Circulating Spexin levels in pregnant women with and without gestational diabetes

Background: Several previous studies suggest that SPX plays a role in appetite control and body weight and blood glucose regulation. The aim of this study to determine SPX levels in healthy pregnancies and in gestational diabetes (GDM) and to investigate the association of SPX levels with weight gain and lipid and glucose metabolism in subjects with and without GDM.Methods: A total of 44 women with GDM and 44 women without GDM were randomly enrolled who applied for GDM screening during the 24-28th week of pregnancy. Demographics, blood glucose and lipid profiles and Spexin levels were compared between groups.Results: The mean age, BMI, and weight gain during pregnancy were higher in the GDM group. The LDL cholesterol, Hba1c, SPX and glucose levels in response to OGTT were higher in the GDM group. The SPX levels were correlated with Hba1c and blood glucose levels after OGTT, and were not correlated with the age, BMI, weight gain during pregnancy, lipid parameters, and fasting blood glucose levels in the whole study population.Conclusions: SPX levels were higher in the GDM group compared with non-GDM group and SPX levels were correlated with HbA1c levels and post-OGTT glucose levels but not with fasting glucose levels

COL4A1 and COL4A2 Mutations Analyses with Perinatal Arterial ?schemic Stroke

Perinatal arterial ischemic stroke (PAIS) is one of the frequent causes of mortality and morbidity, but its etiology remains unclear. COL4A1 and COL4A2 mutations are monogenetic causes of weakness of the basement vascular membranes resulting in cerebral small-vessel disease, cerebral hemorrhage, and porencephaly. We hypothesized that variations in the COL4A1 and COL4A2 genes cause PAIS and performed mutation screening of these genes in 17 PAIS patients by whole-exome sequencing. Clinical, demographic, and laboratory data of the 17 PAIS patients were obtained by evaluating hospital files retrospectively. Patients included in the study were invited to the clinic for COL4A1 and COL4A2 mutation analysis. Results: The patient group consisted of 13 females (76.5%) and four males (23.5%) with a mean age of 107.4 ± 11.5 months. Maternal/fetal and prothrombotic risk factors identified in 52.9% and 94.1% of the patients, respectively. Whole-exome sequencing analysis did not reveal COL4A1 and COL4A2 pathological mutations in any of the patients.  Although we did not find an association between PAIS and COL4A1 and COL4A2 variations, we believe that new studies with larger patient populations may reveal such a relationship

Cetuximab Concomitant with Second-Line Radiation Therapy in Patients with Locally Advanced Recurrent Squamous Cell Head and Neck Cancer

We presented 9 recurrent head and neck carcinoma patients. Priorly all of them had received radiochemotherapy. We used cetuximab and irradiation concomitantly. Overall survival analysis of the patients was performed using the Kaplan-Meier method on SPSS version 15.0. Based on this calculation, mean follow-up duration is 12.8 months. Mean survival time is 19.8 months and annual mean survival rate is 59.3%

Drivers of innovative behaviors: The moderator roles of perceived organizational support and psychological empowerment

Innovative behaviors are one of the most important factors that affect the competitiv performance of organizations. Although there are numerous studies in the literature which try to determine the antecedents of innovative behaviors. there are still gaps to fully understand the nature of these behaviors. In this respect, the purpose of this study is to determine its individual and organizational-level predictors in the light of the Social Exchange Theory. In this respect, we investigated the effect of proactive personality on innovative behaviors and the moderator roles of perceived organizational support and psychological empowerment on this relationship. More specifically, we hypothesized that employees, who have proactive personality, are more prone to exhibit innovative behaviors. We also hypothesized that the proposed relationship between proactive personality and innovative behaviors is stronger when the levels of perceived organizational support and psychological empowerment is high The sample of the study consisted of 436 employees (in white goods sector) working in Istanbul. The findings show that proactive personality, perceived organizational support, and psychological empowerment are the statistically significant and positive predictors of innovative behaviors. The most powerful predictor of innovative behaviors in our theoretical model is proactive personality; the others are perceived organizational support and psychological empowerment, respectively. Following this. the findings also show that while the moderating effect of psychological empowerment is statistically significant, the interactional effect of perceived organizational support is not significant. Managerial and further research implications are provided. (C) AIMI Journal

Valproic acid-induced nocturnal enuresis in pediatric Patients

Background: Valproic acid (VPA) is one of the commonly used antiepileptic drug. It has various side effects which may be fatal, such as fulminant hepatitis. Nocturnal enuresis (NE) has rarely been reported as side effect of VPA. The aim of this study is to evaluate the frequency of VPA‑induced NE and discuss the possible reasons.Materials and Methods: This retrospective cohort study was performed at the Department of Pediatric Neurology, Eskisehir Osmangazi University Hospital, in Eskisehir, Turkey, between April 2014 and April 2015. The patient population was generated from the epilepsy patients who were receiving VPA monotherapy. Control group population was generated from nonepileptic patients who visited our clinic for headache. Age range of the patients and the control group was determined to be 5–15 years. Results: The patients group consisted of 189 (53.7%) boys and 163 (46.3%) girls and mean age of the patients was 9.1 ± 3.02 (5–15) years. The control group consisted of 92 (51.1%) girls and 88 (48.9%) boys and mean age of the patients was 8.75 ± 3.23 (5–15) years. We found the incidence of VPA‑induced NE to be 5.7%. In the control group, incidence of NE was found to be 10.7%. Conclusion: This study is one of the largest series about VPA‑induced NE. NE is a side effect of VPA that is generally overlooked by clinicians and slightly less well‑known too. The literature on VPA‑induced NE is very inadequate, and its etiology is not clear. In our study, we did not detect renal dysfunction in the patients with VPA‑induced NE; therefore, we may speculate that the NE was caused by the increased sleep depth with VPA treatment. We believe that larger prospective studies including  polysomnography may be helpful to shed light on the cause of VPA‑induced NE.Keywords: Enuresis, epilepsy, side effect, sodium valproate, valproic aci

Effects of ammonia on pentylenetetrazole-induced seizure threshold

The effect of chronic perfusion of ammonia on the seizure threshold against pentylenetetrazol was studied. Ammonia plus sodium bicarbonate and saline (0.9%) was continuously administered to two groups of rats respectively. All animals were tested three times for seizure threshold, and were then decapitated and the brains removed for analysis of the amino acids. The results showed that the infusion of ammonia increased the seizure threshold, and this protective effect was accompanied by selective changes in brain glutamate and glutamine. Thus, continuous infusion of ammonia may cause an imbalance between excitatory and inhibitory systems in favor of inhibitory systems. These findings may provide insights into the basic mechanisms of seizures observed in hepatic failure, in other hyperammonemic states, and in epilepsy

The role of anti-Mullerian hormone in predicting the response to clomiphene citrate in unexplained infertility

Objective: To determine the role of anti-Mullerian hormone (AMH) levels in predicting the response to clomiphene citrate (CC) therapy for ovulation induction in women with unexplained infertility. Materials and methods: For this retrospective study, fifty consecutive patients who responded to CC were taken as Group 1, while fifty consecutive patients who failed to show adequate ovulatory response with CC were taken as Group 2. We compared the AMH levels of the two groups and receiver operating characteristic (ROC) curve was used to determine the threshold for AMH in predicting the ovulatory response to CC therapy. Results: Mean age, body mass index, luteinizing hormone, prolactin, and thyroid-stimulating hormone values were similar in the two groups. AMH and antral follicle count (AFC) values were higher in Group 1 than in Group 2 (p = 0.001 and p = 0.001, respectively). There was a statistically significant negative correlation between FSH and AFC (r = -0.339, p = 0.001), while AFC and AMH displayed a statistically significant positive correlation (r = 0.713 and p = 0.001). AMH values and AFC were found to be predictors of the adequate ovulatory response to CC. The area under the ROC curve was 0.86 vs 0.80, respectively. At an AFC cutoff value of 14, the sensitivity and specificity for prediction of ovulation were 68% and 80%, respectively. Conclusion: The AMH and AFC cut-off values for the prediction of positive ovarian response to CC in patients with unexplained infertility were 2.78 ng/mL and 14, respectively. If further prospective and randomized studies confirm our results, these thresholds may be useful to predict successful ovulation induction and reduce the unresponsive cycles. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V

Analysis of the effectiveness of ultrasound and clinical examination methods in fetal weight estimation for term pregnancies

Objective: To compare the accuracy of clinical and ultrasonographic (USG) estimation of fetal weight in non-complicated, term pregnancies. Materials and Methods: Two hundred term pregnant women were included in the study. We used three formulae for the estimation of fetal weight at term; the Hadlock formula for the USG method, and two different formulas for clinical methods, maternal symphysis-fundal height and abdominal circumference at the level of umbilicus. Accuracy was determined by mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight (birth weight +/- 10%). Patients were divided into two groups according to actual birth weight, the normal birth weight group (2500-3999 g) and high birth weight group (>= 4000 g). Results: All three methods statistically overestimated birth weight for the high and normal birth weight groups (p<0.001, p=1.000, p=0.233) (p=0.037, p<0.001, and p<0.001). For both groups, the mean absolute percentage errors of USG were smaller than for the other two clinical methods and the number of estimates were within 10% of actual birth weight for USG was greater than for the clinical methods; the differences were statistically significant (p<0.001). No statistically significant difference of accuracy was observed for all three methods for the high birth weight group (p=0.365, p=0.768, and p=0.540). However, USG systematically underestimated birth weight in this group. Conclusion: For estimation of fetal birth weight in term pregnancies, ultrasonography is better than clinical methods. In the suspicion of macrosomia, it must be remembered that no method is better than any other. In addition, if ultrasonography is used, careful management is recommended because ultrasonography overestimates in this group

The effect of head trauma on fracture healing: biomechanical testing and finite element analysis

WOS: 000287942400010PubMed ID: 21252609Objectives: We aimed to evaluate the effect of head trauma on fracture healing with biomechanical testing, to compare the results obtained from a femur model created by finite element analysis with experimental data, and to develop a finite element model that can be employed in femoral fractures. Methods: Twenty-two Wistar albino rats were randomized into two groups. The control group was subjected to femoral fracture followed by intramedullary fixation, whereas the head trauma group was subjected to femoral fracture followed by intramedullary fixation along with closed blunt head trauma. Bone sections obtained with computed tomography from rat femurs were transferred into a computer and a 3D mathematical model of femur was created. At the end of week 4, femurs were examined by biomechanical testing and finite element analysis. Results: The mean maximum fracture load was significantly higher in the head trauma group than in control group (p 0.05). The head trauma group had significantly higher mean bending rigidity than the control group (p 0.05). There was no significant difference between experimental biomechanical test and finite element analysis (p > 0.05). Conclusion: Noninvasive methods such as finite element analysis are useful in examination of the mechanical structure of bones. Experimental biomechanical test and finite element analysis methods suggest that head trauma contributes to fracture healing