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Introduction: Cushing's syndrome (CS) is rare in pregnancy because CS itself is a cause of anovulatory infertility due to excess cortisol secretion. Moreover it is also difficult to diagnose CS in pregnancy because placental production of corticotropin releasing and adrenocorticotropic hormone (ACTH), increased maternal production of estrogen induced corticosteroid binding globulin leads to physiological hypercortisolism during pregnancy. So physicians face a clinical overlap in many features of CS such as weight gain, fatigue, edema, hypertension, hyperglycemia, stretch marks, mood changes that can also be attributed to pregnancy. Thus their coexistence represents a diagnostic challenge. Herein we report a case of CS that was diagnosed and successfully treated during pregnancy. Clinical Case: A 43-year-old gravida 3 female was consulted at the 21st week of gestation with persistent high blood pressure and hyperglycemia for a month. She had an obstetric history of 2 spontaneous first term abortion, 2 healthy labor 18 years ago and she was healthy after. She was in such a depressive mood that she was consulted with psychiatry many times. On physical examination edema, proximal weakness of lower extremities and hirsutism (modified Ferriman–Gallwey score of 9) was detected. Initial laboratory tests were all within normal range except potassium level (2.7 mmol/L), the results were not consistent with preeclampsia and there was a suspicious adrenal mass detected on ultrasound. She was currently receiving high dose antihypertensive treatment with methyldopa, calcium channel blockers, rapid acting and detemir insulin for diabetes and i.v. potassium replacement. We ruled out conns syndrome with normal plasma aldosterone renin ratio and found catecholamine levels normal. Hormonal analyses revealed with high plasma cortisol levels, increased nocturnal cortisolemia, a suppressed plasma ACTH and dehydroepiandrosterone sulfate level and distinctly elevated 24-hour urinary cortisol greater than 3-fold the upper normal reference range. Non contrast magnetic resonance imaging demonstrated a 47×32 mm left adrenal mass. Laparoscopic adrenalectomy was performed in the 26th week of gestation and the following histopathology revealed an adrenocortical adenoma. Antihypertensive medication was progressively reduced, glycemic control and hypokalemia reversal were achieved. She was followed up with appropriate glucocorticoid replacement. At 34 weeks of gestation, after sudden labor pain and regular uterine contractions a 2586 g male infant with Apgar scores of 8 was born by cesarean section. They were discharged in good health. Conclusion: CS should be kept in mind especially in the case of hypertension and diabetes that started before the 20th gestational age. Analysis of the urinary free cortisol level and circadian rhythm of cortisol is necessary to diagnose. Despite the diagnostic challenge we can achieve better maternal and fetal outcomes with proper management. Figure 1. Non-contrast magnetic resonance imaging of the patient Table 1. Patient's laboratuary test results Table 2. Patient's laboratory test results [ABSTRACT FROM AUTHOR]

Aim: To investigate whether the increased serum levels of testosterone secondary to Dutasteride therapy has any protective effect on cardiovascular system. Material and Methods: A prospective analysis of 50 patients diagnosed benign prostatic enlargement between May 2015 and May 2017 was performed. After randomization 25 patients treated with daily administration of 0.5 mg dutasteride (Dutasteride Group), and 25 patients were not given dutasteride (Control Group). We analyzed some serum novel cardiaovascular marker levels at baseline and after 6 months of the treatment. Echocardiography, carotid intima-media thickness and brachial artery resistive index (RI) were evaluated at baseline and after 6 months of the treatment. Statistical analyses were performed using SPSS, version 21. While “t test” was used for comparison the independent groups, paired t test was used in the matched groups. Statistical significance was considered at p<0.05. Results: The differences in serum Lp a, hs-CRP and NT-proBNP levels were not statistically significant (p>0.05). Additionally, echocardiographic parameters, carotid intima-media thickness and brachial artery RI were similar before and after dutasteride tratment. Conclusion: After the short-term use of dutasteride, there was not a statistically significant difference in serum Lp a, hs-CRP and NT-proBNP levels. Additionally, echocardiographic parameters, carotid intima-media thickness and brachial artery RI were also similar. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether or not the age of spontaneous resolution of monosymptomatic nocturnal enuresis (MNE) was familial. Patients and Methods: A questionnaire was administered to more than 1,500 people, and 100 appropriate participants were identified from four referral hospitals. We included the participants who had MNE and whose parents also had MNE with spontaneous resolution. Then the association between the spontaneous resolution time of MNE in parents and that in their children was investigated. Results: The mean ages of spontaneous resolution were 10.7 (10-30 years), 9.4 (6-17 years) and 10.9 (6-18 years) in participants, their mothers and their fathers, respectively. According to the statistical analysis, there was a positive correlation between participants and both their mothers and fathers (p < 0.05). In addition, it was revealed that familial MNE history based on first- and second-degree relatives, in addition to their parents, was also associated with the increased spontaneous resolution age of MNE (p < 0.05). According to our results, gender and parents' education status were not statistically associated with the spontaneous resolution (p > 0.05). Conclusion: As a conclusion, the age of spontaneous resolution of MNE is familial. Although the exact reasons of spontaneous resolution still remain a mystery; further genetic investigations may be able to resolve this mystery. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

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Splenic cyst was first described by Andral in 1929. Splenic cysts are divided into 2 groups as parasitic and non-parasitic. Splenic mesothelial cyst (SMC) is a rare form of splenic cysts, and its incidence is not known exactly. It is frequently observed in children and young adults. In this case report, a 21-year-old male patient who underwent laparoscopic splenectomy with a diagnosis of symptomatic splenic cyst is discussed. Total splenectomy was decided because of the splenic cyst localization in the splenic hilus. Laparoscopic splenectomy was performed to the patient. SMC is a rare primary splenic cyst and is usually asymptomatic. It is often detected incidentally by imaging modalities. Symptomatic cysts with a size of more than 5 cm should be treated. Spleen sparing techniques are accepted as the current treatment option. In this case report, a young adult patient who underwent laparoscopic splenectomy for symptomatic SMC is discussed in the light of the literature. [ABSTRACT FROM AUTHOR]

Although the effects of cigarette smoking and/or thinner inhalation on various organs have been investigated, there isn't enough study available in literature about their effects on kidneys. Therefore, in this study we investigated the effect of smoking and/or inhalation on the rat kidney. In this study, stand-alone inhalation of thinner and cigarette smoke and their application together were used to determine histopathologic changes, primarily the influences on rat kidneys. The study included 60 Wistar Albino species male rats. The 60 rats were divided into 4 groups of 15 rats each. Of the groups, three were working groups and the fourth was the control group. The rats in the first study group inhaled thinner only (T), those in the second group cigarette smoke only (CS), and the rats in the third group were made to inhale both thinner and cigarette smoke (TC). Each study group was divided into 3 subgroups each comprising 5 rats and inhalation was continued for periods of 2 wk, 4 wk, and 6 wk. Thinner was vaporized into the cage with a millipore pump at a constant pressure twice per day for 1 h for 5 days (toluene 2800-3000 ppm, acetone 500-600 ppm, isobutyl acetate 7000-8000 ppm, and isobutanol 6000-7000 ppm). Cigarette smoke was given 4 times per day for 15 min each, using a mechanism prepared with an aquarium motor (containing 1.2 mg nicotine,13 mg tar, and 13 mg carbonmonoxide; 60 puffs/min). After that, rat kidneys were removed. The kidneys were weighed and were given macroscopic and microscopic examination. There were significant differences for the thinner and thinner + cigarette smoke groups in comparison to the control group, observed in both proximal and distal tubules. However, changes in the cigarette smoke group were only in proximal tubules and were smaller in extent. Thinner has been widely used as a industrial substance. Thinner usage is an important health problem. Those sniffing thinner generally also use cigarettes. The findings of the present study reemphasize the importance of taking immediate measures in order to prevent thinner inhaling among homeless children, who pose an important social problem, and to protect people who work in industrial branches that widely use thinner.