Esra Yancar Demir

Evaluation of suicide cases in Turkey, 2007–2012

Background The aim of this study was to determine the demographic and sociocultural characteristics of suicide attempts by using data from the Turkish Statistical Institute. It is our intent that the work data may contribute to the national suicide data and the development of suicide prevention policies. Material/Methods We obtained our data, which cover the years 2007 to 2012, from the database accessible at the official website of the Turkish Statistical Institute, which permits the use of its data for research purposes. The data were evaluated by using the SPSS 10.0 program. The chi-square test was used for statistical analysis, and the percentage distribution and odds ratios were calculated. Results According to data from the Turkish Statistical Institute, the total number of suicide deaths in Turkey between 2007 and 2012 changed yearly (χ2=42,035–59,209; P<0.001). While suicide deaths in 2007 made up 0.00396% of the total deaths for that year, that figure increased to 0.00426% in 2013. According to the data from the Turkish Statistical Institute, over 1.9 million people died due to all causes between 2007 and 2012 in Turkey. Over 17,000 deaths (0.9%) were due to suicide. Conclusions Suicide is an important public health problem and is multidimensional in nature. Examining this subject from etiological, epidemiological, biological, psychological, sociological, and anthropological perspectives is important to improve the prevention of suicides.

Evaluating the relationship between education level and cognitive impairment with the Montreal Cognitive Assessment Test

Mild cognitive impairment (MCI) is defined as ‘a cognitive decline greater than that expected for an individuals age and education level but that does not interfere notably with activities of daily life’. The Montreal Cognitive Assessment (MoCA) is a screening test for MCI.

The relation of sexual dysfunction to depression and anxiety in patients with Parkinson's disease.

Objective In this study, we aimed to find out whether sexual dysfunction in patients with Parkinson’s Disease (PD) was associated to PD-related disability and whether this relationship was modulated by depressive and anxiety symptoms. Methods Eighty-nine consecutive patients with idiopathic PD who attended to our movement disorders outpatient clinics between January 2011 and June 2014 were included in this study. The diagnosis of PD was confirmed by a movement disorders specialists in Neurology, according to UK Parkinson’s Disease Society Brain Bank Criteria. The Unified PD Rating Scale (UPDRS) motor was used to assess motor disability and Hoehn and Yahr stage (H&Y) was used to establish disease severity. Cognitive function was assessed by the Mini-Mental State Examination. Patients were also administered the Hamilton depression (HAMD) and anxiety (HAMA) rating scales. The sexual functions of the patients were rated by applying the Turkish version of the Arizona Sexual Experiences Scale (ASEX). Results The mean age at the time of the study visit was 67.74±9.05. Male/female ratio was 1.87. Mean UPDRS total was 29.06±13.96 and mean UPDRS motor was 17.62±9.07. Mean HAMD score was 13.92±10.86, 58.4% of the patients had minor or major depression; and mean HAMA score was 7.94±6.49, 56.2% of the patients had minor or major anxiety. The mean ASEX score was 18.54±7.27 out of a maximum of 30. ASEX total scores were correlated with age, H&Y stage and HAMA scores. Age and also age at onset were correlated with ASEX subdomains except sexual desire. There was no correlation between disease duration and ASEX subdomains. UPDRS motor score was correlated with erection/lubrication. HAMD was only correlated with orgasm satisfaction. HAMA score was correlated with stimulation and orgasm. Conclusion In patients with PD, there may be a common factor that modulates both depression, anxiety and sexual function. Further studies are needed to clarify the exact relationship.

Assessment of the mental health of carers according to the stage of patients with diagnosis of Alzheimer-type dementia

In this study, the aims were to assess the mental health state of carers for patients with Alzheimer-type dementia (AD) according to stage of disease and to collect data with the aim of determining precautions to reduce the load of the patient and disease on the carer. The study included 120 patients with stages determined, according to the clinical dementia rating scale (CDR), and 120 patient relatives above the age of 18 who cared for these patients every day, for the whole day or part of the day, and who accepted participation in the research. This prospective and cross-sectional study performed a detailed neurological examination of patients, and after completing the “personal information form” with the interviewer, each patient had CDR and mini-mental test (MMSE) applied to determine stage of dementia and physical state. Carers first completed the “personal information form” and then had the short symptom inventory (SSI) applied. According to the stage of patients, there were significant differences determined in the points for all sub-scales belonging to the SSI of carers. As the disease stage increased, all sub-scale points for the SSI increased. With the transition of disease stages from 0.5–1 to stage 2, from stage 2 to 3, and with the inverse reduction in MMT scores, the points obtained by carers on the SSI sub-scales increased. This data shows that with progressing disease stage, the load on the carer increases and mental health begins to dysfunction.

Hallucination and priapism associated with methylphenidate usage: Two case reports

386 risperidone treatment. The patient initially began the risperidone treatment. On the morning of the following day, 18 mg OROS-methylphenidate was taken. On the day after taking methylphenidate, an incomplete erection formed and lasted 1 day. With the patient continuing treatment, from the 2nd day, a painless full erection formed. On the 5th day, they returned to our clinic. Urologic consultation was requested, and high-flow priapism was identified. OROS-methylphenidate treatment was ended. Continuing with risperidone treatment, the patient’s priapism resolved a few days after finishing OROS-methylphenidate treatment. Routine tests did not encounter any pathology. There was no history of genital trauma.

The seroprevalence of antibodies to Toxoplasma gondii among children with autism

Objective: Although attempts have been made to explain the pathogenesis of autism spectrum disorders (ASD) with many factors such as genetic, immunological, environmental, and infectious agents, this mechanism remains for the most part unknown. Toxoplasma gondii is a parasite that is investigated in many psychiatric diseases. This work examines whether toxoplasmosis plays a role in the pathogenesis of ASD through a seroprevalence study. Method: This study is based on a comparison of 102 children with ASD and 51 healthy children. In addition to routine laboratory tests, a sociodemographic form and a childhood autism rating scale were completed and the participants’ anti-toxoplasma IgM and IgG titers were requested. Results: In 3 ASD children (2.9%) and in 1 control (2%), IgG positivity was identified. All subjects were negative for IgM. There was no statistically significant difference found between the two groups in terms of toxoplasma seropositivity. Conclusion: Our data does not confirm the involvement of toxoplasmosis in the etiopathogenesis of ASD.

Evaluation of sexual dysfunction in Parkinson’s disease between two different regions of Turkey

OBJECTIVE In this study, we aimed to evaluate sexual dysfunction (SD) between two different regions of Turkey in patients with Parkinsons Disease (PD). PATIENTS AND METHODS Forty-three PD patients in Ordu and 71 patients in Istanbul were included. The Unified PD Rating Scale and Hoehn and Yahr Stage (HYS) scale were used to assess disease severity. Cognitive function was assessed by the Mini-Mental State Examination (MMSE). The sexual functions of the patients were evaluated with applying the Turkish version of the Arizona Sexual Experiences Scale (ASEX). RESULTS Mean age of patients in Istanbul was 67.25±8.34years and mean age of patients in Ordu was 67.98±8.93 (p=0.66). There was 87.33% SD in Istanbul group and 95.35% in Ordu group (p=0.20) respectively. In terms of ASEX score, no difference was found between the Istanbul and Ordu groups. ASEX scores were significantly higher in females in both groups. CONCLUSION In this study, we have found that living in the different regions of our country does not have an impact on sexual function in PD patients.

Comorbidity of Weber Syndrome and Holmes Tremor: A case report

Weber’s syndrome is a brainstem disease characterized by ipsilateral 3rd nerve palsy with contralateral hemiparesis. Holmes tremor is a clinically diagnosed irregular tremor, which is, characterized by a combination of resting, postural, and action tremor. Here, we report a case with Weber syndrome and Holmes tremor, who have thalamic and mesencephalic infarctions, because of his interesting features and rare occurrence.