Search

Objective: Chest pain, shortness of breath, increased cardiac biochemical markers and electrocardiographic changes suggest myocarditis in the pediatric age group. We aimed to evaluate our patients with myopericarditis, retrospectively. Material and Methods: Eighteen patients who were diagnosed with myopericarditis between January 2014-December 2017 were evaluated. Results: The age of the patients ranged from 5 months to 17 years (12.8±5). Complaints were chest pain in 16 (88%) patients, fever in 1 patient, respiratory distress and reduction in effort capacity in 1 patient. Twelve patients had upper respiratory tract infection, and one patient had a scorpion injection. The number of white cells was 10045±2706/mm 3 (5900-14580); C-reactive protein was 5.3±6.3 mg/dL (0.01-19). Cardiac enzymes were higher in all patients. The mean creatin kinase myocardial band level was 36.2±11.2 ng/mL (0.8-167) and the mean troponin T was 0.61±0.15 ng/mL (0.051-2.65). The mean level of pro-B type natriuretic peptide from seven patients due to heart failure was 5.122±2.851 pg/mL (110-20.286). Cytomegalovirusimmunglobulin M in one patient and Epstein-Barr virus-immunglobulin M in two patients were positive. Rhinovirus in 5 patients and Adenovirus in 3 patients were detected in the multiplex polymerase chain reaction respiratory tract panel. Electrocardiographic (ECG) evaluation showed sinus tachycardia in 9 patients, ST-T changes in chest leads in 11 patients, and voltage drop in 6 patients. The mean ejection fraction was 68.2±2.9 (35-88). Ten patients had pericardial effusion. Three patients underwent myocardial perfusion scintigraphy and two patients underwent cardiac magnetic resonance imaging. Ten patients were treated with ibuprofen (30 mg/kg/day) and intravenous immunoglobulin (2 g/kg/24 h) was given to twelve patients who showed elevated levels of troponin T in the follow-up. A case of toxic myocarditis developed after scorpion insertion was treated with doxazosin and antivenom. On follow-up, cardiac enzymes remained high on average 6±3.1 (2-13) days. The mean duration of hospitalization was 6±3.6 (2-16) days. Conclusion: Patients with elevated cardiac enzymes and/or ECG changes should be evaluated for myocarditis. © 2018 by Türkiye Klinikleri.

Objective: In this study, we aimed to evaluate the cognitive functions in Parkinson's disease patients with using neuropsychological assessment and to identify its clinical correlates in Parkinson's disease. Methods: Thirty-three patients with idiopatic Parkinson's disease (PD) and 16 control subjects who are being followed by the Neurology Outpatient Clinic were included in this study. After evaluation of the cognitive functions by using MMSE (Mini-Mental State Examination) test, all cases with PD were divided into 2 groups: normal and mild dementia. Glucose, hemoglobin, TSH, cholesterol, homocysteine, vitamin B12 and folic acid levels were examined. Depression was excluded using geriatric depression test. Results: Memory, attention, verbal and visual fluency were evaluated with neuropsychological tests. Both Parkinson's groups demonstrated poor performance compared to the control group, but mental fluency, planning, verbal-visual memory, results of Trail Making Test A and counting backwards were worse in the mild dementia group. Significant difference was found between control and mild dementia groups by orientation, mental control, abstract thinking, logical memory and visuospatial tests. According to Luria's drawing test, mental fluency, and stroop, planning and RAVEN tests, poor performance was observed in the mild dementia group when compared with the other two groups. Conclusion: MMSE test may be used to diagnose dementia in PD patients because of the correlation of MMSE scores and the other memory tests. However, due to disorders detected in verbal-visual memory, mental fluency and planning tests in patients with MMSE scores above 23, the importance of neuropsychological tests is emphasized in determining subclinical cognitive dysfunction in PD patients. Çalışmada, Parkinson hastalarında kognitif fonksiyonları nöropsikolojik testlerle değerlendirerek Parkinson kliniği ile korelasyonun gösterilmesi amaçlandı. Yöntemler: Bu çalışmaya Uludağ Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı Hareket Bozuklukları Polikliniği’nde izlenen idiopatik Parkinson hastalığı tanılı 33 hasta ve 16 sağlıklı kontrol grubu alındı. Olguların kognitif fonksiyonları MMSE (Mini-Mental State Examination- Minimental test) ile değerlendirilerek; Parkinson hastaları kognitif fonksiyonları normal olan ve hafif demansı olan hastalar şeklinde 2 gruba ayrıldı ve glukoz, hemoglobin, TSH, kolesterol, homosistein, B12 vitamini, folik asit değerleri incelendi. Geriatrik depresyon testi ile depresyon dışlandı.Bulgular: Parkinson hastaları ve kontrol grupları arasında nöropsikolojik testler ile bellek, dikkat, kelime ve şekil akıcılığı değerlendirilmiştir. Düşünce akışı, planlama, sözel-görsel bellek, Trail A ve geri sayı tekrarı testlerinde, hafif demansı olan Parkinson grubunda daha belirgin olmak üzere, her iki Parkinson grubunun kötü performans gösterdiği saptanmıştır. Oryantasyon, mental kontrol, soyut düşünme, mantıksal bellek ve vizyospasyal testlerde kontrol grubu ile hafif demansı olan Parkinson grubu arasında anlamlı fark saptandı. Luria çizim testi, Stroop, düşünce akışı, planlama, RAVEN testinde hafif demansı olan Parkinson grubunda diğer iki gruba göre kötü performans görüldü.Sonuç: MMSE skorlariyla bellek testlerinin korelasyon göstermesi nedeniyle Parkinson hastalarında demans tanısında MMSE testinin kullanılabileceğini; ancak MMSE skoru 23 ve üzeri olan Parkinson hastalarında sözel-görsel bellek, düşünce akışı ve planlama testlerinde bozuklukların saptanması, PH’da subklinik gelişen kognitif bozukluğun tanımlanmasında nöropsikolojik testlerin önemini göstermiştir.

Objective: Cheyne Stokes respiration (CSR) is frequently seen in the patients with heart failure (HF) and it increases mortality. In the present study, we aimed to evaluate acute effects of adaptive servo ventilation (ASV) on CSR and neurohormones in the patients with HF. Methods: Nineteen males and 1 female patients with HF in the functional capacity of NYHA II-III were included into the study prospectively. One night polysomnography (PSG) was performed to all patients. In addition to medical treatment, 10 patients having CSR were applied ASV in another night together with PSG.. Arterial blood gases, plasma epinephrine and norepinephrine, serum N-terminal -pro-B type brain natriuretic peptide (NT-pro-BNP) were studied in the first night and after ASV treatment. A Wilcoxon test was used for comparison of parameters before and after treatment; and Mann-Whitney-U test was used for comparison of parameters between the patients with CSR and without CSR. Results: Mean age of 10 patients with CSR was 62.2±11.1 years. Their etiologies were ischemic in 9 patients and idiopathic dilated cardiomyopathy in 1 patient. While there were no significant differences in the levels of PaCO2, HCO3, PH, before and after treatment; PaO2 (75.3 mmHg) and SatO2 (94.7%) significantly increased after the therapy (84.7 mmHg, 96.5% and p=0.007 and p=0.008 respectively). While NT-proBNP (3029.6±1450.5 pg/ml), norepinephrine (625.4±304.7 pg/ml) and epinephrine (65.4±24.1 pg/ml) were higher than normal before ASV treatment, all of them showed significant reductions after treatment (1694.0±925.9 pg/mvl, 333.9±165.4 pg/ml and 45.0±20.5 pg/ml; p=0.005, p=0.005 and p=0.02, respectively). Conclusions: One night ASV treatment improves CSR, partial pressure of oxygen in arterial blood, and oxygen saturation and provides significant reductions in plasma catecholamines and NT-proBNP levels in the patients with HF and CSR. Prospective studies are needed to evaluate long-term effects of ASV treatment on morbidity and mortality in the patients with HF. © Copyright 2009 by AVES Yayincilik Ltd.

Objective: Ceruloplasmin is a protein in the human serum that is synthesized by hepatocytes, but extrahepatic gene expression in the brain, lung, spleen, and testis has also been reported. Ceruloplasmin contains approximately 95% of serum copper and it carries copper from liver to numerous tissues. Ceruloplasmin level reflects largely the copper concentration of the serum. However, ceruloplasmin has also an antioxidant function that is known as the acute phase reactant. Additionally, ceruloplasmin has a role in the oxidation of serotonin, epinephrine, and norepinephrine. Abnormalities in ceruloplasmin levels have been associated with several neurodegenerative diseases. Moreover, the alteration of plasma ceruloplasmin levels has been linked to schizophrenia and its some clinical characteristics including acute or chronic phase, the length of the disease or whether the patients on treatment or not. However, there exists a controversy on relationship between the plasma level of ceruloplasmin and schizophrenia. There are number of reports on the increased or decreased and/or normal level of plasma ceruloplasmin in association with schizophrenia. These differences may have been originated from the usage of different measurement methods, clinical situations, and ethnobiological differences. In the present study, we aimed to investigate the association between plasma ceruloplasmin level and schizophrenia in Turkish patients. Methods: 60 patients (36 women and 24 men, mean of age 31.93±9.37 years, range 19-55) that were diagnosed as schizophrenia according to DSM-IV were included for this study at the Psychotic Disorders Unit, Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey. The control group consisted of 40 healthy subjects in similar age and gender (23 women, 17 men). Venous blood samples were collected from the left forearm into heparinized tubes. The blood samples were centrifuged and the plasma was removed. Erel's ceruloplasmin measurement method that is based on the enzymatic oxidation of ferrous ions to ferric ions was used. SPSS Windows program 13.0 was applied for statistical analysis. Results: Plasma ceruloplasmin levels of schizophrenic patients were significantly higher than the healthy controls (p