Charakter wzrostu gruczolaków przysadki typu prolactinoma zależy od stężenia prolaktyny i płci pacjentów, ale nie od wartości wskaźnika Ki-67

Introduction: The objective of this study was to investigate the effects of some clinical and pathological features of prolactinomas on tumour behaviour.Material and methods: The study included 113 patients with prolactinoma (27 male, 86 female), with a mean age at diagnosis of 34.4 ± 10.0 years (40.3 ± 12.6 in males, 32.6 ± 8.3 in females). Patients were grouped as invasive or non-invasive according to radiological imaging findings. Ki-67 levels were evaluated if possible.Results: The mean adenoma size (longest dimension) was 38.6 ± 21.6 mm and 10.8 ± 9.4 mm in male and female patients. Pre-treatment serum levels of prolactin were defined as mean 1,926 ± 6,662 ng/mL in all, 124.8 ± 63.4 and 4,675 ± 10,049 ng/mL in the noninvasive and invasive groups (p < 0.05). A positive correlation was found between the serum levels of prolactin and tumour size. The rate of patients with Ki-67 ≥ 0.03 was 37.5% and 47.8% in the noninvasive and invasive groups. The reduction rates were 60.8% and 80.4% in tumour sizes and 81.1% and 93.8% in prolactin level in the noninvasive and invasive groups, respectively, (p < 0.05).Conclusions: We found a strong correlation between prolactin levels and invasiveness in male patients compared to females. Ki-67 index was not found to have a place in defining the prognosis.Wstęp: Celem badania była analiza zależności pomiędzy wybranymi danymi klinicznymi i cechami patomorfologicznymi a przebiegiem klinicznym u pacjentów z gruczolakiem przysadki wydzielającym prolaktynę (prolactinoma)/lub z gruczolakiem prolaktynowym przysadki.Materiał i metody: Do badania włączono 113 pacjentów, u których rozpoznano guzy typu prolactinoma (27 mężczyzn, 86 kobiet). Średni wiek pacjentów w momencie rozpoznania wynosił 34,4 ± 10,0 lat (40,3 ± 12,6 u mężczyzn, 32,6 ± 8,3 u kobiet). Na podstawie badań obrazowych/badań radiologicznych guzów pacjentów podzielono na dwie grupy — z gruczolakami inwazyjnymi i gruczolakami nieinwazyjnymi. Wskaźnik Ki-67 oceniono w tych preparatch, gdzie było to możliwe.Wyniki: Średni wymiar gruczolaka (mierzony według najdłuższej osi) wyniósł 38,6 ± 21,6 mm u mężczyzn i 10,8 ± 9,4 mm u kobiet. Średnie stężenie prolaktyny w surowicy przed leczeniem wynosiło 1926 ± 6662 ng/ml w całej grupie badanej, 124,8 ± 63,4 w grupie guzów nienaciekających i 4675 ± 10049 ng/ml w przypadku guzów naciekających (p < 0,05). Stwierdzono istnienie dodatniej zależności pomiędzy stężeniem prolaktyny w surowicy i wymiarem guza. Odsetki pacjentów, u których wartość wskaźnika Ki-67 była duża (≥ 0,03) wyniosły odpowiednio 37,5% w grupie guzów nienaciekających i 47,8% w grupie guzów naciekających. W grupie nowotworów nienaciekających zmniejszenie wymiarów gruczolaka nastąpiło u 60,8% a zmniejszenie stężenia prolaktyny u 81,1% pacjentów, natomiast w grupie guzów naciekających odpowiednie wartości wyniosły 80,4% i 93,8% (p < 0,05).Wnioski: U mężczyzn stwierdzono istnienie wyraźnej zależności pomiędzy stężeniem prolaktyny w surowicy a charakterem naciekającym guza, czego nie wykazano u kobiet. Wskaźnik Ki-67 nie miał związku z charakterem wzrostu guza

Türkiye’de insülin-naiv tıp 2 diyabet hastalarında insülin glarjin ile intensif insülin titrasyonu: Lantit çalışması

WOS: 000362601700003Purpose: This open-label, single-arm, phase 4 study was designed to evaluate the efficacy of intensive insulin glargine titration in type 2 diabetes mellitus (T2DM) patients for 6 months to reach good glycaemic control. Material and Method: Two hundred-forty one insulin-naive T2DM patients were included. The primary efficacy variable was the glycaemic control (HbA1c level of <= 7%). The secondary variables were a fasting blood glucose (FBG) level of <100 mg/dL, the final dose of basal insulin, number of dose adjustments, time to dose titration in reaching target HbA1c level of <= 7%, weight gain and treatment satisfaction using the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Hypoglycemia, severe hypoglycemia and adverse events were also assessed. Results: The mean (+/-SD) HbA1c level of 8.8+/-0.6% at baseline decreased to 7.4+/-0.9% on day-90 (p<0.001) and to 7.3+/-0.9% on day-180 (p<0.001). The percentage of patients with HbA1c <=%7 was 36.9% on day-90 and 40% on day-180. The mean FBG of 186.3+/-52.5 mg/dL at baseline decreased to 111.5+/-36.6 mg/dL on day-90 (p<0.001) and to 114.1+/-34.8 mg/dL on day-180 (p<0.001). The mean insulin glargine dose on the last day of FBG measurement (day-89) was 32.7+/-15.5 IU and the mean number of titrations was 12.7+/-6.6. These values on day-179 were 36.8+/-19.4 IU and 5.8+/-5.7, respectively. The total DTSQ score (20.3+/-7.7) and scores for each item at baseline showed improvement on day-180 (p<0.001). The most frequently reported adverse reactions were hypoglycaemia (49.7%) and weight gain (9.5%). Serious hypoglycaemia cases reported during the first and the second 3-month periods were 11.2% and 13.3%, respectively. Discussion: In conclusion, the use of insulin glargine with intensive dose titration is effective and safe in T2DM patients.Amaç: Bu açık-etiketli, tek-kollu faz 4 çalışma, insulin glarjin ile tedavi edilen tip 2 diabetus mellitus (T2DM) hastalarında iyi glisemik kontrol için etkili dozlara ulaşmada yoğunlaştırılmış insülin titrasyonunu değerlendirmek amacıyla tasarlanmıştır. Gereç ve Yöntem: Önceden insülin kullanmamış 241 T2DM hastası çalışmaya alınmıştır. Birincil değerlendirme kriteri glisemik kontrol (HbA1c seviyesi ≤%7), ikincil kriterler ise açlık kan şekeri (AKŞ) <100 mg/dL, son bazal insülin dozu, doz ayarlama sayısı, hedef HbA1c seviyesine ulaşıldığı an doz titrasyonuna kadar geçen zaman, kilo alımı ve tedavi memnuniyetinin Diyabet Tedavi Memnuniyet Anketi (DTSQ) ile değerlendirilmesi olmuş, ayrıca hipoglisemi, ciddi hipoglisemi ve advers olaylar da değerlendirilmiştir. Bulgular: Başlangıçtaki ortalama ± SD HbA1c seviyesi %8,8±0,6, 90. günde %7,4±0,9 seviyesine (p<0,001), 180. günde ise %7,3±0,9 seviyesine (p<0,001) düşmüştür. HbA1c seviyesi ≤%7 olan hastaların oranı 90. günde %36,9 iken 180. günde %40 olmuştur. Ortalama AKŞ başlangıçta 186,3±52,5 mg/dL iken 90. günde 111,5±36,6 mg/dL’ye (p<0,001), 180. günde ise 114,1± 34,8 mg/dL’ye düşmüştür (p<0,001). Son AKŞ ölçümü sırasında (89. gün) ortalama insülin glarjin dozu 32,7±15,5 IU ve ortalama titrasyon sayısı ise 12,7±6,6 idi. Bu değerler 169. gün 36,8±19,4 IU ve 5,8±5,7 idi. Total DTSQ skoru (20,3±7,7) ve her bir madde için 180. günde başlangıç vizitine göre bir iyileşme izlendi (p<0,001). En sık bildirilen advers olay hipoglisemi (%49,7) ve kilo alımı (%9,5) idi. İlk ve ikinci 3 aylık dönemlerde bildirilen ciddi hipoglisemi olayları sırasıyla %11,2 ve %13,3 idi. Tartışma: Sonuç olarak yoğunlaştırılmış doz titrasyonu ile insülin glarjin kullanımı T2DM hastalarında etkili ve güvenli bir tedavi seçeneğidir

The Effect of Trandolapril on Insulin Resistance is Determined by the Degree of Baseline Resistance Level

Insulin resistance (IR) is the core problem in type 2 diabetes mellitus that may lead to cardiovascular morbidity and mortality. Hypertension commonly accompanies type 2 diabetes. Antihypertensive agents improving IR may reduce the risk of cardiovascular diseases. This study was conducted to assess the effect of trandolapril on IR, glucose and lipid metabolisms in hypertensive subjects with different degrees of IR and investigate the importance of IR level in angiotensin converting enzyme inhibitor response. The subjects were nondiabetic and type 2 diabetic hypertensive patients treated with trandolapril for 12 weeks. Blood pressures (BP) and metabolic parameters were measured in all patients at baseline and after 12 weeks of trandolapril treatment and compared. Trandolapril reduced BP similarly in nondiabetic and diabetic patients. Homeostasis model assessment insulin resistance (HOMA-IR), serum glucose and hemoglobin A1C (A1C) in diabetic patients were higher than nondiabetics. HOMA-IR (from 9.0 &#61617; 1.0 to 6.6 &#61617; 0.7, p4.67 responded better. In conclusion, trandolapril improved insulin sensitivity better in type 2 diabetic hypertensive patients with higher degree of IR compared with the ones with low grade IR, being independent of its hemodynamic action. [Med-Science 2014; 3(2.000): 1140-54

Infertile Women with Bilateral Obstructed Tubes: (A presentation of 7 cases)

OBJECTIVE: Selective salpingography (SS), and tubal cannulation (TC), are possible alternatives to IVF(ICSI)-ET treatment f or bilateral proximal tubal occlusion . We present a series of infertile patients who presented with bilateral tubal blockage in their hysterosalpingographies (HSG’s); and were treated with selective salpingography and tubal cannulation. STUDY DESIGN: Case presentation of 7 infertile patients with bilateral proximal tubal obstruction who were treated with SS and if required TC to provide tubal patency and followed-up for 3 years. RESULTS: In 6 of the 7 couples, at least one of the fallopian tubes was opened with SS-TC. At the end of 3 years’f ollow-up of these couples, 4 achieved pregnancy; 2 being spontaneously and 2 with conventional infertility treatment. 2 of these pregnant couples ( both conceiv ed spontaneously) had diminished ovarian reserves, as well. CONCLUSION: SS-TC is an important, effective and a rather neglected potential alternative to assisted reproductive technologies which demands to be studied in randomized controlled trials

Medicine Science 2014;3(2):1140-54 Trandolapril and insulin resistance Original Investigation The Effect of Trandolapril on Insulin Resistance is Determined by the Degree of Baseline Resistance Level Trandolapril and insulin resistance Original Investigat

Abstract Insulin resistance (IR) i

Effects of different greenhouse media and hormones on Propagation by Cutting of Weigela floribunda and Spiraea x vanhouttei

In the present study, the effects on rooting success of different greenhouse media (Greenhouse-1 media with air temperature at 20±2°C, rooting table temperature at 20±2°C and humidity at 70%±2, Greenhouse-2 media with air temperature at 20±2°C, rooting table temperature at 25±2°C and humidity at 70%±2) and different doses (1000 and 5000 ppm) of hormones (IBA and NAA) on propagation by cutting of Weigela floribunda (Sieb. and Zucc.) K. Koch and Spiraea x vanhouttei (Briot) Zabel which are widely used in landscape studies were investigated. First callus and root formation, root length (RL), the number of root (RN) and rooting percentage (RP) were determined in the scope of this study. For both species, the highest rooting success was determined as 100%. For Weigela floribunda, the highest rooting percentage was determined in Control, IBA 5000 ppm, NAA 1000 ppm and NAA 5000 ppm treatments in Greenhouse-1 media, and also in NAA 1000 ppm and NAA 5000 ppm treatments in Greenhouse-2 media. For Spiraea x vanhouttei, the highest rooting percentage was determined in Control and IBA 5000 ppm treatments in Greenhouse-1 media. In terms of root length and the number of roots, the highest results were obtained in Greenhouse-1 media for Weigela floribunda, in Greenhouse-2 media for Spiraea x vanhouttei. Also, the effects of greenhouse media and hormones on other measured characteristics were statistically evaluated