The impact of cigarette cost on pack sales per capita consumption in the United States.

OBJECTIVES: Evidence suggests that cigarette costs significantly impact tobacco use, yet the effect of state-level cost variations on cigarette sales per capita in the US remains uncertain. This study investigates how state-level cigarette costs affect pack sales per capita consumption. STUDY DESIGN: This was an observational study of cigarette-pack sales per capita consumption in the United States. METHODS: We used the tobacco tax burden data (1989-2019) and a two-way fixed-effects model to analyse how cigarette costs affect consumption. Our predictor variables were average cost per pack, state tax per pack, and combined federal and state tax as a percentage of the retail price. Additionally, we compared the percentage change in state cigarette taxes per pack for each state in five-year intervals, adjusting for inflation. RESULTS: Regression analysis revealed that a 10% increase in the average cost per pack was related to a 9.59% decrease in per capita cigarette consumption (ß_average cost = -0.959, P < 0.001). Similarly, a rise in state tax per pack and a higher tax as a proportion of the retail price per pack were related to a decline in consumption (ß_ state tax = -0.176, P < 0.001), (ß_retail price = -0.323, P < 0.001). States that raised cigarette taxes beyond the rate of inflation had a higher reduction in cigarette per capita sales than those maintaining stable tax rates. CONCLUSIONS: Some states have not raised their cigarette taxes sufficiently to account for inflation. It appears that cigarette costs have significantly reduced cigarette consumption in the US.

Evaluation of personalized methylprednisolone therapy in critically ill COVID-19 patients: an observational comparative study using real-life data.

OBJECTIVE: Methylprednisolone is commonly used to attenuate the cytokine storm and prevent mortality in COVID-19 pneumonia. However, the optimal methylprednisolone dose and duration are unclear. Additional data are required on the effectiveness of methylprednisolone in reducing mortality in COVID-19. This real-life retrospective study aimed to analyze the data of a COVID-19 dedicated ICU and compare the mortality rates of standard care, low-dose, and pulse-dose methylprednisolone in patients requiring mechanical ventilatory support. PATIENTS AND METHODS: Methylprednisolone's indication, dose, and duration were determined according to the severity of COVID-19 pneumonia based on the patient's demographic parameters, comorbidities, laboratory data, radiology, and arterial blood gas analysis results. 867 patients were grouped as: no methylprednisolone (standard care), low-dose (0.5-1 mg/kg/day) methylprednisolone or pulse-dose (250-1,000 mg/day) methylprednisolone. RESULTS: The overall mortality rate was 63.78%. Adjusting the dose of methylprednisolone according to the severity of the disease resulted in statistically similar mortality rates despite the increase in disease severity. Mortality was 62.71% in standard treatment, 65.76% in low-dose, and 62.10% in pulse-dose methylprednisolone groups (p = 0.633). Invasive mechanical ventilation at admission was associated with increased mortality (HR: 1.826 [95% CI: 1.542-2.161]; p < 0.001). Hematologic disorders and malignancies, arterial blood pH and HCO3, neutrophil count, and NLR at admission were also associated with mortality. CONCLUSIONS: Personalizing the dose and duration of methylprednisolone according to the patient's disease severity assessed with demographic, clinical, and laboratory results may benefit mortality in severe COVID-19 patients receiving ventilatory support in the ICU. Hematologic disorders and malignancies, arterial blood pH and HCO3, neutrophil count, and NLR at admission were associated with mortality in our patient cohort.

Endothelial nitric oxide synthase G894T, intron 4 VNTR, and T786C polymorphisms in retinopathy of prematurity.

BACKGROUND: Our objective in this study was to assess the association between eNOS gene, that achieves synthesis of nitric oxide especially in the endothelial cells known to have an important role in angiogenesis and vasculogenesis, G894T, intron 4 VNTR (27-bp repeat) and T786C functional polymorphisms and retinopathy of prematurity (ROP), which is an important cause of morbidity in premature or low birth weight babies. METHODS: A total of 139 babies who were followed up in our neonatal intensive care unit because of premature birth in our hospital or admitted to our unit. 69 of them had retinopathy of prematurity and comprised the patients group. The remaining 70 babies who did not have ROP comprised the control group. An additional of 1 ml of blood samples were drawn from babies who were in the study groups during routine laboratory analysis. eNOS gene polymorphisms were determined by using polymerase chain reaction method. RESULTS: eNOS G894T, intron 4 VNTR and T786C gene polymorphisms did not differ between the patient and control groups (p > 0.05). Using logistic regression analysis; while gender did not differ between two groups; gestational age, birth weight, time on mechanical ventilation differ between two groups. After adjustment for variables other than eNOS gene polymorphisms, we found no significant difference in the genotype distribution of eNOS G894T, intron 4 VNTR and T786C polymorphisms (p > 0.05). CONCLUSION: We observed no association between ROP and eNOS gene polymorphisms but needs more investigation.

Synthesis and biological characterization of Mn0.5Zn0.5EuxDyxFe1.8-2xO4 nanoparticles by sonochemical approach.

Metallic nanoparticles (NPs) possess unique properties which makes them attractive candidates for various applications especially in field of experimental medicine and drug delivery. Many approaches were developed to synthesize divers and customized metallic NPs that can be useful in many areas such as, experimental medicine, drug design, drug delivery, electrical and electronic engineering, electrochemical sensors, and biochemical sensors. Among different metallic nanoparticles, manganese (Mn) NPs are the most prominent materials, in the present study, we have synthetized unique Mn0.5Zn0.5DyxEuxFe1.8-2xO4 NPs by using ultrasonication method (x ≤ 0.1). The structure, and surface morphology of Mn0.5Zn0.5DyxEuxFe1.8-2xO4 NPs was characterized by XRD, SEM, TEM and EDX methods. We have examined the biological effects of Mn0.5Zn0.5DyxEuxFe1.8-2xO4 NPs on both normal (HEK-293) and cancerous (HCT-116) cells. We have found that the treatment of Mn0.5Zn0.5DyxEuxFe1.8-2xO4 NPs post 48 h, showed significant decline in cancer cells population as revealed by MTT assay. The IC50 value of Mn0.5Zn0.5DyxEuxFe1.8-2xO4 NPs was ranged between (2.35 µg/mL to 2.33 µg/mL). To check the specificity of the actions, we found that the treatment of Mn0.5Zn0.5DyxEuxFe1.8-2xO4 NPs did not produce any effects on the normal cells, which suggest that Mn0.5Zn0.5DyxEuxFe1.8-2xO4 NPs selectively targeted the cancerous cells. The anti-bacterial properties of Mn0.5Zn0.5DyxEuxFe1.8-2xO4 NPs were also evaluated by MIC and MBC assays. We suggest that Mn0.5Zn0.5DyxEuxFe1.8-2xO4 NPs produced by sonochemical method possess potential anti-cancer and anti-bacterial capabilities.

Plasma irisin and its associations with oxidative stress in athletes suffering from overtraining syndrome.

Irisin is a novel exercise-induced myokine that may be involved in regulating energy metabolism. We determined whether overtraining syndrome (OTS) and its biochemical markers are associated with plasma irisin levels in athletes. Seven severely overtrained athletes (OA) and 10 healthy control athletes (CA) were recruited and examined at the time of diagnosis (baseline) and after 6- and 12-months follow-up. Training volume and intensity were initially restricted but progressively increased in OA as OTS symptoms alleviated; CA continued their normal training routine. A maximal cycle ergometer test was performed with irisin analyzed before and after the test. Before the exercise test, irisin levels tended to be lower in OA than in CA at baseline (154.5 ± 28.5 vs. 171.7 ± 58.7 ng/mL). In both groups, at rest irisin levels changed only marginally during follow-up and were not affected by maximal exercise, nor were they associated with physical performance or body fat percentage. Irisin concentration at rest correlated positively with an oxidative stress marker, malondialdehyde (MDA) and negatively with an antioxidant protection marker, oxygen radical absorbance capacity (ORAC) in response to the exercise test in OA at baseline. Our findings help to clarify the possible contribution of irisin and its association with oxidative stress in the pathophysiology of OTS.

Clinical characteristics and prognosis of cardiac tamponade patients: 5­year experience at a tertiary center.

BACKGROUND: Cardiac tamponade (CT) is characterized by compression of the cardiac chambers due to pericardial fluid accumulation. The etiology and prognosis may vary in different regions, and thus patient series from various regions can be useful for exploring the etiological and prognostic disparities. The aim of this study was to determine the clinical characteristics of patients with imminent CT, to evaluate the diagnostic performance of biochemical, microbiologic, and pathologic laboratory analysis, and to ascertain the prognosis of CT patients. METHODS: We enrolled all patients with imminent CT who underwent percutaneous pericardiocentesis between July 2012 and December 2017 in this retrospective study. The patients were classified into three etiology groups: (a) malignancy (MRCT); (b) iatrogenic/mechanical complication of myocardial infarction (IMCT); and (c) other causes (OCT). Clinical information, laboratory findings, and survival data were recorded. RESULTS: In total, 186 pericardiocentesis procedures were performed on 153 consecutive patients with CT. The median follow-up was 137 days (range: 1-1937). The MRCT group had the highest mortality rate (79%) in 12 months, while the OCT group had the lowest rate (27%). We determined that increased age, higher serum urea levels, and malignancy-related CT were independent predictors of mortality. The mortality rates of the MRCT and IMCT groups were similar, with both of them being significantly higher than the rate of the OCT group. In all, 15 patients were diagnosed with a new malignancy via pericardial fluid cytology. CONCLUSION: Patients in the MRCT and IMCT groups had a poor prognosis. The presence of malignancy was found to be the most powerful predictor of mortality in CT patients.

A study on the spectral, microstructural, and magnetic properties of Eu-Nd double-substituted Ba0.5Sr0.5Fe12O19 hexaferrites synthesized by an ultrasonic-assisted approach.

In this study, an examination on the spectral, microstructural, and magnetic characteristics of Eu-Nd double-substituted Ba0.5Sr0.5Fe12O19 hexaferrites (Ba0.5Sr0.5NdxEuxFe12-2xO19 (x = 0.00-0.05) HFs) fabricated by an ultrasonic-assisted approach has been presented. An UZ SONOPULS HD 2070 ultrasonic homogenizer with frequency of 20 kHz and power of 70 W was used. The chemical bonding, structure and the morphology of the products were evaluated by Fourier-Transform Infrared (FT-IR) Spectroscopy, XRD (X-ray diffraction), scanning and transmission electron microscopy and techniques. The textural properties of the prepared nanomaterials were examined by using the Brunauer-Emmett-Teller (BET) method. The magnetic properties were studied using a vibrating sample magnetometer (VSM) at room temperature (RT) and low temperature 10 K. The magnitudes of various magnetic parameters including Ms (saturation magnetization), Mr (remanence) and Hc (coercivity) were estimated and evaluated. The M-H loops revealed the hard ferrimagnetic nature for all products at both temperatures. The Ms and Mr values showed a decreasing tendency with increasing degree of Eu3+ and Nd3+ substitutions whereas Hc values displayed an increasing trend. At RT, Ms, Mr and Hc values lie in the ranges of 63.0-68.8 emu·g-1, 24.6-39.2 emu·g-1 and 2252.4-2782.1 Oe, respectively. At 10 K, the values of Ms, Mr and Hc lie between 87.5-97.1 emu·g-1, 33.5-40.1 emu·g-1 and 2060.6-2417.2 Oe, respectively. The observed magnetic properties make the prepared products promising candidates to be applied in the recording media.

Sonochemical synthesis of Dy3+ substituted Mn0.5Zn0.5Fe2-xO4 nanoparticles: Structural, magnetic and optical characterizations.

Mn0.5Zn0.5DyxFe2-xO4 (x ≤ 0.03) nanoparticles (NPs) were fabricated by using Ultrasonic irradiation using UZ SONOPULS HD 2070 ultrasonic homogenizer (frequency of 20 kHz and power of 70 W). Structural and morphological analyses were performed via XRD (X-ray powder diffractometer), TEM (Transmission electron microscopy) and SEM (Scanning electron microscopy). XRD presented the formation of Mn-Zn ferrite with average crystal size in 11 to 18 nm range. Direct optical energy band gaps (Eg) were specified applying diffuse reflectance investigations. Eg values are in a small band range of 1.61-1.67 eV. Low (10 K) and room temperature VSM data were recorded applying ±90 kOe external magnetic field. All samples exhibit superparamagnetic properties at RT. Magnetization parameters significantly increase due to coordination of Dy3+ rare earth ions. Magnetic moment per molecule (nB) increases from 0.952 µB to 1.137 µB and from 2.312 µB to 2.547 µB at RT and at 10 K data respectively. 10 K coercivity (Hc) values decrease from 260 Oe to 43 Oe. All samples have squareness ratios (SQR) of 0.231-0.400 range assigning the multi-domain structure at 10 K. ZFC-FC magnetization curves that were registered for two selected samples exhibit a divergence and a sharp drop below their Tpeak positions. This event is typically correlated to the collective freezing of system and spin-glass-like phase. Real part AC susceptibility data slightly shift toward high temperature regions with increasing frequencies. Critical Slowing Down (CSD) model explained the spin dynamics of interacting NPs consistently with literature and proved the spin-glass behavior of samples at low temperatures.

Ni0.4Cu0.2Zn0.4TbxFe2-xO4 nanospinel ferrites: Ultrasonic synthesis and physical properties.

The Fe3+ ions were replace with Tb3+ ions as highly paramagnetic rare earth element within the structure of Ni0.4Cu0.2Zn0.4Fe2O4 nano-spinel ferrites (NSFs). The structural, magnetic, spectroscopic and optic properties have been studied in details. All products have been synthesized via ultrasonic approach via Qsonica ultrasonic homogenizer, frequency: 20 kHz and power: 70 W for 60 min. No annealing or calcination process was applied for any product. The microstructural analysis of products has been done via X-ray powder diffractometry (XRD) which presented the cubic spinel structure with nanosized distribution of all. The cubic morphology of all products were confirmed by both HR-TEM and FE-SEM. Optical band gap (Eg) values were assessed by applying %DR (percent diffuse reflectance) analysis and Kubelka-Munk theory. The Tauc schemes showed that Eg values are in a narrow range (1.87-1.98 eV). The quadrupole splitting, line width, hyperfine magnetic field, isomer shift values and cation distribution have been determined from 57Fe Mossbauer analysis. The magnetic properties of various nanoparticles have been obtained from VSM (vibration sample magnetometer) measurements at 10 and 300 K (RT). The magnetic results revealed superparamagnetic and soft ferromagnetic traits at 10 and 300 K, respectively. Ms (saturation magnetization) and Mr (remanence) initially increase with increasing Tb3+ substituting level up to x = 0.06 then diminish for further x values. Hc (coercivity) shows an opposite variation tendency of Ms and Mr. The observed magnetic traits are deeply discussed in relation with the structure, morphology, magnetic moments and cation distributions.

Sonochemical synthesis and physical properties of Co0.3Ni0.5Mn0.2EuxFe2-xO4 nano-spinel ferrites.

Nanoparticles (NPs) of composition Co0.3Ni0.5Mn0.2EuxFe2-xO4, where 0.00 ≤ x ≤ 0.10 (hereafter called CNMEuF) were synthesized by sonochemical approach using UZ SONOPULS HD 2070 ultrasonic homogenizer (frequency of 20 kHz and power of 70 W). As-synthesized samples were characterized thoroughly to determine the effects of europium ions (Eu3+) substitution on their structure, morphology and magnetic traits. Structural analyses of the synthesized NPs confirmed their high purity and crystalline cubic phases. Percent diffuse reflectance (%DR) data and Kubelka-Munk theory were exploited to evaluate the optical band gap energies of the studied CNMEuF NPs. Values of optical band gap energies obtained from the Tauc plots were observed in the range of 1.47-1.58 eV. The hysteresis loops (at room temperature and 10 K) of synthesized NPs were analyzed to determine their magnetic properties. These NPs disclosed superparamagnetic and hard ferrimagnetic character at room temperature and 10 K, respectively. With exception, the sample with x = 0.10 revealed soft ferrimagnetic behavior at 10 K. Eu3+ doping was shown to have significant influence on the structure and magnetic attributes of the proposed CNMEuF NPs. Values of various magnetic parameters of proposed compositions were reduced with the increase in Eu3+ dopant contents.

Sonochemical synthesis of Eu3+ substituted CoFe2O4 nanoparticles and their structural, optical and magnetic properties.

Magnetic, optic and microstructural properties of ultrasonically synthesized CoEuxFe2-xO4 (x ≤ 0.1) nanoferrites (NFs) have been examined in this study. After sonochemical synthesis, XRD and FT-IR analyses confirmed the purity, the structure (cubic spinel structure and Fd3m space group) and the spectral properties of the spinel ferrite samples. The spherical morphology and chemical compositions of the products were observed via transmission and scanning electron microscopes along with EDX and elemental mapping. Percent diffuse reflectance (%DR) was used for optical investigation. Optical band gaps (Eg) were estimated utilizing Kubelka-Munk theory and Tauc equation. Eg values are in a narrow band of 1.34 to 1.44 eV. The magnetic parameters like Ms (saturation magnetization), SQR = Mr/Ms (squareness ratio), nB (magnetic moment), Hc (coercivity) and Mr (remanence) have been evaluated by analyzing measurements of magnetization versus magnetic field performed at room (RT; T = 300 K) and low (T = 10 K) temperatures. It is showed that the different produced CoEuxFe2-xO4 (0.00 ≤ x ≤ 0.10) nanospinel ferrites present superparamagnetic (SPM) nature at RT. At low temperature, the various produced CoEuxFe2-xO4 (x ≤ 0.08) nanospinel ferrites display ferrimagnetic (FM) nature. With exception, the x = 0.10 sample exhibit SPM behavior at T = 10 K. It is noticed that the Eu3+ substitutions alter in a significant way on the magnetic data. A decreasing trend in the Ms, Mr and nB values was noted with Eu3+ substitutions.

Structural, optical and magnetic properties of Tm3+ substituted cobalt spinel ferrites synthesized via sonochemical approach.

Co-Tm nano-spinel ferrite with chemical formula CoTmxFe2-xO4 (0.0 ≤ x ≤ 0.08) NPs were prepared via sonochemical approach. X-ray powder diffraction patterns, microscopic images (SEM and TEM) and infrared spectra proved the formation of Co spinel ferrite. The effect of Tm3+ substituted on spinal structure was evaluated by lattice parameters, tetrahedral and octahedral bond length and cationic distribution. The band gap energy (Eg) of samples were estimated by performing UV-Vis percent diffuse reflectance (% DR) and applying the Kubelka-Munk theory. Eg values are in an interval between 1.33 eV and 1.64 eV. The analyses of magnetization were performed at room (300 K; RT) and low (10 K) temperatures. Different magnetic parameters including coercivity Hc, saturation magnetization Ms, remanence Mr, squareness ratio (SQR = Mr/Ms) and magnetic moment nB were deduced and discussed. The results showed superparamagnetic (SPM) nature at RT for x = 0.00 and 0.02 samples. However, the other products exhibit ferromagnetic (FM) nature. At 10 K, all synthesized NPs display FM behavior. An amazing increase in the magnitudes of Ms, Mr and Hc was observed at 10 K in comparison to RT, which is principally due to the reduced thermal fluctuations of magnetic moments at lower temperatures. The Tm3+ substitution affects considerably the magnetizations data. An enhancement in the Ms, Mr, and nB was detected on increasing the Tm3+ concentration. The SQR values at RT are found to be smaller than 0.5 postulating a single domain nature with uniaxial anisotropy for all produced ferrites. However, SQRs are in the range 0.66-0.76 at 10 K, suggesting the multi magnetic domain at low temperature, except the x = 0.02 product where the SQR = 0.47 indicating the single magnetic domain. The obtained magnetic results were investigated deeply with relation to structural and microstructural properties.

Impact of La3+ and Y3+ ion substitutions on structural, magnetic and microwave properties of Ni0.3Cu0.3Zn0.4Fe2O4 nanospinel ferrites synthesized via sonochemical route.

In the current study, Ni0.4Cu0.2Zn0.4La x Y x Fe2-x O4 (x = 0.00 - 0.10) nanospinel ferrites (NSFs) were fabricated via an ultrasonic irradiation route. The creation of single phase of spinel nanoferrites (NSFs) was investigated by X-ray powder diffractometry (XRD) and selected area diffraction pattern (SAED). The cubic morphology of all samples was confirmed by scanning and transmission electron microscopies (SEM and TEM) respectively. The UV-Vis investigations provided the direct optical energy band gap values in a narrow photon energy interval of 1.87-1.92 eV. The 57Fe Mössbauer spectroscopy analysis explained that the hyperfine magnetic fields of Octahedral (Oh) and Tetrahedral (Td) sites decreased with substitution. The paramagnetic properties of NPs decrease with increase of content of doped ions. Investigations of magnetic properties reveal a superparamagnetic nature at 300 K and soft ferromagnetic trait at 10 K. The M s (saturation magnetization) and M r (remanence) decrease and the H c (coercivity) increases slightly with La3+ and Y3+ substitution. The observed magnetic traits are deeply discussed in relation with the morphology, structure, magnetic moments and cation distributions. The microwave characterization of the prepared NSFs showed that, dissipation (i.e., absorption) of incoming microwave energy occurs at a single frequency, for each sample, lying between 7 and 10.5 GHz. The reflection losses (RL) at these frequencies range from -30 to -40 dB and the mechanism of which is explained in the framework of dipolar relaxation and spin rotation. The best microwave properties were obtained with a LaY concentration of x = 0.08 having an RL of -40 dB @ 10.5 GHz and an absorption bandwidth of 8.4 GHz @ -10 dB. With these high values of RL and absorbing bandwidth, LaY doped NiCuZn NSF products would be promising candidates for radar absorbing materials in the X-band.

Contribution of fragmented QRS on myocardial perfusion imaging in the assessment of functionally significant coronary artery stenoses.

OBJECTIVE: The evaluation of the functional significance of coronary artery stenosis is of great clinical importance in patient management or for decisions concerning coronary intervention. Recently, fragmented QRS (fQRS) on electrocardiography (ECG) has been introduced as a predictor of myocardial scarring as well as myocardial ischaemia in coronary artery disease. We aimed to investigate any additive value of fQRS to myocardial perfusion SPECT in evaluating the functional significance of the intermediate degree of coronary stenosis. PATIENTS AND METHODS: Patients who were referred for myocardial perfusion imaging (MPI) to evaluate the functional significance of intermediate (40-70%) coronary artery stenosis were analyzed retrospectively; 102 patients were included in the study. ECG records were evaluated to detect fQRS. MPI was interpreted visually and semiquantitatively by two nuclear medicine physicians blinded to the electrocardiographic findings. Summed stress scores (SSS), summed rest scores and summed difference scores (SDS) were calculated according to the 17-segment model. RESULTS: The mean age of the patients was 62.56±9.5 years, and 64 were males (62.7%). Ischaemia was detected in 30 patients, and the frequency of fQRS was significantly higher in patients with ischaemia than in patients with normal perfusion (54.8% vs. 23.8%, respectively; p<0.001). Myocardial scarring was detected in 15 patients, 7 of whom had coexistent myocardial ischaemia. fQRS was positively correlated with the SSS (r=374, p=0.001), SDS (r=0.460, p=0.001) and summed motion score (r=0.228, p=0.024). fQRS was an independent predictor of myocardial ischemia in multivariate analyses (OR=11.181; CI=3.900-32.057; p<0.001). CONCLUSIONS: The presence of fQRS on ECG is associated with myocardial ischaemia in patients who had an intermediate degree of coronary stenosis.

Association of plasma fatty acid composition with plasma irisin levels in normal weight and overweight/obese children.

BACKGROUND: Irisin has been suggested to protect against overweight. There are no previous data on the association of plasma fatty acid (FA) composition with plasma irisin. OBJECTIVES: We studied the association of FA composition with plasma irisin in normal weight and overweight/obese children. METHODS: This cross-sectional study included pre-pubertal children (388 normal weight children and 55 overweight/obese children); 6-9 years of age, taking part in the Physical Activity and Nutrition in Children Study. After an overnight fast, we measured plasma FA composition by gas chromatography and plasma irisin levels by enzyme-linked immunosorbent assay. RESULTS: Higher proportion of total monounsaturated fatty acids in plasma cholesteryl esters (CEs) (ß = 0.139, P = 0.003) and phospholipids (PLs) (ß = 0.147, P = 0.002) and lower proportion of total polyunsaturated fatty acids in plasma CE (ß = -0.130, P = 0.006) and PL (ß = -0.165, P < 0.001) were associated with higher plasma irisin level in the whole study group. The association of plasma FA composition with plasma irisin level was stronger among overweight/obese children compared to normal weight children. Higher proportion of γ-linolenic acid (ß = 0.324, P = 0.017) and lower proportion of linoleic acid (ß = -0.397, P = 0.005) in plasma CE were related to higher plasma irisin level among overweight/obese children, indicating the direct association of estimated D6D activity in plasma CE (ß = 0.343, P = 0.011) with plasma irisin. Furthermore, higher proportion of oleic acid in plasma CE (ß = 0.345, P = 0.012) and PL (ß = 0.292, P = 0.033) and higher proportion of adrenic acid (ß = 0.366, P = 0.008) and docosapentaenoic acid (ß = 0.351, P = 0.010) in plasma PL were associated with higher plasma irisin level among overweight/obese children. CONCLUSION: Metabolically unfavourable plasma FA profile was associated with higher plasma irisin level especially in overweight/obese children, suggesting that excess body fat might modulate these relationships.

Decreased thioredoxin-1 and increased HSP90 expression in skeletal muscle in subjects with type 2 diabetes or impaired glucose tolerance.

In diabetes, the endogenous defence systems are overwhelmed, causing various types of stress in tissues. In this study, newly diagnosed or diet-treated type 2 diabetics (T2D) (n = 10) were compared with subjects with impaired glucose tolerance (IGT) (n = 8). In both groups, at resting conditions, blood samples were drawn for assessing metabolic indices and skeletal muscle samples (m. vastus lateralis) were taken for the measurements of cellular defence markers: thioredoxin-1 (TRX-1) and stress proteins HSP72, HSP90. The protein level of TRX-1 was 36.1% lower (P = 0.031) and HSP90 was 380% higher (P < 0.001) in the T2D than in the IGT subjects, with no significant changes in HSP72. However, after the adjustment of both analyses with HOMA-IR only HSP90 difference remained significant. In conclusion, level of TRX-1 in skeletal muscle tissue was lower while that of HSP90 was higher in T2D than in IGT subjects. This may impair antioxidant defence and lead to disruptions of protein homoeostasis and redox regulation of cellular defences. Because HSP90 may be involved in sustaining functional insulin signalling pathway in type 2 diabetic muscles and higher HSP90 levels can be a consequence of type 2 diabetes, our results are potentially important for the diabetes research.

Drug-mediated ototoxicity and tinnitus: alleviation with melatonin.

This review evaluates the published basic science and clinical reports related to the role of melatonin in reducing the side effects of aminoglycosides and the cancer chemotherapeutic agent cisplatin, in the cochlea and vestibule of the inner ear. A thorough search of the literature was performed using available databases for the purpose of uncovering articles applicable to the current review. Cochlear function was most frequently evaluated by measuring otoacoustic emissions and their distortion products after animals were treated with cytotoxic drugs alone or in combination with melatonin. Vestibular damage due to aminoglycosides was evaluated by estimating hair cell loss in explanted utricles of newborn rats. Tinnitus was assessed in patients who received melatonin using a visual analogue scale or the Tinnitus Handicap Inventory. Compared to a mixture of antioxidants which included tocopherol, ascorbate, glutathione and N-acetyl-cysteine, melatonin, also a documented antioxidant, was estimated to be up to 150 times more effective in limiting the cochlear side effects, evaluated using otoacoustic emission distortion products, of gentamicin, tobramycin and cisplatin. In a dose-response manner, melatonin also reduced vestibular hair cell loss due to gentamicin treatment in explanted utricles of newborn rats. Finally, melatonin (3 mg daily) limited subjective tinnitus in patients. These findings suggest the potential use of melatonin to combat the ototoxicity of aminoglycosides and cancer chemotherapeutic agents. Additional studies at both the experimental and clinical levels should be performed to further document the actions of melatonin at the cochlear and vestibular levels to further clarify the protective mechanisms of action of this ubiquitously-acting molecule. Melatonin's low cost and minimal toxicity profile supports its use to protect the inner ear from drug-mediated damage.

The effects of levothyroxine substitution on body composition and body mass after total thyroidectomy for benign nodular goiter.

OBJECTIVE: Many patients who have undergone total thyroidectomy complain about weight gain and changes in body composition. This prospective study was designed to evaluate the effect of thyroxine replacement on body mass index (BMI) and body composition following total thyroidectomy for benign multinodular goiter. METHODS: Thirty-three consecutive patients were enrolled. The patients of those histopathological examination revealed carcinoma (n=5) and who did not present for the 6th month follow-up visit (n=6) were excluded. Thyroxine (T4, 100 µg, dose range 50-200 µg) was started in all patients immediately after the surgery and adjusted according to plasma TSH and FT4-FT3 levels in the postoperative 3rd week and postoperative 3rd and 6th months respectively to achieve optimal TSH within normal reference range (0.5- 4.2 mU/L). Changes in weight, BMI and anthropometric measurements were performed preoperatively and in the postoperative 3rd and 6th months. RESULTS: The study completed with 22 patients (17 female and 5 male, mean: 45.8 years; range: 26-64 years). Fourteen patients maintained euthyroid status and eight had subclinical hypothyroidism. There were no significant differences between the subclinical hypothyroid and euthyroid patients in BMI and the other anthropometric values (p>0.05). In the comparisons for age, there were significant changes with regarding weight and BMI. Increases in weight were noted as 2.2±2.7 kg in age over 45 (n= 14, mean: 52.7 years, range: 46-64 years), while 0.1±1.3 kg in age under 45 years (mean; 33.8, range: 26-43 years) and BMI as 0.8±1.0 in age over 45 years compared to 0.04±0.5 in age under 45 years, respectively (p=0.025 and p=0.029, respectively). No significant differences were noted in other anthropometric parameters at the end of 6th month compared to the baseline value except the triceps skin fold (p=0.027). CONCLUSION: Levothyroxine replacement had no effect on their body composition; however, age was found to be an important factor for weight gain and change in BMI during the midterm follow-up period.

Sunrise-related headache: case report.

A male, 34 years of age, suffers from headaches, red and watery eyes. The headaches began in childhood; the frequency of headaches has increased over the years and in the last decade headaches have occurred on a daily basis. If he wakes up before sunrise he feels much better and free of a headache; however, once he continues to sleep during and after sunrise, he suffers from tiredness, headache and nervousness. On magnetic resonance imaging (MRI), benign neuroepithelial cysts or a chronic infarct area was reported at the junction of the left medio-lateral zone of hypothalamus. After repeated MRI examinations, it was decided that the lesion on the left medio-lateral zone of hypothalamus may have disrupted the pineal gland and changed melatonin secretion. It was decided to treat him with 3 mg melatonin daily before going to bed. After a week of treatment, the patient reported that he felt very fresh and was virtually free of headaches.

Contribution of the amount of contrast media used in pulmonary CT angiography to assess the diagnostic value of CT venography; comparison of 100 and 150ml of contrast media.

AIM: To prospectively compare the vascular attenuation achieved with 100ml iohexol (350mgI/ml) 75% with that achieved with 150ml iohexol (350mgI/ml) 75% for computed tomography (CT) venography, which was performed after CT pulmonary angiography. MATERIALS AND METHODS: A total of 122 patients were included in the study. Group A, comprising 52 patients (mean age 64.8 years, mean body weight 70.8kg) received 150ml iohexol (350mgI/ml) contrast media. Group B, comprising 70 patients (mean age 61.2 years, mean body weight 71.4kg) received 100ml iohexol (350mgI/ml) contrast medium. RESULTS: Venous opacification values measured at all levels were significantly higher in group A than those in group B (p<0.001). In group B the mean HU values were between 87 and 115 and only three of the patients had HU values less than 60 at the level of femoral vein. Assuming a venous enhancement of 80HU as the cut-off value for accurate diagnosis of deep venous thrombosis, 22.8% (16/70) in group B and 7.6% (4/52; p=0.028) in group A had non-diagnostic CT venography of left femoral vein. CONCLUSION: One hundred millilitres of contrast medium with a concentration of 350mgI/ml may produce sufficient enhancement, but 150ml of contrast medium provides better accuracy for the diagnosis of deep venous thrombosis diagnosis. For better enhancement of lower extremity deep veins, the concentration of the contrast medium and the patient's body weight may also have significance.