Akut İskemik İnme Hastalarında Yeni Bir Markır: Monosit / HDL Oranı

Objective: Stroke is a major cause of global morbidity and mortality. Ischemic stroke is usually marked by cell death associated with inflammation and oxidative stress, and the role of inflammation in neurological diseases has become increasingly obvious. In our study, we studied the monocyte / HDL ratio (MHR) which can support the theory of inflammation in stroke and can be used in clinical practice. MHR can be used a prognostic marker in stroke patients base on this theory. Methods: Our study registered 91 acute ischemic stroke patients (47 females and 44 males) and 50 healthy controls. Results: MHR was elevated in the patient group and correlated with high-sensitivity C-reactive protein (hsCRP). MHR was higher in patients with high a National Institutes of Health Stroke Scale (NIHSS) than those with a low NIHSS (p=0.050) as well as in patients with a larger infarct area and in than those with a smaller area (p=0.050). The MHR correlated with both the clinical condition and infarct area in acute ischemic stroke patients, which underscores the value of MHR as a new marker. Conclusions: This cross-sectional study of 91 acute ischemic stroke patients indicates that inflammation markers and MHR are correlated with clinical status and even radiological parameters.Amaç: İnme, dünyada major bir morbidite ve mortalite sebebidir. İskemik inmede genellikle inflamasyon ve oksidatif strese bağlı hücre ölümü görülür. Nörolojik hastalıklarda inflamasyonun rolü giderek daha da belirginleşmektedir. Çalışmamızda inmede inflamasyon teorisini destekleyebilen ve klinik uygulamada kullanılabilecek monosit / HDL oranını (MHO) inceledik. Gereç ve Yöntem: Çalışmamızda 91 akut iskemik inme hastası (47 kadın ve 44 erkek) ve 50 sağlıklı kontrol kaydedildi. Bulgular: Hasta grubunda MHO yüksek idi ve yüksek duyarlılıkta C-reaktif protein (hsCRP) ile korele idi. MHO, Ulusal Sağlık Enstitüleri İnme Ölçeği (NIHSS) skoru yüksek olan hastalarda, düşük NIHSS'li (p = 0.050) olanların yanı sıra, ve de daha büyük bir infarkt alanı olanlarda daha küçük infarkt alanına sahip olanlara (p = 0.050) göre daha yüksekti. MHO, yeni bir belirteç olarak, akut iskemik inme hastalarında, hem klinik durum hem de infarkt alanı ile koreledir. Sonuç: 91 akut iskemik inme hastasının, bu cross-sectional çalışması, inflamasyon belirteçlerinin ve MHO'nin; klinik durum ve hatta radyolojik parametrelerle körele olduğunu göstermektedir

A case of osteomalacia initially followed as restless leg syndrome for 6 months

We present a case of a woman with a progressive hip and feet pain. Many biochemical, clinical, and radiological tests were performed for diagnosis. All were found to be normal. The patient was diagnosed as having RLS. 0.25 mg pramipexole was given for treatment. Patient symptoms patient escalated over six months. The patient was reassessed after six months. Vitamin D levels had not been previously examined. We found low vitamin D and calcium levels, as well as pseudofractures in radiography. The diagnosis was changed to osteomalacia. Vitamin D and calcium treatment were started. Symptoms began to regress from the first week of treatment

EFFECT OF MATERNAL MIGRAINE ON CHILDREN'S QUALITY OF SLEEP

Backround and aim - Sleep disorders are common problems associated with migraine. These sleep disorders are known to have a debilitating impact on daily lives of migraine patients. The purpose of this study is to assess the effects of sleep disorders experienced by individuals suffering from migraine on their children as well as the presence of sleep disorders in their children

Role of modified TAN score in predicting prognosis in patients with acute ischemic stroke undergoing endovascular therapy

Objective: The study aimed to evaluate the prognostic role of modified TAN collateral score in predicting functional independence in ischemic stroke patients, who underwent endovascular therapy. Introduction: Identifying the group of patients, who will benefit most from arterial recanalization in patients with acute ischemic stroke, is the basis of success. Collateral circulation is a physiological condition that protects the brain against ischemia and inhibits the growth of a damaged area. The presence of collaterals is a well-known determinant for functional independence. Numerous collateral scoring systems are used for this purpose. The aim of this study was to evaluate the prognostic role of modified TAN collateral score (MTCS) in predicting functional independence in patients, who received endovascular therapy. Materials and methods: Prospective data of 101 patients, who received endovascular therapy from the stroke team of Eskisehir Osmangazi University (ESOGU) between 2016 and 2017, were examined retrospectively for this purpose. Collateral assessments were performed in Computed Tomography Angiography (CTA) according to the modified TAN scoring system (= 50% refers to good collateral status). Good clinical outcome was assessed as mRS 0-2 in the 3rd month. The TICI scoring system was used in the evaluation of recanalization. Patients treated within the first 6 h of symptom onset, patients with NCCT and contrast CTA, patients with internal carotid artery and middle cerebral artery occlusion were included in the study. Posterior system stroke was not included in the study. Conclusion: Of the 101 patients, 50 (49%) had poor MTCS. Presentation and 24th hour NIHSS values of the patients with poor MTCS were higher (p:0.003). The third month mRS values were low in patients with good MTCS on admission, while these values were high in patients, who presented with poor MTCS. Mortality rates were significantly higher in the patient group with poor collateral circulation score (32-5.9%) (p:0.001). No significant differences were found in the presentation ASPECT values and (TICI 2b/3) recanalization rates of the patients. The rate of futile recanalization was significantly higher in the group with poor collateral circulation (52-8%) (p:0.0001). Presentation glucose, NIHSS, mTAN, symptom-puncture time, and good ASPECT score were found to be predictive markers for good outcome by univariate analysis. The major risk factors were determined by performing multiple logistic regression analysis. Presentation glucose, NIHSS, and mTAN (OR:1.013, 1.29, 0.198, respectively) were found to be strong and independent predictors for good clinical outcome. According to Multiple Binary Logistic Regression analysis Backward-ward model, Baseline NIHSS, poor collaterals and baseline glucose are found as predictors for poor outcome. Discussion: This study shows that good collateral score is associated with good clinical response, small final infarct volume, third month low mRS, low admission, and 24-hour NIHSS rates. The likelihood of having long term prognosis is 7 fold higher in patients with poor collaterals. The use of the MTCS system is recommended and supported due to its easy and rapid applicability

Eurasian J Med 2014; 46: 135-7 Cerebral Fat Embolism Diagnosed by Cognitive Disorder

Fat embolism syndrome is a rarely seen complication of skeletal trauma, and it is seen at a rate of 2-5 % after fractures of the long bones of the lower extremities. Its classic triad-+consists of hypoxemia, petechial bleedings on the skin and neurological findings. These neurological findings are highly variable and non-specific, and they can present with lethargy, irritability, delirium, stupor, convulsion or coma. In this report, a male case is presented who was diagnosed with cerebral embolism due to acute cognitive disorder after a segmental tibial fracture. Key Words: Cerebral fat embolism, tibial fracture, acute cognitive disorder, diffusion-weighted MR