A cross-sectional observational study to investigate daily symptom variability, effects of symptom on morning activities and therapeutic expectations of patients and physicians in COPD-SUNRISE study

Chronic obstructive pulmonary disease (COPD) is a lung disease characterized with limitation of airflow that is not completely reversible, progressive deterioration of airways and systemic inflammation. This study has been planned to determine daily symptom variability of patients, expectations of patient and physicians from treatment and patient profiles. A total of 514 patients with COPD from 25 centers were included in this national, multicenter, cross-sectional observational study. Data regarding demographic features, concomitant diseases, history and treatment of COPD and expectations of patients and physicians were all obtained in a single visit. Mean [standard deviation (SD)] age of the patients was 64.1 (9.5) years; age range was 41-92 years, 50% of the patients were younger than 65 years and 91% were males. Educational level of the patients was at least primary school in 80.2%; and 54.3% (30.4%) of the patients had at least one concomitant disease, particularly a cardiovascular disease. Mean (SD) duration of having COPD was 5.4 (4.6) years. The majority of patients were at moderate (43.2%) and severe (35.0%) COPD stages and one or more exacerbations per year was determined in 71%. Inhaled beta-2 agonists (84.2%), inhaled steroids (76.3%) and inhaled long-acting anti-cholinergics (70.0%) were the most commonly used medications. Dyspnea (99.0%), sputum production (92.8%) and wheezing (90.5%) were the most common symptoms, and symptom variability for dyspnea (41.1%), sputum production (61.0%) and cough (53.5%) were seen the most in the morning hours (p< 0.001). Most commonly affected morning activity was climbing up/down the stairs (point of effect: 6.7), followed by wearing socks/shoes (point of effect: 4.3) and showering/bathing (point of effect: 4.2) by COPD. Major treatment expectations of patients were greater symptomatic relief (82.3%) and greater mobility (70.0%), faster symptomatic relief (61.1%) and improvement in morning activities (59.3%); while major treatment expectations of physicians included increased quality of life (100.0%) and decreased morbidity (96.0%). Quitting smoking was the most commonly recommended (88.3%) and implemented (67.9%) non-drug protective approach aimed at decreasing the frequency of exacerbations. Consequently, our results demonstrate that COPD is not a disease of only the elderly, is an important healthcare issue that often disrupt daily living of the patients due to inadequate disease awareness leading to overlooking of the symptoms by patient and physicians, and that a patient-centered approach based on the living standards, life expectancies and preferences of patients was crucial in patient management.     

Cytokines,adipocytokines and inflammatory markers in patients on continuous ambulatory peritoneal dialysis and hemodialysis

Background: Cytokines are essential mediators of immune response. Chronic renal failure patients suffer from chronic inflammation that results from factors such as impaired renal function, accumulation of uremic toxins and bio incompatibility of dialyzer membranes. These patients are also at increased risk of cardiovascular diseases. We have evaluated cytokines, adipocytokines and inflammatory markers in patients with chronic renal failure undergoing hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD).

Material and methods: We have determined serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), leptin and ghrelin levels of chronic renal failure patients treated with either HD (n?=?20) or CAPD (n?=?20). TNF-α, IL-6, ghrelin and leptin measurements were performed by commercially available kits based on enzyme-linked immunosorbent assay (ELISA) method. hsCRP levels were determined by turbidimetric methods.

Results: Serum TNF-α and IL-6 levels of patients on HD were significantly higher than those of the ones on CAPD (p?<?0.05). Ghrelin, leptin and hsCRP concentrations were similar in both groups.

Conclusions: We can conclude that cytokine production is more obvious in HD process.     

Modulatory Effects of Lycopene and Ellagic Acid on Reproductive Dysfunction Induced by Polychlorinated Biphenyl (Aroclor 1254) in Male Rats

Abstract: The present study was conducted to investigate the possible protective effects of lycopene (LP) and ellagic acid (EA) on aroclor (AR) 1254‐induced testicular and spermatozoal toxicity associated with the oxidative stress and apoptosis in male rats. The control group was treated with placebo. LP (10 mg/kg/every other day), EA (2 mg/kg/every other day) and AR (2 mg/kg/day) groups were given alone LP, EA and AR respectively. One of the last two groups received AR + LP, and the other treated with AR + EA. Body and reproductive organ weights, epididymal sperm characteristics, testicular tissue lipid peroxidation levels, antioxidant enzyme activities, histopathological changes and apoptosis via Bax and Bcl‐2 genes were investigated. AR administration caused statistically significant decreases in body‐weight, epididymal sperm concentration, testicular superoxide dismutase activity, diameters of seminiferous tubules, germinal cell layer thickness and Johnsen’s testicular score, and increases in relative weights of testis, epidydimis and seminal vesicles, rates of abnormal sperm and apoptotic cell expression along with degeneration, desquamation and disorganization in spermatogenic cells, and interstitial oedema and congestion in testicular tissue. LP and EA treatments to AR‐treated rats markedly decreased abnormal sperm rates, testicular thiobarbituric acid reactive substances level, and increased the glutathione (GSH) level, GSH‐peroxidase, catalase activities and epidiymal sperm concentration as compared with the alone AR group. Additionally, the AR‐induced histopathological damages were totally or partially recovered by LP or EA administrations respectively. AR damages the testicular tissue and spermatozoa by impairing the oxidant/antioxidant balance and by increasing the apoptotic spermatogenic cell rates. However, both LP and EA have modulator effects on AR‐induced reproductive dysfunction in male rats.     

The Evaluation of Clitoral Blood Flow and Sexual Function in Elite Female Athletes

IntroductionClitoral blood flow measurements using clitoral color Doppler ultrasound have been performed with increasing frequency either in order to assessment of female sexual function/dysfunction. The trials to evaluate the sexual function in healthy subjects, especially in the subgroup of female elite athletes, are limited.AimThe aim of the study was to evaluate whether elite female athletes and sedentary healthy females differ in their clitoral blood flow and sexual function as an expression of their physical fitness status.MethodsTwenty-five female elite athletes (Group I) and healthy female subjects (Group II) were enrolled as volunteers in the study. All women were instructed to complete the Female Sexual Function Index (FSFI) questionnaire. Each subject underwent high definition color Doppler ultrasonography to measure the clitoral blood flow parameters.Main Outcome MeasuresThe effect of physical activity on clitoral blood flow and sexual life in women.ResultsMean age, mean age of menarche, mean marriage age, and body mass index were similar for both groups. In Group I, the mean peak systolic velocity and end-diastolic velocity were higher than those of Group II, whereas the mean RI was similar for both groups. There were statistically significant differences for total FSFI score and all domain scores, except desire domain, between both groups.ConclusionIn elite female athletes as compared with sedentary healthy females, better clitoral blood flow and better sexual function were demonstrated. Therefore it seems superior physical fitness correlates with better sexual function. Karatas OF, Baltaci G, Ilerisoy Z, Bayrak O, Cimentepe E, Irmak R, and Unal D. The evaluation of clitoral blood flow and sexual function in elite female athletes.     

Radiolabeling of EGCG with <Superscript>131</Superscript>I and biodistribution in rats

Epigallocatechin gallate (EGCG), is the most abundant and widely studied catechin in green tea (Camellia sinensis Theaceae). The inhibitory effects of EGCG and green tea extract on carcinogenesis in various organs in rodents have now been demonstrated over the past decade. The aim of study was to label EGCG with I-131, to determinate its structure and to evaluate its biodistribution in Wistar rats. Radiolabeling was carried out by direct electrophilic iodination method (iodogen) and yield was determined by radio thin layer chromatography (RTLC). Radiolabelling yield is determined as 89 ± 1.0%. Besides, determination of structure of iodinated molecule, serum stability, and partition coefficient experiments was performed. The structure analysis of synthesized cold ¹²⁷I-EGCG complex was assessed with LC–MS–MS and ¹H-NMR. ¹H-NMR and LC–MS–MS results of iodinated EGCG (¹²⁷I-EGCG) show that oxidize iodine reacts electrophilic with aromatic ring. Serum stability results showed that in vitro stability of ¹³¹I-EGCG was quite high. It is observed that labeling percentage decreased 83 ± 2% at 24th, Partition coefficient results show that the partition coefficient of EGCG was calculated as theoretical partition coefficient = 2.04 ± 0.42 and the experimental partition coefficient of ¹³¹I-EGCG was found as 1.46 ± 0.2. The biodistribution data shown that the maximum uptake of the radioiodinated EGCG was seen in lung and pancreas at 30 min. The blocking assay results indicated that the uptake of ¹³¹I-EGCG in lung was not significantly change (0.25, 0.23, and 0.22%ID/g at 30, 60, and 150 min, respectively). Biodistribution data showed no significant uptake in a specific organ of the rat. Hence radiolabeled EGCG is seen in some organs (lung, liver, pancreas, kidney, etc.).