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SUMMARY OBJECTIVE: The objective of this study was to examine the effects of orlistat use on metabolic control and weight loss in diabetic and nondiabetic patients. METHODS: A total of 119 patients with body mass index≥40 kg/m2 and receiving orlistat therapy, who applied to the Endocrinology polyclinic between January 2016 and October 2019, were included. The patients' weight changes and biochemical values (i.e., fasting glucose, HbA1c, ALT, creatinine, and lipid parameters) were evaluated at the drug beginning and the last polyclinic control. The patients were divided into groups, whether they had diabetes or used metformin, and compared. RESULTS: The mean age of the 119 patients in the study was 45.3±11.5 years. A total of 94.1% of the patients were females and 5.9% were males. A total of 38.7% of the patients had diabetes and 29.4% had prediabetes. When the patients were compared to whether they had diabetes or used metformin, there was a statistically significant difference between the groups according to weight loss. The mean weight change of patients without diabetes and receiving metformin and orlistat was statistically significantly higher than that of patients with diabetes and receiving metformin and orlistat. DISCUSSION: It was determined that the weight loss effect of orlistat in obesity was seen in all groups, but this effect decreased in the diabetic group.
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Background@#and Purpose There are controversies regarding the role of presynaptic inhibition (PSI) in the mechanisms underlying the efficacy of deep-brain stimulation (DBS) in Parkinson’s disease (PD). We sought to determine the involvement of PSI in DBS-related mechanisms and clinical correlates. @*Methods@#We enrolled PD subjects who had received subthalamic nucleus DBS (STN-DBS) therapy and had been admitted to our clinic between January 2022 and March 2022. The tibial H-reflex was studied bilaterally during the medication-off state, and all tests were repeated 10 and 20 minutes after the simulation was turned off. Simultaneous evaluations based on the Movement-Disorder-Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS-III) were performed in all of the patients. @*Results@#Ultimately we enrolled 18 patients aged 58.7±9.3 years (mean±standard deviation, 10 females). Fifty percent of the patients showed a decrease in the MDS-UPDRS-III score of more than 60% during the stimulation-on period. Comparative analyses of the repeated measurements made according to the stimulation status revealed significant differences only in the left H-reflex/M-response amplitude ratio (H/M ratio). However, no difference in the left H/M ratio was found in the subgroup of patients with a prominent clinical response to stimulation (n=9). Analyses of the less-affected side revealed differences in the H-reflex amplitude and H/M ratio. @*Conclusions@#We found evidence of PSI recovery on the less-affected side of our PD subjects associated with STN-DBS. We hypothesize that the involvement of this spinal pathway and its contribution to the mechanisms of DBS differ between individuals based on the severity of the disease and which brainstem regions and descending tracts are involved.
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@#There is increasing evidence that inflammation is involved in the mechanisms of acute ischemic stroke. The utility of neutrophil-to-lymphocyte ratio (NLR) has recently been reported to help in the prognostication of stroke. The utility of NLR in the diagnosis of stroke remains uncertain. In this retrospective study, patients with acute ischemic stroke who presented within the first 24 hours of symptom onset to our clinic from September to December 2019 were studied, involving 93 patients with stroke and 60 control. The mean age in the stroke group was 71.7 ± 12.2 years whereas it was 72.6 ± 5.7 in the control group (p=0.405). The female/male ratio was 47/46 in the stroke group and it was 26/34 in the control group (p=0.411). The NLR level was higher in patients with ischemic stroke as compared to control (p=0.029) whereas hemoglobin levels were lower in the patient group (p= 0.025). The ROC curve analysis revealed that a NLR cutoff point of 2.34 had 61.3 % sensitivity and 60% specificity in detecting patients with ischemic stroke. The regression analyses also revealed that the NLR and hemoglobin levels were predictors for stroke. In conclusion, NLR and hemoglobin may potentially be paraclinical markers in differential diagnosis of stroke.
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No abstract available.
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Humans , Alzheimer Disease , Hydrocephalus, Normal PressureABSTRACT
This is a report of 2 hypertensive siblings with a history of carotid body tumors and subsequent benign adrenal pheochromocytomas [pheos] in a family where the mother had died of possible adrenal carcinoma. The first case was a 35-year-old woman with paroxysmal hypertensive attacks and a right adrenal mass. She had earlier undergone surgery to remove bilateral carotid body tumors. Investigation revealed excessive excretion of catecholamines and their metabolites in the urine. Abdominal MRI and 131I-MIBG scintigraphy revealed a right adrenal tumor. Right adrenalectomy was performed. The second case, the 45-year-old brother of the first case, was found to have a left adrenal mass on abdominal MRI. Catecholamines and their metabolites in the urine were found to be increased. He had also had surgery to remove bilateral carotid body tumors of the neck. Left adrenalectomy was performed. Both siblings showed no evidence of other familial syndromes, such as multiple neoplasia type 2, von Hippel-Lindau disease or neurofibromatosis type 1. Although the combination of familial carotid body tumors and pheo is rare, a patient who remains hypertensive after removal of a carotid body tumor deserves a careful evaluation to exclude pheo. Such tumors may be extra-adrenal or multifocal