Background: Cholinesterase inhibitors (ChEIs) are currently considered to be the first line treatment for Alzheimer’s disease (AD). Although the target organ for cholinesterase inhibitors is the brain, they may adversely affect cardiacfunction,andtheircholinergicsideeffectsonthecardiovascularsys-tem are still unclear. In this study, it was aimed to examine the side effects caused by donepezil, rivastigmine and galantamine on cardiac rhythm pulse pressure changes in in elderly patients with AD. Methods: 190 consecutive elderly patients with AD were enrolled the study. Elderly patients with AD divided into three groups according to ChEIs including donepezil, rivastig- mine and galantamine. The ECG parameters and pulse pressure were re-corded at the baseline and 1 month after dose of 10 mg/d of donepezil, 10 cm2/dofrivastigmineand24mg/dofgalantamine. Results: 154of190con-secutive elderly patients completed the study. There were no significant changes relative to the baseline in any of the ECG parameters or pulse blood pressurewith any of the administered ChEIs(p > 0.005 foreach comparison) (Figure 1 and 2). Conclusions: It was demonstrated that none of the three ChEIs were associated with increased negative chronotropic, arrhythmo-genic and none of them have changed pulse pressure in the elderly patients with AD. However, when physicians prescribe these drugs, they should be aware of the comorbidities, especially cardiac conduction disease and med- ications of the elderly patients. Background: Nowadays, current therapy methods for Alzheimer’s disease (AD)canonlyreducethesymptomsofthedisease.Therefore,itisimportant to development of new therapeutic agents. Glucagon-like Peptid-1 (GLP-1) has effect on neuronal plasticity, cell survival, neurite outgrowth and protec-tionagainstexcitotoxiccelldeathandoxidativeinjuryduetothecAMPcou- pled receptors with in the brain of rodents and humans. In this retrospective preliminary study we evaluated whether sitagliptin, a GLP-1 inhibitor can improve the cognitive function in elderly diabetic patients with AD. Methods: Eleven diabetic and 13 nondiabetic elderly patients with AD were evaluated retrospectively in our geriatric clinics. Baseline and 6 months after records of MMSE, ADL, IADL and blood sugar under the si- tagliptine therapy were reviewed. Results: Baseline values of the patients were presented as a table. Mean changes of MMSE, ADL and IADL scores from baseline were higher in the sitagliptin treated patients during the 6 months ( P < 0.005, for each comparison). Mean changes of the scores from the baseline were presented in figure. Conclusions: This is the preliminary study, and it is too early to recommend, but we have considered that the sitagliptin can improve the cognitive functions in the patints with AD. Randomized, controlled prospective studies should be done. Therefore we have started a new prospective study related to the cognitive effects of the sitagliptin. Background: Continuous positive airway pressure (CPAP) for sleep apnea syndrome (SAS) may improve cognitive functioning and mood, and reduce daytime sleepiness in patients with Alzheimer’s disease (AD).The purpose of the study was to determine if CPAP slows the rate of cognitive decline in mild to moderate AD’s patients. Methods: This is an exploratory study in- cluding all the patients followed at the Lille memory clinic between 2003 and 2010 for a mild to moderate AD (AD was diagnosed according the NIA criteria (2011); initial Mini Mental State Examination (MMSE) was (cid:1) 15 points), and with a severe SAS defined on a polysomnography exam- inationwithanapnea-hypopneaindex (cid:1) 30.Accordingtothecomplianceof the CPAP treatment, two groups of AD patients were constituted (patients with CPAP vs without CPAP). Mean annual MMSE rates were compared between these two groups. Results: Among the 29 patients included in the study, 20 (69%) accepted with a good compliance the CPAP treatment. The two groups of patients did not differ on epidemiological data. SAS was more severe in the patient group treated with CPAP (IAH: 57.1 6 18.6 vs

Aims The present study aimed to evaluate effect of sitagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4I), on cognitive functions in elderly diabetic patients with and without cognitive impairment. Methods 253 elderly patients with type 2DM, were enrolled in this prospective and observational study. After comprehensive geriatric assessment, the patients were divided into either sitagliptin or non-sitagliptin group. Results A total of 205 patients who completed the study (52 with Alzheimer's Disease (AD)) were re-evaluated 6months later. Sixth-month evaluation revealed no difference between sitagliptin and non-sitagliptin groups in terms of weight, body mass index, and HbA1c (p>0.05). However, the number of patients that required reduced insulin dose was significantly higher in the sitagliptin group (p=0.01). Sitagliptin therapy was associated with an increase in the Mini-Mental State Examination (MMSE) scores (p=0.034); patients without AD receiving only sitagliptin or insulin showed higher MMSE scores as compared to the patients receiving metformin alone (p=0.024). Likewise, the change in MMSE scores in AD patients receiving sitagliptin was significant and indicated improvement as compared to the patients receiving metformin (p=0.047). Conclusion Besides its effects similar to those of insulin and metformin in glycemic control and in reducing need for insulin, 6-month sitagliptin therapy may also associated with improvement of cognitive function in elderly diabetic patients with and without AD. Further randomized controlled trials are needed to support these results.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Aim: When kidney failure occurs the treatment choices for diabetes is narrowed. To evaluate the effect of vildagliptin, a DPP-4 inhibitor, in diabetic nephropathy patients we planned this study. Patients and methods: Twenty two patients (15 M, 7 F, mean age 59,3 + 7,4) admitted to our outpatient clinics within past two and half years with type 2 diabetes mellitus, more than 300 mg/g albuminuria, GFR less than 60 ml/min and started vildagliptin were evaluated retrospectively. Results: After 3 months of vildagliptin treatment HbA1c is tended to be reduced (basal 8,3±1,7; after 3 month: 7,7±1,6; p=0,08 ), eGFR (basal 45,7±19,8 ml/min; after 3 month:44,9±20,1 ml/min; p=0,57) and albuminuria (basal 1572,1 mg/G ± 1829,5; after 3 mo; 1590,1±1936,9; p=0,84) did not changed. Other parameters including

Orthostatic hypotension (OH) is closely associated with falls, cardiovascular events and mortality in the elderly patients. The aim of the study is to evaluate the OH prevalence among patients over the age of 65 years, to find out the impact of this condition on daily living activities, and to determine the possible effects of vitamin D levels on OH in elderly patients. Eight hundred and forty nine geriatric patients who had undergone comprehensive geriatric assessment were retrospectively evaluated and 546 patients were included in the study. The patient's demographic characteristics, blood pressures, comorbid diseases, polypharmacy status, cognitive and nutritional states, basic and instrumental daily living activity indexes and laboratory values were obtained from hospital files. Serum 25-hydroxyvitamin D [25(OH)D] was measured by radioimmunoassay. The prevalence of OH was found to be 27.5%. Both daily living activity indexes were significantly lower in older patients with OH (p<0.02), and serum 25(OH)D levels were significantly lower in older patients with OH (p<0.01). Our findings suggest that vitamin D deficiency may be a factor in OH development. Because this condition is also preventable and correctable, serum vitamin D levels should be checked during the evaluation of OH patients and any detected deficiency should be treated accordingly.

OBJECTIVE:Rivastigmine is commonly used for the treatment of Alzheimer's disease (AD). All cholinesterase inhibitors, including rivastigmine, may cause cardiac side effects. The aim of this study is to compare the electrocardiographic (ECG) and hypotensive effects of formulations of rivastigmine.METHODS:Eighty-five newly diagnosed patients with AD who were treated with rivastigmine were retrospectively evaluated. The ECG records were reviewed at baseline and at administration of either 12 mg of oral rivastigmine or 10 cm(2) transdermal rivastigmine.RESULTS:When compared with the baseline, there were no changes in any of the ECG parameters in all of the patients (P > .05). Moreover, when compared with the mean change from baseline for each treatment group, there were no changes, except heart rate (P = .035).CONCLUSION:It was demonstrated that rivastigmine formulations were not associated with increased arrhythmogenic or hypotensive effects in elderly patients with AD and was not superior to each other.

INTRODUCTION AND OBJECTIVEColonic wall thickening is a common condition in a number of benignant and malignant diseases. This study investigated the accuracy of radiological diagnoses in patients diagnosed with colonic wall thickening using multislice CT (MDCT).MATERIALS AND METHODFiles of patients with colonic wall thickening diagnosed with 64-slice MDCT were reviewed retrospectively. The colonoscopy results of these patients were grouped under neoplastic process (cancer and adenomatous polyp), inflammatory bowel disease (IBD), diverticulitis and other etiology (nonspecific events, ischemic colitis, solitary rectal ulcer, external compression, secondary to volvulus and radiotherapy), and the results were statistically evaluated. p values < 0.05 were considered statistically significant.RESULTSThe study was performed on 505 files (290 males [57.4%], 215 females [42.6%], mean age: 49.15 ± 18.4 years). CT and colonoscopic diagnoses were reviewed and the following CT to colonoscopy ratios was observed: neoplastic process: 44.4% vs. 40.2%; IBD: 42.4% vs. 42.4%; diverticulitis: 4% vs. 4.2%; other etiology: 9.3% vs. 3.2%. Colonoscopy failed to identify pathology in 9.9% of the patients. The sensitivity, specificity, PPV, NPV and accuracy of CT were 95.6%, 90.4%, 87.1%, 96.8% and 92.4%, respectively, in detecting neoplastic processes; 97.2%, 97.9%, 97.2%, 97.9% and 97.6%, respectively, in detecting IBD; 90.5%, 99.8%, 95%, 99.6% and 99.4%, respectively, in detecting diverticulitis, and 50%, 96,7%, 62.5%, 94.6% and 92%, respectively, in detecting other etiology.CONCLUSIONWhile, accuracy of 64 slice-CT in diagnosing colonic wall thickenings secondary especially to neoplastic processes, IBD and diverticulitis was significantly higher, but differential diagnosis is challenging in pathologies due to other etiologies.

To investigate the effects of short-acting analogue insulins on weight, and to demonstrate the difference between analogues. Materials and methods: Our study included patients who have used only intensive insulin therapy with metformin. Those who took other oral antidiabetics, other insulin derivatives, or different insulin combinations were excluded from the study because of the adverse effects on patients' weights. Results: Our study included 118 patients who used insulin glargine with short-acting analogue insulins, i.e. insulin aspart (38 patients), insulin lispro (28 patients), and insulin glulisine (52 patients). After 3 to 6 months of treatment, significant weight gain was observed in the patients who had used insulin aspart and insulin glulisine (P = 0.008). However, in contrast to expectations, it was found that patients who had used insulin lispro experienced weight loss. Weight change in the patient group that used insulin lispro compared with weight change in the insulin glulisine group was found to be statistically significant (P = 0.034). Conclusion: Our study showed that patients who used short-acting insulin analogues gained a little weight, patients who used insulin glulisine gained the most weight, and patients who used insulin lispro lost weight.

Nowadays, current therapy methods for Alzheimer's disease (AD) can only reduce the symptoms of the disease. Therefore, it is important to development of new therapeutic agents. Glucagon-like Peptid-1 (GLP-1) has effect on neuronal plasticity, cell survival, neurite outgrowth and protection against excitotoxic cell death and oxidative injury due to the cAMP coupled receptors with in the brain of rodents and humans. In this retrospective preliminary study we evaluated whether sitagliptin, a GLP-1 inhibitor can improve the cognitive function in elderly diabetic patients with AD. Eleven diabetic and 13 nondiabetic elderly patients with AD were evaluated retrospectively in our geriatric clinics. Baseline and 6 months after records of MMSE, ADL, IADL and blood sugar under the sitagliptine therapy were reviewed. Baseline values of the patients were presented as a table. Mean changes of MMSE, ADL and IADL scores from baseline were higher in the sitagliptin treated patients during the 6 months (P<0.005, for each comparison). Mean changes of the scores from the baseline were presented in figure.

Objective Donepezil is a widely used cholinesterase inhibitor for the treatment of Alzheimer's disease (AD), however its cholinergic adverse side effects on the cardiovascular system are still unclear. In this study, we aimed to examine the adverse side effects caused by donepezil on cardiac rhythm and postural blood pressure changes in elderly patients with Alzheimer Disease. Methods The ECG parameters including heart rate, PR, QT, QTc interval and QRS duration and postural blood pressure changes were recorded at the baseline and at each donepezil dose level (5 and 10 mg/d). Patients Seventy-one consecutive patients who were referred by primary care centers to a Geriatric Clinic were enrolled and underwent comprehensive geriatric assessment. Results Fifty-two subjects completed the study. There were no significant changes relative to the baseline in any of the ECG parameters or arterial blood pressure at any of the investigated dosages of donepezil. Conclusion It was demonstrated that donepezil was not associated with increased negative chronotropic, arrhythmogenic or hypotensive effects for elderly patients with Alzheimer's disease.

Objective: Cholinesterase inhibitors (ChEIs) are widely used for the treatment of Alzheimer’s disease (AD); however, their cholinergic side effects on the cardiovascular system are still unclear. In this study, we aimed to examine the side effects caused by donepezil, rivastigmine, and galantamine on cardiac rhythm and postural blood pressure changes in elderly patients with AD. Methods: Of 204 consecutive elderly patients who were newly diagnosed with AD, 162 were enrolled and underwent comprehensive geriatric assessments. The electrocardiographs (ECGs) and blood pressures were recorded at the baseline and 4 weeks after the dose of 10 mg/d of donepezil, 10 cm 2 /d of rivastigmine, and 24 mg/d of galantamine. Results: There were no changes relative to the baseline in any of the ECG parameters or arterial blood pressure with any of the administered ChEIs. Conclusion: It was demonstrated that none of the 3 ChEIs were associated with increased negative chronotropic, arrhythmogenic, and hypotensive effects for the elderly patients with AD.

Cholinesterase inhibitors (ChEIs) are currently considered to be the first line treatment for Alzheimer's disease (AD). Although the target organ for cholinesterase inhibitors is the brain, they may adversely affect cardiac function, and their cholinergic side effects on the cardiovascular system are still unclear. In this study, it was aimed to examine the side effects caused by donepezil, rivastigmine and galantamine on cardiac rhythm pulse pressure changes in in elderly patients with AD. 190 consecutive elderly patients with AD were enrolled the study. Elderly patients with AD divided into three groups according to ChEIs including donepezil, rivastigmine and galantamine. The ECG parameters and pulse pressure were recorded at the baseline and 1 month after dose of 10 mg/d of donepezil, 10 cm2/d of rivastigmine and 24 mg/d of galantamine. 154 of 190 consecutive elderly patients completed the study. There were no significant changes relative to the baseline in any of the ECG parameters or pulse blood pressure with any of the administered ChEIs (p>0.005 for each comparison) (Figure 1 and 2).