Nocturia in sleep-disordered breathing

Background and purpose: Nocturia is a common complaint in sleep-disordered breathing (SDB), but there is no study demonstrating the prevalence and frequency of nocturnal urination in a large number of SDB patients. To determine the prevalence and frequency of nocturnal urination among patients with SDB of different severities and to discover the factors related to nocturia

Nocturnal groaning associated with REM sleep phenomenon

Bilimsel zemin: Nokturnal inleme, uyku sırasında respiratuvar disritminin eşlik ettiği ekspiryumda monoton ses çıkışının olduğu bir sendromdur. Günümüze kadar çok az nokturnal inlemeli olgu bildirilmiştir. Nokturnal inleme epizodlarının prevalansı özellikle REM uykusunda çok yüksektir. Bu nedenle REM uykusuyla ilişkili bir fenomen olduğu kabul edilmektedir. Bazı çalışmalarda, hastaların birkaçında bruksizm ve uykuda yürüme de vardır denmesine rağmen, REM uykusuyla ilişkili uyku fenomenleriyle birlikteliği açısından herhangi bir bilgi bulunmamaktadır. Amaç: 20 yaşında gündüz aşırı uykululuğu olan kadın hastada nokturnal inleme ve REM uyku fenomenlerinden uyku paralizisi ve hipnagojik halüsi-nasyonların birlikteliğini bildirmek ve bu birlikteliğin nedenlerini tartışmak. Gereç ve yöntemler: Nörolojik muayenesi ve kulak-burun-boğaz muayenesi, Epworth uykululuk skalası, tüm-gece polisomnografi tetkiki, multipl uyku latansı testi yapıldı. Sonuçlar: Nokturnal inlemeli olgularda diğer REM uykusuyla ilişkili fenomenlerin birlikte bulunabileceği akla gelmeli ve her nokturnal inlemeli olguda sorgulanmalıdır. Ancak bu sayede, bu birlikteliğin rastlantısal mı yoksa benzer patofizyolojiye mi bağlı geliştiği aydınlatabilecektir.Nocturnal Groaning Associated with REM Sleep Phenomenon Scientific background: Nocturnal groaning is described as a syndrome with expiratory monotonous vocalization associated with a respiratory dysrhythmia during sleep. To date, few cases have been reported. Nocturnal groaning is a predominantly REM sleep-related phenomenon, because a great prevalence for REM sleep-related episodes had been observed. Although in some literature it was told that nocturnal groan­ing was associated with some cases of bruxism and/or sleepwalking, there is no report of nocturnal groaning associated with any other REM related sleep phenomenon. Objective: To report the association of REM related sleep phenome-nons, such as sleep paralysis and hypnagogic hallucinations with noctur­nal groaning in a-twenty-year-old girl with excessive daytime sleepiness and to discuss the causes of this association. Material and methods: Neurological and ear-nose-throat examina­tions, Epworth sleepiness scale, full-night polysomnography and multi­ple latency test were done. Results: The association of nocturnal groaning with the other REM sleep related phenemenons had to be kept in mind and investigated in every patient with nocturnal groaning. By this means, whether the occurence of this association is due to a coincidence or same patho-physiological background could be enlightened

Restless Leg Syndrome and Its Relationship with Parkinson’s Disease

OBJECTIVE: Restless legs syndrome (RLS) and Parkinson’s disease (PD) exhibit striking similarities in impairment of central dopaminergic transmission and response to dopamine replacement strategies. The main question is whether RLS and PD are associated disorders sharing the common pathophsiology and genetic vulnerability or RLS resulted from nighttime motor disability related to disease itself or treatment or only a comorbidity. The links and also similarities and differences between RLS and PD in respect to epidemiology, clinical features, pathophysiology, neuropharmacology, neurophysiology, neuroimaging, iron metabolism and genetics were reported belo

Polysomnographic Findings in A Late Onset Wilson’s Disease Patient

Scientific BACKGROUND: Wilson’s disease (WD) is an autosomal recessive degenerative disorder of copper metabolism. As a degenerative disease affecting many parts of CNS, WD has the potential to disrupt sleep regulatory mechanisms and to cause sleep disturbances like other neurodegenerative diseases. Sleep in WD has not been extensively studied before. OBJECTIVES: A late onset WD patient who applied to our out-patient clinic for sleep related problems has been extensively evaluated with clinical and laboratory measures. MATERIALS-METHODS: We performed three polysomnographic evaluations, one followed by continuous daytime recording. RESULTS: We diagnosed various abnormalities including breathing, circadian rhythm and movement disorders related to sleep. CONCLUSIONS: Sleep disorders in WD might be a major contributor to morbidity and mortalit

Rate of T alleles and TT genotype at MTHFR 677C->T locus or C alleles and CC genotype at MTHFR 1298A->C locus among healthy subjects in Turkey: Impact on homocysteine and folic acid status and reference intervals

Methylenetetrahydrofolate reductase (MTHFR) is important for folate and homocysteine (Hcy) metabolism. MTHFR 677C->T and 1298A->C MTHFR are two most common mutations which can affect. folate and total homocysteine (tHcy) status This study was designed to determine the rate of,MTHFR 677C->T and 1298A->C mutations. and their Influence Oil serum folate, Hcy and vitamin B12 Status and the reference intervals in 402 healthy Turkish adults. The rate of MTHFR 677C->T or 1298A->C mutations was 50 7% or 54 7%. respectively. The MTHFR 677C->T mutation-specific reference intervals for serum folate and tHcy were characterized by marked shifts in their upper limits In homozygote subjects for MTHFR 677C->T serum folate concentration was lower and serum tHcy concentration was higher than those in the wild genotype. all subjects had lower serum folate and 54% of the subjects had higher tHcy concentration,; than the cutoff Values of = 12 mu mol/L, respectively. Serum vitamin 1312 status was similar in all genotypes Serum tHcy concentrations were inversely correlated with serum folate and vitamin B12 concentrations in all genotypes These data show that the rate of MTHFR 677C->T and 1298A->C mutations is very high in Turks and serum folate and tHcy status are impaired by these mutations

Is There a Relationship Between Use of Anti-Vascular Endothelial Growth Factor Agents and Atrophic Changes in Age-Related Macular Degeneration Patients?

Choroidal neovascularization due to age-related macular degeneration (AMD) is currently treated successfully with anti-vascular endothelial growth factor (VEGF) intravitreal agents. Emerging evidence suggests that anti-VEGF treatment may potentially increase development of geographic atrophy. However, there is not yet direct proof of a causal relationship between geographic atrophy and use of anti-VEGF agents in neovaskuler AMD. The aim of this review is to discuss the evidence concerning the association between anti-VEGF therapy and progression of geographic atrophy

Diyabet Hastalarinda Hipogliseminin Ceza Sorumluluğuna Etkisi

Suç isnat edilen kişilerin, haksız cezai yaptırımdan kaçınmak için savunmalarında sağlık problemlerini öne sürerek, suça konu eylem esnasında iradelerinin yerinde olmadığını iddia etmeleri sık karşılaşılan bir durumdur. Bu konuda akıl ve ruh sağlığı ile ilgili rahatsızlıklar en sık karşımıza çıkanlardır. Ancak, bilinç durumunu etkileyen diğer sağlık problemlerini de unutmamak gerekmektedir. Diyabet hastaları da hipoglisemi atağında işlenen suçlarda iradelerinin devre dışı kaldığını iddia edebilmektedir. Çünkü diyabet hastalarında uzun vadede gelişen görme kaybı, böbrek yetmezliği, kalp krizi, kişilik değişiklikleri gibi bilinen kronik komplikasyonlar yanında, yüksek doz insülin uygulaması nedeniyle ortaya çıkan ve bilişsel işlevlerde bozukluklarla karakterize hipoglisemi ve nöroglikopeni gibi akut tedavi komplikasyonları da mevcuttur. Mahkemeler bu nedenle kişinin cezai sorumluluğunun tespiti hususunda, adli tıp uzmanlarından bilirkişi görüşü isteyebilmektedirler. Bu makalede, diyabet hastalarında sık görülen bir tedavi komplikasyonu olan hipoglisemi ve nöroglikopeninin kişide oluşturduğu bilişsel ve kognitif bozuklukların cezai sorumluluğu etkileyebilecek bir durum olup olmadığı, etkiliyorsa hangi kapsamda etkileyebileceği hususunun, bu konuda görülmüş davalar örnek gösterilerek tartışılması amaçlanmaktadır

Is There a Relationship Between Use of Anti-Vascular Endothelial Growth Factor Agents and Atrophic Changes in Age-Related Macular Degeneration Patients?

Choroidal neovascularization due to age-related macular degeneration (AMD) is currently treated successfully with anti-vascular endothelial growth factor (VEGF) intravitreal agents. Emerging evidence suggests that anti-VEGF treatment may potentially increase development of geographic atrophy. However, there is not yet direct proof of a causal relationship between geographic atrophy and use of anti-VEGF agents in neovaskuler AMD. The aim of this review is to discuss the evidence concerning the association between anti-VEGF therapy and progression of geographic atrophy