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The evaluation of the cochlear aqueduct and internal acoustic canal in patients with unilateral subjective tinnitus and normal hearing
(Aves, 2023) Yılmazsoy, Yunus; Muluk, Nuray Bayar; Özdemir, Adnan; Şencan, Ziya
Objective: We investigated the relationship between idiopathic subjective tinnitus and internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal measurements by temporal magnetic resonance imaging. Methods: In this retrospective study, temporal magnetic resonance imaging sections of 25 patients (8 males and 17 females) with unilateral tinnitus and normal hearing were included. The internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal measurements and internal acoustic canal and cochlear aqueduct shape classification were determined in the ipsilateral tinnitus side and contralateral non-tinnitus side. Results: The cochlear aqueduct length and width and internal acoustic canal opening width, length, width, and area of the ipsilateral tinnitus side were not different from the contralateral side. Similarly, the vestibule area and lateral semicircular canal height and width values were not different between the ipsilateral tinnitus side and the contralateral side. The main cochlear aqueduct type was type 2 in both ipsilateral and contralateral sides. For the internal acoustic canal types, cylindrical and funnel shapes were the most common types for the ipsilateral tinnitus side and contralateral side. There were positive correlations between the internal acoustic canal and vestibule areas; cochlear aqueduct length and internal acoustic canal areas; cochlear aqueduct width and width of the lateral semicircular canal; internal acoustic canal area and length and cochlear aqueduct length; internal acoustic canal opening width and height of the lateral semicircular canal; and width of the lateral semicircular canal dimensions. In older patients, the ipsilateral internal acoustic canal area was found to be smaller. Conclusions: In idiopathic subjective tinnitus, there were no important pathologies detected in the internal acoustic canal, cochlear aqueduct, vestibule area, and lateral semicircular canal. We concluded that there are no statistically significant morphometric differences compared to the healthy side in the internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal areas detected by temporal magnetic resonance imaging in patients with unilateral subjective tinnitus and normal hearing.
Patient use of complementary and alternative medicine for psoriasis vulgaris and factors believed to trigger the disease: A multicenter cross-sectional study with 1621 patients
(Mattioli 1885, 2022) Kayıran, Melek Aslan; Karadağ, Ayşe Serap; Topal, İlteriş Oğuz; Emre, Selma; Adışen, Esra; Kılıç, Sevilay; Keskin, Nuray; Polat, Mualla
Introduction: Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. Objectives: To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. Methods: The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Results: Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Conclusions: Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians.
Analysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: A multicenter study of 1521 patients
(Springer, 2024) Erduran, Funda; Emre, Selma; Hayran, Yıldız; Adışen, Esra; Polat, Asude Kara; Üstüner, Pelin; Öztürkcan, Serap; Polat, Mualla
Methotrexate (MTX) is commonly used as first-line systemic treatment agent in psoriasis. We aimed to evaluate the clinical characteristics and treatment responses of patients with psoriasis undergoing MTX monotherapy. Data from adult patients with plaque psoriasis who received MTX monotherapy for at least 3 months between April 2012 and April 2022 were retrospectively evaluated in 19 tertiary care centers. Our study included 722 female and 799 male patients, a total of 1521 participants. The average age of the patients was 44.3 +/- 15.5 years. Mode of treatment was oral in 20.4% of patients while in 79.4% it was subcutaneous. The median treatment duration was 8 months (IQR = 5-15). The median weekly dose was 15 mg (IQR = 11-15). 1448 (95.2%) patients were taking folic acid supplementation. At week 12, 16.3% of the patients achieved PASI (Psoriasis Area and Severity Index) 90 response while at week 24, 37.3% achieved it. Logistic regression analysis for week 12 identified the following independent factors affecting PASI 90 achievement positively: median weekly MTX dose <= 15 mg (P = 0.011), subcutaneous administration (P = 0.005), no prior systemic treatment (< 0.001) and folic acid use (0.021). In logistic regression analysis for week 24; median weekly MTX dose <= 15 mg (P = 0.001), baseline PASI >= 10 (P < 0.001), no prior systemic treatment (P < 0.004), folic acid use (P = 0.001) and absence of comorbidities (P = 0.009) were determined as independent factors affecting the achievement of PASI 90. Adverse effects were observed in 38.8% of the patients, with nausea/vomiting (23.9%) and transaminase elevation (13%) being the most common. The most common reasons for interruptions (15.3%) and discontinuations (27.1%) of the treatment were patient related individual factors. The use of MTX as the first systemic treatment agent, at doses <= 15 mg/week and concurrent folic acid application are positive predictive factors for achieving the target PASI response both at weeks 12 and 24. In our study, which is one of the most comprehensive studies on MTX treatment in psoriasis, we observed that MTX is an effective and safe treatment option.
Platelet function in euthyroid patients undergoing thyroidectomy in women
(Verduci Publisher, 2013) Alçelik, Aytekin; Aktaş, Gülali; Eroglu, M.; Tosun, M.; Şavlı, Haluk; Dikbaş, Oğuz; Zeyrek, A.
BACKGROUND: Several studies have reported several platelet abnormalities in patients with sub-clinical or overt thyroid dysfunctions. The primary mechanism that affects the hemostatic balance is excess or deficiency of thyroid hormones. The different ways of thyroid gland to the platelet function are not yet clearly understood. The relationship between in the thyroid gland and platelet activation without thyroid hormones has not been studied yet. AIM: The aim of our study is to determine the platelet function in euthyroid patients undergoing thyroidectomy in females. PATIENTS AND METHODS: The study group includes 52 female euthyroid patients undergoing thyroidectomy. The control group consisted with 21 healthy euthyroid female. Platelet count (PC), platelet mass (PM), mean platelet volume (MPV), and platelet distribution width (PDW) were measured. PM was calculated by multiplying MPV and PLT. RESULTS: MPV (8.4 +/- 1.3 versus 7.9 +/- 0.8) and PDW (17.8 +/- 1 versus 17.6 +/- 0.8) values were similar between the two groups. CONCLUSIONS: Thyroid gland does not directly affect platelet activation. Accordingly, platelet abnormalities of thyroid disease can be considered to be independent of the underlying thyroid tissue. This finding suggests that association between thyroid diseases and platelet function is dependent on the status of thyroid hormones.
Postoperative pulmonary complications
(Bilimsel Tıp Publishing House, 2005) Annakkaya, Ali Nihat; Tozkoparan, Ergün; Deniz, Ömer; Bedirhan, İbrahim; Bilgiç, Hayati; Ekiz, Kudret; Demirci, Necmettin
The aim of this study was to evaluate postoperative pulmonary complications of patients undergoing operations in 10 different surgery clinics between November 2002 and June 2003. A total of 158 patients, 66 (41.8%) females and 92 males (58.2%), whose mean age was 53 +/- 18 (20-102) were included in the study. The study was mainly based on the postoperative consultations requested by these clinics. The most common causes of consultation requests were dyspnea (31% [49/158]) and abnormal radiological findings (17.7% [28/158]). Hypoxemia was detected in 36.1% (57) of the patients. Chest X rays of 38% (60) of patients were found as normal. Pleural effusion was the most common radiological abnormality (17.1% [27/158]). Thoracic computed tomography was performed in 28 (17.7%) patients, ventilation perfusion lung scan was performed in 16 (10.1%) patients. Respiratory system examination was normal in 13.3% (21) of patients while postoperative pulmonary complications were detected in 64.6% (102) of patients. The most common respiratory complications observed postoperatively were diaphragmatic dysfunction 20.6% (21/102), worsening of obstructive lung disease (bronchospasm) 18.6% (19), atelectasis 17.6% (18) and pneumonia 14.7% (15) respectively. Upper abdominal and thoracic surgeries had significantly higher rates of prolonged mechanical ventilation and pleural effusion complications than other surgeries (p<0.05).
When did the trauma happen: Before or after death?
(Elsevier Sci Ireland Ltd, 2003) Büken, Bora; Üstündag, N.; Büken, Erhan; Mayda, AS
The role of the multi-inflammatory index as a novel predictor of hospital mortality in acute ischemic stroke
(Springernature, 2023) Demirel, Mustafa Enes; Türel, Canan Akunal
Background and objective Ischemic strokes account for the majority of all strokes. The severity of an acute ischemic stroke (AIS) can be estimated with the help of a number of different scoring systems. However, there is a need for bedside tests that will support the clinical diagnosis and thus help predict the severity of stroke. The research on the multi-inflammatory index (MII), which is calculated using hemogram parameters, has shown immense promise. In light of this, the aim of this study was to establish the association between MII and the severity of AIS. Methods The study included 452 ischemic stroke patients over the age of 18 years who presented to the hospital within 72 hours of the onset of symptoms. Demographic information such as patient age and gender, hemogram parameters, ratios, indices, hospitalization, and mortality status were all recorded. The demographic data, hemogram parameters, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and C-reactive protein (CRP)/lymphocyte ratio (CLR), and MII 1, 2, and 3 were compared between surviving and deceased patients. Results The MII-1, MII-2, and MII-3 index values were determined to be significantly low in the patients with Glasgow Coma Scale (GCS) scores of 13-15 compared to those with GCS scores <= 8, and in patients with National Institutes of Health Stroke Scale (NIHSS) score of 1-4 compared to those with scores of 5-14, 15-20, and >= 21. The NLR, CLR, PLR, MII-1, MII-2, and MII-3 index values were significantly higher in the non survivors (PLR: p=0.004, all other values: p<0.001). The performances of multiple models developed for the mortality cut-off points were evaluated. Together with other factors, Model 1 included the MII-1, Model 2 the MII-2, and Model 3 the MII-3. Although there was no significant difference between the AUC values of the models, the highest sensitivity rate was reached with Model 2 (74.48%), and the highest specificity rate with Model 3 (90.62%). Conclusion Based on our findings, MII is a simple and practical biomarker that can be easily obtained from NLR, PLR, and CRP, and can help in the early detection of poor prognosis in AIS. NLR was found to be superior to PLR and CLR in distinguishing fatal AIS cases.
Ovaryan hiperstimulasyon sendromunun ultrasonografik özellikleri: Olgu sunumu
(Duzce Univ, 2014) Canan, Arzu; Altunrende, Şerife Sevil
Ovarian hyperstimulation syndrom is a serious entity that develops during in vitro fertilization (IVF) treatment. It can be varying from mild to severe clinical manifestations. To diagnose and to differentiate from the other ovarian pathologies, radiologic examinations, especially ultrasonography is very sufficient. Therefore, radiologist should be aware of this syndrome because of its increased frequency recently. We aimed to report an OHSS case who admitted to our clinic and discuss its radiological features.
Habituation and dishabituation of P300
(Lippincott Williams & Wilkins, 2006) Keçeci, Hulusi; Değirmenci, Yıldız; Atakay, Selçuk
Objective: We aimed to see the consequences of habituation and posthabituation by means of repeatedly measuring the effects over a longer period. Method: The study was performed on 27 healthy volunteers. The event-related potentials were recorded from the Fz, the Cz, and the Pz electrode sites. The rare tone-frequent tone probability ratio was 20%. All subjects were asked to press a button when they heard a rare tone. The test was continued until 20 artifact-free rare tones were averaged, which was accepted as I trial block. After 10 trial blocks were obtained in a sequential manner, the test was completed. Result: This study has indicated that P300 amplitudes decrease with repeated stimulations, that is, there is a habituation period. As the test continues, the speed of amplitude decrease slows down and after a while it even starts to increase: that is, a dishabituation occurs. Conclusions: It is very likely that this habituation relates to a period of learning and dishabituation relates to a period of mental fatigue. In these processes, changes of amplitude and latency values reflect changes in amount of neuronal activation.
Oxytocin and social cognition in patients with schizophrenia: Comparison with healthy siblings and healthy controls
(Taylor & Francis Ltd, 2018) Balıkcı, Kuzeymen; Aydın, Orkun; Taş, Cumhur; Danacı, Ayşen Esen
Objective: There is substantial evidence from animal research indicating a key role of the neuropeptide oxytocin (OT) in the regulation of complex social cognition and behaviour. Social cognition is indispensable for social relationships for the whole of human society, and numerous studies have shown impaired social cognition in schizophrenia (SCH) and unaffected first-degree relatives also seem to be impaired, albeit to a lesser extent. Because of that, this study focuses on the role of OT in social cognition in SCH. Methods: Twenty-seven patients with SCH, 27 healthy siblings (HS) of these patients, and 27 psychologically healthy controls (HC) were included in the study. Blood samples were collected through a peripheral venous catheter. Differences in the socio-demographical and WAIS-R were tested by chi-square and one way-ANOVA. To explore the relationships between social cognition and blood samples we performed Pearson correlations. MANCOVA (gender and WAIS-R as covariates) test was performed to investigate the effect of gender on blood levels of OT and WAIS-R on social cognition. Results: Significant differences were found in neurocognitive and social cognitive capacity but not in OT levels. In the healthy control group, there was a positive correlation between blood OT levels and RMET. There is a statistically significant difference between high and low OT groups with regard to social cognition in all subtests of the RMET. Conclusions: In the current study, we found that patients had deficits in social cognition and neurocognition. Lower endogenous OT levels are also predictive for poor social cognitive functioning in HS and HC.
Optic neuropathy related to hydrogen peroxide inhalation
(Lippincott Williams & Wilkins, 2007) Domaç, Füsun M.; Koçer, Abdülkadir; Tanıdır, Remzi
Optic neuropathy related to toxins is a complex, multifactorial disease potentially affecting individuals of all ages. We report a case of presumed toxic optic neuropathy secondary to H2O2 exposure. This has not been previously reported, and the temporal relationship of the exposure to the optic neuropathy is compelling, although not definite, evidence of a causal relationship.
The effect of diet on emotional eating behaviours in individuals
(Termedia Publishing House Ltd, 2023) Güneş, Nurcan Akbaş; Gücük, Sebahat; Özsarı, Süleyman; Özdemir, Çağla; Yüzbaşıoğlu, Sema
Background. Emotional eating is reported to amount to at least 60% in overweight or obese individuals. Emotional eating is a eating behaviour disorder that describes the tendency to binge in response to positive or negative emotions. Reactions to these emotional situations vary from person to person. In addition to its independent effect on weight gain, emotional eating is also known to be associated with low weight loss. Objectives. In this study, we aimed to detect the differences in emotional eating behaviours between dieters and non-dieters and emotional eating behaviours in individuals who diet frequently. Material and methods. A socio-demographic form consisting of 14 questions and the Dutch Eating Behaviour Scale (DEBQ) consisting of 33 questions were applied to the patients. When the patients who were followed up came for control one month later, the DEBQ scale was repeated. Results. When emotional eating behaviours, restrictive eating behaviours and external eating behaviours were evaluated between the patient and control groups, a significant relationship was found in both groups (p = 0.000, p = 0.000, p = 0.001). It was observed that the total scores of the DEBQ scale and external eating behaviours were higher in those who followed 3 or more diets (p = 0.001, p = 0.001). Conclusions. We found that emotional eating behaviours were higher in dieters than in those who did not diet. Emotional eating be-haviour was found to be higher in those who diet frequently.
Effect of sodium glucose Co-transporter 2 inhibitor use on anthropometric measurements and blood glucose in obese and non-obese type 2 diabetic patients
(Elsevier, 2024) Dedemen, Büşra; Duman, Tuba Taslamacıoğlu; Dedemen, Metin Mert; Aktaş, Gülali
Background: Obesity and type 2 diabetes mellitus are closely associated with each other and require careful management. This study aimed to assess the impact of sodium-glucose co-transporter 2 (SGLT2) inhibitors on glycemic control and body composition in diabetic patients, stratified by obesity status. Methods: We enrolled patients diagnosed with type 2 diabetes mellitus, categorized as obese (BMI>30) or non-obese (BMI<30), from our outpatient clinic. SGLT2 inhibitor therapy was added to their existing treatment regimen without altering dietary habits or exercise routines. Anthropometric measurements and laboratory parameters were compared between baseline and the third month of treatment. Results: The study included 40 participants, evenly split between obese and non-obese groups. At the third-month follow-up, significant reductions were observed in BMI, weight, waist and hip circumference, and body fat percentage across both groups (p < 0.001). Conversely, muscle mass percentage significantly increased (p < 0.001). Additionally, there were statistically significant decreases in HbA1c, glucose, CRP, ALT, LDL, and total cholesterol levels from baseline to the third month of treatment (p < 0.001 for HbA1c and glucose; p = 0.009, p = 0.022, p = 0.003, and p = 0.021, respectively, for CRP, ALT, LDL, and total cholesterol). Conclusions: The findings of the present study suggest that SGLT2 inhibitors may offer substantial benefits, particularly in the management of obesity-related type 2 diabetes. (c) 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
The non-HDL-C/HDL-C ratio is a strong and independent predictor of the no-reflow phenomenon in patients with ST-elevation myocardial infarction
(Taylor & Francis Ltd, 2024) Toprak, Kenan; Kaplangöray, Mustafa; Akyol, Selahattin; İnanır, Mehmet; Memioğlu, Tolga; Taşcanov, Mustafa Beğenç; Altıparmak, İbrahim Halil
Background: No-reflow (NR) is the inability to achieve adequate myocardial perfusion despite successful restoration of attegrade blood flow in the infarct-related artery after primary percutaneous coronary intervention. The non-HDL-C/HDL-C ratio has been shown to be superior to conventional lipid markers in predicting most cardiovascular diseases. In this study, we wanted to reveal the predictive value of the NR by comparing the Non-HDL-C/HDL-C ratio with traditional and non-traditional lipid markers in patients who underwent primary percutaneous coronary intervention (pPCI) due to ST-elevation myocardial infarction (STEMI).Methods: A total of 1284 consecutive patients who underwent pPCI for STEMI were included in this study. Traditional lipid profiles were detected and non-traditional lipid indices were calculated. Patients were classified as groups with and without NR and compared in terms of lipid profiles.Results: No-reflow was seen in 18.8% of the patients. SYNTAX score, maximal stent length, high thrombus burden, atherogenic index of plasma and non-HDL-C/HDL-C ratio were determined as independent predictors for NR (p < 0.05, for all). The non-HDL-C/HDL-C ratio predicts the development of NR in STEMI patients with 71% sensitivity and 67% specificity at the best cut-off value. In ROC curve analysis, the non-HDL-C/HDL-C ratio was superior to traditional and non-traditional lipid markers in predicting NR (p < 0.05, for all).Conclusion: The non-HDL-C/HDL-C ratio can be a strong and independent predictor of NR in STEMI patients and and therefore non-HDL-C/HDL-C ratio may be a useful lipid-based biomarker that can be used in clinical practice to improve the accuracy of risk assessment in patients with STEMI.
Monocyte-to-HDL-cholesterol ratio as a prognostic marker in Covid-19
(Jpms Publ, 2024) Ergenç, Hasan; Ergenç, Zeynep; Gözdaş, Hasan Tahsin; Ocak, Özlem Karaca; İnce, Özgür; Bal, Tayibe
Background: There is an urgent need for mortality predictors for COVID-19 so that clinicians can diagnose severe cases and triage them as soon as possible. Many studies have suggested using hematologic markers to predict mortality and severity of COVID-19 disease. This study investigates the use of monocyte-to-high density lipoprotein cholesterol ratio (MHR) as a predictive marker for COVID-19 severity and mortality. Methods: This retrospective cross-sectional study was performed on 81 PCR-confirmed COVID-19 patients between 25 March 2020 to 26 June 2020. Patients were classified into two presentation categories: the non-severe group (n=37) and the severe group (n=44). Patients in the severe group were also divided into two subgroups: severe survivors (n=14) and severe non-survivors (n=30). In the receiver operating characteristic (ROC) analysis, optimal cut -off values of the monocyte count, high -density lipoprotein cholesterol (HDL-C), and MHR were calculated for the differentiation of severe and non-severe COVID-19 patients, as well as survivors and non-survivors. Results: A total of 81 patients, 29 (35.8%) males and 52 (64.2) females, with a median age of 71 (IQR 63-81) years. Both HDL-C and MHR showed a reasonable ability to distinguish severe disease from non-severe disease, while MHR had a higher area under curve (AUC) than HDL-C (0.799, 95%CI 0.704-0.894, p < 0.001 vs 0.734, 95% Cl 0.626-0.843, p < 0.001). Only MHR could distinguish survivors from non-survivors with an ROC AUC of 0.735 (95%Cl 0.619-0.850). The optimal cut -off values of MHR for predicting severe disease were 0.0061 (sensitivity: 66% and specificity: 66%) and 0.0066 (sensitivity: 70% and specificity: 62%) for predicting mortality. The optimal cut -off value of MHR for predicting severe disease was 0.0061 (sensitivity: 66% and specificity: 66%), and it was 0.0066 for predicting mortality among patients with severe disease (sensitivity: 70% and specificity: 62%). Conclusion: Our results showed that MHR was observed to be able to distinguish severe COVID-19 patients from non-severe patients as well as survivors from non-survivors.
Comparison of nursing home-acquired pneumonia and community-acquired pneumonia and evaluation of factors predicting mortality
(Erciyes Univ Sch Medicine, 2022) Yencilek, Halil İlker; Şener, Alp; Özhasenekler, Ayhan; Ergin, Mehmet; Günaydın, Gül Pamukcu; Gökhan, Servan; Ere, Özcan
Objective: The number of admissions to the emergency department (ED) of elderly patients who reside in nursing homes with a diagnosis of pneumonia continues to grow. This study was designed to assess factors that predicted mortality in the patient group defined as those with nursing home-acquired pneumonia (NHAP). Materials and Methods: This was a prospective, observational study conducted in a hospital ED. The data of nursing home patients admitted to the ED with a pneumonia presentation (NHAP) were compared with those of patients with community-acquired pneumonia (CAP). Factors that predicted mortality in the NHAP group were analyzed. SPSS for Windows, Version 16.0 software (SPSS Inc., Chicago, IL, USA) was used to perform the statistical analysis. Results: A total of 98 patients >18 years of age, 36 of whom were NHAP patients, were included in the research. The risk level and rates of intensive care admission and mortality were significantly higher in the NHAP group (p<0.05), and the thiol level, an antioxidant parameter, was lower in the NHAP group than that of the CAP group (p<0.001). Evaluation of the NHAP group alone revealed a higher mortality rate in patients with congestive heart failure, those hospitalized in intensive care, and those with high risk scores (p<0.05). The shock index (SI) value was found to be an independent predictor of mortality in the NHAP group. The study results indicated that each 0.1 unit increase in the Si increased mortality 3.637 times (95% confidence interval: 1.024-12.921) (p=0.046). Conclusion: The findings suggest that the SI could serve as a valuable marker for predicting mortality in NHAP patients.
Recurring disease activity in relapsing remitting multiple sclerosis: The multicenter RDA-RMS study
(Elsevier Sci Ltd, 2024) Tunç, Abdulkadir; Yetkin, Mehmet Fatih; Seferoğlu, Meral; İnanç, Yılmaz; Sıvacı, Ali Özhan; Türkoğlu, Şule Aydın; Baydar, Caner
Background: This study investigates the gap in understanding the dynamics of recurring disease activity (RDA) in RRMS patients after fingolimod (FGL) treatment discontinuation. The aim is to investigate RDA in RRMS patients after stopping FGL, aiming to improve management and comprehension of disease progression post-treatment. Methods: In this multicenter, retrospective study, data from 172 of 944 RRMS patients aged 18-55, across nine centers in Turkey, who discontinued FGL treatment, were analyzed. The collected data included EDSS scores, annualized relapse rates (ARR), lymphocyte counts, and MRI findings, with follow-up assessments conducted at 6 months, 1 year, and up to 2 years. Results: RDA was observed in 31.9 % of patients, with incidences of rebound and reactivation at 20.3 % and 11.6 %, respectively. Factors like younger age, longer treatment duration, lower lymphocyte counts, and higher lesion burden increased RDA risk. Notably, 52.9 % of pregnant patients experienced RDA (16.4 % of the overall RDA group), with rebound occurring in six and reactivation in three. Patients with RDA had longer medication-free intervals and increased ARR. Discontinuation reasons varied, with disease progression linked to a lower RDA risk. Conclusion: Findings highlight the necessity for personalized management and vigilant monitoring after FGL discontinuation in RRMS patients, offering critical insights into RDA risk factors, and the complex interplay between treatment cessation, pregnancy, and disease progression.
Is increased activator protein 1 in cerebrospinal fluid as a potential biomarker that distinguishes idiopathic intracranial from sclerosis?
(Aepress Sro, 2024) Karabörk, Şeyda; Çelik, Hümeyra; Dursun, Ali Doğan; Ankaralı, Handan; Türkoğlu, Şule Aydın
OBJECTIVES: To distinguish whether idiopathic intracranial hypertension (IIH) is a condition predisposing to multiple sclerosis (MS) or an isolated disease, the current gene transcription factor Activator Protein -1 (AP -1) was evaluated with its potential to differentiate both diseases. BACKGROUND: The aim of this study was to investigate the use of AP -1 as biomarkers for the discrimination of IIH and MS. METHODS: AP -1, TNF-alpha, and IL -6 protein values in the CSF of the cases were evaluated by the ELISA method. The numerical measures of the groups and the ability of AP -1 to distinguish the groups were analyzed with the ROC curve. RESULTS: There was no difference between the groups in CSF TNF-alpha, IL -6, CSF, and serum biochemistry analyses. However, it was determined that the AP -1 concentration (pg/ml) was significantly higher in the IIH group, the sensitivity of AP -1 in separating those with IIH was 75%, and the specificity in separating those with MS was 60% in those with an AP -1 concentration of 606.5 and above. CONCLUSION: According to our results, the fact that CSF TNF-alpha and IL -6 values did not differ in IIH compared to MS revealed that IIH could not methodologically control MS, and AP -1 was a supportive parameter in differentiating both diseases (Tab. 2, Fig. 1, Ref. 31) . Text in PDF www.elis.sk
Evaluation of optic nerve sheath complex by magnetic resonance imaging in patients with idiopathic normal pressure hydrocephalus
(Asean Neurological Assoc, 2023) Yılmazsoy, Yunus; Özdemir, Adnan; Arslan, Serdar
Background: We aimed to evaluate the optic nerve and optic nerve sheath diameter of patients with idiopathic normal pressure hydrocephalus with magnetic resonance imaging and to compare with the normal population. Methods: Magnetic resonance images and clinical records of the patients were retrospectively evaluated between 01.01.2015 and 01.01.2020. Twenty one patients in the normal pressure hydrocephalus group and 47 patients in the control group were included. Measurements were performed from the images obtained by creating multiplanar reconstructions from thin-slice Fast Spin Echo T2-weighted images. Measurements were made of optic nerve from the 3 mm posterior to the optic globe, on the plane which is oriented perpendicular to the nerve. Results: There was no difference between the two groups in terms of optic nerve diameters. Optic nerve sheath diameters are significantly higher in the normal pressure hydrocephalus group (p<0.0001). Conclusion: Morphological analysis of the optic nerve sheath complex which contains cerebrospinal fluid will contribute to the diagnosis and understanding chronic effects of normal pressure hydrocephalus, a disease in which changes in brain compliance and cerebrospinal fluid absorption are suspected in its etiology.
Comparative evaluation of intermountain risk score with Mehran risk score for risk estimation of contrast-induced nephropathy and short-term mortality in ST-segment elevation myocardial infarction patients
(Sage Publications Inc, 2023) Toprak, Kenan; Kaplangöray, Mustafa; Memioğlu, Tolga; İnanir, Mehmet; Ermiş, Mehmet Fatih; Toprak, İbrahim Halil; Acar, Osman
Contrast-induced nephropathy (CIN) has become one of the most important causes of in-hospital acute renal failure with the increasing use of contrast-mediated imaging tools. This significantly increases the morbidity and mortality of the affected subjects and causes a financial burden on the health system. In this context, prediction of CIN is important and some risk scores have been developed to predict CIN. The most frequently used and popular among these is the Mehran Score (MS), which is based on a number of hemodynamic and metabolic parameters. The Intermountain Risk Score (IMRS) is a recently developed risk score that highly predicts short-term mortality based on common laboratory parameters, and many parameters of this risk score have been found to be closely associated with CIN. In this context, we aimed to compare MS and IMRS in terms of CIN and short-term mortality estimation. The study included 931 patients who underwent percutaneous coronary intervention. CIN developed in 21.5% of patients. Both MS and IMRS independently predicted CIN. In receiver operating characteristic analysis, IMRS was found to be non-inferior to MS in predicting CIN and IMRS was superior to MS in predicting short-term mortality. IMRS and MS were independently associated with short-term mortality.

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