Protective role of nebivolol via AKT1/Hif-1α/eNOS signaling pathway: nephrotoxicity caused by methotrexate in a rat model.

Methotrexate (MTX) is an antineoplastic and anti-inflammatory agent, which is used in severe diseases. Its use should be limited due to side effects such as nephrotoxicity, myelotoxicity, and hepatotoxicity. Nebivolol (NBV), which is a beta-blocker used in the treatment of hypertension, also contributes to vasodilation in tissues by activating the endothelial nitric oxide synthase (eNOS) enzyme. The purpose of this study is to research the effect of NBV on MTX-induced nephrotoxicity through the AKT1/hypoxia-inducible factor 1-alpha (Hif-1α)/eNOS signaling pathway. The rats were randomly divided into three groups of eight each. The groups were control, MTX, and MTX + NBV. A single dose of 20 mg/kg MTX was given intraperitoneally to the rats on the first day of the study and 10 mg/kg NBV was given orally to the treatment group for 7 days. At the end of the study, rats' blood and kidney tissues were taken for histopathological, immunohistochemical, and biochemical examinations. MTX administration significantly decreased the expression levels of AKT1, eNOS, and Hif-1α compared with the control group (p < 0.001 for all), and NBV treatment increased these values compared with the MTX group (p < 0.001 for all). In conclusion, NBV treatment ameliorated the MTX-induced nephrotoxicity via AKT1/Hif-1α/eNOS signaling pathway.

TRPV2 POLYMORPHISMS INCREASE OR REDUCE THE RISK OF TYPE 2 DIABETES - HASHIMOTO THYROIDITIS COMORBIDITY.

CONTEXT: Thyroid disorders are common in diabetics and related to severe diabetic complications. TRPV2 ion channels have crucial functions in insulin secretion and glucose metabolism which have an important role in the pathophysiology of diabetes. Also, they have a significant effect on various immunological events that are involved in the HT pathophysiology. OBJECTIVE: This study aimed to investigate rs14039 and rs4792742 polymorphisms of the TRPV2 ion channels in type 2 diabetes mellitus (T2DM, n=100) Hashimoto thyroiditis (HT, n=70) and comorbid T2DM and HT (T2DM+HT, n=100) patients and control (n=100). DESIGN: Case-control study. SUBJECT AND METHODS: RT-PCR genotyping was used to determine rs14039 and rs4792742 polymorphisms with DNA samples of subjects and appropriate primer and probes. Besides, required biochemical analyses were performed. RESULTS: It was determined that the frequencies of the rs14039 GG homozygote polymorphic genotype and the G allele were significantly higher in T2DM+HT patients compared to the control (p=0.03 and p=0.01, respectively) and that especially the GG genotype increases the risk of T2DM+HT 3.046-fold (p=0.01, OR=3.046). It was detected that the GG genotype increased the risk of HT 2.54-fold (p=0.05, OR=2.541). TRPV2 rs4792742 polymorphisms reduce the risk of HT and T2DM+HT comorbidity almost by half and have a protective effect against HT and T2DM+HT. CONCLUSION: The rs14039 GG genotype of the TRPV2 gene significantly increases the risks of development of T2DM+HT and HT disorders, may have a significant role in the pathophysiology of these diseases, also leading to predisposition for their development. Conversely, rs4792742 polymorphic genotypes have a strong protective effect against the HT and T2DM+HT comorbidity.

Effects of recurrent sevoflurane anesthesia on cognitive functions with streptozotocin induced Alzheimer disease.

OBJECTIVE: We aimed to investigate the effects of recurrent sevoflurane anesthesia on cognitive functions in Alzheimer Disease. MATERIALS AND METHODS: Rats were divided into 4 groups as followed: control (Group C), sevoflurane (Group S), Alzheimer's (Group A) and Alzheimer's + sevoflurane (Group AS)]. Cognitive functions were evaluated with Radial Arm Maze Test (RAMT). Alzheimer model was created by administering 3 mg/kg (10 µl) STZ. Sevoflurane was administered to S and AS groups. Serum samples and hippocampus tissues were analyzed. RESULTS: In RAM test, the entry-exit data were significantly decreased in A and AS groups. After the 2nd and 3rd administration of anesthesia, the numbers were significantly decreased in Group S. Glial-fibrillary-acidic protein levels were significantly higher in AS compared to the C and S groups. The brain tissue caspase 3 activity was less than 1% in all rats in the Group C, 3 % in 2 rats and 1 % in 1 rat in the Group AS. In A and AS group, serum catalase, myeloperoxidase and ferroxidase activities were found to be higher than in the other groups and myeloperoxidase activity was higher in the AS than in the A Group. Serum native thiol, total thiol and disulfide levels were found to be significantly different in the A and AS groups. CONCLUSION: Sevoflurane anesthesia negatively affected the cognitive functions (Tab. 5, Fig. 10, Ref. 51).

Clinicopathological features of thyroid cancer in the elderly compared to younger counterparts: single-center experience.

PURPOSE: The incidence of thyroid cancer is increased in elderly patients. It tends to be larger and have more aggressive characteristics in these patients. Our aim was to compare features of thyroid carcinoma in geriatric and non-geriatric patients. METHODS: In total, 933 patients with thyroid cancer were retrospectively reviewed. Thyroid functions, ultrasonography features of malignant nodules, cytological and histopathological findings and the rates of recurrence and persistence were compared in patients ≥65 and <65 years old. RESULTS: There were 153 malignant foci in 109 (11.7%) patients ≥65 and 1185 malignant foci in 824 (88.3%) patients <65 years old. Mean nodule diameter was significantly higher in geriatric patients (p = 0.008). Most of the ultrasonographical features of malignant nodules were similar in two groups. Hypoechoic halo was observed in 16.4 and 28.6% of malignant nodules in geriatric and non-geriatric group, respectively (p = 0.034). There was no significant difference in cytological diagnosis. Histopathologically, tumor diameter, rates of microcarcinomas and incidentality were similar. Of all cancer types, 88.8% in geriatric and 93.9% in non-geriatric group were papillary thyroid cancer (p = 0.028). Hurthle cell cancer constituted 3.9 and 1.1% of carcinomas in geriatric and non-geriatric patients, respectively (p = 0.015); 2.0 and 0.2% of tumors in geriatric and non-geriatric group were anaplastic, respectively (p = 0.012). Capsular and vascular invasion, extrathyroidal extension, persistence and recurrence rates were similar. CONCLUSIONS: Rates of anaplastic cancer and Hurthle cell cancer which is known to have worser prognosis among other differentiated thyroid cancers are increased in geriatric ages. Cytological evaluation of thyroid nodules should strongly be considered due to increased tendency for aggressive tumor types in these patients.

Effect of different doses of pregabalin on skeletal muscle ischaemia-reperfusion injury in rats.

AIM/INTRODUCTION: Analgesic, anti-inflammatory and anti-apoptotic effects of pregabalin have been shown previously. In this study, we investigated the protective effect of different doses of pregabalin on skeletal muscle IR injury in rats. MATERIALS AND METHODS: 24 rats were randomly divided into 4 groups (Control, Ischaemia-Reperfusion (IR), IR-Pregabalin 50 mg, IR-Pregabalin 200 mg). Following IR, serum Ischemia Modified Albumin (IMA) and tissue Paraoxonase (PON) were studied and gastrocnemius muscle tissue was removed for histopathologic examination. RESULTS: Interstitial inflammation was higher in the IR group than in the control and Pregabalin 200 mg groups (p = 0.037, p = 0.037, respectively). Congestion was higher in the IR group than in the control, Pregabalin 50 and 200 mg groups (p = 0.001, p = 0.004, p = 0.004, respectively). PON was lower in the IR group than in the Control, Pregabalin 50 and 200 mg groups (p = 0.001, p = 0.007, p = 0.015, respectively). IMA was higher in the IR group than in the Control, Pregabalin 50 and 200 mg groups (p < 0.0001, all). CONCLUSION: We think that administration of pregabalin, more prominent at 200 mg, can reverse the injury that occurs in the skeletal muscle of IR-induced rats. Pregabalin can be safely used for analgesia in cases of IR (Tab. 2, Fig. 9, Ref. 41).

Percutaneous Nephrolithotomy in Children: 17 Years of Experience.

PURPOSE: We analyzed factors that might affect outcome in terms of success and incidence of complications in children up to 17 years after undergoing percutaneous nephrolithotomy. MATERIALS AND METHODS: The data of 346 renal units (294 patients) were analyzed in terms of postoperative outcome. Factors investigated that might affect outcome were patient gender, age, stone laterality, largest stone size, stone burden, number of stones, location of a single stone, previous intervention and instrument size. RESULTS: Mean ± SD patient age was 8.51 ± 4.91 years, and male-to-female ratio was 209:137. Mean ± SD stone burden was 3.49 ± 3.3 cm(2). Stone-free rates after a single procedure were 84.4% and 73.1% in patients with and without clinically insignificant residual stones, respectively. On univariate and multivariate analyses stone burden and number of stones affected the stone-free rate. Complications consisted of bleeding in 41 patients (11.8%), postoperative urinary tract infection in 21 (6%), urosepsis in 4 (0.1%) and hydrothorax in 4 (0.1%). One patient died of multiple organ failure. Through the years blood transfusion and complication rates decreased, and the use of smaller instruments increased significantly. Although bleeding occurred less often in cases where a 14Fr sheath was used rather than a larger sheath (5% vs 12%, p = 0.142), the difference was not significant. No significant factor affecting complication rates was detected. CONCLUSIONS: As in adults, percutaneous nephrolithotomy can be used in children with acceptable complication rates and good success rates for surgical treatment of complex renal stones. Number of stones and stone burden are predictive of postoperative stone-free rate.

Modelling acoustic scattering, sound speed, and attenuation in gassy soft marine sediments.

A model for nonlinear gas bubble pulsation in marine sediments is presented. This model is then linearized to determine the resonance frequency and the damping terms for linear radial oscillations. The linear model is then used to predict the effects that such bubble pulsations will have on the sound speed and attenuation of acoustic waves propagating in gassy marine sediment. The results are compared for monodisperse populations against the predictions of a model of Anderson and Hampton and, furthermore, the additional abilities of the model introduced in this paper are discussed. These features include the removal of the sign ambiguities in the expressions, the straightforward implementation for acoustic propagation through polydisperse bubble populations, the capability to estimate bubble size distributions through a full acoustic inversion, and the capability to predict nonlinear effects.

The thioredoxin reductase activity and hypoxia-inducible factor 1 alpha level in anaerobic and aerobic macrophages.

OBJECTIVES: This study was aimed to demonstrate the thioredoxin reductase (TrxR) activities and Hypoxia-Inducible Factor 1 alpha (HIF-1α) levels in macrophage cell line incubated in aerobic and anaerobic settings. BACKGROUND: Pathological situations including inflammatory disorders are associated with the infiltration of phagocyte system cells into damaged tissues. Whenever the environment of tissues converts into hypoxic conditions, phagocytic cells develop an adaptive mechanism in order to fulfill their defense functions. MATERIALS AND METHODS: The macrophage cells were prepared as two replications both for aerobic and anaerobic media. The E. coli bacteria were inoculated onto the some macrophage culture mediums. TrxR and HIF-1α levels of the samples, obtained from all growth cultures, were measured with the ELISA. RESULTS: On the 5th and 6th day, there was a continuous increase in the count of bacteria in the aerobic medium, while a continuous decrease in the count of bacteria in the anaerobic medium.The TrxRand the HIF-1α levels in the groups with anaerobic and aerobic macrophages with or without E. coli bacteria were evaluated. A statistically significant difference was found between these groups in terms of TrxR and HIF-1α levels (p < 0.05). CONCLUSIONS: Increased TrxR and HIF-1α levels were thought to have an effect on the adaptation of the macrophages in the anaerobic environment (Tab. 5, Fig. 2, Ref. 23).

Quality and extent of informed consent for invasive procedures: a pilot study at the institutional level in Turkey.

OBJECTIVE: To assess the quality of informed consent for patients undergoing invasive procedures and to reveal patient preferences for being informed about the potential risks of treatment and alternatives to treatment. DESIGN: This study was planned as a pilot study. Hospitalized patients' perceptions and expectations about the informed-consent process were explored in a general surgery department. The prepared questionnaire was completed by patients via interview. SETTING: Inpatient services of the general surgery department of a large academic hospital in Istanbul, Turkey. PARTICIPANTS: The study population consisted of hospitalized patients in a general surgery department who underwent invasive procedures in March 2013. MAIN OUTCOME MEASURES: Recognition of consent forms by the patients, rate of patients' recall of risks, rate of patients who were willing to be involved in decision making, and rate of patients who were satisfied with the whole decision-making process were measured. RESULTS: All patients signed consent forms. Most patients did not properly read the consent form since they trusted their physician. Potential exposure to risk seemed to be important for patient expectations. CONCLUSIONS: Paternalism seemed to dominate our clinical setting. The informed-consent process was definitely a separate issue from signing the consent forms. We conclude that the informed-consent process should be modified to be more functional and appropriate to human psychology. We suggest that education is necessary for informed consent to promote better quality and safety in health care.

Hesperidin protects testicular and spermatological damages induced by cisplatin in rats.

The clinic usage of cisplatin, an anticancer drug, is limited due to it has many side effects in many systems and organs. In this context, it was aimed to investigate the protective effect of hesperidin, a citrus flavonoid, on testicular and spermatological damages induced by cisplatin in rats. The rats were randomly divided into four groups. The first group was kept as a control. In the second groups, cisplatin was given at the single dose of 7 mg kg(-1) intraperitoneally. In the third group, hesperidin was orally administered at the dose of 50 mg/kg day(-1) for 14 days. In the fourth group, cisplatin and hesperidin were given together at the same doses. Cisplatin treatment caused significant reductions enzymatic (SOD, CAT and GPx) and nonenzymatic (GSH) antioxidants and significant induction level of TBARS. In addition, cisplatin treatment caused decreased sperm motility, epididymal sperm concentration, increased abnormal sperm rate and histopathological damage. In contrast, hesperidin treatment significantly attenuated the harmful effects. In conclusion, this study clearly demonstrated that hesperidin has protective effects on cisplatin-induced reproductive system toxicity depending on its antioxidant properties. Thus, it is thought that hesperidin may be useful against cisplatin toxicity in patients with cancer in terms of reproductive system.

Human papillomavirus effect on the development of endometrial polyps.

AIM: Although the association of human papillomavirus (HPV) with warts arising in different parts of the human body has been well-demonstrated, the association of HPV with endometrial polyps has never been studied in the literature up to now. MATERIALS AND METHODS: Detection of the HPV DNA was carried out by using 13 high-risk HPV real-time PCR Kit and five low-risk HPV real-time PCR Kit. RESULTS: Among 50 endometrial polyp samples, one endometrial polyp sample revealed a positive result for the presence of HPV type 18. CONCLUSIONS: This first study in the medical literature investigating the possible effect of HPV on the development of endometrial polyps has demonstrated that HPV might have a role in the development of some of the endometrial polyps. If the present authors' hypothesis that endometrial polyps caused by carcinogenic HPV types are prone to proceed to endometrial cancer if left untreated is correct, HPV vaccine has a potential to prevent development of at least some of the endometrial polyps and endometrial cancers.

Successful treatment of non-healing pressure ulcers with topical n-acetyl cysteine.

OBJECTIVE: N-acetyl cysteine (NAC) is a thiol compound with antioxidant and vasodilatory properties. It has multiple potential uses-including as an aid to wound healing-supported by varying levels of evidence. Pressure ulcers (PUs) are a major problem affecting older and bed-bound patients, and are associated with significant morbidity, mortality, and health-care costs. We aimed to study whether topical NAC treatment may be useful in non-healing PUs in a prospective case study in two debilitated nursing home residents suffering from a total of three treatment-resistant PUs. METHOD: PUs were staged as described by the National Pressure Ulcer Advisory Panel. The ulcers were measured at the beginning and weekly thereafter with a standard wound measuring paper ruler. RESULTS: The first patient had a category 3 pressure ulcer and the second patient had one category 3 and one category 4 ulcer. Topical NAC vial administration significantly improved healing in all three PUs without any side effects. CONCLUSION: Our data indicate that NAC may be used in treatment-resistant PUs successfully.

The association between inherited thrombophilia and recurrent pregnancy loss in Turkish women.

OBJECTIVE: To investigate the relation between recurrent pregnancy loss (RPL) and factor V Leiden, prothrombin G20210A, and C677T methylenetetrahydrofolate reductase (MTHFR) mutations. MATERIALS AND METHODS: A case-control study was conducted on 95 consecutive cases with RPL, and 40 age-matched controls who had no history of pregnancy loss and had at least one successful pregnancy. After application of exclusion criteria, 60 patients in the study group and 40 control cases were compared for thrombophilic factors. RESULTS: Thirteen out of 60 RPL cases and one out of 40 in the control group were carriers of factor V Leiden mutation. While six patients were carriers of prothrombin G20210A gene mutation, none in the control group carried this mutation. Twenty-nine out of 60 RPL cases and 17 out of 40 control cases had MTHFR mutation. CONCLUSION: The authors found a positive correlation between RPL and FVL and FII gene mutations, but no significant association between RPL and MTHFR gene mutation.

Ureteritis cystica: A rare entity in children.

Ureteritis cystica (UC) is a benign condition. Although it can often be diagnosed with imaging techniques, we report a case of a child for whom we planned nephrectomy and ureteral augmentation cystoplasty, but abandoned the cystoplasty due to extensive UC in the ureter.

Arterial blood gas analysis predicts futile recanalization in mechanical thrombectomy-treated acute ischemic stroke patients: a multicenter study.

OBJECTIVE: It is known that providing recanalization alone in large vessel occlusions is not sufficient to provide a good 90-day clinical outcome. It is advocated that neuroprotection should be increased before endovascular treatment and that the penumbra should be protected from reperfusion damage after recanalization. However, the effects of blood gas parameters before and after mechanical thrombectomy on clinical outcomes are not clear. The objective of this study is to assess the effectiveness of serial blood gas measures in accurately predicting futile recanalization at an early stage. PATIENTS AND METHODS: This study is a multicenter inquiry that collected data in a prospective manner and analyzed it retrospectively. Patients with a 2b-3 thrombolysis in cerebral infarction (TICI) score after mechanical thrombectomy for recanalization were consecutively analyzed from July 2022 to March 2023. Arterial blood gas parameters, including pH, oxygen saturation (SaO2), partial carbon dioxide pressure (PaCO2), partial oxygen pressure (PaO2), lactate, and bicarbonate (HCO3), were measured at four time points: before mechanical thrombectomy treatment (preoperative), immediately after recanalization (postoperative 1st), during the 3rd hour (postoperative 3rd), and at the 5th hour (postoperative 5th). The patients were categorized into groups based on their modified Rankin Scale (mRS) scores. RESULTS: The study included 136 patients with an average age of 69.71±11.22. The postoperative 1st-hour SaO2 values were lower in the mRS 3-6 group (p=0.038). The postoperative pH and lactate mean were greater in the mRS 3-6 group than in the 0-2 group (p=0.038 and 0.018, respectively). In logistic regression, a unit rise in lactate increased poor functional outcomes 1,632 times (p=0.024). Early neurological recovery was associated with decreased postoperative 3rd-hour lactate (p=0.014). The mean postoperative PaO2 (average of 1, 2, 3 PaO2) was higher in those with symptomatic cerebral bleeding (p=0.044). CONCLUSIONS: Monitoring lactate and pH levels in AIS patients who have had mechanical recanalization can be utilized to predict mortality and morbidity, especially in the first five hours after the procedure. Graphical Abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-abstract-8.jpg.

Urinary trehalase activitiy in contrast-associated acute kidney injury.

OBJECTIVE: Contrast-associated acute kidney injury (CA-AKI) is the third most common cause of hospital-acquired AKI. Sensitive biomarkers can detect kidney injury early on because kidney damage begins immediately after the administration of a contrast medium. Due to its proximal tubule specificity, urinary trehalase can be a useful and early marker for detecting tubular damage. This study aimed to reveal the power of urinary trehalase activity in diagnosing CA-AKI. PATIENTS AND METHODS: This is a prospective, observational, and diagnostic validity study. The study was performed in an academic research hospital's emergency department. Patients aged 18 years and over who underwent contrast-enhanced computed tomography in the emergency department were included in the study. Urinary trehalase activities were measured before and 12, 24, and 48 hours after the administration of a contrast medium. The primary outcome was the occurrence of CA-AKI, while the secondary outcomes were risk factors for CA-AKI, duration of hospital stay after contrast use, and the mortality rate in the hospital. RESULTS: A statistically significant difference between the CA-AKI group and the non-AKI group was found in the activities measured 12 hours after the administration of the contrast medium. Notably, the mean age of the patient group with CA-AKI was considerably higher than that of the non-AKI group. The risk of mortality was found to be remarkably more elevated in patients with CA-AKI. Further, there was a positive correlation between trehalase activity and HbA1c. In addition, a crucial correlation was found between trehalase activity and poor glycemic control. CONCLUSIONS: Urinary trehalase activity can be useful as a marker of acute kidney injuries due to proximal tubule damage. In the diagnosis of CA-AKI, especially the activity of trehalase in the 12th hour might be useful.

Evaluating MEFV mutation frequency in Turkish familial Mediterranean fever suspected patients and gender correlation: a retrospective study.

Familial Mediterranean fever (FMF) is the most frequent hereditary inflammatory disease. FMF causes different clinical manifestations in different ethnic groups and countries. In this study, we retrospectively reviewed the records of 1,152 FMF suspected patients (673 female and 479 male) from November 2006 to December 2010. A commercial kit assay for the identification of MEFV (Mediterranean fever) gene mutations based on PCR and reverse-hybridization was used to investigate 12 mutations of the MEFV gene. 52.17% of 1,152 FMF suspected patients had MEFV mutation and 45.25% of them were male. The rate of MEFV mutation among male and female patients were 56.78 and 48.88%, respectively. These results were statistically significant and might support the suggestion that FMF had much more penetrance in male patients (P = 0.009). Not any significant difference was observed between the male and female patients in terms of heterozygote and homozygote mutation carriage rate (P = 0.071). Also not any significant difference was observed between the male and female patients in terms of compound heterozygote mutation carriage rate (P = 0.058).

Feminizing Adrenocortical Tumors as a Rare Etiology of Isosexual/Contrasexual Pseudopuberty

Objective: Estrogen-secreting adrenocortical tumors (ACTs) are quite rare with feminizing adrenocortical tumors (FATs) accounting for 0.37-2% of all ACTs. The aim was to evaluate clinical and hormonal characteristics of FATS as well as treatment options and follow-up in the pediatric age group. Methods: Medical records of children with ACTs presenting to a single center in the last two decades were reviewed. Literature review within Pubmed revealed 34 pediatric patients (22 boys) with FAT among 192 articles. Results: Among the 25 children presenting with ACTs in the last two decades, two new pediatric cases of FAT were identified, one benign and the other malignant, in two genders with different clinical presentations. Literature review showed that FATs are extremely rare tumors that are most commonly seen in men and boys presenting with gynecomastia. FATs are more common in children ≤8 years of age, with a median age at diagnosis of six years. While boys present with contrasexual pseudopuberty signs, girls present with isosexual pseudopuberty. A high estrogen level strongly supports diagnosis, while elevations in other adrenal hormones may be seen. FATs are usually malignant in adults and prognosis is generally very poor. However, in children approximately half are benign although assessment of malignant potential depends on clinical behavior of the tumor. FATs are very unpredictable so even after surgery long-term follow-up is required. FATs presenting in childhood may have a better prognosis than adult presentation tumors as most FATs in children are followed without recurrence of tumor. Conclusion: FATs are more common in children ≤8 years of age, with a median age at diagnosis of six years. FATs in childhood may have a better prognosis than in adult males.

Success of Simpler Modified Fried Frailty Scale to Predict Mortality among Nursing Home Residents.

OBJECTIVE: Fried frailty scale is the very first and most commonly used assessment scale for an operational definition of frailty with its demonstrated success as a predictor of mobility limitations and mortality. However, it is impractical for use in routine clinical practice. We aimed to study whether a simpler modified Fried frailty scale could predict mortality among nursing home residents. DESIGN: Retrospective longitudinal follow-up study. SETTING: Nursing home. Baseline evaluation was performed in 2009. Mortality was assessed after 4 year. PARTICIPANTS: Two hundred-twenty-four participants were included. MEASUREMENTS: Residents were assessed for demographic characteristics, falls, dementia, the number of regular medications and chronic diseases, body composition by bioimpedance analysis, basic and instrumental activities of daily living besides frailty status by a modified Fried frailty scale. The residents were assessed for mortality after a median follow-up time of 46 months. The association of frailty with mortality was analyzed by the Kaplan-Meier Log-rank test and multivariate Cox Regression analysis. RESULTS: Mortality occurred in 90 (40.2%) of the residents. In multivariate analysis, frailty was an independent predictor of death (Hazzard ratio= 1.4, 95% confidence interval= 1.03-2.6, p=0.03) when adjusted by age, sex, presence of malnutrition, low muscle mass, number of chronic diseases and regular medications. CONCLUSION: Our results suggest that the simpler modified Fried frailty scale can be used as a screening tool for frailty in everyday practice as a tool to identify risky patients for mortality. Future reports studying its role in predicting other adverse outcomes associated with frailty are needed.

Determination of levels of oxidative stress and nitrosative stress in patients with epilepsy.

BACKGROUND: Epilepsy is one of the most common neurological diseases. The underlying pathophysiological mechanisms in epilepsy are still unknown. Oxidative stress is believed to be one of the factors involved in the pathogenesis of epileptogenesis. In various pathophysiological conditions, reactive nitrogen species (RNS) such as nitrogen and peroxynitrite are produced and these RNSs can bind to free nucleosides and nucleotides or to nucleosides and nucleotides existing in the DNA/RNA structure. 8-Nitroguanine (8-NG) is a typical DNA nucleobase product of nitrosative damage generated by RNS. It has been proposed that F2-isoprostanes, in particular 8-iso-Prostaglandin F2α (8-isoPGF2α), are specific, reliable and non-invasive biomarkers of lipid peroxidation in vivo. In the present study, we compared the levels of lipid oxidative stress biomarker 8-isoPGF2α and nitrosative stress DNA biomarker 8-NG in patients with epilepsy undergoing antiepileptic drug (AEDs) treatment and with those in healthy participants. METHODS: The present study comprised 90 patients aged between 17 and 53 who were admitted to the Neurology Clinic of Cumhuriyet University and diagnosed with epilepsy. The patients were assigned into the intervention (n = 45) and control (n = 45) groups. Of the participants in the intervention group, 37.7% (n = 17) were treated with levetiracetam (LEV), 33.3% (n = 15) with valproic acid (VA) and 29% (n = 13) with carbamazepine. Serum 8-iso-PGF2α and 8-NG levels of the participants in the intervention and control groups were determined by ELISA. RESULTS: There was no significant difference between the medication (LEV, VA, Carbamazepine) used by the participants and their 8-iso-PGF2α and 8-NG levels (p > 0.05). However, 8-iso-PGF2α and 8-NG were significantly higher in the participants in the intervention than in the participants in the control group (p < 0.001). CONCLUSION: Our study demonstrated that there was an increase in oxidative and nitrosative stres markers in patients with epilepsy. There was no significant difference between the 8-iso-PGF2α and 8-NG levels of the participants taking three different AEDs.