Browsing by Author "Giray, Semih"

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Creutzfeldt-Jakob disease presented with dizziness, weakness and neuropsychiatric symptoms: 2 Case Reports
(2015) Inanc, Yusuf; Arlier, Zulfikar; Inanc, Yilmaz; Geyik, Sirma; Giray, Semih; Kocaturk, Ozcan
Creutzfeldt-Jakob disease (CJD) is among very rare, progressive, untreatable, neurodegenerative prion diseases. While the incidence is reported as 1/1000000 years in European countries, sporadic cases are rarely presented in Turkey. Clinical findings are in the form of rapid progressive dementia, myoclonus, cerebellar, pyramidal and extra pyramidal symptoms. Definitive diagnosis is established by histopathological examination. Our case is a 64-year-old male and 70-year-old female patients admitted with dizziness emerged as sub-acute weakness, nausea, vomiting, insomnia, imbalance and additional neuropsychiatric complaints. Focal activity slowness and common periodic sharp wave activities were observed in EEG. CJD was considered because bilateral symmetrical diffusion limitation was observed at both sides in the basal ganglia level in cranial diffusion MRI's and 14-3-3 protein was resulted as positive in CSF examinations. CJD, which is a very rare disease in patients presenting with progressive neuropsychiatric symptoms and seizure, is one of the diagnosis to be considered and we wanted to emphasize that there is no treatment for it and preventive measures should be taken.
Demographic Characteristics of Strokes Types in Sanliurfa
(2015) Inanc, Yusuf; Ay, Halil; Inanc, Yilmaz; Arlier, Zulfikar; Kocaturk, Ozcan; Kocaturk, Mehtap; Giray, Semih; Kamisli, Suat
Aim: Sanliurfa training and research hospital for diagnosis and treatment of patients with stroke admitted demographic features planned. We aimed to study demographic feature of stroke patient who admitted to Sanliurfa training and research hospital for diagnosis and treatment. Material and Method: 01/10/2011 and 01/9/2012, ischemic and hemorrhagic brain training and research hospital in Sanliurfa vascular disease diagnosis and treatment without any exclusion criteria, patient sequential 454 retrospectively. Results: 366'si 88 were ischemic, hemorrhagic stroke. 54.6% by sex male,% 45.4 were women. Average age: 67.86 di.56.3% radiologically roaming the front circulation infarct brain infarct% found the rear 23.2. Hospital stay duration: 9.27 day.. Hemorrhagic stroke was longer this Sura in the group. Mortality rate 4.6% in all in packaging (21 patients), ischemic in boots in 1.9% (7 patients), hemorrhagic of boots were found at 15.9% (14 patients). Discussion: our study of Sanliurfa province stroke data in terms of the region together, although a portion of their valuable results. In the summer, the ischemic stroke incidence is higher.
Diffusion MR Imaging in Sporadic Creutzfeldt-Jakob Disease
(2014) Pekoz, Burcak Cakir; Alkan, Ozlem; Giray, Semih; Demir, Senay; Altinkaya, Naime; 0000-0001-7526-3460; 0000-0003-1348-8167; 0000-0002-4209-9075; 0000-0002-0722-3181; AAM-4169-2021; AAM-5169-2021; AAK-9310-2021; AAH-1091-2020
Creutzfeldt-Jakob disease (CJD) is a rare dementing disease and is thought to caused by a prion. It is characterized by rapidly progressive dementia, ataxia, myoclonus, akineticmutism and eventual death. Brain biopsy or autopsy is required for a definitive diagnosis of CJD. Diffusion-weighted imaging became an important tool for early diagnosis of CJD because of the high sensitivity. We present 59-year-old female patient diagnosed as sporadic CJD with typical MR imagings.
Does Stroke Etiology Play A Role in Predicting Outcome of Acute Stroke Patients Who Underwent Endovascular Treatment With Stent Retrievers?
(2017) Giray, Semih; Ozdemir, Ozcan; Bas, Demet F.; Inanc, Yusuf; Arlier, Zulfikar; Kocaturk, Ozcan; 28017193
Aims: The goal of the study was to identify whether the stroke etiology play a role in the recanalization and outcome of patients who underwent mechanical thrombectomy with stent retrievers. Methods and results: A retrospective analysis of a prospectively collected database included consecutive patients treated with stent retrievers. We included patients with cardioembolic stroke and large vessel atherosclerotic disease and compared risk factors for stroke, baseline NIHSS and Alberta Stroke Program Early CT scores (ASPECTS), stroke outcome, recanalization rate, onset-to-recanalization, onset-to-groin puncture time and the procedural time between two groups. Male sex was statistically more common in patients with large vessel atherosclerotic disease. Mean time from symptom onset- to the achievement of recanalization in patients with LVAD was 242 +/- 72.4 compared with cardioembolic stroke patients (301 +/- 70.7; p = 0.014). Time for groin puncture to recanalization was longer in patients with cardioembolic stroke compared to LVAD group (97.5 +/- 44.3 vs 58.2 +/- 21.8; p = 0.002). Time for microcatheter to successful recanalization or procedural termination was longer in patients with cardioembolic stroke compared to LVAD group (63.6 +/- 30.2 vs 34.2 +/- 19.4; p < 0.001) with cardioembolic stroke had significantly worse long-term outcome (mRS 3-6) compared to those with LVAD (60.6% vs 26.3%; p = 0.036). Conclusion: Stroke etiology may play a role in the outcome of acute stroke patients who underwent endovascular stroke therapy. Cardioembolic strokes may be more resistant to endovascular acute stroke treatment. (C) 2016 Elsevier B.V. All rights reserved.
Effects of Enteral Protein Supplements on Nutritional Status and Clinical Outcome in Unconscious Elderly Malnourished Patients
(2014) Gulsen Atalay, Betul; Yagmur, Cahide; Nursal, Tarik; Atalay, Hakan; Sezgin, Nurzen; Giray, Semih; Selcuk, Haldun; https://orcid.org/0000-0002-0722-3181; https://orcid.org/0000-0002-8445-6413; IQV-1169-2023; AAH-1091-2020; AAJ-6976-2021
Aim: Unconscious malnourished patients have reduced serum proteins. Enteral protein supplements may improve their nutritional status and clinical outcome. Our aim for the present study was to determine the effect on nutritional status and patient prognosis of enteral protein supplementation in tube-fed hospitalised unconscious elderly malnourished patients. Methods: In total, 20 patients were fed a standard enteral nutrition formula during the four-day adaptation period. The study group (n = 10) received an enteral protein supplement (2 g/kg/day protein) and the control group (n = 10) received only standard enteral nutrition (1 g/kg/day protein) during the 12-day study period. Nutritional status and clinical outcome were assessed. Results: No difference was observed between the groups with regard to biochemical, inflammatory parameters, anthropometric measurements or nitrogen balance (P > 0.05). Triceps and subscapular skinfold thickness mean levels were elevated in the study group at the end of the study compared with the beginning of the study (P < 0.05). No significant difference was observed between the groups with regard to complications or mortality rate (P > 0.05). Conclusions: In the present study, the use of enteral protein support (EPS) in unconscious malnourished patients provided some advantages in the early stages of medical treatment. Triceps skinfold thickness and subscapular skinfold thickness mean levels were increased significantly in our study group. Although there was no significant difference, serum insulin-growth factor, retinol-binding protein and prealbumin mean values showed a tendency to increase in the study group at the end of the study. We believe that further research is required to determine the effects of EPS on these values in malnourished elderly patients.
Hypertension Alters Phosphorylation of VASP In Brain Endothelial Cells
(2015) Arlier, Zulfikar; Basar, Murat; Kocamaz, Erdogan; Kiraz, Kemal; Tanriover, Gamze; Kocer, Gunnur; Arlier, Sefa; Giray, Semih; Nasircilar, Scher; Gunduz, Filiz; Senturk, Umit K.; Dernir, Necdet; 0000-0003-2645-648X; 24894047; ACE-7635-2022
Hypertension impairs cerebral vascular function. Vasodilator-stimulated phosphoprotein (VASP) mediates active reorganization of the cytoskeleton via membrane ruffling, aggregation and tethering of actin filaments. VASP regulation of endothelial barrier function has been demonstrated by studies using VASP(-/-) animals under conditions associated with tissue hypoxia. We hypothesize that hypertension regulates VASP expression and/or phosphorylation in endothelial cells, thereby contributing to dysfunction in the cerebral vasculature. Because exercise has direct and indirect salutary effects on vascular systems that have been damaged by hypertension, we also investigated the effect of exercise on maintenance of VASP expression and/or phosphorylation. We used imnnunohistochemistry, Western blotting and immunocytochemistry to examine the effect of hypertension on VASP expression and phosphorylation in brain endothelial cells in normotensive [Wistar-Kyoto (WKY)] and spontaneously hypertensive (SH) rats under normal and exercise conditions. In addition, we analyzed VASP regulation in normoxia- and hypoxia-induced endothelial cells. Brain endothelial cells exhibited significantly lower VASP immunoreactivity and phosphorylation at the Ser157 residue in SHR versus WKY rats. Exercise reversed hypertension-induced alterations in VASP phosphorylation. Western blotting and immunocytochemistry indicated reduction in VASP phosphorylation in hypoxic versus normoxic endothelial cells. These results suggest that diminished VASP expression and/or Ser157 phosphorylation mediates endothelial changes associated with hypertension and exercise may normalize these changes, at least in part, by restoring VASP phosphorylation.
Parathyroid Hormone and Ischemic Cerebrovascular Event
(2019) Altay, Hakan; Altin, Cihan; Coner, Ali; Muderrisoglu, Haldun; Giray, Semih; 0000-0002-9635-6313; 0000-0002-0722-3181; 30806331; AAG-8233-2020; AAH-1091-2020
Background: Increased parathyroid hormone (PTH) level is associated with coronary artery disease, hypertension and left ventricular hypertrophy which are all predisposing factors for the ischemic cerebrovascular event ( ICVE). Carotid intima-media thickness (CIMT) and aortic distensibility are the two early, subclinical predictors of atherosclerosis. The relation of PTH with CIMT and aortic distensibility in patients with ICVE has not been previously studied. Objective: Our aim was to study the relationship of PTH levels with aortic distensibility and CIMT in patients with ICVE. Methods: Sixty-four ICVE patients and 50 control group were enrolled in the study. PTH levels, aortic distensibility and CIMT were measured in all individuals. Results: PTH levels were significantly higher in ICVE patients than in the controls (60.1 +/- 21.6 vs. 52.3 +/- 6.2 pg/ml) (p=0. 008). PTH levels were found to be inversely correlated with aortic distensibility (r= -0. 420, p=0.001) and positively correlated with CIMT ( r:0, 285, p=0,002). Conclusion: The present study shows that PTH levels are increased in patients with acute ischemic cerebrovascular event compared to the control group. It also demonstrates that PTH levels are inversely related to aortic distensibility of ascending aorta and positively associated with CIMT.
Real World Data Estimation: Management and Cost-analysis of Stroke in Tertiary Hospitals in Turkey and the Impact of Co-morbid Malnutrition
(2016) Arsava, Ethem Murat; Ozcagli, Tahsin Gokcem; Berktas, Mehmet; Giray, Semih; Guler, Ayse; Gungor, Levent; Ozdemir, Ozcan; Uluc, Kayihan; Yaka, Erdem; Yesilot, Nilufer; https://orcid.org/0000-0002-0722-3181; AAH-1091-2020
Objective: To evaluate the management and cost analysis of first-ever stroke patients in Turkey and determine the impact of comorbid malnutrition. Methods: This study was based on expert's view on the management and cost analysis of stroke patients with or without malnutrition via standardized questionnaire forms filled by experts according to their daily clinical practice. Cost items were related to medical treatment, healthcare resources utilization, tests, consultations and complications. Per admission and total annual direct medical costs were calculated with respect to co-morbid malnutrition. Results: Malnutrition was evident in 7.8(3.6)% [mean(standard error of mean; SEM)] of patients at admission; an additional 7.1(4.8)% and 0.9(0.6)% patients developed malnutrition during Neuro-ICU and stroke unit hospitalization, respectively. Length of hospital stay (LOS) was almost 2-fold in patients with malnutrition (P<0.01 for all hospital units). During the 1-year follow-up period a mean(SEM) of 93.8(15.4)% with and 43.3(3.7)% without malnutrition were expected to experience at least 1 complication. The mean (SEM) per patient annual cost of stroke was US$5201(740) in patients with malnutrition and US$3619(614) in patients without malnutrition, while the corresponding figures for per admission were US$3061(513) and US$1958(372), respectively. Conclusions: In conclusion, our findings revealed that management of stroke and its complications have a relatively high burden on the Turkish health reimbursement system. Furthermore, co-morbid malnutrition, being not uncommonly encountered, increased the overall costs and was associated with longer LOS and higher rate of expected complications during 1-year follow up.
Therapeutic Plasma Exchange in Neurologic Diseases: An Experience with 91 Patients in Seven Years
(2014) Karaca, Sibel; Kozanoglu, Ilknur; Karakurum Goksel, Basak; Karatas, Mehmet; Tan, Meliha; Yerdelen, V. Deniz; Giray, Semih; Artier, Zulfikar
Introduction: In this study, we report the results of our experience of therapeutic plasma exchange (TPE) for neuroimmunologic disorders performed at our hospital over a seven-year period. Methods: We retrospectively reviewed the medical records of 91 patients (53 male, 38 female) who had been treated at our center with TPE. Results: 60 patients with Guillain-BarrS syndrome (GBS), 23 with myasthenia gravis (MG), 4 with chronic inflammatory demyelinating polyneuropathy (CIDP) and 1 patient each with polymyositis, septic encephalopathy, acute disseminated encephalomyelitis (ADEM) and Opsoclonus-Myoclonus syndrome (OMS) received TPE. 26.7% of GBS patient's made complete recovery, 61.7% had partial recovery and 11.7% patients died due to respiratory failure. Despite our best efforts and effective TPE treatments, 13.4% of MG patients deceased, however, 78% had full recovery. Three patients with CIDP were discharged with full and 1 patient with partial recovery. The patient with ADEM had partial recovery with TPE at first, but deceased 2 months later due to pneumonia-related respiratory insufficiency. While, patient with polymyositis had slight-partial recovery, we obtained full recovery with TPE in septic encephalopathy and OMS patients. The side effects and complications of treatments with TPE, which included hypotension, hypocalcaemia and anemia, were mild and manageable. Conclusion: The improvement rates were encouraging and we concluded that significant benefit can be achieved with TPE for the treatment of neuroimmunological disorders.
Watershed Cerebral Infarction in a Patient with Acute Renal Failure
(2015) Ozelsancak, Ruya; Erken, Ertugrul; Giray, Semih; Alkan, Ozlem
Acute renal failure can cause neurologic manifestations such as mood swings, impaired concentration, tremor, stupor, coma, asterixis, dysarthria. Those findings can also be a sign of cerebral infarct. Here, we report a case of watershed cerebral infarction in a 70-year-old female patient with acute renal failure secondary to contrast administration and use of angiotensin converting enzyme inhibitor. Patient was evaluated with magnetic resonance imaging because of dysarthria. Magnetic resonance imaging revealed milimmetric acute ischemic lesion in the frontal and parietal deep white matter region of both cerebral hemisphere which clearly demonstrated watershed cerebral infarction affecting internal border zone. Her renal function returned to normal levels on fifth day of admission (BUN 32 mg/dl, creatinine 1.36 mg/dl) and she was discharged. Dysarthria continued for 20 days.