Tülin Aktürk

Background: The aim of this study is to investigate the frequency of rapid eye movement (REM) sleep behavior disorder (RBD) in Parkinson's disease patients who presented to the movement disorders outpatient clinic and were classified as having benign or malignant phenotypes according to clinical criteria, and to examine the relationship of this condition with motor complications and non-motor symptoms. Materials and Methods: In this cross-sectional study, the medical records of patients diagnosed with Parkinson's disease according to the UK Brain Bank diagnostic criteria at a tertiary training and research hospital were reviewed. Patients were divided into two groups as benign (bPD) and malignant (mPD) phenotypes, based on their disease course and clinical characteristics. Demographic data, Hoehn and Yahr stages, Mini-Mental State Examination (MMSE) scores, Schwab and England activities of daily living scores, and levodopa equivalent daily doses of the included patients were recorded. The presence of RBD was evaluated using physician file records and the IRBD-9 (The Innsbruck REM Sleep Behavior Disorder Diagnostic Inventory) questionnaire administered to patients/relatives via telephone. Results: A total of 73 patients (36 bPD, 37 mPD) who met the inclusion criteria were included in the study. The mean age of the patients in the malignant group (78.2±6.3 years) was significantly higher compared to the benign group (69.3±7.6 years) (p < 0.001). The frequency of RBD was 62.1% in malignant patients, whereas it was 36.1% in benign patients; this difference between the groups was statistically significant (p = 0.036). Additionally, MMSE scores indicating cognitive functions were significantly lower (p < 0.001), and complaints of constipation, an autonomic symptom, were observed more frequently (p = 0.032) in the malignant group. In the logistic regression analysis, advanced age and the presence of clinical RBD were identified as independent risk factors predicting a malignant course. Conclusion: The findings reveal that RBD is not merely an isolated accompanying non-motor symptom in Parkinson's disease; rather, it is a strong and independent clinical marker predicting the evolution of the disease into an aggressive malignant phenotype. Screening for the presence of RBD in routine evaluations is of critical importance for the early identification of patients at risk for cognitive decline and rapid clinical deterioration.

Objective: Decreased level of serum albumin is shown to be associated with an increased risk of mortality after stroke. However, the significance of the albumin/globulin ratio (AGR) as a paraclinical marker in determination of the prognosis of stroke is unclear. In this study, we aimed to examine the potential utility of AGR in determination of the need of intensive care unit monitorization and prognosis of patients with acute stroke. Material and Methods: Sequential samples of all the patients with acute ischemic stroke (AIS) who were hospitalized between 2018 and 2022 in the mentioned centers were analyzed in this research. The data regarding the demographic features, stroke subtypes, and laboratory findings including hemogram, and biochemistry were recorded. AGR, serum osmolality, and colloid osmotic pressure (COP) were also measured. The survival curves of the patients were constructed using the Kaplan-Meier methods and log-rank tests. Estimates of survival changes were made by applying the Cox regression analysis. Results: Ultimately, the data of 328 patients were analyzed. Thirty nine (30.2%) had passed away before discharge. There were significant differences between the deceased patients and patients surviving in terms of stroke classification, serum albumin, AGR, CRP, COP, and white blood cell count (p < 0.05). Serum AGR of 94 patients who were intensive care unit patients showed a statistical difference compared to albumin (p < 0.05). The Cox’s regression analyses showed that low AGR moderately predicted the mortality of patients. Conclusion: We found that the AGR provided important data regarding the necessity of critical care monitorization and prognosis of patients with AIS. Our findings support the potential utility of AGR as a simple, and useful paralinical laboratory marker in patients with AIS.

Nörolojik Acillere Girişdeğerlendirme Ve Tanı Yöntemleri Şeyda Çevik Güneri Bilinç Bozuklukları Vebilinci Kapalı Hastaya Yaklaşım Tülin Aktürk Umut Doğu Aktürk Başağrısına Acil Yaklaşım Ahmet Küçük Epileptik Nöbete Ve Status Epileptikusa Yaklaşım Oruç Şahin Vertigoya Acil Yaklaşım Nihal Tekinalp İnmede Acil Tanı Ve Tedavi Yöntemleri Hikmet Saçmacı Meryem Tuba Sönmez Hareket Bozukluğunda Acil Durumlara Klinik Yaklaşım Meltem Karacan Gölen İnflamatuvar Nöropatilerde Acil Tanı Ve Tedavi Yöntemleri Onur Bulut Nöromuskuler Kavşak Hastalıklarındaacil Yaklaşımlar Aysun Hatice Akça Karpuzoğlu Travmatik Nörolojik Acillere Yaklaşım Ahmet Çağlar Muhammet Hacımustafaoğlu Enfektif Nörolojik Acillerdetanı Ve Tedavi Yöntemleri Şule Özdemir Armağan Covıd-19 ve Tedavi İlişkili Acil Nörolojik Durumlar Nurcan Akbulut

Introduction: To investigate nerve conduction data of lead exposed workers. Methods: A total of 287 subjects, consisting of 197 lead exposed workers and 90 healthy controls were included. Nerve conduction study of motor (median, ulnar, peroneal and tibial) and sensory (median, ulnar and sural) nerves were performed. The data were analyzed as two and three groups. Results: The median blood lead level was 40.90 µg/dl. Median sensory, ulnar motor, and ulnar sensory conduction velocity were lower; distal latency of median motor, median sensory and sural sensory were longer than the controls (p < 0.05). There was no difference between the groups in terms of amplitudes. Discussion: This study was indicated the neurotoxic effect of lead exposure may occur in the peripheral nerves, while the mean blood lead level is 40 µg/dl.

Background The success of various therapy methods in the treatment of insomnia and poor quality sleep, both of which play an active role in the chronicization process of migraine, has been the subject of investigation. The aim of this research was to evaluate the success, acceptability, and efficacy of greater occipital nerve block (GON-B) therapy in chronic migraine (CM) patients in improving their sleep quality and developing their beliefs about sleep . Methods The study included 40 patients with CM from the general population who agreed to receive blockade therapy. Before the injection treatment, 1-week sleep diaries as well as depression and anxiety symptoms were examined. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Pre-Sleep Arousal Scale (PSAS), Epworth Sleepiness Scale (ESS), and Dysfunctional Beliefs and Attitudes about Sleep (DBAS) scales were measured and evaluated both before and after the completion of 3 months of treatment. Results Thirty-seven patients with CM successfully completed our 12-week treatment period. The anxiety and depression scales of the patients decreased after 3 months (p < 0.001). PSQI and its subgroups ratings significantly improved after treatment (p < 0.001). Similarly, ISI, ESS, PSAS, and DBAS test scores also improved after treatment (p < 0.001). Conclusions This study provides evidence as to the applicability and acceptability of GON-B in CM treatment in terms of increased sleep quality; improved sleep beliefs, attitudes, and behaviors; and arousals and decreased insomnia findings.