Effect of premature ejaculation on depression and sexual functions in female partners: A report from Eastern Turkey.

BACKGROUND: Premature ejaculation (PE) is a sexual dysfunction causing female sexual dissatisfaction that eventually leads to poor quality of life in both partners. AIMS: To show the presence of depression, anxiety, sexual function disorders and their prevalence in spouses of males with PE living in Eastern Turkey. MATERIALS AND METHODS: Ninety male patients suffering from PE who referred to the andrology clinic between January 2016 and March 2017 and diagnosed with PE (Acquired Premature ejaculation) according to the DSM-IV criteria and their partners were included in the study. Male patients answered the PE Profile, Arabic Index of PE, PE Diagnostic Tool, and Arizona Sexual Experiences Scale (ASEX) Questionnaires. Spouses of male patients with PE answered the Arizona Sexual Experiences Scale, Beck Depression Inventory, and Beck Anxiety Inventory Questionnaires. SPSS software version 21.0 was used for statistical analysis. RESULTS: Our study revealed a positive correlation between the PE profile and partners' depression levels (P = 0.03). Also, the average ASEX Scale score of the both genders suggest that patients and partners believe they did not have a severe sexual function disorder. CONCLUSIONS: PE can cause psychological problems in both males and females. However, reflection of this pathology can vary from one society to another.

CA 72-4 levels in patients with type 2 diabetes mellitus.

OBJECTIVE: CA 72-4 is one of the blood group carbohydrate antigens which can be used as a tumour marker in ovarian, pancreatic and gastrointestinal carcinomas. It can also be elevated in various benign conditions including pancreatitis. Diabetes mellitus is a chronic disorder related with the pancreas. In this study, we investigated CA 72-4 levels in patients with type 2 diabetes and its relation to the metabolic status. METHODS: Sixty-nine patients with type 2 diabetes mellitus (female/male = 40/29) and 60 healthy subjects (female/male = 35/25) participated in this study. The levels of serum CA 72-4 were measured and faecal occult blood tests (following 3 days of white diet were obtained for three consecutive days) were performed in all patients. Patients had a pathological finding for any of these two parameters were further investigated with upper gastrointestinal endoscopy, colonoscopy and computerised tomography. RESULTS: The mean levels of CA 72-4 was 1.89 +/- 2.61 U/ml in the study group and 1.4 +/- 0.98 U/ml in the control group (p > 0.05). There was no association between CA 72-4 levels and age and sex of the patients, duration of diabetes, body mass index, biochemical indicators of metabolic control (the levels of HbA(1c), fasting and postprandial glucose, serum lipids), the presence of microvascular complications (retinopathy, nephropathy, neuropathy) or treatment modalities. CONCLUSIONS: Elevated levels of CA 72-4 in diabetic patients are not related to diabetes and it should be interpreted as evaluated in a non-diabetic patient.

Thyroid fine needle aspiration biopsy: is topical local anaesthesia beneficial?

OBJECTIVE: Thyroid fine needle aspiration biopsy (TFNAB) is the gold standard in the differential diagnosis of the thyroid nodules. In general, no analgesia is needed before this procedure. However, it is usually believed that the patients may be more comfortable if the procedure is performed under local anaesthetics. In this study, we examined the impact of the use of dermal anaesthetic on the patient's level of discomfort during palpation-guided TFNAB. METHODS: Fifty female patients with nodular goitre were enrolled in this study. Patients were randomised into two groups: a placebo cream was applied to group 1 patients (25 females; mean age 47.45 +/- 11.61 years), and local anaesthesia (EMLA 5% cream) was applied to group 2 patients (25 females; mean age 50.89 +/- 12.01 years) approximately 1 h before TFNAB. All patients were asked to mark the pain they felt during the TFNAB on Visual Analogue Scale. RESULTS: The pain scores during TFNAB were 27.73 +/- 20.01 mm and 24.79 +/- 21.98 mm in the placebo group and in the EMLA group respectively. There was no significant difference between the groups (p = 0.496). CONCLUSIONS: Topical anaesthesia before palpation-guided TFNAB provides no benefit.

Calpain 10 gene single-nucleotide 44 polymorphism may have an influence on clinical and metabolic features in patients with polycystic ovary syndrome.

AIM: This study was designed in order to examine the relationship between Calpain 10 [single-nucleotide polymorphism (SNP) 19,43,44,63] gene polymorphisms and clinical and hormonal characteristics in women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: One hundred and seven patients with PCOS and 114 healthy subjects were included in this study. Serum levels of sex steroids were measured for each individual. Insulin resistance (IR) was evaluated by the homeostasis model assessment (HOMA) and quantitative insulin-sensitivity check index (QUICKI) methods. Insulin and glucose responses to the oral glucose tolerance test (OGTT) were analyzed by calculating the areas under the curve for insulin (AUCI) and glucose by the trapezoidal methods.We used PCR and restriction fragment length polymorphism technique to examine Calpain 10 SNP 19, 43, 44, and 63 polymorphisms. RESULTS: Allele distribution of Calpain 10 SNP 44 gene polymorphism was observed as significantly different between the groups. Calpain 10 SNP 44 TC genotype was found to be increased in PCOS subjects (69.15%) compared to the control subjects (50%). However, when compared to control subjects, patients with PCOS had similar Calpain 10 SNP 19, Calpain 10 SNP 43, and SNP 63 gene polymorphisms. When compared with normal Calpain 10 gene SNP 44 allele in PCOS subjects, subjects with PCOS having Calpain 10 gene SNP 44 allele polymorphism had higher free testosterone, androstenedione, DHEA-S, and fasting insulin levels. Also, PCOS women with Calpain 10 gene SNP 44 allele polymorphism had high Ferriman-Gallwey (F-G) score, acne, prevalence of menstrual disturbances, waist-hip ratio, HOMA-IR, AUCI levels and low QUICKI levels. CONCLUSION: The findings show that Calpain 10 gene SNP 44 allele polymorphism may have a role in PCOS pathogenesis. However, larger-scale studies are needed in this field.

Effect of topical netilmicin on the reduction of bacterial flora on the human conjunctiva.

PURPOSE: To investigate the effects of topical netilmicin on human conjunctival bacterial flora. METHODS: Fifty-six patients' eyes with cataract were treated three times a day with netilmicin 1 day before the surgery. The fellow eyes of the patients were not treated. After 1 day of netilmicin application cultures of the inferior palpebral conjunctiva were performed in both eyes. Bacterial evaluation is qualitative. McNemar test was used for statistical analyses. RESULTS: The number of eyes with positive culture for coagulase negative staphylococcus (CNS) in untreated eyes was 43 (76.8%) and in treated eyes it was 5 (8.93%) and the difference was statistically significant (p=0.000). In untreated eyes number of negative cultures with no bacterial growth was 8 (14.3%) and it was 47 (83.9%) in the treated eyes. The difference among groups was statistically significant (p=0.000). Netilmicin is found very effective for CNS as the percentage of positive cultures (n=43) in untreated eyes to positive cultures (n=4) in the treated fellow eye was 90.7%. Likewise, all patients with Staphylococcus aureus positive cultures in untreated eyes (n=5) had negative culture for this microorganism in their treated fellow eyes (100%). CONCLUSIONS: The Endophthalmitis Vitrectomy Study demonstrated that the most common causes of postoperative endophthalmitis are coagulase negative microorganisms, S aureus and Streptococcus species. As netilmicin was found effective to reduce the number of positive cultures for these bacteria, it can be used to lower the incidence of postoperative endophthalmitis before surgery.

The association of neurofibromatosis, bilateral pheochromocytoma and primary hyperparathyroidism.

Neurofibromatosis (NF) is a hereditary disease and carries increased risk of both benign and malignant tumor development. Pheochromocytoma or hyperparathyroidism have been reported to be associated with NF type 1 (NF1). However, the coexistance of pheochromocytoma and parathyroid adenoma in a patient with NF1 is very rare. We report a case of a 37-year-old male with NF1, bilateral pheochromocytoma and parathyroid adenoma. This association sould be kept in mind in patients with NF1 in initial evaluation as well as during follow-up.

Prevalence of Helicobacter pylori in symptomatic patients and detection of clarithromycin resistance using melting curve analysis.

UNLABELLED: Abstract. BACKGROUND: Clarithromycin is often a component of combination therapies for Helicobacter pylori eradication; however, increases in resistance rates have decreased the success of the treatment. OBJECTIVE: This study was designed to determine the prevalence of H pylori infection in symptomatic patients and to detect clarithromycin resistance rates using melting curve analysis. METHODS: Patients scheduled for upper endoscopy at the Endoscopy Unit of the Department of Gastroenterology, Duzce University, Medical Faculty Hospital, Konuralp/Duzce, Turkey, were assessed for enrollment in the study. Two pairs of gastric biopsy specimens (antrum and corpus) were obtained from each study patient. Histopathologic examination, rapid urease test, culture, and polymerase chain reaction (PCR) of the specimens were used to identify H pylori infection. Clarithromycin resistance was detected using melting curve analysis. RESULTS: Seventy-five patients (41 women, 34 men; mean [SD]age, 42.6 [14.5] years [range, 17-70 years]) were included in the study. Using histopathology and rapid urease test, H pylori was detected in 40 (53.3%) of the 75 specimens. H pylori was detected using PCR in 40 (53.3%) specimens and by culture in 10 (13.3%) specimens. The specificity and sensitivity of PCR and culture were interpreted by comparing them with the results of histopathologic examination and urease tests. The specificity and sensitivity of PCR were 68.6% and 72.5%, respectively, and the specificity and sensitivity of culture were 97.1% and 22.5%, respectively. Of the 40 isolates, 21 (52.5%) were susceptible to clarithromycin, 12 (30.0%) were resistant, and a mixed susceptibility pattern was detected in 7 (17.5%) specimens. H pylori isolates from 19 (79.2%) of the 24 patients who had formerly used clarithromycin showed clarithromycin resistance. CONCLUSIONS: The prevalence of H pylori infection was 53.3% for the symptomatic patients in this study, and 47.5% of the isolates showed clarithromycin resistance using melting curve analysis. The PCR-based system used in this study was accurate for the detection of H pylori infection as well as clarithromycin susceptibility testing directly in biopsy specimens.

[Investigation of erythromycin resistance and resistance phenotypes in group A beta hemolytic streptococci]. / A grubu beta-hemolitik streptokoklarda eritromisin direnç oranlarinin ve direnc fenotipinin arastirilmasi.

Although penicillin resistance has not been determined in group A beta haemolytic streptococci (GABHS) yet, resistance to erythromycin and other macrolids is being reported frequently in the last years. In this study we investigated erythromycin resistance by using agar dilution method in 282 GABHS strains which were isolated from throat cultures that had been evaluated in the Ministry of Health, Ankara Training and Research Hospital's, Microbiology Laboratory. We also determined resistance phenotypes of resistant strains by double disc synergy method using erythromycin and clindamycin discs. Twelve of 282 strains (4.3%) were found resistant to erythromycin; five (41.7%) of which were M phenotype, four (33.3%) of which were constitutive type MLSB phenotype and three (25%) of which were inducible type MLSB phenotype. Investigation of resistance to macrolides that are alternatives to penicillin therapy in GABHS, is very important for the determination of the therapy and also to provide epidemiological data.

Five-year surveillance of nosocomial infections in Ankara Training and Research Hospital.

The objective of this study was to assess the rate of nosocomial infections (NIs), frequency of nosocomial pathogens and antimicrobial susceptibility changes in a 530-bed hospital over a five-year period. Hospital-wide laboratory-based NI surveillance was performed prospectively between 1999 and 2003. The Centers for Disease Control and Prevention's definitions were used for NIs and nosocomial surgical site infections, and NI rates were calculated by the number of NIs per number of hospitalized patients on an annual basis. NI rates ranged between 1.4% and 2.4%. Higher rates were observed in the neurology, neurosurgery, paediatric and dermatology departments; the low rate of NIs overall may be due to the surveillance method used. The most commonly observed infections were urinary tract, surgical site and primary bloodstream infections, and the most frequently isolated pathogens were Escherichia coli, Klebsiella pneumoniae, Enterococcus spp. and Staphylococcus aureus. Carbapenems were the most effective agents against enterobacteriaceae. Meticillin resistance among S. aureus isolates was less than 50%, and all S. aureus and Enterococcus spp. isolates were susceptible to glycopeptides apart from one glycopeptide-resistant E. faecium isolate identified in 2003. Data obtained by the same method enabled comparison between years and assisted in the detection of recent changes. Antimicrobial susceptibility data on nosocomial pathogens provided valuable guidance for empirical antimicrobial therapy of NIs.

[Short communication: investigation of Toxoplasma gondii antibodies in blood donors by Sabin-Feldman Dye Test]. / Kisa bildiri: kan bagilsçilarinda Toxoplasma gondii antikorlarinin Sabin-Feldman Boya testi ile arastirilmasi.

In this study, a serological survey of Toxoplasma gondii infection in healthy blood donors admitted to Blood Center of Ministry of Health, Ankara Training and Research Hospital was carried out. Sera from 390 male and 24 female (ages between 18-59 years) were evaluated by using Sabin Feldman Dye Test (SFDT). Of 414 donors 176 (42.5%) were found positive for T. gondii antibodies. Among the seropositive cases, 106 (25.6%) had 1/16, 40 (9.7%) had 1/64, 28 (6.8%) had 1/256, and two (0.5%) had 1/1024 SFDT titers. The seropositivity rates for females and males were found as 62.5% and 41.3%, respectively, and there was no statistically significant difference (p=0.053). A statistically significant increase was detected in the seropositivity rates with age, 39% being under the age of 40 (18-39 years), 54% over the age of 40 (p<0.01). In conclusion, although it is not necessary to screen the blood donors routinely for T. gondii antibodies, if the transfusion of cellular blood components is planned for immunosuppresive recipients, then those bloods should be tested for T. gondii antibodies.

The effects of rosiglitazone and metformin on insulin resistance and serum androgen levels in obese and lean patients with polycystic ovary syndrome.

AIM: The aim of this study was to assess the effects of metformin and rosiglitazone on insulin resistance and serum androgen levels in both obese and lean patients with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: Forty lean [body mass index (BMI) < 25 kg/m2] and 40 overweight and obese (BMI > 25 kg/m2) patients were included in the study. Waist and hip measurements, serum sex steroid levels, insulin response to 75-g oral glucose tolerance test, fasting insulin, fasting C-peptide levels and homeostasis model assessment of insulin resistance (HOMA-IR) were determined in all patients. The degree of hirsutism was determined by the Ferriman-Gallwey scoring system. Patients were divided into two groups, with 40 (20 overweight and obese; 20 non-obese) patients each. One group was treated with metformin (MET group) 850 mg bid while the other received rosiglitazone (ROSI group) 4 mg/day for 12 weeks. All measurements were repeated at the end of this period. RESULTS: After the 12-week treatment period, HOMA-IR, area under the curve of insulin, fasting insulin and C-peptide levels were observed to have be decreased significantly in all groups. The decrease in the parameters mentioned above was similar in the four groups. The serum levels of free testosterone, androstenedione and DHEA-S decreased in all groups, but the decrease was statistically significant only in the ROSI groups. Within the lean MET group one patient became pregnant and was hence excluded from the final data analysis. Menstruations became regular after metformin therapy in 41.6% of lean and 35.7% of obese patients who had menstrual disturbance prior to the study. Rosiglitazone therapy improved menstrual disturbance in 61.5 % of lean and 53.8% of obese patients. CONCLUSIONS: Our data showed that both metformin and rosiglitazone increased insulin sensitivity in obese patients with PCOS as expected, and in lean patients as well. Rosiglitazone seemed to be more effective in decreasing the androgen levels and in achieving slightly greater improvement in menstrual disturbance than metformin.

Effects of PPARgamma and PPARalpha agonists on serum leptin levels in diet-induced obese rats.

Leptin and peroxisome proliferator-activated receptors are two important adipose tissue factors involved in energy metabolism regulation. It has been shown that PPARgamma agonists decrease leptin levels. However, the effects of PPARalpha agonists on leptin have not been investigated much. The aim of this study was to compare the effects of a PPARgamma agonist rosiglitazone (RSG) and PPARalpha agonist gemfibrozil (G) on body weight and serum insulin and leptin levels in diet-induced obese rats. Male Wistar rats were divided into six groups according to diet and drug therapy. After four weeks, serum glucose, triglyceride, insulin and leptin levels were significantly decreased in the high-fat-fed and RSG-treated groups compared to the group fed a high-fat diet only (162 +/- 19 vs. 207 +/- 34 mg/dl, 58 +/- 20 vs. 112 +/- 23 mg/dl, 3.1 +/- 1.0 vs. 15.2 +/- 4.0 ng/ml, 1.6 +/- 0.5 vs. 3.6 +/- 1.6 ng/ml, respectively). However, these parameters were not statistically different in RSG animals treated with a standard diet compared to the standard diet group. The high fat+RSG group gained much more weight compared to high-fat and high-fat+G groups (p > 0.05). Additionally, serum glucose, insulin and leptin levels were significantly decreased in the high-fat-fed and G-treated group compared to high-fat group (149 +/- 19 vs. 207 +/- 34 mg/dl, 57 +/- 16 vs. 112 +/- 23 mg/dl, 4.3 +/- 2.1 vs. 15.2 +/- 4.0 ng/ml, 1.6 +/- 0.4 vs. 3.6 +/- 1.6 ng/ml, respectively). These results suggest that PPARalpha agonists may decrease serum glucose, insulin and leptin levels as PPARgamma agonists do in diet-induced obese rats.

Acute and chronic effects of different concentrations of free fatty acids on the insulin secreting function of islets.

INTRODUCTION: Lipotoxic effects of free fatty acids (FFAs) on insulin secreting function of islet beta-cells have been demonstrated in recent studies. This toxic effect is especially prominent on postprandial hypertriglyceridemic period. Hypertriglyceridemia and high FFAs levels are the most common metabolic disturbances seen in diabetes mellitus (DM), in particular in uncontrolled cases. AIM OF STUDY: To investigate acute and chronic effects of different concentrations of FFAs on insulin secreting function of pancreas islet beta-cells. MATERIAL AND METHOD: We determined the acute and chronic effects of FFAs on insulin secretion dynamics of isolated rat islets. The insulinotropic effects of four D-glucose concentrations (Nil, 5.6, 8.3 and 27.7 mM) were studied in freshly isolated and perifused islets in the presence of two different concentrations (250 micromol/l and 1,250 micromol/l) of three FFAs (palmitate, stearate and oleate) to determine the acute effects. Chronic effects were investigated similarly on islet cells incubated for 72 hours in the presence of nil, 250 micromol/l and 1,250 micromol/l concentrations of FFAs. RESULTS: There was only a slight increase in insulin secretion at both concentrations of FFAs in freshly isolated islets, and the recovery was complete with a slight decrease in pathologic FFA channel. However, after 72 hour incubation at physiological or higher concentrations of FFAs, insulin secretion was significantly lower, even in the presence of high levels of D-glucose when compared to either nil channel results, or results of the fresh samples. Insulin levels of recovery phase were slightly but significantly lower in physiological and pathologically high FFA conditions when compared to nil condition. In addition, first phase insulin release response was lost in these islets. CONCLUSION: FFAs slightly increased the insulin output of normal fresh pancreas beta-cells. However, chronic exposure to FFAs resulted in loss of first phase insulin release and blunted insulin secretion response to various levels of D-glucose stimulation.

A solitary hydatid cyst of the retrovesical region.

A 70-year-old man presented with a large suprapubic mass. Ultrasonography revealed that the mass was cystic and displaced the bladder anteriorly and superiorly. Computed tomography suggested that the mass could be an echinococcal cyst. Computed tomography also showed that the patient had bilateral hydroureteronephrosis. Echinoccocal haemagglutination was positive at 1:320 dilution. The patient underwent surgical exploration during which the cyst was found to be located in the retrovesical region. The cyst was completely excised and the pathologic examination confirmed the diagnosis.

Effect of transurethral indwelling catheter on serum prostate-specific antigen level in benign prostatic hyperplasia.

OBJECTIVES: The purpose of this prospective study was to determine the influence of indwelling transurethral catheters on the serum prostate-specific antigen (PSA) levels in patients with benign prostatic hyperplasia (BPH). We compared the PSA values of preoperatively catheterized and noncatheterized patients. METHODS: Ninety patients undergoing a prostatectomy for benign disease were included. The indwelling catheter (IC) group and noncatheterized (NC) group each consisted of 45 patients. A total of 83 patients who did not have prostate carcinoma were analyzed by means of PSA, PSA density (PSAD), and pathologic presentations. Prostate pathologies that might elevate PSA values were excluded to demonstrate the correlation of PSA levels and standard urethral catheterization. RESULTS: A statistically significant relationship was determined between an indwelling urethral catheter and an elevated serum PSA value. The average PSA level of the IC group was 2.6 times that of the NC group. CONCLUSIONS: PSA, PSAD, and age-adjusted PSA levels were elevated above normal ranges in patients with BPH who had an indwelling urethral catheter.

Biomarkers of marine pollution observed in species of mullet living in two eastern Mediterranean harbours.

The activities of enzymes associated with xenobiotic metabolism and or oxidative processes, and the levels of aromatic DNA adducts, have been determined in the livers of grey mullet Oedalechilus labeo and Lisa ramada living in two eastern Mediterranean harbours. Glutathione peroxidase GSH P activity was 2.5 times higher 9 IU g-1 liver and glutathione reductase GSSG R activity was twice as high 2.5 IU g-1 liver in fish from the more polluted harbour at Mersin than in the harbour near Erdemli. Superoxide dismutase SOD activity was 25 lower 4.3 IU g-1 liver in the more polluted harbour. The concentrations of glutathione and malondialdehyde varied both with species and environment by a factor of 2.5-3. DNA adducts in liver were determined by 32P postlabelling. In Oedalechilus labeo in the more polluted harbour, adduct levels were 258 21 adducts per 108 nucleotides mean SE; two groups of Lisa ramada were distinguished having 261 48 and 30 6 adducts per 108 nucleotides, respectively. The average adduct level in a group of mullet of mixed species in the less polluted harbour was 3.3 2.3 adducts per 108 nucleotides. The results illuminate the ability of mullet to live in contaminated marine environments, and show that enzyme activities and liver DNA adduct levels can serve as indicators of marine pollution.