MTHFR 677 C > T Gene Polymorphism is Associated with Large for Gestational Age Infants.

BACKGROUND: The aim of this study was to investigate the methylenetetrahydrofolate reductase (MTHFR) 677 C > T gene polymorphism in term infants born small (SGA), appropriate (AGA), and large for gestational age (LGA). METHODS: The study comprised 165 newborns with SGA, LGA and AGA. Genomic DNA was isolated from the peripheral blood. Samples were genotyped for MTHFR 677 C > T gene polymorphisms using PCR-RFLP. RESULTS: There was a statistically significant difference between the genotype and their allelic distribution of AGA, SGA, and LGA. The newborns carrying the TT genotype had higher birth weight than those carrying the CC and CT genotypes. The frequency of MTHFR 677 TT genotype and T allele was significantly higher and was found to be linked with a higher risk in LGA than in the AGA group. CONCLUSIONS: The MTHFR 677 C > T gene polymorphism can be used as a genetic marker in Turkish LGA newborns, but not in SGA.

Evaluation of the Relationship between Static Balance and Mental Fatigue in Healthy Adults: Preliminary Study.

Mental fatigue (MF) occurs when a demanding cognitive-task is performed over a long period of time, making it difficult to continue daily tasks and maintain balance. The aim of this investigation was to determine whether the Stroop test induces mental fatigue and to examine its effects on static balance. The study is a quasi-experimental design with pre-post testing. Twenty participants (19-44) were included. Static posturography was used to evaluate balance at baseline following a 25-min relaxation period of rest and in the MFC (mental-fatigue condition) following the induction of MF with the Stroop test. The other measurements were the Multidimensional Fatigue Inventory (MFI), Fatigue Severity Scale (FSS), and Visual Analogue Scale (VAS). The study found that mental fatigue significantly increased at MFC compared to baseline, as indicated by MFI (p=.031) and FSS (p=.007) results with moderate effect sizes (d = 0.52, d = 0.67, respectively). Similarly, the study found a statistically significant increase in mental fatigue as measured by VAS results (p=.000, d = 0.95). However, the study did not find any statistically significant impairment in static balance due to mental fatigue in healthy young subjects. The results suggest that the Stroop test can induce mental fatigue, but it does not impair static balance.

Investigation of cardiac adverse effects in COVID-19 ARDS patients treated with intravenous immunoglobulin.

OBJECTIVE: The popularity of intravenous immunoglobulin (IVIG) therapy in Acute Respiratory Distress Syndrome (CARDS) secondary to COVID-19 infection is increasing day by day. In this study, we aimed to retrospectively evaluate the possible cardiac effects in our CARDS patients treated with IVIG. METHODS: Demographic and clinical characteristics, mortality, sequential electrocardiography (ECG), echocardiography, cardiac markers, and other laboratory parameters of CARDS patients who received IVIG treatment were recorded. RESULTS: The mean age of the patients was 68.7±13.6%, and 70.5% were female. The mean number of days of hospitalization in the intensive care unit was 18.2±9.7, and the mortality rate was recorded as 35.2%. No pathological rhythm or ischemic change was observed in sequential ECG follow-ups. However, in consecutive ECO follow-ups, the sPAP values at the treatment end were numerically lower, although not statistically significant. CONCLUSION: Our study suggests that IVIG therapy may be used safely in COVID-19 patients with cardiovascular side effects. However, due to the high risk of coagulopathy in these patients, the use of IVIG therapy in COVID-19 infection should be monitored with close monitoring, as it may increase the potential for cardiovascular risk. Furthermore, monitoring cardiac parameters are also essential as it may predict high cardiovascular risk in patients. For this reason, patients need lower infusion rates, steroid combination, adequate hydration, and effective anticoagulation therapy to avoid these side effects.

Assessment of Cerebral Arterial Flow Volume Changes with Carotid Vertebral Artery Duplex Doppler Ultrasound in Young-Middle-aged Subclinical Hashimoto Thyroiditis Patients.

OBJECTIVES: To demonstrate cerebral arterial flow volume changes during the hypothyroid, euthyroid, and hyperthyroid phases and comparing between laboratory findings and cerebral arterial flow changes with carotid-vertebral duplex Doppler ultrasound (CVA-DUSG) in subclinical Hashimoto thyroiditis (HT) patients. METHODS: According to the TSH level, 3 groups were constructed between patient cases. Group 1 (n=29) was the subclinical hyperthyroid group. In this group, the TSH level was between 0.0005 and 0.3 IU/ml. Group 2 (n=175) was the euthyroid group. TSH level in this group was between 0.3 and 4.2 IU/ml. Group 3 (n=76) was the subclinical hypothyroid group. In this group, the TSH level was above 4.2 IU/ml. The control-group (group 4) (n=71) included healthy people. In this group, the TSH level was between 0.3 and 4.2 IU/ml. After obtaining at least three consecutive waves from the bilateral internal cerebral artery and bilateral vertebral artery, volume flows were calculated using CVA-DUSG. Volume flows were calculated as peak systolic velocity + end diastolic velocity/2 × mean arterial diameter. The mean ICA(Internal Carotid Artery) and VA(Vertebral Artery) diameter was measured per ICA and VA. Total cerebral artery flow volume was defined as right ICA + right VA flow volume and left ICA + left VA flow volume. We also demonstrated topographic cerebral artery blood flow changes. Total ICA flow volume was used to assess the anterior part of the brain, total VA flow volume was used to evaluate the posterior part of the brain, right ICA + right VA flow volume was used to assess the right part of the brain, and left ICA + left VA flow volume was used to verify the left part of the brain. RESULTS: There were significant differences between RVA(Right Vertebral Artery) flow volume, LICA (Left Internal Carotid Artery) flow volume, total flow volume, TSH, and T3 and T4 levels in all groups according to the Dunn's multiple comparison test.(p<0.001) Mean TSH level was 0.03 (0.005-0.06) IU/ml in group 1, 2.8 (1.8-3.97) IU/ml in group 2, 7.32 (6.14-9.93) IU/ml in group 3, and 1.76 (1.17-2.49) IU/ml in the control group. The mean T3 level was 4.18 (3.55-5.38) in group 1, 2.88 (2.63-3.16) in group 2, 2.82 (2.49-3.15) in group 3, 3.14 (2.92-3.15) in the control group. The mean T4 level was 1.92 (1.29-2.5) in group 1, 1.16(1.03-1.31) in group 2, 1.01 (0.91-1.16) in group 3, 1.12 (0.97-1.30) in the control group (group 4). Mean total flow volume was 793 (745-898) ml/min in group 1, 742 (684.25-822.5) ml/min in group 2, 747 (692-824) ml/min in group 3, and 700 (673-675) ml/min in the control group. We also demonstrated topographic cerebral arterial volume flow changes with CVA-DUSG. There was a significant difference among all groups in the right and anterior parts of the brain (p < 0.001), and there was a significant difference between groups 1 and 4 in the left part of the brain (p = 0.009). CONCLUSION: This study demonstrated that total cerebral arterial volume flow increased in the hyperthyroid phase of subclinical HT cases without any internal carotid and vertebral artery diameter changes compared with the euthyroid and hypothyroid phases of subclinical HT and healthy cases. We also verified topographic cerebral arterial blood flow changes in subclinical HT cases with a real-time, easily applicable modality (CVA-DUSG) that does not include X-ray or contrast agents. There was a significant difference between all groups in the right and anterior parts of the brain and there was a significant difference between groups 1 and 4 in the left part of the brain.

Single nucleotide polymorphisms in 5-HT receptors in the etiology of premature ejaculation / Polimorfismos de nucleótido único en receptores 5-HT en la etiología de la eyaculación precoz

Introduction and objectives: Premature ejaculation (PE) is characterized by shorter intravaginal ejaculation latency time than it is acceptable for the patient or partner. It is thought that lifelong PE is a neurobiological dysfunction associated with genetic predisposition and with central serotonin neurotransmission dysfunction in receptors. To contribute to the understanding the genetic etiology of lifelong PE, it was planned to compare the 5-HT2C receptor gene rs3813929, rs518147, 5-HT1A receptor gene rs6295, 5-HT1B receptor gene rs11568817 of lifelong PE patients to healthy controls. Materials and methods: For this purpose, 100 patients with premature ejaculation and 100 healthy controls were included in the study. Blood samples for DNA extraction were obtained. Appropriate procedures were applied to the probes (rs3813929, rs518147, rs6295, rs11568817) suitable for the DNA studied. Results: A statistically significant relationship was found between the rs11568817 polymorphism (p=0.019) in the 5-HT1B receptor gene and the rs518147 polymorphism (p=0.016) in the 5-HT2C receptor gene. Also, no statistically significant relationship was found between 5-HT1A receptor gene rs6295 polymorphism and 5-HT2C receptor gene rs3813929 polymorphism and lifelong PE. Conclusions: The relationship between rs3813929 and rs11568817 polymorphisms with lifelong PE was confirmed. Repeating the study in larger sample groups could be useful in determining the genetic etiology of PE. (AU)

Introducción y objetivos: La eyaculación precoz (EP) se caracteriza por un tiempo de latencia de eyaculación intravaginal más corto de lo que es aceptable para el paciente o para la pareja. Se cree que la EP de por vida es una disfunción neurobiológica asociada con la predisposición genética y con la disfunción central de la neurotransmisión de serotonina en los receptores. Para contribuir a la comprensión de la etiología genética de la EP de por vida, se planificó comparar el gen del receptor 5-HT2C rs3813929, rs518147, el gen del receptor 5-HT1A rs6295 y el gen del receptor 5-HT1B rs11568817 de pacientes con EP de por vida con controles sanos. Materiales y métodos: Para este propósito, se incluyeron en el estudio 100 pacientes con eyaculación precoz y 100 controles sanos. Se obtuvieron muestras de sangre para extracción de ADN. Se aplicaron procedimientos apropiados a las sondas (rs3813929, rs518147, rs6295, rs11568817) adecuadas para el ADN estudiado. Resultados: Se encontró una relación estadísticamente significativa entre el polimorfismo rs11568817 (p=0,019) en el gen del receptor 5-HT1B y el polimorfismo rs518147 (p=0,016) en el gen del receptor 5-HT2C. Además, no se encontró una relación estadísticamente significativa entre el polimorfismo del gen del receptor 5-HT1A rs6295 y el polimorfismo del gen del receptor 5-HT2C rs3813929 y la EP de por vida. Conclusiones: Se confirmó la relación entre los polimorfismos rs3813929 y rs11568817 con EP de por vida. Repetir el estudio en grupos de muestra más grandes podría ser útil para determinar la etiología genética de la EP. (AU)

Single nucleotide polymorphisms in 5-HT receptors in the etiology of premature ejaculation.

INTRODUCTION AND OBJECTIVES: Premature ejaculation (PE) is characterized by shorter intravaginal ejaculation latency time than it is acceptable for the patient or partner. It is thought that lifelong PE is a neurobiological dysfunction associated with genetic predisposition and with central serotonin neurotransmission dysfunction in receptors. To contribute to the understanding the genetic etiology of lifelong PE, it was planned to compare the 5-HT2C receptor gene rs3813929, rs518147, 5-HT1A receptor gene rs6295, 5-HT1B receptor gene rs11568817 of lifelong PE patients to healthy controls. MATERIALS AND METHODS: For this purpose, 100 patients with premature ejaculation and 100 healthy controls were included in the study. Blood samples for DNA extraction were obtained. Appropriate procedures were applied to the probes (rs3813929, rs518147, rs6295, rs11568817) suitable for the DNA studied. RESULTS: A statistically significant relationship was found between the rs11568817 polymorphism (p=0.019) in the 5-HT1B receptor gene and the rs518147 polymorphism (p=0.016) in the 5-HT2C receptor gene. Also, no statistically significant relationship was found between 5-HT1A receptor gene rs6295 polymorphism and 5-HT2C receptor gene rs3813929 polymorphism and lifelong PE. CONCLUSIONS: The relationship between rs3813929 and rs11568817 polymorphisms with lifelong PE was confirmed. Repeating the study in larger sample groups could be useful in determining the genetic etiology of PE.

Rehabilitation cost share and cost analysis of traumatic hand injuries: Our single-center results.

OBJECTIVES: This study aims to evaluate the cost expenses and rehabilitation share of hand and/or wrist injuries and to contribute to the development of health and economic policies. PATIENTS AND METHODS: A total of 59 patients (55 males, 4 females; mean age: 39.1±11.3 years; range, 20 to 64 years) who presented with hand and/or wrist injuries between January 2015 and December 2017 were retrospectively reviewed. Demographic data, hand injury information, and the Modified Hand Injury Severity Scores (MHISS) were retrieved from the patient file system. The cost analysis with direct and indirect costs was performed. RESULTS: According to the MHISS, 27.1% of patients had a minor injury, 23.7% had a moderate injury, 18.6% had a severe injury, and 30.5% had a major injury. The mean direct cost of the patients was $726.00±641.87 and the total cost of the indirect cost was $2,776.93±1,619.00. The mean day-off time was 125±68.62 days. Indirect costs accounted for 79% of the total cost. The mean cost of rehabilitation was $150.18±86.88. Rehabilitation costs accounted for 4% of the total cost. There was a positive correlation between the MHISS and direct, indirect and total cost, but not between the MHISS and rehabilitation cost. CONCLUSION: The proportion of the share allocated to rehabilitation expenditures, which is the subunit of direct cost, is low and not related to the injury severity. The data obtained from the study contributed to the creation of evidence-based health and economic policies. We believe that these data also contribute to the planning of rehabilitation services according to the severity of injury which would improve the quality of life and return to work.

Musculoskeletal symptoms and related factors in postacute COVID-19 patients.

AIM: There is a lack of an overview of the factors associated with postacute COVID-19 musculoskeletal symptoms. The aims of this study were as follows: 1- to evaluate the most frequent admission symptoms and the frequency of musculoskeletal symptoms in postacute COVID-19 patients; and 2- to determine the related factors with the postacute COVID-19 musculoskeletal symptoms. METHODS: A total of 280 postacute COVID-19 patients (183 females, 97 males) were enrolled and divided into two groups: 1- patients whose musculoskeletal symptoms initiated with or were aggravated by COVID-19 (n = 240); and 2- patients whose musculoskeletal symptoms did not change with COVID-19 (n = 40). The variables were demographic and treatment data, symptoms on admission, postacute COVID-19 symptoms, laboratory results (complete blood count, erythrocyte sedimentation rate, C-reactive protein, ferritin and d-dimer), chest computed tomography findings and symptoms during acute COVID-19. RESULTS: Most of the patients have fatigue (71.8%), spine pain (70.7%) and myalgia (60.7%). The most common pain region was the back (30.4%). The frequency of dyspnoea was 30%, cough 18.5% and chest pain 10.7%. Having any chronic disease (P = .031), the duration of hospital stay (P = .016), frequency of back pain during acute COVID-19 (P = .018), tomography findings and d-dimer (P = .035) levels were significantly higher, and lymphocyte (P = .024) levels were significantly lower in the patients whose symptoms began with or were aggravated by COVID-19. CONCLUSION: Back pain was the most frequent symptom on admission. The most common postacute COVID-19 musculoskeletal symptoms were fatigue, spine pain and myalgia. Lower lymphocyte and higher d-dimer levels, the presence of COVID-19 findings in tomography and back pain during acute COVID-19 infection, higher duration of hospital stay and having chronic diseases were related to post-COVID-19 musculoskeletal symptoms.

[Complex regional pain syndrome in hand-wrist injuries]. / El-el bilegi yaralanmalarinda kompleks bölgesel agri sendromu.

OBJECTIVES: The aim of this study was to evaluate complex regional pain syndrome (CRPS) following hand/wrist injuries. METHODS: The sociodemographic characteristics of the patients and details regarding the presence of an occupational accident, the type of hand/wrist injury (bone, tendon, nerve, mixed), the Modified Hand Injury Severity Score (MHISS) (minor, moderate, severe, major), and the presence of CRPS were obtained from the hospital information system and analyzed. RESULTS: A total of 311 patient files were included in the study. In all, 23.8% of the patients developed CRPS and 49.2% had mixed-type injuries. There was a relationship between the lesion type and the development of CRPS: a mixed type of injury was most common (p=0.015). Isolated nerve injuries were also associated with the development of CRPS (p=0.001). A significant difference was noted in the MHISS and CRPS occurrence in cases of major injury (p=0.003). CONCLUSION: A high MHISS and/or nerve injury in patients with hand/wrist injuries may be a risk factor for the development of CRPS.

An Enriched Environment Leads to Increased Synaptic Plasticity-Associated miRNA Levels after Experimental Subarachnoid Hemorrhage.

BACKGROUND AND PURPOSE: In subarachnoid hemorrhage (SAH), impairments in motor and cognitive functions may occur and continue in later periods. MicroRNAs (miRNAs) are small non-coding RNAs that can directly or indirectly affect synaptic reconstruction. mir-132, mir-134, and mir-138 are the leading miRNAs that can be effective on some neurological functions through its effects on synaptic plasticity in the relevant brain areas. In our study, it was aimed to determine the levels of miRNAs in the hippocampus and frontal lobe of rats exposed to different environmental conditions after the experimental SAH. METHODS: SAH was created using the cisterna magna double blood-injection method. Brain tissues were collected at different times after the last blood injection. Rats were grouped according to the different environmental conditions in which they were kept. Expression levels of miRNAs were performed by qPCR and ultrastructural changes in samples were determined by transmission electron microscopy (TEM). RESULTS: After SAH, miR-132, miR-134, and miR-138 expressions in the frontal lobes of rats increased in impoverished environment on the 7th day and in the enriched environment on the 14th day. It was observed that the myelin and microtubule structures in the axons that were disrupted after SAH were more organized and stable in the enriched environment. CONCLUSIONS: After SAH, different environmental conditions may affect the miRNA levels associated with synaptic plasticity and microtubule organization in the frontal lobe, and this might have some effects especially on cognitive and motor functions related to this brain area.

Protective and curative role of vitamin D and hormones on the cadmium-induced inhibition of proliferation of human osteoblast cells.

OBJECTIVES: Exposure to cadmium (Cd), which causes environmental and industrial pollution, causes toxicity in many tissues and organs, especially bone, lung and kidney. Hormones, growth factors and other stimuli act on bone tissue through osteoblasts. In this study, it was aimed to determine the effects of Cd on hFOB1.19 osteoblast cells and the protective and healing potentials of estrogen, androgen and vitamin D against the inhibitory effect of Cd on the proliferation. METHODS: hFOB1.19 cells were cultivated in our laboratory using Dulbecco's Modified Eagle's Medium-F12, HEPES medium, containing 10% fetal bovine serum, 1% penicillin/streptomycin in 34.5 °C 5%CO2 incubator. To determine its protective potentials for the toxicity of CdCl2, it was previously applied 1,25(OH) 2D vitamin, 17ß-estradiol, and 5α-androstane for 72 h to cells. To determine their curative potential, osteoblast cells, which were previously exposed to CdCl2 for 72 h, were administered 1,25(OH) 2D vitamin, 17ß-estradiol, and 5α-androstane. Following these applications were determined proliferation by XTT analysis and, the amounts of androgen receptor, estrogen receptor, vitamin D receptor, alkaline phosphatase, osteocalcin and osteoprotegerin by ELISA analysis. RESULTS: Vitamin D has been both preventive and curative effective to increase cell proliferation, which Cd reduces. Interestingly, estrogen had a preventive effect and androgen had a curative effect. CONCLUSIONS: In addition to showing the negative effects of cadmium on the proliferation of osteoblast cells, this study provides an overview of the effects of hormone and vitamin D applications before and after Cd, and these results may serve as a guide for future studies.

Genetic variation in NOD1/CARD4 and NOD2/CARD15 immune sensors and risk of osteoporosis.

The present study was aimed to investigate the relationship between NOD1/CARD4 and NOD2/CARD15 gene polymorphisms and osteoporosis in the Turkish population. The first time we thought that the functional polymorphisms in NOD1/CARD4 and NOD2/CARD15 genes might have triggered the development of osteoporosis. The objective of our study was to determine the relationship between NOD1/CARD4 and NOD2/CARD15 SNPs and osteoporosis. The NOD1/CARD4 (rs5743336) and NOD2/CARD15 (rs2066847) SNPs were analyzed by PCR restriction fragment length polymorphism (PCR-RFLP) in 94 healthy controls and 164 subjects with osteoporosis. PCR products were digested with restriction enzymes AvaI for NOD1/CARD4 and ApaI for NOD2/CARD15. We found that NOD1/CARD4 genotype distribution of AA, GA and GG were 15, 44 and 41% for patients and 17, 46 and 37% for controls, respectively. NOD2/CARD15 mutation was found only in three patients (1.8%) as heterozygote. The results did not show any statistical difference between NOD1/CARD4 and NOD2/CARD15 genotype distribution of patients and healthy groups (χ2 = 1.740, P=0.187; χ2 = 1.311, P=0.519). However, the most frequent AG genotype (46%) of NOD1/CARD4 was observed in healthy controls, GG genotype (44%) of NOD1/CARD4 was observed as the most frequent in osteoporotic patients. NOD2/CARD15 WT/WT genotype, the most frequent genotype, was observed in both groups. Statistical analysis revealed that NOD1/CARD4 and NOD2/CARD15 polymorphisms are not associated with osteoporosis. However, a definite judgement is difficult to be made due to restricted number of patients and small size of control group. Further research is sorely warranted in this direction.

Is there any association between osteoporotic vertebral fracture and vitamin K epoxide reductase complex subunit-1 polymorphism in Turkish society? A pilot study.

OBJECTIVE: In this study, the relationship between osteoporotic vertebral fractures and 9041 Guanine/Adenine and 3673 Guanine/Adenine polymorphisms related to the vitamin K epoxide reductase complex subunit-1 (VKORC1) gene in postmenopausal women with osteoporosis was investigated. METHOD: DNA was isolated from blood samples collected from 150 women with postmenopausal osteoporosis. Genotyping of the two polymorphic regions (9041 Guanine/Adenine and 3673 Guanine/Adenine) in VKORC1 was performed using polymerase chain reaction-restriction fragment length polymorphism analysis. The presence of radiographic fractures among the 150 patients was ascertained by using the Genant method. RESULT: At least one fracture was detected in 98 patients, and no fracture was observed in 52 patients on radiological images. We found no association between the 9041 Guanine/Adenine (p=0.283) and 3673 Guanine/Adenine (p=0.232) polymorphisms of the VKORC1 gene and the development of secondary postosteoporotic fractures in our study. CONCLUSION: There was no relationship between osteoporotic vertebral fracture and VKORC1 gene polymorphism in a postmenopausal Turkish population.

Is there any association between osteoporotic vertebral fracture and vitamin K epoxide reductase complex subunit-1 polymorphism in Turkish society? A pilot study

OBJECTIVE: In this study, the relationship between osteoporotic vertebral fractures and 9041 Guanine/Adenine and 3673 Guanine/Adenine polymorphisms related to the vitamin K epoxide reductase complex subunit-1 (VKORC1) gene in postmenopausal women with osteoporosis was investigated. METHOD: DNA was isolated from blood samples collected from 150 women with postmenopausal osteoporosis. Genotyping of the two polymorphic regions (9041 Guanine/Adenine and 3673 Guanine/Adenine) in VKORC1 was performed using polymerase chain reaction-restriction fragment length polymorphism analysis. The presence of radiographic fractures among the 150 patients was ascertained by using the Genant method. RESULT: At least one fracture was detected in 98 patients, and no fracture was observed in 52 patients on radiological images. We found no association between the 9041 Guanine/Adenine (p=0.283) and 3673 Guanine/Adenine (p=0.232) polymorphisms of the VKORC1 gene and the development of secondary postosteoporotic fractures in our study. CONCLUSION: There was no relationship between osteoporotic vertebral fracture and VKORC1 gene polymorphism in a postmenopausal Turkish population.

Three Single Nucleotide Polymorphisms of LOXL1' in a Turkish Population with Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma.

OBJECTIVES: To investigate the three single nucleotide polymorphisms (SNPs) (rs3825942, rs1048661, and rs2165241) of the LOXL1 gene in pseudoexfoliation syndrome (XFS) and pseudoexfoliation glucoma (XFG) in the Turkish population. MATERIALS AND METHODS: DNA was obtained from blood samples of 48 XFS, 58 XFG, and 171 control subjects. Three LOXL1 SNPs (rs3825942, rs1048661, rs2165241) were investigated with real time PCR, a probe-based genotyping method, and melting curve analysis. RESULTS: All three SNPs of LOXL1 were significantly associated with XFS (rs3825942 p=3.54x10-6, odds ratio [OR]=∞; rs1048661 p=0.008, OR=2.18; rs2165241 p=8.69x10-9, OR=4.30) and XFG (rs3825942 p=3.41x10-7, OR=∞; rs1048661 p=1.75x10-5, OR=3.78; rs2165241 p=3.85x10-11 OR=4.90). No significant differences were observed between the XFS and XFG groups for any of the SNPs. The GG genotype of rs3825942 was more valuable for distinguishing pseudoexfoliative cases from healthy individuals. The homozygous TT genotype of rs2165241 was associated with 6-fold increased XFS risk (p=8.15x10-8, OR=6.32) and 7-fold increased XFG risk (p=1.45x10-10 OR=7.95). The GGT haplotype consisting of all three risk alleles was associated with a 7.45-fold higher risk of XFS/XFG (p=8.65x10-14, OR=7.45). Presence of T allele of rs2165241 conferred 3 times higher risk for men than women (p=6.78x10-5, OR=3.202). CONCLUSION: LOXL1 SNPs are associated with increased risk for pseudoexfoliation in the Turkish population. T allele of rs2165241 was found to be the most important characterized risk factor for our cohort. All SNP distributions were similar to other European and American populations.

Monocyte to High-Density Lipoprotein Ratio Predicts Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome.

Contrast-induced nephropathy (CIN) is associated with worse prognosis in patients with acute coronary syndrome (ACS). Early identification and intervention for patients with a high risk of CIN are very important to improve clinical outcomes. Inflammation plays important role in the development of CIN in the setting of ACS. The monocyte to high-density lipoprotein ratio (MHR) is a novel inflammatory marker. Bleeding is also associated with worse prognosis in such patients. We aimed to investigate whether the preprocedural MHR had a predictive role for CIN development in such patients. In addition, using the thrombolysis in myocardial infarction classification, we aimed to assess whether there was any relationship between bleeding and CIN. A total of 647 patients (496 males; age: 63.3 ± 12.7 years) with ACS who underwent percutaneous coronary intervention (PCI) were included in the study. Seventy patients (10.8%) had developed CIN. Age, diabetes mellitus, contrast volume, estimated glomerular filtration rate, and MHR were independent predictors for CIN. Preprocedural MHR may be used as a simple marker of CIN. It may help with the early identification of patients with ACS who underwent PCI who are at high risk of CIN thus allowing the planning of protective measures.

Predictors of new-onset atrial fibrillation in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention.

BACKGROUND: The development of atrial fibrillation (AF) during the course of acute coronary syndrome (ACS) is related to poor prognosis. Possible predictors of new-onset AF (NOAF) have not been adequately investigated in elderly patients with ACS undergoing percutaneous coronary intervention (PCI). We aimed to identify the factors associated with NOAF in such patients. METHODS: A total of 308 elderly patients with ACS undergoing PCI were enrolled in the study. Patients were divided into two groups: without NOAF [254 patients, 64.6% men, age: 73.5 (69.0-79.0) years] and with NOAF [54 patients, 70.4% men, age: 75.0 (68.7-81.2) years]. Clinical, angiographic, and laboratory features including neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-high-density lipoprotein ratio (MHR) were compared between the groups. RESULTS: The percentages of prior myocardial infarction (MI) (20.4 vs. 5.9%) and Killip III/ IV (24.1 vs. 7.1%), NLR [4.5 (2.6-7.2) vs. 3.2 (2.0-6.0)], and MHR [19.4 (15.7-26.5) vs. 12.9 (9.9-18.5)] were higher in patients with NOAF compared to the others (p = 0.020, < 0.001, 0.030, and < 0.001, respectively). In multivariate regression analysis, prior MI (OR 4.509, 95% CI 1.679-12.106, p = 0.003) and MHR (OR 1.102, 95% CI 1.054-1.152, p < 0.001) independently predicted NOAF. In addition, Killip III/IV was found to be an independent predictor of 6-month overall mortality (HR 2.949, 95% CI 1.218-7.136, p = 0.016). CONCLUSIONS: Prior MI and MHR are independent predictors of NOAF in elderly patients with ACS undergoing PCI. Killip III/IV predicts 6-month overall mortality in such patients.

COMPARISON OF DIFFERENT ENVIRONMENTAL CONDITIONS IN THE FOLLOW-UP OF SUBARACHNOID HEMORRHAGE: An Experimental Rat Study.

AIM: We questioned the effect of different environmental conditions on the brain in rats with subarachnoid haemorrhage. MATERIAL AND METHODS: Microtubules in neurons mediate both the consciousness and memory and regulate firing. Microtubule-associated proteins (MAPs) promote microtubule organisation and dynamics. We investigated MAP2, tau and amyloid beta levels in the hippocampus and the frontal cortex after experimental subarachnoid haemorrhage in rats. Subjects were divided into subgroups and were housed either in an enriched, standard or isolated environment. Tissue levels were measured on day 7 for short-term outcomes and on day 14 for long-term outcomes after SAH. RESULTS: After SAH, the results showed that decreased MAP2 levels, a trend in pathologic tau accumulation and increased amyloid beta levels in different brain regions of rats kept in an isolated environment. Frontal lobe MAP2 levels were increased in rats kept in an enriched environment for 7 days. Pathological hippocampal tau and frontal lobe amyloid beta levels were increased in rats kept in an isolated environment for 7 days. Increased MAP2 levels in the hippocampus, decreased frontal and hippocampal amyloid beta were seen in rats kept in an enriched environment for 14 days. CONCLUSION: Although it would be too early to offer recommendations, results of the present study support that an enriched environment may be more valuable in the follow-up of SAH. Further experimental studies would provide more reliable results to facilitate discussions about how to optimise the patient\'s environmental conditions.

Effects of S1P1 and S1P3 in ER+ and ER- Breast Cancer Cells.

BACKGROUND/AIM: In this study, sphingosine-1-phosphate receptor-1 (S1P1) and S1P3 receptors were silenced to evaluate proliferation, adhesion, viability and lateral motility in estrogen receptor-negative MCF-7 and estrogen receptor-positive MDA-MB-231 breast cancer cells. MATERIALS AND METHODS: Groups of MCF-7 and MDA-MB-231 cells with: no small interfering RNA (siRNA); siRNA with no target; S1P1-silencing siRNA; S1P3-silencing siRNA; and siRNAs silencing both S1P1, and S1P3 were examined for this purpose at 24, 48 and 72 h after intervention. RESULTS: Viability of cells was reduced due to suppression of S1P1/S1P3. While no change was observed in the proliferation of MCF-7 cells, the proliferation of S1P1/S1P3-suppressed MDA-MB-231 cells was reduced. S1P1/S1P3 suppression resulted in reduction of adhesion of MCF-7 cells, but to an increase of MDA-MB-231 cells. Lateral motility was reduced in all S1P1/S1P3-suppressed groups. CONCLUSION: Silencing the receptors simultaneously rather than separately was more effective. Additionally, the different characteristics of cancer cells affected the proliferation and adhesion of cells differently. This difference may be associated with the estrogen receptors in the cells.

Effects of ivabradine and beta-blocker therapy on dobutamine-induced ventricular arrhythmias.

BACKGROUND: Indirect evidences suggest that the If blocker ivabradine may exert an antiarrhythmic effect in ventricular myocardium in heart failure (HF) patients by inhibiting spontaneous depolarisations, but the clinical relevance of this mechanism is not known. Dobutamine (DOB) has been known to increase heart rate and the incidence of cardiac arrhythmias. AIM: In this study, we evaluated the effects of ivabradine on DOB-induced ventricular arrhythmias and compared them with those of beta-blocker (BB) therapy. METHODS: Patients with decompensated HF requiring inotropic support, left ventricular ejection fraction < 35%, and in sinus rhythm were included in the study (ivabradine group - 29 patients, control group - 29 patients, BB group - 15 patients). All patients underwent Holter recording for 6 h before the initiation of DOB infusion. Following baseline recording, DOB was administered at incremental doses of 5, 10, and 15 µg/kg/min, with 6-h steps. Holter monitoring was continued during 18 h of DOB infusion and analysed for the median number of ventricular premature contractions (VPC), ventricular couplets, episodes of non-sustained ventricular tachycardia, and total ventricular arrhythmias in each step of the study protocol. RESULTS: The positive chronotropic effect of incremental DOB doses was blunted by beta-blockade and was totally abolished by ivabradine. The median number of VPCs, ventricular couplets, and total ventricular arrhythmias significantly increased with incremental doses of DOB in the control group (p = 0.018) and, to a lesser extent, in the ivabradine group (p = 0.015). In the BB group the absolute VPCs numbers were smaller than in the control or the ivabradine group, with the on-ivabradine VPCs numbers falling between those seen in control and BB groups. A numeric increase in VPCs with incremental DOB doses occurred in the BB group but did not reach statistical significance (p > 0.05), consistent with a protective effect of beta-blockade. Ivabradine reduced VPCs by 43% at 5 µg/kg/min DOB and by 38% at 10 µg/kg/min DOB against the control group (VPCs median 256 vs. 147 and 251 vs. 158) in the absence of significant differences at 15 µg/kg/min DOB between the control and ivabradine groups (overall p > 0.05). Thus, ivabradine administered without background beta-blockade attenuated the arrhythmogenic effect of increasing doses of DOB in the low and moderate DOB dose but not in the high DOB dose. CONCLUSIONS: In patients with decompensated HF, ivabradine appears to reduce the incidence of VPCs in response to low and medium DOB dose. Whether the anti-arrhythmic effect of ivabradine is additive to the anti-arrhythmic effect of beta-blockade requires further investigation; this should also determine the clinical significance of ventricular arrhythmia attenuation with ivabradine.