Screening of anxiety and quality of life in people with epilepsy.

PURPOSE: Up to 60% of people with epilepsy (PwE) have psychiatric comorbidity including anxiety. Anxiety remains under recognized in PwE. This study investigates if screening tools validated for depression could be used to detect anxiety disorders in PWE. Additionally it analyses the effect of anxiety on QoL. METHOD: 261 participants with a confirmed diagnosis of epilepsy were included. Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Emotional Thermometers (ET), both validated to screen for depression were used. Hospital Anxiety and Depression Scale-Anxiety (HADS-A) with a cut off for moderate and severe anxiety was used as the reference standard. QoL was measured with EQ5-D. Sensitivity, specificity, positive and negative predictive value and ROC analysis as well as multivariate regression analysis were performed. RESULTS: Patients with depression (n=46) were excluded as multivariate regression analysis showed that depression was the only significant determinant of having anxiety in the group. Against HADS-A, NDDI-E and ET-7 showed highest level of accuracy in recognizing anxiety with ET7 being the most effective tool. QoL was significantly reduced in PwE and anxiety. CONCLUSION: Our study showed that reliable screening for moderate to severe anxiety in PwE without co-morbid depression is feasible with screening tools for depression. The cut off values for anxiety are different from those for depression in ET7 but very similar in NDDI-E. ET7 can be applied to screen simultaneously for depression and "pure" anxiety. Anxiety reduces significantly QoL. We recommend screening as an initial first step to rule out patients who are unlikely to have anxiety

Common psychiatric comorbidities in epilepsy: How big of a problem is it?

Psychiatric illness and epilepsy commonly co-occur in adults and in children and adolescents. Theories of comorbidity are complex, but recurring associations between the conditions suggest overlap that is more than simple co-occurrence. Common underlying pathophysiology may imply that epilepsy itself may constituently include psychiatric symptoms. Conditions such as depression or cognitive difficulties commonly occur and in some cases, are considered to be associated with specific epilepsy characteristics such as localization or seizure type. Regardless of etiologic attributions to psychiatric comorbidity, it is clear today that treatment for epilepsy needs to target psychiatric illness. In many cases, quality-of-life improvements depend more upon addressing psychiatric symptoms than seizures themselves

Iron Deficiency Anemia Is Associated with Menstrual Migraine: A Case-Control Study

Design. Case-control study

Change of pitch due to carbamazepine and oxcarbazepine independently

PubMed ID: 23266347[No abstract available

Change of pitch due to carbamazepine and oxcarbazepine independently

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Introduction; Absolute pitch (AP) is the term used to denote the cognitive ability to spontaneously and effortlessly identify and vocally produce specific musical tones without a reference note.1 Abnormalities of pitch perception are a recognized rare side effect of carbamazepine (CBZ). The mechanism of this side effect is not clear. The same symptom may also be associated with oxcarbazepine (OXC) although this is even rarer. We report a twenty-two year-old woman with partial and prolonged secondarily generalized seizures who complained of a one semitone lowering of pitch perception during CBZ therapy. After stopping CBZ and switching to OXC, she noticed that pitch perception was one semitone higher than normal.Absolute pitch (AP) is the term used to denote the cognitive ability to spontaneously and effortlessly identify and vocally produce specific musical tones without a reference note. Abnormalities of pitch perception are a recognized rare side effect of carbamazepine (CBZ). The mechanism of this side effect is not clear. The same symptom may also be associated with oxcarbazepine (OXC) although this is even rarer. We report a twenty-two year-old woman with partial and prolonged secondarily generalized seizures who complained of a one semitone lowering of pitch perception during CBZ therapy. After stopping CBZ and switching to OXC, she noticed that pitch perception was one semitone higher than normal

ALCAPs induce mitochondrial apoptosis and activate DNA damage response by generating ROS and inhibiting topoisomerase I enzyme activity in K562 leukemia cell line

WOS: 000292358500026PubMed ID: 21624350Endemic Alkanna cappadocica was used to isolate novel antitumor molecules from Turkish landscapes in our previous studies. In this study, deoxyalkannin (ALCAP1), beta,beta-dimethylacrylalkannin (ALCAP2), acetylalkannin (ALCAP3), and alkannin (ALCAP4) as well as the novel isolated compounds 5-methoxydeoxyalkannin (ALCAP5), 8-methoxydeoxyalkannin (ALCAP6), 5-methoxyacetylalkannin (ALCAP7), 5-methoxy-beta,beta-dimethylacrylalkannin (ALCAP8) were characterized. The topoisomerase I (topo I) inhibitory activity of ALCAPs was investigated using in vitro plasmid relaxation assay and found that ALCAP2, 3, 4 and 7 were potent inhibitors at 2-6 mu M concentrations. Further, DNA damage response to ALCAP treatments was also studied by measuring the H2AX((S139)) and ATM((S1981)) phosphorylations. ALCAP2, 7 and 8 induced the DNA damage and apoptosis, consistently resulted in PARP cleavage at nanomolar concentrations in K562 leukemia cells. Moreover, when the free radical (ROS) generating capacity of the compounds was studied by 2',7'-dichlorofluorescein-diacetate assay using flow cytometry, we found that a known antioxidant N-acetyl-cysteine almost completely abrogated the H2AX((S139)) phosphorylations and the caspase 3 cleavage and activation. Thus, gamma H2AX((S139)) foci formation remained higher than the control, and an increase in CHK2((T68)) phosphorylation was observed by ALCAP2 and 7 treatments suggested that, these compounds can be potential therapeutics against tumor cell growth because of their unique DNA damaging abilities additional to enzyme inhibition similar to those of doxorubicin. (C) 2011 Elsevier Inc. All rights reserved.TUBITAK (The Scientific and Technical Research Council of Turkey)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [105S101, 106S200]; Ege UniversityEge University [06MUH004]We thank Dr. Serdar Senol for his invaluable assistance in collection and identification of the plant material. This research was supported by grants 105S101 and 106S200 from TUBITAK (The Scientific and Technical Research Council of Turkey), and a grant from Ege University BAP project 06MUH004 to EB and KSK