The relationship between childhood trauma, emotion recognition, and irritability in schizophrenia patients.

This study investigated the relationship between childhood trauma, irritability, and emotion recognition, in schizophrenia patients during a psychotic break. Thirty-six schizophrenia inpatients and 36 healthy controls were assessed with the Irritability Questionnaire (IRQ) and two facial emotion recognition tasks, the Emotion Discrimination Test (EDT) and Emotion Identification Test (EIT). Patients were further assessed with the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II), the Positive and Negative Symptom Scale (PANSS), and the Childhood Trauma Questionnaire-28 (CTQ-28). EDT and EIT performance was significantly impaired in patients compared to healthy controls. Furthermore, patients tended to misidentify sad, surprised, or angry faces as showing fear, and this misidentification correlated with the patients' irritability. Childhood adversity increased irritability both directly and indirectly through emotion misidentification.

Prevalence of Psychiatric Comorbidity in Symptomatic Gastroesophageal Reflux Subgroups.

BACKGROUND: Limited data exist regarding the psychosocial aspects of gastroesophageal reflux disease (GERD). Some GERD subgroups, such as functional heartburn and hypersensitive esophagus, might show different psychiatric comorbidities than others. AIM: We aimed to evaluate the psychiatric comorbidities of GERD subgroups using a cross-sectional design. METHODS: A group of GERD patients at a tertiary outpatient clinic were evaluated via upper GIS (gastrointestinal system) endoscopy, esophageal manometry, and 24-h impedance-pH monitoring. Thirty-nine patients diagnosed with erosive reflux disease, 44 with non-erosive reflux disease, 20 with functional heartburn, 11 with hypersensitive esophagus, and 44 healthy controls participated. Psychiatric diagnoses were made using the Structured Clinical Interview for Diagnostics and Statistical Manual of Mental Disorders IV. Psychometric measurements of the patients were performed using the Somatosensory Amplification Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, and Short-Form 36. Healthy controls were evaluated with the same psychometric scales except for the Short-Form 36. RESULTS: All of the GERD subgroups were significantly more depressed than the control group. Depressive disorders were significantly more prevalent in the functional heartburn group than in the non-erosive reflux disease and erosive reflux disease groups. The trait anxiety level of the functional heartburn group was significantly higher than those of the control and non-erosive reflux disease groups. The quality of life scores of the GERD subgroups were significantly lower than the population standards. CONCLUSIONS: Depressive disorders were frequently comorbid in the GERD subgroups studied (30-65 %). It is essential to consider the high prevalence rates of comorbid depression when managing GERD.

Evaluation of the Relationship Between Microalbuminuria and Urine Ischemia-Modified Albumin Levels in Patients with Diabetic Nephropathy.

INTRODUCTION: Ischemia-modified albumin (IMA) is a marker which can be associated with oxidative stress in various ischemic and non-ischemic processes. Oxidative stress plays roles in diabetes mellitus, its complications and pathogenesis. Serum IMA levels are examined in various clinical events. However, urine IMA levels have not yet been evaluated in diabetic patients. In this study, we aim to examine the relationship between metabolic features and urine microalbuminuria levels of diabetic patients and their urine IMA levels. MATERIALS AND METHODS: There were totally 50 type 2 diabetic patients in the study at the Mevlana University Hospital. Patients with cerebrovascular disease, acute myocardial infarction, hemodialysis patients with end stage chronic renal failure, pulmonary embolism, and malignant disease were excluded from the study. Metabolic features, urine IMA levels and cardiological parameters of patients were evaluated. RESULTS: Mean age of patients was 59 ± 9 years, 20 of them (40%) were male and 30 of them (60%) were female. There were six patients with albuminuria value of <0.03 mg/g (normal), there were 39 patients with microalbuminuria value of 0.03-0.3 mg/g and there were five patients with macroalbuminuria of >0.3 mg/g. According to the analysis of patients with microalbuminuria (n = 39), there was no correlation between IMA levels and numerical demographic data, albuminuria, glucose, HbA1c, lipid profile, creatinine, uric acid, hematological parameters. DISCUSSION: Conclusively, there was no relationship between urine IMA levels and microalbuminuria related to the diabetic nephropathy. These findings can be associated with urinary excretion mechanisms of IMA.

Association between PDW and Long Term Major Adverse Cardiac Events in Patients with Acute Coronary Syndrome.

BACKGROUND: The aim of the present study was to perform a preliminary evaluation of the potential association between platelet distribution width (PDW) and frequency of major adverse cardiovascular events (MACEs) development in an observational study of acute coronary syndrome (ACS) patients. METHODS: A total of 679 consecutive patients with ACS (498 (73.3%) males; mean age was 63.31±11.2 years; study population composed of 320 patients with acute myocardial infarction and 359 patients with unstable angina pectoris) subjected to primary percutaneous coronary intervention with transradial approach (TRA) were retrospectively enrolled to the study. Tertiles were formed based on PDW levels. The associations between PDW and in-hospital and long-term MACEs were analysed. RESULTS: The frequencies of in-hospital instent thrombosis (P=0.05), long-term instent restenosis (P=0.005) and long-term total MACEs (P=0.008) were higher in tertiles having a high PDW value. In multivariate analyses, PDW was an independent predictor of in-hospital and long-term MACEs (odds ratio 1.081, 95% confidence interval 1.003-1.165; p=0.042). The projected Kaplan-Meier incidence of a MACEs in the PDW tertiles groups were 12.8%, 12.1%, and 21.6% at 40 months (respectively, p=0.003). CONCLUSIONS: The pre-procedural PDW may be an independent predictor of both in-hospital and long-term adverse outcomes in patients with ACS.

A surgeon's nightmare: Complications.

OBJECTIVE: Our study aimed to determine the physically and psychologically most difficult complication resulting in chronic discomfort and occurring sensationally in the postoperative period of operations performed frequently in the daily surgical routine. MATERIAL AND METHODS: We performed a survey among surgeons who participated in the 19(th) National Surgery Congress. The questions were related to the complications encountered in the frequent procedures performed in the daily general surgery routine and resulting in chronic life discomfort but which are not life threatening. Three hundred and sixty general surgeons participated in the survey and they were asked which complication among the given ones was the most difficult for a surgeon to manage physically and psychologically. The received answers were recorded and evaluated with descriptive statistical analysis. RESULTS: Among the surgeons who participated in the survey, 345 were male (96%) and 15 female (4%); 218 (61%) general surgeons served in universities whereas 112 (30%) surgeons served in other public institutes and 30 (9%) served in private hospitals. With regard to the ranking of the complications that are most difficult to manage by the surgeons, pain and hemorrhage developing after hemorrhoidectomy were in the first place with 90 (25%) votes, whereas persistent hypocalcemia after total thyroidectomy was in the second place with 73 (20%) votes. Furthermore, 286 (80%) surgeons stated that the complications did not discourage them from performing the same operation again. CONCLUSION: Our results indicated that among the determined complications of operations performed in daily surgery routine, pain and hemorrhage developing after hemorrhoidectomy were the most difficult to manage. In addition, it was observed that complications did not discourage surgeons to perform the same operation again, contrary to popular belief.

The disrupted connection between cerebral hemispheres in schizophrenia patients: a diffusion tensor imaging study.

AIM: In schizophrenia, the disruption of the communication between two brain hemispheres has not been shown clearly in the anatomical aspect despite other studies with different modalities suggested so. In this study, the structural integrity and the variables affecting the structural integrity of the corpus callosum, which is the main connection between two hemispheres, was investigated via diffusion tensor imaging (DTI). METHODS: The participants were evaluated by SCID-I and symptoms of the patients were assessed with PANSS. DT images of 25 schizophrenia patients and 17 healthy volunteers were acquired via 1.5 T MR. Fractioned Anisotropy (FA) values of two groups, measured on the DT images, were compared. RESULTS: It was found that fractioned anisotropy (FA) values were lower in the genu of the patients than the healthy controls; however, there was no difference between the FA values of the patients and the controls in the splenium. Moreover, a significant negative correlation between the splenium FA values and the antipsychotic medication doses; and a trend level negative correlation of splenium FA and PANSS scores were found. CONCLUSION: Corpus callosum is the most important structure that connects two frontal lobes. The hypothesis that posits the fundamental role of the disconnection of frontal lobes in schizophrenia is supported by the findings of this study.

[Small frontal gray matter volume in first-episode depression patients]. / Ilk Atak Depresyon Hastalarinda Azalmis Frontal Korteks Hacimleri.

OBJECTIVE: Brain imaging studies have shown that depressed individuals suffer from inadequate frontal lobe functions vis à vis smaller frontal lobes. The effects of depression's recurrent nature and long-term antidepressant treatment are not definitely known. This study aimed to examine frontal lobe volume at the onset of clinical depression by including first-episode drug-naive depressed patients. METHOD: The study included 23 first-episode drug-free major depression patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and 28 healthy age- and sex-matched controls. Cranial magnetic resonance (MR) images were obtained in both groups using a 1.5 Tesla device. Gray and white matter volumes in the frontal lobes were measured using the Medical Image Processing Analysis and Visualization (MIPAV) computer program. RESULTS: Frontal gray matter volume in the patients was lower than that in the control group. White matter and total intracranial volume did not differ between the 2 groups. Small gray matter volume was not correlated with the duration or severity of illness. CONCLUSION: The results of this study indicate that frontal lobe gray matter volume is low in first-episode depressed patients and is independent of both illness severity and duration. This result suggests that the observed changes in the frontal lobe could have occurred before the clinical symptoms of depression were observed.

The relationship between glycemic control and platelet activity in type 2 diabetes mellitus.

AIMS: Platelet activity and aggregation potential, which are essential components of thrombogenesis and atherosclerosis, can be conveniently estimated by measuring mean platelet volume (MPV) as part of whole blood count. It has been shown that MPV was significantly higher in diabetes mellitus (DM); however, the effect of glycemic control on MPV has not been studied. The aim of this study was to investigate the relationship among MPV, glycemic control, and micro- and macrovascular complications in type 2 DM. METHODS: Seventy patients with type 2 DM and 40 age- and sex-matched healthy individuals were enrolled. Diabetic patients were grouped into those with glycated hemoglobin (HbA1c) levels 7% (Group B, n=35 patients). Initially, both groups were compared with regard to MPV, HbA1c, serum lipid levels, coronary artery disease, retinopathy, neuropathy, and nephropathy. Thereafter, Group B was called to monthly visits to obtain improved control glycemic control, which was defined as achievement of HbA1c