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Mild cognitive impairment (MCI) and Alzheimer's disease (AD) affect a high proportion of the elderly population with an increasing prevalence. Sleep disturbances are frequent in those with MCI and AD. This review summarizes existing research on sleep disturbances and neuroinflammation in MCI and AD. Although strong evidence supports various pathways linking sleep and AD pathology, the temporal direction of this central relationship is not yet known. Improved understanding of sleep disturbance and neuroinflammation in MCI and AD may aid in the identification of targets for their prevention. [ABSTRACT FROM AUTHOR]

In the present study, the bioaccumulation of six heavy metals (Cd, Cr, Cu, Hg, Pb, and Zn) in Hediste ( Nereis) diversicolor (O.F. Müller, 1776) and also in the muscle and liver of Mugil cephalus (Linnaeus, 1758) collected from seven stations in the Bafa Lake was investigated. Sediment samples were also collected in each site to assess heavy metal levels and to provide additional information on pollution of the lake. The mean concentrations of heavy metals in sediment, H. diversicolor, and muscle and liver of the fish were found to be in the magnitude of Cr>Pb>Zn>Cu>Cd>Hg, Zn>Cu>Cr>Pb>Hg>Cd, Zn>Cu>Pb>Cr >Hg>Cd, and Cu>Zn>Cr>Cd>Pb>Hg, respectively. Hg, Cu, and Zn in H. diversicolor and Hg and Zn in muscle and also Hg, Cd, Cu, and Zn in liver of fish accumulated in a higher degree than in sediment. There was no clear relationship between metal concentrations in sediments, polychaetes, and fish, except Cr. According to international criteria and Turkish regulations, Pb and Zn values in edible muscle of the fish collected from stations S6 and S5 exceeded the food safety limits, respectively. The results of this study suggest that these sentinel species can be considered as good anthropogenic biological indicators for heavy metal pollution along the Bafa Lake. [ABSTRACT FROM AUTHOR]

Abstract: Although elderly people are particularly vulnerable to the adverse effects of alcohol, alcohol use disorders in late life have received relatively little attention in the literature. Our objectives were to assess the prevalence of alcohol use disorders (abuse and dependence), the medical profile and psychosocial characteristics in elderly people visiting emergency department (ED). A cohort of 2405 patients aged over 60 who came to the ED of a university hospital during a 3-month period was studied. Alcohol use disorder diagnosis (DSM-IV), medical profile and social characteristics were collected from retrospective review of patient files. The data derived from 128 patients (mean age, 69.8±6.8 years; 87% males) with alcohol use disorders and 128 non-alcoholic controls. The prevalence of current alcohol use disorder was 5.3%. The most common current alcohol-induced disorders were alcohol intoxication and alcohol-induced mood disorder. Social factors associated with alcohol use disorders were being homeless, living alone, being divorced and never married. Falls and delirium were frequent ED admission circumstances in elderly drinkers. Drinkers more commonly presented with gastrointestinal disorders. In conclusion, alcohol use disorders among older patients admitted in ED are common and occur more frequently among men. Falls and delirium are the main ED admission circumstances in elderly drinkers. Alcohol use disorders are also associated with gastrointestinal problems. [Copyright &y& Elsevier]

Plasma viscosity is a major determinant of capillary blood flow. It has been suggested that alteration in plasma viscosity contributes to impaired blood flow and to increased cardiovascular risk. The aim of this study was to investigate the plasma viscosity levels and its possible role in the cardiovascular risk in patients with low grade nephrotic proteinuria. 20 patients with low‐grade nephrotic proteinuria (mean age: 35±5 years) and 20 healthy controls (mean age: 33±4 years) were participated in the study. Plasma viscosity was measured by Harkness capillary viscometer. Biochemical analysis were measured by commercial enzymatic kits. Plasma viscosity, plasma levels of creatinine, fibrinogen and triglyceride were increased in patients with proteinuria than in the healthy controls (p<0.001, p<0.001, p<0.001, and p<0.001, respectively). The plasma levels of total protein and albumin were significantly lower in patients with low grade nephrotic proteinuria than in healthy controls (p<0.001 and p<0.001, respectively). Plasma viscosity was negatively correlated with plasma albumin (r=-0.835, p<0.001) and total protein (r=-0.862, p<0.001) in proteinuric patients. When the correlation analyses were performed a significant positive correlation was found between plasma viscosity and fibrinogen (r=0.636, p<0.001). In the stepwise multiple regression analysis plasma viscosity was found to be related with plasma total protein (t=-6.456, p<0.001) in the patients. When the stepwise multiple regression analysis were performed in healthy controls, the significant relationship was only found between plasma viscosity and fibrinogen (t=+2.202, p<0.01). These results suggested that altered plasma composition associated with low‐grade nephrotic proteinuria may be involving the determination of plasma viscosity. Thus, the plasma viscosity in patients with low‐grade nephrotic proteinuria may have a prognostic value in assessing cardiovascular risk in this group. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the relationship between plasma viscosity and lipoprotein and apolipoprotein pattern in normo‐ and hypercholesterolemic patients with peripheral occlusive arterial disease (POAD). 40 patients with POAD have been selected (8 females and 32 males, mean age: 54±3.2 years) with clinically evident superficial femoral occlusive artery disease. They were separated into two groups as normocholesterolemic (plasma total cholesterol <200 mg/dl) and hypercholesterolemic (plasma total cholesterol >200 mg/dl). Plasma total cholesterol, high density lipoprotein cholesterol (HDL‐C), low density lipoprotein cholesterol (LDL‐C), triglycerides, total protein, and albumin levels were determined by enzymatic methods using commercial kits. Levels of apolipoprotein AI (apo AI), and apolipoprotein B (apo B) were measured using a immunoturbidometric method. Plasma viscosity (PV) was measured by capillary viscometer. Classifying the patients with PAOD according to the cholesterol levels; hypercholesterolemic (mean total‐cholesterol: 227.90±26.97 mg/dl) patients had significantly higher LDL‐C, PV and triglyceride levels compared with nornocholesterolemic patients (p<0.001, p<0.001, p<0.001, respectively). HDL‐C and apo B were significantly lower in hypercholesterolemic patients than in normocholesterolemic patients (p<0.001, p<0.001, respectively). PV was positively correlated with total cholesterol (r=0.485, p<0.05), atherogenic index (r=0.624, p<0.01), total‐C/HDL‐C ratio (r=0.624, p<0.05), and LDL‐C/HDL‐C ratio (r=0.707, p<0.001) in hypercholesterolemic patients with POAD. PV was higher in hypercholesterolemic patients with POAD than in normocholesterolemic patients with POAD. We suggest that POAD patients should be regarded as a heterogenous group with lipid and lipoprotein parameters in order to assess the microcirculation in the affected limb. In case of dyslipidemia in POAD patients an elevated plasma viscosity should be considered as coexisting risk factor. [ABSTRACT FROM AUTHOR]

Purpose: Elevated intraocular pressure and systemic hemodynamic changes are main risk factors in primary open-angle glaucoma (POAG). Sleep-disordered breathing (SDB) characterized by snoring, excessive daytime sleepiness and insomnia is accompanied by large swings in blood pressure and repetitive hypoxic periods during sleep. The aim of this study was to evaluate whether there is any relationship between SDB and POAG. Methods: Consecutively, 212 outpatients with POAG and 218 outpatients without POAG were recruited. Both eyes were examined. An interviewer-administered semi-structured questionnaire was used to collect SDB-related symptoms. Results: After controlling for age, relative to control group, POAG patients showed a high prevalence of snoring (47.6%, p=0.04), snoring plus, excessive daytime sleepiness (27.3%, p=0.01) and snoring plus, excessive daytime sleepiness, plus insomnia (14.6%, p=0.01). Conclusion: We found a high prevalence of SDB in patients with POAG. Chronic hemodynamic changes and recurrent severe hypoxia resulting from SDB may contribute to anoxic optic nerve damage, implicated in glaucoma. [ABSTRACT FROM AUTHOR]

Background: Uganda imports approximately 90% of its medicines, with about 60% being distributed by the private sector. To discourage importation and promote local production of 37 selected locally manufactured medicines, the Ugandan government through the Ministry of Health in 2017 increased the import verification fees from 2 to 12%. The increase in verification fees ultimately affects cost and availability of these medicines. This study aimed to assess the cost and availability of the selected essential medicines after the 12% increase in verification fees in Uganda., Methods: A cross sectional study among 328 wholesale and retail pharmacies and seven key informant interviews was conducted using a pretested data collection checklist and in-depth interview guide from February to September 2021 in Uganda. Data on the availability and prices of the medicines before (2017) and after (2020) the increase in verification fees was collected. Paired sample T-Test was used to test if there is a significant difference in prices before and after the 12% increase in verification fees., Results: Mean availability of imported medicines was higher (54.8%, CI: 49.3-60.4) than the locally produced medicines (37.1%, CI: 31.9-42.7) except for locally manufactured parenteral preparations (54.6.%, CI: 49.1-60.1). Availability of locally produced medicines was mainly low (45%) while the imported medicines were fairly high (74%). Most commonly available locally manufactured medicines were Surgical spirit (89.9%), ORS (86%), Dextrose 5% solution (74.4%), Paracetamol 500 mg Tablets (73.8%) and Sodium Chloride 0.9% solution (72.9%). Most commonly available imported medicines were; Omeprazole 20 mg (94.2%), Amoxicillin Trihydrate 125 mg/5 ml (92.4%), Ciprofloxacin 500 mg (91.4%), Paracetamol Suspension 120 mg/5 ml (91.5%) and Metronidazole 200 mg Tablets (88.1%). Increase in lowest-priced local and imported medicines was significant for 10 (23.8%) and 7 (15.9%) of the medicines respectively. The median prices of imported medicines were generally higher than locally produced medicines. The median unit prices of 12 (28.6%) locally produced medicines and 20 (47.6%) imported medicines were higher than the international median unit prices., Conclusions: The overall availability of imported medicines was still higher than the local medicines. The median prices of local and imported medicines generally increased or remained the same after the introduction of import verification fees. There is a need for price controls and transparency in the private sector., (© 2024. The Author(s).)

This prospective, randomized, controlled study aimed to investigate the effects of standardized adjuvant hypnosis on pain, depression, anxiety, aerobic exercise practices, quality of life, and disease impact score in female patients with fibromyalgia syndrome (FMS). This study included 47 female patients with FMS who had been under treatment for at least six months. The hypnosis group ( n  = 24) received a total of three hypnosis sessions and was taught to patients' self-hypnosis. The patients in this group practiced self-hypnosis for six months. During this period, all patients also continued their medical treatment. The Visual Analogue Scale (VAS) was used to determine the intensity of pain. At the end of the six-month follow-up period, it was determined that the patients of FMS with hypnosis therapy had lower pain intensity, FMS symptoms, depression, and anxiety symptoms, and better well-being than those in the control group ( p  < .05). Standardized hypnosis is an effective method in reducing pain, depression and anxiety symptoms and improving quality of life in patients with FMS.

Background: The local manufacture of pharmaceuticals is an opportunity to develop a broader manufacturing and knowledge-based economy and reduce over dependence on imports. To promote local production, the Ugandan government introduced Buy Uganda Build Uganda policy geared towards promoting use of locally manufactured goods. It also increased import verification fees in 2017 for 37 selected locally manufactured essential medicines from 2 to 12% to discourage importation of these medicines. This study assessed the impact of the increase in verification fees on local production capacity of the medicines., Methods: This was a mixed methods study looking at production capacity before and after introduction of the 12% import verification fees. It was conducted among six (6) local pharmaceutical industries in Uganda and seven (7) key informant interviews with experts in the pharmaceutical sector between February and September 2021., Results: The overall increase in local production capacity of the selected medicines was 8.2% from 2017 to 2020. The most significant increases were in the production of capsules (100.6%, P = 0.03) and oral liquids (170.8%, P = 0.0001). All the industries registered an increase in number of employees between 2017 and 2020 with an average percentage increase of 42%. There was a 14.7% (95% CI 2.76-17.6%) change in installed capacity of the compression machine (P = 0.033) and 27.7% (95% CI 24.6-33.9%) change in installed capacity of the Blow-Fill-Seal (BFS) filling machines (P = 0.011). There was also an increase in the number and capacity of installed utilities such as the heating ventilation and air conditioning (968%) and standby generators (131%). Only two (2) industries registered an increase in critical quality control equipment and one had all the critical equipment available by 2020. Most of the key informants reported positive impact of the increment of import verification on local manufacturing capacity., Conclusions: Local pharmaceutical production capacity increased with the increase in import verification fees with significant increases in production of oral liquids and capsules. Successful implementation of policies supporting local production will promote the development of local pharmaceutical industries. Governments should consider increasing the list of medicines to benefit from the import verification fees increase by adding all essential generic medicines for which there is adequate domestic production capacity and technical skills., (© 2023. The Author(s).)

Monitoring liver and cardiac iron stores by magnetic resonance imaging (MRI) enables identifying patients at risk of organ-specific morbidity and better tailoring of iron chelation therapy in thalassemia. Nevertheless, serum ferritin (SF) remains the only tool for monitoring iron status in most resource-poor regions. In this study, we assessed the impact of using MRI techniques to guide iron chelation therapy on iron overload outcomes in a cohort of 99 patients with thalassemia major (TM, mean age at baselines 20.7 ± 6.9 years) followed from 2006 to 2019. We also assessed the ability of SF trends to predict changes in consecutive liver iron concentration (LIC) and cardiac T2* (cT2*) measurements. The most commonly used chelator was deferasirox at baseline (65%) and final (72%) assessments. Overall, patients with safe LIC values (< 7 mg/g dw) increased from 57 to 77%, and safe cT2* values (> 20 ms) increased from 72 to 86%. We obtained the most significant improvement in patients with severe and moderate liver (p = 0.006 and p < 0.001) and cardiac (p < 0.0013 and p < 0.0001) iron overload at baseline. SF trends were in the same direction in 64% of changes in LIC, but only 42% of changes were proportional. Most of the changes in SF (64%) and LIC (61%) could not predict changes in cT2*. Moreover, downward trends in SF and LIC were associated with worsening cardiac iron in 29% and 23.5% of consecutive cT2* measurements. Liver and cardiac MRI-driven oral iron chelation improved the iron status of subjects with TM and demonstrated the importance of using validated MRI techniques in critical clinical decisions., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: This study aimed to investigate the relationships between intravaginal ejaculatory latency time (IELT), severity of disease, and chronotype in lifelong premature ejaculation (PE)., Materials and Methods: Evaluation was made of 114 males with PE and 103 healthy individuals, and comparisons were made of self-estimated IELT, Arabic Index of Premature Ejaculation (AIPE), Pittsburg Sleep Quality Index (PSQI), and Morningness-Eveningness Questionnaire (MEQ)., Results: The frequency of morningness chronotype (78.1%) was significantly higher, and Morningness-Eveningness Questionnaire (MEQ) scores were negatively correlated with both IELT (r = -0.490, p < 0.001) and Arabic Index of Premature Ejaculation (AIPE) scores (r = -0.639, p < 0.001) in the PE group. MEQ scores significantly predicted IELT (t = -2.465, p = 0.015) and AIPE scores (t = -4.003, p = 0.000) in the PE group but not in the control group., Conclusion: It can be asserted that morningness chronotype is more common, and ejaculatory latency time and PE severity are associated with chronotype in males with PE., (© 2021 S. Karger AG, Basel.)

Benzalkonium chloride (BAC) is a common ingredient of disinfectants used for industrial, medical, food safety and domestic applications. It is a common pollutant detected in surface and wastewaters to induce adverse effects on Human health as well as aquatic and terrestrial life forms. Since disinfectant use is essential in combatting against microorganisms, the best approach to reduce ecotoxicity level is to restrict BAC use. We report here that encapsulation of BAC in mesoporous silica nanoparticles can provide an efficient strategy for inhibition of microbial activity with lower than usual concentrations of disinfectants. As a proof-of-concept, Listeria monocytogenes was evaluated for minimum inhibitory concentration (MIC) of nanomaterial encapsulated BAC. Aptamer molecular gate structures provided a specific targeting of the disinfectant to Listeria cells, leading to high BAC concentrations around bacterial cells, but significantly reduced amounts in total. This strategy allowed to inhibition of BAC resistant Listeria strains with 8 times less the usual disinfectant dose. BAC encapsulated and aptamer functionalized silica nanoparticles (AptBACNP) effectively killed only target bacteria L. monocytogenes, but not the non-target cells, Staphylococcus aureus or Escherichia coli. AptBACNP was not cytotoxic to Human cells as determined by in vitro viability assays., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Schizophrenia is known to be accompanied with increased cardiovascular mortality, which causes reduced life expectancy., Aim: The aim of the current study was to investigate if atherogenic index of plasma (AIP) could be a good marker in assessing cardiovascular disease (CVD) risk in patients with schizophrenia., Methods: Patients with schizophrenia ( n  = 328) and healthy controls ( n  = 141) were recruited. Schizophrenia patients were evaluated according to the presence of antipsychotic (AP) drug use as AP(+)Sch group and AP(-)Sch group. Atherogenic indices, such as AIP, Castelli's risk index-I (CRI-I), Castelli's risk index-II (CRI-II), and atherogenic coefficient (AC), were calculated according to the laboratory examination of serum lipid parameters., Results: According to the comparison of serum lipid levels, triglyceride (TG) levels were found to be highest and high-density lipoprotein-cholesterol levels were lowest in AP(+)Sch group than AP(-)Sch group and control group (CG) ( p  < 0.001). AIP, CRI-I, and CRI-II scores were found to be significantly higher in AP(+)Sch group than AP(-)Sch group, and in AP(-)Sch than healthy controls ( p  < 0.001). Mean AC scores were higher in AP(+)Sch group than both AP(-)Sch and CG and were similar in AP(-)Sch and control subjects ( p  < 0.001). According to the correlation analysis, AIP scores were positively correlated with duration of disease ( r  = 0.235; p  = 0.002) and age ( r  = 0.226; p  = 0.003) in AP(+)Sch group but not in drug-free subjects. In all groups, atherogenic indices of CRI-I, CRI-II, and AC scores were found to be positively correlated with AIP scores ( p  < 0.001)., Conclusion: Our results suggest that AIP is an easily calculable and reliable marker for determining the CVD risk in both drug-free schizophrenia patients and patients under AP treatment.

Study Objectives: First, to determine whether the 3-item Observation and Interview-based Diurnal Sleepiness Inventory (ODSI) measures the degree of excessive daytime sleepiness in patients with suspected narcolepsy or idiopathic hypersomnia (IH). Second, to assess the correlation between the ODSI and the Epworth Sleepiness Scale (ESS) as well as objective polysomnographic measurements. Third, to test the accuracy of the ODSI to detect narcolepsy or IH (narcolepsy/IH) compared with the ESS., Methods: A total of 181 patients complaining of excessive daytime sleepiness filled in the ESS and the ODSI and underwent measurements including actigraphy, full-night polysomnography, Multiple Sleep Latency Test, and 24-hour bedrest sleep recording., Results: Narcolepsy or IH was diagnosed in 76 patients. The ODSI found excessive daytime sleepiness in 92.3% of all patients and in 98.7% of those diagnosed with narcolepsy/IH. In the whole population, the ODSI was significantly positively correlated with the ESS (R = .547; 95% confidence interval: .436, .642; P < .001) and weakly with 24-hour total sleep time on bedrest recording (R = .208; 95% confidence interval: .056, .350; P = .047) but not with the Multiple Sleep Latency Test. The ODSI offered a higher negative (92.9%) and positive (44.9%) predictive value to detect narcolepsy/IH than did the ESS (66.7% and 43.3%, respectively). In the IH group, the ODSI's third-item score (daily sleepiness duration) was significantly higher in patients with than without increased 24-hour total sleep time (P = .023)., Conclusions: The ODSI is a brief, simple first-line questionnaire that explores both intensity and duration of daytime sleepiness and offers a high sensitivity to detect narcolepsy and IH., (© 2020 American Academy of Sleep Medicine.)

Workplace violence in healthcare is gradually becoming a major concern in many countries around the world and research has usually been focused on the victims of violence. The aim of this study was to investigate the psychopathology of individuals who commit violence against healthcare workers. The study included 50 subjects (patient or relative of patient) aged 18-65 years who had committed violence against a healthcare worker (study group) and a control group of 55 subjects with no history of violence. A Sociodemographic Questionnaire, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Barratt Impulsiveness Scale (BIS-11), State-Trait Anger Expression Inventory (STAXI), and Eysenck Personality Questionnaire-Revised Short Form (EPQ-RSF) were administered to both the study group and the control group. A psychiatric disorder was diagnosed in 50% of the violent offenders group and in 16.4% of the control group. It was determined that 54.8% of the patient relatives and 44.4% of the patients themselves who committed a violent act against healthcare workers had at least one psychiatric diagnosis and these rates did not differ between the patients and their relatives ( χ 2 = 0.492, p = 0.483). Comparisons of the scale scores between the groups revealed that the STAXI scores ( p < .001), BIS-11 total scores ( p < .001), BDI, and BAI scores were statistically significantly higher in the violent offenders group. Considering the higher rates of psychiatric disorders and higher levels of anger and impulsivity among people who commit violent acts against healthcare workers, psychotherapeutic interventions such as stress and anger management interventions, improvement of interaction and communication between patients, their relatives and healthcare workers, and the implementation of rehabilitating punitive programs for violent offenders may be beneficial to reduce the rates of violent behavior against healthcare workers., (© Copyright 2019 Springer Publishing Company, LLC.)

Introduction: There is no established reference standard for subjective measures of sleepiness in older adults., Methods: This study compares the Observation and Interview-based Diurnal Sleepiness Inventory (ODSI) with two existing instruments for measurement of sleepiness and daily functioning, the Epworth Sleepiness Scale (ESS) and Functional Outcomes of Sleep Questionnaire (FOSQ)., Results: A total of 125 study participants were included in this study and were administered the ODSI, ESS and FOSQ; subjects had a mean age of 70.9 ± 5.27 years, mean Apnea-Hypopnea Index of 31.9 ± 27.9 events/hour and normal cognitive functioning (Mini-Mental State Examination score > 24). The ODSI showed a significant association with the ESS (Spearman's ρ: 0.67, P < 0.001) and with the FOSQ (Spearman's ρ: -0.52, P < 0.001). The ODSI 1 item (assessing sleepiness in active situations) was borderline significantly correlated with the ESS (β = 0.14; 95% confidence interval [CI], -0.01 to 0.29; P = 0.069). ODSI 2 item (sleepiness in passive situations) was correlated with the ESS (β = 1.65; 95% CI, 1.32 to 1.98; P < 0.001). Both ODSI 1 (β = -0.15; 95% CI, -0.24 to -0.07; P < 0.001) and ODSI 2 (β = -0.35; 95% CI, -0.55 to 0.16; P < 0.001) were significantly correlated with the FOSQ., Conclusion: The ODSI is a suitable measure of sleepiness and is appropriate for usage in clinical care in older adults., Competing Interests: Disclosure All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership or other equity interest and expert testimony or patent-licensing arrangements) or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. The authors report no conflicts of interest in this work.

Background: A novel ischemia marker named ischemia modified albumin was previously considered as an early marker of myocardial ischemia, however due to recent reports, its contribution was demonstrated in different pathologies such as oxidative stress, diabetes, stroke and cancer. We aimed to investigate the relation between oxidative stress and thyroid dysfunctions determining IMA levels since IMA is closely related with increased oxidative stress., Methods: A total of 88 individuals were participated in this study: 34 cases in hypothyroid, 27 cases in hyperthyroid and 27 cases in euthyroid group. Ischemia-modified albumin levels were measured by albumin cobalt binding test and thyroid hormone levels were determined with electrochemiluminescent method., Results: Ischemia modified albumin levels were significantly decreased in hypothyroid group compared to hyperthyroid and euthyroid groups (p < 0.001). In hyperthyroid individuals ischemia modified albumin levels were higher compared to euthyroid ones (p < 0.001). Ischemia modified albumin was negatively correlated with TSH levels (r = -0.473, p < 0.001), and positively correlated with FT4 and FT3 levels (r = 0.496, p < 0.001 and r = 0.275, p = 0.010, respectively)., Conclusion: We suggest that albumin adjusted IMA levels are significantly lower in hypothyroid group than hyperthyroid and euthyroid groups., (© 2014 Wiley Periodicals, Inc.)

Duloxetine is a balanced and potent serotonin and noradrenaline reuptake inhibitor which is known to be effective in depression and anxiety disorders. The common adverse effects include dry mouth, nausea, insomnia, somnolence, dizziness and constipation. Reported adverse effects of the extra pyramidal symptoms (EPS) are rare. In this case, a patient who suffered from acute dystonia, after only one dose of 30 mg duloxetine is presented.

In this study, the state of the five stations' quality was assessed on the basis of determination of temporal and spatial variability of nutrients with physicochemical variables. Besides this, organic matter of sediment, secchi disc depth and suspended solids were also determined. The samples were collected seasonally from different areas such as harbor and important touristic marinas along the eastern Aegean during June 2008-2009. As a result, the nutrients ranged between NH₄: 0.10-25.6, NO₂: 0.01-1.5, NO₃: 0.19-7.0, o.PO₄: 0.17-6.8, TPO₄: 0.32-9.6 and Si: 0.30-13.8 μM, respectively. Precipitation leads to large changes in temperature, salinity, dissolved oxygen and nutrients. The highest nutrient values in this study were observed during the rainy season except o.PO₄-P and TPO₄-P. However, the physico-chemical variables have exhibited considerable temporal variations while nutrients showed spatial differences. The relatively high nutrient increase in the sampling stations coupled with surface runoff events during rainy period and pollution arising from both point and non-point sources., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

This biomonitoring study presents the spatial and temporal distributions of heavy metals in the soft tissues of a major fouling species Amphibalanus amphitrite living on hard substrate at different sites along the eastern Aegean coast. A. amphitrite has been chosen as a strong candidate for monitoring heavy metals. Sediment and seawater samples were also collected to detect their metal contents in order to gain more information on the environmental conditions and possible bioaccumulation patterns. The physico-chemical characteristics of sampling stations have been measured in order to characterize the sampling area. The order of metal concentrations in barnacles, sediment and seawater decreased in the following order Cu>Fe>Zn>Mn>Cd>Cr>Pb>Hg, Fe>Mn>Zn>Cu>Pb>Cr>Hg>Cd and Fe>Zn>Mn>Cu>Pb>Cr>Cd>Hg, respectively. These results showed that barnacles accumulate Cu in a higher degree than both sediment and seawater. Moreover, metal concentrations in barnacle have the potential for use in any future regulatory framework monitoring and eventually controlling ambient metal pollution levels., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

O6-Methylguanine DNA methyltransferase (O6-MGMT) reverses DNA alkylation damage produced alkylating agents. O6-MGMT is also a major determinant of cellular resistance to adjuvant chemotherapy with alkylating drugs. O6-MGMT activity was measured in samples from patients with gastric cancer, including tumor, adjacent normal appearing mucosa, and peripheral blood leukocytes (PBL). O6-MGMT activity of PBL from healthy individuals was evaluated as control. There was no significant difference between controls and patients for O6-MGMT activity in PBL. O6-MGMT activity was significantly increased in tumor tissue. Tumor O6-MGMT activity was found to be independent from tumor subgroups and tumor grade. A positive correlation was determined between O6-MGMT activity in tumor and in circulating PBL. The results indicate that O6-MGMT, a defense protein against alkylating agent-mediated carcinogenesis, increased in gastric tumors. This may explain the low response rate to drug combinations, including chloroethylnitrosoureas, exhibited by patients with gastric cancer.

Red blood cell (RBC) deformability is an important hemorheological parameter to determine the passage of RBC through narrow capillaries and the reduction of blood viscosity under high shear rates. Although it has been substantial evidence that diabetes mellitus (DM) and hypercholesterolemia increase the risk of coronary heart disease, the mechanism is unclear. In this study the relationship between hemorheological parameters and plasma cholesterol in type 2 diabetic patients (n=55, mean age 43.4+/-9.2 years) was examined. Type 2 diabetic patients were classified as normocholesterolemic (n=25; cholesterol < or = 200 mg/dl) and hypercholesteroloemic (n=30; cholesterol > 200 mg/dl) subgroups. Hypercholesterolemic type 2 diabetic patients had the highest blood and plasma viscosity and the lowest RBC deformability. The results were significantly different from normocholesterolemic type 2 diabetic patients (p<0.001). Our data suggest that elevated plasma cholesterol may impair RBC deformability and increase in blood and plasma viscosity by an additional effect to hyperglycemia in type 2 diabetic patients.

The relationship between pain and sleep seems to be reciprocal: if pain may interrupt or disturb sleep, poor sleep can also influence pain perception. However the influence of sleep disturbances on pain sensitivity remain poorly investigated. The aim of this study was to assess the effect of REM sleep deprivation on the reaction of rats subjected to different noxious stimuli. In each experiment 16 Wistar male rats were randomly assigned to two groups: controls (n=8), and REM sleep deprived rats (n=8). REM sleep deprivation was elicited using the 'inverted flower pot' technique. Four different experiments were performed to assess the sensitivity to mechanical (vocalization threshold in paw pressure), thermal (tail withdrawal latency in hot water immersion), electrical (envelope of 2nd peep in tail shock test) and chemical (analgesic behavior in formalin test) noxious stimuli. All experiments were performed over a 5-day period with baseline (day 1, day 2) in a dry environment and REM sleep deprivation (day 3, day 4 and day 5) in a wet environment. Under wet conditions, vocalization threshold in the paw pressure test (-20%, P=0.005), and tail withdrawal latency in the hot water immersion test (-21%, P=0.006) were significantly lower, and the envelope of 2nd peep in the tail electrical shock was significantly greater (+78%, P=0.009), in REM sleep deprived rats compared to controls. However, under wet conditions the mean duration of nociceptive behaviors in the formalin test did not differ between the two groups. In conclusion, REM sleep deprivation induces a significant increase in the behavioral responses to noxious mechanical, thermal and electrical stimuli in rats.

The objective of the study was to investigate the effect of moderate glomerular dysfunction on oxidative stress. We determined the plasma and erythrocyte malondialdehyde (MDA) levels, as a marker of lipid peroxidation, erythrocyte glutathione (GSH) levels and activities of GSH-Px, GSH Red and SOD as an antioxidant enzymes, and plasma trace element levels containing Fe, Cu and Zn in twenty proteinuric patients (6.8 +/- 5.1 g/day) with moderate glomerular function and in 20 anemic control subjects. We found that the erythrocyte and plasma MDA levels and erythrocyte GSH-Px activities were significantly higher (p < 0.001, p < 0.001, p < 0.001, respectively) and the erythrocyte GSH levels and activities of GSH-Red and SOD activities were significantly lower (p < 0.001, p < 0.001, p < 0.001, respectively) in the patients than in the anemic subjects. Plasma Fe and Zn levels were not to be found significantly different in the patients compared to the anemic subjects. But plasma Cu levels were significantly higher in the patients (p < 0.05) when compared with the levels of anemic subjects. This study was concluded that cellular antioxidant activity decreases in proteinuric patients with moderate glomerular function. This may increase lipid peroxidation reactions by causing oxidative stress in erythrocyte membranes.

The aim of this study was to assess the effect of paradoxical sleep deprivation (PSD) and sleep recovery on the vocalization threshold in rats submitted to a mechanical noxious stimulus. Sixteen male Wistar rats were randomly assigned in two groups: controls (n=8), paradoxical sleep deprived rats (n=8). PSD was performed using the 'inverted flower pot' technique. Paw pressure test was used to assess the sensitivity to mechanical noxious stimulus (vocalization threshold). The experiment was divided into three periods: baseline (day 1, day 2), PSD (day 3, day 4, day 5) and recovery (day 6, day 7, day 8, day 9). After 48 and 72 h of PSD, the vocalization thresholds decreased significantly in comparison to the control rats (day 4: 245+/-21 vs. 303+/-20 g, P=0.05; day 5: 256+/-17 vs. 324+/-22 g, P=0.02). In PSD group, relative to controls, vocalization thresholds increased significantly after 48, 72, and 96 h of recovery sleep periods (day 7: 378+/-24 vs. 307+/-8 g P=0.01; day 8: 384+/-27 vs. 316+/-23 g, P=0.02; day 9: 395+/-24 vs. 328+/-15 g, P=0.02). Vocalization thresholds on day 6 were not significantly different in both groups (375+/-20 vs. 324+/-24 g, P=0.08). In conclusion, experimental PSD in rats induces a significant decrease in vocalization threshold to mechanical noxious stimulus, which is totally reversed during the sleep recovery period.

The results of previous studies that examined serum trace metal status of epileptic patients receiving antiepileptic drug (AED) therapy were variable. We measured serum zinc (Zn) and copper (Cu) levels in 52 epileptic children who were treated with either carbamazepine (CBZ) or valproic acid (VPA) or with a combination of CBZ and VPA. Serum Zn levels were significantly lower in the epileptics than in the two control groups which consisted of 7 untreated epileptics and 12 normal children (p < 0.05). Combination therapy and monotherapy with CBZ increased serum Cu levels (p < 0.05). No significant alteration in serum Cu levels was observed with VPA monotherapy. Serum Zn and serum Cu concentrations of the untreated epileptics were not significantly different from those of normal controls. Our results indicate that serum trace metal homeostasis may be affected by AED therapy, but not by the convulsive disorder itself.

The effects of coronary artery diseases on haemorheological parameters (blood viscosity, erythrocyte deformability and haemoglobin level) and serum trace element (Cu,Zn) levels were investigated. Subjects were 16 male patients having coronary artery disease. Three blood samples were drawn pre-operation and at the 10th and 30th day after operation. To determine the effects of by-pass surgery on haemorheological parameters and serum trace elements, we used a centrifugal method for erythrocyte deformability, Harkness relative viscometer for blood viscosity, spectrophotometry for haemoglobin level, and atomic absorption spectrophotometry for trace elements. Parameters of coronary artery patients were compared with normal values.