Effect of ketogenic diet versus regular diet on voice quality of patients with Parkinson's disease.

Diets that have effects on health problems can vary in their composition. Whilst following a regular diet (RD) a person typically consumes about 30% of calories from fat. Ketogenic diet (KD) is a form of diet whereby a person consumes as much as 90% of calories from fat. KD has been trialed as a treatment for neurological diseases and obesity. Parkinson's disease (PD) is a neurologic disease that impacts the quality of voice. Voice Handicap Index (VHI) is a test that gives information to clinical and physiological assessment about voice. We assessed the impact of KD and RD on voice quality (VQ). Seventy-four patients with PD who reported a voice disorder related to their disease were randomly assigned to the KD or RD groups. We investigated the VHI change of subjects before and 3 months after diet. Sixty-eight PD patients completed the study. Baseline VHI values did not differ significantly between groups. All mean VHI parameters improved in KD group (p˂ 0.001). Currently there are different therapies that address speech and voice disorders in patients with PD. As such KD may be an alternative therapy to improve VQ of patients with PD. A larger sample size is necessary to determine the role and pathophysiology of KD on VQ of PD patients.

Variance of melatonin and cortisol rhythm in patients with allergic rhinitis.

OBJECTIVE: Allergic rhinitis is an IgE-mediated inflammatory disease which effects 10%-50% of the normal population. The mechanism of its formation and the circadian rhythm of cortisol and melatonin in allergic rhinitis have not been investigated. STUDY DESIGN: Salivary levels of melatonin and cortisol were measured by radioimmunoassay in 35 newly diagnosed allergic rhinitis patients and in 23 control subjects matched for age and gender. RESULTS: In the study group; amplitude, baseline and peak levels of salivary melatonin were significantly decreased compared with healty controls (p<0.001). No differences were found in the acrophase and the peak duration of salivary melatonin between the study and control groups (p>0.05). In the study subjects, the circadian rhythm of cortisol was flattened when compared with the control group. The amplitude and the 24h mean levels of salivary cortisol in the study group were significantly lower than in the control group and the acrophase was delayed in patients compared with control subjects (p<0.001). CONCLUSION: The circadian rhythms of salivary melatonin and cortisol were found to be disrupted in patients with allergic rhinitis. These results may also be contributive data to explain the pathogenesis of allergic rhinitis and also they can be applicable as adjunctive therapeutic tools in the future and melatonin drugs might be an alternative in the therapy of resistant allergic rhinitis patients or allergic rhinitis patients who cannot use cortisol drugs.

Rapidly developing iatrogenic hyponatremia in a child following tonsillectomy.

Hyponatremia develops as a result of the inappropriate secretion of antidiuretic hormone. In rare cases, it develops as an iatrogenic complication. For example, acute iatrogenic post-tonsillectomy hyponatremia has been described in children following the infusion of hypo- or isotonic fluid. We report a case of rapidly developing post-tonsillectomy iatrogenic hyponatremia in a 5-year-old girl following an excessive infusion of hypotonic fluid. Her signs and symptoms began with nausea and vomiting and progressed to seizures and coma. We corrected the electrolyte disturbance by infusing a 3% sodium chloride solution until her neurologic manifestations disappeared, at which time her serum sodium concentration had risen back to 135 mEq/L. Otolaryngologists are not generally exposed to much information about hyponatremia, so we must be aware of its associated neurologic signs and symptoms.

[Patterns of cervical metastasis from squamous cell carcinoma of the head and neck]. / Bas ve boyun yassi epitel hücreli kanserlerinde boyun yayilim modelleri.

OBJECTIVES: In this study, the existence, distribution and characteristics of cervical lymph nodes metastases in patients with laryngeal, hypopharyngeal and intraoral squamous cell cancer were investigated. PATIENTS AND METHODS: A retrospective review of the charts of 81 laryngeal, hypopharyngeal and intraoral cancer patients (10 females, 71 males; mean age 55.9 years; range 30 and 81 years) surgically treated and followed up in Haseki Training and Research Hospital Ear, Nose and Throat Clinic between January 2004 and October 2007 was evaluated. The demographic data of the patients, tumor localization sites, surgical techniques, TNM stages and regional neck metastases were evaluated. RESULTS: In laryngeal cancer patients, metastatic lymph nodes were found in 36 of 83 (43%) neck specimens. Patients with intraoral tumors had metastases in six (36.4%) of 20 neck specimens. In hypopharynx tumor patients in six of seven (85.7%) showed metastasis. CONCLUSION: These results suggest that elective neck treatment in patients with head and neck squamous cell cancers, should include neck levels I, II, III, IV and V. Upper aerodigestive system squamous cell cancers have specific patterns of invasion in cervical region. According to the localization of the primary tumor, high risk sites of metastases were detected. Selective neck dissections were planned according to these invasion patterns of tumors.