Fatty acid-binding protein-4 as a biomarker predicting acromegaly-associated diabetes mellitus

Background/aimThe known pathogenesis of diabetes mellitus (DM) in acromegaly is mainly based on growth hormone (GH) and insulin-like growth factor-1 (IGF-1) excess. Fatty acid-binding protein 4 (FABP-4), a novel adipokine, is found to induce insulin resistance and type 2 DM. We aimed to investigate the possible effect of FABP-4 on glucose metabolism in patients with acromegaly.Materials and methodsThis case-control study included 28 patients newly diagnosed with acromegaly and 57 healthy volunteers. The patients with acromegaly were classified according to their glycemic status as with DM, prediabetes, and normal glucose tolerance. Anthropometric measurements, laboratory test results, and FABP-4 levels of the subjects were evaluated.ResultsAlthough no difference was observed in FABP-4 levels between acromegaly and control groups, the FABP-4 level was higher in the patients with acromegaly having DM compared to the patients with acromegaly having prediabetes and NGT, and the control group (p = 0.004, p = 0.001, p = 0.004, respectively). Logistic regression analysis suggested that the FABP-4 is an independent predictor of DM in acromegaly (β = 7.382, OR = 38.96, 95% CI: 1.52-5.76, p = 0.018).Conclusion The FABP-4 may be a helpful predictor of acromegaly-associated DM.     

Premenstrual syndrome and fibromyalgia: the frequency of the coexistence and their effects on quality of life

Objective: We aimed to investigate the association between Premenstrual syndrome (PMS) and fibromyalgia syndrome (FMS), to assess common symptoms and quality of life (QOL) of them.

Methods: Patients with PMS formed the PMS group and age-matched healthy normal controls were included in the control group. The diagnosis of the FMS and PMS were based on new American College of Rheumatology FMS criteria and DSM-IV PMS criteria. FMS-related symptoms assessed by visual analog scale and number of tender points (TePs) were analyzed. QOL, PMS severity and FMS severity were assessed with SF-36, fibromyalgia impact questionnaire (FIQ) and premenstrual assessment form (PAF), respectively. Patients with PMS were divided into two subgroups according to coexistence of FMS or not.

Results: The frequency of FMS in PMS and control group were 20 and 0%, respectively (p?=?0.002). FMS-related symptoms, number of TePs in the PMS group were higher than those in the control group. The mean mental component summary (MCS) score of SF-36 was low in the PMS group. The mean PAF score in PMS with FMS subgroup was higher than those in without FMS subgroup. The mean physical component summary of SF-36 was low in the PMS patient with FMS. There was correlation between PAF score and FIQ score (r?=?0.476, p?Conclusion: FMS was common among the patients with PMS and frequently seen in the PMS patients having severe premenstrual complaints. Mental QOL was distressed in the patients with PMS but while FMS accompanied to PMS, the physical QOL was decreased.     

Microvascular Decompression for Primary Trigeminal Neuralgia : Short-Term Follow-Up Results and Prognostic Factors

Objective

The aim of this prospective study was to demonstrate the influence of some factors on the prognosis of microvascular decompression in 37 patients with trigeminal neuralgia.

Methods

The results of microvascular decompression (MVD) in 37 patients with trigeminal neuralgia were evaluated at 6 months after surgery and were compared with clinical and operative findings.

Results

The sex of the patient, the patient''s age at surgery, the side of the pain, and the duration of symptoms before surgery did not play any significant roles in prognosis. Also, the visual analogue scale (VAS) of the patient, the duration of each pain attack, and the frequency of pain over 24 hours did not play any significant roles in prognosis. In addition, intraoperative detection of the type of conflicting vessel, the degree of severity of conflict, and the location of the conflict around the circumference of the root did not play any roles in prognosis. The only factors affecting the prognosis in MVD surgery were intraoperative detection of the site of the conflict along the root and neuroradiological compression signs on preoperative magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA).

Conclusion

These findings demonstrated that if neurovascular compression is seen on preoperative MRI/MRA and/or compression is found intraoperative at the root entry zone, then the patient will most likely benefit from MVD surgery.     

Intravenous paracetamol versus dexketoprofen in acute musculoskeletal trauma in the emergency department: A randomised clinical trial

Introduction

Musculoskeletal system traumas are among the most common presentations in the emergency departments. In the treatment of traumatic musculoskeletal pain, paracetamol and non-steroidal anti-inflammatory analgesics (NSAID) are frequently used. Our aim in this study is to compare the efficacy of intravenous dexketoprofen and paracetamol in the treatment of traumatic musculoskeletal pain.

Granulomatous Mastitis: Clinical,Pathological Features,and Management

Abstract: This clinical study was conducted to present clinical, radiologic, and histopathologic features of Granulomatous Mastitis (GM) and evaluate the result of surgical and steroid treatment. Sixteen cases diagnosed histologically as GM were reviewed. Patient characteristics, clinical presentation, radiologic imaging, microbiologic, histopathologic assessment, treatment modalities, recurrence, morbidity, and follow‐up data were analyzed. Majority of the patients were child bearing age and all of the patients had a history of breast feeding. Radiologic findings were nonspecific. Histopathology showed the characteristic distribution of granulomatous inflammation in all cases. In 12 cases, surgical excision of the lesion with negative margins was performed. Four cases required quadranectomy because of wideness of the disease. Three patients who had local reoccurrence and three resistant patients were treated by oral prednisone after surgical attempt. Complete remission was obtained and no further recurrence was observed in this patients. GM predominantly occurs in premenopausal women and the clinical symptoms might be misjudged as breast cancer. Histopathologic examination remains the gold standard for the diagnosis. Wide excision of the lesions is the recommended therapy and we suggest steroid therapy in resistant or recurrent disease following the idea that the disease has an autoimmune component.     

Prevalence of Dyslipidemia and Associated Factors in Obese Children and Adolescents

Objective:Childhood-onset obesity is associated with increased mortality and morbidity related to cardiovascular diseases (CVD) during adulthood. Dyslipidemia has a fundamental role in the pathogenesis of CVD. This study aimed to evaluate the prevalence of dyslipidemia and related factors among obese children and adolescents.Methods:Obese patients aged between 2 and 18 years were included in the study. Serum concentrations of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), fasting glucose levels, insulin, thyroid-stimulating hormone (TSH), free thyroxine (fT4), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver ultrasound findings were evaluated retrospectively.Results:Among 823 obese patients, 353 (42.9%) met the dyslipidemia criteria: 21.7% had hypertriglyceridemia, 19.7% had low levels of HDL-C, 18.6% had hypercholesterolemia, and 13.7% had high levels of LDL-C. Older age and/or high body mass index (BMI) were related to increased prevalence of dyslipidemia. Hepatosteatosis was more common among dyslipidemic patients. The frequency of insulin resistance (IR) and of higher levels of ALT and TSH were also detected in dyslipidemic patients. Patients with both dyslipidemia and grade 2-3 hepatosteatosis had higher levels of ALT, AST and TSH and lower levels of fT4.Conclusion:Prevalence of dyslipidemia is high in obese children, and hypertriglyceridemia is in the foreground. Higher levels of IR and more apparent abnormal liver function test results are observed in the context of dyslipidemia and hepatosteatosis coexistence. Metabolic and hormonal alterations related with thyroid functions may also be associated with dyslipidemia and hepatosteatosis in obese patients.     

Translation,cultural adaptation,reliability, and validity of the Turkish version of the Penn Shoulder Score

Purpose: The purpose of this study is to translate the Penn Shoulder Score into Turkish and to establish its cultural adaptation, reliability, and validity in patients with shoulder dysfunctions.

Methods: The Penn Shoulder Score was translated and culturally adapted from English into Turkish. Subsequently, the Penn Shoulder Score, the Constant Score, the American Shoulder and Elbow Score, and the Western Ontario Rotator Cuff Index were completed by 97 patients with shoulder dysfunctions. To determine the test–retest reliability, 30 patients completed the Penn Shoulder Score again on day 3. Intraclass correlation coefficient and Cronbach alpha were calculated to assess reliability. The validity of the questionnaire was assessed in terms of convergent validity with Pearson Correlation Coefficient using the Constant Score, the American Shoulder and Elbow Score, and the Western Ontario Rotator Cuff Index.

Results: Internal consistency was good, with a Cronbach alpha of 0.81. The Intraclass correlation coefficient was 0.90 (95% confidence interval: 0.78, 0.90), demonstrating good test–retest reliability. Pearson correlation coefficients of the Penn Shoulder Score in relation with the Constant Score, the American Shoulder and Elbow Score, and the Western Ontario Rotator Cuff Index were 0.65, 0.78, and ?0.77, respectively.

Conclusion: The Turkish version of the Penn Shoulder Score is a reliable and valid measure for assessing patients with shoulder dysfunctions.

• Implications for Rehabilitation

• The Turkish version of the Penn shoulder score is valid and reliable outcome measure for assessing patients with shoulder dysfunctions.

• The Turkish version of the Penn shoulder score could be easily performed by patients and it is easy to score by clinicians. It is recommended to use in clinical settings and in research.

     

Assessment of the predictive value of serum progesterone levels on early pregnancy prognosis in spontaneous twin gestations: a prospective study

OBJECTIVES: The aim of this study was to assess the predictive value of serum progesterone levels in early pregnancy prognosis in spontaneous dichorionic-diamniotic twin gestations. STUDY DESIGN: This study was carried out among 38 spontaneous dichorionic-diamniotic twin gestations between January 2003 and June 2005 in the Department of Obstetrics and Gynaecology at the Gulhane Military Medical Academy. Serum progesterone levels were measured at 7 and 10 weeks' gestation and pregnancies were followed until 14 gestational weeks by ultrasound examination. RESULTS: We found that a progesterone level of 58 nmol/l in the 7th gestational week and of 51 ng/ml at 10 gestational weeks has a predictive value for viable intrauterine twin pregnancies with 83% sensitivity and 69% specificity and 83% sensitivity and 84% specificity, respectively. CONCLUSION: Progesterone levels in the early gestational weeks may be a biochemical marker for the prediction of a twin pregnancy outcome and may reduce the number of ultrasound examinations.