Hormone replacement therapy process and effects of reproductive factors on bone mineral density in postmenopausal women

Amaç: Menopoz sonrası kadınlarda hormon replasman tedavi (HRT) sürecinin ve parite, menopoz yaşı, menopoz süresi gibi reprodüktif faktörlerin kemik mineral yoğunluğu üzerine etkileri araştırıldı. Hastalar ve Yöntemler: Trakya Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Kliniği Menopoz Polikliniği'ne başvuran 322 menopoz sonrası kadının (ort. yaş 52.4±6.2; dağılım 38-76) yaş, reprodüktif öykü ve hormon replasmanı ile ilgili bilgileri arşivden çıkarıldı. Hastalar, östrojen kullanım süreleri ve halen kullanmakta olup olmadıklarına göre sınıflandırıldı ve bu özelliklerinin kemik mineral yoğunluğuna etkileri analiz edildi. Kadınların lomber vertebra, femur, trokanter ve wards kemik dansitometreleri DEXA (dual-energy X-ray absorpsiometri) yöntemiyle ölçüldü. Bulgular: Hormon replasman tedavisi kullanımı üç yıldan fazla olan menopoz sonrası kadınlardaki wards ve trokanter kemik mineral yoğunlukları, üç yıldan az olanlara göre anlamlı olarak yüksek bulundu. Vertebral kemik yoğunlukları, üç yılın üzerinde HRT kullananlarda hiç kullanmayanlara göre daha yüksek saptandı. Wards ve vertebral kemik yoğunluğu değerleri, halen HRT'yi kullanmakta olan ve üç yıldan daha uzun süredir kullananlarda hiç HRT kullanmamış kadınlara göre daha yüksek tespit edildi. Geçmişte HRT kullanıp sonradan bırakmış olan kadınlarda kemik mineral yoğunluğu değerleri hiç HRT kullanmamış olan kadınlardan farklı olmadığı bulundu.. Parite ve menopoz sonrasında geçen süre artışının kemik yoğunluğunu düşürdüğü görüldü. Sonuç: Vertebra ve kalça kemik mineral yoğunlukları, HRT kullanımının ancak üç yıl veya daha uzun süreli kullanımlarında ve HRT'nin kullanıldığı dönem içinde artmaktadır. Parite ve menopoz sonrası geçen süre ise osteoporoz riskini artıran faktörlerdir.Objectives: The effects of hormone replacement therapy (HRT) and reproductive factors such as parity, age of menopause, and duration of menopause on bone mineral density (BMD) in postmenopausal women were investigated. Patients and Methods: Age, reproductive history and HRT data of 322 postmenopausal women (mean age 52.4±6.2 years; range 38- 76) who applied to the outpatient menopause clinic of Trakya University Medical Faculty were gathered from the medical archives of the outpatient clinic. Patients were grouped according to the duration and current status of estrogen therapy and the effects of these variables on BMD were analysed. Bone mineral densities of lumbar spine, femur, trochanter, and Ward's triangle sites were measured by Dual Energy X-ray Absorptiometry (DEXA). Results: Bone mineral densities of trochanter, and Ward's triangle sites of postmenopausal women who received HRT for more than 3 years were found to be significantly higher than those women who were treated for less than 3 years. Vertebral bone densities were significantly higher in postmenopausal women who received HRT for more than 3 years, compared to those women who were never treated with HRT. Ward's triangle and vertebral bone densities were significantly higher in postmenopausal women who received HRT for more than 3 years and those currently on HRT, compared to those women who never received HRT. BMD values of women who started but interrupted their HRTs, were similar to the values found in women who never received HRT. Increasing parity and duration of menopause were the factors that reduced BMD values. Conclusion: It appeared that BMD of hip and spine increased in postmenopausal women after the third or more years on HRT and during the period of treatment with HRT. Parity and duration of menopause were identified as factors which increase the risk of osteoporosis

The use of plants in the traditional management of diabetes in Nigeria: Pharmacological and toxicological considerations

Ethnopharmacological relevance: The prevalence of diabetes is on a steady increase worldwide and it is now identified as one of the main threats to human health in the 21st century. In Nigeria, the use of herbal medicine alone or alongside prescription drugs for its management is quite common. We hereby carry out a review of medicinal plants traditionally used for diabetes management in Nigeria. Based on the available evidence on the species׳ pharmacology and safety, we highlight ways in which their therapeutic potential can be properly harnessed for possible integration into the country׳s healthcare system. Materials and methods: Ethnobotanical information was obtained from a literature search of electronic databases such as Google Scholar, Pubmed and Scopus up to 2013 for publications on medicinal plants used in diabetes management, in which the place of use and/or sample collection was identified as Nigeria. ‘Diabetes’ and ‘Nigeria’ were used as keywords for the primary searches; and then ‘Plant name – accepted or synonyms’, ‘Constituents’, ‘Drug interaction’ and/or ‘Toxicity’ for the secondary searches. Results: The hypoglycemic effect of over a hundred out of the 115 plants reviewed in this paper is backed by preclinical experimental evidence, either in vivo or in vitro. One-third of the plants have been studied for their mechanism of action, while isolation of the bioactive constituent(s) has been accomplished for twenty three plants. Some plants showed specific organ toxicity, mostly nephrotoxic or hepatotoxic, with direct effects on the levels of some liver function enzymes. Twenty eight plants have been identified as in vitro modulators of P-glycoprotein and/or one or more of the cytochrome P450 enzymes, while eleven plants altered the levels of phase 2 metabolic enzymes, chiefly glutathione, with the potential to alter the pharmacokinetics of co-administered drugs. Conclusion: This review, therefore, provides a useful resource to enable a thorough assessment of the profile of plants used in diabetes management so as to ensure a more rational use. By anticipating potential toxicities or possible herb–drug interactions, significant risks which would otherwise represent a burden on the country׳s healthcare system can be avoided

Unusual Presentation of Prostate Adenocarcinoma: Collet-Sicard Syndrome with Dysfunctions of Cranial Nerves VII and VIII

Collet-Sicard syndrome is characterized by the unilateral paralysis of cranial nerves IX-XII. The most common cause is an extradural tumor in the posterior fossa. This syndrome may occasionally occur because of distant metastases. Collet-Sicard syndrome which results from metastatic prostate carcinoma is very rare. A review of the English literature showed that this is the second report of metastatic prostate carcinoma with Collet-Sicard syndrome and dysfunctions of cranial nerves VII and VIII. On the other hand, this is the first report of a patient with prostate carcinoma who initially presented with Collet-Sicard syndrome and showed dysfunctions of cranial nerves VII and VIII

Şizofreni ve glutatyon peroksidaz 1 (pro197leu) polimorfizmi arasındaki ilişkinin bir Türk hasta grubunda araştırılması

Introduction: Schizophrenia is a complex disease characterized with psychosis, cognitive dysfunction and negative symptoms. The etiology is unknown in most cases. Free radicals and antioxidant system balance shifting in favor of oxidants resulted from oxidative stress has been accounted for in the pathogenesis of schizophrenia. In this study, we aimed to elucidate the role of the pro197leu polymorphism of glutathione peroxidase 1 (GPX1) enzyme, the major subunit of glutathione peroxidase, in the etiopathogenesis of schizophrenia. Materials and Methods: The study group was composed of 100 patients (54 males and 46 females) and 100 healthy volunteers (66 males and 34 females). The study was conducted using the PCR\RFLP method. Results: The allele frequencies of pro197 and leu197 variants of GPX1 were similar in the control group and schizophrenic patients (p=0.318). Distributions of the genotype frequencies were similar between the controls and patients (p=0.402), as well as males and females in patient group (p=0.225). Conclusion: The pro197leu polymorphism of GPX1 gene may not constitute any susceptibility for schizophrenia in Turkish population studied.Amaç: Şizofreni, psikoz, bilişsel fonksiyon bozuklukları ve negatif semptomlarla seyreden kompleks bir hastalıktır. Etyoloji, bir çok vakada bilinmemektedir. Şizofreni patogenezinde serbest radikal-antioksidan sisteminde dengenin oksidanların lehine bozulması suçlanmaktadır. Bu çalışmamızda glutatyon peroksidazın en önemli alt grubu olan glutatyon peroksidaz 1 (GPX1) enzimini kodlayan gendeki pro197leu polimorfizminin şizofreni etyopatogenezindeki rolünü aydınlatmayı hedefledik. Gereç ve yöntem: Çalışmamıza 100 hasta (54 erkek ve 46 kadin) ve 100 sağlıklı gönüllü dahil edildi. PCR/RFLP yöntemi çalışma metodu olarak seçildi. Bulgular: GPX1 genindeki pro197 ve leu197 allellerinin sıklıkları (p=0,318) ve pro/pro, pro/leu, leu/leu genotiplerinin dağılımları (p=0.402) kontrol ve şizofreni gruplarında benzer bulundu. Ayrıca genotip dağılımları açısından kadınlar ve erkekler arasında anlamlı bir ilişki bulunamadı (p=0,225). Sonuç: GPX1 genindeki pro197leu polimorfizminin çalışılan Türk toplumunda şizofreniye yatkınlık oluşturmadığı tespit edildi

Şizofreni ve glutatyon peroksidaz 1 (pro197leu) polimorfizmi arasındaki ilişkinin bir Türk hasta grubunda araştırılması

Introduction: Schizophrenia is a complex disease characterized with psychosis, cognitive dysfunction and negative symptoms. The etiology is unknown in most cases. Free radicals and antioxidant system balance shifting in favor of oxidants resulted from oxidative stress has been accounted for in the pathogenesis of schizophrenia. In this study, we aimed to elucidate the role of the pro197leu polymorphism of glutathione peroxidase 1 (GPX1) enzyme, the major subunit of glutathione peroxidase, in the etiopathogenesis of schizophrenia. Materials and Methods: The study group was composed of 100 patients (54 males and 46 females) and 100 healthy volunteers (66 males and 34 females). The study was conducted using the PCR\RFLP method. Results: The allele frequencies of pro197 and leu197 variants of GPX1 were similar in the control group and schizophrenic patients (p=0.318). Distributions of the genotype frequencies were similar between the controls and patients (p=0.402), as well as males and females in patient group (p=0.225). Conclusion: The pro197leu polymorphism of GPX1 gene may not constitute any susceptibility for schizophrenia in Turkish population studied.Amaç: Şizofreni, psikoz, bilişsel fonksiyon bozuklukları ve negatif semptomlarla seyreden kompleks bir hastalıktır. Etyoloji, bir çok vakada bilinmemektedir. Şizofreni patogenezinde serbest radikal-antioksidan sisteminde dengenin oksidanların lehine bozulması suçlanmaktadır. Bu çalışmamızda glutatyon peroksidazın en önemli alt grubu olan glutatyon peroksidaz 1 (GPX1) enzimini kodlayan gendeki pro197leu polimorfizminin şizofreni etyopatogenezindeki rolünü aydınlatmayı hedefledik. Gereç ve yöntem: Çalışmamıza 100 hasta (54 erkek ve 46 kadin) ve 100 sağlıklı gönüllü dahil edildi. PCR/RFLP yöntemi çalışma metodu olarak seçildi. Bulgular: GPX1 genindeki pro197 ve leu197 allellerinin sıklıkları (p=0,318) ve pro/pro, pro/leu, leu/leu genotiplerinin dağılımları (p=0.402) kontrol ve şizofreni gruplarında benzer bulundu. Ayrıca genotip dağılımları açısından kadınlar ve erkekler arasında anlamlı bir ilişki bulunamadı (p=0,225). Sonuç: GPX1 genindeki pro197leu polimorfizminin çalışılan Türk toplumunda şizofreniye yatkınlık oluşturmadığı tespit edildi

Gender-related clinical and management differences in patients with chronic heart failure with reduced ejection fraction

Aim Gender-related differences have been described in the clinical characteristics and management of patients with chronic heart failure with reduced ejection fraction (HFrEF). However, published data are conflictive in this regard