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.

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.

Effect of orlistat on the total ghrelin and leptin levels in obese patients

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Obesity, characterized by hyperleptinemia and hypoghrelinemia, has become a major health problem all over the world and is associated with an increased risk of complications including insulin resistance, hypertension, dyslipidemia, diabetes mellitus and atherosclerosis. The use of the pancreatic lipase inhibitor Orlistat can help seriously overweight people to achieve and maintain weight loss. The aim of our study was to compare the serum leptin and ghrelin levels in obese subjects who take orlistat with those receiving only dietary treatment. Twenty-one obese patients and 10 control subjects participated. The obese patients were divided into two groups; one group (n=11) took orlistat (120 mg, 3 times daily) and received dietary treatment and the other (n=10) only received the dietary treatment. The study lasted twelve weeks. The concentrations of serum ghrelin, leptin, insulin and C-peptide, and routine biochemical parameters, were measured in both groups. The serum ghrelin level was higher in control (183±62 fmol/ml) than obese (59±30 fmol/ml) subjects while the plasma leptin level was lower in control (8.7±12 ìg/L) than obese (36.7±19 ìg/L) subjects (all p<0.001). BMI and the total blood cholesterol, LDL and triglyceride levels fell significantly after both orlistat and dietary treatment in the obese subjects (all p<0.01), and the plasma ghrelin level rose (p<0.01). The leptin level demonstrated the opposite trend in both groups but only the patients taking orlistat showed a significant change (p<0.05).Taken together, these results show that orlistat has no effect on body weight in obese subjects additional to that conferred by a non-pharmacological life-style intervention. We therefore conclude that weight lost rather than type of treatment might be more valuable in obesity (AU)

Effect of orlistat on the total ghrelin and leptin levels in obese patients.

Obesity, characterized by hyperleptinemia and hypoghrelinemia, has become a major health problem all over the world and is associated with an increased risk of complications including insulin resistance, hypertension, dyslipidemia, diabetes mellitus and atherosclerosis. The use of the pancreatic lipase inhibitor Orlistat can help seriously overweight people to achieve and maintain weight loss. The aim of our study was to compare the serum leptin and ghrelin levels in obese subjects who take orlistat with those receiving only dietary treatment. Twenty-one obese patients and 10 control subjects participated. The obese patients were divided into two groups; one group (n=11) took orlistat (120 mg, 3 times daily) and received dietary treatment and the other (n=10) only received the dietary treatment. The study lasted twelve weeks. The concentrations of serum ghrelin, leptin, insulin and C-peptide, and routine biochemical parameters, were measured in both groups. The serum ghrelin level was higher in control (183+/-62 fmol/ml) than obese (59+/-30 fmol/ml) subjects while the plasma leptin level was lower in control (8.7+/-12 microg/L) than obese (36.7+/-19 microg/L) subjects (all p<0.001). BMI and the total blood cholesterol, LDL and triglyceride levels fell significantly after both orlistat and dietary treatment in the obese subjects (all p<0.01), and the plasma ghrelin level rose (p<0.01). The leptin level demonstrated the opposite trend in both groups but only the patients taking orlistat showed a significant change (p<0.05).Taken together, these results show that orlistat has no effect on body weight in obese subjects additional to that conferred by a non-pharmacological life-style intervention. We therefore conclude that weight lost rather than type of treatment might be more valuable in obesity.

Neuroprotection by alpha-lipoic acid in streptozotocin-induced diabetes.

Glial cells provide structural and metabolic support for neurons, and these cells become reactive to any insult to the central nervous system. The streptozotocin (STZ) rat model was used to study glial reactivity and the prevention of gliosis by alpha-lipoic acid (alpha-LA) administration. The expression of glial fibrillary acidic protein (GFAP), S100B protein, and neuron specific enolase (NSE) was determined as well as lipid peroxidation (LPO) and glutathione (GSH) levels in some brain tissues. Western blot analyses showed GFAP, S100B, and NSE levels significantly increased under STZ-induced diabetes in brain, and LPO level increased as well. Administration of alpha-LA reduced the expression both of glial and neuronal markers. In addition, alpha-LA significantly prevented the increase in LPO levels found in diabetic rats. GSH levels were increased by the administration of alpha-LA. This study suggests that alpha-LA prevents neural injury by inhibiting oxidative stress and suppressing reactive gliosis.

Effect of melatonin on oxidative status of rat brain, liver and kidney tissues under constant light exposure.

An enormous amount of data has been published in recent years demonstrating melatonin's defensive role against toxic free radicals. In the present study, we examined the role of melatonin as an antioxidant against the effect of continuous light exposure. Rats were divided into three groups. Control rats (group A) were kept under natural conditions whereas other group of rats (group B and C) were exposed to constant light for inhibition of melatonin secretion by the pineal gland. Group C rats also received melatonin via s.c. injection (1 mg x kg(- 1) body weight x day(- 1)). At the end of experiment, all animals were sacrificied by decapitation, serum and tissue samples were removed for determination of malondialdehyde (MDA), a product of lipid peroxidation, conjugated dienes levels and glutathione peroxidase (GSH-Px) activity levels. It was found that lipid peroxidation was increased in the rats which were exposed to constant light. Melatonin injection caused a decrease in lipid peroxidation, especially in the brain. In addition, melatonin application resulted in increased GSH-Px activity, which has an antioxidant effect. Thus, melatonin is not only a direct scavenger of toxic radicals, but also stimulates the antioxidative enzyme GSH-Px activity to detoxify hydroxyl radical produced by constant light exposure.

The effect of L-carnitine on insulin resistance in hemodialysed patients with chronic renal failure.

We investigated the effect of L-carnitine in seven patients, four female and three male (mean age 44.4 +/- 6.0 years) with chronic renal failure. Six patients, four female and two male (mean age 49.3 +/- 2.2 years) with chronic renal failure were given a placebo (0.9% sodium chloride) as control. After the basal data were obtained, patients received a single intravenous dose of L-carnitine (1 g) or placebo and two hours later insulin sensitivity was studied by the intravenous insulin tolerance test. No change was observed in biochemical data and K(itt) values in the placebo group. K(itt) increased significantly with carnitine (from 2.99 +/- 0.3 to 3.54 +/- 0.2%/min, p < 0.03) compared to the control group (p < 0.02). This result suggests that L-carnitine may improve the insulin resistance common among uremic patients.

Renal blood flow detection with Doppler ultrasonography in patients with hepatic cirrhosis.

BACKGROUND: Hepatorenal syndrome, a well-recognized complication of established liver disease, is characterized by early renal vasoconstriction before clinically recognized renal disease. Renal vasoconstriction causes increased renal vascular resistance, which can be detected noninvasively by Doppler ultrasonography. OBJECTIVE: To detect early renal hemodynamic changes in patients with hepatic cirrhosis who had clinically normal renal functions. PATIENTS: Twenty patients with hepatic cirrhosis and ascites, 11 patients with hepatic cirrhosis without ascites, and 23 healthy control subjects. All cirrhotic patients had normal serum urea nitrogen and creatinine values. MAIN OUTCOME MEASURES: Peak systolic, peak diastolic, and mean flow velocities; pulsatile index; resistive index; and peak systolic velocity/peak diastolic velocity ratio as measured by renal Doppler ultrasonography. RESULTS: Peak diastolic flow velocity was significantly lower in cirrhotic patients with ascites than in cirrhotic patients without ascites and control subjects (P < .02 and P < .004, respectively), but the peak systolic flow velocity/peak diastolic flow velocity ratio (P < .007 and P < .001, respectively), pulsatile index (P < .007 and P < .001, respectively), and resistive index (P < .007 and P < .001, respectively) were significantly higher in cirrhotic patients with ascites than in cirrhotic patients without ascites and controls. CONCLUSION: Renal Doppler ultrasonography can noninvasively identify a subgroup of nonazotemic patients with hepatic cirrhosis who are at high risk for subsequent development of renal dysfunction and hepatorenal syndrome.