Increased risk of eating disorders in women with polycystic ovary syndrome: a case-control study

Abstract

Data on eating disorders in women with PCOS is insufficient. The objective of this case study was to examine the hypothesis that women with PCOS exhibit more impaired eating than healthy women. Women diagnosed with PCOS under the 2003 Rotterdam Diagnostic Criteria (n?=?40) were compared with a healthy control group (n?=?40). The groups also were divided into two as normal body weight and overweight/obese. The Eating Disorders Assessment Questionnaire (EDE-Q) and the Three Factor Eating Questionnaire (TFEQ-R21), were completed by all participants in order to evaluate eating behaviors in addition to eating disorders. Among the overweight/obese group, the average total and subscale scores of the EDE-Q as well as the total and sub-factor scores of the TFEQ-R21 were higher in women with PCOS compared to controls (p?<?.05). However, this statistically significant result was not shown among the women with normal weight (p?>?.05). In comparison to the controls, the PCOS women displayed higher values of the tool scores indicating abnormal restraint eating, body shape concern and weight concern subscale scores (p?<?.05). This result suggests that the evaluation of eating disorders should be added to routine screening and the monitoring of women with PCOS.     

Clinical and pathological correlations of marrow PUMA and P53 expressions in myelodysplastic syndromes

p53 is a key regulator of apoptosis. p53 upregulated modulator of apoptosis (PUMA) is a critical mediator of p53‐dependent and independent apoptosis. The objective of this study was to evaluate the relationship of p53 and PUMA to the prognosis of MDS. Bone marrow biopsies of MDS patients at the time of diagnosis (n = 76) and at the time of transformation (n = 19) were included in the study group. The expression of p53 and PUMA was evaluated using immunohistochemistry. When compared to the control group, both p53 (p < 0.001) and PUMA (p = 0.012) expression levels were significantly higher in MDS group. In MDS group, there was a moderate positive correlation between p53 and PUMA expressions. PUMA expression was not correlated with event free and overall survival. However, overall survival was significantly lower in cases with p53 expression in more than 50% of the cells. There was an increase in PUMA expression in cases that showed transformation as compared to the initial diagnostic bone marrows but was not statistically significant. The correlation that existed between p53 and PUMA was lost in transformed cases. Our results showed that PUMA and p53 expressions are increased in MDS marrows compared to normal marrows. PUMA expression increases further during transformation while the expression of p53 is not significantly altered which suggests that PUMA alterations might be a late event during the evolution of MDS.     

Is it possible that direct rigid laryngoscope-related ischemia–reperfusion injury occurs in the tongue during suspension laryngoscopy as detected by ultrasonography: a prospective controlled study

Abstract

Background: Tongue-related complications can be seen in suspension laryngoscopy (SL) procedures.

Aims/objectives: This study aimed to detect tongue edema associated with the pressure exerted by a rigid direct laryngoscope by measuring the tongue area using ultrasonography (USG) in patients undergoing SL procedures.

Material and methods: The study group included 31 patients and the control group consisted of 33 patients. Submental USG examinations of the tongue in the coronal plane were performed. In the study and control groups, the first examination (TA¹) was done immediately after intubation and the second examination (TA²) was done after the surgery procedure but before extubation. The USG results regarding tongue area for both the groups were compared.

Results: The study and control groups significantly differed in terms of the postoperative tongue area measurements (TA²), as well as tongue edema (based on the TA²???TA¹) values.

Conclusions and significance: Direct rigid laryngoscopes may cause tongue edema in SL procedures which was demonstrated by the USG. This tongue edema can be a result of ischemia–reperfusion injury in the tongue due to the pressure exerted by a direct rigid laryngoscope. This study is the first to demonstrate the possible role of USG examination in determining the side effects of SL procedures on the tongue.

Trial Registration ClinicalTrials.gov Identifier: NCT04205253     

Bilateral acute iris transillumination following a fumigation therapy: a village-based traditional method for the treatment of ophthalmomyiasis

Bilateral acute iris transillumination (BAIT) is a relatively new clinical entity characterized by bilateral acute loss of iris pigment epithelium, iris transillumination, pigment dispersion in the anterior chamber and atonic pupilla. We report herein a 50-year-old female who presented with bilateral ocular pain, severe photophobia and red eyes. One month ago, a fly hit her eye, and she instantly complained of a discomfort and sensation of a foreign body in both eyes. She used a fumigation therapy, a traditional method for the treatment of ophthalmomyiasis. During follow-up examinations, intraocular pressures increased over 40?mmHg bilaterally despite maximal medical therapy, which necessitated trabeculectomy surgery with mitomycin. This is a typical BAIT case with no antecedent fluoroquinolone use or viral disease, but a fumigation therapy. There might be a possible relationship between BAIT and traditional fumigation therapy or this association might be coincidental, both of which need further evaluation.     

Effect of Intraoperative Valsalva Maneuver Application on Bleeding Point Detection and Postoperative Drainage After Thyroidectomy Surgeries

The purpose of this paper was to analyze the effect of Valsalva maneuver application before finalizing thyroidectomy operations on the identification of bleeding points and postoperational drainage. One hundred patients (age range, 24–76 years) with multinodular goiter, recurrent multinodular goiter, toxic diffuse multinodular goiter, or papillary thyroid cancer were included in the study and were divided into 2 groups of 50 randomly. Both groups underwent thyroidectomy operation, only 1 group received intraoperative Valsalva maneuver application (twice, 30 seconds of 30-cm PEEP). The size of the thyroid gland, the duration of operation, hospital stay, and drain usage were reported. Postoperational occurrences of drainage, hematoma, reoperation, and additional complications were compared between the groups. Valsalva maneuver application helped to identify minor bleeding points in 32% of the cases. There was no significant difference between the study groups regarding the thyroid gland size, operation duration, hospital stay, and the duration of drain usage (P > 0.05 for all). The amount of drainage as well as the frequencies of hematoma, reoperation, and further complications was not significantly different between the study groups (P > 0.05 for all). Intraoperative application of Valsalva maneuver is only useful to detect minor bleeding points in some patients during thyroidectomy operations, but it had no effect on the duration of postoperative drain usage, the amount of drainage, and risk of hematoma. Therefore, intraoperative application of Valsalva maneuver has no beneficial effect on postoperative hemorrhagic complication after thyroidectomy operations.Key words: Drainage, Hemostasis, Thyroidectomy, Valsalva maneuverThyroidectomy is one of the most commonly performed operations worldwide.¹ Though a series of improvements were introduced to the operation process, still several postoperative complications remain to be faced such as seroma, wound infection, skin flap complications, and hematoma.^2,3Despite the richness of the blood vessels in the thyroid area,⁴ the rate of postoperational bleedings thus hematoma events are low (1–5% of the cases).⁵ However, once not controlled, hematoma can result in airway compression and create a life-threatening situation for the patient.⁶ Hence, preventive measures have been emphasized and employed to avoid postoperational bleedings after thyroidectomy. These approaches range from exercises to avoid Valsalva maneuver kind of forces such as coughing or straining at opening bowel⁷ to the use of drains after the operation. However, recent literature indicates that the drain usage does not have a significant effect on the recovery period or on the duration of the hospital stay.^3,5,8,9 Furthermore, it may cause wound infection and contribute to the discomfort of the patients.^5,8,10,11 Thus a proper hemostasis and an early detection of potential bleeding sites are crucial steps for a successful operation and a steady recovery period.⁴ Several techniques have been used to detect and treat bleeding points immediately after the operation to prevent postoperational hematoma. These techniques involve the use of hydrogen peroxide, water in the wound, Valsalva maneuver, and Trendelenburg tilt.^4,7 Recently, the success of Valsalva maneuver and Trendelenburg tilt application on bleeding point detection was demonstrated by Moumoulidis et al.⁴ However, no further information is provided until now regarding the postoperational evaluation of the patients.In this paper, we aim to analyze the effect of the Valsalva maneuver application on the identification of bleeding points before finalizing the surgery and its influence on the postoperative drainage, complications, and recovery process.     

The comparison of various oral hygiene strategies in neuromuscularly disabled individuals

BACKGROUND: This study aims to investigate the effect of various oral hygiene strategies on the symptoms of inflammation in neuromuscularly disabled patients and to define the optimum hygiene method. METHODS: Fifty-nine neuromuscularly disabled participants, suffering from cerebral palsy, were randomly divided into five groups as follows: Group M: manual toothbrush (n=14), Group E: electrically powered toothbrush (n=9), Group MC: manual toothbrush and chlorhexidine gluconate (CHX) spray (n=13), Group EC: electrically powered toothbrush and CHX spray (n=9), and Group C: CHX spray (n=14). The oral hygiene applications were provided by the parents and staff. At baseline and after 21 days the plaque index (PI), the gingival index (GI), and bleeding on probing (BOP) were recorded. RESULTS: In intra-group comparisons of the pre- and post-application scores, in all groups the PI and GI scores and BOP percentages, except in Group C, were found significantly different (p<0.05). There were significant differences among the post-application scores, between Group M and Group E and between Group C and Group E in PI scores; between Group C and Group E the difference in GI scores were found statistically significant (p<0.05). CONCLUSIONS: Although all oral hygiene strategies reduced plaque and gingival inflammation, the results of our study suggested the electrically powered toothbrush could be more recommendable to neuromuscularly disabled people in these strategies, while the combined procedures appeared to be neither beneficial nor favorable.