Objective: To investigate serum nesfatin-1 levels at 24-28 weeks of pregnancy in women newly diagnosed with gestational diabetes and determine the association of nesfatin-1 with several metabolic parameters. Subjects and methods: Forty women newly diagnosed with gestational diabetes at 24-28 weeks of pregnancy and 30 healthy pregnant women matched in age and gestational week were included in this cross-sectional study. Serum nesfatin-1 levels were analyzed using ELISA, and the relationship between nesfatin-1 and several metabolic parameters were assessed. Results: Serum nesfatin-1 levels were found to be lower in women with gestational diabetes compared to the pregnant women in the control sample (p = 0.020). Multiple linear regression analysis revealed that nesfatin-1 was lower in participants with gestational diabetes independently from gestational age, BMI, HOMA-IR, fasting plasma glucose, and age. In correlation analysis, the only variable that was found to have a statistically significant correlation with nesfatin-1 was gestational age (p = 0.015, r = 0.30). Conclusion: Lower nesfatin-1 levels in women with gestational diabetes compared to the control group at 24-28 weeks of gestation draws attention to nesfatin-1 levels in gestational diabetes and motivates further research in this area. Arch Endocrinol Metab. 2017;61(5):455-9

The aim of this study was to evaluate coagulation disorders in patients with metastatic colorectal cancer treated with bevacizumab by using rotation thrombelastogram (ROTEM(®)) and correlate ROTEM(®) parameters with routine coagulation tests. A total of 18 colorectal cancer patients who received bevacizumab combined with chemotherapy were included. There was no statistically significant difference between results of platelet count, prothrombin time (PT) and activated partial thromboplastin time (APTT), fibrinogen, and D-Dimer obtained at baseline and on day 1 of chemotherapy cycles 4, 8, and 12. CFT value was significantly increased on day 1 of cycle 12 compared with baseline value by both INTEM and EXTEM assays while CT and MCF showed no significant difference. Correlation analysis revealed significant correlation between laboratory parameters and ROTEM(®) parameters. Platelet count showed a positive correlation with MCF in INTEM (r = 0.627) and EXTEM (r = 0.699) assays while showed a negative correlation with CFT in EXTEM (r = -603). There was a significant negative correlation between fibrinogen levels and CFT in INTEM (r = -0.617) and EXTEM (r = -0.512). Our data demonstrated the value of TEG over conventional coagulation tests in evaluating antiangiogenesis agents-induced coagulation disorders.

Many reports led to the consensus on the use of progesterone (P) for luteal-phase support. Vaginal P application is the method of choice due to its simplicity and high patient convenience but is hampered by application difficulties and personal or cultural aversions. Inappropriate vaginal P use may alter successful implantation, leading physicians to consider alternate P application routes. A worldwide survey revealed that intramuscular plus vaginal P (combined P) is the method used in nearly one-third of in vitro fertilization (IVF) cycles, particularly in Asia and North America; unfortunately, the outcomes of this approach have not been clearly elucidated. In the current analysis, we evaluated any additional benefit of short course parenteral P in addition to vaginal P capsules during a specific period in terms of implantation, pregnancy rates, miscarriages and ectopic pregnancies in cleavage stage embryo transfer (ET) cycles of good-prognosis patients. Despite significantly higher implantation rates in the combined arm, clinical and ongoing pregnancies were comparable in both groups, whereas a trend toward increased pregnancy rates was observed with combined support. The available data are too limited to draw conclusions.

Intrauterine insemination (IUI) is a common treatment for couples with subfertility. Clomiphene citrate, gonadotropins, and letrozole are used for ovulation induction in IUI cycles. It has been well documented that luteal support with exogenous progesterone after in vitro fertilization is associated with higher pregnancy and live birth rates. Yet, luteal phase support in IUI cycles has become a debatable issue. The aim of this prospective controlled study was to assess the effect of luteal phase vaginal progesterone supplementation on β-hCG positivity and clinical pregnancy rates in women undergoing IUI. This prospective controlled randomised study was conducted at a tertiary infertility center. 87 patients with unexplained infertility or male subfertility who were treated with IUI using gonadotropins were enrolled. Patients in the study group (n = 44) received luteal phase vaginal progesterone supplementation. Patients in the control group (n = 43) did not receive any luteal phase support. There was no statistical difference between two groups in terms of β-hCG positivity and clinical pregnancy rates. Our findings do not show any beneficial effect of luteal phase support in IUI cycles stimulated with gonadotropins. Although luteal phase support in IUI cycles stimulated with gonadotropins is widely adopted, there is a lack of robust evidence.

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Background: Bariatric surgery is an important treatment option of obesity over the last decade. While bariatric surgery reduces weight and helps maintanence, it significantly reduces the obesity-related comorbidities, as well. Secondary hyperparathyroidism is a common metabolic complication of bariatric surgery, despite the recommended dose of calcium and vitamin D replacement. We have presented in our article that one of the results of bariatric surgery may be parathyroid adenoma (PA), although the long-term results are unknown. Methods: A total of 838 patients who had undergone sleeve gastrectomy (SG) between 2015 and 2018 were screened retrospectively. We analyzed the data of five patients with parathyroidectomy with PA and indicative of operation according to international guideline. Parathormone (PTH), 25-OH vitamin D3 (25OHD), calcium, phosphate (P), albümin, and alkaline phosphatase were evaluated, which were measured before and after parathyroidectomy. Weight changes of patients before and after bariatric surgery were calculated. Results: Mean age of the 838 patients were 38.7 -10.4 (years) with SG. Six hundred and eighty three subjects (81.5%) were women and 155 (18.5%) were men. Mean body weight changed before and after SG was respectively, 45.04 -6.37 kg/m 2 , 35.80 -7.6937 kg/m 2 , ( p = 0.002). All patients with PA were female and the mean age was 41.4 -9.0 (years). The mean time from bariatric surgery to parathyroid surgery was 2 -1 years. In 838 cases, PA was detected in five cases and the prevalence was found to be 0.6%. Conclusion: Long-term hypocalcemia may cause development of PA as a result of parathyroid gland stimulation. Clarification of increased PTH secondary to hypocalcemia, intestinal adaptation mechanisms, local effect of the wnt signaling pathway, change in carrier proteins, and the effect of adipokines on multifactorial conditions are extremely important to prevent bone loss in patients who underwent bariatric surgery. Development of PA after bariatric surgery is a serious complication and should not be overlooked. Therefore, long-term and strict follow-up is very important after surgery.

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