The investigation of the role of sirtuin-1 on embryo implantation in oxidative stress–induced mice

Journal of Assisted Reproduction and Genetics - Implantation is essential for a successful pregnancy. Despite the increasing number of studies, implantation is still an unknown process. This study...     

Effectiveness of mesalamine and propolis in experimental colitis

This study was conducted to investigate the effects of propolis and mesalamine on experimental colitis in rats. Distal colitis was induced in rats by intracolonic instillation of 2 mL of 4% acetic acid. The animals were randomly assigned to 5 groups: group 1, control, (n=8); group 2, colitis, received no treatment (n=8); group 3, colitis+mesalamine, 2 mL once a day via an enema (n=8); group 4, colitis+propolis, 600 mg/kg once a day via intragastric lavage (n=8); and group 5, colitis+ mesalamine+propolis for 1 wk (n=8). Levels of nitric oxide were statistically significantly different in comparisons between groups 1 and 2, groups 2 and 3, and groups 4 and 5. Malondialdehyde levels were significantly different when group 2 was compared with groups 3, 4, and 5. A significant difference was observed when group 3 was compared with group 4 for myeloperoxidase. Most propolis-treated rats had normal histology; mesalamine-treated and propolis+mesalamine-treated rats had inflammatory cell infiltration at rates of 50% and 33%, respectively. The investigators concluded that propolis and mesalamine are efficient independently and in combination, but that their combined effect was not observed to be additive in experimental colitis.     

Preventing tuberculosis in children receiving anti-tnf treatment

Anti-tumor necrosis factor (TNF) treatment has been a breakthrough in the management of juvenile idiopathic arthritis (JIA). However, they are associated with a significant risk of tuberculosis. We evaluated JIA patients who received etanercept treatment from an eastern Mediterranean country with moderate tuberculosis frequency. JIA patients under anti-TNF treatment, etanercept, were enrolled to the study. Chest X-rays, Tuberculin Skin Test (TST), clinical histories, family screening, and physical examinations were reviewed retrospectively. If TST was above 10 mm in a patient with one Bacillus Calmette-Guerin, cultures and, if needed, thorax computerized tomography were obtained. These patients received 1-2 months of isoniazid (INH) treatment which was followed by an INH prophylaxis for a period of 9 months while etanercept treatment was started. All were re-evaluated within 3 months intervals. A total of 36 patients under etanercept treatment were enrolled to the study. Mean age of the patients was 14.00 years (range 4-22 years). Median duration of disease was 36.00 months (range 4-216 months). Median duration of etanercept therapy was 11.5 months (3-48 months) at final evaluation. Seven patients had an initial TST score above 10 mm. All received INH treatment as outlined above. They had normal examinations and X-rays during follow-up. With proper initial evaluation, anti-TNF treatment is safe even in countries where tuberculosis is moderately frequent. An initial 1-2 months of INH treatment followed by chemoprophylaxis for 9 months is suggested for children with a TST of >10 mm.     

Uterine FK506-binding protein 52 (FKBP52)–peroxiredoxin-6 (PRDX6) signaling protects pregnancy from overt oxidative stress

Immunophilin FK506-binding protein 52 (FKBP52) is a cochaperone that binds to the progesterone receptor (PR) to optimize progesterone (P₄)-PR signaling. We recently showed that Fkbp52-deficient (Fkbp52^−/−) mice have reduced uterine PR responsiveness and implantation failure which is rescued by excess P₄ supplementation in a genetic background-dependent manner. This finding led us to hypothesize that FKBP52 has functions in addition to optimizing PR activity. Using proteomics analysis, we found that uterine levels of peroxiredoxin-6 (PRDX6), a unique antioxidant, are significantly lower in Fkbp52^−/− mice than in WT and PR-null (Pgr^−/−) mice. We also found that Fkbp52^−/− mice with reduced uterine PRDX6 levels are susceptible to paraquat-induced oxidative stress (OS), leading to implantation failure even with P₄ supplementation. The same dose of paraquat did not interfere with implantation in WT mice. Moreover, treatment with antioxidants α-tocopherol and N-acetylcysteine (NAC) attenuated paraquat-induced implantation failure in P₄-treated Fkbp52^−/− mice. Functional analyses using mouse embryonic fibroblasts show that Fkbp52 deficiency associated with reduced PRDX6 levels promotes H₂O₂-induced cell death, which is reversed by the addition of NAC or by forced expression of PRDX6, suggesting that Fkbp52 deficiency diminishes the threshold against OS by reducing PRDX6 levels. These findings provide evidence that heightened uterine OS in Fkbp52^−/− females with reduced PRDX6 levels induces implantation failure even in the presence of excess P₄. This study shows that FKBP52–PRDX6 signaling protects pregnancy from overt OS.     

Evaluation of foot care and self-efficacy in patients with diabetes in Turkey: an interventional study

Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus. The aim of this study was to evaluate the impact of foot care education on patient awareness of the importance of foot care, their foot care-related behavior and sense of self efficacy in being able to take care of their own feet in Turkey. The study was a randomized controlled study. Ninety patients with diabetes mellitus were followed. Cases were stratified by the presence and absence of education on foot care. Foot care education relevant to the needs of the study group was developed on the basis of Bandura’s social learning theory. The diabetic foot care self efficacy scale (DFCSES), the foot self-care behavior scale (FSCBS), and the diabetic foot knowledge subscale (DFKS) were used to evaluate, at 3-month intervals, the knowledge patients had about foot care before and after receiving the education. The scores for DFCSES, FSCBS, and DFKS of the experimental group increased during follow-up in the study group receiving foot care education while the scores of the cases in control group did not change. Education is a major tool for improvement in awareness of foot care in cases with diabetes mellitus. Self-efficacy levels of individuals regarding foot care should be evaluated, and accordingly, individual strategies should be developed to provide efficient foot care.     

Acute Tubular Injury Associated with Mesalazine Therapy in an Adolescent Girl with Inflammatory Bowel Disease

Mesalazine is a first-line drug in pediatric inflammatory bowel disease, and is effective as primary treatment and maintenance therapy. It’s usually well tolerated, but various side effects have been described. A 15-year-old female with ulcerative colitis developed polyuria, polydipsia, vomiting, and fatigue. She was receiving mesalazine (500 mg, thrice daily, p.o.) and prednisolone for 4 months. She was detected as acute tubular injury as she had dehydration, acidosis, hypostenuria, hematuria, proteinuria, low levels of potassium, uric acid and bicarbonate. These findings were attributed to interstitial nephritis as a side effect of mesalazine, however as renal biopsy was disapproved by the parents, it was not confirmed. After discontinuation of mesalazine her renal tubular functions improved. Potassium and phosphorus supplements were stopped after 7 months, although she had to continue bicarbonate supplementation. We conclude that regular renal screening is important in patients receiving 5-ASA therapy to prevent rare but serious complications, such as interstitial nephritis sometimes leading to chronic renal failure.     

Role of myocardial bridging in the apical localization of stress cardiomyopathy

BACKGROUND: The apical ballooning syndrome is precipitated by emotional or physical stress but the underlying mechanism remains poorly understood. The contribution of myocardial bridging on the aetiology and the onset of the syndrome is not known. METHODS: We observed 8 patients with chest pain, T-wave inversion in several leads of the ECG, transient left ventricular apical ballooning and no significant angiographic stenosis. RESULTS: There were 7 women and I man. The median age was 67.5 years. Seven patients had an intense emotional or physical stress (87.5%). All patients presented with chest pain and aT-wave inversion in the precordial leads. The median elevation of creatine-kinase was 171 IU. In all patients, echocardiography showed an alteration of the left ventricular function with a very extensive apical akinesia. Left ventricular hypertrophy was observed in 7 patients. A myocardial bridging in the mid segment of the left anterior descending coronary artery was observed in 5 patients (62.5%). Recovery was complete in all patients. During follow-up, no patient showed recurrence. CONCLUSIONS: Our data suggest that myocardial bridging possibly enhanced by catecholamines during stress may contribute, in association with left ventricular hypertrophy, to the preferential apical localization of the apical ballooning syndrome. Further investigations are necessary to confirm     

Cardiac T2* MRI assessment in patients with thalassaemia major and its effect on the preference of chelation therapy

The aim of the study is to assess the relationship between T2* magnetic resonance imaging (MRI) values and age, serum ferritin level, left ventricular ejection fraction (LVEF), splenectomy status, and to identify appropriate modifications to chelation therapy based on T2* MRI results of children with thalassaemia major. Sixty-four patients with thalassaemia major (37 girls/27 boys) older than 8 years of age were enrolled in the study. Based on the first T2* MRI, the patients’ myocardial iron depositions were classified into three groups: T2* MRI <10 ms (high risk group), T2* MRI 10–20 ms (medium-risk group) and T2* MRI >20 ms (low-risk group). There was no significant relationship between T2* MRI value and ages, serum ferritin levels and splenectomy status of thalassaemia major patients. The mean LVEFs were 60, 75, and 72.5 % in the high-, medium-, and low-risk groups, respectively (P = 0.006). The mean cardiac iron concentrations calculated from the T2* MRI values were 4.96 ± 1.93, 1.65 ± 0.37, and 0.81 ± 0.27 mg/g in the high-, medium-, and low-risk groups, respectively. Chelation therapies were re-designed in 24 (37.5 %) patients according to cardiac risk as assessed by cardiac T2* MRI. In conclusion, until recently, T2* MRI has been employed to demonstrate cardiac siderosis without a direct relationship with the markers used in follow-up of patients with thalassaemia. However, modifications of chelation therapies could reliably be planned according to severity of iron load displayed by T2* MRI.