Browsing by Author "Ocal, Ruhsen"

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Aspirin Resistance in Cerebrovascular Disease and the Role of Glycoprotein IIIa Polymorphism in Turkish Stroke Patients
(2016) Derle, Eda; Ocal, Ruhsen; Kibaroglu, Seda; Celikkol, Ceyda; Bayraktar, Nilufer; Verdi, Hasibe; Atac, Belgin F.; Can, Ufuk; https://orcid.org/0000-0002-3964-268X; https://orcid.org/0000-0002-7886-3688; https://orcid.org/0000-0003-0591-009X; https://orcid.org/0000-0001-6868-2165; https://orcid.org/0000-0001-8689-417X; 26809135; V-3553-2017; AAJ-2956-2021; Y-8758-2018; V-5499-2017; ABG-9966-2020; AAJ-2999-2021
Aspirin resistance occurs in 5-45% of high-risk patients, with various mechanisms proposed for its development. This study aimed to determine the relationships among aspirin resistance, aspirin dosage, type of aspirin and glycoprotein IIIa P1A1/A2 polymorphism in patients with vascular risk factors. Two hundred and eight (75 symptomatic, 133 asymptomatic) patients with vascular risk factors who were using aspirin for primary or secondary prevention were prospectively included. The symptomatic group was further classified into two groups according to aspirin use at the time of stroke. Aspirin resistance was measured by the PFA-100 system (collagen/epinephrine cartridge) and glycoprotein IIIa P1A1/A2 polymorphism was determined by PCR. The overall prevalence of aspirin resistance was 32.2%. The mean age of patients with aspirin resistance was significantly higher than that in those who did not have resistance (P=0.009). The prevalence of aspirin resistance was similar for the symptomatic and asymptomatic under aspirin therapy groups. The resistance rate was found to be highest with 100mg enteric-coated preparation use (39.3%). Increasing the aspirin dosage and/or shifting to uncoated preparations caused a change in aspirin sensitivity of 36-60%. Repeated measurements showed development of aspirin resistance in 14% of patients who were sensitive to aspirin in previous measurements. Glycoprotein IIIaP1A1/A2 polymorphism, aspirin resistance and development of atherothrombotic stroke were not significantly related. The effect of aspirin can change by time, dosage and type of preparation used. There are no relationships among glycoprotein IIIa P1A1/A2 polymorphism, aspirin resistance and development of atherothrombotic stroke. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
The clinico-radiological spectrum of Dyke-Davidoff-Masson syndrome in adults
(2017) Ocal, Ruhsen; Ayas, Zeynep Ozozen; Asil, Kiyasettin; 28733757; V-3553-2017
Dyke-Davidoff-Masson syndrome (DDMS) is characterized by cerebral hemiatrophy, seizure, contralateral hemiplegia/hemiparesis, and mental retardation. In this study, clinical and radiological investigations of seven patients who were diagnosed with DDMS as adult age were evaluated and discussed. Seven patients (four male, three female) were included. The mean age +/- SD of the patients was 46 +/- 21 years. Clinical presentation of six patients was epileptic seizure. One patient was presented with head trauma due to a fall. Two patients had complex partial seizures, three patients had generalized tonic-clonic seizures (GTC), and one had GTC and myoclonic seizure. Mental retardation was in five patients. A congenital cause was detected in one patient in the etiologic investigation and acquired causes in two patients. In four patients, the etiology was not identified. We observed left-hemisphere involvement in four patients and right-hemisphere involvement in three patients. Brain imaging was performed by CT only in four patients and by MRI only in three patients. All patients were diagnosed with DDMS at adulthood. Atrophy in basal ganglia was detected in five patients, and atrophy in brain stem in four patients. Calvarial thickening was observed in four patients. Three patients had hyperpneumatization in mastoid cells. Sinus hyperpneumatization, including the paranasal and frontal sinuses, was seen in six patients. DDMS can also be diagnosed in adulthood symptomatically (mild-severe) or asymptomatically in adulthood. As a result, DDMS is a syndrome with wide clinical and radiological spectra that can be variably symptomatic at different stages of life.
Comparison of Brain MRI Angiography and Brain MRI Cisternography in Patients with Hemifacial Spasm
(2016) Ocal, Ruhsen; Tunc, Tuba; Ayas, Zeynep Ozozen; Yilmaz, Omer; Inan, Levent Ertugrul; 26908032
The aim of this study was to compare the ability of brain magnetic resonance imaging angiography and brain magnetic resonance imaging cisternography of showing the neurovascular contiguity of the facial nerve in patients with hemifacial spasm. This study included a total of 35 patients (28 females, 7 males), with an average age of 57.5 +/- 13.8 years, who presented to our outpatient clinic of movement disorders. All patients were prospectively applied brain magnetic resonance imaging angiography and brain magnetic resonance imaging cisternography, and the results were evaluated by a radiologist who was blind to study protocol. The study included 35 patients, of whom 28 (80 %) were female and 7 (20 %) were male. Brain magnetic resonance imaging angiography demonstrated facial nerve compression of vascular origin in 5 (14.3 %) patients presenting with the clinical presentation of hemifacial spasm. Neurovascular compression of facial nerve was shown by brain magnetic resonance imaging cisternography in 13 (37.1 %) patients. No statistically significant difference was found between brain magnetic resonance imaging angiography and brain magnetic resonance imaging cisternography techniques in detecting a compressive interaction causing hemifacial spasm between facial nerve and adjacent vascular structures (p > 0.05).
Complications of Liver Transplant in Adult Patients With the Hepatic Form of Wilson Disease
(2018) Ocal, Ruhsen; Ocal, Serkan; Kirnap, Mahir; Moray, Gokhan; Haberal, Mehmet; 0000-0003-3719-9482; 0000-0003-2498-7287; 0000-0002-3462-7632; 29527989; V-3553-2017; ABH-4817-2020; AAH-9198-2019; AAE-1041-2021; AAJ-8097-2021
Objectives: Wilson disease is an autosomal, recessive, inherited disorder of copper metabolism that results in the accumulation of copper in many organs and tissues. This disease is mainly characterized by dysfunction due to copper accumulation in the liver, kidney, brain, cornea, bone, heart, and blood cells. The clinical spectrum is broad in Wilson disease. Asymptomatic Wilson disease may be present, but findings related to the involvement of an individual organ or multiple organ failure can be seen. These findings can include neurologic and neuropsychiatric complications. Our aim here was to examine the neurologic complications and our clinical experience in patients who underwent liver transplant for Wilson disease in our clinic. Materials and Methods: We retrospectively reviewed the medical records of transplant patients with Wilson disease who were seen at Baskent University Faculty of Medicine Transplantation Science between 2005 and 2017. Patient demographics, neurologic complaints, findings from neurologic examinations, and imaging findings were recorded. We also recorded the presence of the Kayser-Fleischer ring, serum ceruloplasmin, 24-hour copper urine levels, and levels of dry copper in liver in each patient. Results: Our study included 19 patients who ranged in age range from 18 to 44 years (mean age of 26 years). Seven of 19 patients (36.8%) had neurologic symptoms, including epileptic seizures in 2 patients (10.5%), encephalopathy in 1 patient (5.2%), tremor in 3 patients (15.7%), and headache in 1 patient (5.2%).The cause of these long-term neurologic complications was the immunosuppressive drugs. Patients with epileptic seizures were provided with seizure control medication (levetiracetam).Tremor did not need treatment. Conclusions: In Wilson disease, neurologic complications can be severe. The most common complication seen in our patients was tremor. Early diagnosis and treatment may slow down neurologic disability.
Crimean-Congo Hemorrhagic Fever Presented with Headache: A Case Report
(2014) Ocal, Ruhsen; Delikan, Okan; Cebi, Kazim; Ocal, Serkan; Bulut, Cemal; Bayazit, Tolga; https://orcid.org/0000-0003-3719-9482; ABH-4817-2020
Headache is one of the most common symptoms of patients applying to emergency departments. In the majority of these patients the cause is usually primary. Although secondary headaches are less common, the diagnosis of the underlying reasons is important since they may be due to a potentially dangerous cause. Headache is also a common symptom of infection. The first symptom of infection can be a serious headache. Headaches which do not respond to medical treatment usually suggest secondary headache. Crimean-Congo haemorrhagic fever (CCHF) is an endemic disease with high mortality. Timely diagnosis as well as treatment of patients with high rates of transmission is also important in terms of disease prevention measures. In this study, a patient diagnosed as CCHF as a cause of secondary headache has been reported.
Detection of Multiple Sclerosis Disease by EEG Coherence Analysis
(2019) Karaca, Busra Kubra; Aksahin, Mehmet Feyzi; Ocal, Ruhsen; V-3553-2017
Multiple sclerosis (MS) is a chronic and inflammatory disease affecting the brain and spinal cord. Although the exact cause of MS is not known, genetic, environmental and immunological factors are involved in the etiology of the disease. The lack of a single diagnostic test for early diagnosis of MS and the similarity of clinical features in MS to other diseases is a serious problem. Early detection of MS is important, and therefore a rapid and reliable pre-diagnosis of MS is important for the treatment and prognosis of the disease. Electroencephalography (EEG) signals provide important information about brain and nerve diseases. Therefore, in the proposed study, a decision support system has been developed which will contribute to the pre-diagnosis by using EEG signals. In this context, coherence analysis of bipolar channel pairs of EEG signals obtained from MS patients and healthy individuals was performed and feature extraction was performed from certain frequency bands. Using the obtained features, the "Subspace Discriminant" classifier was trained with 95.8% accuracy and then the system was tested. As a result, accuracy, sensitivity and specificity rates were 91.67%, 85.71% and 100%, respectively.
Detection of multiple sclerosis from photic stimulation EEG signals
(2021) Karaca, Busra Kubra; Aksahin, Mehmet Feyzi; Ocal, Ruhsen
Background: Multiple Sclerosis (MS) is characterized as a chronic, autoimmune and inflammatory disease of the central nervous system. Early diagnosis of MS is of great importance for the treatment and course of the disease. In addition to the many methods, cost-effective and non-invasive electroencephalogram signals may contribute to the pre-diagnosis of MS. Objectives: The aim of this paper is to classify male subjects who have MS and who are healthy control using photic stimulation electroencephalogram signals. Methods: Firstly the continuous wavelet transformation (CWT) method was applied to electroencephalogram signals under photic stimulation with 5Hz, 10Hz, 15Hz, 20Hz, and 25Hz frequencies. The sum, maximum, minimum and standard deviation values of absolute CWT coefficients, corresponding to "1-4 Hz" and "4-13 Hz" frequency ranges, were extracted in each stimulation frequency region. The ratios of these values obtained from the frequency ranges "1-4Hz" and "4-13Hz" was decided as features. Finally, various machine learning classifiers were evaluated to test the effectivity of determined features. Results: Consequently, the overall accuracy, sensitivity, specificity and positive predictive value of the proposed algorithm were 80 %, 72.7 %, 88.9 %, and 88.9 %, respectively by using the Ensemble Subspace k-NN classifier algorithm. Conclusions: The results showed how photic stimulation electroencephalogram signals can contribute to the prediagnosis of MS.
EFFECT OF LIVER TRANSPLANTATION ON NEUROLOGICAL MANIFESTATIONS AND BRAIN MAGNETIC RESONANCE IMAGING FINDINGS IN WILSON DISEASE
(2019) Soy, Ebru H. Ayvazoglu; Ocal, Ruhsen; Benli, Sibel; Donmez, Fuldem; Agildere, Muhtesem; Ocal, Serkan; Haberal, Mehmet; 0000-0002-0993-9917; AAC-5566-2019; AAB-5802-2020
Evaluation of Neuroimaging Findings of Central Nervous System Complications in Heart Transplant Recipients
(2020) Turnaoglu, Hale; Agildere, Ahmet Muhtesem; Rahatli, Feride Kural; Donmez, FuldemYildirim; Ocal, Ruhsen; Sezer, Taner; Can, Ufuk; Sezgin, Atilla; Aslamaci, Sait; 0000-0002-2278-1827; 0000-0001-8689-417X; 0000-0003-4223-7017; 29790456; AAJ-5931-2021; AAJ-2999-2021; AAB-5802-2020
Objectives: In this study, we presented neuroradiologic findings and diagnoses of neurologic complications in a series of heart transplant recipients. Materials and Methods: A retrospective review was conducted at Baskent University Hospital. We searched the hospital and radiology databases and identified 109 heart transplant recipients. Thirty-one of these recipients had neuroradiologic evaluations secondary to presentation of neurologic symptoms after heart transplant, with 18 patients evaluated with computed tomography and 22 patients evaluated with magnetic resonance imaging (overlap of imaging-defined groups occurred in 9 recipients). Computed tomography and magnetic resonance imaging studies were retrieved from the Picture Archiving and Communication System, with each type of imaging retrospectively evaluated on consensus by 2 radiologists. Results: Radiopathologic findings related to symptoms were detected in 12 of the 31 study patients. The most common abnormality was posterior reversible leuko-encephalopathy syndrome (5 patients, 4.6%). The other abnormalities were ischemic stroke (3 patients, 2.8%), hemorrhagic stroke (1 patient, 0.9%), intracranial abscess (2 patients, 1.8%), and intracranial dissemination of sinusoidal fungal infection and related hemorrhagic infarct (1 patient, 0.9%). The other 19 heart transplant recipients who underwent computed tomography and/or magnetic resonance imaging for neurologic complaints showed no neuroradiologic findings related to neurologic symptoms. Conclusions: Posterior reversible leukoencephalopathy syndrome and ischemic stroke were the most common neurologic complications in our heart transplant recipients. The other complications were hemorrhagic stroke, intracranial abscess, and intracranial dissemination of sinusoidal fungal infection. Neurologic complications are common in heart transplant recipients and should be identified promptly for early treatment. For the recognition of these complications, computed tomography should be performed for initial evaluation to rule out edema or hemorrhage. However, in the presence of serious neurologic symptoms that cannot be explained by computed tomography, magnetic resonance imaging should be indicated.
The frequency of buccopalpebral reflex in Parkinson disease
(2016) Eser, Hulya; Unal, Yasemin; Kutlu, Gulnihal; Ocal, Ruhsen; Inan, Levent Ertugrul; 27966319; V-3553-2017
Background/aim: This study aimed to define the frequency of a primitive reflex, the buccopalpebral reflex (BPR), and its association with the clinical situation in patients with Parkinson disease. Materials and methods: Between May 2010 and May 2011, 222 patients, 115 with Parkinson disease and 107 patients without any sign of neurodegenerative disease, were included in the study. All included patients were examined for BPR and snout reflex and were also evaluated with the Mini Mental State Examination. All patients with Parkinson disease were classified with the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr Score to determine their clinical severity. Results: Sixteen patients with Parkinson disease (13.9%) had a BPR (+) and 4 patients in the control group (3.7%) (P < 0.001). The UPDRS score, UPDRS daily life activities score, and UPDRS motor system score were all higher in the group with BPR (+). All patients with a BPR also had a positive snout reflex. Conclusion: BPR is more frequent in patients with Parkinson disease than in patients without a neurodegenerative disease.
Frequency of headache among university students and its effect on daily living activities
(2021) Ocal, Ruhsen; Iyigundogdu, Ilkin; Kirnap, Nazli Gursoy; Talu, Irem; Alkislar, Defne; Aras, Dilay; Uner, Aylin; Uzunalioglu, Ece; 0000-0001-7860-040X; AAJ-2053-2021
Background & Objective: Headache is a common symptom in the general population. The aim of this study was to investigate the frequency of headache among a university students population in Ankara, Turkey; and to evaluate the factors affecting the headache and the effect of headache on students' quality of life. Methods: A face-to-face questionnaire was applied to all participants in the study. In the questionnaire, demographic data, personal background and family history of the participants as well as the presence of headache were collected. The characteristic features of the headache, accompanying symptoms and medication use for the headache were evaluated. The 36-Item Short Form Survey (SF-36), Beck depression and Beck anxiety scales were administered to all participants. Results: Three hundred and sixty six university students participated in the study. Three hundred and thirty one participants (90.4%) had experienced headache at least once in their lifetime. Headache was more common in women (p 0.01). Depression was found in 135 (36.9%) students with the Beck depression scale, and anxiety was found in 236 (64.5%) students with the Beck anxiety scale. There was no relationship between depression or anxiety and the presence of headache (p 0.05). Emotional role difficulties, social function, pain and general health scores were significantly lower on SF-36 in the group with headache (p<0.05) than without headache. Conclusion: Headache adversely affects the quality of life and is a common symptom among university students, independent of depression and anxiety.
Lentiform Fork Sign in A Case with End-Stage Renal Disease and Metabolic Acidosis
(2015) Derle, Eda; Kibaroglu, Seda; Cinar, Pinar; Ocal, Ruhsen; Can, Ufuk; 0000-0002-3964-268X; 0000-0001-8689-417X; 0000-0003-2122-1016; 25381213; AAJ-2956-2021; V-3553-2017; AAJ-2999-2021; AAI-8830-2021
Neurologic Complications After Liver Transplant: Experience at a Single Center
(2015) Derle, Eda; Kibaroglu, Seda; Ocal, Ruhsen; Kirnap, Mahir; Can, Ufuk; Benli, Sibel; Haberal, Mehmet; 0000-0003-2122-1016; 0000-0002-3964-268X; 0000-0001-8689-417X; 0000-0002-3462-7632; 0000-0002-9975-3170; 25894184; V-3553-2017; AAH-9198-2019; AAI-8830-2021; AAJ-2956-2021; AAJ-2999-2021; AAJ-8097-2021; AAJ-4403-2021
Objectives: Neurologic complications occur frequently after liver transplants. Up to 43% of patients experience severe postsurgical neurologic complications. These complications are significantly associated with longer hospital stay, morbidity, and mortality. The aim of this retrospective study was to evaluate the type and incidence of neurologic complications after liver transplants in adult patients. Materials and Methods: We retrospectively evaluated the medical records of 176 adult patients who had undergone liver transplants between 1995 and 2013. We recorded the demographic data, type of neurologic complications, type, and level of immunosuppressive treatment, and cause of liver failure. Results: Our study sample consisted of 48 deceased-donor liver transplants and 128 living-donor transplants (n = 176). Fifty-three of the patients (30.1%) were female. The age range of the total sample was 18 to 66 years (mean age, 43.1 +/- 13.7 y). As immunosuppressive treatment, most patients received tacrolimus alone (52%) or tacrolimus combined with mycophenolate mofetil (33%). Neurologic complications occurred in 74 of the patients (42%). The most common neurologic complications were diffuse encephalopathy (22.2%) and seizure (14.2%). Other neurologic complications were posterior reversible encephalopathy (1.7%), peripheral neuropathy (1.7%), cerebrovascular disease (1.1%), and central nervous system infection (1.1%). Age, cause of liver failure, and type of transplant were not associated with occurrence of neurologic complications. Conclusions: There was a high incidence of neurologic complications after liver transplants. Diffuse encephalopathy and seizure were common complications. Physicians should be aware of the high risk of neurologic complications after liver transplants. Factors such as immunosuppressive toxicity and metabolic imbalance that predispose patients to neurologic complications after liver transplants should be evaluated immediately, and treatment of postoperative neurologic complications should be initiated as early as possible.
Neurological Findings in Wilson's Patients at First Examination
(2017) Ocal, Ruhsen; V-3553-2017
Aim: Wilson's disease (WD) is a hereditary disease that causes the accumulation of copper in many organs and tissues due to impaired copper transport. WD is presented with neurological and neuropsychiatric findings. Prognosis is usually dependent on severity of liver involvement and neurological involvement. Early treatment can control brain damage and symptoms. The time of diagnosis is related to prognosis. Our aim in this study is to determine the frequency of WD neurological manifestations in our clinic and to convey our clinical experience. Methods: Patients with diagnosis of WD and complaints were examined in the neurology outpatient clinic between 2014 and 2017. Clinical and radiological images of the patients were reviewed. Results: A total of 36 patients (11 female, 25 male) were included in the study. In the neurological examination of these patients. Only tremor was found in 4 patients, tremor and dystonia in 2 patients, tremor and chorea in 2 patients, tremor and choreatetosis in 1 patient and epilepsy in 2 patients. Neurological involvement was detected in 30.5 % of 36 WD neurological follow-up patients. Tremor is the most common neurologic finding in patient with involvement of central nervous system in WD. Symptom is tremor with 81.8 % of patients with neurological symptoms. Tremor was detected in 44.4 % of patients with WD, while another 55.6 % were accompanied by another movement disorders. Conclusion: Neurological complications are common in Wilson's disease. The most common symptom seen is tremor.
The Nutritional Risk Screening 2002 Tool For Detecting Malnutrition Risk in Hospitalised Patients: Perspective From A Developing Country
(2014) Gokcan, Hale; Selcuk, Haldun; Tore, Emin; Gulseren, Pinar; Cambaz, Hatice; Saritas, Seniz; Ocal, Ruhsen; Basaran, Ozgur; Yilmaz, Ugur; Akin, Ebru; https://orcid.org/0000-0001-5663-0683; https://orcid.org/0000-0002-8445-6413; 25599788; AAR-8893-2020; AAJ-6976-2021; V-3553-2017
Background/Aims: To verify the validity of the Nutritional Risk Screening (NRS) 2002 test in a Turkish population. Materials and Methods: We prospectively investigated 2566 patients at a tertiary referral hospital. Nutritional status was screened using NRS 2002, and the length of the stay (LOS) was the main outcome measure. Hospital stays >10 days were accepted as prolonged LOS. NRS scores >= 3 were accepted as indicating risk for malnutrition. Statistical analyses were performed to determine the independent risk factors for malnutrition risk and prolonged LOS. Results: The mean age of patients was 56.6 +/- 16.9 years. According to the NRS 2002, 964 patients (37.6%) were without risk, 1320 (51.4%) warranted surveillance and 282 (11%) were at high risk for malnutrition. Malnutrition rate was the highest in the intensive care unit (22.01%). Prolonged LOS was seen in 24.4% of patients. Intensive care unit stay [odds ratio (OR): 0.585; confidence interval (CI): 1.45-2.22; p<0.001] and an NRS score >= 3 (OR: 0.88; CI: 1.87-3.13; p<0.001) were independent risk factors for prolonged LOS. Conclusion: Improving healthcare outcomes while avoiding preventable healthcare costs is an important goal of healthcare provision in developing countries. NRS 2002 was predictive of LOS, and thus, of patient prognosis. Further community-based studies are warranted to assess the impact of NRS 2002 on reducing healthcare costs.
Rare Presentation of Midbrain Infarction: Isolated Medial Rectus Palsy
(2015) Derle, Eda; Ocal, Ruhsen; Kibaroglu, Seda; Can, Ufuk; 0000-0001-8689-417X; 0000-0002-3964-268X; 0000-0003-2122-1016; 26183888; AAJ-2999-2021; AAJ-2956-2021; AAI-8830-2021; V-3553-2017
A 69-year-old woman presented with sudden onset of diplopia. In neurologic examination left medial rectus palsy without abduction nystagmus was detected. Brain magnetic resonance imaging revealed acute ischemic lesion in mesencephalon on diffusion-weighted images. Sponteneous resolution was observed after 1 month. Medial rectus palsy is a rare presention of acute ischemic stroke and early neuroimaging is important to establish such lesions. (C) 2015 S. Karger AG, Basel
Relationship between Helicobacter pylori infection and white matter lesions in patients with migraine
(2022) Ocal, Serkan; Ocal, Ruhsen; Suna, Nuretdin; 35597897
Background/aim White matter lesions (WML) are more frequently observed in migraine patients than in the average population. Associations between Helicobacter pylori (H. pylori) infection and different extraintestinal pathologies have been identified. Here, we aimed to investigate the association between H. pylori infection and WML in patients diagnosed with episodic migraine. Materials and methods A retrospective study was conducted with 526 subjects with a diagnosis of episodic migraine. Hyperintensity of WML had been previously evaluated in these patients with brain magnetic resonance imaging (MRI) examinations. Previous endoscopic gastric biopsy histopathological examination of the same patients and reports on H. pylori findings were recorded. The demographic characteristics of the patients, such as age, gender and chronic systemic diseases such as hypertension and diabetes mellitus (DM) were recorded. Statistical evaluation was made. Results Evaluation was made among 526 migraine patients who met the inclusion criteria, comprising 397 (75.5%) females and 129 (24.5%) males with a mean age of 45.57 +/- 13.46 years (range, 18-69 years). WML was detected on brain MRI in 178 (33.8%) patients who were also positive for H. pylori (p < 0.05). Subjects who are H. pylori-positive with migraine, WML were observed at a 2.5-fold higher incidence on brain MRI (odds ratio: 2.562, 95% CI 1.784-3.680). WML was found to be more significant in patients with hypertension and migraine than those without (p < 0.001). Older age was also found to be associated with WML (OR = 1.07, 95% CI: 0.01-0.04, p < 0.001). The age (p < 0.001), H. pylori (p < 0.001), hypertension (p < 0.001), and hypertension + DM (p < 0.05), had significant associations in predicting WML according to the multivariate logistic regression analysis. The presence of hypertension had a higher odds ratio value than the other variables. Conclusion It was concluded that H. pylori infection, as a chronic infection, can be considered a risk factor in developing WML in subjects with migraine.
Relationship Between White Matter Hyperintensities and Retinal Nerve Fiber Layer, Choroid, and Ganglion Cell Layer Thickness in Migraine Patients
(2018) Iyigundogdu, Ilkin; Derle, Eda; Asena, Leyla; Kural, Feride; Kibaroglu, Seda; Ocal, Ruhsen; Akkoyun, Imren; Can, Ufuk; 0000-0001-7860-040X; 0000-0003-2122-1016; 0000-0002-6848-203X; 0000-0002-4226-4034; 0000-0002-3964-268X; 0000-0002-2860-7424; 0000-0001-8689-417X; 28952336; AAJ-2053-2021; AAI-8830-2021; E-5914-2016; AAL-9808-2021; AAJ-2956-2021; V-3553-2017; AAK-7713-2021; AAJ-2999-2021
Aim To compare the relationship between white matter hyperintensities (WMH) on brain magnetic resonance imaging and retinal nerve fiber layer (RNFL), choroid, and ganglion cell layer (GCL) thicknesses in migraine patients and healthy subjects. We also assessed the role of cerebral hypoperfusion in the formation of these WMH lesions. Methods We enrolled 35 migraine patients without WMH, 37 migraine patients with WMH, and 37 healthy control subjects examined in the Neurology outpatient clinic of our tertiary center from May to December 2015. RFNL, choroid, and GCL thicknesses were measured by optic coherence tomography. Results There were no differences in the RFNL, choroid, or GCL thicknesses between migraine patients with and without WMH (p>0.05). Choroid layer thicknesses were significantly lower in migraine patients compared to control subjects (p<0.05), while there were no differences in RFNL and GCL thicknesses (p>0.05). Conclusions The only cerebral hypoperfusion' theory was insufficient to explain the pathophysiology of WMH lesions in migraine patients. In addition, the thinning of the choroid thicknesses in migraine patients suggests a potential causative role for cerebral hypoperfusion and decreased perfusion pressure of the choroid layer.
RESTLESS LEG SYNDROME FREQUENCY IN HEALTH WORKERS
(2019) Ocal, Ruhsen; Atguden, Gizem; Aycan, Cagri; Balaban, Zeynep; Senar, Seran; Yavuz, Sena; 31517455
Introduction - Restless Leg Syndrome (RLS) is a disease, primarily composed of sensational symptoms, caused by the urge to move lower extremities especially at night, and characterized by undesired feelings of the legs. Decreasing of the dopaminergic effect at night is thought to be responsible from these symptoms. RLS patients suffer from low quality of sleep affecting their daily life activities even causing socio-economic loss. Although RLS is a common and treatable disease, it can not be diagnosed easily due to the variability of symptoms. Aim - The purpose of this study is to determine the frequency of RLS among health workers and to define the disease causing factors. Method - A questionnaire was applied to 174 randomly selected health workers at Baskent University Medical Faculty (KA17/285). The demographic information, history of illnesses or usage of drugs, socioeconomic status, working hours and daytime sleepiness were questioned. Included in the questionnaire were diagnostic criteria for RLS, frequency assessment scale, and survey of sleep quality. We used "the diagnostic criteria of international RLS working group" for the diagnosis, and "Pittsburgh sleep quality index survey" to determine the quality of sleep. Reliability and validity studies were performed on both tests. Results - A significant relationship between socio-economic status and RLS was found (p<0.05) as an increase of RLS frequency in parallel with decreased socio-economic status. RLS was found to be common among health workers. We suggest that health workers should be checked regularly, and they should be informed about the disease in order to raise an awareness and hence increase their quality of life.
Seizure as a Neurologic Complication After Liver Transplant
(2015) Derle, Eda; Kibaroglu, Seda; Ocal, Ruhsen; Kirnap, Mahir; Kilinc, Munire; Benli, Sibel; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-7979-0276; 0000-0003-2122-1016; 0000-0002-3964-268X; 0000-0002-9975-3170; 25894183; AAJ-8097-2021; AAJ-8674-2021; AAI-8830-2021; AAJ-2956-2021; AAH-9198-2019; AAJ-4403-2021; V-3553-2017
Objectives: Seizure is a common complication after liver transplant and has been reported to occur in up to 42% of patients in different case series. Multiple factors can trigger seizures, including immunosuppressive toxicity, sepsis, metabolic imbalance, and structural brain lesions. The aim of this retrospective study was to evaluate seizure types and associated factors in adult liver transplant patients. Materials and Methods: We retrospectively evaluated the medical records of 142 adult patients who received a liver transplant between 2005 and 2013. We recorded demographic data, immunosuppressive treatment, seizure type, cause, recurrence, and treatment. Results: Of the 146 patients, 23 (15.7%) had a seizure after the liver transplant. This group included 10 females and 13 males, with ages ranging between 18 and 63 (39.9 +/- 14.8 y). Generalized tonic-clonic seizures were the most common, occurring in 20 patients (87%). We observed complex partial seizure and status epilepticus in 1 and 2 patients. Immunosuppressive drug-related seizure occurred in 8 patients (34.8%) with normal drug blood levels, and all but 1 of these patients experienced seizure within the first week after transplant. Multiple factors (26.1%), metabolic imbalance (17.4%), structural lesion (13%), and sepsis (8.7%) were the other factors identified as underlying conditions. Conclusions; In conclusion, seizure occurred in a significant proportion of patients who underwent liver transplant. Immunosuppressive drugs were the most common factor associated with seizure occurrence and drug cessation prevented seizure recurrence.