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Nonketotic hyperglycemia (NKH) usually involves frequent seizures up to 25%, and these seizures are the first finding of diabetes mellitus in 50% of the patients. The most common seizure type is reported as epilepsia partialis continua (EPK), and some occipital lobe seizures and aphasic seizures may also be seen in these patients. The recovery from seizures by the correction of hyperglycemia. The cranial magnetic resonance imaging (MRI) findings associated with both status epilepticus (SE) and seizures induced by hyperglycemia have been described; however, their significance and underlying mechanisms have not been understood. Although consensus has been reached on the acute treatment of SE, insufficient information is available on the long term or maintenance treatment, especially in SEs with acute symptoms. This study aimed to report and discuss the cranial MRI findings of a patient with NKH who was diagnosed with nonconvulsive status epilepticus in the light of the literature. [ABSTRACT FROM AUTHOR]

Acute periictal imaging abnormalities caused by status epilepticus (SE) have been reported in recent years. In this study, periictal magnetic resonance imaging (MRI) changes, follow-up MRIs and electroencephalographic (EEG) features (e.g. periodic lateralized epileptiform discharges [PLEDs]) of 4 patients with SE were discussed. Diffusion restriction was the most common periictal MRI change (4/4) and it tended to resolve (3/4). Permanent MRI changes were seen in two patients. Patients with SE and periictal MRI changes mostly had PLEDs in EEG (3/4) and poor outcomes (3/4). [ABSTRACT FROM AUTHOR]

Skull base osteomyelitis (SBO) typically presents with severe otalgia and unilateral otorrhea in immune-compromised, particularly in elderly diabetic patients. Skull base osteomyelitis usually presents with external otitis but it can also occur as a complication of acute otitis media and mastoiditis. Complications of SBO are venous sinus thrombosis, meningitis, abscess, cranial neuropathies and carotid invasion with or without ischemic stroke. Here we report a case with SBO presenting with facial paralysis, lower cranial nerve palsies and bilateral carotid involvement which occurred following sore throat and bilateral otalgia. [ABSTRACT FROM AUTHOR]

Background. Diabetic patients exhibit platelet hyperreactivity, which renders them resistant to antithrombotic treatments. We aimed to investigate the prevalence and predictors of aspirin resistance in diabetic patients. Material and methods. A total of 93 diabetic and 37 non-diabetic participants were included into the study. Aspirin resistance was measured with a whole-blood desktop platelet function analyzer (PFA-100) with an epinephrine agonist. Results. Altogether 41.9% patients with DM were aspirin non-responders. Aspirin resistance was observed in 43.2% of non-diabetic patients ( p = 0.89). Presence of diabetes mellitus had no effect on aspirin response (RR 0.95 (95% CI 0.44-2.05), p = 0.89) in the whole study population. Hypercholesterolemia was the only predictor of aspirin resistance in multivariate analysis in diabetic patients (RR 3.09 (95% CI 1.17-8.16), p = 0.023). Conclusion. The prevalence of aspirin resistance is comparable in diabetic and non-diabetic patients. Hypercholesterolemia is the only independent predictor of aspirin resistance in diabetic patients. [ABSTRACT FROM AUTHOR]

Lennox-Gastaut syndrome (LGS) is an epileptic encephalopathy characterized by several types of seizures, special EEG patterns, and cognitive deterioration with resistance to therapy and poor prognosis. It is a well known phenomenon that some antiepileptic drugs (AED) have a worsening effect on some seizure types, especially in the generalized epilepsies of childhood. However, its underlying pathogenetic mechanisms are not fully understood. In this paper, a case with LGS who developed tonic status epilepticus induced by diazepame given intravenously is reported and the topic of seizure aggravation caused by AED and LGS is discussed. [ABSTRACT FROM AUTHOR]

Stiripentol (STP), a recent antiepileptic drug, has been approved for use in addition to valproat (VPA) and clobazam in Dravet syndrome. On the other hand, the incidence of sudden unexpected death in epilepsy (SUDEP) commonly seen in patients with intractable epilepsy, is high in patients with Dravet yndrome. In our case, who was resistant to polytherapy and had multiple cardiopulmonary arrest due to status epilepticus (SE) or intravenous diazepam; STP was used in combination with other antiepileptic drugs (AED). However, acute reversible encephalopathy developed after six months of therapy. It is argued that the condition may have been caused by hyperamonnemia due to pharmacokinetic interaction between VPA and STP. Treatment options and protective measures are discussed using recent literature on Dravet syndrome, SUDEP and STP. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Mood Disorders is the property of Yerkuere Tantim ve Yayincilik A.S. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Brucellosis is a zoonotic disease, especially in endemic regions all over the world, it is a common infectious disease. However, brucellosis borne thyroid gland infection is quite rare. The purpose of this study is to draw attention to the thyroid abscess borne due to brucella, which also show an unusual clinical graphic. Within this study we aim to represent a case with thyroid abscess dominated Brucella spp. [ABSTRACT FROM AUTHOR]

Malignancy is an important cause of mortality in acromegaly. Hematological malignancies are very rare in acromegaly. Here, we report an 80-year-old patient with acromegaly and multiple myeloma. Patient died within a month of diagnosis. Previous studies have shown that growth hormone and somatomedin-C activate B lymphocyte and somatomedin-C receptors are found in multiple myeloma cells. Possible effects of growth hormone and somatomedin-C on multiple myeloma progression are discussed in the light of the relevant literature. [ABSTRACT FROM AUTHOR]

Thyrotoxic hypokalemic periodic paralysis is a rare complication of thyrotoxicosis. This clinic condition is often encountered in Asian populations and male gender while thyrotoxicosis is frequently seen in women. The escape of potassium into cell is the mechanism responsible for this disease and its etiology is not completely known. Thyroid hormones, carbohydrate rich diet, alcohol consumption and excessive exercise are regarded as the precipitating factors. This clinical picture is generally difficult to define at first attack. Here, we report a forty-two-year-old male patient with Basedow- Graves disease who was diagnosed as having thyrotoxic hypokalemic periodic paralysis during the first paralytic attack. His symptoms improved after potassium replacement and treatment with beta-blocker and antithyroid drugs. The permanent cure was achieved with radioactive iodine ablation therapy. [ABSTRACT FROM AUTHOR]

Fibrolamellar carcinoma of the liver is a variant of hepatocellular carcinoma. It is relatively common in young people and has equal gender distribution. The disease presents as abdominal pain, weight loss and malaise. In several reports of fibrolamellar liver tumors, high cobalamin level has been demonstrated in the human's serum. Therefore, serum cobalamin has been found as a good tumour marker for fibrolamellar hepatocellular carcinoma. Elevated production or decreased elimination of haptocorrin may play an important role for this phenomen. For early fibrolamellar carcinoma, surgical resection, when feasible, is the gold standard for the treatment. In advanced stage of the disease; single-modality treatments (recombinant interferon á-2b or sorafenib) can be tried. Herein, we report a case of metastatic fibrolamellar hepatocellular carcinoma that was presented with high vitamin B12 levels and continued subcutaneous recombinant interferon á-2b thrice-weekly. [ABSTRACT FROM AUTHOR]

Primary testicular lymphomas are rare malignancy. We discussed the patient who had referred with mass into left testis at 73 years old diagnosis as diffuse large B-cell testicular lymphoma. Systemic chemotherapy (R-CHOP) was given to the patient. Prophylactic radiotherapy was performed for the contralateral testis and central nervous system. Complete remission was achieved in the patient. [ABSTRACT FROM AUTHOR]

Background: To date, it has been suggested that there may be many genetic, environmental, and vascular factors that affect hand preference. In previous studies evaluating the relationship between cerebral dominance and hand preference, carotid and vertebral artery (VA) Doppler ultrasonography (USG) was generally preferred; and these studies only measured VA diameters. Unlike other studies, we aimed to reevaluate the relationship between hand preference and cerebral vascular dominance by measuring VA and internal carotid artery (ICA) diameters. In addition, we used carotid and VA computed tomography (CT) angiography instead of Doppler USG.Methods and Material: A total of 345 participants were included in the study. The results of carotid and VA CT angiography taken during hospitalization were retrospectively evaluated by two radiologists, and the Edinburgh Hand Preference Questionnaire was applied to these patients.Results: In right-handed patients, the diameter of the left VA was significantly larger than the diameter of the right VA (p = 0.005). In left-handed patients, the diameter of the left ICA was larger than the diameter of the right ICA, but the difference was not statistically significant (p = 0.055). There was no significant difference between the diameter of the right and left ICA in right-handed patients (p = 0.771).Conclusions: In our study, we found a correlation between the dominant hemisphere VA diameter and hand preference. Using CT angiography, we were able to eliminate many challenges of ultrasonography that make radiological evaluation difficult, such as differences of opinion between radiologists, and technical and anatomical reasons. [ABSTRACT FROM AUTHOR]

• Immediate switch from SCBs to LCM is safe and tolerable with good response rates in both focal- and generalized-onset seizures. • The likelihood of a successful switch is higher in patients when the reason for the switch is AEs. • Immediate switching seems like a preferable option with a decreased risk of AEs. Lacosamide (LCM) is a new-generation anti-seizure medication approved for monotherapy and add-on therapy for focal-onset epilepsy. It has novel pharmacodynamics and favorable pharmacokinetic qualities with good clinical response. This study aims to evaluate the effectiveness and tolerability of LCM when used in the immediate switch from sodium channel blockers in patients with focal-onset and generalized-onset epilepsies. This retrospective, multicenter observational study was conducted with adult patients who received LCM as mono- or polytherapy through immediate switch with 6 to 52 months follow-up. The clinical data obtained during the follow-up period were analyzed to assess retention rate, seizure freedom, more than 50% seizure reduction, and adverse effects. A total of 32 patients (eight females, 24 males) with a median age of 49.75 (range, 23–86) years, median age at epilepsy onset of 32.58 (range, 0.5–85) years, and median epilepsy duration of 17.17 (range, 1–46) years were included in this study. Seizure frequency was between 1 and 90 in the past 6 months. Seven (21.9%) of the patients had structural brain lesions and 27 (84.4%) of the patients had EEG abnormalities. The adverse effects leading to switching were hyponatremia, rash, elevated liver enzymes, pain, and erectile dysfunction. At 14.34 (range, 6–52) months follow-up, 30 (93.75%) patients in total retained LCM, 20 (66.7%) of them were seizure-free, and 13 were on LCM monotherapy. Responder rate was 81.25%. Eight (25%) of the patients experienced adverse effects after the immediate switch. One patient with generalized-onset epilepsy needed to quit LCM due to an increase in seizures. Seizure frequency did not change in three patients in the focal-onset group. Immediate switch to LCM showed favorable outcomes with a significant reduction in seizure frequency, high retention rates, and tolerable adverse effect profiles in both focal-onset and generalized-onset seizures. [ABSTRACT FROM AUTHOR]

Transthyretin-related familial amyloid polyneuropathy (TTR-FAP) is an autosomal dominant disorder caused by mutations of the transthyretin (TTR) gene. The mutant amyloidogenic transthyretin protein causes the systemic accumulation of amyloid fibrils that result in organ dysfunction. TTR-associated FAP is a progressive and fatal disease, if left untreated, and should be considered in the differential diagnosis of any person presenting with a progressive polyneuropathy, particularly with accompanying autonomic involvement. The clinical, electrophysiological, histopathological, and genetic characteristics of 17 patients from Turkey (5 female, 13 male) from nine families with polyneuropathy and mutations in TTR were evaluated. Sequence analysis of the TTR gene revealed five mutations (Val30Met, Glu89Gln, Gly53Glu, Glu54Gly and Gly47Glu). Mean age at disease onset was 40.4 ± 13.9 years (range 21–66 years). The most commonly reported initial complaint was paresthesia in the feet (asymmetric in three patients). Three patients (2 male) with the Glu89Gln mutation presented with carpal tunnel syndrome. Two patients with the Gly53Glu mutation showed episodes of dysarthria and hemiparesis, consistent with this genotype. Seven patients died during the period of follow-up as a result of systemic involvement. Our study suggests that a cohort of patients from Turkey with TTR-FAP exhibits clinical and genetic heterogeneity. [ABSTRACT FROM AUTHOR]

Introduction: Major depressive disorder (MDD) is an important risk factor for cardiovascular mortality and morbidity. Red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) can be obtained with a basic hemogram test. These parameters have been found as a predictor of mortality in the general population and in several diseases such as cardiovascular disease. Methods: Our study included 100 patients with newly diagnosed MDD and 100 healthy control patients (who had no depressive symptoms and without heart disease) admitted to our outpatient clinics. Patients with MDD were started on selective serotonin reuptake inhibitor (SSRI) treatment and followed up for 3 months. Both MDD and control patients' laboratory tests and physical, neurological, and psychiatric examinations were performed both at diagnosis and after 3 months of treatment. Results: In total, 100 patients with MDD were evaluated and 80 were included in our study. The control group consisted of 91 healthy individuals. The mean age was 44 ± 10.6 years for patients with MDD and 39.8 ± 11.4 years for the control group. There was no significant difference between the age for groups ( P = 0.13); 55% of patients with MDD and 33% of the control group was male. NLR levels were found to be 2.55 ± 0.7 and RDW levels were found to be 14.3 ± 2.6 in patients with MDD; NLR levels were found to be 1.41 ± 0.8 and RDW levels were found to be 13.4 ± 1.8 in the control group. RDW and NLR levels were significantly higher in patients with MDD compared to the control group. The significant difference between the levels of RDW and NLR in patients with MDD and the control group was dissolved after SSRI treatment ( P < 0.001). RDW [median 14.3, interquartile range (IQR) 2.8 vs. median 13.25, IQR 2.45; P < 0.001] and NLR (median 2.3, IQR 1.1 vs. median 2.0, IQR 1.15; P < 0.001) levels were significantly higher in patients with MDD compared to the control group. Conclusion: Our study showed that hematological inflammatory markers might be useful parameters that can be used in patients with MDD for coronary artery disease risk. Specifically, RDW and NLR seem to be more hopeful. Advanced, detailed, and larger studies are needed. [ABSTRACT FROM AUTHOR]

Background and Objectives : Studies have shown that inflammation markers can be used as prognostic tools in predicting acute ischemic stroke. In this study, we conducted a comparison of several inflammation scores in predicting left atrial thrombosis (LAT) in patients with ischemic stroke without AF. Materials and Methods : In this single-center, retrospective study, we included 303 consecutive patients with ischemic stroke. Each patient underwent a transesophageal echocardiography (TEE) examination within 10 days of admission to detect the presence of LAT. To identify independent predictors of LAT, we conducted a multivariate logistic regression analysis. Results : In total, 303 patients who had ischemic stroke were included in the analysis. LAT was detached in 34 patients at the time of the TEE examination. The patients were categorized into two groups based on their LAT status. The Prognostic Nutritional Index (PNI), HALP score, and C-reactive Protein-Albumin Ratio (CAR) were identified as statistically significant predictors of LAT. Based on the results of the multivariate regression analysis, the CAR emerged as the only independent predictor of LAT. Conclusions : Among several inflammation scores, the PNI, HALP, and CAR were statistically significant predictors of LAT in ischemic stroke patients without AF. CAR was identified as the optimal score for the prediction of LAT in patients with stroke and without AF.