Hepatic encephalopathy and atypical cortical involvement in cranial MRI: Case report

Hepatik ensefalopati karaciğer fonksiyon bozukluğuna bağlı olarak hastalarda nöropsikiyatrik belirtilerin gelişimi ile karakterizedir. Siroz, portal hipertansiyon veya porto-sistemik şantlar ve akut karaciğer yetmezliği durumlarında gelişebilir. Hafif mental durum bozukluklarından derin komaya kadar değişen geniş bir klinik tablo ile ortaya çıkabilir. Manyetik rezonans görüntüleme (MRG) başta olmak üzere nöro-görüntüleme teknikleri hepatik ensefalopati tanısında kullanılabilir. Sağlıklı bireylerde kolayca metabolize edilebilen maddelerin birikimine bağlı olarak özellikle T1 ağırlıklı MRG'de iki yanlı globus pallidus yapılarında sinyal artışı izlenir. Hepatik ensefalopatide kortikal tutulum oldukça nadir bildirilmiştir. Bu yazıda kortikal ve subkortikal yapıların tutulumu ile seyreden bir hepatik ensefalopati olgusu sunulmuştur.Hepatic encephalopathy is characterized by neuropsychiatric abnormalities occurring in patients with liver dysfunction. It most commonly occurs in association with cirrhosis, portal hypertension, portal-systemic shunts and acute liver failure. Clinical features of hepatic encephalopathy varies between mild cognitive impairment to deep coma. Several neuroimaging techniques, especially magnetic resonance imaging (MRI), may eventually be useful for the diagnosis of hepatic encephalopathy. Cranial MRI may demonstrate high signal intensity in the bilateral globus pallidum on T1-weighted images. Cortical involvement due to hepatic encephalopathy is rarely reported in the literature. We presented here a case of hepatic encephalopathy with cortical and subcortical involvement

Özal, Ankara'da:Başbakan, 55 gün sonra yurda döndü

Taha Toros Arşivi, Dosya No: 47-Turgut ÖzalUnutma İstanbul projesi İstanbul Kalkınma Ajansı'nın 2016 yılı "Yenilikçi ve Yaratıcı İstanbul Mali Destek Programı" kapsamında desteklenmiştir. Proje No: TR10/16/YNY/010

Subcutaneous NPH Insulin for Severe Hypertriglyceridemia in a Pregnant Patient with Type V Hyperlipoproteinemia: a Case Report

An increase in triglyceride levels in familial hyperlipidemia during pregnancy has been reported. Severe hypertriglyceridemia can lead to complications such as acute pancreatitis, preeclampsia, maternal and fetal complications. Because of the teratogenic effects associated with fibrate therapy in pregnancy, alternative treatment strategies such as insulin as a rapid and potent activator of lipoprotein lipase are required during pregnancy. We report a case of hypertriglyceridemia in a 33-year-old pregnant woman in whom treatment with merely single one time administration of Neutral Protamine Hagedorn insulin was accompanied by a reduction in the serum triglyceride level; to the best of our knowledge, this has never been reported in the literature. Her triglyceride level was 3616 mg/dL before insulin treatment and 1246 mg/dL after insulin treatment. Although this regimen was used safely and effectively in our patient, comprehensive studies are required to evaluate the effectiveness and safety of subcutaneously intermediate-acting Neutral Protamine Hagedorn insulin for the treatment of severe hypertriglyceridemia in non-diabetic pregnant women

Effectiveness and Safety of Initiation and Titration of Insulin Glargine 300 U/mL in Insulin-Naive Patients with Type 2 Diabetes Mellitus Uncontrolled on Oral Antidiabetic Drug Treatment in Turkey: The EASE Study

Objective: The aim of the study was to evaluate the effectiveness and safety of insulin glargine 300 U/ mL (Gla-300) in insulin-naive patients with type 2 diabetes mellitus (T2DM) inadequately controlled on oral antidiabetic drug (OADs) treatment in Turkey. Methods: One hundred eight patients from 20 centers enrolled in the study. Starting from baseline, Gla-300 was self-administered subcutaneously and once daily in the evening. The primary outcome was the mean change in glycated hemoglobin A1c (HbA1c) from baseline to week 24. Results: The mean (±SD) Hb1Ac level of 9.4% (±0.8) at baseline decreased to 7.5% (±0.9) at week 12 (P <.1) and to 7.3% (±0.9) at week 24 (P <.1). Although none of the patients were within the target Hb1Ac level of ≤7% at baseline, the percentage of patients who achieved the target Hb1Ac level was 30.4% at week 12 and increased to 42.9% at week 24. Gla-300 treatment achieved the Hb1Ac target in 21 (19.4%) patients without experiencing a hypoglycemic event and in 27 (25.0%) patients who experienced at least one hypoglycemic event. For each self-monitoring blood glucose time point, significant improvements were observed as compared to baseline (P <.001). Statistically significant improvement (P <.001) was seen in the treatment satisfaction questionnaire – status version scores between baseline and week 24. Conclusion: This study indicated that Gla-300 is effective to provide a successful glycemic control with low risk of hypoglycemia added to OADs in insulin-naive patients with T2DM, and it has the potential to improve the quality of life of patients