Effects of the Cold Pressor Test on Popliteal Vein Diameter, Flow Velocity, and Blood Flow in the Lower Limb in 60 Healthy Individuals.

BACKGROUND In various situations such as pain, exposure to hot or cold, and mental stress, where physiological stress occurs, the increased excitatory response in the sympathetic efferent neurons leads to an increased return of blood flow from the peripheral veins to the right atrium. The cold pressor test (CPT) is based on the effects of a cold stimulus that activates afferent sensory pathways to trigger a sympathetic response, resulting in an increase in blood pressure. This study aimed to evaluate the effects of the cold pressor test on popliteal vein diameter, flow velocity, and blood flow in the lower limbs in 60 healthy individuals. MATERIAL AND METHODS We included 30 men and 30 women age 18-40 years. Baseline vein diameter, flow velocity, and blood flow of the left popliteal vein were measured by Doppler ultrasound, then the left hand was immersed in a bucket of cold water. After immersing the hand in cold water for 1 minute (CPT-1), 3 measurements of vein diameter, flow velocity, and blood flow were taken again, and their averages were calculated. RESULTS In the study, data obtained from the individuals were statistically analyzed. At CPT-1, venous diameter and flow values showed significant increase compared to baseline (P=0.001, P<0.001, respectively). CONCLUSIONS In healthy volunteers, CPT increases venous flow in the popliteal veins. However, our study did not provide evidence for the hypothesis that the increase in venous return is due to venoconstriction mechanisms.

An Evaluation of Minimal F-wave Sensitivity in Carpal Tunnel Syndrome.

Background and objective Several recent studies have explored whether F-waves can be a sensitive and useful tool for diagnosing carpal tunnel syndrome (CTS). In light of this, we aimed to measure the minimal F-wave latencies in patients with mild, moderate, and severe electrophysiologically diagnosed carpal CTS, as well as individuals without CTS, to determine at which point this parameter becomes sensitive to the syndrome. Materials and methods Nerve conduction studies were carried out in a room where a temperature of 22-24 °C was maintained. The F-waves of the median nerve in all patients and individuals in the control group were recorded. The F-wave with the highest velocity (minimal F) was categorized into the normal, mild, moderate, and severe groups for statistical analysis. All measurements were performed by the same electrophysiology-experienced neurologist. Results Post-hoc analysis demonstrated that the F latency values of the moderate and severe CTS groups were significantly higher than those of the control group (p<0.001 for all comparisons). Furthermore, the F latency values of the severe CTS group were significantly higher than those of the moderate group (p=0.026). Conclusions Based on our findings, minimal F-wave latency is a reliable indicator of moderate to severe CTS. This sensitivity significantly increases in severe cases while disappearing in the presence of mild CTS.

The prevalence of papilledema in patients with migraine: a crucial cooccurrence of migraine and idiopathic intracranial hypertension.

OBJECTIVE: We aimed to investigate the prevalence of idiopathic intracranial hypertension (IIH) in patients with migraine by screening for papilledema. MATERIALS AND METHODS: We have included all the patients with migraine who applied to our neurology clinic during December 2019 and accepted to participate in the study. The demographic and clinical characteristics including migraine subtype (episodic/chronic), headache frequency per month, and headache characteristics of all patients were interrogated. Besides, the presence of fibromyalgia (FM) and chronic fatigue syndrome (CFS) was noted. Fundus examination was performed in all of the patients and the presence of papilledema was noted. RESULTS: Overall, 158 consecutive migraineurs were included in this study. The mean age of the group was 35.9 ± 9.9 and the female/male ratio was 134/24. Papilledema was determined in 10 (6%) patients. There was a past medical history of having IIH in one of these patients. In four of the patients, the diagnosis of IIH was newly established. Comparative analyses between episodic migraineurs and chronic migraineurs revealed that female gender was more prevalent in chronic migraineurs (p = 0.00) and the comorbidities of FM and CFS were more common in chronic migraineurs. Remarkably, papilledema was found to be more common in chronic migraineurs. The results of the logistic regression analyses revealed that obesity was the only predictor for the presence of papilledema (p = 0.014). CONCLUSION: Our results may suggest that IIH should be kept in mind as a notable comorbidity in migraineurs, particularly in the subgroup of obese patients with chronic migraine.

Nutritional status and anthropometric measurements of patients with multiple sclerosis.

OBJECTIVE: To determine the nutritional status and anthropometric measurements of patients with multiple sclerosis (MS). METHODS: This research was conducted on 37 (15 men, 22 women) new diagnosed MS patients who applied to Ankara Numune Education and Research Hospital, Ankara Turkey, from June to August 2011. The nutritional status of patients was determined by a 3-day and 24-hour dietary record and a food frequency questionnaire. Body composition was analyzed by bioelectrical impedance analyzer, and body mass index was calculated. The Nutrient Data Base (BEBIS) program was used to evaluate the energy and nutrient intakes of patients and compared with Dietary Reference Intakes recommendations. Blood samples were collected and serum glucose, lipid profiles, total protein, albumin, total calcium, magnesium, vitamin B12, and vitamin D levels were analyzed. RESULTS: Approximately 5.4% of patients were underweight, 54.1% were normal weight, 24.3% were overweight and 16.2% were obese. Daily mean energy intakes were 2730+/-840.97 kcal in men and 1967+/-647.24 kcal in women. The percentage of the carbohydrates was 46.9%, proteins was 14.6%, and fats of the total energy was 38.4%. Approximately 16.7% of the patients' serum vitamin D, and 6.7% of the patients' serum vitamin B12 levels were below than the reference ranges. CONCLUSION: Multiple sclerosis patients have high body mass index values and poor nutritional status. It was verified that life style modification with adequate and balanced nutritional habits is very important in MS patients.

Drug treatment failures and effectivity in children with newly diagnosed epilepsy.

PURPOSE: To determine the percentage of children whom first-line antiepileptic drug treatment failed and the specific reasons for the treatment failure in newly diagnosed epilepsy. METHODS: Hospital records were reviewed for 225 children who were newly diagnosed with epilepsy, started on the first antiepileptic drug, and then monitored for approximately 4.2 years. RESULTS: Of the 225 patients analyzed, the mean age was 7.9 ± 0.6 years at diagnosis. Most of the patients suffered from primarily generalized tonic-clonic seizures (in 84 patients, 37.3%). 114 patients (50.6%) were classified as having idiopathic epilepsy, 64 (28.4%) had symptomatic epilepsy and 47 (20.8%) has cryptogenic epilepsy. Valproic acid (n: 120, 53.3%), carbamazepine (n: 45, 20%) and oxcarbazepine (n: 31, 13.7%) were the most frequently prescribed antiepileptic drugs. Overall, 67.5% (n: 152) patients were treated successfully with the first antiepileptic drug. Seventy-three patients failed with the first-line antiepileptic drug. Of these patients, 28 discontinued medication because of adverse effects (38.3%), 26 because of lack of efficacy (35.6%) and 19 (26.02%)because of a combination of inefficacy and adverse effects. Age at diagnosis, seizure, etiology and antiepileptic drug selection are considered to be associated with drug treatment failure in childhood epilepsy. There was no statistically significant effect of any of these variables on first-line treatment outcome. CONCLUSION: Approximately one-third of the children with newly diagnosed epilepsy fail the first prescribed antiepileptic drug. Adverse effects and lack of efficacy contributed equally to the treatment failures.