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Prophylactic therapy response varies in migraine patients. The present study investigated the relationship between the resistance to the drugs commonly used in prophylactic therapy and the possible polymorphic variants of proteins involved in the metabolism of these drugs. Migraine patients with the MDR1 3435TT genotype exhibited a better treatment response to topiramate than migraine patients with the CC and CT genotypes ( p =0.020). The MDR1 C3435T polymorphism was also found to be a higher risk factor for topiramate treatment failure in a comparison of the number of days with migraine ( β 2 =1.152, p =0.015). However, there was no significant relationship between the treatment response to topiramate and either the CYP2D6 or CYP2C19 polymorphism, and there were no significant correlations between the treatment responses to amitriptyline, propranolol, and valproic acid and the MDR1 , CYP2D6 and CYP2C19 gene polymorphisms. This is the first study to investigate the effect of the polymorphic variants on prophylactic therapy response in migraine patients.

OBJECTIVE: Anatomical variations of the extrahepatic biliary tree are frequently seen and may cause challenging conditions for surgeons. We aimed to investigate the morphological variations of the gall-bladder in patients who underwent cholecystectomy and their effects during and after the surgery, by using a new anatomical classification. PATIENTS AND METHODS: Dissection time, perioperative bleeding, perioperative/postoperative complication rates, the difference between preoperative/postoperative hematocrit and leukocyte levels of 164 symptomatic cholelithiasis patients who underwent laparoscopic cholecystectomy were evaluated. The patients' gallbladders were categorized in "seven" different types regarding their anatomical positions and morphometric relations with the liver's acute margin and fossa of the gallbladder. Relations between these gallbladders types and perioperative/postoperative parameters were also examined. RESULTS: The median time to complete the dissection of the gallbladder from the fossa was 375.5 seconds. The mean length of the fossa was 68.06 +/- 15.08 mm, the average size of the gallbladder was 92.10 +/- 18.79 mm. A positive correlation was found between dissection time and length of fossa vesica and also in the size of the gallbladder (p = 0.003, p = 0.034). Moreover, a positive correlation was found between the dissection time and the perioperative perforation risk of the gallbladder (p = 0.005). The most common type of gallbladder was type I and III (23.2%). The least common gallbladder type among the patients assessed as part of the study was type VI (6.7%). When the gallbladder types were compared, the perioperative perforation rate of the gallbladder wall was found to be significantly higher in morphological type V (p = 0.014). CONCLUSIONS: The perioperative perforation rate of the gallbladder wall was found significantly higher in morphological type V. To perform a safe cholecystectomy, surgeons should be aware of anatomical variations of the gallbladder and its relations with the liver parenchyma, which are important for surgical strategies.

Background: Contrast induced nephropathy (CIN) has been proven to be a clinical condition related to adverse cardiovascular outcomes. In recent studies, the monocyte to high density lipoprotein ratio (MHR) has been postulated as a novel parameter associated with adverse renal and cardiovascular outcomes. In this study we investigated the association of MHR with CIN in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods: Consecutive STEMI patients treated with primary PCI were prospectively recruited. Subjects were categorized into two groups; as patients who developed CIN (CIN+) and patients who did not develop CIN (CIN–) during hospitalization. CIN was defined as either a 25% increase in serum creatinine from baseline or 44.20 µmol/L increase in absolute value, within 72 h of intravenous contrast administration. Results: A total number of 209 patients were included in the study. Thirty-two patients developed CIN (15.3%). In the CIN (+) patients, monocytes were higher [1.02 (0.83–1.39) vs. 0.69 (0.53–0.90) 109/L, p9/mmol, p Conclusions: Higher MHR levels may predict CIN development after primary PCI in STEMI patients.

Bu araştırmada, Dr. Damla Özyurtlu ve Dr. Muhammet Okay Örün birlikte ve öncelikli olarak çalışmış ve makaleye eşit katkı sağlamışlardır. Gelişmekte olan ülkelerde Vitamin B12 ve folik asit eksikliği önemli bir halk sağlığı sorunudur. Vitamin B12 ve folik asit eksikliğinin bilişsel fonksiyonlar üzerinde olumsuz etkileri olduğu, demans gelişim riskinde artış ile ilişkili olduğu bilinmektedir. Hematolojik tutulum olmadan da nörolojik tutulumun olabileceği bilinmektedir. Bu çalışmada vitamin B12 ve folik asit eksikliğinin hematolojik parametreler ve bilişsel performans üzerindeki etkisinin araştırılması amaçlanmıştır. Çalışmaya 2011-2013 yılları arasında unutkanlık yakınması ile Uludağ Üniversitesi Tıp Fakültesi Nöroloji Polikliniği’ne başvuran 235 olgu dahil edildi. Vitamin B12 ve folik asit düzeylerinin hematolojik parametreler ve bilişsel durum üzerine etkisi retrospektif olarak incelendi. Serumda düşük vitamin B12 düzeyinin bilişsel performans üzerine anlamlı bir etkisi olmadığı görüldü. Ancak yaş gruplarındaki vitamin B12 ve folik asit düzeyleri ele alındığında, ileri yaştaki hastalarda folik asit eksikliğinin, diğer yaş gruplarından daha sık olduğu görüldü (p=0,044). Vitamin B12 ve folik asit eksikliğinin ileri yaştaki hastalarda gözlenebileceği, bu vitaminlerin eksikliği sonucu ortaya çıkan kalıcı nörolojik hasarların tedaviyle önlenebilir olduğuna dikkat çekilmiştir. Vitamin B12 and folic acid deficiency is an important public health problem in the developing countries. It is well known that vitamin B12 and folic acid deficiency has negative effects on cognitive functions and is associated with increased risk for dementia. This situation only doesn’t effect the hematological system, it also effects neurological system without hematological involvement. The purpose of this study was to investigate the effects of these vitamins on hematological parameters and cognitive performance. Between 2011-2013 years, 235 patients who referred to the Uludag University Neurology policlinic with complaint of forgetfullness were investigated retrospectively. There was no statistical relation between low blood vitamin B12 and folic acid levels and cognitive performance. In the older age groups folat deficiency was more common when compared with younger age patients and this was statistically significant ( p=0,044). Vitamin B12 and folic acid deficiency can be observed especially in the elderly people, and permanent neurological deficits secondary to this deficiency could be easily prevented by vitamin replacement.