms of the average performance value of the modules (p > 0.05). However, a significant difference was found in the average performance for the auditory sequencing module considering the educational status of individuals (p = 0.019). Furthermore, it was determined that computer experience (> 5 years) and having a personal computer have a significant effect on auditory memory (p = 0.049) and identification (p = 0.027). These results show that the instructions and information used in the program are clear and understandable, the colors and texts used in the program are readable, the program is easy to use, and the individuals are not disturbed by the sounds used in the program. However, it would be valuable to apply it to individuals with hearing losses to evaluate the efficacy of the program.

A Comprehensive Review on Oxysterols and Related Diseases.

The present review aims to provide a complete and comprehensive summary of current literature relevant to oxysterols and related diseases. Oxidation of cholesterol leads to the formation of a large number of oxidized products, generally known as oxysterols. They are intermediates in the biosynthesis of bile acids, steroid hormones, and 1,25- dihydroxyvitamin D3. Although oxysterols are considered as metabolic intermediates, there is a growing body of evidence that many of them are bioactive, and their absence or excess may be part of the cause of a disease phenotype. These compounds derive from either enzymatic or non-enzymatic oxidation of cholesterol. This study provides comprehensive information about the structures, formation, and types of oxysterols even when involved in certain disease states, focusing on their effects on metabolism and linkages with these diseases. The role of specific oxysterols as mediators in various disorders, such as degenerative (age-related) and cancer-related disorders, has now become clearer. Oxysterol levels may be employed as suitable markers for the diagnosis of specific diseases or in predicting the incidence rate of diseases, such as diabetes mellitus, Alzheimer's disease, multiple sclerosis, osteoporosis, lung cancer, breast cancer, and infertility. However, further investigations may be required to confirm these mentioned possibilities.

In Vitro Evaluation of the Primary Stability of Short Implants in Different Surgical Techniques.

PURPOSE: This study was designed to evaluate the effects of four different surgical techniques on the primary stability of short implants in two sizes (4-mm and 6-mm length) through resonance frequency analysis and insertion torque measurement in vitro. MATERIALS AND METHODS: Forty implant site preparations and implant insertions were performed in pig ribs. Guided surgery, bone condensing, conventional drilling, and undersized preparation surgical techniques were used five times in each bone block to prepare 4-mm/6-mm-length implant beds. The maximum insertion torque and implant stability quotient (ISQ) values were recorded for each implant. RESULTS: Both the ISQ and torque differed significantly for various surgical techniques (P = .009 and P < .001). The conventional technique had higher ISQ (79.00), whereas the condenser technique had higher torque (48.00 Ncm) than did the other techniques. The mean torque was significantly higher in all surgical techniques other than the guided surgery group regardless of implant length (P < .01 for all). Implant lengths were not significantly different in terms of ISQ and torque in all surgical techniques. CONCLUSION: There are significant correlations between the implant bed preparation technique and primary implant stability when using short implants. Conventional surgery and the bone condensing technique are favorable alternatives with higher primary stability and torque values in short implants.

Zinc, copper, and oxysterol levels in patients with type 1 and type 2 diabetes mellitus.

BACKGROUND: The present study has the objective to assess the zinc (Zn), copper (Cu), and oxysterols plasma levels in type 1 (DM1) (n = 26) and type 2 (DM2) (n = 80) diabetes patients, as compared to healthy controls (n = 71), in order to testify whether metal levels may have a significant impact on the association between oxysterols and diabetes. METHODS: Plasma trace elements and plasma oxysterols were assessed using atomic absorption spectrometry and LC-MS/MS, respectively. Lifestyle, smoking status, alcohol intake, and drug usage, as well as microvascular complications, were also monitored and reported. RESULTS: The obtained data demonstrated that both DM1 and DM2 patients were characterized by significantly elevated HbA1c, FBG, TC, LDL-C, VLDL-C, and TG levels as compared to controls. Plasma Zn levels and Zn/Cu ratio in DM1 and DM2 patients were about 3- and 2-fold lower than controls. No significant differences in plasma Cu levels were reported. The 7-ketocholesterol (7-kchol) levels in DM1 and DM2 patients exceeded these values in healthy individuals by 2.5 and 5-fold, respectively. Similarly, cholestan-3ß, 5α, 6ß-triol (chol-triol) levels were more than 3- and 6-fold higher when compared to the respective values in non-diabetic controls. In regression models decreased plasma Zn and elevated oxysterol levels were significantly associated with HbA1c and fasting plasma glucose levels, after adjustment for anthropometric and clinical variables, as well as routine biochemical markers. CONCLUSIONS: Plasma Zn concentration is inversely associated with both 7-kchol and chol-triol levels. Assessment of Zn and oxysterol levels may be used both for risk assessment and as targets for the treatment of diabetes mellitus.

Effects of clozapine and haloperidol treatment on plasma concentrations of androgen hormones and androgendependent organ changes in rats.

OBJECTIVES: Metabolic and endocrine adverse effects are among the most concerning unfavorable consequences of commonly used psychotropic drugs. The present research was planned to assess and determine the effects of haloperidol and clozapine on testosterone, cortisol, and corticosterone levels and also their influence on androgen-dependent organs in adult male Wistar rats. MATERIALS AND METHODS: Animals were casually distributed into three groups (n = 10 in each group). Drugs were administered intraperitoneally for 28 days. The control group received 2 mL of physiological saline, the second group received haloperidol (0.5 mg/kg), and the third group received clozapine (0.5 mg/kg). The subsequent testosterone, cortisol, and corticosterone plasma concentration levels were analyzed with chemiluminescent immunoassay. RESULTS: Clozapine and haloperidol treatments altered testosterone hormone levels. Testosterone mean values in both the clozapine (1.00-0.58) and haloperidol (0.65-0.62) groups were found to be lower than compared to controls (P = 0.003, P < 0.001). Histomorphometric analysis results also showed reduced testes size and reduced weight of androgen-dependent organs in drug-treated rats. CONCLUSION: It can be suggested that clozapine and haloperidol are effective in reducing the testosterone plasma concentration level and androgen-dependent organ sizes; therefore, clinicians should be aware of these effects when considering the use of antipsychotic drugs.

The Effect of Effort Test on the Levels of Ischemia Modified Albumin, 7-ketocholesterol and Cholestan-3ß , 5α , 6ß -triol and their Role in the Diagnosis of Coronary Artery Disease.

BACKGROUND: Oxysterols have been shown to play a role in plaque formation while ischemia modified albumin (IMA) is widely accepted as an acute marker for ischemia. The effort test is one of the methods used to identify the presence of coronary artery disease. Thus, there may be a relationship between effort test result and the levels of IMA, 7-ketocholesterol (7-KC) and cholestane-3ß,5α,6ß-triol (C-triol). METHODS: Thirty patients who underwent effort test and 30 healthy subjects were included in the study. IMA levels were determined with the albumin-cobalt binding test, 7-KC and C-triol levels were determined with LC-MS/MS. Among the patients, two subgroups were identified according to the results of the effort test, group 1 consisted of patients with a positive effort test (n = 12), and group 2 consisted of patients who had a negative effort test (n = 18). RESULTS: 7-KC levels of patients were significantly higher compared to healthy subjects (39.87 ± 2.13 ng/mL, 20.26 ± 1.35 ng/mL; p=0.001). In patients, post-test 7-KC levels were significantly lower than pre-test levels (post-test vs. pre-test: 37.73 ± 2.44 ng/mL vs. 41.07 ± 2.18 ng/mL; p<0.001). There was a significant difference in post-test 7-KC levels among all study groups (negative, positive and healthy: 37.73 ± 2.44 ng/mL, 39.87 ± 2.13 ng/mL, 20.26 ± 1.35 ng/mL, respectively). There was no significant difference in IMA levels. CONCLUSIONS: Patients with positive effort test had significantly higher levels of 7-KC. Additionally, after the effort test, the 7-KC value was reduced. 7-KC is a biomarker of oxidative damage and its value or changes before and after the effort test may be used as a biomarker in the diagnosis and follow-up of coronary artery disease.

Fusionless instrumentation in growing spine and adjacent segment problems: an experimental study in immature pigs.

STUDY DESIGN: Experimental study. OBJECTIVE: To compare the effects of fusionless instrumentation (FI) and instrumented fusion (IF) on the adjacent segment in an immature pig model. SUMMARY OF BACKGROUND DATA: Observations reveal proximal junctional kyphosis after FI. Possible reasons are stress concentration, repeated distractive forces, and/or soft tissue damage done in the index surgery. It was speculated that FI can decrease stressors to the junctional area by preserving the spinal mobility in some manner; however, this has not been proven to date. METHODS: Thirteen piglets of 10- to 14-week age were used. FI and IF were performed on 7 and 3 piglets, respectively, and 3 piglets formed the control group. Control piglets did not undergo any surgical procedures. T11-L4 instrumentation, decortication, and grafting were applied to IF piglets. In FI groups, however, L1-L2 was left uninstrumented and unfused using T11-T12 and L3-L4 levels as anchors to the growing construct. A total of 4 lengthening procedures were performed: 1 in the index operation and 3 more, once in each lengthening procedure monthly, for 3 months. Four months after the index operations, all piglets were killed and the adjacent segment motion capabilities, disc, and facets were evaluated with radiographical, magnetic resonance imaging, biomechanical, and histological analyses. RESULTS: Comparison of proximal junctional Cobb angles of the postindex (mean: 21, range: 17-27) and presacrification (mean: 21, range: 11-31) radiographs in the FI group revealed no difference (P> 0.05). In magnetic resonance imaging, both surgical group proximal adjacent discs showed degeneration to some degree that was statistically indifferent (P = 0.903). Biomechanical evaluation revealed restriction of adjacent segment motion in all directions for both groups; however, this negative effect was significantly less in FI group (P < 0.01). Degeneration observed in histological evaluation in adjacent discs and facets of FI group was significantly lower (P = 0.00). CONCLUSION: In this quadruped straight spine model, in comparison with IF applications, FI is closer to normal physiology even after several lengthening procedures regarding the adjacent segment discs, facet joints, and motion, when interpreting the radiological, biomechanical, and histological results altogether.