Medical Science and Discovery

Serum paraoxonase enzyme activity after balneotherapy in patients with fibromyalgia

2020-03-30T15:29:52+03:00

Objective: The aim of this study was to compare the serum paraoxonase (PON 1) levels between patients with fibromyalgia syndrome (FMS) and healthy control subjects, and to investigate the possible effect of balneotherapy (BT) on PON 1 enzyme activity in FMS patients.

Methods: The study included 45 female patients with FMS, and 35 healthy female volunteers. To measure PON 1 enzyme activity, venous blood samples were taken twice from the FMS group, before and after BT, and once from the control group. The Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ) scales were applied to the FMS patients before and after BT.

Results: There was no difference between the FMS group and healthy control group in terms of serum PON1 activity (p>0.05). The comparison of the serum PON 1 activity of the FMS group before and after BT revealed a statistically significant increase after BT (p=0.001). A statistically significant decrease was determined in the VAS and FIQ scores of the FMS group after BT compared to the pre-treatment values (p=0.002, p=0.001, respectively).

Conclusion: BT is an effective non-pharmacologic method in the treatment of FMS. There was an increase in serum PON 1 activity in patients with FMS after BT. BT may have a regulatory effect on the antioxidant system of patients with FMS.

Seasonal clustering in epilepsy

2020-03-30T15:29:50+03:00

Objective: There are few studies in the literature suggesting that epileptic attacks can cluster especially in winter. We aimed to confirm the most frequent month and season in which our patients with epilepsy visited the emergency room because we had similar observations in our clinical experience.

Material and Methods: Patients admitted to the emergency room due to convulsive epileptic seizures between January 2017 and December 2019 were included in the study. The month of seizures was recorded.

Results: In our study, epileptic seizures clustered significantly in winter.

Conclusion: Although more detailed data should be collected on this subject, we think this is an indirect result of the change in vitamin D metabolism, as suggested in other studies.

The neutrophil lymphocyte ratio may predict the discharge status in patients admitted to the emergency department

2020-03-30T15:29:46+03:00

Objective: The neutrophil to lymphocyte ratio (NLR) has been investigated as an indicator of mortality and/or morbidity in many clinical pathologies. However, these studies have mostly been conducted for specific diseases. We investigated whether there is a relationship between the NLR and hospitalization or discharge decisions in the emergency department (ED).

Methods: We retrospectively reviewed the medical records of patients admitted to the ED. The NLR values of the patients were calculated, and their demographic characteristics (age and gender) and clinical outcomes were recorded.

Results: Of the 1970 patients, 1400 (71.1%) were discharged from the ED, and 570 (28.9%) were hospitalized. The patients who were discharged were younger and had lower NLR values, and this group had a lower female gender ratio (p<0.001, p<0.001, and p<0.001, respectively). The NLR threshold for discharge was 4.8, with a sensitivity of 70% and a specificity of 60%. Of the 570 hospitalized patients, 478 (83.9%) were discharged from the hospital and 92 (16.1%) died. Deceased patients were statistically significantly older with higher NLR values (p<0.001 and p=0.001, respectively). The threshold value of NLR for predicting mortality was calculated as 11.5, with a sensitivity of 45% and a specificity of 77%.

Conclusions: Our study reveals that the NLR is an important predictor of hospitalization and mortality in patients admitted to the ED regardless of diagnosis. ED physicians may consider to discharge patients with NLR values below 4.8 instead of spending additional time with advanced tests. In addition, clinicians should review the risk of mortality in patients with NLR values greater than 11.5 more thoroughly concerning mortality and should consider early aggressive treatment options.

Investigation of angiogenic factors in obese rats exposed to low oxygen pressure

2020-03-30T15:29:49+03:00

Objective: Obesity, which is one of the most important health problems of today's people, remains current due to the risks of illness it brings due to the increase rate in the world.

Material and Methods: Male Sprague Dawley rats were used in our study of obesity. Rats were divided into four groups as standard diet/ normal oxygen, standard diet/low oxygen, high-fat diet/normal oxygen and high-fat diet / low oxygen. For the study, a special cage with a low oxygen level of 17-18% was made in a closed system. After achieving the desired 25% weight increase in obese group rats, blood, liver, lung, white adipose tissue and brown adipose tissue were obtained from the rats. In these tissues, adrenomedullin, hypoxic inducible factor 1-α (HIF1-α) and matrix metalloproteinase-II (MMP-II) levels were measured by ELISA.

Results: According to our results, there was a significant increase in adrenomedullin, HIF1-α and MMP-II in white adipose tissue, and adrenomedullin and MMP-II in brown adipose tissue. It was found that the amount of HIF1-α increased significantly in liver and lung tissues.

Conclusion: According to the metabolic status of adipose tissue, it is thought that the effect of adrenomedullin, HIF1-α and MMP-II can increase vascularization of brown adipose tissue and provide energy consumption.

Diagnosis of cholesteatoma by the b1000 value DWI MRI according to the signal intensity

2020-03-30T15:29:47+03:00

Objective: The cholesteatoma (CL) can be evaluated visually or numerically on an apparent diffusion coefficient (ADC) map, which obtained from at least two different b-valued diffusion-weighted imaging (DWI). In this study, we aimed to evaluate the signal intensity (SI) of the lesion both visually and numerically only on the DWI image without ADC. In case of positive results a second ‘b’ value is not required, so this method could be shorten the duration of the MRI examination.

Material and Methods: Between January 2017 and May 2018, we included patients with chronic otitis media (COM) with a clinical suspicion of primary CL who underwent DWI. Two radiologists and one ear, nose, throat specialist evaluated the radiological images and the pathology results.

Results: The mean SI measurement was significantly higher in the CL group by both observers (observer LR; CL: 107.94 ± 53.36, COM: 37.34 ± 14.70, observer FC; CL: 108.56 ± 50.00, COM: 37.06 ± 15.44; p<0001). ROC analysis showed that a mean SI value of 48.6 was the cut-off value in predicting the diagnosis of CL. The mean SI was significantly higher in the CL group (p<0.001).

Conclusion: We demonstrated a significant difference between CL and COM concerning the diagnosis by visual and numerical signal evaluation only via b1000 valuable images. In false-positive cases, ADC is still confirmatory for high diagnostic accuracy.

Influence of hyperthyroidism on hepatic antioxidants and cytokines Levels: An Experimental Study

2020-03-30T15:29:44+03:00

Objective: Thyroid diseases greatly affect the liver. Hyperthyroidism can affect the function of the liver. This study aimed to investigate the possible change of antioxidant and pro-inflammatory cytokines levels in liver tissue in hyperthyroid rats.

Material and Methods: This study was carried out with 2 experimental groups. Hyperthyroid group was fed with 4 mg/kg L-thyroxine added standard fodder. Control group was fed with standard rat fodder. Liver selenium (Se) levels were measured by inductively coupled plasma optical emission spectrophotometer (ICP-OES). The antioxidant markers such as Selenoprotein P (SelP), and glutathione peroxidase (GPx), and the pro-inflammatory cytokines such as Interleukin (IL)-18, and Tumor necrosis factor-α (TNF-α) levels were studied in liver tissues by ELISA. All markers levels of liver samples were measured in tissue homogenates.

Results: Se, SelP, and GPx levels of the hyperthyroidism group were lower than the control group. (p=0.038, p=0.046, p=0.008 respectively). There was a significant increase in IL-18 and TNF-α levels in hyperthyroidism group when compared to control group (p=0.002, p=0.023 respectively). There was positive correlation between FT3 and FT4, IL-18 and TNF-α (r=0.761, r=0.843, and r=0.826 respectively), but there was negative correlation between FT3 and Se, SelP, and GPx (r=-0.833, r=-0.754, and r=-0.778 respectively).

Conclusion: Our findings showed that antioxidant marker levels were decreased, and pro-inflammatory cytokine levels were increased in liver tissues of hyperthyroid rats. These findings suggest that impaired antioxidant and pro-inflammatory status may play a role in liver pathogenesis due to hyperthyroidism.

The association of axillary lymph node-positive breast cancer with metabolic parameters of 18F-fluorodeoxyglucose PET / CT

2020-03-30T15:29:43+03:00

Objective: This study aims to examine the association between 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) metabolic parameters of lymph node-positive and lymph node-negative breast carcinomas.

Material and method: We included breast carcinomas patients who underwent 18F-FDG PET/CT imaging at our department between May 2018 and December 2019. A total of 108 female breast cancer patients were included (aged 48.8 ± 13.6years; range, 28-84 years). PET scanning was performed in 3D mode from the skull ceiling to the half of the thigh. According to pathology reports, we divided the patients into two groups: a lymph node-positive group of patients and a lymph node-negative group of patients. We calculated the sensitivity and specificity for determining the PET/CT pathological lymph node. Metabolic parameters like TLG (Total lesion glycolysis), MTV (Metabolic tumor volume), SUVmean, and SUVmax values were calculated.

Result: The lymph node-positive group’s body weight and body mass index(BMI) were statistically higher than the lymph node-negative group (p=0,027,p=0,022 respectively). SUV max and SUV mean of the lymph node-positive group were statistically higher than the lymph node-negative group (p=0.008, p=0,009, respectively). Both TLG and MTV of the lymph node-positive group were statistically higher than the lymph node-negative group (p=0.01, P= 0.01, respectively). Ki-67(%) of the lymph node-positive group was not statistically different from the lymph node-negative group. We calculated the PET/CT’s sensitivity and specificity as 78,57% and 59,09%, respectively. For the positive predictive value of PET/CT, we found 55%, and for the negative predictive value, it was 81.25%.

Conclusions: PET/CT metabolic parameters of patients with lymph node-positive breast cancer were higher than patients with lymph node-negative. High body weight and BMI appears to increase the possibility of metastases of lymph node. The sensitivity of PET/CT can be considered to be useful in determining the pathological lymph node, but the specificity of PET/CT is not very good.