Affective temperaments in pregnancy

Aim: There are many studies on the mood disorders that occur during pregnancy, but no studies that question how affective temperaments, which are the antecedents of the mood disorders, are influenced by pregnancy. This study aims to examine the affective temperaments in women without any psychiatric diagnoses during the pregnancy period.

Method: The study included 100 pregnant women at the third trimester of their pregnancy (pregnant group) and 75 non-pregnant women (control group). Structured Clinical Interview for DSM Axis-I Disorders (SCID-I) was used for the evaluation of psychiatric disorders; Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A) was used for the evaluation of affective temperaments.

Results: The cyclothymic, irritable and anxious temperament scores of the pregnant women were significantly lower than that of the non-pregnant women (p?Conclusion: The third trimester of pregnancy is associated with significantly lower affective temperament. Future studies may help to understand the biological background of the present findings.     

Myointimoma of the glans penis

Myointimoma is a recently described benign tumor, which is regarded as a rare type of mesenchymal tumor of the penis. The present patient was a 50-year-old man who had a nodule located in the glans penis. He had a 2 month history of a mass. An excisional biopsy was performed. The histological findings revealed a multinodular tumor that was characterized by spindle-shaped cells located in the intravascular area. This case, in addition to 11 cases reported in the literature, demonstrates that the myointimoma is frequently misdiagnosed on clinical and pathological grounds because of its rarity. Histological and immunohistochemical features are summarized on the basis of the present case and previously published reports.     

Mean platelet volume is elevated in patients with patent foramen ovale

Introduction

Platelets play a major role in thromboembolic events. Increased mean platelet volume (MPV) indicates higher platelet reactivity and also a tendency to thrombosis. Patent foramen ovale (PFO), persistence of the fetal anatomic shunt between right and left atria, is strongly associated with cryptogenic stroke. The aim of this study is to determine the relationship between MPV and PFO and if such an association exists, whether higher MPV levels may require antiplatelet therapy before a thromboembolic event happens, together with a literature review.

Material and methods

Thirty patients (15 women, 15 men), free of any cerebrovascular events, were diagnosed with PFO by transesophageal echocardiography (TEE), enrolled as the study group. Thirty consecutive patients (16 women and 14 men), who were diagnosed as normal in TEE, were enrolled as the control group. These two groups were compared according to MPV and anatomical features of the right atrium.

Results

There was no significant difference between study and control groups in clinical features and also no difference was observed in platelet counts; however, MPV in the PFO group was significantly higher than the control group (8.38 ±0.93 fl and 7.45 ±0.68 fl respectively).

Conclusions

Our results indicate that elevated MPV may be detected in patients with PFO. This might be one of the explanations for the relationship between PFO and cryptogenic stroke; however, larger cohorts are warranted in order to define further mechanisms.     

Is the Cell Death in Mesial Temporal Sclerosis Apoptotic?

PURPOSE: Mesial temporal sclerosis (MTS) is characterized by neuronal loss in the hippocampus. Studies on experimental models and patients with intractable epilepsy suggest that apoptosis may be involved in neuronal death induced by recurrent seizures. METHODS: We searched evidence for apoptotic cell death in temporal lobes resected from drug-resistant epilepsy patients with MTS by using the terminal deoxynucleotidyl transferase (TdT) and digoxigenin-11-dUTP (TUNEL) method and immunohistochemistry for Bcl-2, Bax, and caspase-cleaved actin fragment, fractin. The temporal lobe specimens were obtained from 15 patients (six women and nine men; mean age, 29 +/- 8 years). RESULTS: Unlike that in normal adult brain, we observed Bcl-2 immunoreactivity in some of the remaining neurons dispersed throughout the hippocampus proper as well as in most of the reactive astroglia. Bax immunopositivity was increased in almost all neurons. Fractin immunostaining, an indicator of caspase activity, was detected in approximately 10% of these neurons. Despite increased Bax expression and activation of caspases, we could not find evidence for DNA fragmentation by TUNEL staining. We also could not detect typical apoptotic changes in nuclear morphology by Hoechst-33258 or hematoxylin counterstaining. CONCLUSIONS: These data suggest that either apoptosis is not involved in cell loss in MTS, or a very slow rate of cell demise may have precluded detecting TUNEL-positive neurons dying through apoptosis. Increased Bax expression and activation of caspases support the latter possibility.     

MPO-ANCA-associated pulmonary-renal vasculitis in a patient with diabetes mellitus

Diabetes mellitus is one of the major causes of chronic renal failure. Typical findings of diabetic nephropathy are early hyperfiltration followed by microalbuminuria and overt proteinuria, resulting in a progressive decrease in glomerular filtration rate. Rapidly progressive glomerulonephritis has rarely been reported in patients with diabetes mellitus. Here, we describe a patient with MPO-ANCA-associated vasculitis, presenting with pulmonary-renal syndrome. Immunosuppressive treatment, including pulse methyl-prednisolone and cyclophosphamide, was administered and the disease was resolved.     

Evaluation of anticoagulant system in Turkish children with Perthes disease

BACKGROUND: Perthes Disease (PD) is generally a self-limiting disease of childhood but it causes severe pain and may lead to deformity of the femoral head. Intravascular thrombosis seems to form the main mechanism in the pathogenesis of the disease. The aim of this study was to determine hereditary thrombotic risk factors in Turkish children with PD. METHODS: In 46 Perthes patients (35 male, 11 female), family history of thrombotic events was investigated, Protein C (PC), free-Protein S (f-PS), antithrombin (AT) activities, fibrinogen level, and resistance to activated Protein C (APC) were measured. The results were compared with a healthy control group of 79 children matched by age and sex. The relationship between the severity of disease and coagulation system abnormalities was evaluated. RESULTS: While the mean PC and AT activities were significantly lower in the patients than those of the controls, the proportions of patients with low AT activity, resistance to APC, and a history of hereditary thrombophilia were significantly higher than those of the controls. No difference was observed in coagulation system disorders relative to severity of the disease and bilateral or unilateral disease involvement. CONCLUSIONS: This study shows that a possible association between PD and inherited hypercoagulability. Determination of thrombotic risk factors in these patients may bring a new approach to the treatment. Most importantly, this may be a stimulant to take precautions for other thrombotic events, which patients may face later in life.     

Low-Dose Aspirin Does Not Increase Implantation Rates in Patients Undergoing Intracytoplasmic Sperm Injection: A Prospective Randomized Study

Purpose: The aim was to evaluate the effect of aspirin on pregnancy and implantation rates in an unselected group of patients undergoing intracytoplasmic sperm injection (ICSI). Methods: Two hundred and seventy-nine patients were randomized to receive 80 mg of aspirin (n = 139) or no treatment (r = 136) starting from the first day of controlled ovarian hyperstimulation. Results: Duration of stimulation, gonadotropin consumption, peak estradiol, number of oocytes retrieved, fertilization rate, cleavage rate, and number of embryos transferred were similar in the two groups. Implantation and clinical pregnancy rates were 15.6% and 39.6% versus 15.1% and 43.4% in aspirin treated and untreated groups, respectively (P > 0.05). Conclusions: Low-dose aspirin administration does not improve implantation and pregnancy rates in an unselected group of patients undergoing ICSI.     

Does tonsillectomy reduce the risk of being a habitual or severe snorer?

We assessed the relationship between tonsillectomy and being a habitual or severe snorer. Volunteers were asked to provide their age and sex, a detailed snoring history covering the frequency and intensity of snoring, and their smoking and alcohol intake habits. After oral and nasal examinations, the tonsil size scores, Mallampati index scores, and nasal obstructions of the volunteers were recorded. Body heights and weights were measured, and body mass indexes were calculated. Being male, aging, an increase in body mass index and tonsillectomy were identified as independent risk factors for being a habitual and severe snorer. Although a nasal obstruction was found to be an independent risk factor for being a habitual snorer, an obstructive tongue base was identified as an independent risk factor for being a severe snorer. Tonsillectomy reduces the risk of being both a habitual and severe snorer. This reduced incidence and intensity of snoring following tonsillectomy could be accepted as a long-term beneficial side effect of the operation.