Uğur Çakır

Patients Recovering From Abdominal Surgery Who Walked With Volunteers Exhibited Improved Postoperative Recovery Profiles During Hospitalization

Background Early walking as part of a perioperative care program benefits patients who have had surgery. However, the impact of early walking by itself on the mental and physical recovery of postoperative patients has not been examined.

The prevalence of post-traumatic stress disorder in patients with burn injuries, and their quality of life.

Abstract Objective. The aim of this study was to investigate the prevalence of post-traumatic stress disorder (PTSD) in patients with burn injuries undergoing physical therapy, and to evaluate their quality of life. Methods. A total of 21 patients who underwent physical therapy for burn injuries between October 2012 and December 2012, in the Physical Therapy and Rehabilitation outpatient clinic of a Training and Research Hospital, were included in the study. The sociodemographic form for data collection, the Clinician- Administered PTSD Scale (CAPS) for the diagnosis of PTSD, and the Short Form 36 (SF-36) Health Survey for the assessment of the quality of life, were used. Results. Eight patients (38.1%) had PTSD. These patients had poor physical functioning, and indicated a lower rate of role functioning-physical, vitality, and role functioning-social, compared to those without PTSD. However, it did not reach statistical significance. The physical functioning related to the quality of life was statistically significantly lower in the patients with contracture. Conclusions. PTSD seems to be an important health issue in patients with burn injuries. Clinicians who attempt to tailor treatment interventions should keep in mind that these patients require psychosocial rehabilitation, as well as physical therapy.

Impact of diabetic foot on selected psychological or social characteristics.

With great interest, we read the recent paper [1] “Does the diabetic foot have a significant impact on selected psychological or social characteristics of patients with diabetes mellitus?”. The authors aimed to compare selected psychological and social characteristics between diabetic patients with and without the diabetic foot (DF). They have concluded that patients with DF had a predominantly worse standard of living and patients with DF appeared to have good stress tolerability and mental health and did not reveal severe forms of depression or any associated consequences.

Vitamin B12 and vitamin B12 supplementation effects on cognitive functions after bariatric surgery.

1. Comajuncosas J, Hermoso J, Gris P, et al. Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy: a prospective 3-year follow-up study. Am J Surg 2014;207: 1–6. 2. Sørensen LT, Hemmingsen UB, Kirkeby LT, et al. Smoking is a risk factor for incisional hernia. Arch Surg 2005;140:119–23. 3. Sørensen LT, Karlsmark T, Gottrup F. Abstinence from smoking reduces incisional wound infection: a randomized controlled trial. Ann Surg 2003;238:1–5. 4. Owens M, Barry M, Janjua AZ, et al. A systematic review of laparoscopic port site hernias in gastrointestinal surgery. Surgeon 2011;9:218–24. 5. Bunting DM. Port-site hernia following laparoscopic cholecystectomy. JSLS 2010;14:490–7. 6. Helgstrand F, Rosenberg J, Bisgaard T. Trocar site hernia after laparoscopic surgery: a qualitative systematic review. Hernia 2011;15:113–21.

Tardive Dyskinesia Associated with Bupropion

Present report describes a 46 year old male patient with a diagnosis of major depression who developed tardive dyskinesia during bupropion therapy. Our patient had no history of neuroleptic use and his laboratory and neurologic examinations were normal. He had no family history of neurologic diseases. Although bupropion induced dyskinesia has been previously reported in the literature, it is rare and our case is the first case regarding tardive dyskinesia.

Leukocytosis after Clozapine Treatment in a Patient with Chronic Schizophrenia

Clozapine is an atypical antipsychotic drug that is approved by the US Food and Drug Administration (FDA) for the treatment of psychotic disorders. Agranulocytosis is a well-established side effect of clozapine; clozapine has also been associated with other blood dyscrasias like leukocytosis, albeit rarely. In this paper, we aim to report a case of possible clozapine-associated leukocytosis in a 41-year-old woman.

A new diagnostic tool for masked hypertension: impaired sleep quality

Introduction The aim of this study was to evaluate the relationship between masked hypertension and impaired sleep quality. Additionally, we evaluated the diagnostic role and prevalence of poor sleep quality among patients with newly diagnosed masked hypertension. Material and methods A total of 112 individuals, 72 patients with newly diagnosed masked hypertension and 40 normotensive healthy volunteers, were included in this study. All patients underwent evaluation comprising 12-lead electrocardiography, transthoracic echocardiography, 24-hour Holter ECG, and basic laboratory tests. Additionally, all participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI). Results The total PSQI score was significantly higher in the masked hypertension group than in the normotensive healthy volunteers (4.13 ±2.43 vs. 2.33 ±1.67, p < 0.001). A PSQI score > 5 was found in 45.8% (n = 33) of patients in the masked hypertension group and 15% (n = 6) of patients in the normotensive group (p < 0.001). The non-dipper pattern was found in 17.5% of the healthy volunteer group and 59.94% (n = 41) of the masked hypertension group (p < 0.001). When we compared the dipping pattern of the masked hypertension groups, there was a significant difference in PSQI score between the dipper and non-dipper groups (4.87 ±3.21 vs. 3.58 ±2.33, p < 0.001). Multiple logistic regression analyses showed that masked hypertension, LV mass, and LV mass index score were independent predictors of poor PSQI. Conclusions This study demonstrates impaired sleep quality in subjects with masked hypertension, particularly those with a non-dipper pattern. Additionally, this study indicates that impaired sleep quality may help diagnose masked hypertension, particularly in the non-dipper group.

Prevalence of Depression in Patients with β-Thalassemia as Assessed by the Beck’s Depression Inventory [Hemoglobin. 2014;38(4):289–291.]

We read with great interest the recent article by Shafiee et al. (1) in which the authors examined the prevalence of depression in patients with b-thalassemia as assessed by the Beck’s Depression Inventory. They concluded that the noticeable rate of depression in thalassemic patients signifies the necessity for improving psychosocial care in this specific group of patients. To add to the clear discussion provided by the authors, we wish to emphasize an important factor that should be taken into consideration when evaluating the prevalence of depression and/or anxiety symptoms. Antidepressants are highly effective and widely used drugs in the treatment of both anxiety and depression. Various studies and treatment guidelines have proposed different lengths of time for assessing the response to antidepressant treatment or full recovery. The Texas Medication Algorithm specifies a period of 6 weeks, while the American Psychiatric Association specifies a period of 4 weeks (2,3). Thus, an unknown history of antidepressant use within the 2-month period of time previous to the study may have had an unnoticed effect on the study results. We recommend that future studies assessing the prevalence of anxiety and/or depression symptoms in a specific population should consider the history of antidepressant use at least 2 months before the study is begun.

Letter to the Editor concerning ''The prevalence of depressive symptoms before and after surgery and its association with disability in patients undergoing lumbar spinal fusion'' by M. Wahlman et al. (2014) Eur Spine J 23:129-134

We read with great interest the recent article by Wahlman et al. [1] in which the authors examined the prevalence of depressive symptoms before and after surgery and its association with disability in patients undergoing lumbar spinal fusion. They concluded that one-third of their patients with chronic back pain undergoing spinal fusion had depressive symptoms pre-operatively and the prevalence of depressive symptoms decreased after surgery, so there is no need to exclude depressive patients from operation, but screening measures and appropriate treatment practices throughout both pre-operative and postoperative periods are encouraged. To add to the clear discussion provided by the authors, we wish to emphasize an important factor that should be taken into consideration when evaluating the prevalence of depression and/or anxiety symptoms. Antidepressants are highly effective and widely used drugs in the treatment of both anxiety and depression. Various studies and treatment guidelines have proposed different lengths of time for assessing the response to antidepressant treatment or full recovery. The Texas Medication Algorithm specifies a period of 6 weeks, while the American Psychiatric Association specifies a period of C4 weeks [2, 3]. Thus, an unknown history of antidepressant use within the 2-month period of time previous to the study may have had an unnoticed effect on the study results. In our opinion, future studies assessing the prevalence of anxiety and/or depression symptoms in a specific population should consider the history of antidepressant use at least 2 months before the study began.

Cognitive schemas of women those have major depressive disorder comorbid with sexual trauma related posttraumatic stress disorder

Objective: In this study, it has been aimed to evaluate the cognitive schemas of women those have major depressive disorder (MDD) comorbid sexual trauma related posttraumatic stress disorder (PTSD) and then to compare schemas of women those have MDD comorbid PTSD with schemas of women those have MDD without comorbid PTSD. Methods: Thirty-two women those met DSM IV-TR criteria for MDD comorbid with PTSD, and 30 women have MDD without comorbid PTSD participated the study. ATQ (Automatic Thoughts Questionnaire), DAS (Dysfunctional Attitudes Scale) and YSQ-90 (Young Schema Questionnaire) were used to assessment of the beliefs, attitudes and schemas of two groups. Results: Women those have MDD comorbid with PTSD had the significantly higher scores of automatic thoughts and three early maladaptive schemas (EMS) which were failure, vulnerability and subjugation as compared with women those have no PTSD comorbidity. Women with PTSD comorbidity have also higher rates of suicidal and self-harm behaviors. Conclusion: Women those have MDD comorbid with sexual violence related PTSD had more negative beliefs, schemas and higher risk of suicidal and self-harm behaviors in comparison with women those have MDD without PTSD. Clinicians should consider these results while they establish their treatment plans and case formulations.