Kamile Marakoğlu

Evaluation of the levels of oxidative stress factors and ischemia modified albumin in the cord blood of smoker and non-smoker pregnant women

Objective: The aim of this cross-sectional study was to determine the oxidant and antioxidant status and a novel ischemia marker – ischemia modified albumin – in the cord blood of smoker and non-smoker pregnants. Methods: This study was performed on 30 smoker and 60 non-smoker pregnant women. Malondialdehyde (MDA), vitamin A and E, total antioxidant capacity (TAC) and ischemia modified albumin (IMA) levels and superoxide dismutase activities (SOD) were determined in the cord blood of the contributors. Results: In the cord blood of the smoker women compared to the non-smokers; MDA (µmol/L) levels increased (5.17 ± 0.25, 3.60 ± 0.06, p = 0.000), IMA (ABSU) levels increased (0.913 ± 0.02, 0.830 ± 0.01, p = 0.050), SOD (U/ml) activities decreased (8.22 ± 0.14, 8.63 ± 0.14, p = 0.045), Vit A(µg/L) (339.06 ± 17.52, 454.91 ± 16.56, p = 0.000) and Vit E (mg/L) levels decreased (2.8 ± 0.15, 7.58 ± 0.38, p = 0.000) and TAC (Mm Trolox) levels decreased (3.25 ± 0.15, 4.08 ± 0.09, p =  0.000), and these differences were statistically significant. We found moderate and strong positive correlations between smoking status and IMA (r =  0.325, p =  0.002) and smoking status and MDA levels (r = 0.636, p =  0.000). Smoking status presented weak, moderate and strong negative correlations with SOD activities, TAC, Vit A and Vit E levels, respectively (r = −0.237, p =  0.024), (r = −0.420, p =  0.000), (r = −0.443, p=0.000), (r = −0.795, p =  0.000). Conclusion: It was determined that smoking cigarette during gestation disturbed the balance between the oxidant and antioxidant system and caused oxidative stress. Increased IMA levels in cord blood of smoker pregnants suggests that smoking during pregnancy causes fetal ischemia.

Anencephalic Infant With Cleft Palate and Natal Teeth: A Case Report

Objective Natal/neonatal teeth are very common in children with complete unilateral and bilateral cleft lip and palate. This article outlines a patient with intrauterine growth retardation, anencephaly, atrial septal defect, ventricular septal defect, two maxillary first natal incisor teeth, cleft palate, short neck, low-set ears, hypertelorism, retrognathia, and simian-line on the right hand. There is no conclusive evidence of a correlation between these findings and a known syndrome, suggesting that this case may be a hitherto undefined clinical combination with neonatal teeth.

Smoking Status and Smoke-Related Gingival Melanin Pigmentation in Army Recruitments

This study aimed to define the smoking status and smoke-related gingival melanin pigmentation in army recruitments and was conducted with army recruitments in Sivas. Nine hundred eight subjects were examined. The oral and dental health of those subjects was checked and recorded. The smoking status of the subjects was self-reported and recorded on questionnaires by researchers. The chi2 test and Kruskal-Wallis test were used for statistical analysis. More than one-half of the subjects (54.3%) were primary school graduates and the mean age was 20.2 +/- 0.95 years. The response rate regarding smoking was 100%. Of the respondents, 596 (65.7%) were current smokers, 12 (1.3%) were former smokers, and 300 (33.0%) were never smokers. The gingival melanin pigmentation rate was 27.5% in current smokers and 8.6% in those who never smoked (p = 0.000). Smoking five to nine cigarettes a day appeared to be sufficient to cause gingival melanin pigmentation. The proportion of smokers who had melanin pigmentation did not change after 10 cigarettes a day. A rehabilitation project on smoking prevention and smoking cessation for army recruitments is urgently needed.

Evaluation of quality of life and depression levels in individuals with Type 2 diabetes

Introduction: Improving the quality of life in diabetic individuals is known to reduce morbidity and mortality. We aimed to investigate the quality of life and depression symptomatology situations and the related factors in patients with Type 2 diabetes mellitus (DM) in this study. Materials and Methods: In this study, 440 adult patients with Type 2 DM and under treatment admitted to Selcuk University Family Medicine Outpatient Diabetes Education Clinic were included in the study. A questionnaire containing sociodemographic characteristics of the participants, the Short Form 36 (SF-36) quality of life questionnaire was applied with Beck depression inventory face to face interviews. Results: Mean scores of females in all SF-36 subscales were statistically significantly lower than those of male patients. Physical function, physical role limitations, general health, social function, emotional role limitations, and mental health mean scores of the patients with 1–10 years duration of diabetes were found statistically significantly higher than those with 20 years and over duration of diabetes. Physical function, physical role limitations, pain, general health, and social function mean scores in patients using oral antidiabetic drug (OAD) was statistically significantly higher compared to patients using insulin + OAD. The average physical function scores of the patients with no complications were statistically significantly higher than those with two and more complications. Conclusion: Quality of life and depression symptomatology are worse in females, the elderly, the overweight, people with lower level of education, in the widowed or divorced, homemakers, those with low incomes, those with longer duration of diabetes, patients using insulin, and those with two or more complications. There are many medical and sociodemographic factors affecting the quality of life and depressive symptomatology in the individuals with diabetes, so both health care workers and patients should pay the necessary attention to this issue.

Assessment of atrial electromechanical delay and P-wave dispersion in patients with type 2 diabetes mellitus.

OBJECTIVES Diabetes mellitus is an independent and strong risk factor for development of atrial fibrillation (AF). Electrophysiologic and electromechanical abnormalities are associated with a higher risk of AF. In this study we aimed to determine the correlation of atrial conduction abnormalities between the surface electrocardiographic and tissue Doppler echocardiographic measurements in type 2 diabetes mellitus (T2DM) patients. METHODS A total of 88 consecutive T2DM patients and 49 age-, gender-, and body mass index-matched healthy volunteers were included in the present study. Baseline characteristics were recorded and 24-hour ambulatory blood pressure monitoring, transthoracic echocardiography, and 12-lead surface electrocardiography were performed for all study participants. Atrial electromechanical delay (EMD) intervals were measured. RESULTS Maximum P-wave duration and P-wave dispersion (Pd) were significantly higher in patients with T2DM (105.7±10.2ms vs. 102.2±7.5ms, p=0.02; 40.6±7.6ms vs. 33.6±5.9ms, p<0.001, respectively). Interatrial, intraatrial, and intraleft atrial EMD were significantly higher in the T2DM patients when compared with the controls (16.5±7.8ms vs.11.2±4.4ms, p<0.001; 9.0±7.3ms vs. 6.0±3.8ms, p=0.002, and 7.4±5.2ms vs. 5.1±3.2ms, p=0.002 respectively). Correlation analysis showed a positive correlation between interatrial EMD and Pd (r=0.429, p<0.001) and left atrial volume (r=0.428, p<0.001). CONCLUSIONS In this study, there was significant EMD and Pd in patients with T2DM as compared with healthy volunteers. Additionally, interatrial EMD was correlated with Pd and left atrial volume index.

Evaluation of Netrin‐1 Levels and Albuminuria in Patients With Diabetes

Netrin‐1 is a diagnostic biomarker that has been identified recently for chronic renal failure (CRF) in animal experiments. Netrin‐1 levels in urine have been shown to have increased significantly at the acute kidney damage. Human studies on the relation between the CRF and plasma netrin‐1 levels have not been found in the literature. This study aimed to investigate whether plasma netrin‐1 levels increased in the early stages of the CRF in diabetic patients.

The effects of smoking cessation on visceral adiposity index levels

Background: Known to cause important metabolic disturbances, weight gain becomes a major health problem after smoking cessation. Visceral adiposity index (VAI) is becoming increasingly popular in the detection of cardiometabolic risks in several disorders and general population. Here, we aimed to investigate the effects of quitting smoking on VAI levels. Materials and Methods: Of 350 participants included into the cigarette cessation program, 70 (20%) completed the study and were enrolled into the analyses. VAI levels were calculated at the baseline and 3rd month after cigarette cessation. Results: Thirty-eight (54.3%) out of 70 participants were male. While the mean age was found as 42 ± 1.0 years, mean starting age of smoking was found to be 16.87 ± 0.45 years, and mean smoking time was 23.07 ± 1.18 years. While VAI levels were found higher in men at the baseline, VAI levels were found similar in both genders at the end of the study. Higher VAI levels were found in those smoking >20 cigarettes/day, compared to those smoking ≤20 cigarettes/day. Although weight, waist circumference, body mass index (BMI), and high-density lipoprotein cholesterol levels increased, VAI levels were found to decrease significantly at the 3rd month. In subgroup analyses, VAI levels were seen to decrease significantly only in men (P = 0.005). Furthermore, VAI levels were found to decrease (P < 0.001) in those with BMI ≥25 kg/m2, whereas no significant change was observed in those with BMI <25 kg/m2. Conclusions: Although body weight increases significantly after quitting smoking, VAI levels, an indicator of cardiovascular risks, decrease significantly, especially in men or obese patients.

Evaluation of pharmacologic therapies accompanied by behavioural therapy on smoking cessation success: a prospective cohort study in Turkey

ABSTRACT OBJECTIVE: The main objective of this study is to compare the rate of smoking cessation in the first month, third month, sixth month, first-year, and second year among those who quit smoking following different pharmacological and behavioural therapies administered at the Selcuk University’s Smoking Cessation Clinic in Turkey. METHODS: In this study, 3322 people who presented to the clinic in order to quit smoking were advised one of the most suitable medical treatments (varenicline, bupropion, NRT) accompanied by behaviour therapy after their health queries and examinations were made and Fagerström scores were evaluated. Smoking cessation patients were followed up clinically and by making calls after smoking cessation. RESULTS: The smoking cessation success rate in the cases using varenicline in the first month was 63.5% (766/1206), in the third month 46.8% (548/1170), in the sixth month 32.1% (386/1201), first year 25.6% (298/1163), and 19.9% (211/1059) in the second year. The success rate in the cases using bupropion in the first month was 49.9% (559/1120), in the third month 35.6% (405/1138), in the sixth month 26.4% (319/1210), first year 21.9% (261/1192), and 16.0% (133/832) in the second year. The success rate in the cases using NRT was 53.2% (25/47) in the first-month, 24.3% (9/37) in the third-month, and 27.3% (6/22) in the sixth-month assessments. The rates of smoking cessation in the cases using varenicline and behavioural therapy in the 1st, 3rd, 6th, 12th, and 24th month were significantly higher compared to the cases using bupropion and behavioural therapy (p = .000, p = .000, p = .008, p = .034, and p = .028; respectively). CONCLUSIONS: It has been observed in this study that varenicline as a smoking cessation drug is better tolerated than other medications and it seems to be more effective.

Plasma netrin-1 levels significantly increase in smokers

OBJECTIVES Netrin-1 is a laminin like protein that has recently been suggested to involve in the pathophysiology of atherosclerosis and treatment targets. The relationship between netrin-1 and atherosclerosis has not been evaluated in a human research previously and the effect of smoking on plasma netrin-1 levels as well. In this study, we aimed to evaluate plasma netrin-1 levels in smokers and non-smokers and the impact of smoking on netrin-1 levels. Our second aim was to evaluate the existence of peripheral artery disease in these groups by means of ankle brachial index (ABI) measurements and the relation between plasma netrin-1 levels and peripheral artery disease. DESIGN AND METHODS Smoker and non-smoker male patients were contributed in the study, 112 males in each group. ABI of all patients was determined with an automatic device and plasma netrin-1 levels were quantified with an enzyme-linked immunosorbent assay. Netrin-1 levels were compared between smoker and non-smoker cases, and the cases with and without peripheral arterial disease. RESULTS Plasma netrin-1 levels of smokers (4.54±2.87pg/mL) were significantly higher than in non-smokers (3.81±1.26pg/mL) (p=0.015). Similarly, netrin-1 levels of cases with peripheral arterial disease (6.21±2.16pg/mL) were significantly higher than the ones without peripheral arterial disease (4.07±2.16pg/mL) (p=0.002). Amount of smoking (packet⋅year) and ABI were found to be significantly related with netrin-1 levels. The relationship between PAD and netrin-1 levels remained significant after adjusting for smoking status. CONCLUSION We can conclude that plasma netrin-1 levels significantly increase in smokers and peripheral artery disease is significantly related with netrin-1 levels after adjusting for smoking status.

Arterial Stiffness and Carotid Intima-Media Thickness in Diabetic Peripheral Neuropathy

Background We investigated the relationship between peripheral neuropathy and parameters of arterial stiffness and carotid intima media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM). Material/Methods The study included 161 patients (80 females and 81 males), 69 of whom had peripheral neuropathy. All patients underwent 24-h blood pressure monitoring, and arterial stiffness parameters were measured. The CIMT was measured using B-mode ultrasonography and patients also underwent transthoracic echocardiographic examination. Results Patients with peripheral neuropathy, compared with those without it, were older (54.68±8.35 years vs. 51.04±7.89 years; p=0.005) and had T2DM for longer periods (60 vs. 36 months; p=0.004). Glycated hemoglobin (HbA1c) values (8.55±1.85 mg/dL vs. 7.30±1.51 mg/dL; p<0.001), pulse wave velocity (PWV) (7.74±1.14 m/s vs. 7.15±1.10 m/s; p=0.001), CIMT (anterior 0.74±0.15 mm vs. 0.67±0.13 mm; p=0.01), and left ventricular mass (LVM) index (98.68±26.28 g/m2 vs. 89.71±19.70 g/m2; p=0.02) were all significantly increased in the group with peripheral neuropathy compared to the group without peripheral neuropathy. We determined that duration of diabetes, HbA1c, and LVM index were predictors of peripheral neuropathy. Conclusions A significant relationship was found between diabetic neuropathy and increased PWV, a parameter of arterial stiffness, as well as CIMT, a marker of systemic atherosclerosis. Diabetic peripheral neuropathy may be a determinant of subclinical atherosclerosis in T2DM.