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Pituitary adenomas are a group of disease with broad different clinical characteristics and complications. We aimed to present the data of patients being followed in a single center and discuss the pituitary adenomas based on the literature. Two hundred and twenty patients followed at Department of Endocrinology and Metabolism, Medical School of Ondokuz Mayis University, were included into study. Clinical characteristics, laboratory findings and treatment modalities were examined retrospectively. 59% of patients were female and 41% were male. Mean age during the diagnosis was 43.7 years. Pituitary macroadenomas were 62% of all adenomas and 73% of pituitary adenomas were functional. Among the functional adenomas, the most frequently seen types were prolactin-secreting adenoma and growth-hormone secreting adenoma. Treatment options were surgical treatment (67%), medical treatment (20%) and radiotherapy (7%). Post-operative complications were developed in 27 (13.2%) of patients. In patients with non-functional adenoma, the cure after surgery was detected as 19.6% and the remission after the surgery was detected as 8.9%. In this study, the characteristics of the pituitary adenomas were found similar to the literature in general. The early diagnosis of the disease has a significant importance in terms of treatment and the response to the treatment.

Purpose To investigate the diagnostic and prognostic significance of the blood-count derived systemic immunoinflammatory parameters in patients with thyroid-associated ophthalmopathy (TAO). Methods In this retrospective case-control study, the blood-count parameters and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, and systemic immune-inflammatory index (SII), thyroid peroxidase antibody, and anti-thyroglobulin antibody were evaluated in 46 patients with TAO and 46 matched controls. The associations of the immunoinflammatory parameters with clinical outcomes were analyzed among TAO patients. Results Significant differences were found in NLR, PLR, SII, and lymphocyte count between the controls and the TAO group (p < 0.05 for all). In logistic regression analysis, these inflammatory parameters did not have any prognostic effect on the clinical outcomes of the TAO (p > 0.05 for all). The patients, who needed systemic treatment due to any ocular involvement of TAO during the follow-up period, had significantly lower platelet count (p = 0.001) and PLR (p = 0.02) at the time of initial diagnosis when compared to the no treatment-needed group of the TAO patients. The initial platelet count was significantly associated with the subsequent steroid need due to TAO during the follow-up period (β = −0.02, p = 0.03). Conclusions NLR, PLR, and SII may serve as potential inflammatory markers in the identification of the TAO, although they have no evident prognostic significance in TAO. However, the relatively lower platelet count at initial diagnosis may be associated with the need for systemic therapy during the follow-up in patients with TAO.

Objective: Hypoglycemia is a serious adverse effect of hydroxychloroquine (HCQ) which is very rare in non-diabetic patients. This case report describes a non-diabetic patient without any other chronic diseases, who experienced mild hypoglycemia related to HCQ used for COVID-19 treatment.Methods: All etiologies causing hypoglycemia were investigated and a 72-hour fast test was performed.Results: A 34-year-old male patient was admitted to our hospital with a high fever, cough, and chest pain. The result of his COVID-19 PCR test was positive. He received HCQ for 10 days for the treatment of COVID-19 infection. He experienced fatigue, dizziness, severe headache, weakness and feeling of hunger after discontinuation of HCQ during his isolation at home. Before COVID-19 infection, he never experienced hypoglycemia symptoms. He did not have a history of chronic diseases, drug use, alcohol consumption, or smoking. A 72-hour fasting test was performed. He complained about headache and weakness during the 72-hour test period. The PG level was determined as 49 mg/dl during these symptoms. Concurrent insulin and C-peptide levels were

Objective Our study aims to evaluate the patients’ immunity regarding childhood vaccination after leukemia treatment and determine the vaccines that require additional doses. Methodology Sixty-six patients who were followed up with the diagnosis of ALL and AML between 2013 and 2016 were included in our study. The patient's gender, age at diagnosis, leukemia type, leukemia risk groups, vaccination status before chemotherapy (CT) and serologies of hepatitis A, hepatitis B, varicella, measles, rubella, mumps at the end of CT were recorded. Results At the end of the treatment, loss of protective antibody response against hepatitis A (47.4%), hepatitis B (68.2%), varicella (64.2%), measles (45.5%), rubella (43.9%), and mumps (50%) vaccines were shown. Loss of protective antibodies against hepatitis A (66.7%), hepatitis B (100%), varicella (100%), measles (100%), rubella (91.7%), and mumps (91.7%) in high-risk ALL patients was higher than patients in standard-intermediate risk ALL. Conclusion Loss of humoral immunity against hepatitis A, hepatitis B, varicella, MMR was shown in patients with leukemia at the end of the treatment. Due to the significant decrease in hepatitis B and MMR protective antibodies in the high-risk group, we recommend patients with leukemia who have completed chemotherapy to be vaccinated with hepatitis B vaccine three months and MMR vaccine six months after the treatment.

Objectives: We sought to evaluate the possible correlation between serum vitamin D levels and exudative age-related macular degeneration (AMD). Methods: We conducted a cross-sectional study including 95 patients with exudative AMD and 95 healthy age-and sex-matched controls. The participants’ serum 25-hydroxyvitamin D3 (25(OH)D3) levels were measured, and the results were classified into three categories: deficient (< 20.0 ng/mL), insufficient (20.1–29.9 ng/mL), and sufficient (>30.0 ng/mL). We compared serum 25(OH)D3 levels between the two study groups and the AMD ratio between the patients with deficient serum 25(OH)D3 levels and those with levels in the sufficient and insufficient ranges. Results: The median 25(OH)D3 levels were significantly lower in patients with AMD compared to the control subjects (p = 0.042). The frequencies of patients with AMD among the vitamin D categories were statistically significant (p = 0.043). Subgroup analysis showed that the frequency of patients with AMD and deficient vitamin D levels was significantly higher than that found in the patients who had sufficient and/or insufficient ranges of vitamin D levels (55.0% vs. 36.0%, p = 0.043, respectively). Conclusions: Serum 25(OH)D3 levels may have an impact on the neovascular type of AMD. As 25(OH)D3 levels decrease, the frequency of AMD increases. © 2020, Oman Medical Specialty Board. All rights reserved.

Purpose To compare the central corneal thickness (CCT), intraocular pressure (IOP), and tear insulin-like growth factor 1 (IGF-1) levels between patients with acromegaly and a control group and to evaluate the possible effect of tear IGF-1 and duration of the disease on CCT and IOP. Methods We included 31 patients with acromegaly (study group) and 40 age- and sex-matched controls in the study. Patients with acromegaly were divided into 2 subgroups based on disease status (active/inactive). All participants underwent complete ophthalmologic evaluation including CCT and IOP values. Basal tear samples were collected from both groups and tear IGF-1 levels were measured. The CCT, IOP, and tear IGF-1 levels were compared between groups and subgroups and the association between tear IGF-I levels and ocular parameters (CCT, IOP) and disease duration were also evaluated. Results Central corneal thickness, IOP, and tear IGF-1 levels did not show a significant difference between study and control groups. We also did not find a significant difference in terms of CCT, IOP, or tear IGF-1 levels between subgroups of patients. Correlation analysis did not show an association between the duration of disease and tear IGF-1 levels with CCT or IOP. Conclusions There was no significant difference in tear IGF-1 levels between patients with acromegaly and controls. Additionally, there was no correlation between disease duration and tear IGF-1 levels with CCT or IOP levels. This lack of association may suggest that tear IGF-1 levels might not have an effect on CCT or IOP findings in patients with acromegaly.

Endocan is a newly identified proteoglycan released from endothelium, stimulating angiogenesis and when increased, indicates endothelial activation (inflammation). Our aim was to examine the association between serum endocan levels and urine albumin-creatinine ratio (UACR).One hundred and thirty-seven patients with type 2 diabetes mellitus and normal serum creatinine who had no co-morbidities other than hypertension, diabetic nephropathy, retinopathy, or neuropathy were divided into normoalbuminuria (G1), microalbuminuria (G2), and macroalbuminuria (G3) groups and compared cross-sectionally regarding serum endocan levels.There were 55, 47, and 35 patients in G1, G2, and G3, respectively. The groups were comparable in terms of gender, age, duration of diabetes, diabetic neuropathy/retinopathy, fasting glucose, HbA1c, serum creatinine level, and eGFR. Patients in G3 had significantly higher blood pressure but lower serum albumin and endocan levels. UACR showed a negative bivariate correlation with serum endocan levels (r = -.282, p = .001). There was bivariate positive correlation between endocan and systolic blood pressure (r=.185, p = .030). In linear regression analysis, UACR was negatively correlated with endocan while positively correlated with systolic blood pressure, duration of diabetes, and platelet distribution width.Patients with macroalbuminuria had lower endocan levels, and increasing UACR was associated with decreasing serum endocan levels. Despite the occurrence of angiogenesis and glomerular hypertrophy in the early phase of diabetic nephropathy, ensuing significant renal injury over time may reduce the expression of endocan. Serum endocan levels may represent a novel marker for nephropathy progression.

BACKGROUND/AIMS Acute pancreatitis (AP) is a life-threatening disease with a rising incidence. The aim of this study was to investigate the association between oxidative status, lymphocyte deoxyribonucleic acid (DNA) damage, and acute pancreatitis. MATERIALS AND METHODS A total of 45 patients with AP and 35 healthy controls were included in the study. We assessed pancreatic enzymes, oxidative stress, and lymphocyte DNA damage. The severity of AP disease was determined by the Harmless Acute Pancreatitis Score (HAPS) and Balthazar scoring systems. RESULTS In AP patients, lymphocyte DNA damage was significantly higher than in controls [49.84±25.48 arbitrary units (AU) vs. 28.80±13.98 AU, p

Objective The aim of this study was to assess the predisposition for atherosclerosis in patients with RLS through serum sLOX-1 (serum Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1) measurements. Background Recent epidemiological studies have suggested an association of RLS with certain chronic conditions such as diabetes mellitus (DM), obesity, hypertension (HT), and hyperlipidemia. LOX-1 is expressed in endothelial cells, macrophages, and in smooth muscle cells under the effect of proatherogenic conditions. Methods This study was a prospective, cross-sectional, case-controlled. We measured the serum sLOX-1 levels in 37 restless legs syndrome patients and 38 controls. Results Serum sLOX-1 level was significantly lower in the patient group. The two groups were similar in glucose, HbA1c, creatinine, LDL cholesterol, TG, HDL, total protein, albumin, AST, ALT, GGT, ALP, HGB, HCT, MCV, transferrin saturation rate (TSR), ferritin, CRP, TSH, FT4, FT3, B12, and folic acid levels. Also the two groups were similar with respect to age at menarche, number of previous births, number of abortions and/or curettage, total duration of breastfeeding, percentage of patients in menopause, and age at menopause. Conclusion Our results may suggest a lower atherosclerotic risk among RLS patients as compared to the general population (Tab. 3, Ref. 33).

Generalized osteoporosis associated with gestation and lactation is a rarely-seen case, which is seen during the final period of gestation or right after birth/delivery. The etiology and pathogenesis are not fully known. The fact that the pre-existing osteoporosis may be aggravated by gestation, that it may stem from genetic susceptibility, or that it may even be random are still under discussion. The most commonly-seen symptom is particularly the short stature due to lumbar pain during the lactation period as well as the vertebral compression fractures. In this study, we aimed to draw the attention to this rare case seen in the patients applying to the clinic with the complaint of post-natal lumbar pain, by starting from the two cases whose diagnoses and treatments were performed in our clinic.

Burning mouth syndrome is a chronic and persistent painful condition characterized by burning sensation in the oral mucosa. We investigated the etiological factors of patients presented with the history of burning in the mouth who admitted our outpatient clinics over the 8-years period and who had no underlying identifiable local factors. We also tried to determine their demographic and clinical characteristics. Our aim was to investigate the association between burning mouth and psychiatric disorders such as depression and anxiety, chronic diseases like diabetes mellitus (DM) and other laboratory studies in patients complaining of solely burning in the mouth.The study included patients with the history of burning in mouth who presented in our outpatient clinic between 2005 and 2012. They were evaluated by a neurologist, a psychiatrist, an internist, and a dentist. Complete blood counts, biochemical analysis and cranial magnetic resonance imaging (MRI) were performed for all patients.A total of 26 (22 (84%) females, 4 (15%) males; mean age 55.9 years) patients were enrolled in this study. Five (19.2%) of the patients had depression, 2 (7.7%) had anxiety disorder, 2 (7.7%) had diabetes mellitus, 8 (30%) had B12 vitamin deficiency, 3 (11.5%) had decreased ferritin levels in blood, and 1 (3.8%) had folic acid deficiency. Cranial MRI of all patients were normal. Nine patients (34.6%) had no etiological causes.A multidisciplinary approach in the management of burning mouth and establishment of common criteria for the diagnosis would provide insight into the underlying pathophysiological mechanism.Az „égő száj” szindróma krónikus és perzisztáló, fájdalmas állapot, melyet az orális mucosa égő érzete jellemez. Az etiológiai faktorokat vizsgáltuk azon betegek esetében, akiknek a kórtörténetében az égő száj szindróma szerepel és az elmúlt nyolc évben jártak szakambulanciánkon és nem áll fenn náluk mögöttes, azonosítható lokális faktor. Célunk volt az égő száj és a pszichiátriai megbetegedések - úgy mint depresszió és szorongás -, krónikus megbetegedések - mint a diabetes mellitus (DM) - és egyéb laboratóriumi tanulmányok közötti összefüggést vizsgálni azon betegek körében, akik kizárólag az égő szájra panaszkodnak.A jelen tanulmányba a 2005 és 2012 között szakambulanciánkon megjelent, kórtörténetükben égő száj szindrómával rendelkező betegeket vontuk be. Neurológus, pszichiáter, belgyógyász és fogorvos látta őket. Teljes vérképet, biokémiai analízist és cranialis MRI-t végeztek el minden betegen.Mind a 26 [22 (84%) nő, négy (15% férfi, átlagéletkor 55,9 év)] beteg részt vett a tanulmányban. Közülük ötnek (19,2%) volt depressziója, két (7,7%) főnek volt szorongásos megbetegedése, két (7,7%) főnek volt diabetes mellitusa, nyolc (30%) főnek B12-vitamin-hiánya, három (11,5%) főnek csökkent szérumferritinszintje és egy (3,8%) főnek folsavhiánya. A cranialis MRI mindegyik betegnél normális volt. Kilenc (34,6%) betegnél nem voltak etiológiai okok.Az égő száj kezelését illető multidiszciplináris megközelítés és közös megegyezésen alapuló diagnosztikai kritérium együttesen biztosítani tudnák a háttérben zajló patofiziológiai mechanizmusba való betekintést.

BACKGROUND In this study, we aimed to examine the impact of fasting during the month of Ramadan on autosomal dominant polycystic kidney disease (-ADPKD) patients with normal to near-normal glomerular filtration rate (GFR). MATERIALS AND METHODS This was a prospective observational study of patients with ADPKD, the majority of whom had normal or near-normal GFR. Patients were divided into two groups: the fasting group (FG) and the nonfasting group (NFG). Assessments in the NFG were performed 1 week before and 1 month after Ramadan, while FG patients were assessed on the last day of fasting in addition to the abovementioned visits. The following parameters were checked at each visit: blood pressure (BP), weight, sodium, potassium, blood urea nitrogen (BUN), creatinine, calcium, phosphorus, glucose, lipid profile, bicarbonate, urine density, 24-hour urine volume, 24-hour urine protein, GFR, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule-1 (KIM-1). Kidney function tests were carried out on the 7th day of fasting in the FG for the identification of early kidney damage. RESULTS Of the overall group of 54 patients, 23 were in FG (19 female) and 31 were in NFG (18 female). There were no significant differences between the two groups in terms of age, gender, ADPKD duration, and presence of hypertension. The mean estimated glomerular filtration rate (eGFR) values of FG and NFG were 86.4 ± 18.5 and 66.1 ± 36.5 mL/min/1.73m2, respectively. During the follow-up period, no significant changes occurred in BP, weight, creatinine, 24-hour urine volume, NGAL, KIM-1, or GFR in either group (p > 0.05), while 24-hour urinary protein was significantly decreased in FG (p

Purpose: To investigate the association of Behcet disease activity with serum and tear interleukin-2 levels.Methods: The study was designed as a prospective case control study. The study population consisted of 45 patients with Behcet disease and 24 age and sex-matched healthy participants. Behcet disease patients were classified as active (24 patients) or inactive (21 patients) according to disease activity. Serum and tear interleukin-2 levels were determined using the enzyme-linked immunosorbent assay method.Results: The mean serum and tear interleukin-2 levels of the active disease, inactive disease, and control groups were 17.04 ± 5.02 and 32.61 ± 16.53 pg/mL; 15.20 ± 4.68 and 29.61 ± 8.30 pg/mL; and 14.22 ± 4.18 and 28.89 ± 8.73 pg/mL, respectively. There was no statistically significant difference between the groups with respect to all measured data.Conclusions: There was no significant difference in serum or tear IL-2 levels between Behcet patients and controls; there was no association of ...

Increased serum levels of the activated aspartic lysosomal endopeptidase cathepsin D (CatD) have been found in patients with acute myocardial infarction (AMI). However, to date there have been no analyses of clinical follow-up data measuring the enzyme course and its role in the development of post-MI heart failure. This study aimed to evaluate the role of serum CatD activity in the development of heart failure in patients with ST-segment elevation acute myocardial infarction (STEMI). Eighty-eight consecutive patients (79.5 % men, mean age 57.4 ± 10.2 years) with STEMI were included in this study. Serum CatD activity was measured directly after primary percutaneous coronary intervention (PCI), before discharge, and at the 6-month follow-up. Patients were monitored for major adverse cardiovascular events (MACE), defined as hospitalization due to cardiovascular causes, recurrent nonfatal myocardial infarction, unplanned PCI, new-onset heart failure, and cardiovascular mortality. Serum CatD activity was significantly higher in patients with AMI after PCI and during follow-up (FU) than that in age-matched controls (16.2 ± 7.5 and 29.8 ± 8.9 vs. 8.5 ± 4.2 RFU; p

ObjectiveDiabetes mellitus and obesity are well-known risk factors associated with obstructive sleep apnea (OSA). Cushing’s syndrome (CS) is also characterized by obesity and diabetes mellitus. However, the association between CS and OSA remains unclear. Therefore, we investigated the possible associations between CS and OSA in this study.Patients and methodsThirty female patients with newly diagnosed active CS and 30 age-, gender- and body mass index (BMI)-matched controls were included in this study. All participants were evaluated by overnight polysomnography. OSA was defined as having an apnea–hypopnea index (AHI) score of ≥5 events/h. Insulin resistance was calculated by homeostasis model assessment (HOMA) scores. Fasting serum cortisol was also determined.ResultsThe prevalence of OSA was higher (50% vs 23%,P = 0.003) in patients with CS compared with the control subjects. The mean HOMA (P = 0.046) and AHI (P = 0.028) scores were higher in patients with CS compared with the control subjects. AHI was positively correlated with the HOMA scores (r = 0.281,P = 0.046) in both groups. Linear regression analysis showed that serum cortisol remained as an independent predictor for AHI after controlling for BMI and HOMA score (P ConclusionsThe prevalence of OSA increased in patients with CS compared with control subjects with similar ages and BMI levels. Hypercortisolemia is an independent risk factor for developing OSA. The presence of OSA needs to be considered in patients with CS.

Objective:Biochemical observations of the decrease in mortality rate and prediction of the degree of coronary artery stenosis before symptomatic improvement are gaining importance. In our study, we aimed to evaluate the etiological value of the recently discovered resistin biomolecule in coronary atherosclerosis pathogenesis.Methods:In this study, we evaluated and compared serum resistin levels in patients with angiographically proven coronary artery disease (stenosis ratio >25%) (n=43) and in the control group with angiographically proven normal coronary artery diameter (stenosis ratio 0.05). While considering both patient and control group correlations, we determined a positive correlation between resistin and fasting insulin (p=0.012, r=0.304), HOMA-IR (p=0.046, r=0.243), homocysteine (p=0.05; r 0.239), and hsCRP (p=0.029, r=0.265).Conclusion:Resistin values differ between patients and control subjects but were not statistically significant. The modifying effect of anti-hyperlipidemic agents over serum resistin levels may have a preventive role in the process of atherosclerosis. We think that effective results will be obtained in raising the selected threshold level of atherosclerosis diagnosis and increasing the number of patients.

Background: Childhood obesity characterized by excessive fat in the body is one of the most serious health problems worldwide due to the social, medical, and physiological complications. Obesity and associated diseases are triggering factors for oxidative stress and inflammation. The aim of this study was to explore the possible association between childhood obesity and inflammatory and oxidative status. Material/Methods: Thirty-seven obese children and 37 healthy controls selected from among children admitted to BLIND University Paediatrics Department were included in the study. Anthropometric measurements were performed using standard methods. Glucose, lipid parameters, CRP, insulin, total oxidant status (TOS), total anti-oxidant status (TAS) levels, and total thiol levels (TTL) were measured in serum. HOMA index (HOMA-IR) were calculated. The differences between the groups were evaluated statistically using the Mann-Whitney U test. Results: Body mass index was significantly higher in the obese group (median: 28.31(p

Noduler tiroit hastaligi sik gorulen endokrinolojik bir hastalik olup prevalansi iyot alimina gore onemli olcude degismektedir. Her iki cinsiyette de yas ile birlikte noduler guatr prevalansinda artis saptanmistir. Tiroit nodulu ile karsilasildiginda ilk yapilmasi gereken malign-benign ayirimi, sonrasinda kompresyon belirtileri, tiroit fonksiyonlarinin degerlendirilmesi ve cerrahi gereken nodul ile medikal tedavi gereken nodul ayirimini yapmak olmalidir. Klinik degerlendirme sonrasindaki ilk degerlendirme serum TSH olcumu ve ultrasonografik inceleme olmalidir. Preopeartif olarak tiroit kanserinin teshisinde Tiroit ince igne aspirasyon biyopsisi sitolojik incelemesinin en etkili ve spesifik metod oldugu ispatlanmistir. J. Exp. Clin. Med., 2012; 29:S315-S320 Approach to thyroid nodules Nodular thyroid disease is a common endocrinopathy that prevalence varies according to the iodine uptake. Nodular goiter becomes more prevalent in both gender as the age increases. When patient with a thyroid nodule is seen compression symptoms, thyroid function and malign-benign separation are the first investigations that should be performed. The next step should be the evaluation of the nodule to decide whether surgery or medical treatment is required. After clinical evaluation of a patient with a thyroid nodule, serum TSH measurement and ultrasonographic evaluation are the first investigations that should be performed. Cytological examination of fine needle aspiration biopsy (FNAB) specimens has been proved to be the most efficient and specific method of diagnosing thyroid cancer preoperatively. J. Exp. Clin. Med., 2012; 29:S315-S320

Objective: To investigate bone resorption and formation markers as well as bone mineral density in women with restless legs syndrome (RLS). Methods: This was a prospective cross-sectional case-control study involving drug-naive women with RLS and age- and body mass index (BMI)–matched female controls. Routine blood analyses, markers of bone formation, procollagen 1 n-terminal peptide, bone resorption, c-telopeptide of type 1 collagen (CTX), sclerostin, and bone mineral density (BMD) were compared between the 2 groups. Pregnant or breastfeeding women and individuals with comorbidities other than iron deficiency, type 2 diabetes mellitus, or hypertension were excluded. Results: A significant increase in lumbar BMD was found among 78 women with RLS as compared to 78 age- and BMI-matched controls ( p = 0.001). The proportion of patients with osteopenia as defined by a lumbar T score was significantly lower among patients with RLS ( p = 0.040). CTX and sclerostin were significantly lower in patients with RLS ( p = 0.006 and p = 0.011, respectively), as were the levels of 25-hydroxy vitamin D 3 , calcemia, and free T3 ( p = 0.017, p = 0.017, and p = 0.002, respectively). Conclusions: Despite lower 25-hydroxy vitamin D 3 , patients with RLS had lower bone resorption markers, higher lumbar BMD, and lower frequency of lumbar osteopenia. As patients with RLS make movements night and day to decrease the severity of their symptoms, they unconsciously perform exercise, which may potentially explain the better bone profile among patients with RLS than in controls.

Objectives: We investigated whether pomegranate extract plays a protective antioxidant role against mesenteric ischemia-reperfusion injury (IR), which can lead to a systemic response and damage distant organs, such as the lung, liver, and kidney. Methods: Forty female Wistar-Albino rats were separated into four groups: laparotomy, laparotomy + PG, mesenteric IR, and mesenteric IR and pomegranate (IR + PG). In the laparotomy + PG and IR + PG groups, pomegranate (225 mg/kg) was given by oral gavage at the beginning of the study. Ischemia was induced for 30 minutes, and reperfusion was subsequently allowed for 60 minutes in the IR and IR + PG groups. The malondialdehyde (MDA) and total antioxidant activity (AOA) levels were evaluated in blood samples. Additionally, all tissues were removed for the measurement of AOA and total oxidant status as well as for subsequent histopathological evaluation. The oxidative stress index was calculated. Results: Histopathological changes in all organs were significantly higher in the IR group and significantly lower in the IR + PG group vs. the other groups. Serum MDA levels were significantly lower in the IR + PG group than in the IR group. No significant difference was found in AOA levels of the groups. Discussion: These data may explain the positive protective effects of pomegranate based on the histopathologic findings in ischemic conditions in an intestinal IR injury model.

The purpose of the present study was to investigate the effect of alpha-lipoic acid (ALA) on the thicknesses of various retinal layers and on the numbers of retinal ganglion cells and vascular endothelial growth factor levels in experimental diabetic mouse retinas. Twenty-one male BALB/C mice were made diabetic by the intraperitoneal administration of streptozotocin (200 mg/kg). One week after the induction of diabetes, the mice were divided randomly into three groups: control group (non-diabetic mice treated with alpha-lipoic acid, n = 7), diabetic group (diabetic mice without treatment, n = 7), and alpha-lipoic acid treatment group (diabetic mice with alpha-lipoic acid treatment, n = 7). At the end of the 8th week, the thicknesses of the inner nuclear layer (INL), outer nuclear layer (ONL), and full-length retina were measured; also retinal ganglion cells and VEGF expressions were counted on the histological sections of the mouse retinas and compared with each other. The thicknesses of the full-length retina, ONL, and INL were significantly reduced in the diabetic group compared to the control and ALA treatment groups (p = 0.001), whereas the thicknesses of these layers did not show a significant difference between ALA treatment and control groups. The number of ganglion cells in the diabetic group was significantly lower than those in the control and ALA treatment groups (p = 0.001). The VEGF expression was significantly higher in the diabetic group and mostly observed in the ganglion cell and inner nuclear layers compared to the control and ALA treatment groups (p = 0.001). Therefore, the number of ganglion cells and VEGF levels did not show significant differences between the ALA treatment and control groups (p = 0.7). Our results show that alpha-lipoic acid treatment may have an impact on reducing VEGF levels, protecting ganglion cells, and preserving the thicknesses of the inner and outer layers in diabetic mouse retinas.

Background: This study is designed to investigate the effect of three different analgesics, used to treat pain in AP, on oxidative stress, DNA damage in mononuclear leukocytes, and on oxidative status. Methods: This parallel design randomized controlled trial is composed of three treatment arms, intravenous paracetamol, intravenous dexketoprofen, and intravenous tramadol. Results: A total of 107 patients were diagnosed with acute pancreatitis within the study period in the ED. Seventy-seven of them were included in the study; 26 patients for the paracetamol group, 24 patients for the dexketoprofen group, and 27 patients for the tramadol group. The mean age of study subjects was 52.73 ± 15.38 and 66% (n = 51) of them were men. At the beginning of the study (before treatment), mean levels of DNA damage, TOS, and OSI levels were significantly higher and TAS was significantly lower in the acute pancreatitis groups than in the control group. DNA damage and OSI in HAPS-positive patients were found to be significantly greater than HAPS-negative patients (p = 0.046). DNA damage and oxidative stress were compared between the three groups. There were no differences between the groups in terms of DNA damage (p = 0.42) and also for the oxidatif stress parameters (OSI,TAS,TOS had p-values of p = 0.26, p = 0.78, p = 0.35, respectively). Conclusions: There is no difference between the effects of paracetamol, dexketoprofen, and tramadol, which are commonly used to manage acute pain in AP, on DNA damage in human T-lymphocytes and on serine parameters of oxidative status. © 2016, Verlag Klinisches Labor GmbH. All rights reserved.

Introduction. All findings of preeclampsia appear as the clinical consequences of diffuse endothelial dysfunction. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) was recently introduced as a TNF related cytokine in various inflammatory and noninflammatory disorders. sTWEAK was found to be related to endothelial dysfunction in patients with chronic kidney disease. In our study we aimed to compare sTWEAK levels in women with preeclampsia to corresponding levels in a healthy pregnant control group.Materials and Methods. The study was undertaken with 33 patients with preeclampsia and 33 normal pregnant women. The concentration of sTWEAK in serum was calculated with an enzyme linked immunosorbent assay (ELISA) kit.Results. Serum creatinine, uric acid, LDH levels, and uPCR were significantly higher in the patient group compared to the control group. sTWEAK levels were significantly lower in preeclamptic patients (332 ± 144 pg/mL) than in control subjects (412 ± 166 pg/mL) (p=0.04).Discussion. Our study demonstrates that sTWEAK is decreased in patients with preeclampsia compared to healthy pregnant women. There is a need for further studies to identify the role of sTWEAK in the pathogenesis of preeclampsia and to determine whether it can be regarded as a predictor of the development of preeclampsia.

Antidiyabetik ilaçların sayısının artışı tip 2 diyabette hedeflenen HbA1C seviyesini düşürmüştür. Diyabetin uzun dönem komplikasyonlarını azaltmak için sıkı HbA1C kontrolü oldukça önemlidir. Oral antidiyabetiklerin çoğu glisemik kontrolü iyileştirmede etkilidirler ancak açlık hiperglisemisi ve HbA1C ≥ %7 seviyeleri olan tip 2 diyabetli hastalarda glisemiyi normale yakın seviyelere indirmede ender olarak başarılı olurlar. Farklı etki mekanizmalı oral ilaçların kombine kullanımı HbA1C düzeylerini düşürmede ilave etki sağlar. Aynı zamanda daha fazla terapötik güç, daha fazla kolaylık, daha az doz ve yan etki sağlanabilir. Metformin ve yaşam stili değişikliği ile başarısız olunan hastalarda tedavi seçenekleri ya ikinci bir oral ya da enjektabl ajan eklemektir. Eğer HbA1C değeri metformin ve sülfonilüre veya bazal insülin ile başarılamazsa, intensif insülin tedavisi başlanması önerilmektedir. Geleneksel basamaklı yaklaşım basamaklar arasında önemli gecikmelerin yaşanabileceği ve glisemik kontrolün sağlanamadığı sürenin uzayabileceği bir yaklaşımdır. Kısa süreli hiperglisemi dönemleri bile komplikasyon riskini büyük oranda artırır. Basamaklı tedavi yaklaşımdan uzaklaşarak kombinasyon tedavisine erken başlamayı içeren yeni bir tedavi anlayışına geçmek gerekir. Combination treatment of type 2 diabetes mellitus The increasing number of antidiabetic drugs decreased HbA1C levels in type 2 diabetes. Strict HbA1C control is very important to decrease the long term complications of diabetes. Although most of the oral antidiabetic drugs are adequate for glycemic control, they are not successful to control patients whose HbA1C levels are more than 7% and who have fasting hyperglycemia. The combined use of the oral drugs that affect in different ways provides additional success to lower HbA1C levels. Moreover, not only are they useful and provide additional power but also they have less side effects with lower doses. In patients whose medical treatment is unsuccessful with metformin and altered life style, adding a second oral or an injectable drug are the other therapeutic alternatives. If the HbA1C levels could not be decreased with metformin, sulfonilurea and basal insulin, intensive insulin therapy must be started. Traditional “step by step” approach may cause worse glycemic control and delay the steps of the therapy. Although hyperglycemia pe¬riods last in short periods it may increase the complications. Traditional “step by step” approach should be avoided and new therapeutic approachs should be preferred including early combined therapy. J. Exp. Clin. Med., 2012; 29:S39-S43

The adrenal gland consists of two endocrine tissues of different embryological origin, namely the primarily steroid-producing adrenocortical tissue, and the catecholamine-producing chromaffin cells. 1 Adrenal catecholamines and steroids are important regulators of the stress response, immune function, blood pressure and energy homeostasis. 2 Chromaffin cells regulate steroid hormone release by the adrenal cortex. Steroids induce catecholamine production in the medulla. Consequently, disorders of the adrenal cortex have been shown to affect chromaffin cell function and vice versa. 3 We report on a patient with an unusual combination of Addison’s disease and phaeochromocytoma, whose initial presentation was adrenocortical failure. After replacement therapy for adrenocortical failure, a clinical presentation of phaeochromocytoma emerged.

SEZER, OZLEM/0000-0001-5727-7965 WOS: 000361339400009 PubMed: 26067744 Although colchicines are the only effective treatment of familial Mediterranean fever (FMF), resistance to colchicines (CR) which is observed in up to 30% of the patients is still a problem. Clinically, resistance to colchicine is defined as three or more attacks within the last 6 months period while using >= 2 mg/day colchicine. Previous studies have shown decreased vitamin D levels in FMF patients compared with healthy controls. The aim of this study is to evaluate whether vitamin D levels differ between CR and non-CR FMF patients. This study included 64 FMF patients who were being followed in Nephrology Clinic of Samsun Research and Education Hospital for at least 1 year. FMF was diagnosed according to the criteria defined by Livneh et al. Serum 25-hydroxy vitamin D (25-OHD) concentration (ng/mL) was detected in all FMF patients who were not in an acute attack period. From 64 patients 29 were accepted as CR. Mean 25-OHD level was 9.39 +/- 1.00 ng/mL in CR patients and 18.48 +/- 1.09 ng/mL in colchicine responsive patients (p

Bisphenol A (BPA) is known as an endocrine disruptor and it is supposed to have a role on the development of central precocious puberty (CPP). Kisspeptin, a hypothalamic peptide, is a neuromodulator of gonadotropin releasing hormone and it has an important role on regulation of the onset of puberty. The BPA levels in girls with CPP and premature thelarche (PT) and its relation with kisspeptin levels were investigated.Twenty-eight girls with CPP, 28 girls with PT and 22 prepubertal girls as a control group were enrolled to the study. Urinary BPA and serum kisspeptin levels were compared in the groups. Bivariate correlations were performed to evaluate the relations of BPA with kisspeptin and estradiol.There was no statistical difference between groups regarding BPA levels. Serum kisspeptin levels were higher in CPP group than controls [306.56 (interquartile range (IQR), 175.63–504.66) vs. 157.62 (IQR, 55.61–285.00) p: 0.008]. There were no correlations between BPA and kisspeptin levels (r: 0.088, p: 0.391) and between BPA and estradiol (r: –0.171, p: 0.144).The BPA levels did not differentiate between groups and it seems that the exposed amount of BPA in daily life did not affect kisspeptin levels in girls with CPP and PT.

Kenan Celik,1 Mehmet A Cikrikcioglu,1 Gulistan Halac,2 Elif Kilic,3 Siddika Ayhan,3 Nihal Ozaras,4 Kemal Yildiz,5 Rabia S Yildiz,1 Mehmet Zorlu,1 Cumali Karatoprak,1 Mustafa Cakirca,1 Muharrem Kiskac1 1Department of Internal Medicine, 2Department of Neurology, 3Department of Biochemistry, 4Department of Physical Medicine and Rehabilitation, Medical Faculty, Bezmialem Vakif University, Fatih, 5Department of Internal Medicine, Private Medicana International Istanbul Hospital, Beylikdüzü, Istanbul, Turkey Background: Endocan is a recently introduced marker of endothelial dysfunction. The objective of this study was to compare serum endocan levels in patients with restless legs syndrome (RLS) and control subjects in order to elucidate whether RLS is associated with endothelial dysfunction. Methods: A total of 31 drug naïve female patients with RLS and 31 age- and BMI-matched women were included in the study. Patients with pathological or physiological conditions or with a history of medication use that could potentially influence endothelial functions were excluded, as well as those with alcohol or drug abuse history. The two groups were compared with routine blood tests and serum endocan levels. Results: Patients with RLS had lower serum endocan levels than the controls (P=0.037). There was a negative bivariate correlation between RLS severity score and serum endocan levels (r=-0.406, P=0.023). While white blood cell count was significantly higher in RLS group, 25-hydroxy vitamin D3, vitamin B12, transferrin saturation rate, and HDL-cholesterol were significantly lower. Creatininemia and diastolic blood pressure were also marginally insignificantly lower in RLS group. Due to the presence of differences between two groups in these variables, a linear regression analysis was performed that showed a positive association between endocan and creatininemia (β=0.310, P=0.022), and a negative association between endocan and RLS (β=-0.502, P

Background and purpose In our study, we investigated the effects of methylene blue (MB) on histopathological changes in renal ischemia/reperfusion (I/R) injury rat model. Material and methods Twenty-one Sprague–Dawley male rats were divided equally into three groups. Group 1 (control) was administered intraperitoneal saline solution. In Groups 2 (untreated group) and 3 (MB treatment), the renal arteries were clamped, and ischemia (for 1hour) and then reperfusion (for 4hours) were applied. Thirty minutes before ischemia, the untreated group received physiological saline, whereas the treatment group was administered 30mg/kg MB through an intraperitoneal route. Blood samples were drawn, and renal specimens were harvested 5.5hours after physiologic saline injection in the control and immediately after the reperfusion period in the other groups. The levels of tissue superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), total oxidant status (TOS), total antioxidant status (TAS), plasma urea, creatinine and ischemia modified albumin (IMA) were measured. Moreover, the histopathological damage score of the renal tissue was determined. Results MB significantly alleviated the severity of histopathological damage by increasing the levels of tissue SOD and TAS and decreasing TOS concentrations in the renal I/R model ( p Conclusion Administration of MB in renal I/R damage may play a protective role.

Objective: We aimed to examine the knowledge and consciousness levels of participators about Graves orbitopathy (GO) by conducting an investigation of ophthalmopathy consciousness of Graves patients, providing coordination among all health institutions and ophthalmologists and giving information about the subject to patients.Materials and Methods: A total of 50 Graves patients applying to the Ondokuz Mayis University Endocrinology outpatient service were included in the study. Specially prepared questionnaire forms were used for the evaluation. The education levels of the patients were evaluated in four groups as illiterates and graduates of primary school, secondary school-high school, and university.Results: Overall, 38.8% of the graduates of primary school, 71.4% of the graduates of secondary school-high school, and 63.6% of university graduates had GO consciousness. Although 24% of the patients had this consciousness, they were not going to regular eye check-ups; 86% of the patients had this GO information through their physicians. Also, 46% of the patients were smoking, and it was detected that just half of them were warned about smoking.Conclusion: It was observed that although the patients who were followed up with Graves were seen by all healthcare centers, they were not adequately informed about eye involvement. Thus, these patients should be informed at the first visit, and regular ophthalmologic examinations should be provided for them. © 2014 by Erciyes University School of Medicine.

TUNCEL, OZGUR KORHAN/0000-0002-2989-5894 WOS: 000331638200010 PubMed: 23625193 VEGF is a specific mitogen for endothelial cells. GM-CSF is a key player in the regulation of steadystate functions. The aim of this study was to evaluate VEGF and GM-CSF levels in thyroid nodules >1 cm, which are negative for malignancy with fine needle aspiration biopsy. Age, serum VEGF, GM-CSF, TSH, fT3, fT4, anti-TG, anti-TPO, thyroid size, and thyroid volume were compared between 41 female patients and 20 healthy female volunteers. This study was performed with 41 female patients who were euthyroid and whose nodules were benign. Twenty healthy female volunteers were enrolled as the control group. VEGF and GM-CSF were assayed by ELISA; TSH, fT3, and fT4 were detected by electrochemiluminescence method and anti-TPO and antiTG were detected by competitive immunoassay method. Only thyroid volume and anti-TG levels were significantly different between the two groups (p < 0.007 and p < 0.026, respectively). Other parameters including VEGF and GM-CSF were not significantly different. VEGF has a weak positive correlation only with anti-TPO levels in the patient group (r = 0.325, p = 0.036). There was a weak positive correlation between anti-TPO and anti-TG (r = 0.388, p = 0.007). There was a positive correlation between nodule size and thyroid volume (r = 0.464, p = 0.015). GM-CSF was not correlated with any parameters. VEGF and GM-CSF were not found to be increased in euthyroid patients with benign nodules and they do not seem to play a role in development of simple nodular goiter.

Objectives Pituitary diseases may cause psychiatric and personality alterations. We aimed to compare the personality traits of acromegalic patients with those of patients with non-functioning pituitary adenomas and a healthy control group. Design Fifty-eight acromegalic patients, 45 patients with non-functioning adenoma, and 40 healthy subjects were enrolled in the study. Cloninger's Temperament and Character Inventory (TCI), Beck Depression Inventory, Beck Anxiety Inventory, and Rosenberg Self-Esteem Scale (RSES) were used to assess personality, depression, anxiety, and self-esteem. Results Depression score was higher in acromegaly and non-functioning adenoma groups than healthy controls. RSES scores were similar among the three groups. Regarding the scales of TCI, only novelty-seeking was significantly reduced in acromegaly and non-functioning adenoma than the control group. Pairwise comparisons revealed that the difference was due to the difference between acromegalic patients and controls. Scales of TCI were correlated with depression and anxiety in patients with acromegaly and non-functioning adenoma but not in healthy controls. Conclusion This study showed that novelty-seeking was reduced in patients with acromegaly. Both the hormonal lack and excess and structural changes can lead to cognitive and personality changes in acromegaly. More studies are needed to be carried out about personality characteristics in pituitary diseases.

PubMed: 23397103 Pituitary tumors are the third most common primary intracranial neoplasm. Pathologic proliferation of the somatotrophs results as overproduction of growth hormone presenting as acromegaly. In pituitary adenomas typical visual field (VF) defect is bitemporal hemianopsia but tumor size and optic chiasmal position may cause variable VF defects and VF examination may remain normal. We retrospectively reviewed the medical records of 23 acromegalic patients with pituitary adenomas who received VF tests in the Department of Ophthalmology and Endocrinology, Ondokuz Mayis University Hospital, between 2000 and 2012. Pituitary tumor volume was calculated after performing measurements of tumor diameter in three orthogonal planes using Cavalieri's principle. VF test was performed with a Humphrey field analyzer 750 using a 4-mm Goldmann size III stimulus. The mean age of the 23 patients (11 male/12 female) was 50.4 ± 11.9 years. 15 patients (65.2 %) had normal VF, two patients (9 %) had quadrantanopsia, three patients (13 %) had hemianopsia and three patients (13 %) had three quadrantanopsia. Among the patients with normal VF, four patients had a suprasellar mass that was elevating the chiasm and spreading along the optic tracts. We also observed VF defects typical of a chiasmal compression even though no suprasellar extension was detected in a few cases. Tumor volume of the patients with VF defects was significantly larger than tumor volume of patients with normal VF (p = 0.02). Tumor volume is an important parameter in VF defects. Advanced neuroimaging assesments should always be complemented in patients even with normal VF. © 2013 Springer Science+Business Media Dordrecht.

To describe a central retinal artery occlusion in a patient with antineutrophil cytoplasmic antibody (ANCA) negative Churg-Strauss syndrome.Review of clinical and laboratory findings of a 44-year-old woman with ANCA negative Churg-Strauss syndrome that developed sudden vision loss in left eye.Left central retinal artery occlusion was diagnosed by retinal whitening, a cherry-red spot, and delayed arterial filling on fluorescein angiography. Perinuclear ANCA and cytoplasmic ANCA were negative.Central retinal artery occlusion can occur in ANCA negative Churg-Strauss syndrome. Patients with this diagnosis should be considered for prophylactic high dose corticosteroid, regardless of their ANCA status.