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Article ; Online: Outcomes of intravenous thrombolytic therapy in cardioembolic strokes

Gönül Akdağ / Murat Seyit / Sibel Canbaz Kabay / Fatma Akkoyun / Neslihan Eşkut / Mustafa Çetiner

Journal of Surgery and Medicine, Vol 5, Iss 2, Pp 111-

2021 Volume 114

Abstract: Background/Aim: It is controversial whether intravenous recombinant tissue plasminogen activator (IV r-tPA) treatment outcomes in cardioembolic strokes differ from other types of strokes. This study aims to investigate the clinical data of patients with ... ...

Abstract	Background/Aim: It is controversial whether intravenous recombinant tissue plasminogen activator (IV r-tPA) treatment outcomes in cardioembolic strokes differ from other types of strokes. This study aims to investigate the clinical data of patients with cardioembolic and large-vessel atherosclerosis who received IV r-tPA treatment and compare and discuss the results according to the literature. Methods: The data of the patients who were admitted within the first 4.5 hours following the onset of symptoms, diagnosed with acute ischemic stroke in the Neurology clinic of Kütahya Evliya Çelebi Training and Research Hospital and underwent IV r-tPA were evaluated in this retrospective cohort study. Demographic data, clinical and functional results of patients were compared between the two groups (cardioembolic and large vessel atherosclerosis). Results: Eighty-five patients with ischemic stroke who received IV r-tPA treatment due to cardioembolism and large-vessel atherosclerosis were included in the study. There were 51 patients (60%) in the cardioembolic stroke group and 34 patients (40%) in the large vascular atherosclerotic group. There was no significant difference in terms of functional results between the groups (62.7% vs 44.1%; P=0.09). While symptomatic intracerebral hemorrhage was not detected in the large-vessel atherosclerosis group, it occurred in 3.9% of the cardioembolic stroke group. Conclusion: This study proved that functional and clinical results are similar between cardioembolic and large-vessel atherosclerosis patients who were treated with IV r-tPA treatment. Regardless of the etiology, all suitable patients with acute ischemic stroke should be treated with thrombolytic therapy.
Keywords	acute ischemic stroke ; cardioembolic stroke ; intravenous thrombolytic therapy ; Medicine ; R ; Medicine (General) ; R5-920 ; Surgery ; RD1-811
Subject code	616
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	Journal of Surgery and Medicine
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: How Does Entacapon Affect Homocysteine Levels?

Gönül Akdağ / Feriha Özer / Mithat Bedir / Özlem Çokar / Belgin Petek Balcı / Gülsün Gül

Türk Nöroloji Dergisi, Vol 27, Iss 2, Pp 145-

2021 Volume 150

Abstract: Objective: To determine homocysteine, vitamin B12, and folate levels in patients with Parkinson’s disease and to investigate the effect of entacapone use on homocysteine levels. Materials and Methods: The records of patients who were followed up in our ... ...

Abstract	Objective: To determine homocysteine, vitamin B12, and folate levels in patients with Parkinson’s disease and to investigate the effect of entacapone use on homocysteine levels. Materials and Methods: The records of patients who were followed up in our outpatient clinic between 2009 and 2010 were reviewed retrospectively. The demographic, clinical characteristics, and laboratory findings of the patients were recorded. The control group consisted of healthy subjects with similar demographic characteristics. The patients were divided into two groups according to the treatment they received. Results: The control group consisted of 22 healthy subjects (group 1), group 2 comprised 22 patients [entacapone (+)], and group 3 constitued 50 patients [entacapone (-)]. The homocysteine levels of the control group were significantly lower than the entacapone (-) and entacapone (+) groups. The vitamin B12 level of the control group was significantly higher than in the entacapone (-) group. The folate levels of the control group were significantly higher than those of the entacapone (-) group. There was no significant difference between the entacapone (-) and entacapone (+) groups in terms of homocysteine, vitamin B12, and folate levels. Conclusion: Levodopa treatment affects homocysteine levels in patients with Parkinson’s disease. The effect of levodopa + entacapone on plasma homocysteine levels should be evaluated together with basal vitamin B12 and folate levels and genetic features.
Keywords	idiopathic parkinson’s disease ; entacapone ; homocysteine ; Medicine ; R ; Neurology. Diseases of the nervous system ; RC346-429
Subject code	610
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effects of Hypoxia on the Vestibular System in Obstructive Sleep Apnea Syndrome Observed on a Video Head Impulse Test

Muhammet Fatih Topuz / Fatih Oğhan / Gönül Akdağ / Pınar Yıldız Gülhan / Onur Erdoğan / Özlem Arık / Aykut Ceyhan / Nurullah Türe / Ali Güvey

ENT Updates, Vol 11, Iss 3, Pp 148-

2021 Volume 152

Keywords	Medicine ; R ; Otorhinolaryngology ; RF1-547
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Continuing Education and Scientific Research Association (CESRA), Turkey
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Relation of Apathy to Motor and Non-motor Findings in Parkinson’s Disease

Melek Gürbüz / Gönül Akdağ / Özge Arıcı Düz / Feriha Özer / Özlem Çokar / Lütfü Hanoğlu

Haseki Tıp Bülteni, Vol 57, Iss 2, Pp 129-

2019 Volume 134

Abstract: Aim:It has been shown that motor symptoms, as well as non-motor symptoms, significantly affect the quality of life of patients with idiopathic Parkinson’s disease. In our study, the association of apathy, one of the NMS, with motor and non-motor symptoms ...

Abstract	Aim:It has been shown that motor symptoms, as well as non-motor symptoms, significantly affect the quality of life of patients with idiopathic Parkinson’s disease. In our study, the association of apathy, one of the NMS, with motor and non-motor symptoms was investigated.Methods:Patients with stage 1-3 IPH according to the Hoehn-Yahr Scale (H&Y) were included in the study. Patients who received dementia diagnosis according to the DSM IV criteria were excluded from the study. The patients were evaluated using the Unified Parkinson’s Disease Rating Scale (UPDRS), non-motor symptoms Questionnaire (NMSQ), Geriatric Depression Scale (GDS), and the revised diagnostic criteria for apathy.Results:Apathy was found in 26 of 68 patients who were included in the study. Patients with and without apathy were compared in terms of age, clinical and demographic characteristics, L-dopa equivalent doses, depression, and NMSQ scores. The group of patients with apathy consisted of nine females and 17 males and the mean age was 64.3±7.7 years. The non-apathy group included 25 females and 17 males and the mean age was 66.8±9.1 years. There was no statistically significant difference between the groups in terms of age, education, age at onset, duration of illness and L-dopa equivalent doses. The male-to-female ratio was significantly higher in the apathy group. The mean GDS and NMSQ scores in the apathy group were significantly higher than in the non-apathy group. There was a statistically significant difference between the groups in H&Y stage and total UPDRS and subscales scores. It was noteworthy that the rate of stage 3 patients was higher in the group of patients with apathy. The number of patients having bradykinesia in the apathy group and the number of patients having tremor in the group without apathy was higher.Conclusion:Our study showed that apathy, one of the non-motor symptoms, was more prominent in male gender, associated with UPDRS scores, clinical stage and bradykinesia, and accompanied by depression.
Keywords	Parkinson’s disease ; motor symptoms ; non-motor symptoms ; apathy ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors Associated with Prognosis in Patients with Guillain-Barré Syndrome

Mustafa Çetiner / Murat Seyit / Gönül Akdağ / Hayri Demirbaş / Özge Temel / Sibel Canbaz Kabay

Türk Nöroloji Dergisi, Vol 25, Iss 3, Pp 140-

2019 Volume 145

Abstract: Objective: We aimed to evaluate the demographic, clinical, laboratory and electrophysiological findings of patients with inpatient Guillain-Barré syndrome in our clinics and to investigate the effect of these parameters on the prognosis of the disease. ... ...

Abstract	Objective: We aimed to evaluate the demographic, clinical, laboratory and electrophysiological findings of patients with inpatient Guillain-Barré syndrome in our clinics and to investigate the effect of these parameters on the prognosis of the disease. Materials and Methods: Between January 2014 and April 2018, file records of patients admitted to our clinics with the diagnosis of Guillain-Barré syndrome were retrospectively reviewed. Demographic characteristics, clinical, laboratory and electrophysiological findings of the patients at the time of admission were recorded. Patients were clinically graded according to the Hughes classification at the time of admission and on the 3rd month after discharge. Results: In the study, 25 of the 51 patients were male (49%) and 26 were female (51%) and the mean age was 54.21±17.32 years. According to clinical and electrophysiologic diagnosis, 34 patients (66.7%) had acute inflammatory demyelinating polyradiculoneuropathy, 9 patients (17.6%) had acute motor axonal neuropathy, 6 patients (11.8%) had acute motor sensory axonal neuropathy and 2 patients (3.9%) had Miller Fisher syndrome. According to Hughes scoring on the 3rd month after discharge, 31 patients (60.8%) had in good prognosis (Hughes score ≤2) and 20 patients (39.2%) had in poor prognosis group (Hughes score >2). In the comparison between the two groups according to clinical, demographic, and laboratory parameters, older age (≥50), high Hughes score at admission, weakness in extremities as first complaint, the presence of complications, need for mechanical ventilation and presence of gastroenteritis as a leading infection were evaluated as prognostic factors. Conclusion: The most common variant of Guillain-Barré syndrome in our study was acute inflammatory demyelinating polyradiculoneuropathy. Older age (≥50), high Hughes score at admission, weakness in extremities as the first symptom, presence of complications, need for mechanical ventilation, and presence of gastroenteritis as a precursor infection were ...
Keywords	Guillain-Barré syndrome ; clinical findings ; prognosis ; Medicine ; R ; Neurology. Diseases of the nervous system ; RC346-429
Subject code	610 ; 616
Language	English
Publishing date	2019-09-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Epilepsy due to Intracranial Surgery

Gönül AKDAĞ / Demet İLHAN ALGIN / Ahmet MUSMUL / Oğuz Osman ERDİNÇ

Archives of Epilepsy, Vol 23, Iss 1, Pp 19-

15 Years of Experience

2017 Volume 24

Abstract: Objectives:Epidemiological studies have shown increased incidence of epilepsy in cases of brain trauma, central nervous system infection, cerebrovascular disease (CVD), and brain tumours. The etiology of epilepsy vary by age of the patient. In the ... ...

Abstract	Objectives:Epidemiological studies have shown increased incidence of epilepsy in cases of brain trauma, central nervous system infection, cerebrovascular disease (CVD), and brain tumours. The etiology of epilepsy vary by age of the patient. In the etiology of partial and secondarily generalized partial seizures in adult patients, CVD is the most common cause of acute, symptomatic seizures. Frequency of seizures is estimated to be 15% to 20% after cranial operation.Methods:Eighty-four patients who were admitted to epilepsy clinic between 2000 and 2015 with history of cranial surgery and symptomatic seizures were included in the present study.Results:Etiology conditions were 41 (48.8%) cases of space-occupying lesions (SOL), 19 (22.6%) instances of trauma, 19 (22.6%) cases of CVD, and 5 (6.0%) with ventriculoperitoneal shunt. Preoperative seizures had been observed in 17 (20.2%) of patients. No seizure was seen in 11 (13.1%) patients. Electroencephalography findings revealed focal abnormalities in 39 (46.4%) patients, and were normal in 26 (31.0%) patients. Total of 43 (51.2%) patients were treated with monotherapy, and 32 (38.1%) patients were under polytherapy.Conclusion:Most common etiological factor for patients with pre- or postoperative epilepsy who had undergone cranial surgery was SOL. Focal EEG results commonly indicate lesions. Onset of seizures may be delayed. Patients responded well to monotherapy treatment of seizures.
Keywords	antiepileptic drugs ; postsurgical epilepsy ; symptomatic epilepsy ; Neurology. Diseases of the nervous system ; RC346-429 ; Medicine ; R
Language	English
Publishing date	2017-04-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluation of Autonomic Function in Patients with Obstructive Sleep Apnea

Bengü Ertan / Demet Ilhan Algin / Gönül Akdag / Gülnur Tekgöl Uzuner / Oguz Osman Erdinç

Türk Uyku Tıbbı Dergisi, Vol 2, Iss 2, Pp 38-

2015 Volume 41

Abstract: Objective Obstructive Sleep Apnea syndrome (OSAS) is a condition in which ever-repeating obstruction of upper airway during the sleep. In the present study, we aimed to evaluate the autonomic nervous system function in patients with moderate to severe ... ...

Abstract	Objective Obstructive Sleep Apnea syndrome (OSAS) is a condition in which ever-repeating obstruction of upper airway during the sleep. In the present study, we aimed to evaluate the autonomic nervous system function in patients with moderate to severe OSAS. Materials and Methods Totally, 29 patients diagnosed with OSAS by Polysomnography (PSG) and scored moderate to severe based on American Academy of Sleep Medicine (AASM) International Scoring in Eskişehir Osmangazi University Faculty of Medicine, Department of Neurophysiology Sleep Laboratory were included the study. Thırty healthy individuals included as control group. Analyzing protocol of electrophysiological autonomic nervous system functions included Sympathetic Skin Response (SDY) for sympathetic nervous system and RR Interval Variability (RRIV) for parasympathetic nervous system both during rest and after Hyperventilation (HV). Results Patient group included 29 patients consists of 4 women (14%) and 25 men (86%) and control group included 30 healthy volunteers consists of 18 women (60%) and 12 men (40%). The mean age was 46.6±10.2 years for the patient group and 43.5±12.2 years for the control group. In patient group, 12 patients had moderate OSAS and 17 patients had severe OSAS. No statistically significant difference was found for the values of mean SDY latency, RRIV and HV-RRIV between groups (p>0.05). Conclusion In our study, significant autonomic dysfunction was not found in patients with OSAS.
Keywords	Obstructive sleep apnea syndrom ; autonomic nervous system ; RR interval variability ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2015-06-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Relationship Between Carotid Intima-media Thickness and Homosystein in Ischemic Stroke

Okan Delikan / Belgin Petek Balcı / Feriha Özer / Gönül Akdağ

Nöropsikiyatri Arşivi, Vol 49, Iss 1, Pp 53-

2012 Volume 58

Abstract: Objective: The vast majority of ischemic strokes occur due to atherosclerosis. Although the precise mechanism is unknown, high homocysteine (HM) levels are considered to play a role in the development of atherosclerosis. In this study, the relationship ... ...

Abstract	Objective: The vast majority of ischemic strokes occur due to atherosclerosis. Although the precise mechanism is unknown, high homocysteine (HM) levels are considered to play a role in the development of atherosclerosis. In this study, the relationship between high HM and carotid intima-media thickness (CIMT), as an early predictor of atherosclerosis, is evaluated in patients with ischemic stroke.Methods: Eighty-one patients diagnosed with acute ischemic cerebrovascular disease and control group of 41 healthy volunteers were evaluated prospectively. The patients underwent cranial imaging, and neurological examinations were performed. The demographic characteristics of the groups were recorded. In addition, risk factors for ischemic stroke, such as hypertension (HT), diabetes mellitus (DM) and cardiac disease were evaluated. CIMT was measured using Doppler ultrasound, and HM vitamin B12, and folate levels were recorded.Results: There was no significant difference between the groups for the presence of DM. In patients group, HT was statistically more frequent than in control group (p <0.001). In both groups, there was no relationship between HM levels and lipid profile. Similarly, there was no relationship between lipid profile and CIMT. HM was negatively correlated with folate and vitamin B12. CIMK was statistically higher in patients than in controls (p<0.001). Vitamin B12 deficiency was statistically higher in patients group (p<0.05). Conclusion: In our study, we did not find statistically significant relationship between CIMT and HM levels in ischemic stroke patients. However, according to previous literature, high HM levels are known to cause atherosclerotic vascular disease. Therefore, vitamin B12 replacement in people with high HM levels can contribute to the prevention of ischemic stroke. (Archives of Neuropsychiatry 2012; 49: 53-8)
Keywords	Ischemic stroke ; homocysteine ; carotid intima-media thickness ; Psychiatry ; RC435-571 ; Neurology. Diseases of the nervous system ; RC346-429 ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Psychiatry ; DOAJ:Medicine (General) ; DOAJ:Health Sciences ; DOAJ:Neurology
Subject code	610
Language	Turkish
Publishing date	2012-03-01T00:00:00Z
Publisher	Galenos Yayicilik
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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