TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Peripheral Nerve Function Changes Due to Hypoxia in Obstructive Sleep Apnea(2019) Avci, Aynur Yilmaz; Avci, Suat; 0000-0001-9004-9382Introduction: Chronic hypoxia is known to be one of the risk factors for peripheral neuropathy. However, the effect of intermittent hypoxia on peripheral nerves is not fully understood. This study evaluated the relation between intermittent hypoxia and peripheral nerve function in Obstructive Sleep Apnea (OSA) patients. Materials and Methods: In this retrospective study, 86 patients who underwent polysomnography (PSG) and electroneuromyography were enrolled. Participants with diseases affecting peripheral nerves and lung function were excluded from the study. Hypoxia parameters were obtained from the PSG study. Lower extremity motor and sensory nerve conduction studies of all patients were evaluated. Results: In patients with OSA, peroneal nerve distal motor latency and sural sensory nerve action potential amplitude was low and velocity was significantly slower than controls (p<0.001, p<0.04, p<0.001, respectively). After adjustment for age and body mass index, the results remained significantly (p<0.001, p<0.01, p<0.001, respectively). The nerve conduction results were significantly correlated with the hypoxia parameters. After adjustment for confounding factors, logistic regression analyses revealed that hypoxia parameters were independently associated with nerve conduction results. Conclusion: OSA and intermittent hypoxia may affect both motor and sensory nerve conduction, which suggests that subclinical sensorimotor peripheral neuropathy is associated with OSA. The related intermittent hypoxia and OSA may be a cause of axonal and demyelinating neuropathies.Item The relationship between clinical and laboratory findings and duration of sleep where oxygen saturation remains below 90-95% in obstructive sleep apnea(2016) Avci, Suat; Avci, Aynur Yilmaz; Yagbasan, Berna Devrim; Gunizi, HuseyinObjective: The aim of the present study was to determine correlations between CT90 and CT95 values and physical examination parameters, chronic metabolic diseases, smoking, mean platelet volume, cerebral magnetic resonance imaging (MRI), presence and number of hyperintense foci in obstructive sleep apnea (OSA). Methods: A total of 1154 patients who underwent polysomnography in our sleep laboratory between 2011 and 2014 were screened retrospectively. Among them, 72 cases who underwent ear, nose and throat examinations, cerebral MR, CBC and biochemical tests were included in the study. All patients underwent a detailed anamnesis together with (1) measurements of BMI (body mass index) (2) circumferences of neck and abdomen, (3) examination of oropharynx, (4) Muller maneuver with the aid of fiberoptic endoscope, (5) estimation of Epworth sleep scale scores, (6) and polysomnographic (PSG) tests. Results: According to the severity of OSA, the patients had simple snoring (22.2%), mild (19.4%) and severe OSA (38.9%). In multivariate regression analysis, body mass index (BMI) (p=0.026) and apnea/hypopnea index (AHI) (p=0.013) were seen as independent variables affecting CT90 (R-2=49%). Multivariate linear regression analysis demonstrated that independent variables of smoking (p=0.001), AHI (p=0.003) and number of hyperintense foci (p=0.013) affected CT95 (R-2=%47.9), while relationships between diabetes, BMI and CT95 were not statistically significant. Conclusion: Since CT95 values are affected by smoking without any statistically significant correlation with retropalatal and retroglossal Muller stages, we think that consideration of CT90 value will be more appropriate in the evaluation of the severity of chronic intermittent hypoxia in patients with obstructive sleep apnea. However, the correlation between CT90 value and AHI is closer to the value indicated in the literature, but not stronger.Item Hypoxia parameters, physical variables, and severity of obstructive sleep apnea(2016) Avci, Suat; Avci, Aynur Yilmaz; Lakadamyali, Huseyin; Aydin, Erdinc; 0000-0001-9004-9382; 0000-0001-6864-7378; 0000-0003-2155-8014; F-6770-2019; AAJ-2379-2021; O-3636-2018Objective: To determine the relation between hypoxia and physical parameters in patients who had different levels of severity of obstructive sleep apnea (OSA). Methods: This was a retrospective, cross-sectional study of 259 men who were evaluated with overnight polysomnography. Severity of OSA was graded based on the apnea-hypopnea index (AHI): normal/simple snoring (n=31); mild OSA (n=70); moderate OSA (n=63); severe OSA (n=95). Patients with different severity were divided into subgroups, based on having the lowest or highest values of the total sleep time with oxygen saturation <90% (ST90) or minimum oxygen saturation (min SaO(2)). Results: Median AHI was 20.4 events/hour. Univariate analysis showed that ST90 was correlated with AHI (r=0.772; p <= 0.001) and Epworth sleepiness scale (ESS) (r=0.344; p <= 0.001), and min SaO(2) was inversely correlated with AHI (r=-0.748; p <= 0.001) and ESS (r=-0.319; p <= 0.001). Multivariate linear regression showed that ST90 was independently associated with AHI, ESS, and neck circumference, and min SaO(2) was independently inversely associated with AHI, ESS, and body mass index (BMI). In patients who had severe OSA, the subgroups which had lowest and highest min SaO(2) differed significantly in BMI, modified Mallampati score, neck and waist circumferences, and ret-roglossal Muller grade. In patients with percentage of sleep time with oxygen saturation below 90% (CT90) <10%, the upper limit of ST90 was 36 minutes and corresponded to 70% lower limit of min SaO(2). Conclusion: Hypoxia parameters show significant variation in OSA severity categories. None of the physical parameters had clinically useful relations with hypoxia parameters in OSA patients except patients who had severe OSA.Item Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging(2018) Avci, Aynur Yilmaz; Toprak, Munire Kilinc; Lakadamyali, Liatioe; Akinci, SinanObjective: Migraine is linked with an elevation in vascular risk factors, ischemic stroke, and a variety of constitutional brain lesions. However, the pathogenesis of this relationship is still inexplicit. The link between cardiac diseases and comorbid migraine-ischemic stroke might be a vascular disease involving both heart and brain. In this study, an association between mitral valve prolapse (MVP), migraine, and the presence of brain white matter hyperintensities (WMHs) were evaluated among adult subjects with migraine headache devoid of any traditional vascular risk factors. Materials and Methods: Four hundred subjects (200 subjects with migraine headache, 200 healthy controls; age range 18-50 years) were incorporated in the retrospective study. Existence of a headache compatible with migraine was diagnosed according to the International Headache Society-2 criteria. The participants were devoid of any known comorbid diseases, vascular risk factors or inflammatory diseases. All patients, both those with migraine and controls were screened with echocardiography to assess for MVP and with brain magnetic resonance imaging co evaluate the presence of any WMHs. Results: The prevalence of MVP was found to be higher in the migraine group (p<0.011). The odds ratio (OR) for the presence of MVP in patients with migraine compared with controls was 2.44 [95% confidence interval (CI): 1.25-4.74; p=0.0086]. The OR for the presence of WMHs in patients with migraine compared with controls was 5.88 (95% CI: 3.42-10.10; p<0.0001). After modifying for confounding factors, multiple linear regression analyses revealed that migraine was independently and positively associated with MVP (p=0.044), tricuspid regurgitation (p=0.003), and WMHs (p<0.001), and mitral regurgitation and migraine was independently and positively connected with WMHs (p<0.005 and p<0.001, respectively). Conclusion: MVP is found CO be independently associated with migraine when compared with controls. Therefore, we suggest that MVP might have an association with migraine. Nevertheless, we could not demonstrate any correlation between MVP and WMHs. Hence, we suggest that MVP might nor be involved in the evolution of WMHs in migraine