Erdal Isik

Detection of oxidative DNA damage in lymphocytes of patients with Alzheimer's disease

Oxidative damage to DNA may play an important role in both normal ageing and in neurodegenerative diseases. The deleterious consequences of excessive oxidations and the pathophysiological role of reactive oxygen species have been intensively studied in Alzheimers disease. Although the role of oxidative stress in the aetiology of Alzheimers disease is still not clear, the detection of an increased damage status in the cells of patients could have important therapeutic implications. The levels of oxidative damage in peripheral lymphocytes of 24 Alzheimers disease patients and of 21 age-matched controls were determined by comet assay applied to freshly isolated blood samples with oxidative lesion-specific DNA repair endonucleases (endonuclease III for oxidized pyrimidines, formamidopyrimidine glycosylase for oxidized purines). It was demonstrated that Alzheimers disease is associated with elevated levels of oxidized pyrimidines and purines (p<0.0001) as compared with age-matched control subjects. It was also demonstrated that the comet assay is useful as a biomarker of oxidative DNA damage when used with oxidative lesion-specific enzymes.

Erythrocyte Glutathione Levels in Lithium-Induced Hypothyroidism

AbstractBackground and objective: Lithium, widely used in the prophylaxis of psychiatric patients with bipolar affective disorders, is well known to induce thyroid alterations. However, a possible metabolic linkage between blood thyroxine levels and its regulatory function on erythrocyte glutathione concentration has not yet been evaluated in lithium-treated patients. The aim of this study was to assess the antioxidative capacity of erythrocytes in lithium-induced hypothyroidism before and after thyroxine replacement. Patients and methods: Thyroid ultrasound with clinical and laboratory evaluation of thyroid function and thyroid-stimulating hormone assay were performed prior to and at 6-month intervals during lithium prophylaxis in 76 patients with bipolar affective disorders. The daily lithium dosage was adjusted to 600–1200mg and the mean duration of treatment was 2.2 ± 0.4 years. Final assessment revealed that 12 patients had evidence of primary hypothyroidism, and these were assigned as the test group. Lithium prophylaxis was supplemented with thyroxine at a dosage of 100 mg/day within 6 months after thyroid dysfunction was diagnosed. Red blood cell superoxide dismutase activities and the glutathione contents were measured before and after thyroxine replacement. In order to assess the effect of long-term lithium administration on red blood cell glutathione and superoxide dismutase levels, 12 patients who had not developed hypothyroidism during the follow-up period were selected for the lithium-treated euthyroid group. Mann Whitney U-test and Wilcoxon rank sum W-test were used for comparison of data. Results: A comparison of the lithium-treated test group with healthy volunteers and their own values after thyroxine replacement revealed a significant decrease in red blood cell glutathione concentrations (p = 0.000) in the hypothyroid state. However, no clinically significant changes were observed in red blood cell superoxide dismutase activities of the test group. A statistical survey also demonstrated that there was no significant difference in the thyroid-stimulating hormone values as well as the red blood cell glutathione contents or superoxide dismutase activities between healthy controls and lithium-treated euthyroid subjects. Conclusions: It is most likely that lithium primarily inhibited hormone production in the thyroid and that this led to a compensatory increase in thyroid-stimulating hormone secretion with a significant decrease in the red blood cell glutathione content. While the red blood cell glutathione content of hypothyroid patients was reduced to 40% of the post-thyroxine level, unchanged superoxide dismutase activity might render the erythrocytes vulnerable to oxidative stress and ultimately haemolysis. Thyroxine replacement during lithium prophylaxis of psychiatric patients is advisable in order to prevent subclinical hypothyroidism and related defects of erythrocyte antioxidant capacity.

Clozapine-induced myoclonic seizures and valproic acid

Within a 3-year period, in 220 patients receiving clozapine, we observed myoclonic seizures in two who had no previous epileptic history. Seizures appeared at the titration phase at relatively low doses, and resolved with the addition of valproic acid, allowing further increases of the clozapine dose to therapeutic levels.

Prevalence of insomnia symptoms: results from an urban district in Ankara, Turkey

Objective. Characteristics of insomnia symptoms in Turkey are not well established. The goal of this study was to determine the prevalence of insomnia and related symptoms in an urban district of Turkey. Method. The study was carried out in Ankara, in an urban district with a population of 2665. Out of the 1332 people in the sample, 1034 in the 15–65 age range were included in the study. Interviews were conducted according to the “Sleep Disorders Assessment Questionnaire” developed by the researchers. The Insomnia Severity Index (ISI) was also given to the subjects with a sleep problem to measure the subjective quality and quantity of insomnia symptoms. Results and conclusion. A total of 29.4% of all participants reported a sleep problem, out of which 23.7% defined one or more of the insomnia symptoms which included difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), non-restorative sleep (NRS) and sleep deprivation (SD). Insomnia risk was found to be significantly increased with age, female sex, smoking and chronic medical illness. A total of 75.9% of participants who reported insomnia symptoms did not seek medical help for their complaint. According to the ISI, among the subjects with insomnia symptoms, 79 (32.2%) had subthreshold insomnia, 43 (17.6%) had clinical insomnia, 12 (4.9%) had severe clinical insomnia, while 88 (35.9%) did not score in the range indicating insomnia. The findings are discussed in the light of previous research and in relation to sociocultural factors emphasizing the need for public education on sleep disorders as medical conditions.

Differences in Executive Functions and Problem Solving Styles of Protracted Sober and Relapsed Alcohol-dependent Patients

In this study, it is aimed to compare the executive functioning and problem solving styles of relapsed alcoholdependent and protracted sober patients and to evaluate the potential clinical factors that act on the duration of sobriety. Fifty-six male patients meeting the DSM-IV alcohol dependence criteria included in the study. All patients were in sobriety period, classified as 32 of them in acute sobriety (relapsed after a maximum period of 6 months sobriety and just completed 3 weeks of detoxification) and 24 of them as protracted sobriety group (sober for a minimum period of 12 months). To evaluate the executive functions and problem solving styles Stroop test, Hanoi Tower Test and Problem Solving Inventory were applied. No significant differences found between two groups regarding executive functions. The protracted sobers were found to use “reflective” and “planfulness” styles more than the relapsed group. There was not any correlation between executive function and cumulative drinking, length of sobriety, educational status, age, alcohol dependency in the family, duration of illness, the amount of daily drinking, and amount of hospitalization. It is concluded that problem solving styles may play a role in staying sober as the “reflective” and “planfulness” styles were being used significantly more in the protracted sober group. Executive functioning which had been shown to be distorted in alcohol-dependent patients did not differ in relapsed and protracted sobriety. Further studies are needed to receive these results to be a determinant in the duration of sobriety.

TARC: Turkish aripiprazole consensus report- Aripiprazole use and switching from other antipsychotics to aripiprazole- consensus recommendations by a Turkish multidisciplinary panel:

In this review, we have attempted to share our 10 years’ clinical experience with aripiprazole use and switching from other antipsychotics to aripiprazole. There are various reasons for switching, including a partial or complete lack of efficacy, adverse side effects, and partial or noncompliance with medication. Aripiprazole has some unique receptor-binding qualities that provides some advantages over other antipsychotics in certain clinical situations. We have covered potential clinical scenarios for aripiprazole use as a single agent and switching from other agents in inpatient and outpatient settings. Patients switched from other antipsychotics to aripiprazole have been shown to benefit from significant improvements in clinical response and tolerability. This review examines the strategies for switching patients from antipsychotic drugs to aripiprazole.

An Examination of Psychological and Biochemical Parameters of American Football Players and Volleyball Players: A Discriminate Analysis

Abstract This study was carried out to determine the psychological and biochemical parameters of the American Football players who chose this high-contact sport, and to compare those parameters with those of the players of volleyball, a non-contact sport. Participants were 39 American Football Players, and 21 volleyball players. According to t-test results, there were some statistically significant differences between the average points of conscientiousness, competition anxiety, and intensity of the American football as compared to those of the volleyball players. Discriminate analysis revealed one significant function. According to discriminate function, analysis were correctly placed at 79.5 percent to the American footballers (n=31), and 85.7 percent to the volleyball players (n=18). However, 20.5 percent of the American footballer (n=8) and 14.3 percent of the volleyball players (n=3) were wrongly placed. According to dissociation analysis, the 81.7 percent players were correctly classified. In conclusion, it was revealed that the American Football Players took more self-responsibility; are more prone o worry about failure, and had more intensity and stress levels than the Volleyball Players. Nevertheless, both the American Football Players and volleyball players showed psychological and biochemical differences that obviously discriminated them according to their particular sport.