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Adar S, Demircan A, Akçin Aİ, Dündar Ü, Toktaş H, Yeşil H, Eroğlu S, Eyvaz N, Beştaş E, Köseoğlu Toksoy C. Evaluation of finger strength and spasticity in hemiplegic patients using hand-finger robotic device: A validity and reliability study. Medicine (Baltimore) 2023; 102:e36479. [PMID: 38065919 PMCID: PMC10713106 DOI: 10.1097/md.0000000000036479] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
We aimed to investigate the validity, reliability, and clinical relevance of Amadeo hand-finger robotic rehabilitation system measurements for evaluating spasticity and strength in hemiplegic patients. In total, 161 participants (107 hemiplegic patients and 54 sex- and age-matched healthy controls) were included in this study. Spasticity was evaluated using the Modified Ashworth Scale, hand motor functions were evaluated using the Fugl-Meyer Assessment Hand Subscale, and hand grip and pinch strength were evaluated using the Jamar hand grip and pinch dynamometer. The Amadeo (Tyromotion) hand-finger robotic rehabilitation system was used to evaluate finger spasticity and strength of the participants. A statistically significant difference was found between the median values of the Modified Ashworth Scale (both clinical and robotic evaluation results) and the mean values of hand flexor and extensor strength measured with the robotic device in patients compared to healthy subjects (P < .01). Statistically, excellent agreement was obtained between the clinical and robotic test-retest results of the scale (P < .01) (intra-class correlation coefficient, ICC = .98-.99; ICC = .98-.99, respectively). There was a statistically significant positive correlation between the clinical and robotic device results of the Modified Ashworth Scale (r = .72; P < .01). There was a statistically significant positive correlation between the hand strength values measured with the robotic device, Jamar grip, pinch, and Fugl-Meyer Assessment Hand Subscale scores (P < .01) in the patient group. Hand finger spasticity and strength measurements of the Amadeo hand-finger robotic rehabilitation system were valid, reliable, and clinically correlated in stroke patients.
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Affiliation(s)
- Sevda Adar
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ali Demircan
- Ataturk Vocational School of Health Services, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ali İzzet Akçin
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ümit Dündar
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hasan Toktaş
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hilal Yeşil
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Selma Eroğlu
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Nuran Eyvaz
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ersin Beştaş
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Cansu Köseoğlu Toksoy
- Department of Neurology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Yeşil M, Köseoğlu Toksoy C. Does idiopathic carpal tunnel syndrome deteriorate proprioception of the hand? A case-control study. Jt Dis Relat Surg 2023; 34:215-223. [PMID: 36700285 PMCID: PMC9903128 DOI: 10.52312/jdrs.2023.950] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 12/14/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES This study aims to investigate the deterioration in kinesthetic kinesthesia (KKS) and visual kinesthesia (VKS) of the hand as a component of proprioception in patients with idiopathic carpal tunnel syndrome (CTS). PATIENTS AND METHODS This study included a total of 90 hands of 60 patients (9 males, 51 females; mean age: 47.6±9.4 years; range, 28 to 60 years) who were diagnosed with CTS and 25 hands of 25 healthy individuals (8 males, 17 females; mean age: 42.6±14.4 years; range, 20 to 60 years) as the controls between January 2019 and January 2021. The KKS and VKS scores were compared between the groups. Clinical parameters such as pain levels, hand grip strength (HGS) values, and two-point discrimination (2PD) test scores were compared between the patients with and without KKS or VKS deficits. The association between the severity of electromyographic findings and KKS or VKS deficits was examined. RESULTS The mean VKS score of the CTS group was 22.9±1.6 and the KKS score was 20.8±3.4, which was significantly lower than that of the control group (p=0.002 and p<0.001, respectively). The CTS patients performed less accurate repetitions in visually cued (60%) and kinesthetically cued (40%) positions than the control group (100% both). There were significantly more patients with VKS and KKS deficits in the moderate or severe CTS groups than in the mild CTS group (p<0.001 and p=0.007, respectively), and KKS or VKS deficits were significantly associated with the impaired HGS (p=0.042 and p=0.048, respectively) and functional status (p=0.020 and p=0.016, respectively) accompanied by the increased symptom severity (p=0.010 and p=0.002, respectively). CONCLUSION Our study results suggest that idiopathic CTS is associated with impaired proprioception and kinesthetic sense of the hand. In addition, idiopathic CTS is related to impaired hand function and severe symptoms. Screening kinesthetic sense in patients with idiopathic CTS prior to decompression surgery or postoperative hand therapy is helpful to set realistic goals and achieve superior clinical outcomes.
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Affiliation(s)
- Murat Yeşil
- Afyonkarahisar Sağlık Bilimleri Üniversitesi, Ortopedi ve Travmatoloji Anabilim Dalı, 03200 Afyonkarahisar, Türkiye.
| | - Cansu Köseoğlu Toksoy
- Department of Neurology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Türkiye
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Kurtses Gürsoy B, Köseoğlu Toksoy C. Psychological Resilience and Stress Coping Styles in Migraine Patients. Neuropsychiatr Dis Treat 2023; 19:63-72. [PMID: 36636140 PMCID: PMC9830698 DOI: 10.2147/ndt.s398838] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/24/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE It was aimed to determine the level of psychological resilience and to investigate the psychological and clinical parameters that affect the resilience level in migraine patients. PATIENTS AND METHODS A total of 100 migraine patients and 100 healthy controls who agreed to participate in the study filled in the sociodemographic data form and also Beck Anxiety Scale, Beck Depression Scale, Psychological Resilience Scale for Adults, Perceived Stress Scale, Stress Coping Styles Scale, and Psychological Well-Being Scale. Also, the results of Migraine Disability Assessment Scale (MIDAS) were recorded in order to determine the clinical parameters of migraine patients. RESULTS When the migraine patients were examined in terms of the number of painful days in the last 3 months, duration of illness, and correlations between clinical scales, there were statistically significant correlations between the psychological resilience scale and well-being (r=0.691 p<0.001), positive coping styles (r=0.676 p<0.001), Beck depression scale (r=-0.670 p<0.001). CONCLUSION Self-confident approach, social support-seeking approach, and level of psychological well-being predict psychological resilience in migraine patients. Interventions aiming to increase the level of psychological resilience, which is negatively correlated with depression, are expected to increase the quality of life of patients with migraine.
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Affiliation(s)
- Betül Kurtses Gürsoy
- Afyonkarahisar Health Science University, Faculty of Medicine, Department of Psychiatry, Afyonkarahisar, Turkey
| | - Cansu Köseoğlu Toksoy
- Afyonkarahisar Health Science University, Faculty of Medicine, Department of Neurology, Afyonkarahisar, Turkey
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Abstract
BACKGROUND After the first COVID-19 case, reported neurological complications are increasing day by day. METHOD In this paper, we present a benign-course Guillain-Barré syndrome (GBS) emerging 2 weeks after COVID-19 infection in a 35-years-old male. RESULTS Cough and fever were started 18 days ago and his PCR test was resulted positive for COVID-19 infection. After treatment and quarantine were completed, he developed sudden leg weakness following autonomic features. Cerebrospinal fluid was suggestive for GBS despite the electrodiagnostic test was not helpful because it was done in the first days. He recovered without needing any immunotherapy. CONCLUSION Our case suggested that COVID-19 can cause atypical benign GBS forms in addition to well-known variants. Comprehensive studies are needed to describe the unknowns and determine the exact prevalence of GBS after COVID-19 infection, including mild cases that did not require hospital admission.
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Affiliation(s)
- Ülkü Türk Börü
- Department of Neurology, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkey
| | - Cansu Köseoğlu Toksoy
- Department of Neurology, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkey
| | - Cem Bölük
- Cerrahpasa Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hayri Demirbaş
- Department of Neurology, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkey
| | - Ahmet Çağdaş Yılmaz
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkey
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Börü ÜT, Bölük C, Toksoy CK, Demirbaş H. Acute cerebellitis, transverse myelitis and polyradiculoneuritis related to post-COVID-19 infection. J Spinal Cord Med 2022; 45:765-768. [PMID: 36175361 PMCID: PMC9542541 DOI: 10.1080/10790268.2021.1969502] [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] [Indexed: 10/14/2022] Open
Abstract
CONTEXT Guillain-Barré syndrome (GBS), acute cerebellitis and transverse myelitis are rare complications of COVID-19 infection separately. The combination of these three, however, has not yet been reported. FINDINGS We present an atypical case (42-year-old man) that developed acute ascending flaccid paraparesis, ataxia and urinary retention two weeks after COVID-19 infection. Neurological examination revealed distal and proximal weakness (4/5) on lower extremities, decreased tendon reflexes, sixth cranial nerve palsy and dysmetria without sensory disturbance. His cranial MRI showed cerebellitis whereas the spinal MRI showed transverse myelitis at the T11/12 level. Albuminocytologic dissociation was present in the cerebrospinal fluid. The nerve conduction study was concordant with early findings of GBS. He recovered well after corticosteroid treatment without needing any immunotherapy. On day seven of hospitalization, the modified Rankin Scale score was 0. CONCLUSION COVID-19 infection may present with a combination of neurological manifestations such as cerebellitis, transverse myelitis and GBS. This patient presented significant functional recovery after treatment with corticosteroid without immunotherapy.
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Affiliation(s)
- Ülkü Türk Börü
- Department of Neurology, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkey
| | - Cem Bölük
- Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Cansu Köseoğlu Toksoy
- Department of Neurology, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkey
| | - Hayri Demirbaş
- Department of Neurology, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkey
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Köseoğlu Toksoy C, Yavuz T, Orhan S, Şarlak Konya P, Korkmaz D, Tünay H, Bozkurt E, Coşğun İG, Demirtürk N, Doğan İ, Türk Börü Ü. Neurological symptoms and findings in COVID-19: a prospective clinical study. Neurol Res 2021; 44:1-6. [PMID: 34269161 DOI: 10.1080/01616412.2021.1952740] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We sought to evaluate neurologic symptoms and findings in patients with COVID-19 infection hospitalized in a ward and intensive care unit (ICU). METHODS This study was designed as a prospective study. Hospitalized COVID-19 rRt-PCR positive patients in the ward and ICU were included in the study. A 54-item questionnaire was used to evaluate the patients. Patients were examined within 3 hours of hospitalization. RESULTS A total of 379 patients were included in the study. The mean age of the patients was 56.1 ± 17.8. 89 of the patients were in intensive care. At least one general symptom was recorded in 95.5% of patients. The most common neurologic symptoms were myalgia (48.5%), headache (39.6%), anosmia (34.8%), and dysgeusia (34%). Neurological symptoms in ICU patients were higher than in the ward. 53.6% of patients had comorbidities. DISCUSSION This study indicated that the prevalence of neurological symptoms was very high in patients with COVID-19. The percentage of neurological symptoms and findings was higher in patients hospitalized in ICU.
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Affiliation(s)
- Cansu Köseoğlu Toksoy
- Department of Neurology, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Tunzala Yavuz
- Department of Anesthesiology and Reanimation, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Semiha Orhan
- Department of Internal Medicine, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Petek Şarlak Konya
- Department of Infectious Disease, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Derya Korkmaz
- Department of Infectious Disease, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Havva Tünay
- Department of Infectious Disease, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Erhan Bozkurt
- Department of Internal Medicine, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - İbrahim Güven Coşğun
- Department of Pulmonary Disease, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Neşe Demirtürk
- Department of Infectious Disease, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - İsmet Doğan
- Department of Biostatistics, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Ülkü Türk Börü
- Department of Neurology, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
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Köseoğlu Toksoy C, Demirbaş H, Bozkurt E, Acar H, Türk Börü Ü. Headache related to mask use of healthcare workers in COVID-19 pandemic. Korean J Pain 2021; 34:241-245. [PMID: 33785677 PMCID: PMC8019959 DOI: 10.3344/kjp.2021.34.2.241] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/02/2021] [Accepted: 02/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background It has been reported that a new type of headache may develop as a result of face mask use during the COVID-19 pandemic. The aim of this study is to investigate the clinical features of face mask-related headache during the COVID-19 pandemic. Methods This is a cross-sectional study carried out on healthcare workers at the Afyonkarahisar Health Sciences University. The number of workers at our university was established. Sample size was calculated using the G*Power program. A questionnaire consisting of questions relating to pre-existing headache, an aggravation in headache, and de-novo headache was filled out by 3 neurologists with all participants. Results Data was collected from a total of 375 participants, after the exclusion of 5 individuals who refused to participate. Out of all participants, 26 (6.9%) used a filtering mask, 274 (73.1%) used a surgical mask, 75 (20.0%) participants used a combination of both masks. The number of participants with preexisting headache was 114 (30.4%) had pre-existing headache. Of those with pre-existing headache, 77 (67.5%) healthcare workers had reported an aggravation in their headache after mask use. De-novo headache was observed in 116 (30.9%) of participants. De-novo headache characteristics included throbbing in 17 (14.7%) participants and pressing in 99 (85.3%) participants. In addition, symptoms such as tachypnea, sleep disturbance, and fatigue were found to be significantly higher. Conclusions This study indicates that healthcare workers develop headaches due to use of masks during the COVID-19 outbreak.
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Affiliation(s)
- Cansu Köseoğlu Toksoy
- Department of Neurology, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Hayri Demirbaş
- Department of Neurology, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Erhan Bozkurt
- Department of Internal Medicine, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Hakan Acar
- Department of Neurology, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Ülkü Türk Börü
- Department of Neurology, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
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Özer D, Bölük C, Türk Börü Ü, Altun D, Taşdemir M, Köseoğlu Toksoy C. Greater occipital and supraorbital nerve blockade for the preventive treatment of migraine: a single-blind, randomized, placebo-controlled study. Curr Med Res Opin 2019; 35:909-915. [PMID: 30285507 DOI: 10.1080/03007995.2018.1532403] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Nerve injections have been used for the acute and preventive treatment of migraine in recent decades. Most of these injections focused on greater occipital nerve (GON) blockade. However, few studies were placebo controlled, and only a few of them investigated GON and supraorbital nerve (SON) blockade together. This study aimed to evaluate the efficacy of GON and SON blockade with local anesthetics for the preventive treatment of migraine without aura. METHODS Eighty-seven patients diagnosed with migraine without aura were included in the study. Patients were divided randomly. One group was injected with 1% lidocaine, the other group was injected with 0.9% saline. GON and SON injections were done bilaterally. The injections were repeated weekly for 3 weeks. Patients were followed up for 2 months to assess clinical response. RESULTS Seventy-one patients completed the study. After 2 months, the number of headache days decreased significantly from 12.8 ± 10.9 to 5.3 ± 7.4, and VAS decreased from 8.3 ± 1.0 to 5.5 ± 1.9 in the blockade group. The number of headache days decreased from 12.4 ± 10.3 to 7.5 ± 7.2 and VAS decreased from 8.2 ± 1.1 to 7.4 ± 1.3 in the placebo group. Response was seen in 65.1% of the patients in the blockade group (65.4% for episodic migraine, 64.7% for chronic migraine) and 28.6% of the patients in the placebo group. The difference was significant. CONCLUSIONS The results suggest that GON and SON blockade with lidocaine was more effective than the placebo in the prophylactic treatment of both episodic and chronic migraine.
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Affiliation(s)
- Duygu Özer
- a Department of Neurology , University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital , Istanbul , Turkey
| | - Cem Bölük
- a Department of Neurology , University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital , Istanbul , Turkey
| | - Ülkü Türk Börü
- a Department of Neurology , University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital , Istanbul , Turkey
| | - Deniz Altun
- b Department of Public Health , Istanbul Medeniyet University , Istanbul , Turkey
| | - Mustafa Taşdemir
- b Department of Public Health , Istanbul Medeniyet University , Istanbul , Turkey
| | - Cansu Köseoğlu Toksoy
- c Department of Neurology , Gaziosmanpaşa Taksim Training and Research Hospital , Istanbul , Turkey
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Köseoğlu Toksoy C, Bölük C, Türk Börü Ü, Akın S, Yılmaz AY, Coşkun Duman S, Taşdemir M. Stroke Prevalence in a Coastal Town on the Black Sea Coast in Turkey: Community Based Study. Neurol Res Int 2018; 2018:8246123. [PMID: 30057814 PMCID: PMC6051058 DOI: 10.1155/2018/8246123] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/29/2018] [Accepted: 06/10/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study aims to determine the stroke prevalence in Akçakoca which is a rural area in Turkey. METHODS The study was designed as a cross-sectional, door-to-door survey. The stroke questionnaire was completed by a trained team in the presence of the participants according to their answers. Based on the screenings, patients who had been diagnosed with stroke previously were reexamined by a neurologist and determined the prevalence values, risk factors, and stroke types. RESULTS A total of 3750 people over 44 years old were reached in the screenings. It was determined that 83 people had previously suffered a stroke. The prevalence rate of stroke in those above 44 years was found to be 2.2 (98% confidence level and ± 2% margin of error). 70 (84.3%) patients had suffered an ischemic stroke while 12 (14.5%) had suffered a hemorrhagic stroke. Male/female ratio was 1.1. CONCLUSION The results of this study give the prevalence rate of stroke among the Turkish population living in a rural area. Due to a lack of other similar studies, it is impossible to make any data comparison. However, the results of this study help shed light on the stroke prevalence rate.
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Affiliation(s)
- Cansu Köseoğlu Toksoy
- Gaziosmanpaşa Taksim Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Cem Bölük
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Ülkü Türk Börü
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Seydahmet Akın
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey
| | | | - Sanem Coşkun Duman
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Mustafa Taşdemir
- Istanbul Medeniyet University, Department of Public Health, Istanbul, Turkey
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Abstract
Objectives We aimed to determine whether multiple sclerosis (MS) and methylprednisolone and disease-modifying drugs have an effect on menopausal age. Methods A total of 86 patients and 98 healthy subjects were included in this study. The natural menopausal age of the patients and healthy subjects were compared. The cumulative dosages of methylprednisolone, beta interferons (IFNβs), and glatiramer acetate were calculated. The effects of the Expanded Disability Status Scale (EDSS), duration of the disease, and cumulative dosage of medications on menopausal age were evaluated. Results The patients’ mean menopausal age was 45.3 ± 4.8 years and healthy subjects’ menopausal age was 46.8 ± 4.3 years, with no significant difference between the two groups. The cumulative dosage of methylprednisolone showed an effect on menopausal age. There was a significant inverse correlation between menopausal age and dosage of IFNβ-1b, while the disease duration and EDSS score showed no correlation with menopausal age. Conclusions We conclude that menopausal age is not affected by MS. However, long-term methylprednisolone and IFNβ-1b treatments may change menopausal age in a dose-dependent manner.
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Affiliation(s)
- Ülkü Türk Börü
- 1 University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Cansu Köseoğlu Toksoy
- 1 University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Cem Bölük
- 1 University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Adnan Bilgiç
- 2 Konya Eregli State Hospital, Department of Neurology, Konya, Turkey
| | - Mustafa Taşdemir
- 3 Istanbul Medeniyet University, Department of Public Health, Istanbul, Turkey
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Börü ÜT, Bilgiç AB, Köseoğlu Toksoy C, Yılmaz AY, Tasdemir M, Sensöz NP, Öztop Çakmak Ö, Duman A, Bölük C. Prevalence of Multiple Sclerosis in a Turkish City Bordering an Iron and Steel Factory. J Clin Neurol 2018; 14:234-241. [PMID: 29629528 PMCID: PMC5897208 DOI: 10.3988/jcn.2018.14.2.234] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 12/10/2017] [Accepted: 12/12/2017] [Indexed: 02/07/2023] Open
Abstract
Background and Purpose Multiple sclerosis (MS) is an autoimmune disease characterized by inflammatory demyelination. Recent studies have shown that long-term exposure to air pollutants (including PM10 particulates) is potentially an environmental risk factor for MS. We aimed to determine the prevalence rates of MS in two cities with different levels of air pollution. Methods This door-to-door population-based study was conducted between April 2014 and June 2015. Two cities were screened for the prevalence rates of MS: 1) Karabük, which borders an iron-and-steel factory, and 2) Akçakoca, which is a coastal city located in the same region. A validated survey form was used for screening MS. The 2010 McDonald Criteria were used for diagnosing MS. The patients were examined twice, first by a neurology assistant in the field and then by a senior neurologist in public health centers in the cities. Results The prevalence of MS was 95.9/100,000 in Karabük and 46.1/100,000 in Akçakoca. In total, 33 patients were diagnosed with clinically definite MS. The female/male ratio was 1.5, and 21 patients were diagnosed with relapsing-remitting MS, 9 with secondary progressive MS, and 3 with primary progressive MS. Conclusions We found that the prevalence of MS was more than two fold higher in Karabük than in Akçakoca, which supports a link between air pollution and the pathogenesis of MS. However, larger etiological and epidemiological studies are needed to confirm this hypothesis.
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Affiliation(s)
- Ülkü Türk Börü
- Department of Neurology, University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Adnan Burak Bilgiç
- Department of Neurology, University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Cansu Köseoğlu Toksoy
- Department of Neurology, University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Abdullah Yasir Yılmaz
- Department of Neurology, University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Tasdemir
- Department of Public Health, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nilay Padir Sensöz
- Department of Neurology, University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey
| | | | - Arda Duman
- Department of Neurology, Maltepe State Hospital, Istanbul, Turkey
| | - Cem Bölük
- Department of Neurology, University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey.
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