Medical Science and Discovery

Pigmentation of the Tongue, Nails, and Gingiva Following Adriamycin Therapy: A Literature Review and Clinical Insights

Aslı Geçgel, Oğuzcan Özkan, Fatma Pınar Açar, Burçak Karaca Yayla, Erdem Göker — Thu, 28 Mar 2024 00:00:00 +0300

Objective: Hyperpigmentation in the mucosa of the tongue and mouth may also occur with the administration of combination chemotherapy containing doxorubicin (Adriamycin). Chemotherapeutic agents may occasionally necessitate discontinuation, either temporarily or permanently, despite the fact that most of these side effects are purely cosmetic and resolve following treatment. The return of nail growth and coloration a few weeks or months after therapy cessation suggests the involvement of chemotherapeutic drugs. Following Adriamycin administration, pigmentation observed in the tongue, nails, and oral mucosa typically diminishes upon discontinuation of the medication without the need for additional treatment. However, careful monitoring is essential to ensure that no alternative explanations are overlooked.

Conclusion: To enhance awareness and facilitate the exchange of experiences regarding the management of this rare side effect, we present four cases of patients who developed nail, oral mucosa, and gingiva pigmentation following combination therapy with Adriamycin and cyclophosphamide in our clinic.

Investigation of Vascular Endothelial Growth Factor and Endostatin Levels in Some Rat Tissues in Response to Cold Stress and Diet

Filiz Coban, Muhittin Yurekli — Sun, 03 Mar 2024 00:00:00 +0300

Objective: Obesity, the disease of our age, is a condition that occurs when there is an excess of fat tissue in the body. It is not merely a concern about weight gain, but rather a medical issue that elevates the risk of various diseases including heart disease, diabetes, high blood pressure, and certain cancers. This study aimed to explore the impact of a high-fat diet under normal conditions and cold stress, as well as the influence of propolis as a dietary supplement, on vascular endothelial growth factor (VEGF) and endostatin levels in rats fed with propolis.

Material and Methods: Thirty-six 3-month-old female Wistar rats (6 rats in each group) sourced from Inonu University Experimental Animal Production and Research Center were utilized for the study. Propolis was administered by gavage, dissolved in water, at a dosage of 2 mL per day for two weeks.

Results: The group exhibiting at least a 20% increase in weight due to high-fat diet consumption was categorized as the obese group. Tissues including heart, liver, lung, brown adipose, and white adipose tissues were procured from the obese, propolis-treated, and control groups. Endostatin and vascular endothelial growth factor levels were assessed in the tissues using the ELISA method. The study revealed an elevation in VEGF levels in brown adipose tissue in both cold stress and propolis treatment groups, accompanied by a reduction in white adipose tissue compared to the control group. Additionally, VEGF levels displayed a general increase in lung, liver, and heart tissues. Conversely, endostatin levels, an antiangiogenic factor, decreased in brown adipose tissue while increasing in white adipose tissue. In liver, lung, and heart tissues, endostatin levels exhibited a general decrease.

Conclusion: The findings suggest that both cold stress and propolis treatment influence VEGF and endostatin levels in various rat tissues, indicating potential implications for obesity-related conditions and angiogenesis regulation.

Single Center Evaluation of Long-Term Results of Glargin U-300 in Insulin Naive Patients In a Real-World Setting

Deniz Gezer, Seval Müzeyyen Ecin — Thu, 07 Mar 2024 00:00:00 +0300

Objective: Insulin therapy stands as one of the most effective and well-established therapeutic options for managing glycemic control in Diabetes Mellitus (DM). Glargine 300 U/mL (Gla-300) represents a new long-acting insulin analog, which has demonstrated a decrease in the risk of hypoglycemia and a reduction in the total number of injections due to prolonged insulin absorption. In this study, we investigated the long-term effects of Gla-300 on Fasting Plasma Glucose (FPG) and HbA1c levels, as well as the incidence of hypoglycemia in insulin-naive patients admitted to the Internal Medicine outpatient clinic, over a period of 0, 3, 6, 12, and 24 months..

Material and Methods: Between January 2018 and June 2022, insulin-naive patients diagnosed with Type 2 Diabetes Mellitus (T2DM) who initiated treatment with Gla-300 and sought care at the Internal Medicine outpatient clinic were subjected to retrospective analysis.

Results: The study included 49 insulin-naive patients. A statistically significant decrease was observed in Fasting Plasma Glucose (FPG) (p = 0.03) and HbA1c (p = 0.02) levels during the 24-month follow-up period of Glargine U-300. Additionally, a significant reduction in both FPG (p < 0.01) and HbA1c (p < 0.01) values was achieved at the time of diagnosis and at 3 months. Hypoglycemia was reported in only 1 patient (2%) during our study, indicating a very low hypoglycemia rate.

Conclusion: Diabetes mellitus (DM) poses a significant public health challenge, resulting in economic burden and diminished quality of life. Developed to address these challenges, Gla-300 serves as a long-acting basal insulin that effectively reduces the risk of hypoglycemia while offering targeted glycemic control, as evidenced by our study findings. In Turkey, there is a pressing need for multicenter, prospective real-world studies that incorporate parameters such as insulin dosage and weight monitoring.

Evaluation of Perfusion and Function in Cardiac Radionuclide Imaging in Cases of Heart Failure with Mid-Range Ejection Fraction

Sule Ceylan — Tue, 19 Mar 2024 00:00:00 +0300

Objective: Heart failure with mid-range ejection fraction (HFmrEF) poses a significant clinical challenge due to its diverse etiology and variable prognosis. Patients with HFmrEF exhibit an intermediate level of left ventricular dysfunction, making their management and prognosis less well-defined compared to those with heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF). Coronary artery disease (CAD) is a common underlying cause of HFmrEF and can further exacerbate myocardial dysfunction under stress conditions. In this study, we aimed to evaluate the change in left ventricular ejection fraction with stress in the presence of coronary artery disease in cases of heart failure with mid-range ejection fraction.

Material and Methods: In this retrospective study, we included 507 patients diagnosed with coronary artery disease and an left ventricular ejection fraction (LVEF) of 41-49% measured by echocardiography. All patients underwent a treadmill exercise test using the Bruce protocol, with progressively increasing speed and incline. Myocardial perfusion was assessed using stress gated myocardial perfusion scintigraphy (MPS), and fixed and reversible defects were identified in cases of coronary artery disease. Cardiac scintigraphic images were acquired from the right anterior oblique to the left posterior oblique. We calculated post-stress LVEF and the percentage decrease in LVEF to evaluate cardiac function.

Results: Resting LVEF was measured as 46 (43-50), while post-stress LVEF was 35 (25-47) in all patients. Myocardial perfusion was evaluated using stress gated MPS in all patients, with 200 (39.5%) patients showing both fixed and reversible perfusion defects. The rate of decrease in LVEF due to stress was significantly higher in patients with reversible perfusion defects (15.90 (6-30.43) vs. 28.26 (24-43.18), p: 0.0005). Post-stress LVEF was lower in patients with reversible perfusion defects (40 (31-47) vs. 33 (25-38), p: 0.0005).

Conclusion: In cases of impaired left ventricular perfusion, quantitative calculations of LVEF may vary, and their reliability may decrease as the ejection fraction decreases under stress conditions. Clinicians should consider this variability in the follow-up of patients with heart failure and mid-range ejection fraction.

Bibliometric Analysis of The Top 100 Most Cited Articles on The Thalamus Anatomy

Erdal Horata — Fri, 22 Mar 2024 00:00:00 +0300

Objective: The thalamus regulates complex tasks like motor function and executive control while transmitting sensory information to higher centers. Bibliometric analysis analyzes studies in a research area and guides planning studies in that area. Despite bibliometric analysis in anatomy, there is no study on the thalamus' anatomy. This study aims to perform a bibliometric analysis of the 100 most cited articles on the anatomy of the thalamus, a clinically important region, to guide research in this area, as there is no study on this topic in anatomy.

Material and Methods: Bibliometric analysis was used to evaluate human studies on the anatomy of the thalamus that were published in the Web of Science database between 2004 and 2023. As a result of the analysis, 1704 documents from the last twenty years were found. The data of the first 100 most cited articles were obtained.

Results: The average number of citations of the articles was 229.14. The publication years of the first 5 most cited studies were 2006-2010. The most cited study was by Heckemann et al. (2006). Articles were mostly published in NeuroImage. The United States has the strongest bibliographic link, publishes the most articles and is the most cited. Snyder Abraham Z. is the author with the most articles on this topic. Keyword co-occurrence analysis revealed 4 different clusters: the thalamus and its relationship to related anatomical structures, the connection between the thalamus and psychiatric and mood disorders, the relationship of the thalamus to the cerebral cortex, and the function of the thalamus.

Conclusion: Researchers show high interest in studies on the anatomy of the thalamus. The fact that the studies to be planned on the anatomy of the thalamus have to do with neuroimaging is one of the factors that may increase the number of citations.