Archaeogenetic analysis of Neolithic sheep from Anatolia suggests a complex demographic history since domestication

Yurtman, ozer, Yuncu et al. provide an ancient DNA data set to demonstrate the impact of human activity on the demographic history of domestic sheep. The authors demonstrate that there may have been multiple domestication events with notable changes to the gene pool of European and Anatolian sheep since the Neolithic. Sheep were among the first domesticated animals, but their demographic history is little understood. Here we analyzed nuclear polymorphism and mitochondrial data (mtDNA) from ancient central and west Anatolian sheep dating from Epipaleolithic to late Neolithic, comparatively with modern-day breeds and central Asian Neolithic/Bronze Age sheep (OBI). Analyzing ancient nuclear data, we found that Anatolian Neolithic sheep (ANS) are genetically closest to present-day European breeds relative to Asian breeds, a conclusion supported by mtDNA haplogroup frequencies. In contrast, OBI showed higher genetic affinity to present-day Asian breeds. These results suggest that the east-west genetic structure observed in present-day breeds had already emerged by 6000 BCE, hinting at multiple sheep domestication episodes or early wild introgression in southwest Asia. Furthermore, we found that ANS are genetically distinct from all modern breeds. Our results suggest that European and Anatolian domestic sheep gene pools have been strongly remolded since the Neolithic

Chemical injury to the tongue following contact with sodium hydroxide drain cleaner

Solid sodium hydroxide compounds are used to unclog drains. In Turkey, these agents are easily available and commonly used by housewives. They are sold in weak bags and usually stored within these bags. We present the case of an elders woman with dementia who developed severe alkaline tongue burn and edema after unintentional short contact with solid sodium hydroxide drain cleaner. Official legislation for safety packing in Turkey will lead to reduction in the incidence of accidental caustic injuries

A Comparison between Frequency of Depressive Symptoms and Quality of Life Among Patients with Essential Tremor and Parkinson's Disease

Objective: Essential tremor is a movement disorder characterized by action tremor. There are a lot of studies that have shown the high comorbidity rates of depression in Parkinson's disease (PD). Depression has been found to exert negative effect on quality of life of patients with PD. Although essential tremor (ET) is a movement disorder like PD, few studies have examined the prevalence and the effects of depressive symptoms on quality of life in patients with ET. The aim of this study was to assess the depressive symptoms and their effect on quality of life in a sample of patients with PD, ET and healthy controls

Weakness in the Emergency Department: Hypokalemic Periodic Paralysis Induced By Strenuous Physical Activity

SUMMARY: Hypokalemic periodic paralysis is a rare but serious disorder that is typically caused by a channelopathy. Thyrotoxicosis, heavy exercise, high carbohydrate meal and some drugs can trigger channelopathy in genetically predisposed individuals. A 33-year-old male patient presented to the emergency department with weakness in the lower extremities. He stated that he had done heavy physical activity during the previous week. The patient exhibited motor weakness in the lower extremities (2/5 strength) during the physical examination. Initial laboratory tests showed a potassium level of 1.89 mEq/L. The initial electrocardiogram demonstrated T wave inversion and prominent U waves. The patient was treated in the emergency department with oral and intravenous potassium. The physical and ECG symptoms resolved within 16 hours of potassium supplementation and biochemical tests showed normal serum potassium levels. The patient was discharged shortly after the resolution of the symptoms. Weakness is an important but nonspecific symptom that may be brought on by a number of underlying physiological processes. Hypokalemic periodic paralysis is a rare disease that may be triggered by heavy physical activity and presents with recurrent admissions due to weakness. Key words: Emergency department, hypokalemic periodic paralysis, muscle weaknes

Comparison of diagnostic and prognostic utility of lactate and procalcitonin for sepsis in adult cancer patients presenting to emergency department with systemic inflammatory response syndrome

Objectives: Differentiating sepsis from other noninfectious causes of systemic inflammatory response syndrome (SIRS) in cancer patients is often challenging. Although lactate and procalcitonin have been studied extensively regarding sepsis management, little is known about their utility in cancer patients.This study aimed to compare the diagnostic and prognostic utility of lactate and procalcitonin for sepsis in cancer patients. Material and methods: This prospective case-control study was conducted with adult cancer patients presenting to emergency department (ED) with at least two SIRS criteria. The infection status of each patient was determined retrospectively.Main diagnostic variables were calculated for diagnostic and prognostic utilities of lactate and procalcitonin. Results: Among 86 patients, mean age was 61. Twenty-two (25.6%) were determined in the sepsis group.In the ROC analysis, a lactate value of 1 mmol/L predicted sepsis with 86.36% (95%CI: 65.1%–97.1%) sensitivity and 28.12% (95%CI: 17.6%–40.76%) specificity. A procalcitonin value of 0.8 ng/mL yielded a sensitivity of 63.64% (95%CI: 40.7%–82.8%) and 76.56% (95%CI: 63.4%–86.2%) specificity for differential diagnosis of sepsis in cancer patients.Lactate and procalcitonin showed similar abilities in differentiating sepsis from non-infective SIRS in cancer patients [AUROCs of 0.638 (95%CI:0.527–0.739) vs 0.637 (95%CI:0.527–0.738), respectively. p=0.994].They were also similar in predicting poor clinical outcome with AUROCs of 0.629 (95%CI:0.518–0.731) and 0.584 (95%CI: 0.473–0.69), respectively (p=0.577). Conclusions: The results of this study indicated that, none of the lactate and procalcitonin can be recommended alone to differentiate sepsis from non-infectious SIRS and to predict the poor clinical outcomes in adult cancer patients with SIRS in the ED. Keywords: Cancer, Sepsis, Lactate, Procalcitoni

Evaluation of the Diagnostic Role of Bedside Lung Ultrasonography in Patients with Suspected Pulmonary Embolism in the Emergency Department

Background: Despite the existence of detailed consensus guidelines, challenges remain regarding efficient, appropriate, and safe imaging methods for the diagnosis of suspected pulmonary embolism. Aims: To investigate the role of the wedge sign, B-lines, and pleural effusion seen on bedside lung ultrasound in the diagnosis of pulmonary embolism. Study Design: Diagnostic accuracy study. Methods: During the first evaluation of patients with suspected pulmonary embolism, bedside lung ultrasound was performed, and the B-lines, wedge sign, and pleural effusion were investigated. Computed tomography angiography was used as a confirmatory test and was compared with the lung ultrasound findings. Results: Pulmonary embolism was detected in 38 (38%) patients. In the comparison of bedside lung ultrasound results, statistically significant differences were found between the groups in terms of the B-lines and wedge sign (p=0.005 and p<0.001, respectively). There were no significant differences in terms of effusion (p=0.234). Comparison of these findings with computed tomography angiography of the chest showed weak negative correlations between the groups in terms of B-lines (r=-0297) and a moderately positive correlation in terms of the wedge sign (r=0.523). The sensitivity, specificity, and positive and negative predictive values of lung ultrasound findings alone were low. In the logistic regression analysis, the wedge sign (p<0.01, OR=69.45, 95% CI=6.94-695.17) and B-line (p=0.033, OR=1.96, 95% CI=0.41-8.40) were found to be effective in the diagnosis of pulmonary embolism. Conclusion: Although the role of lung ultrasound has been increasing in the management of critically ill patients, its value is limited and cannot replace the gold standard tests in the diagnosis of pulmonary embolis

Parkinson hastalığı’nda depresyon sıklığı ve yaşam kalitesini etkileyen faktörler

Amaç: Klinik çalışmalar, Parkinson Hastalığı'nda (PH) depresyon sıklığının yüksek olduğunu ve yaşam kalitesini olumsuz yönde etkilediğini ortaya koymuştur. Bu çalışmadaki amacımız ayaktan izlenen Parkinson hastalarında depresyon sıklığını ve hastaların yaşam kalitesini değerlendirmektir.Yöntem: Parkinson Hastalığı olan 78 hasta Hamilton Depresyon Değerlendirme Ölçeği (HDDÖ), Yaşam Kalitesi Ölçeği Kısa Formu (YKÖ-KF), Mini Mental Durum Değerlendirmesi (MMDD) ile değerlendirilmiştir. PH belirtilerinin şiddeti ise Hoehn-Yahr (HY) Evresi ve Birleşik Parkinson Hastalığı Değerlendirme Ölçeği-III (motor alt ölçeği) ile (BPHDÖ-III) değerlendirilmiştir.Bulgular: Ondokuz (%24,4) Parkinson hastasında, DSM-IV major depresyon tanı ölçütlerine göre depresyon eş tanısının olduğu saptanmıştır. HDDÖ puanları, PH'nın şiddetinin depresyonun gelişmesine katkıda bulunduğunu düşündürecek biçimde, HY evresi ve BPHDÖ motor alt ölçeği puanlarıyla korelasyon göstermiştir. Multipl regresyon analizi sonuçları hastaların yaşı, PH süresi, BPHDÖ ve MMDD puanları ile HDDÖ puanları gibi değişkenlerin hepsinin yaşam kalitesi üzerine anlamlı ve olumsuz bir etki gösterdiğini ortaya koymuştur. L-DOPA tedavisi de yaşam kalitesini olumsuz yönde etkilemekteydi. Sonuç: Bulgularımız, PH'da depresyon komorbiditesinin yüksek olduğunu desteklemiştir. Depresyon, Parkinson hastalarında zaten bozulmuş olan yaşam kalitesini daha da kötüleştirmektedir.Objective: Clinical studies seem to indicate that the frequency of depression is high and has a negative impact on quality of life in patients with Parkinson's Disease (PD). The aim of this study is to assess the frequency of depression and the quality of life in a sample of Parkinson's Disease outpatients.Method: Seventy-eight patients with PD were evaluated with Hamilton Depression Rating Scale (HAM-D), Short form of WHO Quality of Life Scale and Mini Mental State Examination Scale (MMSES). Severity of PD symptoms were evaluted with Hoehn-Yahr(HY) Stage and Motor Subscale of United Parkinson's Disease Rating Scale-III (UPDRS).Results: Nineteen patients (24.4%) had comorbid depression according to DSM-IV criteria. The score of HAM-D was significantly correlated with HY stage and UPDRS scores, indicating that the severity of PD is a contributing factor on development of depression. According to the results of multiple regression analysis, age, duration of PD, scores of UPDRS, MMSES andHAM-D all have significant and negative impact on quality of life in patients with PD. L-DOPA treatment also has a negative effect on patient's quality of life.Discussion: Our results have shown the high comorbidity rate of depression in PD. Depression seems to increase the worsening of already disturbed quality of life in patients with PD