Investigation of the protective effect of anzer propolis in cerebral ischemia-reperfusion injury.

OBJECTIVE: Globally, stroke is the leading cause of disability and death. With the use of thrombolytic therapy, reperfusion injury, and its consequences came to the fore. We aimed to find out how anzer propolis, which can only be obtained in Turkey's Eastern Black Sea region, affected ischemia-reperfusion injury using biochemical and histological techniques. MATERIALS AND METHODS: 32 female Wistar albino rats were divided into 4 groups, including a control group. Three of the groups underwent 30 minutes of induced ischemia via clamping of the common carotid artery, followed by ischemia-reperfusion injury through the release of the clamp. One group received no treatment, another received oral administration of 100 mg/kg of anzer propolis one hour before surgery, and the third group received oral administration of 40 mg/kg of acetylsalicylic acid just before surgery. Histopathological examination assessed apoptosis and tissue necrosis, while serum and brain tissue were evaluated for levels of nerve growth factor (NGF), Interlokin 1ß (IL-1ß), Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), total antioxidant capacity (TAS), and total oxidant capacity (TOS). RESULTS: Anzer propolis and acetylsalicylic acid significantly reduced hyperemia in vessels, vacuolization in neurons, glial cell infiltration, and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) positivity. The anzer propolis group had the highest NGF levels. The anzer propolis and acetylsalicylic acid groups had lower levels of TNF-a and IL-6 in the brain tissue than the ischemia-reperfusion group, while TAS levels were higher. CONCLUSIONS: The findings obtained in this study suggest that anzer propolis has a neuroprotective effect against ischemia-reperfusion injury and will have beneficial effects on neurodegeneration. We believe our findings will contribute to the clinical treatment of ischemia-reperfusion injury.

OVERTREATMENT AND HYPOGLYCEMIA PREVALENCE IN GERIATRIC PATIENTS WITH TYPE-2 DIABETES IN THE TURKISH POPULATION.

OBJECTIVE: To determine the prevalence of over-treatment and hypoglycemia in Turkish type-2 diabetes patients and to identify the risk factors. METHODS: Patients ≥ 65 years, having a minimum 5 years of type-2 diabetes, were included in the study. Patients' body mass index, mean HbA1c level, disease onset and medications related with their co-morbidities were recorded. Over-treatment is defined as the use of non-metformin therapies despite having HbA1c levels < 7%. A history of hypoglycemia episodes in the last three months and patients' home blood glucose measurements were recorded. Factors relating to hypoglycemia and over-treatment were analyzed. RESULTS: After applying criteria, 755 patients were included in the study: 728 patients (96.4%) had at least one comorbidity. 257 patients (34%) were found to have HbA1c levels < 7%. 217 of them (84.4%) were using non-metformin therapies. 497 patients (65.8%) were using insulin. The over-treatment prevalence in the ≥ 65 years group was 28.7%. The over-treatment ratio in ≥ 80 years group was 28.2%. Hypoglycemia prevalence in the last three months was 23.3%. It was 22.7% for patients ≥ 80 years. Mean age, disease duration, body mass index, insulin usage and doses were found to be significantly different in over-treated patients compared to the others. CONCLUSIONS: This study showed that despite recent guidelines, there is still a considerable amount of over-treated geriatric patients who are at risk of hypoglycemia and related morbidity and mortality. Insulinization rate was high. Physicians should not avoid de-intensifying the treatment of geriatric patients who have multiple co-morbidities.

Depression and functional outcome after stroke: the effect of antidepressant therapy on functional recovery.

AIM: The optimal strategy to prevent post-stroke depression is an important but still-unresolved issue. This study examined the differences in functional recovery among post-stroke depressed patients (DP) compared to post-stroke non-depressed patients (NDP) over the course of six months after stroke. METHODS: On the basis of a semistructured psychiatric examination, DSM-IV diagnostic criteria and the Hamilton Depression score, a consecutive series of ischemic or hemorrhagic stroke patients were included in this study. They had suffered from first-time stroke, and did not have depression diagnosis before. During follow-up, treatment with 20 mg/day citalopram per os was initiated whenever a diagnosis of depression was established. Their functional recoveries were assessed using the Scandinavian Stroke Scale, the modified Rankin scale and the Barthel index during acute hospitalization, at the time of depression diagnosis and at the third and sixth month follow-up visits. RESULTS: Forty patients met the diagnostic criteria and 11 patients suffered from depression during the follow-up period. There were no differences in demographic variables, lesion characteristics and neurological symptoms between DP and NDP. Functional recovery in DP was impaired in comparison to NDP (P<0.05). All DP, whose mood improved after administration of citalopram, and improved daily functions living functions during the follow-up. CONCLUSION: This study's findings suggest that remission of post-stroke depression is associated with improvement in functional recovery. Early diagnosis and effective treatment of depression will help the rehabilitation outcome of stroke patients.