Relationship between Neck Circumference and Non-Alcoholic Fatty Liver Disease in Childhood Obesity

Objective:

The aim of this study was to establish the association between anthropometric parameters and non-alcoholic fatty liver disease (NAFLD) and to determine the most reliable measurement as a parameter in predicting NAFLD.

Methods:

Two-hundred fifty-three obese children of ages 10 to 18 years were enrolled in this study. Anthropometric data and metabolic parameters such as fasting blood glucose, insulin and lipid levels, were measured. Liver function tests were assessed. NAFLD was determined by ultrasound.

Results:

Most metabolic parameters and anthropometric indices were significantly higher in children with NAFLD. A univariate logistic regression analysis was performed, taking NAFLD status as the dependent variable and anthropometric parameters as the independent variables. NAFLD was affected significantly by the anthropometric values. The multiple logistic regression analysis showed that neck circumference (NC) was the only parameter which determined the risk in both genders. Each 1 cm increase in the NC increased the risk of NAFLD 1.544-fold (p<0.001, 95% confidence interval (CI): 1.357-2.214) in the boys and 1.733-fold (p=0.001, 95% CI: 1.185-2.012) in the girls. Receiver operating characteristic analysis was performed to compare the reliability of anthropometric measurements. NC was observed to be a better indicator.

Conclusion:

Measurement of the NC was shown to be associated with NAFLD in children. We suggest the use of NC as a novel, simple, practical, and reliable anthropometric index in predicting children at risk for NAFLD.     

Diabetes and Sexual Function

Diabetes mellitus (DM) is a global health issue and a major risk factor for sexual dysfunction. Diabetic patients are at an increased risk for erectile dysfunction (ED), ejaculatory disorders, and hypogonadism. ED in these patients results from a multitude of pathophysiological mechanisms that culminate in vascular, neurogenic, and myogenic damage. Furthermore, these patients are often difficult to treat with current pharmacologic therapies. Ejaculatory disorders can be problematic, often requiring invasive modalities for those patients who wish to procreate. Finally, hypogonadism remains a topic of great debate in the diabetic population and general population alike. Its relation to the development of low sexual drive and even DM, itself, requires further investigation. Overall, the complex pathophysiology of this condition makes it difficult to develop clinical treatments tailored specifically for diabetic patients. As our understanding of diabetic ED progresses, the development of novel and effective treatment strategies will evolve.     

The role of late-phase pulse inversion harmonic imaging in the detection of occult hepatic metastases.

OBJECTIVE: The purpose of this study was to investigate the efficacy of late-phase pulse inversion harmonic imaging (PIHI) in detecting occult metastases and to compare the results with helical computed tomography (CT) in a group of patients whose fundamental liver sonographic results were normal. METHODS: Thirty-two patients (21 women and 11 men; age range, 20-87 years) with a known primary malignancy were enrolled in the study. The patients were evaluated with conventional sonography, unenhanced PIHI, and PIHI 3 minutes after the injection of Levovist (SH U 508A; Schering AG, Berlin, Germany). All patients also underwent triphasic helical CT within 1 week after sonography. In 1 patient, mangafodipir-enhanced magnetic resonance imaging was performed as part of the clinical workup. RESULTS: After Levovist injection, in 4 (12.5%) of 32 patients, at least 1 hypoechoic lesion was detected by PIHI; multiple lesions were shown in 1 patient. The mean diameter of newly detected lesions was 12 mm. Triphasic helical CT also showed all of the lesions that were detected by PIHI. The diagnoses were confirmed by biopsy and CT findings in 2 patients and by the typical CT and magnetic resonance imaging findings in 1 patient. For the fourth patient, the diagnosis was confirmed by follow-up and CT. Conclusions. Late-phase PIHI is comparable to helical CT for detecting occult hepatic metastases, but it protects patients from the potentially hazardous effects of radiation and iodinated contrast agents. Further series involving a larger number of patients are needed to determine its place in the evaluation of cancer staging and treatment planning.     

Ptosis as a unique hallmark for autosomal recessive WNT1‐associated osteogenesis imperfecta

Osteogenesis imperfecta (OI) is a heritable connective tissue disorder, mainly characterized by bone fragility and low bone mass. Defects in the type I procollagen‐encoding genes account for the majority of OI, but increasingly more rare autosomal recessive (AR) forms are being identified, which are caused by defects in genes involved in collagen metabolism, bone mineralization, or osteoblast differentiation. Bi‐allelic mutations in WNT1 have been associated with a rare form of AR OI, characterized by severe osteoporosis, vertebral compression, scoliosis, fractures, short stature, and variable neurological problems. Heterozygous WNT1 mutations have been linked to autosomal dominant early‐onset osteoporosis. In this study, we describe the clinical and molecular findings in 10 new patients with AR WNT1‐related OI. Thorough revision of the clinical symptoms of these 10 novel patients and previously published AR WNT1 OI cases highlight ptosis as a unique hallmark in the diagnosis of this OI subtype.     

Evaluation of river water genotoxicity using the piscine micronucleus test

The Berdan River, which empties into the Mediterranean Sea on the east coast of Turkey, receives discharges of industrial and municipal waste. In the present study, the in vivo piscine micronucleus (MN) test was used to evaluate the genotoxicity of water samples collected from different locations along the Berdan River. Nile tilapia (Oreochromis niloticus) were exposed in the laboratory for 2, 4, and 6 days, and micronuclei were evaluated in peripheral blood erythrocytes, gill cells, and caudal fin epithelial cells. A single dose of 5 mg/L cyclophosphamide was used as a positive control. In addition to micronuclei, nuclear abnormalities (NAs), such as binucleated cells and blebbed, notched, and lobed nuclei, were assessed in the erythrocytes, and chemical analyses were carried out to determine the amount of heavy metals in the water samples. MN and NA frequencies were significantly elevated (up to 2- to 3-fold) in fish exposed to river water samples taken downstream of potential discharges, and the elevated responses in gill and fin cells were related to the concentration of heavy metals in the water. MN frequencies (expressed as micronucleated cells/1,000 cells), in both treated and untreated fish, were greatest in gill cells (range: 0.80-3.70), and generally lower in erythrocytes (range: 0.50-2.80), and fin cells (range: 0.45-1.70). The results of this study indicate that the Berdan River is contaminated with genotoxic pollutants and that the genotoxicity is related to the discharge of wastes into the river water.     

Synthesis, characterisation and cytotoxic properties of the N1,N4-diarylidene-S-methyl-thiosemicarbazone chelates with Fe(III) and Ni(II)

Reactions of 2-hydroxy-3-methoxy, 2-hydroxy-4-methoxy-benzaldehyde with 3- and 4-methoxy-substituted salicylaldehyde S-methyl-thiosemicarbazones in the presence of FeCl(3) and NiCl(2) resulted in the corresponding methoxy-substituted N(1),N(4)-diarylidene-S-methyl-thiosemicarbazone chelates. Characterisation of the compounds in the [Fe(L)Cl] and [Ni(L)] general formula was accomplished by means of elemental analysis, conductivity and magnetic measurements, (1)H NMR, UV-vis, IR and mass spectroscopy. Cytotoxicity and proliferation experiments using K562 chronic myeloid leukemia cell line and ECV 304 human endothelial cell line imply that the iron(III) chelates may have anti-leukemic effects with 3.5 microg/dl LD(50) dose.     

Effects of various enteral nutrition solutions on bacterial translocation and intestinal morphology during the postoperative period

Bacterial translocation is the passage of bacteria or endotoxins from the gastrointestinal tract to extraintestinal sites, such as mesenteric lymph nodes, liver, spleen, and bloodstream. In this study, the investigators examined the effects of various enteral nutrients on bacterial translocation and intestinal morphology during the postoperative period. Sixty rats were randomly divided into 5 groups, each of which included 12 animals; cecal mobilization was performed in all groups. Group I rats were fed rat chow and water; group II was given standard enteral nutrients; group III, high-energy enteral nutrients; group IV, enteral nutrients supplemented with fiber; and group V, immunonutrients. Bacterial translocation was detected in mesenteric lymph nodes, spleen, liver, and blood cultures. Changes in the terminal ileum were scored from 0 to 4 with the morphologic scoring system. Bacterial translocation was predominantly detected in mesenteric lymph nodes. Rats fed immunonutrients (group V) showed a significant reduction in bacterial translocation compared with other groups. Although minor morphologic alterations in the villi were observed in groups IV and V, the histologic scores of these groups were not statistically different from the scores of control group members. In the present study, investigators evaluated the effects of various enteral nutritional solutions on bacterial translocation and intestinal morphology during the postoperative period. Enteral diets supplemented with arginine, nucleotides, and ω-3 fatty acids were found to reduce bacterial translocation. The investigators concluded that this effect might be related to improvement in immune function resulting from the use of immunonutrients.