Relation between unconjugated bilirubin and RDW, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio in Gilbert's syndrome.

BACKGROUND: Unconjugated bilirubin (UCB) plays a protective role in coronary artery disease. Red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are inflammatory biomarkers and higher levels are related to atherosclerosis and adverse cardiovascular events. AIM: We aimed to investigate the relation between UCB levels and RDW, NLR, PLR in people with Gilbert's syndrome (GS). MATERIALS AND METHODS: We selected 2166 subjects (1082 with GS and 1084 healthy controls) from a database having 33,695 people. RDW, NLR and PLR were investigated in the subjects with GS and compared with the healthy controls. Linear regression analysis was used to evaluate the relation between variables. RESULTS: NLR and PLR were higher in the subjects with GS compared to the controls (p < 0.001). RDW was similar in both groups (p = 0.318). UCB was negatively correlated with lymphocyte counts (p = 0.040), and positively correlated with RDW (p < 0.001) and PLR (p = 0.037) in the subjects with GS. There was no significant correlation between UCB and NLR (p = 0.078). RDW (p < 0.001) and lymphocyte counts (p = 0.030) were significantly associated with UCB levels in the regression analysis conducted in the subjects with GS. CONCLUSION: There is a negative association between UCB and NLR, PLR due to low amounts of lymphocyte counts, which causes increased risk of CVD. These results suggest that the cardio-protective effect of UCB is due to both anti-oxidative and anti-inflammatory ways indirectly.

Development of a medication adherence scale for familial Mediterranean fever (MASIF) in a cohort of Turkish children.

OBJECTIVES: To develop and assess the validity and reliability of an adherence scale concerning medical treatment in paediatric FMF patients. METHODS: The Medication Adherence Scale in FMF Patients (MASIF) is a 18-item questionnaire that evaluates adherence to medication in four domains. Validation of the instrument was accomplished in paediatric FMF patients (aged 2-18 years) under medication at least for 6 months. The first step was to build up the scale through qualitative approach (with interviews using semi-structured questions). Validation analyses included assessment of feasibility, face and content validity; construct validity, internal consistency and test-retest reliability. RESULTS: One hundred and fifty patients with FMF were enrolled in the study. The mean age of the patients was 11.11±4.02 years and 48.7% of them were male. The MASIF was found to be feasible and valid for both face and content. It correlated with the Morisky Medication Adherence Scale as a gold standard thereby demonstrating good construct validity (r=0.515, p<0.001). Assessment of content validity identified four subscales. The internal consistency, Cronbach's alpha was 0.728. There was a positive and significant correlation between test and retest scores (r=0.843; p<0.001). Also, a significant correlation between parents' and children's reports (r=0.781, p<0.001). CONCLUSIONS: Based on these results, the use of this scale to assess and follow up the adherence to treatment in paediatric FMF patients under medical treatment is recommended.

An in vitro and in vivo investigation of the cytotoxic effects of caffeic acid (3,4-dihydroxycinnamic acid) phenethyl ester and bortezomib in multiple myeloma cells.

BACKGROUND/AIM: In this study, the in vitro and in vivo effectiveness of caffeic acid (3,4-dihydroxycinnamic acid) phenethyl ester (CAPE) in combination with bortezomib, a proteasome inhibitor, was explored in multiple myeloma (MM) cells. MATERIALS AND METHODS: The cytotoxic effects of CAPE and bortezomib were determined by XTT cell proliferation assay. Apoptosis levels were analyzed with annexin V-fluorescein isothiocyanate, nuclear factor kappa beta (NF-κB) was analyzed with electrophoretic mobility-shift assay, and interleukin (IL)-6 levels were analyzed with enzyme-linked immunosorbent assay to evaluate CAPE's mechanism of action. To investigate the in vivo effectiveness of CAPE and bortezomib, an experimental plasmacytoma model was induced in BALB/c mice. RESULTS: Increasing concentrations of CAPE and bortezomib decreased the proliferation of ARH-77 cells in a dose-dependent manner. With doses of CAPE IC50, a significant increase in apoptosis and a significant decrease in IL-6 levels were detected. The NF-κB DNA- binding activity decreased compared to the basal ARH-77 level. The administration of CAPE alone or in combination with bortezomib increased the rate of survival compared to the control group. CONCLUSION: We think that our study, which is the first to demonstrate the in vitro and in vivo effectiveness of the.combined use of CAPE and bortezomib, will be a pioneer for future human applications of CAPE in MM.

Measures of pituitary gland and stalk: from neonate to adolescence.

OBJECTIVE: The aim of this study is to provide normative data about pituitary diameters in a pediatric population. Pituitary imaging is important for the evaluation of the hypothalamo-pituitary axis defect. However, data about normal pituitary gland diameters and stalk are limited, especially in children. Structure and the measurements of pituitary gland and pituitary stalk may change due to infection, inflammation, or neoplasia. METHODS: Among 14,854 cranial/pituitary gland magnetic resonance imaging scans performed from 2011 to 2013, 2755 images of Turkish children aged between 0 and 18 were acquired. After exclusions, 517 images were left. Four radiologists were educated by an experienced pediatric radiologist for the measurement and assessment of the pituitary gland and pituitary stalk. Twenty cases were measured by all radiologists for a pilot study and there was no interobserver variability. RESULTS: There were 10-22 children in each age group. The maximum median height of the pituitary gland was 8.48±1.08 and 6.19±0.88 mm for girls and boys, respectively. Volumes were also correlated with gender similar to height. Minimum median height was 3.91±0.75 mm for girls and 3.81±0.68 mm for boys. The maximum and minimum pituitary stalk basilar artery ratios for girls were 0.73±0.12 and 0.59±0.10 mm. The ratios for boys were 0.70±0.12 and 0.56±0.11 mm. CONCLUSION: Our study demonstrated the pituitary gland and stalk size data of children in various age groups from newborn to adolescent. It is thought that these data can be applied in clinical practice. Future prospective follow-up studies with larger samples, which correlate the structural findings with the clinical and laboratory results are awaited.

Association between left-handedness and cardiac autonomic function in healthy young men.

BACKGROUND: Effects of nonright-handedness on risk for sudden death associated with coronary artery disease via sympathetic imbalance contributed to ventricular arrhythmogenesis previously have been demonstrated. This study hypothesized that left-handedness might be associated with cardiac autonomic functions in healthy young men. The aim of this study was to examine the association between left-handedness and cardiac autonomic functions in healthy young men. METHODS: A total of 992 asymptomatic young male subjects underwent routine health checkup between May 2012 and July 2013, and were included in this study. All were submitted to a standard protocol that included a complete clinical examination, laboratory evaluation, 12-lead electrocardiogram, and 2D-echocardiogram. Fifty-two subjects were left-handed; 32 subjects had abnormal QRS-T angle. Statistical analyses were performed using statistical package SPSS 15.0 (IBM Corp., Armonk, NY, USA) and statistical significance was assessed at the two-tailed 0.05 threshold. RESULTS: A total of 52 (5%) subjects were left-handed; 32 (3%) subjects had an abnormal frontal QRS-T angle. The mean age, body mass index, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting glucose, current smoking, estimated glomerular filtration rate, hemoglobin, leukocyte count, platelet count, and echocardiographic parameters were not different between two groups. But subjects with left-handedness had greater prevalence of abnormal QRS-T angle. The left-handedness group had 18 subjects with abnormal QRS-T angle (34%) and the right-handedness group had 14 subjects with abnormal QRS-T angle (1.4%). The difference between two groups was significant (P < 0.001). CONCLUSION: In this study, there was a significant association between left-handedness and abnormal QRS-T angle in healthy young subjects.

Neutrophil-lymphocyte ratio is associated with low high-density lipoprotein cholesterol in healthy young men.

OBJECTIVE: It has been reported that the neutrophil-lymphocyte ratio is significantly elevated in patients with low high-density lipoprotein cholesterol (<35 mg/dL). But in this study, some patients had hypertension that may have affected the neutrophil-lymphocyte ratio. This study consisted of 1274 asymptomatic healthy young men. In contrast with the previous study, we investigated the neutrophil-lymphocyte ratio in healthy young men with low high-density lipoprotein cholesterol compared with controls. METHODS: We studied 1274 asymptomatic young males (military personnel screening) who underwent routine health check-up. Of them, 102 subjects had low high-density lipoprotein cholesterol. RESULTS: The neutrophil-lymphocyte ratio was significantly higher among the men with low high-density lipoprotein cholesterol than that of the control group (P < 0.001). CONCLUSION: We conclude that the neutrophil-lymphocyte ratio is significantly elevated in asymptomatic healthy young men with low high-density lipoprotein cholesterol compared with control participants.

Association between the development of diabetic foot and serum fetuin­A levels.

INTRODUCTION: Fetuin­A is a glycoprotein secreted from hepatocytes, which affects diabetes and peripheral arterial disease. However, there has been no studies regarding the relation between diabetic foot and fetuin­A levels. OBJECTIVES: We aimed to analyze the association between diabetic foot development and serum fetuin­A levels. PATIENTS AND METHODS: Following the approval of the local ethical board, 137 patients were included in the study. Patients were divided into 3 groups: diabetes group (n = 49), diabetic foot group (n = 57), and control group (n = 31). In all patients, serum fetuin­A, C­reactive protein, magnesium, and hemoglobin A1c (HbA1c) levels were measured. Diabetic foot wounds were classified according to the Wagner classification and lower extremity arteries were evaluated by ultrasonography. RESULTS: Median fetuin­A levels in patients with diabetic foot were significantly higher than in those with diabetes. However, the differences in HbA1c levels between both groups were not statistically significant. A positive correlation was found between the Wagner classification and ultrasound evaluation of the peripheral arteries (degree of atherosclerosis) in patients with diabetic foot. In the diabetic foot group, fetuin­A levels were also found to be positively correlated with ultrasound evaluation. CONCLUSIONS: We observed a positive correlation between serum fetuin­A levels and the development of diabetic foot.