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Öğe Acute and subacute effects of thymoquinone on acute methanol intoxication: An assessment based on serum TBARS and BDNF levels in rat model(Marmara Univ, Fac Medicine, 2022) Kozak, Hasan Huseyin; Kilinc, Ibrahim; Ozkurkculer, AlpaslanObjectives: Previous studies have shown the role of oxidative stress in methanol (MeOH) neurotoxicity. In clinical practice ethanol (EtOH) was used for the treatment of MeOH intoxication. Treatment with EtOH results in depression of the central nervous system, which may occur even at therapeutic doses. It also induces oxidative stress. Antioxidant and neuroprotective effects of thymoquinone (TQ) are known in different models of neurotoxicity. There are no studies investigating the protective effect of TQ against acute MeOH intoxication. We aimed to evaluate the effect of TQ administration on serum thiobarbituric acid reactive substances (TBARS) and Brain-Derived Neurotrophic Factor (BDNF) levels in rats with experimentally-induced MeOH intoxication. Materials and Methods: Six groups were constituted. Methotrexate (Mtx) treatment (0.3 mg/kg/day) intraperitoneally (i.p.) was given for 7 days to slow down the formate metabolism of all rats except controls in order to create a MeOH intoxication similar to that in humans. On the 8th day of the experiment, 3 g/kg MeOH was injected i.p. in MeOH, EtOH and TQ groups. Four hours after MeOH administration, 0.5 g/kg EtOH was injected i.p. in EtOH group and 30 mg/kg TQ was administered i.p. in TQ1 and TQ2 groups. In addition, a total of 5 doses of 30 mg/kg TQ was injected i.p. 24, 48, 72 and 96 hours after the first dose in TQ2 group. Saline solution was given i.p. in the other groups. Blood samples were obtained for evaluating serum TBARS and BDNF levels. Results: The highest TBARS level was found in MeOH+MTx group and this increase was statistically significant as compared to control and Mtx groups (p<0.001) . A statistically significant reduction was detected in serum TBARS levels in MeOH+Mtx+EtOH, MeOH+Mtx+TQ1 and MeOH+Mtx+TQ2 groups (p<0.001). Maximum serum BDNF level elevation was found in MeOH+Mtx group and this increase was statistically significant as compared to control and Mtx groups (p<0.001). Serum BDNF levels were higher in MeOH+Mtx+EtOH, MeOH+Mtx+TQ1 and MeOH+Mtx+TQ2 groups and the difference was statistically significant (p<0.001). Conclusions: Thymoquinone could suppress proinflammation and lipid peroxidation in MeOH intoxication, lead to rapid toxicity adaptation, and play the role of neuroprotection more effectively than EtOH. These results may suggest that TQ could be used as an alternative treatment option in MeOH intoxication.Öğe Antidepressant-Induced Sleep Bruxism: Prevalence, Incidence, and Related Factors(Lippincott Williams & Wilkins, 2015) Uca, Ali Ulvi; Uguz, Faruk; Kozak, Hasan Huseyin; Gumus, Haluk; Aksoy, Fadime; Seyithanoglu, Abdullah; Kurt, Hatice GuncuObjective The relationship between sleep bruxism and antidepressant drugs in patients remains unclear. In this study, we aimed to investigate the incidence rate of antidepressant-related bruxism and to examine whether antidepressant use is associated with this adverse effect in the patients. Methods The study sample was gathered from 2 hospitals. A total of 807 patients who met the inclusion criteria were included in the study. The sample was divided into 2 groups: the antidepressant group (n = 506) and the control group (n = 301). Sleep bruxism was established with reports from the study participants on the basis of the International Classification of Sleep Disorders: Diagnosis and Coding Manual Second Edition. Results The prevalence of bruxism was significantly higher in the antidepressant group (24.3%) than in the control group (15.3%). The incidence of antidepressant-induced bruxism was 14.0%. The antidepressants most associated with bruxism were paroxetine, venlafaxine, and duloxetine. The patients experiencing antidepressant-induced bruxism had higher age compared with those who did not experience this adverse effect. Conclusions The results of the present study suggest that bruxism is frequently observed in women taking antidepressants and that it seems to be associated with antidepressant use at least in some patients.Öğe BISOPROLOL-INDUCED DELIRIUM IN A PATIENT WITH ISCHEMIC STROKE: A CASE REPORT(Gunes Kitabevi Ltd Sti, 2015) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Uguz, FarukDelirium is a common neuropsychiatric syndrome that involves a number of symptoms including diffuse cognitive impairment, hallucinations, mood lability and disturbances in the sleep-wake cycle. Besides, delirium is a common condition associated with adverse outcomes, including increase in morbidity, mortality, and need of health services utilization. Even though the etiology of cognitive impairment is multifactorial, drugs also are known to be an important cause of delirium. In this study, we present a patient manifesting a bisoprolol-induced acute delirium, for whom the delirium symptoms completely disappear after bisoprolol was ceased. Bisoprolol is widely used in cardiology for the treatment of hypertension and arrhythmia. Beta-blocking agents have been recognized for some time to have central nervous system effects, which could adversely cause common psychiatric syndromes.Öğe A case of rasagiline-induced spontaneous orgasms in a female patient(Elsevier Sci Ltd, 2014) Uca, Ali Ulvi; Kozak, Hasan Huseyin[Abstract Not Availabe]Öğe Cerebral Venous Sinus Thrombosis as a Rare Complication of Systemic Lupus Erythematosus: Subgroup Analysis of the VENOST Study(Elsevier, 2019) Duman, Taskin; Demirci, Seden; Uluduz, Derya; Kozak, Hasan Huseyin; Demir, Serkan; Misirli, Cemile Handan; Kucukoglu, HayriyeAim: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics. Material and Method: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded. Results: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 +/- 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up. Conclusions: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.Öğe Clinical and radiologic features and their relationships with neurofunctional scores in patients with acute cerebellar infarct(Medknow Publications & Media Pvt Ltd, 2016) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Poyraz, Necdet; Anliacik, Suleyman Omer; Tokgoz, Osman SerhatBackground: Cerebellar infarct is a rare condition with very nonspecific clinical features. The aim of this study was to assess the full spectrum of the clinical characteristics, neuroimaging findings and neurofunctional analyses of cerebellar infarction, and the relationship between them. Materials and Methods: Data were collected from 59 patients admitted to our department during an 8-year period. We retrospectively analyzed the relationship between demographic characteristics, clinical symptomatology, etiological factors, functional condition, vascular distribution, frequency of subcortical white matter lesions (WMLs), and concomitant lesion outside the cerebellum in patients with acute cerebellar infarct (ACI) at time of admission. Results: The mean age in our series was 65.2 years, with most being male (57.6%). The posterior inferior cerebellar (PICA) artery was the most commonly affected territory at 62.7%. There was concomitant lesion outside the cerebellum in 45.7%. The main etiology in PICA was cardioembolism. While mean National Institutes of Health Stroke Scale on admission was 2.08 +/- 1.67 in study group, modified Rankin Scale (mRS) on admission was detected to be mRS1 (n: 44, 74.5%) and mRS2 (n: 12, 20.3%) most frequently. Fourteen (35%) patients were detected to be in Fazekas stage 0; 11 (27.5%) patients in Fazekas stage 1; 6 (15%) patients in Fazekas stage 2; and 9 (22.5%) patients in Fazekas stage 3. Conclusion: Cerebellar infarct is very heterogeneous. The other cerebral area infarcts which accompany ACI negatively affect neurologic functional scores. Although it is difficult to detect the relationship between WMLs and neurologic functional severity, timely detection of risk factors and their modulation may be associated with prevention and treatability of WMLs, and this may be one of the important points for prevention of stroke-related disability.Öğe Cluster-tic syndrome and bilateral internuclear ophthalmoplegia as the manifestation of multiple sclerosis(Asean Neurological Assoc, 2015) Uca, Ali Ulvi; Kozak, Hasan HuseyinThis report describes a 35-year-old female suffering from a cluster-tic syndrome and bilateral internuclear ophthalmoplegia as the initial manifestation of multiple sclerosis. Magnetic resonance imaging of the brain revealed multiple pontine hyperintense lesions. To our knowledge, there is no previous report of multiple sclerosis presenting as cluster-tic syndrome and bilateral internuclear ophthalmoplegia in the literature. The cluster headache attacks and peri-ocular neuralgiform pain resolved after treatment with intravenous methyl-prednisolone and oral carbamazepine.Öğe Coexistence of Migraine Headache and Red Ear Syndrome(Galenos Yayincilik, 2014) Uca, Ali Ulvi; Kozak, Hasan Huseyin[Abstract Not Availabe]Öğe Cortical Blindness(Journal Neurological Sciences, 2013) Uca, Ali Ulvi; Kozak, Hasan HuseyinWhen bilateral retrochiasmal lesions from the beginning of the lateral geniculate body to the occipital cortex are present, there is a cortical blindness.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 Delirium in patients with acute ischemic stroke admitted to the non-intensive stroke unit: Incidence and association between clinical features and inflammatory markers(Termedia Publishing House Ltd, 2017) Kozak, Hasan Huseyin; Uguz, Faruk; Kilinc, Ibrahim; Uca, Ali Ulvi; Tokgoz, Osman Serhat; Akpinar, Zehra; Ozer, NejlaBackground: Stroke patients with development of delirium have unfavorable outcomes, higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Studies suggest that delirium is associated with abnormal immunological responses and a resultant increase in inflammatory markers. Objective: Our aim was to determine whether there is an entity relationship between delirium, inflammation and acute ischemic stroke (AIS). Methods: Sixty AIS patients admitted to the hospital were consecutively recruited. Delirium was diagnosed with the clinical assessment according to the Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of Interleukin-1 beta (IL-1 beta), Interleukin 18 (IL-18), Tumor Necrosis Factor-alpha (TNF-alpha), Brain-Derived Neurotrophic Factor (BDNF), and Neuron Specific Enolase (NSE) at admission. Results: Eleven (18.3%) of 60 patients were diagnosed with delirium, and the majority (n = 8, 72.7%) was the hypoactive type. Delirious and non-delirious patients had similar demographic and clinical features. Delirious patients had significantly higher lengths of hospital stay, National Institutes of Health Stroke Scale (NIHSS) at admission and discharge compared to non-delirious patients. In addition, there was no significant statistical difference between delirious and non-delirious patients with AIS in respect of levels of TNF-alpha, IL-1 beta, IL-18, BDNF and NSE. This study suggests that delirium is not scarce in patients with AIS admitted to the non-intensive stroke unit, and that delirium developing after AIS seems not to be associated with serum TNF-alpha, IL-1 beta, IL-18, BDNF and NSE but is associated with length of hospital stay and stroke severity. (C) 2016 Published by Elsevier Sp. z o.o. on behalf of Polish Neurological Society.Öğe Determinants of in-hospital muscle loss in acute ischemic stroke- Results of the Muscle Assessment in Stroke Study (MASS)(Churchill Livingstone, 2023) Gungor, Levent; Arsava, Ethem Murat; Guler, Ayse; Isikay, Canan Togay; Aykac, Ozlem; Caglayan, Hale Zeynep Batur; Kozak, Hasan HuseyinBackground & aims: There is a change in the mass and composition of paretic and non-paretic skeletal muscles in the chronic phase of stroke. The multi-center, prospective, and observational Muscle Assessment in Stroke Study (MASS) was performed to evaluate the degree of muscle loss during the in-hospital acute stroke setting and determine factors contributing to this loss.Methods: Acute dysphagic ischemic stroke patients (n = 107) admitted to neuro-intensive care units were evaluated by computed tomography on days 1 and 14 after admission to determine the cross-sectional muscle area (CSMA) at the level of the mid-humerus, mid-thigh, and third lumbar vertebra. The percentage change in CSMA and variables associated with this change were evaluated by univariate and multivariate analyses.Results: There were significant reductions in CSMA in all the muscle groups analyzed; the most prom-inent change was observed in the arms (both: 14.2 +/- 10.7%; paretic: 17.7 +/- 11.6%; non-paretic: 10.1 +/- 12.5%), followed by the muscles in the legs (both: 12.4 +/- 8.7%; paretic: 12.9 +/- 9.9%; non-paretic: 12.0 +/- 9.3%) and L3-vertebra level (5.6 +/- 9.8%) (P < 0.001 for all). Higher calorie (r =-0.378, P < 0.001) or protein (r =-0.352, P < 0.001) intake was negatively associated with the decrease in CSMA of upper extremities. A substantial protein (>= 0.4 g/kg/d) or calorie (>= 5 kcal/kg/d) gap between targeted or actual intake was related to a larger decrease in CSMA in all the anatomic regions (P < 0.05 for all). Other significant predictors of muscle loss included history of diabetes mellitus, male sex, higher BMI, in-hospital infections, and the necessity for invasive mechanical ventilation.Conclusions: There is a considerable degree of loss in the global muscle mass in acute ischemic stroke patients over a two-week period. Along with several factors, falling significantly behind the daily protein or calorie targets was related to the decrease in the muscle area. Trial registration information: clinicaltrials.gov identifier NCT03825419.(c) 2023 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.Öğe Foix-Chavany-Marie syndrome after an isolated pontine infarct: A 7-year follow-up(Medknow Publications & Media Pvt Ltd, 2015) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Dundar, Mehmet Akif[Abstract Not Availabe]Öğe Glomus Tumor as a Rare Cause of Dizziness(Galenos Yayincilik, 2015) Kozak, Hasan Huseyin; Uca, Ali Ulvi[Abstract Not Availabe]Öğe Hypomanic Episode Improved Spontaneously after Isolated Acute Cerebellar Infarct: A Case Report(Elsevier, 2015) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Uguz, FarukCerebellum provides functions to be maintained at a basal level by regulating mental performance by means of functional and anatomic links critical for cognition structures. The status emerging with the determination of cognitive and affective disorders after the posterior lobe injury of the cerebellum was termed as a Cerebellar Cognitive Affective Syndrome'' by Schmahmann and Sherman in 1998. The present report presents the clinical course in a patient with a diagnosis of hypomanic episode after cerebellar infarct.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 Masturbation and orgasm as migraine headache treatment: Report of a case(Asean Neurological Assoc, 2015) Uca, Ali Ulvi; Kozak, Hasan HuseyinThis is a report of an unusual case, where the patient used clitoral and/or vaginal masturbation and orgasm for treatment of migraine attack. While the non drug treatment was effective, she subsequently developed depression. The orgasm from masturbation, resulting in the rush of endorphins, probably relieved the migraine. However, as demonstrated in our patient, the patient also had sexual aversion, tiredness, feeling of shame and guilt, followed by depression from the alternative non-drug treatment.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 A New Therapeutic Approach to Obesity: Stroke?(Springer, 2017) Tokgoz, Serhat; Kozak, Hasan Huseyin[Abstract Not Availabe]Öğe Parkinsonism Related to Varenicline in a Patient During Smoking Cessation(Lippincott Williams & Wilkins, 2015) Uca, Ali Ulvi; Kozak, Hasan Huseyin; Uguz, Faruk; Gumus, Haluk[Abstract Not Availabe]