Can auditory and vestibular findings differentiate vestibular migraine and meniere’s disease?

Background and Objectives: Besides evaluating the auditory and vestibular systems of patients with vestibular migraine (VM) and Meniere's disease (MD), this study aimed to examine the clinical overlaps between these two conditions by detailed evaluation of the patient's symptoms. Subjects and Methods: The ears of the patients with VM and MD were evaluated and patients' vestibular and auditory complaints were questioned particularly. Pure tone audiometry, vestibular evoked myogenic potential (VEMP) responses, and caloric test results were evaluated for objective measurements. Results: The VM group had better air-conduction and bone conduction threshold and speech reception threshold and speech discrimination score test values (p<0.05). Regarding the interaural N1-P1 asymmetry ratio, the cervical VEMP between the groups had significant differences (p=0.019). The MD group had more unilateral tinnitus and ear fullness complaints and canal paresis results (p<0.01). The VM group had more motion sickness complaints (p<0.01). Conclusions: If only ears with hearing loss are evaluated; there was no significant difference between VM and MD, but regardless of hearing level or only the patients with normal hearing were evaluated, the VM group had better hearing levels. It should be considered that patients with VM may have VM-independent hearing loss, and patient complaints should be sufficiently detailed to make an accurate distinction from MD.J Audiol Otol

The frequency of complementary and integrative medicine methods in headache patients and their spending habits

Background It is known that complementary and integrative medicine (CIM) methods are especially used by patients with chronic headaches. The aim of our study is to increase the knowledge on this topic, to provide objective data about use in Turkish headache patients. Methods This study included 425 patients with headache. The survey form prepared was filled in under the supervision of a health professional. The questionnaire included 2 items, about CIM methods and finance. Results Among the patients evaluated, 316 were female, and 109 were male. All of 52% answered yes to the question “did you ever use any CIM treatment method for headaches during your life?”. The most frequently used methods were combined (herbal+one or more other method) (29.6%), herbal (9.4%) and cupping therapy (4.2%). Among the patients that used combined methods, 26.9% had spent 30–100TL (5–25euro), 20.6% had spent 100–300TL (25–70euro), 26.9% had spent 300–500TL (70–120euro) and the last two groups that formed 12.6% had spent 500–1000 (120–250euro) and &gt;1000TL (&gt;250euro). Conclusion Half of the patients that applied to outpatient clinic with headaches use one or more of these methods and make budgets in accordance with their income levels. Physicians should have sufficient knowledge and clinical opinions about the CIM methods used by headache patients

Evaluation of stroke risk factors and characteristics in the comorbidity of cancer

Aim: Stroke and cancer can be followed together and in the presence of cancer, there may be changes in classical stroke characteristics. The aim of this study was to determine the effect of cancer on stroke risk factors, radiological and clinical features. Materials and Methods: Patients who were hospitalized with the diagnosis of stroke between 2014-2020 were included in the study retrospectively. By examining the stroke and cancer characteristics of the patients; The differences in demographic findings, stroke risk factors, and radiological features of stroke between patients with and without cancer were examined. The anti-cancer treatments used and the characteristics of cancer were evaluated in stroke patients. Results: 281 stroke patients were evaluated and cancer was detected in 52 patients. There was no significant difference in terms of demographic characteristics of the patients. No significant difference was observed in stroke patients with cancer in terms of risk factors except smoking and alcohol use. Multiple ischemic lesions were more evident on magnetic resonance imaging (MRI) in stroke patients with cancer. The most common cancer was lung cancer. Conclusion: Stroke and cancer are increasingly common comorbidities. As the time between stroke and cancer development decreases, while the risk factors for cancer are more prominent, classical risk factors for stroke are observed less frequently

Hearing loss and stigma

Amaç: Bu çalışmada işitme kaybı ve işitme cihazı ile ilişkili stigma değerlendirildi. Hastalar ve Yöntemler: Bu çalışmada Eylül 2015 - Mart 2016 tarihleri arasında işitme kaybı ile Kulak Burun Boğaz polikliniğine başvuran ve muayene sonucunda işitme cihazı önerilen ancak cihazı kullanmayı reddeden 35 hasta yapılandırılmış formlarla değerlendirildi. Bulgular: İşitme kaybı olan hastaların %57.1’i işitme kaybından daha ciddi öncelikleri olduğunu düşünmekteydi. Hastaların cihaz edinmesinde stigma ile ilişkili en önemli engeller “işitme cihazının dışarıdan fark edilmesi” (%45.7) ve işitme cihazının kullanıcıyı “yaşlı” (%37.1) ve “engelli” (%45.7) gösterdiği düşüncesi idi. Sonuç: Stigma işitme cihazı edinimindeki önemli engellerden biridir. İşitme kaybı için yardım isteyen hastalara psikososyal destek gereklidir. İşitme kaybı ile ilgili stigma hakkında toplumsal farkındalık artırılmalı ve medya stigma engelinin kırılması için yardım etmelidir.Objectives: This study aims to evaluate the stigma associated with hearing loss and hearing aid. Patients and Methods: A total of 35 patients were examined with structured forms, who were admitted to the Ear Nose and Throat outpatient clinic between September 2015 and March 2016 with hearing loss and were recommended to use hearing aid but refused to do so. Results: Patients with hearing loss believed that they had more serious priorities than their hearing impairment (57.1%). The most important barriers associated to stigma in the adoption of hearing aid were the thoughts of “hearing aid is noticeable from outside” (45.7%) and the hearing aid makes the user look “old” (37.1%) and “disabled” (45.7%). Conclusion: Stigma is one of the important barriers of hearing aid adoption. Psychosocial support is necessary for the patients who seek help for their hearing loss. Social awareness should be increased about stigma associated to hearing loss and the media should help to disrupt the stigma barrier

Mezial temporal lob epilepsili olgularda wada testi ve ameliyat öncesi/amaliyat sonrası bellek ilişkisi

Objectives: To study the correlation between Wada memory test and neuropsychometric tests which were applied preoperatively to mesial temporal lobe epilepsy patients associated with hippocampal sclerosis (MTLE-HS) who had undergone selective amygdalohippocampectomy and find out the effects of early onset epileptic seizures on atypical memory dominance. Methods: Drug-resistant 27 patients (16 left, 11 right MTLE-HS) had video EEG, cranial MRI and Wada test preoperatively. Weschler visual subtest and verbal memory processing tests were applied to all patients before surgery and the first year after the operation. Results: The number of left hemisphere memory dominant patients was 6 (22.2%) and the number of atypical memory dominant patients was 21 (77.8%) according to the Wada test. There was a significant difference between the two groups when compared for epileptic seizure onset age; (p=0.042), and also a significant diffference when compared for HS (right/left) side (p=0.002). When we analyzed the correlation between preoperative and postoperative verbal and nonverbal tests and left memory Wada dominance; in verbal memory processing tests ‘delayed recall’ scores between groups were significant (p=0.042), on the other hand in patients with atypical memory dominance ‘total learning’ scores between groups were significant (p<0.001). Conclusion: As a result, we found that the earlier the onset of seizures, the more atypical the memory dominance (right or bilateral). The Wada test was effective for assessing verbal memory; on the other hand, it was inadequate for assessing visual memory dominance. If the scores of ‘delayed recall’ in verbal memory were high in the patients with typical verbal dominance and ‘total learning’ scores in the patients with atypical verbal dominance, the scores also tended to rise after the operation.Amaç: Selektif amigdalohippokampektomi yapılan hipokampal sklerozla ilişkili mesial temporal lob epilepsili (HS-MTLE) hastalarda ameliyat öncesi dönemde yapılan Wada testi ile nöropsikometrik testler arasındaki ilişkiyi inceleyerek erken yaşta başlayan epilepsi nöbetlerinin belleğin atipikleşmesi üzerindeki etkilerini araştırmak. Gereç ve Yöntem: Medikal tedaviye dirençli 27 hastaya (16 sol, 11 sağ HS-MTLE) cerrahi oncesi video EEG, kranial manyetik rezonans görüntüleme, Wada testi ile ameliyat öncesi ve sonrası birinci yılda Weschler görsel subtest ve sözel bellek süreçleri testleri uygulanmıştır. Bulgular: Wada bellek testinde sol hemisfer dominant bulunanlarn sayısı 6 (%22.2), atipik yerleşimli olanların sayısı 21 (%77.8) idi. Bellek dominansı sol ve atipik olanlarda nöbet başlama yaşı (p=0.042), ve HS (sağ/sol) tarafı açısından karşılaştırıldığında da anlamlı fark saptanmıştır (p=0.002). Yine sol bellek dominant olanlar ile ameliyat öncesi ve sonrası verbal ve nonverbal testler arasındaki korelasyona bakıldığında sözel bellek süreçleri testlerinden ‘gecikmeli hatırlama’ puanları arasında anlamlı ilişki bulunurken (r=0.829; p=0.042) atipik bellek dominansı olanlarda ‘toplam öğrenme’ puanları arasında anlamlı ilişki bulunmuştur (r=0.731; p<0.001). Sonuç: Nöbet başlama yaşı ne kadar düşükse bellek dominansı o kadar atipiktir (sağ veya bilateral). Wada testi sırasında yapılan bellek değerlendirmesi verbal belleği değerlendirmede etkili ancak görsel belleği değerlendirmede yetersizdir. Tipik bellek dominansı olanlarda ‘gecikmeli hatırlama’, atipik olanlarda ‘toplam öğrenme ’ puanları başlangıçta yüksek ise, ameliyat sonrası dönemde de yükselme göstermektedir

Investigation of Propolis’ Effect on Thiobarbituric Acid Reactive Substances and Anti-Oxidant Enzyme Levels of Hippocampus in Diabetic Rats Induced by Streptozotocin

BACKGROUND: Propolis is an organic resinous viscous substance collected from flower bud and plant sprig by bees. Propolis has a potential treatment agent for oxidative damage caused by diabetes in hippocampus due to its flavonoid and phenolic content.AIM: In this study effect of propolis on thiobarbituric acid reactive substances and anti-oxidative enzyme levels of hippocampus in diabetic rats induced by streptozotocin was investigated.MATERIALS AND METHODS: The study involved measuring levels of SOD, CAT, GSH-Px and TBARs in hippocampus tissue of STZ-induced diabetic rats (Adult Male Sprague Dawley rats) after applying propolis for one month. The subjects of the study were composed of 51 rats randomly assigned to four groups (Control, STZ, P+STZ and STZ+P). For analysis of data, Kruskal Wallis Test was utilized.RESULTS: The findings of the study showed that there were no significant difference in the levels of TBARS, SOD, CAT and GSH-Px of hippocampus across the groups.CONCLUSION: Propolis application in four-week duration does not have effect on TBARS, SOD, CAT and GSH-Px levels of hippocampus of diabetic rats. These findings mean that more time for observing oxidative harms on hippocampus is needed

Use of the Modified Visual Magnetic Resonance Rating Scale in alzheimer’s disease and ıts correlation with cognitive decline

Amaç: Alzheimer hastalığı (AH) araştırmaları için daha ileri nörogörüntüleme teknikleri geliştirilmiş olsa da, yapısal manyetik rezonans görüntüleme (MRG) AH’nin klinik tanısında önemini korumaktadır. Birçok parametreyi değerlendiren kapsamlı görsel MRG derecelendirme ölçeklerinin, hastalığın kognitif ve davranışsal görünümleriyle ilişkisi yeterince araştırılmamıştır. Bu çalışmada, Modifiye Görsel Manyetik Rezonans Derecelendirme Skalası’nın (MGMRDS) 7 alt bölümünün, AH tanısı almış hastaların demografik, kognitif ve davranışsal verileri ile korelasyonunu değerlendirmek amaçlanmıştır. Gereç ve Yöntemler: Retrospektif çalışmamıza beyin MRG ve nöropsikometrik test (NPT) verileri olan, Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı (DSM-IV-TR) ölçütleri ile Ulusal Nörolojik ve İletişimsel Bozukluklar ve İnme Enstitüsü & Alzheimer Hastalığı ve İlişkili Bozukluklar Derneği (NINCDS–ADRDA) kriterleri temelinde AH tanısı almış, 50 yaş ve üzeri toplam 42 hasta dahil edildi. Beyin MRG verileri, hasta yaş, cinsiyet ve tanı verilerine kör bir nöroradyolog tarafından MGMRDS kullanılarak değerlendirildi. MGMRDS verilerinin kognitif ve davranışsal test sonuçlarıyla korelasyonu incelendi. Bulgular: Hastaların %61,9’u kadın, yaş ortalaması 75,19±9,26 (53–92) yıl idi. Ortalama eğitim süresi 5,02±4,84 (0–15) yıl, ortalama hastalık süresi 4,52±2,94 yıldı. Ortalama Mini Mental Durum Testi skoru 18,51±5,43 (4–30) iken, ortalama Klinik Demans Derecelendirmesi (KDD) skoru 1,07±0,42 (0,5–2,0) idi. Sulkal atrofi puanları uzun süreli hatırlama ve yüz tanıma ile negatif korele idi; ventriküler atrofi skorları ise öğrenme puanları, meyve–insan ve yüz tanıma değişkenleri ile ters korelasyon gösterdi. Anlık hatırlama, öğrenme puanı, kendiliğinden hatırlama, meyve–insan ve KDD değişkenleri ile mediyal temporal atrofi değişkeni arasında anlamlı ilişki gözlendi. Tartışma ve Sonuç: Beyin MRG’ye dayalı görsel derecelendirme skalaları kullanmak, demans değerlendirmelerinde tanıyı doğrulayıcı, ucuz ve pratik bir yaklaşımdır. MGMRDS, kognitif (yürütücü işlevler, bellek, dikkat, dil) verilerle de anlamlı korelasyon göstermektedir. Bu ölçeği daha geniş hasta gruplarında değişik kognitif bozukluklarda değerlendirecek çalışmalar klinik açıdan faydalı olacaktır.Aim: Although more advanced neuroimaging techniques have been developed for research on Alzheimer’s disease (AD), structural magnetic resonance imaging (MRI) remains important in the clinical diagnosis of AD. The relationship between comprehensive MRI visual rating scales evaluating many parameters and cognitive and behavioral appearances of the disease has not been adequately investigated. In this study, we aimed to evaluate the correlation of the 7 subsections of the Modified Visual Magnetic Resonance Rating Scale (MVMRRS) with demographic, cognitive, and behavioral characteristics of patients diagnosed with AD. Materials and Methods: The retrospective study included a total of 42 patients aged 50 years and older whose brain MRI and neuropsychometric test results were available and who were diagnosed with AD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSMIV-TR) and of the National Institute of Neurological and Communicative Disorders and Stroke & the Alzheimer’s Disease and Related Disorders Association (NINCDS–ADRDA). By use of the Modified Visual Magnetic Resonance Rating Scale (MVMRRS), the brain MRI data were evaluated by a neuroradiologist blinded to the patient age, sex, and diagnosis data. Correlation of MVMRRS data with cognitive and behavioral test results was analyzed. Results: The mean patient age was 75.19±9.26 (53–92) years and 61.9% of all patients were female. The mean education level was 5.02±4.84 (0–15) years and the mean illness duration was 4.52±2.94 years. The mean Mini-Mental State Examination score was 18.51±5.43 (4–30) while the mean Clinical Dementia Rating (CDR) score was 1.07±0.42 (0.5–2.0). Sulcal atrophy scores were negatively correlated with longterm recall and facial recognition while ventricular atrophy scores were inversely correlated with the learning scores and fruit–human and facial recognition parameters. A significant relationship was observed between the immediate recall, learning score, spontaneous recall, fruit–human, and CDR variables and the medial temporal atrophy variable. Discussion and Conclusion: In dementia assessment, the use of MRI-based visual rating scales is an inexpensive and practical approach that also improves the diagnostic accuracy. Furthermore, the MVMRRS shows significant correlation with cognitive (executive functions, memory, attention, and language) data. Further studies to evaluate this scale in larger groups of patients with different patterns of cognitive impairment would be of clinical benefit

Real-life experiences with galcanezumab and predictors for treatment response in Turkey

BackgroundThe complexity of clinical practice extends far beyond the controlled settings of trials, and there is a need for real-world studies aimed at identifying which patients will respond to anti-CGRP monoclonal antibodies in different countries. This study aimed to investigate the efficacy and safety of galcanezumab in treating migraine in a real-life setting in Turkey, as well as identify predictors of treatment response.MethodsA total of 476 patients who diagnosed with migraine according to ICHD-3 criteria and treated with galcanezumab by headache specialists were voluntarily participated in this cross-sectional study. Galcanezumab is indicated for the prevention of migraine in adults who have at least 4 monthly migraine days in Turkey. All patients filled out a survey on Google Form that comprised 54 questions, addressing various aspects such as demographics, migraine characteristics, previous use of acute symptomatic medication, failures with preventive drug classes, comorbidities, most bothersome symptoms, as well as the interictal burden of migraine.ResultsAmong the participants, 89.3% reported that galcanezumab treatment was beneficial for them. A decrease in the frequency (80.0%), severity (85.7%), and acute medication usage for migraine attacks (71.4%) was reported with galcanezumab treatment. An adverse effect related to galcanezumab was reported in 16.3% of cases, but no serious adverse reactions were observed. Remarkably, 14.3% of participants reported no longer experiencing any headaches, and 18.9% did not require any acute treatment while receiving galcanezumab treatment. A logistic regression model showed that male gender, lack of ictal nausea, and previous failure of more than 2 prophylactic agents may predict the non-responders.ConclusionsThe first large series from Turkey showed that galcanezumab treatment is safe and effective in most of the patients diagnosed with migraine by headache experts in the real-life setting. Patients reported a significant decrease in both ictal and interictal burden of migraine and expressed satisfaction with this treatment

Perception of Orthodontic Treatment Need Among Orthodontists, General Dentists and Lay People

Aim:The main objective of our study was to examine the possible differences in dental esthetic perceptions among dentists, orthodontists and laypeople.Subjects and Methods:The participants of the study consisted of 3 different groups as orthodontists, dentists who have at least 4 years clinical experience and laypeople. Thirty individuals were selected for each group. All the selected people were asked to complete the questionnaires. Assessment of treatment need was obtained by evaluating the Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN). This index contains a series of 10 black and white photographs of anterior teeth displaying varying degrees of malocclusion. The participants of this study were asked to rank each black and white photograph between 1 and 10 according to their perception of orthodontic treatment need.Results:There were only minor differences in perception of orthodontic treatment need. Differences were detected in photographs 1 and 9. In photograph 1, orthodontists and dentists gave similar scores but lay people scored higher than dental professionals.Conclusion:The present study aimed to investigate the possible differences in perception of orthodontic treatment need among orthodontists, general dentists and lay people and the results found only minor differences between the groups

New CagL amino acid polymorphism patterns of helicobacter pylori in peptic ulcer and non-ulcer dyspepsia

Background and Objectives: Helicobacter pylori infection is associated with chronic gastritis, ulcers, and gastric cancer. The H. pylori Type 4 secretion system (T4SS) translocates the CagA protein into host cells and plays an essential role in initiating gastric carcinogenesis. The CagL protein is a component of the T4SS. CagL amino acid polymorphisms are correlated with clinical outcomes. We aimed to study the association between CagL amino acid polymorphisms and peptic ulcer disease (PUD) and non-ulcer dyspepsia (NUD). Materials and Methods: A total of 99 patients (PUD, 46; NUD, 53) were enrolled and screened for H. pylori by qPCR from antrum biopsy samples. The amino acid polymorphisms of CagL were analyzed using DNA sequencing, followed by the MAFFT sequence alignment program to match the amino acid sequences. Results: Antrum biopsy samples from 70 out of 99 (70.7%) patients were found to be H. pylori DNA-positive. A positive band for cagL was detected in 42 out of 70 samples (PUD, 23; NUD, 19), and following this, these 42 samples were sequenced. In total, 27 different polymorphisms were determined. We determined three CagL amino acid polymorphism combinations, which were determined to be associated with PUD and NUD. Pattern 1 (K35/N122/V134/T175/R194/E210) was only detected in PUD patient samples and was related to a 1.35-fold risk (p = 0.02). Patterns 2 (V41/I134) and 3 (V41/K122/A171/I174) were found only in NUD patient samples and were linked to a 1.26-fold increased risk (p = 0.03). Conclusions: We observed three new patterns associated with PUD and NUD. Pattern 1 is related to PUD, and the other two patterns (Patterns 2 and 3) are related to NUD. The patterns that we identified include the remote polymorphisms of the CagL protein, which is a new approach. These patterns may help to understand the course of H. pylori infection.Istanbul Aydin University Scientific Research Projects Uni