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Background: The relationship between vitamin D and cognitive status remains controversial. We aimed to evaluate the effect of vitamin D replacement on cognitive functions in healthy and cognitively intact vitamin D deficient older females. Methods: This study was designed as a prospective interventional study. A total of 30 female adults aged ≥60 with a serum 25 (OH) vitamin D level of <10 ng/ml were included. Participants were administered 50 000 IU vitamin D3 weekly for 8 weeks followed by a maintenance therapy of 1000 U/day. Detailed neuropsychological assessment was performed prior to vitamin D replacement and repeated at 6 months by the same psychologist. Results: Mean age was 63 ± 6.7 years and baseline vitamin D level was 7.8 ± 2.0 (range: 3.5–10.3) ng/ml. At 6 months, vitamin D level was 32.5 ± 3.4 (32.2–55) ng/ml. The Judgement of Line Orientation Test (P = 0.04), inaccurate word memorizing of the Verbal Memory Processes Test (P = 0.02), perseveration scores of the Verbal Memory Processes Test (P = 0.005), topographical accuracy of the Warrington Recognition Memory Test (P = 0.002), and the spontaneous self‐correction of an error in the Boston Naming Test (P = 0.003) scores increased significantly, while the delayed recall score in the Verbal Memory Processes Test (P = 0.03), incorrect naming of words in the Boston Naming Test (P = 0.04), interference time of the Stroop Test (P = 0.05), and spontaneous corrections of the Stroop Test (P = 0.02) scores decreased significantly from baseline. Conclusion: Vitamin D replacement has a positive effect on cognitive domains related to visuospatial, executive, and memory processing functions. [ABSTRACT FROM AUTHOR]

Aim: Low muscle mass (LMM) is a prerequisite to define sarcopenia. We aimed to report muscle-mass reference cut-off points adjusted for height and weight as muscle-mass threshold best discriminating muscle-weakness and adjusted for body mass index (BMI) significantly lower than that of healthy young population.Material and Method: We included young adults between 18 and 39 years and community dwelling older adults 60-99 years of age. Bioimpedance analysis (BIA) was used to assess skeletal muscle mass. Skeletal muscle mass index (SMMI) adjusted for height, weight, BMI were calculated [SMMI (height), SMMI (weight), SMMI (BMI)]. Handgrip strength was evaluated with Jamar hydraulic dynamometer for muscle-strength. SMMI (height) and SMMI (weight) cut-offs that predict low muscle-strength were calculated with receiver operator characteristic (ROC) analysis. Low muscle-strength was evaluated by three different thresholds, i.e. 32 kg/22 kg, 30 kg/20 kg, 26 kg/16 kg in males/females. SMMI (BMI) cut-offs were calculated as "mean young SMMI (BMI)-two standard deviation."Results: The young and older reference groups included 301 and 992 individuals, respectively. LMM cut-points for SMMI (height) were (i) 10.8 vs. 8.9 kg/m2 for 32/22 kg; 10.8 vs. 9.4 kg/m2 for 30/20 kg and 11.1 vs. 8.9 kg/m2 for the 26/16 kg thresholds, in males and females, respectively. LMM cut-points for the SMMI (weight) were 40.6% and 33.2% for the all three studied muscle-strength thresholds for males and females, respectively. For all the analyses sensitivity, specificity and likelihood ratios were not sufficiently high in both genders. The SMMI (BMI) cut-points were 1.049 vs. 0.823 kg/BMI for males and females, respectively.Conclusions: We presented the very first cut-off thresholds for muscle-mass adjusted by height and weight that best discriminate muscle-weakness in the older adults and by BMI that is significantly lower than that of healthy young population. This study suggests that correlation between total skeletal muscle mass measured by BIA (either adjusted for height or weight) and muscle strength is low. [ABSTRACT FROM AUTHOR]

Objective: Resistant epilepsy is widely seen in clinical settings manipulate the researchers to pursuit novel anti-epileptic treatments. Although trimetazidine (TMZ) is commonly used in the treatment of angina and ischemic diseases, it is considered that the drug may be beneficial in the treatment of epileptic seizures and convulsions. We aimed to evaluate electrophysiologically the protective effects of high dose acute TMZ on epileptic seizures and convulsions in a rat model of epilepsy induced by pentilentetrazol (PTZ). Method: Forty-eight male Sprague-Dawley rats were used for the EEG evaluation (Group-A; n=24) and behavioral assessment (Group-B; n=24). Grup-A1 and Grup-B1 were determined as control group and given no medication. 35 mg/kg (Group-A2, -A3 and -A4) and 70 mg/kg (Group-B2, -B3 and -B4) of PTZ were administered intraperitoneally (ip.) so as to generate seizures and convulsions. Group-A2 and Group-B2 were treated with saline. 40 mg/kg (Grup-A3 and Grup-B3) and 80 mg/kg of TMZ (Group-A4 and Group-B4) were administered to the treatment groups by ip. Brain malondialdehyde (MDA) levels, spike-percentage values, Racine's Convulsion Scale (RCS) scores and "first myoclonic jerk (FMJ)" latencies of each rat were determined. Results: Brain MDA levels, spike-percentage values, RCS scores, and FMJ latencies of Group-A2 and Group-B2 were significantly increased compared to those of the control's (Grup-A1 and Grup-B1) (P<0.05 for all comparisons). However, in TMZ treated groups (Group-A3 and -A4; Group-B3 and -B4) the elevated values of these parameters were found to be significantly decreased (P<0.05 for all comparisons). Conclusions: This study has demonstrated that the high dose acute TMZ administration may prevent PTZ-induced seizures and convulsions in rats. Furthermore, it can be also said that TMZ has a neuroprotective effects on oxidative stress associated with PTZ. Therefore, it may be considered for use with therapeutic purposes of TMZ in resistant epilepsy patients in the future. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 61-year-old woman with intravascular large B-cell lymphoma (IVLBCL) presented with fever and weakness.

Impaired endothelium-dependent vasomotion is a diffuse disease process resulting in abnormal regulation of blood vessel tone and loss of several atheroprotective effects of the normal endothelium. The aim of the present study was to investigate the effects of aging and hypertension on endothelial function. Sixty-six geriatric subjects with ages over 60 (48 hypertensive and 18 healthy) and 40 middle-aged subjects (16 hypertensive and 24 healthy) were included in the study. Systemic vascular endothelial function was evaluated through measuring brachial arterial vasodilation, a physiologic answer to reactive hyperemia occured with increased blood flow in the vessel after transient ischemia (flow-mediated dilation, FMD%), and with carotid artery intima-media thickness (IMT) measurement, using high-resolution ultrasonography. Endothelial independent vasodilation was also measured after administration of sublingual isosorbide dinitrate (isosorbide dinitrate mediated dilation, IDNMD%). FMD% was significantly decreased in elderly and/or hypertensive (HT) patients (geriatric HT: 9.5 ± 4.7%, geriatric non-HT: 12.7 ± 5.5%, middle-aged HT: 12.9 ± 4.3% and middle-aged non-HT: 18.9 ± 8.1%) (geriatric HT versus geriatric non-HT (P = 0.02), geriatric HT versus middle-aged HT (P = 0.01), geriatric non-HT versus middle-aged non-HT (P = 0.008)). Both FMD% and IDNMD% were inversely correlated with age, baseline vessel diameter and carotid artery intima-media thickness. FMD% was also inversely correlated with diastolic blood pressure. No correlation was found between FMD% and systolic blood pressure, serum cholesterol and triglyceride levels. Endothelium dependent (EDD) and independent dilatation of large arteries decreased with aging even in the healthy elderly, and FMD further declined in HT elderly patients, indicating that age and hypertension independently impair endothelial function. Positive correlations with age and hypertension, and significant inverse correlation with FMD, makes carotid artery IMT a possible indicator of endothelial function. [Copyright &y& Elsevier]

Background: Procalcitonin (PCT) represents a new marker of systemic inflammatory reactions to bacterial infections. The main aim in this study was to determine the diagnostic value of PCT in predicting the clinical severity of febril neutropenic attacks, compare it with that of C-reactive protein (CRP), and clarify its importance in culture-positive attacks., Methods: Between February 2001 and April 2002, 36 patients who were neutropenic due to various hematologic disorders and febrile were entered into the study. Blood samples were obtained on the first day of fever for the measurement of serum PCT and CRP levels., Results: In clinically severe neutropenic fever attacks, means of serum PCT and CRP levels were measured as 0.93+/-1.33 ng/mL and 67+/-24 mg/L, while they were 0.37+/-0.23 ng/mL and 32+/-19 mg/L in clinically mild ones (p = 0.033 and p < 0.001). On the other hand, no statistical significance was found between culture-positive and negative attacks when either serum PCT or CRP levels were taken into consideration (p = 0.133 and p = 0.141). The specificity and positive predictive value of the serum PCT test for severe febrile neutropenia was higher than that of the serum CRP test (0.80 vs. 0.57 and 0.50 vs. 0.39). However, sensitivity and negative predictive value for CRP were higher than the values for PCT (1.00 vs. 0.40 and 1.00 vs. 0.73). Diagnostic value and positive likelihood ratio of CRP for severe febrile neutropenia were higher than those of PCT (71 vs. 67 and 2.32 vs. 2.00)., Conclusions: PCT and CRP are comparable with each other in prediction of the clinical severity of febrile neutropenic attacks. Furthermore, serum CRP levels correlate with the duration of fever.