Although there have been many studies on seizures following stroke, there is still much we do not know about them. In this study, we evaluated the characteristics of seizures in stroke patients. There were 2267 patients with a first-ever stroke, and after excluding 387 patients, 1880 were available for analysis. Of these 1880 patients, we evaluated 200 patients with seizures and 400 patients without seizures. We investigated the seizures according to age, gender, stroke type, the aetiology of ischaemic stroke and the localisation of the lesion. The seizures were classified as early onset and late onset and the seizure type as partial, generalised or secondarily generalised. Seizures occurred in 200 (10.6%) of 1880 strokes. The number of patients with seizures were 138 (10.6%) in ischaemic stroke group and 62 (10.7%) in haemorrhagic stroke group. Patients with ischaemic strokes had 41 embolic (29.7%) and 97 thrombotic (70.3%) origin, and these were not statistically significant in comparison with controls. Cortical involvement for the development of seizures was the most important risk factor (odds ratios = 4.25, p < 0.01). It was concluded that embolic strokes, being younger than 65 years old, and cortical localisation of stroke were important risks for developing seizures.

Increased AChE and decreased LOOHs, which were influenced by increased PON1, were considered as indicators of efforts towards the protection of dopaminergic activity in central nervous system in RLS group. Increased ESR, MPV and low HRVi indicate elevated sympathetic activity in RLS group. Elevated sympathetic activity might be beneficial in relieving RLS symptoms, also causing increases in TOS. The evidence we found regarding oxidative stress and autonomic nervous system might be seminal in RLS treatment.

AEC of AHF patients measured at admission was found to be a stronger predictor of mortality than all other hemogram parameters and this is consistent with the increased sympatho-adrenal activity theory.

Objective: To demonstrate the presence of splenomegaly in primary antiphospholipid syndrome (PAPS) patients without accompanying portal hypertension or comorbidity. Methods: Twelve patients (7 women) aged 23–65 years followed upon the diagnosis of PAPS were enrolled in the study. We documented the identified causes of splenomegaly in patients with PAPS, and searched for the potential causes of splenomegaly in patients with spleen enlargement. PAPS patients with or without splenomegaly were evaluated in terms of demographic and clinical findings. Results: Splenomegaly was present in 6 of the 12 patients. In these patients, there were no infections, hematological disorders, portal hypertension or malignancy that might lead to splenomegaly. The long axis of spleen was found to be in the range of 137–155 mm in patients with splenomegaly. Splenomegaly was more frequently determined in female PAPS patients. The splenomegaly group had a longer duration of disease (median 5.5 vs. 0.75 years) and a higher number of thrombotic events (median 3 vs. 1.5). The splenomegaly group was especially composed of patients who never received any anticoagulant and acetylsalicylic acid, or who used these agents irregularly for very short periods. Conclusion: Splenomegaly was observed in association with disease duration, frequency of thrombotic events and irregular antiaggregant or anticoagulant treatment in patients with PAPS, in the absence of comorbidity or portal hypertension.

Aims:To investigate the prevalence of low T3 in patients with acute coronary syndrome (ACS). Methods: A total of 135 (44 female, 91 male) patients with the diagnosis of ACS hospitalized in coronary care unit were enrolled in the study. Results: The prevalence of low TT3 in ACS was 36%. The probability of acute complications in patients with low TT3 was 1.81 times that of patients with normal TT3 (95% confidence interval, 1.24 -2.67). TT3 and FT3 values were lower in the patients with acute complications than in those without acute complications (P Ͻ 0.001 and P ϭ 0.011, respectively). TT3 and FT3 values were lower in patients with heart failure than in patients without heart failure (P Ͻ 0.001 and P ϭ 0.003, respectively). The relative risk of heart failure in patients with low TT3 versus in those with normal TT3 was 2.78 with 95% confidence interval 1.52 to 5.07. Average TT3 values of the patients with arrhythmia and without arrhythmia were similar (P ϭ 0.032). There was no difference in terms of occurrence of arrhythmia in ACS patients with low TT3 and with normal TT3 (P ϭ 0.992). Conclusions: A low T3 in ACS was related to complications. Low T3 in ACS might be a factor, which protects against arrhythmia but predisposes to heart failure.Key Words: acute coronary syndrome, low t3, nonthyroidal illness, heart failure, arrhythmia (The Endocrinologist 2010;20: 23-26) N onthyroidal illness (NTI) refers to a group of changes in serum thyroid hormones, and TSH in patients with serious nonthyroidal diseases, including infection, inflammation, starvation, malignancy, trauma, burns, major surgical operations, psychosis, stroke, and acute coronary syndrome (ACS). 1-4 The most common and earliest alteration is inhibition of T4 -T3 conversion, which leads to low T3 serum levels. This is thought to be related to the inhibition of type 1 5Јdeiodinase enzyme action by a cytokine, such as tumor necrosis factor, released by inflammatory cells. Several drugs also inhibit this enzyme (eg, corticosteroids, propiltiouracil, iodinated contrast media, propranolol). As the illnesses becomes severe, serum TT4 and FT4 decrease. Several factors are involved in this decrease. Low thyroid binding globulin (nephrotic syndrome, liver disease) and high free fatty acids, which interfere with T4 binding to thyroid binding globulin. This, in turn, causes low TSH, and T4 decreases again, establishing a new equilibrium. TSH may also be inhibited by cytokines, dopamine, and corticosteroids. 4 The magnitude of the thyroid hormone alteration correlates with the severity of the disease with the lowest T3 and T4 values associated with decreased survival. 2,5 Recent studies show that low T3 is associated with increased mortality in patients with serious hearth disorders, and is an independent predictor of mortality in hospitalized cardiac patients. 6 We investigated the prevalence of patients with low T3 in the ACS and its subtypes (unstable angina pectoris ͓USAP͔, myocardial infarction with ST-elevation ͓STEMI͔, and myocardial infarction with non-ST-...