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Khan M, Arauz A, Uluduz D, Barboza MA, Duman T, Cano-Nigenda V, Awan S, Wasay M. Predictors of Mortality and Functional Outcome in Pregnancy and Puerperium-Related Cerebral Venous Thrombosis. Cerebrovasc Dis 2022; 52:393-400. [PMID: 36566747 DOI: 10.1159/000527155] [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] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/09/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Cerebral venous thrombosis (CVT) associated with pregnancy and puerperium has long been recognized, with poor information in terms of functional outcomes. Our objective was to analyze risk factors, clinical, imaging, and laboratory variables to predict functional outcome and death in this population. METHODS CVT registries from three referral centers from Pakistan, Turkey, and Mexico, recruiting prospective cases, were combined for CVT associated with pregnancy or puerperium. Datasets and variables were standardized. Demographic characteristics, presentation, risk factors, and functional outcomes in pregnancy/puerperium-related CVT were analyzed. Binary logistic regression was used to assess predictors of outcome. The main outcome was modified Rankin score >2 at 30 days and mortality at 30 days. RESULTS Five hundred fifty-three cases (median age 28 years [IQR 23-34]) of CVT associated with pregnancy and puerperium were included; 439 cases (79.4%) happened in the puerperium and 20.6% during pregnancy (53.5% occurred during the first trimester). Anemia (36.7%) and dehydration (22.9%) were the commonest obstetric risk factors identified. Predictors of poor outcome (mRS >2) were encephalopathy (OR 12.8, p < 0.001), cases from Mexican origin (OR 3.1, p = 0.004), fever/puerperal infection (OR 2.7, p = 0.02), and anemia (OR 2.2, p = 0.01). Cases from Mexican origin (OR 12.0, p = 0.003) and Encephalopathy (OR 7.7, p < 0.001), presented with the highest mortality association in the final adjusted model. DISCUSSION/CONCLUSION In CVT associated with pregnancy and puerperium, encephalopathy, fever/puerperal infection, and anemia are associated with bad functional outcomes, meanwhile encephalopathy and cases from Mexican origin with higher mortality in the acute (30-days) of CVT onset. Anemia and infection are potential reversible predictors of poor outcome that clinicians should be aware of in order to prevent poor outcomes in these patients.
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Affiliation(s)
- Maria Khan
- Rashid Hospital, Dubai, United Arab Emirates
| | - Antonio Arauz
- Stroke Clinic, Instituto Nacional de Neurologia y Neurocirugía Manuel Velasco Suarez, Mexico City, Mexico
| | - Derya Uluduz
- Neurology Department, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Miguel A Barboza
- Neurosciences Department, Hospital Dr. Rafael A. Calderon Guardia, CCSS, San Jose, Costa Rica
| | - Taskin Duman
- Department of Neurology, School of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Vanessa Cano-Nigenda
- Stroke Clinic, Instituto Nacional de Neurologia y Neurocirugía Manuel Velasco Suarez, Mexico City, Mexico
| | - Safia Awan
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Mohammad Wasay
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
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Dogru-Huzmeli E, Duman T, Cakmak AI, Aksay U. Can diplopia complaint be reduced by telerehabilitation in multiple sclerosis patient during the pandemic?: A case report. Neurol Sci 2021; 42:4387-4390. [PMID: 33763810 PMCID: PMC7990493 DOI: 10.1007/s10072-021-05194-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 11/24/2022]
Abstract
Hospital visits and regular rehabilitation of chronic patients due to COVID-19 pose a risk. Therefore, patients with chronic illnesses who need regular rehabilitation have been victims of the pandemic process. Because of their fear of being infected, they were deprived of the chance of their symptoms being rehabilitated. Therefore, it is extremely important to rehabilitate individuals with chronic illnesses in need of rehabilitation through telerehabilitation. In this study, we aimed to show the effect of Cawthorne-Cooksey exercises to be applied through telerehabilitation on eye movements, vision, and quality of life in a patient suffering from diplopia due to multiple sclerosis (MS). It has been found that Cawthorne-Cooksey exercises improve the quality of life and reduce the complaints of diplopia in MS patients with diplopia. In addition, the patient verbally stated that his balance increased after Cawthorne-Cooksey exercises. As a result, Cawthorne-Cooksey exercises are a rehabilitation method that gives positive results in the treatment of diplopia and it is recommended to apply this method via telerehabilitation.
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Affiliation(s)
- Esra Dogru-Huzmeli
- Physiotherapy and Rehabilitation Department, Health Science Faculty, Hatay Mustafa Kemal University, Hatay, Turkey.
| | - Taskin Duman
- Department of Neurology, Tayfur Ata Sokmen Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Ayse Idil Cakmak
- Department of Ophtalmology, Tayfur Ata Sokmen Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Ufuk Aksay
- Physiotherapy and Rehabilitation Department, Health Science Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
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Dogru-Huzmeli E, Duman T. There is an impairment in time perception of patients with multiple sclerosis. Somatosens Mot Res 2021; 38:140-145. [PMID: 33719839 DOI: 10.1080/08990220.2021.1879777] [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: 10/21/2022]
Abstract
OBJECTIVE The objective of this study is to examine time perception impairment in multiple sclerosis (MS) patients. METHOD The study was performed with 60 MS patients and 60 age-matched healthy people. Estimation and Production Tests were carried out with a standard personal laptop computer and participants were aware to count the seconds by the 'start' command and to stop by the 'stop' command. The outcome measure was the ratio between the estimated duration and the target (7 s, 32 s, or 58 s) one for the Estimation Test and the Produced duration and the target (7 s, 32 s, or 58 s) one for the Production Test; and each time duration was repeated three times both for Production and Estimation Tests. RESULTS We found a significant difference in the Estimation Test (7 s, 32 s, 58 s), and the Production Test (7 s, 32 s, 58 s) between the MS group and healthy control group (p < .05). It was observed that patients with MS had a higher deviation from the target time compared to the control group. It was found that this difference was statistically significant (p < .05). There was a high and negative correlation between the Estimation and Production Tests in MS patients. CONCLUSION In conclusion, our data suggests that time estimation and production are disturbed in MS patients, and cognitive rehabilitation is required for most of them.
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Affiliation(s)
- Esra Dogru-Huzmeli
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Taskin Duman
- Department of Neurology, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
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Demetgul O, Duman T, Guntel M. Investigation of the Association between Headache Type, Frequency, and Clinical and Radiological Findings in Patients with Multiple Sclerosis. Neurol India 2020; 68:1333-1337. [PMID: 33342864 DOI: 10.4103/0028-3886.304126] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM In this study, we aimed to investigate the prevalence of primary headaches in patients with multiple sclerosis (MS), to determine the type of headache according to the criteria of International Headache Society and to investigate the relationship between primary headache type and MS subtype, and the relationship between the localization of plaques in the brain magnetic resonance imaging (MRI) with MS clinic. METHODS In this study, we include the patients diagnosed with MS according to the Mc Donald criteria and functional loss determined with Expanded Disability Status Scale (EDSS). We include the patients who were questioned about headache characteristics in detail and the patients who have MRI previously. MRI evaluations of plaque localization of the patients were classified retrospectively. FINDINGS Headache in 54.4% of 320 patients participated in the study are available (23.8% tension-type headache (TTH), 30.6% migraine). When we look at the first three initial symptoms of MS patients, the patients who have polysymptomatic symptoms at the beginning are 25.3%, those with motor symptoms are 23.1%, and patients with optical symptoms are 19.7%. The mean EDSS was 2.6 ± 1.9. When we look the lesion localization, at most pericallosal lesions are present. Mean disease duration was 9.9 years in patients with TTH and 4.5 years in patients with migraine. The difference was statistically significant (P < 0.05). The mean EDSS score was 4.7 in patients with TTH and 1.8 in patients with migraine, and the difference was statistically significant (P < 0.001). The average number of lesions in the brain was 22.07 in patients with TTH and 15.79 in patients with migraine. The difference was statistically significant (P < 0.001). RESULTS In this study, the frequency of headache in MS patients was found to be greater than the general population and we found a higher incidence of migraine-type headache in these patients. We observed that the tension type of headache is more frequent in MS patients with higher ages, longer disease duration, more plaque numbers, and high EDSS scores.
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Affiliation(s)
- Ozcan Demetgul
- Neurology Clinic, Hatay State Hospital, Antakya, Hatay, Turkey
| | - Taskin Duman
- Neurology Department, Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Murat Guntel
- Neurology Department, Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
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Dogru Huzmeli E, Duman T. Somatosensory impairments in patients with multiple sclerosis: association with dynamic postural control and upper extremity motor function. Somatosens Mot Res 2020; 37:117-124. [PMID: 32295464 DOI: 10.1080/08990220.2020.1753685] [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: 10/24/2022]
Abstract
Purpose: We planned this study to bring attention to the somatosensory impairments in patients with multiple sclerosis (PwMS) and to investigate relationship of somatosensory impairments with dynamic postural stability and upper extremity motor function.Methods: Seven males and 23 females, 30 patients with mean EDSS 2.9 (SD = 1.4), aged between 18 and 65 years (mean = 41.43 ± 14.90 years) were included in this clinical study. Light touch sensorial assessment was made with Semmes Weinstein monofilament test and proprioception by distal proprioception test. Hand strength was measured by the Jamar dynamometer, fine motor skill was examined with nine-hole peg test, functional reach test in sitting and standing position was applied. Nottingham Extended Activities of Daily Living Scale (NEADLS) was used to measure everyday activities.Results: We found a negative and moderate correlation between FRT in standing and light touch of the middle of the heel (right: -0.515), metatarsal bone (right r: 0.453, left r: -0.426), and medial of the foot (right r: -0.462). There was a negative and moderate correlation between NEADLS and light touch of the metatarsal bone (right r: -0.564, left r: -0.472), medial of the foot (right r: -0.531, left r: -0.479), and lateral of the foot (right r: -0.526). We found a positive and moderate correlation between proprioception of the ankle (right r: 0.421 left r: 0.588) and NEADLS.Conclusions: We found impairment in light touch and proprioception and, associations between sensorial functions and dynamic postural stability in PwMS. Also impaired sensorial functions cause dependent patients in daily living activities. In the assessment of balance and falling risk, independency in daily living activities; foot light touch and proprioception sense should be taken into account, hence it may provide guidance in planning rehabilitation programmes.Abbreviations: MS: multiple sclerosis; PwMS: patients with multiple sclerosis; VAS: visual analogue scale; FRT: functional reach test; 9-HPT: Nine-hole peg test; EDSS: The Expanded Disability Status Scale; NEADLS: Nottingham Extended Activities of Daily Living Scale.
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Affiliation(s)
- Esra Dogru Huzmeli
- Physiotherapy and Rehabilitation, Department, Health Science Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Taskin Duman
- Neurologia Department, Tayfur Ata Sokmen Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
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Uluduz D, Midi I, Duman T, Yayla V, Karahan AY, Afsar N, Goksu EO, Mengulluoglu N, Aytac E, Sungur MA, Yesilot N, Ince B, Yalin OO, Oruc S, Senol MG, Yilmaz A, Gokce M, Demirci S, Kusbeci OY, Uzuner G, Caglayan HZB, Acikgoz M, Kurucu H, Ozdag F, Baybas S, Ekmekci H, Cabala M, Yaman M, Yürekli VA, Tekeli H, Genc H, Utku U, Sahin S, Tokuc FEU, Uzuner N, Bektas H, Kablan Y, Goksel BK, Milanlioglu A, Orken DN, Aluclu U, Colakoglu S, Tufekci A, Bakar M, Nazliel B, Tascilar N, Goksan B, Kozak HH, Demir S, Mısırli CH, Kucukoglu H, Cinar N, Domac FM, Ozturk S, Gunes T. Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study. Seizure 2020; 78:113-117. [PMID: 32353818 DOI: 10.1016/j.seizure.2020.02.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 07/03/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). METHOD VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. RESULTS The mean age of the patients in the ES group was 39.73 ± 12.64 and 40.17 ± 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. CONCLUSIONS In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.
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Affiliation(s)
- Derya Uluduz
- Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Ipek Midi
- Department of Neurology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Taskin Duman
- Department of Neurology, Mustafa Kemal University, School of Medicine, Hatay, Turkey.
| | - Vildan Yayla
- Clinic of Neurology, Saglik Bilimleri University, Bakirkoy Sadi Konuk Research and Training, Hospital, Istanbul, Turkey
| | - Ali Yavuz Karahan
- Department of Physical Medicine and Rehabilitation, Usak University, School of Medicine, Usak, Turkey
| | - Nazire Afsar
- Department of Neurology, Acıbadem Mehmet Aydinlar University, Istanbul, Turkey
| | - Eylem Ozaydin Goksu
- Clinic of Neurology, Antalya Research and Training Hospital, Antalya, Turkey
| | | | - Emrah Aytac
- Department of Neurology, Firat University, School of Medicine, Elazig, Turkey
| | - Mehmet Ali Sungur
- Department of Biostatistics, Duzce University, School of Medicine, Duzce, Turkey
| | - Nilufer Yesilot
- Department of Neurology, Istanbul University, School of Medicine, Istanbul, Turkey
| | - Birsen Ince
- Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Osman Ozgur Yalin
- Clinic of Neurology, Saglik Bilimleri University, Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Serdar Oruc
- Department of Neurology, Kocatepe University, School of Medicine, Afyon, Turkey
| | - Mehmet Guney Senol
- Clinic of Neurology, Sisli Hamidiye Research and Training Hospital, Istanbul, Turkey; Clinic of Neurology, Saglik Bilimleri University, II. Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey
| | - Arda Yilmaz
- Department of Neurology, Mersin University, School of Medicine, Mersin, Turkey
| | - Mustafa Gokce
- Department of Neurology, Sütçü İmam University, School of Medicine, Kahramanmaraş, Turkey
| | - Seden Demirci
- Department of Neurology, Aspendos Anatolian Hospital, Antalya, Turkey; Department of Neurology, Süleyman Demirel University, School of Medicine, Isparta, Turkey
| | | | - Gulnur Uzuner
- Department of Neurology, Osmangazi University, School of Medicine, Eskisehir, Turkey
| | | | - Mustafa Acikgoz
- Department of Neurology, Bülent Ecevit University, School of Medicine, Zonguldak, Turkey
| | - Hatice Kurucu
- Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Fatih Ozdag
- Clinic of Neurology, Saglik Bilimleri University, II. Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey
| | - Sevim Baybas
- Clinic of Neurology, Bakirkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul, Turkey
| | - Hakan Ekmekci
- Department of Neurology, Selçuk University, School of Medicine, Konya, Turkey
| | - Murat Cabala
- Clinic of Neurology, Saglik Bilimleri University, Bakirkoy Sadi Konuk Research and Training, Hospital, Istanbul, Turkey
| | - Mehmet Yaman
- Department of Neurology, Kocatepe University, School of Medicine, Afyon, Turkey
| | - Vedat Ali Yürekli
- Department of Neurology, Süleyman Demirel University, School of Medicine, Isparta, Turkey
| | - Hakan Tekeli
- Clinic of Neurology, Saglik Bilimleri University, II. Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey; Clinic of Neurology, Sancaktepe Research and Training Hospital, Istanbul, Turkey
| | - Hamit Genc
- Department of Neurology, Mersin University, School of Medicine, Mersin, Turkey
| | - Uygar Utku
- Department of Neurology, Sütçü İmam University, School of Medicine, Kahramanmaraş, Turkey
| | - Sevki Sahin
- Department of Neurology, Maltepe University, School of Medicine, Istanbul, Turkey
| | | | - Nevzat Uzuner
- Department of Neurology, Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Hesna Bektas
- Clinic of Neurology, Ataturk Research and Training Hospital, Ankara, Turkey
| | - Yuksel Kablan
- Department of Neurology, Inonu University, School of Medicine, Malatya, Turkey
| | | | - Aysel Milanlioglu
- Department of Neurology, Yüzüncü Yıl University, School of Medicine, Van, Turkey
| | | | - Ufuk Aluclu
- Department of Neurology, Dicle University, School of Medicine, Diyarbakir, Turkey
| | - Sena Colakoglu
- Department of Neurology, Mustafa Kemal University, School of Medicine, Hatay, Turkey
| | - Ahmet Tufekci
- Department of Neurology, Recep Tayyip Erdoğan University, School of Medicine, Rize, Turkey
| | - Mustafa Bakar
- Department of Neurology, Uludağ University, School of Medicine, Bursa, Turkey
| | - Bijen Nazliel
- Department of Neurology, Gazi University, School of Medicine, Ankara, Turkey
| | - Nida Tascilar
- Department of Neurology, Bülent Ecevit University, School of Medicine, Zonguldak, Turkey; Department of Neurology, Medipol University, Istanbul, Turkey
| | - Baki Goksan
- Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Hasan Huseyin Kozak
- Department of Neurology, Necmettin Erbakan University, School of Medicine, Konya, Turkey
| | - Serkan Demir
- Clinic of Neurology, Saglik Bilimleri University, II. Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey; Clinic of Neurology, Sancaktepe Research and Training Hospital, Istanbul, Turkey
| | - Cemile Handan Mısırli
- Clinic of Neurology, Saglik Bilimleri University, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Hayriye Kucukoglu
- Clinic of Neurology, Bakirkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul, Turkey
| | - Nilgun Cinar
- Department of Neurology, Maltepe University, School of Medicine, Istanbul, Turkey
| | - Fusun Mayda Domac
- Clinic of Neurology, Erenkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul, Turkey
| | - Serefnur Ozturk
- Department of Neurology, Selçuk University, School of Medicine, Konya, Turkey
| | - Taskin Gunes
- Clinic of Neurology, Saglik Bilimleri University, Istanbul Research and Training Hospital, Istanbul, Turkey
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Huzmeli ED, Korkmaz NC, Duman T, Gokcek O. Effects of sensory deficits on balance, functional status and trunk control in patients diagnosed with guillain-barre syndrome. ACTA ACUST UNITED AC 2018; 23:301-307. [PMID: 30351287 PMCID: PMC8015565 DOI: 10.17712/nsj.2018.4.20180098] [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] [Indexed: 11/29/2022]
Abstract
Objectives: To investigate the effects of sensory deficits on balance, functional status and trunk control in patients diagnosed with Guillain–Barré syndrome (GBS). Methods: Twenty patients who were diagnosed with GBS and who were in the neurology department of Mustafa Kemal University in 2017, participated in this descriptive study. There were 11 males and 9 females, and the average age was 41.55 ± 18.49 years. The trunk control of the GBS patients was assessed using the trunk impairment scale (TIS), reaching function was assessed using the functional reaching test (FRT) in the sitting position and body balance assessed using the Berg balance scale (BBS).Light touch was assessed using Semmes–Weinstein monofilament test, proprioception was assessed using the distal proprioception test and disability status was assessed using the Guillain–Barré syndrome disability scale (GBSDS). Results: We found a moderate, positive and significant correlation between proprioception scores and the BBS and between proprioception scores and the TIS. The correlation between proprioception and FRT in the sitting position and between proprioception and the GBSDS was not significant. We found a moderate and negative correlation between light touch and the FRT in the sitting position, TIS, BBS, but a moderate and positive correlation between light touch and the GBSDS. Conclusion: Neurologists and physiotherapists should both take sensory and motor function into consideration in the assessment and rehabilitation program of patients diagnosed with GBS.
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Affiliation(s)
- Esra-Dogru Huzmeli
- School of Physical Therapy and Rehabilitation, Hatay Mustafa Kemal University, Antakya, Turkey. E-mail:
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Uluduz D, Midi I, Duman T, Colakoglu S, Tüfekci A, Bakar M, Nazliel B, Tascilar N, Goksan B, Sungur MA, Kozak HH, Demir S, Misirli CH, Kucukoglu H, Cinar N, Domac FM, Ozturk S, Yayla V, Karahan AY, Afsar N, Goksu EO, Mengulluoglu N, Aytac E, Yesilot N, Ince B, Yalin OO, Oruc S, Demirci S, Senol MG, Yilmaz A, Gokce M, Yilmaz Kusbeci Ö, Uzuner G, Batur Caglayan HZ, Acikgoz M, Zeydan B, Ozdag F, Baybas S, Ekmekci H, Cabalar M, Yaman M, Yurekli VA, Tekeli H, Genc H, Utku U, Ucan Tokuc FE, Uzuner N, Bektas H, Kablan Y, Goksel BK, Milanlioglu A, Necioglu Orken D, Aluclu U. Behçet’s disease as a causative factor of cerebral venous sinus thrombosis: subgroup analysis of data from the VENOST study. Rheumatology (Oxford) 2018; 58:600-608. [DOI: 10.1093/rheumatology/key153] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 04/26/2018] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behçet’s disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST).
Methods
VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis.
Results
BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18–36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%).
Conclusions
BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score ⩾2).
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Affiliation(s)
- Derya Uluduz
- School of Medicine, Department of Neurology, Istanbul Cerrahpasa University, Istanbul
| | - Ipek Midi
- School of Medicine, Department of Neurology, Marmara University, Istanbul
| | - Taskin Duman
- School of Medicine, Department of Neurology, Mustafa Kemal University, Hatay
| | - Sena Colakoglu
- School of Medicine, Department of Neurology, Mustafa Kemal University, Hatay
| | - Ahmet Tüfekci
- School of Medicine, Department of Neurology, Recep Tayyip Erdoğan University, Rize
| | - Mustafa Bakar
- School of Medicine, Department of Neurology, Uludağ University, Bursa
| | - Bijen Nazliel
- School of Medicine, Department of Neurology, Gazi University, Ankara
| | - Nida Tascilar
- School of Medicine, Department of Neurology, Bülent Ecevit University, Zonguldak
| | - Baki Goksan
- School of Medicine, Department of Neurology, Istanbul Cerrahpasa University, Istanbul
| | - Mehmet Ali Sungur
- School of Medicine, Department of Biostatistics, Düzce University, Düzce
| | - Hasan Huseyin Kozak
- School of Medicine, Department of Neurology, Necmettin Erbakan University, Konya
| | - Serkan Demir
- Clinic of Neurology, Sultan Abdulhamid Han Research and Training Hospital, Istanbul
| | - Cemile Handan Misirli
- Clinic of Neurology, Haydarpasa Training and Research Hospital, Health Sciences University, Istanbul
| | - Hayriye Kucukoglu
- Clinic of Neurology, Bakirkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul
| | - Nilgun Cinar
- School of Medicine, Department of Neurology, Maltepe University, Istanbul
| | - Fusun Mayda Domac
- Clinic of Neurology, Erenkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul
| | - Serefnur Ozturk
- School of Medicine, Department of Neurology, Selçuk University, Konya
| | - Vildan Yayla
- Clinic of Neurology, Bakirkoy Sadi Konuk Research and Training Hospital, Istanbul
| | - Ali Yavuz Karahan
- School of Medicine, Department of Physical Medicine and Rehabilitation, Usak University, Usak
| | - Nazire Afsar
- School of Medicine, Department of Neurology, Acibadem Mehmet Ali Aydinlar University, Istanbul
| | | | | | - Emrah Aytac
- Clinic of Neurology, Ankara Research and Training Hospital, Ankara
| | - Nilufer Yesilot
- Department of Neurology, Istanbul University, Istanbul Faculty of Medicine Istanbul
| | - Birsen Ince
- School of Medicine, Department of Neurology, Istanbul Cerrahpasa University, Istanbul
| | - Ozgur Osman Yalin
- Clinic of Neurology, Istanbul Training and Research Hospital, Health Sciences University, Istanbul
| | - Serdar Oruc
- School of Medicine, Department of Neurology, Kocatepe University, Afyon
| | - Seden Demirci
- School of Medicine, Department of Neurology, Süleyman Demirel University, Isparta
| | - Mehmet Guney Senol
- School of Medicine, Department of Neurology, Istanbul Cerrahpasa University, Istanbul
| | - Arda Yilmaz
- School of Medicine, Department of Neurology, Mersin University, Mersin
| | - Mustafa Gokce
- School of Medicine, Department of Neurology, Kahramanmaras Sutcu Imam University, Kahramanmaras
| | - Özge Yilmaz Kusbeci
- Clinic of Neurology, Bozyaka Education, Research and Training Hospital, İzmir
| | - Gulnur Uzuner
- School of Medicine, Department of Neurology, Osmangazi University, Eskisehir
| | | | - Mustafa Acikgoz
- School of Medicine, Department of Neurology, Bülent Ecevit University, Zonguldak
| | - Burcu Zeydan
- School of Medicine, Department of Neurology, Istanbul Cerrahpasa University, Istanbul
| | - Fatih Ozdag
- Clinic of Neurology, Sultan Abdulhamid Han Research and Training Hospital, Istanbul
| | - Sevim Baybas
- Clinic of Neurology, Bakirkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul
| | - Hakan Ekmekci
- School of Medicine, Department of Neurology, Selçuk University, Konya
| | - Murat Cabalar
- Clinic of Neurology, Bakirkoy Sadi Konuk Research and Training Hospital, Istanbul
| | - Mehmet Yaman
- School of Medicine, Department of Neurology, Kocatepe University, Afyon
| | - Vedat Ali Yurekli
- School of Medicine, Department of Neurology, Süleyman Demirel University, Isparta
| | - Hakan Tekeli
- Clinic of Neurology, Sultan Abdulhamid Han Research and Training Hospital, Istanbul
| | - Hamit Genc
- School of Medicine, Department of Neurology, Mersin University, Mersin
| | - Uygar Utku
- School of Medicine, Department of Neurology, Kahramanmaras Sutcu Imam University, Kahramanmaras
| | | | - Nevzat Uzuner
- School of Medicine, Department of Neurology, Osmangazi University, Eskisehir
| | - Hesna Bektas
- Clinic of Neurology, Ataturk Research and Training Hospital, Ankara
| | - Yuksel Kablan
- School of Medicine, Department of Neurology, Inonu University, Malatya
| | - Basak K Goksel
- School of Medicine, Department of Neurology, Baskent University, Adana
| | - Aysel Milanlioglu
- School of Medicine, Department of Neurology, Yüzüncü Yıl University, Van, Turkey
| | | | - Ufuk Aluclu
- School of Medicine, Department of Neurology, Dicle University, Diyarbakir, Turkey
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9
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Duman T, Guntel M, Colakoglu S, Selcuk D. A "Neurosarcoidosis, Mystenia Gravis and Transvers Myelite" case. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3712] [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: 10/18/2022]
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10
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Duman T, Uluduz D, Midi I, Bektas H, Kablan Y, Goksel BK, Milanlioglu A, Necioglu Orken D, Aluclu U. A Multicenter Study of 1144 Patients with Cerebral Venous Thrombosis: The VENOST Study. J Stroke Cerebrovasc Dis 2017; 26:1848-1857. [PMID: 28583818 DOI: 10.1016/j.jstrokecerebrovasdis.2017.04.020] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 02/03/2017] [Accepted: 04/13/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Based on a number of small observational studies, cerebral venous sinus thrombosis has diverse clinical and imaging features, risk factors, and variable outcome. In a large, multicenter cerebral venous thrombosis (VENOST) study, we sought to more precisely characterize the clinical characteristics of Caucasian patients. METHODS All data for the VENOST study were collected between the years 2000 and 2015 from the clinical follow-up files. Clinical and radiological characteristics, risk factors, and outcomes were compared in terms of age and sex distribution. RESULTS Among 1144 patients 68% were women, and in older age group (>50 years) male patients were more prevalent (16.6% versus 27.8%). The most frequent symptoms were headache (89.4%) and visual field defects (28.9%) in men, and headache (86.1%) and epileptic seizures (26.8%) in women. Gynecological factors comprised the largest group in women, in particular puerperium (18.3%). Prothrombotic conditions (26.4%), mainly methylenetetrahydrofolate reductase mutation (6.3%) and Factor V Leiden mutation (5.1%), were the most common etiologies in both genders. 8.1% of patients had infection-associated and 5.2% had malignancy-related etiology that was significantly higher in men and older age group. Parenchymal involvement constitutively hemorrhagic infarcts, malignancy, and older age was associated with higher Rankin score. Epileptic seizures had no effect on prognosis. CONCLUSIONS Clinical and radiological findings were consistent with previous larger studies but predisposing factors were different with a higher incidence of puerperium. Oral contraceptive use was not a prevalent risk factor in our cohort. Malignancy, older age, and hemorrhagic infarcts had worse outcome.
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Affiliation(s)
- Taskin Duman
- Department of Neurology, School of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Derya Uluduz
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
| | - Ipek Midi
- Department of Neurology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Hesna Bektas
- Clinic of Neurology, Ataturk Research and Training Hospital, Ankara, Turkey
| | - Yuksel Kablan
- Department of Neurology, School of Medicine, Inonu University, Malatya, Turkey
| | - Basak K Goksel
- Department of Neurology, School of Medicine, Baskent University, Adana, Turkey
| | - Aysel Milanlioglu
- Department of Neurology, School of Medicine, Yüzüncü Yıl University, Van, Turkey
| | - Dilek Necioglu Orken
- Clinic of Neurology, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey
| | - Ufuk Aluclu
- Department of Neurology, School of Medicine, Dicle University, Diyarbakır, Turkey
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Abstract
The aim of this study was to investigate increase of QTc dispersion and P-wave dispersion during migraine attacks. Fifty-five patients (16–65 years of age, 49 women, six men) with migraine were included in our study. Heart rate, QTc interval, maximum and minimum QTc interval, QTc dispersion, maximum and minimum P-wave duration and P-wave dispersion were measured from 12-lead ECG recording during migraine attacks and pain-free periods. ECGs were transferred to a personal computer via a scanner and then used for magnification of x400 by Adobe Photoshop software. Maximum QTc interval (454 ± 24 ms vs. 429 ± 23 ms, P < 0.001), QTc interval (443 ± 26 ms vs. 408 ± 22 ms, P <0.001) and QTc dispersion (63 ± 18 ms vs. 43 ± 14 ms, P <0.001) were found significantly higher during migraine attacks compared with pain-free periods. Maximum P-wave duration (107 ± 11 ms vs. 100 ± 11 ms, P <0.001) and P-wave dispersion (45 ± 13 ms vs. 35 ± 13 ms, P <0.001) were found higher during migraine attacks than pain-free periods. We concluded that migraine attacks are associated with increased QTc and P-wave dispersion compared with pain-free periods.
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Affiliation(s)
- M Duru
- Mustafa Kemal University Faculty of Medicine, Department of Emergency Medicine, Antakya/Hatay, Turkey.
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12
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Abstract
Primary stabbing headache is an excruciating and relatively rare type of headache that typically lasts for only a few seconds. Pain is predominantly felt in the distribution of the first division of the trigeminal nerve and can be experienced as single stabs or as a series of stabs, either per day or every few days. Primary stabbing headache has been well-defined for decades and must be kept in mind during diagnosis. Exclusion of other possible causes is necessary in order to establish diagnosis. Indomethacin has classically been considered the first treatment option, but therapeutic failure occurs in up to 35% of cases. Recent studies have suggested that cyclooxygenase-2 inhibitors, gabapentin, nifedipine, paracetamol, and melatonin are also effective treatments.
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Affiliation(s)
- Murat Guntel
- Department of Neurology, Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | - Ozge Hurdogan
- Department of Neurology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Derya Uluduz
- Department of Neurology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey.
| | - Taskin Duman
- Department of Neurology, Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
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13
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Okuyucu E, Melek I, Colakoglu S, Demetgul O, Guntel M, Duman T. Cerebral venous thromboembolism complication of isotretinoin use: a case report. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.1418] [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: 10/22/2022]
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14
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Duman T, Kurucu H, Uluduz D. Benign paroxysmal torticollis, vertigo and migraine attacks in a patient. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.560] [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: 10/22/2022]
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15
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Kucuksahin O, Ateş A, Türkçapar N, Törüner M, Duman T, Şahin A, Turgay M, Kınıklı G, Çetinkaya H, Bıyıklı Z, Düzgün N. AB0011 Association between Single Nucleotide Polymorphisms (SNPS) in Prospective Genes and Susceptibility to Ankylosing Spondylitis, Inflammatory Bowel Disease in A Turkish Population. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5622] [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: 11/04/2022]
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16
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Yalcin H, Okuyucu EE, Ucar E, Duman T, Yilmazer S. Changes in liquid emptying in migraine patients: diagnosed with liquid phase gastric emptying scintigraphy. Intern Med J 2013; 42:455-9. [PMID: 22498119 DOI: 10.1111/j.1445-5994.2012.02741.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Gastric stasis is suspected mostly to be encountered during acute migraine attack. The aim of this study is to evaluate the liquid phase gastric emptying and motility in migraine patients in ictal and interictal periods in comparison to normal subjects with gastric emptying scintigraphy. Seven women with migraine and age, sex matched controls who applied to the Neurology Department from May 2009 to May 2010 were compared. Gastric emptying study with a standard liquid was performed one time in the non-migraineur group and two times in the migraineur group. Non-migraineur controls and migraineurs were compared. The mean T1/2 was longer in ictal period in migraineurs. The T1/2 of migraineurs interictally and the control groups were similar. The T1/2 of migraineurs ictally and migraineurs interictally were also compared. We also considered the percentage of the radioactive material remaining in the stomach. There were no significant differences between non-migraineurs and migraineurs interictally. However, increased amount of radioactive material remaining in the stomach was observed in migraineurs ictally. We concluded that the liquid emptying was delayed in spontaneous migraine attacks in migraine without aura, however in the interictal period the emptying of liquids did not differ between migraineurs and non-migraineurs.
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Affiliation(s)
- H Yalcin
- Department of Nuclear Medicine, Mustafa Kemal University School of Medicine, Hatay, Turkey.
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17
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Abstract
An increased number of sensitized patients await kidney transplantation (KTx). Sensitization has a major impact on patient mortality and morbidity due to prolonged waiting time and may preclude live donor transplantation. However, recent reports have shown that KTx can be performed successfully using novel immunosuppressive protocols. This study presents our experience with patients displaying donor-specific antibody (DSA) (+). We enrolled 5 lymphocyte cross-match (LCM) negative (complement-dependent cytotoxicity) and panel-reactive antibody (PRA) plus DSA-positive patients mean fluorescein intensity [MFI] > 1000) who underwent living kidney donor procedures. All subjects were females and their mean age was 36.7 years. In our protocol, we started mycophenolate mofetil (2 g/d), tacrolimus (0.01 mg/kg) and prednisolone (0.5 mg/kg) on day -6. We performed 2 sessions of total plasma exchange (TPE) with albumin replacement and administered 2 doses of IVIG (5 g/d). On day -1, we added rituximab (200 mg). On the operation day and on day +4, the patients received doses of basiliximab. Serum samples were taken on days -6, 0, and 30 as well as at 1 year after transplantation. All patients displayed immediate graft function. Mean basal DSA titer was 5624 MFI. After desensitization, the MFI titers decreased at the time of transplantation to 2753 MFI, and were 2564 MFI at the 1st month and 802 MFI at 1st year. Three patients experienced acute rejection episodes (60%). After treatment for rejection, the average follow-up was 17 months and last creatinine levels were 0.6-0.8 mg/dL (minimum-maximum). In conclusion, KTx can be succesfully performed in sensitized patients displaying DSA. However, there seems to be a greater acute rejection risk. There is no consensus regarding adequate doses of IVIG or plasmapheresis treatments; furthermore, more studies are needed to clarify the safe MFI titer of the DSA.
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Affiliation(s)
- K Keven
- Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey
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18
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Baltaci V, Demirel C, Baltaci A, Ayvaz Ö, Ünsal E, Duman T. Preimplantation genetic diagnosis for mucopolysaccharidose type I: analysis of a novel indel mutation. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1377] [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: 10/26/2022]
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19
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Baltaci A, Baltaci V, Demirel C, Ünsal E, Ayvaz Ö, Duman T. Outcome of preimplantation genetic diagnosis (PGD) for single gene disorders with HLA typing. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1368] [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: 11/16/2022]
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20
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Okuyucu EE, Guven O, Duman T, Gorur S, Melek IM, Akcin S, Yılmazer S. EEG abnormalities during treatment with tadalafil, a phosphodiesterase type 5 inhibitor. Neurol Res 2013; 31:313-5. [DOI: 10.1179/174313209x382548] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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21
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Unsal E, Ayvaz O, Duman T, Ozer L, Akyigit F, Baltaci A, Baltaci V. P-49 Preimplantation genetic diagnosis (PGD) for single gene disorders with HLA typing: A brief report. Reprod Biomed Online 2013. [DOI: 10.1016/s1472-6483(13)60112-1] [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: 10/26/2022]
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22
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Ayvaz O, Unsal E, Baltaci A, Duman T, Ozer L, Akyigit F, Baltaci V. P-36 Preimplantation genetic diagnosis for mucopolysaccharidose type I: Analysis of a novel indel mutation. Reprod Biomed Online 2013. [DOI: 10.1016/s1472-6483(13)60099-1] [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: 11/29/2022]
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23
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Yilmazer S, Okuyucu E, Melek I, Duman T. Generalized anhidrosis. Neurosciences (Riyadh) 2013; 18:178-179. [PMID: 23545621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Serkan Yilmazer
- Neurology Department, Faculty of Medicine, Mustafa Kemal University, Antakya, Hatay, Turkey.
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24
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Okuyucu EE, Duman T, Akcin E. Reversible parkinsonism with oxcarbazepine use. Parkinsonism Relat Disord 2009; 15:787-8. [DOI: 10.1016/j.parkreldis.2009.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 02/26/2009] [Accepted: 03/20/2009] [Indexed: 10/20/2022]
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25
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Düzgün N, Duman T, Haydardedeoğlu FE, Tutkak H. Cytotoxic T lymphocyte-associated antigen-4 polymorphism in patients with rheumatic heart disease. ACTA ACUST UNITED AC 2009; 74:539-42. [DOI: 10.1111/j.1399-0039.2009.01347.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Okuyucu EE, Duman T, Melek IM, Seydaoglu G. Correlation of sleep disorder and Parkinson's disease severity in Turkish patients. Neurosciences (Riyadh) 2009; 14:298-299. [PMID: 21048638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Esra E Okuyucu
- Neurology Department, School of Medicine, Mustafa Kemal University, Antioch, Turkey. Tel. +90 (326) 2140649 Ext. 109. E-mail:
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27
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Abstract
BACKGROUND AND PURPOSE Peripheral nervous system involvement is rare in sickle cell disease (SCD). The aim of this study is to determine the peripheral nerve involvement electrophysiologically in SCD patients without clinically evident neurological signs, symptoms and to determine the relationship between the frequency of sickle cell crisis and peripheral neuropathy. METHODS Fifty-one patients with SCD and fifty-one healthy controls were enrolled to the study. Conventional electrophysiological studies of peripheral nerves were performed to all subjects. The data about the frequency of sickle cell crisis were obtained. RESULTS Peripheral nervous system involvement was detected in ten (19.6%) patients. Five (9.8%) patients had sensorimotor axonal neuropathy, two (3.9%) sensory axonal neuropathy, one (2%) patient had ulnar sensory neuropathy and two (3.9%) had median sensory neuropathy. Sural nerve sensorial action potential was unobtainable in eight (15.7%) patients and prolonged F latencies were observed in three (5.9%). The frequency of neuropathy was higher in SCD patients when compared with the controls. The frequency of sickle cell crisis was not significantly correlated with peripheral neuropathy. CONCLUSION Subclinical peripheral nerve involvement may be seen in SCD patients. Electrophysiological examinations are recommended in routine examination to diagnose early neuropathy in SCD patients without neurologic symptoms.
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Affiliation(s)
- E E Okuyucu
- Department of Neurology, Mustafa Kemal University, Antioch, Turkey.
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28
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Fansa I, Altug ME, Melek I, Ucar E, Kontas T, Akcora B, Atik E, Duman T. The Neuroprotective and Anti-inflammatory Effects of Diltiazem in Spinal Cord Ischaemia–Reperfusion Injury. J Int Med Res 2009; 37:520-33. [DOI: 10.1177/147323000903700228] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The protective effects of diltiazem were examined in a rabbit model of spinal cord ischaemia–reperfusion induced by infrarenal aortic occlusion for 30 min. In the diltiazem group ( n = 6), an intravenous infusion (2 μg/kg per min) was started 10 min before ischaemia induction; normal saline solution was infused in the control group ( n = 6). Neurological function was assessed using modified Tarlov criteria 24 h after surgery. Plasma samples were analysed for interleukin (IL)-6 and IL-10. Spinal tissue was analysed for malondialdehyde, nitric oxide and reduced glutathione activities. Tarlov scores of the diltiazem-treated rabbits indicated significantly improved hind-limb motor function compared with the control group. The diltiazem group also had better quantitative and qualitative histopathological findings. Diltiazem infusion significantly reduced IL-6 levels 3 and 24 h after reperfusion compared with the control group. The mean IL-10 level in the diltiazem group was significantly higher than in the control group 24 h after reperfusion. It is concluded that diltiazem has cytoprotective and anti-inflammatory properties, leading to reduced spinal cord injury.
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Affiliation(s)
- I Fansa
- Department of Cardiovascular Surgery, Faculty of Medicine, Mustafa Kemal University, Antakya/Hatay, Turkey
| | - ME Altug
- Department of Surgery, Faculty of Veterinary Medicine, Mustafa Kemal University, Antakya/Hatay, Turkey
| | - I Melek
- Department of Neurology, Faculty of Medicine, Mustafa Kemal University, Antakya/Hatay, Turkey
| | - E Ucar
- Department of Internal Medicine, Faculty of Medicine, Mustafa Kemal University, Antakya/Hatay, Turkey
| | - T Kontas
- Department of Biochemistry, Faculty of Veterinary Medicine, Mustafa Kemal University, Antakya/Hatay, Turkey
| | - B Akcora
- Department of Paediatric Surgery, Faculty of Medicine, Mustafa Kemal University, Antakya/Hatay, Turkey; and
| | - E Atik
- Department of Pathology, Faculty of Medicine, Mustafa Kemal University, Antakya/Hatay, Turkey
| | - T Duman
- Department of Neurology, Faculty of Medicine, Mustafa Kemal University, Antakya/Hatay, Turkey
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29
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Okuyucu EE, Tunc T, Karazincir S, Duman T. Restless legs syndrome in a person with Fahr's disease. Neurosciences (Riyadh) 2009; 14:89-90. [PMID: 21048583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Esra E Okuyucu
- Department of Neurology, Faculty of Medicine, Mustafa Kemal University, Antakya (Antochia), Hatay, Turkey. Tel. +90 (326) 2551405. Fax. +90 (326) 2144977. E-mail:
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30
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Ertaş M, Baykan B, Tuncel D, Gökçe M, Gökçay F, Sirin H, Deniz O, Oztürk V, Idiman F, Karli N, Zarifoğlu M, Yildiz N, Siva A, Saip S, Göksan B, Ak F, Aluçlu U, Duman T, Melek IM, Bulut S, Berilgen S. A comparative ID migraine screener study in ophthalmology, ENT and neurology out-patient clinics. Cephalalgia 2008; 29:68-75. [PMID: 18771489 DOI: 10.1111/j.1468-2982.2008.01702.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.
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Affiliation(s)
- M Ertaş
- Departments of Neurology, Medical Faculties of Istanbul University, Istanbul, Turkey
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31
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Abstract
In a 20-year-old male patient, a 180 degree inversion of visual image was found as a manifestation of multiple sclerosis. Upside down reversal of vision is not a well-known sign in multiple sclerosis. Exact mechanism is still unknown. Lesions involving cortical areas, mainly the parieto-occipital region, have occasionally been documented. To our knowledge this is the first report of upside-down reversal of vision in multiple sclerosis with cerebra lesion on MRI. Multiple Sclerosis 2008; 14: 266—267. http://msj.sagepub.com
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Affiliation(s)
- Esra Emine Okuyucu
- Department of Neurology, Faculty of Medicine, Mustafa Kemal University, Antakya (Antochia), Hatay, Turkey,
| | - Semsettin Okuyucu
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Mustafa Kemal University, Antakya (Antochia), Hatay, Turkey
| | - Sinem Karazincir
- Department of Radiology, Mustafa Kemal University, Antakya (Antochia), Hatay, Turkey
| | - Ertap Akoglu
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Mustafa Kemal University, Antakya (Antochia), Hatay, Turkey
| | - Taskin Duman
- Department of Neurology, Faculty of Medicine, Mustafa Kemal University, Antakya (Antochia), Hatay, Turkey
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Serarslan G, Okuyucu EE, Melek IM, Hakverdi S, Duman T. Widespread maculopapular rash due to intramuscular interferon beta-1a during the treatment of multiple sclerosis. Mult Scler 2007. [DOI: 10.1177/0961203307079945] [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: 11/15/2022]
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Serarslan G, Okuyucu EE, Melek IM, Hakverdi S, Duman T. Widespread maculopapular rash due to intramuscular interferon beta-1a during the treatment of multiple sclerosis. Mult Scler 2007; 14:259-61. [DOI: 10.1177/1352458507079945] [Citation(s) in RCA: 9] [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] [Indexed: 11/15/2022]
Abstract
We describe a 41-year-old woman with multiple sclerosis, who presented erythematous maculopapular rash on the trunk and extremities after the second injection of interferon beta-1a. Histopathologic examination of the lesion revealed lymphocytic exocytosis and perivascular lymphocytic infiltrate in the dermis. Oral antihistamine and topical corticosteroid was started. After improvement of the lesions, the third injection was performed. However, the same reaction occurred. A prick test, which was performed 6 weeks after the eruption, also revealed positive reaction. Although injection-site reactions have been observed with interferon beta-1a, to our knowledge there have been no previous reports of interferon beta-1a-induced widespread cutaneous reaction. Multiple Sclerosis 2008; 14: 259—261. http://msj.sagepub.com
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Affiliation(s)
- G. Serarslan
- Department of Dermatology, Mustafa Kemal University, Faculty of Medicine, Antakya, Turkey,
| | - EE Okuyucu
- Department of Neurology, Mustafa Kemal University, Faculty of Medicine, Antakya, Turkey
| | - IM Melek
- Department of Neurology, Mustafa Kemal University, Faculty of Medicine, Antakya, Turkey
| | - S. Hakverdi
- Department of Pathology, Mustafa Kemal University, Faculty of Medicine, Antakya, Turkey
| | - T. Duman
- Department of Neurology, Mustafa Kemal University, Faculty of Medicine, Antakya, Turkey
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Incecik F, Akoglu E, Sangün O, Melek I, Duman T. Effects of valproic acid on hearing in epileptic patients. Int J Pediatr Otorhinolaryngol 2007; 71:611-4. [PMID: 17270285 DOI: 10.1016/j.ijporl.2006.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Revised: 12/21/2006] [Accepted: 12/22/2006] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Since some case reports about the ototoxicity of valproic acid have been published, probable adverse effects of valproic acid on hearing in the epileptic patients became a subject of interest. We wanted to investigate if ototoxicity occurs in pediatric epileptic patients using VPA for long terms. METHODS Twenty-one epileptic patients who have been using valproic acid at least for 6 months as monotherapy and 21 age-sex matched controls were included in the study. Audiometric tests were performed to all patients between the frequencies of 125 and 16,000 Hz. The effects of dosage, duration of therapy and serum levels of the VPA, on the audiometric results were investigated and the audiometric results were compared between the groups. RESULTS There was no difference in hearing thresholds of the groups between 125 and 16,000 Hz frequencies. Relation could not be established between the duration of VPA therapy, dosage of the drug, blood level of drug, age and sex of the patients and the auditory signs. CONCLUSIONS Although we could not find any deleterious effect of VPA on hearing thresholds in our patient series, we think it is useful to perform audiometric tests at intervals while VPA is being used for long periods, considering the presented case reports about sensorineural hearing loss.
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Affiliation(s)
- Faruk Incecik
- Mustafa Kemal University Medical Faculty, Department of Pediatrics, Hatay, Turkey.
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Melek IM, Erdogan S, Celik S, Aslantas O, Duman T. Evaluation of oxidative stress and inflammation in long term Brucella melitensis infection. Mol Cell Biochem 2006; 293:203-9. [PMID: 16810561 DOI: 10.1007/s11010-006-9243-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Accepted: 05/16/2006] [Indexed: 10/24/2022]
Abstract
The Brucella genus is able to cause chronic infection in a wide range of mammals including humans. Oxidative events, lipid peroxidation and inflammatory response against Brucella infection have not yet been well elucidated in vivo. We have investigated oxidative/antioxidative status and nitric oxide production in plasma, brain, liver and spleen during a 60 day period of B. melitensis infection in a rat model. In addition, inducible nitric oxide synthase (iNOS), IL-10, IL-12, IFN-gamma and TNF-alpha mRNA transcriptions were analyzed by semiquantitative reverse transcriptase PCR (RT-PCR) in brain samples. Animals were infected with B. melitensis and sacrificed at 7th, 15th, 30th, 45th and 60th day of post-inoculation. Malondialdehyde (MDA), as an indicator of lipid peroxidation, and nitric oxide (NO) concentrations were significantly increased after Brucella inoculation and began to decline to basal levels from 45th day in plasma, liver and spleen. However, iNOS transcription was not induced during the infection period in brains. In contrast, MDA level was increased in brain during the late phase of infection without any change in NO production. The infection did not alter the antioxidant enzyme activities in the tissues; although significantly increased catalase activity was observed between days 30 and 45 in the liver. Transcription analyses demonstrated that IL-10, IL-12 and IFN-gamma mRNA level were not induced in the brain. Only TNF-alpha mRNA was weakly up-regulated in brain 30 days after pathogen inoculation. The results obtained in this study demonstrate that B. melitensis induces lipid peroxidation and NO production in the liver and spleen in the early days of infection, but that these levels subsequently decline. Moreover, Brucella does not appear to induce antioxidant enzyme activities and inflammation during two months of infection. However, the pathogen does stimulate cerebral lipid peroxidation in the late phase of infection without causing significant inflammation.
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Affiliation(s)
- Ismet M Melek
- Department of Neurology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
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Abstract
Sickle cell disease (SCD) is a common form of hemoglobinopathy and is highly prevalent worldwide. Silent cerebral infarction, which represents infarction without clinical signs, is a risk factor for clinical stroke in patients with SCD. It is well known that silent infarction predisposes patients with SCD to overt stroke. The aim of the present study is to investigate the effect of silent infarction on neurological soft signs (NSS), which demonstrate subtle impairments in sensory integration, motor coordination and the sequencing of complex motor acts and to evaluate whether NSS can be used in clinical practice to evaluate the patients at risk of stroke in SCD patients with silent infarction. Fifty-nine SCD patients without any documented history of cerebrovascular accident and 28 healthy controls were included in this study. All the patients with SCD were evaluated with cerebral magnetic resonance imaging. We found that the NSS scores were significantly higher in patients with silent cerebral infarction than those in patients without silent infarction and control subjects (p < 0.05). Importantly, there was no significant difference in the NSS scores between the patients without silent infarction and control subjects. These results indicate that high NSS scores represnt an important finding for diagnosis of silent infarction in SCD patients. As silent infarction increases the risk for stroke in patients with SCD, NSS can be used to provide additional information in diagnosis of the patients with possible stroke risk during the course of SCD.
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Affiliation(s)
- Ismet Melek
- Department of Neurology, Faculty of Medicine, Mustafa Kemal University, Nöroloji ABD. 31100, Antakya, Turkey.
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Abstract
OBJECTIVE Parkinson's disease (PD) has both motor and nonmotor features. Parkinson's disease patients are prone to dry eye due to both autonomic dysfunction and motor symptoms affecting blinking. This study was conducted to investigate the changes in tear functions in PD patients. DESIGN Nonrandomized, prospective, clinical study. PARTICIPANTS Fifty-six eyes of 56 consecutive patients with PD were studied. Thirty-six eyes of age-matched non-PD patients without pathology affecting tear tests were examined as control subjects. INTERVENTION Modified Hoehn-Yahr (H-Y) scale, blink rate (BR), and tear tests were examined. MAIN OUTCOME MEASURES Modified H-Y scale, BR, dry eye assessment questionnaire, meibomian gland evaluation, tear meniscus height, tear breakup time, fluorescein stain, rose bengal stain, Schirmer's test, and phenol red thread test. RESULTS Overall tear function abnormalities were significantly more common in PD patients (P = 0.001, Mann-Whitney U test). Each test was found to be significantly disturbed in PD patients relative to controls (P<0.05, Mann-Whitney U test). Each PD patient had at least 1 abnormal test. Overall tear function abnormalities as assessed by the total abnormal test count correlated with the H-Y score (P<0.001, Spearman rho correlation). Parkinson's disease patients' mean BR (12.7+/-7.42 per minute) was significantly less than the controls' (21.8+/-7.37) (P<0.01, Student's t test). The abnormality in each tear test, except those for meibomian gland function and tear meniscus height, was significantly related to the H-Y scores (P<0.05, chi2 linear-by-linear association). CONCLUSION The results of this study indicate that PD is associated with disturbances in tear function. With the exception of meibomian gland disease and tear meniscus height, the tests were found to have a linear association with the H-Y scale, which may be attributed to associated dysfunctions of PD.
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Affiliation(s)
- Cengaver Tamer
- Department of Ophthalmology, Faculty of Medicine, Mustafa Kemal University, Antakya-Hatay, Turkey.
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Tekin M, Akçayöz D, Comak E, Boğoçlu G, Duman T, Fitoz S, Ilhan I, Akar N. Screening the SLC26A4 gene in probands with deafness and goiter (Pendred syndrome) ascertained from a large group of students of the schools for the deaf in Turkey. Clin Genet 2003; 64:371-4. [PMID: 12974744 DOI: 10.1034/j.1399-0004.2003.00144.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tekin M, Duman T, Boğoçlu G, İncesulu A, Çomak E, Fitoz S, Yılmaz E, İlhan I, Akar N. Frequency of mtDNA A1555G and A7445G mutations among children with prelingual deafness in Turkey. Eur J Pediatr 2003; 162:154-158. [PMID: 12655418 DOI: 10.1007/s00431-002-1129-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2002] [Accepted: 10/30/2002] [Indexed: 12/17/2022]
Abstract
UNLABELLED Considerable differences on the frequencies of the mitochondrial 12S rRNA A1555G and tRNA(Ser(UCN)) A7445G mutations have been reported in different populations. Our screening of 168 patients coming from independent Turkish families with prelingual sensorineural non-syndromic deafness revealed three deaf children with A1555G (1.8%) but no examples of A7445G. One proband with the mitochondrial A1555G mutation has also evidence for right parietal infarct on a brain imaging study, for which common thrombotic mutations were found to be negative. CONCLUSION This study shows that the mitochondrial A1555G mutation is among the significant causes of prelingual non-syndromic deafness in the Turkish population.
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Affiliation(s)
- M Tekin
- Division of Pediatric Molecular Pathology and Genetics, Ankara University School of Medicine, Dikimevi, 06100, Ankara, Turkey.
- Birlik Mah 8. Cadde No 8/3, Çankaya, 06610, Ankara, Turkey.
| | - T Duman
- Division of Pediatric Molecular Pathology and Genetics, Ankara University School of Medicine, Dikimevi, 06100, Ankara, Turkey
| | - G Boğoçlu
- Division of Pediatric Molecular Pathology and Genetics, Ankara University School of Medicine, Dikimevi, 06100, Ankara, Turkey
| | - A İncesulu
- Dept. of ENT, Ankara Social Security Hospital, Ankara, Turkey
| | - E Çomak
- Dept. of Pediatrics, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - S Fitoz
- Dept. of Radiodiagnostics, Ankara University School of Medicine, Dikimevi, 06100, Ankara, Turkey
| | - E Yılmaz
- Division of Pediatric Molecular Pathology and Genetics, Ankara University School of Medicine, Dikimevi, 06100, Ankara, Turkey
| | - I İlhan
- Dept. of Pediatrics, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - N Akar
- Division of Pediatric Molecular Pathology and Genetics, Ankara University School of Medicine, Dikimevi, 06100, Ankara, Turkey
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Tekin M, Duman T, Boğoçlu G, Incesulu A, Cin S, Akar N. Moderate hearing loss and pseudodominant inheritance due to L90P/35delG mutations in the GJB2 (connexin 26) gene. Genet Couns 2003; 14:379-86. [PMID: 14738110] [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: 04/28/2023]
Abstract
Mutations in the GJB2 (connexin 26-Cx26) gene are responsible for 20-50% of cases with prelingual non-syndromic deafness in a large part of the world including Turkey. Although most of the cases with Cx26 deafness have a recessive mode of inheritance, a small group of families demonstrated dominant or pseudodominant inheritance. In this report we present a Turkish family in which the proband had congenital profound deafness and was found to be homozygous for the 35delG mutation, whereas the father and a paternal uncle who had milder, late-onset sensorineural hearing loss had compound heterozygous 35delG and L90P mutations. This family and previous reports with the L90P mutation demonstrate that the hearing loss associated with the L90P/35delG genotype is consistently milder than that of 35delG homozygotes. GJB2 gene screening should be considered in families with seemingly dominant inheritance and late-onset moderate hearing loss.
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Affiliation(s)
- M Tekin
- Division of Pediatric Molecular Pathology and Genetics, Ankara University School of Medicine, Ankara 06 100, Turkey.
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Ocal G, Adiyaman P, Berberoğlu M, Cetinkaya E, Akar N, Uysal A, Duman T, Evliyaoğlu O, Aycan Z, Lumbroso S, Sultan C, Lumbrasso S. Mutations of the 5alpha-steroid reductase type 2 gene in six Turkish patients from unrelated families and a large pedigree of an isolated Turkish village. J Pediatr Endocrinol Metab 2002; 15:411-21. [PMID: 12008688 DOI: 10.1515/jpem.2002.15.4.411] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe six Turkish patients with 5alpha-steroid reductase type 2 deficiency from unrelated Turkish families and a large pedigree of one of these patients who reside north-west of Anatolia. Patients NA, KS, BD and SY presented for evaluation of bilateral inguinal masses with female phenotypes. Patient ABE had penoscrotal hypospadias with male phenotype. Homozygous mutation of the 5alphaSR2 gene was identified in five of these patients by genomic DNA analysis. These mutations were Leu55Gln in exon 1 (in patients FG, BD and ABE), deltaMet157 in exon 3 (in patient NA), and splice junction abnormality in intron 1 (in patient SY). One individual (patient KS) was found to be a compound heterozygous carrier of two different mutations, Leu55Gln in exon 1 and Arg171Ser in exon 3. Patient FG had a large pedigree with the Leu55Gln mutation in exon 1. The pedigree of this family with marital consanguinity is remarkable, and possibly due to the isolation of this family because of economic and social problems. A further 85 individuals belonging to this family were analyzed for exon 1 Leu55Gln mutations in the 5alphaSR2 gene. Forty-two of these 85 individuals (49.41%) had this alteration; 11 were homozygous (8 genetic male, 3 genetic female) and 31 heterozygous (18 genetic male, genetic female) for this mutation. It was interesting to see asymptomatic homozygous female carriers. In conclusion, according to our results and those of other Turkish patients reported by different investigators, 5aSR2 gene mutation analysis, especially for Leu55Gln in exon 1 and deltaMet157 in exon 3, must be carried out in Turkish patients with male pseudohermaphroditism. Homozygous asymptomatic female carriers must be taken into consideration in this clinical entity, especially in a closed population, because of the risk of transmitting the disease to their offspring.
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Affiliation(s)
- G Ocal
- Division of Pediatric Endocrinology and Pediatric Molecular Genetics, Ankara University, Faculty of Medicine, Turkey
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Malaspina P, Tsopanomichalou M, Duman T, Stefan M, Silvestri A, Rinaldi B, Garcia O, Giparaki M, Plata E, Kozlov AI, Barbujani G, Vernesi C, Papola F, Ciavarella G, Kovatchev D, Kerimova MG, Anagnou N, Gavrila L, Veneziano L, Akar N, Loutradis A, Michalodimitrakis EN, Terrenato L, Novelletto A. A multistep process for the dispersal of a Y chromosomal lineage in the Mediterranean area. Ann Hum Genet 2001; 65:339-49. [PMID: 11592923 DOI: 10.1017/s0003480001008727] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2001] [Indexed: 11/07/2022]
Abstract
In this work we focus on a microsatellite-defined Y-chromosomal lineage (network 1.2) identified by us and reported in previous studies, whose geographic distribution and antiquity appear to be compatible with the Neolithic spread of farmers. Here, we set network 1.2 in the Y-chromosomal phylogenetic tree, date it with respect to other lineages associated with the same movements by other authors, examine its diversity by means of tri- and tetranucleotide loci and discuss the implications in reconstructing the spread of this group of chromosomes in the Mediterranean area. Our results define a tripartite phylogeny within HG 9 (Rosser et al. 2000), with the deepest branching defined by alleles T (Haplogroup Eu10) or G (Haplogroup Eu9) at M172 (Semino et al. 2000), and a subsequent branching within Eu9 defined by network 1.2. Population distributions of HG 9 and network 1.2 show that their occurrence in the surveyed area is not due to the spread of people from a single parental population but, rather, to a process punctuated by at least two phases. Our data identify the wide area of the Balkans, Aegean and Anatolia as the possible homeland harbouring the largest variation within network 1.2. The use of recently proposed tests based on the stepwise mutation model suggests that its spread was associated to a population expansion, with a high rate of male gene flow in the Turkish-Greek area.
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Affiliation(s)
- P Malaspina
- Department of Biology, University Tor Vergata, Rome, Italy
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Akar N, Duman T, Akar E, Deda G, Sipahi T. The alpha2 Gene alleles of the platelet collagen receptor integrin alpha2 beta1 in Turkish children with cerebral infarct. Thromb Res 2001; 102:121-3. [PMID: 11323022 DOI: 10.1016/s0049-3848(01)00228-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The possible role of point mutations in the platelet integrin alpha2 beta1 gene in Turkish children with ischemic stroke was evaluated in this study. The case-control study included 44 pediatric patients with cerebral infarct (age range, 10 months to 18 years) and 96 healthy unrelated individuals. Genotyping was performed according to previously described methods. Distribution of the three haplotypes were 36.4%, 45.3%, 10.4% and 31.8%, 50.0%, 13.6% for the controls and the patients, respectively. A new fourth haplotype was found which was 7.8% and 4.5% respectively. Our data indicated that these haplotypes are not risk factors in pediatric stroke group.
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Affiliation(s)
- N Akar
- Department of Pediatric Molecular Genetics, Ankara University, Ankara, Turkey.
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Abstract
OBJECTIVES The purpose of this study was to clarify etiologic factors, prior symptoms and clinical features of isole superior cerebellar artery (SCA) territory infarcts. METHODS All data were collected from consecutive 21 patients with isole SCA infarcts involved on computerized tomography. RESULTS The risk factors including hypertension, cardiopathy and rhythm disturbances, hyperlipidemia, diabetes mellitus, abnormality in homeostasis, smoking, oral contraceptive have been identified. Headache, nausea-vomiting, vertigo, gait imbalance and diplopia were the most common complaints at onset. During the clinical course, the most common findings have been found as dysmetria and dysdiadochokinesia, dysarthria, ataxia and vertigo. Although 19 patients were improved in different degrees, 2 patients died because of cardiorespiratory arrest. Classical syndrome of SCA was only seen in 2 patients. CONCLUSION According to our findings, SCA territory infarcts have multiple risk factors, and various clinical features as well as the syndrome of SCA are usually rare and incomplete.
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Affiliation(s)
- A K Erdemoglu
- Department of Neurology, Ankara Numune State Teaching Hospital, Turkey
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Duman T, Oztürk S. Spontaneous early improvement following ischemic stroke. Stroke 1996; 27:1130. [PMID: 8650726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Duman T. Discharge planning for foreign nationals: complex, complicated. Disch Plann Update 1992; 12:3-4. [PMID: 10123063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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