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Item Neutrophil to lymphocyte ratio, stroke severity and short term clinical outcomes in acute ischemic stroke(2021) Iyigundogdu, Ilkin; Derle, Eda; Kibaroglu, Seda; Can, Ufuk; 0000-0001-7860-040X; 0000-0002-3964-268X; AAJ-2053-2021; AAJ-2956-2021Background: Neutrophil to lymphocyte ratio is an easily evaluated systemic inflammation indicator. However, there are limited reports on neutrophil to lymphocyte ratio and functional outcome in ischemic stroke. In this study, we aimed to evaluate the association of neutrophil to lymphocyte ratio and stroke severity, short term functional outcomes and mortality in patients with acute ischemic stroke. Methods: The clinical data of patients who were > 18 age-old and hospitalized with acute ischemic stroke in Baskent University Hospital, Ankara, Turkey between January 2018 and May 2019 were studied retrospectively. Neutrophil to lymphocyte ratio were measured. The neutrophil to lymphocyte ratio and National Institute of Health Stroke Scale (NIHSS) score at admission, mortality during hospitalization and Modified Rankin Scale (mRS) score at discharge of the patients with acute ischemic stroke were correlated. Results: Among the acute ischemic stroke patients due to the exclusion criteria, the data of 134 patients were evaluated. Median age of the patients were 76 +/- 12.5 years and 82 patients (61.2%) were male. The median NIHSS scores of the patients at admission was 5 +/- 4.5. Mortality during the hospitalization was seen in 8 patients (6%). The median neutrophil to lymphocyte ratio value of the patients at admission were found to be 2.6 +/- 3.4. Neutrophil to lymphocyte ratio and NIHSS scores of the patients at admission, duration of the hospitalization, mRS scores at discharge and mortality during hospitalization were found to be positively correlated. Conclusion: Neutrophil to lymphocyte ratio is a simple and easily measured marker and can be used as a potential indicator for prognosis in acute ischemic stroke. However further prospective multicenter investigations are required to confirm the role of neutrophil to lymphocyte ratio for predicting the prognosis in acute ischemic stroke patients.Item Hyperprolactinemia and galactorrhea with duloxetine in neuropathic pain management(2021) Derle, Eda; Can, Ufuk; 34671951Duloxetine is a serotonin-norepinephrine reuptake inhibitor that is widely used in chronic pain treatment in various diseases. Hyperprolactinemia and galactorrhea are rare side effects of this medication. Here, we reported a 34-year-old female with multiple sclerosis who used duloxetine for pain management and mood disorder and experienced galactorrhea.Item Predictors of progression in primary progressive multiple sclerosis in a large Turkish cohort(2020) Vural, Atay; Derle, Eda; Sayat-Gurel, Guliz; Karabudak, Rana; Tuncer, Asli; 0000-0003-2122-1016; 31743849; AAI-8830-2021Background: Studies on the predictors of progression for primary progressive multiple sclerosis (PPMS) are limited and there is no information in the literature for populations outside Europe and North America. In this study, we aimed to identify predictors of progression in a large Turkish PPMS cohort. Methods: We analyzed a cohort of 157 PPMS patients to investigate the effect of age of onset, gender, onset symptoms, presence or absence of relapses, and baseline gadolinium-enhancing lesions on the rate of progression to EDSS6 by using Kaplan-Meier analysis and multivariate Cox regression. Results: Older age of onset and presence of spinal motor symptoms at onset were associated with a shorter time to EDSS6 and presence of supratentorial signs at onset was associated with a longer time to EDSS6 according to Kaplan-Meier analysis. These factors remained significant after multivariate Cox-regression analysis. Clinical relapses were present in 22.3% and gadolinium-enhancing lesions on baseline MRI were present in 28% of patients, but these factors were not predictive of time to EDSS6. Conclusion: We identified age of onset and symptom at onset as predictors of progression in Turkish PPMS patients. Presence of clinical relapses or baseline gadolinium-enhancing lesions did not affect PPMS progression rate.Item Clinical results of carotid artery stenting versus carotid endarterectomy(2016) Derle, Eda; Akinci, Tuba; Kibaroglu, Seda; Harman, Ali; Kural, Feride; Cinar, Pinar; Kilinc, Munire; Akay, Hakki T.; Can, Ufuk; Benli, Ulku S.; 0000-0002-7386-7110; 0000-0002-4226-4034; 0000-0002-9975-3170; 0000-0003-2122-1016; 0000-0002-3964-268X; 0000-0001-8689-417X; 27744460; AAI-8830-2021; AAJ-2956-2021; K-9824-2013; AAL-9808-2021; AAJ-4403-2021; AAJ-2999-2021Objective: To review our results of carotid artery stenting (CAS) and carotid endarterectomy (CEA). Methods: We evaluated the medical records of patients undergoing carotid artery revascularization procedure, between 2001 and 2013 in Baskent University Hospital, Ankara, Turkey. Carotid artery stenting or CEA procedures were performed in patients with asymptomatic carotid stenosis (=70%) or symptomatic stenosis (=50%). Demographic data, procedural details, and clinical outcomes were recorded. Primary outcome measures were in 30-day stroke/transient ischemic attacks (TIA)/amaurosis fugax or death. Secondary outcome measures were nerve injury, bleeding complications, length of stay in hospital, stroke, restenosis (ICA patency), and all-cause death during long-term follow-up. Results: One hundred ninety-four CEA and 115 CAS procedures were performed for symptomatic and/or asymptomatic carotid artery stenosis. There is no significant differences 30-day mortality and neurologic morbidity between CAS (13%) and CEA procedures (7.7%). Length of stay in hospital were significantly longer in CEA group (p=0.001). In the post-procedural follow up, only in symptomatic patients, restenosis rate was higher in the CEA group (p=.045). The other endpoints did not differ significantly. Conclusions: Endovascular stent treatment of carotid artery atherosclerotic disease is an alternative for vascular surgery, especially for patients that are high risk for standard CEA. The increasing experience, development of cerebral protection systems and new treatment protocols increases CAS feasibility.Item Spontaneous Spinal Subarachnoid Hemorrhage with Residual Arachnoid Cyst: A Case Report(2017) Derle, Eda; Iyigundogdu, Ilkin; Yilmaz, Cem; 0000-0003-2122-1016; 0000-0001-7860-040X; 0000-0002-2353-8044; 27593750; AAI-8830-2021; AAJ-2053-2021; AAK-2948-2021Spinal subarachnoid hemorrhage is a rare condition that usually occurs because of secondary causes and idiopathic spontaneous ones are extremely rare. We report a 56-year-old woman who presented with severe headache, neck pain and urinary retention. Magnetic resonance imaging revealed subarachnoid hemorrhage that extended from T1 to lumbar vertebrae. She was treated conservatively and symptoms were resolved within 1 month. An asymptomatic arachnoid cyst was observed on the follow-up magnetic resonance imaging after 3 months with no neurologic deterioration. She was still stable clinically and radiologically at the end of 19 months. Spinal subarachnoid hemorrhage is a surgical emergency, although in some cases a conservative approach may be useful.