Evaluation of insulin sensitivity in patients with Klinefelter's syndrome: a hyperinsulinemic euglycemic clamp study

Patients with Klinefelter’s syndrome have a higher incidence of diabetes mellitus and the percentage of insulin resistance was reported to be high in these patients. However, little is known about the insulin sensitivity assessed by the hyperinsulinemic euglycemic clamp in these patients. In the present study, subjects included 13 newly diagnosed patients with Klinefelter’s syndrome, and 9 age- and body mass index-matched healthy males. The hyperinsulinemic euglycemic clamp was performed in all patients and controls. Insulin resistance was present in five (38.5%) patients with Klinefelter’s syndrome. Compared with control subjects, patients with Klinefelter’s syndrome had elevated plasma concentrations of fasting insulin, follicle-stimulating hormone, luteinizing hormone, estradiol, and sex hormone-binding globulin, whereas they had reduced plasma free testosterone and total testosterone concentrations. The multivariate linear regression analysis showed that fasting glucose, fasting insulin, free testosterone, and total testosterone were independently associated with M-value. In conclusion, the present study by using hyperinsulinemic euglycemic clamp indicates the high prevalence of insulin resistance in Klinefelter’s syndrome patients. However, these patients did not have reduced mean M-values compared with the controls, although their plasma insulin levels were significantly elevated. It is possible that hyperinsulinemia may be the primary metabolic abnormality rather than insulin resistance.     

Role of propolis on biochemical parameters in kidney and heart tissues against l-NAME induced oxidative injury in rats

Nitric oxide (NO), produced by endothelial NO synthase, is recognised as a central antiinflammatory and antiatherogenic principle in the vasculature. Epidemiological and clinical studies have demonstrated that a growing list of natural products, as components of the daily diet or phytomedical preparations, may improve vascular function by enhancing NO bioavailability. In this article, we investigated antioxidant effects of propolis on biochemical parameters in kidney and heart tissues of acute NO synthase inhibited rats by Nω-nitro-l-arginine methyl ester (l-NAME). There was increase (p?l-NAME treatment groups when compared with control rats, but NO levels were decreased in both kidney and heart tissues. There were statistically significant changes (p?l-NAME?+?propolis treated rats as compared with l-NAME-treated group. In summary, propolis may influence endothelial NO production.     

Successful Treatment of Myocardial Bridge with Alcohol Septal Ablation in Hypertrophic Obstructive Cardiomyopathy

Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by left ventricular hypertrophy of various morphologies, with variety of clinical manifestations and hemodynamic dysfunctions. Myocardial bridge (MB) is frequently seen in HOCM patients and the decrease of flow in the coronary artery segment going intramurally through the myocardium beneath a muscle bridge is also associated with angina, myocardial ischemia, arrhythmia, and sudden death in these patients. We present here a rare case of successful treatment of MB with alcohol septal ablation in hypertrophic cardiomyopathy which has not been reported previously.     

Cardiovascular disease risk factors in post-menopausal women in West Anatolia

Cardiovascular risk factors are important causes of morbidity and mortality in postmenopausal women. The aim of this cross-sectional study was to evaluate the cardiovascular risk factors in 207 postmenopausal Turkish women over 45 years old in a rural district of West Anatolia, Manisa Muradiye district. A questionnaire on socioeconomic and sociodemographic characteristics was conducted in the women followed by the measurement of blood pressure, fasting blood glucose, cholesterol levels, and waist-hip ratio along with an electrocardiogram (ECG). The European Cardiology Society risk index was used for cardiovascular risk evaluation. The results showed that 86% percent of the women will be carrying more than a 5% probability of developing a cardiovascular risk in the next 10 years. Moreover, the results proved 7% of the women are at high risk for a cardiovascular condition. Hypertension, hypercholesterolemia, and impaired glucose tolerance, were observed in 62%, 35.3%, and 13.5% of the women, respectively. Seven percent had smoked for at least six months. Fourteen cases had complained of exercise angina and pathologic ECG signs were diagnosed in one-third of these 14 cases. The waist-hip ratio measured 0.8 or more in 66.2% of the cases, with a range of 68-147 cm (mean; 95.6 +/- 11.55). The results indicate that the risk of a cardiovascular condition developing is extremely high in postmenopausal West Anatolian women and increases with age. Morever, the prevalance of hypertension increased with age and was very closely related with low socioeconomic levels. These hazardous cardiovascular disease risk factors should be considered as high priority health problems in rural and low socioeconomic areas of developing communities. Intervention to modify the cardiovascular risk factors should be included in routine primary health care programs.     

Henoch-Schönlein purpura in two brothers imprisoned in the same jail: presentation two months apart

We present two brothers who came to us with similar complaints within a two-month interval and who were diagnosed as having Henoch-Sch?nlein purpura. Interestingly, the two brothers were prisoners in the same jail. In addition, we shall review the small number of familial Henoch-Sch?nlein purpura cases that have been reported in the literature to date. Our two patients exhibited arthritis and/or arthralgia, purpuric skin lesions, abdominal pain and hemiaturia, and were treated with steroids. We did not detect the presence of any inciting agent and hypothesize that an undefined factor present in the shared environment might have triggered the disease in two subjects with a similar genetic background.     

Comparison of anterior chamber depth measurements taken with the Pentacam,Orbscan IIz and IOLMaster in myopic and emmetropic eyes

Purpose: This study determined to assess the degree of agreement between anterior chamber depth (ACD) measurements obtained using three different devices and to analyse the relationship between ACD and spherical equivalent (SE) refraction. Methods: In this cross‐sectional study, 42 eyes of 42 patients with a mean SE of ? 4.69 ± 4.61 D (range 0.00 D to ? 14.88 D) were analysed. Measurements of ACD between the corneal epithelium and the anterior surface of the crystalline lens, obtained using the Pentacam, Orbscan IIz and IOLMaster, were compared. The relationships between SE and ACD measurements obtained with different devices were also investigated. The results were analysed using Bland?Altman analyses, single‐sample t‐test and Pearson’s correlation test. Results: Orbscan ACD measurements were an average of 0.05 mm less than Pentacam measurements (p = 0.01). IOLMaster measurements were an average of 0.06 mm less than Orbscan measurements (p < 0.001). None of the ACD values measured by any of the devices were correlated with increasing SE (p > 0.05 for all). There was a weak positive correlation between SE and the difference in ACD measurements with Pentacam and Orbscan (p = 0.04); however, the differences between Pentacam and IOLMaster ACD measurements and Orbscan and IOLMaster ACD measurements seemed to be independent of SE (p = 0.17 and p = 0.54, respectively). Conclusions: The ACD in clinically normal eyes is measured differently by various non‐ultrasonic devices. However, the observed mean error between these modalities is too small to create any noticeable difference in refractive outcome. No significant relationship was found between SE and ACD measurements obtained by Pentacam, Orbscan or IOLMaster.     

Meningitis and pneuomocephalus. A rare complication of external dacryocystorhinostomy

Meningitis due to fracture of the fovea ethmoidalis during external dacryocystorhinostomy is a rare complication. We report a case of pneumocephalus and meningitis in a 51-year-old female who underwent an external dacryocystorhinostomy (DCR). Although extracranial complications during or after external DCR have been well-described, only one case of meningitis has been reported in the literature. Physical examination, computerised tomography, lumbar puncture, and bacteriologic cultures were used to make the diagnosis. The patient responded well to antibiotic therapy. Her symptoms resolved immediately and she was discharged on the 21st post-operative day. This complication emphasises the importance of careful surgical technique and a thorough knowledge of regional anatomy, during DCR and similar procedures.