Do We Care Enough About the Presence of Sexual Problems in Diabetic Patients?

Purpose: Sexual health is not only the absence of sexual dysfunction or disability, but also the presence of physical, emotional, mental, and social well-being related to sexuality. The current study aims to determine whether all adult patients who have applied for their regular health check-ups due to diabetes mellitus had ever voluntarily expressed their sexual problems to a specialist and whether they were asked about the presence of sexual dysfunction. It also aims to determine how the physicians attach importance to the issue. Patients and Methods: All patients aged 18-65 years with type 1 and type 2 diabetes mellitus, who applied to our hospital between the years of January 2021 and 2022, were questioned by filling out a questionnaire for the presence of sexual problems in addition to screening for chronic complications of diabetes mellitus (retinopathy, nephropathy, and neuropathy) and routine history and physical examination. Results: The association between the presence of sexual problems and whether patients were questioned about the relevant issue in their previous controls and gender and age factors, educational background, presence of comorbidities, duration of marriage, and microvascular complications of diabetes mellitus were examined. In a population of 595 patients, 53.78% of the patients stated that they had sexual problems; however, 9.91% had been questioned about this issue by the physician. It was observed that 6.3% of female and 15.3% of male patients had previously consulted a doctor voluntarily due to their sexual problems. Conclusion: This study presents empirical findings that shed light on the inadequacies in healthcare providers' approach to addressing sexual health concerns among individuals diagnosed with diabetes, as well as the shortcomings in patients' effective communication of these concerns.

The Investigation of Radiographic Findings of Mandibles on Panoramic Radiographs of Patients with Primary Hyperparathyroidism Using Fractal Analysis.

OBJECTIVE: The basis of the research is the application of fractal analysis (FA) to panoramic radiographs of patients with primary hyperparathyroidism (PHPT). In addition, the relationship between the relevant biochemistry parameters and fractal values of healthy controls and patients with PHPT will be evaluated. MATERIALS AND METHODS: In the current study, FA was performed with ImageJ program on panoramic radiographs of 48 patients diagnosed with PHPT. Fractal dimension (FD) values of the patients and 48 healthy subjects were compared. In addition, biochemical [parathyroid hormone (PTH), serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and vitamin D] parameters and FD values of both groups were analyzed with Mann-Whitney U-tests and Pearson correlation coefficient (P < .05). RESULTS: FD values of four different angular areas were significantly lower in the patient group than in the healthy group (P < .05). There was no statistically significant difference between the patient and control groups in the measurements between the apexes of the right and left premolar and molar teeth. The mean PTH, Ca, P, and vitamin D values of the patients with PHPT and control group were highly significant, and all the parameters of the patient group showed higher values than the control group except for the P values (P < .001). In the patient group and control group, there was no significant difference between mean ALP values (P = .48). No correlation was found between the two groups. CONCLUSION: Bone biopsy is the gold standard method for the diagnosis of bone structure changes in patients with PHPT. However, it is not used routinely because it is an invasive method. The FA method applied to panoramic radiographs may be used as a noninvasive, easy-to-apply method to reveal the changes in the trabecular structure of the jaw bones of the patients.

Low prevalence of obesity in Behçet's disease is associated with high obestatin level.

OBJECTIVE: Chronic inflammatory diseases are associated with altered body composition. Ghrelin has anti-inflammatory effects, and its level is altered in obesity and inflammatory diseases. The aim of the study was to evaluate the prevalence of obesity and ghrelin and obestatin levels in patients with Behçet's disease (BD). MATERIAL AND METHODS: One hundred and forty-three (143) patients with BD and 112 healthy controls (HC) were enrolled. Participants were subdivided according to the body mass index (BMI) as lean (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (≥30 kg/m2). In addition to the routine evaluations (fasting blood glucose, lipid profile, and kidney and liver function tests), serum acylated-ghrelin (AG), unacylated-ghrelin (UAG), total ghrelin (TG) and obestatin levels were analyzed. Student's t-test and chi-square test were used for statistical analysis. RESULTS: The prevalence of obesity was relatively lower in the BD group than in the HC group (12.6% vs. 20.5%, p=0.089). Serum ghrelin levels were similar in the BD and HC groups (p>0.05 for all) although the obestatin level was higher in the BD group compared to the HC group (p<0.001). Serum UAG, TG and obestatin levels were lower in obese BD patients (n=18) than non-obese BD patients (p=0.027, p=0.014 and p=0.001, respectively). CONCLUSION: The obestatin level was high and the prevalence of obesity was low in the BD group. Moreover, obese BD patients had low obestatin levels. These results suggest that obestatin may protect BD patients from obesity.

Role of ultrasonographic chronic kidney disease score in the assessment of chronic kidney disease.

PURPOSE: Ultrasonography (US) is an inexpensive, noninvasive and easy imaging procedure to comment on the kidney disease. Data are limited about the relation between estimated glomerular filtration rate (e-GFR) and all 3 renal US parameters, including kidney length, parenchymal thickness and parenchymal echogenicity, in chronic kidney disease (CKD). In this study, we aimed to investigate the association between e-GFR and ultrasonographic CKD score calculated via these ultrasonographic parameters. METHODS: One hundred and twenty patients with stage 1-5 CKD were enrolled in this study. The glomerular filtration rate was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. US was performed by the same radiologist who was blinded to patients' histories and laboratory results. US parameters including kidney length, parenchymal thickness and parenchymal echogenicity were obtained from both kidneys. All 3 parameters were scored for each kidney, separately. The sum of the average scores of these parameters was used to calculate ultrasonographic CKD score. RESULTS: The mean age of patients was 63.34 ± 14.19 years. Mean kidney length, parenchymal thickness, ultrasonographic CKD score and median parenchymal echogenicity were found as 96.2 ± 12.3, 10.97 ± 2.59 mm, 6.28 ± 2.52 and 1.0 (0-3.5), respectively. e-GFR was positively correlated with kidney length (r = 0.343, p < 0.001), parenchymal thickness (r = 0.37, p < 0.001) and negatively correlated with CKD score (r = -0.587, p < 0.001) and parenchymal echogenicity (r = -0.683, p < 0.001). Receiver operating characteristic curve analysis for distinction of e-GFR lower than 60 mL/min showed that the ultrasonographic CKD score higher than 4.75 was the best parameter with the sensitivity of 81% and positive predictivity of 92% (AUC, 0.829; 95% CI, 0.74-0.92; p < 0.001). CONCLUSION: We found correlation between e-GFR and ultrasonographic CKD score via using all ultrasonographic parameters. Also, our study showed that ultrasonographic CKD score can be useful for distinction of CKD stage 3-5 from stage 1 and 2. We suggested that the ultrasonographic CKD score provided more objective data in the assessment of CKD.

Platelet-to-lymphocyte ratio predicts mortality better than neutrophil-to-lymphocyte ratio in hemodialysis patients.

PURPOSE: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were established showing the poor prognosis in some diseases, such as cardiovascular diseases and malignancies. The risk of mortality in patients with end-stage renal disease (ESRD) was higher than normal population. In this study, we aimed to investigate the relationship between NLR, PLR, and all-cause mortality in prevalent hemodialysis (HD) patients. METHODS: Eighty patients were enrolled in study. NLR and PLR obtained by dividing absolute neutrophil to absolute lymphocyte count and absolute platelet count to absolute lymphocyte count, respectively. The patients were followed prospectively for 24 months. The primary end point was all-cause mortality. RESULTS: Mean levels of neutrophil, lymphocyte, and platelet were 3904 ± 1543/mm(3), 1442 ± 494/mm(3), 174 ± 56 × 10(3)/mm(3), respectively. Twenty-one patients died before the follow-up at 24 months. Median NLR and PLR were 2.52 and 130.4, respectively. All-cause mortality was higher in patients with high NLR group compared to the patients with low NLR group (18.8 vs. 7.5 %, p = 0.031) and in patients with higher PLR group compared to patients with lower PLR group (18.8 vs. 7.5 %, p = 0.022). Following adjusted Cox regression analysis, the association of mortality and high NLR was lost (p = 0.54), but the significance of the association of high PLR and mortality increased (p = 0.013). CONCLUSION: Although both NLR and PLR were associated with all-cause mortality in prevalent HD patients, only PLR could independently predict all-cause mortality in these populations.