Huseyin Tugrul Celik

Wet-cupping removes oxidants and decreases oxidative stress

OBJECTIVES Wet-cupping therapy is one of the oldest known medical techniques. Although it is widely used in various conditions such as acute\chronic inflammation, infectious diseases, and immune system disorders, its mechanism of action is not fully known. In this study, we investigated the oxidative status as the first step to elucidate possible mechanisms of action of wet cupping. MATERIAL AND METHODS Wet cupping therapy is implemented to 31 healthy volunteers. Venous blood samples and Wet cupping blood samples were taken concurrently. Serum nitricoxide, malondialdehyde levels and activity of superoxide dismutase and myeloperoxidase were measured spectrophotometrically. RESULTS Wet cupping blood had higher activity of myeloperoxidase, lower activity of superoxide dismutase, higher levels of malondialdehyde and nitricoxide compared to the venous blood. CONCLUSION Wet cupping removes oxidants and decreases oxidative stress.

Relationship between late arteriovenous fistula (AVF) stenosis and neutrophil–lymphocyte ratio (NLR) in chronic hemodialysis patients

Abstract Objectives: Primary cause of late arteriovenous fistula (AVF) dysfunction is venous stenosis as result of neointimal hyperplasia. The mechanism of AVF stenosis is not exactly understood. But inflammation is a contributing factor for development of AVF stenosis. Neutrophil–lymphocyte ratio (NLR) reflects systemic inflammation, and it was investigated in many diseases. The aim of this study was to investigate the relationship between NLR and AVF stenosis in chronic hemodialysis patients. Materials and methods: Of 593 patients applied to the department of interventional radiology between January 2011 and November 2012, a total of 108 patients meeting the appropriate criteria were included in this study. All patients were assessed with Color Doppler ultrasonography and then digital subtraction angiography was used for the patients with abnormal results. Sixty-four patients were classified as patients with AVF stenosis (group 1) and 44 patients without AVF stenosis (group 2). Routine biochemical and complete blood count values measured six months ago were recorded for all patients. Results: Mean NLR (3.47 ± 0.46 vs. 2.27 ± 0.22; p < 0.001) was higher in group 1 compared to group 2, whereas high-density lipoprotein (HDL; 31.8 ± 12.6 mg/dL vs. 51.5 ± 11.9 mg/dL; p < 0.001) was lower in group 1. NLR level was correlated with degree of AVF stenosis (r = 0.625; p < 0.01). Receiver operating characteristic curve analysis showed that NLR (optimal-cut-off = 2.70) was a useful parameter in prediction of AVF stenosis (AUC = 0.893, sensitivity = 98.4% and specificity = 75%; p < 0.001). NLR level and HDL < 30 mg/dL in logistic regression analysis are independent predictors of AVF stenosis. Conclusions: For hemodialysis patients with increased level of NLR and decreased level of HDL, regular monitoring with regard to the development of AVF stenosis may be beneficial. Our study suggests that the mechanism of AVF stenosis might have similarities to that of atherosclerosis.

Benefits of the neutrophil-to-lymphocyte ratio for the prediction of gestational diabetes mellitus in pregnant women.

AIMS There is growing consensus in the literature that inflammation plays a central role in the pathophysiology of obesity, Type 2 Diabetes Mellitus (T2DM), Gestational Diabetes Mellitus (GDM) and cardiovascular complications. Measuring the neutrophil-to-lymphocyte ratio (NLR) provides a simple inexpensive method for the assessment of inflammatory status. We investigated the predictive value of pre-procedural (before the oral glucose tolerance test (OGTT)) NLR on the development of GDM in pregnancy. METHODS 42 women with GDM and 68 women without GDM were included in the study. Complete Blood Count and biochemical tests were followed by a diagnostic 4-point 100-g-OGTT within 2 weeks. GDM was diagnosed by the Carpenter and Coustan criteria. The NLR was calculated from the data. RESULTS The mean NLR level was significantly higher in GDM women (3.00±0.83 vs. 2.26±0.43 p<0.001, respectively). In ROC analysis, NLR>2.93 had 76.2% sensitivity and 94.1% specificity in predicting GDM. Logistic regression analysis showed that elevated NLR (OR: 5.512, 95% CI: 1.352-22.475, p=0.017) was an independent variable for predicting GDM in pregnancy. CONCLUSIONS An elevated NLR level is a powerful and independent predictor of GDM. The results of this study suggested that inflammation plays a central role in the pathogenesis of GDM.

Serum levels of endocan correlate with the presence and severity of pre-eclampsia.

Abstract Background: Endocan, a cysteine-rich dermatan sulfate proteoglycan expressed by endothelial cells, is seemed to be a new biomarker for endothelial dysfunction. Pre-eclampsia (PE) is characterized by the new onset of hypertension, proteinuria after 20 weeks of gestation, placental vascular remodeling, systemic vascular inflammation and endothelial dysfunction. The aim of this study was to investigate the relationship of PE and its severity with serum endocan levels. Methods: A cross-sectional study was performed. Serum was collected from women with PE and normotensive controls. Serum endocan and tumor necrosis factor alpha (TNF-α) concentrations were measured by a specific enzyme linked immunosorbent assay. Results: Patients with PE had significantly higher median (interquartile range) endocan and mean TNF-α concentrations than controls [20.04 (12.26) ng/mL vs 15.55 (6.19) ng/mL, p < 0.001 for endocan; 26.49 ± 12.14 pg/mL vs 14.62 ± 5.61 pg/mL, p < 0.001 for TNF-α; respectively]. Serum endocan concentrations were positively correlated with systolic blood pressure (r = 0.618, p < 0.001), diastolic blood pressure (r = 0.608, p < 0.001), the amount of 24-h proteinuria (r = 0.786, p < 0.001) and TNF-α (r = 0.474, p < 0.001) in women with PE. In subgroup analysis, patients with severe PE had significantly higher endocan concentrations than those with mild PE. Receiver operating characteristic analysis of endocan was used to identify the patients with PE and also discriminating between mild and severe PE. Conclusion: Serum endocan concentrations were significantly elevated in women with PE versus normotensive controls, and concentrations seem to be associated with the severity of the disease.

Sleep deprivation in the last trimester of pregnancy and inadequate vitamin D: Is there a relationship?

Background Disturbed sleep is a significant health issue for pregnant women. Inadequate vitamin D intake is common among pregnant women and can affect many bodily systems. The purpose of this cross‐sectional study was to test the hypothesis that serum vitamin D levels are low in pregnant women who have poor sleep quality in their last trimester. Methods We enrolled 92 pregnant women who were admitted to the Maternity Clinic of Turgut Ozal University (Ankara, Turkey) in their last trimester. Venous blood sampling was performed to determine serum 25‐hydroxyvitamin D levels. Sleep quality was measured by the Pittsburgh Sleep Questionnaire. The Student t test and Chi‐square test were used to evaluate the relationships between variables. Logistic regression analysis was used to identify independent predictors of the vitamin D level. Results The median score of the Pittsburgh Sleep Questionnaire was 6.2 ± 3.3 (range, 1–17). We determined that 43.5% (40) of participants had poor sleep quality. The mean number of sleep hours at night was 8.6 ± 1 hours (range, 6.30–11 hours), and the mean sleep latency was 20.3 ± 12.7 minutes (range, 5–60 minutes). Vitamin D levels were measured for 87 participants; the median serum level of 25 (OH) vitamin D was 22.9 ± 16.2 ng/mL (range, 4.9–99 ng/mL). Among all patients, we did not determine any significance between the vitamin D‐deficient group and the non–vitamin D‐deficient group with regard to the Pittsburgh Sleep Questionnaire Inventory (PSQI) total score and subcomponents scores of the questionnaire (p > 0.05). Among 37 patients with poor sleep quality and for whom the vitamin D level was measured, 56.8% (21) women had vitamin D deficiency, and 81% (30) women had vitamin D insufficiency. However, we did not find any significance between participants with poor sleep and participants with good sleep quality with regard to age, occupational status, relationship with her partner, prepregnancy body mass index (BMI), weight gain during pregnancy, being primiparus, length of labor, and mode of delivery. Our findings further showed that being in a low income family was associated with poor sleep quality. Conclusion Inadequate vitamin D and poor sleep quality are prevalent in pregnant women, but low levels of vitamin D are not associated with poor sleep quality. Further studies with larger sample sizes and studies that include preterm deliveries and special sleep disorders should be performed to understand this issue better.

Ameliorative effect of selenium in cisplatin-induced testicular damage in rats.

In this study, we investigated the protective effect of selenium (Se) on cisplatin (Cis) induced testicular damage using histopathological, immunohistochemical and biochemical approaches. Twenty-one male Wistar rats were equally divided into three groups of seven rats each: control (C), Cis, and Cis+Se. Cis and Cis+Se group rats received Cis at a dose of 12mg/kg b.w./day, intraperitoneally for 3 consecutive days. Cis+Se group rats received selenium via oral gavage 3mg/kg/day (twice-a day as 1.5mg/kg) until 11th consecutive days starting at 5 days before cisplatin injection. C group received only 0.9% NaCl intraperitoneally and orally at same time and at equal volume. After the treatment, the histopathological, immunohistochemical and biochemical examinations were performed. In seminiferous tubules of Cis treated rats were observed the most consistent findings characterized with vacuolization, desquamation, disorganization, and also was a considerable reduction in elongated spermatids, however the Cis+Se group exhibited improved histopathologic changes. In the immunohistochemical examinations, caspase-3 immunopositive cells displayed higher in the Cis group according to C and Cis+Se groups. Bcl-2 and NF-κB staining revealed a moderate number in the C group and significantly fewer in the Cis group compared to the Cis+Se groups. Additionally, MDA levels were also significantly increased in the Cis group in comparison to Control group, but pretreatment with selenium prevented elevation of MDA levels significantly in Cis+Se group rats. This study indicates that Cis-treatment induced testicular apoptosis and lipid peroxidation, and combined treatment with selenium prevented severity of the toxicity in rats.

Is Kidney Injury Molecule 1 a Valuable Tool for the Early Diagnosis of Contrast-Induced Nephropathy?

Aim/Scope Contrast-induced nephropathy (CIN) is a common complication of diagnostic/therapeutic procedures. Serum creatinine levels are sensitive but often lead to diagnostic delays in acute kidney injury and potential misclassification of actual injury status. Kidney injury molecule (KIM-1) is a novel early marker of acute kidney injury. The aim of our study was to evaluate the KIM-1 levels in patients with CIN. We performed a single-center, nested case-control study. Materials and Methods Three thousand two hundred patients who had undergone coronary angiography were included in the study. Thirty-two patients were diagnosed with CIN. Twenty patients who had undergone coronary angiography but did not have CIN were evaluated as a control group (n = 20). The diagnosis of CIN was performed according to the KDIGO 2012 Acute Kidney Injury Guideline criteria. Urinary KIM-1 levels were measured by enzyme-linked immunosorbent assay before as well as on the 6th and 48th hours of contrast exposure. Serum creatinine levels were measured before as well as on the 24th and 48th hours after angiographic procedure. Results We demonstrated that KIM-1 levels increased in the patients with CIN significantly on the sixth hour when compared with the baseline (P < 0.01; median levels, 0.27 and 0.70 mg/dL) but not in the controls (P = 0.107). The precontrast and 48th-hour KIM-1 levels were median ones and were also significantly different (P = 0.001, the median levels were 0.27 and 0.60 mg/dL, respectively). Conclusions Because creatinine is a sensitive but a late marker of CIN, KIM-1 may be used for early diagnosis and early initiation of treatment and may reduce risk for morbidity.

8-Hydroxydeoxyguanosine as a Useful Marker for Determining the Severity of Trichloroethylene Exposure

ABSTRACT The aim of this study was to determine 8-hydroxydeoxyguanosine (8-OH-dG) levels in trichloroethylene (TCE)-exposed workers. Oxidative stress biomarkers and biochemical parameters were monitored among 26 TCE-exposed workers and 78 age-matched control subjects. Levels of urinary 8-OH-dG were analyzed by liquid chromatography tandem mass spectrometry. Urinary 8-OH-dG levels were significantly higher for TCE-exposed group (p < .001). Spearmans correlation test revealed positive correlations between urinary trichloroacetic acid levels and age, urinary 8-OH-dG, urinary total oxidant status, and urinary total antioxidant status (p = .042, p < .001, p < .001, and p < .001, respectively). 8-OH-dG may be a useful marker to determine the extent of TCE exposure.

Levels of ischemia-modified albumin in transient tachypnea of the newborn.

AIM The aim of the article is to evaluate ischemia-modified albumin (IMA) levels in infants with transient tachypnea of the newborn (TTN) and to find out its relation to the disease severity. Patients and METHODS Infants with > 37 weeks of gestation, without any respiratory and cardiac symptoms and without any maternal health problems, and diagnosed as TTN were allocated as the study group. Patients with obvious retractions, grunting, hypercarbia (Pco 2 > 60 mm Hg) or hypoxia (oxygen saturation < 88% with Fio 2 of 0.60) were managed with nasal continuous positive airway pressure (CPAP). During the postnatal 0 to 24 hours, blood samples were collected in 2 mL for IMA. RESULTS A total of 47 patients were diagnosed TTN, and allocated as the study group. Of the 47 patients, 43 patients without respiratory symptoms were enrolled as the control group. IMA levels in TTN were found to be significantly higher (p < 0.05). In addition, IMA levels were significantly increased in the nasal CPAP group versus supplemental oxygen therapy groups (p < 0.05). IMA levels were determined to be significantly higher in the > 3 days of oxygen therapy group (p < 0.05). IMA levels with a cutoff point of 0.87 ABSU, sensitivity of 81.1% and specificity of 69.8% predicted TTN (area under the curve [AUC] = 0.85; p < 0.05). IMA levels with > 0.98 ABSU, 78% sensitivity, and 86% specificity indicated the prediction of CPAP requirement (AUC = 0.86; p < 0.05). CONCLUSION IMA levels were significantly higher in infants with diagnosed TTN. Therefore, IMA may be used as a new marker for predicting TTN and disease severity.

Mercury concentration in maternal serum, cord blood, and placenta in patients with amalgam dental fillings: effects on fetal biometric measurements

Abstract Aim: We aimed to determine the extent to which mercury is transmitted from the mother to fetus via the umbilical cord in patients with amalgam dental fillings, and its effect on fetal biometric measurements. Methods: Twenty-eight patients as the study group with amalgam fillings, and 32 of them as the control group were included in this prospective case–control study. The mercury levels were measured in the maternal and cord venous sera, and the placental samples. Two groups were compared in terms of these and the fetal/neonatal biometric measurements. Results: In the study group, the maternal and umbilical cord mercury levels were found to be significantly higher than those from the control group (p = 0.006 and p = 0.010, respectively). These high levels did not affect the fetal biometric measurements. Conclusions: The presence of high serum mercury levels in pregnant women with amalgam fillings is important, and warrants further long-term studies in order to investigate the fetal neurological effects as well.