Relation of maternal vitamin D status with gestational diabetes mellitus and perinatal outcome

Objective: To investigate the relationship between maternal vitamin D status and glucose intolerance, and its impact on pregnant women and their newborns. Methods: A cohort of pregnant women were divided into three groups: women with gestational diabetes mellitus, ones with normal results both after the 50 gr and 100 gr OGTT (CG-1) and ones having a positive result after the 50 gr OGTT screening but negative results for gestational diabetes mellitus (GDM) after the 100 gr OGTT (CG-2) Results: The newborn length in CG-1 was greater than in GDM and CG-2 (p= 0.002 and p= 0.02). Fasting blood glucose and insulin resistance (IR) were negatively correlated with length of the newborns (r=-0.3, p=0.03 and r=-0.3, p=0.01). The newborns of women with GDM had lower APGAR-1 and 5 scores than those of CG-1 and CG-2 (APGAR-1 p= 0.001 and p= 0.004, APGAR-5 p=0.005 and p=0.007, respectively). APGAR scores were correlated negatively with IR (APGAR-1 r=- 0.32, p=0.01, APGAR-5 r=-0.3, p=0.03) and positively with 25OHD levels (APGAR-1 r=0.3, p=0.01, APGAR-5 r=0.3, p=0.02). Conclusion: Vitamin D deficiency, gestational diabetes and insulin resistance are interrelated. Severe vitamin D deficiency during pregnancy is associated with poor pregnancy and neonatal outcome

Phosphodiesterases and cAMP pathway in pituitary diseases

© 2019 Bizzi, Bolger, Korbonits and Ribeiro-Oliveira. Human phosphodiesterases (PDEs) comprise a complex superfamily of enzymes derived from 24 genes separated into 11 PDE gene families (PDEs 1-11), expressed in different tissues and cells, including heart and brain. The isoforms PDE4, PDE7, and PDE8 are specific for the second messenger cAMP, which is responsible for mediating diverse physiological actions involving different hormones and neurotransmitters. The cAMP pathway plays an important role in the development and function of endocrine tissues while phosphodiesterases are responsible for ensuring the appropriate intensity of the actions of this pathway by hydrolyzing cAMP to its inactive form 5'-AMP. PDE1, PDE2, PDE4, and PDE11A are highly expressed in the pituitary, and overexpression of some PDE4 isoforms have been demonstrated in different pituitary adenoma subtypes. This observed over-expression in pituitary adenomas, although of unknown etiology, has been considered a compensatory response to tumorigenesis. PDE4A4/5 has a unique interaction with the co-chaperone aryl hydrocarbon receptor-interacting protein (AIP), a protein implicated in somatotroph tumorigenesis via germline loss-of-function mutations. Based on the association of low PDE4A4 expression with germline AIP-mutation-positive samples, the available data suggest that lack of AIP hinders the upregulation of PDE4A4 protein seen in sporadic somatotrophinomas. This unique disturbance of the cAMP-PDE pathway observed in the majority of AIP-mutation positive adenomas could contribute to their well-described poor response to somatostatin analogs and may support a role in tumorigenesis.We are grateful for the support by Fundação de Amparo à Pesquisa de Minas Gerais—Fapemig (AR-O), Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq (AR-O, MB) and the Medical Research Council UK (MK), and the NIH, USA (GB)

Does student behavior differ in relation to perception /evaluation of campus environments? a post-occupancy research in two university campuses

A Post Occupancy Evaluation (POE) survey was applied to 93 students at two universities; Dokuz Eylul University and Karadeniz Technical University. The survey consists questions on: (1) participants' characteristics, (2) physical environmental characteristics, (3) favorite places, (4) the most and the least liked features and possibilities for improvement, (5) physical activity engagement level, and (6) time spent in the campus. Results showed that users' subjective evaluations of their campuses are reflected in their behavior. The students of the negatively evaluated campus reported that they spent less time in campus compared to students of the more positively evaluated campus

Iatrogenic Cushing’s syndrome with inhaled steroid plus antidepressant drugs

Abstract Current guidelines recommend the use of inhaled corticosteroids (ICS) for suppression of airway inflammation in patients with asthma. Although it is well known that ICS cause dose-related adrenocortical suppression, it is less known that they can lead to iatrogenic Cushing’s syndrome (CS). Fluticasone propionate (FP) is an ICS more potent than beclomethasone and budesonide. FP is metabolized as mediated by cytochrome P450 3A4 in the liver and the gut. Systemic bioactivity of FP can increase with the use of drugs that affect the cytochrome P450. Herein, we report the rapid development of iatrogenic CS in a patient receiving paroxetine and mirtazepine for 12 weeks in addition to inhaled FP.</p

Iatrogenic Cushing's syndrome with inhaled steroid plus antidepressant drugs

Current guidelines recommend the use of inhaled corticosteroids (ICS) for suppression of airway inflammation in patients with asthma. Although it is well known that ICS cause dose-related adrenocortical suppression, it is less known that they can lead to iatrogenic Cushing's syndrome (CS). Fluticasone propionate (FP) is an ICS more potent than beclomethasone and budesonide. FP is metabolized as mediated by cytochrome P450 3A4 in the liver and the gut. Systemic bioactivity of FP can increase with the use of drugs that affect the cytochrome P450. Herein, we report the rapid development of iatrogenic CS in a patient receiving paroxetine and mirtazepine for 12 weeks in addition to inhaled FP

Evaluation of Androgen Levels in Patients with Acute Coronary Syndrome

Objectives: To determine plasma levels of free Testosterone (fT) and dehydroepiandrosterone sulphate (DHEA-S) in male patients with acute coronary syndrome. Methods: We checked the serum fT and DHEA-S levels of 30 healty male subjects and 64 male patients with acute coronary syndrome whose coronary artery diseases were confirmed by coronary angiography. Results: We observed no difference between two groups on the level of fT while DHEA-S level was significantly lower (p = 0.01). No correlation had existed between lipid parameters and levels of fT and DHEA-S. Conclusion: More comprehensive studies are needed about whether lower levels of DHEAS in patients are contributed to acute coronary syndrome or are the effect of disease. [Med-Science 2012; 1(4.000): 323-30

A rare case of solitary subcutaneous scalp metastasis from follicular thyroid carcinoma revealed with positron emission tomography/computed tomography: A case report and review

Differentiated thyroid cancer frequently metastasizes to regional cervical lymph nodes and in advanced cases metastases can be seen in the lungs and skeleton. Metastases to the skin or subcutaneous tissue are rare. Here we present a 49-year-old female patient with solitary scalp metastasis from follicular thyroid carcinoma FTC which was revealed with positron emission tomography (PET)/computed tomography (CT) imaging. PET showed flourodeoxiglucose avid lesion in the left vertex scalp. Scalp lesion was removed totally and histopathological examination revealed well-differentiated thyroid cancer metastasis

Familial acromegaly due to aryl hydrocarbon receptor-interacting protein (AIP) gene mutation in a Turkish cohort

Aryl hydrocarbon receptor-interacting protein (AIP) is associated with 15-20 % of familial isolated pituitary adenomas and 50-80 % of cases with AIP mutation exhibit a somatotropinoma. Herein we report clinical characteristics of a large family where AIP R304X variants have been identified. AIP mutation analysis was performed on a large (n = 52) Turkish family across six generations. Sella MRIs of 30 family members were obtained. Basal pituitary hormone levels were evaluated in 13 family members harboring an AIP mutation. Thirteen of 52 family members (25 %) were found to have a heterozygous nonsense germline R304X mutation in the AIP gene. Seven of the 13 mutation carriers (53.8 %) had current or previous history of pituitary adenoma. Of these 7 mutation carriers, all but one had somatotropinoma/somatolactotropinoma (85.7 % of the pituitary adenomas). Of the 6 acromegaly patients with AIP mutation (F/M: 3/3) the mean age at diagnosis of acromegaly was 32 +/- A 10.3 years while the mean age of symptom onset was 24.8 +/- A 9.9 years. Three of the six (50 %) acromegaly cases with AIP mutation within the family presented with a macroadenoma and none presented with gigantism. Biochemical disease control was achieved in 66.6 % (4/6) of the mutation carriers with acromegaly after a mean follow-up period of 18.6 +/- A 17.6 years. Common phenotypic characteristics of familial pituitary adenoma or somatotropinoma due to AIP mutation vary between families or even between individuals within a family

Third trimester physiological hypercortisolemia may protect from postpartum depression and stress

OBJECTIVE: This study was aimed to evaluate the impact of physiological alterations in cortisol milieu on mood changes during late pregnancy and postpartum. PATIENTS AND METHODS: A total of 77 healthy pregnant subjects were prospectively evaluated after 36 weeks of gestation and at 3-4 weeks postpartum. Free cortisol (FC) was calculated using Coolen’s equation and the free cortisol index (FCI) was defined as serum Total cortisol/Cortisol-binding globulin. Concurrently, status of depression, anxiety and stress were graded using Beck Depression Inventory, Beck Anxiety Inventory and Perceived Stress Scale. Statistical analysis was performed and p<0.05 was considered statistically significant. RESULTS: Higher FC levels during late pregnancy were associated with lower scores on stress and depression early postpartum, albeit the latter was not statistically significant. Additionally, as FCI increased during late pregnancy both the scores on stress and depression decreased during early postpartum. CONCLUSIONS: Increased cortisol levels during the latter periods of pregnancy may have long-lasting protective effects. They may enable the mother to cope with the changing and demanding conditions during postpartum