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Spigelian hernia is a rare form of abdominal wall hernia. It occurs when peritoneum with or without organs or preperitoneal fat exists through a defect in the Spigelian fascia. A 63 year old male patient complaint of inguinal hernias and Spigelian hernia treated with laparoscopic approach that has been not previously reported in the literature. The use of the laparoscope has simplified the diagnosis, clarified its localization, and facilitated the subsequent repair of these hernias.

Relationship between plasma levels of prolactin and the severity of negative symptoms in patients with schizophrenia Objective: The aim of this study was to evaluate the relationship between plasma levels of prolactin and negative symptoms. Methods: One hundred fourteen patients with schizophrenia were included in this crosssectional study. The patients were classified into groups with and without hyperprolactinemia. Plasma levels of prolactin and clinical features were compared between these groups. Results: Negative symptom scores in the group with hyperprolactinemia were significantly higher than in the non-hyperprolactinemic group. There was also a positive correlation between plasma levels of prolactin and negative symptom scores. However, there was no statistically significant difference between schizophrenia subtypes with regard to plasma prolactin levels. Patients treated with conventional neuroleptics or novel antipsychotics such as risperidone, paliperidone and amisulpride had higher prolactin levels than patients treated with aripiprazole, olanzapine, quetiapine, ziprasidone, and clozapine. Conclusion: This study indicated that we should be aware of prolactin levels, especially when negative symptoms are prominent in patients with schizophrenia. Plasma levels of prolactin could be an important biological marker for the severity of negative symptoms in the treatment of patients with schizophrenia. Thus, this finding may change the present pharmacotherapy for negative symptoms in schizophrenia based on prolactin levels.

ObjectivesData regarding schizophrenia treatment has been increasing whereas the information about predictors of treatment response is limited. In this study, our aim is to investigate the serum levels of reproductive hormones as a biological predictor in terms.MethodsThirty-three hospitalized male patients in GATA Haydarpasa Training Hospital with the diagnosis of first episode psychosis were included into the study. The study was prospective and naturalistic in design. The clinical course was recorded by means of Positive and Negative Symptom Scale (PANSS) in pretreatment period, 2nd and 6th weeks of the study. Prolactin, FSH, LH, estrogen, testesterone and oxytocin serum levels were also measured at the same dates.ResultsTreatment response was assessed as unresponsive when PANSSttl scores were lower than 25%, partial response when PANSSttl scores were between 25%-40% changes, and response when PANSSttl scores were higher than 40%. Patients were grouped according to those cut-off points. There was a significant positive correlation between oxytocin, FSH serum levels and positive symptoms (ρ = 0.437, P = 0.011; r = 0.385, P = 0.027). There was also significant negative correlation between testesterone serum levels and negative and total psychopathology scores (r = −0.352, P = 0.044; r = −0.429, P = 0.013). It was seen that pretreatment testerone levels had a significant biological marker on predicting remission when the serum levels were lower than 460,91 ng/dL.ConclusionsThis study shows that hypothalamo-hypophysial-gonadal axis hormones and reproductive hormones, especially testesterone, may be an important biological marker of treatment response prediction in first episode psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The aim of this study was to evaluate the relationship between plasma levels of prolactin and negative symptoms. Methods: One hundred fourteen patients with schizophrenia participated in this cross-sectional study. The patients were assigned to groups with hyperprolactinemia and without hyperprolactinemia. Plasma levels of prolactin and clinical features were compared in these groups. Results: Negative symptom scores in the group with hyperprolactinemia were significantly higher than the non-hyperprolactinemic group. There was also a positive correlation between plasma levels of prolactin and negative symptom scores. Additionally there was no statistically significant difference between schizophrenia subtypes in terms of prolactin plasma levels.The patients treated with conventionel neuroleptics or novel antipsychotics such as risperidone, paliperidone and amisulpride, had higher prolactin levels than the other patients treated with aripiprazol, olanzapine, quetiapine, ziprasidone and clozapine. Conclusions: This study indicated that we should be aware of prolactin levels especially when negative symptoms are prominent in patients with schizophrenia. Plasma levels of prolactin could be an important biological marker for the severity of negative symptoms in the treatment of patients with schizophrenia. Thus, this finding may change the present pharmacotherapy for negative symptoms in schizophrenia based on prolactin levels.