Yüksel Kıvrak

increased mean platelet volume in patients with panic disorder

Objective The relationship between platelet activation and psychiatric disorders has been shown in previous work. Mean platelet volume (MPV) is a measure of platelet size and a good indicator of platelet activity, which increases in cardiovascular diseases (CVDs). It is known that anxiety is a considerable factor in the etiology of mortality in CVDs. The aim of the present study was to investigate any probable difference in the MPV of patients with panic disorder (PD). Methods Sixty-one drug-free patients, aged 18–65 years and diagnosed with PD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were included in the study, along with 63 healthy age- and sex-matched volunteers. The body mass index (BMI) was calculated and MPV measured for each subject. Results The MPV was found to be higher in the PD group compared to the control group (P=0.004). There were no significant differences between the two groups in terms of platelet count or BMI. Conclusion Alterations in platelet activity may be a reflection of abnormal 5-hydroxytryptamine (5-HT) 1A receptor function in the central nervous system of subjects with a diagnosis of PD. These findings may elucidate the relationship between CVDs and PD. The findings of the present study suggest that MPV is increased in PD patients.

Pain perception: predictive value of sex, depression, anxiety, somatosensory amplification, obesity, and age.

Objective Factors affecting pain sensation are still being investigated. In this study, we aimed to examine the effects of sex, age, body mass index (BMI), somatosensory amplification, anxiety, and depression on the perception of pain. Methods Venipuncture was performed on 140 healthy individuals. All the cases completed a sociodemographic data form, visual analog scale (VAS), Beck Anxiety Inventory (BAI), Beck Depression Inventory, and Somatosensory Amplification Scale. Height and weight were also measured. Results When both the sexes were compared, there was no difference in terms of VAS, BMI, age, and Beck Depression Inventory, but Somatosensory Amplification Scale and BAI were found to be higher in females. A correlation was found among VAS points, BAI, and BMI. The results of a regression analysis show that the BAI score is a predictor for the VAS score. Conclusion These results indicate that anxiety may be a predictor of pain, whereas sex, depression, somatosensory amplification, age, and weight do not appear to influence the perception of pain.

Mean platelet volume and red cell distribution width levels in initial evaluation of panic disorder

Background As the relationship between psychological stress and platelet activation has been widely studied in recent years, activated platelets lead to certain biochemical changes, which occur in the brain in patients with mental disorders. However, data relating to the mean platelet volume (MPV) in patients with panic disorder (PD) are both limited and controversial. Herein, we aimed to evaluate, for the first time, the red cell distribution width (RDW) levels combined with MPV levels in patients with PD. Patients and methods Between January 2012 and June 2015, data of 30 treatment-naïve patients (16 females, 14 males; mean age: 37±10 years; range: 18–59 years) who were diagnosed with PD and 25 age- and sex-matched healthy volunteers (10 females, 15 males; mean age: 36±13 years; range: 18–59 years) (control group) were retrospectively analyzed. The white blood cell count (WBC), MPV, and RDW levels were measured in both groups. Results The mean WBC, MPV, and RDW levels were 9,173.03±2,400.31/mm3, 8.19±1.13 fl, and 12.47±1.14%, respectively, in the PD group. These values were found to be 7,090.24±1,032.61, 6.85±0.67, and 11.63±0.85, respectively, in the healthy controls. The WBC, MPV, and RDW levels were significantly higher in the patients with PD compared to the healthy controls (P=0.001, P=0.001, and P=0.003, respectively). However, there was no significant difference in the platelet number between the patients with PD and healthy controls (P>0.05). Conclusion Our study results are the first to demonstrate that the RDW levels combined with MPV levels significantly increase among patients with PD. We believe that increased RDW and MPV levels can be used as a novel marker for PD.

Diffuse Hair Loss Induced by Sertraline Use.

Hair loss is a rare side effect of psychotropic drugs. The most related drug class with this side effect is the mood stabilizers. Studies reporting the sertraline-induced alopecia are limited in number. Sertraline is a potent antidepressant which inhibits the serotonin reuptake from the presynaptic terminals selectively. The reason for hair loss could not be elucidated completely. Psychotropic drugs are usually considered to lead to hair loss through influencing the telogen phase of hair follicle. This paper reports a 21-year-old male with diffuse hair loss induced by sertraline use and improved by quitting the drug. To the best of our knowledge, there are no other case reports on sertraline-induced alopecia within 2 weeks.

Cytological and cytometric analysis of oral mucosa in patients with Alzheimer’s and Parkinson’s disease

Background Alzheimer’s disease (AD) and Parkinson’s disease (PD) are the two most common neurodegenerative diseases. Recent studies have sought to identify precursor symptoms of AD and PD that occur before the onset of the disease. We evaluated changes in the oral mucosa of patients with AD and PD using a stereological method. Patients and methods The study included 29 patients with AD, 30 patients with idiopathic PD, and 30 healthy volunteers. Brush biopsies were obtained from all participants, and the nucleator method was used to estimate the volume of cells obtained from the buccal mucosa. Results Cytomorphometric analysis revealed that the nuclear volume was 484.39±117.10 µm3 in the AD group, 509.71±132.26 µm3 in PD patients, and 509.30±100.21 µm3 in the control group. The cytoplasmic volume was 115,456.60±30,664.98 µm3 in the AD group, 103,097.93±25,034.65 µm3 in PD patients, and 109,528.45±28,381.43 µm3 in the control group. The nuclear and cytoplasmic volumes were not significantly different among groups (P>0.05). Conclusion The cytomorphometric analysis revealed no significant differences in the cytoplasmic and nuclear volumes of buccal cells obtained from patients with AD and PD and healthy volunteers.

Hyperprolactinemia Due to the Sulpiride Addition to Venlafaxine Treatment: A Case Report

Hiperprolaktinemi, hipotalamo-hipofizyal eksenin en cok karsilasilan endokrin bozuklugudur. En sik nedenleri hipofiz adenomlari, kronik bobrek yetersizligi ve antipsikotik ilac kullanimidir. Prolaktinin normal duzeyi 20–25 ng/ml altindadir. Antipsikotik ilaclar hiperprolaktinemiye on hipofizdeki D2 dopamin reseptorlerini bloke ederek neden olurlar. Antipsikotiklerin neden oldugu hiperprolaktineminin en sik belirtileri; galaktore, menstruel dongu duzensizlikleri, amenore, libidoda azalma, goguste duyarlilik, kemik mineral dansitesinde azalmadir. Bu nedenle de galaktoreyi erken fark etmek onemlidir. Bilebildigimiz kadari ile literaturde sulpiridin cok dusuk dozda (50 mg/gun) kullanimi sonrasi gorulen hiperprolaktinemiye bagli galaktore olgusu bulunmamaktadir. Bu yazida depresyon tanisi ile venlafaksin 150 mg/gun kullanan hastanin tedavisine sulpirid 50 mg/gun eklenilmesi sonucu hiperprolaktinemiye bagli galaktore gorulen bir olgu sunulmustur.

Type D personality, childhood traumas, depression, anxiety, and impulsivity in individuals attempting suicide

Objective: The objective of this study was to investigate the relationship between sociodemographic characteris-tics, anxiety, depression, impulsiveness, childhood traumas, Type D personality and suicide attempt in individuals, who applied with a suicide attempt and followed up after hospitalization or as outpatient and to determine the related risk factors. Methods: Total 91 individuals (46 individuals, who attempted suicide and 45 individuals as the control group) were included in the study. Sociodemographic Data Form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Type D Personality Scale (DS14), Childhood Trauma Questionnaire (CTQ) and Barratt Impulsive-ness Scale (BIS11) were carried out for each participant. Results: Considering the sociodemographic data, there was no significant difference between the patient and control group in respect of the age and marital status. On the other hand, we detected a significant difference between the groups regarding employment status, educational level, history of mental disorder. The comparison of the groups showed a significant difference in DS14, negative affectivity, social inhibition, BDI, BAI, BIS11 and CTQ scores. The childhood traumas (OR=1.51 and type D persona-lity (OR=1.21 were risk factors for the suicide attempt. Discussion: The results of our study indicated that childhood traumas and type D personality may have a direct correlation with the suicide risk. Considering the determination of the risk suicide-related risk factors, we believe our study may contribute to the literature in respect of the devel- opment of the preventive mental health politics for the decrease or prevention of the suicide attempts.

Acute respiratory depression due to treatment with clonazepam: a case report

Bipolar disorder is one of the most common psychiatric disorders. Benzodiazepines can be used as an additional treatment for mania. Adding a benzodiazepine such as clonazepam or lorazepam to acute attack treatment, provides a faster and more effective treatment. High dose parenteral use of benzodiazepines can lead to respiratory depression. As far as we know, no cases of Intensive Care Unit follow-up requiring respiratory depression due to olanzapine or clonazepam use in an otherwise healthy than a psychiatric disorder is reported in the literature. We report a case of respiratory depression due to treatment of manic episode with olanzapine 10 mg pills and clonazepam 2 mg pills.

Increased Mean Platelet Volume in Patients with Depression

Aim: It is well known that the mean platelet volume (MPV) is a good indicator of platelet activity and the incidence of cardiovascular diseases. Major depressive disorder may emerge in association with the cardiovascular diseases. In this study, we aimed to investigate the relationship between MPV and major depressive disorder. Material and Method: MPV values of 65 patients with major depression were compared with 66 age- and sex-matched healthy subjects. Body mass index (BMI), MPV, platelet count (PLC) of all participants were measured. Beck Depression Scale (BDS) was performed to measure severity of depression. Results: MPV values of patients who had major depression were found to be significantly higher than the control group. Comparing Major Depression with the control group, there was no significant difference in terms of platelet count. In the depression group, there was no correlation between the severity of depression and MPV. Discussion: As a result, the mean platelet volume was determined to have a significant in crease in major depressive disorder compared with healthy individuals. This also may be informative about the association between pathologies related vascular structure such as vascular atherosclerosis and depression.

SmartClamp circumcision versus conventional dissection technique in terms of parental anxiety: A prospective clinical study

INTRODUCTION We prospectively analyzed parental anxiety and outcomes of the SmartClamp circumcision and the classic surgical dissection technique. METHODS A total of 250 boys underwent circumcision between 2009 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine in Turkey. The initial 125 children were circumcised by conventional dissection method and the remaining children were operated on with a SmartClamp device. Children in both groups were compared in terms of bleeding, infection, penile edema, operative time, cosmetic result, length of the inner mucosal layer, and parental anxiety. We used a State-Trait Anxiety Inventory (STAI) form to gauge how the circumcision affected parental anxiety. This form was completed by parents on postoperative day 2. RESULTS There were no statistically significant differences among the 2 groups in terms of age, bleeding, infection, and cosmetic displeasure (p > 0.05). The STAI scores of the parents from the SmartClamp group were statistically higher than that of the other group (p < 0.001). Penile edema was more common in the SmartClamp group (p = 0.039). However, the mean operative time was statistically shorter (p < 0.001) and the inner mucosal length was significantly longer in the SmartClamp group (p < 0.001). CONCLUSION Circumcision with the SmartClamp device was faster. Cosmetic results and complication rates were similar. Unfortunately, this technique seemed to entail the disadvantages of longer mucosal length, penile edema, and higher parental anxiety. Urologists should keep these points in mind when choosing a technique.