The influence of Body Roundness Index on sensorial block level of spinal anaesthesia for elective caesarean section: an observational study.

In this prospective trial, we investigate the effectiveness of maternal Body Roundness Index in predicting the spread of spinal anaesthesia and vasopressor requirement in parturients receiving spinal anaesthesia during the elective caesarean section. We prospectively enrolled 175 parturients. Spinal anaesthesia performed with 10 mg 0.5% hyperbaric bupivacaine at the L3-L4 intervertebral space and the optimal cut-off points of the BRI evaluated as 6.59 by receiver operating characteristic analysis calculating area under the curve. Parturients were divided into two groups with BRI <6.59 and BRI ≥6.59 for analyses. Multivariate logistic regression analysis was used to test for a relationship between variables and maximum sensory block level and vasopressor requirement. BRI was found as an independent risk factor associated with maximum sensory block level (OR = 1.378, 95% CI: 1.125-1.687, p = 0.002). Hypotension and bradycardia events after spinal anaesthesia was not associated with BRI and other variables. The present study indicates that BRI was a practical tool to predict spinal drug distribution in term parturients undergoing caesarean delivery.Impact statementWhat is already known on this subject? Spinal anaesthesia is a commonly used anaesthetic technique for the caesarean section. However, the spinal drug distribution is highly unpredictable. Anthropometric variables may predict the intrathecal drug distribution in parturients. Body Roundness Index (BRI) captures body circumference regarding height to predict body fat percentage, consider the shape of the human body as an ellipse. An ellipsoid body shape might affect the spread of spinal anaesthesia.What do the results of this study add? Our results show that the BRI was as an independent risk factor associated with maximum sensory block level in term parturients undergoing caesarean delivery.What are the implications of these findings for future clinical practice and/or further research? A future study would present the possibility to design a formula for the exact amount of local anaesthetic to be used in spinal anaesthesia with the aid of maternal BRI.

Thiol-disulfide homeostasis in breast cancer patients.

OBJECTIVE: The aim of our study is to assess thiol-disulfide homeostasis (TDH), which is a biomarker of systemic oxidative stress, in breast cancer patients. MATERIALS AND METHODS: Thirty-seven breast cancer patients and 31 age-matched healthy volunteers were enrolled in this study. Serum native thiol, disulfide, and total thiol levels and disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios were analyzed using a novel colorimetric method. RESULTS: Serum native thiol level was statistically significantly lower in breast cancer patients (350.39 ± 7.15) than in healthy controls (380.60 ± 7.35) (P = 0.008). Serum disulfide level was statistically significantly higher in breast cancer patients (24.96 ± 0.85) than in healthy controls (19.25 ± 1.34) (P = 0.002). CONCLUSION: To our knowledge, this study is the first study in the literature that investigated TDH in breast cancer patients. We have concluded that an alteration in TDH due to oxidative stress is likely to have a role in the pathogenesis of breast cancer.

Visceral Adiposity Index Levels in Patients with Hypothyroidism.

OBJECTIVE: To assess visceral adiposity index (VAI) as a sign of cardio-vascular diseases (CVD) in hypothyroidism patients and to compare CVD risks in overt or subclinical hypothyroidism patients. MATERIALS AND METHODS: Sixty-eight hypothyroidism patients (29 with overt and 39 with subclinical hypothyroidism) and 33 age- and gender-matched control patients were included. VAI levels were calculated with the following formula: (waist circumference (WC)/[36.58+(1.89xbody mass index (BMI))])x[(triglyceride (TG) (mmol/L)/0.81)x(1.52xhigh-density lipoprotein cholesterol (HDL-cholesterol) (mmol/L))] and (WC/[39.68+(1.88xBMI)])x[(TG (mmol/L)/1.03)x(1.31xHDL-cholesterol (mmol/L))], respectively. RESULTS: While body weight (p < 0.01), BMI (p < 0.01), TG and VAI levels (p < 0.01) were higher in hypothyroidism patients than controls, HDL-cholesterol levels were lower (p = 0.02). When patients were divided to groups as subclinical (n = 39) and overt hypothyroidism (n = 29) and compared with each other and controls (n = 33), body weight (p = 0.02 and p = 0.02, respectively), BMI (p = 0.01 and p < 0.01, respectively) and TG (p < 0.01 and p = 0.03, respectively) were higher in overt and subclinical hypothyroidism groups than controls. HDL-cholesterol was lower only in the group with overt hypothyroidism than controls (p = 0.01). Although found similar to each other in overt and subclinical hypothyroidism groups, VAI levels were observed to be higher in both groups than controls (p < 0.01 and p = 0.02, respectively). In correlation analysis, a positive correlation was determined between thyroid stimulating hormone (TSH), BMI and VAI levels (p = 0.03 and p < 0.01, respectively). CONCLUSIONS: Due to the association between increased VAI levels, and metabolic syndrome and CVDs, we consider that several measures should be promptly taken to decrease these risk factors, and further studies with a larger sample size should be performed.

Evaluation of 25-Hydroxyvitamin D Levels in Central Anatolia, Turkey.

BACKGROUND/AIM: The aim of this study is to evaluate serum 25-hydroxyvitamin D levels measured within one year at an Education and Research Hospital in Turkey to identify vitamin D insufficiency/deficiency (which is very commonly seen in the society) and to provide a current approach to treatment management. MATERIALS AND METHODS: This retrospective descriptive study was carried out by examining the data relating to 35,667 individuals. RESULTS: Of the individuals participating in the study, 94.47% had a serum 25-hydroxyvitamin D level less than 30 ng/ml, 76.25% had a serum 25-hydroxyvitamin D level less than 20 ng/ml, and 32.20% had a serum 25-hydroxyvitamin D level less than 10 ng/ml. The mean serum 25-hydroxyvitamin D level of all individuals included in the study was 15.2±8.8 ng/ml. The mean serum 25-hydroxyvitamin D level was 14.5±8.8 ng/ml among women and 18.1±8.4 ng/ml among men, respectively (p<0.001). CONCLUSION: Vitamin D deficiency/insufficiency is widespread in the world and in Turkey. The data obtained from this study suggest that without measuring serum 25-hydroxyvitamin D level will be cost-effective in every age group (except for those are at risk of toxicity) as in children aged 0-1 year old in Turkey and that making a decision in this direction will make a great contribution to the economy of the country.