Disordered bone metabolism in hereditary spherocytosis patients.

Aim: This study was planned to evaluate bone health in patients with hereditary spherocytosis.Materials and methods: In this prospective study, a total of 30 hereditary spherocytosis patients which followed in the Pediatric Hematology and Oncology Department of KSU Medical Faculty and 30 patients for control group were included. Patient and control group were chosen equal in age and sex. Hemogram and biochemical tests (serum calcium, phosphorus, alkaline phosphatase, parathormone, vitamin D) and osteocalcin were studied from the patient and control groups. Also DXA examination was performed in the patient group.Results: There was a significant difference in hemogram parameters between the two groups due to hemolytic anemia in hereditary spherocytosis patients. In the patient group, osteocalcin was 6.88 ± 4.35 ng/ml, vitamin D was 17.74 ± 7.76 ng/ml and in the control group osteocalcin was 11.93 ± 8.92 ng/ml, vitamin D was 24.04 ± 11.70 ng/ml. There was a statistically significant difference between the vitamin D and osteocalcin levels of the two groups (p = 0.017 and 0.008, respectively). Bone density was assessed in the patient group. In patients DXA results showed lower Z-scores then the normal population according to age and sex.Conclusion: Hereditary spherocytosis patients should be followed closely in terms of development, puberty, bone health as they are in other hemolytic anemias. Nutritional recommendations, vitamin D supplementation, physical activity should be advised to protect bone health.

Lead, selenium and nickel concentrations in epithelial ovarian cancer, borderline ovarian tumor and healthy ovarian tissues.

OBJECTIVE: Wide variation exists in ovarian cancer incidence rates suggesting the importance of environmental factors. Due to increasing environmental pollution, trace elements and heavy metals have drawn attention in studies defining the etiology of cancer, but scant data is available for ovarian cancer. Our aim was to compare the tissue concentrations of lead, selenium and nickel in epithelial ovarian cancer, borderline tumor and healthy ovarian tissues. METHODS: The levels of lead, selenium and nickel were estimated using atomic absorption spectrophotometry in formalin-fixed paraffin-embedded tissue samples. Tests were carried out in 20 malignant epithelial ovarian cancer, 15 epithelial borderline tumor and 20 non-neoplastic healthy ovaries. Two samples were collected for borderline tumors, one from papillary projection and one from the smooth surface of cyst wall. RESULTS: Pb and Ni concentrations were found to be higher both in malignant and borderline tissues than those in healthy ovaries. Concentrations of Pb and Ni in malignant tissues, borderline papillary projections and capsular tissue samples were not different. Comparison of Se concentrations of malignant, borderline and healthy ovarian tissues did not reveal statistical difference. Studied metal levels were not found to be different in either papillary projection or in cyst wall of the borderline tumors. CONCLUSIONS: This study revealed the accumulation of lead and nickel in ovarian tissue is associated with borderline and malignant proliferation of the surface epithelium. Accumulation of these metals in epithelial ovarian cancer and borderline ovarian tumor has not been demonstrated before.

Comparison of Vitamin D levels in cases with preeclampsia, eclampsia and healthy pregnant women.

The aim of this study is to assess vitamin D levels in eclampsia, preeclampsia and healthy pregnant women and the role of vitamin D deficiency in the etiology of preeclampsia (PE). Forty healthy pregnant women, 83 preeclamptic and 32 eclamptic pregnant women were included. Maternal and infant medical records were reviewed. Blood samples were obtained from all groups. Demographics and serum vitamin D levels were compared between the groups. No statistical differences were observed in age, gravidity, parity, weight, height and BMI between the three groups. Week of pregnancy and weight at birth in eclamptic and preeclamptic patients were lower compared to the healthy patients (P<0.001 and P<0.001, respectively). Systolic and diastolic blood pressures were higher in eclamptic (P<0.001) and preeclamptic patients (P<0.001) compared to the healthy pregnant group. The rate of cesarean section was found to be higher in preeclamptic and eclamptic patients (P<0.001). Vitamin D levels were lower in both preeclamptic and eclamptic patients compared to healthy normotensive pregnant women (P<0.001). Preeclamptic and eclamptic women were similar in terms of the data compared. Vitamin D supplementation is considered to decrease the risk of both preeclampsia and eclampsia in the patient population at risk for vitamin D deficiency.

Follow-up of P dispersion after transcatheter closure of an atrial septal defect in children.

OBJECTIVES: To determine in paediatric patients with atrial septal defects whether differences in P wave dispersion occurred with transcatheter closures using the Amplatzer septal occluder. METHOD: A total of 31 children who had undergone transcatheter closures were evaluated. P maximum, P minimum, and P dispersion were measured with 12-lead surface electrocardiography, before the procedure and one week, one month, three months, six months and one year following the procedure. SPSS 10 was used for statistical analysis. RESULTS: There were 23 (74.2%) females and 8 (25.8%) males with an overall mean age of 7.5 +/- 4.1 years and mean weight of 26.2 +/- 16.9 kg. The P maximum and P minimum measurements differed between patients during the follow-up period. Both measurements decreased with time. However, P dispersion was not significantly different throughout the follow-up period (before the procedure P maximum 95.4 +/- 15.6 ms, P minimum 64.5 +/- 15.4 ms, and P dispersion 30.8 +/- 11.4 ms; one year later, P maximum 76.1 +/- 14.6 ms, P minimum 47.1 +/- 12.1 ms, and P dispersion 29.1 +/- 9.1 ms). CONCLUSION: Over time, there are no P dispersion differences in transcatheter closures using the Amplatzer septal occluder.

Plasma selenium levels in Turkish women with polycystic ovary syndrome.

OBJECTIVE(S): To evaluate selenium (Se) levels in serum and their relation with hyperandrogenism and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS) and in control subjects. STUDY DESIGN: Women with any gynecological problem who presented to the Kahramanmaras Sutcuimam University Medical Faculty Gynecology and Obstetric Outpatient Clinic were invited to participate. Group 1 consisted of 36 cases with a diagnosis of PCOS according to the 2003 Rotterdam Consensus Criteria, and Group 2 (control group) consisted of 33 age- and BMI-matched healthy women. In all cases, serum total testosterone (tT), dihydroepiandrostenedione-sulfate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), insulin, glucose (mg/dL), total cholesterol (TC) (mg/dL), high density lipoprotein-cholesterol (HDL-C) (mg/dL), low density lipoprotein-cholesterol (LDL-C) (mg/dL), triglyceride (TG) (mg/dL) and Se levels were measured. RESULTS: The level of FSH was significantly lower, and the levels of LH, E2, tT, and DHEAS were significantly higher in group 1 than in group 2 (p<0.05). The hirsutism score was significantly higher among PCOS women compared to the control group (p<0.05). Although insulin levels and HOMA-IR were markedly increased in the PCOS group compared to the control group, the differences were not significant (p>0.05). The plasma Se level was significantly lower in PCOS women compared to the control group (p<0.05). When we combined the all women in two groups, regarding them as one group (combined group, n=69), a negative correlation between Se and LH and tT was present (p<0.05). CONCLUSION(S): Our results show decreased plasma concentrations of Se and a negative correlation between Se and LH, tT in women with PCOS. These results indicate that Se may play a role in the pathogenesis of PCOS related with hyperandrogenism.

Trace elements in nasal polyps.

The aim of our study is to evaluate the status of selenium and zinc in nasal polyp tissues and to investigate the possible role of trace elements and antioxidants including superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in nasal polyps. In this study, the antioxidant enzyme and trace element levels measured in polyp tissues of 37 patients were compared with the levels measured in conchal mucosa of 27 control cases. The antioxidant enzyme and trace element levels in tissues were measured with graphite and flame spectrophotometry methods using Shimatsu UV.1601 spectrophotometer and Perkin Elmer atomic spectrometer. The mean tissue zinc and selenium levels were, respectively, 2.55 µg/g and 30.03 pg/g in patient group, 4.37 µg/g and 44.95 pg/g in control group. The mean tissue SOD and GSH-Px levels were, respectively, 4.27 and 0.69 U/mg protein in patient group, 7.09 and 0.77 U/mg protein in control group. When the measured levels in patients and control cases were compared, there were statistically significant differences between zinc, selenium, and SOD levels (P = 0.001). There was no significant difference between GSH-Px levels (P = 0.465). In conclusion, it has been revealed that the levels of zinc, selenium, and SOD in nasal polyps were significantly lower, and it may be concluded that this may have a role in the development of nasal polyps.

Plasma selenium, zinc, copper and lipid levels in postmenopausal Turkish women and their relation with osteoporosis.

It has been shown that the trace elements and lipids play role in the growth, development and maintenance of bones. We aimed to investigate serum selenium (Se), zinc (Zn), copper (Cu) and lipid (total cholesterol, triglyceride (TG), high density lipoprotein-cholesterol, low-density lipoprotein-cholesterol) levels in postmenopausal women with osteoporosis, osteopenia and in healthy controls, and to determine the relationship between Se, Zn, Cu and lipid parameters and bone mineral density (BMD). The study included 107 postmenopausal women; 35 healthy (group 1), 37 osteopenic (group 2) and 35 osteoporotic (group 3). The women in all three groups were carefully matched for body mass index (BMI). Serum concentrations of Se, Zn and Cu were measured by atomic absorption spectrophotometry. Plasma Se, Cu, Zn and lipid levels were similar in all groups (p > 0.05). When we combined the women in each of the three groups, and considered them as one group (n = 107) we found a positive correlation between BMI and lumbar vertebra BMD, femur neck BMD, femur total BMD; a positive correlation between TG and femur neck BMD, femur total BMD; a positive correlation between Zn and lumbar vertebra BMD (total T score) (p < 0.05). There was no correlation between Se, Cu, Zn, P and lipid parameters (p > 0.05). Although BMI has a positive effect on BMD, trace elements and lipids, except Zn and TG, did not directly and correlatively influence BMD. Further studies are needed to clarify the role and relationship of trace elements and lipid parameters in postmenopausal osteoporosis.

Serum reference levels of selenium, zinc and copper in healthy pregnant women at a prenatal screening program in southeastern Mediterranean region of Turkey.

PROJECT: The aim of the study was to investigate the serum reference range for Selenium (Se), Zinc (Zn) and Copper (Cu) levels in women of 10-14 (group I) and 16-20 (group II) weeks of gestation and compare them with those in non-pregnant healthy women and healthy men. PROCEDURE: This cross-sectional study was performed in 351 pregnant women [group I (n: 177) and group II (n: 174)], 30 non-pregnant women and 30 men as controls. The levels of Se, Zn and Cu levels were determined on flame and furnace atomic absorption spectrophotometer using Zeeman background correction. RESULTS: In the 10-14 weeks of gestation Se, Zn and Cu serum levels were 44.85+/-9.23, 81.30+/-31.94 and 132.33+/-38.24 microg/dl, in 16-20 weeks of gestation were 47.18+/-10.92, 74.25+/-22.47 and 164.86+/-39.69 microg/dl, in non-pregnant women were 55.38+/-8.81, 121.41+/-29.22 and 104.75+/-39.14 microg/dl also in men 72.24+/-9.28, 134.85+/-15.95 and 78.29+/-20.90 microg/dl, respectively. CONCLUSION: A significant low level of serum Se, Zn and a high level of Cu in the pregnant women in the 10-14 and 16-20 weeks of gestation were detected when compared with that of non-pregnant women and men.

Ischemia-reperfusion injury in skeletal muscle: comparison of the effects of subanesthetic doses of ketamine, propofol, and etomidate.

BACKGROUND: Interest in the effects of anesthetics in skeletal ischemia-reperfusion injury (IRI) has recently emerged. Thus, the objective was to compare the effects of subanesthetic doses of ketamine, propofol, and etomidate in a skeletal IRI model. METHODS: IRI was applied to rats by tourniquet method. Under thiopental anesthesia, five experimental groups were established as follows: (1) sham-control, (2) IRI, (3) IRI+Ketamine, (4) IRI+Propofol, and (5) IRI+Etomidate. Malondialdehyde, superoxide dismutase, catalase, and glutathione peroxidase were measured in skeletal muscle via a spectrophotometer. Zinc, iron, copper, and selenium were evaluated by atomic absorption spectrophotometer. RESULTS: While the values of malondialdehyde and glutathione peroxidase were higher and lower, respectively, those of superoxide dismutase and catalase were identical in IRI group in comparison with sham-control. Zinc displayed a decrease in IRI group; however, no differences in iron and copper levels were determined. In rats treated with subanesthetic doses of ketamine, elevated malondialdehyde levels in IRI group were reversed to control levels by each dose. While each dose of ketamine decreased superoxide dismutase activities in comparison with IRI group, a reduction in catalase activity was only seen in 3mg/kg ketamine-treated rats. The attenuated glutathione peroxidase activity seen in IRI was greatly reversed by ketamine administration in all doses. No differences in zinc, copper, and iron levels were detected between IRI and ketamine-treated groups. Similar results were obtained either by the administration of propofol or etomidate. CONCLUSIONS: Subanesthetic doses of ketamine, propofol and etomidate displayed beneficial effects in IRI.

Selenium levels in first-degree relatives of diabetic patients.

The present study was conducted to evaluate the serum selenium levels in first-degree relatives of diabetic patients (FDR) according to controls. Insulin resistance, serum lipid levels, inflammation markers, and blood pressure were also studied in these patients. Serum levels of selenium in FDR were significantly lower than control group (74.65 +/- 5.9 vs 88.7 +/- 8.7 microg/dl, p < 0.0001). HsCRP, HOMA-IR, insulin, homocysteine levels were significantly higher in FDR according to the control group (1.32 +/- 0.9 vs 0.63 +/- 0.4 mg/dL, p < 0.0001; 2.07 +/- 0.84 vs 1.51 +/- 0.69, p < 0.0001; 9.26 +/- 3.8 vs 6.8 +/- 2.98 microU/MI, p < 0.0001; 15.7 +/- 7.4 vs 11.5 +/- 5.1 micromol/L, p < 0.0001, respectively). There was significant correlation between selenium levels and hsCRP (r = - 0.450, p < 0.0001). There was also weak significant correlation also between HOMA-IR and selenium levels (r = -0.227, p = 0.003). There was a correlation between systolic blood pressure and BMI (r = 0.365, p < 0.0001). But there was no correlation between selenium levels and blood pressure or other parameters. HsCRP, HOMA-IR, homocysteine levels in individuals with selenium levels < 80 microg/L (n = 78) was significantly higher than hsCRP HOMA-IR, homocysteine levels in individuals with selenium levels >or= 80 (n = 91; 1.23 +/- 0.98 vs 0.81 +/- 0.76 mg/dL, p < 0.003; 1.99 +/- 0.88 vs 1.64 +/- 0.74, p < 0.005; 15.0 +/- 7.6 vs 12.9 +/- 5.7 micromol/L, p < 0.049, respectively). Selenium deficiency may contribute to cardiovascular disease risk in FDR.

Evaluation of serum selenium levels in Turkish women with gestational diabetes mellitus, glucose intolerants, and normal controls.

The aim of the study was to investigate the association between serum selenium levels in patients with gestational diabetes mellitus (GDM) and glucose intolerants and compare them with those of glucose-tolerant pregnant women. This cross-sectional study was prospectively performed in a total of 178 pregnant women undergoing a 50-g oral glucose tolerance test between 24 and 28 weeks of gestation who were grouped according to their status of glucose tolerance as with gestational diabetes (group A, abnormal 1- and 3-h glucose tolerance test; n = 30), glucose intolerant (group B, abnormal 1-h but normal 3-h glucose tolerance test; n = 47), or normal controls (group C, normal 1-h glucose test; n = 101). Serum selenium levels were measured with a graphite furnace atomic absorption spectrophotometer using a matrix modifier. Median maternal age and gestational age at the time of diagnosis in group A (gestational age = 24.8 [24-27]), group B (gestational age = 24.7 [24-27]), and group C (gestational age = 25 [24-28]) did not differ. Patients with gestational diabetes mellitus and those with glucose intolerants had lower selenium level than that of the normal pregnant women (P < 0.001). There was a significant inverse correlation between selenium and blood glucose level, and also selenium supplementation might prove beneficial on patients with GDM and prevent or retard them from secondary complications of diabetes.

Are changes in urinary parameters during pregnancy clinically significant?

We aimed to objectively determine changes in the various urinary parameters along with CaOx saturation level during pregnancy. The study included 15 pregnant women who had no known diseases and were taking no medication except prenatal supplements. Mean age of the patients was 26 years (range 20-30). In all of them, this study was carried out in each trimester and 3 months post partum. All participants were followed up, and blood and urine samples were obtained during the pregnancy and during 3 months post partum. All subjects collected 24-h urine samples. The pregnant women had hypercalciuria in all three trimesters. Except for the first trimester, urine calcium levels in all trimesters were significantly higher when compared with the post-partum period (P<0.01 for second trimester, P<0.05 for third trimester). Urine oxalate level in post-partum period was significantly higher than urine oxalate levels in each trimester (P<0.05). The urine citrate levels were similarly higher than normal levels in three trimesters. Urine citrate level of the post-partum period was in normal reference ranges. This difference was not statistically significant (P>0.05). We believe that hypercalciuria encountered at pregnancy is a reversible physiologic condition. Also, citrate and magnesium as urinary inhibitors increased in urine during gestation preventing stone formation. We think that long time periods are needed for hypercalciuria to be able to lead to the formation of urinary calculi in pregnant women (except women having a positive family history). Therefore, we think that the pregnancy alone does not predispose to a suitable condition for calculi.

The role of urtica dioica (urticaceae) in the prevention of oxidative stress caused by tourniquet application in rats.

Tourniquets are used in extremity surgery and provide a relatively bloodless field, thereby minimizing blood loss and helping identify the vital structures. However, they may cause an ischemia-reperfusion injury with potentially harmful local and systemic consequences. Many therapeutic effects such as diuretic, natriuretic, hypotensive, anti-rheumatic, anti-prostatic, and in-vitro anti-oxidant effects of the Urtica dioica (UD) have been determined. In the present study, we aimed to investigate the potential role of UD plant for prevention of oxidative stress in muscle tissues generated by tourniquet application in rats. Wistar rats were used in this study. The UD extract or 1.15% KCl aqueous solution, in which UD leaf samples were homogenized, was given to each group of eight rats once a day for 5 days through an intraesophageal canule. No treatment was applied to untreated group. Tourniquets were applied to the left posterior limb of rats for 1 or 2 h followed by a reperfusion period of 1 h. After the ischemia and reperfusion, the rats were killed with a high dose of anesthetic drug, and malonyldialdehyde (MDA) levels were measured in their tibialis anterior muscles. Basal MDA levels were obtained from tibialis anterior muscles of 8 control rats, which were not exposed to ischemia. MDA levels were lower in the UD-treated rats than those in untreated and KCl-treated rats after either 1 or 2 h of ischemia and 1 h reperfusion. These results indicate that UD has a potential antioxidant effect on ischemic muscle tissues.

Effect of mesalazine, metronidazole and gentamicin on bacterial translocation in experimental colitis.

BACKGROUND AND AIM: In inflammatory bowel disease it has been established that enteric microorganisms are present in the final stage of the active inflammatory process. The purpose of the present study was to investigate the effects of mesalazine, and metronidazole-gentamicin combination, on bacterial translocation in an animal colitis model. METHODS: Fifty rats were stratified into five groups. The control group (group NC) was given only 2 mL saline enema and the remaining four groups were given 2 mL acetic acid enema. Group CC was the diseased control group. The treatment regimens started on the fifth day: mesalazine enema in group MesC, metronidazole-gentamicin in group MGC, and mesalazine + metronidazole + gentamicin in group MesMGC. After death on day 10, 2.5-cm colonic segments from all groups were weighed separately. In all rats, histopathological scoring was done, and samples from feces, blood, liver and spleen underwent microbiological analyses. RESULTS: For all diseased rats, both mean weight loss and colonic segment weight/bodyweight ratio was significantly higher than that in the sham group. As compared with other groups, body and colonic segment changes as well as histopathological scoring in rats receiving mesalazine enema either solely or in combination with the antibiotics were lower. No bacterial growth was found in the blood, liver and spleen of the rats in the control group while enteric bacteria, mainly Escherichia coli (35%) were the most common bacteria translocated to that in the latter. Antibiotic combination, alone or in combination with mesalazine was effective in reducing the bacterial translocation while mesalazine administration did not properly influence its regression. CONCLUSIONS: Gram-negative enteric bacteria, predominantly E. coli, was the most common bacteria isolated in bacterial translocation occurring in acetic acid-induced colitis. This trial showed that mesalazine alone did not incorporate the reduction of infectious events, despite its beneficial effect on inflammatory changes in experimental colitis. Metronidazole and gentamicin combination given intraperitoneally was more effective than topical mesalazine in decreasing bacterial translocation.