Evaluation of stroke risk factors and characteristics in the comorbidity of cancer

Aim: Stroke and cancer can be followed together and in the presence of cancer, there may be changes in classical stroke characteristics. The aim of this study was to determine the effect of cancer on stroke risk factors, radiological and clinical features. Materials and Methods: Patients who were hospitalized with the diagnosis of stroke between 2014-2020 were included in the study retrospectively. By examining the stroke and cancer characteristics of the patients; The differences in demographic findings, stroke risk factors, and radiological features of stroke between patients with and without cancer were examined. The anti-cancer treatments used and the characteristics of cancer were evaluated in stroke patients. Results: 281 stroke patients were evaluated and cancer was detected in 52 patients. There was no significant difference in terms of demographic characteristics of the patients. No significant difference was observed in stroke patients with cancer in terms of risk factors except smoking and alcohol use. Multiple ischemic lesions were more evident on magnetic resonance imaging (MRI) in stroke patients with cancer. The most common cancer was lung cancer. Conclusion: Stroke and cancer are increasingly common comorbidities. As the time between stroke and cancer development decreases, while the risk factors for cancer are more prominent, classical risk factors for stroke are observed less frequently

Relation of Apathy to Motor and Non-motor Findings in Parkinson’s Disease

Aim:It has been shown that motor symptoms, as well as non-motor symptoms, significantly affect the quality of life of patients with idiopathic Parkinson’s disease. In our study, the association of apathy, one of the NMS, with motor and non-motor symptoms was investigated.Methods:Patients with stage 1-3 IPH according to the Hoehn-Yahr Scale (H&Y) were included in the study. Patients who received dementia diagnosis according to the DSM IV criteria were excluded from the study. The patients were evaluated using the Unified Parkinson’s Disease Rating Scale (UPDRS), non-motor symptoms Questionnaire (NMSQ), Geriatric Depression Scale (GDS), and the revised diagnostic criteria for apathy.Results:Apathy was found in 26 of 68 patients who were included in the study. Patients with and without apathy were compared in terms of age, clinical and demographic characteristics, L-dopa equivalent doses, depression, and NMSQ scores. The group of patients with apathy consisted of nine females and 17 males and the mean age was 64.3±7.7 years. The non-apathy group included 25 females and 17 males and the mean age was 66.8±9.1 years. There was no statistically significant difference between the groups in terms of age, education, age at onset, duration of illness and L-dopa equivalent doses. The male-to-female ratio was significantly higher in the apathy group. The mean GDS and NMSQ scores in the apathy group were significantly higher than in the non-apathy group. There was a statistically significant difference between the groups in H&Y stage and total UPDRS and subscales scores. It was noteworthy that the rate of stage 3 patients was higher in the group of patients with apathy. The number of patients having bradykinesia in the apathy group and the number of patients having tremor in the group without apathy was higher.Conclusion:Our study showed that apathy, one of the non-motor symptoms, was more prominent in male gender, associated with UPDRS scores, clinical stage and bradykinesia, and accompanied by depression

Identification of protein-protein interaction bridges for multiple sclerosis

Motivation: Identifying and prioritizing disease-related proteins is an important scientific problem to develop proper treatments. Network science has become an important discipline to prioritize such proteins. Multiple sclerosis, an autoimmune disease for which there is still no cure, is characterized by a damaging process called demyelination. Demyelination is the destruction of myelin, a structure facilitating fast transmission of neuron impulses, and oligodendrocytes, the cells producing myelin, by immune cells. Identifying the proteins that have special features on the network formed by the proteins of oligodendrocyte and immune cells can reveal useful information about the disease.Results: We investigated the most significant protein pairs that we define as bridges among the proteins providing the interaction between the two cells in demyelination, in the networks formed by the oligodendrocyte and each type of two immune cells (i.e. macrophage and T-cell) using network analysis techniques and integer programming. The reason, we investigated these specialized hubs was that a problem related to these proteins might impose a bigger damage in the system. We showed that 61%-100% of the proteins our model detected, depending on parameterization, have already been associated with multiple sclerosis. We further observed the mRNA expression levels of several proteins we prioritized significantly decreased in human peripheral blood mononuclear cells of multiple sclerosis patients. We therefore present a model, BriFin, which can be used for analyzing processes where interactions of two cell types play an important role

Reliability and validity of the Turkish version of the questionnaire for the assessment of self-reported olfactory functioning and olfaction-related quality of life

Objective: To examine the reliability and validity of the Turkish version of the questionnaire for the assessment of self-reported olfactory functioning and olfaction-related quality of life (ASOF).Methods: Three different surveys [ASOF, beck depression inventory (BDI), and 36-Item Short-Form Health Survey (SF-36) questionnaire] were completed by 112 subjects with subjective olfactory dysfunction (OD) and 21 healthy controls. Sniffin' Sticks tests were performed. Internal consistency, test-retest reliability, and validity were analyzed.Results: The Cronbach a coefficients for the ASOF self-reported capability of perceiving (ASOF-SRP) specific odors scale (SOC) and ASOF self-reported olfaction-related quality of life (ASOF-ORQ) were 0.98 and 0.97, with relatively high internal consistency, respectively. The test-retest reliability for the ASOF was high for all subscales. ASOF-SRP-SOC, ASOF-SRP, and ASOF-ORQ showed significant positive correlations with the overall SF-36 score and negative correlations with BDI. The ASOF scale scores in healthy controls were significantly higher than those in patients with hyposmia and anosmia (p=0.001). TDI composite score and its subscales (threshold, discrimination, and identification) showed significant negative correlations with the BDI score and significant positive correlations with each of the SF-36 domains and overall SF-36 scores and ASOF subtests.Conclusion: This study showed that the Turkish version of the ASOF is a reliable and valid measure to determine the olfactory function and impairment in daily life associated with OD. Because of the easy-to-use features of the ASOF, it is a useful tool for initial assessment and follow-up of the subjects with OD

Nocturnal blood pressure changes in Parkinson's disease: Correlation with autonomic dysfunction and vitamin D levels

Nocturnal blood pressure (BP) changes are an indicator of autonomic dysfunction. We aim to investigate the correlation between nocturnal blood pressure (BP) variability, vitamin D levels and Parkinson's disease severity (PD) in this study. Thirty-five patients with PD participated in the study. Disease severity was evaluated by United Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr Scale (HYS). Equivalent levodopa dose was calculated and 25-hydroxyvitamin D levels were measured. The Non-Motor Symptom Questionnaire (NMSQ) was applied to all patients. Ambulatory BP monitoring for 24 h was established. Patients were divided into three groups according to nocturnal BP results: dippers (normal finding-a decline in mean nighttime BP of more than 10%); non-dippers (pathological-a decline in mean nighttime BP of less than 10%); reverse dippers (pathological-an increase in mean nighttime BP) .The mean score of the NMSQ was higher in the group with HYS > 2 (p = 0.050). Four patients were dipper, 17 patients were non-dipper and 16 patients were reverse dipper. There was no significant difference between the three groups in terms of age, gender, disease duration, age of the disease onset, disease stage, disease duration, dopamine agonist usage, levodopa equivalent dose, vitamin D level and NMSQ scores. NMSQ scores are high in advanced PD. Ambulatory BP monitoring is useful in detecting autonomic dysfunction. The number of patients with non-dipping and reverse dipping is high in PD, independent from PD severity, drug dose, vitamin D and the other NMS symptoms

Evaluation of pai-1 polymorphisms in central and peripheral thromboembolies

Thromboembolism is a clinical finding that occurs due to thrombus; formed in the vascular system and has various etiological factors. It can be classified as central and peripheral thromboembolism. Our objective in this study is to explore genetic risk factors in central and peripheral thromboembolism and reveal the differences. 342 thromboembolism patients were retrospectively included to the study between January 2016 and December 2019. Demographic characteristics, risk factors for thromboembolism and genetic mutations in central and peripheral thromboembolism groups were overviewed. The genetic mutations evaluated in patients were Factor V Leiden G1691A, Factor V HR1299R, Factor II (Prothrombin) G20210A, MTHFR (Methylenetetrahydrofolate reductase) C677T, MTHFR A1298C, PAI 4G/5G. Within the scope of the study, genetic analyzes of 106 patients were reached and included in the study. Seventy-two central thromboembolism (69.8%), 34 (31.2%) peripheral thromboembolisms were detected. Sixty-three of the central thromboembolisms were from arterial and nine were from venous origin. There was no significant difference between age, gender and risk factors of central thromboembolism and peripheral thromboembolism patients (p0.05), but smoking was more common in central thromboembolism patients (p: 0.041). 4G/5G polymorphism was observed more frequently in patients with central thromboembolism (p: 0.039). Thromboembolism is a multifactorial disease, PAI-1 4G/5G polymorphism is a medium risk factor for thromboembolism. We conclude that PAI-1 4G/5G polymorphism is more frequent in central thromboembolism than peripheral thromboembolism and its evaluation can give more information about the thromboembolic risk analyze

Restless legs syndrome in aircrew

INTRODUCTION: Restless legs syndrome (RLS) is characterized by an uncomfortable sensation on the legs, which causes the urge to move the legs.The main cause is unknown but there are many risk factors, including geographical properties and high altitude. Our objective was to explore the frequency of RLS in aircrew. METHODS: There were 301 Turkish aircrew who were admitted to Istanbul Medipol University Hospital Neurology Department for periodic examinations and 272 healthy (non-aircrew) subjects included in the study. The International RLS Study Group's Questionnaire and the International RLS Study Group Rating Scale (IRLSSGRS) were used to evaluate RLS. The participants filled the RLS questionnaire and then both groups were divided into two subgroups as having RLS or not.The subjects' years in the profession, average flight duration in a month, daily sleep duration, smoking, and coffee consumption were recorded. None of the subjects had previously been diagnosed with RLS. RESULTS: The frequency of RLS was 6.7% in the aircrew group and 7.9% in the control group, and there was no significant difference between the two groups. Age, gender, daily duration of sleep, smoking, coffee consumption, family history of RLS, being a pilot or a flight attendant, years in profession, and monthly flight hours were similar in aircrew with and without RLS. DISCUSSION: The RLS frequency in aircrew was similar to that of the control group. We can conclude flying at high altitude wasn't a risk factor for RLS

Olfactory training ball improves adherence and olfactory outcomes in post-infectious olfactory dysfunction

Purpose In an effort to make olfactory training (OT) simpler, we designed an 'olfactory training ball' (OTB)-a baseball-size ball with four odor-containing tubes to use in OT. The study aimed to investigate the effects of OT with the OTB in comparison to classical OT with special attention to the effects of adherence to OT on olfactory outcome measures. Methods Sixty patients with olfactory dysfunction following infections of the upper respiratory tract received OT either with classical methods-sniffing odors from jars (COT)-or the OTB for 12 weeks. Patients exposed themselves to the odors for 5 min twice daily. Adherence was measured with a modified version of the Morisky scale. Before and after OT, all patients underwent extensive olfactory testing using the Sniffin' Sticks test. Results At the end of the 12 weeks of OT, TDI composite score (22.1 +/- 2.8 vs. 19.9 +/- 4.7, P = 0.044) and odor discrimination subtest scores (9.1 +/- 1.8 vs.7.6 +/- 2.5, P = 0.013) of the OTB group were significantly higher than that of the COT group. Adequate adherence to OT was significantly higher in patients receiving OTB when compared to those receiving COT (63% vs. 30%, P = 0.019). Conclusion The present study shows that a novel OT device, the OTB, provides better adherence to the training process compared to COT. Moreover, findings of the current study show that better adherence to the OT process is associated with better olfactory outcomes

Malign melanomlu olguda beyin metastazı: Melanotik patern

Dear Editor, A man aged 58 years who had been under follow up for malignant melanoma (MM) for six years, was admitted to the neurology outpatient clinic with symptoms of headache and loss of balance. He had had very severe and throbbing headaches for the last 3 days that were not accompanied by nausea and vomiting, and were not completely relieved by analgesics. He also reported loss of balance in the last 2 days, and he had difficulty in holding objects and climbing stairs. From his past medical history, it was learned that he had undergone surgery for MM located on the skin of left shoulder and a lung metastasis that was detected four months ago. On his neurologic examination, he had blurry papillary boundaries prominent on the right side and truncal ataxia. Contrast-enhanced brain magnetic resonance imaging revealed supra- and infratentorial multiple MM metastases that showed lesions in susceptibility weighted imaging (SWI) and VenBOLD sequences that were hyperintense on axial T1-weighted images and hypointense on axial T2-weighted images (Figure 1). Regression of lesions was observed following radiotherapy (Figure 2).Sayın Editör, Altı yıldır malign melanom (MM) nedeni ile takip edilen 58 yaşında erkek hasta baş ağrısı ve dengesizlik şikayetleri ile nöroloji polikliniğimize başvurdu. Son 3 gündür çok şiddetli olan, zonklayıcı, bulantı ve kusmanın eşlik etmediği, analjezikle tamamen geçmeyen baş ağrısı mevcuttu. Son 2 gündür dengesizlik yakınması da olan hasta eşyaları tutarken ve merdiven çıkarken zorlanmaktaydı. Özgeçmişinde 6 yıl önce geçirilmiş sırt bölgesinde MM operasyonu ve 4 ay önce tespit edilen akciğer metastazı olduğu öğrenildi. Nörolojik muayenesinde sağda daha belirgin olmak üzere papil sınırları silikti ve trunkal ataksisi vardı. Kontrastlı kraniyal manyetik rezonans görüntülemede supra-infratentorial alanda multipl, T1A kesitlerde hiperintens, T2A kesitlerde hipointens, venöz bold sekansta [duyarlılık ağırlıklı görüntüleme (SWI)] duyarlılık artefaktları gösteren MM metastazları saptandı (Şekil 1). Uygulanan radyoterapi sonrası lezyonlarda gerileme olduğu görüldü (Şekil 2)

Efficiency of double inversion recovery (DIR) sequence in the evaluation of supratentorial cortical lesions in multiple sclerosis

WOS: 000429001000004The aim of this study is to investigate if the three-dimensional (3D) double inversion recovery (DIR) sequence is superior compared to the 3D fluid-attenuated inversion-recovery (FLAIR) sequence in detecting intracortical, mixed, juxtacortical (JX), and deep grey matter (GM) lesions in multiple sclerosis (MS) patients. The correlation between intracortical lesion load and disability status was also investigated. Magnetic resonance imaging examinations of 24 patients (9 males, 15 females; mean age 34.4 +/- 12.0 (16-69) were retrospectively evaluated from our database. Lesions were counted and classified according to anatomic regions as intracortical, mixed, JX, and deep GM on the 3D DIR and FLAIR sequences. The incidence of lesions on the two sequences were identified and compared. The relationship between the number of lesions and type of MS, patient age, gender, duration of the disease, disability, the mean number of attacks per year and Expanded Disability Status Scale (EDSS) score was also investigated. More lesions were detected by the DIR sequence compared to the FLAIR sequence in all regions except for thalamus (11/12). The lesion detection superiority of DIR was statistically significant for intracortical lesions (p<0.001) and GM lesions (intracortical + mixed) (p<0.001). Lesion load of the JX area in the DIR sequence decreased as the disease duration (r=-0.444; p=0.030) and age (r=-0.473; p=0.020) increased. JX lesion load in the DIR sequence decreased as the number of attacks increased (r=-0.602; p=0.002). More mixed lesion load on the DIR sequence were found in cerebral atrophy group than in no cerebral atrophy group (p=0.026). EDSS score increased as the disease duration and number of attacks increased (p=0.003, p<0.001). There was no correlation between lesion location and EDSS score. The DIR sequence is superior to the FLAIR sequence in the detection of intracortical and GM lesions. Also, the mixed lesion load on the DIR sequence is correlated with cerebral atrophy