Search

Context: This study evaluated the diagnostic accuracy of repetitive nerve stimulation (RNS) compared with single-fiber electromyography (SF-EMG) in generalized myasthenia gravis (MG). Aims: The aim of the study was to determine the diagnostic sensitivity of RNS in various muscles and assess the effect of varying decrement cutoff values on diagnostic efficacy. Setting and Design: This was a prospective study of 34 confirmed generalized MG patients. Subjects and Methods: RNS was performed on five muscles. Clinical features, autoantibody presence, and SF-EMG jitter rates recorded from the frontalis muscle were analyzed. Patients were classified according to the MG Foundation of America classification. Statistical Analysis: SPSS version 23 was used for descriptive statistics, comparisons of categorical and quantitative data, and correlation analysis, with the significance level set at P < 0.05. Results: Among the patients (58.8% males and mean age = 59.47 ± 13.37 years), SF-EMG detected increased jitter in 91.2%, whereas RNS identified a significant decrease of 50% across at least one muscle. The decremental response was >10% in the abductor digiti minimi (ADM), trapezius, nasalis, abductor pollicis brevis, and extensor indicis proprius muscles in 5.9%, 26.5%, 29.4%, 11.8%, and 29.4% of patients, respectively. A sensitivity improvement at lower decrement values was observed only in the ADM muscle. A significant correlation was found between decreases in the trapezius muscle and seropositivity. Conclusions: Optimal muscle selection improves RNS diagnostic accuracy in MGs. The study recommends incorporating the spinal accessory and radial nerves in RNS due to their high sensitivity, although modifying the decrement cutoff value has a limited overall effect.

Objective: Previous research suggests that high levels of fibrinogen and low levels of albumin are associated with the occurrence of ischemic stroke and the severity of the disease. As a recently described rational parameter, the fibrinogen-to-albumin ratio (FAR) has been studied in several conditions associated with inflammation and pro-coagulation, such as retinal venous occlusion, coronary artery disease, and cancers. This study aims to research the usefulness of FAR when diagnosing ischemic stroke and the prediction of its severity and prognosis. Materials and Methods: The study involved 52 patients with acute ischemic stroke and 39 control cases between the ages of 18 and 80. The demographics, medical history, primary diagnosis, examination findings, imaging findings, and laboratory tests of all patients were derived from our hospital records. Stroke severity was classified into three groups: mild, moderate, and severe. The FAR values were compared between the stroke and control groups and between the stroke severity groups. For statistical analysis, SPSS 23.0 (IBM) was used, and P < 0.05 was considered significant. Results: Fibrinogen levels and FAR values were significantly higher and albumin levels lower in the patients with stroke than in the control group (P < 0.001). The FAR cut-off value was 6.65 for the diagnosis of acute ischemic stroke; it was more sensitive and specific than albumin and fibrinogen. There were no significant differences between the severity stages of stroke, the etiologic subgroup of stroke, length of hospitalization, and short-term prognostic effect on patients with stroke in terms of FAR, fibrinogen, and albumin (P > 0.05). Conclusion: This study suggests that FAR would be an innovative, sensitive, and specific diagnostic marker for patients with acute ischemic stroke. However, it would be insufficient to predict stroke severity, etiology, and short-term prognosis.

Aim: Fibrinogen and albumin are proteins that play a role in inflammation. In this study, it was aimed to investigate the role of fibrinogen, albumin, and fibrinogen/albumin ratio (FAR) levels as markers of disease severity and prognosis in coronavirus disease 2019 (COVID-19) patients. Material and Methods: Seventy-one patients aged between 19 and 84 years diagnosed with COVID-19 who were hospitalized in Sakarya University Training and Research Hospital, Neurology Department between March and May 2020 were analyzed retrospectively. Fibrinogen, albumin, FAR, D-dimer, platelet, and C-reactive protein (CRP) levels of the patients were compared according to the length of hospitalization duration, survival, and clinical severity of COVID-19. Results: Twenty-eight (%39.4) of the patients were male and 43 (%60.6) were female, and the mean age was 55.7±20.7 years. There was a significant difference between the groups of COVID-19 clinical severity in terms of age, fibrinogen, albumin, FAR, D-dimer, and CRP values (all p values were

Özet Amaç Bu çalışmada hastane başvurularında özellikle depresif bozukluk, yaygın anksiyete bozukluğu, baş ağrısı bozuklukları ve fibromiyalji sendromu gibi stres temelinde gelişen hastalık tanıları alan vakaların cinsiyet faktörünün reproduktif yaş aralığındaki mukayeseli istatiksel analizini yapmak amaçlanmıştır. Yöntem Çalışmada bir kamu hastanesine üç ayda başvuran 20-45 yaş aralığındaki hastaların retrospektif olarak hasta kayıt bilgileri taranmış, başvurdukları poliklinikler, yaş aralıkları, aldıkları tanılar, medeni durumları kaydedilmiş ve bu parametrelerle sistematik veri analizi yapılmıştır. Nitel araştırma yöntemlerinden durum çalışması deseni araştırmanın yöntemi için seçilmiştir. Bulgular Psikiyatri polikliniğine başvuran 20-45 yaş arası depresyon tanısı alan hastaların %70’i kadınlardan %30’u erkeklerden, anksiyete tanısı alan hastaların %69’u kadınlardan %31’i erkeklerden oluşmaktadır. Fibromiyalji sendromu tanısı alan hastaların %93’ü kadınlardan %7’si erkeklerden oluşmaktadır. Nöroloji polikliniğine başvuran 20-45 yaş arası baş ağrısı bozukluğu tanısı alan hastaların %66’sı kadınlardan %34’ü erkeklerden oluşmaktadır. Medeni hal özelinde incelendiğinde evli kadınların bahsi geçen stres temelli hastalık tanılarını daha fazla aldığı izlenmektedir. Evli kadınların en sık depresyon, ikinci sıklıkta baş ağrısı tanısı, üçüncü sıklıkla anksiyete bozukluğu tanıları aldıkları gözlenmektedir. Sonuç Reproduktif yaş aralığında kadınların erkeklere kıyasla hastaneye başvuru ve strese bağlı hastalık tanıları almasındaki yoğunluk kadının fiziksel, ruhsal ve sosyodemografik etkenlerden çok daha fazla etkilendiği ve psikolojik açıdan 30-35 yaş aralığında bu etkilerinin en üst düzeye ulaştığı ayrıca evli olmanın kadınlar için stres ve iş yükü getirisiyle hastalıkların ortaya çıkışını kolaylaştırdığı sonucunu doğurmaktadır.

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (