Investigation of The Effects of Serum Iron and Copper Levels in Ischemic Stroke Disease Development

INTRODUCTION: Ischemic stroke is characterized by loss of focal cerebral function due to impaired of brain-blood flow. Environmental factors and genetic factors may be effective together in the pathogenesis of ischemic stroke. Trace elements are important components of the biological structure, and toxic effects may occur when these trace elements are taken in more than the amount required for biological functions. The risk of neurological diseases such as ischemic stroke may increase as a result of imbalances in trace element levels. Therefore, the aim of this study is to investigate the effects of serum iron and copper levels in the development of ischemic stroke disease. METHODS: Our study consisted of 20 ischemic stroke patients and 36 healthy controls. Serum iron and copper levels measurements were performed using atomic absorption spectrophotometer method. RESULTS: Serum iron and copper levels were detected significantly lower in the patient group with ischemic stroke compared to the healthy control group (p<0.05). However, the significant difference was not determined in comparison of serum copper and iron levels according to gender between patient with ischemic stroke and healthy control groups (p>0.05). DISCUSSION AND CONCLUSION: In our study, it was determined that serum iron and copper levels may be effective risk factors for ischemic stroke disease. Thus, it was concluded that serum iron and copper trace element levels may be important biomarkers that may be evaluated in the diagnosis, prognosis and treatment of ischemic strok

Comparison of risk factors between patients with ischemic stroke due to intracranial or extracranial atherosclerosis and the 3 months prognosis

Tıpta Uzmanlık Teziİnme en sık izlenen nörolojik hastalıklardan biridir. İskemik inmelerin %50'si geniş arter aterosklerozuna bağlıdır. İnme ölüm sebepleri arasında tüm dünyada ilk üç sırada yer almaktadır. Dahası yüksek morbidite sebeplerindendir ve önde gelen uzun süreli engellilik nedenleri arasındadır. Çalışmamızın amacı intrakranial veya ekstrakranial ateroskleroza bağlı iskemik inme geçiren hastaların risk faktörlerini karşılaştırıp, aralarında hangi farklar olduğunu saptamak, prognozlarını belirlemek ve prognoza hangi risk faktörlerinin daha etkili olduğunu araştırmaktır. Böylelikle daha etkin bir koruma ve tedavi ile inme oranları azaltılabilir ve prognoz iyileştirilirse hastaların sekelleri azaltılabilir. Çalışmamız prospektif olarak tasarlanıp ilk 7 gün içerisinde iskemik inme nedeni ile yatırılarak tedavi edilen hastalarla yapıldı. Dahil edilme kriterleri olarak aterosklerotik inme tanısı için görüntüleme yöntemleri ile iskemik bölgeyi sulayan arteriyal yapılarda %50'den fazla stenoz veya oklüzyon saptanması, diğer olası iskemik inme nedenlerinin dışlanmış olması olarak belirlendi. Çalışmamıza Mart 2013 ile Nisan 2014 tarihleri arasında 58 intrakranial ve 57 ekstrakranial ateroskleroza bağlı inme geçiren toplam 115 hasta dahil edildi. Ekstrakranial ateroskleroz grubunda erkek hasta üstünlüğü bulundu (p=0.003). Hafif ile orta şiddetli inmeler arasında yaşın yüksek olması anlamlı bulundu (p=0.003). Bu fark ekstrakranial aterosklerozda daha belirgindi. Konjestif kalp yetmezliği ile ağır inme ilişkili bulundu (p<0.001). İntrakranial ateroskleroz grubunda erkek hastalar hafif şiddetli inme ile ilişkili bulundu (p=0.029). Alkol kullanımı daha hafif inme ile ilişkili bulundu (p=0.052). İnme şiddeti (p<0.001), yaş artışı (p=0.018), hipertansiyon varlığı (p=0.035), konjestif kalp yetmezliği (p=0.007) kötü prognoz ile ilişkili bulundu. Erkek cinsiyet (p=0.021) ve alkol tüketimi (p=0.016) iyi prognoz için anlamlı bulundu. Ekstrakranial aterosklerozda konjestif kalp yetmezliği (p=0.002) ve inme şiddeti (p<0.001) kötü prognoz ile ilişkili iken, intrakranial grupta sadece inme şiddeti kötü prognozla ilişkili bulundu (p<0.001). Sonuç olarak aterosklerotik inmelerde prognozu iyileştirebilmek için hipertansiyon gibi vasküler risk faktörlerinin daha sıkı takibi ve özellikle ekstrakranial grupta konjestif kalp yetmezliğine dikkat edilmesi gerekir.AbstractStroke is one of the most common neurological diseases. 50% of ischemic stroke occurs due to the large artery atherosclerosis. Stroke ranks among the top three causes of death worldwide. Moreover, it has high morbidity and it is one of the leading causes of long-term disability. The aims of our study were to compare risk factors in patients with intracranial or extracranial atherosclerotic ischemic stroke; to assess differences in risk factors and prognosis; to assess factors affecting prognosis. Thus, with more effective protection and treatment, we can reduce stroke rate and reduce stroke sequelae by improving the prognosis. Our study was designed prospectively and conducted with patients who were hospitalized due to ischemic stroke, within the first 7 days. Inclusion criteria were the diagnosis of atherosclerotic ischemic stroke, defined as more than 50% stenosis or occlusion in arterial structure supplying ischemic area; and having excluded other possible causes of ischemic stroke. Between March 2013 and April 2014 a total of 115 patients, 58 intracranial and 57 extracranial atherosclerotic stroke, were included in our study. İn extracranial atherosclerotic group we found male predominance (p=0.003). Mild to moderate stroke severity was associated with aging (p=0.003). This difference was more pronounced in extracranial atherosclerosis. Congestive heart failure was associated with severe stroke (p<0.001). Male gender was associated with mild stroke severity in intracranial atherosclerosis group (p=0.029). Alcohol use was associated with mild stroke severity (p=0.052). Stroke severity (p<0.001), increasing age (p=0.018), presence of hypertension (p=0.035), congestive heart failure (p=0.007) were associated with poor prognosis. Male gender (p=0.021) and alcohol consumption (p=0.016) were significant for good prognosis. In extracranial atherosclerosis group congestive heart failure (p=0.002) and stroke severity (p<0.001) were associated with poor prognosis. In intracranial atherosclerosis group only stroke severity was associated with poor prognosis (p<0.001). As a result, to improve prognosis in atherosclerotic stroke, more strict monitoring of vascular risk factors such as hypertension, is needed, and attention should be paid to congestive heart failure especially in extracranial atherosclerosis

Evaluating the Effects of Night Shifts on Attention and Executive Function of Trakya University Residents Using the Tower of Hanoi Test

DergiPark: 700193tmsjAims: This study aims to evaluate the effects of night shifts on attention and executive function among residents working atTrakya University Hospital. Methods: This prospective study was performed between November 2019 – January 2020 on 83residents working at Trakya University Hospital. The Tower of Hanoi test was used to measure the attention and function level oftwo different groups of residents. The first group being residents working with night shifts and the other group being residentswith regular working hours. After the participants finished solving the puzzle, the number of moves and the finishing time wererecorded. The demographic data about smoking, coffee intake, sleep hours, departments, and hand dominance were also recorded. Results: The participants were composed of 36 (43.4 %) female and 47 (56.6 %) male residents. The difference in smokingrate and sleep time between the two groups were found to be statistically significant whereas the difference between the completion time and moves was not statistically significant. Conclusion: Smoking and duration of sleep may affect the Tower of Hanoipuzzle performance. Although residents working with night shifts did not under-perform, the importance of sleep for cognitiveskills such as attention and coordination cannot be underestimated. Stress caused by night shifts may affect reaction time forproblem-solving, but further studies are needed. Keywords: Nightshift, attention, Tower of Hanoi tes

Late-Onset Generalized Myoclonic Seizure: Case Report

Most of the epileptic seizures that begin at an advanced age are focal onset seizures due to an underlying structural lesion. Generalized myoclonic seizures, usually seen in adolescence, are very rare in elderly patients without a history of epilepsy. In this study, we present a 60-year-old patient with generalized myoclonic seizures with electrophysiological findings. Because of the late-onset, myoclonic jerks were first evaluated with the diagnosis of non-epileptic psychogenic attack in an external health center. The patient was diagnosed with seizure recordings in Electroencephalography-video monitoring. The patient responded well to the antiepileptic treatment and became seizure-free

The Relationship between Diffusion-Weighted Magnetic Resonance Imaging Lesions and 24-Hour Rhythm Holter Findings in Patients with Cryptogenic Stroke

Background and objectives: Cranial magnetic resonance imaging findings of patients considered to be cryptogenic stroke may be useful in determining the clinical and prognostic significance of arrhythmias, such as atrial premature beats and atrial run attacks, that are frequently encountered in rhythm Holter analysis. This study was conducted to investigate the relationship between short atrial runs and frequent premature atrial contractions detected in Holter monitors and infarct distributions in cranial magnetic resonance imaging of patients diagnosed with cryptogenic stroke. Materials and Methods: We enrolled the patients with acute ischemic stroke whose etiology were undetermined. We divided the patients in two groups according to diffusion-weighted magnetic resonance imaging as single or multiple vascular territory acute infarcts. The demographic, clinical, laboratory, echocardiographic, and rhythm Holter analyses were compared. Results: The study investigated 106 patients diagnosed with cryptogenic stroke. Acute cerebral infarctions were detected in 31% of the investigated patients in multiple territories and in 69% in a single territory. In multivariate logistic regression analysis, the total premature atrial contraction count (OR = 1.002, 95% CI: 1.001&#8315;1.004, p = 0.001) and short atrial run count (OR = 1.086, 95% CI: 1.021&#8315;1.155, p = 0.008) were found as independent variables that could distinguish between infarctions in a single or in multiple vascular territories. Conclusions: Rhythm Holter monitoring of patients with infarcts detected in multiple vascular territories showed significantly higher premature atrial contractions and short atrial run attacks. More effort should be devoted to the identification of cardioembolic etiology in cryptogenic stroke patients with concurrent acute infarcts in the multiple vascular territories of the brain

A Case of Autoimmune Encephalitis with Refractory Status Epilepticus

Refractory status epilepticus is usually caused by a severe brain injury and has a high rate of mortality and morbidity despite the infusion of antiepileptic drugs and anesthetic agents. Autoimmune encephalitis is one cause of refractory status epilepticus and status epilepticus may be the initial symptom. The seizures are generally resistant to standard treatment and may require immunotherapeutics. This is a description of a patient who had refractory status epilepticus despite appropriate doses of antiepileptic and general anesthetic drugs, but responded to intravenous immunoglobulin therapy. Examinations revealed an ovarian teratoma with a negative serum N-methyl-D-aspartate receptor antibody