Frequency and determinants of erectile dysfunction in Turkish diabetic men

Background: Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance. ED is observed more frequently and manifests earlier in diabetic patients compared to the normal population.Material and Methods: One hundred and seventeen consecutive male type 2 diabetes patients seen in our Diabetes Outpatient Clinic were included in our study and these patients were evaluated in terms of the presence and duration of ED, treatment and response to treatment of ED, duration of diabetes mellitus, HbA1c levels, and the presence of microalbuminuria, estimated from 24‑hour urine collections.Results: The patients included in our study were divided into three groups: Patients with no ED, mild‑to‑moderate ED, and severe ED. Twenty‑nine patients (24.8%) fell in the no ED group, 28 (23.9%) in the mild‑to‑moderate ED group, and 60 (51.3%) in the severe ED group. There were statistically significant differences between these three groups in terms of age (P = 0.015) and duration of diabetes mellitus (P = 0.03). The groups were similar in terms of microalbuminuria measured from 24‑hour urine collections and HbA1c levels (P = 0.328 and P = 0.905, respectively). Twenty‑three of the 88 patients with ED (26.1%) were on ED treatment and 43.5% of these patients reported benefit from the therapy.Conclusion: Age and duration of diabetes were the main determinants of the presence and severity of ED in male Turkish type 2 diabetic patients. The HbA1c levels were higher in patients with ED, but the differences in levels between the groups did not reach statistical significance.Key words: Diabetes mellitus, erectile dysfunction, microalbuminuri

Thorax computed tomography findings and anti-SARS-CoV-2 immunoglobulin G levels in polymerase chain reaction-negative probable COVID-19 cases.

OBJECTIVE: This study aimed to evaluate the SARS-CoV-2 immunoglobulin G (IgG) levels after 6 months of polymerase chain reaction (PCR) negativebut assumed to be COVID-19 positive cases to investigate the relationship between IgG levels and thoracic computed tomography (CT) findings.METHODS: This was a single-center study that included patients whose PCR test results were negative at least three times using nasopharyngealswabs but had clinical findings of COVID-19 and thoracic CT findings compatible with viral pneumonia. Six months after discharge, the IgG antibodieswere analyzed. The cutoff value for negative and positive serology was defined as <1.4 (index S/C) and ≥1.4 (index S/C), respectively. In addition, thepatients were categorized according to their thoracic CT findings as high (typical) and low (atypical). Also, the patients were grouped into classes as<5% lung involvement versus ≥5% lung involvement.RESULTS: The patients’ mean age was 49.78±12.96 years. PCR was negative, but patients with COVID-19 symptoms who had SARS-CoV-2 IgGpositive were 81.9% (n=95). The antibody titer and lung involvement ≥5% were statistically significantly higher in SARS-CoV-2 IgG positive cases(p<0.001 and p=0.021). Age and chest CT findings were the risk factors for lung involvement (OR=1.08, p<0.001 and OR=2.19, p=0.010, respectively).CONCLUSION: This study is valuable because increasing severity (≥5%) of lung involvement appears to be associated with high and persistent IgGantibody titers. In probable cases of COVID-19, even if the PCR test is negative, high IgG titers 6 months after discharge can predict the rate of lungparenchymal involvement

Effect of vildagliptin add-on treatment to metformin on plasma asymmetric dimethylarginine in type 2 diabetes mellitus patients

Mustafa Cakirca,1 Cumali Karatoprak,1 Mehmet Zorlu,1 Muharrem Kiskac,1 Mustafa Kanat,2 Mehmet Ali Cikrikcioglu,1 Pinar Soysal,3 Mehmet Hursitoglu,4 Ahmet Adil Camli,1 Reha Erkoc,1 Muhammad Abdul-Ghani5 1Internal Medicine Clinic, Faculty of Medicine, Bezmialem Vakif University, 2Department of Internal Medicine, Medical Faculty, Istanbul Medipol University, 3Department of Geriatric Medicine, Medical Faculty, Dokuz Eylül University, 4Department of Internal Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey; 5Division of Medicine – Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA Aims: A close association has been demonstrated between increased cardiovascular risk and high asymmetric dimethylarginine (ADMA) levels in type 2 diabetes mellitus (DM) patients. We planned to measure serum ADMA levels in type 2 DM patients using vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor. Materials and methods: A total of 68 type 2 DM patients who were on metformin were enrolled in the study. Based on the glycemic levels of patients, vildagliptin was added on to treatment in 33 patients. Patients were followed for 6 months. Serum ADMA, C-reactive protein, and fibrinogen levels were compared in groups of patients using metformin or metformin + vildagliptin, after 6 months. Results: Serum ADMA levels were found to be significantly lower in the group using vildagliptin compared to the group using metformin + vildagliptin (P<0.001). However, serum C-reactive protein and fibrinogen levels were statistically similar in the two study groups (P=0.34 and P=0.23, respectively). Conclusion: Metformin + vildagliptin treatment was observed to lower serum ADMA levels in type 2 DM patients. Our findings notwithstanding, large-scale prospective randomized controlled studies are warranted to conclude that vildagliptin provides cardiovascular protection along with diabetes regulation. Keywords: asymmetric dimethylarginine (ADMA), dipeptidyl peptidase-4 (DPP-4) inhibitor, vildagliptin, type 2 diabetes mellitu

Serum endocan levels in women with restless legs syndrome

Kenan Celik,1 Mehmet A Cikrikcioglu,1 Gulistan Halac,2 Elif Kilic,3 Siddika Ayhan,3 Nihal Ozaras,4 Kemal Yildiz,5 Rabia S Yildiz,1 Mehmet Zorlu,1 Cumali Karatoprak,1 Mustafa Cakirca,1 Muharrem Kiskac1 1Department of Internal Medicine, 2Department of Neurology, 3Department of Biochemistry, 4Department of Physical Medicine and Rehabilitation, Medical Faculty, Bezmialem Vakif University, Fatih, 5Department of Internal Medicine, Private Medicana International Istanbul Hospital, Beylikdüzü, Istanbul, Turkey Background: Endocan is a recently introduced marker of endothelial dysfunction. The objective of this study was to compare serum endocan levels in patients with restless legs syndrome (RLS) and control subjects in order to elucidate whether RLS is associated with endothelial dysfunction. Methods: A total of 31 drug naïve female patients with RLS and 31 age- and BMI-matched women were included in the study. Patients with pathological or physiological conditions or with a history of medication use that could potentially influence endothelial functions were excluded, as well as those with alcohol or drug abuse history. The two groups were compared with routine blood tests and serum endocan levels. Results: Patients with RLS had lower serum endocan levels than the controls (P=0.037). There was a negative bivariate correlation between RLS severity score and serum endocan levels (r=-0.406, P=0.023). While white blood cell count was significantly higher in RLS group, 25-hydroxy vitamin D3, vitamin B12, transferrin saturation rate, and HDL-cholesterol were significantly lower. Creatininemia and diastolic blood pressure were also marginally insignificantly lower in RLS group. Due to the presence of differences between two groups in these variables, a linear regression analysis was performed that showed a positive association between endocan and creatininemia (β=0.310, P=0.022), and a negative association between endocan and RLS (β=-0.502, P<0.001). Conclusion: The results of this study seem to suggest that patients with RLS may have better endothelial functions when compared with the general population and that these patients may be better protected against atherosclerosis. Keywords: endocan, restless legs syndrome, RLS, atherosclerosis, endothelial&nbsp