Effects of Alendronate and Raloxifene on Bone Density and Bone Turnover Markers in Postmenopausal Women

OBJECTIVE: The aim of this study was to compare the effects of once weekly alendronate sodium (ALN) and daily raloxifene hydrochloride (RLX) treatment on bone mineral density (BMD) and bone turnover markers in postmenopausal osteoporotic women. STUDY DESIGN: We included 343 postmenopausal women with osteoporosis (femoral neck BMD Tscore, less than -2.5), but 286 (83.4%) completed the study. Women (aged ≤75 yr; ≥2 yr since their last menstrual period) randomly classified into three groups. Group 1 (n=96) received ALN (70mg/week) and group 2 (n=95) received RLX (60 mg/day) and group 3 (n=95) received placebo. The efficacy of treatment was evaluated by BMD measurements at spine and hip, as well as by the measurement of bone turnover markers such as bone specific alkaline phosphatase (BSAP) and urine dehydroxyproline (DOHP) at baseline, 6th and 12th months. RESULTS: The evaluation of the changes in BMD and bone markers at 12 months were different between the placebo and each of the active treatment groups (P<0.05). The increase in BMD at 1 yr in ALN group was significantly greater than RLX group. The 4.5% increase in lumbar spine BMD with ALN was different from the 2% increase in RLX group (P<0.001). The 2.6 % increase in femoral neck BMD with ALN was different from the 1.8% increase in the RLX group (P=0.03). The biochemical markers of bone turnover D-OHP and BSAP in both treatment groups decreased from baseline and were different from placebo at 1 year. The decreases in D-OHP and BSAP were approximately 2.1 fold greater in the ALN group. The decreases were significantly greater in ALN group than in RLX group (P<0.001). CONCLUSION: ALN 70 mg once- weekly significantly produced greater increases in spine and greater but not significantly increases in hip BMD and significantly greater reductions in markers of bone turnover than RLX in 1 yr treatment period. Both ALN and RLX treatment groups have similar safety and tolerability profiles

The Ultrastructure of the Zona Fasciculata Layer of Suprarenal Gland During Pregnancy

OBJECTIVE: Increased estrogen levels affect the suprarenal gland cortex, thus raising the adrenocorticotropic hormone (ACTH) during pregnancy. This study aimed to examine possible structural changes in the suprarenal gland cortex in relation to the hormonal fluctuations during pregnancy. STUDY DESIGN: The suprarenal glands of 6-day, 12-day and 18-day pregnant rats were removed and compared with those of the control group under electron microscope. RESULTS: Lipid droplets in zona fasciculata cells were observed to increase significantly in number and volume, enlarged mitochondria, active Golgi region in comparison to the control groups on 6th and 12th days of pregnancy. On day 18 were observed to lipid droplets were seen to decrease and similar characteristics with the control group. CONCLUSION: In conclusion, with the increased estrogen hormone of pregnancy, various structural changes were observed in the cortex of suprarenal glands as related to mutual interaction among secreted hormones from the suprarenal glands, hypophysis and placenta

Comparison of the Different Type and the Different Routes of Administration of Human Chorionic Gonadotropin During Trigger of Ovulation in ICSI Cycles and the Relation with Body Mass Index

OBJECTIVE: To confirm that HcG levels in follicular fluid and serum after intramuscular (IM) or subcutaneous(SC) administration of purified (p)HcG and SC administration of recombinant(r)HcG and their associations with body mass index (BMI) and oocytes maturation in ICSI cyle. STUDY DESIGN: We used pHcG or rHcG for triggering ovulation of all patients . Group1(n:56) received IMpHcG and Group2(n:57) received SCpHcG and Group3( n:47) received rHcG . Serum and follicular fluid HcG levels were measured on the day of oocytes retrieved as primary outcome. RESULT: There was a significant difference on serum and follicular fluid HcG levels among three groups. No correlation was found between BMI and oocytes maturation for Group1 and Group2. But there was a significantly negative correlation between BMI and oocytes maturation in Group3. CONCLUSION: When comparing the different administration routes of HcG , the S.C. route of HcG seems to be safer and useful for obese patients

Time dependent influence of etonogestrel on the caspase-3 imunereactivity and apoptotic indexes of rat uterus and ovaries

Apoptosis is necessary for the balance between cell proliferation and loss. Thirty-six Wistar-Albino rats were subjected to investigate apoptotic effect of widely used implantable progestins on ovarian and uterine tissues. Rats were divided into 6 groups. In the first five groups, we applied etonogestrel (IMP) subcutaneous implants (n = 30). The rats in groups were sacrificed sequentially every 10 days after application. The rats in the last group (n = 6) were accepted as controls. Apoptotic index (AI) values and Caspase-3 immunereactivities of ovaries and uterus were recorded. In IMP groups, AI and Hscore values in stroma and glandular epithelium of uterus, granulosa and teca-lutein cells of the ovary increased with the longer progesterone exposure. Increase in AI and Hscore values were more prominent after 30 days of exposure for teca-lutein cells of ovary. Progestins increased apoptosis in ovaries and uterus by the longer exposure. Apoptosis increased in ovaries by chronic progesterone exposure. The apoptotic effect of progestin on endometrium is clear but long-term systemic application may lead to alterations in ovarian physiology. We evaluated time dependent apoptotic effect of etonogestrel on reproductive physiology and discussed progestins effect from another point of view in this study

Protection from cyclophosphamide-induced ovarian damage with bone marrow-derived mesenchymal stem cells during puberty

Objective: In female cancer survivors, the accelerated loss of primordial follicles may lead to premature ovarian failure. We investigated the protective effects of bone marrow derived mesenchymal stem cells (BMMSC) and gonadotropin releasing hormone analogue (GnRHa) against chemotherapeutic-induced ovarian toxicity in a rat model. Material and methods: Forty-eight Wistar albino female rats were divided into four groups. Group 1 was composed of rats that were given 200 mg/kg cyclophosphamide injection for each cycle (two cycles for each rat). Both cyclophosphamide and 0.4 mu g GnRHa were administered to Group 2. Cyclophosphamide and 4 million/kg BMMSC were administered to Group 3. Cyclophosphamide, GnRHa, and BMMSC were administered to Group 4. Germ cell apoptosis, DNA fragmentation and primordial follicular count were investigated with Cleave Caspase-9 and TUNEL analysis. The presence of the SRY gene on the Y chromosome in the ovary of the recipient female rats was checked with PCR. Results: Immunohistochemical staining (IHS) of Caspase-9 and TUNEL was higher in Group 1 than in Group 3 (p<0.05). Similarly, Group 4 had higher values than Group 3 (p<0.05). The presence of the SRY gene was detected in Groups 3 and 4 with the PCR analysis. The mean primordal follicle count was lowest in Group 1 and the mean primordial follicle counts were higher in Groups 2 and 3 than in Group 1. The difference between Group 1 and Group 4 was not significant. Conclusion: BMMSC therapy was found to be protective from germ cell apoptosis and DNA damage when it was used with chemotherapy regimens including alkylating agents

Alterations of Ionized and Total Magnesium Levels in Pregnant Women with Gestational Diabetes Mellitus

Background/Aims: The aim of this prospective study was to determine ionized and total magnesium (Mg) levels in pregnant subjects with and without gestational diabetes mellitus (GDM). Methods: Eighty-five women, 26-28 weeks pregnant, were recruited for routine oral glucose tolerance tests (OGTT); 45 had normal OGTT results and 40 were diagnosed with GDM. Electrolyte levels, including ionized and total Mg, were analyzed. Results: Gestational age and BMI were similar between the two groups (p = 0.800, p = 0.025). Multivitamin use was higher in the control group (p = 0.036). Fasting blood glucose was higher in the GDM group (p < 0.001). The median total Mg levels were 1.9 mg/dl (range 1.6-2.2) in the control group and 1.8 mg/dl (range 1.2-2.1) in the GDM group (p < 0.001). The median ionized Mg levels were 0.5 mmol/l (range 0.4-0.6) in the control group and 0.4 mmol/l (range 0.4-0.5) in the GDM group (p < 0.001). Conclusion: Our study revealed a relationship between low total and ionized Mg levels and GDM, as in type 2 diabetes mellitus (DM). The literature regarding type 2 DM and our findings suggest that Mg is the key ion in the pathophysiology of GDM. Low-dose Mg supplementation was not related to GDM; however, pharmacological doses in the various stages of pregnancy could be beneficial and should be investigated. (C) 2014 S. Karger AG, Base

Effect of Stem Cell Application on Asherman Syndrome, on Experimental Rat Model

We evaluate the effect of stem cells to induce endometrial proliferation and angiogenesis on Asherman Syndrome (AS). The experimental study was performed in stemcell research laboratory. Forty Wistar-Albino rats were divided according to groups. In group1 (n = 10) to establish the model; trichloroacetic acid was injected to right uterine horn. Two weeks later, intrauterine synechia was confirmed. In group2 (n = 10), 2 weeks later, 2 x 106 mesenchymal stem cells (MSC) were injected into right uterine horn followed by three intraperitoneal injections of MSCs. In group3 (n = 10), daily oral estrogen was initiated on the second week. In group4 (n = 10), MSC injections and oral estrogen was given together. The amount of fibrosis, vascularisation, inflammation and immunohistochemical staining with vascular endothelial growth factor (VEGF), proliferating cell nuclear antigen (PCNA) and Ki-67 were evaluated in the uterine tissues. In all treatment groups; fibrosis decreased but vascularisation and immunhistohemical stainings increased in the experimental side. The amount of fibrosis, vascularisation, Ki-67 and PCNA scores were similar between group2 and 3. In group4, comparing to group2, less fibrosis but more Ki-67, PCNA and VEGF staining was observed. Stem cells, when added to estrogen, are a highly effective alternative to induce regeneration of endometrium in Asherman Syndrome therapy.Wo

Ovulation Induction is a More Effective Stimulant on Antiovarian Antibody Production than In Vitro Fertilization

<p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>. </b><a href="https://link.springer.com/article/10.1007/s12325-016-0356-z">https://link.springer.com/article/10.1007/s12325-016-0356-z</a></p><p></p> <p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p><br></p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p

Clinical characteristics, disease activity, functional status, and quality of life results of patients with psoriatic arthritis using biological and conventional synthetic disease-modifying antirheumatic drugs

Objectives: This study aims to compare the clinical characteristics, disease activity, and quality of life (QoL) of patients with psoriatic arthritis (PsA) who use biological and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in a nationwide cohort throughout Turkey. Patients and methods: A total of 961 patients (346 males, 615 females; mean age: 46.9±12.2 years; range, 18 to 81 years) with PsA according to the classification criteria for PsA were included in the study. The patients’ demographic and clinical characteristics, physical examination results, Disease Activity Score 28, Disease Activity Index for Psoriatic Arthritis and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Psoriasis Area and Severity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, Psoriatic Arthritis Quality of Life (PsAQoL), and Short Form-36 scores were all recorded. Results: Of the patients, 23% underwent biological DMARD (bDMARD) monotherapy, 42% underwent conventional synthetic DMARD (csDMARD) monotherapy, 10% underwent a csDMARD combination therapy, and 10% underwent a combination bDMARD and csDMARD treatment. The Visual Analog Scale (VAS pain), patient global assessment, physician global assessment, and BASDAI scores were found to be lower among patients using combination treatment of csDMARD and bDMARD, while the swollen joint count was found to be lower among patients using bDMARD. The PsAQoL score was found to be the lowest among patients not using any medication and the highest among those using bDMARD. Conclusion: In our study, patients with PsA were successfully treated with both csDMARD and bDMARD monotherapy. When the biological treatments used for PsA were compared with csDMARD, it was found that biological treatments had a positive effect on both disease activity and the QoL. Combinations of csDMARDs and bDMARDs were preferred in cases in which the disease activity was still high or increased. Because of the highest efficacy of the combined treatment, we highly suggest increasing the number of patients on combined treatment

Enthesitis and its relationship with disease activity, functional status, and quality of life in psoriatic arthritis: A multi-center study

Psoriatic arthritis (PsA) is an inflammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its significant relations to disease activity and quality of life. Our objective is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life, using data from a national registry. Patients with PsA meeting ClASsification criteria for Psoriatic Arthritis (CASPAR) were enrolled by means of a multi-centre Turkish League Against Rheumatism (TLAR) Network Project. The following information was recorded in web-based case report forms: demographic, clinical and radiographic data; physical examination findings, including tender and swollen joint counts (TJC and SJC); nail and skin involvement; Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate (DAS 28-ESR); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Maastricht Ankylosing Spondylitis Enthesitis Score (MASES); Psoriasis Area Severity Index (PASI); Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s); Health Assessment Questionnaire (HAQ); Bath Ankylosing Spondylitis Functional Index (BASFI); Health Assessment Questionnaire for the spondyloarthropathies (HAQ-s); Psoriatic arthritis quality of Life scale (PsAQoL); Short Form 36 (SF-36); Hospital Anxiety Depression Scale (HADS); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and Fibromyalgia Rapid Screening Tool (FiRST) scores. The patients were divided into two groups, namely with and without enthesitis, based on the triple Likert-type physician-reported statement of ‘active enthesitis’, ‘history of enthesitis’ or ‘none’ in the case report forms. Patients with active enthesitis were compared to others in terms of these clinical parameters. A total of 1130 patients were enrolled in this observational study. Of these patients, 251 (22.2%) had active enthesitis according to the clinical assessment. TJC, HAQ-s, BASDAI, FiRST and PsAQoL were significantly higher whereas the SF-36 scores were lower in patients with enthesitis (p < 0.05). Chronic back pain, dactylitis, and tenosynovitis were more frequent in the enthesopathy group (59.4%/39%, 13.1%/6.5% and 24.7%/3.4%, respectively). Significant positive correlations between the MASES score and the TJC, HAQ, DAS 28-ESR, BASDAI, FiRST and PsAQoL scores, and a negative correlation with the SF-36 score were found. When linear regression analysis was performed, the SF-36 MCS and PCS scores decreased by − 9.740 and − 11.795 units, and the FiRST scores increased by 1.223 units in patients with enthesitis. Enthesitis is an important involvement of PsA with significant relations to quality of life determined with PsAQoL and SF-36 scores. Our study found higher frequency of dactylitis and chronic back pain, and worse quality of life determined with SF-36 and PsAQoL scores in patients with enthesitis