Evaluation of Autonomic Dysfunction in Obstructive Sleep Apnea Syndrome

The nervous system, which controls the body's internal organs is called Autonomic Nervous System. Parkinson's disease, vascular diseases, diabetes mellitus and Guilllain-Barre syndrome cause to disotonomia. Recent studies has been shown, obstructive sleep apnea syndrome cause to disotonomia too. To investigate disotonomia in in obstructive sleep apnea syndrome , should be preferred the methods like analysis of heart rate variability and sympathetic skin response which have low cost and easy applicability. Thus, it will be possible to prevent morbidity and mortality due to autonomic dysfuncion. [Archives Medical Review Journal 2012; 21(2.000): 109-121

Obstructive Sleep Apnea Syndrome

Obstructive sleep apnea syndrome is characterized by repeated airway collapse during sleep. The syndrome affects adult men more common than women. The most frequent and characteristic nocturnal symptom is snoring, the most important daytime symptom is sleepiness. The social, neuropsychological and cardiovascular consequences of obstructive sleep apnea syndrome cause severe morbidity and mortality. Early diagnosis and treatment of this disease may reduce mortality and morbidity due to cardiovascular causes. [Archives Medical Review Journal 2012; 21(2.000): 134-150

Searching for the existence of polyneuropathy and dysautonomia in patients with obstructive sleep apnea syndrome

Amaç: Bu çalışmanın amacı obstruktif uyku apne sendromu (OUAS) hastalarında polinöropati ve otonomik disfonksiyon varlığının araştırılması ve bunların hastalık şiddeti ile ilişkilerinin belirlenmesidir. Metod: Bu çalışmaya Dokuz Eylül Üniversitesi Tıp Fakültesi Uyku ve Epilepsi Merkezi'ne Eylül 2008 ve Mayıs 2009 tarihleri arasında başvuran, polisomnografisi çekilerek ağır OUAS tanısı konmuş 20 hasta, hafif - orta OUAS tanısı konmuş 20 hasta ve aynı yaş grubundaki 20 sağlıklı olgu (kontrol grubu) alınmıştır. Olgulara klasik elektronöromiyografi (ENMG) polinöropati protokolü, sağ üst ve sol alt ekstremiteden sempatik deri yanıtı (SDY) incelemesi, istirahatte-derin solunumda-valsalva manevrasında-ayakta kalp hız değişkenliği (KHD) incelemesi ve Schirmer testi yapılmıştır. Bulgular: Ağır OUAS ve hafif OUAS gruplarında kontrol gurbuna göre sağ tibialis posterior motor sinir iletim hız ortalamasında istatistiksel olarak anlamlı azalma ve ağır OUAS grubunda kontrol grubuna göre sempatik deri yanıtı amplitüd ortalamasında istatistiksel olarak anlamlı artış saptanmıştır (p Sonuç: OUAS'ın periferal nöropati oluşumuna neden olduğu ve otonomik disfonksiyon görülme riskinin OUAS şiddeti ile korele olarak arttığı gözlenmiştir Aim: The aim of our study is to search for the existence of polyneuropathy, dysautonomia and to identify the correlations of sickness level of patients with Obstructive Sleep Apnea Syndrome (OSAS). Method: The research is based on the real cases at Dokuz Eylul University of Medicine Sleep and Epilepsy Center, observed during October 2008-May 2009. The patients were selected by polysomnography samples based on 20 persons at same ages with following criteriaæ high leveled OUAS (AHİ ? 30), middle-low OUAS (5 ? AHİ Results: High and middle-low leveled OSAS patients had a decrease in the average velocity of motor conduction in right tibialis posterior when compared to the control group. Besides we observed an increase in the average amplitud of symphatic skin responses in high leveled OSAS patients than control group. Results are statistically significant (p Conclusion: OSAS indicates a risk of possible peripheral neuropathy and autonomic dysfunction risk increases in positive correlation with level of OSAS

Value of Multiple Sleep Latency Test Periods and Clinical Correlation

Amaç: Bu çalışmanın amacı gündüz aşırı uykululuk yakınması nedeniyle multipl sleep latans test (MSLT) yapılan hastalarda çekim periyodlarındaki elektrofizyolojik bulgular ile narkolepsi semptomlarının ilişkilerinin incelenmesidir. Materyal ve Metod: Çalışmaya 2009-2010 yılları arasında Dokuz Eylül Üniversitesi Tıp Fakültesi Uyku Polikliniğine gündüz aşırı uykululuk yakınmasıyla başvurmuş 26 olgu retrospektif olarak alınmıştır. Olguların narkolepsi semptomları (karabasan-halusinasyon-katapleksi) ve MSLT ile belirlenen REM başlangıçlı uyku (SOREM) sayısı, SOREM (+) ve SOREM (-) hastalardaki uyku latansları karşılaştırılmıştır. Veriler SPSS 20.0 ile analiz edilmiştir. Bulgular: Olguların ortalama uyku latansları değerlendirildiğinde uyku latanslarının ilk uyku periyodundan sona doğru giderek uzadığı ve bunun istatistiksel olarak anlamlı olduğu gözlenmiştir (p:0.007). Sonuç: Ortalama uyku latanslarının ilk uyku periyodundan sona doğru giderek uzadığı, bunun tekrarlayan uyku periyodlarıyla giderek azalan uyku yüküne bağlı olduğu düşünülmüştür.Purpose: Patients with complaints excessive daytime sleepiness were evaluated with Multiple Sleep Latency Test (MSLT) electrophysiological findings and researched narcolepsy symptoms like nightmare, hallucinations, cataplexy in this study. Material and Method: To study 26 patients were admitted retrospectively with complaints of excessive daytime sleepiness at Dokuz Eylul University Faculty of Medicine Sleep Clinic in the dates December 2009- December 2010. Cases of narcolepsy symptoms (hallucinations-nightmare-cataplexy) and MSLT were evaluated together. The onset of REM sleep (SOREM) was counted, than SOREM (+) and SOREM (-) patients' sleep latency and narcolepsy symptoms were compared. All data were analyzed with SPSS 20.0. Results: The mean sleep latency assessed sleep latencies, gradually widening towards the end of the first sleep period, and it has been observed to be statistically significant(p:0.007). Conclusion: The mean sleep latency assessed sleep latencies, gradually widening towards the end of the first sleep period, and it has been observed to be statistically significant(p:0.007) and we thinked that it can be decreased of need to sleep during nap periods

Comorbidity of Bipolar Disorder and Multiple Sclerosis: A Case Report

Multiple sclerosis is a chronic demyelinating disease of a central nervous system. Neuropsychiatric symptoms are common in multiple sclerosis and bipolar disorder is one of the most common psychiatric disorders that coexist with multiple sclerosis. Manic episodes may be the first presenting symptom of multiple sclerosis as comorbid pathology or as an adverse effect of pharmacotherapies used in multiple sclerosis. The comorbidity of bipolar disorder and multiple sclerosis is well-proven but its etiology is not known and investigated accurately. Recent studies support a common genetic susceptibility. Management of bipolar disorder in multiple sclerosis is based on evidence provided by case reports and treatment should be individualized. In this report, the association between bipolar disorder and multiple sclerosis, epidemiology, ethiology and treatment is discussed through a case had diagnosed as multiple sclerosis and had a manic episode with psychotic features. [Cukurova Med J 2013; 38(4.000): 832-836

Neuropsychiatric evaluation in HIV positive patients: a preliminary study

WOS: 000406284600012Purpose: The aim of this study was to assess neuropsychiatric symptoms of HIV infected patients and determine related socio-demographic and clinical features. Material and Methods: A total of 10 HIV (+) outpatients who have been followed in Department of Infectious Diseases and Clinical Microbiology, Cukurova University Medical School were included in the study. To evaluate cognitive functions, a neuropsychological test battery consisted of 8 tests were administered. All patients completed Symptom Check List (SCL-90) to determine psychological symptoms and Hamilton Depression Rating Scale (HAM-D) were used to evaluate the severity of depression. Results: The sample included 10 patients (4 females, 6 males). All patients had low or mid socioeconomic status, one half were married and seven patients had high or more level education. Executive functions and memory were impaired secondary to attentional narrowing in all HIV infected patients. Four patients were not diagnosed as depression (HAM-D<7) and other had mild to moderate depression. Only one patient was using an antidepressant medication. Others were neither referred for a psychiatric assessment, nor took a psychiatric treatment. Depression, obsessive-compulsive symptoms, somatization and interpersonal sensitivity subscales found to be high as were measured by SCL-90. Conclusion: Cognitive impairment and depression is highly prevalent in HIV (+) patients and have negative effects on treatment adherence, psychosocial functioning and quality of life, so these disorders should be examined in regular psychiatric interviews and be treated regardless infection and its treatment

Neuropsychiatric evaluation in HIV positive patients: a preliminary study

Amaç: Bu çalışmada HIV (+) bireylerde nöropsikiyatrik belirtilerin ve ilişkili sosyodemografik ve klinik bulguların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya Çukurova Üniversitesi Tıp Fakültesi Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji polikliniğinden takipli 10 HIV (+) hasta alınmıştır. Kognitif işlevlerin değerlendirilmesi amacıyla her hastaya 8 testten oluşan nöropsikolojik test bataryası uygulanmıştır. Genel psikolojik belirtilerin taranması amacıyla her hasta SCL-90 doldurmuş, depresif belirtiler Hamilton Depresyon Derecelendirme Ölçeği (HAM-D) ile değerlendirilmiştir. Bulgular: Çalışmaya alınan 10 hastanın sosyo-demografik özellikleri ele alındığında; grubun 6'sının erkek, 4'ünün kadın, tümünün düşük ya da orta sosyoekonomik düzeyde, yarısının evli ve üçü dışında tümünün lise ve üzeri eğitim almış olduğu belirlendi. Hastaların tümünde belirgin dikkat daralması ve dikkat daralmasına ikincil bellek ve yürütücü işlev bozukluğu saptandı. Çalışmaya alınan olguların 4'ünde depresyon saptanmazken (HAM-D<7), geriye kalan 6 olguda hafif ve orta derecede depresyon mevcuttu. Sadece bir hasta antidepresan tedavi almaktaydı. Geriye kalan hastaların psikiyatrik başvurusu ya da tedavi öyküsü yoktu. SCL-90 ile yapılan genel psikiopatolojik belirti taramasında depresyon, obsesif-kompülsif özellikler, somatizasyon ve kişilerarası duyarlılık alt ölçek puanları yüksek olarak saptandı. Sonuç: Bilişsel bozulma ve depresyon HIV (+) olgularda oldukça sıktır ve hayat kalitesini olumsuz etkilemektedir. Hastanın psikososyal işlevselliğini ve tedavi uyumunu önemli derecede etkileyen bu bozukluklar muayene sırasında rutin olarak sorgulanmalı, gerekli durumlarda kişiler enfeksiyon ve tedavisinden bağımsız olarak tedavi edilmelidir.Purpose: The aim of this study was to assess neuropsychiatric symptoms of HIV infected patients and determine related socio-demographic and clinical features. Material and Methods: A total of 10 HIV (+) outpatients who have been followed in Department of Infectious Diseases and Clinical Microbiology, Cukurova University Medical School were included in the study. To evaluate cognitive functions, a neuropsychological test battery consisted of 8 tests were administered. All patients completed Symptom Check List (SCL-90) to determine psychological symptoms and Hamilton Depression Rating Scale (HAM-D) were used to evaluate the severity of depression. Results: The sample included 10 patients (4 females, 6 males). All patients had low or mid socioeconomic status, one half were married and seven patients had high or more level education. Executive functions and memory were impaired secondary to attentional narrowing in all HIV infected patients. Four patients were not diagnosed as depression (HAM-D<7) and other had mild to moderate depression. Only one patient was using an antidepressant medication. Others were neither referred for a psychiatric assessment, nor took a psychiatric treatment. Depression, obsessive-compulsive symptoms, somatization and interpersonal sensitivity subscales found to be high as were measured by SCL-90. Conclusion: Cognitive impairment and depression is highly prevalent in HIV (+) patients and have negative effects on treatment adherence, psychosocial functioning and quality of life, so these disorders should be examined in regular psychiatric interviews and be treated regardless infection and its treatment

EVALUATION OF RENAL FUNCTION IN ALZHEIMER'S DISEASE AND GERIATRIC PATIENTS: RESULTS FROM A TURKISH TWO- CENTER STUDY

WOS: 000393585400008PubMed ID: 28680350Background: Alzheimer's disease (AD) is a severe multifactorial neurodegenerative proteopathy associated with advanced age. Discrepancies in the renal function of these patients compared to geriatric patients with dementia have rarely been reported. In this study, we aimed to disclose the importance of associated renal changes for the patho genesis of AD. Methods: Patients with AD (n = 107) and geriatric patients with dementia and without dementia (n = 124) (231 patients in total) from Dokuz Eylul and Cukurova University Hospitals were enrolled in the study. We measured serum Na, K, Cl, Ca, BUN, creatinine, total protein levels and MDRD [eGFR] in all groups. Results: From Izmir Center, the first study arm consisted of patients with AD dementia (n = 74), and the second arm included geriatric patients with dementia (n = 79). From Adana, 78 patients were recruited to the study, of which 33 were with AD and 45 were geriatric patients without dementia. When we analyzed comparatively the AD and geriatric dementia patients study arms, a statistically significant difference was observed both in the median age (p < 0.001), as well as in the biochemical parameters from Izmir Center: Na (p < 0.001), K (p < 0.001), Cl (p < 0.05), Ca (p < 0.001), BUN (p < 0.05), creatinine (p < 0.001), total protein (p < 0.001) and MDRD [eGFR] (p < 0.001). How ever, these were not significantly different between AD and geriatric patients without dementia in the Adana group. Conclusions: Our results indicate that renal function is prone to alterations in different age groups of patients with AD. However, there is no conclusive evidence that renal function is one of the risk factors in AD

Evaluation of Renal Function in Alzheimer’s Disease and Geriatric Patients: Results from a Turkish Two-Center Study

Background: Alzheimer’s disease (AD) is a severe multifactorial neurodegenerative proteopathy associated with advanced age. Discrepancies in the renal function of these patients compared to geriatric patients with dementia have rarely been reported. In this study, we aimed to disclose the importance of associated renal changes for the pathogenesis of AD