Attitude towards seeking psychological help regarding psychiatric symptoms and stigma in patients with fibromyalgia.

OBJECTIVE: The current study aimed to examine the psychiatric symptoms that can be seen in fibromyalgia (FM) patients, their attitudes toward seeking psychological help, and their concerns about stigma. Besides, it was investigated whether the stigma concerns that they may experience about receiving psychiatric treatment constitute an obstacle for patients to receive psychiatric treatment. SUBJECTS AND METHODS: This cross-sectional descriptive study was conducted between February and July 2020. Various seeking help were measured with Attitude Towards Seeking Psychological Help Scale-Short Form (ATSPPH-SF), Self-Stigma in the Process of Seeking Psychological Help Scale (SSPSPHS), Intention to Seek Psychological Help Inventory (ISPHI), and Social Stigma Due to Seeking Psychological Help Scale (SSDSPHS). FM symptoms of patients were measured with The Symptom Screening Questionnaire, Revised 90 Items (SCL-90-R). Quality-of-life parameters were measured with Fibromyalgia Impact Questionnaire (FIQ). RESULTS: Fibromyalgia patients had higher somatization (p=0.001), psychotism (p=0.045) and phobic anxiety (p=0.015) scores than controls. The ATSPPH-SF (p=0.002) and SSPSPHS (p=0.043) scale scores of the FM patients were higher than the controls. There was a significant positive correlation between FIQ and SSPSPHS (r=0.288, p=0.043) and SCL-90 overall (r=0.602, p<0.001) and all subscales scores. Patients with high active psychotic symptom levels had higher FM exposure scale scores and SCL-90 overall scores than those with low active psychotic symptom levels (p<0.001). CONCLUSIONS: The findings of this study showed that fibromyalgia patients have more somatization symptoms than healthy individuals, and as psychiatric symptoms increase in these individuals, their level of being affected by FM increases.

Vascular complications and associated comorbidities in newly diagnosed pre-diabetes: is it the tip of the iceberg?

OBJECTIVE: The aim of this study was to investigate the prevalence of microvascular and macrovascular diabetic complications and the associated comorbidities in newly diagnosed pre-diabetic individuals. PATIENTS AND METHODS: This cross-sectional study includes 100 newly diagnosed pre-diabetic individuals. Fasting plasma glucose, HbA1c, and oral glucose tolerance (OGTT) were tested according to the American Diabetes Association's diagnostic criteria for pre-diabetes, besides anthropometric measurements, lipid profiles, and demographic and biochemical parameters. Comorbidities like hypertension, obesity, dyslipidemia etc., were evaluated. All participants were screened for microvascular (retinopathy, nephropathy, neuropathy) and macrovascular [coronary artery disease (CAD) and cerebrovascular event-peripheral artery disease] complications. RESULTS: Microvascular complications were found in 12% of the participants (neuropathy: 4%, nephropathy: 8%) and 19% had macrovascular complications. Of the participants, 21% of the cases presented hypertension, 21% dyslipidemia and 48% obesity. A high probability of developing non-alcoholic fatty liver disease-related fibrosis [estimated using non-alcoholic fatty liver disease fibrosis score (NFS)] was found in 68% of cases. History of dyslipidemia (OR: 5.00, 95% CI: 1.10-22.56; p=0.037) was an independent risk factor for the development of vascular complications. CONCLUSIONS: Diabetic vascular complications were found in approximately one-third of pre-diabetic cases. Dyslipidaemia was found to be an important risk factor for the development of vascular complications in these individuals.

Increase in subcutaneous adipose tissue in the frontal scalp may be associated with androgenetic alopecia and metabolic syndrome.

OBJECTIVE: Recent studies have suggested that androgenetic alopecia (AGA) may be associated with other disorders, especially metabolic syndrome (MetS). This study aimed to determine whether a connection exists between MetS and AGA based on the thickness of the subcutaneous adipose tissue in the scalp. PATIENTS AND METHODS: This cross-sectional study included 34 participants with AGA who had MetS and 33 participants with AGA who did not have MetS. The Hamilton-Norwood scale was employed for classifying AGA and MetS was identified using the US National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III criteria). The body mass index (BMI), blood pressure, and lipid profiles of the participants were assessed. Hepatosteatosis and the thickness of the subcutaneous adipose tissue in the scalp were examined using ultrasonography. RESULTS: Compared with the control group, the MetS+AGA group had higher BMI (p = 0.011), systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001) and waist circumference (p = 0.003). Furthermore, the MetS+AGA group had a higher prevalence of dyslipidemia, hypertension (HT) and diabetes mellitus (DM) and higher rates of grade 6 alopecia than the control group (p = 0.019). Compared with the control group, those with MetS had thicker subcutaneous adipose tissue in the frontal scalp (p = 0.018). CONCLUSIONS: The subcutaneous adipose tissue in the frontal scalp was thicker in individuals with AGA who had high Hamilton scores. The concomitance of AGA and MetS may be associated with a high increase in subcutaneous adipose tissue and less favorable metabolic parameters.

Investigation on the prevalence of thyroid cancer in Graves' patients in northeastern part of Turkey: is surgery a better option for patients with Graves' disease who develop antithyroid drug-related major adverse events?

OBJECTIVE: To determine the prevalence of thyroid cancer in Graves' patients who underwent surgical intervention with and without a history of anti-thyroid drug related major adverse events. PATIENTS AND METHODS: The data of 530 patients with Graves' disease between 2015 and 2020 were retrospectively reviewed. Preoperative ultrasonography reports and thyroid-stimulating hormone receptor antibody values and postoperative histopathological findings were available for 94 patients that had undergone total thyroidectomy procedure. We compared the prevalence of thyroid cancer between patients with and without a history of anti-thyroid drug related major adverse events. RESULTS: Thyroid cancer was detected in 31 of 94 patients that had undergone total thyroidectomy. Of these patients, 18 had at least one nodule; however, thyroid cancer was incidentally detected in 13 patients without nodule. The 31 patients had the following cancer subtypes: 22 had papillary microcarcinoma, 8 papillary carcinoma and 1 noninvasive follicular thyroid neoplasm with papillary-like nuclear features. While thyroid cancer was present in half of the patients operated owing to anti-thyroid drug-related major adverse event, it was detected in 30% of the patients operated due to other reasons. CONCLUSIONS: In the present study, the prevalence of thyroid cancer among patients with Graves' disease was found to be much higher than those of other studies in the literature, suggesting that surgery can be considered primarily for the treatment of Graves' disease. Considering the surgical option in the first plan instead of radioactive iodine therapy appears to be reasonable in patients who develop anti-thyroid drug-related major adverse events.

The relationship of serum asprosin level with diabetic and non-diabetic retinopathy.

OBJECTIVE: This study was aimed at investigating the role of serum asprosin level in diabetic retinopathy pathogenesis and differential diagnosis diabetic and non-diabetic retinopathy. PATIENTS AND METHODS: The cross-sectional study was conducted between May 2021 and August 2021. A total of 21 subjects with diabetic retinopathy, 21 subjects with non-diabetic retinopathy, 21 subjects with type 2 diabetes mellitus (T2DM) without retinopathy and 21 healthy controls were included in the study. Biochemical parameters, serum asprosin, serum IL-6 and TNF-α levels were measured in all participants. RESULTS: Fasting blood glucose (FBG), HbA1c, HOMA-IR and LDL levels were higher in diabetic patients than non-diabetic. The blood asprosin levels were higher in the diabetic retinopathy group compared to the healthy control group (p=0.001), T2DM without diabetic retinopathy (p=0.010), and non-diabetic retinopathy group (p=0.043). There is a significant positive relationship between asprosin level and high FBG, HbA1c and HOMA-IR scores. CONCLUSIONS: Serum asprosin level is significantly increased in DRP group than others. A high asprosin level might be a risk factor for the development of diabetic complications, such as diabetic retinopathy. These findings suggest that the measurement of serum asprosin level may support clinicians in determining the risk of DRP development.

Predictive value of inflammatory and hematological data in diabetic and non-diabetic retinopathy.

OBJECTIVE: The current study aimed at investigating the predictive role of inflammatory, hematological and biochemical parameters in diabetic and non-diabetic retinopathy. MATERIALS AND METHODS: The cross-sectional study was conducted between June 2019 and September 2020. We included patients with diabetic retinopathy (proliferative DR=14, non-proliferative DR=16), patients with non-diabetic retinopathy (n=30), patients with Type 2 Diabetes Mellitus (T2DM) without retinopathy (n=30) and control group (n=30). Demographic, hematological, and biochemical parameters of the participants were examined. RESULTS: Participants' age and duration of diabetes mellitus were higher in proliferative and non-proliferative DR groups than patients with T2DM without retinopathy (p<0.001). There were significantly difference in terms of BMI (p<0.001), HbA1c (p<0.001), glucose (p<0.001), LDL (p<0.001), AST (p=0.001), hemoglobin (p<0.001), urea (p<0.001), creatinine (p<0.001), lymphocyte (p=0.001), and neutrophil (p=0.002) levels between groups. IL-6 levels were higher in proliferative DR, non-proliferative DR, and non-diabetic retinopathy groups than the control group. TNF-α levels were higher in proliferative DR and non-diabetic retinopathy groups than the control group. The NLR and PLR median values were significantly higher in the proliferative DR group than in other groups (p<0.001). CONCLUSIONS: The current study showed that IL-6 and TNF-α levels are elevated in diabetic and non-diabetic retinopathy. In addition, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) median levels are higher in proliferative diabetic retinopathy than other groups. These findings support the inflammatory process may be accelerating the development of retinopathy.

A new perspective on the pleiotropic blood pressure improvement effect of sitagliptin: downregulation of miRNA-155 and miRNA-21.

INTRODUCTION: Deterioration of vascular responses is the crucial event in the initiation of cardiovascular problems in hypertension (HT) and diabetes mellitus (DM). A well-known oral antidiabetic, sitagliptin, has pleiotropic effects besides improving glycemic state in type-2 DM. This study aimed to investigate the therapeutic effect of sitagliptin on blood pressure with previously unassessed parameters of well-known pathophysiological processes and especially at the microRNA (miRNA) level where there are many unknowns. METHODS: N-nitro-L-arginine methyl ester (L-NAME)-induced HT model was performed on nondiabetic male rats. Four groups (including 7 rats in each) were formed: normotensives, sitagliptin-treated, HT and sitagliptin-treated HT. Asymmetric dimethylarginine (ADMA), intercellular adhesion molecule-1 (ICAM-1) and tyrosine hydroxylase (TH), HT related miRNAs were evaluated. In-vitro vessel responses were observed. RESULTS: L-NAME led to a significant increase in blood pressure. Hypertensives exhibited significantly increased contractile responses, consistent with increased ADMA, ICAM-1. Sitagliptin decreased TH levels but not statistically significantly. The new side of the study was the miRNA-21 and miRNA-155 expressions were in line with other parameters in both the HT and sitagliptin-treated HT groups. CONCLUSION: Sitagliptin may control comorbidities, especially HT and introduces new targets to alleviate vascular responses. The new knowledge is; sitagliptin may show these effects through microRNAs (Tab. 2, Fig. 6, Ref. 46).

ASSESSMENT OF SERUM ALARIN LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS.

OBJECTIVE: We aimed to investigate the potential relationship between plasma alarin levels and type 2 diabetes mellitus (T2DM). PATIENTS AND METHOD: We included 154 participants, divided into four groups in a cross-sectional study design. The first group includes patients with T2DM without complications (n=30), the second group patients with T2DM with microvascular complications (T2DM-noC n=32), the third group patients with T2DM with macrovascular complications, T2DM-MV (n=32) and the last group is the healthy control group (n=60). RESULTS: In our study 94 patients were diabetic; 47 females and 47 males. The control group consists of 60 people, 30 women and 30 men. It was found that these had a significant (p>0.05) variation in serum alarin levels among the T2DM (T2DM-noC=3.1±0.7 ng/mL T2DM-mV=2.8±0.4 ng/mL, T2DM-MV= 3.6±0.4 ng/mL) versus control group (15.6±2.6).We failed to find a significant variation of serum alarin levels (p>0.05) between T2DM subgroups. Serum alarin levels were significantly higher among control patients (p<0.05). There was no difference between diabetic sub-groups. CONCLUSION: We concluded that serum alarin levels in patients with T2DM are lower than in normal people. Further studies are needed to investigate the possible prognostic value of alarin in clinical practice in T2DM.

Protective effect of adenosine triphosphate against sunitinib-related skin damage in rats.

Cutaneous side effects associated with sunitinib use are a major problem in patients receiving cancer treatment. The aim of this study was to investigate the protective effect of adenosine triphosphate (ATP) against possible skin damage resulting from sunitinib use in rats. Thirty Albino Winstar rats were divided into the following three groups: healthy controls (HCs, n = 10), sunitinib (SUN, n = 10), and sunitinib + ATP (SAT, n = 10). ATP was injected intraperitoneally at a dose of 2 mg/kg. One hour subsequent to the administration of ATP and 0.9% NaCl, the SAT and SUN groups were orally administered a dose of 25 mg/kg sunitinib to the stomach. Macroscopic evaluation of the skin indicated lower levels of skin damage in the SAT group than in the SUN group. As an indicator of oxidative stress, malondialdehyde (MDA), total oxidant status (TOS), and oxidative stress index (OSI) levels were significantly higher in the SUN group than in the HC group, while total glutathione (tGSH) and total antioxidant status (TAS) levels were significantly lower. However, MDA, TOS, and OSI levels were significantly lower in the SAT group than in the SUN group, while tGSH and TAS levels were significantly higher. Histopathological examination revealed keratin plugs with edema, vasopathology, and inflammatory cell infiltration in the SUN group. The SAT group showed less necrotic epithelium, keratin plugs, edema, and vasopathology than the SUN group. ATP can be effective in preventing skin damage caused by sunitinib use by reducing oxidative stress.

Effect of melatonin on torsion and reperfusion induced pathogenesis of rat uterus.

We investigated the use of melatonin to improve fertility and reduce uterine damage caused by torsion of the uterus in pregnant rats. We used 35 pregnant rats at gestational age 18 days. The animals were randomized into five groups. Group 1 was anesthetized only. Group 2 was subjected to experimental uterine torsion of 360° and the torsion was corrected after 6 h. Group 3 was subjected to uterine torsion of 360°, the torsion was corrected after 6 h and melatonin was administered at the time of correction. Group 4 rats were subjected to 360º uterine torsion and melatonin was administered 6 h later at the time of correction. Group 5 was administered melatonin followed by uterine torsion of 360 degrees followed by correction of torsion 6 h later. Samples were obtained from the uterine horns on the day 1 postpartum. We used Bax, Bcl-2 and caspase 3 staining to measure apoptosis in the uterine tissues. The mRNA levels of Rho-associated, coiled-coil containing protein kinases 1 (ROCK1), homeobox D10 (Hox4 HoxD10), TLR4, NFκB1, caveolin 1 (Cav1) heat shock protein 90 alpha (cytosolic), class B member 1 (Hsp90ab1) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) were determined using quantitative real-time polymerase chain reaction analysis (qRT-PCR). Bax, Bcl-2 and caspase 3 were detected using immunohistochemistry. No difference was observed among groups with respect to abortion, neonatal mortality or congenital abnormalities. Compared to the control group, the mRNA levels of Rock1, Hox4, TLR4, NFκB1, Cav1 and Hsp90 genes were decreased significantly in the study groups; the decrease was greater in groups 3 and 4, which were treated with melatonin. The greatest amount of Bax staining was found in group 1 and the least amount of Bcl-2 staining was found in groups 4 and 5; the greatest amount of caspase 3 staining was found in group 2. Our findings indicate that melatonin reduced uterine torsion related tissue damage and that its application during torsion was more effective than application following removal of torsion.