Serum Copeptin Levels in Adult Patients with a Migraine Attack: A Cross-Sectional Study

Aim:This study investigated the potential role of serum copeptin, a mediator of acute pain via sympathetic stress stimulation, as a biomarker of varying degrees of migraine-related disability. Specifically, we aimed to analyze whether the serum copeptin level can be used to differentiate migraine types (e.g., with and without aura).Methods:The study population included 80 consecutively consenting adult patients who had migraine attacks and attended the emergency department from June 2020 through November 2020, as well as 80 age- and sex-matched healthy controls. Using the Migraine Disability Assessment Scale (MIDAS), the same medical professional assessed each patient’s level of headache-related disability. Based on their MIDAS scores, the patients were separated into four groups: no disability (score 0-5; group MIDAS-I); mild disability (score 6-10; group MIDAS-II); moderate impairment (score 11-20; group MIDAS-III); and severe disability (score >20; group MIDAS-IV). There were also two categories of migraineurs: those with auras and those without auras. Upon admission, comparisons were made between the groups’ serum copeptin values.Results:In comparison to the control group, the patient group’s serum copeptin levels were noticeably higher (2113.30±206.20 vs. 1383.40±488.40; p<0.001). The study of the receiving operator’s characteristics showed that the cut-off copeptin level was 1898.5 pg/mL, with 90% sensitivity and 82.4% specificity for distinguishing patients from controls. There were no noticeable differences in the mean serum copeptin levels between the patient groups when compared by MIDAS score. Additionally, patients with and without aura did not differ notably in terms of mean serum copeptin levels. (2118.70±211.60 vs. 2071.10±160.40).Conclusion:Serum copeptin levels may be used as a diagnostic aid to help anticipate migraine-related headache attacks when combined with clinical signs and symptoms

A young puerperal woman presenting to emergency department with severe dyspnea

Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy presenting with heart failure (HF) secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of HF is found. The symptoms and signs of this rare disorder mimic those of the physiological changes of pregnancy or other cardiovascular diseases. Consequently, its diagnosis is frequently delayed, which worsens an already poor prognosis. Here, we report a young adult who was diagnosed with PPCM, early, with the help of focused cardiac ultrasonography, performed after presenting to the emergency department with nonspecific respiratory complaints, including dyspnea and hemoptysis, which suggested at first pulmonary embolism. Keywords: Acute heart failure, Echocardiography, Cardiomyopathy, Ultrasoun

A new side effect of synthetic cannabinoid use by the bucket (waterpipe) method: Acute respiratory distress syndrome (ARDS)

The use and content of synthetic canibinden (SCs) has been rapidly increased in the last decades. The complex content of these substances bring along a wide spectrum of side effects. In addition to the expected neuropsychological side effects of pleasure-inducing substances such as agitation, anxiety, panic attack and hallucinations, rare cases of cerebrovascular diseases, seizures, acute renal injury, myocardial infarction and chronic lung injury have also been previously reported.Here we report a 19-year -old male who was presented with acute respiratory distress syndrome (ARDS) within hours of inhaled SC use with the rarely preferred bucket method. There is limited information in the literature about pulmonary effects of SCs and we could not detect any other ARDS case that develoed within hours after consumption of SC with the bucket method

8-armed octopus: Evaluation of clinicopathologic prognostic factors of urothelial carcinoma of the upper urinary system

Background/aim: This study was designed to determine the characteristic features of upper urinary system urothelial carcinomas (UUSUCs) and to evaluate the clinicopathological parameters associated with prognosis