The Worth of Total Calcium Levels Adjusted By Various Formulae in the Di-agnosis of Hypocalcemia

Purpose: The aim was to evaluate the diagnostic accuracy of the corrected total calcium (cCa) calculated with different formulas in the diagnosis of hypocalcemia. Materials and Methods: Whole blood free calcium and serum total calcium levels of a total of 410 individuals were evaluated.cCa levels were calculated using the Modified Orrell, Orrell, Payne, Berry, and James methods. In each of the hypoalbuminemia and normoalbuminemia groups, the diagnostic performance parameters of measured total calcium and cCa in the diagnosis of hypocalcemia were calculated. Hypocalcemia was diagnosed by measuring free calcium levels. The difference between the groups was analyzed using the Mann-Whitney.U test.A Spearman correlation analysis was performed to determine the correlation between free calcium and total Ca levels. Results: In the diagnosis of hypocalcemia, the test with the highest sensitivity in the hypoalbuminemia group was the total calcium test, measured at a rate of 80.3%. The sensitivity was <60% in all cCa levels calculated with the five different formulas. Sensitivity rates were <40% for measured and all cCa concentrations in the normoalbuminemia group.In the hypoalbuminemia group, a low level of correlation was observed between free calcium and each calcium level calculated by the Modified Orrell, Payne, Orrell, Berry, and James method (p<0.001,r=0.240;0.258;0.230;0.247;0.193). Conclusion: The formulas used to calculate the cCa concentration need improvement. cCa did not replace free calcium,and cCa did not outperform the total calcium level in the diagnosis of hypocalcemia.We are of the opinion that it is not reliable to comment on the free calcium levels by cCa concentration

Do Avanafil and Zaprinast Change Some Selected Cytokine Levels In Ovariectomized Rat’s Liver?

Studies reported that phosphodiesterase-5 inhibitors (PDE-5Is) positively contributed to bone-mineral-density and thickness in rats with ovariectomy, which have the same condition with postmenapozal period. To explain the positive contribution mechanism on bone mineral density of PDE-5Is, we investigated the effect of zaprinast and avanafil on levels of some pro -or anti-resorptive cytokines in ovariectomized-rats. Albino female rats (8 months and 250-350 g) were used and four groups of equal-number were randomly assigned (n=6). Groups; was the sahm operated, positive control (OVX), Zaprinast and OVX, Avanafil and OVX groups, respectively. The levels of Estrogen, IL-1β, IL-6, IL-8, IL-10 and TNF-α were measured by ELISA kits, in liver of rats. IL-1β, IL-6, IL-8 and TNF-α levels were high in groups with OVX compared to sham group, while IL-10 levels were low. Also, IL-1β, IL-6, IL-8 and TNF-α levels were low in zaprinast and especially avanafil-treated groups with OVX and were similar to the sahm group values (p=0.001 for IL-1β, p=0.045 for IL-6, p=0.008 for IL-8, p=0.006 for IL-10, p=0.026 for TNF-α). Zaprinast and especially avanafil inhibited IL-1β, 8 and TNF-α and increased the IL-10 levels compared to the OVX group. This may support opinion that PDE-5Is enhance bone mineralization by inhibiting proresorptive cytokines

The Effect of Inhaler Aromatherapy on Pain and Anxiety in Patients undergoing Shock Wave Lithotripsy

Aim: The aim of this study was to determine the effects of inhaler aromatherapy on pain and anxiety during the shock wave lithotripsy (SWL) protocol. Material and Methods: This placebo-controlled prospective double-blind study included 120 patients who were scheduled to undergo SWL. Patients were randomly assigned a control placebo group 1 (n=40), the lavender group 2 (n=40), and the frankincense group 3 (n=40). The nebulizer (a rate of 2%) was prepared and operated on in the SWL room before the procedure. Data were collected using the visual analog scale (VAS) and the state-trait anxiety inventory (STAI-I). Results: Of the 120 patients included in the study, 67 (55.8%) were male and 53 (44.2%) were female. The mean age of the patients was 37.38±11.35 years. The mean stone size was 11.07±3.09 mm. There were no statistically significant difference between the groups in terms of VAS scores of the patients after the procedure (p=0.557). While there was no statistically significant change in the STAI-I score in group 1 and group 2 after the procedure compared to the pre-procedure, a statistically significant decrease was detected in group 3 (p=0.030). The percentages of patients with changing STAI-I scores were compared, it was observed that the decrease in STAI-I score in group 2 and group 3 at a higher rate compared to group 1 (p=0.018). Conclusion: Frankincense reduced anxiety more significantly than lavender. Both had no significant effect on pain. Inhaler aromatherapy can be used in the SWL process to reduce anxiety and improve treatment compliance

Effect of Varicocele and Its Treatment on Testosterone in Hypogonadal Men with Varicocele: Review of the Literature

Varicocele might cause deterioration in Leydig cell functions, and it is a significant risk factor for hypogonadism. Some controversial issues have been raised in the treatment of hypogonadal men with varicoceles. Symptomatic hypogonadal men with varicoceles have two options: testosterone replacement therapy or varicocele treatment. Both approaches have some advantages and disadvantages. This review summarizes the effect of varicoceles on total plasma testosterone level and addresses whether varicocele repair is effective to improve testosterone levels in hypogonadal men with varicoceles. Experience from large clinical studies in the literature suggests that varicocele repair may increase serum testosterone level in men with varicoceles and testosterone deficiency. Varicocele repair could be offered to men with clinically palpable varicocele and hypogonadism. As the treatment method, microsurgical varicocele repair could be preferred to provide the best improvement. Another advantage of varicocele repair for hypogonadism, instead of exogenoti, testosterone treatment, is its ability to preserve the fertility status in men who may desire a child in the future. However, further studies are required to clarify varicocel-related Leydig cell dysfunction and to advise hypogonadal patients about the sufficient effectiveness of varicocele repair

Systematic review of treatment methods for recurrent varicoceles to compare post-treatment sperm parameters, pregnancy and complication rates

We aimed to define which method would be the best for the treatment of recurrent varicoceles. We analysed 21 studies to compare post-treatment improvement in semen parameters, spontaneous pregnancy and complication rates between the treatment methods. Overall spontaneous pregnancy rate was significantly higher in the surgical methods (44.3%) than in the radiological interventions (17.9%; p = .007). Post-treatment improvement rates in sperm parameters were significantly higher in the open surgical methods (77.5%) than in the radiological interventions (62.5%; p = .032). Post-treatment recurrence rates were 3.8% in the open surgical methods, 17.6% in the laparoscopic surgery and 3.3% in the radiological interventions. However, technical failure rate was 11.8% in the radiologic interventions. To analyse open surgical methods, recurrence rate was 0.6% in the microsurgical methods and 19% in the macroscopic methods, revealing significant difference (p < .001). Post-treatment testicular atrophy rate was significantly higher in the laparoscopic surgery (2.9%) than in the open surgery (0.3%; p = .033). In conclusion, surgical methods have higher pregnancy rates and higher improvement rate in sperm parameters than radiological interventions for the treatment of recurrent varicocele. Microsurgical redo varicocelectomy has lower recurrence and testicular atrophy rates than macroscopic varicocelectomy series. Therefore, patients with recurrent varicoceles should be informed based on these findings

Histological and morphological development of the prepuce from birth to prepubertal age

Purpose: To study the histological changes of the preputial tissue from birth to prepubertal age in order to define unnoticed morphological changes. Materials and Methods: Prepuce samples were obtained from 79 healthy boys who underwent routine ritual circumcision. Specimens were divided into six groups according to the boys’ age: newborn, 0–1 year of age, 2–3 years of age, 4–5 years of age, 6–7 years of age, and 8–9 years of age. Histologic analysis of the specimens was performed by H&E, Masson’s trichrome, Verhoeff–Von Gieson, immunohistochemical staining. Results: Microscopic examinations showed that average epithelial thickness increased after the neonatal period (p=0.001). When collagen fiber density was evaluated, no significant differences between groups were found (p=0.083). When the elastic fibers in the dermis were evaluated, it was determined that the number and thickness of elastic fibers increased with age. Immunohistochemical examinations showed that the number of peripheral nerves marked with S100 was lower in the neonatal period than at other ages (p=0.048). When the vessels marked with CD105 antibody were counted, there was no significant difference between the groups (p=0.078). Conclusions: This is the first study to examine the age-related structure of connective tissue elements in the foreskin. Our results showed that the prepuce’s prepubertal maturation process is continuous, and the first 2 years of life are appropriate not only in relation to the physiological effects of age but also the optimum structural changes for wound healing, such as vessel diameter, epithelium thickness, peripheral nerve count

The spatial and temporal variability of limnological properties of a very large and deep reservoir

The reservoir of Keban Dam is a very deep and large water body of temperate zone exhibiting special characteristics with respect to its limnological properties. One of the major characteristics is the development and seasonal persistence of metalimnetic oxygen minima. This characteristic has been observed for three consecutive years. Spatial heterogeneity with respect to several parameters was another distinct property that has been clearly identified. The long term study has identified the existence of an order in the behavior. The modeling for strategy development seems to be a very useful tool to assess the major system variables to be controlled and to achieve comparative evaluation of possible management practices

Effects Of N-Acetyl Cysteine, Vitamin E And Vitamin C On Liver Glutathione Levels Following Amiodarone Treatment In Rats

Introduction Amiodarone, a pharmaceutical extensively used to suppress atrial and ventricular tachyarrhythmias, is also known to cause many side effects on many tissues. N-acetyl-cysteine (NAC), vitamin E and vitamin C are known as antioxidants for their ability to minimize oxidative stress. In the peer-reviewed literature, there is no study reporting on the protective effects of these antioxidant agents against its hepatotoxicity. Aim We investigated the oxidative effects of NAC, vitamins E and C on liver tissue after amiodarone treatment. Material and methods Rats were randomly assigned to: control; amiodarone group; amiodarone + NAC treated group; amiodarone + Vit. E group and amiodarone + Vit. C group. Liver tissues were isolated from animals and total glutathione levels were measured. Results In all time intervals, the level of glutathione increased. When all time intervals were compared, the amiodarone group revealed the lowest levels. The antioxidant co-administered group was studied; the glutathione levels were statistically significantly higher than the sole amiodarone group. When vitamins E, C or N-acetyl cysteine were examined, there was no statistically significant difference among them. Conclusions In this study we found that hepatotoxicity capacity of amiodarone may be reduced by taking up antioxidants. In addition, the effect documented here may be reproducible and may be applied to clinical settings.PubMedWoSScopu