Evaluation of the effect of chiropractic manipulative treatment on oxidative stress in sacroiliac joint dysfunction.

OBJECTIVES: This study aims to investigate the effect of chiropractic manipulative treatment on sacroiliac joint dysfunction (SIJD) and its relationship to oxidative stress (OXS) parameters. PATIENTS AND METHODS: Thirty-three patients diagnosed with SIJD (20 males, 13 females; mean age 36.3±9.7 years; range, 18 to 60 years) and 30 healthy volunteers (20 males, 10 females; mean age 36.4±12.2 years; range, 20 to 57 years) were included in this cross-sectional, case-control study conducted between February 2017 and September 2017. Manipulation was applied to the patients once a week for a duration of four weeks. The patients were evaluated at pre-treatment and one month after treatment with visual analog scale, SIJD test, and total thiol, native thiol, disulphide, and ischemia-modified albumin (IMA) as OXS indicators. RESULTS: Prior to treatment, we demonstrated that serum native thiol (µmol/L) and total thiol (µmol/L) levels in the patient group were lower compared to control subjects (p=0.03 and p=0.02, respectively). Serum IMA levels were higher in the patient group (p=0.01). There was no change in OXS parameters after manipulative treatment in the patient group. CONCLUSION: Manipulation is useful in SIJD. Thiol/disulphide homeostasis and serum IMA levels may be used to measure the OXS in patients with SIJD.

Changes in the choroidal thickness in reproductive-aged women with iron-deficiency anemia.

BACKGROUND: The aim of this study was to investigate the potential significance of the central macular thickness (foveal thickness-FT) and choroidal thickness (CT) in the eyes of patients with iron-deficiency anemia, the most common form of the anemia, via enhanced-depth imaging optical coherence tomography (EDI-OCT). We also investigated whether such changes might serve as an early indicator of underlying hematological disease. METHODS: This prospective clinical study compared 96 female patients with iron-deficiency anemia and 60 healthy female control subjects. The macular and choroidal thicknesses in the temporal and nasal subfoveal areas were measured using enhanced-depth imaging optical coherence tomography (EDI-OCT) at 500 and 1500 microns and in five different regions (FCT, T1500, T500, N500, and N1500). RESULTS: The mean ages of the patients and healthy controls were 34.08 ± 10.39 years and 32.29 ± 8.28 years, respectively (P =0.232). There were no significant changes in macular thickness between the groups (225.58 ± 19.76 vs. 222.45 ± 13.51, P =0.2). The choroidal thickness was significantly reduced in the patient group relative to the controls at all measured points (foveal choroidal thickness, P = 0.042; nasal-500 microns, P = 0.033; temporal-500 microns, P = 0.033; and temporal-1500 microns, P = 0.019). At some points, the choroidal thickness findings correlated with the hemoglobin values (temporal-500 microns, r = -0.287, P = 0.001; nasal-500 microns, r = -0.287, P = 0.005; nasal-1500 microns, r = -0.245, P = 0.016; and temporal-1500 microns, r = -0.280, P = 0.06). CONCLUSIONS: Patients with iron-deficiency anemia had a significantly reduced choroidal thickness.

The involvement of nitric oxide in the physiopathology of hepatoportal sclerosis.

BACKGROUND AND AIM: Hepatoportal sclerosis (HPS) is a clinical syndrome of unspecified etiology depicted by enlarged spleen and portal hypertension in the lack of other chronic liver disease findings, hematological disorders or any infectious disease in the liver. Nitric oxide (NO) molecule has many important functions in human body including phagocytosis in macrophages, neural transmission and endothelial relaxation. Although there is no data in literature that depicts the role of NO in HPS pathogenesis, this study was conducted in order to evaluate the potential role of NO in patients with HPS. PATIENTS AND METHODS: The study participants included 24 HPS patients and 20 healthy controls. The median age of HPS and control patients was 41.2 ± 13.9 and 46.5 ± 12.4 years, respectively. NO was predicted as nitric oxide metabolites (NOx) by Griess reaction after transformation of nitrate to nitrite by nitrate reductase using the commercially obtainable Nitric Oxide Assay Kit. RESULTS: Serum NOx levels were 2.69 ± 2.98 µmol/L and 0.85 ± 1.05 µmol/L for the HPS patients and controls, respectively. Serum NO levels were significantly higher in patients with HPS compared to the control group (p<0.001). ROC curve analysis suggested that the optimum NOx cut-off point for HPS was 1.305 with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 83.3%, 90 %, 90.9 %, and 81.8% respectively. CONCLUSION: Circulating NO concentration was notably higher in patients with HPS in comparison to the control group. Our study verified that an elevated level of NO might have a role in the pathogenesis of HPS.

Evaluation of serum TWEAK concentration in patients with acute pancreatitis.

BACKGROUND AND AIM: Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is a member of the tumor necrosis factor super family of structurally-related cytokines. The aim of this study was to determine the diagnostic and prognostic role of serum TWEAK concentration in patients with acute pancreatitis. METHODS: Twenty four patients with acute pancreatitis and 24 consecutive healthy age- and sex-matched control subjects were included in the study. The serum concentrations of TWEAK were measured at admission and then at remission. The average time between admission and remission was 7-10 days. RESULTS: At admission, TWEAK concentration was significantly lower in patients with acute pancreatitis compared to control subjects (p < 0.001). Serum TWEAK concentrations were elevated after the remission period, however the differences were not statistically significant. In addition, serum TWEAK concentration showed a significant, inverse correlation with amylase, lipase, CRP, AST, fibrinogen, LDH and a positive correlation with calcium, albumin and platelet count. CONCLUSIONS: Patients with acute pancreatitis have lower serum TWEAK concentration than healthy subjects. These results suggest that serum TWEAK concentration could be a potential biomarker of acute pancreatitis.

[A case of acute pancreatitis due to Weil's disease]. / Weil hastaligina bagli bir akut pankreatit olgusu.

Leptospirosis, the most common vasculitic zoonosis in the world, is characterized with jaundice and acute renal failure. However, pancreatitis is an uncommon complication of leptospirosis. In this report, an acute pancreatitis case due to Weil's disease has been presented. A 31-year-old female patient with high levels of glucose, blood urea nitrogen, creatinine, creatine kinase, bilirubin, amylase and lipase, has been diagnosed to have leptospirosis by the high positive result (1/800) of microscopic agglutination test against Leptospira interrogans serogroup icterohemorrhagiae. The patient has been treated with supportive and symptomatic therapy, and with penicillin G for leptospirosis. Following triple hemodialysis, all the blood biochemistry tests returned to normal on the tenth day of therapy. This case was reported to draw attention to Leptospira infections which should be considered in the differential diagnosis of patients with jaundice and pancreatitis.

[Antibody levels to diphtheria in various community segments]. / Toplumun çesitli kesimlerinde difteriye karsi antikor düzeyleri.

The aim of this study was to detect the immune status of our population against diphtheria. For this purpose, the levels of diphtheria IgG antibodies in various age groups were investigated in 150 subjects aged over 20 years old, by using ELISA method. The positive immunity rate against diphtheria was found 62%, while there was no statistically significant difference between the rates of males (66.7%) and females (57.7%) (p > 0.05). Eighty percent of subjects aged between 20-29 years, 71.4% of 30-39 years, 50% of 40-49 years, 55.6% of 50-59 years, 47.6% of 60-69 years and 60% of 70-79 years old groups were found to have protective levels (over 0.01 IU/ml) of antibodies to diphtheria. There was no significant difference in immunity against diphtheria between these age groups (p > 0.05). However, 76% of subjects aged below 40 years old were immune to diphtheria, while 54% of subjects aged above 40 years old were so, with a statistically significant difference (p < 0.05). There was no significant difference in the rate of immunity between subjects in terms of occupation, levels of education, geographic location and vaccination status (p > 0.05).

[Case report: brucellosis complicated by epididymo-orchitis and paravertebral abscess]. / Olgu raporu: epididimo-orsit ve paravertebral abseli brusellozis.

Brucellosis which is a zoonotic infection involving many systems, is widespread in Turkey. Although muscular and skeletal system involvements are common, genitourinary system complications (epididymo-orchitis) are observed rarely. Brucellosis accompanied by abscess formation in the vertebra is generally seen in the elderly and patients with chronic diseases, while epididymo-orchitis in young patients. However, it is very unusual to detect these two complications together. In this report, a case of 42 years old male patient with epididymo-orchitis and paravertebral abscess due to brucellosis, has been presented.

The effect of ursodeoxycholic acid treatment on epidermal growth factor in patients with bile reflux gastritis.

BACKGROUND/AIMS: Study was performed to evaluate the effect of ursodeoxychlic acid treatment on epidermal growth factor, which is secreted in response to mucosal injury and is also a factor in the protection and healing of gastric mucosal injury in patients with bile reflux gastritis following cholecystectomy. METHODS: Thirty-one dyspeptic patients who had previously undergone cholecystectomy were included in the study. Upper gastrointestinal endoscopy was performed before and after a six week ursodeoxychlic acid treatment period and a biopsy was taken. Endoscopic biopsy materials were stained with epidermal growth factor (Zymed, supersensitive) immunohistochemical monoclonal kit. RESULTS: The results of endoscopic examination prior to treatment were as follows: 24 cases (77%) had reflux gastritis, five cases (16%) antral gastritis, two cases (6.5%) diffuse gastritis and all cases had enterogastric reflux. In all but one case, epidermal growth factor was found to be positive at varning degrees. After ursodeoxychlic acid treatment, complete healing was observed at endoscopy in nine cases (29%) and partial healing at varning degrees was observed in all others. The degree of positivity of epidermal growth factor reduced significantly (p<0.001). CONCLUSIONS: A decrease in the degree of epidermal growth factor positivity was observed following ursodeoxychlic acid treatment. This can be explained by the decrease in epidermal growth factor release due to healing of mucosal injury following treatment. Further investigations are needed to clarify whether ursodeoxychlic acid has a direct effect on epidermal growth factor.

[Case report: a brain hydatid cyst]. / Olgu raporu: beyinde kist hidatik olgusu.

Hydatid cyst is a zoonotic infection caused by larval stage of Echinococcosis granulosus. Although any organ may be involved, bone, brain and heart involvements are uncommon. The brain involvement rate varies from 1% to 3% in hydatid disease. In this report, a 42 years old female patient has been presented in whom brain hydatic cyst was diagnosed by radiological and histopathological findings.