Myasthenia Gravis Attack after Oral Risperidone Treatment: A Case Report

Myasthenia gravis (MG) is an autoimmune disease, which can be triggered by anticholinergic agents. The 6-year-old female patient was admitted to the outpatient clinic. She was had been previously diagnosed with comorbid attention deficit hyperactivity disorder and conduct disorder and was receiving short-acting methylphenidate and risperidone, as recommended by a child psychiatrist. However, after using the drugs, she stated that she was overly tired during the day and that her eyelids drooped. Hence, the current treatment was stopped. She was hospitalized with a prediagnosis of ocular type MG and pyridostigmine (90 mg/day) treatment was started. The patient recovered and subsequently the treatment was stopped. Since psychiatric symptoms of the patient resurfaced, long-acting methylphenidate treatment was initiated. During this treatment, the symptoms of MG did not return. The Naranjo's scale of adverse drug reaction probability was completed. Consequently, there may be an association between risperidone and MG.

Surgical Treatment Results in Unilateral Wilms Tumor: Experience from a High-Volume Pediatric Oncology Center in Turkey

Objective: The aim of this study is to evaluate the clinical characteristics, factors effecting treatment approach and long-term outcome of patients with Wilms tumor. Methods: We identified demographic features, mode of presentation, applied treatments and long term outcomes of 88 patients treated between 1990-2011 at Clinical Ethics Committee of Hacettepe University Faculty of Medicine.according to Turkish Pediatric Oncology Group protocol. Data were processed with SPSS programme and chi-square test was used for statistical analysis. Results: Study included 88 patients consisting of 50 females and 38 males and the mean age at presentation was 3±2.48 years. Patients are classified as stage 1 (n=35, 39.8%), stage 2 (n=16, 18.2%), stage 3 (n=17, 19.3%) and stage 4 (n=20, 22.7%). Pathologic examination of tumors revealed favorable histology in 76 patients (86.4%) and unfavorable histology in 10 patients (11.4%). Forty nine patients (55.6%) received preoperative chemotherapy and patient’s age at diagnosis and the physical examination findings influence the decision of administration of preoperative chemotherapy (p<0.05). 25% of patients under 1 year of age and 75% of patients between 3-5 years old received preoperative chemotherapy. The palpated mass were crossing the midline in 20.5% of patients who were subjected to primary surgery. Tumor ruptured in 5.6% of patients intraoperatively. Long term prognosis of patients were as follows: 68 (83.9%) children were cured, 13 (16%) children died due to recurrences and metastasis. Survival rates reached 100% in stage 1 and 2 patients but decreased to 75% and 50% in stage 3 and 4 patients respectively. Conclusion: Age at presentation and physical examination findings are significant in surgical planning. Stage is the most important prognostic factor. Wilms tumor patients are treated with low complication and high survival rates due to multidisciplinary treatment approach at our institution.

Is there Any Difference between the Patients with Primary Endometriomas and those with Recurrent Endometriomas?

Correlation Between Psoas Muscle Area and Clinical Fragilty Score in Transcatheter Aortic Valve Replacement Patients

Investigation of BK Virus Infections in Haematopoietic Stem Cell Transplant Recipients

Objective: Haemorrhagic cystitis associated with BK virus (BKV) is a common and life-threatening complication in patients with haematopoietic stem cell transplantation (HSCT). In this study, we aimed to investigate the incidence of BKV infection in children with HSCT. Methods: A total of 21 patients aged 7 months to 16 years followed between July 2014 and July 2015 were included in the study. 19 of the patients received allogeneic HSCT and 2 received autologous HSCT. artus® BK Virus RG PCR Kit (Qiagen GmbH, Hilden, Germany) was used for detection of BKV DNA in urine and blood samples. Results: BKV infection was detected in 10 (47%) of 21 patients. Cystitis due to BKV developed in 4 (19%) of the patients. Haemorrhagic cystitis was observed to appear at a median of 23 days after HSCT. Urinary viral load was found to be >108 copies/μl within the previous week before the development of cystitis, and this finding has been accepted as a prognostic indicator. On the other hand, viral load in blood increased to >104 copies/ μl after 21-28 days from the onset of cystitis. All patients with cystitis were allogeneic HSCT recipients under myeloablative therapy (high-intensity regimen) for conditioning regimen. Conclusions: Screening of HSCT recipients for BKV infection, especially for viruria, is important for establishing the predictive diagnosis of patients at high risk for haemorrhagic cystitis and for better management of their treatment. Klimik Dergisi 2018; 31(2): 148-52.

Validity and reliability of Turkish version of the gugging swallowing screen test in the early period of hemispheric stroke

Corresponding Author: Ebru Karaca Umay E-mail: [email protected] Submitted: 12 June 2017 Accepted: 10 January 2018 You may cite this article as: Karaca Umay E, Gürçay E, Bahçeci K, Öztürk E, Yılmaz V, Gündoğdu İ, et al. Validity and reliability of Turkish version of the gugging swallowing screen test in the early period of hemispheric stroke. Neurol Sci Neurophysiol 2018; 35: 6-13 Abstract Objective: The Gugging Swallowing Screen (GUSS) test is a bedside screening test for the assessment of all phases of swallowing in acute-period stroke. The present study aimed to evaluate whether GUSS was effective for the detection of dysphagia in the early period after stroke, as well as to conduct Turkish translation, and validity and reliability studies.

Comparison of Different Treatment Methods for Idiopathic Sudden Sensorineural Hearing Loss

To evaluate the effectiveness of different therapies for idiopathic sudden sensorineural hearing loss and prognostic factors, and determine the most successful treatment according to the audiogram type and time from onset to treatment.

Schwannoma in the Supraclavicular Region: Case Report

Schwannomas are benign tumors arising from schwann cells in peripheral, cranial, and autonomic nerve sheaths. Approximately half of all cases of schwannomas are observed in the head and neck region. In this study, a 71-year-old male patient presenting with a stiff mobile mass in the left supraclavicular region and diagnosed as a schwannoma after total excision was presented.

The Ignored Parameter in the Diagnosis of Obstructive Sleep Apnea Syndrome The Oxygen Desaturation Index

The apnea-hypopnea index (AHI) does not provide information about the apnea depth and length. We aimed to evaluate the correlation of the oxygen desaturation index (ODI) with AHI and the subjective symptoms because it is known that hypoxia plays an important role in morbidity and complications of obstructive sleep apnea syndrome (OSAS).

Comparison of Early Versus Delayed Oral Feeding After Total Laryngectomy in Terms of Pharyngocutaneous Fistula Development

There is still no consensus on the effect of early oral feeding and nasogastric tube feeding on the development of pharyngocutaneous fistula (PCF) after total laryngectomy. The aim of the present study was to compare the effects of early oral feeding and nasogastric tube (NGT) feeding after total laryngectomy on the incidence of PCF.