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ABSTRACT Background: Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy. There is little information about the application of F-wave studies for evaluation of UNE. Objective: The aim of this study was to evaluate the diagnostic value of minimum F-wave (F-min) latency alterations by comparing this with nerve conduction analyses in UNE-suspected patients. Methods: Ninety-four UNE-suspected patients were admitted to this study. Sensory and motor nerve conduction and F-wave analyses on the median and ulnar nerves were performed on both upper extremities. Results: A total of 188 upper extremities of 94 patients were examined. Their mean age was 41.4±12.9 years, and 69 patients were female (73.4%). The mean ulnar-nerve across-elbow motor conduction velocity (MCV) in the affected arms was significantly slower than the velocity in healthy arms. The mean ulnar-nerve F-min latencies were significantly longer in the affected arms. Fifty-one patients were electrophysiologically diagnosed as presenting UNE (54.2%). Significantly slower mean ulnar-nerve across-elbow MCV, longer mean ulnar-nerve F-min latency and longer distal onset latency were detected in UNE-positive arms. Lastly, patients who were symptomatic but had normal nerve conduction were evaluated separately. Only the mean ulnar F-min latency was significantly longer in this group, compared with the healthy arms. Conclusion: Our study confirmed the utility of F-min latency measurements in the electrodiagnosis of UNE. F-wave latency differences can help in making an early diagnosis to provide better treatment options.

RESUMO Introdução: A neuropatia ulnar do cotovelo (NUC) é a segunda neuropatia por encarceramento mais comum. Existem poucas informações sobre a aplicação dos estudos da onda F para avaliação da NUC. Objetivo: O objetivo deste estudo foi avaliar o valor diagnóstico das alterações mínimas de latência da onda F (F-min), comparando-as com análises de condução nervosa em pacientes com suspeita de NUC. Métodos: Noventa e quatro pacientes com suspeita de NUC foram admitidos neste estudo. A condução nervosa sensitiva e motora e as análises da onda F nos nervos mediano e ulnar foram realizadas em ambas as extremidades superiores. Resultados: Um total de 188 membros superiores de 94 pacientes foi examinado. A média de idade foi 41,4±12,9 anos e 69 pacientes eram do sexo feminino (73,4%). A velocidade de condução motora média do nervo ulnar através do cotovelo (VCM) nos braços afetados foi significativamente mais lenta do que a velocidade em braços saudáveis. As latências médias F-min do nervo ulnar foram significativamente mais longas nos braços afetados. Cinquenta e um pacientes foram diagnosticados eletrofisiologicamente como apresentando NUC (54,2%). Pacientes com presença de NUC tiveram, de forma significativa, detecção de VCM mais lenta no nervo ulnar ao nível do cotovelo, presença de latência mais longa da onda F-mínima no nervo ulnar, bem como latência de início distal mais longa. Por fim, os pacientes sintomáticos, e com condução nervosa normal, foram avaliados separadamente. Apenas a latência da onda F mínima média do nervo ulnar foi significativamente maior neste grupo, em comparação com os braços saudáveis. Conclusão: Nosso estudo confirmou a utilidade das medidas de latência da onda F-mínima no eletrodiagnóstico da NUC. As diferenças de latência da onda F podem ajudar a fazer um diagnóstico precoce para fornecer melhores opções de tratamento.

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Introduction - To present a rare case of bilateral acute angle-closure glaucoma secondary to duloxetine administered for the treatment of depression. Case presentation - A 46 year old woman developed bilateral closed angle glaucoma after 15 days of duloxetine usage. Intraocular pressures (IOP) were 52 and 55 mm Hg in right and left eyes respectively, with shallow anterior chamber and angle closure on gonioscopy. Discontinuing duloxetine treatment, initiation of antiglaucomatous treatment and bilateral Nd:YAG Laser iridotomy obtained normalized IOP and anterior chamber depth. Conclusion - Duloxetine, used in the treatment of depression can be responsible for acute angle-closure glaucoma by leading to mydriasis and ciliary effusion.

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BACKGROUND/AIMS: Studies about defecation patterns have been mostly conducted on infants who were breastfed in a short term but were fed predominantly with formula. In this study, defecation patterns of 125 infants, most of them being breastfed during 12th month were evaluated. MATERIALS AND METHODS: Frequency, consistency and color of the stool were analyzed in relation to the feeding pattern at the 15th day and at the 1st, 2nd, 3rd, 4th, 5th, 6th and 12th months. RESULTS: Frequency of defecation was highest in 15th day with a median of 6/day. It decreased with age (p=0.0001), being 4/day and 3/day in 1st and 2nd months respectively, and 2/day between 3rd-12th months. During first 5 months, the stool frequency was higher in infants who were exclusively breastfed compared to those being fed with breastfed and formula (p<0.05). The effect of the feeding pattern on stool frequency disappeared in the following months (p>0.05). Stool frequency decreased by half at the 2nd month when the rate of less than once/day attained its highest value (24.8%). In those who had a rate of less than once/day, stool frequency stayed low until the 6th month and exclusively breastfed rate was also found lower (p<0.05). CONCLUSION: Besides the age, exclusive breastfeeding was also effective on stool frequency. It points out that infants who are fed with formula in addition to breastfeeding may defecate less than once per day hence should not be diagnosed as having constipation depending solely on defecation frequency and should not receive unneccesary treatments.

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To identify the normal defecation patterns and the factors affecting these patterns in the first two years of life, a questionnaire was given to the parents of 1,021 children who were followed in a well-child clinic. The time of first meconium passage, presence of colic symptoms, frequency, color, and consistency of stools were recorded.Mann Whitney U, Wilcoxon, chi-square, and correlation tests were used in the statistical analyses. The median number of defecations per day was six in the first month of life. This decreased to once in the second month and almost all cases remained so until the end of the 24th month. At the second month of age, 39.3% of infants passed stools less than once a day. This pattern of rare defecation was seen until the end of 6 months, when supplemental foods were started. Stool frequency was higher in exclusively breast-fed infants (p = 0.0001). Infants who had colic symptoms in the first 2 months had less frequent defecation during the first 2 years of life (p = 0.0001). In addition to confirming the previously observed defecation patterns of 0-2-year-old infants, this study provides the relationship between colic symptoms and stool frequency, and showed that the second month of life was unique in the sense that the frequency of stooling decreased to half of the previous month and 39.3% of these infants defecated less than once a day.

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The intracellular mechanisms controlling mechano-dependent production of the two extracellular matrix proteins collagen XII and fibronectin were analyzed. Fibroblasts were cultured on either tensed (attached) or released (floating) collagen type-I gels, respectively. Collagen XII and fibronectin production was three- to fivefold higher under tensed than under released conditions. The general inhibitor of tyrosine phosphorylation, genistein (50 microM), and the MAP kinase inhibitor PD98059 (20 microM) selectively reduced collagen XII accumulation by tensed cultures. Addition of PD98059, but not genistein, downregulated tensile stress-induced tyrosine phosphorylation levels of ERK1/2 and focal adhesion kinase. Staurosporine as well as pretreatment with phorbol ester, which constitute means to downregulate classical and novel PKC activity, specifically blocked collagen XII but not fibronectin accumulation in tensed fibroblasts. ERK1/2 phosphorylation levels were not affected by staurosporine treatment. Chronic exposure to the protein kinase C inhibitors bisindolylmaleimide and calphostin C blocked increased production of both fibronectin and collagen XII from cells under tension. The data manifest that the mechano-dependent production of collagen XII and fibronectin requires separate pathways. The FAK-ERK1/2 pathway, a genistein-sensitive tyrosine kinase, and a distinct classical/novel PKC appear selectively required for increased production of collagen XII in cells under tensile stress, whereas fibronectin induction is regulated by a different PKC-dependent pathway.

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