Background/Aims: Nonalcoholic fatty liver disease is related to obesity, metabolic syndrome, and insulin resistance. Nonalcoholic fatty liver disease and metabolic syndrome may also be encountered in non-obese, non-diabetic individuals, and there are no published data about the prevalence of these conditions in non-obese, non-diabetic Turkish subjects. We aimed to determine the difference between non-obese, non-diabetic nonalcoholic fatty liver disease patients and healthy controls in terms of insulin resistance and metabolic syndrome in Turkish subjects. Materials and Methods: Non-obese, non-diabetic individuals (n=219) were enrolled. The cohort was divided into two groups according to presence of steatosis in ultrasonography: nonalcoholic fatty liver disease group (n=143) and healthy control group (n=76). Insulin resistance and metabolic syndrome were analyzed and compared between the two groups. Results: The prevalences of metabolic syndrome (32.2% vs. 5.3%, respectively; p<0.001) and insulin resistance (46.2% vs. 9.2%, respectively; p<0.001) were significantly higher in the nonalcoholic fatty liver disease group. According to multiple logistic regression analysis, age (odds ratio 1.534; p=0.0032), insulin resistance (odds ratio 1.074; p<0.001), and serum ALT levels (odds ratio 1.102; p<0.001) were independently associated with nonalcoholic fatty liver disease. Conclusion: Insulin resistance and metabolic syndrome are not rare in non-obese, non-diabetic Turkish subjects with nonalcoholic fatty liver disease. Ultrasonographically detected fatty liver was independently associated with insulin resistance, irrespective of the presence of metabolic syndrome.
Background: It was the aim of this study to analyze the clinical manifestations, the incidence of each variant and the comorbid conditions of benign paroxysmal positional vertigo (BPPV) as well as the response to treatment. Methods: One hundred and fifty-seven patients with BPPV were reviewed prospectively. An extensive neurotologic examination was performed. All patients were treated with an appropriate canalith repositioning maneuver (CRM). Results: In 138 patients, the posterior canal (PC) was involved, in 14 patients, the horizontal canal (HC), in 2 patients, the anterior canal (AC), and in 3 patients, both the PC and HC. A history of head trauma was identified in 17 patients. In 1 patient sensorineural hearing loss on the affected side and in another bilateral peripheral vestibular loss was present. A history of migraine was reported in 21 cases. A resolution attributable to the first CRM was achieved in 132 patients. Conclusions: PC involvement was the most frequent type constituting 87.9% of all BPPV cases. HC, AC and mixed canal types were relatively rare constituting 8.9, 1.3 and 1.9% of the cases, respectively. Response to the first CRM was recorded in 84.1%. Association with migraine was recorded in 13.4% of the patients.
The dinoflagellate species Gonyaulax pacifica Kofoid is reported for the first time from northeastern Mediterranean coast of Turkey; it has not previously been reported for any Turkish coastal waters. The morphological characteristics of this species are described in detail and information about its ecological and biogeographical distribution is given.
Ge lifl Ta ri hi/Re cei ved: 29.02.2012 Ka bul Ta ri hi/Ac cep ted: 23.08.2012 Özet Gecikmiş ensefalopati (GE) akut karbon monoksit (CO) intoksikasyonu ardından gözle görülür bir iyileşme periyodu ardından yaklaşık 20. günde gelişen farklı seviyelerde kognitif bozukluk, kişilik değişiklikleri, hareket bozuklukları ve fokal nörolojik bulguları içeren bir nöropsikiyatrik sendromdur. Hiperbarik oksijen tedavisi (HBO) uygulanmasına karşın CO intoksikasyonuna bağlı GE gelişen, kognitif bozukluk ve ılımlı parkinsonizm bulguları ile başvuran 35 yaşında kadın hasta sunulmaktadır. Kraniyal manyetik rezonans görüntülemede (MRG) her iki kaudat nukleus ve globus pallidusta anormal sinyal intensitesi ve difüzyon kısıtlaması saptanan hastada HBO tedavisine devam edilmiş ve 6 ay içinde tam iyileşme sağlanmıştır. Seçilmiş hastalarda CO intoksikasyonuna bağlı akut etkileri ortadan kaldırmak için erken dönemde uygulanan HBO tedavisinin olumlu etkisi aşikardır. Bu çalışmada ayrıca HBO tedavisinin, CO intoksikasyonuna bağlı GE gelişiminin önlenmesi veya sınırlandırılmasındaki yararı gözden geçirilecektir. (Türk Nöroloji Dergisi 2012; 18:118-22) Anah tar Ke li me ler: Karbon monoksit (CO), intoksikasyon, gecikmiş ensefalopati, manyetik rezonans görüntüleme (MRG), hiperbarik oksijen tedavisi (HBO) Sum maryDelayed encephalopathy (DE) is a neuropsychiatric syndrome that can generally arise within 20 days of acute carbon monoxide (CO) intoxication after apparent recovery and involves variable degrees of cognitive deficits, personality changes, movement disorders and focal neurologic deficits. We report a 35-year-old female patient with delayed encephalopathy due to CO intoxication, presenting with cognitive impairment and mild parkinsonism despite receiving hyberbaric oxygen therapy (HBO). Magnetic resonance imaging (MRI) showed abnormal signal intensity and decreased diffusivity at both caudate nuclei and globus pallidus. She continued to receive additional HBO therapy and recovered completely within six months. The positive effects of early HBO therapy in selected patients on reversing the acute effects of CO intoxication is apparent. Here, we also review the beneficial effect of HBO in preventing or limiting the late neurocognitive deficits associated with severe CO intoxication.
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