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106. Alzheimer hastalığında beyin omurilik sıvısında (BOS) biyolojik belirteçler ve BOS'un PC12 hücre hattı canlılığı üzerine in vitro etkisinin değerlendirilmesi

Author

Yaka, Erdem, Yener, Görsev G., and Nöroloji Ana Bilim Dalı

Subjects
Nöroloji, Neurology
Abstract

l.OZET ALZHEIMER HASTALIĞINDA BEYİN OMURİLİK SIVISINDA (BOS) BİYOLOJİK BELİRTEÇLER VE BOS'UN PC 12 HÜCRE HATTI CANLILIĞI ÜZERİNE İN VİTRO ETKİSİNİN DEĞERLENDİRİLMESİ Dr. Erdem Yaka Giriş ve amaç: Günümüzde, Alzheimer hastalığının (AH) kesin tanısı ancak post-mortem beyin incelemesi ile konulabilmektedir. Yaşayan bir hastada kesin AH tanısı koyabilecek hiçbir laboratuvar incelemesi yoktur. Bu konuda özelleşmiş merkezlerde, AH tanısı klinik ölçütlerle % 90 doğrulukla konmakla birlikte, her sağlık merkezinde uygulanabilecek, kesin tanı koymayı hedefleyen laboratuvar belirteçlerine ulaşmak için çalışmalar devam etmektedir. Son bilgiler ışığında, duyarlılık ve özgüllükleriyle ön plana çıkan üç BOS belirteci vardır: A0mo.-A0i.42 ve f-tau. Çalışmamızda bu belirteçlerin olgu ve kontrollerde BOS düzeyleri, ELISA yöntemiyle belirlenmiş, klinik tanı esas alınarak özgüllük ve duyarlılıkları, laboratuvanmız için hesaplanmıştır. Ayrıca, 'Muhtemel Alzheimer hastalığı' (MAH) olgularının BOS'lannın PC 12 hücre hattına sitotoksik etkisinin olup olmadığı araştırılmıştır. Bu amaçla hücre hattına AH ve kontrol BOS'lannın eklenmesinden sonra, hücre canlılığı, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) testiyle değerlendirilmiş ve gruplar arasında karşılaştırma yapılmıştır. Yöntem: Çalışmaya, Dokuz Eylül Üniversitesi Nöroloji Anabilim Dalı Demans Polikliniği hastalan arasından seçilmiş 15 Alzheimer hastası ve nörolojik bir sorunu olmayan, herhangi bir cerrahi girişim nedeniyle spinal anestezi uygulanması gereken hastalar arasından seçilmiş 15 kontrol dahil edilmiştir. AH olgularının ve kontrollerin her birinden, lomber 4-5 aralığından lateral dekubit pozisyonunda 2.5 cc BOS alınmıştır. Örnekler, Araştırma Laboratuvan'nda (AR-LAB) çalışılmıştır.Bulgular: Alzheimerli olguların ve kontrollerin BOS belirteçleri ortalamaları karşılaştırıldığında, olguların APmo ortalamalarının kontrollerin ortalamalarından anlamlı olarak düşük olduğu (p=0,014), f-tau değer ortalamalarının olgularda anlamlı olarak yüksek olduğu saptanmıştır (p=0,04). Alzheimerli olguların Ap^2 ortalamaları ise kontrollerden farklı bulunmamıştır (p=0,054). Olgularda, f-tau'nun ayrıca, hastalık süresi ile orta güçlükte pozitif korelasyon gösterdiği bulunmuştur (Spearman Rho=0,575; p=0,025). Canlı kalan hücre sayısı ortalamaları değerlendirildiğinde, olguların canlı kalan hücre sayısı ortalamasının da kontrollerden farklı olmadığı izlenmiştir (p=0,056). Sonuç: Bu çalışmada, f-tau'nun, klinik tanı ölçütleri esas alındığında, en yüksek duyarlılık ve özgüllüğe ulaşan BOS belirteci olduğu saptanmıştır (duyarlılık %73.3, özgüllük %80). Olası başka bir çalışmada kullanılabilmek üzere, AH'de BOS f-tau eşik değeri (74,34 pg/ml) laboratuvanmız için belirlenmiştir. AH'li BOS'lann PC12 hücre hattına sitotoksik etkisi gösterilememiştir. Ancak elde ettiğimiz sonuçlar geniş olgu serilerinde bu sonucun değişebileceğini düşündürmüştür. Aynca sitotoksisitenin serum ve idrar örneklerinde araştırılması uygun olacaktır. Anahtar kelimeler: Alzheimer hastalığı, BOS belirteçleri, sitotoksisite, PC 12 hücre hattı. 2. ingilizce özet biochemical markers in cerebrospinal fluid (csf) and evaluation of the effect of csf on pc 12 cell line viability in alzheimer's disease Dr.Erdem Yaka Background and objectives: The definite diagnosis of Alzheimer's disease (AD) is based on post mortem pathological examination. To date, there is no laboratory test that can discriminate patients with AD from healthy individuals. Although, there is a relatively high accuracy rate of the clinical diagnosis of AD (~ %90) in expert research academic centers, the studies which aim to find out pathognomonic laboratory markers available for AD still continue. In the perspective of recent knowledge, there are three CSF markers which have the highest sensitivity and specificity. Ap*^, AP1.42 and p-tau. In this study, concentrations of these markers in CSF were quantified using the ELISA assays and the sensitivity and specificity for our laboratory were determined. Also, the effects of 'Probable Alzheimer's Disease' (PRAD) patients'CSF on the survival of PC 12 cell line were assessed. For that purpose, cell line viability was evaluated by 3-(4,5-dimethyltbiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test and the results were compared between groups. Method: In the present study, 15 PRAD patients and 15 control subjects were included. PRAD patients were selected from the patients of Dokuz Eylül University Neurology Department Dementia outpatient clinic and control subjects were selected from the patients who were undergone epidural anesthesia because of any surgical operation. The control subjects did not have any neurological complaint. Lumbar CSF samples, which were obtained using a standardized protocol, were studied in Research Laboratory (RES-LAB). Results: There was a significant decrease of APi^o (p=0,014) and increase of p-tau (p=0,04) in patients with AD when compared with controls. AP1.42 concentration was not significantly different between groups (p=0,054) There was a positive corelation between duration of thedisease and CSF of p-tau concentration in patients with AD (Spearman Rho=0,575; p=0,025). There was no significant difference in cell line viability values between groups (p=0,056). Conclusion: In this study, it is concluded that when the clinical diagnostic criteria is taken into consideration, the CSF marker which has the highest sensitivity and specificity is p-tau (%73.3, %80). CSF p-tau cut off value (74,34 pg/ml) for our laboratory is determined for further studies. The cytotoxic effect of PRAD patients' CSF on PC12 cell line is not demonstrated; but, in larger series this finding may change, since there is a trend to show toxicity of CSF in AD. Further studies on cytotoxicity in serum or urine are also needed to clarify possible peripheral toxic agents in AD. Key words: Alzheimer's disease, CSF markers, cytotoxicity, PC 12 cell line 55

Published
2004

116. A COMPOSITE SCORE FOR DOKUZ EYLUL COGNITIVE STATE NEUROCOGNITIVETEST BATTERY: A DOOR-TO-DOOR SURVEY STUDY WITH ILLITERATE, LOW AND HIGH EDUCATED ELDERLY IN TURKEY.

Author

KURT, Pınar, KESKİNOĞLU, Pembe, YAKA, Erdem, UÇKU, Reyhan, and YENER, Görsev

Subjects
COGNITIVE testing, ILLITERATE persons, EDUCATION of older people, MILD cognitive impairment, DIAGNOSIS of dementia, DIAGNOSIS
Abstract

Copyright of Turkish Journal of Geriatrics / Türk Geriatri Dergisi is the property of Turkish Geriatrics Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2014

118. Cerebrospinal Fluid and Serum Beta Secretase Activities in Alzheimer's Disease.

Author

Yaka, Erdem, Genç, Şermin, İyılıkçı, Leyla, and Yener, Görsev

Subjects
*CEREBROSPINAL fluid, *ALZHEIMER'S patients, *BIOMARKERS, *SERUM, *NEUROLOGICAL research
Abstract

Objective: In this study, we aimed to investigate β secretase activities in cerebrospinal fluid (CSF) and serum of patients with Alzheimer's disease (AD) as a possible biological marker in AD. Methods: The serum and the CSF samples were investigated in both patient and control groups. For serum analysis, thirteen patients diagnosed with 'probable AD' according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) and National Institute of Neurological Disorders and Stroke-Alzheimer Disease and Related Disorders (NINCDS/ADRDA) criteria and twelve controls were studied. For CSF analysis twelve patients diagnosed with 'probable AD' according to DSM IV and NINCDS/ADRDA criteria and nine controls were studied. Results: There was no statistical difference in CSF β secretase activity between AD patients (mean±S.E., 343.8 ± 47.9) and the controls (mean±S.E., 409.6 ± 34.9). There was also no statistical difference in serum β secretase activity between the patients (mean±S.E., 2298.9 ± 70.3) and the controls (mean±S.E., 2438.2 ± 119.4). Conclusions: In conclusion, these results indicate that beta-secretase activity is not changed in Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Published
2010

119. Koma Halindeki Yoğun Bakım Hastalarında Amantadin Tedavisinin Nörolojik İyileşme ve Mortalite Üzerine Etkisinin İncelenmesi.

Author

Aydın, Kutlay, Öner, Özlem, Tokur, Murat Emre, Yılmaz, Barış, Ergan, Begüm, Yaka, Erdem, and Gökmen, Necati

Subjects
AMANTADINE, INFLUENZA, ARREST
Abstract

Amaç: Geçirilmiş kardiyak arrest ve travmatik beyin hasarı (TBI) sonrası komatöz olarak yoğun bakım ünitesinde (YBÜ) takip edilen hastalarda, amantadin kullanımının nörolojik iyileşmeye ve mortalite oranlarına etkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışma grubuna, beyin hasarı gelişimi sonrası ilk 72 saat içerisinde en az 200 mg/24 st dozunda intravenöz amantadin infüzyon tedavisi başlanan ve en az 14 gün intravenöz amantadin alan hastalar dahil edildi. Kontrol grubu olarak demografik verileri ve klinik özellikleri benzer tarihsel kohort grubu seçildi. Her iki grupta yer alan hastaların, demografik verileri, tanısı, yatış tarihi, beyin hasarı gelişme zamanı, Glaskow koma skoru (GKS), JFK koma iyileşme skoru (KİS), maluliyet derecelendirme skoru (MDS) kaydedildi. Bulgular: Altmış üç hasta çalışmaya dahil edildi. Hastalar amantadin tedavisi alanlar (n=33) ve kontrol grubu (n=30) olarak gruplandırıldı. Olguların 42’si erkek (%66,7) ve 21’i kadın (%33,3) hastalardan oluşuyordu (p=0,072). Tüm hastaların yaş ortalaması 56,65±19,73 idi. Çalışmaya dahil edilen komatöz durumdaki hastaların 28’inde travma (%44,4) öyküsü bulunmaktaydı. Tedaviye başlamadan önceki GKS için tüm grubun ortalaması 5,02±2,37, amantadine tedavisi alan grupta 5,15±1,67 ve kontrol grubunda ise 4,86±2,99 olarak tespit edildi (p=0,209). Olguların 12. haftadaki GKS’ları değerlendirildiğinde 11,55±3,7, travma hastalarında amantadin tedavisi alan grupta 11,91±3,84, kontrol grubunda ise 10,5±3,29 olduğu görüldü (p=0,0049). Çalışmamızda hastaların 12. haftadaki mortalitesine bakıldığında, amantadin tedavisi alan grupta 5 (%25,4), almayan grupta ise 11 (%36,7) hastanın eks olduğu görüldü (p=0,005). Beyin ölümü, travma öyküsü olmayan ve amantadin almayan grupta 2 (%3,17) hastada gerçekleşmiştir. Sonuç: Amantadin hidroklorür, Parkinson hastalığında ve influenza profilaksisinde diskinezi tedavisi için onay almış bir ilaçtır. Etki mekanizması dopamin salınımı ve geri alım inhibisyonu yoluyla bir N-metil-d-aspartat reseptör antagonisti ve dopamin agonisti şeklindedir. Dopaminerjik ve glutaminerjik yollardaki bozulmanın TBI’deki bilişsel eksikliklerden sorumlu olduğu düşünülmektedir. Amantadin ile tedavinin, travmatik beyin hasarı olan hastalarda nörolojik iyileşmeyi ve sağkalımı olumlu etkilediği saptanmıştır. [ABSTRACT FROM AUTHOR]

Published
2022

120. Intravenous Thrombolysis in Acute Ischemic Stroke: Experiences in Dokuz Eylül University Hospital, Medical Faculty, Department of Neurology.

Author

Öztürk, Vesile, Yaka, Erdem, Uğurel, Burcu, Poyraz, Turan, Men, Süleyman, and Kutluk, Kürşad

Subjects
*THROMBOLYTIC therapy, *HEART diseases, *CEREBROVASCULAR disease, *CORONARY disease, *DRUG therapy, *CEREBRAL edema
Abstract

Acute stroke is the second leading cause of death after heart diseases in the world. Acute ischemic stroke (AIS) accounts for 80% of all strokes. The idea that AIS is an incurable disease has been abolished during the recent years because of thrombolytic treatment. To date, the only proven therapy in acute ischemic stroke to prevent infarction and minimize the degree of permanent brain injury is thrombolytic treatment. But it has some limitations; it has narrow theuropatic index and high risk of serious complications and also well-established stroke centers are needed for this therapy. We present 21 patients with acute ischemic stroke (13 male, 8 female) who were treated with intravenous recombinant tissue plasminogen activator (IV rt-PA) in our department between 19.09.2006 - 30.01.2008. The neurological statuses of the patients were assessed by "The National Institutes of Health Stroke Scale" (NIHSS) before thrombolysis application, at 24 hour, at 1 week and at 3 months. At the first day of the therapy, 75% of patients had excellent global outcomes (minimal or no deficit). The neurological examinations of IV rt-PA patients at 1 month and at 3 months were also excellent. Symptomatic intracranial bleeding was occurred in one patient as a result of IV rt-PA threapy. Four patients were died, one patient died because of brain edema without hemorrhage, one patient died because of brain hemorrhage, the others died because of systemic reasons. Despite low number of patients, our experience contributed important information that IV rt-PA treatment is effective and reliable in well-selected patients. [ABSTRACT FROM AUTHOR]

Published
2008

121. A COMPOSITE SCORE FOR DOKUZ EYLUL COGNITIVE STATE NEUROCOGNITIVETEST BATTERY: A DOOR-TO-DOOR SURVEY STUDY WITH ILLITERATE, LOW AND HIGH EDUCATED ELDERLY IN TURKEY

Author

Kurt, Pinar, Keskinoglu, Pembe, Yaka, Erdem, Ucku, Reyhan, and Görsev G. Yener

Subjects
Mild Cognitive Impairment, Questionnaire, Dementia, social sciences
Abstract

This study aimed to develop a composite score for the Turkish neuropsychological test battery named Dokuz Eylul Cognitive State for a large well educated and less educated elderly population, including those with mild cognitive impairment and dementia. Materials and Method: Dokuz Eylul Cognitive State total scores were obtained by summing scores acquired from individual Dokuz Eylul Cognitive State subtests to establish a total composite score. Control participants (n=363) were dwelling in the community and tested by means of a door-to-door survey. The utility of the total score was further tested in independent samples of dementia patients with various etiologic backgrounds (n=53) or mild cognitive impairment (n=53) participants. Results: Areas under the receiver operating characteristics curve in well and less educated dementia patients and healthy participants were found to be 0.931 and 0.954, respectively. A cut-off point of 72/73 of Dokuz Eylul Cognitive State for the well educated elderly had the highest sensitivity (83.8) and specificity (90.3), whereas a cut-off point of 49/50 for the less educated elderly had the highest sensitivity (91.2) and specificity (88.6). The Cronbach's values of the Dokuz Eylul Cognitive State for well educated and less educated elderly were higher than 0.8. Conclusion: These results support the validity of the Dokuz Eylul Cognitive State total score for the purpose of detecting and monitoring the progression of receiver operating characteristics and dementia in patients with different levels of education in clinical and research settings

123. Management Of Carotid Artery Stenosis: Experiences in Dokuz Eylül University Hospital.

Author

Ozturk, Vesile, Men, Süleyman, Ugurel, Burcu, Goktay, Yigit, Yaka, Erdem, Kaya, Derya, and Kutluk, Kursad

Subjects
*BRAIN diseases, *MENTAL illness, *ATHEROSCLEROSIS, *CAROTID artery, *ARTERIAL stenosis, *NEURORADIOLOGY, *ENDARTERECTOMY, *CEREBROVASCULAR disease, *DEVELOPMENTAL disabilities, *PATHOLOGICAL psychology
Abstract

Vascular brain diseases are known to be the second cause of death worldwide, and the third cause of death in the developed countries. Approximately 20 % of the cases with stroke are due to carotid artery atherosclerosis. The treatment of patients with carotid atherosclerosis consists of an effective medical treatment together with neuroradiologic interventions (stending) or surgery (endarterectomy). In our university hospital from 2003 till now, symptomatic or asymptomatic patients with carotid artery atherosclerosis have been assessed by a multidisciplinary committee in which the instructors from the departments of neurology, cardiovascular surgery and interventional radiology take part and the treatment or preventive procedures for these patients have been assigned accordingly. Between June 2003 and September 2007, 139 patients referred mostly from the neurology department have been assessed by this committee in our hospital. In this article, the experiences from the demographic features, treatment decisions and outcomes of these patients are discussed. Of the 139 patients assessed by the committee, 37 patients have been decided to be followed only by a medical treatment, 97 patients have been decided to have an interventional treatment, and 5 patients have undergone endarterectomy. Among 97 patients decided to have an interventional treatment, 3 had an intracranial stending. In the remaining 94 patients who had an extracranial stending, 8 had subclavian and 86 had carotid artery stending. After carotid stent procedure, in 2 cases a major and in 8 cases a minor neurological complication have developed. Finally, carotid stending is a procedure with acceptable complication ratio and an alternative treatment to endarterectomy in experienced centers. Each center should have a treatment suggestion depending on its facilities and experiences, making a common decision together with patients by suggesting each alternative. Ideally this decision should be made by a committee in which a neurologist, an interventional radiologist and a cardiovascular surgeon take part, as in our center. More importantly, symptomatic patients require either interventional treatment or endarterectomy apart from medical treatment alone. The patients should be protected from a second stroke by an optimal medical treatment in addition to these procedures. [ABSTRACT FROM AUTHOR]

Published
2008

124. The COVID-19 from Neurological Overview

Author

Rifat Erdem Togrol, Nerses Bebek, Hakan Ekmekçi, Türkan Acar, Ayse Deniz Elmali, Tuğçe Mengi, Ethem Murat Arsava, Hacer Durmuş Tekçe, Nazire Afsar, Ufuk Ergün, Gülşen Akman Demir, Şerefnur Öztürk, Demet Ilhan Algin, Erdem Yaka, Yesim Parman, E. Koc, Atilla Özcan Özdemir, Aylin Akcali, Ömer Karadaş, Ozden Sener, Fettah Eren, Sevki Sahin, Arman Çakar, Esra Aciman Demirel, Mehmet Ilker Yon, Aybala Neslihan Alagöz, Füsun Erdoğan, Başar Bilgiç, Firuze Delen, Mehmet Uğur Çevik, Ali Ulvi Uca, Rana Karabudak, Özlem Kayım Yıldız, F. Irsel Tezer, Semih Ayta, Haluk Gümüş, Ayse Sagduyu Kocaman, Oğuz Osman Erdinç, Cavit Boz, Demet Özbabalık Adapınar, Kayihan Uluc, Nese Tuncer, Ayşe Bora Tokçaer, Neşe Çelebisoy, Esen Saka Topcuoglu, Mehmet Akif Topcuoglu, KKÜ, Maltepe Üniversitesi, Tıp Fakültesi, Acar, Turkan, Demirel, Esra Aciman, Afsar, Nazire, Akcali, Aylin, Demir, Gulsen Akman, Alagoz, Aybala Neslihan, Mengi, Tugce Angin, Arsava, Ethem Murat, Ayta, Semih, Bebek, Nerses, Bilgic, Basar, Boz, Cavit, Cakar, Arman, Celebisoy, Nese, Cevik, Mehmet Ugur, Delen, Firuze, Tekce, Hacer Durmus, Ekmekci, Hakan, Elmali, Ayse Deniz, Erdinc, Oguz Osman, Erdogan, Fusun Ferda, Eren, Fettah, Ergun, Ufuk, Parman, Yesim Gulsen, Gumus, Haluk, Algin, Demet Ilhan, Karabudak, Rana, Karadas, Omer, Yildiz, Ozlem Kayim, Koc, Emine Rabia, Adapinar, Demet Ozbabalik, Ozdemir, Atilla Ozcan, Ozturk, Serefnur, Kocaman, Ayse Sagduyu, Sahin, Sevki, Topcuoglu, Esen Saka, Sener, Ozden, Tezer, F. Irsel, Togrol, Rifat Erdem, Tokcaer, Ayse Bora, Topcuoglu, Mehmet Akif, Tuncer, Nese, Uca, Ali Ulvi, Uluc, Kayihan, Yaka, Erdem, Yon, Mehmet Ilker, Acibadem University Dspace, and Ege Üniversitesi

Subjects
PNEUMONIA, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Disease, CORONAVIRUS INFECTION, GUIDELINES, DISEASE, CHINA, HOSPITALIZED-PATIENTS, nöroloji, MANAGEMENT, Neurological manifestation, Medicine, TELEMEDICINE, Intensive care medicine, RC346-429, business.industry, Meningoencephalitis, covid-19 pandemisi, medicine.disease, N95 RESPIRATORS, Clinical neurology, Pneumonia, covid-19, Neurology (clinical), Neurology. Diseases of the nervous system, business, ACUTE RESPIRATORY SYNDROME, SYSTEM
Abstract

Objective. Comparison of ultrasound (US)-guided erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) in video-assisted thoracic surgery (VATS) patients. The primary outcome was to compare perioperative and postoperative (48 hours) opioid consumption. Methods. A total of 60 patients were randomized into two groups (N =30): an ESPB group and an SAPB group. All the patients received intravenous patient-controlled postoperative analgesia and ibuprofen 400 mg intravenously every eight hours. Visual analog scale (VAS) scores, opioid consumption, and adverse events were recorded. Results. Intraoperative and postoperative opioid consumption at 0-8, 8-16, and 16-24 hours and rescue analgesic use were significantly lower in the ESPB group (P< 0.05). Static/dynamic VAS scores were significantly lower in the ESPB group (P< 0.05). There was no significant difference between static VAS scores at the fourth hour. There were no differences between adverse effects. Block procedure time and one-time puncture success were similar between groups (P > 0.05 each). Conclusion. US-guided ESPB may provide better pain control than SAPB after VATS. Question. Even though there are studies about analgesia management after VATS, clinicians want to perform the technique that is both less invasive and more effective. Findings. This randomized trial showed that US-guided ESPB provides effective analgesia compared with SAPB. Meaning. Performing single-injection ESPB reduces VAS scores and opioid consumption compared with SAPB.

Published
2020

125. Akut iskemik inmeli hastalarda ilk 24 saat içinde uygulanan tedavi sonrasında prognozun değerlendirilmesi

Author

Yeğnidemir, Bilge, Yaka, Erdem, and Klinik Sinir Bilimler Ana Bilim Dalı

Subjects
Stroke, Nöroloji, Brain ischemia, Neurology, Ischemia, Thrombosis, Prognosis
Abstract

Amaç: Serebrovasküler nedenlere bağlı ölüm ve sakatlık oranlarının yüksek olması ülke popülasyonunda tanı, tedavi ve takip süreçleri ile ilgili geniş örneklemli çalışma ihtiyacını ortaya çıkarmaktadır. Bu çalışmada, akut iskemik inme hastalarının demografik, klinik ve laboratuvar özellikleri tanımlanarak ilk 24 saatte uygulanan akut iskemik inme tedavisi sonrasında prognozun değerlendirilmesi amaçlanmıştır. Yöntem: Dokuz Eylül Üniversitesi Eğitim ve Uygulama Hastanesi Nöroloji Servisi'ne, İnme Ünitesi ve Nöroloji Yoğun Bakım Ünitesine Ağustos 2013 ve Ağustos 2018 tarihleri arasında Akut İskemik İnme tanısıyla yatırılmış 371 hastanın, hastane elektronik veri tabanlarında yer alan tüm verilerine ulaşılarak, veriler retrospektif olarak değerlendirilmiştir.Bulgular: Akut iskemik inme tedavisi sonrası görülen toplam komplikasyon sayısı ve komplikasyon yaşamadan taburcu olma oranları değerlendirildiğinde intravenöz tromboliz (IV tPA) alan grubun mekanik trombektomi (MT) (p=0,001) ve diğer endovasküler tedavilerden birini alan gruba göre (p=0,031) daha az sayıda komplikasyon yaşadığı, ayrıca komplikasyon yaşamadan taburcu olma oranının (%33,8) diğer gruplardan daha yüksek olduğu saptanmıştır (p=0,045). Hastane yatış sürelerine bakıldığında da yine IV tPA alan hastaların, MT uygulanan hastalar (p=0,030) ile IV tPA ve MT uygulanan hastalardan (p=0,004) daha kısa hastane yatış oranına sahip olduğu görülmektedir.Sonuç: IV tPA alan grubun diğer gruplarla karşılaştırıldığında daha iyi prognoza sahip olduğu görülmüştür. Tedavi grupları arasında oluşan bu fark, tedavi öncesi yapılan klinik değerlendirme bulguları, hastaların mevcut risk faktörleri ve demografik profilleriyle açıklanamamaktadır. Ayrıca, erkek cinsiyetin, hipertansiyon tanısının ve acile başvuru anında yüksek kan basıncına sahip olmanın ilk 24 saat içinde uygulanan tedaviden bağımsız olarak akut iskemik inme prognozunu olumsuz etkilediği gösterilmiştir.Anahtar Sözcükler: Akut İskemik İnme, İntravenöz Tromboliz, Mekanik Trombektomi, Prognoz Objective: The high disability and mortality rates due to cerebrovascular causes reveal the need for large sample studies on the diagnosis, treatment and follow-up processes in the local population. In this study, we aimed to evaluate the prognosis of acute ischemic stroke patients after the acute ischemic stroke treatment performed in the first 24 hours.Method: The study included 371 patients with acute ischemic stroke who were admitted to the Neurology Department, Stroke Unit and Neurology Intensive Care Unit of Dokuz Eylül University Education and Practice Hospital between August 2013 and August 2018. All the data of the patients in the hospital electronic databases were reached and evaluated retrospectively.Results: When the total number of complications occured after acute ischemic stroke treatment and the rate of discharges without complications were evaluated, it is seen that intravenous thrombolysis (IV tPA) group has less number of complications than mechanical thrombectomy (MT) (p = 0.001) and other endovascular treatments (p = 0.031). Besides, the discharging rates without complications in the IV tPA group (33.8%) were higher than the other groups (p = 0.045). When the length of stay in hospital is considered, it was observed that patients who received IV tPA had a shorter hospitalization rate than patients treated with MT (p = 0.030) and patients treated with IV tPA and MT (p = 0.004).Conclusions: It was observed that the group received IV tPA had a better prognosis compared to the other groups. This difference between treatment groups cannot be explained by clinical evaluation findings, current risk factors and demographic profiles of patients. Additionally, it has been shown that male gender, hypertension and high blood pressure at the time of admission to the emergency room adversely affect the prognosis of acute ischemic stroke independently of the treatment performed in the first 24 hours.Keywords: Acute Ischemic Stroke, Intravenous Thrombolysis, Mechanical Thrombectomy, Prognosis 75

Published
2019

126. The effect of amantadine treatment on neurological outcome and mortality in mechanically ventilated severe head trauma patients in intensive care unit.

Author

Öner Ö, Hanci V, Gürkok MÇ, Ergan B, Yaka E, and Gökmen AN

Subjects
Humans, Male, Female, Middle Aged, Adult, Retrospective Studies, Aged, Adolescent, Aged, 80 and over, Brain Injuries, Traumatic mortality, Brain Injuries, Traumatic drug therapy, Young Adult, Treatment Outcome, Craniocerebral Trauma mortality, Amantadine therapeutic use, Respiration, Artificial statistics & numerical data, Intensive Care Units statistics & numerical data, Glasgow Coma Scale
Abstract

This study aims to investigate the effect of amantadine use on neurological outcomes and mortality in patients with severe traumatic brain injury (TBI) (Glasgow coma score [GCS] between 3 and 8) who have been followed up on mechanical ventilators in the intensive care unit (ICU). Data from the hospital's electronic records were retrospectively searched. Patients over 18 years of age, with severe brain trauma (GCS between 3-8), who were treated with endotracheal intubation and invasive mechanical ventilation at admission to the ICU, and who were treated with Amantadine hydrochloride at least once in the first week of follow-up were included in the study. To evaluate the patients' neurological outcomes, the GCS and FOUR scores were used. GCS and FOUR scores were recorded on the 1st, 3rd, and 7th days of the first week. In addition, the score difference between the 1st and 7th day was calculated for both scores. The patients were divided into 2 groups: those receiving amantadine treatment (Group A, n = 44) and the control group (Group C, n = 47). The median age of all patients was 39 (18-81) (P = .425). When Group A and Group C were compared, no statistically significant results were found between the 1st, 3rd, and 7th day GCS values (P = .474, P = .483, and P = 329, respectively). However, the difference in GCS values between day 1 and day 7 (∆ GCS 7-1) was statistically significant (P = .012). Similarly, when Group A and Group C were compared, no statistically significant results were found between the 1st, 3rd, and 7th day FOUR score values (P = .948, P = .471, and P = .057, respectively). However, the FOUR score values between day 1 and day 7 (∆ FOUR score 7-1) were statistically significant (P = .004). There was no statistically significant difference among the groups in terms of ICU length of stay, duration of non-ICU hospital stay, and length of hospital stay (P = .222, P = .175, and P = .067, respectively). Amantadine hydrochloride may help improve neurological outcomes in patients with severe TBI. However, further research is needed to investigate this topic., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Published
2024
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