Objectives Data regarding schizophrenia treatment has been increasing whereas the information about predictors of treatment response is limited. In this study, our aim is to investigate the serum levels of reproductive hormones as a biological predictor in terms. Methods Thirty-three hospitalized male patients in GATA Haydarpasa Training Hospital with the diagnosis of first episode psychosis were included into the study. The study was prospective and naturalistic in design. The clinical course was recorded by means of Positive and Negative Symptom Scale (PANSS) in pretreatment period, 2nd and 6th weeks of the study. Prolactin, FSH, LH, estrogen, testesterone and oxytocin serum levels were also measured at the same dates. Results Treatment response was assessed as unresponsive when PANSSttl scores were lower than 25%, partial response when PANSSttl scores were between 25%-40% changes, and response when PANSSttl scores were higher than 40%. Patients were grouped according to those cut-off points. There was a significant positive correlation between oxytocin, FSH serum levels and positive symptoms (ρ = 0.437, P = 0.011; r = 0.385, P = 0.027). There was also significant negative correlation between testesterone serum levels and negative and total psychopathology scores ( r = −0.352, P = 0.044; r = −0.429, P = 0.013). It was seen that pretreatment testerone levels had a significant biological marker on predicting remission when the serum levels were lower than 460,91 ng/dL. Conclusions This study shows that hypothalamo-hypophysial-gonadal axis hormones and reproductive hormones, especially testesterone, may be an important biological marker of treatment response prediction in first episode psychosis. Disclosure of interest The authors have not supplied their declaration of competing interest.
In this report a 20-year-old male patient who had suffered tonic-clonic seizure after a single induction dose of etomidate until a bispectral index value of 60 is presented. Our best knowledge, this case is the first report of pure etomidate (with induction dose) induced generalized tonic clonic seizure proven with EEG. Anaesthesiologists should be careful against such a complication even in the induction stage of anaesthesia during etomidate use.
We aimed to investigate the efficacy and complications of combined spinalepidural anesthesia and general anesthesia in percutaneous stone surgery prospectively.
We present a case of bilateral pneumothorax (PNX) and pneumo-mediastinum that developed after manual ventilation with a bag valve device during transport. A 65-year-old female patient underwent a lumbar disc stabilization surgery under general anesthesia. Manual ventilation with a bag valve device was performed during transport to imaging center. However, the patient developed bilateral pneumothorax and pneumo-mediastinum. The chest tube was inserted, and the patient made a rapid recovery. The chest tube was removed on the third postoperative day, and she was discharged uneventfully on the sixth postoperative day.
Prefrontal and/or temporo-limbic abnormalities associated with antisocial personality disorder (APD), high psychopathy scores and violent behaviours can readily be evaluated by neuroimaging methods.In this study, we compared the brain metabolites in adult male military conscripts with APD, high psychopathy scores and serious violent crimes (n = 15) with age- and educational-level-matched healthy controls (n = 15) by means of magnetic resonance spectroscopy.All cases were diagnosed by means of the Diagnostic Statistical Manual-IV APD module of the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II) semistructured questionnaire in Turkish. The psychopathy scores were evaluated by means of the Hare Psychopathy Checklist-Revised translated into Turkish (PCL-R). PCL-R is a 20-item, reliable and valid instrument for assessment of psychopathy, both in categorical and dimensional natures. All patients had a total score of 29 (of possible 40) or higher from PCL-R, indicating a high degree of psychopathy.Our results showed no significant differences in ratio of N-acetyl aspartate (NAA), creatine (Cr) and choline-related compounds in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC) and amygdala-hippocampus regions of cases compared with controls. ACC NAA/Cr was significantly negatively correlated with both the PCL-R total score and the PCL-R factor I score (interpersonal/affective problems) among the cases.As ACC plays an important role in decision-making and emotional information processing, we postulate that the lower NAA/Cr ratio, suggesting impaired neural integrity, may increase the severity of interpersonal/affective problems of the psychopathy factor in male subjects exhibiting APD, high psychopathy overall scores and violent crimes.
BACKGROUND Carbon monoxide (CO) poisoning is commonly seen during the winter season in Turkey due to use of charcoal stoves and water heaters, but narghile smoking is a rare cause of CO poisoning. CASE REPORT In this paper, we report a CO poisoning case caused by narghile smoking. The patient was admitted to the ED with nausea, dizziness, vertigo, and syncope. CONCLUSIONS The diagnosis of CO poisoning depends on suspicious anamnesis. The major treatment of CO poisoning is oxygen supply.