Asprosin, visfatin and subfatin as new biomarkers of obesity and metabolic syndrome.

OBJECTIVE: Metabolic syndrome (MetS) and obesity are important public health problems associated with adipose tissue mass. Asprosin, visfatin, and subfatin are new members of which fate in MetS and obesity has not been fully revealed yet. Thus, this study was to investigate the association between asprosin, visfatin, subfatin, and biochemical values, demographic data, and body composition measurement values in MetS patients with and without obesity. PATIENTS AND METHODS: Blood samples were taken from a total of 90 people, including 31 MetS patients with obesity, 29 MetS patients without obesity, and 30 healthy (control). Asprosin, visfatin, and subfatin were studied by the ELISA method. RESULTS: There was a negative correlation between asprosin and Body Mass Index (BMI) in the MetS + Obese group. The correlations between asprosin and urea and fasting insulin (FI) levels in the MetS group were positive and statistically significant (p < 0.05). While there was a statistically significant negative correlation (p < 0.05) between visfatin and BMI in the MetS + Obese group, the correlation with waist circumference in the MetS + Obese and MetS groups was statistically significant and negative (p < 0.05). There was a statistically significant negative relationship (p < 0.05) between aspartate aminotransferase value and visfatin. The results between visfatin values and asprosin and subfatin in all groups were significant (p < 0.05). CONCLUSIONS: There is a direct relationship between circulating amounts of asprosin, visfatin, and subfatin hormones and age, weight, height, diastolic blood pressure, high-density lipoprotein-cholesterol, aspartate aminotransferase, alanine transaminase, and creatinine. Therefore, asprosin, visfatin, and subfatin hormones are the new biomarkers of metabolic turbulence.

Differentiation between benign and malignant ovarian masses using multiparametric MRI.

PURPOSE: To investigate the capabilities of multiparametric MRI including dynamic contrast enhanced (DCE) perfusion and diffusion-weighted imaging (DWI) to discriminate between benign and malignant ovarian masses. METHODS: A total of 43 women with a total of 43 ovarian masses were retrospectively included. They had a mean age of 51.26±18.05 (SD) years (range: 20-88years). Twenty women had benign and 23 had malignant ovarian tumors. All women had multiparametric MRI examinations including DWI (b50-b800) and DCE perfusion imaging at 1-5T. Results of DWI (apparent diffusion coefficient [ADC], b-800) and DCE imaging (volume transfer coefficient [Ktrans], rate constant [Kep], interstitial volume [Ve], initial area under the curve [iAUC]) were compared between benign and malignant ovarian masses. RESULTS: Mean ADC was significantly lowed in malignant tumors (0.92±0.25 [SD]×10-3 mm2/s (range: 0.6-1.6×10-3 mm2/s) than in benign tumors (1.37±0.69 [SD]×10-3 mm2/s; range: 0.4-2.9×10-3 mm2/s) (P=0.011). B-800 was significantly greater in malignant tumors (80.61±24.73 [SD] s/mm2; range: 24-110 s/mm2) than in benign ones (61.15±22.17 [SD] s/mm2; range: 38-155 s/mm2) (P=0.010). Ktrans was lower in benign tumors (0.13±0.06 [SD] min-1; range: 0-0.2min-1) than in malignant ones (0.25±0.16 [SD] min-1; range: 0.1-0.8min-1) (P=0.002). Kep was significantly greater in malignant tumors (0.55±0.19 [SD] min-1; range: 0.1-1.9min-1) than in benign ones (0.44±0.38 [SD] min-1; range: 0.2-1.1min-1) (P=0.003). iAUC was greater in malignant tumors (15.59±7.98 [SD] mM/min; range: 6.6-42.1mM/min) than in benign ones (7.98±5.06 [SD] mM/min; range: 0.2-17.7mM/min) (P=0.001). No differences in Ve were found between benign and malignant masses (P=0.084). The area under the ROC curve was significant for all parameters but Ve. Logistic regression analysis revealed 5.590 and 11.637 times higher malignancy risk for an ADC≤0.93×10-3 mm2/s and an iAUC≥13.88mM/min, respectively. CONCLUSION: Multiparametric MRI has high accuracy in discrimination between benign and malignant ovarian masses. Therefore, adding these methods to the more common MRI protocol can help select the best treatment option in women with ovarian mass.

Prevalence of Human Herpesvirus-8 and BK Polyoma Virus Infections in End-stage Renal Disease and the Influence of Renal Transplantation.

Viral infections lead to significant morbidity and mortality in kidney transplant recipients. We evaluated 49 kidney transplant recipients for human herpesvirus 8 (HHV-8) and BK polyomavirus infections in conjunction with data obtained from 43 donors. The seroprevalence of HHV-8 was 6.9% in donors and 12.2% in recipients. HHV-8 DNA was detected below the limit of quantification (<5000 copies/mL) in a recipient with HHV-8 seropositivity at the pretransplant period and was undetectable at month 3 after transplantation. Transient viruria with BK polyomavirus was recorded in 10.2% of recipients without viremia. Multiple factors contribute to viral reactivation, particularly immunosuppressive treatment. Reduction in maintenance immunosuppression seems beneficial in terms of viral reactivation. At our center, routine use of valganciclovir for antiviral prophylaxis may be effective for the prevention of HHV-8 reactivation.

Investigation of biological effects of some Mannich Bases containing Bis-1,2,4- Triazole.

In this study, the effects of Mannich bases containing bis-1,2,4-triazole on the levels of in vivo malondialdehyde (MDA) and antioxidant vitamins (A, E, C) were examined in serum, livers and kidneys of rats. DA and vitamin (A, E, C) levels were determined by high performance liquid chromatography (HPLC). Antioxidant effect was investigated by determining the MDA levels in Saccharomyces cerevisiae cells as in vitro. Furthermore, the antitumor effects of compounds were investigated against MCF-7 human breast cancer cells. Interrelations of results among control and compound groups were evaluated using SPSS statistical software package. As a result, some of the compounds showed effective biological activity when compared to control conditions. The test compounds used in this study may be effective for utilization in the selection and design of model compounds for further studies.

Combination Therapy in Pulmonary Arterial Hypertension: Single Centre Long-term Experience.

BACKGROUND: Pulmonary arterial hypertension (PAH) is a progressive disease of the pulmonary vascular bed and causes right heart failure and death. Combination therapy which targets three different pathways is necessary due to the progressive nature of the disease. In patients with PAH, there are two approaches in combination therapy: "first-line up-front" and "sequential add-on" treatment. In "firstline up-front" treatment, patients receive double or triple drug therapy from the start. In the "sequential add-on" approach, a single drug is initially started and then according to the patient's requirements, a second or third drug is added. There is insufficient evidence about the efficiency and safety of treatment approaches. In this study, we aimed to evaluate the treatment approach in patients with PAH at a tertiary centre. METHODS: Pulmonary arterial hypertension was diagnosed according to clinical, echocardiographic and right heart catheterization findings. The patients received bosentan, sildenafil and iloprost treatment in accordance with guidelines recommendations. Clinical worsening in patients was defined as death, requirement of hospitalization for PAH, a 15% decline in the six-minute walk test (6MWT) distance, deterioration in functional capacity, and symptoms and findings of right heart failure. RESULTS: At the end of the follow-up period, clinical and echocardiographic findings, brain natriuretic peptide (BNP) levels and oxygen saturation were similar between patients who completed the study with monotherapy and with combination therapy. The follow-up period was significantly longer in patients who required combination treatment. Two patients (6.9%) died and four patients (13.8%) were hospitalized due to recurrent symptoms and findings of right heart failure. At the end of follow-up, 10 patients (34.5%) completed the study with a single drug, 15 patients (51.7%) with two drugs and four patients (13.8%) with three drugs. CONCLUSION: In this study, combination therapy was given to patients as "sequential add-on therapy". At the end of the follow-up period, monotherapy was sufficient in 34.5% of patients of the study group and in eight patients, sildenafil or prostaglandin analogues were added; a total of 15 patients (48.4%) completed the study under dual therapy. Four patients (12.9%) received combination therapy with three drugs.

Acute Anterior Myocardial Infarction Accompanied by Acute Inferior Myocardial Infarction: A Very Rare Coronary Artery Anomaly.

Coronary artery anomalies are rare and mostly silent in clinical practice. First manifestation of this congenital abnormality can be devastating as syncope, acute coronary syndrome, and sudden cardiac death. Herein we report a case with coronary artery anomaly complicated with ST segment myocardial infarction in both inferior and anterior walls simultaneously diagnosed during primary percutaneous coronary intervention.

Assessment of wild mint from Tunceli as source of bioactive compounds, and its antioxidant Activity.

The types of wild mint (Mentha spicata L.) were sampled from different geographical regions in Tunceli (Turkey) in order to find out their vitamin, mineral, phenolic contents and their antioxidant properties. The total phenol varied from 77.7±0.242 to 52.34±0.351 mg of GAEs/g of dry mint. The highest radical effect of scavenging was observed in Mazgirt parting of the ways 7.5 km with 6.17±0.245 mg/mL. The highest reducing power and metal chelating were observed in the mint from Cicekli parting of the ways 6.5 km Demirkapi. Among the various macronutrients which were estimated in the plant samples, potassium was presented in the highest quantity followed by calcium and phosphate. Although rutin and resveratrol were not determined in any samples, kaempferol and catechin levels were found out in almost all samples. The concentrations of vitamin A ranged between 42,14±5.70 and 13.61±3.00 (mg/kg dry weight). These results show that plants of mint are quite rich in phenolic compounds, and these have been appeared to have antioxidant activity, which agrees with this work, since the extract showed a higher content of phenolic compounds and higher antioxidant activity and mint may be considered as a natural alternative source for food, pharmacology and medicine sectors.

KPC-producing Klebsiella pneumoniae, finally targeting Turkey.

We report here the first identification of the worldwide spread of Klebsiella pneumoniae carbapenemase-2-producing and carbapenem-resistant K. pneumoniae clone ST258 in Turkey, a country where the distantly-related carbapenemase OXA-48 is known to be endemic. Worryingly, this isolate was also resistant to colistin, now considered to be the last-resort antibiotic for carbapenem-resistant isolates.

Parkinsonism in elderly rheumatoid arthritis patients.

OBJECTIVE: The incidences of extrapyramidal symptoms and Parkinson's disease were reported to be increased in patients with rheumatoid arthritis (RA). In this study we aimed to explore the frequency of the symptoms of Parkinsonism among RA patients older than 60 years. PATIENTS AND METHODS: 30 (6 males, 24 females) consecutive RA patients, followed at a rheumatology outpatient clinic, who were 60 years of age or older; 23 patients who were diagnosed as PD and 50 sex and age matched healthy controls were included to the study. All participants were examined for the motor and non-motor findings of Parkinsonism including bradykinesia, rigidity, tremor, postural abnormality, upper limb sway abnormality, gait impairment, decrease in facial expression, seborrhea, slowing of speech and impairment in the self care. RESULTS: When the RA, PD cases and healthy control group were compared for bradykinesia, rigidity, tremor, posture, upper limb sway, gait impairment, facial expression, seborrhea, speech and self care; highly significant differences were seen for all parameters. Two out of the 30 RA cases (6,7%) were diagnosed as Parkinson's disease. CONCLUSIONS: The signs of Parkinsonism and Parkinson's disease were found more frequent in elderly RA cases as compared to healthy controls.

Evaluation of antioxidant properties, elemental and phenolic contents composition of wild nettle (Urtica dioica L.) from Tunceli in Turkey.

Wild nettle (Urtica dioica L.) types were sampled from different geographical regions in Tunceli (Turkey) to determine their mineral, vitamin, phenolic contents and their antioxidant properties. The total phenol varied from 37.419 ± 0.380 to 19.182 ± 1.00 mg of GAEs g(-1) of dry nettle. The highest radical scavenging effect was observed in Mazgirt parting of the ways 7.5 km with 33.70 ± 0.849 mg mL(-1). The highest reducing power was observed in the nettles from Mazgirt parting of the ways 7.5 km. Among the various macronutrients estimated in the plant samples, potassium was present in the highest quantity followed by calcium and phosphate. Kaempferol and resveratrol were not determined in some nettle samples but rutin levels were determined in all samples. Vitamin A concentrations were ranged between 13.64 ± 1.90 and 5.74 ± 1.00 (mg kg(-1) dry weight). These results show that Urtica dioica L. collected from Tunceli in Turkey could be considered as a natural alternative source for food, pharmacology and medicine sectors.

Protective effect of resveratrol, a red wine constituent polyphenol, on rats subjected to portal vein thrombosis.

This experimental study investigated the prophylactic effects of the antioxidant and antiaggregant compound resveratrol (R) on portal vein thrombosis (PVT) in rats. Thirty rats weighing 200- 250 g were distributed in 3 groups: Group A (n = 10) and underwent PVT+R, Group B (n = 10) PVT alone, and Group C (n = 10) were subjected to a sham operation. Group A rats received R (60 mg/d per naso-gastric tube) for 10 days before PVT. Concerning antioxidant status, statistically significant increases in both tissue and plasma levels of reduced glutathione (GSH) and decrease in malondialdehyde (MDA) levels were observed in the PVT+R group compared with the PVT group (P < .001 for all). Comparison of these parameters with those of the sham group revealed significantly higher tissue and plasma levels of GSH and low MDA levels among the sham-operated group when compared with to the PVT+R or PVT groups (P < .001 for all). Concerning the antiaggregant status, significant increases of c-AMP levels were detected in rats treated with R before experiencing PVT (P < .001). Cyclic AMP levels in the sham group were significantly higher than those of either the PVT or PVT+R groups (P < .001). One may advise patients undergoing liver transplantation and carrying certain cardiovascular disease risk factors to ingest foods containing R to minimize PVT.

Effect of resveratrol on oxidative stress enzymes in rats subjected to 70% partial hepatectomy.

This experimental study investigated the antioxidant status of rats after resveratrol (R) treatment following 70% partial hepatectomy. Thirty Wistar albino rats (200 to 250 g) were divided among: groups A and B (n = 10 each) underwent laparotomy and 70% partial hepatectomy (PH). Whereas rats in group A received resveratrol 60 mg/d per nasogastric tube for 7 days before and 3 days after PH (PH + R), those in group B underwent PH only. Rats in group C (n = 10) were subjected to a sham operation. Significant increases in tissue levels of reduced glutathione (GSH) and decreased malondialdehyde (MDA) levels were observed in the PH group receiving R compared with those of the PH group (P < .001 for all). Comparison of these parameters with those of the sham group revealed significantly higher tissue levels of GSH and lower MDA levels among sham-operated compared with PH + R and PH groups (P < .001 for all). Concerning the NO levels, a trend to a slightly decrease was observed in the PH + R group (P < .06). Interleukin-6 levels showed significant decreases in both PH + R and PH groups (P < .001 and P < .05, respectively). The tissue GSH levels were slightly decreased in PH + R (P < .05), and decreased in the PH group compared with the controls (P = .002). We have suggested that patients undergoing living donor liver transplantation would likely benefit from prophylactic treatment with foods having resveratrol.

Influence of oxidative stress and inflammation on rHuEPO requirements of hemodialysis patients with CRP values "in normal range".

AIMS: We sought to evaluate influences of oxidative stress (OS) on rHuEPO requirements in hemodialysis patients without chronic inflammation. METHODS: Sixty-eight hemodialysis patients and 46 healthy controls underwent measurements plasma levels of antioxidative agents, such as glutathione peroxidase (GPX), superoxide dismutase (SOD), and oxidative compounds including malonyldialdehyde (MDA). We retrospectively analyzed the last 3 months' rHuEPO requirements, iron indices, and CRP levels. RESULTS: Plasma levels for SOD, GPX, and MDA were 974.4+/-216.4 U/gHb, 44.4+/-13.6 U/gHb, 10.0+/-2.0 nmol/mL, respectively yielding results that were different from healthy controls (P<.0001). Increased OS negatively correlated with hemoglobin levels (P<.0001) and positively correlated with rHuEPO requirements (P<.01). Increased antioxidative capacity positively correlated with hemoglobin levels (P<.0001) and negatively correlated with rHuEPO requirements (P<.0001). For further analyses, hemodialysis patients were subgrouped according to rHuEPO requirements as group I (lowest 1/3, n=23), group II (moderate 1/3, n=23) and group III (highest 1/3, n=22). Group III displayed the highest MDA (P<.05), the lowest SOD (P<.0001), and comparable GPX (P<.05) levels. Group III also had the highest CRP and the lowest albumin levels compared with the others (P<.01). CONCLUSION: OS has strong adverse influences on rHuEPO responses of HD patients with "normal" CRP levels, but it should not be forgotten that CRP levels in the "normal" range may still reflect ongoing microinflammation.

Dexmedetomidine during coronary artery bypass grafting surgery: is it neuroprotective?--A preliminary study.

BACKGROUND: In the present study, we aimed to determine whether during coronary artery bypass grafting (CABG) surgery, dexmedetomidine has protective effects against cerebral ischemic injury. METHOD: Twenty-four patients, aged 50-70 years, undergoing CABG surgery were randomized into two groups of 12 patients each: those receiving dexmedetomidine (group D) and those not receiving it (group C). As basal blood samples from arterial and jugular bulb catheters were drawn, dexmedetomidine (1 microg/kg bolus and infusion at a rate of 0.7 microg/kg/h) was administered to patients in group D. Arterial and jugular venous blood gas analyses, serum S-100B protein (S-100B), neuron-specific enolase (NSE) and lactate measurements were performed after induction, 10 min after the initiation of cardiopulmonary bypass (CPB), 1 min after declamping, at the end of CPB, at the end of the operation and 24 h after surgery. Mann-Whitney U- and Wilcoxon's tests were used for statistical analyses. RESULTS: No significant between-group differences were found regarding arterial and jugular venous pH, PO(2), PCO(2) and O(2) saturations. S-100B, NSE and lactate levels were also similar between groups D and C. During the post-operative period, there were no clinically overt neurological complications in any patient. CONCLUSION: Cerebral ischemia marker (S-100B, NSE, lactate) patterns were as expected during CPB; however, there were no differences between the groups, which led us to believe that during CABG surgery dexmedetomidine has no neuroprotective effects. Future studies with larger populations are recommended to further establish the effects of this drug.

Hepatitis C infection in hemodialysis patients: Protective against oxidative stress?

Hepatitis C virus (HCV) infection is a common problem that increases morbidity and mortality in hemodialysis patients. These patients are also at risk of increased oxidative stress. The aim of this study was to evaluate possible interactions between HCV infection and oxidative stress indicators in a group of hemodialysis patients awaiting transplantation. We evaluated 73 patients (29 women, 44 men; ages, 49.3 +/- 13.3 years; dialysis duration, 81.7 +/- 48.8 months; Kt/V > or = 1.3). Indicators of plasma oxidative status were monitored at the beginning of a clinically stable hemodialysis session. Measurements were performed for plasma superoxide dismutase (SOD), glutathione peroxidase (GPX), and malonyldialdehyde (MDA) by spectrophotometric methods. We retrospectively recorded the prior year's monthly laboratory values for alanine aminotransferase (ALT), C-reactive protein (CRP), albumin, lipids, homocysteine, Lp(a), calcium, phosphorus, intact parathyroid hormone, and predialysis blood urea nitrogen (BUN) creatinine, as well as clinical findings of body mass index and pre- and postdialysis blood pressures. We excluded patients with chronic inflammation (mean CRP levels > or = 10 mg/L) or HCV infection of duration <12 months or clinically advanced liver failure. Twenty-six patients had HCV. The sex distribution, mean age, and dialysis duration were similar between groups. HCV-infected patients showed significantly lower levels of MDA, albumin, total cholesterol, triglyceride, predialysis creatinine, and phosphorus. Antioxidative indicator levels were also higher in the HCV group, but they were not statistically significant. In conclusion, HCV infection in dialysis patients is associated with decreased levels of plasma oxidative load.