Mini-mental state exam versus Montreal Cognitive Assessment in patients with diabetic retinopathy.

BACKGROUND: Mini-mental state exam (MMSE) was used several times but no study has examined cognition on the Montreal Cognitive Assessment (MoCA) in diabetes and diabetic retinopathy (DR). In this study, we compared MMSE with MoCA in patients with DR and searched for an association between the severity of DR and cognitive impairment (CI). METHODS: This cross-sectional study comprised 120 consecutive patients with diabetes. Patients were divided into four groups as no DR, mild DR, severe nonproliferative DR (PDR) and PDR. Each group consisted 30 inviduals. CI was assessed using the MMSE and MoCA. RESULTS: The number of subjects with a score>21 were significantly lower on the MoCA than on the MMSE between groups (all P<0.05). The mean MoCA score was significantly lower than the MMSE score (P<0.001) There was a linear association between the grade of DR and a score<21 on both tests, CONCLUSION: MoCA provides more insight into the cognitive function in DR.

Is there a relationship between Parkinson's disease and Chlamydia pneumoniae?

OBJECTIVES: The aim was to investigate a possible relationship between Chlamydia pneumoniae and Parkinson's disease (PD). STUDY DESIGN: Serum samples obtained from a cohort of 51 patients with PD and from 37 age- and sex-matched controls were assessed for the presence of antibodies. The control group was selected from healthy people. In both groups, 5 mL of blood was taken and after centrifugation frozen at -80°C. Presence and concentration for C. pneumoniae IgM and IgG were determined by the enzyme linked immunosorbent assay (ELISA) and immunofluorescence (IFA), using C. pneumoniae IgG and IgM kit (Euroimmun, Germany). RESULTS: Chlamydia pneumoniae IgG was positive in 50 (98%) patients in ELISA study. C. pneumoniae IgG was positive in 34 (92%) control subjects in ELISA study. C. pneumoniae IgG positivity in patients was slightly higher, but the difference did not reach statistical significance (P = 0.17). No statistically significant difference was found between the patient and the control groups in IFA study (P ≥ 0.5). C. pneumoniae IgM results (both ELISA and IFA study) was negative in the both PD group and control group.

Greater occipital nerve blockade for the treatment of chronic migraine: a randomized, multicenter, double-blind, and placebo-controlled study.

OBJECTIVES: We aimed to assess the efficacy of greater occipital nerve (GON) blockade at chronic migraine (CM) treatment. MATERIALS AND METHODS: Patients with CM were randomly divided into two groups of 42. GON blockade was administered four times (once per week) with saline in group A or bupivacaine in group B. After 4 weeks of treatment, blinding was removed; in group A, GON blockade was achieved using bupivacaine, while group B continued to receive bupivacaine, and blockade was administered once per month, then followed for 2 months. Primary endpoint was the difference in number of headache days, duration of headache, and pain scores. RESULTS: Seventy-two of 84 patients completed the study. After 1 month of treatment, number of headache days had decreased from 16.9 ± 5.7 to 13.2 ± 6.7 in group A (P = 0.035) and from 18.1 ± 5.3 to 8.8 ± 4.8 in group B (P < 0.001), (P = 0.004, between groups); duration of headache (hour) had decreased from 24.2 ± 13.7 to 21.2 ± 13.4 in group A (P = 0.223) and from 25.9 ± 16.3 to 19.3 ± 11.5 in group B (P < 0.001), (P = 0.767, between groups). VAS score decreased from 8.1 ± 0.9 to 6.7 ± 1.6 in group A (P = 0.002) and from 8.4 ± 1.5 to 5.3 ± 2.1 in group B (P < 0.001), (P = 0.004, between groups). After blinding was removed (in 2nd and 3rd month), group A exhibited similar results like group B in 3rd month. CONCLUSIONS: Our results suggest that GON blockade with bupivacaine was superior to placebo and was found to be effective, safe, and cost-effective for the treatment of CM. According to our knowledge, this is the first randomized, multicentre, double-blind, and placebo-controlled study in the literature in this field of work.

Mini mental state exam versus Montreal cognitive assessment in patients with age-related macular degeneration.

OBJECTIVE: To compare the ability of the MMSE and MoCA to identify cognitive dysfunction in patients with age-related macular degeneration (AMD). PATIENTS AND METHODS: The study included 81 (29 female, 52 male) AMD patients who were recruited from the Ophthalmology Department of Kirikkale University during 2012. Participants were screened for cognitive impairment using the MMSE and MoCA. The scores were recorded for all participants. The primary outcome measure was the proportion of patients with a score less than 21 on either test. RESULTS: The percentage of subjects who scored below a cut off of 21/30 was higher on the MoCA (48.1%) than on the MMSE (18.5%) (p = 0.05). The range and standard deviation of scores was larger with the MoCA (7-30, 5.34) than with the MMSE (19-30, 3.26). There was a more pronounced ceiling effect of the MMSE than of the MoCA. The mean MMSE scores of dry-and wet-type AMD patients was significantly higher than the MoCA scores of the same patients (p = 0.000 and p = 0.000). CONCLUSIONS: The MoCA seems to be more sensitive than the MMSE to early cognitive impairment in AMD patients.