Effects of COVID-19 pandemic lockdown on the metabolic control of type 2 diabetes mellitus in patients

ABSTRACT Objective: The effects of the COVID-19 pandemic on the control of diabetes mellitus in patients are largely unknown. In this study we aimed to analyze the impact of the pandemic and the ensuing lockdown on the management of type 2 diabetes mellitus. Subjects and methods: A total of 7,321patients with type 2 diabetes mellitus (4,501 from the pre-pandemic period, 2,820 from the post-pandemic period) were studied retrospectively. Results: The admission of patients with diabetes melitus (DM) decreased significantly during the pandemic (4,501 pre-pandemic vs. 2,820 post-pandemic; p < 0.001). The mean age of patients was statistically lower (51.5 ± 14.0 vs. 49.7 ± 14.5 years; p < 0.001), and the mean glycated hemoglobin (A1c) level was significantly higher (7.9% ± 2.4% vs. 7.3% ± 1.7%; p < 0.001) in the post-pandemic period than in the pre-pandemic. The female/male ratio was similar in both periods (59.9%/40.1% for pre-pandemic, 58.6%/41.4% for post-pandemic; p = 0.304). As calculated by month the pre-pandemic rate of women was higher only in January (53.1% vs. 60.6%, p = 0.02). Mean A1c levels were higher in the postpandemic period than in the same month of the previous year, excluding July and October (p = 0.001 for November, p < 0.001 for others). Postpandemic patients admitted to the outpatient clinic were significantly younger than prepandemic visits for July (p = 0.001), August (p < 0.001) and December (p < 0.001). Conclusion: The lockdown had detrimental effects on blood sugar management in patients with DM. Hence, diet and exercise programs should be adapted to home conditions, and social and psychological support should be provided to patients with DM

Evaluation of oxidative stress in degenerative rotator cuff tears

Background: Oxidative stress occurs as a result of the disruption of the balance between the formations of reactive oxygen species and antioxidant defense mechanisms during the conversion of nutrients into energy. Increased body oxidative stress has been reported to be involved in the etiology of several degenerative and chronic diseases. We hypothesized that the body oxidative stress level is higher in patients with atraumatic degenerative rotator cuff tear than that in healthy individuals. Methods: The patients who underwent arthroscopic repair for atraumatic, degenerative rotator cuff tear were prospectively evaluated. A total of 30 patients (group 1, 19 females and 11 males; mean age: 57.33 ± 6.96 years; range: 50-77 years) and 30 healthy individuals (group 2, 18 females and 12 males; mean age: 56.77 ± 6 years; range: 51-72 years) were included in the study. The Constant and American Shoulder and Elbow Surgeons scoring systems were used to evaluate the clinical outcomes. Serum oxidative stress parameters of the patients and the control group were biochemically evaluated. Accordingly, thiol/disulfide (DS) balance (DS/native thiol [NT], DS/total thiol [TT]), Total Oxidant Status (TOS), oxidative stress index, and nuclear factor erythroid-2–associated factor-2 values were used as the biochemical parameters indicating an increase in the serum oxidative stress level. Total antioxidant status and NT/TT values served as the biochemical parameters indicating a decrease in the serum oxidative stress level. Results: The study follow-up duration was 12 months. A statistically significant increase was observed in American Shoulder and Elbow Surgeons and Constant scores of patients who underwent arthroscopic rotator cuff repair relative to that during the preoperative period (P = .01). The values of biochemical parameters (DS/NT, DS/TT, TOS, oxidative stress index, and nuclear factor erythroid-2–associated factor-2), which indicated an increase in the serum oxidative stress, were significantly higher in preoperative patients than those in postoperative patients, albeit the control group values were significantly lower than those of the postoperative patients. The biochemical parameters (NT/TT and total antioxidant status) indicating a decrease in the serum oxidative stress levels were significantly higher in the postoperative patients than those in the preoperative patients and significantly lower than those in the control group. Conclusion: High levels of markers indicating an increase in the serum oxidative stress in patients with degenerative rotator cuff rupture suggested that TOS may be involved in the etiopathogenesis of rotator cuff degeneration. Although the oxidative load decreases during the postoperative period, the fact that it is still higher than that in healthy individuals supports this claim. © 2022 Journal of Shoulder and Elbow Surgery Board of Trustee

In vitro investigation of the effect of anti-inflammatory and analgesic drugs on measurement of tumor markers

Background: It has been shown that some drugs used as parenteral affect biochemical measurements. Anti-inflammatory and analgesic drugs may also have the potential to affect measurement methods. Objective: The aim of the study was to investigate the effects of seven different anti-inflammatory and analgesic pharmacological agents commonly used in wards and intensive care units on thy-roglobulin, CA125, CA15-3, CA19-9, CEA, PSA and total HCG tests measured by immunoassay technique. Methods: The study was performed using hormone control material (BioRad Lyphocheck Immunoassay Plus Control) in the PETINIA immunoassay method (Siemens, Atellica, USA). 20 µL of tenoxicam, dexamethasone, methylprednisolone, paracetamol, diclofenac sodium, dexketoprofen, and metamizole sodium were added into 180 µL of the control solution, respectively. After vortex-ing the sample, it was incubated for 20 minutes at room temperature. Thyroglobulin, CA125, CA15-3, CA19-9, CEA, total PSA and total HCG tests were studied from the control sample. The study was re-performed by adding 20 µL of distilled water. The measurements were repeated 3 times, and the mean values were recorded. Percentage deviation rates from the target value were calculated. Results: Metamizole sodium led to negative interference in the CA 19-9, total HCG, CA 125, CEA, total PSA and CA15-3 at a rate of-42.1%,-24.62%,-24.34%,-23.66%,-14.33%, and-13.91%, respectively. With the administration of metamizole sodium, the only positive interference was determined at a rate of 6.02% in thyroglobulin. Paracetamol-induced maximum deviation was calculated at the rate of-26.41% in CA 19-9. CA 19-9 deviated-12.22% from diclofenac sodium and-22.41% from dexketoprofen. With methylprednisolone administration, positive interference was detected at a rate of 14.46% in thyroglobulin and negative interference at a rate of-12% in total PSA. The highest deviation due to dexketoprofen was seen in CA 19-9 at a rate of-22.41%. Conclusion: This study demonstrated the potential of anti-inflammatory, analgesic, and antipyretic agents to affect tumor marker measurements. Especially in the follow-up of cancer patients, anti-inflammatory interference may increase the likelihood of malpractice by causing erroneous clinical evaluations. © 2022 Bentham Science Publishers

Klinik laboratuvarda gereksiz testleri önleme yöntemi

Amaç: Sağlık hizmetlerinin ücretsiz olduğu ülkelerde laboratuvar test maliyetleri artmaktadır. Test sıralarını engellemeden gereksiz testleri önlemek için yeni yazılım yöntemleri önemli tasarruflar sağlayabilir. Bu çalışmanın amacı, akıllı laboratuvar yazılımlarında tanımlanan algoritmalar ile 2 yıl boyunca engellenen gereksiz test miktarlarının tespit edilmesidir. Materyal ve Metod: Algin IQ (Abbott, USA) yazılımı, klinisyenlerin sipariş vermesini engellemeden gereksiz testleri tespit eden ve iptal eden algoritmalar tanımlamıştır. Ocak 2018'den Ocak 2020'ye kadar istenen beş farklı laboratuvar testinin (direkt bilirubin, klor, AST, serbest PSA ve serbest T3) engellenen miktarları hesaplandı. Ocak 2016 ile Ocak 2018 arasında çalışılan aynı testlerin yazılımsız çalışılan oransal miktarları ile karşılaştırılmıştır. Bulgular: Algoritmalar 261540 AST, 174096 direkt bilirubin, 135373 klor, 27486 serbest T3, 1160 serbest PSA'yı engelledi. 2 yılda toplam 599656 test daha az tüketildi. Sonuç: Bu çalışmada tanımlanan algoritmalar, gereksiz testleri başarıyla engellemiştir. Herhangi bir klinik laboratuvar bu basit algoritmaları kullanabilir ve diğer testler için uyarlayabilir. Klinik laboratuvarlarda akıllı laboratuvar yazılımları kullanılarak milyonlarca dolar tasarruf edilebilir

Amino acid metabolism disorders and PAH gene mutations in Southeastern Anatolia Region

Objectives: Inborn errors of metabolism are generally autosomal recessive inherited disorders. The incidence and genetic features of neonatal metabolic disorders vary significantly by regions and populations. In this study, we aimed to determine the amino acid metabolism disorders and evaluate the genetic test results of these patients retrospectively

The Effect of Dexpanthenol Treatment on Renal Parenchymal Injury in Rats with Induced Renovascular Occlusion

&lt;p&gt;&lt;strong&gt;Abstract&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Kidney damage due to ischemia-reperfusion injury (IRI) is a serious cause of morbidity and mortality. We induced an experimental kidney ischemia-reperfusion model in rats where intraperitoneal dexpanthenol were given and compared to controls in terms of oxidative stress, tubular damage, apoptosis, and its effect on renal inflammation.&nbsp;Twelve-week-old male albino Wistar rats were used for creating the experimental model and the study sample were divided into three groups (n=16); control group (intraperitoneal 2cc/kg saline was injected), IRI group and IRI+dexpanthenol group via intraperitoneal injection. Blood samples were obtained from rats 24 hours after perfusion and their left kidneys were removed. In order to determine the percentage of apoptotic cells, a total of 100 cells were counted in each region and the number of cells with caspase-3 positivity was recorded for each region. Mortality was lower, although not statistically significant in the IRI+dexpanthenol group (n=3; 18.8%) compared to the IRI group (n=6; 37.5%) (p=0.216). In addition, kidney parenchyma and tubular damages were significantly lower in the dexpanthenol group compared to the IRI group (p&lt;0.05). Dexpanthenol significantly decreased oxidative stress and inflammation. Caspase-3 positive stained cell numbers were lower in the dexpanthenol group and also apoptosis rates were significantly lower (p&lt;0.05). Dexpanthenol treatment in kidney ischemia-reperfusion models showed significant recovery in kidney tubular cell and parenchyma damages, apoptosis, oxidative stress, and inflammation. These results show us that dexpanthenol treatment can be a promising alternative in improving the prognosis of adults with kidney IRI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Özet&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;İskemi-reperfüzyon injürisine (IRI) bağlı böbrek hasarı ciddi bir morbidite ve mortalite nedenidir. İntraperitoneal dekspantenol verilen ratlarda deneysel bir böbrek iskemi-reperfüzyon modeli oluşturduk ve oksidatif stres, tübüler hasar, apoptoz ve renal inflamasyon üzerindeki etkisi açısından kontrollerle karşılaştırdık. Deneysel modelin oluşturulmasında 12 haftalık erkek albino Wistar ratlar kullanıldı ve çalışma örneklemi 3 gruba ayrıldı (n=16); kontrol grubu (intraperitoneal 2cc/kg salin enjekte edildi), IRI grubu ve intraperitoneal enjeksiyon uygulaması ile oluşturulan IRI+dekspantenol grubu. Perfüzyondan 24 saat sonra ratlardan kan örnekleri toplandı ve sol böbrekleri alındı. Apoptotik hücre yüzdesini belirlemek için her bölgede toplam 100 hücre sayıldı ve her bölge için kaspaz-3 pozitifliği olan hücre sayısı kaydedildi. Mortalite IRI+dekspantenol grubunda (n=3; 18.8), IRI grubuna (n=6; %37.5) göre istatistiksel olarak anlamlı düzeyde olmamakla beraber daha düşüktü&nbsp;(p=0.216). Ayrıca böbrek parankimi ve tübüler hasarlar dekspantenol grubunda IRI grubuna göre anlamlı olarak daha düşüktü (p&lt;0.05). Dekspantenol, oksidatif stresi ve enflamasyonu önemli ölçüde azaltmıştı. Dekspantenol grubunda kaspaz-3 pozitif boyanan hücre sayıları ve apoptoz oranları anlamlı olarak düşüktü (p&lt;0.05).&nbsp;Böbrek iskemi-reperfüzyon modellerinde dekspantenol tedavisi, böbrek tübüler hücre ve parankim hasarlarında, apoptozda, oksidatif streste ve inflamasyonda önemli iyileşme gösterdi. Bu sonuçlar bize dekspantenol tedavisinin böbrek IRI'si olan yetişkinlerin prognozunu iyileştirmede umut verici bir alternatif olabileceğini göstermektedir.&lt;/p&gt;Dekspantenol Tedavisinin Renovasküler Oklüzyon Oluşturulan Ratlarda Renal Parankim Hasarına Etkis

Association between the No-Reflow Phenomenon and Soluble CD40 Ligand Level in Patients with Acute ST-Segment Elevation Myocardial Infarction

Background and objectives: No-reflow (NR) phenomenon is defined as insu ffi cient myocardial perfusion in coronary circulation in the absence of angiographic evidence of mechanical obstruction. The primary mechanisms of the NR occurrence are thought to be high platelet activity and thrombus burden. Soluble CD40 ligand (sCD40L), which is released into the plasma following platelet activation, accelerates the inflammatory process and causes further platelet activation. The aim of our study is to investigate the relationship between the NR phenomenon and sCD40L level in patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 81 acute STEMI patients undergoing primary percutaneous coronary intervention and 40 healthy participants were included in this study. Acute STEMI patients were classified into two groups: 41 patients with the NR phenomenon (NR group) and 40 patients without the NR phenomenon (non-NR group). The serum sCD40L level was measured for all groups. Results: The serum sCD40L level was significantly higher in the NR group than in non-NR and control groups (379 +/- 20 pg / mL, 200 +/- 15 pg / mL and 108 +/- 6.53 pg / mL, respectively; p < 0.001). Univariate regression analysis demonstrated that male sex, age, Gensini score and sCD40L level were the possible factors a ff ecting the occurrence of the NR phenomenon. In multivariate regression analysis, age (odds ratio [OR], 1.091; 95% confidence interval [CI], 1.023-1.163; p < 0.008) and serum sCD40L (OR, 1.016; 95% CI, 1.008-1.024; p < 0.001) remained the independent predictor of the presence of NR. Conclusions: Our study showed that serum sCD40L level was an independent predictor of the NR phenomenon occurrence