No abstract

Charles Bonnet syndrome (CBS) is characterized by visual hallucinations with preservation of cognitive abilities. The hallucinations consist mostly of vivid (realistic) objects and tend to reoccur. Here, we evaluate the etiologies, symptoms, treatments, and prognoses of 13 CBS cases. All patients had visual hallucinations but were normal on cognitive and psychiatric assessments. Patient demographic and clinical characteristics, treatment options, and 3-month follow-up data were retrospectively reviewed. The possible causes of CBS and what the patients perceived during their hallucinations were recorded. Antipsychotic agents, such as risperidone and quetiapine, and anticonvulsants, such as levetiracetam, may be effective in some cases.

No abstract

The aim of this study was to examine the effects of smartphone use on the median nerve. Materials and Methods: Participants were classified into three groups according to their smartphone use frequencies; high smartphone users (with Smartphone addiction scale (SAS) score of higher than 71), low smartphone users (SAS score less than 71) and classical type mobile phones users. The Visual analogue scale (VAS), quick-disabilities of arm, shoulder, hand (qDASH) and median nerve conductions of the participants were assessed. Groups were compared to each other as well as dominant and non-dominant hand nerve measurements of participants were also compared. Results: VAS and qDASH values were not significantly different between groups. It was observed that the rare use of smartphones affected the median nerve conductions in a lesser manner compared to the classical mobile phone use. However, using smart phone in an increasing rate influenced the median nerves adversely. Conclusion: Excessive use of smartphone can lead to carpal tunnel syndrome via affecting the median nerve. In recent decades, there has been a widespread use of smartphones even at the level of addiction. This should be noted while designing the smartphones and voice applications should be used more often. Furthermore, it can be beneficial to follow up the median nerve conductions of patients who are addicted to smartphones with the help of electrophysiological studies.

Background The aim of the present study was to investigate the correlation of the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio with the severity of idiopathic carpal tunnel syndrome (CTS). Methods A total of 407 patients with idiopathic CTS (neurophysiologically 150 mild, 144 moderate, and 113 severe) and 206 subjects without CTS were included (control group). Results There was a positive correlation between the severity of CTS and NLR (r = 0.224; P < 0.001), age (r = 0.333; P < 0.001), and body mass index (r = 0.251; P < 0.001). A 1‐unit increase in NLR level was associated with an approximately 1.7‐fold higher incidence of CTS (P = 0.002; odds ratio = 1.668; 95% confidence interval = 1.199‐2.319). Conclusions Our results suggest that neurophysiologically more severe CTS is associated with higher NLR levels. The role of systemic inflammation in CTS should be investigated in further studies.

Objective: We investigated the effects of inappropriate sexual behaviors (ISBs) and neuropsychiatric symptoms (NPSs) of patients with Alzheimer disease (AD), and of caregivers’ depression, on the caregiver burden. Method: One hundred forty three patients with AD and their caregivers were included in the study. Sixty-five patients without AD who needed care due to their disability and their caregivers were enrolled for the comparison. Depression in caregivers was diagnosed using The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (SCID-I). The Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Scale were used to evaluate the severity of AD. The Neuropsychiatric Inventory (NPI) was used to assess the NPSs of patients. Caregiver burden was evaluated using the Zarit Burden Interview (ZBI). Results: Inappropriate sexual behaviors were found in 13 (9.1%) of the AD group. Inappropriate sexual behaviors were more common in moderate or severe AD ( P = .009, χ2 = 9.396). The prevalence of depression (n = 38, 26.6%) was higher in caregivers of AD group with ISBs ( P = .000, χ2 = 24.69). The ZBI scores of caregivers of patients with AD were higher than the comparison group. In addition, the ZBI scores of caregivers of patients with AD were significantly higher in the AD group with ISB, a high total score of NPI, and a low score of MMSE. The caregivers of AD group with depression had higher ZBI scores ( P < .05). Conclusions: The severity of AD, the presence of NPSs in patients, and major depression in caregivers were risk factors for an increased caregiver burden.

Background: Conventional antiepileptic drugs (AEDs) have been used for many years to treat epilepsy, and physicians are generally familiar with their side-effect profiles and potential drug interactions. However, AEDs affect patient vitamin and mineral levels in a manner that is not well understood. The goal of this study was to determine the relationship between AEDs and patient vitamins and mineral levels. Materials and methods: We conducted a retrospective analysis of liver enzyme levels, thyroid hormone levels, lipid profiles, and vitamin values (e.g., B12 and folic acid) in patients treated with carbamazepine, valproic acid, or levetiracetam at our institution. Patients were included in the study if their medical data included total cholesterol, triglyceride levels, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels obtained on follow-up at least three months after the start of antiepileptic treatment with carbamazepine, valproic acid, or levetiracetam. Patients were grouped according to the antiepileptic drug used. We analyzed liver thyroid function tests, lipid profiles, levels of B12, and folic acid levels using laboratory test results and compared the findings from each group. Results: Carbamazepine, valproic acid, and levetiracetam did not change the levels of liver enzymes such as aspartate transaminase and alanine aminotransferase (p values respectively: .802, .094). Cholesterol and LDL levels were lower in patients using carbamazepine (p values respectively: .005, .005), and no significant difference was observed for HDL and triglyceride levels (p values respectively: .400, .091). While thyroidstimulating hormone levels were significantly higher in patients on medication than the control group (p=.007), the levels were still within reference ranges. No significant difference was found between triiodothyronine and thyroxine levels (p values respectively: .065, .053). The levels of B12 and folic acid were observed to be high in the group using carbamazepine (p values respectively: .049, .004). Conclusion: Valproic acid and carbamazepine do not induce a significant increase in liver enzymes compared to levetiracetam, a new-generation antiepileptic medication, and they had no impact on lipoproteins such as HDL that are protective against coronary artery disease. These medications do not affect the levels of thyroid hormones in comparison to levetiracetam and the control group. Although carbamazepine and valproic acid are metabolized in the liver, liver enzyme monitoring is required; they have only affected liver enzyme values as much as levetiracetam and the control group.

Objectives Neutrophil to eosinophil ratio, neutrophil to lymphocyte ratio, C-reactive protein to albumin ratio, and red blood cell distribution width (RDW) have been studied in patients with acute cerebral infarction (ACI). However, the low-density lipoprotein cholesterol (LDL-C) to lymphocyte ratio has never been studied. Hence, our objective was to study the LDL-C to lymphocyte ratio with regard to in-hospital mortality rates of patients with ACI. Materials and methods We retrospectively examined our patients diagnosed with ACI between January 2015 and December 2018. The patients' clinical data and imaging and laboratory results during the acute period were retrieved from our database and saved for statistical analysis. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of the variables and to calculate the cut-off values. Results A total of 172 patients with ACI, including 43 patients who died and 129 patients who survived in the hospital, were included in the study. The median age of the patients who died was significantly higher than that of those who survived (p: <0.001). Median triglyceride level, LDL-C to lymphocyte ratio, and RDW-SD values were significantly higher in patients who died (p = 0.017, p: <0.001, and p = 0.003, respectively). Areas under the ROC curve were found to be as follows: LDL-C to lymphocyte ratio: 0.774 (95% CI: 0.697-0.851), RDW-SD: 0.562 (95% CI: 0.456-0.669), and triglyceride level: 0.621 (95% CI: 0.531-0.732). The cut-off value of the LDL-C to lymphocyte ratio was 59.71 (sensitivity: 79.1%; specificity: 58.1%). Conclusions The LDL-C to lymphocyte ratio can be used as a marker to predict in-hospital mortality in patients with ACI. We recommend further studies to verify our findings.