Effect of sildenafil citrate treatment on serum dehydroepiandrosterone sulfate levels in patients with erectile dysfunction

WOS: 000241721600038PubMed: 16979704Objectives. To investigate the effect of sildenafil citrate treatment on serum dehydroepiandrosterone sulfate (DHEAS) levels in patients with erectile dysfunction (ED). Methods. A total of 124 men with a mean age of 45.9 years were included in the study. Group 1 consisted of 78 patients with ED, as determined by the Sexual Health Inventory of Male (SHIM) scale (score less than 2 1). Group 2 consisted of 46 healthy men with a SHIM score of 21 or greater. The 78 patients with ED took 100 mg sildenafil citrate at least eight times in 1 month. The SHIM scale was administered and serum DHEAS levels measured before and after treatment in the ED group. The serum DHEAS levels were also measured in the control group. The treatment response was defined as positive if the SHIM score was 21 or greater after sildenafil administration. Results. At the end of sildenafil citrate treatment, the serum DHEAS levels and SHIM scores had increased significantly in the ED group (P = 0.013 and P = 0.001, respectively). In groups 1 and 2, the mean pretreatment serum DHEAS level of the men younger than 50 years old was 200.1 +/- 77.9 and 279.4 +/- 125.4 mu g/dL, respectively (P = 0.013). The elevation of the serum DHEAS levels and SHIM scores was more significant in the sildenafil responders (P = 0.002 and P = 0.001), respectively. Conclusions. Serum DHEAS levels were significantly greater in the patients younger than 50 years old than in the older patients in the ED group. The serum DHEAS levels increased significantly after sildenafil citrate treatment in the ED group (especially in the younger men). Also, patient age was an important factor affecting the sildenafil citrate response

Acute necrotizing encephalopathy causing human bocavirus.

Acute necrotizing encephalopathy is characterized by multiple, symmetrical lesions involving the thalamus, brainstem, cerebellum, and white matter and develops secondarily to viral infections. Influenza viruses are the most common etiological agents. Here, we present the first case of acute necrotizing encephalopathy to develop secondarily to human bocavirus. A 3-year-old girl presented with fever and altered mental status. She had had a fever, cough, and rhinorrhea for five days. The patient was admitted to the intensive care unit with an initial diagnosis of encephalitis when vomiting, convulsions, and loss of consciousness developed. Signs of meningeal irritation were detected upon physical examination. There was a mild increase in proteins, but no cells, in the cerebrospinal fluid (CSF). Brain magnetic resonance imaging showed symmetrical, heterogeneous hyperintensities bilaterally in the caudate nuclei and putamen. Ammonium, lactate, tandem mass spectroscopy, and urine organic acid were normal. No bacteria were detected in the CSF cultures. Human bocavirus was detected in a nasopharyngeal aspirate using real-time PCR, while no influenza was detected. Oseltamivir, acyclovir, 3% hypertonic saline solution, and supportive care were used to treat the patient, who was discharged after two weeks. She began to walk and talk after one month of physical therapy and complete recovery was observed after six months. Human bocavirus is a recently identified virus that is mainly reported as a causative agent in respiratory tract infections. Here, we present a case of influenza-like acute necrotizing encephalopathy secondary to human bocavirus infection

PCR-Free Methodology for Detection of Single-Nucleotide Polymorphism with a Cationic Polythiophene Reporter

This study presents a nonamplification-based nucleic acid assay for the detection of single-nucleotide polymorphism (SNP) associated with familial Mediterranean fever (FMF) besides polymerase chain reaction (PCR)-based methodologies. The major objective is to show the potential of the proposed assay for rapid screening of FMF in a Mediterranean region of 400 million population. The assay relies on binding difference of specially designed wild and mutant primers to the target genomic DNA, followed by determination of unbound primers by quick titration of a cationic polythiophene reporter. The fluorescent reporter exhibits signal transition from 525 to 580 nm in the presence of unbound primers, and it correlates the binding affinity of label-free primers to the homozygous wild and mutant genomes. As a proof of concept, 26 real samples are studied relying on the ON and OFF fluorescence signals of the cationic polythiophene reporter. The results are analyzed by principal component analysis (PCA), which provides clear separation of healthy and patient individuals. The further analysis by support vector machine (SVM) classification has revealed that our assay converges to 96% overall accuracy. These results support that the PCR-free nucleic acid assay has a significant potential for rapid and cost-effective screening of familial Mediterranean fever

Determination of HER2 and p53 Mutations by Sequence Analysis Method and EGFR/Chromosome 7 Gene Status by Fluorescence in Situ Hybridization for the Predilection of Targeted Therapy Modalities in Immunohistochemically Triple Negative Breast Carcinomas in Turkish Population

Triple negative breast cancer (TNBC), an agressive subtype accounts nearly 15 % of all breast carcinomas. Conventional chemotherapy is the only treatment modality thus new, effective targeted therapy methods have been investigated. Epidermal growth factor receptor (EGFR) inhibitors give hope according to the recent studies results. Also therapeutic agents have been tried against aberrant p53 signal activity as TNBC show high p53 mutation rates. Our aim was to detect the incidence of mutations/amplifications identified in TNBC in our population. Here we used sequence analysis to detect HER2 (exon 18-23), p53 (exon 5-8) mutations; fluorescence in situ hybridization (FISH) method to analyse EGFR/chromosome 7 centromere gene status in 82 immunohistochemically TNBC. Basaloid phenotype was identified in 49 (59.8 %) patients. EGFR amplification was noted in 5 cases (6.1 %). All EGFR amplified cases showed EGFR overexpression by immunohistochemistry (IHC). p53 mutations were identified in 33 (40.2 %) cases. Almost 60 % of the basal like breast cancer cases showed p53 mutation. Only one case showed HER2 mutation (exon 20:g.36830_3). Our results showed that gene amplification is not the unique mechanism in EGFR overexpression. IHC might be used in the decision of anti-EGFR therapy in routine practice. p53 mutation rate was lower than the rates reported in the literature probably due to ethnic differences and low sensitivity of sanger sequences in general mutation screening. We also established the rarity of HER2 mutation in TNBC. In conclusion EGFR and p53 are the major targets in TNBC also for our population

Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Gram-Negative Bacteria in a Pediatric Intensive Care Unit

Article; Early AccessWe aimed to analyze risk factors of ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR), pan-drug-resistant (PDR), and extensively drug-resistant (XDR) gram-negative bacteria (GNB) in a pediatric intensive care unit (PICU). This retrospective study evaluated pediatric patients diagnosed with VAP at a tertiary referral hospital. Of the 46 children in the present study, 40 (86.9%) had VAP caused by MDR-, XDR-, and PDR-GNB. Most patients (60.9%) had spent >28 days in the PICU at the time of diagnosis. Respiratory failure necessitating PICU admission was associated with XDR infection-induced VAP ( p = 0.034). High rates of prior broad-spectrum antibiotic use were observed in patients with XDR GNB-induced VAP. VAP induced by MDR-, XDR-, and PDR-GNB occurred more frequently than that caused by drug-susceptible GNB in PICU patients. Long stays for more than 28 days in the PICU and past use of broad-spectrum antibiotics can lead to the development of XDR-GNB-induced VAP. The high antibiotic resistance rates detected in our study highlight the importance of strict infection control measures and antimicrobial stewardship programs in PICUs

Effects of ranibizumab and zoledronic acid on endometriosis in a rat model

Purpose To investigate the histological efficacy of ranibizumab and zoledronic acid in an experimentally induced endometriosis model as compared with danazol, buserelin acetate and dienogest. Methods Endometrial implants were introduced in 52 female Wistar albino rats, which were then randomly divided into six groups. The animals were, respectively, given dienogest, danazol, buserelin acetate, zoledronic acid, ranibizumab and 0.9% NaCl. After 4 weeks, the volumes and histopathological properties of the implants were evaluated and the implants were excised completely at the third laparotomy. A histopathological scoring system was used to evaluate the preservation of epithelia. Endometrial explants were evaluated immunohistochemically. Results Among the groups, the histological score was significantly lower in the zoledronic acid and ranibizumab groups compared with the controls (p 0.001). There were no significant differences regarding ellipsoidal volume levels between groups (p > 0.05). However, there was a statistically significant difference regarding cell numbers according to the degree of Bcl-2, NF-kappa B, and CD31 staining (p 0.001). There was no statistically significant difference in Bcl-2, CD31, or NF-kappa B staining in the binary comparisons between the other groups (p > 0.05). For Bcl-2 staining, the staining rate of the group treated with zoledronic acid was significantly lower compared with the dienogest and danazol groups (p 0.05). The staining rates of CD31 and NF-kappa B were significantly lower in the zoledronic acid and ranibizumab groups compared with the controls (p 0.05). Conclusion According to these results, zoledronic acid and ranibizumab may be putative candidates for the treatment of endometriosis.This study was funded by The Technological and Scientific Research Council of Turkey (TUBITAK) (213S002).Technological and Scientific Research Council of Turkey (TUBITAK) [213S002

Two different homozygous mutations in two Turkish siblings: DGUOK and HPS5

Background: Genetic disorders are enormously diverse both in terms of genotype and phenotype. Each case requires a careful and cautious investigation. Case Presentation: In this paper, we report two siblings who were admitted to our clinic with various symptoms. The older one, a 13-year old boy, presented with mental retardation, lack of speech, autistic behavior, and selfmutilation. And the younger one, a 6-month old girl, presented with growth retardation, dysmorphic face, and strabismus. We used next generation sequencing for our definitive diagnoses and followed a path from genotype to phenotype. Conclusion: We found homozygous changes in DGUOK (NM_080916.2 c.566T>G) and HPS5 (NM_181507.1 c.219G>A) genes in the siblings. In the literature review, we did not find any article that investigates two different autosomal recessive disorders in two siblings. On this aspect, we present a different approach. [JBCGenetics 2020; 3(1.000): 41-44

A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV)

Background/aim: To characterize the clinical course of noninvasive positive pressure ventilation (NIPPV) and high flow humidified nasal cannula ventilation (HFNC) procedures; perform risk analysis for ventilation failure. Material and methods: This prospective, multi-centered, observational study was conducted in 352 PICU admissions (1 month-18 years) between 2016 and 2017. SPSS-22 was used to assess clinical data, define thresholds for ventilation parameters and perform risk analysis. Results: Patient age, onset of disease, previous intubation and hypoxia influenced the choice of therapy mode: NIPPV was preferred in older children (p = 0.002) with longer intubation (p 0.001), ARDS (p = 0.001), lower respiratory tract infections (p 0.001), chronic respiratory disease, (p = 0.005), malignancy (p = 0.048) and immune deficiency (p = 0.026). The failure rate was 13.4%. sepsis, ARDS, prolonged intubation, and use of nasal masks were associated with NIV failure (p = 0.001, p 0.001, p 0.001, p = 0.025). The call of intubation or re-intubation was given due to respiratory failure in twenty-seven (57.5%), hemodynamic instability in eight (17%), bulbar dysfunction or aspiration in 5 (10.6%), neurological deterioration in 4 (8.5%) and developing ARDS in 3 (6.4%) children. A reduction of less than 10% in the respiration within an hour increased the odds of failure by 9.841 times (OR: 9.841, 95% CI: 2.0021-48.3742). FiO(2) > 55% at 6th hours and PRISM-3 >8 were other failure predictors. Of the 9.9% complication rate, the most common complication was pressure ulcerations (4.8%) and mainly observed when using full-face masks (p = 0.047). Fifteen (4.3%) patients died of miscellaneous causes. Tracheostomy cannulation was performed on 16 children due to prolonged mechanical ventilation (8% in NIPPV, 2.6% in HFNC) Conclusion: Absence of reduction in the respiration rate within an hour, FiO(2) requirement >55% at 6th hours and PRISM-3 score >8 predict NIV failure

New oral anticoagulants-TURKey (NOAC-TURK): Multicenter cross-sectional study

Sinan, Umit Yasar/0000-0002-4837-7099; Altay, Servet/0000-0001-7112-3970; Askin, Lutfu/0000-0001-7768-2562; Yildirimturk, Ozlem/0000-0001-9841-4524; Canpolat, Ugur/0000-0002-4250-1706WOS: 000403533300003PubMed: 28100898Objective: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). in this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed. Methods: the New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study. A total of 2,862 patients from 21 different centers of Turkey under the treatment of NOACs for at least three months were included in this study. Demographic, clinical, and laboratory characteristics of study participants with their medications used were obtained through the NOAC-TURK survey database. Additional necessary medical records were obtained from electronic health records of participating centers. Results: of the 2. 862 patients, 1.131 (39.5%) were male and the mean age was 70.3 +/- 10.2 years. Hypertension was found as the most frequent comorbidity (81%). the most common indication for NOACs was permanent atrial fibrillation (83.3%). NOACs were mainly preferred because of inadequate therapeutic range or overdose during warfarin usage. the most frequent complication was bleeding (n=217, 7.6%), and major bleeding was observed in 1.1% of the patients. Embolic events were observed in 37 patients (1.3%). Rivaroxaban and dabigatran were both more preferred than apixaban. Almost half of the patients (47.6%) were using lower doses of NOACs, which is definitely much more than expected. Conclusion: the NOAC-TURK study showed an important overview of the current NOACs treatment regimens in Turkey. Although embolic and bleeding complications were lower than or similar to previous studies, increased utilization of low-dose NOACs in this study should be considered carefully. According to the results of this study, NOACs treatment should be guided through CHA(2)DS(2)-VASc and HASBLED scores to ensure more benefit and less adverse effects in NVAF patients.Turkish Society of CardiologyThe study was funded by Turkish Society of Cardiology