Implications of obstructive sleep apnea on reproductive health: a study on anti-Mullerian hormone levels.

PURPOSE: This study aimed to explore the association between anti-mullerian hormone (AMH) levels and obstructive sleep apnea (OSA) severity. METHODS: A cross-sectional design was employed to evaluate AMH levels in 68 premenopausal women diagnosed with OSA at Van Yüzüncü Yil University Faculty of Medicine. OSA severity was scored according to the 2018 AASM guidelines using a 16-channel Embla device. AMH levels were measured from blood samples using a commercially available kit. RESULTS: The study found that AMH levels in OSA patients were significantly lower than those in the healthy control group. A statistically significant negative correlation between AMH and AHI levels was observed. When stratified by OSA severity, the lowest AMH levels were found in the severe OSA group. CONCLUSION: OSA may have potential endocrine implications, especially concerning reproductive health. Decreased AMH levels in OSA patients could indicate future risks of infertility or early menopause.

Evaluation of cerebrospinal fluid levels for ALOX5, S100B, DEFA1, and GFAP in infectious meningitis.

BACKGROUND: The aim of this study was to determine how the levels of peptide and protein-based biomarkers in cerebrospinal fluid change in bacterial, tuberculous, and aseptic meningitis, and to determine the success of these agents in distinguishing between different types of infectious meningitis. METHODS: The levels of arachidonate-5-lipoxygenase, S100 calcium-binding protein B, defensin-α 1, and glial fibrillary acidic protein in cerebrospinal fluid samples from 20 tuberculosis, 40 bacterial, 25 aseptic meningitis patients, and 55 control groups were measured and compared using an enzyme-linked immunosorbent assay. RESULTS: The mean age of the patients was 37.9 ±â€…14.4 years. The parameter that contributed the most to the differential diagnosis of the infectious meningitis groups was S100 calcium-binding protein B. The S100 calcium-binding protein B levels were significantly higher in the tuberculous meningitis group than in the other groups, and arachidonate-5-lipoxygenase levels were significantly higher in the tuberculous meningitis and bacterial meningitis groups (P < .05). CONCLUSION: This study showed that cerebrospinal fluid arachidonate-5-lipoxygenase, and S100 calcium-binding protein B levels may differ in bacterial, aseptic, and tuberculous meningitis, and the results obtained may be quite effective as important potential biomarkers in the differential diagnosis of different types of meningitis.

The role of irisin in predicting obstructive sleep apnea severity among obese individuals: a comparative analysis.

PURPOSE: This study aimed to investigate the predictive value of circulating irisin levels in discriminating the presence and severity of obstructive sleep apnea (OSA) in obese individuals. METHODS: This study was conducted on obese volunteers with and without OSA. All volunteers underwent polysomnography. Blood samples were taken on the day of the test. In addition to routine biochemistry studies, irisin levels were determined by enzyme-linked immunosorbent measurement. ROC analysis was performed to determine the predictive value of irisin. RESULTS: Of 100 volunteers, 75 had OSA and 25 did not. Irisin levels were significantly lower in the group with OSA than in the non-OSA group. The lowest irisin levels were determined in the group with severe OSA. Irisin levels showed high sensitivity and specificity in distinguishing between OSA and non-OSA groups. It had high sensitivity and specificity in differentiating severe OSA from other groups in subgroups, while it had low sensitivity and specificity in differentiating patients with mild and moderate OSA. In logistic regression analysis, a low irisin level was determined to be a risk factor for OSA independent of BMI. CONCLUSION: This study indicated that irisin levels decrease in obese individuals with OSA, correlating with the severity of the condition. Additionally, irisin levels may act as an independent predictor for OSA. The predictive value of irisin in identifying severe OSA among obese patients suggests its potential as a promising biomarker.

Effects of fluoride on oxidative DNA damage, nitric oxide level, lipid peroxidation and cholinesterase enzyme activity in a rotenone-induced experimental Parkinson's model.

OBJECTIVE: Environmental toxins are known to be one of the important factors in the development of Parkinson's disease (PD). This study was designed to investigate the possible contribution of fluoride (F) exposure to oxidative stress and neurodegeneration in rats with PD induced by rotenone (ROT). MATERIALS AND METHODS: A total of 72 Wistar albino male rats were used in the experiment and 9 groups were formed with 8 animals in each group. ROT (2 mg/kg) was administered subcutaneously (sc) for 28 days. Different doses of sodium fluoride (NaF) (25, 50 and 100 ug/mL) were given orally (po) for 4 weeks. Malondialdehyde (MDA), glutathione (GSH), nitric oxide (NO), oxidative DNA damage (8-OHdG) and cholinesterase (AChE/BChE) enzyme activities were evaluated in serum and brain tissue homogenates. RESULTS: Rats treated with ROT and NaF had significant increases in serum and brain MDA, NO content, and decreases in GSH. In addition, the combination of ROT and NaF triggered oxidative DNA damage and resulted in increased AChE/BChE activity. CONCLUSIONS: Findings suggest that NaF and ROT may interact synergistically leading to oxidative damage and neuronal cell loss. As a result, we believe that exposure to pesticides in combination with NaF is one of the environmental factors that should not be ignored in the etiology of neurological diseases such as PD in populations in areas with endemic fluorosis.

Blood prestin levels in COVID-19 patients.

BACKGROUND: Many studies have found that viral infections affect different tissues, including the inner ear. Coronavirus disease 2019 (COVID-19), a viral infection, is a significant health problem worldwide. Prestin is a motor protein with important functions both in the outer hair cells of the inner ear and in cardiac tissue. In addition, prestin is promising as an early biomarker in the detection of ototoxicity. To determine the severity of infection in COVID-19 patients and to determine whether other tissues are affected by the infection, lactate dehydrogenase (LDH), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase MB (CK-MB), biochemical markers such as ferritin and D-dimer are used. This study aimed to compare prestin levels in patients with COVID-19 and healthy volunteers. METHODS: In blood samples taken from 45 patients diagnosed with COVID-19 and 40 healthy volunteers, prestin levels were determined with the kit that used an enzyme-linked immunosorbent assay method and was commercially available. At the same time, LDH, CRP, ALT, AST, CK-MB, ferritin, and D-dimer levels were also detected in both patients and healthy control groups and correlations with prestin levels were examined. RESULTS: The main result of our study is that serum prestin levels in COVID-19 patients are significantly higher than in healthy controls ( p < 0.001). In addition, a statistically significant strong positive correlation was found between prestin-LDL ( r = 0.537, p = 0.001), prestin-CRP ( r = 0.654, p = 0.001), and prestin-D-dimer ( r = 0.659, p = 0.001). CONCLUSION: The levels of prestin, a motor protein in inner ear outer hair cells and cardiac myocytes, were found to be higher in COVID-19 patients than in healthy volunteers. It also showed a positive correlation with CRP and D-dimer. This may be associated with systemic dysfunction.

Determination of Serum Differential Carnitine Ester Levels in HIV(+) Patients: A Cross-Sectional Study.

OBJECTIVE: It has been reported that carnitine deficiency is observed in various viral infections and in the follow-up of the prognosis of some diseases. In this cross-sectional study, we aimed to determine how carnitine ester derivatives change in HIV-positive patients. MATERIALS AND METHODS: In this study, 25 HIV-infected patients who applied to Harran University Faculty of Medicine Education Research and Practice Hospital Infectious Diseases and Clinical Microbiology Outpatient Clinic and who did not receive any antiretroviral treatment, as well as 25 healthy volunteers were included in the study. Carnitine ester levels in serum samples were measured by Liquid Chromatography-Mass Spectrometry/Mass Spectrometry (LC-MS/MS) method (Shimadzu North America, Columbia, MD, USA). RESULTS: While suberoylcarnitine (C8DC), myristoleylcarnitine (C14:1), tetradecadienoylcarnitine (C14:2), palmitoleylcarnitine (C16:1), and linoleylcarnitine (C18:2) levels in HIV(+) patients were quite low compared to the control group, tiglylcarnitine (C5:1) levels were high (p ≤ 0.05). In addition, C5:1 and C14:2 index parameters according to VIP score, and C5:1 and C14:1/C16 index parameters according to ROC analysis were determined as markers with high potential to distinguish HIV(+) patients from healthy volunteers. CONCLUSION: This study showed that levels of acylcarnitine derivatives might be altered in HIV(+) patients, and the results obtained may contribute to a better understanding of carnitine metabolism.

Plasma Free Amino Acid Profile in HIV-Positive Cases.

BACKGROUND: Increasing the sensitivity and availability of liquid chromatography tandem mass spectrometry (LC-MS/MS) devices may provide advantages in terms of revealing the changes in metabolic pathways in HIV-positive patients and elucidating the physiopathology. INTRODUCTION: The aim of this study was to determine the difference in amino acid levels between HIV-positive patients and healthy individuals by using LC-MS / MS and investigate its relationship with HIV infection. MATERIAL AND METHODS: Concentrations of 36 different amino acids and their derivatives were measured and compared in venous plasma samples from 24 HIV-positive patients and 24 healthy individuals by using the LC-MS/MS method (Shimadzu North America, Columbia, MD, USA). RESULTS: HIV-positive subjects had significantly lower alanine, 1-methyl-L-histidine, valine, aspartate, cysteine, cystine, methionine, lysine, glutamine, imino acid, tyrosine, tryptophan, threonine, sarcosine, and argininosuccinic acid and significantly higher 3-methyl-L -histidine, asparagine, glutamate, and carnosine levels as compared to healthy controls. No significant differences were detected in other amino acids. CONCLUSION: The significant differences in amino acid profile between HIV-positive and healthy subjects may represent an auxiliary biomarker of cellular damage in asymptomatic HIV-positive patients that may be examined in more detail in further studies. It may also provide guidance for symptomatic cases in terms of the association between symptoms, clinical manifestations, and deficiency or excess of certain amino acids in the context of the complete metabolomics record of HIVpositive patients.

The levels of 25-hydroxy vitamin D, parathyroid hormone, calcitonin and lipid profiles in patients with calcaneal spur.

Objectives: The aim of this study was to investigate the 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), and calcitonin levels and lipid profiles in patients with calcaneal spurs. Patients and methods: Between March 2018 and June 2019, a total of 50 patients (30 males, 20 females; mean age: 39.8±8.1 years; range, 24 to 54 years) admitted to our clinic with heel pain and diagnosed with heel spurs based on radiographic images were included. The control group consisted of 50 age- and sex-matched healthy volunteers (32 males, 18 females; mean age: 35.7±9.6 years; range, 20 to 56 years). Blood samples were collected from all participants. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride, phosphate, and calcium levels were measured using the colorimetric method. The PTH and 25(OH)D levels were measured using the chemiluminescent microparticle immunoassay. Calcitonin levels were detected using the chemiluminescent immunometric assay. Results: In the patients with calcaneal spurs, 25(OH)D and HDL-C levels were significantly lower (p<0.001), while LDL-C, triglyceride, and PTH levels were significantly higher (p<0.05, p<0.002 and p<0.001, respectively). There was no significant difference in the calcium, phosphate, body mass index, and calcitonin levels between the groups. Conclusion: Our study results suggest that calcaneal spur formation is associated not only with weight-related pressure, but also with lipid levels and hormonal alterations involved in calcium metabolism. Based on these findings, hormonal alterations and lipids should be considered in patients with calcaneal spurs.

The Evaluation of Thiol/Disulfide Homeostasis and Oxidative DNA Damage in Patients with Obsessive Compulsive Disorder.

Objective: In this study, we aimed to examine thiol/disulfide homeostasis and oxidative DNA damage in patients with OCD and compare them with healthy controls. Methods: Thirty-five patients previously diagnosed with OCD in Van Yuzuncu Yil University Department of Psychiatry and thirty-three healthy volunteers were included in the study. The severity of the symptoms was measured using the Yale-Brown Obsessive-Compulsive Scale. Five ml of blood samples were taken from the patient and control groups. The samples were stored at appropriate conditions until use. Leukocyte DNA was isolated and the levels of 8-hydroxy-2-deoxyguanosine (8-OHdG) and deoxyguanosine were detected to assess the oxidative DNA damage. The level of oxidative DNA damage was expressed as 8-OHdG/106dG. Total thiol/native thiol levels were measured for thiol/disulfide homeostasis. The level of disulfide was determined by subtracting the native thiol value from the total thiol value and the result was divided by two. Results: were given as percentages. Results: The total and native thiol levels in patients with OCD were significantly lower, and the disulfide levels were significantly higher in patients with OCD than healthy control subjects. In addition, 8-OHdG, an indicator of DNA damage, was significantly lower in the control group compared to the patient group. Conclusion: Increased levels of disulfide/native thiol and disulfide/total thiol in patients with OCD show that levels of oxidative stress were elevated and therefore, higher 8-OHdG levels in patients with OCD is a marker of oxidative DNA damage.

The synergistic effects of testosterone and phophodiesterase-5 inhibitor combination on oxidative stress markers, matrix metalloproteinases and oxidative DNA damage: A randomized controlled experimental study / Efecto sinérgico del uso combinado de testosterona y el inhibidor de fosfodiesterasa en los marcadores del estrés oxidativo, metaloproteinasas de la matriz y daño oxidativo del AND: estudio experimental contolado y aleatorizado

Purpose: To investigate the effects of combined tadalafil and testosterone usage on oxidative stress, DNA damage and MMPs in testosterone deficiency.Methods: Fifty rats were randomly divided into 5 groups (group-1: sham group-placebo, group-2: bilateral orchiectomy (ORX), group-3: bilateral ORX+tadalafil, group-4: bilateral ORX+testosterone, group-5: bilateral ORX+tadalafil+testosterone). Group-3 received tadalafil (5mg/kg/day, oral). Group-4 was administered testosterone undecanoate (100mg/kg i.m., single dose). Group-5 was administered a combination of tadalafil and testosterone undecanoate. All groups were compared with regard to serum nicotinamide adenine dinucleotide phosphate oxidase-4 (NOX-4), total thiol, matrix metalloproteinase-2 (MMP-2), MMP-3 and MMP-9, tissue inhibitor of metalloproteinases-1 (TIMP-1) and TIMP-2 and 8-hydroxy-2-deoxy guanosine (8-OHdG) levels.Results: Total thiol levels of group-2 were significantly lower than the other groups and thiol levels were higher in group-1 and group-5 than in the other groups. NOX4, MMP2 and 9 levels in group-2 were higher than in the other groups. MMP-9 levels in group-5 were lower than in groups 3 and 4 (p=.001). The level of 8-OHdG in groups 2 and 3 was higher than in the other groups (p=.001). In correlation analysis, 8-OHdG, MMP2, and 9 levels were negatively correlated with total thiol, whereas NOX4 and 8-OHdG levels were positively correlated with MMPs values.Conclusions: The combination of testosterone with PDE-5 inhibitor suppresses MMP-9 levels and increases total thiol levels better than testosterone alone and tadalafil alone. Therefore, testosterone can be considered for use with PDE-5 inhibitor from the initial stage in case of testosterone deficiency. (AU)

Objetivo: Investigar los efectos del uso combinado de tadalafil y testosterona en cuanto a estrés oxidativo, daño del ADN y metaloproteinasas de la matriz (MMPs) en la deficiencia de testosterona.Métodos: Se dividió aleatoriamente a cincuenta ratas en cinco grupos (grupo-1: grupo de simulación-placebo, grupo-2: orquiectomía bilateral (ORX), grupo-3: ORX bilateral+tadalafil, grupo-4: ORX bilateral+testosterona, grupo-5: ORX bilateral+tadalafil+testosterona). El grupo 3 recibió tadalafil (5mg/kg/day, oral). El Grupo 4 recibió undecanoato de testosterona (100mg/kg i.m, dosis única). El Grupo 5 recibió una combinación de tadalafil y undecanoato de testosterona. Se comparó a todos los grupos con respecto a los niveles séricos de nicotinamida adenina dinucleótido fosfato oxidasa-4 (NOX-4), tiol total, metaloproteinasa de la matriz 2 (MMP-2), MMP-3 y MMP-9, inhibidor tisular de metaloproteinasas-1 (TIMP-1) y TIMP-2, y 8-hidroxi-2-deoxi guanosina (8-OHdG).Resultados: Los niveles totales de tiol del grupo 2 fueron significativamente menores que en el resto de grupos, y los niveles de tiol fueron mayores del grupo 1 y el grupo 5 con respecto a los demás grupos. Los niveles de NOX4, MMP2 y 9 en el grupo 2 fueron mayores que los del resto de grupos. Los niveles de MMP-9 del grupo 5 fueron menores que los de los grupos 3 y 4 (p=0,001). El nivel de 8-OHdG de los grupos 2 y 3 fue mayor que los del resto de grupos (p=0,001). En el análisis de correlación, los niveles de 8-OHdG, MMP2, y 9 guardaron una correlación negativa con tiol total, mientras que los niveles de NOX4 y 8-OHdG se correlacionaron positivamente con los valores de MMPs.Conclusiones: La combinación de testosteronay el inhibidor de PDE-5 suprime los niveles de MMP-9 e incrementa los niveles totales de tiol, de mejor manera que testosterona y tadalafilen solitario. Por tanto, puede considerarse el uso de testosterona con el inhibidor de PDE-5 en las etapas iniciales de deficiencia de testosterona. (AU)

The synergistic effects of testosterone and phophodiesterase-5 inhibitor combination on oxidative stress markers, matrix metalloproteinases and oxidative DNA damage: A randomized controlled experimental study.

PURPOSE: To investigate the effects of combined tadalafil and testosterone usage on oxidative stress, DNA damage and MMPs in testosterone deficiency. METHODS: Fifty rats were randomly divided into 5 groups (group-1: sham group-placebo, group-2: bilateral orchiectomy (ORX), group-3: bilateral ORX+tadalafil, group-4: bilateral ORX+testosterone, group-5: bilateral ORX+tadalafil+testosterone). Group-3 received tadalafil (5mg/kg/day, oral). Group-4 was administered testosterone undecanoate (100mg/kg i.m., single dose). Group-5 was administered a combination of tadalafil and testosterone undecanoate. All groups were compared with regard to serum nicotinamide adenine dinucleotide phosphate oxidase-4 (NOX-4), total thiol, matrix metalloproteinase-2 (MMP-2), MMP-3 and MMP-9, tissue inhibitor of metalloproteinases-1 (TIMP-1) and TIMP-2 and 8-hydroxy-2-deoxy guanosine (8-OHdG) levels. RESULTS: Total thiol levels of group-2 were significantly lower than the other groups and thiol levels were higher in group-1 and group-5 than in the other groups. NOX4, MMP2 and 9 levels in group-2 were higher than in the other groups. MMP-9 levels in group-5 were lower than in groups 3 and 4 (p=.001). The level of 8-OHdG in groups 2 and 3 was higher than in the other groups (p=.001). In correlation analysis, 8-OHdG, MMP2, and 9 levels were negatively correlated with total thiol, whereas NOX4 and 8-OHdG levels were positively correlated with MMPs values. CONCLUSIONS: The combination of testosterone with PDE-5 inhibitor suppresses MMP-9 levels and increases total thiol levels better than testosterone alone and tadalafil alone. Therefore, testosterone can be considered for use with PDE-5 inhibitor from the initial stage in case of testosterone deficiency.

Serum irisin is a novel biomarker for bladder cancer detection.

BACKGROUND: This study intended to investigate irisin levels in bladder cancer patients and healthy controls. OBJECTIVE: Our aim was to evaluate if serum irisin could be used as a diagnostic tool in bladder cancer and further, if it could differentiate muscle-invasive and non-muscle-invasive bladder cancer patients. METHODS: In this study, 90 primary bladder cancer patients in addition to 30 age-matched healthy individuals for the control group were prospectively included. Bladder cancer patients were divided into two subgroups as non-muscle-invasive (60 patients) and muscle-invasive (30 patients). Blood samples were obtained before the diagnosis of the disease. Serum irisin levels were measured using ELISA. Demographic data as well as tumor grade and stage were noted. RESULTS: Mean serum irisin level was significantly lower in the bladder cancer patients compared to the control group (4.53 ± 2.55 vs. 16.5 ± 5.67, p < 0.001). Also, serum irisin level was statistically lower in the muscle-invasive bladder cancer group compared to the non-muscle-invasive counterparts (3.19 ± 1.47 vs. 5.18 ± 2.73, p < 0.001). Serum irisin could differentiate bladder cancer patients from healthy individuals with a sensitivity of 86.2% and a specificity of 89.7% at a cut-off value of 8.689 (AUC = 0.859). Moreover, to discriminate between NMIBC and MIBC, the sensitivity was 75% and the specificity was 73.7% at a cut-off value of 3.97 (AUC = 0.732). CONCLUSION: Our results showed that serum irisin levels can be used for the diagnosis of bladder cancer. Also, it can help distinguish high-grade and stage tumor.

Stimulating effects of vardenafil, tadalafil, and udenafil on vascular endothelial growth factor, angiogenesis, vitamin D3, bone morphogenic proteins in ovariectomized rats.

OBJECTIVE: This study investigated the effect of vardenafil, tadalafil, and udenafil from phosphodiesterase-5 inhibitors (PDE-5Is) on bone morphogenic-protein (BMP)2 and 4 levels, along with angiogenesis in ovariectomized rat's kidney. METHOD: Rats were randomly divided into five groups (n = 10). Sham: abdomen was opened, and closed. OVX: ovaries were removed. OVX + vardenafil, OVX + tadalafil, and OVX + udenafil groups: ovaries were removed and closed, and after 6 months from postoperative, 10 mg/kg of vardenafil, tadalafil, and udenafil were administrated as daily a single-dose for 60 days, respectively. Histopathologic and immunohistochemical examinations were performed for angiogenesis, and biochemical analysis for vascular endothelial growth-factor (VEGF), VitaminD3, BMP2 and 4 levels in rat's kidney. RESULTS: VEGF, BMP2 and 4, VitaminD3, and angiogenesis were high in the all inhibitor groups compared with the sham and OVX (p < .05). However, BMP4 levels were only high in the OVX + tadalafil group (p < .05). CONCLUSION: The results indicated that vardenafil, udenafil, and especially tadalafil increased VEGF, BMP2, and VitaminD3 levels.

Dynamic Thiol/Disulfide Homeostasis and Oxidative DNA Damage in Adult Attention Deficit Hyperactivity Disorder.

OBJECTIVE: Insufficient number of oxidative stress studies have been conducted in patients with adult attention deficit hyperactivity disorder (ADHD). The objective of the current study is to examine the thiol/disulfide homeostasis as well as oxidative DNA damage levels in adult ADHD patients and to compare them with the results of healthy control subjects. METHODS: The study was inclusive of forty-nine patients who were diagnosed with adult ADHD, as well as thirty-three healthy volunteers to be used as the control group. The diagnosis of the patients was conducted according to the DSM-5 diagnostic criteria. Blood were stored under appropriate laboratory conditions. For the purpose of detecting the oxidative DNA damage level, an extraction of genomic DNA from leukocytes was carried out, and furthermore the levels of 8-hydroxy-2-deoxyguanosine (8-OHdG), apart from deoxyguanosine, were measured accordingly. RESULTS: Total thiol and the native thiol levels were observed to be statistically lower in adult ADHD patients as compared to the subjects in the healthy control group (p = 0.001). It was observed that the disulfide levels were higher in adult ADHD patients as compared to the healthy control subjects (p = 0.001). In addition, the levels of 8-OHdG, which are considered as a marker for assessing DNA damage, were found to be significantly lower in the control group as compared to the adult ADHD patients (p = 0.001). CONCLUSION: It was observed that the thiol/disulfide homeostasis had shifted towards disulfide, and 8-OHdG levels were increased in adult ADHD patients.

Is ischaemia-modified albumin a biomarker in wagner classification in diabetic foot ulcers?

BACKGROUND: We aimed to determine the relationship of ischaemia-modified albumin (IMA) with diabetic foot ulcers and its predictive value in the Wagner classification. METHODS: Our cross-sectional study was conducted in 120 diabetic foot patients and 60 healthy individuals with similar body mass index (BMI) and age. Patients with a diabetic foot were classified according to the Wagner classification. Biochemical parameters, C-reactive protein (CRP) and IMA levels were measured in all patients and healthy volunteers. Screening performance characteristics of CRP and IMA were calculated according to Wagner classes and the presence of osteomyelitis. RESULTS: The levels of BMI, CRP and IMA in diabetic foot patients were significantly higher than the healthy controls. When we grouped the patients according to the Wagner classification, there were no significant differences between the Wagner groups in terms of BMI. The highest IMA levels were detected in Wagner grade 5. CRP had higher sensitivity and specificity than IMA in the discrimination of other grades, except for grade 4-5 separation. For Wagner grade 4-5 distinction, IMA had 84.6% sensitivity and 94.7% specificity. CONCLUSION: IMA had a higher predictive value in discrimination of the Wagner grade 4-5. In the management of diabetic foot patients, it may be recommended that IMA is evaluated by clinicians.

Analysis of endogenous oxidative damage markers and association with pulmonary involvement severity in patients with SARS-CoV-2 pneumonia.

INTRODUCTION: The SARS-CoV-2 virus affects many organs, especially the lungs, with widespread inflammation. We aimed to compare the endogenous oxidative damage markers of coenzyme Q10, nicotinamide dinucleotide oxidase 4, malondialdehyde, and ischemia-modified albumin levels in patients with pneumonia caused by SARS-CoV-2 and in an healthy control group. We also aimed to compare these parameters between patients with severe and non-severe pulmonary involvement. METHODS: The study included 58 adult patients with SARS-CoV-2 pneumonia and 30 healthy volunteers. CoQ10 and MDA levels were determined by high-pressure liquid chromatography. NOX4 and IMA levels were determined by ELISA assay and colorimetric method. RESULTS: Higher levels of CoQ10, MDA, NOX4, and IMA and lower levels of COQ10H were observed in patients with SARS-CoV-2 pneumonia than in the control group. MDA, IMA, NOX4, and CoQ10 levels were significantly higher in patients with severe pulmonary involvement than in patients with non-severe pulmonary involvement, but no significant difference was observed in CoQ10H levels. CoQ10 levels were significantly and positively correlated with both ferritin and CRP levels. CONCLUSION: SARS-CoV-2 pneumonia is significantly associated with increased endogenous oxidative damage. Oxidative damage seems to be associated with pulmonary involvement severity.

NOX4, MDA, IMA and oxidative DNA damage: can these parameters be used to estimate the presence and severity of OSA?

PURPOSE: Obstructive sleep apnoea (OSA) involves recurrent obstructive apnoeas and hypopnoeas which cause cyclic hypoxia, reoxygenation and formation of reactive oxygen species (ROS). We aimed to investigate a member of the nicotinamide adenine dinucleotide phosphate oxidase (NOX) family of enzymes, specifically (NOX4), not previously studied in humans, as well as 8-OHdG/106dG, MDA and IMA, which are known to be associated with oxidative stress. We also evaluated these parameters in predicting the presence and severity of OSA. METHODS: All 120 subjects (90 with OSA, 30 healthy controls) underwent polysomnography and had blood serum samples taken at the same time of day. Subjects were grouped by presence and severity of OSA, and serum markers were compared among groups. RESULTS: Age and body mass index were not significantly different among groups. In the OSA group, the levels of NOX4, IMA, MDA and 8-OHdG/106dG were significantly higher than in the healthy control group. NOX4 and other parameters were positively correlated with the severity of OSA. For all parameters, the highest levels were detected in patients with severe OSA. CONCLUSIONS: The repeated hypoxia of OSA is associated with increases in the serum levels of inflammatory mediators such as MDA, IMA and 8-OHdG/106dG and the ROS NOX4. In this study, NOX4 and other markers were associated with the presence and severity of OSA.

Investigation of Thiol/Disulfide Balance and Oxidative DNA Damage in Patients Experiencing Avalanche Disaster and with a Diagnosis of Post-Traumatic Stress Disorder.

Objective: There are few studies on oxidative stress in patients with post-traumatic stress disorder (PTSD). The thiol/disulfide homeostasis is a new marker of oxidative stress. This study aimed to examine the oxidative DNA damage and thiol/disulfide homeostasis after 6 months in patients who developed PTSD after an avalanche disaster and to compare them with healthy controls. Methods: A total of 31 patients who developed PTSD after 2 consecutive avalanche disasters that occurred in Van on February 4 and 5, 2020, resulting in 42 deaths, and 33 healthy volunteers were included in the study. The patients were followed up by a psychiatrist within the framework of psychosocial intervention during their admission to Yüzüncü Yil University Medical Faculty Emergency Service. The patients monitored for a long time were diagnosed according to DSM-5 diagnostic criteria. The clinical follow-up was evaluated with the post-traumatic stress disorder self-assessment (PTSD-KD) and the impact of events scale. To determine oxidative DNA damage, 8-hydroxy-2-deoxyguanosine (8-OHdG) and deoxyguanosine (dG) levels were determined by isolating leukocyte DNA. Oxidative DNA damage was given as a ratio of 8-OHdG/106dG. Total thiol/native thiol levels were also determined. Disulfide levels were calculated by subtracting native thiol results from the total thiol results and dividing them by 2. Results: It was determined that total thiol and native thiol levels in patients with PTSD were statistically significantly lower than in the healthy control group (P = .001), and the disulfide levels were higher in the PTSD group compared with that in the healthy control group (P = .001). In addition, 8-OHdG, an indicator of DNA damage, was found to be significantly lower in the control group than in the patient group (P = .001). Conclusion: In our study, thiol/disulfide homeostasis was observed to shift toward disulfide in patients with PTSD when compared with healthy controls. The level of 8-OHdG, the indicator of DNA damage, was observed to increase in patients with PTSD. This result indicates that thiol/disulfide homeostasis can be significant in the pathophysiology of oxidative stress in these patients.