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Öğe Acute-Phase Stroke Outcome and Lipids(Kare Publ, 2021) Tokgoz, Osman Serhat; Guney, Figen; Kaya, Ahmet; Bugrul, Ahmet; Eruyar, Esra; Buyukgol, Huseyin; Seyithanoglu, AbdullahObjectives: The aim of the study is to investigate the relationship of lipid subgroups with short-term mortality in acute stroke (AS). Methods: This retrospective study included 698 patients with AS who presented within 24 h of symptom onset. A hemogram from peripheral venous blood samples was taken at admission. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low- density lipoprotein cholesterol (LDL- C), TC/HDL-C rate, and TG/HDL-C rate were recorded. Duration of follow-up was defined as 30 days. Results: 64 out of 698 patients died during the follow-up period. The mean TG, TG/HDL-C, and TC/HDL-C levels were significantly lower in the mortality group than the survival group. In the receiver operating characteristic (ROC) analysis, the cutoff values and area under the curve of the TG, TG/HDL-C, TC, and TC/HDL- C levels for short-term stroke mortality are as follows ([100.2 mg/dL, 0.648]; [2.52, 0.650]; [170.50 mg/dL, 0.598]; and [4.32, 0.640], respectively). In the Cox regression model, only TG and TG/HDL-C, according to their ROC cutoff values, were independent variables as short-term mortality predictors ( TG =100.2 mg/dL, HR:2.413, 95% CI: 1.345-4.327, P:0.004); ( TG/HDL =2.56, HR: 2.720, 95% CI: 1.389-5.359, P:0.003, respectively). Conclusion: Dyslipidemia is a well-known as a risk factor of stroke. However, this study focused on the estimation that lower TG and TG/HDL-C levels at the time of hospital admission might be predictors of short-term mortality within a month of AS attack, which is a different subject from long term risk factors of stroke. Serum TG level may be a better indicator for mortality in the acute hypercatabolic trauma such as stroke.Öğe Acute-Phase Stroke Outcome and Lipids(Kare Publ, 2021) Tokgoz, Osman Serhat; Guney, Figen; Kaya, Ahmet; Bugrul, Ahmet; Eruyar, Esra; Buyukgol, Huseyin; Seyithanoglu, AbdullahObjectives: The aim of the study is to investigate the relationship of lipid subgroups with short-term mortality in acute stroke (AS). Methods: This retrospective study included 698 patients with AS who presented within 24 h of symptom onset. A hemogram from peripheral venous blood samples was taken at admission. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low- density lipoprotein cholesterol (LDL- C), TC/HDL-C rate, and TG/HDL-C rate were recorded. Duration of follow-up was defined as 30 days. Results: 64 out of 698 patients died during the follow-up period. The mean TG, TG/HDL-C, and TC/HDL-C levels were significantly lower in the mortality group than the survival group. In the receiver operating characteristic (ROC) analysis, the cutoff values and area under the curve of the TG, TG/HDL-C, TC, and TC/HDL- C levels for short-term stroke mortality are as follows ([100.2 mg/dL, 0.648]; [2.52, 0.650]; [170.50 mg/dL, 0.598]; and [4.32, 0.640], respectively). In the Cox regression model, only TG and TG/HDL-C, according to their ROC cutoff values, were independent variables as short-term mortality predictors ( TG =100.2 mg/dL, HR:2.413, 95% CI: 1.345-4.327, P:0.004); ( TG/HDL =2.56, HR: 2.720, 95% CI: 1.389-5.359, P:0.003, respectively). Conclusion: Dyslipidemia is a well-known as a risk factor of stroke. However, this study focused on the estimation that lower TG and TG/HDL-C levels at the time of hospital admission might be predictors of short-term mortality within a month of AS attack, which is a different subject from long term risk factors of stroke. Serum TG level may be a better indicator for mortality in the acute hypercatabolic trauma such as stroke.Öğe Atypical Sporadic Creutzfeldt-Jakob Disease Mimicking Nonconvulsive Status Epilepticus(Kare Publ, 2014) Uca, Ali Ulvi; Genc, Bulent Oguz; Guney, Figen; Akpinar, ZehraSporadic Creutzfeldt- Jakob disease (sCJD) is the most common disorder among the very rare prion diseases (human transmissible subacute spongiform encephalopathies). The diagnosis might be easy if a patient with characteristics features of myoclonus, progressive dementia and periodic electroencephalography activity. Diagnosis of some patients with unusual symptoms and signs may be challenging. The reported case is a 65 years old female patient who was finally diagnosed as CJD, after previously being misdiagnosed with depression, dementia and refractory nonconvulsive status epilepticus.Öğe Colchicine Toxicity in End-Stage Renal Disease Patients: A Case-Control Study(Lippincott Williams & Wilkins, 2014) Solak, Yalcin; Atalay, Huseyin; Biyik, Zeynep; Alibasic, Hayrudin; Gaipov, Abduzhappar; Guney, Figen; Kucuk, AdemColchicine has been used in a number of disorders. Because colchicine is partially excreted from the kidney, there is a need for dose reduction in case of renal functional impairment. There are no data with regards to safe dosing schedule of colchicine in hemodialysis patients. We aimed to evaluate adverse effects of colchicine use in a hemodialysis cohort. We screened hemodialysis patients who were using colchicine for any reason. All patients were interviewed regarding possible toxicities of colchicine use and were examined with a special focus on neuromuscular system. Creatine kinase and myoglobin were used to detect any subclinical muscle injury or rhabdomyolysis, respectively. Twenty-two maintenance hemodialysis patients who were on colchicine for more than 6 months and 20 control hemodialysis patients not using colchicine were included in the study. Four of 22 patients were using 0.5 mg/day, 4 patients were using 1.5 mg/day, and 14 patients were using 1 mg/day colchicine. Mean duration for colchicine use was 8.9 +/- 8.2 years. There was no difference between the groups in terms of myoneuropathic signs and symptoms and blood counts except for white blood cell count, which was significantly higher in patients on colchicine. Serum creatine kinase (56.3 +/- 39.5 and 52.1 +/- 36.1 for colchicine and control groups, respectively, P = 0.72) and myoglobin (191.4 +/- 108.8 and 214.6+/-83.5 for colchicine and control groups, respectively, P = 0.44) levels were not different between the groups. We conclude that in a small number of haemodialysis patients who were apparently tolerating colchicine, detailed assessment revealed no evidence of sublinical toxicity when compared with controls.Öğe A cross-sectional study to assess the association between major depression and inflammatory markers in patients with acute ischemic stroke(Wolters Kluwer Medknow Publications, 2019) Kozak, Hasan Huseyin; Uguz, Faruk; Kilinc, Ibrahim; Uca, Ali Ulvi; Tokgoz, Osman Serhat; Guney, Figen; Ozer, NejlaBackground: Increased interest in the relationship between affective disorder and long-term health consequences has generated recent examinations of depression and stroke. Observations suggest that depressive disorder is associated with abnormal physiological and immunological responses and a resultant increase in inflammatory markers. Given the high prevalence of stroke and associated costs for the community, it is important to understand the mechanisms that may impact on the outcome to achieve the best possible prognosis. Aims: The view that inflammatory factors contribute to depression is predicated on findings that circulating cytokines and other inflammatory factors are increased in depressed patients. Therefore, it has been hypothesized that inflammation could be one of the mechanisms by which depression increases risk for ischemic stroke. Our aim was to determine whether there is any relationship between major depression and tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), IL-18, brain-derived neurotrophic factor (BDNF), and neuron-specific enolase (NSE) in patients with acute ischemic stroke (AIS). Study Design: This was as a cross-sectional design. Materials and Methods: This study has a cross-sectional design, and it was conducted in Necmettin Erbakan University, the Meram Faculty of Medicine in Konya, Turkey, between 2014 and 2015. Fifty-three AIS patients admitted to the hospital within the first 24 h after stroke onset were recruited. Major depression was ascertained by means of the structured clinical interview for the diagnostic and statistical manual of mental disorders, Fourth Edition/Clinical Version. The enzyme-linked immunosorbent assay was used to measure the serum levels of TNF-alpha, IL-1 beta, IL-18, BDNF, and NSE at admission. Results: A total of 53 patients with a mean age of 65.9 years were recruited. Of these patients, 17 (32.1%) had major depression. Depressive and nondepressive patients had similar demographical and clinical features. There was no significant statistical difference between depressive and nondepressive patients with AIS with respect to levels of TNF-alpha, IL-1 beta, IL-18, BDNF, and NSE. Conclusion: This study suggests that in patients who have experienced AIS, there is no significant relationship between major depression and basal proinflammatory cytokines (TNF-alpha, IL-1 beta, IL-18), BDNF, and NSE.Öğe A Neuro-Behcet's Case Operated with the Intracranial Mass Misdiagnosis(Korean Neurosurgical Soc, 2012) Tokgoz, Osman Serhat; Akpinar, Zehra; Guney, Figen; Seyithanoglu, AbdullahBehcet's disease (BD) is an inflammatory systemic disorder with oral and genital ulcers, as well as ophthalmologic and cutaneous symptoms. Neurological manifestations in BD represent between 2.2% to 50% of the cases. The 25-year-old male patient, diagnosed with BD three years earlier, was admitted to our clinic with complaints of recurrent headaches. Tumor-like-parenchimal involvement was detected on a cranial magnetic resonance imaging. The lesion was removed surgically and then he suffered from right hemiparesis and epilepsy. Pathological examination of the lesion noted a demyelinating non-tumoural etiology. A neuro-Behcet's case with parenchymal involvement has been examined in light of the literature, in terms of a tumor and a demyelinating disease differential diagnosis.Öğe Neutrophil Lymphocyte Ratio as a Predictor of Stroke(Elsevier Science Bv, 2013) Tokgoz, Serhat; Kayrak, Mehmet; Akpinar, Zehra; Seyithanoglu, Abdullah; Guney, Figen; Yuruten, BetigulBackground: The aim of this study is to investigate the relationship of the neutrophil to lymphocyte ratio (NLR) with short-term mortality in acute stroke. Methods: This retrospective study included 255 patients with acute cerebral infarction who presented within 24 hours of symptom onset. A hemogram from peripheral venous blood samples was taken at the time of admission. The NLR was calculated as the ratio of neutrophils to lymphocytes. Duration of follow-up was defined as 60 days. Results: Seventy-one of 255 patients died during the follow-up period. The median NLR was significantly increased among the mortality group compared with the survival group (median 11.50, interquartile ratio [IQR] 10.40 vs median 3.79, IQR 4.72; P = .001). In our multivariate Cox regression model, NLR >5.0 (hazard ratio [HR] 3.30; 95% confidence interval [CI] 1.35-8.07), National Institutes of Health Stroke Scale score (HR 1.11; 95% CI 1.07-1.16), glucose values at admission (HR 1.007; 95% CI 1.002-1.011), and history of coronary artery disease (HR 2.49; 95% CI 1.26-4.92) were predictors of short-term mortality. The sensitivity for short-term mortality when the NLR was >5 was 83.10%, and the specificity was 62.00%. The positive predictive value of a NLR >5 was 45.7%, and negative predictive value was 90.50%. A strong linear association between NLR and National Institutes of Health Stroke Scale score was also observed (r = 0.64; P = .001). In addition, the NLR was higher in both the atherosclerotic and cardioembolic stroke subgroups than the lacunar infarct subgroup (6.5 [IQR 7.2], 7.5 [IQR 8.9], and 3.20 [IQR 3.50], respectively; P = .001). Conclusions: The NLR at the time of hospital admission may be a predictor of short-term mortality in acute stroke patients. Because of the routine use and inexpensive nature of hemogram analysis, the NLR should be investigated in future prospective, randomized controlled trials investigating acute stroke.Öğe Postanoxic Parkinsonism: A Case Report(Turkish Neurological Soc, 2013) Gumus, Haluk; Guney, FigenPostanoxic encephalopathy is a rare syndrome manifested by neurological signs in the late period. In this case we aim to discuss postanoxic parkinsonism occurring late following resuscitation.Öğe Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: A prospective, crossover study(Wiley, 2012) Solak, Yalcin; Biyik, Zeynep; Atalay, Huseyin; Gaipov, Abduzhappar; Guney, Figen; Turk, Suleyman; Covic, AdrianAim: Pruritus is common in dialysis patients. Peripheral neuropathy is also prevalent in this patient population. However, the role of neuropathy in the genesis of uraemic itch has not been adequately studied to date. Therefore, we aimed to investigate the effects of gabapentin and pregabalin on uraemic pruritus along with neuropathic pain in patients receiving haemodialysis. Methods: This is a 14 week long randomized, prospective, cross-over trial. Haemodialysis patients with established neuropathy and/or neuropathic pain were included. Fifty patients were randomly assigned to gabapentin 300 mg after each haemodialysis session and pregabalin 75 mg daily. After 6 weeks of treatment, cross-over was performed and patients received the other drug for another 6 weeks. Short Form of McGill Pain Questionnaire and Visual Analogue Scale were used to evaluate pain and pruritus, respectively. At each week's visit, patients were interrogated in terms of adverse effects of study drugs. Baseline laboratory data and demographic characteristics were recorded from patient charts. Results: Forty (12 males, 28 females) out of 50 patients completed the study. Mean age was 58.2 +/- 13.7. Overall, 29 out of 40 patients (72.5%) had pruritus symptoms at baseline evaluation. Fifteen patients (37.5%) were diabetic. Thirty-one out of 40 patients (77.5%) had electromyography (EMG)-proven peripheral neuropathy. Twenty three patients (57.5%) had both EMG-proven neuropathy and pruritus. Gabapentin and pregabalin improved both neuropathic pain and pruritus significantly. There was no difference between the study drugs in terms of efficacy against pain and pruritus. Conclusion: Treatment of neuropathic pain with either pregabalin or gabapentin effectively ameliorates uraemic itch.Öğe Serum Neuroinflammatory Markers' Levels and Evaluation of Peripheral Large Nerve Fibre Function in Patients with Psoriasis(Galenos Yayincilik, 2016) Balevi, Ali; Ozdemir, Mustafa; Guney, Figen; Tol, Huseyin; Okudan, Nilsel; Belviranli, Muaz; Sahin, Kemal TahirObjective: Currently, tumor necrosis factor-alpha (TNF-alpha) inhibitors are widely used all over the world, especially in the treatment of severe psoriasis. However, multiple sclerosis (MS) and peripheral neuropathy occurrence associated with TNF-a inhibitors have been reported in the treatment of patients with psoriasis. It is not known whether TNF-a inhibitors reveal underlying neurological disorders in patients with psoriasis. The aim of this study was to investigate whether there is an association between psoriasis and MS or peripheral neuropathy. Methods: In this study, 50 psoriasis patients and 25 healthy controls were enrolled. Neurological examination and needle electromyography test were performed. Serum levels of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), S-100 calcium-binding protein (S100B) and neuron specific enolase (NSE), which are involved in neuroinflammatory process, were measured. Results: Serum MMP-9 levels were higher in psoriasis patients compared to healthy controls. Serum MMP-2 and NSE levels were decreased in psoriasis patients compared to healthy controls. There was no significant difference in S100B levels between two groups. All neurophysiological parameters in each individual patient and control were found to be within normal limits and there was no difference between groups. Conclusion: NSE and MMP-9 might play role in the occurrence of MS in psoriasis patients. Especially, we are in the opinion that it might be useful to measure the serum levels of these markers before the administration of TNF-a inhibitors in psoriasis patients with family history of MS.
