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.

Diagnostic Accuracy of Neutrophil/Lymphocyte Ratio, Red Cell Distribution Width and Platelet Distribution Width in Ovarian Torsion.

The main aim of this diagnostic case-control study of 136 patients with ovarian cysts (44 patients with ovarian torsion and 92 controls) was to determine the diagnostic value of haematologic inflammatory markers (neutrophil/lymphocyte ratio [NLR], red cell distribution width [RDW] and platelet distribution width [PDW]) for torsioned ovarian cysts. The presence of a torsioned ovarian cyst was identified by a 1.18-fold increase in the NLR (95%CI: 1.04-1.34, P = 0.009), a 1.22-fold increase in the RDW (95%CI: 1.04-1.43, P = 0.023) and a 1.93-fold increase in the PDW (95%CI: 1.19-3.14, P = 0.007). The NLR was the best predictor of a torsioned ovarian cyst (AUC: 0.74; 95% CI: 0.68-0.83). When an NLR cut-off value of 2.44 was used to determine ovarian torsion, the sensitivity, specificity, + LR and -LR were 70.5%, 70.7%, 2.40 and 0.42, respectively. In conclusion, the NLR may have diagnostic and prognostic value in determining torsioned ovarian cysts.

The effect of intra-abdominal pressure on sensory block level of single-shot spinal anesthesia for cesarean section: an observational study.

BACKGROUND: Increased intra-abdominal pressure in pregnancy is thought to affect intrathecal drug spread. However this assumption remains largely untested. The aim of this prospective study was to evaluate the association between intra-abdominal pressure and maximum sensory block level in parturients receiving spinal anesthesia for cesarean section. METHODS: Parturients having elective cesarean section with single-shot spinal anesthesia using hyperbaric bupivacaine 12.5mg were included. Intra-abdominal pressure was measured via a bladder catheter after establishing a T4 sensory block and at the end of surgery in the supine position with 10° left lateral tilt. We recorded demographic data, descriptive characteristics of pregnancy, self-reported weight gain and weight of the newborn. As secondary outcomes, we evaluated onset of sensory block, maximum sensory block, motor block, number of hypotensive episodes, fluid and ephedrine requirements, time to first analgesic request, time to one-point recovery of motor block and side effects. RESULTS: The median value of the maximum sensory block level was T2 in 117 parturients. Median [interquartile range] pre-incision and postoperative intra-abdominal pressure were 13 [11-16] and 9 [6-10]mmHg respectively. No association was observed between maximum sensory block level and pre-incision intra-abdominal pressure (P=0.83). Weight was associated with pre-incision intra-abdominal pressure with an estimated odds ratio of 1.04 per kg (99.4% CI: 1.00-1.08). There was a moderate correlation between pre-incision and postoperative intra-abdominal pressure with a Spearman correlation coefficient of 0.67 (99.5% CI: 0.5-0.79). There was no association between pre-incision intra-abdominal pressure and secondary outcomes. CONCLUSIONS: In parturients, intra-abdominal pressure was not associated with spinal block spread, block onset time, recovery or side effects.

An high performance liquid chromatographic method for the quantification of cotinine in the urine of preschool children.

Tobacco smoke exposure is an important and preventable cause of morbidity among children. Enviromental tobacco smoke (ETS) increases respiratory symptoms and disease and also decreases lung function in children who live in a household with at least one smoker. We have developed a simple and reliable HPLC method with diode array dedection to determine the urine concentrations of cotinine in children aged 3 to 6 years, exposed to ETS. The assay involved a liquid-liquid extraction with chloroform. The HPLC method utilized a Chromasil C18 column (150 mm x 4.6 mm i.d.) and an isocratic mobile phase of phosphate buffer: acetonitrile (83:17 v/v, 0.02 M containing 0.1% triethylamine, adjusted to pH 6.72 with orthophosphoric acid), at a flow rate of 0.7 ml min(-1). The detection was performed at 260 nm and the total analysis time of analysis was less than 15 min. Linearity ranged from 0 to 80 microg L(-1); correlation coefficients (r2) for calibration curves were greater than 0.99. With 2 mL of urine for extraction, the limit of detection was 0.1 microg L(-1). The mean extraction ratio of cotinine was 88.78%. This analytical method is suitable for the determination of cotinine levels in a large number of urine samples.