ABSTRACT
A cross-sectional, population-based, 2-stage prevalence study was conducted in a sample of 1019 community-dwelling persons over the age of 70 years living in Istanbul. In the first phase, participants were screened with the Mini-Mental State Examination for evidence of cognitive impairment. In the second phase, 79% of those who screened positive (n = 322) and 9% of screen-negatives (n = 63) underwent a standardized diagnostic workup. Diagnosis of dementia and Alzheimer's disease (AD) was made according to established criteria. Ninety-three cases of dementia were identified, 58 of whom were diagnosed with probable AD. Based on these numbers, the prevalence rates of probable AD and dementia were calculated to be 11.0% (95% CI, 7.0% to 15.0%) and 20.0% (95% CI, 14.0% to 26.0%), respectively, in this population. Prevalence rates of dementia and AD in Istanbul, Turkey, are comparable with those seen in the Western world.
Subject(s)
Dementia/epidemiology , Urban Population/statistics & numerical data , Aged , Alzheimer Disease/epidemiology , Apolipoproteins E/genetics , Catchment Area, Health , Cross-Sectional Studies , Dementia/genetics , Demography , Female , Gene Frequency , Humans , Male , Mass Screening , Prevalence , Turkey/epidemiologyABSTRACT
BACKGROUND AND OBJECTIVE: Familial Mediterranean fever (FMF) is an inherited inflammatory disease characterized by recurrent febrile polyserositis. Central nervous system (CNS) involvement in FMF is uncommon, but recently cases with multiple sclerosis (MS) and FMF have been reported. Here we assess patients with both FMF and MS, in order to clarify any relationship between FMF and MS, and to evaluate disease characteristics. PATIENTS AND METHODS: Our MS database between 1986-2005 was screened retrospectively, and patients with both FMF and inflammatory/demyelinating CNS disease were evaluated among a total of 2800 patients including definite MS (n = 2268) and other demyelinating disorders. RESULTS: There were 12 patients with FMF, who developed a CNS disorder with multifocal white matter lesions. Median age at onset of FMF was 7 years, and median age at neurological onset was 26.8 years. Nine patients (including two siblings) had definite MS according to clinical and MRI findings, whereas 3 patients had atypical features suggesting other demyelinating disorders. Disease severity varied among the patients between very mild to a fatal course. All 8 patients evaluated for oligoclonal IgG bands in CSF were positive. CONCLUSION: The rate of FMF among our patients with definite MS is almost 4 times the expected prevalence in Turkey. Our series including a sibling pair concordant for FMF and MS may suggest that similar genetic susceptibility and environmental factors might be responsible, although coincidence still remains a possibility. A prospective study on a larger sample seems to be justified.
Subject(s)
Central Nervous System/pathology , Familial Mediterranean Fever/diagnosis , Familial Mediterranean Fever/epidemiology , Multiple Sclerosis/diagnosis , Multiple Sclerosis/epidemiology , Adolescent , Adult , Age of Onset , Central Nervous System/physiopathology , Child , Child, Preschool , Comorbidity , Databases, Factual , Disease Progression , Environment , Familial Mediterranean Fever/cerebrospinal fluid , Genetic Predisposition to Disease/genetics , Humans , Middle Aged , Multiple Sclerosis/cerebrospinal fluid , Nerve Fibers, Myelinated/pathology , Oligoclonal Bands/cerebrospinal fluid , Prevalence , Retrospective Studies , Turkey/epidemiologyABSTRACT
We report an unusual case of celiac disease in a 31-year-old woman with gait disorder, stimulus-induced myoclonus and abnormalities of eye movement. We suggest that celiac disease can present with a variety of unusual neurological manifestations.
Subject(s)
Celiac Disease/complications , Nervous System Diseases/etiology , Adult , Celiac Disease/therapy , Eye Movements , Female , Gait , Humans , Movement Disorders/etiology , Myoclonus/etiology , Nervous System Diseases/physiopathologyABSTRACT
OBJECTIVE: To evaluate growth process and insulin like growth factor-1 (IGF-1) levels in children with familial Mediterranean fever (FMF). METHODS: This prospective study group consisted of 51 children with FMF under colchicine therapy (20 boys, 31 girls) and 42 healthy children (22 boys, 20 girls). All children were prepubertal. Bone ages and IGF-1 levels were determined in all cases. Height velocity (HV), height standard deviation score (SDS), target height and target height SDS were calculated. RESULTS: There was no statistical difference in age, HSDS, target height SDS and bone ages between healthy and diseased subjects. HV of children with FMF did not differ significantly from the control group. There was no statistical difference in age, HSDS, target height SDS and bone ages between healthy and FMF subjects. HV of children with FMF did not differ significantly from the control group. There was no significant correlation between disease duration, number of attacks, erythrocyte sedimentation rate and HV, HSDS and IGF-1 levels of FMF patients. There was positive correlation between cumulative colchicine dose and HV (r = 0.29). CONCLUSION: Growth and IGF-1 levels of children with FMF do not differ from their healthy peers. However, there was positive correlation between HV and cumulative colchicine dose. This study suggests that colchicine not only has no adverse influence on growth, but more by suppressing disease activity and inflammation it has an enhancing role.
