Comparison of the Effects of Sevoflurane and Desflurane on Endothelial Glycocalyx in Patients Undergoing Laparoscopic Hysterectomy: A Randomized, Double-Blind Trial.

Objective: Various enzymes, reactive oxygen species, inflammatory conditions, and major surgeries cause endothelial glycocalyx breakdown. Inhalation of anaesthetic agents may have protective effects on the endothelium. This study compared syndecan-1 and heparan sulfate levels to evaluate the effects of sevoflurane and desflurane on the endothelial glycocalyx. Methods: This prospective randomized, double-blind study included 46 patients undergoing laparoscopic hysterectomy. The participants were allocated into sevoflurane and desflurane groups. Subsequently, blood samples were drawn at three time points: before anaesthesia induction for a baseline value (T0), after pneumoperitoneum (T1), and after extubation (T2). Heparan sulfate and syndecan-1 levels were measured. Results: There was no statistical difference between the sevoflurane and desflurane groups in terms of heparan sulfate and syndecan-1 levels at any time point. A significant difference was found only in the desflurane group in the intragroup comparisons of the measurements of heparan sulfate levels (χ2=29.826, P < 0.001). Matched pairs of the time points in the desflurane group showed that P=0.036 (Z=-2.099) for T1-T0, P < 0.001 (Z=-3.924) for T2-T0, and P < 0.001 (Z=-4.197) for T2-T1. The change in percentage between T2 and T1 of heparan sulfate in the desflurane group was found to be statistically significant (P=0.034). Conclusion: The damage caused by surgical stress on the endothelial glycocalyx can be reduced by both desflurane and sevoflurane. The protective effect of desflurane is more prominent than that of sevoflurane.

Evaluation of oxidative stress and inflammation in patients with polycystic ovary syndrome.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine and metabolic disorder characterized by hyperandrogenism, hyperinsulinemia, and insulin resistance. The prevalence of PCOS is increasing worldwide. Although the etiology of this disease is currently unknown, it is thought to be closely related to inflammation and oxidative stress. Our study aimed to compare patients have PCOS to healthy volunteers and assess the changes in oxidative stress and inflammatory parameters in these patients. METHODS: Thirty patients between the ages of 18-45 diagnosed with PCOS and 30 healthy volunteers with the same demographic characteristics were included in this study. Clinical parameters were measured using immunoassays. Oxidative stress biomarkers, total oxidant (TOS), total antioxidant (TAS), total thiol (TT), and native thiol (NT) levels were measured using photometric methods according to Erel's method. The dynamic disulfide level (DIS) and oxidative stress index (OSI) were calculated using mathematical equations. Among the inflammatory parameters, values for interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α (TNF-α) were measured photometrically using commercially purchased kits. RESULTS: Moreover, TT and NT levels were lower in patients with PCOS compared to those in the healthy group statistically significantly (P<0.001). In addition, TAS, TOS, OSI, DIS, IL-1ß, IL-6, and TNF-α levels were identified to be significantly higher in the patients with PCOS than those in the healthy group (P<0.001). CONCLUSION: Evaluation of oxidative stress and clinical parameters used in the follow-up may be beneficial for the disease.

Treatment strategies with vitamin E and C in autologous intraperitoneal ovarian transplantation and its impact on ovarian surface epithelium and follicle reserve.

The objective of this study was to assess the impact of Vitamin E (Vit E) and Vitamin C (Vit C) on markers of the oxidant-antioxidant system, ovarian follicle reserves, and the surface epithelium in autologous intraperitoneal ovarian transplantation conducted in rats. The study aimed to investigate how these antioxidants influence various aspects related to transplantation outcomes, including oxidative stress markers, the preservation of follicle reserves, and the condition of the surface epithelium. A total of 20 adult female Wistar Albino rats were included in the study and randomly assigned to four different groups. Group 1, consisting of 5 rats, served as the control group and underwent a surgical procedure where their abdomens were opened and closed without any further intervention. Group 2, also consisting of 5 rats, underwent ovarian transplantation. In Group 3, comprising 5 rats, an intraperitoneal (IP) administration of 20 mg/kg body weight (b.w.) of Vitamin E (Vit E) was given 15 min prior to ovarian transplantation. Lastly, in Group 4, which included 5 rats, an IP administration of 50 mg/kg body weight (b.w.) of Vitamin C (Vit C) was given 15 min before ovarian transplantation. Vaginal cytology was performed in order to monitor the estrus phase in the rats. Biochemically, tissue and serum malondialdehyde (MDA) levels and erythrocyte superoxide dismutase (SOD) levels were measured. Histopathologically, the number of dysplastic changes in the ovarian surface epithelium and primordial, primary, secondary, Graaffian, and atretic follicles were examined. Dysplastic changes in the surface epithelium of Group 2 were found to be significantly higher than in Group 1 and 4 (p < 0.02). In Group 2, the ovarian follicle reserves (primordial, primary, secondary, and Graaffian follicles) were significantly lower than in other groups (p < 0.02). In addition, a significant decrease in SOD levels was found in Group 2 compared to other groups (p < 0.02). The study showed that Vit E and Vit C in autologous intraperitoneal ovarian transplantation preserved the ovarian follicle reserve. Vit C was found to be more effective than Vit E.

TQ-Ox, a novel synthetic derivative of thymoquinone on ovarian cancer cells in vitro.

There are many studies in the literature on thymoquinone (TQ)-related cancer cells and models, and there is no relevant study investigating the efficacy of the oxime derivative of TQ (TQ-Ox). This study synthesized TQ-Ox and examined its cytotoxic, genotoxic and apoptotic properties in ovarian cancer cells. The structure TQ-Ox was confirmed with NMR. The cytotoxicity by luminometric ATP, intracellular reactive oxygen species (iROS) by fluorometric, intracellular calcium (iCa2+) by fluorometric, mitochondrial membrane potential (MMP) by flow cytometry, glutathione (GSH) levels with GSH/GSSG-Glo assay, DNA damage by comet assay, and apoptosis by acridine orange/ethidium bromide dye were determined. Concentrations of TQ-Ox were statistically increased cytotoxicity, DNA damage, apoptosis, iROS, and iCa2+ in a concentration-dependent manner (p < 0.001). Besides, MMP and GSH levels also decreased statistically significantly (p < 0.001) with increasing concentrations. TQ-Ox would be an effective treatment option by increasing cytotoxicity, genotoxicity, and apoptosis in ovarian carcinoma.

A New and Alternative Route: Transvaginal Natural Orifice Transluminal Endoscopic Scarless Surgery (vaginal natural orifice transluminal endoscopic surgery) For Class 2 and Class 3 Obese Patients Suffering From Benign and Malignant Gynecologic Pathologies.

Background. This study was conducted to investigate the effectiveness of vaginal natural orifice transluminal endoscopic surgery (vNOTES) gynecologic scarless surgery in benign and malignant class 2 and class 3 obese patients. Materials and methods. The class 2 and class 3 obese women undergoing vNOTES scarless surgery for benign and malign indications at a tertiary referral medical center between January 2019 and April 2021 were retrospectively analyzed and surgical outcomes were measured. Results. In this study, 81 class 2 and class 3 obese patients underwent gynecological procedures using vNOTES scarless surgery. Of the 81 operations, 55 of the class 2 obese patients with benign pathologies, and 26 of the class 3 obese patients had malign pathologies. No conversion to conventional laparoscopy or even laparotomy was needed in any of the procedures. All of the surgeries were performed by the same surgeon (Prof. Dr Ahmet Kale). vNOTES scarless surgery was performed on 26 class 3 obese patients with malign pathologies. Of the 26 class 3 obese patients, 22 of the class 3 obese patients with early-stage endometrial carcinoma had very high mean body mass index 41.5 kg/m2 (range 20.6-56) and 4 of the class 3 obese patients had ascites with unknown cause and diagnosed with peritoneal carcinomatosis. The mean postoperative pain VAS scores of class 2 obese patients undergoing vNOTES scarless surgery with benign pathology at 6, 12, and 24 h were 3.19, 1.11, and .66, respectively, and the mean postoperative pain VAS scores of class 3 obese patients underwent vNOTES scarless surgery with malign pathology at 6, 12, and 24 h were 3.30, 1.76, and 1.03, respectively. Conclusion. vNOTES scarless surgery is an alternative surgical method for diagnosis and treatment not only in benign obese cases, but also in severely obese patients with early stage endometrial cancer and patients had with ascites with unknown cause. In the near future, vNOTES scarless surgery will become more preferable by experienced surgeons in benign and malignant obese cases as it has increased satisfaction with esthetic results such as less pain, and improved postoperative quality of life in the short and long term.

Predictive value of maternal serum podocalyxin in the diagnosis of preeclampsia: a prospective case-control study.

OBJECTIVE: s: There is a need for markers to facilitate the diagnosis of preeclampsia, one of the most chief causes of maternal and infant mortality. Preeclampsia causes damage to the glomeruli and vascular endothelium in pregnant women. Podocalyxin is a sialoglycoprotein found in both glomeruli and vascular endothelium. In this study, we investigated the levels of podocalyxin in preeclampsia, and studied its potential to predict preeclampsia. MATERIAL AND METHODS: Women admitted to the Health Sciences University Derince Training and Research Hospital, Department of Obstetrics and Gynecology between February-November 2018 due to high direct blood and diagnosed with preeclampsia according to the 2013 American College of Obstetricians and Gynecologists criteria were included in the study. The control group consisted of healthy volunteers having similar demographic features (gestational week, gravida, parity, and age) with the preeclampsia group. The main outcome variable was serum podocalyxin levels. RESULTS: The mean (± SD) podocalyxin levels of the study and control groups were 124.15 ± 39.63 ng/mL and 71.47 ± 16.86 ng/mL, respectively ( t = 7.845 , p < 0.001 ). Using a cut-off of 91.7123, podocalyxin could predict preeclampsia with 90% sensitivity and 98% specificity. Furthermore, podocalyxin levels were significantly higher than the normotensive participants in both early ( 14 3.81 ± 5 1.96 ng/mL vs. 75. 35 ± 1 9.36 ng/mL ) and late-onset ( 11 0.22 ± 1 9.11 ng/mL vs 68. 26 ± 1 4.13 ng/mL ) preeclampsia (p < 0.001). CONCLUSIONS: Serum podocalyxin levels increase in preeclampsia. We conclude that podocalyxin is a candidate for predicting preeclampsia.

Could serum S100B be a predictor of neuronal damage and clinical poor outcomes associated with the use of synthetic cannabinoids? S100B to predict neuronal damage of SC in the ED.

AIM: This study aims to evaluate the serum S100B levels to predict neuronal damage and poor clinical outcomes associated with the use of synthetic cannabinoids. METHOD: Thirty patients identified as synthetic cannabinoid users and 30 healthy controls were included in the study. S100B levels were compared between healthy controls and synthetic cannabinoid users. The following were considered to be composite outcomes: the need for endotracheal intubation, incidence of seizures, the need for intensive care unit admission, and in-hospital mortality. Clinical and laboratory findings associated with composite clinical outcomes were examined. RESULTS: The mean S100B level was 19.3 (95% CI: 17.7 to 21.4) pg/mL in patients who use synthetic cannabinoid, and 15.9 (95% CI: 15 to 16.9) pg/mL in the controls; mean df: -3.6 (95% CI: -5.6 to -1.6). In patients with and without composite clinical outcomes, the mean S100B level measured 24.5 (95% CI: 21.2 to 27.9) pg/mL and 17.4 (95% CI: 15.8 to 18.4) pg/mL, respectively; mean df: -7.4 (95% CI: -10.2 to -4.6). With the cut-off value for S100B set at 20pg/mL based on the highest sensitivity, the sensitivity, specificity, PPV, and NPV for S100B were 89.9%, 52.0%, 44.4%, and 91.9%, respectively; odds ratio: 13.2, 95% CI (2.1 to 28.1). CONCLUSION: Our data suggest that serum S100B levels are elevated in patients using synthetic cannabinoids. These results show that S100B can help clinicians stratify risk or may have a role in excluding those with neuronal damage.

Effect of multiparity on bone mineral density, evaluated with bone turnover markers.

OBJECTIVE: Our aim was to investigate the effect of parity on osteoporosis by evaluating bone mineral density, markers of bone turn-over and other factors that are effective in osteoporosis in multiparous (five deliveries or more) and nulliparous women in the post-menopausal period. METHODS: A total of 91 multiparous (five deliveries or more) and 31 nulliparous postmenopausal women were included in this study. All patients were interviewed on sociodemographic characteristics, gynecologic history, personal habits, levels of physical activity, and life-long intake of calcium. Bone mineral density was measured at lumbar (L1-4) and femoral neck regions with Dexa. RESULTS: The mean age of multiparous women was 58.79±7.85 years, and the mean age of nulliparous women was 55.84±7.51. The femoral BMD was 0.94±0.16 and lumbar BMD 1.01±0.16 in multiparous women, femoral BMD was 0.99±0.16 and lumbar BMD 1.07±0.14 in nulliparous women. There were no statistical differences between the femoral and lumbar T scores and BMD values of the two groups. Lumbar T scores and lumbar BMD showed a decrease with increasing total duration of breast-feeding in multiparous women. The independent risk factors for osteoporosis in the regression analysis of multiparous women were found to be the duration of menopause and body weight of 65kg and less. CONCLUSION: There is no difference between the bone mineral densities of multiparous and nulliparous women. Females with lower body-weight and longer duration of menopause should be followed-up more carefully for development of osteoporosis.

Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery

ABSTRACT Objective: To share our first experience with laparoscopic pectopexy, a new technique for apical prolapse surgery, and to evaluate the feasibility of this technique. Materials and Methods: Seven patients with apical prolapse underwent surgery with laparoscopic pectopexy. The lateral parts of the iliopectineal ligament were used for a bilateral mesh fixation of the descended structures. The medical records of the patients were reviewed, and the short-term clinical outcomes were analyzed. Results: The laparoscopic pectopexy procedures were successfully performed, without intraoperative and postoperative complications. De novo apical prolapse, de novo urgency, de novo constipation, stress urinary incontinence, anterior and lateral defect cystoceles, and rectoceles did not occur in any of the patients during a 6-month follow-up period. Conclusion: Although laparoscopic sacrocolpopexy has shown excellent anatomical and functional long-term results, laparoscopic pectopexy offers a feasible, safe, and comfortable alternative for apical prolapse surgery. Pectopexy may increase a surgeon's technical perspective for apical prolapse surgery.

Effect of multiparity on bone mineral density, evaluated with bone turnover markers / Efeito da multiparidade sobre a densidade mineral óssea, avaliada por marcadores de remodelação óssea

Abstract Objective: Our aim was to investigate the effect of parity on osteoporosis by evaluating bone mineral density, markers of bone turn-over and other factors that are effective in osteoporosis in multiparous (five deliveries or more) and nulliparous women in the post-menopausal period. Methods: A total of 91 multiparous (five deliveries or more) and 31 nulliparous postmenopausal women were included in this study. All patients were interviewed on sociodemographic characteristics, gynecologic history, personal habits, levels of physical activity, and life-long intake of calcium. Bone mineral density was measured at lumbar (L1-4) and femoral neck regions with Dexa. Results: The mean age of multiparous women was 58.79 ± 7.85 years, and the mean age of nulliparous women was 55.84 ± 7.51. The femoral BMD was 0.94 ± 0.16 and lumbar BMD 1.01 ± 0.16 in multiparous women, femoral BMD was 0.99 ± 0.16 and lumbar BMD 1.07 ± 0.14 in nulliparous women. There were no statistical differences between the femoral and lumbar T scores and BMD values of the two groups. Lumbar T scores and lumbar BMD showed a decrease with increasing total duration of breast-feeding in multiparous women. The independent risk factors for osteoporosis in the regression analysis of multiparous women were found to be the duration of menopause and body weight of 65 kg and less. Conclusion: There is no difference between the bone mineral densities of multiparous and nulliparous women. Females with lower body-weight and longer duration of menopause should be followed-up more carefully for development of osteoporosis.

Resumo Objetivo: Investigar o efeito da paridade sobre a osteoporose por meio da avaliação da densidade mineral óssea, marcadores de remodelação óssea e outros fatores eficazes na avaliação da osteoporose em multíparas (cinco partos ou mais) e nulíparas no período pós-menopausa. Métodos: Foram incluídas neste estudo 91 multíparas (cinco partos ou mais) e 31 nulíparas, todas na pós-menopausa. As pacientes foram entrevistadas para a determinação das características sociodemográficas, história ginecológica, hábitos pessoais, níveis de atividade física e ingestão de cálcio ao longo da vida. A densidade mineral óssea foi medida na região lombar (L1-4) e do colo femoral com a Dexa. Resultados: A média de idade das multíparas e nulíparas foi de 58,79 ± 7,85 anos e 55,84 ± 7,51, respectivamente. Nas multíparas, a DMO femoral e lombar foi de 0,94 ± 0,16 e 1,01 ± 0,16, respectivamente; nas nulíparas, a DMO femoral e lombar foi de 0,99 ± 0,16 e 1,07 ± 0,14, respectivamente. Não houve diferença estatisticamente significativa entre os T-escores femoral e lombar e os valores de DMO dos dois grupos. O T-escore e a DMO lombar mostraram uma diminuição em caso de aumento na duração total da lactação materna em multíparas. Encontrou-se que os fatores de risco independentes para a osteoporose na análise de regressão das multíparas são a duração da menopausa e o peso corporal menor ou igual a 65 kg. Conclusão: Não há diferença entre a densidade mineral óssea de multíparas e nulíparas. As mulheres com menor peso corporal e maior duração da menopausa devem ser acompanhadas com mais atenção para determinar se há desenvolvimento de osteoporose.

Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery.

OBJECTIVE: To share our first experience with laparoscopic pectopexy, a new technique for apical prolapse surgery, and to evaluate the feasibility of this technique. MATERIALS AND METHODS: Seven patients with apical prolapse underwent surgery with laparoscopic pectopexy. The lateral parts of the iliopectineal ligament were used for a bilateral mesh fixation of the descended structures. The medical records of the patients were reviewed, and the short-term clinical outcomes were analyzed. RESULTS: The laparoscopic pectopexy procedures were successfully performed, without intraoperative and postoperative complications. De novo apical prolapse, de novo urgency, de novo constipation, stress urinary incontinence, anterior and lateral defect cystoceles, and rectoceles did not occur in any of the patients during a 6-month follow-up period. CONCLUSION: Although laparoscopic sacrocolpopexy has shown excellent anatomical and functional long-term results, laparoscopic pectopexy offers a feasible, safe, and comfortable alternative for apical prolapse surgery. Pectopexy may increase a surgeon's technical perspective for apical prolapse surgery.

The effect of vitamin D on clinical manifestations and activity of Behçet's disease.

INTRODUCTION: Immune mechanisms have been implemented to have a role in the pathogenesis of Behçet's disease (BD) and vitamin D has been shown to have a regulatory role in the immune system function. AIM: To evaluate the vitamin D levels of BD patients and its relationship between clinical findings and disease activity of BD. MATERIAL AND METHODS: Sixty-eight patients with BD and 70 age- and sex-matched controls were examined retrospectively. Demographic features, vitamin D levels for both groups and clinical findings, disease activity, drug usage for BD patients were examined from their medical reports. Disease activity was calculated for each patient according to Krause's BD activity assessment. RESULTS: Mean vitamin D levels of patients and controls were 15.35 ±7.18 ng/ml and 18.44 ±5.79 ng/ml, respectively. Vitamin D levels were significantly lower in BD patients than in controls (p = 0.006). Mean vitamin D levels of active and inactive BD cases were 15.68 ±7.31 ng/ml and 15.08 ±7.17 ng/ml, respectively (p = 0.73). Disease activity of patients using and not using vitamin D was similar (p = 0.51). CONCLUSIONS: Significantly lower levels of vitamin D were observed in BD patients. Our results indicate that there is no correlation between BD activity and a vitamin D level. Together with these, vitamin D replacement treatment was found to have no effect on disease activity.

[Effect of multiparity on bone mineral density, evaluated with bone turnover markers]. / Efeito da multiparidade sobre a densidade mineral óssea, avaliada por marcadores de remodelação óssea.

OBJECTIVE: Our aim was to investigate the effect of parity on osteoporosis by evaluating bone mineral density, markers of bone turn-over and other factors that are effective in osteoporosis in multiparous (5 deliveries or more) and nulliparous women in the post-menopausal period. METHODS: A total of 91 multiparous (5 deliveries or more) and 31 nulliparous postmenopausal women were included in this study. All patients were interviewed on sociodemographic characteristics, gynecologic history, personal habits, levels of physical activity, and life-long intake of calcium. Bone mineral density was measured at lumbar (L1-4) and femoral neck regions with Dexa. RESULTS: The mean age of multiparous women was 58.79±7.85 years, and the mean age of nulliparous women was 55,84±7,51. The femoral BMD was 0,94±0,16 and lumbar BMD 1,01±0,16 in multiparous women, femoral BMD was 0,99±0,16 and lumbar BMD 1,07±0,14 in nulliparous women. There were no statistical differences between the femoral and lumbar T scores and BMD values of the two groups. Lumbar T scores and lumbar BMD showed a decrease with increasing total duration of breast-feeding in multiparous women. The independent risk factors for osteoporosis in the regression analysis of multiparous women were found to be the duration of menopause and body weight of 65kg and less. CONCLUSION: There is no difference between the bone mineral densities of multiparous and nulliparous women. Females with lower body-weight and longer duration of menopause should be followed-up more carefully for development of osteoporosis.

The hepatoprotective effect of coumarin and coumarin derivates on carbon tetrachloride-induced hepatic injury by antioxidative activities in rats

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Coumarins are a vast group of natural compounds and some of them possess antioxidant activities. The comparison of the antioxidant activity of some coumarins with various chemical molecular structure has not been investigated in previous studies. Therefore, this study was aimed to investigate the hepatoprotective effect against carbon tetrachloride (CCl4) -induced hepatic injury by coumarin (1,2-benzopyrone) and coumarin derivatives, esculetin (6,7-dihydroxycoumarin), scoparone (6,7-dimethoxycoumarin), and 4-methylumbelliferone (7-hyroxy-4-methyl) in male Sprague–Dawley rats. Product of lipid peroxidation, malondialdehyde (MDA), activities of antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT) were evaluated for oxidative stress in hepatic injury. Gamma glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH) were detected in plasma as a biomarker of hepatic injury. Significantly elevated levels of MDA and lowered levels of SOD and CAT activities were observed in liver of rats exposed to CCl4, when compared to control values. Similarly, administration of CCl4 increased LDH and GGT levels in serum. Pre-treatment of rats with esculetin (35 mg kg−1, orally) and scoparone (35 mg kg−1, orally) significantly prevented CCl4-induced decrease in MDA levels and increase in SOD and CAT, whereas 4-methylumbelliferone (35 mg kg−1) and coumarin (30 mg kg−1) had no effect against CCl4-induced rise in serum enzymes. Esculetin and scoparone also showed protective properties as was evidenced in reduced LDH and GGT levels in serum. The results of this study indicate that the chemical structures of coumarins play an important role in the prevention of oxidative stress (AU)

Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome.

OBJECTIVE: We measured the levels of neutrophil activating peptide-2 (NAP-2) and pentraxin-3 (PTX-3) in acute coronary syndromes (ACS) patients and compared their diagnostic accuracy with cardiac troponin I (cTnI). METHODS: We conducted a prospective cohort study to determine the diagnostic accuracy of PTX-3, NAP-2 and cTnI for the prediction of ACS. Consecutively eighty-three patients with sudden chest pain admitted to Dicle University Emergency Department within the first six hours of symptom onset were included in our study. Mean serum levels of PTX-3, NAP-2 and cTnI were compared between control and patient groups and ACS subgroups. Their sensitivities and specificities in early diagnosis of ACS were identified. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic validity of the markers, and areas under the ROC curve (AUC) were compared. RESULTS: In the patient group, mean serum concentrations of NAP-2 (53.03+22.77 ng/ml) and PTX-3 (1.73+0.82 ng/ml) were considerably higher than those of the control group (24.54+9.50 and 0.50+0.39 ng/ml, respectively) (p<0.01). When compared with the control group, PTX-3 levels of all three ACS subtypes (unstable angina pectoris (USAP) - 1.62+0.41 ng/ml, non-ST elevation myocardial infarction (NSTEMI) -1.63+0.31 ng/ml and ST-elevation myocardial infarction (STEMI) - 1.75+0.89 ng/ml) were higher, whereas NAP-2 levels were higher in USAP (56.29+22.60 ng/ml) and STEMI (52.05+20.99 ng/ml) patients (p<0.01). For diagnosing ACS within the first six hours of presentation, PTX-3 sensitivity was 98.5% and specificity was 92.3%, and NAP-2 sensitivity - 98.1% and specificity - 41.3%. The ROC curve AUC values were: 0.962 for PTX-3 (95% CI 0.802 - 1.073), 0.840 for NAP-2 (95% CI 0.684 - 0.991), and 0.683 for cTnI (95% CI 0.610 - 0.940). CONCLUSION: Pentraxin-3 is a sensitive and specific marker for ACS diagnosis when compared with cardiac markers in patients admitted to the emergency department (ED) within the first six hours of onset of chest pain.

The hepatoprotective effect of coumarin and coumarin derivates on carbon tetrachloride-induced hepatic injury by antioxidative activities in rats.

Coumarins are a vast group of natural compounds and some of them possess antioxidant activities. The comparison of the antioxidant activity of some coumarins with various chemical molecular structure has not been investigated in previous studies. Therefore, this study was aimed to investigate the hepatoprotective effect against carbon tetrachloride (CCl(4)) -induced hepatic injury by coumarin (1,2-benzopyrone) and coumarin derivatives, esculetin (6,7-dihydroxycoumarin), scoparone (6,7-dimethoxycoumarin), and 4-methylumbelliferone (7-hyroxy-4-methyl) in male Sprague-Dawley rats. Product of lipid peroxidation, malondialdehyde (MDA), activities of antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT) were evaluated for oxidative stress in hepatic injury. Gamma glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH) were detected in plasma as a biomarker of hepatic injury. Significantly elevated levels of MDA and lowered levels of SOD and CAT activities were observed in liver of rats exposed to CCl(4), when compared to control values. Similarly, administration of CCl(4) increased LDH and GGT levels in serum. Pre-treatment of rats with esculetin (35 mg kg(-1), orally) and scoparone (35 mg kg(-1), orally) significantly prevented CCl(4)-induced decrease in MDA levels and increase in SOD and CAT, whereas 4-methylumbelliferone (35 mg kg(-1)) and coumarin (30 mg kg(-1)) had no effect against CCl(4)-induced rise in serum enzymes. Esculetin and scoparone also showed protective properties as was evidenced in reduced LDH and GGT levels in serum. The results of this study indicate that the chemical structures of coumarins play an important role in the prevention of oxidative stress.

The role of the heart-type fatty acid binding protein in the early diagnosis of acute coronary syndrome and its comparison with troponin I and creatine kinase-MB isoform.

OBJECTIVES: The aim of this study was to research the effectiveness of the heart-type fatty acid binding protein (H-FABP) in the early diagnosis of acute coronary syndrome (ACS) in patients admitted to emergency service (ES) within 6 hours of onset of chest pain. EQUIPMENT AND METHOD: A total of 83 patients admitted with chest pain to our ES were included in this study. The patients were divided into 2 groups: those with a diagnosed ACS and those diagnosed with non-cardiac-related chest pain. Patients were also were divided into 2 groups according to the time of admission: those admitted within 0 to 3 hours and 3 to 6 hours of onset of chest pain. Peripheral venous blood samples were obtained from all patients for H-FABP, troponin I, and creatine kinase-MB (CK-MB) serum concentration measurements. RESULTS: Of a total of 83 patients, 21.6% (n = 18) were in the control group and 78.3% (n = 65) were in the ACS group. The average H-FABP value for the patients in the control group was 0.86 ± 0.54 ng/mL. When the ACS and control groups were compared in means of cardiac markers for CK-MB (P = .000) and H-FABP (P = .000), there was a statistically significant difference, whereas no difference was observed for troponin I (P = .013). In the ACS group, H-FABP sensitivity for diagnosis was found to be 98% and specificity was 71%; CK-MB sensitivity was 86% and specificity was 52%; and troponin I sensitivity was 77% and specificity was 20%. CONCLUSIONS: For patients admitted with chest pain to ES, H-FABP was found to be more sensitive and specific than troponin I and CK-MB in the early diagnosis of ACS.

Serum resistin and adiponectin levels in young non-obese women with polycystic ovary syndrome.

INTRODUCTION: Although polycystic ovary syndrome (PCOS) was described more than half a century ago, the underlying cause of PCOS is still unknown. The aim of our study was to evaluate whether serum resistin and adipocytokine levels alter and its changes relate with low grade inflammation in non-obese young women with PCOS. SUBJECTS AND METHODS: Newly diagnosed 31 young non-obese women with PCOS (mean age 21.8 +/- 5.4 years; body mass index (BMI): 23.8 +/- 6.6 kg/m(2)) and 25 BMI- and age-matched, regular-cycling, healthy women (mean age 24.9 +/- 5.7 years; BMI: 23.1 +/- 5.8 kg/m(2)) were included the study Anthropometric measurements were evaluated. Resistin, adiponectin, glucose, insulin, hormone profiles, Lipoprotein (Lp)(a), high sensitive C reactive protein (hs-CRP), and homocysteine levels were measured in the beginning of oral glucose tolerance test. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. RESULTS: Non-obese young women with PCOS had high adiponectin levels (28.01 +/- 6.47 ng/ml in PCOS vs. 23.89 +/- 7.70 ng/ml in control subjects, p = 0.034), whereas serum resistin levels were not significantly different compared with healthy controls (14.14 +/- 6.6 ng/ml in PCOS vs. 13.78 +/- 4.26 ng/ml in control subjects). There were no significant differences between two groups in terms of fasting insulin, Lp(a), homocysteine, and hs-CRP levels. Mean HOMA-IR value of patients with PCOS was similar with control subjects (1.93 +/- 0.73 in PCOS; 1.15 +/- 0.54 in control group). CONCLUSIONS: Resistin levels did not change in non-obese young women with PCOS whereas adiponectin level in non-obese young women with PCOS was significantly higher than control subjects, perhaps, because of no insulin resistance. Circulating resistin levels may not be candidate to play a role in pathogenesis of PCOS without insulin resistance or obesity.

Effects of combined pulse electromagnetic field stimulation plus glutamine on the healing of colonic anastomosis in rats.

PURPOSE: An experimental study was designed to investigate the effect of combined pulse electromagnetic field (PEMF) stimulation plus glutamine administration on colonic anastomosis. METHODS: Anastomosis of the left colon was performed in 28 rats, which were divided into four groups; Group 1: normal resection anastomosis plus oral 50 mg/kg/day glutamine; Group 2: normal resection anastomosis plus PEMF stimulation plus oral 50 mg/kg/day glutamine; Group 3: normal resection anastomosis plus PEMF stimulation; Group 4: normal resection anastomosis. On the seventh postoperative day, the animals were killed and the bursting pressure and tissue hydroxyproline concentration of the anastomosis were analyzed and compared. RESULTS: The mean anastomotic bursting pressure in Group 2 was significantly higher than in Groups 1 and 4. On the other hand, the mean anastomotic bursting pressure in Group 1 was significantly higher than in Group 4. The collagen deposition and the fibroblast infiltration were significantly increased on the seventh day in Group 3 compared the other groups. On the other hand, Groups 1 and 2 had higher scores for collagen deposition and fibroblast infiltration than Group 4. CONCLUSIONS: In conclusion, burst pressures, hydroxyproline, and histologic features (fibroblast infiltration and collagen deposition) were improved in the PEMF group, and both PEMF and glutamine-enriched nutrition provide a significant gain in the strength of colonic anastomoses in rats.

A new and practical aspartate aminotransferase test in vaginal washing fluid for the detection of preterm premature rupture of membranes.

OBJECTIVES: To determine whether measurement of aspartate aminotransferase (Ast) and alanine aminotransferase (Alt) levels in vaginal fluid is useful for the diagnosis of preterm premature rupture of membranes (PPROM). STUDY DESIGN: The PPROM group and normal pregnancy group consisted of 36 and 48 pregnant patients between 26 and 36 weeks' gestation, respectively. Vaginal fluid Ast and Alt levels were measured in both groups. RESULTS: Vaginal fluid Alt level was not statistically significant in the PPROM group as compared with the control group (p = 0.064). Vaginal Ast level was statistically significant in the PPROM (14.4 +/- 17.46 U/l) group as compared with the control group (3.08 +/- 7.8 U/l; p = 0.001). The optimal cutoff value of 3 IU/l for Ast gave a sensitivity level of 91% at a specificity of 83%, with positive and negative predictive values of 80 and 93%, respectively. CONCLUSION: Ast measurement from vaginal washing fluid appears to be a useful marker for the detection of PPROM.