Matrix metalloproteinase-9 (MMP-9) influences extracellular matrix remodeling, inflammation, and renal hemodynamics in patients with various kidney diseases, including diabetic kidney disease (DKD). This cross-sectional study investigated the relationship between urinary MMP-9, proteinuria, and pulse wave velocity (PWV) in 67 patients with DKD and 21 healthy controls. Biochemical and clinical parameters were analyzed, and urinary MMP-9 levels were measured and normalized to creatinine. Both urinary MMP-9 levels and PWV were significantly higher in patients with DKD compared to healthy controls. Urinary MMP-9 levels correlated positively with proteinuria (r = 0.360, p = 0.003), SBP (r = 0.333, p = 0.006), and PWV (r = 0.316, p = 0.009), and negatively with eGFR (r = − 0.350, p = 0.004). Backward stepwise multiple linear regression analysis showed that urinary MMP-9 was the only variable retained in the final model and remained independently associated with proteinuria in patients with DKD. Our study highlights urinary MMP-9 as a potential biomarker reflecting not only renal dysfunction but also systemic vascular complications in DKD. These findings emphasize the dual role of MMP-9 in mediating renal and vascular pathology and suggest its potential prognostic and therapeutic significance.

The objective of this study is to compare the hemostatic efficacy of oxidised regenerated cellulose powder (Surgicel® Powder) and fibrin glue (Tisseel®) in a rat model of liver parenchymal haemorrhage, and to evaluate their effects on tissue healing. Preoperative haemoglobin and haematocrit values were comparable among the groups (p > 0.05). At 24 h, postoperative haemoglobin and haematocrit values differed significantly among the three groups (p = 0.045 and p = 0.042, respectively), with lower values in the saline-compression control group and relatively preserved values in the Surgicel® Powder and Tisseel® groups. However, no statistically significant difference was identified between the two active treatment groups. Histopathological evaluation revealed no statistically significant between-group differences in necrosis, inflammation, fibrosis, haemorrhage, or granulation tissue formation (p > 0.05).

Ischaemic priapism is a urological emergency that may lead to irreversible erectile dysfunction due to cavernosal tissue damage. In this experimental study, we evaluated the acute effects of pirfenidone, pentoxifylline, and dexpanthenol on ischaemia–reperfusion injury (IRI) in a rat model of ischaemic priapism. A total of 68 male Wistar albino rats were randomly assigned to seven groups, including sham, control (IRI), and treatment groups receiving pirfenidone, pentoxifylline, dexpanthenol, or combination therapies. Ischaemic priapism was induced under anaesthesia, followed by a reperfusion period. Serum inflammatory (IL-1β, IL-10), oxidative stress (MDA, TOS, TAS), and endothelial (eNOS) markers were analysed, and histopathological evaluation was performed using semi-quantitative scoring. The control group demonstrated significantly higher IL-1β, eNOS, and MDA levels compared with treatment groups. Pirfenidone and pentoxifylline significantly reduced IL-1β and MDA levels and improved histopathological scores, while pentoxifylline also increased IL-10 levels, indicating enhanced anti-inflammatory activity. In contrast, dexpanthenol demonstrated a more limited effect, with significant improvement observed only in MDA levels. Combination therapies did not demonstrate superiority over monotherapy. These findings suggest that pirfenidone and pentoxifylline may have potential as adjunctive therapeutic options for limiting cavernosal tissue injury and preserving erectile function in ischaemic priapism.

Aim: This study aimed to perform a descriptive evaluation of serum periostin levels in newly diagnosed, treatment-naive multiple myeloma (MM) patients and to explore short-term changes following induction therapy. Methods: Between May 2020 and May 2021, patients diagnosed with MM and healthy volunteers were recruited from the Hematology Unit of the Faculty of Medicine, Necmettin Erbakan University. Demographic characteristics, MM-related clinical findings, and treatment response data of the patients were documented. Serum periostin levels in MM patients before treatment were compared with those in healthy controls. Additionally, baseline periostin levels in the patient group were compared with post-treatment values. Results: Thirty-six MM patientswere included in our study (17 females, 47.2%; 19 males, 52.8%), with an average age of 63.11±12.13 years. The control group consisted of 18 males (50%) and 18 females (50%), with a mean age of 61.94±10.53 years. Serum periostin levels were significantly elevated in the MM group compared with controls healthy (25.25 ng/mL vs. 14.84 ng/mL, p<0.001). No statistically significant associations were observed between baseline periostin levels and disease stage, cytogenetic risk groups, survival, or treatment response. In the 28 patients who completed induction chemotherapy, the median periostin value decreased from 24.96 (11.21-94.87) ng/mL at diagnosis to 17.97 (3.16-47.7) ng/mL after three courses of treatment (p<0.001). Conclusion: In MM patients, serum periostin levels were elevated at diagnosis and decreased significantly following induction therapy. This study is the first to demonstrate a significant reduction in periostin levels after induction therapy in MM. These findings should be considered preliminary and hypothesis-generating. Larger, well-designed studies are required to clarify the clinical relevance of periostin in MM.

Ischaemic priapism is a urological emergency in which sustained cavernosal veno-occlusion produces progressive hypoxia, acidosis, smooth muscle compromise, and ultimately corporal fibrosis. Cavernosal injury is not confined to the ischaemic phase, as reperfusion following detumescence may further amplify tissue damage through oxidative stress, inflammatory activation, and endothelial dysfunction; adjunctive pharmacological strategies targeting this early reperfusion phase remain insufficiently characterised. This study was designed to evaluate and compare the acute effects of pirfenidone, pentoxifylline, dexpanthenol, and selected combination regimens on biochemical and histopathological markers of cavernosal injury in a rat model of ischaemic priapism-related ischaemia–reperfusion injury. Sixty-eight adult male Wistar albino rats were randomly allocated into seven groups: Sham, Control/IRI, pirfenidone, pentoxifylline, dexpanthenol, pirfenidone+dexpanthenol, and pentoxifylline+dexpanthenol. Ischaemic priapism was induced using a vacuum-assisted constriction-band model followed by a one-hour reperfusion period. Serum IL-1β, IL-10, malondialdehyde, and endothelial nitric oxide synthase levels were measured, and cavernosal tissues were evaluated by semi-quantitative histopathological scoring. Group comparisons used parametric or non-parametric tests with multiplicity adjustment. The study protocol was approved by the Animal Experiments Local Ethics Committee of Necmettin Erbakan University KONÜDAM Experimental Medicine Application and Research Center (22 December 2023; No. 2023-060). All procedures complied with institutional animal-care guidelines, and the study is reported in accordance with ARRIVE 2.0. Sixty-seven animals were included in the final analysis. Relative to the Sham group, the Control/IRI group exhibited significantly elevated IL-1β, IL-10, malondialdehyde, and endothelial nitric oxide synthase levels alongside marked histopathological injury, confirming successful model induction. Pirfenidone significantly attenuated IL-1β and malondialdehyde levels and improved the composite pathology score. Pentoxifylline significantly reduced IL-1β, IL-10, malondialdehyde, and endothelial nitric oxide synthase levels and similarly improved the composite pathology score. Dexpanthenol attenuated malondialdehyde levels but did not consistently improve endothelial nitric oxide synthase or overall histopathological injury. Combination regimens produced endpoint-specific effects without consistently surpassing the corresponding monotherapies. Pirfenidone and pentoxifylline attenuated selected biochemical and histopathological components of acute cavernosal ischaemia–reperfusion injury in this experimental model. These findings are hypothesis-generating; additional studies incorporating long-term erectile function assessment, fibrotic remodelling markers, and pharmacokinetic evaluation are warranted to clarify the translational relevance.

Background: Ischaemic priapism may cause irreversible cavernosal injury through hypoxia, oxidative stress, inflammation, endothelial dysfunction, and fibrotic remodelling. Adjunctive pharmacological strategies targeting early cavernosal ischaemia–reperfusion injury remain insufficiently defined. Objectives: To compare the acute effects of pirfenidone, pentoxifylline, dexpanthenol, and their combinations in a rat model of ischaemic priapism-related cavernosal ischaemia–reperfusion injury. Materials and Methods: Sixty-eight adult male Wistar albino rats were allocated to seven groups. Ischaemic priapism was induced using a vacuum-assisted constriction-band model followed by reperfusion. Serum IL-1β, IL-10, MDA, and eNOS levels and semi-quantitative cavernosal histopathology scores were evaluated. Results: Sixty-seven animals were analysed. Control/IRI increased IL-1β, IL-10, MDA, eNOS, and histopathological injury. Pirfenidone reduced IL-1β and MDA and improved total pathology scores. Pentoxifylline reduced IL-1β, IL-10, MDA, and eNOS with accompanying histopathological improvement. Dexpanthenol reduced MDA only. Combination regimens showed endpoint-specific effects without consistent superiority over monotherapy. Discussion: Pirfenidone and pentoxifylline attenuated selected acute biochemical and structural injury pathways, whereas dexpanthenol showed limited pathway-specific activity. Conclusion: Pirfenidone and pentoxifylline warrant further investigation as adjunctive strategies for limiting early cavernosal injury after ischaemic priapism.

Cardiovascular disorders are closely linked to metabolic syndrome and remain a leading cause of mortality worldwide, despite advances in early detection and treatment. Adipokines, cardiokines, and myokines play critical roles in maintaining systemic metabolic homeostasis. In this study, we measured serum levels of fatty acid binding protein 4 (FABP4), follistatin-like 1 (FSTL1), irisin, and adiponectin in 243 male patients undergoing elective coronary angiography. We investigated the associations of these biomarkers with coronary artery disease (CAD) and their correlation with metabolic syndrome status. FSTL1 levels were predicted using a Particle Swarm Optimization-enhanced Adaptive Neuro-Fuzzy Inference System (PSO-ANFIS) based on artificial intelligence. Patients with CAD exhibited significantly lower FABP4 levels (p<0.0001), and low FABP4 levels emerged as an independent predictor of CAD in logistic regression analysis (odds ratio 0.903, 95% CI 0.825-0.987, p=0.025). The combination of adiponectin, FSTL1, and irisin as a biomarker strategy demonstrated high sensitivity and specificity for diagnosing metabolic syndrome (AUC = 0.92, 95% CI 0.88-0.96). Both FSTL1 and adiponectin independently correlated with metabolic syndrome (p<0.001, odds ratio 1.039, 95% CI 1.025-1.054; p<0.001, odds ratio 0.979, 95% CI 0.971-0.988, respectively). The prediction of FSTL1 levels using PSO-ANFIS supports the concept of harmonization among metabolic messengers. These findings underscore the potential of FABP4 and FSTL1 as valuable biomarkers for diagnosing metabolic and cardiovascular diseases, thereby facilitating personalized interventions targeting organokine pathways.

Background and aim: In Fabry disease (FD), primary factors such as glycosphingolipid deposition that initiate kidney damage and secondary factors that advance kidney damage to fibrosis are different. Periostin is a molecule of proven importance in renal inflammation and fibrosis. It was previously shown that periostin plays an essential role in the process leading to renal fibrosis and its expression is increased in many kidney diseases. In the present study, we aimed to reveal the relationship between periostin and Fabry nephropathy. Material-method: This cross-sectional study included 18 FD patients (10 males, 8 females) with enzyme replacement therapy (ERT) indications and 22 healthy control patients of similar age and gender. At the time of diagnosis, plasma alpha-galactosidase A (α-gal-A) and globotriaosylsphingosine (lyso-Gb3), proteinuria, and kidney function tests of all FD patients before ERT were scanned from the hospital system. Periostin was studied from serum samples collected and stored before ERT. Parameters related to serum periostin levels in Fabry disease were investigated. Results: In FD patients, serum periostin was negatively correlated with age of first symptom and GFR; and positively correlated with proteinuria and lyso-Gb3. In regression analysis, we found that serum periostin was the only independent determinant of proteinuria in patients with Fabry disease. The serum periostin levels were significantly lower in patients with low proteinuria, and the serum periostin levels were correlated with proteinuria. Discussion: Periostin may be a valuable marker of Fabry nephropathy and proteinuria. Periostin seems to be one of the molecules that may have an important role in the management of the fibrotic process in Fabry nephropathy. We think that the role of periostin among these mechanisms is worth investigating. In addition to standard ERTs, periostin-reducing therapies may contribute to better kidney survival in Fabry disease. Progressive fibrosis processes caused by periostin in patients with Fabry disease are still a hidden issue waiting to be clarified. Progressive fibrosis processes caused by periostin in Fabry patients are still a hidden issue waiting to be clarified. Resumen: Antecedente y objetivo: En la enfermedad de Fabry (EF), son diferentes los factores primarios tales como el depósito de glicoesfingolípidos que inicia el daño renal, y los factores secundarios que progresan de daño renal a fibrosis. Periostina es una molécula de importancia probada en la inflamación renal y la fibrosis. Se ha demostrado previamente que periostina juega un papel esencial en el proceso que causa la fibrosis renal, y que su expresión se incrementa en muchas enfermedades renales. En el presente estudio, nuestro objetivo fue revelar la relación entre la periostina y la nefropatía de Fabry. Material y método: Este estudio transversal incluyó 18 pacientes con EF (10 varones y 8 mujeres) con indicación de terapia enzimática (ERT) y 22 controles sanos con edad y sexo similares. En el momento del diagnóstico se escanearon del sistema hospitalario las pruebas de alfa-galactosidasa A (α-gal-A) plasmática y globotriaosilsfingosina (lyso-Gb3), proteinuria y función renal de todos los pacientes con EF antes de la ERT. Se analizó el nivel de periostina en las muestras séricas recogidas y almacenadas antes de realizar la ERT. Se investigaron los parámetros relacionados con los niveles séricos de periostina en la enfermedad de Fabry. Resultados: En los pacientes con EF, el nivel de periostina sérica se correlacionó negativamente con la edad del primer síntoma y la GFR, y positivamente con proteinuria y lyso-Gb3. En el análisis de regresión, encontramos que el nivel de periostina sérico fue el único determinante independiente de proteinuria en los pacientes con EF. Los niveles séricos de periostina fueron significativamente menores en los pacientes con baja proteinuria, correlacionándose los niveles séricos de periostina con proteinuria. Discusión: La periostina puede ser un marcador valioso de nefropatìa de Fabry y proteinuria. Periostina parece ser una de las moléculas que pueden jugar un papel importante en el manejo del proceso fibrótico en la nefropatía de Fabry. Creemos que merece investigar el papel de periostina entre estos mecanismos. Además de las ERT estándar, las terapias reductoras de periostina pueden contribuir a una mejor supervivencia del riñón en la EF. Los procesos de fibrosis progresiva causados por periostina en los pacientes con EF siguen constituyendo una cuestión poco conocida que debe esclarecerse.

Purpose: Exposure to Environmental Tobacco Smoke (ETS) remains a worldwide public health problem. The purpose of this study was to investigate the relationship between parents' smoking habits at home and children's exposure to environmental tobacco smoke by measuring urinary cotinine levels and urine cotinine/creatinine ratios in children. Materials and Methods: This case-control typed analytical study was conducted with 357 children in the 0-18 age group. The case group consisted of 180 children exposed to environmental cigarette smoke. As the control group, it consisted of 177 healthy children and non-smoking in their family. The levels of cotinine and creatinine in spot urinary were analyzed in both groups. Results: The urinary cotinine level of the children was found to be statistically higher in those whose parents were smokers, female gender, fathers with a low educational level, and those with 3 or fewer rooms in the house. The urinary cotinine/creatinine ratio of the children was found to be statistically higher in those whose parents were smokers (15.91 pg/mg (1.54-147.54) vs 7.90 pg/mg (1.29-68.52)), female gender (13.19 pg/mg (1.79-115.07) vs 10.45 pg/mg (1.29-147.54)). Urinary cotinine levels in the ETS exposed group were affected 1042 times more than in the ETS unexposed group [OR:1042,462, 95% CI (139.821.839-7772.246)]. Conclusion: In the present study, urinary cotinine levels were found to be higher in children exposed to tobacco smoke than in children not exposed to tobacco smoke. In the light of these results, urinary cotinine can be used as a biomarker to evaluate exposure to ETS in children. Educating parents is essential to raising their awareness of exposure to ETS and teaching the right behaviors to protect children's health, especially in the home environment.

OBJECTIVE Ionizing radiation (IR) has a wide area of use and its effects on human health have been discussed since its discovery. This study aimed to show oxidative stress and inflammation due to ionizing radiation exposure based on biomarkers in healthcare workers. METHOD This study was conducted with 172 people, who were exposed to IR in the work environment and those who did not have exposure to radiation. In this cross-sectional study, a data collection form was used to obtain data from the participants. In addition, 6 ml of blood was taken to measure their tumor necrosis factor (TNF)-alpha, total oxidant status (TOS), interleukin (IL)-10 and total antioxidant status (TAS) levels, and calculate their oxidative stress index (OSI) values. RESULTS In the ionizing radiation group, 50% of the participants were men, the mean age was 35.91±7.07 years, and the mean duration of employment was 9.80±7.1 years. The TOS, OSI, TNF-α and IL-10 values were higher and TAS was lower in the ionizing radiation group compared to the participants without exposure to ionizing radiation. Gender, smoking, alcohol use, presence of chronic diseases, regular medication use, antioxidant supplement use, and exposure to radiation for medical diagnosis and treatment within the last year did not affect oxidative stress and inflammation in the radiation workers. The cut-off values of the TOS, TAS, OSI, TNF-α and IL-10 biomarkers were also determined. CONCLUSION Occupational low-dose long-term exposure to ionizing radiation was found to increase oxidative stress and inflammation.