Changes in bone turnover markers in adolescents with gastroesophageal reflux disease treated with lansoprazole.

Background: Proton pump inhibitors (PPIs) have been suggested to lead to bone resorption, while the effects of PPIs on the bone mineral metabolism in children has received only limited attention in literature to date. The present study investigates whether lansoprazole alters bone turnover markers in adolescents with gastroesophageal reflux disease (GERD). Patients and methods: Included in the study were adolescents aged 16-18 with GERD and a healthy volunteers group. The GERD patient group was treated with lansoprazole 30 mg once daily for eight weeks. The serum calcium, phosphorus, magnesium, alkaline phosphatase (ALP), parathormone (PTH), 25 (OH) vitamin D, osteocalcin and urinary calcium, creatinine, deoxypyridinoline (DPD), collagen type-1 crosslinked C-telopeptide (CTX) and collagen type-1 crosslinked N-telopeptide (NTX) of both groups were studied before and after the end of the treatment. Results: A comparison of the 30 patients with GERD and the 30 volunteers revealed no significant difference in the serum calcium, phosphorus, magnesium, ALP, urinary calcium/creatinine ratio, 25 (OH) vitamin D and PTH levels measured before and after the lansoprazole treatment, while the osteocalcin, DPD, CTX and NTX values were found to be higher after treatment when compared to those at pre- treatment. Conclusions: The results of this study reveal that eight weeks of treatment with 30 mg lansoprazole daily increased the bone turnover markers of CTX, NTX, DPD and osteocalcin in adolescents aged 16-18.

Correlation between 25-hydroxy vitamin D levels and COVID-19 severity in pregnant women: a cross-sectional study.

OBJECTIVE: To evaluate the relationship between 25-hydroxy vitamin D (25(OH)D) levels and disease severity in hospitalized COVID-19 positive pregnant women. METHODS: The COVID-19 (+) pregnant women (confirmed by PCR test) were classified as asymptomatic, mild symptomatic, and severe disease according to their symptoms and laboratory results. Severe COVID-19 criteria were respiratory symptoms and/or findings. The following laboratory results were considered as poor prognostic factors: the number of lymphocytes <800/µl and/or CRP value >10 times the upper limit of the normal range and/or ferritin value >500 ng/ml and/or D-Dimer value >1000 µg/l. The patients were divided into two groups; asymptomatic or mild symptomatic group (Group 1), and severe disease and/or poor prognostic factor group (Group 2). The 25(OH)D levels were compared between groups. ROC curve analysis was used to analyze the cutoff value for vitamin D to predict the severity of COVID-19. RESULTS: 25(OH)D levels were found to be statistically significantly lower in group 2 (15.5 (10.25) ng/ml in Group 1, 13 (12) ng/ml in Group 2, p = .010). The 25(OH)D level under 14.5 ng/ml was associated with severe COVID-19 and/or poor prognostic factors (p = .010). The risk of severe COVID-19 and/or having poor prognostic factors was 1.87 times higher among pregnant women who had 25(OH)D levels below 14.5 ng/ml. This value was found to have 54.1% sensitivity and 61.3% specificity in predicting severe COVID-19 and/or poor prognostic laboratory findings in pregnant women. CONCLUSION: There is a relationship between vitamin D status and the severity of COVID-19 in pregnant women. During the pandemic period, vitamin D supplementation for pregnant women should gain more importance.

Effect of high-frequency bio-oxidative ozone therapy for masticatory muscle pain: a double-blind randomised clinical trial.

To evaluate the effect of bio-oxidative ozone application at the points of greatest pain in patients with chronic masticatory muscle pain. A total number of 40 (40 women, with a mean age of 31·7) were selected after the diagnosis of myofacial pain dysfunction syndrome according to the Research Diagnostic Criteria for temporomandibular disorder (RDC/TMD). The patients were randomly divided into two groups: patients received the ozone therapy at the point of greatest pain, ozone group (OG; n = 20); patients received the sham ozone therapy at the point of greatest pain, placebo group (PG; n = 20). Ozone and placebo were applied three times per week, for a total of six sessions. Mandibular movements were examined, masticator muscles tenderness were assessed and pressure pain threshold (PPT) values were obtained. Subjective pain levels were evaluated using visual analogue sale (VAS). These assessments were performed at baseline, 1 month and 3 months. Ozono therapy decreased pain intensity and increased PPT values significantly from baseline to 1 month and 3 months in OG compared with PG. PPTs of the temporal (OG = 24·85 ± 6·65, PG = 20·65 ± 5·43, P = 0.035) and masseter (OG = 19·03 ± 6·42, PG = 14·23 ± 2·95, P = 0.007) muscles at 3 months of control (T2) were significantly higher in the OG group. PPT value of the lateral pole was also significantly higher at T2 in the OG group (OG = 21·25 ± 8·43, PG = 15·35 ± 4·18, P = 0.012). Mandibular movements did not show significant differences between treatment groups except right lateral excursion values at T2 (OG = 8·90 ± 1·77, PG = 6·85 ± 2·41, P = 0.003); however, OG demonstrated significantly better results over time. Overall improvements in VAS scores from baseline to 3 months were OG 67·7%; PG 48·4%. Although ozone therapy can be accepted as an alternative treatment modality in the management of masticatory muscle pain, sham ozone therapy (placebo) showed significant improvements in the tested parameters.

Can extracorporeal magnetic innervation be a treatment modality for primary dysmenorrhea?

BACKGROUND/AIMS: To evaluate the efficacy of extracorporeal magnetic innervation (ExMI) as a treatment for primary dysmenorrhea compared with nonsteroidal anti-inflammatory drugs (NSAIDs) and combined oral contraceptives (COCs). METHODS: The cases were randomized into three groups (NSAID = 51, ExMI = 53, COC = 54). ExMI was applied for a total of 10 sessions. Women in the NSAID group used an oral NSAID at the start of each menstruation. Women in the COC group were given combined pills. Of the treatment options, ExMI was applied for only a single period, whereas NSAID and COC use continued for 12 months. RESULTS: At the first menstruation, visual analog scale (VAS) scores improved significantly in all groups (p < 0.001). NSAIDs and COCs continued to show efficacy over the entire study period (p < 0.05). However, in the ExMI group, VAS values increased from the first menstruation until 12 months. The VAS score at the 12th month was significantly higher in the ExMI group than in the other groups (p < 0.05), but markedly lower than the pretreatment value (49.9 ± 8.3 vs. 71.1 ± 10.1, p < 0.001). CONCLUSIONS: ExMI therapy might be a promising novel noninvasive option for primary dysmenorrhea. Efficacy began to decline after 3 months, but continued for 12 months.

Transcutaneous electrical nerve stimulation improves low back pain during pregnancy.

BACKGROUND: To compare the efficiency of transcutaneous electrical nerve stimulation (TENS) with those of exercise and acetaminophen for the treatment of pregnancy-related low back pain (LBP) during the third trimester of pregnancy. METHODS: This prospective study included 79 subjects (≥32 gestational weeks) with visual analog scale (VAS) pain scores ≥5. Participants were divided randomly into a control group (n = 21) and three treatment groups [exercise (n = 19); acetaminophen (n = 19); TENS (n = 20)]. The VAS and the Roland-Morris disability questionnaire (RMDQ) were completed before and 3 weeks after treatment to assess the impact of pain on daily activities. RESULTS: During the study period, pain intensity increased in 57% of participants in the control group, whereas pain decreased in 95% of participants in the exercise group and in all participants in the acetaminophen and TENS groups. Post-treatment VAS and RMDQ values were significantly lower in the treatment groups (p < 0.001). VAS and RMDQ scores indicated a significantly greater degree of pain relief in the TENS group than in the exercise and acetaminophen groups (p < 0.001). No adverse effect of TENS application on pregnant women was observed during the study. CONCLUSION: TENS is an effective and safe treatment modality for LBP during pregnancy. TENS improved LBP more effectively than did exercise and acetaminophen.

Maternal serum 25(OH)D levels in the third trimester of pregnancy during the winter season.

OBJECTIVE: To measure serum 25(OH)D levels of pregnant women in the last trimester during the winter season and to determine the factors affecting their serum levels. METHODS: In all, 79 pregnant women in the third trimester were examined between November 2008 and March 2009. Serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, and 25(OH)D levels were measured. Maternal age, education, socioeconomic status (SES), nutrition, dressing habits, and level of sunlight exposure were determined and their correlation with serum 25(OH)D levels were statistically compared. RESULTS: The mean serum 25(OH)D level of the study group was 11.95 ± 7.20 ng/ml, and the prevalence of severe vitamin D deficiency [25(OH)D < 10 ng/ml] in pregnant women was 45.6%. No association was detected between severe vitamin D deficiency and maternal age, gravidity, skin phototype, benefiting from ultraviolet index, and educational status of the cases. Also in patients who used multivitamin supplements and good SES, 25(OH)D levels were significantly higher (p=0.046, p=0.025, respectively). CONCLUSIONS: This study showed a remarkable high rate of vitamin D deficiency in pregnant women during the winter season and we have found high levels of vitamin D in patients supplemented with multivitamins and in ones with good SES.