EVALUATION OF THE RELATIONSHIP BETWEEN MEDICAL NUTRITION TREATMENT, PENTRAXIN-3, HSCRP AND BODY COMPOSITION ANALYSIS IN TYPE 2 DIABETIC PATIENTS.

Objective: Medical Nutrition Therapy (MNT) is important in the treatment and regulation of diabetic patients. In this study, it was aimed to evaluate the effects of medical nutrition therapy on Pentraxin-3, hsCRP and body composition analysis in Type 2 diabetes patients (DM). Methods: This study included 160 individuals who were admitted and diagnosed with Type 2 DM. Laboratory, clinical, anthropometric and body composition parameters were obtained 3 months after baseline evaluation of the patients and the MNT was given by the dietitian. Results: After 3 months MNT, weight, body mass index, waist circumference, body fat weight, body fat ratio and visceral fat area (p<0.001), glucose (p<0.001), insulin (p=0.033), HOMA index (p=0.004), HbA1c (p<0.001), total cholesterol (p=0.001), LDL (p=0.008), ALT (p<0.001) and hsCRP (p<0.001) levels were significantly lower than they were before MNT. There wasn't significant difference in triglyceride (p=0.509), HDL (p=0.079), Pentraxin-3 (p=0.706) levels and waist-to-hip ratio (p=0.802). The level of Framingham risk score after MNT was significantly lower (p<0.001). Conclusion: In this study, it was cocluded that MNT, applied to patients with Type 2 DM decreased cardiovascular risk and inflammation, contributed to the maintenance of glycemic control, and a significantly improved the body composition.

Cytotoxic, anti-proliferative and apoptotic effects of noscapine on human estrogen receptor positive (MCF-7) and negative (MDA-MB-231) breast cancer cell lines.

AIM: Noscapine, a naturally occurring alkaloid obtained from opium poppy, is a microtubule-targeting agent. This study is aimed to investigate the effects of noscapine on human breast cancer cell lines by comparing them with those of tamoxifen and docetaxel. METHODS: MCF-7 and MDA MB-23 cell lines were used to observe the effects of docetaxel, tamoxifen, and noscapine on cell proliferation. For each drug, cell blocks were prepared from cultured cells treated with IC50 dose of each drug and these were examined histologically. The expressions of Ki-67, Bcl-2, BAX, and cyclin-D1 were assessed immunohistochemically. RESULTS: Although noscapine showed cytotoxic effects on both cell lines in a time and dose dependent manner, MDA-MB-231 cells were more susceptible to its effects. Noscapine inhibited MCF-7 and MDA-MB-231 cells proliferation in vitro with IC50 value of 29 µM and 69 µM, respectively, which was comparable with IC50 of tamoxifen (40 µM and 50 µM) and docetaxel (43 nM and 32 nM). Noscapine showed anti-proliferative effects by decreasing Ki-67, cyclin-D1 and apoptotic effects by increasing BAX/Bcl-2 ratio in both breast cancer cells. Its effect was comparable with tamoxifen and docetaxel. CONCLUSION: Noscapine may be a good chemotherapeutic agent for the treatment of breast cancer, especially in estrogen receptor­negative breast cancer (Tab. 2, Fig. 7, Ref. 40).

Evaluation of knowledge level related to obstructive sleep apnea syndrome.

OBJECTIVE: Our aim in this study is to evaluate the knowledge level of outpatients about obstructive sleep apnea syndrome (OSAS). SUBJECTS AND METHODS: This cross-sectional analytical study included 1651 patients and patient relatives who applied to Konya Training and Research Hospital outpatient clinics. Sociodemographic data form and OSAS knowledge level questionnaire were applied to participants. SPSS 21 package program was used for the statistical analysis of the data. It was accepted that p value was <0.05. RESULTS: The average knowledge score in the knowledge level questionnaire was 15.1 (3-33). 61% of the participants had never heard of OSAS before. Those who are married, those living in the city center and women have a higher level of knowledge. When age, education level and income level increased, the score of information also increased. Most of the participants' information source was the social media with 56.5% (n = 364) and least were health workers with 19.8% (n = 127). The knowledge level of people whose information sources were doctors, were significantly higher than other information sources such as nurses, friends, internet and television as. There was no significant difference between the other groups. CONCLUSION: In our study, it was concluded that the level of knowledge about OSAS in the society was not sufficient and that the society had to be informed about this disease which has serious complications and awareness should be established.

The Relationship between Metabolic Parameters, Cardiac Parameters and MIC-1/GDF15 in Obese Children.

Objective: Childhood obesity which is a predictor of adulthood obesity is associated with type 2 diabetes, metabolic syndrome, dyslipidemia, coronary artery diseases and subclinical inflammation. Growth differentiation factor-15, also known as macrophage inhibitory cytokine-1 (MIC-1/GDF15) is a member of the transforming growth factor- ß super family and increases during inflammatory states. Adults with obesity have increased serum concentrations of MIC-1/GDF15. MIC-1/GDF15 is associated with cardio metabolic risk in adults. Design: Identification of obese children at higher risk for cardio metabolic complications is important. The relations of MIC-1/GDF15 to parameters of obesity in children have never been studied. Methods: We measured serum MIC-1/GDF15 concentration in obese children by ELISA and evaluated its relationship with anthropometric, biochemical and echocardiographic parameters. Results: No significant difference in serum MIC-1/GDF15 between normal-weight and obese children was observed. MIC-1/GDF15 was positively correlated with CRP, ALT and aortic dimension when normal-weight and obese children were analyzed together. Conclusions: MIC-1/GDF15 may provide a link between childhood obesity and cardio metabolic complications that will occur in time course. Further work would be required to find out if MIC-1/GDF15 has any role in the early inflammatory, cardiac and metabolic changes in childhood obesity.

Levels of arginine and its products in dialysis patients.

OBJECTIVES: Chronic renal failure is among significant public health problems all over the world. Despite advances in diagnosis and treatment approaches, cardiovascular morbidity and mortality is still high in chronic renal failure patients on dialysis. The aim this study is to investigate the importance of arginine, asymmetric dimethylarginine (ADMA) and nitric oxide (NO) levels in the pathophysiology of cardiovascular morbidity and mortality in patients with dialysis treatment program. PATIENTS AND METHODS: 53 patients with chronic renal failure receiving hemodialysis treatment and 34 healthy persons were participated to the study. Arginine and ADMA levels were measured by high-performance liquid chromatography (HPLC) fluorescence detector. NO levels were assessed by a colorimetric method. Albumin, urea, creatinine levels was performed using the spectrophotometric method. RESULTS: Arginine levels were similar in dialysis patients when compared to the control group. Similarly NO levels did not show any difference between patient group and the control group. ADMA levels were found to be significantly high in dialysis patients compared to the control group (p < 0.005). Arginine/ADMA ratio was lower in the patient group compared to the control group (p < 0.001). Dialysis patients who have diagnosed coronary artery disease had low levels of albumin and creatinine. Arginine levels, ADMA levels and NO levels did not show any difference in the patients with coronary artery disease or not (p > 0.05). Arginine levels were significantly higher in men compared to women. Pearson correlation analysis showed that there was a correlation between NO and arginine levels. Arginine and Arginine/ADMA showed a positive correlation while ADMA and arginine/ADMA levels showed a negative correlation. CONCLUSIONS: As a result, our data showed that ADMA clearance was impaired in hemodialysis patients. Increase in ADMA levels may play a role in atherosclerosis dependent morbidity and mortality.

Effect of ascitic media formed by glycerin on the prevention of peritoneal adhesions.

AIM: We aimed to investigate whether or not artificial ascites media formed using glycerin are effective in the prevention of intraperitoneal adhesions. METHODS: Thirty-six Wistar albino male rats were used in the study. The rats were divided into 3 groups as follows. Group I: control group; group II (isotonic group): 3 ml of 0.9% NaCl was injected into the peritoneal cavity, and group III (glycerin group): 0.5 ml of liquid glycerin and 3 ml of 0.9% NaCl was injected into the peritoneal cavity. RESULTS: There were serious adhesions in the control group. Adhesion rates were lower in the isotonic group compared with the control group, but the difference was not statistically significant (p > 0.05). When adhesion rates of the glycerin group were compared with the control and isotonic groups, significant differences were found, especially between the glycerin and control groups (p < 0.05). CONCLUSIONS: According to the results of our study, the use of isotonic solution and liquid glycerin decreases postoperative adhesions. We suggest that glycerin was more effective as it has the chemical ability to draw water to its media. As such, the formation of adhesions may be decreased by increasing the amount of physiological liquid inside the abdomen.

Diuretics, plasma brain natriuretic peptide and chronic obstructive pulmonary disease.

BACKGROUND: Brain natriuretic peptide (BNP) is associated with increased myocardial stretching. This study aims to assess the effect of mild diuretics on plasma BNP levels in patients with an acute exacerbation of chronic obstructive pulmonary disease (COPD) who have high plasma concentrations of BNP. METHODS: Thirty consecutive patients with an acute exacerbation of COPD without any clinical evidence of cor pulmonale who had elevated plasma BNP concentrations (group 1) and 15 patients with stable COPD as controls (group 2) participated in this study. A mild diuretic treatment in addition to the standard treatment for an acute attack of COPD was randomised to 15 patients in group 1 (group 1A). The remaining patients in group 1 only took standard treatment for acute COPD exacerbation (group 1B). Plasma BNP concentrations were measured on admission and repeated on the 5th and 10th days. RESULTS: There was a significant decrease in plasma BNP concentrations, more striking in group 1A than 1B. Both in group 1A and 1B, the fall in plasma BNP concentrations was independent of either presence or absence of right ventricular dysfunction on echo evaluation. CONCLUSION: Adding mild diuretics to the standard treatment for an acute attack of COPD may rapidly reduce plasma BNP levels in COPD patients with acute exacerbations who have high plasma BNP levels without any clinical evidence of cor pulmonale.

Testosterone secretion and semen plasma enzyme activity in rams with genital pathology stimulated with GnRH.

Testosterone secretion in response to GnRH stimulation and enzymatic activity of semen plasma was evaluated comparatively in rams with or without genital abnormality. Scrota, testes and epididymides of 128 rams between 1.5 and 6 years old from various breeds were examined clinically and ultrasonographically. Bilaterally cryptorchid rams (n = 2), and rams with focal testicular degeneration (n = 3) or unilateral sperm granuloma localized in the caput (n = 3) epididymis or the cauda epididymis (n = 3), diagnosed by either clinical or ultrasonographic examination, were selected for the further investigation of spermatologic parameters, testosterone secretion in response to GnRH stimulation, and enzymatic activity of semen plasma before histopathologic confirmation of lesions. Except for the cryptorchid rams, sperm parameters determined in ejaculates were similar to intact controls (n = 3). GnRH administration increased plasma testosterone levels significantly irrespective of the type of genital pathology (P < 0.01). The testosterone response calculated based on area under the curve following GnRH administration in rams having genital abnormality was not significantly different from the controls. Aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) activity in the semen plasma varied between rams, with the lowest mean values in the bilaterally cryptorchid group (P < 0.05). Spermatic granuloma localized either in the caput or cauda of the epididymis was associated with a significant reduction in the semen plasma AST activity compared to controls (P < 0.01). In conclusion, our results indicated that the ability of testicular tissue to secrete testosterone in response to GnRH stimulation in rams with bilateral cryptorchidism, focal testicular degeneration and unilateral sperm granuloma was similar to that of intact controls, and that reduced semen plasma AST activity may have a diagnostic value in the diagnosis of the epididymal obstruction in rams. Focal testicular degeneration did not influence AST, alkaline phosphatase (ALP) and LDH activity in semen plasma.

Effects of nimodipine and magnesium sulfate on endogenous antioxidant levels in brain tissue after experimental head trauma.

To examine the effects of calcium antagonists nimodipine and magnesium sulfate (MgSO4) on tissue endogenous antioxidant levels, the authors studied superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels in rabbit brain 1 hour after experimental head trauma. Forty New Zealand rabbits were anesthetized and randomly divided into four groups. Group 1 (n = 10) was the sham operated group. Group 2 (n = 10), the control group, received head trauma and no treatment. Group 3 (n = 10) received head trauma and intravenous (IV) 2 microgr/kg nimodipine. Group 4 (n = 10) received head trauma and IV 100 mg/kg MgSO4. Head trauma was delivered by performing a craniectomy over the right hemisphere and dropping a weight of 20 g from a height of 40 cm. In the right (traumatized) hemisphere, SOD and GPx decreased by 57.60% +/- 9.60% and 72.93% +/- 5.51% respectively from sham values. Magnesium sulfate, but not nimodipine, reduced the magnitude of decrease of SOD and GPx to 19.43% +/- 7.15% and 39.01% +/- 7.92% respectively from sham values. In the left (nontraumatized) hemisphere, MgSO4 increased SOD to 42.43% +/- 24.76% above sham values. The authors conclude that MgSO4 treatment inhibited the decrease in SOD and GPx levels in experimental brain injury.

Effects of magnesium sulfate on tissue lactate and malondialdehyde levels in experimental head trauma.

OBJECTIVE: To determine the effects of magnesium sulfate (MgSO4) on tissue lactate and malondialdehyde (MDA) levels in rabbit brain after experimental head trauma. DESIGN: Prospective, randomized trial. SUBJECTS: Thirty New Zealand rabbits. INTERVENTIONS: Group 1 (n = 10) was the sham operated group. Group 2 (n = 10) (untreated group) and group 3 (n = 10) received head trauma with the weight drop method. MgSO4 was administered 100 mg/kg (15 %) i. v. immediately after the head trauma to group 3. Trauma was applied to one side. The non-contused side was named as "a" and the contused side as "b". MEASUREMENTS: One hour after trauma, brain cortices were resected and the concentrations of lactate and MDA were determined using the spectrophotometric enzymatic and thiobarbituric acid methods. One-way ANOVA and Tukey's HSD tests were used for the evaluation of the results. P < 0.05 was considered as significant. Pearson's correlation test was used between lactate and MDA levels (P < 0.001). RESULTS: There were significant differences between MDA and lactate levels of group 1 and all other groups; non-contused (a) and contused (b) sides of groups 2 and 3; groups 2b-3a, 2b-3b (P < 0.05). The difference in MDA levels was significant between groups 2a-3b (P < 0.05). Correlation between lactate and MDA was very good in group 1, and excellent in groups 2a, 2b, 3a, and 3b. CONCLUSIONS: These results demonstrate that head trauma leads to an increase in brain tissue lactate and MDA levels, and MgSO4 suppresses the rise in contused tissue when given after head trauma.

Effect of oral glucose loading on serum gastrin level in pregnant and non-pregnant women.

AIM: To evaluate the relationship between the changes in gastrin and insulin serum concentrations after oral glucose loading in pregnant and non-pregnant women. METHODS: Thirty women, 12 pregnant and 18 non-pregnant, with normal fasting glucose values were included in the study. Serum concentrations of gastrin, glucose, insulin, and glucagon were analyzed at 0 (t1), 30 (t2) and 60 (t3) minutes after 75 g oral glucose loading. Gastrin, insulin, and glucagon levels were determined by means of radioimmunoassay kits. RESULTS: Serum gastrin concentration in pregnant women increased insignificantly (gastrin median values 57.91, 70.62, and 68.70 for t1, t2, and t3, respectively; Friedman's test, p = 0.264). In non-pregnant women gastrin levels insignificantly increased from t1 to t2, but reduced significantly from t2 to t3 (gastrin median values 62.91, 86.92, and 62.25 for t1, t2 and t3, respectively; Bonferroni adjusted Wilcoxon test, p = 0.002). Unlike in pregnant women, the changes in gastrin release in non-pregnant women were associated with changes in blood glucose concentrations at t2 and t3, which were induced by oral glucose loading. Glucose median values were 7.48 and 6.43 for t2 and t3, respectively. The insulin release due to the oral glucose loading markedly increased at t2 and t3 (Friedman's test, p < 0.001), whereas glucagon release decreased irrespective of pregnancy. CONCLUSION: Changes in blood glucose concentrations induced by oral glucose loading could influence gastrin release, especially in non-pregnant women. Changes in insulin and glucagon levels induced by oral glucose loading, particularly after 60 minutes, could not be associated with changes in gastrin release.

The effects of splenic artery ligation in an experimental model of secondary hypersplenism.

OBJECTIVE: To induce hypersplenism in rats by splenic vein ligation and to investigate the effects of splenic artery ligation in this model. BACKGROUND: Selective arterial embolisation and splenic artery ligation (SAL) are used in the treatment of secondary hypersplenism in some medical centres but these methods are not common. MATERIALS AND METHODS: Thirty male Saprague-Dawley rats were allocated to three groups (n = 10). The first group underwent laparotomy, the second and third groups underwent laparotomy and splenic vein ligation. At the end of the third week, laparotomy was performed in the first and second groups and splenic artery ligation in the third group. Erythrocyte, leukocyte and platelet counts were performed weekly. At the end of the sixth week, the animals were sacrificed and the spleens were taken for histopathologic examination. RESULTS: In the second and third groups, after splenic vein ligation, the erythrocyte and platelet counts were significantly reduced at the end of the second week (p < 0.01). In the second group, which underwent splenic vein ligation only, the levels remained low throughout the experiment. In the third group, after splenic artery ligation, there were rises in both erythrocyte and platelet counts; the levels were similar to the levels in the control group at three weeks after splenic artery ligation (p > 0.05). No significant changes were observed in the leukocyte counts throughout the experiment (p > 0.05). CONCLUSIONS: Splenic vein ligation successfully induces experimental secondary hypersplenism. This state can be ameliorated by splenic artery ligation.

The impact of oral feeding on the severity of acute pancreatitis.

BACKGROUND: In the management of acute pancreatitis, oral feeding is prohibited and either enteral or parenteral feeding is commenced for the patients in an effort to not increase the secretion of the pancreatic enzymes. PURPOSE: This study was undertaken in an attempt to determine the impact of oral feeding on the severity of acute pancreatitis and to compare this impact with that of parenteral feeding. MATERIALS AND METHODS: Twenty-four female Sprague-Dawley rats were divided into two groups. In both groups, acute pancreatitis was induced by ligation of the main biliopancreatic duct. The rats in group I were fed orally and the rats in group II were fed parenterally. The rats were sacrificed at 48 hours, and blood samples were obtained from the heart upon exposure of the abdominal and thoracic cavities. The pancreas and the left lung were removed for histopathological examination. The levels of lactic dehydrogenase (LDH), serum glutamic oxaloacetic transaminase (SGOT), glucose, calcium and blood urea nitrogen, base deficit, partial oxygen pressure, leukocyte count, and hematocrit level among Ranson criteria and the level of amylase were measured. The pancreas and the lung were examined under a light microscope. RESULTS: The levels of LDH, SGOT, and calcium for the rats in group I were significantly higher when compared with the rats in group II (P <0.05). Similarly, the levels of amylase for the rats in group I were found to be higher when compared with the rats in group II, but the difference was not significant. Inflammatory changes observed in the pancreas were less severe whereas inflammatory changes observed in the lung were more severe for the rats in group I when compared with the rats in group II. CONCLUSION: The blood levels of the enzymes were adversely affected for the rats fed orally. In contrast, inflammatory changes observed in the pancreas were more severe for the rats fed parenterally. The study suggests that certain hormones released from the duodenum upon stimulation by oral nutrient intake lessens the severity of pancreatitis through protective effects on the pancreas, whereas the elevated levels of the enzymes cause endothelial damage resulting in destruction in distant organs such as the lung.