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Search Results: 1 - 10 of 227931 matches for " Hava D?NMEZ KEKL?KO?LU "
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Cognitive Impairment in Patients with Early Relapsing-Remitting Multiple Sclerosis
Hava Dnmez KEKLKOLU
N?ropsikiyatri Ar?ivi , 2010,
Abstract: Objective: Cognitive impairment is a common symptom in every phase and every type of multiple sclerosis. Different results, between 32% and 70%, have been reported in studies on the incidence and characteristics of cognitive impairment in patients with relapsing-remitting multiple sclerosis (RRMS). This big difference is explained by the use of different neuropsychological tests and different patient groups. The aim of this study was to analyze the incidence and characteristics of cognitive impairment in patients with early RRMS by applying standardized Turkish neuropsychological tests, commonly used in our country.Methods: 67 patients followed with diagnosis of RRMS and with disease duration up to 5 years were enrolled in the study. All participants underwent neuropsychological, magnetic resonance imaging (MRI) and clinical evaluation. Functional deficits of the subjects were assessed using the Expanded Disability Status Scale (EDSS). The patients without depression according to the Hamilton Depression Rating Scale (HDRS), underwent the Frenchay Aphasia Screening Test (FAST), the Standardized Mini-Mental State Examination (SMME) and the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog). All results were assessed statistically.Results: Out of 67 RRMS patients (41 women, 26 men) evaluated in this study, 17 (23.4%) patients had depression. Of the rest 50 patients, 7 (14%) had a cognitive impairment according to SMME, 22 (44%) patients had cognitive impairment according to ADAS-cog and 1 patients had aphasia according to FAST. No statistically significant correlation was observed between cognitive impairment and clinical features, EDSS score or cranial MRI lesion load.Conclusion: Our results suggest that 44% of patients with early RRMS had cognitive impairment. There was no statistically significant correlation between cognitive impairment, EDSS score or number of lesions on cranial MRI. (Archives of Neuropsychiatry 2010; 47: 88-90)
Adie's Tonic Pupil and Anti-Ganglioside IgG Antibodies
Hava DNMEZ KEKLKOLU,Berker BAKBAK,?zge SARA?
Journal of Neurological Sciences , 2012,
Abstract: Objective: The presence of anti-ganglioside IgG antibodies has been reported in the Guillain-Barre Syndrome (GBS) and the Miller-Fisher Syndrome (MFS). Adie's tonic pupil (ATP) is similar to GBS and its variants with the symmetric decrease in reflexes and the mydriasis that is an indicator of a parasympathetic disorder but the relationship between ATP and anti-ganglioside antibodies is unknown. Our aim in this study was to investigate the presence of anti-ganglioside IgG antibodies in patients with ATP.Patients and method: The study group consisted of a total of 20 persons with 10 patients and 10 control subjects. The control group consisted of healthy persons who did not have any problems that could influence the immune system. A neuro-ophthalmological examination was performed in all patients and the presence of anti-ganglioside antibodies in the serum was investigated.Results: Serum anti-ganglioside antibodies were negative in the 3 patients included in the study according to the review of old patient charts. Anti-GD1b, anti-GT1b and anti-GM3 antibodies were positive in 2 and anti-GM3 antibodies in 1 of the 7 patients included in the study after a new diagnosis was made. Anti-ganglioside antibodies were negative in all control group subjects.Conclusion: At least one of the anti-ganglioside antibodies was found to be positive in approximately half of the ATP patients in the acute stage (3 of the 7 acute or subacute stage ATP patients). These results indicate that anti-ganglioside antibodies may play a role in ATP development.
Should the Western Aphasia Battery Be Translated into Turkish?
Hava DNMEZ KEKLKOLU,Deniz SEL?UK?,Selda KESK?N
N?ropsikiyatri Ar?ivi , 2010,
Abstract: Objective: Aphasia tests are used to classify and diagnose aphasia. Aphasia tests, which can classify aphasia quantitatively, are needed for a standard classification of aphasia and to compare studies performed in different centers. The aim of this study was to assess the feasibility of the Turkish version of the Western Aphasia Battery (WAB), which classifies aphasia quantitatively, in Turkish speaking patients with aphasia. Methods: This study consisted of two stages. In the first stage, WAB was translated and adapted into Turkish. The Frenchay Aphasia Screening Test-Turkish (FAST) and Gulhane Aphasia Test (GAT) were applied to 20 aphasic patients in the second stage. Test results and lesion localizations were evaluated.Results: Two patients, who were found to be normal according to FAST, were evaluated to be aphasic according to the other tests. There was a high degree of correlation between the WAB-Turkish and the GAT scores. The results of the two tests regarding the lesion localization were also similar. The only difference was in the classification of aphasia. Conclusion: The difference in aphasia classification may be due to the personal interpretation of the test administrator during GAT aphasia classification or lack of a WAB standardization study. A standardization study for the Turkish version of WAB will be useful for studies on evaluation and classification of aphasia. (Archives of Neuropsychiatry 2010; 47: 40-6)
The Prognostic Value of Serum Uric Acid Level in Acute Ischemic Stroke
Hava DNMEZ KEKLKOLU,Selda KESK?N,Tahir KURTULU? YOLDA?
Journal of Neurological Sciences , 2009,
Abstract: Introduction and Objective: Uric acid is a natural anti-oxidant that plays a role in acute oxidative stress reactions like acute ischemic stroke. In this study, we aimed to search the relation between serum uric acid level, length of hospital stay and severity of stroke in acute stroke patients, and consequently, the prognostic value of serum uric acid level.Patients and Methods: We performed a retrospective study on 100 patients who had presented to the emergency department with the findings of acute ischemic stroke. All the laboratory, radiological and clinical investigations were recorded. All the risk factors, National Institute of Health Stroke Scale (NIHSS), laboratory values, clinical findings, length of hospital stay of the patients and the treatment modalities were recorded.Results: The median serum uric acid level was 5.25±2.03 mg/dl. The median level in females was found to be higher than that in males. The length of hospital stay varied from 2 to 57 days and the median value was 13±8.66 days. In the multivariate analysis, increases in the levels of serum uric acid measured were significantly associated with decreased length of hospital stay. We detected a low value correlation between NIHSS and serum uric acid levels, but it was statistically insignificant. According to our results, there was a strong negative correlation between serum uric acid levels and the length of hospital stay, and a weak correlation between the serum uric acid level and the severity of stroke.
Methanol Poisoning and Putaminal Hemorrhage: Case Report
Hava DNMEZ KEKLKOLU,Tahir KURTULU? YOLDA?,Y?ld?z ?ORUH
Journal of Neurological Sciences , 2007,
Abstract: Methanol is a highly toxic substance used as an industrial solvent and automotive antifreeze. The central nervous system and the visual pathway are the main targets of methanol poisoning. We present the cranial computerized tomography (CT) imaging findings in acute methanol intoxication in a 44-years-old man who was admitted to the emergency department with weakness, blurred vision and a progressive decrease in the level of consciousness. CT imaging showed bilateral putaminal hemorrhagic lesions. A case is hereby presented in which CT played an important role in making the diagnosis due to poor patient's history and unavailability of methanol assay.
Carbon Monoxide Induced Parkinsonism
Havva DNMEZ KEKLKOLU,Hafize Nalan GüNE?,Tahir Kurtulu? YOLDA?
Journal of Neurological Sciences , 2009,
Abstract: Carbon monoxide (CO) poisoning is a rather common in winter months of our country because of stove and flash gas heater. While low doses CO poisoning induce cardiac and neuropsychiatric symptoms; high doses acute or chronic CO poisoning induce coma and death. We evaluated consuquent 10 patients parkinsonism findings who submitted our hospital in the last 6 months. The patients were minimum 22 maximum 60 years-old (Mean 38). Three patients had unilateral and seven patients had bilateral hypokinesia and rigidity. Together with this symptoms; all patients had encephalopathy, psychotic, cardiac or internal symptoms, at different levels. Patients took hyperbaric oxygen, pramipexola and different treatment for their sypmtoms and one of the patients died at the hospital because of cardiac arrest. Other 9 patients symptoms have reduced and their treatment are continuing.
Effect of Long-Term Carbamazepine and Valproic Acid Treatment on Body Mass Index and Plasma Lipid Levels Research Article
Orhan Deniz,Hava Dnmez Kekliko?lu,Selda Keskin,G?nül Vural
N?ropsikiyatri Ar?ivi , 2011,
Abstract: Objective: Long-term treatment with carbamazepine (CBZ) and valproic acid (VPA) is associated with many metabolic changes that influence the serum levels of cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides and the body mass index (BMI). The aim is to evaluate the serum lipids and BMI in adult epileptic patients on long-term CBZ or VPA monotherapy.Methods: To evaluate the serum lipids and BMI in adult epileptic patients onlong-term CBZ or VPA monotherapy.Results: Total cholesterol and LDL levels were significantly higher in patients receiving CBZ, while HDL values were found to be significantly lower in patients receiving VPA. Statistically significant differences were not found between the patient and control groups in terms of BMI.Conclusion: These data suggest that long-term VPA treatment significantly correlated with decreased HDL levels, while CBZ treatment significantly correlated with elevation in the values of total cholesterol and LDL. Long-term CBZ or VPA treatment do not seem to affect the BMI. (Archives of Neuropsychiatry 2011; 48: 103-6)
Relation of Serum Uric Acid Level with Cognitive Functions and Number of Plaques in Patients with Relapsing-Remitting Multiple Sclerosis
Tahir Kurtulu? Yolda?,Hava Dnmez Kekliko?lu,?zkan Zengin,Elif Banu SOLAK
N?ropsikiyatri Ar?ivi , 2010,
Abstract: Objective: Several studies have identified impaired performance on the cognition test in people with multiple sclerosis (MS), yet uncertainty remains over the cause of this impairment. The aim of this study was to evaluate the correlation of serum uric acid (UA) level with cognitive impairment and magnetic resonance imaging (MRI) lesions in patients with relapsing-remitting multiple sclerosis (RRMS).Methods: In this study, 50 adults patients with RRMS (disease period 1-5 years) were assessed with neuropsychological test batteries and laboratory blood studies. All the patients were subjected to oranial MRI examination and clinical evaluation with the expanded disability status scale (EDSS) was applied. Results: Cognitive impairment was found in 44% of the patients. Mean UA serum level was measured as 4.38±1.60 mg/dl (2-9 mg/dl) and the mean EDSS score was 2.09±2.01 (0-7). Even it is not statistically significant, the relation between serum UA level and cognitive functions or number of plaques on MRI was found at about statistically significant level (p=0.09). A statistically significant correlation was observed between the scores of the concentration and distractibility subtest scores of the ADAS-cog test and the serum UA levels (p=0.01). However, the effects of exhaustion and emotional disorders on this relation can not be excluded.Conclusion: Our findings suggest that in RRMS patients there is no primary deficit in serum uric acid. Cognitive impairment and total MRI lesion load in RRMS patients are not directly effected by serum UA level. (Archives of Neuropsychiatry 2010; 47: 333-7)
Dural ectasia of the optic nerve sheath: is it always benign?
Berker Bakbak, Hava D nmez, Tülay Kansu, et al
Eye and Brain , 2009, DOI: http://dx.doi.org/10.2147/EB.S7750
Abstract: ral ectasia of the optic nerve sheath: is it always benign? Case report (7737) Total Article Views Authors: Berker Bakbak, Hava D nmez, Tülay Kansu, et al Published Date November 2009 Volume 2009:1(Default) Pages 5 - 7 DOI: http://dx.doi.org/10.2147/EB.S7750 Berker Bakbak1, Hava D nmez2, Tülay Kansu3, Hayyam Kiratli4 1Hacettepe University Institute of Neurological Sciences and Psychiatry, Neuro-ophthalmology Unit, Ankara, Turkey; 2Diskapi Yildirim Beyazid Education and Research Hospital Neurology Clinic, Ankara, Turkey; 3Hacettepe University Medical Faculty, Department of Neurology, Neuro-Ophthalmology Unit, Ankara, Turkey; 4Hacettepe University Medical Faculty, Department of Ophthalmology, Ocular Oncology Unit, Ankara, Turkey Abstract: A 36-year-old woman with a 3-month history of progressive visual loss had papilledema, dilatation of the optic nerve sheaths and normal cerebrospinal fluid pressures. She was diagnosed as dural ectasia of the optic nerve sheaths and surgical decompression was performed. In this case report, severe visual loss is described as a serious complication of this rare disease and the importance of early surgical intervention is emphasized.
Neuropsychiatric Findings in a Delayed Encephalopathy Due to Carbon Monoxide Intoxication
A. Emre SARGIN,Hava DNMEZ,Sibel ?RSEL,Tahir Kurtulu? YOLDA?
N?ropsikiyatri Ar?ivi , 2009,
Abstract: Carbon monoxide (CO) intoxication can be a deadly condition and is a very common public health problem in Turkey due to the use of coal stoves during the winter months in homes. Carbon monoxide intoxication accounts for more than half of the deaths due to intoxications in Turkey. It is very likely to misdiagnose the cases of delayed anoxic encephalopathy (DAE) which are seen after the latent period following the acute intoxication. In delayed anoxic encephalopathy, following complete recovery and after a latent period, neurologic and/or psychiatric symptoms appear again. The symptom triad of DAE is mental deterioration, urinary and/or gaita incontinence and gait disturbances. The psychiatric appearance in DAE can be seen in a variety of very different findings including dementia, amnestic syndromes, organic affective disorders, personality disorders and psychosis. In this case report, we present a 35-year-old man, who was admitted to the hospital because of irritability and loose mind. The patient did not have any previous psychiatric or neurologic disorder, but he had CO intoxication 33 days before the admission and was discharged from the hospital following a hyperbaric oxygen treatment with a complete recovery. After a 15-day latency period he was admitted to the hospital because of the mentioned symptoms. The differential diagnosis of the rich neuropsychiatric findings together with cranial magnetic resonance imaging findings (MRI) are discussed in this patient. (Archives of Neuropsychiatry 2009; 46: 121-4)
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