Subjective cognitive assessments and N-back are not correlated, and they are differentially affected by anxiety and depression.

Cognitive function (CF) is a core feature related to all psychiatric disorders. However, self-report scales of CF (SRSC) may not always correlate with CF's objective measures and may have different mediators. Tools to select for evaluating CF in diverse psychiatric populations and their determinants need to be studied. In this study, we aimed to assess the association of SRSC (Perceived Deficit Questionnaire-Depression (PDQ-D), and World Health Organization's Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS) and its inattentiveness subscale) with Letter-N-back as an objective measure of CF, and to analyze their association with psychopathology. Two hundred nine (131 nonclinical, and 78 clinical with a psychiatric diagnosis of ICD10 F31-39 [mood disorders excluding Bipolar I] or F40-F49 [neurotic, stress-related or psychosomatic disorder] categories) participants were evaluated with PDQ-D, ASRS, Beck Depression Inventory (BDI), and Beck's Anxiety Inventory (BAI), and N-back. Both groups' data were included in the analysis. PDQ-D showed a small correlation with N-back scores, whereas ASRS showed no correlation. PDQ-D and ASRS showed a large correlation. Age and BAI scores significantly predicted both PDQ-D and ASRS, whereas the cognitive subscale of BDI predicted PDQ-D, but not ASRS. Only BAI scores predicted N-back results. The mediation model revealed that 2-back scores of N-back task directly affects PDQ-D scores, independent of BDI scores. However, the cognitive subscale of BDI moderated 2-back and PDQ-D association. On the contrary, BAI scores significantly mediated the association of 2-back scores with PDQ-D. The direct effect of 2-back scores in PDQ-D was insignificant in the mediation of BAI scores. Our study validates the discordance between SRSC and an objective measurement of CF. Anxiety may affect both self-report and objective measurement of CF, whereas depressive thought content may lead to higher cognitive dysfunction reports in nondemented participants.

The Effect of Thyroid Eye Disease on Corneal Biomechanical Properties.

Objectives: The aim of this study was to identify corneal biomechanical parameters measured by ORA in patients with TED compared to the healthy group. The NOSPECS classification of patients is used to assess the relation between biomechanical changes and disease severity. Methods: We included 22 TED patients, diagnosed with TED for more than five years, and 43 healthy participants. The NOSPECS classification was assessed as mild (grade 1-3) and severe (grade 4-6) disease. For each group, corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), Goldmann-correlated intraocular pressure (IOPg) and corneal compensated intraocular pressure (IOPcc) parameters were measured by ORA. Results: The mean age was 38.8±11.6 years for the TED patients and 42.9±15.58 years for the control group. For TED patients and healthy volunteers, the mean levels of CRF, CH, and CCT were measured as follows: 10.43±2.04 vs 10.28±1.91mmHg, p=0.67; 10.18±1.81 vs 10.21±1.68 mmHg, p=0.90; 550.31±35.73 vs 545.23±37.91 µm, p=0.47, respectively. These values were not significant between groups, but they were significantly higher in females compared to males in TED patients [CRF;10.68 (IQR: 9.49-12.14) vs 8.96 (IQR: 8.04-9.92) mmHg, p=0.002, CH; 10.43 (IQR: 9.48-11.25) vs 8.58 (IQR: 7.90-9.95) mmHg, p=0.003 and CCT; 554.25 (IQR: 536.05-579.52) vs 527.40 (IQR: 492.25-545.90) µm, p=0.014]. CRF values were negatively correlated with NOSPECS score (r=-0.317, p=0.036) and significantly higher CRF was observed in mild patients compared to severe disease (11.43 (IQR: 10.14-12.87) vs 9.46 (IQR: 8.75-10.28) mmHg, p=0.008). Conclusion: We found a significant gender effect on corneal biomechanical parameters of TED patients. CRF, CH and CCT values were significantly higher in females compared to males with TED. The clinical severity score of TED showed negative correlation with CRF. CRF value might be a useful parameter in follow-up of TED patients in clinical practice.

A novel investigation method for axonal damage in neuromyelitis optica spectrum disorder: In vivo corneal confocal microscopy.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory autoimmune disorder that damages optic nerves, brainstem, and spinal cord. In vivo corneal confocal microscopy (IVCM) is a noninvasive technique that provides corneal images with dendritic cells (DCs) and corneal subbasal nerve plexus (SBP), which arises from the trigeminal nerve. OBJECTIVE: We investigated corneal SBP changes in NMOSD and proposed IVCM as a potential new disease severity biomarker for NMOSD. METHODS: Seventeen age-sex matched NMOSD patients and 19 healthy participants underwent complete neurologic and ophthalmologic examinations. The duration of disease, first symptom, presence of optic neuritis attack, antibody status, Expanded Disability Status Scale(EDSS) score and disease severity score(DSS) were recorded. Retinal nerve fibre layer (RNFL) thickness was measured with optical coherence tomography, and corneal SBP images were taken with IVCM. RESULTS: NMOSD patients had significantly reduced corneal nerve fibre lenght-density and corneal nerve branch lenght-density compared with controls, while DC density was increased. NMOSD patients also showed significantly reduced RNFL thickness compared with controls. EDSS,DSS levels were inversely correlated with IVCM parameters. CONCLUSION: We observed significant corneal nerve fibre loss in NMOSD patients in relation to disease severity. IVCM can be a candidate noninvasive imaging method for axonal damage assessment in NMOSD that warrants further investigation.

Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity.

PURPOSE: This study aims to establish a clinically applicable classification of reflux patterns in patients with great saphenous vein insufficiency and to evaluate the relationship between this classification, the demographics, and severity of clinical findings. METHODS: This is a retrospective study from prospectively collected data of 503 patients who had the complaint of varicose vein. All patients had complete physical examination and their medical history was recorded. Lower limbs of all patients were examined with Doppler ultrasonography. A total of 787 limbs with great saphenous vein insufficiency were included in the analysis. The reflux patterns of great saphenous vein insufficiency were classified into 4 types as: type 1, great saphenous vein reflux without involvement of malleolar region and saphenofemoral junction (SFJ); type 2, reflux involving malleolar region with competent SFJ; type 3, reflux involving SFJ with competent malleolar region; and type 4, reflux involving both the SFJ and the malleolar region. We evaluated the association between the classification of great saphenous vein insufficiency and age, sex, body mass index (BMI), disease duration, clinical, etiological, anatomical and pathophysiological elements (CEAP) classification and venous clinical severity score (VCSS). RESULTS: The mean age of the patients was 45.3±11.7 years, with a male-to-female ratio of 2:3. The most common reflux pattern in patients with great saphenous vein insufficiency was type 3 (48.9%), while 14.8% of patients had type 1, 10.4% had type 2, and 25.7% had type 4. Patients with type I reflux pattern were younger in age (p = 0.002), had lower BMI (p = 0.002), fewer number of children (p = 0.008), as well as milder clinical severity score (p = 0.002) compared to other reflux types. Duration of disease symptoms was not significantly correlated with the reflux patterns, but VCSS increased with the involvement of malleolar region as in type 2 compared to type 1 (2.82±1.67 vs. 2.74±2.31), and further increased with the involvement of SFJ as in type 3 (4.13±2.92 vs. 2.82±1.67). Patients with diffuse reflux pattern (type 4) had the most severe clinical presentation (4.59±2.9). CONCLUSION: We developed a clinically applicable classification of reflux patterns in patients with great saphenous vein insufficiency based on the involvement of malleolar region and/or SFJ. We showed an association between weight, BMI, VCSS, CEAP classification and the extent of insufficiency.

The Effect of Urine pH and Urinary Uric Acid Levels on the Development of Contrast Nephropathy.

BACKGROUND: Hyperuricemia may cause acute kidney injury by activating inflammatory, pro-oxidative and vasoconstrictive pathways. In addition, radiocontrast causes an acute uricosuria, potentially leading to crystal formation. We therefore aimed to investigate the effect of urine acidity and urine uric acid level on the development of contrast-induced nephropathy (CIN) in patients undergoing elective coronary angiography. METHODS: We enrolled 175 patients who underwent elective coronary angiography. CIN was defined as a >25% increase in the serum creatinine levels relative to basal values 48-72 h after contrast use. Prior to coronary angiography and 48-72 h later, serum uric acid, urea, creatinine, bicarbonate levels, and spot uric acid to creatinine ratio (UACR) were measured. RESULTS: Of the 175 subjects included, 29 (16.6%) developed CIN. Those who developed CIN had a higher prevalence of diabetes, higher UACR (0.60 vs. 0.44, p = 0.014), higher contrast volume, and lower serum sodium level. With univariate analysis of a logistic regression model, the risk of CIN was found to be associated with diabetes (p = 0.0016, OR = 3.8 [95% CI: 1.7-8.7]), urine UACR (p = 0.0027, OR = 9.6 [95% CI: 2.2-42.2]), serum sodium (p = 0.0079, OR = 0.8 [95% CI: 0.77-0.96]), and contrast volume (p = 0.0385, OR = 1.8 [95% CI: 1.03-3.09]). In a multiple logistic regression model with stepwise method of selection, diabetes (p = 0.0120, OR = 3.2 [95% CI: 1.3-8.1]) and UACR (p = 0.0163, OR = 6.9 [95% CI: 1.4-33.4]) were the 2 risk factors finally identified. CONCLUSIONS: We have demonstrated that higher urine UACR is associated with the development of CIN in patients undergoing elective coronary angiography.

Antidiuretic Hormone and Serum Osmolarity Physiology and Related Outcomes: What Is Old, What Is New, and What Is Unknown?

CONTEXT: Although the physiology of sodium, water, and arginine vasopressin (AVP), also known as antidiuretic hormone, has long been known, accumulating data suggest that this system operates as a more complex network than previously thought. EVIDENCE ACQUISITION: English-language basic science and clinical studies of AVP and osmolarity on the development of kidney and cardiovascular disease and overall outcomes. EVIDENCE SYNTHESIS: Apart from osmoreceptors and hypovolemia, AVP secretion is modified by novel factors such as tongue acid-sensing taste receptor cells and brain median preoptic nucleus neurons. Moreover, pharyngeal, esophageal, and/or gastric sensors and gut microbiota modulate AVP secretion. Evidence is accumulating that increased osmolarity, AVP, copeptin, and dehydration are all associated with worse outcomes in chronic disease states such as chronic kidney disease (CKD), diabetes, and heart failure. On the basis of these pathophysiological relationships, an AVP receptor 2 blocker is now licensed for CKD related to polycystic kidney disease. CONCLUSION: From a therapeutic perspective, fluid intake may be associated with increased AVP secretion if it is driven by loss of urine concentration capacity or with suppressed AVP if it is driven by voluntary fluid intake. In the current review, we summarize the literature on the relationship between elevated osmolarity, AVP, copeptin, and dehydration with renal and cardiovascular outcomes and underlying classical and novel pathophysiologic pathways. We also review recent unexpected and contrasting findings regarding AVP physiology in an attempt to explain and understand some of these relationships.

Evaluation of the Antidiabetic Property of Capparis Ovata Desf. Var. Palaestina Zoh. Extracts Using In vivo and In vitro Approaches.

BACKGROUND AND OBJECTIVE: This paper is focused on evaluating the various biological activities of C. ovata var. palaestina extracts which could beneficially influence diabetes and its complications. METHODS: Alloxan-induced diabetic BALB-c mice were administered intraperitoneally with 100, 300, 500mg/kg doses of ethanol and aqueous extracts of buds and fruits. Furthermore, HPLC, phenolic and flavonoid compounds analysis, ABTS and DPPH free radical scavenging activity, anti-inflammatory activity, agar well diffusion and MIC tests were carried out. RESULTS: Fruit-aqueous; 100mg/kg, 300mg/kg and bud-aqueous; 500mg/kg extracts showed significant hypoglycemic activity. All extracts indicated important antioxidant activity, however, bud-aqueous extract demonstrated the most potent activity. HPLC study exhibited that rutin is found in high amounts in bud-aqueous and bud-ethanol extracts. Furthermore, the bud-aqueous extract depicted stronger and broader antimicrobial activity than other extracts. Fruit-ethanol and bud-ethanol extracts denoted the most potent anti-inflammatory effect even though this effect was significantly shown by all extracts. Finally, high levels of phenolic and flavonoid content were involved in all extracts, but the highest levels were found in fruit-ethanol and bud-ethanol extracts. CONCLUSION: The results showed that extracts which indicated hypoglycemic, antioxidant, antiinflammatory, antimicrobial activities may provide a valuable contribution to the management of diabetes and its complications.

Hypoglycemic activity of Capparis ovata desf. var. palaestina zoh. methanol extract

Caper (Capparis ovata Desf. and Capparis spinosa L.) is naturally widespread in Turkey. Traditionally, buds, fruits, seeds and roots of this plant are used as tonic, diuretic, anti-rheumatic, expectorant, antidiabetic, and antifungal. The aim of this study is to evaluate potential hypoglycemic effect of C. ovata var. palaestina extracts in alloxan-induced diabetic mice. For this purpose; diabetic mice were administered with 100, 300, 500 mg/kg (i.p.) doses of methanol extract of bud and fruit. Blood glucose levels were screened 60, 120, 240 and 360 min. after treatment. Furthermore, high resolution mass spectrometry (HRMS) analysis, ABTS and DPPH free radical scavenging activity test, and phenolic and flavonoid compounds analysis of extracts were carried out. The data obtained from in vivo study revealed that fruit-methanol 500 mg/kg (FM3), bud-methanol 300 mg/kg (BM2), bud-methanol 500 mg/kg (BM3) extracts showed significant hypoglycemic activity. All extracts indicated significant antioxidant activity, however bud-methanol (BM) extract demonstrated the most potent antioxidant activity. Moreover high levels of phenolic substances and flavonoids were involved in all extracts, but the highest levels were found in FM extract. HRMS study showed that rutin, quercetin 3-O-glucoside (isoquercitrin) and stachydrine substances had seen in BM extract. The results of this study showed that the C. ovata var. palaestina extracts which, indicate hypoglycemic, antioxidant activities, might provide additional support in diabetes.

Protective Effect of Boric Acid on Oxidative DNA Damage In Chinese Hamster Lung Fibroblast V79 Cell Lines.

OBJECTIVE: Many studies have been published on the antioxidative effects of boric acid (BA) and sodium borates in in vitro studies. However, the boron (B) concentrations tested in these in vitro studies have not been selected by taking into account the realistic blood B concentrations in humans due to the lack of comprehensive epidemiological studies. The recently published epidemiological studies on B exposure conducted in China and Turkey provided blood B concentrations for both humans in daily life and workers under extreme exposure conditions in occupational setting. The results of these studies have made it possible to test antioxidative effects of BA in in vitro studies within the concentra- tion range relevant to humans. The aim of this study was to investigate the protective ef- fects of BA against oxidative DNA damage in V79 (Chinese hamster lung fibroblast) cells. The concentrations of BA tested for its protective effect was selected by taking the blood B concentrations into account reported in previously published epidemiological studies. Therefore, the concentrations of BA tested in this study represent the exposure levels for humans in both daily life and occupational settings. MATERIALS AND METHODS: In this experimental study, comet assay and neutral red uptake (NRU) assay methods were used to determinacy to toxicity and genotoxicity of BA and hydrogen peroxide (H2O2). RESULTS: The results of the NRU assay showed that BA was not cytotoxic within the tested concentrations (3, 10, 30, 100 and 200 µM). These non-cytotoxic concentrations were used for comet assay. BA pre-treatment significantly reduced (P<0.05, one-way ANOVA) the DNA damaging capacity of H2O2 at each tested BA concentrations in V79 cells. CONCLUSION: Consequently, pre-incubation of V79 cells with BA has significantly reduced the H2O2-induced oxidative DNA damage in V79 cells. The protective effect of BA against oxidative DNA damage in V79 cells at 5, 10, 50, 100 and 200 µM (54, 108, 540, 1080, and 2161 ng/ml B equivalents) concentrations was proved in this in vitro study.

The risk factors effecting the dry mouth in inpatients in Hospital in west Anatolia.

AIM: The aim of the present study was to evaluate the inpatients with dry mouth and the associated risk factors. BACKGROUND: Dry mouth is defined as the excessive decrease in the amount of saliva. Hyposalivation may lead to rapid deterioration in oral health and may facilitate the development of opportunistic oral infections. Oral hygiene and evaluation of oral health are basic nursing activities. DESIGN: Cross-sectional. PARTICIPANTS: The sample size was determined to be 90 inpatients according to the power analysis calculated for the patients with dry mouth who were able or unable to take oral liquids. The study was completed with 247 inpatients in the Internal Medicine Clinic. METHODS: A patient information form was used to collect the data for the present study. Saliva samples taken for analyses of flow rates. RESULTS: The amount of saliva of patients who were unable to take oral liquid was 10·7 times lower than those taking >1500 ml of liquids daily. The amount of saliva of patients receiving humidified oxygen was 2·3 times lower than those not receiving humidified oxygen. The amount of saliva of those receiving anticholinergic drugs was 3·64 times lower than those not receiving anticholinergic drugs. CONCLUSIONS: Inability to take oral liquids and receiving humidified oxygen and anticholinergic drug therapy were significant factors for the development of dry mouth. RELEVANCE TO CLINICAL PRACTICE: The results are important for determining the risk factors for dry mouth. Being aware of dry mouth and knowing the associated risk factors are valuable information for nurses to initiate required procedures, as well as to prevent the development of oral health problems.