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Öğe Conjunctival impression cytology and tear film parameters in patients with multiple sclerosis(Springer, 2022) Belviranli, Selman; Oltulu, Pembe; Uca, Ali Ulvi; Gundogan, Ali Osman; Mirza, Enver; Altas, Mustafa; Turk, NazliPurpose To evaluate conjunctival impression cytology (CIC) findings and tear film parameters in patients with multiple sclerosis (MS) compared with controls. Methods Thirty-three patients with MS (MS group) and 33 age- and sex-matched healthy subjects (control group) were included in this cross-sectional comparative study. CIC grades, tear break-up time (TBUT), Schirmer 1 test results, and Ocular Surface Disease Index (OSDI) scores were compared between the two groups, and correlations between CIC grade, TBUT, Schirmer 1 test result, OSDI score, Expanded Disability Status Scale score, and disease duration were analyzed. Results Mean CIC grade was higher in the MS group than in the control group (1.48 +/- 0.71 and 0.39 +/- 0.56, respectively; p < 0.001). In the MS group, CIC of the 14 participants (42.4%) was grade 2-3. In the control group, CIC of the only one participant (3.3%) was grade 2, and none of them was grade 3. TBUT (8.12 +/- 3.16, 13.06 +/- 4.23 s in MS and control groups, respectively; p < 0.001) and Schirmer 1 test results (8.45 +/- 5.75, 17.36 +/- 10.89 mm in MS and control groups, respectively; p < 0.001) were lower, and OSDI score (36.36 +/- 19.19, 13.70 +/- 15.36 in MS and control groups, respectively; p < 0.001) was higher in the MS group compared to the control group. Conclusion In patients with MS, objective findings of dry eye, subjective symptoms related to dry eye, and CIC abnormalities, including high grades of conjunctival squamous metaplasia and goblet cell loss, are more common. Patients with MS should be monitored for ocular surface alterations and dry eye disease.Öğe Evaluation of upper extremity ataxia through image processing in individuals with multiple sclerosis(Assoc Arquivos Neuro- Psiquiatria, 2022) Erdeo, Fatma; Yildiz, Ibrahim; Uca, Ali Ulvi; Altas, MustafaBackground: Impaired dexterity is a frequently reported disability among people with ataxic multiple sclerosis (MS). Objective: To quantify and standardize the evaluation of upper extremity coordination disorder among patients with multiple sclerosis (MS), using the Tablet Ataxia Assessment Program (TAAP). Methods: The X and Y axis movements of 50 MS patients and 30 healthy individuals who were evaluated using the International Cooperative Ataxia Rating Scale (ICARS) were also assessed using TAAP. The functional times of the participants' right and left hands were recorded using the nine-hole peg test (NHPT). The upper extremity coordination of individuals with MS was evaluated using the upper extremity kinetic functions section of ICARS. Results: The deviations for the X and Y axis movements of the MS group were greater than those of the control group (p<0.05). Significant correlations were shown between TAAP scores and NHPT and ICARS scores. The strongest correlation was found between NHPT and ICARS in the dominant hand (r(nhpt)=0.356, p(nhpt)=0.001; r(icars)=0.439, p(icars)=0.000). In correlating the Y axis with ICARS, the deviations in the Y axis were found to be greater in the non-dominant hand than those in the X axis (r(yright)=0.402, p(yright)=0.004; r(yleft)=0.691, p(yleft)=0.000). Conclusion: Measurement using TAAP is more sensitive than other classical and current methods for evaluating ataxia. We think that TAAP is an objective tool that will allow neurorehabilitation professionals and clinicians to evaluate upper extremity coordination.Öğe Evaluation of upper extremity ataxia through image processing in individuals with multiple sclerosis(Assoc Arquivos Neuro- Psiquiatria, 2022) Erdeo, Fatma; Yildiz, Ibrahim; Uca, Ali Ulvi; Altas, MustafaBackground: Impaired dexterity is a frequently reported disability among people with ataxic multiple sclerosis (MS). Objective: To quantify and standardize the evaluation of upper extremity coordination disorder among patients with multiple sclerosis (MS), using the Tablet Ataxia Assessment Program (TAAP). Methods: The X and Y axis movements of 50 MS patients and 30 healthy individuals who were evaluated using the International Cooperative Ataxia Rating Scale (ICARS) were also assessed using TAAP. The functional times of the participants' right and left hands were recorded using the nine-hole peg test (NHPT). The upper extremity coordination of individuals with MS was evaluated using the upper extremity kinetic functions section of ICARS. Results: The deviations for the X and Y axis movements of the MS group were greater than those of the control group (p<0.05). Significant correlations were shown between TAAP scores and NHPT and ICARS scores. The strongest correlation was found between NHPT and ICARS in the dominant hand (r(nhpt)=0.356, p(nhpt)=0.001; r(icars)=0.439, p(icars)=0.000). In correlating the Y axis with ICARS, the deviations in the Y axis were found to be greater in the non-dominant hand than those in the X axis (r(yright)=0.402, p(yright)=0.004; r(yleft)=0.691, p(yleft)=0.000). Conclusion: Measurement using TAAP is more sensitive than other classical and current methods for evaluating ataxia. We think that TAAP is an objective tool that will allow neurorehabilitation professionals and clinicians to evaluate upper extremity coordination.Öğe Impact of unilateral trigeminal neuralgia on bilateral ocular surface alterations(Wiley, 2022) Altas, Mustafa; Oltulu, Pembe; Uca, Ali Ulvi; Belviranli, Selman; Gundogan, Ali Osman; Mirza, Enver; Oltulu, RefikObjective To evaluate ocular surface alterations in both eyes of patients with unilateral trigeminal neuralgia (TN) compared with controls. Background Corneal nerves mainly originate from the trigeminal nerve, and neurosensory abnormalities are important factors in ocular surface alterations and dry eye etiopathogenesis. Methods Twenty-four patients with idiopathic unilateral TN and 24 healthy controls with similar sex and age distributions were included in this cross-sectional study conducted from February 15 to September 15, 2021. The eyes on the affected sides of the patients with TN were treated as Group 1, their contralateral eyes as Group 2, and the right eyes of the controls as Group 3. All participants were evaluated for tear film and ocular surface using the Schirmer 1 test, tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) score, and conjunctival impression cytology grading. Results The mean (SD) ages of the patients with TN (17 of 24 females, 70.8%) and controls (15 of 24 females, 62.5%) were 49.7 (11.7) and 48.5 (9. 6) years, respectively. The median [25th, 75th percentile] Schirmer 1 test results in Groups 1, 2, and 3 were 5.0 [4.0, 14.0], 7.0 [3.2, 11.7], and 10.0 [6.0, 15.7] mm, respectively, with no statistically significant differences between Groups 1 and 2 (p = 0.697), Groups 1 and 3 (p = 0.133), or Groups 2 and 3 (p = 0.129). The median TBUT scores in Groups 1, 2, and 3 were 7.0 [5.0, 10.0], 8.0 [5.2, 10.0], and 12.5 [8.0, 13.0] s, respectively, showing reduced times for both Groups 1 and 2 versus Group 3 (median difference = -3.0 [95% CI: -5.0, -1.0], p = 0.001, and median difference = -3.0 [95% CI: -5.0, -2.0], p = 0.001, respectively). Conjunctival impression cytology grades were significantly higher in Groups 1 and 2 versus Group 3 (median difference = 2.0 [95% CI: 1.0, 2.0], p < 0.001, and median difference = 1.0 [95% CI: 1.0, 2.0], p < 0.001, respectively). The median OSDI score in TN patients (30.2 [25.0, 34.9]) was significantly higher than in the controls (8.3 [0.0, 18.7]), with a median difference of 20.8 (95% CI: 14.7, 27.1), p < 0.001. Conclusion Even if pain is unilateral in patients with TN, there are significant abnormalities in conjunctival cytology and tear functions in both eyes. There seem to be various pathophysiological mechanisms of TN that affect the bilateral ocular surface and lead to significant alterations.Öğe Is acute stress and plasminogen activator inhibitor polymorphism associated with acute ischemic stroke?(Elsevier Science Bv, 2016) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Altas, Mustafa[Abstract Not Availabe]Öğe Modafinil-induced spontaneous unwelcome orgasms(Wiley-Blackwell, 2014) Uca, Ali Ulvi; Altas, Mustafa[Abstract Not Availabe]Öğe Myasthenia gravis with acute respiratory failure in the emergency department(Kare Publ, 2016) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Teke, Turgut; Altas, Mustafa; Karatas, EmineAcute respiratory failure (ARF) is defined as a sudden malfunction in the ability of respiratory system to maintain adequate gas exchange. Acute hypercapnic respiratory failure develops as a result of ventilation deficiency and it is defined as an increase of PaCO2 above 45 mmHg. Myasthenia Gravis (MG) is a sporadically developing auto- immune deficiency where the neuro-muscular transmission is affected and it is one of the important reasons for neurologically-induced respiratory distress. Here, we report a case of a 75-year-old male patient previously undiagnosed MG, who presented with ARF. MG is not a common entity that we encounter daily. Patients on occasions may present to the emergency department because of acute exacerbation. Though most of them were known cases, we should be aware of some unrecognized cases and should consider MG as a differential diagnosis for patients with acute respiratory failure. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.Öğe Paroxysmal Dystonia as the First Manifestation of Multiple Sclerosis with Internal Capsular Plaque(Galenos Yayincilik, 2014) Uca, Ali Ulvi; Altas, Mustafa[Abstract Not Availabe]Öğe Personality disorders in pateints with multiple sclerosis: Prevalence and association with depressive and anxiety disorders and clinical features(Asean Neurological Assoc, 2016) Uca, Ali Ulvi; Uguz, Faruk; Kozak, Hasan Huseyin; Turgut, Keziban; Tekin, Gonca; Altas, Mustafa; Akpinar, ZehraObjective: This study examines the current prevalence of mood, anxiety and personality disorders in patients with multiple sclerosis (MS), the impact of personality disorders on clinical features of MS and the existence of depressive and anxiety disorders. Methods: The study sample comprised of 55 patients with relapsing-remitting MS and 56 control subjects. Axis I diagnoses including mood and anxiety disorders and personality disorders were ascertained by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition / Clinical Version and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders, respectively. The Expanded Disability Status Scale (EDSS) was used to determine degree of disability due to MS. Results: The prevalence of any mood, any anxiety and any personality disorders in patients with MS were 40.0%, 38.2% and 45.5%, respectively, which are significantly higher than the control subjects. Major depression, generalized anxiety disorder, avoidant personality disorder and obsessive-compulsive personality disorder were more frequent in patients with MS compared to the controls. In comparison to MS patients without personality disorders, MS patients with personality disorders had a more frequent occurence of any mood disorder, any anxiety disorder, major depression, posttraumatic stress disorders and MS attacks, and higher scoresof EDSS. Conclusions: Mood, anxiety and personality disorders are frequently seen in patients with MS. The results also suggest that personality disorders may negatively affect the existence of mood and anxiety disorders as well as the clinical course of MS in the patients.Öğe Possible roles of sestrin2 in multiple sclerosis and its relationships with clinical outcomes(Assoc Arquivos Neuro- Psiquiatria, 2022) Odabas, Faruk Omer; Uca, Ali Ulvi; Akdag, Turan; Demirdogen, Filiz; Altas, Mustafa; Tokgoz, Osman SerhatBackground: Characterized by demyelination, inflammation and axonal damage, multiple sclerosis (MS) is one of the most common disorders of central nervous system led by the immune system. There is an urgent and obvious need for biomarkers for the diagnosis and follow-up of MS. Objective: To investigate serum levels of sestrin2 (SESN2), a protein that responds to acute stress, in MS patients. Methods: A total of 85 participants, 40 patients diagnosed previously with relapsing-remitting MS and 45 healthy controls, were included. Serum SESN2 parameters were investigated in blood samples drawn from each participant in the patient and control groups. Results: SESN2 levels were significantly lower in MS patients than in controls (z:-3.06; p=0.002). In the ROC analysis of SESN2, the predictive level for MS was 2.36 ng/mL [sensitivity, 72.50%; specificity, 55.56%; p=0.002; area under the curve (AUC)=0.693]. For the cut-off value in both groups, SESN2 was an independent predictor for MS [Exp (B)=3.977, 95% confidence interval (95%CI) 1.507-10.494 and p=0.013]. Conclusions: The decreased expression of SESN2 may play a role in MS pathogenesis, and SESN2 could be used as a biomarker for MS and as immunotherapeutic agent to treat MS.Öğe Possible roles of sestrin2 in multiple sclerosis and its relationships with clinical outcomes(Assoc Arquivos Neuro- Psiquiatria, 2022) Odabas, Faruk Omer; Uca, Ali Ulvi; Akdag, Turan; Demirdogen, Filiz; Altas, Mustafa; Tokgoz, Osman SerhatBackground: Characterized by demyelination, inflammation and axonal damage, multiple sclerosis (MS) is one of the most common disorders of central nervous system led by the immune system. There is an urgent and obvious need for biomarkers for the diagnosis and follow-up of MS. Objective: To investigate serum levels of sestrin2 (SESN2), a protein that responds to acute stress, in MS patients. Methods: A total of 85 participants, 40 patients diagnosed previously with relapsing-remitting MS and 45 healthy controls, were included. Serum SESN2 parameters were investigated in blood samples drawn from each participant in the patient and control groups. Results: SESN2 levels were significantly lower in MS patients than in controls (z:-3.06; p=0.002). In the ROC analysis of SESN2, the predictive level for MS was 2.36 ng/mL [sensitivity, 72.50%; specificity, 55.56%; p=0.002; area under the curve (AUC)=0.693]. For the cut-off value in both groups, SESN2 was an independent predictor for MS [Exp (B)=3.977, 95% confidence interval (95%CI) 1.507-10.494 and p=0.013]. Conclusions: The decreased expression of SESN2 may play a role in MS pathogenesis, and SESN2 could be used as a biomarker for MS and as immunotherapeutic agent to treat MS.Öğe Serum levels of irisin and nesfatin-1 in multiple sclerosis(Assoc Arquivos Neuro- Psiquiatria, 2022) Altas, Mustafa; Uca, Ali Ulvi; Akdag, Turan; Odabas, Faruk Omer; Tokgoz, Osman SerhatBackground: Multiple sclerosis (MS) is an inflammatory and neurodegenerative autoimmune chronic neurological disease. Currently, there are no effective serum biomarkers to verify MS diagnosis, to assess disease prognosis, and evaluate response to MS treatment. Objective: The present study is a preliminary assessment of irisin and nesfatin-1 serum levels in patients with relapsing-remitting MS (RRMS). Methods:A total of 86 participants, 42 patients with RRMS diagnosis and 44 healthy controls were included in the study. The serum irisin and nesfatin-1 parameters of the patients and control group members were analyzed.Results:Irisin and nesfatin-1 levels of the RRMS patients were significantly lower than the controls (z:-3.82, p<0.001; z:-4.79, p<0.001, respectively) The cut-off level of irisin is 10.390 (ng/mL) (sensitivity: 84.1%, specificity: 71.4%, AUC: 0.800), and the cut-off level of nestatin-1 is 7.155 (ng/mL) (sensitivity: 68.2%, specificity: 64.3%, AUC: 0.739) in the ROC analysis. For these cut-off levels in the case-control groups, the lower irisin and nesfatin-1 levels are the independent variables for MS patients (OR 9.723, 95%CI 2.884-32.785, p<0.001; OR 3.992, 95%CI 1.336-11.928, p<0.001) respectively. Conclusion: The present study revealed lower irisin and nesfatin-1 levels in patients with RRMS. These findings suggest that the decreased levels of irisin and nesfatin-1 peptides may contribute to MS pathogenesis such as inflammation, oxidative stress, and apoptosis in MS, leading to demyelination, axonal damage with neuronal loss, and gliosis.Öğe Serum levels of irisin and nesfatin-1 in multiple sclerosis(Assoc Arquivos Neuro- Psiquiatria, 2022) Altas, Mustafa; Uca, Ali Ulvi; Akdag, Turan; Odabas, Faruk Omer; Tokgoz, Osman SerhatBackground: Multiple sclerosis (MS) is an inflammatory and neurodegenerative autoimmune chronic neurological disease. Currently, there are no effective serum biomarkers to verify MS diagnosis, to assess disease prognosis, and evaluate response to MS treatment. Objective: The present study is a preliminary assessment of irisin and nesfatin-1 serum levels in patients with relapsing-remitting MS (RRMS). Methods:A total of 86 participants, 42 patients with RRMS diagnosis and 44 healthy controls were included in the study. The serum irisin and nesfatin-1 parameters of the patients and control group members were analyzed.Results:Irisin and nesfatin-1 levels of the RRMS patients were significantly lower than the controls (z:-3.82, p<0.001; z:-4.79, p<0.001, respectively) The cut-off level of irisin is 10.390 (ng/mL) (sensitivity: 84.1%, specificity: 71.4%, AUC: 0.800), and the cut-off level of nestatin-1 is 7.155 (ng/mL) (sensitivity: 68.2%, specificity: 64.3%, AUC: 0.739) in the ROC analysis. For these cut-off levels in the case-control groups, the lower irisin and nesfatin-1 levels are the independent variables for MS patients (OR 9.723, 95%CI 2.884-32.785, p<0.001; OR 3.992, 95%CI 1.336-11.928, p<0.001) respectively. Conclusion: The present study revealed lower irisin and nesfatin-1 levels in patients with RRMS. These findings suggest that the decreased levels of irisin and nesfatin-1 peptides may contribute to MS pathogenesis such as inflammation, oxidative stress, and apoptosis in MS, leading to demyelination, axonal damage with neuronal loss, and gliosis.Öğe Sleep quality, morningness-eveningness preference, mood profile, and levels of serum melatonin in migraine patients: a case-control study(Springer Heidelberg, 2017) Kozak, Hasan Huseyin; Boysan, Murat; Uca, Ali Ulvi; Aydin, Adem; Kilinc, Ibrahim; Genc, Emine; Altas, MustafaThe melatonin as the pineal gland's secretory product is implicated in the pathophysiology of migraine. Melatonin has critical functions in human physiology, and research underscores the importance of melatonin in circadian rhythm, sleep, and mood regulation. Clinical observations have indicated that migraine attacks have a seasonal, menstrual, and circadian timing, suggesting that chronobiological mechanisms and their alterations may causally involve in the etiology of the disease. However, the topic has received relatively little attention in the migraine literature. Associations between melatonin, circadian preference, sleep, and mood states were investigated in the current study. Fifty-five patients (47 females and 8 males) were compared to 57 gender and age-matched control subjects (40 females and 17 males). A socio-demographical questionnaire, the Beck Depression Inventory, Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), Profile of Mood States (POMS), and Morningness-Eveningness Questionnaire were administered to volunteers. Blood samples were taken from all participants at about 1:00 AM in an unlit room not to hamper melatonin secretion, and blood melatonin levels were measured using quantitative ELISA test. In comparison with controls, melatonin levels were significantly lower among migraine patients. Migraineurs reported significantly greater scores on the BAI, confusion-bewilderment subscale of the POMS, and total and sleep latency subscale of the PSQI. Migraine patients who had nausea during the migraine attacks and who reported bouts relevant to certain food consumption, such as cheese or chocolate, had significantly lower levels of melatonin. Contrarily, groups did not reveal statistically substantial difference in circadian preferences.Öğe Subarachnoid hemorrhage occurring after bee sting(Termedia Publishing House Ltd, 2016) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Altas, Mustafa; Elbeyli, Ahmet Burak[Abstract Not Availabe]Öğe An Undercovered Health Threat in Turkey: Transdermal Methanol Intoxication(Lippincott Williams & Wilkins, 2015) Uca, Ali Ulvi; Kozak, Hasan Huseyin; Altas, MustafaMethanol is a clear, colorless solvent used in antifreeze solutions, varnishes, cologne, copying machine fluids, perfume, spirit, paint, and fuel. Even small amounts of ingested methanol can cause acute permanent neurological dysfunction and irreversible blindness. Although there are many reports of methanol poisoning due to suicidal or accidental ingestion, reports of transdermal absorption are rare. We present a 68-year-old man with transdermal methanol intoxication applied to our hospital's emergency department with weakness, loss of vision, and altered state of consciousness.
