Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Coven, Ilkersearch.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/closedAccess

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    Levatiracetam for The Management of Lance-Adams Syndrome
    (2014) Ilik, Faik; Kemal Ilik, Mustafa; Coven, Ilker
    Chronic post-hypoxic myoclonus, also known as Lance-Adams syndrome (LAS) is a neurological complication characterized by uncontrolled myoclonic jerks following cardiac arrest. In this article, clinical manifestation and symptomatic treatment options are discussed especially concerning the rationale of use of levatiracetam in patients with Lance-Adams syndrome. Clinical presentation is action myoclonus associated with cerebellar ataxia, postural imbalance, and very mild intellectual deficit. An 18-year-old female patient was admitted to our intensive care unit in a coma. She had a cardiorespiratory arrest after a splenectomy in a local hospital. Then, myoclonic movements were continuously observed over the entire body, including the face. On day 14 of hospitalization, we started levatiracetam 1000 mg daily. The frequency of convulsion movements was reduced. The patient level of consciousness was 15 on the Glasgow coma scale (GCS) on the Mini-Mental State Examination (MMSE) score was 23 out of 30. She was later transferred to the rehabilitation department. Vigilance is required to ensure early diagnosis and timely intervention for the myoclonic jerks. We would like to emphasize that LAS should be considered in patients with the myoclonic jerks following cardiac arrest and that levatiracetam therapy may be useful as treatment.
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    Presence of Matrix Metalloproteinase-2 and Tissue Inhibitor Matrix Metalloproteinase-2 Gene Polymorphisms and Immunohistochemical Expressions in Intracranial Meningiomas
    (2014) Coven, Ilker; Ozer, Ozge; Ozen, Ozlem; Altinors, Nur; Sahin, Feride Iffet; https://orcid.org/0000-0001-6731-2461; https://orcid.org/0000-0001-7308-9673; https://orcid.org/0000-0001-7308-9673; 25259564; ITT-4755-2023; AAC-7232-2020; AAC-7232-2020
    Object. Meningiomas are benign extraaxial tumors with a slow progression. Some of them, in spite of being benign in nature, may show an aggressive progression pattern. To investigate the behavioral characteristics of meningiomas, researchers have studied matrix metalloproteinases (MMPs), their tissue inhibitors (TIMPs), interstitial collagens, proteins, vascular endothelial growth factors (VEGF), and tumor necrosis factors. Methods. In this study, the authors investigated MMP2 and TIMP2 gene polymorphisms in formalin-fixed paraffin-embedded tissue samples obtained from meningioma patients who had previously undergone surgery at the authors' institution. In addition, brain invasion, Ki-67 index, and MMP-2 and TIMP-2 expressions were investigated using immunohistochemical methods. MMP2 (735C>T, 1575G>A, 1306C>T) and TIMP2 (418G>C, 303C>T) gene polymorphisms were investigated from paraffin-embedded tissue sections using the polymerase chain reaction restriction fragment length polymorphism method. Results. There were statistically significant differences between genotype (p = 0.001) and allele frequencies (p = 0.001 and OR 7.4 [95% CI 1.5-36.2]) in patient and control groups for MMP2 1306C>T polymorphism. The authors did not find a statistically significant difference for other polymorphisms. GA genotype was found to be more frequent when brain invasion was suspected for MMP2 1575G>A polymorphism (p = 0.006), There was not a statistically significant difference for other MMP2 or TIMP2 gene polymorphisms. Conclusions. The authors' results support the importance of MMPs and their tissue inhibitors in meningioma pathogenesis. In future studies, these gene polymorphisms, especially MMP2 1306C>T and 1575G>A, should be investigated for meningioma or brain invasion susceptibility in larger study groups.
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    The Effect of Spinal Versus General Anesthesia on İntraocular Pressure in Lumbar Disc Surgery in The Prone Position: A Randomized, Controlled Clinical Trial
    (2018) Pinar, Huseyin Ulas; Kasdogan, Zumrut Ela Arslan; Basaran, Betul; Coven, Ilker; Karaca, Omer; Dogan, Rafi; https://orcid.org/0000-0003-0473-6763; https://orcid.org/0000-0003-1933-2075; 29414618; Q-2420-2015; GQO-9198-2022
    Objective: To compare IOP changes between spinal anesthesia (SA) and general anesthesia (GA) in patients who underwent lumbar disc surgery in the prone position. Design: Prospective, randomized, controlled trial. Setting: Operating room. Patients: Forty ASA I-II patients scheduled for lumbar disc surgery in prone position. Intervention: Patients were randomly allocated to the SA or GA groups. Measurements: IOP was measured before anesthesia (IOP1), 10 min after spinal or general anesthesia in supine position (IOP2), 10 min after being placed in the prone position (IOP3), and at the end of the operation in the prone position (IOP4). Main results: There was no significant difference between baseline IOP1 (group GA = 19.4 +/- 3.2 mmHg; group SA = 18.6 +/- 2.4 mmHg) and IOP2 values (group GA = 19.7 +/- 4.1 mmHg; group SA = 18.4 +/- 1.9 mmHg) between and within the groups. IOP values after prone positioning and group GA measurements (IOP3 = 21.6 +/- 3.1 mmHg; IOP4 = 33.9 +/- 3.1 mmHg) were significantly higher when compared with the SA group (IOP3 = 19.3 +/- 2.7 mmHg, IOP4 = 26.9 +/- 2.4 mmHg) (p = 0.018 and p < 0.001, respectively). Furthermore, IOP3 was significantly increased when compared with IOP2 in the GA group but not in the SA group (p = 0.019 and p = 0.525, respectively). In both groups, IOP4 values were significantly higher than the other three measurements (p < 0.001). Conclusion: The results indicated that IOP increase is significantly less in patients who undergo lumbar disc surgery in the prone position under SA compared with GA.
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    Radiofrequency Thermocoagulation of the Ganglion Impar for Coccydynia Management: Long-Term Effects
    (2019) Kircelli, Atilla; Demircay, Emre; Ozel, Omer; Coven, Ilker; Isik, Semra; Civelek, Erdinc; Kabatas, Serdar; 0000-0003-2109-1274; 29617062
    Objective To investigate the short- and long-term effects of ganglion impar radiofrequency thermocoagulation (RFT) treatment in patients with chronic coccydynia. Methods We retrospectively analyzed the medical records of patients who underwent RFT of the ganglion impar between 2009 and 2011. Pain intensity visual numeric scale (VNS) scores and Euroqol 5D (EQ-5D) index scores were recorded pre-intervention and post-intervention at the first, sixth, and twelfth months. The differences between pre-procedural VNS scores and post-procedural VNS scores at the first, sixth, and twelfth months were evaluated. The success of the intervention was recorded as the percentage difference between the pre-intervention VNS scores and post-intervention VNS scores at the first, sixth, and twelfth months. Results The mean age of the patients, including 11 females (55%) and 8 males (45%), was 48.7 +/- 14.3 years. The average follow-up duration was 17.3 +/- 2.9 months. Statistically significant differences were observed between the pre- and post-procedure VNS scores (P < 0.0001). Improvements in VNS scores were correlated with improvements in EQ-5D index scores. Mid-term (sixth month) and long-term (twelfth month) evaluations after the intervention revealed that 67.4% and 61.1% of the patients had successful outcomes, respectively. Conclusion Our data suggested that RFT of the ganglion impar in patients with chronic coccydynia resulted in effective outcomes, and patients who responded to RFT had significantly lower post-RFT pain scores.