A single course of isotretinoin therapy has no clinically significant effect on bone metabolism.
Objective: Long-term treatment with carbamazepine (CBZ) and valproic acid (VPA) is associated with many metabolic changes that influence the serum levels of cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides and the body mass index (BMI). The aim is to evaluate the serum lipids and BMI in adult epileptic patients on long-term CBZ or VPA monotherapy. Methods: To evaluate the serum lipids and BMI in adult epileptic patients on long-term CBZ or VPA monotherapy. Results: Total cholesterol and LDL levels were significantly higher in patients receiving CBZ, while HDL values were found to be significantly lower in patients receiving VPA. Statistically significant differences were not found between the patient and control groups in terms of BMI. Conclusion: These data suggest that long-term VPA treatment significantly correlated with decreased HDL levels, while CBZ treatment significantly correlated with elevation in the values of total cholesterol and LDL. Long-term CBZ or VPA treatment do not seem to affect the BMI. (Archives of Neuropsychiatry 2011; 48: 103-6) Key words: Epilepsy, antiepileptic treatment, body mass index, lipid profile ÖZET Amaç: Uzun süreli karbamazepin (KBZ) ve valproik asit (VPA) tedavisi total kolesterol, düflük-yüksek dansiteli lipoprotein, trigliserit ve vücut kitle indeksini etkileyen birçok metabolik de¤iflikli¤e yol açabilir. Uzun süreli VPA ve KBZ monoterapisi alm›fl olan yetiflkin hastalarda serum lipidleri ve vücut kitle indeksini de¤erlendirmek, amaçlanm›flt›r. Yöntemler: Karbamazepin (n=36) ve valproik asit (n=53) kullanan 89 epileptik hastada total kolesterol, düflük-yüksek dansiteli lipoprotein, trigliserit ve vücut kitle indeksleri ölçüldü. De¤erler kontrol (22) grubu ile karfl›laflt›r›ld›. Bulgular: KBZ alan grupta total kolesterol ve düflük dansiteli lipoprotein anlaml› düzeyde kontrol grubundan yüksek bulundu. VPA alan grupta yüksek dansiteli lipoprotein anlaml› düzeyde kontrol grubundan düflük bulundu. Hasta gruplar› ve kontrol grubu aras›nda vücut kitle indeksi aç›s›ndan istatistiksel olarak anlaml› bir sonuç saptanmad›. Sonuç: Bu sonuçlar uzun süreli VPA tedavisinin serum yüksek dansiteli lipoprotein düzeyinde anlaml› bir düflüklük ile, KBZ tedavisinin ise düflük dansiteli lipoprotein ve total kolesterol yüksekli¤i ile beraber oldu¤unu göstermektedir. Uzun süreli VPA ve KBZ tedavisi vücut kitle indeksini etkilemiyor gibi görünmektedir. (Nöropsikiyatri Arflivi 2011; 48: 103-6)
ÖZET Amaç: Multipl skleroz hastalar›nda biliflsel testlerde bozukluk oldu¤unu gösteren birçok çal›flma olmas›na ra¤men, bu bozuklu¤un nedenleri tam olarak ayd›nlat›lamam›flt›r. Bu çal›flmadaki amac›m›z relapsing-remitting multipl skleroz (RRMS) hastalar›nda serum ürik asit (ÜA) düzeyi ile biliflsel fonksiyonlar ve kranyal manyetik rezonans görüntüleme (MRG)'deki plak say›s› aras›ndaki iliflkiyi araflt›rmakt›r. Yöntemler: Bu çal›flmada RRMS'li 50 eriflkin hasta (hastal›k süresi 1,5 y›l) nöropsikolojik test bataryalar› ve kan incelemeleri ile de¤erlendirildi. Hastalar›n tümüne kranyal MRG incelemesi ve geniflletilmifl özürlülük durumu ölçe¤i EDSS ile birlikte klinik de¤erlendirme yap›ld›. Bulgular: Hastalar›n %44'ünde biliflsel bozukluk saptanm›flt›r. Ortalama serum ürik asit düzeyi 4.38±1.60 mg/dl (2-9 mg/dl) bulunmufltur. Çal›flmaya al›nan hastalar›n EDSS'leri ortalama 2.09±2.01 (0-7)'dir. Serum ÜA düzeyi ile biliflsel fonksiyonlar veya MRG'ki plak say›s› aras›nda istatistiksel olarak anlaml› olmasa da anlaml›l›k düzeyine yak›n bir iliflki saptanm›flt›r ( p=0.09). ADAS-cog alt testlerinden konsantrasyon ve dikkatin da¤›labilirli¤i skorlar› ile ürik asit düzeyi aras›nda istatistiksel olarak anlaml› bir iliflki gözlendi (p=0.01). Fakat yorgunluk ve emosyonel bozuklu¤un bu iliflkiye olan etkisi d›fllanamad›. Sonuç: Bizim sonuçlar›m›za göre RRMS hastalar›nda serum ÜA düzeyinde herhangi bir bozukluk saptanmam›flt›r. Biliflsel fonksiyonlar ve kranyal plak say›lar› serum ÜA düzeyinden do¤rudan etkilenmemektedir. (Nöropsikiyatri Arflivi 2010; 47: 333-7) Anahtar kelimeler: Biliflsel fonksiyonlar, multipl skleroz, ürik asit ABSTRACT Objective: Several studies have identified impaired performance on the cognition test in people with multiple sclerosis (MS), yet uncertainty remains over the cause of this impairment. The aim of this study was to evaluate the correlation of serum uric acid (UA) level with cognitive impairment and magnetic resonance imaging (MRI) lesions in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: In this study, 50 adults patients with RRMS (disease period 1-5 years) were assessed with neuropsychological test batteries and laboratory blood studies. All the patients were subjected to oranial MRI examination and clinical evaluation with the expanded disability status scale (EDSS) was applied. Results: Cognitive impairment was found in 44% of the patients. Mean UA serum level was measured as 4.38±1.60 mg/dl (2-9 mg/dl) and the mean EDSS score was 2.09±2.01 (0-7). Even it is not statistically significant, the relation between serum UA level and cognitive functions or number of plaques on MRI was found at about statistically significant level (p=0.09). A statistically significant correlation was observed between the scores of the concentration and distractibility subtest scores of the ADAS-cog test and the serum UA levels (p=0.01). However, the effects of exhaustion and emotional disorders on this relation can not be excluded. Conclusion: Our findings suggest that in RRMS patients there ...
Objective: Cognitive impairment is a common symptom in every phase and every type of multiple sclerosis. Different results, between 32% and 70%, have been reported in studies on the incidence and characteristics of cognitive impairment in patients with relapsing-remitting multiple sclerosis (RRMS). This big difference is explained by the use of different neuropsychological tests and different patient groups. The aim of this study was to analyze the incidence and characteristics of cognitive impairment in patients with early RRMS by applying standardized Turkish neuropsychological tests, commonly used in our country. Methods: 67 patients followed with diagnosis of RRMS and with disease duration up to 5 years were enrolled in the study. All participants underwent neuropsychological, magnetic resonance imaging (MRI) and clinical evaluation. Functional deficits of the subjects were assessed using the Expanded Disability Status Scale (EDSS). The patients without depression according to the Hamilton Depression Rating Scale (HDRS), underwent the Frenchay Aphasia Screening Test (FAST), the Standardized Mini-Mental State Examination (SMME) and the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog). All results were assessed statistically. Results: Out of 67 RRMS patients (41 women, 26 men) evaluated in this study, 17 (23.4%) patients had depression. Of the rest 50 patients, 7 (14%) had a cognitive impairment according to SMME, 22 (44%) patients had cognitive impairment according to ADAS-cog and 1 patients had aphasia according to FAST. No statistically significant correlation was observed between cognitive impairment and clinical features, EDSS score or cranial MRI lesion load. Conclusion: Our results suggest that 44% of patients with early RRMS had cognitive impairment. There was no statistically significant correlation between cognitive impairment, EDSS score or number of lesions on cranial MRI. (Archives of Neuropsychiatry 2010; 47: 88-90)
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