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Alaçam Köksal S, Boncuk Ulaş S, Acar BA, Acar T, Güzey Aras Y, Köroğlu M. Evaluation of the relationship between idiopathic restless legs syndrome and serum hepcidin levels. Brain Behav 2023; 13:e3259. [PMID: 37726920 PMCID: PMC10636386 DOI: 10.1002/brb3.3259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION The relationship between restless legs syndrome (RLS) and iron deficiency is a well-known topic. However, the etiology of the disease has not been determined. As the central iron deficiency is the most critical biological abnormality for RLS, we planned a study examining the relationship between RLS and hepcidin, which is the only regulatory hormone of iron metabolism known so far. METHODS International Restless Legs Syndrome Study Group diagnostic criteria (2014) were taken as a basis. A total of 40 RLS patients and 40 healthy controls were included in the study. To avoid the potential variables that might cause secondary RLS, all the participants were asked to provide hemogram, ferritin, iron, thyroid function tests, and sedimentation analysis. The hepcidin levels were measured with a Human Hepcidin (Hepc 25) ELISA kit (MyBioSource). RESULTS The statistically significant results of our analysis show that the red blood cell count, the neutrophil count, the percentage of lymphocytes and neutrophils, and, more distinctively, hepcidin levels were higher in RLS patients in comparison with the control group. CONCLUSION In this study, no differences were found in iron and ferritin values. High levels of hepcidin, the main regulator of iron metabolism, in those with primary RLS support the possibility that hepcidin may play a role in the pathogenesis of RLS. We think that larger studies on this subject can give clearer ideas.
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Affiliation(s)
| | | | | | - Türkan Acar
- Department of Neurology, Faculty of MedicineSakarya UniversitySerdivanSakaryaTurkey
| | - Yeşim Güzey Aras
- Department of Neurology, Faculty of MedicineSakarya UniversitySerdivanSakaryaTurkey
| | - Mehmet Köroğlu
- Department of Microbiology, Faculty of MedicineSakarya UniversitySerdivanSakaryaTurkey
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Boncuk Ulaş S, Acar T, Acar BA, Alaçam Köksal S, Güzey Aras Y, Alagöz AN, Gül SS, Uçaroğlu Can N, Köroğlu M. Investigation of the relationship between serum irisin level in the idiopathic restless legs syndrome: Could be a marker independent of physical activity? Brain Behav 2023:e3100. [PMID: 37246480 DOI: 10.1002/brb3.3100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/30/2023] Open
Abstract
INTRODUCTION Restless legs syndrome (RLS) is a common but underdiagnosed neurological syndrome. It is characterized by the feeling of discomfort and desire to move, especially in the lower extremities, which often occurs at night, and the cure or relief of symptoms with movement. Irisin is a hormonelike polypeptide that was first identified in 2012, weighs 22 kDa, consists of 163 amino acids, and is mainly synthesized in muscle. Its synthesis increases with exercise. Here in this study, we planned to investigate the relationship among serum irisin level, physical activity, lipid profile, and RLS. MATERIAL AND METHODS A total of 35 patients with idiopathic RLS and 35 volunteers were included in the study. Then, venous blood was taken from the participants in the morning after 12 h of night fasting. RESULTS The mean value of serum irisin level was 16.9 ± 14.1 ng/mL in the case group and 5.1 ± 5.9 ng/mL in the control group, which was statistically quite significant (p < .001). A significant efficiency (under the curve area 0.886 [0.804-0.967]) of irisin value was observed in the differentiation of patients in the case and control groups. DISCUSSION Serum irisin level was significantly higher in the case group than in the control group. In conclusion, we suggest that irisin may play a role in the pathophysiology of RLS independently of the intensity and duration of physical activity and anthropometric data, such as body weight, body mass index, and waist/hip ratio.
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Affiliation(s)
| | - Türkan Acar
- Department of Neurology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | | | | | - Yeşim Güzey Aras
- Department of Neurology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | | | - Sıdıka Sinem Gül
- Department of Neurology, Yenikent State Hospital, Sakarya, Turkey
| | - Nimet Uçaroğlu Can
- Department of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Mehmet Köroğlu
- Department of Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
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Boncuk Ulaş S, Güzey Aras Y, Irmak Gözükara S, Acar T, Acar BA. Correlates of Zonulin and Claudin-5, markers of intestinal and brain endothelial permeability, in Parkinson's Disease: A pilot study. Parkinsonism Relat Disord 2023; 110:105361. [PMID: 36963340 DOI: 10.1016/j.parkreldis.2023.105361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/19/2023]
Abstract
INTRODUCTION Idiopathic Parkinson's Disease is a chronic, progressive, neurodegenerative disease that affects the substantia nigra pars compacta and dopaminergic neurons in the brain stem. Since zonulin and claudin-5 are involved in intestinal and brain endothelial permeability and it is hypothesized that the brain-gut axis is relevant in IPD, the aim of our study is to evaluate whether the relationship between Zonulin and Claudin-5 levels and Parkinson's Disease patients. METHODS A total of 139 patients, including 34 mild, 33 moderate, 39 severe stage patients and 33 healthy controls were included. The patients' demographic data, age of onset, disease duration, disease type and drugs were noted. UPDRS and H&Y scores were evaluated. Prodromal stage symptoms and non-motor symptoms were noted. Zonulin and Claudin-5 levels in the serum were studied. RESULTS The mean Zonulin value was significantly higher in the IPD group compared to the control one (16.0 ± 10.5 vs. 11.1 ± 4.3; p = 0.0012). Likewise, the mean Claudin-5 value in the IPD group was again significantly higher than in the control group (8.4 ± 5.5 vs. 6.2 ± 3.4; p = 0.0003). The combined ROC curve, though, showed only modest albeit significant discriminant ability. Moreover, neither zonulin nor claudin-5 related to age, phenotype or disease duration, and in terms of non-motor symptoms there was only a significant association between zonulin and urine problems and between claudin-5 and sleep symptoms. CONCLUSION Our results suggest an association of these markers of intestinal and brain endothelial permeability and IPD, although these remain modest and preliminary and warrant further consideration in larger studies including prodromal cases.
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Affiliation(s)
| | - Yeşim Güzey Aras
- Department of Neurology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
| | - Sezen Irmak Gözükara
- Department of Biochemistry, Sakarya University Training and Research Hospital, Sakarya, Turkey.
| | - Türkan Acar
- Department of Neurology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
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Vatan MB, Acar BA, Acar T, Güzey Aras Y, Varım P, Boncuk Ulaş S, Eryılmaz HA, Dalkılıç Ş, Polat Zafer A, Turhan O, Çakmak AC, Ağaç MT, Tatlı E. The CHA2DS2-VASc risk score predicts futile recanalization after endovascular treatment in patients with acute ischemic stroke. NeuroAsia 2023. [DOI: 10.54029/2023kep] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Objective: This study aimed to evaluate the utility of the CHA2DS2-VASc score for predicting futile recanalization among patients with acute ischemic stroke (AIS) who underwent endovascular treatment (EVT).
Methods: A total of 97 AIS patients who achieved complete or near-complete recanalization after EVT were included in our study. Clinical, angiographic, and laboratory data were analyzed retrospectively. Using the modified Rankin Scale (mRS) at 90 days after the intervention, the patients were divided into two groups, the futile recanalization group (mRS ≥3) and the favorable recanalization group (mRS ≤2). The receiver-operating characteristics (ROC) curve was used to determine the cut-off value of the CHA2DS2-VASc score for predicting futile recanalization.Multivariate stepwise logistic regression analysis analyzed the association between the CHA2DS2-VASc score and futile recanalization risk after EVT.
Results: The CHA2DS2-VASc score was significantly higher in patients with futile recanalization compared to patients with favorable recanalization [4 (3-6) vs. 3 (1-4), p=0.002]. A ROC curve analysis revealed that the cut-off value of CHA2DS2-VASc score for predicting futile recanalization was >3, with sensitivity and specificity of 65% and 72%, respectively (Area under curve (AUC), 0.697; 95% Confidence interval (CI):0.580-0.814). In multivariate analysis;the CHA2DS2- VASc score (Odds ratio (OR)=1.637, 95% CI:1.181-2.334, p=0.004) and baseline National Institutes of Health Stroke Scale score (OR=1.217, 95% CI:0.985-1.503, p=0.039) were found independent predictors for futile recanalization after EVT.
Conclusion: The CHA2DS2-VASc score can be used as a simple and effective tool to predict futile recanalization in patients with AIS.
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Yavlal F, Doğan Güngen B, Güzey Aras Y, Çelik Y. [Evaluation of pre- and post-transplant electroencephalographic examination in hematopoietic stem cell transplant patients]. Ideggyogy Sz 2023; 76:51-57. [PMID: 36892295 DOI: 10.18071/isz.76.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Background and purpose <p>Haemato­poietic stem cell transplantation (HSCT) is one of the most effective treatment methods for many malignant and non-malignant diseases. In this study, we aimed to detect electroencephalographic (EEG) anomalies at an early stage in patients who underwent allogeneic and autologous HSCT and required the management of potentially life-threatening non-convulsive seizures.</p>. Methods <p>The study was conducted with 53 patients. The age, gender, HSCT type (allogeneic or autologous), and treatment regimens applied before and after HSCT were recorded. All patients underwent EEG monitoring twice, once on the first day of hospitalization and again one week after conditioning regimens began and HSCT was performed.</p>. Results <p>When the pre-transplant EEG findings were examined, 34 (64.2%) patients had normal EEGs and 19 (35.8%) had abnormal EEGs. After transplantation, 27 (50.9%) had normal EEG findings, 16 (30.2%) had a basic activity disorder, 6 (11.3%) had a focal anomaly, and 4 (7.5%) had a ge­ne­ra­lised anomaly. In the allogeneic group, the anomaly rate in post-transplant EEGs was significantly higher than that in the auto­lo­gous group (p<0.05).</p>. Conclusion <p>It is important to consider the likelihood of epileptic seizures in the clinical follow-up of HSCT patients. EEG monitoring is crucial for the early diagnosis and treat­ment of such non-convulsive clinical ma­ni­festations. </p>.
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Affiliation(s)
- Figen Yavlal
- Medicana International Istanbul Hospital, Department of Neurology, Istanbul, Turkey
| | - Belma Doğan Güngen
- Istinye University Medical Faculty, Department of Neurology, Istanbul, Turkey
| | - Yeşim Güzey Aras
- Sakarya University Training and Researche Hospital. Department of Neurology, Sakarya, Turkey
| | - Yusuf Çelik
- Biruni University, Faculty of Medicine, Department of Biostatistics, Istanbul, Turkey
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Yavlal F, Aras YG, Ulaş SB. Evaluation of sleep disorders before and after transplantation in patients undergoing hematopoietic stem cell transplantation. Eur Rev Med Pharmacol Sci 2022; 26:8935-8944. [PMID: 36524513 DOI: 10.26355/eurrev_202212_30568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Hematopoietic stem cell transplantation (HSCT) is an important curative treatment option for many hematologic diseases. Sleep disorders in patients with HSCT are a significant but often overlooked health problem. Therefore, this study aims to determine the frequency of sleep disorders in HSCT patients and to compare and evaluate the data before and after transplantation between autologous and allogeneic HSCT patient groups. PATIENTS AND METHODS Patients who were referred to the Bone Marrow Transplantation Centre Clinic at Medicana International Istanbul Hospital by other centres and those who were suitable for HSCT treatment according to evaluations were included in the study. The patients underwent allogeneic and autologous HSCT. The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI) were applied to both groups before transplantation and on the 7th and 100th days after transplantation. RESULTS The PSQI total and sub-scale scores, ESS scores and ISI scores on the 7th and 100th days after transplantation were statistically significantly lower than the scores before transplantation. CONCLUSIONS Sleep disorders were significantly reduced in patients after HSCT. Moreover, the scores in the seven subscales of the PSQI statistically significantly decreased on the 7th and 100th days after transplantation, and sleep statistically improved and showed great improvement on the 100th day after transplantation. We believe that early detection and treatment of sleep disorders may be beneficial for this group of patients to improve their quality of life and response to treatment.
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Affiliation(s)
- F Yavlal
- Department of Neurology, Medicana International Istanbul Hospital, Istanbul, Turkey.
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Acar BA, Acar T, Vatan MB, Aras YG, Ulaş SB, Eryılmaz HA, Dalkılıç Ş, Zafer AP, Turhan O, Vatan A, Varım P, Kaya T. Predictive value of systemic immune-inflammation index for cerebral reperfusion and clinical outcomes in patients with acute ischemic stroke undergoing endovascular treatment. Eur Rev Med Pharmacol Sci 2022; 26:5718-5728. [PMID: 36066145 DOI: 10.26355/eurrev_202208_29507] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The systemic immune inflammation (SII) index has been an excellent prognostic indicator in patients with acute ischemic stroke (AIS). In this study, we assessed the utility of the SII in predicting the prognosis and reperfusion status of patients with AIS who underwent endovascular treatment (EVT). PATIENTS AND METHODS 123 consecutive AIS patients were enrolled in our study. The receiver-operating characteristics (ROC) curve was used to determine the cut-off value of SII for predicting unsuccessful cerebral reperfusion. Multivariate logistic regression analysis analyzed the association between SII and unsuccessful reperfusion rate after EVT. RESULTS The median value of SII was significantly higher in patients with unsuccessful reperfusion compared to patients with successful reperfusion [2,029 (1,217-2,771) vs. 1,172 (680-2,145) respectively, p=0.003)]. A ROC curve analysis showed that the best cut-off value of SII for predicting unsuccessful reperfusion status was 1,690, with sensitivity and specificity of 71% and 69%, respectively. The area under the curve (AUC) was 0.673 (95% CI; 0.552-0.793). Multivariate analysis demonstrated that SII ≥ 1,690 value was an independent predictor of unsuccessful cerebral reperfusion and unfavorable clinical outcome after EVT (Hazard ratio - H.R.=3.713, 95% CI: 1.281-10.76, p=0.016, HR=2.28, 95% CI: 1.06-4.88, p=0.035, respectively). CONCLUSIONS We suggested that SII is a potential indicator to predict the unsuccessful cerebral reperfusion and unfavorable clinical outcome for patients with AIS undergoing EVT.
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Affiliation(s)
- B A Acar
- Department of Neurology, Department of Cardiology, Department of Infectious Disease, Department of Internal Medicine, Sakarya University Training and Research Hospital, Sakarya, Turkey.
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Güngen BD, Aras YG, Gül SS, Acar T, Acar BA, Can NU. How childhood trauma and emotions influence essential tremor and its severity in Sakarya Province. Eur Rev Med Pharmacol Sci 2022; 26:2721-2726. [PMID: 35503617 DOI: 10.26355/eurrev_202204_28602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Essential tremor (ET) is among the most common central nervous system disorders. It is characterised by symmetrical and bilateral postural tremor, usually affecting the hands. Alongside such motor symptoms, psychiatric symptoms, such as anxiety and depression, often occur. This study aimed to investigate how anxiety, depression and childhood trauma influence ET patients' tremor frequency and severity. PATIENTS AND METHODS The participants comprised 85 patients and 70 control volunteers. Participating patients have been admitted to our clinic for hand tremor complaints and diagnosed with ET, according to the Washington Heights Inwood Genetic Study of Essential Tremor (WHIGET) diagnosis criteria, and they returned for follow-up for at least one year after their initial treatment. Patients with thyroid dysfunction, Parkinson's disease, central nervous system pathology, a history of smoking or alcohol use or a history of drug use that may cause tremor were excluded from the study. Patients' demographic data, such as their age and gender, age at disease onset, disease duration, family history and tremor severity were recorded. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Childhood Trauma Questionnaire (CTQ) were applied to all patients. RESULTS Statistically significant differences were found in BDI score averages and BAI score averages between the patient and control groups (p = 0.002; p = 0.001) and physical abuse, emotional neglect and sexual abuse scores on the CTQ scale (p = 0.001, p = 0.007 and p = 0.001, respectively). CONCLUSIONS Childhood mental trauma and emotional mood disorders are more common among ET patients. However, these disorders do not appear to affect ET severity.
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Affiliation(s)
- B D Güngen
- Department of Neurology, Rumeli University, Istanbul, Turkey.
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Kocayigit I, Kilic H, Acar BA, Acar T, Aras YG, Can Y, Eryılmaz HA, Boncuk S, Akdemir R. Should coronary catheter laboratories be used in the treatment of ischemic stroke? Endovascular treatment in acute ischemic stroke performed by interventional cardiologists. Eur Rev Med Pharmacol Sci 2022; 26:1846-1851. [PMID: 35363332 DOI: 10.26355/eurrev_202203_28329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the technical success and in-hospital outcomes of endovascular thrombectomy (ET) in acute ischemic stroke (AIS) patients performed by interventional cardiologists. PATIENTS AND METHODS ET for AIS provides fast, effective and safe recanalization. Insufficient number of catheter laboratories for stroke interventions and experienced interventional neurologists are limiting the widespread application of such a promising treatment method. RESULTS 123 patients with AIS and eligible for ET were evaluated retrospectively. 65 patients were female (52.8%) and the mean age of the patients was 71.5 ± 11.9 years. Most of the patients had a middle cerebral artery (MCA) occlusion (112 patients, 91%). Successful recanalization (thrombolysis in cerebral infarction grading 2b or higher) was achieved in 109 patients (88.6%). Access site complication was observed only in 3 patients (2.4%). Intracranial bleeding was observed in 17 patients (13.8%) and only 8 of them were symptomatic (6.5%). In-hospital death occurred in 19 patients (15.4%). The initial National Institutes of Health Stroke Scale (NIHSS) was 16.8±3.3 (median 18) which improved significantly to 10.4±7.2 (median 11) at 24 hours (p<0.001). Dramatic neurologic improvement was observed in 60 of 123 patients (48.8%). The modified rankin score of the patients was significantly lower at discharge compared to admission (4.2±0.7 vs. 2.9±2, p<0.001). CONCLUSIONS ET in AIS can be performed safely with high success rates by trained interventional cardiologists within the stroke team. Until the number of stroke centers is sufficient, endovascular treatment of AIS can be supported by experienced interventional cardiologists.
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Affiliation(s)
- I Kocayigit
- Department of Cardiology, Faculty of Medicine, University of Sakarya, Sakarya, Turkey.
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Acar T, Boncuk S, Acar B, Güzey Aras Y. Complete Recovery in Cryptogenic NORSE with Early Immunotherapy: A Case Report. tnd 2021. [DOI: 10.4274/tnd.2020.01879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Acar T, Acar BA, Karabacak M, Aras YG. HaNDL Syndrome Presenting With Confusion: A Rare Case Report. Noro Psikiyatr Ars 2020; 57:340-342. [PMID: 33354130 PMCID: PMC7735145 DOI: 10.29399/npa.23233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 05/23/2018] [Indexed: 06/12/2023] Open
Abstract
HaNDL syndrome (Syndrome of Transient Headache and Neurologic Deficit with Cerebrospinal Fluid Lymphocytosis) characterized by sudden onset headache, transient neurological deficits, and cerebrospinal fluid (CSF) lymphocytosis, is a self-limited clinical entity that is rarely seen. In this article, we present a case with HaNDL syndrome in a 28-year-old male patient who presented with confusion and agitation after sudden onset of headache, right hemiparesis, and lymphocytosis pleocytosis.
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Affiliation(s)
- Türkan Acar
- Sakarya University, Faculty of Medicine, Neurology Department, Sakarya, Turkey
| | | | - Mustafa Karabacak
- Sakarya University, Faculty of Medicine, Neurology Department, Sakarya, Turkey
| | - Yeşim Güzey Aras
- Sakarya University, Faculty of Medicine, Neurology Department, Sakarya, Turkey
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Acar T, Acar BA, Aras YG, Doğan T, Boncuk S, Eryılmaz HA, Can N, Can Y. Demographic characteristics and neurological comorbidity of patients with COVID-19. ACTA ACUST UNITED AC 2020; 66Suppl 2:82-85. [PMID: 32965362 DOI: 10.1590/1806-9282.66.s2.82] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/03/2020] [Indexed: 01/15/2023]
Abstract
ABSTRACT The COVID-19 infection that started in the Wuhan Province of the People's Republic of China and has now spread throughout the world is not limited to the respiratory system, but also causes other systemic symptoms through viremia. Recent data show that the central and peripheral nervous system involvement is particularly substantial. Thus, the present study aims to investigate the current neurological comorbidities and symptoms of patients with COVID-19 who were followed up by our clinic physicians.
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Affiliation(s)
- Türkan Acar
- . Sakarya University Training and Research Hospital, Sakarya, Turkey
| | | | - Yeşim Güzey Aras
- . Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Turan Doğan
- . Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Sena Boncuk
- . Sakarya University Training and Research Hospital, Sakarya, Turkey
| | | | - Nimet Can
- . Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Yusuf Can
- . Sakarya University Training and Research Hospital, Sakarya, Turkey
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Ayas ZÖ, Aras YG, Güngen BD. An Unusual Recurrence of Miller Fisher Syndrome: Three Times in Eight Years. ACTA ACUST UNITED AC 2020; 57:78-79. [PMID: 32110156 DOI: 10.29399/npa.22871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/12/2017] [Indexed: 11/07/2022]
Abstract
Miller Fisher Syndrome (MFS) is an acute, autoimmune polyneuropathy usually associated with a good prognosis which is clinically characterized by ataxia, ophtalmoplegia, and areflexia. MFS has a monophasic course, double recurrence can be seen in rare cases. But three attacks are very rare. In this article, we discussed a rare case of MFS and approach to the treatment that recurred 3 times within a period of 8 years. It is emphasized that MFS cases may occur a recurring pattern, and plasma exchange should be definitely tried as a therapeutic approach when clinical deterioration occurs under intravenous immunoglobulin (IVIg) therapy.
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Affiliation(s)
- Zeynep Özözen Ayas
- Sakarya University Training and Research Hospital, Department of Neurology, Sakarya, Turkey
| | - Yeşim Güzey Aras
- Sakarya University Training and Research Hospital, Department of Neurology, Sakarya, Turkey
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Acar T, Aras YG, Gül SS, Acar BA. Effective INR Level May Be Delayed in Secondary Prevention of Stroke Due to Atrial Fibrillation with Warfarin in the Patients with Diabetes Mellitus. ACTA ACUST UNITED AC 2018; 56:273-276. [PMID: 31903036 DOI: 10.29399/npa.23395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 10/10/2018] [Indexed: 12/26/2022]
Abstract
Introduction Warfarin is a drug used for anticoagulation in diseases, especially atrial fibrillation (AF). The effectiveness of warfarin is monitored by the International Normalized Ratio (INR) and should be kept between 2.0 and 3.0 in the AF clinic. This drug the significant variability in dose response and the narrow therapeutic index among individuals. However, the effective INR level may not be achieved due to some reasons, or the time to achieve the effective INR level may lengthen. Our aim in this study is to investigate whether there is a difference in terms of dose and duration in achieving the effective INR level by the warfarin treatment due to the coexistence of AF and stroke between patients with and without diabetes mellitus (DM). Methods A total of 70 patients whose warfarin treatment was initiated due to non-valvular AF and who were diagnosed with acute ischemic stroke were included in the study, 30 of these patients were DM patients and 40 were non-DM patients. The total dose and time values at achieving the effective INR level after the initiation of warfarin treatment according to the clinical protocol during follow-ups in hospital were statistically compared between the two groups. Results In the study, it was found that the total warfarin dose was significantly higher in the DM group compared to the non DM group (p<0.05). It was detected that the time to achieve the effective INR level was also significantly longer in the DM group than in the non-DM group (p<0.05). Conclusion In the presence of DM diagnosis, the higher dose warfarin and longer follow-up are required to achieve effective INR levels in stroke patients whose warfarin treatment was initiated due to non-valvular AF.
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Affiliation(s)
- Türkan Acar
- Department of Neurology, Sakarya University Research and Training Hospital, Sakarya, Turkey
| | - Yeşim Güzey Aras
- Department of Neurology, Sakarya University Research and Training Hospital, Sakarya, Turkey
| | - Sıdıka Sinem Gül
- Department of Neurology, Sakarya University Research and Training Hospital, Sakarya, Turkey
| | - Bilgehan Atilgan Acar
- Department of Neurology, Sakarya University Research and Training Hospital, Sakarya, Turkey
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Aras YG, Güngen BD, Sipahi S, Demiryürek BE. Effects of Hemodialysis on Visual Pathways Assessed by Visual Evoked Potentials (VEPs). ACTA ACUST UNITED AC 2018; 55:123-126. [PMID: 30057452 DOI: 10.29399/npa.18117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/27/2016] [Indexed: 11/07/2022]
Abstract
Introduction Uremia is a metabolic disorder that affects the functions of the central nervous system (CNS). Visual evoked potentials (VEPs) can be used to demonstrate uremia-induced effects on the CNS. Data on VEPs of patients with chronic renal failure (CRF) are limited. The purpose of this study was to examine the effects of renal failure and the ultrafiltration rate (UFR) on CNS functions in patients undergoing hemodialysis (HD) using VEPs. Methods The study consisted of 30 CRF patients undergoing HD, and a control group of 28 individuals, matched in terms of age and gender. Patients with mental retardation, diabetes mellitus, demyelinating disease, stroke, use of neurotoxic drugs, and ophthalmologic diseases were excluded from the study. The pattern VEP (PVEP) parameters recorded were latencies to N75 (N1), P100 (P1) and N135 (N2) waves, and the peak-to-peak amplitude of a P100 wave. The PVEP was taken twice just before and 24 h after HD, and the PVEP parameters were compared. Additionally, the effect of the UFR on the PVEP parameters was examined. Results There was no difference between the HD group and control group in terms of gender and age (mean ages of 49.56±12.52 and 48.53±13.28 years, respectively). The average HD period was 87.53±56.34 months. The P1 latencies between the two eyes the patients with CRF were prolonged when compared to those of the controls (right eye p=0.002; left eye p=0.019). A single HD session significantly shortened the latency of the P1 waves compared to that of the baseline waves (p<0.000). Additionally, there was a positive correlation between the difference in the P1 latency before and after HD and the UFR (right eye p=0.03, r=0.525; left eye p=0.022, r=0.417, respectively). Conclusion We conclude that VEP, which is an easy, cheap, and simple electrophysiological method, can be used to determine subclinical CNS dysfunction in patients with CRF and show the effect of fluid removal during HD on the visual pathways, and to show the corrective effect of effective fluid imaging on the visual pathways.
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Affiliation(s)
- Yeşim Güzey Aras
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Belma Doğan Güngen
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Savaş Sipahi
- Department of Nephrology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Bekir Enes Demiryürek
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
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Aras YG, Aydemir Y, Güngen BD, Güngen AC. Evaluation of central and peripheral neuropathy in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2018; 13:1857-1862. [PMID: 29922052 PMCID: PMC5995289 DOI: 10.2147/copd.s159738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The aim of the study was to investigate the frequency and characteristics of peripheral nervous system (PNS) and central nervous system (CNS) involvement in COPD. Methods The study included 41 COPD patients and 41 healthy volunteers. Electrophysiological studies were carried out: electromyography (EMG) and visual evoked potentials (VEPs). The median nerve, ulnar nerve, common peroneal nerve, and tibial nerve were evaluated for latency, amplitude, and conduction velocity. Results The mean age of patients with COPD was 61.8 years and disease duration 10.3 years. There was no difference between patient and control groups in terms of age, BMI, smoking status, or biochemical parameters. Upon VEP examination, latencies were significantly prolonged and amplitudes shortened in the patient group compared to the control group. In EMG measurements, conduction velocity and amplitudes in all nerves were low in the patient group. Similarly, latencies in all nerves were higher in patients with COPD. Conclusion Central and peripheral nervous system involvement could develop in patients with moderate-severe COPD, and these patients should be monitored for neuropathic changes in combination with neurological examination.
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Affiliation(s)
- Yeşim Güzey Aras
- Department of Neurology, Research and Training Hospital, Sakarya University
| | - Yusuf Aydemir
- Department of Pulmonology, Sakarya University, Adapazarı
| | | | - Adil Can Güngen
- Department of Pulmonology, Istinye University, Istanbul, Turkey
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Acar T, Aras YG. Retrospective comparison of efficacy of levetiracetam and lacosamide add-on treatments in patients with partial onset seizure. Ideggyogy Sz 2018; 71:197-204. [PMID: 29889462 DOI: 10.18071/isz.71.0197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background and purpose The study aims to retrospectively compare the efficacy of lacosamide (LCS) and levetiracetam (LEV) in add-on treatment in patients with partial-onset epilepsy. Methods Patients who have been followed-up for at least one year due to diagnosis of partial epilepsy between September 2014 and December 2017 and who had no seizure control, despite using at least two antiepileptic monotherapies, and therefore undergone LEV or LCS add-on treatment were retrospectively reviewed. Of the patients, total number of seizures and seizure control rates 6 months before and 3 and 6 months after the add-on treatment were compared. Results There was no statistically significant difference between the 30 patients in the LEV group (12 females, 18 males, mean age 29.7±6.6) and 28 patients in the LCS group (12 females, 16 males, mean age 28.2±6.4) in terms of age, gender and the duration of illness. When the LEV and LCS groups were evaluated separately, the mean number of seizures within 3 and 6 months after the add- on treatment were significantly lower than the mean number of seizures in the last 6 months before the add-on treatment (p<0.005 and p<0.005 respectively). There was no statistically significant difference between the two groups when compared with each other in terms of the rate of decrease in number of seizures and seizure control before and after the add-on treatment (p=0.445 and p=0.238, respectively). Conclusion LCS appears to be as effective as the currently well-established LEV in the treatment of partial onset seizures. No comparative study was found in the literature similar to this subject matter. There is a need for prospective studies for the comparison of the efficacies of these two drugs.
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Affiliation(s)
- Türkan Acar
- Sakarya University, Medical Faculty, Department of Neurology, Adapazan, Turkey
| | - Yeşim Güzey Aras
- Sakarya University, Medical Faculty, Department of Neurology, Adapazan, Turkey
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Acar BA, Acar MAG, Acar T, Varım C, Alagöz AN, Demiryürek EB, Doğan Güngen B, Güzey Aras Y. Patients with primary restless legs syndrome have higher prevalence of autonomic dysfunction and irritable bowel syndrome. Singapore Med J 2018; 59:539-544. [PMID: 29372261 DOI: 10.11622/smedj.2018010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Given the limited data on autonomic dysfunction in patients with primary restless legs syndrome (pRLS), we compared autonomic dysfunction and presence of irritable bowel syndrome (IBS) between patients with pRLS and control patients. METHODS Consecutive adult drug-naïve patients with pRLS, and age- and gender-matched healthy control patients were enrolled in this study. Diagnoses, based on validated self-reported questionnaires, were made using the following guidelines: Rome III classification system for functional gastrointestinal disorders for IBS; Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) for the presence of anxiety and depression, respectively; Pittsburgh Sleep Quality Index (PSQI) for severity of sleep disturbances; and Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT) for autonomic dysfunction. RESULTS There were 88 patients with pRLS (18 male, 70 female) and 128 control patients (40 men, 88 women). The mean age of the pRLS patients and control patients was 50.3 ± 9.3 years and 49.7 ± 8.2 years, respectively. Overall, 41 (46.6%) of the patients with pRLS and 16 (12.5%) of the control patients had IBS. Among patients with pRLS, IBS was significantly more common and the total autonomic SCOPA-AUT scores were higher than those found among control patients. Among pRLS patients with IBS, total autonomic SCOPA-AUT, PSQI, BAI and BDI scores were significantly higher than among pRLS patients without IBS. The presence of IBS did not affect the severity of restless legs syndrome. CONCLUSION The presence of autonomic nervous system impairment in patients with pRLS and the strong link between IBS and pRLS merit further, more extensive investigation.
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Affiliation(s)
| | - Mustafa Atahan Gürkan Acar
- Department of Surgery, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Türkan Acar
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Ceyhun Varım
- Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | | | - Enis Bekir Demiryürek
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Belma Doğan Güngen
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Yeşim Güzey Aras
- Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey
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Özdil Demiryürek E, Demiryürek BE, Tekin A, Güzey Aras Y, Doğan Güngen B, Erdoğan S. The Association Between Childhood Traumatic Events and Headache-Related Parameters in Patients with Migraine: A Cross-Sectional Study in Turkish Population. ACTA ACUST UNITED AC 2017; 54:291-294. [PMID: 29321699 DOI: 10.5152/npa.2016.8817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction The aim of this study is to investigate the association between childhood traumatic events and headache-related clinical parameters in migraine patients. Methods 95 patients diagnosed with migraine and 50 healthy controls were included in the study. A socio-demographic form, the Childhood Trauma Questionnaire (CTQ), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) were completed by all participants. Additionally, the Visual Analog Scale (VAS) and the Migraine Disability Assessment Test (MIDAS) were applied to migraine patients. Results Positive correlations were found between emotional abuse, physical abuse, physical neglect, CTQ total scores, and headache frequency (r=0.33, r=0.24, r=0.26 and r=0.28 respectively) in migraine patients. A positive correlation was found between physical neglect and headache duration (r=0.28). Positive correlations were also found between emotional abuse and physical neglect, and MIDAS total scores (r=0.22 and r=0.23, respectively). Emotional abuse and CTQ total scores were associated with younger mean age of headache onset (r=-0.24 and r=-0.23). Conclusion Childhood traumatic events are associated with more frequent and more severe headache episodes, and younger headache onset in migraine patients.
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Affiliation(s)
- Esra Özdil Demiryürek
- Clinic of Psychiatry, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Bekir Enes Demiryürek
- Clinic of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Atilla Tekin
- Clinic of Psychiatry, Abant İzzet Baysal University İzzet Baysal Mental and Neurological Disorders Training and Research Hospital, Bolu, Turkey
| | - Yeşim Güzey Aras
- Clinic of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Belma Doğan Güngen
- Clinic of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Sebatiye Erdoğan
- Clinic of Neurology, Bağcılar Training and Research Hospital, İstanbul, Turkey
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Güngen AC, Aydemir Y, Güngen BD, Yazar EE, Yağız O, Aras YG, Gümüş H, Erkorkmaz Ü. Effects of aspiration pneumonia on the intensive care requirements and in-hospital mortality of hospitalised patients with acute cerebrovascular disease. Arch Med Sci 2017; 13:1062-1068. [PMID: 28883847 PMCID: PMC5575211 DOI: 10.5114/aoms.2016.61011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/01/2015] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION In this study, we aimed to evaluate the effects of the development of aspiration pneumonia (AP) on the intensive care unit (ICU) requirements and in-hospital mortality of patients hospitalised in the neurology ward due to an acute cerebrovascular accident (CVA). MATERIAL AND METHODS Five hundred and three patients hospitalised in the neurology ward following an acute CVA were retrospectively analysed. The patients were divided into two groups: those with AP (group 1) and those without AP (group 2). Demographic characteristics and physical and radiological findings, including the localisation, lateralisation and aetiology of the infarction, in addition to ICU requirements and mortality, were evaluated. RESULTS Aspiration pneumonia was detected in 80 (15.9%) patients during the in-hospital stay. Transfer to the ICU for any reason was required in 37.5% of the patients in group 1 and 4.7% of those in group 2 (p < 0.001). In-hospital mortality occurred in 7.5% and 1.4% of the patients in group 1 and group 2, respectively (p = 0.006). The incidence of AP was highest in patients with an infarction of the medial cerebral artery (MCA) (p < 0.001). The AP was associated with older age (p < 0.001), hypertension (p = 0.007), echocardiography findings (p = 0.032) and the modified Rankin Scale (mRS) score (p < 0.001). CONCLUSIONS Our findings suggest that the requirement rate for transfer to the ICU and the mortality rate appear to be significantly higher in patients with a diagnosis of AP. Precautions should be taken, starting from the first day of hospitalisation, to decrease the incidence of AP in patients with acute CVA, focusing especially on older patients and those with a severe mRS score.
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Affiliation(s)
- Adil Can Güngen
- Department of Pulmonology, Sakarya University, Sakarya, Turkey
| | - Yusuf Aydemir
- Department of Pulmonology, Sakarya University, Sakarya, Turkey
| | - Belma Dogan Güngen
- Department of Pulmonology, Sakarya University, Training and Research Hospital, Sakarya, Turkey
| | - Esra Ertan Yazar
- Department of Pulmonology, Yedikule Chest Diseases and Chest Surgery Training Hospital, Istanbul, Turkey
| | - Orhan Yağız
- Department of Neurology, Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Yeşim Güzey Aras
- Department of Pulmonology, Sakarya University, Training and Research Hospital, Sakarya, Turkey
| | - Hatice Gümüş
- Department of Neurology, Türkan Özilhan State Hospital, Izmir, Turkey
| | - Ünal Erkorkmaz
- Department of Biostatistics, Medical Faculty, Sakarya University, Sakarya, Turkey
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Güngen BD, Tunç A, Aras YG, Gündoğdu AA, Güngen AC, Bal S. Predictors of intensive care unit admission and mortality in patients with ischemic stroke: investigating the effects of a pulmonary rehabilitation program. BMC Neurol 2017; 17:132. [PMID: 28693521 PMCID: PMC5504678 DOI: 10.1186/s12883-017-0912-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 07/05/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the predictors of intensive care unit (ICU) admission and mortality among stroke patients and the effects of a pulmonary rehabilitation program on stroke patients. METHODS This prospective study enrolled 181 acute ischemic stroke patients aged between 40 and 90 years. Demographical characteristics, laboratory tests, diffusion-weighed magnetic resonance imaging (DWI-MRI) time, nutritional status, vascular risk factors, National Institute of Health Stroke Scale (NIHSS) scores and modified Rankin scale (MRS) scores were recorded for all patients. One-hundred patients participated in the pulmonary rehabilitation program, 81 of whom served as a control group. RESULTS Statistically, one- and three-month mortality was associated with NIHSS and MRS scores at admission and three months (p<0.001; r=0.440, r=0.432, r=0.339 and r=0.410, respectively). One and three months mortality- ICU admission had a statistically significant relationship with parenteral nutrition (p<0.001; r=0.346, r=0.300, respectively; r=0.294 and r=0.294, respectively). Similarly, there was also a statistically significant relationship between pneumonia onset and one- and three-month mortality- ICU admission (p<0.05; r=0.217, r=0.127, r=0.185 and r=0.185, respectively). A regression analysis showed that parenteral nutrition (odds ratio [OR] =13.434, 95% confidence interval [CI] =1.148-157.265, p=0.038) was a significant predictor of ICU admission. The relationship between pulmonary physiotherapy (PPT) and ICU admission- pneumonia onset at the end of three months was statistically significant (p=0.04 and p=0.043, respectively). CONCLUSION This study showed that PPT improved the prognosis of ischemic stroke patients. We believe that a pulmonary rehabilitation program, in addition to general stroke rehabilitation programs, can play a critical role in improving survival and functional outcomes. TRIAL REGISTRATION NCT03195907 . Trial registration date: 21.06.2017 'Retrospectively registered'.
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Affiliation(s)
| | - Abdulkadir Tunç
- Bezmialem Vakif Universitesi Tip Fakultesi Hastanesi, Istanbul, Turkey.
| | - Yeşim Güzey Aras
- Bezmialem Vakif Universitesi Tip Fakultesi Hastanesi, Istanbul, Turkey
| | | | - Adil Can Güngen
- Bezmialem Vakif Universitesi Tip Fakultesi Hastanesi, Istanbul, Turkey
| | - Serdar Bal
- Bezmialem Vakif Universitesi Tip Fakultesi Hastanesi, Istanbul, Turkey
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Ayas ZÖ, Kotan D, Aras YG. Autoimmune neurological syndromes associated limbic encephalitis and paraneoplastic cerebellar degeneration. Neurosci Lett 2016; 632:187-91. [PMID: 27592059 DOI: 10.1016/j.neulet.2016.08.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/01/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Autoimmune neurological syndrome is a group of disorders caused by cancer affecting nervous system by different immunological mechanisms. In this study, we aim to study the clinical symptoms, cerebrospinal fluid (CSF) findings, autoantibody tests, computed tomography (CT), magnetic resonance imaging (MRI) signs and treatment outcome of patients with autoimmune syndromes. METHODS In this study, 7 patients (4 male, 3 female) diagnosed with autoimmune neurological syndrome were retrospectively examined. RESULTS Five of patients were diagnosed with limbic encephalitis, two of them were paraneoplastic cerebellar degeneration. Confusion and seizure were the most seen symptoms. Two patients had psychiatric disturbances (28,5%) followed by seizure. Headache was seen in 2 patients (% 28,5), disartria in 1 patient (% 14,2), and gait disorder in 2 patients (28,5%). The duration of symptoms was 46 (3-150) days on average. CSF abnormalities were detected in 2 patients. CT and MRI of the brain was available in all patients. Five patients had involvement of mesiotemporal region, two patients had diffuse cerebellar atrophy. One of patients had anti-GABAR B1 positivity. Tumors were detected in 2 patients while investigation for paraneoplasia screening. CONCLUSION Remission is only possible with the detection and treatment of the malignancy. Early diagnosis and treatment are of paramount importance.
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Affiliation(s)
- Zeynep Özözen Ayas
- Department of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
| | - Dilcan Kotan
- Department of Neurology, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Yeşim Güzey Aras
- Department of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey
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