Fakülteler / Faculties
Permanent URI for this communityhttps://hdl.handle.net/11727/1395
Browse
9 results
Search Results
Item Vaccination in Individuals with Multiple Sclerosis - Part I(2023) Cinar, Bilge Piri; Tuncer, Asli; Bilge, Nuray; Bunul, Sena Destan; Gozubatik Celik, Rabia Gokcen; Ciftci, Eda Derle; Genc, Gencer; Karaman, Bedriye; Kilic, Ahmet Kasim; Sariteke, Alp; Seferoglu, Meral; Tiftikcioglu, Bedile Irem; Tunc, Abdulkadir; Uncu, Gulgun; Yavas, Irfan; Yetkin, Mehmet Fatih; Efendi, Husnu; Siva, Aksel; 0000-0001-6900-4702Multiple sclerosis (MS) is an autoimmune and demyelinating disease of the central nervous system. It is a chronic disease, and in the evaluation of all other health and vital processes, decisions should be made by considering the disease process and the drugs used by the patient. Since vaccination can be performed at every stage of life, from childhood to adulthood, immune system activity, except where it is characteristic of the vaccine, should be reviewed in patients with MS. In this review, the applications of different vaccines in individuals with MS are discussed in two separate sections.Item The Relationship Between Bladder Functions, Pelvic Floor Muscle Strength, Fall, and Fatigue in Multiple Sclerosis(2023) Tezeren, Halime Ceren; Keser, Ilke; Sen, Ilker; Tuncer, Asli; 0000-0002-4034-580X; 37778159Background: The aim of this study was to determine the relationship between the severity of bladder functions, fatigue, quality of life (QoL), fall, and pelvic floor muscle strength in patients with Multiple Sclerosis (PwMS).Methods: Patients were divided into two groups according to their Expanded Disability Status Scale (EDSS) bladder scores as Group 1 (EDSS bladder score 0-1, mildly affected group, n = 25) and Group 2 (EDSS bladder score 2-3-4, moderate and severely affected group, n = 21). Pelvic floor muscle (PFM) strength (EMG-Biofeedback device), fear of fall (Fall Efficacy Scale (FES-1)), fatigue (Fatigue Severity Scale (FSS)), QoL (Urogenital Distress Inventory-short form (UDI-6), and Incontinence Impact Questionnaire-short form (IIQ-7)) were evaluated.Results: 46 female patients diagnosed with MS were included in this study. No significant differences in baseline characteristics were seen between the groups except age. EDSS bladder score were 1 (0-1) and 3 (2-4), EMG-Biofeedback score were 79,5 +/- 8,11 and 41,7 +/- 5,48, FSS score were 38,7 +/- 2,80 and 54 +/- 2,20, FES-I score were 16,9 +/- 2,15 and 40,2 +/- 7,39, UDI-6 score were 4,24 +/- 0,47 and 8,42 +/- 0,64, IIQ-7 score were 3,64 +/- 0,86 and 18,2 +/- 1,42 in Group 1 and Group 2. As a result of statistical analysis, significant differences were found in less fatigue and fall, higher PFM strength and better QoL with mildly affected PwMS (p<0,05).Conclusion: There was a significant difference in terms of bladder function level in PFM strength, fall, fatigue and QoL between the mildly affected group and the moderate and severely affected group.Item Effects of Nutrition Education Given to Persons with Multiple Sclerosis and Their Families on Diet Quality and Anthropometric and Biochemical Measurements(2022) Uzdil, Zeynep; Turker, Perim Fatma; Terzi, MuratObjective In this study, it was aimed to investigate the effects of nutrition education given to persons with multiple sclerosis and their families on anthropometric and biochemical measurements and diet quality. Methods Data from 51 persons with multiple sclerosis were analysed in this intervention study. The study was conducted with 3 groups. The education group consisted of only persons with multiple sclerosis, the family education group consisted of persons with multiple sclerosis and a family member living with them, and the control group consisted of persons with multiple sclerosis who had not received an education. Anthropometric and biochemical measurements and dietary quality assessments were made before (T1) and immediately after education (T2) and also 3 months after education (follow-up, T3). Results The distribution of family education group diet quality scores showed a significant increase from "poor" to "needs improvement" at T3 compared to T1. The upper middle arm circumference measurements of the female control group were decreased at T2 and T3 [from 29.0 (23-34) cm to 28.0 (22-31) cm and to 27.5 (22-31) cm]. Women in family education group, levels of serum haemoglobin and haematocrit were higher than in control group at T2 and T3. Also, men in family education group, levels of alanine aminotransferase were lower than those in education group at follow up. Levels of total cholesterol and low-density lipoprotein cholesterol in education group were higher than those control group at T1, T2, and T3. Conclusion This study indicates that nutrition education affects some biochemical and anthropometric measurements in persons with multiple sclerosis. Diet quality improved when receiving education together with families.Item Effect of Fingolimod (FTY720) on Choroidal Thickness in Patients with Multiple Sclerosis(2017) Kal, Ali; Ulusoy, Mahmut Oguz; Horasanli, Bahriye; Cezairlioglu, Sefik; Kal, Oznur; 0000-0002-7751-4961; 0000-0001-7544-5790; 0000-0003-3142-1011; 28619430; AAJ-7586-2021; AAJ-4936-2021Objective: Using spectral domain optical coherence tomography (SD-OCT), to compare the choroidal thickness in a healthy population (group 1), with newly diagnosed multiple sclerosis (MS) patients (group 2), with MS patients who underwent beta-interferon monotherapy (group 3) and MS patients who underwent fingolimod therapy for 1 year (group 4) Methods: Twenty-five control subjects (25 eyes), 24 newly diagnosed (24 eyes) MS patients, 22 MS patients who underwent fingolimod monotherapy for 1 year (22 eyes), and 24 MS patients who underwent beta-interferon monotherapy for 1 year (24 eyes) were included in this study. The control group consisted of age- and gender matched healthy individuals. The choroidal thickness measurements were performed using a high-speed and high-resolution SD-OCT device. The choroidal thickness measurements were compared using a One Way Anova and Post-Hoc Tukey test. Results: Ninety-five eyes of 95 participants were included in this study. The mean age of the control group was 27.83 +/- 4.60, and it was 26.83 +/- 6.79, 27.87 +/- 6. 46 and 27.58 +/- 6.65 in the newly diagnosed MS group, fingolimod group and beta-interferon group, respectively. In fingolimod group N-1000, N-1500 and T-1500 was significantly lower than control group. (p = 0.026, p = 0.06 p = 0.13) Conclusion: Choroidal thickness values at N-1000, N-1500 and T-1500 levels in fingolimod group were found lower than in control but higher than in newly diagnosed MS group. This result can be explained with the therapeutic effect of the fingolimod on MS.Item Unfavorable Outcome of Pediatric Onset Multiple Sclerosis: Follow-Up in the Pediatric and Adult Neurology Departments of One Referral Center, in Turkey(2016) Derle, Eda; Kurne, Asli Tuncer; Konuskan, Bahadir; Karabudak, Rana; Anlar, Banu; 0000-0001-6727-6229; 0000-0003-2122-1016; 27645334; HJH-2490-2023; I-9090-2013; AAI-8830-2021Background:: The prevalence of MS starting under 18 years of age ranges between 2-10% of the total MS population. Objective:: We aimed to examine the clinical and long term follow-up data of pediatric-onset cases in our institutional MS database. Method:: We evaluated the clinical data from the MS database of the Departments of Neurology and Pediatric Neurology of Hacettepe University Hospital. Results:: The clinical features of 74 patients who had experienced the first attack before age 18 years comprised 3.9% of our MS population. Median age at onset was 15 (3, 5-17, IQR=3.63) years, and female: male ratio was 2.4. The most frequent symptom at onset was brainstemicerebellar dysfunction (32.4%). Seventy two patients (97.3%) initially had relapsing remitting course and in the follow-up, 17 (23%) of them developed secondary progressive (SP) course. The median interval to develop SPMS course was 10 (5-21, IQR=8) years. At the last visit, median disease duration was 6.67 (0.83-25, IQR=9.06) years, 41 (55.4%) of them had EDSS of >= 4. Conclusion:: These findings illustrate the profile of our pediatric MS patients: almost all are relapsing remitting initially; about one fourth become secondarily progressive in 10 years, and about half acquire disability EDSS >= 4 in mean 8 years. (C) 2016 Elsevier B.V. All rights reserved.Item Effects of Body Temperature Lowering on Visual Evoked Potentials in Patients with Multiple Sclerosis(2021) Poyraz, Turan; Idiman, Fethi; Keskin, Ahmet Onur; Karaoglan, Leyla Iyilikci; Idiman, EgemenObjective: Aggravation of neurologic symptoms in patients with multiple sclerosis (MS) due to heating is well known. This phenomenon, known as Uhthoff phenomenon (UP), is explained by transient conduction block in demyelinated nerve fibers and transected axons. The threshold of conduction block dependent on temperature is probably proportional to the degree of demyelination or axonal injury. On the other hand, about half of all patients reported improvement in a cold bath (anti-UP effect). This study aimed to assess the effects of body cooling on clinical parameters lneuro-opthalmologic examination and contrast sensitivity in visual acuity/Sloan letter rest, and the Expanded Disability Status Scale (EDSS)] and electrophysiologic measurements [visual evoked potentials (VEP)] in patients with MS previously clinically affected by optic neuritis. Materials and Methods: Twenty patients who described a UP or anti-UP effect with definite MS according to the McDonald and Poser criteria were enrolled in the study. Before the cooling process, all patients with a history of optic neuritis (at least once) were examined clinically, neurologically and neuro-ophthalmologically, and electrophysiologically. Body cooling was achieved using a "Medivance Arctic Sun Temperature Management System" and the body temperature was decreased by about 1 degrees C. After that, all patients were re-evaluated clinically and electrophysiologically. Results: After the cooling process, P100 latency significantly shortened at the 1st, 6th and 24th hours (p<0.001, p<0.001, p<0.001) and EDSS scores improved significantly (p<0.001). Visual acuity, including contrast sensitivity and color vision, significantly improved in both affected and unaffected eyes (p<0.001). Conclusion: These results suggest that heat caused a conduction block in demyelinated or transected axons in the visual pathways. Our results also demonstrate that the cool: o process had beneficial effects on clinical disability scores (EDSS) and the visual system based on clinical and electrophysiologic (VEP) evaluations. These find suggest that the cooling process may be used for symptomatic therapy and increasing life quality of patients with MS.Item Detection of multiple sclerosis from photic stimulation EEG signals(2021) Karaca, Busra Kubra; Aksahin, Mehmet Feyzi; Ocal, RuhsenBackground: 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.Item Optical coherence tomography angiography findings of multiple sclerosis with or without optic neuritis(2020) Ulusoy, Mahmut Oguz; Horasanli, Bahriye; Isik-Ulusoy, Selen; 32048550Objective: Nowadays, retinal microvascular structures can be investigated using optical coherence tomography angiography (OCTA). We aimed to evaluate the probable vascular changes in the foveal and peripapillary regions of patients with multiple sclerosis (MS). Methods: A total of 20 patients with relapsing remitting multiple sclerosis (RRMS) and 24 healthy controls were recruited in this study. All participants' superficial and deeper retinal and peripapillary layers were evaluated using OCTA after a total ophthalmologic examination. Results: In the superficial plexus, the whole image (49.53 +/- 3.9% and 51.83 +/- 2.1%, p = 0.009), superior hemisphere (49.44 +/- 4.11% and 51.63 +/- 2.3%, p = 0.018), inferior hemisphere (49.75 +/- 3.9% and 52.03 +/- 2.2%, p = 0.012), parafoveal (51.87 +/- 3.9% and 53.08 +/- 3.46%, p = 0.048) and perifoveal (50.41 +/- 3.86% and 52.76 +/- 2.1%, p = 0.007) vascular densities were statistically significant lesser in patients with RRMS than in controls. In the optic disc OCTA parameters, the vessel density of the inferior (50.15 +/- 6.99% and 53.04 +/- 3.63% p = 0.043) and temporal sector (48.09 +/- 5.47% and 50.85 +/- 5.24%, p = 0.045) were statistically significantly lesser in patients with RRMS than in controls. Conclusion: The reductions in vessel density of the retinal or peripapillary area of patients with RRMS shown in this study should be investigated further to determine whether it is a secondary lesion to optic neuritis (ON) or a primary vasculopathic condition of MS.Item 'Is RLS a harbinger and consequence of MS?: Striking results of the 'RELOMS-T' study'(2020) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, Murat; Boz, Cavit; Tuncel, Deniz; Karabudak, Rana; Siva, Aksel; Ozcan, Abdulcemal; Neyal, Munife; Goksel, Basak Karakurum; Balal, Mehmet; Sen, Sedat; Ekmekci, Ozgul; Oksuz, Nevra; Kaya, Derya; 0000-0003-2766-2277; 32473575; AAE-2609-2021Background: Although studies report a high prevalence rate of restless legs syndrome (RLS) among patients with multiple sclerosis (PwMS) ranging from 13.3 to 65.1%, little is known about the causes of this relationship. Methods: To ascertain the prevalence, features and impact of RLS among PwMS a nation-wide, multicenter, prospective and a cross-sectional survey, designed to reflect all of the PwMS throughout Turkey, was conducted in 13 centers. Exploring the relationship of the two conditions could possibly contribute to the understanding of the causes of the high and wide-ranging prevalence rates and the pathophysiology of both diseases. Results: Of the 1068 participants 173 (16,2%) found to have RLS [RLS(+)] and 895 (83,8%) did not [RLS(-)]. Among the RLS(+) 173, all but 8 patients (4,6%) were underdiagnosed in terms of RLS. More than half of the patients with RLS had 'severe' or 'very severe' RLS. The onset of RLS was before or synchronous with the onset of MS in about a half of our patients. Conclusion: We conclude that RLS should be meticulously investigated in PwMS and MS can be a direct cause of RLS at least in part of PwMS. Our data about the timing of the onset of MS and RLS, along with the high prevalence of RLS in PwMS suggest that the pathologic changes in the initial phases of MS can possibly trigger RLS symptoms.