Low level of Nesfatin-1 is associated with gestational diabetes mellitus

Introduction: Gestational diabetes mellitus (GDM) occurs in ～10–25% of pregnancies. Nesfatin-1, plays a role in carbohydrate metabolism by inhibiting glucagon secretion, besides has a glucose-dependent insulinotropic effect. Explanation of the GDM pathogenesis is important due to preventing gestational complications. We aimed to investigate relationship between GDM and Nesfatin-1.

Material and methods: Seventy-nine pregnant subjects were randomly allocated to either GDM group (GDG, n?=?38) or control group (CG, n?=?41). For GDM diagnosis, 50 and 100?g oral glucose tolerance test (OGTT) were used. Nesfatin-1, insulin and other parameters were measured for all subjects. The homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.

Results: Nesfatin-1 was found lower and insulin was found higher in GDG than CG. Negative correlation has been founded between Nesfatin-1 with weight, BMI, fasting glucose, serum glucose level at first hour of the 50?g OGTT and HOMA-IR.

Conclusion: In this study, patients with GDM had lower Nesfatin-1 levels than without GDM. Therefore, when the Nesfatin-1 effects on the GDM pathogenesis is clear, it may be contributed to diagnosis and treatment of the GDM.     

Evaluation of obstructive sleep apnea symptoms in pregnant women with chronic disease

Objective: Obstructive sleep apnea syndrome (OSAS) is a disease which is estimated to be undiagnosed to a large extent. Hence, the prevalence of OSAS in pregnant women is unknown. We aimed to evaluate the symptoms of obstructive sleep apnea in pregnant women with chronic diseases.

Methods: In the study, 97 pregnant women with chronic diseases and 160 healthy pregnant women were included. A form questioning socio-demographic characteristics and pregnancy characteristics, Epworth scale and the Berlin questionnaire to evaluate the risk of OSAS were applied to participants.

Results: It has been determined that 10–12.5% of healthy pregnant women, 34–45.4% of pregnants with chronic diseases and 20.6–23.3% of all pregnant women had a high risk of OSAS, the pregnants with chronic disease compared to healthy pregnant women had statistically significant higher risk of OSAS. The risk of OSAS was found to be significantly higher especially in pregnant women with hypertension and diabetes.

Conclusions: OSAS can lead to the adverse consequences in pregnancy, should be questioned for all pregnants especially those with chronic diseases. Pregnant women with OSAS should be monitored more carefully in terms of diabetes and hypertension in antenatal care.     

Comparative effects of risedronate,atorvastatin, estrogen and SERMs on bone mass and strength in ovariectomized rats

Objective

The aim of this study was to investigate bone protective effects of risedronate, atorvastatin, raloxifene and clomiphene citrate in ovariectomized rats.

Methods

Our study was conducted on 63 rats at Experimental Research Center of Celal Bayar University. Six-month-old rats were divided into seven groups. There were five drug administered ovariectomized groups, one ovariectomized control group without drug administration and one non-ovariectomized control group without drug administration. Eight weeks postovariectomy, rats were treated with the bisphosphonate risedronate sodium, the statin atorvastatin, the estrogen 17β-estradiol and the selective estrogen receptor modulators (SERMs) raloxifene hydrochloride and clomiphene citrate by gavage daily for 8 weeks. At the end of the study, rats were killed under anesthesia. For densitometric evaluation, left femurs and tibiae were removed. Left femurs were also used to measure bone volume. Right femurs were used for three-point bending test.

Results

Compared to ovariectomized group, femur cortex volume increased significantly in non-ovariectomized group (p = 0.016). Compared to non-ovariectomized group, distal femoral metaphyseal and femur midshaft bone mineral density values were significantly lower in ovariectomized group (p = 0.047). In ovariectomy + atorvastatin group, whole femur and femur midshaft bone mineral density and three-point bending test maximal load values were significantly higher than ovariectomized group (p = 0.049, 0.05, and 0.018). When compared to the ovariectomized group, no significant difference was found with respect to femoral maximum load values in groups treated with risedronate, estrogen, raloxifene and clomiphene (p = 0.602, 0.602, 0.75, and 0.927). In ovariectomy + risedronate group, femur midshaft bone mineral density values were significantly higher than the values in ovariectomized group (p = 0.023). When compared to ovariectomized group, no significant difference was found with respect to femur midshaft bone mineral density values in groups treated with estrogen, raloxifene and clomiphene (p = 0.306, 0.808, and 0.095).

Conclusions

While risedronate sodium prevented the decrease in bone mineral density in ovariectomized rats, atorvastatin maintained mechanical characteristics of bone and also prevented the decrease in bone mineral density as risedronate sodium.     

<Emphasis Type="Italic">Demodex folliculorum</Emphasis> in patients with rheumatoid arthritis

The objective of this study was to investigate the incidence and density of Demodex folliculorum in the patients with rheumatoid arthritis (RA). Forty-one patients with RA and twenty-seven age and sex matched healthy controls were enrolled in this study. Disease Activity Score (DAS 28) was used for the assessment of disease activity. Out of 41 patients, 33 were females and 8 males. The mean disease duration was 10.9 ± 8.2 years. The mean DAS 28 was 3.8 ± 1.2. No statistically significant differences in the incidence and density of Demodex mites were found between patients with RA and controls. Although immunosuppression is thought to be a risk factor for the D. folliculorum infestation no such correlations could be found in the 41 immunosuppressed patients with RA, therefore, further studies with larger groups are needed.     

A Kalman filter-based approach to reduce the effects of geometric errors and the measurement noise in the inverse ECG problem

In this article, we aimed to reduce the effects of geometric errors and measurement noise on the inverse problem of Electrocardiography (ECG) solutions. We used the Kalman filter to solve the inverse problem in terms of epicardial potential distributions. The geometric errors were introduced into the problem via wrong determination of the size and location of the heart in simulations. An error model, which is called the enhanced error model (EEM), was modified to be used in inverse problem of ECG to compensate for the geometric errors. In this model, the geometric errors are modeled as additive Gaussian noise and their noise variance is added to the measurement noise variance. The Kalman filter method includes a process noise component, whose variance should also be estimated along with the measurement noise. To estimate these two noise variances, two different algorithms were used: (1) an algorithm based on residuals, (2) expectation maximization algorithm. The results showed that it is important to use the correct noise variances to obtain accurate results. The geometric errors, if ignored in the inverse solution procedure, yielded incorrect epicardial potential distributions. However, even with a noise model as simple as the EEM, the solutions could be significantly improved.     

Beneficial role of intravenous calcitriol on bone mineral density in children with severe secondary hyperparathyroidism

Objectives: In this prospective study, the effect of calcitriol therapy on bone mineral density and osteopenia in patients with severe secondary hyperparathyroidism has been investigated. Materials and methods: The study was carried out on 24 chronic dialysis patients consisting of 13 boys and 11 girls, aged between 8–18 years. Patients were divided into 3 groups according to the severity of hyperparathyroidism and therapy regimens. Group I consisted of 5 patients with normal parathormon levels who did not receive calcitriol therapy. In group II and III, there were patients with secondary hyperparathyroidism. Group II consisted of 10 patients receiving oral calcitriol therapy. Group III consisted of 9 patients receiving intravenous (IV) calcitriol. Bone mineral density was measured by dual energy x-ray absorptiometry. Osteopenia was defined as a Z-score worse than −2. Bone mineral density was assessed as baseline and at the end of one year. Results: A significant improvement was observed in Z-score in the group III whereas the mean value of Z-score tended to be worse in group I and it was not significantly different in group II from the initial values. The better Z-score in group III was associated with more effective stabilization of alkaline phosphatase level and bone specific alkaline phosphatases (BAP) concentrations. Conclusion: Significant improvement of Z-score in group III suggested the beneficial role in IV administration of calcitriol in chronic dialysis patients. This revised version was published online in August 2006 with corrections to the Cover Date.     

Guidelines for the Management of Tinea Capitis in Children

Abstract: Practice guidelines for the treatment of tinea capitis (TC) from the European Society for Pediatric Dermatology are presented. Tinea capitis always requires systemic treatment because topical antifungal agents do not penetrate the hair follicle. Topical treatment is only used as adjuvant therapy to systemic antifungals. The newer oral antifungal agents including terbinafine, itraconazole, and fluconazole appear to have efficacy rates and potential adverse effects similar to those of griseofulvin in children with TC caused by Trichophyton species, while requiring a much shorter duration of treatment. They may be, however, more expensive ( Grading of recommendation A; strength of evidence 1a ). Griseofulvin is still the treatment of choice for cases caused by Microsporum species. Its efficacy is superior to that of terbinafine ( Grading of recommendation A; strength of evidence 1b ), and although its efficacy and treatment duration is matched by fluconazole ( Grading of recommendation A; strength of evidence 1b ) and itraconazole ( Grading of recommendation A; strength of evidence 1b ), griseofulvin is cheaper. It must be noted, however, that griseofulvin is nowadays not available in certain European countries (e.g., Belgium, Greece, Portugal, and Turkey).     

Adjunctive Hyperbaric Oxygen Therapy or Alone Antibiotherapy? Methicillin Resistant Staphylococcus aureus Mediastinitis in a Rat Model

OBJECTIVE

In the post-sternotomy mediastinitis patients, Staphylococcus aureus is the pathogenic microorganism encountered most often. In our study, we aimed to determine the efficacy of antibiotic treatment with vancomycin and tigecycline, alone or in combination with hyperbaric oxygen treatment, on bacterial elimination in experimental S. aureus mediastinitis.

METHODS

Forty-nine adult female Wistar rats were used. They were randomly divided into seven groups, as follows: non-contaminated, contaminated control, vancomycin, tigecycline, hyperbaric oxygen, hyperbaric oxygen + vancomycin and hyperbaric oxygen + tigecycline. The vancomycin rat group received 10 mg/kg/day of vancomycin twice a day through intramuscular injection. The tigecycline group rats received 7 mg/kg/day of tigecycline twice a day through intraperitoneal injection. The hyperbaric oxygen group underwent 90 min sessions of 100% oxygen at 2.5 atm pressure. Treatment continued for 7 days. Twelve hours after the end of treatment, tissue samples were obtained from the upper part of the sternum for bacterial count assessment.

RESULTS

When the quantitative bacterial counts of the untreated contaminated group were compared with those of the treated groups, a significant decrease was observed. However, comparing the antibiotic groups with the same antibiotic combined with hyperbaric oxygen, there was a significant reduction in microorganisms identified (P<0.05). Comparing hyperbaric oxygen used alone with the vancomycin and tigecycline groups, it was seen that the effect was not significant (P<0.05).

CONCLUSION

We believe that the combination of hyperbaric oxygen with antibiotics had a significant effect on mediastinitis resulting from methicillin-resistant Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus mediastinitis can be treated without requiring a multidrug combination, thereby reducing the medication dose and concomitantly decreasing the side effects.