Evaluation of sexual functional status and consistency of scales in patients with hypogonadotropic hypogonadism before and after testosterone replacement therapy: a single-center experience

ABSTRACT Objective: This study aimed to investigate the frequency of sexual dysfunction and the effect of short-term testosterone replacement therapy on sexual functions in congenital hypogonadism patients. Furthermore, we sought to reveal the consistency of the self-report scales used for the diagnosis of sexual dysfunction and the relationship between biochemical parameters. Materials and methods: The study was conducted on 47 young male patients aged above 18 years who were diagnosed with hypogonadotropic hypogonadism. Short (IIEF-5) and long (IIEF-15) forms of the International Index of Erectile Function and Arizona Sexual Experiences Scale (ASEX) were applied before treatment under the supervision of a physician. The patients’ blood pressure, height, and weight were measured, and their luteinizing hormone (LH), FSH, and total testosterone levels were recorded. Patients who started their treatments were called for a follow-up checkup after 6 months. Their blood pressure, height, and weight were measured by reapplying the ASEX, IIEF-5, and IIEF-15. In addition, their LH, FSH, and total testosterone levels in the biochemical tests were rerecorded. Results: In this study, the sexual dysfunction status of patients diagnosed with hypogonadotropic hypogonadism before and after treatment was evaluated using the ASEX, IIEF-15, and IIEF-5 scales. A decrease in sexual dysfunction was observed in all three scales after treatment compared with that before treatment. The IIEF-5 and IIEF-15 scales were found to be uncorrelated in terms of the pretreatment values but were correlated in terms of the post-treatment values. Although a correlation was observed between ASEX and IIEF-5 before treatment, no correlation was detected between ASEX and IIEF-15. After the treatment, ASEX was found to be correlated with both IIEF-5 and IIEF-15. The results of the scales indicated the correlation in all categories, except the pretreatment results of the IIEF-15 scale. Conclusion: The results of the current study demonstrated a significant improvement in the sexual function of hypogonadism patients undergoing short-term testosterone therapy. The ASEX, IIEF-5, and IIEF-15 scales used in the diagnosis and follow-up of sexual dysfunction were useful for evaluating sexual functions in hypogonadotropic hypogonadism patients

Evaluation of newborns with vitamin D deficiency: A single-center experience

Aim: To evaluate the demographic, clinical, and laboratory characteristics (primarily phosphorus, calcium (Ca), and alkaline phosphatase (ALP) levels of newborns with low 25-OHD levels. Methods: In this retrospective study, babies whose 25-OHD levels were determined during hospitalization were evaluated. The newborns were classified as stated by their serum 25-OHD levels as follows: severely deficient, <5 ng/mL (group 1); deficient, 5–20 ng/mL (group 2); and insufficient, 20 to 30 ng/mL (group 3). In addition to the newborns' serum 25-OHD levels, their serum Ca, phosphorus, parathormone (PTH), and alkaline phosphatase levels and their mothers' 25-OHD levels were also measured. Results: A total of 568 newborns were included. Serum 25-OHD level was severely deficient in 112 patients (19.7%). The mothers of the babies in group 1 were younger than those of the babies in the other groups. First PTH level (F3,1, p = 0.04) and maternal ALP level were highest in group 1. In all the groups, the maternal 25-OHD level was <30 ng/mL. Vitamin D supplementation rate during pregnancy was found to be significantly lower in the severely deficient and deficient groups than in the insufficient group (F1,84, p = 0.01). Conclusion: 25-OHD deficiency continues to be a problem among pregnant women and their babies in Turkey despite the introduction of a supplementation program. This study emphasizes the need to improve maternal 25-OHD status to support maternal and infant health. &nbsp

Wpływ testosteronowej terapii zastępczej na stężenia witaminy D i FGF-23 w hipogonadyzmie wrodzonym

Introduction: Patients with hypogonadism are at increased risk of cardiac and metabolic diseases and osteoporosis. Vitamin D and Fibroblast growth factor-23 (FGF-23) play role in the regulation of bone mineral metabolism and endothelial functions. Low vitamin D levels are reported in hypogonadism, while there is no data about the effect of testosterone replacement therapy (TRT). We investigated the effect of TRT on vitamin D and FGF-23 levels along with endothelial functions and insulin resistance in hypogonadal patients. Material and methods: Patients with congenital hypogonadotrophic hypogonadism (CHH) (n=32, age 20.6 ±1.58 years) were enrolled. TRT was implemented in transdermal form. The demographic parameters, FGF-23, 25(OH)D3, Asymmetric dimethylarginine (ADMA) and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured both before and after TRT. Results: After a follow-up period of 3.63±1.33 months, ADMA and FGF-23 levels were significantly increased (p=0.03 and p=0.005 respectively), while the 25(OH)D3 and HOMA-IR index were not significantly changed. The body mass index and waist circumference levels of the patients were also increased (p<0.001 and p=0.02) along with a significant decrease in the HDL cholesterol levels (p=0.006). Conclusions: The results show that a short term TRT increases plasma FGF-23 and ADMA levels, in young, treatment naive patients with CHH. Whether this is an early implication of TRT related adverse effects in this very young and treatment naïve population of CHH is not clear. Future prospective studies are required to find out the long-term effects of TRT on cardio-metabolic morbidity and mortality in this specific population.  Wstęp: U chorych z hipogonadyzmem występuje zwiększone ryzyko chorób sercowych I metabolicznych oraz osteoporozy. Witamina D i czynnik wzrostu fibroblastów-23 (FGF-23) uczestniczą w regulacji metabolizmu kostnego i czynności śródbłonka. Istnieją doniesienia na temat niskiego stężenia witaminy D w hipogonadyzmie, natomiast brakuje danych dotyczących wpływu testosteronowej terapii zastępczej (TRT) na to stężenie. Autorzy zbadali wpływ TRT na stężenia witaminy D i FGF-23 oraz na czynność śródbłonka i poziom insulinooporności u chorych z hipogonadyzmem. Materiał i metody: Do badania włączono chorych z wrodzonym hipogonadyzmem hipogonadotropowym (CHH) (n = 32, wiek 20,6 ± 1,58 roku). Chorzy otrzymywali TRT w postaci przezskórnej. Przez rozpoczęciem leczenia i po jego zakończeniu u chorych zebrano dane demograficzne, zmierzono stężenia FGF-23, 25(OH)D3 i asymetryczej dimetyloargininy (ADMA) oraz określono wskaźnik insulinooporności HOMA-IR. Wyniki: Po okresie obserwacji trwającym 3,63 ± 1,33 miesiąca stwierdzono istotne zwiększenie stężeń ADMA i FGF-23 (odpowiednio p = 0,03 i p = 0,005), natomiast stężenie 25(OH)D3 i wskaźnik HOMA-IR nie zmieniły się istotnie. Ponadto zaobserwowano u chorych zwiększenie wskaźnika masy ciała i obwodu pasa (p < 0,001 I p = 0,02) oraz istotne zmniejszenie stężenia cholesterol frakcji HDL (p = 0,006). Wnioski: Wyniki badania pokazują, że krótkotrwałe stosowanie TRT u młodych chorych z CHH, uprzednio nieleczonych, powoduje zwiększenie osoczowego stężenia FGF-23 i ADMA, lecz nie wpływa na stężenie witaminy D. Nie jest jasne, czy jest to wczesny efekt działań niepożądanych TRT w tej grupie bardzo młodych pacjentów z CHH. Konieczne są dalsze prospektywne badania w celu ustalenia długookresowego wpływu TRT na chorobowość i śmiertelność w związku z chorobami sercowymi i metabolicznymi w tej szczególnej populacji

Maqui berry extract inhibits filamentation of Candidaalbicans and improves the antifungal efficacy of nystatin

Candidiasis caused by Candida albicans is one of the most common fungal infections in modern society. The limited arsenal of clinical drugs, their side effects and emerging resistance, largely contribute to the low efficacy of current antifungal therapies. The morphogenetic yeast-to-hyphae transition is the key virulence feature for the establishment of local and systemic C. albicans infections. We show that a delfinidin-rich fruit extract from Aristotelia chilensis ([Molina], Stuntz) (maqui berry) inhibits filamentation of C. albicans, in both laboratory and clinical strains. The extract acts synergistically with nystatin, with filament formation completely prevented by the combination of ¼×MIC of nystatin and 0.125 mg/ml of the extract. The combination treatment results in increased survival of C. albicans-infected zebrafish embryos compared to treatment with nystatin. Neither the extract nor its combination with nystatin was toxic at effective doses. These results warrant further investigation of maqui berry extract as adjuvant antifungal treatment

Reliability and Validity of the Turkish Version of Patient and Observer Scar Assessment Scale in Patients with Burnso

Objective: To evaluation reliability and validity of the Turkish version of Patient and Observer Scar Assessment Scale (POSAS) in patients with burns. Methods: This is a methodologically study. Data were collected using POSAS, survey form and plexiglas. Patient Scar Assessment Scale (PSAS) was completed by patients (n=53) and Observer Scar Assessment Scale (OSAS) was completed by two observers separately. The test-retest was measured applying the scales in 25 patients after two weeks. Data were analyzed by Kruskal-Wallis and Mann-Whitney U test. Content validity was determined using Kaiser-Meyer-Olkin, Barlett's test and structure validity was performed by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA); reliability was evaluated using internal consistency, Cronbach's alpha and intraclass correlation coefficient (ICC). Results: Factor weights were in appropriate range according to EFA, 6 items single factor structure of the original scale was valid and had high consistency index according to CFA, ICC between the 7th item and the total points was proportional, inner consistency was highly reliable (PSAS alpha=0.992, OSAS alpha=0.993), consistency between the observers was high (alpha=0.952, r=0.909). It was determined OSAS scores increased as the burn degree increased (p<0.05). Conclusion: POSAS was determined to be a valid and reliable scale in patients with burns in the Turkish society

Fucoidan and Derived Oligo-Fucoses: Structural Features with Relevance in Competitive Inhibition of Gastrointestinal Norovirus Binding

Norovirus infections belong to the most common causes of human gastroenteritis worldwide and epidemic outbreaks are responsible for hundreds of thousands of deaths annually. In humans, noroviruses are known to bind to gastrointestinal epithelia via recognition of blood-group active mucin-type O-glycans. Considering the involvement of l-alpha-fucose residues in these glycans, their high valency on epithelial surfaces far surpasses the low affinity, though specific interactions of monovalent milk oligosaccharides. Based on these findings, we attempted to identify polyfucoses (fucans) with the capacity to block binding of the currently most prevalent norovirus strain GII.4 (Sydney, 2012, JX459908) to human and animal gastrointestinal mucins. We provide evidence that inhibitory effects on capsid binding are exerted in a competitive manner by alpha-fucosyl residues on Fucus vesiculosus fucoidan, but also on the galacto-fucan from Undaria pinnatifida and their oligo-fucose processing products. Insight into novel structural aspects of fucoidan and derived oligosaccharides from low-mass Undaria pinnatifida were revealed by GCMS and MALDI mass spectrometry. In targeting noroviral spread attenuation, this study provides first steps towards a prophylactic food additive that is produced from algal species

Rough Kansei Mining Model for Market-Oriented Product Design

Companies need to develop new products towards customer's satisfaction in order to survive in the boom and bust cycle in todays' economy. The capturing of customer satisfaction depends on customer needs, and generally, understanding emotions has a challenge for designers. Kansei engineering is a type of methodology to help customers and designers analyze needs and emotion for the new product development. Producing new product design with Kansei data increases customer satisfaction and helps to reach market goals. In this study, a market-oriented baby cradle design methodology is proposed, and we obtain the new product strategies with association rule extraction by using rough set theory. To obtain efficient rules, beforehand we selected sales knowledge-related Kansei words with our proposed approach: cost-based and multiclass decision-theoretic rough set (DTRS) attribute reduction. The new product design strategies which are obtained with proposed design methodology are consistent with customer expectations (mood space) and expert opinions (design team)

Arthroscopic Treatment of a Case with Concomitant Subacromial and Subdeltoid Synovial Chondromatosis and Labrum Tear

Synovial chondromatosis is a disease that seldomly seen in shoulder joint and is related to benign synovial proliferation and synchronous chondral tissue formation within the joint cavity. Patients suffer from progressive restriction of range of motion and shoulder pain. Extra-articular involvement is an extremely rare condition. Degenerative osteoarthritis, joint subluxation, and bursitis are common complications in untreated patients. Open or arthroscopic surgery is suitable while there is no consensus related to superiority of different approaches. We presented an arthroscopic treatment of a male patient, 48 years old with labrum tear and synovial chondromatosis localized in subacromial and subdeltoid region. Advantages of arthroscopic surgery in the presence of intra- and extra-articular combined pathologies are also discussed

Zinc-induced alterations in contractile properties of rat diaphragm muscle in vitro

The effect of zinc ions on the isometric contraction of rat diaphragm muscles in the presence and in the absence of external calcium was studied. Using a transducer, the isometric force was measured as a function of supramaximal electrical stimulation, either directly or indirectly applied to the muscle. The following parameters were measured: peak twitch tension, PT, twitch contraction time, CT, relaxation half-time, RT-1/2, and peak rates of tension increase and decrease, +dP/dt and -dP/dt. The following zinc-induced alterations were observed: an increase of the PT; a decrease of the RT-1/2; an increase in the +dP/dt and -dP/dt. The CT was not changed significantly. Our results suggest that zinc ions have a positive inotropic effect on isolated diaphragm muscle. The increase in PT may be explained by a zinc-activated Ca2+ uptake by sarcoplasmic reticulum. This was followed by an increase in the rate of rise of tension development, which was secondary to increased -dP/dt. The mechanism(s) by which extracellular Ca2+ contributes to this action of zinc is not known

Effect of static magnetic field on experimental dermal wound strength

Context: An animal model. Aim: We sought to evaluate the effect of static magnetic fields on cutaneous wound healing. Materials and Methods: Male Wistar rats were used. Wounds were created on the backs of all rats. Forty of these animals (M group) had NeFeB magnets placed in contact with the incisions, either parallel (Pa) and perpendicular (Pr) to the incision. The other 40 animals (sham [S] group) had nonmagnetized NeFeB bars placed in the same directions as the implanted animals. Half of the animals in each group were killed and assessed for healing on postoperative day 7 and the other half on postoperative day 14. The following assessments were done: gross healing, mechanical strength, and histopathology. Statistical Analysis Used: Intergroup differences were compared by using the Mann-Whitney U or t test. Values for P less than 0.05 were accepted as significant. Results and Conclusions: There were no differences between the magnetic and sham animals with respect to gross healing parameters. The mechanical strength was different between groups. On postoperative day 14, the MPr14 had significantly higher scores than the other groups. When static, high-power, magnetic fields are placed perpendicular to the wound, increased wound healing occurs in the skin of the experimental model