Abnormal Sexual Behavior During Sleep in Temporal Lobe Epilepsy: a Case Report

Herein, we describe a case who presented with abnormal sexual behaviour during sleep. Video-electroencephalography monitoring during sleep revealed an abnormality suggesting an epileptic basis. The patient was successfully treated with carbamazepin. The psychiatric symptoms that were thought to be related to abnormal sexual behaviours were controlled with antipsychotic treatment. Our findings strongly emphasize the fact that efforts should be spent to increase awareness of seizure activity at night, which can be misinterpreted as benign parasomnias. Such a misinterpretation may have serious consequences, such as insufficient seizure control, progressive personality changes, and cognitive impairment

Lipid Peroxidation and Paraoxonase Activity in Nocturnal Cyclic and Sustained Intermittent Hypoxia

Purpose Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) have been known to be associated with atherosclerosis and hypoxia which was suggested to have an important role in this process by the way of increased oxidative stress. In the present study, we aimed to evaluate the effects of nocturnal hypoxia pattern (intermittent versus sustained) on serum lipid peroxidation and paraoxonase (PON) activity. Methods Blood collections were performed in 44 OSA, 11 non-apneic, nocturnal desaturated COPD, and 14 simple snorer patients after full-night polysomnographic recordings. Nocturnal sleep and respiratory parameters, oxygen desaturation indexes, serum malondialdehyde (MDA) levels by measuring with the help of the formation of thiobarbituric acid reactive substances (TBARS), and PON activity were assessed in all subjects. Results OSA and COPD patients showed nocturnal hypoxemia, with a minimum oxygen saturation (SaO2) in ranges of 53–92 % and 50–87 %, respectively. The mean levels of TBARS was 15.7±3.6 nmol and 15.3±3.4 nmol malondialdehyde (MDA)/ml in OSA and COPD patients, respectively, while the mean level of the control group was 4.1±1.2 nmol MDA/ml. The mean PON activity was found to be 124.2± 35.5 U/l in OSA patients and 124.6±28.4 U/l in COPD patients. The mean PON activity of the control group was 269.0±135.8 U/l. The increase in TBARS levels and the decrease in PON1 levels were statistically significant in both OSA and COPD patients according to controls (p<0.001 for TBARS as well as PON1). Conclusion The results of this study revealed that both OSA and non-apneic, nocturnal desaturated COPD patients showed increased levels of lipid peroxidation and decreased PON activity despite the differences in nocturnal hypoxia pattern

Narcolepsy risk loci outline role of T cell autoimmunity and infectious triggers in narcolepsy

Narcolepsy has genetic and environmental risk factors, but the specific genetic risk loci and interaction with environmental triggers are not well understood. Here, the authors identify genetic loci for narcolepsy, suggesting infection as a trigger and dendritic and helper T cell involvement. Narcolepsy type 1 (NT1) is caused by a loss of hypocretin/orexin transmission. Risk factors include pandemic 2009 H1N1 influenza A infection and immunization with Pandemrix (R). Here, we dissect disease mechanisms and interactions with environmental triggers in a multi-ethnic sample of 6,073 cases and 84,856 controls. We fine-mapped GWAS signals within HLA (DQ0602, DQB1*03:01 and DPB1*04:02) and discovered seven novel associations (CD207, NAB1, IKZF4-ERBB3, CTSC, DENND1B, SIRPG, PRF1). Significant signals at TRA and DQB1*06:02 loci were found in 245 vaccination-related cases, who also shared polygenic risk. T cell receptor associations in NT1 modulated TRAJ*24, TRAJ*28 and TRBV*4-2 chain-usage. Partitioned heritability and immune cell enrichment analyses found genetic signals to be driven by dendritic and helper T cells. Lastly comorbidity analysis using data from FinnGen, suggests shared effects between NT1 and other autoimmune diseases. NT1 genetic variants shape autoimmunity and response to environmental triggers, including influenza A infection and immunization with Pandemrix (R)

The Physico-Chemical and Microbial Content of White Cheese Obtained Using Plant-based, Animal and Microbial Enzymes

It is required to increase the amount of coagulant enzyme substitutes obtained from various sources that are equivalent to animal rennet in order to meet the rising demand for cheese. This study looked into the availability of plant-based enzymes as an alternative to rennet made from animals and microorganisms, which are frequently employed in the manufacturing of white cheese. Using animal (100% chymosin), microbial (obtained from Muchor miehei), and plant-based (Safflower seed, 80% chymosin-20 percent pepsin, purified from Cartamus tinctorius L.) enzymes, 6 varieties of raw and pasteurized milk cheese were made for this purpose. The values of SH, ripening index, water-soluble nitrogen (WSN), nitrogen dissolved in trichloroacetic acid (TCA), and yeast-mold increased after storage in cheeses made with various coagulant enzymes. During storage, the values for dry matter, pH, protein, Total Aerobic Mesophilic Bacteria (TAMB), lactobacilli, lactococci and coliforms all reduced. In terms of L*, a* and b* values, different rennet usage was discovered to be significant among cheese samples. The casein protein began to hydrolyze and the strength of the bands decreased in SDS-PAGE with the breakdown of the αs-casein and β-casein fractions on the 90th day of maturation in P1 and P4 numbered cheeses, which used plant-based enzyme made from raw and pasteurized milk. These changes in casein fractions resulted in a bitter taste in cheese made with plant-based enzymes. The use of plant-based enzymes in the manufacturing of white cheese was shown to produce results that were comparable to those of animal and microbial enzymes and did not have any negative effects on the cheese's physicochemical and microbiological quality parameters. When making fresh white cheese, the plant-based enzyme extracted from Carthamus tinctorius L. can be employed as a promising source of plant coagulants

Contralateral suppression of otoacoustic emissions in migraine patients without vestibular involvement

Özet: Vestibüler flikayeti olmayan migren hastalar›nda kontralateral otoakustik emisyon süpresyonu Amaç: Bu çal›flman›n amac› duyusal modülasyon bozuklu¤una yol açan migren hastal›¤› olan kiflilerde iflitme sistemi refleksi ölçümünde kullan›lan bir test olan kontralateral otoakustik süpresyon testinin sonuçlar›n›n de¤erlendirilmesidir. Yöntem: Çal›flmaya nöroloji poliklini¤ine baflvuran, Uluslararas› Bafla¤r›s› Derne¤i&apos;nin 2004 y›l› kriterlerine göre migren tan›s› alan ve vestibüler flikayeti olmayan gönüllü migren hastalar› ve sa¤l›kl› gönül-lüler dahil edildi. Bütün gönüllülere tam otolojik muayene, saf ses odyometri testi yap›ld›. Bilateral otoakustik emisyon yan›t› al›nan 30 gö-nüllü migren hastas› ve karfl›laflt›rma için yafl ve cinsiyet özellikleri gö-nüllü hasta grubuna benzeyen 30 sa¤l›kl› gönüllü çal›flmaya dahil edildi. Çal›flmaya dahil edilen gönüllülere kontralateral 50 dB SPL genifl bant gürültü ile maske yap›larak 65 dB click uyaran ile maskeli ve maskesiz otoakustik emisyon ölçümleri yap›ld›. Her iki gruptan elde edilen veriler karfl›laflt›r›ld›. Bulgular: Sa¤l›kl› gönüllülerin de¤erlendirilen 60 kula¤›n›n 40&apos;›nda (%67) süpresyon testi pozitif olarak tespit edilirken migren hastalar›n›n de¤erlendirilen 60 kula¤›ndan 30&apos;unda (%50) süpresyon testi pozitif olarak tespit edildi. Fakat süpresyon pozitifli¤i oranlar›nda ve süpres-yon emisyon de¤erlerinde istatistiksel olarak anlaml› bir fark izlenmedi. ‹ki grup aras›nda istatistiksel olarak anlaml› bir fark olmasa da migrenli grupta kontralateral supresyon cevaplar›nda azalma izlendi. Sonuç: Vestibüler flikayeti olmayan migren hastalar›nda normal kiflilerle karfl›laflt›r›ld›¤›nda istatistiksel olarak anlaml› olmasa da kontralateral süpresyon cevaplar›nda bir azalma izlenmektedir. Daha büyük seri içeren yeni çal›flmalar ile kontralateral otoakustik emisyon testi vestibüler flikayeti olmayan migren hastalar›nda odyovestibüler flikayetlerin erken tan›s›nda kullanabilece¤i kanaatindeyiz. Anahtar sözcükler: Kontralateral süpresyon testi, MOC refleksi, non-vestibüler migren, otoakustik emisyon. Abstract Objective: Our aim was to investigate contralateral suppression of otoacoustic emission for the evaluation of auditory reflex in patients with migraine which is a disease that may cause dysfunction of sensorial modulation. Methods: Voluntary migraine patients without vestibular symptoms who consulted to Neurology Clinic, and diagnosed according to the IHS 2004 criteria, and healthy volunteers were included in the study. All volunteers underwent complete otorhinolaryngologic and puretone audiometric examinations. Thirty voluntary migraine patients with bilateral otoacoustic emission measurements, and 30 healthy volunteers matched in terms of age and sex were included in the study. Otoacoustic emission measurements were obtained with 65 dB SPL click stimulus with and without mask by masking with contralateral 50 dB SPL broad band noise. Responses were compared between two groups. Results: Positive result was obtained in suppression tests in 40 of 60 (67%) ears of healthy volunteers and in 30 of 60 (50%) ears of migraine patients. However, there was no statistically significant difference between groups regarding positive suppression frequency and suppression values. Even though a statistically significant difference between migraine patients without vestibular involvement and control group was not seen, there was a decrease in contralateral suppression responses in the migraine group. Conclusion: Although it is statistically insignificant, we have demonstrated that migraine patients without vestibular symptoms showed a decrease in the suppression values compared to the healthy volunteers. We believe that in new studies with larger series, contralateral otoacoustic emission suppression test can be used as an early tool to diagnose audiovestibular symptoms in migraine patients without any vestibular involvement

An investigation of sleep profiles in individuals with idiopathic scoliosis

Objective: Sleep behaviors have not been well investigated in individuals with idiopathic scoliosis (IS). This study aimed to investigate sleep quality and daytime sleepiness in individuals with IS and investigate the relationship between sleep parameters and curve magnitude, trunk deformity severity, pain, and emotional status in adolescents with IS. Material and Methods: Ninety-one participants between the ages of 10 and 19 years with IS were included. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI), and daytime sleepiness was assessed with Epworth sleepiness scale (ESS). Pain was assessed using the short-form McGill pain questionnaire; the presence or severity of depressive feelings was evaluated using the Beck depression scale. Results: The majority of the participants (64.8%) had poor sleep quality, while daytime sleepiness was within normal limits in most participants (85.7%).The frequency of participants without pain (52.7%) was similar to participants with pain (47.3%). The prevalence of participants with depressed mood was 35.2%. Participants with poor sleep quality were more likely to have a higher sensorial index (p<0.001), higher total pain scores (p=0.001), and less lumbar axial rotation (p=0.046). Higher pain (r=0.391), depression scores (r=0.234), and lower lumbar axial trunk rotation (r=-0.317) were associated with increased daytime sleepiness. Conclusion: We observed poor sleep quality and an association with pain in patients with IS. Curve magnitude had no adverse effect on sleep quality or daytime sleepiness. Therefore, the sleep profile and its association with pain should be considered during the rehabilitation process in patients with IS

Intracranial metallic foreign bodies in a man with a headache

We report the case of a 22-year old man with intracranial metallic foreign bodies who presented complaining of a headache. His history of headaches had begun when he was five years old and continued with increasing severity. Six months before hospital admission, nausea and vomiting began to accompany his headache. Computed tomography scan revealed that 2 metallic foreign bodies were located adjacent to the vertex and another was next to the ambient cistern. The location and position of foreign bodies suggested that they were introduced in infancy through the anterior fontanelle before its closure in an unsuccessful homicide attempt. This case is one of the few reported cases combining headache and intracranial foreign bodies and we discuss the relationship between headache and these metallic materials