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Objectives: Kidney transplantation recipients (KTRs) have higher cardiovascular complications risk compared to the general population. Cardiovascular risk factors (CVRF, Traditional and non-traditional) are widely studied to understand the causes of increased cardiovascular disease (CVD) risk in KTRs. Fetuin-A prevents from vascular calcification (VC) by inhibiting production and collapsing of apatite crystals to the vascular wall. The relationship between fetuin-A levels and CVRF in KTRs was investigated in this study. Methods: Sixty-two KTRs with no prior CVD history participated. Anthropometrical, laboratory (fetuin-A, inflammation markers, antioxidants, lipid peroxidation products) and cardiological (echocardiographic, pulse wave velocity) measurements were performed. Participants were divided into two groups according to normal (≥ 0.5 g/L, n = 32, NFA) and low (< 0.5 g/L, n = 30, LFA) fetuin-A levels according to manufacturer’s reference range, and the results were compared. Results: No significant difference was observed in demographic features, body mass index, systolic and diastolic blood pressures, left ventricle mass index, waist and hip circumferences, left ventricle hypertrophy and waist-hip ratios between the two groups (p > 0.05). The ratios of drug usage such as immunosuppressives, anti-hypertensives and statin were comparable between two groups. Parathormone levels were significantly higher in the NFA group (p = 0.015) and glomerular filtration rate was calculated significantly higher in LFA group (p = 007). The comparison of other CVRF reveals no significant difference (p > 0.05). Conclusions: Although many CVRF improved in KTRs, subclinical inflammation markers were still higher than the healthy population. Identification and early recognition of CVRF in high-risk individuals may contribute to the reduction of cardiovascular mortality. In our study, we observed no significant relationship between fetuin-A levels and CVRFs. We evaluated the relationship between serum fetuin-A levels on cardiovascular risk factors by its role in pathophysiology.

BACKGROUND Increased cardiovascular risk, represented by endothelial inflammation, probably starts with the very first course of type-2 diabetes (T2DM). Almost 85.2% of all T2DM patients are overweight or obese. Thrombosis accounts 80% of all deaths in patients with diabetes. The thrombotic-fibrinolytic equilibrium shifts in favor of thrombosis by plasminogen activator inhibitor-1 (PAI-1). PAI-1 secretion is induced primarily by CRP. PAI-1 overexpression predisposes unstable plaque development. The contribution of obesity and diabetes to this process is not clearly understood. In this study, we aimed to investigate comparison of inflammatory markers, PAI-1 levels and arterial stiffness according to BMI and impaired glucose metabolism in patient with newly diagnosed T2DM. METHODS Newly diagnosed 60 T2DM patients were enrolled. Demographics and measurements were noted. Liver (AST, ALT), kidney (urea, creatinine, albumin/creatinine ratio), metabolic (fasting blood glucose, post-prandial blood glucose, insulin, c-peptide, HbA1c, total cholesterol, low-density lipoprotein [LDL], high-density lipoprotein [HDL], triglyceride) parameters, inflammatory markers [hsCRP, fibrinogen]), PAI-1 levels and pulse wave velocity was measured from all participants. The results were compared. RESULTS Inflammatory markers and PAI-1 levels were significantly elevated in obese group compared to overweight participants. The correlation analysis showed that waist and hip circumferences, high-sensitive CRP, fibrinogen and PAI-1 levels were positively correlated with BMI but not with HbA1c levels. CONCLUSIONS The results of our study showed that lipid levels, glycemic and blood pressure values of the obese and overweight patients were similar. BMI affects inflammatory markers and PAI-1 levels independent of glucose regulation and insulin resistance in newly diagnosed T2DM. According to the current study BMI is found to be more prominent in terms of inflammatory markers and PAI-1 levels compared to insulin resistance and impaired glucose metabolism in newly diagnosed T2DM.

Background:AA amyloidosis has been associated with uncontrolled chronic inflammatory diseases such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), inflammatory bowel disease (IBD) and hereditary periodic fever syndromes, and the most common cause is familial Mediterranean fever (FMF) in Turkey.Objectives:We herein aimed to evaluate clinical and laboratory characteristics and treatment responses of patients with AA amyloidosis retrospectively in a tertiary referral center.Methods:Study group was consisting of patients with biopsy proven AA amyloidosis, and their data were recorded from their charts. Treatment responses were categorized as follows:complete responsewas defined as no increase in serum creatinine and a proteinuria below 1gr/day;partial responseas 50% decrease in proteinuria; andstable disease as no significant change in serum creatinine and proteinuria. Progressive disease was defined as increase in serum creatinine and/or proteinuria under treatment.Results:173 patients were identified, and 10 patients with no biopsy result and/or missing data were excluded. A total of 163 patients (79 females, 84 males) were included in the study. Median age of patients was 45.4, and median age at diagnosis of amyloidosis was 33.5. Most common cause of amyloidosis was FMF (78.5%), followed by idiopathic cases (7.9%) and patients with AS (4.9%). A quarter (26%) of amyloidosis patients had a family history for AA amyloidosis, and 59% of patients with FMF had a family history of FMF. Amyloidosis was confirmed by renal biopsy in 76.1%, by gastrointestinal (GIS) biopsy in 11.7%, and by other biopsies in the remaining. Renal involvement was documented in 160 (98.2%) patients, while GIS involvement in 20.9%, heart in 13.5%, thyroid in 3.7% and bone marrow in 3.1%. In FMF patients, most common MEFV mutation was M694V (77.7%); and 66.7% of the patients had homozygous, 14.6% had compound heterozygous, and 18.7% heterozygous exon 10 variants. Mean age at diagnosis of amyloidosis was earlier in homozygotes (29.1) and compound heterozygotes (32.3) compared to heterozygotes (43.9) (p = 0.001). There was no difference in treatment responses, organ involvement, progression to end stage renal disease (ESRD) and mortality between monoallelic and biallelic exon 10 mutations (p = 0.42). While 44.3% (n = 70) of patients had chronic renal disease (CRD) at time of diagnosis, ESRD developed in 45.3% (n = 73) of patients. During follow-up, 55 patients underwent renal transplantation and recurrence of renal amyloidosis occurred in 24% of them. Mean creatinine and proteinuria levels at time of diagnosis were higher in patients with ESRD than those without ESRD (p Figure 1: Survival graphic of AA amyloidosis patients who developed ESRD according to their baseline GFR statusConclusion:Increased rate of ESRD and progression of amyloidosis findings in patients who presented with GFRDisclosure of Interests:None declared

Giriş: Obezite, yüksekprevalansı ve eşlik eden komorbiditeleri nedeniyle toplum sağlığını tehdit edenen önemli sorunlardan biridir. Bu komorbiditelerin her birinin sağlık içinçeşitli riskleri vardır. Obezite ile ilişkili komorbiditeler hakkında insanlarınfarkındalığını araştıran çok az çalışma vardır.Yöntem: Bu çalışmaya,Endokrinoloji ve Dahiliye polikliniklerine başvuran, vücut kitle indeksi>18,5kg/m2 olan ve obezite ile ilişkili komorbiditelere ilişkinbir anket doldurmayı kabul eden beş yüz yetişkin hasta dahil edildi. Her doğrucevap 1 puan olarak puanlandı. Her bir katılımcının toplam puanı ve ortalamatoplam puanı hesaplandı. Skorlar normal kilolu, kilolu ve obez gruplardakarşılaştırıldı. Anketin yanı sıra yaş, cinsiyet, eğitim düzeyi ve bel çevresi,kalça çevresi, boy ve kiloları ölçüldü.Bulgular: Toplam puanı enyüksek olmasına rağmen obez grupta ortalama eğitim skoru en düşüktü. Obeziteile ilişkili inme, meme kanseri ve osteoartritis farkındalığı obez grupta diğergruplara göre anlamlı olarak yüksek bulundu, ancak kadın ve erkek arasında farkyoktu. Obeziteye bağlı menstrüel düzensizlik ve infertilite farkındalığıkadınlarda daha yüksek iken obezite ilişkili hipertansiyon ve prostat kanserifarkındalığı erkeklerde daha yüksekti.Sonuç: Eğitim düzeyiobez grupta en düşük olmasına rağmen obezite ile ilişkili komorbiditelerinfarkındalığı en yüksek düzeydedir., Introduction: Obesity is one of the most important community healththreatening problem, because of its high prevalence and associatedcomorbidities. Each of these comorbidities have various risks for health. Thereare very few studies investigating the awareness of people about obesityassociated comorbiditiesMethods: Five-hundred adult patients, admitted to Endocrinology& Internal Medicine outpatient clinics, whose body mass index was>18.5kg/m2 and completed a questionnaire concerning obesity associatedcomorbidities were included in this study. Each correct answer was scored as 1point. Each participant’s total score and mean total score (MTS) wascalculated. The scores among normal weight, overweightand obese groups were compared. Besides the questionnaire, age, gender,education level was asked and waist and hip circumference, height and weightwere measured by the researchers.Results: Mean education scorewas the lowest in the obese group, altough MTS was the highest. Awareness of obesity associated stroke, breast cancerand osteoarthritis were significantly higher in the obese group when comparedto the other groups, but there was no difference between men and women. Awarenessof obesity associated menstrual irregularity and infertility was higher inwomen, hypertension and prostate cancer was higher in men.Conclusions: Although the education level was lowest in the obesegroup, the awareness of obesity-associated comorbidities was highest.

Objective. Nocturia is the most common lower urinary tract symptom and its prevalence increases with age. The frequency of nocturia and related bother are not widely investigated in young adults in the literature. In this study we aimed to investigate frequency, bothersome and relation of nocturia with anxiety in medical students. Methods. A questionnaire consisting of 19 items were sent to medical students via social media by using Survey Monkey TM software. Questions include demographic characteristics, fluid intake habits, voiding symptoms, and bother score related to nocturia. Also, Beck Anxiety Inventory was used to measure level of anxiety. Results. A total of 221 students replied the survey. The mean age was 20.7 ± 2.10. Forty-seven (21.3%) students had nocturia. The rate of nocturia was 27.4% and 13.4% in women and men, respectively ( p =0.011). The frequency of nocturia per night was 80.2%, 17.3% and 2.2% (1, 2, 3 times; respectively). While the frequency of nocturia was found to be related with bother scores there were no relation of gender with degree of bother. Conclusion. Nocturia is frequent in medical students, especially in women. Commonly, nocturia do not cause bother in young adults with one episode and it is not related with anxiety.

Parasitic infestations are mostly encountered in underdeveloped or developing countries. Taenia saginata is the most frequently found genus in Turkey and cases occur particularly in the Southeastern Anatolian Region. A 57-year-old woman admitted to hospital with the complaints of weakness, weight lose and abdominal pain. Gastroscopy was performed and a tumoral mass was observed. Pathologic evaluation of the endoscopic biopsies was reported as signet ring cell gastric carcinoma. Tapeworm was incidentally observed when the incision was made for jejunal bypass. Fifteen-meter-long parasite was extracted. There are not enough studies and case reports that questioned the relationship between taeniasis and cancer.

Introduction Many studies determine different risk factors for sexual dysfunction (SD) in women, but little is known about the influence of socioeconomic and cultural factors, medical and psychological features on female SD frequency in patients under renal replacement therapy (RRT). Aim This study aimed to compare the relationship between medical, psychological, sociocultural‐economic factors, and SD frequency in patients on RRT with the diagnosis of end‐stage renal disease. Method The 115 RRT patients (hemodialysis [HD] 39, peritoneal dialysis [PD] 43, kidney transplant [KT] 33) and 103 healthy premenopausal female volunteers (control) without any known health problems were included in the study. Main Outcome Measures The questionnaire forms containing sociodemographic data, the hospital anxiety depression scale, and Arizona Sexual Experiences Scale were completely filled by subjects who were included in the study. Results There was no significant difference about mean age, dialysis duration, and body mass index between the groups. While there were significant differences among participants training period and employment conditions, socioeconomic status scores were similar. Significant differences were found in marriage type, marital duration, husband's age, training period and working time per week, spending time with each other, weekly sexual intercourse frequency, the number of children, mothers' and fathers' education. RRT groups were more depressed than control, but no significant differences were observed among the RRT groups. PD and HD groups were more anxious than the KT and control groups. It was identified that SD rates were higher in KT and dialysis patients compared with the control. SD rates were significantly high in the HD group. Multivariate analysis showed that marital duration and being an HD patient are independent SD risk factors for RRT population. Conclusion Successful KT may improve SD. Differences in sociocultural, economic, medical, and psychological factors among individuals with SD should be taken into consideration in their treatment management. Koca TG, Koca N, and Ersoy A. The comparison of the relationship between sociocultural‐economic features and sexual dysfunction frequency in sexually active premenopausal female patients on renal replacement therapy. J Sex Med 2012;9:3171–3179.

The mammalian target of rapamycin inhibitors is commonly preferred for solid organs for transplantation. Although these drugs have various adverse effects, sirolimus-related lymphedema has been rarely reported. We report a case of lymphedema related to everolimus after a kidney transplant. A 60-year-old woman successfully received a deceased-donor kidney. Everolimus was added to the treatment in postoperative month 3 owing to other immunosuppressive drugs' adverse effects. Edema occurred first on her feet in the first year after the transplant. During 3 months' follow-up, with no immunosuppressive adjustment, the edema progressed. Diagnosis of lymphedema was established. Several weeks after discontinuing everolimus, the patient's lymphedema began to resolve itself and completely disappeared in 3 months. The mammalian target of rapamycin inhibitors rarely causes lymphedema by inhibiting different subtypes of vascular endothelial growth factors, which results in impaired lymphangiogenesis. While there are few reports about sirolimus-related lymphedema, this case represents the first everolimus-related case of lymphedema. Further studies are warranted to explain the underlying mechanisms.