Male hypogonadism is defined as the deficiency of testosterone or sperm production synthesized by testicles or the deficiency of both. The reasons for hypogonadism may be primary, meaning testicular or secondary, meaning hypothalamohypophyseal. In hypogonadotropic hypogonadism (HH), there is indeficiency in gonadotropic hormones due to hypothalamic or hypophyseal reasons. Gonadotropin-releasing hormone (GnRH) is an important stimulant in releasing follicular stimulant hormone (FSH), mainly luteinizing hormone (LH). GnRH omitted is under the effect of many hormonal or stimulating factors. Kisspeptin is present in many places of the body, mostly in hypothalamic anteroventral periventricular nucleus and arcuate nucleus. Kisspeptin has a suppressor effect on the metastasis of many tumors such as breast cancer and malign melanoma metastases, and is called "metastin" for this reason. Kisspeptin is a strong stimulant of GnRH. In idiopathic hypogonadotropic hypogonadism (IHH) etiology, there is gonadotropic hormone release indeficiency which cannot be clearly described. A total of 30 male hypogonatropic hypogonadism diagnosed patients over 30 years of age who have applied to Haydarpasa Education Hospital Endocrinology and Metabolic Diseases Service were included in the study. Compared to the control group, the effect of kisspeptin on male patients with hypogonatropic hypogonadism and on insulin resistance developing in hypogonadism patients was investigated in our study. A statistically significant difference was detected between average kisspeptin measurements of the groups (p < 0.01). Kisspeptin measurement of the cases in the patient group were detected significantly high. No statistically significant relation was detected among kisspeptin and LH/FSH levels. Although a positive low relation was detected between kisspeptin measurements of patient group cases and homeostasis model assessment of insulin resistance (HOMA-IR) measurements, this relation was statistically insignificant. When the patient and control groups were compared for HOMA-IR, no statistically significant difference was detected. The reason for high kisspeptin levels in the patient group compared to the control group makes us consider that there may be a GPR54 resistance or GnRH neuronal transfer pathway defect. When patients and control groups were compared for HOMA-IR, the difference was not statistically significant. It is considered that kisspeptin is one of the reasons for hypogonatropic hypogonadism and has less effect on insulin resistance.
In this study, we showed that PTX-3 levels, in both FMF attack and attack-free periods, were significantly higher than in the control group. Finally, PTX-3 may be a promising biomarker for FMF diagnosis and may predict FMF attacks (Tab. 2, Fig. 2, Ref. 18).
OBJECTIVE: Data on the effect of anticholinergic cognitive burden (ACB) in older adults with subjective cognitive decline (SCD) are limited. We aimed to study whether ACB increases the future risk of dementia in older adults with SCD. METHODS: The retrospective cohort analysis was carried out on 1496 older adults. Out of those, 109 older patients with SCD followed up over 36 months were studied. They were divided into two groups according to cognitive status at last visit: group I included the subjects with SCD who did not progress to dementia and group II included those who progressed to dementia. The drugs with anticholinergic effects that were received by subjects three months or more were identified from records. The drugs were categorized as having absent (ACB = 0), possible (ACB = 1), and definite (ACB = 2) anticholinergic properties based on an ACB scale. ACB was calculated for each subject by adding the score of each drug and classified as no or low ACB (ACB ≤ 2) and high ACB (ACB ≥ 3). RESULTS: The mean age of all subjects was 72.5 ± 6.3 years and 66.1% of the sample was female. The median follow-up time for all subjects was 75 months (range, 36-185). Fifteen (13.8%) of 109 participants with baseline SCD developed dementia. High ACB was present in 12 subjects (12.8%) in group I and 7 subjects (46.7%) in group II (p = .001). The 75-84 and 85 + age groups (hazard ratio (HR)
Aim: A new malnutrition diagnostic criterion called the Global Leadership Initiative on Malnutrition (GLIM) was created by an initiative of the same name as these criteria in 2018. The present study aims to evaluate the differences and superiority of MNA, NRS-2002 screening tests, and GLIM criteria in patients hospitalized in palliative care with a diagnosis of malnutrition. Material and Method: 148 patients who were hospitalized in palliative care due to clinical malnutrition were included in the study. MNA, NRS-2002, and GLIM screening tests were filled out by dieticians for each patient within the first 48 hours of hospitalization. Within the framework of GLIM criteria, patients were recorded for weight loss from phenotypic criteria based on information obtained from their relatives (more than five percent in the last six months or ten percent or more over the last six months). Hand dynamometer and calf circumference measurements were made to show muscle loss. Low Body Mass Index (BMI) was accepted as 20 kg/m2 for individuals under the age of 70 years, and <22 for individuals above the age of 70 years. Decreased food intake which is among the etiologic criteria was detected by calculating the mean daily consumed calories of a patient. Individuals with CRP>5 mg/L were accepted as inflammation positive. Results: Mean age in the total series was 72.98 with 70.4 in males and 75.5 in females including a total of 148 patients. Among the patients 50.67% (n=75) were males and 49.32% (n=73) were females. Malnutrition was found to be present in 141/148 (94.6%) patients according to the GLIM screening test. Malnutrition risk was present in 131/148 (87.9%) and 139/148 (93.2%) according to MNA-SF and NRS-2002, respectively. The results of the GLIM criteria and the other two screening tests were compared. While the results of the GLIM criteria and NRS-2002 test were similar, a significant difference was found between the GLIM test results and the results of MNA-SF. Conclusion:The GLIM screening test is an easy-to-use and sensitive test for the diagnosis of patients hospitalized in palliative care centers. GLIM test and NRS-2002 were found to be similar for diagnosing malnutrition. Although the results of MNA and GLIM tests were close, a significant difference was found between them in the diagnosis of malnutrition.
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