Zmiany stężeń hormonów tarczycy u pacjentów z rozpoznaniem śmierci mózgu mają związek z non-thyroidal illness syndrome

Introduction: Alterations in thyroid hormone levels occur in patients with acute neurological disease states. The aim of this study is to study changes in thyroid hormones in patients with brain death (BD). Material and methods: Eleven brain-dead patients were studied prospectively. Thyroid hormones were measured on admission to the intensive care unit, the day before BD diagnosis (BD before), and the day after BD diagnosis (BD day). Results: Thyroid stimulating hormone (TSH) and free triiodothyronine (fT3) concentrations were found to be significantly low on ad­mission, BD before, and BD day compared to age-matched healthy controls. TSH levels were shown to be increasing on BD day. Free thyroxine (fT4) levels were within normal limits in all cases except in one case having low fT4 levels with normal TSH levels. No statisti­cally significant changes were encountered between admission thyroid hormone levels and BD-before and BD-day thyroid hormone levels. Six patients were on steroid therapy when BD-before blood samples were drawn, and no difference in thyroid hormone levels was encountered between steroid users and non-users. Correlation analysis showed a positive correlation between GCS and TSH, but a negative association between fT3 and APACHE II. Conclusion: We have shown that patients with BD have altered thyroid hormones days before BD diagnosis, and these alterations con­tinue until the diagnosis of BD. The changes in thyroid hormones are compatible with non-thyroidal illness syndrome

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Correlation of perilipin 2 and lipid metabolism in elective cesarean section and vaginal delivery: a prospective study with oxidative and apoptotic pathways

Vaginal delivery (VD) and elective cesarean (CS) delivery modes may cause significant differences in maternal and fetal metabolism. In this study, we aimed to investigate changes in lipid metabolism, oxidative and apoptotic signaling pathways during VD and CS in maternal and cord blood and placenta tissue. The study included two groups of participants delivered via 90 CS and 90 VD. Maternal and cord blood samples were collected from the participants. In addition, placenta samples were also taken after delivery. Total oxidant (TOS), malondialdehyde (MDA), total antioxidant (TAS), glutathione (GSH), cleaved caspase 3 (CASP3) and perilipin 2 (PLIN2) levels were measured to determine oxidative stress, antioxidant levels and apoptosis status in the VD and CS groups. Besides, PLIN2 mRNA expressions in placental specimens were analyzed. We found no statistically significant difference in maternal age, body mass index, gestational age, birth weight and Apgar scores in both groups (P > 0.05). The increase in MDA, TOS, GSH and TAS levels was higher in the VD group compared to the CS group (P < 0.05). Similarly, PLIN2 levels and lipid profiles showed an increase in the VD group (P < 0.05 vs CS group). Likewise, PLIN2 expression enhanced in the VD group (P < 0.05 vs CS group). However, CASP3 activity reduced in maternal and cord blood in the VD group compared to the CS group. Our results support that the delivery mode may cause differences in lipid profile, oxidative and apoptotic status by affecting PLIN2 levels in both maternal and cord blood and placenta tissue.WOS:0006520852000042-s2.0-85106280968PubMed: 3400956

A NEW MARKER PERILIPINE COUNTERWORK WITH VITAMIN D THROUGH REGULATION LIPID METABOLISM IN OBESES

Introduction: Vitamin D deficiency and obesity are common controversial health problems. Vit D supports lipolysiv from the outside, stimulates lipogenesis. Perilipine protein, which allows the use of lipids in the mitochondria in cell. Our main aim of this research was to control obesity prognosis monitoring Perilipine levels related by WO treatments. Methods: During winter months, patients that have admitted the hospital whose ages ranged from 18 to 65 years at 80 obese and normal BMI individuals were included the study. Blood samples from patients were taken and measured for VitD level. Experimental groups arranged again according to BMI and VitD results. Results: The mean age of the patients was +/- 34(18-65). After organized samples, vitamin D deficiency group which 25-OH D levels were < 20 nglml, were 37.75 +/- 4.79 higher Perilipine levels than normal VItD individuals. However, Perilipine levels were increased in obese patients display positive correlation with BMI. Discussion: These results were indicated that high frequency of vitamin D deficiency drives obesity relatively especially in winter months. The research findings suggest that Perilipine expression has direct correlation by vitamin D alteration. For this purpose, Perilipine can be a novel marker to prevent obesity and should he controlled previously identified obesity groups treated new methods of VitD uptake.WOS:0005261216000152-s2.0-8508339293

Short- and long-term effects of rapamycin on ischemic damage and apoptotic changes in torsion of rat testes

Rapamycin has antioxidant defense mechanisms and immune suppressive effects. To detect the short- and long-term effects of rapamycin on ischemic damage and apoptotic changes in torsion of rat testes, mature male albino Wistar rats (n = 48) were included in the study as control, sham, early torsion-detorsion (T/D), early rapamycin treatment, early rapamycin control, late T/D, late rapamycin treatment, and late rapamycin control. The right testis was rotated 720 degrees in a clockwise direction during 4 h in operation groups. Rapamycin was administered orally three times: 30 min before detorsion and 24 and 48 h after detorsion. The animals were killed on the third day in early groups and on the tenth day in late groups after detorsion. Statistically significant differences among all groups were detected for SOD and TBARS, mean seminiferous tubule diameter (MSTD) and Cosentino's histologic score (CHS), caspase 3, bax, average number of apoptotic cells per tubule (ANPCT), and percentage of apoptotic tubule (PAT) values. ANPCT values were 10% lower in the rapamycin treatment groups compared with the untreated T/D groups, and the PAT values were also approximately 1.3 times lower. Although short-term usage of rapamycin may reduce to the tubular injury caused by I/R conversely to apoptosis in the testicular tissue after testicular torsion, rapamycin may have the potential to increase the long-term apoptosis with/without testicular torsion and a subsequent regression in fertility.DUBAP Project [2018.04.02.739]The study was funded by DUBAP Project Number: 2018.04.02.739.WOS:0005610132000012-s2.0-85089600269PubMed: 3281304

Serum Clara cell secretory protein (CC-16) in non-smoking patients with obstructive sleep apnea

Objective This study aimed to determine the association between the severity of obstructive sleep apnea (OSA) and serum Clara cell protein (CC16) levels in non-smoking patients with OSA. Methods This prospective study included non-smoking patients who presented with sleep-related disturbances and underwent polysomnography (PSG). The serum CC16 level was measured and its relationship to PSG parameters was investigated. Results The study included 128 patients (83 men) with a mean age of 48.4 +/- 11.9. OSA was detected in 66 men (70%) and 29 women (30%) (p = 0.051). The severity of OSA was mild in 32 (25%), moderate in 28 (22%), and severe in 35 (27%) of the patients. There was no significant difference in CC16 levels between the OSA group (1746 +/- 1006) and the OSA negative group (1721 +/- 1201,p = 0.91) levels. There was no significant difference between the CC16 levels of the each four groups. Mean serum CC16 levels were significantly lower in OSA negative men than OSA positive men (777 vs 1462,p = 0.005). No significant difference was observed in CC16 values according to OSA severity in women. Conclusion The serum CC16 level does not differ between non-smoking OSA patients and OSA negative patients.WOS:0005623130000012-s2.0-85081686113PubMed: 3214459