Does Blood Flow Change according to Mood? Blood Rheology in Bipolar Disorder.

OBJECTIVE: Bipolar disorder (BD) is associated with increased rates of cardiovascular diseases. There is growing evidence that blood viscosity may have a common role, correlated with well-known major risk factors that promote cardiovascular disease. In this study we aimed to investigate the whole blood viscosity (WBV) in different stages of BD. METHODS: A total of 121 bipolar patients and 41 age-gender matched healthy controls were included. Forty-four of bipolar patients were in manic, 35 were depressed and 42 were in euthymic state. WBV was calculated from hematocrit and total plasma protein according to Simone's formula at low and high shear rates (LSR and HSR). RESULTS: WBV at HSR of manic group was 16.91±1.01, depressive group was 17.23±0.80, euthymic group was 17.63±0.95, and control group was 17.52±0.71 (p =0.001). WBV at LSR of manic depressive, euthymic and control group were 53.10±20.58, 60.30±17.02, 8.91±20.33, and 62.01±19.28, respectively (p =0.001). Both WBV at HSR and LSR of manic group was significantly lower than that of the euthymic and control groups (p =0.001 and 0.010 respectively for HSR, p =0.001 and 0.011 respectively for LSR). WBV was significantly positively correlated with lipid profile except high density lipoprotein (HDL). CONCLUSION: Our results demonstrate a decrement in blood viscosity in manic episode compared with euthymics and controls. Positive correlation of blood viscosity with lipid parameters (except HDL), and negative correlation with number of previous manic episodes suggest that manic episode has favorable effect on cardiovascular risk regarding to blood viscosity.

Serum osmolarity in male patients with bipolar disorder manic episode.

NEW FINDINGS: What is the central question of this study? The main goal of this study was, for the first time, to investigate the role of the serum osmolarity in bipolar disorder manic episode. What is the main finding and its importance? Our results demonstrate a diminished serum osmolarity in manic episode compared with healthy control subjects. This finding supports the hypothesis of a fluid and electrolyte imbalance during acute episodes. Decreased serum osmolarity might be a reflection of a relative haemodilution in mania. Imbalance of water and electrolyte homeostasis has been suggested to be associated with acute episodes of bipolar disorder. In this study, we aimed to investigate, for the first time, the serum osmolarity in bipolar disorder manic episode. A total of 68 bipolar inpatients in manic episode and 60 age- and sex-matched healthy control subjects were included in the study. Serum osmolarity was calculated from sodium (Na+ ), glucose and blood urea nitrogen (BUN) according to following formula: (2 × Na+ ) + (BUN/2.8) + (glucose/18). The significance level was accepted as P < 0.05. The serum osmolarity of manic patients was 295.34 ± 4.90 mosmol/l and that of the control group was 298.46 ± 5.33 mosmol/l. The serum osmolarity of the manic group was significantly lower than that of control subjects (P < 0.001). When we compared the components of serum osmolarity, a statistically significant difference was also observed between groups in terms of glucose (85.85 ± 12.25 mg/dl for manic, 92.95 ± 20.77 mg/dl for control subjects, P = 0.019) and Na+ (140.73 ± 2.06 mmol/l for manic, 142.06 ± 2.48 mmol/l for control subjects, P = 0.001). For BUN concentrations, there was no statistically significant difference between manic (25.50 ± 9.85 mg/dl) and control (26.61 ± 6.64 mg/dl) groups (P = 0.461). Our results demonstrate a diminished serum osmolarity in manic episode compared with healthy control subjects. This finding supports the hypothesis of a fluid and electrolyte imbalance during acute episodes. Decreased serum osmolarity might be a reflection of a relative haemodilution in mania. However, exploration of the role of fluid and electrolyte homeostasis and mechanisms of related hormones may contribute to a better understanding of the aetiology of bipolar disorder.

Usefulness of ischemia-modified albumin in predicting oxidative stress in patients with vitiligo.

AIM: To investigate the emphasis of oxidative stress in the pathogenesis of vitiligo through an evaluation of ischemia-modified albumin (IMA). Results/methodology: IMA was of higher statistical significance in patients than in the control group (IMA: 0.57 ± 0.2 vs 0.52 ± 0.2 ΔABSU; p < 0.0001). IMA (p < 0.0001; OR: 8.9; 95% CI = 3.1-26.1) was found as an independent predictor of oxidative stress. Increases in affected body surface area and age were found to be independent risk factors for IMA. The sensitivity, specificity and positive and negative predictive values and capacity of IMA were higher than other studied biomarkers. DISCUSSION/CONCLUSION: IMA can be detected in the condition of oxidative stress in vitiligo; it has great potential as a biomarker of said condition, when compared with other studied biomarkers.

Successful treatment of sodium oxalate induced urolithiasis with Helichrysum flowers.

ETHNOPHARMACOLOGICAL RELEVANCE: Helichrysum (Asteraceae) flowers, known as "altin otu, yayla çiçegi, kudama çiçegi" , are widely used to remove kidney stones and for their diuretic properties in Turkey. AIM OF THE STUDY: To determine the curative effect of infusions prepared from capitulums of Helichrysum graveolens (M. Bieb.) Sweet (HG) and H. stoechas ssp. barellieri (Ten.) Nyman (HS) on sodium oxalate induced kidney stones. MATERIALS AND METHODS: Infusions prepared from the capitulums of HG and HS were tested for their curative effect on calcium oxalate deposition induced by sodium oxalate (70mg/kg i.p.). Following the injection of sodium oxalate for 5 days, plant extracts were administered to rats at two different doses. Potassium citrate was used as positive control. Water intake, urine volume, body, liver and kidney weights were measured; biochemical and hematological analyses were conducted on urine and blood samples. Additionally, histopathological examinations were done on kidney samples. RESULTS: H. stoechas extract showed prominent effect at 156mg/kg dose (stone formation score: 0.33), whereas number of kidney stones was maximum in sodium oxalate group (stone formation score: 2.33). The reduction in the uric acid and oxalate levels of urine samples and the elevation in the urine citrate levels are significant and promising in extract groups. Some hematological, biochemical and enzymatic markers are also ameliorated by the extracts. CONCLUSIONS: This is the first report on the curative effect of immortal flowers. Our preliminary study indicated that Helichrysum extracts may be used for treatment of urolithiasis and Helichrysum extracts are an alternative therapy to potassium citrate for patients suffering from kidney stones.

Serum ß-trophin level as a new marker for noninvasive assessment of nonalcoholic fatty liver disease and liver fibrosis.

OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease and evaluation of fibrosis is important. We aimed to investigate the utility of serum ß-trophin in NAFLD and its ability to predict liver fibrosis. PATIENTS AND METHODS: Serum samples of consecutive patients with biopsy-proven NAFLD and age-matched and sex-matched healthy controls were used to measure ß-trophin using ELISA. Correlations between histopathological features of NAFLD and ß-trophin were analyzed. Whereas patients with fibrosis scores less than 2 were grouped in the mild fibrosis group, patients with scores of 2 or more were grouped in the significant fibrosis group. Univariate/multivariate logistic regression analyses were carried out to evaluate the independent predicting factors of liver fibrosis. Receiver operating characteristics (ROCs) were assessed to determine the best cut-off values for NAFLD and fibrosis. RESULTS: Sixty-nine patients with NAFLD and 69 healthy controls were enrolled in the study. Serum ß-trophin levels were lower in NAFLD patients compared with the controls (2.34±0.06 vs. 1.94±0.09 ng/ml, respectively, P<0.001). In NAFLD, serum ß-trophin was related to liver fibrosis and inflammation. The mild fibrosis group had higher serum ß-trophin levels than the significant fibrosis group (2.11±0.12 vs. 1.72±0.11, respectively, P<0.001). In multivariate analysis, ß-trophin remained an independent predictor of significant fibrosis (odds ratio, 0.237; 95% confidence interval, 0.059-0.949; P<0.001). ROC analysis showed that serum ß-trophin was statistically significant in the identification of significant fibrosis (area under receiver operating characteristic, 0.844; 95% confidence interval, 0.718-0.970; P<0.001). The best cut-off value was 1.786, with the best sensitivity (71.43%) and specificity (95.65%). CONCLUSION: Serum ß-trophin may be a potential noninvasive marker for the identification of NAFLD and significant liver fibrosis.

DR-70 as a novel diagnostic biomarker for gastric cancer.

BACKGROUND/AIMS: To assess the utility of the DR-70 immunoassay in the diagnosis of gastric cancer. MATERIALS AND METHODS: A total of 29 patients with histologically proven malignant gastric tumor and 29 healthy blood donors were enrolled in this study. DR-70 immunoassay was performed using an enzyme-linked immunosorbent assay kit to quantify the serum levels of fibrin degradation products. RESULTS: The DR-70 values in patients with gastric cancer significantly differed from the values in controls (p<0.0001). Receiver operating characteristic curve analysis revealed ≥1.45 µg/mL as the best cut-off value to distinguish between patients with gastric cancer and healthy controls. The area under the receiver operating characteristic curve was 0.871. Using ≥1.45 µg/mL as the cut-off value, the DR-70 immunoassay showed a good clinical performance with a sensitivity of 82.8% and a specificity of 79.3%. The positive predictive value was 80.0%, and the negative predictive value was 82.1%. CONCLUSION: The DR-70 immunoassay reliably differs between gastric cancer and healthy controls, promising to become a useful cancer detection tool in clinical practice.