Supra-aortic Stenting Experiences in Over Eighty Year Old Patients

INTRODUCTION: Stroke is a common disease at any age but it is mostly seen in older population. Increasing aging of the population all over the world boostes importance of primary and secondary prevention measures for stroke. Carotid artery stenosis is observed in 10% of people over 80 years of age. Our aim is to share the clinical results and outcomes of patients over 80 years of age who underwent supraaortic stenting. METHODS: In this study we examined retrospectively 25 patients which are over 80 years of age and underwent supra-aortic stenting between January 2014- January 2017 in Gaziantep University Neurology Clinic. Patients were examined for vascular risk factors. Patient with symptomatic carotid artery (>50%) and vertebral artery stenosis (>60%) underwent stenting. Vascular complications and clinical results are recorded RESULTS: Twenty-five patients were included in study. 15 (60%) of these patients were male and 10 (40%) were female. The mean age of the patients was 81.33 ± 1.63. 40% of patients had previous stroke history or transient ischemic attack (TIA), 36% of them had hypertension (HT), 20% of them had coronary artery disease (CAD), 8% of them had hyperlipidemia (HL) and 8% of them had diabetes mellitus (DM). 25 patients applied 31 stenting. 1 (4%) patient had periprocedural asystole and 4(16%) patients had periprocedural bradycardia. There was an infarction of the middle cerebral artery (MCA) ipsilateral to the stent in 1 (4%) patient. Reperfusion bleeding did not occur in any patient. 2 (8%) patients had post-procedural encephalopathy and agitation lasting shorter than 24 hours. Hypotension was observed in 8 patients (32%). Twelve (48%) patients had post-procedural headache lasting shorter than 24 hours. DISCUSSION AND CONCLUSION: Supra-aortic stenting in patients over 80 years of age is a treatment modality in which the complication rate is low if the appropriate case is selected

Multipl sklerozda farklı interferon beta tedavilerinin klinik parametreler ve kraniyal MRI üzerine etkisi

TEZ3755Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2001.Kaynakça (s. 54-65) var.vii, 69 s. ; 30 cm.

Local Governance Quality and the Environmental Cost of Forced Migration

Can high-quality local governance alleviate the environmental impact of large-scale refugee migration? The recent surge in refugee flows has brought additional challenges to local governments in Europe, the Middle East and certain regions of Africa and Asia. In this paper, we focus on the case of Syrian refugees in Turkey and show that the quality of local governance plays a critical role in mitigating the environmental deterioration. We employ text analysis methods to construct a unique data set on local governance quality from the independent audit reports on municipalities. Using a quasi-experimental econometric strategy, we show that the Syrian refugee influx has worsened environmental outcomes along several dimensions in Turkey. Specifically, we find that the deterioration in environmental outcomes is almost entirely driven by provinces with poor-quality governance. Those provinces fail to invest sufficiently in waste management practices and environmental services in response to increased refugee settlements. We argue that good local governance practices can smooth out the refugee integration process and complement the efforts of central governments

Watershed Cerebral Infarction in a Patient with Acute Renal Failure

Acute renal failure can cause neurologic manifestations such as mood swings, impaired concentration, tremor, stupor, coma, asterixis, dysarthria. Those findings can also be a sign of cerebral infarct. Here, we report a case of watershed cerebral infarction in a 70-year-old female patient with acute renal failure secondary to contrast administration and use of angiotensin converting enzyme inhibitor. Patient was evaluated with magnetic resonance imaging because of dysarthria. Magnetic resonance imaging revealed milimmetric acute ischemic lesion in the frontal and parietal deep white matter region of both cerebral hemisphere which clearly demonstrated watershed cerebral infarction affecting internal border zone. Her renal function returned to normal levels on fifth day of admission (BUN 32 mg/dl, creatinine 1.36 mg/dl) and she was discharged. Dysarthria continued for 20 days

A case with basilar artery thrombosis resulted in Locked-in syndrome in spite of endovascular treatment

Locked-in Sendrome is a clinical picture consist of quadriplegia, lower cranial nerve paralysis, and mutism with preservation of only vertical gaze and upper eyelid movement. Consciousness remains intact and the patient is able to communicate intentionally using eye blinking. The most common cause underlying the locked-in syndrome is thrombosis of the basilar artery. In this study, we reported a 49-years-old male with past medical history for cerebrovascular disease presented with acute basilar artery thrombosis, manifesting as reduced level of consciousness, weakness in all extremity dominated on the right side, speech impairment, horizontal gaze disorder and for reaching us of the last munite of endovascular intervention threshold, so it can perform only mechanical and intra-arterial thrombosis treatment method as an endovascular treatment modalities of acute stroke

A Controlled Study of Psychiatric Manifestations and Electroencephalography Findings in Chronic Kidney Disease Patients With Sagliker Syndrome

6th International Congress on Uremia Research and Toxicity -- MAY 18-19, 2009 -- Poiana Brasov, ROMANIAWOS: 000281212400012PubMed ID: 20797571Sagliker syndrome (SS) is a novel syndrome that was described in 2004 in patients with chronic kidney disease (CKD). The aim of this study was to assess psychiatric evaluations and electroencephalography (EEG) findings of patients with CKD and SS to compare them with patients with CKD having characteristics similar to that of the study group, in terms of age and gender. The study group comprised 13 patients with CKD and SS. The control group included 13 patients with CKD. Psychiatric diseases were diagnosed using the Structure Clinical Interview. Beck Depression Inventory, Beck Anxiety Inventory, Social Comparison Scale, Hopelessness Scale, and Mini Mental State Examination (MMSE) were administered to the groups. Moreover, EEG recording for all the patients was performed. According to the results obtained from the Structure Clinical Interview, 69.2% of patients with CKD and SS were diagnosed with a mental disease, as compared with only 3 (23.1%) patients with CKD. There was a significant difference between the study and the control group (P < .001). As compared with the control group, patients with CKD and SS had significantly higher scores on the Beck Depression Inventory, the Beck Anxiety Inventory, and the Hopelessness Scale. However, patients with CKD and SS had significantly lower scores on the Social Comparison Scale. The MMSE scores were not significantly different between the 2 groups. When the 2 groups were evaluated separately, no significant differences were found between the EEG abnormalities and psychiatric diagnosis of both the groups. However, an evaluation of EEG abnormalities in all cases with CKD suggested a statistically significant difference between them. In the EEG recordings, electrical seizures activity was not enrolled in any of the cases. In the present study, psychiatric morbidity for patients with CKD and SS was worse than for patients with only CKD. These results indicate a need to develop an effective psychologic strategy for dealing with psychiatric disorders among patients with CKD and SS. (C) 2010 by the National Kidney Foundation, Inc. All rights reserved

Hometown Conflict and Refugees' Integration Efforts

How does violence in origin areas affect the educational outcomes of refugees in their destinations? Using administrative panel data, we find that heightened violence in the hometowns of Syrian students leads to improvements in their school outcomes in Türkiye. Turkish language and Math scores of refugee students improve, with larger impacts on Turkish scores. There is no impact on naturalized Syrian students. We observe positive spillovers on Turkish students. These findings suggest ongoing violence in refugee-origin areas reduces the prospect of returning home, and induces students to increase their integration effort by investing in education

How does the use of antiplatelet and anticoagulants affect the success of mechanical thrombectomy in acute ischemic stroke cases? = Hogyan befolyásolja a thrombocytaaggregáció-gátlók és az antikoagulánsok használata a mechanikus thrombectomia sikerességét akut ischaemiás stroke esetén?

In this study, we wanted to investigate the effect of antiplatelet and anticoagulant use on the success of mechanical thrombectomy in acute ischemic stroke cases. 174 patients who were brought to the Stroke Center of Gaziantep University Şahinbey Research and Practice Hospital between January 2018 and February 2019 due to acute ischemic stroke and who underwent mechanical thrombectomy were retrospectively analyzed. The demographic characteristics, antiplatelet/anticoagulant use before the stroke and mTICI (modified-Throm­bolysis-In-Cerebral-Infarction) scores used for reperfusion in mechanical thrombectomy were evaluated. The findings were analyzed statistically (p<0.05). The mean age was 63.3 ± 13.5 in 174 patients who underwent mechanical thrombectomy. 23/174 (13.2%) patients were using anticoagulant therapy (warfarin-OAC or new generation oral anticoagulant-NOAC) and 28/174 (16.1%) were using antiplatelet therapy. A history of atrial fibrillation (AF) was significantly higher in patients receiving anticoagulant therapy before acute ischemic stroke (p=0.001). Patients with a history of hyper tension (HT), diabetes mellitus (DM) and coronary artery disease (CAD) before acute ischemic stroke were receiving antiplatelet therapy in higher rates (respectively; p=0.003, p=0.037, p=0.005). Successful recanalization (mTICI ≥ 2b) was higher in patients with a history of anticoagulant use and who underwent mechanical thrombectomy (p=0.025). Our study showed that the use of anti­platelet or anticoagulants before mechanical thrombec­tomy may have an indirect positive effect on the success of the procedure

A case of multiple cerebral fat embolism syndrome associated with femoral fracture after motorcycle accident

Fat embolism syndrome is a clinical condition which is caused by oil particles introduce into the systemic circulation and result in respiratory distress, altered consciousness and petechial rashes. The most common occurrence develops following the long bone fractures within 24-72 hours. The clinical picture may vary from mild respiratory distress to grave respiratory failure and coma.We aimed to present case of diagnosis and treatment process with fat embolism syndrome following femur fractures due to motorcycle acciden