Advanced oxidation protein products and malondialdehyde — the new biological markers of oxidative stress — are elevated in postmenopausal women

Objectives: The aim of the study was to measure advanced oxidation protein products (AOPPs) as markers for oxidative stress to evaluate cardiovascular risk in pre- and postmenopausal women and to compare the results with malondialde­hyde (MDA) levels. Material and methods: Twenty premenopausal women and 84 naturally postmenopausal patients were enrolled in the study. AOPP and MDA plasma levels were measured. The postmenopausal group was further subdivided into two groups: postmenopausal age of 40–49 and of 50–59 years. AOPP and MDA levels were compared between premenopausal, 40–49 and 50–59 year old menopausal women. Results: Plasma AOPP and MDA levels in postmenopausal women were increased when compared with their premeno­pausal peers (123.83 ± 55.51 μmol/L vs. 61.59 ± 16.42 μmol/L and 6.50 ± 1.05 μmol/L vs. 5.98 ± 0.77 μmol/L; respectively). Mean plasma AOPP levels in the two menopausal age groups were both significantly higher from the premenopausal group (118.64 ± 59.1 μmol/L vs. 61.59 ± 16.42 μmol/L and 132.31 ± 48.97 μmol/L vs. 61.59 ± 16.42 μmol/L; respectively). No significant difference was found in mean AOPP levels between postmenopausal subjects of 40–49 and 50–59 years age (118.64 ± 59.12 μmol/L vs. 132.31 ± 48.97 μmol/L). Mean plasma MDA levels of each of two postmenopausal age groups were both significantly higher from the premenopausal group (6.50 ± 1.04 μmol/L vs. 5.98 ± 0.77 μmol/L and 6.50 ± 1.10 μmol/L vs. 5.98 ± 0.77 μmol/L; respectively). However, no statistically significant difference between the two postmenopausal age groups (6.50 ± 1.04 μmol/L vs. 6.50 ± 1.10 μmol/L) was found. Conclusions: AOPP and MDA levels are elevated in postmenopausal women as compared to their premenopausal peers, suggesting they can be used as markers for cardiovascular risk in postmenopausal women

Oral Cavity Beta-Defensin Levels Are Regulated Differently during Radiotherapy in Head and Neck Cancer Patients

Background: Human beta-defensins (hBDs) are small cationic peptides of the epithelium with broad antimicrobial and immune response-regulatory activities. hBDs are also related to oncogenesis, and their secretion profiles are affected by radiotherapy treatment. The present study aimed to investigate the oral cavity hBD 1-3 levels in head and neck cancer patients and its relation to radiotherapy treatment. Methods: Sixteen head and neck cancer patients (all with a history of smoking) were included in this study. Periodontal parameters were measured before radiotherapy, and medical information was collected from registries. Oral rinses of the patients were collected before radiotherapy; on the 1st, 3rd, and 6th weeks of radiotherapy; and the 1st month following the end of radiotherapy. hBD 1–3 levels were measured using ELISA. Results: Oral hBD-1 levels increased during radiotherapy at week 6 (p = 0.019). hBD-1 levels returned to pretreatment levels after the end of radiotherapy. No significant change was detected for hBD-2 or hBD-3 levels during or after radiotherapy. Conclusions: The constant expression of hBD-1, which is distinct from the infection and inflammation-dependent expression profiles of hBD-2 and hBD-3, may explain why this peptide is the only one affected by radiotherapy

Oral Cavity Calprotectin and Lactoferrin Levels in Relation to Radiotherapy

Background: Lactoferrin, an iron-binding glycoprotein, and calprotectin, a calcium binding protein, are sensitive markers of inflammation and their fecal levels increase during radiotherapy of prostate cancer patients. With this background, we analyzed mouthrinse calprotectin and lactoferrin levels of head- and neck-cancer patients before, during and after radiotherapy. Methods: Twenty cancer patients (mean age 55.85 ± 15.01, 80% male), who had been planned to undergo radiotherapy to the head and neck area, were included in this study. Mouthrinse samples were collected before radiotherapy, at the 3rd and 6th weeks of radiotherapy and 4 weeks after the radiotherapy. Mouthrinse samples were analyzed for calprotectin and lactoferrin using commercial ELISA kits. Results: Calprotectin levels increased significantly during radiotherapy (p = 0.022). Both markers, lactoferrin (p = 0.011) and calprotectin (p = 0.006), decreased significantly after the treatment. Conclusions: Present study results may suggest that the elevations in calprotectin and lactoferrin levels during radiotherapy reflect the increased and emerging inflammatory environment in the oral cavity, thus may increase the risk of periodontal disease initiation or progression

Oral Cavity Calprotectin and Lactoferrin Levels in Relation to Radiotherapy

Background: Lactoferrin, an iron-binding glycoprotein, and calprotectin, a calcium binding protein, are sensitive markers of inflammation and their fecal levels increase during radiotherapy of prostate cancer patients. With this background, we analyzed mouthrinse calprotectin and lactoferrin levels of head- and neck-cancer patients before, during and after radiotherapy. Methods: Twenty cancer patients (mean age 55.85 ± 15.01, 80% male), who had been planned to undergo radiotherapy to the head and neck area, were included in this study. Mouthrinse samples were collected before radiotherapy, at the 3rd and 6th weeks of radiotherapy and 4 weeks after the radiotherapy. Mouthrinse samples were analyzed for calprotectin and lactoferrin using commercial ELISA kits. Results: Calprotectin levels increased significantly during radiotherapy (p = 0.022). Both markers, lactoferrin (p = 0.011) and calprotectin (p = 0.006), decreased significantly after the treatment. Conclusions: Present study results may suggest that the elevations in calprotectin and lactoferrin levels during radiotherapy reflect the increased and emerging inflammatory environment in the oral cavity, thus may increase the risk of periodontal disease initiation or progression

İleri yaşta dehidroepiandrosteron ile spontan gebelik: üç olgu sunumu ve literatür derlemesi

It has been reported recently that dehydroepiandrosterone (DHEA) supplementation in older patients with low ovarian reserve increases the response to infertility treatment. Three women of age >3S years with low ovarian reserve parameters including high FSH, low AFC have been treated with DHEA for various time intervals are reported here. They conceived spontaneously after a few months of treatment which resulted in healthy newborns. Although there are not many randomized controlled trials about the value of DHEA treatment in infertile patient population, previous case reports support that DHEA increases spontaneous pregnancy rates. Considering healthy livebirths of the relatively older age of the mentioned cases, DHEA might be improving also oocyte quality as an additional impact.Son yıllarda dehidroepiandrosteronun düşük over rezervli hasta grubunda infertilite tedavisine yanıtı arttırdığı saptanmıştır. Bu olgu serisinde, 35 yaşından büyük ve kötü over rezervi, yüksek 3. gün FSH’sı ve düşük antral folikül sayısı ile kanıtlanmış üç hastada kısa süreli dehidroepiandrosteron kullanımı ile spontan gelişen ve sağlıklı biçimde terme ulaşan gebelik olguları ve bu konudaki güncel literatür bilgileri gözden geçirilmektedir. Dehidroepiandrosteron ile yapılan çok geniş randomize çalışmalar bulunmasa da literatürdeki olgu sunumları ve burada sunulan vakalar, bu androjenin düşük over rezervli hastalarda spontan gebelik şansını arttırdığını kanıtlamaktadır. Gebeliklerin ileri anne yaşına rağmen sağlıklı canlı doğum ile sonuçlanmaları da oosit kalitesini iyileştirdiği fikrini desteklemektedir

Oral Cavity Calprotectin and Lactoferrin Levels in Relation to Radiotherapy

Background: Lactoferrin, an iron-binding glycoprotein, and calprotectin, a calcium binding protein, are sensitive markers of inflammation and their fecal levels increase during radiotherapy of prostate cancer patients. With this background, we analyzed mouthrinse calprotectin and lactoferrin levels of head- and neck-cancer patients before, during and after radiotherapy.Methods: Twenty cancer patients (mean age 55.85 ± 15.01, 80% male), who had been planned to undergo radiotherapy to the head and neck area, were included in this study. Mouthrinse samples were collected before radiotherapy, at the 3rd and 6th weeks of radiotherapy and 4 weeks after the radiotherapy. Mouthrinse samples were analyzed for calprotectin and lactoferrin using commercial ELISA kits.Results: Calprotectin levels increased significantly during radiotherapy (p = 0.022). Both markers, lactoferrin (p = 0.011) and calprotectin (p = 0.006), decreased significantly after the treatment.Conclusions: Present study results may suggest that the elevations in calprotectin and lactoferrin levels during radiotherapy reflect the increased and emerging inflammatory environment in the oral cavity, thus may increase the risk of periodontal disease initiation or progression.</p

Growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula in infants with cow’s milk protein allergy

ObjectiveTo evaluate growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula (eHCF) in infants with cow’s milk protein allergy (CMPA).MethodsA total of 226 infants (mean ± SD age: 106.5 ± 39.5 days, 52.7% were girls) with CMPA who received eHCF comprising at least half of the daily dietary intake were included. Data on anthropometrics [weight for age (WFA), length for age (LFA) and weight for length (WFL) z-scores] were recorded at baseline (visit 1), while data on infant feeding and stool records, anthropometrics and Infant Feeding and Stool Patterns and Formula Satisfaction Questionnaires were recorded at visit 2 (on Days 15 ± 5) and visit 3 (on Days 30 ± 5).ResultsFrom baseline to visit 2 and visit 3, WFA z-scores (from −0.60 ± 1.13 to −0.54 ± 1.09 at visit 2, and to −0.44 ± 1.05 at visit 3, p &lt; 0.001) and WFL z-scores (from −0.80 ± 1.30 to −0.71 ± 1.22 at visit 2, and to −0.64 ± 1.13 at visit 3, p = 0.002) were significantly increased. At least half of infants never experienced irritability or feeding refusal (55.7%) and spit-up after feeding (50.2%). The majority of mothers were satisfied with the study formula (93.2%), and wished to continue using it (92.2%).ConclusionsIn conclusion, eHCF was well-accepted and tolerated by an intended use population of infants  ≤ 6 months of age with CMPA and enabled adequate volume consumption and improved growth indices within 30 days of utilization alongside a favorable gastrointestinal tolerance and a high level of parental satisfaction

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

KÖTÜ OBSTETRİK ÖYKÜSÜ VE TROMBOFİLİSİ OLAN GEBELERDE ANTİKOAGULAN TEDAVİNİN GEBELİK SONUÇLARI ÜZERİNE ETKİSİ

Plasenta aracılı gebelik komplikasyonları önemli mortalite ve morbidite nedenlerinin başında gelmektedir. Preeklampsi, ablasyo plasenta, intrauterin gelişme geriliği, intrauterin fetal ölüm ve tekrarlayan gebelik kaybı plasenta aracılı gebelik komplikasyonlarıdır. Trombofililer plasenta ilişkili gebelik komplikasyonları ile ilişkilidir. Bu çalışmada amaç kötü obstetrik öyküsü ve trombofilisi olan hastalarda antikoagulan tedavinin gebelik sonuçları üzerine etkisini araştırmaktır. Bu çalışmada 2006-2009 yılları arasında Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı&#8217;na başvuran; obstetrik kayıtlarında preeklampsi, İUGG, İUFÖ, ablasyo plasenta, tekrarlayan gebelik kaybı tanılarından en az biri olan hastaların dosyaları incelendi. Bu hastalardan en az bir kalıtsal trombofilik mutasyon taşıyan 204&#8217;ü çalışmaya dahil edildi. Hastalar son gebeliklerinde antikoagulan tedavi alıp almama durumuna göre gruplandı. Tedavi grubu aspirin (80 mg/gün), düşük molekül ağırlıklı heparin (4000 IU/gün) ve düşük molekül ağırlıklı heparin + aspirin alanlar olarak alt gruplara ayrıldı. Bu gruplar son gebelikteki doğum haftaları, doğum ağırlıkları, Apgar skorları; canlı doğum, ölü doğum, neonatal ölüm, abortus oranları; obstetrik komplikasyonlar, doğum şekli ve yenidoğan takip oranları açısından karşılaştırıldı. Trombofili 96 çeşitlerine göre de hastalar gruplanarak her bir grup için tedavi alıp almamanın ve tedavi çeşidinin gebelik sonuçları üzerine etkisi araştırıldı. Obstetrik komplikasyonlar içinde de TGK olan grup ayrı olarak incelenerek antikoagulan tedavinin ve tedavi çeşitlerinin gebelik sonuçları üzerine etkisi araştırıldı. Tedavi alan ve almayan gruplar obstetrik komplikasyonlar açısından karşılaştırıldığında tedavi alan grupta %81,9 oranında, tedavisiz grupta ise %50 oranında herhangibir komplikasyon izlenmedi (p<0,001). Tedavi alan ve almayan grup canlı doğum, ölü doğum, neonatal ölüm ve abortus oranları açısından karşılaştırıldığında tedavi alan grupta canlı doğum oranı %91 iken tedavisiz grupta %60 oranında; abortus oranı ise tedavisiz grupta % 40, tedavili grupta ise %6,3 oranında bulundu(p<0,001). Tedavi alan gruptaki doğum haftası, 1. ve 5.dakika Apgar skorları tedavi almayan gruba göre istatistiksel anlamlı olarak daha fazla bulundu. Tedavi alt grupları arasında bu parametreler açısından anlamlı fark bulunamadı. Ancak tedavi almayan grupla aspirin alan grup arasında fark olmaması tedavi alan gruptaki etki farkını DMAH&#8217;ın yarattığını düşündürdü. Kötü obstetrik öyküsü ve trombofilisi olan gebelerde antikoagulan tedavi ile güvenilir ve etkili olarak daha iyi gebelik sonuçları elde edilmektedir. Ancak özellikle DMAH için potansiyel riskler ve maliyet düşünüldüğünde rutin kullanıma geçmeden önce yarar-zarar ilişkisini gösteren randomize kontrollü, metodolojik olarak iyi düzenlenmiş çalışmalara gerek vardır.Placenta related complications are leading causes of mortality and morbidity in pregnancy. Preeclampsia, placental abruption, intrauterine growth restriction, recurrent pregnancy losses and intrauterine fetal death are some of these placenta related obstetric complications and thrombophilias are associated with these complications. The aim of this study is to investigate effects of anticoagulant therapy on pregnancy outcomes in patients with thrombophilia and previous poor obstetric outcomes. Medical records of patient who were seen in the Department of Obstetrics and Gynecology at Gazi University Medical Faculty between 2006 and 2009 with at least one of the following diagnoses on their obstetric records were screened: preeclampsia, IUGR, IUFD, placental abruption, and recurrent pregnancy losses. Among these, 204 of them who were carrying at least one hereditary thrombophilia mutation were included in this study. Patients were divided in two groups depending on history of whether or not anticoagulation therapy is used in their last pregnancies. Treatment group was also subdivided in aspirin (80mg/ day), low molecular weight heparin (4000IU/ day) and LMWH + aspirin groups. These groups were compared in gestational age, birthweight, Apgar scores, live birth rate, stillbirth rate, neonatal demise, abortus rates, obstetric complications, mode of delivery and admission rates to the neonatal intensive care unit. Treatment and treatment subgroups&#8217; effects on pregnancy outcomes were investigated in each group of patients with different thrombophilia type. Also in obstetric complications, recurrent pregnancy loss group was studied seperately and effects of anticoagulation treatment and treatment subgroups on pregnancy outcomes were investigated. When treated and untreated groups compared for obstetric complications, no complications were observed in 81.9% in treated group and 50% in untreated group (p<0.001). When treated and untreated groups were compared in live birth rate, stilbirth, neonatal demise and abortus rates, live birth rate was 91% in treated group, 60% in untreated group; abortus rate was 40% in untreated group, 6.3% in treated group (p<0.001). Gestational age, first and 5th minute Apgar scores were significantly higher in treated group when compared to untreated group. No significant differences could be observed among different treatment subgroups in terms of these parameters. However, observed effects in treatment group may be due to LMWH, since no difference were observed between aspirin-takers group and untreated group. For pregnant women with thrombophilia and previous poor obstetric outcomes anticoagulant therapy provides safe and effective obstetric outcomes. However, when potential risks and costs considered, especially for LMWH, there is a need for well designed randomized controlled trials demonstrating risk-benefit profiles before their routine use in practice

OKUL YÖNETİCİLERİNİN LİDERLİK STİLLERİYLE ÖĞRETMENLERİN TÜKENMİŞLİK DÜZEYLERİ ARASINDAKİ İLİŞKİ (ANKARA İLİ ÖRNEĞİ)

Bu araştırmanın amacı, ilköğretim okullarında görev yapan okul yöneticilerinin liderlik stilleri ile öğretmenlerin mesleki tükenmişlik düzeyleri arasındaki ilişkiyi saptamaktır. Araştırma, ilişkisel tarama modelindedir. Araştırmanın örneklemini, Ankara ili Büyükşehir Belediyesi sınırları içerisinde bulunan 8 merkez ilçede, 2008-2009 öğretim yılında eğitim ve öğretim yapan öğretmenler arasından rastlantısal olarak seçilen 300 ilköğretim okulu öğretmeni oluşturmaktadır. Araştırma bulgularına göre öğretmenlerin yaşadıkları en fazla tükenmişlik alt boyutu duygusal tükenme, en az kişisel başarıalt boyutu olup; okul yöneticileri okullarında idealleştirilmiş etki (atfedilen), idealleştirilmiş etki (kazanılmış), telkinle güdüleme, entelektüel uyarım, bireysel destek ve koşullu ödül liderlik stillerini uyguladıkça, öğretmenlere yönelik tükenmişlik görülme sıklığında azalma meydana geldiği, laissez-faire liderlik davranışları sergileyen okul yöneticilerinin görev yaptıkları okullarda, öğretmenlerin daha fazla tükenmişlik yaşadıkları; dönüşümsel liderliğin alt boyutlarından idealleştirilmiş etki (davr.) ve entelektüel uyarımın, duygusal tükenmenin, anlamlı bir yordayıcısı olduğu; dönüşümsel liderliğin alt boyutlarından telkinle güdüleme, entelektüel uyarım, idealleştirilmiş etki (davr.) ve idealleştirilmiş etki (atf.) duyarsızlaşmanın anlamlı bir yordayıcısı olduğu; bireysel desteğin önemli bir etkiye sahip olmadığı; dönüşümsel liderliğin alt boyutlarından idealleştirilmiş etki (davr.) ve entelektüel uyarımın kişisel başarının anlamlı bir yordayıcısı olduğu; işlemsel liderliğin alt boyutlarından koşullu ödül duygusal tükenmenin anlamlı bir yordayıcısı olduğu; işlemsel liderliğin alt boyutlarından koşullu ödül, istisnalarla yönetim (aktif) ve laissez-faire duyarsızlaşmanın anlamlı bir yordayıcısı olduğu; işlemsel liderliğin alt boyutlarından koşullu ödül, istisnalarla yönetim (aktif) ve laissez-faire duyarsızlaşmanın anlamlı bir yordayıcısı olduğu, diğer değişkenlerin önemli bir etkiye sahip olmadığı sonuçlarına ulaşılmıştır.The aim of this research is to find out the relationship between the leadership stylies of the directors who work at primary schools as managers and teachers\' occupational exhaustion levels. The research principlely is based on reciprocal relationship model. 300 teachers as the samples of the research were coincidentally selecteted among the primary school teachers who worked in the eight main administrative districts within the the border of Ankara Municipality during the 2008-2009 educational period. According to the results of the reseach \"emotional exhaustion\" is the most commonly seen exhaustion as the lowest dimention, the least one is personal accomplishment; when the school managers apply the idealized effect (attributed), idealized effect (acquired), inspirarion with suggestion, intellectual warning, individual support, and conditional prize leadership stlies, there is a decrease in the frequency of teachers' exhaustion. In the schools where the school directors apply laissez-faire leadership behaviours, the teachers are facing with more exhaustion; the idealized effect (behaviour) in the lowest dimention of transformative leadership and intellectual warning, emotional exhaustion, a meaningful support; inspiration with suggestion in the lowest dimention of the transformative leadership, intellectual warning, idealized effect (behaviour) and idealized effect (atributed), a meaningful support of being ignorent; individual support does not have a significant impact; both the idealized effect (behaviour) and intellectual warning in the lowest dimentions of the transformative leadership have important suppoprt in the personal success; in the lowest dimentions of the oprerative leadership conditional prize supports emotional exhaustion; in the lowest dimentions of the operative leadership, conditional prize with exceptional managing (active) and laissez-faire is a meaningful support of being ignorent; the other variations do not have an important impact